Статті в журналах з теми "Nonstandardized assessment"
Щоб переглянути інші типи публікацій з цієї теми, перейдіть за посиланням: Nonstandardized assessment.
Оформте джерело за APA, MLA, Chicago, Harvard та іншими стилями
Ознайомтеся з топ-42 статей у журналах для дослідження на тему "Nonstandardized assessment".
Біля кожної праці в переліку літератури доступна кнопка «Додати до бібліографії». Скористайтеся нею – і ми автоматично оформимо бібліографічне посилання на обрану працю в потрібному вам стилі цитування: APA, MLA, «Гарвард», «Чикаго», «Ванкувер» тощо.
Також ви можете завантажити повний текст наукової публікації у форматі «.pdf» та прочитати онлайн анотацію до роботи, якщо відповідні параметри наявні в метаданих.
Переглядайте статті в журналах для різних дисциплін та оформлюйте правильно вашу бібліографію.
1
Coelho, Carl, Mark Ylvisaker, and Lyn S. Turkstra. "Nonstandardized Assessment Approaches for Individuals with Traumatic Brain Injuries." Seminars in Speech and Language 26, no. 04 (November 2005): 223–41. http://dx.doi.org/10.1055/s-2005-922102.
2
Lundine, Jennifer P., and Audrey Hall. "Using Nonstandardized Assessments to Evaluate Cognitive-Communication Abilities following Pediatric Traumatic Brain Injury." Seminars in Speech and Language 41, no. 02 (March 2020): 170–82. http://dx.doi.org/10.1055/s-0040-1701685.
Анотація:
AbstractThe subtle cognitive-communication challenges experienced by students with traumatic brain injury (TBI) are often missed, leaving these students with unmet needs in the school environment and increasing the likelihood for negative social, academic, and vocational outcomes. For children and adolescents with TBI, nonstandardized assessment offers several advantages over standardized assessment procedures, and may improve speech-language pathologists' ability to identify students who might benefit from intervention services. This article discusses curriculum-based assessment and discourse analysis specifically and uses case studies to demonstrate how these procedures can be used within the school environment. Nonstandardized assessment procedures are a valuable tool to measure a student's cognitive-communication abilities and the effects of intervention in real-world contexts.
3
Kantor, Jiří, and Xianmei Lei. "Arts-based assessment in educational settings." International Journal of Evaluation and Research in Education (IJERE) 9, no. 4 (December 1, 2020): 947. http://dx.doi.org/10.11591/ijere.v9i4.20346.
Анотація:
<p>Arts-based assessment is an objective measure that incorporates artistic experience or artistic materials into the assessment process and enables to get unique contributions about pupils. The current survey focused on arts-based assessment in the Czech Republic to explore the following issues: how did arts therapists assess suitability of therapy for pupils; which areas of therapeutic process were evaluated and what made the process of arts-based assessments specific in educational institutions. A mixed methods study used a statistical analysis of a survey with “The Practice in Arts Therapies questionnaire” (n = 142 arts therapists) and an inductive analysis of qualitative interviews (n = 10 arts therapists). Results revealed that arts-based assessments were more likely to be characterized by qualitative nonstandardized assessments based on observation, analysis of artistic products/artistic process and reflexive techniques and are related to prevalent humanistic orientation. Educational environment influenced the assessments mainly in the content and organization of the process. On this basis, there is a need to support the usage of standardized arts-based assessments and to develop standards for the implementation of arts-based assessment suitable for educational institutions. More advanced training in this area should be included into professional courses and further education of arts therapists.</p>
4
Manee, Fahad S., Mohammed Shaban Nadar, Naser M. Alotaibi, and Mehdi Rassafiani. "Cognitive Assessments Used in Occupational Therapy Practice: A Global Perspective." Occupational Therapy International 2020 (August 26, 2020): 1–8. http://dx.doi.org/10.1155/2020/8914372.
Анотація:
This exploratory study was aimed at evaluating the current status of global occupational therapy practice on the use of assessments for clients with cognitive impairments and providing recommendations for ongoing evidence. We targeted international occupational therapy clinicians working with clients experiencing neurocognitive impairments. 323 occupational therapists from a wide range of clinical practice areas participated in the study. A large number of therapists used noncognitive specific assessments with a focus on functional approaches. The most commonly used standardized assessments were the COPM (56.7%), followed by MMSE (54.2%) and MoCA (45.5%), while the nonstandardized assessments were clinical observation (38.4%) and generic ADL assessment (34.1%). The use of main assessments was significantly different across world regions (p<0.05), as were the reasons for choosing them (p<0.05). The occupational therapists’ use of assessment tools with clients suffering from neurocognitive impairments is inconsistent across the globe. The identification of international best practices for selecting and implementing proper outcome measures is warranted. It is essential to promote the development of an occupational therapy initiative to support the use of appropriate assessments at the international levels to facilitate consistent best practice.
5
Patry, Alexandre, Claude Vincent, Christian Duval, and Emmanuelle Careau. "Psychometric properties of home accessibility assessment tools: A systematic review." Canadian Journal of Occupational Therapy 86, no. 3 (April 25, 2019): 172–84. http://dx.doi.org/10.1177/0008417418824731.
Анотація:
Background. Although home environment assessments are commonly performed by occupational therapists working in home care, use of nonstandardized measures created in-house or lack of measure use can cast a shadow over the quality of these assessments for people with disabilities. To ensure quality of home environment assessments, occupational therapists need standardized measures with demonstrated psychometric properties. Purpose. This study provides a critical appraisal of objective accessibility measures of the home environment. Method. A systematic review was undertaken for which three databases—CINAHL, PubMed, and Embase—were searched to identify accessibility measures of the home environment and evaluate their psychometric properties. Two authors independently assessed the quality of selected studies using the critical appraisal form for psychometric articles. Findings. Ten studies discussing seven accessibility measures were identified and selected for this review. No measures showed strong evidence of both good reliability and validity. Only one study addressed the responsiveness of a measure of accessibility. Implications. As occupational therapists are specialists of the person–environment relationship, the lack of evidence of the psychometric properties of objective accessibility measures of the home environment harms evidence-based occupational therapy practice. This review identified the most promising assessment tools, but further research is needed.
6
Tyler, Ann A., and Leslie C. Tolbert. "Speech-Language Assessment in the Clinical Setting." American Journal of Speech-Language Pathology 11, no. 3 (August 2002): 215–20. http://dx.doi.org/10.1044/1058-0360(2002/022).
Анотація:
Time constraints are a significant factor for clinic-based and school-based speech-language pathologists. Yet, with a planning process that incorporates parent information and accounts for child temperament, a comprehensive speech and language assessment can be completed within a 90-minute time frame. A parent questionnaire is completed prior to the assessment date, focusing on developmental history, including information about family history of learning difficulties and episodes of otitis media. Standardized and nonstandardized procedures are included in the assessment process in order to obtain clinically relevant information and provide parents and public service agencies with necessary qualifying scores. The Bankson-Bernthal Test of Phonology (BBTOP; Bankson & Bernthal, 1991) is the choice of instruments for standardized articulation/phonology testing, whereas the Preschool Language Scale-3 (PLS-3; Zimmerman, Steiner, & Pond, 1992) and a spontaneous language sample are recommended as language measures. A spontaneous sample also provides opportunity for clinical judgment regarding speech intelligibility, pragmatic skills, voice, and fluency. A recommendation session concludes the evaluation with a discussion of the child's performance on speech and language measures, overall impressions, and recommendations. This discussion includes strengths and weaknesses, with focus on answering parents' questions and addressing their concerns.
7
Archibald, Lisa M. D. "The Reciprocal Influences of Working Memory and Linguistic Knowledge on Language Performance: Considerations for the Assessment of Children With Developmental Language Disorder." Language, Speech, and Hearing Services in Schools 49, no. 3 (July 5, 2018): 424–33. http://dx.doi.org/10.1044/2018_lshss-17-0094.
Анотація:
Purpose This article considers how the language performance of school-age children with language impairments, such as developmental language disorder, is influenced by the reciprocal relationship of existing linguistic knowledge and working memory resources and the resultant implications for assessment. Method A viewpoint is provided by reviewing working memory theory, empirical evidence of the reciprocal relationship between working memory and existing language knowledge, and critically evaluating available standardized and nonstandardized tools designed to assess working memory or linguistic skills. Conclusions Speech-language pathologists with an excellent understanding of the reciprocal relationship between working memory and linguistic knowledge will need to examine performance across tasks and contexts varying in these demands in order to achieve an accurate clinical profile of relevant strengths and weaknesses for individual children.
8
Romli, Muhammad Hibatullah, Lynette Mackenzie, Meryl Lovarini, Maw Pin Tan, and Lindy Clemson. "The Clinimetric Properties of Instruments Measuring Home Hazards for Older People at Risk of Falling: A Systematic Review." Evaluation & the Health Professions 41, no. 1 (December 22, 2016): 82–128. http://dx.doi.org/10.1177/0163278716684166.
Анотація:
Home hazards are associated with falls among older people living in the community. However, evaluating home hazards is a complex process as environmental factors vary according to geography, culture, and architectural design. As a result, many health practitioners commonly use nonstandardized assessment methods that may lead to inaccurate findings. Thus, the aim of this systematic review was to identify standardized instruments for evaluating home hazards related to falls and evaluate the clinimetric properties of these instruments for use by health practitioners. A systematic search was conducted in the Medline, CINAHL, AgeLine, Web of Science databases, and the University of Sydney Library CrossSearch Engine. Study screening, assessment, and quality ratings were conducted independently. Thirty-six studies were identified describing 19 instruments and three assessment techniques. The clinimetric properties varied between instruments. The Home Falls and Accidents Screening Tool, Home Safety Self-Assessment Tool, In-Home Occupational Performance Evaluation, and Westmead Home Safety Assessment were the instruments with high potential for evaluating home hazards associated with falls. Health practitioners can choose the most appropriate instruments for their practice, as a range of standardized instruments with established clinimetric properties are available.
9
Doğan, Umut. "Evaluating the Profile of Psychological Strategies: An Applied Profile for Assessing the Perceived Effectiveness of Athletes’ Psychological Strategies in Sport." Case Studies in Sport and Exercise Psychology 5, no. 1 (January 1, 2021): 30–41. http://dx.doi.org/10.1123/cssep.2020-0023.
Анотація:
An alternative assessment tool called the Profile of Psychological Strategies (ProPS) was recently developed to measure athletes’ perceptions of (a) which strategies they use, (b) to pursue which psychological outcomes, and (c) how effective their strategies are in pursuing those psychological outcomes. This case study explains the process of evaluating this new, flexible, and highly applied tool’s theoretical validity/coherence, reliability, and immediate utility with 101 competitive athletes. This study showed that the theoretical validity and reliability of even nonstandardized, highly applied assessment tools can be evaluated. The ProPS was found to have good preliminary levels of divergent validity and immediate utility. The ProPS was also preliminarily found to have acceptable levels of known-group, concurrent, and convergent evidence, as well as test–retest reliability. Athletes in higher resilience and/or lower concentration disruption groups tended to report higher levels of effectiveness in selected psychological strategies. This case study can be useful for sport experts, especially sport psychology practitioners, wishing to use the ProPS to measure athletes’ psychological strategies and for those aiming to evaluate their own applied assessment tool.
10
Craig, Holly K., and Julie A. Washington. "Oral Language Expectations for African American Preschoolers and Kindergartners." American Journal of Speech-Language Pathology 11, no. 1 (February 2002): 59–70. http://dx.doi.org/10.1044/1058-0360(2002/007).
Анотація:
Fundamental to improving our clinical and empirical understanding of African American students is the development of appropriate, culture-fair assessment methods. This investigation provides descriptive information in the form of means and standard deviations for the performances of 100 typically developing African American preschool and kindergarten students on selected measures of oral language production and comprehension. The measures included four derived from free-play spontaneous language samples: a dialect density measure, mean length of C-units, frequencies of complex syntax, and number of different words. Two measures were derived from responses to nonstandardized elicitations in the form of question prompts and probes of active/passive voice construction. Performances were stable for socioeconomic status on all measures. Dialect density and number of different words varied significantly by gender. Responding to requests for information in the form of question prompts showed a statistically significant increase from preschool to kindergarten. The protocol is recommended for culturefair assessment purposes with African American students as they begin formal education.
11
Cerrone, Albert, Jacob Hochhalter, Gerd Heber, and Anthony Ingraffea. "On the Effects of Modeling As-Manufactured Geometry: Toward Digital Twin." International Journal of Aerospace Engineering 2014 (2014): 1–10. http://dx.doi.org/10.1155/2014/439278.
Анотація:
A simple, nonstandardized material test specimen, which fails along one of two different likely crack paths, is considered herein. The result of deviations in geometry on the order of tenths of a millimeter, this ambiguity in crack path motivates the consideration of as-manufactured component geometry in the design, assessment, and certification of structural systems. Herein, finite element models of as-manufactured specimens are generated and subsequently analyzed to resolve the crack-path ambiguity. The consequence and benefit of such a “personalized” methodology is the prediction of a crack path for each specimen based on its as-manufactured geometry, rather than a distribution of possible specimen geometries or nominal geometry. The consideration of as-manufactured characteristics is central to the Digital Twin concept. Therefore, this work is also intended to motivate its development.
12
Teckie, Sewit, Susan A. McCloskey, and Michael L. Steinberg. "Value: A Framework for Radiation Oncology." Journal of Clinical Oncology 32, no. 26 (September 10, 2014): 2864–70. http://dx.doi.org/10.1200/jco.2014.55.1150.
Анотація:
In the current health care system, high costs without proportional improvements in quality or outcome have prompted widespread calls for change in how we deliver and pay for care. Value-based health care delivery models have been proposed. Multiple impediments exist to achieving value, including misaligned patient and provider incentives, information asymmetries, convoluted and opaque cost structures, and cultural attitudes toward cancer treatment. Radiation oncology as a specialty has recently become a focus of the value discussion. Escalating costs secondary to rapidly evolving technologies, safety breaches, and variable, nonstandardized structures and processes of delivering care have garnered attention. In response, we present a framework for the value discussion in radiation oncology and identify approaches for attaining value, including economic and structural models, process improvements, outcome measurement, and cost assessment.
13
Bascom, Rebecca, Timothy J. Craig, and Diane Schuler. "Clinical Update: Evaluating the Allergic Patient: Practical Techniques." Guides Newsletter 4, no. 2 (March 1, 1999): 3–4. http://dx.doi.org/10.1001/amaguidesnewsletters.1999.marapr02.
Анотація:
Abstract Despite rapid advances in understanding of the biology of allergic disorders, practical techniques for evaluating the allergic patient remain fairly constant. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) requires appropriate assessment before an examiner diagnoses the disorder, determines causation, evaluates whether the patient has reached maximal medical improvement, and rates permanent impairment, if any. A careful history includes both occupational and environmental assessment. Patients with allergic occupational asthma typically must be removed from exposure to the allergen. The environmental assessment should determine the nature of the patient's dwelling, its construction material, heating and ventilation, and the presence or absence of a damp basement, pets, rodents or cockroaches, or hobbies performed in the home. A physical examination should focus on the eyes, nose, lungs, and skin and should exclude obstructive sleep apnea. A thorough medical evaluation always is required, and assessment of immunologic sensitization involves diagnostic allergy skin testing or laboratory assessment. Although the allergens used in such tests are purified and the tests themselves increasingly are standardized, concerns remain regarding nonstandardized laboratories and remote testing. Spirometry is an essential element in objectively defining the nature and severity of respiratory complaints; rhinolaryngoscopy helps differentiate asthma from laryngeal dysfunction and can evaluate sinus disease; and limited cut CT of the sinuses is more cost effective than plain sinus films.
14
Schultheis, Maria T., and Ronald R. Mourant. "Virtual Reality and Driving: The Road to Better Assessment for Cognitively Impaired Populations." Presence: Teleoperators and Virtual Environments 10, no. 4 (August 2001): 431–39. http://dx.doi.org/10.1162/1054746011470271.
Анотація:
Individuals with cognitive impairments can be faced with difficulties that may challenge their ability to drive an automobile, and this impairment is often very disruptive to vocational, social, and domestic activities. Rehabilitation specialists are often given the task of determining capacity to drive. However, traditional assessment methods are fraught with various limitations, including dependence on subjective interpretation of behaviors, nonstandardized procedures, and few ecologically valid measures. A virtual reality-based driving-assessment system (VR-DAS) offers the opportunity to overcome many of the limitations of current methodologies. Specifically, a VR-DAS permits the development of relevant driving scenarios that can provide objective and quantifiable measures of driving behaviors, allowing for increasing standardization and consistency of protocols. VR-DAS also allows for the creation of realistic and interactive driving scenarios at varying levels of challenge and complexity. When coupled with the immersive features offered through a headmounted display (HMD), the VR-DAS may allow drivers to experience the sense of real-life driving, resulting in behavior and responsiveness that may be more predictive of actual driving ability. To examine these potential benefits and the validity of a VR-DAS, a collaborative study is presently being conducted, comparing VR-DAS performance and actual behind-the-wheel performance in adults with acquired brain injury (such as traumatic brain injury and stroke).
15
HUYS, GEERT, KLAAS D'HAENE, MORTEN DANIELSEN, JAANA MÄTTÖ, MARIA EGERVÄRN, and PETER VANDAMME. "Phenotypic and Molecular Assessment of Antimicrobial Resistance in Lactobacillus paracasei Strains of Food Origin." Journal of Food Protection 71, no. 2 (February 1, 2008): 339–44. http://dx.doi.org/10.4315/0362-028x-71.2.339.
Анотація:
Antimicrobial resistance data in food-associated lactic acid bacteria (LAB) such as lactobacilli are mostly based on nonstandardized methodologies and/or have been obtained for only a limited number of strains. This susceptibility study included a diverse collection of 115 isolates mainly of food origin originally identified as Lactobacillus paracasei or Lactobacillus casei. Upon reidentification and removal of potential replicate isolates using repetitive DNA element PCR fingerprinting, 65 genotypically unique L. paracasei strains and the L. casei type strain were selected for broth microdilution and Etest assays using the LAB susceptibility test medium. In both methodologies, strains appeared uniformly susceptible to ampicillin and clindamycin but exhibited natural resistance to streptomycin and gentamicin. Three L. paracasei strains from cheese displayed acquired resistance to tetracycline (MIC ≥ 32 μg/ml) and/or to erythromycin (MIC >16 μ g/ml), which was linked to the presence of a tet(M) or tet(W) gene and/or an erm(B) gene, respectively. Partial sequencing revealed that the tet(M) genes found in two of these strains belonged to two tet(M) sequence homology groups previously found in enterococci. Collectively, phenotypic and genotypic data allowed us to propose tentative epidemiological cutoffs for L. paracasei and L. casei for differentiating susceptible strains from those strains harboring one or more acquired resistance factors.
16
Bleile, Ken. "Evaluating Articulation and Phonological Disorders When the Clock Is Running." American Journal of Speech-Language Pathology 11, no. 3 (August 2002): 243–49. http://dx.doi.org/10.1044/1058-0360(2002/026).
Анотація:
The clinical evaluation of communication is a key element in the therapeutic process. This paper describes an approach to an initial clinical evaluation of a preschool-aged child referred to a clinic for problems in communication. Topics addressed in the evaluation include: What is the purpose of the evaluation? In which setting should the evaluation be held? What aspects of the client's background may contribute to his or her possible communication disorder? How are speech and language assessed in only 60 to 90 minutes? How is hearing assessed? What information should be conveyed to the client's family? The author's general approach to clinical evaluation emphasizes the importance of nonstandardized assessment procedures for obtaining the case history and for collecting and analyzing speech and language samples. The author focuses on linguistic-motor aspects of articulation and phonology disorders and emphasizes the importance of evaluating both the child's major speech errors as well as his or her better speech-making abilities.
17
Pluhar, Emily I., Syidah Abdullah, and E. Thomaseo Burton. "Endorsement of Binge Eating Symptoms in a Sample of Predominantly Non-Hispanic Black Adolescents." Clinical Pediatrics 59, no. 8 (April 10, 2020): 766–72. http://dx.doi.org/10.1177/0009922820915897.
Анотація:
Binge eating disorder (BED) as well as individual subthreshold binge eating symptoms are related to deleterious physical and socioemotional outcomes among adolescents. The present study examined the prevalence of specific binge eating behaviors among a sample of primarily non-Hispanic Black outpatients presenting to weight management and endocrinology clinics. Analyses are based on 103 adolescents (69.9% female, 66.9% non-Hispanic Black) who endorsed one or more binge eating symptoms on a nonstandardized clinical assessment patterned after Diagnostic Statistical Manual of Mental Disorders, Fifth Edition ( DSM-5) criteria. The most commonly endorsed symptom was eating in excess of what is considered normal (71.8%), while least commonly endorsed symptoms included guilt, distress, and embarrassment due to overeating (17.5% to 26.2%). More than half of the participants endorsed multiple specific binge eating symptoms. The level of subthreshold symptomatology reported underscores the importance of developmental and cultural tailoring of prevention and intervention efforts to address these behaviors as a means of curbing clinical-level onset of BED.
18
Tuntevski, Kiril, Brandon C. Durney, Anna K. Snyder, P. Rocco LaSala, Ajay P. Nayak, Brett J. Green, Donald H. Beezhold, Rita V. M. Rio, Lisa A. Holland, and Slawomir Lukomski. "Aspergillus Collagen-Like Genes (acl): Identification, Sequence Polymorphism, and Assessment for PCR-Based Pathogen Detection." Applied and Environmental Microbiology 79, no. 24 (October 11, 2013): 7882–95. http://dx.doi.org/10.1128/aem.02835-13.
Анотація:
ABSTRACTThe genusAspergillusis a burden to public health due to its ubiquitous presence in the environment, its production of allergens, and wide demographic susceptibility among cystic fibrosis, asthmatic, and immunosuppressed patients. Current methods of detection ofAspergilluscolonization and infection rely on lengthy morphological characterization or nonstandardized serological assays that are restricted to identifying a fungal etiology. Collagen-like genes have been shown to exhibit species-specific conservation across the noncollagenous regions as well as strain-specific polymorphism in the collagen-like regions. Here we assess the conserved region of theAspergilluscollagen-like (acl) genes and explore the application of PCR amplicon size-based discrimination among the five most common etiologic species of theAspergillusgenus, includingAspergillus fumigatus,A. flavus,A. nidulans,A. niger, andA. terreus. Genetic polymorphism and phylogenetic analysis of theaclF1gene were additionally examined among the available strains. Furthermore, the applicability of the PCR-based assay to identification of these five species in cultures derived from sputum and bronchoalveolar fluid from 19 clinical samples was explored. Application of capillary electrophoresis on nanogels was additionally demonstrated to improve the discrimination betweenAspergillusspecies. Overall, this study demonstrated thatAspergillusaclgenes could be used as PCR targets to discriminate between clinically relevantAspergillusspecies. Future studies aim to utilize the detection ofAspergillusaclgenes in PCR and microfluidic applications to determine the sensitivity and specificity for the identification ofAspergilluscolonization and invasive aspergillosis in immunocompromised subjects.
19
Di Giovine, Paolo, Antonella Pinto, Rose-Marie Ölander, Dorothea Sesardic, Paul Stickings, Guy Berbers, Shona Neal, et al. "External Quality Assessment for the Determination of Diphtheria Antitoxin in Human Serum." Clinical and Vaccine Immunology 17, no. 8 (July 7, 2010): 1282–90. http://dx.doi.org/10.1128/cvi.00096-10.
Анотація:
ABSTRACT Accurate determination of diphtheria toxin antibodies is of value in determining the rates of immunity within broad populations or the immune status of individuals who may be at risk of infection, by assessing responses to vaccination and immunization schedule efficacy. Here we report the results of an external quality assessment (EQA) study for diphtheria serology, performed within the dedicated surveillance network DIPNET. Twelve national laboratories from 11 European countries participated by testing a standard panel of 150 sera using their current routine method: Vero cell neutralization test (NT), double-antigen enzyme-linked immunosorbent assay (ELISA; DAE), dual double-antigen time-resolved fluorescence immunoassay (dDA-DELFIA), passive hemagglutination assay (PHA), toxin binding inhibition assay (ToBI), and in-house or commercial ELISAs. The objective of the study was not to identify the best assay, as the advantages and drawbacks of methods used were known, but to verify if laboratories using their routine method would have categorized (as negative, equivocal, or positive) a serum sample in the same way. The performance of each laboratory was determined by comparing its results on a quantitative and qualitative basis to NT results from a single reference laboratory, as this test is considered the in vitro “gold standard.” The performance of laboratories using NT was generally very good, while the laboratories’ performance using other in vitro methods was variable. Laboratories using ELISA and PHA performed less well than those using DAE, dDA-DELFIA, or ToBI. EQA is important for both laboratories that use in vitro nonstandardized methods and those that use commercial ELISA kits.
20
Jimenez, Juan Carlos, Melissa M. Smith, and Samuel Eric Wilson. "Sexual Dysfunction in Men after Open or Endovascular Repair of Abdominal Aortic Aneurysms." Vascular 12, no. 3 (May 2004): 186–91. http://dx.doi.org/10.1258/rsmvasc.12.3.186.
Анотація:
Few studies have thoroughly investigated the incidence and detailed the degree of sexual disability after aortic aneurysm surgery. Reports prior to 1990 vary greatly in the incidence of postoperative dysfunction mostly because of nonstandardized methods of assessment. In this article, we compare the incidence of reported sexual dysfunction after aortic reconstruction, open and endovascular abdominal aortic aneurysm repair. Pertinent studies on sexual dysfunction following open and endovascular aortic aneurysm repair were identified from a MEDLINE search of English-language publications since 1966. Newer standardized methods of assessment have identified relatively high rates of sexual dysfunction prior to and after intervention. Aortic aneurysm patients have a baseline incidence of sexual dysfunction of approximately 30%, which doubles over the next 7 years. Patients who had open aortic operations reported significantly increased sexual dysfunction during the first postoperative year. Endovascular repair with unilateral internal iliac occlusion results in new sexual dysfunction in approximately 10% of patients, but this increases significantly with bilateral internal iliac occlusion. When compared with open operation, the incidence of sexual dysfunction is lower overall in patients with endovascular aortic aneurysm repairs, which includes those who have internal iliac artery occlusion, but it is increased with bilateral iliac occlusion. Surgeons should be aware of the preoperative prevalence of sexual dysfunction in patients undergoing aortic procedures.
21
Lensen, K. D. F., E. F. I. Comans, A. E. Voskuyl, C. J. van der Laken, E. Brouwer, A. T. Zwijnenburg, L. M. Pereira Arias-Bouda, A. W. J. M. Glaudemans, R. H. J. A. Slart, and Y. M. Smulders. "Large-Vessel Vasculitis: Interobserver Agreement and Diagnostic Accuracy of18F-FDG-PET/CT." BioMed Research International 2015 (2015): 1–8. http://dx.doi.org/10.1155/2015/914692.
Анотація:
Introduction.18F-FDG-PET visualises inflammation. Both atherosclerosis and giant cell arteritis cause vascular inflammation, but distinguishing the two may be difficult. The goal of this study was to assess interobserver agreement and diagnostic accuracy of18F-FDG-PET for the detection of large artery involvement in giant cell arteritis (GCA).Methods. 3118F-FDG-PET/CT scans were selected from 2 databases. Four observers assessed vascular wall18F-FDG uptake, initially without and subsequently with predefined observer criteria (i.e., vascular wall18F-FDG uptake compared to liver or femoral artery18F-FDG uptake). External validation was performed by two additional observers. Sensitivity and specificity of18F-FDG-PET were determined by comparing scan results to a consensus diagnosis.Results. The highest interobserver agreement (kappa: 0.96 in initial study and 0.79 in external validation) was observed when vascular wall18F-FDG uptake higher than liver uptake was used as a diagnostic criterion, although agreement was also good without predefined criteria (kappa: 0.68 and 0.85). Sensitivity and specificity were comparable for these methods. The criterion of vascular wall18F-FDG uptake equal to liver18F-FDG uptake had low specificity.Conclusion. Standardization of image assessment for vascular wall18F-FDG uptake promotes observer agreement, enables comparative studies, and does not appear to result in loss of diagnostic accuracy compared to nonstandardized assessment.
22
Zarbo, Richard J., and M. Elizabeth H. Hammond. "Conference Summary, Strategic Science Symposium." Archives of Pathology & Laboratory Medicine 127, no. 5 (May 1, 2003): 549–53. http://dx.doi.org/10.5858/2003-127-0549-cssss.
Анотація:
Abstract Context.—Practicing pathologists often encounter controversial clinical issues and nonstandardized laboratory approaches to the evolving science of predictive/prognostic tumor marker assays. This dilemma becomes especially acute when the assay is the sole determinant for selection of a specific therapy. Objectives.—To summarize the areas of practical agreement and identify opportunities for improvement in Her-2/neu testing of breast cancer. Design.—The College of American Pathologists created a new comprehensive education model, called Strategic Science, with expert speakers integrating new and evolving basic, clinical, and scientific issues of Her-2/neu testing with aspects of laboratory management. Setting.—Symposium held May 4 and 5, 2002, in Rosemont, Ill. Participants.—Ten speakers and more than 100 attendees. Results.—Components addressed were new technology assessment, practice guidelines, quality assurance, regulatory compliance, risk and liability, billing and coding, cost analysis, consultation, information management, and results reporting. Conclusions.—This Strategic Science symposium derived areas of practical agreement, defined the current state-of-the-art, and identified areas for improvement in Her-2/neu testing.
23
Lee, Sang Moo, Gaeun Kim, Jeonghoon Ahn, Hae Sun Suh, and Dae Seog Heo. "FACTORS INFLUENCING DECISION MAKING ON THERAPEUTIC INTERVENTIONS." International Journal of Technology Assessment in Health Care 29, no. 3 (July 2013): 331–35. http://dx.doi.org/10.1017/s0266462313000214.
Анотація:
Objectives: The aim of this study was to explore factors that influenced decision making in the assessment of new health technology in Korea.Methods: We analyzed the decision-making results of the Committee for New Health Technology Assessment (CnHTA) on fifty-three new nondrug health technologies in Korea from July 2007 to December 2010. The scope of the committee was mainly limited to safety and efficacy/effectiveness, and every decision was based on a systematic review of the literature. The committee was composed of healthcare professionals, policy makers, lawyers, and representatives from nongovernmental organizations. Decisions made on therapeutic interventions were included, while those on diagnostic procedures were excluded.Results: Factors that positively influenced decisions were lower complication rate than existing technology, similar or greater effectiveness compared with existing technology, ability to save critical organs, absence of alternative intervention, decreased invasiveness, expansion of patient's set of choices, and similarity to the mechanism of existing technology. Factors that negatively influenced decisions were higher complication rates than existing technology, lower effectiveness than comparable technology, low levels of evidence, unknown mechanisms of intervention, inconsistency, lack of long-term outcomes, lack of comparative data, nonstandardized technology, heterogeneity between control and treatment, excessively diverse indications, and nongeneralizability.Conclusions: This qualitative analysis of past decision-making results provided us with clues on the values that decision makers on the Korean CnHTA considered in terms of safety and effectiveness. These findings will help us develop appraisal guidelines and enhance the objectivity of decision-making processes in Korea.
24
Bedaiwy, Mohamed A., Rachel Pope, Drisana Henry, Kristin Zanotti, Sangeeta Mahajan, William Hurd, Tommaso Falcone, and James Liu. "Standardization of Laparoscopic Pelvic Examination: A Proposal of a Novel System." Minimally Invasive Surgery 2013 (2013): 1–4. http://dx.doi.org/10.1155/2013/153235.
Анотація:
Objective. Laparoscopic pelvic assessment is often performed in a nonstandardized fashion depending on the surgeon’s discretion. Reporting anatomic findings is inconsistent and lesions in atypical locations may be missed. We propose a method for systematic pelvic assessment based on anatomical landmarks. Design. Retrospective analysis. Setting. Tertiary care academic medical center. Intervention. We applied this system to operative reports of 540 patients who underwent diagnostic or operative laparoscopy for unexplained infertility between 2006 and 2012. The pelvis was divided into 2 midline zones (zone I and II) and right and left lateral zones (zone III and IV). All reports were evaluated for the comprehensiveness of description with respect to normal findings or pathology for each zone. Results. Of 540 surgeries, all reports commented on the uterus, tubes, and ovaries (100%), but only 17% (n=93, 95% CI: 13.8–20.2) commented on the dome of the bladder and the anterior cul-de-sac. 24% (n=130, 95% CI: 20.4–27.6) commented on the posterior cul-de-sac, and 5% (n=29, 95% CI: 3.2–6.8) commented on the pelvic sidewall. Overall, 6% (n=34, 95% CI: 4–8) reported near complete documentation of the pelvic zones. Conclusion. Implementation of a systematic approach for laparoscopic pelvic examination will enhance the diagnostic accuracy and provide better communication between care providers. In the absence of pelvic pathology, we recommend a minimum of 6 photographs of the 6 pelvic zones.
25
Dralle, Henning, Antonio Sitges-Serra, Peter Angelos, Manuel C. Durán Poveda, Gianlorenzo Dionigi, Marcin Barczynski, Eimear Phelan, and Gregory Randolph. "Intraoperative Monitoring of the Recurrent Laryngeal Nerve during Thyroidectomy: A Standardized Approach (Part 1)." World Journal of Endocrine Surgery 3, no. 3 (2011): 144–50. http://dx.doi.org/10.5005/jp-journals-10002-1079.
Анотація:
ABSTRACT One of the most feared complications in thyroid surgery is injury to the superior laryngeal nerve or recurrent laryngeal nerve. Neural identification during surgery is insufficient to assess nerve injury. Intraoperative nerve monitoring of the vagal nerve and recurrent laryngeal nerve during thyroid surgery is a new adjunct designed to allow better identification of nerves at risk and therefore reduce complications related to their injury. This new working tool does not substitute adequate surgical technique but merely provides the surgeon with an adjunct to routine visual identification and functional assessment. The use of nerve monitoring requires standardization of the monitoring procedure. Pursuant to this, we will discuss in two related articles the current state of the art standardized technique of nerve monitoring in thyroid surgery. The aim of part 1 is to provide a concise overview of nerve monitoring in thyroid surgery and its effectiveness. This will include a brief review of the surgical anatomy of the recurrent laryngeal nerve and the key landmarks used to identify the nerve during surgery. Part 2 will describe how to perform the standardized nerve monitoring in a step by step fashion during thyroid surgery which will diminish variable results and misleading information associated with a nonstandardized nerve monitoring procedure.
26
Silkes, JoAnn P., and Kaitlin Winterstein. "Speech-Language Pathologists' Use of Hearing Screening for Clients With Aphasia: Challenges, Potential Solutions, and Future Directions." American Journal of Speech-Language Pathology 26, no. 1 (February 2017): 11–28. http://dx.doi.org/10.1044/2016_ajslp-14-0181.
Анотація:
Purpose The co-occurrence of aphasia and hearing loss can lead to compounded receptive communication impairment that is significantly worse than in either disorder alone. Therefore, identifying potential hearing loss is a critical part of communication assessment for clients with neurogenic communication disorders, many of whom have aphasia. This clinical focus article explores speech language pathologists' (SLPs') hearing-screening practices with this population, identifies patterns of concern, and presents potential solutions and future research needs. Method SLPs completed an online survey. Data were obtained from 102 SLPs who work with adults with aphasia. Results Most respondents indicated that they do some form of hearing screening, although few do them in a reliable, valid manner. Awareness of American Speech-Language-Hearing Association hearing-screening guidelines was low. The most common reasons given for not conducting screenings included cost and lack of proper equipment and time. Conclusions SLPs are an important resource for identifying potential hearing loss in individuals with aphasia. These data suggest that hearing screenings are being conducted only inconsistently with this population, often using nonstandardized methods. The results demonstrate a need to develop hearing-screening tools that are affordable, easily accessible, and validated for aphasia, and to raise awareness of currently available hearing-screening protocols and tools.
27
Coyle, Andrew, Ira Helenius, Christina M. Cruz, E. Allison Lyons, Natalie May, John Andrilli, M. Merav Bannet, Rachel Pinotti, and David C. Thomas. "A Decade of Teaching and Learning in Internal Medicine Ambulatory Education: A Scoping Review." Journal of Graduate Medical Education 11, no. 2 (April 1, 2019): 132–42. http://dx.doi.org/10.4300/jgme-d-18-00596.1.
Анотація:
ABSTRACT Background Ambulatory training in internal medicine residency programs has historically been considered less robust than inpatient-focused training, which prompted a 2009 revision of the Accreditation Council for Graduate Medical Education (ACGME) Program Requirements in Internal Medicine. This revision was intended to create a balance between inpatient and outpatient training standards and to spur innovation in the ambulatory setting. Objective We explored innovations in ambulatory education in internal medicine residency programs since the 2009 revision of the ACGME Program Requirements in Internal Medicine. Methods The authors conducted a scoping review of the literature from 2008 to 2017, searching PubMed, ERIC, and Scopus databases. Articles related to improving educational quality of ambulatory components of US-based internal medicine residency programs were eligible for inclusion. Articles were screened for relevance and theme categorization and then divided into 6 themes: clinic redesign, curriculum development, evaluating resident practice/performance, teaching methods, program evaluation, and faculty development. Once a theme was assigned, data extraction and quality assessment using the Medical Education Research Study Quality Instrument (MERSQI) score were completed. Results A total of 967 potentially relevant articles were discovered; of those, 182 were deemed relevant and underwent full review. Most articles fell into curriculum development and clinic redesign themes. The majority of included studies were from a single institution, used nonstandardized tools, and assessed outcomes at the satisfaction or knowledge/attitude/skills levels. Few studies showed behavioral changes or patient-level outcomes. Conclusions While a rich diversity of educational innovations have occurred since the 2009 revision of the ACGME Program Requirements in Internal Medicine, there is a significant need for multi-institution studies and higher-level assessment.
28
Kim, Paul Jeong, Ruth Peace, Jamie Mieras, Tanya Thoms, Denise Freeman, and Jeffrey Page. "Interrater and Intrarater Reliability in the Measurement of Ankle Joint Dorsiflexion is Independent of Examiner Experience and Technique Used." Journal of the American Podiatric Medical Association 101, no. 5 (September 1, 2011): 407–14. http://dx.doi.org/10.7547/1010407.
Анотація:
Background: Goniometric measurement is currently being used as a diagnostic and outcomes assessment tool for ankle joint dorsiflexion. Despite its common use, its interrater and intrarater reliability has been questioned. Methods: This is a prospective study examining whether the experience of the examiner or the technique used affects the interrater and intrarater reliability for measuring ankle joint dorsiflexion. Fourteen asymptomatic individuals (8 male and 6 female) with a mean age of 28.2 years (range, 23–52) were enrolled into this study. The years of clinical experience of the five examiners averaged 10.4 years (range, 0–26). Four examiners used a modified Root, Weed and Orien method of measuring ankle joint dorsiflexion. The fifth examiner utilized a nonstandardized technique. A standard goniometer was used for bilateral measurements of ankle joint dorsiflexion with the knee extended and flexed. All five examiners repeated each measurement three times during each of the three sessions, with each session spaced at least 1 week apart. Results: The interclass correlation coefficient reveals a moderate intrarater and poor interrater reliability in ankle joint dorsiflexion measurements using a standard goniometer. More importantly, further analysis indicates that the use of a standardized technique for measurement of ankle joint dorsiflexion or years of clinical experience does not increase the intrarater or interrater reliability. Conclusions: The utility of the goniometric measurement of ankle joint dorsiflexion may be limited. (J Am Podiatr Med Assoc 101(5): 407–414, 2011)
29
Guzman, Alvaro, Ryszard Zebrak, Kelly J. Rohan, Irshad A. Sumar, Svetlana Savchenko, John W. Stiller, Adela Valadez-Meltzer, et al. "A Prospective Longitudinal Study of Seasonality in African Students Living in the Greater Washington, D.C. Metropolitan Area." Scientific World JOURNAL 7 (2007): 577–83. http://dx.doi.org/10.1100/tsw.2007.110.
Анотація:
We conducted a prospective, longitudinal study of seasonality in a vulnerable population, i.e., African students who migrated to a temperate climate. Consistent with previous cross-sectional studies, we hypothesized lower mood and energy, and higher appetite and weight, in fall/winter than in spring/summer. Four cohorts of African students attending a year-long nursing school program without vacation in Washington, D.C., were assessed monthly for 1 year. Forty-three subjects (mean age = 33.46 ± 6.25), consisting of predominantly females (76.7%), completed the study. The cohorts began their academic program in different seasons (one each in winter, spring, summer, and fall), inherently minimizing confounding influences on seasonality, such as academic and immigration stress, as well as allowing adjustment for an order effect. At each assessment, students completed three 100-mm visual analog scales for mood, energy, and appetite, and were weighed on a digital scale. For each standardized dependent variable, a repeated measure ANOVA was used and, if a significant effect of month was identified, averages for spring/summer and fall/winter were compared using paired ttests. In addition, a mixed model for repeated measures was applied to raw (nonstandardized) data. Body weight was significantly higher in fall/winter than in spring/summer (p < 0.01). No seasonal differences in mood, energy, or appetite were found. Benefiting from certain unique features of our cohorts allowing adjustment for order effects, this is the first study to identify a seasonal variation in body weight with a peak in winter using longitudinal monthly measurements.
30
Sakakibara, Brodie M., William C. Miller, Janice J. Eng, Catherine L. Backman, and François Routhier. "Influences of Wheelchair-Related Efficacy on Life-Space Mobility in Adults Who Use a Wheelchair and Live in the Community." Physical Therapy 94, no. 11 (November 1, 2014): 1604–13. http://dx.doi.org/10.2522/ptj.20140113.
Анотація:
Background Self-efficacy has important implications for health and functioning in people with limited mobility. However, the influence of self-efficacy on mobility in adults who use wheelchairs has yet to be investigated. Objective The study objective was to: (1) estimate the direct association between wheelchair use self-efficacy and life-space mobility and (2) investigate an indirect effect through wheelchair skills. Design This was a cross-sectional study. Methods Participants (N=124) were adults who use a wheelchair, live in the community, and were 50 years of age and older (X̅=59.67, range=50–84), with at least 6 months of experience with manual wheelchair use; 60% were men. The 20-item Life-Space Assessment, the 65-item Wheelchair Use Confidence Scale, and the 32-item Wheelchair Skills Test-Questionnaire were used to measure life-space mobility, self-efficacy, and wheelchair skills, respectively. Results Self-efficacy had a statistically significant association with life-space mobility (nonstandardized regression coefficient=0.23, 95% confidence interval=0.07, 0.39) after controlling for sex, number of comorbidities, geographic location, and assistance with using a wheelchair. This model accounted for 37.1% of the life-space mobility variance, and the unique contribution of self-efficacy was 3.5%. The indirect effect through wheelchair skills was also statistically significant (point estimate=0.21, 95% bootstrapped confidence interval=0.05, 0.43) and accounted for 91.3% of the direct effect of self-efficacy on life-space mobility. This model accounted for 39.2% of the life-space mobility variance. Limitations Causality could not be established because of the study design. The self-report nature of data from volunteers may be influenced by recall bias, social desirability, or both. Conclusions Wheelchair use self-efficacy had both direct and indirect associations with life-space mobility after controlling for confounding variables. Interventions targeted toward improving self-efficacy may lead to improvements in life-space mobility.
31
Westercamp, Matthew, Paul Malpiedi, Amber Vasquez, Danica Gomes, Carmen Hazim, Benjamin J. Park, and Rachel Smith. "Supporting Healthcare-Associated Infection (HAI) Surveillance in Resource-Limited Settings: Lessons Learned, 2015–2019." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s395—s396. http://dx.doi.org/10.1017/ice.2020.1037.
Анотація:
Background: Since 2015, the CDC has supported the development and implementation of healthcare-associated infection (HAI) surveillance in resource-limited settings through technical support of case definitions and methods that are feasible with existing surveillance capacity and integration with clinical care to maximize sustainability and data use for action. Methods: Surveillance initiatives included facility-level implementation programs in Kenya, Sierra Leone, Thailand, and Georgia; larger national or regional network-level projects in India and Vietnam were also supported. For assessment and planning, surveillance capacities were grouped into 3 domains: staff, informatics, and diagnostic capacities. Based on these capacities, simplified case definitions surveillance methodologies were devised to balance resources and effort with the anticipated value and use of findings. Results: There was broad understanding of the importance of HAI surveillance; however, the required resources and other challenges (eg, training, staffing, quality of available data) were underappreciated. Staff capacities were often influenced by a lack of dedicated surveillance staff and limited experience in systematic data collection and analysis. Informatics capacities were generally limited by the lack of digital data management, nonstandardized clinical data collection and storage, and the inability to assign and maintain unique patient identifiers. We found that capacity for diagnostics, a critical component of traditional HAI surveillance systems, was limited by its availability, frequency of use, and inconsistent rationale in clinical care. We found that successful surveillance strategies were generally simple, matched existing capacities, and targeted specific HAI priorities identified by clinical teams. For example, in Kenya and Sierra Leone, participating facilities established, with minimal external support, simplified SSI surveillance among post–caesarean-delivery patients. These initiatives improved integration of surveillance with clinical care through encouraging participation of the clinical team in surveillance and planning. Furthermore, these models directly linked surveillance activities to improved patient care (eg, combined clinical checklists with surveillance data collection forms). Discussion: In resource-limited settings, the local cost and effort required to establish and sustain the necessary infrastructure for HAI surveillance can be substantial. Establishing actionable and sustainable HAI surveillance can be achieved through simplifying HAI surveillance to match existing capacities and can result in valuable surveillance programs, even in very resource-limited settings.Funding: NoneDisclosures: None
32
Pagani-Estévez, Gabriel L. "Occipital Neuromodulation: A Surgical Technique with Reduced Complications." Pain Physician 7;19, no. 7;9 (September 14, 2016): E1005—E1012. http://dx.doi.org/10.36076/ppj/2016.19.e1005.
Анотація:
Background: Occipital neuromodulation is a promising treatment modality for refractory headache, but lead migration remains a frequent surgical complication. Objectives: The primary objective was to identify surgical techniques that may minimize adverse events, particularly lead migration. We hypothesized that a surgical technique employing 2-point anchoring of stimulator leads designed to provide a tension-relief loop and the use of ultrasound for lead placement would decrease the complication rate. Study Design and Setting: A retrospective analysis was performed through electronic medical record chart review in a tertiary referral center. Methods: Institutional Review Board (IRB) approval was obtained. Eighteen patients had a trial and subsequent permanent occipital nerve stimulator (ONS) implantation between 2004 and 2011 and were included. Adverse events were recorded and efficacy outcome variables analyzed for significance. Results: The cohort was a median (IQR) 45 (37 – 58) in age and 9 (50%) were women. Tension-relief loops placed via a 2-point anchoring technique and ultrasound use for occipital lead placement were evident in 16 (89%) and 13 (72%), respectively. There was one (6%) clinically insignificant lead position change, not definitively a lead migration, which could have been an artifact of fluoroscope positioning. Adverse events included one (6%) battery malfunction, one (6%) lead malfunction, and 2 (12%) post-implantation infections. Following ONS, there were significant reductions in numeric rating scale (NRS) pain scores from a median (IQR) of 9.5 (8.25 – 10) to 2.5 (1 – 4.75) (P < 0.0001), headache days per week from 7 (7 – 7) to 1.5 (0.375 – 1.75) (P = 0.0005), and the number of daily headache medication from 3 (2.25 – 4) to 2.5 (2 – 3.75) (P = 0.0112). Limitations: Limitations include retrospective study design, investigator bias, and nonstandardized intervals of headache burden assessment. Conclusions: In ONS, utilization of a 2-point anchoring technique with a tension-relief loop may significantly minimize the risk of lead migration, based on the absence of definitive lead migration in our series. Ultrasound use may improve the anatomic accuracy of lead placement with the possibility of improved efficacy. ONS was associated with significantly decreased headache pain, frequency, and medication use. Key words: Occipital neuromodulation, occipital nerve stimulation, surgical technique, lead migration, tension-relief loop
33
Denham, Susan, Taylor Hawkins, Kelsey Johnson, Jenna Rhoads, and Sara Sims. "The Functionality of the Biomechanical Prosthetic Finger When Compared to Standardized and Nonstandardized Assessments." American Journal of Occupational Therapy 71, no. 4_Supplement_1 (July 1, 2017): 7111515251p1. http://dx.doi.org/10.5014/ajot.2017.71s1-po5072.
34
Benjamin, R. J., and D. B. Sacks. "Glycated protein update: implications of recent studies, including the diabetes control and complications trial." Clinical Chemistry 40, no. 5 (May 1, 1994): 683–87. http://dx.doi.org/10.1093/clinchem/40.5.683.
Анотація:
Abstract On the basis of the results of the Diabetes Control and Complications Trial (DCCT), the American Diabetes Association (ADA) now recommends tight control of blood glucose to near-normal concentrations as the primary goal for most eligible insulin-dependent diabetic patients. In the DCCT, intensive therapeutic intervention was based on frequent self-monitoring of blood glucose and monthly measurements of glycohemoglobin. The importance of glycohemoglobin assessments serves to highlight the present inadequacies in laboratory measurements of this analyte, which hinders wide implementation of the ADA recommendations. Clinical interventions aimed at achieving the DCCT's published therapeutic goals may place patients at a significantly increased risk for life-threatening hypoglycemia, if the therapy is based on nonstandardized laboratory results. Clinical laboratories will now be under increasing pressure to provide reproducible, standardized measurements of glycohemoglobin, a goal that recent research has shown to be realistic, if widespread interlaboratory calibration is adopted. Finally, recent advances in measuring glycated serum proteins appear to warrant reevaluation of such assays during future intensive therapy trials, as potentially important tools for fine-tuning tight blood glucose control.
35
Daly, Lauren T., Michael C. Daly, Amin Mohamadi, and Neal Chen. "Chronic Scapholunate Interosseous Ligament Disruption: A Systematic Review and Meta-Analysis of Surgical Treatments." HAND 15, no. 1 (July 20, 2018): 27–34. http://dx.doi.org/10.1177/1558944718787289.
Анотація:
Background: Although many techniques have been described, there is no clear optimal surgical treatment for chronic scapholunate interosseous ligament (SLIL) disruption. Methods: We identified 255 articles reporting outcomes of SLIL reconstruction. Of these, 40 studies (978 wrists) met eligibility requirements and reported sufficient data on radiographic outcomes to be included in the study. The mean and standard deviation of preoperative and follow-up assessments including scapholunate gap (SLG) and scapholunate angle (SLA) were used to calculate pooled standardized mean differences (SMD) with 95% confidence intervals (CIs). For other radiographic or clinical outcomes, there were not enough reported data to calculate a pooled effect size, and pooled nonstandardized comparisons were made. Results: The SMD between preoperative and postoperative SLA in tenodesis reconstruction was 0.7 (CI, 0.29 to 1.11, P = .001) and 0.04 (CI, –0.27 to 0.38, P = .8) for capsulodesis reconstruction. For SLG, tenodesis demonstrated an SMD of 1.1 (CI, 0.6 to 1.55, P < .001) compared with 0.1 (CI, –0.36 to 0.59, P = .6) for capsulodesis reconstruction. Tenodesis had a significant improvement compared with capsulodesis in SLA ( P = .01) and SLG ( P = .005). Tenodesis also showed improvement in grip strength and Disabilities of the Arm, Shoulder and Hand scores. Conclusions: Comparing preoperative and postoperative radiographic measurements, tenodesis reconstruction demonstrated significantly improved SLG and SLA relative to capsulodesis. Interpreted in the context of the limitations, existing data demonstrates some benefit of tenodesis reconstruction.
36
Fuller, Christopher, Joanne Savage, Sarah Besser, Andrew Hayward, Barry Cookson, Ben Cooper, and Sheldon Stone. "“The Dirty Hand in the Latex Glove”: A Study of Hand Hygiene Compliance When Gloves Are Worn." Infection Control & Hospital Epidemiology 32, no. 12 (December 2011): 1194–99. http://dx.doi.org/10.1086/662619.
Анотація:
Background and Objective.Wearing of gloves reduces transmission of organisms by healthcare workers' hands but is not a substitute for hand hygiene. Results of previous studies have varied as to whether hand hygiene is worse when gloves are worn. Most studies have been small and used nonstandardized assessments of glove use and hand hygiene. We sought to observe whether gloves were worn when appropriate and whether hand hygiene compliance differed when gloves were worn.Design.Observational study.Participants and Setting.Healthcare workers in 56 medical or care of the elderly wards and intensive care units in 15 hospitals across England and Wales.Methods.We observed hand hygiene and glove usage (7,578 moments for hand hygiene) during 249 one-hour sessions. Observers also recorded whether gloves were or were not worn for individual contacts.Results.Gloves were used in 1,983 (26.2%) of the 7,578 moments for hand hygiene and in 551 (16.7%) of 3,292 low-risk contacts; gloves were not used in 141 (21.1%) of 669 high-risk contacts. The rate of hand hygiene compliance with glove use was 41.4% (415 of 1,002 moments), and the rate without glove use was 50.0% (1,344 of 2,686 moments). After adjusting for ward, healthcare worker type, contact risk level, and whether the hand hygiene opportunity occurred before or after a patient contact, glove use was strongly associated with lower levels of hand hygiene (adjusted odds ratio, 0.65 [95% confidence interval, 0.54-0.79]; P<.0001).Conclusion.The rate of glove usage is lower than previously reported. Gloves are often worn when not indicated and vice versa. The rate of compliance with hand hygiene was significantly lower when gloves were worn. Hand hygiene campaigns should consider placing greater emphasis on the World Health Organization indications for gloving and associated hand hygiene.Trial Registration.National Research Register N0256159318.
37
Westercamp, Matthew, Aqueelah Barrie, Christiana Conteh, Danica Gomes, Hassan Benya, Jamine Weiss, Anna Maruta, and Rachel Smith. "Feasible Surgical Site Infection Surveillance in Resource-Limited Settings: A Pilot in Sierra Leone." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s38. http://dx.doi.org/10.1017/ice.2020.517.
Анотація:
Background: Surgical site infections (SSIs) are among the most common healthcare-associated infections (HAIs) in low- and middle-income countries (LMICs). SSI surveillance can be challenging and resource-intensive to implement in LMICs. To support feasible LMIC SSI surveillance, we piloted a multisite SSI surveillance protocol using simplified case definitions and methodology in Sierra Leone. Methods: A standardized evaluation tool was used to assess SSI surveillance knowledge, capacity, and attitudes at 5 proposed facilities. We used simplified case definitions restricted to objective, observable criteria (eg, wound purulence or intentional reopening) without considering the depth of infection. Surveillance was limited to post-cesarean delivery patients to control variability of patient-level infection risk and to decrease data collection requirements. Phone-based patient interviews at 30-days facilitated postdischarge case finding. Surveillance activities utilized existing clinical staff without monetary incentives. The Ministry of Health provided training and support for data management and analysis. Results: Three facilities were selected for initial implementation. At all facilities, administration and surgical staff described most, or all, infections as “preventable” and all considered SSIs an “important problem” at their facility. However, capacity assessments revealed limited staff availability to support surveillance activities, limited experience in systematic data collection, nonstandardized patient records as the basis for data collection, lack of unique and consistent patient identifiers to link patient encounters, and no quality-assured microbiology services. To limit system demands and to maximize usefulness, our surveillance data collection elements were built into a newly developed clinical surgical safety checklist that was designed to support surgeons’ clinical decision making. Following implementation and 2 months of SSI surveillance activities, 77% (392 of 509) of post-cesarean delivery patients had a checklist completed within the surveillance system. Only 145 of 392 patients (37%) under surveillance were contacted for final 30-day phone interview. Combined SSI rate for the initial 2-months of data collection in Sierra Leone was 8% (32 of 392) with 31% (10 of 32) identified through postdischarge case finding. Discussion: The surveillance strategy piloted in Sierra Leone represents a departure from established HAI strategies in the use of simplified case definitions and implementation methods that prioritize current feasibility in a resource-limited setting. However, our pilot implementation results suggest that even these simplified SSI surveillance methods may lack sustainability without additional resources, especially in postdischarge case finding. However, even limited phone-based patient interviews identified a substantial number of infections in this population. Although it was not addressed in this pilot study, feasible laboratory capacity building to support HAI surveillance efforts and promote appropriate treatment should be explored.Funding: NoneDisclosures: None
38
Hall, Audrey, Jennifer P. Lundine, and Rebecca J. McCauley. "Nonstandardized Assessment of Cognitive-Communication Abilities Following Pediatric Traumatic Brain Injury: A Scoping Review." American Journal of Speech-Language Pathology, August 5, 2021, 1–22. http://dx.doi.org/10.1044/2021_ajslp-20-00231.
Анотація:
Purpose The purpose of this study is to describe and synthesize existing research on nonstandardized assessment of cognitive-communication abilities in children with traumatic brain injury (TBI) in order to improve the detection, diagnosis, and tracking of injury sequelae and guide appropriate service provision. Materials and Method A search of peer-reviewed journal databases revealed 504 unique articles published between January 2000 and August 2019. For full inclusion, articles had to report on empirical studies examining variables related to the nonstandardized assessment of cognitive-communication skills following TBI in children. Review articles, expert opinion pieces, and non–English language articles were excluded. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guided this process. Results Results were tabulated for each of the 14 articles that met full inclusion criteria. Included studies presented five different types of nonstandardized assessment: discourse analysis ( n = 3), systematic observation of child's performance during an instrumental activity of daily living ( n = 4), virtual reality tasks ( n = 3), structured cognitive tasks ( n = 2), and functional rating scales ( n = 2). The majority of included studies compared the outcomes of nonstandardized assessment against subtest scores and checklists drawn from a variety of existing standardized and criterion-referenced assessments. Targeted cognitive-communication skills included attention, working memory, self-regulation, planning, multitasking, social problem-solving, inferencing, and macrolevel discourse. Conclusions Preliminary research suggests that a well-designed and systematically implemented nonstandardized assessment can yield essential information about children's cognitive-communication abilities in real-world contexts. Further research is needed to validate these assessments and to determine in which settings and situations they may prove most effective. Supplemental Material https://doi.org/10.23641/asha.15079026
39
Beverly, Brenda L., and L. Amanda Mathews. "Speech-Language Pathologist and Parent Perspectives on Speech-Language Pathology Services for Children With Autism Spectrum Disorders." Focus on Autism and Other Developmental Disabilities, September 13, 2020, 108835762095438. http://dx.doi.org/10.1177/1088357620954380.
Анотація:
Many speech-language pathologists (SLPs) are underprepared to serve children with autism spectrum disorders (ASDs), despite a growing need and increased expectation for ASD expertise. To understand this practice gap, 60 SLPs and 26 parents of children with ASDs were surveyed regarding SLP knowledge and competency. Of concern was that only about 50% of SLPs correctly identified ASD defining criteria. Respondents rated eight SLP practices as Important to Very Important, but SLPs reported being only Somewhat Competent to Competent. The parents’ rating of SLP competency was significantly lower than parental ratings of importance for one educational practice, use of nonstandardized assessment and observational methods. Also, parents rated the development of the Individualized Education Program significantly higher in importance than SLPs rated it. Findings varied for ASD specialty subgroups. Results support socially valid improvements in preparation for SLPs on the frontlines of assessment, treatment, and development of health and educational systems for children with ASDs.
40
Roitsch, Jane, Jessica Prebor, and Anastasia M. Raymer. "Cognitive Assessments for Patients With Neurological Conditions: A Preliminary Survey of Speech-Language Pathology Practice Patterns." American Journal of Speech-Language Pathology, July 19, 2021, 1–12. http://dx.doi.org/10.1044/2021_ajslp-20-00187.
Анотація:
Purpose Speech-language pathologists (SLPs) are often responsible for assessing cognitive disorders that affect communication for individuals with diagnosed or suspected acute or degenerative neurological conditions. However, consensus on appropriate assessment tools for various neurological disorders remains elusive. This preliminary survey was conducted to study current practices in the use of published and unpublished tools by SLPs when assessing cognitive-communication impairments across common neurologic conditions. Method An 18-item web-based survey was sent to SLPs through ASHA Communities and social media, asking them to select which cognitive assessment tools they use to evaluate the cognitive-communication status of individuals with Parkinson's disease, multiple sclerosis, dementia, stroke (i.e., cerebrovascular accident), and traumatic brain injury. The 100 SLPs who completed the online survey represent a spectrum of professionals seeing neurologic patients across the United States. Results Among the 100 responding SLPs, no unique pattern of assessment tool use was noted across neurologic disorders as indicated by a chi-square analysis. A common set of nonstandardized and observational assessment practices was reported most commonly, regardless of the neurologic condition. Conclusions This study shows consistent cognitive assessment practices by SLPs across various neurological conditions rather than unique protocols relevant to the patterns typical across disorders. However, the amount of clinical evaluations supported by informal observation and/or the completion of select subtests of standardized assessment tools is considerable. This preliminary information conflicts with principles of rigorous assessment and increases the risk of erroneous findings when identifying cognitive impairments. Further research into the decision-making process of clinician assessment selection is warranted to encourage consistent, evidence-based practice for persons with cognitive impairments. Better recognition of the limitations imposed by providing clinical services that impact the reliability and validity of cognitive assessments can drive future clinical practice policy and practice recommendations.
41
Rohilla, Latika, Sukhpal Kaur, Mona Duggal, Prahbhjot Malhi, Bhavneet Bharti, and Devi Dayal. "Diabetes Self-Management Education and Support to Improve Outcomes for Children and Young Adults With Type 1 Diabetes: An Umbrella Review of Systematic Reviews." Science of Diabetes Self-Management and Care, August 1, 2021, 263501062110318. http://dx.doi.org/10.1177/26350106211031809.
Анотація:
Purpose The objectives of this umbrella review were to describe various aspects of diabetes self-management education and support (DSMES)-related interventions and their effect on clinical, behavioral, and psychosocial outcomes among children and young adults with type 1 diabetes (T1DM) and identify gaps in current DSMES-related research. Methods An umbrella review of systematic reviews on DSMES interventions was conducted in accordance with the PRISMA 2009 statement. Four international medical databases were searched for eligible review articles published in English in the last 10 years that dealt with children and youths with T1DM and were conducted in accordance with a priori protocol. Results Out of the 234 citations screened, only 8 systematic reviews representing 166 studies were considered eligible for further analysis. Glycemic management (A1C) is the most common outcome variable (108 studies). Common behavioral and psychosocial outcome variables examined are episodes of hypoglycemia (27 studies) and diabetic ketoacidosis (21 studies) and self-care behavior and generic quality of life (20 studies each). Several gaps in DSMES-related research studies are identified, including uneven geographical distribution of study population, methodological weaknesses in study designs, missing important outcome variables, use of nonstandardized assessment tools, and lack of assessment of the sustainability of effects. Conclusion The effects of DSMES interventions on clinical, behavioral, and psychosocial outcomes are varied. The heterogeneity of implementation and evaluation makes it difficult to draw clear conclusions about elements of DSMES that are most effective. There is a need for long-term assessment of the psychosocial and behavioral outcomes using validated and generalizable instruments.
42
Razeghi, Orod, Iain Sim, Caroline H. Roney, Rashed Karim, Henry Chubb, John Whitaker, Louisa O’Neill, et al. "Fully Automatic Atrial Fibrosis Assessment Using a Multilabel Convolutional Neural Network." Circulation: Cardiovascular Imaging 13, no. 12 (December 2020). http://dx.doi.org/10.1161/circimaging.120.011512.
Анотація:
Background: Pathological atrial fibrosis is a major contributor to sustained atrial fibrillation. Currently, late gadolinium enhancement (LGE) scans provide the only noninvasive estimate of atrial fibrosis. However, widespread adoption of atrial LGE has been hindered partly by nonstandardized image processing techniques, which can be operator and algorithm dependent. Minimal validation and limited access to transparent software platforms have also exacerbated the problem. This study aims to estimate atrial fibrosis from cardiac magnetic resonance scans using a reproducible operator-independent fully automatic open-source end-to-end pipeline. Methods: A multilabel convolutional neural network was designed to accurately delineate atrial structures including the blood pool, pulmonary veins, and mitral valve. The output from the network removed the operator dependent steps in a reproducible pipeline and allowed for automated estimation of atrial fibrosis from LGE-cardiac magnetic resonance scans. The pipeline results were compared against manual fibrosis burdens, calculated using published thresholds: image intensity ratio 0.97, image intensity ratio 1.61, and mean blood pool signal +3.3 SD. Results: We validated our methods on a large 3-dimensional LGE-cardiac magnetic resonance data set from 207 labeled scans. Automatic atrial segmentation achieved a 91% Dice score, compared with the mutual agreement of 85% in Dice seen in the interobserver analysis of operators. Intraclass correlation coefficients of the automatic pipeline with manually generated results were excellent and better than or equal to interobserver correlations for all 3 thresholds: 0.94 versus 0.88, 0.99 versus 0.99, 0.99 versus 0.96 for image intensity ratio 0.97, image intensity ratio 1.61, and +3.3 SD thresholds, respectively. Automatic analysis required 3 minutes per case on a standard workstation. The network and the analysis software are publicly available. Conclusions: Our pipeline provides a fully automatic estimation of fibrosis burden from LGE-cardiac magnetic resonance scans that is comparable to manual analysis. This removes one key source of variability in the measurement of atrial fibrosis.