The Comparison of Two Methods of Instruction in Teaching the Wechsler Intelligence Scale for Children

The study was conducted in an effort to determine if there were any differences in terms of student learning between two methods of instruction in teaching the Wechsler Intelligence Scale for Children (WISC). The scores on two outcome measures--a cognitive examination and a performance examination--were compared between students in an ExperimentaI group who learned by means of independent study and those in a Control group who Iearned to understand, administer, and score the WISC by means of a traditional method

The Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System: properties, applications, and interpretation

The Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System is a collection of health-related quality of life (HRQOL) questionnaires targeted to the management of chronic illness. The measurement system, under development since 1987, began with the creation of a generic CORE questionnaire called the Functional Assessment of Cancer Therapy-General (FACT-G). The FACT-G (now in Version 4) is a 27-item compilation of general questions divided into four primary QOL domains: Physical Well-Being, Social/Family Well-Being, Emotional Well-Being, and Functional Well-Being. It is appropriate for use with patients with any form of cancer, and extensions of it have been used and validated in other chronic illness condition (e.g., HIV/AIDS; multiple sclerosis; Parkinson's disease; rheumatoid arthritis), and in the general population. The FACIT Measurement System now includes over 400 questions, some of which have been translated into more than 45 languages. Assessment of any one patient is tailored so that the most-relevant questions are asked and administration time for any one assessment is usually less than 15 minutes. This is accomplished both by the use of specific subscales for relevant domains of HRQOL, or computerized adaptive testing (CAT) of selected symptoms and functional areas. FACIT questionnaires can be administered by self-report (paper or computer) or interview (face-to-face or telephone). Available scoring, normative data and information on meaningful change now allow one to interpret results in the context of a growing literature base

Predictors of health-related quality of life in patients with colorectal cancer

<p>Abstract</p> <p>Background</p> <p>Most studies that have identified variables associated with the health-related quality of life (HRQL) of patients with colorectal cancer have been cross-sectional or included patients with other diagnoses. The objectives of this study were to identify predictors of HRQL in patients with colorectal cancer and interpret the clinical importance of the results.</p> <p>Methods</p> <p>We conducted a population-based longitudinal study of patients identified through three regions of the California Cancer Registry. Surveys were completed by 568 patients approximately 9 and 19 months post-diagnosis. Three HRQL outcomes from the Functional Assessment of Cancer Therapy – Colorectal (FACT-C) were evaluated: social/family well-being (SWB), emotional well-being (EWB) and the Trial Outcome Index (TOI), which is a colorectal cancer-specific summary measure of physical function and well-being. Sociodemographic, cancer/health, and healthcare variables were assessed in multivariable regression models. We computed the difference in predicted HRQL scores corresponding to a large difference in a predictor variable, defined as a 1 standard deviation difference for interval variables or the difference relative to the reference category for nominal variables. The effect of an explanatory variable on HRQL was considered clinically meaningful if the predicted score difference was at least as large as the minimally important difference.</p> <p>Results</p> <p>Common predictors of better TOI, SWB and EWB were better general health and factors related to better perceived quality of cancer care. Predictor variables in addition to general health and perceived quality of care were identified only for SWB. Being married/living as married was associated with better SWB, whereas being male or of Hispanic ethnicity was associated with worse SWB. Among the sociodemographic, cancer/health, and healthcare variables evaluated, only Hispanic ethnicity had a clinically meaningful effect on an HRQL outcome.</p> <p>Conclusion</p> <p>Our findings, particularly the information on the clinical importance of predictor variables, can help clinicians identify patients who may be at risk for poor future HRQL. Potentially modifiable factors were related to perceived quality of cancer care; thus, future research should evaluate whether improving these factors improves HRQL.</p

Edaphic adaptation maintains the coexistence of two cryptic species on serpentine soils

• Premise of the study: Divergent edaphic adaptation can contribute to reproductive isolation and coexistence between closely related species, yet we know little about how small-scale continuous edaphic gradients contribute to this phenomenon. We investigated edaphic adaptation between two cryptic species of California wildflower, Lasthenia californica and L. gracilis (Asteraceae), which grow in close parapatry on serpentine soil. • Methods: We reciprocally transplanted both species into the center of each species’ habitat and the transition zone between species. We quantified multiple components of fitness and used aster models to predict fitness based on environmental variables. We sampled soil across the ridge throughout the growing season to document edaphic changes through time. We sampled naturally germinating seedlings to determine whether there was dispersal into the adjacent habitat and to help pinpoint the timing of any selection against migrants. • Key results: We documented within-serpentine adaptation contributing to habitat isolation between close relatives. Both species were adapted to the edaphic conditions in their native region and suffered fitness trade-offs when moved outside that region. However, observed fitness values did not perfectly match those predicted by edaphic variables alone, indicating that other factors, such as competition, also contributed to plant fitness. Soil water content and concentrations of calcium, magnesium, sodium, and potassium were likely drivers of differential fitness. Plants either had limited dispersal ability or migrants experienced early-season mortality outside their native region. • Conclusions: Demonstrating that continuous habitats can support differently adapted, yet closely related, taxa is important to a broader understanding of how species are generated and maintained in nature

Using Multiple Anchor- and Distribution-Based Estimates to Evaluate Clinically Meaningful Change on the Functional Assessment of Cancer Therapy-Biologic Response Modifiers (FACT-BRM) Instrument

Objective: The interpretation of health-related quality of life (HRQL) data from clinical trials can be enhanced by understanding the degree of change in HRQL scores that is considered meaningful. Our objectives were to combine distribution-based and two anchor-based approaches to identify minimally important differences (MIDs) for the 27-item Trial Outcome Index (TOI), the seven-item Social Well-Being (SWB) subscale, and the six-item Emotional Well-being (EWB) subscale from the Functional Assessment of Cancer Therapy-Biological Response Modifiers (FACT-BRM) instrument. Methods: Distribution-based MIDs were based on the standard error of measurement. Anchor-based approaches utilized patient-reported global rating of change (GRC) and change in physician-reported performance status rating (PSR). Correlations and weighted kappa statistics were used to assess association and agreement between the two anchors. FACT-BRM changes were evaluated for three time periods: baseline to month 1, month 2 to month 3, and month 5 to month 6. Results: Association between GRC and change in PSR was poor. Correlation between the anchors and HRQL change scores was largest at month 1 and decreased through month 6. Combining results from all approaches, the MIDs identified were 5–8 points for the TOI, 2 points for the SWB subscale, and 2–3 points for the EWB subscale. Conclusions: We combined patient-reported estimates, physician-reported estimates, and distribution-based estimates to derive MIDs for HRQL outcomes from the FACT-BRM. These results will enable interpretation of treatment group effects in a clinical trial setting, and they can be used to estimate sample size or power when designing future studies

PPARγ agonists do not directly enhance basal or insulin-stimulated Na+ transport via the epithelial Na+ channel

Selective agonists of peroxisome proliferator-activated receptor gamma (PPARgamma) are anti-diabetic drugs that enhance cellular responsiveness to insulin. However, in some patients, fluid retention, plasma volume expansion, and edema have been observed. It is well established that insulin regulates Na(+) reabsorption via the epithelial sodium channel (ENaC) located in the distal tubule. Therefore, we hypothesized that these agonists may positively modulate insulin-stimulated ENaC activity leading to increased Na(+) reabsorption and fluid retention. Using electrophysiological techniques, dose-response curves for insulin-mediated Na(+) transport in the A6, M-1, and mpkCCD(cl4) cell lines were performed. Each line demonstrated hormone efficacy within physiological concentration ranges and, therefore, can be used to monitor clinically relevant effects of pharmacological agents which may affect electrolyte transport. Immunodetection and quantitative PCR analyses showed that each cell line expresses viable and functional PPARgamma receptors. Despite this finding, two PPARgamma agonists, pioglitazone and GW7845 did not directly enhance basal or insulin-stimulated Na(+) flux via ENaC, as shown by electrophysiological methodologies. These studies provide important results, which eliminate insulin-mediated ENaC activation as a candidate mechanism underlying the fluid retention observed with PPARgamma agonist use

Comparing SF-36 scores across three groups of women with different health profiles

Background: The widespread use of the Medical Outcomes Study (MOS) 36-item Short-Form Health Survey (SF-36) facilitates the comparison of health-related quality of life (HRQL) across independent studies. Objectives : To compare the scores of eight scales and two summary scales of the SF-36 across participants in the Women’s Healthy Eating and Living (WHEL) trial, the Women’s Health Initiative-Dietary Modification trial (WHI-DM), and the MOS, and to illustrate the use of effect sizes for interpreting the importance of group differences. Methods : WHEL and WHI-DM are both multi-center dietary interventions; only data from the UC Davis sites were used in our study. WHEL participants had a recent history of breast cancer, WHI-DM participants were healthy, postmenopausal women, and women in the MOS had a history of hypertension, diabetes, heart disease, or depression. General linear models were used to identify statistically significant differences in scale scores. Meaningful differences were determined by effect sizes computed using a common within-group standard deviation (SD) and SDs from normative data. Results : After adjusting for age and marital status, SF-36 scores for the WHI-DM and WHEL samples were similar and both had statistically significantly higher scores than the MOS sample. Relative to the WHEL or WHI-DM studies, MOS scores for scales related to the physical domain were clearly meaningfully lower whereas scale scores related to the mental health domain were potentially meaningfully lower. Conclusions : The HRQL of breast cancer survivors is comparable to that of healthy women and better than that of women with chronic health conditions, particularly with respect to physical health. This study illustrated the use of ranges of effects sizes for aiding the interpretation of SF-36 scores differences across independent studies.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43569/1/11136_2004_Article_6673.pd

The association between health literacy and indicators of cognitive impairment in a diverse sample of primary care patients

To confirm the association of health literacy scores as measured by Health Literacy Assessment Using Talking Touchscreen Technology (Health LiTT) with cognitive ability and education. To determine whether this association differs by cognitive task

Edaphic adaptation maintains the coexistence of two cryptic species on serpentine soil

• Premise of the study: Divergent edaphic adaptation can contribute to reproductive isolation and coexistence between closely related species, yet we know little about how small-scale continuous edaphic gradients contribute to this phenomenon. We investigated edaphic adaptation between two cryptic species of California wildflower, Lasthenia californica and L. gracilis (Asteraceae), which grow in close parapatry on serpentine soil. • Methods: We reciprocally transplanted both species into the center of each species’ habitat and the transition zone between species. We quantified multiple components of fitness and used aster models to predict fitness based on environmental variables. We sampled soil across the ridge throughout the growing season to document edaphic changes through time. We sampled naturally germinating seedlings to determine whether there was dispersal into the adjacent habitat and to help pinpoint the timing of any selection against migrants. • Key results: We documented within-serpentine adaptation contributing to habitat isolation between close relatives. Both species were adapted to the edaphic conditions in their native region and suffered fitness trade-offs when moved outside that region. However, observed fitness values did not perfectly match those predicted by edaphic variables alone, indicating that other factors, such as competition, also contributed to plant fitness. Soil water content and concentrations of calcium, magnesium, sodium, and potassium were likely drivers of differential fitness. Plants either had limited dispersal ability or migrants experienced early-season mortality outside their native region. • Conclusions: Demonstrating that continuous habitats can support differently adapted, yet closely related, taxa is important to a broader understanding of how species are generated and maintained in nature