A quantitative synthesis of developmental disability research: The impact of functional assessment methodology on treatment effectiveness.

2010 ◽  
Vol 11 (1) ◽  
pp. 4-19 ◽  
Author(s):  
Caitlin H. Delfs ◽  
Jonathan M. Campbell
Keyword(s):  
Developmental Disability ◽  
Functional Assessment ◽  
Treatment Effectiveness ◽  
Assessment Methodology ◽  
Quantitative Synthesis ◽  
The Impact ◽  
Disability Research

Preprocedural β-Blockers in the Functional Assessment of Intermediate Coronary Lesions by Instantaneous Wave-Free Ratio

Angiology ◽  
2021 ◽  
pp. 000331972199617
Author(s):  
Monica Verdoia ◽  
Rocco Gioscia ◽  
Matteo Nardin ◽  
Orazio Viola ◽  
Marta Francesca Brancati ◽  
...  
Keyword(s):  
Functional Assessment ◽  
Lesion Length ◽  
Functional Evaluation ◽  
Luminal Diameter ◽  
Coronary Syndrome ◽  
Coronary Stenoses ◽  
Minimal Luminal Diameter ◽  
Coronary Lesions ◽  
Β Blockers ◽  
The Impact

Aim: Instantaneous wave-free ratio (iFR) has emerged as the strategy of choice for the assessment of intermediate coronary lesions. The impact of preprocedural β-blockers therapy on the iFR was the aim of this study. Methods: We included patients undergoing functional assessment of intermediate (40%-70%) coronary lesions in 2 centers. The iFR measurement was performed by pressure-recording guidewire and calculated at the core laboratory using the manufacturers’ dedicated software. Minimal luminal diameter, reference diameter, percent diameter stenosis, and length of the lesion were measured. Positive iFR was considered for values <0.90. Results: We included 197 patients undergoing functional evaluation of 223 coronary lesions. Patients on β-blockers (69%) had more frequently hypertension ( P = .05); previous myocardial infarction ( P = .01); therapy with clopidogrel ( P = .02), statins, and aspirin; and acute coronary syndrome at presentation ( P < .001, respectively). Mean iFR values were slightly higher in patients on β-blockers (0.94 ± 0.06 vs 0.92 ± 0.06, P = .11). The rate of positive iFR was significantly lower with β-blockers (14.9% vs 27.5%, P = .04). On multivariate analysis, β-blockers use was a predictor of the significance of coronary stenoses (odds ratio [OR] = 0.48; 95% CI = 0.23-0.98; P = .05) together with lesion length (OR = 1.04; 95% CI = 1.01-1.07; P = .007). Conclusion: Among patients undergoing iFR, preprocedural β-blockers are associated with higher absolute values and a lower rate of positive iFR.

scholarly journals New Zealand community mental healthcare provider experience in schizophrenia management with 3-monthly paliperidone palmitate

2020 ◽  
pp. 103985622092886
Author(s):  
Cathal Cassidy ◽  
Wayne Miles
Keyword(s):  
New Zealand ◽  
Relapse Prevention ◽  
Patient Management ◽  
Treatment Effectiveness ◽  
Mental Healthcare ◽  
Paliperidone Palmitate ◽  
Online Questionnaire ◽  
Provider Experience ◽  
Management Changes ◽  
The Impact

Objectives: To understand the impact of 3-monthly treatment with paliperidone palmitate on patient management, including non-adherence and relapse, from a psychiatrist and nurse perspective for 73 patients enrolled in a patient familiarisation programme (PFP) in New Zealand. Methods: An online questionnaire was sent to clinicians with at least 6 months of regular interaction with PFP patients. Questions addressed treatment effectiveness and patient management changes. Analyses are descriptive only and do not represent patient or carer perspectives. Results: Seven psychiatrists, representing 58 of 73 (79.5%) of patients, and 17 nurses responded to the survey. Psychiatrists were satisfied with efficacy and tolerability and relapse prevention. Treatment goals were either ‘met’ (2/7; 28.6%) or ‘exceeded’ (5/7; 71.4%). The focus on adherence issues decreased and the focus on life areas and recovery goals increased. Conclusions: From the clinician perspective, 3-monthly paliperidone palmitate offers patients the potential to remain adherent and improve social functioning.

scholarly journals Impact of the type of mask on the effectiveness of and adherence to continuous positive airway pressure treatment for obstructive sleep apnea

2014 ◽  
Vol 40 (6) ◽  
pp. 658-668 ◽  
Author(s):  
Rafaela Garcia Santos de Andrade ◽  
Vivien Schmeling Piccin ◽  
Juliana Araújo Nascimento ◽  
Fernanda Madeiro Leite Viana ◽  
Pedro Rodrigues Genta ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Treatment Effectiveness ◽  
Obstructive Sleep ◽  
Pubmed Database ◽  
Osa Treatment ◽  
The Impact

Continuous positive airway pressure (CPAP) is the gold standard for the treatment of obstructive sleep apnea (OSA). Although CPAP was originally applied with a nasal mask, various interfaces are currently available. This study reviews theoretical concepts and questions the premise that all types of interfaces produce similar results. We revised the evidence in the literature about the impact that the type of CPAP interface has on the effectiveness of and adherence to OSA treatment. We searched the PubMed database using the search terms "CPAP", "mask", and "obstructive sleep apnea". Although we identified 91 studies, only 12 described the impact of the type of CPAP interface on treatment effectiveness (n = 6) or adherence (n = 6). Despite conflicting results, we found no consistent evidence that nasal pillows and oral masks alter OSA treatment effectiveness or adherence. In contrast, most studies showed that oronasal masks are less effective and are more often associated with lower adherence and higher CPAP abandonment than are nasal masks. We concluded that oronasal masks can compromise CPAP OSA treatment adherence and effectiveness. Further studies are needed in order to understand the exact mechanisms involved in this effect.

Abstract P369: Polypharmacy, Adverse Outcomes, and Treatment Effectiveness in Elderly Patients With Atrial Fibrillation

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Aniqa Alam ◽  
Nemin Chen ◽  
Pamela L Lutsey ◽  
Richard MacLehose ◽  
J'Neka Claxton ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Elderly Patients ◽  
Rate Control ◽  
Treatment Effectiveness ◽  
Adverse Outcomes ◽  
Pharmacy Claims ◽  
Increased Risk ◽  
The Impact

Background: Polypharmacy is highly prevalent in elderly individuals with chronic conditions, including atrial fibrillation (AF). The impact of polypharmacy on adverse outcomes and on treatment effectiveness in elderly AF patients remains unaddressed. Methods: We studied 338,810 AF patients ≥75 years of age with 1,761,660 active prescriptions [mean (SD), 5.1 (3.8) per patient] enrolled in the MarketScan Medicare Supplemental database in 2007-2015. Polypharmacy was defined as ≥5 active prescriptions at AF diagnosis based on outpatient pharmacy claims. AF treatments (oral anticoagulation, rhythm and rate control) and cardiovascular endpoints (ischemic stroke, bleeding, heart failure) were defined based on inpatient, outpatient and pharmacy claims. Multivariable Cox models were used to estimate associations of polypharmacy with cardiovascular endpoints and the interaction between polypharmacy and AF treatments in relation to cardiovascular endpoints. Results: Prevalence of polypharmacy was 52% (176,007 of 338,810). Patients with polypharmacy had increased risk of major bleeding [hazard ratio (HR) 1.16, 95% confidence interval (CI) 1.12, 1.20] and heart failure (HR 1.33, 95%CI 1.29, 1.36), but not of ischemic stroke (HR 0.96, 95%CI 0.92, 1.00), compared to those not with polypharmacy (Table). Polypharmacy status did not consistently modify the effectiveness of oral anticoagulants. However, rhythm control (vs. rate control) was more effective in preventing heart failure hospitalization in patients not with polypharmacy (HR 0.87, 95%CI 0.76, 0.99) than among those with polypharmacy (HR 0.98, 95%CI 0.91, 1.07, p for interaction = 0.02). Conclusion: Polypharmacy is frequent among elderly patients with AF, associated with adverse outcomes, and potentially affecting the effectiveness of AF treatments. Optimizing management of polypharmacy in elderly AF patients may lead to improved outcomes.

Improving the Impact and Return of Investment of Game-Based Learning

2013 ◽  
Vol 4 (1) ◽  
pp. 1-15 ◽  
Author(s):  
Christian Sebastian Loh
Keyword(s):  
Learning Organizations ◽  
Learning Technology ◽  
Assessment Methodology ◽  
Game Based Learning ◽  
Bottom Line ◽  
Technology Investment ◽  
Meaningful Information ◽  
Game Environment ◽  
The Impact

Today’s economic situation demands that learning organizations become more diligent in their business dealings to reduce cost and increase bottom line for survival. While there are many champions and proponents claiming that game-based learning (GBL) is sure to improve learning, researchers have, thus far, been unable to (re)produce concrete, empirical evidence supporting this claim. Lacking appropriate assessment methodologies to showcase the effectiveness of the learning technology and to convince stakeholders that GBLs could really work, it is no wonder that many learning organizations regard GBL training as a potentially high-risk technology investment. This paper describes a GBL assessment methodology designed specifically to collect player-generated data in an in situ manner (i.e., within the game environment itself) through telemetry. This methodology further incorporate data visualization to translate the data collected into meaningful information and actionable intelligence for various stakeholders.

Key expressions of trauma-related distress in Cambodian children: A step toward culturally sensitive trauma assessment and intervention

2020 ◽  
pp. 136346152090600 ◽  
Author(s):  
Caleb J Figge ◽  
Cecilia Martinez-Torteya ◽  
Sopheap Taing ◽  
Sotheara Chhim ◽  
Devon E Hinton
Keyword(s):  
Mental Health Problems ◽  
Treatment Effectiveness ◽  
Intervention Development ◽  
Severe Trauma ◽  
Care Providers ◽  
Physical And Mental Health ◽  
Culturally Specific ◽  
Trauma Assessment ◽  
Stress Symptoms ◽  
The Impact

More than half of all children in Cambodia experience direct abuse and over 70% experience other traumatic events, which significantly increase their risks for a range of physical and mental health problems. Additionally, Cambodian children face longstanding sociopolitical, intergenerational, and cultural factors that compound the impact of other trauma. As a result, rates of posttraumatic stress symptoms among Cambodian youth are high. However, care providers often rely on Western-based nosology that does not account for culturally specific expressions of trauma. A greater understanding of culturally-salient expressions of distress can help inform diagnostic assessment accuracy and treatment effectiveness and monitoring. The current study utilized a qualitative design to interview 30 Cambodian caregivers of children with trauma experiences and 30 Cambodian children (ages 10–13 years) with trauma experiences to identify key local expressions of trauma. Findings reveal certain PTSD symptoms and culturally-specific frequent and severe trauma-related problems for Cambodian children and domains of functioning impacted by trauma. Certain symptoms seem particularly important to evaluate in this group, such as anger, physical complaints (e.g., headache and palpitations), and cognitive-focused complaints (in particular, “thinking too much”). All caregivers and children reported physical health as impacted by trauma-related problems, highlighting a particularly salient domain of functioning for this population. Expressions of distress explored in the current study are discussed in the context of assessment and intervention development to inform diagnostic and clinical efforts for those working with trauma-exposed Cambodian children.

Use of a mass balance model for developing guidelines for treatment plant recycle streams

2001 ◽  
Vol 1 (4) ◽  
pp. 169-176
Author(s):  
K.H. Carlson ◽  
W.H. Bellamy
Keyword(s):  
Treatment Effectiveness ◽  
Treatment Plant ◽  
Significant Risk ◽  
Balance Model ◽  
Sludge Dewatering ◽  
Adequate Treatment ◽  
Materials Balance ◽  
Treatment Conditions ◽  
The Impact ◽  
Plant Treatment

Recycling treatment, plant waste streams has become an important issue and the EPA is currently developing a rule for controlling and potentially limiting these streams. The impact to the overall treatment process and the relative risk of various recycle streams can be evaluated with a materials balance model of a treatment plant. A steady-state materials balance model was developed and applied to the recycle of backwash waste water, clarifier sludge supernatant and sludge dewatering supernatant. Recycling backwash water reduced the plant treatment effectiveness from 3.0 log to 2.95 log removal when the recycle stream was treated (0.5 log removal) and 2.84 log removal when not treated. Recycling clarifier sludge supernatant resulted in a reduction of performance from 3.0 log to 2.78 log removal with adequate treatment (0.5 log removal) and 1.95 log removal with inadequate treatment (10% removal). The model was used to identify vulnerable treatment conditions. Conventional treatment with a poorly operated or upset clarifier was identified as a significant risk with the overall treatment effectiveness decreasing from 3.0 to 2.3 log removal.

scholarly journals Non-potable Water Quality Assessment Methodology for Water Conservation in Arid Climates

2020 ◽  
Vol 5 (3-4) ◽  
pp. 215-234
Author(s):  
Geraldine Seguela ◽  
J. R. Littlewood ◽  
G. Karani
Keyword(s):  
Quality Assessment ◽  
Water Conservation ◽  
Potable Water ◽  
Salt Content ◽  
Infiltration Rate ◽  
Medical Facility ◽  
Assessment Methodology ◽  
Soil Infiltration ◽  
The Impact ◽  
Soil Infiltration Rate

Abstract This paper documents a non-potable water (NPW) quality assessment methodology for a decentralized non-potable water system in Abu Dhabi (AD), capital city of the United Arab Emirates (UAE), which is dominated by sandy and salty soil, high temperature, and humidity. The context is a medical facility case study (MFCS) in AD, which includes a landscape 50% as large as its building footprint. The project identified the need to investigate the impact of air handling unit (AHU) air conditioning (A/C) condensate water (CW) quality on soil health and building hydraulic systems. The aim of the research was to measure the impact of using recycled on-site NPW sources in a MFCS in AD, to alleviate the use of desalinated potable water and reduce associated energy consumption, operation cost, and greenhouse gas emissions for landscape irrigation (LI) and water feature (WF) use. CW has been tested in 2016 and in 2017 and analysed against local authority’s parameter limits to establish suitability for LI and WF use. The findings are that in AD CW classification and characterization is a gap in knowledge whereby salinity and toxicity concentration limits should be addressed by the local authority because CW has an impact on soil infiltration rate due its low dissolved salt content as evidenced by the water test results. The recommendations for this paper are to develop a sustainable water conservation and reuse (SWC) strategy forming the basis for a water protocol by the competent authority for regional medical facility including a methodology for assessing on-site NPW quality for outdoor reuse to reduce soil infiltration problems and consequently conserve water and associated energy. The next steps are to confirm if the MFCS soil infiltration rate is affected by the CW or other factors, and to test additional NPW types.

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