Multiple Assessment Tools Research Articles

Current Trends in Pediatric Physical Therapy Practice for Children With Down Syndrome

Physical therapists (PTs) have a broad range of approaches to the management of Down syndrome (DS). To examine the breadth of physical therapy practice for children with DS. A survey was distributed to 1000 randomly selected members of the Academy of Pediatric Physical Therapy. Responses were categorized into 13 thematic subcategories and 3 International Classification of Functioning, Disability and Health (ICF) subcategories. One hundred eight PTs participated. Joint stability and alignment were the most common physical therapy-related problem. Functional movement was the most common physical therapy intervention. Most clinicians identified and treated at the ICF level of body functions and structure. Multiple assessment tools were used and tended to include norm-referenced tests. There was diversity of interventions with varying amounts of supporting evidence. PTs manage children with DS for a wide variety of needs with a variety of interventions.

MUSICOTERAPIA EM PACIENTES COM DOENÇA DE ALZHEIMER – UMA REVISÃO SISTEMÁTICA

A doença de Alzheimer (DA) é a enfermidade neurodegenerativa e progressiva cujo principal sintoma é o déficit na memória. Atualmente, não existe tratamento medicamentoso capaz de aliviar tais pacientes e prolongar a sua independência funcional. Neste cenário, intervenções não farmacológicas mostram-se alternativas apropriadas para a conservação do bem-estar e amusicoterapia é uma alternativa promissora. O presente trabalho objetiva através de uma revisão sistemática, analisar os efeitos obtidos pela intervenção da musicoterapia em pacientes com DA, principalmente no que se refere aos sintomas comportamentais e perda cognitiva. Para isso, realizamos uma pesquisa bibliográfica eletrônica no MEDLINE/PubMed, até o mês de fevereiro de 2020 utilizando os termos: 'Alzheimer's disease' AND 'music therapy' AND 'humans'. Os critérios de inclusão foram: estudos observacionais (coorte, caso controle) e ensaios clínicos randomizados; idiomas: português, inglês eespanhol. Foram excluídos aqueles que utilizaram outras estratégias não farmacológicas em pacientes com DA além da musicoterapia; aqueles artigos cujos participantes apresentavam demência que não DA e para a avaliação da qualidade metodológica dos artigos utilizamos o instrumento Assessment of Multiple Systematic Reviews. Ao todo a pesquisa bibliográfica nos forneceu 160 artigos dentre os quais oito se adequaram integralmente aos critérios de inclusão e qualidade. Os estudos evidenciaram efeitos benéficos do emprego da musicoterapia como intervenção não farmacológica em pacientes com DA, contribuindo na diminuição dos sintomas psicológicos e comportamentais dos pacientes.

What's Happening in Lab? Multi-Dimensional Assessment Tools to Track Student Experience through a Unit Operations Laboratory Sequence

Unit operations laboratory courses culminate many topics from the curriculum and are often the first time students apply their knowledge in hands-on settings. However, many instructors do not directly assess key learning objectives, creating a disparity between desired and actual learning. Using multiple assessment tools, we analyzed student survey and test data throughout a unit operations laboratory sequence to reveal student attitudes and perceptions of their learning experience alongside their actual knowledge and abilities gained.

Examining the impact of flipping the classroom on student performance in an undergraduate course in project management

This paper examines the impact of adopting a flipped classroom model on the academic performance of students in an introductory undergraduate course in project management. The study was conducted over a three-semester period during which the course was transformed from a traditional lecture-oriented format to semi-flipped and flipped modes of instruction in search of a more fruitful learning environment for students with diverse academic backgrounds and program needs. A combination of performance- and perception-based data were collected for analytical purposes. Multiple assessment tools were included in the study to measure students' performance with respect to various layers of intended learning outcomes. The results showed that students in semi-flipped and flipped classrooms on average outperformed their peers in all the assessment categories considered. There were no statistically significant differences in performance between the semi-flipped and flipped classrooms. Furthermore, the study revealed that the majority of students viewed the flipped classroom favourably and noted that it offered advantages over a traditional lecture-oriented format.

An integrative approach to detect protein–energy wasting among chronic kidney disease maintenance hemodialysis patients

<br><b>Background:</b> Malnutrition is a major predictor of overall outcome in patients on hemodialysis. Regular and frequent evaluation of the nutritional status of these patients is advisable. <b>Aims and Objectives:</b> This study aimed to look at nutritional status of a hemodialysis cohort and to evaluate whether multiple assessment tools improve the detection of malnutrition in this cohort. <b>Materials and Methods:</b> A prospective study in two outpatient hemodialysis centers was conducted over 6 months. Stable patients without any irreversible organ damage and preserved cognitive function were included in the study. Data collected included demographics, comorbid conditions, and baseline laboratory investigations. The nutritional assessment tools included body mass index (BMI), 7-point Subjective Global Assessment, Global Leadership In Malnutrition (GLIM), handgrip strength, and body composition analysis. <b>Results:</b> A total of 121 subjects (77 males, 44 females) participated in the study. Based on BMI, only 14% were underweight. 7-point SGA detected 77 malnourished subjects, whereas according to GLIM criteria, all patients had some degree of malnutrition. Body composition analysis showed depleted total body protein mass in majority of patients. There was a correlation between total body protein mass and handgrip strength. The assessment tools showed some degree of correlation in patients who were malnourished. <b>Conclusions:</b> Use of a single assessment tool often underdiagnoses malnutrition in hemodialysis patients. An integrative approach using multiple evaluation tools may be beneficial in these groups of patients.<br>

A review of performance assessment tools for rescuer response in opioid overdose simulations and training programs.

Since the 1990s, more than 600 overdose response training and education programs have been implemented to train participants to respond to an opioid overdose in the United States. Given this substantial investment in overdose response training, valid assessment of a potential rescuers' proficiency in responding to an opioid overdose is important. The aim of this article is to review the current state of the literature on outcome measures utilized in opioid overdose response training. Thirty-one articles published between 2014 and 2020 met inclusion criteria. The reviewed articles targeted laypersons, healthcare providers, and first responders. The assessment tools included five validated questionnaires, fifteen non-validated questionnaires, and nine non-validated simulation-based checklists (e.g., completion of critical tasks and time to completion). Validated multiple choice knowledge assessment tools were commonly used to assess the outcomes of training programs. It is unknown how scores on these assessment tools may correlate with actual rescuer performance responding to an overdose. Seven studies reported ceiling effects most likely attributed to participants' background medical knowledge or experience. The inclusion of simulation-based outcome measures of performance, including the commission of critical errors and the time to naloxone administration, provides better insight into rescuer skill proficiency.

Contrasting cumulative risk and multiple individual risk models of the relationship between Adverse Childhood Experiences (ACEs) and adult health outcomes

BackgroundA very large body of research documents relationships between self-reported Adverse Childhood Experiences (srACEs) and adult health outcomes. Despite multiple assessment tools that use the same or similar questions, there is a great deal of inconsistency in the operationalization of self-reported childhood adversity for use as a predictor variable. Alternative conceptual models are rarely used and very limited evidence directly contrasts conceptual models to each other. Also, while a cumulative numeric ‘ACE Score’ is normative, there are differences in the way it is calculated and used in statistical models. We investigated differences in model fit and performance between the cumulative ACE Score and a ‘multiple individual risk’ (MIR) model that enters individual ACE events together into prediction models. We also investigated differences that arise from the use of different strategies for coding and calculating the ACE Score.MethodsWe merged the 2011–2012 BRFSS data (N = 56,640) and analyzed 3 outcomes. We compared descriptive model fit metrics and used Vuong’s test for model selection to arrive at best fit models using the cumulative ACE Score (as both a continuous or categorical variable) and the MIR model, and then statistically compared the best fit models to each other.ResultsThe multiple individual risk model was a better fit than the categorical ACE Score for the ‘lifetime history of depression’ outcome. For the outcomes of obesity and cardiac disease, the cumulative risk and multiple individual risks models were of comparable fit, but yield different and complementary inferences.ConclusionsAdditional information-rich inferences about ACE-health relationships can be obtained from including a multiple individual risk modeling strategy. Results suggest that investigators working with large srACEs data sources could empirically derive the number of items, as well as the exposure coding strategy, that are a best fit for the outcome under study. A multiple individual risk model could also be considered in addition to the cumulative risk model, potentially in place of estimation of unadjusted ACE-outcome relationships.

Neuropsychiatric changes during the COVID-19 pandemic in multiple sclerosis patients.

This study reported on a variety of psychological reactions related to anxiety, sleep quality, depression, fatigue, and quality of life in individuals with multiple sclerosis (MS), related to the Covid-19 quarantine experience. The aim of this study was to investigate the neuropsychiatric effects of the COVID-19 pandemic in MS patients and to analyze the risk factors contributing to psychological stress. The study was designed as a prospective, cross-sectional survey study. Multiple assessment tools that are used in neurological practice, including Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Fatigue Impact Scale (FIS), Pittsburgh Sleep Quality Index (PSQI), and Multiple Sclerosis Quality of Life-54 (MSQOL-54) were administered prospectively both during the early and the peak stages of COVID-19 outbreak (ESO and PSO, respectively). The survey forms were designed using SurveyMonkey and the participants were participating in the survey via a web link and QR code. Fifty patients were included in the study. BDI scores, PSQI and FSI measurements, cognitive and social subscale scores and total FIS score, MSQOL-54 measurements, physical and mental subscale scores, and total MSQOL-54 score at PSO were significantly different than those at ESO. The body mass index values of the patients increased significantly at PSO compared to those measured at ESO. The results provide a basis for the development of psychological interventions that could minimize the prevalence of sleep disorders and depression and could improve patients' quality of life during the outbreak.

Relationship between Course Evaluations and Course Grades in Six Allied Health Programs

PurposeMost faculty members are evaluated by their administration, in part, based upon student evaluation results. This study sought to determine the relationship between course evaluation scores and course grades, in order to ensure academic rigor and optimize faculty evaluation practices. MethodsOverall course evaluation results were compared to average course grades for six allied health programs, over 3 years (n = 256 observations). ResultsThere was no overall relationship between evaluation scores and course grades; however, individual differences between programs were seen. ConclusionGrades achieved in a course did not affect the overall course evaluations. However, since there was a correlation between grades earned and course evaluations for some programs in the School of Allied Health, the importance of utilizing multiple assessment tools to determine the effectiveness of a course must be stressed.

Exploring the Predictive Ability of the Motor-Free Visual Perception Test (MVPT) and Trail Making Test (TMT) for On-Road Driving Performance.

Resuming driving after a change in functional ability is challenging for patients with a neurological condition. Although a combination of assessment tools has been suggested for use in driving evaluation, resources and availability of tools have been a problem. To examine the predictive ability of two commonly used tools, the Motor-Free Visual Perception Test (MVPT) and the Trail Making Test, Parts A and B (TMTA and TMTB), on on-road driving performance. Retrospective chart review of 82 patient charts between 2015 and 2016. Local rehabilitation hospital. Eighty-two patients with a primary neurological diagnosis (general neurological condition, n = 13; spinal cord injury, n = 11; stroke, n = 58). MVPT, TMTA, and TMTB. Among the patients, 36 passed and 46 failed the on-road evaluation. The TMTA and TMTB scores were significantly different between those who passed or failed the on-road evaluation. Logistic regression analyses revealed that the TMTB completion time was the only significant predictor of on-road driving performance (for the all-patient model, 66% prediction accuracy, -2 log-likelihood [LL] = 93.47, exp β = 0.98; for the stroke-only model, 76% prediction accuracy, -2LL = 59.61, exp β = 0.97). Our findings suggest that the TMTB is a better predictor of on-road driving performance for patients with a neurological condition than the MVPT. The findings shed light on the importance of selecting proper tools when assessing driving performance. Future prospective studies with a wider array of predictive variables are recommended to support the present findings. Occupational therapists should revisit the use of the MVPT in driving assessment and consider multiple assessment tools when evaluating and predicting driving performance.

Comprehensive Assessment of Alcohol Consumption in People Living with HIV (PLWH): The New Orleans Alcohol Use in HIV Study.

High frequency of alcohol use among people living with HIV (PLWH) warrants careful assessment and screening to better understand its impact on HIV disease progression and development of comorbidities. Due to the limitations of the tools used to measure alcohol use, the links to health consequences are not fully understood. We completed a cross-sectional analysis to examine the prevalence of alcohol consumption using multiple alcohol assessment tools and their correlation and consistency in a cohort of PLWH (N=365) enrolled in the New Orleans Alcohol Use in HIV (NOAH) Study. Alcohol use was assessed with the Alcohol Use Disorders Identification Test (AUDIT), timeline followback (TLFB) Calendar, lifetime drinking history, Alcohol and Drug Addiction Severity Index, and blood levels of phosphatidylethanol (PEth). Spearman's correlations were estimated for continuous measures of alcohol consumption; Wilcoxon rank-sum tests were used to compare means; and logistic regression was used to estimate odds of alcohol use by demographic characteristics. Self-report of current alcohol use varied from 58.9 to 73.7% depending on the assessment. All the self-reported alcohol measures showed statistically significant correlations with the biological marker PEth. The highest correlation was with TLFB grams (r=0.67, p<0.001). Using TLFB, 73.7% of the cohort reported using alcohol in the last 30days, and 61.6% had a positive PEth value. The prevalence of risky drinkers, meeting the TLFB>3 (women) or >4 (men) drinks/day or>7 (women) or>14 (men) drinks/week, was 49.0%. Medium-risk drinking defined as an AUDIT score≥8 was reported in 40.3%, and high-risk drinkers/probable AUD (AUDIT score≥16) was met by 17.0% of the cohort. Our results demonstrate the importance of comprehensive assessments for alcohol use, including self-report via multiple assessment tools administered by trained staff, as well as the addition of biomarkers for improved classification of subjects into different drinking categories.

Building strong foundations for educational achievement: Language assessments in early childhood education for deaf and hard of hearing children

AbstractIt is widely accepted that assessment plays a role in monitoring the development of young children with special needs in early intervention/early childhood settings. The process of assessing young children's language skills often looks for delays within a solid language foundation. However, many children who are deaf or hard of hearing (DHH) may not have a solid language foundation to assess, leading to inaccurate assessment. When we reframe how we assess language skills in children who are DHH, we ensure the assessment provides a comprehensive picture of the child's language development. It is important to modify language assessment tools where necessary while ensuring the assessment stays reliable and valid. It is critical to use multiple assessment tools to monitor the child's progress, including standardized assessments and assessment tools normed for DHH populations. Finally, it is crucial to monitor the child's skills in each language that they are using, regardless of which language is used most often. We explain why each of these factors needs to be considered in the assessment of young children who are DHH, will discuss the challenges of assessing this population, and will provide solutions to some of the challenges of assessing language skills in of young children who are DHH.

Self-report Pain Scale Reliability in Veterans and Service Members With Traumatic Brain Injuries Undergoing Inpatient Rehabilitation.

Pain in trauma patients with traumatic brain injury (TBI) may heighten cognitive-behavioral impairment and impede rehabilitation efforts. Multiple self-report pain assessment tools have been shown reliable in cognitively intact adults and children but are understudied in the cognitively impaired, particularly in persons with TBI. The objective of this study was to assess the utility and reliability of four pain assessment instruments among TBI patients during inpatient rehabilitation and the influence of cognitive impairment. Participants self-completed four pain intensity measures, the Verbal Descriptor Scale, Faces Pain Scale (Faces), Numerical Rating Scale (NRS), and Color-Enhanced Visual Analog Scale (CAS), during five study visits over a 2-week period. Data were collected on time to completion and most preferred pain measure. To assess scale reliability, participants re-rated their current pain. To assess scale responsiveness, standard mean response was measured across time and a worst past pain experience was rated. Cognitive impairment was assessed with the Memory, Orientation, and Amnesia Test. The NRS was the most preferred measure by participants at every time point in the study. Mean pain measure completion time for all measures was under 11seconds and did not significantly change during the study period. All scales showed very high test-retest reliability, with very strong correlations. Standard mean response from day 0 to 14 ranged from 0.387 to 0.532 across the scales. When stratified by cognitive impairment, the mean scores were consistently nominally higher for impaired participants, reaching statistical significance only for the CAS and Faces at baseline. In the cognitive impaired group, reliability for the Faces showed some weakening, as did the VAS to a milder degree. All four pain measures demonstrated good utility, very high test-retest reliability, and satisfactory responsiveness. Greater cognitive impairment was associated with elevated pain ratings, especially in the Faces and CAS. The NRS was the most preferred by patients, regardless of cognitive impairment level.

Systematic review of nutrition screening and assessment in inflammatory bowel disease.

BACKGROUNDMalnutrition is prevalent in inflammatory bowel disease (IBD). Multiple nutrition screening (NST) and assessment tools (NAT) have been developed for general populations, but the evidence in patients with IBD remains unclear.AIMTo systematically review the prevalence of abnormalities on NSTs and NATs, whether NSTs are associated with NATs, and whether they predict clinical outcomes in patients with IBD.METHODSComprehensive searches performed in Medline, CINAHL Plus and PubMed. Included: English language studies correlating NSTs with NATs or NSTs/NATs with clinical outcomes in IBD. Excluded: Review articles/case studies; use of body mass index/laboratory values as sole NST/NAT; age < 16.RESULTSOf 16 studies and 1618 patients were included, 72% Crohn’s disease and 28% ulcerative colitis. Four NSTs (the Malnutrition Universal Screening Tool, Malnutrition Inflammation Risk Tool (MIRT), Saskatchewan Inflammatory Bowel Disease Nutrition Risk Tool (SaskIBD-NRT) and Nutrition Risk Screening 2002 (NRS-2002) were significantly associated with nutritional assessment measures of sarcopenia and the Subjective Global Assessment (SGA). Three NSTs (MIRT, NRS-2002 and Nutritional Risk Index) were associated with clinical outcomes including hospitalizations, need for surgery, disease flares, and length of stay (LOS). Sarcopenia was the most commonly evaluated NAT associated with outcomes including the need for surgery and post-operative complications. The SGA was not associated with clinical outcomes aside from LOS.CONCLUSIONThere is limited evidence correlating NSTs, NATs and clinical outcomes in IBD. Although studies support the association of NSTs/NATs with relevant outcomes, the heterogeneity calls for further studies before an optimal tool can be recommended. The NRS-2002, measures of sarcopenia and developments of novel NSTs/NATs, such as the MIRT, represent key, clinically-relevant areas for future exploration.

An Experimental Study on Factors Influencing the Musical Intelligence of Young Adolescents

In order to confine the full array of abilities and talents that people possess, Gardner theorizes that people do not havejust an intellectual capacity, but have many different kinds of intelligence, including intrapersonal, logicalmathematical, naturalistic, body-kinesthetic, musical, interpersonal, spatial-visual, existential and linguistic intelligences. According to Howard Gardner, people who are musically intelligent have good thinking in patterns, rhythms and sounds. Such entities have a strong appreciation for music and often they are good at musical composition and performance. By keeping in view above facts, this study was designed to identity the types of multiple intelligences among young adolescents along with, to assess the effect of various human ecological factors (as stated by Bronfenbrenner) on Multiple Intelligences of secondary level students. To achieve this aim, standardized Multiple Intelligence Assessment Tool developed by Kaur (2006) was implemented on a sample consisting of 200 students from higher secondary schools of both areas of Mahendergarh (Haryana), i.e., rural and urban. Results revealed that fathers' education and occupation, residence of location and relationship with the peers of the young adolescents were observed to be significantly associated with musical intelligence of the respondents. Other variables had no significant association with the musical intelligence of the young adolescent girls.

Early identification of severe community-acquired pneumonia: a retrospective observational study

BackgroundCommunity-acquired pneumonia (CAP) is a leading cause of sepsis worldwide. Prompt identification of those at high risk of adverse outcomes improves survival by enabling early escalation of care. There are...

Exploring Relationship of Family Variables on Intrapersonal Intelligence of Young Adolescent Girls

There is a wide gap between the popularity of intrapersonal intelligence as a concept and its application in society. People often misinterpret intrapersonal intelligence for a form of magnetism or gregariousness. They don't perceive it as something that can be improved and they identify it as, “either one has it or one doesn't”. By understanding what intrapersonal intelligence really is and how we can administer it in our lives, we can commence to leverage all if that intelligence, education and experience stored over a period of time. Similar idea was proposed by Howard Gardner in the theory of multiple intelligences, where human intelligence differentiates into specific 'modalities', rather than seeing intelligence as dominated by a single general ability. Ecological Systems Theory bestowed by Bronfenbrenner (1979) discribes that there are five systems arranged from the closest to the individual to the farthest and these systems directly or indirectly affects the human development. The present study was designed to study the level of intrapersonal intelligence and impact of various human ecological factors affecting it. To achieve this aim, standardized Multiple Intelligence Assessment Tool developed by Kaur (2006) was administered on a study sample consisting of 200 students from higher secondary schools of both areas of Mahendergarh (Haryana), i.e., rural and urban. Results revealed that parental occupation, caste and discipline by the parents were found to be significantly associated with intrapersonal intelligence of the respondents. Yet other human ecological factors such as frequency of visit to relatives/ friends by respondents, exposure to mass media, type of people living in nearby area and availability of newspaper at home had no effect on intrapersonal intelligence of the young adolescents.

Nutrient intake and dietary quality changes within a personalized lifestyle intervention program for metabolic syndrome in primary care.

A team-based 12-month lifestyle program for the treatment of metabolic syndrome (MetS) (involving physicians, registered dietitians (RDs), and kinesiologists) was previously shown to reverse MetS in 19% of patients (95% confidence interval, 14% to 24%). This work evaluates changes in nutrient intake and diet quality over 12 months (n = 205). Individualized diet counselling was provided by 14 RDs at 3 centres. Two 24-h recalls, the Canadian Healthy Eating Index (HEI-C), and the Mediterranean Diet Score (MDS) were completed at each time point. Total energy intake decreased by 145 ± 586 kcal (mean ± SD) over 3 months with an additional 76 ± 452 kcal decrease over 3-12 months. HEI-C improved from 58 ± 15 to 69 ± 12 at 3 months and was maintained at 12 months. Similarly, MDS (n = 144) improved from 4.8 ± 1.2 to 6.2 ± 1.9 at 3 months and was maintained at 12 months. Changes were specific to certain food groups, with increased intake of fruits, vegetables, and nuts and decreased intake of "other foods" and "commercial baked goods" being the most prominent changes. There was limited change in intake of olive oil, fish, and legumes. Exploratory analysis suggested that poorer diet quality at baseline was associated with greater dietary changes as assessed by HEI-C. Novelty Multiple dietary assessment tools provided rich information on food intake changes in an intervention for metabolic syndrome. Improvements in diet were achieved by 3 months and maintained to 12 months. The results provide a basis for further dietary change implementation studies in the Canadian context.

Sensorimotor integration assessment by the Symbol-Digit modalities test in patients with Parkinson’s disease

To the Editor We read the recent findings by Fil-Balkan et al,[1][1] with great interest. Multiple neuropsychological assessment tools have been utilised in patients with Parkinson’s disease to evaluate sensorimotor integration at various levels. The Symbol-Digit modalities test (SDMT) is a

Design and evaluation of aclinical competency committee.

IntroductionIn postgraduate medical education, group decision-making has emerged as an essential tool to evaluate the clinical progress of residents. Clinical competency committees (CCCs) have been set up to ensure informed decision-making and provide feedback regarding performance of residents. Despite this important task, it remains unclear how CCCs actually function in practice and how their performance should be evaluated.MethodsIn the prototyping phase of a design-based approach, a CCC meeting was developed, using three theoretical design principles: (1) data from multiple assessment tools and multiple perspectives, (2) a shared mental model and (3) structured discussions. The meetings were held in a university children’s hospital and evaluated using observations, interviews with CCC members and an open-ended questionnaire among residents.ResultsThe structured discussions during the meetings provided a broad outline of resident performance, including identification of problematic and excellent residents. A shared mental model about the assessment criteria had developed over time. Residents were not always satisfied with the feedback they received after the meeting. Feedback that had been provided to a resident after the first CCC meeting was not addressed in the second meeting.DiscussionThe principles that were used to design the CCC meeting were feasible in practice. Structured discussions, based on data from multiple assessment tools and multiple perspectives, provided a broad outline of resident performance. Residency programs that wish to implement CCCs can build on our design principles and adjust the prototype to their particular context. When running a CCC, it is important to consider feedback that has been provided to a resident after the previous meeting and to evaluate whether it has improved the resident’s performance.Electronic supplementary materialThe online version of this article (10.1007/s40037-018-0490-1) contains supplementary material, which is available to authorized users.