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Jakobsson, Jan G., and Mark Z. Johnson. "Perioperative regional anaesthesia and postoperative longer-term outcomes." F1000Research 5 (October 11, 2016): 2501. http://dx.doi.org/10.12688/f1000research.9100.1.
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Regional anaesthesia provides effective anaesthesia and analgesia in the perioperative setting. Central neuraxial blocks—that is, spinal and epidural blocks—are well established as an alternative or adjunct to general anaesthesia. Peripheral blocks may be used as part of multimodal anaesthesia/analgesia in perioperative practice, reducing the need for opioid analgesics and enhancing early recovery. Furthermore, regional anaesthesia has increased in popularity and may be done with improved ease and safety with the introduction of ultrasound-guided techniques. The effects of local anaesthetics and regional anaesthesia on long-term outcomes such as morbidity, mortality, the quality of recovery beyond the duration of analgesia, and whether it can expedite the resumption of activities of daily living are less clear. It has also been suggested that regional anaesthesia may impact the risk of metastasis after cancer surgery. This article provides an overview of current evidence around quality of recovery, risk for delirium, long-term effects, and possible impact on cancer disease progression associated with the clinical use of local and regional anaesthetic techniques. In summary, there is still a lack of robust data that regional anaesthesia has a clinical impact beyond its well-acknowledged beneficial effects of reducing pain, reduced opioid consumption, and improved quality of early recovery. Further high-quality prospective studies on long-term outcomes are warranted.
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Hyslop, Dean R., and Wilbur Townsend. "The Longer‐term Impacts of Job Displacement on Labour Market Outcomes in New Zealand." Australian Economic Review 52, no. 2 (December 31, 2018): 158–77. http://dx.doi.org/10.1111/1467-8462.12312.
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Reynolds, Rebecca M., and Adrienne Gordon. "Obesity, fertility and pregnancy: can we intervene to improve outcomes?" Journal of Endocrinology 239, no. 3 (December 2018): R47—R55. http://dx.doi.org/10.1530/joe-18-0199.
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Rates of obesity among women of reproductive age have risen dramatically in recent decades. Obesity impacts on health of women across their reproductive lifespan with adverse effects on not only fertility and short-term complications of pregnancy, but also on longer term health outcomes for both women and their children. This places considerable burden and cost on health services. Here, we review the evidence linking maternal obesity to adverse fertility, pregnancy and longer term health outcomes for women and their children. We discuss the outcomes of recent lifestyle, pharmacological and surgical intervention studies. As many of these studies have not shown a significant improvement in clinical outcomes, we discuss the need for better study design in future trials.
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Fryer, Roland G., and Lawrence F. Katz. "Achieving Escape Velocity: Neighborhood and School Interventions to Reduce Persistent Inequality." American Economic Review 103, no. 3 (May 1, 2013): 232–37. http://dx.doi.org/10.1257/aer.103.3.232.
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This paper reviews the evidence on the efficacy of neighborhood and school interventions in improving the long-run outcomes of children growing up in poor families. We focus on studies exploiting exogenous sources of variation in neighborhoods and schools and which examine at least medium-term outcomes. Higher-quality neighborhoods improve family safety, adult subjective well-being and health, and girls' mental health. But they have no detectable impact on youth human capital, labor market outcomes, or risky behaviors. In contrast, higher-quality schools can improve children's academic achievement and can have longer-term positive impacts of increasing educational attainment and earnings and reducing incarceration and teen pregnancy.
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Deemer, Alexa R., Jack H. Drake, Connor P. Littlefield, and Kenneth A. Egol. "Surgeon Volume Impacts Outcomes Following Ankle Fracture Repair." Foot & Ankle Orthopaedics 7, no. 3 (July 2022): 247301142211167. http://dx.doi.org/10.1177/24730114221116790.
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Background: The purpose of this study was to determine the impact of surgeon volume on outcomes following ankle fracture fixation. Methods: Over 7 years, 362 patients who met inclusion criteria (>18 years with rotational ankle fractures) were identified and treated by orthopaedic surgeons at several hospitals within an academic medical center and were retrospectively reviewed. Surgeons that completed less than 24 ankle fixations per year (<90th percentile) during the study period were classified as low-volume (LV) and surgeons completing 24 or more ankle fixations per year (>90th percentile) were classified as high-volume (HV). Chart review was conducted to gather data regarding perioperative, radiographic, inpatient, and long-term outcome data (average 12-month follow-up). Results: One hundred thirty-four patients (37.0%) were treated by LV surgeons and 228 (63.0%) were treated by HV surgeons. Although both cohorts had a similar breakdown of fracture patterns ( P = .638), the LV cohort had a greater incidence of open fractures ( P = .024). No differences were found regarding wait time to surgery, surgery duration, and LOS. Radiographically, more patients in the HV cohort achieved anatomic mortise after surgery (96.5% vs 89.6%, P = .008). Patients in the LV cohort took longer to heal radiographically (4.27 ± 2.4 months vs 5.59 ± 2.9 months, P < .001), and also had higher rates of reoperation and hardware removal ( P < .05). Lastly, all cost variables were lower for high-volume surgeons ( P < .05). Conclusion: In this single-center study, we found that patients treated by LV surgeons took 30% longer to heal radiographically and had greater reoperation rates than those treated by HV surgeons. Additionally, patients treated by high-volume surgeons had more anatomic postoperative radiographic ankle mortise reductions and was less cost-effective than when performed by high-volume surgeons. Level of Evidence: Level III, retrospective comparative study.
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Rodríguez-Planas, Núria. "Longer-Term Impacts of Mentoring, Educational Services, and Learning Incentives: Evidence from a Randomized Trial in the United States." American Economic Journal: Applied Economics 4, no. 4 (October 1, 2012): 121–39. http://dx.doi.org/10.1257/app.4.4.121.
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This paper reports on a randomized evaluation of a program designed to improve high school graduation and postsecondary education enrollment among low-performing high school students. Treated youths were offered mentoring, educational services, and financial rewards. The program was evaluated when the youths were 19, 21, and 24 years old. Treated youths obtained their high school diplomas earlier and were more likely than controls to attend postsecondary education. Five years after the end of the program, we find no significant overall effects of this intervention on employment outcomes. The program improved outcomes to a greater extent for the female enrollees than the male ones. (JEL D83, I21, I28, J13)
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Leeds, Lesley, Jolyon Meara, and Peter Hobson. "The impact of discharge to a care home on longer term stroke outcomes." Clinical Rehabilitation 18, no. 8 (December 2004): 924–28. http://dx.doi.org/10.1191/0269215504cr807oa.
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Uleberg, O., K. Pape, T. Kristiansen, P. R. Romundstad, and P. Klepstad. "Population-based analysis of the impact of trauma on longer-term functional outcomes." British Journal of Surgery 106, no. 1 (September 17, 2018): 65–73. http://dx.doi.org/10.1002/bjs.10965.
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Patnaik, Ankita, Michael Levere, Gina Livermore, Arif Mamun, and Jeffrey Hemmeter. "Promoting Readiness of Minors in Supplemental Security Income (PROMISE): Early Impacts from a Multi-Site Random Assignment Evaluation." Evaluation Review 45, no. 5 (October 2021): 228–70. http://dx.doi.org/10.1177/0193841x211055588.
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Background PROMISE was a federal initiative to support youth receiving Supplemental Security Income (SSI) during the transition to adulthood. Objectives This article presents estimates of the impacts of the six PROMISE projects on youth and family outcomes as of 18 months after enrolling in PROMISE. Research Design The study uses a randomized controlled trial design. Subjects The six PROMISE projects each enrolled a minimum of 2000 treatment and control youth (and their parents) residing in their service areas who were aged 14 to 16 and receiving SSI. Measures We estimated impacts on outcomes related to youth and family service use, school enrollment, training, employment, earnings, and federal disability program participation using survey and administrative data. Results The projects succeeded in connecting more youth to transition services and more families to support services during the 18 months after enrollment, and most increased the likelihood that youth applied for state vocational rehabilitation services. On average, there was no impact on youth’s school enrollment, but there were favorable impacts on youth’s receipt of job-related training, employment, earnings, and total income. The projects did not affect parents’ employment, earnings, or income, on average. For most outcomes PROMISE affected, the impacts varied substantially across the projects. Conclusions The positive short-term impacts of PROMISE on youth’s use of transition services, youth employment, and families’ use of services are consistent with the program logic model and suggest there might be potential for longer-term favorable impacts on youth and family outcomes.
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Pages, Remy, Dylan J. Lukes, Drew H. Bailey, and Greg J. Duncan. "Elusive Longer-Run Impacts of Head Start: Replications Within and Across Cohorts." Educational Evaluation and Policy Analysis 42, no. 4 (August 24, 2020): 471–92. http://dx.doi.org/10.3102/0162373720948884.
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Using an additional decade of data from the National Longitudinal Survey of Youth 1979 Children and Young Adults (CNLSY), this study replicated and extended Deming’s evaluation of Head Start’s life cycle skill formation impacts in three ways. Extending the measurement interval for Deming’s adulthood outcomes, we found no statistically significant impacts on earnings and mixed evidence of impacts on other adult outcomes. Applying Deming’s sibling comparison framework to more recent birth cohorts born to CNLSY mothers revealed mostly negative Head Start impacts. Combining all cohorts showed generally null impacts on school-age and early adulthood outcomes.
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Alizadeh, Reza Fazl, Zhobin Moghadamyeghaneh, Matthew D. Whealon, Mark H. Hanna, Steven D. Mills, Alessio Pigazzi, Michael J. Stamos, and Joseph C. Carmichael. "Body Mass Index Significantly Impacts Outcomes of Colorectal Surgery." American Surgeon 82, no. 10 (October 2016): 930–35. http://dx.doi.org/10.1177/000313481608201015.
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There are limited data regarding the association between body mass index (BMI) and colorectal surgery outcomes. We sought to evaluate the effect of BMI on short-term surgical outcomes in colon and rectal surgery patients in the United States. The American College of Surgeons National Surgery Quality Improvement Project database was used to identify all patients who underwent colon or rectal resection from 2005 to 2013. Multivariate regression analysis was used to assess the independent effect of BMI on outcomes. A total of 206,360 patients underwent colorectal resection during the study period. Of these, 3.2 per cent of patients were underweight (BMI < 18.5), 23.8 per cent patients were normal weight (18.5 ≤, BMI < 25), 26.5 per cent were overweight (25 ≤, BMI < 30), 25.2 per cent were obese (30 ≤, BMI < 40), and 5.3 per cent were morbidly obese (BMI ≥ 40). Underweight patients had longer length of stay (confidence interval: 2.70–3.49, P < 0.001) and higher mortality (adjusted odds ratio: 1.45, P < 0.01) compared with patients with a normal BMI. Morbidly obese patients had the highest overall morbidity rate compared with normal BMI patients (adjusted odds ratio: 1.53, confidence interval: 1.42–1.64, P < 0.01). BMI is associated with outcomes in colon and rectal surgery patients. Underweight and morbidly obese patients have a significantly increased risk of postsurgical complications compared with those with normal BMI.
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Attwood, Sophie, and Cother Hajat. "How will the COVID-19 pandemic shape the future of meat consumption?" Public Health Nutrition 23, no. 17 (August 12, 2020): 3116–20. http://dx.doi.org/10.1017/s136898002000316x.
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AbstractSince its recent onset, the COVID-19 pandemic has altered the daily lives of millions around the world. One area particularly affected is our diets, with food supply chain disruptions, media coverage of food safety issues and restaurant closures all influencing consumer dietary behaviour. Given this situation, we pose a timely question – what is the impact of the current pandemic on longer-term meat consumption patterns? This issue is pertinent given accumulating evidence that overconsumption of meat, particularly red meat, is associated with negative environmental and health outcomes. Here, we discuss how the current pandemic has already begun to shift public awareness of illnesses linked to animals and has resulted in short-term changes in patterns of meat consumption. Past zoonotic outbreaks, such as SARS and swine flu, are also referred to, and we find that these led to similar short-term reductions in meat intake, a shift in the type of meat chosen and longer-lasting impacts on consumer perceptions of the health risks associated with meat. We conclude that, if immediate changes in eating patterns as a result of COVID-19 are retained in the longer term, one possible opportunity to emerge from the current pandemic may be a shift away from overconsumption of meat, leading to potential health and environmental benefits in the longer term.
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Stolwyk, Renerus J., Tijana Mihaljcic, Dana K. Wong, Jodie E. Chapman, and Jeffrey M. Rogers. "Poststroke Cognitive Impairment Negatively Impacts Activity and Participation Outcomes." Stroke 52, no. 2 (February 2021): 748–60. http://dx.doi.org/10.1161/strokeaha.120.032215.
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This systematic review and meta-analysis aimed to investigate whether cognition is associated with activity and participation outcomes in adult stroke survivors. Five databases were systematically searched for studies investigating the relationship between general- and domain-specific cognition and longer-term (>3 months) basic activities of daily living (ADL), instrumental ADLs, and participation outcomes. Eligibility for inclusion, data extraction, and study quality was evaluated by 2 reviewers using a standardized protocol. Effect sizes ( r ) were estimated using a random-effects model. Sixty-two publications were retained for review, comprising 7817 stroke survivors (median age 63.57 years, range:18–96 years). Median length of follow-up was 12 months (range: 3 months–11 years). Cognition (all domains combined) demonstrated a significant medium association with all 3 functional outcomes combined, r =0.37 (95% CI, 0.33–0.41), P <0.001. Moderator analyses revealed these effects persisted regardless of study quality, order in which outcomes were collected (sequential versus concurrent), age, sample size, or follow-up period. Small to medium associations were also identified between each individual cognitive domain and the separate ADL, instrumental ADL, and participation outcomes. In conclusion, poststroke cognitive impairment is associated with early and enduring activity limitations and participation restrictions, and the association is robust to study design factors, such as sample size, participant age, follow-up period, or study quality. Cognitive assessment early poststroke is recommended to facilitate early detection of disability, prediction of functional outcomes, and to inform tailored rehabilitation therapies.
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Kelley, Scott R., Emilie Duchalais, and David W. Larson. "Short-Term Outcomes with Robotic Right Colectomy." American Surgeon 84, no. 11 (November 2018): 1768–73. http://dx.doi.org/10.1177/000313481808401133.
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Few series have reported on the impact of robotic right colectomy compared with conventional laparoscopy. Even fewer have reported on the outcomes of intracorporeal anastomoses. The aim of our study was to determine the impact of robotic surgery on short-term operative outcomes in patients undergoing right colectomy with intracorporeal anastomosis. One hundred and fourteen consecutive patients who underwent a right colectomy by two colorectal surgeons between 2012 and 2017 were included. Patients were separated into two groups: laparoscopic technique with extracorporeal anastomosis (n = 87) and robotic technique with intracorporeal anastomosis (n = 27). Univariate analysis was performed to determine differences in outcomes. Differences between cohorts were only identified with regard to gender (62 vs 37%, P = 0.022) and year of surgery. In comparison with laparoscopy, robotic colectomy resulted in a shorter time of GI recovery (1.3 ± 0.6 vs 3 ± 1.1, P < 0.0001), lower rates of postoperative ileus (4 vs 28%, P = 0.007), lower overall morbidity (26 vs 52%, P = 0.019), less blood loss ( P = 0.001), 50 per cent lower narcotic use, and longer operative time (255 ± 66 vs 139 ± 49, P < 0.001). Despite longer operative time, robotic surgery improved GI recovery, significantly lowered oral morphine equivalent usage, and decreased short-term complications.
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White, C., J. Stirling, R. Hopkins, J. Morris, L. Montague, D. Tantam, and S. Lewis. "Predictors of 10-year outcome of first-episode psychosis." Psychological Medicine 39, no. 9 (February 3, 2009): 1447–56. http://dx.doi.org/10.1017/s003329170800514x.
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BackgroundPredictors of outcome for psychosis are poorly understood. Duration of untreated psychosis (DUP) appears to predict short-term outcome although its medium- to long-term role remains unclear. Neurodevelopmental indices such as pre-morbid function and/or neurological soft signs may predict longer-term outcome. We aimed to assess the impact of a range of clinical and demographic variables on long-term outcome of a geographically defined, epidemiological first-episode psychosis cohort.MethodA 10-year follow-up was undertaken of a consecutively presenting sample of 109 cases of first-episode psychosis aged 16–50 years. Baseline assessments included positive, negative and depression symptoms, DUP, neurological soft signs and pre-morbid functioning. Multi-dimensional outcomes were assessed blind to baseline data.ResultsAll participants were traced at a mean of 10.5 years post-index admission: 11 had died, 10 from non-natural causes. Of the surviving cases, 70% were comprehensively re-assessed by interview. Summary data on the remainder were collected from their family practitioner and chart review. Poor 10-year outcomes were predicted independently by poor pre-morbid functioning, baseline negative symptoms and longer DUP. The same measures, plus neurological soft signs, appeared to predict outcomes in a DSM-IV schizophrenia/schizo-affective subgroup.ConclusionsPoor pre-morbid functioning, baseline symptoms, DUP and neurological soft signs at onset independently predict poor long-term outcome in first-episode psychosis.
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Rajaratnam, D., K. Hyun, C. Wong, M. Garcia, J. Lau, H. Lowe, A. Yong, L. Kritharides, D. Brieger, and P. Roy. "Impact of Racial Background on Longer-Term Outcomes in Patients Undergoing Contemporary Percutaneous Coronary Intervention." Heart, Lung and Circulation 30 (2021): S309—S310. http://dx.doi.org/10.1016/j.hlc.2021.06.483.
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Cohodes, Sarah R. "The Long-Run Impacts of Specialized Programming for High-Achieving Students." American Economic Journal: Economic Policy 12, no. 1 (February 1, 2020): 127–66. http://dx.doi.org/10.1257/pol.20180315.
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I evaluate long-run academic impacts of specialized programming for high-achieving students by analyzing Advanced Work Class (AWC), an accelerated curriculum delivered in dedicated classrooms for fourth through sixth graders in Boston Public Schools. Fuzzy regression discontinuity estimates show that AWC has positive yet imprecise impacts on test scores and improves longer-term outcomes, increasing high school graduation and college enrollment. These gains are driven by black and Latino students. An analysis of mechanisms highlights the importance of staying “on track” throughout high school, with little evidence that AWC gains result from peer effects. (JEL H75, I21, I28, J15)
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Atuhaire, Patience, Sean S. Brummel, Blandina Theophil Mmbaga, Konstantia Angelidou, Lee Fairlie, Avy Violari, Gerhard Theron, et al. "The impact of short term Antiretroviral Therapy (ART) interruptions on longer term maternal health outcomes—A randomized clinical trial." PLOS ONE 15, no. 1 (January 30, 2020): e0228003. http://dx.doi.org/10.1371/journal.pone.0228003.
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Smith, David Horton. "The Global Historical and Contemporary Impacts of Voluntary Membership Associations on Human Societies." Voluntaristics Review 2, no. 5-6 (April 25, 2018): 1–125. http://dx.doi.org/10.1163/24054933-12340019.
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AbstractReviewed here is global research on how 13 types of Voluntary Membership Associations (MAs) have significantly or substantially had global impacts on human history, societies, and life. Such outcomes have occurred especially in the past 200+ years since the Industrial Revolution circa 1800 CE, and its accompanying Organizational Revolution. Emphasized are longer-term, historical, and societal or multinational impacts of MAs, rather than more micro-level (individual) or meso-level (organizational) outcomes. MAs are distinctively structured, with power coming from the membership, not top-down. The author has characterized MAs as the dark matter of the nonprofit/third sector, using an astrophysical metaphor. Astrophysicists have shown that most physical matter in the universe is dark in the sense of being unseen, not stars or planets.
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Rutherford, Amanda, and Thomas Rabovsky. "Evaluating Impacts of Performance Funding Policies on Student Outcomes in Higher Education." ANNALS of the American Academy of Political and Social Science 655, no. 1 (August 10, 2014): 185–208. http://dx.doi.org/10.1177/0002716214541048.
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Concerns about performance and cost efficiency have taken center stage in discussions about the funding and oversight of public universities in recent years. One of the primary manifestations of these concerns is the rise of performance funding policies, or policies that seek to directly link state appropriations to the outcomes institutions generate for students. Despite the popularity of these policies, relatively little systematic research examines their effect on student outcomes at public colleges and universities. We use data collected from the Integrated Postsecondary Education Data System (IPEDS) to analyze the effectiveness of performance funding policies as a mechanism for improving student graduation, persistence, and degree attainment in more than 500 postsecondary institutions in all fifty states over a span of 18 years. We find that current performance funding policies are not associated with higher levels of student performance and that these policies may in fact contribute to lower performance over a longer period of time. However, more recent policies linked to institutional base funding may produce some likelihood of long-term improvement and require additional research.
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Li, Amy Y., and Alec I. Kennedy. "Performance Funding Policy Effects on Community College Outcomes: Are Short-Term Certificates on the Rise?" Community College Review 46, no. 1 (December 8, 2017): 3–39. http://dx.doi.org/10.1177/0091552117743790.
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Objective: Performance funding (PF) policies allocate a portion of state funding to colleges based on student outcomes. This study is the first to account for policy type and design differences, and explores the impact of performance funding on three levels of credential completions: short-term certificates, medium-term certificates, and associate’s degrees. Method: We create a panel dataset of 751 two-year colleges from years 1990 to 2013 using data from the Integrated Postsecondary Education Data System. We conduct a series of analyses using difference-in-differences with the inclusion of college- and state-level control variables. Results: We find that, on average, performance funding produces no significant changes in completions of any of the three credentials. Policy types characterized by a greater proportion of funding tied to the base budget, mission differentiation in performance metrics, inclusion of underrepresented student metrics, and longer periods of operating years produce an increase in short-term certificates, no significant change in medium-term certificates, and a decrease in associate’s degrees. Contributions: This study’s findings suggest that because awarding more short-term certificates is a relatively quick and cost-effective way to capture performance funds, colleges might be engaging in a path of least resistance by churning out short-term certificates and redirecting focus away from associate’s degrees, which is concerning given that short-term certificates generally offer limited labor market benefits compared to medium-term certificates and associate’s degrees. Our results also underscore the importance of policy designs in explaining differential impacts on credential completion.
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Bettinger, Eric, Oded Gurantz, Laura Kawano, Bruce Sacerdote, and Michael Stevens. "The Long-Run Impacts of Financial Aid: Evidence from California’s Cal Grant." American Economic Journal: Economic Policy 11, no. 1 (February 1, 2019): 64–94. http://dx.doi.org/10.1257/pol.20170466.
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We examine the long-term impacts of California’s state-based financial aid by tracking educational and labor force outcomes for up to 14 years after high school graduation. We identify program impacts by exploiting variation in eligibility rules using GPA and family income cutoffs that are ex ante unknown to applicants. Aid eligibility increases undergraduate and graduate degree completion, and for some subgroups, raises longer-run annual earnings and the likelihood that young adults reside in California. These findings suggest that the net cost of financial aid programs may frequently be overstated, though our results are too imprecise to provide exact cost-benefit estimates. (JEL H75, I21, I22, I23, I26, I28)
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Zanoni, Wladimir, and Anna D. Johnson. "Child Care Subsidy Use and Children’s Outcomes in Middle School." AERA Open 5, no. 4 (October 2019): 233285841988454. http://dx.doi.org/10.1177/2332858419884540.
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This article examines associations between child care subsidy use in early childhood and children’s middle school outcomes. Using a unique database linking administrative records of child care subsidy receipt with parental earnings, social assistance data, and students’ public school outcomes, we generate quasi-experimental estimates of subsidy effects on children’s reading and math test scores and school absences in third through eighth grades. Findings suggest that subsidies are associated with reduced absenteeism in seventh and eighth grades and with increased reading and math scores in third grade, but only for the subset of children whose subsidies were used to attend licensed center- or home-based care. Results provide initial evidence for longer term impacts of the child care subsidy program on children’s school performance.
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Bachmann, C., J. Beecham, T. O’Connor, J. Briskman, and S. Scott. "A good investment: longer-term cost savings of sensitive parenting in childhood." European Psychiatry 65, S1 (June 2022): S423. http://dx.doi.org/10.1192/j.eurpsy.2022.1074.
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Introduction Good quality parenting in early childhood is reliably associated with positive mental and physical health over the lifespan. Objectives The hypothesis that early parenting quality has significant long-term financial benefits has not been previously tested. Methods Design: Longitudinal study with follow-up from 2012 to 2016; UK multicentre study cohort. Participants: 174 young people drawn from 2 samples, one at moderate risk of poor outcomes and one at high risk, assessed aged 4–6 years then followed up in early adolescence (mean age 12.1 years). Measures: The primary outcome was total costs: health, social care, extra school support, out-of-home placements and family-born expenditure, determined through semistructured economic interviews. Early parenting quality was independently assessed through direct observation of parent–child interaction. Results Costs were lower for youths exposed to more sensitive parenting (most sensitive quartile mean £1,619, least sensitive quartile mean £21,763; p < .001). Costs were spread across personal family expenditure and education, health, social and justice services. The cost difference remained significant after controlling for several potential confounders. These included demographic variables (family poverty, parental education); exposure to child abuse; and child/young person variables including level of antisocial behaviour in both childhood and adolescence, IQ and attachment security. Conclusions This study is the first showing that more sensitive early parental care predicts lower costs to society many years later, independent of poverty, child and youth antisocial behaviour levels and IQ. The findings provide novel evidence for the public health impact of early caregiving quality and likely financial benefits of improving it. Disclosure No significant relationships.
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Warren, Amy, Trudi Marchant, Darcee Schulze, and Donna Chung. "From Economic Abuse to Economic Empowerment: Piloting a Financial Literacy Curriculum With Women Who Have Experienced Domestic and Family Violence." Affilia 34, no. 4 (August 11, 2019): 498–517. http://dx.doi.org/10.1177/0886109919868828.
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Economic abuse as a form of men’s violence against women has only been recently recognized as a form of violence in its own right. It is known to further exacerbate the detrimental long-term impacts of domestic and family violence on women and children. There is evidence to suggest the effectiveness of financial literacy programs in mitigating some of these impacts and improving women’s financial well-being in the longer term; however, there are very few domestic violence–informed, empirically evaluated programs internationally. This article reports the findings of a specialist domestic violence financial literacy curriculum, which was developed and piloted in Western Australia using pre–post measures and focus groups. These findings suggest that such financial literacy programs delivered in refuge settings have effective short-term outcomes among women. Lessons learned from the pilot and the implications for future implementation and scaling up of programs and research are also discussed.
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Hirata, Katsuya, Masatoshi Nozaki, Narutaka Mochizuki, Shinya Hirano, and Kazuko Wada. "Impact of Time to Neonatal Transport on Outcomes of Transient Tachypnea of the Newborn." American Journal of Perinatology 36, no. 10 (December 14, 2018): 1090–96. http://dx.doi.org/10.1055/s-0038-1676490.
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Objective To assess effects of neonatal transport on transient tachypnea of the newborn (TTN) in outborn term neonates. Study Design This retrospective cohort study included 66 term neonates diagnosed with TTN and transported to the Osaka Women's and Children's Hospital neonatal intensive care unit between January 2003 and March 2018. A multivariate logistic regression analysis identified perinatal and neonatal transport factors associated with adverse short-term outcomes defined as mechanical ventilation >48 hours, continuous positive airway pressure >72 hours, pulmonary hemorrhage, and requirement for inhaled nitric oxide, thoracentesis, or surfactant replacement therapy. Results A lower gestational age (GA) (37.7 [37.2, 38.3] vs. 39.6 [37.8, 40.3] weeks, p = 0.002), longer time to neonatal transport (10.0 [4.3, 25.5] vs. 5.5 [2.7, 9.7] hours, p = 0.01), and higher respiratory rates during transport (70 [60, 85] vs. 60 [55, 78.8] breaths/min, p = 0.04) were significantly associated with adverse short-term outcomes. After adjusting for GA, sex, cesarean section, and time to neonatal transport, GA (odds ratio [OR], 0.37; 95% confidence interval [CI], 0.24–0.87) and time to neonatal transport (OR, 1.07; 95% CI, 1.01–1.13) were significantly associated with adverse outcomes. Conclusion Short-term adverse prognosis of TTN is strongly associated with a lower GA and longer time between birth and neonatal transport.
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Ashford, Nathaniel K., Jamie Oh, Kara McMullen, Gretchen J. Carrougher, Sean A. Hickey, Colleen M. Ryan, Jeffrey C. Schneider, Nicole S. Gibran, and Barclay T. Stewart. "114 Long Term Impact of Hospital Acquired Multi-drug Resistant Organisms on Health-related Quality of Life." Journal of Burn Care & Research 43, Supplement_1 (March 23, 2022): S73—S74. http://dx.doi.org/10.1093/jbcr/irac012.116.
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Abstract Introduction MDROs colonize wounds and cause infections for hospitalized burn patients, which may lead to increased infection risk, wound complications, longer (LOS) and more cost. Little is known about the long-term impacts of MDRO colonization and infection on burn survivors. We aimed to describe the impacts of colonization on long-term health-related quality of life (HRQoL), itch, and pain. Methods Data from adult participants in a multicenter longitudinal outcome study were used. Data was described and χ 2 and Kruskal-Wallis testing was applied to determine differences between the two groups. Outcomes included Veterans RAND 12 (VR-12) physical component summary score (PCS), and PROMIS 29 domains for pain intensity, fatigue, pain interference, physical function, and sleep disturbance. Pruritus was assessed using the 4-D Itch scale for total itch. Multilevel, multiple linear regressions were used for outcome measures at 6 m post-injury. Random effects regression with robust standard errors (SE) were used to evaluate the impacts over time. Results The study included 704 individuals and 92 were MDRO colonized (13%). Colonized patients had larger burns (25% TBSA, IQR 9-45 vs. 8% TBSA, IQR 3–20; p < .001), more operations (4, IQR 2-7 vs. 1, IQR 1-3; p < .001), more grafting (17% TBSA, IQR 3-46 vs. 3% TBSA, IQR 1- 9; p < .001), more ventilator days (2, IQR 0–8 vs. 0 IQR 0-0; p < .001), and longer LOS (34 days, IQR 17 – 64 vs. 16, IQR 9 - 27; p < .001). Adjusting for confounding covariables, such as demographics, colonization was associated with a lower PCS score (OR -0.33, 95% CI -0.68, -0.06; p=.018); a higher fatigue score (OR 0.46, 95% CI 0.13, 0.79; p = .007) and worse itch (OR 0.4, 95% CI -0.01, 0.75; p = .036). There was no association with pain intensity, pain interference, or sleep disturbance. Random effects regression indicated that colonization was associated with lower PCS (OR -5.0, 95% CI -8.60, -1.39; p = .007). Conclusions Impact of colonization extends beyond the immediate hospitalization and likely has long-term effects on HRQoL. Given our observation of lower physical function after MDRO, more granular research on taxa-specific effects, timing of colonization, and interventions are indicated to elucidate the impact on HRQoL.
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Owens, Caroline, Tammy Reasoner, and Amy Webb Girard. "Preliminary Impacts of a Produce Prescription Program in South Georgia." Current Developments in Nutrition 6, Supplement_1 (June 2022): 854. http://dx.doi.org/10.1093/cdn/nzac065.038.
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Abstract Objectives Identify short-term changes in food security, dietary patterns, and biometrics following a six-week nutrition education and produce prescription intervention in South Georgia. Methods The Open Hand Atlanta Cooking Matters Produce Prescription Program adopts a holistic approach to a nutrition intervention by combining cooking classes, nutrition education, and weekly boxes of local produce over a six-month period. Baseline and six-week program data collected in South Georgia during 2021 were used to examine changes in food security and dietary patterns among program graduates (n = 62). Results Using paired t-tests for numerical outcomes and McNemar's tests for categorical food security, we examined participants’ reported changes in dietary outcomes. After six weeks of nutrition education and receiving local produce boxes, program participants reported increased consumption of dark greens, non-fried vegetables, and beans, alongside reduced consumption of fried foods and meals away from home. However, these changes were not statistically significant among our sample. Similarly, program participants reported non-statistically significant improvements in food security. Composite scores of healthy consumption, healthy purchasing, and resource management all improved from baseline to six-week follow-up with statistically significant improvements in healthy purchasing behaviors. Conclusions Among our sample, six weeks of nutrition education and produce receipt resulted in statistically significant changes in healthy purchasing behaviors and improvements across a suite of other dietary variables. Further longitudinal follow-up will examine longer-term changes associated with the produce prescription program. Funding Sources Open Hand Atlanta.
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Rose, Sean C., Keith Owen Yeates, Joseph T. Nguyen, Patrick M. Ercole, Natalie M. Pizzimenti, and Matthew T. McCarthy. "Subconcussive Head Impacts and Neurocognitive Function Over 3 Seasons of Youth Football." Journal of Child Neurology 36, no. 9 (April 9, 2021): 768–75. http://dx.doi.org/10.1177/08830738211004490.
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Objective: To determine the association between repetitive subconcussive head impacts and neurobehavioral outcomes in youth tackle football players. Methods: Using helmet-based sensors, we measured head impacts for 3 consecutive seasons of play in 29 male players age 9-11. Cumulative impact g’s were calculated. Players completed a battery of outcome measures before and after each season, including neuropsychological testing, vestibular-ocular sensitivity, and self- and parent-reported measures of symptoms and attention-deficit hyperactivity disorder (ADHD). Results: Average cumulative impact over 3 seasons was 13 900 g. High-intensity hits predicted worse change for self-reported social adjustment ( P = .001). Cumulative impact did not predict change in any of the outcome measures. History of ADHD, anxiety, and depression predicted worse change for self-reported symptoms and social adjustment, independent of head impacts. When players were stratified into 3 groups based on cumulative impact across all 3 seasons, differences in outcome measures existed prior to the start of the first season. These differences did not further increase over the course of the 3 seasons. Conclusion: Over 3 consecutive seasons of youth tackle football, we found no association between cumulative head impacts and neurobehavioral outcomes. Larger sample sizes and longer follow-up times would further assist in characterizing this relationship.
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Jackson, C. Kirabo, Shanette C. Porter, John Q. Easton, Alyssa Blanchard, and Sebastián Kiguel. "School Effects on Socioemotional Development, School-Based Arrests, and Educational Attainment." American Economic Review: Insights 2, no. 4 (December 1, 2020): 491–508. http://dx.doi.org/10.1257/aeri.20200029.
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Using value-added models on data from Chicago Public Schools, we find that high schools impact students' self-reported socioemotional development (SED) by enhancing social well-being and promoting hard work. Conditional on their test score impacts, schools that improve SED in ninth grade reduce school-based arrests and increase high school completion and college going. For most longer-run outcomes, using both SED and test score value added more than doubles the variance of the explained school effect relative to using test score value added alone. Results suggest that high school impacts on SED can be captured using self-report surveys and SED can be fostered by schools to improve longer-run outcomes. (JEL I21, J24, K42)
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Macdiarmid, Jennie I., Jennifer Loe, Flora Douglas, Anne Ludbrook, Caroline Comerford, and Geraldine McNeill. "Developing a timeline for evaluating public health nutrition policy interventions. What are the outcomes and when should we expect to see them?" Public Health Nutrition 14, no. 4 (August 16, 2010): 729–39. http://dx.doi.org/10.1017/s1368980010002168.
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AbstractObjectiveTo develop a timeline for evaluating public health nutrition policy interventions.DesignConcept mapping, a stakeholder-driven approach for developing an evaluation framework to estimate the ‘time to impact’ for policy interventions. The Schools (Health Promotion and Nutrition) (Scotland) Act 2007 was used as the model to develop the evaluation timeline as it had typical characteristics of government policy. Concept mapping requires stakeholders to generate a list of the potential outcomes, sort and rate the outcomes. Multidimensional scaling and hierarchical cluster data analysis were used to develop an anticipated timeline to impact for the policy.SettingUnited Kingdom.SubjectsOne hundred and eleven stakeholders representing nutrition, public health, medicine, education and catering in a range of sectors: research, policy, local government, National Health Service and schools.ResultsEighty-five possible outcomes were identified and grouped into thirteen clusters describing higher-level themes (e.g. long-term health, food literacy, economics, behaviour, diet, education). Negative and unintended consequences were anticipated relatively soon after implementation of the policy, whereas positive outcomes (e.g. dietary changes, health benefits) were thought likely to take longer to emerge. Stakeholders responsible for implementing the legislation anticipated that it would take longer to observe changes than those from policy or research.ConclusionsDeveloping an anticipated timeline provides a realistic framework upon which to base an outcome evaluation for policy interventions and identifies positive and negative outcomes as well as considering possible unintended consequences. It offers benefit to both policy makers and researchers in mapping the progress expected towards long-term health goals and outcomes.
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Lee, Ju Young, Hyun Jung Lee, Yong Kyun Kim, Shinae Yu, Jiwon Jung, Yong Pil Chong, Sang-Oh Lee, et al. "Impact of Fluoroquinolone Exposure Prior to Tuberculosis Diagnosis on Clinical Outcomes in Immunocompromised Patients." Antimicrobial Agents and Chemotherapy 60, no. 7 (April 18, 2016): 4005–12. http://dx.doi.org/10.1128/aac.01749-15.
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ABSTRACTThere have been concerns about an association of fluoroquinolone (FQ) use prior to tuberculosis (TB) diagnosis with adverse outcomes. However, FQ use might prevent clinical deterioration in missed TB patients, especially in those who are immunocompromised, until they receive definitive anti-TB treatment. All adult immunocompromised patients with smear-negative and culture-positive TB at a tertiary care hospital in Korea over a 2-year period were included in this study. Long-term FQ (≥7 days) use was defined as exposure to FQ for at least 7 days prior to TB diagnosis. A total of 194 patients were identified: 33 (17%) in the long-term FQ group and 161 (83%) in the comparator, including a short-term FQ group (n= 23), non-FQ group (n= 78), and a group receiving no antibiotics (n= 60). Patients in the long-term FQ group presented with atypical chest radiologic pattern more frequently than those in the comparator (77% [24/31] versus 46% [63/138];P= 0.001). The median time from mycobacterial test to positive mycobacterial culture appeared to be longer in the long-term FQ group (8.1 weeks versus 7.7 weeks;P= 0.09), although the difference was not statistically significant. Patients in the long-term FQ group were less likely to receive empirical anti-TB treatment (55% versus 74%;P= 0.03). The median time from mycobacterial test to anti-TB therapy was longer in the long-term FQ group (4.6 weeks versus 2.2 weeks;P< 0.001), but there was no significant difference in FQ resistance (0% versus 3%;P> 0.99) or in the 30-day (6% versus 6%;P> 0.99) or 90-day (12% versus 12%;P> 0.99) mortality rate between the two groups. FQ exposure (≥7 days) prior to TB diagnosis in immunocompromised patients appears not to be associated with adverse outcomes.
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Saavedra-Rivano, Neantro. "Mankind at a Crossroads." International Journal of Software Science and Computational Intelligence 12, no. 3 (July 2020): 28–37. http://dx.doi.org/10.4018/ijssci.2020070103.
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The focus of this article is an examination of the impact that sentience of AI systems would have on mankind. Although the notion of sentience for AI systems is subject to controversy, we believe that its plausibility confers a sense of urgency to the kind of exercise developed here. For completeness, the article distinguishes the near-future and longer-term impacts of artificial intelligence. While the short-term impact is deemed to be mostly positive, the outlook for longer-term impact is considered to be negative under a variety of scenarios, including the adoption of man-machine symbiosis tools. The main reason for the negative outlook in the latter case is the heterogeneity of the world. This implies that only a privileged minority would benefit from symbiosis, an outcome that makes likely a world dominated by a minority of “superhumans.” These conclusions should not be taken lightly, and this article endeavors to raise the attention of scientists and policymakers. In this connection, the paper offers suggestions as to policy measures which could avert this disastrous outlook.
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Michalsen, Andreas, Chenying Li, Katharina Kaiser, Rainer Lüdtke, Larissa Meier, Rainer Stange, and Christian Kessler. "In-Patient Treatment of Fibromyalgia: A Controlled Nonrandomized Comparison of Conventional Medicine versus Integrative Medicine including Fasting Therapy." Evidence-Based Complementary and Alternative Medicine 2013 (2013): 1–7. http://dx.doi.org/10.1155/2013/908610.
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Fibromyalgia poses a challenge for therapy. Recent guidelines suggest that fibromyalgia should be treated within a multidisciplinary therapy approach. No data are available that evaluated multimodal treatment strategies of Integrative Medicine (IM). We conducted a controlled, nonrandomized pilot study that compared two inpatient treatment strategies, an IM approach that included fasting therapy and a conventional rheumatology (CM) approach. IM used fasting cure and Mind-Body-Medicine as specific methods. Of 48 included consecutive patients, 28 were treated with IM, 20 with CM. Primary outcome was change in the Fibromyalgia Impact Questionnaire (FIQ) score after the 2-week hospital stay. Secondary outcomes included scores of pain, depression, anxiety, and well being. Assessments were repeated after 12 weeks. At 2 weeks, there were significant improvements in the FIQ (P<0.014) and for most of secondary outcomes for the IM group compared to the CM group. The beneficial effects for the IM approach were reduced after 12 weeks and no longer statistically significant with the exception of anxiety. Findings indicate that a multimodal IM treatment with fasting therapy might be superior to CM in the short term and not inferior in the mid term. Longer-term studies are warranted to assess the clinical impact of integrative multimodal treatment in fibromyalgia.
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Stockly, Olivia, Audrey E. Wolfe, Gretchen J. Carrougher, Barclay T. Stewart, Nicole S. Gibran, Karen J. Kowalske, Jeffrey C. Schneider, Colleen M. Ryan, and Steven E. Wolf. "81 Inhalation Injury Is Associated with Long-term Physical, Satisfaction with Life, and Employment Outcomes: A Longitudinal National Database Study." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S52—S53. http://dx.doi.org/10.1093/jbcr/iraa024.085.
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Abstract Introduction The effects of inhalation injury on mortality are well established. However, little is known about the long-term impacts of inhalation injuries on survivors. This study aims to describe the inhalation injury population and examine differences in long-term physical, mental, employment, and satisfaction with life outcomes between adult burn survivors with and without inhalation injury. Methods Data from the Burn Model System National Database (1993–2019) were analyzed. Demographic and clinical characteristics of those with and without inhalation injury were assessed. The Physical Health Composite Scale (PCS) and Mental Health Composite Scale (MCS) of the Short Form-12 Health Survey, Employment Status, and Satisfaction with Life Scale (SWLS) were analyzed at 24 months post-injury. Regression analyses assessed whether inhalation injury was associated with each outcome, which were adjusted for age, gender, race, ethnicity, and burn size. Results The analysis included 4,045 individuals (452 with inhalation injury, 3,593 without inhalation injury). Those with inhalation injury had larger burn size, longer hospital lengths of stay, and more operations; they were less likely to be employed at injury and injured at work, and took longer to gain employment after injury (Table 1). Two years after injury, individuals with inhalation injury were half as likely to be working (OR = 0.49, p< 0.001), and had worse PCS (β=-2.51, p=0.021) and SWL scores (β=-2.35, p=0.006) compared to those without inhalation injury. MCS scores did not differ between groups. Conclusions Burn survivors with inhalation injuries experience lower rates of employment, worse physical functioning, and worse satisfaction with life outcomes at 24 months post-injury compared to those without inhalation injuries. Applicability of Research to Practice Burn survivors with an inhalation injury may require supplementary resources and treatment as well as monitoring of sequelae long-term.
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Brown, David W., Amanda E. Kowalski, and Ithai Z. Lurie. "Long-Term Impacts of Childhood Medicaid Expansions on Outcomes in Adulthood." Review of Economic Studies 87, no. 2 (July 25, 2019): 792–821. http://dx.doi.org/10.1093/restud/rdz039.
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Abstract We use administrative data from the Internal Revenue Service to examine long-term impacts of childhood Medicaid eligibility expansions on outcomes in adulthood at each age from 19 to 28. Greater Medicaid eligibility increases college enrolment and decreases fertility, especially through age 21. Starting at age 23, females have higher contemporaneous wage income, although male increases are imprecise. Together, both genders have lower mortality. These adults collect less from the earned income tax credit and pay more in taxes. Cumulatively from ages 19 to 28, at a 3% discount rate, the federal government recoups 58 cents of each dollar of its “investment” in childhood Medicaid.
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Murphy, Catherine, Jayasree Nair, Brian Wrotniak, Emily Polischuk, and Shamim Islam. "Antibiotic Treatments and Patient Outcomes in Necrotizing Enterocolitis." American Journal of Perinatology 37, no. 12 (July 15, 2019): 1250–57. http://dx.doi.org/10.1055/s-0039-1693429.
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Abstract Objective This study aimed to examine the impact of different antibiotic treatments on necrotizing enterocolitis (NEC) outcomes. Study Design Patient outcomes, including total parenteral nutrition and hospitalization durations, abdominal surgeries, intestinal strictures, and mortality data, were analyzed and compared by various antibiotic groups and treatment durations for 160 NEC patients managed at the Women and Children's Hospital of Buffalo between 2008 and 2016. Results Fourteen different antibiotics were used for NEC, most commonly ampicillin, gentamicin, and metronidazole (AGM). Medical (vs. surgical) NEC patients more likely received AGM (37 vs. 6%, p < 0.001). Surgical (vs. medical) NEC patients more likely received vancomycin (80 vs. 30%, p < 0.001) and antipseudomonal agents (69 vs. 15%, p < 0.001). For medical NEC there were no outcome differences between patients receiving only AGM versus those receiving other treatments; in patients receiving AGM, there were no outcome differences in durations of ≤10 days versus longer courses. Conclusion Antibiotic use for NEC varies substantially without definite outcome differences. Particularly with medical NEC, AGM for ≤10 days had comparable outcomes to other treatments. In light of growing concern for short and longer term adverse effects with early-life antibiotic exposure, narrow-spectrum and shorter course NEC treatment may be preferred.
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McCormick, Meghan P., Robin Neuhaus, E. Parham Horn, Erin E. O’Connor, Hope I. White, Samantha Harding, Elise Cappella, and Sandee McClowry. "Long-Term Effects of Social–Emotional Learning on Receipt of Special Education and Grade Retention: Evidence From a Randomized Trial of INSIGHTS." AERA Open 5, no. 3 (July 2019): 233285841986729. http://dx.doi.org/10.1177/2332858419867290.
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Social–Emotional Learning (SEL) programs are school-based preventive interventions that aim to improve children’s social–emotional skills and behavioral development. Although meta-analytic research has shown that SEL programs can improve academic and behavioral outcomes in the short term, few studies have examined program effects on receipt of special education services and grade retention in the longer term. Using an experimental design, the current study leveraged administrative data available through students’ school records (N = 1,634) to examine the impacts of one SEL program implemented in kindergarten and first grade on receipt of special education and grade retention in fifth grade. The study further considered whether impacts varied for low- versus high-income students. Findings revealed no difference between treatment and control group students in grade retention. However, treatment group students were less likely to ever receive special education services by the end of fifth grade, with low-income students appearing to drive this effect. Implications are discussed.
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Mach, Markus, Matthias Koschutnik, Manuel Wilbring, Bernhard Winkler, Matthias Reinweber, Konstantin Alexiou, Utz Kappert, et al. "Impact of COPD on Outcome in Patients Undergoing Transfemoral versus Transapical TAVI." Thoracic and Cardiovascular Surgeon 67, no. 04 (April 4, 2019): 251–56. http://dx.doi.org/10.1055/s-0039-1685177.
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Objective The purpose of this study was to evaluate the impact of chronic obstructive pulmonary disease (COPD) on clinical outcomes in patients referred for transfemoral (TF) as well as transapical (TA) aortic valve implantation and furthermore to delineate possible advantages of the TF access. Methods One thousand eight hundred forty-two patients undergoing transcatheter aortic valve implantation (TAVI) at two study centers were included in the present analysis. The outcome was measured and classified according to Valve Academic Research Consortium-II criteria. Kaplan–Meier estimate was used to assess long-term survival. Results The present analysis suggests that COPD has limited influence on post-procedural outcome after TAVI. Comparing the TF to TA approach, no significant difference on the impact of COPD on clinical outcomes has been found, except for longer post-procedural ventilation times in COPD patients treated via TA access (p < 0.001). Conclusions COPD in patients referred for TAVI procedure was associated with poorer overall long-term survival, thus characterizing a high-risk population for futile treatment; however, the selection of access did not result in a significant difference in most Valve Academic Research Consortium-II-defined clinical outcomes in COPD patients.
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Bartels, Chantal, Jeffrey Thorne, Reeva B. Makhijani, Grow R. Daniel, John Nulsen, Claudio Benadiva, and Lawrence Engmann. "Longer duration of progesterone elevation adversely impacts pregnancy outcomes during IVF in women ≤ 40 years." Fertility and Sterility 112, no. 3 (September 2019): e197. http://dx.doi.org/10.1016/j.fertnstert.2019.07.633.
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Berk, Michael, Lisa P. Henry, Kathryn S. Elkins, Susy M. Harrigan, Meredith G. Harris, Helen Herrman, Henry J. Jackson, and Patrick D. McGorry. "The Impact of Smoking on Clinical Outcomes After First Episode Psychosis: Longer-Term Outcome Findings From the EPPIC 800 Follow-Up Study." Journal of Dual Diagnosis 6, no. 3-4 (December 30, 2010): 212–34. http://dx.doi.org/10.1080/15504263.2010.537498.
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Mokher, Christine G., Toby J. Park-Gaghan, and Shouping Hu. "Accelerating to Success: The Impact of Florida's Developmental Education Reform on Credit Accumulation." Teachers College Record: The Voice of Scholarship in Education 122, no. 12 (December 2020): 1–38. http://dx.doi.org/10.1177/016146812012201206.
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Background/Context Underprepared students at community colleges are often assigned to a sequence of developmental education courses that can substantially delay, or even halt, their progress to degree completion. In 2014, Florida implemented a comprehensive reform under Senate Bill (SB) 1720 that allowed the majority of incoming students to enroll directly into college-level courses, while remaining developmental education courses were offered in new instructional modalities that were designed to be completed more quickly than traditional semester-long courses. Colleges provided extensive advising and academic support services intended to help students succeed while progressing at a more accelerated pace. Purpose/Objective/Research Question/Focus of Study In this study, we examined the impact of Florida's developmental education reform on early momentum. More specifically, we defined early momentum as student success in early outcomes (such as the number of credits attempted and earned), which may set students on a promising long-term trajectory on subsequent postsecondary outcomes. Population/Participants/Subjects Our sample included all first-time-in-college students enrolled in all 28 public state colleges. We included three cohorts of students before the reform and up to three cohorts of students after the reform. Each cohort consisted of approximately 70,000 students. Research Design We used an interrupted time series design to compare student outcomes three years before the reform with those up to three years after the reform. Our outcome variables, measured one and three years following initial college enrollment, represented continuous indicators for the number of college-level credits attempted and the number of college-level credits earned. We also examined whether the data revealed heterogeneity in the reform's impacts by race/ethnicity, family income status, and level of high school academic preparation. Findings/Results We found small positive effects on all outcomes, indicating that the reform accelerated student success in both the short term and longer term. The impacts of the reform were even greater for Black, Hispanic, Indigenous, low-income, and underprepared students (particularly in the first year), thus reducing existing achievement gaps. Conclusions/Recommendations Florida's SB 1720 consisted of a complementary set of reform efforts that may together have a larger impact than any single component alone. The results suggest that initial momentum gains in the first year may have set some students on a more successful long-term trajectory, particularly those most likely to be assigned to developmental education before the reform. Colleges should continue to provide comprehensive student support services to help students succeed while progressing at a more accelerated pace.
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Kerns, Becky K., Michelle A. Day, and Dana Ikeda. "Long-Term Seeding Outcomes in Slash Piles and Skid Trails after Conifer Removal." Forests 11, no. 8 (August 1, 2020): 839. http://dx.doi.org/10.3390/f11080839.
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Conifer removal in interior woodland ecosystems of the western US is a common management treatment used to decrease fire hazard and shift woodlands to more historical states. Woody material is frequently removed by skidding material off site and via slash pile burning. Assessing the long-term outcomes of seeding treatments after such ground disturbing activities is critical for informing future management and treatment strategies. Using two designed experiments from a central Oregon juniper woodland, we resampled slash piles and skid trails 8 years after seeding. Our objectives were to assess the long-term vegetation response to conifer removal, ground disturbance, and seeding source (cultivar and local) in slash piles and skid trails. We found that seeded species persisted in the long term, but abundance patterns depended on the species, seed source, and the type of disturbance. In general, there were more robust patterns of persistence after pile burning compared to skid trails. Seeding also suppressed exotic grass cover in the long term, particularly for the local seed source. However, the invasion levels we report are still problematic and may have impacts on biodiversity, forage and fire behavior. Our short-term results were not predictive of longer-term outcomes, but short- and long-term patterns were somewhat predictable based on species life history traits and ecological succession. The use of a mix of species with different life history traits may contribute to seeding success in terms of exotic grass suppression. Lastly, our results suggest that locally adapted seed sources may perform as well or better compared to cultivars. However, more aggressive weed treatments before and after conifer removal activities and wider seeding application may be needed to effectively treat exotic grass populations.
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Hull, Marie, and Katherine Duch. "One-to-One Technology and Student Outcomes: Evidence From Mooresville’s Digital Conversion Initiative." Educational Evaluation and Policy Analysis 41, no. 1 (September 21, 2018): 79–97. http://dx.doi.org/10.3102/0162373718799969.
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This article uses a difference-in-differences strategy to evaluate the impact of a one-to-one laptop program. Teaching practices changed with the introduction of the program, and the district worked to make wireless Internet more accessible in the community. We find that while short-term impacts of the program were statistically insignificant, math scores improved by 0.13 standard deviations in the medium term. Time spent on homework stayed constant, but students spent more of their homework time using a computer. We also investigate the impact of the program on other measures of student behavior as well as heterogeneity in impacts. A limitation of this study is that we cannot distinguish which aspects of the program were most important in improving student outcomes.
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Holt, Kelly, Imran Khan Niazi, Imran Amjad, Nitika Kumari, Usman Rashid, Jens Duehr, Muhammad Samran Navid, Muhammad Shafique, and Heidi Haavik. "The Effects of 4 Weeks of Chiropractic Spinal Adjustments on Motor Function in People with Stroke: A Randomized Controlled Trial." Brain Sciences 11, no. 6 (May 21, 2021): 676. http://dx.doi.org/10.3390/brainsci11060676.
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Chiropractic spinal adjustments have been shown to result in short-term increases in muscle strength in chronic stroke patients, however, the effect of longer-term chiropractic spinal adjustments on people with chronic stroke is unknown. This exploratory study assessed whether 4 weeks of chiropractic spinal adjustments, combined with physical therapy (chiro + PT), had a greater impact than sham chiropractic with physical therapy (sham + PT) did on motor function (Fugl Meyer Assessment, FMA) in 63 subacute or chronic stroke patients. Secondary outcomes included health-related quality of life and other measures of functional mobility and disability. Outcomes were assessed at baseline, 4 weeks (post-intervention), and 8 weeks (follow-up). Data were analyzed using linear mixed-effects models or generalized linear mixed models. A post-hoc responder analysis was performed to investigate the clinical significance of findings. At 4 weeks, there was a larger effect of chiro + PT, compared with sham + PT, on the FMA (difference = 6.1, p = 0.04). The responder analysis suggested the improvements in motor function seen following chiropractic spinal adjustments may have been clinically significant. There was also a robust improvement in both groups in most measures from baseline to the 4- and 8-week assessments, but between-group differences were no longer significant at the 8-week assessment. Four weeks of chiro + PT resulted in statistically significant improvements in motor function, compared with sham + PT, in people with subacute or chronic stroke. These improvements appear to be clinically important. Further trials, involving larger group sizes and longer follow-up and intervention periods, are required to corroborate these findings and further investigate the impacts of chiropractic spinal adjustments on motor function in post-stroke survivors. ClinicalTrials.gov Identifier NCT03849794.
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Stubbs, R. James, Cristiana Duarte, Ruairi O'Driscoll, Jake Turicchi, and Joanna Michalowska. "Developing evidence-based behavioural strategies to overcome physiological resistance to weight loss in the general population." Proceedings of the Nutrition Society 78, no. 4 (October 31, 2019): 576–89. http://dx.doi.org/10.1017/s0029665119001083.
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Physiological and behavioural systems are tolerant of excess energy intake and responsive to energy deficits. Weight loss (WL) changes body structure, physiological function and energy balance (EB) behaviours, which resist further WL and promote subsequent weight regain. Measuring and understanding the response of EB systems to energy deficits is important for developing evidence-based behaviour change interventions for longer-term weight management. Currently, behaviour change approaches for longer-term WL show modest effect sizes. Self-regulation of EB behaviours (e.g. goal setting, action plans, self-monitoring, relapse prevention plans) and aspects of motivation are important for WL maintenance. Stress management, emotion regulation and food hedonics may also be important for relapse prevention, but the evidence is less concrete. Although much is known about the effects of WL on physiological and psychological function, little is known about the way these dynamic changes affect human EB behaviours. Key areas of future importance include (i) improved methods for detailed tracking of energy expenditure, balance and by subtraction intake, using digital technologies, (ii) how WL impacts body structure, function and subsequent EB behaviours, (iii) how behaviour change approaches can overcome physiological resistance to WL and (iv) who is likely to maintain WL or relapse. Modelling physiological and psychological moderators and mediators of EB-related behaviours is central to understanding and improving longer-term weight and health outcomes in the general population.
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King, Sarah, Céline Miani, Josephine Exley, Jody Larkin, Anne Kirtley, and Rupert A. Payne. "Impact of issuing longer- versus shorter-duration prescriptions: a systematic review." British Journal of General Practice 68, no. 669 (March 12, 2018): e286-e292. http://dx.doi.org/10.3399/bjgp18x695501.
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BackgroundLong-term conditions place a substantial burden on primary care services, with drug therapy being a core aspect of clinical management. However, the ideal frequency for issuing repeat prescriptions for these medications is unknown.AimTo examine the impact of longer-duration (2–4 months) versus shorter-duration (28-day) prescriptions.Design and settingSystematic review of primary care studies.MethodScientific and grey literature databases were searched from inception until 21 October 2015. Eligible studies were randomised controlled trials and observational studies that examined longer prescriptions (2–4 months) compared with shorter prescriptions (28 days) in patients with stable, chronic conditions being treated in primary care. Outcomes of interest were: health outcomes, adverse events, medication adherence, medication wastage, professional administration time, pharmacists’ time and/or costs, patient experience, and patient out-of-pocket costs.ResultsFrom a search total of 24 876 records across all databases, 13 studies were eligible for review. Evidence of moderate quality from nine studies suggested that longer prescriptions are associated with increased medication adherence. Evidence from six studies suggested that longer prescriptions may increase medication waste, but results were not always statistically significant and were of very low quality. No eligible studies were identified that measured any of the other outcomes of interest, including health outcomes and adverse events.ConclusionThere is insufficient evidence relating to the overall impact of differing prescription lengths on clinical and health service outcomes, although studies do suggest medication adherence may improve with longer prescriptions. UK recommendations to provide shorter prescriptions are not substantiated by the current evidence base.
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Hikichi, Hiroyuki, Jun Aida, Katsunori Kondo, and Ichiro Kawachi. "Six-year follow-up study of residential displacement and health outcomes following the 2011 Japan Earthquake and Tsunami." Proceedings of the National Academy of Sciences 118, no. 2 (January 4, 2021): e2014226118. http://dx.doi.org/10.1073/pnas.2014226118.
Full textAbstract:
Studies examining the long-term health consequences of residential displacement following large-scale disasters remain sparse. Following the 2011 Japan Earthquake and Tsunami, victims who lost their homes were resettled by two primary means: 1) group relocation to public housing or 2) individual relocation, in which victims moved into public housing by lottery or arranged for their own accommodation. Little is known about how the specific method of residential relocation affects survivors’ health. We examined the association between residential relocation and long-term changes in mental and physical well-being. Our baseline assessment predated the disaster by 7 mo. Two follow-up surveys were conducted ∼2.5 y and 5.5 y after the disaster to ascertain the long-term association between housing arrangement and health status. Group relocation was associated with increased body mass index and depressive symptoms at 2.5-y follow-up but was no longer significantly associated with these outcomes at 5.5-y follow-up. Individual relocation at each follow-up survey was associated with lower instrumental activities of daily living as well as higher risk of cognitive impairment. Our findings underscore the potential complexity of long-term outcomes associated with residential displacement, indicating both positive and negative impacts on mental versus physical dimensions of health.
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McLaughlin, Jessica, Nibras Chowdhury, Svetolik Djurkovic, Omer Shahab, Mehmet Sayiner, Yun Fang, and Ruth Kennedy. "Clinical outcomes and financial impacts of malnutrition in sepsis." Nutrition and Health 26, no. 3 (June 22, 2020): 175–78. http://dx.doi.org/10.1177/0260106020930145.
Full textAbstract:
Background: In the United States in 2014 approximately 1.7 million adults were hospitalized with sepsis, resulting in about 270,000 deaths. Malnutrition in hospitalized patients contributes to increased morbidity, mortality, and costs, especially in the critically ill population. Aim: Our goal was to investigate the prevalence of malnutrition in sepsis and the impact it has on clinical and financial outcomes in our most critically ill patients. Methods: We implemented nutritional screening by a registered dietitian of 1000 patients admitted with sepsis to specialized care units. We calculated the prevalence of malnutrition, and compared outcomes including mortality, length of stay, and financial costs. Results: About 10% of patients with sepsis admitted to our specialized care units were diagnosed with malnutrition on admission after implementation of mandatory assessment. Conclusions: Although mortality did not reach statistical significance, these patients had more comorbidities, longer hospital stays, and higher total costs.
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Nagaraj, Kala, Vandana Kamath, and Aditya Goyal. "Binocular vision parameters in chronic heavy alcoholics: Short-term outcomes of alcohol detoxification." Medical hypothesis, discovery & innovation in optometry 2, no. 3 (March 14, 2022): 94–101. http://dx.doi.org/10.51329/mehdioptometry131.
Full textAbstract:
Background: Alcohol consumption is rising in developing countries such as India, and alcohol addiction has systemic and ocular impacts. This study aimed to investigate the binocular functions of chronic heavy alcoholics before and after alcohol detoxification.
Methods: A prospective before–after study was designed and conducted at Treda De-Addiction Centre, Bengaluru, India. Males in the age range of 30–40 years who had been alcohol addicts for more than six years and met the inclusion criteria were recruited. We performed a routine optometric examination followed by detailed binocular vision assessment, including accommodative, vergence, and oculomotor tests on the first day of rehabilitation and one month after initiation of rehabilitation.
Results: Twenty-five males with of the age (mean ± standard deviation [SD]) 36.24 ± 4.33 years were evaluated. The pre- and post-detoxification mean ± SD of the monocular (right eye: 5.98 ± 3.50, 6.60 ± 3.49; left eye: 6.18 ± 3.69, 7.10 ± 3.78) and binocular accommodative facility (7.10 ± 3.93, 7.40 ± 4.51) did not change significantly (all P > 0.05). Eighteen (72%) of the participants had non-strabismic binocular vision anomalies (NSBVA), among whom the accommodative infacility and convergence insufficiency were higher in frequency and remained constant after alcohol detoxification. Furthermore, the binocular vision parameters showed no statistically significant difference between the pre- and post-detoxification values (all P > 0.05).
Conclusions: The binocular vision parameters did not change significantly after one month of alcohol detoxification in the chronic heavy drinkers. Most long-term alcoholics had NSBVA with no change after rehabilitation, indicating that short-term alcohol detoxification may not aid in the recovery of binocular parameters. However, further validation is required. Assessing the impact of vision therapy in addition to a longer period of abstinence can confirm or refute the persistence of observed effects of chronic alcohol consumption on binocular functions and NSBVA in this population.