<p>Since teachers’ referrals involve evaluation of students through sustained observation, comprehensive features of giftedness can be identified. In 2007, a project called Having Opportunities Promotes Excellence (HOPE) was launched at Purdue University with funds from the Jack Kent Cooke Foundation (Gentry et al., 2015). This 3-year project aimed to help identify giftedness among low-income and ethnically diverse students and serve these students in advanced programs. To do so, the project team created the <i>HOPE Scale</i> (Gentry et al., 2015), an instrument used by teachers to assess the academic and socioemotional characteristics of gifted students. Previous results from Project HOPE served as the foundation for the current studies. This dissertation is comprised of three related research papers investigating the <i>HOPE Scale</i> as an equitable measure for identifying underrepresented students for the gifted services. Following are the purpose and research questions for each of these related studies.</p><p></p><h3><a></a><a>Study 1: Validity Evidence for the <i>HOPE Scale</i> to Identify Gifted Students from Low-Income and Multicultural Families in Korea</a> </h3><div><a></a></div><p></p><h3><a></a><a>Study 2: Exploring Individual and Classroom Characteristics on Students’ Outcome Scores from the <i>HOPE</i> Teacher Rating Scale</a></h3><div><a></a><h3><a></a><a></a><a>Study 3: The Relationship between Students’ Academic Achievement and the <i>HOPE</i> Teacher-rating Scale: Exploration to Equitably Identify Underrepresented Gifted Students</a></h3><br></div>

Background: There is a high incidence of moderate to severe postoperative pain in patients undergoing neurosurgery. Post-craniotomy headache (PCH) remains undertreated due to the cautious use of opioids in this surgical population. Various alternative analgesics such as acetaminophen and scalp blocks are widely utilized for the treatment of PCH, but this is often inadequate. Although a multimodal approach to the management of PCH may be effective in improved pain relief, only a limited number of randomized controlled trials have explored this. Aim: This study aims to investigate whether or not a multimodal analgesic regime, consisting of gabapentinoids and non-steroidal inflammatory drugs (NSAIDs) provides superior pain relief in patients undergoing elective craniotomy compared to the standard of care analgesia utilized at a local South African hospital. Methods: Twenty-seven patients, 18 years or older, scheduled for elective craniotomy for the management of their epilepsy were recruited into this clinical trial. Enrolled participants were randomized into one of two groups. The experimental group received oral 150mg pregabalin one hour before surgery, IV 40mg parecoxib at surgical closure, and oral 150mg pregabalin two hours after surgery. The control group received a matching placebo at these respective time points. Postoperatively, all patients received standard of care analgesia consisting of 24 hours IV paracetamol and additional analgesia as required (prn). Pain assessments using the numerical rating scale (NRS) and visual analogue scale (VAS) were performed at 1 hour, 8 hours, 24 hours, 48 hours and 72 hours postoperatively. Additional analgesia consumption, postoperative nausea and vomiting, as well as the incidence of any adverse events were captured. Results: Patients who received placebo showed an average trend of higher mean NRS pain scores compared to patients receiving pregabalin and parecoxib, although there was no significant difference (p = 0.218) in the maximum mean NRS pain scores between the experimental and control groups. However, patients who received pregabalin and parecoxib consumed significantly less dihydrocodeine than those who received placebo (p = 0.029). No significant differences were identified in use of other additional opioids and non-opioid analgesia during the first 24 postoperative hours. Conclusion: There is insufficient evidence to confirm that the perioperative use of pregabalin and parecoxib reduces PCH in patients undergoing elective craniotomy. The study medication did, however, result in a significant reduction in the use of postoperative dihydrocodeine, although it was also associated with higher rates of reported blurred vision and dizziness.

BACKGROUND: Major Depressive Disorder (MDD) is a common mental health illness, characterized by persistent feelings of sadness, diminished interests, guilt, low-self esteem, and disturbances in sleep and appetite. A significant percentage of patients with MDD are treatment resistant. Electroconvulsive Therapy (ECT) is a biological procedure utilized for treatment resistant illnesses. Diagnosis and clinical conditions primarily dictate when ECT is the appropriate treatment modality for an individual. Circumstances requiring rapid clinical response, risks affiliated with alternative treatments, resistance to pharmacotherapy, and medical history are all factors that designate ECT as the treatment of choice. METHODS: The objective of this systematic review was to examine how different anesthetics or combinations of agents affect ECT’s therapeutic efficacy in depressed, adult patients. Electroencephalography (EEG) and motor seizure durations and Hamilton Depression Rating Scale (HDRS) scores were used as primary measures of clinical outcomes. Two rounds of literature searches were conducted in the PubMed, Web of Science, and Google Scholar databases to identify randomized controlled trials and crossover trials that examined the effects of different intravenous sedatives and hypnotic agents on ECT. Two reviewers independently evaluated the internal validity and quality of studies, extracted data, and analyzed statistics. Utilizing all relevant data, standardized mean differences (SMD) with 95% confidence intervals (CIs), and heterogeneity measures were calculated. Ten studies with 373 participants were included. RESULTS: Thiopental only anesthesia was associated with longer EEG seizure duration when compared to propofol only treatment. The pooled effect size from studies with propofol anesthesia also suggests that this agent is associated with shorter seizure durations. If assessed individually with thiopental, the combination of ketamine and thiopental is correlated with increased motor as well as EEG seizure durations. When pooled; however, studies with patient groups assigned to anesthesia consisting of ketamine and another primary agent do not show significant differences either in EEG or motor seizure durations. Additionally, no difference exists in HDRS score reductions between propofol and methohexital. Of note; however, ketamine combined with either propofol or thiopental had significantly greater decreases in HDRS scores. CONCLUSION: Choice of anesthetic should be determined based on anticipated clinical outcome, adverse effect profile, reemergence, and patient preference. If long seizures are preferred, thiopental may be a reasonable option. However, if significantly larger decreases in depression score are preferred, then the combinations of ketamine and propofol or ketamine and thiopental appear to be the therapies of choice. Small sample sizes and insufficient clinical data limit the interpretations of these variables that determine therapeutic efficacy. Larger randomized control trials and crossover trials would provide greater insight into the optimal use of intravenous anesthetic agents with minimal adverse effects.

Opioid abuse costs affect the majority of the adult population in our society directly or indirectly. The current prevailing medical treatment for opioid addiction is methadone maintenance treatment (MMT). MMT reduces infectious disease spread, illicit drug use, criminal activity, and overdose potential. MMT is only as effective as the length of time a client remains active and compliant with the program. In previous studies, therapeutic alliance (TA) has been shown to positively influence the effectiveness of substance abuse treatment. However, a gap exists in research in regards to the impact of TA on the effectiveness of MMT outcomes. The theoretical framework of this study is based on therapeutic alliance, which guided an examination on whether therapeutic alliance (as measured by the Session Rating Scale) influenced MMT retention and compliance (drug screens and session attendance). Archival data from 264 clients receiving MMT for opioid dependence were reviewed from a nonprofit community-based agency in Arizona. Logistic regression results revealed that TA did not significantly affect retention or compliance. However, issues were noted such as how the SRS was administered, a lack of understanding by clients regarding scoring the SRS, and unique social desirability demands when clients are in MMT. The finding that TA alone did not significantly affect retention and compliance does not decrease the need to find effective means to improve MMT outcomes. Rather, the findings suggest a critical need to identify and utilize measures more appropriate for clients receiving MMT. In doing so, positive social change may be achieved by assisting clinical staff in developing a strong therapeutic alliance with MMT clients as they focus on problem solving as a joint venture when challenges in the recovery process arise.

The Hamilton Rating Scale for Depression (HRS), a 17-item observer-rated scale, was first developed in 1960 to assess the severity of depressive symptomatology in patients diagnosed as suffering from depression. The HRS has since demonstrated high inter-rater reliability (with coefficients ranging from .87 to .94), and has proven useful in measuring changes of severity following treatment.

No description available.

Bakgrund: I Sverige drabbas cirka 30 000 personer av stroke varje år. Stroke är ett samlingsnamn för hjärnskador orsakade av blödning eller infarkt i hjärnan. Stroke uppenbarar sig som en plötslig förlust av kroppsfunktion som styrs av hjärnan. En genomsnittlig strokepatient förlorar nästan två miljoner neuroner, 14 miljarder synapser och 12 km myeliniserade nervfibrer varje minut som stroken är obehandlad. För dessa patienter krävs det en snabb handläggning och snabba insatser för att minimera de hjärnskador som uppstår. Det finns olika behandlingsalternativ för att återskapa blodflödet i hjärnan för de patienter som drabbats av infarkt i hjärnan. Innan behandling påbörjas behöver stroke-diagnosen bli bekräftad, och andra sjukdomar uteslutna, med radiologi. Det är ambulanssjuksköterskan som prehospitalt bedömer strokepatienten och beslutar om fortsatt handläggning. Till sin hjälp har ambulanssjuksköterskan skattningsskala för att fortast möjligt identifiera patient som drabbats av stroke. Om ambulanssjuksköterskan bedömer att patient drabbats av stroke och patienten uppfyller vissa förutbestämda kriterier, förvarnar ambulanssjuksköterskan mottagande sjukhus om patienten. Detta för att vårdkedjan skall bli så snabb som möjligt och tid till behandling skall kunna bli så kort som möjligt. Syfte: Syftet var att belysa hur ambulanssjuksköterskan identifierar patienters strokesymptom prehospitalt. Metod: Studien är en forskningsöversikt som baserades på kvantitativa, vetenskapliga, empiriska studier. Litteratursökningen gjordes i databaserna Cinahl och Pubmed. Resultat: Resultatet visade att det fanns flera olika skattningsskalor som ambulanssjuksköterskan kunde använda vid identifiering av stroke. Det fanns även andra undersökningar som kunde utföras prehospitalt som var gynnsam för strokepatienten. Det var av vikt att ambulanssjuksköterskan fortast möjligt kunde identifiera en strokepatient för att sedan transportera patienten till lämplig sjukvårdsinrättning. Slutsats: Tidsfaktorn är den viktigaste aspekten gällande att genomföra en framgångsrik behandling av strokepatienten. För att korta ned tiden till behandling är det viktigt med snabb identifiering av strokepatienten, snabb transport till sjukhus som erbjuder rätt behandling och en effektiv vårdkedja. Eftersom kompetensen i Sveriges ambulanser är hög, med specialistutbildade ambulanssjuksköterskor, skulle de kunna tillämpa NIHSS-skattningsskalan, vilket är en mer omfattande skattningsskala, prehospitalt under transport av patienten till sjukhus. På detta sätt skulle läkare på mottagande sjukhus få ett bättre underlag för sin bedömning som då kan gå snabbare, och på så sätt korta ned tid till behandling. / Background: In Sweden about 30 000 persons suffering a stroke every year. Stroke is a generic name for brain damages caused by a hemorrhage or an infarction in the brain. Stroke appears as a suddenly loss of body function controlled by the brain. There is a loss of about 14 billion synapses and 12 km myelinated nerve fibers in an average stroke patient every minute the stroke is untreated. It takes a fast processing and action to minimize the brain damages that appears to these patients. There are different kinds of treatment possible to restitute blood flow in the brain for those patients suffering an infarction in the brain. Before treatment can be started, the stroke diagnosis must be confirmed and other diseases ruled out by radiology. It is the ambulance the nurse assesses the stroke patient in the prehospital settings. As a support the ambulance nurse can use a rating scale to rapidly identify a patient suffering a stroke. If the ambulance nurse’s prehospital diagnosis is that a patient is suffering a stroke, and the patient fulfills a certain criteria, the ambulance nurse pre-warns the receiving hospital. The reason of that is to make the care chain as fast as possible and the time to treatment as short as possible. Aim: The purpose of this study was to illustrate how an ambulance nurse identifies patient’s stroke symptoms in the prehospital setting. Method: The study is a literature review based on quantive, scientific, empirical studies. The literature search was made in the databases Cinahl and PubMed. Result: The result showed that there were several different rating scales that an ambulance nurse could use in the identification of stroke. There were other examinations that could be performed pre-hospital, which was beneficial for stroke patients. It was important that the ambulance nurse could quickly identify a stroke victim in order to rapidly transport the patient to an appropriate medical facility. Conclusion: Time is the most important aspect regarding the implementation of a successful treatment of stroke patients. In order to shorten time to treatment it is essential for a rapid identification of stroke patients, rapid transport to hospitals that offer the right treatment and efficient health services. Since the competence in Swedish ambulances is high, with specialist trained ambulance nurses, they would be able to apply the NIHSS-rating scale, which is a more extensive rating scale, in the prehospital setting, during transport of patient to hospitals. In this way, doctors at the receiving hospital have better basis for its assessment, which then can be accelerated, and could shorten time to treatment.

No description available.

The challenge facing children learning language bilingually has led to efforts to improve the assessment and treatment of language learning difficulties. One of these efforts is the development and validation of the Spanish-English Language Proficiency Scale (SELPS). Previous research has been performed to validate the scale for English language proficiency but not for Spanish language proficiency. Twenty-four sequential bilingual children produced spontaneous narrative language samples that were rated using the SELPS and coded for language sample variables using the Systemic Analysis of Language Transcripts software. Several language sample variables, most notably the Subordination Index, the number of omitted bound morphemes, and the number of code-switched words, were correlated with the SELPS subscale scores and total score. Findings have implications for screening the Spanish language proficiency of Spanish-English bilingual children who are between four and eight years of age.

Background: Visual Analog Scale (VAS) and Numeric Rating Scale (NRS) are commonly used for measuring pain intensity. Although several studies have investigated agreement between VAS and NRS, there is a lack of knowledge about agreement in persistent neck pain and whether neck disability affects the agreement. Objective: Evaluate agreement between the two pain rating scales VAS and NRS for patients with persistent neck pain, and evaluate if the agreement is affected by neck disability, measured with Neck Disability Index. Methods: A cohort study with 43 participants with neck pain &gt; 3 months. Neck pain now and average neck pain last week was measured on VAS and NRS, and were recorded two times. Correlation between VAS and NRS was analyzed with Spearmans r and agreement was calculated with Bland Altman. Between group differences in patients with high (&gt;15) compared to low (&lt;15) NDI regarding agreement in VAS/NRS, were analyzed with Mann-Whitney U-test. Results: There was a significant positive correlation between VAS and NRS (r=0,927–r=0,909, p&gt;0,01) and neck disability did not affect the agreement. The largest mean difference was 0,5 with variation between -2 to 2 in 95% of the patients. Conclusion: The same measurement (VAS or NRS) should be used for repeated measuring in neck pain. It is important to be aware of the differences between VAS and NRS, especially when research results will be implemented in primary care.