112 research outputs found

    Literature Review Of Early And Precocious Puberty In Girls

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    Parent and Teacher Perceptions of Intermediate Students\u27 Experiences in Virtual Intensive Reading Classes

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    The learning gap between intermediate students on grade level and those below grade level continues to grow. Intermediate students with below-grade-level reading comprehension skills struggle with informational texts and across-content material. The purpose of this basic qualitative study was to explore parent and teacher perceptions of intermediate students’ experiences in virtual intensive reading classes. The conceptual frameworks were Vygotsky’s zone of proximal development and social learning and Epstein’s model of parental involvement, which supports learning through interaction and support. The research questions included changes teachers observed in the reading patterns of their intermediate students enrolled in virtual intensive reading classes, changes parents observed in reading patterns, and suggestions teachers and parents could offer to improve virtual intensive reading classes. Data collection for this basic qualitative study utilized Zoom audio-recorded interviews and transcription software tools, and analysis will identify significant patterns. The results indicated that parents and teachers had different priorities. Parents focused on teacher response and communication, whereas teachers worked to solve dilemmas faced in virtual learning environments, such as attendance and some aspects of materials. Both groups should become receptive to each other’s perceptions and work together to improve the conditions and experiences of their students. The potential social change lies in improving the learning experience and efficacy of virtual intensive reading classes for intermediate students by lessening the gap between students with and without reading difficulties, eliminating hurdles in other classes and high school, and having a higher graduation rate at high school

    Driving evaluation methods for able-bodied persons and individuals with lower extremity disabilities: a review of assessment modalities

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    Assessing the driving abilities of individuals with disabilities is often a very challenging task because each medical condition is accompanied by physical impairments and because relative individual functional performance may vary depending on personal characteristics.We identified existing driving evaluation modalities for able-bodied and lower extremity-impaired subjects (spinal cord injury patients and amputees) and evaluated the potential relationships between driving performance and the motor component of driving.An extensive scoping review of the literature was conducted to identify driving assessment tools that are currently used for able-bodied individuals and for those with spinal cord injury or lower extremity amputation. The literature search focused on the assessment of the motor component of driving. References were electronically obtained via Medline from the PubMed, Ovid, Web of Science and Google Scholar databases.This article compares the current assessments of driving performance for those with lower extremity impairments with the assessments used for able-bodied persons. Very few articles were found concerning “Lower Extremity Disabilities,” thus confirming the need for further studies that can provide evidence and guidance for such assessments in the future. Little is known about the motor component of driving and its association with the other driving domains, such as vision and cognition. The available research demonstrates the need for a more evidenced-based understanding of how to best evaluate persons with lower extremity impairment

    Rasch Analysis of the International Quality of Life Basic Data Set Version 2.0

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    Objective: To examine the internal construct validity of the International Spinal Cord Injury Quality of Life Basic Data Set Version 2.0 (QoL-BDS V2.0) and compare this with the internal construct validity of the original version of the QoL-BDS. Design: International cross-sectional psychometric study. Setting: Spinal rehabilitation units, clinics, and community. Participants: The study involved 5 sites and 4 countries, 2 of whose primary language is not English. Each site included a consecutive sample of inpatients with spinal cord injury or disease (SCI/D) and a convenience sample of individuals with SCI/D living in the community (N=565). Main outcome measures: The QoL-BDS V2.0 consists of the 3 original items on satisfaction with life as a whole, physical health, psychological health of the QoL-BDS, and an additional item on satisfaction with social life. All 4 items are answered on a 0-10 numeric rating scale. Rasch analysis was performed on versions 1.0 and 2.0 of the QoL-BDS to examine the ordering of the items' response options, item scaling, reliability, item fit, local item independence, differential item functioning, and unidimensionality. Results: The sample included 565 participants with 57% outpatients and 43% inpatients. Mean age was 51.4 years; 71% were male; 65% had a traumatic injury, 40% had tetraplegia, and 67% were wheelchair users. Item thresholds were collapsed for ordering, and subsequent analyses showed good internal construct validity for the QoL-BDS V2.0 with a person separation reliability of 0.76 and Cronbach α of 0.81. Infit and outfit statistics ranged 0.62-0.91. No local dependencies and multidimensionality were found. Differential item functioning was observed only for country and inpatients vs outpatients but not for other participants' characteristics. Differences in internal construct validity between the 3-item and 4-item versions were minimal. Conclusions: The results of this Rasch analysis support the internal construct validity of the QoL-BDS V2.0

    Computational Fluid Dynamics and Data-Based Mechanistic Modelling of a Forced Ventilation Chamber

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    The research behind this article ultimately concerns control system robustness and optimisation for the regulation of temperatures in multiple buildings that are linked to a controllable external heating supply network. Lancaster University campus is being used as a case study, for which the building management system provides data. Nonetheless, situations arise when it is difficult or expensive to obtain suitable data for specific rooms or buildings and, in such cases, computational fluid dynamics (CFD) models are utilised to investigate relevant heat transfer phenomena. Such models can be limited by their complexity and they are inappropriate for model-based control design. Hence, the present article investigates a hybrid approach based on both CFD and data-based mechanistic (DBM) models. DBM models are obtained initially from statistical analysis of observational time-series but are only considered credible if they can be interpreted in physically meaningful terms. A laboratory forced ventilation chamber is used to investigate the modelling issues arising and to make recommendations relating to the wider project. The chamber is first discretised into finite volumes and the associated Navier--Stokes equations are solved to determine the physical properties of each zone. The model responses are compared with experimental data and analysed using the DBM approach

    Qualidade de vida e lesão medular traumática: um estudo com uso de data sets internacionais

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    Avaliar a qualidade de vida (QV) de pessoas com lesão medular traumática (LMT) e sua associação com o tempo de LMT. Estudo quantitativo, analítico e transversal. Os dados foram coletados com dois instrumentos validados (questionário biosociodemográfico e Data Set de QV da International Spinal Cord Society). Amostra com 81 participantes, 81,5% do sexo masculino, com média de idade de 36±11,9 anos. A satisfação com a saúde psicológica apresentou maior escore (7,2), apesar disso, 86,4% estavam insatisfeitos ou completamente insatisfeitos com a QV geral. Não houve diferença quando comparado o nível da LMT com satisfação com a vida como um todo (p=0,237). A QV geral foi associada ao tempo de LMT (p=0,005), sugerindo que após cinco anos da LMT, as pessoas tendem a ficar mais satisfeitas com suas vidas. Este estudo mostrou que a maioria dos participantes com LMT apresentam-se insatisfeitos com a qualidade de vida

    Rehabilitation medicine summit: building research capacity Executive Summary

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    The general objective of the "Rehabilitation Medicine Summit: Building Research Capacity" was to advance and promote research in medical rehabilitation by making recommendations to expand research capacity. The five elements of research capacity that guided the discussions were: 1) researchers; 2) research culture, environment, and infrastructure; 3) funding; 4) partnerships; and 5) metrics. The 100 participants included representatives of professional organizations, consumer groups, academic departments, researchers, governmental funding agencies, and the private sector. The small group discussions and plenary sessions generated an array of problems, possible solutions, and recommended actions. A post-Summit, multi-organizational initiative is called to pursue the agendas outlined in this report (see Additional File 1)

    A pilot feasibility cluster randomised controlled trial of screening and brief alcohol intervention to prevent hazardous drinking in young people aged 14-15 years in a high school setting (SIPS JR-HIGH)

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    Background: Approximately 33% of 15- to 16-year-olds in England report alcohol intoxication in the past month. This present work builds on the evidence base by focusing on Alcohol Screening and Brief Intervention (ASBI) to reduce hazardous drinking in younger adolescents. Objectives: To explore the feasibility and acceptability of a future definitive cluster randomised controlled trial (cRCT) of ASBI in a school setting to staff, young people and parents; to explore the fidelity of the interventions as delivered by school learning mentors; to estimate the parameters for the design of a definitive cRCT of brief alcohol intervention, including rates of eligibility, consent, participation and retention at 12 months; and to pilot the collection of cost and resource-use data to inform the cost-effectiveness/utility analysis in a definitive trial. Setting: Seven schools across one geographical area in North East England. Methods: Feasibility of trial processes, recruitment and retention and a qualitative evaluation examined facilitators and barriers to the use of ASBI approaches in the school setting in this age group. A three-arm pilot cRCT (with randomisation at the school level) with qualitative evaluation to assess the feasibility of a future definitive cRCT of the effectiveness and cost-effectiveness of ASBI in a school setting, with an integrated qualitative component. The trial ran in parallel with a repeated cross-sectional survey, which facilitated screening for the trial. Participants: Year 10 school pupils (aged 14–15 years). Interventions: Young people who screened positive on a single alcohol screening question, and consented to take part, were randomised to one of three groups: (1) feedback that their drinking habits may be risky and provision of an advice leaflet (control condition, n?=?two schools); (2) feedback as for the control condition plus a 30-minute brief interactive session, which combined structured advice and motivational interviewing techniques, delivered by the school learning mentor (intervention 1, n?=?two schools); or (3) feedback as for the control condition plus a 30-minute brief interactive session as for intervention 1 plus a 60-minute session involving family members delivered by the school learning mentor (intervention 2, n?=?three schools). Young people were followed up at 12 months. Main outcome measures: Feasibility and acceptability. Randomisation: Randomisation was carried out at the school level. Randomisation achieved balance on two school-level variables (numbers of pupils in school year and proportion receiving free school meals). Blinding: School staff, young people and researchers were not blind to the intervention allocated. Results: A total of 229 young people were eligible for the trial; 182 (79.5%) were randomised (control, n?=?53; intervention 1, n?=?54; intervention 2, n?=?75). Of the 75 randomised to intervention 2, 67 received intervention 1 (89%). Eight received both intervention 1 and intervention 2 (11%). In total, 160 out of 182 were successfully followed up at 12 months (88%). Interviews were carried out with six school lead liaisons, 13 learning mentors, 27 young people and seven parents (n?=?53). Analysis shows that the school setting is a feasible and acceptable place to carry out ASBI, with learning mentors seen as suitable people to do this. Intervention 2 was not seen as feasible or acceptable by school staff, parents or young people. Outcomes/conclusions: It is feasible and acceptable to carry out a trial of the effectiveness and cost-effectiveness of single-session ASBI with young people in the school setting, with learning mentors delivering the intervention. Future work should include a definitive study that does not include a parental arm

    A realist evaluation of an enhanced court‐based liaison and diversion service for defendants with neurodevelopmental disorders

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    Background: In England, court‐based mental health liaison and diversion (L&D) services work across courts and police stations to support those with severe mental illness and other vulnerabilities. However, the evidence around how such services support those with neurodevelopmental disorders (NDs) is limited. Aims: This study aimed to evaluate, through the lens of court and clinical staff, the introduction of a L&D service for defendants with NDs, designed to complement the existing L&D service. Methods: A realist evaluation was undertaken involving multiple agencies based within an inner‐city Magistrates' Court in London, England. We developed a logic model based on the initial programme theory focusing on component parts of the new enhanced service, specifically training, screening, signposting and interventions. We conducted semi‐structured interviews with the court staff, judiciary and clinicians from the L&D service. Results: The L&D service for defendants with NDs was successful in identifying and supporting the needs of those defendants. Benefits of this service included knowledge sharing, awareness raising and promoting good practice such as making reasonable adjustments. However, there were challenges for the court practitioners and clinicians in finding and accessing local specialist community services. Conclusion: A L&D service developed for defendants with NDs is feasible and beneficial to staff and clinicians who worked in the court setting leading to good practice being in place for the defendants. Going forward, a local care pathway would need to be agreed between commissioners and stakeholders including the judiciary to ensure timely and equitable access to local services by both defendants and practitioners working across diversion services for individuals with NDs

    Alcohol Use and Sustained Virologic Response to Hepatitis C Virus Direct-Acting Antiviral Therapy.

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    IMPORTANCE: Some payers and clinicians require alcohol abstinence to receive direct-acting antiviral (DAA) therapy for chronic hepatitis C virus (HCV) infection. OBJECTIVE: To evaluate whether alcohol use at DAA treatment initiation is associated with decreased likelihood of sustained virologic response (SVR). DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study used electronic health records from the US Department of Veterans Affairs (VA), the largest integrated national health care system that provides unrestricted access to HCV treatment. Participants included all patients born between 1945 and 1965 who were dispensed DAA therapy between January 1, 2014, and June 30, 2018. Data analysis was completed in November 2020 with updated sensitivity analyses performed in 2023. EXPOSURE: Alcohol use categories were generated using responses to the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) questionnaire and International Classification of Diseases, Ninth Revision and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnoses for alcohol use disorder (AUD): abstinent without history of AUD, abstinent with history of AUD, lower-risk consumption, moderate-risk consumption, and high-risk consumption or AUD. MAIN OUTCOMES AND MEASURES: The primary outcome was SVR, which was defined as undetectable HCV RNA for 12 weeks or longer after completion of DAA therapy. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% CIs of SVR associated with alcohol category. RESULTS: Among 69 229 patients who initiated DAA therapy (mean [SD] age, 62.6 [4.5] years; 67 150 men [97.0%]; 34 655 non-Hispanic White individuals [50.1%]; 28 094 non-Hispanic Black individuals [40.6%]; 58 477 individuals [84.5%] with HCV genotype 1), 65 355 (94.4%) achieved SVR. A total of 32 290 individuals (46.6%) were abstinent without AUD, 9192 (13.3%) were abstinent with AUD, 13 415 (19.4%) had lower-risk consumption, 3117 (4.5%) had moderate-risk consumption, and 11 215 (16.2%) had high-risk consumption or AUD. After adjustment for potential confounding variables, there was no difference in SVR across alcohol use categories, even for patients with high-risk consumption or AUD (OR, 0.95; 95% CI, 0.85-1.07). There was no evidence of interaction by stage of hepatic fibrosis measured by fibrosis-4 score (P for interaction = .30). CONCLUSIONS AND RELEVANCE: In this cohort study, alcohol use and AUD were not associated with lower odds of SVR. Restricting access to DAA therapy according to alcohol use creates an unnecessary barrier to patients and challenges HCV elimination goals
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