859 resultados para health state classification system


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DUE TO COPYRIGHT RESTRICTIONS ONLY AVAILABLE FOR CONSULTATION AT ASTON UNIVERSITY LIBRARY AND INFORMATION SERVICES WITH PRIOR ARRANGEMENT

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PurposeTo develop and validate a classification system for focal vitreomacular traction (VMT) with and without macular hole based on spectral domain optical coherence tomography (SD-OCT), intended to aid in decision-making and prognostication.MethodsA panel of retinal specialists convened to develop this system. A literature review followed by discussion on a wide range of cases formed the basis for the proposed classification. Key features on OCT were identified and analysed for their utility in clinical practice. A final classification was devised based on two sequential, independent validation exercises to improve interobserver variability.ResultsThis classification tool pertains to idiopathic focal VMT assessed by a horizontal line scan using SD-OCT. The system uses width (W), interface features (I), foveal shape (S), retinal pigment epithelial changes (P), elevation of vitreous attachment (E), and inner and outer retinal changes (R) to give the acronym WISPERR. Each category is scored hierarchically. Results from the second independent validation exercise indicated a high level of agreement between graders: intraclass correlation ranged from 0.84 to 0.99 for continuous variables and Fleiss' kappa values ranged from 0.76 to 0.95 for categorical variables.ConclusionsWe present an OCT-based classification system for focal VMT that allows anatomical detail to be scrutinised and scored qualitatively and quantitatively using a simple, pragmatic algorithm, which may be of value in clinical practice as well as in future research studies.

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Run-off-road (ROR) crashes have increasingly become a serious concern for transportation officials in the State of Florida. These types of crashes have increased proportionally in recent years statewide and have been the focus of the Florida Department of Transportation. The goal of this research was to develop statistical models that can be used to investigate the possible causal relationships between roadway geometric features and ROR crashes on Florida's rural and urban principal arterials. ^ In this research, Zero-Inflated Poisson (ZIP) and Zero-Inflated Negative Binomial (ZINB) Regression models were used to better model the excessive number of roadway segments with no ROR crashes. Since Florida covers a diverse area and since there are sixty-seven counties, it was divided into four geographical regions to minimize possible unobserved heterogeneity. Three years of crash data (2000–2002) encompassing those for principal arterials on the Florida State Highway System were used. Several statistical models based on the ZIP and ZINB regression methods were fitted to predict the expected number of ROR crashes on urban and rural roads for each region. Each region was further divided into urban and rural areas, resulting in a total of eight crash models. A best-fit predictive model was identified for each of these eight models in terms of AIC values. The ZINB regression was found to be appropriate for seven of the eight models and the ZIP regression was found to be more appropriate for the remaining model. To achieve model convergence, some explanatory variables that were not statistically significant were included. Therefore, strong conclusions cannot be derived from some of these models. ^ Given the complex nature of crashes, recommendations for additional research are made. The interaction of weather and human condition would be quite valuable in discerning additional causal relationships for these types of crashes. Additionally, roadside data should be considered and incorporated into future research of ROR crashes. ^

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Board of Governors Meeting of the State University System of Florida, Academic and Student Affairs Committe Meeting held at Graham Center Ballroom, Modesto Maidique Campus, Florida International University on September 15, 2011

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Board of Governors Meeting of the State University System of Florida, Regular Meeting Meeting held at Graham Center Ballroom, Modesto Maidique Campus, Florida International University on September 14, 2011

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Board of Governors Meeting of the State University System of Florida, Strategic Planning Committee Part A Meeting held at Graham Center Ballroom, Modesto Maidique Campus, Florida International University on September 14, 2011

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Board of Governors Meeting of the State University System of Florida, Facilities Committee. Meeting held at Graham Center Ballroom, Modesto Maidique Campus, Florida International University on September 14, 2011

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The purpose of this study was to examine the factorsbehind the failure rates of Associate in Arts (AA)graduates from Miami-Dade Community College (M-DCC) transferring to the Florida State University System (SUS). In M-DCC's largest disciplines, the university failure rate was 13% for Business & Management, 13% for Computer Science, and 14% for Engineering. Hypotheses tested were: Hypothesis 1 (H1): The lower division (LD) overall cumulative GPA and/or the LD major field GPA for AA graduates are predictive of the SUS GPA for the Business Management, Computer Science, and Engineering disciplines. Hypothesis 2 (H2): Demographic variables (age, race, gender) are predictive of performance at the university among M-DCC AA graduates in Engineering, Business & Management, and Computer Science. Hypothesis 3 (H3): Administrative variables (CLAST -College Level Academic Skills Test subtests) are predictive of university performance (GPA) for the Business/Management, Engineering, and Computer Science disciplines. Hypothesis 4 (H4): LD curriculum variables (course credits, course quality points) are predictive of SUS performance for the Engineering, Business/Management and Computer Science disciplines. Multiple Regression was the inferential procedureselected for predictions. Descriptive statistics weregenerated on the predictors. Results for H1 identified the LD GPA as the most significant variable in accounting for the variability of the university GPA for the Business & Management, Computer Science, and Engineering disciplines. For H2, no significant results were obtained for theage and gender variables, but the ethnic subgroups indicated significance at the .0001 level. However, differentials in GPA may not have been due directly to the race factor but, rather, to curriculum choices and performance outcomes while in the LD. The CLAST computation variable (H3) was a significant predictor of the SUS GPA. This is most likely due to the mathematics structure pervasive in these disciplines. For H4, there were two curriculum variables significant in explaining the variability of the university GPA (number of required critical major credits completed and quality of the student's performance for these credits). Descriptive statistics on the predictors indicated that 78% of those failing in the State University System had a LD major GPA (calculated with the critical required university credits earned and quality points of these credits) of less than 3.0; and 83% of those failing at the university had an overall community college GPA of less than 3.0.

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The objective of this study was to verify the association between some mobility items of the International Classification Functionality (ICF), with the evaluations Gross Motor Function Measure (GMFM-88), 1-minute walk test (1MWT) and if the motor impairment influences the quality of life in children with Cerebral Palsy (PC), by using the Paediatric Quality of Life Inventory (PedsQL 4.0 versions for children and parents). The study included 22 children with cerebral palsy spastic, classified in levels I, II, and III on the Gross Motor Function Classification System (GMFCS), with age group of 9.9 years old. Among those who have participated, seven of them were level I, eight of them were level II and seven of them were level III. All of the children and teenagers were rated by using check list ICF (mobility item), GMFM-88, 1-minute walk test and PedsQL 4.0 questionnaires for children and parents. It was observed a strong correlation between GMFM-88 with check list ICF (mobility item), but moderate correlation between GMFM-88 and 1-minute walk test (1MWT). It was also moderate the correlation between the walking test and the check list ICF (mobility item). The correlation between PedsQl 4.0 questionnaires for children and parents was weak, as well as the correlation of both with GMFM, ICF (mobility item) and the walking test. The lack of interrelation between physical function tests and quality of life, indicates that, regardless of the severity of the motor impairment and the difficulty with mobility, children and teenagers suffering of PC spastic, functional level I, II and III GMFCS and their parents have a varied opinion regarding the perception of well being and life satisfaction.

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Dados suplementares associados com este artigo disponíveis na versão online em: http://dx.doi.org/10.1016/j.marpol.2016.06.021

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Tesis (Optometra). -- Universidad de La Salle, Facultad de Ciencias de La Salud. Programa de Optometria, 2014

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Dietary fiber was classified according to its solubility in an attempt to relate physiological effects to chemical types of fiber. Soluble fibers (B-glucans, gums, wheat dextrin, psyllium, pectin, inulin) were considered to have benefits on serum lipids, while insoluble fibers (cellulose, lignin, pectins, hemicelluloses) were linked with laxation benefits. More important characteristics of fiber in terms of physiological benefits are viscosity and fermentability. Viscous fibers (pectins, B-glucans, gums, psyllium) are those that have gel-forming properties in the intestinal tract, and fermentable fibers (wheat dextrin, pectins, B-glucans, gum, inulin) are those that can be metabolized by colonic bacteria. Objective: To summarize the beneficial effects of dietary fiber, as nutraceuticals, in order to maintain a healthy gastrointestinal system. Methods: Our study is a systematic review. Electronic databases, including PubMed, Medline, with supplement of relevant websites, were searched. We included randomized and non-randomized clinical trials, epidemiological studies (cohort and case-control). We excluded case series, case reports, in vitro and animal studies. Results: The WHO, the U.S. Food and Drug Administration (FDA), the Heart Foundation and the Romanian Dietary Guidelines recommends that adults should aim to consume approximately 25–30 g fiber daily. Dietary fiber is found in the indigestible parts of cereals, fruits and vegetables. There are countries where people don’t eat enough food fibers, these people need to take some kind of fiber supplement. Evidence has been found that dietary fiber from whole foods or supplements may (1) reduce the risk of cardiovascular disease by improving serum lipids and reducing serum total and low-density lipoprotein (LDL) cholesterol concentrations, (2) decreases the glycaemic index of foods, which leads to an improvement in glycemic response, positive impact on diabetes, (3) protect against development of obesity by increasing satiety hormone leptin concentrations, (4) reduced risk of developing colorectal cancer by normalizes bowel movements, improve the integrity of the epithelial layer of the intestines, increase the resistance against pathogenic colonization, have favorable effects on the gut microbiome, wich is the second genomes of the microorganisms, (5) have a positive impact on the endocrine system by gastrointestinal polypeptide hormonal regulation of digestion, (6) have prebiotic effect by short-chain fatty acids (SCFA) production; butyrate acid is the preferred energy source for colonic epithelial cells, promotes normal cell differentiation and proliferation, and also help regulate sodium and water absorption, and can enhance absorption of calcium and other minerals. Although all prebiotics are fiber, not all fiber is prebiotic. This generally refers to the ability of a fiber to increase the growth of bifidobacteria and lactobacilli, which are beneficial to human health, and (7) play a role in improving immune function via production of SCFAs by increases T helper cells, macrophages, neutrophils, and increased cytotoxic activity of natural killer cells. Conclusion: Fiber consumption is associated with high nutritional value and antioxidant status of the diet, enhancing the effects on human health. Fibers with prebiotic properties can also be recommended as part of fiber intake. Due to the variability of fiber’s effects in the body, it is important to consume fiber from a variety of sources. Increasing fiber consumption for health promotion and disease prevention is a critical public health goal.

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BACKGROUND: Health state valuation data are often excluded from studies that aim to provide a nationally representative set of values for preference-based health-related quality of life (HRQoL) instruments. The purpose was to provide a systematic examination of exclusion criteria used in the derivation of societal scoring algorithms for preference-based HRQoL instruments. METHODS: Data sources included MEDLINE, official instrument websites, and publication reference lists. Analyses that used data from national valuation studies and reported a scoring algorithm for a generic preference-based HRQoL instrument were included. Data extraction included exclusion criteria and associated justifications, exclusion rates, the characteristics of excluded respondents, and analyses that explored consequential implications of exclusion criteria on the respective national tariff. RESULTS: Seventy-six analyses (from 70 papers) met the inclusion criteria. In addition to being excluded for logical inconsistencies, respondents were often excluded if they valued fewer than 3 health states or if they gave the same value to all health states. Numerous other exclusion criteria were identified, with varying degrees of justification, often based on an assumption that respondents did not understand the task or as a consequence of the chosen statistical modeling techniques. Rates of exclusion ranged from 0% to 65%, with excluded respondents more likely to be older, less educated, and less healthy. Limitations included that the database search was confined to MEDLINE; study selection focused on national valuation studies that used standard gamble, time tradeoff, and/or visual analog scale techniques; and only English-language studies were included. CONCLUSION: Exclusion criteria used in national valuation studies vary considerably. Further consideration is necessary in this important and influential area of research, from the design stage to the reporting of results.