SEARCH · PubMed Health

Results for “Learning outcomes”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 991 records · Page 55Linked to original sources

PubMed2006

Healthy Weigh (El camino saludable) phase 1: a retrospective critical examination of program evaluation.

BACKGROUND: Healthy Weigh (El camino saludable) is an obesity prevention program for low-income, predominantly Hispanic and African American families in an urban community in Tarrant County, Texas. Healthy Weigh Phase 1 was a successful community-campus partnership that took place in summer (June-August) and fall (September-November) 2003. The program met stated objectives and extensively engaged students from several health disciplines in service learning. This article describes what we learned about the evaluation of the program by examining the phase 1 evaluation process. CONTEXT: Family environments are important intervention settings for establishing life-long dietary practices. Available in English and Spanish, Healthy Weigh Phase 1 helped families that were at risk for overweight and obesity to adopt healthy eating, physical activity, and weight management patterns. METHODS: Analysis of a program logic model and formative evaluation data identified evaluation questions that could have improved the phase 1 evaluation process. Questions were categorized according to Donabedian's structure-process-outcome framework, and potential benefits of each question were identified. The Centers for Disease Control and Prevention's Framework for Program Evaluation in Public Health standards were used to judge the overall quality of the phase 1 evaluation process. CONSEQUENCES: The phase 1 evaluation process successfully assessed the program's effects and generally met evaluation standards. Our critical examination also highlighted structure and process evaluation issues with potential for strengthening future interventions, community partnerships, and program outcomes. INTERPRETATION: Lessons learned influenced the phase 2 grant activities. Most importantly, we learned that involvement of program participants as full partners in program design, evaluation, and implementation is essential. Our understanding and practice of program evaluation evolved as Healthy Weigh became a true community-based participatory research endeavor.

Adolescent↗

PubMed2003

From process to outcome: the effect of portfolio assessment on student learning.

Literature suggests that assessment may influence student learning in a positive or negative way. Despite the support for the use of portfolio assessment, relatively little is known about its effect on student learning. The purpose of this study was to evaluate the effectiveness of portfolio assessment in enhancing student learning. Students undertaking the Bachelor of Nursing programme in a University in Hong Kong participated in the study. Twelve of the students who underwent portfolio assessment described, in individual semi-structured interviews, their experience and perceptions of this form of assessment. This paper reported on the qualitative findings of the study, which employed both qualitative and quantitative methods. Three themes emerged from the students' accounts: (1) the students favoured the use of portfolio assessment; (2) the process of preparing portfolios yielded positive academic and affective outcomes; and (3) unexpected findings in the form of spontaneous collaborative learning and apparent increased interest in learning during the process of preparing portfolios for those students who lacked motivation. The qualitative findings contribute to a better understanding of the use of portfolio assessment and have implications for teaching.

Affect↗

PubMed2000

Distance learning: health education for ninth-grade students.

A telehealth programme for schools was established by staff at the East Carolina University schools of nursing, health education, social work, nutrition, education and medicine, in conjunction with the Eastern Area Health Education Center. A health education curriculum was developed for rural high schools using the North Carolina Information Highway for delivery. A Web page provided additional resources for teachers, teenagers and health professionals. Four telehealth sessions were conducted over three years: two with the pilot school and two with a second school on-line simultaneously. A total of 76 ninth-grade students completed the courses. Evaluation indicated successful outcomes in student learning. Respondents to a follow-up survey of members of the first telehealth class had positive comments about the experience. Utilization of the Web page increased steadily from 1997.

Education, Distance↗

PubMed2006

Student self-assessment and its impact on learning - a pilot study.

Student self-assessment is widely reported to offer numerous advantages to the learner. It is a popular practice for empowering students and the advantages are claimed to incorporate increased dialogue between students and teachers and the development of skills that encompass critical awareness and reflectivity. It is, potentially, a process that may enable health care practitioners to be lifelong learners, equipped with the skills for autonomy in learning and professional practice. As such it might be viewed as an essential element of the curriculum. This paper reports on a study designed to evaluate the implementation of self-assessment among student health care practitioners. The pilot study examined the impact of self-assessment on learning and how the process was perceived by students and staff. Findings indicated that a varied approach had been taken to its implementation, which had significant repercussions in the way in which it was perceived by students. Similarly, there was a varied approach taken by students to the process of self-assessment and this had significant repercussions for its overall value as a learning tool. The outcomes of this study provide a sound rational for maintaining and expanding the practice of student self-assessment and important lessons for the process of doing so.

Anxiety↗

PubMed1996

Naltrexone, relapse prevention, and supportive therapy with alcoholics: an analysis of patient treatment matching.

Alcohol-dependent patients (N = 97) were randomly assigned to receive either naltrexone or placebo and either relapse prevention therapy or supportive therapy. The present report explored the hypothesis that patients could be matched to the above treatments on the basis of specific pretreatment characteristics. Treatment matching variables explored included craving, alcohol dependence severity, and cognitive measures of learning and memory. Results of linear regression analyses tentatively suggest that patients experiencing higher levels of craving and poorer cognitive functioning may derive the greatest benefit from naltrexone versus placebo. For psychotherapy, lower levels of verbal learning were associated with poorer drinking outcomes for relapse prevention therapy but not for supportive therapy. Conversely, higher levels of verbal learning were associated with better outcomes for relapse prevention therapy but not for supportive therapy.

Adolescent↗

PubMed2025

Machine learning on multiple epigenetic features reveals H3K27Ac as a driver of gene expression prediction across patients with glioblastoma.

Epigenetic mechanisms play a crucial role in driving transcript expression and shaping the phenotypic plasticity of glioblastoma stem cells (GSCs), contributing to tumor heterogeneity and therapeutic resistance. These mechanisms dynamically regulate the expression of key oncogenic and stemness-associated genes, enabling GSCs to adapt to environmental cues and evade targeted therapies. Importantly, epigenetic reprogramming allows GSCs to transition between cellular states, including therapy-resistant mesenchymal-like phenotypes, underscoring the need for epigenetic-targeting strategies to disrupt these adaptive processes. Understanding these epigenetic drivers of gene expression provides a foundation for novel therapeutic interventions aimed at eradicating GSCs and improving glioblastoma outcomes. Using machine learning (ML), we employ cross-patient prediction of transcript expression in GSCs by combining epigenetic features from various sources, including ATAC-seq, CTCF ChIP-seq, RNAPII ChIP-seq, H3K27Ac ChIP-seq, and RNA-seq. We investigate different ML and deep learning (DL) models for this task and ultimately build our final pipeline using XGBoost. The model trained on one patient generalizes to other 11 patients with high performance. Notably, H3K27Ac alone from a single patient is sufficient to predict gene expression in all 11 patients. Furthermore, the distribution of H3K27Ac peaks across the genomes of all patients is remarkably similar. These findings suggest that GSCs share a common distributional pattern of enhancer activity characterized by H3K27Ac, which can be utilized to predict gene expression in GSCs across patients. In summary, while GSCs are known for their transcriptomic and phenotypic heterogeneity, we propose that they share a common epigenetic pattern of enhancer activation that defines their underlying transcriptomic expression pattern. This pattern can predict gene expression across patient samples, providing valuable insights into the biology of GSCs.

Glioblastoma↗

PubMed2005

Neuropsychiatric movement disorders following streptococcal infection.

The aim of this study was to describe post-streptococcal movement disorders that form part of the acute rheumatic fever complex. The clinical records of patients diagnosed with Sydenham's chorea were analyzed retrospectively to investigate epidemiology, the significance of socioeconomic deprivation, clinical manifestations, treatments, outcomes, long-term morbidity, and disease evolution. Forty-two patients (21 males, 21 females) were diagnosed with Sydenham's chorea. The median presentation age was 9 years 8 months (range 3y 5mo to 13y 2mo). Nineteen patients were of indigenous African ancestry; 23 were of mixed ancestry. All patients lived in poverty and had poor access to medical care. Twelve of the total group had disabling symptoms for longer than 2 years; six of these patients developed paediatric autoimmune neuropsychiatric disorder associated with Streptococcus (Paediatric autoimmune neuropsychiatric disorder associated with Streptococcus [PANDAS]), five Tourette syndrome (TS), and one learning difficulties. Poor outcome was significantly more prevalent in patients of mixed ancestry, in those with a positive family history, previous behavioural problems, or a failure to complete 10 days of penicillin and 'bed-rest'/hospitalization. Sydenham's chorea is one manifestation of post-streptococcal neuropsychiatric movement disorders. This study demonstrates that patients can present with one diagnosis and evolve other neuropsychiatric conditions such as TS and PANDAS. In the South African context, it is important to delineate neuropsychiatric movement disorders associated with streptococcal infections. The potential genetic susceptibility should be explored.

Adolescent↗

PubMed2004

ERP correlates of feedback and reward processing in the presence and absence of response choice.

The feedback negativity is a component of the event-related brain potential that is elicited by feedback stimuli associated with unfavorable outcomes. The present research investigated whether this component reflects an evaluation of the valence of experienced outcomes or a process of learning about actions that led to those outcomes. The latter hypothesis predicts that the feedback negativity should be observed only when negative outcomes are experienced in relation to executed actions. Contrary to this prediction, feedback negativities were observed in simple monetary gambling tasks in which participants made no active choices (experiment 1) and no overt actions (experiment 2). However, the amplitude of the component was reduced in these tasks relative to a gambling task in which the outcomes appeared to be contingent upon participants' response choices. This reduction was correlated with changes in participants' subjective ratings of involvement in the tasks, suggesting that the evaluative process indexed by the feedback negativity is sensitive to the motivational significance of ongoing events.

Adolescent↗

PubMed2005

Post-master's certificate in nursing education.

With the continued shortage of nursing faculty, schools of nursing need short yet effective means of preparing educators to teach in their programs. One such strategy is a post-master's certificate in nursing education. This article describes the courses, learning activities, and outcomes of a post-master's certificate program in nursing education. Twenty-five graduates, randomly selected from the 53 who had completed the program, were interviewed. The findings indicated that a post-master's certificate was an effective strategy for preparing nurse educators and meeting the demands for more faculty in a short period of time.

Certification↗

PubMed2000

Improving physician-delivered counseling in a primary care setting: lessons from a failed attempt.

BACKGROUND: The high prevalence of behavioral risk factors for cardiovascular diseases demands innovative approaches to achieving behavior change. Primary care physicians are in an ideal position for offering such interventions. PURPOSE: To evaluate whether training of primary care physicians in counseling skills based on the Transtheoretical Model (TTM) leads to motivational and behavioral changes in their patients. METHOD: Seventy-four primary care physicians in Germany were randomly assigned to either an intervention condition (one day of training in TTM-based counseling plus brochures matched to their patients' "stages of change") or a control condition (usual care). Baseline and 12-month follow-up data were collected from 305 of their patients who signed up for a health check-up. OUTCOME MEASURE: Patients' movements across the stages of change for smoking, diet, exercise and stress management. RESULTS: After 12 months, patients of physicians in the intervention group did not show more movement through the stages of change for any of the behaviors than did patients of control physicians. Additionally, there were no differences between groups in counseling frequency, counseling intensity, or patient satisfaction with counseling. CONCLUSIONS: A high dropout rate at follow-up and resulting "power" problems limit the possible conclusions. The high numbers of patients in early stages of change and the minimal improvement over time underline the need for improving motivational counseling skills of primary care physicians in Germany. In our study the dissemination of these strategies failed. We offer lessons we feel can be learned from this outcome. Further studies should focus on ways to enhance the process of educating physicians for implementing counseling strategies in primary care settings.

Clinical Trial↗

PubMed2005

Relationships among polycyclic aromatic hydrocarbon-DNA adducts, proximity to the World Trade Center, and effects on fetal growth.

Polycyclic aromatic hydrocarbons (PAHs) are toxic pollutants released by the World Trade Center (WTC) fires and various urban combustion sources. Benzo[a]pyrene (BaP) is a representative member of the class of PAHs. PAH-DNA adducts, or BaP-DNA adducts as their proxy, provide a measure of chemical-specific genetic damage that has been associated with increased risk of adverse birth outcomes and cancer. To learn whether PAHs from the WTC disaster increased levels of genetic damage in pregnant women and their newborns, we analyzed BaP-DNA adducts in maternal (n = 170) and umbilical cord blood (n = 203) obtained at delivery from nonsmoking women who were pregnant on 11 September 2001 and were enrolled at delivery at three downtown Manhattan hospitals. The mean adduct levels in cord and maternal blood were highest among newborns and mothers who resided within 1 mi of the WTC site during the month after 11 September, intermediate among those who worked but did not live within this area, and lowest in those who neither worked nor lived within 1 mi (reference group). Among newborns of mothers living within 1 mi of the WTC site during this period, levels of cord blood adducts were inversely correlated with linear distance from the WTC site (p = 0.02). To learn whether PAHs from the WTC disaster may have affected birth outcomes, we analyzed the relationship between these outcomes and DNA adducts in umbilical cord blood, excluding preterm births to reduce variability. There were no independent fetal growth effects of either PAH-DNA adducts or environmental tobacco smoke (ETS), but adducts in combination with in utero exposure to ETS were associated with decreased fetal growth. Specifically, a doubling of adducts among ETS-exposed subjects corresponded to an estimated average 276-g (8%) reduction in birth weight (p = 0.03) and a 1.3-cm (3%) reduction in head circumference (p = 0.04). The findings suggest that exposure to elevated levels of PAHs, indicated by PAH-DNA adducts in cord blood, may have contributed to reduced fetal growth in women exposed to the WTC event.

Adolescent↗

PubMed2007

Song discrimination learning in zebra finches induces highly divergent responses to novel songs.

Perceptual biases can shape the evolution of signal form. Understanding the origin and direction of such biases is therefore crucial for understanding signal evolution. Many animals learn about species-specific signals. Discrimination learning using simple stimuli varying in one dimension (e.g. amplitude, wavelength) can result in perceptual biases with preferences for specific novel stimuli, depending on the stimulus dimensions. We examine how this translates to discrimination learning involving complex communication signals; birdsongs. Zebra finches (Taeniopygia guttata) were trained to discriminate between two artificial songs, using a Go/No-Go procedure. The training songs in experiment 1 differed in the number of repeats of a particular element. The songs in experiment 2 differed in the position of an odd element in a series of repeated elements. We examined generalization patterns by presenting novel songs with more or fewer repeated elements (experiment 1), or with the odd element earlier or later in the repeated element sequence (experiment 2). Control birds were trained with only one song. The generalization curves obtained from (i) control birds, (ii) experimental birds in experiment 1, and (iii) experimental birds in experiment 2 showed large and systematic differences from each other. Birds in experiment 1, but not 2, responded more strongly to specific novel songs than to training songs, showing 'peak shift'. The outcome indicates that learning about communication signals may give rise to perceptual biases that may drive signal evolution.

Acoustic Stimulation↗

PubMed2004

Trends and outcomes in transplantation for complex congenital heart disease: 1984 to 2004.

BACKGROUND: Cardiac transplantation for patients with complex congenital heart disease poses several anatomic and physiologic challenges for the transplant surgeon. We undertook the current single center study to evaluate surgical outcomes and lessons learned through a nearly twenty year experience with cardiac transplantation for complex congenital heart disease. METHODS: A retrospective review was performed to evaluate all patients undergoing cardiac transplantation from January 1, 1984 through January 1, 2004. Donor and recipient demographic and intraoperative and postoperative variables were acquired and correlated with perioperative (30-day) and late mortality in both univariate and multivariate analyses, and with Kaplan-Meier survival estimates. RESULTS: One hundred and six patients underwent transplantation for complex congenital heart disease and were followed for a median of 56 months. Thirty-seven (34.9%) patients died. Male gender and later year of transplantation were protective, and neonatal age and pulmonary artery reconstruction detrimental in multivariable modeling of overall mortality. Transplantation to a physiologic or anatomic single lung did not impact on survival. Patients in the study cohort had comparable survival estimates when compared with all those in the entire cohort without complex congenital heart disease. When comparing patients by era of transplantation, both cohorts demonstrated improved survival with later transplantation. CONCLUSIONS: Outcomes with transplantation for complex congenital heart disease have improved annually over the past twenty years. Transplantation to an anatomic or physiologic single lung did not impair overall survival. Pulmonary artery reconstruction imparted an increase in mortality both short and long term, a finding which merits further investigation.

Adolescent↗

PubMed1995

The learning curve for AIDS-related Pneumocystis carinii pneumonia: experience from 3,981 cases in Veterans Affairs Hospitals 1987-1991.

Previous studies have found lower mortality rates for AIDS-related Pneumocystis carinii pneumonia (PCP) in hospitals with higher levels of experience with PCP. It is not known if patients are selectively referred to better hospitals or if there is a learning curve whereby outcomes improve as physicians gain experience in treating PCP. We assessed cases of PCP at 140 Veterans Administration (VA) Medical Centers in the United States. During 1987-1991, 3,981 patients were hospitalized with first-episode AIDS-related PCP. Mortality at 30 days after admission. For these 3,981 hospitalizations at the 140 study hospitals, the 30-day mortality was 19%. Logistic regression models indicate that older age, race, geographic area, earlier year of treatment, hospitalization in the previous 12 months, and lower levels of hospital experience with AIDS were significant predictors of mortality at 30 days after admission. Compared with hospitals that had treated three cases or fewer of first-episode PCP, the odds of mortality at 30 days at hospitals that treated > 50 cases of first-episode PCP were 0.73 (95% confidence interval 0.58-0.91), after controlling for differences in characteristics of the patients, year, and region. Mortality of patients with AIDS-related PCP decreases as VA hospitals gain experience. Longitudinal analyses over a 5-year period suggest that a learning curve best explains this finding.

AIDS-Related Opportunistic Infections↗

PubMedDate not supplied

[The effect of the learning curve and the experience on the technique and the outcome of laparoscopic treatment for gastroesophageal reflux].

The laparoscopic treatment for gastroesophageal reflux disease (GERD) by partial (PF) or total (TF) fundoplication is the current surgical treatment of choice after failure of appropriate medical treatment. The overall results with fundoplication include the initial learning period during which the rate of complications, and failures are assumed to be greater. The aim of this study was to compare the results of laparoscopic treatment for GR in 3 groups of consecutive patients in order to determine the effect of the learning period and the experience on the technique and the outcome. One hundred and fifty patients (84 men and 66 women) with an average age of 52.2 years (18 to 78) were included. Surgery was indicated for failure or early relapse following the end of medical treatment. The preoperative work-up (endoscopy, barium meal or oesophageal pH monitoring) was governed by the clinical picture. The choice between TF and PF was based on the results of pH monitoring. Three groups of 50 patients around were chronologically defined. The parameters that were examined were: the operative technique; the conversion rate; the mortality and morbidity rate; the duration of surgery and hospitalization and the results at short and medium term follow-up. The three groups were comparable with respect to patient characteristics and the nature of their GERD. All patients had an endoscopy, 91% a barium meal, 77.5% underwent esophageal manometry and 67% pH monitoring. One hundred and thirty two patients had a TF and 18 had a PF. Rosetti's type TF became the reference procedure (80.3% in group III) and closure of the diaphragmatic crura was performed systematically in group III (100%). The duration of surgery was significantly reduced between group I and the two other groups (138, 100, 80 mn.). The rate of conversion, due to a variety of causes, decreased from 10.2% to 4% and then 0%. The average duration of hospitalization decreased from 5.8 to 4.2 days (p = 0.01). There was no mortality and the morbidity rate decreased from 14.3% to 4% and then 0%. There was 7 cases of relapse (4.6%), 5 in group 1 (10.2%) and 2 in group II (4%), with no cases in group III although the follow-up is shorter. There is an effect of the learning curve on the outcome of treatment for GR and this must be taken into account in the training of surgeons (training within experienced departments and "guidance" during their initial interventions) and also in publications in order to allow a more accurate comparison of the different treatments for GERD.

Adolescent↗

PubMedDate not supplied

Lessons learned from cross-border medical response to the terrorist bombings in Tabba and Ras-el-Satan, Egypt, on 07 October 2004.

INTRODUCTION: Large-scale, terrorist attacks can happen in peripheral areas, which are located close to a country's borders and far from its main medical facilities and involve multi-national casualties and responders. The objective of this study was to analyze the terrorist suicide bombings that occurred on 07 October 2004, near the Israeli-Egyptian border, as representative of such a complex scenario. METHODS: Data from formal debriefings after the event were processed in order to learn about victim outcomes, resource utilization, critical events, and time course of the emergency response. RESULTS: A total of 185 injured survivors were repatriated: four were severely wounded, 13 were moderately injured, and 168 were mildly injured. Thirty-eight people died. A forward medical team landed at the border town's airport, which provided reinforcement in the field and in the local hospital. Israeli and Egyptian search and rescue teams collaborated at the destruction site. One-hundred sixty-eight injured patients arrived at the small border hospital that rapidly organized itself for the mass-casualty incident, operating as an evacuation "staging hospital". Twenty-three casualties secondarily were distributed to two major trauma centers in the south and the center of Israel, respectively, either by ambulance or by helicopter. CONCLUSION: Large-scale, terrorist attacks at a peripheral border zone can be handled by international collaboration, reinforcement of medical teams at the site itself and at the peripheral neighboring hospital, rapid rearrangement of an "evacuation hospital", and efficient transport to trauma centers by ambulances, helicopters, and other aircraft.

Blast Injuries↗

PubMed2002

Adolescent outcomes of childhood conduct disorder among clinic-referred boys: predictors of improvement.

Much remains to be learned about the adolescent outcomes of clinic-referred boys whose childhood conduct problems are serious enough to meet diagnostic criteria for conduct disorder (CD). Six structured diagnostic assessments were conducted over 7 years of 73 clinic-referred 7-12-year-old boys who met criteria for CD in Wave 1. There were substantial individual differences in the adolescent outcomes of CD, ranging from worsening to sustained recovery, with most boys showing persistent, but fluctuating levels of CD. Improvement in CD was not accounted for by treatment or incarceration, but more positive outcomes over Waves 2-7 were predicted prospectively with substantial accuracy, using a combination of baseline predictors: less initial severity of CD, fewer symptoms of attention-deficit hyperactivity disorder, higher child verbal intelligence, greater family socioeconomic advantage, and not having antisocial biological parents.

Adolescent↗

PubMed2004

Psychobiological mechanisms of socioeconomic differences in health.

The association between low socioeconomic status and poor health is well established. Empirical studies suggest that psychosocial factors are important mediators for these effects, and that the effects are mediated by psychobiological mechanisms related to stress physiology. The objective of this paper is to explore these psychobiological mechanisms. Psychobiological responses to environmental challenges depend on acquired expectancies (learning) of the relations between responses and stimuli. The stress response occurs whenever an individual is faced with a challenge. It is an essential element in the total adaptive system of the body, and necessary for adaptation, performance and survival. However, a period of recovery is necessary to rebalance and to manage new demands. Individuals with low social status report more environmental challenges and less psychosocial resources. This may lead to vicious circles of learning to expect negative outcomes, loss of coping ability, strain, hopelessness and chronic stress. This type of learning may interfere with the recovery processes, leading to sustained psychobiological activation and loss of dynamic capacity to respond to new challenges. Psychobiological responses and health effects in humans and animals depend on combinations of demands and expected outcomes (coping, control). In studies of humans with chronic psychosocial stress, and low SES, cortisol baseline levels were raised, and the cortisol response to acute stress attenuated. Low job control was associated with insufficient recovery of catecholamines and cortisol, and a range of negative health effects. Biological effects of choice of lifestyle, which also depends on the acquired outcome expectancies, reinforce these direct psychobiological effects on health. The paper concludes that sustained activation and loss of capacity to respond to a novel stressor could be a cause of the higher risk of illness and disease found among people with lower SES.

Adaptation, Psychological↗