WorldWideScience

Sample records for comprehensive clinical assessment

  1. A comprehensive clinical competency-based assessment in periodontics.

    Science.gov (United States)

    Shiloah, J; Scarbecz, M; Bland, P S; Hottel, T L

    2017-05-01

    Traditional periodontics clinical examinations in dental education frequently assess a narrow set of clinical skills and do not adequately assess the ability of students to independently manage a periodontal patient. As an alternative, the authors developed a comprehensive periodontics competency case experience (CCCE) for senior dental students and surveyed students regarding their experience with the CCCE. Students challenging the CCCE must treat a patient with moderate periodontitis and must independently decide when a state of periodontal and oral health has been achieved. Students are also required to conduct an oral presentation to periodontology faculty. Dental students who completed the CCCE had a favourable impression of the experience, compared with the traditional clinical examinations taken in the junior year. The majority of students rated all the components of the CCCE as 'somewhat' or 'very helpful'. About 72.4% of students felt that being able to work independently on the examination was very helpful for learning about the clinical management of patients with periodontal disease, followed by 'simulation of care in private practice' (65.5%), and oral photography experience (55.2%). The greatest difficulty reported by students was finding an acceptable patient. About 62.1% of students rated 'finding the right patient' as very difficult. Students reported having to screen a mean of 5.9 patients (SD: 4.5) to find a qualified patient. The results of the survey will be useful in improving the examination as an assessment tool in periodontal therapy.

  2. Comprehensive geriatric assessment and its clinical impact in oncology.

    NARCIS (Netherlands)

    Maas, H.A.; Janssen-Heijnen, M.L.; Olde Rikkert, M.G.M.; Wymenga, A.N.

    2007-01-01

    Comprehensive geriatric assessment (CGA) is a process that consists of a multidimensional data-search and a process of analyzing and linking patient characteristics creating an individualized intervention-plan, carried out by a multidisciplinary team. In general, the positive health care effects of

  3. A Health Science Process Framework for Comprehensive Clinical Functional Assessment

    Science.gov (United States)

    2014-02-01

    longterm care, spinal cord injuries, amputations , and other clinical situations that can benefit from rehabilitation activities. One of the five...forces. The project vision is to improve TBI functional classification, health care processes, and rehabilitation outcomes by establishing and...create a cross-systems tool set for TBI rehabilitation models and functional health optimization. The second set of objectives is focused on development

  4. Assessing Competencies in a Master of Science in Clinical Research Program: The Comprehensive Competency Review.

    Science.gov (United States)

    Robinson, Georgeanna F W B; Moore, Charity G; McTigue, Kathleen M; Rubio, Doris M; Kapoor, Wishwa N

    2015-12-01

    Competencies in Master of Science Clinical Research programs are becoming increasingly common. However, students and programs can only benefit fully from competency-based education if students' competence is formally assessed. Prior to a summative assessment, students must have at least one formative, formal assessment to be sure they are developing competence appropriate for their stage of training. This paper describes the comprehensive competency review (CCR), a milestone for MS students in Clinical Research at the University of Pittsburgh's Institute for Clinical Research Education. The CCR involves metacognitive reflection of the student's learning as a whole, written evidence of each competency, a narrative explaining the choice of evidence for demonstrating competencies, and a meeting in which two faculty members review the evidence and solicit further oral evidence of competence. CCRs allow for individualized feedback at the midpoint in degree programs, providing students with confidence that they will have the means and strategies to develop competence in all areas by the summative assessment of competence at their thesis defense. CCRs have also provided programmatic insight on the need for curricular revisions and additions. These benefits outweigh the time cost on the part of students and faculty in the CCR process.

  5. Comprehensive clinical evaluation as an outcome assessment for a graduate orthodontics program.

    Science.gov (United States)

    Pinskaya, Yuliya B; Hsieh, Tsung-Ju; Roberts, W Eugene; Hartsfield, James K

    2004-11-01

    To supplement the American Board of Orthodontics (ABO) objective grading system (OGS) for posttreatment dental casts and panoramic radiographs, a comprehensive clinical assessment (CCA) method was developed to assess facial form, dental esthetics, vertical dimension, arch form, periodontium preservation, root resorption, and treatment efficiency. The sum of the CCA and the ABO OGS scores was defined as the clinical outcome. To determine a 3-year baseline for treatment outcomes in a graduate orthodontic program, the posttreatment records of 521 consecutive patients were evaluated. The mean ABO OGS score for the entire sample was 34.4 points: 32.4, 33.1, and 37.8 points for 1998, 1999, and 2000, respectively. The mean CCA score for the entire sample was 4.67 points: 2.96, 5.13, and 6.15 points for 1998, 1999, and 2000, respectively. Corresponding ABO OGS and CCA scores showed a progressive decrease in the quality of finished cases that was associated with a treatment time increase from 28.9 to 39.3 months. Overall, longer active treatment times resulted in a diminished clinical outcome, primarily due to "patient burn-out." Scoring of all finished cases is an effective means for determining clinical outcomes. However, the data suggest that, in initiating a clinical grading program, it is important to establish a multiyear baseline. Patients who are progressing well in treatment tend to be finished by the time the current class graduates, and the problem patients are transferred. Because long treatment times are associated with diminished clinical outcomes, it is often in the best interest of the uncooperative patient to terminate treatment rather than extend active mechanics in an attempt to achieve a better result.

  6. Three Decades of Comprehensive Geriatric Assessment: Evidence Coming From Different Healthcare Settings and Specific Clinical Conditions.

    Science.gov (United States)

    Pilotto, Alberto; Cella, Alberto; Pilotto, Andrea; Daragjati, Julia; Veronese, Nicola; Musacchio, Clarissa; Mello, Anna Maria; Logroscino, Giancarlo; Padovani, Alessandro; Prete, Camilla; Panza, Francesco

    2017-02-01

    Comprehensive geriatric assessment (CGA) is a multidisciplinary diagnostic and treatment process that identifies medical, psychosocial, and functional capabilities of older adults to develop a coordinated plan to maximize overall health with aging. Specific criteria used by CGA programs to evaluate patients include age, medical comorbidities, psychosocial problems, previous or predicted high healthcare utilization, change in living situation, and specific geriatric conditions. However, no universal criteria have been agreed upon to readily identify patients who are likely to benefit from CGA. Evidence from randomized controlled trials and large systematic reviews and meta-analyses suggested that the healthcare setting may modify the effectiveness of CGA programs. Home CGA programs and CGA performed in the hospital were shown to be consistently beneficial for several health outcomes. In contrast, the data are conflicting for posthospital discharge CGA programs, outpatient CGA consultation, and CGA-based inpatient geriatric consultation services. The effectiveness of CGA programs may be modified also by particular settings or specific clinical conditions, with tailored CGA programs in older frail patients evaluated for preoperative assessment, admitted or discharged from emergency departments and orthogeriatric units or with cancer and cognitive impairment. CGA is capable of effectively exploring multiple domains in older age, being the multidimensional and multidisciplinary tool of choice to determine the clinical profile, the pathologic risk and the residual skills as well as the short- and long-term prognosis to facilitate the clinical decision making on the personalized care plan of older persons.

  7. Preschool Anxiety Disorders: Comprehensive Assessment of Clinical, Demographic, Temperamental, Familial, and Life Stress Correlates

    Science.gov (United States)

    Dougherty, Lea R.; Tolep, Marissa R.; Bufferd, Sara J.; Olino, Thomas M.; Dyson, Margaret; Traditi, Jennifer; Rose, Suzanne; Carlson, Gabrielle A.; Klein, Daniel N.

    2013-01-01

    This study examined correlates of preschoolers’ anxiety disorders using a comprehensive, multi-method design. Participants included a community sample of 541 three-year-old children, of whom 106 (19.6%) met criteria for at least one anxiety disorder. Child and parental psychopathology and life stress were assessed with clinical interviews. Child temperament and parenting behavior were assessed with laboratory observations. Mothers and fathers reported on their parenting styles. Compared to preschoolers with no anxiety disorder, preschoolers with an anxiety disorder were more likely to meet criteria for comorbid depressive and oppositional defiant disorders and to exhibit greater temperamental behavioral inhibition and lower positive affectivity, and more sleep problems. Children with anxiety disorders also experienced more stressful life events in the previous six months, and their mothers had a higher rate of current anxiety disorders. Compared to children with other anxiety disorders, children with only specific phobia exhibited a somewhat different pattern of associations than children with other anxiety disorders. Overall, the findings suggest that many of the correlates observed in older youth with anxiety disorders are also observed in preschoolers. PMID:23368788

  8. Assessment of Reading Comprehension

    Directory of Open Access Journals (Sweden)

    Madani HABIB

    2016-06-01

    Full Text Available This study attempts to shed light on the concept of assessment as an essential pedagogical practice for the improvement of the teaching-learning process. Particularly, it stresses the strategies and the techniques that should be used in assessing reading comprehension with reference to EFL classrooms. It describes the kinds of tasks that actually reveal students’ reading comprehension abilities and needs. Moreover, this paper aims to illustrate the types and the advantages of assessment for both teachers and learners. More importantly, this study tries to bring equitable evidence of how reading comprehension can be adequately assessed. The findings showed that assessment of reading comprehension is central to English language teaching as it provides teachers with essential information about students’ weaknesses, needs, obstacles, and deficits. Thus, teachers can implement the appropriate techniques and use the assessment results to amend their classroom instruction and enhance the learning abilities.

  9. Potocki-Shaffer syndrome: comprehensive clinical assessment, review of the literature, and proposals for medical management.

    Science.gov (United States)

    Swarr, Daniel T; Bloom, Douglas; Lewis, Richard Alan; Elenberg, Ewa; Friedman, Ellen M; Glotzbach, Caron; Wissman, Scott D; Shaffer, Lisa G; Potocki, Lorraine

    2010-03-01

    Potocki-Shaffer syndrome is a rare contiguous gene deletion syndrome due to haploinsufficiency of the 11p11.2p12 region and is characterized by craniofacial abnormalities, developmental delay, intellectual disability, multiple exostoses, and biparietal foramina. In this study, six patients with the Potocki-Shaffer syndrome were identified and evaluated using a multidisciplinary protocol that included assessments by a geneticist, ophthalmologist, otolaryngologist, orthopedist, nephrologist, audiologist, and neuropsychologist. Diagnostic studies included skeletal survey, magnetic resonance imaging of the brain, renal ultrasound, complete blood count, comprehensive metabolic panel, thyroid studies, and urinalysis. Using array comparative genomic hybridization, we further characterized the deletion in five of these patients. The results of these evaluations were combined with a comprehensive review of reported cases. Our data highlight the characteristic facial features, biparietal foramina, moderate-to-severe developmental delay and intellectual disability, myopia and strabismus, and multiple exostoses seen with this disorder. We also identify for the first time an association of Potocki-Shaffer syndrome with sensorineural hearing loss and autistic behaviors. Finally, we provide recommendations for the health maintenance of patients with Potocki-Shaffer syndrome.

  10. Comprehensive Geriatric Assessment and Transitional Care in Acutely Hospitalized Patients The Transitional Care Bridge Randomized Clinical Trial

    NARCIS (Netherlands)

    Buurman, Bianca M.; Parlevliet, Juliette L.; Allore, Heather G.; Blok, Willem; van Deelen, Bob A. J.; van Charante, Eric P. Moll; de Haan, Rob J.; de Rooij, Sophia E.

    2016-01-01

    IMPORTANCE Older adults acutely hospitalized are at risk of disability. Trials on comprehensive geriatric assessment (CGA) and transitional care present inconsistent results. OBJECTIVE To test whether an intervention of systematic CGA, followed by the transitional care bridge program, improved activ

  11. Principles for Classroom Comprehension Assessment.

    Science.gov (United States)

    Valencia, Sheila W.; Pearson, P. David

    1988-01-01

    Principles that should guide reading comprehension assessment include acknowledging the complexity of reading, focusing on orchestrating rather than isolating skills, regarding reading as a dynamic process, developing techniques that encourage student-teacher interactions, and using a variety of reading comprehension measures. The principles are…

  12. Comprehensive neurotoxicity assessment

    NARCIS (Netherlands)

    Kulig, B.M.

    1996-01-01

    Significant progress has been made in recent years in terms of both the conceptualization of neurotoxicity assessment strategies as well as in the development of behavioral techniques for evaluating neurotoxic exposures. A tiered approach, for example, has been advocated as an assessment strategy in

  13. Electroconvulsive Therapy: A Comprehensive Assessment

    Directory of Open Access Journals (Sweden)

    Tayfun Zeren

    2003-08-01

    Full Text Available Electroconvulsive therapy (ECT is one of the most important discoveries of psychiatric treatments. This article comprehensively assesses historical progress, mechanism of actions, practical methods, indications, side effects, complications, drug interactions of ECT and attitudes towards ECT. [Archives Medical Review Journal 2003; 12(4.000: 340-377

  14. Questionnaires used to assess barriers of clinical guideline use among physicians are not comprehensive, reliable, or valid: a scoping review.

    Science.gov (United States)

    Willson, Melina L; Vernooij, Robin W M; Gagliardi, Anna R

    2017-06-01

    This study described the number and characteristics of questionnaires used to assess barriers of guideline use among physicians. A scoping review was conducted. MEDLINE and EMBASE were searched from 2005 to June 2016. English-language studies that administered a questionnaire to assess barriers of guideline use among practicing physicians were eligible. Summary statistics were used to report study and questionnaire characteristics. Questionnaire content was assessed with a checklist of 57 known barriers. Each of the 178 included studies administered a unique questionnaire. The number of questionnaires increased yearly from 2005 to 2015. Few were pilot-tested (50, 28.1%) or tested for psychometric properties (3, 1.7%). Two were based on theory. None probed for the full range of known barriers. Ten included a free-text option. The majority assessed professional barriers (177, 99.4%) but few of the 14 factors within this domain. Questionnaire characteristics did not change over time. Organizations administered questionnaires that were not reliable or valid and did not comprehensively assess barriers and may have selected interventions unlikely to promote guideline use. Research is needed to construct a questionnaire that is practical, adaptable, and robust and leads to the selection of interventions that support guideline use. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  15. Comprehensive Environmental Assessment Applied to ...

    Science.gov (United States)

    In September 2013, EPA announced the availability of the final report, Comprehensive Environmental Assessment Applied to Multiwalled Carbon Nanotube Flame-Retardant Coatings in Upholstery Textiles: A Case Study Presenting Priority Research Gaps for Future Risk Assessments. This final report presents a case study of multiwalled carbon nanotubes (MWCNTs); it focuses on the specific example of MWCNTs as used in flame-retardant coatings applied to upholstery textiles. This case study is organized around the comprehensive environmental assessment (CEA) framework, which structures available information pertaining to the product life cycle, environmental transport and fate, exposure-dose in receptors (i.e., humans, ecological populations, and the environment), and potential impacts in these receptors. A group of experts representing multiple disciplines and multiple sector perspectives used an earlier draft of the case study in conjunction with a structured workshop process to identify and prioritize research gaps that, if pursued, could inform future MWCNT assessment efforts. The final report is not a health, risk, or exposure assessment and as such does not draw conclusions about potential risks, or present an exhaustive review of the literature. Rather, it presents the MWCNT research priorities that experts identified in this application of CEA in order to aid research planning throughout the scientific community. The outcomes of these research efforts may subsequ

  16. A comprehensive assessment of the association between anemia, clinical covariates and outcomes in a population-wide heart failure registry.

    Science.gov (United States)

    Jonsson, Asa; Hallberg, Ann-Charlotte; Edner, Magnus; Lund, Lars H; Dahlstrom, Ulf

    2016-05-15

    The aim was to investigate the prevalence of, predictors of, and association with mortality and morbidity of anemia in a large unselected cohort of patients with heart failure (HF) and reduced ejection fraction (HFrEF) and to explore if there were specific subgroups of high risk. In patients with HFrEF in the Swedish Heart Failure Registry, we assessed hemoglobin levels and associations between baseline characteristics and anemia with logistic regression. Using propensity scores for anemia, we assessed the association between anemia and outcomes with Cox regression, and performed interaction and sub-group analyses. There were 24,511 patients with HFrEF (8303 with anemia). Most important independent predictors of anemia were higher age, male gender and renal dysfunction. One-year survival was 75% with anemia vs. 81% without (p anemia was for all-cause death 1.34 (1.28-1.40; p anemia was associated with greater risk with lower age, male gender, EF 30-39%, and NYHA-class I-II. In HFrEF, anemia is associated with higher age, male gender and renal dysfunction and increased risk of mortality and morbidity. The influence of anemia on mortality was significantly greater in younger patients, in men, and in those with more stable HF. The clinical implication of these findings might be in the future to perform targeted treatment studies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Assessment Format and Comprehension Performance.

    Science.gov (United States)

    Seda, Ileana

    In response to the tradition of examining a new test's validity by comparing it with a well-established multiple-choice test, a study investigated whether multiple-choice tests with one right answer can measure the reading comprehension process as defined by constructivists. The study compared the information obtained from two different…

  18. Current Development in Elderly Comprehensive Assessment and Research Methods

    Directory of Open Access Journals (Sweden)

    Shantong Jiang

    2016-01-01

    Full Text Available Comprehensive geriatric assessment (CGA is a core and an essential part of the comprehensive care of the aging population. CGA uses specific tools to summarize elderly status in several domains that may influence the general health and outcomes of diseases of elderly patients, including assessment of medical, physical, psychological, mental, nutritional, cognitive, social, economic, and environmental status. Here, in this paper, we review different assessment tools used in elderly patients with chronic diseases. The development of comprehensive assessment tools and single assessment tools specially used in a dimension of CGA was discussed. CGA provides substantial insight into the comprehensive management of elderly patients. Developing concise and effective assessment instruments is helpful to carry out CGA widely to create a higher clinical value.

  19. Reading Comprehension Assessment: A Cognitive Basis.

    Science.gov (United States)

    Johnston, Peter H.

    Drawing on work from a number of disciplines, this volume brings together experimental and theoretical information relevant to the problems of assessing children's reading comprehension. After a short introduction, the first section defines reading comprehension, presenting theoretical issues intended to provide an understanding of what is being…

  20. Comprehensive brachytherapy physical and clinical aspects

    CERN Document Server

    Baltas, Dimos; Meigooni, Ali S; Hoskin, Peter J

    2013-01-01

    Modern brachytherapy is one of the most important oncological treatment modalities requiring an integrated approach that utilizes new technologies, advanced clinical imaging facilities, and a thorough understanding of the radiobiological effects on different tissues, the principles of physics, dosimetry techniques and protocols, and clinical expertise. A complete overview of the field, Comprehensive Brachytherapy: Physical and Clinical Aspects is a landmark publication, presenting a detailed account of the underlying physics, design, and implementation of the techniques, along with practical guidance for practitioners. Bridging the gap between research and application, this single source brings together the technological basis, radiation dosimetry, quality assurance, and fundamentals of brachytherapy. In addition, it presents discussion of the most recent clinical practice in brachytherapy including prostate, gynecology, breast, and other clinical treatment sites. Along with exploring new clinical protocols, ...

  1. Screening assessment and requirements for a comprehensive assessment: Volume 1, Draft. Columbia River comprehensive impact assessment

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-04-01

    To evaluate the impact to the Columbia River from the Hanford Site-derived contaminants, the U.S. Department of Energy, U.S. Environmental Protection Agency, and Washington State Department of Ecology initiated a study referred to as the Columbia River Comprehensive Impact Assessment (CRCIA). To address concerns about the scope and direction of CRCIA as well as enhance regulator, tribal, stockholder, and public involvement, the CRCIA Management Team was formed in August 1995. The Team agreed to conduct CRCIA using a phased approach. The initial phase, includes two components: 1) a screening assessment to evaluate the potential impact to the river, resulting from current levels of Hanford-derived contaminants in order to support decisions on Interim Remedial Measures, and 2) a definition of the essential work remaining to provide an acceptable comprehensive river impact assessment. The screening assessment is described in Part I of this report. The essential work remaining is Part II of this report. The objective of the screening assessment is to identify areas where the greatest potential exists for adverse effects on humans or the environment. Part I of this report discusses the scope, technical approach, and results of the screening assessment. Part II defines a new paradigm for predecisional participation by those affected by Hanford cleanup decisions.

  2. 临床路径实施效果模糊综合评价研究%Study on the Fussy Comprehensive Assessment of Clinical Pathway Implementation Effect

    Institute of Scientific and Technical Information of China (English)

    陈航; 吕冰; 和征

    2012-01-01

    临床路径是基于循证医学、医疗质量保证和促进先进的医院管理思想和方法.临床路径在缩短住院天数、降低病人住院费用、减少医疗资源浪费和减少并发症等方面都发挥着重要作用.当前许多医院都实施了临床路径,但缺少对临床路径实施效果科学的评价方法,产生无法通过科学评价进行持续改进临床路径的问题.首先分析了临床路径的实施流程,设计了临床路径实施效果评价指标体系;其次,采用层次分析法确定临床路径实施效果评价指标权重,采用模糊综合评价法对临床路径实施效果进行评价;最后,通过实例说明了临床路径实施效果评价过程.实际应用结果表明,此方法简便可行、科学可靠,结果相对客观可信.%Clinical pathway is advanced hospital management ideas and methods of medical quality assurance and promotion based on evidence-based medicine. Clinical pathway plays an important role in shorter hospital stay, lower hospitalization costs, and reducing the waste of medical resources, and reducing complications. At present, many hospitals have implemented the clinical pathways. But they are the lack of scientific evaluation methods of the clinical pathway implementation effect, which cannot pass continuous improvement of clinical path through the scientific evaluation. This paper firstly analyzes the implementation process of clinical pathway, and designs the implementation effect evaluation index system of the clinical pathway, secondly, the paper determines the clinical pathway implementation effect evaluation index weights by using the analytic hierarchy process, and evaluates the clinical pathway implementation effect by using fuzzy comprehensive evaluation method. Finally, the paper proves the clinical pathway implementation effect evaluation process through an example. The practical application results show that this method is simple, feasible, scientific and reliable

  3. Landfill mining: Developing a comprehensive assessment method.

    Science.gov (United States)

    Hermann, Robert; Wolfsberger, Tanja; Pomberger, Roland; Sarc, Renato

    2016-11-01

    In Austria, the first basic technological and economic examinations of mass-waste landfills with the purpose to recover secondary raw materials have been carried out by the 'LAMIS - Landfill Mining Österreich' pilot project. A main focus of its research, and the subject of this article, is the first conceptual design of a comprehensive assessment method for landfill mining plans, including not only monetary factors (like costs and proceeds) but also non-monetary ones, such as the concerns of adjoining owners or the environmental impact. Detailed reviews of references, the identification of influences and system boundaries to be included in planning landfill mining, several expert workshops and talks with landfill operators have been performed followed by a division of the whole assessment method into preliminary and main assessment. Preliminary assessment is carried out with a questionnaire to rate juridical feasibility, the risk and the expenditure of a landfill mining project. The results of this questionnaire are compiled in a portfolio chart that is used to recommend, or not, further assessment. If a detailed main assessment is recommended, defined economic criteria are rated by net present value calculations, while ecological and socio-economic criteria are examined in a utility analysis and then transferred into a utility-net present value chart. If this chart does not support making a definite statement on the feasibility of the project, the results must be further examined in a cost-effectiveness analysis. Here, the benefit of the particular landfill mining project per capital unit (utility-net present value ratio) is determined to make a final distinct statement on the general benefit of a landfill mining project.

  4. The Chornobyl accident: A comprehensive risk assessment

    Energy Technology Data Exchange (ETDEWEB)

    Vargo, G.J. [ed.; Poyarkov, V.; Bar`yakhtar, V.; Kukhar, V.; Los, I.; Kholosha, V.; Shestopalov, V.

    1999-10-01

    The authors, all of whom are Ukrainian and Russian scientists involved with Chornobyl nuclear power plant since the April 1986 accident, present a comprehensive review of the accident. In addition, they present a risk assessment of the remains of the destroyed reactor and its surrounding shelter, Chornobyl radioactive waste storage and disposal sites, and environmental contamination in the region. The authors explore such questions as the risks posed by a collapse of the shelter, radionuclide migration from storage and disposal facilities in the exclusion zone, and transfer from soil to vegetation and its potential regional impact. The answers to these questions provide a scientific basis for the development of countermeasures against the Chornobyl accident in particular and the mitigation of environmental radioactive contamination in general. They also provide an important basis for understanding the human health and ecological risks posed by the accident.

  5. Measures of Reading Comprehension: A Latent Variable Analysis of the Diagnostic Assessment of Reading Comprehension

    Science.gov (United States)

    Francis, David J.; Snow, Catherine E.; August, Diane; Carlson, Coleen D.; Miller, Jon; Iglesias, Aquiles

    2006-01-01

    This study compares 2 measures of reading comprehension: (a) the Woodcock-Johnson Passage Comprehension test, a standard in reading research, and (b) the Diagnostic Assessment of Reading Comprehension (DARC), an innovative measure. Data from 192 Grade 3 Spanish-speaking English language learners (ELLs) were used to fit a series of latent variable…

  6. Assessing the quality of proton PBS treatment delivery using machine log files: comprehensive analysis of clinical treatments delivered at PSI Gantry 2.

    Science.gov (United States)

    Scandurra, D; Albertini, F; van der Meer, R; Meier, G; Weber, D C; Bolsi, A; Lomax, A

    2016-02-01

    Pencil beam scanning (PBS) proton therapy requires the delivery of many thousand proton beams, each modulated for position, energy and monitor units, to provide a highly conformal patient treatment. The quality of the treatment is dependent on the delivery accuracy of each beam and at each fraction. In this work we describe the use of treatment log files, which are a record of the machine parameters for a given field delivery on a given fraction, to investigate the integrity of treatment delivery compared to the nominal planned dose. The dosimetry-relevant log file parameters are used to reconstruct the 3D dose distribution on the patient anatomy, using a TPS-independent dose calculation system. The analysis was performed for patients treated at Paul Scherrer Institute on Gantry 2, both for individual fields and per series (or plan), and delivery quality was assessed by determining the percentage of voxels in the log file dose distribution within  +/-  1% of the nominal dose. It was seen that, for all series delivered, the mean pass rate is 96.4%. Furthermore, this work establishes a correlation between the delivery quality of a field and the beam position accuracy. This correlation is evident for all delivered fields regardless of individual patient or plan characteristics. We have also detailed further usefulness of log file analysis within our clinical workflow. In summary, we have highlighted that the integrity of PBS treatment delivery is dependent on daily machine performance and is specifically highly correlated with the accuracy of beam position. We believe this information will be useful for driving machine performance improvements in the PBS field.

  7. Assessing the quality of proton PBS treatment delivery using machine log files: comprehensive analysis of clinical treatments delivered at PSI Gantry 2

    Science.gov (United States)

    Scandurra, D.; Albertini, F.; van der Meer, R.; Meier, G.; Weber, D. C.; Bolsi, A.; Lomax, A.

    2016-02-01

    Pencil beam scanning (PBS) proton therapy requires the delivery of many thousand proton beams, each modulated for position, energy and monitor units, to provide a highly conformal patient treatment. The quality of the treatment is dependent on the delivery accuracy of each beam and at each fraction. In this work we describe the use of treatment log files, which are a record of the machine parameters for a given field delivery on a given fraction, to investigate the integrity of treatment delivery compared to the nominal planned dose. The dosimetry-relevant log file parameters are used to reconstruct the 3D dose distribution on the patient anatomy, using a TPS-independent dose calculation system. The analysis was performed for patients treated at Paul Scherrer Institute on Gantry 2, both for individual fields and per series (or plan), and delivery quality was assessed by determining the percentage of voxels in the log file dose distribution within  +/-  1% of the nominal dose. It was seen that, for all series delivered, the mean pass rate is 96.4%. Furthermore, this work establishes a correlation between the delivery quality of a field and the beam position accuracy. This correlation is evident for all delivered fields regardless of individual patient or plan characteristics. We have also detailed further usefulness of log file analysis within our clinical workflow. In summary, we have highlighted that the integrity of PBS treatment delivery is dependent on daily machine performance and is specifically highly correlated with the accuracy of beam position. We believe this information will be useful for driving machine performance improvements in the PBS field.

  8. The Assessment of Reading Comprehension: Considerations and Cautions

    Science.gov (United States)

    Snyder, Lynn; Caccamise, Donna; Wise, Barbara

    2005-01-01

    This article discusses the main purposes of reading comprehension assessment and identifies the key features of good assessment. The article also identifies pitfalls that clinicians and educators should avoid to conduct valid assessments of reading comprehension, such as the degree to which the measure taps the constructive and integrative…

  9. Structured assessments of clinical competence.

    Science.gov (United States)

    Boursicot, Katharine A M

    2010-06-01

    Clinical teachers are often involved in assessing clinical competence in the workplace, in universities and colleges. Assessments commonly used to formally assess clinical competence include long and short cases and the objective structured clinical examination which, if well designed, is a fair and reliable method of assessing clinical competence.

  10. Species for the screening assessment. Columbia River Comprehensive Impact Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Becker, J.M.; Brandt, C.A.; Dauble, D.D.; Maughan, A.D.; O`Neil, T.K.

    1996-03-01

    Because of past nuclear production operations along the Columbia River, there is intense public and tribal interest in assessing any residual Hanford Site related contamination along the river from the Hanford Reach to the Pacific Ocean. The Columbia River Comprehensive Impact Assessment was proposed to address these concerns. The assessment of the Columbia River is being conducted in phases. The initial phase is a screening assessment of the risk, which addresses current environmental conditions for a range of potential uses. One component of the screening assessment estimates the risk from contaminants in the Columbia River to the environment. The objective of the ecological risk assessment is to determine whether contaminants from the Columbia River pose a significant threat to selected receptor species that exist in the river and riparian communities of the study area. This report (1) identifies the receptor species selected for the screening assessment of ecological risk and (2) describes the selection process. The species selection process consisted of two tiers. In Tier 1, a master species list was developed that included many plant and animal species known to occur in the aquatic and riparian systems of the Columbia River between Priest Rapids Dam and the Columbia River estuary. This master list was reduced to 368 species that occur in the study area (Priest Rapids Dam to McNary Dam). In Tier 2, the 181 Tier 1 species were qualitatively ranked based on a scoring of their potential exposure and sensitivity to contaminants using a conceptual exposure model for the study area.

  11. Reading Comprehension Assessment : From Text Perspectives

    OpenAIRE

    小林, 美代子; コバヤシ, ミヨコ; MIYOKO, KOBAYASHI

    2004-01-01

    This paper investigates the nature of reading comprehension questions. Very few studies have so far examined comprehension questions in relation to text features. Kintsch and Yarbrough (1982) and Shohamy and Inbar (1991) are among the few studies, and their results suggest that there is an interaction between text features and the focus of questions. The present study builds on these findings and examines how Meyer's (1975, 1985) model of content structure analysis can help identify what exac...

  12. Reading Comprehension Tests Vary in the Skills They Assess: Differential Dependence on Decoding and Oral Comprehension

    Science.gov (United States)

    Keenan, Janice M.; Betjemann, Rebecca S.; Olson, Richard K.

    2008-01-01

    Comprehension tests are often used interchangeably, suggesting an implicit assumption that they are all measuring the same thing. We examine the validity of this assumption by comparing some of the most popular reading comprehension measures used in research and clinical practice in the United States: the Gray Oral Reading Test (GORT), the two…

  13. Randomized Clinical Trial of Interceptive and Comprehensive Orthodontics

    Science.gov (United States)

    King, G.J.; Spiekerman, C.F.; Greenlee, G.M.; Huang, G.J.

    2012-01-01

    Focusing public insurance programs on interceptive orthodontics (IO) may increase access for low-income children. This report presents outcomes from a randomized clinical trial (RCT) comparing IO with comprehensive orthodontics (CO) in Medicaid patients. One hundred seventy pre-adolescents with Medicaid-eligible malocclusions were randomized to IO (n = 86) followed by observation (OBS) or OBS followed by CO (n = 84). One hundred thirty-four completed the trial. Models at pre-treatment (baseline) and following ≤ 2 years of intervention and 2 years of OBS (48 mos) were scored by calibrated examiners using the Peer Assessment Rating (PAR) and Index of Complexity, Outcome and Need (ICON). Overall outcomes and clinically meaningful categorical ICON data on need/acceptability, complexity, and improvement were compared. At baseline, groups were balanced by age, gender, ethnicity, and PAR/ICON scores. Most were minorities. Most (77%) were rated as difficult-to-very difficult. Scores improved significantly for both groups, but CO more than IO (PAR, 18.6 [95%CI 15.1, 22.1] vs.10.1 [95%CI 6.7, 13.4]; ICON, 44.8 [95% CI 39.7, 49.9] vs. 35.2 [95%CI 29.7, 40.6], respectively). On average, IO is effective at reducing malocclusions in Medicaid patients, but less than CO. (ClinicalTrials.gov number CT00067379) PMID:22699670

  14. Randomized clinical trial of interceptive and comprehensive orthodontics.

    Science.gov (United States)

    King, G J; Spiekerman, C F; Greenlee, G M; Huang, G J

    2012-07-01

    Focusing public insurance programs on interceptive orthodontics (IO) may increase access for low-income children. This report presents outcomes from a randomized clinical trial (RCT) comparing IO with comprehensive orthodontics (CO) in Medicaid patients. One hundred seventy pre-adolescents with Medicaid-eligible malocclusions were randomized to IO (n = 86) followed by observation (OBS) or OBS followed by CO (n = 84). One hundred thirty-four completed the trial. Models at pre-treatment (baseline) and following ≤ 2 years of intervention and 2 years of OBS (48 mos) were scored by calibrated examiners using the Peer Assessment Rating (PAR) and Index of Complexity, Outcome and Need (ICON). Overall outcomes and clinically meaningful categorical ICON data on need/acceptability, complexity, and improvement were compared. At baseline, groups were balanced by age, gender, ethnicity, and PAR/ICON scores. Most were minorities. Most (77%) were rated as difficult-to-very difficult. Scores improved significantly for both groups, but CO more than IO (PAR, 18.6 [95%CI 15.1, 22.1] vs.10.1 [95%CI 6.7, 13.4]; ICON, 44.8 [95% CI 39.7, 49.9] vs. 35.2 [95%CI 29.7, 40.6], respectively). On average, IO is effective at reducing malocclusions in Medicaid patients, but less than CO. (ClinicalTrials.gov number CT00067379).

  15. A Case for Naturalistic Assessment of Reading Comprehension.

    Science.gov (United States)

    Moore, David W.

    1983-01-01

    Presents a historical overview of the introduction of the major reading comprehension assessments, showing that the predominant approaches were shaped by the prevailing educational measurement milieu and were implemented largely in response to public pressure. Argues in favor of a naturalistic reading comprehension assessment for evaluating those…

  16. An Assessment Model for Proof Comprehension in Undergraduate Mathematics

    Science.gov (United States)

    Mejia-Ramos, Juan Pablo; Fuller, Evan; Weber, Keith; Rhoads, Kathryn; Samkoff, Aron

    2012-01-01

    Although proof comprehension is fundamental in advanced undergraduate mathematics courses, there has been limited research on what it means to understand a mathematical proof at this level and how such understanding can be assessed. In this paper, we address these issues by presenting a multidimensional model for assessing proof comprehension in…

  17. Assessing Comprehension: Selected Interactions of Task and Reader.

    Science.gov (United States)

    Davey, Beth

    1989-01-01

    Summarizes key findings from five studies investigating how features of test questions (question format, testing condition, and question type) affect reading comprehension assessment outcomes. Discusses implications for assessment design and instructional practice. (MM)

  18. Establishment of assessment system for comprehensive clinical competency of general practice residents%全科住院医师临床综合能力评价指标体系的研究

    Institute of Scientific and Technical Information of China (English)

    寿涓; 祝墡珠; 张向杰; 杨华

    2013-01-01

    Objective To establish a assessment system for comprehensive clinical competency of general practice residents.Methods An assessment system for comprehensive clinical competency of general practice residents was developed with modified Delphi expert consultation during November 2010 to October 2011.Thirty three experts in clinical practice,education and administration of general practice were invited for two-round Delphi questionnaire consultation.Results In two-round consultation,the expert activity coefficient was 100%,the authority coefficient was 0.852 and 0.855,and the coordination coefficient for the importance of the indicators was 0.228 and 0.245 respectively (P =0.000).The opinions among the experts became consistent from round 1 to round 2.An assessment system was established,which consisted of 5 first-level (professionalism,communicate skills,clinical competency and professional development ability) and 36 second-level indicators.Conclusion The index system established in this study may be used as references for evaluating comprehensive clinical abilities of general practitioners systematically and objectively.%目的 建立全科住院医师临床综合能力评价指标体系,有效地衡量全科医师的临床能力.方法 在2010年11月至2011年10月间,采用改进的Delphi专家咨询法,在上海市全科医师规范化培训临床基地和社区基地,遴选33名相关专业(全科医疗、教学、行政管理)的专家进行了两轮函询.结果 两轮函询中专家的积极系数均为100%;权威程度分别为0.852和0.855;评价指标重要性的专家协调系数分别为0.228和0.245(P=0.000),专家意见渐趋一致.最终建立了一套由5个一级指标(职业态度、沟通技能、临床能力、社区实践能力、职业发展能力)和36个二级指标组成的指标体系,用于上海市全科住院医师临床综合能力的评价.结论 建立的指标体系设置合理,能全面、客观地衡量全科住院医师的临床综合能力.

  19. Development of multiple choice items for reading comprehension assessment

    OpenAIRE

    Lance, Burrows

    2010-01-01

    Creating reading comprehension assessment instruments remains a problem for many EFL educators and researchers, alike. This paper will first provide an overview of literature pertaining to the various facets that make up the concept of reading comprehension. In addition, the cognitive processing model framework proposed by Embretson and Wetzel, will be discussed in detail. From the basis of this model, an explanation of how to create reading comprehension multiple-choice items of varying diff...

  20. Classification and clinical assessment

    Directory of Open Access Journals (Sweden)

    F. Cantini

    2012-06-01

    Full Text Available There are at least nine classification criteria for psoriatic arthritis (PsA that have been proposed and used in clinical studies. With the exception of the ESSG and Bennett rules, all of the other criteria sets have a good performance in identifying PsA patients. As the CASPAR criteria are based on a robust study methodology, they are considered the current reference standard. However, if there seems to be no doubt that they are very good to classify PsA patients (very high specificity, they might be not sensitive enough to diagnose patients with unknown early PsA. The vast clinical heterogeneity of PsA makes its assessment very challenging. Peripheral joint involvement is measured by 78/76 joint counts, spine involvement by the instruments used for ankylosing spondylitis (AS, dactylitis by involved digit count or by the Leeds dactylitis index, enthesitis by the number of affected entheses (several indices available and psoriasis by the Psoriasis Area and Severity Index (PASI. Peripheral joint damage can be assessed by a modified van der Heijde-Sharp scoring system and axial damage by the methods used for AS or by the Psoriatic Arthritis Spondylitis Radiology Index (PASRI. As in other arthritides, global evaluation of disease activity and severity by patient and physician and assessment of disability and quality of life are widely used. Finally, composite indices that capture several clinical manifestations of PsA have been proposed and a new instrument, the Psoriatic ARthritis Disease Activity Score (PASDAS, is currently being developed.

  1. A study of clinical performance of nurses who recently completed the comprehensive basic nursing course

    Directory of Open Access Journals (Sweden)

    B. B. Ntombela

    1996-05-01

    Full Text Available A study was conducted to assess clinical performance of registered nurses who had recently completed the new comprehensive basic nursing course. This regional project was undertaken because of controversy surrounding clinical competence of the graduates/diplomates of the new regulation course. Senior qualified nurses gave their views according to Likert Scale statements and open-ended questions. Findings were that the sample was of the opinion that clinical performance of the new graduates/diplomates falls short of expectations.

  2. Assessing Comprehension During Reading with the Reading Strategy Assessment Tool (RSAT)

    OpenAIRE

    Magliano, Joseph P.; Millis, Keith K.; Levinstein, Irwin

    2011-01-01

    Comprehension emerges as the results of inference and strategic processes that support the construction of a coherent mental model for a text. However, the vast majority of comprehension skills tests adopt a format that does not afford an assessment of these processes as they operate during reading. This study assessed the viability of the Reading Strategy Assessment Tool (RSAT), which is an automated computer-based reading assessment designed to measure readers’ comprehension and spontaneous...

  3. The Comprehensiveness of Competing Higher Education Sustainability Assessments

    Science.gov (United States)

    Bullock, Graham; Wilder, Nicholas

    2016-01-01

    Purpose: The purpose of this paper is to analyze the comprehensiveness of competing higher education sustainability assessments. Higher education institutions (HEIs) have been increasingly communicating their sustainability commitments to the public. To assist the public in evaluating these claims, a broad range of actors have assessed the…

  4. A comprehensive pain assessment tool (COMPAT) for chronic pancreatitis

    DEFF Research Database (Denmark)

    Teo, Keng Lik; Johnson, M H; Drewes, A M

    2017-01-01

    BACKGROUND/OBJECTIVES: Chronic pancreatitis (CP) pain is challenging to treat. Treatment selection is hampered by there being no validated pain assessment tool that accounts for the complexity of CP pain and its underlying mechanisms. This study aims to develop a comprehensive pain assessment tool...

  5. The Comprehensiveness of Competing Higher Education Sustainability Assessments

    Science.gov (United States)

    Bullock, Graham; Wilder, Nicholas

    2016-01-01

    Purpose: The purpose of this paper is to analyze the comprehensiveness of competing higher education sustainability assessments. Higher education institutions (HEIs) have been increasingly communicating their sustainability commitments to the public. To assist the public in evaluating these claims, a broad range of actors have assessed the…

  6. The 2015 Illapel earthquake: a comprehensive assessment

    Science.gov (United States)

    Tilmann, Frederik; Zhang, Yong; Moreno, Maros; Saul, Joachim; Eckelmann, Felix; Palo, Mauro; Deng, Zhiguo; Babeyko, Andrey; Chen, Kejie; Baez, Juan-Carlos; Schurr, Bernd; Wang, Rongjiang; Dahm, Torsten

    2016-04-01

    On September 16, 2015, the convergent Chilean margin again experienced a great subduction megathrust earthquake. The MW=8.2 Illapel earthquake occurred in the Metropolitan segment north of where the Juan-Fernandez ridge meets the Chile trench and subduction style and geometry change over a short distance. Combining GPS displacement measurements, InSAR interferograms, strong motion data, broadband seismological waveforms and backprojection of high frequency teleseismic signals we derive a comprehensive description of the coseismic rupture. Further, we determine accurate depths for the mostly offshore aftershock sequence by careful observations of teleseismic depth phases and derive moment tensors for the larger earthquakes from waveform modelling of body- and surface waves. The rupture nucleated near the coast but then propagated to the north and updip. The resulting simple rupture geometry is approximately circular with a peak slip of 6 m, and a diameter of approximately 100 km, centered below the middle slope of the forearc. Forward modelling of tsunami propagation for this model successfully predicts approximate tsunami wave heights measured at 3 tide gauges along the North Central Chile coast, confirming that the rupture diminished towards the trench. Similar to previous observations, high frequency seismic radiation is mostly emitted downdip of the region of most intense slip, but unlike in most previous events, the high frequency emitters do not track the whole rupture along-strike but are confined to a small region within ˜ 50 km of the epicenter. The time evolution of high frequency seismic radiation also peaks earlier than the long period rupture evolution, indicating that the final phase of the rupture progressed smoothly. The aftershocks extend significantly beyond the limits of the main rupture in both north and south direction; their pattern of propagation suggests triggering by coseismic changes to the Coulomb failure stress. Plate interface events

  7. Heparin-Induced Thrombocytopenia: A Comprehensive Clinical Review.

    Science.gov (United States)

    Salter, Benjamin S; Weiner, Menachem M; Trinh, Muoi A; Heller, Joshua; Evans, Adam S; Adams, David H; Fischer, Gregory W

    2016-05-31

    Heparin-induced thrombocytopenia is a profoundly dangerous, potentially lethal, immunologically mediated adverse drug reaction to unfractionated heparin or, less commonly, to low-molecular weight heparin. In this comprehensive review, the authors highlight heparin-induced thrombocytopenia's risk factors, clinical presentation, pathophysiology, diagnostic principles, and treatment. The authors place special emphasis on the management of patients requiring procedures using cardiopulmonary bypass or interventions in the catheterization laboratory. Clinical vigilance of this disease process is important to ensure its recognition, diagnosis, and treatment. Misdiagnosis of the syndrome, as well as misunderstanding of the disease process, continues to contribute to its morbidity and mortality.

  8. Assessing clinical competency: reports from discussion groups.

    Science.gov (United States)

    Turnwald, Grant; Stone, Elizabeth; Bristol, David; Fuentealba, Carmen; Hardie, Lizette; Hellyer, Peter; Jaeger, Laurie; Kerwin, Sharon; Kochevar, Deborah; Lissemore, Kerry; Olsen, Christopher; Rogers, Kenita; Sabin, Beth; Swanson, Cliff; Warner, Angeline

    2008-01-01

    This report describes proposed new models for assessment of eight of the nine clinical competencies the American Veterinary Medical Association Council on Education requires for accreditation. The models were developed by discussion groups at the Association of American Veterinary Medical Colleges' Clinical Competency Symposium. Clinical competencies and proposed models (in parentheses) are described. Competency 1: comprehensive patient diagnosis (neurologic examination on a dog, clinical reasoning skills); Competency 2: comprehensive treatment planning (concept mapping, computerized case studies); Competency 3: anesthesia, pain management (student portfolio); Competency 4: surgery skills (objective structured clinical examination, cased-based examination, "super dog" model); Competency 5: medicine skills (clinical reasoning and case management, skills checklist); Competency 6: emergency and intensive care case management (computerized case study or scenario); Competency 7: health promotion, disease prevention/biosecurity (360 degrees evaluation, case-based computer simulation); Competency 8: client communications and ethical conduct (Web-based evaluation forms, client survey, communicating with stakeholders, telephone conversation, written scenario-based cases). The report also describes faculty recognition for participating in clinical competency assessments.

  9. Adolescent views on comprehensive health risk assessment and counseling: assessing gender differences.

    Science.gov (United States)

    Kadivar, Hajar; Thompson, Lindsay; Wegman, Martin; Chisholm, TaJuana; Khan, Maryum; Eddleton, Katie; Muszynski, Michael; Shenkman, Elizabeth

    2014-07-01

    Adolescence is an important time for the detection of health risk behaviors and factors with subsequent counseling and intervention. Limited research has examined adolescent perceptions of comprehensive health risk assessments (HRAs) and counseling with an assessment of gender differences. Participants were identified using Florida's Medicaid and State Children's Health Insurance Program databases. A total of 35 low-income, racially/ethnically diverse adolescents (ages 14-18 years) participated in eight focus groups stratified by gender. Adolescents completed an internet-based, tablet-administered, comprehensive HRA and then participated in a semi-structured interview. Discussions were recorded, transcribed, and analyzed using a multi-step, team-based approach applying grounded theory to determine major themes. Male adolescents desired less parental involvement, had less understanding of the protections of clinical confidentiality and the need for comprehensive HRA, and placed greater emphasis on the importance of professional appearance. In contrast, more females valued face-to-face interactions and stressed the importance of concern from the health risk assessor. Overall, adolescents placed importance on their relationship with the health risk assessor, and on valuing trust, confidentiality, and nonjudgmental care. Adolescents preferred to complete HRAs in clinical, private, and professional settings, and reported that tablet technology supported their confidentially in completing the HRA. Furthermore, they stressed the importance of autonomy and learning about the health risk outcomes for risk reduction. Gender differences exist in adolescent perceptions of comprehensive HRAs. Adolescent perceptions of HRAs support their use in confidential primary care settings using modalities that emphasize nonjudgmental, private care, and the use of communication techniques that respect adolescents' autonomy to change health risks. Copyright © 2014. Published by Elsevier

  10. Responsive Assessment: Assessing Student Nurses' Clinical Competence.

    Science.gov (United States)

    Neary, Mary

    2001-01-01

    A study involving 300 nursing students, 155 nurse practitioners, and 80 assessors tested a model of responsive assessment that includes identification of learning needs and potential, assignment to suitable placements, continuous assessment of clinical practice and patient care, and alignment of teaching and assessment with patient needs and…

  11. Wrist proprioceptive acuity: A comprehensive robot-aided assessment.

    Science.gov (United States)

    Cappello, Leonardo; Contu, Sara; Konczak, Juergen; Masia, Lorenzo

    2015-08-01

    Proprioception is the sense of the body awareness. Proprioceptive deficits represent frequent consequences of several neurological conditions like stroke, Parkinson's disease and others. The assessment of such somatosensory function is crucial, although the available clinical tests are not sensitive enough. The human wrist is a crucial joint for many activities of daily living and to address the lack of its characterization in terms of proprioceptive acuity the authors in previous studies proposed a novel method that combined the use of a 3-DoF robot and a threshold haunting paradigm. Further experiments were performed to characterize the proprioceptive acuity of the dominant wrist for adduction, extension, pronation and supination by using a 2-alternative-forced-choice test. The acuity thresholds obtained from six subjects (mean values ± standard deviation of 1.65±0.39 for extension, 1.13±0.34 for adduction, 1.90±0.58 for pronation and 1.70±0.30 for supination) were finally combined with the ones harvested in the previous studies for flexion and abduction in order to build the first comprehensive database of human wrist proprioceptive acuity.

  12. A comprehensive environmental impact assessment method for shale gas development

    Directory of Open Access Journals (Sweden)

    Renjin Sun

    2015-03-01

    Full Text Available The great success of US commercial shale gas exploitation stimulates the shale gas development in China, subsequently, the corresponding supporting policies were issued in the 12th Five-Year Plan. But from the experience in the US shale gas development, we know that the resulted environmental threats are always an unavoidable issue, but no uniform and standard evaluation system has yet been set up in China. The comprehensive environment refers to the combination of natural ecological environment and external macro-environment. In view of this, we conducted a series of studies on how to set up a comprehensive environmental impact assessment system as well as the related evaluation methodology and models. First, we made an in-depth investigation into shale gas development procedures and any possible environmental impacts, and then compared, screened and modified environmental impact assessment methods for shale gas development. Also, we established an evaluating system and assessment models according to different status of the above two types of environment: the correlation matrix method was employed to assess the impacts on natural ecological environment and the optimization distance method was modified to evaluate the impacts on external macro-environment. Finally, we substitute the two subindexes into the comprehensive environmental impact assessment model and achieved the final numerical result of environmental impact assessment. This model can be used to evaluate if a shale gas project has any impact on environment, compare the impacts before and after a shale gas development project, or the impacts of different projects.

  13. Assessment of Clinical Competence.

    Science.gov (United States)

    Newble, David I.

    1979-01-01

    Reviews current approaches to the examination of medical students' clinical competence, mentioning differences in approaches adopted in Australia, Great Britain, and North America. Test methods used in examination are discussed critically and their separate strengths and weaknesses are highlighted. Newer approaches involving multiple methods and…

  14. The Clinical Interview for Depression: A Comprehensive Review of Studies and Clinimetric Properties

    DEFF Research Database (Denmark)

    Guidi, Jenny; Fava, Giovanni A; Bech, Per

    2011-01-01

    Background: A comprehensive assessment of the wide spectrum of depressive symptomatology, particularly in its subclinical forms, is lacking in standard rating scales. There is also an emerging need for instruments that can detect small differences in therapeutic studies and have good sensitivity....... highlights the utility of the CID in clinical research and practice. Its clinimetric characteristics, particularly the broad evaluation of affective symptomatology and the sensitivity to change, make it an instrument of choice in therapeutic trials....

  15. Musical obsessions: a comprehensive review of neglected clinical phenomena.

    Science.gov (United States)

    Taylor, Steven; McKay, Dean; Miguel, Euripedes C; De Mathis, Maria Alice; Andrade, Chittaranjan; Ahuja, Niraj; Sookman, Debbie; Kwon, Jun Soo; Huh, Min Jung; Riemann, Bradley C; Cottraux, Jean; O'Connor, Kieron; Hale, Lisa R; Abramowitz, Jonathan S; Fontenelle, Leonardo F; Storch, Eric A

    2014-08-01

    Intrusive musical imagery (IMI) consists of involuntarily recalled, short, looping fragments of melodies. Musical obsessions are distressing, impairing forms of IMI that merit investigation in their own right and, more generally, research into these phenomena may broaden our understanding of obsessive-compulsive disorder (OCD), which is phenomenologically and etiologically heterogeneous. We present the first comprehensive review of musical obsessions, based on the largest set of case descriptions ever assembled (N=96). Characteristics of musical obsessions are described and compared with normal IMI, musical hallucinations, and visual obsessional imagery. Assessment, differential diagnosis, comorbidity, etiologic hypotheses, and treatments are described. Musical obsessions may be under-diagnosed because they are not adequately assessed by current measures of OCD. Musical obsessions have been misdiagnosed as psychotic phenomena, which has led to ineffective treatment. Accurate diagnosis is important for appropriate treatment. Musical obsessions may respond to treatments that are not recommended for prototypic OCD symptoms.

  16. [Clinical features and comprehensive treatment of skull base osteosarcoma].

    Science.gov (United States)

    Hu, Ke; Wan, Jinghai; Ni, Song; Li, Xueji; Liu, Shaoyan; Meng, Xiaoli; Qian, Haipeng

    2015-05-01

    To analyze the clinical features and treatment of skull base osteosarcoma. The clinical data of 18 patients with skull base osteosarcoma, who were admitted to the CAMS Cancer Hospital from January 2005 to November 2013, were retrospectively analyzed. The patients were followed up by telephone, outpatient review and other means. Fifteen patients were followed up, 4 cases received surgery only, and 11 cases received surgery with adjuvant chemotherapy and/or radiotherapy. Kaplan-Meier survival curve analysis was used to analyze the clinical data and Log rank method was used for verification. Nine patients died among the 15 patients who were followed up for 3-103 months (mean 25.0 months): seven patients died of local recurrence, and two patients died of distant metastasis, and six patients were still alive. Four patients received surgery only, with a median survival time of 25.0 months, and 11 patients received comprehensive treatment, with a median survival time of 47.0 months (P = 0.02). Five patients received sub-total resection, with a mean survival time of 47.0 months, and 10 patients received total resection, with a mean survival time of 45.0 months (P = 0.37). The 1- and 2-year recurrence rates were 46.6% and 68.9%, respectively. The overall 1-, 2-, 3- and 5-year survival rates were 82.4%, 61.8%, 36.0% and 36.0%, respectively, with a median survival time of 30.0 months. To compare the long bone and head and neck osteosarcoma with skull base osteosarcoma, the skull base osteosarcoma has a lower total resection rate, a higher recurrence rate, and a poorer prognosis. Radical surgery and comprehensive treatment are appropriate for skull base osteosarcoma.

  17. Clinical Observation on Comprehensive Treatment on Cutaneous Region for Low Back Pain

    Institute of Scientific and Technical Information of China (English)

    Zhao Feng; Liu Shu-tian

    2014-01-01

    Objective: To observe the clinical effects of comprehensive treatmenton cutaneous region for low back pain. Methods: One hundred and twenty outpatients with low back pain who met the diagnostic criteria were randomly divided into a cutaneous region group or a medication group, 60 cases in each group. The cases in the cutaneous region group were treated by Nie-pinching up the skin of the lumbosacral region, cupping and acupuncture. Those in the medication group were treated by oral administration of Celecoxib capsule. The visual analogue scale (VAS) and Oswestry disability index (ODI) were used to assess the therapeutic effects. Results: After treatment, the VAS scores of both groups were different from those before treatment, showing statistical significances (allP Conclusion: Both comprehensive treatment on the cutaneous region and Celecoxib capsule can obviously relieve low back pain. But comprehensive treatment on the cutaneous region is better than Celecoxib capsule in the therapeutic effects.

  18. A Comprehensive Assessment Strategy for Physics Laboratory Courses

    CERN Document Server

    Khaparde, Rajesh B

    2013-01-01

    The objective of physics laboratory training is to develop, in students, a variety of important cognitive and psycho-motor abilities related to experimental physics. These include conceptual understanding, procedural understanding, experimental skills and the experimental problem solving ability. It has been noted that strategies adopted for the assessment of what students learn and develop through a laboratory course are often inconsistent with the objectives of the laboratory courses. The author has developed a comprehensive assessment strategy which can be used at the school, college and university level. The strategy is based on four tools of assessment, namely, test on conceptual understanding, test on procedural understanding, an experimental test, and the continuous assessment. The relative weightage for each of the four tools depends on the level and emphasis of the laboratory course. The four tools of assessment, with respect to the type of questions, design, grading schemes, administration of each t...

  19. Standardised Testing and Assessment in Comprehensive School in Scandinavian Countries

    DEFF Research Database (Denmark)

    Andreasen, Karen Egedal; Eva, Hjörne,

    Assessments can be considered to be an integrated part of formal educational settings, in different forms and used for different purposes. In this contribution we will discuss and analyse the use of assessments in comprehensive school in Scandinavian countries through time, as we will include...... different kinds of documentary and empirical studies in the argumentation. We will focus on which kinds of assessments has been used, for which purposes and the role of this in the perspective of society. More contemporary trends will be discussed, specially the use of standardised testing. Scandinavian...... countries differ at some points concerning the use of assessments of this character. Assessments points to and creates differences between pupils and play a key role in processes of socialisation, marginalisation and in- and exclusion in society, as discussed by theorists such as Bourdieu and Bernstein...

  20. The clinical phenotypes of autoimmune hepatitis: A comprehensive review.

    Science.gov (United States)

    Wang, Qixia; Yang, Fan; Miao, Qi; Krawitt, Edward L; Gershwin, M Eric; Ma, Xiong

    2016-01-01

    Autoimmune hepatitis (AIH) fulfills the generally accepted contemporary criteria of an autoimmune liver disease: the presence of autoantibodies and autoreactive T cells, a female gender bias, association with other autoimmune diseases, response to immunosuppressive therapy and strong associations with the major histocompatibility complex HLA loci. It occurs worldwide in both children and adults and is marked by both etiopathogenic and clinical heterogeneity, differing from the other putative autoimmune liver diseases, primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC), albeit occasionally presenting with overlapping features of PBC or PSC. Although diagnostic criteria have been established and validated, there are still major issues to be clarified due to its variability, such as autoantibody-negative AIH, drug-induced AIH, AIH sharing features with PBC or PSC, and post-transplant de novo AIH. In view of the diverse presentations and courses, including classical chronic onset, acute and acute severe onset, cirrhosis and decompensated cirrhosis, individualized management of patients is indicated. Each patient should receive a personalized analysis of the benefits and side effect risks of drugs. Herein we describe a comprehensive review of the clinical phenotypes of AIH underscoring its clinical heterogeneity.

  1. Assessment of Clinical Supervisor Competencies.

    Science.gov (United States)

    Getz, Hildy

    1999-01-01

    Presents a focus and process to assist those training clinical supervisors to assess competencies of the supervisor. States that process creates a practical framework that can be adapted for supervision competencies in other fields. Concludes that assessment methodology gives meaning to the support and structure vital at all levels of training…

  2. Towards the development of a comprehensive framework: Qualitative systematic survey of definitions of clinical research quality.

    Science.gov (United States)

    von Niederhäusern, Belinda; Schandelmaier, Stefan; Mi Bonde, Marie; Brunner, Nicole; Hemkens, Lars G; Rutquist, Marielle; Bhatnagar, Neera; Guyatt, Gordon H; Pauli-Magnus, Christiane; Briel, Matthias

    2017-01-01

    To systematically survey existing definitions, concepts, and criteria of clinical research quality, both developed by stakeholder groups as well as in the medical literature. This study serves as a first step in the development of a comprehensive framework for the quality of clinical research. We systematically and in duplicate searched definitions, concepts and criteria of clinical research quality on websites of stakeholders in clinical research until no further insights emerged and in MEDLINE up to February 2015. Stakeholders included governmental bodies, regulatory agencies, the pharmaceutical industry, academic and commercial contract research organizations, initiatives, research ethics committees, patient organizations and funding agencies from 13 countries. Data synthesis involved descriptive and qualitative analyses following the Framework Method on definitions, concepts, and criteria of clinical research quality. Descriptive codes were applied and grouped into clusters to identify common and stakeholder-specific quality themes. Stakeholder concepts on how to assure quality throughout study conduct or articles on quality assessment tools were common, generally with no a priori definition of the term quality itself. We identified a total of 20 explicit definitions of clinical research quality including varying quality dimensions and focusing on different stages in the clinical research process. Encountered quality dimensions include ethical conduct, patient safety/rights/priorities, internal validity, precision of results, generalizability or external validity, scientific and societal relevance, transparency and accessibility of information, research infrastructure and sustainability. None of the definitions appeared to be comprehensive either in terms of quality dimensions, research stages, or stakeholder perspectives. Clinical research quality is often discussed but rarely defined. A framework defining clinical research quality across stakeholders

  3. Readability and comprehensibility of informed consent forms for clinical trials

    Directory of Open Access Journals (Sweden)

    Anvita Pandiya

    2010-01-01

    A shortened Informed Consent Form, with information that a reasonable person would want to understand along with specific information that the person wants in particular would be a good option to improve understanding or comprehensibility. Additional informational meetings with a qualified person like a counselor could help in comprehension. Questionnaires designed to test comprehension of patient, peer review, patient writing the salient features could help evaluate the comprehensibility of the Informed Consent Form.

  4. Assessment of grammar comprehension: Adaptation of TROG for Serbian language

    Directory of Open Access Journals (Sweden)

    Anđelković Darinka Č.

    2007-01-01

    Full Text Available In this study we present our adaptation and preliminary standardization of Test for Reception of Grammar TROG (Bishop, 1989 for Serbian language. TROG is a receptive test of grammatical structures, constructed primarily for an assessment of grammatical development and detection of children with Specific Language Impairment (SLI. Due to the lack of standardized tests for language development in our clinical community, TROG is selected for adaptation as a test which includes two components relevant for discrimination of children with language difficulties: a measure of receptive abilities and b distinguishing knowledge of grammar from semantic aspect of comprehension. Preliminary standardization was done on a sample of 335 participants between 4 and 7 years of age, divided into 8 age subsamples. Since dynamic of language change at early ages is faster, age samples covered range of 3 months at the ages 4;0-4;2, 4;3-4;5, 4;6-4;8, 4;9-4;11, and range of 6 months at the ages 5;0-5;5, 5;6-5;11, 6;00-6;05, 6;06-6;11. Analyses have revealed that the first version of Serbian TROG is discriminative for the differences between age samples, but discrimination is smaller then it was expected. The test discriminates three age-samples (4;0-4;8, 4;9-5;5, and 5;6-6;11. It is easier for the children older then 5 years, which causes statistical significance of discrimination to tilt within a narrow margin around 0,05. Reliability of the whole instrument is estimated very high - between 0,86 and 0,91, depending on the method of estimation. However, reliability estimated for particular blocks (grammatical structure revealed that internal consistency of blocks is not homogeneous. This finding prevents reliable estimation of competence for particular structures, and makes difficult to define which contrast is understood by a child and which is not. Furthermore, internal inconsistency of blocks may also be additional source of low discrimination of test for children

  5. Study on Nursing Clinical Teachers' Comprehensive Quality Evaluation Model on the Basis of Fuzzy Mathematics

    Directory of Open Access Journals (Sweden)

    Zhijuan Liu

    2013-04-01

    Full Text Available In this study, we study on the nursing clinical teachers' comprehensive quality evaluation model on the basis of fuzzy mathematics. First, it obtains the nursing clinical teachers' comprehensive quality evaluation index framework by making use of Delphi method. Then, it constructs the comprehensive quality evaluation hierarchy model by applying the analytic hierarchy process, to obtain the weight for each index, based on which to establish fuzzy comprehensive evaluation model, thus acquiring new method for nursing clinical teachers' comprehensive quality evaluation. Examples have proven the feasibility and effectiveness of this method.

  6. Regional comprehensive assessment on environment-health of China

    Institute of Scientific and Technical Information of China (English)

    WANGWuyi; LIRibang; LIAOYongfeng; LIHairong; YANGLinsheng; TANJianan

    2004-01-01

    The aim of the study was to assess the environment-health development in different regions of China. 175 indicators, such as average life expectancy at birth, emission intensity of waste gas, GDP etc. were chosen to describe various aspects of the environment, health and development of China. Of all the indicators, life expectancy can sufficiently reflect health situation of population. Consequently,life expectancy was identified as key indicator, and 42 out of 175 indicators were selected for establishing the environment-health indicator framework with three grades of integrative indices to assess the development of environment-health of China. Based on the hierarchical relation between various grades of indices, the comprehensive environment-health index was calculated and contributed to classify the environment-health situation of 30 provinces, municipalities and autonomous regions in China which were divided into five grades by four predefined limits. Comprehensive assessment indicates that the environment-health situation of the eastern and coastal areas is superior to that of inland which is the western regions with underdeveloped economy and rigorous natural condition.Especially, the Qinghai-Tibet and Yunnan-Guizhou plateaus in southwestern China are most vulnerable in the environment and population health. These fit in with the pattern of national socio-economic development, which fully shows that socio-economic context plays a dominant role in the improvement of envirnment-health in China

  7. Using miscue analysis to assess comprehension in deaf college readers.

    Science.gov (United States)

    Albertini, John; Mayer, Connie

    2011-01-01

    For over 30 years, teachers have used miscue analysis as a tool to assess and evaluate the reading abilities of hearing students in elementary and middle schools and to design effective literacy programs. More recently, teachers of deaf and hard-of-hearing students have also reported its usefulness for diagnosing word- and phrase-level reading difficulties and for planning instruction. To our knowledge, miscue analysis has not been used with older, college-age deaf students who might also be having difficulty decoding and understanding text at the word level. The goal of this study was to determine whether such an analysis would be helpful in identifying the source of college students' reading comprehension difficulties. After analyzing the miscues of 10 college-age readers and the results of other comprehension-related tasks, we concluded that comprehension of basic grade school-level passages depended on the ability to recognize and comprehend key words and phrases in these texts. We also concluded that these diagnostic procedures provided useful information about the reading abilities and strategies of each reader that had implications for designing more effective interventions.

  8. A breast cancer clinical registry in an Italian comprehensive cancer center: an instrument for descriptive, clinical, and experimental research.

    Science.gov (United States)

    Baili, Paolo; Torresani, Michele; Agresti, Roberto; Rosito, Giuseppe; Daidone, Maria Grazia; Veneroni, Silvia; Cavallo, Ilaria; Funaro, Francesco; Giunco, Marco; Turco, Alberto; Amash, Hade; Scavo, Antonio; Minicozzi, Pamela; Bella, Francesca; Meneghini, Elisabetta; Sant, Milena

    2015-01-01

    In clinical research, many potentially useful variables are available via the routine activity of cancer center-based clinical registries (CCCR). We present the experience of the breast cancer clinical registry at Fondazione IRCCS "Istituto Nazionale dei Tumori" to give an example of how a CCCR can be planned, implemented, and used. Five criteria were taken into consideration while planning our CCCR: (a) available clinical and administrative databases ought to be exploited to the maximum extent; (b) open source software should be used; (c) a Web-based interface must be designed; (d) CCCR data must be compatible with population-based cancer registry data; (e) CCCR must be an open system, able to be connected with other data repositories. The amount of work needed for the implementation of a CCCR is inversely linked with the amount of available coded data: the fewer data are available in the input databases as coded variables, the more work will be necessary, for information technology staff, text mining analysis, and registrars (for collecting data from clinical records). A cancer registry in a comprehensive cancer center can be used for several research aspects, such as estimate of the number of cases needed for clinical studies, assessment of biobank specimens with specific characteristics, evaluation of clinical practice and adhesion to clinical guidelines, comparative studies between clinical and population sets of patients, studies on cancer prognosis, and studies on cancer survivorship.

  9. 42 CFR 418.54 - Condition of participation: Initial and comprehensive assessment of the patient.

    Science.gov (United States)

    2010-10-01

    ... comprehensive assessment of the patient. 418.54 Section 418.54 Public Health CENTERS FOR MEDICARE & MEDICAID... Participation: Patient Care § 418.54 Condition of participation: Initial and comprehensive assessment of the patient. The hospice must conduct and document in writing a patient-specific comprehensive assessment...

  10. Comprehensive country energy assessments using the MARKAL-MACRO model

    Energy Technology Data Exchange (ETDEWEB)

    Reisman, A.W.

    1997-07-01

    A number of comprehensive country energy assessments were performed in the late 1970s and early 1980s in cooperation with the governments of various countries. The assessments provided a framework for analyzing the impacts of various national strategies for meeting energy requirements. These analyses considered the total energy framework. Economics, energy supply, national resources, energy use, environmental impacts, technologies, energy efficiencies, and sociopolitical impacts were some of the factors addressed. These analyses incorporated the best available data bases and computer models to facilitate the analyses. National policy makers identified the various strategies to examine. The results of the analyses were provided to the national policy makers to support their decision making. Almost 20 years have passed since these assessments were performed. There have been major changes in energy supply and use, technologies, economics, available resources, and environmental concerns. The available tools for performing the assessments have improved drastically. The availability of improved computer modeling, i.e., MARKAL-MACRO, and improved data collection methods and data bases now permit such assessments to be performed in a more sophisticated manner to provide state of the art support to policy makers. The MARKAL-MACRO model was developed by Brookhaven National Laboratory over the last 25 years to support strategic energy planning. It is widely used in the international community for integrating analyses of environmental options, such as reduction of greenhouse gas emissions. It was used to perform the analyses in the least cost energy strategy study for the Energy Policy Act of 1992. Improvements continue to be made to MARKAL-MACRO and its capabilities extended. A methodology to conduct Country Energy Assessments using MARKAL-MACRO is discussed.

  11. Fuzzy Comprehensive Assessment Method to Determine Tectonic Stress Patterns

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hai; QI Lan; HAO Caizhe; GUO Lei

    2007-01-01

    The tectonic stress patterns were determined by a fuzzy comprehensive assessment method. Data of in-situ survey and fault information were utilized in the method. First, by making pressure and tension in the directions of along-river, cross-river, shear clockwise, and shear counter-clockwise, 26 types of tectonic stress patterns were presented. And the stress vector of each pat-tern was obtained with FE software by taking unit displacement as boundary load. Then, by takingthe 26 types of tectonic stress patterns as index set and 3 main stresses as factor set and choosing various operators, comparison of directions of computational stress vector and survey stress vector was made and the most possible tectonic stress pattern was obtained. Taking the 26 types of tectonic stress patterns as index set and strike angle as factor set, comparison of relationships between formation of fault and tectonic stress was made, and the tectonic stress patterns were assessed with known fault information. By summarizing the above assessment results, the most impossible tectonic stress pattern was obtained. Finally an engineering case was quoted to validate that the method is more feasible and reliable than traditional empirical method.

  12. Using a New Reading Comprehension Assessment to Measure Discourse Representations and Identify Types of Comprehenders

    Science.gov (United States)

    Carlson, Sarah; Seipel, Ben; McMaster, Kristen

    2011-01-01

    Many researchers focus on assessing the cognitive components of reading comprehension. However, researchers are challenged to find the best way to measure the cognitive components of reading comprehension because many reading comprehension assessments differ in terms of format (i.e., cloze, multiple-chose, open-ended); presentation (i.e., print);…

  13. Identification of contaminants of concern Columbia River Comprehensive Impact Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Napier, B.A.; Batishko, N.C.; Heise-Craff, D.A.; Jarvis, M.F.; Snyder, S.F.

    1995-01-01

    The Columbia River Comprehensive Impact Assessment (CRCIA) Project at the Pacific Northwest Laboratory (PNL) is evaluating the current human and ecological risks from contaminants in the Columbia River. The risks to be studied are those attributable to past and present activities on the Hanford Site. The Hanford Site is located in southcentral Washington State near the town of Richland. Human risk from exposure to radioactive and hazardous materials will be addressed for a range of river use options. Ecological risk will be evaluated relative to the health of the current river ecosystem. The overall purpose of the project is to determine if enough contamination exists in the Columbia River to warrant cleanup actions under applicable environmental regulations. This report documents an initial review, from a risk perspective, of the wealth of historical data concerning current or potential contamination in the Columbia River. Sampling data were examined for over 600 contaminants. A screening analysis was performed to identify those substances present in such quantities that they may pose a significant human or ecological risk. These substances will require a more detailed analysis to assess their impact on humans or the river ecosystem.

  14. Comprehensive Adult Student Assessment Systems Braille Reading Assessment: An Exploratory Study

    Science.gov (United States)

    Posey, Virginia K.; Henderson, Barbara W.

    2012-01-01

    Introduction: This exploratory study determined whether transcribing selected test items on an adult life and work skills reading test into braille could maintain the same approximate scale-score range and maintain fitness within the item response theory model as used by the Comprehensive Adult Student Assessment Systems (CASAS) for developing…

  15. Comprehensive Adult Student Assessment Systems Braille Reading Assessment: An Exploratory Study

    Science.gov (United States)

    Posey, Virginia K.; Henderson, Barbara W.

    2012-01-01

    Introduction: This exploratory study determined whether transcribing selected test items on an adult life and work skills reading test into braille could maintain the same approximate scale-score range and maintain fitness within the item response theory model as used by the Comprehensive Adult Student Assessment Systems (CASAS) for developing…

  16. Dynamic assessment versus static assessment: A study of reading comprehension ability in Iranian EFL learners

    OpenAIRE

    Nazari, Behzad; Mansouri, Saeed

    2014-01-01

    This study extends traditional or static assessment of reading comprehension in foreign language contexts and applies dynamic assessment (DA) to the development of learners’ reading ability. To homogenize the research population (N= 250), an Oxford Placement Test (OPT) was administered. On the basis of the test results, the population was sorted into three groups of reading-low, reading-mid, and reading-high students. The participants of this study were a sample of 30 participants with the lo...

  17. Clinical reasoning in nursing: teaching strategies and assessment tools

    Directory of Open Access Journals (Sweden)

    Emília Campos de Carvalho

    Full Text Available ABSTRACT Objective: To present the concept and development of teaching strategies and the assessment tools regarding clinical reasoning for accurate practice. Method: This is a theoretical reflection based on scientific studies. Results: Comprehension of the essential concepts of the thought process and its articulation with the different teaching strategies and the assessment tools which has allowed presenting ways to improve the process of diagnostic or therapeutic clinical reasoning. Conclusion: The use of new strategies and assessment tools should be encouraged in order to contribute to the development of skills that lead to safe and effective decision making.

  18. The value of residential photovoltaic systems: A comprehensive assessment

    Science.gov (United States)

    Borden, C. S.

    1983-01-01

    Utility-interactive photovoltaic (PV) arrays on residential rooftops appear to be a potentially attractive, large-scale application of PV technology. Results of a comprehensive assessment of the value (i.e., break-even cost) of utility-grid connected residential photovoltaic power systems under a variety of technological and economic assumptions are presented. A wide range of allowable PV system costs are calculated for small (4.34 kW (p) sub ac) residential PV systems in various locales across the United States. Primary factor in this variation are differences in local weather conditions, utility-specific electric generation capacity, fuel types, and customer-load profiles that effect purchase and sell-back rates, and non-uniform state tax considerations. Additional results from this analysis are: locations having the highest insolation values are not necessary the most economically attractive sites; residential PV systems connected in parallel to the utility demonstrate high percentages of energy sold back to the grid, and owner financial and tax assumptions cause large variations in break-even costs. Significant cost reduction and aggressive resolution of potential institutional impediments (e.g., liability, standards, metering, and technical integration) are required for a residential PV marker to become a major electric-grid-connected energy-generation source.

  19. Comprehensive seismic hazard assessment of Tripura and Mizoram states

    Indian Academy of Sciences (India)

    T G Sitharam; Arjun Sil

    2014-06-01

    Northeast India is one of the most highly seismically active regions in the world with more than seven earthquakes on an average per year of magnitude 5.0 and above. Reliable seismic hazard assessment could provide the necessary design inputs for earthquake resistant design of structures in this region. In this study, deterministic as well as probabilistic methods have been attempted for seismic hazard assessment of Tripura and Mizoram states at bedrock level condition. An updated earthquake catalogue was collected from various national and international seismological agencies for the period from 1731 to 2011. The homogenization, declustering and data completeness analysis of events have been carried out before hazard evaluation. Seismicity parameters have been estimated using G–R relationship for each source zone. Based on the seismicity, tectonic features and fault rupture mechanism, this region was divided into six major subzones. Region specific correlations were used for magnitude conversion for homogenization of earthquake size. Ground motion equations (Atkinson and Boore 2003; Gupta 2010) were validated with the observed PGA (peak ground acceleration) values before use in the hazard evaluation. In this study, the hazard is estimated using linear sources, identified in and around the study area. Results are presented in the form of PGA using both DSHA (deterministic seismic hazard analysis) and PSHA (probabilistic seismic hazard analysis) with 2 and 10% probability of exceedance in 50 years, and spectral acceleration (T = 0.2 s, 1.0 s) for both the states (2% probability of exceedance in 50 years). The results are important to provide inputs for planning risk reduction strategies, for developing risk acceptance criteria and financial analysis for possible damages in the study area with a comprehensive analysis and higher resolution hazard mapping.

  20. Development and Validation of an Online Dynamic Assessment for Raising Students' Comprehension of Science Text

    Science.gov (United States)

    Wang, Jing-Ru; Chen, Shin-Feng

    2016-01-01

    This article reports on the development of an online dynamic approach for assessing and improving students' reading comprehension of science texts--the dynamic assessment for reading comprehension of science text (DARCST). The DARCST blended assessment and response-specific instruction into a holistic learning task for grades 5 and 6 students. The…

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

    Science.gov (United States)

    McClellan, Jeffrey L.

    2011-01-01

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

  2. How to assess and improve children's reading comprehension?

    NARCIS (Netherlands)

    Muijselaar, M.M.L.

    2016-01-01

    Reading comprehension is one of the most important skills children have to acquire during the final years of primary education. It is therefore unfortunate that many children have severe problems with a proper understanding of texts. To design methods that foster children’s reading comprehension, mo

  3. How to assess and improve children's reading comprehension?

    NARCIS (Netherlands)

    Muijselaar, M.M.L.

    2016-01-01

    Reading comprehension is one of the most important skills children have to acquire during the final years of primary education. It is therefore unfortunate that many children have severe problems with a proper understanding of texts. To design methods that foster children’s reading comprehension, mo

  4. Clinical observation on common peroneal nerve palsy treated with comprehensive therapy

    Institute of Scientific and Technical Information of China (English)

    杨丽娟

    2014-01-01

    Objective To compare the difference of the clinical efficacy on common peroneal nerve palsy between the comprehensive therapy of electroacupuncture,moxibustion and moving cupping method and western medication.Methods Ninety cases of common peroneal nerve palsy were randomized into a comprehensive therapy group and a western medication group,45 cases in each

  5. A multiparametric computational algorithm for comprehensive assessment of genetic mutations in mucopolysaccharidosis type IIIA (Sanfilippo syndrome).

    Science.gov (United States)

    Ugrinov, Krastyu G; Freed, Stefan D; Thomas, Clayton L; Lee, Shaun W

    2015-01-01

    Mucopolysaccharidosis type IIIA (MPS-IIIA, Sanfilippo syndrome) is a Lysosomal Storage Disease caused by cellular deficiency of N-sulfoglucosamine sulfohydrolase (SGSH). Given the large heterogeneity of genetic mutations responsible for the disease, a comprehensive understanding of the mechanisms by which these mutations affect enzyme function is needed to guide effective therapies. We developed a multiparametric computational algorithm to assess how patient genetic mutations in SGSH affect overall enzyme biogenesis, stability, and function. 107 patient mutations for the SGSH gene were obtained from the Human Gene Mutation Database representing all of the clinical mutations documented for Sanfilippo syndrome. We assessed each mutation individually using ten distinct parameters to give a comprehensive predictive score of the stability and misfolding capacity of the SGSH enzyme resulting from each of these mutations. The predictive score generated by our multiparametric algorithm yielded a standardized quantitative assessment of the severity of a given SGSH genetic mutation toward overall enzyme activity. Application of our algorithm has identified SGSH mutations in which enzymatic malfunction of the gene product is specifically due to impairments in protein folding. These scores provide an assessment of the degree to which a particular mutation could be treated using approaches such as chaperone therapies. Our multiparametric protein biogenesis algorithm advances a key understanding in the overall biochemical mechanism underlying Sanfilippo syndrome. Importantly, the design of our multiparametric algorithm can be tailored to many other diseases of genetic heterogeneity for which protein misfolding phenotypes may constitute a major component of disease manifestation.

  6. Comprehensive assessment of metabolic syndrome among rural Bangladeshi women

    Directory of Open Access Journals (Sweden)

    Jesmin Subrina

    2012-01-01

    Full Text Available Abstract Background Metabolic syndrome (MS, defined as a constellation of cardiovascular disease (CVD risk factors, is one of the fastest growing public health burdens in the Asia-Pacific region. This trend is despite the fact that people in this region are no more overweight than Europeans and Americans. Unfortunately, in South Asia, MS screening has only been performed in a few countries other than Bangladesh. Therefore the present study is designed to conduct a comprehensive screening of MS in Bangladeshi rural women, which includes estimation of prevalence and assessment of risk factor. Methods A total of 1535 rural Bangladesh women aged ≥ 15 years were studied using a population based cross-sectional survey. The prevalence of MS was estimated using NCEP ATP III, modified NCEP ATP III and IDF criteria. Results The prevalence rates of MS were 25.60% (NCEP ATP III, 36.68% (modified NCEP ATP III, and 19.80% (IDF, as revealed by the present study. Furthermore, based on the NCEP ATP III criteria, 11.60% of the subjects were found to have excess waist circumference; 29.12% had elevated blood pressure, 30.42% had elevated fasting plasma glucose level, 85.47% had low HDL values and 26.91% had increased triglyceride values. Low plasma HDL level was found to be the most common abnormality in the target population and elevated waist circumference was the least frequent component. Conclusions The present study reveals a high prevalence of MS and its associated risk factors in rural Bangladeshi women. These findings are important in that they provide insights that will be helpful in formulating effective public health policy, notably the development of future health prevention strategies in Bangladesh.

  7. A comprehensive database of published tDCS clinical trials (2005-2016).

    Science.gov (United States)

    Lefaucheur, Jean-Pascal

    2016-12-01

    Transcranial direct current stimulation (tDCS) is a technique of noninvasive cortical stimulation allowing significant modification of brain functions. Clinical application of this technique was reported for the first time in March 2005. This paper presents a detailed list of the 340 articles (excluding single case reports) which have assessed the clinical effect of tDCS in patients, at least when delivered to cortical targets. The reviewed conditions were: pain syndromes, Parkinson's disease, dystonia, cerebral palsy, post-stroke limb motor impairment, post-stroke neglect, post-stroke dysphagia, post-stroke aphasia, primary progressive aphasia, multiple sclerosis, epilepsy, consciousness disorders, Alzheimer's disease and other types of dementia, tinnitus, depression, auditory hallucinations and negative symptoms of schizophrenia, addiction and craving, autism, and attention disorders. The following data were collected: (i) clinical condition; (ii) study design; (iii) sample size; (iv) anode and cathode locations; (v) stimulation intensity and electrode area; (vi) number and duration of sessions; (vii) clinical outcome measures and results. This article does not include any meta-analysis and aims simply at providing a comprehensive overview of the raw data reported in this field to date, as an aid to researchers. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  8. Tennessee National Wildlife Refuge: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Tennessee NWR for the next 15 years. This plan outlines the Refuge vision and purpose...

  9. Windom Wetland Management District: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Windom Wetland Management District for the next 15 years. This plan outlines the...

  10. Wyandotte National Wildlife Refuge: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Wyandotte NWR for the next 15 years. This plan outlines the Refuge vision and purpose...

  11. Necedah National Wildlife Refuge: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Necedah NWR for the next 15 years. This plan outlines the Refuge vision and purpose and...

  12. Rydell National Wildlife Refuge: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Rydell NWR for the next 15 years. This plan outlines the Refuge vision and purpose and...

  13. Columbia National Wildlife Refuge: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Columbia NWR for the next 15 years. This plan outlines the Refuge vision and purpose...

  14. Shiawassee National Wildlife Refuge: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Shiawassee NWR for the next 15 years. This plan outlines the Refuge vision and purpose...

  15. Dynamic assessment in EFL classrooms: Assessing listening comprehension in three proficiency levels

    Directory of Open Access Journals (Sweden)

    Sara Hashemi Shahraki

    2015-01-01

    Full Text Available The use of dynamic assessment (DA, grounded in Vygotskian Sociocultural theory, in classrooms is believed to have the potential to provide a situation for creating a group of learners’ Zone of Proximal Development (ZPD (Poehener, 2009. The present study explored the implementation of DA in English as Foreign Language (EFL classrooms on groups of learners at different proficiency levels in the context of listening comprehension. 146 Iranian EFL learners at three proficiency levels were selected for this study (experimental groups=71 and control groups=75. A multi-assessment procedure in the format of dynamic and non-dynamic pretest-enrichment phase-dynamic and non-dynamic posttest was conducted. During the nine-week group dynamic assessment procedures, mediational strategies were only given to the experimental groups. The quantitative data analysis revealed that through mediated interactions within the group’s ZPD, group dynamic assessment is able to determine the learners’ developed abilities in listening comprehension while at the same time support the development of individual learners in this skill. Moreover, it was found that the level of proficiency of the learners did not have a significant effect on learners’ gains from group dynamic assessment procedures. These findings can have implications for all classroom teachers that the use of DA in classroom setting cannot only be beneficial to them but also be considered as a strategic learning and assessment method that can meet both the learners’ and teacher’s needs.

  16. Transitional cardiovascular physiology and comprehensive hemodynamic monitoring in the neonate: relevance to research and clinical care.

    Science.gov (United States)

    Azhibekov, Timur; Noori, Shahab; Soleymani, Sadaf; Seri, Istvan

    2014-02-01

    A thorough understanding of developmental cardiovascular physiology is essential for early recognition of cardiovascular compromise, selective screening of at-risk groups of neonates, and individualized management using pathophysiology-targeted interventions. Although we have gained a better understanding of the physiology and pathophysiology of postnatal cardiovascular transition over the past decade with the use of sophisticated methods to study neonatal hemodynamics, most aspects of neonatal hemodynamics remain incompletely understood. In addition, targeted therapeutic interventions of neonatal hemodynamic compromise have not been shown to improve mortality and clinically relevant outcomes. However, the recent development of comprehensive hemodynamic monitoring systems capable of non-invasive, continuous and simultaneous bedside assessment of cardiac output, organ blood flow, microcirculation, and tissue oxygen delivery has made sophisticated analysis of the obtained physiologic data possible and has created new research opportunities with the potential of direct implications to patient care.

  17. Students' Assessment and Self-assessment of Nursing Clinical Faculty Competencies: Important Feedback in Clinical Education?

    Science.gov (United States)

    Lovrić, Robert; Prlić, Nada; Zec, Davor; Pušeljić, Silvija; Žvanut, Boštjan

    2015-01-01

    The students' assessment of clinical faculty competencies and the faculty members' self-assessment can provide important information about nursing clinical education. The aim of this study was to identify the differences between the students' assessment of the clinical faculty member's competencies and the faculty member's self-assessment. These differences can reveal interesting insights relevant for improving clinical practice.

  18. Validation of a Cognitive Diagnostic Model across Multiple Forms of a Reading Comprehension Assessment

    Science.gov (United States)

    Clark, Amy K.

    2013-01-01

    The present study sought to fit a cognitive diagnostic model (CDM) across multiple forms of a passage-based reading comprehension assessment using the attribute hierarchy method. Previous research on CDMs for reading comprehension assessments served as a basis for the attributes in the hierarchy. The two attribute hierarchies were fit to data from…

  19. ENVIRONMENTAL IMPACT ASSESSMENT TAXONOMY PROVIDING COMPREHENSIVE COVERAGE OF MIDPOINTS, ENDPOINTS, DAMAGES, AND AREAS OF PROTECTION

    Science.gov (United States)

    Prior to conducting a comprehensive impact assessment, such as a Life Cycle Impact Assessment (LCIA), there is a need to discuss the range of impacts which could and should be included. Up to this point in time, there has not been available a comprehensive list of impacts for po...

  20. What Is the Basis for Self-Assessment of Comprehension When Reading Mathematical Expository Texts?

    Science.gov (United States)

    Österholm, Magnus

    2015-01-01

    The purpose of this study was to characterize students' self-assessments when reading mathematical texts, in particular regarding what students use as a basis for evaluations of their own reading comprehension. A total of 91 students read two mathematical texts, and for each text, they performed a self-assessment of their comprehension and…

  1. Risk assessment of supply chain for pharmaceutical excipients with AHP-fuzzy comprehensive evaluation.

    Science.gov (United States)

    Li, Maozhong; Du, Yunai; Wang, Qiyue; Sun, Chunmeng; Ling, Xiang; Yu, Boyang; Tu, Jiasheng; Xiong, Yerong

    2016-04-01

    As the essential components in formulations, pharmaceutical excipients directly affect the safety, efficacy, and stability of drugs. Recently, safety incidents of pharmaceutical excipients posing seriously threats to the patients highlight the necessity of controlling the potential risks. Hence, it is indispensable for the industry to establish an effective risk assessment system of supply chain. In this study, an AHP-fuzzy comprehensive evaluation model was developed based on the analytic hierarchy process and fuzzy mathematical theory, which quantitatively assessed the risks of supply chain. Taking polysorbate 80 as the example for model analysis, it was concluded that polysorbate 80 for injection use is a high-risk ingredient in the supply chain compared to that for oral use to achieve safety application in clinic, thus measures should be taken to control and minimize those risks.

  2. A comprehensive clinical and genetic study of a large Mexican population with spinocerebellar ataxia type 7.

    Science.gov (United States)

    Velázquez-Pérez, L; Cerecedo-Zapata, C M; Hernández-Hernández, O; Martínez-Cruz, E; Tapia-Guerrero, Y S; González-Piña, R; Salas-Vargas, J; Rodríguez-Labrada, R; Gurrola-Betancourth, R; Leyva-García, N; Cisneros, B; Magaña, J J

    2015-01-01

    Spinocerebellar ataxia type 7 (SCA7) is an inherited neurodegenerative disorder characterized by progressive cerebellar ataxia associated with macular degeneration. We recently described one of the largest series of patients with SCA7 that originated from a founder effect in a Mexican population, which allowed us to perform herein the first comprehensive clinical, neurophysiological, and genetic characterization of Mexican patients with SCA7. In this study, 50 patients, categorized into adult or early phenotype, were clinically assessed using standard neurological exams and genotyped using fluorescent PCR and capillary electrophoresis. Patients with SCA7 exhibited the classical phenotype of the disease characterized by cerebellar ataxia and visual loss; however, we reported, for the first time, frontal-executive disorders and altered sensory-motor peripheral neuropathy in these patients. Semiquantitative analysis of ataxia-associated symptoms was performed using Scale for the Assessment and Rating of Ataxia (SARA) and the Brief Ataxia Rating Scale (BARS) scores, while extracerebellar features were measured employing the Inventory of Non-ataxia Symptoms (INAS) scale. Ataxia rating scales confirmed the critical role size of cytosine-adenine-guanine (CAG) repeat size on age at onset and disease severity, while analysis of CAG repeat instability showed that paternal rather than maternal transmission led to greater instability.

  3. Clinical research of comprehensive rehabilitation in treating brachial plexus injury patients

    Institute of Scientific and Technical Information of China (English)

    ZHOU Jun-ming; GU Yu-dong; XU Xiao-jun; ZHANG Shen-yu; ZHAO Xin

    2012-01-01

    Background Brachial plexus injury is one of the difficult medical problems in the world.The aim of this study was to observe the clinical therapeutic effect of comprehensive rehabilitation in treating dysfunction after brachial plexus injury.Methods Forty-three cases of dysfunction after brachial plexus injury were divided into two groups randomly.The treatment group,which totaled 21 patients (including 14 cases of total brachial plexus injury and seven cases of branch brachial plexus injury),was treated with comprehensive rehabilitation including transcutaneous electrical nerve stimulation,mid-frequency electrotherapy,Tuina therapy,and occupational therapy.The control group,which totaled 22patients (including 16 cases of total brachial plexus injury and six cases of branch brachial plexus injury),was treated with home-based electrical nerve stimulation and occupational therapy.Each course was of 30 days duration and the patients received four courses totally.After four courses,the rehabilitation effect was evaluated according to the brachial plexus function evaluation standard and electromyogram (EMG) assessment.Results In the treatment group,there was significant difference in the scores of brachial plexus function pre- and post-treatment (P <0.01 ) in both "total" and "branch" injury.The scores of two "total injury" groups had statistical differences (P <0.01),while the scores of two "branch injury" groups had statistical differences (P<0.05) after four courses.EMG suggested that the.appearance of regeneration potentials of the recipient nerves in the treatment group was earlier than the control group and had significant differences (P <0.05).Conclusion Comprehensive rehabilitation was more effective in treating dysfunction after brachial plexus injury thannonintegrated rehabilitation.

  4. A Comprehensive Epidemiological Research for Clinical Vibrio parahaemolyticus in Shanghai

    Directory of Open Access Journals (Sweden)

    Huan Li

    2017-06-01

    Full Text Available Vibrio parahaemolyticus is one of the most important pathogen for seafood-borne gastroenteritis in Shanghai and the rest of the world. A total of 42 V. parahaemolyticus strains were isolated from 1900 fecal specimens collected from patients in Shanghai hospital presenting from January 2014 to December 2015. All isolates were evaluated for potential virulence factors [tdh, trh, and type three secretion system (T3SS genes], typed using multilocus sequence typing (MLST and screened for antimicrobial resistance phenotype and genotype. And for the first time, the relationship between virulence, genetic diversity and antimicrobial resistance of these isolates were identified. The results showed that 37 isolates carried the tdh gene (88.1% and only seven isolates were positive for the trh gene. The T3SS1 and T3SS2 genes were detected in all strains and only trh-positive isolates are also containing the T3SS2β genes. MLST analysis of the 42 Shanghai isolates identified 20 sequence types (STs with 16 novel STs and that these clinical V. parahaemolyticus strains showed high degrees of genetic diversity. All isolates expressed high levels of resistance against Ampicillin (100.0%, Streptomycin (100.0%, Cephazolin (92.9%, Kanamycin (92.8% and Amikacin (90.5%, and eight out of 38 resistance genes (SHV, tet(B, strA, qnrA, gryA, qnrB, sulI, sulII were detected in at least two isolates. This study confirms that antimicrobial resistance of clinical V. parahaemolyticus isolates is greater than those of environmental isolates. Furthermore, no clear correlation between antimicrobial resistance and virulence or genetic diversity was found in this study. These results add to epidemiological data of clinical V. parahaemolyticus isolates in Shanghai and highlight the need for additional mechanistic studies, especially antimicrobial resistance, to reduce the burden of disease caused by this pathogen in China.

  5. Clinical spectrum of food allergies: a comprehensive review.

    Science.gov (United States)

    Ho, Marco H-K; Wong, Wilfred H-S; Chang, Christopher

    2014-06-01

    Food allergy is defined as an adverse immune response towards food proteins or as a form of a food intolerance associated with a hypersensitive immune response. It should also be reproducible by a double-blind placebo-controlled food challenge. Many reported that food reactions are not allergic but are intolerances. Food allergy often presents to clinicians as a symptom complex. This review focuses on the clinical spectrum and manifestations of various forms of food allergies. According to clinical presentations and allergy testing, there are three types of food allergy: IgE mediated, mixed (IgE/Non-IgE), and non-IgE mediated (cellular, delayed type hypersensitivity). Recent advances in food allergy in early childhood have highlighted increasing recognition of a spectrum of delayed-onset non-IgE-mediated manifestation of food allergy. Common presentations of food allergy in infancy including atopic eczema, infantile colic, and gastroesophageal reflux. These clinical observations are frequently associated with food hypersensitivity and respond to dietary elimination. Non-IgE-mediated food allergy includes a wide range of diseases, from atopic dermatitis to food protein-induced enterocolitis and from eosinophilic esophagitis to celiac disease. The most common food allergies in children include milk, egg, soy, wheat, peanut, treenut, fish, and shellfish. Milk and egg allergies are usually outgrown, but peanut and treenut allergy tends to persist. The prevalence of food allergy in infancy is increasing and may affect up to 15-20 % of infants. The alarming rate of increase calls for a public health approach in the prevention and treatment of food allergy in children.

  6. Psychometric Structure of a Comprehensive Objective Structured Clinical Examination: A Factor Analytic Approach

    Science.gov (United States)

    Volkan, Kevin; Simon, Steven R.; Baker, Harley; Todres, I. David

    2004-01-01

    Problem Statement and Background: While the psychometric properties of Objective Structured Clinical Examinations (OSCEs) have been studied, their latent structures have not been well characterized. This study examines a factor analytic model of a comprehensive OSCE and addresses implications for measurement of clinical performance. Methods: An…

  7. Preconsent video-assisted instruction improves the comprehension and satisfaction in elderly patient visiting pain clinic.

    Science.gov (United States)

    Kim, Sung Hoon; Koh, Won Uk; Rhim, Jin Ho; Karm, Myong Hwan; Yu, Hye Suk; Lee, Bo Yoeng; Shin, Jin Woo; Leem, Jeong Gill

    2012-10-01

    Elderly patients visiting pain clinic may be at greater risk of misunderstanding the explanation because of age-related cognitive decline. Video instruction may provide a consistent from of teaching in a visual and realistic manner. We evaluated the effect of educational video on the patient understanding and satisfaction in a group of geriatric patients visiting pain clinic. Ninety two patients aged more than 60 years old who were scheduled for transforaminal epidural block were recruited. After exposure to either video or paper instruction process, each patient was asked 5-item comprehension questions, overall satisfaction and preference question. During follow-up period, number of outpatient referral-line call for further explanation was counted. We observed significantly better comprehension in the video education compared with paper instruction (P video group (P = 0.015), and patients visiting pain clinic were more preferred video instruction (P Video approach to instruction process before consent improves treatment comprehension in geriatric patient visiting pain clinic.

  8. Gray comprehensive assessment and optimal selection of water consumption forecasting model

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    A comprehensive assessing method based on the principle of the gray system theory and gray relational grade analysis was put forward to optimize water consumption forecasting models. The method provides a better accuracy for the assessment and the optimal selection of the water consumption forecasting models. The results show that the forecasting model built on this comprehensive assessing method presents better self-adaptability and accuracy in forecasting.

  9. Developing comprehensive and Brief ICF core sets for morbid obesity for disability assessment in Taiwan: a preliminary study.

    Science.gov (United States)

    Lin, Y-N; Chang, K-H; Lin, C-Y; Hsu, M-I; Chen, H-C; Chen, H-H; Liou, T-H

    2014-04-01

    The International Classification of Functioning, Disability, and Health (ICF) provides a framework for measuring functioning and disability based on a biopsychosocial model. The aim of this study was to develop comprehensive and brief ICF core sets for morbid obesity for disability assessment in Taiwan. Observational Other Twenty-nine multidisciplinary experts of ICF METHODS: The questionnaire contained 112 obesity-relevant and second-level ICF categories. Using a 5-point Likert scale, the participants rated the significance of the effects of each category on the heath status of people with obesity. Correlation between an individual's score and the average score of the group indicated consensus. The categories were selected for the comprehensive core set for obesity if more than 50% of the experts rated them as "important" in the third round of the Delphi exercise, and for the brief core set if more than 80% of the experts rated them "very important." Twenty-nine experts participated in the study. These included 18 physicians, 4 dieticians, 3 physical therapists, 2 nurses, and 2 ICF experts. The comprehensive core set for morbid obesity contained 61 categories. Of these, 26 categories were from the component body function, 8 were from body structure, 18 were from activities and participation, and 9 were from environmental factors. The brief core set for obesity disability contained 29 categories. Of these, 19 categories were from the component body function, 3 were from body structure, 6 were from activities and participation, and one was from environmental factors. The comprehensive and brief ICF core sets provide comprehensive information on the health effects of morbid obesity and concise information for clinical practice. Comprehensive and brief core sets were created after three rounds of Delphi technique. Further validation study of these core sets by applying to patients with morbid obesity is needed. The comprehensive ICF core set for morbid obesity

  10. Methods and Strategies for Creating a Culture of Collections Assessment at Comprehensive Universities

    Science.gov (United States)

    Martin, Heath; Robles-Smith, Kimberley; Garrison, Julie; Way, Doug

    2009-01-01

    Differing from those of their liberal arts and Association of Research Libraries counterparts, today's comprehensive universities face a variety of unique challenges and opportunities when it comes to assessing their collections. This article looks at the different needs and interests of comprehensive universities and focuses on the challenges…

  11. Epilogue: Reading Comprehension Is Not a Single Ability--Implications for Assessment and Instruction

    Science.gov (United States)

    Kamhi, Alan G.; Catts, Hugh W.

    2017-01-01

    Purpose: In this epilogue, we review the 4 response articles and highlight the implications of a multidimensional view of reading for the assessment and instruction of reading comprehension. Method: We reiterate the problems with standardized tests of reading comprehension and discuss the advantages and disadvantages of recently developed…

  12. The influence of comprehensive geriatric assessment on drug therapy in elderly patients

    DEFF Research Database (Denmark)

    Larsen, Michael Due; Rosholm, Jens Ulrik; Hallas, Jesper

    2014-01-01

    Comprehensive geriatric assessment of hospitalised patients implies optimising patients' medical treatment, and good coordination between hospital and general practice is essential for the quality of the drug treatment. Only a few studies have investigated the continuation of patients' medication...

  13. Final Amendment to the Comprehensive Conservation Plan & Environmental Assessment: Flint Hills National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This is an amendment, accompanied by an Environmental Assessment (EA), to the current 2000 Comprehensive Conservation Plan (CCP) for Flint Hills NWR. The purpose of...

  14. Cognitive Assessment of Elderly Inpatients: A Clinical Audit

    Directory of Open Access Journals (Sweden)

    Elizabeth Shermon

    2015-01-01

    Full Text Available Background: Comprehensive geriatric assessment including cognitive assessment results in better outcomes and quality of life through facilitating access to support and further care. The National Audit of Dementia Care revealed too few patients were being assessed for cognition and therefore failing to receive adequate care. Methods: This was a retrospective clinical audit in a district general hospital with systematic sampling of the clinical records of 50 inpatients on an elderly care ward. A descriptive analysis of the results was performed. Results: Despite guidance that cognitive assessment should be performed on admission, this was only documented in 22% of the medical notes. However, this rate improved to 56% by discharge. The most commonly used tool was the Abbreviated Mental Test (AMT 10. Assessment completion was independent of gender or social support, but only patients aged over 75 years were assessed. Of those, 75% had some level of cognitive impairment and 36.8% received a new or suspected diagnosis of dementia. Discussion: Cognitive assessment rates continue to be low. Our findings support the need for increased education regarding the importance and benefits of assessment as well as how to complete and document the assessment correctly. Conclusion: Cognitive assessment rates need to be further improved to promote better outcomes for patients with dementia.

  15. Ecosystem Health and Comprehensive Ecological Benefit Assessment of an Artificial Wetland in Western Jilin Province

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    [Objective] This research aimed to assess the state of ecosystem health and comprehensive ecological benefit of an artificial wetland in western Jilin Province. [Method] To investigate the effects of reclaimed water from Yingtai Oil Production Plant on the wetland ecosystem, a comprehensive ecological assessment index of an artificial wetland in the west of Jilin Province was established to measure the ecological economic and social benefits. The quantitative evaluation on the ecosystem health and comprehen...

  16. A Comprehensive Evaluation Rubric for Assessing Instructional Apps

    Directory of Open Access Journals (Sweden)

    Cheng-Yuan Lee

    2015-01-01

    Full Text Available There is a pressing need for an evaluation rubric that examines all aspects of educational apps designed for instructional purposes. In past decades, many rubrics have been developed for evaluating educational computer-based programs; however, rubrics designed for evaluating the instructional implications of educational apps are scarce. When an Internet search for existing rubrics was conducted, only two such rubrics were found, and the evaluation criteria used in those rubrics was not clearly linked to previously conducted research nor were their evaluative dimensions clearly defined. These shortcomings result in reviewers being unable to use those rubrics to provide teachers with a precise analysis of an educational app’s instructional potential. In response, this paper presents a comprehensive rubric with 24-evaluative dimensions tailored specifically to analyze the educational potential of instructional apps.

  17. Assessment of urban sustainable development using fuzzy comprehensive evaluation

    Institute of Scientific and Technical Information of China (English)

    Liu Gaochang

    2006-01-01

    Sustainable development index evaluation system is the foundation of the study on the realization of sustainable development, and it is also an important part to turn sustainable development into operation from philosophical idea. With the rapid economic development, problems of environmental protection appear, and the sustainable development strategy attracts more and more attention of academia and government. However, because sustainable development is a complicated and dynamic process, there is no unified index system to evaluate it at present. Based on the theories on cities and sustainable development and certain principles and guidelines, this paper filters sustainable development index, quantizes some key indexes, designs the index system made up of economy, society, environment and resources and system harmony, and comprehensively evaluates the status quo of the sustainable development of a certain area.

  18. Comprehensive geriatric assessment for older women with early breast cancer – a systematic review of literature

    Directory of Open Access Journals (Sweden)

    Parks Ruth M

    2012-05-01

    Full Text Available Abstract Background The Comprehensive Geriatric Assessment (CGA is an analytical tool increasingly implemented in clinical practice. Breast cancer is primarily a disease of older people; however, most evidence-based research is aimed at younger patients. Methods A systematic review of literature was carried out to assess the use of CGA in older breast cancer patients for clinical decision making. The PubMed, Embase and Cochrane databases were searched. Results A total of nine useful full text article results were found. Only five of these were exclusively concerned with early breast cancer; thus, studies involving a variety of cancer types, stages and treatments were accepted, as long as they included early breast cancer.The results comprised a series of low sources of evidence. However, all results shared a common theme: the CGA has a use in determining patient suitability for different types of cancer treatment and subsequently maximizing the patient’s quality of life. Conclusions There is not yet sufficient high level evidence to instate CGA guidelines as a mandatory practice in the management of breast cancer, due to the heterogeneity of available studies. More studies need to be conducted to cement current work on the benefits of the CGA. An area of particular interest is with regard to treatment options, especially surgery and chemotherapy, and identifying patients who may be suitable for these treatments.

  19. Fuzzy Comprehensive Assessment of Transnational Operation Environment for Chinese Oil Companies

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    A comprehensive method was developed to assess the transnational operation environment in host countries for Chinese oil companies. This method includes an assessment criterion system of the environment, which is to be scored by the experts. Analytical Hierarchy Process (AHP) and fuzzy mathematical methods were used to make evaluation and get the assessment result and ranking of three host countries.

  20. Towards Enhanced Second Language Reading Comprehension Assessment: Computerized versus Manual Scoring of Written Recall Protocols

    Science.gov (United States)

    Heinz, Peter J.

    2004-01-01

    Second language (L2) reading comprehension assessment has long relied upon classical quantitative, product-oriented measurement techniques (i.e., multiple-choice and cloze) in both research and classroom assessment. As Bernhardt (1991) clearly demonstrated, these traditionally employed assessment methods are unable to capture the complex processes…

  1. The Effect of Portfolio Assessment on EFL Learners' Reading Comprehension and Motivation

    Science.gov (United States)

    Hosseini, Hosna; Ghabanchi, Zargham

    2014-01-01

    This study highlighted the humanistic-transformational perspectives via portfolio assessment which offers a conceptual framework for teaching and assessment. More specifically, it attempted to explore the effectof portfolio assessment on EFL learners'reading comprehension ability and motivation in the context of Iran. It adopted the…

  2. The Clinical Assessment and Remote Administration Tablet

    Directory of Open Access Journals (Sweden)

    Jessica A Turner

    2011-12-01

    Full Text Available Electronic data capture of case report forms (CRFs, demographic, neuropsychiatric, or clinical assessments, can vary from scanning hand-written forms into databases to fully electronic systems. Web-based forms can be extremely useful for self-assessment; however, in the case of neuropsychiatric assessments, self-assessment is often not an option. The clinician often must be the person either summarizing or making their best judgment about the subject’s response in order to complete an assessment, and having the clinician turn away to type into a web browser may be disruptive to the flow of the interview. The Mind Research Network (MRN has developed a prototype for a software tool for the real-time acquisition and validation of clinical assessments in remote environments. We have developed the Clinical Assessment and Remote Administration Tablet (CARAT on a Microsoft Windows PC tablet system, which has been adapted to interact with various data models already in use in several large-scale databases of neuroimaging studies in clinical populations. The tablet has been used successfully to collect and administer clinical assessments in several large-scale studies, so that the correct clinical measures are integrated with the correct imaging and other data. It has proven to be incredibly valuable in confirming that data collection across multiple research groups is performed similarly, quickly, and with accountability for incomplete datasets. We present the overall architecture and an evaluation of its use.

  3. Comprehensive ultrasound assessment of complications post-liver transplantation.

    LENUS (Irish Health Repository)

    O'Brien, J

    2010-04-01

    Human liver transplantation for end-stage liver disease was first performed in 1963. Refinements in surgical technique and new immunosuppressive regimens have improved outcomes. Today, transplant patients have a 5-year survival rate of approximately 75%. Nevertheless, significant complications still occur. Ultrasonography (US), is the initial imaging modality of choice allowing bedside assessment for detection and follow-up of early and delayed graft complications, and facilitating interventional procedures. This review outlines the role of ultrasound in post-transplantation assessment.

  4. Comprehensive ultrasound assessment of complications post-liver transplantation

    Energy Technology Data Exchange (ETDEWEB)

    O' Brien, J. [Department of Radiology, Adelaide and Meath Incorporating the National Children' s Hospital, Tallaght, Dublin 24 (Ireland)], E-mail: juliemarobrien@yahoo.com; Buckley, A.R. [Division of Abdominal Imaging, Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia (Canada); Browne, R. [Department of Radiology, Adelaide and Meath Incorporating the National Children' s Hospital, Tallaght, Dublin 24 (Ireland)

    2010-04-15

    Human liver transplantation for end-stage liver disease was first performed in 1963. Refinements in surgical technique and new immunosuppressive regimens have improved outcomes. Today, transplant patients have a 5-year survival rate of approximately 75%. Nevertheless, significant complications still occur. Ultrasonography (US), is the initial imaging modality of choice allowing bedside assessment for detection and follow-up of early and delayed graft complications, and facilitating interventional procedures. This review outlines the role of ultrasound in post-transplantation assessment.

  5. Building a comprehensive syntactic and semantic corpus of Chinese clinical texts

    OpenAIRE

    He, Bin; Dong, Bin; Guan, Yi; Yang, Jinfeng; Jiang, Zhipeng; Yu, Qiubin; Cheng, Jianyi; Qu, Chunyan

    2016-01-01

    Objective: To build a comprehensive corpus covering syntactic and semantic annotations of Chinese clinical texts with corresponding annotation guidelines and methods as well as to develop tools trained on the annotated corpus, which supplies baselines for research on Chinese texts in the clinical domain. Materials and methods: An iterative annotation method was proposed to train annotators and to develop annotation guidelines. Then, by using annotation quality assurance measures, a comprehens...

  6. The business of palliative medicine--part 6: clinical operations in a comprehensive integrated program.

    Science.gov (United States)

    Lagman, Ruth L; Walsh, Declan; LeGrand, Susan B; Davis, Mellar P

    2011-03-01

    The medical care of individuals with advanced disease is complex and has historically been fragmented and suboptimal. Palliative medicine attempts to address these needs. The Harry R. Horvitz Center for Palliative Medicine at the Cleveland Clinic is an established comprehensive integrated program. Structured and seamless clinical operations are important to ensure the best delivery of high-quality medical care and continuity for those affected by life-limiting illness.

  7. A Review of Teen-Tot Programs: Comprehensive Clinical Care for Young Parents and Their Children.

    Science.gov (United States)

    Akinbami, Lara J.; Cheng, Tina L.; Kornfeld, Dana

    2001-01-01

    Comprehensive clinical programs for teenage mothers and their children have been a promising intervention to improve outcomes of teenage childbearing and parenting. Evaluations in this study reported moderate success in preventing repeat pregnancies, continuing education, and improving health care. It is concluded that increased support and…

  8. Definition of variables required for comprehensive description of drug dosage and clinical pharmacokinetics.

    Science.gov (United States)

    Medem, Anna V; Seidling, Hanna M; Eichler, Hans-Georg; Kaltschmidt, Jens; Metzner, Michael; Hubert, Carina M; Czock, David; Haefeli, Walter E

    2017-05-01

    Electronic clinical decision support systems (CDSS) require drug information that can be processed by computers. The goal of this project was to determine and evaluate a compilation of variables that comprehensively capture the information contained in the summary of product characteristic (SmPC) and unequivocally describe the drug, its dosage options, and clinical pharmacokinetics. An expert panel defined and structured a set of variables and drafted a guideline to extract and enter information on dosage and clinical pharmacokinetics from textual SmPCs as published by the European Medicines Agency (EMA). The set of variables was iteratively revised and evaluated by data extraction and variable allocation of roughly 7% of all centrally approved drugs. The information contained in the SmPC was allocated to three information clusters consisting of 260 variables. The cluster "drug characterization" specifies the nature of the drug. The cluster "dosage" provides information on approved drug dosages and defines corresponding specific conditions. The cluster "clinical pharmacokinetics" includes pharmacokinetic parameters of relevance for dosing in clinical practice. A first evaluation demonstrated that, despite the complexity of the current free text SmPCs, dosage and pharmacokinetic information can be reliably extracted from the SmPCs and comprehensively described by a limited set of variables. By proposing a compilation of variables well describing drug dosage and clinical pharmacokinetics, the project represents a step forward towards the development of a comprehensive database system serving as information source for sophisticated CDSS.

  9. Bioactivity assessment and toxicity of crocin: a comprehensive review.

    Science.gov (United States)

    Alavizadeh, Seyedeh Hoda; Hosseinzadeh, Hossein

    2014-02-01

    Since ancient times, saffron, the dried stigma of the plant Crocus sativus L. has been extensively used as a spice and food colorant; in folk medicine it has been reputed to be efficacious for the alleviation and treatment of ailments. In addition to the three founded major constituents including crocin, picrocrocin and safranal, presence of carotenoids, carbohydrates, proteins, anthocyanins, vitamins and minerals provide valuable insights into the health benefits and nutritional value of saffron. Of the carotenoids present in saffron, highly water-soluble crocin (mono and diglycosyl esters of a polyene dicarboxylic acid, named crocetin) is responsible for the majority of its color, and appears to possess various health-promoting properties, as an antioxidant, antitumor, memory enhancer, antidepressant, anxiolytic and aphrodisiac. It is also worth noting that the crocin principle of saffron exhibited high efficacy along with no major toxicity in experimental models. We would be remiss to not consider the great potential of saffron and crocin, which benefits the cuisine and health of human life throughout the world. The present study provides a comprehensive and updated report of empirical investigations on bioactivities and biological characteristics of crocin.

  10. Employing computers for the recruitment into clinical trials: a comprehensive systematic review.

    Science.gov (United States)

    Köpcke, Felix; Prokosch, Hans-Ulrich

    2014-07-01

    Medical progress depends on the evaluation of new diagnostic and therapeutic interventions within clinical trials. Clinical trial recruitment support systems (CTRSS) aim to improve the recruitment process in terms of effectiveness and efficiency. The goals were to (1) create an overview of all CTRSS reported until the end of 2013, (2) find and describe similarities in design, (3) theorize on the reasons for different approaches, and (4) examine whether projects were able to illustrate the impact of CTRSS. We searched PubMed titles, abstracts, and keywords for terms related to CTRSS research. Query results were classified according to clinical context, workflow integration, knowledge and data sources, reasoning algorithm, and outcome. A total of 101 papers on 79 different systems were found. Most lacked details in one or more categories. There were 3 different CTRSS that dominated: (1) systems for the retrospective identification of trial participants based on existing clinical data, typically through Structured Query Language (SQL) queries on relational databases, (2) systems that monitored the appearance of a key event of an existing health information technology component in which the occurrence of the event caused a comprehensive eligibility test for a patient or was directly communicated to the researcher, and (3) independent systems that required a user to enter patient data into an interface to trigger an eligibility assessment. Although the treating physician was required to act for the patient in older systems, it is now becoming increasingly popular to offer this possibility directly to the patient. Many CTRSS are designed to fit the existing infrastructure of a clinical care provider or the particularities of a trial. We conclude that the success of a CTRSS depends more on its successful workflow integration than on sophisticated reasoning and data processing algorithms. Furthermore, some of the most recent literature suggest that an increase in recruited

  11. Assessment of a Comprehensive Anti-Aging Neck Cream.

    Science.gov (United States)

    Saxena, Subhash J; Duque, Deysi; Schirripa, Michael J

    2015-09-01

    With many effective anti-aging solutions for the face, consumer focus is now turning to other parts of the body including the delicate skin on the neck. This study investigates the effect of a new neck cream on the appearance of texture, fine lines and wrinkles, laxity, and hydration. 85 adult females ages 35-65 with Fitzpatrick skin types I through IV applied the test neck cream twice daily for a 3-month study period. Screening was conducted at Baseline, 2, 30, 60, and 90 days via a virtual trial. Subjects rated satisfaction in each of 4 anti-aging categories including hydration, texture, appearance of wrinkles, and appearance of laxity as well as three product attributes including application, feel, and smell. Improvement was statistically significant for all measured categories (hydration, texture, appearance of wrinkles, and appearance of laxity) with 94% of study subjects noting improvement in one or more of the measured categories. Further, the quantity of "Satisfied" and "Highly Satisfied" assessments increased 8-fold from baseline with a 94x increase in the quantity of "Highly Satisfied" assessments. The results demonstrate the product's rapid and continuing ability to improve the self-perceived signs of aging in the neck area including improvement in skin texture on the neck and a reduction in the appearance of wrinkles and laxity along the jawline. Future studies are recommended to determine the primary action mechanisms and to assess the degree of improvement by blinded physician assessment.

  12. The Comprehensive Assessment of Rational Thinking. 2013 Thorndike Award Address

    Science.gov (United States)

    Stanovich, Keith E.

    2016-01-01

    The Nobel Prize in Economics was awarded in 2002 for work on judgment and decision-making tasks that are the operational measures of rational thought in cognitive science. Because assessments of intelligence (and similar tests of cognitive ability) are taken to be the quintessence of good thinking, it might be thought that such measures would…

  13. [Comprehensive assessment of atypical-extraction orthodontic treatment].

    Science.gov (United States)

    Yijia, Xie; Zhou, Hu; Qing, Zhao; Fuwei, Lin; Yang, Zeng; Xiaomei, Xu; Lin, Zeng; Pu, Yang

    2017-04-01

    To discuss through retrospective study associated factors influencing orthodontists to develop orthodontic treatment plans and to calculate constituent ratio of a typical extraction in orthodontic treatment. Systematic sampling was performed among 7 344 orthodontic patients, who received orthodontic treatment from April 2012 to March 2014 in the Department of Orthodontics, West China Hospital of Stomatology, Sichuan University. The study included statistical data on factors that may influence development of treatment plans. Samples were used to calculate extraction-ratio and atypical-extraction-ratio. Research focused on associated factors influencing development of treatment plans while evaluating correlation significances of each factor. Finally, treatment outcomes of atypical-extraction were compared with those of typical-extraction. Among studied patients, 55.31% (406/734) received orthodontic extraction treatment. In orthodontic-extraction-treated patients, typical-extraction accounted for 59.11% (240/406), orthodontists-selected atypical-extraction accounted for 23.15% (94/406), and passive atypical-extraction accounted for 17.73% (72/406). With statistical analysis, we inferred associated factors influencing development of treatment plans as follows: sex and age of patients, sex of orthodontists, accurate condition of specific teeth, Angle's classification, and degree of midline deviation. Tooth loss before treatment also directly influences passive atypical-extraction. Statistically significant factors were not obtained. Significant difference of treatment outcome was not observed between atypical-extraction and typical-extraction-orthodontic treatment (P>0.05). Above mentioned factors may influence orthodontists to develop treatment plans. However, orthodontists should also consider expected results of treatment strategies to prepare individual treatment plans on the basis of comprehensive analysis. 
.

  14. Assessing the Comprehensive Seismic Earth Model using normal mode data

    Science.gov (United States)

    Koelemeijer, Paula; Afanasiev, Michael; Fichtner, Andreas; Gokhberg, Alexey

    2016-04-01

    Advances in computational resources and numerical methods allow the simulation of realistic seismic wave propagation through complex media, while ensuring that the complete wave field is correctly represented in synthetic seismograms. This full waveform inversion is widely applied on regional and continental scales, where particularly dense data sampled can be achieved leading to an increased resolution in the obtained model images. On a global scale, however, full waveform tomography is still and will continue to be limited to longer length scales due to the large computational costs. Normal mode tomography provides an alternative fast full waveform approach for imaging seismic structures in a global way. Normal modes are not limited by the poor station-earthquake distribution and provide sensitivity to density structure. Using normal modes, a more robust long wavelength background model can be obtained, leading to more accurate absolute velocity models for tectonic and mineral physics interpretations. In addition, it is vital to combine all seismic data types across accessible periods to obtain a more complete, consistent and interpretable image of the Earth's interior. Here, we aim to combine the globally sensitive long period normal modes with shorter period full waveform modelling within the multi-scale framework of the Comprehensive Seismic Earth Model (CSEM). The multi-scale inversion framework of the CSEM allows exploitation of the full waveform capacity on both sides of the seismic spectrum. As the CSEM includes high-resolution subregions with velocity variations at much shorter wavelengths than normal modes could constrain, the question arises whether these small-scale variations are noticeable in normal mode data, and which modes respond in particular. We report here on experiments in which we address these questions. We separately investigate the effects of small-scale variations in shear-wave velocity and compressional wave velocity compared to the

  15. Assessment of paediatric clinical audit.

    LENUS (Irish Health Repository)

    Perrem, L M

    2012-02-01

    Consultant paediatricians in Ireland were surveyed to evaluate their perceptions of the hospital audit environment and assess their involvement in the audit process. Eighty nine (77%) replied of whom 66 (74%) had an audit department and 23 (26%) did not. Sixteen (18%) felt their hospital was well resourced for audit and 25 (28%) felt the culture was very positive but only 1 (1%) had protected time. For 61 (69%) consultants audit was very important with 38 (43%) being very actively involved in the process. The most frequent trigger for audit was non consultant hospital doctor (NCHD) career development, cited by 77 (87%). The new Professional Competence Scheme and the National Quality and Risk Management Standards will require the deficiencies identified in this survey be addressed.

  16. On the Effect of Online Formative Assessment on Iranian Lower Intermediate EFL Learners Reading Comprehension

    Directory of Open Access Journals (Sweden)

    Farideh Peyghambarian

    2015-03-01

    Full Text Available Online Formative Assessment (OFA improves EFL students’ reading comprehension enabling them to have a better performance in reading comprehension tests. To lend support to the above mentioned claim, a quasi-experimental study was conducted in Mashhad, Iran. 48 female lower intermediate EFL students took part in this study. Participants were assigned to control and treatment groups.  Participants in both groups received a formative assessment program lasting for 10 sessions. Formative assessment in treatment group was conducted by the site itself, and participants in control group were assessed by the teacher. It was found that participants in treatment group significantly outperformed those in control group. This finding indicated OFA as an effective learning tool in EFL reading comprehension classrooms.

  17. Towards meaningful stakeholder comprehension of sour gas facility risk assessments

    Energy Technology Data Exchange (ETDEWEB)

    McAuley, C.; Hrudey, S.E. [Alberta Univ., Edmonton, AB (Canada). Dept. of Public Health Sciences

    2006-01-15

    This study addressed public concerns in Alberta regarding the development of sour gas projects that are in close proximity to established populations. In particular, it focused on the reasoning of different perspectives of risk assessment between proponents of a sour gas development and the stakeholders affected. The main issues reviewed in this study were the toxicity of hydrogen sulphide and the toxic load models; the specifics of risk assessment and the risk estimation associated with pipeline failures; hazard distances associated with various end-points and set-back distances; the uncertainty that a pipeline failure will occur somewhere; a comparison of other risk scenarios where there are unknown exposure populations; risk management and risk issue management for pipeline failures; the evaluation of risk communication and validation of risk reduction measures and the issue of which risks could provide a useful basis for comparison in discussion about risk acceptability. It was noted that although zero risk is impossible, it was suggested that a better communication and understanding of the health affects of hydrogen sulphide and the toxic load concept in both public and regulatory forums would reduce uncertainty in health risk estimates associated with sour gas pipeline failures. 36 refs., 3 tabs.

  18. FLS and FES: comprehensive models of training and assessment.

    Science.gov (United States)

    Vassiliou, Melina C; Dunkin, Brian J; Marks, Jeffrey M; Fried, Gerald M

    2010-06-01

    The Fundamentals of Laparoscopic surgery (FLS) is a validated program for the teaching and evaluation of the basic knowledge and skills required to perform laparoscopic surgery. The educational component includes didactic, Web-based material and a simple, affordable physical simulator with specific tasks and a recommended curriculum. FLS certification requires passing a written multiple-choice examination and a proctored manual skills examination in the FLS simulator. The metrics for the FLS program have been rigorously validated to meet the highest educational standards, and certification is now a requirement for the American Board of Surgery. This article summarizes the validation process and the FLS-related research that has been done to date. The Fundamentals of Endoscopic Surgery is a program modeled after FLS with a similar mission for flexible endoscopy. It is currently in the final stages of development and will be launched in April 2010. The program also includes learning and assessment components, and is undergoing the same meticulous validation process as FLS. These programs serve as models for the creation of simulation-based tools to teach skills and assess competence with the intention of optimizing patient safety and the quality of surgical education.

  19. Peracetic acid for secondary effluent disinfection: a comprehensive performance assessment.

    Science.gov (United States)

    Antonelli, M; Turolla, A; Mezzanotte, V; Nurizzo, C

    2013-01-01

    The paper is a review of previous research on secondary effluent disinfection by peracetic acid (PAA) integrated with new data about the effect of a preliminary flash-mixing step. The process was studied at bench and pilot scale to assess its performance for discharge in surface water and agricultural reuse (target microorganisms: Escherichia coli and faecal coliform bacteria). The purposes of the research were: (1) determining PAA decay and disinfection kinetics as a function of operating parameters, (2) evaluating PAA suitability as a disinfectant, (3) assessing long-term disinfection efficiency, (4) investigating disinfected effluent biological toxicity on some aquatic indicator organisms (Vibrio fischeri, Daphnia magna and Selenastrum capricornutum), (5) comparing PAA with conventional disinfectants (sodium hypochlorite, UV irradiation). PAA disinfection was capable of complying with Italian regulations on reuse (10 CFU/100 mL for E. coli) and was competitive with benchmarks. No regrowth phenomena were observed, as long as needed for agricultural reuse (29 h after disinfection), even at negligible concentrations of residual disinfectant. The toxic effect of PAA on the aquatic environment was due to the residual disinfectant in the water, rather than to chemical modification of the effluent.

  20. A comprehensive assessment of genioglossus electromyographic activity in healthy adults.

    Science.gov (United States)

    Vranish, Jennifer R; Bailey, E Fiona

    2015-04-01

    The genioglossus (GG) is an extrinsic muscle of the human tongue that plays a critical role in preserving airway patency. In the last quarter century, >50 studies have reported on respiratory-related GG electromyographic (EMG) activity in human subjects. Remarkably, of the studies performed, none have duplicated subject body position, electrode recording locations, and/or breathing task(s), making interpretation and integration of the results across studies extremely challenging. In addition, more recent research assessing lingual anatomy and muscle contractile properties has identified regional differences in muscle fiber type and myosin heavy chain expression, giving rise to the possibility that the anterior and posterior regions of the muscle fulfill distinct functions. Here, we assessed EMG activity in anterior and posterior regions of the GG, across upright and supine, in rest breathing and in volitionally modulated breathing tasks. We tested the hypotheses that GG EMG is greater in the posterior region and in supine, except when breathing is subject to volitional modulation. Our results show differences in the magnitude of EMG (%regional maximum) between anterior and posterior muscle regions (7.95 ± 0.57 vs. 11.10 ± 0.99, respectively; P EMG (P 0.2).

  1. Effect of comprehensive cardiac rehabilitation after heart valve surgery (CopenHeartVR): study protocol for a randomised clinical trial

    National Research Council Canada - National Science Library

    Sibilitz, Kirstine Laerum; Berg, Selina Kikkenborg; Hansen, Tina Birgitte; Risom, Signe Stelling; Rasmussen, Trine Bernholdt; Hassager, Christian; Køber, Lars; Steinbrüchel, Daniel; Gluud, Christian; Winkel, Per; Thygesen, Lau Caspar; Hansen, Jane Lindschou; Schmid, Jean Paul; Conraads, Viviane; Brocki, Barbara Christina; Zwisler, Ann-Dorthe

    2013-01-01

    .... We hypothesise that a comprehensive cardiac rehabilitation programme can improve physical capacity and self-assessed mental health and reduce hospitalisation and healthcare costs after heart valve surgery...

  2. CRITICAL ANALYSIS OF THE MATHEMATICAL RELATIONSHIPS AND COMPREHENSIVENESS OF LIFE CYCLE IMPACT ASSESSMENT APPROACHES

    Science.gov (United States)

    The impact assessment phase of Life Cycle Assessment (LCA) has received much criticism due to lack of consistency. ISO 14042 requires selection of impact categories that “reflect a comprehensive set of environmental issues” related to the system being studied, especi...

  3. The Impact of the 2004 Hurricanes on Florida Comprehensive Assessment Test Scores: Implications for School Counselors

    Science.gov (United States)

    Baggerly, Jennifer; Ferretti, Larissa K.

    2008-01-01

    What is the impact of natural disasters on students' statewide assessment scores? To answer this question, Florida Comprehensive Assessment Test (FCAT) scores of 55,881 students in grades 4 through 10 were analyzed to determine if there were significant decreases after the 2004 hurricanes. Results reveal that there was statistical but no practical…

  4. Measuring New Media Literacies: Towards the Development of a Comprehensive Assessment Tool

    Science.gov (United States)

    Literat, Ioana

    2014-01-01

    This study assesses the psychometric properties of a newly tested self-report assessment tool for media literacy, based on the twelve new media literacy skills (NMLs) developed by Jenkins et al. (2006). The sample (N = 327) consisted of normal volunteers who completed a comprehensive online survey that measured their NML skills, media exposure,…

  5. Developing a Test for Assessing Elementary Students' Comprehension of Science Texts

    Science.gov (United States)

    Wang, Jing-Ru; Chen, Shin-Feng; Tsay, Reuy-Fen; Chou, Ching-Ting; Lin, Sheau-Wen; Kao, Huey-Lien

    2012-01-01

    This study reports on the process of developing a test to assess students' reading comprehension of scientific materials and on the statistical results of the verification study. A combination of classic test theory and item response theory approaches was used to analyze the assessment data from a verification study. Data analysis indicates the…

  6. Investigating Form Comparability in the Idaho Comprehensive Literacy Assessment: Matters of Fairness and Transparency

    Science.gov (United States)

    Squires, David; Trevisan, Michael S.; Canney, George F.

    2006-01-01

    The Idaho Comprehensive Literacy Assessment (ICLA) is a faculty-developed, state-wide, high-stakes assessment of pre-service teachers' knowledge and application of research based literacy practices. The literacy faculty control all aspects of the test, including construction, refinement, administration, scoring and reporting. The test development…

  7. The Effect of Dynamic Assessment on Iranian EFL Learners' Reading Comprehension

    Science.gov (United States)

    Amirian, Mohammad Reza; Davoudi, Mohammad; Ramazanian, Mohsen

    2014-01-01

    Dynamic Assessment (DA), is grounded in Vygotsky's idea on Sociocultural Theory (SCT) of mind, his concept of Zone of Proximal Development (ZPD) and its related metaphor; scaffolding. This study examined the effects of dynamic assessment on improving reading comprehension of Iranian intermediate students who were learning English as a foreign…

  8. CRITICAL ANALYSIS OF THE MATHEMATICAL RELATIONSHIPS AND COMPREHENSIVENESS OF LIFE CYCLE IMPACT ASSESSMENT APPROACHES

    Science.gov (United States)

    The impact assessment phase of Life Cycle Assessment (LCA) has received much criticism due to lack of consistency. ISO 14042 requires selection of impact categories that “reflect a comprehensive set of environmental issues” related to the system being studied, especi...

  9. Integrative Consensus: A Systematic Approach to Integrating Comprehensive Assessment Data for Young Children with Behavior Problems

    Science.gov (United States)

    Shernoff, Elisa S.; Hill, Carri; Danis, Barbara; Leventhal, Bennett L.; Wakschlag, Lauren S.

    2014-01-01

    Comprehensive assessments that include parents and teachers are essential when assessing young children vulnerable to emotional and behavioral problems given the multiple systems and contexts that influence and support optimal development (U. Bronfenbrenner & P. A. Morris, 2006; M. J. Guralnick, 2011). However, more data complicate clinical…

  10. TOXIC SUBSTANCES FROM COAL COMBUSTION-A COMPREHENSIVE ASSESSMENT

    Energy Technology Data Exchange (ETDEWEB)

    C.L. Senior; F. Huggins; G.P. Huffman; N. Shah; N. Yap; J.O.L. Wendt; W. Seames; M.R. Ames; A.F. Sarofim; S. Swenson; J.S. Lighty; A. Kolker; R. Finkelman; C.A. Palmer; S.J. Mroczkowski; J.J. Helble; R. Mamani-Paco; R. Sterling; G. Dunham; S. Miller

    2001-06-30

    UU focused on the behavior of trace metals in the combustion zone by studying vaporization from single coal particles. The coals were burned at 1700 K under a series of fuel-rich and oxygen-rich conditions. The data collected in this study will be applied to a model that accounts for the full equilibrium between carbon monoxide and carbon dioxide. The model also considers many other reactions taking place in the combustion zone, and involves the diffusion of gases into the particle and combustion products away from the particle. A comprehensive study has been conducted at UA to investigate the post-combustion partitioning of trace elements during large-scale combustion of pulverized coal combustion. For many coals, there are three distinct particle regions developed by three separate mechanisms: (1) a submicron fume, (2) a micron-sized fragmentation region, and (3) a bulk (>3 {micro}m) fly ash region. The controlling partitioning mechanisms for trace elements may be different in each of the three particle regions. A substantial majority of semi-volatile trace elements (e.g., As, Se, Sb, Cd, Zn, Pb) volatilize during combustion. The most common partitioning mechanism for semi-volatile elements is reaction with active fly ash surface sites. Experiments conducted under this program at UC focused on measuring mercury oxidation under cooling rates representative of the convective section of a coal-fired boiler to determine the extent of homogeneous mercury oxidation under these conditions. In fixed bed studies at EERC, five different test series were planned to evaluate the effects of temperature, mercury concentration, mercury species, stoichiometric ratio of combustion air, and ash source. Ash samples generated at UA and collected from full-scale power plants were evaluated. Extensive work was carried out at UK during this program to develop new methods for identification of mercury species in fly ash and sorbents. We demonstrated the usefulness of XAFS spectroscopy for

  11. TOXIC SUBSTANCES FROM COAL COMBUSTION-A COMPREHENSIVE ASSESSMENT

    Energy Technology Data Exchange (ETDEWEB)

    C.L. Senior; F. Huggins; G.P. Huffman; N. Shah; N. Yap; J.O.L. Wendt; W. Seames; M.R. Ames; A.F. Sarofim; S. Swenson; J.S. Lighty; A. Kolker; R. Finkelman; C.A. Palmer; S.J. Mroczkowski; J.J. Helble; R. Mamani-Paco; R. Sterling; G. Dunham; S. Miller

    2001-06-30

    UU focused on the behavior of trace metals in the combustion zone by studying vaporization from single coal particles. The coals were burned at 1700 K under a series of fuel-rich and oxygen-rich conditions. The data collected in this study will be applied to a model that accounts for the full equilibrium between carbon monoxide and carbon dioxide. The model also considers many other reactions taking place in the combustion zone, and involves the diffusion of gases into the particle and combustion products away from the particle. A comprehensive study has been conducted at UA to investigate the post-combustion partitioning of trace elements during large-scale combustion of pulverized coal combustion. For many coals, there are three distinct particle regions developed by three separate mechanisms: (1) a submicron fume, (2) a micron-sized fragmentation region, and (3) a bulk (>3 {micro}m) fly ash region. The controlling partitioning mechanisms for trace elements may be different in each of the three particle regions. A substantial majority of semi-volatile trace elements (e.g., As, Se, Sb, Cd, Zn, Pb) volatilize during combustion. The most common partitioning mechanism for semi-volatile elements is reaction with active fly ash surface sites. Experiments conducted under this program at UC focused on measuring mercury oxidation under cooling rates representative of the convective section of a coal-fired boiler to determine the extent of homogeneous mercury oxidation under these conditions. In fixed bed studies at EERC, five different test series were planned to evaluate the effects of temperature, mercury concentration, mercury species, stoichiometric ratio of combustion air, and ash source. Ash samples generated at UA and collected from full-scale power plants were evaluated. Extensive work was carried out at UK during this program to develop new methods for identification of mercury species in fly ash and sorbents. We demonstrated the usefulness of XAFS spectroscopy for

  12. Clinical effects of comprehensive therapy of early psychological intervention and rehabilitation training on neurological rehabilitation of patients with acute stroke

    Institute of Scientific and Technical Information of China (English)

    Duo-Yu Wu; Min Guo; Yun-Suo Gao; Yan-Hai Kang; Jun-Cheng Guo; Xiang-Ling Jiang; Feng Chen; Tao Liu

    2012-01-01

    Objective: To evaluate the clinical effects of comprehensive therapy of psychological intervention and rehabilitation training on the mental health of the patients with acute stroke. Methods: A total of 120 patients with acute stroke were randomly divided into trial group and control group. Both groups were given the corresponding drug therapy, medical basic nursing and convention nursing. Besides, psychological intervention and comprehensive rehabilitation training were added to the trial group. SCL-90, Europ stroke scales (ESS) score were assessed with each patient on day 3 for the first time and on day 21 for the second time;Barthel index was assessed on the day 90. Results: After psychological intervention, SCL-90 declined significantly in the trial group comparing with the control group, there were signicant differences in the somatization, obsession, depression, anxiety, fear, ESS score, Barthel index and other psychological factors between the trial group and control group (P<0.05). Conclusions:Comprehensive therapy of early psychological intervention and rehabilitation training can significantly improve the mental health, limb movement function, stress ability and activity of daily living on the patients with acute stroke.

  13. Clinical swallowing assessment in intensive care unit.

    Science.gov (United States)

    Padovani, Aline Rodrigues; Moraes, Danielle Pedroni; Sassi, Fernanda Chiarion; Andrade, Claudia Regina Furquim de

    2013-01-01

    To report the results of the full clinical swallowing assessment in acute-care population in a large Brazilian teaching hospital. A prospective, descriptive clinical study was conducted during three months in a 30-bed adult clinical emergency ICU from a large Brazilian teaching hospital. Thirty-five patients consecutively referred to the Speech-Language Pathology Service according to our standard clinical practice were included. A full clinical swallowing assessment was completed and includes a Preliminary Assessment Protocol (PAP), a Dysphagia Risk Evaluation Protocol (DREP) and an Oral Feeding Transition Protocol (OFTP). In this study, the prevalence of OD in the ICU setting was of 63%, most of which were classified as moderate and moderate-severe (39%). Patients submitted to orotracheal intubation were very frequently referred to swallowing assessment (74%). The results of the statistical analyses revealed clinical indicators that could correctly classify patients as either having or not having OD on clinical tests. These include cough strength, coordination between breathing and speaking, dysphonia severity, and laryngeal elevation. Twenty six patients (74%) completed all protocols. Of these total, 38% were able to eat a regular diet. The practice with standardized protocols adds an important option for the management of oropharyngeal dysphagia in intensive care unit.

  14. AUTHENTIC ASSESSMENT IN LITERAL AND INFERENTIAL READING COMPREHENSION FOR UNIVERSITY STUDENTS

    OpenAIRE

    Dwi Fita Heriyawati

    2015-01-01

    The teaching of English as a foreign language in Indonesia is widely developed time to time. In the teaching of English, reading comprehension has an important role, because through reading the text the students will acquire the knowledge of science and technology. Furthermore, the teachers have also have to measure the students’ performance in comprehending the reading text. The use of authentic assessment in the literal and inferential reading comprehension can help the students and also th...

  15. Comprehensive assessment of gesture production: a new test of upper limb apraxia (TULIA).

    Science.gov (United States)

    Vanbellingen, T; Kersten, B; Van Hemelrijk, B; Van de Winckel, A; Bertschi, M; Müri, R; De Weerdt, W; Bohlhalter, S

    2010-01-01

    Only few standardized apraxia scales are available and they do not cover all domains and semantic features of gesture production. Therefore, the objective of the present study was to evaluate the reliability and validity of a newly developed test of upper limb apraxia (TULIA), which is comprehensive and still short to administer. The TULIA consists of 48 items including imitation and pantomime domain of non-symbolic (meaningless), intransitive (communicative) and transitive (tool related) gestures corresponding to 6 subtests. A 6-point scoring method (0-5) was used (score range 0-240). Performance was assessed by blinded raters based on videos in 133 stroke patients, 84 with left hemisphere damage (LHD) and 49 with right hemisphere damage (RHD), as well as 50 healthy subjects (HS). The clinimetric findings demonstrated mostly good to excellent internal consistency, inter- and intra-rater (test-retest) reliability, both at the level of the six subtests and at individual item level. Criterion validity was evaluated by confirming hypotheses based on the literature. Construct validity was demonstrated by a high correlation (r = 0.82) with the De Renzi-test. These results show that the TULIA is both a reliable and valid test to systematically assess gesture production. The test can be easily applied and is therefore useful for both research purposes and clinical practice.

  16. Teaching and Assessing Clinical Reasoning Skills.

    Science.gov (United States)

    Modi, Jyoti Nath; Anshu; Gupta, Piyush; Singh, Tejinder

    2015-09-01

    Clinical reasoning is a core competency expected to be acquired by all clinicians. It is the ability to integrate and apply different types of knowledge, weigh evidence critically and reflect upon the process used to arrive at a diagnosis. Problems with clinical reasoning often occur because of inadequate knowledge, flaws in data gathering and improper approach to information processing. Some of the educational strategies which can be used to encourage acquisition of clinical reasoning skills are: exposure to a wide variety of clinical cases, activation of previous knowledge, development of illness scripts, sharing expert strategies to arrive at a diagnosis, forcing students to prioritize differential diagnoses; and encouraging reflection, metacognition, deliberate practice and availability of formative feedback. Assessment of clinical reasoning abilities should be done throughout the training course in diverse settings. Use of scenario based multiple choice questions, key feature test and script concordance test are some ways of theoretically assessing clinical reasoning ability. In the clinical setting, these skills can be tested in most forms of workplace based assessment. We recommend that clinical reasoning must be taught at all levels of medical training as it improves clinician performance and reduces cognitive errors.

  17. Comprehension of Randomization and Uncertainty in Cancer Clinical Trials Decision Making Among Rural, Appalachian Patients.

    Science.gov (United States)

    Krieger, Janice L; Palmer-Wackerly, Angela; Dailey, Phokeng M; Krok-Schoen, Jessica L; Schoenberg, Nancy E; Paskett, Electra D

    2015-12-01

    Comprehension of randomization is a vital, but understudied, component of informed consent to participate in cancer randomized clinical trials (RCTs). This study examines patient comprehension of the randomization process as well as sources of ongoing uncertainty that may inhibit a patient's ability to provide informed consent to participate in RCTs. Cancer patients living in rural Appalachia who were offered an opportunity to participate in a cancer treatment RCT completed in-depth interviews and a brief survey. No systematic differences in randomization comprehension between patients who consented and those who declined participation in a cancer RCT were detected. Comprehension is conceptually distinct from uncertainty, with patients who had both high and low comprehension experiencing randomization-related uncertainty. Uncertainty about randomization was found to have cognitive and affective dimensions. Not all patients enrolling in RCTs have a sufficient understanding of the randomization process to provide informed consent. Healthcare providers need to be aware of the different types of randomization-related uncertainty. Efforts to improve informed consent to participate in RCTs should focus on having patients teach back their understanding of randomization. This practice could yield valuable information about the patient's cognitive and affective understanding of randomization as well as opportunities to correct misperceptions. Education about RCTs should reflect patient expectations of individualized care by explaining how all treatments being compared are appropriate to the specifics of a patient's disease.

  18. Towards a comprehensive climate impacts assessment of solar geoengineering

    Science.gov (United States)

    Irvine, Peter J.; Kravitz, Ben; Lawrence, Mark G.; Gerten, Dieter; Caminade, Cyril; Gosling, Simon N.; Hendy, Erica J.; Kassie, Belay T.; Kissling, W. Daniel; Muri, Helene; Oschlies, Andreas; Smith, Steven J.

    2017-01-01

    Despite a growing literature on the climate response to solar geoengineering—proposals to cool the planet by increasing the planetary albedo—there has been little published on the impacts of solar geoengineering on natural and human systems such as agriculture, health, water resources, and ecosystems. An understanding of the impacts of different scenarios of solar geoengineering deployment will be crucial for informing decisions on whether and how to deploy it. Here we review the current state of knowledge about impacts of a solar-geoengineered climate and identify the major research gaps. We suggest that a thorough assessment of the climate impacts of a range of scenarios of solar geoengineering deployment is needed and can be built upon existing frameworks. However, solar geoengineering poses a novel challenge for climate impacts research as the manner of deployment could be tailored to pursue different objectives making possible a wide range of climate outcomes. We present a number of ideas for approaches to extend the survey of climate impacts beyond standard scenarios of solar geoengineering deployment to address this challenge. Reducing the impacts of climate change is the fundamental motivator for emissions reductions and for considering whether and how to deploy solar geoengineering. This means that the active engagement of the climate impacts research community will be important for improving the overall understanding of the opportunities, challenges, and risks presented by solar geoengineering.

  19. Developing a comprehensive scale to assess college multicultural programming.

    Science.gov (United States)

    Mallinckrodt, Brent; Miles, Joseph R; Bhaskar, Tripti; Chery, Nicole; Choi, Gahee; Sung, Mi-Ra

    2014-01-01

    A barrier to assessing effectiveness of multicultural programming is lack of a relatively brief instrument to measure the wide range of intended outcomes. A frequent goal of programming is to increase cultural empathy, but this is rarely the only intended outcome. We conducted focus groups of campus administrators, student affairs staff, and undergraduate instructors who identified a full range of racial/ethnic multicultural competencies that undergraduates should possess. An 84-item pool generated from these focus groups was combined with the 31-item Scale of Ethnocultural Empathy (SEE; Wang et al., 2003). These 115 items, together with instruments used to gauge concurrent validity, were administered to White undergraduate students in introductory psychology courses at the midpoint (n = 602) and end (n = 676) of fall semester. Exploratory factor analysis suggested 6 subscales for the Everyday Multicultural Competencies/Revised SEE (EMC/RSEE): (a) Cultural Openness and Desire to Learn; (b) Resentment and Cultural Dominance; (c) Anxiety and Lack of Multicultural Self-Efficacy; (d) Empathic Perspective-Taking; (e) Awareness of Contemporary Racism and Privilege; and (f) Empathic Feeling and Acting as an Ally. Item response theory principles guided final selection of subscale items. Analyses suggested good factor stability, reliability, and discriminant validity of the 48-item EMC/RSEE in these undergraduate samples. EMC/RSEE subscales were not strongly correlated with a measure of impression management and were significantly associated with measures of Openness to Diversity Challenge, and Universal-Diverse Orientation.

  20. Cross-Cultural Reading Comprehension Assessment in Malay and English as It Relates to the Dagostino-Carifio Model of Reading Comprehension

    Science.gov (United States)

    Dagostino, Lorraine; Carifio, James; Bauer, Jennifer D. C.; Zhao, Qing

    2013-01-01

    The review of existing literature suggests that few researchers have adopted cross-language comparisons to explore how cultural background affects the assessment of reading comprehension of students. In this present study, the researchers independently reviewed and rated all the items of two reading comprehension tests translated from Malay into…

  1. Comprehensive assessment method for environmental impact of railway based on geographic information system

    Institute of Scientific and Technical Information of China (English)

    吴小萍; 陈秀方; 马超群; 杨晓宇; 冉茂平; 孟祥定

    2004-01-01

    By integrating the merits of the map overlay method and the geographic information system (GIS), a GIS based map overlay method was developed to analyze comprehensively the environmental vulnerability around railway and its impact on the environment, which is adapted for the comprehensive assessment of railway environmental impact and the optimization of railway alignments. The assessment process of the GIS based map overlay method was presented, which includes deciding the system structure and weights of assessment factors, making environmental vulnerability grade maps, and evaluating the alternative alignments comprehensively to obtain the best one. With the GIS functions of spatial analysis, such as overlay analysis and buffer analysis, and functions of handling attribute data, the GIS based map overlay method overcomes the shortcomings of the existing map overlay method and the conclusion is more reasonable. In the end, a detailed case study was illustrated to verify the efficiency of the method.

  2. THE OBJECTIVE ANALOGUE PREDICTION MODEL FOR TROPICAL CYCLONE TRACK WITH COMPREHENSIVE ASSESSMENT OF THE ENVIRONMENT

    Institute of Scientific and Technical Information of China (English)

    钟元

    2002-01-01

    An objective analogue prediction model for tropical cyclone (TC) track is put forward that comprehensively assesses the environmental field. With the parameters of the tropical cyclone and environmental field at initial and future time, objective analogue criteria are set up in the model. Analogous samples are recognized by comprehensive assessment of historical TC cases for similarity with multivariate criteria, using non-linear analogue indexes especially defined for the purpose. When the historical tracks are coordinateconverted and weighted with reference to analogue indexes, forecast tracks are determined. As shown in model verification and forecast experiments, the model has forecasting skill.

  3. The clinical viva: an assessment of clinical thinking.

    Science.gov (United States)

    Roberts, Debbie

    2013-04-01

    In order to enable Masters level pre-registration students to demonstrate sophisticated cognitive abilities, integration of knowledge, complex problem solving, critical opinion, lateral thinking and innovative action; an innovative assessment tool is required (Sadler, 2009). A clinical viva was devised to enable third year students in their final transitional placement prior to qualifying demonstrate both the art and science of nursing practice. The assessment combines some of the viva element of an Australian assessment model described by Levett-Jones et al. (2011), together with the think aloud approach suggested by Banning (2008); whereby the think aloud model acts as a catalyst for eliciting students' understandings and knowledge and the SOAP model is a mechanism for the assessment of students' understandings and knowledge. Rust (2002) calls for students to be afforded opportunities for regular formative feedback; therefore, the assessment includes a replica formative assessment, one week prior to the summative assessment. This formative test prevents assessment being seen as a snapshot of the student's development and encourages assessment for learning and is an approach which is suggested to discourage surface learning (Rust, 2002). A holistic rubric was developed in an attempt to capture the students' abilities against the six cognitive operators or heuristics suggested by Banning (2008). Open-ended questions were devised to be asked of the students as advocated by Levett-Jones et al. (2011), to uncover the student's cognitive abilities, integration of knowledge, complex problem solving, critical opinion, lateral thinking and innovative action. Roberts (2011) calls for new and innovative ways of assessing student learning which bridges the artificial divide between theory and practice and enables students to demonstrate both the art and science of nursing practice (p610). The clinical viva has the potential to be one such mechanism.

  4. Assessing registered nurses' clinical skills in orthopaedics.

    Science.gov (United States)

    Clarke, Sonya; McDonald, Sinead; Rainey, Debbie

    The aim of this article is to explore the views of registered nurses undertaking the new Objective Structured Clinical Examination (OSCE), incorporating an integrated preparatory skills workshop. The workshop and the OSCE were audited with particular regard to the student experience. This article describes the audit process and the results of three questionnaires: one carried out before the OSCE assessment, a second immediately after the workshop and a third four days after the assessment. The results provide an insight into the student experience.

  5. Metaphor-related figurative language comprehension in clinical populations: a critical review

    Directory of Open Access Journals (Sweden)

    Maity Siqueira

    2016-12-01

    Full Text Available This paper aims to critically review current studies with respect to definitions,methods, and results on the comprehension of metaphor, metonymy,idioms, and proverbs under the following clinical conditions: aphasia,Alzheimer’s disease, autism, brain injuries, specific language impairment,and Williams Syndrome. A comprehensive search of experimentalpsycholinguistic research was conducted using EBSCOhost, PsychInfo,PUBMED, and Web of Science databases. Thirty-eight studies met thereview inclusion criteria. Results point to deficits in figurative languagecomprehension in all conditions considered, lack of clear definitions ofthe phenomena investigated, and varied methods throughout the sample.Patients’ difficulties are attributed to multiple factors, such as a lack ofTheory of Mind, executive dysfunctions, and poor semantic knowledge.The study of nonliteral aspects of language comprehension in clinicalpopulations reveals a range of disparate impairments. There was no specificfeature about metaphor-related phenomena identified that could, on its own,account for the difficulty some populations have to understand figurativelanguage. Rather, metaphor-related language comprehension difficultiesare often part of pragmatic, linguistic, and/or cognitive impairments.Keywords: Figurative language. Metaphor. Metonymy. Proverb. Clinicalpopulations

  6. Use of clinical simulation for assessment in EHR-procurement

    DEFF Research Database (Denmark)

    Jensen, Sanne; Rasmussen, Stine L.; Lyng, Karen M.

    2013-01-01

    design methods are widely described, there are very limited descriptions of how to assess and compare different EHR-platforms and their support in work processes upon its procurement. This paper describes the method we have developed to undertake this task. It is discussed how the method differs and how......In Denmark, two large regions cooperate in a public intervention process of acquiring a new eHealth-platform to support the daily clinical work of approximately 40,000 users in 14 hospitals. It is essential that the new platform, besides fulfilling comprehensive detailed specifications, supports...... the daily work practice consisting of numerous mixed tasks executed by many different clinical actors in various settings. Within health informatics it has proven beneficial to use human factors approaches in the design process to secure systems that are responsive to the actual field of application. While...

  7. Integration of comprehensive abortion‐care services in a Maternal and Child Health clinic in Cambodia

    National Research Council Canada - National Science Library

    Delvaux, Thérèse; Sœur, Sophal; Rathavy, Tung; Crabbé, François; Buvé, Anne

    2008-01-01

    Objectives  To document the pilot experience of provision of safe abortion/post‐abortion services implemented in 2002 at the Mother Child Health clinic in Sihanoukville, Cambodia, and to profile clients and assess their uptake of post...

  8. Personality Assessment Use by Clinical Neuropsychologists

    Science.gov (United States)

    Smith, Steven R.; Gorske, Tad T.; Wiggins, Chauntel; Little, Jessica A.

    2010-01-01

    The present study is an exploration of the personality assessment practices of clinical neuropsychologists. Professional members of the National Academy of Neuropsychology and the International Neuropsychological Society (N = 404) were surveyed to examine use of several forms of personality, behavior, and emotional function measures. Results…

  9. Mapping and assessing clinical handover training interventions

    NARCIS (Netherlands)

    Stoyanov, Slavi; Boshuizen, Els; Groene, Oliver; Van der Klink, Marcel; Kicken, Wendy; Drachsler, Hendrik; Barach, Paul

    2013-01-01

    Stoyanov, S., Boshuizen, H. P. A., Groene, O., Van der Klink, M., Kicken, W., Drachsler, H., & Barach, P. (2012). Mapping and assessing clinical handover training interventions. British Medical Journal Quality & Safety, 21, i50-i57. doi:10.1136/bmjqs-2012-001169

  10. Triangular model integrating clinical teaching and assessment.

    Science.gov (United States)

    Abdelaziz, Adel; Koshak, Emad

    2014-01-01

    Structuring clinical teaching is a challenge facing medical education curriculum designers. A variety of instructional methods on different domains of learning are indicated to accommodate different learning styles. Conventional methods of clinical teaching, like training in ambulatory care settings, are prone to the factor of coincidence in having varieties of patient presentations. Accordingly, alternative methods of instruction are indicated to compensate for the deficiencies of these conventional methods. This paper presents an initiative that can be used to design a checklist as a blueprint to guide appropriate selection and implementation of teaching/learning and assessment methods in each of the educational courses and modules based on educational objectives. Three categories of instructional methods were identified, and within each a variety of methods were included. These categories are classroom-type settings, health services-based settings, and community service-based settings. Such categories have framed our triangular model of clinical teaching and assessment.

  11. Enhanced Performance of the Eurostat Method for Comprehensive Assessment of Urban Metabolism

    NARCIS (Netherlands)

    Voskamp, Ilse M.; Stremke, Sven; Spiller, Marc; Perrotti, Daniela; Hoek, van der Jan Peter; Rijnaarts, Huub H.M.

    2016-01-01

    Sustainable urban resource management depends essentially on a sound understanding of a city's resource flows. One established method for analyzing the urban metabolism (UM) is the Eurostat material flow analysis (MFA). However, for a comprehensive assessment of the UM, this method has its limita

  12. Assessing the Depth and Breadth of Vocabulary Knowledge with Listening Comprehension

    Science.gov (United States)

    Teng, Feng

    2014-01-01

    This study was inspired by Qian (1999) and Staehr (2009) and researched 88 Chinese learners who had already passed the College English Test 4 (CET). These learners volunteered to participate in the study regarding the depth and breadth of vocabulary knowledge and its relationship with listening comprehension, which was assessed by analyzing the…

  13. Comprehensive assessment of depression and behavioral problems in long-term care.

    NARCIS (Netherlands)

    Koopmans, R.T.C.M.; Zuidema, S.U.; Leontjevas, R.; Gerritsen, D.L.

    2010-01-01

    BACKGROUND: The IPA Taskforce on Mental Health Issues in Long-Term Care Homes seeks to improve mental health care in long-term care (LTC) homes. The aim of this paper is to provide recommendations on comprehensive assessment of depression and behavioral problems in order to further stimulate countri

  14. Comprehensive assessment of depression and behavioral problems in long-term care

    NARCIS (Netherlands)

    Koopmans, Raymond T C M; Zuidema, Sytse U; Leontjevas, Roeslan; Gerritsen, Debby L

    2010-01-01

    BACKGROUND: The IPA Taskforce on Mental Health Issues in Long-Term Care Homes seeks to improve mental health care in long-term care (LTC) homes. The aim of this paper is to provide recommendations on comprehensive assessment of depression and behavioral problems in order to further stimulate countri

  15. The Impact of Portfolio Assessment on EFL Learners' Reading Comprehension Ability

    Science.gov (United States)

    Charvade, Mahshid Rostami; Jahandar, Shahrokh; Khodabandehlou, Morteza

    2012-01-01

    The aim of this study is to investigate the effectiveness of portfolio assessment on EFL learners' reading comprehension ability. 50 EFL language learners at intermediate level all female from a private institute were selected for this purpose. Then they were randomly divided into the control and experimental group. The control group received the…

  16. Application of the Fuzzy Comprehensive Assessment Technique to Optimal Selection of Pipeline Design Alternative

    Institute of Scientific and Technical Information of China (English)

    ChuFeixue; ChuYanfan; LiuXiumin

    2005-01-01

    Regarding the influencing factors in an optimal selection of pipeline design alternative as fuzzy variables with different weights, a fuzzy comprehensive assessment was applied to an optimal selection of the design alternative. Giving the Lanzhou-Chengdu pipeline as an example to explain the process, the result shows that this method is acceptable.

  17. Two Steps Forward, Three Steps Back: The Stormy History of Reading Comprehension Assessment.

    Science.gov (United States)

    Sarroub, Loukia; Pearson, P. David

    1998-01-01

    Examines the historical course of reading-comprehension assessment practices over 25 years (from the 1970s to the mid-1990s), examining changing views of reading processes, practices, and policies. Characterizes progress in terms of political and practical constraints. Finds that, although very different formats are used today, the functions of…

  18. A shoulder pain score : A comprehensive questionnaire for assessing pain in patients with shoulder complaints

    NARCIS (Netherlands)

    Winters, JC; Sobel, JS; Groenier, KH; Arendzen, JH; MeyboomDeJong, B

    1996-01-01

    This study describes the validation and application of a comprehensive questionnaire (the shoulder pain score) in assessing pain experienced by patients with shoulder complaints. The shoulder pain score comprised six pain symptom questions selected from the literature, together with a 101-Numerical

  19. FL State Profile. Florida: Florida Comprehensive Assessment Test[R] (FCAT)

    Science.gov (United States)

    Center on Education Policy, 2010

    2010-01-01

    This paper provides information about the Florida Comprehensive Assessment Test[R] (FCAT). The purpose of the exam is to: (1) Determine prospective high school graduates' mastery of the state curriculum; (2) Encourage districts and schools to identify and serve students at risk of academic failure; (3) Provide data to state policymakers on student…

  20. The Role of Reading Comprehension in Large-Scale Subject-Matter Assessments

    Science.gov (United States)

    Zhang, Ting

    2013-01-01

    This study was designed with the overall goal of understanding how difficulties in reading comprehension are associated with early adolescents' performance in large-scale assessments in subject domains including science and civic-related social studies. The current study extended previous research by taking a cognition-centered approach based on…

  1. Assessing reading comprehension in adolescent low achievers : Subskills identification and task specificity

    NARCIS (Netherlands)

    van Steensel, R.; Oostdam, R.; van Gelderen, A.

    2013-01-01

    On the basis of a validation study of a new test for assessing low-achieving adolescents’ reading comprehension skills – the SALT-reading – we analyzed two issues relevant to the field of reading test development. Using the test results of 200 seventh graders, we examined the possibility of

  2. Comprehensive geriatric assessment : recognition of identified geriatric conditions by community-dwelling older persons

    NARCIS (Netherlands)

    van Rijn, Marjon; Suijker, Jacqueline J; Bol, Wietske; Hoff, Eva; Ter Riet, Gerben; de Rooij, Sophia E; Moll van Charante, Eric P; Buurman, Bianca M

    2016-01-01

    OBJECTIVES: to study (i) the prevalence of geriatric conditions in community-dwelling older persons at increased risk of functional decline and (ii) the extent to which older persons recognise comprehensive geriatric assessment (CGA)-identified conditions as relevant problems. METHODS: trained regis

  3. The Telephone Interview for Cognitive Status (Modified) : Relation with a comprehensive neuropsychological assessment

    NARCIS (Netherlands)

    van den Berg, Esther; Ruis, Carla; Biessels, Geert Jan; Kappelle, L. Jaap; van Zandvoort, Martine J. E.

    2012-01-01

    The modified Telephone Interview for Cognitive Status (TICS-m) is a widely used screening instrument for (Alzheimer's) dementia. Psychometric evaluation of the TICS-m is limited. This study examined the relation between the TICS-m and a comprehensive neuropsychological assessment in older persons (n

  4. Assessing Students – Clinical Competence Versus Performance

    Directory of Open Access Journals (Sweden)

    John Ruedy

    2007-06-01

    Full Text Available The recent elaboration of the range of physiciancompetencies upon which the quality of health care isdependent has fostered the development of a variety ofmethods of assessing medical student competencies andperformance. Such assessments are essential inproviding feedback to students to guide their learningand to faculty on the success of the curriculum inachieving competency outcomes. In addition theyprovide evidence that students have achieved minimumrequirements for progressing. Well-designed ObservedStructured Clinical Examinations (OSCEs, MiniClinical Examinations (Mini-CEXs and some forms ofMulti-Source Feedback (MSF can meet acceptablestandards of validity and reliability and are feasible.Competency assessments are limited in predicting howa student will actually act in the work situationparticularly in humanistic skills. More emphasis needsto be placed on student performance, in suchcompetencies as communication and professionalism, ina variety of settings by a number of observers.

  5. Reading Assessment Methods for Middle-School Students: An Investigation of Reading Comprehension Rate and Maze Accurate Response Rate

    Science.gov (United States)

    Hale, Andrea D.; Henning, Jaime B.; Hawkins, Renee O.; Sheeley, Wesley; Shoemaker, Larissa; Reynolds, Jennifer R.; Moch, Christina

    2011-01-01

    This study was designed to investigate the validity of four different aloud reading comprehension assessment measures: Maze, comprehension questions, Maze accurate response rate (MARR), and reading comprehension rate (RCR). The criterion measures used in this study were the Woodcock-Johnson III Tests of Achievement (WJ-III ACH) Broad Reading…

  6. A Comprehensive Program for the Enhancement of Accrual to Clinical Trials.

    Science.gov (United States)

    Porter, Mark; Ramaswamy, Bhuvaneswari; Beisler, Karen; Neki, Poonam; Single, Nancy; Thomas, James; Hofacker, Janie; Caligiuri, Michael; Carson, William E

    2016-07-01

    The Ohio State University Comprehensive Cancer Center (OSUCCC) embarked on a single institution campaign over 2 years to enhance the enrollment of cancer patients into therapeutic clinical trials. The goal of this campaign was to achieve a 40 % increase in accrual over a 2-year period. The entire process of accruing patients to clinical trials at the OSUCCC was carefully evaluated and broken down into several interlocking components. The four key areas of emphasis were as follows: (i) tasking of OSUCCC leadership with increased oversight of the entire process; (ii) education of all stakeholders [patients, their families, nurses and staff, physicians (both internal and external), Disease-Specific Committees (DSCs), and the OSUCCC leadership] as to the purpose, advantages, and availability of clinical trials, with an emphasis on accrual to cancer clinical trials (CCTs) being a critical function of all OSUCCC employees; (iii) increased oversight of the portfolio of clinical trials by DSCs; and (iv) optimization of accrual operations and infrastructure center-wide. The accrual goal was achieved a full 4 months ahead of schedule. In total, 2327 patients were accrued to therapeutic clinical trials over the course of this 2-year campaign. Prior to implementation of the accrual program, the accrual rate was consistently below 15 %. From 2009 onwards, the therapeutic accrual rate was always greater than 25 %. A campaign to educate key stakeholders in the clinical trials accrual process was successful in its goal of increasing accrual to therapeutic trials.

  7. Clinical outcomes assessment in clinical trials to assess treatment of femoroacetabular impingement

    DEFF Research Database (Denmark)

    Harris-Hayes, Marcie; McDonough, Christine M; Leunig, Michael

    2013-01-01

    Patient-reported outcome measures are an important component of outcomes assessment in clinical trials to assess the treatment of femoroacetabular impingement (FAI). This review of disease-specific measures and instruments used to assess the generic quality of life and physical activity levels...

  8. An analysis of clinical reasoning through a recent and comprehensive approach: the dual-process theory

    Directory of Open Access Journals (Sweden)

    Thierry Pelaccia

    2011-03-01

    Full Text Available Context. Clinical reasoning plays a major role in the ability of doctors to make diagnoses and decisions. It is considered as the physician's most critical competence, and has been widely studied by physicians, educationalists, psychologists and sociologists. Since the 1970s, many theories about clinical reasoning in medicine have been put forward.Purpose. This paper aims at exploring a comprehensive approach: the “dual-process theory”, a model developed by cognitive psychologists over the last few years.Discussion. After 40 years of sometimes contradictory studies on clinical reasoning, the dual-process theory gives us many answers on how doctors think while making diagnoses and decisions. It highlights the importance of physicians’ intuition and the high level of interaction between analytical and non-analytical processes. However, it has not received much attention in the medical education literature. The implications of dual-process models of reasoning in terms of medical education will be discussed.

  9. Information warehouse - a comprehensive informatics platform for business, clinical, and research applications.

    Science.gov (United States)

    Kamal, Jyoti; Liu, Jianhua; Ostrander, Michael; Santangelo, Jennifer; Dyta, Ravi; Rogers, Patrick; Mekhjian, Hagop S

    2010-11-13

    Since its inception in 1997, the IW (Information Warehouse) at the Ohio State University Medical Center (OSUMC) has gradually transformed itself from a single purpose business decision support system to a comprehensive informatics platform supporting basic, clinical, and translational research. The IW today is the combination of four integrated components: a clinical data repository containing over a million patients; a research data repository housing various research specific data; an application development platform for building business and research enabling applications; a business intelligence environment assisting in reporting in all function areas. The IW is structured and encoded using standard terminologies such as SNOMED-CT, ICD, and CPT. The IW is an important component of OSUMC's Clinical and Translational Science Award (CTSA) informatics program.

  10. The conjoint Rorschach comprehensive system: reliability and validity in clinical and nonclinical couples.

    Science.gov (United States)

    Aschieri, Filippo

    2013-01-01

    This article presents the comparison of 2 paired groups of satisfied (n = 22) and distressed (n = 22) couples using a conjoint version of the Rorschach Comprehensive System (CS; Exner, 2003). The aim of the study was to evaluate if the couples' verbalizations could be coded reliably using standard CS variables and if the 2 groups of protocols differed on several dimensions hypothesized to reflect relational dissatisfaction. The results showed good to excellent interrater reliability for the selected CS variables. Comparisons revealed expected moderate to large differences between the satisfied and distressed groups with regard to communication (R), some of the affective variables (DEPI%, Afr, SumV%, Col-Shading Blends%), and cognitive variables (X-%, WDA% Sum6%, WSum6%). Among variables connected with aggression, only AgPast% was moderately higher in the distressed group of couples. Overall, the results support the use of the Conjoint Rorschach Comprehensive System (ConRCS) in couples' assessments.

  11. Lake Whitney Comprehensive Water Quality Assessment, Phase 1B- Physical and Biological Assessment (USDOE)

    Energy Technology Data Exchange (ETDEWEB)

    Doyle, Robert D; Byars, Bruce W

    2009-11-24

    Baylor University Center for Reservoir and Aquatic Systems Research (CRASR) has conducted a phased, comprehensive evaluation of Lake Whitney to determine its suitability for use as a regional water supply reservoir. The area along the Interstate 35 corridor between Dallas / Fort Worth Metroplex and the Waco / Temple Centroplex represents one of the fastest growth areas in the State of Texas and reliable water supplies are critical to sustainable growth. Lake Whitney is situated midway between these two metropolitan areas. Currently, the City of Whitney as well as all of Bosque and Hill counties obtain their potable water from the Trinity Sands aquifer. Additionally, parts of the adjoining McLennan and Burleson counties utilize the Trinity sands aquifer system as a supplement to their surface water supplies. Population growth coupled with increasing demands on this aquifer system in both the Metroplex and Centroplex have resulted in a rapid depletion of groundwater in these rural areas. The Lake Whitney reservoir represents both a potentially local and regional solution for an area experiencing high levels of growth. Because of the large scope of this project as well as the local, regional and national implications, we have designed a multifaceted approach that will lead to the solution of numerous issues related to the feasibility of using Lake Whitney as a water resource to the region. Phase IA (USEPA, QAPP Study Elements 1-4) of this research focused on the physical limnology of the reservoir (bathymetry and fine scale salinity determination) and develops hydrodynamic watershed and reservoir models to evaluate how salinity would be expected to change with varying hydrologic and climatic factors. To this end, we implemented a basic water quality modeling program in collaboration with the Texas Parks and Wildlife Department and the Texas Commission on Environmental Quality to add to the developing long-term database on Lake Whitney. Finally, we conducted an initial

  12. A Research Agenda for Radiation Oncology: Results of the Radiation Oncology Institute's Comprehensive Research Needs Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Jagsi, Reshma, E-mail: rjagsi@med.umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Bekelman, Justin E. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States); Brawley, Otis W. [Department of Hematology and Oncology, Emory University, and American Cancer Society, Atlanta, Georgia (United States); Deasy, Joseph O. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Le, Quynh-Thu [Department of Radiation Oncology, Stanford University, Stanford, CA (United States); Michalski, Jeff M. [Department of Radiation Oncology, Washington University, St. Louis, MO (United States); Movsas, Benjamin [Department of Radiation Oncology, Henry Ford Health System, Detroit, MI (United States); Thomas, Charles R. [Department of Radiation Oncology, Oregon Health and Sciences University, Portland, OR (United States); Lawton, Colleen A. [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States); Lawrence, Theodore S. [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Hahn, Stephen M. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States)

    2012-10-01

    Purpose: To promote the rational use of scarce research funding, scholars have developed methods for the systematic identification and prioritization of health research needs. The Radiation Oncology Institute commissioned an independent, comprehensive assessment of research needs for the advancement of radiation oncology care. Methods and Materials: The research needs assessment used a mixed-method, qualitative and quantitative social scientific approach, including structured interviews with diverse stakeholders, focus groups, surveys of American Society for Radiation Oncology (ASTRO) members, and a prioritization exercise using a modified Delphi technique. Results: Six co-equal priorities were identified: (1) Identify and develop communication strategies to help patients and others better understand radiation therapy; (2) Establish a set of quality indicators for major radiation oncology procedures and evaluate their use in radiation oncology delivery; (3) Identify best practices for the management of radiation toxicity and issues in cancer survivorship; (4) Conduct comparative effectiveness studies related to radiation therapy that consider clinical benefit, toxicity (including quality of life), and other outcomes; (5) Assess the value of radiation therapy; and (6) Develop a radiation oncology registry. Conclusions: To our knowledge, this prioritization exercise is the only comprehensive and methodologically rigorous assessment of research needs in the field of radiation oncology. Broad dissemination of these findings is critical to maximally leverage the impact of this work, particularly because grant funding decisions are often made by committees on which highly specialized disciplines such as radiation oncology are not well represented.

  13. Utilizing a novel tool for the comprehensive assessment of resident operative performance.

    Science.gov (United States)

    Glarner, Carly E; McDonald, Robert J; Smith, Amy B; Leverson, Glen E; Peyre, Sarah; Pugh, Carla M; Greenberg, Caprice C; Greenberg, Jacob A; Foley, Eugene F

    2013-01-01

    A mechanism for more effective and comprehensive assessment of surgical residents' performance in the operating room (OR) is needed, especially in light of the new requirements issued by the American Board of Surgery. Furthermore, there is an increased awareness that assessments need to be more meaningful by including not only procedure-specific and general technical skills, but also nontechnical skills (NOTECHS), such as teamwork and communication skills. Our aims were to develop a methodology and create a tool that comprehensively assesses residents' operative performance. A procedure-specific technical skill assessment for laparoscopic colon resections was created through use of task analysis. Components of previously validated tools were added to broaden the assessment to include general technical skills and NOTECHS. Our instrument was then piloted in the OR to measure face and content validity through an iterative process with faculty evaluators. Once the tool was finalized, postgraduate 3 (PG3) and PG5 residents on a 2-month long rotation were assessed by 1 of 4 colorectal surgeons immediately after completing a case together. Construct validity was measured by evaluating the difference in scores between PG3 and PG5 residents' performance as well as the change in scores over the course of the rotation. Sixty-three assessments were performed. All evaluations were completed within 48 hours of the operation. There was a statistically significant difference between the PG3 and PG5 scores on procedure-specific performance, general technical skills, NOTECHS, and overall performance. Over the course of the rotation, a statistically significant improvement was found in residents' scores on the procedure-specific portion of the assessment but not on the general surgical skills or NOTECHS. This is a feasible, valid, and reliable assessment tool for the comprehensive evaluation of resident performance in the OR. We plan to use this tool to assess resident operative

  14. Assessing clinical competency in the health sciences

    Science.gov (United States)

    Panzarella, Karen Joanne

    To test the success of integrated curricula in schools of health sciences, meaningful measurements of student performance are required to assess clinical competency. This research project analyzed a new performance assessment tool, the Integrated Standardized Patient Examination (ISPE), for assessing clinical competency: specifically, to assess Doctor of Physical Therapy (DPT) students' clinical competence as the ability to integrate basic science knowledge with clinical communication skills. Thirty-four DPT students performed two ISPE cases, one of a patient who sustained a stroke and the other a patient with a herniated lumbar disc. Cases were portrayed by standardized patients (SPs) in a simulated clinical setting. Each case was scored by an expert evaluator in the exam room and then by one investigator and the students themselves via videotape. The SPs scored each student on an overall encounter rubric. Written feedback was obtained from all participants in the study. Acceptable reliability was demonstrated via inter-rater agreement as well as inter-rater correlations on items that used a dichotomous scale, whereas the items requiring the use of the 4-point rubric were somewhat less reliable. For the entire scale both cases had a significant correlation between the Expert-Investigator pair of raters, for the CVA case r = .547, p < .05 and for the HD case r = .700, p < .01. The SPs scored students higher than the other raters. Students' self-assessments were most closely aligned with the investigator. Effects were apparent due to case. Content validity was gathered in the process of developing cases and patient scenarios that were used in this study. Construct validity was obtained from the survey results analyzed from the experts and students. Future studies should examine the effect of rater training upon the reliability. Criterion or predictive validity could be further studied by comparing students' performances on the ISPE with other independent estimates

  15. Association of the pre-internship objective structured clinical examination in final year medical students with comprehensive written examinations.

    Science.gov (United States)

    Eftekhar, Hasan; Labaf, Ali; Anvari, Pasha; Jamali, Arsia; Sheybaee-Moghaddam, Farshad

    2012-01-01

    The purpose of this study is to evaluate the association of the pre-internship Objective Structured Clinical Examination (OSCE) in final year medical students with comprehensive written examinations. SUBJECTS AND MATERIAL: All medical students of October 2004 admission who took part in the October 2010 National Comprehensive Pre-internship Examination (NCPE) and pre-internship OSCE were included in the study (n = 130). OSCE and NCPE scores and medical grade point average (GPA) were collected. GPA was highly correlated with NCPE (r = 0.76 and P<0.001) and moderately with OSCE (r = 0.68 and P < 0.001). Similarly a moderate correlation was observed between NCPE and OSCE scores(r = 0.6 and P < 0.001).Linear stepwise regression shows r(2) of a model applying GPA as predictor of OSCE score is 0.46 (β = 0.68 and P < 0.001), while addition of gender to the model increases r(2) to 0.59 (β = 0.61 and 0.36, for GPA and male gender, respectively and P < 0.001). Logistic forward regression models shows male gender and GPA are the only dependent predictors of high score in OSCE. OR of GPA and male gender for high OSCE score are 4.89 (95% CI = 2.37-10.06) and 6.95 (95% CI = 2.00-24.21), respectively (P < 0.001). Our findings indicate OSCE and examination which mainly evaluate knowledge, judged by GPA and NCPE are moderately to highly correlated. Our results illustrate the interwoven nature of knowledge and clinical skills. In other words, certain level of knowledge is crucial for appropriate clinical performance. Our findings suggest neither OSCE nor written forms of assessments can replace each other. They are complimentary and should also be combined by other evaluations to cover all attributes of clinical competence efficiently.

  16. Suspected pulmonary embolism and deep venous thrombosis: A comprehensive MDCT diagnosis in the acute clinical setting

    Energy Technology Data Exchange (ETDEWEB)

    Salvolini, Luca [Radiology Department, ' Umberto I' Hospital - Ospedali Riuniti - ' Politecnica delle Marche' University, Via Conca, 60020 Ancona (Italy)], E-mail: lucasalvolini@alice.it; Scaglione, Mariano [Emergency and Trauma CT Section, Department of Radiology, Cardarelli Hospital, Via G. Merliani 31, 80127 Naples (Italy); Giuseppetti, Gian Marco; Giovagnoni, Andrea [Radiology Department, ' Umberto I' Hospital - Ospedali Riuniti - ' Politecnica delle Marche' University, Via Conca, 60020 Ancona (Italy)

    2008-03-15

    Both pulmonary arterial and peripheral venous sides of venous thromboembolism (VTE) can now be efficiently and safely investigated by multi-detector CT (MDCT) at the same time by a combined CT angiography/CT venography protocol. In the emergency setting, the use of such a single test for patients suspected of suffering from VTE on a clinical grounds may considerably shorten and simplify diagnostic algorithms. The selection of patients to be submitted to MDCT must follow well-established clinical prediction rules in order to avoid generalized referral to CT on a generic clinical suspicion basis and excessive population exposure to increased ionizing radiation dose, especially in young patients. Clinical and anatomical wide-panoramic capabilities of MDCT allow identification of underlying disease that may explain patients' symptoms in a large number of cases in which VTE is not manifest. The analysis of MDCT additional findings on cardiopulmonary status and total thrombus burden can lead to better prognostic stratification of patients and influence therapeutic options. Some controversial points such as optimal examination parameters, clinical significance of subsegmentary emboli, CT pitfalls and/or possible falsely positive diagnoses, and outcome of untreated patients in which VTE has been excluded by MDCT without additional testing, must of course be taken into careful consideration before the definite role of comprehensive MDCT VTE 'one-stop-shop' diagnosis in everyday clinical practice can be ascertained.

  17. Classroom assessment of reading comprehension: How are preservice Foundation Phase teachers being prepared?

    Directory of Open Access Journals (Sweden)

    Carisma Nel

    2012-04-01

    Full Text Available A number of assessment studies in recent years have shown that the educational achievement of learners in South African schools is unacceptably poor. The Department of Education’s systemic evaluations, conducted in Grade 3 (first cycle in 2001, second cycle in 2007 show very low levels of literacy among learners. Reading comprehension and writing scores averaged 39% for the first and 36% for the second cycle. Research indicates that less attention has been given to children’s reading comprehension skills compared to decoding skills. Teacher preparation programmes should provide candidates with a rigorous, research-based curriculum and opportunities to practise a range of predefined skills and knowledge. The demands of competent literacy instruction and assessment, and the training experiences necessary to learn it, have been seriously underestimated by universities. Teacher education programmes should ensure that teachers, amongst other crucial aspects, know how to assess the progress of every student and change instruction when it is not working and also know how to communicate results of assessments to various stakeholders, especially parents. The purpose of this article is to report on the training that pre-service teachers receive, related to reading comprehension assessment practices, within a BEd foundation phase teacher preparation programme.

  18. The feasibility and validity of the comprehensive ICF core set for stroke in Chinese clinical settings.

    Science.gov (United States)

    Wang, Pu; Li, Huagang; Guo, Yi; Xie, Yuxiao; Ge, Ruidong; Qiu, Zhuoying

    2014-02-01

    To inspect the feasibility and content validity of the comprehensive International Classification of Functioning, Disability and Health (ICF) core set for stroke by describing relevant aspects of functioning, disability and environmental factors affected in Chinese patients post stroke. Multicentre, cross-sectional study. Department of rehabilitation medicine. The content validity was evaluated using frequency and percentage of 208 patients with a mean age of 60 years post stroke in China. Aspects of body function and structure, activity and participation, and environmental factors in the comprehensive ICF core set for stroke. Six ICF categories of body function were identified as a problem in over 90% (n = 187) of the patients (functions of the cardiovascular system and neuromusculoskeletal and movement-related functions). Impairments of brain, upper and lower extremity were identified as a problem in over 50% (n = 104) of the patients. Four ICF categories of activities and participation were documented as a problem in 100% (n = 208) of the patients (domestic and civic life). In environmental factors, nine ICF categories were documented as barriers by more than 10% (n = 20) and fewer than 50% (n = 104) of the patients (products and technology, physical geography, societal attitudes, services, systems and polices). Six ICF categories were identified as facilitators in over 90% (n = 187) of the patients (support and relationships and attitudes). The findings suggest that it is feasible to apply the comprehensive ICF core set for stroke in the Chinese clinical setting, after the appropriate reduction of some categories according to Chinese patients' characteristics and culture.

  19. Clinical analysis of the early comprehensive intervention on hypoxic ischemic encephalopathy

    Institute of Scientific and Technical Information of China (English)

    Xu-E Li; Yi-MinDu; Yan-JuGuo; Zhi-QingWu; Su-GeHao

    2015-01-01

    Objective:To explore the clinical efficacy of the early comprehensive intervention on hypoxic ischemic encephalopathy (HIE).Methods:HIE children who were admitted in our department from March, 2014 to May, 2015 were included in the study and randomized into the observation group and the control group. The patients in the control group were given routine fluid infusion, electrolyte disturbance correcting, blood sugar maintaining, convulsion controlling, intracranial pressure reducing, hormone, mannitol, vitamins, infection preventing, and other treatments. Based on the treatments given in the control group, the patients in the observation group were given the comprehensive intervention. After treatment, the serum related indicators, NBNA, and DQ in the two groups were observed.Results:The levels of serum AST, LDH, CK, and CK-MB in the observation group were significantly lower than those in the control group (P0.05). NBNA score in the observation group was significantly superior to that in the control group (P<0.05). DQ values at 3, 6, 12, 18, and 24 months in the observation group were significantly higher than those in the control group (P<0.05).Conclusions:Early comprehensive intervention on HIE patients can effectively reduce the serum cardiac enzyme levels, increase the therapeutic effect, improve the intelligence and motor development levels and DQ in order to enhance the living qualities.

  20. Assessing reading comprehension with narrative and expository texts: Dimensionality and relationship with fluency, vocabulary and memory.

    Science.gov (United States)

    Santos, Sandra; Cadime, Irene; Viana, Fernanda L; Chaves-Sousa, Séli; Gayo, Elena; Maia, José; Ribeiro, Iolanda

    2017-02-01

    Reading comprehension assessment should rely on valid instruments that enable adequate conclusions to be taken regarding students' reading comprehension performance. In this article, two studies were conducted to collect validity evidence for the vertically scaled forms of two Tests of Reading Comprehension for Portuguese elementary school students in the second to fourth grades, one with narrative texts (TRC-n) and another with expository ones (TRC-e). Two samples of 950 and 990 students participated in Study 1, the study of the dimensionality of the TRC-n and TRC-e forms, respectively. Confirmatory factor analyses provided evidence of an acceptable fit for the one-factor solution for all test forms. Study 2 included 218 students to collect criterion-related validity. The scores obtained in each of the test forms were significantly correlated with the ones obtained in other reading comprehension measures and with the results obtained in oral reading fluency, vocabulary and working memory tests. Evidence suggests that the test forms are valid measures of reading comprehension. © 2016 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  1. Instructor and Dental Student Perceptions of Clinical Communication Skills via Structured Assessments.

    Science.gov (United States)

    McKenzie, Carly T

    2016-05-01

    The aim of this study was to use structured assessments to assess dental students' clinical communication skills exhibited during patient appointments. Fourth-year dental students (n=55) at the University of Alabama at Birmingham evaluated their own interpersonal skills in a clinical setting utilizing the Four Habits Coding Scheme. An instructor also assessed student-patient clinical communication. These assessments were used to identify perceived strengths and weaknesses in students' clinical communication. Both instructor assessments and student self-assessments pinpointed the following clinical communication skills as effective the most often: patient greeting, avoidance of jargon, and non-verbal behavior. There was also relative agreement between instructor assessments and student self-assessments regarding clinical communication skills that were rated as not effective most frequently: ensuring patient comprehension, identification of patient feelings, and exploration of barriers to treatment. These resulted pointed to strengths and weaknesses in the portion of the curriculum designed to prepare students for effective provider-patient communication. These results may suggest a need for the school's current behavioral science curriculum to better address discussion of potential treatment barriers and patient feelings as well as techniques to ensure patient comprehension.

  2. Triangular model integrating clinical teaching and assessment

    Directory of Open Access Journals (Sweden)

    Abdelaziz A

    2014-03-01

    Full Text Available Adel Abdelaziz,1,2 Emad Koshak3 1Medical Education Development Unit, Faculty of Medicine, Al Baha University, Al Baha, Saudi Arabia; 2Medical Education Department, Faculty of Medicine, Suez Canal University, Egypt; 3Dean and Internal Medicine Department, Faculty of Medicine, Al Baha University, Al Baha, Saudi Arabia Abstract: Structuring clinical teaching is a challenge facing medical education curriculum designers. A variety of instructional methods on different domains of learning are indicated to accommodate different learning styles. Conventional methods of clinical teaching, like training in ambulatory care settings, are prone to the factor of coincidence in having varieties of patient presentations. Accordingly, alternative methods of instruction are indicated to compensate for the deficiencies of these conventional methods. This paper presents an initiative that can be used to design a checklist as a blueprint to guide appropriate selection and implementation of teaching/learning and assessment methods in each of the educational courses and modules based on educational objectives. Three categories of instructional methods were identified, and within each a variety of methods were included. These categories are classroom-type settings, health services-based settings, and community service-based settings. Such categories have framed our triangular model of clinical teaching and assessment. Keywords: curriculum development, teaching, learning, assessment, apprenticeship, community-based settings, health service-based settings

  3. Clinical applications of cone beam computed tomography in endodontics: A comprehensive review.

    Science.gov (United States)

    Cohenca, Nestor; Shemesh, Hagay

    2015-06-01

    Cone beam computed tomography (CBCT) is a new technology that produces three-dimensional (3D) digital imaging at reduced cost and less radiation for the patient than traditional CT scans. It also delivers faster and easier image acquisition. By providing a 3D representation of the maxillofacial tissues in a cost- and dose-efficient manner, a better preoperative assessment can be obtained for diagnosis and treatment. This comprehensive review presents current applications of CBCT in endodontics. Specific case examples illustrate the difference in treatment planning with traditional periapical radiography versus CBCT technology.

  4. Pain and placebo in pediatrics: a comprehensive review of laboratory and clinical findings.

    Science.gov (United States)

    Simmons, Kanesha; Ortiz, Robin; Kossowsky, Joe; Krummenacher, Peter; Grillon, Christian; Pine, Daniel; Colloca, Luana

    2014-11-01

    Pain modulation by placebo mechanisms is one of the most robust and best-studied phenomena, yet almost all research investigating the mechanisms and implications of the placebo analgesia are based on adult research. After highlighting crucial aspects that need to be considered in studying pain modulation in children, this comprehensive review examines studies related to pain modulation with an emphasis on factors such as age, neural development and pain measures. We critically discuss psychological mechanisms underlying placebo effects, including (1) verbally induced expectations, (2) conditioning and learning mechanisms, and (3) child-parent-physician interactions. Taken together, research suggests that placebo mechanisms can affect therapeutic outcomes and potentially be exploited clinically to improve clinical outcomes in pediatric population. Recommendations for further investigating the mechanistic bases and harnessing placebo effects for supportive therapeutic applications are given.

  5. Exploring dynamic assessment as a means of identifying children at risk of developing comprehension difficulties.

    Science.gov (United States)

    Elleman, Amy M; Compton, Donald L; Fuchs, Douglas; Fuchs, Lynn S; Bouton, Bobette

    2011-01-01

    In this study, the authors explore a newly constructed dynamic assessment (DA) intended to tap inference-making skills that they hypothesize will be predictive of future comprehension performance. The authors administered the test to 100 second-grade children using a dynamic format to consider the concurrent validity of the measure. The dynamic portion of the assessment comprised teaching children to be "reading detectives" by using textual clues to solve what was happening in the story. During the DA children listened to short passages and answered three inferential questions (i.e., one setting, two causal). If children were unable to answer a question, they were reminded what a reading detective would do and given a set of increasingly concrete prompts and clues to orient them to the relevant portion of text until they could answer the question correctly. Results showed that the DA correlated significantly with a standardized measure of reading comprehension and explained a small but significant amount of unique variance in reading comprehension above and beyond vocabulary and word identification skills. In addition, results suggest that DA may be better than the standardized measure of reading comprehension at identifying intraindividual differences in young children's reading abilities.

  6. Assessment of Sustainability of Urban Water Supply and Demand Management Options: A Comprehensive Approach

    Directory of Open Access Journals (Sweden)

    Kumudu Rathnayaka

    2016-12-01

    Full Text Available A comprehensive evaluation framework that can assess a wide range of water supply and demand management policy options in terms of economic, social, environmental, risk-based, and functional performance is crucial to ascertain their level of sustainability. However, such a detailed, generic, and holistic policy evaluation framework is not found in the literature. This paper reviews studies to evaluate water supply and/or demand management options conducted during 2000–2016. Primarily, the paper reviews the evaluation criteria used by different studies for decision making given their significant difference and the importance of a comprehensive set of criteria to complete a rigorous evaluation. In addition, a comprehensive set of water supply and demand management options are not considered together for a comparative assessment to prioritise best options for a certain area and time. Further, performance of these options needs to be evaluated for a range of uncertainties arising from changes of spatial and temporal variables of the system. While this paper highlights the important aspects that need to be included in a comprehensive policy evaluation framework, available studies collectively present a rich set of information to support it.

  7. Comprehensive reference ranges for hematology and clinical chemistry laboratory parameters derived from normal Nigerian adults.

    Directory of Open Access Journals (Sweden)

    Timzing Miri-Dashe

    Full Text Available BACKGROUND: Interpretation of laboratory test results with appropriate diagnostic accuracy requires reference or cutoff values. This study is a comprehensive determination of reference values for hematology and clinical chemistry in apparently healthy voluntary non-remunerated blood donors and pregnant women. METHODS AND FINDINGS: Consented clients were clinically screened and counseled before testing for HIV, Hepatitis B, Hepatitis C and Syphilis. Standard national blood donors' questionnaire was administered to consented blood donors. Blood from qualified volunteers was used for measurement of complete hematology and chemistry parameters. Blood samples were analyzed from a total of 383 participants, 124 (32.4% males, 125 (32.6% non-pregnant females and 134 pregnant females (35.2% with a mean age of 31 years. Our results showed that the red blood cells count (RBC, Hemoglobin (HB and Hematocrit (HCT had significant gender difference (p = 0.000 but not for total white blood count (p>0.05 which was only significantly higher in pregnant verses non-pregnant women (p = 0.000. Hemoglobin and Hematocrit values were lower in pregnancy (P = 0.000. Platelets were significantly higher in females than men (p = 0.001 but lower in pregnant women (p =  .001 with marked difference in gestational period. For clinical chemistry parameters, there was no significant difference for sodium, potassium and chloride (p>0.05 but gender difference exists for Bicarbonate (HCO3, Urea nitrogen, Creatinine as well as the lipids (p0.05. CONCLUSIONS: Hematological and Clinical Chemistry reference ranges established in this study showed significant gender differences. Pregnant women also differed from non-pregnant females and during pregnancy. This is the first of such comprehensive study to establish reference values among adult Nigerians and difference observed underscore the need to establish reference values for different populations.

  8. Comprehensive Assessment and Evaluation of Students with Learning Disabilities: A Paper Prepared by the National Joint Committee on Learning Disabilities

    Science.gov (United States)

    Learning Disability Quarterly, 2011

    2011-01-01

    The National Joint Committee on Learning Disabilities (NJCLD) strongly supports comprehensive assessment and evaluation of students with learning disabilities by a multidisciplinary team for the identification and diagnosis of students with learning disabilities. Comprehensive assessment of individual students requires the use of multiple data…

  9. Clinical reasoning in nursing: teaching strategies and assessment tools.

    Science.gov (United States)

    Carvalho, Emília Campos de; Oliveira-Kumakura, Ana Railka de Souza; Morais, Sheila Coelho Ramalho Vasconcelos

    2017-01-01

    To present the concept and development of teaching strategies and the assessment tools regarding clinical reasoning for accurate practice. This is a theoretical reflection based on scientific studies. Comprehension of the essential concepts of the thought process and its articulation with the different teaching strategies and the assessment tools which has allowed presenting ways to improve the process of diagnostic or therapeutic clinical reasoning. The use of new strategies and assessment tools should be encouraged in order to contribute to the development of skills that lead to safe and effective decision making. Apresentar o conceito de raciocínio clínico, seu desenvolvimento, as estratégias para seu ensino e os instrumentos de avaliação para uma prática acurada. Trata-se de uma reflexão teórica fundamentada em estudos científicos. A compreensão dos conceitos essenciais do processo de pensamento e sua articulação com as diferentes estratégias de ensino e com os instrumentos de avaliação permitiram exemplificar meios de aprimorar o processo de raciocínio clínico diagnóstico ou terapêutico. A utilização de novas estratégias e instrumentos de avaliação deve ser estimulado para contribuir com o desenvolvimento das habilidades que culminam na tomada de decisão segura e eficaz.

  10. Nursing students' views of clinical competence assessment.

    Science.gov (United States)

    Bradshaw, Carmel; O'Connor, Maureen; Egan, Geraldine; Tierney, Katie; Butler, Mary Pat; Fahy, Anne; Tuohy, Dympna; Cassidy, Irene; Quillinan, Bernie; McNamara, Mary C

    This paper reports on some outcomes of a research study evaluating a new assessment framework of clinical competence used in undergraduate nursing programmes in the Mid West Region of Ireland. First, this paper presents both the strengths and weaknesses of the present model, as articulated by student nurses. Second, it generates a broader critical debate around the concept of competency assessment. The model of competence in question was developed by the Irish Nursing Board then elaborated on by the University of Limerick in partnership with local health service providers in 2002. Methodology involved a triangulated approach, comprising a series of focus group interviews with students (n=13) and preceptors (n=16) followed by a survey of students (n=232) and preceptors (n=837). Findings from the student focus groups are reported here. Themes identified using Burnard's (1991) framework for analysis are preparation for competency assessment, competency documentation, supporting assessment in practice, organisational and resource factors and the competency assessment structure and process. Results from this research have implications for refinement and revision of the present competency assessment framework, for student and staff preparation and for collaboration between stakeholders.

  11. Comprehensive geriatric assessment can predict postoperative morbidity and mortality in elderly patients undergoing elective surgery.

    Science.gov (United States)

    Kim, Kwang-Il; Park, Kay-Hyun; Koo, Kyung-Hoi; Han, Ho-Seong; Kim, Cheol-Ho

    2013-01-01

    The proportion of elderly patients who undergo surgery has rapidly increased; however, clinical indicators predicting outcomes are limited. Our aim was to evaluate the significance of comprehensive geriatric assessment (CGA) in elderly patients undergoing elective surgery. We studied 141 consecutive elderly patients (age: 78.0±6.5 years old, male: 41.1%) who were referred to our geriatric department for surgical risk evaluation. CGA was performed to evaluate physical health, functional status, psychological health, and social support. The primary composite outcome of this study was in-hospital death or post-discharge institutionalization. In-hospital adverse events, such as delirium, pressure ulcers, pneumonia, and urinary tract infections, were also evaluated. The associations between CGA and in-hospital adverse events, in-hospital death, and post-discharge institutionalization were investigated. There were 32 adverse outcomes (6 in-hospital deaths and 26 post-discharge institutionalizations). Compared with the patients who were discharged to their homes, patients with adverse outcomes were characterized by poor nutritional status and prior strokes. However, there was no significant difference in surgical risk or anesthesia type. The CGA results showed that patients with adverse outcomes were associated with functional dependency and poor nutrition. The cumulative number of impairments in the CGA domain was significantly associated with adverse outcomes, in-hospital events, and prolonged hospital stays. In multiple logistic regression analysis, cumulative impairment in CGA was independently associated with surgical outcomes in elderly patients undergoing elective surgery. Preoperative CGA can identify elderly patients at greater risk for mortality, post-discharge institutionalization, adverse in-hospital events, and prolonged length of hospital stay.

  12. Ecological Equivalence Assessment Methods: What Trade-Offs between Operationality, Scientific Basis and Comprehensiveness?

    Science.gov (United States)

    Bezombes, Lucie; Gaucherand, Stéphanie; Kerbiriou, Christian; Reinert, Marie-Eve; Spiegelberger, Thomas

    2017-08-01

    In many countries, biodiversity compensation is required to counterbalance negative impacts of development projects on biodiversity by carrying out ecological measures, called offset when the goal is to reach "no net loss" of biodiversity. One main issue is to ensure that offset gains are equivalent to impact-related losses. Ecological equivalence is assessed with ecological equivalence assessment methods taking into account a range of key considerations that we summarized as ecological, spatial, temporal, and uncertainty. When equivalence assessment methods take into account all considerations, we call them "comprehensive". Equivalence assessment methods should also aim to be science-based and operational, which is challenging. Many equivalence assessment methods have been developed worldwide but none is fully satisfying. In the present study, we examine 13 equivalence assessment methods in order to identify (i) their general structure and (ii) the synergies and trade-offs between equivalence assessment methods characteristics related to operationality, scientific-basis and comprehensiveness (called "challenges" in his paper). We evaluate each equivalence assessment methods on the basis of 12 criteria describing the level of achievement of each challenge. We observe that all equivalence assessment methods share a general structure, with possible improvements in the choice of target biodiversity, the indicators used, the integration of landscape context and the multipliers reflecting time lags and uncertainties. We show that no equivalence assessment methods combines all challenges perfectly. There are trade-offs between and within the challenges: operationality tends to be favored while scientific basis are integrated heterogeneously in equivalence assessment methods development. One way of improving the challenges combination would be the use of offset dedicated data-bases providing scientific feedbacks on previous offset measures.

  13. Preferred question types for computer-based assessment of clinical reasoning: a literature study.

    Science.gov (United States)

    van Bruggen, Lisette; Manrique-van Woudenbergh, Margreet; Spierenburg, Emely; Vos, Jacqueline

    2012-11-01

    Clinical reasoning is a core competence of doctors. Therefore, the assessment of clinical reasoning of undergraduate students is an important part of medical education. Three medical universities in the Netherlands wish to develop a shared question database in order to assess clinical reasoning of undergraduate students in Computer-Based Assessments (CBA). To determine suitable question types for this purpose a literature study was carried out. Search of ERIC and PubMed and subsequent cross referencing yielded 30 articles which met the inclusion criteria of a focus on question types suitable to assess clinical reasoning of medical students and providing recommendations for their use. Script Concordance Tests, Extended Matching Questions, Comprehensive Integrative Puzzles, Modified Essay Questions/Short Answer Questions, Long Menu Questions, Multiple Choice Questions, Multiple True/False Questions and Virtual Patients meet the above-mentioned criteria, but for different reasons not all types can be used easily in CBA. A combination of Comprehensive Integrative Puzzles and Extended Matching Questions seems to assess most aspects of clinical reasoning and these question types can be adapted for use in CBA. Regardless of the question type chosen, patient vignettes should be used as a standard stimulus format to assess clinical reasoning. Further research is necessary to ensure that the combination of these question types produces valid assessments and reliable test results.

  14. Do First Language Writing and Second Language Reading Equal Second Language Reading Comprehension? An Assessment Dilemma

    Science.gov (United States)

    1992-01-01

    FNIGNUMBE SDo First Language Writing and Second Language ReadingLn Equal Second Language Reading Comprehension? An _ Assessment Dilemma ~ -6. AUTHOR...young writer knows about writing in the first language forms the basis of new hypotheses rather than interferes with writing in another language" (1982, p...Jones and Tetroe (1987) interpret this finding as "strong, direct data for the transfer of first - language skill to the second language" (p. 55). Like

  15. Assessment of Sustainability of Urban Water Supply and Demand Management Options: A Comprehensive Approach

    OpenAIRE

    Kumudu Rathnayaka; Hector Malano; Meenakshi Arora

    2016-01-01

    A comprehensive evaluation framework that can assess a wide range of water supply and demand management policy options in terms of economic, social, environmental, risk-based, and functional performance is crucial to ascertain their level of sustainability. However, such a detailed, generic, and holistic policy evaluation framework is not found in the literature. This paper reviews studies to evaluate water supply and/or demand management options conducted during 2000–2016. Primarily, the pap...

  16. Comprehensive genomic sequencing and the molecular profiles of clinically advanced breast cancer.

    Science.gov (United States)

    Ross, Jeffrey S; Gay, Laurie M

    2017-02-01

    Targeting specific mutations that have arisen within a tumour is a promising means of increasing the efficacy of treatments, and breast cancer is no exception to this new paradigm of personalised medicine. Traditional DNA sequencing methods used to characterise clinical cancer specimens and impact treatment decisions are highly sensitive, but are often limited in their scope to known mutational hot spots. Next-generation sequencing (NGS) technologies can also test for these well-known hot spots, as well as identifying insertions and deletions, copy number changes such as ERBB2 (HER2) gene amplification, and a wide array of fusion or rearrangement events. By rapidly analysing many genes in parallel, NGS technologies can make efficient use of precious biopsy material. Comprehensive genomic profiling (CGP) by NGS can reveal targetable, clinically relevant genomic alterations that can stratify tumours by predicted sensitivity to a variety of therapies, including HER2- or MTOR-targeted therapies, immunotherapies, and other kinase inhibitors. Many clinically relevant genomic alterations would not be identified by IHC or hotspot testing, but can be detected by NGS. In addition to the most common breast carcinoma subtypes, rare subtypes analysed with CGP also harbour clinically relevant genomic alterations that can potentially direct therapy selection, illustrating that CGP is a powerful tool for guiding treatment across all breast cancer subtypes.

  17. Clinical risk assessment in intensive care unit

    Directory of Open Access Journals (Sweden)

    Saeed Asefzadeh

    2013-01-01

    Full Text Available Background: Clinical risk management focuses on improving the quality and safety of health care services by identifying the circumstances and opportunities that put patients at risk of harm and acting to prevent or control those risks. The goal of this study is to identify and assess the failure modes in the ICU of Qazvin′s Social Security Hospital (Razi Hospital through Failure Mode and Effect Analysis (FMEA. Methods: This was a qualitative-quantitative research by Focus Discussion Group (FDG performed in Qazvin Province, Iran during 2011. The study population included all individuals and owners who are familiar with the process in ICU. Sampling method was purposeful and the FDG group members were selected by the researcher. The research instrument was standard worksheet that has been used by several researchers. Data was analyzed by FMEA technique. Results: Forty eight clinical errors and failure modes identified, results showed that the highest risk probability number (RPN was in respiratory care "Ventilator′s alarm malfunction (no alarm" with the score 288, and the lowest was in gastrointestinal "not washing the NG-Tube" with the score 8. Conclusions: Many of the identified errors can be prevented by group members. Clinical risk assessment and management is the key to delivery of effective health care.

  18. Reliability and validity of the C-BiLLT: a new instrument to assess comprehension of spoken language in young children with cerebral palsy and complex communication needs.

    Science.gov (United States)

    Geytenbeek, Joke J; Mokkink, Lidwine B; Knol, Dirk L; Vermeulen, R Jeroen; Oostrom, Kim J

    2014-09-01

    In clinical practice, a variety of diagnostic tests are available to assess a child's comprehension of spoken language. However, none of these tests have been designed specifically for use with children who have severe motor impairments and who experience severe difficulty when using speech to communicate. This article describes the process of investigating the reliability and validity of the Computer-Based Instrument for Low Motor Language Testing (C-BiLLT), which was specifically developed to assess spoken Dutch language comprehension in children with cerebral palsy and complex communication needs. The study included 806 children with typical development, and 87 nonspeaking children with cerebral palsy and complex communication needs, and was designed to provide information on the psychometric qualities of the C-BiLLT. The potential utility of the C-BiLLT as a measure of spoken Dutch language comprehension abilities for children with cerebral palsy and complex communication needs is discussed.

  19. Concepts of Causality in Psychopathology: Applications in Clinical Assessment, Clinical Case Formulation and Functional Analysis

    NARCIS (Netherlands)

    Haynes, S.H.; O'Brien, W.H.; Kaholokula, J.K.; Witteman, C.L.M.

    2012-01-01

    This paper discusses and integrates concepts of causality in psychopathology, clinical assessment, clinical case formulation and the functional analysis. We propose that identifying causal variables, relations and mechanisms in psychopathology and clinical assessment can lead to more powerful and e

  20. Clinical reasoning in nursing: teaching strategies and assessment tools

    National Research Council Canada - National Science Library

    Emília Campos de Carvalho; Ana Railka de Souza Oliveira-Kumakura; Sheila Coelho Ramalho Vasconcelos Morais

    2017-01-01

    Results: Comprehension of the essential concepts of the thought process and its articulation with the different teaching strategies and the assessment tools which has allowed presenting ways to improve...

  1. Comprehensive genetic testing in the clinical evaluation of 1119 patients with hearing loss.

    Science.gov (United States)

    Sloan-Heggen, Christina M; Bierer, Amanda O; Shearer, A Eliot; Kolbe, Diana L; Nishimura, Carla J; Frees, Kathy L; Ephraim, Sean S; Shibata, Seiji B; Booth, Kevin T; Campbell, Colleen A; Ranum, Paul T; Weaver, Amy E; Black-Ziegelbein, E Ann; Wang, Donghong; Azaiez, Hela; Smith, Richard J H

    2016-04-01

    Hearing loss is the most common sensory deficit in humans, affecting 1 in 500 newborns. Due to its genetic heterogeneity, comprehensive diagnostic testing has not previously been completed in a large multiethnic cohort. To determine the aggregate contribution inheritance makes to non-syndromic hearing loss, we performed comprehensive clinical genetic testing with targeted genomic enrichment and massively parallel sequencing on 1119 sequentially accrued patients. No patient was excluded based on phenotype, inheritance or previous testing. Testing resulted in identification of the underlying genetic cause for hearing loss in 440 patients (39%). Pathogenic variants were found in 49 genes and included missense variants (49%), large copy number changes (18%), small insertions and deletions (18%), nonsense variants (8%), splice-site alterations (6%), and promoter variants (hearing loss or when the loss was congenital and symmetric. The spectrum of implicated genes showed wide ethnic variability. These findings support the more efficient utilization of medical resources through the development of evidence-based algorithms for the diagnosis of hearing loss.

  2. Exploring Teachers’ Practices for Assessing Reading Comprehension Abilities in English as a Foreign Language

    Directory of Open Access Journals (Sweden)

    Muñoz Marín Jorge Hugo

    2009-11-01

    Full Text Available This paper reports the findings of an exploratory study that aimed at identifying the assessment practices that English teachers have in the reading comprehension program at Universidad de Antioquia. Data collection included documentary analysis and interviews of 15 teachers and of the head of the program. Findings suggest diverse practices in assessing reading comprehension, the use of quantitative instruments to evaluate qualitatively, students’ lack of familiarity with qualitative assessment practices, teachers’ lack of familiarity with alternative assessment and teachers’ concern for verification of achievement of learning objectives. Conclusions highlight the need to expand the teachers’ assessment repertoire through in-service programs designed for the specificity of teaching reading comprehension skills. Key words: Foreign language reading, reading abilities, reading comprehension, assessment criteria, teachers’ assessment practices Este artículo reporta los hallazgos de un estudio exploratorio que buscó identificar las prácticas evaluativas de los profesores de inglés en el programa de comprensión lectora de la Universidad de Antioquia. La recolección de datos incluyó un análisis documental y entrevistas con 15 profesores y el coordinador del programa. Los hallazgos sugieren prácticas diversas en la evaluación de la comprensión lectora, el uso de instrumentos cuantitativos para evaluar cualitativamente, la falta de familiaridad de los estudiantes con las prácticas de evaluación cualitativa, la falta de familiaridad de los profesores con la evaluación alternativa y la preocupación de los profesores por verificar el cumplimiento de los objetivos de aprendizaje. Las conclusiones señalan la necesidad de expandir el repertorio evaluativo de los profesores por medio de programas de desarrollo profesional centrados en la enseñanza de habilidades en la comprensión lectora. Palabras clave: Lectura en lengua

  3. The Gap between Tobacco Treatment Guidelines, Health Service Organization, and Clinical Practice in Comprehensive Cancer Centres

    Directory of Open Access Journals (Sweden)

    R. Mazza

    2011-01-01

    Full Text Available Smoking cessation is necessary to reach a higher quality of life, and, for a cancer patient, it represents an important step in improving the outcome of both prognosis and therapy. Being a cancer patient addicted to nicotine may be a critical situation. We conducted a survey to monitor how many comprehensive cancer centres in Italy have an outpatient smoker clinic and which kinds of resources are available. We also inquired about inpatient services offering psychological and pharmacological support for smoking cessation, reduction, or care of acute nicotine withdrawal symptoms. What we have witnessed is a significant gap between guidelines and services. Oncologists and cancer nurses are overscheduled, with insufficient time to engage in discussion on a problem that they do not consider directly related to cancer treatment. Furthermore, smoking habits and limited training in tobacco dependence and treatment act as an important barrier and lead to the undervaluation of smokers' needs.

  4. Model-Driven Paediatric Cardiomyopathy Pathways - A Clinical Impact Assessment.

    Science.gov (United States)

    Stroetmann, Karl A; Thiel, Rainer

    2017-01-01

    Intermediate results from an ongoing health technology assessment exercise of a simulation model of paediatric cardiomyopathy are reported. Comprehensive data on paediatric cardiomyopathy/heart failure, treatment options, incidence and prevalence, prognoses for different outcomes to be expected were collected. Based on this knowledge, a detailed clinical pathway model was developed and validated against the clinical workflow in a tertiary paediatric care hospital. It combines three disease stages and various treatment options with estimates of the probabilities of a child moving from one stage to another. To reflect the complexity of initial decision taking by clinicians, a three-stage Markov model was combined with a decision tree approach - a Markov decision process. A Markov Chain simulation tool was applied to compare estimates of transition probabilities and cost data of present standard of care treatment options for a cohort of children over ten years with expected improvements from using a clinical decision support tool based on the disease model under development. Early results indicate a slight increase of overall costs resulting from the extra cost of using such a tool in spite of some savings to be expected from improved care. However, the intangible benefits in life years saved of severely ill children and the improvement in QoL to be expected for moderately ill ones should more than compensate for this.

  5. Clinical assessment of bone mass in children

    Directory of Open Access Journals (Sweden)

    L A Sheplyagina

    2005-01-01

    Full Text Available Objective. To give clinical assessment of bone mass main indices in healthy children living in Moscow and Moscow region. Material and methods. 357 healthy children aged 5-16 years (194 male, 163 female were included. Physical development, bone mineral density (BMD by 2-power radiological absorptiometry, bone mineral content (BMC were evaluated. Results. Significant variability of height in children age groups was revealed. 40,2% had disharmonious physical development. BMC and BMD were closely associated with height (r=0,8, p=0,0001 and body mass (r=0,7, p=0,0001. Bone mass indices were proved to be significantly less in children with height and body mass less then 10% percentile. BMD growth rate was less than mineral accumulation rate. Method of body mass clinical assessment in children was elaborated. Conclusion. Application of elaborated tables of conjugated values of anthropometric and densitometric indices allows to decrease of osteopenia overdiagnosis in children and determine causes of insufficient bone mineral content.

  6. Comprehensive assessment and network analysis of the emerging genetic susceptibility landscape of prostate cancer.

    Science.gov (United States)

    Hicks, Chindo; Miele, Lucio; Koganti, Tejaswi; Vijayakumar, Srinivasan

    2013-01-01

    Recent advances in high-throughput genotyping have made possible identification of genetic variants associated with increased risk of developing prostate cancer using genome-wide associations studies (GWAS). However, the broader context in which the identified genetic variants operate is poorly understood. Here we present a comprehensive assessment, network, and pathway analysis of the emerging genetic susceptibility landscape of prostate cancer. We created a comprehensive catalog of genetic variants and associated genes by mining published reports and accompanying websites hosting supplementary data on GWAS. We then performed network and pathway analysis using single nucleotide polymorphism (SNP)-containing genes to identify gene regulatory networks and pathways enriched for genetic variants. We identified multiple gene networks and pathways enriched for genetic variants including IGF-1, androgen biosynthesis and androgen signaling pathways, and the molecular mechanisms of cancer. The results provide putative functional bridges between GWAS findings and gene regulatory networks and biological pathways.

  7. Human scenarios for the screening assessment. Columbia River Comprehensive Impact Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Napier, B.A.; Harper, B.L.; Lane, N.K.; Strenge, D.L.; Spivey, R.B.

    1996-03-01

    Because of past nuclear production operations along the Columbia River, there is intense public and tribal interest in assessing any residual Hanford Site related contamination along the river from the Hanford Reach to the Pacific Ocean. The Columbia River Impact Assessment (CRCIA) was proposed to address these concerns. The assessment of the Columbia River is being conducted in phases. The initial phase is a screening assessment of risk, which addresses current environmental conditions for a range of potential uses. One component of the screening assessment estimates the risk from contaminants in the Columbia River to humans. Because humans affected by the Columbia river are involved in a wide range of activities, various scenarios have been developed on which to base the risk assessments. The scenarios illustrate the range of activities possible by members of the public coming in contact with the Columbia River so that the impact of contaminants in the river on human health can be assessed. Each scenario illustrates particular activity patterns by a specific group. Risk will be assessed at the screening level for each scenario. This report defines the scenarios and the exposure factors that will be the basis for estimating the potential range of risk to human health from Hanford-derived radioactive as well as non-radioactive contaminants associated with the Columbia River.

  8. Development of a questionnaire to assess the factors associated with clinical learning of nursing students: A Delphi study

    OpenAIRE

    M Emami Maybodi; M. Mirzaei; T Farajkhoda; Soltani-Arabshahi, K

    2015-01-01

    Introduction : Inhibiting factors in clinical learning of nursing students cause a huge gap between the optimum and the current situation in performance of the graduates . Due to the lack of a comprehensive and reliable tool for the identification of these factors in Iran , this study aimed to develop a scale to assess the related items to nursing students’ clinical learning.   Methods : This descriptive study used Delphi approach to assess factors associated with clinical learning of nursing...

  9. Optimal clinical assessment strategies for chemotherapy-induced peripheral neuropathy (CIPN): a systematic review and Delphi survey.

    Science.gov (United States)

    McCrary, J Matt; Goldstein, David; Boyle, Frances; Cox, Keith; Grimison, Peter; Kiernan, Matthew C; Krishnan, Arun V; Lewis, Craig R; Webber, Kate; Baron-Hay, Sally; Horvath, Lisa; Park, Susanna B

    2017-06-07

    Chemotherapy-induced peripheral neuropathy (CIPN) is a prominent side effect of the treatment of cancer. Despite this frequent complication, there has been no comprehensive review and quality appraisal of CIPN assessments. The purpose of this study is to provide a definitive quality appraisal of CIPN assessment strategies for clinical use. Relevant studies were identified through database searches of Medline, Embase, CINAHL, and Cochrane. CIPN assessment strategies from included articles were extracted and initially rated by an oncologist and neurophysiologist according to criteria related to assessment depth, comprehensiveness, appropriateness, and reliability. The six highest scoring assessment strategies were the focus of a two-round Delphi survey of a working party of 32 physicians, nurses, and consumers to achieve consensus on the highest rated assessments for each criterion. The database search yielded 117 distinct CIPN assessments that were extracted from 2373 articles. Three patient-reported outcome surveys and three clinician-based assessments were included in the Delphi survey. No consensus was generated regarding the best overall CIPN assessment, although good (≥70%) consensus was achieved regarding the best assessment within each criterion. The Participant Neurotoxicity Questionnaire (PNQ) was rated the highest overall and patient-reported outcome (PRO) assessment, while the Total Neuropathy Score clinical version (TNSc) was the highest rated clinician-based assessment. A diverse range of CIPN assessments currently exists. While several assessments assess CIPN symptoms with adequate comprehensiveness, depth, language, and feasibility, the consensus 'gold standard' clinical assessment remains to be established.

  10. Relative urban ecosystem health assessment: a method integrating comprehensive evaluation and detailed analysis.

    Science.gov (United States)

    Su, Meirong; Yang, Zhifeng; Chen, Bin

    2010-12-01

    Regarding the basic roles of urban ecosystem health assessment (i.e., discovering the comprehensive health status, and diagnosing the limiting factors of urban ecosystems), the general framework integrating comprehensive evaluation and detailed analysis is established, from both bottom-up and top-down directions. Emergy-based health indicators are established to reflect the urban ecosystem health status from a biophysical viewpoint. Considering the intrinsic uncertainty and relativity of urban ecosystem health, set pair analysis is combined with the emergy-based indicators to fill the general framework and evaluate the relative health level of urban ecosystems. These techniques are favorable for understanding the overall urban ecosystem health status and confirming the limiting factors of concerned urban ecosystems from biophysical perspective. Moreover, clustering analysis is applied by combining the health status with spatial geographical conditions. Choosing 26 typical Chinese cities in 2005, relative comprehensive urban ecosystem health levels were evaluated. The higher health levels of Xiamen, Qingdao, Shenzhen, and Zhuhai are in particular contrast to those of Wuhan, Beijing, Yinchuan, and Harbin, which are relatively poor. In addition, the conditions of each factor and related indicators are investigated through set pair analysis, from which the critical limiting factors of Beijing are confirmed. According to clustering analysis results, the urban ecosystems studied are divided into four groups. It is concluded that the proposed framework of urban ecosystem health assessment, which integrates comprehensive evaluation and detailed analysis and is fulfilled by emergy synthesis and set pair analysis, can serve as a useful tool to conduct diagnosis of urban ecosystem health.

  11. Temple syndrome: comprehensive molecular and clinical findings in 32 Japanese patients.

    Science.gov (United States)

    Kagami, Masayo; Nagasaki, Keisuke; Kosaki, Rika; Horikawa, Reiko; Naiki, Yasuhiro; Saitoh, Shinji; Tajima, Toshihiro; Yorifuji, Tohru; Numakura, Chikahiko; Mizuno, Seiji; Nakamura, Akie; Matsubara, Keiko; Fukami, Maki; Ogata, Tsutomu

    2017-06-22

    PurposeTemple syndrome (TS14) is a rare imprinting disorder caused by aberrations at the 14q32.2 imprinted region. Here, we report comprehensive molecular and clinical findings in 32 Japanese patients with TS14.MethodsWe performed molecular studies for TS14 in 356 patients with variable phenotypes, and clinical studies in all TS14 patients, including 13 previously reported.ResultsWe identified 19 new patients with TS14, and the total of 32 patients was made up of 23 patients with maternal uniparental disomy (UPD(14)mat), six patients with epimutations, and three patients with microdeletions. Clinical studies revealed both Prader-Willi syndrome (PWS)-like marked hypotonia and Silver-Russell syndrome (SRS)-like phenotype in 50% of patients, PWS-like hypotonia alone in 20% of patients, SRS-like phenotype alone in 20% of patients, and nonsyndromic growth failure in the remaining 10% of patients in infancy, and gonadotropin-dependent precocious puberty in 76% of patients who were pubescent or older.ConclusionThese results suggest that TS14 is not only a genetically diagnosed entity but also a clinically recognizable disorder. Genetic testing for TS14 should be considered in patients with growth failure plus both PWS-like hypotonia and SRS-like phenotypes in infancy, and/or precocious puberty, as well as a familial history of Kagami-Ogata syndrome due to maternal microdeletion at 14q32.2.Genetics in Medicine advance online publication, 22 June 2017; doi:10.1038/gim.2017.53.

  12. Qualitative analysis of mediational strategies in emotionalized dynamic assessment of L2 reading comprehension

    Directory of Open Access Journals (Sweden)

    Parisa Abdolrezapour

    2013-10-01

    Full Text Available Currently available assessment tools and procedures are lacking one important dimension in providing full understanding of language learners' potential ability. This article focuses on the pedagogical application of emotional intelligence (EI activities integrated by Dynamic Assessment (DA, henceforth, a testing approach nurtured by Vygotsky's sociocultural theory, to second language reading instruction. Our main goal is to gain some insights into learner's abilities and find those forms of mediation during emotionally-based dynamic assessment (EDA intervention that best nurture the development of reading achievement. In this article, learners' improvement in second language (L2 reading comprehension is illustrated with examples of intermediate learners of English completing reading tasks with support from a mediator. The article concludes with recommendations for future research on DA and EI in L2 development.

  13. The Natural History of Flare-Ups in Fibrodysplasia Ossificans Progressiva (FOP): A Comprehensive Global Assessment.

    Science.gov (United States)

    Pignolo, Robert J; Bedford-Gay, Christopher; Liljesthröm, Moira; Durbin-Johnson, Blythe P; Shore, Eileen M; Rocke, David M; Kaplan, Frederick S

    2016-03-01

    glucocorticoids. This study is the first comprehensive global assessment of FOP flare-ups and establishes a critical foundation for the design and evaluation of future clinical trials. © 2015 American Society for Bone and Mineral Research.

  14. An update on the grading of muscle injuries: a narrative review from clinical to comprehensive systems

    Science.gov (United States)

    GRASSI, ALBERTO; QUAGLIA, ALBERTO; CANATA, GIAN LUIGI; ZAFFAGNINI, STEFANO

    2016-01-01

    Muscle injuries are recognized to be among the most frequent injuries occurring in the sporting and athletic population, and they account for more than 30% of all injuries in professional soccer players. Despite their considerable frequency and impact, there is still a lack of uniformity in the categorization, description and grading of muscle injuries. Dozens of systems based on clinical signs, ultrasound imaging (US) appearance or magnetic resonance imaging (MRI) findings have been proposed over the years. Most of them are three-grade systems that take into account pain, ROM limitation, swelling and hematoma, hypoechoic or hyperintense areas on US or MRI, and muscle gap or tendon involvement; however, they still lack evidence-based prognostic value. Recently, new comprehensive classification systems have been proposed, with the aim of developing uniform muscle injury terminology and giving each severity grade prognostic value. The systems that combine detailed MRI and US features with the clinical presentation, such as the Munich Muscle Injury Classification, the ISMuLT classification, and the British Athletic Classification, if used extensively, could improve the diagnosis, prognosis and management of muscle injuries. PMID:27386446

  15. COMPREHENSIVE STUDY OF NEURAL TUBE DEFECTS IN 1000 FOETUSES WITH CLINICAL SPECTRUM

    Directory of Open Access Journals (Sweden)

    Himabindu. N

    2015-12-01

    Full Text Available Introduction: A variety of malformations are included under the description of Neural tube defects (NTDs. These are abnormalities of the embryonic neuralization process. The congenital malformations of human structure and are of great interest to anatomists, obstetricians, pediatricians and radiologists. NTDs are among the commonest and most severe disorders, affecting 0.5-2 per 1000 established pregnancies, and are second commonest group of birth defects, after congenital heart defects. A valuable contribution of this study, the neural tube defects aimed at clinical methods and refined for the prenatal diagnosis in utero. Materials and Methods: This comprehensive study was undertaken to know the incidence of detail knowledge of neural tube defects in KIMS Narketpally and KAMS & RC Hyderabad, among 1000 births during the period of two years. We found seven fetuses with neural tube defects involving brain and spinal cord. A detailed study was done emphasizing on embryology and genetic and non-genetic concepts. Results & Conclusion: The seven fetuses were stillbirths and aborted babies between 20 to 40 weeks, presented with neural tube defects (0.7%. Five fetuses were females and two fetuses were males. The spinal defects were 0.4%, cranial defects 0.2% and complete neural tube defects is 0.1%. This review article discusses the classification, clinical research and epidemiological understanding of NTDs and correlated with the available literatures.

  16. [Comprehensive geriatric assessment in hospitalized patients aged 80 years and more].

    Science.gov (United States)

    Klich-Raczka, Alicja; Dubiel, Marzena; Sulicka, Joanna; Zyczkowska, Jolanta; Pitucha, Melania

    2006-01-01

    Comprehensive geriatric assessment during hospitalization, taking into account the specificity of geriatric patients could be used both in acute and long-term care. We analyzed 63 patients aged at least 80 years, born on odd days and hospitalized at the Department of Internal Medicine and Geriatrics, University Hospital, Kraków. We examined patients using Geriatric Assessment Chart which consisted of Barthel Index (used to determinate motor activity), MMSE, GDS (Geriatric Depression Scale), abbreviated Tinetti Test, Waterlow Index (used to determine the risk of pressure sore development), delirium risk factors scale, and social evaluation. The data were analyzed according to sex, marital status, level of mood, and residence status (free living or institutionalized). The mean age of 47 women and 16 men was 85.0 +/- 4.34 years. Dementia was been found in 60% of examined patients. Depression (usually mild) was encountered in 55.4%. Motor activity was moderately to severely impaired in the entire group, with high level of risk of falls and development of pressure sores. Thirteen per cent of the patients have been admitted with already developed ulcers. The results suggest the need for the comprehensive geriatric assessment both in hospitalized patients and in post-hospital phase of care.

  17. Exploring transcendence in EFL learners’ reading comprehension through computerized dynamic assessment

    Directory of Open Access Journals (Sweden)

    Saman Ebadi

    2016-01-01

    Full Text Available Derived from Vygotsky’s works, dynamic assessment (DA enables learners to move beyond their current level of functioning through offering needs-sensitized mediation. This study aimed at exploring the learners’ development in novel and increasingly more challenging situations called transcendence (TR in an L2 context focusing on reading comprehension through computerized dynamic assessment (CDA. An overall number of 32 BA TEFL advanced students were selected from among undergraduates of a university in Iran to participate in this study. To fulfil the purpose of the study, the researchers developed Computerized Dynamic Reading Assessment to examine Transcendence (CDRAT software which included reading comprehension CDA tests. To monitor the maintenance of learning in different time intervals, two software programs named CDRAT1 and CDRAT2 were utilized in specific time intervals after the posttest. The results indicated that not only did increased task complexity not lead to regression of students’ development, but also it had an effect on enhancing their development. Thus, transcendence had an effect on the generalizability of the contentions to a great extent. In conclusion, it was disclosed that there is no endpoint to progress and merely gaining a low or high score should not be interpreted as the inability of a special learner to surpass. This would more reinforce the need for applying TR in other future DA studies.

  18. Effect of Yoga on migraine: A comprehensive study using clinical profile and cardiac autonomic functions

    OpenAIRE

    Ravikiran Kisan; Sujan, M. U.; Meghana Adoor; Raghavendra Rao; Nalini, A.; Bindu M Kutty; B T Chindanda Murthy; Raju, T. R.; T N Sathyaprabha

    2014-01-01

    Context and Aims: Migraine is an episodic disabling headache requiring long-term management. Migraine management through Yoga therapy would reduce the medication cost with positive health benefits. Yoga has shown to improve the quality of life, reduce the episode of headache and medication. The aim of the present study was to evaluate the efficacy of Yoga as an adjuvant therapy in migraine patients by assessing clinical outcome and autonomic functions tests. Subjects and Methods: Migraine...

  19. Comprehensive Assessments of RNA-seq by the SEQC Consortium: FDA-Led Efforts Advance Precision Medicine

    Directory of Open Access Journals (Sweden)

    Joshua Xu

    2016-03-01

    Full Text Available Studies on gene expression in response to therapy have led to the discovery of pharmacogenomics biomarkers and advances in precision medicine. Whole transcriptome sequencing (RNA-seq is an emerging tool for profiling gene expression and has received wide adoption in the biomedical research community. However, its value in regulatory decision making requires rigorous assessment and consensus between various stakeholders, including the research community, regulatory agencies, and industry. The FDA-led SEquencing Quality Control (SEQC consortium has made considerable progress in this direction, and is the subject of this review. Specifically, three RNA-seq platforms (Illumina HiSeq, Life Technologies SOLiD, and Roche 454 were extensively evaluated at multiple sites to assess cross-site and cross-platform reproducibility. The results demonstrated that relative gene expression measurements were consistently comparable across labs and platforms, but not so for the measurement of absolute expression levels. As part of the quality evaluation several studies were included to evaluate the utility of RNA-seq in clinical settings and safety assessment. The neuroblastoma study profiled tumor samples from 498 pediatric neuroblastoma patients by both microarray and RNA-seq. RNA-seq offers more utilities than microarray in determining the transcriptomic characteristics of cancer. However, RNA-seq and microarray-based models were comparable in clinical endpoint prediction, even when including additional features unique to RNA-seq beyond gene expression. The toxicogenomics study compared microarray and RNA-seq profiles of the liver samples from rats exposed to 27 different chemicals representing multiple toxicity modes of action. Cross-platform concordance was dependent on chemical treatment and transcript abundance. Though both RNA-seq and microarray are suitable for developing gene expression based predictive models with comparable prediction performance, RNA

  20. Geriatric work-up in the Nordic countries. The Nordic approach to comprehensive geriatric assessment

    DEFF Research Database (Denmark)

    Sletvold, O; Tilvis, R; Jonsson, A

    1996-01-01

    , the background for developing a Nordic version of geriatric work-up is shared attitudes and principally the same organization of the health care system, and collaboration within geriatrics for many years. Several trials on comprehensive geriatric assessment and management performed in different settings have......, all being modified by extra- and intraindividual factors. Handicap is defined as the disability gap. Different health professionals have varying responsibilities in the geriatric team-work, but all should be dedicated to establish common goals. The geriatric work-up is presented with success factors...

  1. Comprehensive Assessment of New Modulation Techniques in 40 Gb/s Optical Communication Systems

    Energy Technology Data Exchange (ETDEWEB)

    Bing Linlin; Lei Jianming; Lu Li; Zou Xuecheng, E-mail: leijianming@mail.hust.edu.cn [Research Center for VLSI and Systems, Department of Electronic Science and Technology, Huazhong University of Science and Technology, Wuhan 430074 (China)

    2011-02-01

    In this paper, comprehensive assessments are proposed for intensity modulations and phase modulations respectively. Several key performance features, like receiver sensitivity, chromatic dispersion tolerance, nonlinearity tolerance, and noise sensitivity were compared among these modulation techniques. Results show that 66% duty cycle RZ signal so-called the carrier-suppressed return-to-zero (CSRZ) format has the best performance in the intensity modulations. In phase modulations, the most outstanding modulation is DPSK. DQPSK modulation is also a very promising choice if the effect of noise could be resolved. The combination of intensity modulation and phase modulation will compromise the performance advantages of both.

  2. Effect of Yoga on migraine: A comprehensive study using clinical profile and cardiac autonomic functions

    Science.gov (United States)

    Kisan, Ravikiran; Sujan, MU; Adoor, Meghana; Rao, Raghavendra; Nalini, A; Kutty, Bindu M; Chindanda Murthy, BT; Raju, TR; Sathyaprabha, TN

    2014-01-01

    Context and Aims: Migraine is an episodic disabling headache requiring long-term management. Migraine management through Yoga therapy would reduce the medication cost with positive health benefits. Yoga has shown to improve the quality of life, reduce the episode of headache and medication. The aim of the present study was to evaluate the efficacy of Yoga as an adjuvant therapy in migraine patients by assessing clinical outcome and autonomic functions tests. Subjects and Methods: Migraine patients were randomly given either conventional care (n = 30) or Yoga with conventional care (n = 30). Yoga group received Yoga practice session for 5 days a week for 6 weeks along with conventional care. Clinical assessment (frequency, intensity of headache and headache impact) and autonomic function test were done at baseline and at the end of the intervention. Results: Yoga with conventional care and convention care groups showed significant improvement in clinical variables, but it was better with Yoga therapy. Improvement in the vagal tone along with reduced sympathetic activity was observed in patients with migraine receiving Yoga as adjuvant therapy. Conclusions: Intervention showed significant clinical improvement in both groups. Headache frequency and intensity were reduced more in Yoga with conventional care than the conventional care group alone. Furthermore, Yoga therapy enhanced the vagal tone and decreased the sympathetic drive, hence improving the cardiac autonomic balance. Thus, Yoga therapy can be effectively incorporated as an adjuvant therapy in migraine patients. PMID:25035622

  3. Effect of Yoga on migraine: A comprehensive study using clinical profile and cardiac autonomic functions.

    Science.gov (United States)

    Kisan, Ravikiran; Sujan, Mu; Adoor, Meghana; Rao, Raghavendra; Nalini, A; Kutty, Bindu M; Chindanda Murthy, Bt; Raju, Tr; Sathyaprabha, Tn

    2014-07-01

    Migraine is an episodic disabling headache requiring long-term management. Migraine management through Yoga therapy would reduce the medication cost with positive health benefits. Yoga has shown to improve the quality of life, reduce the episode of headache and medication. The aim of the present study was to evaluate the efficacy of Yoga as an adjuvant therapy in migraine patients by assessing clinical outcome and autonomic functions tests. Migraine patients were randomly given either conventional care (n = 30) or Yoga with conventional care (n = 30). Yoga group received Yoga practice session for 5 days a week for 6 weeks along with conventional care. Clinical assessment (frequency, intensity of headache and headache impact) and autonomic function test were done at baseline and at the end of the intervention. Yoga with conventional care and convention care groups showed significant improvement in clinical variables, but it was better with Yoga therapy. Improvement in the vagal tone along with reduced sympathetic activity was observed in patients with migraine receiving Yoga as adjuvant therapy. Intervention showed significant clinical improvement in both groups. Headache frequency and intensity were reduced more in Yoga with conventional care than the conventional care group alone. Furthermore, Yoga therapy enhanced the vagal tone and decreased the sympathetic drive, hence improving the cardiac autonomic balance. Thus, Yoga therapy can be effectively incorporated as an adjuvant therapy in migraine patients.

  4. Portfolio: a comprehensive method of assessment for postgraduates in oral and maxillofacial surgery.

    Science.gov (United States)

    Kadagad, Poornima; Kotrashetti, S M

    2013-03-01

    Post graduate learning and assessment is an important responsibility of an academic oral and maxillofacial surgeon. The current method of assessment for post graduate training include formative evaluation in the form of seminars, case presentations, log books and infrequently conducted end of year theory exams. End of the course theory and practical examination is a summative evaluation which awards the degree to the student based on grades obtained. Oral and maxillofacial surgery is mainly a skill based specialty and deliberate practice enhances skill. But the traditional system of assessment of post graduates emphasizes their performance on the summative exam which fails to evaluate the integral picture of the student throughout the course. Emphasis on competency and holistic growth of the post graduate student during training in recent years has lead to research and evaluation of assessment methods to quantify students' progress during training. Portfolio method of assessment has been proposed as a potentially functional method for post graduate evaluation. It is defined as a collection of papers and other forms of evidence that learning has taken place. It allows the collation and integration of evidence on competence and performance from different sources to gain a comprehensive picture of everyday practice. The benefits of portfolio assessment in health professions education are twofold: it's potential to assess performance and its potential to assess outcomes, such as attitudes and professionalism that are difficult to assess using traditional instruments. This paper is an endeavor for the development of portfolio method of assessment for post graduate student in oral and maxillofacial surgery.

  5. The Differences across Distributed Leadership Practices by School Position According to the Comprehensive Assessment of Leadership for Learning (CALL)

    Science.gov (United States)

    Blitz, Mark H.; Modeste, Marsha

    2015-01-01

    The Comprehensive Assessment of Leadership for Learning (CALL) is a multi-source assessment of distributed instructional leadership. As part of the validation of CALL, researchers examined differences between teacher and leader ratings in assessing distributed leadership practices. The authors utilized a t-test for equality of means for the…

  6. Dairy reproductive management: assessing a comprehensive continuing education program for veterinary practitioners.

    Science.gov (United States)

    Schuenemann, Gustavo M; Bas, Santiago; Workman, Jeffrey D; Rajala-Schultz, Päivi J

    2010-01-01

    Comprehensive continuing veterinary medical education (CVME) programs are critical for veterinary practitioners to update their knowledge and improve their skills and services. CVME must offer an educational environment in which veterinarians can effectively rejuvenate their knowledge and skills and learn about new practices. The Ohio Dairy Health and Management Certificate Program is a comprehensive CVME program for practicing dairy veterinarians that was developed to provide advanced training on previously identified needs of the dairy industry. Our objectives in this article were (1) to provide a description of a comprehensive CVME program designed to enhance the flow of applied, research-based knowledge from educators and researchers to dairy veterinary practitioners and (2) to provide an assessment of outcomes achieved and experiences gained after the delivery of the first two modules on advanced dairy reproductive management. Findings from the two reproductive modules suggested that (1) the designed dairy reproductive management program was able to meet the participants' educational needs, (2) the implemented delivery methods significantly increased participants' knowledge level, and (3) additional educational needs should be addressed with future programming. In conclusion, results from the participants' self-reports suggested that both reproductive modules were relevant and effective, offering new information with immediate field application. These types of educational programs are important for dairy veterinary practitioners because they are a vital source of information and service providers for dairy producers. For the program to be considered completely successful, a detailed follow-up assessment of participants' behavior change, adoption of new practices and skills, and their on-farm impact is needed.

  7. Using Eye Movements to Assess Language Comprehension in Toddlers Born Preterm and Full Term.

    Science.gov (United States)

    Loi, Elizabeth C; Marchman, Virginia A; Fernald, Anne; Feldman, Heidi M

    2017-01-01

    To assess language skills in children born preterm and full term by the use of a standardized language test and eye-tracking methods. Children born ≤32 weeks' gestation (n = 44) were matched on sex and socioeconomic status to children born full term (n = 44) and studied longitudinally. The Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) were administered at 18 months (corrected for prematurity as applicable). The Looking-While-Listening Task (LWL) simultaneously presents 2 pictures and an auditory stimulus that directs the child's attention to one image. The pattern of eye movements reflects visual processing and the efficiency of language comprehension. Children born preterm were evaluated on LWL 3 times between 18 and 24 months. Children born full term were evaluated at ages corresponding to chronological and corrected ages of their preterm match. Results were compared between groups for the BSID-III and 2 LWL measures: accuracy (proportion of time looking at target) and reaction time (latency to shift gaze from distracter to target). Children born preterm had lower BSID-III scores than children born full term. Children born preterm had poorer performance than children born full term on LWL measures for chronological age but similar performance for corrected age. Accuracy and reaction time at 18 months' corrected age displaced preterm-full term group membership as significant predictors of BSID-III scores. Performance and rate of change on language comprehension measures were similar in children born preterm and full term compared at corrected age. Individual variation in language comprehension efficiency was a robust predictor of scores on a standardized language assessment in both groups. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Assessing hospitals' clinical risk management: Development of a monitoring instrument

    Directory of Open Access Journals (Sweden)

    Pfeiffer Yvonne

    2010-12-01

    Full Text Available Abstract Background Clinical risk management (CRM plays a crucial role in enabling hospitals to identify, contain, and manage risks related to patient safety. So far, no instruments are available to measure and monitor the level of implementation of CRM. Therefore, our objective was to develop an instrument for assessing CRM in hospitals. Methods The instrument was developed based on a literature review, which identified key elements of CRM. These elements were then discussed with a panel of patient safety experts. A theoretical model was used to describe the level to which CRM elements have been implemented within the organization. Interviews with CRM practitioners and a pilot evaluation were conducted to revise the instrument. The first nationwide application of the instrument (138 participating Swiss hospitals was complemented by in-depth interviews with 25 CRM practitioners in selected hospitals, for validation purposes. Results The monitoring instrument consists of 28 main questions organized in three sections: 1 Implementation and organizational integration of CRM, 2 Strategic objectives and operational implementation of CRM at hospital level, and 3 Overview of CRM in different services. The instrument is available in four languages (English, German, French, and Italian. It allows hospitals to gather comprehensive and systematic data on their CRM practice and to identify areas for further improvement. Conclusions We have developed an instrument for assessing development stages of CRM in hospitals that should be feasible for a continuous monitoring of developments in this important area of patient safety.

  9. Assessment of the psychological distress difficulties in patients with cancer using the national comprehensive cancer network rapid screening measure

    Institute of Scientific and Technical Information of China (English)

    Hamid Saeedi Saedi; Mona Koochak Pour; Emad Sabahi; Soodabeh Shahidsales

    2012-01-01

    Objective: Clinical guidelines like National Comprehensive Cancer Network Disease recommend routine psychological distress screening as a common problem among patients with cancer. The purpose of this study was to assess the prevalence of clinically significant emotional distress related to demographic and clinical association by standard distress thermometer (DT) within the patients lived in different regions of Gilan state, Iran. Methods: Participants (n = 256) completed the DT, rapid screening measure for distress and identified the presence or absence of 34 problems using the standardized checklist. Results: More than 59 percent of participants had more than 4 cut-off score for distress. The scores varied significantly in case of reported emotional source of distress, physical, physiological and total number of concerns (P < 0.001).DT scores more than four were more likely to report 22 of 32 problems on the problem list. In case of the practical and family problems, the main problems were related to child care and dealing with children, respectively. Moreover worrisome and nervousness were considered the prominent emotional problems in the list. Conclusion: Our result promise that distress thermometer measurement tool compare favorably with longer measures used to screening of distress in cancerous patients. Accompaniment of a psychologist expert in lethal or chronic disease consultation with the therapeutic team and training the rest of members of the team might be able to decrease the emotional distress problems of the cancerous patients.

  10. Comprehensive Assessment of Seawater Quality Based on an Improved Attribute Recognition Model

    Institute of Scientific and Technical Information of China (English)

    ZHANG Libing; CHENG Jilin; JIN Juliang; JIANG Xiaohong

    2006-01-01

    The attribute recognition model (ARM) has been widely used to make comprehensive assessment in many engineering fields, such as environment, ecology, and economy. However, large numbers of experiments indicate that the value of weight vector has no relativity to its initial value but depends on the data of Quality Standard and actual samples. In the present study, the ARM is enhanced with the technique of data driving, which means some more groups of data from the Quality Standard are selected with the uniform random method to make the calculation of weight values more rational and more scientific. This improved attribute recognition model (IARM) is applied to a real case of assessment on seawater quality. The given example shows that the IARM has the merits of being simple in principle, easy to operate, and capable of producing objective results, and is therefore of use in evaluation problems in marine environment science.

  11. The Effect of Dynamic Assessment on Iranian EFL Learners’ Reading Comprehension

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Amirian

    2014-06-01

    Full Text Available Dynamic Assessment (DA, is grounded in Vygotsky's idea on Sociocultural Theory (SCT of mind, his concept of Zone of Proximal Development (ZPD and its related metaphor; scaffolding. This study examined the effects of dynamic assessment on improving reading comprehension of Iranian intermediate students who were learning English as a foreign language. The participants, a group of Iranian male intermediate EFL learners ranging in age from 17 to 20, were randomly assigned to two groups of 14. In this study, the experimental and control groups’ performances on pre-tests and post-tests were compared through paired-samples and independent-samples t-tests. The treatment period lasted for 2 months (16 sessions. The results showed that the experimental group, which was instructed through DA, outperformed the control group which was instructed in a non-dynamic way.

  12. Social Work Assessment Notes: A Comprehensive Outcomes-Based Hospice Documentation System.

    Science.gov (United States)

    Hansen, Angela Gregory; Martin, Ellen; Jones, Barbara L; Pomeroy, Elizabeth C

    2015-08-01

    This article describes the development of an integrated psychosocial patient and caregiver assessment and plan of care for hospice social work documentation. A team of hospice social workers developed the Social Work Assessment Notes as a quality improvement project in collaboration with the information technology department. Using the Social Work Assessment Tool as an organizing framework, this comprehensive hospice social work documentation system is designed to integrate assessment, planning, and outcomes measurement. The system was developed to guide the assessment of patients' and caregivers' needs related to end-of-life psychosocial issues, to facilitate collaborative care plan development, and to measure patient- and family-centered outcomes. Goals established with the patient and the caregiver are documented in the plan of care and become the foundation for patient-centered, strengths-based interventions. Likert scales are used to assign numerical severity levels for identified issues and progress made toward goals and to track the outcome of social work interventions across nine psychosocial constructs. The documentation system was developed for use in an electronic health record but can be used for paper charting. Future plans include automated aggregate outcomes measurement to identify the most effective interventions and best practices in end-of-life care.

  13. The Effect of Self-assessment on Iranian EFL Learners` Reading Comprehension Skill

    Directory of Open Access Journals (Sweden)

    Rozhin Ghaslani

    2015-03-01

    Full Text Available Alternative assessments have received many attentions in the last decade and several forms of it have been introduced in higher education. Self-assessments are important forms of alternative assessments that play very important role in the development of lifelong learning and the development into autonomous individuals to evaluate their own learning process. This study is conducted to investigate the effects of the use of self-assessment on Iranian EFL reading comprehension skill. For the purpose of this study, 40 students of advanced level of English were chosen from among 68 advanced students from two institutions in Sanandaj based on the results of TOEFL proficiency test. A TOEFL test was administered to 68 advanced EFL learners to ensure their proficiency knowledge, then 40 of them whose scores were between - 1SDabove the mean and -1SD below the mean were selected as the subjects of the study. The results of the study indicated that there was a significant difference between the control and experimental groups` mean scores on the post test. In addition, the findings revealed that self-assessment had a positive effect on the reading ability of the students. The results of this study can be useful for students to become aware of the advantage of the independent learning and can be helpful for teachers to achieve complete information about the learners` strengths and weaknesses.

  14. Comprehensive mitigation framework for concurrent application of multiple clinical practice guidelines.

    Science.gov (United States)

    Wilk, Szymon; Michalowski, Martin; Michalowski, Wojtek; Rosu, Daniela; Carrier, Marc; Kezadri-Hamiaz, Mounira

    2017-02-01

    In this work we propose a comprehensive framework based on first-order logic (FOL) for mitigating (identifying and addressing) interactions between multiple clinical practice guidelines (CPGs) applied to a multi-morbid patient while also considering patient preferences related to the prescribed treatment. With this framework we respond to two fundamental challenges associated with clinical decision support: (1) concurrent application of multiple CPGs and (2) incorporation of patient preferences into the decision making process. We significantly expand our earlier research by (1) proposing a revised and improved mitigation-oriented representation of CPGs and secondary medical knowledge for addressing adverse interactions and incorporating patient preferences and (2) introducing a new mitigation algorithm. Specifically, actionable graphs representing CPGs allow for parallel and temporal activities (decisions and actions). Revision operators representing secondary medical knowledge support temporal interactions and complex revisions across multiple actionable graphs. The mitigation algorithm uses the actionable graphs, revision operators and available (and possibly incomplete) patient information represented in FOL. It relies on a depth-first search strategy to find a valid sequence of revisions and uses theorem proving and model finding techniques to identify applicable revision operators and to establish a management scenario for a given patient if one exists. The management scenario defines a safe (interaction-free) and preferred set of activities together with possible patient states. We illustrate the use of our framework with a clinical case study describing two patients who suffer from chronic kidney disease, hypertension, and atrial fibrillation, and who are managed according to CPGs for these diseases. While in this paper we are primarily concerned with the methodological aspects of mitigation, we also briefly discuss a high-level proof of concept

  15. Nutritional status of an elderly population in Southwest China: a cross-sectional study based on comprehensive geriatric assessment.

    Science.gov (United States)

    Shi, R; Duan, J; Deng, Y; Tu, Q; Cao, Y; Zhang, M; Zhu, Q; Lü, Y

    2015-01-01

    Few data is available on the nutritional status of old Chinese. The present study aimed to describe the nutritional status and clinical correlates for malnutrition risk in the older people. Cross-sectional study. Hospital- and community-based older people were recruited in the region of Chongqing, China. 558 individuals aged 60 years old or over between April 2011 and October 2012. Comprehensive geriatric assessment was performed and nutritional status was assessed by the Mini Nutritional Assessment Short Form (MNA-SF). Nutrition-associated factors were analyzed, including health status (chronic diseases, depression, cognition, function impaired), social factors (education status, marital status, the type of work before 60 years old) and life style factors (smoking, drinking, diet). The mean age was 73.1±8.0 years and 43.9% were men. Prevalence of malnutrition and risk for malnutrition were 3.2% and 19.3 %, respectively. Several factors increased poor nutrition independently including self-rated health, comorbidity, chronic obstructive pulmonary disease, gastrointestinal disease and cognitive impairment. Fish decreased the risk of poor nutrition. The prevalence was relatively low in older people of Chongqing, Southwest China. Poor nutrition was found to be increased due to the common health problems. Thus the patients with these problems should pay more attention on nutritional status. The older people should often have fish because of their nutritional benefit.

  16. Reading comprehension assessment through retelling: differences between dyslexic and language-based learning disable students

    Directory of Open Access Journals (Sweden)

    Adriana Souza Batista Kida

    2016-06-01

    Full Text Available AbstractPurpose: To study reading comprehension performance profiles of children with dyslexia as well as language-based learning disability by means of retelling tasks. Method: 105 children from second to fifth grades of elementary school were gathered into six groups: Dyslexia group (D; n=19, Language-based learning disability group (LBLD; n=16; their respective control groups paired according to different variables - age, gender, grade and school system (public or private (D-control and LBLD-control; and other control groups paired according to different reading accuracy (D-accuracy; LBLD-accuracy. All of the children read an expository text and orally retold the story as they understood it. The analysis quantified propositions (main ideas and details and retold links. A retelling reference standard (3-0 was also established from the best to the worst performance. We compared both clinical groups (D and LBLD with their respective control groups by means of Mann-Whitney tests.Results: D showed the same total of propositions, links and reference standards as D-control, but performed better than D-accuracy in macro structural (total of links and super structural (retelling reference standard measures. Results suggest that dyslexic children are able to use their linguistic competence and their own background knowledge to minimize the effects of their decoding deficit, especially at the highest text processing levels. LBLD performed worse than LBLD-control in all of the retelling measures and LBLD showed worse performance than LBLD-accuracy in the total retold links and retelling reference standard. Those results suggest that both decoding and linguistic difficulties affect reading comprehension. Moreover, the linguistic deficits presented by LBLD students do not allow these pupils to perform as competently in terms of text comprehension as the children with dyslexia do. Thus, failure in the macro and super-structural information processing of the

  17. The Exploration and Practice of the Comprehensive Reform in Graduate Education on Professional Degree of Clinical Medicine

    Science.gov (United States)

    Xu, Ling-Xiao; Yu, Fang; Ma, Zhen-Qiu; Zhou, Tian-Hua; Geng, Xiao-Bei; Huang, He

    2014-01-01

    The comprehensive reform in graduate education of Zhejiang University for a professional degree in clinical medicine accommodates the demand of both the Ministry of Education and Ministry of Health of China for educational reform by putting forward a "5+3" pattern, an innovative training pattern for this degree. The pattern focuses on…

  18. Evaluating the Efficacy of Using a Digital Reading Environment to Improve Reading Comprehension within a Reading Clinic

    Science.gov (United States)

    Ortlieb, Evan; Sargent, Stephan; Moreland, Meagan

    2014-01-01

    This study examined the effectiveness of using the online digital reading environment to increase elementary students' comprehension within a reading clinic. Preservice teachers at a four-year university in the Midwest worked one-on-one with 58 fourth-grade students from three schools who were assigned to one of three conditions: print-based text…

  19. Evaluating the Efficacy of Using a Digital Reading Environment to Improve Reading Comprehension within a Reading Clinic

    Science.gov (United States)

    Ortlieb, Evan; Sargent, Stephan; Moreland, Meagan

    2014-01-01

    This study examined the effectiveness of using the online digital reading environment to increase elementary students' comprehension within a reading clinic. Preservice teachers at a four-year university in the Midwest worked one-on-one with 58 fourth-grade students from three schools who were assigned to one of three conditions: print-based text…

  20. Theoretical foundations of personality assessment in clinical psychology

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    Emil Benedik

    2010-07-01

    Full Text Available The paper emphasizes an important role of personality assessment in clinical psychology, leading theoretical and methodological perspectives, as well as the need for integrating different concepts and methods in personality assessment. Personality assessment in clinical psychology represents methodological frame for better understanding and treatment of psychological (mental disorders. Two principles for personality assessment prevail: one is based on psychological concepts of personality and statistical methodology, and the other relies on findings from clinical practice (clinical psychology, psychiatry and related fields. Since we do not yet have a generally accepted paradigm of personality assessment, clinical psychology needs unified concepts and methodology for personality assessment. Several authors have attempted to integrate and unify psychological concepts and methodology of assessment in the last decade. This is the path to development of clinical psychology and psychological science in general.

  1. Comprehensive analysis of MGMT promoter methylation: correlation with MGMT expression and clinical response in GBM.

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    Nameeta Shah

    Full Text Available O⁶-methylguanine DNA-methyltransferase (MGMT promoter methylation has been identified as a potential prognostic marker for glioblastoma patients. The relationship between the exact site of promoter methylation and its effect on gene silencing, and the patient's subsequent response to therapy, is still being defined. The aim of this study was to comprehensively characterize cytosine-guanine (CpG dinucleotide methylation across the entire MGMT promoter and to correlate individual CpG site methylation patterns to mRNA expression, protein expression, and progression-free survival. To best identify the specific MGMT promoter region most predictive of gene silencing and response to therapy, we determined the methylation status of all 97 CpG sites in the MGMT promoter in tumor samples from 70 GBM patients using quantitative bisulfite sequencing. We next identified the CpG site specific and regional methylation patterns most predictive of gene silencing and improved progression-free survival. Using this data, we propose a new classification scheme utilizing methylation data from across the entire promoter and show that an analysis based on this approach, which we call 3R classification, is predictive of progression-free survival (HR  = 5.23, 95% CI [2.089-13.097], p<0.0001. To adapt this approach to the clinical setting, we used a methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA test based on the 3R classification and show that this test is both feasible in the clinical setting and predictive of progression free survival (HR  = 3.076, 95% CI [1.301-7.27], p = 0.007. We discuss the potential advantages of a test based on this promoter-wide analysis and compare it to the commonly used methylation-specific PCR test. Further prospective validation of these two methods in a large independent patient cohort will be needed to confirm the added value of promoter wide analysis of MGMT methylation in the clinical

  2. A Discrepancy in Comprehension and Production in Early Language Development in ASD: Is It Clinically Relevant?

    Science.gov (United States)

    Davidson, Meghan M.; Ellis Weismer, Susan

    2017-01-01

    This study examined the extent to which a discrepant comprehension-production profile (i.e., relatively more delayed comprehension than production) is characteristic of the early language phenotype in autism spectrum disorders (ASD) and tracked the developmental progression of the profile. Our findings indicated that a discrepant…

  3. On the Effect of Negotiated Metacognitive Assessments on Improving Listening Comprehension: A Case of Iranian EFL Learners

    Directory of Open Access Journals (Sweden)

    Masoud Yazdani Moghadam

    2015-05-01

    Full Text Available This paper reports a study investigating the role of negotiated assessment of metacognitive listening strategies in enhancing listening comprehension. To this aim, 60 Iranian EFL learners at intermediate level of language proficiency were assigned to an experimental (n = 30 and control group (n = 30. An attempt was made by the teacher in experimental group to raise students’ awareness of metacognitive strategies both prior to and after the doing listening comprehension tasks in a time bracket of eight weeks. Nonetheless, the control group followed conventional product-oriented approach to listening instruction; that is, no attempt was made to engage them in metacognitive instruction. Listening comprehension of both groups was assessed by listening section of IELTS at the onset and end of the study. Results of the study revealed that negotiated metacognitive assessment managed to significantly increase gains in listening comprehension. Furthermore, the experimental group significantly outperformed the control group. The results gave more credence to the positive role of process-based approach to teaching listening comprehension. The results are discussed in the light of metacognition and some pedagogical implications are included. Keywords: Listening comprehension, metacognition, metacognitive awareness, negotiated metacognitive assessment

  4. Comprehensive landscape-ecological index as the basis for the areas assessment

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    Надія Максименко

    2016-10-01

    Full Text Available Currently, different methods are used for spatial assessment of environmental conditions of the territory. The most informative are geochemical methods, which involve conducting field research with the selection and analysis of samples. Typically, the analytical data are used in the calculations of environmental indexes, ratios, integral indicators, etc. The authors believe that disadvantage of these methods is ignoring the landscape features of the territory, which does not allow to objectively assess it. The article substantiates the introduction of the landscape-ecological index (LEI to assess the environmental status of any territory. LEI calculation methodology includes a solid geochemical survey of the territory with sampling of all components of the environment (soil, vegetation, water. LEI calculation is carried out by the ratio of laboratory analysis samples results from standard rates for each sample at each point of selection and an integral factor of the landscape sensitivity in which each experimental area is located. Integral sensitivity rate of the landscape is calculated on the basis of the sensitivity assessment matrix developed by the authors. The authors foresee matrix filling based on expert assessments of the landscape sensitivity from 0 to 1, where 0 is the lowest sensitivity, and 1 - the highest. Testing methods were implemented on the example of Pechenigy reservoir basin within Kharkiv region. Based on the field experiment two indicators have been designed: a comprehensive environmental index (KEI J.V. Gryb method, and landscape-ecological index (LEI, the author’s (N.V. Maksymenko method. The obtained results formed the basis for mapping two models that reflect KEI and LEI spatial distribution. Comparative evaluation of the two models shows that it is the landscape-ecological index that allows a realistic assessment of the environmental condition and the environmental problems of the area.

  5. Comprehensive Assessment of the Psoriasis Patient (CAPP): A Report from the GRAPPA 2015 Annual Meeting.

    Science.gov (United States)

    Paek, So Yeon; Thompson, Jordan M; Qureshi, Abrar A; Merola, Joseph F; Husni, M Elaine

    2016-05-01

    Outcome measures for psoriasis severity are complex because of the heterogeneous presentation of the disease. At the 2015 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), members introduced the Comprehensive Assessment of the Psoriasis Patient (CAPP), a novel disease severity measure to more accurately assess the full burden of plaque psoriasis and subtypes, including inverse, scalp, nail, palmoplantar, and genital psoriasis. The CAPP is based on a 5-point physician's global assessment for 7 psoriasis phenotypes and incorporates visual analog scale-based, patient-derived, patient-reported outcomes. By quantifying disease effects of plaque psoriasis, 6 other psoriasis subtypes, as well as quality of life and daily function, the CAPP survey identifies a subset of psoriasis patients with moderate to severe psoriasis that would not be considered moderate to severe when assessed by the Psoriasis Area and Severity Index. The current version of CAPP is focused entirely on psoriasis. Feedback from our industry colleagues and collaborators has suggested that a psoriatic arthritis (PsA) measure may be important to include in the CAPP. At the 2015 GRAPPA meeting, we administered a survey to 106 GRAPPA members to determine whether a PsA measure should be included. A majority (74%) of respondents across all professions agreed that the CAPP should include a measure of PsA. Although responses varied widely on how PsA should be measured, a majority of the respondents reported that presence of PsA in both peripheral and axial joint assessment was important.

  6. A comprehensive assessment of family caregivers of stroke survivors during inpatient rehabilitation.

    Science.gov (United States)

    Young, Mary Ellen; Lutz, Barbara J; Creasy, Kerry Rae; Cox, Kim J; Martz, Crystal

    2014-01-01

    Stroke caregivers have been identified as a group at high risk for poor outcomes as a result of the suddenness of stroke and a potentially high level of care needed due to significant functional limitations of the patient. However, there is little research on the assessment of family members who will assume the caregiving role prior to patient discharge from rehabilitation. The purpose of this article is to delineate critical assessment domains identified by a subset of spousal stroke caregivers. Semi-structured interviews were conducted pre- and post-discharge from rehabilitation as part of a larger study that focused on identifying caregiver and stroke survivor needs as they transitioned home from inpatient rehabilitation. For this study, two semi-structured interviews with 14 spousal caregivers were analyzed using grounded theory methods. Long-term stroke survivor outcomes were dependent upon the commitment, capacity and preparedness of the family caregiver. Twelve domains of assessment were identified and presented. A comprehensive, systematic caregiver assessment to understand the caregiver's concerns about stroke should be conducted during rehabilitation to help the team to develop a plan to address unmet needs and better prepare family caregivers to take on the caregiving role. Stroke is a sudden event that often leaves stroke survivors and their families in crisis. The needs of stroke family caregivers are not often systematically assessed as part of inpatient rehabilitation. Long-term stroke survivor outcomes are dependent upon the commitment, capacity and preparedness of the family caregiver. Stroke caregiver assessment should include the commitment, capacity and preparedness to provide care, and the overall impact of stroke in order to develop discharge plans that will adequately address the needs of the stroke survivor/caregiver dyad.

  7. Value of comprehensive renal ultrasound in children with acute urinary tract infection for assessment of renal involvement: comparison with DMSA scintigraphy and final diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Brader, Peter; Riccabona, Michael [Medical University Graz, Division of Pediatric Radiology, Department of Radiology, Graz (Austria); Schwarz, Thomas [Medical University Graz, Division of Nuclear Medicine, Department of Radiology, Graz (Austria); Seebacher, Ursula [Medical University Graz, Department of Pediatric Surgery, Graz (Austria); Ring, Ekkehard [Medical University Graz, Department of Pediatrics, Graz (Austria)

    2008-12-15

    The aim of this study was to evaluate the value of comprehensive renal ultrasound (US), i.e., combining greyscale US and amplitude-coded color Doppler sonography (aCDS), for assessment of urinary tract infection (UTI) in infants and children, compared to (1) {sup 99m}Tc DMSA scintigraphy and (2) final diagnosis. Two hundred eighty-seven children with UTI underwent renal comprehensive US and DMSA scintigraphy. The results were compared with regard to their reliability to diagnose renal involvement, using (1) DMSA scintigraphy and (2) final diagnosis as the gold standard. Sixty-seven children clinically had renal involvement. Sensitivity increased from 84.1% using only aCDS to 92.1% for the combined US approach, using DMSA scintigraphy as the reference standard. When correlated with the final diagnosis, sensitivity for DMSA scintigraphy was 92.5%; sensitivity for comprehensive US was 94.0%. Our data demonstrate an increasing sensitivity using the combination of renal greyscale US supplemented by aCDS for differentiation of upper from lower UTI. Sensitivity for DMSA and comprehensive US was similar for both methods compared to the final diagnosis. Comprehensive US should gain a more important role in the imaging algorithm of children with acute UTI, thereby reducing the radiation burden. (orig.)

  8. National survey of comprehensive pharmacy services provided in cancer clinical trials.

    Science.gov (United States)

    Khandoobhai, Anand; Poi, Ming; Kelley, Katherine; Mirtallo, Jay; Lopez, Ben; Griffith, Niesha

    2017-06-01

    Pharmacy services provided in clinical trials at National Cancer Institute (NCI)-designated centers were assessed. This was a cross-sectional survey of 61 NCI-designated cancer centers. Directors of pharmacy were contacted and data were collected electronically via Qualtrics over 2 months. Trial participants were asked to estimate the frequency that their sites performed 26 services and the perceived importance of these services. Services were examined with respect to the difference between their reported performance and their reported importance. Eight of the 26 services showed a difference of at least 40% between the proportion of respondents performing the activities "often" or "almost always" and the proportion considering them "important" or "very important." Demographic information was collected, as well as perceived barriers. Survey response rate was 59% (36 out of 61). The majority of services for clinical trials (19 out of 26) were viewed as important for pharmacists to perform; however, less than half (10 out of 26) were performed more than 50% of the time. Eight services had a gap of more than 40% when comparing the importance versus extent of implementation. Some of the largest gaps were reported in investigator-initiated trials development, medication reconciliation, therapeutic drug monitoring, and oral chemotherapy adherence assessment. Future studies can assist with cost justification by demonstrating the regulatory, safety, and financial benefits of pharmacist involvement in cancer trials. A survey of pharmacy directors at cancer centers revealed gaps between what respondents considered important pharmacist services in the provision of cancer clinical trials and the actual performance of those services in their institution. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  9. A Prototypicality Validation of the Comprehensive Assessment of Psychopathic Personality (CAPP) Model Spanish Version.

    Science.gov (United States)

    Flórez, Gerardo; Casas, Alfonso; Kreis, Mette K F; Forti, Leonello; Martínez, Joaquín; Fernández, Juan; Conde, Manuel; Vázquez-Noguerol, Raúl; Blanco, Tania; Hoff, Helge A; Cooke, David J

    2015-10-01

    The Comprehensive Assessment of Psychopathic Personality (CAPP) is a newly developed, lexically based, conceptual model of psychopathy. The content validity of the Spanish language CAPP model was evaluated using prototypicality analysis. Prototypicality ratings were collected from 187 mental health experts and from samples of 143 health professionals and 282 community residents. Across the samples the majority of CAPP items were rated as highly prototypical of psychopathy. The Self, Dominance, and Attachment domains were evaluated as being more prototypical than the Behavioral and Cognitive domains. These findings are consistent with findings from similar studies in other languages and provide further support for the content validation of the CAPP model across languages and the lexical approach.

  10. A Comprehensive Probabilistic Tsunami Hazard Assessment: Multiple Sources and Short-Term Interactions

    Science.gov (United States)

    Anita, G.; Selva, J.; Laura, S.

    2011-12-01

    We develop a comprehensive and total probabilistic tsunami hazard assessment (TotPTHA), in which many different possible source types concur to the definition of the total tsunami hazard at given target sites. In a multi-hazard and multi-risk perspective, such an innovative approach allows, in principle, to consider all possible tsunamigenic sources, from seismic events, to slides, asteroids, volcanic eruptions, etc. In this respect, we also formally introduce and discuss the treatment of interaction/cascade effects in the TotPTHA analysis. We demonstrate how external triggering events may induce significant temporary variations in the tsunami hazard. Because of this, such effects should always be considered, at least in short-term applications, to obtain unbiased analyses. Finally, we prove the feasibility of the TotPTHA and of the treatment of interaction/cascade effects by applying this methodology to an ideal region with realistic characteristics (Neverland).

  11. Assessment of alexithymia with the Rorschach Comprehensive System: the Rorschach Alexithymia Scale (RAS).

    Science.gov (United States)

    Porcelli, Piero; Mihura, Joni L

    2010-03-01

    In this study, we developed the Rorschach Alexithymia Scale (RAS) to be used with protocols scored with the Comprehensive System (CS; Exner, 1993). A total of 92 patients with medical disease and 127 psychiatric outpatients were administered the Rorschach and the 20-item Toronto Alexithymia Scale (Bagby, Parker, & Taylor, 1994a, 1994b). We used a systematic approach, including cross-validation, to reduce a pool of 27 CS codes issued from an earlier investigation (Porcelli & Meyer, 2002) to 3 variables: Form%, CDI, and Pop. The RAS showed excellent diagnostic accuracy (hit rate of 92%, sensitivity of 88%, specificity of 94%, and area under the curve of .96). We suggest that the RAS can be used as a reliable integrative tool in a multimethod assessment approach to measuring alexithymia.

  12. The validation and clinical implementation of BRCAplus: a comprehensive high-risk breast cancer diagnostic assay.

    Directory of Open Access Journals (Sweden)

    Hansook Kim Chong

    Full Text Available Breast cancer is the most commonly diagnosed cancer in women, with 10% of disease attributed to hereditary factors. Although BRCA1 and BRCA2 account for a high percentage of hereditary cases, there are more than 25 susceptibility genes that differentially impact the risk for breast cancer. Traditionally, germline testing for breast cancer was performed by Sanger dideoxy terminator sequencing in a reflexive manner, beginning with BRCA1 and BRCA2. The introduction of next-generation sequencing (NGS has enabled the simultaneous testing of all genes implicated in breast cancer resulting in diagnostic labs offering large, comprehensive gene panels. However, some physicians prefer to only test for those genes in which established surveillance and treatment protocol exists. The NGS based BRCAplus test utilizes a custom tiled PCR based target enrichment design and bioinformatics pipeline coupled with array comparative genomic hybridization (aCGH to identify mutations in the six high-risk genes: BRCA1, BRCA2, PTEN, TP53, CDH1, and STK11. Validation of the assay with 250 previously characterized samples resulted in 100% detection of 3,025 known variants and analytical specificity of 99.99%. Analysis of the clinical performance of the first 3,000 BRCAplus samples referred for testing revealed an average coverage greater than 9,000X per target base pair resulting in excellent specificity and the sensitivity to detect low level mosaicism and allele-drop out. The unique design of the assay enabled the detection of pathogenic mutations missed by previous testing. With the abundance of NGS diagnostic tests being released, it is essential that clinicians understand the advantages and limitations of different test designs.

  13. Evaluation of a comprehensive clinical dentistry course at dental schools in Saudi Arabia

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    Haidar Al-Alawi

    2015-01-01

    Full Text Available Introduction: This study aimed to evaluate a Comprehensive Clinical Dentistry Course conducted at two dental schools in Saudi Arabia. Materials and Methods: This cross-sectional cohort study was conducted in two dental schools: King Saud University (KSU and University of Dammam (UOD. The study subjects were students (42 UOD and 30 KSU, patients (32 UOD and 46 KSU, and faculty members (8 UOD and 7 KSU. Evaluations were collected using self-administered surveys. Results: The response rates were 72%, 78%, and 32% for students, patients, and faculty members, respectively. The students′ evaluations demonstrated that case acceptance by supervisors was one of the difficulties facing 57.14% of UOD students compared to 30% of KSU students. The majority of faculty members (39% were restorative specialists (25% UOD, 42.86% KSU. The overall evaluation of UOD faculty members was fair (50% or good to very good (50%. For KSU faculty members, the overall evaluation was good (50% or very good (50%. The mean age of the patients was 33.26 years. The level of education of the study subjects was either secondary school (43.6% or university level (35.9%. Most of the study subjects knew about the program from their friends (57.7%. Approximately 96.1% of the study subjects were satisfied with the overall treatment of students. Discussion: The fundamental aim of the students was to have their cases accepted as early as possible to complete requirements on time. Conclusion: Dental students displayed relatively high psychological stress in relation to case acceptance by their supervisors. Demonstrating good attitude and quality treatment can increase the flow of patients.

  14. Interdisciplinary Learning Works: The Results of a Comprehensive Assessment of Students and Student Learning Outcomes in an Integrative Learning Community

    Science.gov (United States)

    Carmichael, Tami; LaPierre, Yvette

    2014-01-01

    This article describes the development, implementation, and results of an extensive assessment of students and student learning outcomes in an interdisciplinary, integrative learning community. This assessment project took a comprehensive view of student learning by examining specific data and direct and indirect measures of academic growth for…

  15. A comprehensive Probabilistic Tsunami Hazard Assessment for the city of Naples (Italy)

    Science.gov (United States)

    Anita, G.; Tonini, R.; Selva, J.; Sandri, L.; Pierdominici, S.; Faenza, L.; Zaccarelli, L.

    2012-12-01

    A comprehensive Probabilistic Tsunami Hazard Assessment (PTHA) should consider different tsunamigenic sources (seismic events, slide failures, volcanic eruptions) to calculate the hazard on given target sites. This implies a multi-disciplinary analysis of all natural tsunamigenic sources, in a multi-hazard/risk framework, which considers also the effects of interaction/cascade events. Our approach shows the ongoing effort to analyze the comprehensive PTHA for the city of Naples (Italy) including all types of sources located in the Tyrrhenian Sea, as developed within the Italian project ByMuR (Bayesian Multi-Risk Assessment). The project combines a multi-hazard/risk approach to treat the interactions among different hazards, and a Bayesian approach to handle the uncertainties. The natural potential tsunamigenic sources analyzed are: 1) submarine seismic sources located on active faults in the Tyrrhenian Sea and close to the Southern Italian shore line (also we consider the effects of the inshore seismic sources and the associated active faults which we provide their rapture properties), 2) mass failures and collapses around the target area (spatially identified on the basis of their propensity to failure), and 3) volcanic sources mainly identified by pyroclastic flows and collapses from the volcanoes in the Neapolitan area (Vesuvius, Campi Flegrei and Ischia). All these natural sources are here preliminary analyzed and combined, in order to provide a complete picture of a PTHA for the city of Naples. In addition, the treatment of interaction/cascade effects is formally discussed in the case of significant temporary variations in the short-term PTHA due to an earthquake.

  16. Alternative Assessment Strategy and Its Impact on Student Comprehension in an Undergraduate Microbiology Course

    Directory of Open Access Journals (Sweden)

    Barry J. Margulies

    2009-12-01

    Full Text Available Medical Microbiology is a content-intensive course that requires a large time commitment from the students. Students are typically biology or prenursing majors, including students headed for professional schools, such as medical school and pharmacy school. This group is somewhat diverse in terms of background science coursework, so it can be difficult to teach in a way that benefits all the students. Numerous changes have been implemented in our microbiology curriculum to address the different abilities of our students by altering assessment and teaching strategies. It was hypothesized that changing the assessment strategy from the traditional scheme of two or three exams and one final to a new model of seven or eight shorter exams would have a positive impact on student comprehension and retention. The quantity of material taught or expected of the students to learn did not change, but there was definitely an impact on them. Although 30.0% of students routinely did not pass microbiology in previous semesters, the new method of assessment resulted in only 9.63% not completing the semester successfully, as determined by earning a grade of C or better. There is some evidence from conversations and interviews with students that indicates a positive impact of this methodology on student attitude. Implementation of these changes in other courses and their current effectiveness will be examined in the future, with an eye towards more broadly applicable successful teaching techniques in the sciences, especially for nonmajors.

  17. Comprehensive, Quantitative Risk Assessment of CO{sub 2} Geologic Sequestration

    Energy Technology Data Exchange (ETDEWEB)

    Lepinski, James

    2013-09-30

    A Quantitative Failure Modes and Effects Analysis (QFMEA) was developed to conduct comprehensive, quantitative risk assessments on CO{sub 2} capture, transportation, and sequestration or use in deep saline aquifers, enhanced oil recovery operations, or enhanced coal bed methane operations. The model identifies and characterizes potential risks; identifies the likely failure modes, causes, effects and methods of detection; lists possible risk prevention and risk mitigation steps; estimates potential damage recovery costs, mitigation costs and costs savings resulting from mitigation; and ranks (prioritizes) risks according to the probability of failure, the severity of failure, the difficulty of early failure detection and the potential for fatalities. The QFMEA model generates the necessary information needed for effective project risk management. Diverse project information can be integrated into a concise, common format that allows comprehensive, quantitative analysis, by a cross-functional team of experts, to determine: What can possibly go wrong? How much will damage recovery cost? How can it be prevented or mitigated? What is the cost savings or benefit of prevention or mitigation? Which risks should be given highest priority for resolution? The QFMEA model can be tailored to specific projects and is applicable to new projects as well as mature projects. The model can be revised and updated as new information comes available. It accepts input from multiple sources, such as literature searches, site characterization, field data, computer simulations, analogues, process influence diagrams, probability density functions, financial analysis models, cost factors, and heuristic best practices manuals, and converts the information into a standardized format in an Excel spreadsheet. Process influence diagrams, geologic models, financial models, cost factors and an insurance schedule were developed to support the QFMEA model. Comprehensive, quantitative risk assessments

  18. Towards a comprehensive assessment and framework for low and high flow water risks

    Science.gov (United States)

    Motschmann, Alina; Huggel, Christian; Drenkhan, Fabian; León, Christian

    2017-04-01

    Driven by international organizations such as the Intergovernmental Panel on Climate Change (IPCC) the past years have seen a move from a vulnerability concept of climate change impacts towards a risk framework. Risk is now conceived at the intersection of climate-driven hazard and socioeconomic-driven vulnerability and exposure. The concept of risk so far has been mainly adopted for sudden-onset events. However, for slow-onset and cumulative climate change impacts such as changing water resources there is missing clarity and experience how to apply a risk framework. Research has hardly dealt with the challenge of how to integrate both low and high flow risks in a common framework. Comprehensive analyses of risks related to water resources considering climate change within multi-dimensional drivers across different scales are complex and often missing in climate-sensitive mountain regions where data scarcity and inconsistencies represent important limitations. Here we review existing vulnerability and risk assessments of low and high flow water conditions and identify critical conceptual and practical gaps. Based on this, we develop an integrated framework for low and high flow water risks which is applicable to both past and future conditions. The framework explicitly considers a water balance model simulating both water supply and demand on a daily basis. We test and apply this new framework in the highly glacierized Santa River catchment (SRC, Cordillera Blanca, Peru), representative for many developing mountain regions with both low and high flow water risks and poor data availability. In fact, in the SRC, both low and high flow hazards, such as droughts and floods, play a central role especially for agricultural, hydropower, domestic and mining use. During the dry season (austral winter) people are increasingly affected by water scarcity due to shrinking glaciers supplying melt water. On the other hand during the wet season (austral summer) high flow water

  19. Clinical Assessment of Psychopathology in Violent and Nonviolent Juvenile Offenders.

    Science.gov (United States)

    Richardson, Linda M.; And Others

    The Minnesota Multiphasic Personality Inventory (MMPI) and the Rorschach test are frequently used in juvenile justice settings to assess current psychological functioning and to predict future behavior. The Exner Comprehensive System, which standardized the Rorschach, made possible a comparison of the Rorschach and the MMPI in an investigation of…

  20. A comprehensive approach to benefit-risk assessment in drug development

    DEFF Research Database (Denmark)

    Sarac, Sinan B; Rasmussen, Christian H; Rasmussen, Morten A.

    2012-01-01

    phase. The proposed benefit-risk assessment method involves eight successive steps: (1) establishment of the decision context, (2) identification of benefit and risk criteria, (3) weighting, (4) scoring, (5) evaluation of uncertainty, (6) calculation of weighted scores, (7) visualization, and (8...... facilitate decision processes. It employs descriptive statistical methods to highlight the clinically significant differences between drugs in clinical trials. The approach can be used in single as well as in multiple trials and provides clear diagrams as the basis for presentation and discussion...... method, where two or more drugs/doses can be compared. Our aim is to formulate an approach that is simple to apply, allows direct comparison of different types of risks and benefits, and is tailored for application in different disease areas both during clinical development and in the marketing approval...

  1. [Assessing the clinical competence of dental students].

    Science.gov (United States)

    Schoonheim-Klein, M E; van Selms, M K A; Volgenant, C M C; Wiegman, H P; Vervoorn, J M

    2012-06-01

    Nowadays, the competences of dental students are tested more on the basis of quality of their achievements than the quantity. 'Objective Structured Clinical Examinations' (OSCEs) can be used in a pre-clinical phase to test these clinical competences. For the clinical phase, the general examination and the digital portfolio have been developed. Tests are used to stimulate the learning process and to determine whether students are ready for the next step; in addition, the quality of the programme is protected by the set of examinations. The results of the last 5 general examinations reveal the pattern that the number of correct answers increases as the study progresses. The Amsterdam Academic Centre for Dentistry (ACTA) introduced a digital portfolio which was evaluated 1 year later with the help ofan anonymous questionnaire. Students judged the use of the digital portfolio in the clinic to be useful but also costly in time.

  2. Alexithymia and Irony Comprehension and their Relations with Depression, Anxiety, General Symptomatology and Personality Disorders: A Comparison Between Clinical and Non-Clinical Participants

    Directory of Open Access Journals (Sweden)

    Giancarlo Dimaggio

    2011-11-01

    Full Text Available Poor awareness of one's own emotions and theory of mind appears to be a feature of many adult psychiatric conditions. In this study, we explored whether alexithymia and poor understanding of irony, both elements of the metacognitive system, were impaired in a clinical sample ('n' = 20 when compared to a non-clinical group ('n' = 35. We expected that both elements were impaired in the clinical group and explored whether they were correlated with personality disorder traits, global symptomatology, depression and anxiety. Finally, we sought to investigate whether alexithymia and difficulties in irony comprehension were related to each other. Results partially supported our hypotheses. Both emotional awareness and irony comprehension were impaired in the clinical vs. non-clinical sample. Alexithymia was related to personality disorder traits in both groups, and was linked with depression in the clinical group only. Irony understanding was not related to any elements of personality or symptoms, though time in reacting to irony vignettes was linked with cluster A and B traits in the clinical group only. Finally, the two elements were not significantly related to one another, except for a link between alexithymia and time spent in reacting to irony vignettes. With the caveat that the size of the clinical sample was small, results are consistent with the contention that many with psychiatric conditions experience metacognitive deficits which could be the target of intervention.

  3. Comprehensive Red List assessment reveals exceptionally high extinction risk to Madagascar palms.

    Science.gov (United States)

    Rakotoarinivo, Mijoro; Dransfield, John; Bachman, Steven P; Moat, Justin; Baker, William J

    2014-01-01

    The establishment of baseline IUCN Red List assessments for plants is a crucial step in conservation planning. Nowhere is this more important than in biodiversity hotspots that are subject to significant anthropogenic pressures, such as Madagascar. Here, all Madagascar palm species are assessed using the IUCN Red List categories and criteria, version 3.1. Our results indicate that 83% of the 192 endemic species are threatened, nearly four times the proportion estimated for plants globally and exceeding estimates for all other comprehensively evaluated plant groups in Madagascar. Compared with a previous assessment in 1995, the number of Endangered and Critically Endangered species has substantially increased, due to the discovery of 28 new species since 1995, most of which are highly threatened. The conservation status of most species included in both the 1995 and the current assessments has not changed. Where change occurred, more species have moved to lower threat categories than to higher categories, because of improved knowledge of species and their distributions, rather than a decrease in extinction risk. However, some cases of genuine deterioration in conservation status were also identified. Palms in Madagascar are primarily threatened by habitat loss due to agriculture and biological resource use through direct exploitation or collateral damage. The recent extension of Madagascar's protected area network is highly beneficial for palms, substantially increasing the number of threatened species populations included within reserves. Notably, three of the eight most important protected areas for palms are newly designated. However, 28 threatened and data deficient species are not protected by the expanded network, including some Critically Endangered species. Moreover, many species occurring in protected areas are still threatened, indicating that threatening processes persist even in reserves. Definitive implementation of the new protected areas combined with

  4. Using the Evaluative Linguistic Framework for Questionnaires to Assess Comprehensibility of Self-Report Health Questionnaires.

    Science.gov (United States)

    Clerehan, Rosemary; Guillemin, Francis; Epstein, Jonathan; Buchbinder, Rachelle

    2016-06-01

    The Evaluative Linguistic Framework (ELF) was developed to judge the quality of health care texts for patients, based on systemic functional linguistic theory. This approach considers key variables such as context and structure, known to be important for communication. Our objective was to adapt the ELF to evaluate the quality of self-report questionnaires. We reviewed the Health Literacy Questionnaire using the ELF. On the basis of these data, we drafted the preliminary version of the Evaluative Linguistic Framework for Questionnaires (ELF-Q) and applied it to English- and French-language versions of two arthritis self-report questionnaires and to Spanish, Dutch, and Turkish versions of an arthritis questionnaire. The developed ELF-Q was found to be effective for evaluating questionnaires in English and in four other languages. It contains nine items with new descriptions and assessment probes. These include overall organizational or generic structure of the questionnaire, metadiscourse (or text about the text), headings, rhetorical elements (function of each "move" or stage of the text in relation to the reader), the writer-reader relationship, technicality of vocabulary, lexical density (proportion of content words in the text), format, and overall judgment. We added assessment responses on a two- or three-point Likert scale to complement the assessment probes and make the intent and meaning of the probes fully explicit for the questionnaire developer or assessor. The ELF-Q is a framework practical to use for the development or assessment of any type of self-report questionnaire. Its application can identify features of a self-report questionnaire that could be improved to optimize its comprehensibility. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  5. Comprehensive Red List assessment reveals exceptionally high extinction risk to Madagascar palms.

    Directory of Open Access Journals (Sweden)

    Mijoro Rakotoarinivo

    Full Text Available The establishment of baseline IUCN Red List assessments for plants is a crucial step in conservation planning. Nowhere is this more important than in biodiversity hotspots that are subject to significant anthropogenic pressures, such as Madagascar. Here, all Madagascar palm species are assessed using the IUCN Red List categories and criteria, version 3.1. Our results indicate that 83% of the 192 endemic species are threatened, nearly four times the proportion estimated for plants globally and exceeding estimates for all other comprehensively evaluated plant groups in Madagascar. Compared with a previous assessment in 1995, the number of Endangered and Critically Endangered species has substantially increased, due to the discovery of 28 new species since 1995, most of which are highly threatened. The conservation status of most species included in both the 1995 and the current assessments has not changed. Where change occurred, more species have moved to lower threat categories than to higher categories, because of improved knowledge of species and their distributions, rather than a decrease in extinction risk. However, some cases of genuine deterioration in conservation status were also identified. Palms in Madagascar are primarily threatened by habitat loss due to agriculture and biological resource use through direct exploitation or collateral damage. The recent extension of Madagascar's protected area network is highly beneficial for palms, substantially increasing the number of threatened species populations included within reserves. Notably, three of the eight most important protected areas for palms are newly designated. However, 28 threatened and data deficient species are not protected by the expanded network, including some Critically Endangered species. Moreover, many species occurring in protected areas are still threatened, indicating that threatening processes persist even in reserves. Definitive implementation of the new protected

  6. Comprehensive Red List Assessment Reveals Exceptionally High Extinction Risk to Madagascar Palms

    Science.gov (United States)

    Rakotoarinivo, Mijoro; Dransfield, John; Bachman, Steven P.; Moat, Justin; Baker, William J.

    2014-01-01

    The establishment of baseline IUCN Red List assessments for plants is a crucial step in conservation planning. Nowhere is this more important than in biodiversity hotspots that are subject to significant anthropogenic pressures, such as Madagascar. Here, all Madagascar palm species are assessed using the IUCN Red List categories and criteria, version 3.1. Our results indicate that 83% of the 192 endemic species are threatened, nearly four times the proportion estimated for plants globally and exceeding estimates for all other comprehensively evaluated plant groups in Madagascar. Compared with a previous assessment in 1995, the number of Endangered and Critically Endangered species has substantially increased, due to the discovery of 28 new species since 1995, most of which are highly threatened. The conservation status of most species included in both the 1995 and the current assessments has not changed. Where change occurred, more species have moved to lower threat categories than to higher categories, because of improved knowledge of species and their distributions, rather than a decrease in extinction risk. However, some cases of genuine deterioration in conservation status were also identified. Palms in Madagascar are primarily threatened by habitat loss due to agriculture and biological resource use through direct exploitation or collateral damage. The recent extension of Madagascar’s protected area network is highly beneficial for palms, substantially increasing the number of threatened species populations included within reserves. Notably, three of the eight most important protected areas for palms are newly designated. However, 28 threatened and data deficient species are not protected by the expanded network, including some Critically Endangered species. Moreover, many species occurring in protected areas are still threatened, indicating that threatening processes persist even in reserves. Definitive implementation of the new protected areas combined

  7. [Post-marketing clinical study of traditional Chinese medicine--lessons learned from comprehensive evaluation of Fufang Zaoren capsule].

    Science.gov (United States)

    Qing, Shan; Gao, Lin; Zhang, Li; Jia, Jian-Ping; Liu, Xin-Min; Ji, Shao-Liang; Yang, Xiao-Hui

    2013-11-01

    By comprehensive review and analysis of post-marketing clinical research on the efficacy and safety,we concluded that Fufang Zaoren capsule has certain therapeutic effects for insomnia, although current clinical research design needs improving. The post-marketing clinical studies also showed that it causes several adverse reactions at the recommended doses, such as chills, fever, dizziness, nausea, shortness of breath, chest tightness and palpitations, whereas high doses of Fufang Zaoren capsule can cause delayed extrapyramidal symptoms. Health Canada government website also prompted the L-tetrahydropalmatine in Fufang Zaoren capsule caused liver damage in pregnant women. The authors summarized the risk points, factors and risk control in the clinical use of Fufang Zaoren capsule and also present their perspective on the research status, existing problems and corresponding countermeasures in the post-marketing clinical re-evaluation of traditional Chinese medicine.

  8. Study of a Comprehensive Assessment Method for Coal Mine Safety Based on a Hierarchical Grey Analysis

    Institute of Scientific and Technical Information of China (English)

    LIU Ya-jing; MAO Shan-jun; LI Mei; YAO Ji-ming

    2007-01-01

    Coal mine safety is a complex system, which is controlled by a number of interrelated factors and is difficult to estimate. This paper proposes an index system of safety assessment based on correlated factors involved in coal mining and a comprehensive evaluation model that combines the advantages of the AHP and a grey clustering method to guarantee the accuracy and objectivity of weight coefficients. First, we confirmed the weight of every index using the AHP, then did a general safety assessment by means of a grey clustering method. This model analyses the status of mining safety both qualitatively and quantitatively. It keeps management and technical groups informed of the situation of the coal production line in real time, which aids in making correct decisions based on practical safety issues. A case study in the application of the model is presented. The results show that the method is applicable and realistic with regard to the core of a coal mine's safety management. Consequently, the safe production of a mine and the awareness of advanced safe production management is accelerated.

  9. Fuzzy comprehensive evaluation-based disaster risk assessment of desertification in Horqin Sand Land, China.

    Science.gov (United States)

    Wang, Yongfang; Zhang, Jiquan; Guo, Enliang; Sun, Zhongyi

    2015-02-03

    Desertification is a typical disaster risk event in which human settlements and living environments are destroyed. Desertification Disaster Risk Assessment can control and prevent the occurrence and development of desertification disasters and reduce their adverse influence on human society. This study presents the methodology and procedure for risk assessment and zoning of desertification disasters in Horqin Sand Land. Based on natural disaster risk theory and the desertification disaster formation mechanism, the Desertification Disaster Risk Index (DDRI) combined hazard, exposure, vulnerability and restorability factors and was developed mainly by using multi-source data and the fuzzy comprehensive evaluation method. The results showed that high risk and middle risk areas account for 28% and 23% of the study area, respectively. They are distributed with an "S" type in the study area. Low risk and very low risk areas account for 21% and 10% of the study area, respectively. They are distributed in the west-central and southwestern parts. Very high risk areas account for 18% of the study area and are distributed in the northeastern parts. The results can be used to know the desertification disaster risk level. It has important theoretical and practical significance to prevention and control of desertification in Horqin Sand Land and even in Northern China.

  10. Fuzzy Comprehensive Evaluation-Based Disaster Risk Assessment of Desertification in Horqin Sand Land, China

    Directory of Open Access Journals (Sweden)

    Yongfang Wang

    2015-02-01

    Full Text Available Desertification is a typical disaster risk event in which human settlements and living environments are destroyed. Desertification Disaster Risk Assessment can control and prevent the occurrence and development of desertification disasters and reduce their adverse influence on human society. This study presents the methodology and procedure for risk assessment and zoning of desertification disasters in Horqin Sand Land. Based on natural disaster risk theory and the desertification disaster formation mechanism, the Desertification Disaster Risk Index (DDRI combined hazard, exposure, vulnerability and restorability factors and was developed mainly by using multi-source data and the fuzzy comprehensive evaluation method. The results showed that high risk and middle risk areas account for 28% and 23% of the study area, respectively. They are distributed with an “S” type in the study area. Low risk and very low risk areas account for 21% and 10% of the study area, respectively. They are distributed in the west-central and southwestern parts. Very high risk areas account for 18% of the study area and are distributed in the northeastern parts. The results can be used to know the desertification disaster risk level. It has important theoretical and practical significance to prevention and control of desertification in Horqin Sand Land and even in Northern China.

  11. [Comprehensive Assessment of Psychiatric Residents: An Addition to the Program Admission Process].

    Science.gov (United States)

    Luis, E Jaramillo G; Elena, Martín C

    2012-01-01

    The training of medical specialists is a long and complex process. Its purpose is to guarantee the society that they are the right professionals to meet the health needs of the population. The first step to ensure this objective is the admission process. In psychiatry this process, monitoring resident students and the criteria for each one are different in each country. Admission in Colombia is a heterogeneous process, not standardized, which varies greatly from one university to another, even between private and public universities. At the National University of Colombia, the admissions process is handled by the Admissions Office and includes: a written test for which you must obtain a minimum score, a resume rating and an interview. The Teaching Committee and the Department of Psychiatry considered the admission procedure in general to be good, but in need of refinement. Due to the experience of some teachers and given the current rules, a "comprehensive assessment" for master and doctoral students was required and in 1996 it was decided that this method of assessment for admission to a specialization in Psychiatry would serve to complement the admission process. The article describes the experience of the process and its outcomes, strengths and weaknesses. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  12. Assessing metaphor comprehension as a metasemantic ability in students from 9-to-14 years-old.

    Directory of Open Access Journals (Sweden)

    Paolo Iliceto

    2011-01-01

    Full Text Available This article presents a test for assessing metaphor comprehension (MCT in explicit linguistic form for subjects aged 9- to 14 years-old, i.e. in a transitional age where significant qualitative changes appear for this type of ability. Metaphor is viewed as a form of semantic conflict induced by the anomalous combination of the conventional meanings of its main constituents - tenor and vehicle - and metaphor comprehension is framed as a metasemantic ability based on the analysis of these meanings (Gombert 1990, that can have implications both for teaching and for learning strategies.The authors propose a functionalist piagetian frame, based on Piaget’s latest equilibration model (1975, for analysing how this semantic conflict can be faced and solved by children in the developmental span considered. The test is paper-and-pencil, composed of 12 items subdivided into 2 groups of metaphors: Psycho-physical (PP and Conceptual (C, mainly drawn and adapted to Italian language from international literature on metaphor comprehension. The sample is composed of 874 Italian children from 4th to 8th grade, with gender balance, of average social background. By means of Principal Components Analysis, with oblimin rotation, a two-factor solution emerged, that espouses the C/PP metaphors distinction. All corrected item-total correlation coefficients >.30 were representative and acceptable. Correlation coefficients between MCT and Standard progressive Matrices (SPM38 and some validated metalinguistic subtests were all significant at p <0.01 level, showing good convergent validity. Cronbach’s Alpha coefficients for the two subscales were: .62 (C, .51 (PP and .70 for MCT total score. Test-retest correlation oefficients for the two subscales were .79 (C, .69 (PP, and .83 for MCT total score. Cohen’s Kappa coefficients for interrater reliability are: .75 (4th-5th, .74 (6th, .67 (7th, .81 (8th. A twofactor ANOVA (gender and age showed that the test is gender

  13. Comprehensive Assessment of Integration Activity of Business Structures in Russian Regions

    Directory of Open Access Journals (Sweden)

    Mariya Gennad’evna Karelina

    2016-11-01

    Full Text Available In the context of economic sanctions and growing international isolation, the research into regional differences in integration development acquires special relevance for Russia; this fact determines the need for a comprehensive assessment of integration activity of business structures in Russian regions. The diversity of approaches to the study of problems and prospects of economic integration and the current debate about the role of integration processes in the development of regional economies determined a comprehensive approach to the concepts of “integration” and “integration activity” in order to create objective prerequisites for analyzing integration activity of business structures in the regions of Russia. The information base of the research is the data of Russian information and analytical agencies. The tools used in the research include methods for analyzing structural changes, methods for analyzing economic differentiation and concentration, nonparametric statistics methods, and econometric analysis methods. The first part of the paper shows that socio-economic development in constituent entities of Russia is closely connected with the operation of integrated business structures located on their territory. Having studied the structure and dynamics of integration activity, we reveal the growing heterogeneity of integration activity of business structures in Russian regions. The hypothesis about significant divergence of mergers and acquisitions for corporate structures in Russian regions was confirmed by high values of the Gini coefficient, the Herfindahl index and the decile differentiation coefficient. The second part of the paper contains a comparative analysis and proposes an econometric approach to the measurement of integration activity of business structures in subjects of the Russian Federation on the basis of integral synthetic categories. The approach we propose focuses on the development of a system of indicators

  14. AAC assessment and clinical-decision making: the impact of experience.

    Science.gov (United States)

    Dietz, Aimee; Quach, Wendy; Lund, Shelley K; McKelvey, Miechelle

    2012-09-01

    People with complex communication needs often require a comprehensive augmentative and alternative communication (AAC) assessment to maximize participation in daily interactions. Assessment of AAC is a complex process and limited practice guidelines exist. The purpose of this qualitative study was to explore how 25 speech-language pathologists with varying levels of experience approach the AAC assessment process. Participants were classified as either (a) General Practice Speech-Language Pathologists (GPSLPs), (b) AAC Clinical Specialists (AAC-CS), or (c) AAC Research/Policy Specialists (AAC-RS). In-depth, semi-structured interviews were conducted to explore the participants' approach to AAC assessment. The results revealed that GPSLPs approach AAC assessment differently than the AAC-CS and AAC-RS; however, the Specialists reported a similar approach that may help guide the development of practice guidelines for AAC assessment.

  15. Comprehensive assessment of nutritional status and associated factors in the healthy, community-dwelling elderly.

    Science.gov (United States)

    Iizaka, Shinji; Tadaka, Etsuko; Sanada, Hiromi

    2008-03-01

    Malnutrition among the elderly has become a serious problem as their population increases in Japan. To approach the risk of malnutrition in the healthy, community-dwelling elderly is important for early prevention of malnutrition. The nutritional status and mutable associated factors with poor nutritional status specific to the healthy elderly were examined comprehensively. One hundred and thirty healthy elderly people from a senior college in Tokyo, Japan were eligible for this study. Nutritional status was evaluated by Mini-Nutritional Assessment (MNA). The demographic status and potential correlates with poor nutritional status, including the physical factors (mobility, cognitive impairment and oral status) and the psychosocial factors (depression, self-efficacy, attitudes toward health, instrumental activities of daily living, public health service knowledge, and difficulty and dissatisfaction with meal preparation) were investigated. The multiple linear regression analysis using a stepwise procedure adjusted for demographic status was performed to detect independent associated factors. There were 16 participants (12.6%) at risk of malnutrition. The independent associated factors with lower MNA scores were depression (beta = -0.27, P = 0.005), lower self-efficacy (beta = 0.25, P = 0.009), lower attitudes toward health scores (beta = 0.21, P = 0.02) and difficulty with meal preparation (beta = -0.18, P = 0.03). The prevalence of the healthy elderly at the initial risk of malnutrition was relatively high and should not be overlooked. The comprehensive geriatric screening and intervention including mental health, health management and life-situation will be important for the healthy, community-dwelling elderly.

  16. Experience of a comprehensive infertility clinic in the Department of Obstetrics and Gynaecology, University of Singapore.

    Science.gov (United States)

    Ratnam, S S; Chew, P C; Tsakok, M

    1976-09-01

    The diagnosis, treatment, and pregnancy outcome for 709 infertile couples who attended the comprehensive infertility clinic of the University of Singapore's Department of Obstetrics and Gynecology from 1970-1974 are presented. Investigations for most of the couples were completed within 3 months. This short investigative period was attributable primarly to the use of laparoscopy to diagnose female infertility. In 22.5% of the 709 cases infertility was due to ovulation problems. After treatment eith either clomiphene, human pituitory gonadotrophin, or a combination of clomiphene and human chorinic gonadotrophin, pregnancy was achieved in 30.6% of the cases. 11.7% or 83 of the 709 infertility cases were attributed to blocked tubes. 28 of these patients received tubal surgery, but only 14.3% or 4 of these cases resulted in pregnancy. In 14.7% of the 709 cases, infertility was attributed to endometriosis. 90% of the patients with endometriosis were asymptomatic, and the liesons discovered by laparoscopy, were very small. Pregnancy eventually occurred in 27.6% of the cases treated for endometriosis. In 5.8% of the 709 cases infertility was due to mixed gynecological problems, and after treatment, conception occurred among 31.7% of the cases. For 23.1%, or 147 of the 709 couples, infertility was attributed to either oligospermia or azoospermia. 85 of the 147 patients were given hormone therapy and in 12.9% of these cases pregnancy was achieved. 14 of the 147 patients were treated with antibotics for 3-6 months and in 14.3% of these cases pregnancy was achieved. 9 of the 147 patients were surgically treated and in 4 of these cases pregnancy later occurred. 20 of the 147 couples were treated with artifical insemination of donor semen and in 25.0% of these cases pregnancy occurred. Another 19 of the 147 cases were treated with artificial insemination with the husband's semen and conception occurred in 26.8% of these cases. The remaining 22.1% of the 709 couples were

  17. Clinical Considerations in the Assessment of Adolescent Chemical Dependency.

    Science.gov (United States)

    Winters, Ken

    1990-01-01

    Discusses relevant research findings of clinical assessment of adolescent chemical dependency so that service providers can better address these concerns. Three major issues are discussed: the definition of adolescent chemical dependency, clinical domains of assessment (chemical use problem severity, precipitating and perpetuating risk factors,…

  18. Conus: first comprehensive conservation red list assessment of a marine gastropod mollusc genus.

    Directory of Open Access Journals (Sweden)

    Howard Peters

    Full Text Available Marine molluscs represent an estimated 23% of all extant marine taxa, but research into their conservation status has so far failed to reflect this importance, with minimal inclusion on the authoritative Red List of the International Union for the Conservation of Nature (IUCN. We assessed the status of all 632 valid species of the tropical marine gastropod mollusc, Conus (cone snails, using Red List standards and procedures to lay the groundwork for future decadal monitoring, one of the first fully comprehensive global assessments of a marine taxon. Three-quarters (75.6% of species were not currently considered at risk of extinction owing to their wide distribution and perceived abundance. However, 6.5% were considered threatened with extinction with a further 4.1% near threatened. Data deficiency prevented 13.8% of species from being categorised although they also possess characteristics that signal concern. Where hotspots of endemism occur, most notably in the Eastern Atlantic, 42.9% of the 98 species from that biogeographical region were classified as threatened or near threatened with extinction. All 14 species included in the highest categories of Critically Endangered and Endangered are endemic to either Cape Verde or Senegal, with each of the three Critically Endangered species restricted to single islands in Cape Verde. Threats to all these species are driven by habitat loss and anthropogenic disturbance, in particular from urban pollution, tourism and coastal development. Our findings show that levels of extinction risk to which cone snails are exposed are of a similar magnitude to those seen in many fully assessed terrestrial taxa. The widely held view that marine species are less at risk is not upheld.

  19. Conus: first comprehensive conservation red list assessment of a marine gastropod mollusc genus.

    Science.gov (United States)

    Peters, Howard; O'Leary, Bethan C; Hawkins, Julie P; Carpenter, Kent E; Roberts, Callum M

    2013-01-01

    Marine molluscs represent an estimated 23% of all extant marine taxa, but research into their conservation status has so far failed to reflect this importance, with minimal inclusion on the authoritative Red List of the International Union for the Conservation of Nature (IUCN). We assessed the status of all 632 valid species of the tropical marine gastropod mollusc, Conus (cone snails), using Red List standards and procedures to lay the groundwork for future decadal monitoring, one of the first fully comprehensive global assessments of a marine taxon. Three-quarters (75.6%) of species were not currently considered at risk of extinction owing to their wide distribution and perceived abundance. However, 6.5% were considered threatened with extinction with a further 4.1% near threatened. Data deficiency prevented 13.8% of species from being categorised although they also possess characteristics that signal concern. Where hotspots of endemism occur, most notably in the Eastern Atlantic, 42.9% of the 98 species from that biogeographical region were classified as threatened or near threatened with extinction. All 14 species included in the highest categories of Critically Endangered and Endangered are endemic to either Cape Verde or Senegal, with each of the three Critically Endangered species restricted to single islands in Cape Verde. Threats to all these species are driven by habitat loss and anthropogenic disturbance, in particular from urban pollution, tourism and coastal development. Our findings show that levels of extinction risk to which cone snails are exposed are of a similar magnitude to those seen in many fully assessed terrestrial taxa. The widely held view that marine species are less at risk is not upheld.

  20. Comprehensive Assessment of Regional Circular Economy Development Based on Efficiency of Resource & Environment:A Case Study of Jiangsu Province

    Institute of Scientific and Technical Information of China (English)

    Zhong Taiyang; Huang Xianjin; Li Lulu; Wang Chen

    2006-01-01

    In the first, the paper gave a retrospective analysis on the comprehensive assessment of circular economic development. According to the requirement of improving resource & environment efficiency, the paper designed an analytical framework for a comprehensive assessment of regional circular economic growth, which consists of the goal, object and technical line of the comprehensive assessment of regional circular economic development. Given that, the paper discussed the criterion for choosing the assessment index, the approaches of index's weighing determination, the means of data standardization, and the reference system of assessment index value and so on. According to the framework of regional circular economic development evaluation,the paper made a comprehensive evaluation of Jiangsu Province's circular economic development. The result shows that from temporal change, Jiangsu Province's circular economic development had different stages;from the spatial comparison, there is variance among different regions, which could be divided into different types according to the spatial variance and the relation between the development of circular economy and the aggregative index number. There was a remarkable correlation between circular economic development level and GDP or the 2nd industry GDP. Finally, the paper gives some suggestions on how to promote the development of circular economy in Jiangsu Province.

  1. Assessment of Clinical Teachers' Professionalism in Iran: From Residents and Fellowships' Perspective

    Directory of Open Access Journals (Sweden)

    Sima Garshasbi

    2017-02-01

    Full Text Available In the present study, professional conduct of clinical teachers in Tehran University of Medical Sciences in Iran was assessed by their residents (n=292 and fellowships (n=48 using a standard questioner called self-reported measurement equipment. This evaluation was a descriptive cross-sectional study. Professionalism was questioned in four domains including clinical teacher-patient, clinical teacher-student, inter-professional and clinical teacher-self relationships. Accordingly, mean scores of the teachers in cases of clinical teacher-patient; clinical teacher-student, inter-professional (teamwork and clinical teacher-self relations were 61%, 62.2%, 60.6% and 57.6%, respectively. Generally, the teachers achieved 60.35% of the positive scores, and as a result, they were assessed intermediate in the professional behaviors. The residents and fellowships stated that they were not completely satisfied with their teacher's professional conduct and had hidden concerns. It shows that the clinical teachers in our project may not be ideal role models. As a result, developing a comprehensive professionalism and implementing regulations to ensure a successful professionalism are necessary. The precise evaluation of professional conduct in clinical faculty could encourage the maintenance of professional behaviors and potentially decrease negative role modeling and positively influence the hidden curriculums. Operational approaches to formulating regulations and appropriate measures for establishing professional ethics are of great importance.

  2. Assessment of Clinical Teachers' Professionalism in Iran: From Residents and Fellowships' Perspective.

    Science.gov (United States)

    Garshasbi, Sima; Bahador, Hamidollah; Fakhraei, Nahid; Farbod, Abolfazl; Mohammadi, Maryam; Ahmady, Soleiman; Emami Razavi, Seyed Hassan

    2017-01-01

    In the present study, professional conduct of clinical teachers in Tehran University of Medical Sciences in Iran was assessed by their residents (n=292) and fellowships (n=48) using a standard questioner called self-reported measurement equipment. This evaluation was a descriptive cross-sectional study. Professionalism was questioned in four domains including clinical teacher-patient, clinical teacher-student, inter-professional and clinical teacher-self relationships. Accordingly, mean scores of the teachers in cases of clinical teacher-patient; clinical teacher-student, inter-professional (teamwork) and clinical teacher-self relations were 61%, 62.2%, 60.6% and 57.6%, respectively. Generally, the teachers achieved 60.35% of the positive scores, and as a result, they were assessed intermediate in the professional behaviors. The residents and fellowships stated that they were not completely satisfied with their teacher's professional conduct and had hidden concerns. It shows that the clinical teachers in our project may not be ideal role models. As a result, developing a comprehensive professionalism and implementing regulations to ensure a successful professionalism are necessary. The precise evaluation of professional conduct in clinical faculty could encourage the maintenance of professional behaviors and potentially decrease negative role modeling and positively influence the hidden curriculums. Operational approaches to formulating regulations and appropriate measures for establishing professional ethics are of great importance.

  3. Psychological Assessment Training in Clinical Psychology Doctoral Programs.

    Science.gov (United States)

    Mihura, Joni L; Roy, Manali; Graceffo, Robert A

    2017-01-01

    We surveyed American Psychological Association-accredited clinical psychology doctoral programs' (n = 83) training in psychological assessment-specifically, their coverage of various assessment topics and tests in courses and practica, and whether the training was optional or required. We report results overall and separately per training model (clinical science, scientist-practitioner, and practitioner-focused). Overall, our results suggest that psychological assessment training is as active, or even more active, than in previous years. Areas of increased emphasis include clinical interviewing and psychometrics; multimethod, outcomes, health, and collaborative or therapeutic assessment; and different types of cognitive and self-report personality tests. All or almost all practice-focused programs offered training with the Thematic Apperception Test and Rorschach compared to about half of the scientist-practitioner programs and a third of the clinical science programs. Although almost all programs reported teaching multimethod assessment, what constitutes different methods of assessing psychopathology should be clarified in future studies because many programs appear to rely on one method-self-report (especially clinical science programs). Although doctoral programs covered many assessment topics and tests in didactic courses, there appears to be a shortage of program-run opportunities for students to obtain applied assessment training. Finally, we encourage doctoral programs to be familiar with (a) internships' assessment expectations and opportunities, (b) the professional guidelines for assessment training, and (c) the American Psychological Association's requirements for preinternship assessment competencies.

  4. Comprehensive, Mixed-Methods Assessment of a Blended Learning Model for Geospatial Literacy Instruction

    Science.gov (United States)

    Brodeur, J. J.; Maclachlan, J. C.; Bagg, J.; Chiappetta-Swanson, C.; Vine, M. M.; Vajoczki, S.

    2013-12-01

    Geospatial literacy -- the ability to conceptualize, capture, analyze and communicate spatial phenomena -- represents an important competency for 21st Century learners in a period of 'Geospatial Revolution'. Though relevant to in-course learning, these skills are often taught externally, placing time and resource pressures on the service providers - commonly libraries - that are relied upon to provide instruction. The emergence of online and blended modes of instruction has presented a potential means of increasing the cost-effectiveness of such activities, by simultaneously reducing instructional costs, expanding the audience for these resources, and addressing student preferences for asynchronous learning and '24-7' access. During 2011 and 2012, McMaster University Library coordinated the development, implementation and assessment of blended learning modules for geospatial literacy instruction in first-year undergraduate Social Science courses. In this paper, we present the results of a comprehensive mixed-methods approach to assess the efficacy of implementing blended learning modules to replace traditional (face-to-face), library-led, first-year undergraduate geospatial literacy instruction. Focus groups, personal interviews and an online survey were used to assess modules across dimensions of: student use, satisfaction and accessibility requirements (via Universal Instructional Design [UID] principles); instructor and teaching staff perception of pedagogical efficacy and instructional effectiveness; and, administrator cost-benefit assessment of development and implementation. Results showed that both instructors and students identified significant value in using the online modules in a blended-learning setting. Reaffirming assumptions of students' '24/7' learning preferences, over 80% of students reported using the modules on a repeat basis. Students were more likely to use the modules to better understand course content than simply to increase their grade in

  5. Comprehensive Astronaut Immune Assessment Following a Short-Duration Space Flight

    Science.gov (United States)

    Crucian, Brian; Stowe, Raymond; Yetman, Deborah; Pierson, Duane; Sams, Clarence

    2006-01-01

    Immune system dysregulation has been demonstrated to occur during spaceflight and has the potential to cause serious health risks to crewmembers participating in exploration class missions. As a part of an ongoing NASA flight experiment assessing viral immunity (DSO-500), a generalized immune assessment was performed on 3 crewmembers who participated in the recent STS-114 Space Shuttle mission. The following assays were performed: (1) comprehensive immunophenotype analysis; (2) T cell function/intracellular cytokine profiles; (4) secreted Th1/Th2 cytokine profiles via cytometric bead array. Immunophenotype analysis included a leukocyte differential, lymphocyte subsets, T cell subsets, cytotoxic/effector CD8+ T cells, memory/naive T cell subsets and constitutively activated T cells. Study timepoints were L-180, L-65, L-10, R+0, R+3 and R+14. Detailed data are presented in the poster text. As expected from a limited number of human subjects, data tended to vary with respect to most parameters. Specific post-flight alterations were as follows (subject number in parentheses): Granulocytosis (2/3), reduced NK cells (3/3), elevated CD4/CD8 ratio (3/3), general CD8+ phenotype shift to a less differentiated phenotype (3/3), elevated levels of memory CD4+ T cells (3/3), loss of L-selectin on T cell subsets (3/3), increased levels of activated T cells (2/3), reduced IL-2 producing T cell subsets (3/3), levels of IFNg producing T cells were unchanged. CD8+ T cell expression of the CD69 activation markers following whole blood stimulation with SEA+SEB were dramatically reduced postflight (3/3), whereas other T cell function assessments were largely unchanged. Cytometric bead array assessment of secreted T cell cytokines was performed, following whole blood stimulation with either CD3/CD28 antibodies or PMA+ionomycin for 48 hours. Specific cytokines assessed were IFNg, TNFa, IL-2, IL-4, IL-5, IL-10. Following CD3/CD28 stimulation, all three crewmembers had a mission

  6. Comprehensive Astronaut Immune Assessment Following a Short-Duration Space Flight

    Science.gov (United States)

    Crucian, Brian; Stowe, Raymond; Yetman, Deborah; Pierson, Duane; Sams, Clarence

    2006-01-01

    Immune system dysregulation has been demonstrated to occur during spaceflight and has the potential to cause serious health risks to crewmembers participating in exploration class missions. As a part of an ongoing NASA flight experiment assessing viral immunity (DSO-500), a generalized immune assessment was performed on 3 crewmembers who participated in the recent STS-114 Space Shuttle mission. The following assays were performed: (1) comprehensive immunophenotype analysis; (2) T cell function/intracellular cytokine profiles; (4) secreted Th1/Th2 cytokine profiles via cytometric bead array. Immunophenotype analysis included a leukocyte differential, lymphocyte subsets, T cell subsets, cytotoxic/effector CD8+ T cells, memory/naive T cell subsets and constitutively activated T cells. Study timepoints were L-180, L-65, L-10, R+0, R+3 and R+14. Detailed data are presented in the poster text. As expected from a limited number of human subjects, data tended to vary with respect to most parameters. Specific post-flight alterations were as follows (subject number in parentheses): Granulocytosis (2/3), reduced NK cells (3/3), elevated CD4/CD8 ratio (3/3), general CD8+ phenotype shift to a less differentiated phenotype (3/3), elevated levels of memory CD4+ T cells (3/3), loss of L-selectin on T cell subsets (3/3), increased levels of activated T cells (2/3), reduced IL-2 producing T cell subsets (3/3), levels of IFNg producing T cells were unchanged. CD8+ T cell expression of the CD69 activation markers following whole blood stimulation with SEA+SEB were dramatically reduced postflight (3/3), whereas other T cell function assessments were largely unchanged. Cytometric bead array assessment of secreted T cell cytokines was performed, following whole blood stimulation with either CD3/CD28 antibodies or PMA+ionomycin for 48 hours. Specific cytokines assessed were IFNg, TNFa, IL-2, IL-4, IL-5, IL-10. Following CD3/CD28 stimulation, all three crewmembers had a mission

  7. Frailty in patients with acute coronary syndrome: comparison between tools for comprehensive geriatric assessment and the Tilburg Frailty Indicator

    Directory of Open Access Journals (Sweden)

    Uchmanowicz I

    2015-03-01

    Full Text Available Izabella Uchmanowicz,1 Magdalena Lisiak,1 Radosław Wontor,2 Krystyna Łoboz-Grudzień1,21Department of Clinical Nursing, Wrocław Medical University, Wrocław, Poland; 2Department of Cardiology, T Marciniak Memorial Hospital, Wrocław, PolandPurpose: It is a known fact that age is a strong predictor of adverse events in acute coronary syndrome (ACS. In this context, the main risk factor in elderly patients, ie, frailty syndrome, gains special importance. The availability of tools to identify frail people is relevant for both research and clinical purposes. The purpose of this study was to investigate the correlation of a scale for assessing frailty – the Tilburg Frailty Indicator (TFI and its domains (mental and physical – with other research tools commonly used for comprehensive geriatric assessment in patients with ACS.Patients and methods: The study covered 135 people and was carried out in the cardiology ward at T Marciniak Lower Silesian Specialist Hospital in Wroclaw, Poland. The patients were admitted with ACS. ST segment elevation myocardial infarction and non-ST segment elevation myocardial infarction were defined by the presence of certain conditions in reference to the literature. The Polish adaptation of the TFI was used for the frailty syndrome assessment, which was compared to other single measures used in geriatric assessment: the Mini-Mental State Examination (MMSE, the Hospital Anxiety and Depression Scale (HADS, and Katz Index of Independence in Activities of Daily Living (ADLs.Results: The mean TFI value in the studied group amounted to 7.13±2.81 (median: 7, interquartile range: 5–9, range [0, 14]. Significant correlations were demonstrated between the values of the TFI and other scales: positive for HADS (r=0.602, P<0.001 and the reverse for MMSE (r=-0.603, P<0.001 and IADL (r=-0.462, P<0.001. Patients with a TFI score ≥5 revealed considerably higher values on HADS (P<0.001 and considerably lower values on the MMSE

  8. Care planning needs of palliative home care clients: Development of the interRAI palliative care assessment clinical assessment protocols (CAPs)

    OpenAIRE

    Freeman, Shannon; Hirdes, John P; Stolee, Paul; Garcia, John; Smith, Trevor Frise; Steel, Knight; Morris, John N.

    2014-01-01

    Background The interRAI Palliative Care (interRAI PC) assessment instrument provides a standardized, comprehensive means to identify person-specific need and supports clinicians to address important factors such as aspects of function, health, and social support. The interRAI Clinical Assessment Protocols (CAPs) inform clinicians of priority issues requiring further investigation where specific intervention may be warranted and equip clinicians with evidence to better inform development of a ...

  9. Comprehensive echocardiographic assessment of normal mitral Medtronic Hancock II, Medtronic Mosaic, and Carpentier-Edwards Perimount bioprostheses early after implantation.

    Science.gov (United States)

    Blauwet, Lori A; Malouf, Joseph F; Connolly, Heidi M; Hodge, David O; Evans, Katie N; Herges, Regina M; Sundt, Thoralf M; Miller, Fletcher A

    2010-06-01

    Normal Doppler-derived hemodynamic data for mitral valve bioprostheses are limited. To establish parameters for identifying normal function for each of the 3 types of bioprostheses examined, we conducted a comprehensive, retrospective, two-dimensional, and Doppler echocardiographic assessment of 179 patients who underwent implantation of the Medtronic Hancock II or the Medtronic Mosaic (Medtronic, Inc, Minneapolis, MN) porcine mitral valve bioprosthesis or the Carpentier-Edwards Perimount (Edwards Lifesciences LLC, Irvine, CA) bovine pericardial mitral valve bioprosthesis. All bioprostheses were normal by clinical examination, intraoperative transesophageal echocardiography, and postoperative transthoracic echocardiography. Regardless of valve type and body surface area, the pressure half-time was < 124 ms in all patients. Mean gradient < 9.5 mm Hg, mitral E velocity < 2.6 m/s, mitral valve prosthesis time-velocity integral < 69 cm, and ratio of the mitral valve prosthesis time-velocity integral to the left ventricular outflow tract time-velocity integral < 3.4 were recorded in nearly all patients. These cutoff values (mean + 2 standard deviation) are specific, but not sensitive, for identifying mitral valve prosthesis dysfunction. Prostheses with hemodynamic values that are higher than these cutoff values are likely dysfunctional, but in select cases, mitral valve prosthesis dysfunction may be present even when hemodynamic values are lower than these thresholds. Copyright 2010 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.

  10. Improving the clinical assessment of consciousness with advances in electrophysiological and neuroimaging techniques.

    Science.gov (United States)

    Gawryluk, Jodie R; D'Arcy, Ryan C N; Connolly, John F; Weaver, Donald F

    2010-01-29

    In clinical neurology, a comprehensive understanding of consciousness has been regarded as an abstract concept--best left to philosophers. However, times are changing and the need to clinically assess consciousness is increasingly becoming a real-world, practical challenge. Current methods for evaluating altered levels of consciousness are highly reliant on either behavioural measures or anatomical imaging. While these methods have some utility, estimates of misdiagnosis are worrisome (as high as 43%)--clearly this is a major clinical problem. The solution must involve objective, physiologically based measures that do not rely on behaviour. This paper reviews recent advances in physiologically based measures that enable better evaluation of consciousness states (coma, vegetative state, minimally conscious state, and locked in syndrome). Based on the evidence to-date, electroencephalographic and neuroimaging based assessments of consciousness provide valuable information for evaluation of residual function, formation of differential diagnoses, and estimation of prognosis.

  11. Improving the clinical assessment of consciousness with advances in electrophysiological and neuroimaging techniques

    Directory of Open Access Journals (Sweden)

    D'Arcy Ryan CN

    2010-01-01

    Full Text Available Abstract In clinical neurology, a comprehensive understanding of consciousness has been regarded as an abstract concept - best left to philosophers. However, times are changing and the need to clinically assess consciousness is increasingly becoming a real-world, practical challenge. Current methods for evaluating altered levels of consciousness are highly reliant on either behavioural measures or anatomical imaging. While these methods have some utility, estimates of misdiagnosis are worrisome (as high as 43% - clearly this is a major clinical problem. The solution must involve objective, physiologically based measures that do not rely on behaviour. This paper reviews recent advances in physiologically based measures that enable better evaluation of consciousness states (coma, vegetative state, minimally conscious state, and locked in syndrome. Based on the evidence to-date, electroencephalographic and neuroimaging based assessments of consciousness provide valuable information for evaluation of residual function, formation of differential diagnoses, and estimation of prognosis.

  12. Ion mobility spectrometry: a comprehensive and versatile tool for occupational pharmaceutical exposure assessment.

    Science.gov (United States)

    Armenta, S; Blanco, M

    2012-05-15

    The qualitative and quantitative capabilities of ion mobility spectrometry (IMS) as a comprehensive and powerful tool in workplace air monitoring have been demonstrated on the example of a Spanish pharmaceutical company. The developed IMS based procedure is capable of detecting and determining in air samples the active pharmaceutical ingredients (APIs) manipulated and/or produced in this pharmaceutical industry. Sensitivity, in the ng-pg range, selectivity, possibly to provide results in near real time, and reduction of analysis costs are the most important properties that ratify IMS as a serious alternative in occupational exposure assessment. The possibility of false positives by drift time interferences and false negatives by competitive ionization and also desorption process interferences has been deeply evaluated. Moreover, chemometric strategies based on self-modeling curve resolution (SMCR) have been applied to obtain qualitative and quantitative individual component information from overlapped peaks. The IMS procedure has been successfully applied to evaluate the concentration of APIs (nimesulide, dexketoprofen, deflazacort) handled by the pharmaceutical company employees in the making of tablets and granulates, and control measures have been suggested in accordance.

  13. Comprehensive assessment of flexible-ligand docking algorithms: current effectiveness and challenges.

    Science.gov (United States)

    Huang, Sheng-You

    2017-03-14

    Protein-ligand docking has been playing an important role in modern drug discovery. To model drug-target binding in real systems, a number of flexible-ligand docking algorithms with different sampling strategies and scoring methods have been subsequently developed over the past three decades, while rigid-ligand docking is still being used because of its compelling computational efficiency. Here, a comprehensive assessment has been conducted to investigate the effectiveness of flexible-ligand docking versus rigid-ligand docking for three representative docking algorithms (global optimization, incremental construction and multi-conformer docking) in virtual screening and pose prediction on the Directory of Useful Decoys. It was found that overall flexible-ligand docking did not achieve a statistically significant improvement in enrichments over rigid-ligand docking in virtual screening, but all docking programs significantly improved the success rates when considering ligand flexibility in pose prediction. The worse effectiveness of flexible-ligand docking in virtual screening than in pose prediction suggests that the challenges of current docking algorithms exist in ranking more than docking, although the use of flexible-ligand docking in virtual screening was justified by its better effectiveness for more flexible ligand in virtual screening. Challenges for scoring, including internal energy, charge polarization, entropy and flexibility, were investigated and discussed. An empirical way was also proposed to consider loss of ligand conformational entropy for virtual screening. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. A prototypicality validation of the Comprehensive Assessment of Psychopathic Personality model (CAPP).

    Science.gov (United States)

    Hoff, Helge Andreas; Rypdal, Knut; Mykletun, Arnstein; Cooke, David J

    2012-06-01

    Cooke and colleagues recently developed the lexically based model of psychopathy named the Comprehensive Assessment of Psychopathic Personality (CAPP, Cooke, Hart, Logan, & Michie, 2004). The current study was the first to evaluate aspects of the validity of a translated version of the CAPP model, which comprises 33 symptoms from six domains of personality functioning. Prototypicality ratings from 796 Norwegian community residents, forensic mental health professionals, and corrections professionals were obtained. Most CAPP symptoms were evaluated as highly prototypical of psychopathy by all three groups. Symptoms from the Self, Dominance, and Attachment domains were perceived as more prototypical than those from the Behavioral domain. Confirmatory Factor Analysis (CFA) indicated that two CAPP domains were unidimensional whereas evidence of unidimensionality was somewhat weaker for the other domains, but improved substantially after removal of problematic symptoms. Overall, the findings support the content validity of the CAPP model. This may have relevance to the current considerations regarding reformulation of the criteria for Antisocial Personality Disorder in DSM-V.

  15. A Methodology for a Comprehensive Probabilistic Tsunami Hazard Assessment: Multiple Sources and Short-Term Interactions

    Directory of Open Access Journals (Sweden)

    Grezio Anita

    2015-01-01

    Full Text Available We propose a methodological approach for a comprehensive and total probabilistic tsunami hazard assessment (TotPTHA, in which many different possible source types concur to the definition of the total tsunami hazard at given target sites. In a multi-hazard and multi-risk perspective, the approach allows us to consider all possible tsunamigenic sources (seismic events, slides, volcanic eruptions, asteroids, etc.. In this respect, we also formally introduce and discuss the treatment of interaction/cascade effects in the TotPTHA analysis and we demonstrate how the triggering events may induce significant temporary variations in short-term analysis of the tsunami hazard. In two target sites (the city of Naples and the island of Ischia in Italy we prove the feasibility of the TotPTHA methodology in the multi—source case considering near submarine seismic sources and submarine mass failures in the study area. The TotPTHA indicated that the tsunami hazard increases significantly by considering both the potential submarine mass failures and the submarine seismic events. Finally, the importance of the source interactions is evaluated by applying a triggering seismic event that causes relevant changes in the short-term TotPTHA.

  16. A comprehensive framework for the assessment of new end uses in recycled water schemes.

    Science.gov (United States)

    Chen, Zhuo; Ngo, Huu Hao; Guo, Wenshan; Lim, Richard; Wang, Xiaochang C; O'Halloran, Kelly; Listowski, Andrzej; Corby, Nigel; Miechel, Clayton

    2014-02-01

    Nowadays, recycled water has provided sufficient flexibility to satisfy short-term freshwater needs and increase the reliability of long-term water supplies in many water scarce areas, which becomes an essential component of integrated water resources management. However, the current applications of recycled water are still quite limited that are mainly associated with non-potable purposes such as irrigation, industrial uses, toilet flushing and car washing. There is a large potential to exploit and develop new end uses of recycled water in both urban and rural areas. This can greatly contribute to freshwater savings, wastewater reduction and water sustainability. Consequently, the paper identified the potentials for the development of three recycled water new end uses, household laundry, livestock feeding and servicing, and swimming pool, in future water use market. To validate the strengths of these new applications, a conceptual decision analytic framework was proposed. This can be able to facilitate the optional management strategy selection process and thereafter provide guidance on the future end use studies within a larger context of the community, processes, and models in decision-making. Moreover, as complex evaluation criteria were selected and taken into account to narrow down the multiple management alternatives, the methodology can successfully add transparency, objectivity and comprehensiveness to the assessment. Meanwhile, the proposed approach could also allow flexibility to adapt to particular circumstances of each case under study.

  17. Sharing clinical information across care settings: the birth of an integrated assessment system

    Directory of Open Access Journals (Sweden)

    Henrard Jean-Claude

    2009-04-01

    Full Text Available Abstract Background Population ageing, the emergence of chronic illness, and the shift away from institutional care challenge conventional approaches to assessment systems which traditionally are problem and setting specific. Methods From 2002, the interRAI research collaborative undertook development of a suite of assessment tools to support assessment and care planning of persons with chronic illness, frailty, disability, or mental health problems across care settings. The suite constitutes an early example of a "third generation" assessment system. Results The rationale and development strategy for the suite is described, together with a description of potential applications. To date, ten instruments comprise the suite, each comprising "core" items shared among the majority of instruments and "optional" items that are specific to particular care settings or situations. Conclusion This comprehensive suite offers the opportunity for integrated multi-domain assessment, enabling electronic clinical records, data transfer, ease of interpretation and streamlined training.

  18. Dairy nutrition management: Assessing a comprehensive continuing education program for veterinary practitioners.

    Science.gov (United States)

    Schuenemann, G M; Eastridge, M L; Weiss, W P; Workman, J D; Bas, S; Rajala-Schultz, P

    2011-05-01

    The purpose of this study was to assess the effectiveness of a team-based educational program designed to enhance the flow of applied, research-based, nutrition information to dairy veterinarians. A comprehensive dairy cattle nutrition curriculum was developed and participants from 11 veterinary practices located in 5 states (IN, NY, PA, NM, and OH), serving an estimated 186,150 dairy cattle in 469 herds, attended the 2 advanced nutrition modules (∼2.5 d each and ∼40 h of learning) held in 2009. Nutrients, feeding transition cows, calves, and heifers, dry matter intake, feed storage, metabolic diseases, evaluating cows (scoring body condition, manure, and lameness), metabolic blood profiles, and feeding behavior were discussed. Educational materials were delivered through in-class lectures, followed by case-based learning and group discussions. A farm visit and out-of-class assignments were also implemented. Attendees were assessed using pre- and post-tests of knowledge to determine the level of knowledge gained in both nutrition modules. Participants evaluated the program and provided feedback at the conclusion of each module. Veterinarians (100%) reported that the overall program, presentations, and discussions were useful. Attendees found the presented information relevant for their work (agree=60% and strongly agree=40%) and of great immediate use to them (neutral=6.5%, agree=56%, and strongly agree=37.5%). The presented materials and the implemented educational delivery methods substantially increased the knowledge level of the attendees (16.9% points increase from pre-test to post-test scores). Importance of feed particle size, ration evaluation, interpreting feed analysis, balancing carbohydrate components, and metabolic profiling in fresh cows were listed as learned concepts that participants could apply in their practices. Results suggested that both nutrition modules were relevant and effective, offering new information with immediate field

  19. Correlations of clinical assessment tools with written examinations.

    Science.gov (United States)

    Choi, Eun Jeong; Sunwoo, Sung

    2009-03-01

    Despite the goal of medical education, which is 'training to be a primary care physician,' only written examinations (WEs) generally have been used to assess medical student ability. We assessed clinical competence using the CPX (clinical performance examination), PA (portfolio assessment), VMA (video-monitoring assessment), CGD (case group discussion), and PCP (primary clinical practice) during students' clerkships in family medicine and correlated these clinical assessment tools with WEs. Also, we correlated these tools with each other to determine the feasibility of each as a replacement of the other tools. Thirty-nine fourth year students at University of Ulsan College of Medicine took part in their clerkship in family medicine for 2 weeks during the first session of 2005. They took 1 CPX, 2 VMAs, 6 CGDs, and 2 PCPs and were required to submit their portfolios at the end of the clerkship. We evaluated the correlations of these tools and WEs by the overall scores of each class year and in each subject. The CPX, VMA, and PCP showed no significant correlation,while PA showed strong correlation with 4th year students' overall WEs. The CGD showed strong correlation with all overall scores and with almost all subjects. In addition, the PA correlated significantly with CGD. New clinical assessment tools, such as CPX, PA, and VMA, have no significant correlation with WE, even though these tools closely correspond with real clinical practice. Therefore, these tools should be considered as complementary instruments to better assess clinical competence.

  20. Conceptual Models and Guidelines for Clinical Assessment of Financial Capacity.

    Science.gov (United States)

    Marson, Daniel

    2016-09-01

    The ability to manage financial affairs is a life skill of critical importance, and neuropsychologists are increasingly asked to assess financial capacity across a variety of settings. Sound clinical assessment of financial capacity requires knowledge and appreciation of applicable clinical conceptual models and principles. However, the literature has presented relatively little conceptual guidance for clinicians concerning financial capacity and its assessment. This article seeks to address this gap. The article presents six clinical models of financial capacity : (1) the early gerontological IADL model of Lawton, (2) the clinical skills model and (3) related cognitive psychological model developed by Marson and colleagues, (4) a financial decision-making model adapting earlier decisional capacity work of Appelbaum and Grisso, (5) a person-centered model of financial decision-making developed by Lichtenberg and colleagues, and (6) a recent model of financial capacity in the real world developed through the Institute of Medicine. Accompanying presentation of the models is discussion of conceptual and practical perspectives they represent for clinician assessment. Based on the models, the article concludes by presenting a series of conceptually oriented guidelines for clinical assessment of financial capacity. In summary, sound assessment of financial capacity requires knowledge and appreciation of clinical conceptual models and principles. Awareness of such models, principles and guidelines will strengthen and advance clinical assessment of financial capacity.

  1. Clinical Assessment And Diagnosis Of Dementia

    Directory of Open Access Journals (Sweden)

    Srikanth S

    2005-01-01

    Full Text Available Dementia is characterized by progressive decline in an alert individual, leading to loss of independence in day-to-day functioning. It is a generic term for a condition that has various causes and hence myriad clinical presentations. It has to be distinguished from age-related cognitive decline, depression and delirium all of which are common in the elderly population. Detailed history and mental status examination are necessary to identify dementia, fit it into one of the various bedside classifications and pursue the differential diagnosis. This teaching review summarizes current information on definition, differential diagnosis and classification of dementia and presents a brief elaboration of bedside cognitive testing pertaining to dementia. A bird′s eye view of the profiles of various dementia subtypes is also provided so that after reading this article the reader will able to recognize dementia, conduct clinical examination to identify the characteristic cognitive profile and formulate the differential diagnosis with confidence.

  2. A Ten-Year Assessment of a Biomedical Engineering Summer Research Internship within a Comprehensive Cancer Center

    Science.gov (United States)

    Wright, A. S.; Wu, X.; Frye, C. A.; Mathur, A. B.; Patrick, C. W., Jr.

    2007-01-01

    A Biomedical Engineering Internship Program conducted within a Comprehensive Cancer Center over a 10 year period was assessed and evaluated. Although this is a non-traditional location for an internship, it is an ideal site for a multidisciplinary training program for science, technology, engineering, and mathematics (STEM) students. We made a…

  3. There Is Another Way: The Faculty-Developed Idaho Comprehensive Literacy Assessment for K-8 Pre-Service Teachers

    Science.gov (United States)

    Squires, David; Canney, George F.; Trevisan, Michael S.

    2004-01-01

    In this era of external teacher testing with the intent of ensuring the competence of the teaching force, as well as holding students and institutions accountable for results, the Idaho Comprehensive Literacy Assessment (ICLA) stands in sharp contrast. It represents an alternative to external testing of preservice teachers, testing procured from…

  4. Making Episodes, Making Connections: A Reading Comprehension Assessment Tool. The REL's Pacific CHILD Project, Year One Product.

    Science.gov (United States)

    Low, Marylin

    The reading comprehension assessment tool is a product developed for the Regional Educational Laboratory's (REL) initiative, Pacific Communities with High performance In Literacy Development, herein named the Pacific CHILD. This research project is focused on school improvement, especially as it relates to the teaching and learning of early…

  5. Creating a Safe Space: A Case Study of Complex Trauma and a Call for Proactive Comprehensive Psychoeducational Assessments and Reviews

    Science.gov (United States)

    Mainwaring, Debra J.

    2015-01-01

    This article advocates for proactive, dynamic and comprehensive psycho-educational assessments for children and young people who have a history of complex trauma, because of its known effects on development and learning. A case study is shared of a young woman with a history of complex trauma because of exposure to parental neglect, multiple…

  6. Applying Comprehensive Environmental Assessment to Research Planning for Multiwalled Carbon Nanotubes: Refinements to Inform Future Stakeholder Engagement

    Science.gov (United States)

    We previously described our collective judgment methods to engage expert stakeholders in the Comprehensive Environmental Assessment (CEA) workshop process applied to nano-TiO2 and nano-Ag research planning. We identified several lessons learned in engaging stakeholders to identif...

  7. Clinical Assessment Applications of Ambulatory Biosensors

    Science.gov (United States)

    Haynes, Stephen N.; Yoshioka, Dawn T.

    2007-01-01

    Ambulatory biosensor assessment includes a diverse set of rapidly developing and increasingly technologically sophisticated strategies to acquire minimally disruptive measures of physiological and motor variables of persons in their natural environments. Numerous studies have measured cardiovascular variables, physical activity, and biochemicals…

  8.  Objective Structured Clinical Examination: The Assessment of Choice

    Directory of Open Access Journals (Sweden)

    Marliyya Zayyan

    2011-07-01

    Full Text Available  The Objective Structured Clinical Examination is a versatile multipurpose evaluative tool that can be utilized to assess health care professionals in a clinical setting. It assesses competency, based on objective testing through direct observation. It is precise, objective, and reproducible allowing uniform testing of students for a wide range of clinical skills. Unlike the traditional clinical exam, the OSCE could evaluate areas most critical to performance of health care professionals such as communication skills and ability to handle unpredictable patient behavior.

  9. Computerised triage in a prostate assessment clinic.

    Science.gov (United States)

    Rajkumar, G N; Small, D R; Conn, I G

    2004-01-01

    An MS Office package has been developed to score IPSS, take a patient history, compare flows with nomograms and decide on interim management. This is based on these scores, residual volume and laboratory results. A clearly formatted GP letter is produced. The patient uses a touch screen to answer questions on the IPSS and other medical history. These questions and responses are stored in Excel spread sheets. Clinic staff then enter results of flow studies, urinalysis, U&E and PSA. Excel Visual Basic creates a detailed printout for the notes and the MS Office mail merge facility creates a summary printout, which also serves as a letter to the GP. Excel allows embedding of formulae and program code to implement the rules for management. Based on these rules, the program either generates a request for an urgent appointment in the clinic or recommends the use of either an alpha blocker (if not contraindicated by medical history) or 5 alpha reductase inhibitors in the interim period before they are reviewed in clinic. A total of 139 patients have been seen and the computer decisions compared with those of a consultant urologist. Agreement was found in 106, disagreement in 33. However, 21 of the 33 involved computer oversensitivity to flow results. We do not anticipate difficulty improving this and are investigating using an artificial neural network. Of the other 12 patients, the urologist departed from the fixed rules for IPSS, creatinine, PSA and residual urine when only one variable was slightly abnormal. To conclude, this novel user-friendly system shows great potential in the management of prostate outpatients. Some tuning is needed, with particular respect to uroflow results.

  10. [Brain metastasis: clinical and cognitive assessments].

    Science.gov (United States)

    Ramirez, Carole; Blonski, Marie; Belin, Catherine; Carpentier, Antoine; Taillia, Hervé

    2013-01-01

    The incidence of brain metastases (BM) has increased due to the improvement of therapeutics and diagnostic imaging, but also to an aging population. The initial symptoms may develop suddenly or insidiously over weeks or months. The symptoms depend on the location of the BM and related complications (hydrocephalus, tumor hemorrhage, cerebral herniation). Headaches are the most frequent symptoms (50%); they are related to intracranial hypertension. Cognitive deficits are commonly described at diagnosis (67 to 90.5%). Cognitive assessment is essential because of its impact on patients' prognosis and quality of life. Nevertheless, these deficits remain underestimated. The Karnofsky Perfomance Scale and the Mini Mental State Examination (MMSE) seem inadequate. A short battery was proposed and internationally validated, assessing seven domains: attention (Digit Symbol Test WAIS-III), episodic memory (Hopkins Verbal Learning Test [HVLT]), working memory (Digit Span Test WAIS-III), verbal fluency (Controlled Oral Word Association Test [COWA]), fine motor dexterity (Grooved Pegboard Test), information processing speed (Trail Making Test [TMT] A) and executive functions (TMT B). This battery is relevant, feasible and associated with a good compliance. These cognitive tests are currently recommended to assess cognitive functions in patients with BM.

  11. Clinical assessment of transthoracic echocardiography skills: a generalizability study

    DEFF Research Database (Denmark)

    Nielsen, Dorte Guldbrand; O'Neill, Lotte; Jensen, Signe

    2015-01-01

    . An objective assessment instrument for TTE technical proficiency including a global rating score and a checklist score has previously been shown reliability and validity in a standardised setting. Objectives: As clinical test situations typically have several sources of error giving rise to variance in scores...... be considered performing 4 global rating assessments in addition to the checklist assessments to account for both reliability and content validity of the assessment....

  12. Clinical practice of risk assessment of sexual violence

    OpenAIRE

    Judge, Joseph Gerard

    2012-01-01

    Background: Risk assessment of sexual violence involves evidence based evaluation of the risks posed by sexual offenders. It informs risk management; the provision of treatment that reduces the risk of future sexual violence. Previous research has focused on assessment of the predictive accuracy of different risk assessment tools, as well as the identification of risk factors that are associated with recidivism. In contrast, the clinical practice of risk assessment is a research a...

  13. Pain and placebo in pediatrics: A comprehensive review of laboratory and clinical findings

    OpenAIRE

    Simmons, Kanesha; Ortiz, Robin; Kossowsky, Joe; Krummenacher, Peter; Grillon, Christian; Pine, Daniel; Colloca, Luana

    2014-01-01

    Pain modulation by placebo mechanisms is one of the most robust and best-studied phenomena, yet almost all research investigating the mechanisms and implications of the placebo analgesia are based on adult research. After highlighting crucial aspects that need to be considered in studying pain modulation in children, this comprehensive review examines studies related to pain modulation with an emphasis on factors such as age, neural development and pain measures. Psychological mechanisms unde...

  14. Comprehensive assessment of exposures to elongate mineral particles in the taconite mining industry.

    Science.gov (United States)

    Hwang, Jooyeon; Ramachandran, Gurumurthy; Raynor, Peter C; Alexander, Bruce H; Mandel, Jeffrey H

    2013-10-01

    Since the 1970s, concerns have been raised about elevated rates of mesothelioma in the vicinity of the taconite mines in the Mesabi Iron Range. However, insufficient quantitative exposure data have hampered investigations of the relationship between cumulative exposures to elongate mineral particles (EMP) in taconite dust and adverse health effects. Specifically, no research on exposure to taconite dust, which includes EMP, has been conducted since 1990. This article describes a comprehensive assessment of present-day exposures to total and amphibole EMP in the taconite mining industry. Similar exposure groups (SEGs) were established to assess present-day exposure levels and buttress the sparse historical data. Personal samples were collected to assess the present-day levels of worker exposures to EMP at six mines in the Mesabi Iron Range. The samples were analyzed using National Institute for Occupational Safety and Health (NIOSH) methods 7400 and 7402. For many SEGs in several mines, the exposure levels of total EMP were higher than the NIOSH Recommended Exposure Limit (REL). However, the total EMP classification includes not only the asbestiform EMP and their non-asbestiform mineral analogs but also other minerals because the NIOSH 7400 cannot differentiate between these. The concentrations of amphibole EMP were well controlled across all mines and were much lower than the concentrations of total EMP, indicating that amphibole EMP are not major components of taconite EMP. The levels are also well below the NIOSH REL of 0.1 EMP cc(-1). Two different approaches were used to evaluate the variability of exposure between SEGs, between workers, and within workers. The related constructs of contrast and homogeneity were calculated to characterize the SEGs. Contrast, which is a ratio of between-SEG variability to the sum of between-SEG and between-worker variability, provides an overall measure of whether there are distinctions between the SEGs. Homogeneity, which is

  15. Development of clinical assessment criteria for postgraduate nursing students.

    Science.gov (United States)

    Tolhurst, B G; Bonner, A

    2000-04-01

    This paper explores the development and implementation of specific criteria to determine the level of clinical performance of postgraduate nursing students during the first year of a Master of Nursing course. The authors describe two commonly used clinical skill assessment tools and identify limitations of these tools for postgraduate nursing students. As a result of these limitations, Clinical Assessment Criteria (CAC) utilising the framework of Benner (1984) was developed. Inherent within the CAC is four levels of clinical nursing performance, which enable the nurse teacher and student to monitor the progression from novice to proficient levels of practice within a specialty area. Following a successful pilot study, the CAC was incorporated into clinical assessments in nine specialty postgraduate courses. Furthermore, the framework developed for the CAC can also be integrated into a variety of professional development domains.

  16. Clinical assessment of transthoracic echocardiography skills: a generalizability study

    DEFF Research Database (Denmark)

    Nielsen, Dorte Guldbrand; O'Neill, Lotte; Jensen, Signe

    2015-01-01

    Context: Transthoracic echocardiography (TTE) is a widely used cardiac imaging technique that all cardiologists should be able to perform competently. Traditionally, TTE competence has been assessed by unstructured observation or in test situations separated from daily clinical practice. An objec...

  17. Assessing clinical decision making: is the ideal system feasible?

    Science.gov (United States)

    Dubois, R W; Brook, R H

    1988-01-01

    While caring for patients, physicians make a variety of decisions. Can current methods adequately determine whether these decisions are correct? If not, what improvements are needed? This paper begins with a review of several explicit methods to assess physician decision making. It then describes a more comprehensive system that would use Bayesian logic to assess whether a physician responded appropriately to the needs of an individual patient. Although sophisticated branching logic may be theoretically desirable, it may not be feasible. The paper concludes by proposing an explicit, potentially practical method that would judiciously use branching logic.

  18. RESEARCH AND DEVELOPMENT MULTICRITERIAL ECONOMIC AND MATHEMATICAL MODELS COMPREHENSIVE ASSESSMENT TECHNOLOGY GROWING CROPS

    Directory of Open Access Journals (Sweden)

    Loyko V. I.

    2016-10-01

    Full Text Available Production and processing of grains formed in the national economic system of the country a number of cereals-governmental sectors, such as grain production, grain elevator industry, flour, cereals and mixed fodder production, which constitute the grain complex country. The significance and role of the grain as a commodity in the state economy can not be overestimated. This product, is totally liquid, which has a constant, steady demand at any time of the year, in any region. Ongoing measures to increase grain production and improve its implementation did not have a complex character, therefore, insignificant effect on the efficiency of the industry and the competitiveness of grain production. The shortagecovered by imports.According to the characteristics of management in agriculture, it should be emphasized that the absence of objective and timely information at all stages of production of the plant-breeding, and as a result, non-optimal choice of technology of cultivation of agricultural crops, might result in the fact that the cost of labor and material resources increases significantly, the company does not receive profits, and sometimes suffers losses. When selecting cultivation technology for agricultural crops, an agronomist has a database of more than a hundred times-personal of alternative technologies for each crop. It is up to the decision-maker (DMP to find specific criteria to select the most suitable (for the owners and the climatic zone technology of cultivating for the culture. These circumstances explain the relevance of in-depth research of economic and mathematical models and methods of analysis and evaluation of the economic efficiency of technologies of cultivation agricultural crops. The article deals with the process of developing multicriteria economic-mathematical model of a comprehensive assessment of technology of cultivation of agricultural crops.

  19. Optimal management of elderly cancer patients: usefulness of the Comprehensive Geriatric Assessment

    Directory of Open Access Journals (Sweden)

    Caillet P

    2014-09-01

    Full Text Available Philippe Caillet,1,2 Marie Laurent,1,2 Sylvie Bastuji-Garin,1,3,4 Evelyne Liuu,2 Stephane Culine,5 Jean-Leon Lagrange,6 Florence Canoui-Poitrine,1,2,3,* Elena Paillaud1,2,* 1Laboratoire d’Investigation Clinique (LIC, Faculté de Medecine, Université Paris Est Créteil (UPEC, Créteil, Paris, 2Unité de Coordination d’Onco-Gériatrie, Département de Médecine Interne et Gériatrie, Hôpital Henri-Mondor, Assistance Publique – Hopitaux de Paris (AP-HP, Créteil, 3Service de Santé Publique, Hôpital Henri-Mondor, AP-HP, Créteil, 4Unité de Recherche Clinique, Hôpital Henri-Mondor, AP-HP, Créteil, 5Service d’Oncologie Médicale, Hôpital Saint-Louis, AP-HP, Paris, 6Service de Radiotherapie, Hôpital Henri-Mondor, AP-HP, Créteil, France*These authors contributed equally to this workBackground: Cancer is common in older patients, who raise specific treatment challenges due to aging-related, organ-specific physiologic changes and the presence in most cases of comorbidities capable of affecting treatment tolerance and outcomes. Identifying comorbid conditions and physiologic changes due to aging allows oncologists to better assess the risk/benefit ratio and to adjust the treatment accordingly. Conducting a Comprehensive Geriatric Assessment (CGA is one approach developed for this purpose. We reviewed the evidence on the usefulness of CGA for assessing health problems and predicting cancer treatment outcomes, functional decline, morbidity, and mortality in older patients with solid malignancies. Methods: We searched Medline for articles published in English between January 1, 2000 and April 14, 2014, and reporting prospective observational or interventional studies of CGA feasibility or effectiveness in patients aged ≥65 years with solid malignancies. We identified studies with at least 100 patients, a multivariate analysis, and assessments of at least five of the following CGA domains: nutrition, cognition, mood, functional status

  20. Squaw Creek National Wildlife Refuge: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Squaw Creek NWR for the next 15 years. This plan outlines the Refuge vision and purpose...

  1. Aransas National Wildlife Refuge Complex: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Aransas National Wildlife Refuge Complex for the next 15 years. This plan outlines the...

  2. Klamath Marsh National Wildlife Refuge: Final Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Klamath Marsh NWR for the next 15 years. This plan outlines the Refuge vision and...

  3. Texas Mid-coast National Wildlife Refuge Complex: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Texas Mid-coast National Wildlife Refuge Complex for the next 15 years. This plan...

  4. Wichita Mountains National Wildlife Refuge: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Wichita Mountains National Wildlife Refuge for the next 15 years. This plan outlines...

  5. Buffalo Lake National Wildlife Refuge: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Buffalo Lake National Wildlife Refuge for the next 15 years. This plan outlines the...

  6. Attwater Prairie Chicken National Wildlife Refuge: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Attwater Prairie Chicken National Wildlife Refuge for the next 15 years. This plan...

  7. Fish Springs National Wildlife Refuge: Draft Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This draft Comprehensive Conservation Plan (CCP) was written to guide management on Fish Springs NWR for the next 15 years. This plan outlines the Refuge vision and...

  8. Big Stone National Wildlife Refuge: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Big Stone National Wildlife Refuge for the next 15 years. This plan outlines the Refuge...

  9. Marin Islands National Wildlife Refuge: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Marin Islands NWR for the next 15 years. This plan outlines the Refuge vision and...

  10. Big Muddy National Wildlife Refuge: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Big Muddy National Wildlife Refuge for the next 15 years. This plan outlines the Refuge...

  11. Farallon National Wildlife Refuge: Final Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Farallon NWR for the next 15 years. This plan outlines the Refuge vision and purpose...

  12. Fergus Falls Wetland Management District: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Fergus Falls Wetland Management District for the next 15 years. This plan outlines the...

  13. James River National Wildlife Refuge: Draft Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This draft Comprehensive Conservation Plan (CCP) was written to guide management on James River National Wildlife Refuge for the next 15 years. This plan outlines...

  14. Trinity River National Wildlife Refuge: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Trinity River National Wildlife Refuge for the next 15 years. This plan outlines the...

  15. Mark Twain National Wildlife Refuge Complex: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Mark Twain NWR for the next 15 years. This plan outlines the Complex vision and purpose...

  16. Illinois River National Wildlife and Fish Refuges Complex: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Illinois River National Wildlife and Fish Refuges for the next 15 years. This plan...

  17. Deep Fork National Wildlife Refuge: Comprehensive Conservation Plan 1999-2009 and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Deep Fork NWR for the next 15 years. This plan outlines the Refuge vision and purpose...

  18. Detroit Lakes Wetlands Management District: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Detroit Lakes Wetlands Management District for the next 15 years. This plan outlines...

  19. Modoc National Wildlife Refuge: Final Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Modoc NWR for the next 15 years. This plan outlines the Refuge vision and purpose and...

  20. Crab Orchard National Wildlife Refuge: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Crab Orchard National Wildlife Refuge for the next 15 years. This plan outlines the...

  1. Wheeler National Wildlife Refuge Complex: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Wheeler NWR for the next 15 years. This plan outlines the Complex vision and purpose...

  2. Draft Comprehensive Conservation Plan and Environmental Assessment: Cahaba River National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This draft Comprehensive Conservation Plan (CCP) was written to guide management on Cahaba River National Wildlife Refuge (NWR) for the next 15 years. This plan...

  3. Ozark Plateau National Wildlife Refuge: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Ozark Plateau National Wildlife Refuge for the next 15 years. This plan outlines the...

  4. Detroit River International Wildlife Refuge: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Detroit River International Wildlife Refuge for the next 15 years. This plan outlines...

  5. Minnesota Valley National Wildlife Refuge and Wetland Management District: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Minnesota Valley NWR and Wetland Management District for the next 15 years. This plan...

  6. Ellicott Slough National Wildlife Refuge: Final Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Ellicott Slough NWR for the next 15 years. This plan outlines the Refuge vision and...

  7. DeSoto and Boyer Chute National Wildlife Refuges: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on DeSoto and Boyer Chute National Wildlife Refuge for the next 15 years. This plan...

  8. Big Stone Wetland Management District: Comprehensive Conservation Plan and Environmental Assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Big Stone Wetland Management District for the next 15 years. This plan outlines the...

  9. Health Information Technology Evaluation Framework (HITREF) Comprehensiveness as Assessed in Electronic Point-of-Care Documentation Systems Evaluations.

    Science.gov (United States)

    Sockolow, Paulina S; Bowles, Kathryn H; Rogers, Michelle

    2015-01-01

    We assessed the Health Information Technology (HIT) Reference-based Evaluation Framework (HITREF) comprehensiveness in two HIT evaluations in settings different from that in which the HITREF was developed. Clinician satisfaction themes that emerged from clinician interviews in the home care and the hospital studies were compared to the framework components. Across both studies, respondents commented on 12 of the 20 HITREF components within 5 of the 6 HITREF concepts. No new components emerged that were missing from the HITREF providing evidence that the HITREF is a comprehensive framework. HITREF use in a range of HIT evaluations by researchers new to the HITREF demonstrates that it can be used as intended. Therefore, we continue to recommend the HITREF as a comprehensive, research-based HIT evaluation framework to increase the capacity of informatics evaluators' use of best practice and evidence-based practice to support the credibility of their findings for fulfilling the purpose of program evaluation.

  10. Assessing school disaster preparedness by applying a comprehensive school safety framework: A case of elementary schools in Banda Aceh City

    Science.gov (United States)

    Sakurai, A.; Bisri, M. B. F.; Oda, T.; Oktari, R. S.; Murayama, Y.

    2017-02-01

    The study assessed the depth of school disaster safety at public elementary schools in Banda Aceh City, Indonesia in terms of comprehensive school safety, especially school location, disaster management and disaster education. The findings indicate that 56% of public elementary schools in Banda Aceh City are exposed to high tsunami risk, and most externally driven school disaster preparedness activities were not continued by the schools due to lack of ownership and funding. To realize comprehensive school safety, disaster preparedness programs should neither be brought in by external donors, nor be in a patchwork. Rather, it should be conducted jointly and sustainably by the local school and the community and supported by multi-sectoral support in the city. Comprehensive school safety of public elementary schools in Banda Aceh City could be realized by reviewing, updating and localizing school disaster preparedness programs by all the education partners in the city with strong political will and commitment.

  11. The portfolio approach to competency-based assessment at the Cleveland Clinic Lerner College of Medicine.

    Science.gov (United States)

    Dannefer, Elaine F; Henson, Lindsey C

    2007-05-01

    Despite the rapid expansion of interest in competency-based assessment, few descriptions of assessment systems specifically designed for a competency-based curriculum have been reported. The purpose of this article is to describe the design of a portfolio approach to a comprehensive, competency-based assessment system that is fully integrated with the curriculum to foster an educational environment focused on learning. The educational design goal of the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University was to create an integrated educational program-curriculum and instructional methods, student assessment processes, and learning environment-to prepare medical students for success in careers as physician investigators. The first class in the five-year program matriculated in 2004. To graduate, a student must demonstrate mastery of nine competencies: research, medical knowledge, communication, professionalism, clinical skills, clinical reasoning, health care systems, personal development, and reflective practice. The portfolio provides a tool for collecting and managing multiple types of assessment evidence from multiple contexts and sources within the curriculum to document competence and promote reflective practice skills. This article describes how the portfolio was developed to provide both formative and summative assessment of student achievement in relation to the program's nine competencies.

  12. Comprehensive echocardiographic assessment of biventricular function in the rabbit, animal model in cardiovascular research: feasibility and normal values.

    Science.gov (United States)

    Ramos, Sara Roldan; Pieles, Guido; Hui, Wei; Ishii, Ryo; Slorach, Cameron; Friedberg, Mark K

    2017-08-24

    Quantification of cardiac structure and function is central in cardiovascular research. Rabbits are valuable research models of cardiovascular human disease; however, there is little normal data available. The aim of this study was to investigate feasibility and provide normal values for comprehensive echocardiographic assessment of biventricular function in rabbits. New Zealand white rabbits underwent trans-thoracic echocardiography using a general electric (GE) Vivid 7/E9 system with a 10 MHz transducer, under light sedation, to evaluate biventricular function and dimensions. Images for two-dimensional, M-mode, tissue Doppler imaging (TDI) and speckle-tracking strain echocardiography were acquired and analysed. 55 male rabbits (sized matched with a newborn human baby) were studied, mean weight was 2.9 ± 0.23 kg. Adequate images were obtained in 90% for the left ventricle (LV) and 80% for the right ventricle (RV). Two-dimensional speckle-tracking strain was feasible in 60%. Average heart rate was 248 ± 36 beats per minute; LV ejection faction 72 ± 8.0; RV fractional area change 45.9 ± 9.0%; RV myocardial performance index 0.39 ± 0.35; tricuspid annular planar systolic excursion 0.60 ± 0.24 cm. LV TDI parameters were S' 8.6 ± 3.1 cm/s; E' 12.0 ± 4.46 cm/s. RV TDI parameters were S' 10.49 ± 3.18; E' 14.95 ± 4.64 cm/s. LV and RV global peak systolic longitudinal strain were -17 ± 5 and -22 ± 8%, respectively. Comprehensive investigation of biventricular dimensions and function by echocardiography is feasible in the rabbit. Apical views and strain imaging have lower feasibility. Normal values of LV and RV functional parameters are with comparable values to human children. Animal cardiovascular research is key to develop new goals in clinical practice.

  13. A comprehensive assessment of the precision and agreement of anterior corneal power measurements obtained using 8 different devices.

    Directory of Open Access Journals (Sweden)

    Qinmei Wang

    Full Text Available PURPOSE: To comprehensively assess the precision and agreement of anterior corneal power measurements using 8 different devices. METHODS: Thirty-five eyes from 35 healthy subjects were included in the prospective study. In the first session, a single examiner performed on each subject randomly measurements with the RC-5000 (Tomey Corp., Japan, KR-8000 (Topcon, Japan, IOLMaster (Carl Zeiss Meditec, Germany, E300 (Medmont International, Australia, Allegro Topolyzer (Wavelight AG, Germany, Vista (EyeSys, TX, Pentacam (Oculus, Germany and Sirius (CSO, Italy. Measurements were repeated in the second session (1 to 2 weeks later. Repeatability and reproducibility of corneal power measurements were assessed based on the intrasession and intersession within-subject standard deviation (Sw, repeatability (2.77Sw, coefficient of variation (COV, and intraclass correlation coefficient (ICC. Agreement was evaluated by 95% limits of agreement (LoA. RESULTS: All devices demonstrated high repeatability and reproducibility of the keratometric values (2.77Sw0.98. Repeated-measures analysis of variance with Bonferroni post test showed statistically significant differences (P<0.01 among mean keratometric values of most instruments; the largest differences were observed between the EyeSys Vista and Medmont E300. Good agreement (i.e., 95%LoA within ± 0.5D was found between most instruments for flat, steep and mean keratometry, except for EyeSys and Medmont. Repeatability and reproducibility of vectors J(0 and J(45 was good, as the ICCs were higher than 0.9, except J(45 of Medmont and Pentacam. For the 95% LoAs of J(0 and J(45, they were all ≤ ± 0.31 among any two paired devices. CONCLUSIONS: The 8 devices showed excellent repeatability and reproducibility. The results obtained using the RC-5000, KR-8000, IOLMaster, Allegro Topolyzer, Pentacam and Sirius were comparable, suggesting that they could be used interchangeably in most clinical settings. Caution is

  14. Effect of in-hospital comprehensive geriatric assessment (CGA in older people with hip fracture. The protocol of the Trondheim Hip Fracture Trial

    Directory of Open Access Journals (Sweden)

    Taraldsen Kristin

    2011-04-01

    Full Text Available Abstract Background Hip fractures in older people are associated with high morbidity, mortality, disability and reduction in quality of life. Traditionally people with hip fracture are cared for in orthopaedic departments without additional geriatric assessment. However, studies of postoperative rehabilitation indicate improved efficiency of multidisciplinary geriatric rehabilitation as compared to traditional care. This randomized controlled trial (RCT aims to investigate whether an additional comprehensive geriatric assessment of hip fracture patients in a special orthogeriatric unit during the acute in-hospital phase may improve outcomes as compared to treatment as usual in an orthopaedic unit. Methods/design The intervention of interest, a comprehensive geriatric assessment is compared with traditional care in an orthopaedic ward. The study includes 401 home-dwelling older persons >70 years of age, previously able to walk 10 meters and now treated for hip fracture at St. Olav Hospital, Trondheim, Norway. The participants are enrolled and randomised during the stay in the Emergency Department. Primary outcome measure is mobility measured by the Short Physical Performance Battery (SPPB at 4 months after surgery. Secondary outcomes measured at 1, 4 and 12 months postoperatively are place of residence, activities of daily living, balance and gait, falls and fear of falling, quality of life and depressive symptoms, as well as use of health care resources and survival. Discussion We believe that the design of the study, the randomisation procedure and outcome measurements will be of sufficient strength and quality to evaluate the impact of comprehensive geriatric assessment on mobility and other relevant outcomes in hip fracture patients. Trials registration ClinicalTrials.gov, NCT00667914

  15. Reliable and Valid Assessment of Clinical Bronchoscopy Performance

    DEFF Research Database (Denmark)

    Konge, Lars; Larsen, Klaus Richter; Clementsen, Paul

    2012-01-01

    aimed for the use in a clinical setting. Methods: Five junior residents, 5 senior residents and 9 consultants performed 3 bronchoscopies each. All 57 bronchoscopies were video-recorded and assessed blindly and independently by two bronchoscopy experts using the new assessment tool. Results...

  16. Validation of a clinical assessment tool for spinal anaesthesia.

    LENUS (Irish Health Repository)

    Breen, D

    2011-07-01

    There is a need for a procedure-specific means of assessment of clinical performance in anaesthesia. The aim of this study was to devise a tool for assessing the performance of spinal anaesthesia, which has both content and construct validity.

  17. Large observer variation of clinical assessment of dyspnoeic wheezing children

    NARCIS (Netherlands)

    Bekhof, Jolita; Reimink, Roelien; Bartels, Ine-Marije; Eggink, Hendriekje; Brand, Paul L. P.

    2015-01-01

    Background In children with acute dyspnoea, the assessment of severity of dyspnoea and response to treatment is often performed by different professionals, implying that knowledge of the interobserver variation of this clinical assessment is important. Objective To determine intraobserver and intero

  18. The Fertility Assessment and Counselling Clinic - does the concept work?

    DEFF Research Database (Denmark)

    Petersen, Kathrine Birch; Maltesen, Thomas; Forman, Julie L.

    2017-01-01

    INTRODUCTION: The Fertility Assessment and Counselling (FAC) Clinic was initiated to provide women information about their current fertility status to prevent infertility and smaller families than desired. The aim was to study the predictive value of a risk assessment score based on known fertility...

  19. Clinical assessment of selenium status of livestock.

    Science.gov (United States)

    Stowe, H D; Herdt, T H

    1992-12-01

    Assessment of the selenium status of livestock is an important aspect of production medicine, but variations in reported values between laboratories and between methods may be > 30%. Reliable interpretations require considerable experience with an assay and an extensive database from field and research case samples of a variety of species. The Michigan State University Animal Health Diagnostic Laboratory (MSU-ADHL) has offered Se analyses by acid-digestion and fluorometric detection since 1982. This laboratory expects serum Se values (nanograms per milliliter) of livestock to increase gradually with age from starting ranges for neonates of 50 to 80 for calves and sheep and 70 to 90 for foals and pigs. Expected or "normal" values for the adults are in the ranges of 70 to 100 for cattle, 120 to 150 for sheep, 130 to 160 for horses, and 180 to 220 for swine. Normal liver Se concentrations are considered to range between 1.2 and 2.0 micrograms/g on a dry weight basis, regardless of the species or age. Based on samples submitted to MSU-AHDL between September 1990 and August 1991, contemporary feeding practices in the Michigan area resulted in mean serum Se values (nanograms per milliliter) of 75 +/- 19 for adult Holsteins, 170 +/- 27 for adult swine (mixed breeds), and 137 +/- 30 for adult race horses. Within that period of time, two field cases of Se toxicity were diagnosed. One involved feeder pigs with a recorded high serum Se value of 1,525 ng/mL due to a commercial premix manufacturing error.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Life Cycle Assessment, ExternE and Comprehensive Analysis for an integrated evaluation of the environmental impact of anthropogenic activities

    Energy Technology Data Exchange (ETDEWEB)

    Pietrapertosa, F.; Cosmi, C. [National Research Council, Institute of Methodologies for Environmental Analysis C.N.R.-I.M.A.A. C.da S.Loja, I-85050 Tito Scalo (PZ) (Italy); National Research Council, National Institute for the Physics of Matter, C.N.R.-I.N.F.M. Via Cinthia, I-80126 Naples (Italy); Macchiato, M. [Federico II University, Department of Physical Sciences, Via Cinthia, I-80126 Naples (Italy); National Research Council, National Institute for the Physics of Matter, C.N.R.-I.N.F.M. Via Cinthia, I-80126 Naples (Italy); Salvia, M.; Cuomo, V. [National Research Council, Institute of Methodologies for Environmental Analysis C.N.R.-I.M.A.A. C.da S.Loja, I-85050 Tito Scalo (PZ) (Italy)

    2009-06-15

    The implementation of resource management strategies aimed at reducing the impacts of the anthropogenic activities system requires a comprehensive approach to evaluate on the whole the environmental burdens of productive processes and to identify the best recovery strategies from both an environmental and an economic point of view. In this framework, an analytical methodology based on the integration of Life Cycle Assessment (LCA), ExternE and Comprehensive Analysis was developed to perform an in-depth investigation of energy systems. The LCA methodology, largely utilised by the international scientific community for the assessment of the environmental performances of technologies, combined with Comprehensive Analysis allows modelling the overall system of anthropogenic activities, as well as sub-systems, the economic consequences of the whole set of environmental damages. Moreover, internalising external costs into partial equilibrium models, as those utilised by Comprehensive Analysis, can be useful to identify the best paths for implementing technology innovation and strategies aimed to a more sustainable energy supply and use. This paper presents an integrated application of these three methodologies to a local scale case study (the Val D'Agri area in Basilicata, Southern Italy), aimed to better characterise the environmental impacts of the energy system, with particular reference to extraction activities. The innovative methodological approach utilised takes advantage from the strength points of each methodology with an added value coming from their integration as emphasised by the main results obtained by the scenario analysis. (author)

  1. Prologue: Reading Comprehension Is Not a Single Ability

    Science.gov (United States)

    Catts, Hugh W.; Kamhi, Alan G.

    2017-01-01

    Purpose: In this initial article of the clinical forum on reading comprehension, we argue that reading comprehension is not a single ability that can be assessed by one or more general reading measures or taught by a small set of strategies or approaches. Method: We present evidence for a multidimensional view of reading comprehension that…

  2. Is the acute care of frail elderly patients in a comprehensive geriatric assessment unit superior to conventional acute medical care?

    Directory of Open Access Journals (Sweden)

    Ekerstad N

    2016-12-01

    Full Text Available Niklas Ekerstad,1,2 Björn W Karlson,3 Synneve Dahlin Ivanoff,4 Sten Landahl,5 David Andersson,6 Emelie Heintz,7 Magnus Husberg,2 Jenny Alwin2 1Department of Cardiology, NU (NÄL-Uddevalla Hospital Group, Trollhattan, 2Division of Health Care Analysis, Department of Medical and Health Sciences, Linköping University, Linköping, 3Department of Molecular and Clinical Medicine, Institute of Medicine, 4Centre for Ageing and Health, AGECAP, Department of Health and Rehabilitation, 5Department of Geriatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 6Division of Economics, Department of Management and Engineering, Linköping University, Linköping, 7Health Outcomes and Economic Evaluation Research Group, Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden Objective: The aim of this study was to investigate whether the acute care of frail elderly patients in a comprehensive geriatric assessment (CGA unit is superior to the care in a conventional acute medical care unit. Design: This is a clinical, prospective, randomized, controlled, one-center intervention study. Setting: This study was conducted in a large county hospital in western Sweden. Participants: The study included 408 frail elderly patients, aged ≥75 years, in need of acute in-hospital treatment. The patients were allocated to the intervention group (n=206 or control group (n=202. Mean age of the patients was 85.7 years, and 56% were female. Intervention: This organizational form of care is characterized by a structured, systematic interdisciplinary CGA-based care at an acute elderly care unit. Measurements: The primary outcome was the change in health-related quality of life (HRQoL 3 months after discharge from hospital, measured by the Health Utilities Index-3 (HUI-3. Secondary outcomes were all-cause mortality, rehospitalizations, and hospital care costs. Results: After adjustment by

  3. Roadmap to a Comprehensive Clinical Data Warehouse for Precision Medicine Applications in Oncology.

    Science.gov (United States)

    Foran, David J; Chen, Wenjin; Chu, Huiqi; Sadimin, Evita; Loh, Doreen; Riedlinger, Gregory; Goodell, Lauri A; Ganesan, Shridar; Hirshfield, Kim; Rodriguez, Lorna; DiPaola, Robert S

    2017-01-01

    Leading institutions throughout the country have established Precision Medicine programs to support personalized treatment of patients. A cornerstone for these programs is the establishment of enterprise-wide Clinical Data Warehouses. Working shoulder-to-shoulder, a team of physicians, systems biologists, engineers, and scientists at Rutgers Cancer Institute of New Jersey have designed, developed, and implemented the Warehouse with information originating from data sources, including Electronic Medical Records, Clinical Trial Management Systems, Tumor Registries, Biospecimen Repositories, Radiology and Pathology archives, and Next Generation Sequencing services. Innovative solutions were implemented to detect and extract unstructured clinical information that was embedded in paper/text documents, including synoptic pathology reports. Supporting important precision medicine use cases, the growing Warehouse enables physicians to systematically mine and review the molecular, genomic, image-based, and correlated clinical information of patient tumors individually or as part of large cohorts to identify changes and patterns that may influence treatment decisions and potential outcomes.

  4. Evaluating clinical competence during nursing education: A comprehensive integrative literature review.

    Science.gov (United States)

    Lejonqvist, Gun-Britt; Eriksson, Katie; Meretoja, Riitta

    2016-04-01

    This paper explored concepts, definitions and theoretical perspectives evaluating clinical competence during nursing education. The questions were: (i) How is clinical competence evaluated? and (ii) What is evaluated? An integrative review of 19 original research articles from 2009 to 2013 was performed. Results showed that evaluation tools were used in 14, observations in 2 and reflecting writing in 3 studies. The students participated in all but one evaluation alone or together with peers, faculty members or preceptors. Three themes were found: (i) professional practice with a caring perspective; (ii) clinical skills and reflective practice; and (iii) cognitive, affective and psychomotor skills both with a nursing perspective. This review shows an emphasis on structured methods with a risk reducing nursing to tasks and skills why combinations with qualitative evaluations are recommended. A holistic view of competence dominated and in designing evaluations, explicit perspectives and operationalized definitions of clinical competence became evident.

  5. Does the Component Processes Task Assess Text-Based Inferences Important for Reading Comprehension? A Path Analysis in Primary School Children.

    Science.gov (United States)

    Wassenburg, Stephanie I; de Koning, Björn B; de Vries, Meinou H; van der Schoot, Menno

    2016-01-01

    Using a component processes task (CPT) that differentiates between higher-level cognitive processes of reading comprehension provides important advantages over commonly used general reading comprehension assessments. The present study contributes to further development of the CPT by evaluating the relative contributions of its components (text memory, text inferencing, and knowledge integration) and working memory to general reading comprehension within a single study using path analyses. Participants were 173 third- and fourth-grade children. As hypothesized, knowledge integration was the only component of the CPT that directly contributed to reading comprehension, indicating that the text-inferencing component did not assess inferential processes related to reading comprehension. Working memory was a significant predictor of reading comprehension over and above the component processes. Future research should focus on finding ways to ensure that the text-inferencing component taps into processes important for reading comprehension.

  6. Comparison of Next-Generation Sequencing Technologies for Comprehensive Assessment of Full-Length Hepatitis C Viral Genomes

    Science.gov (United States)

    Thomson, Emma; Ip, Camilla L. C.; Badhan, Anjna; Christiansen, Mette T.; Adamson, Walt; Ansari, M. Azim; Breuer, Judith; Brown, Anthony; Bowden, Rory; Bonsall, David; Da Silva Filipe, Ana; Hinds, Chris; Hudson, Emma; Klenerman, Paul; Lythgow, Kieren; Mbisa, Jean L.; McLauchlan, John; Myers, Richard; Piazza, Paolo; Roy, Sunando; Trebes, Amy; Sreenu, Vattipally B.; Witteveldt, Jeroen; Simmonds, Peter

    2016-01-01

    Affordable next-generation sequencing (NGS) technologies for hepatitis C virus (HCV) may potentially identify both viral genotype and resistance genetic motifs in the era of directly acting antiviral (DAA) therapies. This study compared the ability of high-throughput NGS methods to generate full-length, deep, HCV sequence data sets and evaluated their utility for diagnostics and clinical assessment. NGS methods using (i) unselected HCV RNA (metagenomics), (ii) preenrichment of HCV RNA by probe capture, and (iii) HCV preamplification by PCR implemented in four United Kingdom centers were compared. Metrics of sequence coverage and depth, quasispecies diversity, and detection of DAA resistance-associated variants (RAVs), mixed HCV genotypes, and other coinfections were compared using a panel of samples with different viral loads, genotypes, and mixed HCV genotypes/subtypes [geno(sub)types]. Each NGS method generated near-complete genome sequences from more than 90% of samples. Enrichment methods and PCR preamplification generated greater sequence depth and were more effective for samples with low viral loads. All NGS methodologies accurately identified mixed HCV genotype infections. Consensus sequences generated by different NGS methods were generally concordant, and majority RAVs were consistently detected. However, methods differed in their ability to detect minor populations of RAVs. Metagenomic methods identified human pegivirus coinfections. NGS provided a rapid, inexpensive method for generating whole HCV genomes to define infecting genotypes, RAVs, comprehensive viral strain analysis, and quasispecies diversity. Enrichment methods are particularly suited for high-throughput analysis while providing the genotype and information on potential DAA resistance. PMID:27385709

  7. Assessment and revision of clinical pharmacy practice internet web sites.

    Science.gov (United States)

    Edwards, Krystal L; Salvo, Marissa C; Ward, Kristina E; Attridge, Russell T; Kiser, Katie; Pinner, Nathan A; Gallegos, Patrick J; Kesteloot, Lori Lynn; Hylton, Ann; Bookstaver, P Brandon

    2014-02-01

    Health care professionals, trainees, and patients use the Internet extensively. Editable Web sites may contain inaccurate, incomplete, and/or outdated information that may mislead the public's perception of the topic. To evaluate the editable, online descriptions of clinical pharmacy and pharmacist and attempt to improve their accuracy. The authors identified key areas within clinical pharmacy to evaluate for accuracy and appropriateness on the Internet. Current descriptions that were reviewed on public domain Web sites included: (1) clinical pharmacy and the clinical pharmacist, (2) pharmacy education, (3) clinical pharmacy and development and provision for reimbursement, (4) clinical pharmacists and advanced specialty certifications/training opportunities, (5) pharmacists and advocacy, and (6) clinical pharmacists and interdisciplinary/interprofessional content. The authors assessed each content area to determine accuracy and prioritized the need for updating, when applicable, to achieve consistency in descriptions and relevancy. The authors found that Wikipedia, a public domain that allows users to update, was consistently the most common Web site produced in search results. The authors' evaluation resulted in the creation or revision of 14 Wikipedia Web pages. However, rejection of 3 proposed newly created Web pages affected the authors' ability to address identified content areas with deficiencies and/or inaccuracies. Through assessing and updating editable Web sites, the authors strengthened the online representation of clinical pharmacy in a clear, cohesive, and accurate manner. However, ongoing assessments of the Internet are continually needed to ensure accuracy and appropriateness.

  8. Design and Outcomes of a Comprehensive Care Experience Level System to Evaluate and Monitor Dental Students' Clinical Progress.

    Science.gov (United States)

    Teich, Sorin T; Roperto, Renato; Alonso, Aurelio A; Lang, Lisa A

    2016-06-01

    A Comprehensive Care Experience Level (CCEL) system that is aligned with Commission on Dental Accreditation (CODA) standards, promotes comprehensive care and prevention, and addresses flaws observed in previous Relative Value Units (RVU)-based programs has been implemented at the School of Dental Medicine, Case Western Reserve University since 2011. The purpose of this article is to report on the design, implementation, and preliminary outcomes of this novel clinical evaluation system. With the development of the CCEL concept, it was decided not to award points for procedures performed on competency exams. The reason behind this decision was that exams are not learning opportunities and are evaluated with summative tools. To determine reasonable alternative requirements, production data from previous classes were gathered and translated into CCEL points. These RVU points had been granted selectively only for restorative procedures completed after the initial preparation stage of the treatment plan, and achievement of the required levels was checked at multiple points during the clinical curriculum. Results of the CCEL system showed that low performing students increased their productivity, overall production at graduation increased significantly, and fluoride utilization to prevent caries rose by an order of magnitude over the RVU system. The CCEL program also allowed early identification and remediation of students having difficulty in the clinic. This successful implementation suggests that the CCEL concept has the potential for widespread adoption by dental schools. This method also can be used as a behavior modification tool to achieve specific patient care or clinical educational goals as illustrated by the way caries prevention was promoted through the program.

  9. An automated version of the BAT Syntactic Comprehension task for assessing auditory L2 proficiency in healthy adults.

    Science.gov (United States)

    Achim, André; Marquis, Alexandra

    2011-06-01

    Studies of bilingualism sometimes require healthy subjects to be assessed for proficiency at auditory sentence processing in their second language (L2). The Syntactic Comprehension task of the Bilingual Aphasia Test could satisfy this need. For ease and uniformity of application, we automated its English ( Paradis, M., Libben, G., and Hummel, K. (1987) . The Bilingual Aphasia Test. English version. Hillsdale, NJ: Lawrence Erlbaum Associates) and French ( Paradis, M., & Goldblum, M. C. (1987) . The Bilingual Aphasia Test, French version. Hillsdale, NJ: Lawrence Erlbaum Associates) versions. Although the Bilingual Aphasia Test is meant to assess neurological disorders affecting language, we hypothesised that ceiling performance in L2 would be rare and L2 errors should be consistent with lack of processing automaticity. Initial data from 13 French-English and 4 English-French bilinguals confirm these expectations. Thus, the automated Syntactic Comprehension task (available online for PC and Mac platforms) is indeed suited to test bilingual English and French proficiency levels in healthy adults.

  10. A Comparative Study of the Effects of Two Approaches of Dynamic Assessment on the Reading Comprehension of Iranian EFL Learners

    Directory of Open Access Journals (Sweden)

    Jila Naeini

    2015-03-01

    Full Text Available The aim of this study was to examine and compare the impact of two Dynamic Assessment (DA approaches, that is, Feuerstein’s Mediated Learning Experience (MLE and Brown’s Graduated Prompt (GP on Iranian EFL learners’ reading comprehension. Therefore, a mixed methods approach consisting of a semi-structured interview, a pretest, an intervention program, a posttest, and a transfer test was applied to assess and compare the efficacy of two DA approaches. One hundred and two EFL learners taking a General English course at Islamic Azad University were assigned to two experimental groups (MLEG and GPG and one comparison group (CG. The participants in the MLEG took part in the MLE, and the participants in the GPG participated in the GP intervention program.  The results of the qualitative as well as the aggregate and disaggregated quantitative data analyses indicated that both intervention approaches of DA were effective in enhancing the learners’ reading comprehension.

  11. Comparison of student self-assessment with faculty assessment of clinical competence.

    Science.gov (United States)

    Root Kustritz, Margaret V; Molgaard, Laura K; Rendahl, Aaron

    2011-01-01

    At the University of Minnesota, fourth-year veterinary students assessed their clinical competence after completion of a small-animal, internal-medicine clinical rotation using the same rotation assessment form used by supervising faculty. Grades were compared between the two groups. Students identified by faculty as low-performing were more likely to overestimate their competence in the areas of knowledge, clinical skill, and professionalism than were students identified by faculty as higher performing. This finding mirrors research results in human health professional training. Self-assessment should not be used as the primary or sole measure of clinical competence in veterinary medical training without the introduction of measures to ensure the accuracy of student self-assessment, measures that include active faculty mentoring of student self-assessment, student goal-setting and reflection, and availability of subsequent opportunities to practice additional self-assessment.

  12. Army Pacific Pathways: Comprehensive Assessment and Planning Needed to Capture Benefits Relative to Costs and Enhance Value for Participating Units

    Science.gov (United States)

    2016-11-01

    logistics and sustainment units, any training efficiencies or cost avoidance resulting from Pacific Pathways, and non-financial costs , such as...ARMY PACIFIC PATHWAYS Comprehensive Assessment and Planning Needed to Capture Benefits Relative to Costs and Enhance...the costs of Pacific Pathways. The corrected section should read: “For fiscal year 2015, the three Pathway operations cost a total of $34.5 million

  13. Comprehensive experiment-clinical biochemistry: determination of blood glucose and triglycerides in normal and diabetic rats.

    Science.gov (United States)

    Jiao, Li; Xiujuan, Shi; Juan, Wang; Song, Jia; Lei, Xu; Guotong, Xu; Lixia, Lu

    2015-01-01

    For second year medical students, we redesigned an original laboratory experiment and developed a combined research-teaching clinical biochemistry experiment. Using an established diabetic rat model to detect blood glucose and triglycerides, the students participate in the entire experimental process, which is not normally experienced during a standard clinical biochemistry exercise. The students are not only exposed to techniques and equipment but are also inspired to think more about the biochemical mechanisms of diseases. When linked with lecture topics about the metabolism of carbohydrates and lipids, the students obtain a better understanding of the relevance of abnormal metabolism in relation to diseases. Such understanding provides a solid foundation for the medical students' future research and for other clinical applications.

  14. The Clinical anatomy of the physical examination of the abdomen: A comprehensive review.

    Science.gov (United States)

    Bilal, Muhammad; Voin, Vlad; Topale, Nitsa; Iwanaga, Joe; Loukas, Marios; Tubbs, R Shane

    2017-04-01

    Physical examination of the abdomen is an essential skill. Knowledge of its clinical anatomy and application is vital for making diagnoses. Misinterpretation of anatomy during examination can have serious consequences. This review addresses understanding of the anatomy, methodology, and complications of abdominal physical examination. It includes particular reference to modern technology and investigations. Physical examination is performed for diagnostic purposes. However, the art of physical examination is declining as more and more clinicians rely on newer technology. This can have regrettable consequences: negligence, waste of time and resources, and deterioration of clinical skills. With a sound knowledge of clinical anatomy, and realization of the importance of physical examination of the abdomen, clinician, and patients alike can benefit. Clin. Anat. 30:352-356, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  15. Computer utilization and clinical judgment in psychological assessment reports.

    Science.gov (United States)

    Lichtenberger, Elizabeth O

    2006-01-01

    The process of assessment report writing is a complex one, involving both the statistical evaluation of data and clinical methods of data interpretation to appropriately answer referral questions. Today, a computer often analyzes data generated in a psychological assessment, at least in part. In this article, the author focuses on the interaction between the decision-making processes of human clinicians and the test interpretations that are computer-based. The benefits and problems with computers in assessment are highlighted and are presented alongside the research on the validity of automated assessment, as well as research comparing clinicians and computers in the decision-making process. The author concludes that clinical judgment and computer-based test interpretation each have weaknesses. However, by using certain strategies to reduce clinicians' susceptibility to errors in decision making and to ensure that only valid computer-based test interpretations are used, clinicians can optimize the accuracy of conclusions that they draw in their assessment report.

  16. Cardiopulmonary responses and prognosis in hypertrophic cardiomyopathy: a potential role for comprehensive noninvasive hemodynamic assessment.

    Science.gov (United States)

    Finocchiaro, Gherardo; Haddad, Francois; Knowles, Joshua W; Caleshu, Colleen; Pavlovic, Aleksandra; Homburger, Julian; Shmargad, Yael; Sinagra, Gianfranco; Magavern, Emma; Wong, Myo; Perez, Marco; Schnittger, Ingela; Myers, Jonathan; Froelicher, Victor; Ashley, Euan A

    2015-05-01

    This study sought to discover the key determinants of exercise capacity, maximal oxygen consumption (oxygen uptake [Vo2]), and ventilatory efficiency (ventilation/carbon dioxide output [VE/Vco2] slope) and assess the prognostic potential of metabolic exercise testing in hypertrophic cardiomyopathy (HCM). The intrinsic mechanisms leading to reduced functional tolerance in HCM are unclear. The study sample included 156 HCM patients consecutively enrolled from January 1, 2007 to January 1, 2012 with a complete clinical assessment, including rest and stress echocardiography and cardiopulmonary exercise test (CPET) with impedance cardiography. Patients were also followed for the composite outcome of cardiac-related death, heart transplant, and functional deterioration leading to septal reduction therapy (myectomy or septal alcohol ablation). Abnormalities in CPET responses were frequent, with 39% (n = 61) of the sample showing a reduced exercise tolerance (Vo2 max 34). The variables most strongly associated with exercise capacity (expressed in metabolic equivalents), were peak cardiac index (r = 0.51, p Vo2 (r = 0.61, p Vo2 34 (hazard ratio: 3.14; 95% CI: 1.26 to 7.87; p = 0.014), and LAVI >40 ml/m(2) (hazard ratio: 3.32; 95% CI: 1.08 to 10.16; p = 0.036). In HCM, peak cardiac index is the main determinant of exercise capacity, but it is not significantly related to ventilatory efficiency. Peak Vo2, ventilatory inefficiency, and LAVI are associated with an increased risk of major events in the short-term follow-up. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  17. Carbon sequestration by patch fertilization: A comprehensive assessment using coupled physical-ecological-biogeochemical models

    Energy Technology Data Exchange (ETDEWEB)

    Sarmiento, Jorge L. [Princeton Univ., NJ (United States); Gnanadesikan, Anand [Princeton Univ., NJ (United States); Gruber, Nicolas [Univ. of California, Los Angeles, CA (United States); Jin, Xin [Univ. of California, Los Angeles, CA (United States); Armstrong, Robert [State Univ. of New York (SUNY), Plattsburgh, NY (United States)

    2007-06-21

    This final report summarizes research undertaken collaboratively between Princeton University, the NOAA Geophysical Fluid Dynamics Laboratory on the Princeton University campus, the State University of New York at Stony Brook, and the University of California, Los Angeles between September 1, 2000, and November 30, 2006, to do fundamental research on ocean iron fertilization as a means to enhance the net oceanic uptake of CO2 from the atmosphere. The approach we proposed was to develop and apply a suite of coupled physical-ecological-biogeochemical models in order to (i) determine to what extent enhanced carbon fixation from iron fertilization will lead to an increase in the oceanic uptake of atmospheric CO2 and how long this carbon will remain sequestered (efficiency), and (ii) examine the changes in ocean ecology and natural biogeochemical cycles resulting from iron fertilization (consequences). The award was funded in two separate three-year installments: September 1, 2000 to November 30, 2003, for a project entitled “Ocean carbon sequestration by fertilization: An integrated biogeochemical assessment.” A final report was submitted for this at the end of 2003 and is included here as Appendix 1; and, December 1, 2003 to November 30, 2006, for a follow-on project under the same grant number entitled “Carbon sequestration by patch fertilization: A comprehensive assessment using coupled physical-ecological-biogeochemical models.” This report focuses primarily on the progress we made during the second period of funding subsequent to the work reported on in Appendix 1. When we began this project, we were thinking almost exclusively in terms of long-term fertilization over large regions of the ocean such as the Southern Ocean, with much of our focus being on how ocean circulation and biogeochemical cycling would interact to control the response to a given fertilization scenario. Our research on these types of scenarios, which was carried out largely during the

  18. An innovative method to assess clinical reasoning skills: Clinical reasoning tests in the second national medical science Olympiad in Iran.

    Science.gov (United States)

    Amini, Mitra; Moghadami, Mohsen; Kojuri, Javad; Abbasi, Hamidreza; Abadi, Ali Arhami Doolat; Molaee, Nezar Ali; Pishbin, Elham; Javadzade, Hamid Reza; Kasmaee, Vahid Monsef; Vakili, Hasan; Sadat, Mohamad Ali Reis; Akbari, Roghaye; Omidvar, Bita; Shafaghi, Afshin; Dehbozorgian, Marzie; Jafari, Mohammad Morad; Monajemi, Alireza; Arabshahi, Kamran Soltani; Adibi, Peyman; Charlin, Bernard

    2011-10-17

    Clinical reasoning plays a major role in the ability of doctors to make a diagnosis and reach treatment decisions. This paper describes the use of four clinical reasoning tests in the second National Medical Science Olympiad in Iran: key features (KF), script concordance (SCT), clinical reasoning problems (CRP) and comprehensive integrative puzzles (CIP). The purpose of the study was to design a multi instrument for multiple roles approach in clinical reasoning field based on the theoretical framework, KF was used to measure data gathering, CRP was used to measure hypothesis formation, SCT and CIP were used to measure hypothesis evaluation and investigating the combined use of these tests in the Olympiad. A bank of clinical reasoning test items was developed for emergency medicine by a scientific expert committee representing all the medical schools in the country. These items were pretested by a reference group and the results were analyzed to select items that could be omitted. Then 135 top-ranked medical students from 45 medical universities in Iran participated in the clinical domain of the Olympiad. The reliability of each test was calculated by Cronbach's alpha. Item difficulty and the correlation between each item and the total score were measured. The correlation between the students' final grade and each of the clinical reasoning tests was calculated, as was the correlation between final grades and another measure of knowledge, i.e., the students' grade point average. The combined reliability for all four clinical reasoning tests was 0.91. Of the four clinical reasoning tests we compared, reliability was highest for CIP (0.91). The reliability was 0.83 for KF, 0.78 for SCT and 0.71 for CRP. Most of the tests had an acceptable item difficulty level between 0.2 and 0.8. The correlation between the score for each item and the total test score for each of the four tests was positive. The correlations between scores for each test and total score were highest

  19. Research progress of motor function assessments and their clinical applications in Duchenne muscular dystrophy

    Directory of Open Access Journals (Sweden)

    Wei SHI

    2015-07-01

    Full Text Available Duchenne muscular dystrophy (DMD, clinically featured as progressive skeletal muscle atrophy with gradual loss of muscle strength and activity abilities, is the most common genetic muscular disease in children throughout the world. The core and continuous characteristic of DMD is motor dysfunction. Motor function assessments of DMD are now focusing on muscle strength, walking ability, range of motion and ability of activities, still without unified standards. Confirming the comprehensive, scientific, reasonable and accurate evaluation tools for DMD assessment is the premise of research in motor developmental rules of DMD, which will help to better understand the motor progress of DMD and to supply evidences for choosing treatment methods, confirming timing of intervention, assessing effect of treatments and designing rehabilitation plans. DOI: 10.3969/j.issn.1672-6731.2015.06.002

  20. Assessment and remedial clinical education of surgeons in California.

    Science.gov (United States)

    Cosman, Bard C; Alverson, Aaron D; Boal, Peter A; Owens, Erik L; Norcross, William A

    2011-12-01

    Assessment and remedial clinical education of practicing surgeons is feasible and possibly beneficial. Retrospective series. Urban academic medical center. Licensed surgeons. Structured assessment and remedial clinical education based on resident-education models. Assessment and clinical education results. Forty-seven general, general/vascular, and colorectal surgeons were assessed by the University of California, San Diego, Physician Assessment and Clinical Education program in 2000 to 2010. Forty-six (98%) were male (mean [SD] age, 54 [11] years; range, 34-80 years). Thirty-three (70%) came from state medical board actions: 25 from California's disciplinary division, 2 from California's licensing division, 3 from other state boards, and 3 self-referred during other state board actions. Fourteen (30%) came from health care organizations: 8 from California hospitals, 3 from hospitals in other states, 2 self-referred during hospital proceedings, and 1 self-referred during a medical group investigation. Twenty-three (49%) underwent a 2-day assessment only, including a 1-hour mock oral board examination: 8 "passed" with no recommendations; 6, with minor recommendations; 6 had major recommendations; and 3 "failed." Twenty-four surgeons (51%) also completed 26 five-day clinical education programs, with 20 "passes," 1 minor recommendation, 3 major recommendations, and 2 "fails." A program of assessment and remedial clinical education of surgeons designed to meet the needs of one medical board is being used by nongovernmental organizations as well, and it seems to meet the needs of some individual surgeons. This type of program may play a role in the profession's self-regulation.

  1. Hyposplenism: a comprehensive review. Part II: clinical manifestations, diagnosis, and management.

    Science.gov (United States)

    William, Basem M; Thawani, Nitika; Sae-Tia, Sutthichai; Corazza, Gino R

    2007-04-01

    In the first part of this review, we described the physiological basis of splenic function and hypofunction. We also described the wide spectrum of diseases that can result in functional hyposplenism. In the second part of this review, we will be discussing the clinical picture, including complications, diagnostic methods, and management of hyposplenism.

  2. Therapeutic efficacy of rose oil: A comprehensive review of clinical evidence

    Directory of Open Access Journals (Sweden)

    Safieh Mohebitabar

    2017-04-01

    Full Text Available Objective: Rose oil is obtained from the petals of difference Rosa species especially Rosa centifolia L. and Rosa damascena Mill. Various pharmacological properties have been attributed to rose oil. The aim of the present study was to review the rose oil therapeutic effects which had been clinically evaluated in trial studies. Materials and Methods: Google scholar, PubMed, Cochrane Library, and Scopus were searched for human studies which have evaluated the therapeutic effects of rose oil and published in English language until August 2015. Results: Thirteen clinical trials (772 participants were included in this review. Rose oil was administered via inhalation or used topically. Most of the studies (five trials evaluated the analgesic effect of rose oil. Five studies evaluated the physiological relaxation effect of rose oil. Anti-depressant, psychological relaxation, improving sexual dysfunction, and anti-anxiety effects were the other clinical properties reported for rose oil. Conclusion: Numerous studies on the pharmacological properties of rose oil have been done in animals, but studies in humans are few.  In this study, it was observed that rose oil had physiological and psychological relaxation, analgesic and anti-anxiety effects. To obtain conclusive results on the efficacy and safety of rose oil, further clinical trials with larger sample size and better designation are required.

  3. Comprehensive Experiment--Clinical Biochemistry: Determination of Blood Glucose and Triglycerides in Normal and Diabetic Rats

    Science.gov (United States)

    Jiao, Li; Xiujuan, Shi; Juan, Wang; Song, Jia; Lei, Xu; Guotong, Xu; Lixia, Lu

    2015-01-01

    For second year medical students, we redesigned an original laboratory experiment and developed a combined research-teaching clinical biochemistry experiment. Using an established diabetic rat model to detect blood glucose and triglycerides, the students participate in the entire experimental process, which is not normally experienced during a…

  4. Comprehensive Experiment--Clinical Biochemistry: Determination of Blood Glucose and Triglycerides in Normal and Diabetic Rats

    Science.gov (United States)

    Jiao, Li; Xiujuan, Shi; Juan, Wang; Song, Jia; Lei, Xu; Guotong, Xu; Lixia, Lu

    2015-01-01

    For second year medical students, we redesigned an original laboratory experiment and developed a combined research-teaching clinical biochemistry experiment. Using an established diabetic rat model to detect blood glucose and triglycerides, the students participate in the entire experimental process, which is not normally experienced during a…

  5. Effect of Yoga on migraine: A comprehensive study using clinical profile and cardiac autonomic functions

    Directory of Open Access Journals (Sweden)

    Ravikiran Kisan

    2014-01-01

    Conclusions: Intervention showed significant clinical improvement in both groups. Headache frequency and intensity were reduced more in Yoga with conventional care than the conventional care group alone. Furthermore, Yoga therapy enhanced the vagal tone and decreased the sympathetic drive, hence improving the cardiac autonomic balance. Thus, Yoga therapy can be effectively incorporated as an adjuvant therapy in migraine patients.

  6. Analysis of Textual Features of a New Reading Comprehension Assessment: MOCCA

    Science.gov (United States)

    Seipel, Ben; Biancarosa, Gina; Carlson, Sarah; Davison, Mark

    2015-01-01

    Previous research has established two types of struggling readers: those who struggle with lower-level reading skills and those who struggle with higher-level reading skills (Cain & Oakhill, 2006; Perfetti, 2007). The latter group is commonly termed "poor comprehenders": readers who exhibit poor comprehension compared to peers with…

  7. The Comprehensive Business Exam: Usefulness for Assessing Instructional and Student Performance Outcomes

    Science.gov (United States)

    Hahn, William; Leslie, Beth

    2017-01-01

    The authors explore the results of the Comprehensive Business Exam (CBE) administered to business majors during their senior-year business capstone course. The study results identified students' SAT and grade point average as a predictor of CBE performance, and variables that explain the correlation between CBE performance, SAT score, and grade…

  8. Assessment of strategic processing during narrative comprehension in individuals with mild cognitive impairment.

    Science.gov (United States)

    Schmitter-Edgecombe, Maureen; Creamer, Scott

    2010-07-01

    A think-aloud protocol was used to examine the strategies used by individuals with mild cognitive impairment (MCI) during text comprehension. Twenty-three participants with MCI and 23 cognitively healthy older adults (OA) read narratives, pausing to verbalize their thoughts after each sentence. The verbal protocol analysis developed by Trabasso and Magliano (1996) was then used to code participants' utterances into inferential and non-inferential statements; inferential statements were further coded to identify the memory operation used in their generation. Compared with OA controls, the MCI participants showed poorer story comprehension and produced fewer inferences. The MCI participants were also less skilled at providing explanations of story events and in using prior text information to support inference generation. Poorer text comprehension was associated with poorer verbal memory abilities and poorer use of prior text events when producing inferential statements. The results suggest that the memory difficulties of the MCI group may be an important cognitive factor interfering with their ability to integrate narrative events through the use of inferences and to form a global coherence to support text comprehension.

  9. Measuring Reading Comprehension of Content Area Texts Using an Assessment of Knowledge Organization

    Science.gov (United States)

    Davis, Marcia H.; Guthrie, John T.

    2015-01-01

    The authors outline results of 3 studies conducted to examine the structure of disciplinary knowledge from reading measured through proximity data. In Study 1, 168 third-grade students were asked to read a science text and rate the relationships of keywords from the passage. From these ratings, comprehension scores were calculated that related…

  10. The Comprehensive Business Exam: Usefulness for Assessing Instructional and Student Performance Outcomes

    Science.gov (United States)

    Hahn, William; Leslie, Beth

    2017-01-01

    The authors explore the results of the Comprehensive Business Exam (CBE) administered to business majors during their senior-year business capstone course. The study results identified students' SAT and grade point average as a predictor of CBE performance, and variables that explain the correlation between CBE performance, SAT score, and grade…

  11. Corrosion risk assessment and comprehensive evaluation of ship sea water pipe systems

    Directory of Open Access Journals (Sweden)

    YANG Guangfu

    2017-05-01

    Full Text Available In order to propose a comprehensive corrosion risk evaluation model based on an analysis of the corrosion risk of sea water pipe systems of ships in service,the modes of potential corrosion and their causes were first analyzed by identifying the origins of the inner and outer corrosion of the sea water pipe systems. In accordance with the matrixes of corrosion occurrence possibility and corrosion risk consequence,a corrosion risk matrix was established for a sea water pipe system. The method for the quantitative evaluation value of each mode of corrosion possibly occurring in a sea water pipe system was then presented. The comprehensive evaluation model of the corrosion was first built using the Analytical Hierarchy Process(AHP,which can be used for the comprehensive corrosion evaluation. The results show that the comprehensive evaluation value will be expressed as the corrosion risk level and corrosion-induced consequence of the sea water pipe system. This will be very useful for accurately protecting the sea water pipe systems of ships in service from corrosion,thereby attaining the goals of economy,rationality and timeliness.

  12. A Computer System of Referential Resolution to Assess Students' Reading Comprehension

    Science.gov (United States)

    Yang, Yu-Fen; Wong, Wing-Kwong; Yeh, Hui-Chin

    2008-01-01

    The major purpose of this study is to assist college students in constructing mental representation of referential resolution in a computer system. Ninety students were asked to draw mental maps indicating the relationships between references, take reading comprehension tests, and fill out open-ended questionnaire. Results showed that the…

  13. Plain Language in Environmental Policy Documents: An Assessment of Reader Comprehension and Perceptions

    Science.gov (United States)

    Jones, Natasha; McDavid, Justin; Derthick, Katie; Dowell, Randy; Spyridakis, Jan

    2012-01-01

    Several government agencies are seeking quality improvement in environmental policy documents by asking for the implementation of Plain Language (PL) guidelines. Our mixed-methods research examines whether the application of certain PL guidelines affects the comprehension and perceptions of readers of environmental policy documents. Results show…

  14. Assessment of Cognitive Abilities and Reading Comprehension across School-Age Development: A Meta-Analysis

    Science.gov (United States)

    Finn, Diana Baker

    2014-01-01

    The purpose of this study was to examine the relationship of specific cognitive abilities and reading comprehension across a variety of norm referenced tests that align with Cattell-Horn-Carroll (CHC) theory of cognitive abilities and integrative models of reading. Data from existing studies was analyzed by comparing the relationships of four…

  15. Assessing Reliability: Critical Corrections for a Critical Examination of the Rorschach Comprehensive System.

    Science.gov (United States)

    Meyer, Gregory J.

    1997-01-01

    In reply to criticism of the Rorschach Comprehensive System (CS) by J. Wood, M. Nezworski, and W. Stejskal (1996), this article presents a meta-analysis of published data indicating that the CS has excellent chance-corrected interrater reliability. It is noted that the erroneous assumptions of Wood et al. make their assertions about validity…

  16. Patients and nursing staff views of using the education needs assessment tool in rheumatology clinics: a qualitative study.

    Science.gov (United States)

    Hardware, Bernadette; Johnson, Dawn; Hale, Claire; Ndosi, Mwidimi; Adebajo, Adewale

    2015-04-01

    To evaluate the usability of the educational needs assessment tool in clinical practice, from a practitioner and patient perspective and to establish whether patients perceive that they are getting an equally good or equally inadequate education service for their needs. The educational needs assessment tool was developed to enable patients with Rheumatoid Arthritis to assess their education needs prior to a consultation with a health professional. The educational needs assessment tool has been translated into nine languages and measurement properties have been established, however, its usability in clinical practice has not been studied. A qualitative study embedded into a multicentre RCT in which patients had been randomised into either educational needs assessment tool-focused education (Experimental Group) or usual care (control group). Both groups were seen by a clinical nurse specialist. Sixteen patients and four clinical nurse specialists were recruited from the Rheumatology Outpatient Departments of three Acute Hospitals within the U K. Data were collected by interviews with patients and clinical nurse specialist. Analysis followed the Framework approach. Patients and clinical nurse specialist found completion of the educational needs assessment tool straightforward, comprehensive and easy to use. Completing the educational needs assessment tool helped patients to focus on what they needed to know from the clinical nurse specialist. Patients in both the control group and the experimental group felt supported and reassured by their clinical nurse specialist and perceived that they received a good and adequate education provision. This study provides useful insights into the ability of the educational needs assessment tool to assess the educational needs of patients with rheumatoid arthritis in routine clinical practice. The educational needs assessment tool would be useful as a structured guide for nurses when assessing and meeting individual patient

  17. Clinical research participation among adolescent and young adults at an NCI-designated Comprehensive Cancer Center and affiliated pediatric hospital.

    Science.gov (United States)

    Sanford, Stacy D; Beaumont, Jennifer L; Snyder, Mallory A; Reichek, Jennifer; Salsman, John M

    2017-05-01

    Minimal clinical trial participation among adolescents and young adults (AYAs) with cancer limits scientific progress and ultimately their clinical care and outcomes. These analyses examine the current state of AYA clinical research participation at a Midwestern comprehensive cancer center and affiliated pediatric hospital to advise program development and increase availability of trials and AYA participation. Enrollment is examined across all diagnoses, the entire AYA age spectrum (15-39), and both cancer therapeutic and supportive care protocols. his study was a retrospective review of electronic medical records via existing databases and registries for all AYAs. Data were collected for AYAs seen by an oncologist at the adult outpatient cancer center or at the pediatric hospital between the years 2010 and 2014. Descriptive statistics and logistic regression analyses were conducted to characterize this sample. In the pediatric setting, 42.3% of AYAs were enrolled in a study compared to 11.2% in the adult setting. Regression analyses in the pediatric setting revealed that AYAs with private insurance or Caucasian race were more likely to participate. Within the adult setting, ethnicity, race, insurance, and diagnosis were associated with study participation; 54.8% of study enrollments were for cancer therapeutic and 43.4% for supportive care studies. These results are comparable to previously published data and support the need for new local and national AYA initiatives to increase the availability of and enrollment in therapeutic clinical trials. The same is true for supportive care studies which play a crucial role in improving quality of life.

  18. The Spiritual Needs Assessment for Patients (SNAP): development and validation of a comprehensive instrument to assess unmet spiritual needs.

    Science.gov (United States)

    Sharma, Rashmi K; Astrow, Alan B; Texeira, Kenneth; Sulmasy, Daniel P

    2012-07-01

    Unmet spiritual needs have been associated with decreased patient ratings of quality of care, satisfaction, and quality of life. There is a need for a well-validated, psychometrically sound instrument to describe and measure spiritual needs. To develop a valid and reliable instrument to assess patients' spiritual needs. Instrument development was based on a literature review, clinical and pastoral evaluation, and cognitive pretesting (n=15 ambulatory cancer patients). Forty-seven ambulatory cancer patients completed cross-sectional and longitudinal surveys to test instrument validity and reliability. Internal reliability was assessed by Cronbach's α, test-retest reliability by Spearman's correlation coefficients, and construct validity by comparing instrument scores to a previously used single-item spiritual needs question. The Spiritual Needs Assessment for Patients (SNAP) comprises a total of 23 items in three domains: psychosocial (n=5), spiritual (n=13), and religious (n=5). Sixty percent of participants were white, 21% black, 13% Hispanic, and 6% Asian or other. Fifty-eight percent were Catholic, 13% Jewish, 11% Protestant, 2% Buddhist, 2% Muslim, and 2% Hindu. Sixty-eight percent described themselves as spiritual but not religious; 15% reported unmet spiritual needs; 19% wanted help meeting their spiritual needs. Cronbach's α for the total SNAP was 0.95, and for the subscales was psychosocial=0.74, spiritual=0.93, and religious needs=0.86. Test-retest correlation coefficients were total SNAP=0.69, psychosocial needs=0.51, spiritual needs=0.70, and religious needs=0.65. Participants reporting unmet spiritual needs had significantly higher mean scores on the total SNAP (66.3 vs. 49.4, P=0.03) and on the spiritual needs subscale (39.0 vs. 28.3, P=0.02). The results provide preliminary evidence that the SNAP is a valid and reliable instrument for measuring spiritual needs in a diverse patient population. Copyright © 2012 U.S. Cancer Pain Relief Committee

  19. A clinical evaluation of comprehensive dental treatment for children under general anesthesia.

    Science.gov (United States)

    Su, H L; Chen, P S

    1992-12-01

    The purpose of this study is to evaluate the comprehensive dental treatment for children under general anesthesia. From 1989 to 1991, 57 children with mean age of 3 years 2 months were treated, followed up with a minimal of 1 year. This procedure allows the dentition to be restored in one visit. Further care including preventive options and behavior shaping was provided on a 3-6 months recall schedule. The reasons for general anesthesia are that these children were either unable to accept treatment because of handicaps, extreme fear or young age. Their mean number of decayed tooth was 15 (Standard Deviation, SD = 5) and nearly three quarters of the children were under 6 years old. The most frequent treatment procedures were the extraction of teeth, composite resin restoration and Ni-Cr crown restoration. The Ni-Cr crown (1.7% failure rate) was more successful than the amalgam and composite resin restoration (9.7% failure rate). Pedo-strip crown had the highest failure rate (22%) for anterior teeth restoration. Nineteen children needed retreatment with conventional behavior guide. Six children had new caries and required further treatment. Thirty eight children returned for regular recall during the minimal 1 year follow-up period.

  20. Comprehensive molecular pathology analysis of small bowel adenocarcinoma reveals novel targets with potential for clinical utility.

    Science.gov (United States)

    Alvi, Muhammad A; McArt, Darragh G; Kelly, Paul; Fuchs, Marc-Aurel; Alderdice, Matthew; McCabe, Clare M; Bingham, Victoria; McGready, Claire; Tripathi, Shailesh; Emmert-Streib, Frank; Loughrey, Maurice B; McQuaid, Stephen; Maxwell, Perry; Hamilton, Peter W; Turkington, Richard; James, Jacqueline A; Wilson, Richard H; Salto-Tellez, Manuel

    2015-08-28

    Small bowel accounts for only 0.5% of cancer cases in the US but incidence rates have been rising at 2.4% per year over the past decade. One-third of these are adenocarcinomas but little is known about their molecular pathology and no molecular markers are available for clinical use. Using a retrospective 28 patient matched normal-tumor cohort, next-generation sequencing, gene expression arrays and CpG methylation arrays were used for molecular profiling. Next-generation sequencing identified novel mutations in IDH1, CDH1, KIT, FGFR2, FLT3, NPM1, PTEN, MET, AKT1, RET, NOTCH1 and ERBB4. Array data revealed 17% of CpGs and 5% of RNA transcripts assayed to be differentially methylated and expressed respectively (p clinically exploitable markers.

  1. Comprehensive Reproductive System Care Program - Clinical Breast Care Project (CRSCP-CBCP)

    Science.gov (United States)

    2013-04-01

    tests to determine whether an individual in such a high-risk family has a genetic mutation in the BRCAl or BRCA2 genes. · When someone with a...profiles, evaluation of genetic risk and tumor biology. These themes inform researc h across the five BCM TRCOE pillars: (1) Breast Cancer Risk...high clinical relevance, deepening our understanding of the genetic risk of breast disease and the enhancement of our understanding of breast tumor

  2. A comprehensive clinical review of recombinant human bone morphogenetic protein-2 (INFUSE® Bone Graft)

    Science.gov (United States)

    Peckham, Steven M.; Badura, Jeffrey M.

    2007-01-01

    The combination of recombinant human bone morphogenetic protein-2 (rhBMP-2) on an absorbable collagen sponge (ACS) carrier has been shown to induce bone formation in a number of preclinical and clinical investigations. In 2002, rhBMP-2/ACS at a 1.5-mg/cc concentration (INFUSE® Bone Graft, Medtronic Spinal and Biologics, Memphis, TN) was FDA-approved as an autograft replacement for certain interbody spinal fusion procedures. In 2004, INFUSE® Bone Graft was approved for open tibial fractures with an intermedullary (IM) nail fixation. Most recently, in March 2007, INFUSE® Bone Graft was approved as an alternative to autogenous bone grafts for sinus augmentations, and for localised alveolar ridge augmentations for defects associated with extraction sockets. The culmination of extensive preclinical and clinical research and three FDA approvals makes rhBMP-2 one of the most studied, published and significant advances in orthopaedics. This review article summarises a number of clinical findings of rhBMP-2/ACS, including the FDA-approved investigational device exemption (IDE) studies used in gaining the aforementioned approvals. PMID:17639384

  3. Temporal Information Processing as a Basis for Auditory Comprehension: Clinical Evidence from Aphasic Patients

    Science.gov (United States)

    Oron, Anna; Szymaszek, Aneta; Szelag, Elzbieta

    2015-01-01

    Background: Temporal information processing (TIP) underlies many aspects of cognitive functions like language, motor control, learning, memory, attention, etc. Millisecond timing may be assessed by sequencing abilities, e.g. the perception of event order. It may be measured with auditory temporal-order-threshold (TOT), i.e. a minimum time gap…

  4. Temporal Information Processing as a Basis for Auditory Comprehension: Clinical Evidence from Aphasic Patients

    Science.gov (United States)

    Oron, Anna; Szymaszek, Aneta; Szelag, Elzbieta

    2015-01-01

    Background: Temporal information processing (TIP) underlies many aspects of cognitive functions like language, motor control, learning, memory, attention, etc. Millisecond timing may be assessed by sequencing abilities, e.g. the perception of event order. It may be measured with auditory temporal-order-threshold (TOT), i.e. a minimum time gap…

  5. The K-nearest neighbor algorithm predicted rehabilitation potential better than current Clinical Assessment Protocol.

    Science.gov (United States)

    Zhu, Mu; Chen, Wenhong; Hirdes, John P; Stolee, Paul

    2007-10-01

    There may be great potential for using computer-modeling techniques and machine-learning algorithms in clinical decision making, if these can be shown to produce results superior to clinical protocols currently in use. We aim to explore the potential to use an automatic, data-driven, machine-learning algorithm in clinical decision making. Using a database containing comprehensive health assessment information (the interRAI-HC) on home care clients (N=24,724) from eight community-care regions in Ontario, Canada, we compare the performance of the K-nearest neighbor (KNN) algorithm and a Clinical Assessment Protocol (the "ADLCAP") currently used to predict rehabilitation potential. For our purposes, we define a patient as having rehabilitation potential if the patient had functional improvement or remained at home over a follow-up period of approximately 1 year. The KNN algorithm has a lower false positive rate in all but one of the eight regions in the sample, and lower false negative rates in all regions. Compared using likelihood ratio statistics, KNN is uniformly more informative than the ADLCAP. This article illustrates the potential for a machine-learning algorithm to enhance clinical decision making.

  6. Clinically assessed mediolateral knee motion: impact on gait

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Creaby, Mark W; Simic, Milena;

    2011-01-01

    Mediolateral knee movement can be assessed visually with clinical tests. A knee-medial-to-foot position is associated with an increased risk of knee injuries and pathologies. However, the implications of such findings on daily tasks are not well understood. The aim of this study was to investigate...... if a knee-medial-to-foot position assessed during a clinical test was associated with altered hip and knee joint kinematics and knee joint kinetics during gait compared with those with a knee-over-foot position....

  7. The genetics of celiac disease: A comprehensive review of clinical implications.

    Science.gov (United States)

    Dieli-Crimi, Romina; Cénit, M Carmen; Núñez, Concepción

    2015-11-01

    Celiac disease (CD) is a complex immune-related disease with a very strong genetic component. Multiple genetic findings over the last decade have added to the already known MHC influence numerous genetic variants associated to CD susceptibility. Currently, it is well-established that 6 MHC and 39 non-MHC loci, including a higher number of independent genetic variants, are associated to disease risk. Moreover, additional regions have been recently implicated in the disease, which would increase the number of involved loci. Together, the firmly described genetic variants account for roughly 31% of CD heritability, being 25% explained by the MHC influence. These new variants represent markers of disease risk and turn the identification of the causal genes and the causal variants inside the associated loci, as well as their precise biological role on the disease, into a major challenge in CD research. Numerous studies have been developed with this aim showing the high impact of risk variants on gene expression. These studies also indicate a central role of CD4(+) T cells in CD pathogenesis and point to B cells as important players, which is in accordance with the key steps highlighted by the immunological models of pathogenesis. We comprehensively summarize the current knowledge about the genetic architecture of CD, characterized by multiple low-risk variants located within diverse loci which are most likely affecting genes with immune-related functions. These findings are leading to a better understanding of CD pathogenesis and helping in the design of new treatments. The repertoire of potential drug targets for CD has largely broadened last years, bringing us closer to get alternative or complementary treatments to the life-long gluten-free diet, the only effective treatment so far. Epigenetics and microbiota are emerging as potent factors modulating disease risk and putatively affecting disease manifestation, which are also being explored as therapeutic targets.

  8. Using systematically observed clinical encounters (SOCEs to assess medical students’ skills in clinical settings

    Directory of Open Access Journals (Sweden)

    George R Bergus

    2010-11-01

    Full Text Available George R Bergus1–3, Jerold C Woodhead4, Clarence D Kreiter2,51Performance Based Assessment Program, Office of Student Affairs and Curriculum, 2Department of Family Medicine, 3Department of Psychiatry, 4Department of Pediatrics, 5Office of Consultation and Research in Medical Education, Roy J and Lucille A Carver College of Medicine, The University of Iowa, Iowa City, IA, USAIntroduction: The Objective Structured Clinical Examination (OSCE is widely used to assess the clinical performance of medical students. However, concerns related to cost, availability, and validity, have led educators to investigate alternatives to the OSCE. Some alternatives involve assessing students while they provide care to patients – the mini-CEX (mini-Clinical Evaluation Exercise and the Long Case are examples. We investigated the psychometrics of systematically observed clinical encounters (SOCEs, in which physicians are supplemented by lay trained observers, as a means of assessing the clinical performances of medical students.Methods: During the pediatrics clerkship at the University of Iowa, trained lay observers assessed the communication skills of third-year medical students using a communication checklist while the students interviewed and examined pediatric patients. Students then verbally presented their findings to faculty, who assessed students’ clinical skills using a standardized form. The reliability of the combined communication and clinical skills scores was calculated using generalizability theory.Results: Fifty-one medical students completed 199 observed patient encounters. The mean combined clinical and communication skills score (out of a maximum 45 points was 40.8 (standard deviation 3.3. The calculated reliability of the SOCE scores, using generalizability theory, from 10 observed patient encounters was 0.81. Students reported receiving helpful feedback from faculty after 97% of their observed clinical encounters.Conclusion: The SOCE can

  9. Minimal second language exposure, SES, and early word comprehension: New evidence from a direct assessment.

    Science.gov (United States)

    Deanda, Stephanie; Arias-Trejo, Natalia; Poulin-Dubois, Diane; Zesiger, Pascal; Friend, Margaret

    2016-01-01

    Although the extant literature provides robust evidence of the influence of language exposure and socioeconomic status (SES) on language acquisition, it is unknown how sensitive the early receptive vocabulary system is to these factors. The current study investigates effects of minimal second language exposure and SES on the comprehension vocabulary of 16-month-old children in the language in which they receive the greatest exposure. Study 1 revealed minimal second language exposure and SES exert significant and independent effects on a direct measure of vocabulary comprehension in English-dominant and English monolingual children (N = 72). In Study 2, we replicated the effect of minimal second language exposure in Spanish-dominant and Spanish monolingual children (N = 86), however no effect of SES on vocabulary was obtained. Our results emphasize the sensitivity of the language system to minimal changes in the environment in early development.

  10. Parthenium dermatitis severity score to assess clinical severity of disease

    OpenAIRE

    Kaushal K Verma; Arika Bansal; Neetu Bhari; Gomathy Sethuraman

    2017-01-01

    Background: Parthenium dermatitis is the most common type of airborne contact dermatitis in India. It is a chronic disease of a remitting and relapsing course with significant morbidity and distress, but there is no scoring system to assess its severity. Aim: To design a scoring system for the assessment of clinical severity of disease in Parthenium dermatitis and to use this scoring system in various studies to determine its sensitivity, specificity, and reproducibility. Methods and Results:...

  11. Measuring financial toxicity as a clinically relevant patient-reported outcome: The validation of the COmprehensive Score for financial Toxicity (COST).

    Science.gov (United States)

    de Souza, Jonas A; Yap, Bonnie J; Wroblewski, Kristen; Blinder, Victoria; Araújo, Fabiana S; Hlubocky, Fay J; Nicholas, Lauren H; O'Connor, Jeremy M; Brockstein, Bruce; Ratain, Mark J; Daugherty, Christopher K; Cella, David

    2017-02-01

    Cancer and its treatment lead to increased financial distress for patients. To the authors' knowledge, to date, no standardized patient-reported outcome measure has been validated to assess this distress. Patients with AJCC Stage IV solid tumors receiving chemotherapy for at least 2 months were recruited. Financial toxicity was measured by the COmprehensive Score for financial Toxicity (COST) measure. The authors collected data regarding patient characteristics, clinical trial participation, health care use, willingness to discuss costs, psychological distress (Brief Profile of Mood States [POMS]), and health-related quality of life (HRQOL) as measured by the Functional Assessment of Cancer Therapy: General (FACT-G) and the European Organization for Research and Treatment of Cancer (EORTC) QOL questionnaires. Test-retest reliability, internal consistency, and validity of the COST measure were assessed using standard-scale construction techniques. Associations between the resulting factors and other variables were assessed using multivariable analyses. A total of 375 patients with advanced cancer were approached, 233 of whom (62.1%) agreed to participate. The COST measure demonstrated high internal consistency and test-retest reliability. Factor analyses revealed a coherent, single, latent variable (financial toxicity). COST values were found to be correlated with income (correlation coefficient [r] = 0.28; Pfinancial toxicity were race (P = .04), employment status (Pfinancial distress (P = .49). The COST measure demonstrated reliability and validity in measuring financial toxicity. Its correlation with HRQOL indicates that financial toxicity is a clinically relevant patient-centered outcome. Cancer 2017;123:476-484. © 2016 American Cancer Society. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

  12. Comprehensively Assessing Cognitive and Behavioral Risks for HIV Infection among Middle-Aged and Older Adults

    Science.gov (United States)

    Paniagua, Freddy A.; O'Boyle, Michael

    2008-01-01

    A comprehensive survey of HIV/AIDS with middle-aged and older adults should include six domains (e.g., factual knowledge regarding the acquisition and transmission of HIV, traditionally-accepted behavioral risks for HIV infection). A sample of 23 women (54.8%) and 19 men (45.2%), ranging in age from 51 to 85 were surveyed across such domains.…

  13. STUDENTS' SELF-ASSESSMENT IN PRE-CLINICAL AND CLINICAL EDUCATION OF PROSTHETIC DENTISTRY

    Directory of Open Access Journals (Sweden)

    Dimiter Kirov

    2014-09-01

    Full Text Available Background: The ability to self-assess is a critical skill that all health professionals must be able to do, in order to achieve competence. This is essential for the doctors of dental medicine. During their education and practice they apply different clinical and para-clinical procedures. The aim is to evaluate the students' self-assessment skills during the education of clinic and pre-clinic of prosthetic dentistry. Material and methods: After the completion of certain work - preparation for full veneer crown, a questionnaire was provided to each student in preclinical course (n=30 and clinical course (n=30 for self-evaluation. The questionnaire involved: axial reduction, occlusal reduction, facial and lingual reduction, smoothing and finishing. The answers were based on the standard for the university grading scale. Than, the same questionnaire was fulfilled by the assistant professor without seeing students' self-evaluation. Results and Discussion: Results have been reported in percentages. 100% respond rate has been achieved. The students from the preclinical course tend to overestimate their performance (50%. The students from the clinical course tend to submit overall lower grades than the faculty evaluation (25%. Conclusions: The students from clinics have better self-assessment skills. The discrepancy was most pronounced in the junior students. The different evaluations (self-assessment and assistant professor's help students to improve their understanding of certain principles and improve the teaching effectiveness of education of prosthetic dentistry.

  14. Do pressure ulcer risk assessment scales improve clinical practice?

    Directory of Open Access Journals (Sweden)

    Jan Kottner

    2010-07-01

    Full Text Available Jan Kottner1, Katrin Balzer21Department of Nursing Science, Charité-Universitätsmedizin Berlin, Germany; 2Nursing Research Group, Institute for Social Medicine, Universitätsklinikum Schleswig-Holstein, Lübeck, GermanyAbstract: Standardized assessment instruments are deemed important for estimating pressure ulcer risk. Today, more than 40 so-called pressure ulcer risk assessment scales are available but still there is an ongoing debate about their usefulness. From a measurement point of view pressure ulcer (PU risk assessment scales have serious limitations. Empirical evidence supporting the validity of PU risk assessment scale scores is weak and obtained scores contain varying amounts of measurement error. The concept of pressure ulcer risk is strongly related to the general health status and severity of illness. A clinical impact due do the application of these scales could also not be demonstrated. It is questionable whether completion of standardized pressure ulcer risk scales in clinical practice is really needed.Keywords: Braden pressure ulcer, prevention, risk assessment, nursing assessment, predictive value, clinical effectiveness, review

  15. Cutaneous and Mucosal Lichen Planus: A Comprehensive Review of Clinical Subtypes, Risk Factors, Diagnosis, and Prognosis

    Directory of Open Access Journals (Sweden)

    Farzam Gorouhi

    2014-01-01

    Full Text Available Lichen planus (LP is a chronic inflammatory disorder that most often affects middle-aged adults. LP can involve the skin or mucous membranes including the oral, vulvovaginal, esophageal, laryngeal, and conjunctival mucosa. It has different variants based on the morphology of the lesions and the site of involvement. The literature suggests that certain presentations of the disease such as esophageal or ophthalmological involvement are underdiagnosed. The burden of the disease is higher in some variants including hypertrophic LP and erosive oral LP, which may have a more chronic pattern. LP can significantly affect the quality of life of patients as well. Drugs or contact allergens can cause lichenoid reactions as the main differential diagnosis of LP. LP is a T-cell mediated immunologic disease but the responsible antigen remains unidentified. In this paper, we review the history, epidemiology, and clinical subtypes of LP. We also review the histopathologic aspects of the disease, differential diagnoses, immunopathogenesis, and the clinical and genetic correlations.

  16. Comprehensive clinical and pathological analysis of aggressive renal epithelioid angiomyolipoma: report of three cases

    Directory of Open Access Journals (Sweden)

    Luo J

    2014-05-01

    Full Text Available Jindan Luo,1 Ben Liu,1 Yanli Wang,2 Jun Li,2 Ping Wang,1 Jun Chen,1 Chaojun Wang1 1Department of Urology, 2Department of Pathology, The First Affiliated Hospital of College of Medicine, Zhejiang University, Zhejiang, People's Republic of China Abstract: Renal angiomyolipoma (AML is recognized as a benign hamartomatous lesion arising in the kidney with no obvious malignant potential. However, epithelioid AML (EAML, a rare variant of AML, is potentially malignant, with aggressive clinical features. It can occur in patients with or without tuberous sclerosis. Because EAML may mimic renal cell carcinoma in imaging studies, differentiation of this tumor from renal cell carcinoma preoperatively is difficult. At times, the lesions may extend into the renal vein and inferior vena cava or metastasize to other organs such as the lung and liver. To clarify the biological nature of EAML, three specific cases that we encountered in clinical practice are analyzed and reported in detail. Keywords: kidney, malignant, inferior vena cava

  17. Biomedical informatics: development of a comprehensive data warehouse for clinical and genomic breast cancer research.

    Science.gov (United States)

    Hu, Hai; Brzeski, Henry; Hutchins, Joe; Ramaraj, Mohan; Qu, Long; Xiong, Richard; Kalathil, Surendran; Kato, Rand; Tenkillaya, Santhosh; Carney, Jerry; Redd, Rosann; Arkalgudvenkata, Sheshkumar; Shahzad, Kashif; Scott, Richard; Cheng, Hui; Meadow, Stephen; McMichael, John; Sheu, Shwu-Lin; Rosendale, David; Kvecher, Leonid; Ahern, Stephen; Yang, Song; Zhang, Yonghong; Jordan, Rick; Somiari, Stella B; Hooke, Jeffrey; Shriver, Craig D; Somiari, Richard I; Liebman, Michael N

    2004-10-01

    The Windber Research Institute is an integrated high-throughput research center employing clinical, genomic and proteomic platforms to produce terabyte levels of data. We use biomedical informatics technologies to integrate all of these operations. This report includes information on a multi-year, multi-phase hybrid data warehouse project currently under development in the Institute. The purpose of the warehouse is to host the terabyte-level of internal experimentally generated data as well as data from public sources. We have previously reported on the phase I development, which integrated limited internal data sources and selected public databases. Currently, we are completing phase II development, which integrates our internal automated data sources and develops visualization tools to query across these data types. This paper summarizes our clinical and experimental operations, the data warehouse development, and the challenges we have faced. In phase III we plan to federate additional manual internal and public data sources and then to develop and adapt more data analysis and mining tools. We expect that the final implementation of the data warehouse will greatly facilitate biomedical informatics research.

  18. [The need for clinical guidelines for the comprehensive management of patients with cleft lip and palate].

    Science.gov (United States)

    Guerrero-Abello, Paola; Ariza-Araujo, Yoseth; Caycedo-García, Diego J; Pachajoa, Harry

    2016-02-01

    Objective To identify clinical guidelines for the treatment of cleft lip and / or palate in children under one year of age, published in Colombia and internationally. Method A search was conducted in three databases: PubMed, Lilacs and Scielo with the terms "guideline cleft lip and palate", "protocols cleft lip and palate", "guía clínica labio paladar fisurado", "guía de manejo labio paladar fisurado" and "guía labio paladar hendido". In addition to this, we consulted the websites of all pediatric hospitals in Colombia. Results 190 papers were found, of which 96 were not related to the population or focused on treatment, 84 were disciplinary, 8 interdisciplinary and only two were clinical guidelines. Conclusions There are few published guidelines and there is a lack of unified criteria. This gives rise to numerous forms of intervention and the creation of interdisciplinary teams. Therefore, there is a need to reach a consensus regarding the therapeutic approach in order to create treatment protocols based on evidence with quality standards.

  19. A comprehensive review on Aurora kinase: Small molecule inhibitors and clinical trial studies.

    Science.gov (United States)

    Borisa, Ankit C; Bhatt, Hardik G

    2017-08-24

    Aurora kinase belongs to serine/threonine kinase family which controls cell division. Therapeutic inhibition of Aurora kinase showed great promise as probable anticancer regime because of its important role during cell division. Here, in this review, we have carried out exhaustive study of various synthetic molecules reported as Aurora kinase inhibitors and developed as lead molecule at various stages of clinical trials from its discovery in 1995 to till date. We reported details of small molecules, specifically inhibiting all 3 types of Aurora kinases, which includes extensive literature search in various database like various scientific journals, patents, scifinder and PubMed database, internet resources, books, etc. IC50 values of tumor growth inhibition, in-vitro and in-vivo activity along with clinical trial data. Here, we took efforts to describe essence of Aurora kinase and its inhibition which could be used to develop anti-mitotic drug for the treatment of cancer. In conclusion, we also discuss future perspectives for development of novel inhibitors and their scope in drug development process. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  20. mit-o-matic: a comprehensive computational pipeline for clinical evaluation of mitochondrial variations from next-generation sequencing datasets.

    Science.gov (United States)

    Vellarikkal, Shamsudheen Karuthedath; Dhiman, Heena; Joshi, Kandarp; Hasija, Yasha; Sivasubbu, Sridhar; Scaria, Vinod

    2015-04-01

    The human mitochondrial genome has been reported to have a very high mutation rate as compared with the nuclear genome. A large number of mitochondrial mutations show significant phenotypic association and are involved in a broad spectrum of diseases. In recent years, there has been a remarkable progress in the understanding of mitochondrial genetics. The availability of next-generation sequencing (NGS) technologies have not only reduced sequencing cost by orders of magnitude but has also provided us good quality mitochondrial genome sequences with high coverage, thereby enabling decoding of a number of human mitochondrial diseases. In this study, we report a computational and experimental pipeline to decipher the human mitochondrial DNA variations and examine them for their clinical correlation. As a proof of principle, we also present a clinical study of a patient with Leigh disease and confirmed maternal inheritance of the causative allele. The pipeline is made available as a user-friendly online tool to annotate variants and find haplogroup, disease association, and heteroplasmic sites. The "mit-o-matic" computational pipeline represents a comprehensive cloud-based tool for clinical evaluation of mitochondrial genomic variations from NGS datasets. The tool is freely available at http://genome.igib.res.in/mitomatic/.

  1. Problem-based learning using patient-simulated videos showing daily life for a comprehensive clinical approach.

    Science.gov (United States)

    Ikegami, Akiko; Ohira, Yoshiyuki; Uehara, Takanori; Noda, Kazutaka; Suzuki, Shingo; Shikino, Kiyoshi; Kajiwara, Hideki; Kondo, Takeshi; Hirota, Yusuke; Ikusaka, Masatomi

    2017-02-27

    We examined whether problem-based learning tutorials using patient-simulated videos showing daily life are more practical for clinical learning, compared with traditional paper-based problem-based learning, for the consideration rate of psychosocial issues and the recall rate for experienced learning. Twenty-two groups with 120 fifth-year students were each assigned paper-based problem-based learning and video-based problem-based learning using patient-simulated videos. We compared target achievement rates in questionnaires using the Wilcoxon signed-rank test and discussion contents diversity using the Mann-Whitney U test. A follow-up survey used a chi-square test to measure students' recall of cases in three categories: video, paper, and non-experienced. Video-based problem-based learning displayed significantly higher achievement rates for imagining authentic patients (p=0.001), incorporating a comprehensive approach including psychosocial aspects (pmaterials.

  2. Neurofeedback: A Comprehensive Review on System Design, Methodology and Clinical Applications

    Science.gov (United States)

    Marzbani, Hengameh; Marateb, Hamid Reza; Mansourian, Marjan

    2016-01-01

    Neurofeedback is a kind of biofeedback, which teaches self-control of brain functions to subjects by measuring brain waves and providing a feedback signal. Neurofeedback usually provides the audio and or video feedback. Positive or negative feedback is produced for desirable or undesirable brain activities, respectively. In this review, we provided clinical and technical information about the following issues: (1) Various neurofeedback treatment protocols i.e. alpha, beta, alpha/theta, delta, gamma, and theta; (2) Different EEG electrode placements i.e. standard recording channels in the frontal, temporal, central, and occipital lobes; (3) Electrode montages (unipolar, bipolar); (4) Types of neurofeedback i.e. frequency, power, slow cortical potential, functional magnetic resonance imaging, and so on; (5) Clinical applications of neurofeedback i.e. treatment of attention deficit hyperactivity disorder, anxiety, depression, epilepsy, insomnia, drug addiction, schizophrenia, learning disabilities, dyslexia and dyscalculia, autistic spectrum disorders and so on as well as other applications such as pain management, and the improvement of musical and athletic performance; and (6) Neurofeedback softwares. To date, many studies have been conducted on the neurofeedback therapy and its effectiveness on the treatment of many diseases. Neurofeedback, like other treatments, has its own pros and cons. Although it is a non-invasive procedure, its validity has been questioned in terms of conclusive scientific evidence. For example, it is expensive, time-consuming and its benefits are not long-lasting. Also, it might take months to show the desired improvements. Nevertheless, neurofeedback is known as a complementary and alternative treatment of many brain dysfunctions. However, current research does not support conclusive results about its efficacy. PMID:27303609

  3. Brugada syndrome in the paediatric population: a comprehensive approach to clinical manifestations, diagnosis, and management.

    Science.gov (United States)

    Gonzalez Corcia, M Cecilia; de Asmundis, Carlo; Chierchia, Gian-Battista; Brugada, Pedro

    2016-08-01

    Brugada syndrome is an inherited arrhythmogenic disorder, characterised by coved-type ST-segment elevation in the right precordial leads, and is associated with increased risk of sudden death. It is genetically and clinically heterogeneous, presenting typically in the fourth or fifth decade of life. The prevalence of Brugada syndrome in the paediatric population is low compared with the adult population. Interestingly, over the last several years, there has been growing evidence in the literature of onset of the disease during childhood. Most of the paediatric cases reported in the literature consist of asymptomatic Brugada syndrome; however, some patients manifest the disease at different regions of the cardiac conduction system at a young age. Early expression of the disease can be affected by multiple factors, including genetic substrate, hormonal changes, and still unknown environmental exposures. The initial manifestation of Brugada syndrome in children can include sinus node dysfunction and atrial arrhythmias. Brugada syndrome can also manifest as ventricular arrhythmias leading to sudden death at an early age. In symptomatic children, performance of the ajmaline test by an experienced team can be safely used as a diagnostic tool to unmask latent Brugada syndrome. Defining indications for an implantable cardioverter defibrillator in children with the diagnosis of Brugada syndrome remains challenging. Given the rarity of the syndrome in children, most paediatric cardiologists will only rarely see a young patient with Brugada syndrome and there is still no universal consensus regarding the optimal management approach. Care should be individualised according to the specific clinical presentation, taking into account the family history, genetic data, and the family's specific preferences.

  4. Clinical significance of routine lacrimal sac biopsy during dacryocystorhinostomy: A comprehensive review of literature

    Science.gov (United States)

    Koturović, Zoran; Knežević, Miroslav; Rašić, Dejan M.

    2017-01-01

    The main purpose of this paper is to provide the information about the incidence and types of pathology of secondary acquired obstructions of the lacrimal excretory outflow system caused by primary lacrimal sac non-neoplastic and neoplastic lesions. After a thorough literature search, 17 case-control studies were found and selected, data were extracted and categorized, to evaluate specific lacrimal sac pathology mimicking inflammation. A total of 3865 histopathologically examined lacrimal sac wall biopsy specimens from 3662 patients, taken during dacryocystorhinostomy for clinically presumed primary chronic dacryocystitis, were analyzed. The most common reported histopathological finding was non-specific chronic inflammation with or without fibrosis (94.15% of cases). Lacrimal sac-specific pathologies were present in 226 (5.85%) cases. Unsuspected lacrimal sac-specific pathologies were present in 55/226 (24.34%) cases. Almost 45% of primary lacrimal sac malignant neoplasms were not suspected, preoperatively and intraoperatively. Tumor-like lesions of the lacrimal sac were the most common pathology found: (1) lacrimal stones-dacryoliths, (2) pyogenic granuloma, (3) granulation tissues, (4) reactive lymphoid hyperplasia, and (5) lacrimal sac-specific inflammation (Wegener’s granulomatosis and sarcoidosis). Neoplastic pathology was found in 55/3865 (1.42%) lacrimal sac wall biopsy specimens; of those, malignant cases were 2.24 times more frequent than benign. Lymphoma was the most common preoperatively unsuspected or intraoperatively unexpected neoplastic pathology. This analysis of the relevant literature highlights the value of routine lacrimal sac biopsy during surgery for clinically presumed primary acquired nasolacrimal duct obstruction. PMID:27754826

  5. Clinical outcomes in patients with isolated serous tubal intraepithelial carcinoma (STIC): A comprehensive review.

    Science.gov (United States)

    Patrono, Maria Guadalupe; Iniesta, Maria D; Malpica, Anais; Lu, Karen H; Fernandez, Rodrigo Orozco; Salvo, Gloria; Ramirez, Pedro T

    2015-12-01

    OBJECTIVE. Serous tubal intraepithelial carcinoma (STIC) is currently considered the precursor lesion of pelvic (i.e., ovarian or peritoneal) high-grade serous carcinoma. The incidence of STIC has been reported to range from 0.6% to 7% in BRCA mutations carriers. However, the clinical outcome of patients with 'isolated' STIC remains elusive. The aim of this study is to review the published literature on isolated STIC to determine outcomes of these ients and present a summary of management strategies. METHODS. A systematic English-language literature search was conducted in PubMed, MEDLINE-Ovid, Scopus, EBSCO host, Cochrane Library of articles published from February 2006 to April 2015. Study inclusion criteria for review were the following: risk-reducing salpingo-oophorectomy (RRSO), BRCA mutation carriers, non-BRCA mutation carriers, and benign surgical indication. Exclusion criteria were as follows: the presence of synchronous gynecological cancers, concurrent non-gynecological malignancies, the presence of ovarian intraepithelial lesions, and articles that did not include any clinical information and were restricted to pathology information only. RESULTS. A total of 78 patients with isolated STIC were included in our analysis. The median age for all patients was 53.7 years (range; 37-83). Surgical indication was RRSO in 67 patients with BRCA mutations or high-risk personal or family history. In the other 11 patients, an incidental STIC was detected after surgery for non-cancerous indications. Eleven (16.4%) patients received chemotherapy after the diagnosis of STIC. The follow-up time ranged from 2 to 150 months. Three (4.5%) patients with BRCA mutations were diagnosed with primary peritoneal carcinoma (PPC) during the follow-up at 43, 48 and 72 months after RRSO. CONCLUSIONS. The rate of primary peritoneal carcinoma in patients with BRCA mutations and isolated STIC is 4.5%. The role of adjuvant therapy remains elusive and routine surveillance with tumor markers

  6. Clinical significance of routine lacrimal sac biopsy during dacryocystorhinostomy: A comprehensive review of literature.

    Science.gov (United States)

    Koturović, Zoran; Knežević, Miroslav; Rašić, Dejan M

    2017-02-21

    The main purpose of this paper is to provide the information about the incidence and types of pathology of secondary acquired obstructions of the lacrimal excretory outflow system caused by primary lacrimal sac non-neoplastic and neoplastic lesions. After a thorough literature search, 17 case-control studies were found and selected, data were extracted and categorized, to evaluate specific lacrimal sac pathology mimicking inflammation. A total of 3865 histopathologically examined lacrimal sac wall biopsy specimens from 3662 patients, taken during dacryocystorhinostomy for clinically presumed primary chronic dacryocystitis, were analyzed. The most common reported histopathological finding was non-specific chronic inflammation with or without fibrosis (94.15% of cases). Lacrimal sac-specific pathologies were present in 226 (5.85%) cases. Unsuspected lacrimal sac-specific pathologies were present in 55/226 (24.34%) cases. Almost 45% of primary lacrimal sac malignant neoplasms were not suspected, preoperatively and intraoperatively. Tumor-like lesions of the lacrimal sac were the most common pathology found: (1) lacrimal stones-dacryoliths, (2) pyogenic granuloma, (3) granulation tissues, (4) reactive lymphoid hyperplasia, and (5) lacrimal sac-specific inflammation (Wegener's granulomatosis and sarcoidosis). Neoplastic pathology was found in 55/3865 (1.42%) lacrimal sac wall biopsy specimens; of those, malignant cases were 2.24 times more frequent than benign. Lymphoma was the most common preoperatively unsuspected or intraoperatively unexpected neoplastic pathology. This analysis of the relevant literature highlights the value of routine lacrimal sac biopsy during surgery for clinically presumed primary acquired nasolacrimal duct obstruction.

  7. Incidental pulmonary embolism in cancer patients: clinical characteristics and outcome – a comprehensive cancer center experience

    Directory of Open Access Journals (Sweden)

    Abdel-Razeq H

    2011-03-01

    Full Text Available Hikmat N Abdel-Razeq1, Asem H Mansour2, Yousef M Ismael11Department of Internal Medicine, 2Department of Radiology, King Hussein Cancer Center, Amman, JordanBackground and objectives: Cancer patients undergo routine imaging studies much more than others. The widespread use of the recently introduced multi-detector CT scanners has resulted in an increasing number of incidentally diagnosed pulmonary embolism (PE in asymptomatic cancer patients. The significance and clinical outcome of such incidental PE is described.Methods: Both radiology department and hospital databases were searched for all cancer patients with a diagnosis of incidental PE. CT scans were performed using a 64-slice scanner with a 5.0 mm slice thickness.Results: During the study period, 34 patients with incidental PE were identified. The mean age (±SD was 57.7 (±12.4 years. All patients had active cancer, gastric, lung, colorectal, and lymphomas being the most frequent. Most patients had advanced-stage disease at the time of PE diagnosis; 26 (77% patients had stage IV, whereas only 3 patients had stages I or II disease. Twenty-seven (79% patients had their PE while undergoing active treatment with chemotherapy (68% or radiotherapy (12%; none, however, were on hormonal therapy. Most (74% patients had their PE diagnosed without history of recent hospital admission. Except for 5 (15%, all other patients were anticoagulated. With follow-up, 2 patients developed recurrent PE, 2 others had clinical and echocardiographic evidence of pulmonary hypertension, and 9 (26% died suddenly within 30 days of the diagnosis of incidental PE; 2 of these where among the 5 patients who were not anticoagulated.Conclusion: Incidental PE in cancer patients is increasingly encountered. Similar to symptomatic PE, many were diagnosed in patients with advanced stage disease and while undergoing active anti-cancer therapy. A significant percentage of patients had recurrent emboli, pulmonary hypertension

  8. Normal Personality Assessment in Clinical Practice: The NEO Personality Inventory.

    Science.gov (United States)

    Costa, Paul T.; McCrae, Robert R.

    1992-01-01

    The NEO Personality Inventory (NEO-PI) is described as a measure of five factors of personality and its use in clinical assessment and treatment practice is reviewed. Data from 17 adult men and women show links between NEO-PI scales and other measures of psychopathology. (SLD)

  9. Assessment of Clinical Competence: Written and Computer-Based Simulations.

    Science.gov (United States)

    Swanson, David B.; And Others

    1987-01-01

    Literature concerning the validity and reliability of both written and computer-based simulations in assessing clinical competence in the health professions is reviewed, and suggestions are given for the improvement of the psychometric qualities of simulation-based tests. (MSE)

  10. Assessment of competence and progressive independence in postgraduate clinical training.

    NARCIS (Netherlands)

    Dijksterhuis, M.G.; Voorhuis, M.; Teunissen, P.W.; Schuwirth, L.W.; Cate, O.T.J. ten; Braat, D.D.M.; Scheele, F.

    2009-01-01

    CONTEXT: At present, competency-based, outcome-focused training is gradually replacing more traditional master-apprentice teaching in postgraduate training. This change requires a different approach to the assessment of clinical competence, especially given the decisions that must be made about the

  11. Deviant Adolescent Subcultures: Assessment Strategies and Clinical Interventions.

    Science.gov (United States)

    Clark, Cynthia M.

    1992-01-01

    Presents assessment strategies, preventive methods, and clinical interventions to assist clinicians working with teenagers involved with deviant subcultures: Satanism, the neo-Nazi skinhead movement, and violent street gangs. Considers role of alienation as contributing factor in adolescents' participation in these subcultures. Advises therapists…

  12. Upper Limb Assessment in Tetraplegia: Clinical, Functional and Kinematic Correlations

    Science.gov (United States)

    Cacho, Enio Walker Azevedo; de Oliveira, Roberta; Ortolan, Rodrigo L.; Varoto, Renato; Cliquet, Alberto

    2011-01-01

    The aim of this study was to correlate clinical and functional evaluations with kinematic variables of upper limp reach-to-grasp movement in patients with tetraplegia. Twenty chronic patients were selected to perform reach-to-grasp kinematic assessment using a target placed at a distance equal to the arm's length. Kinematic variables (hand peak…

  13. Comprehensive screening of target molecules by next-generation sequencing in patients with malignant solid tumors: guiding entry into phase I clinical trials

    OpenAIRE

    Tanabe, Yuko; Ichikawa, Hitoshi; Kohno, Takashi; Yoshida, Hiroshi; Kubo, Takashi; Kato, Mamoru; Iwasa, Satoru; Ochiai, Atsushi; Yamamoto, Noboru; Fujiwara, Yasuhiro; Tamura, Kenji

    2016-01-01

    It is still controversial whether comprehensive genome screening of target molecules by next generation sequencing (NGS) is needed to increase clinical efficacy of investigational drugs or accelerate drug development, although several studies are being carried out. Therefore, we performed a prospective study to evaluate the feasibility of comprehensive gene screening in this setting. Our findings indicate that actionable alterations were identified in 45% of the analyzed patients, most freque...

  14. Clinical assessment of intraarterial blood gas monitor accuracy

    Science.gov (United States)

    Aziz, Salim; Spiess, R.; Roby, Paul; Kenny, Margaret

    1993-08-01

    The accuracy of intraarterial blood gas monitoring (IABGM) devices is challenging to assess under routine clinical conditions. When comparing discrete measurements by blood gas analyzer (BGA) to IABGM values, it is important that the BGA determinations (reference method) be as accurate as possible. In vitro decay of gas tensions caused by delay in BGA analysis is particularly problematic for specimens with high arterial oxygen tension (PaO2) values. Clinical instability of blood gases in the acutely ill patient may cause disagreement between BGA and IABGM values because of IABGM response time lag, particularly in the measurement of arterial blood carbon dioxide tension (PaCO2). We recommend that clinical assessments of IABGM accuracy by comparison with BGA use multiple bedside BGA instruments, and that blood sampling only occur during periods when IABGM values appear stable.

  15. Challenges assessing clinical endpoints in early Huntington disease

    Science.gov (United States)

    Paulsen, Jane S.; Wang, Chiachi; Duff, Kevin; Barker, Roger; Nance, Martha; Beglinger, Leigh; Moser, David; Williams, Janet K.; Simpson, Sheila; Langbehn, Douglas; van Kammen, Daniel P.

    2010-01-01

    The primary aim of this study was to evaluate the current accepted standard clinical endpoint for the earliest-studied HD participants likely to be recruited into clinical trials. Since the advent of genetic testing for HD, it is possible to identify gene carriers prior to the diagnosis of disease, which opens up the possibility of clinical trials of disease-modifying treatments in clinically asymptomatic persons. Current accepted standard clinical endpoints were examined as part of a multi-national, 32-site, longitudinal, observational study of 786 research participants currently in the HD prodrome (gene-positive but not clinically diagnosed). Clinical signs and symptoms were used to prospectively predict functional loss as assessed by current accepted standard endpoints over 8 years of follow up. Functional capacity measures were not sensitive for HD in the prodrome; over 88% scored at ceiling. Prospective evaluation revealed that the first functional loss was in their accustomed work. In a survival analysis, motor, cognitive, and psychiatric measures were all predictors of job change. To our knowledge, this is the first prospective study ever conducted on the emergence of functional loss secondary to brain disease. We conclude that future clinical trials designed for very early disease will require the development of new and more sensitive measures of real-life function. PMID:20623772

  16. Does the component processes task assess text-based inferences important for reading comprehension? A path analysis in primary school children

    NARCIS (Netherlands)

    S.I. Wassenburg (Stephanie); B.B. de Koning (Björn); de Vries, M.H. (Meinou H.); M. van der Schoot (Menno)

    2016-01-01

    textabstractUsing a component processes task (CPT) that differentiates between higher-level cognitive processes of reading comprehension provides important advantages over commonly used general reading comprehension assessments. The present study contributes to further development of the CPT by eval

  17. Examining the Technical Adequacy of Second-Grade Reading Comprehension Measures in a Progress Monitoring Assessment System. Technical Report # 08-08

    Science.gov (United States)

    Alonzo, Julie; Liu, Kimy; Tindal, Gerald

    2008-01-01

    This technical report describes the development of reading comprehension assessments designed for use as progress monitoring measures appropriate for 2nd Grade students. The creation, piloting, and technical adequacy of the measures are presented. The following are appended: (1) Item Specifications for MC [Multiple Choice] Comprehension - Passage…

  18. Does the component processes task assess text-based inferences important for reading comprehension? A path analysis in primary school children

    NARCIS (Netherlands)

    S.I. Wassenburg (Stephanie); B.B. de Koning (Björn); de Vries, M.H. (Meinou H.); van der Schoot, M. (Menno)

    2016-01-01

    textabstractUsing a component processes task (CPT) that differentiates between higher-level cognitive processes of reading comprehension provides important advantages over commonly used general reading comprehension assessments. The present study contributes to further development of the CPT by eval

  19. Decoding and Reading Comprehension: A Meta-Analysis to Identify Which Reader and Assessment Characteristics Influence the Strength of the Relationship in English

    Science.gov (United States)

    García, J. Ricardo; Cain, Kate

    2014-01-01

    The twofold purpose of this meta-analysis was to determine the relative importance of decoding skills to reading comprehension in reading development and to identify which reader characteristics and reading assessment characteristics contribute to differences in the decoding and reading comprehension correlation. A meta-analysis of 110 studies…

  20. Quality assessment of randomized clinical trial in intensive care.

    Science.gov (United States)

    Gonçalves, Giulliano Peixoto; Barbosa, Fabiano Timbó; Barbosa, Luciano Timbó; Duarte, José Lira

    2009-03-01

    A randomized clinical trial is a prospective study that compares the effect and value of interventions in human beings, of one or more groups vs. a control group. The objective of this study was to evaluate the quality of published randomized clinical trials in Intensive care in Brazil. All randomized clinical trials in intensive care found by manual search in Revista Brasileira de Terapia Intensiva from January 2001 to March 2008 were assessed to evaluate their description by the quality scale. Descriptive statistics and a 95 % confidence interval were used for the primary outcome. Our primary outcome was the randomized clinical trial quality. Our search found 185 original articles, of which 14 were randomized clinical trials. Only one original article (7.1%) showed good quality. There was no statistical significance between the collected data and the data shown in the hypothesis of this search. It can be concluded that in the sample of assessed articles 7% of the randomized clinical trials in intensive care published in a single intensive care journal in Brazil, present good methodological quality.

  1. Clinical application of Assessment of Parenting Competencies (APC)

    DEFF Research Database (Denmark)

    Jacobsen, Stine Lindahl

    This paper is part of a symposium on music therapy with families with Kirsi Tuomi as Chair. It revolves around the clinical application of a new music therapy assessment model on parent-child interaction and parenting competencies. APC was developed for emotional neglected children and their pare......This paper is part of a symposium on music therapy with families with Kirsi Tuomi as Chair. It revolves around the clinical application of a new music therapy assessment model on parent-child interaction and parenting competencies. APC was developed for emotional neglected children......, child somatic hospitals, centers for refuges and other populations where it would be clinical relevant to assess the parent-child interaction. APC is an observational and improvisational based assessment model evaluating dyads of parent and child (child age range is 5-12). It produces information...... (numbers, graphs, and descriptions) of parent-child interaction and parenting competencies including nonverbal communication, level of attunement in the dyad, and level of emotional support from the parent. It is based on video analysis and a fixed assessment protocol. It was developed through a completed...

  2. Comprehensive evaluation and clinical implementation of commercially available Monte Carlo dose calculation algorithm.

    Science.gov (United States)

    Zhang, Aizhen; Wen, Ning; Nurushev, Teamour; Burmeister, Jay; Chetty, Indrin J

    2013-03-04

    A commercial electron Monte Carlo (eMC) dose calculation algorithm has become available in Eclipse treatment planning system. The purpose of this work was to evaluate the eMC algorithm and investigate the clinical implementation of this system. The beam modeling of the eMC algorithm was performed for beam energies of 6, 9, 12, 16, and 20 MeV for a Varian Trilogy and all available applicator sizes in the Eclipse treatment planning system. The accuracy of the eMC algorithm was evaluated in a homogeneous water phantom, solid water phantoms containing lung and bone materials, and an anthropomorphic phantom. In addition, dose calculation accuracy was compared between pencil beam (PB) and eMC algorithms in the same treatment planning system for heterogeneous phantoms. The overall agreement between eMC calculations and measurements was within 3%/2 mm, while the PB algorithm had large errors (up to 25%) in predicting dose distributions in the presence of inhomogeneities such as bone and lung. The clinical implementation of the eMC algorithm was investigated by performing treatment planning for 15 patients with lesions in the head and neck, breast, chest wall, and sternum. The dose distributions were calculated using PB and eMC algorithms with no smoothing and all three levels of 3D Gaussian smoothing for comparison. Based on a routine electron beam therapy prescription method, the number of eMC calculated monitor units (MUs) was found to increase with increased 3D Gaussian smoothing levels. 3D Gaussian smoothing greatly improved the visual usability of dose distributions and produced better target coverage. Differences of calculated MUs and dose distributions between eMC and PB algorithms could be significant when oblique beam incidence, surface irregularities, and heterogeneous tissues were present in the treatment plans. In our patient cases, monitor unit differences of up to 7% were observed between PB and eMC algorithms. Monitor unit calculations were also preformed

  3. Assessing Professionalism: A Theoretical Framework for Defining Clinical Rotation Assessment Criteria.

    Science.gov (United States)

    Armitage-Chan, Elizabeth

    Although widely accepted as an important graduate competence, professionalism is a challenging outcome to define and assess. Clinical rotations provide an excellent opportunity to develop student professionalism through the use of experiential learning and effective feedback, but without appropriate theoretical frameworks, clinical teachers may find it difficult to identify appropriate learning outcomes. The adage "I know it when I see it" is unhelpful in providing feedback and guidance for student improvement, and criteria that are more specifically defined would help students direct their own development. This study sought first to identify how clinical faculty in one institution currently assess professionalism, using retrospective analysis of material obtained in undergraduate teaching and faculty development sessions. Subsequently, a faculty workshop was held in which a round-table type discussion sought to develop these ideas and identify how professionalism assessment could be improved. The output of this session was a theoretical framework for teaching and assessing professionalism, providing example assessment criteria and ideas for clinical teaching. This includes categories such as client and colleague interaction, respect and trust, recognition of limitations, and understanding of different professional identities. Each category includes detailed descriptions of the knowledge, skills, and behaviors expected of students in these areas. The criteria were determined by engaging faculty in the development of the framework, and therefore they should represent a focused development of criteria already used to assess professionalism, and not a novel and unfamiliar set of assessment guidelines. The faculty-led nature of this framework is expected to facilitate implementation in clinical teaching.

  4. Is the acute care of frail elderly patients in a comprehensive geriatric assessment unit superior to conventional acute medical care?

    Science.gov (United States)

    Ekerstad, Niklas; Karlson, Björn W; Dahlin Ivanoff, Synneve; Landahl, Sten; Andersson, David; Heintz, Emelie; Husberg, Magnus; Alwin, Jenny

    2017-01-01

    Objective The aim of this study was to investigate whether the acute care of frail elderly patients in a comprehensive geriatric assessment (CGA) unit is superior to the care in a conventional acute medical care unit. Design This is a clinical, prospective, randomized, controlled, one-center intervention study. Setting This study was conducted in a large county hospital in western Sweden. Participants The study included 408 frail elderly patients, aged ≥75 years, in need of acute in-hospital treatment. The patients were allocated to the intervention group (n=206) or control group (n=202). Mean age of the patients was 85.7 years, and 56% were female. Intervention This organizational form of care is characterized by a structured, systematic interdisciplinary CGA-based care at an acute elderly care unit. Measurements The primary outcome was the change in health-related quality of life (HRQoL) 3 months after discharge from hospital, measured by the Health Utilities Index-3 (HUI-3). Secondary outcomes were all-cause mortality, rehospitalizations, and hospital care costs. Results After adjustment by regression analysis, patients in the intervention group were less likely to present with decline in HRQoL after 3 months for the following dimensions: vision (odds ratio [OR] =0.33, 95% confidence interval [CI] =0.14–0.79), ambulation (OR =0.19, 95% CI =0.1–0.37), dexterity (OR =0.38, 95% CI =0.19–0.75), emotion (OR =0.43, 95% CI =0.22–0.84), cognition (OR = 0.076, 95% CI =0.033–0.18) and pain (OR =0.28, 95% CI =0.15–0.50). Treatment in a CGA unit was independently associated with lower 3-month mortality adjusted by Cox regression analysis (hazard ratio [HR] =0.55, 95% CI =0.32–0.96), and the two groups did not differ significantly in terms of hospital care costs (P>0.05). Conclusion Patients in an acute CGA unit were less likely to present with decline in HRQoL after 3 months, and the care in a CGA unit was also independently associated with lower mortality

  5. Comprehensive neuromechanical assessment in stroke patients: reliability and responsiveness of a protocol to measure neural and non-neural wrist properties.

    Science.gov (United States)

    van der Krogt, Hanneke; Klomp, Asbjørn; de Groot, Jurriaan H; de Vlugt, Erwin; van der Helm, Frans Ct; Meskers, Carel Gm; Arendzen, J Hans

    2015-03-13

    Understanding movement disorder after stroke and providing targeted treatment for post stroke patients requires valid and reliable identification of biomechanical (passive) and neural (active and reflexive) contributors. Aim of this study was to assess test-retest reliability of passive, active and reflexive parameters and to determine clinical responsiveness in a cohort of stroke patients with upper extremity impairments and healthy volunteers. Thirty-two community-residing chronic stroke patients with an impairment of an upper limb and fourteen healthy volunteers were assessed with a comprehensive neuromechanical assessment protocol consisting of active and passive tasks and different stretch reflex-eliciting measuring velocities, using a haptic manipulator and surface electromyography of wrist flexor and extensor muscles (Netherlands Trial Registry number NTR1424). Intraclass correlation coefficients (ICC) and Standard Error of Measurement were calculated to establish relative and absolute test-retest reliability of passive, active and reflexive parameters. Clinical responsiveness was tested with Kruskal Wallis test for differences between groups. ICC of passive parameters were fair to excellent (0.45 to 0.91). ICC of active parameters were excellent (0.88-0.99). ICC of reflexive parameters were fair to good (0.50-0.74). Only the reflexive loop time of the extensor muscles performed poor (ICC 0.18). Significant differences between chronic stroke patients and healthy volunteers were found in ten out of fourteen parameters. Passive, active and reflexive parameters can be assessed with high reliability in post-stroke patients. Parameters were responsive to clinical status. The next step is longitudinal measurement of passive, active and reflexive parameters to establish their predictive value for functional outcome after stroke.

  6. Morinda citrifolia (Noni: A comprehensive review on its industrial uses, pharmacological activities, and clinical trials

    Directory of Open Access Journals (Sweden)

    Reem Abou Assi

    2017-07-01

    Full Text Available Traditional medical practitioners in Hawaii and Polynesia have used Morinda citrifolia L. (Noni for centuries to cure or prevent varieties of illnesses. The popularity of M. citrifolia as a dietary supplement, a food functional ingredient, or as a natural health enhancer is increasing throughout the world. M. citrifolia contains phytochemicals that own antibacterial, antiviral, antifungal, antitumor, anthelminthic, analgesic, hypotensive, anti-inflammatory and immune enhancing effects. Moreover, the increasing vogue of M. citrifolia has attracted industries to employ it as a part of various products and for wide applications such as a natural source of medicines and chemical reagents as well as a green insecticidal. The wide spread of M. citrifolia in tropical climate of the globe, from USA to Brazil reaching to Tahiti, Malaysia and Australia, contributed in enriching its uses and potentials due to the variation in harvest locations. M. citrifolia parts including fruits, seeds, barks, leaves, and flowers are utilized on their own for individual nutritional and therapeutical values, however, the fruit is considered to contain the most valuable chemical compounds. This review discusses in details the industrial uses and the pharmacological activities of M. citrifolia fruit, seed, leaf and root, along with their isolated phytochemical compounds, through describing the conducted in vitro and in vivo studies as well as clinical data.

  7. Comprehensive analysis of clinical significance of stem-cell related factors in renal cell cancer

    Directory of Open Access Journals (Sweden)

    Zhou Libin

    2011-10-01

    Full Text Available Abstract Background C-MYC, LIN28, OCT4, KLF4, NANOG and SOX2 are stem cell related factors. We detected whether these factors express in renal cell carcinoma (RCC tissues to study their correlations with the clinical and pathological characteristics. Methods The expressions of c-MYC, LIN28, SOX2, KLF4, OCT4 and NANOG in 30 RCC patients and 5 non-RCC patients were detected with quantitative real-time reverse transcription-PCR (qRT-PCR. The data were analyzed with Wilcoxon signed rank sum test and x2 test. Results In RCC group, c-MYC expression was significantly higher in RCC tissues compared with normal tissues (P 0.05. Also the expression levels of all above factors were not significantly changed in non-RCC group (P > 0.05. Conclusions The present analysis strongly suggests that altered expression of several stem cell related factors may play different roles in RCC. C-MYC may function as an oncogene and OCT4, KLF4, NANOG and SOX2 as tumor suppressors.

  8. Caries assessment: establishing mathematical link of clinical and benchtop method

    Science.gov (United States)

    Amaechi, Bennett T.

    2009-02-01

    It is well established that the development of new technologies for early detection and quantitative monitoring of dental caries at its early stage could provide health and economic benefits ranging from timely preventive interventions to reduction of the time required for clinical trials of anti-caries agents. However, the new technologies currently used in clinical setting cannot assess and monitor caries using the actual mineral concentration within the lesion, while a laboratory-based microcomputed tomography (MCT) has been shown to possess this capability. Thus we envision the establishment of mathematical equations relating the measurements of each of the clinical technologies to that of MCT will enable the mineral concentration of lesions detected and assessed in clinical practice to be extrapolated from the equation, and this will facilitate preventitive care in dentistry to lower treatment cost. We utilize MCT and the two prominent clinical caries assessment devices (Quantitative Light-induced Fluorescence [QLF] and Diagnodent) to longitudinally monitor the development of caries in a continuous flow mixed-organisms biofilm model (artificial mouth), and then used the collected data to establish mathematical equation relating the measurements of each of the clinical technologies to that of MCT. A linear correlation was observed between the measurements of MicroCT and that of QLF and Diagnodent. Thus mineral density in a carious lesion detected and measured using QLF or Diagnodent can be extrapolated using the developed equation. This highlights the usefulness of MCT for monitoring the progress of an early caries being treated with therapeutic agents in clinical practice or trials.

  9. Rapid Damage Assessment by Means of Multi-Temporal SAR — A Comprehensive Review and Outlook to Sentinel-1

    Directory of Open Access Journals (Sweden)

    Simon Plank

    2014-05-01

    Full Text Available Fast crisis response after natural disasters, such as earthquakes and tropical storms, is necessary to support, for instance, rescue, humanitarian, and reconstruction operations in the crisis area. Therefore, rapid damage mapping after a disaster is crucial, i.e., to detect the affected area, including grade and type of damage. Thereby, satellite remote sensing plays a key role due to its fast response, wide field of view, and low cost. With the increasing availability of remote sensing data, numerous methods have been developed for damage assessment. This article gives a comprehensive review of these techniques focusing on multi-temporal SAR procedures for rapid damage assessment: interferometric coherence and intensity correlation. The review is divided into six parts: First, methods based on coherence; second, the ones using intensity correlation; and third, techniques using both methodologies combined to increase the accuracy of the damage assessment are reviewed. Next, studies using additional data (e.g., GIS and optical imagery to support the damage assessment and increase its accuracy are reported. Moreover, selected studies on post-event SAR damage assessment techniques and examples of other applications of the interferometric coherence are presented. Then, the preconditions for a successful worldwide application of multi-temporal SAR methods for damage assessment and the limitations of current SAR satellite missions are reported. Finally, an outlook to the Sentinel-1 SAR mission shows possible solutions of these limitations, enabling a worldwide applicability of the presented damage assessment methods.

  10. Promoting Assessment Efficacy through an Integrated System for Online Clinical Assessment of Practical Skills

    Science.gov (United States)

    Hay, Peter J.; Engstrom, Craig; Green, Anita; Friis, Peter; Dickens, Sue; Macdonald, Doune

    2013-01-01

    This paper presents evaluation outcomes from an externally funded research project involving the online clinical assessment of practical skills (eCAPS) using web-based video technologies within a university medical programme. eCAPS was implemented to trial this web-based approach for promoting the efficacy of "practical" skills assessment in knee…

  11. Comprehensive Determination of Prostate Tumor ETS Gene Status in Clinical Samples Using the CLIA Decipher Assay.

    Science.gov (United States)

    Torres, Alba; Alshalalfa, Mohammed; Tomlins, Scott A; Erho, Nicholas; Gibb, Ewan A; Chelliserry, Jijumon; Lim, Lony; Lam, Lucia L C; Faraj, Sheila F; Bezerra, Stephania M; Davicioni, Elai; Yousefi, Kasra; Ross, Ashley E; Netto, George J; Schaeffer, Edward M; Lotan, Tamara L

    2017-05-01

    ETS family gene fusions are common in prostate cancer and molecularly define a tumor subset. ERG is the most commonly rearranged, leading to its overexpression, followed by ETV1, ETV4, and ETV5, and these alterations are generally mutually exclusive. We validated the Decipher prostate cancer assay to detect ETS alterations in a Clinical Laboratory Improvement Amendments-accredited laboratory. Benchmarking against ERG immunohistochemistry and ETV1/4/5 RNA in situ hybridization, we examined the accuracy, precision, and reproducibility of gene expression ETS models using formalin-fixed, paraffin-embedded samples. The m-ERG model achieved an area under curve of 95%, with 93% sensitivity and 98% specificity to predict ERG immunohistochemistry status. The m-ETV1, -ETV4, and -ETV5 models achieved areas under curve of 98%, 88%, and 99%, respectively. The models had 100% robustness for ETS status, and scores were highly correlated across sample replicates. Models predicted 41.5% of a prospective radical prostatectomy cohort (n = 4036) to be ERG(+), 6.3% ETV1(+), 1% ETV4(+), and 0.4% ETV5(+). Of prostate tumor biopsy samples (n = 509), 41.2% were ERG(+), 8.6% ETV1(+), 0.4% ETV4(+), and none ETV5(+). Higher Decipher risk status tumors were more likely to be ETS(+) (ERG or ETV1/4/5) in the radical prostatectomy and the biopsy cohorts (P ETS status prediction models for molecular classification of prostate tumors. Copyright © 2017 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.

  12. A comprehensive review of the clinical approach to pregnancy and systemic lupus erythematosus.

    Science.gov (United States)

    Lazzaroni, Maria Grazia; Dall'Ara, Francesca; Fredi, Micaela; Nalli, Cecilia; Reggia, Rossella; Lojacono, Andrea; Ramazzotto, Francesca; Zatti, Sonia; Andreoli, Laura; Tincani, Angela

    2016-11-01

    Nowadays, most of the young women affected by Systemic Lupus Erythematosus (SLE) can carry out one or more pregnancies thanks to the improvement in treatment and the consequent reduction in morbidity and mortality. Pregnancy outcome in these women has also greatly improved in the last decades. A correct timing for pregnancy (tailored on disease activity and established during a preconception counselling), together with a tight monitoring during the three trimesters and the post-partum period (to timely identify and treat possible obstetric complications or maternal disease flares), as well as the concept of multidisciplinary management, are currently milestones of the management of pregnancy in SLE patients. Nevertheless, the increasing knowledge on the compatibility of drugs with pregnancy has allowed a better treatment of these patients, by choosing medications that control maternal disease activity without harming the foetus. However, particular attention and strict monitoring should be dedicated to SLE pregnant women in particular clinical settings: patients with lupus nephritis and patients with aPL positivity or Antiphospholipid syndrome, who are at higher risk for maternal and foetal complications, but also patients with anti-Ro/SSA and/or anti-La/SSB antibodies, because of the risk of neonatal lupus. A discussion on family planning, as well as counselling on contraception, should be part of the everyday-practice for physicians caring for SLE women during their reproductive age. Another issue is the possible reduction of fertility in these women, that can be due to different reasons. Consequently, the request for assisted reproduction techniques has been increasing in the last years, so that rheumatologists and gynaecologists should be prepared to counsel SLE patients also in this particular setting.

  13. A comprehensive review on experimental and clinical findings in intermediate syndrome caused by organophosphate poisoning

    Energy Technology Data Exchange (ETDEWEB)

    Abdollahi, Mohammad, E-mail: mohammad.abdollahi@utoronto.ca; Karami-Mohajeri, Somayyeh

    2012-02-01

    Acute organophosphate (OP) intoxication is important because of its high morbidity and mortality and occurrence of muscular paralysis associated by inhibition of acetylcholinesterase (AChE) activity at the neuromuscular junction. Cholinergic crisis, intermediate syndrome (IMS), and OP-induced delayed neuropathy (OPIDN) are the evidences that can be observed in OP intoxication. The main cause of morbidity due to OP poisoning is IMS that occurs 24–96 h after poisoning. Mechanisms underlying the IMS are not fully known. Although the electrophysiological aspects of delayed neuropathy are best characterized, the IMS remain very little studied. The aim of this study was to revisit current knowledge related to OP and the IMS. For this purpose, a systematic review without date limitation was performed. A total of 599 relevant articles were found and reviewed. Data were categorized according to experimental and clinical studies. Occurrences of persistent AChE inhibition, electromyography changes, muscle cell injury, and oxidative stress are the most important pieces of evidence for involvement of IMS in OP toxicity. Delayed AChE inhibition, muscle necrosis, down regulation or desensitization of postsynaptic ACh receptors, failure of postsynaptic ACh release, and oxidative stress-related myopathy are involved in IMS. Toxicokinetic factors, such as a high lipid-solubility, duration of AChE inhibition and metabolite excretion, evolution of alterations on repetitive nerve stimulation (RNS), type and frequency of muscle lesions can estimate the probability of the IMS. Plasma AChE of less than 200 units is a predictor and the 30 Hz RNS decremental response could be a useful marker for the IMS.

  14. Protein losing enteropathy: comprehensive review of the mechanistic association with clinical and subclinical disease states.

    Science.gov (United States)

    Levitt, David G; Levitt, Michael D

    2017-01-01

    Protein losing enteropathy (PLE) has been associated with more than 60 different conditions, including nearly all gastrointestinal diseases (Crohn's disease, celiac, Whipple's, intestinal infections, and so on) and a large number of non-gut conditions (cardiac and liver disease, lupus, sarcoidosis, and so on). This review presents the first attempt to quantitatively understand the magnitude of the PLE in relation to the associated pathology for three different disease categories: 1) increased lymphatic pressure (e.g., lymphangiectasis); 2) diseases with mucosal erosions (e.g., Crohn's disease); and 3) diseases without mucosal erosions (e.g., celiac disease). The PLE with lymphangiectasis results from rupture of the mucosal lymphatics, with retrograde drainage of systemic lymph into the intestinal lumen with the resultant loss of CD4 T cells, which is diagnostic. Mucosal erosion PLE results from macroscopic breakdown of the mucosal barrier, with the epithelial capillaries becoming the rate-limiting factor in albumin loss. The equation derived to describe the relationship between the reduction in serum albumin (CP) and PLE indicates that gastrointestinal albumin clearance must increase by at least 17 times normal to reduce the CP by half. The strengths and limitations of the two quantitative measures of PLE ((51)Cr-albumin or α1-antitrypsin [αAT] clearance) are reviewed. αAT provides a simple quantitative diagnostic test that is probably underused clinically. The strong, unexplained correlation between minor decreases in CP and subsequent mortality in seemingly healthy individuals raises the question of whether subclinical PLE could account for the decreased CP and, if so, could the mechanism responsible for PLE play a role in the increased mortality? A large-scale study correlating αAT clearance with serum albumin concentrations will be required in order to determine the role of PLE in the regulation of the serum albumin concentration of seemingly healthy

  15. Cervical cancer screening adherence among HIV-positive female smokers from a comprehensive HIV clinic.

    Science.gov (United States)

    Fletcher, Faith E; Vidrine, Damon J; Tami-Maury, Irene; Danysh, Heather E; King, Rachel Marks; Buchberg, Meredith; Arduino, Roberto C; Gritz, Ellen R

    2014-03-01

    HIV-positive women are at elevated risk for developing cervical cancer. While emerging research suggests that gynecologic health care is underutilized by HIV-positive women, factors associated with adherence to Pap testing, especially among HIV-positive female smokers are not well known. We utilized baseline data from a smoking cessation trial and electronic medical records to assess Pap smear screening prevalence and the associated characteristics among the HIV-positive female participants (n = 138). 46 % of the women had at least 1 Pap test in the year following study enrollment. Multiple logistic regression analysis indicated that younger age, African American race, hazardous drinking, increased number of cigarettes smoked per day, and smoking risk perception were associated with non-adherence to Pap smear screening. Cervical cancer screening was severely underutilized by women in this study. Findings underscore the importance of identifying predictors of non-adherence and addressing multiple risk factors and behavioral patterns among HIV-positive women who smoke.

  16. Comprehensive coronary risk determination in primary prevention: an imaging and clinical based definition combining computed tomographic coronary artery calcium score and national cholesterol education program risk score.

    Science.gov (United States)

    Nasir, Khurram; Vasamreddy, Chandra; Blumenthal, Roger S; Rumberger, John A

    2006-06-16

    Cardiovascular disease (CVD) is the leading cause of mortality and a major cause of morbidity. Coronary heart disease (CHD) accounts for nearly half of all CVD deaths. Currently estimation of risk in primary prevention is based on the Framingham risk equations, which inputs traditional risk factors and is helpful in predicting the development of CHD in asymptomatic individuals. However many individuals suffer events in the absence of established risk factors for atherosclerosis and broad based population risk estimations may have little precision when applied to a given individual. To meet the challenge of CHD risk assessment, several tools have been developed to identify atherosclerotic disease in its preclinical stages. This paper aims to incorporate information from coronary artery calcification (CAC) scoring from a computed tomographic "heartscan" (using Electron Beam Tomography (EBT) as the validated prototype) along with current Framingham risk profiling in order to refine risk on an absolute scale by combining imaging and clinical data to affect a more comprehensive calculation of absolute risk in a given individual. For CAC scores above the 75th percentile but or =55 years, women> or =65 years) a CAC = 0 will result in an age point score corresponding to the age-group whose median CAC score is zero i.e., 40-44 years for men and 55-59 years for women. The utilization of CAC scores allows the inclusion of sub-clinical disease definition into the context of modifiable risk factors as well as identifies high-risk individuals requiring aggressive treatment.

  17. Assessment of the quality of sample labelling for clinical research

    Directory of Open Access Journals (Sweden)

    Pablo Pérez-Huertas

    2016-03-01

    Full Text Available Objective: To assess the quality of the labels for clinical trial samples through current regulations, and to analyze its potential correlation with the specific characteristics of each sample. Method: A transversal multicenter study where the clinical trial samples from two third level hospitals were analyzed. The eleven items from Directive 2003/94/EC, as well as the name of the clinical trial and the dose on the label cover, were considered variables for labelling quality. The influence of the characteristics of each sample on labelling quality was also analyzed. Outcome: The study included 503 samples from 220 clinical trials. The mean quality of labelling, understood as the proportion of items from Appendix 13, was of 91.9%. Out of these, 6.6% did not include the name of the sample in the outer face of the label, while in 9.7% the dose was missing. The samples with clinical trial-type samples presented a higher quality (p < 0.049, blinding reduced their quality (p = 0.017, and identification by kit number or by patient increased it (p < 0.01. The promoter was the variable which introduced the highest variability into the analysis. Conclusions: The mean quality of labelling is adequate in the majority of clinical trial samples. The lack of essential information in some samples, such as the clinical trial code and the period of validity, is alarming and might be the potential source for dispensing or administration errors.

  18. Clinical relevance of microbleeds in acute stroke thrombolysis: Comprehensive meta-analysis.

    Science.gov (United States)

    Charidimou, Andreas; Shoamanesh, Ashkan

    2016-10-11

    We performed a systematic review and meta-analysis to assess whether the presence of cerebral microbleeds (CMBs) on pretreatment MRI of patients with acute ischemic stroke treated with IV thrombolysis is associated with increased risk of symptomatic intracerebral hemorrhage (ICH) and poor functional outcome. We searched PubMed for relevant studies and calculated pooled odds ratios (OR) for symptomatic ICH and poor (i.e., modified Rankin Scale score >2) 3- to 6-month functional outcome using random effects models with DerSimonian-Laird weights among individuals with vs without CMBs. Eight eligible studies including 2,601 stroke patients treated with IV thrombolysis were pooled in a meta-analysis. The cumulative CMBs prevalence was 24% (95% confidence interval [CI] 18%-30%). The pooled symptomatic ICH incidence was 5% (95% CI 4%-7%) among patients with CMBs and 3% (95% CI 2%-5%) in patients without CMBs. CMB presence was associated with higher risk of symptomatic ICH compared to patients without CMBs (OR 2.18; 95% CI 1.12-4.22; p = 0.021). Four studies (n = 1,665) reported data on 3- to 6-month poststroke functional outcome. The pooled incidence of poor functional outcome was 52% (95% CI 45%-59%) in patients with CMBs vs 41% (95% CI 35%-46%) in those without CMBs. Meta-analysis of these studies demonstrated OR for CMBs presence and adverse outcome to be 1.58 (95% CI 1.18-2.14; p = 0.002). CMBs are associated with greater symptomatic ICH risk and poor functional outcome in ischemic stroke patients undergoing thrombolytic therapy. In the absence of adjusted analyses and randomized evidence, this risk seems acceptable and should probably not discourage recanalization therapies in this patient population (Level B recommendation: nonrandomized Class IIa evidence). © 2016 American Academy of Neurology.

  19. Decubitus Ulcers of Soft Tissues in Patients with Type 2 Diabetes Mellitus: Clinical Strategies, Insulin Resistance Indicators, Comprehensive Treatment Aspects

    Directory of Open Access Journals (Sweden)

    A.R. Vergun

    2016-10-01

    Full Text Available Background. The causes of decubitus ulcers include ischaemia and neurotrophic tissue changes induced by their chronic compression, continuous pathologic moisture and shift of tissues that determine local ishaemia. The aim of the article: to study clinical options and suppurative complications of decubitus ulcers in patients with type 2 diabetes mellitus (DM in terms of insulin resistance (IR in the context of combined treatment optimization. Materials and methods. Total sample of retro- and prospective analyses involved results of comprehensive treatment of 112 patients. Type 2 DM was diagnosed in 37 patients, I comparison group included 27 patients with decubitus ulcers without complications (I–III stages and DM, with decubitus ulcers stage IV — II comparison group; and the control group included other 75 individuals. Results. The patients with type 2 DM (I comparison group had considerable decrease in HOMA index of β-cell function and increased HOMA index of IR (8.31 ± 0.02, р < 0.01. Patients with type 2 DM with complicated decubitus ulcers (II comparison group had more significant increase of circulating insulin indexes (p2 < 0.01, HOMA index of IR (p2 < 0.05, and considerable decrease on HOMA index of β-cell function (p2 < 0.05. The correlation analysis of HOMA-IR indicators and element concentration in the blood revealed the correlation only in patients with type 2 DM (I and II comparison groups: potent negative correlation (r = –0.72; p < 0.001 was revealed between the HOMA-IR and Mg2+ content in erythrocytes; intermediate negative correlation (r = –0.66; p < 0.01 — between HOMA-IR and Zn2+ concentration in the blood serum; and a negative one (r = –0.69; p < 0.01 — between HOMA-IR and Cr3+ level in the blood serum. Conclusions. The advantage of the proposed classification of decubitus ulcers of soft tissue and a sequence of comprehensive treatment is considering the features of

  20. Health Literacy Assessment in an Otolaryngology Clinic Population.

    Science.gov (United States)

    Megwalu, Uchechukwu C; Lee, Jennifer Y

    2016-12-01

    To assess health literacy in an adult tertiary care otolaryngology clinic population and to explore potential determinants of inadequate health literacy. Cross-sectional study. Tertiary care otolaryngology clinic. The study population included all adult patients treated at 3 of Stanford University's adult otolaryngology clinic sites between March 1 and 11, 2016. Data were collected via an anonymous questionnaire. Health literacy was assessed with the Brief Health Literacy Screen. Ten percent of patients had inadequate health literacy. White race (odds ratio [OR], 0.23) and having English as the primary language (OR, 0.12) were associated with adequate health literacy, while high school or lower level of education (OR, 3.2) was associated with inadequate health literacy. Age, sex, and Hispanic ethnicity were not associated with health literacy. Our study highlights the need for health literacy screening in the otolaryngology clinic setting and identifies sociodemographic risk factors for inadequate health literacy. Further studies are needed to assess the impact of health literacy on patient outcomes and to test specific interventions to address health literacy and health outcomes. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  1. 基于模糊综合评价的高校教学质量评估系统%Fuzzy Comprehensive Evaluation of Teaching Quality Assessment System

    Institute of Scientific and Technical Information of China (English)

    李旭军; 何鲲

    2011-01-01

    利用模糊综合评价法对高校教学质量进行评估,并对模糊综合评价的高校教学质量评估系统进行分析,为高校教学质量的实践评估提供借鉴。%Teaching college teaching quality assessment is an important part of the assessment,the quality of teaching how to make a fair and equitable evaluation has become an important issue.Comprehensive evaluation of the past for teachers mostly qualitative analysis,and have some one-sided and subjective,obviously in the lack of accuracy and comprehensiveness.This paper,the fuzzy comprehensive evaluation method is applied to the assessment of teacher quality of teachers,based on fuzzy comprehensive evaluation of teaching quality assessment system for analysis to the practice of teaching quality evaluation of reference.

  2. Manual Linear Movements to Assess Spasticity in a Clinical Setting

    Science.gov (United States)

    Marinelli, Lucio; Trompetto, Carlo; Mori, Laura; Vigo, Gabriele; Traverso, Elisabetta; Colombano, Federica; Abbruzzese, Giovanni

    2013-01-01

    In a clinical setting, where motor-driven systems are not readily available, the major difficulty in the assessment of the stretch reflex lies in the control of passive limb displacement velocity. A potential approach to this problem arises from the use of manual sinusoidal movements (made by continuous alternating flexions and extensions) paced by an external stimulus. Unfortunately, there are conditions in which sinusoidal movements induce interfering phenomena such as the shortening reaction or postactivation depression. In the present paper, a novel manual method to control the velocity of passive linear movements is described and the results obtained from both healthy subjects and spastic patients are reported. This method is based on the synchronisation of movements with tones played by a metronome at different speeds. In a first set of experiments performed in healthy subjects, we demonstrated consistent control of velocity during passive limb movements using this method. Four joints usually examined during muscle tone assessment were tested: wrist, elbow, knee and ankle joints. Following this, we conducted a longitudinal assessment of the stretch reflex amplitude in wrist flexor muscles in patients with spasticity treated with botulinum toxin type A. The evaluators were not only able to vary the movement velocity based on the metronome speed, but also could reproduce the respective speeds two weeks later, despite the changing degree of hypertonia. This method is easy to perform in a clinical setting and hardware requirements are minimal, making it an attractive and robust procedure for the widespread clinical assessment of reflex hypertonia. PMID:23335966

  3. A Comprehensive Approach for Assessing Person Fit with Test-Retest Data

    Science.gov (United States)

    Ferrando, Pere J.

    2014-01-01

    Item response theory (IRT) models allow model-data fit to be assessed at the individual level by using person-fit indices. This assessment is also feasible when IRT is used to model test-retest data. However, person-fit developments for this type of modeling are virtually nonexistent. This article proposes a general person-fit approach for…

  4. A comprehensive plant-wide assessment of Amcor PET Packaging at Fairfield, California

    Energy Technology Data Exchange (ETDEWEB)

    Kevin Losh; Hui Choi; Yin Yin Wu; Bryan W. Hackett; Ahmad R. Ganji

    2008-02-29

    This report includes the results of the plant-wide assessment of AMCOR PET plants in Fairfield, City of Commerce, and Lathrop California. The project (except the assessment of Lathrop plant) was a cost shared effort between US Department of Energy through Golden Field Office, Golden CO and AMCOR PET Packaging Co. The DOE share of the plant-wide assessment cost was awarded to AMCOR PET in response to the RFP DE-PS36-05GO95009, the 2005 round of funding for “Plant-Wide Energy Efficiency Opportunity Assessments.” The plant-wide assessment included the processes, electrical and gas equipment. Current production practices have been evaluated against best practice standards, as well as utilization of modern technology to improve energy efficiency, reduce the wastes, and improve productivity.

  5. The Impact of a Novel Tool for Comprehensive Assessment of Palliative Care (MPCAT) on Assessment Outcome at 6- and 12-Month Follow-Up.

    LENUS (Irish Health Repository)

    O'Reilly, Martina

    2016-07-01

    Assessment in palliative care settings should be focused, sensitive, specific, and effective to minimize discomfort to vulnerable and often highly morbid patients. This report describes the development of an admission assessment protocol for a Specialist Palliative Care Inpatient Unit and its implementation into clinical practice.

  6. Treatment complexity index for assessing the relationship of treatment duration and outcomes in a graduate orthodontics clinic.

    Science.gov (United States)

    Vu, Christy Q; Roberts, W Eugene; Hartsfield, James K; Ofner, Susan

    2008-01-01

    Clinical cases completed by the Indiana University School of Dentistry (IUSD) graduating orthodontic classes of 2004, 2005, and 2006 were assessed to determine factors that affect orthodontic treatment duration. The sample consisted of 455 consecutively finished patients who received comprehensive treatment in the full permanent dentition. They included optimally finished and prematurely terminated (early debond) patients. The American Board of Orthodontics (ABO) discrepancy index (DI) was used to evaluate the severity of the pretreatment malocclusion. A specifically designed treatment complexity index (TCI) was used to evaluate complexity based on treatment modalities. The ABO objective grading system (OGS) and the IUSD comprehensive clinical assessment (CCA) were used to evaluate the clinical outcome for all patients. The average treatment duration was 29 months. The mean DI, OGS, and CCA scores were 15.30, 23.34, and 4.48, respectively. Increased treatment length was associated with 0.022-in slot size brackets, percent of treatment spent in nickel-titanium wires, Class II malocclusion, increased DI score, and increased TCI score. In evaluating outcomes for 2004 through 2006, there was no significant relationship between treatment duration and clinical outcome as measured by the OGS and CCA scores. The DI and TCI are sensitive prospective indicators of treatment duration. After the introduction of a rigorous clinical protocol for controlling poor outcomes, because of patients exceeding predicted treatment times, the clinical results for this sample are independent of treatment duration.

  7. Breast clinic triage tool: telephone assessment of new referrals.

    Science.gov (United States)

    Cusack, Leila; Brennan, Meagan; Weissenberg, Leisha; Moore, Katrina

    2012-04-01

    Efficient systems to triage increasing numbers of new referrals to breast clinics are needed, to optimise the management of patients with cancer and benign disease. A tool was developed to triage the urgency of referrals and allocate the most appropriate clinician consultation (surgeon or breast physician (BP)). 259 consecutive new referrals were triaged using the tool. 100% new cancers and 256 (98.8%) referrals overall were triaged to both appropriate category of urgency and the appropriate clinician. This triage tool provides a simple method for assessing new referrals to a breast clinic and can be easily delivered by trained administrative staff by telephone.

  8. Comprehensive Assessment on Tourism Eco-environment of Gansu Province Based on Spatial Data

    Institute of Scientific and Technical Information of China (English)

    Wang Lili; Dong Suocheng; Li Yu; Wang Peixian; Qi Xiaoming

    2009-01-01

    The article studies tourism eco-environment of 14 cit-ies of Gangsu Province, China, based on GIS with many kinds of multi-subject spatial database, such as remote sensing data, obser-vation data and literature data. The research results were as fol-lows. First, spatial features of ]4 cities' tourism eco-environment are displayed with five levels of vulnerability respectively. The vulnerability in Gansu becomes worse from Gannan City, located in southern Gansu to Hexi Corridor which lies in northwestern Gansu. Second, the areas of above the middle vulnerability level make up 75% of the total areas of Gansu Province. Third, more than 70% of high-level human and natural tourism resources are in the areas with high vulnerability eco-environment. Fourth, it is crucial to develop comprehensive tourism industry in order to im-prove the harmonious development between tourism industry and eco-environment in Gansu Province.

  9. Comprehensive clinical studies in 34 patients with molecularly defined UPD(14)pat and related conditions (Kagami–Ogata syndrome)

    Science.gov (United States)

    Kagami, Masayo; Kurosawa, Kenji; Miyazaki, Osamu; Ishino, Fumitoshi; Matsuoka, Kentaro; Ogata, Tsutomu

    2015-01-01

    Paternal uniparental disomy 14 (UPD(14)pat) and epimutations and microdeletions affecting the maternally derived 14q32.2 imprinted region lead to a unique constellation of clinical features such as facial abnormalities, small bell-shaped thorax with a coat-hanger appearance of the ribs, abdominal wall defects, placentomegaly, and polyhydramnios. In this study, we performed comprehensive clinical studies in patients with UPD(14)pat (n=23), epimutations (n=5), and microdeletions (n=6), and revealed several notable findings. First, a unique facial appearance with full cheeks and a protruding philtrum and distinctive chest roentgenograms with increased coat-hanger angles to the ribs constituted the pathognomonic features from infancy through childhood. Second, birth size was well preserved, with a median birth length of ±0 SD (range, −1.7 to +3.0 SD) and a median birth weight of +2.3 SD (range, +0.1 to +8.8 SD). Third, developmental delay and/or intellectual disability was invariably present, with a median developmental/intellectual quotient of 55 (range, 29–70). Fourth, hepatoblastoma was identified in three infantile patients (8.8%), and histological examination in two patients showed a poorly differentiated embryonal hepatoblastoma with focal macrotrabecular lesions and well-differentiated hepatoblastoma, respectively. These findings suggest the necessity of an adequate support for developmental delay and periodical screening for hepatoblastoma in the affected patients, and some phenotypic overlap between UPD(14)pat and related conditions and Beckwith–Wiedemann syndrome. On the basis of our previous and present studies that have made a significant contribution to the clarification of underlying (epi)genetic factors and the definition of clinical findings, we propose the name ‘Kagami–Ogata syndrome' for UPD(14)pat and related conditions. PMID:25689926

  10. Comprehensive clinical studies in 34 patients with molecularly defined UPD(14)pat and related conditions (Kagami-Ogata syndrome).

    Science.gov (United States)

    Kagami, Masayo; Kurosawa, Kenji; Miyazaki, Osamu; Ishino, Fumitoshi; Matsuoka, Kentaro; Ogata, Tsutomu

    2015-11-01

    Paternal uniparental disomy 14 (UPD(14)pat) and epimutations and microdeletions affecting the maternally derived 14q32.2 imprinted region lead to a unique constellation of clinical features such as facial abnormalities, small bell-shaped thorax with a coat-hanger appearance of the ribs, abdominal wall defects, placentomegaly, and polyhydramnios. In this study, we performed comprehensive clinical studies in patients with UPD(14)pat (n=23), epimutations (n=5), and microdeletions (n=6), and revealed several notable findings. First, a unique facial appearance with full cheeks and a protruding philtrum and distinctive chest roentgenograms with increased coat-hanger angles to the ribs constituted the pathognomonic features from infancy through childhood. Second, birth size was well preserved, with a median birth length of ±0 SD (range, -1.7 to +3.0 SD) and a median birth weight of +2.3 SD (range, +0.1 to +8.8 SD). Third, developmental delay and/or intellectual disability was invariably present, with a median developmental/intellectual quotient of 55 (range, 29-70). Fourth, hepatoblastoma was identified in three infantile patients (8.8%), and histological examination in two patients showed a poorly differentiated embryonal hepatoblastoma with focal macrotrabecular lesions and well-differentiated hepatoblastoma, respectively. These findings suggest the necessity of an adequate support for developmental delay and periodical screening for hepatoblastoma in the affected patients, and some phenotypic overlap between UPD(14)pat and related conditions and Beckwith-Wiedemann syndrome. On the basis of our previous and present studies that have made a significant contribution to the clarification of underlying (epi)genetic factors and the definition of clinical findings, we propose the name 'Kagami-Ogata syndrome' for UPD(14)pat and related conditions.

  11. Digitised audio questionnaire for assessment of informed consent comprehension in a low-literacy African research population: development and psychometric evaluation.

    Science.gov (United States)

    Afolabi, Muhammed O; Bojang, Kalifa; D'Alessandro, Umberto; Ota, Martin O C; Imoukhuede, Egeruan B; Ravinetto, Raffaella; Larson, Heidi J; McGrath, Nuala; Chandramohan, Daniel

    2014-06-24

    To develop and psychometrically evaluate an audio digitised tool for assessment of comprehension of informed consent among low-literacy Gambian research participants. We conducted this study in the Gambia where a high illiteracy rate and absence of standardised writing formats of local languages pose major challenges for research participants to comprehend consent information. We developed a 34-item questionnaire to assess participants' comprehension of key elements of informed consent. The questionnaire was face validated and content validated by experienced researchers. To bypass the challenge of a lack of standardised writing formats, we audiorecorded the questionnaire in three major Gambian languages: Mandinka, Wolof and Fula. The questionnaire was further developed into an audio computer-assisted interview format. The digitised questionnaire was administered to 250 participants enrolled in two clinical trials in the urban and rural areas of the Gambia. One week after first administration, the questionnaire was readministered to half of the participants who were randomly selected. Participants were eligible if enrolled in the parent trials and could speak any of the three major Gambian languages. The primary outcome measure was reliability and validity of the questionnaire. Item reduction by factor analysis showed that 21 of the question items have strong factor loadings. These were retained along with five other items which were fundamental components of informed consent. The 26-item questionnaire has high internal consistency with a Cronbach's α of 0.73-0.79 and an intraclass correlation coefficient of 0.94 (95% CI 0.923 to 0.954). Hypotheses testing also showed that the questionnaire has a positive correlation with a similar questionnaire and discriminates between participants with and without education. We have developed a reliable and valid measure of comprehension of informed consent information for the Gambian context, which might be easily adapted to

  12. The Clinical Threat Assessment of the Lone-Actor Terrorist.

    Science.gov (United States)

    Meloy, J Reid; Genzman, Jacqueline

    2016-12-01

    The Terrorist Radicalization Assessment Protocol (TRAP-18) is a structured professional judgment instrument for the assessment of individuals who present a concern for lone-actor terrorism. It consists of eight proximal warning behaviors and 10 distal characteristics. Previous research has demonstrated its interrater reliability and some concurrent and postdictive validity. In this article, TRAP-18 is retrospectively applied to the case of US Army psychiatrist and jihadist Malik Nidal Hasan, who committed a mass murder at Fort Hood, Texas in 2009. The strengths and limitations of TRAP-18 as a structured professional judgment instrument for mental health clinicians are discussed, and clinical risk management suggestions are made.

  13. Use of clinical simulation for assessment in EHR-procurement

    DEFF Research Database (Denmark)

    Jensen, Sanne; Rasmussen, Stine L.; Lyng, Karen M.

    2013-01-01

    the daily work practice consisting of numerous mixed tasks executed by many different clinical actors in various settings. Within health informatics it has proven beneficial to use human factors approaches in the design process to secure systems that are responsive to the actual field of application. While...... design methods are widely described, there are very limited descriptions of how to assess and compare different EHR-platforms and their support in work processes upon its procurement. This paper describes the method we have developed to undertake this task. It is discussed how the method differs and how...... it has been adjusted from existing assessment methods. Finally, future considerations are discussed....

  14. Assessing Binocular Interaction in Amblyopia and Its Clinical Feasibility

    OpenAIRE

    MiYoung Kwon; Zhong-Lin Lu; Alexandra Miller; Melanie Kazlas; Hunter, David G.; Peter J. Bex

    2014-01-01

    PURPOSE: To measure binocular interaction in amblyopes using a rapid and patient-friendly computer-based method, and to test the feasibility of the assessment in the clinic. METHODS: Binocular interaction was assessed in subjects with strabismic amblyopia (n = 7), anisometropic amblyopia (n = 6), strabismus without amblyopia (n = 15) and normal vision (n = 40). Binocular interaction was measured with a dichoptic phase matching task in which subjects matched the position of a binocular probe t...

  15. Comprehensive Cognitive Assessments are not Necessary for the Identification and Treatment of Learning Disabilities.

    Science.gov (United States)

    Fletcher, Jack M; Miciak, Jeremy

    2017-02-01

    There is considerable controversy about the necessity of cognitive assessment as part of an evaluation for learning and attention problems. The controversy should be adjudicated through an evaluation of empirical research. We review five sources of evidence commonly provided as support for cognitive assessment as part of the learning disability (LD) identification process, highlighting significant gaps in empirical research and where existing evidence is insufficient to establish the reliability and validity of cognitive assessments used in this way. We conclude that current evidence does not justify routine cognitive assessment for LD identification. As an alternative, we offer an instructional conceptualization of LD: a hybrid model that directly informs intervention and is based on documenting low academic achievement, inadequate response to intensive interventions, and a consideration of exclusionary factors.

  16. Comprehensive Assessment of Eco-environment Vulnerability in Hebei Province Based on ArcGIS

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    [Objective] This study aimed to assess the vulnerability of ecological environment in Hebei Province.[Method] Based on ArcGIS,by using the dominant factor and maximum limits factor method,we established the sensitivity-reality indicator system and assessment model of the eco-environment vulnerability in Hebei Province to quantitatively evaluate its eco-environment vulnerability,and analyzed its spatial distribution.[Result] The status quo of environmental degradation was inconsistent with the sensitivity of...

  17. Peer review in Clinical Pharmacology using the 8-D Assessment

    Science.gov (United States)

    Woodcock, Barry G.

    2017-01-01

    The requirement for editors of clinical pharmacology journals to maintain an overview of the peer review process for manuscripts submitted can be facilitated by use of the 8-D Assessment. The 8-D Assessment comprises peer review criteria to determine if the:1. Design of the study, 2. Diagnoses employed, 3. Drug molecules involved, 4. Dosages applied, 5. Data collected, 6. Discussion of the findings, 7. Deductions made, and 8. Documentation are in accord with the objectives of the study and meet the requirements of evidence-based medicine. This tool, although easy to apply, requires a high level of clinical pharmacology expertise, especially in the fields of drug disposition, pharmacokinetics, and drug action. PMID:28218890

  18. Evaluation of the Military Functional Assessment Program: Preliminary Assessment of the Construct Validity Using an Archived Database of Clinical Data

    Science.gov (United States)

    2013-08-01

    Status (Rbans): Clinical Utility in a Traumatic Brain Injury Sample. Clinical Neuropsychology. 1-14. Moses , J. A. 2004. Test review-Comprehensive...traumatic brain injury (mTBI) have persistent symptoms and/or functional limitations (Iverson, Zasler, & Lange, 2006; Ruff, Camenzuli, & Mueller...diagnoses and symptoms. Diagnosis/symptom Frequency Traumatic brain injury 54 mild TBI 7 penetrating TBI 2 unknown

  19. Face symmetry assessment abilities: Clinical implications for diagnosing asymmetry

    Science.gov (United States)

    Jackson, Tate H.; Mitroff, Stephen R.; Clark, Kait; Proffit, William R.; Lee, Jessica Y.; Nguyen, Tung T.

    2014-01-01

    Introduction An accurate assessment of face symmetry is necessary for the development of a dentofacial diagnosis in orthodontics, and an understanding of individual differences in perception of face symmetry between patients and providers is needed to facilitate successful treatment. Methods Orthodontists, general dentists, and control participants completed a series of tasks to assess symmetry. Judgments were made on pairs of upright faces (similar to the longitudinal assessment of photographic patient records), inverted faces, and dot patterns. Participants completed questionnaires regarding clinical practice, education level, and self-confidence ratings for symmetry assessment abilities. Results Orthodontists showed expertise compared with controls (P <0.001), whereas dentists showed no advantage over controls. Orthodontists performed better than dentists, however, in only the most difficult face symmetry judgments (P = 0.006). For both orthodontists and dentists, accuracy increased significantly when assessing symmetry in upright vs inverted faces (t = 3.7, P = 0.001; t = 2.7, P = 0.02, respectively). Conclusions Orthodontists showed expertise in assessing face symmetry compared with both laypersons and general dentists, and they were more accurate when judging upright than inverted faces. When using accurate longitudinal photographic records to assess changing face symmetry, orthodontists are likely to be incorrect in less than 15% of cases, suggesting that assistance from some additional technology is infrequently needed for diagnosis. PMID:24182582

  20. A Comprehensive Evaluation of Standardized Assessment Tools in the Diagnosis of Fibromyalgia and in the Assessment of Fibromyalgia Severity

    Directory of Open Access Journals (Sweden)

    Chad S. Boomershine

    2012-01-01

    Full Text Available Standard assessments for fibromyalgia (FM diagnosis and core FM symptom domains are needed for biomarker development and treatment trials. Diagnostic and symptom assessments are reviewed and recommendations are made for standards. Recommendations for existing assessments include the American College of Rheumatology FM classification criteria using the manual tender point Survey for diagnosis, the brief pain inventory average pain visual analogue scale for pain intensity, the function subscale of the revised fibromyalgia impact questionnaire (FIQR for physical function, the patient global impression of change and FIQR for overall/global improvement, the hospital anxiety and depression scale depression subscale for depression, the multiple ability self-report questionnaire for cognitive dysfunction, the fatigue severity scale for fatigue, the FIQR for multidimensional function/health-related quality of life, the jenkins sleep scale for sleep disturbance, and the fibromyalgia intensity score for tenderness. Forthcoming assessments including the FIQR for diagnosis, NIH PROMIS, and FIBRO Change scales are discussed.