Cognitive Evaluation: Is It Time to Require Standardized Assessments?

Mounting evidence from across the medical community supports standardized cognitive assessment and intervention. This manuscript presents a clinical perspective on the benefits of utilization of standardized assessments to inform clinical practice. Today’s value-based care initiatives demand standardized testing to support evidence-based practice. Standardized cognitive assessment would wisely be adopted into practice to help practitioners fully identify impairments preventing patients from achieving successful outcomes

Effectiveness of group-based self-management education for individuals with Type 2 diabetes:A systematic review with meta-analyses and meta-regression

Aims: Patient education for the management of Type 2 diabetes can be delivered in various forms, with the goal of promoting and supporting positive self-management behaviours. This systematic review aimed to determine the effectiveness of group-based interventions compared with individual interventions or usual care for improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes. Methods: Six electronic databases were searched. Group-based education programmes for adults with Type 2 diabetes that measured glycated haemoglobin (HbA1c) and followed participants for ≥ 6 months were included. The primary outcome was HbA1c, and secondary outcomes included fasting blood glucose, weight, body mass index, waist circumference, blood pressure, blood lipid profiles, diabetes knowledge and self-efficacy. Results: Fifty-three publications describing 47 studies were included (n = 8533 participants). Greater reductions in HbA1c occurred in group-based education compared with controls at 6–10 months [n = 30 studies; mean difference (MD) = 3 mmol/mol (0.3%); 95% confidence interval (CI): −0.48, −0.15; P = 0.0002], 12–14 months [n = 27 studies; MD = 4 mmol/mol (0.3%); 95% CI: −0.49, −0.17; P < 0.0001], 18 months [n = 3 studies; MD = 8 mmol/mol (0.7%); 95% CI: −1.26, −0.18; P = 0.009] and 36–48 months [n = 5 studies; MD = 10 mmol/mol (0.9%); 95% CI: −1.52, −0.34; P = 0.002], but not at 24 months. Outcomes also favoured group-based education for fasting blood glucose, body weight, waist circumference, triglyceride levels and diabetes knowledge, but not at all time points. Interventions facilitated by a single discipline, multidisciplinary teams or health professionals with peer supporters resulted in improved outcomes in HbA1c when compared with peer-led interventions. Conclusions: Group-based education interventions are more effective than usual care, waiting list control and individual education at improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes.No Full Tex

A Comparison of Modified Team-Based Learning and Lecture-Based Instruction in Occupational Therapy Education

This study explored the comparative effectiveness of team-based learning and lecture-based instruction in consecutive cohorts of occupational therapy students. Further, the study explored student perceptions of team-based learning. The mixed method study employed a two-group, quasi-experimental design and a broad qualitative design using thematic analysis with a convenience sample of consecutive occupational therapy student cohorts (N=70, N=62) in a human movement class. Cohort A (N=70) received instruction using a lecture-based instruction (LBI) approach and individual assessment. Cohort B (N=62) received modified team-based learning (TBL). Mid-term, final examination, and final course grades were compared. Thematic analysis was employed to assess student perceptions of TBL as an instructional method. Students receiving LBI had higher mid-term scores than those receiving TBL (p=.000). Final examination scores were also higher for LBI when compared to TBL (p=.000). However, the final course grade score showed no significant difference between LBI and TBL (p=.562). Thematic analysis revealed that students felt positive about the TBL instructional method. Further, students who participated in the TBL class perceived less academic stress, and believed testing and competency assessments were effective reflections of their learning. Both TBL and LBI are viable methods for occupational therapy educators to use in human movement/kinesiology-based courses

Development of automatic and manual flight director landing systems for the XV-15 tilt rotor aircraft in helicopter mode

The objective of this effort is to determine IFR approach path and touchdown dispersions for manual and automatic XV-15 tilt rotor landings, and to develop missed approach criteria. Only helicopter mode XV-15 operation is considered. The analysis and design sections develop the automatic and flight director guidance equations for decelerating curved and straight-in approaches into a typical VTOL landing site equipped with an MLS navigation aid. These system designs satisfy all known pilot-centered, guidance and control requirements for this flying task. Performance data, obtained from nonstationary covariance propagation dispersion analysis for the system, are used to develop the approach monitoring criteria. The autoland and flight director guidance equations are programmed for the VSTOLAND 1819B digital computer. The system design dispersion data developed through analysis and the 1819B digital computer program are verified and refined using the fixed-base, man-in-the-loop XV-15 VSTOLAND simulation

The upper critical field of filamentary Nb3Sn conductors

We have examined the upper critical field of a large and representative set of present multi-filamentary Nb3Sn wires and one bulk sample over a temperature range from 1.4 K up to the zero field critical temperature. Since all present wires use a solid-state diffusion reaction to form the A15 layers, inhomogeneities with respect to Sn content are inevitable, in contrast to some previously studied homogeneous samples. Our study emphasizes the effects that these inevitable inhomogeneities have on the field-temperature phase boundary. The property inhomogeneities are extracted from field-dependent resistive transitions which we find broaden with increasing inhomogeneity. The upper 90-99 % of the transitions clearly separates alloyed and binary wires but a pure, Cu-free binary bulk sample also exhibits a zero temperature critical field that is comparable to the ternary wires. The highest mu0Hc2 detected in the ternary wires are remarkably constant: The highest zero temperature upper critical fields and zero field critical temperatures fall within 29.5 +/- 0.3 T and 17.8 +/- 0.3 K respectively, independent of the wire layout. The complete field-temperature phase boundary can be described very well with the relatively simple Maki-DeGennes model using a two parameter fit, independent of composition, strain state, sample layout or applied critical state criterion.Comment: Accepted Journal of Applied Physics Few changes to shorten document, replaced eq. 7-

The effect of interleukin-10 and transforming growth factor beta-1 on HLA-DR expression in colonic epithelial cells.

The aim of this study was to assess whether interleukin-10 (IL-10) and/or transforming growth factor beta-1 (TGFbeta1) downregulate HLA-DR expression using the HT29 cell line as a model of colonic epithelial cells. HLA-DR expression was induced in HT29 cells with gamma-interferon. The effects of IL-10 alone, TGFbeta1 alone, and IL-10 and TGFbeta1 in combination were studied. HLA-DR expression was assessed using flow cytometric analysis. Gamma-interferon induced HLA-DR expression in a dose-dependent fashion. In the absence of gamma-interferon, neither IL-10 nor TGFbeta1 induced HLA-DR expression. In isolation, neither IL-10 nor TGFbeta1 downregulated HLA-DR expression. When IL-10 and TGFbeta1 were added in combination, small (6-30%) statistically significant reductions in HLA-DR expression were seen. The biological significance is unclear

Ground-State SiO Maser Emission Toward Evolved Stars

We have made the first unambiguous detection of vibrational ground-state maser emission from SiO toward six evolved stars. Using the Very Large Array, we simultaneously observed the v=0, J=1-0, 43.4-GHz, ground-state and the v=1, J=1-0, 43.1-GHz, first excited-state transitions of SiO toward the oxygen-rich evolved stars IRC+10011, o Ceti, W Hya, RX Boo, NML Cyg, and R Cas and the S-type star chi Cyg. We detected at least one v=0 SiO maser feature from six of the seven stars observed, with peak maser brightness temperatures ranging from 10,000 K to 108,800 K. In fact, four of the seven v=0 spectra show multiple maser peaks, a phenomenon which has not been previously observed. Ground-state thermal emission was detected for one of the stars, RX Boo, with a peak brightness temperature of 200 K. Comparing the v=0 and the v=1 transitions, we find that the ground-state masers are much weaker with spectral characteristics different from those of the first excited-state masers. For four of the seven stars the velocity dispersion is smaller for the v=0 emission than for the v=1 emission, for one star the dispersions are roughly equivalent, and for two stars (one of which is RX Boo) the velocity spread of the v=0 emission is larger. In most cases, the peak flux density in the v=0 emission spectrum does not coincide with the v=1 maser peak. Although the angular resolution of these VLA observations were insufficient to completely resolve the spatial structure of the SiO emission, the SiO spot maps produced from the interferometric image cubes suggest that the v=0 masers are more extended than their v=1 counterparts

Bayesian Power Spectrum Analysis of the First-Year WMAP data

We present the first results from a Bayesian analysis of the WMAP first year data using a Gibbs sampling technique. Using two independent, parallel supercomputer codes we analyze the WMAP Q, V and W bands. The analysis results in a full probabilistic description of the information the WMAP data set contains about the power spectrum and the all-sky map of the cosmic microwave background anisotropies. We present the complete probability distributions for each C_l including any non-Gaussianities of the power spectrum likelihood. While we find good overall agreement with the previously published WMAP spectrum, our analysis uncovers discrepancies in the power spectrum estimates at low l multipoles. For example we claim the best-fit Lambda-CDM model is consistent with the C_2 inferred from our combined Q+V+W analysis with a 10% probability of an even larger theoretical C_2. Based on our exact analysis we can therefore attribute the "low quadrupole issue" to a statistical fluctuation.Comment: 5 pages. 4 figures. For additional information and data see http://www.astro.uiuc.edu/~iodwyer/research#wma

A re-analysis of the three-year WMAP temperature power spectrum and likelihood

We analyze the three-year WMAP temperature anisotropy data seeking to confirm the power spectrum and likelihoods published by the WMAP team. We apply five independent implementations of four algorithms to the power spectrum estimation and two implementations to the parameter estimation. Our single most important result is that we broadly confirm the WMAP power spectrum and analysis. Still, we do find two small but potentially important discrepancies: On large angular scales there is a small power excess in the WMAP spectrum (5-10% at l<~30) primarily due to likelihood approximation issues between 13 <= l <~30. On small angular scales there is a systematic difference between the V- and W-band spectra (few percent at l>~300). Recently, the latter discrepancy was explained by Huffenberger et al. (2006) in terms of over-subtraction of unresolved point sources. As far as the low-l bias is concerned, most parameters are affected by a few tenths of a sigma. The most important effect is seen in n_s. For the combination of WMAP, Acbar and BOOMERanG, the significance of n_s =/ 1 drops from ~2.7 sigma to ~2.3 sigma when correcting for this bias. We propose a few simple improvements to the low-l WMAP likelihood code, and introduce two important extensions to the Gibbs sampling method that allows for proper sampling of the low signal-to-noise regime. Finally, we make the products from the Gibbs sampling analysis publically available, thereby providing a fast and simple route to the exact likelihood without the need of expensive matrix inversions.Comment: 14 pages, 7 figures. Accepted for publication in ApJ. Numerical results unchanged, but interpretation sharpened: Likelihood approximation issues at l=13-30 far more important than potential foreground issues at l <= 12. Gibbs products (spectrum and sky samples, and "easy-to-use" likelihood module) available from http://www.astro.uio.no/~hke/ under "Research

Bayesian angular power spectrum analysis of interferometric data

We present a Bayesian angular power spectrum and signal map inference engine which can be adapted to interferometric observations of anisotropies inthe cosmic microwave background, 21 cm emission line mapping of galactic brightness fluctuations, or 21 cm absorption line mapping of neutral hydrogen in the dark ages. The method uses Gibbs sampling to generate a sampled representation of the angular power spectrum posterior and the posterior of signal maps given a set of measured visibilities in the uv-plane. We use a mock interferometric CMB observation to demonstrate the validity of this method in the flat-sky approximation when adapted to take into account arbitrary coverage of the uv-plane, mode-mode correlations due to observations on a finite patch, and heteroschedastic visibility errors. The computational requirements scale as O(n_p log n_p) where n_p measures the ratio of the size of the detector array to the inter-detector spacing, meaning that Gibbs sampling is a promising technique for meeting the data analysis requirements of future cosmology missions.Comment: 7 pages, 10 figures, expanded discussion and edited to match ApJS approved version, affiliations update