Conceptual and Methodological Issues in Rehabilitation Outcomes for Adults who are Visually Impaired

1997 ◽  
Vol 91 (2) ◽  
pp. 117-130 ◽  
Author(s):  
J.E. Crews ◽  
R.G. Long

This article defines some of the conceptual and methodological issues in creating outcome measures in vision rehabilitation. It proposes a model to describe rehabilitation outcomes in the context of organizational activities and discusses such methodological problems as the clarification and measurement of goals, aggregation of data, self-report and observational data, scaling, frequency of measurements, and causal events.

2017 ◽  
Vol 15 (02) ◽  
pp. 191-197
Author(s):  
MUHSONAT MOHAMAD ZAIN ◽  
NORLIZA MOHAMAD FADZIL ◽  
ZAINORA MOHAMMED

2000 ◽  
Vol 94 (5) ◽  
pp. 292-306 ◽  
Author(s):  
Richard G. Long ◽  
John E. Crews ◽  
Rickilyn Mancil

This article reports on the development and initial implementation of a self-report outcomes measurement instrument. The instrument, tested with veterans in programs at four Veterans Administration Blind Rehabilitation Centers, provided assessments of their functioning on 32 personal and social activities at the beginning and near the end of their programs.


2020 ◽  
Vol 17 (4) ◽  
pp. 437-445
Author(s):  
Irene Ciancarelli ◽  
Giovanni Morone ◽  
Marco Iosa ◽  
Stefano Paolucci ◽  
Loris Pignolo ◽  
...  

Background: Limited studies concern the influence of obesity-induced dysregulation of adipokines in functional recovery after stroke neurorehabilitation. Objective: To investigate the relationship between serum leptin, resistin, and adiponectin and functional recovery before and after neurorehabilitation of obese stroke patients. The adipokine potential significance as prognostic markers of rehabilitation outcomes was also verified. Methods: Twenty obese post-acute stroke patients before and after neurorehabilitation and thirteen obese volunteers without-stroke, as controls, were examined. Adipokines were determined by commercially available enzyme-linked immunosorbent assay (ELISA) kits. Functional deficits were assessed before and after neurorehabilitation with the Barthel Index (BI), modified Rankin Scale (mRS), and Functional Independence Measure (FIM). Results: Compared to controls, higher leptin and resistin values and lower adiponectin values were observed in stroke patients before neurorehabilitation and no correlations were found between adipokines and clinical outcome measures. Neurorehabilitation was associated with improved scores of BI, mRS, and FIM. After neurorehabilitation, decreased values of Body Mass Index (BMI) and resistin together increased adiponectin were detected in stroke patients, while leptin decreased but not statistically. Comparing adipokine values assessed before neurorehabilitation with the outcome measures after neurorehabilitation, correlations were observed for leptin with BI-score, mRS-score, and FIM-score. No other adipokine levels nor BMI assessed before neurorehabilitation correlated with the clinical measures after neurorehabilitation. The forward stepwise regression analysis identified leptin as prognostic factor for BI, mRS, and FIM. Conclusions: Our data show the effectiveness of neurorehabilitation in modulating adipokines levels and suggest that leptin could assume the significance of biomarker of functional recovery.


2006 ◽  
Vol 62 (4) ◽  
Author(s):  
P. Gabel ◽  
L. Bardin ◽  
B. Burkett ◽  
A. Neller

Purpose: To  develop a conceptual model for patients withmusculoskeletal injuries that relates Injury Screening to Measurement and Monitoring (ISMAM). Screening scores would predict quantifiable outcomes on a proposed Global Assessment of Body And Limbs (GABAL) composite scale.  The scale would define status as a percentage of pre-injury capacity using quantitative and qualitative self report outcome measures combined with work and life status data. Background: Screening questionnaires use psychosocial yellow flags and activity limitation to identify potential chronic patients. Outcome measures provide clinical evidence by establishing patient status and assessing intervening change.  Independently developed,definitive statistical links between these established concepts are yet to be determined. Description: The ISMAM components are integrated using a graph of time versus score on the GABAL-scale with initial screening predicting recovery time to a designated pre-injury percentage level.  Actual status would be assessed through initial then subsequent sequential measurements with GABAL-scale scores enabling trendline analysis to  verify if the rate of actual recovery coincides with that predicted by screening. Observations: Face and content validity are apparent because validated screening tools are available and the requiredcomponents for the GABAL-scale would be existing validated outcome measures and quantifiable data.Conclusions: This model should provide a practical method of integrating screening and global measurement thatfacilitates communication across agencies and professions.  A clinical research trial to validate the ISMAM concepthas been initiated.


2011 ◽  
Vol 20 (3) ◽  
pp. 239-243 ◽  
Author(s):  
P. McCrone

Background:Investment in innovative mental health care services requires the use of scarce resources that could be used in alternative ways. Economic evaluation is essential to ensure that such an investment is appropriately compared with investment elsewhere.Method:A non-systematic review of mental health evaluations identifies key methodological issues pertaining to economic studies.Results:Economic evaluations require the measurement and combination of costs and outcomes, and clarity about how this measurement is undertaken is required. Regarding costs, important considerations relate to the perspective to be taken (e.g., health service or societal), method of measurement (patient self-report or use of databases) and valuation (actual costs, fees or expenditure). Decision makers frequently need to compare evidence both within and between clinical areas and therefore there is a tension between the use of condition specific and generic outcome measures. Quality-adjusted life years are frequently used in economic evaluations, but their appropriateness in mental health care studies is still debated.Conclusions:Economic evaluations in the area of mental health care are increasing in number and it is essential that researchers continue to develop and improve methods used to conduct such studies.


2018 ◽  
Vol 30 (1) ◽  
pp. 25-41 ◽  
Author(s):  
Clara R. Grabitz ◽  
Katherine S. Button ◽  
Marcus R. Munafò ◽  
Dianne F. Newbury ◽  
Cyril R. Pernet ◽  
...  

Genetics and neuroscience are two areas of science that pose particular methodological problems because they involve detecting weak signals (i.e., small effects) in noisy data. In recent years, increasing numbers of studies have attempted to bridge these disciplines by looking for genetic factors associated with individual differences in behavior, cognition, and brain structure or function. However, different methodological approaches to guarding against false positives have evolved in the two disciplines. To explore methodological issues affecting neurogenetic studies, we conducted an in-depth analysis of 30 consecutive articles in 12 top neuroscience journals that reported on genetic associations in nonclinical human samples. It was often difficult to estimate effect sizes in neuroimaging paradigms. Where effect sizes could be calculated, the studies reporting the largest effect sizes tended to have two features: (i) they had the smallest samples and were generally underpowered to detect genetic effects, and (ii) they did not fully correct for multiple comparisons. Furthermore, only a minority of studies used statistical methods for multiple comparisons that took into account correlations between phenotypes or genotypes, and only nine studies included a replication sample or explicitly set out to replicate a prior finding. Finally, presentation of methodological information was not standardized and was often distributed across Methods sections and Supplementary Material, making it challenging to assemble basic information from many studies. Space limits imposed by journals could mean that highly complex statistical methods were described in only a superficial fashion. In summary, methods that have become standard in the genetics literature—stringent statistical standards, use of large samples, and replication of findings—are not always adopted when behavioral, cognitive, or neuroimaging phenotypes are used, leading to an increased risk of false-positive findings. Studies need to correct not just for the number of phenotypes collected but also for the number of genotypes examined, genetic models tested, and subsamples investigated. The field would benefit from more widespread use of methods that take into account correlations between the factors corrected for, such as spectral decomposition, or permutation approaches. Replication should become standard practice; this, together with the need for larger sample sizes, will entail greater emphasis on collaboration between research groups. We conclude with some specific suggestions for standardized reporting in this area.


Author(s):  
Elena Karahanna ◽  
Roberto Evaristo ◽  
Mark Srite

This paper presents a discussion of methodological issues that are relevant and idiosyncratic to cross-cultural research. One characteristic that typifies cross-cultural studies is their comparative nature, i.e., they involve a comparison across two separate cultures on a focal phenomenon. When differences across cultures are observed, the question arises as to whether the results are true cultural differences or merely measurement artifacts. Methodological considerations in cross-cultural research focus on ruling out alternative explanations for these differences and thus enhancing the interpretability of the results. The paper presents an overview of key methodological issues in cross-cultural research and reviews methods of preventing or detecting methodological problems.


2019 ◽  
Vol 44 (3) ◽  
pp. 256-265
Author(s):  
Xinyin Chen

In this article, I discuss major theoretical and methodological issues in the study of cultural meanings of children’s behaviors. Research in this area is conducted mainly through assessing individual beliefs using hypothetical vignettes or other self-report methods. I argue that it is important to investigate functional meanings of children’s behaviors from a contextual-developmental perspective, which emphasizes the role of social and developmental processes in mediating links between culture and behaviors. Information about the relevance of behaviors to social interactions and relationships and to the development of adjustment outcomes in different cultures helps us understand the nature of the behaviors beyond individual views. Such understanding is crucial for interpreting cross-cultural differences and similarities in the display of adaptive and maladaptive behaviors.


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