Indicators likely to contribute to clinical and functional improvement among survivors of politically-sanctioned torture

Introduction: Heartland Alliance Marjorie Kovler Center (Kovler Center) is a torture treatment program located in Chicago, Illinois. Established in 1987, Kovler Center provides medical, mental health, and social services, as well as coordination with legal services, to a diverse population of survivors. Historically, Kovler Center used clinical measurement instruments to assess depression, anxiety and posttraumatic stress, but staff was challenged with finding the best way to assess and ultimately measure changes in functional domains. The purpose of this paper is to describe (1) the Kovler Center framework, philosophical pillars, and model of treatment; (2) the comprehensive outcome evaluation program, including the Marjorie Kovler Center Well-Being Questionnaire (MKC WBQ); and (3) the results and implications to date. Methods: Kovler Center measured outcome data utilizing three instruments including a well-being tool and supplemented the data with a satisfaction survey. These instruments were administered at intake and re-administered at six-month intervals up to 24 months. Results/Discussion: With nine years of data, Kovler Center can now provide valid and reliable findings in diagnostic and functional changes, with 86.6% of its clients reporting fewer symptoms of anxiety and depression, 83.1% reporting fewer symptoms of trauma, and significant improvement in employment status, housing status, and physical health after receiving services for 24 months. Indicatorssignificantly correlated with clinical improvement at 24 months include stable housing, stable employment, region from where survivors came, number of days between initial assessment and program admittance, number of services (medical, psychological, social) received while in the program, number of medical problems diagnosed with while in the program, and number of psychological problems diagnosed with while in the program. From the Generalized Linear Mixed Models (GLMM) analysis, the total number of psychological problems and whether or not the participant had a secure legal status while in the program were demonstrated to explain the variance in anxiety, depression, and PTSD. Females were more likely to experience depression while in the program compared to males, and participants from the Middle East were more likely to experience symptoms of depression and PTSD compared to participants from Africa. Conclusions: Since, medical, psychological, and social indicators are demonstrated to correlate with or predict clinical outcomes, this highlights the need for comprehensive and holistic treatment programs for survivors of torture

The Effects of DI Flashcards and Math Racetrack on Multiplication Facts for Two Elementary Students with Learning Disabilities

The purpose of this study was to evaluate the effects of a Direct Instruction (DI) flashcard system paired with a math racetrack to teach basic multiplication facts to two elementary students diagnosed with learning disabilities. The study was conducted in a resource room which served intermediate aged elementary students. The school was located in an urban school district in the Pacific Northwest. Targeted math facts were chosen based on the students’ pretest scores. The effects of the DI flashcard procedure were evaluated using a multiple baseline design across sets of problems. Both participants improved their mastery of multiplication facts. The flash card procedure was inexpensive and easily implemented in a resource room setting

Seedling establishment of Themeda triandra Forssk. in the montane grasslands of Natal.

Thesis (Ph.D.)-University of Natal, Pietermaritzburg, 1994.Soil erosion and vegetation destruction have reached serious proportions in disturbed areas of the montane grasslands of the Natal Drakensberg. Little is known of the inherent ability of indigenous grasses to produce viable seed and establish seedlings for rehabilitation programmes. This study examined the effects of fire and small-scale disturbance on the seedling dynamics of the dominant grass, Themeda triandra Forssk. Annual seed production of T. triandra increased with length of burning rotation, ranging from 21 seeds m⁻² in the annual winter burn to 485 seeds m⁻² in the five-year burn. High predation of seeds (70-98%) and low viability (37% in 15 month-old seeds) contributed to the poor representation of T. triandra in the seed bank when compared to the aboveground vegetation. Seedling densities and survival were monitored by mapping quadrats at six-weekly intervals from November 1986 to September 1989. Highest establishment of T. triandra was recorded in the biennial spring burn treatment (< 184 seedlings m⁻²). Microclimatic studies of the seedling environment demonstrated that increases in photosynthetically active radiation following burning, and high soil moisture associated with accumulation of litter, favour seedling establishment. The main constraint to seedling establishment was high mortality in winter which resulted in a 1% survival of seedlings of T. triandra during the three-year study. This indicates that in the fire-climax grasslands of the study, seedlings contribute little to the population structure. The most significant factor contributing to low survivorship is intraspecific competition between seedlings. Spacing of seedlings in rehabilitation programmes is therefore a critical factor in optimizing seedling establishment. Analysis of the fate of seeds of T. triandra between their production and establishment, showed that the main constraints for seedling establishment were predation, low viability and poor germination. A population model, based on transitions between seeds, seedlings and mature tufts, predicts that a biennial spring burn is the optimal treatment for maximising both seedling establishment and vegetative growth

The Effects of Direct Instruction Flashcards and Rewards with Math Facts at School and in the Home: Acquisition and Maintenance

The purpose of the present study was to evaluate the effects of Direct Instruction (DI) flashcard procedure, combined with strategies and rewards on multiplication fact accuracy of two elementary school-age students. A single subject replication design across three and four sets of multiplication facts was used to evaluate outcomes. The results indicated improvement in math performance for each participant. Follow-up data indicated maintenance of treatment effects over time. Finally, pre and posttest outcomes found generalization to correct writing of math facts for each participant. The benefits of employing DI flashcards in a resource room or home were discussed

Efectos de Dos Procedimentos de Instrucción en Habilidades Básicas con Dos Estudiantes con Discapacidad

The first study focused on increasing her ability to identify letters and to write these letters. The research was conducted in a resource room setting located in a public school in a large urban school district. The effects of employing DI flashcards on letter recognition and letter writing were evaluated in a multiple baseline design. Overall the effects of the experiment were positive; the participant improved her accuracy letter identification accuracy and her skills at writing her letters from the alphabet. The time, cost, and effort needed for Experiment I was minimal and the student enjoyed the procedures. A second study was conducted with a first grade boy. We wanted to determine the effectiveness of Teach Your Child to Read in 100 Easy Lessons along with a DI flashcard procedure to improve a first grade student’s ability to identify sounds and sight words within a public school behavior intervention (BI) classroom setting. Overall the effects of the second experiment were also quite positive. The participant improved his accuracy and ability to say the letter-sounds and target words. Suggestions for future research were made.El objetivo de esta investigación es determinar la efectividad de la Instrucción Directa (ID) procediendo con flashcards con el fin de mejorar habilidades en artes de pre-lectura y lenguaje. Dos medidas diferentes se llevaron a cabo en este estudio. El primero centrado en incrementar su habilidad para identificar letras y para escribirlas. La investigación fue llevada a cabo en una clase adaptada en una escuela pública de un distrito urbano. Los efectos de emplear ID flashcards en el reconocimiento de letras escritas fueron evaluadas a través de un diseño múltiple de base. Los efectos totales del experimento fueron positivos; la participante mejoró su precisión para identificar letras de forma adecuada y sus habilidades en escribir sus letras del alfabeto. El tiempo, coste, y esfuerzo necesario para el experimento I fue mínimo y la alumna disfrutó de los procedimientos. El segundo estudio se llevó a cabo con un chico de primer grado. Queríamos determinar la efectividad de Teach Your Child to Read in 100 Easy Lessons con procedimientos de ID flashcards para mejorar la habilidad de un estudiante para identificar sonidos y palabras vistas en una intervención de conducta (BI) en una escuela pública. Los efectos totales del segundo experimento fueron bastante positivos también. El participante mejoró su precisión y habilidad para decir letras sonantes y palabras objetivo. También se hacen sugerencias para futura investigación

Education, income, occupation, and the 34-year incidence (1965–99) of Type 2 diabetes in the Alameda County Study

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/51500/1/Maty SC, Education, Income, Occupation, and the 34-year Incidence, 2005.pd

Biomarkers of rapid chronic kidney disease progression in type 2 diabetes.

Here we evaluated the performance of a large set of serum biomarkers for the prediction of rapid progression of chronic kidney disease (CKD) in patients with type 2 diabetes. We used a case-control design nested within a prospective cohort of patients with baseline eGFR 30-60 ml/min per 1.73 m(2). Within a 3.5-year period of Go-DARTS study patients, 154 had over a 40% eGFR decline and 153 controls maintained over 95% of baseline eGFR. A total of 207 serum biomarkers were measured and logistic regression was used with forward selection to choose a subset that were maximized on top of clinical variables including age, gender, hemoglobin A1c, eGFR, and albuminuria. Nested cross-validation determined the best number of biomarkers to retain and evaluate for predictive performance. Ultimately, 30 biomarkers showed significant associations with rapid progression and adjusted for clinical characteristics. A panel of 14 biomarkers increased the area under the ROC curve from 0.706 (clinical data alone) to 0.868. Biomarkers selected included fibroblast growth factor-21, the symmetric to asymmetric dimethylarginine ratio, β2-microglobulin, C16-acylcarnitine, and kidney injury molecule-1. Use of more extensive clinical data including prebaseline eGFR slope improved prediction but to a lesser extent than biomarkers (area under the ROC curve of 0.793). Thus we identified several novel associations of biomarkers with CKD progression and the utility of a small panel of biomarkers to improve prediction.We acknowledge all the SUMMIT partners (http://www.imi-summit.eu/) for their assistance with this project. This work was funded by the Innovative Medicine Initiative under grant agreement no. IMI/115006 (the SUMMIT consortium) and the Go-DARTS cohort was funded by the Chief Scientists Office Scotland.This is the accepted manuscript of a paper published in Kidney International (Looker et al., Kidney International, 2015 doi: 10.1038/ki.2015.199). The final version is available at http://dx.doi.org/10.1038/ki.2015.19