Performing disclosure analyses to supplement assessment procedures and facilitate intervention planning is only valuable if the observations are reliable. The purpose of the present study was to evaluate and compare four methods of assessing reliability on one discourse analysis procedure--a modified version of Damico's Clinical Discourse Analysis (1985a, 1985b, 1992). The selected methods were: (a) Pearson product-moment correlations, (b) interobserver agreement, (c) Cohen's kappa, and (d) generalizability coefficients. Results showed high correlation coefficients and high percentages of interobserver agreement when error type was not taken into account. However, interobserver agreement percentages obtained solely for target behavior occurrences and Cohen's kappa revealed that much of the agreement between rates was due to chance and the high frequency of target behavior non-occurrence. Generalizability coefficients revealed that the procedure was fair to good for discriminating among persons with differing levels of language competency for some aspects of communication performance but was less than desirable for others; the aggregate score was below recommended standards for differentiating among people for diagnostic purposes.

Adolescent↗

PubMedDate not supplied

Impact of duration in a cardiac rehabilitation program on coronary risk profile and health-related quality of life outcomes.

BACKGROUND: Optimal cardiac rehabilitation (CR) program length and the time course of changes in relevant outcomes are unknown. The purpose of this study was to assess changes in coronary risk factors and health-related quality of life (HRQoL) after 3 months and 6 months of cardiac rehabilitation. METHODS: This is an observational study of a cohort of 126 consecutive cardiac rehabilitation patients who completed baseline, 3-month, and 6-month evaluations of coronary risk factors and HRQoL. The coronary risk factors included lipid profile, blood pressure, body mass index (BMI), and physical activity level. HRQoL was assessed using the Short Form-36 questionnaire (SF-36) comprising eight health concepts and two component scales (physical [PCS] and mental [MCS]). RESULTS: There was significant improvement in all coronary risk factors and HRQoL measures, except BMI, over the 6-month period (P < 0.001). Significant changes in blood pressure, physical activity, PCS, and high-density lipoprotein cholesterol (HDL-C) were apparent at 3 months, and no additional significant changes in these variables occurred between 3 and 6 months. For total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and MCS, significant change was achieved between 3 and 6 months but not between baseline and 3 months. CONCLUSIONS: Secondary prevention and HRQoL outcomes improved at variable rates. Physical activity and physical function peaked at 3 months and were maintained at program completion. Significant improvements occurred in mental health recovery beyond the traditional 12-week CR program length. Outcomes furthest from normative values showed the most rapid improvement. Optimal duration of participation may vary according to the outcome of interest.

Blood Pressure↗

PubMedDate not supplied

International perspectives on ADHD: introduction to the special series.

Explore the source record for details and available documents.

Adolescent↗

PubMedDate not supplied

Building a decision-support system.

To make decisions in today's dynamic health care environment, hospital managers rely on accurate and timely information--much of it compiled from hospital discharge data. For hospitals, the problem is not the lack of data but the inability to convert it to information useful to hospital management. This article describes how to build a cost-effective decision-support system that can transform HMRI (Hospital Medical Records Institute) data into a powerful management tool.

Canada↗