scholarly journals Clinician Engagement In Feedback Informed Treatment (FIT) and Patient Outcomes

2020 ◽  
Author(s):  
George (Jeb) S Brown ◽  
Christophe Cazauvieilh
Keyword(s):  
Effect Size ◽  
Hierarchical Linear Model ◽  
Outcome Data ◽  
Effect Sizes ◽  
First Year ◽  
Multiple Outcome ◽  
Informed Treatment ◽  
The Mean ◽  
Second Year ◽  
Feedback Informed Treatment

Abstract: Aim, Methods, Results, DiscussionAim: This paper presents analyses of outcome data for 317 therapists treating 14,161 patients over a three-year period to determine if therapists’ effect sizes increased over time. Each therapist treated at least 5 patients in each of their first two years of using outcome measures. Multiple outcome questionnaires were employed. All measures also included a brief alliance scale administered concurrently. Method: A severity adjusted effect size was calculated for each patient using intake scores and diagnostic group as predictors. The mean severity adjusted effect size for each therapist was calculated for their first and second years of using the outcome tools. This was done using a hierarchical linear model to control for sample size in each year, with a minimum sample of 5 cases in each year. Therapist engagement in receiving feedback was measured by counting the number of times the therapist logged into the online platform to view their results in each of the two years.Results: Therapists who logged in the view their data at least 24 times in the second year (n=123; 37%) averaged .92 effect size compared to .82 effect size for those seen by therapists who reviewed their results less frequently (n=214; 63%). Login frequency during the first year was not predictive of effect size during the second year. Discussion: The data provides evidence that effect sizes can trend upwards with measurement and feedback. Therapists’ engagement in receiving feedback appears to increase the likelihood of effect size gain.

Parameters affecting postoperative success of surgery for stage 4A/4B ROP

2019 ◽  
Vol 103 (11) ◽  
pp. 1624-1632
Author(s):  
Cemal Özsaygili ◽  
Sengul Ozdek ◽  
Mehmet Cuneyt Ozmen ◽  
Hatice Tuba Atalay ◽  
Duygu Yalinbas Yeter
Keyword(s):  
Functional Results ◽  
First Year ◽  
Preoperative Treatment ◽  
Posterior Hyaloid ◽  
Retinal Tear ◽  
Stage 4 ◽  
The Mean ◽  
Second Year ◽  
Surgically Induced

PurposeTo describe the long-term anatomical and functional results of surgery for retinal detachment (RD) associated with stage 4 retinopathy of prematurity (ROP) and patient and surgery-related factors affecting postoperative success.DesignRetrospective case series at a single tertiary referral paediatric vitreoretinal practice.MethodsOne hundred and twenty-one eyes of 82 infants (40 female/42 male) who underwent lens-sparing vitrectomy (LSV) or lensectomy with vitrectomy surgery for stage 4A and 4B ROP at Gazi University Department of Ophthalmology between 2011 and 2016 were enrolled in this study. Patient characteristics including gestational age, birth weight, gender, stage of ROP at presentation, preoperative treatment (laser, anti-vascular endothelial growth factor (VEGF) or combined), anatomical and functional outcome and complications were recorded. The effect of birth weight, gestational age, presence of plus disease, preoperative treatment status, surgically induced posterior hyaloid detachment, postoperative vitreous haemorrhage and iatrogenic retinal tear formation on anatomical and functional results was evaluated.Results61.2% of the eyes were stage 4A and 38.8% were stage 4B ROP. The mean follow-up was 24.5 months. 18.2% of the eyes had no preoperative treatment. Anatomical success was 86.5% for stage 4A and 68.1% for stage 4B at the first year, 91.7% for stage 4A and 69.4% for stage 4B at the second year, and 95.8% for stage 4A and 57.9% for stage 4B at the third year. Functional success was 85.1% for stage 4A and 65.9% for stage 4B at the first year, 89.6% for stage 4A and 61.1% for stage 4B at the second year, and 87.5% for stage 4A and 57.8% for stage 4B at the third year. The mean visual acuity was 1.12±0.34 logarithm of the minimum angle of resolution (logMAR) for stage 4A and 1.34±0.32 logMAR at the 3-year follow-up duration (p>0.05). There was preoperative plus disease in 59.5% of the eyes. Subsequent retinal surgeries were required in 17.4% of the eyes. Presence of plus disease and absence of preoperative treatment, iatrogenic retinal tear formation and postoperative vitreous haemorrhage were found to have significant negative effects, while surgical induction of posterior hyaloid detachment and sparing the lens intraoperatively affected the anatomical and functional results positively.ConclusionsSurgery for stage 4 ROP-associated RD resulted in encouraging anatomical and functional outcomes and the results are even better in eyes with preoperative (laser/anti-VEGF) treatment, LSV and surgically induced posterior hyaloid detachment.

scholarly journals The Effect of Knee Flexion on Active and Passive Popliteal Venous Flow When Using Crutches or Knee Scooter While Immobilized

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0007
Author(s):  
Christopher W. Reb ◽  
Edward T. Haupt ◽  
Gregory C. Berlet
Keyword(s):  
Effect Size ◽  
Knee Flexion ◽  
Venous Return ◽  
Effect Sizes ◽  
Medium Effect ◽  
Small Range ◽  
Mean Velocity ◽  
Venous Flow ◽  
Flow Parameters ◽  
The Mean

Category: Trauma; Other Introduction/Purpose: Knee flexion has been demonstrated to impede popliteal venous return with large effect size among patients lying supine for surgery. Passive popliteal flow impedance has also been suggested to occur with knee scooter usage due to knee flexion. This study compared the effect of knee flexion angles on popliteal venous return between upright, crutch and knee scooter positioning when immobilized. Further, the countervailing effect of standardized hallux musculovenous pump activation was observed. Methods: This was an IRB approved study of young, healthy volunteers. Popliteal venous diameter and flow metrics were assessed with venous ultrasonography and compared between straight leg, crutch, and knee scooter positioning while wearing a walking boot and nonweightbearing. Flow was assessed with muscles at rest and with hallux musculovenous pump activation via active oscillation between hallux metatarsophalangeal joint extension and flexion at one motion per second (0.5 Hz) as paced by a metronome. Observer consistency was assessed. Paired-sample Student’s t-test and the Wilcoxon signed rank tests were used to assess within-subject differences for diameter and venous flow parameters, respectively. Knee flexion and musculovenous pump activation effects sizes were calculated. A priori sample size indicated 24 subjects were needed to achieve 80% power to detect a significant ( p < 0.006 ) difference in medial flow for any of 8 comparisons, assuming large effect sizes. Results: 16 of 24 (67%) subjects were female. Twelve limbs (50%) were right sided. The mean age was 21.9 years (SD 3.0 years) and the mean body mass index was 21.9 (SD 1.9). Observer consistencies were excellent (0.93 to 0.99). No significant differences in mean vessel diameter, time-averaged mean velocity, and total volume flow occurred. Corresponding knee flexion effect sizes were small (range -0.04 to -0.26). A significant decrease (-24%) in active median time-averaged peak velocity (TAPV) occurred between upright and crutch position (20.89 cm/s vs. 15.92 cm/s, p < 0.001) with a medium effect size (-0.51). Hallux musculovenous pump increased all flow parameters (all p< 0.001) and effect sizes were comparatively larger (>0.6) across all knee flexion positions. Conclusion: Compared to values reported for supine individuals, upright passive popliteal venous return was observed to be markedly diminished at all knee flexion angles. Knee flexion had minimal effect on diameter, a small effect in further diminishing TAMV and TVF and a medium effect on diminishing TAPV. Hallux musculovenous pump activiation had a large effect on increasing flow at all knee flexion angles. Patients may well be counseled to use toe motion to counter the negative effects of gravity, and to a lesser extent knee flexion, when using crutches and knee scooters while their ankle is immobilized.

The effects of nitrogen and irrigation on timothy (Phleum pratense) grown for production of seed: I. Vegetative growth

1967 ◽  
Vol 69 (2) ◽  
pp. 225-230 ◽  
Author(s):  
D. A. Lambert
Keyword(s):  
Vegetative Growth ◽  
Irrigation Treatment ◽  
Phleum Pratense ◽  
First Year ◽  
Positive Effects ◽  
The Third ◽  
The Mean ◽  
Second Year ◽  
Additional Nitrogen ◽  
Applied Nitrogen

1. Plants of S.48 timothy were established on a 1 ft square pattern for production of seed. Two series of plots, one irrigated and one not irrigated, were treated with three levels of applied nitrogen: 0 (NO), 87 (Nl) and 261 (N2) lb N per acre (0, 97·5 and 292·5 kg N/ha) per annum, for 3 years. In this, the first of two papers, only vegetative aspects of growth are considered. Since the irrigation treatment started only 2 weeks before most of the data were recorded, effects of irrigation on vegetative growth were generally small.2. The number of tillers per plant was increased by application of nitrogen; the lower increment was more effective than the additional nitrogen in the higher dose.3. The weight of tillers per plant was increased by nitrogen at both levels of application. The mean weight of each tiller was increased by nitrogen after the first year, predominantly in the N 2 treatment. In the second year, irrigation also increased the weight per tiller.4. The weight of roots per plant was significantly affected by application of nitrogen. In the first year, the weight was increased by nitrogen in irrigated plots; in the second year the roots were significantly heavier in the Nl treatment than in N0 and N2 treatments, where weights were similar; the same situation existed in irrigated plots in the third year, but in non-irrigated plots the weights of roots were similar in N1 and N2 treatments and were heavier than in the N0 treatment. Irrigation had positive effects on the weight of roots in the first and second years.

Diet and condition of bobcats, Lynx rufus, in Nova Scotia during autumn and winter

1992 ◽  
Vol 70 (6) ◽  
pp. 1114-1119 ◽  
Author(s):  
Christopher R. Matlack ◽  
Alison J. Evans
Keyword(s):  
Nova Scotia ◽  
Condition Index ◽  
Lynx Rufus ◽  
First Year ◽  
Age Classes ◽  
Winter Diet ◽  
The Mean ◽  
Second Year ◽  
Autumn And Winter ◽  
Hare Population

A study was conducted from 1980 to 1982 on the diet and condition of bobcats, Lynx rufus, in the province of Nova Scotia. Skinned carcasses were provided by trappers, hunters, fur buyers, and taxidermists. The autumn–winter diet was determined from analysis of 1099 stomachs. Canine teeth were sectioned and aged to group the bobcats into three age-classes: juvenile, yearling, and adult. Snowshoe hare, Lepus americanus, occurred most frequently as a prey item, followed by white-tailed deer, Odocoileus virgìnianus, and small mammals. The mean weights of hare and deer consumed per feeding were similar. Male bobcats consumed deer more frequently and in larger quantities than did females. Adults consumed deer more frequently and in larger quantities than did juveniles. Bobcats harvested in the first year of the study (1980–1981) consumed deer more frequently than did those harvested in the second year (1981–1982), while hare population levels were found to be lower in the first year than in the second. A condition index was developed by dividing the sum of the weights of mesenteric, kidney, and sternum fat by the weight of the skinned carcass. The groups (males, adults, and specimens harvested in 1980–1981) that more frequently consumed deer were found to be in the best condition.

scholarly journals Empathy variation of undergraduate medical students after early clinical contact: a cross-sectional study in China

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e035690
Author(s):  
Xiong Ye ◽  
Haiying Guo ◽  
Zhou Xu ◽  
Hui Xiao
Keyword(s):  
Medical Students ◽  
Early Stage ◽  
Teaching Hospitals ◽  
Secondary Outcome ◽  
First Year ◽  
Long Term Effects ◽  
Undergraduate Medical Students ◽  
Cross Sectional ◽  
The Mean ◽  
Second Year

ObjectivesEmpathy education is very important for medical students. There is little research on the influence of early clinical practice on the development of empathy and other aspects of professionalism in medical students. The aim of this study was to compare the self-reported empathy levels of first-year and second-year undergraduate medical students before and after their early clinical contact curriculum.SettingThe study was conducted at the Shanghai University of Medicine & Health Sciences, Shanghai, China.ParticipantsA total of 257 undergraduate medical students participated in the study. The 154 first-year students were studying in 10 community-based teaching hospitals, and the 103 second-year students were studying in 3 university-affiliated hospitals.Primary and secondary outcome measuresPrimary measures: the Jefferson Scale of Empathy—Student version (JSE-S) was compared between students of different sexes and in different academic years before their early clinical contact course. Secondary measures: comparisons were made after they finished the curriculum 3 weeks later.ResultsA total of 219 of 257 students responded (85.21% response rate), and 214 answers could be analysed (135 first-year and 79 second-year students; 120 female and 94 male individuals). No significant differences in the empathy scores before early clinical contact were observed between students of different sexes and in different academic years. After early clinical contact, the mean JSE-S score of the participants was significantly higher than the mean score at the beginning of the curriculum.ConclusionsEmpathy-focused training during early clinical contact can improve the empathetic capacity of undergraduate medical students. Fostering empathetic attitudes among undergraduate medical students is necessary for the early stage of their medical education. Further research is needed on the long-term effects of empathy-focused education in entry-level medical students.

Incidence of Illness in Early Group and Family Day-Care

PEDIATRICS ◽  
1976 ◽  
Vol 58 (4) ◽  
pp. 607-613
Author(s):  
Anna-Beth Doyle
Keyword(s):  
Psychological Health ◽  
Day Care ◽  
Care Center ◽  
First Year ◽  
Early Group ◽  
Day Care Center ◽  
Family Day Care ◽  
Telephone Interviews ◽  
The Mean ◽  
Second Year

The frequency of reported illness in children enrolled in a day-care center was compared to frequency in home-reared children and in children in family day-care homes. Children ranged from 6 to 42 months of age (mean, 21 months). Data on seven categories of illness were collected by bimonthly telephone interviews with parents during two consecutive winters. In the first year of the study gastrointestinal and total illnesses were reported significantly more frequently in children enrolled in the day-care center, though major illnesses were not. In the second year of the study illnesses were significantly more frequently reported in center children though mainly at the younger ages, that is, prior to 2 years of age. The mean numbers of illnesses and symptoms reported per call over the 2 years of the study were 2.56, 1.36, and 1.35 for center, home-reared and family day-care children respectively. Though it has been shown elsewhere that psychological health may be unaffected by early group care, the present findings imply that physical health may be somewhat reduced. It is unknown whether these children will be more resistant to infection at a later age.

Does Multicultural Education Improve Students’ Racial Attitudes? Implications for Closing the Achievement Gap

2011 ◽  
Vol 42 (8) ◽  
pp. 1252-1274 ◽  
Author(s):  
Ogo Okoye-Johnson
Keyword(s):  
Achievement Gap ◽  
Multicultural Education ◽  
Effect Size ◽  
Racial Attitudes ◽  
Relative Effectiveness ◽  
Effect Sizes ◽  
Age Group ◽  
Closing The Achievement Gap ◽  
Curricular Intervention ◽  
The Mean

The effects of multicultural education on the racial attitudes of students in prekindergarten through twelfth grade are examined in this meta-analysis. Multicultural education was operationalized for this study as programs and curricula dealing with racial and cultural diversity. The effect sizes of curricular intervention and reinforcement dimensions of multicultural education in suburban and urban settings among age groups 3-8 and 9-16 were compared to see the relative effectiveness of multicultural education on students’ racial attitudes. The mean effect size of 0.488 from a total of 60 effect sizes calculated using 30 studies shows that exposure to multicultural education led to a reduction in students’ racial attitudes. However, the mean effect size of 0.645 from curricular intervention studies was higher than the mean effect size of the reinforcement studies at 0.08, indicating that the curricular intervention dimension of multicultural education was more effective in reducing students’ racial attitudes. Multicultural education was more effective in reducing racial attitudes in urban areas with a mean effect size of 0.72, than in suburban areas with a mean effect size of 0.587. Multicultural education was also more effective in reducing racial attitudes among the 9-16 age group with a mean effect size of 0.751, than among the 3-8 age group with a mean effect size of 0.208. Implications for research and for practice with emphasis on closing the achievement gap that exists among the various student subgroups primarily in under achieving inner-city public schools are discussed.

Does date of birth or a capacity for facultative placentotrophy influence offspring quality in a viviparous skink, Niveoscincus microlepidotus?

2006 ◽  
Vol 54 (5) ◽  
pp. 369 ◽  
Author(s):  
Natalia Atkins ◽  
Roy Swain ◽  
Susan M. Jones
Keyword(s):  
First Year ◽  
Offspring Survival ◽  
Offspring Quality ◽  
Weather Patterns ◽  
Annual Variations ◽  
Egg Ratio ◽  
Annual Activity ◽  
The Mean ◽  
Second Year ◽  
Fat Bodies

Niveoscincus microlepidotus is a viviparous lizard that exhibits biennial reproduction: births in spring optimise offspring survival in this species’ alpine habitat. Over three annual activity seasons, we investigated the hypothesis that date of birth influences offspring characteristics. In the first year of our study, there was no effect of date of birth on any offspring characteristic measured. In the second year, later-born offspring grew significantly faster. In the third year, later-born offspring were significantly longer and heavier at birth. These varying results may be attributable to differences in basking opportunities for the gestating females due to annual variations in spring weather patterns. To test the hypothesis that both lecithotrophic (yolk) and placentotrophic nutrients support embryos during their extended gestation, we determined the degree of placentotrophy for this species. The mean dry neonate : dry egg ratio of 0.755 indicates that this species is predominantly lecithotrophic. Only in the first year of the study did the data suggest a potential for facultative placentotrophy in this species. We therefore suggest that in N. microlepidotus lecithotrophic nutrition is converted into embryonic fat bodies that support the embryo in utero over winter until spring parturition.

Evaluation of retention of knowledge and skills imparted to first-year medical students through basic life support training

2014 ◽  
Vol 38 (1) ◽  
pp. 42-45 ◽  
Author(s):  
Sushma Pande ◽  
Santosh Pande ◽  
Vrushali Parate ◽  
Sanket Pande ◽  
Neelam Sukhsohale
Keyword(s):  
Medical Students ◽  
Basic Life Support ◽  
Life Support ◽  
Basic Knowledge ◽  
First Year ◽  
Knowledge And Skills ◽  
The Mean ◽  
Second Year ◽  
Retention Of Knowledge ◽  
First Year Medical Students

Poor awareness among medical graduates about basic life support (BLS) is a matter of great concern. The presence of a trained rescuer is the key determinant of ultimate survival from life-threatening emergencies. To achieve this goal, early exposure to such life-saving skills is the right decision to foster these skills for medical students, which can be reenforced in succeeding years. Forty-two first-year medical students participated in this study. The entire procedure consisted of faculty training, assessment of knowledge of students by a pretest questionnaire, a lecture, a demonstration, and hands-on training using a mannequin (with special emphasis on the site, depth, rate, and sustainment of uninterrupted chest compressions). Posttest 1 was conducted to assess the knowledge gained. The retention of knowledge and skills in the second year was evaluated by posttest 2 and directly observed procedural skills, respectively. Student feedback was collected on five-point Likert scale. Analysis using a Freidman test indicated the mean rank for posttest 1 (2.81) to be significantly higher than the pretest (1.26), indicating a gain in knowledge. The mean rank for posttest 2 (1.93) was lower than for posttest 1 (2.81) but was significantly higher compared with the pretest (1.26), indicating a significant retention of knowledge during the second year. Directly observed procedural skill evaluation showed that 7% students could perform all the seven steps correctly and that 74% students could perform three or more steps correctly, signifying a good retention of skill. Two students taught BLS skills to their family members as well. The results of this study suggest that the program provides students with sound basic knowledge and adequate practical skills in BLS.

scholarly journals Introducere în metaanaliză. Metaanaliza corelațiilor

2020 ◽  
Vol 6 (2) ◽  
pp. 112-127
Author(s):  
Laurențiu Maricuțoiu
Keyword(s):  
Statistical Method ◽  
Confidence Intervals ◽  
Effect Size ◽  
Meta Analysis ◽  
Relevant Information ◽  
Effect Sizes ◽  
The Mean

The present paper discusses the fundamental principles of meta-analysis, as a statistical method for summarising results of correlational studies. We approach fundamental issues such as: the finality of meta-analysis and the problems associated with study artefacts. The paper also contains recommendations for: selecting the studies for meta-analysis, identifying the relevant information within these studies, computing mean effect sizes, confidence intervals and heterogeneity indexes of the mean effect size. Finally, we present indications for reporting meta-analysis results.

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