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Future Evaluation (future + evaluation)
Selected AbstractsThree-month Follow-up of Brief Computerized and Therapist Interventions for Alcohol and Violence Among TeensACADEMIC EMERGENCY MEDICINE, Issue 11 2009Rebecca M. Cunningham MD Abstract Objectives:, Alcohol use and violent behaviors are well documented among adolescents and have enormous effects on morbidity and mortality. The authors hypothesized that universal computer screening of teens in an inner-city emergency department (ED), followed by a brief intervention (BI), would be 1) feasible (as measured by participation and completion of BI during the ED visit) and well received by teens (as measured by posttest process measures of intervention acceptability) and 2) effective at changing known precursors to behavior change such as attitudes, self-efficacy, and readiness to change alcohol use and violence. Methods:, Adolescent patients (ages 14,18 years) at an urban ED were approached to complete a computerized survey. The survey was conducted daily from 12 noon to 11 pm from September 2006 through November 2008. Adolescents reporting both alcohol use and violence in the past year were randomized to a control group or a 35-minute BI delivered by a computer or therapist as part of the SafERteens study. Validated measures were administered, including demographics, alcohol use, attitudes toward alcohol and violence, self-efficacy for alcohol and violence, readiness to change alcohol and violence, and process questions, including likeability of intervention. Results:, A total of 2,423 adolescents were screened. Thirteen percent of those approached refused. The population was 45% male, 58% African American, and 6.2% Hispanic. Of those screened, 637 adolescents (26%) screened positive; 533 were randomized to participate, and 515 completed the BI prior to discharge. The BIs were well received by the adolescents overall; 97% of those randomized to a BI self-reported that they found one intervention section "very helpful." At posttest, significant reductions in positive attitudes for alcohol use and violence and significant increases in self-efficacy related to alcohol/violence were found for both therapist and computer interventions. At 3-month follow-up there was 81% retention, and generalized estimating equations (GEE) analysis showed that participants in both interventions had significant reductions in positive attitudes for alcohol use (therapist p = 0.002, computer p = 0.0001) and violence (therapist p = 0.012, computer p = 0.007) and significant increases in self-efficacy related to violence (therapist p = 0.0.04, computer p = 0.002); alcohol self-efficacy improved in the therapist BI condition only (therapist p = 0.050, computer p = 0.083). Readiness to change was not significantly improved. Conclusions:, This initial evaluation of the SafERteens study shows that universal computerized screening and BI for multiple risk behaviors among adolescents is feasible, well received, and effective at altering attitudes and self-efficacy. Future evaluations of the SafERteens study will evaluate the interventions' effects on behavioral change (alcohol use and violence) over the year following the ED visit. [source] Optimization of a flow cytometry-based protocol for detection and phenotypic characterization of multipotent mesenchymal stromal cells from human bone marrowCYTOMETRY, Issue 6 2006Elena A. Jones Abstract Background: To study the biology of rare bone marrow (BM) multipotent mesenchymal stromal cells (MSCs), recognized protocols are needed. Colony-forming unit-fibroblast (CFU-F) assays have historically been used for the enumeration of MSCs. However, the need to isolate and further analyze MSCs requires new strategies based on cell surface markers. The purpose of this work was to verify the phenotype of BM MSCs in vivo and to develop flow cytometry-based methods for their evaluation. Methods: Pre-enrichment with D7-FIB-conjugated microbeads, cell sorting for CD45lowD7-FIB+LNGFR+ cells, and CFU-F assay were used to confirm the phenotype of BM MSCs in vivo. Further phenotypic characterization of MSCs was performed using three-color flow cytometry following pre-enrichment or by direct four-color flow cytometry. The sensitivity of direct flow cytometry/rare event analysis for the accurate enumeration of MSCs was validated using 85 samples from patients with neoplastic BM diseases. Results: In normal BM, a significant correlation was found between the frequencies of CFU-Fs and CD45lowD7-FIB+LNGFR+ cells (n = 19, R = 0.719, P = 0.001). Following cell sorting, ,15% of these cells were clonogenic. The same cells were enriched using LNGFR-based positive selection, CD45/Glycophorin A-based depletion, or plastic adherence. CD45lowD7-FIB+LNGFR+ cells expressed classic makers of cultured MSCs CD73/SH3 and CD105/SH2 and markers of stromal reticular cells CD106/VCAM and alkaline phosphatase. Novel markers were identified including leukemia inhibitory factor receptor and gp130. CD45lowD7-FIB+LNGFR+ cells were increased fourfold in the floating fat fraction of normal BM aspirates. Their frequency was decreased in chronic lymphocytic leukemia (threefold, n = 13, P = 0.049) and chronic myelogenous leukemia (ninefold, n = 11, P = 0.001) compared with that in age-matched controls (n = 26 and n = 31, respectively). Conclusions: This study demonstrates the usefulness of flow cytometry-based methods for the detection, enumeration and further phenotypic analysis of BM MSCs. These findings have broad applications for the future evaluation of BM MSCs in health and disease. © 2006 International Society for Analytical Cytology [source] Shaking table tests of 1:4 reduced-scale models of masonry infilled reinforced concrete frame buildingsEARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 6 2001Abstract Two models of masonry infilled reinforced concrete frame buildings were tested at the shaking table. Models were built in the reduced scale 1:4 using the materials produced in accordance to modelling demands of true replica modelling technique. The first model represented a one-storey box-like building and the second one the two-stories building with plan shaped in the form of a letter H. Models were shaken with the series of horizontal sine dwell motions with gradually increasing amplitude. Masonry infills of tested models were constructed of relatively strong bricks laid in weak mortar. Therefore, typical cracks developed and propagated along mortar beds without cracking of bricks or crushing of infill corners. Data collected from tests will be used in future evaluation, verification and development of computational models for prediction of in-plane and out-of-plane behaviour of masonry infills. The responses of tested models can be well compared with global behaviour of real structures using the modelling rules. The similarity of local behaviour of structural elements, e.g. reinforced concrete joints, is less reliable due to limitations in modelling of steel reinforcement properties. The model responses showed that buildings designed according to Eurocodes are able to sustain relatively high dynamic excitations due to a significant level of structural overstrength. Copyright © 2001 John Wiley & Sons, Ltd. [source] Pemphigus mouse model as a tool to evaluate various immunosuppressive therapiesEXPERIMENTAL DERMATOLOGY, Issue 3 2009Yujiro Takae Abstract:, Pemphigus vulgaris (PV) is an autoimmune bullous disease caused by immunoglobulin G (IgG) autoantibodies against desmoglein 3 (Dsg3). We have generated an active disease mouse model for PV by adoptive transfer of Dsg3,/, lymphocytes. In this study, we investigated the benefits and limitations of this model as a tool to evaluate various immunosuppressive therapeutic strategies. We used the following three measurements to evaluate the effects of the drugs during the time course: Dsg3 enzyme-linked immunosorbent assay scores that represent the level of production of anti-Dsg3 IgG, body weight loss that reflects the severity of oral erosions and PV score that reflects the extent of skin lesions. We examined various immunosuppressive agents currently used to treat patients with PV model mice in preventive protocol. Cyclophosphamide almost completely suppressed the production of anti-Dsg3 IgG, development of body weight loss and the appearance of the PV phenotype in contrast with the control group without the drug. Azathioprine, cyclosporin A and tacrolimus hydrate also showed suppressive effects to various degrees. However, methylprednisolone and dexamethasone failed to show significant effects in contrast to the findings reported in humans. Knowing the advantages and limitations of this model will provide an important foundation for the future evaluation and development of novel therapeutic strategies. [source] Housing satisfaction for persons with psychiatric disabilitiesJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 6 2003Sam Tsemberis Provision of residential services to people with mental illness has assumed increasing importance since deinstitutionalization and as community- based services have increased. This large-scale multisite study of housing programs specifically for persons with mental illness examines one of the factors that lead to successful residential tenure for persons with serious mental illness. To date, the Lehman Quality of Life Scale has been used primarily to assess satisfaction with housing in studies of residential services. This article reports on a new measure of housing satisfaction. This new 25-item instrument was developed, field tested in a variety of housing settings across the country, and analyzed for reliability and validity by a group of housing researchers and clinicians. The implications of using this instrument for future evaluation and research on housing for persons with mental illness are examined. © 2003 Wiley Periodicals, Inc. J Comm Psychol 31: 581,590, 2003. [source] Hormone replacement therapy and cardiovascular disease: increased risks of venous thromboembolism and stroke, and no protection from coronary heart diseaseJOURNAL OF INTERNAL MEDICINE, Issue 5 2004G. D. O. Lowe Abstract. Hormone replacement therapy (HRT) was increasingly promoted over the last 40 years to improve quality of life, and to reduce the risks of osteoporotic fractures and coronary heart disease (CHD). In recent years, observational studies, randomized trials and systematic reviews of such trials have shown that HRT does not reduce, but actually increases cardiovascular risk. HRT increases the relative risks of venous thromboembolism (twofold), and of fatal or disabling stroke (by 50%); whilst increasing the early risk of myocardial infarction and having no protective effect against CHD on longer term use. Possible mechanisms for these increased cardiovascular risks include down-regulation of several inhibitory pathways of blood coagulation, resulting in increased coagulation activation, which promotes venous and arterial thrombosis. The implications for prescription are discussed, as are lessons for future evaluation of health care interventions. [source] Magnetic resonance image registration in multiple sclerosis: Comparison with repositioning error and observer-based variabilityJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 5 2002I Leng Tan MD Abstract Purpose To study the use of image registration in the analysis of multiple sclerosis (MS) lesion volume and compare this with repositioning error and observer-based variability. Materials and Methods The normalized mutual information (NMI) algorithm is evaluated in an accuracy study using a phantom, followed by a validation study on magnetic resonance (MR) data of MS patients. Further, using scan-rescan MR data, the effect of registration on MS lesion volume compared with repositioning error and observer-based variability is assessed. Results The registration accuracy was near perfect in the phantom study, while the in vivo validation study demonstrated an accuracy on the order of 0.2,0.3 mm. In the scan-rescan study, quantification accounted for 15.6% of the relative variance, repositioning for 44.4%, and registration for 40.0%. Conclusion NMI resulted in robust and accurate alignment of MR brain images of MS patients. Its use in the detection of changes in MS using large serial MR imaging (MRI) data warrants future evaluation. J. Magn. Reson. Imaging 2002;15:505,510. © 2002 Wiley-Liss, Inc. [source] Exposure of human peripheral blood lymphocytes to electromagnetic fields associated with cellular phones leads to chromosomal instabilityBIOELECTROMAGNETICS, Issue 2 2003Maya Mashevich Abstract Whether exposure to radiation emitted from cellular phones poses a health hazard is at the focus of current debate. We have examined whether in vitro exposure of human peripheral blood lymphocytes (PBL) to continuous 830 MHz electromagnetic fields causes losses and gains of chromosomes (aneuploidy), a major "somatic mutation" leading to genomic instability and thereby to cancer. PBL were irradiated at different average absorption rates (SAR) in the range of 1.6,8.8 W/kg for 72 hr in an exposure system based on a parallel plate resonator at temperatures ranging from 34.5,37.5 °C. The averaged SAR and its distribution in the exposed tissue culture flask were determined by combining measurements and numerical analysis based on a finite element simulation code. A linear increase in chromosome 17 aneuploidy was observed as a function of the SAR value, demonstrating that this radiation has a genotoxic effect. The SAR dependent aneuploidy was accompanied by an abnormal mode of replication of the chromosome 17 region engaged in segregation (repetitive DNA arrays associated with the centromere), suggesting that epigenetic alterations are involved in the SAR dependent genetic toxicity. Control experiments (i.e., without any RF radiation) carried out in the temperature range of 34.5,38.5 °C showed that elevated temperature is not associated with either the genetic or epigenetic alterations observed following RF radiation,the increased levels of aneuploidy and the modification in replication of the centromeric DNA arrays. These findings indicate that the genotoxic effect of the electromagnetic radiation is elicited via a non-thermal pathway. Moreover, the fact that aneuploidy is a phenomenon known to increase the risk for cancer, should be taken into consideration in future evaluation of exposure guidelines. Bioelectromagnetics 24:82,90, 2003. © 2003 Wiley-Liss, Inc. [source] Assessing Effective Care in Normal Labor: The Bologna ScoreBIRTH, Issue 2 2001Beverley Chalmers DSc(Med) The intention of the "Bologna score" is to quantify, both in an individual labor and in a wider population, the extent to which labors have been managed as if they are normal as opposed to complicated. In this way it may be possible to assess both attitudes and practices within a maternity service toward the effective care of normal labor. A scoring system for normal labor was proposed at the World Health Organization (Regional Office for Europe) Task Force Meeting on Monitoring and Evaluation of Perinatal Care, held in Bologna in January 2000. This paper describes conceptual development of the scale. Recommendations for future evaluation of the Bologna score's validity and potential include field testing globally, comparison with the Apgar score, and evaluation of the relative weight contributed by each of the five measures comprising the Bologna score. [source] Receptor activator of NF-,B ligand, macrophage inflammatory protein-1,, and the proteasomeCANCER, Issue S3 2003Novel therapeutic targets in myeloma Abstract BACKGROUND The bone destruction in myeloma patients is largely responsible for the clinical features of the disease. However, only recently has attention focused on identifying and developing drugs targeted specifically at the osteolysis. Receptor activator of NF-,B ligand (RANKL), macrophage inflammatory protein (MIP)-1,, and proteasomal function have been implicated in the pathogenesis of myeloma and associated bone disease. We provide "proof of principle" in preclinical myeloma models that these are indeed valid molecular targets in development of novel therapeutics. METHODS The efficacy of antagonists of RANKL and MIP-1, bioactivities (RANK.Fc and neutralizing monoclonal anti-MIP-1, antibody) in ameliorating osteolysis and reducing tumor burden was evaluated in a mouse model in which murine myeloma 5TGM1 cells are injected intravenously into syngeneic mice. In addition, the activity of a petidyl aldehyde proteasome inhibitor (proteasome inhibitor-1 [PSI]) on tumor growth was tested in a murine 5TGM1 plasmacytoma model and in mice intravenously inoculated with 5TGM1 cells. RESULTS RANK.Fc and anti-MIP-1, antibody inhibited the development and progression of osteolytic lesions and significantly reduced tumor load assessed by serum monoclonal paraprotein titers. Intratumoral injections of PSI inhibited growth of 5TGM1 plasmacytomas and induced tumor regression in some cases. In addition, systemic administration of PSI significantly prolonged time to onset of paraplegia in tumor-bearing mice. CONCLUSIONS The results highlight the critical roles of RANKL and MIP-1, in the development and progression of myeloma and provide a basis for future evaluation in myeloma patients of novel therapeutics that disrupt interactions of RANKL and MIP-1, with their cognate receptors. The data also suggest that further studies in preclincal myeloma models aimed at identifying other proteasome inhibitors with antitumor efficacy would be worthwhile. Cancer 2003;97(3 Suppl):813,7. © 2003 American Cancer Society. DOI 10.1002/cncr.11133 [source] Forage quality and tannin concentration and composition of a collection of the tropical shrub legume Flemingia macrophyllaJOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE, Issue 7 2006Meike S Andersson Abstract A collection of 23 Flemingia macrophylla (Willd.) Merrill accessions of different growth habits and contrasting digestibility and one Flemingia stricta reference accession were assessed for forage quality with particular emphasis on digestibility, condensed tannin concentration and fiber content. Large differences in in vitro dry matter digestibility (IVDMD) (356 to 598 g kg,1), content of crude protein (CP) (121 to 254 g kg,1) and extractable condensed tannins (CT) (0 to 268 g kg,1), protein-binding capacity of extractable CT or astringency (1.7 to 7.9 protein-binding entities) (PBE) and monomer composition of extractable CT were detected. IVDMD and extractable CT were negatively correlated and extractable CT was positively correlated with protein-binding capacity. Prodelphinidin was positively and propelargonidin negatively correlated with protein-binding capacity of extractable CT. The accessions CIAT 18438, CIAT 21083, CIAT 21090 and CIAT 22082 were superior to the most widely used accession CIAT 17403 in terms of forage quality and could be an option in production systems with acid infertile soils. In future evaluations, particular attention needs to be paid to chemical and structural features related to the composition of extractable CT and their effect on nitrogen utilization by ruminants. Copyright © 2006 Society of Chemical Industry [source] Treating Substance-Abusing Parents: A Study of the Pima County Family Drug Court ApproachJUVENILE AND FAMILY COURT JOURNAL, Issue 4 2004JOSÉ B. ASHFORD ABSTRACT A geographical comparison-group design was used to examine the effectiveness of the Pima County (Arizona) Court Assisted Treatment Services (CATS) program and its drug court intervention. The study compared the summary statistics for the volunteers to the family drug court (n=33) with a treatment-refusal group (n=42) and a treatment-as-usual group (n=45) from a matched geographical area. The findings of this study indicate that the family drug court group had higher engagement and completion rates of residential treatment than was true of the other comparison groups. In addition, the volunteers to the family drug court group had fewer parental rights severed, a higher percentage of permanency decisions reached within one year, earlier permanency decisions, and a higher percentage of children placed with their parents. The implications of this study's findings for future evaluations of the components of a family drug court intervention are discussed. [source] Evaluation of a teen dating violence social marketing campaign: Lessons learned when the null hypothesis was acceptedNEW DIRECTIONS FOR EVALUATION, Issue 110 2006Emily F. Rothman This chapter describes an evaluation of a teen dating violence prevention media campaign, including evaluation design and results, and the challenges that arose during the evaluation process. It makes recommendations for future evaluations of mass media campaigns that target adolescents. [source] Public,Private Partnerships: An International Performance ReviewPUBLIC ADMINISTRATION REVIEW, Issue 3 2007Graeme A. Hodge Public,private partnerships are enjoying a global resurgence in popularity, but there is still much confusion around notions of partnership, what can be learned from our history with partnerships, and what is new about the partnership forms that are in vogue today. Looking at one particular family of public,private partnerships, the long-term infrastructure contract, this article argues that evaluations thus far point to contradictory results regarding their effectiveness. Despite their continuing popularity with governments, greater care is needed to strengthen future evaluations and conduct such assessments away from the policy cheerleaders. [source] Gene therapy for lysosomal storage diseases: the lessons and promise of animal modelsTHE JOURNAL OF GENE MEDICINE, Issue 5 2004N. Matthew Ellinwood Abstract There are more than 40 different forms of inherited lysosomal storage diseases (LSDs) known to occur in humans and the aggregate incidence has been estimated to approach 1 in 7000 live births. Most LSDs are associated with high morbidity and mortality and represent a significant burden on patients, their families, and health care providers. Except for symptomatic therapies, many LSDs remain untreatable, and gene therapy is among the only viable treatment options potentially available. Therapies for some LSDs do exist, or are under evaluation, including heterologous bone marrow transplantation (BMT), enzyme replacement therapy (ERT), and substrate reduction therapy (SRT), but these treatment options are associated with significant concerns, including high morbidity and mortality (BMT), limited positive outcomes (BMT), incomplete response to therapy (BMT, ERT, and SRT), life-long therapy (ERT, SRT), and cost (BMT, ERT, SRT). Gene therapy represents a potential alternative therapy, albeit a therapy with its own attendant concerns. Animal models of LSDs play a critical role in evaluating the efficacy and safety of therapy for many of these conditions. Naturally occurring animal homologs of LSDs have been described in the mouse, rat, dog, cat, guinea pig, emu, quail, goat, cattle, sheep, and pig. In this review we discuss those animal models that have been used in gene therapy experiments and those with promise for future evaluations. Copyright © 2004 John Wiley & Sons, Ltd. [source] Benign breast lesions at risk of developing cancer,A challenging problem in breast cancer screening programsCANCER, Issue 3 2009Five years' experience of the Breast Cancer Screening Program in Verona (1999-2004) Abstract BACKGROUND: Cytology and core-needle biopsies are not always sufficient to exclude malignancy in benign breast lesions (BBL) that are at risk of developing cancer, and open biopsy often is mandatory. In screening programs, open biopsies performed for lesions that are at risk of developing malignancy are considered benign. The authors of this report evaluated the impact of the screen-detected BBL at risk of developing cancer that were counted in the quota of benign breast open biopsies in the Breast Cancer Screening Program of Verona. METHODS: Benign open biopsies were subdivided into 4 groups according to their risk of developing cancer: Histo1, normal histology; Histo2, ,pure' BBL (fibroadenoma, fibrocystic disease, mastitis, adenosis); Histo3, BBL with a low risk of developing cancer (radial scar, papilloma, papillomatosis, phyllodes tumor, mucocele-like lesion); and Histo4, BBL with a high risk of developing cancer (atypical columnar cell hyperplasia, atypical ductal hyperplasia, atypical lobular hyperplasia). RESULTS: Of 510 open biopsies, 83 biopsies were benign, and the ratio of benign to malignant biopsies was 1:5. Histo1 was observed in 4.8% of all benign open biopsies, Histo2 was observed in 37.4%, Histo3 was observed in 31.3%, and Histo4 was observed 26.5%. CONCLUSIONS: BBL at risk of developing cancer may be numerous in screening programs. It is inappropriate to include BBL at risk of developing cancer in the overall benign open biopsy rate. The authors propose separating pure BBL from lesions at higher risk of developing cancer. To date, there is no evidence to support the premise that detecting high-risk proliferative lesions leads to benefits in terms of reduced mortality; however, these lesions need to be counted separately for future evaluations. Cancer 2009. © 2008 American Cancer Society. [source] | |||||||||||||