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PubMed2001

Enhancing comprehension of consent for research in older patients with psychosis: a randomized study of a novel consent procedure.

OBJECTIVE: The ability of individuals with schizophrenia to provide informed consent for research has become the focus of public debate. The authors examined whether a novel consent procedure improved the comprehension of consent for older patients with psychosis. METHOD: Fifty outpatients with schizophrenia or other psychotic disorders and 19 normal comparison subjects aged 40-80 were randomly assigned to groups given either a routine or an enhanced consent procedure. The latter utilized a computerized presentation that included sequential bullet points and summaries of key information. A posttest measured comprehension of consent-relevant information. RESULTS: A significantly greater proportion of patients who received the enhanced consent procedure scored 100% on first and second trials of the posttest, compared to those receiving the routine procedure (trial 1: 42.3% versus 8.3%; trial 2: 80.8% versus 45.8%, respectively). CONCLUSIONS: The enhanced consent method improved comprehension of information relevant for consent in older patients with psychosis.

Adult↗

PubMed1999

Design and reliability of pediatric HealthQuiz: preliminary report of a comprehensive, computerized, self-administered child health assessment.

The time available for pediatric ambulatory visits is rarely sufficient to permit a truly comprehensive health assessment. We hypothesized that a reliable, computerized, self-administered questionnaire could be designed to screen for a full range of pediatric health issues and provide a comprehensive health database for pediatric patients. An age- and gender-specific pediatric questionnaire of 478 questions was formatted to elicit only a "Yes," "No," or "Not Sure" response and structured in a branched, decision-tree format. The initial draft was reviewed for content by pediatric experts in Canada and the United States and revised in accordance with their suggestions. The questionnaire was divided into two modules, Medical Peds, covering biomedical issues and Prevent Peds, covering prevention, psychosocial, educational, and safety topics. Cognitive interviews were carried out with 132 parents in pediatric ambulatory care centers in Chicago and Halifax, with use of scripted and nonscripted probe questions, to ensure comprehensibility among patients with widely varying educational levels and health knowledge. Reliability was tested in 100 parents of children aged 1 month to 12 years, through use of five different test-retest sequences. Respondents' impressions were surveyed on completion of the procedure. Following content reviews, and cognitive and reliability testing, the total bank of questions was reduced to 375. As a result of the use of branching logic, individual parents answered an average of 111 Prevent Peds and 144 Medical Peds questions. Average time required to complete the entire questionnaire was 13 minutes for Prevent Peds and 19 minutes for Med Peds. Retesting within 36 hours showed an overall 97% concordance of response pairs in the Medical Peds and Prevent Peds questionnaires. There were no statistically significant differences in test-retest reliability between different sequence formats used, (e.g., HealthQuiz followed by personal interview, or HealthQuiz vs. HealthQuiz). A few questions that frequently elicited "Not Sure" responses were eliminated. As a result, the majority of questions elicited either a "Yes" or "No" response. Pediatric HealthQuiz identified a wide spectrum of child health problems that are often overlooked in routine health visits. Parents completing Pediatric HealthQuiz indicated a high degree of satisfaction with the procedure. Most reported that they believed the information would improve their child's health care.

Canada↗

PubMed1992

The effects of summarization instruction on text comprehension of students with learning disabilities.

This study examined the effectiveness of a summarization strategy for increasing comprehension of expository prose in students with learning disabilities. Thirty students with learning disabilities from Grades 6 through 9 were randomly assigned to experimental and control groups. In addition, 15 students without disabilities served as a normal comparison group for comprehension. Students in the experimental condition were trained to criterion on five rules of summarization. Direct instruction in the summarization strategy significantly increased reading comprehension of the students in the experimental group. Strategy usage was maintained over time, and students were reported to generalize its use.

Adolescent↗

PubMed1989

Comprehension aids for on-line reading of expository text.

A chapter of expository text was presented on a CRT with optional "windowing" of definitions of selected words varying in relevance to each screen's main ideas. A test treatment was interposed to influence reading strategies. Dependent variables included text reading time, frequency of definition "calls," definition reading rates, and scores on a final comprehension test. Results indicate that a technical chapter can be read from a CRT with appreciable content retention. Subjects accessed 80% of available definitions, but those able to "call" content-relevant definitions increased their frequency of definition "calls." Definition reading rate diminished; comprehension and processing time increased only for subjects accessing the theoretically relevant definitions. The results suggest how the use of definitions enhances the comprehension of on-line training manuals, texts, and help screens. "Callable" definitions need not include all low-frequency technical concepts but only those relevant to reductive main ideas.

Adult↗

PubMed1989

Reading comprehension in adolescents with learning disabilities: semantic and syntactic effects.

Ninety-two adolescents with learning disabilities were randomly assigned to four groups to determine the effects of semantic and syntactic complexity on the reading comprehension of content area prose. One group served as a control and read a social studies passage without change. The three treatment groups read passages with syntactic and/or semantic modifications. Comprehension was significantly better for those groups reading passages with combined semantic and syntactic modifications and syntactic modifications alone, when compared to the control group. Semantic modifications alone did not significantly improve comprehension.

Adolescent↗

PubMed1991

The effect of extra time on reading comprehension scores for university students with and without learning disabilities.

The purpose of this study was to examine the effects of extra time on the ability of university students with and without learning disabilities to complete a reading comprehension test under timed and extra-time conditions. The participants were 16 students identified as having learning disabilities and 15 normally achieving students, all attending the University of California. The Nelson-Denny Reading Comprehension and Reading Rate Test was used. Percentile ranks were obtained for reading rates on individuals, and for comprehension scores under timed and extra-time conditions. The major findings of this study were that there is a significant difference between scores obtained by students with learning disabilities and by normally achieving students under timed conditions and that there are no significant differences in test performance between students with learning disabilities and normally achieving university students when students with learning disabilities are provided extra time. Normally achieving students did not perform significantly better with extra time.

Achievement↗

PubMed1994

An eye-movement analysis of the effects of scotopic sensitivity correction on parsing and comprehension.

Does scotopic sensitivity correction enhance parsing and, thus, comprehension? Twenty-two readers with scotopic sensitivity (mean age = 20.3 yrs.; 40.9% male) parsed sentences under scotopic correction and control conditions. Measures included eye-movement indices of parsing and comprehension questions. Although eye movements suggested enhanced parsing, comprehension scores were not significantly improved with correction.

Adolescent↗

PubMed2001

The effect of production variables in monolog and dialog on comprehension by novel listeners.

Prior research has identified a number of dimensions along which speakers modify referring expressions. The present study aimed to determine and describe the actual relationship existing between these production characteristics and corresponding measures of listener comprehension. Spoken descriptions were elicited from eight speakers during monolog and dialog conditions of the tangram task. In a subsequent listening experiment, 163 new subjects listened to the referring expressions from the speech corpus, and were asked to select, from an array of tangram figures, the one that was being described in the referring expression. Results revealed that the production variables most commonly documented by previous researchers collectively contributed to listener comprehension to a surprisingly small, but consistently significant, degree. Furthermore, the communicative context in which referring expressions were produced did not substantially influence their overall comprehensibility; instead, communicative context, as well as the individual characteristics of the speaker who produced the referring expression, appeared to affect which variables listeners found most useful when inferring what the speaker meant.

Adult↗

PubMedDate not supplied

Eye fixations predict reading comprehension: the relationships between reading skill, reading speed, and visual inspection.

This experiment addressed the question of whether reading comprehension and speed could be predicted by eye fixations. From a sample of university students who completed tests of reading comprehension and vocabulary, we selected a group of highly skilled readers and a group of less skilled readers. These two groups then read sentences as their eye movements were monitored, with fixation locations and durations recorded. A discriminant function analysis showed that fixation duration was a successful predictor of reading comprehension, but that the number of fixations, regressive fixations, reading speed, and vocabulary were not reliable predictors. A multiple regression analysis revealed that reading speed was predicted by the number of fixations, the average fixation duration, and the duration of the final fixation upon the sentence, but there was no relationship with reading ability. Highly skilled readers are those who can extract information efficiently, but are not necessarily those who have fast overall reading rates.

Adolescent↗

PubMedDate not supplied

Comprehensive radiotherapy for advanced Hodgkin's disease refractory to chemotherapy.

Seven patients with advanced nodular sclerosing Hodgkin's disease who relapsed after initial intensive combination chemotherapy were selected for individualized pathologic restaging and comprehensive radiotherapy. One patient failed to respond completely to mantle-field irradiation and no further staging or radiotherapy was undertaken. Six other patients underwent staging laparotomy and received total nodal irradiation including prophylactic lung irradiation (5 cases) and hepatic irradiation (3 cases). Irradiation was well tolerated. Complete remission was achieved by 5 patients and 2 continue in remission 29+ and 32+ months after beginning of irradiation. Five of the 7 patients remain alive. This study indicates that comprehensive irradiation is a relatively well tolerated and effective treatment for carefully selected patients with advanced Hodgkin's disease who have relapsed after combination chemotherapy. For selected patients, pathologic restaging and comprehensive radiotherapy can be considered as an alternative to further chemotherapy.

Adolescent↗

PubMed1999

The role of the pediatric nurse practitioner in the comprehensive management of pediatric oncology patients in the inpatient setting.

The role of the pediatric nurse practitioner (PNP) in the comprehensive management of pediatric oncology patients in the inpatient setting was examined at a large tertiary teaching hospital. This article shows role responsibilities including new diagnosis teaching, procedures, routine chemotherapy, patients' comprehensive medical management, coordination of nursing care across settings, phone triage, and professional development. A PNP's typical day is highlighted to illustrate the innovative merging of traditional ambulatory care roles with that of the PNP as a comprehensive manager of pediatric oncology patients in the inpatient setting. This role provides a more seamless care experience and provides critical links in the delivery of health care to pediatric oncology patients.

Drug Therapy↗

PubMed2006

Comprehensive comparative analysis of kinesins in photosynthetic eukaryotes.

BACKGROUND: Kinesins, a superfamily of molecular motors, use microtubules as tracks and transport diverse cellular cargoes. All kinesins contain a highly conserved approximately 350 amino acid motor domain. Previous analysis of the completed genome sequence of one flowering plant (Arabidopsis) has resulted in identification of 61 kinesins. The recent completion of genome sequencing of several photosynthetic and non-photosynthetic eukaryotes that belong to divergent lineages offers a unique opportunity to conduct a comprehensive comparative analysis of kinesins in plant and non-plant systems and infer their evolutionary relationships. RESULTS: We used the kinesin motor domain to identify kinesins in the completed genome sequences of 19 species, including 13 newly sequenced genomes. Among the newly analyzed genomes, six represent photosynthetic eukaryotes. A total of 529 kinesins was used to perform comprehensive analysis of kinesins and to construct gene trees using the Bayesian and parsimony approaches. The previously recognized 14 families of kinesins are resolved as distinct lineages in our inferred gene tree. At least three of the 14 kinesin families are not represented in flowering plants. Chlamydomonas, a green alga that is part of the lineage that includes land plants, has at least nine of the 14 known kinesin families. Seven of ten families present in flowering plants are represented in Chlamydomonas, indicating that these families were retained in both the flowering-plant and green algae lineages. CONCLUSION: The increase in the number of kinesins in flowering plants is due to vast expansion of the Kinesin-14 and Kinesin-7 families. The Kinesin-14 family, which typically contains a C-terminal motor, has many plant kinesins that have the motor domain at the N terminus, in the middle, or the C terminus. Several domains in kinesins are present exclusively either in plant or animal lineages. Addition of novel domains to kinesins in lineage-specific groups contributed to the functional diversification of kinesins. Results from our gene-tree analyses indicate that there was tremendous lineage-specific duplication and diversification of kinesins in eukaryotes. Since the functions of only a few plant kinesins are reported in the literature, this comprehensive comparative analysis will be useful in designing functional studies with photosynthetic eukaryotes.

Algal Proteins↗

PubMed2005

Rationale, design and conduct of a comprehensive evaluation of a primary care based intervention to improve the quality of life of osteoarthritis patients. The PraxArt-project: a cluster randomized controlled trial [ISRCTN87252339].

BACKGROUND: Osteoarthritis (OA) has a high prevalence in primary care. Conservative, guideline orientated approaches aiming at improving pain treatment and increasing physical activity, have been proven to be effective in several contexts outside the primary care setting, as for instance the Arthritis Self management Programs (ASMPs). But it remains unclear if these comprehensive evidence based approaches can improve patients' quality of life if they are provided in a primary care setting. METHODS/DESIGN: PraxArt is a cluster randomised controlled trial with GPs as the unit of randomisation. The aim of the study is to evaluate the impact of a comprehensive evidence based medical education of GPs on individual care and patients' quality of life. 75 GPs were randomised either to intervention group I or II or to a control group. Each GP will include 15 patients suffering from osteoarthritis according to the criteria of ACR. In intervention group I GPs will receive medical education and patient education leaflets including a physical exercise program. In intervention group II the same is provided, but in addition a practice nurse will be trained to monitor via monthly telephone calls adherence to GPs prescriptions and advices and ask about increasing pain and possible side effects of medication. In the control group no intervention will be applied at all. Main outcome measurement for patients' QoL is the GERMAN-AIMS2-SF questionnaire. In addition data about patients' satisfaction (using a modified EUROPEP-tool), medication, health care utilization, comorbidity, physical activity and depression (using PHQ-9) will be retrieved. Measurements (pre data collection) will take place in months I-III, starting in June 2005. Post data collection will be performed after 6 months. DISCUSSION: Despite the high prevalence and increasing incidence, comprehensive and evidence based treatment approaches for OA in a primary care setting are neither established nor evaluated in Germany. If the evaluation of the presented approach reveals a clear benefit it is planned to provide this GP-centred interventions on a much larger scale.

Evidence-Based Medicine↗

PubMed2025

A comprehensive integration of data on the association of ITPKC polymorphisms with susceptibility to Kawasaki disease: a meta-analysis.

BACKGROUND: This study aims to conduct a comprehensive meta-analysis of existing research to define clear associations between variations in the ITPKC gene and the risk of developing Kawasaki disease (KD). METHODS: A comprehensive search was conducted across multiple databases, including but not limited to PubMed, Scopus, EMBASE, and CNKI, up to June 1, 2024, to gather relevant information. This search utilized keywords and MeSH terms related to hyperbilirubinemia and genetic factors. The inclusion criteria encompassed original case-control, longitudinal, or cohort studies. Correlations were analyzed as odds ratios (ORs) with 95% confidence intervals (CIs) using Comprehensive Meta-Analysis software. RESULTS: Eighteen case-control studies with 5,434 KD cases and 9,419 controls were analyzed. Of these, ten studies assessed 3,129 KD cases and 6,172 controls for the rs28493229 variant, four examined 1,039 cases and 1,688 controls for the rs2290692 variant, two focused on 595 cases and 820 controls for the rs7251246 variant, and two investigated 671 cases and 739 controls for the rs10420685 variant. Results showed a significant association between the rs28493229 polymorphism and increased KD risk across all five genetic models. Subgroup analysis indicated this polymorphism correlates with KD susceptibility in Asians but not in the Chinese population. In contrast, no associations were found between the rs2290692, rs7251246, and rs10420685 polymorphisms and KD risk. CONCLUSIONS: Our pooled data indicate a significant association between the ITPKC rs28493229 polymorphism's minor allele and an increased risk of developing KD, suggesting this variant may enhance susceptibility. Conversely, SNPs rs2290692, rs7251246, and rs10420685 do not demonstrate a statistically significant relationship with KD.

Humans↗

PubMedDate not supplied

Continuing education: a comprehensive approach to improving cancer pain management and patient satisfaction.

PURPOSE/OBJECTIVES: To report on the development and outcomes of a comprehensive program to improve cancer pain management and patient satisfaction. DATA SOURCES: Published research and guidelines, review articles, and patients' personal experiences. DATA SYNTHESIS: A comprehensive cancer pain management program includes performance improvement, patient satisfaction, nursing education, and pain management rounds. This approach to pain can result in effective pain management, patients' reports of acceptable levels of pain, and an increase in patient satisfaction. CONCLUSIONS: Semiweekly pain management rounds provided the opportunity for nurses to practice equianalgesic dosing and make recommendations for changes in pain management. Effective pain management plans can lead to an increase in scores that measure patient satisfaction. IMPLICATIONS FOR NURSING: Nursing pain management education and subsequent use of pain management principles during and between pain management rounds can lead to effective pain management and satisfaction for patients with cancer. Research is needed to assess whether comprehensive programs can change pain management practices in other patient populations.

Drug Administration Schedule↗

PubMed2000

Syntactic comprehension, verbal memory, and calculation abilities in Spanish-English bilinguals.

This article analyzes the interfering effect of the second language (L2) on the first language (L1) in native Spanish speakers living in the United States. We examined 3 linguistic aspects: (a) syntactic comprehension, (b) verbal memory, and (c) calculation abilities. We carried out 2 different studies. In the 1st study, we studied syntactic understanding in 50 Spanish-English bilinguals. For all participants, L1 was Spanish and L2 was English, and all learned English early in life and had attended English schools. Results for the Spanish Syntactic Comprehension Test (Marcos & Ostrosky, 1995) were compared with the normative results obtained with 40 Spanish monolingual participants. We observed that the closer to the English syntax the sentences were, the easier it was for the participants to understand them. Participants who had been exposed to English between the ages of 5 and 12 outperformed participants exposed to English before 5 years of age. Language preference correlated with syntactic comprehension. Women outperformed men. In the 2nd study, verbal memory and calculation abilities were examined in L1 and L2 in a group of 85 Spanish-English bilinguals. Parallel versions of the different tests were administered in Spanish and English. The results indicated some significant differences between the 2 languages in several verbal learning and calculation ability subtests. Most of the verbal memory subtests were better performed in L1. Scores on tasks measuring speed and calculation accuracy were higher in the participant's native language. Best spoken language proved to be a significant variable in some verbal memory subtests performed in English but not in Spanish. We analyze implications of bilingualism in neuropsychological testing. We also present some suggestions to minimize the bilingualism effect.

Adult↗

PubMed1986

Electrical stimulation of Wernicke's area interferes with comprehension.

Arrays of subdural electrodes were placed over the lateral convexity of the dominant hemisphere for propositional language in four patients with epilepsy as part of an evaluation prior to cortical resections. Stimulation was performed over several days. When we stimulated the posterior temporal language area, reading and comprehension of complex verbal information were impaired, but comprehension of nonverbal and simple verbal data was not affected. Impairment produced by stimulation seemed to be due to language comprehension difficulties, rather than impaired praxis or initial word storage.

Adolescent↗

PubMed2006

Outcomes for surgical and endovascular management of intracranial aneurysms using a comprehensive grading system.

OBJECTIVE: A systematic approach to the consideration of various factors on outcome demands a comprehensive grading system for patients with intracranial aneurysms. We have previously identified potential patient- and lesion-specific factors that correlate strongly with outcome after treatment for intracranial aneurysms, and we have developed a comprehensive grading system based on these factors. In this study, we evaluate this grading system in a large series of aneurysm patients treated by surgery and endovascular therapy. METHODS: Between January 1998 and January 2003, ruptured and unruptured aneurysm patients were prospectively entered into a database. Based on our previous study that showed which factors correlated strongly with outcome, data were collected on patient age, aneurysm size, Hunt and Hess grade, and Fisher scale (if presenting with subarachnoid hemorrhage), and a Massachusetts General Hospital grade was then applied. The modified Glasgow Outcome Scale was used for clinical assessment at follow-up, and a binary analysis classified patients into favorable versus unfavorable outcome. Univariate and multivariate analyses for the predictor variables were performed. RESULTS: One thousand forty-nine aneurysms in 914 patients were identified. Fifty-eight percent (n = 608) of the lesions were unruptured, and 25% (n = 261) were treated endovascularly. For patients treated either surgically or endovascularly, worsening outcome was demonstrated for higher Hunt and Hess grade (surgery, P < 0.001; endovascular, P < 0.001), Fisher scale (surgery, P < 0.001; endovascular, P < 0.001) and for older patients (surgery, P < 0.001; endovascular, P = 0.004). Size of aneurysm had a significant effect on outcome after surgery (P = 0.04), but not after endovascular therapy (P = 0.3). Overall, there was a greater proportion of favorable outcomes for anterior circulation compared with posterior circulation lesions (P < 0.0001). For both the surgical and endovascular subgroups, MGH grade correlated well with clinical outcomes. CONCLUSION: The MGH grade is a comprehensive grading system that is easily applied and that allows separation of patients with aneurysms into groups with markedly different outcomes. This information can potentially be helpful in making treatment decisions and when discussing projected outcome before surgical or endovascular intervention of both unruptured and ruptured aneurysms.

Adult↗