Assessment and diagnosis

  • 文章类型: Journal Article
    在对国际开发协会的定义发表评论时,我们依次讨论它的主要组成部分。虽然每个在技术上都是准确的,我们认为,当放在一起时,定义,或者更准确地说,它经常被用来使用,变得有问题。我们概述了当前有关阅读障碍的不同概念,并得出结论,出于诊断目的对定义进行操作通常会导致科学上有疑问的诊断,并无意中导致严重的教育不平等。我们提出了一个更简单的定义,描述了主要的困难,避免引用因果解释,出乎意料,和次要结果,并将从业者和政策制定者的重点重新定向到解决和满足所有苦苦挣扎的读者需求的重要性。
    In offering a commentary upon the IDA definition, we address its main components in turn. While each is technically accurate, we argue that, when taken together, the definition, or more accurately, the use to which it is often put, becomes problematic. We outline different current conceptions of dyslexia and conclude that the operationalisation of the definition for diagnostic purposes often results in scientifically questionable diagnoses and inadvertently leads to significant educational inequity. We propose a simpler definition that describes the primary difficulty, avoids reference to causal explanation, unexpectedness, and secondary outcomes, and redirects practitioner and policymaker focus to the importance of addressing and meeting the needs of all struggling readers.
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  • 文章类型: Journal Article
    这篇综述旨在确定临床医生和培训师在自闭症谱系障碍(ASD)的评估和诊断中可用的毕业后培训途径。这项研究以两个研究问题为指导:关于ASD特定教育的已知情况,培训,或其他可用于支持任何学科的临床医生的途径,毕业后,满足与ASD问题评估相关的所需专业知识?关于寻求向其他临床医生提供培训的临床医生可用的教育途径,毕业后,在评估ASD问题时?进行了范围审查,在五个数据库中完成了搜索(PubMed,PsycINFO,PsycEXTRA,ERIC和CINAHL)。还使用“高级”搜索功能执行了Google搜索策略。符合条件的记录是文学,用英语写的,检查毕业后的培训和/或临床医生的教育,以评估和/或诊断ASD。确定了14条相关记录。研究生培训有可能增强临床医生对ASD评估和诊断的信心和服务提供。全系统培训方法在建设大规模、诊断能力和远程指导的使用提供了一个具有成本效益的,便捷的培训交付模式。发现缺乏支持ASD诊断培训途径的证据,这可能对临床医生和服务用户构成挑战。发现的有限证据表明,高质量的研究对于确定如何在ASD评估和诊断中建立临床医生的能力以及确定培训途径是否是必要的组成部分至关重要。
    This review aimed to identify the post-graduation training pathways available for both clinicians and trainers in the assessment and diagnosis of Autism Spectrum Disorder (ASD). The study was guided by two research questions: What is known about ASD-specific educational, training, or other pathways available to support clinicians of any discipline, post-graduation, to meet the required expertise relevant to assessments of ASD concerns? What is known about the educational pathways available to clinicians seeking to provide training to other clinicians, post-graduation, in the assessment of ASD concerns? A scoping review was undertaken with searches completed across five databases (PubMed, PsycINFO, PsycEXTRA, ERIC and CINAHL). A Google search strategy was also executed using the \"advanced\" search function. Eligible records were literature, written in English, that examined post-graduation training and/ or education of clinicians to assess and/ or diagnose ASD. Fourteen relevant records were identified. Post-graduate training has the potential to enhance clinician confidence and service provision in ASD assessment and diagnosis. System-wide training approaches show promise in building large-scale, diagnostic capacity and the use of tele-mentoring offers a cost-effective, convenient mode of training delivery. A lack of evidence to support ASD diagnostic training pathways was found and may pose a challenge for clinicians and service users. The limited evidence found suggests that high quality research will be fundamental in determining how to build clinician capacity in ASD assessment and diagnosis and to ascertain whether training pathways are a necessary component.
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  • 文章类型: Journal Article
    背景:考虑性别和性别相关因素对于理解和支持健康和福祉至关重要。尽管性别和性别都会影响发育障碍的人,在胎儿酒精谱系障碍(FASD)患者中,关于这些因素及其影响的研究相对较少,复杂的神经发育障碍影响了约4%-5%的人口。需要了解FASD中与性别和性别相关的差异,以促进循证评估,治疗计划,和宣传。要开始解开这些因素,我们调查了FASD评估患者在整个生命周期中临床表现和体验方面的性别差异.
    方法:我们分析了来自加拿大29个FASD诊断中心的2574份临床记录。参与者的年龄范围为1至61岁(平均15.2岁),一半以上(58.3%)是出生时的男性。研究变量包括参与者人口统计学,产前酒精暴露(PAE)的物理指标,神经发育障碍,FASD诊断,同时发生的身体和心理健康诊断,和环境逆境。
    结果:在FASD诊断结果或PAE的物理指标方面,男性和女性之间没有显着差异。然而,男性经历了明显更多的神经发育障碍。女性的内分泌问题发生率更高,焦虑,和抑郁/情绪障碍,而男性的注意力缺陷多动障碍发生率较高,行为障碍,和对立的反抗障碍。逆境也因性别而异,女性在受害/监护方面遭受创伤和法律问题的比率更高,和男性在学校和冒犯/监禁方面有更多困难。基于性别的差异在青少年(13-17岁)和成年人(≥25岁)中最为明显。
    结论:患有PAE/FASD的个体在整个生命周期的临床表现和经历中经历了显著的性别相关差异。这项研究的结果应该有助于指导研究人员,服务提供商,和政策制定者改善FASD筛查,诊断,和干预,更好地解决所有性别的PAE/FASD患者的需求。
    Consideration of sex- and gender-related factors is critical for understanding and supporting health and wellbeing. Although both sex and gender influence people with developmental disabilities, there is relatively little research on these factors and their influences among individuals with fetal alcohol spectrum disorder (FASD), a complex neurodevelopmental disability impacting an estimated 4%-5% of the population. Understanding sex- and gender-related differences in FASD is needed to facilitate evidence-informed assessment, treatment planning, and advocacy. To begin unpacking these factors, we investigated sex-based differences in clinical presentation and experiences among individuals assessed for FASD across the lifespan.
    We analyzed 2574 clinical records from 29 FASD diagnostic centers in Canada. Participants ranged in age from 1 to 61 years (mean 15.2 years), and more than half (58.3%) were male at birth. Study variables included participant demographics, physical indicators of prenatal alcohol exposure (PAE), neurodevelopmental impairment, FASD diagnosis, co-occurring physical and mental health diagnoses, and environmental adversity.
    There were no significant differences between males and females with respect to FASD diagnostic outcome or physical indicators of PAE. However, males experienced significantly more neurodevelopmental impairment. Females experienced higher rates of endocrine problems, anxiety, and depressive/mood disorders, whereas males had higher rates of attention deficit-hyperactivity disorder, conduct disorder, and oppositional defiant disorder. Adversity also differed by sex, with females experiencing higher rates of trauma and legal problems with victimization/custody, and males having more difficulties with school and offending/incarceration. Sex-based differences were most apparent in adolescents (13-17 years) and adults (≥25 years).
    Individuals with PAE/FASD experience notable sex-related differences in clinical presentation and experiences across the lifespan. Findings from this study should help to guide researchers, service providers, and policy makers to improve FASD screening, diagnosis, and intervention and better address the needs of individuals with PAE/FASD of all genders.
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  • 文章类型: Journal Article
    自2016年澳大利亚胎儿酒精谱系障碍诊断指南(FASD)发布以来,在该疾病的识别和诊断方面取得了相当大的进展。作为审查和更新指南的更大过程的一部分,本研究的目的是确定参与FASD评估和诊断的广泛利益相关者的审查重点.62个利益攸关方,包括医疗保健从业人员,研究人员,其他专家,有文化专长的人,生活经验和消费者代表完成了一项在线调查,要求他们描述最多五个优先事项,以审查《澳大利亚FASD诊断指南》。共描述了267个优先事项。回答的内容分析揭示了与诊断标准相关的优先领域(n=82,30.7%),指南内容(n=91,34.1%),指南传播(n=15,5.6%)和指南实施(n=63,23.6%)。其他考虑因素包括FASD的预防和筛查(n=16,6%)。让利益攸关方参与确定优先事项将确保修订后的《澳大利亚指南》对主要最终用户尽可能具有相关性和意义,并满足那些受诊断影响最大的有生活经验的个人的需求。
    Since the 2016 release of the Australian Guide to the Diagnosis of Fetal Alcohol Spectrum Disorder (FASD), considerable progress has been made in the identification and diagnosis of the disorder. As part of a larger process to review and update the Guide, the aim of this study was to identify review priorities from a broad range of stakeholders involved in the assessment and diagnosis of FASD. Sixty-two stakeholders, including healthcare practitioners, researchers, other specialists, individuals with cultural expertise, lived experience and consumer representatives completed an online survey asking them to describe up to five priorities for the review of the Australian Guide to the Diagnosis of FASD. A total of 267 priorities were described. Content analysis of responses revealed priority areas relating to diagnostic criteria (n = 82, 30.7%), guideline content (n = 91, 34.1%), guideline dissemination (n = 15, 5.6%) and guideline implementation (n = 63, 23.6%). Other considerations included prevention and screening of FASD (n = 16, 6%). Engaging stakeholders in setting priorities will ensure the revised Australian Guide can be as relevant and meaningful as possible for the primary end-users and that it meets the needs of individuals with lived experience who will be most affected by the diagnosis.
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  • 文章类型: Journal Article
    Individuals with fetal alcohol spectrum disorder (FASD) experience a range of neurodevelopmental challenges, often compounded by social and environmental adversity. One of the most concerning outcomes that can be associated with FASD is involvement in the justice system, where individuals with FASD are vastly over-represented. Individuals with FASD who are both justice-involved and Indigenous experience added layers of marginalization. In this community-based study, we explored the needs of 16 adults who participated in an FASD-informed restorative justice program in an Indigenous community in Alberta, Canada. Clinical record reviews and client interviews were used to gather information. Diverse needs were identified, including pervasive neurodevelopmental difficulties, notable physical and mental health challenges, complex experiences of psychosocial trauma, and varied criminogenic needs. This study increases our understanding of the unique and complex biopsychosocial and criminogenic needs of Indigenous justice-involved adults with FASD. Such an understanding is a first step in developing tailored interventions for individuals with FASD and has important practice and policy implications for supporting positive outcomes. For Indigenous individuals with FASD, intervention efforts should be integrated within the community context to promote collective healing.
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  • 文章类型: Journal Article
    BACKGROUND: Physical examination and health assessment skills are essential components of nursing practice, and the critical elements to be taught merit further investigation.
    OBJECTIVE: To develop and evaluate a physical examination and health assessment course based on a self-directed learning framework.
    METHODS: An action research design was employed.
    METHODS: A baccalaureate nursing program of the university of science and technology in central Taiwan.
    METHODS: A convenience sample comprising 23 teaching faculty members and 41 enrolled second-year students was recruited.
    METHODS: Structured questionnaires were developed for data collection. A paired t-test and the Kruskal-Wallis test were used for data analysis.
    RESULTS: The course consisted of four parts: health history taking from a holistic perspective, examination skills in diverse systems, case exercise and discussion, and final objective structured clinical examination. Statistical significance was found in the areas of physical examination skills, critical thinking, and case analysis. Participants with mid-to high-level self-directed learning had significantly higher scores than those with low-level self-directed learning on physical examination skills and problem assessment. Internal and discriminant validity were supported.
    CONCLUSIONS: The study results provide evidence supporting the use of self-directed learning framework in curriculum design. The course integrated necessary knowledge and skills enabled students to practice physical examination, and assessment skills may enhance student confidence in approaching patients in clinical encounters. However, the study was a descriptive design. The generalization of the results needs to be further validated by an experimental study.
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  • 文章类型: Journal Article
    区域农业干旱恢复力(RADR)评估与诊断是识别区域农业准确抵御干旱灾害不足的重要基础工作。为了定量评估区域农业系统在复杂条件下减少干旱灾害损失的能力,并确定脆弱性指标,建立了RADR的评估和诊断模型.首先,该模型采用改进的模糊层次分析法确定指标权重,然后提出了一种基于连接数和改进连接熵的评估方法。此外,基于减法的集合对电位用于诊断漏洞索引。此外,在安徽省淮北平原地区进行了实际应用。评价结果显示,2005年至2014年该地区的RADR整体处于相对较弱的态势。然而,在这10年中,平均等级值从3.144降至2.790,RADR有增强的趋势。此外,该地区六个城市增强RADR的可能性从东到西下降,干旱应急条件是淮北平原RADR的薄弱环节。
    Assessment and diagnosis of regional agricultural drought resilience (RADR) is an important groundwork to identify the shortcomings of regional agriculture to resist drought disasters accurately. In order to quantitatively assess the capacity of regional agriculture system to reduce losses from drought disasters under complex conditions and to identify vulnerability indexes, an assessment and diagnosis model for RADR was established. Firstly, this model used the improved fuzzy analytic hierarchy process to determine the index weights, then proposed an assessment method based on connection number and an improved connection entropy. Furthermore, the set pair potential based on subtraction was used to diagnose the vulnerability indexes. In addition, a practical application had been carried out in the region of the Huaibei Plain in Anhui Province. The evaluation results showed that the RADR in this area from 2005 to 2014 as a whole was in a relatively weak situation. However, the average grade values had decreased from 3.144 to 2.790 during these 10 years and the RADR had an enhanced tendency. Moreover, the possibility of RADR enhancement for six cities in this region decreased from east to west, and the drought emergency condition was the weak link of the RADR in the Huaibei Plain.
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  • 文章类型: Journal Article
    It is estimated that one third to one half of the 2.3 million individuals inside U.S. jails and prisons have a mental illness in contrast to 18.3% of the general population. The implications of this on training mental health professionals to provide efficacious treatment inside correctional facilities, as well as planning for the rehabilitation and reintegration of incarcerated individuals, are significant and numerous. This article will present a brief history and overview of mental health services in the U.S. correctional system, as well as a discussion of the barriers to and potential facilitators of providing effective care in the future.
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  • 文章类型: Journal Article
    Different math indices can be used to assess math potential at school entry. We evaluated whether standardized math achievement (TEMA-2 performance), core number abilities (dot enumeration, symbolic magnitude comparison), non-verbal intelligence (NVIQ) and visuo-spatial working memory (VSWM), in combination or separately, predicted mental addition problem solving speed over time. We assessed 267 children\'s TEMA-2, magnitude comparison, dot enumeration, and VSWM abilities at school entry (5 years) and NVIQ at 8 years. Mental addition problem solving speed was assessed at 6, 8, and 10 years. Longitudinal path analysis supported a model in which dot enumeration performance ability profiles and previous mental addition speed predicted future mental addition speed on all occasions, supporting a componential account of math ability. Standardized math achievement and NVIQ predicted mental addition speed at specific time points, while VSWM and symbolic magnitude comparison did not contribute unique variance to the model. The implications of using standardized math achievement and dot enumeration ability to index math learning potential at school entry are discussed.
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  • 文章类型: Journal Article
    我们开发了一个简短的,评估成人自闭症谱系疾病(ASC)的线人报告访谈,叫做发展,维度和诊断性访谈-成人版(3Di-Adult);并完成了初步评估。收集了ASC参与者的信息报告(n=39),非自闭症心理健康状况的非临床对照组(n=29)和临床对照组(n=20)。平均给药时间为38分钟(ASC为50分钟)。内部一致性(αs≥0.93)和评分者之间的一致性(ICC≥0.99)很高。当区分ASC和非ASC时,3Di-Adult显示出优异的敏感性(95%)和特异性(92%)。3Di-Adult显示出有望作为一种心理测量的声音和时间效率的访谈,用于收集DSM-5对成人ASC评估的标准化线人报告,在研究和临床实践中。
    We developed a brief, informant-report interview for assessing autism spectrum conditions (ASC) in adults, called the Developmental, Dimensional and Diagnostic Interview-Adult Version (3Di-Adult); and completed a preliminary evaluation. Informant reports were collected for participants with ASC (n = 39), a non-clinical comparison group (n = 29) and a clinical comparison group (n = 20) who had non-autistic mental health conditions. Mean administration time was 38 min (50 min for ASC). Internal consistency (αs ≥ 0.93) and inter-rater agreement (ICCs ≥ 0.99) were high. When discriminating ASC from non-ASC, the 3Di-Adult showed excellent sensitivity (95%) and specificity (92%). The 3Di-Adult shows promise as a psychometrically sound and time-efficient interview for collecting standardised informant reports for DSM-5 assessments of ASC in adults, in research and clinical practice.
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