Yes / It is questionable whether existing outcome measurement instruments (OMIs) in dementia research reflect what key stakeholders' value. We attained consensus from over 300 key stakeholders, including people living with dementia, and identified 13 core outcome items for use in nonpharmacological and community-based interventions for people with dementia living at home. In this systematic review we review OMIs that have previously been used in dementia care research to determine how, or even if, the 13 core outcome items can be measured. We extracted self-reported OMIs from trials, reviews and reports of instrument development. Searches were undertaken in the ALOIS database, Medline, PsycINFO, CINAHL, socINDEX and COSMIN database. We aimed to assess the psychometric properties of OMI items for face validity with the core outcome items, content validity, internal consistency and responsiveness. We held a co-research workshop involving people living with dementia and care partners in order to ratify the findings. In total 347 OMIs were located from 354 sources. Of these 76 OMIs met the inclusion criteria. No OMIs were deemed to have sufficient face validity for the COS items, and no OMIs proceeded to further assessment. The 'best' available OMI is the Engagement and Independence in Dementia Questionnaire (EID-Q). This study provides a practical resource for those designing dementia research trials. Being able to measure the COS items would herald a paradigm shift for dementia research, be responsive to what key stakeholders value and enhance the ability to make comparisons. / This study was funded jointly by the Economic and Social Research Council (ESRC) and the National Institute for Health Research (NIHR). ESRC is part of UK Research and Innovation (UKRI).

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This dissertation examines whether the magnitude of the outcome effect is impacted by the type of performance evaluation system (subjective versus formula-based). The outcome effect is a phenomenon that occurs when an evaluator overemphasizes the outcome of a decision and ignores essential information that is available to the evaluator (e.g., market information, information about the decision-making process). This outcome focus leads to a more positive (negative) performance evaluation when the outcome exceeds (fails to meet) expectations. Prior studies have not examined whether the type of evaluation system (formula-based versus subjective) has an impact on the magnitude of the outcome effect. In a formula-based evaluation system, outcome measures are pre-weighted and an overall variance measure is easily calculated. Conversely, there are no predefined weights or overall variance measures in a subjective system. Instead, evaluators weight the importance of outcome information themselves. For this dissertation, I conducted an experiment in which 99 business professionals enrolled in a MBA program evaluated the performance of a retail store manager. Their evaluation was based on information that they received about the manager's decision, along with situational factors that may have impacted the decision outcome. The results demonstrate that although the magnitude of the outcome effect was larger when a formula-based system was employed relative to a subjective system, this difference was not statistically significant. Nonetheless, this study provides initial evidence that managers using formula-based evaluation systems should be particularly aware of the outcome effect when conducting performance appraisals. In addition, this study documents the perceived controllability of four financial and four non-financial measures that are commonly employed to evaluate performance in the retail industry. As hypothesized, the non-financial measures were perceived to be more controllable than the financial measures. This suggests that non-financial measures should be included in the mix of performance measures used in a performance appraisal system. / Ph. D.

Background: Standardized outcome measures used in assessment of chronic disease need to be relevant to the client if interventions based on the results are to be meaningful. The Modified Health Assessment Questionnaire (MHAQ) (Pincus et al., 1983) is an eight-item questionnaire used commonly with individuals with Rheumatoid Arthritis (RA) to assess self-reported function. This scale has been translated and validated in multiple languages and cultures but has never been evaluated for its relevance with a Canadian Indigenous population despite its frequent application in clinical and health research settings. Purpose: The primary objective of the following study was to determine whether or not the MHAQ is an appropriate measurement tool to adequately document the lived experiences of activity and participation in First Nations individuals diagnosed with RA. Methodology: A mixed methods sequential explanatory approach was utilized. The quantitative component consisted of secondary analysis of an existing clinical database developed at the University of Manitoba Health Sciences Arthritis Centre (UMHSAC). MHAQ scores and other indicators of disease activity of First Nations (n=252) and Caucasian (n=633) individuals with RA were examined for significant differences. The results informed a qualitative phase using interpretive description methodology whereby semi-structured interviews were held with 25 First Nations individuals with RA. Results: A significant relationship was observed between ethnicity and MHAQ score (p<0.001) where the First Nations cohort demonstrated significantly higher scores in pain and MHAQ scores (p<0.001), as well as physician global assessment and morning stiffness (p<0.05). Pain was the single greatest predictor of MHAQ score (p<0.001). In contrast, a convergence coding matrix comparing MHAQ scores to first-hand narratives found only 65% agreement in responses. The thematic analysis of the qualitative component resulted in three key themes: Ka-wachi-wa-pinaywin (“Coldness in the bones”), Adaptive Resilience, and Family Relations. Conclusion: Concurrent validity of the MHAQ in a First Nations population was supported through statistical analyses but convergent validity was not supported by subsequent qualitative and mixed methods approaches. The assessment of disability requires an integrated approach that takes into consideration an individual’s personal context. Both barriers and facilitators in the environment, as well as personal factors, must be addressed. / February 2016

The purpose of the current study is to apply the delay and probability discounting in the areas of parent training and probability of success of treatment. There was a total of 31 participants that completed one demographic questionnaire and two probability and delay discounting surveys either via computer or with paper and pencil. Participants had two options in the surveys: one was an immediate reward, and one with a probability delay. The first survey gave scenarios of hours of parent training, the second was a monetary probability discounting survey.

Thesis (M Med(Family Medicine)) -- University of Limpopo, 2010. / Abstract AIM The aim of the study was to measure the maternal and foetal outcomes of the deliveries attended to at Emkhuzweni Health Centre, Swaziland. Objectives The objectives of the study were: .:. To determine maternal outcomes of the deliveries attended to at Emkhuzweni Health Centre. .:. To determine foetal outcomes of the deliveries attended to at Emkhuzweni Health Centre. .:. To identify risk factors that affect maternal and foetal outcomes at Emkhuzweni Health Centre Methods A retrospective chart review was performed for all 520 deliveries at Emkhuzweni Health Centre between January 1,2007 and December 31 2007. Labouring mothers were eligible for the study if they met the inclusion criteria. The study was conducted after ethical approvals from the relevant authorities were obtained. Data were obtained from records for the following variables: age, address, gravidity, parity, health service where ANC was attended, risk factor, mode of delivery, maternal condition after delivery and post-delivery maternal hospital stay. For each foetus, the APGAR score at the first and fifth minute, weight and sex of the neonate and condition after delivery were recorded. Results The results revealed that the maternal outcomes after delivery were normal for 89.85% of the mothers; 3.4% of those who delivered at EHC had PPH, 5.4% developed puerperal sepsis, 1 % PIH and 0.2% cases resulted in maternal death. The majority of mothers (61.7%) were discharged from the maternity ward in less than 24 hrs. As far as foetal outcomes were concerned, normal babies accounted for 68% of births, early onset neonatal sepsis for 1.9%, congenital malformation (0.6%), stillbirth (1.5%), low birth weight (9.2%), preterm babies (17.8 %) and neonatal death (0.4%0. Conclusion This study found that the maternal outcomes at Emkhuzweni Health Centre in 2007 were similar to those in Swaziland as a whole and in other developing countries, except that there was a higher rate of pre-term delivery among pregnant women assisted at Emkhuzweni Health Centre. The foetal outcomes of Emkhuzweni Health Centre in 2007 were similar to the data from developing countries. Additionally, however; significant numbers of pre-term babies were delivered and a high incidence of neonatal sepsis was observed at the Health Centre. Some of the risk factors for the observed maternal and foetal outcomes were poor antenatal care attendance, distance of the Health Centre from the home state of the pregnant woman, preterm labour, under age and teenage pregnancies.

ABSTRACT Background: On behalf of the Orthopedic clinic, Västerås, a study has been conducted with focus on comparing the results after conservative and surgical treatment due to complete achillestendon rupture. Aim: To compare results when testing the active and passive range of motion, calf muscle endurance, estimation of pain related to the achillestendon and self-efficacy to be physically active for individuals who have undergone conservative or surgical treatment after complete achillestendon rupture. Method: 14 individuals afflicted by complete achillestendon rupture in 2010 were recruited as a purposive sample. Examination were conducted of: Ankle range of motion with a goniometer, calf muscle endurance through a toe-raise test, estimation of pain intensity related to the achillestendon by VAS and self-efficacy to be physically active through “Exercise self-efficacy scale”. P-value and the median were calculated. Result: The results of ankle range of motion and calf muscle endurance were based on the difference between the injured and the healthy side. When testing active plantarflexion the conservative group had a median of 4 ̊ and the surgical group had a median of 10 ̊. At the toe-raise test the conservative group had a median of 11 toe-raises and the surgical group a median of 7. Through estimation of “Exercise self-efficacy scale” the conservative group had a median of 115 point and the surgical group a median of 94. When testing active dorsiflexion, passive plantarflexion, passive dorsiflexion and estimation of pain related to the achillestendon the median value were 0 for both groups. Conclusion: There was no statistical significance between the groups.   Key words: Achilles tendon, operative, rupture, self efficacy, treatment outcome. / SAMMANFATTNING Bakgrund: På uppdrag av Ortoped kliniken Västerås, har en studie genomförts med fokus på att jämföra resultat efter konservativ respektive operativ behandling i samband med total hälseneruptur. Syfte: Att jämföra resultaten vid test av aktiv och passiv fotledsrörlighet, vadmuskeluthållighet, skattning av smärta relaterat till hälsenan samt self-efficacy för att vara fysiskt aktiv för individer som genomgått konservativ respektive operativ behandling efter total hälseneruptur. Metod: 14 individer som drabbats av total hälseneruptur under 2010 rekryterades enligt ett ändamålsenligt urval. Undersökningar gjordes av fotledsrörlighet med hjälp av goniometer, vadmuskeluthållighet via ett tåhävningstest, skattning av smärtintensitet relaterat till hälsenan via VAS och self-efficacy för att vara fysiskt aktiv via ”Exercise self-efficacy scale”. P-värde och median beräknades. Resultat: Resultaten för fotledsrörligheten och vadmuskeluthålligheten baserade sig på skillnaden mellan frisk och skadad sida. Vid test av aktiv plantarflexion hade den konservativa gruppen en median på 4° och den operativa gruppen en median på 10°. Vid tåhävningstestet hade den konservativa gruppen en median på 11 stycken tåhävningar och den operativa gruppen en median på 7. Vid skattning via ”Exercise self-efficacy scale” hade den konservativa gruppen en median på 115 poäng och den operativa gruppen en median på 94. Vid test av aktiv dorsalflexion, passiv plantarflexion, passiv dorsalflexion samt vid skattning av smärta blev medianvärdet 0 för båda grupperna. Slutsats: Det förelåg ingen statistisk signifikant skillnad mellan grupperna.   Nyckelord: Behandlingsresultat, egen förmåga, hälsena, operationer, ruptur.

published_or_final_version / Dentistry / Doctoral / Doctor of Philosophy

High Grade Serous Carcinoma is the most aggressive tubal/ovarian histotype. The Rb pathway, which functions to preserve cell cycle regulation and genomic stability, is frequently deregulated in HGSC. The aim of this study was to identify non-redundant mechanisms of Rb pathway deregulation with clinical relevance. Immunohistochemistry analysis of P16 and RB1 expression identified a P16 homogeneous/RB1+ subgroup with the shortest recurrence free survival, while P16 heterogeneous/RB1+ and P16 homogenous/RB1- subgroups showed longer recurrence free survival. These P16/RB1 categories were shared between precursor lesions and the associated HGSC. Characterization of the Rb pathway in the three subgroups revealed CCNE1 amplification and highest protein expression in the P16 homogeneous/RB1+, high cyclin D1 protein expression in P16 heterogeneous/RB1+, and E2F3 amplification and highest Ki67 protein expression in P16 homogeneous/RB1- subgroup. Rb pathway deregulation is common in HGSC, occurs early in tumor development, and results from multiple non-redundant mechanisms that correlate with clinical outcome.