Forecasting Police Calls during Peak Times for the City of Cleveland

For a period of time, professors from the Cleveland State University worked closely with the City of Cleveland Police Department. This partnership resulted in access to police records cataloging all emergency 911 calls for the city since 1995. Here, we describe forecasting approaches that can be used by the Police Department based on hourly 911 calls in the years 2001 to 2003 throughout the city during peak call time: the third shift during summer months. This case study is appropriate for class discussions in advanced courses in statistics to explore the application of time series analysis techniques

Long-Dose Intensive Therapy Is Necessary for Strong, Clinically Significant, Upper Limb Functional Gains and Retained Gains in Severe/Moderate Chronic Stroke

Background. Effective treatment methods are needed for moderate/severely impairment chronic stroke. Objective. The questions were the following: (1) Is there need for long-dose therapy or is there a mid-treatment plateau? (2) Are the observed gains from the prior-studied protocol retained after treatment? Methods. Single-blind, stratified/randomized design, with 3 applied technology treatment groups, combined with motor learning, for long-duration treatment (300 hours of treatment). Measures were Arm Motor Ability Test time and coordination-function (AMAT-T, AMAT-F, respectively), acquired pre-/posttreatment and 3-month follow-up (3moF/U); Fugl-Meyer (FM), acquired similarly with addition of mid-treatment. Findings. There was no group difference in treatment response (P ≥ .16), therefore data were combined for remaining analyses (n = 31; except for FM pre/mid/post, n = 36). Pre-to-Mid-treatment and Mid-to-Posttreatment gains of FM were statistically and clinically significant (P \u3c .0001; 4.7 points and P \u3c .001; 5.1 points, respectively), indicating no plateau at 150 hours and benefit of second half of treatment. From baseline to 3moF/U: (1) FM gains were twice the clinically significant benchmark, (2) AMAT-F gains were greater than clinically significant benchmark, and (3) there was statistically significant improvement in FM (P \u3c .0001); AMAT-F (P \u3c .0001); AMAT-T (P \u3c .0001). These gains indicate retained clinically and statistically significant gains at 3moFU. From posttreatment to 3moF/U, gains on FM were maintained. There were statistically significant gains in AMAT-F (P = .0379) and AMAT-T P = .003

Household Food Insecurity Is Inversely Associated with Social Capital and Health in Females from Special Supplemental Nutrition Program for Women, Infants, and Children Households in Appalachian Ohio

Food insecurity has been negatively associated with social capital (a measure of perceived social trust and community reciprocity) and health status. Yet, these factors have not been studied extensively among women from households participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) or the WIC Farmers’ Market Nutrition Program. A cross-sectional, self-administered, mailed survey was conducted in Athens County, Ohio, to examine the household food security status, social capital, and self-rated health status of women from households receiving WIC benefits alone (n=170) and those from households receiving both WIC and Farmers’ Market Nutrition Program benefits (n=65), as well as the relationship of food security, social capital, and self-rated health status. Household food security and perceived health status were not significantly different between groups; however, high social capital was greater (χ2=8.156, P=0.004) among WIC, compared to WIC/Farmers’ Market Nutrition Program group respondents. Overall, household food insecurity was inversely associated with perceived health status (r=−0.229, P=0.001) and social capital (r=0.337, P\u3c0.001). Enabling networking among clients, leading to client-facilitated programs and projects, and developing programs that strengthen social capital, including community-based mentoring programs and nutrition education programs that are linked to community-based activities, are needed, as is additional research to verify these findings

Capability of 2 Gait Measures for Detecting Response to Gait Training in Stroke Survivors: Gait Assessment and Intervention Tool and The Tinetti Gait Scale

Zimbelman J, Daly JJ, Roenigk KL, Butler K, Burdsall R, Holcomb JP. Capability of 2 gait measures for detecting response to gait training in stroke survivors: Gait Assessment and Intervention Tool and the Tinetti Gait Scale. Objective:To characterize the performance of 2 observational gait measures, the Tinetti Gait Scale (TGS) and the Gait Assessment and Intervention Tool (G.A.I.T.), in identifying improvement in gait in response to gait training. Design: In secondary analysis from a larger study of multimodal gait training for stroke survivors, we measured gait at pre-, mid-, and posttreatment according to G.A.I.T. and TGS, assessing their capability to capture recovery of coordinated gait components. Setting: Large medical center. Participants: Cohort of stroke survivors (N=44) greater than 6 months after stroke. Interventions: All subjects received 48 sessions of a multimodal gait-training protocol. Treatment consisted of 1.5 hours per session, 4 sessions per week for 12 weeks, receiving these 3 treatment aspects: (1) coordination exercise, (2) body weight–supported treadmill training, and (3) overground gait training, with 46% of subjects receiving functional electrical stimulation. Main Outcome Measures: All subjects were evaluated with the G.A.I.T. and TGS before and after completing the 48-session intervention. An additional evaluation was performed at midtreatment (after session 24). Results: For the total subject sample, there were significant pre-/post-, pre-/mid-, and mid-/posttreatment gains for both the G.A.I.T. and the TGS. According to the G.A.I.T., 40 subjects (91%) showed improved scores, 2 (4%) no change, and 2 (4%) a worsening score. According to the TGS, only 26 subjects (59%) showed improved scores, 16 (36%) no change, and 1 (2%) a worsening score. For 1 treatment group of chronic stroke survivors, the TGS failed to identify a significant treatment response to gait training, whereas the G.A.I.T. measure was successful. Conclusions: The G.A.I.T. is more sensitive than the TGS for individual patients and group treatment response in identifying recovery of volitional control of gait components in response to gait training

Development and Testing of The Gait Assessment and Intervention Tool (G.A.I.T.): A Measure of Coordinated Gait Components

Recent neuroscience methods have provided the basis upon which to develop effective gait training methods for recovery of the coordinated components of gait after neural injury. We determined that there was not an existing observational measure that was, at once, adequately comprehensive, scored in an objectively-based manner, and capable of assessing incremental improvements in the coordinated components of gait. Therefore, the purpose of this work was to use content valid procedures in order to develop a relatively inexpensive, more comprehensive measure, scored with an objectively-based system, capable of incrementally scoring improvements in given items, and that was both reliable and capable of discriminating treatment response for those who had a stroke. Eight neurorehabilitation specialists developed criteria for the gait measure, item content, and scoring method. In subjects following stroke (\u3e12 months), the new measure was tested for intra- and inter-rater reliability using the Intraclass Correlation Coefficient; capability to detect treatment response using Wilcoxon Signed Ranks Test; and discrimination between treatment groups, using the Plum Ordinal Regression. The Gait Assessment and Intervention Tool (G.A.I.T.) is a 31-item measure of the coordinated movement components of gait and associated gait deficits. It exhibited the following advantages: comprehensive, objective-based scoring method, incremental measurement of improvement within given items. The G.A.I.T. had good intra- and inter-rater reliability (ICC = .98, p = .0001, 95% CI = .95, .99; ICC = .83, p = .007, 95% CI = .32, .96, respectively. The inexperienced clinician who had training, had an inter-rater reliability with an experienced rater of ICC = .99 (p = .0001, CI = .97, .999). The G.A.I.T. detected improvement in response to gait training for two types of interventions: comprehensive gait training (z = −2.93, p = .003); and comprehensive gait training plus functional electrical stimulation (FES; z = −3.3, p = .001). The G.A.I.T. was capable of discriminating between two gait training interventions, showing an additive advantage of FES to otherwise comparable comprehensive gait training (parameter estimate = 1.72, p = .021; CI, .25, 3.1)

Development and Testing of The Gait Assessment and Intervention Tool (G.A.I.T.): A Measure of Coordinated Gait Components

Recent neuroscience methods have provided the basis upon which to develop effective gait training methods for recovery of the coordinated components of gait after neural injury. We determined that there was not an existing observational measure that was, at once, adequately comprehensive, scored in an objectively-based manner, and capable of assessing incremental improvements in the coordinated components of gait. Therefore, the purpose of this work was to use content valid procedures in order to develop a relatively inexpensive, more comprehensive measure, scored with an objectively-based system, capable of incrementally scoring improvements in given items, and that was both reliable and capable of discriminating treatment response for those who had a stroke. Eight neurorehabilitation specialists developed criteria for the gait measure, item content, and scoring method. In subjects following stroke (\u3e12 months), the new measure was tested for intra- and inter-rater reliability using the Intraclass Correlation Coefficient; capability to detect treatment response using Wilcoxon Signed Ranks Test; and discrimination between treatment groups, using the Plum Ordinal Regression. The Gait Assessment and Intervention Tool (G.A.I.T.) is a 31-item measure of the coordinated movement components of gait and associated gait deficits. It exhibited the following advantages: comprehensive, objective-based scoring method, incremental measurement of improvement within given items. The G.A.I.T. had good intra- and inter-rater reliability (ICC = .98, p = .0001, 95% CI = .95, .99; ICC = .83, p = .007, 95% CI = .32, .96, respectively. The inexperienced clinician who had training, had an inter-rater reliability with an experienced rater of ICC = .99 (p = .0001, CI = .97, .999). The G.A.I.T. detected improvement in response to gait training for two types of interventions: comprehensive gait training (z = −2.93, p = .003); and comprehensive gait training plus functional electrical stimulation (FES; z = −3.3, p = .001). The G.A.I.T. was capable of discriminating between two gait training interventions, showing an additive advantage of FES to otherwise comparable comprehensive gait training (parameter estimate = 1.72, p = .021; CI, .25, 3.1)

Volatile Anesthetic and Outcome in Acute Trauma Care: Planned Secondary Analysis of the PROPPR Study

BACKGROUND: This retrospective analysis of prospectively collected data from the PROPPR study describes volatile anesthetic use in severely injured trauma patients undergoing anesthesia. METHODS: After exclusions, 402 subjects were reviewed of the original 680, and 292 had complete data available for analysis. Anesthesia was not protocolized, so analysis was of contemporary practice. RESULTS: The small group who received no volatile anesthetic (n = 25) had greater injury burden (Glasgow Coma Scale CONCLUSION: In this acutely injured trauma population, choice of volatile anesthetic did not appear to influence short-term mortality and morbidity. Subjects who received no volatile were more severely injured with greater mortality, representing hemodynamic compromise where volatile agent was limited until stable. As anesthetic was not protocolized, these findings that choice of specific volatile was not associated with short-term survival require prospective, randomized evaluation

Long-Dose Intensive Therapy Is Necessary for Strong, Clinically Significant, Upper Limb Functional Gains and Retained Gains in Severe/Moderate Chronic Stroke

Background. Effective treatment methods are needed for moderate/severely impairment chronic stroke. Objective. The questions were the following: (1) Is there need for long-dose therapy or is there a mid-treatment plateau? (2) Are the observed gains from the prior-studied protocol retained after treatment? Methods. Single-blind, stratified/randomized design, with 3 applied technology treatment groups, combined with motor learning, for long-duration treatment (300 hours of treatment). Measures were Arm Motor Ability Test time and coordination-function (AMAT-T, AMAT-F, respectively), acquired pre-/posttreatment and 3-month follow-up (3moF/U); Fugl-Meyer (FM), acquired similarly with addition of mid-treatment. Findings. There was no group difference in treatment response (P ≥ .16), therefore data were combined for remaining analyses (n = 31; except for FM pre/mid/post, n = 36). Pre-to-Mid-treatment and Mid-to-Posttreatment gains of FM were statistically and clinically significant (P \u3c .0001; 4.7 points and P \u3c .001; 5.1 points, respectively), indicating no plateau at 150 hours and benefit of second half of treatment. From baseline to 3moF/U: (1) FM gains were twice the clinically significant benchmark, (2) AMAT-F gains were greater than clinically significant benchmark, and (3) there was statistically significant improvement in FM (P \u3c .0001); AMAT-F (P \u3c .0001); AMAT-T (P \u3c .0001). These gains indicate retained clinically and statistically significant gains at 3moFU. From posttreatment to 3moF/U, gains on FM were maintained. There were statistically significant gains in AMAT-F (P = .0379) and AMAT-T P = .003