The Impact of Integrated Support and Context on Treatment Implementation and Child Outcomes Following Behavioral Consultation

2021 ◽  
pp. 014544552110540
Author(s):  
George Noell ◽  
Kristin Gansle ◽  
Veronica Gulley

Assuring treatment plan implementation following consultation is critically important because implementation is strongly related to outcomes. Treatment implementation has been hypothesized to be influenced by both the nature of the follow-up support provided and contextual variables. However, studies to date have not examined both issues while directly measuring implementation. This study examined treatment implementation following consultation for 48 teachers in public schools who had referred a student for intervention services in a randomized clinical field trial. Participating teachers in the experimental group received Integrated Support (IS). IS includes social influence, planning, and performance feedback elements. IS was compared to weekly follow-up meetings alone. Treatment implementation and child outcomes were markedly superior for IS as compared to weekly follow-up. Three school climate factors were found to be correlated with treatment implementation for the IS group, but not the weekly follow-up group. Participants rated treatment implementation, treatment acceptability, and consultant effectiveness positively and similarly across conditions. The implications of these findings for future work examining school culture, consultation and intervention are discussed.

Materials ◽  
2021 ◽  
Vol 14 (14) ◽  
pp. 3972
Author(s):  
Maha Abdel-Halim ◽  
Dalia Issa ◽  
Bruno Ramos Chrcanovic

The present review aimed to evaluate the impact of implant length on failure rates between short (<10 mm) and long (≥10 mm) dental implants. An electronic search was undertaken in three databases, as well as a manual search of journals. Implant failure was the outcome evaluated. Meta-analysis was performed in addition to a meta-regression in order to verify how the risk ratio (RR) was associated with the follow-up time. The review included 353 publications. Altogether, there were 25,490 short and 159,435 long implants. Pairwise meta-analysis showed that short implants had a higher failure risk than long implants (RR 2.437, p < 0.001). There was a decrease in the probability of implant failure with longer implants when implants of different length groups were compared. A sensitivity analysis, which plotted together only studies with follow-up times of 7 years or less, resulted in an estimated increase of 0.6 in RR for every additional month of follow-up. In conclusion, short implants showed a 2.5 times higher risk of failure than long implants. Implant failure is multifactorial, and the implant length is only one of the many factors contributing to the loss of an implant. A good treatment plan and the patient’s general health should be taken into account when planning for an implant treatment.


Author(s):  
Kelli L Sullivan ◽  
Paulina A Kulesz ◽  
Steven Paul Woods

Abstract Objective Retrospective and prospective memory deficits are associated with lower quality of life (QoL); however, there are no validated measures that comprehensively and directly assess the impact of memory problems on QoL. The Survey of Memory-Related Quality of Life (SMRQoL) was developed as a 30-item questionnaire to measure memory-related QoL. Method Both HIV+ (n = 195) and HIV− (n = 146) participants completed the SMRQoL, a neurocognitive research battery, and validated self-report questionnaires of memory, QoL, and mood. Participants were recruited into younger (age ≤ 40 years) and older (age ≥ 50 years) groups per the parent study design. Results The SMRQoL had a unidimensional factor structure and demonstrated measurement invariance across the HIV+ and HIV− participants. Analyses of 111 clinically stable participants (e.g., persons with no incident or remitting central nervous system disorders) who returned for a 14-month follow-up visit indicated that the SMRQoL had adequate test–retest stability. There was a significant interaction of age and HIV status on the SMRQoL, such that older HIV+ participants reported the lowest memory-related QoL. SMRQoL scores were associated with validated measures of mental and physical QoL, self-reported memory and cognitive symptoms, and performance-based memory and executive functions. Conclusions The SMRQoL shows evidence of reliability and validity as a measure of memory-related QoL that can be used to assess the impact of memory problems on everyday life, but future work is needed to demonstrate the measure’s incremental value in the context of diagnosis and treatment.


2019 ◽  
Vol 45 (1) ◽  
pp. 18-29
Author(s):  
Burak Cem Konduk

This study investigates whether and how the impact of drivers of aspiration levels changes across the cases of consistent and inconsistent performance feedback within the context of a retailer. Analysis of internal corporate data shows that while past aspiration level and performance–aspiration gap positively influence the current aspiration level in the case of inconsistent feedback, performance feedback consistency changes only the impact of performance relative to peers. This study replicates past research in a different industry and country due to limited empirical evidence, introduces real-world complexity into aspiration theory, pinpoints performance–aspiration gap as the primary performance feedback, introduces a new sign for the impact of performance relative to peers, and reconciles its previously detected mixed impact. The findings suggest that organizational attention has an inward focus in the case of inconsistent feedback. The results also point out that leaders can trigger change through a performance outcome that lags behind the corresponding aspiration level rather than the performance of peers and eventually move their organizations toward high performance targets by starting with feasible rather than stretch goals.


Author(s):  
Daoud Kiomjian ◽  
F. Jordan Srour ◽  
Issam Srour

Conventional wisdom in the management literature holds that diversity is positively correlated with performance. Yet, the findings from the construction field indicate that this is not always the case. In an effort to study the interaction between diversity and performance in the construction industry, this paper presents the elements of a theoretical mathematical model to explore the relationship between diversity and knowledge sharing which is a precursor of performance. This model includes five dimensions of diversity: ethnicity, age, experience, language and education. At the heart of the mathematical model is a fuzzy based system that generates the probability of knowledge sharing among members with different demographic attributes. The presented fuzzy system will, in future work, become the foundation of an agent based model used to study the impact of worker interactions on productivity.


2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Calla Evans

Through remote wardrobe interviews with five self-identified infinifat participants, this paper explores how those existing in a body larger than a US dress-size 32 access fashion. The majority of research that has occurred at the intersection of fat studies and fashion studies has focused on the fashion and dressing experiences of women who fit the conventional definition of “plus-size.” Commercially available, mass-produced fashion options drop off dramatically for women larger than a US dress-size 28 and become almost non-existent for those who are a size 32 or larger. By focusing on infinifat or superfat people who exist beyond a size 32 I draw attention to the impact that the lack of access to fashion has on the subjectivities infinifat people can perform. The findings in this paper build from existing literature on plus-size dressing that focuses on limitations in identity construction and performance experienced by those who are able to access commercially available plus-size fashion. Without readily available, situationally-appropriate clothing, infinifat and superfat people are limited in the subjectivities they can perform and are excluded from specific social spaces. This exclusion serves to remarginalize an already marginalized group and is felt most acutely by those who embody additional marginalized identity markers, such as those who are racialized or living in poverty. In this way, the findings presented in this paper further address the infinifat-sized gain existing literature on plus-size dressing and lay the foundation for future work that engages with the infinifatshion community.


2013 ◽  
Author(s):  
Celia McGillivray

<p>Concurrent review may be seen as a relatively new quality improvement strategy or an improvement over an existing quality improvement strategy, but research is scant. This strategy incorporates several key elements of performance feedback, which may be broadly defined as sharing non-judgmental information to professionals regarding discrepancies between their actual performance and standards of care. The distinction between concurrent review and performance feedback is the timing of information provided. Concurrent review incorporates the provision ofmedical information regarding a provider's performance during the patient's hospitalization, so that the plan ofcare is altered. This study evaluated concurrent review by examining the impact on stroke measures and whether physician and nurse practice patterns in managing stroke patients were altered.</p>


Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3099-3099
Author(s):  
Caitlin L. Costello ◽  
Edward D. Ball ◽  
Sue Corringham ◽  
Hongying Li ◽  
Karen Messer

Abstract Abstract 3099 Background: The development of a risk-stratification model that relies on molecular cytogenetic markers to assess disease aggressiveness and provide therapeutic guidance would be beneficial for the management of patients with multiple myeloma (MM). High-risk cytogenetic abnormalities, including deletion 17p (del17p), are known to confer a poor prognosis. Intensified consolidation with high-dose therapy (HDT) and autologous stem cell transplantation (ASCT) following induction therapy has been proposed as the preferred initial treatment for high-risk MM, such as del17p. With this background, we report the impact of del17p on the timing and outcome of transplant in patients with MM. Methods: We performed a retrospective review of 226 patients with MM who underwent HDT/ASCT at the University of California, San Diego Moores Cancer Center between 1/2000 and 7/2011. Conventional cytogenetic analyses were utilized for all patients either at diagnosis or at relapse, but prior to ASCT. Fluorescence in situ hybridization was also assessed when available. The primary objective was to evaluate the impact of del17p, a known high-risk chromosomal abnormality, on the overall survival (OS) and progression-free survival (PFS) after ASCT, compared with patients without chromosomal abnormalities. A secondary objective was to assess the OS and PFS for patients with del17p who received ASCT within a year of diagnosis, compared with those who underwent ASCT more than 12 months from diagnosis. Results: In 226 patients with conventional cytogenetic data prior to ASCT, chromosomal abnormalities were noted in 82 (36%) patients. Of these, 21 (25%) patients harbored a del17p abnormality. Table 1 shows the patient characteristics and ASCT outcomes. Prior to undergoing ASCT, 4 (19%)patients with del17p achieved a complete remission (CR) or stringent complete remission (sCR), and 6 (29%) achieved a CR or sCR after ASCT. In patients without chromosomal abnormalities, 19 (13%) achieved CR or sCR prior to ASCT, and 45 (31%) achieved it after ASCT. Median follow-up of surviving patients was 47 months (range 5–283). Median PFS after ASCT in patients with del17p and normal cytogenetics were 8.3 months (95%CI: 4.6-N/A) and 33 months (95%CI: 21.7–61.8), respectively (HR 2.15, 95%CI: 1.19–3.89; p=0.011) (Figure 1). Median OS after ASCT in patients with del17p and normal cytogenetics were 47.5 months (95%CI: 19.9-N/A) and 68 months (95%CI 51.1-N/A), respectively (HR: 2.27, 95%CI 1.15–4.48; p=0.018) (Figure 2). Median PFS in patients with del17p who received an ASCT after 12 months and within 12 months from diagnosis was 6.13 months (95%CI: 2.7-NA) and 22.6 months (95%CI: 5.4-NA), respectively (HR=1.22, 95%CI 0.40–3.82; p=0.71). Median OS in del17p patients who received an ASCT after 12 months and within 12 months from diagnosis was 65.6 months (95%CI: 19.3-NA) and 47.5 months (95%CI: 19.9-NA), respectively (HR=0.97, 95%CI 0.26–3.62; p=0.96). Conclusions: In this single center study with long follow up, we demonstrate that a del17p abnormality in MM confers a shorter PFS and OS after ASCT. Furthermore, the use of HDT/ASCT as part of the upfront treatment plan within 12 months of diagnosis does not significantly affect the outcome in patients with a del17p abnormality. Further studies are required to better define a risk-stratified treatment plan for this subset of high-risk multiple myeloma. Disclosures: No relevant conflicts of interest to declare.


2017 ◽  
Vol 38 (2) ◽  
pp. 68-81 ◽  
Author(s):  
Stephanie Gerow ◽  
Mandy Rispoli ◽  
Jennifer Ninci ◽  
Emily V. Gregori ◽  
Shanna Hagan-Burke

The purpose of this study was to assess the impact of parent training on parent implementation of functional communication training (FCT) in the trained routine and in a novel routine. Three young children with developmental delays and their parents participated. A multiple-probe across parent-child dyads was used to evaluate the impact of parent training on parent fidelity of FCT. The data indicated that verbal and written instructions with performance feedback resulted in accurate implementation of FCT during the trained routine. The generalization assessment suggested that instructions and performance feedback promoted generalization for one parent and an additional training component was needed for another parent. The third parent did not complete the generalization assessment. The results suggest verbal and written instructions and performance feedback can lead to accurate implementation of FCT during the trained routine, but additional training components may be necessary to facilitate generalization to a novel routine.


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