[On the evaluation of the deficiencies, handicaps and corporal prejudices. Criteria of evaluation, tables, guides, charts and methods of evaluation].
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Accidents, Occupational↗
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Human evaluative conditioning: acquisition trials, presentation schedule, evaluative style and contingency awareness.
Two different processes may be operative in human Pavlovian conditioning: signal learning and evaluative learning. Whereas most studies on evaluative conditioning focused on a mere demonstration of the phenomenon or on a theoretical analysis of the underlying processes, some basic parameters of evaluative learning are still unexplored. Hence, using the standard neutral picture--(dis)liked picture pairing paradigm (Baeyens, Eelen & Van den Bergh, 1990), in this study the effect of two parameters of evaluative conditioning was assessed on a between-subjects base, namely the Number of Acquisition Trials (2/5/10/20) and the Presentation Schedule of the stimulus pairs (blockwise or random). Additionally, the study included an exploratory analysis of the potential effects of the Evaluative Style of subjects (Feelers vs Thinkers, operationalized in terms of speed of emitting evaluations). Finally, the relationship between contingency awareness and evaluative learning was reassessed. Neutral-liked conditioning was found to be quadratically related to the number of acquisition trials (increase in effect up to 10 trials, decrease from 10 to 20 trials), whereas neutral-disliked conditioning linearly increased with increasing numbers of trials. Randomized vs blockwise presentation schedules of the stimulus pairs did differentially affect the overall pattern of conditioning, but in a way which was both unexpected and difficult to account for theoretically. Both the Evaluative Style of subjects and contingency awareness were demonstrated to be generally orthogonal to conditioned shifts in CS valence. Based on these findings, some practical suggestions are provided for the application of evaluating conditioning based therapeutical interventions to affective-behavioral disorders which are centred around inappropriate (dis)likes.
Adult↗
Evaluation of drug treatment in mild hypertension: VA-NHLBI feasibility trial. Plan and preliminary results of a two-year feasibility trial for a multicenter intervention study to evaluate the benefits versus the disadvantages of treating mild hypertension. Prepared for the Veterans Administration-National Heart, Lung, and Blood Institute Study Group for Evaluating Treatment in Mild Hypertension.
A feasibility trial to investigate the practicality of determining the advantages and disadvantages of prompt pharmacologic treatment for mild hypertension was jointly funded by the Veterans Administration and the National Heart, Lung and Blood Institute. Its clinical phase has been completed, and it demonstrated 1. that the required relatively young asymptomatic population could be enrolled in the study and 2. that it could be persuaded to adhere to the protocol for 2 years; however, it was evident that intensive efforts would be required in both areas. The feasibility trial screened almost 120,000 potential subjects over a period of 16 months to randomize about 1,000 subjects at four clinical centers. These men and women were 21 to 50 years old, had diastolic pressures from 85 to 105 mm Hg as outpatients, and had no evidence of cardiovascular renal abnormalities. They were randomized in double-blind fashion into active drug therapy and placebo groups. Stepped care therapy involved 50 mg chlorthalidone (Step 1), 100 mg chlorthalidone (Step 2) and 100 chlorthalidone plus 0.25 mg reserpine (Step 3). Death, myocardial infarction, stroke, angina pectoris, and congestive heart failure were the "major" morbid events that were looked for; also recorded were "minor" morbid events consisting primarily of electrocardiographic arrhythmias. The development of significant hypertension was considered a treatment failure. Side effects were carefully tabulated in both active drug and placebo groups. The study revealed an average drop in diastolic pressure of almost 12 mm Hg for active drug group and less than half of that for the placebo group; once established 6 months after randomization, the new pressure levels persisted almost without change throughout the study. Although the feasibility trial was not designed to answer the primary question regarding the benefits of treatment, the events were tabulated for each group. A total of 12 placebo-treated subjects developed significant hypertension and were put on active drug. There was not a significant difference between the two groups in the incidence of "major" morbid events; a total of eight active and five placebo patients developed myocardial infarction or died suddenly. There, however, was an excess of arrhythmias among the active drug subjects (17 in the active group versus 8 in the placebo group on the basis of preliminary data). Finally, there were twice as many side effects and 20 times as many chemical abnormalities among the active as among the placebo subjects. A protocol for a full scale study of the benefits of pharmacologic therapy in mild hypertensives has been prepared and is ready for implementation as needed; it involves relatively minor modifications of the protocol tested in the feasibility trial.
Adult↗
[Evaluation of evaluation of evaluation].
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Adult↗
Evaluation of emerging technologies for coronary revascularization. Participants in the National Heart, Lung, and Blood Institute Conference on the Evaluation of Emerging Coronary Revascularization Technologies.
Despite significant advances in coronary angioplasty, the problems of restenosis, chronic total occlusion, diffuse disease, and abrupt closure after the procedure remain to be solved. New devices that address these problems continue to evolve. Although a controlled clinical trial is the ultimate test of any device, rapid device design changes and resource limitations require evaluating which of the new devices justify a full clinical trial. A registry mechanism for this initial evaluation is proposed and detailed. Payment for procedures using new devices is a problem for industry, insurers, hospitals, and physicians. It is proposed that reimbursement be based on the service performed rather than the device used to perform it. Costs beyond the clinical costs should be borne by the sponsor of the device. Financial conflict of interest is a recognized problem in new device evaluation. It is not always practical to insist on exclusion from the evaluation process of individuals with a financial stake in the outcome, but disclosure of the presence of such a financial interest is recommended in the reporting of results.
Angioplasty, Balloon, Coronary↗
Project 2000 curriculum evaluation: the case for teacher evaluation.
Project 2000 has changed the role of nurse teachers. Thus evaluation of Project 2000 should incorporate a theoretical framework that not only evaluates the individual school/college of nursing curriculum but also enhances the teachers' professional development. This paper suggests that teacher professional development would be enhanced by teacher self-evaluation (action research). A collaborative approach between teachers and an evaluation co-ordinator would ensure that the quality of the curriculum is maintained (MacDonald 1991). It is argued that the implementation of monitored innovation would fulfil the criteria for the developing school/college of nursing put forward by Holly et al (1989).
Curriculum↗
Effect of acquisition of knowledge on self-evaluation and the relationship of self-evaluation to perception of real and ideal self-concept.
To investigate the effect of knowledge acquisition on self-evaluation and self-concept 69 graduate nursing students--25 in an experimental group, 18 in control group I, and 26 in control group II--enrolled in three nursing courses provided demographic data, self-evaluation of entering behavior, and personality test data. The latter two tests were given on pre- and posttest bases. Seven hypotheses were tested. Overall results showed: The experimental group which was taught by means of mastery learning acquired significantly more knowledge than the control groups which received the traditional lecture-discussion method of learning; there was an inverse relationship between knowledge acquisition and self-evaluation of entering behavior; positive correlation between "amount of overestimation or underestimation of previous knowledge'' and extremes of self-concept was partially supported; in general, single students were less able to evaluate accurately by what they thought they knew than were married subjects; employment was inversely related with knowledge acquisition and course grade. The relationship between self-concept and acquisition of knowledge was not significant.
Education, Nursing, Graduate↗
Evaluating an information system for medical care evaluation studies.
The purpose of this study was to evaluate a computerized information system, the Professional Activity Study-Medical Audit Program (PAS-MAP), when used by the medical staff of a hospital to conduct medical care evaluation studies. PAS-MAP was compared to a manual system for collecting data not contained on the face sheets of medical records. The results indicated that, compared to the manual system, PAS-MAP: was less costly if more than 41 per cent of hospitalized patients were included in medical care evaluation studies; was as timely as the manual system for data it could provide but provided fewer clinical data elements than physicians requested; and was less protective against human error. Three decision makers assigned weights indicating the relative importance of these results. The weights were combined in an additive model to arrive at a score for each system. Based on these scores, the manual system was recommended for implementation.
Abstracting and Indexing↗
Dental assistant evaluation index: a technic to evaluate the work performance of Indian Health Service dental assistants.
1. The DAEI appears to be a useful instrument to evaluate dental assistant students in a reliable, uniform manner for the "core" dental assistant activities. 2. Calibration of the supervisors will be needed if the evaluation data are to be used on comparative bases from clinic to clinic or area to area. 3. Further study is needed to confirm the reliability and to establish the validity of the index. The current study should be considered an initial effort that should be continuously modified to maximize its usefulness. 4. Further study is needed to ascertain whether there is a real difference in the way dental auxiliaries view their job as compared to dentists. 5. Scores for dental assistants cannot be indiscriminately compared in a meaningful manner between auxiliaries at different locations. Even within a facility, caution should be applied before making conclusions based upon comparative scores. 6. The use of the DAEI for assessing the quality of the Dental Assistant Training Center was not adequately evaluated. The index may have this potential, but more study is required before it will be clear as to how the index might apply.
Arizona↗
Evaluation of the consistency of Acute Physiology and Chronic Health Evaluation (APACHE II) scoring in a surgical intensive care unit.
OBJECTIVES: To determine the applicability of the Acute Physiology and Chronic Health Evaluation (APACHE II) scoring system in a Swiss ICU, and to evaluate its utility in evaluating data from 2 yrs of consecutive admissions to show that the predictability of outcome is similar to that predictability observed by Knaus et al. in 1985 (in 5,815 patients), with the provision that large numbers of patients are studied. DESIGN: Prospective clinical trial over 2 yrs, with statistical analysis of the Swiss patients, and between the Swiss patients and the patients studied by Knaus et al. Receiver operating characteristic curves were calculated. SETTING: Surgical ICU in a Swiss university hospital. PATIENTS: A total of 2,061 consecutive patients admitted to the surgical ICU who were classified as postoperative (elective or emergency) and nonoperative. Hospital mortality rate was considered. RESULTS: Patients were 53 +/- 16 yrs of age. Mean APACHE II score was 10.5 +/- 7.0. The mean APACHE II score was significantly (p < .001) lower in the 1,813 survivors (9.0 +/- 5.2) than in the 248 nonsurvivors (21.5 +/- 8.5). The mortality rate was higher among the Swiss patients when compared with the patients studied by Knaus et al. who had postoperative scores of 20 to 29 and nonoperative scores of > 24. The distribution of the scores and mortality rates were stable during the two study periods, as were the differences in mortality rates between the Swiss population and that population studied by Knaus et al. Sensitivity and specificity of the scores were highest in the emergency surgery group (87% and 78%), and lowest in the elective surgery group (76% and 73%). The APACHE equation underestimated the risk of death. CONCLUSIONS: The APACHE II score, because of its consistency over time and the stability of the mortality rates, can be used in our surgical ICU without modification. The calculated risk of death gives no additional information.
Adolescent↗
A self-evaluation token system versus an external evaluation token system alone in a residential setting with predelinquent youth.
This study compared the effects of self-evaluation and adult-dispensed tokens on room-cleaning behavior of six predelinquent youths in a residential token-economy setting. The self-evaluation token system proved to be as effective as the external adult-administered system in increasing room-cleaning behavior and was more effective in maintaining performance after contingencies were withdrawn. The self-evaluation token system increased resistance to extinction, compared to the external token system, and appeared to be a useful component for a traditional token-economy system.
Adolescent↗
Evaluation of skin irritancy of sodium lauryl sulphate: a comparative study between the replica method and visual evaluation.
For 20 years, using the replica method, we have evaluated the skin irritancy of about 10,000 commercial products which come into contact with the skin. In this method, test substances are usually applied on the flexor side of the upper arm for 24 h by semi-open patch test. Subsequently, skin replicas are taken and skin irritancy is evaluated microscopically. In the semi-open patch test, test substances are not completely occluded as in the closed patch test. Thus, this method is less invasive than the closed patch test method to the tested subjects. In this study, we investigated the sensitivity of microscopic scoring (MS) of the replica and visual scoring (VS) of the skin. Sodium lauryl sulphate (SLS) at 0.02%, 0.05%, and 0.2% was applied on 20 subjects' upper arms, using closed and semi-open methods. In both the closed patch test and the semi-open patch test, the value of MS correlated with the concentration of SLS, while VS did not show such a clear correlation. In addition, we compared 2 clinical tests for skin irritancy which are commonly performed in Japan: VS of 48 h closed patch test reaction on the subjects' upper backs and MS of 24 h semi-open patch test reaction on the subjects' upper arms (replica method). MS on the upper arms resulted in a constant score, regardless of the location of application, while VS on the upper back produced results which differed widely depending on the location. Thus, the replica method is a useful clinical test for skin irritancy, because it is sensitive, reproducible and non-invasive.
Adolescent↗
Evaluation by objectives: A systematic approach to the evaluation of educational programs and activities in dental education.
In response to the need for more effective utilization of resources, many institutions of higher learning are beginning to use corporate management methods. These methods, MBO being the most familiar example, center on the common comprehension at all levels of the goals of the corporation. However, institutions of higher learning uniformly lack a cohesiveness of purpose that extends from the level of president to that of teaching faculty. It is a mistake to assume that institutional educational goals are understood and supported by appropriate educational objectives at the department and program level. The evaluation-by-objective format is a concise graphical way to identify areas of support and confusion. It can be applied at each level of the institution and transmitted upward so that personnel at each administrative level can see the way in which its goals and objectives are perceived at lower levels. The proposed format facilitates grouping of educational objectives into programs, providing a framework for the estimation of effort and of needed resources. Since perceptions of effort and required resources will differ depending upon perspective, important issues will be identified, a most significant benefit of the system. The format leads to the formulation of an action plan, which should be reviewed periodically. The first step toward scientific management in institutions of higher learning must be a clear understanding of institutional and subunit goals, along with a set of education objectives that will accomplish these goals. The evaluation-by-objective format directs itself to exactly that concern.
Education, Dental↗
[Clinical evaluation of per-rectal scintigraphy using I-123 IMP--evaluation of the portal hemodynamic changes after TAE].
Per-rectal portal scintigraphy using I-123 IMP was performed before and after TAE in 29 patients with hepatoma. Index of porto-systemic shunt (PSS index) was obtained by lung/(lung + liver) uptake ratio at 30 min after administration of IMP. The influence of TAE on portal circulation was evaluated by using this PSS index. PSS index increased 16 of 29 patients (55.2%) after TAE. PSS index increased after TAE especially in cases of severe liver dysfunction before TAE, marked portal involvement, and embolization of a larger liver volume. PSS index also increased when there was deterioration of esophageal varices, ascites, and hepatic coma after TAE. PSS index is useful for evaluation of portal circulation after TAE.
Amphetamines↗
Evaluation of the Abbott Bichromatic Analyzer 100 (A proposal for an evaluation scheme).
This report summarizes a one year evaluation of Abbott's ABA 100, with respect to mechanical parts (syringe plates, precision and linearity of photometry, band width of several filters, multicuvet precision, temperature control) and the reliability of several methods (endpoint procedures: determination of the glucose concentration with hexokinase- and the glucose dehydrogenase method, and of the protein concentration; enzyme activities: alanine and aspartate aminotransferase, creatine kinase, alkaline phosphatase). The critical batch size was estimated as an indicator of economy (about 40 samples per day for the glucose concentration). Various aspects of the instrument are discussed with respect to its use in clinical chemistry.
Autoanalysis↗
Bioeconomic evaluation of embryo transfer in beef production systems: II. Economic evaluation of steer production.
A bioeconomic model was developed and used to evaluate economic implications of embryo transfer for steer production. Sensitivity analysis indicated that the net returns were strongly influenced by pregnancy and growth rates. Matching of recipient and embryo sizes reduced dystocia prevalence and resulted in as much as a $98 saving per transfer in costs associated with dystocia. Optimal weight and age and net returns at slaughter were found to be a function of mature size and growth rate. Varying growth rates resulted in optimal slaughter weight and net present value (NPV) ranging from 403 to 494 kg and $156 to $273, respectively, for medium-sized steer genotypes characterized by a mature size of 600 kg. The optimal slaughter weight ranged from 456 to 607 kg and NPV from $182 to $344 for large-sized steer genotypes characterized by a mature size of 750 kg. The results showed that high pregnancy rates and embryos with high growth rates generated the greatest profitability from investment in embryo transfer. The model has a wide potential application in formulating optimal biological and economic strategies for matching embryo genetic resources to physical and economic environments for commercial beef production.
Age Factors↗
[Evaluation of osteodensitometry. Report of the National Agency for the Development of Medical Evaluation].
The progress made in recent years in the field of bone densitometry, particularly concerning dual-energy x-ray absorptiometry, has resulted in the development of reliable techniques of bone mineral density measurement, especially for measurements in the lumbar spine on anteroposterior views and in the forearm. However, technical improvements are still necessary and concern the standardisation of equipment, measurements in the femur, on lateral views of the lumbar spine and on the whole body, and the definition of normal curves. The value of these measurements must be examined in the light of the epidemiological context of osteoporosis and its current and future cost to the community. They must be evaluated in relation to two pathological situations: osteoporosis and osteopenia. Osteoporosis is a disease characterised by the development of fractures due to bone fragility. It is accompanied by a reduction in bone density and other abnormalities of bone architecture and metabolism, without any disturbance of mineralisation. It is responsible for pain, a functional handicap which alters the patient's quality of life. Osteopenia corresponds to an abnormally low bone density. It is accompanied by an increased risk of fractures. Although it remains asymptomatic, therapeutic intervention may nevertheless be justified. The threshold of therapeutic intervention depends on the degree of bone loss, the patient's age, other associated risk factors and the benefit-risk ratio of the drug used. In all forms of vertebral osteoporosis, the essential conditions for the diagnosis are a decreased vertebral bone density and deformation of a vertebral body.(ABSTRACT TRUNCATED AT 250 WORDS)
Absorptiometry, Photon↗
Evaluation and re-evaluation of genetic radiation hazards in man. I. Interspecific comparison of estimates of mutation rates.
A detailed presentation is made of the experimental data from the various systems used by Abrahamson et al. [2] to conclude that the per locus per rad (low LET) radiation-induced forward mutation rates in organisms, whose DNA content varies by a factor of about 1000, is proportional to genome size. Additional information pertinent in this context is also reviewed. It is emphasized that the mutation rates cited by Abrahamson et al. [2], although considered as pertaining to mutations at specific loci, actually derive from a broad variety of genetic end-points. It is argued that an initial (if not sufficient) condition for sound inter-specific mutation rate comparisions, covering a wide range of organisms and detecting systems of various sensitivities, requires a reasonalbly consistent biological definition of a specific locus mutation, namely, a transmissible intra-locus change. Granting the differences between systems in their resolving power to detect intragenic change, the data cited in this paper do not support the existence of a simple proportionality between radiotion-induced intra-locus mutation rate and genome size for the different species reviewed here. Furthermore, in Drosophila melanogaster, where individual salivary gland chromosome bands (that can differ greatly in DNA content) are usually associated with individual loci or at least distinct complementation groups, radiation-induced intra-locus mutation rates are not correlated with apparent differences in the DNA content of bands. This result is incompatible with the notion that most of the DNA in a band represents a radiation-mutable target capable of eliciting the kind of mutation observed in mutation rate experiments. All these considerations argue against the validity of the hypothesis of Abrahamson et al. [2] and their generalization that, for the evaluation of genetic radiation hazards in man, we can now "extrapolate from mutation rates obtained in lower organisms to man with greater confidence" on the basis of DNA content (italics are ours).
Animals↗