scholarly journals Using generalizability theory to evaluate the comparative reliability of developmental measures in neurogenetic syndrome and low-risk populations

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Lisa R. Hamrick ◽  
Alison M. Haney ◽  
Bridgette L. Kelleher ◽  
Sean P. Lane
Keyword(s):  
Generalizability Theory ◽  
Low Risk ◽  
Neurogenetic Syndrome

Applying Generalizability Theory to Optimize Analysis of Spontaneous Teacher Talk in Elementary Classrooms

2020 ◽  
Vol 63 (6) ◽  
pp. 1947-1957
Author(s):  
Alexandra Hollo ◽  
Johanna L. Staubitz ◽  
Jason C. Chow
Keyword(s):  
Special Education Teachers ◽  
Generalizability Theory ◽  
Child Outcomes ◽  
Elementary Classrooms ◽  
Teacher Talk ◽  
Group Instruction ◽  
Data Set ◽  
School Year ◽  
Minimum Number ◽  
Representative Samples

Purpose Although sampling teachers' child-directed speech in school settings is needed to understand the influence of linguistic input on child outcomes, empirical guidance for measurement procedures needed to obtain representative samples is lacking. To optimize resources needed to transcribe, code, and analyze classroom samples, this exploratory study assessed the minimum number and duration of samples needed for a reliable analysis of conventional and researcher-developed measures of teacher talk in elementary classrooms. Method This study applied fully crossed, Person (teacher) × Session (samples obtained on 3 separate occasions) generalizability studies to analyze an extant data set of three 10-min language samples provided by 28 general and special education teachers recorded during large-group instruction across the school year. Subsequently, a series of decision studies estimated of the number and duration of sessions needed to obtain the criterion g coefficient ( g > .70). Results The most stable variables were total number of words and mazes, requiring only a single 10-min sample, two 6-min samples, or three 3-min samples to reach criterion. No measured variables related to content or complexity were adequately stable regardless of number and duration of samples. Conclusions Generalizability studies confirmed that a large proportion of variance was attributable to individuals rather than the sampling occasion when analyzing the amount and fluency of spontaneous teacher talk. In general, conventionally reported outcomes were more stable than researcher-developed codes, which suggests some categories of teacher talk are more context dependent than others and thus require more intensive data collection to measure reliably.

Exploring the Validity and Operational Impact of Using Allied Health Assistants to Conduct Dysphagia Screening for Low-Risk Patients Within the Acute Hospital Setting

2020 ◽  
Vol 29 (4) ◽  
pp. 1944-1955 ◽  
Author(s):  
Maria Schwarz ◽  
Elizabeth C. Ward ◽  
Petrea Cornwell ◽  
Anne Coccetti ◽  
Pamela D'Netto ◽  
...  
Keyword(s):  
At Risk ◽  
Allied Health ◽  
Assessment Tool ◽  
Hospital Setting ◽  
Low Risk ◽  
False Negatives ◽  
Exact Agreement ◽  
Risk Patients ◽  
Impact Phase ◽  
Operational Impact

Purpose The purpose of this study was to examine (a) the agreement between allied health assistants (AHAs) and speech-language pathologists (SLPs) when completing dysphagia screening for low-risk referrals and at-risk patients under a delegation model and (b) the operational impact of this delegation model. Method All AHAs worked in the adult acute inpatient settings across three hospitals and completed training and competency evaluation prior to conducting independent screening. Screening (pass/fail) was based on results from pre-screening exclusionary questions in combination with a water swallow test and the Eating Assessment Tool. To examine the agreement of AHAs' decision making with SLPs, AHAs ( n = 7) and SLPs ( n = 8) conducted an independent, simultaneous dysphagia screening on 51 adult inpatients classified as low-risk/at-risk referrals. To examine operational impact, AHAs independently completed screening on 48 low-risk/at-risk patients, with subsequent clinical swallow evaluation conducted by an SLP with patients who failed screening. Results Exact agreement between AHAs and SLPs on overall pass/fail screening criteria for the first 51 patients was 100%. Exact agreement for the two tools was 100% for the Eating Assessment Tool and 96% for the water swallow test. In the operational impact phase ( n = 48), 58% of patients failed AHA screening, with only 10% false positives on subjective SLP assessment and nil identified false negatives. Conclusion AHAs demonstrated the ability to reliably conduct dysphagia screening on a cohort of low-risk patients, with a low rate of false negatives. Data support high level of agreement and positive operational impact of using trained AHAs to perform dysphagia screening in low-risk patients.

Colonoscopy May Be Overused in Patients at Low Risk

2008 ◽  
Vol 41 (15) ◽  
pp. 41
Author(s):  
ALICIA AULT
Keyword(s):  
Low Risk

Guidelines Bring New Strategy in Low-Risk AF

2012 ◽  
Vol 45 (15) ◽  
pp. 12-13
Author(s):  
BRUCE JANCIN
Keyword(s):  
Low Risk ◽  
New Strategy

Vasomotor Combo Poses Low Risk to Breasts

2011 ◽  
Vol 44 (17) ◽  
pp. 24
Author(s):  
HEIDI SPLETE
Keyword(s):  
Low Risk

Papillary Thyroid Carcinoma: How Radical Lymphadenectomy Should be Performed?

Swiss Surgery ◽  
2003 ◽  
Vol 9 (2) ◽  
pp. 63-68
Author(s):  
Schweizer ◽  
Seifert ◽  
Gemsenjäger
Keyword(s):  
High Risk ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Low Risk ◽  
Papillary Thyroid ◽  
Sentinel Nodes ◽  
Fand Sich ◽  
Radical Lymphadenectomy ◽  
N Status

Fragestellung: Die Bedeutung von Lymphknotenbefall bei papillärem Schilddrüsenkarzinom und die optimale Lymphknotenchirurgie werden kontrovers beurteilt. Methodik: Retrospektive Langzeitstudie eines Operateurs (n = 159), prospektive Dokumentation, Nachkontrolle 1-27 (x = 8) Jahre, Untersuchung mit Bezug auf Lymphknotenbefall. Resultate: Staging. Bei 42 Patienten wurde wegen makroskopischem Lymphknotenbefall (cN1) eine therapeutische Lymphadenektomie durchgeführt, mit pN1 Status bei 41 (98%) Patienten. Unter 117 Patienten ohne Anhalt für Lymphknotenbefall (cN0) fand sich okkulter Befall bei 5/29 (17%) Patienten mit elektiver (prophylaktischer) Lymphadenektomie, und bei 2/88 (2.3%) Patienten ohne Lymphadenektomie (metachroner Befall) (p < 0.005). Lymphknotenrezidive traten (1-5 Jahre nach kurativer Primärtherapie) bei 5/42 (12%) pN1 und bei 3/114 (2.6%) cN0, pN0 Tumoren auf (p = 0009). Das 20-Jahres-Überleben war bei TNM I + II (low risk) Patienten 100%, d.h. unabhängig vom N Status; pN1 vs. pN0, cN0 beeinflusste das Überleben ungünstig bei high risk (>= 45-jährige) Patienten (50% vs. 86%; p = 0.03). Diskussion: Der makroskopische intraoperative Lymphknotenbefund (cN) hat Bedeutung: - Befall ist meistens richtig positiv (pN1) und erfordert eine ausreichend radikale, d.h. systematische, kompartiment-orientierte Lymphadenektomie (Mikrodissektion) zur Verhütung von - kurablem oder gefährlichem - Rezidiv. - Okkulter Befall bei unauffälligen Lymphknoten führt selten zum klinischen Rezidiv und beeinflusst das Überleben nicht. Wir empfehlen eine weniger radikale (sampling), nur zentrale prophylaktische Lymphadenektomie, ohne Risiko von chirurgischer Morbidität. Ein empfindlicherer Nachweis von okkultem Befund (Immunhistochemie, Schnellschnitt von sampling Gewebe oder sentinel nodes) erscheint nicht rational. Bei pN0, cN0 Befund kommen Verzicht auf 131I Prophylaxe und eine weniger intensive Nachsorge in Frage.

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