Autogenic Stories, Projective Drawings, and the Clinical Assessment Process

Author(s):  
John Hunsley ◽  
Eric J. Mash

Evidence-based assessment relies on research and theory to inform the selection of constructs to be assessed for a specific assessment purpose, the methods and measures to be used in the assessment, and the manner in which the assessment process unfolds. An evidence-based approach to clinical assessment necessitates the recognition that, even when evidence-based instruments are used, the assessment process is a decision-making task in which hypotheses must be iteratively formulated and tested. In this chapter, we review (a) the progress that has been made in developing an evidence-based approach to clinical assessment in the past decade and (b) the many challenges that lie ahead if clinical assessment is to be truly evidence-based.


2021 ◽  
Vol 55 (1) ◽  
pp. 1-11
Author(s):  
Stefania Martignon ◽  
David Bartlett ◽  
David J. Manton ◽  
E. Angeles Martinez-Mier ◽  
Christian Splieth ◽  
...  

Non-carious dental lesions such as developmental defects of enamel (DDE) and erosive tooth wear (ETW) are the subject of intensive research. This paper aims to give perspectives on both DDE, including dental fluorosis and molar incisor hypomineralization (MIH), and ETW, presenting epidemiological data from the Americas and associated diagnostic aspects. Besides, it is important to present evidence to guide the clinical assessment process, supporting the clinicians’ management decisions towards better oral health of their patients. The overall increase in the worldwide prevalence of non-carious lesions discussed in this this paper may reflect the need of perceptual changes. Although the number of publications related to these conditions has been increasing in the last years, there is still a need for clinical diagnostic and management awareness to include these conditions in routine dental practice. Besides, it is important to provide recommendations for standardized clinical assessment criteria, improving the process and helping clinicians’ adherence. In this sense, this paper discusses the most commonly implemented indices for each condition. Thus, despite the wide range of diagnostic indices, BEWE is proposed to be the index recommended for ETW assessment, Dean or Thylstrup & Fejerskov indices for fluorosis and preferably the EAPD criteria (or modified DDE index) for MIH. Overall, non-carious lesions are a growing concern, and it is important to implement preventive measures that control their severity and progression, and accurate diagnosis by the dental clinician.


2020 ◽  
Vol 23 (1) ◽  
pp. 21-30
Author(s):  
Nancy E. Dubois ◽  
Catherine Y. Read ◽  
Kelsey O’Brien ◽  
Kelly Ling

Despite high efficacy rates, significant costs and logistical challenges associated with procuring stool from healthy donors for fecal microbiota transplantation (FMT) have presented barriers to broader institutional adoption and limited the availability of this life-saving treatment. Published outcomes for donor screening programs report donor deferral rates between 90% and 96%. Due to the paucity of FMT donor screening data, a secondary analysis on a cohort of previously screened donors (n = 7,968) was conducted to provide a synopsis of the observed trends and rationales for prospective stool donor deferrals. Upon completion of the evaluation, 1.7% of prospective donors (n = 134) qualified for stool donation. Over 50% of donors who completed the online pre-screen were deferred, primarily for a body mass index of 30 kg/m2 or greater (n = 1,516, 37.0%), logistics (n = 841, 20.5%), and travel history (n = 638, 15.5%). Despite pre-screening, 569 donors (72.8%) who completed the in-person clinical assessment were ultimately deferred due primarily to potentially microbiome-mediated diseases (n = 187, 32.9%). A notably small portion of donors (n = 46, 25.6%) were deferred during the laboratory assessment process suggesting the clinical assessment was effective at deferring donors at higher risk for transmissible diseases. Donors lost to follow-up throughout the screening process presented a significant challenge and contributed to a notable (n = 3,117; 39.1%) portion of donor attrition. Findings were used to support recommendations for improving prospective stool donor screening programs and to provide suggestions for future research.


2017 ◽  
Vol 71 (5) ◽  
pp. 767-793 ◽  
Author(s):  
Chad G. Atkins ◽  
Kevin Buckley ◽  
Michael W. Blades ◽  
Robin F.B. Turner

Blood is a bodily fluid that is vital for a number of life functions in animals. To a first approximation, blood is a mildly alkaline aqueous fluid (plasma) in which a large number of free-floating red cells (erythrocytes), white cells (leucocytes), and platelets are suspended. The primary function of blood is to transport oxygen from the lungs to all the cells of the body and move carbon dioxide in the return direction after it is produced by the cells’ metabolism. Blood also carries nutrients to the cells and brings waste products to the liver and kidneys. Measured levels of oxygen, nutrients, waste, and electrolytes in blood are often used for clinical assessment of human health. Raman spectroscopy is a non-destructive analytical technique that uses the inelastic scattering of light to provide information on chemical composition, and hence has a potential role in this clinical assessment process. Raman spectroscopic probing of blood components and of whole blood has been on-going for more than four decades and has proven useful in applications ranging from the understanding of hemoglobin oxygenation, to the discrimination of cancerous cells from healthy lymphocytes, and the forensic investigation of crime scenes. In this paper, we review the literature in the field, collate the published Raman spectroscopy studies of erythrocytes, leucocytes, platelets, plasma, and whole blood, and attempt to draw general conclusions on the state of the field.


2011 ◽  
Author(s):  
Marina Miscioscia ◽  
Alessandra Simonelli ◽  
Michela Gatta ◽  
Marta Sisti

Author(s):  
John Hunsley ◽  
Eric J. Mash

Evidence-based assessment relies on research and theory to inform the selection of constructs to be assessed for a specific assessment purpose, the methods and measures to be used in the assessment, and the manner in which the assessment process unfolds. An evidence-based approach to clinical assessment necessitates the recognition that, even when evidence-based instruments are used, the assessment process is a decision-making task in which hypotheses must be iteratively formulated and tested. In this chapter, we review (a) the progress that has been made in developing an evidence-based approach to clinical assessment in the past decade and (b) the many challenges that lie ahead if clinical assessment is to be truly evidence-based.


2014 ◽  
Vol 23 (2) ◽  
pp. 91-98 ◽  
Author(s):  
Celeste R. Helling ◽  
Jamila Minga

A comprehensive augmentative and alternative communication (AAC) evaluation is critical to providing a viable means of expressive communication for nonverbal people with complex communication needs. Although a number of diagnostic tools are available to assist AAC practitioners with the assessment process, there is a need to tailor the evaluation process to the specific communication needs of the AAC user. The purpose of this paper is to provide a basis for developing an effective and clinically driven framework for approaching a user-tailored AAC evaluation process.


Author(s):  
Nancy Lewis ◽  
Nancy Castilleja ◽  
Barbara J. Moore ◽  
Barbara Rodriguez

This issue describes the Assessment 360° process, which takes a panoramic approach to the language assessment process with school-age English Language Learners (ELLs). The Assessment 360° process guides clinicians to obtain information from many sources when gathering information about the child and his or her family. To illustrate the process, a bilingual fourth grade student whose native language (L1) is Spanish and who has been referred for a comprehensive language evaluation is presented. This case study features the assessment issues typically encountered by speech-language pathologists and introduces assessment through a panoramic lens. Recommendations specific to the case study are presented along with clinical implications for assessment practices with culturally and linguistically diverse student populations.


2017 ◽  
Vol 2 (14) ◽  
pp. 29-40 ◽  
Author(s):  
Christine Vining ◽  
Edgarita Long ◽  
Ella Inglebret ◽  
Megan Brendal

The overrepresentation of American Indian and Alaska Native (AI/AN) children in special education, including children who are dual language learners (DLLs), is a major concern. Speech-language pathologists (SLPs) can play a critical role in reducing this overrepresentation. Using a holistic assessment process that is responsive to the communication patterns of home and community contexts provides a framework for distinguishing actual language disorders from differences associated with cultural and linguistic diversity. This article presents current trends in Native communities that may impact the speech-language assessment process, including a shift from indigenous languages to English and/or Native language revitalization efforts. It also provides a framework for guiding assessment in a manner that considers cultural and linguistic factors in speech-language assessment for AI/AN children who are DLLs.


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