3,037 research outputs found
PIH27 Review of Adherence Measures for use in Phase Iv Studies and Recommendations for a new Standardized Generic Measure
Distribution, species composition and management implications of seed banks in southern New England coastal plain ponds
Author Posting. © The Author(s), 2009. This is the author's version of the work. It is posted here by permission of Elsevier B.V. for personal use, not for redistribution. The definitive version was published in Biological Conservation 142 (2009): 1350-1361, doi:10.1016/j.biocon.2009.01.020.Buried seeds that germinate during periods of low water or water level drawdown can play
important roles in shaping plant community composition, community dynamics and species
richness in ecosystems with fluctuating water levels. Northeastern US coastal plain ponds have
fluctuating water levels and contain a characteristic shoreline flora that contains many rare
plants. The objectives of this study were to: (1) test whether geographically distant ponds in
Cape Cod and Martha’s Vineyard had distinct seed banks, (2) determine if hydrologic status as
permanent and ephemeral ponds led to differences in seed banks, and (3) examine seed diversity
and seed abundance across gradients of shoreline elevations and sediment characteristics. Viable
seeds of 45 plant species were identified from 9 ponds. Native species dominated pond-shore
seed banks and made up 89 to 100% of all species. There was high overlap in seed bank
composition across hydrological classes and geographic regions. One hydrological class captured
73-76% of total species and one geographical region captured 69-78% of the total species
recovered from the entire suite of seed bank samples. Seeds were relatively evenly distributed
along the shorelines of ephemeral ponds but seed diversity and abundance were lower at low
elevations in permanent ponds. Results suggest that strategies to protect pond shorelines to
capture maximum diversity of coastal plain pond plants contained in pond sediment seed banks
should be implemented across pond hydrologic classes and across a wide geographic area.
Shoreline seed distributions indicate that ground-water withdrawals or climate changes that
lower pond water levels in permanent ponds will reduce the diversity and abundance of plants
recovered from seed banks by shifting water levels to a shoreline zone of high sediment organic
matter where seed densities are lower. This effect will be much less in ephemeral ponds where
seed diversity and abundance on pond bottoms was high.This study was funded by the Massachusetts
Environmental Trust and the Barnstable Water Company
Dysautonomia rating scales in Parkinson's disease: Sialorrhea, dysphagia, and constipation—
Upper and lower gastrointestinal dysautonomia symptoms (GIDS)—sialorrhea, dysphagia, and constipation are common in Parkinson's disease (PD) and often socially as well as physically disabling for patients. Available invasive quantitative measures for assessing these symptoms and their response to therapy are time-consuming, require specialized equipment, can cause patient discomfort and present patients with risk. The Movement Disorders Society commissioned a task force to assess available clinical rating scales, critique their clinimetric properties, and make recommendations regarding their clinical utility. Six clinical researchers and a biostatistician systematically searched the literature for scales of sialorrhea, dysphagia, and constipation, evaluated the scales' previous use, performance parameters, and quality of validation data (if available). A scale was designated “Recommended” if the scale was used in clinical studies beyond the group that developed it, has been specifically used in PD reports, and clinimetric studies have established that it is a valid, reliable, and sensitive. “Suggested” scales met at least part of the above criteria, but fell short of meeting all. Based on the systematic review, scales for individual symptoms of sialorrhea, dysphagia, and constipation were identified along with three global scales that include these symptoms in the context of assessing dysautonomia or nonmotor symptoms. Three sialorrhea scales met criteria for Suggested: Drooling Severity and Frequency Scale (DSFS), Drooling Rating Scale, and Sialorrhea Clinical Scale for PD (SCS-PD). Two dysphagia scales, the Swallowing Disturbance Questionnaire (SDQ) and Dysphagia-Specific Quality of Life (SWAL-QOL), met criteria for Suggested. Although Rome III constipation module is widely accepted in the gastroenterology community, and the earlier version from the Rome II criteria has been used in a single study of PD patients, neither met criteria for Suggested or Recommended. Among the global scales, the Scales for Outcomes in PD-Autonomic (SCOPA-AUT) and Nonmotor Symptoms Questionnaire for PD (NMSQuest) both met criteria for Recommended, and the Nonmotor Symptoms Scale (NMSS) met criteria for Suggested; however, none specifically focuses on the target gastrointestinal symptoms (sialorrhea, dysphagia, and constipation) of this report. A very small number of rating scales have been applied to studies of gastrointestinal-related dysautonomia in PD. Only two scales met “Recommended” criteria and neither focuses specifically on the symptoms of sialorrhea, dysphagia, and constipation. Further scale testing in PD among the scales that focus on these symptoms is warranted, and no new scales are needed until the available scales are fully tested clinimetrically. © 2009 Movement Disorder SocietyPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/62130/1/22260_ftp.pd
A Longitudinal Study of Hospitalization Rates for Patients with Chronic Disease: Results from the Medical Outcomes Study.
To prospectively compare inpatient and outpatient utilization rates between prepaid (PPD) and fee-for-service (FFS) insurance coverage for patients with chronic disease. Data from the Medical Outcomes Study, a longitudinal observational study of chronic disease patients conducted in Boston, Chicago, and Los Angeles.A four-year prospective study of resource utilization among 1,681 patients under treatment for hypertension, diabetes, myocardial infarction, or congestive heart failure in the practices of 367 clinicians
A Comparison Of Outcomes In Osteoarthritis Patients Undergoing Total Hip And Knee Replacement Surgery
Objective The aims of this study were to assess changes in physical function and quality of life with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the instrument of the Medical Outcomes Study SF-36 Health Survey (MOS SF-36), respectively, in patients undergoing hip and knee joint replacement surgery and to compare the responsiveness of these two outcome measures 1 year after surgery. Design One hundred and ninety-four patients with osteoarthritis (OA knee 108, OA hip 86) admitted to four hospitals in Sydney were followed over a period of 1 year at 3 monthly intervals. Results WOMAC measures improved significantly after 1 year for OA hip and OA knee: there was reduction in pain of 71% and 53%, reduction in stiffness of 55% and 43% and improvement in physical function of 68% and 43%, respectively. MOS SF-36 measures in those having hip surgery improved significantly for pain (222%), physical function (247%), physical role functioning (402%), general health (110%), vitality (143%), social functioning (169%) and mental health (114%). For those in the knee surgery group, significant improvement was seen for pain (175%), physical function (197%), physical role functioning (275%), vitality (125%) and social functioning (119%). The WOMAC was a more responsive measure than the MOS SF-36. Conclusion WOMAC and MOS SF-36 detect significant and clinically meaningful changes in outcome after hip and knee replacement. WOMAC requires a smaller sample size and is more responsive in the short term. For a follow-up longer than 6 months MOS SF-36 provides additional information. The improvement in outcomes following hip joint surgery were significantly greater than those following knee surgery
Beliefs that influence cost-related medication non-adherence among the “haves” and “have nots” with chronic diseases
The effect of septorhinoplasty on quality of life and nasal function in asians
This is the first study that aimed to assess the effects of septorhinoplasty on quality of life (QOL) in an Asian population. The study consisted of 2 parts. First, the Derriford Appearance Scale 59 (DAS-59) was translated into Korean, and the reliability and validity were assessed by administering the Korean version of Derriford Appearance Scale 59 (DAS-59K) and 36-item short-form health survey to 88 inpatients scheduled for operations. Then, a prospective study was conducted which included 31 patients who underwent primary septorhinoplasty from October 2008 through May 2009. The changes in QOL and nasal symptoms were evaluated by comparing the preoperative and postoperative 3 month DAS-59K and nasal obstruction symptom evaluation scales. Principal component analysis of the DAS-59K showed an optimum 5-factor and the Cronbach α for each factor was greater than 0.7. Significant correlation was found between the DAS-59K and 36-item short-form health survey. Objective evaluation showed at least an improvement in every patient. After septorhinoplasty, there was improvement at scores related to general self-consciousness, negative self-concept, and physical stress (P < 0.05). The pattern of improvement differed by sex, age, and the presence of external nose deviation. Mean nasal obstruction symptom evaluation scores decreased significantly after surgery. The DAS-59K is a reliable and valid test, which can be a useful tool to assess individual response to living with problems of appearance. Septorhinoplasty improves both QOL and nasal function which should be taken into consideration in future counseling of individual patients expecting septorhinoplasty. Copyright © 2013 by Lippincott Williams & Wilkins
Psychometric properties of a prostate cancer radiation late toxicity questionnaire
<p>Abstract</p> <p>Background</p> <p>To construct a short prostate cancer radiation late toxicity (PCRT) questionnaire with health-related quality-of-life (HRQoL) domains.</p> <p>Methods</p> <p>The PCRT was developed by item generation, questionnaire construction (n = 7 experts, n = 8 focus group patients), pilot testing (n = 37), item reduction (n = 100), reliability testing (n = 237), and validity testing (n = 274).</p> <p>Results</p> <p>Reliability of the three item-reduced subscales demonstrated intraclass correlation coefficients (CC) of 0.811 (GU), 0.842 (GI), and 0.740 (sexual). Discriminant validity demonstrated Pearson CC of 0.449 (GU-GI), 0.200 (sexual-GU), and 0.09 (sexual-GI). Content validity correlations between PCRT-PCQoL were 0.35–0.78, PCRT-FACT-G<sup>© </sup>were 0.19–0.39, and PCRT-SF-36<sup>® </sup>were 0.03–0.34.</p> <p>Conclusion</p> <p>We successfully generated a PCRT HRQoL questionnaire including subscales with very good psychometric properties.</p
Medication cost problems among chronically ill adults in the US: did the financial crisis make a bad situation even worse?
A national internet survey was conducted between March and April 2009 among 27,302 US participants in the Harris Interactive Chronic Illness Panel. Respondents reported behaviors related to cost-related medication non-adherence (CRN) and the impacts of medication costs on other aspects of their daily lives. Among respondents aged 40–64 and looking for work, 66% reported CRN in 2008, and 41% did not fill a prescription due to cost pressures. More than half of respondents aged 40–64 and nearly two-thirds of those in this group who were looking for work or disabled reported other impacts of medication costs, such as cutting back on basic needs or increasing credit card debt. More than one-third of respondents aged 65+ who were working or looking for work reported CRN. Regardless of age or employment status, roughly half of respondents reporting medication cost hardship said that these problems had become more frequent in 2008 than before the economic recession. These data show that many chronically ill patients, particularly those looking for work or disabled, reported greater medication cost problems since the economic crisis began. Given links between CRN and worse health, the financial downturn may have had significant health consequences for adults with chronic illness
Solute and sediment export from Amazon forest and soybean headwater streams
Author Posting. © Ecological Society of America, 2016. This article is posted here by permission of Ecological Society of America for personal use, not for redistribution. The definitive version was published in Ecological Applications 27 (2017): 193–207, doi:10.1002/eap.1428.Intensive cropland agriculture commonly increases streamwater solute concentrations and export from small watersheds. In recent decades, the lowland tropics have become the world's largest and most important region of cropland expansion. Although the effects of intensive cropland agriculture on streamwater chemistry and watershed export have been widely studied in temperate regions, their effects in tropical regions are poorly understood. We sampled seven headwater streams draining watersheds in forest (n = 3) or soybeans (n = 4) to examine the effects of soybean cropping on stream solute concentrations and watershed export in a region of rapid soybean expansion in the Brazilian state of Mato Grosso. We measured stream flows and concentrations of NO3−, PO43−, SO42−, Cl−, NH4+, Ca2+, Mg2+, Na+, K+, Al3+, Fe3+, and dissolved organic carbon (DOC) biweekly to monthly to determine solute export. We also measured stormflows and stormflow solute concentrations in a subset of watersheds (two forest, two soybean) during two/three storms, and solutes and δ18O in groundwater, rainwater, and throughfall to characterize watershed flowpaths. Concentrations of all solutes except K+ varied seasonally in streamwater, but only Fe3+ concentrations differed between land uses. The highest streamwater and rainwater solute concentrations occurred during the peak season of wildfires in Mato Grosso, suggesting that regional changes in atmospheric composition and deposition influence seasonal stream solute concentrations. Despite no concentration differences between forest and soybean land uses, annual export of NH4+, PO43−, Ca2+, Fe3+, Na+, SO42−, DOC, and TSS were significantly higher from soybean than forest watersheds (5.6-fold mean increase). This increase largely reflected a 4.3-fold increase in water export from soybean watersheds. Despite this increase, total solute export per unit watershed area (i.e., yield) remained low for all watersheds (<1 kg NO3− N·ha−1·yr−1, <2.1 kg NH4+-N·ha−1·yr−1, <0.2 kg PO43−-P·ha−1·yr−1, <1.5 kg Ca2+·ha−1·yr−1). Responses of both streamflows and solute concentrations to crop agriculture appear to be controlled by high soil hydraulic conductivity, groundwater-dominated hydrologic flowpaths on deep soils, and the absence of nitrogen fertilization. To date, these factors have buffered streams from the large increases in solute concentrations that often accompany intensive croplands in other locations.NSF Grant Numbers: DEB-0640661, DEB-0949370;
Fundação de Amparo á Pesquisa do Estado de São Paulo Grant Number: FAPESP 03/13172-2;
Watson Graduate Student Fellowship;
Center for Latin American and Caribbean Studies at Brown Universit
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