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61.
Dahlberg CA Cusick CP Hawley LA Newman JK Morey CE Harrison-Felix CL Whiteneck GG 《Archives of physical medicine and rehabilitation》2007,88(12):1561-1573
Dahlberg CA, Cusick CP, Hawley LA, Newman JK, Morey CE. Harrison-Felix CL, Whiteneck GG. Treatment efficacy of social communication skills training after traumatic brain injury: a randomized treatment and deferred treatment controlled trial.
Objective
To evaluate the efficacy of a replicable group treatment program to improve social communication skills after traumatic brain injury (TBI).Design
Randomized treatment and deferred treatment controlled trial, with follow-up at 3, 6, and 9 months post-treatment.Setting
Community.Participants
Volunteer sample of 52 people with TBI who were at least 1 year postinjury, who received rehabilitation, and who had identified social communication deficits.Intervention
Twelve weekly group sessions (1.5h each) to improve social communication.Main Outcome Measures
The Profile of Functional Impairment in Communication (PFIC), Social Communication Skills Questionnaire–Adapted (SCSQ-A), Goal Attainment Scale (GAS), Craig Handicap Assessment and Reporting Technique–Short Form social integration and occupation subscales, Community Integration Questionnaire social integration and productivity subscales, and Satisfaction With Life Scale (SWLS).Results
Independent samples t test analysis showed significant treatment effect compared with no treatment on 7 of 10 of the PFIC subscales (P range, .024 to <.001) and the SCSQ-A (P=.005) after the first 12 weeks of the study. After 12 weeks of treatment for all participants, repeated-measures analysis showed significant improvements from baseline on 9 of 10 PFIC subscales (P range, .01−.001), SCSQ-A (P≤.001), GAS (P≤.001), and SWLS (P=.011). At 6-month follow-up, scores were significantly better than baseline on 6 of 10 PFIC scales (P range, .01−.001), the SCSQ-A (P≤.001), GAS (P≤.001), and SWLS (P≤.001).Conclusions
TBI subjects who received social communication skills training had improved communication skills that were maintained on follow-up. Overall life satisfaction for participants was improved. 相似文献62.
63.
64.
Sarah L. Gorst MSc Christopher J. Armitage PhD Simon Brownsell PhD Mark S. Hawley PhD 《Annals of behavioral medicine》2014,48(3):323-336
Background
Home telehealth has the potential to benefit heart failure (HF) and chronic obstructive pulmonary disease (COPD) patients, however large-scale deployment is yet to be achieved.Purpose
The aim of this review was to assess levels of uptake of home telehealth by patients with HF and COPD and the factors that determine whether patients do or do not accept and continue to use telehealth.Methods
This research performs a narrative synthesis of the results from included studies.Results
Thirty-seven studies met the inclusion criteria. Studies that reported rates of refusal and/or withdrawal found that almost one third of patients who were offered telehealth refused and one fifth of participants who did accept later abandoned telehealth. Seven barriers to, and nine facilitators of, home telehealth use were identified.Conclusions
Research reports need to provide more details regarding telehealth refusal and abandonment, in order to understand the reasons why patients decide not to use telehealth. 相似文献65.
M Rotman J T Chen R P Seningen J Hawley G S Wagner R M Davidson M R Gilbert 《The American journal of cardiology》1974,33(3):357-362
Pulmonary arterial diastolic pressure has been shown to be a reliable estimate of left ventricular filling pressure. In 91 patients with acute myocardial infarction, the Swan-Ganz flow-directed catheter was used to measure pulmonary arterial diastolic pressure, which was correlated with clinical and radiographic estimates of left ventricular failure. The physical findings of a third sound gallop and rales were significantly correlated with the level of pulmonary arterial diastolic pressure. In the absence of either a third sound gallop or rales, the pulmonary arterial diastolic pressure was found to be increased in 47 percent of the patients. The presence of rales was a less sensitive determinant of left ventricular dysfunction than a third sound gallop alone or in association with rales. Radiographic findings of increasing pulmonary congestion were significantly correlated with the level of pulmonary arterial diastolic pressure. In the absence of radiographic pulmonary congestion, 24 percent of patients had abnormal pulmonary arterial diastolic pressure. We conclude that measurement of pulmonary arterial diastolic pressure increases the objectivity of the clinical evaluation in patients with acute myocardial infarction. 相似文献
66.
Eisele TP Lindblade KA Wannemuehler KA Gimnig JE Odhiambo F Hawley WA Ter Kuile FO Phillips-Howard P Rosen DH Nahlen BL Vulule JM Slutsker L 《The American journal of tropical medicine and hygiene》2005,73(1):149-156
We present results from a study conducted in western Kenya where all-cause child mortality was assessed among a population with high levels of sustained insecticide-treated bed net (ITN) use for up to six years. Although ITNs were associated with significant reductions in all-cause mortality among infants 1-11 months old, there was no difference in the rate of all-cause mortality among children 12-59 months old with ITNs for 2-4 years, compared historically with children from villages without ITNs, after controlling for seasonality and underlying child mortality across calendar years (adjusted hazard ratio [AHR] = 0.91, 95% confidence interval [CI] = 0.77-1.07). There was no increase in the proportion of child deaths at older ages (12-59 months old) of all child deaths within villages with ITNs for 5-6 years (48.1%) compared historically with villages without ITNs (47.9%), after controlling for seasonality (AHR = 1.03, P = 0.834). We find no evidence that sustained ITN use increased the risk of mortality in older children in this area of intense perennial malaria transmission. 相似文献
67.
Stenotrophomonas maltophilia infection and colonization in the intensive care units of two community hospitals: A study of 143 patients 总被引:4,自引:0,他引:4
Gopalakrishnan R Hawley HB Czachor JS Markert RJ Bernstein JM 《Heart & lung : the journal of critical care》1999,28(2):134-141
Study Objective: To study the epidemiology of Stenotrophomonas maltophilia infections in the intensive care units (ICUs) of community general hospitals. DESIGN: Retrospective chart review of 143 patients with cultures positive for S. maltophilia over a 2-year period. SETTING: Intensive care units of 2 community general hospitals. RESULTS: Patients with S. maltophilia infection or colonization were elderly (mean age 62.4 years), intubated for a mean of 11.8 days, and had a mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score of 16.6. A tracheostomy was present in 22.4%, and underlying chronic respiratory disease and malignancy were found in 25.9% and 15.4%, respectively. Only 2 patients (1.4%) were neutropenic. Most isolates (89.5%) were from the respiratory tract and were part of a polymicrobial culture in 52. 5% of patients. Only a slightly higher APACHE II score (mean = 18.0, SD 7.8 vs mean = 15.6, SD 6.2, P = 0.052) differentiated patients with infection from those with colonization. All but 2 patients were exposed to antibiotics before their positive culture. Crude mortality rate was 41.3% overall and was significantly higher in those with an APACHE II score of 15 or more (48.8% vs 30.5%, P = 0. 028). CONCLUSION: S. maltophilia is emerging as an important cause of nosocomial infection, especially pneumonia, in ICUs of community general hospitals. Patients tend to be elderly, intubated for a mean of about 12 days, have high APACHE II scores, and frequently have a tracheostomy or underlying chronic respiratory disease. In contrast to earlier reports, neutropenia and underlying malignancy are uncommon in our ICU population. We found prior antibiotic exposure was almost universal and similar to previous reports, but use of imipenem was much less common in our community hospital patients. Patients with a high APACHE II score should be considered infected rather than colonized, but differentiation of infection from colonization remains problematic. Isolation of S. maltophilia from a patient carries a crude mortality rate of 41.3%, and patients with an APACHE II score of 15 or more have a significantly higher mortality rate than those with lesser scores, approaching 50%. Trimethoprim-sulfamethoxazole (TMP-SMX) remains the drug of choice for infections caused by S. maltophilia. 相似文献
68.
Intracisternal A-particle genes as movable elements in the mouse genome. 总被引:32,自引:0,他引:32 下载免费PDF全文
E L Kuff A Feenstra K Lueders L Smith R Hawley N Hozumi M Shulman 《Proceedings of the National Academy of Sciences of the United States of America》1983,80(7):1992-1996
We analyzed two functionally defective mouse kappa light chain gene variants previously shown to contain novel insertions of repetitive DNA in their intervening sequences [Hawley, R. G., Shulman, M. J., Murialdo, H., Gibson, D. M. & Hozumi, N. (1982) Proc. Natl. Acad. Sci. USA 79, 7425-7429]. Heteroduplex analysis of the cloned genes shows that the insertions consist of intracisternal A-particle (IAP) genetic elements. Each insertion includes an IAP 5' long terminal repeat (LTR) sequence and extends to a characteristic IAP internal BamHI site where the IAP sequence is interrupted because the mutant genes were cloned from complete BamHI digests of the cellular DNAs. Restriction enzyme mapping indicates that the 5' LTR boundaries of the inserted IAP elements correspond closely to the previously determined rearrangement sites in the mutant genes. The IAP insertions in the two mutants can be distinguished by restriction-site differences and by the fact that one of them contains a deletion that is absent in the other. Nucleotide sequence data are presented for the LTRs of one full-length IAP gene copy randomly selected from a mouse genomic DNA library. These LTRs show many features typical of known integrated retroviral terminal repeat units, and the entire gene is bracketed by short direct repeats within the adjacent cellular DNA. Thus, the findings show that IAP genetic elements can appear in new locations in mouse cellular DNA and suggest that this may occur through a process of proviral insertion. 相似文献
69.
Alison Brenner PhD MPH Kirsten Howard PhD Carmen Lewis MD MPH Stacey Sheridan MD MPH Trisha Crutchfield MHA MSIS Sarah Hawley PhD Dan Reuland MD MPH Christine Kistler MD MPH Michael Pignone MD MPH 《Journal of general internal medicine》2014,29(3):507-513
Purpose
To compare the effects of three methods of values clarification (VCM): balance sheet; rating and ranking; and a discrete choice experiment (DCE) on decision-making about colorectal cancer (CRC) screening among adults in the US and Australia.Methods
Using online panels managed by a survey research organization in the US and Australia, we recruited adults ages 50–75 at average risk for CRC for an online survey. Those eligible were randomized to one of the three VCM tasks. CRC screening options were described in terms of five key attributes: reduction in risk of CRC incidence and mortality; nature of the screening test; screening frequency; complications from screening; and chance of requiring a colonoscopy (as initial or follow-up testing). Main outcomes included self-reported most important attribute and unlabeled screening test preference by VCM and by country, assessed after the VCM.Results
A total of 920 participants were enrolled; 51 % were Australian; mean age was 59.0; 87.0 % were white; 34.2 % had a 4-year college degree; 42.8 % had household incomes less than $45,000 USD per year; 44.9 % were up to date with CRC screening. Most important attribute differed across VCM groups: the rating and ranking group was more likely to choose risk reduction as most important attribute (69.8 %) than the balance sheet group (54.7 %) or DCE (49.3 %), p < 0.0001; most important attribute did not vary by country (p = 0.236). The fecal occult blood test (FOBT)-like test was the most frequently preferred test overall (55.9 %). Unlabeled test choice did not differ meaningfully by VCM. Australians were more likely to prefer the FOBT (AU 66.2 % vs. US 45.1 %, OR 2.4, 95 % CI 1.8, 3.1). Few participants favored no screening (US: 9.2 %, AU: 6.2 %).Conclusions
Screening test attribute importance varied by VCM, but not by country. FOBT was more commonly preferred by Australians than by Americans, but test preferences were heterogeneous in both countries.Electronic supplementary material
The online version of this article (doi:10.1007/s11606-013-2701-0) contains supplementary material, which is available to authorized users.KEY WORDS: values clarification, colorectal cancer screening, patient decision support 相似文献70.
Nora Alhazmi Carroll Ann Trotman Matthew Finkelman Dillon Hawley Driss Zoukhri Evangelos Papathanasiou 《The Angle orthodontist》2019,89(4):637
Objectives:To investigate the relationship between salivary alkaline phosphatase activity (ALP), protein concentration, and chronological age with cervical vertebral maturation stages (CVMS) as noninvasive biomarkers for skeletal maturity assessment.Materials and Methods:This cross-sectional study included 79 subjects (48 females, 31 males; 7 to 23 years old) categorized into five CVMS based on lateral cephalographs evaluated by three examiners. ALP activity and protein concentration in unstimulated whole saliva were compared among five CVMS. The association between age and CVMS was assessed and five multinomial logistic regression models were utilized to predict CVMS based on salivary ALP activity, protein concentration, and chronological age.Results:Salivary ALP reached the peak at early pubertal stage and then declined with a significant difference between CVMS I and CVMS II (P < .001) and between CVMS I and CVMS V (P = .004). A significant positive correlation between age and CVMS was found (rs = 0.763, P < .001). The models'' overall correct classification rates for predicting CVMS were 32.9% using protein concentration, 35.4% using ALP activity, and 53.2% using both ALP activity and age.Conclusions:The combination of salivary ALP activity and chronological age may provide the best CVMS prediction. 相似文献