Four-year treatment outcomes of adult patients enrolled in Mozambique's rapidly expanding antiretroviral therapy program.

Directory of Open Access Journals (Sweden)

Andrew F Auld

Full Text Available BACKGROUND: In Mozambique during 2004-2007 numbers of adult patients (≥15 years old enrolled on antiretroviral therapy (ART increased about 16-fold, from 60 kg, WHO stage IV (AHR 1.7; 95% CI, 1.3-2.4, reference group WHO stage I/II, lack of co-trimoxazole prescription (AHR 1.4; 95% CI, 1.0-1.8, and later calendar year of ART initiation (AHR 1.5; 95% CI, 1.2-1.8. Rates of immunologic treatment failure and regimen-switch were 14.0 and 0.6 events per 100-patient years, respectively. CONCLUSIONS: ART initiation at earlier disease stages and scale-up of co-trimoxazole among ART patients could improve outcomes. Research to determine reasons for low regimen-switch rates and increasing rates of attrition during program expansion is needed.

42 CFR 486.318 - Condition: Outcome measures.

Science.gov (United States)

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Outcome measures. 486.318 Section 486... Organizations Organ Procurement Organization Outcome Requirements § 486.318 Condition: Outcome measures. (a..., territories, or possessions, an OPO must meet all 3 of the following outcome measures: (1) The OPO's donation...

42 CFR 410.146 - Diabetes outcome measurements.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Diabetes outcome measurements. 410.146 Section 410.146 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Training and Diabetes Outcome Measurements § 410.146 Diabetes outcome measurements. (a) Information...

Characteristics and outcomes among older HIV-positive adults enrolled in HIV programs in four sub-Saharan African countries.

Directory of Open Access Journals (Sweden)

Eduard Eduardo

Full Text Available Limited information exists on adults ≥50 years receiving HIV care in sub-Saharan Africa.Using routinely-collected longitudinal patient-level data among 391,111 adults ≥15 years enrolling in HIV care from January 2005-December 2010 and 184,689 initiating ART, we compared characteristics and outcomes between older (≥50 years and younger adults at 199 clinics in Kenya, Mozambique, Rwanda, and Tanzania. We calculated proportions over time of newly enrolled and active adults receiving HIV care and initiating ART who were ≥50 years; cumulative incidence of loss to follow-up (LTF and recorded death one year after enrollment and ART initiation, and CD4+ response following ART initiation.From 2005-2010, the percentage of adults ≥50 years newly enrolled in HIV care remained stable at 10%, while the percentage of adults ≥50 years newly initiating ART (10% [2005]-12% [2010], active in follow-up (10% [2005]-14% (2010], and active on ART (10% [2005]-16% [2010] significantly increased. One year after enrollment, older patients had significantly lower incidence of LTF (33.1% vs. 32.6%[40-49 years], 40.5%[25-39 years], and 56.3%[15-24 years]; p-value<0.0001, but significantly higher incidence of recorded death (6.0% vs. 5.0% [40-49 years], 4.1% [25-39 years], and 2.8% [15-24 years]; p-valve<0.0001. LTF was lower after vs. before ART initiation for all ages, with older adults experiencing less LTF than younger adults. Among 85,763 ART patients with baseline and follow-up CD4+ counts, adjusted average 12-month CD4+ response for older adults was 20.6 cells/mm3 lower than for adults 25-39 years of age (95% CI: 17.1-24.1.The proportion of patients who are ≥50 years has increased over time and been driven by aging of the existing patient population. Older patients experienced less LTF, higher recorded mortality and less robust CD4+ response after ART initiation. Increased programmatic attention on older adults receiving HIV care in sub-Saharan Africa is

31 CFR 10.4 - Eligibility for enrollment as enrolled agent or enrolled retirement plan agent.

Science.gov (United States)

2010-07-01

...) Enrollment as an enrolled agent upon examination. The Director of the Office of Professional Responsibility may grant enrollment as an enrolled agent to an applicant who demonstrates special competence in tax... the Office of Professional Responsibility and who has not engaged in any conduct that would justify...

Dual Enrollment, Structural Reform, and the Completion Agenda

Science.gov (United States)

Karp, Melinda Mechur

2015-01-01

This chapter contextualizes and extends the previous chapters by addressing the intertwined issues of structural systems reform and college completion, as well as the role dual enrollment can play in ensuring equitable postsecondary outcomes for underrepresented students.

The International Dermatology Outcome Measures Group

DEFF Research Database (Denmark)

Gottlieb, Alice B; Levin, Adriane A; Armstrong, April W

2015-01-01

As quality standards are increasingly in demand throughout medicine, dermatology needs to establish outcome measures to quantify the effectiveness of treatments and providers. The International Dermatology Outcome Measures Group was established to address this need. Beginning with psoriasis...

Measuring outcomes in children's rehabilitation: a decision protocol.

Science.gov (United States)

Law, M; King, G; Russell, D; MacKinnon, E; Hurley, P; Murphy, C

1999-06-01

To develop and test the feasibility and clinical utility of a computerized self-directed software program designed to enable service providers in children's rehabilitation to make decisions about the most appropriate outcome measures to use in client and program evaluation. A before-and-after design was used to test the feasibility and initial impact of the decision-making outcome software in improving knowledge and use of clinical outcome measures. A children's rehabilitation center in a city of 50,000. All service providers in the children's rehabilitation center. Disciplines represented included early childhood education, occupational therapy, physical therapy, speech and language pathology, audiology, social work, and psychology. Using a conceptual framework based on the International Classification of Impairment, Disability, and Handicap (ICIDH), an outcome measurement decision-making protocol was developed. The decision-making protocol was computerized in an educational software program with an attached database of critically appraised measures. Participants learned about outcome measures through the program and selected outcome measures that met their specifications. The computer software was tested for feasibility in the children's rehabilitation center for 6 months. Knowledge and use of clinical outcome measures were determined before and after the feasibility testing using a survey of all service providers currently at the centre and audits of 30 randomly selected rehabilitation records (at pretest, posttest, and follow-up). Service providers indicated that the outcomes software was easy to follow and believed that the use of the ICIDH framework helped them in making decisions about selecting outcome measures. Results of the survey indicated that there were significant changes in the service providers' level of comfort with selecting measures and knowing what measures were available. Use of outcome measures as identified through the audit did not change

Measurement properties of outcome measures for vitiligo. A systematic review.

Science.gov (United States)

Vrijman, Charlotte; Linthorst Homan, May W; Limpens, Jacqueline; van der Veen, Wietze; Wolkerstorfer, Albert; Terwee, Caroline B; Spuls, Phyllis I

2012-11-01

OBJECTIVE To summarize and critically appraise the evidence on the measurement properties of clinician-, patient-, and observer-reported outcomes, measuring any construct of interest in patients with all types of vitiligo. DATA SOURCES Electronic databases including PubMed (1948 to July 2011), OVID EMBASE (1980 to July 2011), and CINAHL (EBSCOhost) (1982 to July 2011) were searched. STUDY SELECTION Two authors independently screened all records for eligibility. For inclusion, the study population had to include patients with vitiligo, for which outcome measures were developed or evaluated on their measurement properties. The initial search retrieved 1249 records, of which 14 articles met the inclusion criteria. DATA EXTRACTION Characteristics of the included instruments, study population, and results of the measurement properties were extracted. The Consensus-Based Standards for the Selection of Health Status Measurement Instruments (COSMIN) 4-point checklist, combined with quality criteria for measurement properties, was used to calculate the overall level of evidence per measurement property of each instrument. Independent extraction and assessment was performed by 2 authors. DATA SYNTHESIS Eleven different measurement instruments were identified. Strong evidence was found for a positive internal consistency of the Dermatology Life Quality Index. For other instruments, the evidence of measurement properties was limited or unknown. CONCLUSIONS Recommendations on the use of specific outcome measures for vitiligo should be formulated with caution because current evidence is insufficient owing to a low number of studies with poor methodological quality and unclear clinical relevance. To recommend outcome measures for vitiligo, further research on measurement properties of clinical relevant outcome measures for vitiligo according to COSMIN quality criteria is needed.

Psychopathology and special education enrollment in children with prenatal cocaine exposure.

Science.gov (United States)

Levine, Todd P; Lester, Barry; Lagasse, Linda; Shankaran, Seetha; Bada, Henrietta S; Bauer, Charles R; Whitaker, Toni M; Higgins, Rosemary; Hammond, Jane; Roberts, Mary B

2012-06-01

This study evaluated how enrollment in special education services in 11-year-old children relates to prenatal cocaine exposure (PCE), psychopathology, and other risk factors. Participants were 498 children enrolled in The Maternal Lifestyle Study, a prospective, longitudinal, multisite study examining outcomes of children with PCE. Logistic regression was used to examine the effect of PCE and psychopathology on enrollment in an individualized education plan (IEP; a designation specific to children with special education needs), with environmental, maternal, and infant medical variables as covariates. PCE, an interaction of PCE and oppositional defiant disorder, child attention-deficit hyperactivity disorder, parent-reported internalizing behaviors, and teacher-reported externalizing behaviors, predicted enrollment in an IEP. Other statistically significant variables in the model were male gender, low birth weight, being small for gestational age, white race, caregiver change, low socioeconomic status, low child intelligence quotient, caregiver depression, and prenatal marijuana exposure. PCE increased the likelihood of receiving an IEP with adjustment for covariates. Psychopathology also predicted this special education outcome, in combination with and independent of prenatal cocaine exposure.

Nutritional status and outcomes in hemodialysis patients from the Gulf Cooperation Council countries enrolled in the dialysis outcome and practice patterns study phase 5 (2012-2015

Directory of Open Access Journals (Sweden)

Fadwa S Al-Ali

2016-01-01

Full Text Available Nutrition is an important factor in maintaining good health of hemodialysis (HD patients, affecting their morbidity and mortality. The Dialysis Outcomes and Practice Patterns Study (DOPPS is an international observational study assessing differences in dialysis practices and outcomes across >20 countries. Here, we present the results for the Gulf Cooperation Council (GCC countries regarding nutrition data and its relationship with outcomes as a part of the DOPPS Phase 5 study (2012-2015. Data were from Phase 5 of the DOPPS. Main analyses were based on 927 adult chronic HD patients enrolled at the start of the GCC-DOPPS Phase 5 study from each of the 40 randomly selected GCC HD facilities from Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates. Within each participating facility, 20-30 patients were randomly selected, depending on facility size. Analysis showed minor differences across GCC countries in age, albumin levels, nutrition supplement use, and being bothered by the lack of appetite. Elderly (>60 years old and diabetic HD patients displayed poorer nutritional parameters than young and nondiabetic patients. A low albumin level (<3.2 g/dL was associated with the highest risk of mortality with a hazard ratio (HR of 2.47 (P <0.0001 followed by diabetes with HR 1.57 (P <0.04 and older age [HR= 1.27/10 years older (P <0.01]. Quality of life measures physical component summary and mental component summary correlated negatively with albumin <3.2 g/dL (−2.18 and −5.5, respectively, P <0.05 for each, and with serum creatinine level <7.5 mg/dL (−2.29 and −2.1 respectively, P <0.05 for each. We are presenting the first study of the nutrition status and outcomes for HD patients in the GCC countries in DOPPS. Our results were mostly comparable to findings in previous trials in other countries. Although the data are observational, our study provides good insight into aspects of nutrition in the GCC countries and can be

26 CFR 300.8 - Renewal of enrollment of enrolled actuary fee.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Renewal of enrollment of enrolled actuary fee...) PROCEDURE AND ADMINISTRATION USER FEES § 300.8 Renewal of enrollment of enrolled actuary fee. (a) Applicability. This section applies to the renewal of enrollment of enrolled actuaries with the Joint Board for...

The International Dermatology Outcome Measures Group: formation of patient-centered outcome measures in dermatology.

Science.gov (United States)

Gottlieb, Alice B; Levin, Adriane A; Armstrong, April W; Abernethy, April; Duffin, Kristina Callis; Bhushan, Reva; Garg, Amit; Merola, Joseph F; Maccarone, Mara; Christensen, Robin

2015-02-01

As quality standards are increasingly in demand throughout medicine, dermatology needs to establish outcome measures to quantify the effectiveness of treatments and providers. The International Dermatology Outcome Measures Group was established to address this need. Beginning with psoriasis, the group aims to create a tool considerate of patients and providers using the input of all relevant stakeholders in assessment of disease severity and response to treatment. Herein, we delineate the procedures through which consensus is being reached and the future directions of the project. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Systematic Review of Treatment Outcome Measures for Vulvodynia.

Science.gov (United States)

Sadownik, Leslie A; Yong, Paul J; Smith, Kelly B

2018-07-01

To systematically evaluate the literature regarding vulvodynia treatment outcome measures. A systematic literature search on OVID, PubMed, and PsycINFO databases was conducted from inception until May 2016. Studies were included/excluded based on prespecified criteria. Reported outcome measures were organized into 6 core outcome domains recommended by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT): pain; physical functioning, emotional functioning, participant ratings of global improvement and satisfaction with treatment, symptoms and adverse events, and participant disposition. Of the 206 articles identified for full-text screening, 33 met our criteria. One study adhered to all IMMPACT recommendations. The number of outcomes measured per study ranged from 1 to greater than 20. Patient-reported pain outcomes were found in the majority (27/33; 82%) of studies. Pain severity with intercourse was reported by 24 (73%) of 33 studies-9 different scales were used to measure this outcome. Clinician-reported outcomes were present in 14 (42%) of 33 studies. Methods of measuring vestibular sensitivity by "cotton swab" test were different in 8 of 10 studies. Other domains reported included; physical function (8/33 studies; 24%), sexual function (23/33 studies; 70%), and emotional function (13/33 studies; 39%). Symptoms and adverse events were reported by 15 (45%) of 33 studies. One study formally reported participant disposition using all the information recommended by CONSORT. Comparison of clinical trial results in vulvodynia is not possible because of a lack of standard treatment outcome measures. Vulvodynia researchers should apply the IMMPACT criteria to guide the development of a minimum core set of standard outcome measures that measure holistic health.

Health outcome after major trauma: what are we measuring?

Science.gov (United States)

Hoffman, Karen; Cole, Elaine; Playford, E Diane; Grill, Eva; Soberg, Helene L; Brohi, Karim

2014-01-01

Trauma is a global disease and is among the leading causes of disability in the world. The importance of outcome beyond trauma survival has been recognised over the last decade. Despite this there is no internationally agreed approach for assessment of health outcome and rehabilitation of trauma patients. To systematically examine to what extent outcomes measures evaluate health outcomes in patients with major trauma. MEDLINE, EMBASE, and CINAHL (from 2006-2012) were searched for studies evaluating health outcome after traumatic injuries. Studies of adult patients with injuries involving at least two body areas or organ systems were included. Information on study design, outcome measures used, sample size and outcomes were extracted. The World Health Organisation International Classification of Function, Disability and Health (ICF) were used to evaluate to what extent outcome measures captured health impacts. 34 studies from 755 studies were included in the review. 38 outcome measures were identified. 21 outcome measures were used only once and only five were used in three or more studies. Only 6% of all possible health impacts were captured. Concepts related to activity and participation were the most represented but still only captured 12% of all possible concepts in this domain. Measures performed very poorly in capturing concepts related to body function (5%), functional activities (11%) and environmental factors (2%). Outcome measures used in major trauma capture only a small proportion of health impacts. There is no inclusive classification for measuring disability or health outcome following trauma. The ICF may provide a useful framework for the development of a comprehensive health outcome measure for trauma care.

Health outcome after major trauma: what are we measuring?

Directory of Open Access Journals (Sweden)

Karen Hoffman

Full Text Available Trauma is a global disease and is among the leading causes of disability in the world. The importance of outcome beyond trauma survival has been recognised over the last decade. Despite this there is no internationally agreed approach for assessment of health outcome and rehabilitation of trauma patients.To systematically examine to what extent outcomes measures evaluate health outcomes in patients with major trauma.MEDLINE, EMBASE, and CINAHL (from 2006-2012 were searched for studies evaluating health outcome after traumatic injuries.Studies of adult patients with injuries involving at least two body areas or organ systems were included. Information on study design, outcome measures used, sample size and outcomes were extracted. The World Health Organisation International Classification of Function, Disability and Health (ICF were used to evaluate to what extent outcome measures captured health impacts.34 studies from 755 studies were included in the review. 38 outcome measures were identified. 21 outcome measures were used only once and only five were used in three or more studies. Only 6% of all possible health impacts were captured. Concepts related to activity and participation were the most represented but still only captured 12% of all possible concepts in this domain. Measures performed very poorly in capturing concepts related to body function (5%, functional activities (11% and environmental factors (2%.Outcome measures used in major trauma capture only a small proportion of health impacts. There is no inclusive classification for measuring disability or health outcome following trauma. The ICF may provide a useful framework for the development of a comprehensive health outcome measure for trauma care.

Measuring patient knowledge of asthma: a systematic review of outcome measures.

NARCIS (Netherlands)

Pink, J.; Pink, K.; Elwyn, G.

2009-01-01

BACKGROUND: Asthma self-management education is a key component of international guidelines. No gold standard patient centred outcome measure exists for asthma knowledge. Our aim was to identify high-quality, validated, and reliable outcome measures suitable for use in either the research or

Korean Clinic Based Outcome Measure Studies

OpenAIRE

Jongbae Park

2003-01-01

Background: Evidence based medicine has become main tools for medical practice. However, conducting a highly ranked in the evidence hierarchy pyramid is not easy or feasible at all times and places. There remains a room for descriptive clinical outcome measure studies with admitting the limit of the intepretation. Aims: Presents three Korean clinic based outcome measure studies with a view to encouraging Korean clinicians to conduct similar studies. Methods: Three studies are presented...

Antiretroviral therapy enrollment characteristics and outcomes among HIV-infected adolescents and young adults compared with older adults--seven African countries, 2004-2013.

Science.gov (United States)

Auld, Andrew F; Agolory, Simon G; Shiraishi, Ray W; Wabwire-Mangen, Fred; Kwesigabo, Gideon; Mulenga, Modest; Hachizovu, Sebastian; Asadu, Emeka; Tuho, Moise Zanga; Ettiegne-Traore, Virginie; Mbofana, Francisco; Okello, Velephi; Azih, Charles; Denison, Julie A; Tsui, Sharon; Koole, Olivier; Kamiru, Harrison; Nuwagaba-Biribonwoha, Harriet; Alfredo, Charity; Jobarteh, Kebba; Odafe, Solomon; Onotu, Dennis; Ekra, Kunomboa A; Kouakou, Joseph S; Ehrenkranz, Peter; Bicego, George; Torpey, Kwasi; Mukadi, Ya Diul; van Praag, Eric; Menten, Joris; Mastro, Timothy; Dukes Hamilton, Carol; Swaminathan, Mahesh; Dokubo, E Kainne; Baughman, Andrew L; Spira, Thomas; Colebunders, Robert; Bangsberg, David; Marlink, Richard; Zee, Aaron; Kaplan, Jonathan; Ellerbrock, Tedd V

2014-11-28

Although scale-up of antiretroviral therapy (ART) since 2005 has contributed to declines of about 30% in the global annual number of human immunodeficiency (HIV)-related deaths and declines in global HIV incidence, estimated annual HIV-related deaths among adolescents have increased by about 50% and estimated adolescent HIV incidence has been relatively stable. In 2012, an estimated 2,500 (40%) of all 6,300 daily new HIV infections occurred among persons aged 15-24 years. Difficulty enrolling adolescents and young adults in ART and high rates of loss to follow-up (LTFU) after ART initiation might be contributing to mortality and HIV incidence in this age group, but data are limited. To evaluate age-related ART retention challenges, data from retrospective cohort studies conducted in seven African countries among 16,421 patients, aged ≥15 years at enrollment, who initiated ART during 2004-2012 were analyzed. ART enrollment and outcome data were compared among three groups defined by age at enrollment: adolescents and young adults (aged 15-24 years), middle-aged adults (aged 25-49 years), and older adults (aged ≥50 years). Enrollees aged 15-24 years were predominantly female (81%-92%), commonly pregnant (3%-32% of females), unmarried (54%-73%), and, in four countries with employment data, unemployed (53%-86%). In comparison, older adults were more likely to be male (padults, adolescents and young adults had higher LTFU rates in all seven countries, reaching statistical significance in three countries in crude and multivariable analyses. Evidence-based interventions to reduce LTFU for adolescent and young adult ART enrollees could help reduce mortality and HIV incidence in this age group.

Staff perceptions of using outcome measures in stroke rehabilitation.

Science.gov (United States)

Burton, Louisa-Jane; Tyson, Sarah; McGovern, Alison

2013-05-01

The use of standardised outcome measures is an integral part of stroke rehabilitation and is widely recommended as good practice. However, little is known about how measures are actually used or their impact. This study aimed to identify current clinical practice; how healthcare professionals working in stroke rehabilitation use outcome measures and their perceptions of the benefits and barriers to use. Eighty-four Health Care Professionals and 12 service managers and commissioners working in stroke services across a large UK county were surveyed by postal questionnaire. Ninety-six percent of clinical respondents used at least one measure, however, less than half used measures regularly during a patient's stay. The mean number of tools used was 3.2 (SD = 1.9). Eighty-one different tools were identified; 16 of which were unpublished and unvalidated. Perceived barriers in using outcome measures in day-to-day clinical practice included lack of resources (time and training) and lack of knowledge of appropriate measures. Benefits identified were to demonstrate the effectiveness of rehabilitation interventions and monitor patients' progress. Although the use of outcome measures is prevalent in clinical practice, there is little consistency in the tools utilised. The term "outcome measures" is used, but staff rarely used the measures at appropriate time points to formally assess and evaluate outcome. The term "measurement tool" more accurately reflects the purposes to which they were put and potential benefits. Further research to overcome the barriers in using standardised measurement tools and evaluate the impact of implementation on clinical practice is needed. • Health professionals working in stroke rehabilitation should work together to agree when and how outcome measures can be most effectively used in their service. • Efforts should be made to ensure that standardised tools are used to measure outcome at set time-points during rehabilitation, in order to

31 CFR 10.6 - Enrollment as an enrolled agent or enrolled retirement plan agent.

Science.gov (United States)

2010-07-01

... Director of the Office of Professional Responsibility as a professional organization or society whose... or societies wishing to be considered as qualified sponsors must request this status from the... in paragraph (f) of this section. (o) Enrolled actuaries. The enrollment and the renewal of...

Outcomes Associated With Early Preventive Dental Care Among Medicaid-Enrolled Children in Alabama

Science.gov (United States)

Morrisey, Michael A.; Sen, Bisakha

2017-01-01

Importance There is a recommendation for children to have a dental home by 6 months of age, but there is limited evidence supporting the effectiveness of early preventive dental care or whether primary care providers (PCPs) can deliver it. Objective To investigate the effectiveness of preventive dental care in reducing caries-related treatment visits among Medicaid enrollees. Design, Setting, and Participants High-dimensional propensity scores were used to address selection bias for a retrospective cohort study of children continuously enrolled in coverage from the Alabama Medicaid Agency from birth between 2008 and 2012, adjusting for demographics, access to care, and general health service use. Exposures Children receiving preventive dental care prior to age 2 years from PCPs or dentists vs no preventive dental care. Main Outcome and Measures Two-part models estimated caries-related treatment and expenditures. Results Among 19 658 eligible children, 25.8% (n = 3658) received early preventive dental care, of whom 44% were black, 37.6% were white, and 16.3% were Hispanic. Compared with matched children without early preventive dental care, children with dentist-delivered preventive dental care more frequently had a subsequent caries-related treatment (20.6% vs 11.3%, P dental expenditures ($168 vs $87 per year, P dental care was associated with an increase in the expected number of caries-related treatment visits by 0.14 per child per year (95% CI, 0.11-0.16) and caries-related treatment expenditures by $40.77 per child per year (95% CI, $30.48-$51.07). Primary care provider–delivered preventive dental care did not significantly affect caries-related treatment use or expenditures. Conclusions and Relevance Children with early preventive care visits from dentists were more likely to have subsequent dental care, including caries-related treatment, and greater expenditures than children without preventive dental care. There was no association with subsequent

Measuring Learning Outcomes in Auditing Education

DEFF Research Database (Denmark)

Holm, Claus; Steenholdt, Niels

2003-01-01

The ability to provide sensible measures for learning outcomes in accounting education is under increased scrutiny. In this paper we use a learner perspective in auditing education, which reflects that some students taking accounting classes also are provided with on-the-job training in accounting...... firms. Hence knowledge about learning outcomes for different groups of students is essential information for educators as well as the accounting profession. This paper extends prior research on the role of declarative and procedural knowledge in performing auditing tasks. Measuring learning outcomes......). The study provides evidence, which confirms an interrelationship between declarative and procedural knowledge in auditing, and the findings also suggest that students with auditing experience perform better than students without experience on procedural questions....

National health insurance scheme enrolment and antenatal care among women in Ghana: is there any relationship?

Science.gov (United States)

Dixon, Jenna; Tenkorang, Eric Y; Luginaah, Isaac N; Kuuire, Vincent Z; Boateng, Godfred O

2014-01-01

The objective of this study was to examine whether enrolment in the National Health Insurance Scheme (NHIS) affects the likelihood and timing of utilising antenatal care among women in Ghana. Data were drawn from the Ghana Demographic and Health Survey, a nationally representative survey collected in 2008. The study used a cross-sectional design to examine the independent effects of NHIS enrolment on two dependent variables (frequency and timing of antenatal visits) among 1610 Ghanaian women. Negative binomial and logit models were fitted given that count and categorical variables were employed as outcome measures, respectively. Regardless of socio-economic and demographic factors, women enrolled in the NHIS make more antenatal visits compared with those not enrolled; however, there was no statistical association with the timing of the crucial first visit. Women who are educated, living in urban areas and are wealthy were more likely to attend antenatal care than those living in rural areas, uneducated and from poorer households. The NHIS should be strengthened and resourced as it may act as an important tool for increasing antenatal care attendance among women in Ghana. © 2013 John Wiley & Sons Ltd.

Hepatology may have problems with putative surrogate outcome measures

DEFF Research Database (Denmark)

Gluud, Christian; Brok, Jesper; Gong, Yan

2007-01-01

A surrogate outcome measure is a laboratory measurement, a physical sign, or another intermediate substitute that is able to predict an intervention's effect on a clinically meaningful outcome. A clinical outcome detects how a patient feels, functions, or survives. Surrogate outcome measures occur...... faster or more often, are cheaper, and/or are less invasively achieved than the clinical outcome. In practice, validation is surprisingly often overlooked, especially if a biologic plausible rationale is proposed. Surrogate outcomes must be validated before use. The first step in validation...... predicts the intervention's effect on the clinical outcome. In hepatology a number of putative surrogate outcomes are used both in clinical research and in clinical practice without having been properly validated. Sustained virological response to interferons and ribavirin in patients with chronic...

Culturally Sensitive and Environment-Friendly Outcome Measures in

African Journals Online (AJOL)

Dr Olaleye

A systematic review of evidence on culturally sensitive and environment-friendly outcome measures in ..... which included manual grass cutting/hoeing, assuming the Islamic ... who opined that the starting point for any outcome measure is to ...

Strategic Enrolment Management (SEM) in Self-Financed Higher Education of Hong Kong: Evaluation and Measurement

Science.gov (United States)

Ng, Peggy; Galbraith, Craig

2016-01-01

The purpose of this study is to examine how the dimensions of strategic enrolment management (SEM) tie to the success metrics in the area of enrolment, retention and graduation from senior and programme management perspectives of a self-financed institution in Hong Kong. The literature on SEM has demonstrated that managing enrolment is a global…

Measuring the Effect of In-Country Recruitment Activities on Future International Enrollment at a Large Canadian University

Science.gov (United States)

Soltice, John G.

2016-01-01

There are many recruitment methods and tactics an institution can choose to pursue diversification of international student enrollment goals. Return on investment in a choice of tactic can take up to three or more years to determine thus initial choice is vital. Just as important though is in our ability to measure the return. If we can not…

Measurement of Behavioral and Emotional Outcomes of Youth in Foster Care: Investigation of the Roles of Age and Placement Type.

Science.gov (United States)

Gabrielli, Joy; Jackson, Yo; Brown, Shaquanna

2015-09-01

The Behavioral Assessment System for Children-2 (BASC-2) is used to assess behavioral and emotional outcomes for youth. Research providing evidence for use of the BASC-2 parent-report form historically has included biological parents reporting on their children (Reynolds and Kamphaus 2004). For youth residing in out-of-home placements through enrollment in foster care, caregivers reporting on their functioning may include foster parents or residential staff. Given the significant adverse mental health outcomes for youth in foster care and the need to adequately assess adjustment in foster care, the purpose of the study was to evaluate the measurement properties of caregivers' report on the parent report form (PRS) of the BASC-2 in foster care youth. Using 479 respondents, a measurement model was fit to the data demonstrating adequate fit across Internalizing Problems, Externalizing Problems, and Adaptive Skills. Further, a comparison of measurement properties across child and adolescent groups and groups of youth residing in residential facilities versus foster homes was conducted. Factorial invariance and latent means also were assessed. The BASC-2 PRS was found to be an adequate assessment of psychological outcomes for youth in foster care when completed by foster parents or residential facility staff.

Impact of managed care on cancer trial enrollment.

Science.gov (United States)

Gross, C P; Krumholz, H M

2005-06-01

To determine the relationship between managed care market activity and cancer trial enrollment. Trial participant data were obtained from the National Cancer Institute. Participants in cooperative group trials of breast, colorectal, lung, or prostate cancer during the years 1996 through 2001 were assigned to counties based on their zip code of residence. Linear regression was used to determine the relationship between county enrollment rate and two measures of county managed care activity (penetration and index of competition [IOC]), adjusting for other county characteristics. In bivariate analysis, there was a strong inverse correlation between trial enrollment rate and IOC (r = -0.23; P penetration, proportion uninsured, and other county characteristics. Counties in the lowest quartile of managed care penetration tended to have lower enrollment rates than the remaining counties (r = -0.05; P = .048), while counties in the second, third, and fourth quartiles of penetration all had similar enrollment rates to one another. Cancer trial enrollment rates were suboptimal across all counties, and counties with higher levels of managed care competition had significantly lower enrollment rates. The relationship between managed care penetration and trial enrollment was less consistent. Future efforts to enhance trial participation should address the potential negative influence of market factors.

Knee Injury and Osteoarthritis Outcome Score (KOOS)--development of a self-administered outcome measure

DEFF Research Database (Denmark)

Roos, Ewa M.; Roos, H P; Lohmander, L S

1998-01-01

There is broad consensus that good outcome measures are needed to distinguish interventions that are effective from those that are not. This task requires standardized, patient-centered measures that can be administered at a low cost. We developed a questionnaire to assess short- and long......-term patient-relevant outcomes following knee injury, based on the WOMAC Osteoarthritis Index, a literature review, an expert panel, and a pilot study. The Knee injury and Osteoarthritis Outcome Score (KOOS) is self-administered and assesses five outcomes: pain, symptoms, activities of daily living, sport...

Dual Credit/Dual Enrollment and Data Driven Policy Implementation

Science.gov (United States)

Lichtenberger, Eric; Witt, M. Allison; Blankenberger, Bob; Franklin, Doug

2014-01-01

The use of dual credit has been expanding rapidly. Dual credit is a college course taken by a high school student for which both college and high school credit is given. Previous studies provided limited quantitative evidence that dual credit/dual enrollment is directly connected to positive student outcomes. In this study, predictive statistics…

Understanding girls' enrollment at Louise's Farm School: A qualitative case study

Science.gov (United States)

Nowak, Ashley E. P.

This thesis presents a qualitative case study of enrollment and retention considerations at Louise's Farm School (LFS) in Palmer, Alaska, with a focus on how gender is performed in this domain. Interviews with 25 students, 12 parents, and 14 instructors revealed the enrollment decision-making process, identifying constraints to and enablers of girls' participation. Findings included three primary factors as greatly influencing girls' enrollment: (1) mothers' backgrounds; (2) mothers' knowledge of and the misperceptions regarding outcomes of LFS programing; and (3) girls' interest in LFS curriculum. Findings also exposed differences in mothers' and instructors' expectations for the educative development of girls and boys, suggesting that there is greater pressure on girls to perform academically while boys are expected to need greater space for physical expression.

Psychological Literacy Weakly Differentiates Students by Discipline and Year of Enrolment

Science.gov (United States)

Heritage, Brody; Roberts, Lynne D.; Gasson, Natalie

2016-01-01

Psychological literacy, a construct developed to reflect the types of skills graduates of a psychology degree should possess and be capable of demonstrating, has recently been scrutinized in terms of its measurement adequacy. The recent development of a multi-item measure encompassing the facets of psychological literacy has provided the potential for improved validity in measuring the construct. We investigated the known-groups validity of this multi-item measure of psychological literacy to examine whether psychological literacy could predict (a) students’ course of enrolment and (b) students’ year of enrolment. Five hundred and fifteen undergraduate psychology students, 87 psychology/human resource management students, and 83 speech pathology students provided data. In the first year cohort, the reflective processes (RPs) factor significantly predicted psychology and psychology/human resource management course enrolment, although no facets significantly differentiated between psychology and speech pathology enrolment. Within the second year cohort, generic graduate attributes (GGAs) and RPs differentiated psychology and speech pathology course enrolment. GGAs differentiated first-year and second-year psychology students, with second-year students more likely to have higher scores on this factor. Due to weak support for known-groups validity, further measurement refinements are recommended to improve the construct’s utility. PMID:26909058

Optimism in Enrollment Management

Science.gov (United States)

Buster-Williams, Kimberley

2016-01-01

Enrollment managers, like most managers, have goals that must be focused on with precision, excitement, and vigor. Enrollment managers must excel at enrollment planning. Typically, enrollment planning unites undergraduate and graduate recruitment plans, out-of-state recruitment plans, marketing plans, retention plans, international enrollment…

The Development of NOAA Education Common Outcome Performance Measures (Invited)

Science.gov (United States)

Baek, J.

2013-12-01

The National Oceanic and Atmospheric Administration (NOAA) Education Council has embarked on an ambitious Monitoring and Evaluation (M&E) project that will allow it to assess education program outcomes and impacts across the agency, line offices, and programs. The purpose of this internal effort is to link outcome measures to program efforts and to evaluate the success of the agency's education programs in meeting the strategic goals. Using an outcome-based evaluation approach, the NOAA Education Council is developing two sets of common outcome performance measures, environmental stewardship and professional development. This presentation will examine the benefits and tradeoffs of common outcome performance measures that collect program results across a portfolio of education programs focused on common outcomes. Common outcome performance measures have a few benefits to our agency and to the climate education field at large. The primary benefit is shared understanding, which comes from our process for writing common outcome performance measures. Without a shared and agreed upon set of definitions for the measure of an outcome, the reported results may not be measuring the same things and would incorrectly indicate levels of performance. Therefore, our writing process relies on a commitment to developing a shared set of definitions based on consensus. We hope that by taking the time to debate and coming to agreement across a diverse set of programs, the strength of our common measures can indicate real progress towards outcomes we care about. An additional benefit is that these common measures can be adopted and adapted by other agencies and organizations that share similar theories of change. The measures are not without their drawbacks, and we do make tradeoffs as part of our process in order to continue making progress. We know that any measure is necessarily a narrow slice of performance. A slice that may not best represent the unique and remarkable contribution

A systematic review of measurement properties of patient reported outcome measures in psoriatic arthritis

DEFF Research Database (Denmark)

Højgaard, Pil; Klokker, Louise; Orbai, Ana Maria

2018-01-01

Background: An updated psoriatic arthritis (PsA) core outcome set (COS) for randomized controlled trials (RCTs) was endorsed at the Outcome Measures in Rheumatology (OMERACT) meeting in 2016. Objectives: To synthesize the evidence on measurement properties of patient reported outcome measures...... (PROMs) for PsA and thereby contribute to development of a PsA core outcome measurement set (COMS) as described by the OMERACT Filter 2.0. Methods: A systematic literature search was performed in EMBASE, MEDLINE and PsycINFO on Jan 1, 2017 to identify full-text articles with an aim of assessing...... the measurement properties of PROMs in PsA. Two independent reviewers rated the quality of studies using the COnsensus based standards for the Selection of health Measurement INstruments (COSMIN) checklist, and performed a qualitative evidence synthesis. Results: Fifty-five studies were included in the systematic...

Korean Clinic Based Outcome Measure Studies

Directory of Open Access Journals (Sweden)

Jongbae Park

2003-02-01

Full Text Available Background: Evidence based medicine has become main tools for medical practice. However, conducting a highly ranked in the evidence hierarchy pyramid is not easy or feasible at all times and places. There remains a room for descriptive clinical outcome measure studies with admitting the limit of the intepretation. Aims: Presents three Korean clinic based outcome measure studies with a view to encouraging Korean clinicians to conduct similar studies. Methods: Three studies are presented briefly here including 1 Quality of Life of liver cancer patients after 8 Constitutional acupuncture; 2 Developing a Korean version of Measuring yourself Medical Outcome profile (MYMOP; and 3 Survey on 5 Shu points: a pilot In the first study, we have included 4 primary or secondary liver cancer patients collecting their diagnostic X-ray film and clinical data f개m their hospital, and asked them to fill in the European Organization Research and Treatment of Cancer, Quality of Life Questionnaire before the commencement of the treatment. The acupuncture treatment is set up format but not disclosed yet. The translation and developing a Korean version of outcome measures that is Korean clinician friendly has been sought for MYMOP is one of the most appropriate one. The permission was granted, the translation into Korean was done, then back translated into English only based on the Korean translation by the researcher who is bilingual in both languages. The back translation was compared by the original developer of MYMOP and confirmed usable. In order to test the existence of acupoints and meridians through popular forms of Korean acupuncture regimes, we aim at collecting opinions from 101 Korean clinicians that have used those forms. The questions asked include most effective symptoms, 5 Shu points, points those are least likely to use due to either adverse events or the lack of effectiveness, theoretical reasons for the above proposals, proposing outcome measures

Outcome of relapse after allogeneic HSCT in children with ALL enrolled in the ALL-SCT 2003/2007 trial.

Science.gov (United States)

Kuhlen, Michaela; Willasch, Andre M; Dalle, Jean-Hugues; Wachowiak, Jacek; Yaniv, Isaac; Ifversen, Marianne; Sedlacek, Petr; Guengoer, Tayfun; Lang, Peter; Bader, Peter; Sufliarska, Sabina; Balduzzi, Adriana; Strahm, Brigitte; von Luettichau, Irene; Hoell, Jessica I; Borkhardt, Arndt; Klingebiel, Thomas; Schrappe, Martin; von Stackelberg, Arend; Glogova, Evgenia; Poetschger, Ulrike; Meisel, Roland; Peters, Christina

2018-01-01

Relapse remains the major cause of treatment failure in children with high-risk acute lymphoblastic leukaemia (ALL) undergoing allogeneic haematopoietic stem-cell transplantation (allo-SCT). Prognosis is considered dismal but data on risk factors and outcome are lacking from prospective studies. We analysed 242 children with recurrence of ALL after first allo-SCT enrolled in the Berlin-Frankfurt-Munster (BFM) ALL-SCT-BFM 2003 and ALL-SCT-BFM international 2007 studies. Median time from allo-SCT to relapse was 7·7 months; median follow-up from relapse after allo-SCT until last follow-up was 3·4 years. The 3-year event-free survival (EFS) was 15% and overall survival (OS) was 20%. The main cause of death was disease progression or relapse (86·5%). The majority of children (48%) received salvage therapy without second allo-SCT, 26% of the children underwent a second allo-SCT and 25% received palliative treatment only. In multivariate analyses, age, site of relapse, time to relapse and type of salvage therapy were identified as significant prognostic factors for OS and EFS, whereas factors associated with first SCT were not statistically significant. Combined approaches incorporating novel immunotherapeutic treatment options and second allo-SCT hold promise to improve outcome in children with post allo-SCT relapse. © 2017 John Wiley & Sons Ltd.

Measurement Properties of Outcome Measures for Vitiligo A Systematic Review

NARCIS (Netherlands)

Vrijman, C.; Homan, M.W.L.; Limpens, J.; Veen, W.; Wolkerstorfer, A.; Terwee, C.B.; Spuls, P.I.

2012-01-01

Objective: To summarize and critically appraise the evidence on the measurement properties of clinician-, patient-, and observer-reported outcomes, measuring any construct of interest in patients with all types of vitiligo. Data Sources: Electronic databases including PubMed (1948 to July 2011),

Measurement properties of outcome measures for vitiligo. A systematic review

NARCIS (Netherlands)

Vrijman, Charlotte; Linthorst Homan, May W.; Limpens, Jacqueline; van der Veen, Wietze; Wolkerstorfer, Albert; Terwee, Caroline B.; Spuls, Phyllis I.

2012-01-01

OBJECTIVE To summarize and critically appraise the evidence on the measurement properties of clinician-, patient-, and observer-reported outcomes, measuring any construct of interest in patients with all types of vitiligo. DATA SOURCES Electronic databases including PubMed (1948 to July 2011), OVID

Fall Enrollment Report. 2014

Science.gov (United States)

Iowa Department of Education, 2014

2014-01-01

This report summarizes and analyzes fall enrollment in Iowa's community colleges. Each year, Iowa's 15 community colleges submit data on enrollment on the 10th business day of the fall semester. Some highlights from this report include: (1) Fall 2014 enrollment was 93,772 students--a decline of 0.49 percent from last fall; (2) Enrollment continues…

Patient-reported outcome measures versus inertial performance-based outcome measures: A prospective study in patients undergoing primary total knee arthroplasty.

Science.gov (United States)

Bolink, S A A N; Grimm, B; Heyligers, I C

2015-12-01

Outcome assessment of total knee arthroplasty (TKA) by subjective patient reported outcome measures (PROMs) may not fully capture the functional (dis-)abilities of relevance. Objective performance-based outcome measures could provide distinct information. An ambulant inertial measurement unit (IMU) allows kinematic assessment of physical performance and could potentially be used for routine follow-up. To investigate the responsiveness of IMU measures in patients following TKA and compare outcomes with conventional PROMs. Patients with end stage knee OA (n=20, m/f=7/13; age=67.4 standard deviation 7.7 years) were measured preoperatively and one year postoperatively. IMU measures were derived during gait, sit-stand transfers and block step-up transfers. PROMs were assessed by using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee Society Score (KSS). Responsiveness was calculated by the effect size, correlations were calculated with Spearman's rho correlation coefficient. One year after TKA, patients performed significantly better at gait, sit-to-stand transfers and block step-up transfers. Measures of time and kinematic IMU measures demonstrated significant improvements postoperatively for each performance-based test. The largest improvement was found in block step-up transfers (effect size=0.56-1.20). WOMAC function score and KSS function score demonstrated moderate correlations (Spearman's rho=0.45-0.74) with some of the physical performance-based measures pre- and postoperatively. To characterize the changes in physical function after TKA, PROMs could be supplemented by performance-based measures, assessing function during different activities and allowing kinematic characterization with an ambulant IMU. Copyright © 2015 Elsevier B.V. All rights reserved.

Disability outcome measures in multiple sclerosis clinical trials

DEFF Research Database (Denmark)

Cohen, Jeffrey A; Reingold, Stephen C; Polman, Chris H

2012-01-01

Many of the available disability outcome measures used in clinical trials of multiple sclerosis are insensitive to change over time, inadequately validated, or insensitive to patient-perceived health status or quality of life. Increasing focus on therapies that slow or reverse disability...... recommend practical refinements. Conversely, although substantial data support the multiple sclerosis functional composite as an alternative measure, changes to its component tests and scoring method are needed. Novel approaches, including the use of composite endpoints, patient-reported outcomes...... progression makes it essential to refine existing measures or to develop new tools. Major changes to the expanded disability status scale should be avoided to prevent the loss of acceptance by regulators as a measure for primary outcomes in trials that provide substantial evidence of effectiveness. Rather, we...

Outcome measurements in major trauma--results of a consensus meeting.

Science.gov (United States)

Ardolino, A; Sleat, G; Willett, K

2012-10-01

The NHS Outcomes Framework for England has identified recovery from major injury as an important clinical area. At present, there are no established outcome indicators. As more patients survive major trauma, outcomes will need to be measured in terms of morbidity and not mortality alone. To make recommendations for a selection of outcome measures that could be integrated into National Clinical Audit data collection and form part of clinical governance requirements for Regional Trauma Networks (RTNs) and measures by which RTNs are held to account by government. Specific focus was given to acute care and rehabilitation for both adults and children. A Multiprofessional, multidisciplinary expert group reviewed the current evidence on outcome measures for major trauma in the adult and children's populations, informed by a systematic review carried out jointly by the Trauma Audit and Research Network (TARN) and the Cochrane Injuries Group. A structured discussion covered functional and quality of life outcome measures as well as patient experience and indicators such as return to work, education and social dependency. For the adult population the group agreed with the in-hospital performance and hospital discharge measures recommended in the TARN and Cochrane systematic review. Concerning longer-term outcome indicators, the group suggested the use of the Glasgow Outcome Scale - Extended (GOS-E) and European Quality of Life 5D (EQ-5D) with consideration to be given to the World Health Organisation Quality of Life survey (WHO-QoL). For patients who had ongoing inpatient rehabilitation needs the group thought the measurement of the Rehabilitation Complexity Scale (RCS) and Functional Independence Measure (FIM) were important in total brain injury and, the American Spinal Injury Association Impairment Scale (ASIA) and Spinal Cord Independence Measure (SCIM) in spinal cord injury. For children the group recommended the use of the King's Outcome Scale for Childhood Head Injury

Outcome of relapse after allogeneic HSCT in children with ALL enrolled in the ALL-SCT 2003/2007 trial

DEFF Research Database (Denmark)

Kuhlen, Michaela; Willasch, Andre M; Dalle, Jean-Hugues

2018-01-01

Relapse remains the major cause of treatment failure in children with high-risk acute lymphoblastic leukaemia (ALL) undergoing allogeneic haematopoietic stem-cell transplantation (allo-SCT). Prognosis is considered dismal but data on risk factors and outcome are lacking from prospective studies. We...... analysed 242 children with recurrence of ALL after first allo-SCT enrolled in the Berlin-Frankfurt-Munster (BFM) ALL-SCT-BFM 2003 and ALL-SCT-BFM international 2007 studies. Median time from allo-SCT to relapse was 7·7 months; median follow-up from relapse after allo-SCT until last follow-up was 3·4 years....... The 3-year event-free survival (EFS) was 15% and overall survival (OS) was 20%. The main cause of death was disease progression or relapse (86·5%). The majority of children (48%) received salvage therapy without second allo-SCT, 26% of the children underwent a second allo-SCT and 25% received palliative...

A systematic review of patient-reported outcome measures in paediatric otolaryngology.

Science.gov (United States)

Powell, J; Powell, S; Robson, A

2018-01-01

Recently, there has been increased emphasis on the development and application of patient-reported outcome measures. This drive to assess the impact of illness or interventions, from the patient's perspective, has resulted in a greater number of available questionnaires. The importance of selecting an appropriate patient-reported outcome measure is specifically emphasised in the paediatric population. The literature on patient-reported outcome measures used in paediatric otolaryngology was reviewed. A comprehensive literature search was conducted using the databases Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, and PsycInfo, using the terms: 'health assessment questionnaire', 'structured questionnaire', 'questionnaire', 'patient reported outcome measures', 'PROM', 'quality of life' or 'survey', and 'children' or 'otolaryngology'. The search was limited to English-language articles published between 1996 and 2016. The search yielded 656 articles, of which 63 were considered relevant. This included general paediatric patient-reported outcome measures applied to otolaryngology, and paediatric otolaryngology disease-specific patient-reported outcome measures. A large collection of patient-reported outcome measures are described in the paediatric otolaryngology literature. Greater standardisation of the patient-reported outcome measures used in paediatric otolaryngology would assist in pooling of data and increase the validation of tools used.

Factors influencing the use of outcome measures in physical therapy practice.

Science.gov (United States)

Wedge, Frances M; Braswell-Christy, Jennifer; Brown, Cynthia J; Foley, Kathleen T; Graham, Cecilia; Shaw, Sharon

2012-02-01

Use of outcome measures in physical therapy practice is central to evaluating the effectiveness of treatment interventions, providing accountability and addressing quality of physical therapy programs. There is limited discussion on barriers and facilitators to using outcome measures in physical therapy practice. The purpose of this study was to identify factors that influence a physical therapist when deciding to use outcome measures in clinical practice. Participants were 21 physical therapists, seven each from skilled nursing facilities, outpatient clinics, and inpatient rehabilitation facilities. A grounded theory approach was used for interview and data collection. Common themes were determined from the data and a theory developed to explain the rationale behind physical therapists' decisions to use or not use outcome measures in clinical practice. Three overlapping themes related to (1) concepts of time, (2) knowledge, and (3) facility culture were indentified as factors influencing the use of outcome measures. A fourth encompassing theme, professionalism, identified the value placed on the use of outcome measures in practice. Data revealed that therapists require more information on the outcome measures available, and this information needs to be easily accessible within the workplace. Therapists value information generated by using outcome measures in the clinical setting, but need information on what measures are available and psychometric properties. Information must be easily accessible and measures easy to use. Newer graduates and recent learners have a foundation in the use of outcome measures, but more needs to be done in the clinic and through continuing education to promote increased use and understanding.

The Popularity of Outcome Measures for Hip and Knee Arthroplasties.

Science.gov (United States)

Lovelock, Thomas M; Broughton, Nigel S; Williams, Cylie M

2018-01-01

The optimal methods of determining outcomes following hip and knee arthroplasty remain controversial. The objectives of this study were to determine the most frequently used outcome measures in randomized controlled trials (RCT) and study protocols registered with clinical trials registries (CTR) on hip and knee arthroplasty. A systematic search strategy was undertaken to identify the outcome measures used in RCT and CTR following joint arthroplasty. Databases searched included Embase, Ovid MEDLINE (including In-Process), Cochrane Central Register of Controlled Trials, CINAHL Plus, clinicaltrials.gov, ISRCTN registry, and ANZCTR. Differences in the use of outcome measures between RCT and CTR were assessed using logistic regression. There were 291 RCT and 113 CTR on hip arthroplasty and 452 RCT and 184 CTR on knee arthroplasty that met the inclusion criteria. The most popular outcome measures were the Harris Hip Score and the Knee Society Score. Multiple outcome measures were used in greater than 50% of the included studies. The Oxford Hip Score, Oxford Knee Score, EuroQol-5D, and Knee Injury and Osteoarthritis Outcome Score (all P < .001) were used in significantly more CTR than RCT. There is a clear preference for the use of the Harris Hip Score and Knee Society Score, contrary to existing international guidelines and reviews on the topic. Both measures require clinician input, which potentially influences their validity and increases their overall administration cost. Some patient-reported outcome measures, such as the Oxford Hip and Knee Scores, EuroQol-5D, and KOOS, appear to be increasing in popularity. Copyright © 2017 Elsevier Inc. All rights reserved.

Scope and design of the Following Rehabilitation, Economics and Everyday-Dialysis Outcome Measurements (FREEDOM) Study.

Science.gov (United States)

Jaber, Bertrand L; Finkelstein, Fredric O; Glickman, Joel D; Hull, Alan R; Kraus, Michael A; Leypoldt, John K; Liu, Jiannong; Gilbertson, David; McCarthy, James; Miller, Brent W; Moran, John; Collins, Allan J

2009-02-01

Conventional thrice-weekly hemodialysis (HD) has limited the ability to generate further improvements in patient quality of life, morbidity, and mortality. Daily HD (DHD) offers the promise of providing clinical and economic benefits. The objectives of the Following Rehabilitation, Economics and Everyday-Dialysis Outcome Measurements Study are to evaluate outcomes of DHD (6 times/wk) with the NxStage System One (NxStage Medical Inc, Lawrence, MA) device. Cohort study with matched control group. The DHD group will include up to 500 participants at 70 clinical sites, enrolling for 3 years with a minimum of 1-year follow-up. Study candidates include adult patients (age >or= 18 years) with end-stage renal disease who are considered suitable candidates for DHD with the NxStage System One device by the treating physician and who have Medicare as their primary insurance payer. The control group will consist of a matched thrice-weekly in-center HD cohort derived from the US Renal Data System database using a 10:1 ratio, totaling 5,000 patients. Treatment with DHD and "standard of care" thrice-weekly HD. The primary intent-to-treat analysis compares hospitalization days/patient-year between the DHD and thrice-weekly HD groups. Other outcomes recorded in both groups include non-treatment-related medical expenditures. In addition, in the DHD cohort, changes in quality-of-life measures (baseline, 4 and 12 months, and every 6 months thereafter); urea kinetics; parameters related to anemia, bone and mineral metabolism, and nutrition; vascular access interventions; and use of medications will be examined. This study has the potential to elucidate the health and economic benefits of DHD and complement results of current clinical trials.

Measuring Inclusive Education Outcomes in Alberta, Canada

Science.gov (United States)

Loreman, Tim

2014-01-01

This study details the results of a review of the academic and public sector literature on measuring inclusive education in large systems. It highlights some outcomes drawn from the international literature on inclusion that might be indicative of the presence and quality of inclusive education in an effort to develop a set of outcomes for…

Questionnaires for Measuring Refractive Surgery Outcomes.

Science.gov (United States)

Kandel, Himal; Khadka, Jyoti; Lundström, Mats; Goggin, Michael; Pesudovs, Konrad

2017-06-01

To identify the questionnaires used to assess refractive surgery outcomes, assess the available questionnaires in regard to their psychometric properties, validity, and reliability, and evaluate the performance of the available questionnaires in measuring refractive surgery outcomes. An extensive literature search was done on PubMed, MEDLINE, Scopus, CINAHL, Cochrane, and Web of Science databases to identify articles that described or used at least one questionnaire to assess refractive surgery outcomes. The information on content quality, validity, reliability, responsiveness, and psychometric properties was extracted and analyzed based on an extensive set of quality criteria. Eighty-one articles describing 27 questionnaires (12 refractive error-specific, including 4 refractive surgery-specific, 7 vision-but-non-refractive, and 8 generic) were included in the review. Most articles (56, 69.1%) described refractive error-specific questionnaires. The Quality of Life Impact of Refractive Correction (QIRC), the Quality of Vision (QoV), and the Near Activity Visual Questionnaire (NAVQ) were originally constructed using Rasch analysis; others were developed using the Classical Test Theory. The National Eye Institute Refractive Quality of Life questionnaire was the most frequently used questionnaire, but it does not provide a valid measurement. The QoV, QIRC, and NAVQ are the three best existing questionnaires to assess visual symptoms, quality of life, and activity limitations, respectively. This review identified three superior quality questionnaires for measuring different aspects of quality of life in refractive surgery. Clinicians and researchers should choose a questionnaire based on the concept being measured with superior psychometric properties. [J Refract Surg. 2017;33(6):416-424.]. Copyright 2017, SLACK Incorporated.

Measuring Patient-Reported Outcomes: Key Metrics in Reconstructive Surgery.

Science.gov (United States)

Voineskos, Sophocles H; Nelson, Jonas A; Klassen, Anne F; Pusic, Andrea L

2018-01-29

Satisfaction and improved quality of life are among the most important outcomes for patients undergoing plastic and reconstructive surgery for a variety of diseases and conditions. Patient-reported outcome measures (PROMs) are essential tools for evaluating the benefits of newly developed surgical techniques. Modern PROMs are being developed with new psychometric approaches, such as Rasch Measurement Theory, and their measurement properties (validity, reliability, responsiveness) are rigorously tested. These advances have resulted in the availability of PROMs that provide clinically meaningful data and effectively measure functional as well as psychosocial outcomes. This article guides the reader through the steps of creating a PROM and highlights the potential research and clinical uses of such instruments. Limitations of PROMs and anticipated future directions in this field are discussed.

Effect of diabetes on tuberculosis presentation and outcomes in Kiribati.

Science.gov (United States)

Cavanaugh, J; Viney, K; Kienene, T; Harley, D; Kelly, P M; Sleigh, A; O'Connor, J; Mase, S

2015-05-01

To determine the association between diabetes and the clinical features and treatment outcomes of TB in Kiribati. We enrolled consecutive patients with TB who presented from August 2010 to February 2012 and compared clinical features and TB treatment outcomes for patients with and without diabetes, as measured by haemoglobin A1c assay. Poor outcome was defined as death, default or treatment failure, and good outcome as treatment success or cure. Two hundred and seventy-five eligible persons with TB disease were enrolled; 101 (37%) had diabetes. TB patients with diabetes were more likely to have acid-fast bacilli (AFB) seen on sputum smear microscopy (RR: 1.3; 95% CI: 1.03-1.62). The risk of poor outcome did not differ between patients with or without diabetes (RR: 1.1; 95% CI: 0.5-2.7). TB patients with diabetes are more likely than those without to have sputum with AFB on microscopy. This could increase transmission in the community. Early detection of TB by screening patients with diabetes, and the converse, could be important public health interventions where diabetes and TB are prevalent. © 2015 John Wiley & Sons Ltd.

Outcomes assessment in rotator cuff pathology: what are we measuring?

Science.gov (United States)

Makhni, Eric C; Steinhaus, Michael E; Morrow, Zachary S; Jobin, Charles M; Verma, Nikhil N; Cole, Brian J; Bach, Bernard R

2015-12-01

Assessments used to measure outcomes associated with rotator cuff pathology and after repair are varied. This lack of standardization leads to difficulty drawing comparisons across studies. We hypothesize that this variability in patient-reported outcome measures and objective metrics used in rotator cuff studies persists even in high-impact, peer reviewed journals. All studies assessing rotator cuff tear and repair outcomes in 6 orthopedic journals with a high impact factor from January 2010 to December 2014 were reviewed. Cadaveric and animal studies and those without outcomes were excluded. Outcome measures included range of motion (forward elevation, abduction, external rotation, and internal rotation), strength (in the same 4 planes), tendon integrity imaging, patient satisfaction, and functional assessment scores. Of the 156 included studies, 63% documented range of motion measurements, with 18% reporting range of motion in all 4 planes. Only 38% of studies reported quantitative strength measurements. In 65% of studies, tendon integrity was documented with imaging (38% magnetic resonance imaging/magnetic resonance anrhrogram, 31% ultrasound, and 8% computed tomography arthrogram). Finally, functional score reporting varied significantly, with the 5 most frequently reported scores ranging from 16% to 61% in studies, and 15 of the least reported outcomes were each reported in ≤6% of studies. Significant variability exists in outcomes reporting after rotator cuff tear and repair, making comparisons between clinical studies difficult. Creating a uniformly accepted, validated outcomes tool that assesses pain, function, patient satisfaction, and anatomic integrity would enable consistent outcomes assessment after operative and nonoperative management and allow comparisons across the literature. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Goodbye to Summer Vacation? The Effects of Summer Enrollment on College and Employment Outcomes. A CAPSEE Working Paper

Science.gov (United States)

Liu, Vivian Yuen Ting

2016-01-01

Despite rich evidence on the benefit of summer enrollment at the K-12 level, the college completion literature has so far focused on college readiness, remediation, and financial aid, and has largely overlooked the potential benefits of taking summer courses among college students. Academic momentum theory suggests that summer enrollment may…

Measuring Quality and Outcomes in Sports Medicine.

Science.gov (United States)

Ruzbarsky, Joseph J; Marom, Niv; Marx, Robert G

2018-07-01

Patient-reported outcome measures (PROMs) are objective metrics critical to evaluating outcomes throughout orthopedic surgery. New instruments continue to emerge, increasing the breadth of information required for those intending to use these measures for research or clinical care. Although earlier metrics were developed using the principles of classic test theory, newer instruments constructed using item response theory are amenable to computer-adaptive testing and may change the way these instruments are administered. This article aims to define the psychometric properties that are important to understand when using all PROMs and to review the most widely used instruments in sports medicine. Copyright © 2018 Elsevier Inc. All rights reserved.

Culturally Sensitive and Environment-Friendly Outcome Measures in

African Journals Online (AJOL)

Dr Olaleye

to review research studies on outcome measures that were developed for ... A systematic review of evidence on culturally sensitive and environment- ... Various databases including Google Scholar, PEDro and PubMed were accessed to search for relevant empirical ... utilization of disease-specific, patient-centered outcome.

An Analysis of a Biometric Screening and Premium Incentive-Based Employee Wellness Program: Enrollment Patterns, Cost, and Outcome.

Science.gov (United States)

Maeng, Daniel D; Geng, Zhi; Marshall, Wendy M; Hess, Allison L; Tomcavage, Janet F

2017-11-14

Since 2012, a large health care system has offered an employee wellness program providing premium discounts for those who voluntarily undergo biometric screenings and meet goals. This study evaluates the program impact on care utilization and total cost of care, taking into account employee self-selection into the program. A retrospective claims data analysis of 6453 employees between 2011 and 2015 was conducted, categorizing the sample into 3 mutually exclusive subgroups: Subgroup 1 enrolled and met goals in all years, Subgroup 2 enrolled or met goals in some years but not all, and Subgroup 3 never enrolled. Each subgroup was compared to a cohort of employees in other employer groups (N = 24,061). Using a difference-in-difference method, significant reductions in total medical cost (14.2%; P = 0.014) and emergency department (ED) visits (11.2%; P = 0.058) were observed only among Subgroup 2 in 2015. No significant impact was detected among those in Subgroup 1. Those in Subgroup 1 were less likely to have chronic conditions at baseline. The results indicate that the wellness program enrollment was characterized by self-selection of healthier employees, among whom the program appeared to have no significant impact. Yet, cost savings and reductions in ED visits were observed among the subset of employees who enrolled or met goal in some years but not all, suggesting a potential link between the wellness program and positive behavior changes among certain subsets of the employee population.

Outcome Measures for Clinical Trials in Down Syndrome.

Science.gov (United States)

Esbensen, Anna J; Hooper, Stephen R; Fidler, Deborah; Hartley, Sigan L; Edgin, Jamie; d'Ardhuy, Xavier Liogier; Capone, George; Conners, Frances A; Mervis, Carolyn B; Abbeduto, Leonard; Rafii, Michael; Krinsky-McHale, Sharon J; Urv, Tiina

2017-05-01

Increasingly individuals with intellectual and developmental disabilities, including Down syndrome, are being targeted for clinical trials. However, a challenge exists in effectively evaluating the outcomes of these new pharmacological interventions. Few empirically evaluated, psychometrically sound outcome measures appropriate for use in clinical trials with individuals with Down syndrome have been identified. To address this challenge, the National Institutes of Health (NIH) assembled leading clinicians and scientists to review existing measures and identify those that currently are appropriate for trials; those that may be appropriate after expansion of age range addition of easier items, and/or downward extension of psychometric norms; and areas where new measures need to be developed. This article focuses on measures in the areas of cognition and behavior.

Communication partner training of enrolled nurses working in nursing homes with people with communication disorders caused by stroke or Parkinson's disease.

Science.gov (United States)

Eriksson, Karin; Forsgren, Emma; Hartelius, Lena; Saldert, Charlotta

2016-01-01

To evaluate the effect of a communication partner training programme directed to enrolled nurses working with people with communication disorders in nursing homes, using an individualised approach. Five dyads consisting of a person with stroke-induced aphasia (n = 4) or Parkinson's disease (PD) (n = 1) living in different nursing homes and his/her enrolled nurse participated in the study, which had a replicated single-subject design with multiple baselines across individuals. The main element of the intervention was supervised analysis of video-recorded natural interaction in everyday nursing situations and the formulation of individual goals to change particular communicative strategies. Outcome was measured via blinded assessments of filmed natural interaction obtained at baseline, intervention and follow-up and showed an increased use of the target communicative strategies. Subjective measures of goal attainment by the enrolled nurses were consistent with these results. Measures of perceived functional communication on behalf of the persons with communication disorders were mostly positive; four of five participants with communication disorders and two of five enrolled nurses reported improved functional communication after intervention. The use of an individualised communication partner training programme led to significant changes in natural interaction, which contributes importantly to a growing body of knowledge regarding communication partner training. Communication partner training can improve the communicative environment of people with communication disorders. For people with communication disorders who live in institutions, the main conversation partner is likely to be a professional caretaker. An individualised approach for communication partner training that focussed on specific communication patterns was successful in increasing the use of supportive strategies that enrolled nurses used in natural interaction with persons with communication disorders

Understanding paediatric rehabilitation therapists' lack of use of outcome measures.

Science.gov (United States)

King, Gillian; Wright, Virginia; Russell, Dianne J

2011-01-01

Despite widespread educational and promotional efforts, paediatric rehabilitation therapists still do not systematically or routinely use outcome measures. A review of contextual and psychosocial factors affecting therapists' use of outcome measures was performed, incorporating information from past studies of barriers to therapists' use of measures and more recent information about measure use, knowledge brokering and expert practice. This cumulative and contextual overview provided insights into how many therapists may approach practice. Therapists' beliefs in the importance of establishing effective relationships may lead them to place less value on formal measurement, to adopt a less rigorous and more pragmatic approach to ascertaining whether outcomes are achieved, and to avoid measures that may show little improvement. A relational goal-oriented approach to practice is proposed in which therapists adopt a broader facilitative and educational role with families about the importance of the measurement process.

Measuring Outcomes for Children Late Placed for Adoption.

Science.gov (United States)

Rushton, Alan

1998-01-01

Describes the selection of outcome measures used by the Maudsley Family Research team to assess outcomes--across a broad range of developmental dimensions--of permanent placement for children and adolescents. Developed a package of instruments to examine child emotional, cognitive, social, and academic development; attachment; and self-esteem, for…

Identifying an outcome measure to assess the impact of Mobility Dogs.

Science.gov (United States)

Mudge, Suzie; Rewi, Dallas; Channon, Alexis

2017-01-01

Mobility Dogs® trains dogs to work with people with physical disabilities to increase independence, confidence, self-esteem and participation. Mobility Dogs® seeks to critically evaluate and improve its services as it grows. This study aimed to identify and implement a standardised outcome measure into practice at Mobility Dogs®. Based on the Consolidated Framework for Implementation Research and guided by a steering group of key stakeholders, a three-phase approach was developed to identify and assess an outcome measure. The steering group highlighted the organisation's specific needs, selected participation as the assessment domain and identified core utility requirements of the measure. A comprehensive review of evidence was undertaken to identify and rank potential measures according to the specified needs. Of the seven participation outcome measures that met inclusion criteria, the three highest ranked measures were critically evaluated by the steering group to determine suitability against the organisation's needs. The Impact on Participation and Autonomy (IPA) was selected for implementation into practice at Mobility Dogs®. Use of the IPA is an important first step for Mobility Dogs® to test the benefits of trained service dogs. This process could be replicated by other service dog organisations to identify outcome measures to assess their own services. Implications for Rehabilitation Service dogs (such as Mobility Dogs® in New Zealand) assist people living with physical impairments by performing tasks, however there is limited evidence on outcomes. The process for selecting an appropriate outcome measure for Mobility Dogs® involving partnership between Mobility Dogs® personnel and academics was an effective way to steer the project by determining important properties of the measure, before a search of the literature was undertaken. While the IPA was selected as the most appropriate outcome measure for use at Mobility Dogs®, it was the process that

Dual Enrollment for High School Students

Science.gov (United States)

Edwards, Linsey; Hughes, Katherine

2011-01-01

Dual enrollment programs allow high school students to enroll in college courses and potentially earn college credit. The term concurrent enrollment is sometimes used interchangeably with dual enrollment, and sometimes to refer to a particular model of dual enrollment. In some programs, students earn high school and college credit simultaneously;…

Measuring Gender inequality and equality in education

OpenAIRE

Unterhalter, E. S.

2015-01-01

Since 1995, considerable expertise has built up in measuring aspects of gender inequality and equality, and in researching these in education, particularly formal schooling. Existing international and national measures used for reporting on gender in formal schooling chart gender parity in school enrolment, attendance, progression, and learning outcomes. Gender parity measures the number of girls as a proportion of the number of boys. This measure generates some insights regard...

Measuring Learning Outcomes in Auditing Education

DEFF Research Database (Denmark)

Holm, Claus; Steenholdt, Niels

The ability to provide sensible measures for learning outcomes in accounting education is under increased scrutiny. In this paper we use a learner perspective in auditing education, which reflects that some students taking accounting classes also are provided with on-the-job training in accountin...

42 CFR 423.32 - Enrollment process.

Science.gov (United States)

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Enrollment process. 423.32 Section 423.32 Public... Enrollment process. (a) General rule. A Part D eligible individual who wishes to enroll in a PDP may enroll... approved by CMS. (c) Timely process an individual's enrollment request. A PDP sponsor must timely process...

Measuring outcomes in adult spinal deformity surgery: a systematic review to identify current strengths, weaknesses and gaps in patient-reported outcome measures.

Science.gov (United States)

Faraj, Sayf S A; van Hooff, Miranda L; Holewijn, Roderick M; Polly, David W; Haanstra, Tsjitske M; de Kleuver, Marinus

2017-08-01

Adult spinal deformity (ASD) causes severe disability, reduces overall quality of life, and results in a substantial societal burden of disease. As healthcare is becoming more value based, and to facilitate global benchmarking, it is critical to identify and standardize patient-reported outcome measures (PROMs). This study aims to identify the current strengths, weaknesses, and gaps in PROMs used for ASD. Studies were included following a systematic search in multiple bibliographic databases between 2000 and 2015. PROMs were extracted and linked to the outcome domains of WHO's International Classification of Functioning and Health (ICF) framework. Subsequently, the clinimetric quality of identified PROMs was evaluated. The literature search identified 144 papers that met the inclusion criteria, and nine frequently used PROMs were identified. These covered 29 ICF outcome domains, which could be grouped into three of the four main ICF chapters: body function (n = 7), activity and participation (n = 19), environmental factors (n = 3), and body structure (n = 0). A low quantity (n = 3) of papers was identified that studied the clinimetric quality of PROMs. The Scoliosis Research Society (SRS)-22 has the highest level of clinimetric quality for ASD. Outcome domains related to mobility and pain were well represented. We identified a gap in current outcome measures regarding neurological and pulmonary function. In addition, no outcome domains were measured in the ICF chapter body structure. These results will serve as a foundation for the process of seeking international consensus on a standard set of outcome domains, accompanied PROMs and contributing factors to be used in future clinical trials and spine registries.

Medicaid Enrollment Gap Length and Number of Medicaid Enrollment Periods Among US Children

Science.gov (United States)

Schoendorf, Kenneth C.

2014-01-01

Objectives. We examined gap length, characteristics associated with gap length, and number of enrollment periods among Medicaid-enrolled children in the United States. Methods. We linked the 2004 National Health Interview Survey to Medicaid Analytic eXtract files for 1999 through 2008. We examined linkage-eligible children aged 5 to 13 years in the 2004 National Health Interview Survey who disenrolled from Medicaid. We generated Kaplan-Meier curves of time to reenrollment. We used Cox proportional hazards models to assess the effect of sociodemographic variables on time to reenrollment. We compared the percentage of children enrolled 4 or more times across sociodemographic groups. Results. Of children who disenrolled from Medicaid, 35.8%, 47.1%, 63.5%, 70.8%, and 79.1% of children had reenrolled in Medicaid by 6 months, 1, 3, 5, and 10 years, respectively. Children who were younger, poorer, or of minority race/ethnicity or had lower educated parents had shorter gaps in Medicaid and were more likely to have had 4 or more Medicaid enrollment periods. Conclusions. Nearly half of US children who disenrolled from Medicaid reenrolled within 1 year. Children with traditionally high-risk demographic characteristics had shorter gaps in Medicaid enrollment and were more likely to have more periods of Medicaid enrollment. PMID:25033135

Effects of Social Class and School Conditions on Educational Enrollment and Achievement of Boys and Girls in Rural Viet Nam

Science.gov (United States)

Nguyen, Phuong L.

2006-01-01

This study examines the effects of parental SES, school quality, and community factors on children's enrollment and achievement in rural areas in Viet Nam, using logistic regression and ordered logistic regression. Multivariate analysis reveals significant differences in educational enrollment and outcomes by level of household expenditures and…

Patient reported outcome measures (PROMs)

DEFF Research Database (Denmark)

Bech, Per; Austin, Stephen Fitzgerald; Lau, Marianne Engelbrecht

2018-01-01

INTRODUCTION: Patient-reported outcome measures (PROMs) for anxiety and depressive disorders are an important aspect of measurement-based care. AIM: The aim of the study was to perform a clinimetric analysis of two PROMs scales in patents with depression and anxiety. METHODS: Patients completed...... recruited from two Danish mental health centers with anxiety or depression. The standardization of the SCL-10 and WHO-5 by T-scores indicated that a T-score of 65 corresponding to being moderately in need of treatment and a T-score of 75 to be severely in need of treatment. The coefficient of alpha...... with anxiety or depression undergoing psychotherapy treatment....

2013 Annual Survey of Journalism Mass Communication Enrollments: Enrollments Decline for Third Consecutive Year

Science.gov (United States)

Becker, Lee Bernard; Vlad, Tudor; Simpson, Holly Anne

2014-01-01

Enrollments in journalism and mass communication programs in the United States in the fall of 2013 were down from a year earlier for the third year in a row. Enrollments dropped at the bachelor's, master's, and doctoral levels, and the number of freshmen and sophomores were down dramatically from a year earlier. Enrollments in the…

From Intent to Enrollment, Attendance, and Participation in Preventive Parenting Groups

Science.gov (United States)

Dumas, Jean E.; Nissley-Tsiopinis, Jenelle; Moreland, Angela D.

2007-01-01

Applying the Theory of Planned Behavior (TPB) to the process of engagement in preventive parenting groups, we tested the ability of family and child measures to predict intent to enroll, enrollment, attendance, and quality of participation in PACE (Parenting Our Children to Excellence). PACE is a prevention trial testing the efficacy of a…

Measurement properties of patient-reported outcome measures (PROMS) in Patellofemoral Pain Syndrome: a systematic review.

Science.gov (United States)

Green, Andrew; Liles, Clive; Rushton, Alison; Kyte, Derek G

2014-12-01

This systematic review investigated the measurement properties of disease-specific patient-reported outcome measures used in Patellofemoral Pain Syndrome. Two independent reviewers conducted a systematic search of key databases (MEDLINE, EMBASE, AMED, CINHAL+ and the Cochrane Library from inception to August 2013) to identify relevant studies. A third reviewer mediated in the event of disagreement. Methodological quality was evaluated using the validated COSMIN (Consensus-based Standards for the Selection of Health Measurement Instruments) tool. Data synthesis across studies determined the level of evidence for each patient-reported outcome measure. The search strategy returned 2177 citations. Following the eligibility review phase, seven studies, evaluating twelve different patient-reported outcome measures, met inclusion criteria. A 'moderate' level of evidence supported the structural validity of several measures: the Flandry Questionnaire, Anterior Knee Pain Scale, Functional Index Questionnaire, Eng and Pierrynowski Questionnaire and Visual Analogue Scales for 'usual' and 'worst' pain. In addition, there was a 'Limited' level of evidence supporting the test-retest reliability and validity (cross-cultural, hypothesis testing) of the Persian version of the Anterior Knee Pain Scale. Other measurement properties were evaluated with poor methodological quality, and many properties were not evaluated in any of the included papers. Current disease-specific outcome measures for Patellofemoral Pain Syndrome require further investigation. Future studies should evaluate all important measurement properties, utilising an appropriate framework such as COSMIN to guide study design, to facilitate optimal methodological quality. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effect of analgesic therapy on clinical outcome measures in a randomized controlled trial using client-owned dogs with hip osteoarthritis

Directory of Open Access Journals (Sweden)

Malek Sarah

2012-10-01

Full Text Available Abstract Background Pain and impaired mobility because of osteoarthritis (OA is common in dogs and humans. Efficacy studies of analgesic drug treatment of dogs with naturally occurring OA may be challenging, as a caregiver placebo effect is typically evident. However, little is known about effect sizes of common outcome-measures in canine clinical trials evaluating treatment of OA pain. Forty-nine client-owned dogs with hip OA were enrolled in a randomized, double-blinded placebo-controlled prospective trial. After a 1 week baseline period, dogs were randomly assigned to a treatment (ABT-116 – transient receptor potential vanilloid 1 (TRPV1 antagonist, Carprofen – non-steroidal anti-inflammatory drug (NSAID, Tramadol - synthetic opiate, or Placebo for 2 weeks. Outcome-measures included physical examination parameters, owner questionnaire, activity monitoring, gait analysis, and use of rescue medication. Results Acute hyperthermia developed after ABT-116 treatment (P P ≤ 0.01 and tramadol (P ≤ 0.001 led to improved mobility assessed by owner questionnaire. Nighttime activity was increased after ABT-116 treatment (P = 0.01. Kinetic gait analysis did not reveal significant treatment effects. Use of rescue treatment decreased with treatment in the ABT-116 and Carprofen groups (P R ≥ ±0.40, P ≤ 0.005. Placebo treatment effects were evident with all variables studied. Conclusion Treatment of hip OA in client-owned dogs is associated with a placebo effect for all variables that are commonly used for efficacy studies of analgesic drugs. This likely reflects caregiver bias or the phenomenon of regression to the mean. In the present study, outcome measures with significant effects also varied between groups, highlighting the value of using multiple outcome measures, as well as an a priori analysis of effect size associated with each measure. Effect size data from the present study could be used to inform design of future trials studying

Issues in the definition and measurement of drinking outcomes in alcoholism treatment research.

Science.gov (United States)

Babor, T F; Longabaugh, R; Zweben, A; Fuller, R K; Stout, R L; Anton, R F; Randall, C L

1994-12-01

This article reviews methodological and conceptual issues regarding the choice of drinking outcome measures in alcoholism treatment research. The following issues are discussed: Should drinking outcomes be conceptualized in terms of an underlying unitary disorder, or should provision be made for independent outcomes that cover a wide variety of dimensions? Which drinking outcomes are typically measured in treatment evaluation studies and how are they operationalized? What are the empirical associations among drinking outcome measures? If multiple outcomes are measured, which should be given primary importance? Over what period of time should treatment outcome be evaluated? What procedures can be used to detect, correct or prevent the response bias associated with verbal report methods? Because outcome measures need to fit the hypotheses and practical needs of a particular study, it is unlikely that complete standardization can be achieved across all studies. Nevertheless, given the importance of drinking outcomes and the need for economy, two primary dependent measures are recommended: (1) proportion of available drinking days abstinent; and (2) intensity of drinking, as defined by the total amount consumed (in ounces absolute alcohol) during the follow-up period divided by the number of actual drinking days. This article also proposes a strategy that may help to guide the selection of outcome measures in future research.

Redefining Outcome Measurement: A Model for Brief Psychotherapy.

Science.gov (United States)

McGuinty, Everett; Nelson, John; Carlson, Alain; Crowther, Eric; Bednar, Dina; Foroughe, Mirisse

2016-05-01

The zeitgeist for short-term psychotherapy efficacy has fundamentally shifted away from evidence-based practices to include evidence-informed practices, resulting in an equally important paradigm shift in outcome measurement designed to reflect change in this short-term modality. The present article delineates a short-term psychotherapy structure which defines four fundamental stages that all brief therapies may have in common, and are represented through Cognitive Behavioral Therapy, Solution-Focused Brief Therapy, Narrative Therapy, and Emotion-Focused Therapy. These four theoretical approaches were analyzed via a selected literature review through comparing and contrasting specific and common tasks as they relate to the process of psychotherapy and change. Once commonalities were identified within session, they were categorized or grouped into themes or general stages of change within the parameters of a four to six session model of short-term therapy. Commonalities in therapeutic stages of change may more accurately and uniformly measure outcome in short-term work, unlike the symptom-specific psychometric instruments of longer-term psychotherapy. A systematic framework for evaluating the client and clinician adherence to 20 specific tasks for these four short-term therapies is presented through the newly proposed, Brief Task Acquisition Scale (BTAS). It is further proposed that the client-clinicians' adherence to these tasks will track and ultimately increase treatment integrity. Thus, when the client-clinician relationship tracks and evaluates the three pillars of (1) stage/process change, (2) task acquisition, and (3) treatment integrity, the culmination of these efforts presents a new way of more sensitively measuring outcome in short-term psychotherapy. Data collection is suggested as a first step to empirically evaluate the testable hypotheses suggested within this current model. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message The

Exploring the comparative responsiveness of a core set of outcome measures in a school-based conductive education programme.

Science.gov (United States)

Wright, F V; Boschen, K; Jutai, J

2005-05-01

Conductive education (CE) is a holistic educational system that uses an active cognitive approach to teach individuals with motor disorders to become more functional participants in daily activities. While CE's popularity continues to grow in North America and Europe, its effectiveness has not been established. The lack of definition of responsive outcome measures for evaluation of CE programmes has limited the interpretability of conclusions from earlier studies evaluating effectiveness. To determine which measures from a core set were most responsive to physical, functional and psychosocial changes associated with a school-based CE programme. This was a one-group before and after data collection design using an 8-month follow-up period. We enrolled a referral sample of nine children with cerebral palsy in Kindergarten or Grade 1 (Gross Motor Function Classification System levels 3, 4 or 5). The study took place within a school-based CE programme at a Canadian children's rehabilitation centre. Children participated in a CE full-day class for an entire school year. Physical, functional, psychosocial and participation measures included: Gross Motor Function Measure (GMFM), Quality of Upper Extremity Skills Test (QUEST), Peabody Developmental Motor Scales, Paediatric Evaluation of Disability Inventory (PEDI), Pictorial Scale of Perceived Competence and Social Acceptance for Young Children, Individualized Educational Plan, and Goal Attainment Scaling (GAS). Four children from the study's second year were also evaluated on the Impact on Family Scale (IFS), GAS and School Function Assessment. The Gross Motor Function Measure, QUEST, PEDI (Caregiver Assistance) and IFS were most responsive to change. GAS was useful in documenting and quantifying goals. Problems were encountered in evaluating self-esteem and school participation. Several strong measures of outcome were identified. Further work is needed to find valid and sensitive psychosocial and school participation

A cluster-randomized trial assessing the impact of school water, sanitation, and hygiene improvements on pupil enrollment and gender parity in enrollment.

Science.gov (United States)

Garn, Joshua V; Greene, Leslie E; Dreibelbis, Robert; Saboori, Shadi; Rheingans, Richard D; Freeman, Matthew C

2013-10-01

We employed a cluster randomized trial design to measure the impact of a school based water, sanitation, and hygiene (WASH) improvement on pupil enrollment and on gender parity in enrollment, in primary schools in Nyanza Province, Kenya (2007-2009). Among schools with poor water access during the dry season, those that received a water supply, hygiene promotion and water treatment (HP&WT) and sanitation improvement, demonstrated increased enrollment (β=0.091 [0.009, 0.173] p=0.03), which translates to 26 additional pupils per school on average. The proportion of girls enrolled in school also increased by 4% (prevalence ratio (PR)=1.04 [1.00, 1.07] p=0.02). Among schools with better baseline water access during the dry season (schools that didn't receive a water source), we found no evidence of increased enrollment in schools that received a HP&WT intervention (β=0.016 [-0.039, 0.072] p=0.56) or the HP&WT and sanitation intervention (β=0.027 [-0.028, 0.082]p=0.34), and there was no evidence of improved gender parity (PR=0.99 [0.96, 1.02] p=0.59, PR=1.00 [0.97, 1.02] p=0.75, respectively). Our findings suggest that increased school enrollment and improved gender parity may be influenced by a comprehensive WASH program that includes an improved water source; schools with poor water access during the dry season may benefit most from these interventions.

Evaluating complementary and alternative medicine interventions: in search of appropriate patient-centered outcome measures

Directory of Open Access Journals (Sweden)

Mallory Devon

2006-11-01

Full Text Available Abstract Background Central to the development of a sound evidence base for Complementary and Alternative Medicine (CAM interventions is the need for valid, reliable and relevant outcome measures to assess whether the interventions work. We assessed the specific needs for a database that would cover a wide range of outcomes measures for CAM research and considered a framework for such a database. Methods The study was a survey of CAM researchers, practitioners and students. An online questionnaire was emailed to the members of the Canadian Interdisciplinary Network for CAM Research (IN-CAM and the CAM Education and Research Network of Alberta (CAMera. The majority of survey questions were open-ended and asked about outcome measures currently used, outcome measures' assessment criteria, sources of information, perceived barriers to finding outcome measures and outcome domains of importance. Descriptive quantitative analysis and qualitative content analysis were used. Results One hundred and sixty-four completed surveys were received. Of these, 62 respondents reported using outcome measures in their CAM research and identified 92 different specific outcomes. The most important barriers were the fact that, for many health concepts, outcome measures do not yet exist, as well as issues related to accessibility of instruments. Important outcome domains identified included physical, psychological, social, spiritual, quality of life and holistic measures. Participants also mentioned the importance of individualized measures that assess unique patient-centered outcomes for each research participant, and measures to assess the context of healing and the process of healing. Conclusion We have developed a preliminary framework that includes all components of health-related outcomes. The framework provides a foundation for a larger, comprehensive collection of CAM outcomes. It fits very well in a whole systems perspective, which requires an expanded set of

Ancillary outcome measures for assessment of individuals with cervical spondylotic myelopathy.

Science.gov (United States)

Kalsi-Ryan, Sukhvinder; Singh, Anoushka; Massicotte, Eric M; Arnold, Paul M; Brodke, Darrel S; Norvell, Daniel C; Hermsmeyer, Jeffrey T; Fehlings, Michael G

2013-10-15

Narrative review. To identify suitable outcome measures that can be used to quantify neurological and functional impairment in the management of cervical spondylotic myelopathy (CSM). CSM is the leading cause of acquired spinal cord disability, causing varying degrees of neurological impairment which impact on independence and quality of life. Because this impairment can have a heterogeneous presentation, a single outcome measure cannot define the broad range of deficits seen in this population. Therefore, it is necessary to define outcome measures that characterize the deficits with greater validity and sensitivity. This review was conducted in 3 stages. Stage I: To evaluate the current use of outcome measures in CSM, PubMed was searched using the name of the outcome measure and the common abbreviation combined with "CSM" or "myelopathy." Stage II: Having identified a lack of appropriate outcome measures, we constructed criteria by which measures appropriate for assessing the various aspects of CSM could be identified. Stage III: A second literature search was then conducted looking at specified outcomes that met these criteria. All literature was reviewed to determine specificity and psychometric properties of outcomes for CSM. Nurick grade, modified Japanese Orthopaedic Association Scale, visual analogue scale (VAS) for pain, Short Form (36) Health Survey (SF-36), and Neck Disability Index were the most commonly cited measures. The Short-Form 36 Health Survey and Myelopathy Disability Index have been validated in the CSM population with multiple studies, whereas the modified Japanese Orthopaedic Association Scale score, Nurick grade, and European Myelopathy Scale each had only one study assessing psychometric characteristics. No validity, reliability, or responsiveness studies were found for the VAS or Neck Disability Index in the CSM population. We recommend that the modified Japanese Orthopaedic Association Scale, Nurick grade, Myelopathy Disability Index

42 CFR 417.540 - Enrollment costs.

Science.gov (United States)

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Enrollment costs. 417.540 Section 417.540 Public... PLANS Medicare Payment: Cost Basis § 417.540 Enrollment costs. (a) Principle. Enrollment costs are... of costs included. Enrollment costs include, but are not limited to, reasonable costs incurred in...

Auditory development in early amplified children: factors influencing auditory-based communication outcomes in children with hearing loss.

Science.gov (United States)

Sininger, Yvonne S; Grimes, Alison; Christensen, Elizabeth

2010-04-01

The purpose of this study was to determine the influence of selected predictive factors, primarily age at fitting of amplification and degree of hearing loss, on auditory-based outcomes in young children with bilateral sensorineural hearing loss. Forty-four infants and toddlers, first identified with mild to profound bilateral hearing loss, who were being fitted with amplification were enrolled in the study and followed longitudinally. Subjects were otherwise typically developing with no evidence of cognitive, motor, or visual impairment. A variety of subject factors were measured or documented and used as predictor variables, including age at fitting of amplification, degree of hearing loss in the better hearing ear, cochlear implant status, intensity of oral education, parent-child interaction, and the number of languages spoken in the home. These factors were used in a linear multiple regression analysis to assess their contribution to auditory-based communication outcomes. Five outcome measures, evaluated at regular intervals in children starting at age 3, included measures of speech perception (Pediatric Speech Intelligibility and Online Imitative Test of Speech Pattern Contrast Perception), speech production (Arizona-3), and spoken language (Reynell Expressive and Receptive Language). The age at fitting of amplification ranged from 1 to 72 mo, and the degree of hearing loss ranged from mild to profound. Age at fitting of amplification showed the largest influence and was a significant factor in all outcome models. The degree of hearing loss was an important factor in the modeling of speech production and spoken language outcomes. Cochlear implant use was the other factor that contributed significantly to speech perception, speech production, and language outcomes. Other factors contributed sparsely to the models. Prospective longitudinal studies of children are important to establish relationships between subject factors and outcomes. This study clearly

Patient-Oriented Eczema Measure (POEM), a core instrument to measure symptoms in clinical trials: a Harmonising Outcome Measures for Eczema (HOME) statement

NARCIS (Netherlands)

Spuls, P. I.; Gerbens, L. A. A.; Simpson, E.; Apfelbacher, C. J.; Chalmers, J. R.; Thomas, K. S.; Prinsen, C. A. C.; von Kobyletzki, L. B.; Singh, J. A.; Williams, H. C.; Schmitt, J.

2017-01-01

The Harmonising Outcome Measures for Eczema (HOME) initiative has defined four core outcome domains for a core outcome set (COS) to be measured in all atopic eczema (AE) trials to ensure cross-trial comparison: clinical signs, symptoms, quality of life and long-term control. The aim of this paper is

Measuring outcomes in psychiatry: an inpatient model.

Science.gov (United States)

Davis, D E; Fong, M L

1996-02-01

This article describes a system for measuring outcomes recently implemented in the department of psychiatry of Baptist Memorial Hospital, a 78-bed inpatient and day treatment unit that represents one service line of a large, urban teaching hospital in Memphis. In June 1993 Baptist Hospital began a 15-month pilot test of PsychSentinel, a measurement tool developed by researchers in the Department of Community Medicine at the University of Connecticut. The hospital identified the following four primary goals for this pilot project: provide data for internal hospital program evaluation, provide data for external marketing in a managed care environment, satisfy requirements of the Joint Commission on Accreditation of Health Care Organizations, and generate studies that add to the literature in psychiatry and psychology. PsychSentinel is based on the standardized diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). The outcome measure assesses the change in the number of symptoms of psychopathology that occurs between admission and discharge from the hospital. Included in the nonproprietary system are risk adjustment factors, as well as access to a national reference database for comparative analysis purposes. Data collection can be done by trained ancillary staff members, with as much or as little direct physician involvement as desired. The system has proven to be both time effective and cost effective, and it provides important outcome information both at the program level and at the clinician level. After the pilot test, the staff at Baptist Memorial Hospital determined that the system met all initial objectives identified and recently adopted the system as an ongoing measure of quality patient care in the department of psychiatry.

Effect of analgesic therapy on clinical outcome measures in a randomized controlled trial using client-owned dogs with hip osteoarthritis

Science.gov (United States)

2012-01-01

Background Pain and impaired mobility because of osteoarthritis (OA) is common in dogs and humans. Efficacy studies of analgesic drug treatment of dogs with naturally occurring OA may be challenging, as a caregiver placebo effect is typically evident. However, little is known about effect sizes of common outcome-measures in canine clinical trials evaluating treatment of OA pain. Forty-nine client-owned dogs with hip OA were enrolled in a randomized, double-blinded placebo-controlled prospective trial. After a 1 week baseline period, dogs were randomly assigned to a treatment (ABT-116 – transient receptor potential vanilloid 1 (TRPV1) antagonist, Carprofen – non-steroidal anti-inflammatory drug (NSAID), Tramadol - synthetic opiate, or Placebo) for 2 weeks. Outcome-measures included physical examination parameters, owner questionnaire, activity monitoring, gait analysis, and use of rescue medication. Results Acute hyperthermia developed after ABT-116 treatment (P carprofen (P ≤ 0.01) and tramadol (P ≤ 0.001) led to improved mobility assessed by owner questionnaire. Nighttime activity was increased after ABT-116 treatment (P = 0.01). Kinetic gait analysis did not reveal significant treatment effects. Use of rescue treatment decreased with treatment in the ABT-116 and Carprofen groups (P carprofen or tramadol for treatment of hip arthritis pain in client-owned dogs. PMID:23035739

Enrollment Management Strategies at Four-Year Open Enrollment Institutions of Higher Education

Science.gov (United States)

Santoro, Dana S.

2017-01-01

Enrollment management plans have been researched and documented for the last fifty years and literature verifies that the use of these plans has only become more relevant in the 21st century. Strategies and activities for managing enrollment have been defined and shared for most types of institutions, however, there is limited research on the best…

Dual Enrollment Academy Programs

Science.gov (United States)

Gonzalez, Nicolas; Chavez, Guadalupe

2009-01-01

Dual Enrollment Engineering (DEEA) and Medical Science (DEMSA) Academies are two-year dual enrollment programs for high school students. Students explore engineering and medical careers through college coursework. Students prepare for higher education in engineering and medical fields while completing associate degrees in biology or engineering…

Increasing Enrollment by Better Serving Your Institution's Target Audiences through Benefit Segmentation.

Science.gov (United States)

Goodnow, Betsy

The marketing technique of benefit segmentation may be effective in increasing enrollment in adult educational programs, according to a study at College of DuPage, Glen Ellyn, Illinois. The study was conducted to test applicability of benefit segmentation to enrollment generation. The measuring instrument used in this study--the course improvement…

Comparative Effectiveness of Usual Source of Care Approaches to Improve End-of-Life Outcomes for Children With Intellectual Disability.

Science.gov (United States)

Lindley, Lisa C; Cozad, Melanie J

2017-09-01

Children with intellectual disability (ID) are at risk for adverse end-of-life outcomes including high emergency room utilization and hospital readmissions, along with low hospice enrollment. The objective of this study was to compare the effectiveness of usual source of care approaches to improve end-of-life outcomes for children with ID. We used longitudinal California Medicaid claims data. Children were included who were 21 years with fee-for-service Medicaid claims, died between January 1, 2007, and December 31, 2010, and had a moderate-to-profound ID diagnosis. End-of-life outcomes (i.e., hospice enrollment, emergency room utilization, hospital readmissions) were measured via claims data. Our treatments were usual source of care (USC) only vs. usual source of care plus targeted case management (USC plus TCM). Using instrumental variable analysis, we compared the effectiveness of treatments on end-of-life outcomes. Ten percent of children with ID enrolled in hospice, 73% used the emergency room, and 20% had three or more hospital admissions in their last year of life. USC plus TCM relative to USC only had no effect on hospice enrollment; however, it significantly reduced the probability of emergency room utilization (B = -1.29, P life outcomes for children with ID. Further study of the extent of UCS and TCM involvement in reducing emergency room utilization and hospital readmissions at end of life is needed. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Populations and outcome measures used in ongoing research in sarcopenia.

Science.gov (United States)

Peña Ordóñez, Gloria Gabriela; Bustamante Montes, Lilia Patricia; Ramírez Duran, Ninfa; Sánchez Castellano, Carmen; Cruz-Jentoft, Alfonso J

2017-08-01

Sarcopenia research may be hampered by the heterogeneity of populations and outcome measures used in clinical studies. The aim of this study was to describe the inclusion/exclusion criteria and outcome measures used in ongoing research in sarcopenia. All active intervention studies registered in the World Health Organization with the keyword sarcopenia were included. Study design, type of intervention, inclusion/exclusion criteria and outcome measures were registered and classified. In April 2014, 151 studies on sarcopenia were registered in the WHO database. One hundred twenty-three were intervention studies. Most trials (94.3 %) were single centre and randomized (93.5 %), 51.2 % were double blind. Nutritional interventions (36.6 %), physical exercise (12.2 %) or both (19.5 %) were the most common interventions tested. Only 54.4 % included subjects of both genders, and 46.3 % had an upper age limit. Definition of the target populations was heterogeneous, with 57.7 % including healthy subjects and none using recent definitions of sarcopenia. Lifestyle and the degree of physical activity of subjects were not described or considered in most cases (79.7 %). Subjects with cardiovascular, neuropsychiatric or metabolic disorders and those with physical disability were usually excluded. Muscle mass and muscle strength were the primary outcome variables in 28.5 and 29.5 % of studies and physical performance in 19.5 %, but only 4.1 % used the three variables used the three of them. An additional 26.8 % used biological outcome variables. Little information and agreement existed in the way muscle and physical performance parameters were measured. We found a large heterogeneity in trial design, definition of populations and outcome measures in present research.

Measuring treatment outcomes in gambling disorders: a systematic review.

Science.gov (United States)

Pickering, Dylan; Keen, Brittany; Entwistle, Gavin; Blaszczynski, Alex

2018-03-01

Considerable variation of outcome variables used to measure recovery in the gambling treatment literature has precluded effective cross-study evaluations and hindered the development of best-practice treatment methodologies. The aim of this systematic review was to describe current diffuse concepts of recovery in the gambling field by mapping the range of outcomes and measurement strategies used to evaluate treatments, and to identify more commonly accepted indices of recovery. A systematic search of six academic databases for studies evaluating treatments (psychological and pharmacological) for gambling disorders with a minimum 6-month follow-up. Data from eligible studies were tabulated and analysis conducted using a narrative approach. Guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were adhered to. Thirty-four studies were reviewed systematically (RCTs = 17, comparative designs = 17). Sixty-three different outcome measures were identified: 25 (39.7%) assessed gambling-specific constructs, 36 (57.1%) assessed non-gambling specific constructs, and two instruments were used across both categories (3.2%). Self-report instruments ranged from psychometrically validated to ad-hoc author-designed questionnaires. Units of measurement were inconsistent, particularly in the assessment of gambling behaviour. All studies assessed indices of gambling behaviour and/or symptoms of gambling disorder. Almost all studies (n = 30; 88.2%) included secondary measures relating to psychiatric comorbidities, psychological processes linked to treatment approach, or global functioning and wellbeing. In research on gambling disorders, the incorporation of broader outcome domains that extend beyond disorder-specific symptoms and behaviours suggests a multi-dimensional conceptualization of recovery. Development of a single comprehensive scale to measure all aspects of gambling recovery could help to facilitate uniform reporting practices

The Impact of Continuous Medicaid Enrollment on Diagnosis, Treatment, and Survival in Six Surgical Cancers

Science.gov (United States)

Dawes, Aaron J; Louie, Rachel; Nguyen, David K; Maggard-Gibbons, Melinda; Parikh, Punam; Ettner, Susan L; Ko, Clifford Y; Zingmond, David S

2014-01-01

Objective To examine the effect of Medicaid enrollment on the diagnosis, treatment, and survival of six surgically relevant cancers among poor and underserved Californians. Data Sources California Cancer Registry (CCR), California's Patient Discharge Database (PDD), and state Medicaid enrollment files between 2002 and 2008. Study Design We linked clinical and administrative records to differentiate patients continuously enrolled in Medicaid from those receiving coverage at the time of their cancer diagnosis. We developed multivariate logistic regression models to predict death within 1 year for each cancer after controlling for sociodemographic and clinical variables. Data Collection/Extraction Methods All incident cases of six cancers (colon, esophageal, lung, pancreas, stomach, and ovarian) were identified from CCR. CCR records were linked to hospitalizations (PDD) and monthly Medicaid enrollment. Principal Findings Continuous enrollment in Medicaid for at least 6 months prior to diagnosis improves survival in three surgically relevant cancers. Discontinuous Medicaid patients have higher stage tumors, undergo fewer definitive operations, and are more likely to die even after risk adjustment. Conclusions Expansion of continuous insurance coverage under the Affordable Care Act is likely to improve both access and clinical outcomes for cancer patients in California. PMID:25256223

Measuring Population Health Outcomes

OpenAIRE

Parrish, R. Gibson

2010-01-01

An ideal population health outcome metric should reflect a population's dynamic state of physical, mental, and social well-being. Positive health outcomes include being alive; functioning well mentally, physically, and socially; and having a sense of well-being. Negative outcomes include death, loss of function, and lack of well-being. In contrast to these health outcomes, diseases and injuries are intermediate factors that influence the likelihood of achieving a state of health. On the basis...

Psychometric evaluation of self-report outcome measures for prosthetic applications

OpenAIRE

Hafner, Brian J.; Morgan, Sara J.; Askew, Robert L.; Salem, Rana

2016-01-01

Documentation of clinical outcomes is increasingly expected in delivery of prosthetic services and devices. However, many outcome measures suitable for use in clinical care and research have not been psychometrically tested with prosthesis users. The aim of this study was to determine test-retest reliability, mode-of-administration (MoA) equivalence, standard error of measurement (SEM), and minimal detectable change (MDC) of standardized, self-report instruments that assess constructs of impo...

The International Dermatology Outcome Measures initiative as applied to psoriatic disease outcomes

DEFF Research Database (Denmark)

Gottlieb, Alice B; Armstrong, April W; Christensen, Robin

2014-01-01

In the United States, access to care is the number one issue facing our patients with dermatological conditions. In part, this is because we do not have outcome measures that are useful in clinical practice and available in databases where payers and governmental agencies can compare the performa...

Enrollment in Distance Education Classes Is Associated with Fewer Enrollment Gaps among Nontraditional Undergraduate Students in the US

Science.gov (United States)

Pontes, Manuel C. F.; Pontes, Nancy M. H.

2012-01-01

The purpose of this research is to determine whether nontraditional undergraduate students in the US who enroll in distance education classes are less likely to have an enrollment gap (enrollment gap=part year enrollment). Previous research has shown that preference for distance education classes is significantly greater among nontraditional than…

Quality of life measurement and outcome in aphasia

Directory of Open Access Journals (Sweden)

Spaccavento S

2013-12-01

Full Text Available Simona Spaccavento, Angela Craca, Marina Del Prete, Rosanna Falcone, Antonia Colucci, Angela Di Palma, Anna Loverre IRCCS Salvatore Maugeri Foundation, Cassano Murge Bari, Italy Background: Quality of life (QL can be defined as the individual's perception of their own well-being. Aphasia is the most important potential consequence of stroke and has a profound effect on a patient's life, causing emotional distress, depression, and social isolation, due to loss of language functions. Aims: To draw up a QL questionnaire for aphasics (QLQA focusing particularly on difficulties in interpersonal relationships and on the loss of independence as a result of language disorders. We reported the results of a psychometric evaluation of this measure. Moreover, we experimentally focused on the differences in QLQA between patients affected only by neurological motor impairment and hemiparetic patients with aphasia (PWA in order to verify the specific role of aphasia on QL. We also explored if the QLQA is sensitive to the severity of aphasia and to the time elapsing from the stroke. Methods: A total of 146 consecutive PWA and 37 control subjects were enrolled to evaluate the reliability (internal consistency and test–retest reliability and validity of the QLQA, using standard psychometric methods. Patients were divided into acute (within 3 months since stroke and chronic (beyond 3 months groups, and into mild and severe according to the severity of aphasia. The experimental group of only acute PWA was compared to control subjects, with right hemispherical lesion and without aphasia in QLQA total and partial scores. Results: The QLQA had good internal consistency and test–retest reliability. Acute and chronic PWA and mild and severe ones differed in QLQA total, communication, and autonomy subscales. No differences were found in psychological condition. Between aphasic and control patients, significant differences were found in all QLQA subscales. Conclusion

Measuring and communicating meaningful outcomes in neonatology: A family perspective.

Science.gov (United States)

Janvier, Annie; Farlow, Barbara; Baardsnes, Jason; Pearce, Rebecca; Barrington, Keith J

2016-12-01

Medium- and long-term outcomes have been collected and described among survivors of neonatal intensive care units for decades, for a number of purposes: (1) quality control within units, (2) comparisons of outcomes between NICUs, (3) clinical trials (whether an intervention improves outcomes), (4) end-of-life decision-making, (5) to better understand the effects of neonatal conditions and/or interventions on organs and/or long-term health, and finally (6) to better prepare parents for the future. However, the outcomes evaluated have been selected by investigators, based on feasibility, availability, cost, stability, and on what investigators consider to be important. Many of the routinely measured outcomes have major limitations: they may not correlate well with long-term difficulties, they may artificially divide continuous outcomes into dichotomous ones, and may have no clear relationship with quality of life and functioning of children and their families. Several investigations, such as routine term cerebral resonance imaging for preterm infants, have also not yet been shown to improve the outcome of children nor their families. In this article, the most common variables used in neonatology as well as some variables which are rarely measured but may be of equal importance for families are presented. The manner in which these outcomes are communicated to families will be examined, as well as recommendations to optimize communication with parents. Copyright © 2016 Elsevier Inc. All rights reserved.

Relationship outcomes as measurement criteria to assist communication strategists to manage organisational relationships

Directory of Open Access Journals (Sweden)

E. Botha

2011-06-01

Full Text Available Nonfinancial assets like relationships are increasingly important to managers. Communication managers in particular are focusing on measuring and managing organisational relationships as a means to quantify the return on investment (ROI of public relations and communication strategies. Measuring relationships offers communication managers a way to evaluate its contribution to the organisation. A commonly agreed upon definition of these relationships, however, does not exist. If we consider communication management is a managerial function, it must first refine its instruments of measurement. This study looks at the three-stage model of organisational relationships (relationship antecedents, maintenance strategies and relationship outcomes proposed by Grunig & Huang (2000 to firstly review the development of the model. Secondly, the study takes an in-depth look at each relationship outcomes of trust, commitment, satisfaction and control mutuality. Lastly, we assess the reliability and validity of the use of current relationship outcome measures through a survey of 154 organisational relationships. Previous studies that have utilized these outcomes in the measurement of organisational relationships do not discuss the possible interaction (or relationship among these outcomes. This study contributes to current literature by both providing an improved framework for the measurement of relationship outcomes and hypothesizing about how these outcomes interact with one another. It also discusses the managerial implications of managing relationships through the constant measurement of trust, commitment, satisfaction and control mutuality

Outcome measures for adult critical care: a systematic review.

Science.gov (United States)

Hayes, J A; Black, N A; Jenkinson, C; Young, J D; Rowan, K M; Daly, K; Ridley, S

2000-01-01

1. To identify generic and disease specific measures of impairment, functional status and health-related quality of life that have been used in adult critical care (intensive and high-dependency care) survivors. 2. To review the validity, reliability and responsiveness of the measures in adult critical care survivors. 3. To consider the implications for future policy and to make recommendations for further methodological research. 4. To review what is currently known of the outcome of adult critical care. Searches of electronic databases (MEDLINE, EMBASE, CINAHL, PsycLIT, The Cochrane Library and SIGLE) from 1970 to August 1998. Manual searches of five journals (1985-98) not indexed in electronic databases and relevant conference proceedings (1993-98). Reference lists of six existing reviews, plus snowballing from reference lists of all relevant articles identified. Randomised trials, non-randomised trials (cohort studies) and case series that included data on outcomes after discharge from adult (16 years and over) critical care. If reported, the following data were extracted from each paper: patient characteristics (age, gender, severity of illness, diagnostic category) number of patients eligible for study, follow-up period, number of deaths before follow-up, number and proportion of survivors included in follow-up method of presentation of outcome data - proportion normal as defined by reference values, or aggregate value (e.g. mean or median), or aggregate values plus an indication of variance (e.g. standard deviation or inter-quartile range). Evidence for three measurement properties was sought for each outcome measure that had been used in at least two studies - their validity, reliability and responsiveness in adult critical care. If the authors did not report these aspects explicitly, an attempt was made to use the data provided to provide these measurement properties. For measures that were used in at least ten studies, information on actual reported

Patient-reported outcome measures in arthroplasty registries

DEFF Research Database (Denmark)

Rolfson, Ola; Eresian Chenok, Kate; Bohm, Eric

2016-01-01

survey (SF-12) or the similar Veterans RAND 12-item health survey (VR-12). The most common specific PROMs were the Hip disability and Osteoarthritis Outcome Score (HOOS), the Knee injury and Osteoarthritis Outcome Score (KOOS), the Oxford Hip Score (OHS), the Oxford Knee Score (OKS), the Western Ontario...... of PROMs for hip and knee arthroplasty in registries worldwide. The 2 main types of PROMs include generic (general health) PROMs, which provide a measure of general health for any health state, and specific PROMs, which focus on specific symptoms, diseases, organs, body regions, or body functions...... all elective hip or knee arthroplasty patients and 6 registries collected PROMs for sample populations; 1 other registry had planned but had not started collection of PROMs. The most common generic instruments used were the EuroQol 5 dimension health outcome survey (EQ-5D) and the Short Form 12 health...

EVE and School - Enrolments

CERN Multimedia

EVE et École

2017-01-01

IMPORTANT DATES Enrolments 2017-2018 Enrolments for the school year 2017-2018 to the Nursery, the Kindergarten and the School will take place on 6, 7 and 8 March 2017 from 10 am to 1 pm at EVE and School. Registration forms will be available from Thursday 2nd March. More information on the website: http://nurseryschool.web.cern.ch/.

A tool for evaluating the potential for cost-effective outcomes measurement

Directory of Open Access Journals (Sweden)

Somasekhar MM

2012-04-01

Full Text Available Melinda M Somasekhar1, Alfred Bove2, Chris Rausch1, James Degnan3, Cathy T King1, Arnold Meyer11The Albert J Finestone, MD, Office for Continuing Medical Education, 2Section of Cardiology, Temple University School of Medicine, Philadelphia, PA, USA; 3Measurement and Research Center, Temple University, Philadelphia, PA, USAAbstract: Cost related to higher-level outcomes measurement is often very high. However, the cost burden is felt even more by smaller, less well-funded continuing medical education (CME programs. It is possible to overcome financial and participant-related barriers to measuring Level 6 outcomes, which are patient health outcomes. The Temple University School of Medicine’s Office for Continuing Medical Education developed a sequential tool for attaining cost-effective outcomes measurement for determining the likelihood of a CME intervention to produce significant changes in physician performance. The appropriate selection of the CME topic and specific practice change indictors drive this tool. This tool walks providers through a simple YES or NO decision-making list that guides them toward an accurate prediction of potential programmatic outcomes. Factors considered during the decision-making process include whether: (a the intended change(s will have a substantial impact on current practice; (b the intended practice change(s are well supported by clinical data, specialty organization/government recommendations, expert opinion, etc; (c the potential change(s affects a large population; (d external factors, such as system pressures, media pressures, financial pressures, patient pressures, safety pressures, etc, are driving this intended change in performance; (e there is a strong motivation on the part of physicians to implement the intended change(s; and (f the intended change(s is relatively easy to implement within any system of practice. If each of these questions can be responded to positively, there is a higher likelihood

Cost-effectiveness analysis in severe mental illness : Outcome measures selection

NARCIS (Netherlands)

Stant, A. Dennis; Buskens, Erik; Jenner, Jack A.; Wiersma, Durk; TenVergert, Elisabeth M.

Background: Most economic evaluations conducted in mental healthcare did not include widely recommended preference-based health outcomes like the QALY (Quality-Adjusted Life Years). Instead, studies have mainly been designed as cost-effectiveness analyses that include single outcome measures aimed

42 CFR 406.21 - Individual enrollment.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Individual enrollment. 406.21 Section 406.21 Public... HOSPITAL INSURANCE ELIGIBILITY AND ENTITLEMENT Premium Hospital Insurance § 406.21 Individual enrollment. (a) Basic provision. An individual who meets the requirements of § 406.20 (b) or (c) may enroll for...

42 CFR 460.152 - Enrollment process.

Science.gov (United States)

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Enrollment process. 460.152 Section 460.152 Public...) Participant Enrollment and Disenrollment § 460.152 Enrollment process. (a) Intake process. Intake is an intensive process during which PACE staff members make one or more visits to a potential participant's place...

Outcome Measurement in Nursing: Imperatives, Ideals, History, and Challenges

Science.gov (United States)

Jones, Terry L

2016-05-31

Nurses have a social responsibility to evaluate the effect of nursing practice on patient outcomes in the areas of health promotion; injury and illness prevention; and alleviation of suffering. Quality assessment initiatives are hindered by the paucity of available data related to nursing processes and patient outcomes across these three domains of practice. Direct care nurses are integral to self-regulation for the discipline as they are the best source of information about nursing practice and patient outcomes. Evidence supports the assumption that nurses do contribute to prevention of adverse events but there is insufficient evidence to explain how nurses contribute to these and/or other patient outcomes. The purposes of this article are to examine the imperatives, ideal conditions, history, and challenges related to effective outcome measurement in nursing. The article concludes with recommendations for action to move quality assessment forward, such as substantial investment to support adequate documentation of nursing practice and patient outcomes.

A Binomial Test of Group Differences with Correlated Outcome Measures

Science.gov (United States)

Onwuegbuzie, Anthony J.; Levin, Joel R.; Ferron, John M.

2011-01-01

Building on previous arguments for why educational researchers should not provide effect-size estimates in the face of statistically nonsignificant outcomes (Robinson & Levin, 1997), Onwuegbuzie and Levin (2005) proposed a 3-step statistical approach for assessing group differences when multiple outcome measures are individually analyzed…

Measuring Learning Outcomes. A Learner Perspective in Auditing Education

DEFF Research Database (Denmark)

Holm, Claus; Steenholdt, Niels

2000-01-01

The ability to provide sensible measures for learning outcomes in accounting education is under increased scrutiny. In this paper we use a learner perspective in auditing education which reflects that some students taking accounting classes also are provided with on-the-job training in accounting...... for students taking a graduate auditing course reflect prior accounting work experience for some students and undergraduate accounting coursework experience for all students. This paper extends prior research on the role of declarative and procedural knowledge in performing auditing tasks. Measuring learning...... suggested by Robert M. Gagné. An instrument was developed to measure differences regarding learning outcomes in the context of an auditing course by posing a broad set of questions testing declarative knowledge and the full range of intellectual skills from discrimination to the use of higher...

Outcome Measurement in the Treatment of Spasmodic Dysphonia: A Systematic Review of the Literature.

Science.gov (United States)

Rumbach, Anna; Aiken, Patrick; Novakovic, Daniel

2018-04-11

The aim of this review was to systematically identify all available studies reporting outcomes measures to assess treatment outcomes for people with spasmodic dysphonia (SD). Full-text journal articles were identified through searches of PubMed, Embase, CINAHL, and Cochrane databases and hand searching of journals. A total of 4,714 articles were retrieved from searching databases; 1,165 were duplicates. Titles and abstracts of 3,549 were screened, with 171 being selected for full-text review. During full-text review, 101 articles were deemed suitable for inclusion. An additional 24 articles were identified as suitable for inclusion through a hand search of reference lists. Data were extracted from 125 studies. A total of 220 outcome measures were identified. Considered in reference to the World Health Organization International Classification of Functioning, Disability and Health (ICF), the majority of outcomes were measured at a Body Function level (n = 212, 96%). Outcomes that explored communication and participation in everyday life and attitudes toward communication (ie, activity and participation domains) were infrequent (n = 8; 4%). Quality of life, a construct not measured within the ICF, was also captured by four outcome measures. No instruments evaluating communication partners' perspectives or burden/disability were identified. The outcome measures used in SD treatment studies are many and varied. The outcome measures identified predominately measure constructs within the Body Functions component of the ICF. In order to facilitate data synthesis across trials, the development of a core outcome set is recommended. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

Patient-Oriented Eczema Measure (POEM), a core instrument to measure symptoms in clinical trials: a Harmonising Outcome Measures for Eczema (HOME) statement

OpenAIRE

Spuls, Ph.I.; Gerbens, L.A.A.; Simpson, E.; Apfelbacher, C.J.; Chalmers, J.R.; Thomas, K.S.; Prinsen, C.A.C.; Kobyletzki, L.B. von; Singh, J.A.; Williams, Hywel C.; Schmitt, J.

2017-01-01

Background: The Harmonising Outcome Measures for Eczema (HOME) initiative has defined four core outcome domains for a core outcome set (COS) to be measured in all atopic eczema (AE) trials to ensure cross-trial comparison: clinical signs, symptoms, quality of life and longterm control.\\ud Objectives: The aim of this paper is to report on the consensus process that was used to select the core instrument to consistently assess symptoms in all future AE trials.\\ud Methods: Following the HOME roa...

Maternal Vitamin D Status and Adverse Birth Outcomes in Children from Rural Western Kenya

Directory of Open Access Journals (Sweden)

Eunice N. Toko

2016-12-01

Full Text Available Maternal plasma 25-hydroxyvitamin D (25(OHD status and its association with pregnancy outcomes in malaria holoendemic regions of sub-Saharan Africa is poorly defined. We examined this association and any potential interaction with malaria and helminth infections in an ongoing pregnancy cohort study in Kenya. The association of maternal plasma 25(OHD status with pregnancy outcomes and infant anthropometric measurements at birth was determined in a subset of women (n = 63. Binomial and linear regression analyses were used to examine associations between maternal plasma 25(OHD and adverse pregnancy outcomes. Fifty-one percent of the women had insufficient (<75 nmol/L and 21% had deficient (<50 nmol/L plasma 25(OHD concentration at enrollment. At birth, 74.4% of the infants had insufficient and 30% had deficient plasma 25(OHD concentrations, measured in cord blood. Multivariate analysis controlling for maternal age and body mass index (BMI at enrollment and gestational age at delivery found that deficient plasma 25(OHD levels were associated with a four-fold higher risk of stunting in neonates (p = 0.04. These findings add to the existing literature about vitamin D and its association with linear growth in resource-limited settings, though randomized clinical trials are needed to establish causation.

Arterial Stiffness and Functional Outcome in Acute Ischemic Stroke

OpenAIRE

Lee, Yeong-Bae; Park, Joo-Hwan; Kim, Eunja; Kang, Chang-Ki; Park, Hyeon-Mi

2014-01-01

Objective Arterial stiffness is a common change associated with aging and can be evaluated by measuring pulse wave velocity (PWV) between sites in the arterial tree, with the stiffer artery having the higher PWV. Arterial stiffness is associated with the risk of stroke in the general population and of fatal stroke in hypertensive patients. This study is to clarify whether PWV value predicts functional outcome of acute ischemic stroke. Methods One hundred patients were enrolled with a diagnosi...

Associations between nine family dinner frequency measures and child weight, dietary and psychosocial outcomes

Science.gov (United States)

Fulkerson, Jayne A.; Friend, Sarah E.; Neumark-Sztainer, Dianne

2015-01-01

Background Family meal frequency has been consistently and significantly associated with positive youth dietary and psychosocial outcomes but less consistently associated with weight outcomes. Family meal frequency measurement has varied widely and it is unclear how this variation may impact relationships with youth weight, dietary, and psychosocial outcomes. Objective This study assesses how five parent/caregiver-reported and four child-reported family dinner frequency measures correlate with each other and are associated with health-related outcomes. Design/Participants This secondary, cross-sectional analysis uses baseline, parent/caregiver (n=160) and 8–12 year old child (n=160) data from the Healthy Home Offerings via the Mealtime Environment (HOME) Plus trial (collected 2011–2012). Data were obtained from objective measurements, dietary recall interviews, and psychosocial surveys. Outcome measures Outcomes included child body mass index z-scores (BMIz), fruit, vegetable and sugar-sweetened beverage intake, dietary quality (Healthy Eating Index-2010 [HEI-2010]), family connectedness, and meal conversations. Statistical analyses performed Pearson correlations and general linear models were used to assess associations between family dinner frequency measures and outcomes. Results All family dinner frequency measures had comparable means and were correlated within and across parent/caregiver- and child-reporters (r=0.17–0.94, pdinner frequency measures were significantly associated with BMIz scores and 100% were significantly associated with fruit/vegetable intake and HEI-2010. In adjusted models, most significant associations with dietary and psychosocial outcomes remained but associations with child BMIz remained significant only for parent/caregiver- (β±SE= −0.07±0.03; pdinner frequency measures asking about ‘sitting and eating’ dinner. Conclusions In spite of phrasing variations in family dinner frequency measures (e.g., which family members

2012 Annual Survey of Journalism and Mass Communication Enrollments: Enrollments Decline for Second Year in a Row

Science.gov (United States)

Becker, Lee B.; Vlad, Tudor; Simpson, Holly Anne

2013-01-01

Enrollments in journalism and mass communication programs in the United States have declined over the last two years, reversing a pattern of growth that has sustained the field for twenty years. It is a decline at a time of continued growth in enrollments at universities generally. It is a decline at a time when enrollments have been growing in…

Network meta-analysis of multiple outcome measures accounting for borrowing of information across outcomes.

Science.gov (United States)

Achana, Felix A; Cooper, Nicola J; Bujkiewicz, Sylwia; Hubbard, Stephanie J; Kendrick, Denise; Jones, David R; Sutton, Alex J

2014-07-21

Network meta-analysis (NMA) enables simultaneous comparison of multiple treatments while preserving randomisation. When summarising evidence to inform an economic evaluation, it is important that the analysis accurately reflects the dependency structure within the data, as correlations between outcomes may have implication for estimating the net benefit associated with treatment. A multivariate NMA offers a framework for evaluating multiple treatments across multiple outcome measures while accounting for the correlation structure between outcomes. The standard NMA model is extended to multiple outcome settings in two stages. In the first stage, information is borrowed across outcomes as well across studies through modelling the within-study and between-study correlation structure. In the second stage, we make use of the additional assumption that intervention effects are exchangeable between outcomes to predict effect estimates for all outcomes, including effect estimates on outcomes where evidence is either sparse or the treatment had not been considered by any one of the studies included in the analysis. We apply the methods to binary outcome data from a systematic review evaluating the effectiveness of nine home safety interventions on uptake of three poisoning prevention practices (safe storage of medicines, safe storage of other household products, and possession of poison centre control telephone number) in households with children. Analyses are conducted in WinBUGS using Markov Chain Monte Carlo (MCMC) simulations. Univariate and the first stage multivariate models produced broadly similar point estimates of intervention effects but the uncertainty around the multivariate estimates varied depending on the prior distribution specified for the between-study covariance structure. The second stage multivariate analyses produced more precise effect estimates while enabling intervention effects to be predicted for all outcomes, including intervention effects on

Co-enrolment of Participants into Multiple Cancer Trials: Benefits and Challenges.

Science.gov (United States)

Cafferty, F H; Coyle, C; Rowley, S; Berkman, L; MacKensie, M; Langley, R E

2017-07-01

Opportunities to enter patients into more than one clinical trial are not routinely considered in cancer research and experiences with co-enrolment are rarely reported. Potential benefits of allowing appropriate co-enrolment have been identified in other settings but there is a lack of evidence base or guidance to inform these decisions in oncology. Here, we discuss the benefits and challenges associated with co-enrolment based on experiences in the Add-Aspirin trial - a large, multicentre trial recruiting across a number of tumour types, where opportunities to co-enrol patients have been proactively explored and managed. The potential benefits of co-enrolment include: improving recruitment feasibility; increased opportunities for patients to participate in trials; and collection of robust data on combinations of interventions, which will ensure the ongoing relevance of individual trials and provide more cohesive evidence to guide the management of future patients. There are a number of perceived barriers to co-enrolment in terms of scientific, safety and ethical issues, which warrant consideration on a trial-by-trial basis. In many cases, any potential effect on the results of the trials will be negligible - limited by a number of factors, including the overlap in trial cohorts. Participant representatives stress the importance of autonomy to decide about trial enrolment, providing a compelling argument for offering co-enrolment where there are multiple trials that are relevant to a patient and no concerns regarding safety or the integrity of the trials. A number of measures are proposed for managing and monitoring co-enrolment. Ensuring acceptability to (potential) participants is paramount. Opportunities to enter patients into more than one cancer trial should be considered more routinely. Where planned and managed appropriately, co-enrolment can offer a number of benefits in terms of both scientific value and efficiency of study conduct, and will increase the

Surrogacy assessment using principal stratification when surrogate and outcome measures are multivariate normal.

Science.gov (United States)

Conlon, Anna S C; Taylor, Jeremy M G; Elliott, Michael R

2014-04-01

In clinical trials, a surrogate outcome variable (S) can be measured before the outcome of interest (T) and may provide early information regarding the treatment (Z) effect on T. Using the principal surrogacy framework introduced by Frangakis and Rubin (2002. Principal stratification in causal inference. Biometrics 58, 21-29), we consider an approach that has a causal interpretation and develop a Bayesian estimation strategy for surrogate validation when the joint distribution of potential surrogate and outcome measures is multivariate normal. From the joint conditional distribution of the potential outcomes of T, given the potential outcomes of S, we propose surrogacy validation measures from this model. As the model is not fully identifiable from the data, we propose some reasonable prior distributions and assumptions that can be placed on weakly identified parameters to aid in estimation. We explore the relationship between our surrogacy measures and the surrogacy measures proposed by Prentice (1989. Surrogate endpoints in clinical trials: definition and operational criteria. Statistics in Medicine 8, 431-440). The method is applied to data from a macular degeneration study and an ovarian cancer study.

Psychometric validation of patient-reported outcome measures assessing chronic constipation

Directory of Open Access Journals (Sweden)

Nelson LM

2014-09-01

Full Text Available Lauren M Nelson,1 Valerie SL Williams,1 Sheri E Fehnel,1 Robyn T Carson,2 James MacDougall,3 Mollie J Baird,3 Stavros Tourkodimitris,2 Caroline B Kurtz,3 Jeffrey M Johnston31RTI Health Solutions, Durham, NC, USA; 2Forest Research Institute, Jersey City, NJ, USA; 3Ironwood Pharmaceuticals, Cambridge, MA, USABackground: Measures assessing treatment outcomes in previous CC clinical trials have not met the requirements described in the US Food and Drug Administration's guidance on patient-reported outcomes.Aim: Psychometric analyses using data from one Phase IIb study and two Phase III trials of linaclotide for the treatment of chronic constipation (CC were conducted to document the measurement properties of patient-reported CC Symptom Severity Measures.Study methods: Each study had a multicenter, randomized, double-blind, placebo-controlled, parallel-group design, comparing placebo to four doses of oral linaclotide taken once daily for 4 weeks in the Phase IIb dose-ranging study (n=307 and to two doses of linaclotide taken once daily for 12 weeks in the Phase III trials (n=1,272. The CC Symptom Severity Measures addressing bowel function (Bowel Movement Frequency, Stool Consistency, Straining and abdominal symptoms (Bloating, Abdominal Discomfort, Abdominal Pain were administered daily using interactive voice-response system technology. Intraclass correlations, Pearson correlations, factor analyses, F-tests, and effect sizes were computed.Results: The CC Symptom Severity Measures demonstrated satisfactory test–retest reliability and construct validity. Factor analyses indicated one factor for abdominal symptoms and another for bowel symptoms. Known-groups F-tests substantiated the discriminating ability of the CC Symptom Severity Measures. Responsiveness statistics were moderate to strong, indicating that these measures are capable of detecting change.Conclusion: In large studies of CC patients, linaclotide significantly improved abdominal and

Physical outcome measures for conductive and mixed hearing loss treatment: A systematic review.

Science.gov (United States)

Johansson, M L; Tysome, J R; Hill-Feltham, P; Hodgetts, W E; Ostevik, A; McKinnon, B J; Monksfield, P; Sockalingam, R; Wright, T

2018-05-07

The number of potential options for rehabilitation of patients with conductive or mixed hearing loss is continually expanding. To be able to inform patients and other stakeholders there is a need to identify and develop patient-centred outcomes for treatment of hearing loss. To identify outcome measures in the physical core area used when reporting the outcome after treatment of conductive and mixed hearing loss in adult patients. Systematic review. Systematic review of literature related to reported physical outcome measures after treatment of mixed or conductive hearing loss without restrictions regarding type of intervention, treatment or device. Any measure reporting the physical outcome after treatment or intervention of mixed or conductive hearing loss was sought and categorised. The physical outcomes measures that had been extracted were then grouped into domains. The literature search resulted in the identification of 1,434 studies, of which 153 were selected for inclusion in the review. The majority (57%) of papers reported results from middle ear surgery, with the remainder reporting results from either bone conduction hearing devices or middle ear implants. Outcomes related to complications were categorised into 17 domains, whereas outcomes related to treatment success was categorised in 22 domains. The importance of these domains to patients and other stakeholders needs to be further explored in order to establish which of these domains are most relevant to interventions for conductive or mixed hearing loss. This will allow us to then assess which outcomes measures are most suitable for inclusion in the core set This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Gender Disparity in Education Enrollment in Pakistan

OpenAIRE

Shakil Quayes; Richard David Ramsey

2015-01-01

The paper examines the determinants of school enrollment in Pakistan. The likelihood of school enrollment is estimated using separate logistic regression models for three different age groups. The empirical results indicate severe gender disparity in school enrollment across all age groups, particularly among the older age groups. Although the rate of school enrollment is positively associated with household income, the gender disparity actually deteriorates with an increase in household inco...

The Aphasia Communication Outcome Measure (ACOM): Dimensionality, Item Bank Calibration, and Initial Validation

Science.gov (United States)

Hula, William D.; Doyle, Patrick J.; Stone, Clement A.; Hula, Shannon N. Austermann; Kellough, Stacey; Wambaugh, Julie L.; Ross, Katherine B.; Schumacher, James G.; St. Jacque, Ann

2015-01-01

Purpose: The purpose of this study is to investigate the structure and measurement properties of the Aphasia Communication Outcome Measure (ACOM), a patient-reported outcome measure of communicative functioning for persons with aphasia. Method: Three hundred twenty-nine participants with aphasia responded to 177 items asking about communicative…

The National Outcomes Measurement System for Pediatric Speech-Language Pathology

Science.gov (United States)

Mullen, Robert; Schooling, Tracy

2010-01-01

Purpose: The American Speech-Language-Hearing Association's (ASHA's) National Outcomes Measurement System (NOMS) was developed in the late 1990s. The primary purpose was to serve as a source of data for speech-language pathologists (SLPs) who found themselves called on to provide empirical evidence of the functional outcomes associated with their…

Measuring Outcome in the Treatment of Cocaine Dependence

Science.gov (United States)

Crits-Christoph, Paul; Gallop, Robert; Gibbons, Mary Beth Connolly; Sadicario, Jaclyn S.; Woody, George

2015-01-01

Background Little in known about the extent to which outcome measures used in studies of the treatment of cocaine dependence are associated with longer-term use and with broader measures of clinical improvement. The current study examined reductions in use, and abstinence-oriented measures, in relation to functioning and longer-term clinical benefits in the treatment of cocaine dependence. Methods Overall drug use, cocaine use, and functioning in a number of addiction-related domains for 487 patients diagnosed with DSM-IV cocaine dependence and treated with one of four psychosocial interventions in the NIDA Cocaine Collaborative Treatment Study were assessed monthly during 6 months of treatment and at 9, 12, 15, and 18 month follow-up. Results Measures of during-treatment reduction in use were moderately correlated with drug and cocaine use measures 12 months, but showed non-significant or small correlations with measures of functioning at 12 months. Highest correlations were evident for abstinence measures (maximum consecutive days abstinence and completely abstinent) during treatment in relation to sustained (3 month) abstinence at 12 months. Latent class analysis of patterns of change over time revealed that most patients initially (months 1 to 4 of treatment) either became abstinent immediately or continued to use every month. Over the couse of follow-up, patients either maintained abstinence or used regularly – intermittent use was less common. Conclusions There were generally small associations between various measures of cocaine use and longer-term clinical benefits, other than abstinence was associated with continued abstinence. No one method of measuring outcome of treatment of cocaine dependence appears superior to others. PMID:26366427

Using Patient Reported Outcomes Measures to Promote Integrated Care

Directory of Open Access Journals (Sweden)

Marcel G. M. Olde Rikkert

2018-04-01

Full Text Available Introduction: Patient reported outcome measures (PROMs have been introduced as standardised outcomes, but have not been implemented widely for disease targeted pathways of care, nor for geriatric patients who prefer functional performance and quality of life. Discussion: We describe innovative multipurpose implementation of PROMs as evidenced by two best practices of PROMs application in geriatric and physiotherapy practice. We show that PROMs can show meaningful outcomes in older subjects’ patient journeys, which can at the same time serve individuals and groups of both patients and professionals. Key lesson: PROMs can deliver generic outcomes relevant for older patients, may improve patient-physician relationship, quality of care and prediction of future outcomes in geriatric care, if they are valid, reliable and responsive, but still short and simple. A precondition to make the hard tip from research to practice is that PROMs are carefully positioned in the clinical encounters and in electronic health records.

Educational outcomes in a system of care for children with emotional disturbance.

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Strompolis, Melissa; Vishnevsky, Tanya; Reeve, Charlie L; Munsell, Eylin Palamaro; Cook, James R; Kilmer, Ryan P

2012-01-01

In North Carolina, only 69% of high school students graduate in 4 years; however, recent data suggest that only 42% of students with mental and emotional disabilities graduate. MeckCARES, a system of care (SOC) in Mecklenburg County, North Carolina, is designed to serve youth with severe emotional disturbances and their families. The SOC philosophy is a prominent family-focused approach intended to provide comprehensive, coordinated networks of services, tailored to the needs of the child and family, while emphasizing the strengthening of natural community supports. In addition to other mental health objectives, a particular goal of MeckCARES is to address specific school-based needs of system-identified youth to improve educational outcomes and reduce the risk of dropping out. This study sought to assess empirically the impact that enrollment in MeckCARES has on graduation precursors; namely, grades, suspensions, and absences. This study found that, on average, enrollment in MeckCARES is not associated with positive changes in educational variables. Implications of these findings are discussed, as are future directions. For example, additional research is needed with more sensitive measurement and data collection procedures (i.e., access to graduation rates and Medicaid information) to adequately assess the impact of enrollment in MeckCARES on educational outcomes. © 2012 American Orthopsychiatric Association.

Use of standardized outcome measures in physical therapist practice: perceptions and applications.

Science.gov (United States)

Jette, Diane U; Halbert, James; Iverson, Courtney; Miceli, Erin; Shah, Palak

2009-02-01

Standardized instruments for measuring patients' activity limitations and participation restrictions have been advocated for use by rehabilitation professionals for many years. The available literature provides few recent reports of the use of these measures by physical therapists in the United States. The primary purpose of this study was to determine: (1) the extent of the use of standardized outcome measures and (2) perceptions regarding their benefits and barriers to their use. A secondary purpose was to examine factors associated with their use among physical therapists in clinical practice. The study used an observational design. A survey questionnaire comprising items regarding the use and perceived benefits and barriers of standardized outcome measures was sent to 1,000 randomly selected members of the American Physical Therapy Association (APTA). Forty-eight percent of participants used standardized outcome measures. The majority of participants (>90%) who used such measures believed that they enhanced communication with patients and helped direct the plan of care. The most frequently reported reasons for not using such measures included length of time for patients to complete them, length of time for clinicians to analyze the data, and difficulty for patients in completing them independently. Use of standardized outcome measures was related to specialty certification status, practice setting, and the age of the majority of patients treated. The limitations included an unvalidated survey for data collection and a sample limited to APTA members. Despite more than a decade of development and testing of standardized outcome measures appropriate for various conditions and practice settings, physical therapists have some distance to go in implementing their use routinely in most clinical settings. Based on the perceived barriers, alterations in practice management strategies and the instruments themselves may be necessary to increase their use.

Are current psychometric tools suitable for measuring outcomes of diabetes education?

DEFF Research Database (Denmark)

Eigenmann, C. A.; Colagiuri, R.; Skinner, T. C.

2009-01-01

Aims To critically appraise the suitability, validity, reliability, feasibility and sensitivity to change of available psychometric tools for measuring the education outcomes identified in the (Australian) National Consensus on Outcomes and Indicators for Diabetes Patient Education. Methods Poten...

Measurement-based Treatment of Residual Symptoms Using Clinically Useful Depression Outcome Scale: Korean Validation Study

Science.gov (United States)

Jeon, Sang Won; Han, Changsu; Ko, Young-Hoon; Yoon, Seo Young; Pae, Chi-Un; Choi, Joonho; Park, Yong Chon; Kim, Jong-Woo; Yoon, Ho-Kyoung; Ko, Seung-Duk; Patkar, Ashwin A.; Zimmerman, Mark

2017-01-01

Objective This study was aimed at evaluating the diagnostic validity of the Korean version of the Clinically Useful Depression Outcome Scale (CUDOS) with varying follow-up in a typical clinical setting in multiple centers. Methods In total, 891 psychiatric outpatients were enrolled at the time of their intake appointment. Current diagnostic characteristics were examined using the Structured Clinical Interview for DSM-IV (41% major depressive disorder). The CUDOS was measured and compared with three clinician rating scales and four self-report scales. Results The CUDOS showed excellent results for internal consistency (Cronbach’s α, 0.91), test-retest reliability (patients at intake, r=0.81; depressed patients in ongoing treatment, r=0.89), and convergent and discriminant validity (measures of depression, r=0.80; measures of anxiety and somatization, r=0.42). The CUDOS had a high ability to discriminate between different levels of depression severity based on the rating of Clinical Global Impression for depression severity and the diagnostic classification of major depression, minor depression, and non-depression. The ability of the CUDOS to identify patients with major depression was high (area under the receiver operating characteristic curve=0.867). A score of 20 as the optimal cutoff point was suggested when screening for major depression using the CUDOS (sensitivity=89.9%, specificity=69.5%). The CUDOS was sensitive to change after antidepressant treatment: patients with greater improvement showed a greater decrease in CUDOS scores (p<0.001). Conclusion The results of this multi-site outpatient study found that the Korean version of the CUDOS is a very useful measurement for research and for clinical practice. PMID:28138107

Psychometric evaluation of self-report outcome measures for prosthetic applications.

Science.gov (United States)

Hafner, Brian J; Morgan, Sara J; Askew, Robert L; Salem, Rana

2016-01-01

Documentation of clinical outcomes is increasingly expected in delivery of prosthetic services and devices. However, many outcome measures suitable for use in clinical care and research have not been psychometrically tested with prosthesis users. The aim of this study was to determine test-retest reliability, mode-of-administration (MoA) equivalence, standard error of measurement (SEM), and minimal detectable change (MDC) of standardized, self-report instruments that assess constructs of importance to people with lower limb loss. Prosthesis users (n = 201) were randomly assigned to groups based on MoA (i.e., paper, electronic, or mixed-mode). Participants completed two surveys 2 to 3 d apart. Instruments included the Prosthetic Limb Users Survey of Mobility, Prosthesis Evaluation Questionnaire-Mobility Subscale, Activities-Specific Balance Confidence Scale, Quality of Life in Neurological Conditions-Applied Cognition/General Concerns, Patient-Reported Outcomes Measurement Information System Profile, and Socket Comfort Score. Intraclass correlation coefficients indicated all instruments are appropriate for group-level comparisons and select instruments are suitable for individual-level applications. Several instruments showed evidence of possible floor and ceiling effects. All were equivalent across MoAs. SEM and MDC were quantified to facilitate interpretation of outcomes and change scores. These results can enhance clinicians' and researchers' ability to select, apply, and interpret scores from instruments administered to prosthesis users.

Measuring social inclusion--a key outcome in global mental health.

Science.gov (United States)

Baumgartner, Joy Noel; Burns, Jonathan K

2014-04-01

Social inclusion is increasingly recognized as a key outcome for evaluating global mental health programmes and interventions. Whereas social inclusion as an outcome is not a new concept in the field of mental health, its measurement has been hampered by varying definitions, concepts and instruments. To move the field forward, this paper reviews the currently available instruments which measure social inclusion and are reported in the literature, realizing that no single measure will be appropriate for all studies or contexts. A systematic literature search of English language peer-reviewed articles published through February 2013 was undertaken to identify scales specifically developed to measure social inclusion or social/community integration among populations with mental disorders. Five instruments were identified through the search criteria. The scales are discussed in terms of their theoretical underpinnings, domains and/or key items and their potential for use in global settings. Whereas numerous reviewed abstracts discussed mental health and social inclusion or social integration, very few were concerned with direct measurement of the construct. All identified scales were developed in high-income countries with limited attention paid to how the scale could be adapted for cross-cultural use. Social inclusion is increasingly highlighted as a key outcome for global mental health policies and programmes, yet its measurement is underdeveloped. There is need for a global cross-cultural measure that has been developed and tested in diverse settings. However, until that need is met, some of the scales presented here may be amenable to adaptation.

Does cannabis use affect treatment outcome in bipolar disorder? A longitudinal analysis

DEFF Research Database (Denmark)

van Rossum, Inge; Boomsma, Maarten; Tenback, Diederik

2009-01-01

Research suggests that cannabis use affects negatively on onset and outcome of schizophrenia, but less is known about possible effects in mood disorders. Bipolar in- and outpatients (N = 3459) were enrolled in an observational study. The influence of cannabis exposure on clinical and social...... treatment outcome measures was examined over the course of 1 year, as well as the effects on these associations of third mediating variables. Over 12 months of treatment, cannabis users exhibited less compliance and higher levels of overall illness severity, mania, and psychosis compared with nonusers....... Additionally, cannabis users experienced less satisfaction with life and had a lower probability of having a relationship compared with nonusers. There was little evidence that cannabis-outcome associations were mediated by third variables. An independent impact of cannabis use on psychopathologic outcomes...

CONSIDER - Core Outcome Set in IAD Research: study protocol for establishing a core set of outcomes and measurements in incontinence-associated dermatitis research.

Science.gov (United States)

Van den Bussche, Karen; De Meyer, Dorien; Van Damme, Nele; Kottner, Jan; Beeckman, Dimitri

2017-10-01

This study protocol describes the methodology for the development of a core set of outcomes and a core set of measurements for incontinence-associated dermatitis. Incontinence is a widespread disorder with an important impact on quality of life. One of the most common complications is incontinence-associated dermatitis, resulting from chemical and physical irritation of the skin barrier, triggering inflammation and skin damage. Managing incontinence-associated dermatitis is an important challenge for nurses. Several interventions have been assessed in clinical trials, but heterogeneity in study outcomes complicates the comparability and standardization. To overcome this challenge, the development of a core outcome set, a minimum set of outcomes and measurements to be assessed in clinical research, is needed. A project team, International Steering Committee and panelists will be involved to guide the development of the core outcome set. The framework of the Harmonizing Outcomes Measures for Eczema roadmap endorsed by Cochrane Skin Group Core Outcomes Set Initiative, is used to inform the project design. A systematic literature review, interviews to integrate the patients' perspective and a consensus study with healthcare researchers and providers using the Delphi procedure will be performed. The project was approved by the Ethics review Committee (April 2016). This is the first project that will identify a core outcome set of outcomes and measurements for incontinence-associated dermatitis research. A core outcome set will reduce possible reporting bias, allow results comparisons and statistical pooling across trials and strengthen evidence-based practice and decision-making. This project has been registered in the Core Outcome Measures in Effectiveness Trials (COMET) database and is part of the Cochrane Skin Group Core Outcomes Set Initiative (CSG-COUSIN). © 2016 John Wiley & Sons Ltd.

Gender and Age-Appropriate Enrolment in Uganda

Science.gov (United States)

Wells, Ryan

2009-01-01

Secondary school enrolment in Uganda has historically favoured males over females. Recently, however, researchers have reported that the secondary enrolment gender gap has significantly diminished, and perhaps even disappeared in Uganda. Even if gender parity is being achieved for enrolment broadly, there may be a gender gap concerning…

College Enrollment Motivation: A Theoretical Marketing Approach.

Science.gov (United States)

Pomazal, Richard J.

1980-01-01

Personal beliefs and opinions regarding enrolling at university were obtained from 147 residents to test ability of a consumer/marketing theory of behavioral intention to account for factors related to college enrollment motivation. Analysis of the perceived quality of education revealed factors that were different from enrollment motivational…

Use of the measure your medical outcome profile (MYMOP2 and W-BQ12 (Well-Being outcomes measures to evaluate chiropractic treatment: an observational study

Directory of Open Access Journals (Sweden)

Polus Barbara I

2011-03-01

Full Text Available Abstract Background The objective was to assess the use of the Measure Yourself Medical Outcome Profile (MYMOP2 and W-BQ12 well-being questionnaire for measuring clinical change associated with a course of chiropractic treatment. Methods Chiropractic care of the patients involved spinal manipulative therapy (SMT, mechanically assisted techniques, soft tissue therapy, and physiological therapeutic devices. Outcome measures used were MYMOP2 and the Well-Being Questionnaire 12 (W-BQ12. Results Statistical and clinical significant changes were demonstrated with W-BQ12 and MYMOP2. Conclusions The study demonstrated that MYMOP2 was responsive to change and may be a useful instrument for assessing clinical changes among chiropractic patients who present with a variety of symptoms and clinical conditions.

Medicare Enrollment Dashboard

Data.gov (United States)

U.S. Department of Health & Human Services — The CMS Office of Enterprise Data and Analytics has developed a new interactive Medicare Enrollment Dashboard, which provides current information on the number of...

Proceedings of Patient Reported Outcome Measure?s (PROMs) Conference Sheffield 2016: advances in patient reported outcomes research

OpenAIRE

Croudace, Tim; Brazier, John; Gutacker, Nils; Street, Andrew; Robotham, Dan; Waterman, Samantha; Rose, Diana; Satkunanathan, Safarina; Wykes, Til; Nasr, Nasrin; Enderby, Pamela; Carlton, Jill; Rowen, Donna; Elliott, Jackie; Brazier, John

2016-01-01

Table of contents S1 Using computerized adaptive testing Tim Croudace S2 Well-being: what is it, how does it compare to health and what are the implications of using it to inform health policy John Brazier O1 “Am I going to get better?”—Using PROMs to inform patients about the likely benefit of surgery Nils Gutacker, Andrew Street O2 Identifying Patient Reported Outcome Measures for an electronic Personal Health Record Dan Robotham, Samantha Waterman, Diana Rose, Safarina Satkunanathan, Til W...

Measuring Student Learning Outcomes Using the SALG Instrument

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Scholl, Kathleen; Olsen, Heather M.

2014-01-01

U.S. higher education institutions are being called to question their central nature, priorities, and functions, with prominent and unprecedented attention being given to accountability and the measurement of student learning outcomes. As higher education evolves in how it assesses student learning and leisure studies and recreation departments…

[Improving care for cleft lip and palate patients: uniform and patient-orientated outcome measures].

Science.gov (United States)

Haj, M; de Gier, H H W; van Veen-van der Hoek, M; Versnel, S L; van Adrichem, L N; Wolvius, E B; Hazelzet, J A; Koudstaal, M J

2018-02-01

The quality of care for patients with cleft lip and palate is extremely variable across the world. Treatment protocols differ and methods of data registration are not uniform. Improving this care by means of comparative research is challenging. The best treatment programmes can be identified by uniformly registering patient-orientated outcomes and comparing the outcomes with those of other treatment centres. That knowledge can be used to improve one's own care. An international team consisting of specialists and cleft lip and palate patients has developed a set of outcome measures that are considered by patients to be most important. This team is coordinated by the International Consortium of Health Outcomes Measurement (ICHOM). The cleft lip and palate outcome set can be used by all centres worldwide in following up on cleft lip and palate patients. In the Erasmus Medical Centre in Rotterdam, the 'Zorgmonitor Schisis' (Care Monitor Cleft Lip and Palate) has been built, an application in which these outcome measures are collected at fixed times. Implementing this set of outcome measures in other cleft lip and palate treatment centres and using the outcomes as (inter)national benchmarks will result in transparency and the improvement of the treatment of cleft lip and palate worldwide.

Inflated Grades, Enrollments & Budgets

Directory of Open Access Journals (Sweden)

J. E. Stone

1995-06-01

Full Text Available Reports of the past 13 years that call attention to deficient academic standards in American higher education are enumerated. Particular attention is given the Wingspread Group's recent An American Imperative: Higher Expectations for Higher Education. Low academic standards, grade inflation, and budgetary incentives for increased enrollment are analyzed and a call is made for research at the state level. Reported trends in achievement and GPAs are extrapolated to Tennessee and combined with local data to support the inference that 15% of the state's present day college graduates would not have earned a diploma by mid 1960s standards. A conspicuous lack of interest by public oversight bodies is noted despite a growing public awareness of low academic expectations and lenient grading and an implicit budgetary impact of over $100 million. Various academic policies and the dynamics of bureaucratic control are discussed in relationship to the maintenance of academic standards. The disincentives for challenging course requirements and responsible grading are examined, and the growing movement to address academic quality issues through better training and supervision of faculty are critiqued. Recommendations that would encourage renewed academic integrity and make learning outcomes visible to students, parents, employers, and the taxpaying public are offered and briefly discussed.

Implementation of learning outcome attainment measurement system in aviation engineering higher education

Science.gov (United States)

Salleh, I. Mohd; Mat Rani, M.

2017-12-01

This paper aims to discuss the effectiveness of the Learning Outcome Attainment Measurement System in assisting Outcome Based Education (OBE) for Aviation Engineering Higher Education in Malaysia. Direct assessments are discussed to show the implementation processes that become a key role in the successful outcome measurement system. A case study presented in this paper involves investigation on the implementation of the system in Aircraft Structure course for Bachelor in Aircraft Engineering Technology program in UniKL-MIAT. The data has been collected for five semesters, starting from July 2014 until July 2016. The study instruments used include the report generated in Learning Outcomes Measurements System (LOAMS) that contains information on the course learning outcomes (CLO) individual and course average performance reports. The report derived from LOAMS is analyzed and the data analysis has revealed that there is a positive significant correlation between the individual performance and the average performance reports. The results for analysis of variance has further revealed that there is a significant difference in OBE grade score among the report. Independent samples F-test results, on the other hand, indicate that the variances of the two populations are unequal.

Science dual enrollment: An examination of high school students' post-secondary aspirations

Science.gov (United States)

Berry, Chelsia

The purpose of this study was to determine if participation in science dual enrollment courses influenced African American high school students' post-secondary aspirations that will lead to college attendance. The investigation examined the relationship between African American students' learning experiences and how their self-efficacy and outcome expectations impact their goal setting. The goal was to determine the impact of the following variables on African American students' plan to pursue a bachelor's or advanced degree: (a) STEM exposure, (b) Algebra 1 achievement, (c) level of science class, and (d) receiving science college credit for dual enrollment course. The social cognitive career theory framed this body of research to explore how career and academic interests mature, are developed, and are translated into action. Science dual enrollment participation is a strategy for addressing the lack of African American presence in the STEM fields. The causal comparative ex post facto research design was used in this quantitative study. The researcher performed the Kruskal-Wallis non-parametric analysis of variance and Pearson's chi-square tests to analyze secondary data from the High School Longitudinal Study first follow-up student questionnaire. The results indicate that STEM exposure and early success in Algebra 1 have a statistically significant impact on African American students' ambition to pursue a bachelor's or advanced degree. According to the Pearson's chi-square and independent sample Kruskal-Wallis analyses, level of students' science class and receiving college credit for dual enrollment do not significantly influence African American students' postsecondary aspirations.

Making co-enrolment feasible for randomised controlled trials in paediatric intensive care.

Directory of Open Access Journals (Sweden)

Katie Harron

Full Text Available Enrolling children into several trials could increase recruitment and lead to quicker delivery of optimal care in paediatric intensive care units (PICU. We evaluated decisions taken by clinicians and parents in PICU on co-enrolment for two large pragmatic trials: the CATCH trial (CATheters in CHildren comparing impregnated with standard central venous catheters (CVCs for reducing bloodstream infection in PICU and the CHIP trial comparing tight versus standard control of hyperglycaemia.We recorded the period of trial overlap for all PICUs taking part in both CATCH and CHiP and reasons why clinicians decided to co-enrol children or not into both studies. We examined parental decisions on co-enrolment by measuring recruitment rates and reasons for declining consent.Five PICUs recruited for CATCH and CHiP during the same period (an additional four opened CATCH after having closed CHiP. Of these five, three declined co-enrolment (one of which delayed recruiting elective patients for CATCH whilst CHiP was running, due to concerns about jeopardising CHiP recruitment, asking too much of parents, overwhelming amounts of information to explain to parents for two trials and a policy against co-enrolment. Two units co-enrolled in order to maximise recruitment to both trials. At the first unit, 35 parents were approached for both trials. 17/35 consented to both; 13/35 consented to one trial only; 5/35 declined both. Consent rates during co-enrolment were 29/35 (82% and 18/35 (51% for CATCH and CHiP respectively compared with 78% and 51% respectively for those approached for a single trial within this PICU. The second unit did not record data on approaches or refusals, but successfully co-enrolled one child.Co-enrolment did not appear to jeopardise recruitment or overwhelm parents. Strategies for seeking consent for multiple trials need to be developed and should include how to combine information for parents and patients.

Cancer Outcomes in Low-Income Elders

Data.gov (United States)

U.S. Department of Health & Human Services — Cancer Outcomes in Low-Income Elders, Is There An Advantage to Being on Medicaid Because of reduced financial barriers, dual Medicare-Medicaid enrollment of...

A tool for evaluating the potential for cost-effective outcomes measurement.

Science.gov (United States)

Somasekhar, Melinda M; Bove, Alfred; Rausch, Chris; Degnan, James; King, Cathy T; Meyer, Arnold

2012-01-01

Cost related to higher-level outcomes measurement is often very high. However, the cost burden is felt even more by smaller, less well-funded continuing medical education (CME) programs. It is possible to overcome financial and participant-related barriers to measuring Level 6 outcomes, which are patient health outcomes. The Temple University School of Medicine's Office for Continuing Medical Education developed a sequential tool for attaining cost-effective outcomes measurement for determining the likelihood of a CME intervention to produce significant changes in physician performance. The appropriate selection of the CME topic and specific practice change indictors drive this tool. This tool walks providers through a simple YES or NO decision-making list that guides them toward an accurate prediction of potential programmatic outcomes. Factors considered during the decision-making process include whether: (a) the intended change(s) will have a substantial impact on current practice; (b) the intended practice change(s) are well supported by clinical data, specialty organization/government recommendations, expert opinion, etc; (c) the potential change(s) affects a large population; (d) external factors, such as system pressures, media pressures, financial pressures, patient pressures, safety pressures, etc, are driving this intended change in performance; (e) there is a strong motivation on the part of physicians to implement the intended change(s); and (f) the intended change(s) is relatively easy to implement within any system of practice. If each of these questions can be responded to positively, there is a higher likelihood that the intended practice-related change(s) will occur. Such change can be measured using a simpler and less costly methodology.

Strengthening 4-H by Analyzing Enrollment Data

Science.gov (United States)

Hamilton, Stephen F.; Northern, Angela; Neff, Robert

2014-01-01

The study reported here used data from the ACCESS 4-H Enrollment System to gain insight into strengthening New York State's 4-H programming. Member enrollment lists from 2009 to 2012 were analyzed using Microsoft Excel to determine trends and dropout rates. The descriptive data indicate declining 4-H enrollment in recent years and peak enrollment…

The art and science of using routine outcome measurement in mental health benchmarking.

Science.gov (United States)

McKay, Roderick; Coombs, Tim; Duerden, David

2014-02-01

To report and critique the application of routine outcome measurement data when benchmarking Australian mental health services. The experience of the authors as participants and facilitators of benchmarking activities is augmented by a review of the literature regarding mental health benchmarking in Australia. Although the published literature is limited, in practice, routine outcome measures, in particular the Health of the National Outcomes Scales (HoNOS) family of measures, are used in a variety of benchmarking activities. Use in exploring similarities and differences in consumers between services and the outcomes of care are illustrated. This requires the rigour of science in data management and interpretation, supplemented by the art that comes from clinical experience, a desire to reflect on clinical practice and the flexibility to use incomplete data to explore clinical practice. Routine outcome measurement data can be used in a variety of ways to support mental health benchmarking. With the increasing sophistication of information development in mental health, the opportunity to become involved in benchmarking will continue to increase. The techniques used during benchmarking and the insights gathered may prove useful to support reflection on practice by psychiatrists and other senior mental health clinicians.

Prosthetists' perceptions and use of outcome measures in clinical practice: Long-term effects of focused continuing education.

Science.gov (United States)

Hafner, Brian J; Spaulding, Susan E; Salem, Rana; Morgan, Sara J; Gaunaurd, Ignacio; Gailey, Robert

2017-06-01

Continuing education is intended to facilitate clinicians' skills and knowledge in areas of practice, such as administration and interpretation of outcome measures. To evaluate the long-term effect of continuing education on prosthetists' confidence in administering outcome measures and their perceptions of outcomes measurement in clinical practice. Pretest-posttest survey methods. A total of 66 prosthetists were surveyed before, immediately after, and 2 years after outcomes measurement education and training. Prosthetists were grouped as routine or non-routine outcome measures users, based on experience reported prior to training. On average, prosthetists were just as confident administering measures 1-2 years after continuing education as they were immediately after continuing education. In all, 20% of prosthetists, initially classified as non-routine users, were subsequently classified as routine users at follow-up. Routine and non-routine users' opinions differed on whether outcome measures contributed to efficient patient evaluations (79.3% and 32.4%, respectively). Both routine and non-routine users reported challenges integrating outcome measures into normal clinical routines (20.7% and 45.9%, respectively). Continuing education had a long-term impact on prosthetists' confidence in administering outcome measures and may influence their clinical practices. However, remaining barriers to using standardized measures need to be addressed to keep practitioners current with evolving practice expectations. Clinical relevance Continuing education (CE) had a significant long-term impact on prosthetists' confidence in administering outcome measures and influenced their clinical practices. In all, approximately 20% of prosthetists, who previously were non-routine outcome measure users, became routine users after CE. There remains a need to develop strategies to integrate outcome measurement into routine clinical practice.

Dignity Impact as a Primary Outcome Measure for Dignity Therapy.

Science.gov (United States)

Scarton, Lisa; Oh, Sungho; Sylvera, Ashley; Lamonge, Ralph; Yao, Yingwei; Chochinov, Harvey; Fitchett, George; Handzo, George; Emanuel, Linda; Wilkie, Diana

2018-01-01

Feasibility of dignity therapy (DT) is well established in palliative care. Evidence of its efficacy, however, has been inconsistent and may stem from DT's primary effects differing from the outcomes measured in previous studies. We proposed that DT effects were in the spiritual domain and created a new outcome measure, Dignity Impact Scale (DIS), from items previously used in a large randomized controlled trial (RCT). The purpose of this secondary analysis study was to examine properties of a new measure of dignity impact. Using the DIS, we conducted reanalysis of posttest data from a large 3-arm, multi-site RCT study. Participants were receiving hospice/palliative care (n = 326, 50.6% female, mean age = 65.1 years, 89.3% white, all with a terminal illness with 6 months or less life expectancy). They had been randomized to standard palliative care (n = 111), client-centered care (n = 107), or DT (n = 108). The 7-item DIS was derived from selected items in a posttest DT Patient Feedback Questionnaire. The DIS had strong internal consistency (α = 0.85). The DT group mean DIS score (21.4 ± 5.0) was significantly higher than the usual care group mean score (17.7 ± 5.5; t = 5.2, df = 216, P death, and life completion tasks. We propose that the DIS be used as the primary outcome measure in evaluating the effects of DT.

Systematic review of tools to measure outcomes for young children with autism spectrum disorder.

Science.gov (United States)

McConachie, Helen; Parr, Jeremy R; Glod, Magdalena; Hanratty, Jennifer; Livingstone, Nuala; Oono, Inalegwu P; Robalino, Shannon; Baird, Gillian; Beresford, Bryony; Charman, Tony; Garland, Deborah; Green, Jonathan; Gringras, Paul; Jones, Glenys; Law, James; Le Couteur, Ann S; Macdonald, Geraldine; McColl, Elaine M; Morris, Christopher; Rodgers, Jacqueline; Simonoff, Emily; Terwee, Caroline B; Williams, Katrina

2015-06-01

The needs of children with autism spectrum disorder (ASD) are complex and this is reflected in the number and diversity of outcomes assessed and measurement tools used to collect evidence about children's progress. Relevant outcomes include improvement in core ASD impairments, such as communication, social awareness, sensory sensitivities and repetitiveness; skills such as social functioning and play; participation outcomes such as social inclusion; and parent and family impact. To examine the measurement properties of tools used to measure progress and outcomes in children with ASD up to the age of 6 years. To identify outcome areas regarded as important by people with ASD and parents. The MeASURe (Measurement in Autism Spectrum disorder Under Review) research collaboration included ASD experts and review methodologists. We undertook systematic review of tools used in ASD early intervention and observational studies from 1992 to 2013; systematic review, using the COSMIN checklist (Consensus-based Standards for the selection of health Measurement Instruments) of papers addressing the measurement properties of identified tools in children with ASD; and synthesis of evidence and gaps. The review design and process was informed throughout by consultation with stakeholders including parents, young people with ASD, clinicians and researchers. The conceptual framework developed for the review was drawn from the International Classification of Functioning, Disability and Health, including the domains 'Impairments', 'Activity Level Indicators', 'Participation', and 'Family Measures'. In review 1, 10,154 papers were sifted - 3091 by full text - and data extracted from 184; in total, 131 tools were identified, excluding observational coding, study-specific measures and those not in English. In review 2, 2665 papers were sifted and data concerning measurement properties of 57 (43%) tools were extracted from 128 papers. Evidence for the measurement properties of the reviewed

Measure of functional independence dominates discharge outcome prediction after inpatient rehabilitation for stroke.

Science.gov (United States)

Brown, Allen W; Therneau, Terry M; Schultz, Billie A; Niewczyk, Paulette M; Granger, Carl V

2015-04-01

Identifying clinical data acquired at inpatient rehabilitation admission for stroke that accurately predict key outcomes at discharge could inform the development of customized plans of care to achieve favorable outcomes. The purpose of this analysis was to use a large comprehensive national data set to consider a wide range of clinical elements known at admission to identify those that predict key outcomes at rehabilitation discharge. Sample data were obtained from the Uniform Data System for Medical Rehabilitation data set with the diagnosis of stroke for the years 2005 through 2007. This data set includes demographic, administrative, and medical variables collected at admission and discharge and uses the FIM (functional independence measure) instrument to assess functional independence. Primary outcomes of interest were functional independence measure gain, length of stay, and discharge to home. The sample included 148,367 people (75% white; mean age, 70.6±13.1 years; 97% with ischemic stroke) admitted to inpatient rehabilitation a mean of 8.2±12 days after symptom onset. The total functional independence measure score, the functional independence measure motor subscore, and the case-mix group were equally the strongest predictors for any of the primary outcomes. The most clinically relevant 3-variable model used the functional independence measure motor subscore, age, and walking distance at admission (r(2)=0.107). No important additional effect for any other variable was detected when added to this model. This analysis shows that a measure of functional independence in motor performance and age at rehabilitation hospital admission for stroke are predominant predictors of outcome at discharge in a uniquely large US national data set. © 2015 American Heart Association, Inc.

Measuring what matters to rare disease patients - reflections on the work by the IRDiRC taskforce on patient-centered outcome measures.

Science.gov (United States)

Morel, Thomas; Cano, Stefan J

2017-11-02

Our ability to evaluate outcomes which genuinely reflect patients' unmet needs, hopes and concerns is of pivotal importance. However, much current clinical research and practice falls short of this objective by selecting outcome measures which do not capture patient value to the fullest. In this Opinion, we discuss Patient-Centered Outcomes Measures (PCOMs), which have the potential to systematically incorporate patient perspectives to measure those outcomes that matter most to patients. We argue for greater multi-stakeholder collaboration to develop PCOMs, with rare disease patients and families at the center. Beyond advancing the science of patient input, PCOMs are powerful tools to translate care or observed treatment benefit into an 'interpretable' measure of patient benefit, and thereby help demonstrate clinical effectiveness. We propose mixed methods psychometric research as the best route to deliver fit-for-purpose PCOMs in rare diseases, as this methodology brings together qualitative and quantitative research methods in tandem with the explicit aim to efficiently utilise data from small samples. And, whether one opts to develop a brand-new PCOM or to select or adapt an existing outcome measure for use in a rare disease, the anchors remain the same: patients, their daily experience of the rare disease, their preferences, core concepts and values. Ultimately, existing value frameworks, registries, and outcomes-based contracts largely fall short of consistently measuring the full range of outcomes that matter to patients. We argue that greater use of PCOMs in rare diseases would enable a fast track to Patient-Centered Care.

Differences in Academic Achievement among Texas High School Students as a Function of Music Enrollment

Science.gov (United States)

Horton, Robert Wayne

2012-01-01

Purpose: The purpose of this study was to examine the score differences on the Texas Academic Knowledge and Skills (TAKS) Reading and Mathematics measures among students in Grades 10 and 11 as a function of music enrollment. Specifically, gender, ethnicity, socioeconomic status, and enrollment in choir, band, or orchestra or no music enrollment…

A hierarchy of patient-reported outcome measures for meta-analysis of knee osteoarthritis trials

DEFF Research Database (Denmark)

Juhl, Carsten Bogh; Lund, Hans; Guyatt, GH

2010-01-01

Title A hierarchy of patient-reported outcome measures for meta-analysis of knee osteoarthritis trials: empirical evidence from a survey of high impact journals Objective To develop a prioritized list for extracting patient-reported outcomes (PROs) measuring pain and disability for meta-analyses ......Title A hierarchy of patient-reported outcome measures for meta-analysis of knee osteoarthritis trials: empirical evidence from a survey of high impact journals Objective To develop a prioritized list for extracting patient-reported outcomes (PROs) measuring pain and disability for meta...... composite disability scores. Conclusions As choosing the most favorable PROs from individual trials can overestimate the effect compared to a systematic approach, using a prioritized list as presented in this study is recommended to reduce reviewer's likelihood of biased selection of PROs in meta-analyses....

Functional outcome measures in a surgical model of hip osteoarthritis in dogs.

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Little, Dianne; Johnson, Stephen; Hash, Jonathan; Olson, Steven A; Estes, Bradley T; Moutos, Franklin T; Lascelles, B Duncan X; Guilak, Farshid

2016-12-01

The hip is one of the most common sites of osteoarthritis in the body, second only to the knee in prevalence. However, current animal models of hip osteoarthritis have not been assessed using many of the functional outcome measures used in orthopaedics, a characteristic that could increase their utility in the evaluation of therapeutic interventions. The canine hip shares similarities with the human hip, and functional outcome measures are well documented in veterinary medicine, providing a baseline for pre-clinical evaluation of therapeutic strategies for the treatment of hip osteoarthritis. The purpose of this study was to evaluate a surgical model of hip osteoarthritis in a large laboratory animal model and to evaluate functional and end-point outcome measures. Seven dogs were subjected to partial surgical debridement of cartilage from one femoral head. Pre- and postoperative pain and functional scores, gait analysis, radiographs, accelerometry, goniometry and limb circumference were evaluated through a 20-week recovery period, followed by histological evaluation of cartilage and synovium. Animals developed histological and radiographic evidence of osteoarthritis, which was correlated with measurable functional impairment. For example, Mankin scores in operated limbs were positively correlated to radiographic scores but negatively correlated to range of motion, limb circumference and 20-week peak vertical force. This study demonstrates that multiple relevant functional outcome measures can be used successfully in a large laboratory animal model of hip osteoarthritis. These measures could be used to evaluate relative efficacy of therapeutic interventions relevant to human clinical care.

Treatment of Phonological Disorder: A Feasibility Study With Focus on Outcome Measures.

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Smit, Ann Bosma; Brumbaugh, Klaire Mann; Weltsch, Barbara; Hilgers, Melanie

2018-02-20

In a feasibility study for a randomized controlled trial of treatments for phonological disorders conducted over a period of 8 months, we examined 6 clinically relevant outcome measures. We took steps to reduce error variance and to maximize systematic variance. Six children received traditional treatment (Van Riper, 1939), and 7 received expansion points (Smit, 2000), a treatment program with both phonological and traditional elements. Outcome measures, which were applied to both word list and conversational samples, included percentage of consonants correct (PCC; Shriberg & Kwiatkowski, 1982), PCC for late and/or difficult (L/D) consonants and number of L/D consonants acquired. In repeated-measures analyses of variance, all measures showed significant differences from pretreatment to posttreatment, and the word list measures were associated with very high power values. In analyses of covariance for between-groups contrasts, the adjusted expansion points mean exceeded the adjusted traditional treatment mean for every measure; however, no differences reached significance. For the L/D PCC (conversation) measure, the contrast between groups was associated with a large effect size. We recommend that practitioners use outcome measures related to a word list. We recommend that researchers consider using L/D PCC on the basis of conversational samples to detect differences among treatment groups. https://doi.org/10.23641/asha.5872677.

Enrollment Management: A Market-Centered Perspective

Science.gov (United States)

Kalsbeek, David H.; Hossler, Donald

2009-01-01

Enrollment management, the authors suggested in earlier essays, is a deliberate process of achieving an institution's preferred enrollment profile, starting by identifying the strategic purposes and mission of the institution, and then orchestrating the marketing, recruitment, admissions, pricing and aid, retention programs, academic support…

Proposed outcome measures for prospective clinical trials in juvenile idiopathic arthritis-associated uveitis

DEFF Research Database (Denmark)

Heiligenhaus, Arnd; Foeldvari, Ivan; Edelsten, Clive

2012-01-01

To develop a set of core outcome measures for use in randomized controlled trials (RCTs) and longitudinal observational studies in juvenile idiopathic arthritis (JIA)-associated uveitis.......To develop a set of core outcome measures for use in randomized controlled trials (RCTs) and longitudinal observational studies in juvenile idiopathic arthritis (JIA)-associated uveitis....

EnROL: A multicentre randomised trial of conventional versus laparoscopic surgery for colorectal cancer within an enhanced recovery programme

Directory of Open Access Journals (Sweden)

Kennedy Robin H

2012-05-01

Full Text Available Abstract Background During the last two decades the use of laparoscopic resection and a multimodal approach known as an enhanced recovery programme, have been major changes in colorectal perioperative care. Clinical outcome improves using laparoscopic surgery to resect colorectal cancer but until recently no multicentre trial evidence had been reported regarding whether the benefits of laparoscopy still exist when open surgery is optimized within an enhanced recovery programme. The EnROL trial (Enhanced Recovery Open versus Laparoscopic examines the hypothesis that laparoscopic surgery within an enhanced recovery programme will provide superior postoperative outcomes when compared to conventional open resection of colorectal cancer within the same programme. Methods/design EnROL is a phase III, multicentre, randomised trial of laparoscopic versus open resection of colon and rectal cancer with blinding of patients and outcome observers to the treatment allocation for the first 7 days post-operatively, or until discharge if earlier. 202 patients will be recruited at approximately 12 UK hospitals and randomised using minimization at a central computer system in a 1:1 ratio. Recruiting surgeons will previously have performed >100 laparoscopic colorectal resections and >50 open total mesorectal excisions to minimize conversion. Eligible patients are those suitable for elective resection using either technique. Excluded patients include: those with acute intestinal obstruction and patients in whom conversion from laparoscopic to open procedure is likely. The primary outcome is physical fatigue as measured by the physical fatigue domain of the multidimensional fatigue inventory 20 (MFI-20 with secondary outcomes including postoperative hospital stay; complications; reoperation and readmission; quality of life indicators; cosmetic assessments; standardized performance indicators; health economic analysis; the other four domains of the MFI-20

Psychosocial predictors of treatment outcome for trauma-affected refugees

DEFF Research Database (Denmark)

Sonne, Charlotte Kærgaard; Mortensen, Erik Lykke; Carlsson, Jessica

2016-01-01

outcome. Objective The objective of the study was to examine possible psychosocial predictors of treatment outcome for trauma-affected refugees. Method The participants were 195 adult refugees with posttraumatic stress disorder (PTSD) who were enrolled in a 6- to 7-month treatment programme...

Astronomy Enrollments and Degrees: Results from the 2012 Survey of Astronomy Enrollments and Degrees. Focus On

Science.gov (United States)

Mulvey, Patrick; Nicholson, Starr

2014-01-01

Interest in astronomy degrees in the U.S. remains strong, with astronomy enrollments at or near all-time highs for the 2012-13 academic year. The total number of students taking an introductory astronomy course at a degree-granting physics or astronomy department is approaching 200,000. Enrollments in introductory astronomy courses have been…

Retail price as an outcome measure for the effectiveness of drug law enforcement.

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Bright, David A; Ritter, Alison

2010-09-01

One outcome measure of law enforcement effectiveness is the reduction in drug consumption which occurs as a result of law enforcement interventions. A theoretical relationship between drug consumption and retail price has promoted the use of retail price as a surrogate measure for consumption. In the current article, retail price is examined as a potential outcome measure for the effectiveness of law enforcement. The predictions regarding the relationship between law enforcement intensity and price are only partially supported by research. Explanations for the disconnect between the drug law enforcement activity and retail price include: rapid adaptation by market players, enforcement swamping, assumptions of rational actors, short-run versus long-run effects, structure of the illicit market, simultaneous changes that affect price in perverse ways, the role of violence in markets, and data limitations. Researchers who use retail price as an outcome measure need to take into account the complex relationship between drug law enforcement interventions and the retail price of illicit drugs. Viable outcome measures which can be used as complements to retail price are worth investigation. Copyright 2009 Elsevier B.V. All rights reserved.

Center-size as a predictor of weight-loss outcome in multicenter trials including a low-calorie diet

DEFF Research Database (Denmark)

Gasteyger, Christoph Rolf; Christensen, Robin; Larsen, Thomas Meinert

2010-01-01

weight loss. This is a post hoc analysis of an existing database: 701 obese subjects (77% women, 23% men, mean BMI: 38.9 kg/m(2)) were enrolled at 22 sites (4-85 subjects/site) in five countries to follow a LCD providing 800-1,000 kcal/day during 8 weeks. The main outcome measure was the percentage...

20 CFR 901.11 - Enrollment procedures.

Science.gov (United States)

2010-04-01

... Columbia responsible for the issuance of a license in the field of actuarial science, insurance, accounting... ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Enrollment of Actuaries § 901... enrollment to perform actuarial services under the Employee Retirement Income Security Act of 1974, each...

Measuring quality of life in cleft lip and palate patients: currently available patient-reported outcomes measures.

Science.gov (United States)

Eckstein, Donna A; Wu, Rebecca L; Akinbiyi, Takintope; Silver, Lester; Taub, Peter J

2011-11-01

Patient-reported outcomes in cleft lip and palate treatment are critical for patient care. Traditional surgical outcomes focused on objective measures, such as photographs, anatomic measurements, morbidity, and mortality. Although these remain important, they leave many questions unanswered. Surveys that include aesthetics, speech, functionality, self-image, and quality of life provide more thorough outcomes assessment. It is vital that reliable, valid, and comprehensive questionnaires are available to craniofacial surgeons. The authors performed a literature review to identify questionnaires validated in cleft lip and palate patients. Qualifying instruments were assessed for adherence to guidelines for development and validation by the scientific advisory committee and for content. The authors identified 44 measures used in cleft lip and palate studies. After 15 ad hoc questionnaires, eight generic instruments, 11 psychiatric instruments, and one non-English language questionnaire were excluded, nine measures remained. Of these, four were never validated in the cleft population. Analysis revealed one craniofacial-specific measure (Youth Quality of Life-Facial Differences), two voice-related measures (Patient Voice-Related Quality of Life and Cleft Audit Protocol for Speech-Augmented), and two oral health-related measures (Child Oral Health Impact Profile and Child Oral Health Quality of Life). The Youth Quality of Life-Facial Differences, Child Oral Health Impact Profile, and Child Oral Health Quality of Life questionnaires were sufficiently validated. None was created specifically for clefts, resulting in content limitations. There is a lack of comprehensive, valid, and reliable questionnaires for cleft lip and palate surgery. For thorough assessment of satisfaction, further research to develop and validate cleft lip and palate surgery-specific instruments is needed.

Teen clinics: missing the mark? Comparing pregnancy and sexually transmitted infections rates among enrolled and non-enrolled adolescents.

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Shaw, Souradet Y; Metge, Colleen; Taylor, Carole; Chartier, Mariette; Charette, Catherine; Lix, Lisa; Santos, Rob; Sarkar, Joykrishna; Nickel, Nathan C; Burland, Elaine; Chateau, Dan; Katz, Alan; Brownell, Marni; Martens, Patricia J

2016-06-21

In Manitoba, Canada, school-based clinics providing sexual and reproductive health services for adolescents have been implemented to address high rates of sexually transmitted infections (STIs) and pregnancies. The objectives of this population-based study were to compare pregnancy and STI rates between adolescents enrolled in schools with school-based clinics, those in schools without clinics, and those not enrolled in school. Data were from the PATHS Data Resource held in the Population Health Research Data Repository housed at the Manitoba Centre for Health Policy. Adolescents aged 14 to 19 between 2003 and 2009 were included in the study. Annualized rates of pregnancies and positive STI tests were estimated and Poisson regression models were used to test for differences in rates amongst the three groups. As a proportion, pregnancies among non-enrolled female adolescents accounted for 55 % of all pregnancies in this age group during the study period. Pregnancy rates were 2-3 times as high among non-enrolled female adolescents. Compared to adolescents enrolled in schools without school-based clinics, age-adjusted STI rates were 3.5 times (p pregnancies and STIs were observed among non-enrolled adolescents. Although provision of reproductive and health services to in-school adolescents should remain a priority, program planning and design should consider optimal strategies to engage out of school youth.

A systematic review of measurement properties of patient reported outcome measures in psoriatic arthritis: A GRAPPA-OMERACT initiative.

Science.gov (United States)

Højgaard, Pil; Klokker, Louise; Orbai, Ana-Maria; Holmsted, Kim; Bartels, Else M; Leung, Ying Ying; Goel, Niti; de Wit, Maarten; Gladman, Dafna D; Mease, Philip; Dreyer, Lene; Kristensen, Lars E; FitzGerald, Oliver; Tillett, William; Gossec, Laure; Helliwell, Philip; Strand, Vibeke; Ogdie, Alexis; Terwee, Caroline B; Christensen, Robin

2018-04-01

An updated psoriatic arthritis (PsA) core outcome set (COS) for randomized controlled trials (RCTs) was endorsed at the Outcome Measures in Rheumatology (OMERACT) meeting in 2016. To synthesize the evidence on measurement properties of patient reported outcome measures (PROMs) for PsA and thereby contribute to development of a PsA core outcome measurement set (COMS) as described by the OMERACT Filter 2.0. A systematic literature search was performed in EMBASE, MEDLINE and PsycINFO on Jan 1, 2017 to identify full-text articles with an aim of assessing the measurement properties of PROMs in PsA. Two independent reviewers rated the quality of studies using the COnsensus based standards for the Selection of health Measurement INstruments (COSMIN) checklist, and performed a qualitative evidence synthesis. Fifty-five studies were included in the systematic review. Forty-four instruments and a total of 89 scales were analyzed. PROMs measuring COS domains with at least fair quality evidence for good validity and reliability (and no evidence for poor properties) included the Stockerau Activity Score for PsA (German), Psoriasis Symptom Inventory, visual analogue scale for Patient Global, 36 Item Short Form Health Survey Physical Function subscale, Health Assessment Questionnaire Disability Index, Bath Ankylosing Spondylitis Functional Index, PsA Impact of Disease questionnaire, PsA Quality of Life questionnaire, VITACORA-19, Functional Assessment of Chronic Illness Therapy Fatigue scale and Social Role Participation Questionnaire. At least one PROM with some evidence for aspects of validity and reliability was available for six of the eight mandatory domains of the PsA COS. Copyright © 2018 Elsevier Inc. All rights reserved.

Outcome measures and definition of cure in female stress urinary incontinence surgery: a survey of recent publications.

Science.gov (United States)

Castillo, Peter A; Espaillat-Rijo, Luis M; Davila, G Willy

2010-03-01

Much variability exists in outcome measures used to report success of SUI surgery. We set out to evaluate outcome measures and definitions of cure in SUI surgery studies. Outcome measures, success rates, and definition of cure were analyzed from published series and compared to recommendations by leading authorities. Ninety-one publications were analyzed. Thirty (33%) utilized solely subjective measures, four (4%) utilized only objective measures, and 57 (63%) included both. Sixty-one (67%) used symptom questionnaires, 56 (60%) QOL questionnaires, and six (7%) visual analog scale. Twelve (13%) used voiding diaries and 52 (56%) used self-reporting as an outcome measure. Objective measures: 52 (57%) cough stress test, 37 (41%) urodynamic evaluation, 28 (31%) pad testing and a combination in 33 (36%). Few studies adhered to one set of outcome recommendations. Outcome measures used to evaluate success of anti-incontinence procedures lack consensus and comparability.

Developing a General Outcome Measure Off Growth in Social Skills for Infants and Toddlers

Science.gov (United States)

Carta, Judith; Greenwood, Charles; Luze, Gayle; Cline, Gabriel; Kuntz, Susan

2004-01-01

Proficiency in social interaction with adults and peers is an important outcome in early childhood. The development of an experimental measure for assessing growth in social skills in children birth to 3 years is described. Based on the general outcome measurement (GOM) approach (e.g., Deno, 1997), the measure is intended for use by early…

Developing a General Outcome Measure of Growth in Social Skills for Infants and Toddlers

Science.gov (United States)

Carta, Judith; Greenwood, Charles; Luze, Gayle; Cline, Gabriel; Kuntz, Susan

2004-01-01

Proficiency in social interaction with adults and peers is an important outcome in early childhood. The development of an experimental measure for assessing growth in social skills in children birth to 3 years is described. Based on the general outcome measurement (GOM) approach (e.g., Deno, 1997), the measure is intended for use by early…

The Effect of Empowerment and Self-Determination on Health Outcomes.

Science.gov (United States)

Garces-Ozanne, Arlene; Kalu, Edna Ikechi; Audas, Richard

2016-12-01

There remains a persistent gap in health outcomes between wealthy and poor countries. Basic measures such as life expectancy and infant and under-five mortality remain divergent, with preventable deaths being unacceptably high, despite significant efforts to reduce these disparities. We examine the impact of empowerment, measured by Freedom House's ratings of country's political rights and civil liberties, while controlling for per capita gross domestic product, secondary school enrollment, and income inequality, on national health outcomes. Using data from 1970 to 2013 across 149 countries, our results suggest, quite strongly, that higher levels of empowerment have a significant positive association with life expectancy, particularly for females, and lower rates of infant and under-five mortality. Our results point to the need for efforts to stimulate economic growth be accompanied with reforms to increase the levels empowerment through increasing political rights and civil liberties. © 2016 Society for Public Health Education.

Development of the FOCUS (Focus on the Outcomes of Communication under Six), a Communication Outcome Measure for Preschool Children

Science.gov (United States)

Thomas-Stonell, Nancy L.; Oddson, Bruce; Robertson, Bernadette; Rosenbaum, Peter L.

2010-01-01

Aim: Our aim was to develop an outcome measure, called Focus on the Outcomes of Communication Under Six (FOCUS), that captures real-world changes in preschool children's communication. Conceptually grounded in the World Health Organization International Classification of Functioning, Disability and Health framework, the FOCUS items were derived…

Academic outcomes in Asian children aged 8-11 years with attention-deficit/hyperactivity disorder treated with atomoxetine hydrochloride.

Science.gov (United States)

Mendez, Luis; Singh, Pritibha; Harrison, Gavan; Huang, Yu-Shu; Jin, Xingming; Cho, Soo Churl

2011-06-01

To investigate the relationship between changes in attention-deficit/hyperactivity disorder (ADHD) core symptoms and changes in academic outcome of Asian children treated with atomoxetine. This open-label study enrolled patients aged 8-11 years with DSM-IV-TR-defined ADHD, who were naïve to ADHD medications and met the symptomatic severity threshold of 1.5 standard deviations above the age and gender norm for the ADHDRS-IV-Parent:Inv (ADHDRS) total score. Data collection occurred for 24 weeks and included academic outcome, measured by the school grade average (SGA). Of 228 patients enrolled from China (n = 82), Taiwan (n = 76), and Korea (n = 70), 77.2% completed the study. Statistically significant (P < 0.001) baseline to last observation improvements in ADHDRS and SGA scores were observed. However, no linear correlation between change in ADHDRS total score and SGA (-0.083, P = 0.293) was observed. Despite significant independent improvements in core ADHD symptoms and academic grades over 24 weeks, the mean improvements observed in these measures did not appear to be correlated.

Using Cross-Cultural Dimensions Exercises to Improve and Measure Learning Outcomes in International Business Courses

Science.gov (United States)

Zainuba, Mohamed; Rahal, Ahmad

2012-01-01

This article proposes an approach for using cross-cultural dimensions exercises to improve and measure learning outcomes in international business courses. The following key issues are highlighted: (a) what are the targeted learning outcomes to be assessed, (b) how to measure the accomplishment of these learning outcomes, (c) the input measures…

Goal setting as an outcome measure: A systematic review.

Science.gov (United States)

Hurn, Jane; Kneebone, Ian; Cropley, Mark

2006-09-01

Goal achievement has been considered to be an important measure of outcome by clinicians working with patients in physical and neurological rehabilitation settings. This systematic review was undertaken to examine the reliability, validity and sensitivity of goal setting and goal attainment scaling approaches when used with working age and older people. To review the reliability, validity and sensitivity of both goal setting and goal attainment scaling when employed as an outcome measure within a physical and neurological working age and older person rehabilitation environment, by examining the research literature covering the 36 years since goal-setting theory was proposed. Data sources included a computer-aided literature search of published studies examining the reliability, validity and sensitivity of goal setting/goal attainment scaling, with further references sourced from articles obtained through this process. There is strong evidence for the reliability, validity and sensitivity of goal attainment scaling. Empirical support was found for the validity of goal setting but research demonstrating its reliability and sensitivity is limited. Goal attainment scaling appears to be a sound measure for use in physical rehabilitation settings with working age and older people. Further work needs to be carried out with goal setting to establish its reliability and sensitivity as a measurement tool.

Measure for measure. Outcome assessment of arthritis treatment in clinical practice

OpenAIRE

Gülfe, Anders

2009-01-01

Objective: To investigate (i) the performance and agreement between various activity indices and response criteria in TNF-blockade of RA; (ii) the predictive ability of different response criteria and disease activity states regarding continuation of anti-TNF treatment of RA; (iii) Euro-QoL-5-dimensions utility development during TNF blockade of RA, PsA and SpA. Also, (iv) to develop a simple, utility-based outcome measure, the number needed to treat per quality adjusted life year gained (NN...

The uses of outcome measures within multidisciplinary early childhood intervention services: a systematic review.

Science.gov (United States)

Calder, Samuel; Ward, Roslyn; Jones, Megan; Johnston, Jenelle; Claessen, Mary

2017-07-18

Purpose of the article: To review the use of outcome measures, across the domains of activity, participation, and environment, within multidisciplinary early childhood intervention services. A systematic literature search was undertaken that included four electronic databases: Medline, CINAHL, EMBASE, and the Cochrane Library and Cochrane Database of Systematic Review. Inclusion criteria were age 0-24 months, having or at risk of a developmental disability, in receipt of multidisciplinary early childhood intervention services, and included outcome measures across all domains of the International Classification of Functioning-Child & Youth (ICF-CY). Only peer-reviewed journal articles were considered. Eligible studies were coded using the Oxford Levels of Evidence. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) Scale for randomised controlled trials and the QualSyst for non-randomised control trials. Of the total of 5764 records identified, 10 were considered to meet inclusion criteria. Fourteen outcome measures were identified, addressing the domains of activity, participation, and environment. Of these, eight have been recommended in the early intervention literature. While the methodological quality of the 10 studies varied, these papers make a contribution to the body of research that acknowledges the role of routine and enriched environments. Implications for Rehabilitation Core practice elements of multidisciplinary early childhood intervention services indicate it is necessary to select outcome measures framed within the International Classification of Functioning-Child & Youth to inform clinical decision-making for measuring intervention effectiveness across the domains of activity, participation and environment. Of the identified measures, three (Canadian Occupational Performance Measure, Pediatric Evaluation of Disability Inventory, and Goal Attainment Scaling) are well-established and identified in the literature as

Towards global consensus on outcome measures for atopic eczema research: results of the HOME II meeting.

Science.gov (United States)

Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

2012-09-01

The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes research. In June 2011, the HOME initiative conducted a consensus study involving 43 individuals from 10 countries, representing different stakeholders (patients, clinicians, methodologists, pharmaceutical industry) to determine core outcome domains for atopic eczema trials, to define quality criteria for atopic eczema outcome measures and to prioritize topics for atopic eczema outcomes research. Delegates were given evidence-based information, followed by structured group discussion and anonymous consensus voting. Consensus was achieved to include clinical signs, symptoms, long-term control of flares and quality of life into the core set of outcome domains for atopic eczema trials. The HOME initiative strongly recommends including and reporting these core outcome domains as primary or secondary endpoints in all future atopic eczema trials. Measures of these core outcome domains need to be valid, sensitive to change and feasible. Prioritized topics of the HOME initiative are the identification/development of the most appropriate instruments for the four core outcome domains. HOME is open to anyone with an interest in atopic eczema outcomes research. © 2012 John Wiley & Sons A/S.

Heterogeneity of wound outcome measures in RCTs of treatments for VLUs: a systematic review.

Science.gov (United States)

Gethin, G; Killeen, F; Devane, D

2015-05-01

Venous leg ulcers (VLUs) affect up to 4% of the population aged over 65 years. Outcomes of randomised controlled trials (RCTs) in VLUs are important to guide clinical and resource decision making. Our objective was to identify what endpoints and wound bed outcomes were assessed in RCTs in VLUs; how these were assessed and what reference was made to validity and reliability of methods used. A systematic review of all full text RCTs, published in English, from 1998-2013. Our criteria were met by 102 studies. There were 78 different endpoints recorded, the majority (n=34) related to healing and were evaluated at 12 different times points. Size was the most frequently reported outcome measure (n=99), with photographs, tissue type, exudate, odour and pain also recorded. There was poor reporting of methods used to assess outcomes. Visual analogue scales predominated as a method of assessment, but 95% of studies made no reference to the validity or reliability of assessment methods. Future research in VLUs requires standards for measuring outcomes with acceptable inter-rater reliability and validated measures of patient-reported outcomes.

Functional outcome measures in a surgical model of hip osteoarthritis in dogs

OpenAIRE

Little, Dianne; Johnson, Stephen; Hash, Jonathan; Olson, Steven A.; Estes, Bradley T.; Moutos, Franklin T.; Lascelles, B. Duncan X.; Guilak, Farshid

2016-01-01

Background The hip is one of the most common sites of osteoarthritis in the body, second only to the knee in prevalence. However, current animal models of hip osteoarthritis have not been assessed using many of the functional outcome measures used in orthopaedics, a characteristic that could increase their utility in the evaluation of therapeutic interventions. The canine hip shares similarities with the human hip, and functional outcome measures are well documented in veterinary medicine, pr...

Dual Enrollment Participation from the Student Perspective

Science.gov (United States)

Kanny, M. Allison

2015-01-01

This chapter examines the experiences of five high school students previously enrolled in dual enrollment courses, and discusses the perceived benefits and disadvantages of these experiences from the student perspective.

Outcomes of Children with Hearing Loss: Data Collection and Methods.

Science.gov (United States)

Tomblin, J Bruce; Walker, Elizabeth A; McCreery, Ryan W; Arenas, Richard M; Harrison, Melody; Moeller, Mary Pat

2015-01-01

The primary objective of this article was to describe recruitment, data collection, and methods for a longitudinal, multicenter study involving children with bilateral mild to severe hearing loss. The goals of this research program were to characterize the developmental outcomes of children with mild to severe bilateral hearing loss during infancy and the preschool years. Furthermore, the researchers examined how these outcomes were associated with the child's hearing loss and how home background and clinical interventions mediated and moderated these outcomes. The participants in this study were children who are hard of hearing (CHH) and children with normal hearing (CNH) who provided comparison data. CHH were eligible for participation if (1) their chronological age was between 6 months and 7 years of age at the time of recruitment, (2) they had a better-ear pure-tone average of 25 to 75 dB HL, (3) they had not received a cochlear implant, (4) they were from homes where English was the primary language, and (5) they did not demonstrate significant cognitive or motor delays. Across the time span of recruitment, 430 parents of potential children with hearing loss made contact with the research group. This resulted in 317 CHH who qualified for enrollment. In addition, 117 CNH qualified for enrollment. An accelerated longitudinal design was used, in which multiple age cohorts were followed long enough to provide overlap. Specifically, children were recruited and enrolled continuously across an age span of 6.5 years and were followed for at least 3 years. This design allowed for tests of time (period) versus cohort age effects that could arise by changes in services and technology over time, yet still allowed for examination of important developmental relationships. The distribution of degree of hearing loss for the CHH showed that the majority of CHH had moderate or moderate-to-severe hearing losses, indicating that the sample undersampled children with mild HL. For

Psychometric properties of the Spanish version of the Clinical Outcomes in Routine Evaluation – Outcome Measure

Directory of Open Access Journals (Sweden)

Trujillo A

2016-06-01

Full Text Available Adriana Trujillo,1,2 Guillem Feixas,1,2 Arturo Bados,1 Eugeni García-Grau,1 Marta Salla,1 Joan Carles Medina,1 Adrián Montesano,1,2 José Soriano,3 Leticia Medeiros-Ferreira,4 Josep Cañete,5 Sergi Corbella,6 Antoni Grau,7 Fernando Lana,8 Chris Evans9 1Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology, 2Institute for Brain, Cognition and Behaviour, University of Barcelona, 3Hospital of the Holy Cross and Saint Paul, 4Nou Barris Mental Health Center, Barcelona, 5Hospital of Mataró, Sanitary Consortium of Maresme, Mataró, 6FPCEE, Blanquerna, Universitat Ramon Llull, 7Institute of Eating Disorders, Barcelona, 8MAR Health Park, CAEMIL, Santa Coloma de Gramenet, Spain; 9East London NHS Foundation Trust, NPDDNet, London, UK Objective: The objective of this paper is to assess the reliability and validity of the Spanish translation of the Clinical Outcomes in Routine Evaluation – Outcome Measure, a 34-item self-report questionnaire that measures the client’s status in the domains of Subjective well-being, Problems/Symptoms, Life functioning, and Risk.Method: Six hundred and forty-four adult participants were included in two samples: the clinical sample (n=192 from different mental health and primary care centers; and the nonclinical sample (n=452, which included a student and a community sample.Results: The questionnaire showed good acceptability and internal consistency, appropriate test–retest reliability, and acceptable convergent validity. Strong differentiation between clinical and nonclinical samples was found. As expected, the Risk domain had different characteristics than other domains, but all findings were comparable with the UK referential data. Cutoff scores were calculated for clinical significant change assessment.Conclusion: The Spanish version of the Clinical Outcomes in Routine Evaluation – Outcome Measure showed acceptable psychometric properties, providing support for using the

Forecasting Enrollments with Fuzzy Time Series.

Science.gov (United States)

Song, Qiang; Chissom, Brad S.

The concept of fuzzy time series is introduced and used to forecast the enrollment of a university. Fuzzy time series, an aspect of fuzzy set theory, forecasts enrollment using a first-order time-invariant model. To evaluate the model, the conventional linear regression technique is applied and the predicted values obtained are compared to the…

Methods and Techniques of Enrollment Forecasting.

Science.gov (United States)

Brinkman, Paul T.; McIntyre, Chuck

1997-01-01

There is no right way to forecast college enrollments; in many instances, it will be prudent to use both qualitative and quantitative methods. Methods chosen must be relevant to questions addressed, policies and decisions at stake, and time and talent required. While it is tempting to start quickly, enrollment forecasting is an area in which…

Psychometrics of the Personal Questionnaire: A client-generated outcome measure.

Science.gov (United States)

Elliott, Robert; Wagner, John; Sales, Célia M D; Rodgers, Brian; Alves, Paula; Café, Maria J

2016-03-01

We present a range of evidence for the reliability and validity of data generated by the Personal Questionnaire (PQ), a client-generated individualized outcome measure, using 5 data sets from 3 countries. Overall pretherapy mean internal consistency (alpha) across clients was .80, and within-client alphas averaged .77; clients typically had 1 or 2 items that did not vary with the other items. Analyses of temporal structure indicated high levels of between-clients variance (58%), moderate pretherapy test-retest correlation (r = .57), and high session-to-session Lag-1 autocorrelation (.82). Scores on the PQ provided clear evidence of convergence with a range of outcome measures (within-client r = .41). Mean pre-post effects were large (d = 1.25). The results support a revised caseness cutoff of 3.25 and a reliable change index interval of 1.67. We conclude that PQ data meet criteria for evidence-based, norm-referenced measurement of client psychological distress for supporting psychotherapy practice and research. (c) 2016 APA, all rights reserved).

Comparison of reliability and responsiveness of patient-reported clinical outcome measures in knee osteoarthritis rehabilitation.

Science.gov (United States)

Williams, Valerie J; Piva, Sara R; Irrgang, James J; Crossley, Chad; Fitzgerald, G Kelley

2012-08-01

Secondary analysis, pretreatment-posttreatment observational study. To compare the reliability and responsiveness of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Knee Outcome Survey activities of daily living subscale (KOS-ADL), and the Lower Extremity Functional Scale (LEFS) in individuals with knee osteoarthritis (OA). The WOMAC is the current standard in patient-reported measures of function in patients with knee OA. The KOS-ADL and LEFS were designed for potential use in patients with knee OA. If the KOS-ADL and LEFS are to be considered viable alternatives to the WOMAC for measuring patient-reported function in individuals with knee OA, they should have measurement properties comparable to the WOMAC. It would also be important to determine whether either of these instruments may be superior to the WOMAC in terms of reliability or responsiveness in this population. Data from 168 subjects with knee OA, who participated in a rehabilitation program, were used in the analyses. Reliability and responsiveness of each outcome measure were estimated at follow-ups of 2, 6, and 12 months. Reliability was estimated by calculating the intraclass correlation coefficient (ICC2,1) for subjects who were unchanged in status from baseline at each follow-up time, based on a global rating of change score. To examine responsiveness, the standard error of the measurement, minimal detectable change, minimal clinically important difference, and the Guyatt responsiveness index were calculated for each outcome measure at each follow-up time. All 3 outcome measures demonstrated reasonable reliability and responsiveness to change. Reliability and responsiveness tended to decrease somewhat with increasing follow-up time. There were no substantial differences between outcome measures for reliability or any of the 3 measures of responsiveness at any follow-up time. The results do not indicate that one outcome measure is more reliable or responsive than

Towards global consensus on outcome measures for atopic eczema research: results of the HOME II meeting

NARCIS (Netherlands)

Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F.; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

2012-01-01

The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes

Towards global consensus on outcome measures for atopic eczema research : Results of the HOME II meeting

NARCIS (Netherlands)

Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes

Comparative study of outcome measures and analysis methods for traumatic brain injury trials.

Science.gov (United States)

Alali, Aziz S; Vavrek, Darcy; Barber, Jason; Dikmen, Sureyya; Nathens, Avery B; Temkin, Nancy R

2015-04-15

Batteries of functional and cognitive measures have been proposed as alternatives to the Extended Glasgow Outcome Scale (GOSE) as the primary outcome for traumatic brain injury (TBI) trials. We evaluated several approaches to analyzing GOSE and a battery of four functional and cognitive measures. Using data from a randomized trial, we created a "super" dataset of 16,550 subjects from patients with complete data (n=331) and then simulated multiple treatment effects across multiple outcome measures. Patients were sampled with replacement (bootstrapping) to generate 10,000 samples for each treatment effect (n=400 patients/group). The percentage of samples where the null hypothesis was rejected estimates the power. All analytic techniques had appropriate rates of type I error (≤5%). Accounting for baseline prognosis either by using sliding dichotomy for GOSE or using regression-based methods substantially increased the power over the corresponding analysis without accounting for prognosis. Analyzing GOSE using multivariate proportional odds regression or analyzing the four-outcome battery with regression-based adjustments had the highest power, assuming equal treatment effect across all components. Analyzing GOSE using a fixed dichotomy provided the lowest power for both unadjusted and regression-adjusted analyses. We assumed an equal treatment effect for all measures. This may not be true in an actual clinical trial. Accounting for baseline prognosis is critical to attaining high power in Phase III TBI trials. The choice of primary outcome for future trials should be guided by power, the domain of brain function that an intervention is likely to impact, and the feasibility of collecting outcome data.

Status epilepticus severity score (STESS): A useful tool to predict outcome of status epilepticus.

Science.gov (United States)

Goyal, Manoj Kumar; Chakravarthi, Sudheer; Modi, Manish; Bhalla, Ashish; Lal, Vivek

2015-12-01

The treatment protocols for status epilepticus (SE) range from small doses of intravenous benzodiazepines to induction of coma. The pros and cons of more aggressive treatment regimen remain debatable. The importance of an index need not be overemphasized which can predict outcome of SE and guide the intensity of treatment. We tried to evaluate utility of one such index Status epilepticus severity score (STESS). 44 consecutive patients of SE were enrolled in the study. STESS results were compared with various outcome measures: (a) mortality, (b) final neurological outcome at discharge as defined by functional independence measure (FIM) (good outcome: FIM score 5-7; bad outcome: FIM score 1-4), (c) control of SE within 1h of start of treatment and (d) need for coma induction. A higher STESS score correlated significantly with poor neurological outcome at discharge (p=0.0001), need for coma induction (p=0.0001) and lack of response to treatment within 1h (p=0.001). A STESS of status epilepticus. Further studies on STESS based treatment approach may help in designing better therapeutic regimens for SE. Copyright © 2015 Elsevier B.V. All rights reserved.

Using active learning strategies to investigate student learning and attitudes in a large enrollment, introductory geology course

Science.gov (United States)

Berry, Stacy Jane

There has been an increased emphasis for college instruction to incorporate more active and collaborative involvement of students in the learning process. These views have been asserted by The Association of American Colleges (AAC), the National Science Foundation (NSF), and The National Research Counsel (NRC), which are advocating for the modification of traditional instructional techniques to allow students the opportunity to be more cooperative (Task Group on General Education, 1988). This has guided educators and facilitators into shifting teaching paradigms from a teacher centered to a more student-centered curriculum. The present study investigated achievement outcomes and attitudes of learners in a large enrollment (n ~ 200), introductory geology course using a student centered learning cycle format of instruction versus another similar section that used a traditional lecture format. Although the course is a recruiting class for majors, over 95% of the students that enroll are non-majors. Measurements of academic evaluation were through four unit exams, classroom communication systems, weekly web-based homework, in-class activities, and a thematic collaborative poster/paper project and presentation. The qualitative methods to investigate the effectiveness of the teaching design included: direct observation, self-reporting about learning, and open-ended interviews. By disaggregating emerging data, we tried to concentrate on patterns and causal relationships between achievement performance and attitudes regarding learning geology. Statistical analyses revealed positive relationships between student engagement in supplemental activities and achievement mean scores within and between the two sections. Completing weekly online homework had the most robust relationship with overall achievement performance. Contrary to expectations, a thematic group project only led to modest gains in achievement performance, although the social and professional gains could be

Positive psychology outcome measures for family caregivers of people living with dementia: a systematic review.

Science.gov (United States)

Stansfeld, Jacki; Stoner, Charlotte R; Wenborn, Jennifer; Vernooij-Dassen, Myrra; Moniz-Cook, Esme; Orrell, Martin

2017-08-01

Family caregivers of people living with dementia can have both positive and negative experiences of caregiving. Despite this, existing outcome measures predominately focus on negative aspects of caregiving such as burden and depression. This review aimed to evaluate the development and psychometric properties of existing positive psychology measures for family caregivers of people living with dementia to determine their potential utility in research and practice. A systematic review of positive psychology outcome measures for family caregivers of people with dementia was conducted. The databases searched were as follows: PsychINFO, CINAHL, MEDLINE, EMBASE, and PubMed. Scale development papers were subject to a quality assessment to appraise psychometric properties. Twelve positive outcome measures and six validation papers of these scales were identified. The emerging constructs of self-efficacy, spirituality, resilience, rewards, gain, and meaning are in line with positive psychology theory. There are some robust positive measures in existence for family caregivers of people living with dementia. However, lack of reporting of the psychometric properties hindered the quality assessment of some outcome measures identified in this review. Future research should aim to include positive outcome measures in interventional research to facilitate a greater understanding of the positive aspects of caregiving and how these contribute to well-being.

Gender Preference in Primary School Enrolment among ...

African Journals Online (AJOL)

Gender Preference in Primary School Enrolment among Households in Northern ... Narrowing and eliminating enrolment gaps between male and female ... that income level of the household head, number of male and female children of ...

42 CFR 417.538 - Enrollment and marketing costs.

Science.gov (United States)

2010-10-01

... PREPAYMENT PLANS Medicare Payment: Cost Basis § 417.538 Enrollment and marketing costs. (a) Principle. Costs incurred by an HMO or CMP in performing the enrollment and marketing activities described in subpart k of... 42 Public Health 3 2010-10-01 2010-10-01 false Enrollment and marketing costs. 417.538 Section 417...

German Undergraduate Mathematics Enrolment Numbers: Background and Change

Science.gov (United States)

Ammann, Claudia; Frauendiener, Jorg; Holton, Derek

2010-01-01

Before we consider the German tertiary system, we review the education system and consider other relevant background details. We then concentrate on the tertiary system and observe that the mathematical enrolments are keeping up with the overall student enrolments. At the same time, the first year mathematics enrolments for women are greater than…

20 CFR 901.30 - Authority to suspend or terminate enrollment.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Authority to suspend or terminate enrollment. 901.30 Section 901.30 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... the enrollment of an enrolled actuary if the Joint Board finds that such enrolled actuary (a) Has...

The quality of systematic reviews of health-related outcome measurement instruments.

Science.gov (United States)

Terwee, C B; Prinsen, C A C; Ricci Garotti, M G; Suman, A; de Vet, H C W; Mokkink, L B

2016-04-01

Systematic reviews of outcome measurement instruments are important tools for the selection of instruments for research and clinical practice. Our aim was to assess the quality of systematic reviews of health-related outcome measurement instruments and to determine whether the quality has improved since our previous study in 2007. A systematic literature search was performed in MEDLINE and EMBASE between July 1, 2013, and June 19, 2014. The quality of the reviews was rated using a study-specific checklist. A total of 102 reviews were included. In many reviews the search strategy was considered not comprehensive; in only 59 % of the reviews a search was performed in EMBASE and in about half of the reviews there was doubt about the comprehensiveness of the search terms used for type of measurement instruments and measurement properties. In 41 % of the reviews, compared to 30 % in our previous study, the methodological quality of the included studies was assessed. In 58 %, compared to 55 %, the quality of the included instruments was assessed. In 42 %, compared to 7 %, a data synthesis was performed in which the results from multiple studies on the same instrument were somehow combined. Despite a clear improvement in the quality of systematic reviews of outcome measurement instruments in comparison with our previous study in 2007, there is still room for improvement with regard to the search strategy, and especially the quality assessment of the included studies and the included instruments, and the data synthesis.

CDHPs: as enrollment goes up, a time to tune up.

Science.gov (United States)

Domaszewicz, Sander; Savan, Jay

2014-01-01

One of the clearest findings of Mercer's annual National Survey of Employer-Sponsored Health Plans is that more companies are thinking of adopting a consumer-directed health plan (CDHP) approach, and more employees are enrolling in CDHPs at the companies that offer them. The authors discuss the advantages for organizations that offer CDHPs, as well as outline key considerations for companies looking to update, optimize and align their CDHPs with the realities of health care reform. They also explain how CDHPs go hand in hand with wellness and health management strategies, both of which increase collaboration between employees and employers to control costs and give employees more personal responsibility for better outcomes.

Psychometric properties of carer-reported outcome measures in palliative care: A systematic review

Science.gov (United States)

Michels, Charlotte TJ; Boulton, Mary; Adams, Astrid; Wee, Bee; Peters, Michele

2016-01-01

Background: Informal carers face many challenges in caring for patients with palliative care needs. Selecting suitable valid and reliable outcome measures to determine the impact of caring and carers’ outcomes is a common problem. Aim: To identify outcome measures used for informal carers looking after patients with palliative care needs, and to evaluate the measures’ psychometric properties. Design: A systematic review was conducted. The studies identified were evaluated by independent reviewers (C.T.J.M., M.B., M.P.). Data regarding study characteristics and psychometric properties of the measures were extracted and evaluated. Good psychometric properties indicate a high-quality measure. Data sources: The search was conducted, unrestricted to publication year, in the following electronic databases: Applied Social Sciences Index and Abstracts, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, EMBASE, PubMed, PsycINFO, Social Sciences Citation Index and Sociological Abstracts. Results: Our systematic search revealed 4505 potential relevant studies, of which 112 studies met the inclusion criteria using 38 carer measures for informal carers of patients with palliative care needs. Psychometric properties were reported in only 46% (n = 52) of the studies, in relation to 24 measures. Where psychometric data were reported, the focus was mainly on internal consistency (n = 45, 87%), construct validity (n = 27, 52%) and/or reliability (n = 14, 27%). Of these, 24 measures, only four (17%) had been formally validated in informal carers in palliative care. Conclusion: A broad range of outcome measures have been used for informal carers of patients with palliative care needs. Little formal psychometric testing has been undertaken. Furthermore, development and refinement of measures in this field is required. PMID:26407683

Roster of Astronomy Departments with Enrollment and Degree Data, 2014: Results from the 2014 Survey of Enrollments and Degrees. Focus On

Science.gov (United States)

Nicholson, Starr; Mulvey, Patrick J.

2015-01-01

Undergraduate astronomy enrollments in the US continue to rise with junior and senior level enrollments exceeding the previous year's all-time high. The increasing undergraduate enrollments have produced 428 bachelor's in the 2013-14 academic year, also an all-time high. Undergraduate astronomy degree production will continue to rise given the…

Measuring mental health and wellbeing outcomes for children and adolescents to inform practice and policy: a review of child self-report measures.

Science.gov (United States)

Deighton, Jessica; Croudace, Tim; Fonagy, Peter; Brown, Jeb; Patalay, Praveetha; Wolpert, Miranda

2014-01-01

There is a growing appetite for mental health and wellbeing outcome measures that can inform clinical practice at individual and service levels, including use for local and national benchmarking. Despite a varied literature on child mental health and wellbeing outcome measures that focus on psychometric properties alone, no reviews exist that appraise the availability of psychometric evidence and suitability for use in routine practice in child and adolescent mental health services (CAMHS) including key implementation issues. This paper aimed to present the findings of the first review that evaluates existing broadband measures of mental health and wellbeing outcomes in terms of these criteria. The following steps were implemented in order to select measures suitable for use in routine practice: literature database searches, consultation with stakeholders, application of inclusion and exclusion criteria, secondary searches and filtering. Subsequently, detailed reviews of the retained measures' psychometric properties and implementation features were carried out. 11 measures were identified as having potential for use in routine practice and meeting most of the key criteria: 1) Achenbach System of Empirically Based Assessment, 2) Beck Youth Inventories, 3) Behavior Assessment System for Children, 4) Behavioral and Emotional Rating Scale, 5) Child Health Questionnaire, 6) Child Symptom Inventories, 7) Health of the National Outcome Scale for Children and Adolescents, 8) Kidscreen, 9) Pediatric Symptom Checklist, 10) Strengths and Difficulties Questionnaire, 11) Youth Outcome Questionnaire. However, all existing measures identified had limitations as well as strengths. Furthermore, none had sufficient psychometric evidence available to demonstrate that they could reliably measure both severity and change over time in key groups. The review suggests a way of rigorously evaluating the growing number of broadband self-report mental health outcome measures against

[Patient evaluation and outcome measures].

Science.gov (United States)

Nieto Pol, Enrique

2014-01-01

Both the initial evaluation and follow-up of patients with osteoarthritis require systematic evaluation of the indicators that provide information on the degree of involvement of the disease and allow its quantification. Reliable measures of disease progression help decision-making by clinicians and provide valid information on treatment response and the effectiveness of the distinct therapeutic interventions. The instruments recommended in research, as outcome measures in osteoarthritis, are pain evaluation, assessment of physical function, and self-reported global evaluation. In studies lasting more than 1 year, structural changes are evaluated through simple X-ray. Self-reported quality of life assessment and physician global assessment are also recommended as options. These indicators should be incorporated into routine clinical practice for adequate evaluation and correct follow-up of patients with osteoarthritis. The recommended pain evaluation method for use in clinical practice is the visual analog scale (VAS). The best instrument to evaluate physical function in patients with hip or knee osteoarthritis is the WOMAC scale (Western Ontario and McMaster Universities Osteoarthritis Index). For patient-reported global assessment in routine practice, the recommended scales are VAS or the SF-12 (12-item short-form health survey). Copyright © 2014 Elsevier España, S.L. All rights reserved.

Development and validation of MyLifeTracker: a routine outcome measure for youth mental health

Directory of Open Access Journals (Sweden)

Kwan B

2018-04-01

Full Text Available Benjamin Kwan,1 Debra J Rickwood,1,2 Nic R Telford2 1Faculty of Health, University of Canberra, Bruce, ACT, 2headspace National Youth Mental Health Foundation, Melbourne, VIC, Australia Purpose: Routine outcome measures are now being designed for session-by-session use, with emphasis on clinically meaningful items and sensitivity to change. Despite an increasing mental health service focus for young people aged 12–25 years, there is a lack of outcome measures that are designed to be used across this age group. Consequently, MyLifeTracker (MLT was developed as a brief mental health outcome measure designed for young people for routine use. It consists of the following five items targeting areas of importance to young people: general well-being, day-to-day activities, relationships with friends, relationships with family, and general coping. Participants and methods: The measure was tested with 75,893 young people aged 12–25 years attending headspace centers across Australia for mental health-related issues. Results: MLT showed a robust unidimensional factor structure and appropriate reliability. It exhibited good concurrent validity against well-validated measures of psychological distress, well-being, functioning, and life satisfaction. The measure was further demonstrated to be sensitive to change. Conclusion: MLT provides a psychometrically sound mental health outcome measure for young people. The measure taps into items that are meaningful to young people and provides an additional clinical support tool for clinicians and clients during therapy. The measure is brief and easy to use and has been incorporated into an electronic system that routinely tracks session-by-session change and produces time-series charts for the ease of use and interpretation. Keywords: MyLifeTracker, youth mental health, routine outcome measure, routine outcome monitoring, adolescent and young adult

Engaging the hearts and minds of clinicians in outcome measurement - the UK Rehabilitation Outcomes Collaborative approach.

Science.gov (United States)

Turner-Stokes, Lynne; Williams, Heather; Sephton, Keith; Rose, Hilary; Harris, Sarah; Thu, Aung

2012-01-01

This article explores the rationale for choosing the instruments included within the UK Rehabilitation Outcomes Collaborative (UKROC) data set. Using one specialist neuro-rehabilitation unit as an exemplar service, it describes an approach to engaging the hearts and minds of clinicians in recording the data. Measures included within a national data set for rehabilitation should be psychometrically robust and feasible to use in routine clinical practice; they should also support clinical decision-making so that clinicians actually want to use them. Learning from other international casemix models and benchmarking data sets, the UKROC team has developed a cluster of measures to inform the development of effective and cost-efficient rehabilitation services. These include measures of (1) "needs" for rehabilitation (complexity), (2) inputs provided to meet those needs (nursing and therapy intervention), and (3) outcome, including the attainment of personal goals as well as gains in functional independence. By integrating the use of the data set measures in everyday clinical practice, we have achieved a very high rate of compliance with data collection. However, staff training and ongoing commitment from senior staff and managers are critical to the maintenance of effort required to provide assurance of data quality in the longer term.

Patient-reported outcome measures in arthroplasty registries

DEFF Research Database (Denmark)

Rolfson, Ola; Bohm, Eric; Franklin, Patricia

2016-01-01

The International Society of Arthroplasty Registries (ISAR) Patient-Reported Outcome Measures (PROMs) Working Group have evaluated and recommended best practices in the selection, administration, and interpretation of PROMs for hip and knee arthroplasty registries. The 2 generic PROMs in common use...... are the Short Form health surveys (SF-36 or SF-12) and EuroQol 5-dimension (EQ-5D). The Working Group recommends that registries should choose specific PROMs that have been appropriately developed with good measurement properties for arthroplasty patients. The Working Group recommend the use of a 1-item pain...... should consider the absolute level of pain, function, and general health status as well as improvement, missing data, approaches to analysis and case-mix adjustment, minimal clinically important difference, and minimal detectable change. The Working Group recommends data collection immediately before...

Clinical assessment and patient-reported outcome measures in low-back pain - a survey among primary health care physiotherapists.

Science.gov (United States)

Östhols, Sara; Boström, Carina; Rasmussen-Barr, Eva

2018-05-09

We aimed to map the physiotherapy practice in Sweden of clinical tests and patient-reported outcome measures in low-back pain (LBP), and to study advantages and barriers in using patient-reported outcome measures. An online survey was mailed to 4934 physiotherapists in primary health care in Sweden. Multiple choice questions investigated the use of clinical tests and patient-reported outcome measures in assessing patients with LBP. Open questions investigating the advantages and barriers to the use of patient-reported outcome measures were analyzed with content analysis. The response rate was 25% (n = 1217). Clinical tests were used "always/often" by >60% of the participants, while most patient-reported outcome measures were used by measures were: the clinical reasoning process, to increase the quality of assessment, to get the patient's voice, education and motivation of patients, and communication with health professionals. Barriers were lack of time and knowledge, administrative aspects, the interaction between physiotherapist and patient and, the applicability and validity of the patient-reported outcome measures. Our findings show that physiotherapists working in primary health care use clinical testing in LBP to a great extent, while various patient-reported outcome measures are used to a low-to-very-low extent. Several barriers to the use of patient-reported outcome measures were reported such as time, knowledge, and administrative issues, while important findings on advantages were to enhance the clinical reasoning process and to educate and motivate the patient. Barriers might be changed through education or organizational change-work. To enhance the use of patient-reported outcome measures and thus person-centered care in low-back pain, recommendation, and education on various patient-reported outcome measures need to be advocated. Implications for rehabilitation To increase the effects of rehabilitation in low-back pain, yellow flags, and other

Barriers to Enrollment in Health Coverage in Colorado.

Science.gov (United States)

Martin, Laurie T; Bharmal, Nazleen; Blanchard, Janice C; Harvey, Melody; Williams, Malcolm

2015-03-20

As part of the implementation of the Affordable Care Act, Colorado has expanded Medicaid and also now operates its own health insurance exchange for individuals (called Connect for Health Colorado). As of early 2014, more than 300,000 Coloradans have newly enrolled in Medicaid or health insurance through Connect for Health Colorado, but there also continues to be a diverse mix of individuals in Colorado who remain eligible for but not enrolled in either private insurance or Medicaid. The Colorado Health Foundation commissioned the RAND Corporation to conduct a study to better understand why these individuals are not enrolled in health insurance coverage and to develop recommendations for how Colorado can strengthen its outreach and enrollment efforts during the next open enrollment period, which starts in November 2014. RAND conducted focus groups with uninsured and newly insured individuals across the state and interviews with local stakeholders responsible for enrollment efforts in their regions. The authors identified 11 commonly cited barriers, as well as several that were specific to certain regions or populations (such as young adults and seasonal workers). Collectively, these barriers point to a set of four priority recommendations that stakeholders in Colorado may wish to consider: (1) Support and expand localized outreach and tailored messaging; (2) Strengthen marketing and messaging to be clear, focused on health benefits of insurance (rather than politics and mandates), and actionable; (3) Improve the clarity and transparency of insurance and health care costs and enrollment procedures; and (4) Revisit the two-stage enrollment process and improve Connect for Health Colorado website navigation and technical support.

Use of continuous glucose monitoring as an outcome measure in clinical trials.

Science.gov (United States)

Beck, Roy W; Calhoun, Peter; Kollman, Craig

2012-10-01

Although developed to be a management tool for individuals with diabetes, continuous glucose monitoring (CGM) also has potential value for the assessment of outcomes in clinical studies. We evaluated using CGM as such an outcome measure. Data were analyzed from six previously completed inpatient studies in which both CGM (Freestyle Navigator™ [Abbott Diabetes Care, Alameda, CA] or Guardian(®) [Medtronic, Northridge, CA]) and reference glucose measurements were available. The analyses included 97 days of data from 93 participants with type 1 diabetes (age range, 5-57 years; mean, 18 ± 12 years). Mean glucose levels per day were similar for the CGM and reference measurements (median, 148 mg/dL vs. 143 mg/dL, respectively; P = 0.92), and the correlation of the two was high (r = 0.89). Similarly, most glycemia metrics showed no significant differences comparing CGM and reference values, except that the nadir glucose tended to be slightly lower and peak glucose slightly higher with reference measurements than CGM measurements (respective median, 59 mg/dL vs. 66 mg/dL [P = 0.05] and 262 mg/dL vs. 257 mg/dL [P = 0.003]) and glucose variability as measured with the coefficient of variation was slightly lower with CGM than reference measurements (respective median, 31% vs. 35%; Pblood glucose measurements. CGM inaccuracy and underestimation of the extremes of hyperglycemia and hypoglycemia can be accounted for in a clinical trial's study design. Thus, in appropriate settings, CGM can be a very meaningful and feasible outcome measure for clinical trials.

a locally adapted functional outcome measurement score for total

African Journals Online (AJOL)

Results and success of total hip arthroplasty are often measured using a functional outcome scoring system. Most current scores were developed in Europe and. North America (1-3). During the evaluation of a Total. Hip Replacement (THR) project in Ouagadougou,. Burkina Faso (4) it was felt that these scores were not.

Framework of outcome measures recommended for use in the evaluation of childhood obesity treatment interventions: the CoOR framework.

Science.gov (United States)

Bryant, M; Ashton, L; Nixon, J; Jebb, S; Wright, J; Roberts, K; Brown, J

2014-12-01

Consensus is lacking in determining appropriate outcome measures for assessment of childhood obesity treatments. Inconsistency in the use and reporting of such measures impedes comparisons between treatments and limits consideration of effectiveness. This study aimed to produce a framework of recommended outcome measures: the Childhood obesity treatment evaluation Outcomes Review (CoOR) framework. A systematic review including two searches was conducted to identify (1) existing trial outcome measures and (2) manuscripts describing development/evaluation of outcome measures. Outcomes included anthropometry, diet, eating behaviours, physical activity, sedentary time/behaviour, fitness, physiology, environment, psychological well-being and health-related quality of life. Eligible measures were appraised by the internal team using a system developed from international guidelines, followed by appraisal from national external expert collaborators. A total of 25,486 papers were identified through both searches. Eligible search 1 trial papers cited 417 additional papers linked to outcome measures, of which 56 were eligible. A further 297 outcome development/evaluation papers met eligibility criteria from search 2. Combined, these described 191 outcome measures. After internal and external appraisal, 52 measures across 10 outcomes were recommended for inclusion in the CoOR framework. Application of the CoOR framework will ensure greater consistency in choosing robust outcome measures that are appropriate to population characteristics. © 2014 The Authors. Pediatric Obesity © 2014 International Association for the Study of Obesity.

Goal specificity: a proxy measure for improvements in environmental outcomes in collaborative governance.

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Biddle, Jennifer C; Koontz, Tomas M

2014-12-01

Collaborative governance critics continually call for evidence to support its prevalent use. As is often the case in environmental policy, environmental outcomes occur at a rate incompatible with political agendas. In addition, a multitude of possibly confounding variables makes it difficult to correlate collaborative governance processes with environmental outcomes. The findings of this study offer empirical evidence that collaborative processes have a measurable, beneficial effect on environmental outcomes. Through the use of a unique paired-waterbody design, our dataset reduced the potential for confounding variables to impact our environmental outcome measurements. The results of a path analysis indicate that the output of setting specific pollutant reduction goals is significantly related to watershed partnerships' level of attainment of their environmental improvement goals. The action of setting specific goals (e.g. percentage of load reductions in pollutant levels) is fostered by sustained participation from partnership members throughout the lifecycle of the collaborative. In addition, this study demonstrates the utility of logic modeling for environmental planning and management, and suggests that the process of setting specific pollutant reduction goals is a useful proxy measure for reporting progress towards improvements in environmental outcomes when long-term environmental data are not available. Copyright © 2014 Elsevier Ltd. All rights reserved.

Ultrasound as an Outcome Measure in Gout. A Validation Process by the OMERACT Ultrasound Working Group

DEFF Research Database (Denmark)

Terslev, Lene; Gutierrez, Marwin; Schmidt, Wolfgang A

2015-01-01

OBJECTIVE: To summarize the work performed by the Outcome Measures in Rheumatology (OMERACT) Ultrasound (US) Working Group on the validation of US as a potential outcome measure in gout. METHODS: Based on the lack of definitions, highlighted in a recent literature review on US as an outcome tool...

Conservation covenants on private land: issues with measuring and achieving biodiversity outcomes in Australia.

Science.gov (United States)

Fitzsimons, James A; Carr, C Ben

2014-09-01

Conservation covenants and easements have become essential tools to secure biodiversity outcomes on private land, and to assist in meeting international protection targets. In Australia, the number and spatial area of conservation covenants has grown significantly in the past decade. Yet there has been little research or detailed policy analysis of conservation covenanting in Australia. We sought to determine how conservation covenanting agencies were measuring the biodiversity conservation outcomes achieved on covenanted properties, and factors inhibiting or contributing to measuring these outcomes. In addition, we also investigated the drivers and constraints associated with actually delivering the biodiversity outcomes, drawing on detailed input from covenanting programs. Although all conservation covenanting programs had the broad aim of maintaining or improving biodiversity in their covenants in the long term, the specific stated objectives of conservation covenanting programs varied. Programs undertook monitoring and evaluation in different ways and at different spatial and temporal scales. Thus, it was difficult to determine the extent Australian conservation covenanting agencies were measuring the biodiversity conservation outcomes achieved on covenanted properties on a national scale. Lack of time available to covenantors to undertake management was one of the biggest impediments to achieving biodiversity conservation outcomes. A lack of financial resources and human capital to monitor, knowing what to monitor, inconsistent monitoring methodologies, a lack of benchmark data, and length of time to achieve outcomes were all considered potential barriers to monitoring the biodiversity conservation outcomes of conservation covenants.

An Examination of the EeTPA Portfolio Assessment and Other Measures of Teacher Preparation and Readiness

Science.gov (United States)

Russell, Victoria; Davidson Devall, Kelly F.

2016-01-01

The authors examined the outcomes on several measures of world language teacher preparedness, including university- and state-mandated summative evaluations and the edTPA portfolio assessment, for seven world language teacher candidates during their final semester of clinical practice. The candidates were enrolled in an initial certification…

Translation of the Ibadan Knee/Hip Osteoarthritis Outcome Measure

African Journals Online (AJOL)

Dr Olaleye

rated by the clinician on five and six (0-5) point ordinal scales. IKHOAM has been ... Igbo translation of Ibadan osteoarthritis outcome measure. 176 .... encourage the use of scales and questionnaires in an .... Validation of a Yoruba translation of the World Health ... Scales: A practical guide to their development and use (1st.

Measuring the Effects of Self-Awareness: Construction of the Self-Awareness Outcomes Questionnaire

Directory of Open Access Journals (Sweden)

Anna Sutton

2016-11-01

Full Text Available Dispositional self-awareness is conceptualized in several different ways, including insight, reflection, rumination and mindfulness, with the latter in particular attracting extensive attention in recent research. While self-awareness is generally associated with positive psychological well-being, these different conceptualizations are also each associated with a range of unique outcomes. This two part, mixed methods study aimed to advance understanding of dispositional self-awareness by developing a questionnaire to measure its outcomes. In Study 1, expert focus groups categorized and extended an initial pool of potential items from previous research. In Study 2, these items were reduced to a 38 item self-report questionnaire with four factors representing three beneficial outcomes (reflective self-development, acceptance and proactivity and one negative outcome (costs. Regression of these outcomes against self-awareness measures revealed that self-reflection and insight predicted beneficial outcomes, rumination predicted reduced benefits and increased costs, and mindfulness predicted both increased proactivity and costs. These studies help to refine the self-awareness concept by identifying the unique outcomes associated with the concepts of self-reflection, insight, reflection, rumination and mindfulness. It can be used in future studies to evaluate and develop awareness-raising techniques to maximize self-awareness benefits while minimizing related costs.

Case-control vaccine effectiveness studies: Preparation, design, and enrollment of cases and controls.

Science.gov (United States)

Verani, Jennifer R; Baqui, Abdullah H; Broome, Claire V; Cherian, Thomas; Cohen, Cheryl; Farrar, Jennifer L; Feikin, Daniel R; Groome, Michelle J; Hajjeh, Rana A; Johnson, Hope L; Madhi, Shabir A; Mulholland, Kim; O'Brien, Katherine L; Parashar, Umesh D; Patel, Manish M; Rodrigues, Laura C; Santosham, Mathuram; Scott, J Anthony; Smith, Peter G; Sommerfelt, Halvor; Tate, Jacqueline E; Victor, J Chris; Whitney, Cynthia G; Zaidi, Anita K; Zell, Elizabeth R

2017-06-05

Case-control studies are commonly used to evaluate effectiveness of licensed vaccines after deployment in public health programs. Such studies can provide policy-relevant data on vaccine performance under 'real world' conditions, contributing to the evidence base to support and sustain introduction of new vaccines. However, case-control studies do not measure the impact of vaccine introduction on disease at a population level, and are subject to bias and confounding, which may lead to inaccurate results that can misinform policy decisions. In 2012, a group of experts met to review recent experience with case-control studies evaluating the effectiveness of several vaccines; here we summarize the recommendations of that group regarding best practices for planning, design and enrollment of cases and controls. Rigorous planning and preparation should focus on understanding the study context including healthcare-seeking and vaccination practices. Case-control vaccine effectiveness studies are best carried out soon after vaccine introduction because high coverage creates strong potential for confounding. Endpoints specific to the vaccine target are preferable to non-specific clinical syndromes since the proportion of non-specific outcomes preventable through vaccination may vary over time and place, leading to potentially confusing results. Controls should be representative of the source population from which cases arise, and are generally recruited from the community or health facilities where cases are enrolled. Matching of controls to cases for potential confounding factors is commonly used, although should be reserved for a limited number of key variables believed to be linked to both vaccination and disease. Case-control vaccine effectiveness studies can provide information useful to guide policy decisions and vaccine development, however rigorous preparation and design is essential. Published by Elsevier Ltd.

Comparison of Physician-Predicted to Measured Low Vision Outcomes

Science.gov (United States)

Chan, Tiffany L.; Goldstein, Judith E.; Massof, Robert W.

2013-01-01

Purpose To compare low vision rehabilitation (LVR) physicians’ predictions of the probability of success of LVR to patients’ self-reported outcomes after provision of usual outpatient LVR services; and to determine if patients’ traits influence physician ratings. Methods The Activity Inventory (AI), a self-report visual function questionnaire, was administered pre and post-LVR to 316 low vision patients served by 28 LVR centers that participated in a collaborative observational study. The physical component of the Short Form-36, Geriatric Depression Scale, and Telephone Interview for Cognitive Status were also administered pre-LVR to measure physical capability, depression and cognitive status. Following patient evaluation, 38 LVR physicians estimated the probability of outcome success (POS), using their own criteria. The POS ratings and change in functional ability were used to assess the effects of patients’ baseline traits on predicted outcomes. Results A regression analysis with a hierarchical random effects model showed no relationship between LVR physician POS estimates and AI-based outcomes. In another analysis, Kappa statistics were calculated to determine the probability of agreement between POS and AI-based outcomes for different outcome criteria. Across all comparisons, none of the kappa values were significantly different from 0, which indicates the rate of agreement is equivalent to chance. In an exploratory analysis, hierarchical mixed effects regression models show that POS ratings are associated with information about the patient’s cognitive functioning and the combination of visual acuity and functional ability, as opposed to visual acuity or functional ability alone. Conclusions Physicians’ predictions of LVR outcomes appear to be influenced by knowledge of patients’ cognitive functioning and the combination of visual acuity and functional ability - information physicians acquire from the patient’s history and examination. However

Validating Multidimensional Outcome Assessment Using the TBI Common Data Elements: An Analysis of the TRACK-TBI Pilot Sample.

Science.gov (United States)

Nelson, Lindsay D; Ranson, Jana; Ferguson, Adam R; Giacino, Joseph; Okonkwo, David O; Valadka, Alex; Manley, Geoffrey; McCrea, Michael

2017-06-08

The Glasgow Outcome Scale-Extended (GOSE) is often the primary outcome measure in clinical trials for traumatic brain injury (TBI). Although the GOSE's capture of global function outcome has several strengths, concerns have been raised about its limited ability to identify mild disability and failure to capture the full scope of problems patients exhibit after TBI. This analysis examined the convergence of disability ratings across a multidimensional set of outcome domains in the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Pilot study. The study collected measures recommended by the TBI Common Data Elements (CDE) Workgroup. Patients presenting to 3 emergency departments with a TBI of any severity enrolled in TRACK-TBI prospectively after injury; outcome measures were collected at 3 and six months postinjury. Analyses examined frequency of impairment and overlap between impairment status across the CDE outcome domains of Global Level of Functioning (GOSE), Neuropsychological (cognitive) Impairment, Psychological Status, TBI Symptoms, and Quality of Life. GOSE score correlated in the expected direction with other outcomes (M Spearman's rho = .21 and .49 with neurocognitive and self-report outcomes, respectively). The subsample in the Upper Good Recovery (GOSE 8) category appeared quite healthy across most other outcomes, although 19.0% had impaired executive functioning (Trail Making Test Part B). A significant minority of participants in the Lower Good Recovery subgroup (GOSE 7) met criteria for impairment across numerous other outcome measures. The findings highlight the multidimensional nature of TBI recovery and the limitations of applying only a single outcome measure.

Comparing the responsiveness of functional outcome assessment measures for trauma registries.

Science.gov (United States)

Williamson, Owen D; Gabbe, Belinda J; Sutherland, Ann M; Wolfe, Rory; Forbes, Andrew B; Cameron, Peter A

2011-07-01

Measuring long-term disability and functional outcomes after major trauma is not standardized across trauma registries. An ideal measure would be responsive to change but not have significant ceiling effects. The aim of this study was to compare the responsiveness of the Glasgow Outcome Scale (GOS), GOS-Extended (GOSE), Functional Independence Measure (FIM), and modified FIM in major trauma patients, with and without significant head injuries. Patients admitted to two adult Level I trauma centers in Victoria, Australia, who survived to discharge from hospital, were aged 15 years to 80 years with a blunt mechanism of injury, and had an estimated Injury Severity Score >15 on admission, were recruited for this prospective study. The instruments were administered at baseline (hospital discharge) and by telephone interview 6 months after injury. Measures of responsiveness, including effect sizes, were calculated. Bootstrapping techniques, and floor and ceiling effects, were used to compare the measures. Two hundred forty-three patients participated, of which 234 patients (96%) completed the study. The GOSE and GOS were the most responsive instruments in this major trauma population with effect sizes of 5.3 and 4.4, respectively. The GOSE had the lowest ceiling effect (17%). The GOSE was the instrument with greatest responsiveness and the lowest ceiling effect in a major trauma population with and without significant head injuries and is recommended for use by trauma registries for monitoring functional outcomes and benchmarking care. The results of this study do not support the use of the modified FIM for this purpose.

Measures of outcome for stimulant trials: ACTTION recommendations and research agenda.

Science.gov (United States)

Kiluk, Brian D; Carroll, Kathleen M; Duhig, Amy; Falk, Daniel E; Kampman, Kyle; Lai, Shengan; Litten, Raye Z; McCann, David J; Montoya, Ivan D; Preston, Kenzie L; Skolnick, Phil; Weisner, Constance; Woody, George; Chandler, Redonna; Detke, Michael J; Dunn, Kelly; Dworkin, Robert H; Fertig, Joanne; Gewandter, Jennifer; Moeller, F Gerard; Ramey, Tatiana; Ryan, Megan; Silverman, Kenneth; Strain, Eric C

2016-01-01

The development and approval of an efficacious pharmacotherapy for stimulant use disorders has been limited by the lack of a meaningful indicator of treatment success, other than sustained abstinence. In March, 2015, a meeting sponsored by Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) was convened to discuss the current state of the evidence regarding meaningful outcome measures in clinical trials for stimulant use disorders. Attendees included members of academia, funding and regulatory agencies, pharmaceutical companies, and healthcare organizations. The goal was to establish a research agenda for the development of a meaningful outcome measure that may be used as an endpoint in clinical trials for stimulant use disorders. Based on guidelines for the selection of clinical trial endpoints, the lessons learned from prior addiction clinical trials, and the process that led to identification of a meaningful indicator of treatment success for alcohol use disorders, several recommendations for future research were generated. These include a focus on the validation of patient reported outcome measures of functioning, the exploration of patterns of stimulant abstinence that may be associated with physical and/or psychosocial benefits, the role of urine testing for validating self-reported measures of stimulant abstinence, and the operational definitions for reduction-based measures in terms of frequency rather than quantity of stimulant use. These recommendations may be useful for secondary analyses of clinical trial data, and in the design of future clinical trials that may help establish a meaningful indicator of treatment success. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The barriers and facilitators to routine outcome measurement by allied health professionals in practice: a systematic review

Directory of Open Access Journals (Sweden)

Duncan Edward AS

2012-05-01

Full Text Available Abstract Background Allied Health Professionals today are required, more than ever before, to demonstrate their impact. However, despite at least 20 years of expectation, many services fail to deliver routine outcome measurement in practice. This systematic review investigates what helps and hinders routine outcome measurement of allied health professionals practice. Methods A systematic review protocol was developed comprising: a defined search strategy for PsycINFO, MEDLINE and CINHAL databases and inclusion criteria and systematic procedures for data extraction and quality appraisal. Studies were included if they were published in English and investigated facilitators and/or barriers to routine outcome measurement by allied health professionals. No restrictions were placed on publication type, design, country, or year of publication. Reference lists of included publications were searched to identify additional papers. Descriptive methods were used to synthesise the findings. Results 960 papers were retrieved; 15 met the inclusion criteria. Professional groups represented were Physiotherapy, Occupational Therapy, and Speech and Language Therapy. The included literature varied in quality and design. Facilitators and barriers to routine outcome measurement exist at individual, managerial and organisational levels. Key factors affecting professionals’ use of routine outcome measurement include: professionals’ level of knowledge and confidence about using outcome measures, and the degree of organisational and peer-support professionals received with a view to promoting their work in practice. Conclusions Whilst the importance of routinely measuring outcomes within the allied health professions is well recognised, it has largely failed to be delivered in practice. Factors that influence clinicians’ ability and desire to undertake routine outcome measurement are bi-directional: they can act as either facilitators or barriers. Routine outcome

The patient-specific functional scale: psychometrics, clinimetrics, and application as a clinical outcome measure.

Science.gov (United States)

Horn, Katyana Kowalchuk; Jennings, Sophie; Richardson, Gillian; Vliet, Ditte Van; Hefford, Cheryl; Abbott, J Haxby

2012-01-01

Systematic review of the literature. To summarize peer-reviewed literature on the reliability, validity, and responsiveness of the Patient-Specific Functional Scale (PSFS), and to identify its use as an outcome measure. Searches were performed of several electronic databases from 1995 to May 2010. Studies included were published articles containing (1) primary research investigating the psychometric and clinimetrics of the PSFS or (2) the implementation of the PSFS as an outcome measure. We assessed the methodological quality of studies included in the first category. Two hundred forty-two articles published from 1994 to May 2010 were identified. Of these, 66 met the inclusion criteria for this review, with 13 reporting the measurement properties of the PSFS, 55 implementing the PSFS as an outcome measure, and 2 doing both of the above. The PSFS was reported to be valid, reliable, and responsive in populations with knee dysfunction, cervical radiculopathy, acute low back pain, mechanical low back pain, and neck dysfunction. The PSFS was found to be reliable and responsive in populations with chronic low back pain. The PSFS was also reported to be valid, reliable, or responsive in individuals with a limited number of acute, subacute, and chronic conditions. This review found that the PSFS is also being used as an outcome measure in many other conditions, despite a lack of published evidence supporting its validity in these conditions. Although the use of the PSFS as an outcome measure is increasing in physiotherapy practice, there are gaps in the research literature regarding its validity, reliability, and responsiveness in many health conditions.

Comparison of the enrollment percentages of magnet and non-magnet schools in a large urban school district.

Directory of Open Access Journals (Sweden)

Emily Arcia

2006-12-01

Full Text Available Are magnet schools in a position to meet diversity ideals? As districts are declared unitary and released from court ordered desegregation, many are framing their commitments to fairness and equity in terms of diversity˜i.e., comparable rates of participation and comparable educational outcomes in all segments the student population. In this study, the enrollment statistics for magnet and contiguous non-magnet public schools in Miami-Dade County Public Schools, a large, urban district that had been released from court ordered desegregation, were compared to each other and to district enrollment averages at two time points: the year the district was declared unitary and four years hence. Findings indicated that within four years of being declared unitary, the gains that the magnet schools had made with regards to Black/non-Black desegregation had eroded substantially. Also, in the four year span, magnet schools had not made significant strides in meeting the diversity ideals adopted by the district at being released from supervision by the court. These findings highlight the difficulty of attaining diversity in student enrollment characteristics when quotas are not used and suggest that recruitment and enrollment policies must be crafted with care if districts are to achieve diversity goals.

Effect of removing direct payment for health care on utilisation and health outcomes in Ghanaian children: a randomised controlled trial.

Directory of Open Access Journals (Sweden)

Evelyn Korkor Ansah

2009-01-01

Full Text Available Delays in accessing care for malaria and other diseases can lead to disease progression, and user fees are a known barrier to accessing health care. Governments are introducing free health care to improve health outcomes. Free health care affects treatment seeking, and it is therefore assumed to lead to improved health outcomes, but there is no direct trial evidence of the impact of removing out-of-pocket payments on health outcomes in developing countries. This trial was designed to test the impact of free health care on health outcomes directly.2,194 households containing 2,592 Ghanaian children under 5 y old were randomised into a prepayment scheme allowing free primary care including drugs, or to a control group whose families paid user fees for health care (normal practice; 165 children whose families had previously paid to enrol in the prepayment scheme formed an observational arm. The primary outcome was moderate anaemia (haemoglobin [Hb] < 8 g/dl; major secondary outcomes were health care utilisation, severe anaemia, and mortality. At baseline the randomised groups were similar. Introducing free primary health care altered the health care seeking behaviour of households; those randomised to the intervention arm used formal health care more and nonformal care less than the control group. Introducing free primary health care did not lead to any measurable difference in any health outcome. The primary outcome of moderate anaemia was detected in 37 (3.1% children in the control and 36 children (3.2% in the intervention arm (adjusted odds ratio 1.05, 95% confidence interval 0.66-1.67. There were four deaths in the control and five in the intervention group. Mean Hb concentration, severe anaemia, parasite prevalence, and anthropometric measurements were similar in each group. Families who previously self-enrolled in the prepayment scheme were significantly less poor, had better health measures, and used services more frequently than those in

Multiple Measures of Outcome in Assessing a Prison-Based Drug Treatment Program

Science.gov (United States)

Prendergast, Michael L.; Hall, Elizabeth A.; Wexler, Harry K.

2003-01-01

Evaluations of prison-based drug treatment programs typically focus on one or two dichotomous outcome variables related to recidivism. In contrast, this paper uses multiple measures of outcomes related to crime and drug use to examine the impact of prison treatment. Crime variables included self-report data of time to first illegal activity,…

42 CFR 460.160 - Continuation of enrollment.

Science.gov (United States)

2010-10-01

... of enrollment. Enrollment continues until the participant's death, regardless of changes in health... level of care required under the State Medicaid plan for coverage of nursing facility services. (1... participant no longer meets the State Medicaid nursing facility level of care requirements, the participant...

20 CFR 638.402 - Enrollment by readmission.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Enrollment by readmission. 638.402 Section... Placements in the Job Corps § 638.402 Enrollment by readmission. Procedures for screening and selection of applicants for readmission shall be issued by the Job Corps Director. ...

Gender Preference in Primary School Enrolment among ...

African Journals Online (AJOL)

2017-05-01

May 1, 2017 ... The benefits of equal enrolment and retention in primary schools cannot be underestimated for ... Gender Preference in Primary School Enrolment among Households in Northern Region, Ghana decisions ... is a major decision maker in issues of education (Akaguri, 2011; Al-Samarrai & Peasgood,. 1998).

The Effects of Minimum Wages on Teenage Employment, Enrollment, and Idleness.

Science.gov (United States)

Neumark, David

A study described the effects of minimum wages on teenagers by using individual-level panel data on school and work transitions of teenagers. Panel data from 1979-92 measuring transitions among alternative employment and enrollment activities of teenagers were obtained from matched Current Population Surveys data sets. Findings indicated that…

The numbers, educational status and health of enrolled and non-enrolled school-age children in the Allai Valley, Northwest Frontier Province, Pakistan.

Science.gov (United States)

Hall, Andrew; Kirby, Helen

2010-04-01

A cluster survey of the age, sex and enrolment status of all school-age children 5-14 years old was undertaken in 2006 in a remote rural sub-district of the Northwest Frontier Province, Pakistan about a year after a devastating earthquake. Information was collected on the characteristics of children, their households and parents, and on reasons for non-enrolment. The health and nutritional status of a randomly selected child in each household was assessed and enrolled and non-enrolled children were compared by sex. A total of 2032 children were recorded in 925 households, 845 girls and 1187 boys, a sex ratio of 71 girls/100 boys. Half of all girls were not enrolled in school compared with a fifth of all boys. There was no common reason for non-enrolment and they differed between the sexes. The randomly selected children (n = 897) were moderately malnourished: 43% were stunted, 12% were thin and 46% were anaemic. 66% of a sub-sample of children (n = 269) had a low urinary iodine concentration, which could contribute to a low IQ and impaired hearing. There were no statistically significant differences in the nutritional status or health of non-enrolled and enrolled girls. These data contribute towards an understanding of how to improve the education and health of school-age children in a conservative, rural province of Pakistan. Copyright 2010 Elsevier Ltd. All rights reserved.

Measuring public health practice and outcomes in chronic disease: a call for coordination.

Science.gov (United States)

Porterfield, Deborah S; Rogers, Todd; Glasgow, LaShawn M; Beitsch, Leslie M

2015-04-01

A strategic opportunity exists to coordinate public health systems and services researchers' efforts to develop local health department service delivery measures and the efforts of divisions within the Centers for Disease Control and Prevention's National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) to establish outcome indicators for public health practice in chronic disease. Several sets of outcome indicators developed by divisions within NCCDPHP and intended for use by state programs can be tailored to assess outcomes of interventions within smaller geographic areas or intervention settings. Coordination of measurement efforts could potentially allow information to flow from the local to the state to the federal level, enhancing program planning, accountability, and even subsequent funding for public health practice.

Declining Physics Enrollments: An Exploration of Reasons

Science.gov (United States)

Nelson, Miles A.; Dietrich, Donald G.

1975-01-01

Describes a detailed study used in schools with the highest and lowest percentages of students enrolled in physics in order to determine factors related to enrollment. Twenty-eight indexes were used. Reports percent of variance accounted for and significance level for each variable and offers conclusions. (CP)

Pre-Enrollment Reimbursement Patterns of Medicare Beneficiaries Enrolled in “At-Risk” HMOs

Science.gov (United States)

Eggers, Paul W.; Prihoda, Ronald

1982-01-01

The Health Care Financing Administration (HCFA) has initiated several demonstration projects to encourage HMOs to participate in the Medicare program under a risk mechanism. These demonstrations are designed to test innovative marketing techniques, benefit packages, and reimbursement levels. HCFA's current method for prospective payments to HMOs is based on the Adjusted Average Per Capita Cost (AAPCC). An important issue in prospective reimbursement is the extent to which the AAPCC adequately reflects the risk factors which arise out of the selection process of Medicare beneficiaries into HMOs. This study examines the pre-enrollment reimbursement experience of Medicare beneficiaries who enrolled in the demonstration HMOs to determine whether or not a non-random selection process took place. The three demonstration HMOs included in the study are the Fallon Community Health Plan, the Greater Marshfield Community Health Plan, and the Kaiser-Permanente medical program of Portland, Oregon. The study includes 18,085 aged Medicare beneficiaries who had enrolled in the three plans as of April, 1981. We included comparison groups consisting of a 5 percent random sample of aged Medicare beneficiaries (N = 11,240) living in the same geographic areas as the control groups. The study compares the groups by total Medicare reimbursements for the years 1976 through 1979. Adjustments were made for AAPCC factor differences in the groups (age, sex, institutional status, and welfare status). In two of the HMO areas there was evidence of a selection process among the HMOs enrollees. Enrollees in the Fallon and Kaiser health plans were found to have had 20 percent lower Medicare reimbursements than their respective comparison groups in the four years prior to enrollment. This effect was strongest for inpatient services, but a significant difference also existed for use of physician and outpatient services. In the Marshfield HMO there was no statistically significant difference in pre-enrollment

Impact of health portal enrollment with email reminders on adherence to clinic appointments: a pilot study.

Science.gov (United States)

Horvath, Monica; Levy, Janet; L'Engle, Pete; Carlson, Boyd; Ahmad, Asif; Ferranti, Jeffrey

2011-05-26

Internet portal technologies that provide access to portions of electronic health records have the potential to revolutionize patients' involvement in their care. However, relatively few descriptions of the demographic characteristics of portal enrollees or of the effects of portal technology on quality outcomes exist. This study examined data from patients who attended one of seven Duke Medicine clinics and who were offered the option of enrolling in and using the Duke Medicine HealthView portal (HVP). The HVP allows patients to manage details of their appointment scheduling and provides automated email appointment reminders in addition to the telephone and mail reminders that all patients receive. Our objective was to test whether portal enrollment with an email reminder functionality is significantly related to decreases in rates of appointment "no-shows," which are known to impair clinic operational efficiency. Appointment activity during a 1-year period was examined for all patients attending one of seven Duke Medicine clinics. Patients were categorized as portal enrollees or as nonusers either by their status at time of appointment or at the end of the 1-year period. Demographic characteristics and no-show rates among these groups were compared. A binomial logistic regression model was constructed to measure the adjusted impact of HVP enrollment on no-show rates, given confounding factors. To demonstrate the effect of HVP use over time, monthly no-show rates were calculated for patient appointment keeping and contrasted between preportal and postportal deployment periods. Across seven clinics, 58,942 patients, 15.7% (9239/58,942) of whom were portal enrollees, scheduled 198,199 appointments with an overall no-show rate of 9.9% (19,668/198,199). We found that HVP enrollees were significantly more likely to be female, white, and privately insured compared with nonusers. Bivariate no-show rate differences between portal enrollment groups varied widely according

Patient-reported outcome measures in burning mouth syndrome - a review of the literature.

Science.gov (United States)

Ni Riordain, R; McCreary, C

2013-04-01

Oral Diseases (2013) 19, 230-235 This review aims to investigate the patient-reported outcomes currently used in the burning mouth syndrome literature and to explore whether any standardisation of such measures has taken place. Electronic databases were searched for all types of burning mouth syndrome studies using patient-reported outcome measures. Studies were selected by predefined inclusion criteria. Copies of the papers obtained were thoroughly reviewed. A study-specific data extraction form was used, allowing papers to be reviewed in a standardised manner. The initial literature search yielded a total of 173 citations, 43 of which were deemed suitable for inclusion in this study. Symptom severity and symptomatic relief were reported as a patient-reported outcome measure in 40 of the studies and quantified most commonly using a visual analogue scale. Quality of life was reported in 13 studies included in this review. Depression and/or anxiety was reported in 14 of the studies. As is evident from the variety of questionnaires and instruments used in the evaluation of the impact of burning mouth syndrome on patients' lives, no standardisation of patient outcomes has yet been achieved. © 2012 John Wiley & Sons A/S.

BIOMARKERS S100B AND NSE PREDICT OUTCOME IN HYPOTHERMIA-TREATED ENCEPHALOPATHIC NEWBORNS

Science.gov (United States)

Massaro, An N.; Chang, Taeun; Baumgart, Stephen; McCarter, Robert; Nelson, Karin B.; Glass, Penny

2014-01-01

Objective To evaluate if serum S100B protein and neuron specific enolase (NSE) measured during therapeutic hypothermia are predictive of neurodevelopmental outcome at 15 months in children with neonatal encephalopathy (NE). Design Prospective longitudinal cohort study Setting A level IV neonatal intensive care unit in a free-standing children’s hospital. Patients Term newborns with moderate to severe NE referred for therapeutic hypothermia during the study period. Interventions Serum NSE and S100B were measured at 0, 12, 24 and 72 hrs of hypothermia. Measurements and Main Reseults Of the 83 infants were enrolled, fifteen (18%) died in the newborn period. Survivors were evaluated by the Bayley Scales of Infant Development (BSID-II) at 15 months of age. Outcomes were assessed in 49/68 (72%) survivors at a mean age of 15.2±2.7 months. Neurodevelopmental outcome was classified by BSID-II Mental (MDI) and Psychomotor (PDI) Developmental Index scores, reflecting cognitive and motor outcomes respectively. Four-level outcome classifications were defined a priori: normal= MDI/PDI within 1SD (>85), mild= MDI/PDI <1SD (70–85), moderate/severe= MDI/PDI <2SD (<70), or died. Elevated serum S100B and NSE levels measured during hypothermia were associated with increasing outcome severity after controlling for baseline and soceioeconomic characteristics in ordinal regression models. Adjusted odds ratios for cognitive outcome were: S100B 2.5 (95% CI 1.3–4.8) and NSE 2.1 (1.2–3.6); for motor outcome: S100B 2.6 (1.2–5.6) and NSE 2.1 (1.2–3.6). Conclusions Serum S100B and NSE levels in babies with NE are associated with neurodevelopmental outcome at 15 months. These putative biomarkers of brain injury may help direct care during therapeutic hypothermia. PMID:24777302

Exploring Outcome Measures for Exercise Intervention in People with Parkinson’s Disease

Directory of Open Access Journals (Sweden)

L. A. King

2013-01-01

Full Text Available Background. It is widely believed that exercise improves mobility in people with Parkinson’s disease (PD. However, it is difficult to determine whether a specific type of exercise is the most effective. The purpose of this study was to determine which outcome measures were sensitive to exercise intervention and to explore the effects of two different exercise programs for improving mobility in patients with PD. Methods. Participants were randomized into either the Agility Boot Camp (ABC or treadmill training; 4x/week for 4 weeks. Outcome measures were grouped by the International Classification of Function/Disability (ICF. To determine the responsiveness to exercise, we calculated the standardized response means. t-tests were used to compare the relative benefits of each exercise program. Results. Four of five variables at the structure/function level changed after exercise: turn duration (P=0.03, stride velocity (P=0.001, peak arm speed (P=0.001, and horizontal trunk ROM during gait (P=0.02. Most measures improved similarly for both interventions. The only variable that detected a difference between groups was postural sway in ABC group (F=4.95; P=0.03. Conclusion. Outcome measures at ICF body structure/function level were most effective at detecting change after exercise and revealing differences in improvement between interventions.

Diminished Access: Fall 1982 Enrollment at Independent Colleges and Universities.

Science.gov (United States)

Thrift, Julianne Still; Toppe, Christopher

Results of the fall 1982 survey of enrollments at private colleges and universities are presented, with attention also directed to the effect of the freshman enrollment decline on institutional finance, determinants of enrollment, and future enrollment expectations. Of the approximately 1,500 independent colleges, almost 1,200 institutions…

Transforming the Enrollment Experience Using Design Thinking

Science.gov (United States)

Apel, Aaron; Hull, Phil; Owczarek, Scott; Singer, Wren

2018-01-01

In an effort to simplify the advising and registration process and provide students with a more intuitive enrollment experience, especially at orientation, the University of Wisconsin-Madison's Office of the Registrar and Office of Undergraduate Advising co-sponsored a project to transform the enrollment experience. Using design thinking has…

Estimating the Market Demand and Elasticity for Enrollment at an Institution

Science.gov (United States)

Wohlgemuth, Darin

2013-01-01

This article presents an applied research framework that can be helpful in tuition and net price policy discussions. It is the classic microeconomic concept of market demand applied to enrollment management in higher education. The policy relevance includes measuring a response to price. For example, the results of this model will allow the…

Novel assessment tools to evaluate clinical and laboratory responses in a subset of patients enrolled in the Rituximab in Myositis trial.

Science.gov (United States)

Rider, Lisa G; Yip, Adrienne L; Horkayne-Szakaly, Iren; Volochayev, Rita; Shrader, Joseph A; Turner, Maria L; Kong, Heidi H; Jain, Minal S; Jansen, Anna V; Oddis, Chester V; Fleisher, Thomas A; Miller, Frederick W

2014-01-01

We aimed to assess changes in myositis core set measures and ancillary clinical and laboratory data from the National Institutes of Health's subset of patients enrolled in the Rituximab in Myositis trial. Eighteen patients (5 dermatomyositis, 8 polymyositis, 5 juvenile dermatomyositis) completed more in-depth testing of muscle strength and cutaneous assessments, patient-reported outcomes, and laboratory tests before and after administration of rituximab. Percentage change in individual measures and in the definitions of improvement (DOIs) and standardized response means were examined over 44 weeks. Core set activity measures improved by 18-70% from weeks 0-44 and were sensitive to change. Fifteen patients met the DOI at week 44, 9 patients met a DOI 50% response, and 4 met a DOI 70% response. Muscle strength and function measures were more sensitive to change than cutaneous assessments. Constitutional, gastrointestinal, and pulmonary systems improved 44-70%. Patient-reported outcomes improved up to 28%. CD20+ B cells were depleted in the periphery, but B cell depletion was not associated with clinical improvement at week 16. This subset of patients had high rates of clinical response to rituximab, similar to patients in the overall trial. Most measures were responsive, and muscle strength had a greater degree of change than cutaneous assessments. Several novel assessment tools, including measures of strength and function, extra-muscular organ activity, fatigue, and health-related quality of life, are promising for use in future myositis trials. Further study of B cell-depleting therapies in myositis, particularly in treatment-naïve patients, is warranted.

20 CFR 901.32 - Receipt of information concerning enrolled actuaries.

Science.gov (United States)

2010-04-01

... actuaries. 901.32 Section 901.32 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS... Suspension or Termination of Enrollment § 901.32 Receipt of information concerning enrolled actuaries. If an... Guaranty Corporation, or a member of the Joint Board has reason to believe that an enrolled actuary has...

Do Activity Level Outcome Measures Commonly Used in Neurological Practice Assess Upper-Limb Movement Quality?

Science.gov (United States)

Demers, Marika; Levin, Mindy F

2017-07-01

Movement is described in terms of task-related end point characteristics in external space and movement quality (joint rotations in body space). Assessment of upper-limb (UL) movement quality can assist therapists in designing effective treatment approaches for retraining lost motor elements and provide more detailed measurements of UL motor improvements over time. To determine the extent to which current activity level outcome measures used in neurological practice assess UL movement quality. Outcome measures assessing arm/hand function at the International Classification of Function activity level recommended by neurological clinical practice guidelines were reviewed. Measures assessing the UL as part of a general mobility assessment, those strictly evaluating body function/structure or participation, and paediatric measures were excluded. In all, 15 activity level outcome measures were identified; 9 measures assess how movement is performed by measuring either end point characteristics or movement quality. However, except for the Reaching Performance Scale for Stroke and the Motor Evaluation Scale for Upper Extremity in Stroke Patients, these measures only account for deficits indirectly by giving a partial score if movements are slower or if the person experiences difficulties. Six outcome measures neither assess any parameters related to movement quality, nor distinguish between improvements resulting from motor compensation or recovery of desired movement strategies. Current activity measures may not distinguish recovery from compensation and adequately track changes in movement quality over time. Movement quality may be incorporated into clinical assessment using observational kinematics with or without low-cost motion tracking technology.

CT Measured Psoas Density Predicts Outcomes After Enterocutaneous Fistula Repair

Science.gov (United States)

Lo, Wilson D.; Evans, David C.; Yoo, Taehwan

2018-01-01

Background Low muscle mass and quality are associated with poor surgical outcomes. We evaluated CT measured psoas muscle density as a marker of muscle quality and physiologic reserve, and hypothesized that it would predict outcomes after enterocutaneous fistula repair (ECF). Methods We conducted a retrospective cohort study of patients 18 – 90 years old with ECF failing non-operative management requiring elective operative repair at Ohio State University from 2005 – 2016 that received a pre-operative abdomen/pelvis CT with intravenous contrast within 3 months of their operation. Psoas Hounsfield Unit average calculation (HUAC) were measured at the L3 level. 1 year leak rate, 90 day, 1 year, and 3 year mortality, complication risk, length of stay, dependent discharge, and 30 day readmission were compared to HUAC. Results 100 patients met inclusion criteria. Patients were stratified into interquartile (IQR) ranges based on HUAC. The lowest HUAC IQR was our low muscle quality (LMQ) cutoff, and was associated with 1 year leak (OR 3.50, p < 0.01), 1 year (OR 2.95, p < 0.04) and 3 year mortality (OR 3.76, p < 0.01), complication risk (OR 14.61, p < 0.01), and dependent discharge (OR 4.07, p < 0.01) compared to non-LMQ patients. Conclusions Psoas muscle density is a significant predictor of poor outcomes in ECF repair. This readily available measure of physiologic reserve can identify patients with ECF on pre-operative evaluation that have significantly increased risk that may benefit from additional interventions and recovery time to mitigate risk before operative repair. PMID:29505144

MOOCs: Branding, Enrollment, and Multiple Measures of Success

Science.gov (United States)

Leeds, Elke M.; Cope, Jim

2015-01-01

KSU redefined the MOOC value proposition through collaboration of university leadership and faculty. The new proposition shifts measures of success beyond just course completion to include measures that benefit students, faculty, and the institution. Students benefitted through access to open educational resources, the acquisition of professional…

Shuttle Walking Test as Predictor of Survival in Chronic Obstructive Pulmonary Disease Patients Enrolled in a Rehabilitation Program

DEFF Research Database (Denmark)

Ringbæk, Thomas; Martinez, Gerd; Brøndum, Eva

2010-01-01

BACKGROUND: The Incremental Shuttle Walking Test (ISWT) is used to assess exercise capacity in chronic obstructive pulmonary disease (COPD) and is employed as an outcome measure for pulmonary rehabilitation. We studied the value of this test in predicting survival in COPD patients enrolled...... in a rehabilitation program. METHODS: A total of 416 patients performed an ISWT before entering a 7-week outpatient pulmonary rehabilitation program. Their survival was observed over a mean period of 4.5 years (range = 1.2-7.2 years). RESULTS: During the observation period, 169 (40.6%) patients died. Univariate...... analyses showed that the ISWT as well as age, gender, present and previous tobacco smoking, forced expiratory volume in 1 second, body mass index, oxygen saturation at rest, long-term oxygen therapy, Medical Research Council dyspnea score, and treatment with oral corticosteroids were significantly...

Outcome-driven thresholds for home blood pressure measurement: international database of home blood pressure in relation to cardiovascular outcome.

Science.gov (United States)

Niiranen, Teemu J; Asayama, Kei; Thijs, Lutgarde; Johansson, Jouni K; Ohkubo, Takayoshi; Kikuya, Masahiro; Boggia, José; Hozawa, Atsushi; Sandoya, Edgardo; Stergiou, George S; Tsuji, Ichiro; Jula, Antti M; Imai, Yutaka; Staessen, Jan A

2013-01-01

The lack of outcome-driven operational thresholds limits the clinical application of home blood pressure (BP) measurement. Our objective was to determine an outcome-driven reference frame for home BP measurement. We measured home and clinic BP in 6470 participants (mean age, 59.3 years; 56.9% women; 22.4% on antihypertensive treatment) recruited in Ohasama, Japan (n=2520); Montevideo, Uruguay (n=399); Tsurugaya, Japan (n=811); Didima, Greece (n=665); and nationwide in Finland (n=2075). In multivariable-adjusted analyses of individual subject data, we determined home BP thresholds, which yielded 10-year cardiovascular risks similar to those associated with stages 1 (120/80 mm Hg) and 2 (130/85 mm Hg) prehypertension, and stages 1 (140/90 mm Hg) and 2 (160/100 mm Hg) hypertension on clinic measurement. During 8.3 years of follow-up (median), 716 cardiovascular end points, 294 cardiovascular deaths, 393 strokes, and 336 cardiac events occurred in the whole cohort; in untreated participants these numbers were 414, 158, 225, and 194, respectively. In the whole cohort, outcome-driven systolic/diastolic thresholds for the home BP corresponding with stages 1 and 2 prehypertension and stages 1 and 2 hypertension were 121.4/77.7, 127.4/79.9, 133.4/82.2, and 145.4/86.8 mm Hg; in 5018 untreated participants, these thresholds were 118.5/76.9, 125.2/79.7, 131.9/82.4, and 145.3/87.9 mm Hg, respectively. Rounded thresholds for stages 1 and 2 prehypertension and stages 1 and 2 hypertension amounted to 120/75, 125/80, 130/85, and 145/90 mm Hg, respectively. Population-based outcome-driven thresholds for home BP are slightly lower than those currently proposed in hypertension guidelines. Our current findings could inform guidelines and help clinicians in diagnosing and managing patients.

Associations of maternal organophosphate pesticide exposure and PON1 activity with birth outcomes in SAWASDEE birth cohort, Thailand

Science.gov (United States)

Naksen, Warangkana; Prapamontol, Tippawan; Mangklabruks, Ampica; Chantara, Somporn; Thavornyutikarn, Prasak; Srinual, Niphan; Panuwet, Parinya; Ryan, P. Barry; Riederer, Anne M.; Barr, Dana Boyd

2015-01-01

Prenatal organophosphate (OP) pesticide exposure has been reported to be associated with adverse birth outcomes and neurodevelopment. However, the mechanisms of toxicity of OP pesticides on human fetal development have not yet been elucidated. Our pilot study birth cohort, the Study of Asian Women and Offspring’s Development and Environmental Exposures (SAWASDEE cohort) aimed to evaluate environmental chemical exposures and their relation to birth outcomes and infant neurodevelopment in 52 pregnant farmworkers in Fang district, Chiang Mai province, Thailand. A large array of data was collected multiple times during pregnancy including approximately monthly urine samples for evaluation of pesticide exposure, three blood samples for pesticide-related enzyme measurements and questionnaire data. This study investigated the changes in maternal acetylcholinesterase (AChE) and paraoxonase 1 (PON1) activities and their relation to urinary diakylphosphates (DAPs), class-related metabolites of OP pesticides, during pregnancy. Maternal AChE, butyrylcholinesterase (BChE) and PON1 activities were measured three times during pregnancy and urinary DAP concentrations were measured, on average, 8 times from enrollment during pregnancy until delivery. Among the individuals in the group with low maternal PON1 activity (n = 23), newborn head circumference was negatively correlated with log10 maternal ΣDEAP and ΣDAP at enrollment (gestational age=12±3 weeks; β = −1.0 cm, p = 0.03 and β = −1.8 cm, p <0.01, respectively) and at 32 weeks pregnancy (β = −1.1 cm, p = 0.04 and β = −2.6 cm, p = 0.01, respectively). Furthermore, among these mothers, newborn birthweight was also negatively associated with log10 maternal ΣDEAP and ΣDAP at enrollment (β = −219.7 g, p = 0.05 and β = −371.3 g, p = 0.02, respectively). Associations between maternal DAP levels and newborn outcomes were not observed in the group of participants with high maternal PON1 activity. Our results

Enrollment in Texas Public Schools, 2014-15

Science.gov (United States)

Texas Education Agency, 2016

2016-01-01

This report provides information on enrollment in the Texas public school system from the 2004-05 through 2014-15 school years, based on data collected through the Texas Public Education Information Management System. Enrollment data are provided by grade, race/ethnicity, gender, and economically disadvantaged status, and for special populations…

Enrollment in Texas Public Schools, 2015-16

Science.gov (United States)

Texas Education Agency, 2016

2016-01-01

This report provides information on enrollment in the Texas public school system from the 2005-06 through 2015-16 school years, based on data collected through the Texas Public Education Information Management System. Enrollment data are provided by grade, race/ethnicity, gender, and economically disadvantaged status, and for special populations…

AN ASSESSMENT OF THE ATTITUDES AND OUTCOMES OF STUDENTS ENROLLED IN DEVELOPMENTAL BASIC MATHEMATICS CLASSES AT PRINCE GEORGE'S COMMUNITY COLLEGE

OpenAIRE

Bassette, Lorraine Pratt

2004-01-01

The purposes of this study were to assess the effect of the initial and exiting attitudes toward mathematics and academic outcomes of students placed in the Developmental Mathematics Basic Arithmetic course at a community college in Maryland. Major research questions included were: (1) What is the difference, if any, between the pretest and posttest attitudes toward mathematics of students placed in Basic Arithmetic as measured by the Aiken Mathematics Attitude Survey? (...

Spatial cluster detection for repeatedly measured outcomes while accounting for residential history.

Science.gov (United States)

Cook, Andrea J; Gold, Diane R; Li, Yi

2009-10-01

Spatial cluster detection has become an important methodology in quantifying the effect of hazardous exposures. Previous methods have focused on cross-sectional outcomes that are binary or continuous. There are virtually no spatial cluster detection methods proposed for longitudinal outcomes. This paper proposes a new spatial cluster detection method for repeated outcomes using cumulative geographic residuals. A major advantage of this method is its ability to readily incorporate information on study participants relocation, which most cluster detection statistics cannot. Application of these methods will be illustrated by the Home Allergens and Asthma prospective cohort study analyzing the relationship between environmental exposures and repeated measured outcome, occurrence of wheeze in the last 6 months, while taking into account mobile locations.

Engaging the hearts and minds of clinicians in outcome measurement – the UK rehabilitation outcomes collaborative approach

Science.gov (United States)

2012-01-01

Purpose This article explores the rationale for choosing the instruments included within the UK Rehabilitation Outcomes Collaborative (UKROC) data set. Using one specialist neuro-rehabilitation unit as an exemplar service, it describes an approach to engaging the hearts and minds of clinicians in recording the data. Key messages and implications Measures included within a national data set for rehabilitation should be psychometrically robust and feasible to use in routine clinical practice; they should also support clinical decision-making so that clinicians actually want to use them. Learning from other international casemix models and benchmarking data sets, the UKROC team has developed a cluster of measures to inform the development of effective and cost-efficient rehabilitation services. These include measures of (1) “needs” for rehabilitation (complexity), (2) inputs provided to meet those needs (nursing and therapy intervention), and (3) outcome, including the attainment of personal goals as well as gains in functional independence. Conclusions By integrating the use of the data set measures in everyday clinical practice, we have achieved a very high rate of compliance with data collection. However, staff training and ongoing commitment from senior staff and managers are critical to the maintenance of effort required to provide assurance of data quality in the longer term. PMID:22506959

Treatment of patients with hand osteoarthritis : outcome measures, patient satisfaction, and economic evaluation

NARCIS (Netherlands)

Marks, Miriam

2014-01-01

The aim of this thesis was to investigate the limitations in daily life, outcome measures, clinical outcomes with the emphasis on patient satisfaction, and economic aspects of the treatment of hand osteoarthritis (OA). Patients with hand OA report severe restrictions in daily life, in particular in

Enrollment in Texas Public Schools, 2016-17

Science.gov (United States)

Texas Education Agency, 2017

2017-01-01

This report provides information on enrollment in the Texas public school system from the 2006-07 through 2016-17 school years, based on data collected through the Texas Student Data System. Enrollment data are provided by grade, race/ethnicity, gender, and economically disadvantaged status, and for special populations and instructional programs.…

Improving IS Enrollment Choices: The Role of Social Support

Science.gov (United States)

Akbulut-Bailey, Asli

2012-01-01

Over the last decade, enrollment in Information Systems (IS) and related programs has dropped worldwide and still remains low despite positive job market predictions. Given the significant negative consequences of low enrollments on both academia and industry, the IS community has focused its efforts on mechanisms to increase enrollments. This…

Outcomes of Vogt-Koyanagi-Harada disease: a subanalysis from a randomized clinical trial of antimetabolite therapies

Science.gov (United States)

Shen, Elizabeth; Rathinam, Sivakumar R.; Babu, Manohar; Kanakath, Anuradha; Thundikandy, Radhika; Lee, Salena M.; Browne, Erica N.; Porco, Travis C.; Acharya, Nisha R.

2016-01-01

Purpose To report outcomes of Vogt-Koyanagi-Harada (VKH) disease from a clinical trial of antimetabolite therapies. Design Subanalysis from an observer-masked randomized clinical trial for non-infectious intermediate, posterior, and pan- uveitis. Methods Setting clinical practice at Aravind Eye Hospitals, India Patient Population Forty-three of 80 patients enrolled (54%) diagnosed with VKH. Intervention Patients were randomized to either 25mg oral methotrexate weekly or 1g mycophenolate mofetil twice daily, with a corticosteroid taper. Main outcome measures Primary outcome was corticosteroid-sparing control of inflammation at 5 and 6 months. Secondary outcomes included visual acuity, central subfield thickness, and adverse events. Patients were categorized as acute (diagnosis ≤3 months prior to enrollment) or chronic (diagnosis >3 months prior to enrollment). Results Twenty-seven patients were randomized to methotrexate and 16 to mycophenolate mofetil; 30 had acute VKH. The odds of achieving corticosteroid-sparing control of inflammation with methotrexate were 2.5 times (95% CI: 0.6, 9.8; P=0.20) the odds with mycophenolate mofetil, a difference which was not statistically significant. The average improvement in visual acuity was 12.5 Early Treatment Diabetic Retinopathy Study (ETDRS) letters. On average, visual acuity for patients with acute VKH improved by 14 more ETDRS letters than those with chronic VKH (P<0.001), but there was no difference in corticosteroid-sparing control of inflammation (P=0.99). All 26 eyes with a serous retinal detachment at baseline resolved, and 88% achieved corticosteroid-sparing control of inflammation. Conclusions The majority of patients treated with antimetabolites and corticosteroids were able to achieve corticosteroid-sparing control of inflammation by 6 months. Although patients with acute VKH gained more visual improvement than those with chronic VKH, this did not correspond with a higher rate of controlled inflammation. PMID

Psychosocial predictors of treatment outcome for trauma-affected refugees

Directory of Open Access Journals (Sweden)

Charlotte Sonne

2016-05-01

Full Text Available Background: The effects of treatment in trials with trauma-affected refugees vary considerably not only between studies but also between patients within a single study. However, we know little about why some patients benefit more from treatment, as few studies have analysed predictors of treatment outcome. Objective: The objective of the study was to examine possible psychosocial predictors of treatment outcome for trauma-affected refugees. Method: The participants were 195 adult refugees with posttraumatic stress disorder (PTSD who were enrolled in a 6- to 7-month treatment programme at the Competence Centre for Transcultural Psychiatry (CTP, Denmark. The CTP Predictor Index used in the study included 15 different possible outcome predictors concerning the patients’ past, chronicity of mental health problems, pain, treatment motivation, prerequisites for engaging in psychotherapy, and social situation. The primary outcome measure was PTSD symptoms measured on the Harvard Trauma Questionnaire (HTQ. Other outcome measures included the Hopkins Symptom Check List-25, the WHO-5 Well-being Index, Sheehan Disability Scale, Hamilton Depression and Anxiety Scales, the somatisation scale of the Symptoms Checklist-90, Global Assessment of Functioning scales, and pain rated on visual analogue scales. The relations between treatment outcomes and the total score as well as subscores of the CTP Predictor Index were analysed. Results: Overall, the total score of the CTP Predictor Index was significantly correlated to pre- to post treatment score changes on the majority of the ratings mentioned above. While employment status was the only single item significantly correlated to HTQ-score changes, a number of single items from the CTP Predictor Index correlated significantly with changes in depression and anxiety symptoms, but the size of the correlation coefficients were modest. Conclusions: The total score of the CTP Predictor Index correlated significantly

Progress Towards a Core Set of Outcome Measures in Small-vessel Vasculitis. Report from OMERACT 9

Science.gov (United States)

MERKEL, PETER A.; HERLYN, KAREN; MAHR, ALFRED D.; NEOGI, TUHINA; SEO, PHILIP; WALSH, MICHAEL; BOERS, MAARTEN; LUQMANI, RAASHID

2011-01-01

The past decade has seen a substantial increase in the number and quality of clinical trials of new therapies for vasculitis, including randomized, controlled, multicenter trials that have successfully incorporated measures of disease activity and toxicity. However, because current treatment regimens for severe disease effectively induce initial remission and reduce mortality, future trials will focus on any of several goals including: (a) treatment of mild—moderate disease; (b) prevention of chronic damage; (c) reduction in treatment toxicity; or (d) more subtle differences in remission induction or maintenance. Thus, new trials will require outcome measure instruments that are more precise and are better able to detect effective treatments for different disease states and measure chronic manifestations of disease. The OMERACT Vasculitis Working Group comprises international clinical investigators with expertise in vasculitis who, since 2002, have worked collaboratively to advance the refinement of outcome measures in vasculitis, create new measures to address domains of illness not covered by current research approaches, and harmonize outcome assessment in vasculitis. The focus of the OMERACT group to date has been on outcome measures in small-vessel vasculitis with an overall goal of creating a core set of outcome measures for vasculitis, each of which fulfills the OMERACT filter of truth, discrimination, feasibility, and identifying additional domains requiring further research. This process has been informed by several ongoing projects providing data on outcomes of disease activity, disease-related damage, multidimensional health-related quality of life, and patient-reported ratings of the burden of vasculitis. PMID:19820226

Back to the future: A practice led transition program from Assistant in Nursing to Enrolled Nurse.

Science.gov (United States)

Faithfull-Byrne, Annette; Thompson, Lorraine; Welch, Tony; Williamson, Moira; Schafer, Keppel; Hallinan, Claire

2017-01-01

Continuing professional development is an essential element in professional nursing practice. In our Hospital and Health service, a gap in existing nursing pathways was identified for Assistants in Nursing (AINs), who wished to further their career in nursing and progress to Enrolled Nurse (EN). There is also little in the literature that addresses Assistants in Nursing wishing to progress their career to Enrolled Nurses. This article describes a quality improvement project designed to address this gap. The project was a collaborative venture between a Queensland Hospital and Health Service and an Institute of Tertiary and Further Education (TAFE). The focus was on creating a flexible career path for Assistants in Nursing, wishing to become Enrolled Nurses. The project resulted in the Diploma of Nursing program (theory and practice) being delivered within the hospital setting by nurse educators and clinical nurse consultants. This is unusual in that the program is normally delivered in the tertiary setting, by academic staff from the Institute of Further Education. Program implementation is described along with the challenges encountered. Outcomes from the project were: 78% completion rate; 100% employment on completion of their course of study; and 18% progressing to further their education such as Advance Enrolled Nurse or Registered Nurse. Student satisfaction regarding the program was also positive. The initiative established a local career path for Assistants in Nursing wishing to progress to Enrolled Nurse. This quality project demonstrates that collaborative ventures between the tertiary sector and hospital and health services, can create innovative flexible solutions for staff wishing to further their career in nursing. Copyright © 2016 Elsevier Ltd. All rights reserved.

Long-term neurodevelopmental outcomes in children born with gastroschisis: the tiebreaker.

Science.gov (United States)

Gorra, Adam S; Needelman, Howard; Azarow, Kenneth S; Roberts, Holly J; Jackson, Barbara J; Cusick, Robert A

2012-01-01

We evaluated 2-year neurodevelopmental outcomes in children with gastroschisis. We reviewed the records of children with gastroschisis treated between August 2001 and July 2008. Children discharged from the neonatal intensive care unit were referred to the state-sponsored Developmental Tracking Infant Progress Statewide (TIPS) program. We reviewed TIPS assessments performed before age 2 years. School districts evaluated children referred by TIPS and determined their eligibility for early intervention services. Poor outcomes were defined as scores of "failure" or "moderate/high risk" on the screening assessment or enrollment in early intervention services by 2 years. Children with gastroschisis were compared with case-matched nonsurgical, nonsyndromic children of similar gestational age and birth weight. One hundred five children were born with gastroschisis, and 46 were followed up with TIPS. There was no statistically significant difference in performance on screening assessments or in the rate of enrollment in early intervention services between the gastroschisis children and controls. Children born with gastroschisis have similar 2-year neurodevelopmental outcomes as nonsurgical, nonsyndromic neonatal intensive care unit children of similar gestational age and birth weight. Both groups of children have a higher rate of enrollment in early intervention than their healthy peers. These data suggest that neurodevelopmental outcomes in gastroschisis children are delayed secondary to prematurity rather than the presence of the surgical disease. Copyright © 2012 Elsevier Inc. All rights reserved.

Patient-Reported Disease Activity and Adverse Pregnancy Outcomes in Systemic Lupus Erythematosus and Rheumatoid Arthritis.

Science.gov (United States)

Harris, Nathaniel; Eudy, Amanda; Clowse, Megan

2018-06-15

While increased rheumatic disease activity during pregnancy has been associated with adverse pregnancy outcomes, this activity is typically assessed by the physician. Little is known, however, about the association between patient-reported measures of disease activity and pregnancy outcomes. Univariate and multivariable regression models were used to assess the relationship between patient and physician-reported measures of disease activity and adverse pregnancy outcomes in 225 patients with lupus or rheumatoid arthritis (RA) enrolled in a prospective registry at a single academic center from 2008-2016. In women with RA, patient-reported disease activity is associated with preterm birth (OR 5.9 (1.5-23.9)), and gestational age (beta -1.5 weeks (-2.6, -0.4 weeks)). The physician assessment of disease activity also predicted preterm (OR 2.1 (1.2-3.5)), small for gestational age births (OR 1.8 (1.03-3.1), and gestational age in weeks (beta -0.6 weeks (-0.9, -0.02 weeks)). On the other hand, SLE patient-reported disease activity measures, including the HAQ, pain or global health measures, are not associated with adverse pregnancy outcomes. However, physician measures of SLE disease activity are associated with preterm birth (OR 2.9 (1.-6.3)), cesarean delivery (OR 2.3 (1.0-5.3)), and preeclampsia (OR 2.8 (1.3-6.3)). The results do not appear to be driven by lupus nephritis or antiphospholipid syndrome. For women with RA, patient-reported measures of disease activity may be useful adjuncts to physician-reported measures in identifying pregnancies at greater risk. In contrast, in SLE, no patient-reported measures were associated with adverse outcomes while physician measures of disease activity helped predict several adverse pregnancy outcomes. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

No common denominator: a review of outcome measures in IVF RCTs.

Science.gov (United States)

Wilkinson, Jack; Roberts, Stephen A; Showell, Marian; Brison, Daniel R; Vail, Andy

2016-12-01

Which outcome measures are reported in RCTs for IVF? Many combinations of numerator and denominator are in use, and are often employed in a manner that compromises the validity of the study. The choice of numerator and denominator governs the meaning, relevance and statistical integrity of a study's results. RCTs only provide reliable evidence when outcomes are assessed in the cohort of randomised participants, rather than in the subgroup of patients who completed treatment. Review of outcome measures reported in 142 IVF RCTs published in 2013 or 2014. Trials were identified by searching the Cochrane Gynaecology and Fertility Specialised Register. English-language publications of RCTs reporting clinical or preclinical outcomes in peer-reviewed journals in the period 1 January 2013 to 31 December 2014 were eligible. Reported numerators and denominators were extracted. Where they were reported, we checked to see if live birth rates were calculated correctly using the entire randomised cohort or a later denominator. Over 800 combinations of numerator and denominator were identified (613 in no more than one study). No single outcome measure appeared in the majority of trials. Only 22 (43%) studies reporting live birth presented a calculation including all randomised participants or only excluding protocol violators. A variety of definitions were used for key clinical numerators: for example, a consensus regarding what should constitute an ongoing pregnancy does not appear to exist at present. Several of the included articles may have been secondary publications. Our categorisation scheme was essentially arbitrary, so the frequencies we present should be interpreted with this in mind. The analysis of live birth denominators was post hoc. There is massive diversity in numerator and denominator selection in IVF trials due to its multistage nature, and this causes methodological frailty in the evidence base. The twin spectres of outcome reporting bias and analysis of non

How do aggregated patient-reported outcome measures data stimulate health care improvement? A realist synthesis

Science.gov (United States)

Dalkin, Sonia; Gibbons, Elizabeth; Wright, Judy; Valderas, Jose Maria; Meads, David; Black, Nick

2017-01-01

Objectives Internationally, there has been considerable debate about the role of data in supporting quality improvement in health care. Our objective was to understand how, why and in what circumstances the feedback of aggregated patient-reported outcome measures data improved patient care. Methods We conducted a realist synthesis. We identified three main programme theories underlying the use of patient-reported outcome measures as a quality improvement strategy and expressed them as nine ‘if then’ propositions. We identified international evidence to test these propositions through searches of electronic databases and citation tracking, and supplemented our synthesis with evidence from similar forms of performance data. We synthesized this evidence through comparing the mechanisms and impact of patient-reported outcome measures and other performance data on quality improvement in different contexts. Results Three programme theories were identified: supporting patient choice, improving accountability and enabling providers to compare their performance with others. Relevant contextual factors were extent of public disclosure, use of financial incentives, perceived credibility of the data and the practicality of the results. Available evidence suggests that patients or their agents rarely use any published performance data when selecting a provider. The perceived motivation behind public reporting is an important determinant of how providers respond. When clinicians perceived that performance indicators were not credible but were incentivized to collect them, gaming or manipulation of data occurred. Outcome data do not provide information on the cause of poor care: providers needed to integrate and interpret patient-reported outcome measures and other outcome data in the context of other data. Lack of timeliness of performance data constrains their impact. Conclusions Although there is only limited research evidence to support some widely held theories of how

An exploratory study of whether pregnancy outcomes influence maternal self-reported history of child maltreatment.

Science.gov (United States)

Cammack, Alison L; Hogue, Carol J; Drews-Botsch, Carolyn D; Kramer, Michael R; Pearce, Brad D; Knight, Bettina; Stowe, Zachary N; Newport, D Jeffrey

2018-02-22

Childhood maltreatment is common and has been increasingly studied in relation to perinatal outcomes. While retrospective self-report is convenient to use in studies assessing the impact of maltreatment on perinatal outcomes, it may be vulnerable to bias. We assessed bias in reporting of maltreatment with respect to women's experiences of adverse perinatal outcomes in a cohort of 230 women enrolled in studies of maternal mental illness. Each woman provided a self-reported history of childhood maltreatment via the Childhood Trauma Questionnaire at two time points: 1) the preconception or prenatal period and 2) the postpartum period. While most women's reports of maltreatment agreed, there was less agreement for physical neglect among women experiencing adverse perinatal outcomes. Further, among women who discrepantly reported maltreatment, those experiencing adverse pregnancy outcomes tended to report physical neglect after delivery but not before, and associations between physical neglect measured after delivery and adverse pregnancy outcomes were larger than associations that assessed physical neglect before delivery. There were larger associations between post-delivery measured maltreatment and perinatal outcomes among women who had not previously been pregnant and in those with higher postpartum depressive symptoms. Although additional larger studies in the general population are necessary to replicate these findings, they suggest retrospective reporting of childhood maltreatment, namely physical neglect, may be prone to systematic differential recall bias with respect to perinatal outcomes. Measures of childhood maltreatment reported before delivery may be needed to validly estimate associations between maternal exposure to childhood physical neglect and perinatal outcomes. Copyright © 2018 Elsevier Ltd. All rights reserved.

An introduction to patient-reported outcome measures (PROMs) in physiotherapy

NARCIS (Netherlands)

Kyte, D.G.; Calvert, M.; Wees, P.J. van der; Hove, R. Ten; Tolan, S.; Hill, J.C.

2015-01-01

The use of patient-reported outcome measures (PROMs) is set to rise in physiotherapy. PROMs provide additional 'patient-centred' data which is unique in capturing the patient's own opinion on the impact of their disease or disorder, and its treatment, on their life. Thus, PROMs are increasingly used

Directly measured secondhand smoke exposure and COPD health outcomes

Directory of Open Access Journals (Sweden)

Balmes John

2006-06-01

Full Text Available Abstract Background Although personal cigarette smoking is the most important cause and modulator of chronic obstructive pulmonary disease (COPD, secondhand smoke (SHS exposure could influence the course of the disease. Despite the importance of this question, the impact of SHS exposure on COPD health outcomes remains unknown. Methods We used data from two waves of a population-based multiwave U.S. cohort study of adults with COPD. 77 non-smoking respondents with a diagnosis of COPD completed direct SHS monitoring based on urine cotinine and a personal badge that measures nicotine. We evaluated the longitudinal impact of SHS exposure on validated measures of COPD severity, physical health status, quality of life (QOL, and dyspnea measured at one year follow-up. Results The highest level of SHS exposure, as measured by urine cotinine, was cross-sectionally associated with poorer COPD severity (mean score increment 4.7 pts; 95% CI 0.6 to 8.9 and dyspnea (1.0 pts; 95% CI 0.4 to 1.7 after controlling for covariates. In longitudinal analysis, the highest level of baseline cotinine was associated with worse COPD severity (4.7 points; 95% CI -0.1 to 9.4; p = 0.054, disease-specific QOL (2.9 pts; -0.16 to 5.9; p = 0.063, and dyspnea (0.9 pts; 95% CI 0.2 to 1.6 pts; p Conclusion Directly measured SHS exposure appears to adversely influence health outcomes in COPD, independent of personal smoking. Because SHS is a modifiable risk factor, clinicians should assess SHS exposure in their patients and counsel its avoidance. In public health terms, the effects of SHS exposure on this vulnerable subpopulation provide a further rationale for laws prohibiting public smoking.

Patient-reported outcomes (PROs): the significance of using humanistic measures in clinical trial and clinical practice.

Science.gov (United States)

Refolo, P; Minacori, R; Mele, V; Sacchini, D; Spagnolo, A G

2012-10-01

Patient-reported outcome (PRO) is an "umbrella term" that covers a whole range of potential types of measurement but it is used specifically to refer to all measures quantifying the state of health through the evaluation of outcomes reported by the patient himself/herself. PROs are increasingly seen as complementary to biomedical measures and they are being incorporated more frequently into clinical trials and clinical practice. After considering the cultural background of PROs - that is the well known patient-centered model of medicine -, their historical profile (since 1914, the year of the first outcome measure) and typologies, the paper aims at debating their methodological complexity and implementation into practice. Some clinical trials and therapeutic managements utilizing patient-centered measures will be also analyzed.

Measurement properties of the Health of the Nation Outcome Scales (HoNOS) family of measures: protocol for a systematic review

Science.gov (United States)

Harris, Meredith G; Sparti, Claudia; Scheurer, Roman; Coombs, Tim; Pirkis, Jane; Ruud, Torleif; Kisely, Steve; Hanssen-Bauer, Ketil; Siqveland, Johan; Burgess, Philip M

2018-01-01

Introduction The Health of the Nation Outcome Scales (HoNOS) for adults, and equivalent measures for children and adolescents and older people, are widely used in clinical practice and research contexts to measure mental health and functional outcomes. Additional HoNOS measures have been developed for special populations and applications. Stakeholders require synthesised information about the measurement properties of these measures to assess whether they are fit for use with intended service settings and populations and to establish performance benchmarks. This planned systematic review will critically appraise evidence on the measurement properties of the HoNOS family of measures. Methods and analysis Journal articles meeting inclusion criteria will be identified via a search of seven electronic databases: MEDLINE via EBSCOhost, PsycINFO via APA PsycNET, Embase via Elsevier, Cumulative Index to Nursing and Allied Health Literature via EBSCOhost, Web of Science via Thomson Reuters, Google Scholar and the Cochrane Library. Variants of ‘Health of the Nation Outcome Scales’ or ‘HoNOS’ will be searched as text words. No restrictions will be placed on setting or language of publication. Reference lists of relevant studies and reviews will be scanned for additional eligible studies. Appraisal of reliability, validity, responsiveness and interpretability will be guided by the COnsensus-based Standards for the selection of health Measurement INstruments checklist. Feasibility/utility will be appraised using definitions and criteria derived from previous reviews. For reliability studies, we will also apply the Guidelines for Reporting Reliability and Agreement Studies to assess quality of reporting. Results will be synthesised narratively, separately for each measure, and by subgroup (eg, treatment setting, rater profession/experience or training) where possible. Meta-analyses will be undertaken where data are adequate. Ethics and dissemination Ethics approval is

Measurement properties of the Health of the Nation Outcome Scales (HoNOS) family of measures: protocol for a systematic review.

Science.gov (United States)

Harris, Meredith G; Sparti, Claudia; Scheurer, Roman; Coombs, Tim; Pirkis, Jane; Ruud, Torleif; Kisely, Steve; Hanssen-Bauer, Ketil; Siqveland, Johan; Burgess, Philip M

2018-04-20

The Health of the Nation Outcome Scales (HoNOS) for adults, and equivalent measures for children and adolescents and older people, are widely used in clinical practice and research contexts to measure mental health and functional outcomes. Additional HoNOS measures have been developed for special populations and applications. Stakeholders require synthesised information about the measurement properties of these measures to assess whether they are fit for use with intended service settings and populations and to establish performance benchmarks. This planned systematic review will critically appraise evidence on the measurement properties of the HoNOS family of measures. Journal articles meeting inclusion criteria will be identified via a search of seven electronic databases: MEDLINE via EBSCOhost, PsycINFO via APA PsycNET, Embase via Elsevier, Cumulative Index to Nursing and Allied Health Literature via EBSCOhost, Web of Science via Thomson Reuters, Google Scholar and the Cochrane Library. Variants of 'Health of the Nation Outcome Scales' or 'HoNOS' will be searched as text words. No restrictions will be placed on setting or language of publication. Reference lists of relevant studies and reviews will be scanned for additional eligible studies. Appraisal of reliability, validity, responsiveness and interpretability will be guided by the COnsensus-based Standards for the selection of health Measurement INstruments checklist. Feasibility/utility will be appraised using definitions and criteria derived from previous reviews. For reliability studies, we will also apply the Guidelines for Reporting Reliability and Agreement Studies to assess quality of reporting. Results will be synthesised narratively, separately for each measure, and by subgroup (eg, treatment setting, rater profession/experience or training) where possible. Meta-analyses will be undertaken where data are adequate. Ethics approval is not required as no primary data will be collected. Outcomes will be

Biomarkers S100B and neuron-specific enolase predict outcome in hypothermia-treated encephalopathic newborns*.

Science.gov (United States)

Massaro, An N; Chang, Taeun; Baumgart, Stephen; McCarter, Robert; Nelson, Karin B; Glass, Penny

2014-09-01

To evaluate if serum S100B protein and neuron-specific enolase measured during therapeutic hypothermia are predictive of neurodevelopmental outcome at 15 months in children with neonatal encephalopathy. Prospective longitudinal cohort study. A level IV neonatal ICU in a freestanding children's hospital. Term newborns with moderate to severe neonatal encephalopathy referred for therapeutic hypothermia during the study period. Serum neuron-specific enolase and S100B were measured at 0, 12, 24, and 72 hours of hypothermia. Of the 83 infants enrolled, 15 (18%) died in the newborn period. Survivors were evaluated by the Bayley Scales of Infant Development-II at 15 months. Outcomes were assessed in 49 of 68 survivors (72%) at a mean age of 15.2 ± 2.7 months. Neurodevelopmental outcome was classified by Bayley Scales of Infant Development-II Mental Developmental Index and Psychomotor Developmental Index scores, reflecting cognitive and motor outcomes, respectively. Four-level outcome classifications were defined a priori: normal = Mental Developmental Index/Psychomotor Developmental Index within 1 SD (> 85), mild = Mental Developmental Index/Psychomotor Developmental Index less than 1 SD (70-85), moderate/severe = Mental Developmental Index/Psychomotor Developmental Index less than 2 SD (encephalopathy are associated with neurodevelopmental outcome at 15 months. These putative biomarkers of brain injury may help direct care during therapeutic hypothermia.

Alzheimer Disease Biomarkers as Outcome Measures for Clinical Trials in MCI.

Science.gov (United States)

Caroli, Anna; Prestia, Annapaola; Wade, Sara; Chen, Kewei; Ayutyanont, Napatkamon; Landau, Susan M; Madison, Cindee M; Haense, Cathleen; Herholz, Karl; Reiman, Eric M; Jagust, William J; Frisoni, Giovanni B

2015-01-01

The aim of this study was to compare the performance and power of the best-established diagnostic biological markers as outcome measures for clinical trials in patients with mild cognitive impairment (MCI). Magnetic resonance imaging, F-18 fluorodeoxyglucose positron emission tomography markers, and Alzheimer's Disease Assessment Scale-cognitive subscale were compared in terms of effect size and statistical power over different follow-up periods in 2 MCI groups, selected from Alzheimer's Disease Neuroimaging Initiative data set based on cerebrospinal fluid (abnormal cerebrospinal fluid Aβ1-42 concentration-ABETA+) or magnetic resonance imaging evidence of Alzheimer disease (positivity to hippocampal atrophy-HIPPO+). Biomarkers progression was modeled through mixed effect models. Scaled slope was chosen as measure of effect size. Biomarkers power was estimated using simulation algorithms. Seventy-four ABETA+ and 51 HIPPO+ MCI patients were included in the study. Imaging biomarkers of neurodegeneration, especially MR measurements, showed highest performance. For all biomarkers and both MCI groups, power increased with increasing follow-up time, irrespective of biomarker assessment frequency. These findings provide information about biomarker enrichment and outcome measurements that could be employed to reduce MCI patient samples and treatment duration in future clinical trials.

Recommendations for a first Core Outcome Measurement set for complex regional PAin syndrome Clinical sTudies (COMPACT)

Science.gov (United States)

Grieve, Sharon; Perez, Roberto SGM; Birklein, Frank; Brunner, Florian; Bruehl, Stephen; Harden R, Norman; Packham, Tara; Gobeil, Francois; Haigh, Richard; Holly, Janet; Terkelsen, Astrid; Davies, Lindsay; Lewis, Jennifer; Thomassen, Ilona; Connett, Robyn; Worth, Tina; Vatine, Jean-Jacques; McCabe, Candida S

2017-01-01

Complex Regional Pain Syndrome (CRPS) is a persistent pain condition that remains incompletely understood and challenging to treat. Historically, a wide range of different outcome measures have been used to capture the multidimensional nature of CRPS. This has been a significant limiting factor in the advancement of our understanding of the mechanisms and management of CRPS. In 2013, an international consortium of patients, clinicians, researchers and industry representatives was established, to develop and agree on a minimum core set of standardised outcome measures for use in future CRPS clinical research, including but not limited to clinical trials within adult populations The development of a core measurement set was informed through workshops and supplementary work, using an iterative consensus process. ‘What is the clinical presentation and course of CRPS, and what factors influence it?’ was agreed as the most pertinent research question that our standardised set of patient-reported outcome measures should be selected to answer. The domains encompassing the key concepts necessary to answer the research question were agreed as: pain, disease severity, participation and physical function, emotional and psychological function, self efficacy, catastrophizing and patient's global impression of change. The final core measurement set included the optimum generic or condition-specific patient-reported questionnaire outcome measures, which captured the essence of each domain, and one clinician reported outcome measure to capture the degree of severity of CRPS. The next step is to test the feasibility and acceptability of collecting outcome measure data using the core measurement set in the CRPS population internationally. PMID:28178071

Certifying Enrollment Management Professionals

Science.gov (United States)

Tremblay, Christopher W.

2015-01-01

Most current professionals who serve in an enrollment management leadership capacity likely were trained "on the job," or at professional development events, primarily because credit-bearing credentials, degrees, and other formal programs were nonexistent (Phair 2014). However, that landscape has since changed, and now there are multiple…

Arterial stiffness and functional outcome in acute ischemic stroke.

Science.gov (United States)

Lee, Yeong-Bae; Park, Joo-Hwan; Kim, Eunja; Kang, Chang-Ki; Park, Hyeon-Mi

2014-03-01

Arterial stiffness is a common change associated with aging and can be evaluated by measuring pulse wave velocity (PWV) between sites in the arterial tree, with the stiffer artery having the higher PWV. Arterial stiffness is associated with the risk of stroke in the general population and of fatal stroke in hypertensive patients. This study is to clarify whether PWV value predicts functional outcome of acute ischemic stroke. ONE HUNDRED PATIENTS WERE ENROLLED WITH A DIAGNOSIS OF ACUTE ISCHEMIC STROKE AND CATEGORIZED INTO TWO GROUPS: large-artery atherosclerosis (LAAS) or small vessel disease (SVD) subtype of Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification. Each group was divided into two sub-groups based on the functional outcome of acute ischemic stroke, indicated by modified Rankin Scale (mRS) at discharge. Poor functional outcome group was defined as a mRS ≥ 3 at discharge. Student's t-test or Mann-Whitney U-test were used to compare maximal brachial-ankle PWV (baPWV) values. Twenty-four patients whose state was inadequate to assess baPWV or mRS were excluded. There were 38 patients with good functional outcome (mRS vs. 1,789.80 ± 421.91, p = 0.022), while there was no significant difference of baPWV among patients with LAAS subtype (2,071.76 ± 618.42 vs. 1,878.00 ± 365.35, p = 0.579). Arterial stiffness indicated by baPWV is associated with the functional outcome of acute ischemic stroke. This finding suggests that measurement of baPWV predicts functional outcome in patients with stroke especially those whose TOAST classification was confirmed as SVD subtype.

Evaluation of outcome measures for use in clinical practice for adults with musculoskeletal conditions of the knee: a systematic review.

Science.gov (United States)

Howe, Tracey E; Dawson, Lesley J; Syme, Grant; Duncan, Louise; Reid, Judith

2012-04-01

This systematic review reported on the clinimetric properties of outcome measures for use in clinical practice for adults with musculoskeletal conditions of the knee. A systematic search was performed in Medline, EMBASE, Cinahl and AMED to identify studies examining the clinimetric properties of outcome measures for adults undergoing conservative treatment of ligament injuries, meniscal lesions, patellofemoral pain and osteoarthritis of the knee. Outcomes measures taking less than 20 min to administer and requiring minimal equipment and space were included. Pairs of authors used a checklist to record the characteristics of the outcome measures, their reported clinimetric properties and the demographics of the study populations. The OMERACT filters of 'truth' and 'discrimination' were applied to the data for each outcome measure by an expert panel. Forty-seven studies were included evaluating 37 outcome measures. Ten outcome measures had adequate supporting evidence for 'truth' and 'discrimination': AAOS, AKPS, goniometer measurement, IKDC, KOOS, LEFS, Lysholm, Tegner, WOMAC and WOMET. However none of the outcome measures had been comprehensively tested across all clinimetric properties. Despite the widespread use of some outcome measures in clinical practice and primary research, data on the clinimetric properties were available for only 37 and of these only 10 had adequate supporting evidence for use in this population. However, before a core set of outcome measures can be recommended use in clinical practice, for adults with musculoskeletal conditions of the knee, consensus should be obtained on 'feasibility' in terms of burden on the clinician and the participant. Copyright © 2011 Elsevier Ltd. All rights reserved.

Fatigue is a reliable, sensitive and unique outcome measure in rheumatoid arthritis.

LENUS (Irish Health Repository)

Minnock, Patricia

2009-12-01

Fatigue is an important symptom in patients with RA. Measurement of fatigue in clinical trials and in clinical practice requires scales that are reproducible, sensitive to change and practical. This study examined the reliability and sensitivity to change of fatigue and its relative independence as an outcome measure in RA.

Do E-Textbooks Impact Learning Outcomes?

Science.gov (United States)

Fike, David; Fike, Renea

2016-01-01

The primary focus of this study was to determine if student learning outcomes in an undergraduate Statistics course differed based upon the type of textbook used (e-textbook or hardcopy). Fifty-six students enrolled in the course were allowed to choose textbook type. After controlling for student demographics and academic preparedness, student…

Patient Reported Outcome Measure of Spiritual Care as Delivered by Chaplains.

Science.gov (United States)

Snowden, Austyn; Telfer, Iain

2017-01-01

Chaplains are employed by health organizations around the world to support patients in recognizing and addressing their spiritual needs. There is currently no generalizable measure of the impact of these interventions and so the clinical and strategic worth of chaplaincy is difficult to articulate. This article introduces the Scottish PROM, an original five-item patient reported outcome measure constructed specifically to address this gap. It describes the validation process from its conceptual grounding in the spiritual care literature through face and content validity cycles. It shows that the Scottish PROM is internally consistent and unidimensional. Responses to the Scottish PROM show strong convergent validity with responses to the Warwick and Edinburgh Mental Well-Being Scale, a generic well-being scale often used as a proxy for spiritual well-being. In summary, the Scottish PROM is fit for purpose. It measures the outcomes of spiritual care as delivered by chaplains in this study. This novel project introduces an essential and original breakthrough; the possibility of generalizable international chaplaincy research.

Clinical Outcomes Measures for Assessment of Longevity in the Dental Implant Literature : ORONet Approach

NARCIS (Netherlands)

Bassi, Francesco; Carr, Alan B.; Chang, Ting-Ling; Estafanous, Emad; Garrett, Neal R.; Happonen, Risto-Pekka; Koka, Sreenivas; Laine, Juhani; Osswald, Martin; Reintsema, Harry; Rieger, Jana; Roumanas, Eleni; Salinas, Thomas J.; Stanford, Clark M.; Wolfaardt, Johan

2013-01-01

The Oral Rehabilitation Outcomes Network (ORONet) Longevity Working Group undertook a search of the literature from 1995 to 2009 on randomized controlled trials related to longevity of osseointegrated implants. Outcomes measures used in these studies were identified and subjected to the OMERACT

Presurgery resting-state local graph-theory measures predict neurocognitive outcomes after brain surgery in temporal lobe epilepsy.

Science.gov (United States)

Doucet, Gaelle E; Rider, Robert; Taylor, Nathan; Skidmore, Christopher; Sharan, Ashwini; Sperling, Michael; Tracy, Joseph I

2015-04-01

This study determined the ability of resting-state functional connectivity (rsFC) graph-theory measures to predict neurocognitive status postsurgery in patients with temporal lobe epilepsy (TLE) who underwent anterior temporal lobectomy (ATL). A presurgical resting-state functional magnetic resonance imaging (fMRI) condition was collected in 16 left and 16 right TLE patients who underwent ATL. In addition, patients received neuropsychological testing pre- and postsurgery in verbal and nonverbal episodic memory, language, working memory, and attention domains. Regarding the functional data, we investigated three graph-theory properties (local efficiency, distance, and participation), measuring segregation, integration and centrality, respectively. These measures were only computed in regions of functional relevance to the ictal pathology, or the cognitive domain. Linear regression analyses were computed to predict the change in each neurocognitive domain. Our analyses revealed that cognitive outcome was successfully predicted with at least 68% of the variance explained in each model, for both TLE groups. The only model not significantly predictive involved nonverbal episodic memory outcome in right TLE. Measures involving the healthy hippocampus were the most common among the predictors, suggesting that enhanced integration of this structure with the rest of the brain may improve cognitive outcomes. Regardless of TLE group, left inferior frontal regions were the best predictors of language outcome. Working memory outcome was predicted mostly by right-sided regions, in both groups. Overall, the results indicated our integration measure was the most predictive of neurocognitive outcome. In contrast, our segregation measure was the least predictive. This study provides evidence that presurgery rsFC measures may help determine neurocognitive outcomes following ATL. The results have implications for refining our understanding of compensatory reorganization and predicting

The new Childhood Arthritis and Rheumatology Research Alliance (CARRA) registry: design, rationale, and characteristics of patients enrolled in the first 12 months.

Science.gov (United States)

Beukelman, Timothy; Kimura, Yukiko; Ilowite, Norman T; Mieszkalski, Kelly; Natter, Marc D; Burrell, Grendel; Best, Brian; Jones, Jason; Schanberg, Laura E

2017-04-17

Herein we describe the history, design, and rationale of the new Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry and present the characteristics of patients with juvenile idiopathic arthritis (JIA) enrolled in the first 12 months of operation. The CARRA Registry began prospectively collecting data in the United States and Canada in July 2015 to evaluate the safety of therapeutic agents in persons with childhood-onset rheumatic disease, initially restricted to JIA. Secondary objectives include the evaluation of disease outcomes and their associations with medication use and other factors. Data are collected every 6 months and include clinical assessments, detailed medication use, patient-reported outcomes, and safety events. Follow-up is planned for at least 10 years for each participant and is facilitated by a telephone call center. As of July 2016, 1192 patients with JIA were enrolled in the CARRA Registry at 49 clinical sites. At enrollment, their median age was 12.4 years old and median disease duration was 2.6 years. Owing to preferential enrollment, patients with systemic JIA (13%) and with a polyarticular course (75%) were over-represented compared to patients in typical clinical practice. Approximately 49% were currently using biologic agents and ever use of oral glucocorticoids was common (47%). The CARRA Registry provides safety surveillance data to pharmaceutical companies to satisfy their regulatory requirements, and several independently-funded sub-studies that use the Registry infrastructure are underway. The new CARRA Registry successfully enrolled nearly 1200 participants with JIA in the first 12 months of its operation. Sustainable funding has been secured from multiple sources. The CARRA Registry may serve as a model for the study of other uncommon diseases.

Vision and vision-related outcome measures in multiple sclerosis

DEFF Research Database (Denmark)

Balcer, Laura J; Miller, David H; Reingold, Stephen C

2015-01-01

Visual impairment is a key manifestation of multiple sclerosis. Acute optic neuritis is a common, often presenting manifestation, but visual deficits and structural loss of retinal axonal and neuronal integrity can occur even without a history of optic neuritis. Interest in vision in multiple...... sclerosis is growing, partially in response to the development of sensitive visual function tests, structural markers such as optical coherence tomography and magnetic resonance imaging, and quality of life measures that give clinical meaning to the structure-function correlations that are unique...... of investigators involved in the development and study of visual outcomes in multiple sclerosis, which had, as its overriding goals, to review the state of the field and identify areas for future research. We review data and principles to help us understand the importance of vision as a model for outcomes...

Medicaid Managed Care Enrollment Report

Data.gov (United States)

U.S. Department of Health & Human Services — This report is composed annually and profiles enrollment statistics on Medicaid managed care programs on a plan-specific level. This report also provides...

Initial constructs for patient-centered outcome measures to evaluate brain-computer interfaces.

Science.gov (United States)

Andresen, Elena M; Fried-Oken, Melanie; Peters, Betts; Patrick, Donald L

2016-10-01

The authors describe preliminary work toward the creation of patient-centered outcome (PCO) measures to evaluate brain-computer interface (BCI) as an assistive technology (AT) for individuals with severe speech and physical impairments (SSPI). In Phase 1, 591 items from 15 existing measures were mapped to the International Classification of Functioning, Disability and Health (ICF). In Phase 2, qualitative interviews were conducted with eight people with SSPI and seven caregivers. Resulting text data were coded in an iterative analysis. Most items (79%) were mapped to the ICF environmental domain; over half (53%) were mapped to more than one domain. The ICF framework was well suited for mapping items related to body functions and structures, but less so for items in other areas, including personal factors. Two constructs emerged from qualitative data: quality of life (QOL) and AT. Component domains and themes were identified for each. Preliminary constructs, domains and themes were generated for future PCO measures relevant to BCI. Existing instruments are sufficient for initial items but do not adequately match the values of people with SSPI and their caregivers. Field methods for interviewing people with SSPI were successful, and support the inclusion of these individuals in PCO research. Implications for Rehabilitation Adapted interview methods allow people with severe speech and physical impairments to participate in patient-centered outcomes research. Patient-centered outcome measures are needed to evaluate the clinical implementation of brain-computer interface as an assistive technology.

Men in Childcare Services: From Enrolment in Training Programs to Job Retention

Science.gov (United States)

Pirard, Florence; Schoenmaeckers, Pauline; Camus, Pascale

2015-01-01

This article presents a study conducted in Federation Wallonia-Brussels (FWB) to identify factors that motivate men to enrol in training programmes and work in a field where women are the majority, in a context in which few proactive measures are taken to overcome gender stereotypes. Comprehensive interviews conducted with male childcare…

Faustmann and the forestry tradition of outcome-based performance measures

Science.gov (United States)

Peter J. Ince

1999-01-01

The concept of land expectation value developed by Martin Faustmann may serve as a paradigm for outcome-based performance measures in public forest management if the concept of forest equity value is broadened to include social and environmental benefits and costs, and sustainability. However, anticipation and accurate evaluation of all benefits and costs appears to...

Motivation for Enrolment and Influence of Postgraduate Study ...

African Journals Online (AJOL)

Motivation for Enrolment and Influence of Postgraduate Study Programme on Career Satisfaction among Agriculture Students in Southwestern Nigeria. ... and the need to meet requirements for choice career/job (mean=3.09) ranked as the major factors influencing enrolment for postgraduate programme among respondents ...

A randomized study comparing outcomes of stapled and hand-sutured anastomoses in patients undergoing open gastrointestinal surgery.

Science.gov (United States)

Chandramohan, S M; Gajbhiye, Raj Narenda; Agwarwal, Anil; Creedon, Erin; Schwiers, Michael L; Waggoner, Jason R; Tatla, Daljit

2013-08-01

Although stapling is an alternative to hand-suturing in gastrointestinal surgery, recent trials specifically designed to evaluate differences between the two in surgery time, anastomosis time, and return to bowel activity are lacking. This trial compared the outcomes of the two in subjects undergoing open gastrointestinal surgery. Adult subjects undergoing emergency or elective surgery requiring a single gastric, small, or large bowel anastomosis were enrolled into this open-label, prospective, randomized, interventional, parallel, multicenter, controlled trial. Randomization was assigned in a 1:1 ratio between the hand-sutured group (n = 138) and the stapled group (n = 142). Anastomosis time, surgery time, and time to bowel activity were collected and compared as primary endpoints. A total of 280 subjects were enrolled from April 2009 to September 2010. Only the time of anastomosis was significantly different between the two arms: 17.6 ± 1.90 min (stapled) and 20.6 ± 1.90 min (hand-sutured). This difference was deemed not clinically or economically meaningful. Safety outcomes and other secondary endpoints were similar between the two arms. Mechanical stapling is faster than hand-suturing for the construction of gastrointestinal anastomoses. Apart from this, stapling and hand-suturing are similar with respect to the outcomes measured in this trial.

Enrollment of SME Managers to Growth-oriented Training Programs

DEFF Research Database (Denmark)

Bager, Torben; Jensen, Kent Wickstrøm; Schou Nielsen, Pia

2015-01-01

Purpose: Entrepreneurial learning through formal growth-oriented training programs for SME managers promises to enhance the growth competences and growth intentions of the enrolled managers. The impact of such programs, however, depends on who enrolls since initial competence and growth-intention......Purpose: Entrepreneurial learning through formal growth-oriented training programs for SME managers promises to enhance the growth competences and growth intentions of the enrolled managers. The impact of such programs, however, depends on who enrolls since initial competence and growth...... has from 2012 to 2015 trained about 700 SME managers. Data are currently available for 366 of these participants. This evidence is compared with survey results from a randomly selected control group of 292 growth oriented SME managers in the same firm-size group. The data were analyzed through...... of the program. Originality/value The paper is the first systematic study of the importance of who enrolls in training programs for SME managers....

Barriers to Online Postsecondary Education Crumble: Enrollment in Traditional Face-to-Face Courses Declines as Enrollment in Online Courses Increases

Science.gov (United States)

Gray, Dahli

2013-01-01

Contrary to expectations, total postsecondary enrollment in the United States (US) declined in Fall 2011. In fact, it continues to decline while online enrollment continues to increase. Students can more easily cross geographic boundaries as online access causes barriers to postsecondary education to crumble, and more than 50% of the demand for…

2011 Annual Survey of Journalism and Mass Communication Enrollments: Enrollments Decline, Reversing the Increase of a Year Earlier, and Suggesting Slow Growth for Future

Science.gov (United States)

Becker, Lee B.; Vlad, Tudor; Kalpen, Konrad

2012-01-01

Enrollments in journalism and mass communication programs declined in the autumn of 2011, compared to a year earlier. Enrollments were down slightly at the senior and junior levels and substantially at the freshman level. Enrollment increased at the sophomore level. The majority of administrators say they have made curricular changes in the past…

The importance of patient-reported outcome measures in reconstructive urology.

Science.gov (United States)

Jackson, Matthew J; N'Dow, James; Pickard, Rob

2010-11-01

Patient-reported outcome measures (PROMs) are now recognised as the most appropriate instruments to assess the effectiveness of healthcare interventions from the patient's perspective. The purpose of this review was to identify recent publications describing the use of PROMs following reconstructive urological surgery. A wide systematic search identified only three original articles published in the last 2 years that prospectively assessed effectiveness using a patient-completed condition-specific or generic health-related quality of life (HRQoL) instrument. These publications illustrate the need to administer PROMs at a postoperative interval relevant to the anticipated recovery phase of individual procedures. They also highlight the difference in responsiveness of generic HRQoL instruments to symptomatic improvement between straightforward conditions such as pelviureteric junction obstruction and complex multidimensional conditions such as meningomyelocele. PROMs uptake and awareness is increasing in reconstructive urology but more work is required to demonstrate the effectiveness of surgical procedures for patients and healthcare funders alike. Healthcare policy-makers now rely on these measures to determine whether specific treatments are worth financing and to compare outcomes between institutions.

Systematic review of tools to measure outcomes for young children with autism spectrum disorder

NARCIS (Netherlands)

McConachie, H.; Parr, J.R.; Glod, M.; Hanratty, J.; Livingstone, N.; Oono, I.P.; Robalino, S.; Baird, G.; Beresford, B.; Charman, T.; Garland, D.; Green, J.; Gringras, P.; Jones, G.; Law, J.; Le Couteur, A.S.; Macdonald, G.; McColl, E.M.; Morris, C.; Rodgers, J.; Simonoff, E.; Terwee, C.B.; Williams, K.

2015-01-01

Background: The needs of children with autism spectrum disorder (ASD) are complex and this is reflected in the number and diversity of outcomes assessed and measurement tools used to collect evidence about children�s progress. Relevant outcomes include improvement in core ASD impairments, such as

Medicaid Enrollment - New Adult Group

Data.gov (United States)

U.S. Department of Health & Human Services — Total Medicaid Enrollees - VIII Group Break Out Report Reported on the CMS-64 The enrollment information is a state-reported count of unduplicated individuals...

Developing a General Outcome Measure of Growth in Movement for Infants and Toddlers.

Science.gov (United States)

Greenwood, Charles R.; Luze, Gayle J.; Cline, Gabriel; Kuntz, Susan; Leitschuh, Carol

2002-01-01

The development of an experimental measure for assessing growth in movement in children (ages birth-3) is described. Results from the use of the Movement General Outcome Measurement with 29 infants and toddlers demonstrated the feasibility of the measure. The 6-minute assessment was found reliable in terms of inter-observer agreement. (Contains…

Competition in health insurance markets: limitations of current measures for policy analysis.

Science.gov (United States)

Scanlon, Dennis P; Chernew, Michael; Swaminathan, Shailender; Lee, Woolton

2006-12-01

Health care reform proposals often rely on increased competition in health insurance markets to drive improved performance in health care costs, access, and quality. We examine a range of data issues related to the measures of health insurance competition used in empirical studies published from 1994-2004. The literature relies exclusively on market structure and penetration variables to measure competition. While these measures are correlated, the degree of correlation is modest, suggesting that choice of measure could influence empirical results. Moreover, certain measurement issues such as the lack of data on PPO enrollment, the treatment of small firms, and omitted market characteristics also could affect the conclusions in empirical studies. Importantly, other types of measures related to competition (e.g., the availability of information on price and outcomes, degree of entry barriers, etc.) are important from both a theoretical and policy perspective, but their impact on market outcomes has not been widely studied.

Can community change be measured for an outcomes-based initiative? A comparative case study of the success by 6 initiative.

Science.gov (United States)

Minich, Lisa; Howe, Steven; Langmeyer, Daniel; Corcoran, Kevin

2006-12-01

One of the challenges facing nonprofit organizations today is the demand for measurable results. Increasingly, these organizations are focusing less on program outputs and program outcomes in favor of community outcomes or changes demonstrated in the larger community. Success by 6(R) is a popular United Way initiative that emphasizes defining and measuring community outcomes. In this paper, we describe our work with 24 Success by 6(R) initiatives around the country. It is clear that not all of these initiatives are measuring community outcomes. Of those initiatives that are experiencing some success measuring community outcomes, similar measurement strategies are reported. Additionally, our experience suggests several United Way employees express dissatisfaction with the logic model as a framework for defining and measuring community outcomes although no preferred alternative model is identified. Evaluators working with community-wide initiatives must find ways to communicate the differences between program and community outcomes to key stakeholders and funders.

Discrepancies between patient-reported outcome measures when assessing urinary incontinence or pelvic-prolapse surgery

DEFF Research Database (Denmark)

Larsen, Michael Due; Lose, Gunnar; Guldberg, Rikke

2016-01-01

INTRODUCTION AND HYPOTHESIS: In order to assess the outcome following surgery for urinary incontinence (UI) and pelvic organ prolapse (POP) the importance of patient-reported outcome measures, in addition to the clinical objective measures, has been recognised. The International Consultation...... on Incontinence has initiated the development and evaluation of disease-specific questionnaires (ICIQ) to compare the patient's degree of improvement. Alternatively, the Patient's Global Impression of Improvement (PGI-I score) with an inherent before-after assessment has been widely accepted in recent studies...

Impact of Baseline Assessment Modality on Enrollment and Retention in a Facebook Smoking Cessation Study.

Science.gov (United States)

Villanti, Andrea C; Jacobs, Megan A; Zawistowski, Grace; Brookover, Jody; Stanton, Cassandra A; Graham, Amanda L

2015-07-16

Few studies have addressed enrollment and retention methods in online smoking cessation interventions. Fully automated Web-based trials can yield large numbers of participants rapidly but suffer from high rates of attrition. Personal contact with participants can increase recruitment of smokers into cessation trials and improve participant retention. To compare the impact of Web-based (WEB) and phone (PH) baseline assessments on enrollment and retention metrics in the context of a Facebook smoking cessation study. Participants were recruited via Facebook and Google ads which were randomly displayed to adult smokers in the United States over 27 days from August to September 2013. On each platform, two identical ads were randomly displayed to users who fit the advertising parameters. Clicking on one of the ads resulted in randomization to WEB, and clicking on the other ad resulted in randomization to PH. Following online eligibility screening and informed consent, participants in the WEB arm completed the baseline survey online whereas PH participants completed the baseline survey by phone with a research assistant. All participants were contacted at 30 days to complete a follow-up survey that assessed use of the cessation intervention and smoking outcomes. Participants were paid $15 for follow-up survey completion. A total of 4445 people clicked on the WEB ad and 4001 clicked on the PH ad: 12.04% (n=535) of WEB participants and 8.30% (n=332) of PH participants accepted the online study invitation (PFacebook app (66/114, 57.9% WEB vs 17/35, 49% PH) or that completed the 30-day follow-up survey (49/114, 43.0% WEB vs 16/35, 46% PH). A total of $6074 was spent on ads, generating 3,834,289 impressions and resulting in 8446 clicks (average cost $0.72 per click). Per participant enrollment costs for advertising alone were $27 WEB and $87 PH. A more intensive phone baseline assessment protocol yielded a lower rate of enrollment, equivalent follow-up rates, and higher

CTE Dual Enrollment: A Strategy for College Completion and Workforce Investment

Science.gov (United States)

Zinth, Jennifer Dounay

2014-01-01

Dual enrollment programs are expanding and so are dual enrollment programs with a career and technical education (CTE) focus. Recent data available from the National Center on Education Statistics show that 82 percent of high schools had students enrolling in dual enrollment coursework in 2010-11. Nearly half of the schools had students…

20 CFR 901.31 - Grounds for suspension or termination of enrollment.

Science.gov (United States)

2010-04-01

... enrollment. 901.31 Section 901.31 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS...) Failure to satisfy requirements for enrollment. The enrollment of an actuary may be terminated if it is found that the actuary did not satisfy the eligibility requirements set forth in §§ 901.12 or 901.13...

An International Standard Set of Patient-Centered Outcome Measures After Stroke

NARCIS (Netherlands)

Salinas, J. (Joel); Sprinkhuizen, S.M. (Sara M.); Ackerson, T. (Teri); Bernhardt, J. (Julie); Davie, C. (Charlie); George, M.G. (Mary G.); Gething, S. (Stephanie); Kelly, A.G. (Adam G.); Lindsay, P. (Patrice); Liu, L. (Liping); Martins, S.C.O. (Sheila C.O.); Morgan, L. (Louise); B. Norrving (Bo); Ribbers, G.M. (Gerard M.); Silver, F.L. (Frank L.); Smith, E.E. (Eric E.); Williams, L.S. (Linda S.); Schwamm, L.H. (Lee H.)

2015-01-01

markdownabstract__BACKGROUND AND PURPOSE:__ Value-based health care aims to bring together patients and health systems to maximize the ratio of quality over cost. To enable assessment of healthcare value in stroke management, an international standard set of patient-centered stroke outcome measures

Relationship of patient-reported outcomes with MRI measures in rheumatoid arthritis

DEFF Research Database (Denmark)

Baker, Joshua F; Conaghan, Philip G.; Emery, Paul

2017-01-01

PURPOSE: We assessed whether MRI measures of synovitis, osteitis and bone erosion were associated with patient-reported outcomes (PROs) in a longitudinal clinical trial setting among patients with rheumatoid arthritis (RA). METHODS: This longitudinal cohort of 291 patients with RA was derived from...

34 CFR 668.38 - Enrollment in telecommunications and correspondence courses.

Science.gov (United States)

2010-07-01

... 34 Education 3 2010-07-01 2010-07-01 false Enrollment in telecommunications and correspondence... Student Eligibility § 668.38 Enrollment in telecommunications and correspondence courses. (a) If a student..., or graduate degree. (b)(1) For purposes of this section, a student enrolled in a telecommunications...

Social Environmental Moderators of Long-term Functional Outcomes of Early Childhood Brain Injury

Science.gov (United States)

Wade, Shari L.; Zhang, Nanhua; Yeates, Keith Owen; Stancin, Terry; Taylor, H. Gerry

2017-01-01

IMPORTANCE Pediatric traumatic brain injury (TBI) contributes to impairments in behavior and academic performance. However, the long-term effects of early childhood TBI on functioning across settings remain poorly understood. OBJECTIVE To examine the long-term functional outcomes of early childhood TBI relative to early childhood orthopedic injuries (OIs). We also examine the moderating role of the social environment as defined by parent report and observational measures of family functioning, parenting practices, and home environment. DESIGN, SETTING, AND PARTICIPANTS A prospective, longitudinal, observational cohort study conducted at each child’s home, school, and hospital, including 3 children’s hospitals and 1 general hospital in the Midwest. Patients were enrolled in the initial study between January 2003 and October 2006. Follow-ups were completed between January 2010 and April 2015. Fifty-eight children who sustained a TBI (67%of original enrolled cohort) and 72 children who sustained an OI (61% of the original enrolled cohort) were prospectively followed up from shortly after injury (between the ages of 3 and 7 years at enrollment) to an average of 6.7 years after injury, with assessments occurring at multiple points. MAIN OUTCOMES AND MEASURES Long-term functional outcomes in everyday settings, as assessed through the Child and Adolescent Functional Assessment Scale (CAFAS). RESULTS Of the 130 children included, the median age for those with OIs was 11.72 years and 11.97, 12.21, and 11.72 years for those with complicated mild, moderate, and severe TBIs, respectively. Children with moderate and severe TBI were rated as having more functional impairments in multiple domains than those with OIs (P authoritarian (mean CAFAS of 56.45, 41.80, 54.90, and 17.12 for severe TBI, moderate TBI, complicated mild TBI, and OI, respectively, with significant difference between severe TBI and OI [difference = 39.33; P < .001], moderate TBI and OI [difference = 24

Considerations for analysis of time-to-event outcomes measured with error: Bias and correction with SIMEX.

Science.gov (United States)

Oh, Eric J; Shepherd, Bryan E; Lumley, Thomas; Shaw, Pamela A

2018-04-15

For time-to-event outcomes, a rich literature exists on the bias introduced by covariate measurement error in regression models, such as the Cox model, and methods of analysis to address this bias. By comparison, less attention has been given to understanding the impact or addressing errors in the failure time outcome. For many diseases, the timing of an event of interest (such as progression-free survival or time to AIDS progression) can be difficult to assess or reliant on self-report and therefore prone to measurement error. For linear models, it is well known that random errors in the outcome variable do not bias regression estimates. With nonlinear models, however, even random error or misclassification can introduce bias into estimated parameters. We compare the performance of 2 common regression models, the Cox and Weibull models, in the setting of measurement error in the failure time outcome. We introduce an extension of the SIMEX method to correct for bias in hazard ratio estimates from the Cox model and discuss other analysis options to address measurement error in the response. A formula to estimate the bias induced into the hazard ratio by classical measurement error in the event time for a log-linear survival model is presented. Detailed numerical studies are presented to examine the performance of the proposed SIMEX method under varying levels and parametric forms of the error in the outcome. We further illustrate the method with observational data on HIV outcomes from the Vanderbilt Comprehensive Care Clinic. Copyright © 2017 John Wiley & Sons, Ltd.

A critical appraisal of instruments to measure outcomes of interprofessional education.

Science.gov (United States)

Oates, Matthew; Davidson, Megan

2015-04-01

Interprofessional education (IPE) is believed to prepare health professional graduates for successful collaborative practice. A range of instruments have been developed to measure the outcomes of IPE. An understanding of the psychometric properties of these instruments is important if they are to be used to measure the effectiveness of IPE. This review set out to identify instruments available to measure outcomes of IPE and collaborative practice in pre-qualification health professional students and to critically appraise the psychometric properties of validity, responsiveness and reliability against contemporary standards for instrument design. Instruments were selected from a pool of extant instruments and subjected to critical appraisal to determine whether they satisfied inclusion criteria. The qualitative and psychometric attributes of the included instruments were appraised using a checklist developed for this review. Nine instruments were critically appraised, including the widely adopted Readiness for Interprofessional Learning Scale (RIPLS) and the Interdisciplinary Education Perception Scale (IEPS). Validity evidence for instruments was predominantly based on test content and internal structure. Ceiling effects and lack of scale width contribute to the inability of some instruments to detect change in variables of interest. Limited reliability data were reported for two instruments. Scale development and scoring protocols were generally reported by instrument developers, but the inconsistent application of scoring protocols for some instruments was apparent. A number of instruments have been developed to measure outcomes of IPE in pre-qualification health professional students. Based on reported validity evidence and reliability data, the psychometric integrity of these instruments is limited. The theoretical test construction paradigm on which instruments have been developed may be contributing to the failure of some instruments to detect change in

42 CFR 460.42 - Suspension of enrollment or payment by CMS.

Science.gov (United States)

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Suspension of enrollment or payment by CMS. 460.42... enrollment or payment by CMS. (a) Enrollment. If a PACE organization commits one or more violations specified in § 460.40, CMS may suspend enrollment of Medicare beneficiaries after the date CMS notifies the...

What You Need To Know About Enrollment Management.

Science.gov (United States)

Lapovsky, Lucie

1999-01-01

Provides basic information that a college or university chief financial officer (CFO) must know about enrollment management in order to understand how to work effectively with admissions and financial aid professionals to maximize tuition revenue and enroll the optimal class. Specific suggestions for CFO involvement are outlined. (Author/MSE)

Efficacy of Dual Enrollment in Rural Southwest Virginia

Science.gov (United States)

Carter, Karen Glass

2009-01-01

The intent of this dissertation was to determine if enrollment into a career and technical education dual enrollment program encouraged students to continue their education into postsecondary education and if workplace readiness skills were increased. This study completed a factorial analysis of student demographic and factorial data as associated…

Systematic literature review of patient-reported outcome measures used in assessment and measurement of sleep disorders in chronic obstructive pulmonary disease.

Science.gov (United States)

Garrow, Adam P; Yorke, Janelle; Khan, Naimat; Vestbo, Jørgen; Singh, Dave; Tyson, Sarah

2015-01-01

Sleep problems are common in patients with chronic obstructive pulmonary disease (COPD), but the validity of patient-reported outcome measures (PROMs) that measure sleep dysfunction has not been evaluated. We have reviewed the literature to identify disease-specific and non-disease-specific sleep PROMs that have been validated for use in COPD patients. The review also examined the psychometric properties of identified sleep outcome measures and extracted point and variability estimates of sleep instruments used in COPD studies. The online EMBASE, MEDLINE, PsycINFO, and SCOPUS databases for all years to May 2014 were used to source articles for the review. The review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Criteria from the Medical Outcomes Trust Scientific Advisory Committee guidelines were used to evaluate the psychometric properties of all sleep PROMs identified. One COPD-specific and six non-COPD-specific sleep outcome measures were identified and 44 papers met the review selection criteria. We only identified one instrument, the COPD and Asthma Sleep Impact Scale, which was developed specifically for use in COPD populations. Ninety percent of the identified studies used one of two non-disease-specific sleep scales, ie, the Pittsburgh Sleep Quality Index and/or the Epworth Sleep Scale, although neither has been tested for reliability or validity in people with COPD. The results highlight a need for existing non-disease-specific instruments to be validated in COPD populations and also a need for new disease-specific measures to assess the impact of sleep problems in COPD.

Use of and confidence in administering outcome measures among clinical prosthetists: Results from a national survey and mixed-methods training program.

Science.gov (United States)

Gaunaurd, Ignacio; Spaulding, Susan E; Amtmann, Dagmar; Salem, Rana; Gailey, Robert; Morgan, Sara J; Hafner, Brian J

2015-08-01

Outcome measures can be used in prosthetic practices to evaluate interventions, inform decision making, monitor progress, document outcomes, and justify services. Strategies to enhance prosthetists' ability to use outcome measures are needed to facilitate their adoption in routine practice. To assess prosthetists' use of outcome measures and evaluate the effects of training on their confidence in administering performance-based measures. Cross-sectional and single-group pretest-posttest survey. Seventy-nine certified prosthetists (mean of 16.0 years of clinical experience) were surveyed about their experiences with 20 standardized outcome measures. Prosthetists were formally trained by the investigators to administer the Timed Up and Go and Amputee Mobility Predictor. Prosthetists' confidence in administering the Timed Up and Go and Amputee Mobility Predictor was measured before and after training. The majority of prosthetists (62%) were classified as non-routine outcome measure users. Confidence administering the Timed Up and Go and Amputee Mobility Predictor prior to training was low-to-moderate across the study sample. Training significantly (p measures. Interactive training resulted in a statistically significant increase of prosthetists' confidence in administering the Timed Up and Go and Amputee Mobility Predictor and may facilitate use of outcome measures in clinical practice. Frequency of outcome measure use in the care of persons with limb loss has not been studied. Study results suggest that prosthetists may not regularly use standardized outcome measures and report limited confidence in administering them. Training enhances confidence and may encourage use of outcome measures in clinical practice. © The International Society for Prosthetics and Orthotics 2014.

FOREIGN LANGUAGE OFFERINGS AND ENROLLMENTS IN PUBLIC SECONDARY SCHOOLS, FALL 1965.

Science.gov (United States)

RUTIMANN, HANS; TEAGUE, CAROLINE

THIS REPORT ON FOREIGN LANGUAGE ENROLLMENTS, THE EIGHTH IN A SERIES PUBLISHED ANNUALLY, SHOWS THE LANGUAGE ENROLLMENT DISTRIBUTION IN PUBLIC SECONDARY SCHOOLS (GRADES 7 TO 12) WHICH, IN 1965, WAS 85.8 PERCENT ENROLLED IN SPANISH, FRENCH, GERMAN, RUSSIAN, AND ITALIAN, 13.9 PERCENT ENROLLED IN LATIN, AND 0.3 PERCENT IN "OTHER" LANGUAGES. THREE BASIC…

Birth outcome measures and prenatal exposure to 4-tert-octylphenol

International Nuclear Information System (INIS)

Lv, Shenliang; Wu, Chunhua; Lu, Dasheng; Qi, Xiaojuan; Xu, Hao; Guo, Jianqiu; Liang, Weijiu; Chang, XiuLi

2016-01-01

Exposure to 4-tert-octylphenol (tOP) has been linked with adverse health outcomes in animals and humans, while epidemiological studies about associations between prenatal exposure to tOP and fetal growth are extremely limited. We measured urinary tOP concentrations in 1100 pregnant women before their delivery, and examined whether tOP levels were associated with birth outcomes, including weight, length, head circumference and ponderal index at birth. tOP could be detected in all samples, and the median uncorrected and creatinine-corrected tOP concentrations were 0.90 μg/L (range from 0.25 to 20.05 μg/L) and 1.33 μg/g creatinine (range from 0.15 to 42.49 μg/g creatinine), respectively. Maternal urinary log-transformed tOP concentrations were significantly negatively associated with adjusted birth weight [β (g) = −126; 95% confidence interval (CI): −197, −55], birth length [β (cm) = −0.53; 95% CI:−0.93, −0.14], and head circumference [β (cm) = −0.30; 95% CI: −0.54, −0.07], respectively. Additionally, considering sex difference, these significant negative associations were also found among male neonates, while only higher maternal tOP concentrations were associated with a significant decrease in birth weight among female neonates. This study suggested significant negative associations between maternal urinary tOP concentrations and neonatal sizes at birth, and they differed by neonatal sex. Further epidemiological studies are required to more fully elaborate the associations between prenatal tOP exposure and birth outcomes. - Highlights: • We measured 4-tert-octylphenol (tOP) in urine from 1100 Chinese pregnant women. • The associations between maternal tOP levels and birth outcomes were investigated. • Prenatal exposure to tOP in the selected area was widespread at higher levels. • Maternal tOP levels were significantly negatively associated with birth sizes. • The associations between tOP and birth outcomes might

Single-case synthesis tools II: Comparing quantitative outcome measures.

Science.gov (United States)

Zimmerman, Kathleen N; Pustejovsky, James E; Ledford, Jennifer R; Barton, Erin E; Severini, Katherine E; Lloyd, Blair P

2018-03-07

Varying methods for evaluating the outcomes of single case research designs (SCD) are currently used in reviews and meta-analyses of interventions. Quantitative effect size measures are often presented alongside visual analysis conclusions. Six measures across two classes-overlap measures (percentage non-overlapping data, improvement rate difference, and Tau) and parametric within-case effect sizes (standardized mean difference and log response ratio [increasing and decreasing])-were compared to determine if choice of synthesis method within and across classes impacts conclusions regarding effectiveness. The effectiveness of sensory-based interventions (SBI), a commonly used class of treatments for young children, was evaluated. Separately from evaluations of rigor and quality, authors evaluated behavior change between baseline and SBI conditions. SBI were unlikely to result in positive behavior change across all measures except IRD. However, subgroup analyses resulted in variable conclusions, indicating that the choice of measures for SCD meta-analyses can impact conclusions. Suggestions for using the log response ratio in SCD meta-analyses and considerations for understanding variability in SCD meta-analysis conclusions are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

Does Open Enrollment Control Premiums? A Case Study from the “Medigap” Market

Directory of Open Access Journals (Sweden)

Thomas Rice

2004-09-01

Full Text Available This article analyzes a change in “Medigap” regulations that occurred in Missouri in 1999. It allows Medicare beneficiaries in the state to switch to a different carrier each year so long as they retain the same standardized policy type, without losing their open enrollment privileges. The analysis is based on a comparison of various outcomes in Missouri and those in two comparison states, Kansas and Florida. We found little evidence that the policy change affected premiums charged by insurance carriers in Missouri, but conclude that other desirable aspects of the change make it potentially attractive for other states to follow.

Relationships between Student, Staff, and Administrative Measures of School Climate and Student Health and Academic Outcomes

Science.gov (United States)

Gase, Lauren Nichol; Gomez, Louis M.; Kuo, Tony; Glenn, Beth A.; Inkelas, Moira; Ponce, Ninez A.

2018-01-01

BACKGROUND School climate is an integral part of a comprehensive approach to improving the wellbeing of students; however, little is known about the relationships between its different domains and measures. This study examined the relationships between student, staff, and administrative measures of school climate in order to understand the extent to which they were related to each other and student outcomes. METHODS The sample included 33,572 secondary school students from 121 schools in Los Angeles County during the 2014–2015 academic year. A multilevel regression model was constructed to examine the association between the domains and measures of school climate and five outcomes of student wellbeing: depressive symptoms or suicidal ideation, tobacco use, alcohol use, marijuana use, and grades. RESULTS Student, staff, and administrative measures of school climate were weakly correlated. Strong associations were found between student outcomes and student reports of engagement and safety, while school staff reports and administrative measures of school climate showed limited associations with student outcomes. CONCLUSIONS As schools seek to measure and implement interventions aimed at improving school climate, consideration should be given to grounding these efforts in a multi-dimensional conceptualization of climate that values student perspectives and includes elements of both engagement and safety. PMID:28382671

Relationships Among Student, Staff, and Administrative Measures of School Climate and Student Health and Academic Outcomes.

Science.gov (United States)

Gase, Lauren N; Gomez, Louis M; Kuo, Tony; Glenn, Beth A; Inkelas, Moira; Ponce, Ninez A

2017-05-01

School climate is an integral part of a comprehensive approach to improving the well-being of students; however, little is known about the relationships between its different domains and measures. We examined the relationships between student, staff, and administrative measures of school climate to understand the extent to which they were related to each other and student outcomes. The sample included 33,572 secondary school students from 121 schools in Los Angeles County during the 2014-2015 academic year. A multilevel regression model was constructed to examine the association between the domains and measures of school climate and 5 outcomes of student well-being: depressive symptoms or suicidal ideation, tobacco use, alcohol use, marijuana use, and grades. Student, staff, and administrative measures of school climate were weakly correlated. Strong associations were found between student outcomes and student reports of engagement and safety, while school staff reports and administrative measures of school climate showed limited associations with student outcomes. As schools seek to measure and implement interventions aimed at improving school climate, consideration should be given to grounding these efforts in a multidimensional conceptualization of climate that values student perspectives and includes elements of both engagement and safety. © 2017, American School Health Association.

Association of Mode of Locomotion and Independence in Locomotion With Long-Term Outcomes After Spinal Cord Injury

Science.gov (United States)

Krause, James; Carter, Rickey E; Brotherton, Sandra

2009-01-01

Background/Objective: To explore the association of mode of locomotion (ambulation vs wheelchair use) and independence in locomotion (independent vs require assistance) with health, participation, and subjective well-being (SWB) after spinal cord injury (SCI). Research Design: Secondary analysis was conducted on survey data collected from 2 rehabilitation hospitals in the Midwest and a specialty hospital in the southeastern United States. The 1,493 participants were a minimum of 18 years of age and had traumatic SCI of at least 1 year duration at enrollment. Main Outcome Measures: Three sets of outcome measures were used: SWB, participation, and health. SWB was measured by 8 scales and a measure of depressive symptoms, participation by 3 items, health by general health ratings, days in poor health, hospitalizations, and treatments. Results: Small but significant associations were observed between independence in locomotion and every outcome. Ambulation was associated with greater participation but a mixed pattern of favorable and unfavorable health and SWB outcomes. Supplemental analyses were conducted on those who ambulated but who were dependent on others to do so (n = 117), because this group reported poor outcomes in several areas. Individuals who were independent in wheelchair use reported substantially better outcomes than nonwheelchair users and those dependent on others in wheelchair use. Conclusions: Although ambulation is often a recovery goal, individuals with SCI who ambulate do not uniformly report better outcomes than wheelchair users, and those who depend on others for assistance with ambulation may experience a unique set of problems. PMID:19810625

Critical Components of Community College Enrollment Management Planning

Science.gov (United States)

Bucher, Karen Hart

2010-01-01

Enrollment management has become a common practice at four-year institutions, but has not been extensively explored at community colleges. As students have more educational options available to them, community colleges have begun to explore ways to grow their enrollment, improve student retention and increase graduation rates. This study explored…

Brief 74 Nuclear Engineering Enrollments and Degrees Survey, 2014 Data

Energy Technology Data Exchange (ETDEWEB)

None, None

2015-03-15

The 2014 survey includes degrees granted between September 1, 2013 and August 31, 2014, and enrollments for fall 2014. There are three academic programs new to this year's survey. Thirty-five academic programs reported having nuclear engineering programs during 2014, and data were provided by all thirty-five. The enrollments and degrees data include students majoring in nuclear engineering or in an option program equivalent to a major. Two nuclear engineering programs have indicated that health physics option enrollments and degrees are also reported in the health physics enrollments and degrees survey.

Test-Retest Reliability of Dual-Task Outcome Measures in People With Parkinson Disease

NARCIS (Netherlands)

Strouwen, C.; Molenaar, E.A.; Keus, S.H.; Munks, L.; Bloem, B.R.; Nieuwboer, A.

2016-01-01

BACKGROUND: Dual-task (DT) training is gaining ground as a physical therapy intervention in people with Parkinson disease (PD). Future studies evaluating the effect of such interventions need reliable outcome measures. To date, the test-retest reliability of DT measures in patients with PD remains

Health economics research into supporting carers of people with dementia: A systematic review of outcome measures

Science.gov (United States)

2012-01-01

Advisory bodies, such as the National Institute for Health and Clinical Excellence (NICE) in the UK, advocate using preference based instruments to measure the quality of life (QoL) component of the quality-adjusted life year (QALY). Cost per QALY is used to determine cost-effectiveness, and hence funding, of interventions. QALYs allow policy makers to compare the effects of different interventions across different patient groups. Generic measures may not be sensitive enough to fully capture the QoL effects for certain populations, such as carers, so there is a need to consider additional outcome measures, which are preference based where possible to enable cost-effectiveness analysis to be undertaken. This paper reviews outcome measures commonly used in health services research and health economics research involving carers of people with dementia. An electronic database search was conducted in PubMed, Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, the National Health Service Economic Evaluation Database (NHS EED), Database of Abstracts of Reviews of Effects (DARE) and Health Technology Assessment database. Studies were eligible for inclusion if they included an outcome measure for carers of people with dementia. 2262 articles were identified. 455 articles describing 361 studies remained after exclusion criteria were applied. 228 outcome measures were extracted from the studies. Measures were categorised into 44 burden measures, 43 mastery measures, 61 mood measures, 32 QoL measures, 27 social support and relationships measures and 21 staff competency and morale measures. The choice of instrument has implications on funding decisions; therefore, researchers need to choose appropriate instruments for the population being measured and the type of intervention undertaken. If an instrument is not sensitive enough to detect changes in certain populations, the effect of an intervention may be underestimated, and hence

Differences in access and patient outcomes across antiretroviral ...

African Journals Online (AJOL)

Objective. To assess differences in access to antiretroviral treatment (ART) and patient outcomes across public sector treatment facilities in the Free State province, South Africa. Design. Prospective cohort study with retrospective database linkage. We analysed data on patients enrolled in the treatment programme across ...

Stroke scale score and early prediction of outcome after stroke

International Nuclear Information System (INIS)

Ahmed, R.; Zuberi, F.Z.; Afsar, S.

2004-01-01

Objective: To evaluate the baseline National Institute of Health Stroke Scale (NIHSS) score as a predictor of functional outcome after ischemic stroke. Subjects and Methods: The study included 50 patients who presented to Civil Hospital, Karachi, during the study period with acute stroke and were evaluated with CT scan of brain. Only those patients were enrolled in the study that had acute ischemic stroke. The enrolled subjects were then evaluated for the neurological impairment using National Institute of Health Stroke Scale (NIHSS). The subjects were followed-up and their functional outcome was assessed using Barthel index (BI) on the 7th day of their admission. Results: Of the fifty patients enrolled in the study, 31 (62%) were males and 19 (38%) were females, with age ranging from 45 years to 95 years and a mean age of 59.9 years. Neurological impairment at presentation was assessed by NIHSS. The score ranged between 2 and 28. The functional outcome was evaluated on the 7th day using Barthel index (BI), which ranged from 0 to 80. NIHSS score was found to be a good predictor of functional outcome in patients with ischemic stroke (p<0.001). Other factors like gender, hypertension and heart disease did not affect the functional recovery in such patients. Various factors were found to be significant for early prediction of stroke recovery. The NIHSS score was the strongest predictor of outcome after ischemic stroke. Age at the time of the event was also found to be an important predictor for stroke recovery. Conclusion: The NIHSS score is a good predictor of patient's recovery after stroke. Assessing the patient's neurological impairment at first presentation of ischemic stroke can guide the physician regarding the prognosis and management plan. (author)

Early Experience with Employee Choice of Consumer-Directed Health Plans and Satisfaction with Enrollment

Science.gov (United States)

Fowles, Jinnet Briggs; Kind, Elizabeth A; Braun, Barbara L; Bertko, John

2004-01-01

Objective To assess the initial impact of offering consumer-defined health plan (CDHP) options on employees. Data Sources/Study Setting A mail survey of 4,680 employees in the corporate offices of Humana Inc. in June 2001. Study Design The study was a cross-sectional mail survey of employees aged 18 and older who were eligible for health care benefits. The survey was conducted following open enrollment. The primary outcome is the choice of consumer-directed health plan or not; the secondary outcome is satisfaction with the enrollment process. Important covariates include sociodemographic characteristics (age, gender, race, educational level, exempt or nonexempt status, type of coverage), health status, health care utilization, and plan design preferences. Data Collection Methods A six-page questionnaire was mailed to the home of each employee, followed by a reminder postcard and two subsequent mailings to nonrespondents. Principal Findings The response rate was 66.2 percent. Seven percent selected one of the two new plan options. Because there were no meaningful differences between employees choosing either of the two new options, these groups were combined in multivariate analysis. A logistic regression modeled the likelihood of choosing the novel plan options. Those selecting the new plans were less likely to be black (odds ratio [OR] 0.46), less likely to have only Humana coverage (OR 0.30), and more likely to have single coverage (OR 1.77). They were less likely to have a chronic health problem (OR 0.56) and more likely to have had no recent medical visits (OR 3.21). They were more likely to believe that lowest premiums were the most important plan attribute (OR 2.89) and to think there were big differences in the premiums of available plans (OR 5.19). Employees in fair or poor health were more likely to have a difficult time during the online enrollment process. They were more likely to find the communications very helpful (OR 0.42) and the benefits

Therapy optimization in multiple sclerosis: a prospective observational study of therapy compliance and outcomes.

Science.gov (United States)

Coyle, Patricia K; Cohen, Bruce A; Leist, Thomas; Markowitz, Clyde; Oleen-Burkey, MerriKay; Schwartz, Marc; Tullman, Mark J; Zwibel, Howard

2014-03-13

Data sources for MS research are numerous but rarely provide an objective measure of drug therapy compliance coupled with patient-reported health outcomes. The objective of this paper is to describe the methods and baseline characteristics of the Therapy Optimization in MS (TOP MS) study designed to investigate the relationship between disease-modifying therapy compliance and health outcomes. TOP MS was designed as a prospective, observational, nationwide patient-focused study using an internet portal for data entry. The protocol was reviewed and approved by Sterling IRB. The study was registered with ClinicalTrials.gov. It captured structured survey data monthly from MS patients recruited by specialty pharmacies. Data collection included the clinical characteristics of MS such as MS relapses. Disability, quality of life and work productivity and activity impairment were assessed quarterly with well-validated scales. When events like severe fatigue or new or worsening depression were reported, feedback was provided to treating physicians. The therapy compliance measure was derived from pharmacy drug shipment records uploaded to the study database. The data presented in this paper use descriptive statistics. The TOP MS Study enrolled 2966 participants receiving their disease-modifying therapy (DMT) from specialty pharmacies. The mean age of the sample was 49 years, 80.4% were female, 89.9% were Caucasian and 55.7% were employed full or part time. Mean time since first symptoms was 11.5 years; mean duration since diagnosis was 9.5 years. Patient-reported EDSS was 3.5; 72.2% had a relapsing-remitting disease course. The most commonly reported symptoms at the time of enrollment were fatigue (74.7%), impaired coordination or balance (61.8%) and numbness and tingling (61.2%). Half of the sample was using glatiramer acetate and half was using beta-interferons. Demographic and clinical characteristics of the TOP MS sample at enrollment are consistent with other community

PROMIS GH (Patient-Reported Outcomes Measurement Information System Global Health) Scale in Stroke: A Validation Study.

Science.gov (United States)

Katzan, Irene L; Lapin, Brittany

2018-01-01

The International Consortium for Health Outcomes Measurement recently included the 10-item PROMIS GH (Patient-Reported Outcomes Measurement Information System Global Health) scale as part of their recommended Standard Set of Stroke Outcome Measures. Before collection of PROMIS GH is broadly implemented, it is necessary to assess its performance in the stroke population. The objective of this study was to evaluate the psychometric properties of PROMIS GH in patients with ischemic stroke and intracerebral hemorrhage. PROMIS GH and 6 PROMIS domain scales measuring same/similar constructs were electronically collected on 1102 patients with ischemic and hemorrhagic strokes at various stages of recovery from their stroke who were seen in a cerebrovascular clinic from October 12, 2015, through June 2, 2017. Confirmatory factor analysis was performed to evaluate the adequacy of 2-factor structure of component scores. Test-retest reliability and convergent validity of PROMIS GH items and component scores were assessed. Discriminant validity and responsiveness were compared between PROMIS GH and PROMIS domain scales measuring the same or related constructs. Analyses were repeated stratified by stroke subtype and modified Rankin Scale score validity was good with significant correlations between all PROMIS GH items and PROMIS domain scales ( P 0.5) was demonstrated for 8 of the 10 PROMIS GH items. Reliability and validity remained consistent across stroke subtype and disability level (modified Rankin Scale, <2 versus ≥2). PROMIS GH exhibits acceptable performance in patients with stroke. Our findings support International Consortium for Health Outcomes Measurement recommendation to use PROMIS GH as part of the standard set of outcome measures in stroke. © 2017 American Heart Association, Inc.

Report from the third international consensus meeting to harmonise core outcome measures for atopic eczema/dermatitis clinical trials (HOME)

Science.gov (United States)

Chalmers, JR; Schmitt, J; Apfelbacher, C; Dohil, M; Eichenfield, LF; Simpson, EL; Singh, J; Spuls, P; Thomas, KS; Admani, S; Aoki, V; Ardeleanu, M; Barbarot, S; Berger, T; Bergman, JN; Block, J; Borok, N; Burton, T; Chamlin, SL; Deckert, S; DeKlotz, CC; Graff, LB; Hanifin, JM; Hebert, AA; Humphreys, R; Katoh, N; Kisa, RM; Margolis, DJ; Merhand, S; Minnillo, R; Mizutani, H; Nankervis, H; Ohya, Y; Rodgers, P; Schram, ME; Stalder, JF; Svensson, A; Takaoka, R; Teper, A; Tom, WL; von Kobyletzki, L; Weisshaar, E; Zelt, S; Williams, HC

2014-01-01

Summary This report provides a summary of the third meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in San Diego, CA, U.S.A., 6–7 April 2013 (HOME III). The meeting addressed the four domains that had previously been agreed should be measured in every eczema clinical trial: clinical signs, patient-reported symptoms, long-term control and quality of life. Formal presentations and nominal group techniques were used at this working meeting, attended by 56 voting participants (31 of whom were dermatologists). Significant progress was made on the domain of clinical signs. Without reference to any named scales, it was agreed that the intensity and extent of erythema, excoriation, oedema/papulation and lichenification should be included in the core outcome measure for the scale to have content validity. The group then discussed a systematic review of all scales measuring the clinical signs of eczema and their measurement properties, followed by a consensus vote on which scale to recommend for inclusion in the core outcome set. Research into the remaining three domains was presented, followed by discussions. The symptoms group and quality of life groups need to systematically identify all available tools and rate the quality of the tools. A definition of long-term control is needed before progress can be made towards recommending a core outcome measure. What's already known about this topic? Many different scales have been used to measure eczema, making it difficult to compare trials in meta-analyses and hampering improvements in clinical practice. HOME core outcome measures must pass the OMERACT (Outcome Measures in Rheumatology) filter of truth (validity), discrimination (sensitivity to change and responsiveness) and feasibility (ease of use, costs, time to perform and interpret). It has been previously agreed as part of the consensus process that four domains should be measured by the core outcomes: clinical signs, patient

The Socioeconomic Impact of HIV/AIDS on Education Outcomes in Uganda: School Enrolment and the Schooling Gap in 2002/2003

Science.gov (United States)

Kasirye, Ibrahim; Hisali, Eria

2010-01-01

Due to high prime-age mortality--a result of the HIV/AIDS scourge, the number of orphans in Uganda continues to rise. Using the 2002/2003 Uganda National Household Survey, this paper investigates how HIV/AIDS orphan status affects schooling enrolment and grade progression. Our results show that HIV/AIDS orphans are not significantly less likely to…

Measuring Learning Outcomes. Evolution of Cognitive Skills among Graduate Students in Auditing

DEFF Research Database (Denmark)

Holm, Claus; Steenholdt, Niels

with the knowledge provided in a graduate course the student learns from his prior experiences and stores the important aspects of each experience in memory in accordance with such schemas. The schemas available for students taking a graduate auditing course reflects prior accounting work experience for some...... students and undergraduate accounting coursework experience for all students. This paper extends prior research on the role of declarative and procedural knowledge in performing auditing tasks. Measuring learning outcomes is a complex matter requiring sensible measures for both declarative knowledge...... outcomes in the context of an auditing course by posing a broad set of questions testing declarative knowledge and the full range of intellectual skills from discrimination to the use of higher-order-rules . The paper presents data collected in September 1999 including 34 graduate students representing...

Historical perspective: The pros and cons of conventional outcome measures in Parkinson's disease.

Science.gov (United States)

Lim, Shen-Yang; Tan, Ai Huey

2018-01-01

Conventional outcome measures (COMs) in Parkinson's disease (PD) refer to rating scales, questionnaires, patient diaries and clinically-based tests that do not require specialized equipment. It is timely at this juncture - as clinicians and researchers begin to grapple with the "invasion" of digital technologies - to review the strengths and weaknesses of these outcome measures. This paper discusses advances (including an enhanced understanding of PD itself, and the development of clinimetrics as a field) that have led to improvements in the COMs used in PD; their strengths and limitations; and factors to consider when selecting and using a measuring instrument. It is envisaged that in the future, a combination of COMs and technology-based objective measures will be utilized, with different methods having their own strengths and weaknesses. Judgement is required on the part of the clinician and researcher in terms of which instrument(s) are appropriate to use, depending on the particular clinical or research setting or question. Copyright © 2017 Elsevier Ltd. All rights reserved.

Outcome measures for oral health based on clinical assessments and claims data: feasibility evaluation in practice.

Science.gov (United States)

Hummel, Riët; Bruers, Josef; van der Galiën, Onno; van der Sanden, Wil; van der Heijden, Geert

2017-10-05

It is well known that treatment variation exists in oral healthcare, but the consequences for oral health are unknown as the development of outcome measures is still in its infancy. The aim of this study was to identify and develop outcome measures for oral health and explore their performance using health insurance claims records and clinical data from general dental practices. The Dutch healthcare insurance company Achmea collaborated with researchers, oral health experts, and general dental practitioners (GDPs) in a proof of practice study to test the feasibility of measures in general dental practices. A literature search identified previously described outcome measures for oral healthcare. Using a structured approach, identified measures were (i) prioritized, adjusted and added to after discussion and then (ii) tested for feasibility of data collection, their face validity and discriminative validity. Data sources were claims records from Achmea, clinical records from dental practices, and prospective, pre-determined clinical assessment data obtained during routine consultations. In total eight measures (four on dental caries, one on tooth wear, two on periodontal health, one on retreatment) were identified, prioritized and tested. The retreatment measure and three measures for dental caries were found promising as data collection was feasible, they had face validity and discriminative validity. Deployment of these measures demonstrated variation in clinical practices of GDPs. Feedback of this data to GDPs led to vivid discussions on best practices and quality of care. The measure 'tooth wear' was not considered sufficiently responsive; 'changes in periodontal health score' was considered a controversial measure. The available data for the measures 'percentage of 18-year-olds with no tooth decay' and 'improvement in gingival bleeding index at reassessment' was too limited to provide accurate estimates per dental practice. The evaluated measures 'time to first

Questioning the Use of Outcome Measures to Evaluate Principal Preparation Programs

Science.gov (United States)

Fuller, Ed; Hollingworth, Liz

2018-01-01

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

Plasma levels of soluble urokinase-type plasminogen activator receptor (suPAR and early mortality risk among patients enrolling for antiretroviral treatment in South Africa

Directory of Open Access Journals (Sweden)

Bangani Nonzwakazi

2007-05-01

Full Text Available Abstract Background Serum concentrations of soluble urokinase-type plasminogen activator receptor (suPAR have a strong independent association with HIV-1-related mortality. The practical utility of plasma suPAR in assessing short-term all-cause mortality risk was evaluated in patients with advanced immunodeficiency enrolling in an antiretroviral treatment (ART programme in South Africa. Methods An enzyme-linked immunosorbent assay (ELISA was used to measure plasma concentrations of suPAR in patients at the time of enrolment to the ART programme. The association between plasma suPAR concentrations, baseline patient characteristics and cohort outcomes after 4 months of ART were determined. Results Patients (n = 293, 70% female had a median age of 33 years and were followed up for a median of 5 months from enrolment. The median CD4 cell count was 47 cells/μl (IQR = 22–72 and 38% of patients had WHO stage 4 disease. 218 (74% patients remained alive after 4 months of ART; 39 (13% died and 36 (12% were lost to the programme for other reasons. Patients who died had significantly higher plasma suPAR concentrations compared to those who either survived (P 10 suPAR concentrations were significantly associated with lower CD4 cell counts, WHO clinical stage 4 disease and male sex. In multivariate analysis to identify factors associated with death, log10 suPAR concentration was the most strongly associated variable (P Conclusion Plasma suPAR concentration was the strongest independent predictor of short-term mortality risk among patients with advanced immunodeficiency enrolling in this ART programme. However, lack of a discriminatory threshold did not permit this marker to be used to triage patients according to short-term mortality risk.

Magnesium, hemostasis, and outcomes in patients with intracerebral hemorrhage.

Science.gov (United States)

Liotta, Eric M; Prabhakaran, Shyam; Sangha, Rajbeer S; Bush, Robin A; Long, Alan E; Trevick, Stephen A; Potts, Matthew B; Jahromi, Babak S; Kim, Minjee; Manno, Edward M; Sorond, Farzaneh A; Naidech, Andrew M; Maas, Matthew B

2017-08-22

We tested the hypothesis that admission serum magnesium levels are associated with hematoma volume, hematoma growth, and functional outcomes in patients with intracerebral hemorrhage (ICH). Patients presenting with spontaneous ICH were enrolled in an observational cohort study that prospectively collected demographic, clinical, laboratory, radiographic, and outcome data. We performed univariate and adjusted multivariate analyses to assess for associations between serum magnesium levels and initial hematoma volume, final hematoma volume, and in-hospital hematoma growth as radiographic measures of hemostasis, and functional outcome measured by the modified Rankin Scale (mRS) at 3 months. We included 290 patients for analysis. Admission serum magnesium was 2.0 ± 0.3 mg/dL. Lower admission magnesium levels were associated with larger initial hematoma volumes on univariate ( p = 0.02), parsimoniously adjusted ( p = 0.002), and fully adjusted models ( p = 0.006), as well as greater hematoma growth ( p = 0.004, p = 0.005, and p = 0.008, respectively) and larger final hematoma volumes ( p = 0.02, p = 0.001, and p = 0.002, respectively). Lower admission magnesium level was associated with worse functional outcomes at 3 months (i.e., higher mRS; odds ratio 0.14, 95% confidence interval 0.03-0.64, p = 0.011) after adjustment for age, admission Glasgow Coma Scale score, initial hematoma volume, time from symptom onset to initial CT, and hematoma growth, with evidence that the effect of magnesium is mediated through hematoma growth. These data support the hypothesis that magnesium exerts a clinically meaningful influence on hemostasis in patients with ICH. © 2017 American Academy of Neurology.

Measuring outcomes of communication partner training of health care professionals:

DEFF Research Database (Denmark)

Isaksen, Jytte; Jensen, Lise Randrup

health care, and other communicative exchanges associated with appropriate health care [3]. As a consequence of these challenges in patient-provider communication, implementation of evidence- based methods of communication partner training is becoming increasingly frequent in different health care...... with large groups of trainees, e.g. all staff from a ward. Self-rating questionnaires, however, present another set of issues when used as outcome measures, including the need to examine their content validity, reliability and sensitivity to change [9]. This work appears to be lacking for most...... of the available questionnaires. However, it is important in order to lay the groundwork for future studies, which compare the efficacy and outcome of different methods of implementing conversation partner training in clinical practice. Aims: The overall purpose of this round table is to: 1. provide an overview...

Routine outcome measurement in mental health service consumers: who should provide support for the self-assessments?

Science.gov (United States)

Gelkopf, Marc; Pagorek-Eshel, Shira; Trauer, Tom; Roe, David

2015-06-01

This study examined whether mental health community service users completed outcome self-reports differently when assessments were supervised by internal vs. external staff. The examination of potential differences between the two has useful implications for mental health systems that take upon themselves the challenge of Routine Outcome Measurement (ROM), as it might impact allocation of public resources and managed care program planning. 73 consumers completed the Manchester Short Assessment of Quality of Life (MANSA), a shortened version of the Recovery Assessment Scale (RAS), and a functioning questionnaire. Questionnaires were administered, once using support provided by internal staff and once using support provided by external professional staff, with a one-month time interval and in random order. A MANOVA Repeated Measures showed no differences in outcomes of quality of life and recovery between internal and external support. Functioning scores were higher for the internal support when the internal assessments were performed first. Overall, except for the differences in functioning assessment, outcome scores were not determined by the supporting agency. This might indicate that when measuring quality of life and recovery, different supporting methods can be used to gather outcome measures and internal staff might be a good default agency to do this. Differences found in functioning assessment are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Outcomes of Children With and Without Hepatic Encephalopathy From the Pediatric Acute Liver Failure Study Group.

Science.gov (United States)

Ng, Vicky L; Li, Ruosha; Loomes, Kathleen M; Leonis, Mike A; Rudnick, David A; Belle, Steven H; Squires, Robert H

2016-09-01

Hepatic encephalopathy (HE) is challenging to identify in children with acute liver failure and was not a requirement for enrollment into the Pediatric Acute Liver Failure Study Group (PALFSG). The outcomes of PALFSG participants presenting with and without HE are presented. PALFSG participants were classified based on daily assessment of HE during the first 7 days following study enrollment: group 1-never developed HE; group 2-no HE at enrollment with subsequent HE development; and group 3-HE at study enrollment. Clinical and biochemical parameters and outcomes of death, spontaneous recovery, or liver transplantation were compared between groups. Data from 769 PALFSG (54% boys; median age 4.2 years; range 0-17.9 years) participants were analyzed, with 277 in group 1 (36%), 83 in group 2 (11%), and 409 in group 3 (53%). Mortality occurred in 11% of all participants and was highest among group 3 participants who demonstrated persistent grade III-IV HE (55%) or showed progression of HE (26%). Eleven (4%) group 1 participants died within 21 days of enrollment. Spontaneous recovery was highest in group 1 (79%) and lowest in group 2 (25%; P liver failure prognostication schema are needed.

An analysis of predictors of enrollment and successful achievement for girls in high school Advanced Placement physics

Science.gov (United States)

Depalma, Darlene M.

A problem within science education in the United States persists. U.S students rank lower in science than most other students from participating countries on international tests of achievement (National Center for Education Statistics, 2003). In addition, U.S. students overall enrollment rate in high school Advanced Placement (AP) physics is still low compared to other academic domains, especially for females. This problem is the background for the purpose of this study. This investigation examined cognitive and motivational variables thought to play a part in the under-representation of females in AP physics. Cognitive variables consisted of mathematics, reading, and science knowledge, as measured by scores on the 10th and 11th grade Florida Comprehensive Assessment Tests (FCAT). The motivational factors of attitude, stereotypical views toward science, self-efficacy, and epistemological beliefs were measured by a questionnaire developed with questions taken from previously proven reliable and valid instruments. A general survey regarding participation in extracurricular activities was also included. The sample included 12th grade students from two high schools located in Seminole County, Florida. Of the 106 participants, 20 girls and 27 boys were enrolled in AP physics, and 39 girls and 20 boys were enrolled in other elective science courses. Differences between males and females enrolled in AP physics were examined, as well as differences between females enrolled in AP physics and females that chose not to participate in AP physics, in order to determine predictors that apply exclusively to female enrollment in high school AP physics and predictors of an anticipated science related college major. Data were first analyzed by Exploratory Factor Analysis, followed by Analysis of Variance (ANOVA), independent t-tests, univariate analysis, and logistic regression analysis. One overall theme that emerged from this research was findings that refute the ideas that

Core outcome measurement instruments for clinical trials in nonspecific low back pain

Science.gov (United States)

Chiarotto, Alessandro; Boers, Maarten; Deyo, Richard A.; Buchbinder, Rachelle; Corbin, Terry P.; Costa, Leonardo O.P.; Foster, Nadine E.; Grotle, Margreth; Koes, Bart W.; Kovacs, Francisco M.; Lin, C.-W. Christine; Maher, Chris G.; Pearson, Adam M.; Peul, Wilco C.; Schoene, Mark L.; Turk, Dennis C.; van Tulder, Maurits W.; Terwee, Caroline B.; Ostelo, Raymond W.

2018-01-01

Abstract To standardize outcome reporting in clinical trials of patients with nonspecific low back pain, an international multidisciplinary panel recommended physical functioning, pain intensity, and health-related quality of life (HRQoL) as core outcome domains. Given the lack of a consensus on measurement instruments for these 3 domains in patients with low back pain, this study aimed to generate such consensus. The measurement properties of 17 patient-reported outcome measures for physical functioning, 3 for pain intensity, and 5 for HRQoL were appraised in 3 systematic reviews following the COSMIN methodology. Researchers, clinicians, and patients (n = 207) were invited in a 2-round Delphi survey to generate consensus (≥67% agreement among participants) on which instruments to endorse. Response rates were 44% and 41%, respectively. In round 1, consensus was achieved on the Oswestry Disability Index version 2.1a for physical functioning (78% agreement) and the Numeric Rating Scale (NRS) for pain intensity (75% agreement). No consensus was achieved on any HRQoL instrument, although the Short Form 12 (SF12) approached the consensus threshold (64% agreement). In round 2, a consensus was reached on an NRS version with a 1-week recall period (96% agreement). Various participants requested 1 free-to-use instrument per domain. Considering all issues together, recommendations on core instruments were formulated: Oswestry Disability Index version 2.1a or 24-item Roland-Morris Disability Questionnaire for physical functioning, NRS for pain intensity, and SF12 or 10-item PROMIS Global Health form for HRQoL. Further studies need to fill the evidence gaps on the measurement properties of these and other instruments. PMID:29194127

Antibody levels to recombinant VAR2CSA domains vary with Plasmodium falciparum parasitaemia, gestational age, and gravidity, but do not predict pregnancy outcomes.

Science.gov (United States)

Fried, Michal; Kurtis, Jonathan D; Swihart, Bruce; Morrison, Robert; Pond-Tor, Sunthorn; Barry, Amadou; Sidibe, Youssoufa; Keita, Sekouba; Mahamar, Almahamoudou; Andemel, Naissem; Attaher, Oumar; Dembele, Adama B; Cisse, Kadidia B; Diarra, Bacary S; Kanoute, Moussa B; Narum, David L; Dicko, Alassane; Duffy, Patrick E

2018-03-09

Maternal malaria is a tropical scourge associated with poor pregnancy outcomes. Women become resistant to Plasmodium falciparum pregnancy malaria as they acquire antibodies to the variant surface antigen VAR2CSA, a leading vaccine candidate. Because malaria infection may increase VAR2CSA antibody levels and thereby confound analyses of immune protection, gravidity-dependent changes in antibody levels during and after infection, and the effect of VAR2CSA antibodies on pregnancy outcomes were evaluated. Pregnant women enrolled in a longitudinal cohort study of mother-infant pairs in Ouelessebougou, Mali provided plasma samples at enrollment, gestational week 30-32, and delivery. Antibody levels to VAR2CSA domains were measured using a multiplex bead-based assay. Antibody levels to VAR2CSA were higher in multigravidae than primigravidae. Malaria infection was associated with increased antibody levels to VAR2CSA domains. In primigravidae but not in secundigravidae or multigravidae, antibodies levels sharply declined after an infection. A relationship between any VAR2CSA antibody specificity and protection from adverse pregnancy outcomes was not detected. During malaria infection, primigravidae acquire short-lived antibodies. The lack of an association between VAR2CSA domain antibody reactivity and improved pregnancy outcomes suggests that the recombinant proteins may not present native epitopes targeted by protective antibodies.

High school cigarette smoking and post-secondary education enrollment: Longitudinal findings from the NEXT Generation Health Study.

Science.gov (United States)

Sabado, Melanie D; Haynie, Denise; Gilman, Stephen E; Simons-Morton, Bruce; Choi, Kelvin

2017-12-01

The inverse association between smoking and educational attainment has been reported in cross-sectional studies. Temporality between smoking and education remains unclear. Our study examines the prospective association between high school cigarette and smoking post-secondary education enrollment. Data were collected from a nationally representative cohort of 10th graders who participated in the Next Generation Health Study (2010-2013). Ethnicity/race, urbanicity, parental education, depression symptoms, and family affluence were assessed at baseline. Self-reported 30-day smoking was assessed annually from 2010 to 2012. Post-secondary education enrollment was measured in 2013 and categorized as either not enrolled or enrolled in technical school, community college, or 4-year college/university. Multinomial logistic regression was used to evaluate the association between cigarette smoking duration and post-secondary education enrollment (N=1681). Participants who smoked 1, 2, or 3years during high school had lower odds of attending a 4-year college (relative to a no enrollment) than non-smokers (adjusted OR: smoking 1year=0.30, 2years=0.28, 3years=0.14). Similarly, participants who smoked for 2 or 3years were less likely than non-smokers to enroll in community college (adjusted OR: 2years=0.31, 3years=0.40). These associations were independent of demographic and socioeconomic factors. There was a prospective association between high school smoking and the unlikelihood of enrollment in post-secondary education. If this represents a causal association, strategies to prevent/delay smoking onset and promote early cessation in adolescents may provide further health benefits by promoting higher educational attainment. Copyright © 2017. Published by Elsevier Inc.

Course Placement Series: Spotlight on High School Math Course Enrollment. Policy Brief

Science.gov (United States)

Tennessee Department of Education, 2015

2015-01-01

The Tennessee Department of Education explored course enrollment patterns in an effort to better understand in which courses students are enrolling and whether course enrollment policies and procedures are promoting students' interests. This report focuses on math course enrollment patterns throughout high school by following the 2013-14 twelfth…

Determinants of School Enrolment of Children in Slums of Varanasi

Directory of Open Access Journals (Sweden)

Pallavi Nayak

2016-03-01

Full Text Available Introduction: Education plays a vital role to developing a nation. In India, urban slums constituting about 22.6% of the urban population are the poor and socially disadvantaged. This slum community is least concerned for school enrolment of their children inspite of the fact that primary education is compulsory and is free in public schools. In urban areas schools available are mostly of private sector that are not free and beyond affordability to slums; government and corporation schools are few, but beyond reach. Motive of the parents is to involve children in income generating activities and the girls are more deprived of school enrolment in poorer society. Objectives: 1 assess the enrolment status of slum children and 2 determine the factors influencing school enrolment.Methodology: The data was collected during 2011-12 from 15 randomly selected slums out of 227 in which a total of 893 families were contacted and mothers with children aged 5-15 years interrogated. In addition to child history on age, sex and school enrolment, the family background characteristics were e.g. religion, caste, and family size as well as age, education and occupation of both mother & father were recorded.Results: Out of 1145 children, male and female equal represented; mostly (90.9% were Hindus and half were SC/ST class. About 30% father and 57.2% mothers were illiterate; about half fathers were unskilled-worker and 96.0% mother’s house wife. Overall 31.3% children were not enrolled and were decreasing from 49.2% to 24.3% to 21.4% in the age groups 5-6, 7-9 and 10-15 years respectively. Enrolment was poor in Muslims (50.0% compared to Hindus (29.4%; enrolment was similar irrespective of child sex among Hindus, but in Muslims 62.5% male and 35.4% female children were only enrolled. Similar was the situation as one move from SC/ST (67.6% to OBC (73.4% and general caste (77.9%. Education of father and mother had significant role to enrolment but not the age and

Measuring Longitudinal Student Performance on Student Learning Outcomes in Sustainability Education

Science.gov (United States)

Jarchow, Meghann E.; Formisano, Paul; Nordyke, Shane; Sayre, Matthew

2018-01-01

Purpose: The purpose of this paper is to describe the student learning outcomes (SLOs) for a sustainability major, evaluate faculty incorporation of the SLOs into the courses in the sustainability major curriculum and measure student performance on the SLOs from entry into the major to the senior capstone course. Design/methodology/approach:…

Parenting programs during adolescence: Outcomes from universal and targeted interventions offered in real-world settings.

Science.gov (United States)

Alfredsson, Elin K; Thorvaldsson, Valgeir; Axberg, Ulf; Broberg, Anders G

2018-04-26

The aim of this naturalistic study was to explore short and long-term outcomes of five different group-based parenting programs offered to parents of 10 to 17-year-olds. Three hundred and fifteen parents (277 mothers and 38 fathers) who had enrolled in a parenting program (universal: Active Parenting, COPE; Connect; targeted: COMET; Leadership training for parents of teenagers [LFT]) answered questionnaires at three measurement waves (baseline, post-measurement, and one-year follow-up). The questions concerned parenting style, parental mental health, family climate and adolescent mental health. Results revealed small to moderate changes in almost all outcome variables and in all parenting programs. Overall, parents in COMET reported the largest short and long-term changes. No substantial differences in change were seen between the other programs. The results support the general effectiveness of parenting programs for parents of adolescents. © 2018 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Leadership Style, Employee Satisfaction, and Productivity in the Enrollment Department of a Proprietary University

Science.gov (United States)

Chitwood, James

2010-01-01

The success of an enrollment department is critical to the success of an educational institution. The quantitative research study used a correlational design to measure the relationship between perceived leadership style, employee satisfaction, and departmental productivity. A sample of 41 admissions personnel from a Midwest proprietary university…

Development and evaluation of an Individualized Outcome Measure (IOM) for randomized controlled trials in mental health.

Science.gov (United States)

Pesola, Francesca; Williams, Julie; Bird, Victoria; Freidl, Marion; Le Boutillier, Clair; Leamy, Mary; Macpherson, Rob; Slade, Mike

2015-12-01

Pre-defined, researcher-selected outcomes are routinely used as the clinical end-point in randomized controlled trials (RCTs); however, individualized approaches may be an effective way to assess outcome in mental health research. The present study describes the development and evaluation of the Individualized Outcome Measure (IOM), which is a patient-specific outcome measure to be used for RCTs of complex interventions. IOM was developed using a narrative review, expert consultation and piloting with mental health service users (n = 20). The final version of IOM comprises two components: Goal Attainment (GA) and Personalized Primary Outcome (PPO). For GA, patients identify one relevant goal at baseline and rate its attainment at follow-up. For PPO, patients choose an outcome domain related to their goal from a pre-defined list at baseline, and complete a standardized questionnaire assessing the chosen outcome domain at baseline and follow-up. A feasibility study indicated that IOM had adequate completion (89%) and acceptability (96%) rates in a clinical sample (n = 84). IOM was then evaluated in a RCT (ISRCTN02507940). GA and PPO components were associated with each other and with the trial primary outcome. The use of the PPO component of IOM as the primary outcome could be considered in future RCTs. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

14 CFR 141.93 - Enrollment.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Enrollment. 141.93 Section 141.93 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) SCHOOLS AND... limitations and simulated emergency landing instructions; and (x) A description of and instructions regarding...

Quantitative outcome measures for systemic sclerosis-related Microangiopathy - Reliability of image acquisition in Nailfold Capillaroscopy.

Science.gov (United States)

Dinsdale, Graham; Moore, Tonia; O'Leary, Neil; Berks, Michael; Roberts, Christopher; Manning, Joanne; Allen, John; Anderson, Marina; Cutolo, Maurizio; Hesselstrand, Roger; Howell, Kevin; Pizzorni, Carmen; Smith, Vanessa; Sulli, Alberto; Wildt, Marie; Taylor, Christopher; Murray, Andrea; Herrick, Ariane L

2017-09-01

Nailfold capillaroscopic parameters hold increasing promise as outcome measures for clinical trials in systemic sclerosis (SSc). Their inclusion as outcomes would often naturally require capillaroscopy images to be captured at several time points during any one study. Our objective was to assess repeatability of image acquisition (which has been little studied), as well as of measurement. 41 patients (26 with SSc, 15 with primary Raynaud's phenomenon) and 10 healthy controls returned for repeat high-magnification (300×) videocapillaroscopy mosaic imaging of 10 digits one week after initial imaging (as part of a larger study of reliability). Images were assessed in a random order by an expert blinded observer and 4 outcome measures extracted: (1) overall image grade and then (where possible) distal vessel locations were marked, allowing (2) vessel density (across the whole nailfold) to be calculated (3) apex width measurement and (4) giant vessel count. Intra-rater, intra-visit and intra-rater inter-visit (baseline vs. 1week) reliability were examined in 475 and 392 images respectively. A linear, mixed-effects model was used to estimate variance components, from which intra-class correlation coefficients (ICCs) were determined. Intra-visit and inter-visit reliability estimates (ICCs) were (respectively): overall image grade, 0.97 and 0.90; vessel density, 0.92 and 0.65; mean vessel width, 0.91 and 0.79; presence of giant capillary, 0.68 and 0.56. These estimates were conditional on each parameter being measurable. Within-operator image analysis and acquisition are reproducible. Quantitative nailfold capillaroscopy, at least with a single observer, provides reliable outcome measures for clinical studies including randomised controlled trials. Copyright © 2017 Elsevier Inc. All rights reserved.

Measuring intangibles: Managing intangibles for tangible outcomes in research and innovation

International Nuclear Information System (INIS)

Carayannis, E.G.

2004-01-01

Knowledge sharing is critical to the success and survival of companies in knowledge intensive industries. It is essential to effectively measure knowledge creation and sharing to facilitate good investment decision making in knowledge management initiatives. This paper will focus on the identification of intangible benefits, the cause and effect relationships, and the applicability of existing metrics to these intangibles. The premise is that existing measurements may not apply. The development of new metrics for managing intangible assets to obtain tangible outcomes is a necessity. (author)

Validation of Patient-Reported Outcomes Measurement Information System Computerized Adaptive Tests Against the Foot and Ankle Outcome Score for 6 Common Foot and Ankle Pathologies.

Science.gov (United States)

Koltsov, Jayme C B; Greenfield, Stephen T; Soukup, Dylan; Do, Huong T; Ellis, Scott J

2017-08-01

The field of foot and ankle surgery lacks a widely accepted gold-standard patient-reported outcome instrument. With the changing infrastructure of the medical profession, more efficient patient-reported outcome tools are needed to reduce respondent burden and increase participation while providing consistent and reliable measurement across multiple pathologies and disciplines. The primary purpose of the present study was to validate 3 Patient-Reported Outcomes Measurement Information System computer adaptive tests (CATs) most relevant to the foot and ankle discipline against the Foot and Ankle Outcome Score (FAOS) and the Short Form 12 general health status survey in patients with 6 common foot and ankle pathologies. Patients (n = 240) indicated for operative treatment for 1 of 6 common foot and ankle pathologies completed the CATs, FAOS, and Short Form 12 at their preoperative surgical visits, 1 week subsequently (before surgery), and at 6 months postoperatively. The psychometric properties of the instruments were assessed and compared. The Patient-Reported Outcomes Measurement Information System CATs each took less than 1 minute to complete, whereas the FAOS took 6.5 minutes, and the Short Form 12 took 3 minutes. CAT scores were more normally distributed and had fewer floor and ceiling effects than those on the FAOS, which reached as high as 24%. The CATs were more precise than the FAOS and had similar responsiveness and test-retest reliability. The physical function and mobility CATs correlated strongly with the activities subscale of the FAOS, and the pain interference CAT correlated strongly with the pain subscale of the FAOS. The CATs and FAOS were responsive to changes with operative treatment for 6 common foot and ankle pathologies. The CATs performed as well as or better than the FAOS in all aspects of psychometric validity. The Patient-Reported Outcomes Measurement Information System CATs show tremendous potential for improving the study of patient

The Influence of Hearing Aid Use on Outcomes of Children With Mild Hearing Loss.

Science.gov (United States)

Walker, Elizabeth A; Holte, Lenore; McCreery, Ryan W; Spratford, Meredith; Page, Thomas; Moeller, Mary Pat

2015-10-01

This study examined the effects of consistent hearing aid (HA) use on outcomes in children with mild hearing loss (HL). Five- or 7-year-old children with mild HL were separated into 3 groups on the basis of patterns of daily HA use. Using analyses of variance, we compared outcomes between groups on speech and language tests and a speech perception in noise task. Regression models were used to investigate the influence of cumulative auditory experience (audibility, early intervention, HA use) on outcomes. Full-time HA users demonstrated significantly higher scores on vocabulary and grammar measures compared with nonusers. There were no significant differences between the 3 groups on articulation or speech perception measures. After controlling for the variance in age at confirmation of HL, level of audibility, and enrollment in early intervention, only amount of daily HA use was a significant predictor of grammar and vocabulary. The current results provide evidence that children's language development benefits from consistent HA use. Nonusers are at risk in areas such as vocabulary and grammar compared with other children with mild HL who wear HAs regularly. Service providers should work collaboratively to encourage consistent HA use.

Characteristics of HIV-Infected Children at Enrollment into Care and at Antiretroviral Therapy Initiation in Central Africa.

Directory of Open Access Journals (Sweden)

Adebola Adedimeji

Full Text Available Despite the World Health Organization (WHO regularly updating guidelines to recommend earlier initiation of antiretroviral therapy (ART in children, timely enrollment into care and initiation of ART in sub-Saharan Africa in children lags behind that of adults. The impact of implementing increasingly less restrictive ART guidelines on ART initiation in Central Africa has not been described.Data are from the Central Africa International Epidemiologic Databases to Evaluate AIDS (IeDEA pediatric cohort of 3,426 children (0-15 years entering HIV care at 15 sites in Burundi, DRC, and Rwanda. Measures include CD4 count, WHO clinical stage, age, and weight-for-age Z score (WAZ, each at enrollment into HIV care and at ART initiation. Changes in the medians or proportions of each measure by year of enrollment and year of ART initiation were assessed to capture potential impacts of changing ART guidelines.Median age at care enrollment decreased from 77.2 months in 2004-05 to 30.3 months in 2012-13. The median age at ART initiation (n = 2058 decreased from 83.0 months in 2004-05 to 66.9 months in 2012-13. The proportion of children ≤24 months of age at enrollment increased from 12.7% in 2004-05 to 46.7% in 2012-13, and from 9.6% in 2004-05 to 24.2% in 2012-13 for ART initiation. The median CD4 count at enrollment into care increased from 563 (IQR: 275, 901 in 2004-05 to 660 (IQR: 339, 1071 cells/μl in 2012-13, and the median CD4 count at ART initiation increased from 310 (IQR:167, 600 in 2004-05 to 589 (IQR: 315, 1113 cells/μl in 2012-13. From 2004-05 to 2012-13, median WAZ improved from -2 (IQR: -3.4, -1.1 to -1 (IQR: -2.5, -0.2 at enrollment in care and from -2 (IQR: -3.8, -1.6 to -1 (IQR: -2.6, -0.4 at ART initiation.Although HIV-infected children ≤24 months of age accounted for half of all children enrolling in care in our cohort during 2012-13, they represented less than a quarter of all those who were initiated on ART during the same period

7 CFR 1469.6 - Enrollment criteria and selection process.

Science.gov (United States)

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Enrollment criteria and selection process. 1469.6... General Provisions § 1469.6 Enrollment criteria and selection process. (a) Selection and funding of... existing natural resource, environmental quality, and agricultural activity data along with other...

Can We Boost College Summer Enrollment Using Behavioral Science?

Science.gov (United States)

MDRC, 2017

2017-01-01

MDRC's Center for Applied Behavioral Science (CABS) and Postsecondary Education policy area launched the Encouraging Additional Summer Enrollment (EASE) project in collaboration with Great Lakes Higher Education Corporation & Affiliates and the Ohio Association of Community Colleges. The project aims to increase summer enrollment rates among…

Outcomes Measurement in Voice Disorders: Application of an Acoustic Index of Dysphonia Severity

Science.gov (United States)

Awan, Shaheen N.; Roy, Nelson

2009-01-01

Purpose: The purpose of this experiment was to assess the ability of an acoustic model composed of both time-based and spectral-based measures to track change following voice disorder treatment and to serve as a possible treatment outcomes measure. Method: A weighted, four-factor acoustic algorithm consisting of shimmer, pitch sigma, the ratio of…

Effect of telmisartan on functional outcome, recurrence, and blood pressure in patients with acute mild ischemic stroke: a PRoFESS subgroup analysis

DEFF Research Database (Denmark)

Bath, Philip M W; Martin, Reneé H; Palesch, Yuko

2009-01-01

BACKGROUND AND PURPOSE: High blood pressure (BP) is common in acute ischemic stroke and associated independently with a poor functional outcome. However, the management of BP acutely remains unclear because no large trials have been completed. METHODS: The factorial PRoFESS secondary stroke...... prevention trial assessed BP-lowering and antiplatelet strategies in 20 332 patients; 1360 were enrolled within 72 hours of ischemic stroke, with telmisartan (angiotensin receptor antagonist, 80 mg/d, n=647) vs placebo (n=713). For this nonprespecified subgroup analysis, the primary outcome was functional...... outcome at 30 days; secondary outcomes included death, recurrence, and hemodynamic measures at up to 90 days. Analyses were adjusted for baseline prognostic variables and antiplatelet assignment. RESULTS: Patients were representative of the whole trial (age 67 years, male 65%, baseline BP 147/84 mm Hg...

5 CFR 894.602 - May I cancel my enrollment at any time?

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false May I cancel my enrollment at any time... Cancellation of Coverage § 894.602 May I cancel my enrollment at any time? No. You may only cancel your enrollment during an open season. Exceptions: You may cancel your dental and/or vision enrollment if you...

Can we decide which outcomes should be measured in every clinical trial? A scoping review of the existing conceptual frameworks and processes to develop core outcome sets.

Science.gov (United States)

Idzerda, Leanne; Rader, Tamara; Tugwell, Peter; Boers, Maarten

2014-05-01

The usefulness of randomized control trials to advance clinical care depends upon the outcomes reported, but disagreement on the choice of outcome measures has resulted in inconsistency and the potential for reporting bias. One solution to this problem is the development of a core outcome set: a minimum set of outcome measures deemed critical for clinical decision making. Within rheumatology the Outcome Measures in Rheumatology (OMERACT) initiative has pioneered the development of core outcome sets since 1992. As the number of diseases addressed by OMERACT has increased and its experience in formulating core sets has grown, clarification and update of the conceptual framework and formulation of a more explicit process of area/domain core set development has become necessary. As part of the update process of the OMERACT Filter criteria to version 2, a literature review was undertaken to compare and contrast the OMERACT conceptual framework with others within and outside rheumatology. A scoping search was undertaken to examine the extent, range, and nature of conceptual frameworks for core set outcome selection in health. We searched the following resources: Cochrane Library Methods Group Register; Medline; Embase; PsycInfo; Environmental Studies and Policy Collection; and ABI/INFORM Global. We also conducted a targeted Google search. Five conceptual frameworks were identified: the WHO tripartite definition of health; the 5 Ds (discomfort, disability, drug toxicity, dollar cost, and death); the International Classification of Functioning (ICF); PROMIS (Patient-Reported Outcomes Measurement System); and the Outcomes Hierarchy. Of these, only the 5 Ds and ICF frameworks have been systematically applied in core set development. Outside the area of rheumatology, several core sets were identified; these had been developed through a limited range of consensus-based methods with varying degrees of methodological rigor. None applied a framework to ensure content validity of

Outcome measures and scar aesthetics in minimally invasive video-assisted parathyroidectomy.

LENUS (Irish Health Repository)

Casserly, Paula

2012-02-01

OBJECTIVES: To compare the scar outcome of video-assisted parathyroidectomy (VAP) with traditional bilateral cervical exploration (BCE) using previously validated scar assessment scales, and to examine the feasibility of introducing VAP into a general otolaryngology-head and neck practice. DESIGN: A retrospective review of medical records from a prospectively obtained database of patients and long-term follow-up of scar analysis. PATIENTS: The records of 60 patients undergoing parathyroidectomy were reviewed: 29 patients underwent VAP and 31 patients underwent an open procedure with BCE. The groups were matched for age and sex. A total of 46 patients were followed up to assess scar outcome. MAIN OUTCOME MEASURES: The primary outcome was a comparison of patient and observer scar satisfaction between VAP and traditional BCE using validated scar assessment tools: the Patient Scar Assessment Scale and the Manchester Scar Scale. The secondary outcomes were to retrospectively evaluate our results with VAP and to assess the suitability of introducing this technique into a general otolaryngology-head and neck practice. RESULTS: The average scar length in the VAP group was 1.7 cm, and the average scar length in the BCE group was 4.3 cm. The patients in the BCE group scored higher than the patients in the VAP group on the Manchester Scar Scale (P < .01) and on the Patient and Observer Scar Scales (P = .02), indicating a worse scar outcome. The mean operative time in the VAP group was 41 minutes compared with 115 minutes in the open procedure BCE group. There was no difference between the 2 groups in terms of postoperative complications. CONCLUSIONS: Video-assisted parathyroidectomy is a safe and feasible procedure in the setting of a general otolaryngology-head and neck practice, with outcomes and complication rates that are comparable to those of traditional bilateral neck exploration. Both patient and observer analysis demonstrated that VAP was associated with a more

Motivational Orientations of Non-Traditional Adult Students to Enroll in a Degree-Seeking Program

Science.gov (United States)

Francois, Emmanuel Jean

2014-01-01

The purpose of this research was to investigate the motivational orientations of non-traditional adult students to enroll in a degree-seeking program based on their academic goal. The Education Participation Scale (EPS) was used to measure the motivational orientations of participants. Professional advancement, cognitive interest, and educational…

Validation of the Focus on the Outcomes of Communication under Six outcome measure

Science.gov (United States)

Thomas-Stonell, Nancy; Oddson, Bruce; Robertson, Bernadette; Rosenbaum, Peter

2013-01-01

Aim The aim of this study was to establish the construct validity of the Focus on the Outcomes of Communication Under Six (FOCUS©),a tool designed to measure changes in communication skills in preschool children. Method Participating families' children (n=97; 68 males, 29 females; mean age 2y 8mo; SD 1.04y, range 10mo–4y 11mo) were recruited through eight Canadian organizations. The children were on a waiting list for speech and language intervention. Parents completed the Ages and Stages Questionnaire – Social/Emotional (ASQ-SE) and the FOCUS three times: at assessment and at the start and end of treatment. A second sample (n=28; 16 males 12 females) was recruited from another organization to correlate the FOCUS scores with speech, intelligibility and language measures. Second sample participants ranged in age from 3 years 1 month to 4 years 9 months (mean 3y 11mo; SD 0.41y). At the start and end of treatment, children were videotaped to obtain speech and language samples. Parents and speech–language pathologists (SLPs) independently completed the FOCUS tool. SLPs who were blind to the pre/post order of the videotapes analysed the samples. Results The FOCUS measured significantly more change (p<0.01) during treatment than during the waiting list period. It demonstrated both convergent and discriminant validity against the ASQ-SE. The FOCUS change corresponded to change measured by a combination of clinical speech and language measures (κ=0.31, p<0.05). Conclusion The FOCUS shows strong construct validity as a change-detecting instrument. PMID:23461266

Evaluation of a Computer-Based Recruitment System for Enrolling Men Who Have Sex With Men Into an Observational HIV Behavioral Risk Study.

Science.gov (United States)

Khosropour, Christine M; Dombrowksi, Julia C; Hughes, James P; Manhart, Lisa E; Golden, Matthew R

2016-09-15

Enrolling large numbers of high-risk men who have sex with men (MSM) into human immunodeficiency virus (HIV) prevention studies is necessary for research with an HIV outcome, but the resources required for in-person recruitment can be prohibitive. New methods with which to efficiently recruit large samples of MSM are needed. At a sexually transmitted disease clinic in Seattle, Washington, in 2013-2014, we used an existing clinical computer-assisted self-interview that collects patients' medical and sexual history data to recruit, screen, and enroll MSM into an HIV behavioral risk study and compared enrollees with men who declined to enroll. After completing the clinical computer-assisted self-interview, men aged ≥18 years who reported having had sex with men in the prior year were presented with an electronic study description and consent statement. We enrolled men at 2,661 (54%) of 4,944 visits, including 1,748 unique individuals. Enrolled men were younger (mean age = 34 years vs. 37 years; P partners (11 vs. 8; P use (15% vs. 8%; P < 0.001) than men who declined to enroll, but the HIV test positivity of the two groups was similar (1.9% vs. 2.0%; P = 0.80). Adapting an existing computerized clinic intake system, we recruited a large sample of MSM who may be an ideal population for an HIV prevention study. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The Role of Patient-Reported Outcome Measures in Value-Based Payment Reform.

Science.gov (United States)

Squitieri, Lee; Bozic, Kevin J; Pusic, Andrea L

2017-06-01

The U.S. health care system is currently experiencing profound change. Pressure to improve the quality of patient care and control costs have caused a rapid shift from traditional volume-driven fee-for-service reimbursement to value-based payment models. Under the 2015 Medicare Access and Children's Health Insurance Program Reauthorization Act, providers will be evaluated on the basis of quality and cost efficiency and ultimately receive adjusted reimbursement as per their performance. Although current performance metrics do not incorporate patient-reported outcome measures (PROMs), many wonder whether and how PROMs will eventually fit into value-based payment reform. On November 17, 2016, the second annual Patient-Reported Outcomes in Healthcare Conference brought together international stakeholders across all health care disciplines to discuss the potential role of PROs in value-based health care reform. The purpose of this article was to summarize the findings from this conference in the context of recent literature and guidelines to inform implementation of PROs in value-based payment models. Recommendations for evaluating key perspectives and measurement goals are made to facilitate appropriate use of PROMs to best benefit and amplify the voice of our patients. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Measuring Learning Outcomes. A Learner Perspective in Auditing Education

DEFF Research Database (Denmark)

Holm, Claus; Steenholdt, Niels

The ability to provide sensible measures for learning outcomes in accounting education is under increased scrutiny. In this paper we use a learner perspective in auditing education which reflects that some students taking accounting classes also are provided with on-the-job training in accounting...... is part of every day life within most accounting firms. Developing a sound on-the-job training environment is pivotal in the recruitment and design of supervision, and in the end for the expected "successrate" in retaining (valuable) employees. Prior research suggests that scripts or schemas provide...

Cigarette Smoking During Substance Use Disorder Treatment: Secondary Outcomes from a National Drug Abuse Treatment Clinical Trials Network study.

Science.gov (United States)

McClure, Erin A; Campbell, Aimee N C; Pavlicova, Martina; Hu, Meichen; Winhusen, Theresa; Vandrey, Ryan G; Ruglass, Lesia M; Covey, Lirio S; Stitzer, Maxine L; Kyle, Tiffany L; Nunes, Edward V

2015-06-01

The majority of patients enrolled in treatment for substance use disorders (SUDs) also use tobacco. Many will continue to use tobacco even during abstinence from other drugs and alcohol, often leading to smoking-related illnesses. Despite this, little research has been conducted to assess the influence of being a smoker on SUD treatment outcomes and changes in smoking during a treatment episode. In this secondary analysis, cigarette smoking was evaluated in participants completing outpatient SUD treatment as part of a multi-site study conducted by the National Drug Abuse Treatment Clinical Trials Network. Analyses included the assessment of changes in smoking and nicotine dependence via the Fagerström Test for Nicotine Dependence during the 12-week study among all smokers (aim #1), specifically among those in the experimental treatment group (aim #2), and the moderating effect of being a smoker on treatment outcomes (aim #3). Participants generally did not reduce or quit smoking throughout the course of the study. Among a sub-set of participants with higher baseline nicotine dependence scores randomized to the control arm, scores at the end of treatment were lower compared to the experimental arm, though measures of smoking quantity did not appear to decrease. Further, being a smoker was associated with poorer treatment outcomes compared to non-smokers enrolled in the trial. This study provides evidence that patients enrolled in community-based SUD treatment continue to smoke, even when abstaining from drugs and alcohol. These results add to the growing literature encouraging the implementation of targeted, evidence-based interventions to promote abstinence from tobacco among SUD treatment patients. Copyright © 2015 Elsevier Inc. All rights reserved.

Noninvasive Ventilation Intolerance: Characteristics, Predictors, and Outcomes.

Science.gov (United States)

Liu, Jinhua; Duan, Jun; Bai, Linfu; Zhou, Lintong

2016-03-01

Noninvasive ventilation (NIV) intolerance is one reason for NIV failure. However, the characteristics, predictors, and outcomes of NIV intolerance are unclear. A prospective observational study was performed in the respiratory intensive care unit of a teaching hospital. Subjects with acute respiratory failure who used NIV were enrolled. Initially, continuous use of NIV was encouraged. However, if the subject could not tolerate NIV, it was used intermittently. NIV intolerance was defined as termination of NIV due to subject refusal to receive it because of discomfort, even after intermittent use was attempted. A total of 961 subjects were enrolled in the study. Of these, 50 subjects (5.2%) experienced NIV intolerance after a median 2.4 h of NIV support. Age (OR = 0.98, 95% CI 0.963-0.996) and heart rate (OR = 1.02, 95% CI 1.006-1.030) measured before NIV were 2 independent risk factors of NIV intolerance. After 1-2 h of NIV, independent risk factors of NIV intolerance were heart rate (OR = 1.03, 95% CI 1.016-1.044) and breathing frequency (OR = 1.06, 95% CI 1.027-1.099). Intolerant subjects had no improvement in mean arterial pressure, heart rate, or breathing frequency after the NIV intervention. Moreover, intolerant subjects had a higher intubation rate (44.0% vs 25.8%, P = .008) and higher mortality (34.0% vs 22.4%, P = .08). The three most common complaints were that NIV worsened subjects' distress (46%), that NIV resulted in dyspnea (26%), and that the flow or pressure of NIV was too strong to bear (16%). NIV intolerance worsened subjects' outcomes. Younger subjects with a high heart rate and breathing frequency may be more likely to experience NIV intolerance. Copyright © 2016 by Daedalus Enterprises.

Changes in Depression, Health Anxiety, and Pain Catastrophizing Between Enrollment and 1 Month After a Radius Fracture.

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Golkari, Sina; Teunis, Teun; Ring, David; Vranceanu, Ana-Maria

2015-01-01

To test the difference in symptoms of (1) depression, (2) health anxiety, and (3) catastrophic thinking between 1 and 6 weeks after injury to the radius. In total, 69 adult patients with a minimally displaced radial head or distal radius fracture were prospectively enrolled. After diagnosis, we recorded demographic variables, 11-point ordinal numerical pain score, and agreement with "no pain, no gain"; Disabilities of the Arms, Shoulder, and Hand (DASH) questionnaire; Center for Epidemiologic Studies Depression Scale; the Whiteley Index; and the Pain Catastrophizing Scale. In total, 55 patients (80%) returned after 1 month to reevaluate pain, Disabilities of the Arms, Shoulder, and Hand, Center for Epidemiologic Studies Depression, Whiteley Index, and Pain Catastrophizing Scale scores. Center for Epidemiologic Studies Depression scores decreased by an average of 5 ± 9 points (p psychologic measures are used as a screening tool to predict outcome after treatment, one should account for a patient's disease phase. Prognostic level I. Copyright © 2015 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Correlating nerve conduction studies and clinical outcome measures on carpal tunnel syndrome: lessons from a randomized controlled trial

NARCIS (Netherlands)

Schrijver, H.M.; Gerritsen, A.A.M.; Strijers, R.L.; Uitdehaag, B.M.J.; Scholten, R.J.P.M.; Vet, de H.C.W.; Bouter, L.M.

2005-01-01

0.4) were found between the neurophysiologic and clinical outcome measures after 12 months, and between the changes in these different categories of outcome measures. This study confirms that the parameters of NCS improve significantly after treatment for CTS, but the modest correlations between

Adverse selection and supply-side factors in the enrollment in community-based health insurance in Northwest Ethiopia: A mixed methodology.

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Atafu, Asmamaw; Kwon, Soonman

2018-05-20

Since 2010, the Ethiopian government introduced different measures to implement community-based health insurance (CBHI) schemes to improve access to health service and reduce the catastrophic effect of health care costs. The aim of this study was to examine the determinants of enrollment in CBHI in Northwest Ethiopia. In this study, we utilized a mix of quantitative (multivariate logistic regression applied to population survey linked with health facility survey) and qualitative (focus group discussion and in-depth interview) methods to better understand the factors that affect CBHI enrollment. The study revealed important factors, such as household, informal association, and health facility, as barriers to CBHI enrollment. Age and educational status, self-rated health status, perceived quality of health services, knowledge, and information (awareness) about CBHI were among the characteristics of individual household head, affecting enrollment. Household size and participation in an informal association, such as local credit associations, were also positively associated with CBHI enrollment. Additionally, health facility factors like unavailability of laboratory tests were the main factor that hinders CBHI enrollment. This study showed a possibility of adverse selection in CBHI enrollment. Additionally, perceived quality of health services, knowledge, and information (awareness) are positively associated with CBHI enrollment. Therefore, policy interventions to mitigate adverse selection as well as provision of social marketing activities are crucial to increase enrollment in CBHI. Furthermore, policy interventions that enhance the capacity of health facilities and schemes to provide the promised services are necessary. Copyright © 2018 John Wiley & Sons, Ltd.

Creating a Novel Video Vignette Stroke Preparedness Outcome Measure Using a Community-Based Participatory Approach.

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Skolarus, Lesli E; Murphy, Jillian B; Dome, Mackenzie; Zimmerman, Marc A; Bailey, Sarah; Fowlkes, Sophronia; Morgenstern, Lewis B

2015-07-01

Evaluating the efficacy of behavioral interventions for rare outcomes is a challenge. One such topic is stroke preparedness, defined as inteventions to increase stroke symptom recognition and behavioral intent to call 911. Current stroke preparedness intermediate outcome measures are centered on written vignettes or open-ended questions and have been shown to poorly reflect actual behavior. Given that stroke identification and action requires aural and visual processing, video vignettes may improve on current measures. This article discusses an approach for creating a novel stroke preparedness video vignette intermediate outcome measure within a community-based participatory research partnership. A total of 20 video vignettes were filmed of which 13 were unambiguous (stroke or not stroke) as determined by stroke experts and had test discrimination among community participants. Acceptable reliability, high satisfaction, and cultural relevance were found among the 14 community respondents. A community-based participatory approach was effective in creating a video vignette intermediate outcome. Future projects should consider obtaining expert and community feedback prior to filming all the video vignettes to improve the proportion of vignettes that are usable. While content validity and preliminary reliability were established, future studies are needed to confirm the reliability and establish construct validity. © 2014 Society for Public Health Education.

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

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

2009-09-30

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

The Challenges of Career and Technical Education Concurrent Enrollment: An Administrative Perspective

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Haag, Patricia W.

2015-01-01

Career and technical education concurrent enrollment may pose unique challenges in programming and enrollment for program administrators, and this chapter describes the experiences and challenges of a CTE concurrent enrollment administrator.

Enrollment Time as a Requirement for Biometric Hand Recognition Systems

OpenAIRE

Carvalho, João; Sá, Vítor; Tenreiro de Magalhães, Sérgio; Santos, Henrique

2015-01-01

Biometric systems are increasingly being used as a means for authentication to provide system security in modern technologies. The performance of a biometric system depends on the accuracy, the processing speed, the template size, and the time necessary for enrollment. While much research has focused on the first three factors, enrollment time has not received as much attention. In this work, we present the findings of our research focused upon studying user’s behavior when enrolling in...

Measurement properties of patient reported outcome measures for spondyloarthritis: A systematic review.

Science.gov (United States)

Png, Kelly; Kwan, Yu Heng; Leung, Ying Ying; Phang, Jie Kie; Lau, Jia Qi; Lim, Ka Keat; Chew, Eng Hui; Low, Lian Leng; Tan, Chuen Seng; Thumboo, Julian; Fong, Warren; Østbye, Truls

2018-03-21

This systematic review aimed to identify studies investigating measurement properties of patient reported outcome measures (PROMs) for spondyloarthritis (SpA), and to evaluate their methodological quality and level of evidence relating to the measurement properties of PROMs. This systematic review was guided by the preferred reporting items for systematic review and meta-analysis (PRISMA). Articles published before 30 June 2017 were retrieved from PubMed ® , Embase ® , and PsychINFO ® (Ovid). Methodological quality and level of evidence were evaluated according to recommendations from the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). We identified 60 unique PROMs from 125 studies in 39 countries. Twenty-one PROMs were validated for two or more SpA subtypes. The literature examined hypothesis testing (82.4%) most frequently followed by reliability (60.0%). A percentage of 77.7% and 42.7% of studies that assessed PROMs for hypothesis testing and reliability, respectively had "fair" or better methodological quality. Among the PROMs identified, 41.7% were studied in ankylosing spondylitis (AS) only and 23.3% were studied in psoriatic arthritis (PsA) only. The more extensively assessed PROMs included the ankylosing spondylitis quality of life (ASQoL) and bath ankylosing spondylitis functional index (BASFI) for ankylosing spondylitis, and the psoriatic arthritis quality of life questionnaire (VITACORA-19) for psoriatic arthritis. This study identified 60 unique PROMs through a systematic review and synthesized evidence of the measurement properties of the PROMs. There is a lack of validation of PROMs for use across SpA subtypes. Future studies may consider validating PROMs for use across different SpA subtypes. Copyright © 2018 Elsevier Inc. All rights reserved.

Admission Path, Family Structure and Outcomes in Ghana's Public Universities: Evidence from KNUST Students Enrolled in the Social Sciences

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Yusif, Hadrat; Ofori-Abebrese, Grace

2017-01-01

At the Kwame Nkrumah University of Science and Technology (KNUST) in Ghana, first year enrolment increased by 1466.81% from 708 in 1961/1962 to 11,093 in 2011. In the 2013/2014 academic year, the total student population was 45,897. There are now five main admission paths, comprising regular, mature, fee paying, less endowed, and protocol/staff…

Relationships Affecting Enrollment Using Social, Economic, and Academic Data

Science.gov (United States)

Britton, R. Jason

2012-01-01

The process of strategically planning enrollment in higher education, particularly at private institutions has seen tremendous changes in a short period of time. Changes in perspectives toward the value of a college degree, along with economic and social factors, have contributed to the difficulty of discovering relationships affecting enrollment.…

42 CFR 438.810 - Expenditures for enrollment broker services.

Science.gov (United States)

2010-10-01

... activities such as distributing, collecting, and processing enrollment materials and taking enrollments by...; or (iii) Owns or controls an MCO, PIHP, PAHP, PCCM or other health care provider in the State. (2... been, or is now, subject to civil money penalties under the Act. (3) Approval. The initial contract or...

Theoretical framework and methodological development of common subjective health outcome measures in osteoarthritis: a critical review

Directory of Open Access Journals (Sweden)

Johnston Marie

2007-03-01

Full Text Available Abstract Subjective measures involving clinician ratings or patient self-assessments have become recognised as an important tool for the assessment of health outcome. The value of a health outcome measure is usually assessed by a psychometric evaluation of its reliability, validity and responsiveness. However, psychometric testing involves an accumulation of evidence and has recognised limitations. It has been suggested that an evaluation of how well a measure has been developed would be a useful additional criteria in assessing the value of a measure. This paper explored the theoretical background and methodological development of subjective health status measures commonly used in osteoarthritis research. Fourteen subjective health outcome measures commonly used in osteoarthritis research were examined. Each measure was explored on the basis of their i theoretical framework (was there a definition of what was being assessed and was it part of a theoretical model? and ii methodological development (what was the scaling strategy, how were the items generated and reduced, what was the response format and what was the scoring method?. Only the AIMS, SF-36 and WHOQOL defined what they were assessing (i.e. the construct of interest and no measure assessed was part of a theoretical model. None of the clinician report measures appeared to have implemented a scaling procedure or described the rationale for the items selected or scoring system. Of the patient self-report measures, the AIMS, MPQ, OXFORD, SF-36, WHOQOL and WOMAC appeared to follow a standard psychometric scaling method. The DRP and EuroQol used alternative scaling methods. The review highlighted the general lack of theoretical framework for both clinician report and patient self-report measures. This review also drew attention to the wide variation in the methodological development of commonly used measures in OA. While, in general the patient self-report measures had good methodological