248 research outputs found
Relationship between cardiovascular risk and lipid testing in one health care system: a retrospective cohort study.
BackgroundThe US Preventive Services Taskforce (USPSTF) recommends routine lipid screening beginning age 35 for men [1]. For women age 20 and older, as well as men age 20-34, screening is recommended if cardiovascular risk factors are present. Prior research has focused on underutilization but not overuse of lipid testing. The objective is to document over- and under-use of lipid testing in an insured population of persons at low, moderate and high cardiovascular disease (CVD) risk for persons not already on statins.MethodsThe study is a retrospective cohort study that included all adults without prior CVD who were continuously enrolled in a large integrated healthcare system from 2005 to 2010. Measures included lipid test frequency extracted from administrative data and Framingham cardiovascular risk equations applied using electronic medical record data. Five year lipid testing patterns were examined by age, sex and CVD risk. Generalized linear models were used to estimate the relative risk for over testing associated with patient characteristics.ResultsAmong males and females for whom testing is not recommended, 35.8 % and 61.5 % received at least one lipid test in the prior 5 years and 8.4 % and 24.4 % had two or more. Over-testing was associated with age, race, comorbidity, primary care use and neighborhood income. Among individuals at moderate and high-risk (not already treated with statins) and for whom screening is recommended, between 21.4 % and 25.1 % of individuals received no screening in the prior 5 years.ConclusionsBased on USPSTF lipid screening recommendations, this study documents substantial over-testing among individuals with low CVD risk and under-testing among individuals with moderate to high-risk not already on statins. Opportunity exists to better focus lipid screening efforts appropriate to CVD risk
A study of reading theses containing materials that could be used with slow learners in grades I-VI
Thesis (Ed.M.)--Boston University. Missing p. 28The purpose of this study is to summarize the theses and
dissertations which contain reading materials that have been
or could be adapted for use with slow-learning cJ:lildren in
the elementary school. These studies were completed at Boston University during the years 1943 through 1960
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Congenital myasthenic syndrome in Golden Retrievers is associated with a novel COLQ mutation.
BackgroundCongenital myasthenic syndromes (CMSs) are a group of inherited disorders of neuromuscular transmission that may be presynaptic, synaptic, or postsynaptic. Causative mutations have been identified in 4 breeds including the Labrador Retriever, Jack Russell Terrier, Heideterrier, and Danish Pointing Dog.Hypothesis/objectiveClinical and genetic characterization of a neuromuscular disorder in Golden Retriever (GR) puppies.AnimalsFour GR puppies from California were evaluated for generalized muscle weakness beginning at weaning. Biological specimens were collected from the affected puppies, and familial information was obtained. Blood or buccal swabs were obtained from 63 unaffected GRs.MethodsComplete physical, neurological, electrodiagnostic, and histological evaluations and biochemical quantification of muscle acetylcholine receptors were performed. Polymerase chain reaction was used to amplify the 17 exons of COLQ, and sequences were obtained by Sanger sequencing. Variant frequency was assessed in unrelated GRs and a public database.ResultsClinical, neurological, and electrodiagnostic evaluations confirmed a disorder of neuromuscular transmission in a GR family. Sequencing of all exons and splice sites of a primary candidate gene, COLQ, identified a point mutation that predicts an amino acid substitution (G294R). The primary COLQ transcript was absent from affected muscle samples. All affected puppies were homozygous for the mutation, which was not detected outside this GR family or in other breeds.Conclusions and clinical importanceWe confirmed the diagnosis of a CMS in GR puppies and identified a novel COLQ mutation. The COLQ gene encodes the collagenous tail of acetylcholinesterase, the enzyme responsible for termination of skeletal muscle contraction by clearing acetylcholine at the neuromuscular junction. Clinicians and breeders should be aware of this CMS in GR puppies with an early onset of weakness
Schoolwide Application of Positive Behavior Support in an Urban High School:. Journal Of Positive Behavior Interventions
Abstract: The nuances of the application of schoolwide positive behavior supports (PBS) in an urban high school setting were investigated. Impact of implementation was measured using qualitative interviews and observations, including the School-wide Evaluation Tool (SET), Effective Behavior Support Survey, Student Climate Survey, and office disciplinary referrals. The results indicated that schoolwide PBS was implemented in an urban high school setting with some success. The overall level of implementation of PBS reached 80% as measured by the SET. Staff and teachers increased their level of perceived priority for implementing PBS in their school. A decrease in monthly discipline referrals to the office and the proportion of students who required secondary and tertiary supports was noted. These findings seem to indicate that PBS may be an important process for improving outcomes for teachers and students in urban high school settings
Towards an Intelligent Tutor for Mathematical Proofs
Computer-supported learning is an increasingly important form of study since
it allows for independent learning and individualized instruction. In this
paper, we discuss a novel approach to developing an intelligent tutoring system
for teaching textbook-style mathematical proofs. We characterize the
particularities of the domain and discuss common ITS design models. Our
approach is motivated by phenomena found in a corpus of tutorial dialogs that
were collected in a Wizard-of-Oz experiment. We show how an intelligent tutor
for textbook-style mathematical proofs can be built on top of an adapted
assertion-level proof assistant by reusing representations and proof search
strategies originally developed for automated and interactive theorem proving.
The resulting prototype was successfully evaluated on a corpus of tutorial
dialogs and yields good results.Comment: In Proceedings THedu'11, arXiv:1202.453
ACC/AHA/ASNC Guidelines for the Clinical Use of Cardiac Radionuclide Imaging—Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASNC Committee to Revise the 1995 Guidelines for the Clinical Use of Cardiac Radionuclide Imaging)44The ACC/AHA Task Force on Practice Guidelines makes every effort to avoid any actual or potential conflicts of interest that might arise as a result of an outside relationship or personal interest of a member of the writing panel. Specifically, all members of the writing panel are asked to provide disclosure statements of all such relationships that might be perceived as real or potential conflicts of interest. These statements are reviewed by the parent task force, reported orally to all members of the writing panel at the first meeting, and updated as changes occur.55This document was approved by the American College of Cardiology Foundation Board of Trustees in July, 2003, the American Heart Association Science Advisory and Coordinating Committee in July, 2003, and the American Society of Nuclear Cardiology Board of Directors in July, 2003.66When citing this document, the American College of Cardiology Foundation, the American Heart Association, and the American Society of Nuclear Cardiology request that the following citation format be used: Klocke FJ, Baird MG, Bateman TM, Berman DS, Carabello BA, Cerqueira MD, DeMaria AN, Kennedy JW, Lorell BH, Messer JV, O’Gara PT, Russell RO Jr, St. John Sutton MG, Udelson JE, Verani MS, Williams KA. ACC/AHA/ASNC guidelines for the clinical use of cardiac radionuclide imaging—executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASNC Committee to Revise the 1995 Guidelines for the Clinical Use of Radionuclide Imaging). J Am Coll Cardiol 2003;42:1318–33.77(J Am Coll Cardiol 2003;42:1318–33)88©2003 by the American College of Cardiology Foundation and the American Heart Association, Inc.
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