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1.
J Sch Psychol ; 104: 101308, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38871417

RESUMO

Children who engage more in classroom instruction tend to also have higher levels of academic achievement relative to their peers who engage less. Although research has clearly established an association between such learning behaviors and academic achievement, the directionality of this relationship, and the possibility of bidirectional relations, remain unclear. It is possible that this lack of clarity stems from the fact that interrelationships between achievement and learning behaviors may differ across student-teacher relationship contexts. We evaluated this possibility using a large nationally representative sample of kindergarten to third grade students (N = 2010) from the Early Childhood Longitudinal Study-Kindergarten Cohort of 2011. Using latent profile moderation analyses, we identified three profiles of student-teacher relationships across kindergarten through third grade students: (a) Close (68%), (b) Conflictual (16%), and (c) Uninvolved (16%). Our follow-up models identified bidirectional relations that differed across these profiles, indicating more robust bidirectional learning behavior-achievement interrelationships in the Close profile and more unidirectional achievement to learning behavior relations in the Conflictual and Uninvolved profiles. These findings illustrate how differences in environmental contexts impact the relationship between students' learning behaviors and their achievement. Future studies should consider contextual influences when investigating children's academic growth processes and developing interventions.


Assuntos
Sucesso Acadêmico , Relações Interpessoais , Aprendizagem , Professores Escolares , Estudantes , Humanos , Feminino , Masculino , Estudantes/psicologia , Criança , Estudos Longitudinais , Professores Escolares/psicologia , Instituições Acadêmicas , Pré-Escolar
2.
J Sch Psychol ; 103: 101278, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38432729

RESUMO

Behavior rating scales are frequently used assessment tools designed to measure social skills. Use of norm-referenced assessments such as behavior rating scales requires examiners and test publishers to consider when norms become obsolete and norm-referenced scores can no longer be validly interpreted. A fundamental factor influencing norm obsolescence regards changes in baseline levels of targeted traits within the population. Yet, limited research exists regarding how social skills may change at a population level over time as measured by established assessment tools. Thus, the present study investigates population trends in social skills of K-12 children as rated by parents, teachers, and students by concordantly linking the Social Skills Rating System (SSRS; nparent = 833, nteacher = 1215, nstudent = 4105) and the Social Skills Improvement System-Rating Scales (SSIS-RS; nparent = 2400, nteacher = 750, nstudent = 800) using validity samples collected during the development of the SSIS-RS (nparent = 240, nteacher = 221, nstudent = 224). Analyses evaluated differences between ratings on the standardization data from 1988 and 2007 by informant, sex, grade level, and sex by grade level. After applying linear linking techniques, we conducted a series of statistical comparisons that revealed a general upward trend of ratings for the 2007 sample compared to the 1988 sample, with important differences across sex, grade level, and informant. We conclude with a discussion of the implications of these findings for consideration and assessment of children's social skills.


Assuntos
Pessoal de Educação , Habilidades Sociais , Criança , Humanos , Escala de Avaliação Comportamental , Relações Pais-Filho , Pais
3.
Sch Psychol ; 2023 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-38095962

RESUMO

The Academic Competence Evaluation Scales-Short Form (ACES-SF) is a brief measure of students' academic skills and academic enablers that is completed by K-12 teachers for screening and intervention planning purposes. This study examined the factor structure and measurement invariance of the ACES-SF using multigroup confirmatory factor analysis to support cross-group comparisons of students' academic competence across grade level, gender, and race/ethnicity. The sample included 512 certified K-8 teachers from across the United States who provided demographic information and ACES-SF ratings for 1,024 students (50% female). Results indicated good fit of a seven-factor structure and full scalar invariance across gender, grade level, and race/ethnicity. Implications and future directions are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

4.
Front Psychol ; 14: 1229653, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37868591

RESUMO

Introduction: Despite increasing interest in measuring social and emotional learning (SEL), there is a lack of European-validated tools for assessing the efficacy of SEL programs. The aim of this study was to validate an Italian version of the social skills improvement system (SSIS) SEL brief scales-student form. Methods: Participants were 1,175 students (mean age: 11.02 years; SD: 2.42; range: 8-16 years; males: 46.8%) recruited at schools in Northern Italy. Statistical analyses and results: Initial confirmatory factor analysis encountered a series of challenges, implying non-convergence of the original five-factor measurement model (self-awareness, self-management, social awareness, relationship skills, and responsible decision-making) based on the Collaborative on Academic Social Emotional Learning (CASEL) competency framework established with students in the United States. Further exploratory and confirmatory analyses supported a four-factor model that remained partially invariant across gender groups. The Italian version of the SSIS SEL brief scales was thus shown to be an efficient measurement tool for estimating social and emotional learning in students. Discussion: We discuss the implications of findings in relation to selecting valid and reliable instruments for assessing children's and adolescents' SEL competencies, while considering the culturally-situated nature of the constructs under study.

5.
J Clin Med ; 12(10)2023 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-37240618

RESUMO

BACKGROUND: Periprosthetic fractures now account for 14.1% of all hip revisions. Surgery is often highly specialised and can involve the revision of implants, fixation of fractures, or a combination of both. Delays to surgery are frequent as specialist equipment and surgeons are often required. UK guidelines are currently moving in favour of early surgery in a similar way to the neck of femur fractures, despite a lack of evidential consensus. METHODS: A retrospective review of all patients who underwent surgery for periprosthetic fractures around a total hip replacement (THR) at a single unit between 2012 and 2019 was performed. Risk factors for complications, length of stay (LOS), and time to surgery data were collected and analysed using regression analysis. RESULTS: A total of 88 patients met the inclusion criteria: 63 (72%) were treated with open reduction internal fixation (ORIF) and 25 (28%) underwent revision THR. Baseline characteristics were similar in both the ORIF and revision groups. Revision surgery was more likely to be delayed than ORIF owing to the need for specialist equipment and personnel (median 143 h vs. 120 h, p = 0.04). Median LOS was 17 days if operated within 72 h and 27 days if delayed beyond this (p < 0.0001), but there was no increase in 90-day mortality (p = 0.66), HDU admission (p = 0.33), or perioperative complications (p = 0.27) with delay beyond 72 h. CONCLUSION: Periprosthetic fractures are complex and require a highly specialised approach. Delaying surgery does not result in increased mortality or complications but does increase length of stay. Further multicentre research into this area is required.

6.
Mil Med ; 188(1-2): e182-e189, 2023 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-34865104

RESUMO

INTRODUCTION: We describe results of the U.S. Army Ocular Teleconsultation program from 2004 through 2018 as well as the current condition, benefits, barriers, and future opportunities for teleophthalmology in the clinical settings and disease areas specific to the U.S. Military. MATERIALS AND METHODS: This was a retrospective, noncomparative, consecutive case series. A total of 653 ocular teleconsultations were reviewed; 76 concerned general policy questions and underwent initial screening to determine the year each request was received, the average and median initial consultant response time, the number of participating consultants, the country from which the request originated, the military status and branch of each U.S. patient for which a request was submitted, and the nationality, age, and military status of foreign patients for whom consults were requested. The remaining 577 requests were further analyzed to determine the diagnostic category of the request, whether or not an evacuation recommendation was provided by a consultant, the relationship of the request to trauma, if and what type of nonocular specialty consultant(s) participated in the consultation request, and if and what type of ancillary imaging accompanied the request. RESULTS: The number of requests was 13 in 2004, compared to 80 in 2011 and 11 in 2018. The average response time in 2018 was 2.27 hours compared to 9. 73 hours in 2004. The number of participating ocular specialists was 5 in 2004, compared to 39 in 2013 and 13 in 2018. Requests originating from Iraq and Afghanistan comprised 61.1% (399/653) of requests. The U.S. Army personnel comprised the largest percentage of consults at 38.6% (252/653). Nonmilitary patients from the USA accounted for 18.5% (121/653) of consults. Non-U.S. patients including coalition forces, contractors, detainees, and noncombatants accounted for 14.4% (94/653) of consults, of which 22% (21/94) were children. Anterior segment consults accounted for 45.1% (260/577) of consults, with corneal surface disease being the largest subset within this diagnostic category. Evacuation was recommended in 22.7% (131/577) of overall cases and 41.1% (39/95) of trauma cases. Requests were associated with either combat-related or accidental trauma in 16.5% (95/577) of cases. Dermatology and neurology were the most commonly co-consulted specialties, representing 40.0% (32/80) and 33.75% (27/80) of consults, respectively. Photographs of suspected ocular pathology accompanied 37.4% of consults, with the likelihood requesters included photographs being greatest in cases involving pediatric ophthalmology (7/9, 77.8%) and oculoplastics (86/120, 71.7%). CONCLUSIONS: Army teleophthalmology has been an indispensable resource in supporting and advancing military medicine, helping to optimize the quality, efficiency, and accessibility of ophthalmic care for U.S. Military personnel, beneficiaries, allied forces, and local nationals worldwide. A dedicated ophthalmic care and coordination system which utilizes new advances in teleconsultation technology could further enhance our current capability to care for the ophthalmic needs of patients abroad, with opportunity for improving domestic care as well.


Assuntos
Militares , Oftalmologia , Consulta Remota , Telemedicina , Criança , Humanos , Estados Unidos , Estudos Retrospectivos , Consulta Remota/métodos
7.
Sch Psychol ; 38(2): 119-128, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36174169

RESUMO

Although originally conceived of as a marriage of direct behavioral observation and indirect behavior rating scales, recent research has indicated that Direct Behavior Ratings (DBRs) are affected by rater idiosyncrasies (rater effects) similar to other indirect forms of behavioral assessment. Most of this research has been conducted using generalizability theory (GT), yet another approach, many-facet Rasch measurement (MFRM), has recently been utilized to illuminate the previously opaque nature of these rater idiosyncrasies. The purpose of this study was to utilize both approaches (GT and MFRM) to consider rater effects with 126 second- through fifth-grade students who were rated on two DBR-Multi-Item Scales by four raters (22 of these ratings were fully crossed). Results indicated the presence of rater effects and revealed nuances about their nature, including showing differences across construct domains, identifying items that are potentially more susceptible to rater effects than others, and isolating specific raters who appear to have been more susceptible to rater effects than other raters. These findings further indicate the indirect nature of DBRs and offer potential avenues for addressing and ameliorating rater effects in research and practice. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Escala de Avaliação Comportamental , Estudantes , Humanos
8.
Front Psychiatry ; 13: 836217, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36186864

RESUMO

Human epidemiological data links maternal immune activation (MIA) during gestation with increased risk for psychiatric disorders with a putative neurodevelopmental origin, including schizophrenia and autism. Animal models of MIA provide evidence for this association and suggest that inflammatory cytokines represent one critical link between maternal infection and any potential impact on offspring brain and behavior development. However, to what extent specific cytokines are necessary and sufficient for these effects remains unclear. It is also unclear how specific cytokines may impact the development of specific cell types. Using a human cellular model, we recently demonstrated that acute exposure to interferon-γ (IFNγ) recapitulates molecular and cellular phenotypes associated with neurodevelopmental disorders. Here, we extend this work to test whether IFNγ can impact the development of immature glutamatergic neurons using an induced neuronal cellular system. We find that acute exposure to IFNγ activates a signal transducer and activator of transcription 1 (STAT1)-pathway in immature neurons, and results in significantly increased major histocompatibility complex I (MHCI) expression at the mRNA and protein level. Furthermore, acute IFNγ exposure decreased synapsin I/II protein in neurons but did not affect the expression of synaptic genes. Interestingly, complement component 4A (C4A) gene expression was significantly increased following acute IFNγ exposure. This study builds on our previous work by showing that IFNγ-mediated disruption of relevant synaptic proteins can occur at early stages of neuronal development, potentially contributing to neurodevelopmental disorder phenotypes.

9.
Front Psychol ; 13: 928189, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35983195

RESUMO

The SSIS SEL Brief Scales (SSIS SELb) are multi-informant (teacher, parent, and student) measures that were developed to efficiently assess the SEL competencies of school-age youth in the United States. Recently, the SSIS SELb was translated into multiple languages for use in a multi-site study across six European countries (Croatia, Greece, Italy, Latvia, Portugal, and Romania). The purpose of the current study was to examine concurrent and predictive evidence for the SEL Composite scores from the translated versions of the SSIS SELb Scales. Results indicated that SSIS SELb Composite scores demonstrated expected positive concurrent and predictive relationships with scores from the Connor-Davidson Resilience Scale (CD-RISC) and negative relationships with scores from the problem behavior scales of the Strengths and Difficulties Questionnaire (SDQ). Although there were a few exceptions, these patterns generally were consistent across informants (parents, teachers, and students) and samples providing initial validity evidence for the Composite score from the translated versions of the SSIS SELb Scales. Limitations and future research directions are discussed.

10.
Iowa Orthop J ; 42(1): 169-177, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35821950

RESUMO

Background: Preoperative counseling may reduce postoperative opioid requirements; however, there is a paucity of randomized controlled trials (RCTs) demonstrating efficacy. The purpose of this study was to perform an interventional, telehealth-based RCT evaluating the effect of peri-operative counseling on quantity and duration of opioid consumption following primary total joint arthroplasty (TJA). Methods: Participants were randomized into three groups: 1. Control group, no perioperative counseling; 2. Intervention group, preoperative educational video; 3. Intervention group, preoperative educational video and postoperative acceptance and commitment therapy (ACT). Opioid consumption was evaluated daily for 14 days and at 6 weeks postoperatively. Best-case and worse-case intention to treat analyses were performed to account for non-responses. Bonferroni corrections were applied. Results: 183 participants were analyzed (63 in Group 1, 55 in Group 2, and 65 in Group 3). At 2 weeks postoperatively, there was no difference in opioid consumption between Groups 1, 2, and 3 (p>0.05 for all). At 6 weeks postoperatively, Groups 2 and 3 had consumed significantly less opioids than Group 1 (p=0.04, p<0.001) (Table 1). Group 3 participants were less likely to obtain an opioid refill relative to Group 1 participants (p=0.04). Participants in groups 2 and 3 ceased opioid consumption a median of 6 days and 2 days sooner than Group 1, respectively (p<0.001, p=0.03) (Table 2). Conclusion: Perioperative opioid counseling significantly decreases the quantity and duration of opioid consumption at 6 weeks following primary TJA. Level of Evidence: I.


Assuntos
Artroplastia do Joelho , Transtornos Relacionados ao Uso de Opioides , Analgésicos Opioides/uso terapêutico , Aconselhamento , Humanos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle
11.
Foot Ankle Int ; 43(8): 1099-1109, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35611474

RESUMO

BACKGROUND: This work used software-guided radiographic measurement to assess the effects of progressive lateral column lengthening (LCL) on restoring alignment in a novel cadaveric model of stage II-B flatfoot deformity. METHODS: A stage II-B flatfoot was created in 8 cadaveric specimens by transecting the spring ligament complex, anterior deltoid, and interosseous talocalcaneal and cervical ligaments. Weightbearing computed tomographic (WBCT) scans were performed with specimens under 450 N of compressive load in the intact, flat, and 6-, 8-, and 10-mm lateral column-lengthening conditions. Custom software-guided radiographic measurements of the lateral talo-first metatarsal (Meary) angle, anteroposterior talo-first metatarsal angle, naviculocuneiform overlap, and 2 new measures (plantar fascia [PF] distance and angle) were recorded on digitally reconstructed radiographs. Four anonymized analysts performed measurements twice. Intra- and interobserver agreement was assessed using intraclass correlation coefficients (ICCs). RESULTS: Six-millimeter LCL restored alignment closest to the intact foot in this new cadaveric model, whereas 10-mm lengthening tended toward overcorrection. The PF line displaced laterally in the flatfoot condition, and LCL restored the PF line to a location beneath the talonavicular joint. Interobserver agreement was excellent for PF distance (ICC = 0.99) and naviculocuboid overlap (ICC = 0.91), good for Meary angle (ICC = 0.81) and PF angle (ICC = 0.69), and acceptable for the talonavicular coverage angle (ICC = 0.65). CONCLUSION: In this stage II-B cadaveric flatfoot model, cervical ligament transection was essential to create deformity after the medial hindfoot ligaments were transected. Software-guided radiographic measurement proved reliable; standardized implementation should improve comparability between studies of flatfoot deformity. The novel PF distance performed most consistently (ICC = 0.99) and warrants further study. With this model, we found that a 6-mm LCL restored alignment closest to the intact foot, whereas 10-mm lengthening tended toward overcorrection. CLINICAL RELEVANCE: Future joint-sparing flatfoot corrections may consider using a relatively small LCL combined with other bony and/or anatomic ligament/tendon reconstructions.


Assuntos
Pé Chato , Cadáver , Pé Chato/diagnóstico por imagem , Pé Chato/cirurgia , , Humanos , Ligamentos Articulares , Software
12.
Commun Biol ; 5(1): 372, 2022 04 19.
Artigo em Inglês | MEDLINE | ID: mdl-35440709

RESUMO

Diverse GABAergic interneuron networks orchestrate information processing in the brain. Understanding the principles underlying the organisation of this system in the human brain, and whether these principles are reflected by available non-invasive in vivo neuroimaging methods, is crucial for the study of GABAergic neurotransmission. Here, we use human gene expression data and state-of-the-art imaging transcriptomics to uncover co-expression patterns between genes encoding GABAA receptor subunits and inhibitory interneuron subtype-specific markers, and their association with binding patterns of the gold-standard GABA PET radiotracers [11C]Ro15-4513 and [11C]flumazenil. We found that the inhibitory interneuron marker somatostatin covaries with GABAA receptor-subunit genes GABRA5 and GABRA2, and that their distribution followed [11C]Ro15-4513 binding. In contrast, the inhibitory interneuron marker parvalbumin covaried with GABAA receptor-subunit genes GABRA1, GABRB2 and GABRG2, and their distribution tracked [11C]flumazenil binding. Our findings indicate that existing PET radiotracers may provide complementary information about key components of the GABAergic system.


Assuntos
Flumazenil , Receptores de GABA-A , Encéfalo/diagnóstico por imagem , Encéfalo/metabolismo , Flumazenil/metabolismo , Humanos , Neuroimagem , Receptores de GABA-A/genética , Receptores de GABA-A/metabolismo , Transmissão Sináptica
13.
Ecol Evol ; 12(1): e8488, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35127022

RESUMO

Species responses to disturbance influence their extinction risks. Greater sage-grouse (Centrocercus urophasianus) are bioindicators of sagebrush ecosystem health and the loss of sagebrush (Artemisia spp.) due to wildfire, can cause long-term declines in sage-grouse populations and other sagebrush obligate species. We examined the demographic response of a greater sage-grouse population following a mega-wildfire using stochastic age-structured female-based matrix models over 6 years (2013-2018). Notably, chick survival (range = 0.18-0.38) and female survival (yearling range: 0.20-0.68; adult range: 0.27-0.75) were low compared to values reported for greater sage-grouse in other parts of their distribution. Greater sage-grouse displayed variation in demographic tactics after the fire; however, adult female survival explained most of the variation in λ during each year, which reflected a declining population in 3 of 6 years with more uncertainty observed in 2015 when populations may have been increasing, and 2017 and 2018, when populations may have been declining. The continued annual population decline observed since 2016 suggested there were additional strong environmental impacts that may have been compounded by the fire effects, prolonging recovery of greater sage-grouse. Our results support others that reported negative effects to greater sage-grouse demographics from broad-scale fire and provide a baseline for understanding how this species responds to loss of sagebrush cover based on their life history strategy.

14.
Arthroscopy ; 38(5): 1488-1495.e5, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-34655765

RESUMO

PURPOSE: To assess an automated text-messaging system for patients after hip arthroscopy and its impact at 90 days on the Hip Disability Osteoarthritis Outcome Score Physical Function Short form (HOOS-PS, HOOS-Pain), compliance with rehabilitation guidelines, and patient satisfaction. METHODS: One hundred twenty-one participants (average age 29 ± 8.7 years, 52% female) undergoing hip arthroscopy at 2 academic institutions were prospectively enrolled and randomized to receive (1) standard perioperative communication or (2) additional automated mobile phone text messages. Inclusion criteria included ability to communicate in written English and access to a mobile phone with text-messaging capability. Patients undergoing revision surgery or simultaneous femoral or acetabular osteotomy were excluded. HOOS-PS and HOOS-Pain were collected preoperatively, and after surgery an automated mobile phone robot sent participants in the therapeutic arm intermittent text messages for 90 days. At 90 days all participants again completed HOOS-PS, HOOS-Pain, and additional survey questions on satisfaction with their experience (10-point scale), communication from the surgical team (10-point scale) and adherence to physical therapy exercises, weight-bearing guidelines, and brace use, The primary outcome assessed was a statistically significant change in HOOS-PS and HOOS-Pain; secondary outcomes included change in satisfaction, communication, and adherence to physical therapy exercises, weightbearing guidelines, or brace use. Wilcoxon rank sum was used to compare HOOS-PS and HOOS-Pain scores at 0 and 90 days. Demographic characteristics and survey variables were compared using Students t test for continuous variables and χ2 or Fisher exact test for categorical variables as appropriate. RESULTS: There were statistically significant and clinically relevant improvements in HOOS-PS and HOOS-Pain in both groups (P < .05). Subjective feedback was strongly positive, with 96% of text message participants reporting they would choose automated messages if it was offered to them again in the future. CONCLUSIONS: Ninety days of automated text messaging after hip arthroscopy failed to show a significant difference in HOOS-PS (P = .09), HOOS-Pain (P = .13), patient-reported compliance with postoperative guidelines, or satisfaction with support and communication from the surgical team. LEVEL OF EVIDENCE: I, randomized control trial (RCT).


Assuntos
Osteoartrite do Quadril , Envio de Mensagens de Texto , Acetábulo , Adulto , Artroscopia , Feminino , Humanos , Masculino , Dor , Adulto Jovem
15.
J Sch Psychol ; 89: 72-90, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34836577

RESUMO

Students often hear their peers use biased language regarding race, religion, sexual orientation, or disability status in the school setting. Prior research has indicated that biased language is related to school climate, and specifically to school-based relationships between peers and between students and their teachers. This study investigated the longitudinal associations among student-student relationships, teacher-student relationships, and being the target of or hearing biased language in middle school students. Students (N = 501; 46.5% White, 21.8% Hispanic, 13% African American, and 15% Multi-Racial; 48.7% female) reported on how much they were targeted or heard biased language related to race/religion, sexual orientation, and disability status. Students also reported on their relationships with their peers and teachers. Using a cross-lagged panel model with the overall sample, a negative unidirectional association from being the target of or hearing biased language and student-student relationships and teacher-student relationships was identified. Separate models for boys and girls identified unique patterns. For boys, biased-language exposure predicted more negative student-student relationships and teacher-student relationships, whereas for girls, biased-language exposure was not associated with school-based relationships. Implications include addressing language use and building positive student-student and teacher-student relationships.


Assuntos
Relações Interpessoais , Idioma , Feminino , Humanos , Masculino , Grupo Associado , Professores Escolares , Instituições Acadêmicas , Estudantes
17.
Injury ; 52(11): 3415-3419, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34417002

RESUMO

BACKGROUND: Neck of femur fractures are common injuries in the elderly population and carry significant morbidity and mortality. The introduction of a Best Practice Tariff (BPT) in 2010 laid out the criteria for optimising hip fracture care. These outcomes are audited annually by the National Hip Fracture Database. Meeting all six key targets attracts a financial uplift for each patient; one of these criteria is for an operation within 36 hours of admission. LOCAL PROBLEM: A large district general, seeing on average 551 hip fracture patients a year. In 2017, the trust was ranked 152/160 in England for meeting the 36-hour target to surgery, although theatre capacity was sufficient. The average time to theatre was 43.68 hours, significantly above the national average. BPT was only achieved in 45.7% of cases. METHOD: In January 2018 an anaesthetic 'hot week' was introduced with the same anaesthetist responsible for the hip fracture lists to allow for continuity of care and timely identification of potential delays to surgery. Further responsibilities include attending trauma meeting, liaising with the orthopaedic and the orthogeriatric teams, and advising on medical optimisation of patients for theatre. RESULTS: Comparing data for 2017 (pre-intervention) with 2018 (post-implementation), the following results in key measures were noted: Surgery within 36 hours increased from 54% to 87.5% of patients. Mean time to surgery fell from 43.68 hours to 25.11 hours. Attainment of BPT targets increased from 45.7% to 84%. Trust ranking went from 152nd to 20th for time to surgery and from 131st to 18th for meeting BPT. Rescheduled operations went from 126 to 31. As a result, mean length of stay reduced by 5.1 days. Mortality remained unchanged. CONCLUSION: Implementation of an anaesthetic 'hot week' may help trusts improve times to theatre where sufficient theatre capacity is already in place.


Assuntos
Fraturas do Quadril , Melhoria de Qualidade , Idoso , Fraturas do Quadril/cirurgia , Hospitais Gerais , Humanos , Tempo de Internação , Estudos Retrospectivos , Reino Unido
18.
J Bone Joint Surg Am ; 103(18): 1744-1756, 2021 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-34252068

RESUMO

➤: There is a growing body of evidence implicating psychosocial factors, including anxiety, depression, kinesiophobia, central sensitization, and pain catastrophizing, as negative prognostic factors following total knee arthroplasty (TKA). ➤: Symptoms of anxiety and depression likely represent risk factors for negative outcomes in patients undergoing TKA. However, few studies have assessed the impact of preoperative interventions for these conditions on postoperative outcomes. ➤: The Tampa Scale of Kinesiophobia and the Central Sensitization Inventory have demonstrated value in the diagnosis of kinesiophobia and central sensitization. Higher preoperative indices of kinesiophobia and central sensitization predict worse patient-reported outcomes postoperatively. ➤: Although evidence is limited, cognitive-behavioral therapy for kinesiophobia and duloxetine for central sensitization may help to diminish the negative impact of these preoperative comorbidities. It is important to note, however, that outside the realm of TKA, cognitive-behavioral therapy has been recognized as a more effective treatment for central sensitization than medical treatment. ➤: Awareness of these issues will allow surgeons to better prepare patients regarding postoperative expectations in the setting of a comorbid psychosocial risk factor. Further research into the role of preoperative assessment and possible treatment of these conditions in patients undergoing TKA is warranted.


Assuntos
Artroplastia do Joelho/psicologia , Transtornos Mentais/diagnóstico , Transtornos Mentais/terapia , Escalas de Graduação Psiquiátrica , Sensibilização do Sistema Nervoso Central , Humanos , Medição da Dor , Prognóstico
19.
J Sch Psychol ; 86: 15-31, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34051910

RESUMO

The purpose of the current study was to advance the understanding of the cross-grade dynamics of academic enablers in three ways: (a) to compare overall levels of academic enablers across children's elementary school years, (b) to determine if the relationship between academic enablers and academic achievement remained consistent across children's elementary school years, and (c) to determine if the interrelationships between academic enablers remained consistent across elementary school. We examined cross-grade dynamics using a sample of elementary-aged children (N = 536) and structural equation modeling methodology to compare primary (K-3rd grade) and intermediate (4th-5th grade) students. After establishing measurement invariance, we tested whether (a) academic enabler means and variances were equivalent for younger and older elementary students, (b) the relationships between academic enablers and academic achievement were equivalent for younger and older elementary students, and (c) the interrelations between academic enablers were equivalent for younger versus older students. The findings revealed few differences in mean levels of academic enablers but several differences in the relationships between academic enablers and academic achievement, as well as academic enabler interrelations across grade groups. Implications of these findings for research and practice are discussed.


Assuntos
Sucesso Acadêmico , Logro , Idoso , Criança , Escolaridade , Humanos , Instituições Acadêmicas , Estudantes
20.
J Sch Psychol ; 86: 198-221, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34051914

RESUMO

Rater-mediated assessments, such as teacher behavior rating scales, measure student behavior indirectly through the lens of a rater. As a result, scores from rater-mediated assessments can be influenced by rater effects- individual differences in rater perspectives, attitudes, beliefs, and interpretation of rating scale items. Rater effects are a fundamental aspect of all rater-mediated assessments. However, traditional approaches to evaluate rater effects (i.e., classical test theory, generalizability theory, and multilevel modeling) merely estimate how much score variability is due to the rater. These approaches, while informative, do not offer a solution to the problem. In contrast, Many-facet Rasch measurement (MFRM) approaches estimate and control for rater effects in rater-mediated assessments so that scores are adjusted to account for rater variability. Thus, MFRM offers unique insights into individual- and group-level rater effects that can be used to inform a solution. The resultant purpose of this paper is to introduce MFRM, discuss its advantages for evaluating rater effects in rater-mediated assessments, and demonstrate its use through an applied example.


Assuntos
Escala de Avaliação Comportamental , Pessoal de Educação , Humanos , Reprodutibilidade dos Testes
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