Upper limb function is important for individuals with tetraplegia because upper limb function supports global function for these individuals. As a result, a great deal of time and effort has been devoted to the restoration of upper limb function. Appropriate outcome measures that can be used to characterize the neurological status of the upper limb have been one of the current barriers in substantiating the efficacy of interventions. Techniques and protocols to evaluate changes in upper limb neurological status have not been applied to the SCI population adequately. The objectives of this thesis were to develop a measure; which is called the Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP). Development of the scoring approach, testing for reliability and construct validity, and determining impairment and function relationships specific to the upper limb neurological were established. The GRASSP is a clinical measure of upper limb impairment which incorporates the construct of “sensorimotor upper limb function”; comprised of three domains which include five subtests. The GRASSP was designed to capture information on upper limb neurological impairment for individuals with tetraplegia. The GRASSP defines neurological status with numerical values, which represent the deficits in a predictive pattern, is reliable and valid as an assessment technique, and the scores can be used to determine relationships between impairment and functional capability of the upper limb. The GRASSP is recommended for use in the very early acute phases after injury to approximately one year post injury. Use of the GRASSP is recommended when a change in neurological status is being assessed.

Emotional intelligence and self-determined motivation have been independently identified as important personal variables that are liable to foster optimal work functioning. However, the relationship between these two variables has never been assessed. Furthermore, research has also provided evidence that supervisor support, a social variable, is considered to be a significant source of influence on self-determined behaviour regulation. Thus the primary objective of the project was to jointly assess emotional intelligence and supervisor support as antecedents of self-determined work motivation; secondly, to assess the associations of self-determined work motivation on work outcome variables and psychological welfare; and thirdly, to examine the association between emotional intelligence and psychological well-being on 512 police source handlers. Specifically, it was proposed that emotional intelligence would be positively associated to self-determined work motivation and would display a unique association with work motivation, once the variance from supervisor support has been controlled for. It was further proposed that self-determined work motivation would, in turn, be positively associated with positive work outcomes; specifically, job satisfaction, job performance, future work intentions, and psychological well-being. Lastly, it was hypothesized that emotional intelligence would be positively associated to psychological well-being. Data was analyzed using structural equations modeling. Results revealed that emotional intelligence and supervisor support were both uniquely associated with work motivation. Together, these two variables explained a high proportion of the variance of work motivation. Work motivation, in turn, was positively associated with job satisfaction, job performance, future work intention, and psychological well-being. Emotional intelligence and psychological well-being were also positively associated. Overall, the findings of this thesis provide a basis for future research aimed at determining the causal relationship between emotional intelligence and self-determined motivation. It is further suggested that findings gleaned from this study can provide a better understanding of how certain interpersonal behaviours can impact specific work outcomes, which can provide researchers and practitioners with information to improve individual and organizational outcomes of interest.

Most pediatric orthopaedic interventions are intended to improve or preserve physical function, yet their outcomes have been assessed using primarily surrogate measures (e.g., radiographic indices) that may not accurately represent patients'function. Physical function may be more appropriately measured with activity-based scales, but these have been infrequently applied in surgical studies. The purpose of this study was to identify existing activity-based physical-function scales appropriate for pediatric orthopaedics, to present criteria useful for scale selection, and to discuss the special problems of measuring physical function in children. Twenty-one scales relevant to pediatric orthopaedics are described according to their target population, purpose, method of administration, content, and quality of standardization. These scales have been further classified according to a new taxonomy. The unique aspects of measuring physical function in children are discussed and include the effect of age and development, method of reporting, and question formats. Standardized measures of physical function based on physical-activity ability exist and should be used more frequently to assess pediatric orthopaedic interventions

Hysterectomy is the second highest frequency of gynecologic surgery. With limited medical resources, understanding of qualities and expenses of different types of surgery can be used as a reference for patients and hospital administrators in making related decisions. Therefore, the purpose of this study is to compare the outcomes between ¡§Total Abdominal Hysterectomy¡¨ and ¡§Laparoscopic Hysterectomy¡¨. Data sources are the health insurance report data files and charts of a regional teaching hospital. There were 114 cases between January 2006 and June 2010 at the sample hospital. Operating time, length of stay, and intra-operative blood loss between both types of hysterectomy are analyzed and compared by using t-test. Linear regression analysis is then used to examine the predictive factors that impact the outcomes of both types of surgery. The results indicate that, in terms of clinical results, laparoscopic hysterectomy takes 120.45 minutes on average, and total abdominal hysterectomy 104.35 minutes; laparoscopic hysterectomy requires an average of 4.73 days of hospital stay, and total abdominal hysterectomy 5.54 days; and finally, laparoscopic hysterectomy causes an average of intra-operative blood loss of 249.70cc, and total abdominal hysterectomy 290.21cc, laparoscopic hysterectomy costs an average of NT$69,268.85, and total abdominal hysterectomy NT$46,634.88. In regard to hospitalization costs, laparoscopic hysterectomy costs an average of NT$49,732.50, and total abdominal hysterectomy costs NT$42,066.27. Based on findings of this study, the following suggestions are proposed: (1) Laparoscopic hysterectomy can be safely and effectively used for patients with large uterine myoma or multiple myoma. (2)Hospitals should develop standardized medical treatment procedures; therefore, cost control would not be at the expense of the quality of care. Furthermore, standardization of medical treatment can be used to pinpoint whether there is any waste in the medical treatment process. Keywords: uterine myoma, hysterectomy, total abdominal hysterectomy, laparoscopic hysterectomy, outcome.

Given the conflicting research results on the effectiveness of whole-school reform models (Nunnery, 1998; Stringfield & Herman, 1997; American Institutes for Research, 1999; U.S. Department of Education, 2004), there is a need to focus on the evaluation procedures of whole-school reform organizations. Because the ultimate goal is to improve school performance, it should also be a goal of each whole-school reform organization to design a comprehensive data collection system to evaluate each school’s performance. A comprehensive reporting system was developed for a school reform organization, the Accelerated Schools Project (ASP). Using the steps of the research and development process recommended by Borg and Gall (1989), this study: (a) developed a theoretical framework for the reporting system, (b) identified data that should be collected in the reporting system, (c) performed a field test with an expert panel of educational professionals, (d) developed a preliminary form of the reporting system, (e) performed a main field test with principals and coaches in the ASP network, (f) reported field test results, (g) revised the preliminary reporting system, (h) developed a website for the reporting system, and (i) provided recommendations for the completion, dissemination and implementation of the system in accelerated schools across the nation. This study has important implications for both the ASP community and for the entire whole-school reform community. For the ASP community, the reporting system could be used: (a) to collect data in all accelerated schools across the nation (b) as a longitudinal database of information to monitor data on each ASP school, and (c) to generate school summary reports on ASP schools. These data will assist researchers in measuring the effectiveness of the ASP model on student achievement and other important variables. For the whole-school reform community, the method used in this study could be replicated in other school reform organizations to develop a comprehensive reporting system. By providing consistent data for school reform organizations to evaluate the impact of their models on students and schools, educational researchers will be better equipped to understand each model’s impact, and thus will better understand the diverse research results on school reform effectiveness.

Thesis (Ph. D.)--University of California, San Diego, and San Diego State University, 2004. / Vita. Includes bibliographical references (leaves 122-130).

Thesis (Ph. D. in Hearing and Speech Sciences)--Vanderbilt University, Dec. 2009. / Title from title screen. Includes bibliographical references.

Anxiety disorders commonly co-occur in children and adolescents with an autism spectrum disorder (ASD). Recently, treatment of anxiety using cognitive behavioral therapy (CBT) has been modified and studied in youth with ASD, with results consistently demonstrating positive treatment outcomes. In typically developing populations, CBT gains are well maintained as long as 14-years post-treatment; however, maintenance of CBT has not yet been studied in anxious youth with ASD. Using a sample of 32 youth who previously completed one of three CBT for anxiety in ASD treatment studies, the present study re-assessed parent report of anxiety symptoms in youth, 12-26 months (M = 17.16 Months; SD = 4.32) following treatment completion. Retrospective data from the original studies' screening/baseline and post-treatment time points were used in combination with newly obtained follow-up data to determine treatment maintenance. Compared to baseline, follow-up scores on all measures of anxiety were associated with large effects for treatment. Compared to post-treatment, no significant differences in scores were observed; however, scores on the Pediatric Anxiety Rating Scale suggested a small effect for return in symptoms. While the percentage of individuals with remission of their primary anxiety diagnosis was identical at post-treatment and follow-up, significantly fewer individuals were rated as responders at follow-up as compared to post-treatment. Similar to CBT for anxiety in neurotypical youth, CBT for anxiety in youth with ASD appears to be relatively durable over a one to two year interval. Despite this, a significant portion of participants demonstrate some level of symptom regression. Future study should investigate factors associated with poor treatment maintenance, as well as modifications or additions to treatment protocols (e.g., booster sessions) that may help maintain treatment gains.

To identify those with kidney disease early and thus facilitate earlier instigation of disease-progression slowing treatments, new definitions of chronic kidney disease (CKD) were introduced in 2002 (KDOQI). After this, the worldwide introduction of estimated glomerular filtration rate (eGFR) reporting (2006 onwards), also facilitated more widespread identification of those with CKD. Prognosis in those with CKD identified in this way was not known and the numbers with CKD appeared higher than originally expected. This thesis aimed to improve understanding of outcomes in those who met the definition of chronic kidney disease and facilitate better directed care. Data-linkage of several healthcare datasets including to laboratory, morbidity and mortality healthcare data for individuals in the Grampian region with measures of renal function in 2003 allowed those aims to be addressed. Patterns in the testing of kidney function over time were also described. Mortality and RRT initiation during the GLOMMS-I cohort's 6.5 years of follow-up were described, as were variables that were associated with these outcomes. Other measures of decline of kidney function over time (progression), were explored and compared to the ultimate measure of progression - the initiation of RRT. Various models to predict outcomes (RRT initiation, mortality and survival) were explored. Measures of model performance including discrimination, calibration, goodness of model fit and predictive performance were described. Overall the aim of this thesis was met - to improve the understanding of the prognosis of those currently labelled with chronic kidney disease. The work in this thesis has also provided the necessary information to plan and start a much wider population based study of outcome in those both with and without CKD (GLOMMS-II).

The persistence of water conflicts in many arid regions is not simply a matter of water shortages, but rather the lack of equitable agreements that govern the allocation of disputed water resources to mitigate the adverse impacts of hostility and resentment. As such, equity is at the heart of many trans-boundary water disputes. Mindful of the dynamics and implications of inequitable water allocation on inter-state relationships and overall regional stability, this research aims at eliciting and developing theoretical criteria for equitable distribution of water (process equity) responsible for creating equitable outcomes and perception. This research makes the distinction between “process equity” and “outcome equity” and their impact on attaining and sustaining water security, peace, and hydro-stability. These parameters of equitable processes will be developed through a review of current literature addressing the issues of water equity in arid regions, coupled with case study analyses and cross-case comparisons and semi-structured interviews of key water negotiators. These key cases will be selected through a systematic screening methodology that analyzes nine pertinent cases. Collectively, employing these methods will yield in-depth analysis and findings applicable to other international water dispute cases in the context of arid regions. Proposing an alternative strategy that views water as a catalyst for peace and cooperation rather than conflict and altercation, this research further advocates for the development and adoption of an interdisciplinary, transformative approach to conflict resolution to advance water disputes to plausible and implementable agreements. Aiming to inform the theory and practice of hydro-diplomacy along disputed water resources, this approach encapsulates three key components, including rules of engagement, mechanisms of engagement, and neutral third-party mediation. Water satiety is identified as a major characteristic of equitable water allocation agreements that ensure the level of satisfaction of all involved stakeholders and the extent to which acceptable agreements, durable implementation, and sustainable relationships among co-riparians are attained and maintained. / text