Trajectories Of Daily Ptsd Symptoms In Recent Traumatic Injury Victims
assessment; care; checklist pcl; ecological momentary; growth analysis; latent class; posttraumatic stress disorder (PTSD); posttraumatic stress disorder (PTSD); Psychiatry; Psychology; PTSD symptom trajectories; resilience; scale; survivors; traumatic injury
Objective: Prior research has identified different PTSD symptom (PTSS)trajectories over months and years posttrauma that warrant different levels of clinical attention. Earlier identification of at-risk trauma victims can facilitate efficient and appropriate intervention efforts. Method: Using latent class growth analysis, we examined daily PTSS trajectories beginning 6 weeks postinjury in 68 injury victims. Resulting classes were compared on key characteristics at 6 and 21 weeks postinjury. Results: Three trajectories were identified: a nonreactive class (67.8%) with low initial symptom levels that remained low, a moderate-stable class (27.9%) with elevated symptom levels that remained constant, and a severe-increasing class (4.4%) with high symptom levels that increased. Conclusions: High-risk injury victims can be identified by their daily PTSS, allowing for early identification of those at risk for elevated distress and in greater need for intervention.
Hruska B; Pacella M L; George R L; Delahanty D L
Psychological Trauma-Theory Research Practice and Policy
2016
2016-11
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1037/tra0000145" target="_blank" rel="noreferrer noopener">10.1037/tra0000145</a>
Evaluation Of Functionally Meaningful Measures For Clinical Trials Of Cognition Enhancement In Schizophrenia
battery; matrics; Psychiatry; reliability; scale; standardization; validity
Objective: Because reduction of psychotic symptoms in schizophrenia does not result in adequate community functioning, efforts have shifted to other areas, such as cognitive impairment. The U. S. Food and Drug Administration requires that drugs for cognition enhancement in schizophrenia show improvement on two distinct outcome measures in clinical trials: an accepted cognitive performance battery and a functionally meaningful coprimary measure. The authors examined the reliability, validity, and practicality of functionally meaningful measures. Method: In this four-site validation study, schizophrenia patients were assessed at baseline (N= 166) and 4 weeks later (N= 144) on performance-based (Independent Living Scales, Test of Adaptive Behavior in Schizophrenia [TABS], and UCSD Performance-based Skills Assessment [UPSA]) and interview-based (Cognitive Assessment Interview and Clinical Global Impression Scale for Cognition) candidate coprimary measures. In addition, cognitive performance, community functioning, and clinical symptoms were assessed. Both full and short forms of the performance-based measures were evaluated. Results: All measures were well tolerated by patients, had adequate test-retest reliability, and showed good utility as a repeated measure. Measures differed in their correlation with cognitive performance, with performance-based measures having stronger correlations than interview-based measures. None of the measures had notable floor or ceiling effects or missing data. Conclusions: Among the full-form measures, the UPSA was judged to have the strongest overall properties. Among the short forms, the TABS and UPSA appeared to have the strongest features. Use of the short forms saves time, but at the cost of lower test-retest reliability and weaker correlations with cognitive performance.
Green M F; Schooler N R; Kern R S; Frese F J; Granberry W; Harvey P D; Karson C N; Peters R N N; Stewart M; Seidman L J; Sonnenberg J; Stone W S; Walling D; Stover E; Marder S R
American Journal of Psychiatry
2011
2011-04
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1176/appi.ajp.2010.10030414" target="_blank" rel="noreferrer noopener">10.1176/appi.ajp.2010.10030414</a>
A Randomized Trial Testing the Superiority of a Postdischarge Care Management Model for Stroke Survivors
Cardiovascular System & Cardiology; clinical-trials; follow-up; intervention; multiple end-points; Neurosciences & Neurology; outcomes; quality-of-life; randomized trial; rehabilitation; scale; Stroke care management; support
Objective: We sought to evaluate whether comprehensive postdischarge care management for stroke survivors is superior to organized acute stroke department care with enhanced discharge planning in improving a profile of health and well-being. Methods: This was a randomized trial of a comprehensive postdischarge care management intervention for patients with ischemic stroke and National Institutes of Health Stroke Scale scores greater than or equal to 1 discharged from an acute stroke department. An advanced practice nurse performed an in-home assessment for the intervention group from which an interdisciplinary team developed patient-specific care plans. The advanced practice nurse worked with the primary care physician and patient to implement the plan during the next 6 months. The intervention and usual care groups were compared using a global and closed hypothesis testing strategy. Outcomes fell into 5 domains: (1) neuromotor function, (2) institution time or death, (3) quality of life, (4) management of risk, and (5) stroke knowledge and lifestyle. Results: Treatment effect was near 0 SD for all except the stroke knowledge and lifestyle domain, which showed a significant effect of the intervention (P = .0003). Conclusions: Postdischarge care management was not more effective than organized stroke department care with enhanced discharge planning in most domains in this population. The intervention did, however, fill a postdischarge knowledge gap.
Allen K; Hazelett S; Jarjoura D; Hua K D; Wright K; Weinhardt J; Kropp D
Journal of Stroke & Cerebrovascular Diseases
2009
2009-11
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1016/j.jstrokecerebrovasdis.2009.02.002" target="_blank" rel="noreferrer noopener">10.1016/j.jstrokecerebrovasdis.2009.02.002</a>
DIMENSIONS OF CAREER DECIDEDNESS
anxiety; choice; college-students; Psychology; scale; vocational indecision
In two separate studies that factor analyzed nine measures of career decidedness taken by college freshmen, a single factor empirically defined choice status.
Savickas M L; Carden A D; Toman S; Jarjoura D
Measurement and Evaluation in Counseling and Development
1992
1992-10
Journal Article
n/a
Altered Mental Status and Delirium
adults; Altered mental status; cognitive impairment; confusion assessment method; delirium; Dementia; Elderly; elderly-patients; Emergency Medicine; Emergency Medicine; emergency-department patients; haloperidol; intensive-care-unit; Length of Stay; Medical decision-making capacity; scale; screening tools
Older patients who present to the emergency department frequently have acute or chronic alterations of their mental status, including their level of consciousness and cognition. Recognizing both acute and chronic changes in cognition are important for emergency physicians. Delirium is an acute change in attention, awareness, and cognition. Numerous life threatening conditions can cause delirium; therefore, prompt recognition and treatment are critical. The authors discuss an organized approach that can lead to a prompt diagnosis within the time constraints of the emergency department.
Wilber S T; Ondrejka J E
Emergency Medicine Clinics of North America
2016
2016-08
Journal Article
<a href="http://doi.org/10.1016/j.emc.2016.04.012" target="_blank" rel="noreferrer noopener">10.1016/j.emc.2016.04.012</a>
A Comparison of Quality-of-Life Domains and Clinical Factors in Ovarian Cancer Patients: A Gynecologic Oncology Group Study
carcinoma; chemotherapy; cytoreduction; functional assessment; General & Internal Medicine; Health Care Sciences & Services; intraperitoneal; Neurosciences & Neurology; ovarian-cancer; quality-of-life; scale; scores; therapy; trials
Context. Women diagnosed with ovarian cancer are at risk for reduced quality of life (QOL). It is imperative to further define these declines to interpret treatment outcomes and design appropriate clinical interventions. Objectives. The primary objective of this study was to compare data obtained from ovarian cancer patients with normative data to assess the degree to which QOL differs from the norm. Secondary objectives were to examine demographic variables and determine if there was a correlation between physical/functional and social/emotional scores during chemotherapy. Methods. Patients with Stage III/IV ovarian cancer on Gynecologic Oncology Group Protocols 152 and 172 who underwent surgery followed by intravenous paclitaxel and cisplatin completed the Functional Assessment of Cancer Therapy-Ovarian. The Functional Assessment of Cancer Therapy scale includes the four domains of physical, functional, social, and emotional well-being (PWB, FWB, SWB, and EWB, respectively). Results. Ovarian cancer patients had a total QOL (Functional Assessment of Cancer Therapy-General) score similar to the U.S. female adult population. However, the reported subscale scores were 2.0 points (95% confidence interval [Cl] 1.4-2.5, P< 0.001, effect size = 0.37) lower in PWB, 0.9 points (95% CI 0.3-1.5, P= 0.005, effect size = 0.13) lower in FWB, 5.0 points (95% CI 4.6-5.3, P< 0.001, effect size = 0.74) higher in SWB, and 0.8 points (95% CI 0.3-1.2, P< 0.001, effect size = 0.16) lower in EWB. Correlation between the sum of PWB and FWB and the sum of SWB and EWB was r= 0.53 (P< 0.001). Age was positively correlated with EWB (r= 0.193; 95% CI 0.09-0.29). Conclusion. Ovarian cancer patients have decreased QOL in physical, functional, and emotional domains; however, they may compensate with increased social support. At the time of diagnosis and treatment, patients' QOL is affected by inherent characteristics. Assessment of treatment outcomes should take into account the effect of these independent variables. J Pain Symptom Manage 2010;39:839-846. (C) 2010 US. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved
Von Gruenigen V E; Huang H Q; Gil K M; Gibbons H E; Monk B J; Rose P G; Armstrong D K; Cella D; Wenzel L
Journal of Pain and Symptom Management
2010
2010-05
Journal Article
<a href="http://doi.org/10.1016/j.jpainsymman.2009.09.022" target="_blank" rel="noreferrer noopener">10.1016/j.jpainsymman.2009.09.022</a>
DISSOCIATION PHENOMENA AND AGE
age differences; dissociation; multiple personality; multiple personality-disorder; Psychiatry; Psychology; scale
Younger and older subjects selected from non-psychiatric populations were administered two scales to determine frequency of dissociation. Younger subjects were found to dissociate more frequently than older subjects, suggesting that dissociative experiences become less common with increasing age.
Torem M S; Hermanowski R W; Curdue K J
Stress Medicine
1992
1992-01
Journal Article
<a href="http://doi.org/10.1002/smi.2460080104" target="_blank" rel="noreferrer noopener">10.1002/smi.2460080104</a>
STRESSORS AND WELL-BEING AMONG CAREGIVERS TO OLDER ADULTS WITH DEMENTIA - THE IN-HOME VERSUS NURSING-HOME EXPERIENCE
alzheimers-disease; burden; care; caregiving stress; family caregiving; family member; Geriatrics & Gerontology; hassles; institutionalization; long-term care; nursing-homes; predictors; scale
Stephens M A P; Kinney J M; Ogrocki P K
Gerontologist
1991
1991-04
Journal Article
<a href="http://doi.org/10.1093/geront/31.2.217" target="_blank" rel="noreferrer noopener">10.1093/geront/31.2.217</a>
Global Health Partnerships for Continuing Medical Education: Lessons from Successful Partnerships
continuing medical education; cooperation; experience; global health; Health Care Sciences & Services; internet; life long learning; partnerships; physicians; professionals; russia; scale; trust; virtual cardiac symposia; worldwide
The past decade has witnessed an increase in global partnerships created to strengthen health systems and provide training to health professionals in low- and middle-income countries. These partnerships are complex interventions. This study focused on unpacking the characteristics of global partnerships that provide continuing education for health professionals. A realist approach underpinned the research design to identify the mechanisms that shape successful global partnerships. Two case studies focusing on global continuing medical education (CME) were studied longitudinally using a realist evaluation approach. To complement that finding, published research reports of global CME partnerships were synthesized using a realist synthesis approach. Data were collected over a three-year period and included interviews, participant observations, document reviews, and surveys. A hybrid thematic approach guided the data analysis. The study results suggested that global CME partnerships are highly dependent on human factors. On the one hand, motivational factors related to individual players help to shape the partnership goals, directions, and outcomes. On the other hand, relational factors such as trust, communication, and understanding play a key role in developing and sustaining global partnerships. As such, these partnerships highly rely on the individuals who champion the partnership at the country level or at the partnership level and in their ability to build relationships as well as empower key stakeholders.
Sriharan A; Harris J; Davis D; Clarke M
Health Systems & Reform
2016
2016
Journal Article
<a href="http://doi.org/10.1080/23288604.2016.1220776" target="_blank" rel="noreferrer noopener">10.1080/23288604.2016.1220776</a>
The MATRICS consensus cognitive battery, part 1: Test selection, reliability, and validity
improve cognition; memory; performance; programs; Psychiatry; Rehabilitation; scale; schizophrenia; severe mental-illness; support
Objective: The lack of an accepted standard for measuring cognitive change in schizophrenia has been a major obstacle to regulatory approval of cognition-enhancing treatments. A primary mandate of the National institute of Mental Health's Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative was to develop a consensus cognitive battery for clinical trials of cognition-enhancing treatments for schizophrenia through a broadly based scientific evaluation of measures. Method: The MATRICS Neurocognition Committee evaluated more than 90 tests in seven cognitive domains to identify the 36 most promising measures. A separate expert panel evaluated the degree to which each test met specific selection criteria. Twenty tests were selected as a beta battery. The beta battery was administered to 176 individuals with schizophrenia and readministered to 167 of them 4 weeks later so that the 20 tests could be compared directly. Results: The expert panel ratings are presented for the initially selected 36 tests. For the beta battery tests, data on test-retest reliability, practice effects, relationships to functional status, practicality, and tolerability are presented. Based on these data, 10 tests were selected to represent seven cognitive domains in the MATRICS Consensus Cognitive Battery. Conclusions: The structured consensus method was a feasible and fair mechanism for choosing candidate tests, and direct comparison of beta battery tests in a common sample allowed selection of a final consensus battery. The MATRICS Consensus Cognitive Battery is expected to be the standard tool for assessing cognitive change in clinical trials of cognition-enhancing drugs for schizophrenia. it may also aid evaluation of cognitive remediation strategies.
Nuechterlein K H; Green M F; Kern R S; Baade L E; Barch D M; Cohen J D; Essock S; Fenton W S; Frese F J; Gold J M; Goldberg T; Heaton R K; Keefe R S E; Kraemer H; Mesholam-Gately R; Seidman L J; Stover E; Weinberger D R; Young A S; Zalcman S; Marder S R
American Journal of Psychiatry
2008
2008-02
Journal Article
<a href="http://doi.org/10.1176/appi.ajp.2007.07010042" target="_blank" rel="noreferrer noopener">10.1176/appi.ajp.2007.07010042</a>