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MCC’s $177.7 million Armenia Compact (2006-2011) funded the $8.4 million Rural Road Rehabilitation Project to improve the quality of 24 kilometers of rural roads. The project was designed on the theory that improved rural roads would reduce transportation costs, enhance residents’ access to markets and social infrastructure, and increase vehicular activity, thereby increasing employment opportunities (both short- and long-term) and agricultural investment and production, eventually resulting in increased household income. In addition, about a quarter of the project cost went to fund the design of 430 kilometers of rural roads that were subsequently rehabilitated by the World Bank and the Government of Armenia.

Study Type: Independent Evaluation

Study Status: Completed

Program at a Glance

• Program Name: Armenia Compact
• Program Type: Compact
• Region: Europe, Asia, and Pacific
• Country: Armenia
• Program Dates: September 30, 2006 – September 29, 2011

Study

General Metadata

• Contractor: Mathematica
• Sector: Transportation
• Intervention Type(s): Transport infrastructure
• Cross-Sector Theme(s): agriculture productivity
• Project Objective:The Objective of the Rural Road Rehabilitation Project is to expand the access of rural communities to agricultural markets, non-farm income opportunities and social infrastructure by improving the condition of rural roads.

Evaluation Methodology

• Evaluation Type: Impact
• Evaluation Methodology Type: Differences in Differences with matching
• Location Type: Rural

Milestones

• Contract Start: September 2006
• Evaluation Design Report Published: June 2010
• Interim Report Published: NA
• Final Data Package Published: April 2015
• Final Report Publication: February 2017

Many people have health problems that affect how well they can do normal activities, either for a short time or for their lifetime. These problems may be present from birth or result from illness, injury, or aging. Rehabilitation, or rehab, can help patients regain the ability to do normal activities. Rehab providers include doctors, nurses, psychologists, and physical, occupational, speech, or language therapists.

Rehab treatments often lack a common definition. Rehab providers often name treatments by the type of professional who delivers them or the problem they treat, rather than by the content of the treatment. Also, treatments can vary across rehab providers. Using a standard way to define rehab treatments may help researchers compare these treatments.

In this study, the research team created and tested a manual to help rehab providers use standard ways to define rehab treatments.

The Burn Injury Model Systems National Longitudinal Database is a prospective, longitudinal, multicenter research study that examines functional and psychosocial outcomes following burns for over 3,000 adults and 2,000 children. The BMS National Database consists of data collected from individuals with moderate to severe burn injury; these data are collected by institutions across the country to learn more about long term outcomes after a burn injury.

The objective of the database is to provide a core set of variables which support rigorous research that:

1. Contributes to improved care and outcomes of individuals (both adult and pediatric) with severe burns.
2. Contributes to evidence-based rehabilitation interventions and clinical and practice guidelines that improve the lives of individuals with severe burns.
3. Studies the longitudinal course of severe burn injuries and their secondary effects and factors that affect that course.
4. Identifies and evaluates trends over time in etiology, demographics, injury severity characteristics, treatment of burns, health services delivery, and short-term and long-term outcomes of persons who incur a severe burn.
5. Establishes expected rehabilitation outcomes for persons with severe burns.
6. Facilitates other research such as the identification of potential persons for enrollment in appropriate burns clinical trials and research projects or as a springboard to population-based studies.

The primary goal of this project was to determine the neurobiologic basis for elevated activity in the contralesional primary motor cortex (PMC). In healthy individuals, unimanual movement (with either the left or right hand) is associated with activity in a network of predominantly contralateral brain regions, including the primary motor cortex. This laterality is often compromised following a middle cerebral artery (MCA) stroke. Neuroimaging studies of these patients have shown that unimanual movements with the effected hand are associated with elevated blood oxygen level dependent (BOLD) signal in both the lesioned and the nonlesioned primary motor cortices. Elevated activity in the contralesional PMC is well-established in chronic stroke patients and is associated with poor motor rehabilitation outcomes. Yet the neurobiologic basis for this aberrant neural activity is equivocal.

One factor that may contribute to elevated activity in the contralesional PMC is increased cortical excitatory tone within the contralesional hemisphere. While approximately 80% of the descending corticospinal neurons that control the right hand originate in the left PMC, 20% originate in the right PMC. Elevated activity in the right PMC of left-sided stroke patients may reflect compensatory activity of these descending fibers. Neural activity in the PMC reflects the balance of local excitatory (glutamatergic) and inhibitory (GABAergic) processing. It can be measured in two manners: electrophysiologically, using single hemisphere paired pulse transcranial magnetic stimulation (TMS), and neurochemically, using magnetic resonance spectroscopy (MRS).

Another factor that may contribute to elevated activity in the contralesional PMC is a loss of transcallosal inhibition between the hemispheres. During right hand movement, the left PMC of healthy individuals actively inhibits the right PMC via inhibitory projections through the corpus callosum. In left MCA stroke patients, elevated activity in the contralesional (right) PMC when moving the right hand may reflect a loss of typical inhibition from the left PMC. The integrity of inter-hemispheric information transfer can be measured in two manners: using bi-hemispheric paired-pulse TMS, and using a multimodal brain stimulation/brain imaging approach, interleaved TMS/MRI. Through interleaved TMS/MRI, researchers can selectively stimulate the ipsilesional PMC and quantify the amount of TMS-induced activity in the contralesional PMC.

These two explanations were tested through a cross-sectional investigation of neural function in left MCA stroke patients with mild-moderate right upper extremity impairment and controls matched for age and cardiovascular risk factors. To assess the clinical relevance of these factors on motor dysfunction, the researchers performed a detailed kinematic assessment of movement efficiency, smoothness and compensation.

Since 2001, Vermont Department of Corrections (DOC) sex offender treatment providers and probation and parole officers have scored every adult male sex offender under community supervision on three measures of static (unchangeable) risk at intake (i.e., Static-99, RRASOR-Rapid Risk Assessment for Sex Offence Recidivism, and VASOR-Vermont Assessment of Sex Offender Risk) and one measure of dynamic (changeable) risk (i.e, SOTNPS) at intake and then every six months thereafter. This project conducted record reviews to verify the accuracy of the risk assessment scores and examined how scores on the Sex Offender Treatment Needs and Progress Scale (SOTNPS) and one or more of these static risk instruments can be combined into an overall model of risk assessment. An empirically derived decision-making model was created to assist correctional administrators, probation and parole officers, and treatment providers in allocating and delivering supervision and treatment services based on an individual's treatment needs and risk to sexually re-offend.

Three hypotheses were tested. First, it was expected that one or more static risk measures (Static-99R, Static-2002R and VASOR) would predict sexual recidivism with moderate accuracy in the sample. Second, a dynamic risk measure, Sex Offender Treatment Needs and Progress Scale (SOTNPS), or a subset of risk factors contained in this measure would also predict sexual recidivism with moderate accuracy and be sensitive to the changes in dynamic risk over time. Third, a combined static and dynamic risk measure would predict sexual recidivism more accurate than either measure alone.

This study seeks to examine important components of our nation's sex offender tracking and monitoring systems, with a focus on risk assessment and sexual recidivism (measured by re-arrest). Data were collected from 1,789 adult sex offenders in the following states.

• Florida: 500 cases
• Minnesota: 500 cases
• New Jersey: 291 cases
• South Carolina: 498 cases

The data file contains another 551 cases from the state of Massachusetts. However, due to how and when those cases were identified they were not included in the Principal Investigator's focus and analysis. There are also another 151 cases where a study participant's state is missing. Total there are 2,491 cases and 1,947 variables.

The National Health and Aging Trends Study (NHATS) began in 2011 and fosters research to guide efforts to reduce disability, maximize health and independent functioning, and enhance quality of life at older ages. NHATS aims to provide the basis for understanding trends in late-life functioning, how these differ for various population subgroups, and the economic and social consequences of aging and disability for individuals, families, and society.

NHATS gathers information on a nationally representative sample of Medicare beneficiaries ages 65 and older. The sample is refreshed periodically so that researchers may study national-level disability trends as well as individual trajectories. Annual, in-person interviews collect detailed information on the disablement process and its consequences.

The NHATS interview is guided by a conceptual framework that recognizes physical and cognitive capacity is distinct from the environment in which activities take place. Among the specific content areas included are: the physical, social, technological and service environment, physical and cognitive capacity, use of assistive devices and rehabilitation, help received with daily activities (self-care, household, and medical), participation in valued activities, and wellbeing. A last month of life interview focuses on quality of end of life care. Periodically caregivers of NHATS respondents are interviewed in the supplemental National Study of Caregiving (NSOC). Linkages to Medicare records are also available.

Content was developed by a multidisciplinary team of researchers from the fields of demography, geriatric medicine, epidemiology, health services research, economics, and gerontology. NHATS is being led by the Johns Hopkins University Bloomberg School of Public Health in collaboration with the University of Michigan, with data collection by Westat, and support from the National Institute on Aging.

This dataset contains measures of the number and density of health care services per United States Census Tract or ZIP Code Tabulation Area (ZCTA) from 1990 through 2022. The dataset includes four separate files for four different geographic areas (GIS shapefiles from the United States Census Bureau).

The National Spinal Cord Injury Statistical Center (NSCISC) is operated by the University of Alabama at Birmingham Department of Physical Medicine and Rehabilitation through funding from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). NSCISC supports and directs the collection, management, and analysis of the world's largest and longest spinal cord injury (SCI) research database. Organizationally, NSCISC is currently at the hub of a network of 14 NIDILRR-sponsored and 5 subcontract-funded Spinal Cord Injury Model Systems located at major medical centers throughout the United States. In addition to maintaining the national SCI database, NSCISC personnel conduct ongoing, database-oriented research. NSCISC produces annuals reports and "Facts and Figures at a Glance" which can be accessed here.

The National Spinal Cord Injury Database has been in existence since 1973 and captures data from an estimated 6% of new SCI cases in the U.S. Since its inception, 28 federally funded SCI Model Systems have contributed data to the National SCI Database. As of March 2016, the database contained information on 31,645 persons who sustained traumatic spinal cord injuries. To assure comparability of data acquired by personnel in various centers, rigid scientific criteria have been established for the collection, management, and analysis of information entered into the database. National Spinal Cord Injury Statistical Center staff has also developed quality control procedures that further enhance the reliability and validity of the database.

Within the scope of the Spinal Cord Injury Model System program, the purposes of the National SCI Database are as follows:

1. to study the longitudinal course of traumatic SCI and factors that affect that course;
2. to identify and evaluate trends over time in etiology, demographic, and injury severity characteristics of persons who incur a SCI;
3. to identify and evaluate trends over time in health services delivery and treatment outcomes for persons with SCI;
4. to establish expected rehabilitation treatment outcomes for persons with SCI; and
5. to facilitate other research such as the identification of potential persons for enrollment in appropriate SCI clinical trials and research projects or as a springboard to population-based studies.

The Database, however, is not intended to study the effectiveness of model systems care as compared to other systems of health care delivery. It is also not by itself intended to gather and maintain population-based data on spinal cord injuries.

Education is an essential part of childhood, and attending school is vital to community integration for children with special health care needs. These children continue to face significant barriers to obtaining a high-quality educational experience, despite decades of federal legislation designed to promote full inclusion and access to schools for everyone. Children with special health care needs often struggle with school functioning because chronic health problems increase the risk for lengthy illnesses and hospitalizations. Pediatric rehabilitation specialists assist these children and their families with the transition back to school after a health event. However, there is a lack of information available to help clinicians, families, and educators plan for the dynamic experience of disability as a child develops and interacts with the school environment. Healthcare providers need this information to evaluate their transition services from hospital to community and develop new interventions that can improve the educational success of these children over time. The purpose of this project was to engage former patients and their families to identify the school experiences and processes that affect their return to school, a key aspect of community integration, after medical rehabilitation. This study used focus groups with parents, former patients, and clinicians to understand the experience of return to school after pediatric rehabilitation, identify barriers and supports, and the impact on educational outcomes based on lived experience.

The Stroke Recovery in Underserved Populations 2005-2006 study was created to address the National Institute on Aging (NIA) Request For Application entitled "Research on Mind-Body Interactions and Health" (RFA OD-03-008). It addressed the NIA interest in "the impact of optimism, happiness, or a positive attitude on well-being and health; and social functioning and health." The study examined how positive emotion (e.g., joy, gratitude, love, contentment) and social networks independently and interactively contribute to recovery of functional status after stroke within two underserved groups. The specific study aims were to:

1. Examine recovery of functional status (motor and cognitive function), for White, African American and Hispanic persons with stroke discharged from rehabilitation facilities
2. Examine the contributions of positive emotion and social networks on recovery of functional status (motor and cognitive function), for White, African American, and Hispanic persons with stroke discharged from rehabilitation facilities; and
3. Examine the interaction between positive emotion and social networks on recovery of functional status (motor and cognitive function) for White, African American, and Hispanic persons with stroke discharged from rehabilitation facilities.

The data were collected by the IT Health Track at four time points: at admission and discharge from rehabilitation facility, and 80-180 days and 365-425 days after discharge. These data emphasize recovery of motor and cognitive functional status, positive emotion, and social networks

The dataset contains 226 variables and 1219 cases from 11 rehabilitation facilities across the United States.

The Traumatic Brain Injury Model Systems National Data and Statistical Center (TBINDSC) located at Craig Hospital in Englewood, Colorado, is a central resource for researchers and data collectors within the Traumatic Brain Injury Model Systems (TBIMS) program. The primary purpose of the TBINDSC is to advance medical rehabilitation by increasing the rigor and efficiency of scientific efforts to longitudinally assess the experience of individuals with traumatic brain injury (TBI). The TBINDSC provides technical assistance, training, and methodological consultation to 16 TBIMS centers as they collect and analyze longitudinal data from people with TBI in their communities, and as they conduct research toward evidence-based TBI rehabilitation interventions.