Use Of Functional Assessment Research Articles

18 F-FDG PET/CT use in functional assessment of the testes: A systematic review.

Our study analysed previous studies employing positron emission tomography with co-registered computer tomography (PET/CT) in andrological patient evaluation and assessed the differences in 2-[18 F]F-fluoro-2'-deoxyglucose (FDG) uptake between three groups: healthy testes, benign and malignant testicular pathology. Medline and Embase were systematically searched for studies involving FDG-PET/CT imaging of testes with results expressed as mean standardised uptake value (SUVmean ). A one-way ANOVA was used to compare SUVmean between three groups. All papers assessing andrological parameters were pooled to compare fertility data. Seventeen studies, including three relating to fertility diagnosis, with a total of 830 patients, were included in the review. One-way ANOVA showed a statistical difference between mean values of tracer SUVmean in healthy and malignant testes (Dif.=-2.77, 95% CI=-4.32 to 1.21, p<0.01) as well as benign and malignant (Dif.=-2.95, 95% CI=-4.33 to -1.21, p<0.01) but no difference between healthy and benign (Dif.=0.19, 95% CI=-0.96 to 1.33, p=0.90). There is some evidence to suggest that FDG uptake and testicular volume are positively correlated to total sperm count, sperm concentration and sperm motility and that germ cells are likely to account for the majority of testicular FDG accumulation. Our findings indicate that malignant testicular lesions demonstrate a significantly higher FDG uptake than benign testicular lesions or healthy testes. Some evidence also suggests that FDG-PET could visualise metabolic activity and thus spermatogenesis; however more studies are required to determine whether FDG-PET could also be used to diagnose infertility. Further studies should focus on correlating both sex hormone-serum levels and semen analysis results with imaging data.

Establishing the South Australian Macrobenthic Traits (SAMT) database: A trait classification for functional assessments.

Trait‐based approaches are increasingly used as a proxy for understanding the relationship between biodiversity and ecosystem functioning. Macrobenthic fauna are considered one of the major providers of ecosystem functions in marine soft sediments; however, several gaps persist in the knowledge of their trait classification, limiting the potential use of functional assessments. While trait databases are available for the well‐studied North Atlantic benthic fauna, no such trait classification system exists for Australia. Here, we present the South Australian Macrobenthic Traits (SAMT) database, the first comprehensive assessment of macrobenthic fauna traits in temperate Australian waters. The SAMT database includes 13 traits and 54 trait‐modalities (e.g., life history, morphology, physiology, and behavior), and is based on records of macrobenthic fauna from South Australia. We provide trait information for more than 250 macrobenthic taxa, including outcomes from a fuzzy coding procedure, as well as an R package for using and analyzing the SAMT database. The establishment of the SAMT constitutes the foundation for a comprehensive macrobenthic trait database for the wider southern Australian region that could facilitate future research on functional perspectives, such as assessments of functional diversity and changes to ecosystem functioning.

Functional assessments in the UK social security system: the experiences of claimants with mental health conditions

AbstractEligibility for health-related income benefits in the United Kingdom is now determined through the use of functional assessments conducted by healthcare professionals. Claimant satisfaction with both Personal Independence Payment (PIP) and Work Capability Assessments (WCA) has been mixed and concerns have been raised that mental health conditions are not well-understood in this context, but academic research has so far been limited. Individuals with a range of common mental disorders and severe mental illness were interviewed (n=18) about their experiences of undergoing eligibility assessments for health-related income benefits. Data were analysed using a thematic analysis approach.Eleven out of the 18 participants had been turned down for one or more income benefits and successful claims were more likely where supported by health and care professionals. Eligibility assessments were overwhelmingly perceived as focusing on physical health with limited scope to explore the impact of mental health on functioning. Evidence from this and other studies suggests that improvements are needed to the eligibility assessment process for all claimants but particularly those with a mental health condition.

Aortic Stenosis and Heart Failure: Disease Ascertainment and Statistical Considerations for Clinical Trials.

Aortic stenosis is a progressive disease that develops over decades, and once symptomatic and untreated, is associated with poor survival. Transcatheter aortic valve replacement has evolved significantly in the past decade and has expanded its indication from surgically inoperable and high-risk patients to patients with intermediate risk. Assessment of heart failure-related outcomes include the use of functional assessments, disease-specific quality of life surveys and standardised ascertainment of events, such as hospitalisations. Multiple statistical approaches are currently being tested to account for recurrent events such as hospitalisations for heart failure or to combine binary and continuous outcomes, both intended to assess the holistic burden of the disease, as opposed to the traditional analysis of time to first event.

Use of Functional Assessment to Define Therapeutic Goals and Treatment.

This article summarizes the presentations and discussions from a workshop, "Using Functional Assessment to Define Therapeutic Goals and Treatment," which took place on November 30 to December 1, 2017. This workshop brought together transdisciplinary leaders in the fields of function and disability and clinical investigators engaged in research on geriatric populations to outline opportunities and challenges for incorporating measures of function in clinical research. Topics addressed included reliable and clinically feasible measures of function and key domains of health (eg, musculoskeletal, cognitive, and sensory) that are most strongly associated with patients' perceptions of well-being, independence, and quality of life across a wide array of diseases and interventions. The workshop also focused on the importance of function in medical decision making to inform communications between specialty physicians and patients about prognosis and goals of care. Workshop participants called for more research on the role of function as a predictor of an intervention's effectiveness and an important treatment outcome. Such research would be facilitated by development of a core set of simple, short, functional measures that can be used by all specialties in the clinical setting to allow "big data" analytics and a pragmatic research. J Am Geriatr Soc 67:1782-1790, 2019.

Morphological evaluation of the calcaneofibular ligament in different ankle positions using a three-dimensional MRI sequence.

Evaluating images of the lateral ligament of the ankle is not easy, and evaluation of the calcaneofibular ligament (CFL) in particular is difficult. We prospectively conducted morphological measurements of the CFL in different ankle positions and obtain basic data for use in functional assessment of the CFL, diagnosis of CFL injury, and determination of treatment effects. The subjects were ten healthy volunteers (ten ankles) with a mean age of 27.8years and no history of ankle disease. Imaging was done using a 3-T magnetic resonance imaging (MRI) machine and fast imaging employing steady-state acquisition cycled phases (FIESTA-C), a three-dimensional (3D) sequence, with the ankle in a neutral position, maximum dorsiflexion, and maximum plantar flexion. 3D images of the CFL, peroneal muscle tendons, fibula, and calcaneus were prepared at a workstation, and morphological measurements of the CFL were made. In all positions, the CFL showed a gently curving course with the peroneal muscle tendons as a fulcrum. The tortuosity angle was significantly smaller in plantar flexion (30.0° ± 7.4°) than in the neutral position (41.7° ± 8.3°). 3D MRI sequences showed that, in all positions, the CFL curved due to the influence of the peroneal muscle tendons. With maximum plantar flexion, the CFL tortuosity angle was small, which was thought to have been due to the tension in the CFL.

AVERSIVE CONTROL IN BEHAVIOR ANALYSIS: AN ANALYSIS OF JEAB AND JABA PUBLICATIONS (1958-2018)

We analyzed the frequency of publications on aversive control and publication trends concerning specific aversive contingencies. The articles were published between 1958 and 2018 in two journals: Journal of the Experimental Analysis of Behavior (JEAB) and Journal of Applied Behavior Analysis (JABA). We selected articles that presented at least one of the following descriptors in the title, abstract, or keywords: aversive, avoidance, escape, negative reinforcement, and punishment. We verified that the publication frequency on aversive control was higher in JEAB than in JABA until the 1990s, at which point the trend was reversed. An irregular increase has been observed in JEAB publications on the topic since 2000. The rise of applied research on aversive control is related to growing interest in negative reinforcement. This significant decrease in studies on aversive control may be related to stricter ethical regulations in research and related to the assertions of some authors to reduce the aversive control use. The increase in applied studies since the 1990s appears to be related to the greater use of functional assessments and the development of treatments for behavioral problems that result from negative reinforcement contingencies. Key words: aversive control, aversive contingencies, Behavior Analysis, publication.

A Quantitative Dot Blot Assay for AAV Titration and Its Use for Functional Assessment of the Adeno-associated Virus Assembly-activating Proteins

While adeno-associated virus (AAV) is widely accepted as an attractive vector for gene therapy, it also serves as a model virus for understanding virus biology. In the latter respect, the recent discovery of a non-structural AAV protein, termed assembly-activating protein (AAP), has shed new light on the processes involved in assembly of the viral capsid VP proteins into a capsid. Although many AAV serotypes require AAP for assembly, we have recently reported that AAV4, 5, and 11 are exceptions to this rule. Furthermore, we demonstrated that AAPs and assembled capsids of different serotypes localize to different subcellular compartments. This unexpected heterogeneity in the biological properties and functional roles of AAPs among different AAV serotypes underscores the importance of studies on AAPs derived from diverse serotypes. This manuscript details a straightforward dot blot assay for AAV quantitation and its application to assess AAP dependency and serotype specificity in capsid assembly. To demonstrate the utility of this dot blot assay, we set out to characterize capsid assembly and AAP dependency of Snake AAV, a previously uncharacterized reptile AAV, as well as AAV5 and AAV9, which have previously been shown to be AAP-independent and AAP-dependent serotypes, respectively. The assay revealed that Snake AAV capsid assembly requires Snake AAP and cannot be promoted by AAPs from AAV5 and AAV9. The assay also showed that, unlike many of the common serotype AAPs that promote heterologous capsid assembly by cross-complementation, Snake AAP does not promote assembly of AAV9 capsids. In addition, we show that the choice of nuclease significantly affects the readout of the dot blot assay, and thus, choosing an optimal enzyme is critical for successful assessment of AAV titers.

A Quantitative Dot Blot Assay for AAV Titration and Its Use for Functional Assessment of the Adeno-associated Virus Assembly-activating Proteins

A Quantitative Dot Blot Assay for AAV Titration and Its Use for Functional Assessment of the Adeno-associated Virus Assembly-activating Proteins

Functional Assessments Used by Occupational Therapists with Older Adults at Risk of Activity and Participation Limitations: A Systematic Review.

IntroductionThe use of functional assessments to evaluate patient change is complicated by a lack of consensus as to which assessment is most suitable for use with older adults. Objective: To identify and appraise the properties of assessments used to evaluate functional abilities in older adults.MethodsA systematic review of randomised controlled trials of occupational therapy interventions was conducted up to 2012 to identify assessments used to measure function. Two authors screened and extracted data independently. A second search then identified papers investigating measurement properties of each assessment. Studies from the second search were included if: i) published in English, ii) the assessment was not modified from its original published form, iii) study aim was to evaluate the quality of the tool, iv) and was original research. Translated versions of assessments were excluded. Measurement quality was rated using the COSMIN checklist and Terwee criteria.ResultsTwenty-eight assessments were identified from the systematic search of occupational therapy interventions provided to older adults. Assessments were of varied measurement quality and many had been adapted (although still evaluated as though the original tool had been administered) potentially altering the conclusions drawn about measurement quality. Synthesis of best evidence established 15 functional assessments have not been tested in an older adult population.ConclusionsThe Functional Autonomy Measurement System (SMAF) appears to be a promising assessment for use with older adults. Only two tools (the SMAF and the Assessment of Motor and Process Skills (AMPS)) were deemed to be responsive to change when applied to older adults. Health professionals should use functional assessments that have been validated with their population and in their setting. There are reliable and valid assessments to capture the functional performance of older adults in community and hospital settings, although further refinement of these assessments may be necessary.

APPLIED BEHAVIOR ANALYSIS IN ACQUIRED BRAIN INJURY REHABILITATION: A META‐ANALYSIS OF SINGLE‐CASE DESIGN INTERVENTION RESEARCH

The purpose of this meta‐analysis was to complete a systematic evidence‐based review of published behavioral treatment studies employing single‐case designs with both children and adults with acquired brain injury. Peer‐reviewed journals were searched using PsycINFO, Medline, and ERIC databases with combinations of terms such as brain injury, behavior disorder, behavior therapy, behavior modification, behavior analysis, and verbal behavior. A total of 112 acquisition and reduction studies met the established inclusion criteria. The data extracted from each study included specific details about the participants, target responses, intervention characteristics, use of functional assessment, and outcome characteristics. A data extraction software program was also used to extract data from graphs to calculate percentage of nonoverlapping data as an effect size. The studies were then evaluated along several dimensions from multiple evidence‐based practice frameworks. Collectively, interventions targeted a wide range of behaviors for acquisition and reduction, but only five interventions were classified as well established according to the American Psychological Association Division 12 criteria. Furthermore, methodology of the identified studies was found to be relatively poor. A variety of methodological concerns are discussed. Copyright © 2014 John Wiley &amp; Sons, Ltd.

Moving from Pathology to Possibility: Integrating Strengths-based Interventions in Child Welfare Provision

Child welfare providers are increasingly required to demonstrate that strengths-based, evidence-informed practices are central to their intervention methodology. This case study describes how a large child welfare agency instituted cognitive behavioural therapy (CBT) as the core component of a strength-based practice model with the goal of developing a unifying methodology for treatment and intervention across diverse programmes that range from community-based counselling to wraparound to acute residential care. One factor that aided implementation was that many agency staff had previously been using a variety of strengths-based tools, such as therapeutic crisis intervention, skills-based training, solution-focused therapy, and relaxation techniques in their work with children and youth. Challenges included creating a common training curriculum about CBT, trauma-focused CBT, and solution-focused therapy for hundreds of diverse staff; implementing ongoing support in the form of supervision and training; managing staff members' other theoretical orientations and some resistance to change; and developing documentation to integrate CBT into clinical assessments, progress notes, and service plans. This paper also describes the evaluation plan to assess fidelity to the practice model, including trauma-focused CBT practice checklists, a revised utilisation review process to assess documentation of strengths-based interventions in case records, and the use of functional assessments to measure client outcomes.

Use of Functional Assessment to Address the Fainting of an Adolescent Boy with Traumatic Brain Injury: A Case Study

Use of Functional Assessment to Address the Fainting of an Adolescent Boy with Traumatic Brain Injury: A Case Study

Functional Impact of Sydenham’s Chorea: A Case Report

<strong>Background:</strong> Sydenham’s chorea (SC) is the most common type of acquired chorea in childhood. In some cases, symptoms (most commonly described in terms of neurological signs) last up to 2 years, and many cases relapse. This report describes the clinical course in terms of functional abilities following diagnosis of SC. <strong>Case report:</strong> Standardized assessments across the domains of activity and participation were administered following diagnosis, prior to and following treatment with haloperidol to measure treatment response and identify occupational therapy intervention needs. SC was observed to significantly reduce the child’s participation and independence in activities of daily living. In this case, the standardized assessments administered highlighted difficulties with both motor and process skills. At 1 week after commencing haloperidol, both motor and process skills had improved. Clinically significant changes in self-care and mobility were noted with less improvement with handwriting. At 9 weeks, most symptoms and functional difficulties had resolved. <strong>Discussion:</strong> Given the process difficulties detected in this case, and the possibility of enduring symptoms, the use of functional assessments is advocated in the routine management of SC. These findings illustrate the potential for motor and non-motor sequelae in acute childhood movement disorders and related functional disabling consequences.

Functional Impact of Sydenham's Chorea: A Case Report.

Sydenham's chorea (SC) is the most common type of acquired chorea in childhood. In some cases, symptoms (most commonly described in terms of neurological signs) last up to 2 years, and many cases relapse. This report describes the clinical course in terms of functional abilities following diagnosis of SC. Standardized assessments across the domains of activity and participation were administered following diagnosis, prior to and following treatment with haloperidol to measure treatment response and identify occupational therapy intervention needs. SC was observed to significantly reduce the child's participation and independence in activities of daily living. In this case, the standardized assessments administered highlighted difficulties with both motor and process skills. At 1 week after commencing haloperidol, both motor and process skills had improved. Clinically significant changes in self-care and mobility were noted with less improvement with handwriting. At 9 weeks, most symptoms and functional difficulties had resolved. Given the process difficulties detected in this case, and the possibility of enduring symptoms, the use of functional assessments is advocated in the routine management of SC. These findings illustrate the potential for motor and non-motor sequelae in acute childhood movement disorders and related functional disabling consequences.

ゾタロリムス(zotarolimus)溶出ステント留置後に認めた造影上の再狭窄に対する冠血流予備量比(FFR)による機能的評価の有用性

ゾタロリムス(zotarolimus)溶出ステント留置後に認めた造影上の再狭窄に対する冠血流予備量比(FFR)による機能的評価の有用性

Usefulness of Functional Assessment in the Treatment of Patients With Moderate Angiographic Paclitaxel-Eluting Stent Restenosis

In recent years there has been a debate about the functional severity of restenosis of drug-eluting stents. The aim of the present study was to assess the functional severity of stenosis in patients with moderate angiographic restenosis after paclitaxel-eluting stents (PES) deployment. Forty-two patients with moderate angiographic restenosis at the in-stent segment and/or approximately 5mm from the stent edge were enrolled. For comparison, furthermore, 42 patients with de novo stenosis lesions matched for angiographic severity were assigned to the control group. Quantitative coronary angiography and functional assessment using fractional flow reserve (FFR) were performed. Although percent diameter stenosis was not significantly different between the 2 groups (PES group, 40.6±11.2%; de novo group, 40.6±9.0%, P=0.981), the functional severity of stenosis was significantly less in the PES group than in the de novo group (FFR: PES group, 0.86±0.07; de novo group, 0.79±0.10, P=0.002). FFR was preserved in patients with moderate angiographic restenosis after PES deployment, and the functional severity of restenosis is often limited. Therefore, revascularization should be performed with caution for patients with moderate angiographic restenosis after PES deployment.

AS-117: Usefulness of Functional Assessment for Angiographic Restenosis after Deployment of Zotarolimus-Eluting Stent

AS-117: Usefulness of Functional Assessment for Angiographic Restenosis after Deployment of Zotarolimus-Eluting Stent

Issues in the Management of Challenging Behaviours of Adults with Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a particularly important risk factor for challenging behaviours such as aggression, tantrums, self-injury and pica. Adults with ASD have rarely been studied with respect to these problems. This is particularly disconcerting since there are far more adults than children with ASD. In addition, because of adults' increased physical size and longer history of these problems, treating these behaviours effectively is important. Psychological methods, particularly applied behaviour analysis, and pharmacotherapy have been the most frequently addressed treatments for challenging behaviours associated with ASD in the research literature. In many cases, challenging behaviours have clear environmental antecedents. In these cases, behavioural interventions, such as applied behaviour analysis, should be used to reduce the behaviours. When environmental factors cannot be identified or when challenging behaviours are very severe, pharmacological treatments may be necessary in combination with behavioural interventions. Newer antipsychotics are the most researched medications for use with this population. Currently, risperidone and aripiprazole are the only medications that have US FDA approval for the treatment of behaviours associated with ASD, specifically irritability; however, they are indicated for use in children not adults. It is important not to use medications unnecessarily, due to possible side effects associated with their use. Based on available research, some recommendations for the treatment of challenging behaviours of adults (and children) with ASD include the use of functional assessment, side-effect monitoring of medications and behavioural methods whenever possible. Additionally, future research in this area needs to focus more on adults, as most current research has used child samples.

Functional assessment and positive support strategies for promoting resilience: Effects on teachers and high‐risk children

AbstractThe purpose of this study was to conduct an experimental analysis of teachers' use of functional assessment (FA) and positive behavior support (PBS) for addressing challenging behaviors in young children. A group of 35 experimental teachers participated in professional development designed to provide step‐by‐step training and guided implementation of FA linked to PBS intervention planning for children identified with challenging behavior in prekindergarten through first‐grade classrooms. A randomly designated group of 35 control teachers received neither training nor consultation for implementing FA and PBS. At post‐intervention, experimental teachers reported increased resilience as evidenced in their significantly higher competence and self‐efficacy along with greater utilization of FA and PBS practices compared with control teachers. Increased levels of resilience were also documented on multiple measures for experimental children with challenging behaviors who received FA and PBS. Specifically, experimental children demonstrated more positive behaviors and fewer challenging behaviors compared with control children at post‐intervention. The findings offer empirical support for providing professional development in FA and PBS as a proactive strategy for promoting improved competence for teachers and, more importantly, for improving resilience among children with behavioral concerns. © 2011 Wiley Periodicals, Inc.