RESUMO
IMPORTANCE: Insufficient voluntary forearm movements are associated with ineffective and inefficient functional performance among people poststroke. Although evidence supports the application of the occupational therapy task-oriented (OTTO) approach for this population, the training protocol does not explicitly address the role of forearm rotation movements. In addition, a need exists for theoretical support for orthotic interventions for people poststroke. Objective: To examine the efficacy of (1) a forearm rotation orthosis, (2) the OTTO approach, and (3) the combination of the two with people poststroke with a hemiparetic arm. DESIGN: Stratified, randomized, two-group, single-blinded, repeated-measures design. SETTING: Rehabilitation clinic. PARTICIPANTS: Participants (N = 14) with a diagnosis of stroke and at least 10° of voluntary shoulder and elbow movement. INTERVENTION: Participants were stratified into three groups by motor function (mild, moderate, severe) and randomly assigned either to 6 wk of no treatment followed by 6 wk of OTTO or to 6 wk of orthotic intervention followed by 6 wk of orthosis plus OTTO. Outcomes and Measures: Primary outcome measures were the Canadian Occupational Performance Measure (COPM), Wolf Motor Function Test (WMFT), and Motor Activity Log (MAL), administered at baseline (Week 1), at the end of Phase 1 (Week 7), and at the end of Phase 2 (Week 15) by blinded evaluators. RESULTS: Both groups showed clinically important improvements on the COPM. No significant differences were found on the WMFT or MAL. CONCLUSIONS AND RELEVANCE: The OTTO intervention provides clinically important benefits in self-perceived functional performance to people poststroke. What This Article Adds: The OTTO approach is an occupation-focused intervention that aims at functional performance and emphasizes clients' active engagement throughout the process. The findings suggest that the protocol of the OTTO intervention and its efficacy are appropriate for clinical practice.
Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Braço , Canadá , Antebraço , Humanos , Aparelhos Ortopédicos , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/complicações , Resultado do Tratamento , Extremidade SuperiorRESUMO
Multiple reports highlight the increasingly quantitative nature of biological research and the need to innovate means to ensure that students acquire quantitative skills. We present a tool to support such innovation. The Biological Science Quantitative Reasoning Exam (BioSQuaRE) is an assessment instrument designed to measure the quantitative skills of undergraduate students within a biological context. The instrument was developed by an interdisciplinary team of educators and aligns with skills included in national reports such as BIO2010, Scientific Foundations for Future Physicians, and Vision and Change Undergraduate biology educators also confirmed the importance of items included in the instrument. The current version of the BioSQuaRE was developed through an iterative process using data from students at 12 postsecondary institutions. A psychometric analysis of these data provides multiple lines of evidence for the validity of inferences made using the instrument. Our results suggest that the BioSQuaRE will prove useful to faculty and departments interested in helping students acquire the quantitative competencies they need to successfully pursue biology, and useful to biology students by communicating the importance of quantitative skills. We invite educators to use the BioSQuaRE at their own institutions.
Assuntos
Disciplinas das Ciências Biológicas/educação , Avaliação Educacional , Modelos Educacionais , Reprodutibilidade dos TestesRESUMO
To control order effects in questionnaires containing paired comparisons, Ross (1934) described an optimal ordering of the pairings. The pairs can also be balanced so that every stimulus appears equal numbers of times as the first and the second member of a pair. First, we describe and illustrate the optimally spaced, balanced ordering of pairings. Then we show how the optimally spaced, balanced order can be used to implement a matrix-sampling design or a fully incomplete design when the number of stimuli n is so large that respondents cannot reasonably be expected to judge all n(n - 1)/2 pairs. The algorithm for balancing and optimally spacing the list of pairs is described.
Assuntos
Algoritmos , Comportamento de Escolha , Julgamento , Aprendizagem por Associação de Pares , Inquéritos e Questionários , Aprendizagem por Discriminação , Humanos , Modelos EstatísticosRESUMO
BACKGROUND: This observational study assessed the relation between mass media campaigns and service volume for a statewide tobacco cessation quitline and stand-alone web-based cessation program. METHODS: Multivariate regression analysis was used to identify how weekly calls to a cessation quitline and weekly registrations to a web-based cessation program are related to levels of broadcast media, media campaigns, and media types, controlling for the impact of external and earned media events. RESULTS: There was a positive relation between weekly broadcast targeted rating points and the number of weekly calls to a cessation quitline and the number of weekly registrations to a web-based cessation program. Additionally, print secondhand smoke ads and online cessation ads were positively related to weekly quitline calls. Television and radio cessation ads and radio smoke-free law ads were positively related to web program registration levels. There was a positive relation between the number of web registrations and the number of calls to the cessation quitline, with increases in registrations to the web in 1 week corresponding to increases in calls to the quitline in the subsequent week. Web program registration levels were more highly influenced by earned media and other external events than were quitline call volumes. CONCLUSION: Overall, broadcast advertising had a greater impact on registrations for the web program than calls to the quitline. Furthermore, registrations for the web program influenced calls to the quitline. These two findings suggest the evolving roles of web-based cessation programs and Internet-use practices should be considered when creating cessation programs and media campaigns to promote them. Additionally, because different types of media and campaigns were positively associated with calls to the quitline and web registrations, developing mass media campaigns that offer a variety of messages and communicate through different types of media to motivate tobacco users to seek services appears important to reach tobacco users. Further research is needed to better understand the complexities and opportunities involved in simultaneous promotion of quitline and web-based cessation services.