Biomedical subjects

Richard Goldstein

Publications and source records attributed to Richard Goldstein.

22 records · Page 2Linked to original sources

PubMedDate not supplied

Characteristics of facility-based community integration programs for people with brain injury.

OBJECTIVES: To conduct a nationwide telephone survey to gather data on some of the quantifiable characteristics of community integration programs available nationwide to adults with brain injury. DESIGN: The Community Integration Program Questionnaire was used to interview 49 outpatient facility-based community integration programs between June 2002 and June 2003. We then used descriptive statistics to analyze the characteristics of the programs. RESULTS: There was tremendous variability in the areas of staffing, client, and programmatic characteristics. CONCLUSIONS: There is considerable variability among programs with respect to quantifiable characteristics of facility-based community integration programs. Future studies should explore which characteristics affect outcomes.

Activities of Daily Living↗

PubMedDate not supplied

Characteristics of residential community integration programs for adults with brain injury.

OBJECTIVES: To gather data on some quantifiable characteristics of residential community integration programs available to adults with brain injury. PARTICIPANTS: Directors, assistant directors, or coordinators of community integration programs for people with brain injury. MEASUREMENT TOOLS: The Community Integration Program Questionnaire (CIPQ). DESIGN: Nationwide telephone survey of 30 residential community integration programs between June 2002 and June 2003. RESULTS: There was tremendous variability in the areas of staffing, client, and programmatic characteristics. Staff-to-client ratio varied from 0.77 to 3.3. Lengths of stay ranged from 0.13 to 288 months. Times from injury to admission varied from 0.2 to 180 months. CONCLUSIONS: The considerable variability in characteristics of residential community integration programs for adults with brain injury presents significant challenges to researchers seeking to identify vital program components and to consumers attempting to compare programs.

Adult↗

PubMedDate not supplied

The accuracy of artificial neural networks in predicting long-term outcome after traumatic brain injury.

OBJECTIVE: This study compared the accuracy of artificial neural networks to multiple regression and classification and regression trees in predicting outcomes of 1,644 patients in the Traumatic Brain Injury Model Systems database 1 year after injury. METHODS: Data from rehabilitation admission were used to predict discharge scores on the Functional Independence Measure, the Disability Rating Scale, and the Community Integration Questionnaire. RESULTS: Artificial neural networks did not demonstrate greater accuracy in predicting outcomes than did the more widely used method of multiple regression. Both of these methods outperformed classification and regression trees. CONCLUSION: Because of the sophisticated form of multiple regression with splines that was used, firm conclusions are limited about the relative accuracy of artificial neural networks compared to more widely used forms of multiple regression.

Brain Injuries↗

PubMedDate not supplied

Contractures in burn injury: defining the problem.

This study prospectively examined the incidence and severity of large joint contractures after burn injury and determined predictors of contracture development. Data were collected prospectively from 1993 to 2002 for consecutive adult burn survivors admitted to a regional burn center. Demographic and medical data were collected on each subject. The primary outcome measures included the presence of contractures, number of contractures per patient, and severity of contractures at each of four joints (shoulder, elbow, hip, knee) at time of hospital discharge. Logistic regression analysis was performed to determine predictors of the presence and severity of contractures and a negative binomial regression was performed to determine predictors of the number of contractures. Of the 985 study patients, 381 (38.7%) developed at least one contracture at hospital discharge. Among those with at least one contracture, the mean is three contractures per person. The shoulder was the most frequently contracted joint (38%), followed by the elbow (34%) and knee (22%). Most contractures were mild (60%) or moderate (32%) in severity. Statistically significant predictors of contracture development were length of stay (P < .005) and extent of burn (P = .033) and graft (P < .005). Predictors of the severity of contracture include graft size (P < .005), amputation (P = .034), and inhalation injury (P = .036). More than one third of the patients with a major burn injury developed a contracture at hospital discharge, which highlights the importance of therapeutic positioning and intensive therapy intervention during acute hospitalization. Furthermore, this challenges the burn care community to find new and better ways of preventing contractures after burn injury.

Adult↗