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Sample records for performing outcomes assessment

  1. Perspectives to Performance of Environment and Health Assessments and Models—From Outputs to Outcomes?

    Directory of Open Access Journals (Sweden)

    Jouni T. Tuomisto

    2013-06-01

    Full Text Available The calls for knowledge-based policy and policy-relevant research invoke a need to evaluate and manage environment and health assessments and models according to their societal outcomes. This review explores how well the existing approaches to assessment and model performance serve this need. The perspectives to assessment and model performance in the scientific literature can be called: (1 quality assurance/control, (2 uncertainty analysis, (3 technical assessment of models, (4 effectiveness and (5 other perspectives, according to what is primarily seen to constitute the goodness of assessments and models. The categorization is not strict and methods, tools and frameworks in different perspectives may overlap. However, altogether it seems that most approaches to assessment and model performance are relatively narrow in their scope. The focus in most approaches is on the outputs and making of assessments and models. Practical application of the outputs and the consequential outcomes are often left unaddressed. It appears that more comprehensive approaches that combine the essential characteristics of different perspectives are needed. This necessitates a better account of the mechanisms of collective knowledge creation and the relations between knowledge and practical action. Some new approaches to assessment, modeling and their evaluation and management span the chain from knowledge creation to societal outcomes, but the complexity of evaluating societal outcomes remains a challenge.

  2. Investigating ESL Students' Performance on Outcomes Assessments in Higher Education

    Science.gov (United States)

    Lakin, Joni M.; Elliott, Diane Cardenas; Liu, Ou Lydia

    2012-01-01

    Outcomes assessments are gaining great attention in higher education because of increased demand for accountability. These assessments are widely used by U.S. higher education institutions to measure students' college-level knowledge and skills, including students who speak English as a second language (ESL). For the past decade, the increasing…

  3. Relationship between hospital financial performance and publicly reported outcomes.

    Science.gov (United States)

    Nguyen, Oanh Kieu; Halm, Ethan A; Makam, Anil N

    2016-07-01

    Hospitals that have robust financial performance may have improved publicly reported outcomes. To assess the relationship between hospital financial performance and publicly reported outcomes of care, and to assess whether improved outcome metrics affect subsequent hospital financial performance. Observational cohort study. Hospital financial data from the Office of Statewide Health Planning and Development in California in 2008 and 2012 were linked to data from the Centers for Medicare and Medicaid Services Hospital Compare website. Hospital financial performance was measured by net revenue by operations, operating margin, and total margin. Outcomes were 30-day risk-standardized mortality and readmission rates for acute myocardial infarction (AMI), congestive heart failure (CHF), and pneumonia (PNA). Among 279 hospitals, there was no consistent relationship between measures of financial performance in 2008 and publicly reported outcomes from 2008 to 2011 for AMI and PNA. However, improved hospital financial performance (by any of the 3 measures) was associated with a modest increase in CHF mortality rates (ie, 0.26% increase in CHF mortality rate for every 10% increase in operating margin [95% confidence interval: 0.07%-0.45%]). Conversely, there were no significant associations between outcomes from 2008 to 2011 and subsequent financial performance in 2012 (P > 0.05 for all). Robust financial performance is not associated with improved publicly reported outcomes for AMI, CHF, and PNA. Financial incentives in addition to public reporting, such as readmissions penalties, may help motivate hospitals with robust financial performance to further improve publicly reported outcomes. Reassuringly, improved mortality and readmission rates do not necessarily lead to loss of revenue. Journal of Hospital Medicine 2016;11:481-488. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

  4. Clinical Outcome Assessments: Conceptual Foundation-Report of the ISPOR Clinical Outcomes Assessment - Emerging Good Practices for Outcomes Research Task Force.

    Science.gov (United States)

    Walton, Marc K; Powers, John H; Hobart, Jeremy; Patrick, Donald; Marquis, Patrick; Vamvakas, Spiros; Isaac, Maria; Molsen, Elizabeth; Cano, Stefan; Burke, Laurie B

    2015-09-01

    An outcome assessment, the patient assessment used in an endpoint, is the measuring instrument that provides a rating or score (categorical or continuous) that is intended to represent some aspect of the patient's health status. Outcome assessments are used to define efficacy endpoints when developing a therapy for a disease or condition. Most efficacy endpoints are based on specified clinical assessments of patients. When clinical assessments are used as clinical trial outcomes, they are called clinical outcome assessments (COAs). COAs include any assessment that may be influenced by human choices, judgment, or motivation. COAs must be well-defined and possess adequate measurement properties to demonstrate (directly or indirectly) the benefits of a treatment. In contrast, a biomarker assessment is one that is subject to little, if any, patient motivational or rater judgmental influence. This is the first of two reports by the ISPOR Clinical Outcomes Assessment - Emerging Good Practices for Outcomes Research Task Force. This report provides foundational definitions important for an understanding of COA measurement principles. The foundation provided in this report includes what it means to demonstrate a beneficial effect, how assessments of patients relate to the objective of showing a treatment's benefit, and how these assessments are used in clinical trial endpoints. In addition, this report describes intrinsic attributes of patient assessments and clinical trial factors that can affect the properties of the measurements. These factors should be considered when developing or refining assessments. These considerations will aid investigators designing trials in their choice of using an existing assessment or developing a new outcome assessment. Although the focus of this report is on the development of a new COA to define endpoints in a clinical trial, these principles may be applied more generally. A critical element in appraising or developing a COA is to

  5. Assessment of Student Professional Outcomes for Continuous Improvement

    Science.gov (United States)

    Keshavarz, Mohsen; Baghdarnia, Mostafa

    2013-01-01

    This article describes a method for the assessment of professional student outcomes (performance-type outcomes or soft skills). The method is based upon group activities, research on modern electrical engineering topics by individual students, classroom presentations on chosen research topics, final presentations, and technical report writing.…

  6. Assessing Higher Education Learning Outcomes in Brazil

    Science.gov (United States)

    Pedrosa, Renato H. L.; Amaral, Eliana; Knobel, Marcelo

    2013-01-01

    Brazil has developed an encompassing system for quality assessment of higher education, the National System of Higher Education Evaluation (SINAES), which includes a test for assessing learning outcomes at the undergraduate level, the National Exam of Student Performance (ENADE). The present system has been running since 2004, and also serves as…

  7. Practical framework for Bloom's based teaching and assessment of engineering outcomes

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    Mead, Patricia F.; Bennett, Mary M.

    2009-06-01

    ABET's outcomes-based assessment and evaluation requirements for engineering school accreditation has been a catalyst for curricular reform for engineering programs across the U.S. and around the world. Norfolk State University launched programs in Electronics and Optical Engineering in 2003. In 2007, Norfolk State became one of only six accredited Optical Engineering programs in the United States. In preparation for their first ABET evaluation in fall 2007, the faculty initiated an embedded-assessment program to insure continuous improvement toward the desired learning outcomes. The initial program design includes embedded assessments that have been generated using a practical framework for the creation of course activities based on Bloom's Learning Taxonomy. The framework includes specific performance criteria for each ABET-defined learning outcome. The embedded assessments are generated by individual faculty for courses that they are assigned to teach, and the performance criteria provide sufficient information to guide the faculty as they generate the embedded assignments. The assignments are typically administered through course exams, projects, electronic portfolio assignments, and other structured educational activities. The effectiveness of the assessment design is being evaluated through faculty surveys, faculty group discussions, and student performance. This paper outlines the assessment and evaluation plan, and the integrated processes that have been used to support the evaluation of learning outcomes using embedded assessment instruments.

  8. Ipsilesional upper limb performance in stroke individuals: relationship among outcomes of different tests used to assess hand function

    Directory of Open Access Journals (Sweden)

    Bianca Pinto Cunha

    Full Text Available Abstract Introduction: Stroke individuals have sensorimotor repercussions on their ipsilesional upper limb. Therefore, it is important to use tests that allow an adequate assessment and follow-up of such deficits. Physical and occupational therapists commonly use maximal grip strength tests to assess the functional condition of stroke individuals. However, one could ask whether a single test is able to characterize the hand function in this population. Objective: The aim of this study was to investigate the relationship among outcomes of different tests frequently used to describe the function of the hand in the ipsilesional upper limb of stroke individuals. Methods: Twenty-two stroke individuals performed four hand function tests: maximal handgrip strength (HGSMax, maximal pinch grip strength (PGSMax, Jebsen-Taylor Hand Function Test (JTHFT and Nine Hole Peg Test (9-HPT. All tests were performed with the ipsilesional hand. Pearson's correlation analyses were performed. Results: the results indicated a moderate and positive relationship between HGSMax and JTHFT (r = 0.50 and between JTHFT and 9-HPT (r = 0.55. Conclusion: We conclude that the existence of only moderate relationships between test outcomes demonstrates the need to use at least two instruments to better describe the ipsilesional hand function of stroke individuals.

  9. Technical Performance as a Predictor of Clinical Outcomes in Laparoscopic Gastric Cancer Surgery.

    Science.gov (United States)

    Fecso, Andras B; Bhatti, Junaid A; Stotland, Peter K; Quereshy, Fayez A; Grantcharov, Teodor P

    2018-03-23

    The purpose of this study was to evaluate the relationship between technical performance and patient outcomes in laparoscopic gastric cancer surgery. Laparoscopic gastrectomy for cancer is an advanced procedure with high rate of postoperative morbidity and mortality. Many variables including patient, disease, and perioperative management factors have been shown to impact postoperative outcomes; however, the role of surgical performance is insufficiently investigated. A retrospective review was performed for all patients who had undergone laparoscopic gastrectomy for cancer at 3 teaching institutions between 2009 and 2015. Patients with available, unedited video-recording of their procedure were included in the study. Video files were rated for technical performance, using Objective Structured Assessments of Technical Skills (OSATS) and Generic Error Rating Tool instruments. The main outcome variable was major short-term complications. The effect of technical performance on patient outcomes was assessed using logistic regression analysis with backward selection strategy. Sixty-one patients with available video recordings were included in the study. The overall complication rate was 29.5%. The mean Charlson comorbidity index, type of procedure, and the global OSATS score were included in the final predictive model. Lower performance score (OSATS ≤29) remained an independent predictor for major short-term outcomes (odds ratio 6.49), while adjusting for comorbidities and type of procedure. Intraoperative technical performance predicts major short-term outcomes in laparoscopic gastrectomy for cancer. Ongoing assessment and enhancement of surgical skills using modern, evidence-based strategies might improve short-term patient outcomes. Future work should focus on developing and studying the effectiveness of such interventions in laparoscopic gastric cancer surgery.

  10. Motivation Monitoring and Assessment Extension for Input-Process-Outcome Game Model

    Science.gov (United States)

    Ghergulescu, Ioana; Muntean, Cristina Hava

    2014-01-01

    This article proposes a Motivation Assessment-oriented Input-Process-Outcome Game Model (MotIPO), which extends the Input-Process-Outcome game model with game-centred and player-centred motivation assessments performed right from the beginning of the game-play. A feasibility case-study involving 67 participants playing an educational game and…

  11. The Fishery Performance Indicators: A Management Tool for Triple Bottom Line Outcomes

    Science.gov (United States)

    Anderson, James L.; Anderson, Christopher M.; Chu, Jingjie; Meredith, Jennifer; Asche, Frank; Sylvia, Gil; Smith, Martin D.; Anggraeni, Dessy; Arthur, Robert; Guttormsen, Atle; McCluney, Jessica K.; Ward, Tim; Akpalu, Wisdom; Eggert, Håkan; Flores, Jimely; Freeman, Matthew A.; Holland, Daniel S.; Knapp, Gunnar; Kobayashi, Mimako; Larkin, Sherry; MacLauchlin, Kari; Schnier, Kurt; Soboil, Mark; Tveteras, Sigbjorn; Uchida, Hirotsugu; Valderrama, Diego

    2015-01-01

    Pursuit of the triple bottom line of economic, community and ecological sustainability has increased the complexity of fishery management; fisheries assessments require new types of data and analysis to guide science-based policy in addition to traditional biological information and modeling. We introduce the Fishery Performance Indicators (FPIs), a broadly applicable and flexible tool for assessing performance in individual fisheries, and for establishing cross-sectional links between enabling conditions, management strategies and triple bottom line outcomes. Conceptually separating measures of performance, the FPIs use 68 individual outcome metrics—coded on a 1 to 5 scale based on expert assessment to facilitate application to data poor fisheries and sectors—that can be partitioned into sector-based or triple-bottom-line sustainability-based interpretative indicators. Variation among outcomes is explained with 54 similarly structured metrics of inputs, management approaches and enabling conditions. Using 61 initial fishery case studies drawn from industrial and developing countries around the world, we demonstrate the inferential importance of tracking economic and community outcomes, in addition to resource status. PMID:25946194

  12. Clinician-Reported Outcome Assessments of Treatment Benefit: Report of the ISPOR Clinical Outcome Assessment Emerging Good Practices Task Force.

    Science.gov (United States)

    Powers, John H; Patrick, Donald L; Walton, Marc K; Marquis, Patrick; Cano, Stefan; Hobart, Jeremy; Isaac, Maria; Vamvakas, Spiros; Slagle, Ashley; Molsen, Elizabeth; Burke, Laurie B

    2017-01-01

    A clinician-reported outcome (ClinRO) assessment is a type of clinical outcome assessment (COA). ClinRO assessments, like all COAs (patient-reported, observer-reported, or performance outcome assessments), are used to 1) measure patients' health status and 2) define end points that can be interpreted as treatment benefits of medical interventions on how patients feel, function, or survive in clinical trials. Like other COAs, ClinRO assessments can be influenced by human choices, judgment, or motivation. A ClinRO assessment is conducted and reported by a trained health care professional and requires specialized professional training to evaluate the patient's health status. This is the second of two reports by the ISPOR Clinical Outcomes Assessment-Emerging Good Practices for Outcomes Research Task Force. The first report provided an overview of COAs including definitions important for an understanding of COA measurement practices. This report focuses specifically on issues related to ClinRO assessments. In this report, we define three types of ClinRO assessments (readings, ratings, and clinician global assessments) and describe emerging good measurement practices in their development and evaluation. The good measurement practices include 1) defining the context of use; 2) identifying the concept of interest measured; 3) defining the intended treatment benefit on how patients feel, function, or survive reflected by the ClinRO assessment and evaluating the relationship between that intended treatment benefit and the concept of interest; 4) documenting content validity; 5) evaluating other measurement properties once content validity is established (including intra- and inter-rater reliability); 6) defining study objectives and end point(s) objectives, and defining study end points and placing study end points within the hierarchy of end points; 7) establishing interpretability in trial results; and 8) evaluating operational considerations for the implementation of

  13. The Impact of Digital Skills on Educational Outcomes: Evidence from Performance Tests

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    Pagani, Laura; Argentin, Gianluca; Gui, Marco; Stanca, Luca

    2016-01-01

    Digital skills are increasingly important for labour market outcomes and social participation. Do they also matter for academic performance? This paper investigates the effects of digital literacy on educational outcomes by merging data from the Italian National Assessment in secondary schools with an original data-set on performance tests of…

  14. A Better Leveled Playing Field for Assessing Satisfactory Job Performance of Superintendents on the Basis of High-Stakes Testing Outcomes

    Science.gov (United States)

    Young, I. Phillip; Cox, Edward P.; Buckman, David G.

    2014-01-01

    To assess satisfactory job performance of superintendents on the basis of school districts' high-stakes testing outcomes, existing teacher models were reviewed and critiqued as potential options for retrofit. For these models, specific problems were identified relative to the choice of referent groups. An alternate referent group (statewide…

  15. Utilizing Machine Learning and Automated Performance Metrics to Evaluate Robot-Assisted Radical Prostatectomy Performance and Predict Outcomes.

    Science.gov (United States)

    Hung, Andrew J; Chen, Jian; Che, Zhengping; Nilanon, Tanachat; Jarc, Anthony; Titus, Micha; Oh, Paul J; Gill, Inderbir S; Liu, Yan

    2018-05-01

    Surgical performance is critical for clinical outcomes. We present a novel machine learning (ML) method of processing automated performance metrics (APMs) to evaluate surgical performance and predict clinical outcomes after robot-assisted radical prostatectomy (RARP). We trained three ML algorithms utilizing APMs directly from robot system data (training material) and hospital length of stay (LOS; training label) (≤2 days and >2 days) from 78 RARP cases, and selected the algorithm with the best performance. The selected algorithm categorized the cases as "Predicted as expected LOS (pExp-LOS)" and "Predicted as extended LOS (pExt-LOS)." We compared postoperative outcomes of the two groups (Kruskal-Wallis/Fisher's exact tests). The algorithm then predicted individual clinical outcomes, which we compared with actual outcomes (Spearman's correlation/Fisher's exact tests). Finally, we identified five most relevant APMs adopted by the algorithm during predicting. The "Random Forest-50" (RF-50) algorithm had the best performance, reaching 87.2% accuracy in predicting LOS (73 cases as "pExp-LOS" and 5 cases as "pExt-LOS"). The "pExp-LOS" cases outperformed the "pExt-LOS" cases in surgery time (3.7 hours vs 4.6 hours, p = 0.007), LOS (2 days vs 4 days, p = 0.02), and Foley duration (9 days vs 14 days, p = 0.02). Patient outcomes predicted by the algorithm had significant association with the "ground truth" in surgery time (p algorithm in predicting, were largely related to camera manipulation. To our knowledge, ours is the first study to show that APMs and ML algorithms may help assess surgical RARP performance and predict clinical outcomes. With further accrual of clinical data (oncologic and functional data), this process will become increasingly relevant and valuable in surgical assessment and training.

  16. The Social Responsibility Performance Outcomes Model: Building Socially Responsible Companies through Performance Improvement Outcomes.

    Science.gov (United States)

    Hatcher, Tim

    2000-01-01

    Considers the role of performance improvement professionals and human resources development professionals in helping organizations realize the ethical and financial power of corporate social responsibility. Explains the social responsibility performance outcomes model, which incorporates the concepts of societal needs and outcomes. (LRW)

  17. 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.

  18. Performance success from self-assessments

    International Nuclear Information System (INIS)

    Hughes, G.

    1996-01-01

    This paper provides information on and successes of self-assessments completed at the Callaway plant. It stresses the vital needs and substantial benefits from these continual self-improvement efforts. The Callaway plant staff use a variety of methods and techniques to do self-assessments with the focus on performance outcomes. Self-assessments help Callaway focus on the priority issues and direct resources properly. Callaway's success has been due to this learning culture. The Callaway plant is a Westinghouse four-loop plant in the state of Missouri and has been operational since 1984

  19. Risk-adjusted payment and performance assessment for primary care.

    Science.gov (United States)

    Ash, Arlene S; Ellis, Randall P

    2012-08-01

    Many wish to change incentives for primary care practices through bundled population-based payments and substantial performance feedback and bonus payments. Recognizing patient differences in costs and outcomes is crucial, but customized risk adjustment for such purposes is underdeveloped. Using MarketScan's claims-based data on 17.4 million commercially insured lives, we modeled bundled payment to support expected primary care activity levels (PCAL) and 9 patient outcomes for performance assessment. We evaluated models using 457,000 people assigned to 436 primary care physician panels, and among 13,000 people in a distinct multipayer medical home implementation with commercially insured, Medicare, and Medicaid patients. Each outcome is separately predicted from age, sex, and diagnoses. We define the PCAL outcome as a subset of all costs that proxies the bundled payment needed for comprehensive primary care. Other expected outcomes are used to establish targets against which actual performance can be fairly judged. We evaluate model performance using R(2)'s at patient and practice levels, and within policy-relevant subgroups. The PCAL model explains 67% of variation in its outcome, performing well across diverse patient ages, payers, plan types, and provider specialties; it explains 72% of practice-level variation. In 9 performance measures, the outcome-specific models explain 17%-86% of variation at the practice level, often substantially outperforming a generic score like the one used for full capitation payments in Medicare: for example, with grouped R(2)'s of 47% versus 5% for predicting "prescriptions for antibiotics of concern." Existing data can support the risk-adjusted bundled payment calculations and performance assessments needed to encourage desired transformations in primary care.

  20. Performance Assessment for Pump-and-Treat Closure or Transition

    Energy Technology Data Exchange (ETDEWEB)

    Truex, Michael J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Johnson, Christian D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Becker, Dave J. [U.S. Army Corps of Engineers Environmental and Munitions Center of Expertise, Huntsville, AL (United States); Lee, Michelle H. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Nimmons, Michael J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-09-29

    A structured performance assessment approach is useful to evaluate pump-and-treat (P&T) groundwater remediation, which has been applied at numerous sites. Consistent with the U.S. Environmental Protection Agency’s Groundwater Road Map, performance assessment during remedy implementation may be needed, and should consider remedy optimization, transition to alternative remedies, or remedy closure. In addition, a recent National Research Council study examined groundwater remediation at complex contaminated sites and concluded that it may be beneficial to evaluate remedy performance and the potential need for transition to alternative approaches at these sites. The intent of this document is to provide a structured approach for assessing P&T performance to support a decision to optimize, transition, or close a P&T remedy. The process presented in this document for gathering information and performing evaluations to support P&T remedy decisions includes use of decision elements to distinguish between potential outcomes of a remedy decision. Case studies are used to augment descriptions of decision elements and to illustrate each type of outcome identified in the performance assessment approach. The document provides references to resources for tools and other guidance relevant to conducting the P&T assessment.

  1. A Patient-Assessed Morbidity to Evaluate Outcome in Surgically Treated Vestibular Schwannomas.

    Science.gov (United States)

    Al-Shudifat, Abdul Rahman; Kahlon, Babar; Höglund, Peter; Lindberg, Sven; Magnusson, Måns; Siesjo, Peter

    2016-10-01

    Outcome after treatment of vestibular schwannomas can be evaluated by health providers as mortality, recurrence, performance, and morbidity. Because mortality and recurrence are rare events, evaluation has to focus on performance and morbidity. The latter has mostly been reported by health providers. In the present study, we validate 2 new scales for patient-assessed performance and morbidity in comparison with different outcome tools, such as quality of life (QOL) (European Quality of Life-5 dimensions [EQ-5D]), facial nerve score, and work capacity. There were 167 total patients in a retrospective (n = 90) and prospective (n = 50) cohort of surgically treated vestibular schwannomas. A new patient-assessed morbidity score (paMS), a patient-assessed Karnofsky score (paKPS), the patient-assessed QOL (EQ-5D) score, work capacity, and the House-Brackmann facial nerve score were used as outcome measures. Analysis of paMS components and their relation to other outcomes was done as uni- and multivariate analysis. All outcome instruments, except EQ-5D and paKPS, showed a significant decrease postoperatively. Only the facial nerve score (House-Brackmann facial nerve score) differed significantly between the retrospective and prospective cohorts. Out of the 16 components of the paMS, hearing dysfunction, tear dysfunction, balance dysfunction, and eye irritation were most often reported. Both paMS and EQ-5D correlated significantly with work capacity. Standard QOL and performance instruments may not be sufficiently sensitive or specific to measure outcome at the cohort level after surgical treatment of vestibular schwannomas. A morbidity score may yield more detailed information on symptoms that can be relevant for rehabilitation and occupational training after surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. The Assessment of Patient Clinical Outcome: Advantages, Models, Features of an Ideal Model

    Directory of Open Access Journals (Sweden)

    Mou’ath Hourani

    2016-06-01

    Full Text Available Background: The assessment of patient clinical outcome focuses on measuring various aspects of the health status of a patient who is under healthcare intervention. Patient clinical outcome assessment is a very significant process in the clinical field as it allows health care professionals to better understand the effectiveness of their health care programs and thus for enhancing the health care quality in general. It is thus vital that a high quality, informative review of current issues regarding the assessment of patient clinical outcome should be conducted. Aims & Objectives: 1 Summarizes the advantages of the assessment of patient clinical outcome; 2 reviews some of the existing patient clinical outcome assessment models namely: Simulation, Markov, Bayesian belief networks, Bayesian statistics and Conventional statistics, and Kaplan-Meier analysis models; and 3 demonstrates the desired features that should be fulfilled by a well-established ideal patient clinical outcome assessment model. Material & Methods: An integrative review of the literature has been performed using the Google Scholar to explore the field of patient clinical outcome assessment. Conclusion: This paper will directly support researchers, clinicians and health care professionals in their understanding of developments in the domain of the assessment of patient clinical outcome, thus enabling them to propose ideal assessment models.

  3. The Assessment of Patient Clinical Outcome: Advantages, Models, Features of an Ideal Model

    Directory of Open Access Journals (Sweden)

    Mou’ath Hourani

    2016-06-01

    Full Text Available Background: The assessment of patient clinical outcome focuses on measuring various aspects of the health status of a patient who is under healthcare intervention. Patient clinical outcome assessment is a very significant process in the clinical field as it allows health care professionals to better understand the effectiveness of their health care programs and thus for enhancing the health care quality in general. It is thus vital that a high quality, informative review of current issues regarding the assessment of patient clinical outcome should be conducted. Aims & Objectives: 1 Summarizes the advantages of the assessment of patient clinical outcome; 2 reviews some of the existing patient clinical outcome assessment models namely: Simulation, Markov, Bayesian belief networks, Bayesian statistics and Conventional statistics, and Kaplan-Meier analysis models; and 3 demonstrates the desired features that should be fulfilled by a well-established ideal patient clinical outcome assessment model. Material & Methods: An integrative review of the literature has been performed using the Google Scholar to explore the field of patient clinical outcome assessment. Conclusion: This paper will directly support researchers, clinicians and health care professionals in their understanding of developments in the domain of the assessment of patient clinical outcome, thus enabling them to propose ideal assessment models.

  4. Measurement properties of performance-based outcome measures to assess physical function in young and middle-aged people known to be at high risk of hip and/or knee osteoarthritis

    DEFF Research Database (Denmark)

    Kroman, S L; Roos, Ewa M.; Bennell, K L

    2014-01-01

    To systematically appraise the evidence on measurement properties of performance-based outcome measures to assess physical function in young and middle-aged people known to be at high risk of hip and/or knee osteoarthritis (OA).......To systematically appraise the evidence on measurement properties of performance-based outcome measures to assess physical function in young and middle-aged people known to be at high risk of hip and/or knee osteoarthritis (OA)....

  5. Context for performance assessment

    International Nuclear Information System (INIS)

    Kocher, D.C.

    1997-01-01

    In developing its recommendations on performance assessment for disposal of low-level radioactive waste, Scientific committee 87-3 of the National Council on Radiation Protection and Measurements (NCRP) has considered a number of topics that provide a context for the development of suitable approaches to performance assessment. This paper summarizes the Committee' discussions on these topics, including (1) the definition of low-level waste and its sources and properties, as they affect the variety of wastes that must be considered, (2) fundamental objectives and principles of radioactive waste disposal and their application to low-level waste, (3) current performance objectives for low-level waste disposal in the US, with particular emphasis on such unresolved issues of importance to performance assessment as the time frame for compliance, requirements for protection of groundwater and surface water, inclusion of doses from radon, demonstrating compliance with fixed performance objectives using highly uncertain model projections, and application of the principle that releases to the environment should be maintained as low as reasonably achievable (ALARA), (4) the role of active and passive institutional controls over disposal sites, (5) the role of the inadvertent human intruder in low-level waste disposal, (6) model validation and confidence in model outcomes, and (7) the concept of reasonable assurance of compliance

  6. Quantifying risk and assessing outcome in cardiac surgery.

    Science.gov (United States)

    Higgins, T L

    1998-06-01

    Quality improvement, research, and reporting of outcome results can be stratified by preoperative risk by using a logistic regression equation or scores to correct for multiple risk factors. The more than 30-fold mortality differences between lowest and highest risk patients make it critical to stratify outcome results by patient severity. Probabilities are not predictions, however, and caution must be exercised when applying scores to individuals. Outcome assessment will grow in its importance to professionals, initially in the guise of quality reporting and improvement, but increasingly as a tool for risk assessment, patient counseling, and directing therapeutic decisions based on more complete information about patient subgroups. Physicians may be called on for recommendations in choosing systems for their hospitals and communities. Therefore, it is important to have an understanding of how such systems are developed, what factors indicate adequate performance of a system, and how such systems of risk stratification should be applied in practice.

  7. Effect of Manager’s Role in Performance Based Pay on Employee Outcomes

    Directory of Open Access Journals (Sweden)

    Azman, I

    2014-12-01

    Full Text Available According to the recent literature pertaining on Islamic based organizational compensation, performance based pay consists of two essential features: communication and performance appraisal. Recent studies in this field highlights that the ability of managers to appropriately communicate pay information and appraise employee performance may have a significant impact on employee outcomes, especially job satisfaction and organizational commitment. Therefore, this study was undertaken to assess the relationship between manager’s role in performance based pay and employee outcomes using self-administered questionnaires collected from employees at a district council in Peninsular Malaysia. The outcomes of the SmartPLS path model analysis showed that pay communication does not act as an important determinant of job satisfaction, but performance appraisal does act as an important determinant of job satisfaction. Conversely, pay communication and performance appraisal act as important determinants of organizational commitment. In addition, this study provides discussion, implications and conclusion

  8. A preliminary assessment of financial stability, efficiency, health systems and health outcomes using performance-based contracts in Belize.

    Science.gov (United States)

    Bowser, Diana M; Figueroa, Ramon; Natiq, Laila; Okunogbe, Adeyemi

    2013-01-01

    Over the last 10 years, Belize has implemented a National Health Insurance (NHI) program that uses performance-based contracts with both public and private facilities to improve financial sustainability, efficiency and service provision. Data were collected at the facility, district and national levels in order to assess trends in financial sustainability, efficiency payments, year-end bonuses and health system and health outcomes. A difference-in-difference approach was used to assess the difference in technical efficiency between private and public facilities. The results show that per capita spending on services provided by the NHI program has decreased over the period 2006-2009 from BZ$177 to BZ$136. The private sector has achieved higher levels of technical efficiency, but lower percentages of efficiency and year-end bonus payments. Districts with contracts through the NHI program showed greater improvements in facility births, nurse density, reducing maternal mortality, diabetes deaths and morbidity from bronchitis, emphysema and asthma than districts without contracts over the period 2006-2010. This preliminary assessment of Belize's pay-for-performance system provides some positive results, however further research is needed to use the lessons learned from Belize to implement similar reforms in other systems.

  9. Communicating Learning Outcomes and Student Performance through the Student Transcript

    Science.gov (United States)

    Kenyon, George; Barnes, Cynthia

    2010-01-01

    The university accreditation process now puts more emphasis on self assessment. This change requires universities to identify program objectives, performance indicators, and areas for improvement. Many accrediting institutions are requiring that institutions communicate clearly to constituents: 1) what learning outcomes were achieved by students,…

  10. 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

  11. Mediation analysis of severity of needs, service performance and outcomes for patients with mental disorders.

    Science.gov (United States)

    Roux, Paul; Passerieux, Christine; Fleury, Marie-Josée

    2016-12-01

    Needs and service performance assessment are key components in improving recovery among individuals with mental disorders. To test the role of service performance as a mediating factor between severity of patients' needs and outcomes. A total of 339 adults with mental disorders were interviewed. A mediation analysis between severity of needs, service performance (adequacy of help, continuity of care and recovery orientation of services) and outcomes (personal recovery and quality of life) was carried out using structural equation modelling. The structural equation model provided a good fit with the data. An increase in needs was associated with lower service performance and worse outcomes, whereas higher service performance was associated with better outcomes. Service performance partially mediated the effect of patient needs on outcomes. Poorer service performance has a negative impact on outcomes for patients with the highest needs. Ensuring more efficient services for patients with high needs may help improve their recovery and quality of life. © The Royal College of Psychiatrists 2016.

  12. Relations between student perceptions of assessment authenticity, study approaches and learning outcome

    NARCIS (Netherlands)

    Gulikers, J.T.M.; Bastiaens, Th.J.; Kirschner, P.A.; Kester, L.

    2006-01-01

    This article examines the relationships between perceptions of authenticity and alignment on study approach and learning outcome. Senior students of a vocational training program performed an authentic assessment and filled in a questionnaire about the authenticity of various assessment

  13. Predictors of student performance on the Pharmacy Curriculum Outcomes Assessment at a new school of pharmacy using admissions and demographic data.

    Science.gov (United States)

    Gillette, Chris; Rudolph, Michael; Rockich-Winston, Nicole; Blough, Eric R; Sizemore, James A; Hao, Jinsong; Booth, Chris; Broedel-Zaugg, Kimberly; Peterson, Megan; Anderson, Stephanie; Riley, Brittany; Train, Brian C; Stanton, Robert B; Anderson, H Glenn

    To characterize student performance on the Pharmacy Curriculum Outcomes Assessment (PCOA) and to determine the significance of specific admissions criteria and pharmacy school performance to predict student performance on the PCOA during the first through third professional years. Multivariate linear regression models were developed to study the relationships between various independent variables and students' PCOA total scores during the first through third professional years. To date, four cohorts have successfully taken the PCOA examination. Results indicate that the Pharmacy College Admissions Test (PCAT), the Health Science Reasoning Test (HSRT), and cumulative pharmacy grade point average were the only consistent significant predictors of higher PCOA total scores across all students who have taken the exam at our school of pharmacy. The school should examine and clarify the role of PCOA within its curricular assessment program. Results suggest that certain admissions criteria and performance in pharmacy school are associated with higher PCOA scores. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. ADMINISTRATOR’S ROLE IN PERFORMANCE BASED REWARD AS A DETERMINANT OF EMPLOYEE OUTCOMES

    Directory of Open Access Journals (Sweden)

    Azman ISMAIL

    2015-06-01

    Full Text Available According to the recent literature pertaining on workplace compensation program, administrators often play two important roles in planning and implementing performance based reward: communication and performance appraisal. Recent studies in this field highlights that the ability of administrators to appropriately communicate pay information and appraise employee performance may have a significant impact on employee outcomes, especially job satisfaction and organizational commitment. Therefore, this study was conducted to assess the relationship between administrator’s role in performance based reward and employee outcomes using self-administered questionnaires collected from employees at a district council in Malaysia. The outcomes of the SmartPLS path model analysis showed that pay communication does not act as an important determinant of job satisfaction, but performance appraisal does act as an important determinant of job satisfaction. Conversely, both pay communication and performance appraisal act as important determinants of organizational commitment. Hence, discussion, implications and conclusion are elaborated.

  15. School Competence and Fluent Academic Performance: Informing Assessment of Educational Outcomes in Survivors of Pediatric Medulloblastoma.

    Science.gov (United States)

    Holland, Alice Ann; Hughes, Carroll W; Stavinoha, Peter L

    2015-01-01

    Academic difficulties are widely acknowledged but not adequately studied in survivors of pediatric medulloblastoma. Although most survivors require special education services and are significantly less likely than healthy peers to finish high school, measured academic skills are typically average. This study sought to identify potential factors associated with academic difficulties in this population and focused on school competence and fluent academic performance. Thirty-six patients (ages 7-18 years old) were recruited through the Departments of Neurosurgery and Neuro-Oncology at Children's Medical Center Dallas and Cook Children's Medical Center in Fort Worth, TX. Participants completed a neuropsychological screening battery including selected Woodcock-Johnson III Tests of Achievement subtests. Parents completed the Child Behavior Checklist. School competence was significantly correlated with measured academic skills and fluency. Basic academic skill development was broadly average, in contrast to significantly worse fluent academic performance. School competence may have utility as a measure estimating levels of educational success in this population. Additionally, academic difficulties experienced by childhood medulloblastoma survivors may be better captured by measuring deficits in fluent academic performance rather than skills. Identification of these potential factors associated with educational outcomes of pediatric medulloblastoma survivors has significant implications for research, clinical assessment, and academic services/interventions.

  16. Systematic Review: Aesthetic Assessment of Breast Reconstruction Outcomes by Healthcare Professionals.

    Science.gov (United States)

    Maass, Saskia W M C; Bagher, Shaghayegh; Hofer, Stefan O P; Baxter, Nancy N; Zhong, Toni

    2015-12-01

    Achieving an aesthetic outcome following postmastectomy breast reconstruction is both an important goal for the patient and plastic surgeon. However, there is currently an absence of a widely accepted, standardized, and validated professional aesthetic assessment scale following postmastectomy breast reconstruction. A systematic review was performed to identify all articles that provided professional assessment of the aesthetic outcome following postmastectomy, implant- or autologous tissue-based breast reconstruction. A modified version of the Scientific Advisory Committee's Medical Outcomes Trust (MOT) criteria was used to evaluate all professional aesthetic assessment scales identified by our systematic review. The criteria included conceptual framework formation, reliability, validity, responsiveness, interpretability, burden, and correlation with patient-reported outcomes. A total of 120 articles were identified: 52 described autologous breast reconstruction, 37 implant-based reconstruction, and 29 both. Of the 12 different professional aesthetic assessment scales that exist in the literature, the most commonly used scale was the four-point professional aesthetic assessment scale. The highest score on the modified MOT criteria was assigned to the ten-point professional aesthetic assessment scale. However, this scale has limited clinical usefulness due to its poor responsiveness to change, lack of interpretability, and wide range of intra- and inter-rater agreements (Veiga et al. in Ann Plast Surg 48(5):515-520, 2002). A "gold standard" professional aesthetic assessment scale needs to be developed to enhance the comparability of breast reconstruction results across techniques, surgeons, and studies to aid with the selection of procedures that produce the best aesthetic results from both the perspectives of the surgeon and patients.

  17. Key Performance Indicators in Irish Hospital Libraries: Developing Outcome-Based Metrics

    Directory of Open Access Journals (Sweden)

    Michelle Dalton

    2012-12-01

    Full Text Available Objective – To develop a set of generic outcome-based performance measures for Irishhospital libraries.Methods – Various models and frameworks of performance measurement were used as atheoretical paradigm to link the impact of library services directly with measurablehealthcare objectives and outcomes. Strategic objectives were identified, mapped toperformance indicators, and finally translated into response choices to a single-questiononline survey for distribution via email.Results – The set of performance indicators represents an impact assessment tool whichis easy to administer across a variety of healthcare settings. In using a model directlyaligned with the mission and goals of the organization, and linked to core activities andoperations in an accountable way, the indicators can also be used as a channel throughwhich to implement action, change, and improvement.Conclusion – The indicators can be adopted at a local and potentially a national level, asboth a tool for advocacy and to assess and improve service delivery at a macro level. Toovercome the constraints posed by necessary simplifications, substantial further research is needed by hospital libraries to develop more sophisticated and meaningful measures of impact to further aid decision making at a micro level.

  18. Assessment of Outcome in Hypospadias Surgery - A Review

    Directory of Open Access Journals (Sweden)

    Alexander eSpringer

    2014-01-01

    Full Text Available Hypospadias is a challenging field of urogenital reconstructive surgery with different techniques being currently used. Modern surgery claims that it is possible to create a functionally and cosmetically normal penis. Continuous reevaluation and assessment of outcome may have a major impact on future clinical practice. Assessment of outcome includes: complication rate, cosmetic appearance of the penis, functional outcome (micturition, sexuality and psychological factors such as quality of life and psychosexual life. This article briefly reviews current strategies of outcome assessment and outlines that in the future long-term assessment should be designed in web-based prospective studies multicenter studies. Somehow in the future we will be able to give an accurate estimation of the long-term consequences of being born with hypospadias.

  19. e-Learning in Advanced Life Support-What factors influence assessment outcome?

    Science.gov (United States)

    Thorne, C J; Lockey, A S; Kimani, P K; Bullock, I; Hampshire, S; Begum-Ali, S; Perkins, G D

    2017-05-01

    To establish variables which are associated with favourable Advanced Life Support (ALS) course assessment outcomes, maximising learning effect. Between 1 January 2013 and 30 June 2014, 8218 individuals participated in a Resuscitation Council (UK) e-learning Advanced Life Support (e-ALS) course. Participants completed 5-8h of online e-learning prior to attending a one day face-to-face course. e-Learning access data were collected through the Learning Management System (LMS). All participants were assessed by a multiple choice questionnaire (MCQ) before and after the face-to-face aspect alongside a practical cardiac arrest simulation (CAS-Test). Participant demographics and assessment outcomes were analysed. The mean post e-learning MCQ score was 83.7 (SD 7.3) and the mean post-course MCQ score was 87.7 (SD 7.9). The first attempt CAS-Test pass rate was 84.6% and overall pass rate 96.6%. Participants with previous ALS experience, ILS experience, or who were a core member of the resuscitation team performed better in the post-course MCQ, CAS-Test and overall assessment. Median time spent on the e-learning was 5.2h (IQR 3.7-7.1). There was a large range in the degree of access to e-learning content. Increased time spent accessing e-learning had no effect on the overall result (OR 0.98, P=0.367) on simulated learning outcome. Clinical experience through membership of cardiac arrest teams and previous ILS or ALS training were independent predictors of performance on the ALS course whilst time spent accessing e-learning materials did not affect course outcomes. This supports the blended approach to e-ALS which allows participants to tailor their e-learning experience to their specific needs. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. 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.

  1. Innovative Outcome Assessment in Graduate Business Education and Continuous Improvement

    Directory of Open Access Journals (Sweden)

    Chattopadhyay Satya P.

    2014-11-01

    Full Text Available The changed environment of global economy with painful austerity and restructuring measures causing severe economic dislocations in many diverse parts of the world have brought into focus the usefulness and value of management education in general and graduate management education in particular. The various accrediting bodies in America, Europe and Asia in recent years have shifted their emphasis to ensuring that learning outcomes of students in the program are tied to the goals and missions of the academic institution and meet the needs of the external partners of the academic enterprise that the students go on to serve. This has resulted in rapid advances in the field of innovative outcome assessment, and measurement of competency in performing higher order tasks as well as demonstration of traits related to successful transition into the business world and contribution to the success of the enterprise where the students are employed. The mere assessment/measurement of traits is not the end, but rather the first step in the cycle of continuous improvement in the tradition of the Plan-Do-Study-Act tradition of TQM. The goal is to identify shortcomings or opportunities for improvement via the assessment process and then to “close the loop” by introducing planned changes to improve system performance.

  2. Can Perceptuo-Motor Skills Assessment Outcomes in Young Table Tennis Players (7-11 years) Predict Future Competition Participation and Performance? An Observational Prospective Study.

    Science.gov (United States)

    Faber, Irene R; Elferink-Gemser, Marije T; Faber, Niels R; Oosterveld, Frits G J; Nijhuis-Van der Sanden, Maria W G

    2016-01-01

    Forecasting future performance in youth table tennis players based on current performance is complex due to, among other things, differences between youth players in growth, development, maturity, context and table tennis experience. Talent development programmes might benefit from an assessment of underlying perceptuo-motor skills for table tennis, which is hypothesized to determine the players' potential concerning the perceptuo-motor domain. The Dutch perceptuo-motor skills assessment intends to measure the perceptuo-motor potential for table tennis in youth players by assessing the underlying skills crucial for developing technical and tactical qualities. Untrained perceptuo-motor tasks are used as these are suggested to represent a player's future potential better than specific sport skills themselves as the latter depend on exposure to the sport itself. This study evaluated the value of the perceptuo-motor skills assessment for a talent developmental programme by evaluating its predictive validity for competition participation and performance in 48 young table tennis players (7-11 years). Players were tested on their perceptuo-motor skills once during a regional talent day, and the subsequent competition results were recorded half-yearly over a period of 2.5 years. Logistic regression analysis showed that test scores did not predict future competition participation (p >0.05). Yet, the Generalized Estimating Equations analysis, including the test items 'aiming at target', 'throwing a ball', and 'eye-hand coordination' in the best fitting model, revealed that the outcomes of the perceptuo-motor skills assessment were significant predictors for future competition results (R2 = 51%). Since the test age influences the perceptuo-motor skills assessment's outcome, another multivariable model was proposed including test age as a covariate (R2 = 53%). This evaluation demonstrates promising prospects for the perceptuo-motor skills assessment to be included in a talent

  3. Can Perceptuo-Motor Skills Assessment Outcomes in Young Table Tennis Players (7-11 years Predict Future Competition Participation and Performance? An Observational Prospective Study.

    Directory of Open Access Journals (Sweden)

    Irene R Faber

    Full Text Available Forecasting future performance in youth table tennis players based on current performance is complex due to, among other things, differences between youth players in growth, development, maturity, context and table tennis experience. Talent development programmes might benefit from an assessment of underlying perceptuo-motor skills for table tennis, which is hypothesized to determine the players' potential concerning the perceptuo-motor domain. The Dutch perceptuo-motor skills assessment intends to measure the perceptuo-motor potential for table tennis in youth players by assessing the underlying skills crucial for developing technical and tactical qualities. Untrained perceptuo-motor tasks are used as these are suggested to represent a player's future potential better than specific sport skills themselves as the latter depend on exposure to the sport itself. This study evaluated the value of the perceptuo-motor skills assessment for a talent developmental programme by evaluating its predictive validity for competition participation and performance in 48 young table tennis players (7-11 years. Players were tested on their perceptuo-motor skills once during a regional talent day, and the subsequent competition results were recorded half-yearly over a period of 2.5 years. Logistic regression analysis showed that test scores did not predict future competition participation (p >0.05. Yet, the Generalized Estimating Equations analysis, including the test items 'aiming at target', 'throwing a ball', and 'eye-hand coordination' in the best fitting model, revealed that the outcomes of the perceptuo-motor skills assessment were significant predictors for future competition results (R2 = 51%. Since the test age influences the perceptuo-motor skills assessment's outcome, another multivariable model was proposed including test age as a covariate (R2 = 53%. This evaluation demonstrates promising prospects for the perceptuo-motor skills assessment to be

  4. Outcomes Assessment in Dental Hygiene Programs.

    Science.gov (United States)

    Grimes, Ellen B.

    1999-01-01

    A survey of 22 dental-hygiene-program directors found that programs routinely and effectively assess student outcomes and use the information for program improvements and to demonstrate accountability. Both policy and faculty/administrative support were deemed important to implementation. Time constraints were a major barrier. Outcomes-assessment…

  5. Risk-adjusted Outcomes of Clinically Relevant Pancreatic Fistula Following Pancreatoduodenectomy: A Model for Performance Evaluation.

    Science.gov (United States)

    McMillan, Matthew T; Soi, Sameer; Asbun, Horacio J; Ball, Chad G; Bassi, Claudio; Beane, Joal D; Behrman, Stephen W; Berger, Adam C; Bloomston, Mark; Callery, Mark P; Christein, John D; Dixon, Elijah; Drebin, Jeffrey A; Castillo, Carlos Fernandez-Del; Fisher, William E; Fong, Zhi Ven; House, Michael G; Hughes, Steven J; Kent, Tara S; Kunstman, John W; Malleo, Giuseppe; Miller, Benjamin C; Salem, Ronald R; Soares, Kevin; Valero, Vicente; Wolfgang, Christopher L; Vollmer, Charles M

    2016-08-01

    To evaluate surgical performance in pancreatoduodenectomy using clinically relevant postoperative pancreatic fistula (CR-POPF) occurrence as a quality indicator. Accurate assessment of surgeon and institutional performance requires (1) standardized definitions for the outcome of interest and (2) a comprehensive risk-adjustment process to control for differences in patient risk. This multinational, retrospective study of 4301 pancreatoduodenectomies involved 55 surgeons at 15 institutions. Risk for CR-POPF was assessed using the previously validated Fistula Risk Score, and pancreatic fistulas were stratified by International Study Group criteria. CR-POPF variability was evaluated and hierarchical regression analysis assessed individual surgeon and institutional performance. There was considerable variability in both CR-POPF risk and occurrence. Factors increasing the risk for CR-POPF development included increasing Fistula Risk Score (odds ratio 1.49 per point, P ratio 3.30, P performance outliers were identified at the surgeon and institutional levels. Of the top 10 surgeons (≥15 cases) for nonrisk-adjusted performance, only 6 remained in this high-performing category following risk adjustment. This analysis of pancreatic fistulas following pancreatoduodenectomy demonstrates considerable variability in both the risk and occurrence of CR-POPF among surgeons and institutions. Disparities in patient risk between providers reinforce the need for comprehensive, risk-adjusted modeling when assessing performance based on procedure-specific complications. Furthermore, beyond inherent patient risk factors, surgical decision-making influences fistula outcomes.

  6. Health systems performance in sub-Saharan Africa: governance, outcome and equity.

    Science.gov (United States)

    Olafsdottir, Anna E; Reidpath, Daniel D; Pokhrel, Subhash; Allotey, Pascale

    2011-04-16

    The literature on health systems focuses largely on the performance of healthcare systems operationalised around indicators such as hospital beds, maternity care and immunisation coverage. A broader definition of health systems however, needs to include the wider determinants of health including, possibly, governance and its relationship to health and health equity. The aim of this study was to examine the relationship between health systems outcomes and equity, and governance as a part of a process to extend the range of indicators used to assess health systems performance. Using cross sectional data from 46 countries in the African region of the World Health Organization, an ecological analysis was conducted to examine the relationship between governance and health systems performance. The data were analysed using multiple linear regression and a standard progressive modelling procedure. The under-five mortality rate (U5MR) was used as the health outcome measure and the ratio of U5MR in the wealthiest and poorest quintiles was used as the measure of health equity. Governance was measured using two contextually relevant indices developed by the Mo Ibrahim Foundation. Governance was strongly associated with U5MR and moderately associated with the U5MR quintile ratio. After controlling for possible confounding by healthcare, finance, education, and water and sanitation, governance remained significantly associated with U5MR. Governance was not, however, significantly associated with equity in U5MR outcomes. This study suggests that the quality of governance may be an important structural determinant of health systems performance, and could be an indicator to be monitored. The association suggests there might be a causal relationship. However, the cross-sectional design, the level of missing data, and the small sample size, forces tentative conclusions. Further research will be needed to assess the causal relationship, and its generalizability beyond U5MR as a health

  7. Health systems performance in sub-Saharan Africa: governance, outcome and equity

    Directory of Open Access Journals (Sweden)

    Pokhrel Subhash

    2011-04-01

    Full Text Available Abstract Background The literature on health systems focuses largely on the performance of healthcare systems operationalised around indicators such as hospital beds, maternity care and immunisation coverage. A broader definition of health systems however, needs to include the wider determinants of health including, possibly, governance and its relationship to health and health equity. The aim of this study was to examine the relationship between health systems outcomes and equity, and governance as a part of a process to extend the range of indicators used to assess health systems performance. Methods Using cross sectional data from 46 countries in the African region of the World Health Organization, an ecological analysis was conducted to examine the relationship between governance and health systems performance. The data were analysed using multiple linear regression and a standard progressive modelling procedure. The under-five mortality rate (U5MR was used as the health outcome measure and the ratio of U5MR in the wealthiest and poorest quintiles was used as the measure of health equity. Governance was measured using two contextually relevant indices developed by the Mo Ibrahim Foundation. Results Governance was strongly associated with U5MR and moderately associated with the U5MR quintile ratio. After controlling for possible confounding by healthcare, finance, education, and water and sanitation, governance remained significantly associated with U5MR. Governance was not, however, significantly associated with equity in U5MR outcomes. Conclusion This study suggests that the quality of governance may be an important structural determinant of health systems performance, and could be an indicator to be monitored. The association suggests there might be a causal relationship. However, the cross-sectional design, the level of missing data, and the small sample size, forces tentative conclusions. Further research will be needed to assess the

  8. Total hip arthroplasty outcomes assessment using functional and radiographic scores to compare canine systems.

    Science.gov (United States)

    Iwata, D; Broun, H C; Black, A P; Preston, C A; Anderson, G I

    2008-01-01

    A retrospective multi-centre study was carried out in order to compare outcomes between cemented and uncemented total hip arthoplasties (THA). A quantitative orthopaedic outcome assessment scoring system was devised in order to relate functional outcome to a numerical score, to allow comparison between treatments and amongst centres. The system combined a radiographic score and a clinical score. Lower scores reflect better outcomes than higher scores. Consecutive cases of THA were included from two specialist practices between July 2002 and December 2005. The study included 46 THA patients (22 uncemented THA followed for 8.3 +/- 4.7M and 24 cemented THA for 26.0 +/- 15.7M) with a mean age of 4.4 +/- 3.3 years at surgery. Multi-variable linear and logistical regression analyses were performed with adjustments for age at surgery, surgeon, follow-up time, uni- versus bilateral disease, gender and body weight. The differences between treatment groups in terms of functional scores or total scores were not significant (p > 0.05). Radiographic scores were different between treatment groups. However, these scores were usually assessed within two months of surgery and proved unreliable predictors of functional outcome (p > 0.05). The findings reflect relatively short-term follow-up, especially for the uncemented group, and do not include clinician-derived measures, such as goniometry and thigh circumference. Longer-term follow-up for the radiographic assessments is essential. A prospective study including the clinician-derived outcomes needs to be performed in order to validate the outcome instrument in its modified form.

  9. Enabling performance skills: Assessment in engineering education

    Science.gov (United States)

    Ferrone, Jenny Kristina

    Current reform in engineering education is part of a national trend emphasizing student learning as well as accountability in instruction. Assessing student performance to demonstrate accountability has become a necessity in academia. In newly adopted criterion proposed by the Accreditation Board for Engineering and Technology (ABET), undergraduates are expected to demonstrate proficiency in outcomes considered essential for graduating engineers. The case study was designed as a formative evaluation of freshman engineering students to assess the perceived effectiveness of performance skills in a design laboratory environment. The mixed methodology used both quantitative and qualitative approaches to assess students' performance skills and congruency among the respondents, based on individual, team, and faculty perceptions of team effectiveness in three ABET areas: Communications Skills. Design Skills, and Teamwork. The findings of the research were used to address future use of the assessment tool and process. The results of the study found statistically significant differences in perceptions of Teamwork Skills (p performance skills, such as teamwork, among freshman engineering students; (2) incorporate feedback into the learning process; (3) strengthen the assessment process with a follow-up plan that specifically targets performance skill deficiencies, and (4) integrate the assessment instrument and practice with ongoing curriculum development. The findings generated by this study provides engineering departments engaged in assessment activity, opportunity to reflect, refine, and develop their programs as it continues. It also extends research on ABET competencies of engineering students in an under-investigated topic of factors correlated with team processes, behavior, and student learning.

  10. Clinical outcomes assessment for the management of sport-related concussion.

    Science.gov (United States)

    Valovich McLeod, Tamara C; Register-Mihalik, Johna K

    2011-02-01

    PATIENT SCENARIO: An adolescent female youth soccer athlete, with a previous concussion history, suffered a second concussion 4 wk ago. Her postconcussive symptoms are affecting her school performance and social and family life. CLINICAL OUTCOMES ASSESSMENT: Concussion is typically evaluated via symptoms, cognition, and balance. There is no specific patient-oriented outcomes measure for concussion. Clinicians can choose from a variety of generic and specific outcomes instruments aimed at assessing general health-related quality of life or various concussion symptoms and comorbidities such as headache, migraine, fatigue, mood disturbances, depression, anxiety, and concussion-related symptoms. CLINICAL DECISION MAKING: The data obtained from patient self-report instruments may not actively help clinicians make return-to-play decisions; however, these scales may be useful in providing information that may help the athlete return to school, work, and social activities. The instruments may also serve to identify issues that may lead to problems down the road, including depression or anxiety, or serve to further explore the nature of an athlete's symptoms. Concussion results in numerous symptoms that have the potential to linger and has been associated with depression and anxiety. The use of outcomes scales to assess health-related quality of life and the effect of other symptoms that present with a concussion may allow clinicians to better evaluate the effects of concussion on physical, cognitive, emotional, social, school, and family issues, leading to better and more complete management.

  11. A method to assess the influence of individual player performance distribution on match outcome in team sports.

    Science.gov (United States)

    Robertson, Sam; Gupta, Ritu; McIntosh, Sam

    2016-10-01

    This study developed a method to determine whether the distribution of individual player performances can be modelled to explain match outcome in team sports, using Australian Rules football as an example. Player-recorded values (converted to a percentage of team total) in 11 commonly reported performance indicators were obtained for all regular season matches played during the 2014 Australian Football League season, with team totals also recorded. Multiple features relating to heuristically determined percentiles for each performance indicator were then extracted for each team and match, along with the outcome (win/loss). A generalised estimating equation model comprising eight key features was developed, explaining match outcome at a median accuracy of 63.9% under 10-fold cross-validation. Lower 75th, 90th and 95th percentile values for team goals and higher 25th and 50th percentile values for disposals were linked with winning. Lower 95th and higher 25th percentile values for Inside 50s and Marks, respectively, were also important contributors. These results provide evidence supporting team strategies which aim to obtain an even spread of goal scorers in Australian Rules football. The method developed in this investigation could be used to quantify the importance of individual contributions to overall team performance in team sports.

  12. DMSA study performed during febrile urinary tract infection: a predictor of patient outcome?

    International Nuclear Information System (INIS)

    Camacho, V.; Estorch, M.; Tembl, A.; Mena, E.; Flotats, A.; Hernandez, Ma.; Fraga, G.; Carrio, I.

    2002-01-01

    DMSA study is an established method for the assessment of renal sequelae after acute pyelonephritis related to febrile urinary tract infection (UTI). However, at the moment is not established if the DMSA study performed during the acute UTI has any prognostic value for outcome assessment. Objectives: to assess the usefulness of DMSA study performed during febrile UTI as predictor of patient outcome. Methods: One hundred-fifty-two children (74 boys) with mean age 20 months (range 1m-12 y) with first febrile UTI were studied by DMSA planar scintigraphy during the acute illness period (first 5 days). All patients had positive grown bacillus in urine (78% E. coli, 8% P. mirabilis), and all followed the same antibiotic treatment. After acute UTI all patients were explored by voiding cysto urethrography for diagnosis of vesicoureteral reflux (VUR). Fifty-seven patients who had an abnormal DMSA study, VUR, or recurrent UTI underwent a DMSA control study (mean 8m after UTI). Results: DMSA study during febrile UTI was normal in 112 children (74%). In 95 of these children, follow-up DMSA studies were not performed due to a good clinical outcome (no VUR, no recurrent UTI). In the remaining 17 patients, follow-up DMSA studies were normal as well. Forty children (26%), who presented focal or diffuse cortical lesions during acute UTI, underwent a DMSA control study. Twenty-six of them presented a normal control DMSA, and 14 (9% of all patients) presented cortical lesions, 10 associated with a high-grade VUR. Fifty-seven children were followed by control DMSA, and no significant correlation between initial and follow-up study was found (κ= 0.250, p<0.007). Conclusion: These results indicate that DMSA study performed during febrile UTI may not be useful as predictor of patient outcome. Voiding cysto urethrography and control DMSA study seem to be more useful to select patients at risk of development of chronic cortical lesions

  13. Faculty Governance and Outcomes Assessment: Compatible or Combustible?

    Science.gov (United States)

    DeBoy, James L.; Monsilovich, Sally B.; DeBoy, Joanne R.

    2013-01-01

    This paper identifies the various factors driving the outcomes assessment movement, contrasts the old paradigm with the model now espoused by regional accreditors, discusses the six-step process of student outcomes assessment, emphasizes faculty ownership of the process to prevent administrative usurpation, and proposes specific strategies to…

  14. DEFINING THE RELEVANT OUTCOME MEASURES IN MEDICAL DEVICE ASSESSMENTS: AN ANALYSIS OF THE DEFINITION PROCESS IN HEALTH TECHNOLOGY ASSESSMENT.

    Science.gov (United States)

    Jacobs, Esther; Antoine, Sunya-Lee; Prediger, Barbara; Neugebauer, Edmund; Eikermann, Michaela

    2017-01-01

    Defining relevant outcome measures for clinical trials on medical devices (MD) is complex, as there is a large variety of potentially relevant outcomes. The chosen outcomes vary widely across clinical trials making the assessment in evidence syntheses very challenging. The objective is to provide an overview on the current common procedures of health technology assessment (HTA) institutions in defining outcome measures in MD trials. In 2012-14, the Web pages of 126 institutions involved in HTA were searched for methodological manuals written in English or German that describe methods for the predefinition process of outcome measures. Additionally, the institutions were contacted by email. Relevant information was extracted. All process steps were performed independently by two reviewers. Twenty-four manuals and ten responses from the email request were included in the analysis. Overall, 88.5 percent of the institutions describe the type of outcomes that should be considered in detail and 84.6 percent agree that the main focus should be on patient relevant outcomes. Specifically related to MD, information could be obtained in 26 percent of the included manuals and email responses. Eleven percent of the institutions report a particular consideration of MD related outcomes. This detailed analysis on common procedures of HTA institutions in the context of defining relevant outcome measures for the assessment of MD shows that standardized procedures for MD from the perspective of HTA institutions are not widespread. This leads to the question if a homogenous approach should be implemented in the field of HTA on MD.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    Patient-reported outcome measures are an important component of outcomes assessment in clinical trials to assess the treatment of femoroacetabular impingement (FAI). This review of disease-specific measures and instruments used to assess the generic quality of life and physical activity levels...... developed recently and have not been established in the literature. Although currently used generic and activity-level measures have limitations, as well, they should be considered, depending on the specific goals of the study. Additional research is needed to assess the properties of these measures fully...

  16. Twelve tips for assessing surgical performance and use of technical assessment scales

    DEFF Research Database (Denmark)

    Strandbygaard, Jeanett; Scheele, Fedde; Sørensen, Jette Led

    2017-01-01

    Using validated assessment scales for technical competence can help structure and standardize assessment and feedback for both the trainee and the supervisor and thereby avoid bias and drive learning. Correct assessment of operative skills can establish learning curves and allow adequate monitoring....... However, the assessment of surgical performance is not an easy task, since it includes many proxy parameters, which are hard to measure. Although numerous technical assessment scales exist, both within laparoscopic and open surgery, the validity evidence is often sparse, and this can raise doubts about...... reliability and educational outcome. Furthermore, the implementation of technical assessment scales varies due to several obstacles and doubts about accurate use. In this 12-tips article, we aim to give the readers a critical and useful appraisal of some of the common questions and misunderstandings regarding...

  17. Effect of Engaging Trainees by Assessing Peer Performance

    DEFF Research Database (Denmark)

    Loumann Krogh, Charlotte; Ringsted, Charlotte; Kromann, Charles B

    2014-01-01

    during training. Outcome measures were in-training performance and performance, both of which were measured two weeks after the course. Trainees' performances were videotaped and assessed by two expert raters using a checklist that included a global rating. Trainees' satisfaction with the training...... was also evaluated. RESULTS: The intervention group obtained a significantly higher overall in-training performance score than the control group: mean checklist score 20.87 (SD 2.51) versus 19.14 (SD 2.65) P = 0.003 and mean global rating 3.25 SD (0.99) versus 2.95 (SD 1.09) P = 0.014. Postcourse...

  18. Outcomes Assessment in Accredited Health Information Management Programs

    Science.gov (United States)

    Bennett, Dorine

    2010-01-01

    The purpose of this study was to determine the use and perceived usefulness of outcomes assessment methods in health information management programs. Additional characteristics of the outcomes assessment practices were recognized. The findings were evaluated for significant differences in results based on age of the program, type of institution,…

  19. Performance Assessment Framework for Private Finance Initiative Projects in Malaysia

    Directory of Open Access Journals (Sweden)

    Lop Nor Suzila

    2016-01-01

    Full Text Available Private Finance Initiative (PFI is viewed as restructuring the previous privatisation concept in delivering value for money for the Malaysian public infrastructure. Among the restructuring efforts in the privatisation is specifying the standard assessment of private concessionaires’ performance through the execution of key performance indicators (KPIs where the private concessionaires’ performance is benchmarked against the government’s standard. KPIs have served as useful tools in assessing performance of PFI projects. However, there is still lacking on determination methods performed to define and measure this KPIs and the absence of guidelines or a framework is also an issue in the implementation of the PFI procurement in Malaysia. Therefore, the objectives of this paper is to investigate the notion of performance assessment model approaches globally (i.e. UK, China, Australia, Serbia and Malaysia and to identify direction for PFI performance assessment tools (KPIs to be practiced in Malaysia. Based on the consideration of these models, this research paper propose an initial framework of performance assessment for PFI projects in Malaysia. The framework is deliberate to cover the performance of PFI at the operation and maintenance phase. The outcomes of this paper can serve as a theoretical base for the development of comprehensive and effective performance assessment for PFI projects in Malaysia.

  20. Performance assessment

    International Nuclear Information System (INIS)

    Doe, T.

    1985-01-01

    The purpose of performance assessment is to show that the repository is expected to serve its stated function - disposing of radioactive waste safely both during operation and for the postclosure period. Performance assessment is a straightforward concept, but its application may be very complicated. The concept of performance assessment has been clarified by the Nuclear Regulatory Commission (NRC) in their Draft Generic Technical Position on Licensing Assessment Methodology for High-Level Waste Geologic Repositories (NRC, 1984). This document has gone a long way toward defining the criteria that the NRC will use to determine whether or not information from site characterization is adequate to meet the regulations of the Nuclear Regulatory Commission and the Environmental Protection Agency (EPA). A favorable determination is required for issuance of a construction authorization, which is the first major regulatory requirement for developing a working repository. It is, therefore, essential that a research program be developed that not only resolves the outstanding technical issues, but also does it in such a way that the results are clearly applicable to the formal performance assessment and licensing procedures. The definitions of performance assessment are reviewed and the current NRC thinking is summarized

  1. PERFORMANCE ASSESSMENT FOR FIELD SPORTS

    Directory of Open Access Journals (Sweden)

    Christopher Carling

    2009-03-01

    Full Text Available DESCRIPTION The book covers the various sport science assessment procedures for sports such as soccer, rugby, field hockey and lacrosse. It provides detailed and clear information about laboratory and field-based methods that can be used to assess and improve both individual and team performance. PURPOSE The book aims to provide a contemporary reference tool for selection of appropriate testing procedures for sports across a range of scientific disciplines. FEATURES The text begins with a chapter on the rationales for performance assessments, the use of technology and the necessity for procedures to conform to scientific rigor, explaining the importance of test criteria. This chapter ends by emphasizing the importance of the feedback process and vital considerations for the practitioner when interpreting the data, selecting which information is most important and how to deliver this back to the athlete or coach in order to deliver a positive performance outcome. The next two chapters focus on psychological assessments with respect to skill acquisition, retention and execution providing a variety of qualitative and quantitative options, underpinned with scientific theory and contextualized in order to improve the understanding of the application of these methods to improve anticipation and decision-making to enhance game intelligence.Chapter 4 provides coverage of match analysis techniques in order to make assessments of technical, tactical and physical performances. Readers learn about a series of methodologies ranging from simplistic pen and paper options through to sophisticated technological systems with some exemplar data also provided. Chapters 5 through 7 cover the physiological based assessments, including aerobic, anaerobic and anthropometric procedures. Each chapter delivers a theoretical opening section before progressing to various assessment options and the authors make great efforts to relate to sport-specific settings. The final

  2. Conducting Systematic Outcome Assessment in Private Addictions Treatment Settings

    Directory of Open Access Journals (Sweden)

    Gerard J Connors

    2017-07-01

    Full Text Available Systematic outcome assessment is central to ascertaining the impact of treatment services and to informing future treatment initiatives. This project was designed to be conducted within the clinical operations of 4 private addictions treatment centers. A structured interview was used to assess patients’ alcohol and other drug use and related variables (on treatment entry and at 1, 3, and 6 months following treatment discharge. The primary outcomes were percentage of days abstinent (PDA from alcohol and drugs, PDA from alcohol, and PDA from other drugs. Collateral reports during follow-up also were gathered. A total of 280 patients (56% men across the 4 programs participated. Percentage of days abstinent for each outcome increased significantly from baseline to the 1-month follow-up assessment, and this change was maintained at the 3- and 6-month follow-up assessments. Collateral reports mirrored the patient follow-up reports. Secondary outcomes of patient ratings of urges/cravings, depression, anxiety, and general life functioning all indicated significant improvement from baseline over the course of the follow-up. The results suggest the feasibility of conducting systematic outcome assessment in freestanding private addictions treatment environments.

  3. Can Perceptuo-Motor Skills Assessment Outcomes in Young Table Tennis Players (7–11 years) Predict Future Competition Participation and Performance? An Observational Prospective Study

    Science.gov (United States)

    2016-01-01

    Forecasting future performance in youth table tennis players based on current performance is complex due to, among other things, differences between youth players in growth, development, maturity, context and table tennis experience. Talent development programmes might benefit from an assessment of underlying perceptuo-motor skills for table tennis, which is hypothesized to determine the players’ potential concerning the perceptuo-motor domain. The Dutch perceptuo-motor skills assessment intends to measure the perceptuo-motor potential for table tennis in youth players by assessing the underlying skills crucial for developing technical and tactical qualities. Untrained perceptuo-motor tasks are used as these are suggested to represent a player’s future potential better than specific sport skills themselves as the latter depend on exposure to the sport itself. This study evaluated the value of the perceptuo-motor skills assessment for a talent developmental programme by evaluating its predictive validity for competition participation and performance in 48 young table tennis players (7–11 years). Players were tested on their perceptuo-motor skills once during a regional talent day, and the subsequent competition results were recorded half-yearly over a period of 2.5 years. Logistic regression analysis showed that test scores did not predict future competition participation (p >0.05). Yet, the Generalized Estimating Equations analysis, including the test items ‘aiming at target’, ‘throwing a ball’, and ‘eye-hand coordination’ in the best fitting model, revealed that the outcomes of the perceptuo-motor skills assessment were significant predictors for future competition results (R2 = 51%). Since the test age influences the perceptuo-motor skills assessment’s outcome, another multivariable model was proposed including test age as a covariate (R2 = 53%). This evaluation demonstrates promising prospects for the perceptuo-motor skills assessment to be

  4. Subjective versus objective assessment in early clinical outcome of modified Lapidus procedure for hallux valgus deformity.

    Science.gov (United States)

    Chopra, S; Moerenhout, K; Crevoisier, X

    2016-02-01

    Studies have assessed the outcome of hallux valgus surgeries based on subjective questionnaires, usually the American Orthopaedic Foot and Ankle Society Score, and radiographic results reporting good to excellent outcome at 6-12 months postoperatively. However, contrasting results were reported by gait studies at 12-24 months postoperatively. In a previous study, we found nine gait parameters which can describe the altered gait in hallux valgus deformity. This study aimed, to assess the outcome of modified Lapidus at 6 months postoperatively, using gait assessment method, to determine if the nine specified gait parameters effectively relates with the clinical scores and the radiological results or add information missed by these commonly used clinical assessments. We assessed 21 participants including 11 controls and 10 patients with moderate to severe hallux valgus deformity. The patient group was followed 6 months postoperatively. The ambulatory gait assessment was performed utilizing pressure insoles and inertial sensors. Clinical assessment includes foot and ankle questionnaires along with radiographic results. Comparison was made using non parametric tests, Phallux valgus surgeries. The existing clinical assessment overestimates the functional outcome at the early postoperative phase. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. 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

  6. Does Mother Know Best? Parental Discrepancies in Assessing Child Behavioral and Educational Outcomes

    DEFF Research Database (Denmark)

    Gupta, Nabanita Datta; Lausten, Mette; Pozzoli, Dario

    2018-01-01

    We investigate the degree of correspondence between parents’ reports on child behavioral and educational outcomes using wave four of a rich Danish longitudinal survey of children (the DALSC). All outcomes are measured at age 11 when the children are expected to be in fifth grade. Once discrepancies...... are detected, we analyze whether they are driven by noisy evaluations or by systematic bias, focusing on the role of parental characteristics and response heterogeneity. We then explicitly assess the relative importance of the mother’s versus the father’s assessments in explaining child academic performance...... and diagnosed mental health to investigate whether one parent is systematically a better informant of their child’s outcomes than the other. Our results show that parental psychopathology, measured as maternal distress, is a source of systematic misreporting of child functioning, that the parent–child...

  7. Assessment of COPD-related outcomes via a national electronic medical record database.

    Science.gov (United States)

    Asche, Carl; Said, Quayyim; Joish, Vijay; Hall, Charles Oaxaca; Brixner, Diana

    2008-01-01

    The technology and sophistication of healthcare utilization databases have expanded over the last decade to include results of lab tests, vital signs, and other clinical information. This review provides an assessment of the methodological and analytical challenges of conducting chronic obstructive pulmonary disease (COPD) outcomes research in a national electronic medical records (EMR) dataset and its potential application towards the assessment of national health policy issues, as well as a description of the challenges or limitations. An EMR database and its application to measuring outcomes for COPD are described. The ability to measure adherence to the COPD evidence-based practice guidelines, generated by the NIH and HEDIS quality indicators, in this database was examined. Case studies, before and after their publication, were used to assess the adherence to guidelines and gauge the conformity to quality indicators. EMR was the only source of information for pulmonary function tests, but low frequency in ordering by primary care was an issue. The EMR data can be used to explore impact of variation in healthcare provision on clinical outcomes. The EMR database permits access to specific lab data and biometric information. The richness and depth of information on "real world" use of health services for large population-based analytical studies at relatively low cost render such databases an attractive resource for outcomes research. Various sources of information exist to perform outcomes research. It is important to understand the desired endpoints of such research and choose the appropriate database source.

  8. Development and application of course-embedded assessment system for program outcome evaluation in the Korean nursing education: A pilot study.

    Science.gov (United States)

    Park, Jee Won; Seo, Eun Ji; You, Mi-Ae; Song, Ju-Eun

    2016-03-01

    Program outcome evaluation is important because it is an indicator for good quality of education. Course-embedded assessment is one of the program outcome evaluation methods. However, it is rarely used in Korean nursing education. The study purpose was to develop and apply preliminarily a course-embedded assessment system to evaluate one program outcome and to share our experiences. This was a methodological study to develop and apply the course-embedded assessment system based on the theoretical framework in one nursing program in South Korea. Scores for 77 students generated from the three practicum courses were used. The course-embedded assessment system was developed following the six steps suggested by Han's model as follows. 1) One program outcome in the undergraduate program, "nursing process application ability", was selected and 2) the three clinical practicum courses related to the selected program outcome were identified. 3) Evaluation tools including rubric and items were selected for outcome measurement and 4) performance criterion, the educational goal level for the program, was established. 5) Program outcome was actually evaluated using the rubric and evaluation items in the three practicum courses and 6) the obtained scores were analyzed to identify the achievement rate, which was compared with the performance criterion. Achievement rates for the selected program outcome in adult, maternity, and pediatric nursing practicum were 98.7%, 100%, and 66.2% in the case report and 100% for all three in the clinical practice, and 100%, 100%, and 87% respectively for the conference. These are considered as satisfactory levels when compared with the performance criterion of "at least 60% or more". Course-embedded assessment can be used as an effective and economic method to evaluate the program outcome without running an integrative course additionally. Further studies to develop course-embedded assessment systems for other program outcomes in nursing

  9. Objective Integrated Assessment of Functional Outcomes in Reduction Mammaplasty

    Science.gov (United States)

    Passaro, Ilaria; Malovini, Alberto; Faga, Angela; Toffola, Elena Dalla

    2013-01-01

    Background: The aim of our study was an objective integrated assessment of the functional outcomes of reduction mammaplasty. Methods: The study involved 17 women undergoing reduction mammaplasty from March 2009 to June 2011. Each patient was assessed before surgery and 2 months postoperatively with the original association of 4 subjective and objective assessment methods: a physiatric clinical examination, the Roland Morris Disability Questionnaire, the Berg Balance Scale, and a static force platform analysis. Results: All of the tests proved multiple statistically significant associated outcomes demonstrating a significant improvement in the functional status following reduction mammaplasty. Surgical correction of breast hypertrophy could achieve both spinal pain relief and recovery of performance status in everyday life tasks, owing to a muscular postural functional rearrangement with a consistent antigravity muscle activity sparing. Pain reduction in turn could reduce the antalgic stiffness and improved the spinal range of motion. In our sample, the improvement of the spinal range of motion in flexion matched a similar improvement in extension. Recovery of a more favorable postural pattern with reduction of the anterior imbalance was demonstrated by the static force stabilometry. Therefore, postoperatively, all of our patients narrowed the gap between the actual body barycenter and the ideal one. The static force platform assessment also consistently confirmed the effectiveness of an accurate clinical examination of functional impairment from breast hypertrophy. Conclusions: The static force platform assessment might help the clinician to support the diagnosis of functional impairment from a breast hypertrophy with objectively based data. PMID:25289256

  10. An ecologically valid performance-based social functioning assessment battery for schizophrenia.

    Science.gov (United States)

    Shi, Chuan; He, Yi; Cheung, Eric F C; Yu, Xin; Chan, Raymond C K

    2013-12-30

    Psychiatrists pay more attention to the social functioning outcome of schizophrenia nowadays. How to evaluate the real world function among schizophrenia is a challenging task due to culture difference, there is no such kind of instrument in terms of the Chinese setting. This study aimed to report the validation of an ecologically valid performance-based everyday functioning assessment for schizophrenia, namely the Beijing Performance-based Functional Ecological Test (BJ-PERFECT). Fifty community-dwelling adults with schizophrenia and 37 healthy controls were recruited. Fifteen of the healthy controls were re-tested one week later. All participants were administered the University of California, San Diego, Performance-based Skill Assessment-Brief version (UPSA-B) and the MATRICS Consensus Cognitive Battery (MCCB). The finalized assessment included three subdomains: transportation, financial management and work ability. The test-retest and inter-rater reliabilities were good. The total score significantly correlated with the UPSA-B. The performance of individuals with schizophrenia was significantly more impaired than healthy controls, especially in the domain of work ability. Among individuals with schizophrenia, functional outcome was influenced by premorbid functioning, negative symptoms and neurocognition such as processing speed, visual learning and attention/vigilance. © 2013 Elsevier Ireland Ltd. All rights reserved.

  11. Instrument development and evaluation for patient-related outcomes assessments

    Directory of Open Access Journals (Sweden)

    Farnik M

    2012-03-01

    Full Text Available Małgorzata Farnik, Władysław PierzchałaDepartment of Pneumonology, Silesian University of Medicine, Katowice, PolandAbstract: Patient-related outcomes measures could provide important information for the current state of the art in medical care and even have an impact on macrodecisions in the health care system. Patient-related outcomes were initially defined as subjective health indicators that allow disability and illness to be assessed, based on patient, caregiver, or physician self-reports. As illness involves psychological and behavioral complex processes of care, a multidisciplinary approach in measuring patient-reported outcomes should be recommended, such as quality of life questionnaires. Patient-related outcomes measures should correspond to specific clinical situations and bring opportunities to improve quality of care. Objective measurements enable quantitative data to be collected and analyzed. Depending on the aim of the research, investigators can use existing methods or develop new tools. This publication presents a methodology for developing patient-related outcomes measures, based on a multistage procedure. The proper definition of specific study objectives and the methodology of instrument development are crucial for successfully transferring the study concept. The model of instrument development is the process of starting from the preliminary phase and includes questionnaire design and scaling, pilot testing (cognitive debriefing, revision of the preliminary version, evaluation of the new tool, and implementation. Validation of the new instrument includes reliability, reproducibility, internal consistency, and responsiveness. The process of designing the new tool should involve a panel of experts, including clinicians, psychologists (preliminary phase, and statisticians (scale development and scoring, and patients (cognitive debriefing. Implementation of a new tool should be followed by evaluation study – assessment of

  12. 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.

  13. 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.

  14. A Perspective on Student Learning Outcome Assessment at Qatar University

    Science.gov (United States)

    Al-Thani, Shaikha Jabor; Abdelmoneim, Ali; Daoud, Khaled; Cherif, Adel; Moukarzel, Dalal

    2014-01-01

    This paper provides a unique perspective on the student learning outcome assessment process as adopted and implemented at Qatar University from 2006 to 2012. The progress of the student learning outcome assessment and continuous improvement efforts at the university and the initiatives taken to establish a culture of assessment and evidence-based…

  15. Does performance status influence the outcome of Nd:YAG laser therapy of proximal esophageal tumors?

    NARCIS (Netherlands)

    Alexander, G. L.; Wang, K. K.; Ahlquist, D. A.; Viggiano, T. R.; Gostout, C. J.; Balm, R.

    1994-01-01

    The value of endoscopic palliative therapy for malignant obstruction in the proximal esophagus has been questioned. To assess the importance of pre-treatment performance status on treatment outcome, we reviewed the records of patients with tumors of the proximal esophagus undergoing endoscopic laser

  16. 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

    , Neck Disability Index, and 30-Meter Walk Test are most appropriate for the assessment of CSM. However, 6 additional outcome measures (QuickDASH, Berg Balance Scale, Graded Redefined Assessment of Strength Sensibility and Prehension, Grip Dynamometer, and GAITRite Analysis) were identified, which provide complementary assessments for CSM. SUMMARY STATEMENTS: There does not exist a single or composite of outcome instruments that measures myelopathy impairment, function/disability, and participation that have also demonstrated reliability, validity, and responsiveness in a CSM population. More work in the development and psychometric evaluation of new or existing measures is necessary to identify the ideal composite of measures to be used in the clinical and research settings. The mJOA, Nurick grade, NDI, MDI, and 30MWT should be adopted in any clinical practice that treats CSM both for screening and clinical follow-up. We propose that clinicians and researchers consider using the ancillary measures identified, such as the QuickDASH, Berg Balance Scale, GRASSP version 1.0, Grip Strength, and GAITRite Analysis. It is highly recommended that baseline and follow-up measurements should be performed in patients with CSM.

  17. The effects of kinesiotape on athletic-based performance outcomes in healthy, active individuals: a literature synthesis

    Science.gov (United States)

    Drouin, Jillian L.; McAlpine, Caitlin T.; Primak, Kari A.; Kissel, Jaclyn

    2013-01-01

    Context: The effect of the application of kinesiotape to skin overlying musculature on measurable athletic-based performance outcomes in healthy individuals has not been well established. Objective: To systematically search and assess the quality of the literature on the effect of kinesiotape on athletic-based performance outcomes in healthy, active individuals. Methods: An electronic search strategy was conducted in MANTIS, Cochrane Library and EBSCO databases. Retrieved articles that met the eligibility criteria were rated for methodological quality by using an adaption of the critical appraisal criteria in Clinical Epidemiology by Sackett et al. Results: Ten articles met the inclusion criteria. Seven articles had positive results in at least one athletic-based performance measure compared to controls. Conclusion: Evidence is lacking to support the use of kinesiotape as a successful measure for improving athletic-based performance outcomes in healthy individuals. However, there is no evidence to show that kinesiotape has a negative effect on any of the performace measures. PMID:24302784

  18. Assessing the performance of prediction models: a framework for traditional and novel measures

    DEFF Research Database (Denmark)

    Steyerberg, Ewout W; Vickers, Andrew J; Cook, Nancy R

    2010-01-01

    The performance of prediction models can be assessed using a variety of methods and metrics. Traditional measures for binary and survival outcomes include the Brier score to indicate overall model performance, the concordance (or c) statistic for discriminative ability (or area under the receiver...

  19. Assessing the performance of prediction models: A framework for traditional and novel measures

    NARCIS (Netherlands)

    E.W. Steyerberg (Ewout); A.J. Vickers (Andrew); N.R. Cook (Nancy); T.A. Gerds (Thomas); M. Gonen (Mithat); N. Obuchowski (Nancy); M. Pencina (Michael); M.W. Kattan (Michael)

    2010-01-01

    textabstractThe performance of prediction models can be assessed using a variety of methods and metrics. Traditional measures for binary and survival outcomes include the Brier score to indicate overall model performance, the concordance (or c) statistic for discriminative ability (or area under the

  20. Complex Situational Tasks in Assessment of Educational Outcomes in “Psychological Assessment of Students” Module of the Master’s Programme in School Psychology

    Directory of Open Access Journals (Sweden)

    Andruschenko T.Y.,

    2016-12-01

    Full Text Available The paper discusses the content of midterm performance evaluation of graduate students within the “Psychological Assessment” module of the master’s programme in School Psychology and focuses on the logic of the module’s design in relation to the professional standard in Educational Psychology. Complex situational tasks are considered in the modular program as the main means of assessing educational outcomes. The content of these tasks is determined by a range of diagnostic situations and closely corresponds with the real-life practice of educational psychologists. Setting complex situational tasks is related to a number of components of the educational psychologist’s professional activity in the field of psychological assessment, such as: planning the sequence of professional actions; ensuring the methodological background for assessment; taking into account deontological aspects of communication with assessed individuals; carrying out professional actions; reflecting on the process and outcomes of assessment. The paper analyses the place and role of graduate students’ self-assessment in finding solutions to complex situational tasks and offers a description of one such task that can be used in midterm performance evaluation of graduate students.

  1. Outcome-based ventilation: A framework for assessing performance, health, and energy impacts to inform office building ventilation decisions.

    Science.gov (United States)

    Rackes, A; Ben-David, T; Waring, M S

    2018-04-23

    This article presents an outcome-based ventilation (OBV) framework, which combines competing ventilation impacts into a monetized loss function ($/occ/h) used to inform ventilation rate decisions. The OBV framework, developed for U.S. offices, considers six outcomes of increasing ventilation: profitable outcomes realized from improvements in occupant work performance and sick leave absenteeism; health outcomes from occupant exposure to outdoor fine particles and ozone; and energy outcomes from electricity and natural gas usage. We used the literature to set low, medium, and high reference values for OBV loss function parameters, and evaluated the framework and outcome-based ventilation rates using a simulated U.S. office stock dataset and a case study in New York City. With parameters for all outcomes set at medium values derived from literature-based central estimates, higher ventilation rates' profitable benefits dominated negative health and energy impacts, and the OBV framework suggested ventilation should be ≥45 L/s/occ, much higher than the baseline ~8.5 L/s/occ rate prescribed by ASHRAE 62.1. Only when combining very low parameter estimates for profitable impacts with very high ones for health and energy impacts were all outcomes on the same order. Even then, however, outcome-based ventilation rates were often twice the baseline rate or more. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Assessing local outcomes in heterogeneous gliomas

    International Nuclear Information System (INIS)

    Dowson, Nicholas; Bourgeat, Pierrick; Salvado, Olivier; Rose, Stephen; Thomas, Paul; Fay, Michael; Jeffree, Rosalind L; Winter, Craig; Coulthard, Alan; Smith, Jye; Gal, Yaniv; Crozier, Stuart

    2014-01-01

    Tumours are known to be heterogeneous, yet typical treatment plans consider them as a single unit. This may influence treatment outcomes. However, treatment cannot be customised to intra-tumour variation without a method to establish outcomes at an intra-tumour scale. This work proposes a method to both assess and measure outcomes locally within tumours. Methods: Four patients were scanned at two post-surgery time points using contrast enhanced MRI and 3,4-dihydroxy-6-[18F]-fluoro-L-phenylalanine (18F-DOPA) PET. The shell of active tumour tissue is divided into a set of small subregions at both time points. Local outcome is measured from changes in subregion volume over time. The utility of the proposed approach is evaluated by measuring the correlation between PET uptake and documented growth. Correlation with overall survival time was also examined. Results: Local outcomes were heterogeneous and evidence of a positive correlation between local 18F-DOPA uptake and local progression was observed. Conclusions: Given that intra-tumour outcomes are heterogeneous the consistently positive correlation between FDOPA uptake and progression, local analysis of tumours could prove useful for treatment planning.

  3. Assessing Treatment Outcomes in Attention-Deficit/Hyperactivity Disorder: A Narrative Review

    Science.gov (United States)

    Weiss, Margaret D.

    2012-01-01

    Objective: To review measures used to assess treatment response in patients with attention-deficit/hyperactivity disorder (ADHD) across the life span. Data Sources: Keyword searches of English-language articles in the PubMed database up to and including the May 4, 2011, index date were performed with the search strings (1) (attention deficit disorder with hyperactivity [MeSH] OR ADHD) AND (outcome assessment [MeSH] OR adaptation of life skills OR executive function [MeSH]) and (2) (attention deficit disorder with hyperactivity [MeSH] OR ADHD) AND (function OR functioning OR quality of life [MeSH]). Study Selection: Articles found through this search were then selected based on relevance to the topic area; no specific quality criteria were applied. Data Extraction: Narrative review. Results: The vast majority of studies assessing ADHD treatments have measured treatment response using ADHD symptom measures. Additional domains relevant for assessing treatment response among children and adults with ADHD include functional impairment, quality of life, adaptive life skills, and executive function. Validated rating scales exist for assessing these additional domains, but there has been minimal research evaluating the sensitivity of these instruments for detecting treatment response in pediatric and adult samples. Conclusions: Assessment of treatment outcomes in ADHD should move beyond symptom assessment to incorporate measures of functioning, quality of life, adaptive skills, and executive function, especially when assessing long-term treatment response. The authors recommend a potential battery and schedule of measures that could be used to more comprehensively assess treatment response in patients with ADHD. PMID:23585986

  4. Assessments in outcome evaluation in aphasia therapy

    DEFF Research Database (Denmark)

    Isaksen, Jytte; Brouwer, Catherine E.

    2015-01-01

    Abstract Outcomes of aphasia therapy in Denmark are documented in evaluation sessions in which both the person with aphasia and the speech-language therapist take part. The participants negotiate agreements on the results of therapy. By means of conversation analysis, we study how such agreements...... on therapy outcome are reached interactionally. The sequential analysis of 34 video recordings focuses on a recurrent method for reaching agreements in these outcome evaluation sessions. In and through a special sequence of conversational assessment it is claimed that the person with aphasia has certain...

  5. The Brief Symptom Inventory and the Outcome Questionnaire-45 in the Assessment of the Outcome Quality of Mental Health Interventions

    Directory of Open Access Journals (Sweden)

    Aureliano Crameri

    2016-01-01

    Full Text Available Self-report questionnaires are economical instruments for routine outcome assessment. In this study, the performance of the German version of the Outcome Questionnaire-45 (OQ-45 and the Brief Symptom Inventory (BSI was evaluated when applied in analysis of the outcome quality of psychiatric and psychotherapeutic interventions. Pre-post data from two inpatient samples (N=5711 and one outpatient sample (N=239 were analyzed. Critical differences (reliable change index and cut-off points between functional and dysfunctional populations were calculated using the Jacobson and Truax method of calculating clinical significance. Overall, the results indicated that the BSI was more accurate than the OQ-45 in correctly classifying patients as clinical subjects. Nonetheless, even with the BSI, about 25% of inpatients with schizophrenia attained a score at admission below the clinical cut-off. Both questionnaires exhibited the highest sensitivity to psychopathology with patients with personality disorders. When considering the differences in the prescores, both questionnaires showed the same sensitivity to change. The advantage of using these self-report measures is observed primarily in assessing outpatient psychotherapy outcome. In an inpatient setting two main problems—namely, the low response rate and the scarce sensitivity to psychopathology with severely ill patients—limit the usability of self-report questionnaires.

  6. Performance Assessments: A Review of Definitions, Quality Characteristics, and Outcomes Associated with Their Use in K-12 Schools

    Science.gov (United States)

    Bland, Lynne M.; Gareis, Christopher R.

    2018-01-01

    After nearly two decades of federal and state accountability requirements relying on conventional standardized assessments, Virginia and several other states are moving to create more balanced approaches to statewide assessment systems that include the use of performance assessments. But Palm (2008) states, "Performance assessment can mean…

  7. Assessing learning outcomes and cost effectiveness of an online sleep curriculum for medical students.

    Science.gov (United States)

    Bandla, Hari; Franco, Rose A; Simpson, Deborah; Brennan, Kimberly; McKanry, Jennifer; Bragg, Dawn

    2012-08-15

    Sleep disorders are highly prevalent across all age groups but often remain undiagnosed and untreated, resulting in significant health consequences. To overcome an inadequacy of available curricula and learner and instructor time constraints, this study sought to determine if an online sleep medicine curriculum would achieve equivalent learner outcomes when compared with traditional, classroom-based, face-to-face instruction at equivalent costs. Medical students rotating on a required clinical clerkship received instruction in 4 core clinical sleep-medicine competency domains in 1 of 2 delivery formats: a single 2.5-hour face-to-face workshop or 4 asynchronous e-learning modules. Immediate learning outcomes were assessed in a subsequent clerkship using a multiple-choice examination and standardized patient station, with long-term outcomes assessed through analysis of students' patient write-ups for inclusion of sleep complaints and diagnoses before and after the intervention. Instructional costs by delivery format were tracked. Descriptive and inferential statistical analyses compared learning outcomes and costs by instructional delivery method (face-to-face versus e-learning). Face-to-face learners, compared with online learners, were more satisfied with instruction. Learning outcomes (i.e., multiple-choice examination, standardized patient encounter, patient write-up), as measured by short-term and long-term assessments, were roughly equivalent. Design, delivery, and learner-assessment costs by format were equivalent at the end of 1 year, due to higher ongoing teaching costs associated with face-to-face learning offsetting online development and delivery costs. Because short-term and long-term learner performance outcomes were roughly equivalent, based on delivery method, the cost effectiveness of online learning is an economically and educationally viable instruction platform for clinical clerkships.

  8. Comparison of Outcome of Students' Performance Using the ...

    African Journals Online (AJOL)

    This study compared the outcome of students' performance using the standard setting method with the equivalent outcome they would have obtained using the absolute grading method. It involved the comparison of fail, pass, honors and distinction grades in Digestive System, Endocrine System, Cardiovascular System and ...

  9. Effect of Engaging Trainees by Assessing Peer Performance: A Randomised Controlled Trial Using Simulated Patient Scenarios

    Directory of Open Access Journals (Sweden)

    Charlotte Loumann Krogh

    2014-01-01

    Full Text Available Introduction. The aim of this study was to explore the learning effect of engaging trainees by assessing peer performance during simulation-based training. Methods. Eighty-four final year medical students participated in the study. The intervention involved trainees assessing peer performance during training. Outcome measures were in-training performance and performance, both of which were measured two weeks after the course. Trainees’ performances were videotaped and assessed by two expert raters using a checklist that included a global rating. Trainees’ satisfaction with the training was also evaluated. Results. The intervention group obtained a significantly higher overall in-training performance score than the control group: mean checklist score 20.87 (SD 2.51 versus 19.14 (SD 2.65 P=0.003 and mean global rating 3.25 SD (0.99 versus 2.95 (SD 1.09 P=0.014. Postcourse performance did not show any significant difference between the two groups. Trainees who assessed peer performance were more satisfied with the training than those who did not: mean 6.36 (SD 1.00 versus 5.74 (SD 1.33 P=0.025. Conclusion. Engaging trainees in the assessment of peer performance had an immediate effect on in-training performance, but not on the learning outcome measured two weeks later. Trainees had a positive attitude towards the training format.

  10. Clinical and economic outcomes assessment in nuclear cardiology

    International Nuclear Information System (INIS)

    Shaw, L.J.; Miller, D.D.; Berman, D.S.; Hachamovitch, R.

    2000-01-01

    The future of nuclear medicine procedures, as understood within our current economic climate, depends upon its ability to provide relevant clinical information at similar or lower comparative costs. With an ever-increasing emphasis on cost containment, outcome assessment forms the basis of preserving the quality of patient care. Today, outcomes assessment encompasses a wide array of subjects including clinical, economic, and humanistic (i.e., quality of life) outcomes. For nuclear cardiology, evidence-based medicine would require a threshold level of evidence in order to justify the added cost of any test in a patient's work-up. This evidence would include large multicenter, observational series as well as randomized trial data in sufficiently large and diverse patient populations. The new movement in evidence-based medicine is also being applied to the introduction of new technologies, in particular when comparative modalities exist. In the past 5 years, it has seen a dramatic shift in the quality of outcomes data published in nuclear cardiology. This includes the use of statistically rigorous risk-adjusted techniques as well as large populations (i.e., >500 patients) representing multiple diverse medical care settings. This has been the direct result of the development of multiple outcomes databases that have now amassed thousands of patients worth of data. One of the benefits of examining outcomes in large patient datasets is the ability to assess individual endpoints (e.g., cardiac death) as compared with smaller datasets that often assess combined endpoints (e.g., death, myocardial infarction, or unstable angina). New technologies for the diagnosis of coronary artery disease have contributed to the rising costs of care. In the United States and in Europe, costs of care have risen dramatically, consuming an ever-increasing amount of available resources. The overuse of diagnostic angiography often leads to unnecessary revascularization that does not lead to

  11. United States Air Force Academy Educational Outcomes Assessment Working Group. Phase 2

    National Research Council Canada - National Science Library

    Porter, David

    1997-01-01

    This publication provides an account of educational outcomes assessment activity undertaken by seven assessment teams under the Phase II Charter of the Dean of the Faculty's Educational Outcomes Assessment Working Group...

  12. Evaluating and Enhancing Outcomes Assessment Quality in Higher Education Programs

    Science.gov (United States)

    Wolf, Kenneth; Goodwin, Laura

    2007-01-01

    Accreditation is a mark of distinction indicating that an institution has met high standards set by the profession, and an increasingly important feature of the accreditation process in higher education is "outcomes assessment." This article presents two rubrics for evaluating the quality of an institution's outcomes assessment system. One rubric…

  13. Boredom in Achievement Settings: Exploring Control-Value Antecedents and Performance Outcomes of a Neglected Emotion

    Science.gov (United States)

    Pekrun, Reinhard; Goetz, Thomas; Daniels, Lia M.; Stupnisky, Robert H.; Perry, Raymond P.

    2010-01-01

    The linkages of achievement-related boredom with students' appraisals and performance outcomes were examined in a series of 5 exploratory, cross-sectional, and predictive investigations. Studies 1 and 2 assessed students' boredom in a single achievement episode (i.e., state achievement boredom); Studies 3, 4, and 5 focused on their habitual…

  14. Can Preoperative Psychological Assessment Predict Outcomes After Temporomandibular Joint Arthroscopy?

    Science.gov (United States)

    Bouloux, Gary F; Zerweck, Ashley G; Celano, Marianne; Dai, Tian; Easley, Kirk A

    2015-11-01

    Psychological assessment has been used successfully to predict patient outcomes after cardiothoracic and bariatric surgery. The purpose of this study was to determine whether preoperative psychological assessment could be used to predict patient outcomes after temporomandibular joint arthroscopy. Consecutive patients with temporomandibular dysfunction (TMD) who could benefit from arthroscopy were enrolled in a prospective cohort study. All patients completed the Millon Behavior Medicine Diagnostic survey before surgery. The primary predictor variable was the preoperative psychological scores. The primary outcome variable was the difference in pain between the pre- and postoperative periods. The Spearman rank correlation coefficient and the Pearson product-moment correlation were used to determine the association between psychological factors and change in pain. Univariable and multivariable analyses were performed using a mixed-effects linear model and multiple linear regression. A P value of .05 was considered significant. Eighty-six patients were enrolled in the study. Seventy-five patients completed the study and were included in the final analyses. The mean change in visual analog scale (VAS) pain score 1 month after arthroscopy was -15.4 points (95% confidence interval, -6.0 to -24.7; P psychological factors was identified with univariable correlation analyses. Multivariable analyses identified that a greater pain decrease was associated with a longer duration of preoperative symptoms (P = .054) and lower chronic anxiety (P = .064). This study has identified a weak association between chronic anxiety and the magnitude of pain decrease after arthroscopy for TMD. Further studies are needed to clarify the role of chronic anxiety in the outcome after surgical procedures for the treatment of TMD. Copyright © 2015. Published by Elsevier Inc.

  15. International cross-cultural validation study of the Canadian haemophilia outcomes: kids' life assessment tool.

    Science.gov (United States)

    McCusker, P J; Fischer, K; Holzhauer, S; Meunier, S; Altisent, C; Grainger, J D; Blanchette, V S; Burke, T A; Wakefield, C; Young, N L

    2015-05-01

    Health-related quality of life (HRQoL) assessment is recognized as an important outcome in the evaluation of different therapeutic regimens for persons with haemophilia. The Canadian Haemophilia Outcomes-Kids' Life Assessment Tool (CHO-KLAT) is a disease-specific measure of HRQoL for 4 to 18-year-old boys with haemophilia. The purpose of this study was to extend this disease-specific, child-centric, outcome measure for use in international clinical trials. We adapted the North American English CHO-KLAT version for use in five countries: France, Germany, the Netherlands, Spain and the United Kingdom (UK). The process included four stages: (i) translation; (ii) cognitive debriefing; (iii) validity assessment relative to the PedsQL (generic) and the Haemo-QoL (disease-specific) and (iv) assessment of inter and intra-rater reliability. Cognitive debriefing was performed in 57 boys (mean age 11.4 years), validation was performed in 144 boys (mean age 11.0 years) and reliability was assessed for a subgroup of 64 boys (mean age 12.0 years). Parents also participated. The mean scores reported by the boys were high: CHO-KLAT 77.0 (SD = 11.2); PedsQL 83.8 (SD = 11.9) and Haemo-QoL 79.6 (SD = 11.5). Correlations between the CHO-KLAT and PedsQL ranged from 0.63 in Germany to 0.39 in the Netherlands and Spain. Test-retest reliability (concordance) for child self-report was 0.67. Child-parent concordance was slightly lower at 0.57. The CHO-KLAT has been fully culturally adapted and validated for use in five different languages and cultures (in England, the Netherlands, France, Germany and Spain) where treatment is readily available either on demand or as prophylaxis. © 2014 John Wiley & Sons Ltd.

  16. Are existing outcome instruments suitable for assessment of spinal trauma patients?

    Science.gov (United States)

    Stadhouder, Agnita; Buckens, Constantinus F M; Holtslag, Herman R; Oner, F Cumhur

    2010-11-01

    Valid outcome assessment tools specific for spinal trauma patients are necessary to establish the efficacy of different treatment options. So far, no validated specific outcome measures are available for this patient population. The purpose of this study was to assess the current state of outcome measurement in spinal trauma patients and to address the question of whether this group is adequately served by current disease-specific and generic health-related quality-of-life instruments. A number of widely used outcome measures deemed most appropriate were reviewed, and their applicability to spinal trauma outcome discussed. An overview of recent movements in the theoretical foundations of outcome assessment, as it pertains to spinal trauma patients has been attempted, along with a discussion of domains important for spinal trauma. Commonly used outcome measures that are recommended for use in trauma patients were reviewed from the perspective of spinal trauma. The authors further sought to select a number of spine trauma-relevant domains from the WHO's comprehensive International Classification of Functioning, Disability and Health (ICF) as a benchmark for assessing the content coverage of the commonly used outcome measurements reviewed. The study showed that there are no psychometrically validated outcome measurements for the spinal trauma population and there are no commonly used outcome measures that provide adequate content coverage for spinal trauma domains. Spinal trauma patients are currently followed either as a subset of the polytrauma population in the acute and early postacute setting or as a subset of neurological injury in the long-term revalidation medicine setting.

  17. Monitoring individual and joint action outcomes in duet music performance

    DEFF Research Database (Denmark)

    Loehr, Janeen; Kourtis, Dimitrios; Vesper, Cordula

    2013-01-01

    We investigated whether people monitor the outcomes of their own and their partners’ individual actions as well as the outcome of their combined actions when performing joint actions together. Pairs of pianists memorized both parts of a piano duet. Each pianist then performed one part while their...

  18. Simulation Performance and National Council Licensure Examination for Registered Nurses Outcomes: Field Research Perspectives.

    Science.gov (United States)

    Brackney, Dana E; Lane, Susan Hayes; Dawson, Tyia; Koontz, Angie

    2017-11-01

    This descriptive field study examines processes used to evaluate simulation for senior-level Bachelor of Science in Nursing (BSN) students in a capstone course, discusses challenges related to simulation evaluation, and reports the relationship between faculty evaluation of student performance and National Council Licensure Examination for Registered Nurses (NCLEX-RN) first-time passing rates. Researchers applied seven terms used to rank BSN student performance (n = 41, female, ages 22-24 years) in a senior-level capstone simulation. Faculty evaluation was correlated with students' NCLEX-RN outcomes. Students evaluated as "lacking confidence" and "flawed" were less likely to pass the NCLEX-RN on the first attempt. Faculty evaluation of capstone simulation performance provided additional evidence of student preparedness for practice in the RN role, as evidenced by the relationship between the faculty assessment and NCLEX-RN success. Simulation has been broadly accepted as a powerful educational tool that may also contribute to verification of student achievement of program outcomes and readiness for the RN role.

  19. IMPLEMENTASI PERFORMANCE ASSESSMENT DALAM EVALUASI HASIL BELAJAR MAHASISWA PADA MATA KULIAH TEORI PRAKTEK BOLA VOLI

    Directory of Open Access Journals (Sweden)

    - Nasuka

    2010-04-01

    Full Text Available Volleyball subject is both theory and practice subject. In accordance with the standards of competence and basic competence to be achieved, this course, beside providing the theory of playing volleyball game, also consist of playing the game in the field. Based on the characteristics of the course it is necessary to assess both theory and practice aspect. Performance assessment is an alternative assessment that covers all aspects of student ability. Research was carried out by implementing evaluation tools to asses learning outcomes through early field trials and the second field trials. In addition, students‟ perceptions are collected through the questionnaire and teacher‟s perception through interview. Learning outcomes in both early and later field trials showed good results. There are 98% of students agreed with the application of the evaluation system. Lecturer stated that it‟s a practical system. Keywords: Performance assessment; evaluation tools; volleyball

  20. [The methodological basis of expert assessment of unfavourable outcomes of the stomatological treatment in the framework of civil law proceedings].

    Science.gov (United States)

    Pigolkin, Iu I; Murzova, T V; Mirzoev, Kh M

    2011-01-01

    The authors discuss peculiarities of the performance of forensic medical expertise in the cases of unfavourable outcomes of the stomatological treatment. The methodological basis of expert assessment has been created to be applied in situations related to the unfavourable outcomes of dental care.

  1. Totality of outcomes: A different paradigm in assessing interventions for treatment of tuberculosis

    Directory of Open Access Journals (Sweden)

    Grace Montepiedra

    2016-08-01

    Full Text Available Conventional analytic methods used for tuberculosis (TB outcomes research use standardized outcomes definitions and assess safety and efficacy separately. These methods are subject to important limitations. Conventionally utilized outcome definitions fail to capture important aspects of patients' treatment experience and obscure meaningful differences between patients.Assessing safety and efficacy separately fails to yield an objective risk–benefit comparison to guide clinical practice. We propose to address these issues through an analytic approach based on prioritized outcomes. This approach enables a more comprehensive and integrated assessment of TB interventions. It simultaneously considers a “totality of outcomes”, including clinical benefit, adverse events, and quality of life. These composite outcomes are ranked terms of overall desirability and compared using statistical methods for ordinal outcomes. Here we discuss the application of this approach to TB research, the considerations involved with prioritizing TB treatment outcomes, and the statistical methods involved in comparing prioritized outcomes. Keywords: Tuberculosis, Treatment outcome, Risk–benefit assessment

  2. A Pedagogical Alliance for Academic Achievement: Socio-Emotional Effects on Assessment Outcomes

    Science.gov (United States)

    Leighton, Jacqueline P.; Guo, Qi; Chu, Man-Wai; Tang, Wei

    2018-01-01

    Assessment of student learning outcomes is often discussed in relation to curriculum, standards and even administration practices. However, assessment of learning outcomes is rarely discussed in light of students' socio-emotional contexts, which might help or hinder learning outcomes. For example, do students' perceptions of the teacher as…

  3. The use of computer adaptive tests in outcome assessments following upper limb trauma.

    Science.gov (United States)

    Jayakumar, P; Overbeek, C; Vranceanu, A-M; Williams, M; Lamb, S; Ring, D; Gwilym, S

    2018-06-01

    performing as well as, if not better than, established fixed scales. Superior properties such as floor-ceiling effects and ease of use support their use in the assessment of outcome after trauma. As CATs are being increasingly used in patient outcomes research, further psychometric evaluation, especially involving longitudinal studies and groups of patients with specific injuries are required to inform clinical practice using these contemporary measures. Cite this article: Bone Joint J 2018;100-B:693-702.

  4. Assessing the outcome of Strengthening Laboratory Management ...

    African Journals Online (AJOL)

    SLMTA) is a competency-based management training programme designed to bring about immediate and measurable laboratory improvement. The aim of this study is to assess the outcome of SLMTA on laboratory quality management system in ...

  5. Implementation and Use of the Pharmacy Curriculum Outcomes Assessment at US Schools of Pharmacy.

    Science.gov (United States)

    Gortney, Justine Schuller; Bray, Brenda S; Salinitri, Francine D

    2015-11-25

    To describe how schools and colleges of pharmacy use the Pharmacy Curriculum Outcomes Assessment (PCOA) in relation to student assessment and curricular feedback. A survey was distributed to all programs that have implemented the PCOA. The survey was designed to assess 3 domains regarding the use of the PCOA: rationale for use, logistics of administration, and performance data review and distribution. A 79% response rate (41/52) was obtained. The mix of responses was 93% current PCOA users and 7% past users. The most common reasons for PCOA use were for programmatic assessment and benchmarking. The examination was most frequently administered during the P3 year, with minimal stakes attached to performance. Significant differences in responses based on public vs private institution were seen with respect to length of accreditation of current PCOA users, messaging to students regarding performance, inclusion of results in student advising, and distribution of results to stakeholders. Programs were using the PCOA primarily as an assessment in the P3 year for reasons related to programmatic and curricular assessment. Some differences existed between public and private institutional PCOA use and examination-related processes and results distribution.

  6. Process of performance assessment

    International Nuclear Information System (INIS)

    King, C.M.; Halford, D.K.

    1987-01-01

    Performance assessment is the process used to evaluate the environmental consequences of disposal of radioactive waste in the biosphere. An introductory review of the subject is presented. Emphasis is placed on the process of performance assessment from the standpoint of defining the process. Performance assessment, from evolving experience at DOE sites, has short-term and long-term subprograms, the components of which are discussed. The role of mathematical modeling in performance assessment is addressed including the pros and cons of current approaches. Finally, the system/site/technology issues as the focal point of this symposium are reviewed

  7. NRC performance assessment program

    International Nuclear Information System (INIS)

    Coplan, S.M.

    1986-01-01

    The U.S. Nuclear Regulatory Commission's (NRC) performance assessment program includes the development of guidance to the U.S. Department of Energy (DOE) on preparation of a license application and on conducting the studies to support a license application. The nature of the licensing requirements of 10 CFR Part 60 create a need for performance assessments by the DOE. The NRC and DOE staffs each have specific roles in assuring the adequacy of those assessments. Performance allocation is an approach for determining what testing and analysis will be needed during site characterization to assure that an adequate data base is available to support the necessary performance assessments. From the standpoint of establishing is implementable methodology, the most challenging performance assessment needed for licensing is the one that will be used to determine compliance with the U.S. Environmental Protection Agency's (EPA) containment requirement

  8. Daily FOUR score assessment provides accurate prognosis of long-term outcome in out-of-hospital cardiac arrest.

    Science.gov (United States)

    Weiss, N; Venot, M; Verdonk, F; Chardon, A; Le Guennec, L; Llerena, M C; Raimbourg, Q; Taldir, G; Luque, Y; Fagon, J-Y; Guerot, E; Diehl, J-L

    2015-05-01

    The accurate prediction of outcome after out-of-hospital cardiac arrest (OHCA) is of major importance. The recently described Full Outline of UnResponsiveness (FOUR) is well adapted to mechanically ventilated patients and does not depend on verbal response. To evaluate the ability of FOUR assessed by intensivists to accurately predict outcome in OHCA. We prospectively identified patients admitted for OHCA with a Glasgow Coma Scale below 8. Neurological assessment was performed daily. Outcome was evaluated at 6 months using Glasgow-Pittsburgh Cerebral Performance Categories (GP-CPC). Eighty-five patients were included. At 6 months, 19 patients (22%) had a favorable outcome, GP-CPC 1-2, and 66 (78%) had an unfavorable outcome, GP-CPC 3-5. Compared to both brainstem responses at day 3 and evolution of Glasgow Coma Scale, evolution of FOUR score over the three first days was able to predict unfavorable outcome more precisely. Thus, absence of improvement or worsening from day 1 to day 3 of FOUR had 0.88 (0.79-0.97) specificity, 0.71 (0.66-0.76) sensitivity, 0.94 (0.84-1.00) PPV and 0.54 (0.49-0.59) NPV to predict unfavorable outcome. Similarly, the brainstem response of FOUR score at 0 evaluated at day 3 had 0.94 (0.89-0.99) specificity, 0.60 (0.50-0.70) sensitivity, 0.96 (0.92-1.00) PPV and 0.47 (0.37-0.57) NPV to predict unfavorable outcome. The absence of improvement or worsening from day 1 to day 3 of FOUR evaluated by intensivists provides an accurate prognosis of poor neurological outcome in OHCA. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  9. Do continuous assessment results affect final exam outcomes? Evidence from a microeconomics course

    Directory of Open Access Journals (Sweden)

    Juan Carlos Reboredo

    2017-04-01

    Full Text Available Continuous assessment aims to enhance student learning and understanding of a subject and so achieve better educational outcomes. We investigated how continuous assessment grades affected final exam grades. Using a dataset for six academic post-Bologna Process years (2009-2015 for a first-year undergraduate microeconomics course offered at a Spanish public university, we examined conditional dependence between continuous assessment and final exam grades. Our results would indicate a limited contribution of continuous assessment results to final exam results: the probability of the final exam performance improving on the continuous assessment grade was lower than the probability of the opposite occurring. A consistent exception, however, was students who obtained an A grade for continuous assessment. Our results would cast some doubt on the beneficial effects of continuous assessment advocated by the Bologna Process.

  10. Measurement properties of performance-based outcome measures to assess physical function in young and middle-aged people known to be at high risk of hip and/or knee osteoarthritis: a systematic review.

    Science.gov (United States)

    Kroman, S L; Roos, E M; Bennell, K L; Hinman, R S; Dobson, F

    2014-01-01

    To systematically appraise the evidence on measurement properties of performance-based outcome measures to assess physical function in young and middle-aged people known to be at high risk of hip and/or knee osteoarthritis (OA). Electronic searches were performed in MEDLINE, CINAHL, Scopus and SPORTDiscus in May 2013. Two reviewers independently rated the measurement properties using the 4-point COSMIN checklist. Best evidence synthesis was made using COSMIN quality, consistency and direction of findings and sample size. Twenty of 2736 papers were eligible for inclusion and 24 different performance-based outcome measures knee or obese populations were evaluated. No tests related to hip populations were included. Twenty-five measurement properties including reliability (nine studies), construct validity (hypothesis testing) (nine studies), measurement error (three studies), structural validity (two studies), interpretability (one study) and responsiveness (one study) were evaluated. A positive rating was given to 12.5% (30/240) of all possible measurement ratings. Tests were grouped into two categories based on the population characteristics. The one-legged hop for distance, followed by the 6-m timed hop and cross over hop for distance were the best-rated tests for the knee-injured population. Whereas the 6-min walk test was the only included test for the obese population. This review highlights the many gaps in knowledge about the measurement properties of performance-based outcome measures for young and middle-aged people known to be at high risk of hip and/or knee OA. There is a need for consensus on which outcome measures should be used and/or combined when assessing physical function in this population. Further good quality research is required. Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  11. The Effects of Performance-Based Assessment Criteria on Student Performance and Self-Assessment Skills

    Science.gov (United States)

    Fastre, Greet Mia Jos; van der Klink, Marcel R.; van Merrienboer, Jeroen J. G.

    2010-01-01

    This study investigated the effect of performance-based versus competence-based assessment criteria on task performance and self-assessment skills among 39 novice secondary vocational education students in the domain of nursing and care. In a performance-based assessment group students are provided with a preset list of performance-based…

  12. Effects of Mindfulness Practice on Performance-Relevant Parameters and Performance Outcomes in Sports: A Meta-Analytical Review.

    Science.gov (United States)

    Bühlmayer, Lucia; Birrer, Daniel; Röthlin, Philipp; Faude, Oliver; Donath, Lars

    2017-11-01

    Mindfulness as a present-oriented form of mental training affects cognitive processes and is increasingly considered meaningful for sport psychological training approaches. However, few intervention studies have examined the effects of mindfulness practice on physiological and psychological performance surrogates or on performance outcomes in sports. The aim of the present meta-analytical review was to examine the effects of mindfulness practice or mindfulness-based interventions on physiological and psychological performance surrogates and on performance outcomes in sports in athletes over 15 years of age. A structured literature search was conducted in six electronic databases (CINAHL, EMBASE, ISI Web of Knowledge, PsycINFO, MEDLINE and SPORTDiscus). The following search terms were used with Boolean conjunction: (mindful* OR meditat* OR yoga) AND (sport* OR train* OR exercis* OR intervent* OR perform* OR capacity OR skill*) AND (health* OR adult* OR athlete*). Randomized and non-randomized controlled studies that compared mindfulness practice techniques as an intervention with an inactive control or a control that followed another psychological training program in healthy sportive participants were screened for eligibility. Eligibility and study quality [Physiotherapy Evidence Database (PEDro)] scales were independently assessed by two researchers. A third independent researcher was consulted to achieve final consensus in case of disagreement between both researchers. Standardized mean differences (SMDs) were calculated as weighted Hedges' g and served as the main outcomes in comparing mindfulness practice versus control. Statistical analyses were conducted using a random-effects inverse-variance model. Nine trials of fair study quality (mean PEDro score 5.4, standard deviation 1.1) with 290 healthy sportive participants (athletics, cyclists, dart throwers, hammer throwers, hockey players, hurdlers, judo fighters, rugby players, middle-distance runners, long

  13. Association between changes on the Negative Symptom Assessment scale (NSA-16) and measures of functional outcome in schizophrenia.

    Science.gov (United States)

    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.

  14. 24 CFR 115.206 - Performance assessments; Performance standards.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Performance assessments; Performance standards. 115.206 Section 115.206 Housing and Urban Development Regulations Relating to Housing... AGENCIES Certification of Substantially Equivalent Agencies § 115.206 Performance assessments; Performance...

  15. Assessing Confidence in Performance Assessments Using an Evidence Support Logic Methodology: An Application of Tesla

    International Nuclear Information System (INIS)

    Egan, M.; Paulley, A.; Lehman, L.; Lowe, J.; Rochette, E.; Baker, St.

    2009-01-01

    The assessment of uncertainties and their implications is a key requirement when undertaking performance assessment (PA) of radioactive waste facilities. Decisions based on the outcome of such assessments become translated into judgments about confidence in the information they provide. This confidence, in turn, depends on uncertainties in the underlying evidence. Even if there is a large amount of information supporting an assessment, it may be only partially relevant, incomplete or less than completely reliable. In order to develop a measure of confidence in the outcome, sources of uncertainty need to be identified and adequately addressed in the development of the PA, or in any overarching strategic decision-making processes. This paper describes a trial application of the technique of Evidence Support Logic (ESL), which has been designed for application in support of 'high stakes' decisions, where important aspects of system performance are subject to uncertainty. The aims of ESL are to identify the amount of uncertainty or conflict associated with evidence relating to a particular decision, and to guide understanding of how evidence combines to support confidence in judgments. Elicitation techniques are used to enable participants in the process to develop a logical hypothesis model that best represents the relationships between different sources of evidence to the proposition under examination. The aim is to identify key areas of subjectivity and other sources of potential bias in the use of evidence (whether for or against the proposition) to support judgments of confidence. Propagation algorithms are used to investigate the overall implications of the logic according to the strength of the underlying evidence and associated uncertainties. (authors)

  16. The long-term effect of premier pay for performance on patient outcomes.

    Science.gov (United States)

    Jha, Ashish K; Joynt, Karen E; Orav, E John; Epstein, Arnold M

    2012-04-26

    Pay for performance has become a central strategy in the drive to improve health care. We assessed the long-term effect of the Medicare Premier Hospital Quality Incentive Demonstration (HQID) on patient outcomes. We used Medicare data to compare outcomes between the 252 hospitals participating in the Premier HQID and 3363 control hospitals participating in public reporting alone. We examined 30-day mortality among more than 6 million patients who had acute myocardial infarction, congestive heart failure, or pneumonia or who underwent coronary-artery bypass grafting (CABG) between 2003 and 2009. At baseline, the composite 30-day mortality was similar for Premier and non-Premier hospitals (12.33% and 12.40%, respectively; difference, -0.07 percentage points; 95% confidence interval [CI], -0.40 to 0.26). The rates of decline in mortality per quarter at the two types of hospitals were also similar (0.04% and 0.04%, respectively; difference, -0.01 percentage points; 95% CI, -0.02 to 0.01), and mortality remained similar after 6 years under the pay-for-performance system (11.82% for Premier hospitals and 11.74% for non-Premier hospitals; difference, 0.08 percentage points; 95% CI, -0.30 to 0.46). We found that the effects of pay for performance on mortality did not differ significantly among conditions for which outcomes were explicitly linked to incentives (acute myocardial infarction and CABG) and among conditions not linked to incentives (congestive heart failure and pneumonia) (P=0.36 for interaction). Among hospitals that were poor performers at baseline, mortality was similar in the two groups of hospitals at the start of the study (15.12% and 14.73%; difference, 0.39 percentage points; 95% CI, -0.36 to 1.15), with similar rates of improvement per quarter (0.10% and 0.07%; difference, -0.03 percentage points; 95% CI, -0.08 to 0.02) and similar mortality rates at the end of the study (13.37% and 13.21%; difference, 0.15 percentage points; 95% CI, -0.70 to 1.01). We

  17. Key performance outcomes of patient safety curricula: root cause analysis, failure mode and effects analysis, and structured communications skills.

    Science.gov (United States)

    Fassett, William E

    2011-10-10

    As colleges and schools of pharmacy develop core courses related to patient safety, course-level outcomes will need to include both knowledge and performance measures. Three key performance outcomes for patient safety coursework, measured at the course level, are the ability to perform root cause analyses and healthcare failure mode effects analyses, and the ability to generate effective safety communications using structured formats such as the Situation-Background-Assessment-Recommendation (SBAR) situational briefing model. Each of these skills is widely used in patient safety work and competence in their use is essential for a pharmacist's ability to contribute as a member of a patient safety team.

  18. The assessment and treatment of performance anxiety in musicians.

    Science.gov (United States)

    Clark, D B; Agras, W S

    1991-05-01

    Performance anxiety in musicians may be severe enough to require intervention but has been the subject of relatively little clinical research. The authors' objectives were to describe the results of a comprehensive clinical and laboratory assessment and to perform a double-blind, placebo-controlled study comparing buspirone, cognitive-behavior therapy, and the combination of these treatments for performance anxiety. Ninety-four subjects were recruited by mass media announcements and were seen in a university-based outpatient psychiatric clinic. Assessments were 1) questionnaires for all 94 subjects, 2) diagnostic interview of 50 subjects, and 3) laboratory performance of 34 subjects. Treatment conditions were 1) 6 weeks of buspirone, 2) 6 weeks of placebo, 3) a five-session, group cognitive-behavior therapy program with buspirone, or 4) the cognitive-behavior therapy program with placebo. Treatment outcome measures included subjective anxiety ratings and heart rate measures during a laboratory performance, a questionnaire measure of performance confidence, and a blind rating of musical performance quality. All subjects fulfilled criteria for DSM-III-R social phobia. Of the 15 full-time professional musicians, ten had tried propranolol and three had stopped performing. Most of the subjects had substantial anxiety and heart rate increases during laboratory speech and musical performances. Cognitive-behavior therapy resulted in statistically significant reductions in subjective anxiety, improved quality of musical performance, and improved performance confidence. Buspirone was not an effective treatment. Cognitive-behavior therapy is a viable treatment approach for performance anxiety in musicians.

  19. Survivorship care plans: are randomized controlled trials assessing outcomes that are relevant to stakeholders?

    Science.gov (United States)

    Birken, Sarah A; Urquhart, Robin; Munoz-Plaza, Corrine; Zizzi, Alexandra R; Haines, Emily; Stover, Angela; Mayer, Deborah K; Hahn, Erin E

    2018-03-23

    The purpose of this study was to compare outcomes assessed in extant randomized controlled trials (RCTs) to outcomes that stakeholders expect from survivorship care plans (SCPs). To facilitate the transition from active treatment to follow-up care for the 15.5 million US cancer survivors, many organizations require SCP use. However, results of several RCTs of SCPs' effectiveness have been null, possibly because they have evaluated outcomes on which SCPs should be expected to have limited influence. Stakeholders (e.g., survivors, oncologists) may expect outcomes that differ from RCTs' outcomes. We identified RCTs' outcomes using a PubMed literature review. We identified outcomes that stakeholders expect from SCPs using semistructured interviews with stakeholders in three healthcare systems in the USA and Canada. Finally, we mapped RCTs' outcomes onto stakeholder-identified outcomes. RCT outcomes did not fully address outcomes that stakeholders expected from SCPs, and RCTs assessed outcomes that stakeholders did not expect from SCPs. RCTs often assessed outcomes only from survivors' perspectives. RCTs of SCPs' effectiveness have not assessed outcomes that stakeholders expect. To better understand SCPs' effectiveness, future RCTs should assess outcomes of SCP use that are relevant from the perspective of multiple stakeholders. SCPs' effectiveness may be optimized when used with an eye toward outcomes that stakeholders expect from SCPs. For survivors, this means using SCPs as a map to guide them with respect to what kind of follow-up care they should seek, when they should seek it, and from whom they should seek it.

  20. Assessment of Scientific Communication Self-Efficacy, Interest, and Outcome Expectations for Career Development in Academic Medicine

    Science.gov (United States)

    Anderson, Cheryl B.; Lee, Hwa Young; Byars-Winston, Angela; Baldwin, Constance D.; Cameron, Carrie; Chang, Shine

    2015-01-01

    Competency in forms of scientific communication, both written and spoken, is essential for success in academic science. This study examined the psychometric properties of three new measures, based on social cognitive career theory, that are relevant to assessment of skill and perseverance in scientific communication. Pre- and postdoctoral trainees in biomedical science (N = 411) completed online questionnaires assessing self-efficacy in scientific communication, career outcome expectations, and interest in performing tasks in scientific writing, oral presentation, and impromptu scientific discourse. Structural equation modeling was used to evaluate factor structures and model relations. Confirmatory factor analysis supported a 22-item, 3-factor measure of self-efficacy, an 11-item, 2-factor measure of outcome expectations, and a 12-item, 3-factor measure of interest in scientific communication activities. Construct validity was further demonstrated by theory-consistent inter-factor relations and relations with typical communications performance behaviors (e.g., writing manuscripts, abstracts, presenting at national meetings). PMID:26924920

  1. Improvement of medical content in the curriculum of biomedical engineering based on assessment of students outcomes.

    Science.gov (United States)

    Abdulhay, Enas; Khnouf, Ruba; Haddad, Shireen; Al-Bashir, Areen

    2017-08-04

    Improvement of medical content in Biomedical Engineering curricula based on a qualitative assessment process or on a comparison with another high-standard program has been approached by a number of studies. However, the quantitative assessment tools have not been emphasized. The quantitative assessment tools can be more accurate and robust in cases of challenging multidisciplinary fields like that of Biomedical Engineering which includes biomedicine elements mixed with technology aspects. The major limitations of the previous research are the high dependence on surveys or pure qualitative approaches as well as the absence of strong focus on medical outcomes without implicit confusion with the technical ones. The proposed work presents the development and evaluation of an accurate/robust quantitative approach to the improvement of the medical content in the challenging multidisciplinary BME curriculum. The work presents quantitative assessment tools and subsequent improvement of curriculum medical content applied, as example for explanation, to the ABET (Accreditation Board for Engineering and Technology, USA) accredited biomedical engineering BME department at Jordan University of Science and Technology. The quantitative results of assessment of curriculum/course, capstone, exit exam, course assessment by student (CAS) as well as of surveys filled by alumni, seniors, employers and training supervisors were, first, mapped to the expected students' outcomes related to the medical field (SOsM). The collected data were then analyzed and discussed to find curriculum weakness points by tracking shortcomings in every outcome degree of achievement. Finally, actions were taken to fill in the gaps of the curriculum. Actions were also mapped to the students' medical outcomes (SOsM). Weighted averages of obtained quantitative values, mapped to SOsM, indicated accurately the achievement levels of all outcomes as well as the necessary improvements to be performed in curriculum

  2. Ergonomics Climate Assessment: A measure of operational performance and employee well-being.

    Science.gov (United States)

    Hoffmeister, Krista; Gibbons, Alyssa; Schwatka, Natalie; Rosecrance, John

    2015-09-01

    Ergonomics interventions have the potential to improve operational performance and employee well-being. We introduce a framework for ergonomics climate, the extent to which an organization emphasizes and supports the design and modification of work to maximize both performance and well-being outcomes. We assessed ergonomics climate at a large manufacturing facility twice during a two-year period. When the organization used ergonomics to promote performance and well-being equally, and at a high level, employees reported less work-related pain. A larger discrepancy between measures of operational performance and employee well-being was associated with increased reports of work-related pain. The direction of this discrepancy was not significantly related to work-related pain, such that it didn't matter which facet was valued more. The Ergonomics Climate Assessment can provide companies with a baseline assessment of the overall value placed on ergonomics and help prioritize areas for improving operational performance and employee well-being. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  3. Outcomes-Based Assessment and Learning: Trialling Change in a Postgraduate Civil Engineering Course

    Science.gov (United States)

    El-Maaddawy, Tamer; Deneen, Christopher

    2017-01-01

    This paper aims to demonstrate how assessment tasks can function within an outcomes-based learning framework to evaluate student attainment of learning outcomes. An outcomes-based learning framework designed to integrate teaching, learning, and assessment activities was developed and implemented in a civil engineering master-level course. The…

  4. Activity Performance Management Framework Based on Outcome Based Budgeting Malaysian Nuclear Agency

    International Nuclear Information System (INIS)

    Aisya Raihan Abdul Kadir; Mohd Azmi Sidid Omar; Noriah Jamal

    2015-01-01

    The implementation of the Outcome Based Budgeting (OBB) in the planning and implementation of national development and public spending will emphasize the impact and effectiveness of programs and activities in line with the policies and objectives of the four pillars in the National Transformation programme, which is 1 Malaysia: People First, Performance Now, Government Transformation Programme (GTP), Economic Transformation Programme (ETP) and Malaysia Five Year Development Plan. OBB effective implementation at the ministry level was implemented by the Ministry OBB Implementation Committee (OIC) and Program Performance Management Committee (PPMC). At the agency it will be implemented by the Performance Management Committee Activities (APMC). OBB involve strategic implementation cycle consisting of four main processes, namely, outcome-based planning, budgeting, monitoring, evaluation, and reporting performance. OBB will be fully implemented in 2016 to replace the Modified Budgeting System (MBS). Performance Management Framework Activity (APMF) is based on outcome-based planning has been developed using methodologies such as ProLL Model (Logic and Linkages Programme), Problem Tree Analysis (PTA), Top-down approach, SMART principle, Framework Approach and rigour test. By applying this methodology several Activity Performance Management Framework (APMF) has been produced which consists of 3 output, 6 KPI output, 3 outcome and 8 KPI outcome in line with the direction and outcome of programme level and ministries level. APMF was planned at the beginning of each year and reporting of the performance on a quarterly basis through My Results application. (author)

  5. Pharmacy Curriculum Outcomes Assessment for Individual Student Assessment and Curricular Evaluation

    OpenAIRE

    Scott, Day M.; Bennett, Lunawati L.; Ferrill, Mary J.; Brown, Daniel L.

    2010-01-01

    The Pharmacy Curriculum Outcomes Assessment (PCOA) is a standardized examination for assessing academic progress of pharmacy students. Although no other national benchmarking tool is available on a national level, the PCOA has not been adopted by all colleges and schools of pharmacy. Palm Beach Atlantic University (PBAU) compared 2008-2010 PCOA results of its P1, P2, and P3 students to their current grade point average (GPA) and to results of a national cohort. The reliability coefficient of ...

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

    Science.gov (United States)

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

    2015-08-01

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

  7. Application of objective clinical human reliability analysis (OCHRA) in assessment of technical performance in laparoscopic rectal cancer surgery.

    Science.gov (United States)

    Foster, J D; Miskovic, D; Allison, A S; Conti, J A; Ockrim, J; Cooper, E J; Hanna, G B; Francis, N K

    2016-06-01

    Laparoscopic rectal resection is technically challenging, with outcomes dependent upon technical performance. No robust objective assessment tool exists for laparoscopic rectal resection surgery. This study aimed to investigate the application of the objective clinical human reliability analysis (OCHRA) technique for assessing technical performance of laparoscopic rectal surgery and explore the validity and reliability of this technique. Laparoscopic rectal cancer resection operations were described in the format of a hierarchical task analysis. Potential technical errors were defined. The OCHRA technique was used to identify technical errors enacted in videos of twenty consecutive laparoscopic rectal cancer resection operations from a single site. The procedural task, spatial location, and circumstances of all identified errors were logged. Clinical validity was assessed through correlation with clinical outcomes; reliability was assessed by test-retest. A total of 335 execution errors identified, with a median 15 per operation. More errors were observed during pelvic tasks compared with abdominal tasks (p technical performance of laparoscopic rectal surgery.

  8. Introduction to radiological performance assessment

    International Nuclear Information System (INIS)

    Moss, G.

    1995-02-01

    A radiological performance assessment is conducted to provide reasonable assurance that performance objectives for low-level radioactive waste (LLW) disposal will be met. Beginning in the early stages of development, a radiological performance assessment continues through the operational phase, and is instrumental in the postclosure of the facility. Fundamental differences exist in the regulation of commercial and defense LLW, but the radiological performance assessment process is essentially the same for both. The purpose of this document is to describe that process in a concise and straightforward manner. This document focuses on radiological performance assessment as it pertains to commercial LLW disposal, but is applicable to US Department of Energy sites as well. Included are discussions on performance objectives, site characterization, and how a performance assessment is conducted. A case study is used to illustrate how the process works as a whole. A bibliography is provided to assist in locating additional information

  9. A systematic literature search to identify performance measure outcomes used in clinical studies of racehorses.

    Science.gov (United States)

    Wylie, C E; Newton, J R

    2018-05-01

    Racing performance is often used as a measurable outcome variable in research studies investigating clinical diagnoses or interventions. However, the use of many different performance measures largely precludes conduct of meaningful comparative studies and, to date, those being used have not been collated. To systematically review the veterinary scientific literature for the use of racing performance as a measurable outcome variable in clinical studies of racehorses, collate and identify those most popular, and identify their advantages and disadvantages. Systematic literature search. The search criteria "((racing AND performance) AND (horses OR equidae))" were adapted for both MEDLINE and CAB Abstracts databases. Data were collected in standardised recording forms for binary, categorical and quantitative measures, and the use of performance indices. In total, 217 studies that described racing performance were identified, contributing 117 different performance measures. No one performance measure was used in all studies, despite 90.3% using more than one variable. Data regarding race starts and earnings were used most commonly, with 88.0% and 54.4% of studies including at least one measure of starts and earnings, respectively. Seventeen variables were used 10 times or more, with the top five comprising: 'return to racing', 'number of starts', 'days to first start', 'earnings per period of time' and 'earnings per start'. The search strategies may not have identified all relevant papers, introducing bias to the review. Performance indices have been developed to improve assessment of interventions; however, they are not widely adopted in the scientific literature. Use of the two most commonly identified measures, whether the horse returned to racing and number of starts over a defined period of time, would best facilitate future systematic reviews and meta-analyses in advance of the development of a gold-standard measure of race performance outcome. © 2017 EVJ Ltd.

  10. New assessment forms of educational outcomes of students

    Directory of Open Access Journals (Sweden)

    Zemlyanskaya E.N.

    2015-11-01

    Full Text Available In the context of practice-oriented training assessment system applies not only to quality control in vocational education, but becomes one of the control elements of the teacher education system. The article discusses so called assessment for learning. The author believes that the purpose of assessment for learning is to provide research and reflexive independence of students which provides the opportunity to adjust the educational outcomes, forms of students training and evaluation tools. The basic features of assessment for learning are considered from this point of view. The article discusses use of internet-services in assessment for learning , risks and provides procedure of assessment for learning and describes in detail such specific procedures as criteria-based assessment, construction of tests and mindmaps, cumulative assessment.

  11. Profiling outcomes of ambulatory care: casemix affects perceived performance.

    Science.gov (United States)

    Berlowitz, D R; Ash, A S; Hickey, E C; Kader, B; Friedman, R; Moskowitz, M A

    1998-06-01

    The authors explored the role of casemix adjustment when profiling outcomes of ambulatory care. The authors reviewed the medical records of 656 patients with hypertension, diabetes, or chronic obstructive pulmonary disease (COPD) receiving care at one of three Department of Veterans Affairs medical centers. Outcomes included measures of physiological control for hypertension and diabetes, and of exacerbations for COPD. Predictors of poor outcomes, including physical examination findings, symptoms, and comorbidities, were identified and entered into regression models. Observed minus expected performance was described for each site, both before and after casemix adjustment. Risk-adjustment models were developed that were clinically plausible and had good performance properties. Differences existed among the three sites in the severity of the patients being cared for. For example, the percentage of patients expected to have poor blood pressure control were 35% at site 1, 37% at site 2, and 44% at site 3 (P Casemix-adjusted measures of performance were different from unadjusted measures. Sites that were outliers (P Casemix adjustment models can be developed for outpatient medical conditions. Sites differ in the severity of patients they treat, and adjusting for these differences can alter judgments of site performance. Casemix adjustment is necessary when profiling outpatient medical conditions.

  12. The process of performance assessment

    International Nuclear Information System (INIS)

    King, C.M.; Halford, D.K.

    1986-01-01

    An introductory review of the subject of ''Performance Assessment'' will be presented. Emphasis will be placed on the process of performance assessment from the standpoint of defining the process. Performance assessment, from evolving experience at DOE sites, has short-term and long-term subprograms, the components of which will be discussed. The role of mathematical modeling in performance assessment will be addressed including the pros and cons of current approaches. Finally, the ''system/site/technology'' issues as the focal point of this symposium will be reviewed

  13. Assessment of Outcomes of Free Expression Courses.

    Science.gov (United States)

    Andsager, Julie; Ross, Susan Dente

    1999-01-01

    Assesses outcomes of instruction in three college-senior-level courses on freedom of expression. Suggests that increased attention to freedom-of-expression issues may have resulted in broader understanding of First Amendment issues, and individual and media rights. Notes that students seem to develop an appreciation of the reflexive nature of…

  14. Assessment of Scientific Reasoning as an Institutional Outcome

    Science.gov (United States)

    2016-04-01

    expertise in the outcome domain. Student achievement of the Scientific Reasoning and Principles of Science was assessed in the 2012-13 academic year by...scientific reasoning assessment. Overall, students were weakest when answering questions related to (a) proportional reasoning , (b) isolation of...variables, and (c) if-then reasoning . These findings are being incorporates into redesign of the core curriculum to enhance continuity among science courses

  15. OUTCOMES OF ALTERNATIVE ASSESSMENT IN ADULT LANGUAGE TRAINING

    Directory of Open Access Journals (Sweden)

    Brândușa Elena Octavia ȚEICAN

    2016-06-01

    Full Text Available The purpose of this article is to highlight the switch from traditional assessment to alternative, formative assessment, in other words assessment for learning, in adult language training. We focused on two aspects of formative assessment: self-assessment and peer-assessment, methods that can be used as teaching tools in communicative language teaching in adult English classes. Reportedly, these methods lead to improved results in language learning and production, as well as in motivation and self-esteem. Based on previous studies, our aim is to present how frequent employment of formative feedback based on adult opinions and perceptions – obtained via informal interviews – and tailored to their needs, result in improved learner outcome.

  16. Thermal Ablation of T1c Renal Cell Carcinoma: A Comparative Assessment of Technical Performance, Procedural Outcome, and Safety of Microwave Ablation, Radiofrequency Ablation, and Cryoablation.

    Science.gov (United States)

    Zhou, Wenhui; Arellano, Ronald S

    2018-04-06

    To evaluate perioperative outcomes of thermal ablation with microwave (MW), radiofrequency (RF), and cryoablation for stage T1c renal cell carcinoma (RCC). A retrospective analysis of 384 patients (mean age, 71 y; range, 22-88 y) was performed between October 2006 and October 2016. Mean radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior, and location relative to polar lines; preoperative aspects and dimensions used for anatomic classification; and centrality index scores were 6.3, 7.9, and 2.7, respectively. Assessment of pre- and postablation serum blood urea nitrogen, creatinine, and estimated glomerular filtration rate was performed to assess functional outcomes. Linear regression analyses were performed to compare sedation medication dosages among the three treatment cohorts. Univariable and multivariable logistic regression analyses were performed to compare rates of residual disease and complications among treatment modalities. A total of 437 clinical stage T1N0M0 biopsy-proven RCCs measuring 1.2-6.9 cm were treated with computed tomography (CT)-guided MW ablation (n = 44; 10%), RF ablation (n = 347; 79%), or cryoablation (n = 46; 11%). There were no significant differences in patient demographic or tumor characteristics among cohorts. Complication rates and immediate renal function changes were similar among the three ablation modalities (P = .46 and P = .08, respectively). MW ablation was associated with significantly decreased ablation time (P < .05), procedural time (P < .05), and dosage of sedative medication (P < .05) compared with RF ablation and cryoablation. CT-guided percutaneous MW ablation is comparable to RF ablation or cryoablation for the treatment of stage T1N0M0 RCC with regard to treatment response and is associated with shorter treatment times and less sedation than RF ablation or cryoablation. In addition, the safety profile of CT-guided MW ablation is noninferior to those of RF ablation or

  17. Assessing outcomes of tinnitus intervention.

    Science.gov (United States)

    Newman, Craig W; Sandridge, Sharon A; Jacobson, Gary P

    2014-01-01

    It has been estimated that as many as 50 million Americans do experience or have experienced tinnitus. For approximately 12 million of these individuals, tinnitus makes it impossible for them to carry out normal everyday activities without limitation. These are the patients that present to audiology clinics for assessment and management. The tinnitus evaluation includes the measurement of acoustical characteristics of tinnitus and the impact that this impairment has on health-related quality of life (HRQoL). Tinnitus is a disorder that often occurs as a result of auditory system impairment. The impairment for some can impart an activity limitation and a participation restriction (i.e., tinnitus-related disability or handicap, respectively). The goal of tinnitus management is to reduce, or eliminate, activity limitations and participation restrictions by reducing or eliminating a patient's perception of tinnitus or their reaction to tinnitus. Implicit in this statement is the assumption that there exist standardized measures for quantifying the patient's tinnitus perception and their reaction to it. If there existed stable and responsive standardized tinnitus measures, then it would be possible to compare a patient's tinnitus experience at different time points (e.g., before and after treatment) to assess, for example, treatment efficacy. The purposes of the current review are to (1) describe psychometric standards used to select outcome measurement tools; (2) discuss available measurement techniques and their application to tinnitus evaluation and treatment-related assessment within the domains established by the World Health Organization's International Classification of Functioning, Disability and Health; (3) list and briefly describe self-report tinnitus questionnaires; (4) describe how valuation of tinnitus treatment can be assessed using economic models of treatment effectiveness; and (5) provide future directions including the development of a tinnitus

  18. A global assessment of the social and conservation outcomes of protected areas.

    Science.gov (United States)

    Oldekop, J A; Holmes, G; Harris, W E; Evans, K L

    2016-02-01

    Protected areas (PAs) are a key strategy for protecting biological resources, but they vary considerably in their effectiveness and are frequently reported as having negative impacts on local people. This has contributed to a divisive and unresolved debate concerning the compatibility of environmental and socioeconomic development goals. Elucidating the relationship between positive and negative social impacts and conservation outcomes of PAs is key for the development of more effective and socially just conservation. We conducted a global meta-analysis on 165 PAs using data from 171 published studies. We assessed how PAs affect the well-being of local people, the factors associated with these impacts, and crucially the relationship between PAs' conservation and socioeconomic outcomes. Protected areas associated with positive socioeconomic outcomes were more likely to report positive conservation outcomes. Positive conservation and socioeconomic outcomes were more likely to occur when PAs adopted comanagement regimes, empowered local people, reduced economic inequalities, and maintained cultural and livelihood benefits. Whereas the strictest regimes of PA management attempted to exclude anthropogenic influences to achieve biological conservation objectives, PAs that explicitly integrated local people as stakeholders tended to be more effective at achieving joint biological conservation and socioeconomic development outcomes. Strict protection may be needed in some circumstances, yet our results demonstrate that conservation and development objectives can be synergistic and highlight management strategies that increase the probability of maximizing both conservation performance and development outcomes of PAs. © 2015 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.

  19. Technology Performance Level Assessment Methodology.

    Energy Technology Data Exchange (ETDEWEB)

    Roberts, Jesse D.; Bull, Diana L; Malins, Robert Joseph; Costello, Ronan Patrick; Aurelien Babarit; Kim Nielsen; Claudio Bittencourt Ferreira; Ben Kennedy; Kathryn Dykes; Jochem Weber

    2017-04-01

    The technology performance level (TPL) assessments can be applied at all technology development stages and associated technology readiness levels (TRLs). Even, and particularly, at low TRLs the TPL assessment is very effective as it, holistically, considers a wide range of WEC attributes that determine the techno-economic performance potential of the WEC farm when fully developed for commercial operation. The TPL assessment also highlights potential showstoppers at the earliest possible stage of the WEC technology development. Hence, the TPL assessment identifies the technology independent “performance requirements.” In order to achieve a successful solution, the entirety of the performance requirements within the TPL must be considered because, in the end, all the stakeholder needs must be achieved. The basis for performing a TPL assessment comes from the information provided in a dedicated format, the Technical Submission Form (TSF). The TSF requests information from the WEC developer that is required to answer the questions posed in the TPL assessment document.

  20. The influence of stress responses on surgical performance and outcomes: Literature review and the development of the surgical stress effects (SSE) framework.

    Science.gov (United States)

    Chrouser, Kristin L; Xu, Jie; Hallbeck, Susan; Weinger, Matthew B; Partin, Melissa R

    2018-02-22

    Surgical adverse events persist despite several decades of system-based quality improvement efforts, suggesting the need for alternative strategies. Qualitative studies suggest stress-induced negative intraoperative interpersonal dynamics might contribute to performance errors and undesirable patient outcomes. Understanding the impact of intraoperative stressors may be critical to reducing adverse events and improving outcomes. We searched MEDLINE, psycINFO, EMBASE, Business Source Premier, and CINAHL databases (1996-2016) to assess the relationship between negative (emotional and behavioral) responses to acute intraoperative stressors and provider performance or patient surgical outcomes. Drawing on theory and evidence from reviewed studies, we present the Surgical Stress Effects (SSE) framework. This illustrates how emotional and behavioral responses to stressors can influence individual surgical provider (e.g. surgeon, nurse) performance, team performance, and patient outcomes. It also demonstrates how uncompensated intraoperative threats and errors can lead to adverse events, highlighting evidence gaps for future research efforts. Published by Elsevier Inc.

  1. Online feedback assessments in physiology: effects on students' learning experiences and outcomes.

    Science.gov (United States)

    Marden, Nicole Y; Ulman, Lesley G; Wilson, Fiona S; Velan, Gary M

    2013-06-01

    Online formative assessments have become increasingly popular; however, formal evidence supporting their educational benefits is limited. This study investigated the impact of online feedback quizzes on the learning experiences and outcomes of undergraduate students enrolled in an introductory physiology course. Four quiz models were tested, which differed in the amount of credit available, the number of attempts permitted, and whether the quizzes were invigilated or unsupervised, timed or untimed, or open or closed book. All quizzes were composed of multiple-choice questions and provided immediate individualized feedback. Summative end-of-course examination marks were analyzed with respect to performance in quizzes and were also compared with examination performance in the year before the quizzes were introduced. Online surveys were conducted to gather students' perceptions regarding the quizzes. The vast majority of students perceived online quizzes as a valuable learning tool. For all quiz models tested, there was a significant relationship between performance in quizzes and end-of-course examination scores. Importantly, students who performed poorly in quizzes were more likely to fail the examination, suggesting that formative online quizzes may be a useful tool to identify students in need of assistance. Of the four quiz models, only one quiz model was associated with a significant increase in mean examination performance. This model had the strongest formative focus, allowing multiple unsupervised and untimed attempts. This study suggests that the format of online formative assessments is critical in achieving the desired impact on student learning. Specifically, such assessments are most effective when they are low stakes.

  2. Athletic performance outcomes following lumbar discectomy in professional basketball players.

    Science.gov (United States)

    Anakwenze, Okechukwu A; Namdari, Surena; Auerbach, Joshua D; Baldwin, Keith; Weidner, Zachary D; Lonner, Baron S; Huffman, G R; Sennett, Brian J

    2010-04-01

    Retrospective case-control study. To quantify the athletic performance profiles after lumbar discectomy (LD) in a cohort of National Basketball Association (NBA) players in comparison with a control group of matched NBA players who did not undergo LD during the same study period. LD provides symptomatic relief and improved functional outcomes in the majority of patients as assessed by validated measures such as Oswestry Disability Index, Visual Analog Scale, and Short Form-36 (SF-36). Among professional athletes, however, the goal of lumbar HNP treated by discectomy is not only to improve functional status but also, ultimately, to return the player to preinjury athletic performance levels. No study to date has compared the athletic performance profiles before and after discectomy in professional athletes. An analysis of NBA games summaries, weekly injury reports, player profiles, and press releases was performed to identify 24 NBA players who underwent LD for symptomatic lumbar HNP between 1991 and 2007. A 1:2 case: control study was performed using players without history of lumbar HNP who were matched for age, position, experience, and body mass index as control subjects (n = 48). Paired t tests were conducted on the following parameters: games played, minutes per game, points per 40 minutes, rebounds per 40 minutes, assists per 40 minutes, steals per 40 minutes, blocks per 40 minutes, and shooting percentage. For each athletic performance outcome, between-group comparisons evaluating preindex to postindex season performance were done (index season = season of surgery). In the LD group, 18 of 24 players (75%) returned to play again in the NBA, compared with 42 of 48 players (88%, P = 0.31) in the control group. One year after surgery, between-group comparisons revealed statistically significant increase in blocked shots per 40 minutes in the LD (0.18) versus control group (-0.33; P = 0.008) and a smaller decrease in rebounds per 40 minutes in the LD (-0

  3. Comparison of two- and three-dimensional assessment methods of nasolabial appearance in cleft lip and palate patients: Do the assessment methods measure the same outcome?

    Science.gov (United States)

    Mosmuller, David G M; Maal, Thomas J; Prahl, Charlotte; Tan, Robin A; Mulder, Frans J; Schwirtz, Roderic M F; de Vet, Henrica C W; Bergé, Stefaan J; Don Griot, J P W

    2017-08-01

    For the assessment of the nasolabial appearance in cleft patients, a widely accepted, reliable scoring system is not available. In this study four different methods of assessment are compared, including 2D and 3D asymmetry and aesthetic assessments. The data and ratings from an earlier study using the Asher-McDade aesthetic index on 3D photographs and the outcomes of 3D facial distance mapping were compared to a 2D aesthetic assessment, the Cleft Aesthetic Rating Scale, and to SymNose, a computerized 2D asymmetry assessment technique. The reliability and correlation between the four assessment techniques were tested using a sample of 79 patients. The 3D asymmetry assessment had the highest reliability and could be performed by just one observer (Intraclass correlation coefficient (ICC): 0.99). The 2D asymmetry assessment of the nose was highly reliable when performed by just one observer (ICC: 0.89). However, for the 2D asymmetry assessment of the lip more observers were needed. For the 2D aesthetic assessments 3 observers were needed. The 3D aesthetic assessment had the lowest single-observer reliability (ICC: 0.38-0.56) of all four techniques. The agreement between the different assessment methods is poor to very poor. The highest correlation (R: 0.48) was found between 2D and 3D aesthetic assessments. Remarkably, the lowest correlations were found between 2D and 3D asymmetry assessments (0.08-0.17). Different assessment methods are not in agreement and seem to measure different nasolabial aspects. More research is needed to establish exactly what each assessment technique measures and which measurements or outcomes are relevant for the patients. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  4. Technology and outcomes assessment in lung transplantation.

    Science.gov (United States)

    Yusen, Roger D

    2009-01-15

    Lung transplantation offers the hope of prolonged survival and significant improvement in quality of life to patients that have advanced lung diseases. However, the medical literature lacks strong positive evidence and shows conflicting information regarding survival and quality of life outcomes related to lung transplantation. Decisions about the use of lung transplantation require an assessment of trade-offs: do the potential health and quality of life benefits outweigh the potential risks and harms? No amount of theoretical reasoning can resolve this question; empiric data are needed. Rational analyses of these trade-offs require valid measurements of the benefits and harms to the patients in all relevant domains that affect survival and quality of life. Lung transplant systems and registries mainly focus outcomes assessment on patient survival on the waiting list and after transplantation. Improved analytic approaches allow comparisons of the survival effects of lung transplantation versus continued waiting. Lung transplant entities do not routinely collect quality of life data. However, the medical community and the public want to know how lung transplantation affects quality of life. Given the huge stakes for the patients, the providers, and the healthcare systems, key stakeholders need to further support quality of life assessment in patients with advanced lung disease that enter into the lung transplant systems. Studies of lung transplantation and its related technologies should assess patients with tools that integrate both survival and quality of life information. Higher quality information obtained will lead to improved knowledge and more informed decision making.

  5. Improving treatment outcome assessment in a mouse tuberculosis model.

    Science.gov (United States)

    Mourik, Bas C; Svensson, Robin J; de Knegt, Gerjo J; Bax, Hannelore I; Verbon, Annelies; Simonsson, Ulrika S H; de Steenwinkel, Jurriaan E M

    2018-04-09

    Preclinical treatment outcome evaluation of tuberculosis (TB) occurs primarily in mice. Current designs compare relapse rates of different regimens at selected time points, but lack information about the correlation between treatment length and treatment outcome, which is required to efficiently estimate a regimens' treatment-shortening potential. Therefore we developed a new approach. BALB/c mice were infected with a Mycobacterium tuberculosis Beijing genotype strain and were treated with rifapentine-pyrazinamide-isoniazid-ethambutol (R p ZHE), rifampicin-pyrazinamide-moxifloxacin-ethambutol (RZME) or rifampicin-pyrazinamide-moxifloxacin-isoniazid (RZMH). Treatment outcome was assessed in n = 3 mice after 9 different treatment lengths between 2-6 months. Next, we created a mathematical model that best fitted the observational data and used this for inter-regimen comparison. The observed data were best described by a sigmoidal E max model in favor over linear or conventional E max models. Estimating regimen-specific parameters showed significantly higher curative potentials for RZME and R p ZHE compared to RZMH. In conclusion, we provide a new design for treatment outcome evaluation in a mouse TB model, which (i) provides accurate tools for assessment of the relationship between treatment length and predicted cure, (ii) allows for efficient comparison between regimens and (iii) adheres to the reduction and refinement principles of laboratory animal use.

  6. Authentic leadership and nurse-assessed adverse patient outcomes.

    Science.gov (United States)

    Wong, Carol A; Giallonardo, Lisa M

    2013-07-01

    Our purpose was to test a model examining relationships among authentic leadership, nurses' trust in their manager, areas of work life and nurse-assessed adverse patient outcomes. Although several work environment factors have been cited as critical to patient outcomes, studies linking nursing leadership styles with patient outcomes are limited suggesting the need for additional research to investigate the mechanisms by which leadership may influence patient outcomes. Secondary analysis of data collected in a cross-sectional survey of 280 (48% response rate) registered nurses working in acute care hospitals in Ontario was conducted using structural equation modelling. The final model fit the data acceptably (χ(2) = 1.30, df = 2, P = 0.52, IFI = 0.99, CFI = 1.00, RMSEA = 0.00). Authentic leadership was significantly associated with decreased adverse patient outcomes through trust in the manager and areas of work life. The findings suggest that nurses who see their managers as demonstrating high levels of authentic leadership report increased trust, greater congruence in the areas of work life and lower frequencies of adverse patient outcomes. Managers who emphasize transparency, balanced processing, self-awareness and high ethical standards in their interactions with nurses may contribute to safer work environments for patients and nurses. © 2013 John Wiley & Sons Ltd.

  7. Comparison of ASSESS neutralization module results with actual small force engagement outcomes

    International Nuclear Information System (INIS)

    Gardner, B.H.; Snell, M.K.; Paulus, W.K.

    1991-01-01

    The ASSESS Neutralization module (Neutralization) is part of the Analytic System and Software for Evaluation of Safeguards and Security (ASSESS), a vulnerability assessment tool. Neutralization models a fire fight between security inspectors (SIs) and adversaries. This paper reports that a comparison has been made between actual outcomes of police and small military engagements and the results predicted by the Neutralization module for similar scenarios. The results of this comparison show a surprising correlation between predicted outcomes (based on numbers of combatants, weapon types, and exposures, etc.) and the actual outcomes of the engagements analyzed. The importance of this analysis is that given the defenders have intelligence on actual adversary characteristics or are protecting against a design basis threat, defense capabilities can be evaluated before an engagement. Results could then be used to develop a favorable probability of a desired outcome. For example, law enforcement agencies are frequently able to compile the number of criminals, types of weaponry, willingness to use force, etc., from analysis of crime scenes

  8. The effects of performance-based assessment criteria on student performance and self-assessment skills

    NARCIS (Netherlands)

    Fastré, Greet; Van der Klink, Marcel; Van Merriënboer, Jeroen

    2010-01-01

    Fastré, G. M. J., Van der Klink, M. R., & Van Merriënboer, J. J. G. (2010). The effects of performance-based assessment criteria on student performance and self-assessment skills. Advances in Health Science Education, 15(4), 517-532.

  9. Femoral head osteonecrosis: Volumetric MRI assessment and outcome

    International Nuclear Information System (INIS)

    Bassounas, Athanasios E.; Karantanas, Apostolos H.; Fotiadis, Dimitrios I.; Malizos, Konstantinos N.

    2007-01-01

    Effective treatment of femoral head osteonecrosis (FHON) requires early diagnosis and accurate assessment of the disease severity. The ability to predict in the early stages the risk of collapse is important for selecting a joint salvage procedure. The aim of the present study was to evaluate the outcome in patients treated with vascularized fibular grafts in relation to preoperative MR imaging volumetry. We studied 58 patients (87 hips) with FHON. A semi-automated octant-based lesion measurement method, previously described, was performed on the T1-w MR images. The mean time of postoperative follow-up was 7.8 years. Sixty-three hips were successful and 24 failed and converted to total hip arthroplasty within a period of 2-4 years after the initial operation. The rate of failures for hips of male patients was higher than in female patients. The mean lesion size was 28% of the sphere equivalent of the femoral head, 24 ± 12% for the successful hips and 37 ± 9% for the failed (p < 0.001). The most affected octants were antero-supero-medial (58 ± 26%) and postero-supero-medial (54 ± 31%). All but postero-infero-medial and postero-infero-lateral octants, showed statistically significant differences in the lesion size between patients with successful and failed hips. In conclusion, the volumetric analysis of preoperative MRI provides useful information with regard to a successful outcome in patients treated with vascularized fibular grafts

  10. Pre-Primary Education and Long-Term Education Performance: Evidence from Programme for International Student Assessment (PISA) Thailand

    Science.gov (United States)

    Pholphirul, Piriya

    2017-01-01

    Several research papers have assessed the long-term benefits of pre-primary education in terms of academic performance and labor market outcomes. This study analyzes data obtained from the Programme for International Student Assessment (PISA) to estimate the effects of preschool enrollment of Thai students on producing long-term benefits in their…

  11. Assessing the quality of the volume-outcome relationship in uro-oncology.

    Science.gov (United States)

    Mayer, Erik K; Purkayastha, Sanjay; Athanasiou, Thanos; Darzi, Ara; Vale, Justin A

    2009-02-01

    To assess systematically the quality of evidence for the volume-outcome relationship in uro-oncology, and thus facilitate the formulating of health policy within this speciality, as 'Implementation of Improving Outcome Guidance' has led to centralization of uro-oncology based on published studies that have supported a 'higher volume-better outcome' relationship, but improved awareness of methodological drawbacks in health service research has questioned the strength of this proposed volume-outcome relationship. We systematically searched previous relevant reports and extracted all articles from 1980 onwards assessing the volume-outcome relationship for cystectomy, prostatectomy and nephrectomy at the institution and/or surgeon level. Studies were assessed for their methodological quality using a previously validated rating system. Where possible, meta-analytical methods were used to calculate overall differences in outcome measures between low and high volume healthcare providers. In all, 22 studies were included in the final analysis; 19 of these were published in the last 5 years. Only four studies appropriately explored the effect of both the institution and surgeon volume on outcome measures. Mortality and length of stay were the most frequently measured outcomes. The median total quality scores within each of the operation types were 8.5, 9 and 8 for cystectomy, prostatectomy and nephrectomy, respectively (possible maximum score 18). Random-effects modelling showed a higher risk of mortality in low-volume institutions than in higher-volume institutions for both cystectomy and nephrectomy (odds ratio 1.88, 95% confidence interval 1.54-2.29, and 1.28, 1.10-1.49, respectively). The methodological quality of volume-outcome research as applied to cystectomy, prostatectomy and nephrectomy is only modest at best. Accepting several limitations, pooled analysis confirms a higher-volume, lower-mortality relationship for cystectomy and nephrectomy. Future research should

  12. Performance assessment calculational exercises

    International Nuclear Information System (INIS)

    Barnard, R.W.; Dockery, H.A.

    1990-01-01

    The Performance Assessment Calculational Exercises (PACE) are an ongoing effort coordinated by Yucca Mountain Project Office. The objectives of fiscal year 1990 work, termed PACE-90, as outlined in the Department of Energy Performance Assessment (PA) Implementation Plan were to develop PA capabilities among Yucca Mountain Project (YMP) participants by calculating performance of a Yucca Mountain (YM) repository under ''expected'' and also ''disturbed'' conditions, to identify critical elements and processes necessary to assess the performance of YM, and to perform sensitivity studies on key parameters. It was expected that the PACE problems would aid in development of conceptual models and eventual evaluation of site data. The PACE-90 participants calculated transport of a selected set of radionuclides through a portion of Yucca Mountain for a period of 100,000 years. Results include analyses of fluid-flow profiles, development of a source term for radionuclide release, and simulations of contaminant transport in the fluid-flow field. Later work included development of a problem definition for perturbations to the originally modeled conditions and for some parametric sensitivity studies. 3 refs

  13. Frontal assessment battery (FAB) performance following traumatic brain injury hospitalized in an acute care setting.

    Science.gov (United States)

    Rojas, Natalia; Laguë-Beauvais, Maude; Belisle, Arielle; Lamoureux, Julie; AlSideiri, Ghusn; Marcoux, Judith; Maleki, Mohammed; Alturki, Abdulrahman Y; Anchouche, Sonia; Alquraini, Hanan; Feyz, Mitra; Guise, Elaine de

    2018-01-19

    The Frontal Assessment Battery (FAB) has been shown to be useful in several clinical settings. The aim of the present study was to examine the performance of patients with traumatic brain injury (TBI) on the FAB and to predict their acute outcome. The FAB was administered to 89 patients with mild (27 = uncomplicated and 39 = complicated) and moderate (n = 23) TBI during hospitalization in an acute care setting. The length of stay in days (LOS), Glasgow Outcome Scale-Revised score (GOSE) and Disability Rating Scale (DRS) score were collected. Results showed no significant differences between the three groups on the FAB score, but age and education were significantly associated with the FAB score. Parietal lesions were associated with lower total FAB score, and with the Similarities, Motor series and Conflicting instructions subscales, while frontal lesions were associated with lower performance on the Motor series and Conflicting instructions subscales. Total FAB score was significantly correlated with all outcome measures, and together the FAB total score and the Glasgow Coma Scale (GCS) score explained 30.8% of the variance in the DRS score. The FAB may be useful clinically to acutely assess frontal and parietal lobe functions at bedside in patients with TBI and, in combination with the GCS score to measure TBI severity, can enable clinicians to predict early outcome.

  14. Six habits to enhance MET performance under stress: A discussion paper reviewing team mechanisms for improved patient outcomes.

    Science.gov (United States)

    Fein, Erich C; Mackie, Benjamin; Chernyak-Hai, Lily; O'Quinn, C Richard V; Ahmed, Ezaz

    2016-05-01

    Effective team decision making has the potential to improve the quality of health care outcomes. Medical Emergency Teams (METs), a specific type of team led by either critical care nurses or physicians, must respond to and improve the outcomes of deteriorating patients. METs routinely make decisions under conditions of uncertainty and suboptimal care outcomes still occur. In response, the development and use of Shared Mental Models (SMMs), which have been shown to promote higher team performance under stress, may enhance patient outcomes. This discussion paper specifically focuses on the development and use of SMMs in the context of METs. Within this process, the psychological mechanisms promoting enhanced team performance are examined and the utility of this model is discussed through the narrative of six habits applied to MET interactions. A two stage, reciprocal model of both nonanalytic decision making within the acute care environment and analytic decision making during reflective action learning was developed. These habits are explored within the context of a MET, illustrating how applying SMMs and action learning processes may enhance team-based problem solving under stress. Based on this model, we make recommendations to enhance MET decision making under stress. It is suggested that the corresponding habits embedded within this model could be imparted to MET members and tested by health care researchers to assess the efficacy of this integrated decision making approach in respect to enhanced team performance and patient outcomes. Copyright © 2015. Published by Elsevier Ltd.

  15. Clinical significance of C-reactive protein for assessment and outcomes of severe acute pancreatitis

    Directory of Open Access Journals (Sweden)

    REN Linan

    2015-05-01

    Full Text Available ObjectiveTo study the change in serum CRP level in patients with severe acute pancreatitis (SAP, and to explore its clinical significance in predicting outcomes and assessing the severity of SAP. MethodsA retrospective analysis was performed on 52 SAP patients with complete case data and admitted to General Hospital of Shenyang Military Area Command from September 2013 to September 2014. Blood drawing was performed and serum CRP concentration was determined on admission and at 24, 48, 72, 96, 120, and 144 hours after admission. The pattern of its dynamic change was observed. ResultsSerum CRP level in SAP patients significantly increased, and had a positive correlation with clinical outcomes. Forty-two cases (80.77% gradually recovered with aggressive treatment and the serum CRP levels were also slowly reduced (P<0.05. The serum CRP levels in four death cases (7.7% had no significant decrease and was maintained at a high level (P<0.05. Six patients (11.53% had aggravated conditions and recovered after aggressive treatment; meanwhile, the serum CRP levels first increased and then decreased (P<0.05. ConclusionFor SAP patients, serum CRP level fluctuates as their conditions change and can be considered as an important reference index for evaluating the severity and judging the outcomes of SAP.

  16. Performance-based assessment of activities of daily living (ADL) ability among women with chronic widespread pain

    DEFF Research Database (Denmark)

    Wæhrens, Eva Elisabet Ejlersen; Amris, Kirstine; Fisher, Anne G

    2010-01-01

    Functional ability, including the ability to perform activities of daily living (ADL), is considered a core outcome domain in chronic pain clinical trials and is usually assessed through generic or disease-specific self-report questionnaires. Research, however, indicates that self...

  17. Assessing teamwork performance in obstetrics: A systematic search and review of validated tools.

    Science.gov (United States)

    Fransen, Annemarie F; de Boer, Liza; Kienhorst, Dieneke; Truijens, Sophie E; van Runnard Heimel, Pieter J; Oei, S Guid

    2017-09-01

    Teamwork performance is an essential component for the clinical efficiency of multi-professional teams in obstetric care. As patient safety is related to teamwork performance, it has become an important learning goal in simulation-based education. In order to improve teamwork performance, reliable assessment tools are required. These can be used to provide feedback during training courses, or to compare learning effects between different types of training courses. The aim of the current study is to (1) identify the available assessment tools to evaluate obstetric teamwork performance in a simulated environment, and (2) evaluate their psychometric properties in order to identify the most valuable tool(s) to use. We performed a systematic search in PubMed, MEDLINE, and EMBASE to identify articles describing assessment tools for the evaluation of obstetric teamwork performance in a simulated environment. In order to evaluate the quality of the identified assessment tools the standards and grading rules have been applied as recommended by the Accreditation Council for Graduate Medical Education (ACGME) Committee on Educational Outcomes. The included studies were also assessed according to the Oxford Centre for Evidence Based Medicine (OCEBM) levels of evidence. This search resulted in the inclusion of five articles describing the following six tools: Clinical Teamwork Scale, Human Factors Rating Scale, Global Rating Scale, Assessment of Obstetric Team Performance, Global Assessment of Obstetric Team Performance, and the Teamwork Measurement Tool. Based on the ACGME guidelines we assigned a Class 3, level C of evidence, to all tools. Regarding the OCEBM levels of evidence, a level 3b was assigned to two studies and a level 4 to four studies. The Clinical Teamwork Scale demonstrated the most comprehensive validation, and the Teamwork Measurement Tool demonstrated promising results, however it is recommended to further investigate its reliability. Copyright © 2017

  18. Assessing Outcomes of a Realistic Major Preview in an Introductory Sport Management Course

    Science.gov (United States)

    Pierce, David; Wanless, Elizabeth; Johnson, James

    2014-01-01

    This paper assessed the outcomes of a field experience assignment (FEA) in an introductory sport management course designed as a realistic major preview. Student learning outcomes assessed were commitment to the major, intent to pursue the major, expectation of a career in sports, and perceived preparation for a career in sports. A…

  19. Pharmacy curriculum outcomes assessment for individual student assessment and curricular evaluation.

    Science.gov (United States)

    Scott, Day M; Bennett, Lunawati L; Ferrill, Mary J; Brown, Daniel L

    2010-12-15

    The Pharmacy Curriculum Outcomes Assessment (PCOA) is a standardized examination for assessing academic progress of pharmacy students. Although no other national benchmarking tool is available on a national level, the PCOA has not been adopted by all colleges and schools of pharmacy. Palm Beach Atlantic University (PBAU) compared 2008-2010 PCOA results of its P1, P2, and P3 students to their current grade point average (GPA) and to results of a national cohort. The reliability coefficient of PCOA was 0.91, 0.90, and 0.93 for the 3 years, respectively. PBAU results showed a positive correlation between GPA and PCOA scale score. A comparison of subtopic results helped to identify areas of strengths and weaknesses of the curriculum. PCOA provides useful comparative data that can facilitate individual student assessment as well as programmatic evaluation. There are no other standardized assessment tools available. Despite limitations, PCOA warrants consideration by colleges and schools of pharmacy. Expanded participation could enhance its utility as a meaningful benchmark.

  20. Outcomes assessment in cancer: measures, methods, and applications

    National Research Council Canada - National Science Library

    Lipscomb, Joseph; Snyder, Claire; Gotay, Carolyn C

    2005-01-01

    ... on individuals and populations. The findings and recommendations of the working group's 35 internationally recognized members are reported in Outcomes Assessment in Cancer, lucidly written and accessible to both researchers and policy makers in academia, government, and industry. This volume provides the most penetrating yet practical discussion to date of alte...

  1. DOE site performance assessment activities

    International Nuclear Information System (INIS)

    1990-07-01

    Information on performance assessment capabilities and activities was collected from eight DOE sites. All eight sites either currently dispose of low-level radioactive waste (LLW) or plan to dispose of LLW in the near future. A survey questionnaire was developed and sent to key individuals involved in DOE Order 5820.2A performance assessment activities at each site. The sites surveyed included: Hanford Site (Hanford), Idaho National Engineering Laboratory (INEL), Los Alamos National Laboratory (LANL), Nevada Test Site (NTS), Oak Ridge National Laboratory (ORNL), Paducah Gaseous Diffusion Plant (Paducah), Portsmouth Gaseous Diffusion Plant (Portsmouth), and Savannah River Site (SRS). The questionnaire addressed all aspects of the performance assessment process; from waste source term to dose conversion factors. This report presents the information developed from the site questionnaire and provides a comparison of site-specific performance assessment approaches, data needs, and ongoing and planned activities. All sites are engaged in completing the radioactive waste disposal facility performance assessment required by DOE Order 5820.2A. Each site has achieved various degrees of progress and have identified a set of critical needs. Within several areas, however, the sites identified common needs and questions

  2. Texas' performance assessment work

    International Nuclear Information System (INIS)

    Charbeneau, R.J.; Hertel, N.E.; Pollard, C.G.

    1990-01-01

    The Texas Low-Level Radioactive Waste Disposal Authority is completing two years of detailed on-site suitability studies of a potential low-level radioactive waste disposal site in Hudspeth County, Texas. The data from these studies have been used to estimate site specific parameters needed to do a performance assessment of the site. The radiological impacts of the site have been analyzed as required for a license application. The approach adopted for the performance assessment was to use simplified and yet conservative assumptions with regard to releases, radionuclide transport, and dose calculations. The methodologies employed in the performance assessment are reviewed in the paper. Rather than rely on a single computer code, a modular approach to the performance assessment was selected. The HELP code was used to calculate the infiltration rate through the trench covers and the amount of leachate released from this arid site. Individual pathway analyses used spreadsheet calculations. These calculations were compared with those from other computer models including CRRIS, INGDOS, PATHRAE, and MICROSHIELD copyright, and found to yield conservative estimates of the effective whole body dose. The greatest difficulty in performing the radiological assessment of the site was the selection of reasonable source terms for release into the environment. A surface water pathway is unreasonable for the site. Though also unlikely, the groundwater pathway with exposure through a site boundary well was found to yield the largest calculated dose. The more likely pathway including transport of leachate from the facility through the unsaturated zone and returning to the ground surface yields small doses. All calculated doses associated with normal releases of radioactivity are below the regulatory limits

  3. Teamwork assessment in internal medicine: a systematic review of validity evidence and outcomes.

    Science.gov (United States)

    Havyer, Rachel D A; Wingo, Majken T; Comfere, Nneka I; Nelson, Darlene R; Halvorsen, Andrew J; McDonald, Furman S; Reed, Darcy A

    2014-06-01

    Valid teamwork assessment is imperative to determine physician competency and optimize patient outcomes. We systematically reviewed published instruments assessing teamwork in undergraduate, graduate, and continuing medical education in general internal medicine and all medical subspecialties. We searched MEDLINE, MEDLINE In-process, CINAHL and PsycINFO from January 1979 through October 2012, references of included articles, and abstracts from four professional meetings. Two content experts were queried for additional studies. Included studies described quantitative tools measuring teamwork among medical students, residents, fellows, and practicing physicians on single or multi-professional (interprofessional) teams. Instrument validity and study quality were extracted using established frameworks with existing validity evidence. Two authors independently abstracted 30 % of articles and agreement was calculated. Of 12,922 citations, 178 articles describing 73 unique teamwork assessment tools met inclusion criteria. Interrater agreement was intraclass correlation coefficient 0.73 (95 % CI 0.63-0.81). Studies involved practicing physicians (142, 80 %), residents/fellows (70, 39 %), and medical students (11, 6 %). The majority (152, 85 %) assessed interprofessional teams. Studies were conducted in inpatient (77, 43 %), outpatient (42, 24 %), simulation (37, 21 %), and classroom (13, 7 %) settings. Validity evidence for the 73 tools included content (54, 74 %), internal structure (51, 70 %), relationships to other variables (25, 34 %), and response process (12, 16 %). Attitudes and opinions were the most frequently assessed outcomes. Relationships between teamwork scores and patient outcomes were directly examined for 13 (18 %) of tools. Scores from the Safety Attitudes Questionnaire and Team Climate Inventory have substantial validity evidence and have been associated with improved patient outcomes. Review is limited to quantitative assessments of teamwork in internal

  4. Learning-oriented assessment increases performance and written skills in a second year metabolic biochemistry course.

    Science.gov (United States)

    Vanderlelie, Jessica J; Alexander, Heather G

    2016-07-08

    Assessment plays a critical role in learning and teaching and its power to enhance engagement and student outcomes is still underestimated in tertiary education. The current project considers the impact of a staged redesign of an assessment strategy that emphasized relevance of learning, formative assessment, student engagement, and feedback on student performance, failure rates and overall engagement in the course. Significant improvements in final grades (p Biochemistry and Molecular Biology, 44(4):412-420, 2016. © 2016 The International Union of Biochemistry and Molecular Biology.

  5. Short Circuits or Superconductors? Effects of Group Composition on High-Achieving Students' Science Assessment Performance.

    Science.gov (United States)

    Webb, Noreen M.; Nemer, Kariane Mari; Zuniga, Stephen

    2002-01-01

    Studied the effects of group ability composition (homogeneous versus heterogeneous) on group processes and outcomes for high-ability students completing science assessments. Results for 83 high ability students show the quality of group functioning serves as the strongest predictor of high-ability students' performance and explained much of the…

  6. Use of the Derriford Appearance Scale 59 to assess patient-reported outcomes in secondary cleft surgery.

    Science.gov (United States)

    Ricketts, Sophie; Regev, Eran; Antonyshyn, Oleh M; Kiss, Alex; Fialkov, Jeffrey A

    2016-01-01

    Secondary rhinoplasty, one of the final procedures in addressing the stigma of the cleft lip and palate (CLP), has both functional and aesthetic objectives. The way in which physicians evaluate outcomes in surgery concerning aesthetics is changing. Well-designed patient-reported outcome measures to assess health-related quality of life improvements attributable to surgery are increasingly being used. The Derriford Appearance Scale 59 (DAS-59) is currently the only available validated patient-reported outcome measure that assesses concern about physical appearance. Twenty patients with CLP presenting between May 2009 and May 2013 for secondary rhinoplasty to Sunnybrook Health Sciences Centre (Toronto, Ontario) were recruited. DAS-59 measures were administered both preoperatively and at least six months after surgery. Pre- and postoperative measures were scored and compared. Item-by-item analysis of the measure was also performed. Total scores for this CLP group indicated greater concern about appearance than the general population. Across all subscales of the measure, there was a reduction in scores after secondary rhinoplasty suggesting less patient concern with appearance and a positive effect of surgery on patient quality of life. Item-by-item analysis suggested relatively few items in the measure were driving overall change in total scores. Comparison of pre- and postoperative scores with the DAS-59 in secondary cleft rhinoplasty suggests there is less concern with appearance after surgery. However, a small number of items within this generic scale contributing to this difference may suggest the need for a more patient specific measure for assessment of surgical outcomes in the cleft population.

  7. Designing Second Language Performance Assessments. Technical Report.

    Science.gov (United States)

    Norris, John M.; Brown, James Dean; Hudson, Thom; Yoshioka, Jim

    This technical report focuses on the decision-making potential provided by second language performance assessments. First, performance assessment is situated within the broader discussion of alternatives in language assessment and in educational assessment in general. Next, issues in performance assessment design, implementation, reliability, and…

  8. Performance Assessment in Courts - The Swiss Case

    Directory of Open Access Journals (Sweden)

    Andreas Lienhard

    2014-12-01

    Full Text Available Abstract Performance assessments have become commonplace in management, even in the public sector. With the increasing pressure on courts to perform while making efficient use of resources, performance assessments in the justice system are also gaining in importance. However, the need for judicial independence poses special challenges for performance assessments in courts. Against this background, this article conducts a constitutional appraisal, and contrasts the need for judicial independence with the principles governing effectiveness and efficiency, self-government and supervision, and appointment and re-appointment. A duty to guarantee justice can be derived from this that does not in principle exclude the performance assessment of judges, but even renders it essential, subject to compliance with certain requirements. In these circumstances, it seems hardly surprising that numerous countries conduct performance assessments of judges and also that various international institutions have developed principles for this purpose, a summary of which is presented – in Switzerland’s case based on a recently conducted survey. In the field of conflict between the guaranteeing justice and protecting the judiciary, the following key questions arise in particular: What is the purpose of performance assessments and what are the consequences?What is subjected to a performance assessment and what are the assessment criteria?How is performance recorded as the basis for the performance assessment?Who is subjected to a performance assessment, and must a distinction be made between judges in higher and lower courts?Who carries out the performance assessment and what methods of protecting one’s rights are available?Who should receive the results of the performance assessment?The contribution sketches out possible answers to these key questions and aims to encourage academics and practitioners to give further consideration to this subject.

  9. Assessing Technical Writing in Institutional Contexts: Using Outcomes-Based Assessment for Programmatic Thinking.

    Science.gov (United States)

    Carter, Michael; Anson, Chris M.; Miller, Carolyn R.

    2003-01-01

    Notes that technical writing instruction often operates in isolation from other components of students' communication education. Argues for altering this isolation by moving writing instruction to a place of increased programmatic perspective, which may be attained through a means of assessment based on educational outcomes. Discusses two models…

  10. Performance Assessment National Review Group

    International Nuclear Information System (INIS)

    Lieberman, J.A.; Davis, S.N.; Harleman, D.R.F.

    1985-02-01

    Performance assessment involves predicting the potential radiological impact of a nuclear waste disposal system, taking into account all of the natural and engineered components of the system. It includes the analysis and evaluation of predicted system and component performance to determine compliance with regulatory performance criteria. In the context of the nuclear waste management program, performance assessment has five major purposes: to assist in the evaluation and selection of repository sites; to guide the research, development, and testing programs; to assist in the evaluation of repository designs; to assist in the evaluation of the design and performance of engineered barriers; and to show regulatory compliance and support repository licensing. Current performance assessment methodologies are still in the developmental stage. Only the simplest of bounding calculations have produced quantitative predictions of radionuclide releases. The methodologies require considerable extension and validation before they can provide answers suitable for project decisions and licensing. 135 refs., 9 figs., 1 tab

  11. From performance to performativity: The legitimization of US security contracting and its consequences.

    Science.gov (United States)

    Krahmann, Elke

    2017-12-01

    Discussions about the legitimacy of private security companies (PSCs) in multilateral military interventions abound. This article looks at how the United States has sought to legitimize the outsourcing of security services to PSCs through performance-based contracting and performance assessments. Both mechanisms aim to demonstrate the effective provision of publicly desirable outcomes. However, the immaterial and socially constructed nature of security presents major problems for performance assessments in terms of observable and measurable outcomes. Performance has therefore given way to performativity - that is, the repetitive enactment of particular forms of behaviour and capabilities that are simply equated with security as an outcome. The implications of this development for the ways in which security has been conceptualized, implemented and experienced within US interventions have been profound. Ironically, the concern with performance has not encouraged PSCs to pay increased attention to their impacts on security environments and civilian populations, but has fostered a preoccupation with activities and measurable capabilities that can be easily assessed by government auditors.

  12. Operational human performance reliability assessment (OHPRA)

    International Nuclear Information System (INIS)

    Haas, P.M.; Swanson, P.J.; Connelly, E.M.

    1993-01-01

    Operational Human Performance Reliability Assessment (OHPRA) is an approach for assessing human performance that is being developed in response to demands from modern process industries for practical and effective tools to assess and improve human performance, and therefore overall system performance and safety. The single most distinguishing feature of the approach is that is defines human performance in open-quotes operationalclose quotes terms. OHPRA is focused not on generation of human error probabilities, but on practical analysis of human performance to aid management in (1) identifying open-quotes fixableclose quotes problems and (2) providing input on the importance and nature of potential improvements. Development of the model in progress uses a unique approach for eliciting expert strategies for assessing performance. A PC-based model incorporating this expertise is planned. A preliminary version of the approach has already been used successfully to identify practical human performance problems in reactor and chemical process plant operations

  13. Use of the Liverpool Elbow Score as a postal questionnaire for the assessment of outcome after total elbow arthroplasty.

    Science.gov (United States)

    Ashmore, Alexander M; Gozzard, Charles; Blewitt, Neil

    2007-01-01

    The Liverpool Elbow Score (LES) is a newly developed, validated elbow-specific score. It consists of a patient-answered questionnaire (PAQ) and a clinical assessment. The purpose of this study was to determine whether the PAQ portion of the LES could be used independently as a postal questionnaire for the assessment of outcome after total elbow arthroplasty and to correlate the LES and the Mayo Elbow Performance Score (MEPS). A series of 51 total elbow replacements were reviewed by postal questionnaire. Patients then attended the clinic for assessment by use of both the LES and the MEPS. There was an excellent response rate to the postal questionnaire (98%), and 44 elbows were available for clinical review. Good correlation was shown between the LES and the MEPS (Spearman correlation coefficient, 0.84; P PAQ portion of the LES and the MEPS (Spearman correlation coefficient, 0.76; P PAQ component and the MEPS, suggesting that outcome assessment is possible by postal questionnaire.

  14. Assessment of residency program outcomes via alumni surveys.

    Science.gov (United States)

    Lüer, Sonja; Aebi, Christoph

    2017-01-01

    One trend in medical education is outcomes-oriented training. Outcomes usually refer to individuals' acquisition of competencies, for example, during training in residency programs. However, little is known about outcomes of these programs. In order to fill this gap, human resource (HR) data were analyzed and alumni of a pediatric residency program were surveyed at the Department of Pediatrics, Bern University Hospital, Switzerland. Residency program outcomes (demographics, career choices, part-time or full-time work status, competencies, feedback) were assessed through in-house HR databases, publicly available data on the Internet (physician directory and practice homepages), and 2 alumni surveys (S1, S2). In all, 109 alumni met the inclusion criteria. Retention rate at the hospital was low (14%). Forty-six alumni (42%) in private practice were eligible for alumni surveys. Response rates were 87% (S1) and 61% (S2). Time intervals between 2 career decisions (selecting specialty of pediatrics vs selecting setting of private practice) varied widely (late-training decision to enter private practice). Mean employment level in private practice was 60% (range 20%-100%). Most valued rotation was emergency medicine; most desired competencies in future colleagues were the ability to work in a team, proficiency in pediatrics, and working economically. A broadened view on outcomes - beyond individuals' competency acquisition - provides informative insights into a training program, can allow for informed program updates, and guide future program development.

  15. An assessment model in outcomes-based education and training ...

    African Journals Online (AJOL)

    The study addresses a concern in higher education and specifically in health sciences and technology regarding integrated and authentic assessment with an outcomes-based approach. Interviews were conducted with head-hunted academics in health sciences and technology. From the information generated, an ...

  16. Performance assessment in algebra learning process

    Science.gov (United States)

    Lestariani, Ida; Sujadi, Imam; Pramudya, Ikrar

    2017-12-01

    The purpose of research to describe the implementation of performance assessment on algebra learning process. The subject in this research is math educator of SMAN 1 Ngawi class X. This research includes descriptive qualitative research type. Techniques of data collecting are done by observation method, interview, and documentation. Data analysis technique is done by data reduction, data presentation, and conclusion. The results showed any indication that the steps taken by the educator in applying the performance assessment are 1) preparing individual worksheets and group worksheets, 2) preparing rubric assessments for independent worksheets and groups and 3) making performance assessments rubric to learners’ performance results with individual or groups task.

  17. When Things Are Not as They Appear: Assessing the Adequacy of Cluster Randomization When Outcome Events Are Rare at Baseline

    Directory of Open Access Journals (Sweden)

    Veronica Dinaj-Koci

    2012-01-01

    Full Text Available The present study randomly assigned 15 Bahamian elementary schools to one of three intervention conditions. To assess the adequacy of cluster randomization, we examined two concerns identified by the local research team: inequality of gender distribution and environmental risk among groups. Baseline significant differences in risk and protective behaviors were minimal. There were significantly more males in the intervention group. Males had higher rates of risk behavior at all assessments. Poor school performance was also higher among the intervention condition and was significantly associated with increased rates of many but not all risk behaviors. Prior to adjusting for gender and school performance, several risk behaviors appeared to be higher after intervention among intervention youth. Adjusting for gender and school performance eradicated the group differences in risk behavior rates. Results demonstrate the importance of adequate randomization where outcomes of interest are rare events at baseline or differ by gender and there is an unequal gender distribution and the importance of the local research team’s knowledge of potential inequalities in environmental risk (i.e., school performance. Not considering such individual differences could impact the integrity of trial outcomes.

  18. A Conceptual Framework for Assessment of Governance Performance of Lake Basins: Towards Transformation to Adaptive and Integrative Governance

    Directory of Open Access Journals (Sweden)

    Peter Emmanuel Cookey

    2016-03-01

    Full Text Available Governance is essential to lake basin management, but it is the most challenged and needs increased attention. Lake Basin Governance performance assessment is designed to measure the progress and impacts of policies, institutions and the roles of various actors in ensuring sustainability. It measures the performance of technical/operational, social/networks, and institutional arrangement that make up the socio-ecological system. Governance performance assessment becomes very necessary with over-emphasis of institutions on resources utilization and exploitation. The purpose of this paper is to present a governance performance assessment framework specifically for lake basins. The Adaptive Integrated Lake Basin Management (AILBM framework is a diagnostic and prescriptive performance assessment tool with an outcome to produce an adaptive and integrative system with equity, inclusiveness, transparency, accountability and flexibility to problem-solving and resilience. A case study on water governance performance assessment of the Songkhla Lake Basin (SLB in Thailand is provided for illustration and application and indicated a poor performance rating on governance in the Basin, revealing gaps, defects, strengths and weaknesses in the current system, necessary to recommend future improvements.

  19. Review of SR 97 performance assessment

    International Nuclear Information System (INIS)

    Glynn, P.D.

    2000-01-01

    This review has identified many technical problems in the SR 97 performance assessment. The general impression of this reviewer is that SKB has been disingenuous in its performance assessment effort. It has not cited important differences of opinion with its own views. Furthermore, there are many inconsistencies in the SR 97 report that all together leave the impression that there are many more uncertainties in the SR 97 performance assessment than SKB would perhaps care to admit. Additionally, despite SKB's statements to the contrary, many of the analyses conducted for the SR 97 performance assessment can be clearly shown not to have been based on 'conservative' assumptions. Finally, SKB has made little effort to consider possible coupling effects between their different scenarios in SR 97. This is a serious flaw in the SR 97 performance assessment. The comments in this review should not be taken to imply that the KBS-3 nuclear waste disposal method will not be able to meet the safety and radiation protection requirements which SKI and SSI have specified in recent years. Instead, my conclusion is simply that the SR 97 performance assessment of the KBS-3 method would have been more believable had it been based on a forthright and comprehensive discussion of facts, uncertainties and opinions, and on a more conservative choice of assumptions. As it stands, the SR 97 performance assessment is not very credible

  20. Accuracy of densitometric vertebral fracture assessment when performed by DXA technicians-a cross-sectional, multiobserver study

    DEFF Research Database (Denmark)

    Rud, B; Vestergaard, A; Hyldstrup, L

    2016-01-01

    Six dual-energy X-ray absorptiometry (DXA) technicians reviewed lateral images of the spine for deformed vertebrae. The images were acquired with a DXA scanner in 235 patients referred for osteoporosis assessment. The outcome was compared to findings on spinal radiographs assessed by two radiolog......Six dual-energy X-ray absorptiometry (DXA) technicians reviewed lateral images of the spine for deformed vertebrae. The images were acquired with a DXA scanner in 235 patients referred for osteoporosis assessment. The outcome was compared to findings on spinal radiographs assessed by two...... radiologists. Three DXA technicians performed acceptable or better in identifying patients with fractured vertebrae. INTRODUCTION: This is the first study to evaluate the accuracy of vertebral fracture assessment (VFA) when used by DXA technicians as a triage test to select patients with deformed vertebrae...... for spinal radiographs. METHODS: Lateral single-energy scans and radiographs of the thoracolumbar spine (T4-L4) were acquired in 235 patients aged 65 years or more referred for osteoporosis assessment. Six DXA technicians evaluated lateral scans using dedicated software. The DXA technicians were trained...

  1. Perioperative outcomes following surgery for brain tumors: Objective assessment and risk factor evaluation

    Directory of Open Access Journals (Sweden)

    Aliasgar V Moiyadi

    2012-01-01

    Full Text Available Background: Perioperative outcomes following surgery for brain tumors are an important indicator of the safety as well as efficacy of surgical intervention. Perioperative morbidity not only has implications on direct patient care, but also serves as an indicator of the quality of care provided, and enables objective documentation, for comparision in various clinical trials. We document our experience at a tertiary care referral, a dedicated neuro-oncology center in India. Materials and Methods: One hundred and ninety-six patients undergoing various surgeries for intra-axial brain tumors were analyzed. Routine microsurgical techniques and uniform antibiotic policy were used. Navigation/ intraoperative electrophysiological monitoring was not available. The endpoints assessed included immediate postoperative neurological status, neurological outcome at discharge, regional complications, systemic complications, overall morbidity, and mortality. Various risk factors assessed included clinico-epidemiological factors, tumor-related factors, and surgery-related factors. Univariate and multivariate analysis were performed. Results: Median age was 38 years. 72% had tumors larger than 4 cm. Neurological morbidity, and regional and systemic complications occurred in 16.8, 17.3, and 10.7%, respectively. Overall, major morbidity occurred in 18% and perioperative mortality rate was 3.6%. Although a few of the known risk factors were found to be significant on univariate analysis, none achieved significance on multivariate analysis. Conclusions: Our patients were younger and had larger tumors than are generally reported. Despite the unavailability of advanced intraoperative aids we could achieve acceptable levels of morbidity and mortality. Objective recording of perioperative events is crucial to document outcomes after surgery for brain tumors.

  2. Commitment to COT verification improves patient outcomes and financial performance.

    Science.gov (United States)

    Maggio, Paul M; Brundage, Susan I; Hernandez-Boussard, Tina; Spain, David A

    2009-07-01

    After an unsuccessful American College of Surgery Committee on Trauma visit, our level I trauma center initiated an improvement program that included (1) hiring new personnel (trauma director and surgeons, nurse coordinator, orthopedic trauma surgeon, and registry staff), (2) correcting deficiencies in trauma quality assurance and process improvement programs, and (3) development of an outreach program. Subsequently, our trauma center had two successful verifications. We examined the longitudinal effects of these efforts on volume, patient outcomes and finances. The Trauma Registry was used to derive data for all trauma patients evaluated in the emergency department from 2001 to 2007. Clinical data analyzed included number of admissions, interfacility transfers, injury severity scores (ISS), length of stay, and mortality for 2001 to 2007. Financial performance was assessed for fiscal years 2001 to 2007. Data were divided into patients discharged from the emergency department and those admitted to the hospital. Admissions increased 30%, representing a 7.6% annual increase (p = 0.004), mostly due to a nearly fivefold increase in interfacility transfers. Severe trauma patients (ISS >24) increased 106% and mortality rate for ISS >24 decreased by 47% to almost half the average of the National Trauma Database. There was a 78% increase in revenue and a sustained increase in hospital profitability. A major hospital commitment to Committee on Trauma verification had several salient outcomes; increased admissions, interfacility transfers, and acuity. Despite more seriously injured patients, there has been a major, sustained reduction in mortality and a trend toward decreased intensive care unit length of stay. This resulted in a substantial increase in contribution to margin (CTM), net profit, and revenues. With a high level of commitment and favorable payer mix, trauma center verification improves outcomes for both patients and the hospital.

  3. Novel digital imaging techniques to assess the outcome in oral rehabilitation with dental implants: a narrative review.

    Science.gov (United States)

    Benic, Goran I; Elmasry, Moustafa; Hämmerle, Christoph H F

    2015-09-01

    To examine the literature on novel digital imaging techniques for the assessment of outcomes in oral rehabilitation with dental implants. An electronic search of Medline and Embase databases including studies published prior to 28th December 2014 was performed and supplemented by a manual search. A synthesis of the publications was presented describing the use of computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography, optical scanning, spectrophotometry or optical coherence tomography (OCT) related to the outcome measures in implant therapy. Most of the digital imaging techniques have not yet sufficiently been validated to be used for outcome measures in implant dentistry. In clinical research, cone beam CT (CBCT) is increasingly being used for 3D assessment of bone and soft tissue following augmentation procedures and implant placement. Currently, there are no effective methods for the reduction of artifacts around implants in CBCT. Optical scanning is being used for the 3D assessment of changes in the soft tissue contour. The combination of optical scan with pre-operative CBCT allows the determination of the implant position and its spatial relation to anatomical structures. Spectrophotometry is the method most commonly used to objectively assess the color match of reconstructions and peri-implant mucosa to natural dentition and gingiva. New optical imaging techniques may be considered possible approaches for monitoring peri-implant soft tissue health. MRI and ultrasonography appear promising non-ionizing radiation imaging modalities for the assessment of soft tissue and bone defect morphologies. Optical scanners and OCT may represent efficient clinical methods for accurate assessment of the misfit between the reconstructions and the implants. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Can outcome-based continuing medical education improve performance of immigrant physicians?

    Science.gov (United States)

    Castel, Orit Cohen; Ezra, Vered; Alperin, Mordechai; Nave, Rachel; Porat, Tamar; Golan, Avivit Cohen; Vinker, Shlomo; Karkabi, Khaled

    2011-01-01

    Immigrant physicians are a valued resource for physician workforces in many countries. Few studies have explored the education and training needs of immigrant physicians and ways to facilitate their integration into the health care system in which they work. Using an educational program developed for immigrant civilian physicians working in military primary care clinics at the Israel Defence Force, we illustrate how an outcome-based CME program can address practicing physicians' needs for military-specific primary care education and improve patient care. Following an extensive needs assessment, a 3-year curriculum was developed. The curriculum was delivered by a multidisciplinary educational team. Pre/post multiple-choice examinations, objective structured clinical examinations (OSCE), and end-of-program evaluations were administered for curriculum evaluation. To evaluate change in learners' performance, data from the 2003 (before-program) and 2006 (after-program) work-based assessments were retrieved retrospectively. Change in the performance of program participants was compared with that of immigrant physicians who did not participate in the program. Out of 28 learners, 23 (82%) completed the program. Learners did significantly better in the annual post-tests compared with the pretests (p educators, facing the challenge of integrating immigrant physicians to fit their health care system, may consider adapting our approach. Copyright © 2011 The Alliance for Continuing Medical Education, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

  5. Towards quantitative condition assessment of biodiversity outcomes: Insights from Australian marine protected areas.

    Science.gov (United States)

    Addison, Prue F E; Flander, Louisa B; Cook, Carly N

    2017-08-01

    Protected area management effectiveness (PAME) evaluation is increasingly undertaken to evaluate governance, assess conservation outcomes and inform evidence-based management of protected areas (PAs). Within PAME, quantitative approaches to assess biodiversity outcomes are now emerging, where biological monitoring data are directly assessed against quantitative (numerically defined) condition categories (termed quantitative condition assessments). However, more commonly qualitative condition assessments are employed in PAME, which use descriptive condition categories and are evaluated largely with expert judgement that can be subject to a range of biases, such as linguistic uncertainty and overconfidence. Despite the benefits of increased transparency and repeatability of evaluations, quantitative condition assessments are rarely used in PAME. To understand why, we interviewed practitioners from all Australian marine protected area (MPA) networks, which have access to long-term biological monitoring data and are developing or conducting PAME evaluations. Our research revealed that there is a desire within management agencies to implement quantitative condition assessment of biodiversity outcomes in Australian MPAs. However, practitioners report many challenges in transitioning from undertaking qualitative to quantitative condition assessments of biodiversity outcomes, which are hampering progress. Challenges include a lack of agency capacity (staff numbers and money), knowledge gaps, and diminishing public and political support for PAs. We point to opportunities to target strategies that will assist agencies overcome these challenges, including new decision support tools, approaches to better finance conservation efforts, and to promote more management relevant science. While a single solution is unlikely to achieve full evidence-based conservation, we suggest ways for agencies to target strategies and advance PAME evaluations toward best practice. Copyright

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

    Science.gov (United States)

    McClellan, Jeffrey L.

    2011-01-01

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

  7. Faculty and Career Advising: Challenges, Opportunities, and Outcome Assessment

    Science.gov (United States)

    Vespia, Kristin M.; Freis, Stephanie D.; Arrowood, Rebecca M.

    2018-01-01

    Psychology prioritizes students' professional or career development by including it as one of the five undergraduate learning goals. Faculty advisors are critical to that development but likely feel less prepared for the role. Departments face challenges assessing associated student learning outcomes. We introduce an instrument programs can use to…

  8. The outcome of root-canal treatments assessed by cone-beam computed tomography

    NARCIS (Netherlands)

    Liang, Y.H.

    2013-01-01

    In this thesis, in-vivo and ex-vivo methods were utilized to assess the outcome of root canal treatments determined by cone-beam computed tomography (CBCT) and the reliability of the CBCT-findings. CBCT provided useful and reliable information leading to a better understanding of the outcome and

  9. Objective assessment of cosmetic outcome after targeted intraoperative radiotherapy in breast cancer

    DEFF Research Database (Denmark)

    Keshtgar, Mohammed R S; Williams, Norman R; Bulsara, Max

    2013-01-01

    and thus impair cosmesis further, so we objectively evaluated the aesthetic outcome of patients within the TARGIT randomised controlled trial. We have used an objective assessment tool for evaluation of cosmetic outcome. Frontal digital photographs were taken at baseline (before TARGIT or EBRT) and yearly...... in a randomised setting, the aesthetic outcome of patients demonstrates that those treated with TARGIT have a superior cosmetic result to those patients who received conventional external beam radiotherapy....

  10. Issues in developing valid assessments of speech pathology students' performance in the workplace.

    Science.gov (United States)

    McAllister, Sue; Lincoln, Michelle; Ferguson, Alison; McAllister, Lindy

    2010-01-01

    Workplace-based learning is a critical component of professional preparation in speech pathology. A validated assessment of this learning is seen to be 'the gold standard', but it is difficult to develop because of design and validation issues. These issues include the role and nature of judgement in assessment, challenges in measuring quality, and the relationship between assessment and learning. Valid assessment of workplace-based performance needs to capture the development of competence over time and account for both occupation specific and generic competencies. This paper reviews important conceptual issues in the design of valid and reliable workplace-based assessments of competence including assessment content, process, impact on learning, measurement issues, and validation strategies. It then goes on to share what has been learned about quality assessment and validation of a workplace-based performance assessment using competency-based ratings. The outcomes of a four-year national development and validation of an assessment tool are described. A literature review of issues in conceptualizing, designing, and validating workplace-based assessments was conducted. Key factors to consider in the design of a new tool were identified and built into the cycle of design, trialling, and data analysis in the validation stages of the development process. This paper provides an accessible overview of factors to consider in the design and validation of workplace-based assessment tools. It presents strategies used in the development and national validation of a tool COMPASS, used in an every speech pathology programme in Australia, New Zealand, and Singapore. The paper also describes Rasch analysis, a model-based statistical approach which is useful for establishing validity and reliability of assessment tools. Through careful attention to conceptual and design issues in the development and trialling of workplace-based assessments, it has been possible to develop the

  11. Deriving common comorbidity indices from the MedDRA classification and exploring their performance on key outcomes in patients with rheumatoid arthritis.

    Science.gov (United States)

    Putrik, Polina; Ramiro, Sofia; Lie, Elisabeth; Michaud, Kaleb; Kvamme, Maria K; Keszei, Andras P; Kvien, Tore K; Uhlig, Till; Boonen, Annelies

    2018-03-01

    To develop algorithms for calculating the Rheumatic Diseases Comorbidity Index (RDCI), Charlson-Deyo Index (CDI) and Functional Comorbidity Index (FCI) from the Medical Dictionary for Regulatory Activities (MedDRA), and to assess how these MedDRA-derived indices predict clinical outcomes, utility and health resource utilization (HRU). Two independent researchers linked the preferred terms of the MedDRA classification into the conditions included in the RDCI, the CDI and the FCI. Next, using data from the Norwegian Register-DMARD study (a register of patients with inflammatory joint diseases treated with DMARDs), the explanatory value of these indices was studied in models adjusted for age, gender and DAS28. Model fit statistics were compared in generalized estimating equation (prediction of outcome over time) models using as outcomes: modified HAQ, HAQ, physical and mental component summary of SF-36, SF6D and non-RA related HRU. Among 4126 patients with RA [72% female, mean (s.d.) age 56 (14) years], median (interquartile range) of RDCI at baseline was 0.0 (1.0) [range 0-6], CDI 0.0 (0.0) [0-7] and FCI 0.0 (1.0) [0-6]. All the comorbidity indices were associated with each outcome, and differences in their performance were moderate. The RDCI and FCI performed better on clinical outcomes: modified HAQ and HAQ, hospitalization, physical and mental component summary, and SF6D. Any non-RA related HRU was best predicted by RDCI followed by CDI. An algorithm is now available to compute three commonly used comorbidity indices from MedDRA classification. Indices performed comparably well in predicting a variety of outcomes, with the CDI performing slightly worse when predicting outcomes reflecting functioning and health. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  12. Rethinking Functional Outcome Measures: The Development of a Novel Upper Limb Token Transfer Test to Assess Basal Ganglia Dysfunction

    Directory of Open Access Journals (Sweden)

    Susanne P. Clinch

    2018-05-01

    Full Text Available The basal ganglia are implicated in a wide range of motor, cognitive and behavioral activities required for normal function. This region is predominantly affected in Huntington's disease (HD, meaning that functional ability progressively worsens. However, functional outcome measures for HD, particularly those for the upper limb, are limited meaning there is an imperative for well-defined, quantitative measures. Here we describe the development and evaluation of the Moneybox test (MBT. This novel, functional upper limb assessment was developed in accordance with translational neuroscience and physiological principles for people with a broad disease manifestation, such as HD. Participants with HD (n = 64 and healthy controls (n = 21 performed the MBT, which required subjects to transfer tokens into a container in order of size (Baseline Transfer, value (Complex Transfer with and without reciting the alphabet (Dual Transfer. Disease specific measures of motor, cognition, behavior, and function were collected. HD patients were grouped into disease stage, from which, discriminative and convergent validity was assessed using Analysis of Variance and Pearson's correlation respectively. Manifest HD participants were slower than pre-manifest and control participants, and achieved significantly lower MBT total scores. Performance in the Complex Transfer and Dual Transfer tasks were significantly different between pre-manifest and stage 1 HD. All MBT performance variables significantly correlated with routinely used measures of motor, cognition, behavior, and function. The MBT provides a valid, sensitive, and affordable functional outcome measure. Unlike current assessments, MBT performance significantly distinguished the subtle differences between the earliest disease stages of HD, which are the populations typically targeted in clinical trials.

  13. Assessment of Patient-Reported Outcome Instruments to Assess Chronic Low Back Pain.

    Science.gov (United States)

    Ramasamy, Abhilasha; Martin, Mona L; Blum, Steven I; Liedgens, Hiltrud; Argoff, Charles; Freynhagen, Rainer; Wallace, Mark; McCarrier, Kelly P; Bushnell, Donald M; Hatley, Noël V; Patrick, Donald L

    2017-06-01

     To identify patient-reported outcome (PRO) instruments that assess chronic low back pain (cLBP) symptoms (specifically pain qualities) and/or impacts for potential use in cLBP clinical trials to demonstrate treatment benefit and support labeling claims.  Literature review of existing PRO measures.  Publications detailing existing PRO measures for cLBP were identified, reviewed, and summarized. As recommended by the US Food & Drug Administration (FDA) PRO development guidance, standard measurement characteristics were reviewed, including development history, psychometric properties (validity and reliability), ability to detect change, and interpretation of observed changes.  Thirteen instruments were selected and reviewed: Low Back Pain Bothersomeness Scale, Neuropathic Pain Symptom Inventory, PainDETECT, Pain Quality Assessment Scale Revised, Revised Short Form McGill Pain Questionnaire, Low Back Pain Impact Questionnaire, Oswestry Disability Index, Pain Disability Index, Roland-Morris Disability Questionnaire, Brief Pain Inventory and Brief Pain Inventory Short Form, Musculoskeletal Outcomes Data Evaluation and Management System Spine Module, Orebro Musculoskeletal Pain Questionnaire, and the West Haven-Yale Multidimensional Pain Inventory Interference Scale. The instruments varied in the aspects of pain and/or impacts that they assessed, and none of the instruments fulfilled all criteria for use in clinical trials to support labeling claims based on recommendations outlined in the FDA PRO guidance.  There is an unmet need for a validated PRO instrument to evaluate cLBP-related symptoms and impacts for use in clinical trials. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  14. Performance assessment: a peer review

    International Nuclear Information System (INIS)

    Lieberman, J.A.; Lee, W.W.L.

    1986-01-01

    This paper describes the rationale, membership, operation and major observations of the Performance Assessment National Review Group. The Group was assembled by Weston at the request of the US Department of Energy Office of Civilian Radioactive Waste Management to review performance assessment work in the US basalt, salt and tuff repository projects. The purposes were to evaluate the adequacy of the current methods, identify deficiencies, and suggest potential improvement on repository performance assessment. To perform the review, Weston retained a group of distinguished consultants who have had extensive experience in disciplines pertinent to management of radioactive wastes including mathematical modeling of fluid transport. Topics reviewed included flow and transport, source term and uncertainty analysis. While the emphasis was on methodologies, the Projects were specifically requested to show currently available results so that the way they utilized familiar methodologies could be evaluated. This paper will highlight some of the technical observations of the Group as well as some managerial and institutional issues

  15. Making Performance Assessments a Part of Accountability

    Science.gov (United States)

    Haun, Billy

    2018-01-01

    The purpose of this commentary is to describe recent efforts in Virginia to develop and use performance assessments, including the challenges that emerged during this process and key considerations for states that integrate performance assessment into their systems. Performance assessments can play an important role in preparing students for…

  16. Performance Assessment of Mergers and Acquisitions

    DEFF Research Database (Denmark)

    Wang, Daojuan; Moini, Hamid

    2012-01-01

    on the performance measures and benchmarks adopted in M&A research field and the relevant empirical results. We find that the definitions of performance varied in terms of accounting, financial, operational and perceptual metrics. And performance assessment is sensitive to the definition of performance, methodology......Corporate mergers and acquisitions (M&As) have been increasing popular during these decades. However, a majority of research show failure rate (40% - 80%) has not significantly changed. This “success paradox” triggers us to reflect on performance assessment of M&As: how the performance of M...

  17. Comparison of pharmacy students' perceived and actual knowledge using the Pharmacy Curricular Outcomes Assessment.

    Science.gov (United States)

    Naughton, Cynthia A; Friesner, Daniel L

    2012-05-10

    To determine whether a correlation exists between third-year PharmD students' perceived pharmacy knowledge and actual pharmacy knowledge as assessed by the Pharmacy Curricular Outcomes Assessment (PCOA). In 2010 and 2011, the PCOA was administered in a low-stakes environment to third-year pharmacy students at North Dakota State University College of Pharmacy, Nursing, and Allied Sciences (COPNAS). A survey instrument was also administered on which students self-assessed their perceived competencies in each of the core areas covered by the PCOA examination. The pharmacy students rated their competencies slightly higher than average. Performance on the PCOA was similar to but slightly higher than national averages. Correlations between each of the 4 content areas (basic biomedical sciences, pharmaceutical sciences, social/administrative sciences, and clinical sciences) mirrored those reported nationally by the National Association of Boards of Pharmacy (NABP). Student performance on the basic biomedical sciences portion of the PCOA was significantly correlated with students' perceived competencies in the biomedical sciences. No other correlations between actual and perceived competencies were significant. A lack of correlation exists between what students perceive they know and what they actually know in the areas of pharmaceutical science; social, behavioral, and administrative science; and clinical science. Therefore, additional standardized measures are needed to assess curricular effectiveness and provide comparisons among pharmacy programs.

  18. Comparison of Pharmacy Students’ Perceived and Actual Knowledge Using the Pharmacy Curricular Outcomes Assessment

    Science.gov (United States)

    Friesner, Daniel L.

    2012-01-01

    Objective. To determine whether a correlation exists between third-year PharmD students’ perceived pharmacy knowledge and actual pharmacy knowledge as assessed by the Pharmacy Curricular Outcomes Assessment (PCOA). Methods. In 2010 and 2011, the PCOA was administered in a low-stakes environment to third-year pharmacy students at North Dakota State University College of Pharmacy, Nursing, and Allied Sciences (COPNAS). A survey instrument was also administered on which students self-assessed their perceived competencies in each of the core areas covered by the PCOA examination. Results. The pharmacy students rated their competencies slightly higher than average. Performance on the PCOA was similar to but slightly higher than national averages. Correlations between each of the 4 content areas (basic biomedical sciences, pharmaceutical sciences, social/administrative sciences, and clinical sciences) mirrored those reported nationally by the National Association of Boards of Pharmacy (NABP). Student performance on the basic biomedical sciences portion of the PCOA was significantly correlated with students’ perceived competencies in the biomedical sciences. No other correlations between actual and perceived competencies were significant. Conclusion. A lack of correlation exists between what students perceive they know and what they actually know in the areas of pharmaceutical science; social, behavioral, and administrative science; and clinical science. Therefore, additional standardized measures are needed to assess curricular effectiveness and provide comparisons among pharmacy programs. PMID:22611272

  19. Assessing educational outcomes in middle childhood: validation of the Teacher Academic Attainment Scale.

    Science.gov (United States)

    Johnson, Samantha; Marlow, Neil; Wolke, Dieter

    2012-06-01

    Assessing educational outcomes in high-risk populations is crucial for defining long-term outcomes. As standardized tests are costly and time-consuming, we assessed the use of the Teacher Academic Attainment Scale (TAAS) as an outcome measure. Three hundred and forty three children in mainstream schools aged 10 to 11 years (144 males, 199 females; 190 extremely preterm and 153 term; mean age 10 y 9 mo, SD 5.5 mo, range 9 y 8 mo-12 y 3 mo) were assessed using the reading and mathematics scales of the criterion standard Wechsler Individual Achievement Test, 2nd (UK) edition (WIAT-II). Class teachers completed the TAAS, a seven-item questionnaire for assessing academic attainment. The TAAS was also completed at 6 years of age for 266 children. Cronbach's alpha 0.95 indicated excellent internal consistency, and the correlation between TAAS scores at 6 and 11 years indicated good test-retest reliability (r=0.77, pscale studies. © The Authors. Developmental Medicine & Child Neurology © 2012 Mac Keith Press.

  20. Choosing Assessment Instruments for Bulimia Practice and Outcome Research

    Science.gov (United States)

    Sandberg, Katie; Erford, Bradley T.

    2013-01-01

    Six commonly used instruments for assessment of eating disorders were analyzed. Effect size results from Erford et al.'s (2013) meta-analysis for the treatment of bulimia nervosa were used to compare each scale's ability to measure treatment outcomes for bulimia nervosa. Effect size comparisons indicated higher overall effect sizes using the…

  1. Power performance assessment. Final report

    International Nuclear Information System (INIS)

    Frandsen, S.

    1998-12-01

    In the increasingly commercialised wind power marketplace, the lack of precise assessment methods for the output of an investment is becoming a barrier for wider penetration of wind power. Thus, addressing this problem, the overall objectives of the project are to reduce the financial risk in investment in wind power projects by significantly improving the power performance assessment methods. Ultimately, if this objective is successfully met, the project may also result in improved tuning of the individual wind turbines and in optimisation methods for wind farm operation. The immediate, measurable objectives of the project are: To prepare a review of existing contractual aspects of power performance verification procedures of wind farms; to provide information on production sensitivity to specific terrain characteristics and wind turbine parameters by analyses of a larger number of wind farm power performance data available to the proposers; to improve the understanding of the physical parameters connected to power performance in complex environment by comparing real-life wind farm power performance data with 3D computational flow models and 3D-turbulence wind turbine models; to develop the statistical framework including uncertainty analysis for power performance assessment in complex environments; and to propose one or more procedures for power performance evaluation of wind power plants in complex environments to be applied in contractual agreements between purchasers and manufacturers on production warranties. Although the focus in this project is on power performance assessment the possible results will also be of benefit to energy yield forecasting, since the two tasks are strongly related. (au) JOULE III. 66 refs.; In Co-operation Renewable Energy System Ltd. (GB); Centre for Renewable Energy (GR); Aeronautic Research Centre (SE); National Engineering Lab. (GB); Public Power Cooperation (GR)

  2. Effects of a group-based reproductive management extension programme on key management outcomes affecting reproductive performance.

    Science.gov (United States)

    Brownlie, Tom S; Morton, John M; Heuer, Cord; McDougall, Scott

    2015-02-01

    A group-based reproductive management extension programme has been designed to help managers of dairy herds improve herd reproductive performance. The aims of this study were, firstly, to assess effects of participation by key decision makers (KDMs) in a farmer action group programme in 2009 and 2010 on six key management outcomes (KMOs) that affect reproductive performance over 2 years (2009-2010 and 2010-2011), and secondly, to describe KDM intentions to change management behaviour(s) affecting each management outcome after participation in the programme. Seasonal calving dairy herds from four regions of New Zealand were enrolled in the study. Intentions to modify management behaviour were recorded using the formal written action plans developed during the extension programme. KMOs assessed were calving pattern of the herd, pre-calving heifer liveweight, pre-calving and premating body condition score (BCS), oestrus detection, anoestrus cow management and bull management. Participation was associated with improvements in heifer liveweight, more heifers calving in the first 6 weeks of the seasonal calving period, premating BCS and oestrus detection. No significant effects were observed on anoestrus cow management or bull management. KDMs with greater numbers of proposed actions had lower 6 week in-calf rates in the second study year than KDMs who proposed fewer actions. A more effective strategy to ensure more appropriate objectives is proposed. Strategies to help KDMs to implement proposed actions more successfully should be investigated to improve the programme further. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Conceptual framework for performance assessment: competency, competence and performance in the context of assessments in healthcare--deciphering the terminology.

    Science.gov (United States)

    Khan, Kamran; Ramachandran, Sankaranarayanan

    2012-01-01

    The definitions of performance, competence and competency are not very clear in the literature. The assessment of performance and the selection of tools for this purpose depend upon a deep understanding of each of the above terms and the factors influencing performance. In this article, we distinguish between competence and competency and explain the relationship of competence and performance in the light of the Dreyfus model of skills acquisition. We briefly critique the application of the principles described by Miller to the modern assessment tools and distinguish between assessment of actual performance in workplace settings and the observed performance, demonstrated by the candidates in the workplace or simulated settings. We describe a modification of the Dreyfus model applicable to assessments in healthcare and propose a new model for the assessment of performance and performance rating scale (PRS) based on this model. We propose that the use of adapted versions of this PRS will result in benchmarking of performance and allowing the candidates to track their progression of skills in various areas of clinical practice.

  4. Competency Assessment Using Key Performance Indicators

    OpenAIRE

    Elena Alexandra Toader; Laura Brad

    2015-01-01

    The paper proposes a method for computing the scores of the key performance indicators resulted in the competency assessment process. The key performance indicators are estimated considering four performance levels that an IT professional can obtain at the end of the assessment process. We suggest as the best approach for estimating the performance key indicators an online questionnaire filled by 60 employees that work in IT Romanian companies. The results provide evidence that the difference...

  5. Assessing Quality Outcome Measures in Children with Coeliac Disease—Experience from Two UK Centres

    Science.gov (United States)

    Ross, Alexander; Shelley, Helen; Novell, Kim; Ingham, Elizabeth; Callan, Julia; Heuschkel, Robert; Morris, Mary-Anne; Zilbauer, Matthias

    2013-01-01

    Improved diagnosis of coeliac disease has increased incidence and therefore burden on the health care system. There are no quality outcome measures (QOM) in use nationally to assess hospital management of this condition. This study applied QOM devised by the East of England paediatric gastroenterology network to 99 patients reviewed at two tertiary hospitals in the Network, to assess the quality of care provided by nurse led and doctor led care models. The average performance across all QOM was 96.2% at Addenbrooke’s Hospital (AH), and 98.7% at Norfolk and Norwich Hospital (NNUH), whilst 95% (n = 18) of QOM were met. Patient satisfaction was high at both sites (uptake of questionnaire 53 of 99 patients in the study). The study showed a comparably high level of care delivered by both a nurse and doctor led service. Our quality assessment tools could be applied in the future by other centres to measure standards of care. PMID:24284612

  6. Assessing Quality Outcome Measures in Children with Coeliac Disease—Experience from Two UK Centres

    Directory of Open Access Journals (Sweden)

    Alexander Ross

    2013-11-01

    Full Text Available Improved diagnosis of coeliac disease has increased incidence and therefore burden on the health care system. There are no quality outcome measures (QOM in use nationally to assess hospital management of this condition. This study applied QOM devised by the East of England paediatric gastroenterology network to 99 patients reviewed at two tertiary hospitals in the Network, to assess the quality of care provided by nurse led and doctor led care models. The average performance across all QOM was 96.2% at Addenbrooke’s Hospital (AH, and 98.7% at Norfolk and Norwich Hospital (NNUH, whilst 95% (n = 18 of QOM were met. Patient satisfaction was high at both sites (uptake of questionnaire 53 of 99 patients in the study. The study showed a comparably high level of care delivered by both a nurse and doctor led service. Our quality assessment tools could be applied in the future by other centres to measure standards of care.

  7. Assessing Scientific Performance.

    Science.gov (United States)

    Weiner, John M.; And Others

    1984-01-01

    A method for assessing scientific performance based on relationships displayed numerically in published documents is proposed and illustrated using published documents in pediatric oncology for the period 1979-1982. Contributions of a major clinical investigations group, the Childrens Cancer Study Group, are analyzed. Twenty-nine references are…

  8. Relationships between core factors of knowledge management in hospital nursing organisations and outcomes of nursing performance.

    Science.gov (United States)

    Lee, Eun Ju; Kim, Hong Soon; Kim, Hye Young

    2014-12-01

    The study was conducted to investigate the levels of implementation of knowledge management and outcomes of nursing performance, to examine the relationships between core knowledge management factors and nursing performance outcomes and to identify core knowledge management factors affecting these outcomes. Effective knowledge management is very important to achieve strong organisational performance. The success or failure of knowledge management depends on how effectively an organisation's members share and use their knowledge. Because knowledge management plays a key role in enhancing nursing performance, identifying the core factors and investigating the level of knowledge management in a given hospital are priorities to ensure a high quality of nursing for patients. The study employed a descriptive research procedure. The study sample consisted of 192 nurses registered in three large healthcare organisations in South Korea. The variables demographic characteristics, implementation of core knowledge management factors and outcomes of nursing performance were examined and analysed in this study. The relationships between the core knowledge management factors and outcomes of nursing performance as well as the factors affecting the performance outcomes were investigated. A knowledge-sharing culture and organisational learning were found to be core factors affecting nursing performance. The study results provide basic data that can be used to formulate effective knowledge management strategies for enhancing nursing performance in hospital nursing organisations. In particular, prioritising the adoption of a knowledge-sharing culture and organisational learning in knowledge management systems might be one method for organisations to more effectively manage their knowledge resources and thus to enhance the outcomes of nursing performance and achieve greater business competitiveness. The study results can contribute to the development of effective and efficient

  9. Patient Centered Outcomes Assessment of Retreatment and Endodontic Microsurgery Using CBCT Volumetric Analysis

    Science.gov (United States)

    2018-11-09

    treatment outcomes assessment was conducted based upon clinical and CBCT (instead ofPA) findings. The 59th Medical Wing Institutional Review Board...IfCBCT PARL volume rendering gains prominence, greater clarity in our terminology will be possible with quantification of outcomes criteria. Each...outcomes designation could then be tied to prudent course( s) of action, which is the ultimate utility of diagnostic terminology . Clarity of terminology

  10. Provider volume and outcomes for oncological procedures.

    LENUS (Irish Health Repository)

    Killeen, S D

    2012-02-03

    BACKGROUND: Oncological procedures may have better outcomes if performed by high-volume providers. METHODS: A review of the English language literature incorporating searches of the Medline, Embase and Cochrane collaboration databases was performed. Studies were included if they involved a patient cohort from 1984 onwards, were community or population based, and assessed health outcome as a dependent variable and volume as an independent variable. The studies were also scored quantifiably to assess generalizability with respect to any observed volume-outcome relationship and analysed according to organ system; numbers needed to treat were estimated where possible. RESULTS: Sixty-eight relevant studies were identified and a total of 41 were included, of which 13 were based on clinical data. All showed either an inverse relationship, of variable magnitude, between provider volume and mortality, or no volume-outcome effect. All but two clinical reports revealed a statistically significant positive relationship between volume and outcome; none demonstrated the opposite. CONCLUSION: High-volume providers have a significantly better outcome for complex cancer surgery, specifically for pancreatectomy, oesphagectomy, gastrectomy and rectal resection.

  11. Technology and Innovation Management Indicators and Assessment Based on Government Performance

    Directory of Open Access Journals (Sweden)

    Sanja Marinković

    2016-05-01

    Full Text Available Throughout large global databases, such as OECD, UNDP, ITU, Eurostat, World Bank, and Statistical offices of countries, there are many indicators that refer to Technology and Innovation Management (TIM performance of countries. However, a question arises of how to classify and systematically analyze these indicators in terms of measuring, monitoring and enhancing TIM performance at a national level. More specifically, in this paper we pose a question of how to assess the government performance in TIM, as one aspect of the Triple Helix model. Therefore, we use a model of thirty-nine indicators which are classified according to three main management functions: planning, organizing and control, observed as input, process and output, respectively. More importantly, we analyze the relations that exist between these three categories of indicators. Planning indicators are observed as the investments in technological and innovative activities; organizing indicators include the infrastructure, public administration efficiency and cooperation support, while control indicators refer to the national economy R&D, transfer effects and entrepreneurship outcomes. The model is tested for assessing and comparing government performance in TIM for three countries: Serbia, Croatia and Slovenia, for the time period 2007-2012. Finally, as a feedback in the model, we used scores of the countries according to the Global Innovation Index and the Global Competitiveness Index, to verify the results and provide the final conclusion.

  12. How Do States Integrate Performance Assessment in Their Systems of Assessment?

    Science.gov (United States)

    Stosich, Elizabeth Leisy; Snyder, Jon; Wilczak, Katie

    2018-01-01

    This paper reviews state strategies for incorporating performance assessment in policy and practice. Specifically, the paper reviews the use of performance assessment in 12 states in the Innovation Lab Network, a group committed to developing systems of assessment that provide meaningful measures of college and career readiness. This review…

  13. A critical assessment of adverse pregnancy outcome and periodontal disease.

    Science.gov (United States)

    Wimmer, Gernot; Pihlstrom, Bruce L

    2008-09-01

    Pre-term birth is a major cause of infant mortality and morbidity that has considerable societal, medical, and economic costs. The rate of pre-term birth appears to be increasing world-wide and efforts to prevent or reduce its prevalence have been largely unsuccessful. To review the literature for studies investigating periodontal disease as a possible risk factor for pre-term birth and adverse pregnancy outcomes. Variability among studies in definitions of periodontal disease and adverse pregnancy outcomes as well as widespread inadequate control for confounding factors and possible effect modification make it difficult to base meaningful conclusions on published data. However, while there are indications of an association between periodontal disease and increased risk of adverse pregnancy outcome in some populations, there is no conclusive evidence that treating periodontal disease improves birth outcome. Based on a critical qualitative review, available evidence from clinical trials indicates that, although non-surgical mechanical periodontal treatment in the second trimester of pregnancy is safe and effective in reducing signs of maternal periodontal disease, it does not reduce the rate of pre-term birth. Clinical trials currently underway will further clarify the potential role of periodontal therapy in preventing adverse birth outcomes. Regardless of the outcomes of these trials, it is recommended that large, prospective cohort studies be conducted to assess risk for adverse pregnancy outcome in populations with periodontal disease. It is critical that periodontal exposure and adverse birth outcomes be clearly defined and the many potential confounding factors and possible effect modifiers for adverse pregnancy outcome be controlled in these studies. If periodontal disease is associated with higher risk of adverse pregnancy outcome in these specific populations, large multicenter randomized-controlled trials will be needed to determine if prevention or

  14. Assessment of residency program outcomes via alumni surveys

    Directory of Open Access Journals (Sweden)

    Lüer S

    2017-04-01

    Full Text Available Sonja Lüer, Christoph Aebi Department of Pediatrics, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland Background: One trend in medical education is outcomes-oriented training. Outcomes usually refer to individuals’ acquisition of competencies, for example, during training in residency programs. However, little is known about outcomes of these programs. In order to fill this gap, human resource (HR data were analyzed and alumni of a pediatric residency program were surveyed at the Department of Pediatrics, Bern University Hospital, Switzerland.Methods: Residency program outcomes (demographics, career choices, part-time or full-time work status, competencies, feedback were assessed through in-house HR databases, publicly available data on the Internet (physician directory and practice homepages, and 2 alumni surveys (S1, S2. Results: In all, 109 alumni met the inclusion criteria. Retention rate at the hospital was low (14%. Forty-six alumni (42% in private practice were eligible for alumni surveys. Response rates were 87% (S1 and 61% (S2. Time intervals between 2 career decisions (selecting specialty of pediatrics vs selecting setting of private practice varied widely (late-training decision to enter private practice. Mean employment level in private practice was 60% (range 20%–100%. Most valued rotation was emergency medicine; most desired competencies in future colleagues were the ability to work in a team, proficiency in pediatrics, and working economically.Conclusion: A broadened view on outcomes – beyond individuals’ competency acquisition – provides informative insights into a training program, can allow for informed program updates, and guide future program development. Keywords: medical education, career choice, pediatrics, private practice

  15. Assessing Therapist Competence: Development of a Performance-Based Measure and Its Comparison With a Web-Based Measure.

    Science.gov (United States)

    Cooper, Zafra; Doll, Helen; Bailey-Straebler, Suzanne; Bohn, Kristin; de Vries, Dian; Murphy, Rebecca; O'Connor, Marianne E; Fairburn, Christopher G

    2017-10-31

    Recent research interest in how best to train therapists to deliver psychological treatments has highlighted the need for rigorous, but scalable, means of measuring therapist competence. There are at least two components involved in assessing therapist competence: the assessment of their knowledge of the treatment concerned, including how and when to use its strategies and procedures, and an evaluation of their ability to apply such knowledge skillfully in practice. While the assessment of therapists' knowledge has the potential to be completed efficiently on the Web, the assessment of skill has generally involved a labor-intensive process carried out by clinicians, and as such, may not be suitable for assessing training outcome in certain circumstances. The aims of this study were to develop and evaluate a role-play-based measure of skill suitable for assessing training outcome and to compare its performance with a highly scalable Web-based measure of applied knowledge. Using enhanced cognitive behavioral therapy (CBT-E) for eating disorders as an exemplar, clinical scenarios for role-play assessment were developed and piloted together with a rating scheme for assessing trainee therapists' performance. These scenarios were evaluated by examining the performance of 93 therapists from different professional backgrounds and at different levels of training in implementing CBT-E. These therapists also completed a previously developed Web-based measure of applied knowledge, and the ability of the Web-based measure to efficiently predict competence on the role-play measure was investigated. The role-play measure assessed performance at implementing a range of CBT-E procedures. The majority of the therapists rated their performance as moderately or closely resembling their usual clinical performance. Trained raters were able to achieve good-to-excellent reliability for averaged competence, with intraclass correlation coefficients ranging from .653 to 909. The measure was

  16. Performance assessment review for DOE LLW disposal facilities

    International Nuclear Information System (INIS)

    Wilhite, Elmer L.

    1992-01-01

    The United States Department of Energy (US DOE) disposes of low-level radioactive waste in near-surface disposal facilities. Safety of the disposal operations is evaluated for operational safety as well as long-term safety. Operational safety is evaluated based on the perceived level of hazard of the operation and may vary from a simple safety assessment to a safety analysis report. Long-term safety of all low-level waste disposal systems is evaluated through the conduct of a radiological performance assessment. The US DOE has established radiological performance objectives for disposal of low-level waste. They are to protect a member of the general public from receiving over 25 mrem/y, and an inadvertent intruder into the waste from receiving over 100 mrem/y continuous exposure or 500 mrem from a single exposure. For a disposal system to be acceptable, a performance assessment must be prepared which must be technically accurate and provide reasonable assurance that these performance objectives are met. Technical quality of the performance assessments is reviewed by a panel of experts. The panel of experts is used in two ways to assure the technical quality of performance assessment. A preliminary (generally 2 day) review by the panel is employed in the late stages of development to provide guidance on finalizing the performance assessment. The comments from this review are communicated to the personnel responsible for the performance assessment for consideration and incorporation. After finalizing the performance assessment, it is submitted for a formal review. The formal review is accomplished by a much more thorough analysis of the performance assessment over a multi-week time period. The panel then formally reports their recommendations to the US DOE waste management senior staff who make the final determination on acceptability of the performance assessment. A number of lessons have been learned from conducting several preliminary reviews of performance

  17. Geriatrics Curricula for Internal and Family Medicine Residents: Assessing Study Quality and Learning Outcomes.

    Science.gov (United States)

    Cheng, Huai Yong; Davis, Molly

    2017-02-01

    Prior reviews of geriatrics curricula for internal medicine (IM) and family medicine (FM) residents have not evaluated study quality or assessed learning objectives or specific IM or FM competencies. This review of geriatrics curricula for IM and FM residents seeks to answer 3 questions: (1) What types of learning outcomes were measured? (2) How were learning outcomes measured? and (3) What was the quality of the studies? We evaluated geriatrics curricula that reported learning objectives or competencies, teaching methods, and learning outcomes, and those that used a comparative design. We searched PubMed and 4 other data sets from 2003-2015, and assessed learning outcomes, outcome measures, and the quality of studies using the Medical Education Research Study Quality Instrument (MERSQI) and Best Evidence Medical Education (BEME) methods. Fourteen studies met inclusion criteria. Most curricula were intended for IM residents in the inpatient setting; only 1 was solely dedicated to FM residents. Median duration was 1 month, and minimum geriatrics competencies covered were 4. Learning outcomes ranged from Kirkpatrick levels 1 to 3. Studies that reported effect size showed a considerable impact on attitudes and knowledge, mainly via pretests and posttests. The mean MERSQI score was 10.5 (range, 8.5-13) on a scale of 5 (lowest quality) to 18 (highest quality). Few geriatrics curricula for IM and FM residents that included learning outcome assessments were published recently. Overall, changes in attitudes and knowledge were sizeable, but reporting was limited to low to moderate Kirkpatrick levels. Study quality was moderate.

  18. Towards a Model and Methodology for Assessing Student Learning Outcomes and Satisfaction

    Science.gov (United States)

    Duque, Lola C.; Weeks, John R.

    2010-01-01

    Purpose: The purpose of this paper is threefold: first, to introduce a conceptual model for assessing undergraduate student learning outcomes and satisfaction that involves concepts drawn from the services marketing and assessment literatures; second, to illustrate the utility of the model as implemented in an academic department (geography)…

  19. Identifying and assessing strategies for evaluating the impact of mobile eye health units on health outcomes.

    Science.gov (United States)

    Fu, Shiwan; Turner, Angus; Tan, Irene; Muir, Josephine

    2017-12-01

    To identify and assess strategies for evaluating the impact of mobile eye health units on health outcomes. Systematic literature review. Worldwide. Peer-reviewed journal articles that included the use of a mobile eye health unit. Journal articles were included if outcome measures reflected an assessment of the impact of a mobile eye health unit on health outcomes. Six studies were identified with mobile services offering diabetic retinopathy screening (three studies), optometric services (two studies) and orthoptic services (one study). This review identified and assessed strategies in existing literature used to evaluate the impact of mobile eye health units on health outcomes. Studies included in this review used patient outcomes (i.e. disease detection, vision impairment, treatment compliance) and/or service delivery outcomes (i.e. cost per attendance, hospital transport use, inappropriate referrals, time from diabetic retinopathy photography to treatment) to evaluate the impact of mobile eye health units. Limitations include difficulty proving causation of specific outcome measures and the overall shortage of impact evaluation studies. Variation in geographical location, service population and nature of eye care providers limits broad application. © 2017 National Rural Health Alliance Inc.

  20. Reliability and validity of the German version of the Utrecht Questionnaire for Outcome Assessment in Aesthetic Rhinoplasty (D-OAR).

    Science.gov (United States)

    Spiekermann, Christoph; Rudack, Claudia; Stenner, Markus

    2017-11-01

    The outcome of aesthetic rhinoplasty is determined by the patient's subjective satisfaction with the nasal appearance which is difficult to assess. The Utrecht Questionnaire for Outcome Assessment in Aesthetic Rhinoplasty (OAR) is a brief and reliable instrument to assess the influence of the subjective nasal appearance on quality of life in patients undergoing aesthetic rhinoplasty. Preoperative application of this questionnaire reveals important aspects and possible disturbances of the body image which could be negative predictors concerning the result. On the other hand, it represents an appropriate tool to assess the postoperative outcome. The aim of this study was to determine the validity, reliability and responsiveness of the adapted German version of the OAR (D-OAR). The adaption of the OAR to German language was performed by a forward and backward translation process. Patients undergoing rhinoplasty were asked to complete the D-OAR preoperatively, 1, 3 and 12 months after procedure and healthy volunteers without any nasal complaints served as controls to test validity, reliability and responsiveness. An excellent internal consistency, a good test-retest reliability and good inter-item and item-total correlations demonstrated a good reliability of the D-OAR. The convincing validity of the adapted version was proven by an excellent discriminant and a sufficient content validity. Significant differences between pre- and postoperative D-OAR scores revealed a good responsiveness of the instrument. Hence, with a sufficient validity, reliability and sensitivity to changes, the D-OAR is a short and helpful instrument to assess the subjective perception of the nasal appearance in German patients.

  1. Performance outcomes and success factors of vendor managed inventory (VMI)

    NARCIS (Netherlands)

    Claassen, M.J.T.; Weele, van A.J.; Raaij, van E.M.

    2008-01-01

    Purpose – The purpose of this paper is to seek to investigate performance outcomes of vendor managed inventory (VMI) from a buyer's perspective and enablers for its successful application. Design/methodology/approach – Structural equation modelling through Partial Least Squares (PLS) is used to

  2. Assessment of maternal smoking status during pregnancy and the associations with neonatal outcomes.

    Science.gov (United States)

    Bakker, Rachel; Kruithof, Claudia; Steegers, Eric A P; Tiemeier, Henning; Mackenbach, Johan P; Hofman, Albert; Jaddoe, Vincent W V

    2011-12-01

    Single assessment of smoking during pregnancy may lead to misclassification due to underreporting or failure of smoking cessation. We examined the percentage of mothers who were misclassified in smoking status based on single assessment, as compared with repeated assessment, and whether this misclassification leads to altered effect estimates for the associations between maternal smoking and neonatal complications. This study was performed in 5,389 mothers participating in a prospective population-based cohort study in the Netherlands. Smoking status was assessed 3 times during pregnancy using questionnaires. Information on birth weight and neonatal complications was obtained from hospital records. For categorizing mothers per smoking status, Cohen's Kappa coefficient was .86 (p pregnancy, 1.7% (70 of 4,141) and 33.7% (217 of 643), respectively, were reclassified to continued smoking based on repeated assessment. Younger, shorter lower educated mothers who had non-European ethnicity experienced more stress, consumed more alcohol, and did not use folic acid supplements had higher risk of underreporting their smoking status or failure of smoking cessation. Marginal differences were found on the associations of maternal smoking with neonatal complications between single or repeated assessment. Our results suggest that single assessment of smoking during pregnancy leads to underestimation of the continued smoking prevalence, especially among mothers who reported quitting smoking in first trimester. However, this underestimation does not materially change the effect estimates for the associations between maternal smoking and neonatal outcomes.

  3. Curriculum Assessment as a Direct Tool in ABET Outcomes Assessment in a Chemical Engineering Programme

    Science.gov (United States)

    Abu-Jdayil, Basim; Al-Attar, Hazim

    2010-01-01

    The chemical engineering programme at the United Arab Emirates University is designed to fulfil the Accreditation Board for Engineering and Technology (ABET) (A-K) EC2000 criteria. The Department of Chemical & Petroleum Engineering has established a well-defined process for outcomes assessment for the chemical engineering programme in order to…

  4. An Ecological Study of Anterior Cruciate Ligament Reconstruction, Part 2: Functional Performance Tests Correlate With Return-to-Sport Outcomes.

    Science.gov (United States)

    McGrath, Timothy M; Waddington, Gordon; Scarvell, Jennie M; Ball, Nick; Creer, Rob; Woods, Kevin; Smith, Damian; Adams, Roger

    2017-02-01

    Additional high-quality prospective studies are needed to better define the objective criteria used in relation to return-to-sport decisions after anterior cruciate ligament (ACL) reconstruction in active populations. To investigate prospectively the relationship between functional performance test results at 24 weeks postoperative and return-to-sport activity (Tegner activity score) at 12 and 24 months, respectively, after synthetic (ligament advanced reinforcement system [LARS]) and autograft (doubled semitendinosus/gracilis [2ST/2GR]) ACL reconstructions. Case series; Level of evidence, 4. A total of 64 patients who underwent ACL reconstruction (32 LARS, 32 2ST/2GR autograft; mean age, 27.9 years; body mass index [BMI], 24.9 kg/m 2 ) were assessed preoperatively and at staged intervals postoperatively up to 24 weeks for isokinetic testing of quadriceps and hamstring average power per repetition at 60 deg/s and 180 deg/s, a battery of hop tests, peak vertical ground-reaction force (vGRF), and time to peak vGRF (in seconds) during a step- and jump-down task onto a force platform and peak speed (m/s) using a global positioning system (GPS unit) during a running task. A cohort of 32 healthy matched participants (mean age, 26.31 years; BMI, 25.7 kg/m 2 ) were also tested to act as reference. Pearson correlation was calculated to assess correlation of each performance measure at 24 weeks postoperative with activity outcomes (Tegner score) at 12 and 24 months. The strongest correlation between physical performance tests and return-to-sport outcomes was observed with peak speed during running. Large correlations were also observed for hamstring isokinetic power and hop test for distance. Moderate correlations were observed for timed hop, peak vGRF during a jump-down task, and quadriceps isokinetic power. No statistical correlations were observed for time to peak vGRF during a step-down and jump-down task as well as peak vGRF during a step-down task. When the performance

  5. Assessing the Nexus of Built, Natural, and Social Environments and Public Health Outcomes

    Science.gov (United States)

    Archer, R.; Alexander, S.; Douglas, J.

    2017-12-01

    This study investigates community-related environmental justice concerns and chemical and non-chemical health stressors from built, natural, and social environments in Southeast Los Angeles (SELA) County and East Oakland, California. The geographical distribution of health outcomes is related to the built and natural environments, as well as impacts from the social environment. A holistic systems view is important in assessing healthy behaviors within a community, because they do not occur in isolation. Geospatial analysis will be performed to integrate a total environment framework and explore the spatial patterns of exposure to chemical and non-chemical stressors and access to health-promoting environments. Geographic Information Systems (GIS) analysis using primary and secondary existing data will be performed to determine how social environments impact exposure to chemical health stressors and access to health-promoting built and natural environments. This project will develop a comprehensive list of health-promoting built and natural environments (e.g., parks and community gardens) and polluting sites (e.g., shipping ports and sources of pollution not included in federal regulatory databases) in East Oakland and SELA. California Department of Public Health and U.S. Decennial Census data will also be included for geospatial analysis to overlay the distribution of air pollution-related morbidities (e.g. asthma, diabetes, and cancer) and access to health-promoting built and natural environments and related community assets, exposure to polluting industries, social disorganization, and public health outcomes in the target areas. This research will help identify the spatial and temporal distribution and cumulative impacts of critical pollution hotspots causing community environmental health impacts. The research team will also map how social environments impact exposure to chemical health stressors and access to health-promoting built and natural environments. The

  6. Social CRM Adoption and its Impact on Performance Outcomes: a Literature Review

    Directory of Open Access Journals (Sweden)

    Marolt Marjeta

    2015-12-01

    Full Text Available Background and Purpose: Social customer relationship management (social CRM is an emerging concept that integrates traditional CRM and social media in order to provide benefits for organizations and customers. Despite the benefits that social CRM can bring, many organizations are still at the early stage of adoption. To move beyond social marketing and to exploit opportunities offered by sales and customer service, organizations need to be aware of factors that drive social CRM adoption and different implications of social CRM adoption for performance outcomes. This paper aims to provide a review of scholarly literature on social CRM adoption with the focus on factors and performance outcomes.

  7. Performance Objective for Tank Farm Closure Risk Assessments

    International Nuclear Information System (INIS)

    MANN, F.M.; KNEPP, A.J.; BADDEN, J.

    2003-01-01

    To be meaningful, results from a numeric risk assessment of the consequences of an action must be compared against the standards for such an action. That is, before one disposes of waste or closes a facility with waste, one must show that the disposal or closure action protects the public health and safety and the environment. These standards are called performance objectives. Regulations requiring performing performance assessments, (whether federal ones like the Department of Energy [DOE] Order 435.1, Radioactive Waste Management and its implementing guides or Washington State ones like the regulations implementing the Washington Administrative Code [WAC] 173-340 ''Model Toxics Control Act - Cleanup''), usually require that the determination of performance objectives be one of the first steps performed. These performance objectives not only set comparison level for the numeric results, but also define the media, pathways, exposure scenarios (receptors), spatial locations, and times that the performance assessment must consider. Thus, a performance objective consists of a compliance level, place(s) of compliance, and time(s) of compliance. Performance objectives are not the levels that a regulatory agency will enforce in a permit or authorization. Those levels, often called enforcement levels, will be set in the permit or authorization. Rather, performance objectives are those levels against which the results of the numeric simulation will be compared to judge the success of the proposed cleanup or disposal actions. Additional comparison levels may be requested for information purposes, but are not officially part of the decision on the adequacy of the proposed action. To emphasize that the performance objectives discussed in this document are not regulatory performance objectives, the three components of the performance objective will be renamed in this document as assessment standard, point(s) of assessment, and time(s) of assessment. However, whenever

  8. Effect of Physical and Psychosocial Interventions on Hormone and Performance Outcomes in Professional Rugby Union Players: A Systematic Review.

    Science.gov (United States)

    Strahorn, Joshua; Serpell, Benjamin G; McKune, Andrew; Pumpa, Kate L

    2017-11-01

    Strahorn, J, Serpell, BG, McKune, A, and Pumpa, KL. Effect of physical and psychosocial interventions on hormone and performance outcomes in professional rugby union players: a systematic review. J Strength Cond Res 31(11): 3158-3169, 2017-This systematic review investigates the acute effects of physical or psychosocial interventions on testosterone and cortisol responses in elite male rugby union players, and the subsequent association with physical performance areas (e.g., strength, power, sprint performance) or key performance indicators (e.g., coach-identified skills). Medline (via EBSCO), SPORTDiscus, Web of Science, InformIT, ProQuest, Cochrane, and Scopus were searched for relevant articles. Nine articles met the inclusion criteria, with 6 articles examining the effect of speed, strength or power training, and the remaining 3 psychosocial interventions. Quality assessment of the articles as determined by their PEDro score was either 6 or 7 out of 11. This review found that both physical and psychosocial interventions can alter testosterone and cortisol, and physical performance areas important for rugby union are affected by these changes. The limited literature in the field supports the notion that physical interventions of short duration and high intensity, and psychosocial interventions that create a positive environment may elicit a hormonal response that is associated with favorable performance outcomes. Studies that reported psychosocial interventions suggest that testosterone and cortisol may be altered in elite rugby players without metabolic stress, something of great interest to elite athletes and coaches who are looking to elicit a performance advantage without increasing athlete load. Overall, this review identified that when the testosterone responses to an intervention are notably greater than that of cortisol, favorable outcomes are likely. Further research is required to improve our understanding on how to best manipulate training to induce

  9. Performance assessment - risk assessment vive la differences

    International Nuclear Information System (INIS)

    Nitschke, R.L.

    1997-01-01

    In the sister worlds of radioactive waste management disposal and environmental restoration, there are two similar processes and computational approaches for determining the acceptability of the proposed activities. While similar, these two techniques can lead to confusion and misunderstanding if the differences are not recognized and appreciated. In the case of radioactive waste management, the performance assessment process is used to determine compliance with certain prescribed 'performance objectives'. These objectives are designed to ensure that the disposal of radioactive (high-level, low-level, and/or transuranic) waste will be protective of human health and the environment. The environmental link is primarily through assuring protection of the groundwater as a resource. In the case of environmental restoration, the risk assessment process is used to determine the proper remedial action response, if any, for a past hazardous waste release. The process compares the 'no action' or 'leave as is' option with both carcinogenic and noncarcinogenic values for human health to determine the need for any action and to help to help determine just what the appropriate action would need to be. The impacts to the ecological system are evaluated in a slightly, different but similar fashion. Now the common objectives between these two processes notwithstanding. There are some key and fundamental differences that need to be answered that make direct comparisons or a common approach inappropriate. Failure to recognize this can lead to confusion and misunderstanding. This can be particularly problematic when one is faced with an active disposal facility located within the boundaries of an environmental restoration site as is the case at the Idaho National Engineering Laboratory (INEL). Through a critical evaluation of the performance assessment and risk assessment processes, highlighting both similarities and differences, it is hoped that greater understanding and appreciation

  10. Performance objectives for the Hanford Immobilized Low-Activity Waste (ILAW) performance assessment

    International Nuclear Information System (INIS)

    MANN, F.M.

    1999-01-01

    Performance objectives for the disposal of low activity waste from Hanford Waste Tanks have been developed. These objectives have been based on DOE requirements, programmatic requirements, and public involvement. The DOE requirements include regulations that direct the performance assessment and are cited within the Radioactive Waste Management Order (DOE Order 435.1). Performance objectives for other DOE complex performance assessments have been included

  11. Traumatic brain injury (TBI) outcomes in an LMIC tertiary care centre and performance of trauma scores.

    Science.gov (United States)

    Samanamalee, Samitha; Sigera, Ponsuge Chathurani; De Silva, Ambepitiyawaduge Pubudu; Thilakasiri, Kaushila; Rashan, Aasiyah; Wadanambi, Saman; Jayasinghe, Kosala Saroj Amarasiri; Dondorp, Arjen M; Haniffa, Rashan

    2018-01-08

    This study evaluates post-ICU outcomes of patients admitted with moderate and severe Traumatic Brain Injury (TBI) in a tertiary neurocritical care unit in an low middle income country and the performance of trauma scores: A Severity Characterization of Trauma, Trauma and Injury Severity Score, Injury Severity Score and Revised Trauma Score in this setting. Adult patients directly admitted to the neurosurgical intensive care units of the National Hospital of Sri Lanka between 21st July 2014 and 1st October 2014 with moderate or severe TBI were recruited. A telephone administered questionnaire based on the Glasgow Outcome Scale Extended (GOSE) was used to assess functional outcome of patients at 3 and 6 months after injury. The economic impact of the injury was assessed before injury, and at 3 and 6 months after injury. One hundred and one patients were included in the study. Survival at ICU discharge, 3 and 6 months after injury was 68.3%, 49.5% and 45.5% respectively. Of the survivors at 3 months after injury, 43 (86%) were living at home. Only 19 (38%) patients had a good recovery (as defined by GOSE 7 and 8). Three months and six months after injury, respectively 25 (50%) and 14 (30.4%) patients had become "economically dependent". Selected trauma scores had poor discriminatory ability in predicting mortality. This observational study of patients sustaining moderate or severe TBI in Sri Lanka (a LMIC) reveals only 46% of patients were alive at 6 months after ICU discharge and only 20% overall attained a good (GOSE 7 or 8) recovery. The social and economic consequences of TBI were long lasting in this setting. Injury Severity Score, Revised Trauma Score, A Severity Characterization of Trauma and Trauma and Injury Severity Score, all performed poorly in predicting mortality in this setting and illustrate the need for setting adapted tools.

  12. Identifying the performance characteristics of a winning outcome in elite mixed martial arts competition.

    Science.gov (United States)

    James, Lachlan P; Robertson, Sam; Haff, G Gregory; Beckman, Emma M; Kelly, Vincent G

    2017-03-01

    To determine those performance indicators that have the greatest influence on classifying outcome at the elite level of mixed martial arts (MMA). A secondary objective was to establish the efficacy of decision tree analysis in explaining the characteristics of victory when compared to alternate statistical methods. Cross-sectional observational. Eleven raw performance indicators from male Ultimate Fighting Championship bouts (n=234) from July 2014 to December 2014 were screened for analysis. Each raw performance indicator was also converted to a rate-dependent measure to be scaled to fight duration. Further, three additional performance indicators were calculated from the dataset and included in the analysis. Cohen's d effect sizes were employed to determine the magnitude of the differences between Wins and Losses, while decision tree (chi-square automatic interaction detector (CHAID)) and discriminant function analyses (DFA) were used to classify outcome (Win and Loss). Effect size comparisons revealed differences between Wins and Losses across a number of performance indicators. Decision tree (raw: 71.8%; rate-scaled: 76.3%) and DFA (raw: 71.4%; rate-scaled 71.2%) achieved similar classification accuracies. Grappling and accuracy performance indicators were the most influential in explaining outcome. The decision tree models also revealed multiple combinations of performance indicators leading to victory. The decision tree analyses suggest that grappling activity and technique accuracy are of particular importance in achieving victory in elite-level MMA competition. The DFA results supported the importance of these performance indicators. Decision tree induction represents an intuitive and slightly more accurate approach to explaining bout outcome in this sport when compared to DFA. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  13. Responsiveness of performance-based outcome measures for mobility, balance, muscle strength and manual dexterity in adults with myotonic dystrophy type 1.

    Science.gov (United States)

    Kierkegaard, Marie; Petitclerc, Émilie; Hébert, Luc J; Mathieu, Jean; Gagnon, Cynthia

    2018-02-28

    To assess changes and responsiveness in outcome measures of mobility, balance, muscle strength and manual dexterity in adults with myotonic dystrophy type 1. A 9-year longitudinal study conducted with 113 patients. The responsiveness of the Timed Up and Go test, Berg Balance Scale, quantitative muscle testing, grip and pinch-grip strength, and Purdue Pegboard Test was assessed using criterion and construct approaches. Patient-reported perceived changes (worse/stable) in balance, walking, lower-limb weakness, stair-climbing and hand weakness were used as criteria. Predefined hypotheses about expected area under the receiver operating characteristic curves (criterion approach) and correlations between relative changes (construct approach) were explored. The direction and magnitude of median changes in outcome measures corresponded with patient-reported changes. Median changes in the Timed Up and Go test, grip strength, pinch-grip strength and Purdue Pegboard Test did not, in general, exceed known measurement errors. Most criterion (72%) and construct (70%) approach hypotheses were supported. Promising responsiveness was found for outcome measures of mobility, balance and muscle strength. Grip strength and manual dexterity measures showed poorer responsiveness. The performance-based outcome measures captured changes over the 9-year period and responsiveness was promising. Knowledge of measurement errors is needed to interpret the meaning of these longitudinal changes.

  14. Examining the relationships between span of control and manager job and unit performance outcomes.

    Science.gov (United States)

    Wong, Carol A; Elliott-Miller, Pat; Laschinger, Heather; Cuddihy, Michael; Meyer, Raquel M; Keatings, Margaret; Burnett, Camille; Szudy, Natalie

    2015-03-01

    Our aim was to examine the combination of frontline manager (FLM) personal characteristics and span of control (SOC) on their job and unit performance outcomes. Healthcare downsizing and reform have contributed to larger spans for FLMs in Canadian hospitals and increased concerns about manager workload. Despite a heightened awareness of SOC issues among decision makers, there is limited empirical evidence related to the effects of SOC on outcomes. A non-experimental predictive survey design was used to examine FLM SOC in 14 Canadian academic hospitals. Managers (n = 121) completed an online survey of work characteristics and The Ottawa Hospital (TOH) SOC tool. Unit turnover data were collected from organisational databases. The combination of SOC and core self-evaluation significantly predicted role overload, work control and job satisfaction, but only SOC predicted unit adverse outcomes and neither significantly predicted unit turnover. The findings contribute to an understanding of connections between the combination of SOC and core self-evaluation and manager job and unit performance outcomes. Organisational strategies to create manageable FLM SOC are essential to ensure exemplary job and unit outcomes. Core self-evaluation is a personality characteristic that may enhance manager performance in the face of high spans of control. © 2013 John Wiley & Sons Ltd.

  15. Performance Assessment Strategy Plan for the Geologic Repository Program

    International Nuclear Information System (INIS)

    1990-01-01

    Performance assessment is a major constituent of the program being conducted by the US Department of Energy (DOE) to develop a geologic repository. Performance assessment is the set of activities needed for quantitative evaluations to assess compliance with the performance requirements in the regulations for a geologic repository and to support the development of the repository. The strategy for these evaluations has been documented in the Performance Assessment Strategy Plan (DOE, 1989). The implementation of the performance assessment strategy is defined in this document. This paper discusses the scope and objectives of the implementation plan, the relationship of the plan to other program plans, summarizes the performance assessment areas and the integrated strategy of the performance assessment program. 1 fig., 3 tabs

  16. Association of the 2011 ACGME resident duty hour reform with general surgery patient outcomes and with resident examination performance.

    Science.gov (United States)

    Rajaram, Ravi; Chung, Jeanette W; Jones, Andrew T; Cohen, Mark E; Dahlke, Allison R; Ko, Clifford Y; Tarpley, John L; Lewis, Frank R; Hoyt, David B; Bilimoria, Karl Y

    2014-12-10

    In 2011, the Accreditation Council for Graduate Medical Education (ACGME) restricted resident duty hour requirements beyond those established in 2003, leading to concerns about the effects on patient care and resident training. To determine if the 2011 ACGME duty hour reform was associated with a change in general surgery patient outcomes or in resident examination performance. Quasi-experimental study of general surgery patient outcomes 2 years before (academic years 2009-2010) and after (academic years 2012-2013) the 2011 duty hour reform. Teaching and nonteaching hospitals were compared using a difference-in-differences approach adjusted for procedural mix, patient comorbidities, and time trends. Teaching hospitals were defined based on the proportion of cases at which residents were present intraoperatively. Patients were those undergoing surgery at hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). General surgery resident performance on the annual in-training, written board, and oral board examinations was assessed for this same period. National implementation of revised resident duty hour requirements on July 1, 2011, in all ACGME accredited residency programs. Primary outcome was a composite of death or serious morbidity; secondary outcomes were other postoperative complications and resident examination performance. In the main analysis, 204,641 patients were identified from 23 teaching (n = 102,525) and 31 nonteaching (n = 102,116) hospitals. The unadjusted rate of death or serious morbidity improved during the study period in both teaching (11.6% [95% CI, 11.3%-12.0%] to 9.4% [95% CI, 9.1%-9.8%], P adverse outcome. Mean (SD) in-training examination scores did not significantly change from 2010 to 2013 for first-year residents (499.7 [ 85.2] to 500.5 [84.2], P = .99), for residents from other postgraduate years, or for first-time examinees taking the written or oral board

  17. Preliminary melter performance assessment report

    International Nuclear Information System (INIS)

    Elliott, M.L.; Eyler, L.L.; Mahoney, L.A.; Cooper, M.F.; Whitney, L.D.; Shafer, P.J.

    1994-08-01

    The Melter Performance Assessment activity, a component of the Pacific Northwest Laboratory's (PNL) Vitrification Technology Development (PVTD) effort, was designed to determine the impact of noble metals on the operational life of the reference Hanford Waste Vitrification Plant (HWVP) melter. The melter performance assessment consisted of several activities, including a literature review of all work done with noble metals in glass, gradient furnace testing to study the behavior of noble metals during the melting process, research-scale and engineering-scale melter testing to evaluate effects of noble metals on melter operation, and computer modeling that used the experimental data to predict effects of noble metals on the full-scale melter. Feed used in these tests simulated neutralized current acid waste (NCAW) feed. This report summarizes the results of the melter performance assessment and predicts the lifetime of the HWVP melter. It should be noted that this work was conducted before the recent Tri-Party Agreement changes, so the reference melter referred to here is the Defense Waste Processing Facility (DWPF) melter design

  18. 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...

  19. Strategies for Assessing Learning Outcomes in an Online Oceanography Course

    Science.gov (United States)

    Reed, D. L.

    2003-12-01

    All general education courses at the San Jose State University, including those in the sciences, must present a detailed assessment plan of student learning, prior to certification for offering. The assessment plan must state a clear methodology for acquiring data on student achievement of the learning outcomes for the specific course category, as well as demonstrate how students fulfill a strong writing requirement. For example, an online course in oceanography falls into the Area R category, the Earth and Environment, through which a student should be able to demonstrate an understanding of the methods and limits of scientific investigation; distinguish science from pseudo-science; and apply a scientific approach to answer questions about the Earth and environment. The desired learning outcomes are shared with students at the beginning of the course and subsequent assessments on achieving each outcome are embedded in the graded assignments, which include a critical thinking essay, mid-term exam, poster presentation in a symposium-style format, portfolio of web-based work, weekly discussions on an electronic bulletin board, and a take-home final exam, consisting of an original research grant proposal. The diverse nature of the graded assignments assures a comprehensive assessment of student learning from a variety of perspectives, such as quantitative, qualitative, and analytical. Formative assessment is also leveraged into learning opportunities, which students use to identify the acquisition of knowledge. For example, pre-tests are used to highlight preconceptions at the beginning of specific field studies and post-testing encourages students to present the results of small research projects. On a broader scale, the assessment results contradict common misperceptions of online and hybrid courses. Student demand for online courses is very high due to the self-paced nature of learning. Rates of enrollment attrition match those of classroom sections, if students

  20. Performance Assessment Institute-NV

    Energy Technology Data Exchange (ETDEWEB)

    Lombardo, Joesph [Univ. of Nevada, Las Vegas, NV (United States)

    2012-12-31

    The National Supercomputing Center for Energy and the Environment’s intention is to purchase a multi-purpose computer cluster in support of the Performance Assessment Institute (PA Institute). The PA Institute will serve as a research consortium located in Las Vegas Nevada with membership that includes: national laboratories, universities, industry partners, and domestic and international governments. This center will provide a one-of-a-kind centralized facility for the accumulation of information for use by Institutions of Higher Learning, the U.S. Government, and Regulatory Agencies and approved users. This initiative will enhance and extend High Performance Computing (HPC) resources in Nevada to support critical national and international needs in "scientific confirmation". The PA Institute will be promoted as the leading Modeling, Learning and Research Center worldwide. The program proposes to utilize the existing supercomputing capabilities and alliances of the University of Nevada Las Vegas as a base, and to extend these resource and capabilities through a collaborative relationship with its membership. The PA Institute will provide an academic setting for interactive sharing, learning, mentoring and monitoring of multi-disciplinary performance assessment and performance confirmation information. The role of the PA Institute is to facilitate research, knowledge-increase, and knowledge-sharing among users.

  1. Assessing the performance of mental health service facilities for meeting patient priorities and health service responsiveness.

    Science.gov (United States)

    Bramesfeld, A; Stegbauer, C

    2016-10-01

    The World Health Organisation has defined health service responsiveness as one of the key-objectives of health systems. Health service responsiveness relates to the ability to respond to service users' legitimate expectations on non-medical issues when coming into contact with the services of a healthcare system. It is defined by the areas showing respect for persons and patient orientation. Health service responsiveness is particularly relevant to mental health services, due to the specific vulnerability of mental health patients but also because it matches what mental health patients consider as good quality of care as well as their priorities when seeking healthcare. As (mental) health service responsiveness applies equally to all concerned services it would be suitable as a universal indicator for the quality of services' performance. However, performance monitoring programs in mental healthcare rarely assess health service performance with respect to meeting patient priorities. This is in part due of patient priorities as an outcome being underrepresented in studies that evaluate service provision. The lack of studies using patient priorities as outcomes transmits into evidence based guidelines and subsequently, into underrepresentation of patient priorities in performance monitoring. Possible ways out of this situation include more intervention studies using patient priorities as outcome, considering evidence from qualitative studies in guideline development and developing performance monitoring programs along the patient pathway and on key-points of relevance for service quality from a patient perspective.

  2. Energy performance assessment methodology

    Energy Technology Data Exchange (ETDEWEB)

    Platzer, W.J. [Fraunhofer Inst. for Solar Energy Systems, Freiburg (Germany)

    2006-01-15

    The energy performance of buildings are intimately connected to the energy performance of building envelopes. The better we understand the relation between the quality of the envelope and the energy consumption of the building, the better we can improve both. We have to consider not only heating but all service energies related to the human comfort in the building, such as cooling, ventilation, lighting as well. The complexity coming from this embracing approach is not to be underestimated. It is less and less possible to realted simple characteristic performance indicators of building envelopes (such as the U-value) to the overall energy performance. On the one hand much more paramters (e.g. light transmittance) come into the picture we have to assess the product quality in a multidimensional world. Secondly buildings more and more have to work on a narrow optimum: For an old, badly insulated building all solar gains are useful for a high-performance building with very good insulation and heat recovery systems in the ventilation overheating becomes more likely. Thus we have to control the solar gains, and sometimes we need high gains, sometimes low ones. And thirdly we see that the technology within the building and the user patterns and interactions as well influence the performance of a building envelope. The aim of this project within IEA Task27 was to improve our knowledge on the complex situation and also to give a principal approach how to assess the performance of the building envelope. The participants have contributed to this aim not pretending that we have reached the end. (au)

  3. Quantitative Assessment of Breast Cosmetic Outcome After Whole-Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Reddy, Jay P. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Lei, Xiudong [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Huang, Sheng-Cheng; Nicklaus, Krista M. [Department of Biomedical Engineering, University of Texas, Austin, Texas (United States); Fingeret, Michelle C. [Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Shaitelman, Simona F. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hunt, Kelly K. [Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Buchholz, Thomas A. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Merchant, Fatima [Department of Engineering Technology, University of Houston, Houston, Texas (United States); Markey, Mia K. [Department of Biomedical Engineering, University of Texas, Austin, Texas (United States); Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Benjamin D., E-mail: bsmith3@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2017-04-01

    Purpose: To measure, by quantitative analysis of digital photographs, breast cosmetic outcome within the setting of a randomized trial of conventionally fractionated (CF) and hypofractionated (HF) whole-breast irradiation (WBI), to identify how quantitative cosmesis metrics were associated with patient- and physician-reported cosmesis and whether they differed by treatment arm. Methods and Materials: From 2011 to 2014, 287 women aged ≥40 with ductal carcinoma in situ or early invasive breast cancer were randomized to HF-WBI (42.56 Gy/16 fractions [fx] + 10-12.5 Gy/4-5 fx boost) or CF-WBI (50 Gy/25 fx + 10-14 Gy/5-7 fx). At 1 year after treatment we collected digital photographs, patient-reported cosmesis using the Breast Cancer Treatment and Outcomes Scale, and physician-reported cosmesis using the Radiation Therapy Oncology Group scale. Six quantitative measures of breast symmetry, labeled M1-M6, were calculated from anteroposterior digital photographs. For each measure, values closer to 1 imply greater symmetry, and values closer to 0 imply greater asymmetry. Associations between M1-M6 and patient- and physician-reported cosmesis and treatment arm were evaluated using the Kruskal-Wallis test. Results: Among 245 evaluable patients, patient-reported cosmesis was strongly associated with M1 (vertical symmetry measure) (P<.01). Physician-reported cosmesis was similarly correlated with M1 (P<.01) and also with M2 (vertical symmetry, P=.01) and M4 (horizontal symmetry, P=.03). At 1 year after treatment, HF-WBI resulted in better values of M2 (P=.02) and M3 (P<.01) than CF-WBI; treatment arm was not significantly associated with M1, M4, M5, or M6 (P≥.12). Conclusions: Quantitative assessment of breast photographs reveals similar to improved cosmetic outcome with HF-WBI compared with CF-WBI 1 year after treatment. Assessing cosmetic outcome using these measures could be useful for future comparative effectiveness studies and outcome reporting.

  4. Quantitative Assessment of Breast Cosmetic Outcome After Whole-Breast Irradiation

    International Nuclear Information System (INIS)

    Reddy, Jay P.; Lei, Xiudong; Huang, Sheng-Cheng; Nicklaus, Krista M.; Fingeret, Michelle C.; Shaitelman, Simona F.; Hunt, Kelly K.; Buchholz, Thomas A.; Merchant, Fatima; Markey, Mia K.; Smith, Benjamin D.

    2017-01-01

    Purpose: To measure, by quantitative analysis of digital photographs, breast cosmetic outcome within the setting of a randomized trial of conventionally fractionated (CF) and hypofractionated (HF) whole-breast irradiation (WBI), to identify how quantitative cosmesis metrics were associated with patient- and physician-reported cosmesis and whether they differed by treatment arm. Methods and Materials: From 2011 to 2014, 287 women aged ≥40 with ductal carcinoma in situ or early invasive breast cancer were randomized to HF-WBI (42.56 Gy/16 fractions [fx] + 10-12.5 Gy/4-5 fx boost) or CF-WBI (50 Gy/25 fx + 10-14 Gy/5-7 fx). At 1 year after treatment we collected digital photographs, patient-reported cosmesis using the Breast Cancer Treatment and Outcomes Scale, and physician-reported cosmesis using the Radiation Therapy Oncology Group scale. Six quantitative measures of breast symmetry, labeled M1-M6, were calculated from anteroposterior digital photographs. For each measure, values closer to 1 imply greater symmetry, and values closer to 0 imply greater asymmetry. Associations between M1-M6 and patient- and physician-reported cosmesis and treatment arm were evaluated using the Kruskal-Wallis test. Results: Among 245 evaluable patients, patient-reported cosmesis was strongly associated with M1 (vertical symmetry measure) (P<.01). Physician-reported cosmesis was similarly correlated with M1 (P<.01) and also with M2 (vertical symmetry, P=.01) and M4 (horizontal symmetry, P=.03). At 1 year after treatment, HF-WBI resulted in better values of M2 (P=.02) and M3 (P<.01) than CF-WBI; treatment arm was not significantly associated with M1, M4, M5, or M6 (P≥.12). Conclusions: Quantitative assessment of breast photographs reveals similar to improved cosmetic outcome with HF-WBI compared with CF-WBI 1 year after treatment. Assessing cosmetic outcome using these measures could be useful for future comparative effectiveness studies and outcome reporting.

  5. Determination of Safety Performance Grade of NPP Using Integrated Safety Performance Assessment (ISPA) Program

    International Nuclear Information System (INIS)

    Chung, Dae Wook

    2011-01-01

    Since the beginning of 2000, the safety regulation of nuclear power plant (NPP) has been challenged to be conducted more reasonable, effective and efficient way using risk and performance information. In the United States, USNRC established Reactor Oversight Process (ROP) in 2000 for improving the effectiveness of safety regulation of operating NPPs. The main idea of ROP is to classify the NPPs into 5 categories based on the results of safety performance assessment and to conduct graded regulatory programs according to categorization, which might be interpreted as 'Graded Regulation'. However, the classification of safety performance categories is highly comprehensive and sensitive process so that safety performance assessment program should be prepared in integrated, objective and quantitative manner. Furthermore, the results of assessment should characterize and categorize the actual level of safety performance of specific NPP, integrating all the substantial elements for assessing the safety performance. In consideration of particular regulatory environment in Korea, the integrated safety performance assessment (ISPA) program is being under development for the use in the determination of safety performance grade (SPG) of a NPP. The ISPA program consists of 6 individual assessment programs (4 quantitative and 2 qualitative) which cover the overall safety performance of NPP. Some of the assessment programs which are already implemented are used directly or modified for incorporating risk aspects. The others which are not existing regulatory programs are newly developed. Eventually, all the assessment results from individual assessment programs are produced and integrated to determine the safety performance grade of a specific NPP

  6. Assessing the Outcomes of School-Based Partnership Resilience Intervention

    Science.gov (United States)

    Mampane, Ruth; Huddle, Christelle

    2017-01-01

    This study reports on the outcomes of educational psychology school-based intervention. The aim was to determine whether the intervention served as an educational pathway to resilience. Through a concurrent mixed-methods research design interpreted through a pragmatic lens, academic school performance of students in a rural school was used as an…

  7. Subjective and objective performance assessment : Performance pay at Trelleborg Forsheda AB

    OpenAIRE

    Luotonen, David; Hasselström, Markus

    2009-01-01

      The purpose of this thesis is to understand the opinions and potential effects of objective and subjective assessments of performance as a basis for performance pay for blue-collar workers. The study takes a qualitative approach to find out how and why four companies - Trelleborg Forsheda, Finnveden Powertrain, Isaberg Rapid and Parker Hannifin- work with salaries, incentive system and performance assessment the way they do. The concept of individual salary is central in this thesis, and in...

  8. Gamma camera performance: technical assessment protocol

    International Nuclear Information System (INIS)

    Bolster, A.A.; Waddington, W.A.

    1996-01-01

    This protocol addresses the performance assessment of single and dual headed gamma cameras. No attempt is made to assess the performance of any associated computing systems. Evaluations are usually performed on a gamma camera commercially available within the United Kingdom and recently installed at a clinical site. In consultation with the manufacturer, GCAT selects the site and liaises with local staff to arrange a mutually convenient time for assessment. The manufacturer is encouraged to have a representative present during the evaluation. Three to four days are typically required for the evaluation team to perform the necessary measurements. When access time is limited, the team will modify the protocol to test the camera as thoroughly as possible. Data are acquired on the camera's computer system and are subsequently transferred to the independent GCAT computer system for analysis. This transfer from site computer to the independent system is effected via a hardware interface and Interfile data transfer. (author)

  9. Gamma camera performance: technical assessment protocol

    Energy Technology Data Exchange (ETDEWEB)

    Bolster, A.A. [West Glasgow Hospitals NHS Trust, London (United Kingdom). Dept. of Clinical Physics; Waddington, W.A. [University College London Hospitals NHS Trust, London (United Kingdom). Inst. of Nuclear Medicine

    1996-12-31

    This protocol addresses the performance assessment of single and dual headed gamma cameras. No attempt is made to assess the performance of any associated computing systems. Evaluations are usually performed on a gamma camera commercially available within the United Kingdom and recently installed at a clinical site. In consultation with the manufacturer, GCAT selects the site and liaises with local staff to arrange a mutually convenient time for assessment. The manufacturer is encouraged to have a representative present during the evaluation. Three to four days are typically required for the evaluation team to perform the necessary measurements. When access time is limited, the team will modify the protocol to test the camera as thoroughly as possible. Data are acquired on the camera`s computer system and are subsequently transferred to the independent GCAT computer system for analysis. This transfer from site computer to the independent system is effected via a hardware interface and Interfile data transfer. (author).

  10. Subfertility in Women With Rheumatoid Arthritis and the Outcome of Fertility Assessments.

    Science.gov (United States)

    Brouwer, Jenny; Fleurbaaij, Rosalie; Hazes, Johanna M W; Dolhain, Radboud J E M; Laven, Joop S E

    2017-08-01

    Subfertility is frequently encountered among female rheumatoid arthritis (RA) patients and has been associated with disease activity and antirheumatic drugs. However, little is known about the results of the fertility assessments in these women. Our aim was to study the outcome of fertility assessments in subfertile women with RA. A cross-sectional study was performed in a nationwide cohort of female RA patients who were pregnant or trying to conceive between 2002 and 2010 (Pregnancy-Induced Amelioration of Rheumatoid Arthritis Study). Patients who had given consent for future contact (n = 260) received a questionnaire on reproductive history, fertility examinations, and fertility treatments. Medical files were obtained from attending gynecologists. A completed questionnaire was returned by 178 women (68%), of whom 96% had ended their efforts to conceive. Eighty-two subjects (46%) had at least 1 subfertile episode, and for 61 women a diagnosis for subfertility was available. Unexplained subfertility (48%) and anovulation (28%) were the most common gynecologic diagnoses, and both occurred more often in RA patients than reported in the general population. Women with unexplained subfertility more often used nonsteroidal antiinflammatory drugs (NSAIDs) during the periconceptional period. Seventeen percent of all pregnancies were conceived after fertility treatments. Fertility treatments had equal or higher pregnancy rates in RA compared to other subfertile populations. Unexplained subfertility is more often diagnosed in subfertile female RA patients than in the general population, and is related to periconceptional NSAID use. Despite the higher incidence of subfertility in women with RA, the outcome of fertility treatments in these women appears favorable. © 2016 The Authors. Arthritis Care & Research published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology.

  11. Assessment of a Brief Handoff Skills Workshop for Incoming Interns: Do past Handoff Experiences Impact Training Outcomes?

    Directory of Open Access Journals (Sweden)

    Christopher J. Smith

    2015-01-01

    Full Text Available Background Patient care handoffs are a core professional activity that incoming interns are expected to perform without direct supervision upon starting residency, yet training in medical schools is inconsistent. Objective To implement a brief handoff communication workshop for incoming interns and determine whether learner-level determinants were associated with differences in training outcomes. Methods We conducted a one-hour interactive handoff skills workshop for all incoming interns at a Midwestern academic medical center. We performed paired pre/post-intervention assessments of participants' attitudes and ability to perform representative handoff skills. The results were analyzed in aggregate and based upon participants' prior handoff experiences using Wilcoxon signed-rank test. Results Ninety-nine of 108 interns (91.7% completed both pre- and post-surveys. There was significant improvement in all 10 attitude-based questions ( P ≤ 0.014 for all and on the skills assessment (1.07 vs 2.16 on 0–4 point scale, SD 1.25, P ≤ 0.001. Results remained significant regardless of prior training, number of handoffs observed, number of handoffs performed, medical school, or residency discipline. Conclusion A brief interactive workshop for incoming interns can improve participants' confidence and performance of basic handoff skills, regardless of previous training or experience.

  12. The neural coding of expected and unexpected monetary performance outcomes: dissociations between active and observational learning.

    Science.gov (United States)

    Bellebaum, C; Jokisch, D; Gizewski, E R; Forsting, M; Daum, I

    2012-02-01

    Successful adaptation to the environment requires the learning of stimulus-response-outcome associations. Such associations can be learned actively by trial and error or by observing the behaviour and accompanying outcomes in other persons. The present study investigated similarities and differences in the neural mechanisms of active and observational learning from monetary feedback using functional magnetic resonance imaging. Two groups of 15 subjects each - active and observational learners - participated in the experiment. On every trial, active learners chose between two stimuli and received monetary feedback. Each observational learner observed the choices and outcomes of one active learner. Learning performance as assessed via active test trials without feedback was comparable between groups. Different activation patterns were observed for the processing of unexpected vs. expected monetary feedback in active and observational learners, particularly for positive outcomes. Activity for unexpected vs. expected reward was stronger in the right striatum in active learning, while activity in the hippocampus was bilaterally enhanced in observational and reduced in active learning. Modulation of activity by prediction error (PE) magnitude was observed in the right putamen in both types of learning, whereas PE related activations in the right anterior caudate nucleus and in the medial orbitofrontal cortex were stronger for active learning. The striatum and orbitofrontal cortex thus appear to link reward stimuli to own behavioural reactions and are less strongly involved when the behavioural outcome refers to another person's action. Alternative explanations such as differences in reward value between active and observational learning are also discussed. Copyright © 2011 Elsevier B.V. All rights reserved.

  13. Practical session assessments in human anatomy: Weightings and performance.

    Science.gov (United States)

    McDonald, Aaron C; Chan, Siew-Pang; Schuijers, Johannes A

    2016-07-08

    Assessment weighting within a given module can be a motivating factor for students when deciding on their commitment level and time given to study a specific topic. In this study, an analysis of assessment performances of second year anatomy students was performed over four years to determine if (1) students performed better when a higher weighting was given to a set of practical session assessments and (2) whether an improved performance in the practical session assessments had a carry-over effect on other assessment tasks within that anatomy module and/or other anatomy modules that follow. Results showed that increasing the weighting of practical session assessments improved the average mark in that assessment and also improved the percentage of students passing that assessment. Further, it significantly improved performance in the written end-semester examination within the same module and had a carry-over effect on the anatomy module taught in the next teaching period, as students performed better in subsequent practical session assessments as well as subsequent end-semester examinations. It was concluded that the weighting of assessments had significant influences on a student's performance in that, and subsequent, assessments. It is postulated that practical session assessments, designed to develop deep learning skills in anatomy, improved efficacy in student performance in assessments undertaken in that and subsequent anatomy modules when the weighting of these assessments was greater. These deep learning skills were also transferable to other methods of assessing anatomy. Anat Sci Educ 9: 330-336. © 2015 American Association of Anatomists. © 2015 American Association of Anatomists.

  14. Performance on the adult rheumatology in-training examination and relationship to outcomes on the rheumatology certification examination.

    Science.gov (United States)

    Lohr, Kristine M; Clauser, Amanda; Hess, Brian J; Gelber, Allan C; Valeriano-Marcet, Joanne; Lipner, Rebecca S; Haist, Steven A; Hawley, Janine L; Zirkle, Sarah; Bolster, Marcy B

    2015-11-01

    The American College of Rheumatology (ACR) Adult Rheumatology In-Training Examination (ITE) is a feedback tool designed to identify strengths and weaknesses in the content knowledge of individual fellows-in-training and the training program curricula. We determined whether scores on the ACR ITE, as well as scores on other major standardized medical examinations and competency-based ratings, could be used to predict performance on the American Board of Internal Medicine (ABIM) Rheumatology Certification Examination. Between 2008 and 2012, 629 second-year fellows took the ACR ITE. Bivariate correlation analyses of assessment scores and multiple linear regression analyses were used to determine whether ABIM Rheumatology Certification Examination scores could be predicted on the basis of ACR ITE scores, United States Medical Licensing Examination scores, ABIM Internal Medicine Certification Examination scores, fellowship directors' ratings of overall clinical competency, and demographic variables. Logistic regression was used to evaluate whether these assessments were predictive of a passing outcome on the Rheumatology Certification Examination. In the initial linear model, the strongest predictors of the Rheumatology Certification Examination score were the second-year fellows' ACR ITE scores (β = 0.438) and ABIM Internal Medicine Certification Examination scores (β = 0.273). Using a stepwise model, the strongest predictors of higher scores on the Rheumatology Certification Examination were second-year fellows' ACR ITE scores (β = 0.449) and ABIM Internal Medicine Certification Examination scores (β = 0.276). Based on the findings of logistic regression analysis, ACR ITE performance was predictive of a pass/fail outcome on the Rheumatology Certification Examination (odds ratio 1.016 [95% confidence interval 1.011-1.021]). The predictive value of the ACR ITE score with regard to predicting performance on the Rheumatology Certification Examination

  15. Performance assessment in support of compliance certification application for the WIPP project

    International Nuclear Information System (INIS)

    Jow, H.N.; Anderson, D.R.; Marietta, M.; Helton, J.; Basabilvazo, G.

    1998-03-01

    The Waste Isolation Pilot Plant (WIPP) is being developed by the US Department of Energy for the geologic (deep underground) disposal of transuranic (TRU) waste. A Compliance Certification Application (CCA) of the WIPP (1) for such disposal was submitted to the US Environmental Protection Agency (EPA) in October, 1996, and is currently under review, with a decision anticipated in late 1997. An important component of the CCA is a performance assessment (PA) for the WIPP carried out by Sandia National Laboratories. The final outcome of the PA is a complementary cumulative distribution function (CCDF) for radionuclide releases from the WIPP to the accessible environment and an assessment of the confidence with which this CCDF can be estimated. This paper describes the computational process used to develop the CCDF. The results of uncertainty and sensitivity analysis are also presented

  16. Assessing the Effectiveness of a Learning Community Course Design to Improve the Math Performance of First-Year Students

    Science.gov (United States)

    Hansen, Michele J.; Meshulam, Susan; Parker, Brooke

    2013-01-01

    National attention is focused on the persistent high failure rates for students enrolled in math courses, and the search for strategies to change these outcomes is on. This study used a mixed-method research design to assess the effectiveness of a learning community course designed to improve the math performance levels of firstyear students.…

  17. Building capacity for Health Impact Assessment: Training outcomes from the United States

    Energy Technology Data Exchange (ETDEWEB)

    Schuchter, Joseph [Berkeley, CA (United States); Rutt, Candace, E-mail: awr8@cdc.gov [Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity and Obesity, 4770 Buford Highway MS/F-77, Atlanta, GA 30341 (United States); Satariano, William A. [University of California Berkeley, School of Public Health, Division of Community Health and Human Development, Berkeley, CA (United States); Seto, Edmund [University of Washington, Department of Environmental and Occupational Health Sciences, Seattle, WA (United States)

    2015-01-15

    Background: Despite the continued growth of Health Impact Assessment (HIA) in the US, there is little research on HIA capacity-building. A comprehensive study of longer-term training outcomes may reveal opportunities for improving capacity building activities and HIA practice. Methods: We conducted in-depth interviews with HIA trainees in the United States to assess their outcomes and needs. Using a training evaluation framework, we measured outcomes across a spectrum of reaction, learning, behavior and results. Results: From 2006 to 2012, four organizations trained over 2200 people in at least 75 in-person HIA trainings in 29 states. We interviewed 48 trainees, selected both randomly and purposefully. The mean duration between training and interview was 3.4 years. Trainees reported that their training objectives were met, especially when relevant case-studies were used. They established new collaborations at the trainings and maintained them. Training appeared to catalyze more holistic thinking and practice, including a range of HIA-related activities. Many trainees disseminated what they learned and engaged in components of HIA, even without dedicated funding. Going forward, trainees need assistance with quantitative methods, project management, community engagement, framing recommendations, and evaluation. Conclusions: The research revealed opportunities for a range of HIA stakeholders to refine and coordinate training resources, apply a competency framework and leverage complimentary workforce development efforts, and sensitize and build the capacity of communities. - Highlights: • We interviewed HIA trainees in the United States to assess longer-term outcomes. • Training appeared to catalyze a range of beneficial partnerships and activities. • Trainees reported outstanding needs for specific skills and competencies. • There are various opportunities to improve training and capacity-building.

  18. Building capacity for Health Impact Assessment: Training outcomes from the United States

    International Nuclear Information System (INIS)

    Schuchter, Joseph; Rutt, Candace; Satariano, William A.; Seto, Edmund

    2015-01-01

    Background: Despite the continued growth of Health Impact Assessment (HIA) in the US, there is little research on HIA capacity-building. A comprehensive study of longer-term training outcomes may reveal opportunities for improving capacity building activities and HIA practice. Methods: We conducted in-depth interviews with HIA trainees in the United States to assess their outcomes and needs. Using a training evaluation framework, we measured outcomes across a spectrum of reaction, learning, behavior and results. Results: From 2006 to 2012, four organizations trained over 2200 people in at least 75 in-person HIA trainings in 29 states. We interviewed 48 trainees, selected both randomly and purposefully. The mean duration between training and interview was 3.4 years. Trainees reported that their training objectives were met, especially when relevant case-studies were used. They established new collaborations at the trainings and maintained them. Training appeared to catalyze more holistic thinking and practice, including a range of HIA-related activities. Many trainees disseminated what they learned and engaged in components of HIA, even without dedicated funding. Going forward, trainees need assistance with quantitative methods, project management, community engagement, framing recommendations, and evaluation. Conclusions: The research revealed opportunities for a range of HIA stakeholders to refine and coordinate training resources, apply a competency framework and leverage complimentary workforce development efforts, and sensitize and build the capacity of communities. - Highlights: • We interviewed HIA trainees in the United States to assess longer-term outcomes. • Training appeared to catalyze a range of beneficial partnerships and activities. • Trainees reported outstanding needs for specific skills and competencies. • There are various opportunities to improve training and capacity-building

  19. 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...

  20. Integrating Interactive Web-Based Technology to Assess Adherence and Clinical Outcomes in Pediatric Sickle Cell Disease

    Directory of Open Access Journals (Sweden)

    Lori E. Crosby

    2012-01-01

    Full Text Available Research indicates that the quality of the adherence assessment is one of the best predictors for improving clinical outcomes. Newer technologies represent an opportunity for developing high quality standardized assessments to assess clinical outcomes such as patient experience of care but have not been tested systematically in pediatric sickle cell disease (SCD. The goal of the current study was to pilot an interactive web-based tool, the Take-Charge Program, to assess adherence to clinic visits and hydroxyurea (HU, barriers to adherence, solutions to overcome these barriers, and clinical outcomes in 43 patients with SCD age 6–21 years. Results indicate that the web-based tool was successfully integrated into the clinical setting while maintaining high patient satisfaction (>90%. The tool provided data consistent with the medical record, staff report, and/or clinical lab data. Participants reported that forgetting and transportation were major barriers for adherence to both clinic attendance and HU. A greater number of self-reported barriers (P<.01 and older age (P<.05 were associated with poorer clinic attendance and HU adherence. In summary, the tool represents an innovative approach to integrate newer technology to assess adherence and clinical outcomes for pediatric patients with SCD.

  1. The development of a clinical outcomes survey research application: Assessment Center.

    Science.gov (United States)

    Gershon, Richard; Rothrock, Nan E; Hanrahan, Rachel T; Jansky, Liz J; Harniss, Mark; Riley, William

    2010-06-01

    The National Institutes of Health sponsored Patient-Reported Outcome Measurement Information System (PROMIS) aimed to create item banks and computerized adaptive tests (CATs) across multiple domains for individuals with a range of chronic diseases. Web-based software was created to enable a researcher to create study-specific Websites that could administer PROMIS CATs and other instruments to research participants or clinical samples. This paper outlines the process used to develop a user-friendly, free, Web-based resource (Assessment Center) for storage, retrieval, organization, sharing, and administration of patient-reported outcomes (PRO) instruments. Joint Application Design (JAD) sessions were conducted with representatives from numerous institutions in order to supply a general wish list of features. Use Cases were then written to ensure that end user expectations matched programmer specifications. Program development included daily programmer "scrum" sessions, weekly Usability Acceptability Testing (UAT) and continuous Quality Assurance (QA) activities pre- and post-release. Assessment Center includes features that promote instrument development including item histories, data management, and storage of statistical analysis results. This case study of software development highlights the collection and incorporation of user input throughout the development process. Potential future applications of Assessment Center in clinical research are discussed.

  2. Behavior model for performance assessment

    International Nuclear Information System (INIS)

    Brown-VanHoozer, S. A.

    1999-01-01

    Every individual channels information differently based on their preference of the sensory modality or representational system (visual auditory or kinesthetic) we tend to favor most (our primary representational system (PRS)). Therefore, some of us access and store our information primarily visually first, some auditorily, and others kinesthetically (through feel and touch); which in turn establishes our information processing patterns and strategies and external to internal (and subsequently vice versa) experiential language representation. Because of the different ways we channel our information, each of us will respond differently to a task--the way we gather and process the external information (input), our response time (process), and the outcome (behavior). Traditional human models of decision making and response time focus on perception, cognitive and motor systems stimulated and influenced by the three sensory modalities, visual, auditory and kinesthetic. For us, these are the building blocks to knowing how someone is thinking. Being aware of what is taking place and how to ask questions is essential in assessing performance toward reducing human errors. Existing models give predications based on time values or response times for a particular event, and may be summed and averaged for a generalization of behavior(s). However, by our not establishing a basic understanding of the foundation of how the behavior was predicated through a decision making strategy process, predicative models are overall inefficient in their analysis of the means by which behavior was generated. What is seen is the end result

  3. Behavior model for performance assessment.

    Energy Technology Data Exchange (ETDEWEB)

    Borwn-VanHoozer, S. A.

    1999-07-23

    Every individual channels information differently based on their preference of the sensory modality or representational system (visual auditory or kinesthetic) we tend to favor most (our primary representational system (PRS)). Therefore, some of us access and store our information primarily visually first, some auditorily, and others kinesthetically (through feel and touch); which in turn establishes our information processing patterns and strategies and external to internal (and subsequently vice versa) experiential language representation. Because of the different ways we channel our information, each of us will respond differently to a task--the way we gather and process the external information (input), our response time (process), and the outcome (behavior). Traditional human models of decision making and response time focus on perception, cognitive and motor systems stimulated and influenced by the three sensory modalities, visual, auditory and kinesthetic. For us, these are the building blocks to knowing how someone is thinking. Being aware of what is taking place and how to ask questions is essential in assessing performance toward reducing human errors. Existing models give predications based on time values or response times for a particular event, and may be summed and averaged for a generalization of behavior(s). However, by our not establishing a basic understanding of the foundation of how the behavior was predicated through a decision making strategy process, predicative models are overall inefficient in their analysis of the means by which behavior was generated. What is seen is the end result.

  4. Performance-Based Outcomes After Anterior Cruciate Ligament Reconstruction in Professional Athletes Differ Between Sports.

    Science.gov (United States)

    Mai, Harry T; Chun, Danielle S; Schneider, Andrew D; Erickson, Brandon J; Freshman, Ryan D; Kester, Benjamin; Verma, Nikhil N; Hsu, Wellington K

    2017-08-01

    Excellent outcomes have been reported for anterior cruciate ligament (ACL) reconstruction (ACLR) in professional athletes in a number of different sports. However, no study has directly compared these outcomes between sports. To determine if differences in performance-based outcomes exist after ACLR between professional athletes of each sport. Cohort study; Level of evidence, 3. National Football League (NFL), National Basketball Association (NBA), National Hockey League (NHL), and Major League Baseball (MLB) athletes undergoing primary ACLR for an acute rupture were identified through an established protocol of injury reports and public archives. Sport-specific performance statistics were collected before and after surgery for each athlete. Return to play (RTP) was defined as a successful return to the active roster for at least 1 regular-season game after ACLR. Of 344 professional athletes who met the inclusion criteria, a total of 298 (86.6%) returned to play. NHL players had a significantly higher rate of RTP (95.8% vs 83.4%, respectively; P = .04) and a shorter recovery time (258 ± 110 days vs 367 ± 268 days, respectively; P NBA and NFL players showed decreased performance at season 1 after ACLR ( P ≤ .001). NFL players continued to have lower performance at seasons 2 and 3 ( P = .002), while NBA players recovered to baseline performance. The data indicate that NFL athletes fare the worst after ACLR with the lowest survival rate, shortest postoperative career length, and sustained decreases in performance. NHL athletes fare the best with the highest rates of RTP, highest survival rates, longest postoperative career lengths, and no significant changes in performance. The unique physical demand that each sport requires is likely one of the explanations for these differences in outcomes.

  5. Treatment of large posttraumatic tibial bone defects using the Ilizarov method: a subjective outcome assessment.

    Science.gov (United States)

    Krappinger, Dietmar; Irenberger, Alexander; Zegg, Michael; Huber, Burkhart

    2013-06-01

    The treatment of large posttraumatic tibial bone defects using the Ilizarov method was shown to be successful in several studies. These studies, however, typically focus on the radiological and functional outcome using objective parameters only. The aim of the present study was therefore to assess the objective and subjective outcome of a consecutive series of patients with large posttraumatic tibial bone defects using the Ilizarov method. Additionally, it was our goal to assess the physical and mental stress for the patients and their relatives during the long treatment period and the general health status at final follow-up. A consecutive series of 15 patients with posttraumatic tibial bone defects of >30 mm after sustaining open tibial fractures and failure of internal fixation was included. The objective outcome was assessed at final follow-up using Paley's criteria. For the assessment of the subjective outcome, all patients were asked to evaluate their satisfaction with the function of the lower leg, the cosmetic appearance and overall outcome as well. The physical and mental stress of the treatment for the patients and the nearest relative of patients were assessed at the time of frame removal using a custom-made questionnaire. The SF-36 was used to evaluate the general health status at final follow-up. Solid bone union with stable soft tissue coverage and eradication of infection was achieved in all patients despite a high complication rate. The functional outcome at final follow-up was excellent or good in all patients. The patients' satisfaction with the overall outcome and the function of the lower extremity was high as well. The fear of amputation and complications was the major subjective burden for both the patients and their relatives. The long external fixation time is another relevant issue. The Ilizarov method is a safe option for the treatment of large posttraumatic tibial bone defects after failure of internal fixation despite the high

  6. Who Are You More Likely to Help? The Effects of Expected Outcomes and Regulatory Focus on Prosocial Performance

    Science.gov (United States)

    Xiao, Fengqiu; Zheng, Zhiwei; Zhang, Heyi; Xin, Ziqiang; Chen, Yinghe; Li, Yiwei

    2016-01-01

    Prosocial behavior refers to a broad category of actions that benefit other people or the society. Compared with other factors that affect prosocial performance, prosocial outcomes, consisting of prosocial gains and prosocial non-losses have received less attention up to now. In the current research, we explored the influences of different types of expected outcomes and regulatory focus on prosocial performance. Studies 1a and 1b examined the differences in prosocial performance elicited by prosocial gain (e.g., enhancing others’ access to clean water) and prosocial non-loss outcomes (e.g., protecting others from suffering dirty water). We found that the expected prosocial non-loss outcomes induced greater prosocial performance compared with the expected prosocial gain outcomes. Studies 2a and 2b examined the effects of dispositional and situational regulatory focus on prosocial loss aversion. We found that differences in prosocial performance between two expected prosocial outcomes were reduced when promotion focus was primed; whereas a primed prevention focus did not significantly increase this difference. Additionally, participants displayed a greater prosocial loss aversion in the prevention focus condition than in the promotion focus condition. The reason for the non-significant interaction between regulatory focus and expected prosocial outcome was discussed. PMID:27824909

  7. Who Are You More Likely to Help? The Effects of Expected Outcomes and Regulatory Focus on Prosocial Performance.

    Directory of Open Access Journals (Sweden)

    Fengqiu Xiao

    Full Text Available Prosocial behavior refers to a broad category of actions that benefit other people or the society. Compared with other factors that affect prosocial performance, prosocial outcomes, consisting of prosocial gains and prosocial non-losses have received less attention up to now. In the current research, we explored the influences of different types of expected outcomes and regulatory focus on prosocial performance. Studies 1a and 1b examined the differences in prosocial performance elicited by prosocial gain (e.g., enhancing others' access to clean water and prosocial non-loss outcomes (e.g., protecting others from suffering dirty water. We found that the expected prosocial non-loss outcomes induced greater prosocial performance compared with the expected prosocial gain outcomes. Studies 2a and 2b examined the effects of dispositional and situational regulatory focus on prosocial loss aversion. We found that differences in prosocial performance between two expected prosocial outcomes were reduced when promotion focus was primed; whereas a primed prevention focus did not significantly increase this difference. Additionally, participants displayed a greater prosocial loss aversion in the prevention focus condition than in the promotion focus condition. The reason for the non-significant interaction between regulatory focus and expected prosocial outcome was discussed.

  8. Assessing Vocal Performances Using Analytical Assessment: A Case Study

    Science.gov (United States)

    Gynnild, Vidar

    2016-01-01

    This study investigated ways to improve the appraisal of vocal performances within a national academy of music. Since a criterion-based assessment framework had already been adopted, the conceptual foundation of an assessment rubric was used as a guide in an action research project. The group of teachers involved wanted to explore thinking…

  9. URSSA, the Undergraduate Research Student Self-Assessment: A Tool for Assessing Student Outcomes of Undergraduate Research

    Science.gov (United States)

    Laursen, S. L.; Hunter, A.; Weston, T.; Thiry, H.

    2009-12-01

    Evidence-based thinking is essential both to science and to the development of effective educational programs. Thus assessment of student learning—gathering evidence about the nature and depth of students’ learning gains, and about how they arise—is a centerpiece of any effective undergraduate research (UR) program. Assessment data can be used to monitor progress, to diagnose problems, to strengthen program designs, and to report both good outcomes and strategies to improve them to institutional and financial stakeholders in UR programs. While the positive impact of UR on students’ educational, personal and professional development has long been a matter of faith, only recently have researchers and evaluators developed an empirical basis by which to identify and explain these outcomes. Based on this growing body of evidence, URSSA, the Undergraduate Research Student Self-Assessment, is a survey tool that departments and programs can use to assess student outcomes of UR. URSSA focuses on what students learn from their UR experience, rather than whether they liked it. Both multiple-choice and open-ended items focus on students’ gains from UR, including: (1) skills such as lab work and communication; (2) conceptual knowledge and linkages among ideas in their field and with other fields; (3) deepened understanding of the intellectual and practical work of science; (4) growth in confidence and adoption of the identity of scientist; (5) preparation for a career or graduate school in science; and (6) greater clarity in understanding what career or educational path they might wish to pursue. Other items probe students’ participation in important activities that have been shown to lead to these gains; and a set of optional items can be included to probe specific program features that may supplement UR (e.g. field trips, career seminars, housing arrangements). The poster will describe URSSA's content, development, validation, and use. For more information about

  10. Performance Assessment as a Diagnostic Tool for Science Teachers

    Science.gov (United States)

    Kruit, Patricia; Oostdam, Ron; van den Berg, Ed; Schuitema, Jaap

    2018-04-01

    Information on students' development of science skills is essential for teachers to evaluate and improve their own education, as well as to provide adequate support and feedback to the learning process of individual students. The present study explores and discusses the use of performance assessments as a diagnostic tool for formative assessment to inform teachers and guide instruction of science skills in primary education. Three performance assessments were administered to more than 400 students in grades 5 and 6 of primary education. Students performed small experiments using real materials while following the different steps of the empirical cycle. The mutual relationship between the three performance assessments is examined to provide evidence for the value of performance assessments as useful tools for formative evaluation. Differences in response patterns are discussed, and the diagnostic value of performance assessments is illustrated with examples of individual student performances. Findings show that the performance assessments were difficult for grades 5 and 6 students but that much individual variation exists regarding the different steps of the empirical cycle. Evaluation of scores as well as a more substantive analysis of students' responses provided insight into typical errors that students make. It is concluded that performance assessments can be used as a diagnostic tool for monitoring students' skill performance as well as to support teachers in evaluating and improving their science lessons.

  11. Reliability assessment and correlation analysis of evaluating orthodontic treatment outcome in Chinese patients.

    Science.gov (United States)

    Song, Guang-Ying; Zhao, Zhi-He; Ding, Yin; Bai, Yu-Xing; Wang, Lin; He, Hong; Shen, Gang; Li, Wei-Ran; Baumrind, Sheldon; Geng, Zhi; Xu, Tian-Min

    2014-03-01

    This study aimed to assess the reliability of experienced Chinese orthodontists in evaluating treatment outcome and to determine the correlations between three diagnostic information sources. Sixty-nine experienced Chinese orthodontic specialists each evaluated the outcome of orthodontic treatment of 108 Chinese patients. Three different information sources: study casts (SC), lateral cephalometric X-ray images (LX) and facial photographs (PH) were generated at the end of treatment for 108 patients selected randomly from six orthodontic treatment centers throughout China. Six different assessments of treatment outcome were made by each orthodontist using data from the three information sources separately and in combination. Each assessment included both ranking and grading for each patient. The rankings of each of the 69 judges for the 108 patients were correlated with the rankings of each of the other judges yielding 13 873 Spearman rs values, ranging from -0.08 to +0.85. Of these, 90% were greater than 0.4, showing moderate-to-high consistency among the 69 orthodontists. In the combined evaluations, study casts were the most significant predictive component (R(2)=0.86, P<0.000 1), while the inclusion of lateral cephalometric films and facial photographs also contributed to a more comprehensive assessment (R(2)=0.96, P<0.000 1). Grading scores for SC+LX and SC+PH were highly significantly correlated with those for SC+LX+PH (r(SC+LX)vs.(SC+LX+PH)=0.96, r(SC+PH)vs.(SC+LX+PH)=0.97), showing that either SC+LX or SC+PH is an excellent substitute for all three combined assessment.

  12. The Outcome and Assessment Information Set (OASIS): A Review of Validity and Reliability

    Science.gov (United States)

    O’CONNOR, MELISSA; DAVITT, JOAN K.

    2015-01-01

    The Outcome and Assessment Information Set (OASIS) is the patient-specific, standardized assessment used in Medicare home health care to plan care, determine reimbursement, and measure quality. Since its inception in 1999, there has been debate over the reliability and validity of the OASIS as a research tool and outcome measure. A systematic literature review of English-language articles identified 12 studies published in the last 10 years examining the validity and reliability of the OASIS. Empirical findings indicate the validity and reliability of the OASIS range from low to moderate but vary depending on the item studied. Limitations in the existing research include: nonrepresentative samples; inconsistencies in methods used, items tested, measurement, and statistical procedures; and the changes to the OASIS itself over time. The inconsistencies suggest that these results are tentative at best; additional research is needed to confirm the value of the OASIS for measuring patient outcomes, research, and quality improvement. PMID:23216513

  13. VISUAL ART TEACHERS AND PERFORMANCE ASSESSMENT ...

    African Journals Online (AJOL)

    Charles

    qualitative research design; an aspect of descriptive survey research aiming at ... the competence and use of assessment strategies is determined by the type of ... Visual Art Teachers and Performance Assessment Methods in Nigerian Senior ...

  14. National Assessment Meets Teacher Autonomy: National Assessment of Learning Outcomes in Music in Finnish Basic Education

    Science.gov (United States)

    Juntunen, Marja-Leena

    2017-01-01

    In Finland, teachers' have extensive autonomy, that is freedom from control by others over their professional actions in the classroom, and it is considered a strength of Finnish education. At the same time, national assessment of learning outcomes has been constructed to examine the learner's progress and achievements in relation to the criteria…

  15. Assessment of a pay-for-performance program in primary care designed by target users.

    Science.gov (United States)

    Kirschner, Kirsten; Braspenning, Jozé; Akkermans, Reinier P; Jacobs, J E Annelies; Grol, Richard

    2013-04-01

    Evidence for pay-for-performance (P4P) has been searched for in the last decade as financial incentives increased to influence behaviour of health care professionals to improve quality of care. The effectiveness of P4P is inconclusive, though some reviews reported significant effects. To assess changes in performance after introducing a participatory P4P program. An observational study with a pre- and post-measurement. Setting and subjects. Sixty-five general practices in the south of the Netherlands. Intervention. A P4P program designed by target users containing indicators for chronic care, prevention, practice management and patient experience (general practitioner's [GP] functioning and organization of care). Quality indicators were calculated for each practice. A bonus with a maximum of 6890 Euros per 1000 patients was determined by comparing practice performance with a benchmark. Quality indicators for clinical care (process and outcome) and patient experience. We included 60 practices. After 1 year, significant improvement was shown for the process indicators for all chronic conditions ranging from +7.9% improvement for cardiovascular risk management to +11.5% for asthma. Five outcome indicators significantly improved as well as patients' experiences with GP's functioning and organization of care. No significant improvements were seen for influenza vaccination rate and the cervical cancer screening uptake. The clinical process and outcome indicators, as well as patient experience indicators were affected by baseline measures. Smaller practices showed more improvement. A participatory P4P program might stimulate quality improvement in clinical care and improve patient experiences with GP's functioning and the organization of care.

  16. Validity of partial protocols to assess the prevalence of periodontal outcomes and associated sociodemographic and behavior factors in adolescents and young adults.

    Science.gov (United States)

    Peres, Marco A; Peres, Karen G; Cascaes, Andreia M; Correa, Marcos B; Demarco, Flávio F; Hallal, Pedro C; Horta, Bernardo L; Gigante, Denise P; Menezes, Ana B

    2012-03-01

    Most studies comparing prevalence of periodontal disease and risk factors by using partial protocols were performed in adult populations, with several studies being conducted in clinical settings. The aim of this study is to assess the accuracy of partial protocols in estimating the prevalence of periodontal outcomes in adolescents and young adults from two population-based birth cohorts from Pelotas, Brazil, and to assess differences in the estimation and strength of the effect measures when partial protocols are adopted compared to full-mouth examination. Gingival bleeding at probing among adolescents (n = 339) and young adults (n = 720) and dental calculus and periodontal probing depth among young adults were assessed using full-mouth examinations and four partial protocols: Ramfjord teeth (RT), community periodontal index (CPI), and two random diagonal quadrants (1 and 3, 2 and 4). Socioeconomic, demographic, and periodontal health-related variables were also collected. Sensitivity, absolute and relative bias, and inflation factors were calculated. Prevalence ratio for each periodontal outcome for the risk factors was estimated. Two diagonal quadrants showed better accuracy; RT had the worst, whereas CPI presented an intermediate pattern when compared to full-mouth examination. For bleeding assessment in adolescence, RT and CPI underestimated by 18.4% and 16.2%, respectively, the true outcome prevalence, whereas among young adults, all partial protocols underestimated the prevalence. All partial protocols presented similar magnitude of association measures for all investigated periodontal potential risk factors. Two diagonal quadrants protocol may be effective in identifying the risk factors for the most relevant periodontal outcomes in adolescence and in young adulthood.

  17. Authentic Assessment: A Handbook for Educators. Assessment Bookshelf Series.

    Science.gov (United States)

    Hart, Diane

    This book reviews the assessment movement, from the history of testing to the practical considerations of enhancing classroom experiences for teachers and students. It explores making time for assessment, tailoring assessment to desired outcomes, and scoring and evaluating student performance. The chapters are: (1) "Where We've Been: Standardized…

  18. Performance assessment strategy for low-level waste disposal sites

    International Nuclear Information System (INIS)

    Starmer, R.J.; Deering, L.G.; Weber, M.F.

    1988-01-01

    This paper describes US Nuclear Regulatory Commission (NRC) staff views on predicting the performance of low-level radioactive waste disposal facilities. Under the Atomic Energy Act, as amended, and the Low Level Radioactive Waste Policy Act, as amended, the NRC and Agreement States license land disposal of low-level radioactive waste (LLW) using the requirements in 10 CFR Part 61 or comparable state requirements. The purpose of this paper is to briefly describe regulatory requirements for performance assessment in low-level waste licensing, a strategy for performance assessments to support license applications, and NRC staff licensing evaluation of performance assessments. NRC's current activities in developing a performance assessment methodology will provide an overall systems modeling approach for assessing the performance of LLW disposal facilities. NRC staff will use the methodology to evaluate performance assessments conducted by applicants for LLW disposal facilities. The methodology will be made available to states and other interested parties

  19. An overview of performance assessment methodology

    International Nuclear Information System (INIS)

    Hongnian Jow

    2010-01-01

    The definition of performance assessment (PA) within the context of a geologic repository program is a post-closure safety assessment; a system analysis of hazards associated with the facility and the ability of the site and the design of the facility to provide for the safety functions. For the last few decades, PA methodology bas been developed and applied to different waste disposal programs around the world. PA has been used in the safety analyses for waste disposal repositories for low-level waste, intermediate level waste, and high-level waste including spent nuclear fuels. This paper provides an overview of the performance assessment methodology and gives examples of its applications for the Yucca Mountain Project. (authors)

  20. Change in self-assessed comfort level of first-year pharmacy students as an alternative approach to measure teaching effectiveness and learning outcomes.

    Science.gov (United States)

    Oelschlaeger, Peter

    2017-05-01

    Objective measures for assessing teaching effectiveness and learning outcomes in the pharmacy curriculum are needed for improving quality of instruction and faculty development. The purpose of this article is to introduce a new teaching assessment method that focuses on self-assessed change in student comfort with the topics taught rather than evaluation of the instructor and to evaluate its performance in comparison to conventional student evaluations of teaching (SET). Six successive cohorts of first-year pharmacy students were surveyed regarding their comfort level at the beginning and end of a 10-week pharmacology course. The change in self-assessed comfort level (ΔSACL) was interpreted as the amount of learning that occurred. This indicator was compared to ratings of a statement from SET designed to obtain the same information. An increasing ΔSACL suggests an increase in learning over time. Differences were observed between ΔSACL and corresponding results from SET, suggesting that there could be extrinsic factors influencing the results. The use of ΔSACL could provide an alternative or complementary approach to assess teaching effectiveness that focuses less on the instructor and more on the actual student learning outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Reliability assessment and correlation analysis of evaluating orthodontic treatment outcome in Chinese patients

    OpenAIRE

    Song, Guang-Ying; Zhao, Zhi-He; Ding, Yin; Bai, Yu-Xing; Wang, Lin; He, Hong; Shen, Gang; Li, Wei-Ran; Baumrind, Sheldon; Geng, Zhi; Xu, Tian-Min

    2013-01-01

    This study aimed to assess the reliability of experienced Chinese orthodontists in evaluating treatment outcome and to determine the correlations between three diagnostic information sources. Sixty-nine experienced Chinese orthodontic specialists each evaluated the outcome of orthodontic treatment of 108 Chinese patients. Three different information sources: study casts (SC), lateral cephalometric X-ray images (LX) and facial photographs (PH) were generated at the end of treatment for 108 pat...

  2. Computer Self-Efficacy, Computer Anxiety, Performance and Personal Outcomes of Turkish Physical Education Teachers

    Science.gov (United States)

    Aktag, Isil

    2015-01-01

    The purpose of this study is to determine the computer self-efficacy, performance outcome, personal outcome, and affect and anxiety level of physical education teachers. Influence of teaching experience, computer usage and participation of seminars or in-service programs on computer self-efficacy level were determined. The subjects of this study…

  3. Performance Assessment for e-Government Services: An Experience Report

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Yan; Zhu, Liming; Gorton, Ian

    2007-08-14

    The transformation and integration of government services, enabled by the use of new technologies such as application servers and Web services, is fundamental to reduce the cost of government and improving service outcomes to citizens. Many core Government information systems comprise applications running on legacy mainframes, databases and transaction processing monitors. As Governments worldwide provide direct access over the Internet to these legacy applications from the general public, they may be exposed to workloads well above the origin design parameters of these back-end systems. This creates a significant risk of high profile failures for Government agencies whose newly integrated systems become overloaded. In this paper we describe how we conducted a performance assessment of a business-critical, Internet-facing Web services that integrated new and legacy systems from two Australian Government agencies. We leveraged prototype tools from our own research along with known techniques in performance modeling. We were able to clearly demonstrate that the existing hardware and software would be adequate to handle the predicted workload for the next financial year. We were also able to do ‘what-if’ analysis and predict how the system can perform with alternative strategies to scale the system. We conclude by summarizing the lessons learnt, including the importance of architecture visibility, benchmarking data quality, and measurement feasibility due to issues of outsourcing, privacy legislation and cross-agency involvement.

  4. Learning Outcomes in Affective Domain within Contemporary Architectural Curricula

    Science.gov (United States)

    Savic, Marko; Kashef, Mohamad

    2013-01-01

    Contemporary architectural education has shifted from the traditional focus on providing students with specific knowledge and skill sets or "inputs" to outcome based, student-centred educational approach. Within the outcome based model, students' performance is assessed against measureable objectives that relate acquired knowledge…

  5. A telephone questionnaire in order to assess functional outcome after post-traumatic limb salvage surgery: Development and preliminary validation.

    Science.gov (United States)

    Wulterkens, Leonie; Aurégan, Jean-Charles; Letellier, Thomas; Mebtouche, Nasser; Levante, Stéphane; Cottin, Philippe; Bégué, Thierry

    2015-12-01

    Post-traumatic limb salvage surgery is challenging and evaluation of the results remains arduous. No questionnaire specifically assessing functional outcome after post-traumatic limb salvage surgery of the lower extremity exists. Due to regionalization of specialized care, the patients' travel time to the hospital increases. To overcome a higher patients' travel burden, patients' follow up by telephone is an option. We aimed to develop a telephone questionnaire in order to assess functional outcome after post-traumatic limb salvage surgery of the lower extremity. From a review of scores of functional assessment of the lower limb surgery, we have developed a telephone questionnaire. A prospective study was performed to validate this telephone questionnaire. Twenty patients were included. The participants were called to complete the telephone questionnaire twice with an interval of a week. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was completed during the second telephone call. The internal consistency was analyzed by the Cronbach's alpha (α). With the outcome scores of both completions, the test-retest reliability was analyzed by the interclass correlation coefficient (ICC) 2,k with a 95% confidence interval (95% CI). The outcome scores of the second telephone questionnaire and the WOMAC questionnaire were used for the construct validity analysis by the Spearman's rank correlation coefficient (r(s)) with a 95% CI. The internal consistency analysis revealed a α=0.62 which improved to α=0.92 after removing one question from the telephone questionnaire. The final version of the telephone questionnaire comprises 32 questions, divided in 3 subscales: function, daily life and psychology. The total score varies between 0 and 86 points. The test-retest reliability was ICC 2,k=0.93 (95% CI: 0.82-0.97) and the construct validity was r(s)=0.92 (95% CI: 0.81-0.97). We present a specific telephone questionnaire in order to assess functional

  6. Performance assessment handbook for low-level radioactive waste disposal facilities

    International Nuclear Information System (INIS)

    Seitz, R.R.; Garcia, R.S.; Kostelnik, K.M.; Starmer, R.J.

    1992-02-01

    Performance assessments of proposed low-level radioactive waste disposal facilities must be conducted to support licensing. This handbook provides a reference document that can be used as a resource by management and staff responsible for performance assessments. Brief discussions describe the performance assessment process and emphasize selected critical aspects of the process. References are also provided for additional information on many aspects of the performance assessment process. The user's manual for the National Low-Level Waste Management Program's Performance Assessment Center (PAC) on the Idaho National Engineering Laboratory Cray computer is included as Appendix A. The PAC provides users an opportunity to experiment with a number of performance assessment computer codes on a Cray computer. Appendix B describes input data required for 22 performance assessment codes

  7. Validity of the Symbol Digit Modalities Test as a cognition performance outcome measure for multiple sclerosis.

    Science.gov (United States)

    Benedict, Ralph Hb; DeLuca, John; Phillips, Glenn; LaRocca, Nicholas; Hudson, Lynn D; Rudick, Richard

    2017-04-01

    Cognitive and motor performance measures are commonly employed in multiple sclerosis (MS) research, particularly when the purpose is to determine the efficacy of treatment. The increasing focus of new therapies on slowing progression or reversing neurological disability makes the utilization of sensitive, reproducible, and valid measures essential. Processing speed is a basic elemental cognitive function that likely influences downstream processes such as memory. The Multiple Sclerosis Outcome Assessments Consortium (MSOAC) includes representatives from advocacy organizations, Food and Drug Administration (FDA), European Medicines Agency (EMA), National Institute of Neurological Disorders and Stroke (NINDS), academic institutions, and industry partners along with persons living with MS. Among the MSOAC goals is acceptance and qualification by regulators of performance outcomes that are highly reliable and valid, practical, cost-effective, and meaningful to persons with MS. A critical step for these neuroperformance metrics is elucidation of clinically relevant benchmarks, well-defined degrees of disability, and gradients of change that are deemed clinically meaningful. This topical review provides an overview of research on one particular cognitive measure, the Symbol Digit Modalities Test (SDMT), recognized as being particularly sensitive to slowed processing of information that is commonly seen in MS. The research in MS clearly supports the reliability and validity of this test and recently has supported a responder definition of SDMT change approximating 4 points or 10% in magnitude.

  8. Learning outcomes afforded by self-assessed, segmented video–print combinations

    OpenAIRE

    Jack Koumi

    2015-01-01

    Learning affordances of video and print are examined in order to assess the learning outcomes afforded by hybrid video–print learning packages. The affordances discussed for print are: navigability, surveyability and legibility. Those discussed for video are: design for constructive reflection, provision of realistic experiences, presentational attributes, motivational influences and teacher personalisation. The video affordances are examined through a framework of pedagogic design principles...

  9. Assessing risk of fibrosis progression and liver-related clinical outcomes among patients with both early stage and advanced chronic hepatitis C.

    Directory of Open Access Journals (Sweden)

    Monica A Konerman

    Full Text Available Assessing risk of adverse outcomes among patients with chronic liver disease has been challenging due to non-linear disease progression. We previously developed accurate prediction models for fibrosis progression and clinical outcomes among patients with advanced chronic hepatitis C (CHC. The primary aim of this study was to validate fibrosis progression and clinical outcomes models among a heterogeneous patient cohort.Adults with CHC with ≥3 years follow-up and without hepatic decompensation, hepatocellular carcinoma (HCC, liver transplant (LT, HBV or HIV co-infection at presentation were analyzed (N = 1007. Outcomes included: 1 fibrosis progression 2 hepatic decompensation 3 HCC and 4 LT-free survival. Predictors included longitudinal clinical and laboratory data. Machine learning methods were used to predict outcomes in 1 and 3 years.The external cohort had a median age of 49.4 years (IQR 44.3-54.3; 61% were male, 80% white, and 79% had genotype 1. At presentation, 73% were treatment naïve and 31% had cirrhosis. Fibrosis progression occurred in 34% over a median of 4.9 years (IQR 3.2-7.6. Clinical outcomes occurred in 22% over a median of 4.4 years (IQR 3.2-7.6. Model performance for fibrosis progression was limited due to small sample size. The area under the receiver operating characteristic curve (AUROC for 1 and 3-year risk of clinical outcomes was 0.78 (95% CI 0.73-0.83 and 0.76 (95% CI 0.69-0.81.Accurate assessments for risk of clinical outcomes can be obtained using routinely collected data across a heterogeneous cohort of patients with CHC. These methods can be applied to predict risk of progression in other chronic liver diseases.

  10. Nonorganic Failure to Thrive: Developmental Outcomes and Psychosocial Assessment and Intervention Issues.

    Science.gov (United States)

    Heffer, Robert W.; Kelley, Mary L.

    1994-01-01

    This review describes Nonorganic Failure to Thrive, presents developmental outcomes, and discusses psychosocial assessment and intervention issues relevant to this developmental disability of early childhood, focusing on child-specific variables, situational and family variables, parent-child interaction variables, and biopsychosocial formulation…

  11. Policy and Validity Prospects for Performance-Based Assessment.

    Science.gov (United States)

    Baker, Eva L.; And Others

    1994-01-01

    This article describes performance-based assessment as expounded by its proponents, comments on these conceptions, reviews evidence regarding the technical quality of performance-based assessment, and considers its validity under various policy options. (JDD)

  12. Assessment and outcome of 496 penetrating gastrointestinal warfare injuries.

    Science.gov (United States)

    Saghafinia, M; Nafissi, N; Motamedi, M R K; Motamedi, M H K; Hashemzade, M; Hayati, Z; Panahi, F

    2010-03-01

    The abdominal viscera are among the most vulnerable organs of the body to penetrating trauma. Proper management of such trauma in war victims at the first-line hospital where these victims are first seen is of paramount importance. We reviewed medical records of war victims suffering small bowel and colorectal injuries treated at first, second and third-line hospitals during the Iraq-Iran War (1980-88) to assess surgical outcomes. The medical records of 496 Iranian war victims suffering penetrating gastrointestinal (GI) injuries treated at first, second and third-line (tertiary) hospitals, a total of 19 centres, were reviewed. Laparotomy had been performed at the 1st line hospitals for all patients who had an acute abdomen, whose wounds violated the peritoneum or whose abdominal radiographs showed air or shrapnel in the abdominal cavity. Stable patients were transferred from first-line to second-line or from second line to tertiary hospitals postoperatively. The treatments, complications and patient outcomes were documented and analyzed. There were 496 patients; 145, 220 and 131 victims underwent laparotomy for GI injuries at first, second and third-line hospitals respectively. The small intestine and colon respectively were the most prevalent abdominal organs damaged. Those first treated for GI injuries at front-line hospitals (145 victims) had more serious conditions and could not be transferred prior to surgery and presented a higher prevalence of complications and mortality. Overall mortality from GI surgery was 3.6% (18 patients). Eleven patients (7.5%) whose first GI operation was performed at frontline hospitals and 7 patients (3.2%) who underwent their first surgical operation at second-line hospitals died. The most common reason for these deaths was complications relating to the gastrointestinal operation such as anastomotic leak. Six missed injuries were seen at the frontline and one at second line hospitals. There were no deaths at the 3rd line hospitals

  13. Organic migration forms of radionuclides and performance assessment

    International Nuclear Information System (INIS)

    Xu Gouqing

    2010-01-01

    Much attention is paid to inorganic migration forms of radionuclides in groundwater during performance assessment before and organic migration forms, are seldom noted. Therefore some question may come into confidence level in performance assessment. This paper mainly discusses the distribution of organic substances in groundwater and their potential effect on performance assessment. The results obtained in recent years show that clay rocks are generally impermeable to water, but in some cases the interstitial water may be observed in them and the concentration of DOC, HA and FA is rather higher than that in granitic groundwater. The concentration of DOC is relatively low in granitic groundwater, but up to now the effect of organic migration forms of radionuclides in granitic groundwater on performance assessment is not finally determined, it is necessary to make further investigations. (authors)

  14. How physicians identify with predetermined personalities and links to perceived performance and wellness outcomes: a cross-sectional study.

    Science.gov (United States)

    Lemaire, Jane B; Wallace, Jean E

    2014-11-29

    Certain personalities are ascribed to physicians. This research aims to measure the extent to which physicians identify with three predetermined personalities (workaholic, Type A and control freak) and to explore links to perceptions of professional performance, and wellness outcomes. This is a cross-sectional study using a mail-out questionnaire sent to all practicing physicians (2957 eligible, 1178 responses, 40% response rate) in a geographical health region within a western Canadian province. Survey items were used to assess the extent to which participants felt they are somewhat of a workaholic, Type A and/or control freak, and if they believed that having these personalities makes one a better doctor. Participants' wellness outcomes were also measured. Zero-order correlations were used to determine the relationships between physicians identifying with a personality and feeling it makes one a better doctor. T-tests were used to compare measures of physician wellness for those who identified with the personality versus those who did not. 53% of participants identified with the workaholic personality, 62% with the Type A, and 36% with the control freak. Identifying with any one of the personalities was correlated with feeling it makes one a better physician. There were statistically significant differences in several wellness outcomes comparing participants who identified with the personalities versus those who did not. These included higher levels of emotional exhaustion (workaholic, Type A and control freak), higher levels of anxiety (Type A and control freak) and higher levels of depression, poorer mental health and lower levels of job satisfaction (control freak). Participants who identified with the workaholic personality versus those who did not reported higher levels of job satisfaction, rewarding patient experiences and career commitment. Most participants identified with at least one of the three personalities. The beliefs of some participants that

  15. To Assess the Effect of Maternal BMI on Obstetrical Outcome

    Science.gov (United States)

    Lakhanpal, Shuchi; Aggarwal, Asha; Kaur, Gurcharan

    2012-06-01

    AIMS: To assess the effect of maternal BMI on complications in pregnancy, mode of delivery, complications of labour and delivery.METHODS:A crossectional study was carried out in the Obst and Gynae department, Kasturba Hospital, Delhi. The study enrolled 100 pregnant women. They were divided into 2 groups based on their BMI, more than or equal to 30.0 kg/m2 were categorized as obese and less than 30 kg/m2 as non obese respectively. Maternal complications in both types of patients were studied.RESULTS:CONCLUSION: As the obstetrical outcome is significantly altered due to obesity, we can improve maternal outcome by overcoming obesity. As obesity is a modifiable risk factor, preconception counseling creating awareness regarding health risk associated with obesity should be encouraged and obstetrical complications reduced.

  16. Lymphatic Leak Occurring After Surgical Lymph Node Dissection: A Preliminary Study Assessing the Feasibility and Outcome of Lymphatic Embolization

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Yoolim; Won, Je Hwan [Ajou University School of Medicine, Department of Radiology, Ajou University Hospital (Korea, Republic of); Kong, Tae-Wook; Paek, Jiheum; Chang, Suk-Joon; Ryu, Hee-Sug [Ajou University School of Medicine, Department of Obstetrics and Gynecology, Gynecologic Cancer Center (Korea, Republic of); Kim, Jinoo, E-mail: jinoomail@gmail.com [Ajou University School of Medicine, Department of Radiology, Ajou University Hospital (Korea, Republic of)

    2016-12-15

    PurposeTo analyze imaging findings of lymphatic leakage associated with surgical lymph node dissection on lymphangiography and assess the outcome of lymphatic embolization.Materials and MethodsThis retrospective study comprised 21 consecutive patients who were referred for lymphatic intervention between March 2014 and April 2015 due to postsurgical lymphatic leaks. Lymphangiography was performed through inguinal lymph nodes to identify the leak. When a leak was found, lymphatic embolization was performed by fine-needle injection of N-butyl cyanoacrylate into the site of leakage or into an inflow lymphatic vessel or into a pelvic lymph node located below the leakage. Electronic medical records and imaging studies were reviewed to assess the outcome.ResultLymphangiography revealed single or multiple leaks in all but one patient. Lymphatic embolization was performed in 20 patients with leaks. Including the patient who did not undergo embolization, 17 patients (81.0 %) showed initial response to treatment. Three patients underwent repeated embolization with successful results. The overall success rate was 95.2 %. The mean duration of hospitalization after lymphatic intervention was 5.9 days. During a mean follow-up period of 11 months, two patients developed localized swelling in the groin following lipiodol injection. There were no complications related to lymphatic embolization. Three patients were found to have developed small, asymptomatic lymphoceles on CT or MRI that did not require further treatment.ConclusionLymphangiography is useful for detecting lymphatic leakage occurring after lymph node dissection. Furthermore, lymphatic embolization is feasible, effective, and safe for managing leaks demonstrated on lymphangiography.

  17. Outcome assessment of lingual and labial appliances compared with cephalometric analysis, peer assessment rating, and objective grading system in Angle Class II extraction cases.

    Science.gov (United States)

    Deguchi, Toru; Terao, Fumie; Aonuma, Tomo; Kataoka, Tomoki; Sugawara, Yasuyo; Yamashiro, Takashi; Takano-Yamamoto, Teruko

    2015-05-01

    To validate our hypothesis that there would be significant differences in treatment outcomes, including cephalometric values, degree of root resorption, occlusal indices, and functional aspect, between cases treated with labial and lingual appliances. Twenty-four consecutively treated Class II cases with extractions and lingual appliance were compared with 25 matched cases treated with extraction and labial appliance. Orthodontic treatment outcomes were evaluated by cephalometric analysis, peer assessment rating, and an objective grading system (OGS). Additionally, functional analysis was also performed in both groups after orthodontic treatment. Statistical comparison was performed using the Wilcoxon signed rank test within the groups, and the Mann-Whitney U-test was used to compare between the labial and lingual groups. The only significant difference between the groups was that the interincisal angle was larger in the lingual group than in the labial group. OGS evaluation showed that control over root angulation was significantly worse in the lingual group than in the labial group. There was no significant difference between groups in the amount of root resorption or in functional evaluation. Generally, lingual appliances offer comparable treatment results to those obtained with labial appliances. However, care should be taken with lingual appliances because they are more prone to produce uprighted incisors and root angulation.

  18. Personality, Assessment Methods and Academic Performance

    Science.gov (United States)

    Furnham, Adrian; Nuygards, Sarah; Chamorro-Premuzic, Tomas

    2013-01-01

    This study examines the relationship between personality and two different academic performance (AP) assessment methods, namely exams and coursework. It aimed to examine whether the relationship between traits and AP was consistent across self-reported versus documented exam results, two different assessment techniques and across different…

  19. Transparency of the Total System Performance Assessment through the Development of the FEAS Program

    International Nuclear Information System (INIS)

    Hwang, Y.S.; Seo, E.J.; Kang, C.H.

    2003-01-01

    Transparency on the total system performance assessment (TSPA) is the key issue to enhance the public acceptance for a permanent high level radioactive repository. Throughout the lessons accumulated in international projects, it turns out to be important to translate technical languages to more understandable ones. One of the key consolidated statements of the RISCOM project was 'the public should know you have a model, which is clear to everybody about value judgments, facts, uncertainties and questions'. In fact, the final assessment is the integration of identifying and clarifying facts, expert judgment, uncertainties, value judgment, level of significance, and open questions, which cannot be easily understood. Traditionally, the study on features, events, and processes (FEPs) and associated scenarios has been regarded as the starting point to open the communicative discussion on TSPA such as what to evaluate, how to evaluate and how to translate outcomes into more friendly language that many stakeholders can easily understand and react with. However, in most cases, it is difficult for stakeholders outside the performance assessment field to assess the details on the story of the safety assessment; scenario and technical background of it. Fortunately, the advent of the internet era opens up the possibility of two way communication from the beginning of the performance assessment so that every stake bolder can exchange their keen opinions on the safety issues. To achieve it, KAERI develops the systematic approach from the FEPs to Assessment method flow chart, through the formation of integrated FEPs corresponding to the elements in the RES matrix. All information is integrated into the web based program named FEAS (FEp to Assessment through Scenario development) under development in KAERI. In parallel, two independent systems are also under development, the web based quality assurance system and the performance assessment input database. Throughout the next phase

  20. Dehydration: physiology, assessment, and performance effects.

    Science.gov (United States)

    Cheuvront, Samuel N; Kenefick, Robert W

    2014-01-01

    This article provides a comprehensive review of dehydration assessment and presents a unique evaluation of the dehydration and performance literature. The importance of osmolality and volume are emphasized when discussing the physiology, assessment, and performance effects of dehydration. The underappreciated physiologic distinction between a loss of hypo-osmotic body water (intracellular dehydration) and an iso-osmotic loss of body water (extracellular dehydration) is presented and argued as the single most essential aspect of dehydration assessment. The importance of diagnostic and biological variation analyses to dehydration assessment methods is reviewed and their use in gauging the true potential of any dehydration assessment method highlighted. The necessity for establishing proper baselines is discussed, as is the magnitude of dehydration required to elicit reliable and detectable osmotic or volume-mediated compensatory physiologic responses. The discussion of physiologic responses further helps inform and explain our analysis of the literature suggesting a ≥ 2% dehydration threshold for impaired endurance exercise performance mediated by volume loss. In contrast, no clear threshold or plausible mechanism(s) support the marginal, but potentially important, impairment in strength, and power observed with dehydration. Similarly, the potential for dehydration to impair cognition appears small and related primarily to distraction or discomfort. The impact of dehydration on any particular sport skill or task is therefore likely dependent upon the makeup of the task itself (e.g., endurance, strength, cognitive, and motor skill). © 2014 American Physiological Society.

  1. Performing the lockout/tagout risk assessment.

    Science.gov (United States)

    Wallace, W Jon

    2007-03-01

    Lockout/tagout provides the greatest level routine, repetitive, and integral to the production process, a risk assessment should be performed. If the task performed poses an unacceptable risk, acceptable risk reduction methods should be implemented to reduce the risk to acceptable levels.

  2. 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:…

  3. Performance measures, hours of caregiving assistance, and risk of adverse care outcomes among older adult users of Medicaid home and community-based services

    Directory of Open Access Journals (Sweden)

    Margaret K Danilovich

    2015-11-01

    Full Text Available Objectives: This study used validated physical performance measures to examine function, risk of adverse health outcomes, and the relationship with allocated hours of weekly caregiving assistance among older adults receiving home and community-based services through a Medicaid waiver program. Methods: Older adults (n = 42 completed physical performance measures including grip strength, 30-s chair rise, Timed Up and Go, and gait speed. Demographic information including age, gender, and allocated hours of weekly caregiving assistance were also collected. Results: A majority, 72% of females and 86% of males, had weak grip strength, 57% met criteria for fall risk based on their Timed Up and Go score, 83% had lower extremity strength impairments, and 98% were unable to ambulate more than 1.0 m/s. Frailty was prevalent in the sample with 72% of clients meeting Fried’s frailty criteria. The most significant predictors of allocated hours of weekly caregiving assistance approved for clients were race and gait speed. Conclusion: Based on scores on physical performance measures, clients are at risk of falls, hospitalization, and mortality, and scores indicate an urgent need to assess performance in addition to self-reported activities of daily living limitations for this population. Performance measures associated with quantifiable risk of adverse outcomes can be critical indicators for referrals and services needed to enhance the safety and improve care outcomes for homebound older adults.

  4. Assessing Performance of Botswana’s Public Hospital System: The Use of the World Health Organization Health System Performance Assessment Framework

    Directory of Open Access Journals (Sweden)

    Onalenna Seitio-Kgokgwe

    2014-09-01

    Full Text Available Background Very few studies have assessed performance of Botswana public hospitals. We draw from a large research study assessing performance of the Botswana Ministry of Health (MoH to evaluate the performance of public hospital system using the World Health Organization Health Systems Performance Assessment Framework (WHO HSPAF. We aimed to evaluate performance of Botswana public hospital system; relate findings of the assessment to the potential for improvements in hospital performance; and determine the usefulness of the WHO HSPAF in assessing performance of hospital systems in a developing country. Methods This article is based on data collected from document analysis, 54 key informants comprising senior managers and staff of the MoH (N= 40 and senior officers from stakeholder organizations (N= 14, and surveys of 42 hospital managers and 389 health workers. Data from documents and transcripts were analyzed using content and thematic analysis while data analysis for surveys was descriptive determining proportions and percentages. Results The organizational structure of the Botswana’s public hospital system, authority and decision-making are highly centralized. Overall physical access to health services is high. However, challenges in the distribution of facilities and inpatient beds create inequities and inefficiencies. Capacity of the hospitals to deliver services is limited by inadequate resources. There are significant challenges with the quality of care. Conclusion While Botswana invested considerably in building hospitals around the country resulting in high physical access to services, the organization and governance of the hospital system, and inadequate resources limit service delivery. The ongoing efforts to decentralize management of hospitals to district level entities should be expedited. The WHO HSPAF enabled us to conduct a comprehensive assessment of the public hospital system. Though relatively new, this approach proved

  5. Randomised studies of income supplementation: a lost opportunity to assess health outcomes.

    Science.gov (United States)

    Connor, J; Rodgers, A; Priest, P

    1999-11-01

    Despite the wealth of evidence linking low income to ill health, there is little information from randomised studies on how much and how quickly these risks can be reversed by improvements in income. To conduct a systematic review of randomised studies of income supplementation, with particular reference to health outcomes. Extensive searches of electronic databases and contact with previous authors. As well as searching for trials that were specifically designed to assess the effects of increased income, studies of winners and losers of lotteries were also sought: if winning is purely chance, such studies are, in effect, randomised trials of increased income. Ten relevant studies were identified, all conducted in North America, mostly in the late 1960s and 1970s. Five trials were designed to assess the effects of income supplementation on workforce participation and randomised a total of 10,000 families to 3-5 years of various combinations of minimum income guarantees and reduced tax rates. Two trials were designed to assess re-offending rates in recently released prisoners and randomised a total of 2400 people to 3-6 months of benefits. One trial was designed to assess housing allowances and randomised 3500 families to three years of income supplements. One trial assessed the health effects of 12 months of income supplementation in 54 people with severe mental illness. Finally, one study compared three groups of people who won different amounts of money in a state lottery. In all these studies the interventions resulted in increases in income of at least one fifth. However, no reliable analyses of health outcome data are available. Extensive opportunities to reliably assess the effects of increases in income on health outcomes have been missed. Such evidence might have increased the consideration of potential health effects during deliberations about policies that have major implications for income, such as taxation rates, benefit policies, and minimum wage

  6. Performance assessment for low-level radioactive waste disposal

    International Nuclear Information System (INIS)

    Cook, J.R.; Hsu, R.H.; Wilhite, E.L.; Yu, A.D.

    1996-01-01

    In October 1994 the Savannah River Site became the first US DOE complex to use concrete vaults to dispose of low-level radioactive solid waste and better prevent soil and groundwater contamination. This article describes the design and gives a performance assessment of the vaults. Topics include the following: Performance objectives; scope; the performance assessment process-assemble a multidisciplinary working group; collect available data; define credible pathways/scenarios; develop conceptual models; conduct screening and detailed model calculations; assess sensitivity/uncertainty; integrate and interpret results; report. 9 figs., 3 tabs

  7. Institutionalizing Student Outcomes Assessment: The Need for Better Research to Inform Practice

    Science.gov (United States)

    Kezar, Adrianna

    2013-01-01

    This article explores the organizational impediments and facilitators that influence the implementation of student learning outcomes assessment (SLOA). This review points to the importance of culture, leadership, and organizational policies to the implementation of SLOA. However, we need to approach research differently, both conceptually and…

  8. From Process to Outcome: The Effect of Portfolio Assessment on Student Learning.

    Science.gov (United States)

    Tiwari, Agnes; Tang, Catherine

    2003-01-01

    Three findings emerged from 12 Hong Kong student nurses' descriptions of their experiences of portfolio assessment: (1) despite initial anxiety, all favored portfolio use; (2) portfolios had positive academic and affective outcomes; and (3) unexpectedly, spontaneous collaborative learning and increased motivation resulted. (Contains 35…

  9. Background rates of adverse pregnancy outcomes for assessing the safety of maternal vaccine trials in sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Lauren A V Orenstein

    Full Text Available Maternal immunization has gained traction as a strategy to diminish maternal and young infant mortality attributable to infectious diseases. Background rates of adverse pregnancy outcomes are crucial to interpret results of clinical trials in Sub-Saharan Africa.We developed a mathematical model that calculates a clinical trial's expected number of neonatal and maternal deaths at an interim safety assessment based on the person-time observed during different risk windows. This model was compared to crude multiplication of the maternal mortality ratio and neonatal mortality rate by the number of live births. Systematic reviews of severe acute maternal morbidity (SAMM, low birth weight (LBW, prematurity, and major congenital malformations (MCM in Sub-Saharan African countries were also performed.Accounting for the person-time observed during different risk periods yields lower, more conservative estimates of expected maternal and neonatal deaths, particularly at an interim safety evaluation soon after a large number of deliveries. Median incidence of SAMM in 16 reports was 40.7 (IQR: 10.6-73.3 per 1,000 total births, and the most common causes were hemorrhage (34%, dystocia (22%, and severe hypertensive disorders of pregnancy (22%. Proportions of liveborn infants who were LBW (median 13.3%, IQR: 9.9-16.4 or premature (median 15.4%, IQR: 10.6-19.1 were similar across geographic region, study design, and institutional setting. The median incidence of MCM per 1,000 live births was 14.4 (IQR: 5.5-17.6, with the musculoskeletal system comprising 30%.Some clinical trials assessing whether maternal immunization can improve pregnancy and young infant outcomes in the developing world have made ethics-based decisions not to use a pure placebo control. Consequently, reliable background rates of adverse pregnancy outcomes are necessary to distinguish between vaccine benefits and safety concerns. Local studies that quantify population-based background rates of

  10. Evaluating the Student Learning Outcomes Assessment Process in Undergraduate Parks and Recreation Academic Programs

    Science.gov (United States)

    Ross, Craig M.; Young, Sarah J.; Sturts, Jill R.

    2012-01-01

    Institutions of higher education are increasingly being held more accountable for assessing student learning both in and out of their classrooms along with reporting results to their stakeholders. The purpose of this study, which examined assessment of student learning outcomes in undergraduate park and recreation academic programs, was two-fold:…

  11. Assessment of complete unilateral cleft lip and palate treatment outcome using EUROCRAN index and associated factors.

    Science.gov (United States)

    Arshad, Anas Imran; Alam, Mohammad Khursheed; Khamis, Mohd Fadhli

    2017-09-01

    Assessment of treatment outcome is the only non-invasive approach to identify the effects of cleft lip and palate repair and modify management accordingly. Here the aim is to assess the outcome of complete unilateral cleft lip and palate (CUCLP) patients using EUROCRAN index and to check whether there are any factors associated with the treatment outcome. It is a retrospective cross sectional study. Dental models were collected from archives of two cleft referral centers in Pakistan. Five blinded examiners scored 101 models twice at two week interval. The primary outcome was mean EUROCRAN scores based on dental arch relationships and palatal surface morphology. A mean(SD) score of 2.72 (0.76) and 2.20 (0.73) was determined based on dental arch relationships and palatal surface morphology, respectively. According to the final logistic regression model, modified Millard technique (cheiloplasty) and Veau-Wardill-Kilners' method (palatoplasty) had higher odds of producing unfavorable treatment outcome. Present study determined a fair and a fair to poor treatment outcome based on dental arch relationships and palatal surface morphology, respectively. Our study suggests a significant association between treatment outcome and primary surgical techniques for lip and palate. These findings could warrant a modification of management protocols to ensure improvement in future cleft outcomes. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Malnutrition in Hospitalized Pediatric Patients: Assessment, Prevalence, and Association to Adverse Outcomes.

    Science.gov (United States)

    Daskalou, Efstratia; Galli-Tsinopoulou, Assimina; Karagiozoglou-Lampoudi, Thomais; Augoustides-Savvopoulou, Persefone

    2016-01-01

    Malnutrition is a frequent finding in pediatric health care settings in the form of undernutrition or excess body weight. Its increasing prevalence and impact on overall health status, which is reflected in the adverse outcomes, renders imperative the application of commonly accepted and evidence-based practices and tools by health care providers. Nutrition risk screening on admission and nutrition status evaluation are key points during clinical management of hospitalized pediatric patients, in order to prevent health deterioration that can lead to serious complications and growth consequences. In addition, anthropometric data based on commonly accepted universal growth standards can give accurate results for nutrition status. Both nutrition risk screening and nutrition status assessment are techniques that should be routinely implemented, based on commonly accepted growth standards and methodology, and linked to clinical outcomes. The aim of the present review was to address the issue of hospital malnutrition in pediatric settings in terms of prevalence, outline nutrition status evaluation and nutrition screening process using different criteria and available tools, and present its relationship with outcome measures. Key teaching points • Malnutrition-underweight or excess body weight-is a frequent imbalance in pediatric settings that affects physical growth and results in undesirable clinical outcomes. • Anthropometry interpretation through growth charts and nutrition screening are cornerstones for the assessment of malnutrition.To date no commonly accepted anthropometric criteria or nutrition screening tools are used in hospitalized pediatric patients. • Commonly accepted nutrition status and screening processes based on the World Health Organization's growth standards can contribute to the overall hospital nutrition care of pediatric patients.

  13. Assessment Training Effects on Student Assessment Skills and Task Performance in a Technology-Facilitated Peer Assessment

    Science.gov (United States)

    Liu, Xiongyi; Li, Lan

    2014-01-01

    This study examines the impact of an assessment training module on student assessment skills and task performance in a technology-facilitated peer assessment. Seventy-eight undergraduate students participated in the study. The participants completed an assessment training exercise, prior to engaging in peer-assessment activities. During the…

  14. Long-term assessment of psychologic outcomes of orthognathic surgery

    DEFF Research Database (Denmark)

    Lazaridou-Terzoudi, T.; Kiyak, H.A.; Moore, R.

    2003-01-01

    . The level of body image and self-esteem approximated but did not reach that of a nonpatient population. In view of the current psychologic and social environment, patients should be offered the appropriate treatment to correct a disfigurement if it is subjectively perceived by them as a handicap, in part......This long-term study of post-orthognathic surgery patients aimed at assessing perceptions of problems with physical and psychologic functioning, self-concept, body image, and satisfaction with the surgical outcome based on subjective evaluations. In addition, the patient's perception of self...

  15. Long-term assessment of psychologic outcomes of orthognathic surgery

    DEFF Research Database (Denmark)

    Lazaridou-Terzoudi, T.; Kiyak, H.A.; Moore, R.

    2003-01-01

    This long-term study of post-orthognathic surgery patients aimed at assessing perceptions of problems with physical and psychologic functioning, self-concept, body image, and satisfaction with the surgical outcome based on subjective evaluations. In addition, the patient's perception of self-concept....... The level of body image and self-esteem approximated but did not reach that of a nonpatient population. In view of the current psychologic and social environment, patients should be offered the appropriate treatment to correct a disfigurement if it is subjectively perceived by them as a handicap, in part...

  16. An empirical comparison of voluntary and mandatory building energy performance disclosure outcomes

    International Nuclear Information System (INIS)

    Gabe, Jeremy

    2016-01-01

    In 2010, the federal Australian government mandated the disclosure of energy performance ratings in advertisements for sale or lease of large commercial office properties. Prior to 2010, participation in the rating scheme was voluntary. This study first develops a theoretical model of mandatory disclosure policy effectiveness. Then, with a dataset of all ratings since inception of the voluntary regime in 1999, it tests the expectation that initial voluntary adopters have a greater tendency towards environmental stewardship and are more likely to manage and invest in environmental performance improvements, potentially dampening the effectiveness of mandatory disclosure policy. However, multiple statistical models of certification are unable to reject the null hypothesis that there is no difference in energy efficiency outcomes between the mandatory and voluntary adopters at equivalent stages. For urban policymakers, the extrapolation of voluntary adopter performance appears to be a good – perhaps even conservative – estimation of mandatory energy performance disclosure outcomes. - Highlights: •A theoretical model of building energy disclosure policy effectiveness is proposed. •Mandatory disclosure adopters reduce consumption similar to voluntary adopters. •Mandatory building energy disclosure in Australia has been effective. •Early adopters creating a market for energy retrofits is a likely reason for success.

  17. Evaluating social outcomes of HIV/AIDS interventions: a critical assessment of contemporary indicator frameworks.

    Science.gov (United States)

    Mannell, Jenevieve; Cornish, Flora; Russell, Jill

    2014-01-01

    Contemporary HIV-related theory and policy emphasize the importance of addressing the social drivers of HIV risk and vulnerability for a long-term response. Consequently, increasing attention is being given to social and structural interventions, and to social outcomes of HIV interventions. Appropriate indicators for social outcomes are needed in order to institutionalize the commitment to addressing social outcomes. This paper critically assesses the current state of social indicators within international HIV/AIDS monitoring and evaluation frameworks. We analyzed the indicator frameworks of six international organizations involved in efforts to improve and synchronize the monitoring and evaluation of the HIV/AIDS response. Our analysis classifies the 328 unique indicators according to what they measure and assesses the degree to which they offer comprehensive measurement across three dimensions: domains of the social context, levels of change and organizational capacity. The majority of indicators focus on individual-level (clinical and behavioural) interventions and outcomes, neglecting structural interventions, community interventions and social outcomes (e.g. stigma reduction; community capacity building; policy-maker sensitization). The main tool used to address social aspects of HIV/AIDS is the disaggregation of data by social group. This raises three main limitations. Indicator frameworks do not provide comprehensive coverage of the diverse social drivers of the epidemic, particularly neglecting criminalization, stigma, discrimination and gender norms. There is a dearth of indicators for evaluating the social impacts of HIV interventions. Indicators of organizational capacity focus on capacity to effectively deliver and manage clinical services, neglecting capacity to respond appropriately and sustainably to complex social contexts. Current indicator frameworks cannot adequately assess the social outcomes of HIV interventions. This limits knowledge about

  18. 76 FR 45271 - Review and Qualification of Clinical Outcome Assessments; Public Workshop

    Science.gov (United States)

    2011-07-28

    ... announcing a public workshop to discuss measurement principles for clinical outcome assessments (COAs) for... appropriate drug development program. Because the qualification process is separate from the drug marketing... other DDTs. This workshop will focus on FDA review principles specific to all type of COAs, i.e., PRO...

  19. Developing a Rubric to Assess Student Learning Outcomes Using a Class Assignment

    Science.gov (United States)

    Thaler, Nicholas; Kazemi, Ellie; Huscher, Crystal

    2009-01-01

    We developed a rubric to assess several of our department's undergraduate student learning outcomes (SLOs). Target SLOs include applications of principles of research methodology, using appropriate statistics, adherence to the Publication Manual of the American Psychological Association, and written communication skills. We randomly sampled 20…

  20. Negative decision outcomes are more common among people with lower decision-making competence: An item-level analysis of the Decision Outcome Inventory (DOI

    Directory of Open Access Journals (Sweden)

    Andrew M Parker

    2015-04-01

    Full Text Available Most behavioral decision research takes place in carefully controlled laboratory settings, and examination of relationships between performance and specific real-world decision outcomes is rare. One prior study shows that people who perform better on hypothetical decision tasks, assessed using the Adult Decision-Making Competence (A-DMC measure, also tend to experience better real-world decision outcomes, as reported on the Decision Outcomes Inventory (DOI. The DOI score reflects avoidance of outcomes that could result from poor decisions, ranging from serious (e.g., bankruptcy to minor (e.g., blisters from sunburn. The present analyses go beyond the initial work, which focused on the overall DOI score, by analyzing the relationships between specific decision outcomes and A-DMC performance. Most outcomes are significantly more likely among people with lower A-DMC scores, even after taking into account two variables expected to produce worse real-world decision outcomes: younger age and lower socio-economic status. We discuss the usefulness of DOI as a measure of successful real-world decision making.

  1. Patient-Reported Outcome and Observer-Reported Outcome Assessment in Rare Disease Clinical Trials: An ISPOR COA Emerging Good Practices Task Force Report.

    Science.gov (United States)

    Benjamin, Katy; Vernon, Margaret K; Patrick, Donald L; Perfetto, Eleanor; Nestler-Parr, Sandra; Burke, Laurie

    Rare diseases (RDs) affect a small number of people within a population. About 5000 to 8000 distinct RDs have been identified, with an estimated 6% to 8% of people worldwide suffering from an RD. Approximately 75% of RDs affect children. Frequently, these conditions are heterogeneous; many are progressive. Regulatory incentives have increased orphan drug designations and approvals. To develop emerging good practices for RD outcomes research addressing the challenges inherent in identifying, selecting, developing, adapting, and implementing patient-reported outcome (PRO) and observer-reported outcome (ObsRO) assessments for use in RD clinical trials. This report outlines the challenges and potential solutions in determining clinical outcomes for RD trials. It follows the US Food and Drug Administration Roadmap to Patient-Focused Outcome Measurement in Clinical Trials. The Roadmap consists of three columns: 1) Understanding the Disease or Condition, 2) Conceptualizing Treatment Benefit, and 3) Selecting/Developing the Outcome Measure. Challenges in column 1 include factors such as incomplete natural history data and heterogeneity of disease presentation and patient experience. Solutions include using several information sources, for example, clinical experts and patient advocacy groups, to construct the condition's natural history and understand treatment patterns. Challenges in column 2 include understanding and measuring treatment benefit from the patient's perspective, especially given challenges in defining the context of use such as variations in age or disease severity/progression. Solutions include focusing on common symptoms across patient subgroups, identifying short-term outcomes, and using multiple types of COA instruments to measure the same constructs. Challenges in column 3 center around the small patient population and heterogeneity of the condition or study sample. Few disease-specific instruments for RDs exist. Strategies include adapting existing

  2. The role of performance assessment in radioactive waste disposal

    International Nuclear Information System (INIS)

    Stenhouse, M.J.

    1998-01-01

    Performance assessment has many applications in the field of radioactive waste management, none more important than demonstrating the suitability of a particular repository system for waste disposal. The role of performance assessment in radioactive waste disposal is discussed with reference to assessments performed in civilian waste management programmes. The process is, however, relevant, and may be applied directly to the disposal of defence-related wastes. When used in an open and transparent manner, performance assessment is a powerful methodology not only for convincing the authorities of the safety of a disposal concept, but also for gaining the wider acceptance of the general public for repository siting. 26 refs

  3. Small animal PET: aspects of performance assessment

    International Nuclear Information System (INIS)

    Weber, Simone; Bauer, Andreas

    2004-01-01

    Dedicated small animal positron emission tomography (PET) systems are increasingly prevalent in industry (e.g. for preclinical drug development) and biological research. Such systems permit researchers to perform animal studies of a longitudinal design characterised by repeated measurements in single animals. With the advent of commercial systems, scanners have become readily available and increasingly popular. As a consequence, technical specifications are becoming more diverse, making scanner systems less broadly applicable. The investigator has, therefore, to make a decision regarding which type of scanner is most suitable for the intended experiments. This decision should be based on gantry characteristics and the physical performance. The first few steps have been taken towards standardisation of the assessment of performance characteristics of dedicated animal PET systems, though such assessment is not yet routinely implemented. In this review, we describe current methods of evaluation of physical performance parameters of small animal PET scanners. Effects of methodologically different approaches on the results are assessed. It is underscored that particular attention has to be paid to spatial resolution, sensitivity, scatter fraction and count rate performance. Differences in performance measurement methods are described with regard to commercially available systems, namely the Concorde MicroPET systems P4 and R4 and the quad-HIDAC. Lastly, consequences of differences in scanner performance parameters are rated with respect to applications of small animal PET. (orig.)

  4. A user's guide to the disease management literature: recommendations for reporting and assessing program outcomes.

    Science.gov (United States)

    Linden, Ariel; Roberts, Nancy

    2005-02-01

    Recently there has been tremendous growth in the number of lay-press articles and peer-reviewed journal articles reporting extraordinary improvements in health status and financial outcomes due to disease management (DM) interventions. However, closer scrutiny of these reports reveals serious flaws in research design and/or analysis, leaving many to question the veracity of the claims. In recent years, there have been numerous contributions to the literature on how to assess the quality of medical research papers. However, these guidelines focus primarily on randomized controlled trials, with little attention given to the observational study designs typically used in DM outcome studies. As such, general guides to evaluating the medical literature are inadequate in their utility to assist authors and readers of DM outcomes research. The purpose of this paper is to provide authors with a clear and comprehensive guide to the reporting of DM outcomes, as well as to educate readers of the DM literature (both lay and peer reviewed) in how to assess the quality of the findings presented.

  5. 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

  6. Point-of-care outcome assessment in the cancer clinic: Audit of data quality

    International Nuclear Information System (INIS)

    Wong, Karen; Huang, Shao Hui; O'Sullivan, Brian; Lockwood, Gina; Dale, Darlene; Michaelson, Terry; Waldron, John; Bayley, Andrew; Cummings, Bernard; Dawson, Laura A.; Kim, John; Liu, Geoffrey; Ringash, Jolie

    2010-01-01

    Background and purpose: To assess the completeness and accuracy of stage and outcome data in the Anthology of Outcomes (AOs), a prospective point-of-care physician-collected electronic data system for patients at Princess Margaret Hospital. Material and methods: A random sample of 10% of the AO cases registered between July 2003 and December 2005 was drawn. An audit was conducted of the AO data compared with chart review and cancer registry. Results: The AO system was applied first to a head and neck (HN) cancer patient cohort. From 1152 HN cases, 120 were audited. TNM stage was recorded in all cases. Discrepancy was found between the AO and primary data sources in 3-13% of cases. Physician review showed a 3% error rate in overall stage recorded in the AO. Sixty-two outcomes in 43 patients were found on chart review. No outcomes were incorrectly recorded in the AO. Nineteen (31%) outcomes in 17 patients were missed in the AO. Conclusions: Our experience has demonstrated the feasibility of real-time outcome recording at point-of-care. New processes needed to improve the completeness of capture of patient outcomes in the AO have more recently been introduced. This successful system has been expanded to other disease sites.

  7. Development of Integrated Assessment Technology of Risk and Performance

    International Nuclear Information System (INIS)

    Yang, Jun Eon; Kang, Dae Il; Kang, Hyun Gook

    2010-04-01

    The main idea and contents are summarized as below 1) Development of new risk/performance assessment system innovating old labor-intensive risk assessment structure - New consolidated risk assessment technology from various hazard(flood, fire, seismic in NPP) - BOP model development for performance monitoring - Consolidated risk/performance management system for consistency and efficiency of NPP 2) Resolution technology for pending issues in PSA - Base technology for PSA of digital I and C system - Base technology for seismic PSA reflecting domestic seismic characteristics and aging effect - Uncertainty reduction technology for level 2 PSA and best estimation of containment failure frequency 3) Next generation risk/performance assessment technology - Human-induced error reduction technology for efficient operation of a NPP

  8. A method to assess obstetric outcomes using the 10-Group Classification System: a quantitative descriptive study.

    LENUS (Irish Health Repository)

    Rossen, Janne

    2017-01-01

    Internationally, the 10-Group Classification System (TGCS) has been used to report caesarean section rates, but analysis of other outcomes is also recommended. We now aim to present the TGCS as a method to assess outcomes of labour and delivery using routine collection of perinatal information.

  9. Comparative Assessment of Health Workers Performance and The ...

    African Journals Online (AJOL)

    Comparative Assessment of Health Workers Performance and The Performance ... had very high significant effect on performance of health workers which was independent of ... Keywords: Health Worker Performance Factors Hospitals Nigeria ...

  10. Methodology for NDA performance assessment

    International Nuclear Information System (INIS)

    Cuypers, M.; Franklin, M.; Guardini, S.

    1986-01-01

    In the framework of the RandD programme of the Joint Research Centre of the Commission of the European Communities, a considerable effort is being dedicated to performance assessment of NDA techniques taking account of field conditions. By taking account of field conditions is meant measurement samples of the size encountered in practice and training which allows inspectors to design cost efficient verification plans for the real situations encountered in the field. Special laboratory facilities referred to as PERLA are being constructed for this purpose. These facilities will be used for measurement experiments and for training. In this paper, performance assessment is discussed under the headings of measurement capability and in-field effectiveness. Considerable emphasis is given to the role of method specific measurement error models. The authors outline the advantages of giving statistical error models a sounder basis in the physical phenomenology of the measurement method

  11. Effects of a strategy to improve offender assessment practices: Staff perceptions of implementation outcomes.

    Science.gov (United States)

    Welsh, Wayne N; Lin, Hsiu-Ju; Peters, Roger H; Stahler, Gerald J; Lehman, Wayne E K; Stein, Lynda A R; Monico, Laura; Eggers, Michele; Abdel-Salam, Sami; Pierce, Joshua C; Hunt, Elizabeth; Gallagher, Colleen; Frisman, Linda K

    2015-07-01

    This implementation study examined the impact of an organizational process improvement intervention (OPII) on a continuum of evidence based practices related to assessment and community reentry of drug-involved offenders: Measurement/Instrumentation, Case Plan Integration, Conveyance/Utility, and Service Activation/Delivery. To assess implementation outcomes (staff perceptions of evidence-based assessment practices), a survey was administered to correctional and treatment staff (n=1509) at 21 sites randomly assigned to an Early- or Delayed-Start condition. Hierarchical linear models with repeated measures were used to examine changes in evidence-based assessment practices over time, and organizational characteristics were examined as covariates to control for differences across the 21 research sites. Results demonstrated significant intervention and sustainability effects for three of the four assessment domains examined, although stronger effects were obtained for intra- than inter-agency outcomes. No significant effects were found for Conveyance/Utility. Implementation interventions such as the OPII represent an important tool to enhance the use of evidence-based assessment practices in large and diverse correctional systems. Intra-agency assessment activities that were more directly under the control of correctional agencies were implemented most effectively. Activities in domains that required cross-systems collaboration were not as successfully implemented, although longer follow-up periods might afford detection of stronger effects. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Performance indicators analysis at Brazilian and Italian women's volleyball leagues according to game location, game outcome, and set number.

    Science.gov (United States)

    Campos, Fabio A D; Stanganélli, Luiz C R; Campos, Leandra C B; Pasquarelli, Bruno N; Gómez, Miguel-Angel

    2014-04-01

    This study was done to investigate the advantage of playing at home in elite women's volleyball leagues and the influence of performance indicators in the game score according to set number. The sample consisted of 240 games of the Brazilian Volleyball League (n = 132 games) and the Italian Volleyball League (n = 108 games) from the 2011-2012 season. The relationship of performance indicators (including serve, attack, block, and opponents' errors) with the game outcome (win or lose) was assessed. The results showed that there was a home advantage effect in women's volleyball leagues, with a higher prevalence of victory for the home teams in Brazilian and Italian leagues (58 and 56%, respectively). When related to the performance indicators and among the aspects that were most highly correlated with victory, the attack was the technical indicator that explained most of the results of volleyball games.

  13. Assessment set for evaluation of clinical outcomes in multiple sclerosis: psychometric properties

    Czech Academy of Sciences Publication Activity Database

    Řasová, K.; Martinková, Patrícia; Vyškovská, J.; Šedová, Michaela

    -, č. 3 (2012), s. 59-70 ISSN 1179-271X R&D Projects: GA MŠk(CZ) 1M06014 Grant - others:GA MZd(CZ) 1A8628 Institutional support: RVO:67985807 Keywords : outcome assessment * reproducibility of results * psychometric properties * test–retest reliability * internal consistency Subject RIV: FP - Other Medical Disciplines

  14. Current perspectives on performance assessment at the NRC

    International Nuclear Information System (INIS)

    Coplan, S.M.; Eisenberg, N.A.; Federline, M.V.; Randall, J.D.

    1992-01-01

    The Nuclear Regulatory Commission (NRC) staff is engaging in a number of activities involving performance assessment in order to support NRC's program in high-level waste management. Broad areas of activity include: (1) reactive work responding to products and activities of the Department of Energy (DOE), (2) proactive work, including development of an independent performance assessment capability, development of guidance for DOE, support for technical and programmatic integration, (3) a program of regulatory research, and (4) participation in a number of international activities. As the U.S. high-level waste program continues to mature, performance assessment is seen as playing a more prominent role in evaluating safety and focussing technical activities

  15. Strategic Measures of Teacher Performance

    Science.gov (United States)

    Milanowski, Anthony

    2011-01-01

    Managing the human capital in education requires measuring teacher performance. To measure performance, administrators need to combine measures of practice with measures of outcomes, such as value-added measures, and three measurement systems are needed: classroom observations, performance assessments or work samples, and classroom walkthroughs.…

  16. Developing an OMERACT Core Outcome Set for Assessing Safety Components in Rheumatology Trials

    DEFF Research Database (Denmark)

    Klokker, Louise; Tugwell, Peter; Furst, Daniel E

    2016-01-01

    in such COS. The Outcome Measures in Rheumatology (OMERACT) Filter 2.0 emphasizes the importance of measuring harms. The Safety Working Group was reestablished at the OMERACT 2016 with the objective to develop a COS for assessing safety components in trials across rheumatologic conditions. METHODS: The safety......OBJECTIVE: Failure to report harmful outcomes in clinical research can introduce bias favoring a potentially harmful intervention. While core outcome sets (COS) are available for benefits in randomized controlled trials in many rheumatic conditions, less attention has been paid to safety...... that patients consider relevant so that they will be able to make informed decisions. CONCLUSION: The OMERACT Safety Working Group will advance the work previously done within OMERACT using a new patient-driven approach....

  17. Some viewpoints on reference biospheres in Finnish performance assessments

    International Nuclear Information System (INIS)

    Rasilainen, K.; Kattilakoski, E.; Suolanen, V.; Vieno, T.; Vuori, S.

    2002-01-01

    Viewpoints are presented concerning biosphere studies in performance assessments of nuclear waste disposal. The points are based on experiences from several Finnish performance assessments. The latest performance assessment for spent fuel disposal, TILA-99, was considered in the Decision in Principle process for the site selection of the repository. The points given are also based on experiences from participation in international projects dealing with biosphere modelling, for instance BIOMOVS and BIOMASS. (author)

  18. Prevalence of GMC performance assessments in the United Kingdom: a retrospective cohort analysis by country of medical qualification.

    Science.gov (United States)

    Mehdizadeh, L; Potts, H W W; Sturrock, A; Dacre, J

    2017-04-04

    The demographics of doctors working in the UK are changing. The United Kingdom (UK) has voted to leave the European Union (EU) and there is heightened political discourse around the world about the impact of migration on healthcare services. Previous work suggests that foreign trained doctors perform worse than UK graduates in postgraduate medical examinations. We analysed the prevalence by country of primary medical qualification of doctors who were required to take an assessment by the General Medical Council (GMC) because of performance concerns. This was a retrospective cohort analysis of data routinely collected by the GMC. We compared doctors who had a GMC performance assessment between 1996 and 2013 with the medical register in the same period. The outcome measures were numbers experiencing performance assessments by country or region of medical qualification. The rate of performance assessment varied significantly by place of medical qualification and by year; χ 2 (17) = 188, p Economic Area (EEA), were more likely to have a performance assessment than UK trained doctors, with the exception of South African trained doctors. The rate of performance assessment varies significantly by place of medical qualification. This is the first study to explore the risk of performance assessment by individual places of medical qualification. While concern has largely focused on the competence of non-EEA, International Medical Graduates, we discuss implications for how to ensure European trained doctors are fit to practise before their medical licence in the UK is granted. Further research is needed to investigate whether these country effects hold true when controlling for factors like doctors' sex, age, length of time working in the UK, and English language skills. This will allow evidence-based decisions to be made around the regulatory environment the UK should adopt once it leaves the EU. Patients should be reassured that the vast majority of all doctors

  19. The link between performance assessment and quality of data

    International Nuclear Information System (INIS)

    Csullog, G.W.

    1990-11-01

    Performance assessments, using both individual and cumulative inventories, produce estimates of the risk or dose consequences for repository concepts. Unacceptable risk or dose for a given contaminant identify it as a problem contaminant. While risk or dose consequences are common outputs of safety assessments, results can also be reported as estimates of the safe inventory limit for each contaminant in a repository scenario. Once problem contaminants are identified, it may be useful to: validate the data used in the performance assessment; restrict contaminant inventories in the repository; or, improve the containment capability of the repository (including improved packaging). A key point is that performance assessments define the quality of data to be collected. If a contaminant's inventory will be far below its estimated safe inventory limit for a repository, then it is reasonable to accept inventory estimates that have high variances and low confidence. For contaminants that have a significant impact upon performance assessments, efforts must be made to provide the best inventory (source term) estimates practicable. One important goal of characterization programs should be to establish the adequacy of data used in performance assessments. There is little value in striving to improve confidence in data for some waste streams if they are assessed to have a minor impact upon repository performance. Streams that have a major impact upon performance deserve the time, attention and money to be characterized adequately. Waste acceptance must be linked to the quality of characterization data provided by generators. This link sets compliance monitoring requirements

  20. Performance of models for estimating absolute risk difference in multicenter trials with binary outcome

    Directory of Open Access Journals (Sweden)

    Claudia Pedroza

    2016-08-01

    Full Text Available Abstract Background Reporting of absolute risk difference (RD is recommended for clinical and epidemiological prospective studies. In analyses of multicenter studies, adjustment for center is necessary when randomization is stratified by center or when there is large variation in patients outcomes across centers. While regression methods are used to estimate RD adjusted for baseline predictors and clustering, no formal evaluation of their performance has been previously conducted. Methods We performed a simulation study to evaluate 6 regression methods fitted under a generalized estimating equation framework: binomial identity, Poisson identity, Normal identity, log binomial, log Poisson, and logistic regression model. We compared the model estimates to unadjusted estimates. We varied the true response function (identity or log, number of subjects per center, true risk difference, control outcome rate, effect of baseline predictor, and intracenter correlation. We compared the models in terms of convergence, absolute bias and coverage of 95 % confidence intervals for RD. Results The 6 models performed very similar to each other for the majority of scenarios. However, the log binomial model did not converge for a large portion of the scenarios including a baseline predictor. In scenarios with outcome rate close to the parameter boundary, the binomial and Poisson identity models had the best performance, but differences from other models were negligible. The unadjusted method introduced little bias to the RD estimates, but its coverage was larger than the nominal value in some scenarios with an identity response. Under the log response, coverage from the unadjusted method was well below the nominal value (<80 % for some scenarios. Conclusions We recommend the use of a binomial or Poisson GEE model with identity link to estimate RD for correlated binary outcome data. If these models fail to run, then either a logistic regression, log Poisson

  1. Hanford low-level tank waste interim performance assessment

    International Nuclear Information System (INIS)

    Mann, F.M.

    1997-01-01

    The Hanford Low-Level Tank Waste Interim Performance Assessment examines the long-term environmental and human health effects associated with the disposal of the low-level fraction of the Hanford single and double-shell tank waste in the Hanford Site 200 East Area. This report was prepared as a good management practice to provide needed information about the relationship between the disposal system design and performance early in the disposal system project cycle. The calculations in this performance assessment show that the disposal of the low-level fraction can meet environmental and health performance objectives

  2. Assessing the Performance of Natural Resource Systems

    Directory of Open Access Journals (Sweden)

    Bruce Campbell

    2002-01-01

    Full Text Available Assessing the performance of management is central to natural resource management, in terms of improving the efficiency of interventions in an adaptive-learning cycle. This is not simple, given that such systems generally have multiple scales of interaction and response; high frequency of nonlinearity, uncertainty, and time lags; multiple stakeholders with contrasting objectives; and a high degree of context specificity. The importance of bounding the problem and preparing a conceptual model of the system is highlighted. We suggest that the capital assets approach to livelihoods may be an appropriate organizing principle for the selection of indicators of system performance. In this approach, five capital assets are recognized: physical, financial, social, natural, and human. A number of principles can be derived for each capital asset; indicators for assessing system performance should cover all of the principles. To cater for multiple stakeholders, participatory selection of indicators is appropriate, although when cross-site comparability is required, some generic indicators are suitable. Because of the high degree of context specificity of natural resource management systems, a typology of landscapes or resource management domains may be useful to allow extrapolation to broader systems. The problems of nonlinearities, uncertainty, and time lags in natural resource management systems suggest that systems modeling is crucial for performance assessment, in terms of deriving "what would have happened anyway" scenarios for comparison to the measured trajectory of systems. Given that a number of indicators are necessary for assessing performance, the question becomes whether these can be combined to give an integrative assessment. We explore five possible approaches: (1 simple additive index, as used for the Human Development Index; (2 derived variables (e.g., principal components as the indices of performance; (3 two-dimensional plots of

  3. Comparison of performance on process- and product-oriented assessments of fundamental motor skills across childhood.

    Science.gov (United States)

    Logan, Samuel W; Barnett, Lisa M; Goodway, Jacqueline D; Stodden, David F

    2017-04-01

    Process-oriented motor competence (MC) assessments evaluate how a movement is performed. Product-oriented assessments evaluate the outcome of a movement. Determining the concurrent validity of process and product assessments is important to address the predictive utility of motor competence for health. The current study aimed to: (1) compare process and product assessments of the standing long jump, hop and throw across age groups and (2) determine the capacity of process assessments to classify levels of MC. Participants included 170 children classified into three age groups: 4-5, 7-8 and 10-11 years old. Participants' skills were examined concurrently using three process assessments ((Test of Gross Motor Development-2nd edition [TGMD-2]), Get Skilled; Get Active, and developmental sequences) and one product measure (throw speed, jump and hop distance). Results indicate moderate to strong correlations between (1) process assessments across skills and age groups (r range = .37-70) and (2) process and product assessments across skills and age groups (r range = .26-.88). In general, sensitivity to detect advanced skill level is lowest for TGMD-2 and highest for developmental sequences for all three skills. The use of process and product assessments is suggested to comprehensively capture levels of MC in human movement.

  4. Relationship between quality of care and choice of clinical computing system: retrospective analysis of family practice performance under the UK's quality and outcomes framework.

    Science.gov (United States)

    Kontopantelis, Evangelos; Buchan, Iain; Reeves, David; Checkland, Kath; Doran, Tim

    2013-08-02

    To investigate the relationship between performance on the UK Quality and Outcomes Framework pay-for-performance scheme and choice of clinical computer system. Retrospective longitudinal study. Data for 2007-2008 to 2010-2011, extracted from the clinical computer systems of general practices in England. All English practices participating in the pay-for-performance scheme: average 8257 each year, covering over 99% of the English population registered with a general practice. Levels of achievement on 62 quality-of-care indicators, measured as: reported achievement (levels of care after excluding inappropriate patients); population achievement (levels of care for all patients with the relevant condition) and percentage of available quality points attained. Multilevel mixed effects multiple linear regression models were used to identify population, practice and clinical computing system predictors of achievement. Seven clinical computer systems were consistently active in the study period, collectively holding approximately 99% of the market share. Of all population and practice characteristics assessed, choice of clinical computing system was the strongest predictor of performance across all three outcome measures. Differences between systems were greatest for intermediate outcomes indicators (eg, control of cholesterol levels). Under the UK's pay-for-performance scheme, differences in practice performance were associated with the choice of clinical computing system. This raises the question of whether particular system characteristics facilitate higher quality of care, better data recording or both. Inconsistencies across systems need to be understood and addressed, and researchers need to be cautious when generalising findings from samples of providers using a single computing system.

  5. A physiotherapy triage assessment service for people with low back disorders: evaluation of short-term outcomes

    Directory of Open Access Journals (Sweden)

    Bath B

    2012-06-01

    Full Text Available Brenna Bath, Punam PahwaCollege of Medicine, University of Saskatchewan, Saskatoon, CanadaPurpose: To determine the short-term effects of physiotherapy triage assessments on self-reported pain, functioning, and general well-being and quality of life in people with low back-related disorders.Methods: Participants with low back–related complaints were recruited from those referred to a spinal triage assessment program delivered by physiotherapists (PTs. Before undergoing the triage assessment, the participants completed a battery of questionnaires covering a range of sociodemographic, clinical, and psychosocial features. The study used the Numeric Pain Rating Scale (NPRS, the Oswestry Disability Index (ODI, and the Medical Outcomes Survey 36-item short-form version 2 (SF-36v2 to assess self-reported pain, function, and quality of life. Baseline measures and variables were analyzed using a descriptive analysis method (ie, proportions, means, medians. Paired samples t-tests or Wilcoxon matched-pair signed-rank tests were used to analyze the overall group differences between the pretest and posttest outcome measures where appropriate.Results: A total of 108 out of 115 (93.9% participants completed the posttest survey. The Physical Component Summary of the SF36v2 was the only measure that demonstrated significant improvement (P < 0.001.Conclusion: A spinal triage assessment program delivered by PTs can be viewed as a complex intervention that may have the potential to affect a wide range of patient-related outcomes. Further research is needed to examine the long-term outcomes and explore potential mechanisms of improvement using a biopsychosocial framework.Keywords: interprofessional practice, quality of life, back pain, orthopedics

  6. Assessing the appropriateness of parenteral nutrition use in hospitalized patients. A comparison on parenteral nutrition bag prescription in different wards and nutritional outcomes.

    Science.gov (United States)

    Ponta, Monica Laura; Rabbione, Laura; Borgio, Cristina; Quirico, Eliana; Patrito, Elena; Petrachi, Maria Novella; Girotto, Elisabetta; Sillano, Marisa; Geninatti, Silvio; Zanardi, Michela; Pezzana, Andrea

    2018-06-01

    Our aim is to assess parenteral nutrition (PN) bag prescription in hospitalized patients and evaluate clinical outcomes linked to PN therapy. We performed an observational longitudinal retrospective study on PN prescription in a General Public Hospital in Turin, Italy, on ninety-five patients receiving PN prescribed by the Nutrition Support Team (NST). We described patients' demography and assessed nutritional outcomes, as well as PN bag prescription in different wards. Medians were calculated for several clinical parameters before and after PN therapy. A z-test for proportions has been performed to better understand the impact of various conditions on clinical outcomes and to compare differences between administered nutrients and required amounts. The NST resulted responsible for only 18% of bags prescribed in the geriatrics ward and for 48% in the surgery wards. PN was not able to fulfill nutritional requirements resulting in a median lack of 3.1 calories and 0.23 g of proteins per kilogram of reference body weight per day. Despite this, PN therapy was able to improve total blood proteins and calcium blood levels in our cohort. The NST changed the prescription in 55.8% of the pre-existing PN regimens. More strict adherence to guidelines is needed in order to maximize effectiveness of PN and observe a positive impact on clinical parameters. Copyright © 2018 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

  7. Racial and ethnic disparities in stroke outcomes: a scoping review of post-stroke disability assessment tools.

    Science.gov (United States)

    Burns, Suzanne Perea; White, Brandi M; Magwood, Gayenell; Ellis, Charles; Logan, Ayaba; Jones Buie, Joy N; Adams, Robert J

    2018-03-23

    To identify how post-stroke disability outcomes are assessed in studies that examine racial/ethnic disparities and to map the identified assessment content to the International Classification of Functioning, Disability, and Health (ICF) across the time course of stroke recovery. We conducted a scoping review of the literature. Articles published between January 2001 and July 2017 were identified through Scopus, PubMed, CINAHL, and PsycINFO according to predefined inclusion and exclusion criteria. We identified 1791 articles through database and hand-searching strategies. Of the articles, 194 met inclusion criteria for full-text review, and 41 met inclusion criteria for study inclusion. The included studies used a variety of outcome measures encompassing domains within the ICF: body functions, activities, participation, and contextual factors across the time course of stroke recovery. We discovered disproportionate representation among racial/ethnic groups in the post-stroke disability disparities literature. A wide variety of assessments are used to examine disparities in post-stroke disability across the time course of stroke recovery. Several studies have identified disparities through a variety of assessments; however, substantial problems abound from the assessments used including inconsistent use of assessments, lacking evidence on the validity of assessments among racial/ethnic groups, and inadequate representation among all racial/ethnic populations comprising the US. Implications for Rehabilitation An enhanced understanding of racial/ethnic disparities in post-stroke disability outcomes is inherently important among rehabilitation practitioners who frequently engage with racial/ethnic minority populations across the time course of stroke recovery. Clinicians should carefully consider the psychometric properties of assessment tools to counter potential racial bias. Clinicians should be aware that many assessments used in stroke rehabilitation lack cultural

  8. 42 CFR 460.132 - Quality assessment and performance improvement plan.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Quality assessment and performance improvement plan... assessment and performance improvement plan. (a) Basic rule. A PACE organization must have a written quality assessment and performance improvement plan. (b) Annual review. The PACE governing body must review the plan...

  9. Outcome measures in spinal cord injury: recent assessments and recommendations for future directions

    DEFF Research Database (Denmark)

    Alexander, M S; Anderson, K D; Biering-Sørensen, Fin

    2009-01-01

    Study design:Review by the spinal cord outcomes partnership endeavor (SCOPE), which is a broad-based international consortium of scientists and clinical researchers representing academic institutions, industry, government agencies, not-for-profit organizations and foundations. Objectives:Assessme......Study design:Review by the spinal cord outcomes partnership endeavor (SCOPE), which is a broad-based international consortium of scientists and clinical researchers representing academic institutions, industry, government agencies, not-for-profit organizations and foundations. Objectives......:Assessment of current and evolving tools for evaluating human spinal cord injury (SCI) outcomes for both clinical diagnosis and clinical research studies. Methods:a framework for the appraisal of evidence of metric properties was used to examine outcome tools or tests for accuracy, sensitivity, reliability and validity...... for human SCI. Results:Imaging, neurological, functional, autonomic, sexual health, bladder/bowel, pain and psychosocial tools were evaluated. Several specific tools for human SCI studies have or are being developed to allow the more accurate determination for a clinically meaningful benefit (improvement...

  10. Psychological skills training and a mindfulness-based intervention to enhance functional athletic performance: design of a randomized controlled trial using ambulatory assessment.

    Science.gov (United States)

    Röthlin, Philipp; Birrer, Daniel; Horvath, Stephan; Grosse Holtforth, Martin

    2016-07-26

    Struggling to deliver performance in competitions is one of the main reasons why athletes seek the advice of sport psychologists. Psychologists apply a variety of intervention techniques, many of which are not evidence-based. Evidence-based techniques promote quality management and could help athletes, for example, to increase and maintain functional athletic behavior in competitions/games (i.e., being focused on task relevant cues and executing movements and actions in high quality). However, well-designed trials investigating the effectiveness of sport psychological interventions for performance enhancement are scarce. The planed study is founded by the Swiss National Science Foundation and examines the effectiveness of two interventions with elite and sub-elite athletes. A psychological skills training (PST) and a mindfulness-based intervention (MI), administered as group-program, will be compared to a waiting-list control group concerning how they enhance functional athletic behavior - which is a prerequisite for optimal performance. Furthermore, we will investigate underlying mechanisms (mediators) and moderators (e.g., task difficulty, individual characteristics, intervention-expectancy and intervention-integrity). The presented trial uses a randomized controlled design with three groups, comparing PST, MI and a waiting list control condition. Both group interventions will last 5 weeks, consist of four 2 h sessions and will be administered by a trained sport psychologist. Primary outcome is functional athletic behavior assessed using ambulatory assessment in a competition/game. As secondary outcomes competition anxiety, cognitive interference and negative outcome expectations will be assessed. Assessments are held at pre- and post-intervention as well as at 2 months follow up. The study has been approved by the ethical committee of the Swiss Federal Institute of Sport. Both PST and MI are expected to help improve functional behavior in athletes. By

  11. Validity of the mini-mental state examination and the montreal cognitive assessment in the prediction of driving test outcome.

    Science.gov (United States)

    Hollis, Ann M; Duncanson, Haley; Kapust, Lissa R; Xi, Patricia M; O'Connor, Margaret G

    2015-05-01

    To evaluate the effectiveness of two cognitive screening measures, the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), in predicting driving test outcome for individuals with and without cognitive impairment. Retrospective cohort study. A clinical driving evaluation program at a teaching hospital in the United States. Adult drivers who underwent assessment with the MMSE and MoCA as part of a comprehensive driving evaluation between 2010 and 2014 (N=92). MMSE and MoCA total scores were independent variables. The outcome measure was performance on a standardized road test. A preestablished diagnosis of cognitive impairment enhanced the validity of cognitive screening measures in the identification of at-risk drivers. In individuals with cognitive impairment there was a significant relationship between MoCA score and on-road outcome. Specifically, an individual was 1.36 times as likely to fail the road test with each 1-point decrease in MoCA score. No such relationship was detected in those without a diagnosis of cognitive impairment. For individuals who have not been diagnosed with cognitive impairment, neither the MMSE nor the MoCA can be reliably used as an indicator of driving risk, but for individuals with a preestablished diagnosis of cognitive impairment, the MoCA is a useful tool in this regard. A score on the MoCA of 18 or less should raise concerns about driving safety. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  12. [Teaching performance assessment in Public Health employing three different strategies].

    Science.gov (United States)

    Martínez-González, Adrián; Moreno-Altamirano, Laura; Ponce-Rosas, Efrén Raúl; Martínez-Franco, Adrián Israel; Urrutia-Aguilar, María Esther

    2011-01-01

    The educational system depends upon the quality and performance of their faculty and should therefore be process of continuous improvement. To assess the teaching performance of the Public Health professors, at the Faculty of Medicine, UNAM through three strategies. Justification study. The evaluation was conducted under a mediational model through three strategies: students' opinion assessment, self-assessment and students' academic achievement. We applied descriptive statistics, Student t test, ANOVA and Pearson correlation. Twenty professors were evaluated from the Public Health department, representing 57% of all them who teach the subject. The professor's performance was highly valued self-assessment compared with assessment of student opinion, was confirmed by statistical analysis the difference was significant. The difference amongst the three evaluation strategies became more evident between self-assessment and the scores obtained by students in their academic achievement. The integration of these three strategies offers a more complete view of the teacher's performance quality. Academic achievement appears to be a more objective strategy for teaching performance assessment than students' opinion and self-assessment.

  13. DEVELOPMENT AND IMPROVEMENT OF BUSINESS HIGHER EDUCATION THROUGH IMPLEMENTATION OF STUDENTS LEARNING OUTCOMES ASSESSMENT PLAN (SLOAP

    Directory of Open Access Journals (Sweden)

    Zoran Ivanovski

    2013-03-01

    Full Text Available This study presents new vision how to upgrade business higher education at the Faculty of Economics at University of Tourism and Management in Skopje (UTMS. This paper is result of analyses of best practices of leading higher education institutions as well authors experience in higher education and business education and practice. The UTMS is orientated to introduce best practices and objective standards in order to offer high-quality business education for its students. UTMS has mission for permanent implementation of quality improvement measures as a way to achieve high professional and academic standards and become part of prosperous and respective Universities. In order to achieve this goal, UTMS plan to use additional measures, outcomes assessment as a way to measure institutional effectiveness, as well as effective technique for identifying where changes and improvements are necessary. UTMS has developed Students Learning Outcomes Assessment Plan (SLOAP as a way to reach this goal.Based on permanent analysis of students needs as well as business sector suggestions about desirable level of knowledge, skills and competence of the students from Faculty of Economics, gained from conducted evaluations, UTMS decide to make additional improvement and development of business education. This process have 4 phases: 1 evaluation of students attitude towards curricula and the instructors efficiency, 2preparation of the SLOAP (Student Learning Outcomes Assessment Plan document, 3 implementation of two direct measures from the SLOAP through assessment analysis and action planning, and 4 monitoring changes and improvements made as a result of action planning.The first phase was completed in spring semester 2012, as well as second one with development of Comprehensive Exam and Capstone Course as direct measures. Complete SLOAP also has indirect measures like student satisfaction inventory, course evaluations, alumni, and employers’ surveys, and a

  14. Vertical distraction of the severely resorbed edentulous mandible : An assessment of treatment outcome

    NARCIS (Netherlands)

    Raghoebar, Gerry M.; Stellingsma, Kees; Meijer, Henny J. A.; Vissink, Arjan

    2008-01-01

    Purpose: To assess the treatment outcome (implant survival, surgical complications, patient satisfaction) of vertical distraction of the severely resorbed edentulous mandible. Materials and Methods: Forty-six patients with severe resorption of the edentulous mandible (bone height 5 to 8 mm, median 6

  15. Medical assessment of adverse health outcomes in long-term survivors of childhood cancer

    NARCIS (Netherlands)

    Geenen, Maud M.; Cardous-Ubbink, Mathilde C.; Kremer, Leontien C. M.; van den Bos, Cor; van der Pal, Helena J. H.; Heinen, Richard C.; Jaspers, Monique W. M.; Koning, Caro C. E.; Oldenburger, Foppe; Langeveld, Nelia E.; Hart, Augustinus A. M.; Bakker, Piet J. M.; Caron, Huib N.; van Leeuwen, Flora E.

    2007-01-01

    CONTEXT: Improved survival of children with cancer has been accompanied by multiple treatment-related complications. However, most studies in survivors of childhood cancer focused on only 1 late effect. OBJECTIVE: To assess the total burden of adverse health outcomes (clinical or subclinical

  16. 42 CFR 416.43 - Conditions for coverage-Quality assessment and performance improvement.

    Science.gov (United States)

    2010-10-01

    ..., an ongoing program that demonstrates measurable improvement in patient health outcomes, and improves patient safety by using quality indicators or performance measures associated with improved health outcomes and by the identification and reduction of medical errors. (2) The ASC must measure, analyze, and...

  17. Can shared care deliver better outcomes for patients undergoing total hip replacement? A prospective assessment of patient outcomes and associated service use

    NARCIS (Netherlands)

    Rosendal, H.; Beekum, W.T. van; Nijhof, P.; Witte, L.P. de; Schrijvers, A.J.P.

    2000-01-01

    Objectives: To assess whether shared care for patients undergoing total hip replacement delivers better outcomes compared to care as usual. Design: Prospective, observational cohort study. Setting: Two regions in the Netherlands where different organisational health care models have been

  18. ASSESSING STUDENT PERFORMANCE ON INTERPRETING THROUGH PEER-ASSESSMENT

    Directory of Open Access Journals (Sweden)

    Titik Ismailia

    2017-12-01

    Full Text Available As a part of translation interpreting is translating spoken discourse orally. It needs some requirements like ability to speak clearly, clarity, fluency, eye contact, and self-confidence. It also needs linguistic proficiency, analytical skill, listening and recall, interpersonal skills, ethical behaviour, speaking skills, cultural knowledge, and subject knowledge. Evaluating students performance on interpreting can be done through peer assessment. Peer- assessment is one of alternative assessment to grade the peers in group or individuals by commenting on and judging other students work. To do this process there is a join work between listening and speaking, and two students. The first student as a speaker and the second student as an interpreter. Both of them should do the same quality on speak clearly as a speaker and as an interpreter should able to listen and translating the spoken discourse orally. Evaluation can use analytical grade that allows teacher to set clear criteria for correction like fluency, grammar, terminology, general content, and mechanics. Students and teacher can give comment on every criteria based on their own competency. During the process on making criteria, students and teacher can discuss and give reasonable suggestion to make the assessment suitable to the students competency. At the end, a rubric of assessment with the score from 0 to 100 and criteria and also the comment included in the paper of assessment.

  19. Waste package performance assessment

    International Nuclear Information System (INIS)

    Lester, D.H.

    1981-01-01

    This paper describes work undertaken to assess the life-expectancy and post-failure nuclide release behavior of high-level and waste packages in a geologic repository. The work involved integrating models of individual phenomena (such as heat transfer, corrosion, package deformation, and nuclide transport) and using existing data to make estimates of post-emplacement behavior of waste packages. A package performance assessment code was developed to predict time to package failure in a flooded repository and subsequent transport of nuclides out of the leaking package. The model has been used to evaluate preliminary package designs. The results indicate, that within the limitation of model assumptions and data base, packages lasting a few hundreds of years could be developed. Very long lived packages may be possible but more comprehensive data are needed to confirm this

  20. Applying Social Cognitive Theory to Academic Advising to Assess Student Learning Outcomes

    Science.gov (United States)

    Erlich, Richard J.; Russ-Eft, Darlene

    2011-01-01

    Review of social cognitive theory constructs of self-efficacy and self-regulated learning is applied to academic advising for the purposes of assessing student learning. A brief overview of the history of student learning outcomes in higher education is followed by an explanation of self-efficacy and self-regulated learning constructs and how they…

  1. Interprofessional Curbside Consults to Develop Team Communication and Improve Student Achievement of Learning Outcomes.

    Science.gov (United States)

    Kirwin, Jennifer; Greenwood, Kristin Curry; Rico, Janet; Nalliah, Romesh; DiVall, Margarita

    2017-02-25

    Objective. To design and implement a series of activities focused on developing interprofessional communication skills and to assess the impact of the activities on students' attitudes and achievement of educational goals. Design. Prior to the first pharmacy practice skills laboratory session, pharmacy students listened to a classroom lecture about team communication and viewed short videos describing the roles, responsibilities, and usual work environments of four types of health care professionals. In each of four subsequent laboratory sessions, students interacted with a different standardized health care professional role-played by a pharmacy faculty member who asked them a medication-related question. Students responded in verbal and written formats. Assessment. Student performance was assessed with a three-part rubric. The impact of the exercise was assessed by conducting pre- and post-intervention surveys and analyzing students' performance on relevant Center for the Advancement of Pharmacy Education (CAPE) outcomes. Survey results showed improvement in student attitudes related to team-delivered care. Students' performance on the problem solver and collaborator CAPE outcomes improved, while performance on the educator outcome worsened. Conclusions. The addition of an interprofessional communication activity with standardized health care professionals provided the opportunity for students to develop skills related to team communication. Students felt the activity was valuable and realistic; however, analysis of outcome achievement from the exercise revealed a need for more exposure to team communication skills.

  2. Cultural adaptation: translatability assessment and linguistic validation of the patient-reported outcome instrument for irritable bowel syndrome with diarrhea

    Directory of Open Access Journals (Sweden)

    Delgado-Herrera L

    2016-06-01

    Full Text Available Leticia Delgado-Herrera,1 Kathryn Lasch,2 Ana Popielnicki,3 Akito Nishida,4 Rob Arbuckle,5 Benjamin Banderas,6 Susan Zentner,1 Ingrid Gagainis,1 Bernhardt Zeiher1 1Astellas Pharma Global Development, Northbrook, IL, 2Pharmerit International, Newton, MA, USA; 3TransPerfect, Linguistic Validation Group, Boston, MA, USA; 4Development Project Management, Astellas Pharma Inc, Tokyo, Japan; 5Patient-Centered Outcomes Adelphi Values, Bollington, UK; 6Patient-Centered Outcomes Adelphi Values, Boston, MA, USA Background and objective: Following a 2009 US Food and Drug Administration guidance, a new patient-reported outcome (PRO instrument was developed to support end points in multinational clinical trials assessing irritable bowel syndrome with diarrhea (IBS-D symptom severity. Our objective was to assess the translatability of the IBS-D PRO instrument into ten languages, and subsequently perform a cultural adaptation/linguistic validation of the questionnaire into Japanese and US Spanish. Materials and methods: Translatability assessments of the US English version of the IBS-D PRO were performed by experienced PRO translators who were native speakers of each target language and currently residing in target-language countries. Languages were Chinese (People’s Republic of China, Dutch (the Netherlands, French (Belgium, German (Germany, Japanese (Japan, Polish (Poland, Portuguese (Brazil, Russian (Russia, Spanish (Mexico, and Spanish (US. The project team assessed the instrument to identify potential linguistic and/or cultural adaptation issues. After the issues identified were resolved, the instrument was translated into Spanish (US and Japanese through a process of two forward translations, one reconciled translation, and one backward translation. The project team reviewed the translated versions before the instruments were evaluated by cognitive debriefing interviews with samples of five Spanish (US and five Japanese IBS-D patients. Results

  3. Performance Assessment of the Juaboso District Office of the National Health Insurance Authority.

    Science.gov (United States)

    Effah, Paul; Appiah, Kingsley Opoku; Abor, Patience Aseweh

    2016-09-01

    To assess the performance of the National Health Insurance Authority (NHIA) in Ghana. Using a thorough case study of the Juaboso District Office of the NHIA, this study assessed the community coverage rate, the annual expenditure and income, and the trend of claims payment for the period 2009 to 2012 as well as factors influencing the level of patronage of the National Health Insurance Scheme. A self-administered structured questionnaire was used to gather data from the management of the scheme. Secondary data were also gathered from the scheme's audited financial statements. Informal discussions were held with the premium collectors and clients to throw more light on revenue generation challenges. The study found an increasing trend in the coverage rate on a yearly basis. Over the study period, the rate moved from 30.6 to 60.1, representing an increase of 96.7%. This shows that in terms of coverage rate, the Juaboso District Office of the NHIA is performing very well. The study also found that revenue has increased but the percentage rate of increase has decreased, compared with the coverage percentage rate. Expenditure has been on the rise, increasing by as much as 20.7% in 2011. Again, the study revealed a consistent year-on-year increase in the claims payment, consistent with the national trend. Constant clinical auditing of claims payments is required to ensure accountability. This would lead to transparency with regard to performance assessment of the claims. The findings have important implications for the effective management of the NHIA. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  4. The impact of high performance work systems in Irish companies: an examination of company and employee outcomes

    OpenAIRE

    Mkamwa, Thadeus F.

    2010-01-01

    This study examines the impact of High Performance Work Systems (HPWS) on company and employee-level performance outcomes. At the company level, the study examines the outcomes of HPWS usage on innovation, productivity and turnover. The study uses data collected from 132 companies in Ireland who participated in a general manager (GM) and human resource (HR) manager survey conducted in 2006. This study shows that an extensive application ...

  5. Citation analysis did not provide a reliable assessment of core outcome set uptake.

    Science.gov (United States)

    Barnes, Karen L; Kirkham, Jamie J; Clarke, Mike; Williamson, Paula R

    2017-06-01

    The aim of the study was to evaluate citation analysis as an approach to measuring core outcome set (COS) uptake, by assessing whether the number of citations for a COS report could be used as a surrogate measure of uptake of the COS by clinical trialists. Citation data were obtained for COS reports published before 2010 in five disease areas (systemic sclerosis, rheumatoid arthritis, eczema, sepsis and critical care, and female sexual dysfunction). Those publications identified as a report of a clinical trial were examined to identify whether or not all outcomes in the COS were measured in the trial. Clinical trials measuring the relevant COS made up a small proportion of the total number of citations for COS reports. Not all trials citing a COS report measured all the recommended outcomes. Some trials cited the COS reports for other reasons, including the definition of a condition or other trial design issues addressed by the COS report. Although citation data can be readily accessed, it should not be assumed that the citing of a COS report indicates that a trial has measured the recommended COS. Alternative methods for assessing COS uptake are needed. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  6. Validation of a questionnaire assessing patient's aesthetic and functional outcome after nasal reconstruction: the patient NAFEQ-score.

    Science.gov (United States)

    Moolenburgh, S E; Mureau, M A M; Duivenvoorden, H J; Hofer, S O P

    2009-05-01

    In determining patient satisfaction with functional and aesthetic outcome after reconstructive surgery, including nasal reconstruction, standardised assessment instruments are very important. These standardised tools are needed to adequately evaluate and compare outcome results. Since no such instrument existed for nasal reconstruction, a standardised evaluation questionnaire was developed to assess aesthetic and functional outcome after nasal reconstruction. Items of the Nasal Appearance and Function Evaluation Questionnaire (NAFEQ) were derived from both the literature and experiences with patients. The NAFEQ was validated on 30 nasal reconstruction patients and a reference group of 175 people. A factor analysis confirmed the arrangement of the questionnaire in two subscales: functional and aesthetic outcome. High Cronbach's alpha values (>0.70) for both subscales showed that the NAFEQ was an internally consistent instrument. This study demonstrated that the NAFEQ can be used as a standardised questionnaire for detailed evaluation of aesthetic and functional outcome after nasal reconstruction. Its widespread use would enable comparison of results achieved by different techniques, surgeons and centres in a standardised fashion.

  7. Identifying Best Practices for and Utilities of the Pharmacy Curriculum Outcome Assessment Examination.

    Science.gov (United States)

    Mok, Timothy Y; Romanelli, Frank

    2016-12-25

    Objective. A review was conducted to determine implementation strategies, utilities, score interpretation, and limitations of the Pharmacy Curriculum Outcome Assessment (PCOA) examination. Methods. Articles were identified through the PubMed and American Journal of Pharmaceutical Education , and International Pharmaceutical Abstracts databases using the following terms: "Pharmacy Curriculum Outcomes Assessment," "pharmacy comprehensive examination," and "curricular assessment." Studies containing information regarding implementation, utility, and predictive values for US student pharmacists, curricula, and/or PGY1/PGY2 residents were included. Publications from the Academic Medicine Journal , the Accreditation Council for Pharmacy Education (ACPE), and the American Association of Colleges of Pharmacy (ACCP) were included for background information and comparison of predictive utilities of comprehensive examinations in medicine. Results. Ten PCOA and nine residency-related publications were identified. Based on published information, the PCOA may be best used as an additional tool to identify knowledge gaps for third-year student pharmacists. Conclusion. Administering the PCOA to students after they have completed their didactic coursework may yield scores that reflect student knowledge. Predictive utility regarding the North American Pharmacy Licensure Examination (NAPLEX) and potential applications is limited, and more research is required to determine ways to use the PCOA.

  8. Academic outcomes and cognitive performance in problematic Internet users.

    Science.gov (United States)

    Marín Vila, María; Carballo Crespo, José Luis; Coloma Carmona, Ainhoa

    2018-04-15

    Only few studies have examined the relationship between problematic Internet use (PIU) and cognitive and academic performance in adolescents. The aim of this study was to analyze the differences in academic and cognitive performance (perception, attention, memory, verbal fluency and abstract reasoning) between adolescents with and without PIU. A total of 575 students from different high schools of the region of Alicante participated. Students were divided into two groups: adolescents with and without PIU (PIU and NPIU, respectively). Several questionnaires were administered to assess problematic Internet use, as well as students' academic performance. Substance use (alcohol / cannabis) was also assessed as exclusion criteria. A battery of neuropsychological tests was used to assess cognitive abilities. On the one hand, PIU users group obtained poorer academic results than NPIU, in terms of lower marks and more failed subjects. On the other hand, PIU group had a better hit ratio in the perception test than NPIU group. However, PIU adolescents got higher error rates for the abstract reasoning test. This greater number of errors, plus a similar number of hits compared to the NPIU group, could indicated a higher response rate for the PIU group, which may might be associated with greater impulsivity. As occurs in other addictive and non-substance-related problems studies, these results could mean difficulties in impulse control and regulation of response inhibition circuits in PIU users group. Future research is needed to analyze in depth the results presented in this paper.

  9. Assessment of Student Music Performances Using Deep Neural Networks

    Directory of Open Access Journals (Sweden)

    Kumar Ashis Pati

    2018-03-01

    Full Text Available Music performance assessment is a highly subjective task often relying on experts to gauge both the technical and aesthetic aspects of the performance from the audio signal. This article explores the task of building computational models for music performance assessment, i.e., analyzing an audio recording of a performance and rating it along several criteria such as musicality, note accuracy, etc. Much of the earlier work in this area has been centered around using hand-crafted features intended to capture relevant aspects of a performance. However, such features are based on our limited understanding of music perception and may not be optimal. In this article, we propose using Deep Neural Networks (DNNs for the task and compare their performance against a baseline model using standard and hand-crafted features. We show that, using input representations at different levels of abstraction, DNNs can outperform the baseline models across all assessment criteria. In addition, we use model analysis techniques to further explain the model predictions in an attempt to gain useful insights into the assessment process. The results demonstrate the potential of using supervised feature learning techniques to better characterize music performances.

  10. Trochantric severity score a useful tool to assess outcomes after intertrochantric fractures

    Directory of Open Access Journals (Sweden)

    Sandeep Thomas George

    2017-01-01

    CONCLUSION: Trochantric severity score is a useful tool to assess the outcome of management of intertrochanteric fractures. Sliding hip screw may not be an ideal implant for, trochantric fractures with inadequate lateral wall thickness (failure rate of 63%, reverse oblique type of trochanter fractures (failure rates of 50%, and displaced comminuted fractures (failure rate of 13%.

  11. A model to begin to use clinical outcomes in medical education.

    Science.gov (United States)

    Haan, Constance K; Edwards, Fred H; Poole, Betty; Godley, Melissa; Genuardi, Frank J; Zenni, Elisa A

    2008-06-01

    The latest phase of the Accreditation Council for Graduate Medical Education (ACGME) Outcome Project challenges graduate medical education (GME) programs to select meaningful clinical quality indicators by which to measure trainee performance and progress, as well as to assess and improve educational effectiveness of programs. The authors describe efforts to measure educational quality, incorporating measurable patient-care outcomes to guide improvement. University of Florida College of Medicine-Jacksonville education leaders developed a tiered framework for selecting clinical indicators whose outcomes would illustrate integration of the ACGME competencies and their assessment with learning and clinical care. In order of preference, indicators selected should align with a specialty's (1) national benchmarked consensus standards, (2) national specialty society standards, (3) standards of local, institutional, or regional quality initiatives, or (4) top-priority diagnostic and/or therapeutic categories for the specialty, based on areas of high frequency, impact, or cost. All programs successfully applied the tiered process to clinical indicator selection and then identified data sources to track clinical outcomes. Using clinical outcomes in resident evaluation assesses the resident's performance as reflective of his or her participation in the health care delivery team. Programmatic improvements are driven by clinical outcomes that are shown to be below benchmark across the residents. Selecting appropriate clinical indicators-representative of quality of care and of graduate medical education-is the first step toward tracking educational outcomes using clinical data as the basis for evaluation and improvement. This effort is an important aspect of orienting trainees to using data for monitoring and improving care processes and outcomes throughout their careers.

  12. Women referred for occupational risk assessment in pregnancy have no increased risk of adverse obstetric outcomes

    DEFF Research Database (Denmark)

    Bidstrup, Signe Brøker; Kaerlev, Linda; Thulstrup, Ane Marie

    2015-01-01

    pregnant women referred to two Danish clinics of occupational medicine (Copenhagen and Aarhus) from 1984 to 2010 were compared with the referred women's 1,077 non-referred pregnancy outcomes and with the pregnancy outcomes of 345,467 gainfully employed women from the same geographical areas and time period.......72-1.17). CONCLUSION: The women who are referred for occupational risk assessment at two large occupational university departments are not at an increased risk of preterm birth or of delivering low birth weight children. This may reflect that reproductive hazards in Danish workplaces are limited and....../or that the occupational risk assessment and counselling of pregnant women are preventing these selected adverse pregnancy outcomes. FUNDING: The Research Unit at Department of Occupational and Environmental Medicine at Bispebjerg Hospital supported the study financially. TRIAL REGISTRATION: not relevant. The study...

  13. VISUAL ART TEACHERS AND PERFORMANCE ASSESSMENT ...

    African Journals Online (AJOL)

    Charles

    Senior Secondary school visual art teachers constituted the sample of this ... and Performance Assessment Methods in Nigerian Senior Secondary Schools – Bello .... definition includes knowledge, skills, attitudes, metacognition and strategic ...

  14. Communicative-Pragmatic Assessment Is Sensitive and Time-Effective in Measuring the Outcome of Aphasia Therapy

    Directory of Open Access Journals (Sweden)

    Benjamin Stahl

    2017-05-01

    Full Text Available A range of methods in clinical research aim to assess treatment-induced progress in aphasia therapy. Here, we used a crossover randomized controlled design to compare the suitability of utterance-centered and dialogue-sensitive outcome measures in speech-language testing. Fourteen individuals with post-stroke chronic non-fluent aphasia each received two types of intensive training in counterbalanced order: conventional confrontation naming, and communicative-pragmatic speech-language therapy (Intensive Language-Action Therapy, an expanded version of Constraint-Induced Aphasia Therapy. Motivated by linguistic-pragmatic theory and neuroscience data, our dependent variables included a newly created diagnostic instrument, the Action Communication Test (ACT. This diagnostic instrument requires patients to produce target words in two conditions: (i utterance-centered object naming, and (ii communicative-pragmatic social interaction based on verbal requests. In addition, we administered a standardized aphasia test battery, the Aachen Aphasia Test (AAT. Composite scores on the ACT and the AAT revealed similar patterns of changes in language performance over time, irrespective of the treatment applied. Changes in language performance were relatively consistent with the AAT results also when considering both ACT subscales separately from each other. However, only the ACT subscale evaluating verbal requests proved to be successful in distinguishing between different types of training in our patient sample. Critically, testing duration was substantially shorter for the entire ACT (10–20 min than for the AAT (60–90 min. Taken together, the current findings suggest that communicative-pragmatic methods in speech-language testing provide a sensitive and time-effective measure to determine the outcome of aphasia therapy.

  15. Assessment of Joystick control during the performance of powered wheelchair driving tasks

    Directory of Open Access Journals (Sweden)

    Routhier François

    2011-05-01

    Full Text Available Abstract Background Powered wheelchairs are essential for many individuals who have mobility impairments. Nevertheless, if operated improperly, the powered wheelchair poses dangers to both the user and to those in its vicinity. Thus, operating a powered wheelchair with some degree of proficiency is important for safety, and measuring driving skills becomes an important issue to address. The objective of this study was to explore the discriminate validity of outcome measures of driving skills based on joystick control strategies and performance recorded using a data logging system. Methods We compared joystick control strategies and performance during standardized driving tasks between a group of 10 expert and 13 novice powered wheelchair users. Driving tasks were drawn from the Wheelchair Skills Test (v. 4.1. Data from the joystick controller were collected on a data logging system. Joystick control strategies and performance outcome measures included the mean number of joystick movements, time required to complete tasks, as well as variability of joystick direction. Results In simpler tasks, the expert group's driving skills were comparable to those of the novice group. Yet, in more difficult and spatially confined tasks, the expert group required fewer joystick movements for task completion. In some cases, experts also completed tasks in approximately half the time with respect to the novice group. Conclusions The analysis of joystick control made it possible to discriminate between novice and expert powered wheelchair users in a variety of driving tasks. These results imply that in spatially confined areas, a greater powered wheelchair driving skill level is required to complete tasks efficiently. Based on these findings, it would appear that the use of joystick signal analysis constitutes an objective tool for the measurement of powered wheelchair driving skills. This tool may be useful for the clinical assessment and training of powered

  16. Linking payment to health outcomes: a taxonomy and examination of performance-based reimbursement schemes between healthcare payers and manufacturers.

    Science.gov (United States)

    Carlson, Josh J; Sullivan, Sean D; Garrison, Louis P; Neumann, Peter J; Veenstra, David L

    2010-08-01

    To identify, categorize and examine performance-based health outcomes reimbursement schemes for medical technology. We performed a review of performance-based health outcomes reimbursement schemes over the past 10 years (7/98-010/09) using publicly available databases, web and grey literature searches, and input from healthcare reimbursement experts. We developed a taxonomy of scheme types by inductively organizing the schemes identified according to the timing, execution, and health outcomes measured in the schemes. Our search yielded 34 coverage with evidence development schemes, 10 conditional treatment continuation schemes, and 14 performance-linked reimbursement schemes. The majority of schemes are in Europe and Australia, with an increasing number in Canada and the U.S. These schemes have the potential to alter the reimbursement and pricing landscape for medical technology, but significant challenges, including high transaction costs and insufficient information systems, may limit their long-term impact. Future studies regarding experiences and outcomes of implemented schemes are necessary. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  17. ANALYSING PERFORMANCE ASSESSMENT IN PUBLIC SERVICES: HOW USEFUL IS THE CONCEPT OF A PERFORMANCE REGIME?

    Science.gov (United States)

    Martin, Steve; Nutley, Sandra; Downe, James; Grace, Clive

    2016-03-01

    Approaches to performance assessment have been described as 'performance regimes', but there has been little analysis of what is meant by this concept and whether it has any real value. We draw on four perspectives on regimes - 'institutions and instruments', 'risk regulation regimes', 'internal logics and effects' and 'analytics of government' - to explore how the concept of a multi-dimensional regime can be applied to performance assessment in public services. We conclude that the concept is valuable. It helps to frame comparative and longitudinal analyses of approaches to performance assessment and draws attention to the ways in which public service performance regimes operate at different levels, how they change over time and what drives their development. Areas for future research include analysis of the impacts of performance regimes and interactions between their visible features (such as inspections, performance indicators and star ratings) and the veiled rationalities which underpin them.

  18. Specific esophagogram to assess functional outcomes after Heller's myotomy and Dor's fundoplication for esophageal achalasia.

    Science.gov (United States)

    Tsoukali, E; Gouvas, N; Tsiaoussis, J; Pechlivanides, G; Zervakis, N; Mantides, A; Xynos, E

    2011-09-01

    Esophageal emptying assessed at the 'timed barium' esophagogram correlates well with symptomatic outcomes after pneumatic dilation for esophageal achalasia, although 30% of patients with satisfactory outcome exhibit partial improvement in emptying. The aim of the study was to investigate any correlation of esophageal emptying to symptomatic response after laparoscopic Heller's myotomy and Dor's fundoplication. 'Bread and barium' (transit time of a barium opaque bread bolus) and 'timed barium' (height of esophageal barium column 5 minutes after ingestion of 200-250 mL of barium suspension) esophagogram was used to assess esophageal emptying in 73 patients with esophageal achalasia before 1 and 5 years (31 cases) after laparoscopic myotomy and anterior fundoplication. Symptoms assessment was based to a specific score. At 1-year follow-up, excellent and good symptomatic results were obtained in 95% of the cases. Esophageal maximum diameter, esophageal transit time, and esophageal barium column were significantly correlated to each other and to symptom score postoperatively (P achalasia. Complete symptomatic relief does not necessarily reflect complete esophageal emptying. Outcomes do not deteriorate by time. Because of wide availability, esophagogram can be applied in follow-up of postmyotomy patients in conjunction with symptomatic evaluation. © 2011 Copyright the Authors. Journal compilation © 2011, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

  19. Consideration of liners and covers in performance assessments

    Energy Technology Data Exchange (ETDEWEB)

    Phifer, Mark A. [Savannah River National Laboratory, Aiken, SC (United States); Seitz, Robert R. [Savannah River National Laboratory, Aiken, SC (United States); Suttora, Linda C. [USDOE Enviromental Management, Washington, DC (United States)

    2014-09-18

    On-site disposal cells are in use and being considered at several United States Department of Energy (USDOE) sites as the final disposition for large amounts of waste associated with cleanup of contaminated areas and facilities. These disposal cells are typically regulated by States and/or the U.S. Environmental Protection Agency under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) in addition to having to comply with requirements in DOE Order 435.1, Radioactive Waste Management due to the radioactive waste. The USDOE-Environmental Management Office of Site Restoration formed a working group to foster improved communication and sharing of information for personnel associated with these CERCLA disposal cells and work towards more consistent assumptions, as appropriate, for technical and policy considerations related to CERCLA risk assessments and DOE Order 435.1 performance assessments in support of a Record of Decision and Disposal Authorization Statement, respectively. One of the issues considered by the working group, which is addressed in this report, was how to appropriately consider the performance of covers and liners/leachate collections systems in the context of a DOE Order 435.1 performance assessment (PA). This same information may be appropriate for consideration within CERCLA risk assessments for these facilities. These OSDCs are generally developed to meet hazardous waste (HW) disposal design standards under the Resource Conservation and Recovery Act (RCRA) as well as the DOE Order 435.1 performance based standards for disposal of radioactive waste. To meet the standards for HW, the facilities typically include engineered covers and liner/leachate collection systems. Thus, when considering such facilities in the context of a DOE Order 435.1 PA, there is a need to address the evolution of performance of covers and liner/leachate collection systems in the context of meeting a performance standard considering time

  20. TURVA-2012: Performance assessment

    International Nuclear Information System (INIS)

    Hellae, Pirjo; Snellman, Margit; Marcos, Nuria; Pastina, Barbara; Smith, Paul; Koskinen, Kari

    2014-01-01

    TURVA-2012 is Posiva's safety case in support of the Preliminary Safety Analysis Report (PSAR) and application for a construction licence for a repository for disposal of spent nuclear fuel at the Olkiluoto site in south-western Finland. Posiva's safety concept is based on long-term isolation and containment, which is achieved through a robust engineered barrier system (EBS) design and favourable geological conditions at the repository site. The reference design considered in the TURVA-2012 safety case is the KBS-3V design, with the EBS consisting of a copper-iron canister, a buffer of swelling clay material, a backfill in the deposition tunnels of low-permeability material and closure of the central tunnels and other underground openings. The host rock acts as a natural barrier. Each barrier contributes to safety through one or more safety function. The conditions needed for the barriers to fulfil their respective safety functions are expressed in terms of performance targets for the EBS and the target properties for the host rock. The performance assessment (Posiva, 2013), which is a key component of TURVA-2012, analyses the ability of the repository system to provide containment and isolation of the spent nuclear fuel during the long-term evolution of the system and the site. The conditions needed for the barriers to fulfil their respective safety functions are expressed in terms of performance targets for the engineered barriers and target properties for the host rock, for example properties related to the corrosion resistance and mechanical strength of the canister as well as groundwater flow and composition. The analyses take into account the uncertainties in the initial state, the subsequent thermal, hydraulic, mechanical and chemical evolution of the repository system and uncertainties in the evolution. The conclusions of the performance assessment are based mostly on the output of key modelling activities. Whenever modelling is not possible the conclusions

  1. The natural language of the surgeon's clinical note in outcomes assessment: a qualitative analysis of the medical record.

    Science.gov (United States)

    Miller, J Michael; Velanovich, Vic

    2010-06-01

    Physician-generated clinical notes are the central document in recording the clinical decision-making and outcome of care. This is particularly true in an environment where outcomes assessment is becoming increasingly important. The hypothesis of this study is that these notes are inadequate to assess patient-centered outcomes and determine surgeons' core competencies. We preformed a retrospective review of postoperative clinical notes of general surgery patients for a 1-month period. Information from these notes underwent qualitative analysis using the reductionist thematic approach for patient-centered and physician-centered outcomes. Outcomes included 2 physician-centered items (physical examination and objective tests) and 3 patient-centered items (postoperative complications, functional status, and satisfaction). The presence or absence of each item in the clinical note was recorded. Six hundred eighty-one patients of 18 general surgeons were included. Among the surgeons, 28% failed to document symptomatic change in even 1 patient; similarly, 67% failed to document functional change, and 50% failed to document satisfaction. Among all 681 clinical notes only 7% of records mentioned symptomatic change, 1% functional change, 87% physical examination, 26% objective tests, and 3% patient satisfaction. These results were not affected by procedure type or number of patients seen. In general surgery practice, the surgeon's clinical note is a poor measure of physician-centered or patient-centered outcomes, implying that an audit of clinical notes would be an inaccurate method to assess patient outcomes. This has implications for issues surrounding maintenance of certification. Copyright 2010 Elsevier Inc. All rights reserved.

  2. Assessing irrigation performance by using remote sensing

    NARCIS (Netherlands)

    Bandara, K.M.P.S.

    2006-01-01

    Keywords: Performance indicators, performance assessment, diagnostic approach, SEBAL, target level, grain yield, water productivity, error estimation, spatio-temporal resolution.

    In

  3. Incorrect Weighting of Absolute Performance in Self-Assessment

    Science.gov (United States)

    Jeffrey, Scott A.; Cozzarin, Brian

    Students spend much of their life in an attempt to assess their aptitude for numerous tasks. For example, they expend a great deal of effort to determine their academic standing given a distribution of grades. This research finds that students use their absolute performance, or percentage correct as a yardstick for their self-assessment, even when relative standing is much more informative. An experiment shows that this reliance on absolute performance for self-evaluation causes a misallocation of time and financial resources. Reasons for this inappropriate responsiveness to absolute performance are explored.

  4. Can Assessment Reactivity Predict Treatment Outcome among Adolescents with Alcohol and Other Substance Use Disorders?

    Science.gov (United States)

    Kaminer, Yifrah; Burleson, Joseph A.; Burke, Rebecca H.

    2008-01-01

    The objectives of this paper are two-fold: to examine first, if the change from positive to negative alcohol and any other substance use status from baseline assessment to the onset of the first session (i.e., pre-treatment phase) occurs in adolescents, that is, Assessment Reactivity (AR); second, whether AR predicts treatment outcome.…

  5. A literature review on self-care of chronic illness: definition, assessment and related outcomes.

    Science.gov (United States)

    Ausili, Davide; Masotto, Matteo; Dall'Ora, Chiara; Salvini, Lorena; Di Mauro, Stefania

    2014-01-01

    Chronic illnesses care represents a challenging issue for people well-being and future health systems' sustainability. Promotion of self-care is considered a key point for chronically ill patients' care. The aim of this literature was to explore: how self-care of chronic illness has been theoretically defined; how self-care can be assessed in clinical and research settings; what associations exist between self-care and health outcomes of chronically ill patients. A wide range of definitions and terminologies related to self-care of chronic illness has been found in the literature. Although some common elements useful to explain the concept of self-care have been identified, the physical, cognitive, emotional and social processes underlying self-care remain controversial and poorly defined. Valid and reliable disease-specific assessment tools have been developed and used in a growing number of studies; however, the lack of utilization of standardized instruments in clinical practice has been referred by many authors. Significant correlations between self-care of chronic illness and outcome measures e.g. general health status, quality of life and healthcare costs, are reported by a limited number of studies. Supporting patient self-care is recognized as a crucial factor in chronic illness care. A deeper analysis of variables and processes influencing self-care could help for a full description of the phenomenon. A systematic evaluation of self-care in health professionals' everyday clinical practice is strongly recommended. The development of general non-disease-specific assessment tools could facilitate the evaluation of complex patients, especially those with multiple co-morbidities. Although self-care has been recognized as a vital intermediate outcome, further large-scale studies clarifying the association between self-care and patients' and health systems' outcomes are needed.

  6. Performance assessment for underground radioactive waste disposal systems

    International Nuclear Information System (INIS)

    1985-01-01

    A waste disposal system comprises a number of subsystems and components. The performance of most systems can be demonstrated only indirectly because of the long period that would be required to test them. This report gives special attention to performance assessment of subsystems within the total waste disposal system, and is an extension of an IAEA report on Safety Assessment for the Underground Disposal of Radioactive Wastes

  7. Self-assessed performance improves statistical fusion of image labels

    Energy Technology Data Exchange (ETDEWEB)

    Bryan, Frederick W., E-mail: frederick.w.bryan@vanderbilt.edu; Xu, Zhoubing; Asman, Andrew J.; Allen, Wade M. [Electrical Engineering, Vanderbilt University, Nashville, Tennessee 37235 (United States); Reich, Daniel S. [Translational Neuroradiology Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892 (United States); Landman, Bennett A. [Electrical Engineering, Vanderbilt University, Nashville, Tennessee 37235 (United States); Biomedical Engineering, Vanderbilt University, Nashville, Tennessee 37235 (United States); and Radiology and Radiological Sciences, Vanderbilt University, Nashville, Tennessee 37235 (United States)

    2014-03-15

    Purpose: Expert manual labeling is the gold standard for image segmentation, but this process is difficult, time-consuming, and prone to inter-individual differences. While fully automated methods have successfully targeted many anatomies, automated methods have not yet been developed for numerous essential structures (e.g., the internal structure of the spinal cord as seen on magnetic resonance imaging). Collaborative labeling is a new paradigm that offers a robust alternative that may realize both the throughput of automation and the guidance of experts. Yet, distributing manual labeling expertise across individuals and sites introduces potential human factors concerns (e.g., training, software usability) and statistical considerations (e.g., fusion of information, assessment of confidence, bias) that must be further explored. During the labeling process, it is simple to ask raters to self-assess the confidence of their labels, but this is rarely done and has not been previously quantitatively studied. Herein, the authors explore the utility of self-assessment in relation to automated assessment of rater performance in the context of statistical fusion. Methods: The authors conducted a study of 66 volumes manually labeled by 75 minimally trained human raters recruited from the university undergraduate population. Raters were given 15 min of training during which they were shown examples of correct segmentation, and the online segmentation tool was demonstrated. The volumes were labeled 2D slice-wise, and the slices were unordered. A self-assessed quality metric was produced by raters for each slice by marking a confidence bar superimposed on the slice. Volumes produced by both voting and statistical fusion algorithms were compared against a set of expert segmentations of the same volumes. Results: Labels for 8825 distinct slices were obtained. Simple majority voting resulted in statistically poorer performance than voting weighted by self-assessed performance

  8. Self-assessed performance improves statistical fusion of image labels

    International Nuclear Information System (INIS)

    Bryan, Frederick W.; Xu, Zhoubing; Asman, Andrew J.; Allen, Wade M.; Reich, Daniel S.; Landman, Bennett A.

    2014-01-01

    Purpose: Expert manual labeling is the gold standard for image segmentation, but this process is difficult, time-consuming, and prone to inter-individual differences. While fully automated methods have successfully targeted many anatomies, automated methods have not yet been developed for numerous essential structures (e.g., the internal structure of the spinal cord as seen on magnetic resonance imaging). Collaborative labeling is a new paradigm that offers a robust alternative that may realize both the throughput of automation and the guidance of experts. Yet, distributing manual labeling expertise across individuals and sites introduces potential human factors concerns (e.g., training, software usability) and statistical considerations (e.g., fusion of information, assessment of confidence, bias) that must be further explored. During the labeling process, it is simple to ask raters to self-assess the confidence of their labels, but this is rarely done and has not been previously quantitatively studied. Herein, the authors explore the utility of self-assessment in relation to automated assessment of rater performance in the context of statistical fusion. Methods: The authors conducted a study of 66 volumes manually labeled by 75 minimally trained human raters recruited from the university undergraduate population. Raters were given 15 min of training during which they were shown examples of correct segmentation, and the online segmentation tool was demonstrated. The volumes were labeled 2D slice-wise, and the slices were unordered. A self-assessed quality metric was produced by raters for each slice by marking a confidence bar superimposed on the slice. Volumes produced by both voting and statistical fusion algorithms were compared against a set of expert segmentations of the same volumes. Results: Labels for 8825 distinct slices were obtained. Simple majority voting resulted in statistically poorer performance than voting weighted by self-assessed performance

  9. Assessing vocational outcome expectancy in individuals with serious mental illness: a factor-analytic approach.

    Science.gov (United States)

    Iwanaga, Kanako; Umucu, Emre; Wu, Jia-Rung; Yaghmaian, Rana; Lee, Hui-Ling; Fitzgerald, Sandra; Chan, Fong

    2017-07-04

    Self-determination theory (SDT) and self-efficacy theory (SET) can be used to conceptualize self-determined motivation to engage in mental health and vocational rehabilitation (VR) services and to predict recovery. To incorporate SDT and SET as a framework for vocational recovery, developing and validating SDT/SET measures in vocational rehabilitation is warranted. Outcome expectancy is an important SDT/SET variable affecting rehabilitation engagement and recovery. The purpose of this study was to validate the Vocational Outcome Expectancy Scale (VOES) for use within the SDT/SET vocational recovery framework. One hundred and twenty-four individuals with serious mental illness (SMI) participated in this study. Measurement structure of the VOES was evaluated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Both EFA and CFA results supported a two-factor structure: (a) positive outcome expectancy, and (b) negative outcome expectancy. The internal consistency reliability coefficients for both factors were acceptable. In addition, positive outcome expectancy correlated stronger than negative outcome expectancy with other SDT/SET constructs in the expected directions. The VOES is a brief, reliable and valid instrument for assessing vocational outcome expectancy in individuals with SMI that can be integrated into SDT/SET as a vocational rehabilitation engagement and recovery model in psychiatric rehabilitation.

  10. Policy Goals and Outcomes In "Three Worlds of Welfare Capitalism"

    NARCIS (Netherlands)

    Headey, B.; Muffels, R.J.A.

    2003-01-01

    Measures of income mobility should be valuable for assessing performance in achieving national policy goals. We propose a portfolio of measures to assess policy goals relating to 1. economic growth and rising living standards 2. equality of opportunity 3. equality of outcomes 4. income security and

  11. Comparison of the outcomes for laparoscopic gastrectomy performed by the same surgeon between a low-volume hospital and a high-volume center.

    Science.gov (United States)

    Kim, Min Gyu; Kwon, Sung Joon

    2014-05-01

    The volume-outcome relationship in laparoscopic surgery is controversial. This study was designed to identify differences in laparoscopic gastrectomy outcomes between a low-volume hospital and a high-volume center and to provide guidelines for overcoming the problems associated with a low-volume hospital. From April 2009 to November 2012, one surgeon performed 134 totally laparoscopic distal gastrectomies (TLDGs) at a high-volume center (HVC; ASAN Medical Center) and at a low-volume hospital (LVH; Hanyang University Guri Hospital). All laparoscopically assisted gastrectomies were excluded from this study. During the early period of laparoscopic gastrectomy at the low-volume hospital, TLDG with Roux-en-Y gastrojejunostomy (RYGJ) was performed according to the surgeon's choice. The reconstruction method was classified as gastroduodenostomy (GD) or RYGJ. Early surgical outcomes achieved at the LVH were investigated and compared with those obtained at the HVC. The early surgical outcomes differed significantly between the two hospitals. In particular, the postoperative complication rate for the patients who underwent TLDG RYGJ at the LVH was higher than at the HVC (LVH 15.4 % vs. HVC 0 %; p = 0.037). Furthermore, significant differences were observed in the mean operation time (TLDG GD: LVH 141.0 min vs. HVC 117.4 min, p = 0.001; TLDG RYGJ: LVH 186.3 min vs. HVC 134.6 min, p = 0.009) and length of hospital stay (TLDG GD: LVH 8.1 days vs. HVC 7.2 days, p = 0.044; TLDG RYGJ: LVH 11.5 day vs. HVC 6.8 day, p = 0.009). Although all the operations were performed by one experienced surgeon, the early surgical outcomes differed significantly between the low- and high-volume hospitals. Low-volume hospitals often lack well-trained surgical professionals such as first assistants and scrub nurses. Therefore, the authors recommend that a surgeon who works at an LVH should assess potential personnel shortages and find a solution before operating.

  12. Identifying Barriers in Implementing Outcomes-Based Assessment Program Review: A Grounded Theory Analysis

    Science.gov (United States)

    Bresciani, Marilee J.

    2011-01-01

    The purpose of this grounded theory study was to identify the typical barriers encountered by faculty and administrators when implementing outcomes-based assessment program review. An analysis of interviews with faculty and administrators at nine institutions revealed a theory that faculty and administrators' promotion, tenure (if applicable),…

  13. Integrating place-specific livelihood and equity outcomes into global assessments of bioenergy deployment

    International Nuclear Information System (INIS)

    Creutzig, Felix; Corbera, Esteve; Bolwig, Simon; Hunsberger, Carol

    2013-01-01

    Integrated assessment models suggest that the large-scale deployment of bioenergy could contribute to ambitious climate change mitigation efforts. However, such a shift would intensify the global competition for land, with possible consequences for 1.5 billion smallholder livelihoods that these models do not consider. Maintaining and enhancing robust livelihoods upon bioenergy deployment is an equally important sustainability goal that warrants greater attention. The social implications of biofuel production are complex, varied and place-specific, difficult to model, operationalize and quantify. However, a rapidly developing body of social science literature is advancing the understanding of these interactions. In this letter we link human geography research on the interaction between biofuel crops and livelihoods in developing countries to integrated assessments on biofuels. We review case-study research focused on first-generation biofuel crops to demonstrate that food, income, land and other assets such as health are key livelihood dimensions that can be impacted by such crops and we highlight how place-specific and global dynamics influence both aggregate and distributional outcomes across these livelihood dimensions. We argue that place-specific production models and land tenure regimes mediate livelihood outcomes, which are also in turn affected by global and regional markets and their resulting equilibrium dynamics. The place-specific perspective suggests that distributional consequences are a crucial complement to aggregate outcomes; this has not been given enough weight in comprehensive assessments to date. By narrowing the gap between place-specific case studies and global models, our discussion offers a route towards integrating livelihood and equity considerations into scenarios of future bioenergy deployment, thus contributing to a key challenge in sustainability sciences. (letter)

  14. Integrating place-specific livelihood and equity outcomes into global assessments of bioenergy deployment

    Science.gov (United States)

    Creutzig, Felix; Corbera, Esteve; Bolwig, Simon; Hunsberger, Carol

    2013-09-01

    Integrated assessment models suggest that the large-scale deployment of bioenergy could contribute to ambitious climate change mitigation efforts. However, such a shift would intensify the global competition for land, with possible consequences for 1.5 billion smallholder livelihoods that these models do not consider. Maintaining and enhancing robust livelihoods upon bioenergy deployment is an equally important sustainability goal that warrants greater attention. The social implications of biofuel production are complex, varied and place-specific, difficult to model, operationalize and quantify. However, a rapidly developing body of social science literature is advancing the understanding of these interactions. In this letter we link human geography research on the interaction between biofuel crops and livelihoods in developing countries to integrated assessments on biofuels. We review case-study research focused on first-generation biofuel crops to demonstrate that food, income, land and other assets such as health are key livelihood dimensions that can be impacted by such crops and we highlight how place-specific and global dynamics influence both aggregate and distributional outcomes across these livelihood dimensions. We argue that place-specific production models and land tenure regimes mediate livelihood outcomes, which are also in turn affected by global and regional markets and their resulting equilibrium dynamics. The place-specific perspective suggests that distributional consequences are a crucial complement to aggregate outcomes; this has not been given enough weight in comprehensive assessments to date. By narrowing the gap between place-specific case studies and global models, our discussion offers a route towards integrating livelihood and equity considerations into scenarios of future bioenergy deployment, thus contributing to a key challenge in sustainability sciences.

  15. Comment Response on the Final Report: Peer Review of the Total System Performance Assessment-Viability Assessment (TSPA-VA)

    International Nuclear Information System (INIS)

    Pendleton, M. W.

    1999-01-01

    The Management and Operating Contractor established a Performance Assessment Peer Review Panel (hereinafter ''the Panel'') at the request of the U.S. Department of Energy Yucca Mountain Site Characterization Office. The objectives of the peer review were to provide: (1) A formal, independent evaluation and critique of Viability Assessment of a Repository at Yucca Mountain: Total System Performance Assessment, Volume 3 (DOE 1998a; hereinafter ''Total System Performance Assessment-Viability Assessment'') that was conducted in support of the Viability Assessment of a Repository at Yucca Mountain (DOE 1998b). (2) Suggestions for improvements as the U.S. Department of Energy prepares to develop the documentation for a Total System Performance Assessment to support a potential License Application. The Panel conducted a phased review over a two-year period to observe the development and, ultimately, to review the Total System Performance Assessment-Viability Assessment (DOE 1998a). During the development of the Total System Performance Assessment-Viability Assessment (DOE 1998a), the Panel submitted three Interim Reports (Whipple et al., 1997a, 1997b, and 1998) to the Management and Operating Contractor with recommendations and comments on the process models, model abstractions, and draft documentation for the Total System Performance Assessment-Viability Assessment (DOE 1998a). The Panel's Final Report Total System Performance Assessment Peer Review Panel (Whipple et al. 1999; hereinafter ''Final Report'') on the Total System Performance Assessment-Viability Assessment (DOE 1998a) is based primarily on the completed Total System Performance Assessment-Viability Assessment (DOE 1998a), the Total System Performance Assessment-Viability Assessment (TSPA-VA) Analyses Technical Basis Document (CRWMS M and O 1998), and the cited references. The Final Report (Whipple et al. 1999) includes the major points from the three Interim Reports (Whipple et al. 1997a, 1997b, and 1998

  16. Workplace-based assessment: raters' performance theories and constructs.

    Science.gov (United States)

    Govaerts, M J B; Van de Wiel, M W J; Schuwirth, L W T; Van der Vleuten, C P M; Muijtjens, A M M

    2013-08-01

    Weaknesses in the nature of rater judgments are generally considered to compromise the utility of workplace-based assessment (WBA). In order to gain insight into the underpinnings of rater behaviours, we investigated how raters form impressions of and make judgments on trainee performance. Using theoretical frameworks of social cognition and person perception, we explored raters' implicit performance theories, use of task-specific performance schemas and the formation of person schemas during WBA. We used think-aloud procedures and verbal protocol analysis to investigate schema-based processing by experienced (N = 18) and inexperienced (N = 16) raters (supervisor-raters in general practice residency training). Qualitative data analysis was used to explore schema content and usage. We quantitatively assessed rater idiosyncrasy in the use of performance schemas and we investigated effects of rater expertise on the use of (task-specific) performance schemas. Raters used different schemas in judging trainee performance. We developed a normative performance theory comprising seventeen inter-related performance dimensions. Levels of rater idiosyncrasy were substantial and unrelated to rater expertise. Experienced raters made significantly more use of task-specific performance schemas compared to inexperienced raters, suggesting more differentiated performance schemas in experienced raters. Most raters started to develop person schemas the moment they began to observe trainee performance. The findings further our understanding of processes underpinning judgment and decision making in WBA. Raters make and justify judgments based on personal theories and performance constructs. Raters' information processing seems to be affected by differences in rater expertise. The results of this study can help to improve rater training, the design of assessment instruments and decision making in WBA.

  17. Functional Performance and Associations between Performance Tests and Neurological Assessment Differ in Men and Women with Parkinson's Disease.

    Science.gov (United States)

    Medijainen, Kadri; Pääsuke, Mati; Lukmann, Aet; Taba, Pille

    2015-01-01

    Neurological assessment of a patient with Parkinson's disease (PD) is expected to reflect upon functional performance. As women are known to report more limitations even for same observed functional performance level, present study was designed to examine whether associations between neurological assessments and functional performance differ across genders. 14 men and 14 women with PD participated. Functional performance was assessed by measuring walking speeds on 10-meter walk test (10MWT) and by performing timed-up-and-go-test (TUG). Neurological assessment included Hoehn and Yahr Scale (HY), Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Schwab and England Activities of Daily Living Scale (S-E), and Mini Mental State Examination (MMSE). In women with PD, Kendall's tau-b correlation analyses revealed significant correlations between functional performance tests and neurological assessment measures, with the exception in MMSE. No corresponding associations were found for men, although they demonstrated better functional performance, as expected. Men in similar clinical stage of the PD perform better on functional tests than women. Disease severity reflects upon functional performance differently in men and women with PD. Results indicate that when interpreting the assessment results of both functional performance and neurological assessment tests, the gender of the patient should be taken into consideration.

  18. The outcome of the first 1000 cases of LASIK performed at the king Hussein Medical Center

    Energy Technology Data Exchange (ETDEWEB)

    Abdallat, W [King Hussein Medical Centre, Amman (Jordan). Dept. of Ophthalmology

    2011-07-01

    The current study evaluates the refractive and visual outcome of patients who had laser in situ keratomileusis (LASIK) performed at the refractive center at King Hussein Medical centre in Jordan. The predictability of LASIK surgery in terms of refractive and visual outcome results is very good with mild regression in refraction over time. (author).

  19. The outcome of the first 1000 cases of LASIK performed at the king Hussein Medical Center

    International Nuclear Information System (INIS)

    Abdallat, W

    2011-01-01

    The current study evaluates the refractive and visual outcome of patients who had laser in situ keratomileusis (LASIK) performed at the refractive center at King Hussein Medical centre in Jordan. The predictability of LASIK surgery in terms of refractive and visual outcome results is very good with mild regression in refraction over time. (author).

  20. Physician Performance Assessment: Prevention of Cardiovascular Disease

    Science.gov (United States)

    Lipner, Rebecca S.; Weng, Weifeng; Caverzagie, Kelly J.; Hess, Brian J.

    2013-01-01

    Given the rising burden of healthcare costs, both patients and healthcare purchasers are interested in discerning which physicians deliver quality care. We proposed a methodology to assess physician clinical performance in preventive cardiology care, and determined a benchmark for minimally acceptable performance. We used data on eight…

  1. Radioactive Waste Management Complex performance assessment: Draft

    Energy Technology Data Exchange (ETDEWEB)

    Case, M.J.; Maheras, S.J.; McKenzie-Carter, M.A.; Sussman, M.E.; Voilleque, P.

    1990-06-01

    A radiological performance assessment of the Radioactive Waste Management Complex at the Idaho National Engineering Laboratory was conducted to demonstrate compliance with appropriate radiological criteria of the US Department of Energy and the US Environmental Protection Agency for protection of the general public. The calculations involved modeling the transport of radionuclides from buried waste, to surface soil and subsurface media, and eventually to members of the general public via air, ground water, and food chain pathways. Projections of doses were made for both offsite receptors and individuals intruding onto the site after closure. In addition, uncertainty analyses were performed. Results of calculations made using nominal data indicate that the radiological doses will be below appropriate radiological criteria throughout operations and after closure of the facility. Recommendations were made for future performance assessment calculations.

  2. Radioactive Waste Management Complex performance assessment: Draft

    International Nuclear Information System (INIS)

    Case, M.J.; Maheras, S.J.; McKenzie-Carter, M.A.; Sussman, M.E.; Voilleque, P.

    1990-06-01

    A radiological performance assessment of the Radioactive Waste Management Complex at the Idaho National Engineering Laboratory was conducted to demonstrate compliance with appropriate radiological criteria of the US Department of Energy and the US Environmental Protection Agency for protection of the general public. The calculations involved modeling the transport of radionuclides from buried waste, to surface soil and subsurface media, and eventually to members of the general public via air, ground water, and food chain pathways. Projections of doses were made for both offsite receptors and individuals intruding onto the site after closure. In addition, uncertainty analyses were performed. Results of calculations made using nominal data indicate that the radiological doses will be below appropriate radiological criteria throughout operations and after closure of the facility. Recommendations were made for future performance assessment calculations

  3. Web-based questionnaires to assess perinatal outcome proved to be valid.

    Science.gov (United States)

    van Gelder, Marleen M H J; Vorstenbosch, Saskia; Derks, Lineke; Te Winkel, Bernke; van Puijenbroek, Eugène P; Roeleveld, Nel

    2017-10-01

    The objective of this study was to validate a Web-based questionnaire completed by the mother to assess perinatal outcome used in a prospective cohort study. For 882 women with an estimated date of delivery between February 2012 and February 2015 who participated in the PRegnancy and Infant DEvelopment (PRIDE) Study, we compared data on pregnancy outcome, including mode of delivery, plurality, gestational age, birth weight and length, head circumference, birth defects, and infant sex, from Web-based questionnaires administered to the mothers 2 months after delivery with data from obstetric records. For continuous variables, we calculated intraclass correlation coefficients (ICCs) with 95% confidence intervals (CIs), whereas sensitivity and specificity were determined for categorical variables. We observed only very small differences between the two methods of data collection for gestational age (ICC, 0.91; 95% CI, 0.90-0.92), birth weight (ICC, 0.96; 95% CI, 0.95-0.96), birth length (ICC, 0.90; 95% CI, 0.87-0.92), and head circumference (ICC, 0.88; 95% CI, 0.80-0.93). Agreement between the Web-based questionnaire and obstetric records was high as well, with sensitivity ranging between 0.86 (termination of pregnancy) and 1.00 (four outcomes) and specificity between 0.96 (term birth) and 1.00 (nine outcomes). Our study provides evidence that Web-based questionnaires could be considered as a valid complementary or alternative method of data collection. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Self- and peer-assessments of ambulance drivers' driving performance

    Directory of Open Access Journals (Sweden)

    Anna Sundström

    2012-07-01

    Full Text Available The aim of the present study was to develop and examine the quality of the Ambulance Driver Self-assessment Questionnaire (ADSQ and the Ambulance Driver Peer-assessment Questionnaire (ADPQ measuring aspects of, driving performance, driving style and driving competence. In addition the ADSQ measures self-reflection and safety-attitudes. The aim of the study was also to examine ambulance drivers' self- and peer-assessments as well as to examine the accuracy of self-assessments by comparing self-assessed and peer-assessed driving performance, driving style and competence. 76 ambulance drivers employed at two ambulance stations in northern Sweden completed ADSQ and ADPQ. Item analyses were conducted to examine the psychometric properties of the items, and based on the results some revisions were made to improve the questionnaires. The revised questionnaires were functioning rather well, although some subscale demonstrated low internal consistency. Subscale inter-correlations provided support for construct validity. Self- and peer-assessments indicated safe driving performance and good driver competence, which is positive from a traffic safety perspective. A comparison of mean self- and peer-assessment ratings, controlling for age, gender and driving experience showed no significant differences, except for the subscale overtaking. This indicates that ambulance drivers' self-assessments are realistic in most areas.

  5. [Reliability and validity of assessment of educational outcomes obtained by students of Medical Rescue at Medical University of Warsaw].

    Science.gov (United States)

    Panczyk, Mariusz; Stachacz, Grzegorz; Gałązkowski, Robert; Gotlib, Joanna

    2016-01-01

    In the interest of preservation of high degree of objectivity of information about students' educational outcomes, a system of assessment needs to meet criteria of appropriate reliability and validity. Analysis of reliability and validity of the system of assessment of students' educational outcomes for courses followed by an examination and covered by a curriculum in Medical Rescue at Medical University of Warsaw (MU W). A retrospective study enrolling a group of 421 students of eight subsequent full education cycles. Detailed data concerning grades for fourteen courses followed by an examination in the entire course of studies were collected. Reliability (Cronbach's alpha coefficient) and criteria validity (Spearman's rank correlation) were assessed. Internal consistency was estimated using a multiple regression model. The levels of assessment reliability for the general university, pre-clinical, and clinical scopes amounted to alpha: 0.42, 0.53, and 0.70, respectively. The strongest positive correlations between the results of pre-clinical and clinical trainings were found for the Anatomy course (r ≈ 0.30). Only in the case of the Pharmacology course it was found that students' achievements in this field were significantly correlated with all other courses of clinical training. The influence of educational outcomes in particular areas of clinical training on the final grade for the entire course of studies was diverse (β regression between 0.04 and 0.11). While the Pharmacology course had the strongest impact on final results, the Surgery course had the least influence on students' final grades (β = 0.04). 1. Sufficient reliability of the system of assessment of educational outcomes in Medical Rescue showed good precision and repeatability of assessment. 2. A low level of validity was caused by a failure to keep the appropriateness of the assessment of educational outcomes in several clinical courses. 3. Prognostic and diagnostic validity of methods used for

  6. Assessment of Postoperative Analgesic Drug Efficacy

    DEFF Research Database (Denmark)

    Andersen, Lars Peter Kloster; Gögenur, Ismail; Torup, Henrik

    2017-01-01

    BACKGROUND: Pain intensity ratings and opioid consumption (OC) are ubiquitous indicators of pain in postoperative trials of the efficacy of interventional procedures. Unfortunately, consensus on the appropriate statistical handling of these outcomes has not been reached. The aim of this article was......, therefore, to reexamine original data obtained from a postoperative analgesic drug trial, applying a collection of standard statistical methods in analgesic outcome assessments. Furthermore, a modified integrated assessment method of these outcomes was evaluated. METHODS: Data from a randomized, double...... also included an integrated assessment of longitudinally measured pain intensity and opioid consumption (PIOC0-6/0-24 h). Also, estimation of effect size, generalized odds ratio of the individual analgesic outcome variables was performed. RESULTS: Sixty-one patients were included in the final data...

  7. Measuring performance at trade shows

    DEFF Research Database (Denmark)

    Hansen, Kåre

    2004-01-01

    Trade shows is an increasingly important marketing activity to many companies, but current measures of trade show performance do not adequately capture dimensions important to exhibitors. Based on the marketing literature's outcome and behavior-based control system taxonomy, a model is built...... that captures a outcome-based sales dimension and four behavior-based dimensions (i.e. information-gathering, relationship building, image building, and motivation activities). A 16-item instrument is developed for assessing exhibitors perceptions of their trade show performance. The paper presents evidence...

  8. Regional Educational Performance Patterns in Europe

    Directory of Open Access Journals (Sweden)

    Péter Radó

    2011-01-01

    Full Text Available The paper aims to contribute to the assessment of the contextual relevance of various educational policies through an analysis of three aspects of the performance profiles of European countries: participation, the quality of learning outcomes and the equity of learning outcomes. Comparative analysis of international student achievement assessment surveys and statistical data reveals three European performance patterns: the compensative education systems of North and Northwest Europe, the selective education systems of Central Europe and the attritional education systems of Southeast Europe. On the basis of the identified performance patterns, the paper provides a brief outline of major trends within the Central and Southeast European regions, shares reflections on the alignment of policies that fit the distinct context of the two regions and offers a conceptual framework for further comparative research.

  9. Performance Funding Policy Effects on Community College Outcomes: Are Short-Term Certificates on the Rise?

    Science.gov (United States)

    Li, Amy Y.; Kennedy, Alec I.

    2018-01-01

    Objective: Performance funding (PF) policies allocate a portion of state funding to colleges based on student outcomes. This study is the first to account for policy type and design differences, and explores the impact of performance funding on three levels of credential completions: short-term certificates, medium-term certificates, and…

  10. Assessment of masticatory performance by means of a color-changeable chewing gum.

    Science.gov (United States)

    Tarkowska, Agnieszka; Katzer, Lukasz; Ahlers, Marcus Oliver

    2017-01-01

    Previous research determined the relevance of masticatory performance with regard to nutritional status, cognitive functions, or stress management. In addition, the measurement of masticatory efficiency contributes to the evaluation of therapeutic successes within the stomatognathic system. However, the question remains unanswered as to what extent modern techniques are able to reproduce the subtle differences in masticatory efficiency within various patient groups. The purpose of this review is to provide an extensive summary of the evaluation of masticatory performance by means of a color-changeable chewing gum with regard to its clinical relevance and applicability. A general overview describing the various methods available for this task has already been published. This review focuses in depth on the research findings available on the technique of measuring masticatory performance by means of color-changeable chewing gum. Described are the mechanism and the differentiability of the color change and methods to evaluate the color changes. Subsequently, research on masticatory performance is conducted with regard to patient age groups, the impact of general diseases and the effect of prosthetic and surgical treatment. The studies indicate that color-changeable chewing gum is a valid and reliable method for the evaluation of masticatory function. Apart from other methods, in clinical practice this technique can enhance dental diagnostics as well as the assessment of therapy outcomes. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  11. Performance processes within affect-related performance zones: a multi-modal investigation of golf performance.

    Science.gov (United States)

    van der Lei, Harry; Tenenbaum, Gershon

    2012-12-01

    Individual affect-related performance zones (IAPZs) method utilizing Kamata et al. (J Sport Exerc Psychol 24:189-208, 2002) probabilistic model of determining the individual zone of optimal functioning was utilized as idiosyncratic affective patterns during golf performance. To do so, three male golfers of a varsity golf team were observed during three rounds of golf competition. The investigation implemented a multi-modal assessment approach in which the probabilistic relationship between affective states and both, performance process and performance outcome, measures were determined. More specifically, introspective (i.e., verbal reports) and objective (heart rate and respiration rate) measures of arousal were incorporated to examine the relationships between arousal states and both, process components (i.e., routine consistency, timing), and outcome scores related to golf performance. Results revealed distinguishable and idiosyncratic IAPZs associated with physiological and introspective measures for each golfer. The associations between the IAPZs and decision-making or swing/stroke execution were strong and unique for each golfer. Results are elaborated using cognitive and affect-related concepts, and applications for practitioners are provided.

  12. Performance assessment for future low-level waste disposal facilities at ORNL

    International Nuclear Information System (INIS)

    Lee, D.W.; Kocher, D.C.

    1989-01-01

    This paper discusses the strategy for waste management on the Oak Ridge Reservation (ORR) and the approach to preparing future performance assessments that has evolved from previous performance assessment studies of low-level radioactive waste disposal on the ORR. The strategy for waste management is based on the concept that waste classification should be determined by performance assessment other than the sources of waste. This dose-based strategy for waste classification and management places special importance on the preparation and interpretation of waste disposal performance assessments for selecting appropriate disposal technologies and developing waste acceptance criteria. Additionally, the challenges to be overcome in the preparation of performance assessments are discussed. 7 refs

  13. Factors for Consideration in an Open-Flame Test for Assessing Fire Blocking Performance of Barrier Fabrics

    Directory of Open Access Journals (Sweden)

    Shonali Nazaré

    2016-09-01

    Full Text Available The main objective of the work reported here is to assess factors that could affect the outcome of a proposed open flame test for barrier fabrics (BF-open flame test. The BF-open flame test characterizes barrier effectiveness by monitoring the ignition of a flexible polyurethane foam (FPUF layer placed in contact with the upper side of the barrier fabric, exposed to a burner flame from below. Particular attention is given to the factors that influence the ignitibility of the FPUF, including thermal resistance, permeability, and structural integrity of the barrier fabrics (BFs. A number of barrier fabrics, displaying a wide range of the properties, are tested with the BF-open flame test. Visual observations of the FPUF burning behavior and BF char patterns, in addition to heat flux measurements on the unexposed side of the barrier fabrics, are used to assess the protective performance of the BF specimen under the open flame test conditions. The temperature and heat transfer measurements on the unexposed side of the BF and subsequent ranking of BFs for their thermal protective performance suggest that the BF-open flame test does not differentiate barrier fabrics based on their heat transfer properties. A similar conclusion is reached with regard to BF permeability characterized at room temperature. However, the outcome of this BF-open flame test is found to be heavily influenced by the structural integrity of thermally degraded BF. The BF-open flame test, in its current form, only ignited FPUF when structural failure of the barrier was observed.

  14. Self-perception versus professional assessment of functional outcome after ablative surgery in patients with oral cancer.

    Science.gov (United States)

    Beck-Broichsitter, Benedicta E; Huck, Jörn; Küchler, Thomas; Hauke, Daniela; Hedderich, Jürgen; Wiltfang, Jörg; Becker, Stephan T

    2017-02-01

    The extent of functional impairment after ablative surgery in the orofacial region may be directly reflected in a reduction in Quality of Life. This study intended to compare the patients' perception with an objective functional evaluation of the orofacial system in order to bilaterally distinguish direct influence factors. A total of 45 patients were included in this study and were asked to complete the European Organisation for Research and Treatment of Cancer Core Questionnaire (EORTC QLQ-30) and the Head and Neck 35 Module (H&N 35). Afterward one independent speech therapist evaluated the patients applying the Frenchay Dysarthria Assessment regarding four main categories: mouth opening, tongue motility, swallowing and intelligibility. Comparisons between groups were performed using Whitney-Mann U-Wilcoxon test and calculating Spearman's rho. Overall the professional assessments by the speech therapists revealed significantly higher scores regarding intelligibility, swallowing and mouth opening when compared to the patients' self-perception. Smaller tumor sizes, no bone resection and local reconstruction techniques led to significantly better functional outcomes, when assessed by speech therapists. Swallowing was perceived significantly better by patients in cases of local reconstruction. From the professionals' point of view differences were perceived in more items compared to the patients' self-assessments, who widely experienced a more severe functional impairment. Physicians should take this into account when discussing adverse therapy effects with the patients.

  15. Assessing students' learning outcomes, self-efficacy and attitudes toward the integration of virtual science laboratory in general physics

    Science.gov (United States)

    Ghatty, Sundara L.

    Over the past decade, there has been a dramatic rise in online delivery of higher education in the United States. Recent developments in web technology and access to the internet have led to a vast increase in online courses. For people who work during the day and whose complicated lives prevent them from taking courses on campus, online courses are the only alternatives by which they may achieve their goals in education. The laboratory courses are the major requirements for college and university students who want to pursue degree and certification programs in science. It is noted that there is a lack of laboratory courses in online physics courses. The present study addressed the effectiveness of a virtual science laboratory in physics instruction in terms of learning outcomes, attitudes, and self-efficacy of students in a Historically Black University College. The study included fifty-eight students (36 male and 22 female) of different science majors who were enrolled in a general physics laboratory course. They were divided into virtual and traditional groups. Three experiments were selected from the syllabus. The traditional group performed one experiment in a traditional laboratory, while the virtual group performed the same experiment in a virtual laboratory. For the second experiment, the use of laboratories by both groups was exchanged. Learner's Assessment Test (LAT), Attitudes Toward Physics Laboratories (ATPL), and Self-Efficacy Survey (SES) instruments were used. Additionally, quantitative methods such as an independent t-test, a paired t-test, and correlation statistics were used to analyze the data. The results of the first experiment indicated the learning outcomes were higher in the Virtual Laboratory than in the traditional laboratory, whereas there was no significant difference in learning outcomes with either type of lab instruction. However, significant self-efficacy gains were observed. Students expressed positive attitudes in terms of liking

  16. Machine performance assessment and enhancement for a hexapod machine

    Energy Technology Data Exchange (ETDEWEB)

    Mou, J.I. [Arizona State Univ., Tempe, AZ (United States); King, C. [Sandia National Labs., Livermore, CA (United States). Integrated Manufacturing Systems Center

    1998-03-19

    The focus of this study is to develop a sensor fused process modeling and control methodology to model, assess, and then enhance the performance of a hexapod machine for precision product realization. Deterministic modeling technique was used to derive models for machine performance assessment and enhancement. Sensor fusion methodology was adopted to identify the parameters of the derived models. Empirical models and computational algorithms were also derived and implemented to model, assess, and then enhance the machine performance. The developed sensor fusion algorithms can be implemented on a PC-based open architecture controller to receive information from various sensors, assess the status of the process, determine the proper action, and deliver the command to actuators for task execution. This will enhance a hexapod machine`s capability to produce workpieces within the imposed dimensional tolerances.

  17. The Influence of Investment in Workplace Learning on Learning Outcomes and Organizational Performance

    Science.gov (United States)

    Park, Yoonhee; Jacobs, Ronald L.

    2011-01-01

    Although the importance of workplace learning has been recognized in research and practice, there is little empirical support that describes how workplace learning, including both formal and informal learning, is linked to organizational performance. This study investigated the influence of investment in workplace learning on learning outcomes and…

  18. Analysis of Outcomes for High Tibial Osteotomies Performed With Cartilage Restoration Techniques.

    Science.gov (United States)

    Kahlenberg, Cynthia A; Nwachukwu, Benedict U; Hamid, Kamran S; Steinhaus, Michael E; Williams, Riley J

    2017-02-01

    To evaluate reported medium- to long-term outcomes after high tibial osteotomy (HTO) with associated cartilage restoration procedures. A review of the MEDLINE database was performed. The inclusion criteria were English language, clinical outcome study with HTO as the primary procedure, use of a form of cartilage repair included, and the mean follow-up period of at least 2 years. Each identified study was reviewed for study design, patient demographics, type of procedures performed, clinical outcomes, progression to total knee arthroplasty, and complications. Eight hundred and twenty-seven patients (839 knees) were included. The most common cartilage preservation technique used in conjunction with HTO was microfracture (4 studies; 22.2%). The mean Lyscholm scores, reported in 50% of the studies, ranged from 40 to 65.7 preoperatively and improved to a range of 67 to 94.6 postoperatively. Four studies (22.2%) used a visual analog scale for evaluation of pain and all had a mean visual analog scale of less than 3 postoperatively. Among studies evaluating conversion to arthroplasty, the rate of conversion was 6.8% and the range of mean number of years from HTO to conversion was 4.9 to 13.0. The overall reported complication rate was 10.3%. HTO with cartilage restoration procedures provides reliable improvement in functional status in the medium- to long-term period after surgery and has potential to delay or avoid the need for knee arthroplasty surgery. Level IV, systematic review of Level I to IV studies. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  19. The role of employee HR attributions in the relationship between high-performance work systems and employee outcomes

    NARCIS (Netherlands)

    van de Voorde, F.C.; Beijer, Susanne

    2015-01-01

    Although research has shown that the use of high-performance work systems (HPWS) is associated with employee outcomes, our knowledge of the meanings employees attach to HPWS systems and how these shape employee outcomes is still limited. This study examines the signalling impact of enacted HPWS on

  20. The Waste Isolation Pilot Plant Performance Assessment Program

    International Nuclear Information System (INIS)

    Myers, J.; Coons, W.E.; Eastmond, R.; Morse, J.; Chakrabarti, S.; Zurkoff, J.; Colton, I.D.; Banz, I.

    1986-01-01

    The Waste Isolation Pilot Plant (WIPP) Performance Assessment Program involves a comprehensive analysis of the WIPP project with respect to the recently finalized Environmental Protection Agency regulations regarding the long-term geologic isolation of radioactive wastes. The performance assessment brings together the results of site characterization, underground experimental, and environmental studies into a rigorous determination of the performance of WIPP as a disposal system for transuranic radioactive waste. The Program consists of scenario development, geochemical, hydrologic, and thermomechanical support analyses and will address the specific containment and individual protection requirements specified in 40 CFR 191 sub-part B. Calculated releases from these interrelated analyses will be reported as an overall probability distribution of cumulative release resulting from all processes and events occurring over the 10,000 year post-closure period. In addition, results will include any doses to the public resulting from natural processes occurring over the 1,000 year post-closure period. The overall plan for the WIPP Performance Assessment Program is presented along with approaches to issues specific to the WIPP project

  1. An empowerment intervention for Indigenous communities: an outcome assessment.

    Science.gov (United States)

    Kinchin, Irina; Jacups, Susan; Tsey, Komla; Lines, Katrina

    2015-08-21

    Empowerment programs have been shown to contribute to increased empowerment of individuals and build capacity within the community or workplace. To-date, the impact of empowerment programs has yet to be quantified in the published literature in this field. This study assessed the Indigenous-developed Family Wellbeing (FWB) program as an empowerment intervention for a child safety workforce in remote Indigenous communities by measuring effect sizes. The study also assessed the value of measurement tools for future impact evaluations. A three-day FWB workshop designed to promote empowerment and workplace engagement among child protection staff was held across five remote north Queensland Indigenous communities. The FWB assessment tool comprised a set of validated surveys including the Growth and Empowerment Measure (GEM), Australian Unity Wellbeing Index, Kessler psychological distress scale (K10) and Workforce engagement survey. The assessment was conducted pre-intervention and three months post-intervention. The analysis of pre-and post-surveys revealed that the GEM appeared to be the most tangible measure for detecting positive changes in communication, conflict resolution, decision making and life skill development. The GEM indicated a 17 % positive change compared to 9 % for the Australian Unity Wellbeing Index, 5 % for the workforce engagement survey and less than 1 % for K10. This study extended qualitative research and identified the best measurement tool for detecting the outcomes of empowerment programs. The GEM was found the most sensitive and the most tangible measure that captures improvements in communication, conflict resolution, decision making and life skill development. The GEM and Australian Unity Wellbeing Index could be recommended as routine measures for empowerment programs assessment among similar remote area workforce.

  2. Immediate outcome indicators in perioperative care: a controlled intervention study on quality improvement in hospitals in Tanzania.

    Science.gov (United States)

    Bosse, Goetz; Mtatifikolo, Ferdinand; Abels, Wiltrud; Strosing, Christian; Breuer, Jan-Philipp; Spies, Claudia

    2013-01-01

    Outcome assessment is the standard for evaluating the quality of health services worldwide. In this study, outcome has been divided into immediate and final outcome. Aim was to compare an intervention hospital with a Continuous Quality Improvement approach to a control group using benchmark assessments of immediate outcome indicators in surgical care. Results were compared to final outcome indicators. Surgical care quality in six hospitals in Tanzania was assessed from 2006-2011, using the Hospital Performance Assessment Tool. Independent observers assessed structural, process and outcome quality using checklists based on evidence-based guidelines. The number of surgical key procedures over the benchmark of 80% was compared between the intervention hospital and the control group. Results were compared to Case Fatality Rates. In the intervention hospital, in 2006, two of nine key procedures reached the benchmark, one in 2009, and four in 2011. In the control group, one of nine key procedures reached the benchmark in 2006, one in 2009, and none in 2011. Case Fatality Rate for all in-patients in the intervention hospital was 5.5% (n = 12,530) in 2006, 3.5% (n = 21,114) in 2009 and 4.6% (n = 18,840) in 2011. In the control group it was 3.1% (n = 17,827) in 2006, 4.2% (n = 13,632) in 2009 and 3.8% (n = 17,059) in 2011. Results demonstrated that quality assurance improved performance levels in both groups. After the introduction of Continuous Quality Improvement, performance levels improved further in the intervention hospital while quality in the district hospital did not. Immediate outcome indicators appeared to be a better steering tool for quality improvement compared to final outcome indicators. Immediate outcome indicators revealed a need for improvement in pre- and postoperative care. Quality assurance programs based on immediate outcome indicators can be effective if embedded in Continuous Quality Improvement. Nevertheless, final outcome

  3. Performance objectives for the Hanford immobilized low-activity waste (ILAW) performance assessment

    International Nuclear Information System (INIS)

    MANN, F.M.

    1999-01-01

    Before low-level waste may be disposed of, a performance assessment must be written and then approved by the DOE (DOE 1988a, DOE 1999a). The performance assessment is to determine whether ''reasonable assurance'' exists that the performance objectives of the disposal facility will be met. The DOE requirements for waste disposal (DOE 1988a, DOE 1999a) require (see Appendix B): The protection of public health and safety; and The protection of the environment. Although quantitative limits are sometimes stated (for example, the all-pathways exposure limit is 25 mredyear), usually the requirements are stated in a general nature. Quantitative limits were established by: investigating all potentially applicable regulations as well as interpretations of the review panels which DOE has established to review performance assessments; interacting with program management to establish the additional requirements of the program; and interacting with the public (i.e., the Hanford Advisory Board members; as well as affected Tribal Governments) to understand the values of residents in the Pacific Northwest. Because of space considerations, not all radionuclides and dangerous chemicals are listed in this document. The radionuclides listed here are those which were explicitly treated in the ILAW PA (Mann 1998). The dangerous chemicals listed here are those most often detected in Hanford tank waste as documented in the Regulatory Data Quality Objectives Supporting Tank Waste Remediation System Privatization Project (Wiemers 1998)

  4. A Paradigm for Student Learning Outcome Assessment in Information Systems Education: Continuous Improvement or Chasing Rainbows?

    Science.gov (United States)

    Saulnier, Bruce

    2014-01-01

    A paradigm is presented for student learning outcome assessment in information systems education. Successful deployment of the paradigm is illustrated using the author's home institution. The paradigm is consistent with both the scholarship of teaching and learning and the scholarship of assessment. It is concluded that the deployment of the…

  5. The Harmonising Outcome Measures for Eczema (HOME) statement to assess clinical signs of atopic eczema in trials.

    Science.gov (United States)

    Schmitt, Jochen; Spuls, Phyllis I; Thomas, Kim S; Simpson, Eric; Furue, Masutaka; Deckert, Stefanie; Dohil, Magdalene; Apfelbacher, Christian; Singh, Jasvinder A; Chalmers, Joanne; Williams, Hywel C

    2014-10-01

    The lack of core outcome sets for atopic eczema (AE) is a major obstacle for advancing evidence-based treatment. The global Harmonising Outcome Measures for Eczema (HOME) initiative has already defined clinical signs, symptoms, quality of life, and long-term control of flares as core outcome domains for AE trials. This article deals with the standardization of measurement instruments to assess clinical signs of AE. To resolve the current lack of standardization of the assessment of clinical signs of AE, we followed a structured process of systematic reviews and international consensus sessions to identify 1 core outcome measurement instrument for assessment of clinical signs in all future AE trials. Systematic reviews indicated that from 16 different instruments identified to assess clinical signs of AE, only the Eczema Area and Severity Index (EASI) and the objective Scoring Atopic Dermatitis (SCORAD) index were identified as extensively validated. The EASI has adequate validity, responsiveness, internal consistency, and intraobserver reliability. The objective SCORAD index has adequate validity, responsiveness, and interobserver reliability but unclear intraobserver reliability to measure clinical signs of AE. In an international consensus study, patients, physicians, nurses, methodologists, and pharmaceutical industry representatives agreed that the EASI is the preferred core instrument to measure clinical signs in all future AE trials. All stakeholders involved in designing, reporting, and using clinical trials on AE are asked to comply with this consensus to enable better evidence-based decision making, clearer scientific communication, and improved patient care. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  6. The Effects of Low Birth Weight on School Performance and Behavioral Outcomes of Elementary School Children in Oman

    Directory of Open Access Journals (Sweden)

    M. Mazharul Islam

    2015-07-01

    Full Text Available Objectives: Our study aimed to examine the effects of low birth weight (LBW on the school performance and behavior of elementary school children in Oman. Methods: Data were gathered through a cross-sectional survey of nine elementary schools from the Muscat and A’Dhahirah regions. The study utilized a unique database created by linking information from the children’s health cards and current academic and behavioral performance records. Information on children’s performance in various areas such as language, mathematics, science, information technology, sports, and behavior were obtained from the school registers. Birth weight (BW and selected sociodemographic data were obtained from the copy of their health cards kept by each school. A total of 542 elementary school children aged 7–11 years, who had completed grades 2–4, were surveyed.  Results: Data from the school register revealed a very high rate (17.7% of LBW and, overall, 12% of the children exhibited below average performance on selected outcome measures. The below average school performance varied from 5–17% across the six selected areas of school performance. The highest rate of below average performance was observed in science (17%, followed by arithmetic and language (16% each. BW showed significant differential effects on school performance and behavioral outcomes, which remained significant after controlling for the effect of potential confounders. It was found that LBW children were 2–6 times more likely to have poorer school performance in all areas than their normal BW peers. Conclusion: Early intervention programs or special care for LBW children in school could be an effective means of improving educational outcomes and the behavior of these children. Attempts should be made to reduce or prevent poor pregnancy outcomes, which, in turn, would reduce the cost of the health, education, and social services systems.

  7. An evaluation of community assessment tools (CATs in predicting use of clinical interventions and severe outcomes during the A(H1N1pdm09 pandemic.

    Directory of Open Access Journals (Sweden)

    Malcolm G Semple

    Full Text Available During severe influenza pandemics healthcare demand can exceed clinical capacity to provide normal standards of care. Community Assessment Tools (CATs could provide a framework for triage decisions for hospital referral and admission. CATs have been developed based on evidence that supports the recognition of severe influenza and pneumonia in the community (including resource limited settings for adults, children and infants, and serious feverish illness in children. CATs use six objective criteria and one subjective criterion, any one or more of which should prompt urgent referral and admission to hospital. A retrospective evaluation of the ability of CATs to predict use of hospital-based interventions and patient outcomes in a pandemic was made using the first recorded routine clinical assessment on or shortly after admission from 1520 unselected patients (800 female, 480 children <16 years admitted with PCR confirmed A(H1N1pdm09 infection (the FLU-CIN cohort. Outcome measures included: any use of supplemental oxygen; mechanical ventilation; intravenous antibiotics; length of stay; intensive or high dependency care; death; and "severe outcome" (combined: use of intensive or high dependency care or death during admission. Unadjusted and multivariable analyses were conducted for children (age <16 years and adults. Each CATs criterion independently identified both use of clinical interventions that would in normal circumstances only be provided in hospital and patient outcome measures. "Peripheral oxygen saturation ≤ 92% breathing air, or being on oxygen" performed well in predicting use of resources and outcomes for both adults and children; supporting routine measurement of peripheral oxygen saturation when assessing severity of disease. In multivariable analyses the single subjective criterion in CATs "other cause for clinical concern" independently predicted death in children and in adults predicted length of stay, mechanical ventilation

  8. Clinical Outcomes Used in Clinical Pharmacy Intervention Studies in Secondary Care

    Directory of Open Access Journals (Sweden)

    Lene Juel Kjeldsen

    2017-05-01

    Full Text Available The objective was to investigate type, frequency and result of clinical outcomes used in studies to assess the effect of clinical pharmacy interventions in inpatient care. The literature search using Pubmed.gov was performed for the period up to 2013 using the search phrases: “Intervention(s” and “pharmacist(s” and “controlled” and “outcome(s” or “effect(s”. Primary research studies in English of controlled, clinical pharmacy intervention studies, including outcome evaluation, were selected. Titles, abstracts and full-text papers were assessed individually by two reviewers, and inclusion was determined by consensus. In total, 37 publications were included in the review. The publications presented similar intervention elements but differed in study design. A large variety of outcome measures (135 had been used to evaluate the effect of the interventions; most frequently clinical measures/assessments by physician and health care service use. No apparent pattern was established among primary outcome measures with significant effect in favour of the intervention, but positive effect was most frequently related to studies that included power calculations and sufficient inclusion of patients (73% vs. 25%. This review emphasizes the importance of considering the relevance of outcomes selected to assess clinical pharmacy interventions and the importance of conducting a proper power calculation.

  9. Could Learning Outcomes of the First Course in Accounting Predict Overall Academic Performance?

    Science.gov (United States)

    Alanzi, Khalid A.; Alfraih, Mishari M.

    2017-01-01

    Purpose: This study aims to question whether learning outcomes of the first course in accounting could predict the overall academic performance of accounting students as measured by their graduating grade point average (GPA). Design/methodology/approach The sample of the present study was drawn from accounting students who were graduated during…

  10. Assessing Patient-Reported Outcomes Following Orthognathic Surgery and Osseous Genioplasty.

    Science.gov (United States)

    Schwitzer, Jonathan A; Albino, Frank P; Mathis, Ryan K; Scott, Amie M; Gamble, Laurie; Baker, Stephen B

    2015-11-01

    Primary outcomes for orthognathic surgery and genioplasty patients include satisfaction with appearance, improved motor function, and enhanced quality of life. The goal of this study was to assess outcomes among patients undergoing these procedures, and to highlight the potential use of FACE-Q instrument for use in patients with dentofacial deformities. A total of 56 patients presenting for orthognathic surgery and/or osseous genioplasty completed the FACE-Q during preoperative and/or at postoperative visits. FACE-Q scores increased following surgery in satisfaction with facial appearance overall (+24.5, P jawline (+40.7, P < 0.01), and in all satisfaction with chin items (profile, prominence, shape, and overall). Patients also demonstrated increased social confidence (+8.9, P = 0.29). There was no improvement in psychologic well-being (-0.8, P = 0.92). All 3 surgical groups of patients experienced gains in satisfaction with appearance following surgery. Patients who underwent orthognathic surgery either alone or in combination with genioplasty demonstrated statistically significant improvements in satisfaction with facial appearance overall (P < 0.01 for both groups), whereas patients who underwent genioplasty alone did not (P = 0.13). In addition, patients who underwent orthognathic surgery combined with genioplasty demonstrated greater improvement in satisfaction with chin than patients who underwent genioplasty alone. In conclusion, patients who underwent orthognathic surgery and/or genioplasty demonstrated improvement in appearance and social confidence. The use of this model supports the successful outcomes possible for patients undergoing these procedures.

  11. Low-level waste disposal performance assessments - Total source-term analysis

    Energy Technology Data Exchange (ETDEWEB)

    Wilhite, E.L.

    1995-12-31

    Disposal of low-level radioactive waste at Department of Energy (DOE) facilities is regulated by DOE. DOE Order 5820.2A establishes policies, guidelines, and minimum requirements for managing radioactive waste. Requirements for disposal of low-level waste emplaced after September 1988 include providing reasonable assurance of meeting stated performance objectives by completing a radiological performance assessment. Recently, the Defense Nuclear Facilities Safety Board issued Recommendation 94-2, {open_quotes}Conformance with Safety Standards at Department of Energy Low-Level Nuclear Waste and Disposal Sites.{close_quotes} One of the elements of the recommendation is that low-level waste performance assessments do not include the entire source term because low-level waste emplaced prior to September 1988, as well as other DOE sources of radioactivity in the ground, are excluded. DOE has developed and issued guidance for preliminary assessments of the impact of including the total source term in performance assessments. This paper will present issues resulting from the inclusion of all DOE sources of radioactivity in performance assessments of low-level waste disposal facilities.

  12. Development of VIPER: a simulator for assessing vision performance of warfighters

    Science.gov (United States)

    Familoni, Jide; Thompson, Roger; Moyer, Steve; Mueller, Gregory; Williams, Tim; Nguyen, Hung-Quang; Espinola, Richard L.; Sia, Rose K.; Ryan, Denise S.; Rivers, Bruce A.

    2016-05-01

    Background: When evaluating vision, it is important to assess not just the ability to read letters on a vision chart, but also how well one sees in real life scenarios. As part of the Warfighter Refractive Eye Surgery Program (WRESP), visual outcomes are assessed before and after refractive surgery. A Warfighter's ability to read signs and detect and identify objects is crucial, not only when deployed in a military setting, but also in their civilian lives. Objective: VIPER, a VIsion PERformance simulator was envisioned as actual video-based simulated driving to test warfighters' functional vision under realistic conditions. Designed to use interactive video image controlled environments at daytime, dusk, night, and with thermal imaging vision, it simulates the experience of viewing and identifying road signs and other objects while driving. We hypothesize that VIPER will facilitate efficient and quantifiable assessment of changes in vision and measurement of functional military performance. Study Design: Video images were recorded on an isolated 1.1 mile stretch of road with separate target sets of six simulated road signs and six objects of military interest, separately. The video footage were integrated with customdesigned C++ based software that presented the simulated drive to an observer on a computer monitor at 10, 20 or 30 miles/hour. VIPER permits the observer to indicate when a target is seen and when it is identified. Distances at which the observer recognizes and identifies targets are automatically logged. Errors in recognition and identification are also recorded. This first report describes VIPER's development and a preliminary study to establish a baseline for its performance. In the study, nine soldiers viewed simulations at 10 miles/hour and 30 miles/hour, run in randomized order for each participant seated at 36 inches from the monitor. Relevance: Ultimately, patients are interested in how their vision will affect their ability to perform daily

  13. Performance on naturalistic virtual reality tasks depends on global cognitive functioning as assessed via traditional neurocognitive tests.

    Science.gov (United States)

    Oliveira, Jorge; Gamito, Pedro; Alghazzawi, Daniyal M; Fardoun, Habib M; Rosa, Pedro J; Sousa, Tatiana; Picareli, Luís Felipe; Morais, Diogo; Lopes, Paulo

    2017-08-14

    This investigation sought to understand whether performance in naturalistic virtual reality tasks for cognitive assessment relates to the cognitive domains that are supposed to be measured. The Shoe Closet Test (SCT) was developed based on a simple visual search task involving attention skills, in which participants have to match each pair of shoes with the colors of the compartments in a virtual shoe closet. The interaction within the virtual environment was made using the Microsoft Kinect. The measures consisted of concurrent paper-and-pencil neurocognitive tests for global cognitive functioning, executive functions, attention, psychomotor ability, and the outcomes of the SCT. The results showed that the SCT correlated with global cognitive performance as measured with the Montreal Cognitive Assessment (MoCA). The SCT explained one third of the total variance of this test and revealed good sensitivity and specificity in discriminating scores below one standard deviation in this screening tool. These findings suggest that performance of such functional tasks involves a broad range of cognitive processes that are associated with global cognitive functioning and that may be difficult to isolate through paper-and-pencil neurocognitive tests.

  14. Methodology for assessing performance of waste management systems

    International Nuclear Information System (INIS)

    Meshkov, N.K.; Herzenberg, C.L.; Camasta, S.F.

    1988-01-01

    The newly revised draft DOE Order 5820.2, Chapter 3, requires that DOE low-level waste shall be managed on a systematic basis using the most appropriate combination of waste generation reduction, segregation, treatment, and disposal practices so that the radioactive components are contained and the overall cost effectiveness is minimized. This order expects each site to prepare and maintain an overall waste management systems performance assessment supporting the combination of waste management practices used in generation reduction segregation, treatment, packaging, storage, and disposal. A document prepared by EG and G Idaho, Inc. for the Department of Energy called Guidance for Conduct of Waste Management Systems Performance Assessment is specifically intended to provide the approach necessary to meet the systems performance assessment requirement of DOE Order 5820.2, Chapter 3, and other applicable state regulations dealing with LLW (low-level radioactive wastes). Methods and procedures are needed for assessing the performance of a waste management system. This report addresses this need. The purpose of the methodology provided in this report is to select the optimal way to manage particular sets of waste streams from generation to disposal in a safe and cost-effective manner, and thereby assist the DOE LLW mangers in complying with the DOE Order 5820.2, Chapter 3, and the associated guidance document

  15. THE IMPACT OF EMPLOYEE-ORGANIZATION RELATIONSHIP ON INDIVIDUALS’ BEHAVIORAL OUTCOMES OF TASK-RELATED PERFORMANCE, CONTEXTUAL PERFORMANCE AND INTENTION TO TURNOVER: AN EVALUATION WITH SOCIAL EXCHANGE THEORY

    Directory of Open Access Journals (Sweden)

    Seçil BAL TAŞTAN

    2014-01-01

    Full Text Available THE IMPACT OF EMPLOYEE-ORGANIZATION RELATIONSHIP ON INDIVIDUALS’ BEHAVIORAL OUTCOMES OF TASK-RELATED PERFORMANCE, CONTEXTUAL PERFORMANCE AND INTENTION TO TURNOVER: AN EVALUATION WITH SOCIAL EXCHANGE THEORY

  16. Women referred for occupational risk assessment in pregnancy have no increased risk of adverse obstetric outcomes

    DEFF Research Database (Denmark)

    Bidstrup, Signe Brøker; Kaerlev, Linda; Thulstrup, Ane Marie

    2015-01-01

    .72-1.17). CONCLUSION: The women who are referred for occupational risk assessment at two large occupational university departments are not at an increased risk of preterm birth or of delivering low birth weight children. This may reflect that reproductive hazards in Danish workplaces are limited and......INTRODUCTION: Our aim was to study the association between pregnant women's referral status for occupational risk assessment, and their risk of preterm delivery (... pregnant women referred to two Danish clinics of occupational medicine (Copenhagen and Aarhus) from 1984 to 2010 were compared with the referred women's 1,077 non-referred pregnancy outcomes and with the pregnancy outcomes of 345,467 gainfully employed women from the same geographical areas and time period...

  17. Retrofit Weight-Loss Outcomes at 6, 12, and 24 Months and Characteristics of 12-Month High Performers: A Retrospective Analysis.

    Science.gov (United States)

    Painter, Stefanie; Ditsch, Gary; Ahmed, Rezwan; Hanson, Nicholas Buck; Kachin, Kevin; Berger, Jan

    2016-08-22

    Obesity is the leading cause of preventable death costing the health care system billions of dollars. Combining self-monitoring technology with personalized behavior change strategies results in clinically significant weight loss. However, there is a lack of real-world outcomes in commercial weight-loss program research. Retrofit is a personalized weight management and disease-prevention solution. This study aimed to report Retrofit's weight-loss outcomes at 6, 12, and 24 months and characterize behaviors, age, and sex of high-performing participants who achieved weight loss of 10% or greater at 12 months. A retrospective analysis was performed from 2011 to 2014 using 2720 participants enrolled in a Retrofit weight-loss program. Participants had a starting body mass index (BMI) of >25 kg/m² and were at least 18 years of age. Weight measurements were assessed at 6, 12, and 24 months in the program to evaluate change in body weight, BMI, and percentage of participants who achieved 5% or greater weight loss. A secondary analysis characterized high-performing participants who lost ≥10% of their starting weight (n=238). Characterized behaviors were evaluated, including self-monitoring through weigh-ins, number of days wearing an activity tracker, daily step count average, and engagement through coaching conversations via Web-based messages, and number of coaching sessions attended. Average weight loss at 6 months was -5.55% for male and -4.86% for female participants. Male and female participants had an average weight loss of -6.28% and -5.37% at 12 months, respectively. Average weight loss at 24 months was -5.03% and -3.15% for males and females, respectively. Behaviors of high-performing participants were assessed at 12 months. Number of weigh-ins were greater in high-performing male (197.3 times vs 165.4 times, P=.001) and female participants (222 times vs 167 times, Pactivity tracker days and average steps per day were greater in high-performing females (304.7 vs

  18. Intraoperative performance and longterm outcome of phacoemulsification in age-related cataract.

    Directory of Open Access Journals (Sweden)

    Dholakia Sheena

    2004-01-01

    Full Text Available PURPOSE: To evaluate intraoperative performance and longterm surgical outcome after phacoemulsification of age-related cataracts. METHODS: Prospective, observational, non-comparative study of 165 consecutive eyes undergoing phacoemulsification with nuclear sclerosis Grade I to III (Scale I to V. Preoperative evaluation included specular microscopy. Phacoemulsification was performed by a single surgeon using a standardised surgical technique under topical anaesthesia. Intraoperatively, effective phaco time (EPT, wound site thermal injury (WSTI, serious complications (eg. vitreous loss, posterior capsule rupture, zonulolysis and intraoperative posterior capsule opacification (plaque were evaluated. Postoperatively, posterior capsule opacification (PCO, Neodymium:YAG (Nd:YAG laser posterior capsulotomy rate, corneal endothelial count, best corrected visual acuity and cystoid macular oedema were evaluated. Eyes were examined at 6 months and then yearly for 3 years. RESULTS: Mean ages of 78 males and 87 females were 59.12 +/- 8.56 and 58.34 +/- 7.45 years respectively. EPT was 36 +/- 19 seconds and WSTI occurred in 7 eyes (4.7%. No serious intraocular complications occurred. Intraoperative posterior capsule opacification (plaque was present in 21 eyes (13.93%. Postoperatively, PCO occurred in 8 eyes (4.84% and Nd:YAG laser posterior capsulotomy was performed in 3 eyes (1.8%. Endothelial cell loss was 7.1% at 3 years follow-up. At the end of 3 years follow-up, 146 eyes (88.89% maintained a best corrected visual acuity of > or = 6/12. Cystoid macular oedema did not occur in any eye at 1 and 6 months′ follow-up. CONCLUSION: PCO rates and endothelial cell loss were acceptable. Consistent and reproducible outcome can be obtained after phacoemulsification of age related cataracts (grade I to III.

  19. Communication skills training for physicians performing work disability assessments increases knowledge and self-efficacy: results of a randomised controlled trial.

    Science.gov (United States)

    van Rijssen, Jolanda; Schellart, Antonius J M; Anema, Johannes R; van der Beek, Allard J

    2015-07-21

    It was assessed whether a post-graduate communication skills training course would increase physicians' competence and knowledge with regard to communication during work disability assessment interviews, and would change the determinants of their communication behaviour. A randomised controlled trial was performed. At baseline and at follow-up, 42 physicians completed questionnaires. The primary outcome measures were competence and knowledge about communication. The secondary outcome measures were 21 self-reported determinants of communication behaviour. One-way analyses of variance and covariance were performed. There was no significant difference between the intervention and control groups in overall competence, but there was for the introduction phase (intervention: mean = 7.0, SD 2.7; control: mean = 4.8, SD 2.7; p = 0.014). Knowledge about communication was significantly higher (p = 0.001) in the intervention group (mean = 79.6, SD 9.2) than in the control group (mean = 70.9, SD 6.7), especially concerning the information-gathering phase of the interview (intervention: mean = 80.0, SD 10.2; control: mean = 69.4, SD 8.9; p = 0.001). The intervention group scored significantly better on 7 of the 21 self-reported determinants (secondary outcomes), including self-efficacy, intentions, skills and knowledge. The communication skills training course may improve some aspects of physician communication, but not all. Because physicians were unanimously positive about the course, further development is warranted. Implications for Rehabilitation Even though optimal communication is essential in face-to-face assessment interviews for determining entitlement to work disability benefits, and there is a lot at stake for the claimants, this issue has scarcely been addressed in scientific research. A tailor-made two-day communication skills training course, based on scientific research, increases physicians' knowledge about communication

  20. Performance Standards': Utility for Different Uses of Assessments

    Directory of Open Access Journals (Sweden)

    Robert L. Linn

    2003-09-01

    Full Text Available Performance standards are arguably one of the most controversial topics in educational measurement. There are uses of assessments such as licensure and certification where performance standards are essential. There are many other uses, however, where performance standards have been mandated or become the preferred method of reporting assessment results where the standards are not essential to the use. Distinctions between essential and nonessential uses of performance standards are discussed. It is argued that the insistence on reporting in terms of performance standards in situations where they are not essential has been more harmful than helpful. Variability in the definitions of proficient academic achievement by states for purposes of the No Child Left Behind Act of 2001 is discussed and it is argued that the variability is so great that characterizing achievement is meaningless. Illustrations of the great uncertainty in standards are provided.

  1. Web-based application on employee performance assessment using exponential comparison method

    Science.gov (United States)

    Maryana, S.; Kurnia, E.; Ruyani, A.

    2017-02-01

    Employee performance assessment is also called a performance review, performance evaluation, or assessment of employees, is an effort to assess the achievements of staffing performance with the aim to increase productivity of employees and companies. This application helps in the assessment of employee performance using five criteria: Presence, Quality of Work, Quantity of Work, Discipline, and Teamwork. The system uses the Exponential Comparative Method and Weighting Eckenrode. Calculation results using graphs were provided to see the assessment of each employee. Programming language used in this system is written in Notepad++ and MySQL database. The testing result on the system can be concluded that this application is correspond with the design and running properly. The test conducted is structural test, functional test, and validation, sensitivity analysis, and SUMI testing.

  2. Survey and review of near-field performance assessment

    International Nuclear Information System (INIS)

    Apted, M.J.

    1993-01-01

    The aim of this chapter is to describe the performance assessment (PA) context in which near-field models have been developed and applied. An overview is given of a number of PA studies. Although the focus is on near-field models, the overview covers the full context in which the PAs have been performed, including the purpose of the studies and regulatory context. Special emphasis has been given to the scenarios analyzed in the assessments; the scenarios set the framework for model development and application. Another aspect to consider in a study of near-field modeling from the perspective of total PA is the linking between near-field and far-field assessment. (R.P.) 6 tabs

  3. Improved Outcome Prediction Using CT Angiography in Addition to Standard Ischemic Stroke Assessment: Results from the STOPStroke Study

    Science.gov (United States)

    González, R. Gilberto; Lev, Michael H.; Goldmacher, Gregory V.; Smith, Wade S.; Payabvash, Seyedmehdi; Harris, Gordon J.; Halpern, Elkan F.; Koroshetz, Walter J.; Camargo, Erica C. S.; Dillon, William P.; Furie, Karen L.

    2012-01-01

    Purpose To improve ischemic stroke outcome prediction using imaging information from a prospective cohort who received admission CT angiography (CTA). Methods In a prospectively designed study, 649 stroke patients diagnosed with acute ischemic stroke had admission NIH stroke scale scores, noncontrast CT (NCCT), CTA, and 6-month outcome assessed using the modified Rankin scale (mRS) scores. Poor outcome was defined as mRS>2. Strokes were classified as “major” by the (1) Alberta Stroke Program Early CT Score (ASPECTS+) if NCCT ASPECTS was≤7; (2) Boston Acute Stroke Imaging Scale (BASIS+) if they were ASPECTS+ or CTA showed occlusion of the distal internal carotid, proximal middle cerebral, or basilar arteries; and (3) NIHSS for scores>10. Results Of 649 patients, 253 (39.0%) had poor outcomes. NIHSS, BASIS, and age, but not ASPECTS, were independent predictors of outcome. BASIS and NIHSS had similar sensitivities, both superior to ASPECTS (p10/BASIS+ had poor outcomes, versus 21.5% (77/358) with NIHSS≤10/BASIS− (p10/BASIS+ compared to patients who are NIHSS≤10/BASIS−; the odds ratio is 5.4 (95% CI: 3.5 to 8.5) when compared to patients who are only NIHSS>10 or BASIS+. Conclusions BASIS and NIHSS are independent outcome predictors. Their combination is stronger than either instrument alone in predicting outcomes. The findings suggest that CTA is a significant clinical tool in routine acute stroke assessment. PMID:22276182

  4. 5th Total System Performance Assessment Workshop

    International Nuclear Information System (INIS)

    Hwang, Yong Soo; Lee, Youn Myoung; Kang, Chul Hyung; Lee, Sung Ho

    2009-07-01

    Research items on safety assessment of high-level waste repository have been proposed by external invited experts outside KAERI and discussed extensively during the annual 5th performance assessment workshop prepared by safety assessment group in KAERI. This could be useful to set up R and D plans necessary for the next phase of mid- and long-term reaserch area regarding the safety assessment of high-level waste repository. Through the research and the presentation, HLW-related research and development area including such specific research items as current status of HLW safety assessment research, current requirement for the licensing of the repository system, priority on research area, data base building for the safety assessment, source-term modeling as well as safety case, among many others, have been discussed and summarized

  5. Assessing Impact of Technology Based Digital Equalizer Programme on Improving Student Learning Outcomes

    Science.gov (United States)

    Sarkar, Subrata; Mohapatra, Sanjay; Sundarakrishnan, J.

    2017-01-01

    The objective of this research was to assess the impact of the Digital Equalizer program (DE Program) in terms of student learning outcomes of students in subjects like science, mathematics and geography after 8 months of implementing the DE program in 283 schools across 30 districts of Odisha, India. This study was a inter group and intra group…

  6. Validation of the American Board of Orthodontics Objective Grading System for assessing the treatment outcomes of Chinese patients.

    Science.gov (United States)

    Song, Guang-Ying; Baumrind, Sheldon; Zhao, Zhi-He; Ding, Yin; Bai, Yu-Xing; Wang, Lin; He, Hong; Shen, Gang; Li, Wei-Ran; Wu, Wei-Zi; Ren, Chong; Weng, Xuan-Rong; Geng, Zhi; Xu, Tian-Min

    2013-09-01

    Orthodontics in China has developed rapidly, but there is no standard index of treatment outcomes. We assessed the validity of the American Board of Orthodontics Objective Grading System (ABO-OGS) for the classification of treatment outcomes in Chinese patients. We randomly selected 108 patients who completed treatment between July 2005 and September 2008 in 6 orthodontic treatment centers across China. Sixty-nine experienced Chinese orthodontists made subjective assessments of the end-of-treatment casts for each patient. Three examiners then used the ABO-OGS to measure the casts. Pearson correlation analysis and receiver operating characteristic curve analysis were conducted to evaluate the correspondence between the ABO-OGS cast measurements and the orthodontists' subjective assessments. The average subjective grading scores were highly correlated with the ABO-OGS scores (r = 0.7042). Four of the 7 study cast components of the ABO-OGS score-occlusal relationship, overjet, interproximal contact, and alignment-were statistically significantly correlated with the judges' subjective assessments. Together, these 4 accounted for 58% of the variability in the average subjective grading scores. The ABO-OGS cutoff score for cases that the judges deemed satisfactory was 16 points; the corresponding cutoff score for cases that the judges considered acceptable was 21 points. The ABO-OGS is a valid index for the assessment of treatment outcomes in Chinese patients. By comparing the objective scores on this modification of the ABO-OGS with the mean subjective assessment of a panel of highly qualified Chinese orthodontists, a cutoff point for satisfactory treatment outcome was defined as 16 points or fewer, with scores of 16 to 21 points denoting less than satisfactory but still acceptable treatment. Cases that scored greater than 21 points were considered unacceptable. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  7. Development of self and peer performance assessment on iodometric titration experiment

    Science.gov (United States)

    Nahadi; Siswaningsih, W.; Kusumaningtyas, H.

    2018-05-01

    This study aims to describe the process in developing of reliable and valid assessment to measure students’ performance on iodometric titration and the effect of the self and peer assessment on students’ performance. The self and peer-instrument provides valuable feedback for the student performance improvement. The developed assessment contains rubric and task for facilitating self and peer assessment. The participants are 24 students at the second-grade student in certain vocational high school in Bandung. The participants divided into two groups. The first 12 students involved in the validity test of the developed assessment, while the remain 12 students participated for the reliability test. The content validity was evaluated based on the judgment experts. Test result of content validity based on judgment expert show that the developed performance assessment instrument categorized as valid on each task with the realibity classified as very good. Analysis of the impact of the self and peer assessment implementation showed that the peer instrument supported the self assessment.

  8. Key outcomes from risk based assessment of pressure equipment in refineries

    International Nuclear Information System (INIS)

    Firth, D.; Lichti, K.; Hill, T.; Thomas, C.; Widrig, J.; Simmonds, G.; Karstensen, A.

    2012-01-01

    Risk based assessment (RBA) has become the best industry practice for management of pressure equipment reliability. Application of RBA programs significantly reduces risk and gives opportunity to optimize inspection programs and produce long term financial benefits. Quest Integrity Group have implemented risk based inspection programs n a variety of industries including ammonia, methanol, geothermal power, :combined cycle power, gas turbines, gas production facilities and refineries. This paper outlines the semi quantitative RBA procedures that have been followed and lists some of the specific technical outcomes. Advanced inspection and life assessment methods used in support of RBI in refineries ire discussed. Piping in refineries is a key risk issue and it is not uncommon for piping failures to result in major incidents. Specific inspection programs are available to monitor differing damage processes such as flow assisted corrosion, hydrogen damage and corrosion under insulation. During assessment it s often found that numerous pipes have never been inspected especially underground smaller diameter pipes which are frequently considered to be un-piggable using conventional technologies and difficult to inspect. Advanced high accuracy flexible miniaturized ultrasonic intelligent pigging combined with fitness for service assessment such as Invista TM is recommended for inspection of critical pipelines which previously have been un-piggable. The processing of crude oil from a range of sources can result in significant variations in the levels of contaminants such as chlorides and sulfides. Major failures have occurred as a result of very rapid increases in corrosion rates in hydrotreating processes due to rapid changes in chemistry. The outcome of the assessment of plants that have potentially high and variable levels of contaminants often results in a review the process chemistry, how it is monitored and development of a detailed corrosion monitoring program. Fired

  9. Public perceptions of key performance indicators of healthcare in Alberta, Canada.

    Science.gov (United States)

    Northcott, Herbert C; Harvey, Michael D

    2012-06-01

    To examine the relationship between public perceptions of key performance indicators assessing various aspects of the health-care system. Cross-sequential survey research. Annual telephone surveys of random samples of adult Albertans selected by random digit dialing and stratified according to age, sex and region (n = 4000 for each survey year). The survey questionnaires included single-item measures of key performance indicators to assess public perceptions of availability, accessibility, quality, outcome and satisfaction with healthcare. Cronbach's α and factor analysis were used to assess the relationship between key performance indicators focusing on the health-care system overall and on a recent interaction with the health-care system. The province of Alberta, Canada during the years 1996-2004. Four thousand adults randomly selected each survey year. Survey questions measuring public perceptions of healthcare availability, accessibility, quality, outcome and satisfaction with healthcare. Factor analysis identified two principal components with key performance indicators focusing on the health system overall loading most strongly on the first component and key performance indicators focusing on the most recent health-care encounter loading most strongly on the second component. Assessments of the quality of care most recently received, accessibility of that care and perceived outcome of care tended to be higher than the more general assessments of overall health system quality and accessibility. Assessments of specific health-care encounters and more general assessments of the overall health-care system, while related, nevertheless comprise separate dimensions for health-care evaluation.

  10. Performance assessment techniques for groundwater recovery and treatment systems

    Energy Technology Data Exchange (ETDEWEB)

    Kirkpatrick, G.L. [Environmental Resources Management, Inc., Exton, PA (United States)

    1993-03-01

    Groundwater recovery and treatment (pump and treat systems) continue to be the most commonly selected remedial technology for groundwater restoration and protection programs at hazardous waste sites and RCRA facilities nationwide. Implementing a typical groundwater recovery and treatment system includes the initial assessment of groundwater quality, characterizing aquifer hydrodynamics, recovery system design, system installation, testing, permitting, and operation and maintenance. This paper focuses on methods used to assess the long-term efficiency of a pump and treat system. Regulatory agencies and industry alike are sensitive to the need for accurate assessment of the performance and success of groundwater recovery systems for contaminant plume abatement and aquifer restoration. Several assessment methods are available to measure the long-term performance of a groundwater recovery system. This paper presents six assessment techniques: degree of compliance with regulatory agency agreement (Consent Order of Record of Decision), hydraulic demonstration of system performance, contaminant mass recovery calculation, system design and performance comparison, statistical evaluation of groundwater quality and preferably, integration of the assessment methods. Applying specific recovery system assessment methods depends upon the type, amount, and quality of data available. Use of an integrated approach is encouraged to evaluate the success of a groundwater recovery and treatment system. The methods presented in this paper are for engineers and corporate management to use when discussing the effectiveness of groundwater remediation systems with their environmental consultant. In addition, an independent (third party) system evaluation is recommended to be sure that a recovery system operates efficiently and with minimum expense.

  11. Feedback from performance assessment to site characterisation. The SITE-94 example

    International Nuclear Information System (INIS)

    Dverstorp, B.; Geier, J.

    1999-01-01

    Interaction and information exchange between site characterisation and performance assessment are key features of any successful radioactive waste management programme. Some examples are presented of the types of feedback that can be offered from performance assessment to site characterisation, based on SKI's most recent performance assessment project, SITE-94. SITE-94 in Sweden was an assessment of a hypothetical repository for spent nuclear fuel, based on real data gathered in the surface-based investigation of the Aespoe Hard Rock Laboratory site. Examples of feedback are given concerning quality control of data and site investigation procedures, identification of key parameters for the performance assessment, use of models for planning and evaluation of a site investigation, data sampling strategies, and guidance on future priorities for further development of site investigation methods. Because site characterisation serves multiple purposes, including provision of data for repository design and construction, it must account for and compromise among requirements from several lines of analyses in the performance assessment. (author)

  12. Statistical analysis in MSW collection performance assessment.

    Science.gov (United States)

    Teixeira, Carlos Afonso; Avelino, Catarina; Ferreira, Fátima; Bentes, Isabel

    2014-09-01

    The increase of Municipal Solid Waste (MSW) generated over the last years forces waste managers pursuing more effective collection schemes, technically viable, environmentally effective and economically sustainable. The assessment of MSW services using performance indicators plays a crucial role for improving service quality. In this work, we focus on the relevance of regular system monitoring as a service assessment tool. In particular, we select and test a core-set of MSW collection performance indicators (effective collection distance, effective collection time and effective fuel consumption) that highlights collection system strengths and weaknesses and supports pro-active management decision-making and strategic planning. A statistical analysis was conducted with data collected in mixed collection system of Oporto Municipality, Portugal, during one year, a week per month. This analysis provides collection circuits' operational assessment and supports effective short-term municipality collection strategies at the level of, e.g., collection frequency and timetables, and type of containers. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Combination of Glasgow Coma Scale, Age, and Systolic Blood Pressure in Assessing Patients’ Outcomes with Decreased Consciousness

    Directory of Open Access Journals (Sweden)

    Amir S Madjid

    2017-04-01

    Full Text Available Glasgow Coma Scale (GCS is commonly used to assess outcomes of patients with loss of consciousness, but it is insufficient in predicting the outcome of some cases. This study aimed to assess the combination of GCS, systolic blood pressure and age to predict the outcome of patients with decreased consciousness. This was a retrospective cohort observational study of 76 loss of consciousness patients that comes into the Emergency Department of Dr. Cipto Mangunkusumo General Hospital in June-August 2014. Data was obtained from the medical records . GCS, systolic blood pressure and age were recorded when patients were admitted to the triage. Outcome was assessed two weeks after admission in the emergency department. Bivariate analysis on the GCS and age showed significant different between patients with poor outcome group with good outcome group (p<0.05 and no significant different of the systolic blood pressure between both groups (p>0.05. Multivariate analysis on the GCS and age showed good probability equation based on the calibration test and discrimination. The combination of Glasgow Coma Scale and age was accurate in assessing the outcomes of patients with loss of consciousness. Keywords. Glasgow Coma Scale, systolic, age, outcomes     Gabungan Glasgow Coma Scale, Umur, dan Tekanan Darah Sistolik Sebagai Penilai Luaran Pasien Penurunan Kesadaran   Abstrak Glasgow Coma Scale (GCS telah menjadi salah satu penilaian yang digunakan untuk menilai luaran pasien penurunan kesadaran, tetapi dinilai masih belum mampu memprediksi luaran yang terjadi. Penelitian ini bertujuan untuk menilai gabungan GCS, tekanan darah sistolik dan umur untuk memprediksi luaran pasien dengan penurunan kesadaran. Penelitian ini merupakan studi observasional kohort retrospektif yang melibatkan 76 pasien dengan penurunan kesadaran yang datang ke IGD RSUPN Dr. Cipto Mangunkusumo selama bulan Juni-Agustus 2014. Data diambil dari rekam medik. GCS, tekanan darah sistolik dan

  14. Using patient-reported outcomes in schizophrenia: the Scottish Schizophrenia Outcomes Study.

    Science.gov (United States)

    Hunter, Robert; Cameron, Rosie; Norrie, John

    2009-02-01

    The primary aim of the Scottish Schizophrenia Outcomes Study (SSOS) was to assess the feasibility and utility of routinely collecting outcome data in everyday clinical settings. Data were collected over three years in the Scottish National Health Service (NHS). There were two secondary aims of SSOS: first, to compare data from patient-rated, objective, and clinician-rated outcomes, and second, to describe trends in outcome data and service use across Scotland over the three years of the study (2002-2005). This study used a naturalistic, longitudinal, observational cohort design. A representative sample of 1,015 persons with ICD-10 F20-F29 diagnoses (schizophrenia, schizotypal disorders, or delusional disorders) was assessed annually using the clinician-rated measure, the Health of the Nation Outcome Scale (HoNOS), and the patient-reported assessment, the Avon Mental Health Measure (Avon). Objective outcomes data and information on services and interventions were collected. Data were analyzed with regression modeling. Of the 1,015 persons recruited, 78% of the cohort (N=789) completed the study. Over the study period, significant decreases were seen in the number of hospitalizations, incidence of attempted suicide and self-harm, and civil detentions. Avon scores indicated significant improvement on all subscales (behavior, social, access, and mental health) and on the total score. However, HoNOS scores on the behavior and symptom subscales did not change, scores on the impairment subscale increased significantly (indicating increased levels of impairment), and scores on the social subscale decreased significantly (indicating improved social functioning). This study has demonstrated that it is feasible within the Scottish NHS to routinely collect meaningful outcomes data in schizophrenia. Patient-reported assessments were also successfully collected and used in care plans. This model shows that it is possible to incorporate patient-reported assessments into routine

  15. Training and Assessment of Hysteroscopic Skills

    DEFF Research Database (Denmark)

    Savran, Mona Meral; Sørensen, Stine Maya Dreier; Konge, Lars

    2016-01-01

    OBJECTIVE: The aim of this systematic review was to identify studies on hysteroscopic training and assessment. DESIGN: PubMed, Excerpta Medica, the Cochrane Library, and Web of Science were searched in January 2015. Manual screening of references and citation tracking were also performed. Studies...... on hysteroscopic educational interventions were selected without restrictions on study design, populations, language, or publication year. A qualitative data synthesis including the setting, study participants, training model, training characteristics, hysteroscopic skills, assessment parameters, and study...... outcomes was performed by 2 authors working independently. Effect sizes were calculated when possible. Overall, 2 raters independently evaluated sources of validity evidence supporting the outcomes of the hysteroscopy assessment tools. RESULTS: A total of 25 studies on hysteroscopy training were identified...

  16. The relationship between start performance and race outcome in elite 500-m short-track speed skating.

    Science.gov (United States)

    Haug, William B; Drinkwater, Eric J; Mitchell, Lachlan J; Chapman, Dale W

    2015-10-01

    Initial short-track speed-skating 14-m start performance has substantial influence on 500-m race outcome at the international level, yet the relationship has not been systematically quantified. The purpose of this investigation was to examine the relationship between rank position entering first corner (RPEFC) and race outcome and to understand how this relationship changes with competition round and absolute race intensity. Data were compiled from 2011-2014 World Cup seasons and 2010 and 2014 Olympic Winter Games. Association between RPEFC and race outcome was determined through Kendall tau-rank correlations. A visual comparison was made of how the relationship changes with relative competition level (race tau correlations were sorted by competition round) and with race intensity (race tau correlations were sorted by within-event winning time). A very large relationship between RPEFC and race outcome was observed (correlations for cohort, τ = .60; men, τ = .53; women, τ = .67). When examined by competition round (quarter- to A-finals), no substantial change in relationship was observed (men, τ = .57-.46; women, τ = .73-.53). However, when the start-performance relationship was considered by within-event winning time, the relationship strength increased with decreasing time (men, τ = .61 to .46; women, τ = .76 to .57; fastest to 7th- and 8th-fastest combined, respectively). These results establish and quantify RPEFC as an important aspect of elite short-track 500-m race outcome. RPEFC as an indicator of race outcome becomes increasingly important with absolute race intensity, suggesting that RPEFC capability is a discriminating factor for competitors of similar top speed and speed endurance.

  17. Towards effective outcomes in teaching, learning and assessment of law in medical education.

    Science.gov (United States)

    Preston-Shoot, Michael; McKimm, Judy

    2011-04-01

    Law is slowly emerging as a core subject area in medical education, alongside content on the ethical responsibilities of doctors to protect and promote patient health and well-being. Curriculum statements have begun to advise on core content and methods for organising teaching and assessment. However, no comprehensive overview of approaches to the delivery of this law curriculum has been undertaken. This paper reports an assessment of the nature and strength of the published evidence base for the teaching, learning and assessment of law in medical education. It also provides a thematic content overview from the best available literature on the teaching of law to medical students and on the assessment of their legal knowledge and skills. A systematic review of the evidence base was completed. Detailed scrutiny resulted in the inclusion of 31 empirical sources and 11 conceptual papers. The quality of the included material was assessed. Significant gaps exist in the evidence base. Empirical studies of the teaching of law are characterised by insufficient sample sizes and a focus on individual study programmes. They rely on measures of student satisfaction and on evaluating short-term outcomes rather than assessing whether knowledge is retained and whether learning impacts on patient outcomes. Studies reveal a lack of coordination between pre- or non-clinical and clinical medico-legal education. Although evidence on the development of students' knowledge is available, much learning is distant from the practice in which its application would be tested. Law learning in clinical placements appears to be opportunistic rather than structured. The place of law in the curriculum remains uncertain and should be more clearly identified. A more robust knowledge base is needed to realise the aspirations behind curriculum statements on law and to enable medical students to develop sufficient legal literacy to manage challenging practice encounters. Further research is needed into

  18. Adverse Outcome Pathways can drive non-animal approaches for safety assessment.

    Science.gov (United States)

    Burden, Natalie; Sewell, Fiona; Andersen, Melvin E; Boobis, Alan; Chipman, J Kevin; Cronin, Mark T D; Hutchinson, Thomas H; Kimber, Ian; Whelan, Maurice

    2015-09-01

    Adverse Outcome Pathways (AOPs) provide an opportunity to develop new and more accurate safety assessment processes for drugs and other chemicals, and may ultimately play an important role in regulatory decision making. Not only can the development and application of AOPs pave the way for the development of improved evidence-based approaches for hazard and risk assessment, there is also the promise of a significant impact on animal welfare, with a reduced reliance on animal-based methods. The establishment of a useable and coherent knowledge framework under which AOPs will be developed and applied has been a first critical step towards realizing this opportunity. This article explores how the development of AOPs under this framework, and their application in practice, could benefit the science and practice of safety assessment, while in parallel stimulating a move away from traditional methods towards an increased acceptance of non-animal approaches. We discuss here the key areas where current, and future initiatives should be focused to enable the translation of AOPs into routine chemical safety assessment, and lasting 3Rs benefits. © 2015 The Authors. Journal of Applied Toxicology published by John Wiley & Sons Ltd.

  19. Assessment of Innovation and Performance in the Fruit Chain; The Innovation-Performance Matrix

    NARCIS (Netherlands)

    Trienekens, J.H.; Uffelen, van R.L.M.; Debaire, J.; Omta, S.W.F.

    2008-01-01

    Purpose - This paper aims to bridge the concepts of innovation and performance and to develop a framework to assess innovation and performance in food chains. Design/methodology/approach - Based on an extensive literature search the paper identifies critical success factors (CSFs) and related

  20. Defining molecular initiating events in the adverse outcome pathway framework for risk assessment.

    Science.gov (United States)

    Allen, Timothy E H; Goodman, Jonathan M; Gutsell, Steve; Russell, Paul J

    2014-12-15

    Consumer and environmental safety decisions are based on exposure and hazard data, interpreted using risk assessment approaches. The adverse outcome pathway (AOP) conceptual framework has been presented as a logical sequence of events or processes within biological systems which can be used to understand adverse effects and refine current risk assessment practices in ecotoxicology. This framework can also be applied to human toxicology and is explored on the basis of investigating the molecular initiating events (MIEs) of compounds. The precise definition of the MIE has yet to reach general acceptance. In this work we present a unified MIE definition: an MIE is the initial interaction between a molecule and a biomolecule or biosystem that can be causally linked to an outcome via a pathway. Case studies are presented, and issues with current definitions are addressed. With the development of a unified MIE definition, the field can look toward defining, classifying, and characterizing more MIEs and using knowledge of the chemistry of these processes to aid AOP research and toxicity risk assessment. We also present the role of MIE research in the development of in vitro and in silico toxicology and suggest how, by using a combination of biological and chemical approaches, MIEs can be identified and characterized despite a lack of detailed reports, even for some of the most studied molecules in toxicology.

  1. Impact of Molecular Diagnostics for Tuberculosis on Patient-Important Outcomes: A Systematic Review of Study Methodologies.

    Directory of Open Access Journals (Sweden)

    Samuel G Schumacher

    Full Text Available Several reviews on the accuracy of Tuberculosis (TB Nucleic Acid Amplification Tests (NAATs have been performed but the evidence on their impact on patient-important outcomes has not been systematically reviewed. Given the recent increase in research evaluating such outcomes and the growing list of TB NAATs that will reach the market over the coming years, there is a need to bring together the existing evidence on impact, rather than accuracy. We aimed to assess the approaches that have been employed to measure the impact of TB NAATs on patient-important outcomes in adults with possible pulmonary TB and/or drug-resistant TB.We first develop a conceptual framework to clarify through which mechanisms the improved technical performance of a novel TB test may lead to improved patient outcomes and outline which designs may be used to measure them. We then systematically review the literature on studies attempting to assess the impact of molecular TB diagnostics on such outcomes and provide a narrative synthesis of designs used, outcomes assessed and risk of bias across different study designs.We found 25 eligible studies that assessed a wide range of outcomes and utilized a variety of experimental and observational study designs. Many potentially strong design options have never been used. We found that much of the available evidence on patient-important outcomes comes from a small number of settings with particular epidemiological and operational context and that confounding, time trends and incomplete outcome data receive insufficient attention.A broader range of designs should be considered when designing studies to assess the impact of TB diagnostics on patient outcomes and more attention needs to be paid to the analysis as concerns about confounding and selection bias become relevant in addition to those on measurement that are of greatest concern in accuracy studies.

  2. Analysis of the relationships among trust antecedents, organizational structures, and performance outcomes

    OpenAIRE

    Seykora, Joseph T.

    2009-01-01

    Approved for public release, distribution unlimited MBA Professional Report The project explores and seeks to identify relationships among four trust antecedents, two organizational structures, and two performance outcomes. The results will help to further explain associations between trust level (high or low) and organizational structure. Past research found that the edge organization operating in a high trust environment produces the most accurate results in the least amount of time. ...

  3. 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.

  4. Hospital versus individual surgeon’s performance in laparoscopic hysterectomy

    NARCIS (Netherlands)

    Driessen, Sara R C; Wallwiener, Markus; Taran, Florin Andrei; Cohen, Sarah L.; Kraemer, Bernhard; Wallwiener, Christian W.; Van Zwet, Erik W.; Brucker, Sara Y.; Jansen, F.W.

    2017-01-01

    Purpose: To compare hospital versus individual surgeon’s perioperative outcomes for laparoscopic hysterectomy (LH), and to assess the relationship between surgeon experience and perioperative outcomes. Methods: A retrospective analysis of all prospective collected LHs performed from 2003 to 2010

  5. Cochlear implant rehabilitation outcomes in Waardenburg syndrome children.

    Science.gov (United States)

    de Sousa Andrade, Susana Margarida; Monteiro, Ana Rita Tomé; Martins, Jorge Humberto Ferreira; Alves, Marisa Costa; Santos Silva, Luis Filipe; Quadros, Jorge Manuel Cardoso; Ribeiro, Carlos Alberto Reis

    2012-09-01

    The purpose of this study was to review the outcomes of children with documented Waardenburg syndrome implanted in the ENT Department of Centro Hospitalar de Coimbra, concerning postoperative speech perception and production, in comparison to the rest of non-syndromic implanted children. A retrospective chart review was performed for children congenitally deaf who had undergone cochlear implantation with multichannel implants, diagnosed as having Waardenburg syndrome, between 1992 and 2011. Postoperative performance outcomes were assessed and confronted with results obtained by children with non-syndromic congenital deafness also implanted in our department. Open-set auditory perception skills were evaluated by using European Portuguese speech discrimination tests (vowels test, monosyllabic word test, number word test and words in sentence test). Meaningful auditory integration scales (MAIS) and categories of auditory performance (CAP) were also measured. Speech production was further assessed and included results on meaningful use of speech Scale (MUSS) and speech intelligibility rating (SIR). To date, 6 implanted children were clinically identified as having WS type I, and one met the diagnosis of type II. All WS children received multichannel cochlear implants, with a mean age at implantation of 30.6±9.7months (ranging from 19 to 42months). Postoperative outcomes in WS children were similar to other nonsyndromic children. In addition, in number word and vowels discrimination test WS group showed slightly better performances, as well as in MUSS and MAIS assessment. Our study has shown that cochlear implantation should be considered a rehabilitative option for Waardenburg syndrome children with profound deafness, enabling the development and improvement of speech perception and production abilities in this group of patients, reinforcing their candidacy for this audio-oral rehabilitation method. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  6. Principal elements of the Basalt Waste Isolation Project performance assessment studies

    International Nuclear Information System (INIS)

    Baca, R.G.; Wilde, R.T.

    1983-12-01

    In this paper, three of the principal elements of the Basalt Waste Isolation Project (BWIP) performance assessment studies are focused on: (1) development of a methodology for probabilistic risk assessment, (2) performance analyses of repository subsystems, and (3) selection and ranking of disruptive event scenarios. Other elements of the BWIP performance assessment studies are briefly outlined. 12 references, 5 figures

  7. Influence of Flow Sequencing Attributed to Climate Change and Climate Variability on the Assessment of Water-dependent Ecosystem Outcomes

    Science.gov (United States)

    Wang, J.; Nathan, R.; Horne, A.

    2017-12-01

    Traditional approaches to characterize water-dependent ecosystem outcomes in response to flow have been based on time-averaged hydrological indicators, however there is increasing recognition for the need to characterize ecological processes that are highly dependent on the sequencing of flow conditions (i.e. floods and droughts). This study considers the representation of flow regimes when considering assessment of ecological outcomes, and in particular, the need to account for sequencing and variability of flow. We conducted two case studies - one in the largely unregulated Ovens River catchment and one in the highly regulated Murray River catchment (both located in south-eastern Australia) - to explore the importance of flow sequencing to the condition of a typical long-lived ecological asset in Australia, the River Red Gum forests. In the first, the Ovens River case study, the implications of representing climate change using different downscaling methods (annual scaling, monthly scaling, quantile mapping, and weather generator method) on the sequencing of flows and resulting ecological outcomes were considered. In the second, the Murray River catchment, sequencing within a historic drought period was considered by systematically making modest adjustments on an annual basis to the hydrological records. In both cases, the condition of River Red Gum forests was assessed using an ecological model that incorporates transitions between ecological conditions in response to sequences of required flow components. The results of both studies show the importance of considering how hydrological alterations are represented when assessing ecological outcomes. The Ovens case study showed that there is significant variation in the predicted ecological outcomes when different downscaling techniques are applied. Similarly, the analysis in the Murray case study showed that the drought as it historically occurred provided one of the best possible outcomes for River Red Gum

  8. Improving Teachers' Knowledge of Functional Assessment-Based Interventions: Outcomes of a Professional Development Series

    Science.gov (United States)

    Lane, Kathleen Lynne; Oakes, Wendy Peia; Powers, Lisa; Diebold, Tricia; Germer, Kathryn; Common, Eric A.; Brunsting, Nelson

    2015-01-01

    This paper provides outcomes of a study examining the effectiveness of a year-long professional development training series designed to support in-service educators in learning a systematic approach to functional assessment-based interventions developed by Umbreit and colleagues (2007) that has met with demonstrated success when implemented with…

  9. Performance Assessment Position Paper: Time for Compliance

    International Nuclear Information System (INIS)

    Wilhite, E.L.

    2003-01-01

    This study lays out the historical development of the time frame for a low-level waste disposal facility to demonstrate compliance with the DOE performance objectives and requirements. The study recommends that 1,000 years should be used as the time for compliance for all of the performance objectives and requirements (i.e., for the all-pathways, air pathway, radon emanation, water resource protection and inadvertent intruder analyses) for all low-level waste disposal facility performance assessments at the Savannah River Site

  10. Improved Short-Term Outcomes following Orthognathic Surgery Are Associated with High-Volume Centers.

    Science.gov (United States)

    Berlin, Nicholas L; Tuggle, Charles T; Steinbacher, Derek M

    2016-08-01

    Previous studies assessing outcomes following orthognathic surgery rely primarily on single-center/surgeon experience. In addition to issues of generalizability, these studies are limited in evaluating the effect of operative volume on patient outcomes. Orthognathic procedures were identified in the 1999 to 2011 Healthcare Cost and Utilization Project Nationwide Inpatient Sample. Outcomes included occurrence of any in-hospital complication, extended length of stay (>2 days), and increased costs (>$10,784). High-volume hospitals were defined as the 90th percentile of case volume or higher (>31 cases/year). Univariate and multivariate analyses were conducted to identify independent predictors of outcomes. Trend analyses were performed to assess changes in the annual rate of patients treated at high-volume hospitals over the study period. Among 101,692 orthognathic surgery patients, 19.6 percent underwent concurrent ancillary procedures (i.e., genioplasty, rhinoplasty, or septoplasty), and 37.6 percent underwent double-jaw surgery. Fifty-three percent were treated at high-volume hospitals. High-volume hospitals more often performed ancillary procedures (21.4 percent versus 17.4 percent; p surgery (41.3 percent versus 33.4 percent; p orthognathic cases nationwide are performed at a small number of high-volume hospitals. These hospitals discharge patients earlier, perform more complex procedures, and have fewer complications. Risk, III.

  11. Functional Performance and Associations between Performance Tests and Neurological Assessment Differ in Men and Women with Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Kadri Medijainen

    2015-01-01

    Full Text Available Background. Neurological assessment of a patient with Parkinson’s disease (PD is expected to reflect upon functional performance. As women are known to report more limitations even for same observed functional performance level, present study was designed to examine whether associations between neurological assessments and functional performance differ across genders. Methods. 14 men and 14 women with PD participated. Functional performance was assessed by measuring walking speeds on 10-meter walk test (10MWT and by performing timed-up-and-go-test (TUG. Neurological assessment included Hoehn and Yahr Scale (HY, Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS, Schwab and England Activities of Daily Living Scale (S-E, and Mini Mental State Examination (MMSE. Results. In women with PD, Kendall’s tau-b correlation analyses revealed significant correlations between functional performance tests and neurological assessment measures, with the exception in MMSE. No corresponding associations were found for men, although they demonstrated better functional performance, as expected. Conclusion. Men in similar clinical stage of the PD perform better on functional tests than women. Disease severity reflects upon functional performance differently in men and women with PD. Results indicate that when interpreting the assessment results of both functional performance and neurological assessment tests, the gender of the patient should be taken into consideration.

  12. Input data required for specific performance assessment codes

    International Nuclear Information System (INIS)

    Seitz, R.R.; Garcia, R.S.; Starmer, R.J.; Dicke, C.A.; Leonard, P.R.; Maheras, S.J.; Rood, A.S.; Smith, R.W.

    1992-02-01

    The Department of Energy's National Low-Level Waste Management Program at the Idaho National Engineering Laboratory generated this report on input data requirements for computer codes to assist States and compacts in their performance assessments. This report gives generators, developers, operators, and users some guidelines on what input data is required to satisfy 22 common performance assessment codes. Each of the codes is summarized and a matrix table is provided to allow comparison of the various input required by the codes. This report does not determine or recommend which codes are preferable

  13. An Exploratory Investigation of the Assessment Practices of Selected Association to Advance Collegiate Schools of Business--Accredited Business Programs and Linkages with General Education Outcomes

    Science.gov (United States)

    Vitullo, Elizabeth; Jones, Elizabeth A.

    2010-01-01

    This research study investigated the assessment practices of five different undergraduate business programs. It examines the learning outcomes required for the business programs and their linkages with general education outcomes. Specific assessment methods, the results from assessments, and how business program faculty use assessment findings to…

  14. The Impact of Complications on Patients’ Assessment of the Outcome of Tension-Free Vaginal Tape Procedure

    Directory of Open Access Journals (Sweden)

    David Shaker

    2017-11-01

    Full Text Available Introduction: Our study aimed to assess the impact of managed complications of tension-free vaginal tape (TVT on the patients’ assessment of the results as measured by Patient Global Impression of Improvement (PGI-I. Materials and methods: This was a retrospective study, supplemented with a telephone interview, comparing patients who had complications of TVT procedures with those where no complications recorded. The primary outcome was the PGI-I score in the 2 groups. Results: A total of 118 invitations were sent. In all, 60 patients returned the signed consent and completed the telephone interview with one of the authors (response rate = 50.8%. Complications were recorded in 21 patients (group 1 and no complications in 39 patients (group 2. There was no statistically significant difference between PGI-I in both groups. Conclusions: Managed complications of TVT do not seem to affect patients’ assessment of outcome as measured by PGI-I score.

  15. Treatment of uncertainty in low-level waste performance assessment

    International Nuclear Information System (INIS)

    Kozak, M.W.; Olague, N.E.; Gallegos, D.P.; Rao, R.R.

    1991-01-01

    Uncertainties arise from a number of different sources in low-level waste performance assessment. In this paper the types of uncertainty are reviewed, and existing methods for quantifying and reducing each type of uncertainty are discussed. These approaches are examined in the context of the current low-level radioactive waste regulatory performance objectives, which are deterministic. The types of uncertainty discussed in this paper are model uncertainty, uncertainty about future conditions, and parameter uncertainty. The advantages and disadvantages of available methods for addressing uncertainty in low-level waste performance assessment are presented. 25 refs

  16. Putting HLW performance assessment results in perspective

    International Nuclear Information System (INIS)

    Neall, F.; Smith, P.; Sumerling, T.; Umeki, H.

    1995-01-01

    According to performance assessment results for the different disposal concepts investigated, the maximum radiation doses to the population lie well below the limit set in the official Swiss Protection Objective and below the level of present-day natural background radiation. A comparison of different performance assessments has shown that the following key factors determine radionuclide release from a repository: radionuclide inventory, canister material and failure mode, nuclide solubility limits, the permeability of the buffer material, retardation during transport through the near-field, the presence of an excavation disturbed zone in the rock, the distance to the nearest major water-bearing fracture zone, the conceptual model for transport in fractured rock and near-surface dilution and dose factors. (author) 2 figs., 2 tabs

  17. Peer mentoring in doctor performance assessment: strategies, obstacles and benefits.

    NARCIS (Netherlands)

    Overeem, K.; Driessen, E.W.; Arah, O.A.; Lombarts, K.M.; Wollersheim, H.C.H.; Grol, R.P.T.M.

    2010-01-01

    CONTEXT: Mentors are increasingly involved in doctor performance assessments. Mentoring seems to be a key determinant in achieving the ultimate goal of those assessments, namely, improving doctor performance. Little is known, however, about how mentors perceive and fulfil this role. OBJECTIVE: The

  18. Peer mentoring in doctor performance assessment: strategies, obstacles and benefits

    NARCIS (Netherlands)

    Overeem, Karlijn; Driessen, Erik W.; Arah, Onyebuchi A.; Lombarts, Kiki M. J. M. H.; Wollersheim, Hub C.; Grol, Richard P. T. M.

    2010-01-01

    CONTEXT: Mentors are increasingly involved in doctor performance assessments. Mentoring seems to be a key determinant in achieving the ultimate goal of those assessments, namely, improving doctor performance. Little is known, however, about how mentors perceive and fulfil this role. OBJECTIVE: The

  19. Multi-criteria decision making under uncertainty in building performance assessment

    NARCIS (Netherlands)

    Hopfe, C.J.; Augenbroe, G.; Hensen, J.L.M.

    2013-01-01

    Building performance assessment is complex, as it has to respond to multiple criteria. Objectives originating from the demands that are put on energy consumption, acoustical performance, thermal occupant comfort, indoor air quality and many other issues must all be reconciled. An assessment requires

  20. Salt site performance assessment activities

    International Nuclear Information System (INIS)

    Kircher, J.F.; Gupta, S.K.

    1983-01-01

    During this year the first selection of the tools (codes) for performance assessments of potential salt sites have been tentatively selected and documented; the emphasis has shifted from code development to applications. During this period prior to detailed characterization of a salt site, the focus is on bounding calculations, sensitivity and with the data available. The development and application of improved methods for sensitivity and uncertainty analysis is a focus for the coming years activities and the subject of a following paper in these proceedings. Although the assessments to date are preliminary and based on admittedly scant data, the results indicate that suitable salt sites can be identified and repository subsystems designed which will meet the established criteria for protecting the health and safety of the public. 36 references, 5 figures, 2 tables

  1. 42 CFR 460.136 - Internal quality assessment and performance improvement activities.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Internal quality assessment and performance improvement activities. 460.136 Section 460.136 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES....136 Internal quality assessment and performance improvement activities. (a) Quality assessment and...

  2. Visual art teachers and performance assessment methods in ...

    African Journals Online (AJOL)

    This paper examines the competencies of visual arts teachers in using performance assessment methods, and to ascertain the extent to which the knowledge, skills and experiences of teachers affect their competence in using assessment strategies in their classroom. The study employs a qualitative research design; ...

  3. Using Geographic Information Systems (GIS) to assess outcome disparities in patients with type 2 diabetes and hyperlipidemia.

    Science.gov (United States)

    Geraghty, Estella M; Balsbaugh, Thomas; Nuovo, Jim; Tandon, Sanjeev

    2010-01-01

    Geographic information systems (GIS) tools can help expand our understanding of disparities in health outcomes within a community. The purpose of this project was (1) to demonstrate the methods to link a disease management registry with a GIS mapping and analysis program, (2) to address the challenges that occur when performing this link, and (3) to analyze the outcome disparities resulting from this assessment tool in a population of patients with type 2 diabetes mellitus. We used registry data derived from the University of California Davis Health System's electronic medical record system to identify patients with diabetes mellitus from a network of 13 primary care clinics in the greater Sacramento area. This information was converted to a database file for use in the GIS software. Geocoding was performed and after excluding those who had unknown home addresses we matched 8528 unique patient records with their respective home addresses. Socioeconomic and demographic data were obtained from the Geolytics, Inc. (East Brunswick, NJ), a provider of US Census Bureau data, with 2008 estimates and projections. Patient, socioeconomic, and demographic data were then joined to a single database. We conducted regression analysis assessing A1c level based on each patient's demographic and laboratory characteristics and their neighborhood characteristics (socioeconomic status [SES] quintile). Similar analysis was done for low-density lipoprotein cholesterol. After excluding ineligible patients, the data from 7288 patients were analyzed. The most notable findings were as follows: There was, there was found an association between neighborhood SES and A1c. SES was not associated with low-density lipoprotein control. GIS methodology can assist primary care physicians and provide guidance for disease management programs. It can also help health systems in their mission to improve the health of a community. Our analysis found that neighborhood SES was a barrier to optimal glucose

  4. 42 CFR 486.348 - Condition: Quality assessment and performance improvement (QAPI).

    Science.gov (United States)

    2010-10-01

    ... Coverage: Organ Procurement Organizations Organ Procurement Organization Process Performance Measures § 486.348 Condition: Quality assessment and performance improvement (QAPI). The OPO must develop, implement... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Quality assessment and performance...

  5. 10 CFR 63.114 - Requirements for performance assessment.

    Science.gov (United States)

    2010-01-01

    ... processes of engineered barriers in the performance assessment, including those processes that would adversely affect the performance of natural barriers. Degradation, deterioration, or alteration processes of... surrounding region to the extent necessary, and information on the design of the engineered barrier system...

  6. A Triple Aim Framework For the Performance Assessment of Disease Management Programs

    NARCIS (Netherlands)

    Verbeek, N.A.; M.G. Franken (Margreet); M.A. Koopmanschap (Marc); M.P.M.H. Rutten-van Mölken (Maureen)

    2015-01-01

    markdownabstractObjectives: A structured and comprehensive assessment of disease management implementations is not straightforward due to the broadness of the interventions and the various evaluation possibilities. The aim of this study was to develop a comprehensive framework for outcome

  7. Learning outcomes evaluation of a simulation-based introductory course to anaesthesia.

    Science.gov (United States)

    Rábago, J L; López-Doueil, M; Sancho, R; Hernández-Pinto, P; Neira, N; Capa, E; Larraz, E; Redondo-Figuero, C G; Maestre, J M

    2017-10-01

    An increased number of errors and reduced patient safety have been reported during the incorporation of residents, as this period involves learning new skills. The objectives were to evaluate the learning outcomes of an immersive simulation boot-camp for incoming residents before starting the clinical rotations. Airway assessment, airway control with direct laryngoscopy, and epidural catheterization competencies were evaluated. Twelve first-year anaesthesiology residents participated. A prospective study to evaluate transfer of endotracheal intubation skills learned at the simulation centre to clinical practice (primary outcome) was conducted. A checklist of 28 skills and behaviours was used to assess the first supervised intubation performed during anaesthesia induction in ASA I/II patients. Secondary outcome was self-efficacy to perform epidural catheterization. A satisfaction survey was also performed. Seventy-five percent of residents completed more than 21 out of 28 skills and behaviours to assess and control the airway during their first intubation in patients. Twelve items were performed by all residents and 5 by half of them. More than 83% of participants reported a high level of self-efficacy in placing an epidural catheter. All participants would recommend the course to their colleagues. A focused intensive simulation-based boot-camp addressing key competencies required to begin anaesthesia residency was well received, and led to transfer of airway management skills learned to clinical settings when performing for first time on patients, and to increased self-reported efficacy in performing epidural catheterization. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Performance Assessment of Communication Enhancement Devices TEA HI Threat Headset

    Science.gov (United States)

    2015-08-01

    AFRL-RH-WP-TR-2015-0076 Performance Assessment of Communication Enhancement Devices: TEA HI Threat Headset Hilary L. Gallagher...of Communication Enhancement Devices: TEA HI Threat Headset 5a. CONTRACT NUMBER FA8650-14-D-6501 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER...technology in military applications. Objective performance data provided an assessment of the performance of these devices. The TEA HI Threat headset

  9. Scientific Inquiry Self-Efficacy and Computer Game Self-Efficacy as Predictors and Outcomes of Middle School Boys' and Girls' Performance in a Science Assessment in a Virtual Environment

    Science.gov (United States)

    Bergey, Bradley W.; Ketelhut, Diane Jass; Liang, Senfeng; Natarajan, Uma; Karakus, Melissa

    2015-01-01

    The primary aim of the study was to examine whether performance on a science assessment in an immersive virtual environment was associated with changes in scientific inquiry self-efficacy. A secondary aim of the study was to examine whether performance on the science assessment was equitable for students with different levels of computer game…

  10. Tax Performance Assessment in Scandinavian Countries

    Directory of Open Access Journals (Sweden)

    Bunescu Liliana

    2015-04-01

    Full Text Available The aim of this paper is to evaluate fiscal policy performance level in Nordic countries of Europe by quantifying the gap between their performance and an optimum benchmark value. In this study it was selected Denmark, Finland, Sweden and Norway. These countries occupy the first places in the ranking of countries with the highest rate of tax burden in Europe. The first part of paper contains general aspects of fiscal performance in international research and an overview of the Nordic tax systems model. The second part of paper focuses on evaluation of tax policy performance in these countries by using OptimTax scoring analysis. The research is based on a multivariate analysis instrument that uses quantitative data on various aspects of tax policy. OptimTax achieves a score for assessing the degree of optimization of fiscal policy. The results reveal high levels of tax performance in Scandinavian countries and a trend that seems to be more constant than ascending, except Norway.

  11. Integrating place-specific livelihood and equity outcomes into global assessments of bioenergy deployment

    DEFF Research Database (Denmark)

    Creutzig, Felix; Corbera, Esteve; Bolwig, Simon

    2013-01-01

    -study research focused on first-generation biofuel crops to demonstrate that food, income, land and other assets such as health are key livelihood dimensions that can be impacted by such crops and we highlight how place-specific and global dynamics influence both aggregate and distributional outcomes across......Integrated assessment models suggest that the large-scale deployment of bioenergy could contribute to ambitious climate change mitigation efforts. However, such a shift would intensify the global competition for land, with possible consequences for 1.5 billion smallholder livelihoods...... these livelihood dimensions. We argue that place-specific production models and land tenure regimes mediate livelihood outcomes, which are also in turn affected by global and regional markets and their resulting equilibrium dynamics. The place-specific perspective suggests that distributional consequences...

  12. Assessing students' performance in software requirements engineering education using scoring rubrics

    Science.gov (United States)

    Mkpojiogu, Emmanuel O. C.; Hussain, Azham

    2017-10-01

    The study investigates how helpful the use of scoring rubrics is, in the performance assessment of software requirements engineering students and whether its use can lead to students' performance improvement in the development of software requirements artifacts and models. Scoring rubrics were used by two instructors to assess the cognitive performance of a student in the design and development of software requirements artifacts. The study results indicate that the use of scoring rubrics is very helpful in objectively assessing the performance of software requirements or software engineering students. Furthermore, the results revealed that the use of scoring rubrics can also produce a good achievement assessments direction showing whether a student is either improving or not in a repeated or iterative assessment. In a nutshell, its use leads to the performance improvement of students. The results provided some insights for further investigation and will be beneficial to researchers, requirements engineers, system designers, developers and project managers.

  13. [Outcomes after planned home births].

    Science.gov (United States)

    Blix, Ellen; Øian, Pål; Kumle, Merethe

    2008-11-06

    About 150 planned home births take place in Norway annually. Professionals have different opinions on whether such births are safe or not. The aim of the present study was to perform a systematic literature review on maternal and neonatal outcomes after planned home births. A review was performed of literature retrieved from searches in MEDLINE, PubMed, Embase, Cinahl and The Cochrane Library and relevant references found in the articles. The searches were limited to studies published in 1985 and later. 10 studies with data from 30 204 women who had planned and were selected to home birth at the onset of labour were included. Three of the studies had control groups including women with planned hospital births. All included studies were assessed to be of medium quality. Between 9.9 and 23.1 % of women and infants were transferred to hospital during labour or after birth. There were few caesarean sections, other interventions or complications in the studies assessed; the total perinatal mortality rate was 2.9/1000 and the intrapartum mortality rate 0.8/1000. There is no sound basis for discouraging low-risk women from planning a home birth. Results from the included studies do not directly apply to Norwegian conditions. Outcomes and transfers after planned home births should be systematically registered.

  14. 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.

  15. Learning-Oriented Assessment Increases Performance and Written Skills in a Second Year Metabolic Biochemistry Course

    Science.gov (United States)

    Vanderlelie, Jessica J.; Alexander, Heather. G.

    2016-01-01

    Assessment plays a critical role in learning and teaching and its power to enhance engagement and student outcomes is still underestimated in tertiary education. The current project considers the impact of a staged redesign of an assessment strategy that emphasized relevance of learning, formative assessment, student engagement, and feedback on…

  16. An Empirical Study of a Solo Performance Assessment Model

    Science.gov (United States)

    Russell, Brian E.

    2015-01-01

    The purpose of this study was to test a hypothesized model of solo music performance assessment. Specifically, this study investigates the influence of technique and musical expression on perceptions of overall performance quality. The Aural Musical Performance Quality (AMPQ) measure was created to measure overall performance quality, technique,…

  17. Developing a Performance Assessment Framework and Indicators for Communicable Disease Management in Natural Disasters.

    Science.gov (United States)

    Babaie, Javad; Ardalan, Ali; Vatandoost, Hasan; Goya, Mohammad Mehdi; Akbarisari, Ali

    2016-02-01

    Communicable disease management (CDM) is an important component of disaster public health response operations. However, there is a lack of any performance assessment (PA) framework and related indicators for the PA. This study aimed to develop a PA framework and indicators in CDM in disasters. In this study, a series of methods were used. First, a systematic literature review (SLR) was performed in order to extract the existing PA frameworks and indicators. Then, using a qualitative approach, some interviews with purposively selected experts were conducted and used in developing the PA framework and indicators. Finally, the analytical hierarchy process (AHP) was used for weighting of the developed indicators. The input, process, products, and outcomes (IPPO) framework was found to be an appropriate framework for CDM PA. Seven main functions were revealed to CDM during disasters. Forty PA indicators were developed for the four categories. There is a lack of any existing PA framework in CDM in disasters. Thus, in this study, a PA framework (IPPO framework) was developed for the PA of CDM in disasters through a series of methods. It can be an appropriate framework and its indicators could measure the performance of CDM in disasters.

  18. Organizational Performance Assessment: Overview of Publications in National Journals

    Directory of Open Access Journals (Sweden)

    Sandra Mara Iesbik Valmorbida

    2012-12-01

    Full Text Available In the literature there are several tools that aim to assess organizational performance, such as Balanced Scorecard (BSC, National Quality Award (PNQ, Multicriteria Methodology for Decision Aiding (MCDA, Data envelopment analysis (DEA, Analytic Hierarchy Process (AHP, among others. However, it is perceived in practice doubts as to choose the most appropriate for each organizational context. In this sense, it is argued that to measure the performance of the organization it is necessary that this measure is based on an instrument that allows transparency in the evaluation form, and insert those interested in the evaluation process. The credibility of an evaluation therefore depends on the ability to produce consistent information for all subjects involved in the intervention. The search for tools to improve the way to evaluate organizational performance it is increasingly necessary. The objective of this study is to identify the main tools of organizational performance assessment published in national journals in the area of Administration, Accounting and Tourism, classified by CAPES Qualis A1 to B5. The study is characterized as descriptive and qualitative documentation. We analyzed 489 articles, which resulted in the following results:(i identified the main theme of the authors and regular assessment of organizational performance, (ii from the year 2000 publications on the subject grew substantially, (iii Data Envelopment Analysis (DEA, Balanced Scorecard (BSC and Multicriteria for decision aiding methodology(MCDA-C are the most commonly used tools for evaluating performance, (iv most of the tools found in the literature are multiple criteria, (v described the process used by the tools to assess organizational performance.

  19. 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

  20. Quality assurance in performance assessments

    Energy Technology Data Exchange (ETDEWEB)

    Maul, P.R.; Watkins, B.M.; Salter, P.; Mcleod, R [QuantiSci Ltd, Henley-on-Thames (United Kingdom)

    1999-01-01

    Following publication of the Site-94 report, SKI wishes to review how Quality Assurance (QA) issues could be treated in future work both in undertaking their own Performance Assessment (PA) calculations and in scrutinising documents supplied by SKB (on planning a repository for spent fuels in Sweden). The aim of this report is to identify the key QA issues and to outline the nature and content of a QA plan which would be suitable for SKI, bearing in mind the requirements and recommendations of relevant standards. Emphasis is on issues which are specific to Performance Assessments for deep repositories for radioactive wastes, but consideration is also given to issues which need to be addressed in all large projects. Given the long time over which the performance of a deep repository system must be evaluated, the demonstration that a repository is likely to perform satisfactorily relies on the use of computer-generated model predictions of system performance. This raises particular QA issues which are generally not encountered in other technical areas (for instance, power station operations). The traceability of the arguments used is a key QA issue, as are conceptual model uncertainty, and code verification and validation; these were all included in the consideration of overall uncertainties in the Site-94 project. Additionally, issues which are particularly relevant to SKI include: How QA in a PA fits in with the general QA procedures of the organisation undertaking the work. The relationship between QA as applied by the regulator and the implementor of a repository development programme. Section 2 introduces the discussion of these issues by reviewing the standards and guidance which are available from national and international organisations. This is followed in Section 3 by a review of specific issues which arise from the Site-94 exercise. An outline procedure for managing QA issues in SKI is put forward as a basis for discussion in Section 4. It is hoped that