One-year Assessment Research Articles

Quantitative Easing in the Eurozone: a One-Year Assessment

By pumping trillions of euros into the eurozone’s financial system, the ECB’s quantitative easing programme intends to indirectly alter the private sector’s borrowing and spending behaviour. After more than a year since its initial inception, a review of the programme’s impact reveals that policy makers should think twice before further expanding the programme–and could benefit from considering more direct ways of increasing spending in the real economy.

One-year assessment of physical activity level in adult Qatari females: a pedometer-based longitudinal study.

BackgroundPhysical inactivity is a growing health concern and has been identified as the fourth leading risk factor for global mortality. The Arab region includes countries with some of the world’s highest physical inactivity levels, such as Qatar, more specifically the Qatari female population.ObjectiveThe objective of this study is to assess the physical activity levels of Qatari national female adults during a 1-year pedometer-based program.Materials and methodsA total of 549 Qatari national females aged between 18 years and 64 years were included. Data extracted from “Step into Health” program web database in Qatar were used for analyses. Daily habitual physical activity (daily total step count and aerobic steps) was assessed through the Omron HJ-324U pedometer. Step counts were classified as follows: <5,000 steps/d, sedentary; 5,000–7,499 steps/d, low active; and ≥7,500 steps/d, physically active. Statistical significance was set at P-value ≤0.05. Descriptive statistics were used, and habitual physical activity was calculated through repeated measures analysis of variance to determine the difference across the monitored days.ResultsMean age was 37.4±11.7 years, and median body mass index of 28.8 kg/m2 (interquartile range 24.8–33.5). Daily steps for the overall population ranged from 3,505 steps/d to 10,010 steps/d, with a median of 6,008 steps/d. A total of 242 (44.1%) females were sedentary, 178 (32.4%) were low active, and 129 (23.5%) were physically active. The physically active group showed a median of 927 aerobic steps/d (interquartile range 0–4,248).ConclusionBased on the results of this study, Qatari females are not meeting the global recommendations of physical activity. Future research might need to consider barriers to physical activity as well as social, cultural, and environmental factors.

Perceptions of Teamwork Following TeamSTEPPS Implementation at Ambulatory Reproductive Healthcare Facilities [3G

INTRODUCTION: TeamSTEPPS is an evidence-based teamwork system for healthcare professionals designed to improve patient safety. While team training has proven benefits in the hospital setting, it has not been well-studied in the ambulatory care environment. The objective of this project is to evaluate the impact of TeamSTEPPS in a network of ambulatory reproductive healthcare centers in the United States. METHODS: The Teamwork Perceptions Questionnaire (TPQ), a validated self-administered survey containing five domains of seven items each, was used to assess staff perceptions of teamwork within ambulatory reproductive healthcare centers. Unique participant codes linked responses at each time point. Comparisons were made between baseline and six-month assessments using paired t tests. RESULTS: Fifty-seven pairs of surveys were obtained from seven centers. Six of the seven items in the Team Structure, Situation Monitoring, and Mutual Support domains showed improvement, though only four were statistically significant (all P≤.03). Six items in the Leadership domain showed worse scores at six months, and four were statistically significant (all P≤.01). In the Communication domain, five items showed improved scores, though none was statistically significant. CONCLUSION: Six months after implementing TeamSTEPPS, improvements were seen in all domains with the exception of Leadership, though only eight items showed statistically significant change. Worsening perceptions of leadership may be due to increased awareness of best practices or indicate improvements in leadership are difficult. This short observation period may be inadequate to measure the extent of change from the TeamSTEPPS program. One-year assessments, as well as assessments of additional centers, are underway.

Multiply Victimized Women: How Do They Change?

Recent studies have demonstrated that women are frequently victims of several types of violent actions via different agents throughout their life spans. Furthermore, multiple victimizations have been associated with psychological difficulties. The present study aimed to understand the change processes, in a self-directed way, of 19 female victims of multiple violent actions during their lifetimes. The women were evaluated for one year using a depression scale and a qualitative interview. The interviews were analyzed using the innovative moments (IMs) model. The results evidenced three groups, according to the evolution of their depressive symptoms during the one-year evaluation period. There were two unchanged groups, one being the symptomatic group (N = 6), which continuously presented symptoms at a clinical level, and the other the asymptomatic group (N = 7), which did not report depressive symptoms at any assessment moment. The change group (N = 6) exhibited a reliable decrease in clinically significant symptoms. Regarding IMs, the majority of the women were able to develop innovative moments regarding the dominant problem over a one-year evaluation period. Those women mobilized alternative ways to address multiple victimization experiences primarily through reflection IMs. Although there were several exceptions to the problematic narratives during the one-year assessment, the change group had a higher proportion and diversity of IM types—namely, a higher reconceptualization and reflection subtype II—compared with the unchanged groups. Moreover, reconceptualization differentiated the change group from the other two groups. These latter IMs may reflect the concept of “postvictimization growth” and the positive changes that arise from experiences of victimization.

Biotechnology labs reinvented through experiential learning: Enhancing student outcomes through the “flipped lab”

This research study involves the use of experiential learning in biotechnology labs to increase student initiative, creativity and problem-solving skills through a “flipped lab” design. A key element for success in undergraduate biotechnology courses is the integration of theory and practice. Biotechnology labs thus require a new synergy of knowledge and experimental implementation. The conventional lab teaching is solely guided by the cookbook–lab manual. Although it is important in science for students to learn how to follow directions, offering only cookbook labs limits students' access to exploration. Since the ultimate goal is to allow students to think and behave like engineers, rather than to solely learn or replicate what other engineers have already done, the apparent disadvantage of this conventional teaching method is that it leaves little room for student initiative, creativity and critical problem solving.Biotechnology lab teaching can therefore be greatly enhanced by the application of experiential learning activities. Since experiential learning adapts a student-centered model of education and integrates themes with real-life applicability, biotechnology lab teaching will be more effective if students can play a more active role in lab design and procedures. This paper describes the design of a novel biotechnology lab teaching method: the “flipped lab”. A one-year assessment study has been conducted to analyze the effects of the “flipped lab” teaching method on learning outcomes as compared to the conventional model. It quantitatively examines whether the new lab design, with its emphasis on biotechnology-specific technical experience, enhanced students’ design lab activities and students’ achievement of skills. The results show moderate to significant improvement in all but one of the assessed skills, indicating that the new “flipped lab” design has been largely successful in achieving its goals.

Prospective assessment of white matter integrity in adult stem cell transplant recipients.

Hematopoietic stem cell transplantation (HSCT) is often used in the treatment of hematologic disorders. Although it can be curative, the pre-transplant conditioning regimen can be associated with neurotoxicity. In this prospective study, we examined white matter (WM) integrity with diffusion tensor imaging (DTI) and neuropsychological functioning before and one year after HSCT in twenty-two patients with hematologic disorders and ten healthy controls evaluated at similar intervals. Eighteen patients received conditioning treatment with high-dose (HD) chemotherapy, and four had full dose total body irradiation (fTBI) and HD chemotherapy prior to undergoing an allogeneic or autologous HSCT. The results showed a significant decrease in mean diffusivity (MD) and axial diffusivity (AD) in diffuse WM regions one year after HSCT (p-corrected <0.05) in the patient group compared to healthy controls. At baseline, patients treated with allogeneic HSCT had higher MD and AD in the left hemisphere WM than autologous HSCT patients (p-corrected <0.05). One year post-transplant, patients treated with allogeneic HSCT had lower fractional anisotropy (FA) and higher radial diffusivity (RD) in the right hemisphere and left frontal WM compared to patients treated with autologous HSCT (p-corrected <0.05).There were modest but significant correlations between MD values and cognitive test scores, and these were greatest for timed tests and in projection tracts. Patients showed a trend toward a decline in working memory, and had lower cognitive test scores than healthy controls at the one-year assessment. The findings suggest a relatively diffuse pattern of alterations in WM integrity in adult survivors of HSCT.

Patient Reported Outcomes of 'Eat, Walk, Sleep': A Cardiometabolic Lifestyle Program for Cambodian Americans Delivered by Community Health Workers.

This study investigated a community health worker-delivered lifestyle intervention for prevention of cardiometabolic disease, called Eat, Walk, Sleep. It was designed for traumatized, low-literacy Cambodian American refugees. We used a single group, pre-post design to evaluate the effects of the program on self-reported health behaviors. As a control for threats to internal validity, we also measured a nonequivalent dependent variable, i.e., perceived discrimination by health care providers. Of 140 participants enrolled, 114 completed one-year assessments. In intent-to-treat analysis with correction for multiple comparisons, compared with baseline, participants at one year scored higher on cardiometabolic prevention knowledge, self-rated health, physical activity, medication compliance, and preventive screenings, and they reported improved sleep, a modest shift from white to brown rice, and reduced barriers to care. As expected, perceptions of discrimination by health care providers did not change. Self-reported behavioral risk factors improved. A randomized, controlled study with objective measures is warranted.

Abstract T P413: Early Executive Dysfunction Predicts Poor Stroke Outcomes One Year Following Mild Ischemic Stroke

Background: Cognitive dysfunction has been considered a primary deficit to be addressed after mild stroke. Higher order cognitive deficits immediately after mild stroke may lead to poor longitudinal outcomes. However, existing stroke outcome studies tend to focus on physical capacity and mood rather than cognitive function. Aim: To examine contribution of acute impairment of executive function(EF) and verbal memory (VM) after mild stroke to one year outcomes on Stroke Impact Scale (SIS, health-related quality of life), Activity Card Sort (ACS, activity participation), and Reintegration to Normal Living (RNL, life satisfaction), independent of demographics, ADL and depression. Methods: Patients with ischemic stroke and initial NIHSS ≤ 5 enrolled in PROTECT-DC trial were included. Multiple linear regression analyses identified baseline variables significantly associated with each outcome of interest for all patients completing both baseline and one-year assessments. For each outcome, Model 1 included covariates: age, sex, race, education, lesion side, NIHSS, Barthel Index, Lawton IADL, and depression. In Model 2, all Model 1 variables and dichotomized cognitive variables (impaired versus not impaired) were entered into the equation. Examination of R2 change between Models 1 &amp; 2 identified unique contributions of impaired EF or VM to each one-year outcome beyond Model 1 variables. Results: A total of 86 participants completed baseline assessment and one-year SIS were included for analyses. Our results show that EF was significantly and independently associated with the SIS total score beyond other baseline variables. Participants with acute EF deficits at baseline had poorer SIS outcome at one year: mean 7.47 lower SIS score compared to patients without EF deficits (p = .021). Similar results were found for ACS and RNL. Conclusion: Analyses suggest impact of EF deficits on activity participation, health-related quality of life, and life satisfaction one year after mild stroke. The findings highlight importance of assessment of EF deficits after mild stroke. We suggest that rehabilitation interventions aimed at improving long-term outcomes require careful consideration of assessing and treating EF deficits during the acute phase of mild stroke.

One-year assessment of in-hospital cardiac arrest

This retrospective audit evaluated adult patients who suffered in-hospital cardiac arrest (IHCA) against the recent National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report [1]. It looked specifically at the recognition of the acutely unwell, the interventions made, the decisions taken from admission through to the post-arrest period and the outcomes following cardiopulmonary resuscitation (CPR). The audit aims to guide future improvements in preventing cardiac arrest and enhancing end-of-life care decision-making.

M5 Lung function and psychological well-being: One-year outcomes in severe asthma

AimsPsychological comorbidity and impaired quality of life (QoL) are commonly reported in severe and difficult to treat asthma. These factors appear to contribute to asthma attacks and hospital admissions. Changes...

258 Health and safety in small auto collision repair shops - Outcomes of a 1-year intervention

ObjectiveThis study evaluated the effectiveness of a 1-year intervention to assist owners of small collision shops with workplace safety and health improvements.MethodsA comprehensive evaluation containing 92 safety-related questions was conducted...

One-year assessment of surgical outcomes in Class III patients using cone beam computed tomography

The purpose of this study was to apply a novel method to evaluate surgical outcomes at 1 year after orthognathic surgery for Class III patients undergoing two different surgical protocols. Fifty patients divided equally into two groups (maxillary advancement only and combined with mandibular setback) had cone beam computed tomography (CBCT) scans taken pre-surgery, at splint removal, and at 1-year post-surgery. An automatic cranial base superimposition method was used to register, and shape correspondence was applied to assess, the overall changes between pre-surgery and splint removal (surgical changes) and between splint removal and 1-year post-surgery at the end of orthodontic treatment (post-surgical adaptations). Post-surgical maxillary adaptations were exactly the same for both groups, with 52% of the patients having changes >2mm. Approximately half of the post-surgical changes in the maxilla for both groups were vertical. The two-jaw group showed significantly greater surgical and post-surgical changes in the ramus, chin, and most of the condylar surfaces (P<0.05). Post-surgical adaptation on the anterior part of the chin was also more significant in the two-jaw group (P<0.05). Regardless of the type of surgery, marked post-surgical adaptations were observed in the regions evaluated, which explain the adequate maxillary–mandibular relationship at 1-year post-surgery on average, with individual variability.

One-year assessment of surgical outcomes in Class III patients using cone beam computed tomography

One-year assessment of surgical outcomes in Class III patients using cone beam computed tomography

ONE-YEAR OUTCOME-BASED ASSESSMENT AT RYERSON UNIVERSITY: LESSONS AND BEST PRACTICES

A plan for assessing CEAB graduate attributes was executed on a pilot basis during 2010-2011 at Ryerson University. Based on the assessment results, improvements to the programs were recommended. The Faculty of Engineering, Architecture and Science (FEAS) at Ryerson University has eight engineering programs and seven science programs. The development of the CEAB assessment system was overseen by the FEAS Quality Assurance Council which includes several working groups. This paper presents the lessons and best practices gained during this one-year assessment. The best practices are related to the leadership structure, assessment elements, assessment methods, assessment data and results, and future program improvements. The presented best practices should be useful to the engineering programs that are planning to start or have already started the assessment process.

PHP41 One-Year Assessment of Joint Procurement of Pharmaceuticals in the Public Health Sector in Jordan

The aim of this research was to assess the first year of purchasing pharmaceuticals in the public health sector in Jordan through the joint procurement process for the 4 participating parties in comparison with purchasing pharmaceuticals independently before the institution of joint procurement. The first tender under the joint procurement process was issued in 2007 for antibiotics, antiHIY medications, and antituberculosis agents, which represent 15% of the annual pharmaceutical publicsector purchases in Jordan. A research committee solicited lists of purchased quantities and final purchase prices of these pharmaceuticals obtained in 2006 by each participating group and in 2007 through the joint procurement process. The quantity-comparison method was used to compare the costs of drugs purchased in 2006 and 2007, and estimated cost savings were calculated for each product for each party for 2006 and 2007 under the assumption that the same quantities purchased by each participating party in 2006 would be purchased through joint procurement (prices of 2007). Purchasing through the joint procurement process achieved an estimated savings of 2.4%. This savings increased to 8.9% after excluding 1 item (a cephalosporin), the raw material price of which increased markedly in 2007 compared with 2006 because of an international shortage of raw materials Based on these initial findings, applying a joint procurement system for pharmaceuticals in the public health sector in Jordan has potential to reduce expenditures for the purchase of medicines and provide treatment continuously throughout the year.

Results of a One-Year Assessment of Quality Indicators in an Acute Dialysis Program Operated by a Large Dialysis Provider (LDO)

Results of a One-Year Assessment of Quality Indicators in an Acute Dialysis Program Operated by a Large Dialysis Provider (LDO)

Performance Analysis and Assessment of an Industrial Dryer in Ceramic Production

In recent years, exergy analysis has been widely used in the design, operation, and performance assessment of various thermal systems, among which drying, which is an energy intensive operation, is of a great importance. In the ceramic industry, it is aimed at utilizing a minimum amount of energy in order to remove the maximum moisture for the desired final conditions of the product to be dried. In this study, energy and exergy analyses of a ceramic plant, located in Izmir, Turkey, with a yearly production capacity of 24 million m2 were performed using the actual operational data over a period of 12 months. The drying system at the three stages was analyzed and the values for exergy destruction and efficiency for each component of the system and the whole system at a reference (dead state) temperature of 22°C were calculated. For the month of January, energy and exergy efficiencies for the spray dryer (SD) were determined to be 65.50 and 53.7%, respectively. Energy and exergy efficiency values of the vertical dryer (VD) were 45.12 and 43.3%, respectively, and those of the furnace (F) were 35.08 and 16%, respectively. Based on this one-year assessment, the energy efficiency values for the SD, VD, and F varied between 58.48 and 65.50%, 42.44 and 50.87%, and 30.44 and 36.99%, and the exergy efficiency values were in the range of 44.85–65.16%, 34.92–45.42%, and 12.73–16.41%, respectively.

Less correspondence between expectations before and cosmetic results after risk-reducing mastectomy in women who are mutation carriers: A prospective study

Purpose The primary aim was to describe satisfaction with the cosmetic results six months and one year after risk-reducing mastectomy (RRM) with immediate breast reconstruction. Another aim was to ascertain associations between ratings on “correspondence between the overall results and expectations before RRM” and age, mutation carrier status, salpingo-oophorectomy (SOE) before RRM, body image, and with sexual pleasure and discomfort. Methods 91/100 women who underwent RRM between 1997 and 2005 were included. Assessments were made six and twelve months after RRM with questionnaires regarding satisfaction with the cosmetic results, sexuality (SAQ), and body image (BIS). Results At both assessment points, >70% of the women considered the overall results of RRM to correspond to their expectations. Over 80% were satisfied with the size of their breasts, but 49% indicated at the one-year assessment that at least one breast was too hard and 73% indicated that they had no or only minor sensitivity in the breasts. In the univariate analyses, associations between “correspondence between the overall results and expectations before RRM” and mutation carrier status ( p = 0.039) and SOE ( p = 0.025) were found, but only mutation carrier status remained in the multivariate analysis (0.037). Conclusion The majority of the women reported that the results of RRM corresponded to their expectations, with lower levels of correspondence in mutation carriers than in non-carriers. Overall satisfaction with the cosmetic result was high, but a majority of the women were unsatisfied with the softness of the reconstructed breasts. These results can be useful when informing patients about RRM.

Point-Of-Use Drinking Water Treatment in the Developing World: Community Acceptance, Project Monitoring and Revision

Abstract - Project design and implementation of water treatment technologies in the developing world often overlooks potential pitfalls because: 1) technical experts focus on technologies without considering cultural acceptability and 2) projects lack monitoring, evaluation, and project revision. Over the past five years, Engineers Without Borders (EWB) at the UC-Davis partnered with the Rural Agency for Sustainable Development (RASD) in Nkokonjeru, Uganda, to implement sustainable point of use (POU) water systems. POU systems (i.e. Filtron clay pot filters, solar disinfection, chlorine treatment, and colloidal silver) were tested and implemented at RASD’s training center in Nkokonjeru. While all of the systems effectively removed pathogens, cultural appropriateness and education were the most important drivers of project acceptance. After a one-year assessment, it was determined that community preference was driven by transparency of treatment method, cost, stigma, and ease of use. Clay pot filters were preferred because of ease of use and physical particle removal capabilities. However, high cost, lack of local production and transportation difficulties dictated that their use was not sustainable. Biosand filters were introduced as an alternative and although originally deemed to be too complicated, they have been accepted by the community and continue to be manufactured by RASD in Nkokonjeru.

Gait in Individuals with Chronic Hemiparesis: One-Year Follow-up of the Effects of a Neuroprosthesis That Ameliorates Foot Drop

Foot drop is a common cause of gait impairment in individuals with hemiparesis. The objective of this study was to determine the short-term and long-term effects on functional gait of a neuroprosthesis that provides functional electrical stimulation (FES) to correct footdrop. Sixteen individuals (mean age, 55.0 +/- 14.6 years) with chronic hemiparesis (mean years since insult, 5.3 +/- 4.8) were assessed immediately before receiving the neuroprosthesis and two months and one year after using the device. Both follow-up assessments were conducted with FES operating; the one-year follow-up also assessed gait without FES. Outcome measures were gait velocity on an even surface during a 10-m walk, during a six-minute walk, over obstacles, and over a carpet. Foot switches used during the six-minute walk determined stance time, stride time variability, and gait asymmetry. The effect of time and the one-year carryover effect on gait without FES were determined, with significance set at P = 0.05. The neuroprosthesis had a significant short-term and long-term effect on most measured variables. Thus, mean 10-m walk gait velocity improved in two months from 0.67 m/sec to 0.86 m/sec and continued to increase to 1.06 m/sec by the one-year assessment. A carryover effect on gait velocity and stance time without FES were also noted. The 10-m gait velocity without the neuroprosthesis increased by 23.8% by the one-year follow-up assessment. The neuroprosthesis appears to improve gait performance, and gains were further enhanced over time and carried over to gait even without FES. These results suggest orthotic and therapeutic effects on footdrop after prolonged use of the neuroprosthesis.