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Sample records for adequate inter-rater reliability

  1. The inter-rater reliability of Strain Index and OCRA Checklist task assessments in cheese processing.

    PubMed

    Paulsen, Robert; Gallu, Tommaso; Gilkey, David; Reiser, Raoul; Murgia, Lelia; Rosecrance, John

    2015-11-01

    The purpose of this study was to characterize the inter-rater reliability of two physical exposure assessment methods of the upper extremity, the Strain Index (SI) and Occupational Repetitive Actions (OCRA) Checklist. These methods are commonly used in occupational health studies and by occupational health practitioners. Seven raters used the SI and OCRA Checklist to assess task-level physical exposures to the upper extremity of workers performing 21 cheese manufacturing tasks. Inter-rater reliability was characterized using a single-measure, agreement-based intraclass correlation coefficient (ICC). Inter-rater reliability of SI assessments was moderate to good (ICC = 0.59, 95% CI: 0.45-0.73), a similar finding to prior studies. Inter-rater reliability of OCRA Checklist assessments was excellent (ICC = 0.80, 95% CI: 0.70-0.89). Task complexity had a small, but non-significant, effect on inter-rater reliability SI and OCRA Checklist scores. Both the SI and OCRA Checklist assessments possess adequate inter-rater reliability for the purposes of occupational health research and practice. The OCRA Checklist inter-rater reliability scores were among the highest reported in the literature for semi-quantitative physical exposure assessment tools of the upper extremity. The OCRA Checklist however, required more training time and time to conduct the risk assessments compared to the SI. PMID:26154218

  2. Grant Peer Review: Improving Inter-Rater Reliability with Training

    SciTech Connect

    Sattler, David N.; McKnight, Patrick E.; Naney, Linda; Mathis, Randy

    2015-06-15

    In this study, we developed and evaluated a brief training program for grant reviewers that aimed to increase inter-rater reliability, rating scale knowledge, and effort to read the grant review criteria. Enhancing reviewer training may improve the reliability and accuracy of research grant proposal scoring and funding recommendations. Seventy-five Public Health professors from U.S. research universities watched the training video we produced and assigned scores to the National Institutes of Health scoring criteria proposal summary descriptions. For both novice and experienced reviewers, the training video increased scoring accuracy (the percentage of scores that reflect the true rating scale values), inter-rater reliability, and the amount of time reading the review criteria compared to the no video condition. The increase in reliability for experienced reviewers is notable because it is commonly assumed that reviewers—especially those with experience—have good understanding of the grant review rating scale. Our findings suggest that both experienced and novice reviewers who had not received the type of training developed in this study may not have appropriate understanding of the definitions and meaning for each value of the rating scale and that experienced reviewers may overestimate their knowledge of the rating scale. Lastly, the results underscore the benefits of and need for specialized peer reviewer training.

  3. Grant Peer Review: Improving Inter-Rater Reliability with Training.

    PubMed

    Sattler, David N; McKnight, Patrick E; Naney, Linda; Mathis, Randy

    2015-01-01

    This study developed and evaluated a brief training program for grant reviewers that aimed to increase inter-rater reliability, rating scale knowledge, and effort to read the grant review criteria. Enhancing reviewer training may improve the reliability and accuracy of research grant proposal scoring and funding recommendations. Seventy-five Public Health professors from U.S. research universities watched the training video we produced and assigned scores to the National Institutes of Health scoring criteria proposal summary descriptions. For both novice and experienced reviewers, the training video increased scoring accuracy (the percentage of scores that reflect the true rating scale values), inter-rater reliability, and the amount of time reading the review criteria compared to the no video condition. The increase in reliability for experienced reviewers is notable because it is commonly assumed that reviewers--especially those with experience--have good understanding of the grant review rating scale. The findings suggest that both experienced and novice reviewers who had not received the type of training developed in this study may not have appropriate understanding of the definitions and meaning for each value of the rating scale and that experienced reviewers may overestimate their knowledge of the rating scale. The results underscore the benefits of and need for specialized peer reviewer training. PMID:26075884

  4. Grant Peer Review: Improving Inter-Rater Reliability with Training

    PubMed Central

    Sattler, David N.; McKnight, Patrick E.; Naney, Linda; Mathis, Randy

    2015-01-01

    This study developed and evaluated a brief training program for grant reviewers that aimed to increase inter-rater reliability, rating scale knowledge, and effort to read the grant review criteria. Enhancing reviewer training may improve the reliability and accuracy of research grant proposal scoring and funding recommendations. Seventy-five Public Health professors from U.S. research universities watched the training video we produced and assigned scores to the National Institutes of Health scoring criteria proposal summary descriptions. For both novice and experienced reviewers, the training video increased scoring accuracy (the percentage of scores that reflect the true rating scale values), inter-rater reliability, and the amount of time reading the review criteria compared to the no video condition. The increase in reliability for experienced reviewers is notable because it is commonly assumed that reviewers—especially those with experience—have good understanding of the grant review rating scale. The findings suggest that both experienced and novice reviewers who had not received the type of training developed in this study may not have appropriate understanding of the definitions and meaning for each value of the rating scale and that experienced reviewers may overestimate their knowledge of the rating scale. The results underscore the benefits of and need for specialized peer reviewer training. PMID:26075884

  5. Variance Estimation of Nominal-Scale Inter-Rater Reliability with Random Selection of Raters

    ERIC Educational Resources Information Center

    Gwet, Kilem Li

    2008-01-01

    Most inter-rater reliability studies using nominal scales suggest the existence of two populations of inference: the population of subjects (collection of objects or persons to be rated) and that of raters. Consequently, the sampling variance of the inter-rater reliability coefficient can be seen as a result of the combined effect of the sampling…

  6. Grant Peer Review: Improving Inter-Rater Reliability with Training

    DOE PAGESBeta

    Sattler, David N.; McKnight, Patrick E.; Naney, Linda; Mathis, Randy

    2015-06-15

    In this study, we developed and evaluated a brief training program for grant reviewers that aimed to increase inter-rater reliability, rating scale knowledge, and effort to read the grant review criteria. Enhancing reviewer training may improve the reliability and accuracy of research grant proposal scoring and funding recommendations. Seventy-five Public Health professors from U.S. research universities watched the training video we produced and assigned scores to the National Institutes of Health scoring criteria proposal summary descriptions. For both novice and experienced reviewers, the training video increased scoring accuracy (the percentage of scores that reflect the true rating scale values), inter-ratermore » reliability, and the amount of time reading the review criteria compared to the no video condition. The increase in reliability for experienced reviewers is notable because it is commonly assumed that reviewers—especially those with experience—have good understanding of the grant review rating scale. Our findings suggest that both experienced and novice reviewers who had not received the type of training developed in this study may not have appropriate understanding of the definitions and meaning for each value of the rating scale and that experienced reviewers may overestimate their knowledge of the rating scale. Lastly, the results underscore the benefits of and need for specialized peer reviewer training.« less

  7. Inter-rater Reliability of Sustained Aberrant Movement Patterns as a Clinical Assessment of Muscular Fatigue

    PubMed Central

    Aerts, Frank; Carrier, Kathy; Alwood, Becky

    2016-01-01

    Background: The assessment of clinical manifestation of muscle fatigue is an effective procedure in establishing therapeutic exercise dose. Few studies have evaluated physical therapist reliability in establishing muscle fatigue through detection of changes in quality of movement patterns in a live setting. Objective: The purpose of this study is to evaluate the inter-rater reliability of physical therapists’ ability to detect altered movement patterns due to muscle fatigue. Design: A reliability study in a live setting with multiple raters. Participants: Forty-four healthy individuals (ages 19-35) were evaluated by six physical therapists in a live setting. Methods: Participants were evaluated by physical therapists for altered movement patterns during resisted shoulder rotation. Each participant completed a total of four tests: right shoulder internal rotation, right shoulder external rotation, left shoulder internal rotation and left shoulder external rotation. Results: For all tests combined, the inter-rater reliability for a single rater scoring ICC (2,1) was .65 (95%, .60, .71) This corresponds to moderate inter-rater reliability between physical therapists. Limitations: The results of this study apply only to healthy participants and therefore cannot be generalized to a symptomatic population. Conclusion: Moderate inter-rater reliability was found between physical therapists in establishing muscle fatigue through the observation of sustained altered movement patterns during dynamic resistive shoulder internal and external rotation. PMID:27347241

  8. IRR (Inter-Rater Reliability) of a COP (Classroom Observation Protocol)--A Critical Appraisal

    ERIC Educational Resources Information Center

    Rui, Ning; Feldman, Jill M.

    2012-01-01

    Notwithstanding broad utility of COPs (classroom observation protocols), there has been limited documentation of the psychometric properties of even the most popular COPs. This study attempted to fill this void by closely examining the item and domain-level IRR (inter-rater reliability) of a COP that was used in a federally funded striving readers…

  9. Ultrasound assessment for grading structural tendon changes in supraspinatus tendinopathy: an inter-rater reliability study

    PubMed Central

    Hjarbaek, John; Eshoej, Henrik; Larsen, Camilla Marie; Vobbe, Jette; Juul-Kristensen, Birgit

    2016-01-01

    Aim To evaluate the inter-rater reliability of measuring structural changes in the tendon of patients, clinically diagnosed with supraspinatus tendinopathy (cases) and healthy participants (controls), on ultrasound (US) images captured by standardised procedures. Methods A total of 40 participants (24 patients) were included for assessing inter-rater reliability of measurements of fibrillar disruption, neovascularity, as well as the number and total length of calcifications and tendon thickness. Linear weighted κ, intraclass correlation (ICC), SEM, limits of agreement (LOA) and minimal detectable change (MDC) were used to evaluate reliability. Results ‘Moderate—almost perfect’ κ was found for grading fibrillar disruption, neovascularity and number of calcifications (k 0.60–0.96). For total length of calcifications and tendon thickness, ICC was ‘excellent’ (0.85–0.90), with SEM(Agreement) ranging from 0.63 to 2.94 mm and MDC(group) ranging from 0.28 to 1.29 mm. In general, SEM, LOA and MDC showed larger variation for calcifications than for tendon thickness. Conclusions Inter-rater reliability was moderate to almost perfect when a standardised procedure was applied for measuring structural changes on captured US images and movie sequences of relevance for patients with supraspinatus tendinopathy. Future studies should test intra-rater and inter-rater reliability of the method in vivo for use in clinical practice, in addition to validation against a gold standard, such as MRI. Trial registration number NCT01984203; Pre-results. PMID:27221128

  10. Inter-Rater Reliability of Total Body Score-A Scale for Quantification of Corpse Decomposition.

    PubMed

    Nawrocka, Marta; Frątczak, Katarzyna; Matuszewski, Szymon

    2016-05-01

    The degree of body decomposition can be quantified using Total Body Score (TBS), a scale frequently used in taphonomic or entomological studies of decomposition. Here, the inter-rater reliability of the scale is analyzed. The study was made on 120 laymen, which were trained in the use of the scale. Participants scored decomposition of pig carcasses from photographs. It was found that the scale, when used by different people, gives homogeneous results irrespective of the user qualifications (the Krippendorff's alfa for all participants was 0.818). The study also indicated that carcasses in advanced decomposition receive significantly less accurate scores. Moreover, it was found that scores for cadavers in mosaic decomposition (i.e., representing signs of at least two stages of decomposition) are less accurate. These results demonstrate that the scale may be regarded as inter-rater reliable. Some propositions for refinement of the scale were also discussed. PMID:27093214

  11. Inter-rater reliability of three standardized functional tests in patients with low back pain

    PubMed Central

    Tidstrand, Johan; Horneij, Eva

    2009-01-01

    Background Of all patients with low back pain, 85% are diagnosed as "non-specific lumbar pain". Lumbar instability has been described as one specific diagnosis which several authors have described as delayed muscular responses, impaired postural control as well as impaired muscular coordination among these patients. This has mostly been measured and evaluated in a laboratory setting. There are few standardized and evaluated functional tests, examining functional muscular coordination which are also applicable in the non-laboratory setting. In ordinary clinical work, tests of functional muscular coordination should be easy to apply. The aim of this present study was to therefore standardize and examine the inter-rater reliability of three functional tests of muscular functional coordination of the lumbar spine in patients with low back pain. Methods Nineteen consecutive individuals, ten men and nine women were included. (Mean age 42 years, SD ± 12 yrs). Two independent examiners assessed three tests: "single limb stance", "sitting on a Bobath ball with one leg lifted" and "unilateral pelvic lift" on the same occasion. The standardization procedure took altered positions of the spine or pelvis and compensatory movements of the free extremities into account. The inter-rater reliability was analyzed by Cohen's kappa coefficient (κ) and by percentage agreement. Results The inter-rater reliability for the right and the left leg respectively was: for the single limb stance very good (κ: 0.88–1.0), for sitting on a Bobath ball good (κ: 0.79) and very good (κ: 0.88) and for the unilateral pelvic lift: good (κ: 0.61) and moderate (κ: 0.47). Conclusion The present study showed good to very good inter-rater reliability for two standardized tests, that is, the single-limb stance and sitting on a Bobath-ball with one leg lifted. Inter-rater reliability for the unilateral pelvic lift test was moderate to good. Validation of the tests in their ability to evaluate lumbar

  12. SEQUENTIAL TESTING OF MEASUREMENT ERRORS IN INTER-RATER RELIABILITY STUDIES

    PubMed Central

    Jin, Mei; Liu, Aiyi; Chen, Zhen; Li, Zhaohai

    2014-01-01

    Inter-rater reliability is usually assessed by means of the intraclass correlation coefficient. Using two-way analysis of variance to model raters and subjects as random effects, we derive group sequential testing procedures for the design and analysis of reliability studies in which multiple raters evaluate multiple subjects. Compared with the conventional fixed sample procedures, the group sequential test has smaller average sample number. The performance of the proposed technique is examined using simulation studies and critical values are tabulated for a range of two-stage design parameters. The methods are exemplified using data from the Physician Reliability Study for diagnosis of endometriosis. PMID:25525316

  13. Intra and inter-rater reliability study of pelvic floor muscle dynamometric measurements

    PubMed Central

    Martinho, Natalia M.; Marques, Joseane; Silva, Valéria R.; Silva, Silvia L. A.; Carvalho, Leonardo C.; Botelho, Simone

    2015-01-01

    OBJECTIVE: The aim of this study was to evaluate the intra and inter-rater reliability of pelvic floor muscle (PFM) dynamometric measurements for maximum and average strengths, as well as endurance. METHOD: A convenience sample of 18 nulliparous women, without any urogynecological complaints, aged between 19 and 31 (mean age of 25.4±3.9) participated in this study. They were evaluated using a pelvic floor dynamometer based on load cell technology. The dynamometric evaluations were repeated in three successive sessions: two on the same day with a rest period of 30 minutes between them, and the third on the following day. All participants were evaluated twice in each session; first by examiner 1 followed by examiner 2. The vaginal dynamometry data were analyzed using three parameters: maximum strength, average strength, and endurance. The Intraclass Correlation Coefficient (ICC) was applied to estimate the PFM dynamometric measurement reliability, considering a good level as being above 0.75. RESULTS: The intra and inter-raters' analyses showed good reliability for maximum strength (ICCintra-rater1=0.96, ICCintra-rater2=0.95, and ICCinter-rater=0.96), average strength (ICCintra-rater1=0.96, ICCintra-rater2=0.94, and ICCinter-rater=0.97), and endurance (ICCintra-rater1=0.88, ICCintra-rater2=0.86, and ICCinter-rater=0.92) dynamometric measurements. CONCLUSIONS: The PFM dynamometric measurements showed good intra- and inter-rater reliability for maximum strength, average strength and endurance, which demonstrates that this is a reliable device that can be used in clinical practice. PMID:25993624

  14. Inter-Rater Reliability and Validity of the Australian Football League's Kicking and Handball Tests.

    PubMed

    Cripps, Ashley J; Hopper, Luke S; Joyce, Christopher

    2015-09-01

    Talent identification tests used at the Australian Football League's National Draft Combine assess the capacities of athletes to compete at a professional level. Tests created for the National Draft Combine are also commonly used for talent identification and athlete development in development pathways. The skills tests created by the Australian Football League required players to either handball (striking the ball with the hand) or kick to a series of 6 randomly generated targets. Assessors subjectively rate each skill execution giving a 0-5 score for each disposal. This study aimed to investigate the inter-rater reliability and validity of the skills tests at an adolescent sub-elite level. Male Australian footballers were recruited from sub-elite adolescent teams (n = 121, age = 15.7 ± 0.3 years, height = 1.77 ± 0.07 m, mass = 69.17 ± 8.08 kg). The coaches (n = 7) of each team were also recruited. Inter-rater reliability was assessed using Inter-class correlations (ICC) and Limits of Agreement statistics. Both the kicking (ICC = 0.96, p < .01) and handball tests (ICC = 0.89, p < .01) demonstrated strong reliability and acceptable levels of absolute agreement. Content validity was determined by examining the test scores sensitivity to laterality and distance. Concurrent validity was assessed by comparing coaches' perceptions of skill to actual test outcomes. Multivariate analysis of variance (MANOVA) examined the main effect of laterality, with scores on the dominant hand (p = .04) and foot (p < .01) significantly higher compared to the non-dominant side. Follow-up univariate analysis reported significant differences at every distance in the kicking test. A poor correlation was found between coaches' perceptions of skill and testing outcomes. The results of this study demonstrate both skill tests demonstrate acceptable inter-rater reliable. Partial content validity was confirmed for the kicking test, however further research is required to confirm validity of

  15. Measuring the Pain Area: An Intra- and Inter-Rater Reliability Study Using Image Analysis Software.

    PubMed

    Dos Reis, Felipe Jose Jandre; de Barros E Silva, Veronica; de Lucena, Raphaela Nunes; Mendes Cardoso, Bruno Alexandre; Nogueira, Leandro Calazans

    2016-01-01

    Pain drawings have frequently been used for clinical information and research. The aim of this study was to investigate intra- and inter-rater reliability of area measurements performed on pain drawings. Our secondary objective was to verify the reliability when using computers with different screen sizes, both with and without mouse hardware. Pain drawings were completed by patients with chronic neck pain or neck-shoulder-arm pain. Four independent examiners participated in the study. Examiners A and B used the same computer with a 16-inch screen and wired mouse hardware. Examiner C used a notebook with a 16-inch screen and no mouse hardware, and Examiner D used a computer with an 11.6-inch screen and a wireless mouse. Image measurements were obtained using GIMP and NIH ImageJ computer programs. The length of all the images was measured using GIMP software to a set scale in ImageJ. Thus, each marked area was encircled and the total surface area (cm(2) ) was calculated for each pain drawing measurement. A total of 117 areas were identified and 52 pain drawings were analyzed. The intrarater reliability between all examiners was high (ICC = 0.989). The inter-rater reliability was also high. No significant differences were observed when using different screen sizes or when using or not using the mouse hardware. This suggests that the precision of these measurements is acceptable for the use of this method as a measurement tool in clinical practice and research. PMID:25490926

  16. Using Google Street View to Audit the Built Environment: Inter-rater Reliability Results

    PubMed Central

    Wilson, Jeffrey S.; Baker, Elizabeth A.; Miller, Douglas K.; Schootman, Mario

    2012-01-01

    Background Observational field audits are recommended for public health research to collect data on built environment characteristics. A reliable, standardized alternative to field audits that uses publicly available information could provide the ability to efficiently compare results across different study sites and time. Purpose This study aimed to assess inter-rater reliability of built environment audits conducted using Google Street View imagery. Methods In 2011, street segments from St. Louis and Indianapolis were geographically stratified to ensure representation of neighborhoods with different land use and socioeconomic characteristics in both cities. Inter-rater reliability was assessed using observed agreement and the prevalence-adjusted bias-adjusted kappa statistic (PABAK). Results The mean PABAK for all items was 0.84. Ninety-five percent of the items had substantial (PABAK≥0.60) or nearly perfect (PABAK≥0.80) agreement. Conclusions Using Google Street View imagery to audit the built environment is a reliable method for assessing characteristics of the built environment. PMID:23054943

  17. Inter-rater Reliability of Triages Performed by the Electronic Triage System

    PubMed Central

    Pourasghar, Faramarz; Daemi, Amin; Tabrizi, Jafar Sadegh; Ala, Alireza

    2015-01-01

    Objective: To examine the inter-rater reliability of triages performed by the Electronic Triage System (ETS) which has recently developed and used in hospital emergency department (ED). Methods: This cross-sectional study was conducted prospectively and studied 408 visitors of Tabriz Imam Reza hospital’s ED. The variables of interest were age, sex, nurse-assigned triage category, physician-assigned triage category, disease type (trauma, non-trauma), and the referred room within the ED. Cohen’s un-weighted kappa, linear weighted kappa, and quadratic weighted kappa were used to describe the reliability. Results: Un-weighted kappa observed to be 0.186 (95% CI: 0.123-0.249). Linear weighted kappa observed as 0.317 (95% CI: 0.251-0.384) and quadratic weighted kappa as 0.462 (95% CI: 0.336-0.589). In general, low agreement was seen between the triage nurses and ED physicians. For trauma patients and for those who were referred to the cardiopulmonary resuscitation room (CPR), all three types of kappa were higher than other visitors of the ED. Conclusion: Inter-rater reliability of the triages performed by the ETS observed as ranging from poor to moderate. Implementing interventions that would create a common language between nurses and physicians about the triage of the ED visitors seems necessary. The more agreement on the triage of trauma and CPR patients might be due to their condition and the more attention to them. PMID:27162918

  18. Inter-rater and intra-rater reliability of the Bahasa Melayu version of Rose Angina Questionnaire.

    PubMed

    Hassan, N B; Choudhury, S R; Naing, L; Conroy, R M; Rahman, A R A

    2007-01-01

    The objective of the study is to translate the Rose Questionnaire (RQ) into a Bahasa Melayu version and adapt it cross-culturally, and to measure its inter-rater and intrarater reliability. This cross sectional study was conducted in the respondents' homes or workplaces in Kelantan, Malaysia. One hundred respondents aged 30 and above with different socio-demographic status were interviewed for face validity. For each inter-rater and intra-rater reliability, a sample of 150 respondents was interviewed. Inter-rater and intra-rater reliabilities were assessed by Cohen's kappa. The overall inter-rater agreements by the five pair of interviewers at point one and two were 0.86, and intrarater reliability by the five interviewers on the seven-item questionnaire at poinone and two was 0.88, as measured by kappa coefficient. The translated Malay version of RQ demonstrated an almost perfect inter-rater and intra-rater reliability and further validation such as sensitivity and specificity analysis of this translated questionnaire is highly recommended. PMID:18333302

  19. Approaches to describing inter-rater reliability of the overall clinical appearance of febrile infants and toddlers in the emergency department

    PubMed Central

    Thornton, Justin; Asato, Julie; Walker, Nicholas; McCoy, Gary; Baal, Joe; Baal, Jed; Mendoza, Nanse; Banimahd, Faried

    2014-01-01

    Objectives. To measure inter-rater agreement of overall clinical appearance of febrile children aged less than 24 months and to compare methods for doing so. Study Design and Setting. We performed an observational study of inter-rater reliability of the assessment of febrile children in a county hospital emergency department serving a mixed urban and rural population. Two emergency medicine healthcare providers independently evaluated the overall clinical appearance of children less than 24 months of age who had presented for fever. They recorded the initial ‘gestalt’ assessment of whether or not the child was ill appearing or if they were unsure. They then repeated this assessment after examining the child. Each rater was blinded to the other’s assessment. Our primary analysis was graphical. We also calculated Cohen’s κ, Gwet’s agreement coefficient and other measures of agreement and weighted variants of these. We examined the effect of time between exams and patient and provider characteristics on inter-rater agreement. Results. We analyzed 159 of the 173 patients enrolled. Median age was 9.5 months (lower and upper quartiles 4.9–14.6), 99/159 (62%) were boys and 22/159 (14%) were admitted. Overall 118/159 (74%) and 119/159 (75%) were classified as well appearing on initial ‘gestalt’ impression by both examiners. Summary statistics varied from 0.223 for weighted κ to 0.635 for Gwet’s AC2. Inter rater agreement was affected by the time interval between the evaluations and the age of the child but not by the experience levels of the rater pairs. Classifications of ‘not ill appearing’ were more reliable than others. Conclusion. The inter-rater reliability of emergency providers’ assessment of overall clinical appearance was adequate when described graphically and by Gwet’s AC. Different summary statistics yield different results for the same dataset. PMID:25401054

  20. Inter-rater reliability of malaria parasite counts and comparison of methods

    PubMed Central

    2009-01-01

    Background The introduction of artemesinin-based treatment for falciparum malaria has led to a shift away from symptom-based diagnosis. Diagnosis may be achieved by using rapid non-microscopic diagnostic tests (RDTs), of which there are many available. Light microscopy, however, has a central role in parasite identification and quantification and remains the main method of parasite-based diagnosis in clinic and hospital settings and is necessary for monitoring the accuracy of RDTs. The World Health Organization has prepared a proficiency testing panel containing a range of malaria-positive blood samples of known parasitaemia, to be used for the assessment of commercially available malaria RDTs. Different blood film and counting methods may be used for this purpose, which raises questions regarding accuracy and reproducibility. A comparison was made of the established methods for parasitaemia estimation to determine which would give the least inter-rater and inter-method variation Methods Experienced malaria microscopists counted asexual parasitaemia on different slides using three methods; the thin film method using the total erythrocyte count, the thick film method using the total white cell count and the Earle and Perez method. All the slides were stained using Giemsa pH 7.2. Analysis of variance (ANOVA) models were used to find the inter-rater reliability for the different methods. The paired t-test was used to assess any systematic bias between the two methods, and a regression analysis was used to see if there was a changing bias with parasite count level. Results The thin blood film gave parasite counts around 30% higher than those obtained by the thick film and Earle and Perez methods, but exhibited a loss of sensitivity with low parasitaemia. The thick film and Earle and Perez methods showed little or no bias in counts between the two methods, however, estimated inter-rater reliability was slightly better for the thick film method. Conclusion The thin film

  1. Inter-rater reliability of assessed prenatal maternal occupational exposures to solvents, polycyclic aromatic hydrocarbons, and heavy metals.

    PubMed

    Rocheleau, Carissa M; Lawson, Christina C; Waters, Martha A; Hein, Misty J; Stewart, Patricia A; Correa, Adolfo; Echeverria, Diana; Reefhuis, Jennita

    2011-12-01

    Because direct measurements of past occupational exposures are rarely available in population-based case-control studies, exposure assessment of job histories by multiple expert raters is frequently used; however, the subjective nature of this method makes measuring reliability an important quality control step. We evaluated inter-rater reliability of 7729 retrospective jobs reported in the National Birth Defects Prevention Study. Jobs were classified as exposed, unexposed, or exposure unknown by two independent industrial hygienists; exposed jobs were further evaluated for intensity, frequency, and routes. Exposure prevalence ranged from 0.1-9.8%. Inter-rater reliability for exposure (yes/no), assessed by kappa coefficients, was fair to good for cadmium (κ = 0.46), chlorinated solvents (κ = 0.59), cobalt (κ = 0.54), glycol ethers (κ = 0.50), nickel compounds (κ = 0.65), oil mists (κ = 0.63), and Stoddard Solvent (κ = 0.55); PAHs (κ = 0.24) and elemental nickel (κ = 0.37) had poor agreement. After a consensus conference resolved disagreements, an additional 4962 jobs were evaluated. Inter-rater reliability improved or stayed the same for cadmium (κ = 0.51), chlorinated solvents (κ = 0.81), oil mists (κ = 0.63), PAHs (κ = 0.52), and Stoddard solvent (κ = 0.92) in the second job set. Inter-rater reliability varied by exposure agent and prevalence, demonstrating the importance of measuring reliability in studies using a multiple expert rater method of exposure assessment. PMID:22074298

  2. Inter-Rater Reliability of the Modified Ashworth Scale and Modified Modified Ashworth Scale in Assessing Poststroke Elbow Flexor Spasticity

    ERIC Educational Resources Information Center

    Kaya, Taciser; Goksel Karatepe, Altinay; Gunaydin, Rezzan; Koc, Aysegul; Altundal Ercan, Ulku

    2011-01-01

    The Modified Ashworth Scale (MAS) is commonly used in clinical practice for grading spasticity. However, it was modified recently by omitting grade "1+" of the MAS and redefining grade "2". The aim of this study was to investigate the inter-rater reliability of MAS and modified MAS (MMAS) for the assessment of poststroke elbow flexor spasticity.…

  3. Intra-Rater and Inter-Rater Reliability of the Balance Error Scoring System in Pre-Adolescent School Children

    ERIC Educational Resources Information Center

    Sheehan, Dwayne P.; Lafave, Mark R.; Katz, Larry

    2011-01-01

    This study was designed to test the intra- and inter-rater reliability of the University of North Carolina's Balance Error Scoring System in 9- and 10-year-old children. Additionally, a modified version of the Balance Error Scoring System was tested to determine if it was more sensitive in this population ("raw scores"). Forty-six normally…

  4. Leveraging Data Sampling and Practical Knowledge: Field Instructors' Perceptions about Inter-Rater Reliability Data

    ERIC Educational Resources Information Center

    Soslau, Elizabeth; Lewis, Kandia

    2014-01-01

    For accreditation and programmatic decision making, education school administrators use inter-rater reliability analyses to judge credibility of student-teacher assessments. Although weak levels of agreement between university-appointed supervisors and cooperating teachers are usually interpreted to indicate that the process is not being…

  5. Tool for Assessing Responsibility-Based Education (TARE): Instrument Development, Content Validity, and Inter-Rater Reliability

    ERIC Educational Resources Information Center

    Wright, Paul M.; Craig, Mark W.

    2011-01-01

    Numerous scholars have stressed the importance of personal and social responsibility in physical activity settings; however, there is a lack of instrumentation to study the implementation of responsibility-based teaching strategies. The development, content validity, and initial inter-rater reliability testing of the Tool for Assessing…

  6. The Critical Thinking Analytic Rubric (CTAR): Investigating Intra-Rater and Inter-Rater Reliability of a Scoring Mechanism for Critical Thinking Performance Assessments

    ERIC Educational Resources Information Center

    Saxton, Emily; Belanger, Secret; Becker, William

    2012-01-01

    The purpose of this study was to investigate the intra-rater and inter-rater reliability of the Critical Thinking Analytic Rubric (CTAR). The CTAR is composed of 6 rubric categories: interpretation, analysis, evaluation, inference, explanation, and disposition. To investigate inter-rater reliability, two trained raters scored four sets of…

  7. Inter-rater reliability of the Sødring Motor Evaluation of Stroke patients (SMES).

    PubMed

    Halsaa, K E; Sødring, K M; Bjelland, E; Finsrud, K; Bautz-Holter, E

    1999-12-01

    The Sødring Motor Evaluation of Stroke patients is an instrument for physiotherapists to evaluate motor function and activities in stroke patients. The rating reflects quality as well as quantity of the patient's unassisted performance within three domains: leg, arm and gross function. The inter-rater reliability of the method was studied in a sample of 30 patients admitted to a stroke rehabilitation unit. Three therapists were involved in the study; two therapists assessed the same patient on two consecutive days in a balanced design. Cohen's weighted kappa and McNemar's test of symmetry were used as measures of item reliability, and the intraclass correlation coefficient was used to express the reliability of the sumscores. For 24 out of 32 items the weighted kappa statistic was excellent (0.75-0.98), while 7 items had a kappa statistic within the range 0.53-0.74 (fair to good). The reliability of one item was poor (0.13). The intraclass correlation coefficient for the three sumscores was 0.97, 0.91 and 0.97. We conclude that the Sødring Motor Evaluation of Stroke patients is a reliable measure of motor function in stroke patients undergoing rehabilitation. PMID:10599901

  8. The inter-rater reliability of the Risk Instrument for Screening in the Community.

    PubMed

    Weathers, Elizabeth; O'Caoimh, Rónán; O'Sullivan, Ronan; Paúl, Constança; Orfilia, Frances; Clarnette, Roger; Fitzgerald, Carol; Svendrovski, Anton; Cornally, Nicola; Leahy-Warren, Patricia; Molloy, D William

    2016-09-01

    Predicting risk of adverse healthcare outcomes is important to enable targeted delivery of interventions. The Risk Instrument for Screening in the Community (RISC), designed for use by public health nurses (PHNs), measures the 1-year risk of hospitalisation, institutionalisation and death in community-dwelling older adults according to a five-point global risk score: from low (score 1,2) to medium (3) to high (4,5). We examined the inter-rater reliability (IRR) of the RISC between student PHNs (n=32) and expert raters using six cases (two low, medium and high-risk), scored before and after RISC training. Correlations increased for each adverse outcome, statistically significantly for institutionalisation (r=0.72 to 0.80, p=0.04) and hospitalisation (r=0.51 to 0.71, p<0.01) but not death. Training improved accuracy for low-risk but not all high-risk cases. Overall, the RISC showed good IRR, which increased after RISC training. That reliability fell for some high-risk cases suggests that the training programme requires adjustment to improve IRR further. PMID:27594063

  9. Intra and Inter-Rater Reliability of Screening for Movement Impairments: Movement Control Tests from The Foundation Matrix

    PubMed Central

    Mischiati, Carolina R.; Comerford, Mark; Gosford, Emma; Swart, Jacqueline; Ewings, Sean; Botha, Nadine; Stokes, Maria; Mottram, Sarah L.

    2015-01-01

    Pre-season screening is well established within the sporting arena, and aims to enhance performance and reduce injury risk. With the increasing need to identify potential injury with greater accuracy, a new risk assessment process has been produced; The Performance Matrix (battery of movement control tests). As with any new method of objective testing, it is fundamental to establish whether the same results can be reproduced between examiners and by the same examiner on consecutive occasions. This study aimed to determine the intra-rater test re-test and inter-rater reliability of tests from a component of The Performance Matrix, The Foundation Matrix. Twenty participants were screened by two experienced musculoskeletal therapists using nine tests to assess the ability to control movement during specific tasks. Movement evaluation criteria for each test were rated as pass or fail. The therapists observed participants real-time and tests were recorded on video to enable repeated ratings four months later to examine intra-rater reliability (videos rated two weeks apart). Overall test percentage agreement was 87% for inter-rater reliability; 98% Rater 1, 94% Rater 2 for test re-test reliability; and 75% for real-time versus video. Intraclass-correlation coefficients (ICCs) were excellent between raters (0.81) and within raters (Rater 1, 0.96; Rater 2, 0.88) but poor for real-time versus video (0.23). Reliability for individual components of each test was more variable: inter-rater, 68-100%; intra-rater, 88-100% Rater 1, 75-100% Rater 2; and real-time versus video 31-100%. Cohen’s Kappa values for inter-rater reliability were 0.0-1.0; intra-rater 0.6-1.0 for Rater 1; -0.1-1.0 for Rater 2; and -0.1-1 for real-time versus video. It is concluded that both inter and intra-rater reliability of tests in The Foundation Matrix are acceptable when rated by experienced therapists. Recommendations are made for modifying some of the criteria to improve reliability where

  10. Qualitative soil moisture assessment in semi-arid Africa: the role of experience and training on inter-rater reliability

    NASA Astrophysics Data System (ADS)

    Rinderer, M.; Komakech, H.; Müller, D.; Seibert, J.

    2015-03-01

    Soil and water management is particularly relevant in semi-arid regions to enhance agricultural productivity. During periods of water scarcity soil moisture differences are important indicators of the soil water deficit and are traditionally used for allocating water resources among farmers of a village community. Here we present a simple, inexpensive soil wetness classification scheme based on qualitative indicators which one can see or touch on the soil surface. It incorporates the local farmers' knowledge on the best soil moisture conditions for seeding and brick making in the semi-arid environment of the study site near Arusha, Tanzania. The scheme was tested twice in 2014 with farmers, students and experts (April: 40 persons, June: 25 persons) for inter-rater reliability, bias of individuals and functional relation between qualitative and quantitative soil moisture values. During the test in April farmers assigned the same wetness class in 46% of all cases while students and experts agreed in about 60% of all cases. Students who had been trained in how to apply the method gained higher inter-rater reliability than their colleagues with only a basic introduction. When repeating the test in June, participants were given improved instructions, organized in small sub-groups, which resulted in a higher inter-rater reliability among farmers. In 66% of all classifications farmers assigned the same wetness class and the spread of class assignments was smaller. This study demonstrates that a wetness classification scheme based on qualitative indicators is a robust tool and can be applied successfully regardless of experience in crop growing and education level when an in-depth introduction and training is provided. The use of a simple and clear layout of the assessment form is important for reliable wetness class assignments.

  11. Qualitative soil moisture assessment in semi-arid Africa - the role of experience and training on inter-rater reliability

    NASA Astrophysics Data System (ADS)

    Rinderer, M.; Komakech, H. C.; Müller, D.; Wiesenberg, G. L. B.; Seibert, J.

    2015-08-01

    Soil and water management is particularly relevant in semi-arid regions to enhance agricultural productivity. During periods of water scarcity, soil moisture differences are important indicators of the soil water deficit and are traditionally used for allocating water resources among farmers of a village community. Here we present a simple, inexpensive soil wetness classification scheme based on qualitative indicators which one can see or touch on the soil surface. It incorporates the local farmers' knowledge on the best soil moisture conditions for seeding and brick making in the semi-arid environment of the study site near Arusha, Tanzania. The scheme was tested twice in 2014 with farmers, students and experts (April: 40 persons, June: 25 persons) for inter-rater reliability, bias of individuals and functional relation between qualitative and quantitative soil moisture values. During the test in April farmers assigned the same wetness class in 46 % of all cases, while students and experts agreed on about 60 % of all cases. Students who had been trained in how to apply the method gained higher inter-rater reliability than their colleagues with only a basic introduction. When repeating the test in June, participants were given improved instructions, organized in small subgroups, which resulted in a higher inter-rater reliability among farmers. In 66 % of all classifications, farmers assigned the same wetness class and the spread of class assignments was smaller. This study demonstrates that a wetness classification scheme based on qualitative indicators is a robust tool and can be applied successfully regardless of experience in crop growing and education level when an in-depth introduction and training is provided. The use of a simple and clear layout of the assessment form is important for reliable wetness class assignments.

  12. Inter-Rater Reliability and Validity of the Australian Football League’s Kicking and Handball Tests

    PubMed Central

    Cripps, Ashley J.; Hopper, Luke S.; Joyce, Christopher

    2015-01-01

    Talent identification tests used at the Australian Football League’s National Draft Combine assess the capacities of athletes to compete at a professional level. Tests created for the National Draft Combine are also commonly used for talent identification and athlete development in development pathways. The skills tests created by the Australian Football League required players to either handball (striking the ball with the hand) or kick to a series of 6 randomly generated targets. Assessors subjectively rate each skill execution giving a 0-5 score for each disposal. This study aimed to investigate the inter-rater reliability and validity of the skills tests at an adolescent sub-elite level. Male Australian footballers were recruited from sub-elite adolescent teams (n = 121, age = 15.7 ± 0.3 years, height = 1.77 ± 0.07 m, mass = 69.17 ± 8.08 kg). The coaches (n = 7) of each team were also recruited. Inter-rater reliability was assessed using Inter-class correlations (ICC) and Limits of Agreement statistics. Both the kicking (ICC = 0.96, p < .01) and handball tests (ICC = 0.89, p < .01) demonstrated strong reliability and acceptable levels of absolute agreement. Content validity was determined by examining the test scores sensitivity to laterality and distance. Concurrent validity was assessed by comparing coaches’ perceptions of skill to actual test outcomes. Multivariate analysis of variance (MANOVA) examined the main effect of laterality, with scores on the dominant hand (p = .04) and foot (p < .01) significantly higher compared to the non-dominant side. Follow-up univariate analysis reported significant differences at every distance in the kicking test. A poor correlation was found between coaches’ perceptions of skill and testing outcomes. The results of this study demonstrate both skill tests demonstrate acceptable inter-rater reliable. Partial content validity was confirmed for the kicking test, however further research is required to confirm

  13. The inter-rater reliability of the International Classification of Functioning, Disability and Health set for spinal cord injury nursing.

    PubMed

    Li, Kun; Yan, Tiebin; You, Liming; Xie, Sumei; Li, Yun; Tang, Jie; Wang, Yingmin; Gao, Yan

    2016-09-01

    The International Classification of Functioning, Disability and Health (ICF) has potential to be used as a clinical assessment instrument directly. However, difficulty in operationalizing the ICF qualifiers has led to unsatisfactory inter-rater reliability of ICF instruments in previous studies. The ICF set for spinal cord injury (SCI) nursing contains a group of categories that can reflect the functioning of SCI patients from the perspective of nurses. The aim of this study was to explore the inter-rater reliability of the ICF set for SCI nursing. Detailed measuring guidelines were prepared for each category of the ICF set. Two trained nurses then used the ICF set to independently rate 40 SCI patients within the first 3 days after their admission. The results showed that the percentage of the observed agreement between the nurses ranged from 42.5 to 100% (median 75%, interquartile range 62.5-87.5%). The weighted κ ranged from -0.03 to 1.00 (median 0.68, interquartile range 0.45-0.84). A total of 50 categories (79.4%) showed weighted κ greater than 0.4 and 39 categories (61.9%) had weighted κ greater than 0.6. The medians of the weighted κ for the body functions, body structures, activity and participation and environmental factors components were 0.6, 0.64, 0.84, and 0.11, respectively. This study indicated that the inter-rater reliability of the ICF set for SCI nursing was acceptable. Establishment of detailed measuring guidelines could help reduce the differences between raters. Simpler and clearer measuring guidelines are recommended and the definitions of some categories need to be clarified in future studies. PMID:27171607

  14. The Inter-rater Reliability of the Functional Movement Screen within an athletic population using Untrained Raters.

    PubMed

    Elias, Jade E

    2013-07-01

    The Functional Movement Screen (FMS) is a commonly used screening tool designed to identify restrictions to movement patterns and increased injury risk using 7 predesigned tests. The purpose of this study was to analyse the inter- rater reliability of scoring of the FMS using a group of 'untrained' subjects. Additionally, the study also examined if clinical experience level had any effect on reliability. Twenty fully qualified Physiotherapists working at the English Institute of Sport, with elite athletes, volunteered to participate in the study. The group comprised of both Level 2 and Level 3 physiotherapists, based on clinical experience levels. Five elite athletes, free from injury, were recruited and videoed completing 6 of the 7 FMS tests, using a 3 camera system. The videos were scored by each Physiotherapist using the standardised scoring sheet, as developed by Cook et al. (2006) (4,5). Each practitioner marked each athlete completing the 6 tests. The total scores were calculated for each athlete (maximum score of 18). The inter- rater reliability of the test was shown to be high, ICC 0.906. An independent t-test showed no significant differences between the Level 2 and Level 3 practitioners in the total scores (p = 0.502). The results of the test indicate that the FMS is a reliable screening tool when used by 'untrained' practitioners in determining faulty movement patterns and that clinical experience level does not affect the reliability, therefore it may be a useful tool in the screening of athletic populations. PMID:23838983

  15. The Intra- and Inter-Rater Reliability of an Instrumented Spasticity Assessment in Children with Cerebral Palsy

    PubMed Central

    Schless, Simon-Henri; Desloovere, Kaat; Aertbeliën, Erwin; Molenaers, Guy; Huenaerts, Catherine; Bar-On, Lynn

    2015-01-01

    Aim Despite the impact of spasticity, there is a lack of objective, clinically reliable and valid tools for its assessment. This study aims to evaluate the reliability of various performance- and spasticity-related parameters collected with a manually controlled instrumented spasticity assessment in four lower limb muscles in children with cerebral palsy (CP). Method The lateral gastrocnemius, medial hamstrings, rectus femoris and hip adductors of 12 children with spastic CP (12.8 years, ±4.13 years, bilateral/unilateral involvement n=7/5) were passively stretched in the sagittal plane at incremental velocities. Muscle activity, joint motion, and torque were synchronously recorded using electromyography, inertial sensors, and a force/torque load-cell. Reliability was assessed on three levels: (1) intra- and (2) inter-rater within session, and (3) intra-rater between session. Results Parameters were found to be reliable in all three analyses, with 90% containing intra-class correlation coefficients >0.6, and 70% of standard error of measurement values <20% of the mean values. The most reliable analysis was intra-rater within session, followed by intra-rater between session, and then inter-rater within session. The Adds evaluation had a slightly lower level of reliability than that of the other muscles. Conclusions Limited intrinsic/extrinsic errors were introduced by repeated stretch repetitions. The parameters were more reliable when the same rater, rather than different raters performed the evaluation. Standardisation and training should be further improved to reduce extrinsic error when different raters perform the measurement. Errors were also muscle specific, or related to the measurement set-up. They need to be accounted for, in particular when assessing pre-post interventions or longitudinal follow-up. The parameters of the instrumented spasticity assessment demonstrate a wide range of applications for both research and clinical environments in the

  16. Emotional and Behavioral Screener: Test-Retest Reliability, Inter-Rater Reliability, and Convergent Validity

    ERIC Educational Resources Information Center

    Nordness, Philip D.; Epstein, Michael H.; Cullinan, Douglas; Pierce, Corey D.

    2014-01-01

    The Emotional and Behavioral Screener (EBS) is a universal screening instrument designed to identify students whose excessive problem behaviors put them at risk of the education disability category of emotional disturbance (ED). This article reports findings from three studies that address the reliability and validity of the EBS. Studies 1 and 2…

  17. Inter-rater reliability and review of the VA unresolved narratives.

    PubMed Central

    Eagon, J. C.; Hurdle, J. F.; Lincoln, M. J.

    1996-01-01

    To better understand how VA clinicians use medical vocabulary in every day practice, we set out to characterize terms generated in the Problem List module of the VA's DHCP system that were not mapped to terms in the controlled-vocabulary lexicon of DHCP. When entered terms fail to match those in the lexicon, a note is sent to a central repository. When our study started, the volume in that repository had reached 16,783 terms. We wished to characterize the potential reasons why these terms failed to match terms in the lexicon. After examining two small samples of randomly selected terms, we used group consensus to develop a set of rating criteria and a rating form. To be sure that the results of multiple reviewers could be confidently compared, we analyzed the inter-rater agreement of our rating process. Two rates used this form to rate the same 400 terms. We found that modifiers and numeric data were common and consistent reasons for failure to match, while others such as use of synonyms and absence of the concept from the lexicon were common but less consistently selected. PMID:8947642

  18. Test–re-test reliability and inter-rater reliability of a digital pelvic inclinometer in young, healthy males and females

    PubMed Central

    Egerton, Tim; Skinner, Brendon

    2016-01-01

    Objective. The purpose of this study was to investigate the reliability of a digital pelvic inclinometer (DPI) for measuring sagittal plane pelvic tilt in 18 young, healthy males and females. Method. The inter-rater reliability and test–re-test reliabilities of the DPI for measuring pelvic tilt in standing on both the right and left sides of the pelvis were measured by two raters carrying out two rating sessions of the same subjects, three weeks apart. Results. For measuring pelvic tilt, inter-rater reliability was designated as good on both sides (ICC = 0.81–0.88), test–re-test reliability within a single rating session was designated as good on both sides (ICC = 0.88–0.95), and test–re-test reliability between two rating sessions was designated as moderate on the left side (ICC = 0.65) and good on the right side (ICC = 0.85). Conclusion. Inter-rater reliability and test–re-test reliability within a single rating session of the DPI in measuring pelvic tilt were both good, while test–re-test reliability between rating sessions was moderate-to-good. Caution is required regarding the interpretation of the test–re-test reliability within a single rating session, as the raters were not blinded. Further research is required to establish validity. PMID:27069812

  19. Inter-rater reliability of manual and automated region-of-interest delineation for PiB PET

    PubMed Central

    Rosario, Bedda L.; Weissfeld, Lisa A.; Laymon, Charles M.; Mathis, Chester A.; Klunk, William E.; Berginc, Michael D.; James, Jeffrey A.; Hoge, Jessica A.; Price, Julie C.

    2011-01-01

    A major challenge in positron emission tomography (PET) amyloid imaging studies of Alzheimer’s disease is the reliable detection of early amyloid deposition in human brain. Manual region-of-interest (ROI) delineation on structural magnetic resonance (MR) images is generally the reference standard for the extraction of count-rate data from PET images, as compared to automated MR-template(s) methods that utilize spatial normalization and a single set of ROIs. The goal of this work was to assess the inter-rater reliability of manual ROI delineation for PiB PET amyloid retention measures and the impact of CSF dilution correction (CSF) on this reliability for data acquired in elderly control (n=5) and AD (n=5) subjects. The intraclass correlation coefficient (ICC) was used to measure reliability. As a secondary goal, ICC scores were also computed for PiB outcome measures obtained by an automated MR-template ROI method and one manual rater; to assess the level of reliability that could be achieved using different processing methods. Fourteen ROIs were evaluated that included anterior cingulate (ACG), precuneus (PRC) and cerebellum (CER). The PiB outcome measures were the volume of distribution (VT), summed tissue uptake (SUV), and corresponding ratios that were computed using CER as reference (DVR and SUVR). Substantial reliability (ICC = 0.932) was obtained across 3 manual raters for VT and SUV measures when CSF correction was applied across all outcomes and regions and was similar in the absence of CSF correction. The secondary analysis revealed substantial reliability in primary cortical areas between the automated and manual SUV [ICC = 0.979 (ACG/PRC)] and SUVR [ICC = 0.977/0.952 (ACG/PRC)] outcomes. The current study indicates the following rank order among the various reliability results in primary cortical areas and cerebellum (high to low): 1) VT or SUV manual delineation, with or without CSF correction; 2) DVR or SUVR manual delineation, with or without CSF

  20. The impact of revised DSM-5 criteria on the relative distribution and inter-rater reliability of eating disorder diagnoses in a residential treatment setting.

    PubMed

    Thomas, Jennifer J; Eddy, Kamryn T; Murray, Helen B; Tromp, Marilou D P; Hartmann, Andrea S; Stone, Melissa T; Levendusky, Philip G; Becker, Anne E

    2015-09-30

    This study evaluated the relative distribution and inter-rater reliability of revised DSM-5 criteria for eating disorders in a residential treatment program. Consecutive adolescent and young adult females (N=150) admitted to a residential eating disorder treatment facility were assigned both DSM-IV and DSM-5 diagnoses by a clinician (n=14) via routine clinical interview and a research assessor (n=4) via structured interview. We compared the frequency of diagnostic assignments under each taxonomy and by type of assessor. We evaluated concordance between clinician and researcher assignment through inter-rater reliability kappa and percent agreement. Significantly fewer patients received either clinician or researcher diagnoses of a residual eating disorder under DSM-5 (clinician-12.0%; researcher-31.3%) versus DSM-IV (clinician-28.7%; researcher-59.3%), with the majority of reassigned DSM-IV residual cases reclassified as DSM-5 anorexia nervosa. Researcher and clinician diagnoses showed moderate inter-rater reliability under DSM-IV (κ=.48) and DSM-5 (κ=.57), though agreement for specific DSM-5 other specified feeding or eating disorder (OSFED) presentations was poor (κ=.05). DSM-5 revisions were associated with significantly less frequent residual eating disorder diagnoses, but not with reduced inter-rater reliability. Findings support specific dimensions of clinical utility for revised DSM-5 criteria for eating disorders. PMID:26160205

  1. The Santa Barbara Assets and Risks Assessment to Predict Recidivism among Male and Female Juveniles: An Investigation of Inter-Rater Reliability and Predictive Validity

    ERIC Educational Resources Information Center

    Jimerson, Shane R.; Sharkey, Jill D.; O'Brien, Kathryn M.; Furlong, Michael J.

    2004-01-01

    This study aims to advance our understanding of the assessment of numerous factors associated with recidivism among females and males involved in the juvenile justice system. In particular, this study examined the reliability (i.e., inter-rater) and validity (i.e., construct, criterion, and predictive) of the Santa Barbara Assets and Risks…

  2. Inter-rater Reliability of the Modified Ashworth Scale for Spasticity in Hemiplegic Patients.

    ERIC Educational Resources Information Center

    Sloan, R. L.; And Others

    1992-01-01

    This study tested the interrater reliability of the Modified Ashworth Scale in measuring upper and lower limb spasticity in 34 hemiplegic adult patients examined by 2 physiotherapists and 2 doctors. Findings indicated satisfactory reliability for upper limb spasticity but less satisfactory results for lower limb spasticity. (DB)

  3. Inter-rater reliability for movement pattern analysis (MPA): measuring patterning of behaviors versus discrete behavior counts as indicators of decision-making style

    PubMed Central

    Connors, Brenda L.; Rende, Richard; Colton, Timothy J.

    2014-01-01

    The unique yield of collecting observational data on human movement has received increasing attention in a number of domains, including the study of decision-making style. As such, interest has grown in the nuances of core methodological issues, including the best ways of assessing inter-rater reliability. In this paper we focus on one key topic – the distinction between establishing reliability for the patterning of behaviors as opposed to the computation of raw counts – and suggest that reliability for each be compared empirically rather than determined a priori. We illustrate by assessing inter-rater reliability for key outcome measures derived from movement pattern analysis (MPA), an observational methodology that records body movements as indicators of decision-making style with demonstrated predictive validity. While reliability ranged from moderate to good for raw counts of behaviors reflecting each of two Overall Factors generated within MPA (Assertion and Perspective), inter-rater reliability for patterning (proportional indicators of each factor) was significantly higher and excellent (ICC = 0.89). Furthermore, patterning, as compared to raw counts, provided better prediction of observable decision-making process assessed in the laboratory. These analyses support the utility of using an empirical approach to inform the consideration of measuring patterning versus discrete behavioral counts of behaviors when determining inter-rater reliability of observable behavior. They also speak to the substantial reliability that may be achieved via application of theoretically grounded observational systems such as MPA that reveal thinking and action motivations via visible movement patterns. PMID:24999336

  4. Should we trust our judgments about the proficiency of Motivational Interviewing counselors? A glimpse at the impact of low inter-rater reliability

    PubMed Central

    Dunn, Chris; Darnell, Doyanne; Yi, Sheng Kung Michael; Steyvers, Mark; Bumgardner, Kristin; Lord, Sarah Peregrine; Imel, Zac; Atkins, David C.

    2016-01-01

    Standardized rating systems are often used to evaluate the proficiency of Motivational Interviewing (MI) counselors. The published inter-rater reliability (degree of coder agreement) in many studies using these instruments has varied a great deal; some studies report MI proficiency scores that have only fair inter-rater reliability, and others report scores with excellent reliability. How much can we to trust the scores with fair versus excellent reliability? Using a Monte Carlo statistical simulation, we compared the impact of fair (0.50) versus excellent (0.90) reliability on the error rates of falsely judging a given counselor as MI proficient or not proficient. We found that improving the inter-rater reliability of any given score from 0.5 to 0.9 would cause a marked reduction in proficiency judgment errors, a reduction that in some MI evaluation situations would be critical. We discuss some practical tradeoffs inherent in various MI evaluation situations, and offer suggestions for applying findings from formal MI research to problems faced by real-world MI evaluators, to help them minimize the MI proficiency judgment errors bearing the greatest cost.

  5. Measuring Essay Assessment: Intra-Rater and Inter-Rater Reliability

    ERIC Educational Resources Information Center

    Kayapinar, Ulas

    2014-01-01

    Problem Statement: There have been many attempts to research the effective assessment of writing ability, and many proposals for how this might be done. In this sense, rater reliability plays a crucial role for making vital decisions about testees in different turning points of both educational and professional life. Intra-rater and inter-rater…

  6. Intra and Inter-Rater Reliability and Convergent Validity of FIT-HaNSA in Individuals with Grade П Whiplash Associated Disorder

    PubMed Central

    Pierrynowski, Michael; McPhee, Colleen; P. Mehta, Saurabh; C. MacDermid, Joy; Gross, Anita

    2016-01-01

    Background: Whiplash-Associated Disorders (WAD) are common following a motor vehicle accident. The Functional Impairment Test - Hand, and Neck/Shoulder/Arm (FIT-HaNSA) assesses upper extremity physical performance. It has been validated in patients with shoulder pathology but not in those with WAD. Objectives: Establish the Intra and inter-rater reliability and the known-group and construct validity of the FIT-HaNSA in patients with Grade II WAD (WAD2). Methods: Twenty-five patients with WAD2 and 41 healthy controls were recruited. Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI), Disabilities of the Arm, Shoulder and Hand (DASH), cervical range of motion (CROM), and FIT-HaNSA were completed at two sessions conducted 2 to 7 days apart by two raters. Intraclass correlation coefficients (ICC) were used to describe Intra and inter-rater reliability. Spearman rank correlation coefficients (ρ) were used to quantify the associations between scores of the FIT-HaNSA and other measures in the WAD2 group (convergent construct validity). Results: The Intra and inter-ICCs for the FIT-HaNSA scores ranged from 0.88 to 0.89 in the control group and 0.78 to 0.85 in the WAD2 group. Statistically significant differences in FIT-HaNSA performance between the two groups suggested known group construct validity (P < 0.001). The correlations between the NPRS, NDI, DASH, CROM and FIT-HaNSA were generally poor (ρ < 0.4). Conclusion: The study results indicate that the total FIT-HaNSA score has good Intra and inter-rater reliability and the construct validity in WAD2 and healthy controls. PMID:27350797

  7. The Outdoor MEDIA DOT: The Development and Inter-Rater Reliability of a Tool Designed to Measure Food and Beverage Outlets and Outdoor Advertising

    PubMed Central

    Poulos, Natalie S.; Pasch, Keryn E.

    2015-01-01

    Few studies of the food environment have collected primary data, and even fewer have reported reliability of the tool used. This study focused on the development of an innovative electronic data collection tool used to document outdoor food and beverage (FB) advertising and establishments near 43 middle and high schools in the Outdoor MEDIA Study. Tool development used GIS based mapping, an electronic data collection form on handheld devices, and an easily adaptable interface to efficiently collect primary data within the food environment. For the reliability study, two teams of data collectors documented all FB advertising and establishments within one half-mile of six middle schools. Inter-rater reliability was calculated overall and by advertisement or establishment category using percent agreement. A total of 824 advertisements (n=233), establishment advertisements (n=499), and establishments (n=92) were documented (range=8–229 per school). Overall inter-rater reliability of the developed tool ranged from 69–89% for advertisements and establishments. Results suggest that the developed tool is highly reliable and effective for documenting the outdoor FB environment. PMID:26022774

  8. The Outdoor MEDIA DOT: The development and inter-rater reliability of a tool designed to measure food and beverage outlets and outdoor advertising.

    PubMed

    Poulos, Natalie S; Pasch, Keryn E

    2015-07-01

    Few studies of the food environment have collected primary data, and even fewer have reported reliability of the tool used. This study focused on the development of an innovative electronic data collection tool used to document outdoor food and beverage (FB) advertising and establishments near 43 middle and high schools in the Outdoor MEDIA Study. Tool development used GIS based mapping, an electronic data collection form on handheld devices, and an easily adaptable interface to efficiently collect primary data within the food environment. For the reliability study, two teams of data collectors documented all FB advertising and establishments within one half-mile of six middle schools. Inter-rater reliability was calculated overall and by advertisement or establishment category using percent agreement. A total of 824 advertisements (n=233), establishment advertisements (n=499), and establishments (n=92) were documented (range=8-229 per school). Overall inter-rater reliability of the developed tool ranged from 69-89% for advertisements and establishments. Results suggest that the developed tool is highly reliable and effective for documenting the outdoor FB environment. PMID:26022774

  9. Inter-rater and test–retest reliability of quality assessments by novice student raters using the Jadad and Newcastle–Ottawa Scales

    PubMed Central

    Oremus, Carolina; Hall, Geoffrey B C; McKinnon, Margaret C

    2012-01-01

    Introduction Quality assessment of included studies is an important component of systematic reviews. Objective The authors investigated inter-rater and test–retest reliability for quality assessments conducted by inexperienced student raters. Design Student raters received a training session on quality assessment using the Jadad Scale for randomised controlled trials and the Newcastle–Ottawa Scale (NOS) for observational studies. Raters were randomly assigned into five pairs and they each independently rated the quality of 13–20 articles. These articles were drawn from a pool of 78 papers examining cognitive impairment following electroconvulsive therapy to treat major depressive disorder. The articles were randomly distributed to the raters. Two months later, each rater re-assessed the quality of half of their assigned articles. Setting McMaster Integrative Neuroscience Discovery and Study Program. Participants 10 students taking McMaster Integrative Neuroscience Discovery and Study Program courses. Main outcome measures The authors measured inter-rater reliability using κ and the intraclass correlation coefficient type 2,1 or ICC(2,1). The authors measured test–retest reliability using ICC(2,1). Results Inter-rater reliability varied by scale question. For the six-item Jadad Scale, question-specific κs ranged from 0.13 (95% CI −0.11 to 0.37) to 0.56 (95% CI 0.29 to 0.83). The ranges were −0.14 (95% CI −0.28 to 0.00) to 0.39 (95% CI −0.02 to 0.81) for the NOS cohort and −0.20 (95% CI −0.49 to 0.09) to 1.00 (95% CI 1.00 to 1.00) for the NOS case–control. For overall scores on the six-item Jadad Scale, ICC(2,1)s for inter-rater and test–retest reliability (accounting for systematic differences between raters) were 0.32 (95% CI 0.08 to 0.52) and 0.55 (95% CI 0.41 to 0.67), respectively. Corresponding ICC(2,1)s for the NOS cohort were −0.19 (95% CI −0.67 to 0.35) and 0.62 (95% CI 0.25 to 0.83), and for the NOS case–control, the ICC(2

  10. Inter-rater agreement and reliability of the COSMIN (COnsensus-based Standards for the selection of health status Measurement Instruments) Checklist

    PubMed Central

    2010-01-01

    Background The COSMIN checklist is a tool for evaluating the methodological quality of studies on measurement properties of health-related patient-reported outcomes. The aim of this study is to determine the inter-rater agreement and reliability of each item score of the COSMIN checklist (n = 114). Methods 75 articles evaluating measurement properties were randomly selected from the bibliographic database compiled by the Patient-Reported Outcome Measurement Group, Oxford, UK. Raters were asked to assess the methodological quality of three articles, using the COSMIN checklist. In a one-way design, percentage agreement and intraclass kappa coefficients or quadratic-weighted kappa coefficients were calculated for each item. Results 88 raters participated. Of the 75 selected articles, 26 articles were rated by four to six participants, and 49 by two or three participants. Overall, percentage agreement was appropriate (68% was above 80% agreement), and the kappa coefficients for the COSMIN items were low (61% was below 0.40, 6% was above 0.75). Reasons for low inter-rater agreement were need for subjective judgement, and accustom to different standards, terminology and definitions. Conclusions Results indicated that raters often choose the same response option, but that it is difficult on item level to distinguish between articles. When using the COSMIN checklist in a systematic review, we recommend getting some training and experience, completing it by two independent raters, and reaching consensus on one final rating. Instructions for using the checklist are improved. PMID:20860789

  11. The health preoccupation diagnostic interview: inter-rater reliability of a structured interview for diagnostic assessment of DSM-5 somatic symptom disorder and illness anxiety disorder.

    PubMed

    Axelsson, Erland; Andersson, Erik; Ljótsson, Brjánn; Wallhed Finn, Daniel; Hedman, Erik

    2016-06-01

    Somatic symptom disorder (SSD) and illness anxiety disorder (IAD) are two new diagnoses introduced in the DSM-5. There is a need for reliable instruments to facilitate the assessment of these disorders. We therefore developed a structured diagnostic interview, the Health Preoccupation Diagnostic Interview (HPDI), which we hypothesized would reliably differentiate between SSD, IAD, and no diagnosis. Persons with clinically significant health anxiety (n = 52) and healthy controls (n = 52) were interviewed using the HPDI. Diagnoses were then compared with those made by an independent assessor, who listened to audio recordings of the interviews. Ratings generally indicated moderate to almost perfect inter-rater agreement, as illustrated by an overall Cohen's κ of .85. Disagreements primarily concerned (a) the severity of somatic symptoms, (b) the differential diagnosis of panic disorder, and (c) SSD specifiers. We conclude that the HPDI can be used to reliably diagnose DSM-5 SSD and IAD. PMID:27096407

  12. The behavior flexibility rating scale-revised (BFRS-R): factor analysis, internal consistency, inter-rater and intra-rater reliability, and convergent validity.

    PubMed

    Peters-Scheffer, Nienke; Didden, Robert; Green, Vanessa A; Sigafoos, Jeff; Korzilius, Hubert; Pituch, Keenan; O'Reilly, Mark F; Lancioni, Giulio

    2008-01-01

    We examined the psychometric properties of the behavior flexibility rating scale-revised (BFRS-R), a new scale intended for assessing behavioral flexibility in individuals with developmental disabilities. Seventy-six direct care staff members and 56 parents completed the BFRS-R for 70 children with developmental disabilities. Factor analysis revealed three factors (i.e., Flexibility towards objects, Flexibility towards the environment, and Flexibility towards persons) and results of several analyses indicated an excellent internal consistency and good intra-rater and inter-rater reliability of the total scale. These data suggest that the BFRS-R may provide a reliable rating of behavioral flexibility when used by direct-care staff and parents of children with developmental disabilities. PMID:17826945

  13. Establishing the definition and inter-rater reliability of cortical silent period calculation in subjects with focal hand dystonia and healthy controls

    PubMed Central

    Kimberley, Teresa Jacobson; Borich, Michael R.; Prochaska, Kristina D.; Mundfrom, Shannon L.; Perkins, Ariel E.; Poepping, Joseph M.

    2009-01-01

    The purpose of this paper is to describe a clearly defined manual method for calculating cortical silent period (CSP) length that can be employed successfully and reliably by raters after minimal training in subjects with focal hand dystonia (FHD) and healthy subjects. A secondary purpose was to explore intra-subject variability of the CSP in subjects with FHD vs. healthy subjects. Methods Two raters previously naïve to CSP identification and one experienced rater independently analyzed 170 CSP measurements collected in six subjects with focal hand dystonia (FHD) and nine healthy subjects. Intraclass correlation coefficient (ICC) was calculated to quantify inter-rater reliability within the two groups of subjects. The relative variability of CSP in each group was calculated by coefficient of variation (CV). Relative variation between raters within repeated measures of individual subjects was also quantified by CV. Results Reliability measures were as follows: mean of three raters: all subjects: ICC= 0.976; within healthy subjects: ICC=0.965; in subjects with FHD: ICC= 0.956. The median within-subject variability for the healthy group was CV=7.33% and in subjects with FHD: CV= 11.78%. The median variability of calculating individual subject CSP duration between raters was CV=10.23% in subjects with dystonia and CV=10.46% in healthy subjects. Conclusions Manual calculation of CSP results in excellent reliability between raters of varied levels of experience. Healthy subjects display less variability in CSP. Despite greater variability, the CSP in impaired subjects can be reliably calculated across raters. PMID:19686807

  14. Content Validity Index and Intra- and Inter-Rater Reliability of a New Muscle Strength/Endurance Test Battery for Swedish Soldiers.

    PubMed

    Larsson, Helena; Tegern, Matthias; Monnier, Andreas; Skoglund, Jörgen; Helander, Charlotte; Persson, Emelie; Malm, Christer; Broman, Lisbet; Aasa, Ulrika

    2015-01-01

    The objective of this study was to examine the content validity of commonly used muscle performance tests in military personnel and to investigate the reliability of a proposed test battery. For the content validity investigation, thirty selected tests were those described in the literature and/or commonly used in the Nordic and North Atlantic Treaty Organization (NATO) countries. Nine selected experts rated, on a four-point Likert scale, the relevance of these tests in relation to five different work tasks: lifting, carrying equipment on the body or in the hands, climbing, and digging. Thereafter, a content validity index (CVI) was calculated for each work task. The result showed excellent CVI (≥0.78) for sixteen tests, which comprised of one or more of the military work tasks. Three of the tests; the functional lower-limb loading test (the Ranger test), dead-lift with kettlebells, and back extension, showed excellent content validity for four of the work tasks. For the development of a new muscle strength/endurance test battery, these three tests were further supplemented with two other tests, namely, the chins and side-bridge test. The inter-rater reliability was high (intraclass correlation coefficient, ICC2,1 0.99) for all five tests. The intra-rater reliability was good to high (ICC3,1 0.82-0.96) with an acceptable standard error of mean (SEM), except for the side-bridge test (SEM%>15). Thus, the final suggested test battery for a valid and reliable evaluation of soldiers' muscle performance comprised the following four tests; the Ranger test, dead-lift with kettlebells, chins, and back extension test. The criterion-related validity of the test battery should be further evaluated for soldiers exposed to varying physical workload. PMID:26177030

  15. Content Validity Index and Intra- and Inter-Rater Reliability of a New Muscle Strength/Endurance Test Battery for Swedish Soldiers

    PubMed Central

    Larsson, Helena; Tegern, Matthias; Monnier, Andreas; Skoglund, Jörgen; Helander, Charlotte; Persson, Emelie; Malm, Christer; Broman, Lisbet; Aasa, Ulrika

    2015-01-01

    The objective of this study was to examine the content validity of commonly used muscle performance tests in military personnel and to investigate the reliability of a proposed test battery. For the content validity investigation, thirty selected tests were those described in the literature and/or commonly used in the Nordic and North Atlantic Treaty Organization (NATO) countries. Nine selected experts rated, on a four-point Likert scale, the relevance of these tests in relation to five different work tasks: lifting, carrying equipment on the body or in the hands, climbing, and digging. Thereafter, a content validity index (CVI) was calculated for each work task. The result showed excellent CVI (≥0.78) for sixteen tests, which comprised of one or more of the military work tasks. Three of the tests; the functional lower-limb loading test (the Ranger test), dead-lift with kettlebells, and back extension, showed excellent content validity for four of the work tasks. For the development of a new muscle strength/endurance test battery, these three tests were further supplemented with two other tests, namely, the chins and side-bridge test. The inter-rater reliability was high (intraclass correlation coefficient, ICC2,1 0.99) for all five tests. The intra-rater reliability was good to high (ICC3,1 0.82–0.96) with an acceptable standard error of mean (SEM), except for the side-bridge test (SEM%>15). Thus, the final suggested test battery for a valid and reliable evaluation of soldiers’ muscle performance comprised the following four tests; the Ranger test, dead-lift with kettlebells, chins, and back extension test. The criterion-related validity of the test battery should be further evaluated for soldiers exposed to varying physical workload. PMID:26177030

  16. Content Validity and Inter-Rater Reliability of the Halliwick-Concept-Based Instrument "Swimming with Independent Measure"

    ERIC Educational Resources Information Center

    Srsen, Katja Groleger; Vidmar, Gaj; Pikl, Masa; Vrecar, Irena; Burja, Cirila; Krusec, Klavdija

    2012-01-01

    The Halliwick concept is widely used in different settings to promote joyful movement in water and swimming. To assess the swimming skills and progression of an individual swimmer, a valid and reliable measure should be used. The Halliwick-concept-based Swimming with Independent Measure (SWIM) was introduced for this purpose. We aimed to determine…

  17. Inter-rater reliability of the Greek version of CAARMS among two groups of mental health professionals.

    PubMed

    Kollias, C; Kontaxakis, V; Havaki-Kontaxaki, B; Simmons, M B; Stefanis, N; Papageorgiou, C

    2015-01-01

    There is increasing interest within the Greek psychiatric community in the early detection and prevention of psychotic disorders. To support this, there is a need for a valid and reliable tool to identify young people that may be at risk of developing a psychotic disorder. Our team has previously translated the Comprehensive Assessment of At-Risk Mental States (CAARMS). The validity of the CAARMS was ensured by the procedure of translation and the aim of the current study was to estimate the interrater reliability of the CAARMS Greek translation among residents in psychiatry and specialized mental health professionals. 43 mental health workers (27 residents in psychiatry and 16 specialized mental health professionals (i.e. 11 psychiatrists and 5 psychologist) participated in two seminars that covered theoretical information about the ultra high risk concept and training in the CAARMS. During the seminars, 10 vignettes with psychiatric history cases were presented, including healthy, ultra high risk and first episode psychosis. The mean correlated percentage of agreement with the correct answers regarding diagnosis of the presented history cases among all our subjects was 81.42, among specialized mental health professionals 77.88, and among residents 84.46. Intraclass correlation co-efficients were 0.994 for specialized mental health professionals and 0.997 for residents. The translated Greek version of CAARMS presents a satisfying interrater reliability when used by both residents and specialized mental health professionals. Residents declare even higher intraclass correlation co-efficients and mean correlated percentage of agreement than specialized mental health professionals, which indicate that residents are capable of using the CAARMS in early intervention units. PMID:26480226

  18. Low inter-rater reliability in grading of rectal bleeding using NCI CTC and RTOG toxicity scales: a survey of radiation oncologists

    PubMed Central

    Huynh-Le, Minh-Phuong; Zhang, Zhe; Tran, Phuoc T.; DeWeese, Theodore L.; Song, Danny Y.

    2014-01-01

    Purpose/Objective(s) Rectal bleeding is one of the most common toxicities following prostate radiotherapy (RT), and both NCI CTC and RTOG grading scales are frequently used to report outcomes. We measured concordance among genitourinary radiation oncologists in using these scales to grade rectal bleeding. Methods and Materials From 6/2013–1/2014, a web-based survey was sent to 250 American and Canadian academic radiation oncologists who treat prostate cancer. Participants were provided 4 case vignettes where patients received RT and developed rectal bleeding and were asked for management plans and to rate the bleeding according to NCI CTC v.4 and RTOG late toxicity grading (scales provided). In 2 cases, participants were also asked if they would send the patient for colonoscopy. A multilevel, random intercept modeling approach was used to assess sources of variation (case, respondent) in toxicity grading to calculate the intraclass correlation coefficient (ICC). Agreement on a dichotomous grading scale (low grades 1–2 vs. high grades 3–4) was also assessed, using kappa statistic for multiple respondents. Results Seventy-two radiation oncologists (28%) completed the survey. Forty-seven (65%) reported having either written or been principal investigator on a study using these scales. Agreement between respondents was moderate (ICC=0.52, 95% CI 0.47–0.58) when using NCI CTC and fair using the RTOG scale (ICC=0.28, 95% CI 0.20–0.40). Respondents who chose an invasive management were more likely to select a higher toxicity grade (p<0.0001). Using the dichotomous scale, we observed moderate agreement (kappa=0.42, 95% CI 0.40–0.44) with the NCI CTC scale, but only slight agreement with the RTOG scale (kappa=0.19, 95% CI 0.17–0.21). Conclusion Low inter-rater reliability was observed among radiation oncologists grading rectal bleeding using two common scales. Clearer definitions of late rectal bleeding toxicity should be constructed to reduce this variability

  19. The occurrence and inter-rater reliability of myofascial trigger points in the quadratus lumborum and gluteus medius: a prospective study in non-specific low back pain patients and controls in general practice.

    PubMed

    Njoo, K H; Van der Does, E

    1994-09-01

    The presence of a trigger point is essential to the myofascial pain syndrome. This study centres on identifying clearer criteria for the presence of trigger points in the quadratus lumborum and gluteus medius muscle by investigating the occurrence and inter-rater reliability of trigger point symptoms. Using the symptoms and signs as described by Simons' 1990 definition and two other former sets of criteria, 61 non-specific low back pain patients and 63 controls were examined in general practice by 5 observers, working in pairs. From the two major criteria of Simons' 1990 definition only 'localized tenderness' has good discriminative ability and inter-rater reliability (kappa > 0.5). This study does not find proof for the clinical usefulness of 'referred pain', which has neither of these two abilities. The criteria 'jump sign' and 'recognition', on the condition that localized tenderness is present, also have good discriminative ability and inter-rater reliability. Trigger points defined by the criteria found eligible in this study allow significant distinction between non-specific low back pain patients and controls. This is not the case with trigger points defined by Simons' 1990 criteria. Concerning reliability there is also a significant difference between the two different criteria sets. This study suggests that the clinical usefulness of trigger points is increased when localized tenderness and the presence of either jump sign or patient's recognition of his pain complaint are used as criteria for the presence of trigger points in the M. quadratus lumborum and the M. gluteus medius. PMID:7838580

  20. Consensus Conference Follow-up: Inter-rater Reliability Assessment of the Best Evidence in Emergency Medicine (BEEM) Rater Scale, a Medical Literature Rating Tool for Emergency Physicians

    PubMed Central

    Worster, Andrew; Kulasegaram, Kulamakan; Carpenter, Christopher R.; Vallera, Teresa; Upadhye, Suneel; Sherbino, Jonathan; Haynes, R. Brian

    2011-01-01

    Background Studies published in general and specialty medical journals have the potential to improve emergency medicine (EM) practice, but there can be delayed awareness of this evidence because emergency physicians (EPs) are unlikely to read most of these journals. Also, not all published studies are intended for or ready for clinical practice application. The authors developed “Best Evidence in Emergency Medicine” (BEEM) to ameliorate these problems by searching for, identifying, appraising, and translating potentially practice-changing studies for EPs. An initial step in the BEEM process is the BEEM rater scale, a novel tool for EPs to collectively evaluate the relative clinical relevance of EM-related studies found in more than 120 journals. The BEEM rater process was designed to serve as a clinical relevance filter to identify those studies with the greatest potential to affect EM practice. Therefore, only those studies identified by BEEM raters as having the highest clinical relevance are selected for the subsequent critical appraisal process and, if found methodologically sound, are promoted as the best evidence in EM. Objectives The primary objective was to measure inter-rater reliability (IRR) of the BEEM rater scale. Secondary objectives were to determine the minimum number of EP raters needed for the BEEM rater scale to achieve acceptable reliability and to compare performance of the scale against a previously published evidence rating system, the McMaster Online Rating of Evidence (MORE), in an EP population. Methods The authors electronically distributed the title, conclusion, and a PubMed link for 23 recently published studies related to EM to a volunteer group of 134 EPs. The volunteers answered two demographic questions and rated the articles using one of two randomly assigned seven-point Likert scales, the BEEM rater scale (n = 68) or the MORE scale (n = 66), over two separate administrations. The IRR of each scale was measured using

  1. Intra-Rater, Inter-Rater and Test-Retest Reliability of an Instrumented Timed Up and Go (iTUG) Test in Patients with Parkinson’s Disease

    PubMed Central

    van Lummel, Rob C.; Walgaard, Stefan; Hobert, Markus A.; Maetzler, Walter; van Dieën, Jaap H.; Galindo-Garre, Francisca; Terwee, Caroline B.

    2016-01-01

    Background The “Timed Up and Go” (TUG) is a widely used measure of physical functioning in older people and in neurological populations, including Parkinson’s Disease. When using an inertial sensor measurement system (instrumented TUG [iTUG]), the individual components of the iTUG and the trunk kinematics can be measured separately, which may provide relevant additional information. Objective The aim of this study was to determine intra-rater, inter-rater and test-retest reliability of the iTUG in patients with Parkinson’s Disease. Methods Twenty eight PD patients, aged 50 years or older, were included. For the iTUG the DynaPort Hybrid (McRoberts, The Hague, The Netherlands) was worn at the lower back. The device measured acceleration and angular velocity in three directions at a rate of 100 samples/s. Patients performed the iTUG five times on two consecutive days. Repeated measurements by the same rater on the same day were used to calculate intra-rater reliability. Repeated measurements by different raters on the same day were used to calculate intra-rater and inter-rater reliability. Repeated measurements by the same rater on different days were used to calculate test-retest reliability. Results Nineteen ICC values (15%) were ≥ 0.9 which is considered as excellent reliability. Sixty four ICC values (49%) were ≥ 0.70 and < 0.90 which is considered as good reliability. Thirty one ICC values (24%) were ≥ 0.50 and < 0.70, indicating moderate reliability. Sixteen ICC values (12%) were ≥ 0.30 and < 0.50 indicating poor reliability. Two ICT values (2%) were < 0.30 indicating very poor reliability. Conclusions In conclusion, in patients with Parkinson’s disease the intra-rater, inter-rater, and test-retest reliability of the individual components of the instrumented TUG (iTUG) was excellent to good for total duration and for turning durations, and good to low for the sub durations and for the kinematics of the SiSt and StSi. The results of this fully

  2. How to assess and compare inter-rater reliability, agreement and correlation of ratings: an exemplary analysis of mother-father and parent-teacher expressive vocabulary rating pairs

    PubMed Central

    Stolarova, Margarita; Wolf, Corinna; Rinker, Tanja; Brielmann, Aenne

    2014-01-01

    This report has two main purposes. First, we combine well-known analytical approaches to conduct a comprehensive assessment of agreement and correlation of rating-pairs and to dis-entangle these often confused concepts, providing a best-practice example on concrete data and a tutorial for future reference. Second, we explore whether a screening questionnaire developed for use with parents can be reliably employed with daycare teachers when assessing early expressive vocabulary. A total of 53 vocabulary rating pairs (34 parent–teacher and 19 mother–father pairs) collected for two-year-old children (12 bilingual) are evaluated. First, inter-rater reliability both within and across subgroups is assessed using the intra-class correlation coefficient (ICC). Next, based on this analysis of reliability and on the test-retest reliability of the employed tool, inter-rater agreement is analyzed, magnitude and direction of rating differences are considered. Finally, Pearson correlation coefficients of standardized vocabulary scores are calculated and compared across subgroups. The results underline the necessity to distinguish between reliability measures, agreement and correlation. They also demonstrate the impact of the employed reliability on agreement evaluations. This study provides evidence that parent–teacher ratings of children's early vocabulary can achieve agreement and correlation comparable to those of mother–father ratings on the assessed vocabulary scale. Bilingualism of the evaluated child decreased the likelihood of raters' agreement. We conclude that future reports of agreement, correlation and reliability of ratings will benefit from better definition of terms and stricter methodological approaches. The methodological tutorial provided here holds the potential to increase comparability across empirical reports and can help improve research practices and knowledge transfer to educational and therapeutic settings. PMID:24994985

  3. A Multi-Center Pilot Evaluation of the National Institutes of Health Chronic Graft-versus-Host Disease (cGVHD) Therapeutic Response Measures: Feasibility, Inter-rater Reliability, and Minimum Detectable Change

    PubMed Central

    Mitchell, Sandra A.; Jacobsohn, David; Thormann Powers, Kimberly E.; Carpenter, Paul A.; Flowers, Mary E.D.; Cowen, Edward W.; Schubert, Mark; Turner, Maria; Lee, Stephanie J.; Martin, Paul; Bishop, Michael R.; Baird, Kristin; Bolaños-Meade, Javier; Boyd, Kevin; Fall-Dickson, Jane M.; Gerber, Lynn H.; Guadagnini, Jean-Pierre; Imanguli, Matin; Krumlauf, Michael C.; Lawley, Leslie; Li, Li; Reeve, Bryce B.; Clayton, Janine Austin; Vogelsang, Georgia B.; Pavletic, Steven Z.

    2011-01-01

    The lack of standardized criteria for measuring therapeutic response is a major obstacle to the development of new therapeutic agents for chronic graft-versus-host disease (cGVHD). National Institutes of Health (NIH) consensus criteria for evaluating therapeutic response were published in 2006. We report the results of four consecutive pilot trials evaluating the feasibility and estimating the inter-rater reliability and minimum detectable change of these response criteria. Hematology-oncology clinicians with limited experience in applying the NIH cGVHD response criteria (n=34), participated in a 2.5 hour training session on response evaluation in cGVHD. Feasibility and inter-rater reliability between subspecialty cGVHD experts and this panel of clinician raters were examined in a sample of 25 children and adults with cGVHD. The minimum detectable change was calculated using the standard error of measurement. Clinicians’ impressions of the brief training session, the photo atlas, and the response criteria documentation tools were generally favorable. Performing and documenting the full set of response evaluations required a median of 21 minutes (range 12 to 60 minutes) per rater. The Schirmer tear test required the greatest time of any single test (median 9 minutes). Overall, inter-rater agreement for skin and oral manifestations was modest, however, in the third and fourth trials, the agreement between clinicians and experts for all dimensions except movable sclerosis approached satisfactory values. In the final two trials, the threshold for defining change exceeding measurement error was 19–22% body surface area (BSA) for erythema, 18–26% BSA for movable sclerosis, 17–21% BSA for nonmovable sclerosis, and 2.1–2.6 points on the 15 point NIH Oral cGHVD scale. Agreement between clinician-expert pairs was moderate to substantial for the measures of functional capacity and for the gastrointestinal and global cGVHD rating scales. These results suggest that

  4. Internal Consistency and Inter-Rater Reliability of the Questions about Behavioral Function (QABF) Rating Scale When Used by Teachers and Paraprofessionals

    ERIC Educational Resources Information Center

    May, Michael E.; Sheng, Yanyan; Chitiyo, Morgan; Brandt, Rachel C.; Howe, Abigail P.

    2014-01-01

    There has been considerable emphasis on indirect functional behavior assessments in school settings. However, little research has evaluated the reliability of these methods to identify behavioral function. One indirect measure, the Questions About Behavioral Function (QABF) scale, has yet to be extensively studied in school settings, though…

  5. Inter-rater agreement among orthodontists in a blocked experiment.

    PubMed

    Korn, E L; Baumrind, S

    1985-01-01

    Five orthodontists were asked to predict for 64 patients a particular dichotomous outcome of treatment based on pre-treatment X-ray films. The orthodontists rated the cases in blocks of size 4-6 with the knowledge of the number of positive outcomes in each block. We discuss the reasons why this blocked design is appropriate whenever clinicians are asked to rate cases which have not been randomly selected from a clinical practice similar to their own. We give a simple description of the inter-rater agreement for this type of blocked experiment as well as a procedure to test that the agreement is no better than that expected by random independent assignment. PMID:3992073

  6. Comparability and Reliability Considerations of Adequate Yearly Progress

    ERIC Educational Resources Information Center

    Maier, Kimberly S.; Maiti, Tapabrata; Dass, Sarat C.; Lim, Chae Young

    2012-01-01

    The purpose of this study is to develop an estimate of Adequate Yearly Progress (AYP) that will allow for reliable and valid comparisons among student subgroups, schools, and districts. A shrinkage-type estimator of AYP using the Bayesian framework is described. Using simulated data, the performance of the Bayes estimator will be compared to…

  7. Structured interview for mild traumatic brain injury after military blast: inter-rater agreement and development of diagnostic algorithm.

    PubMed

    Walker, William C; Cifu, David X; Hudak, Anne M; Goldberg, Gary; Kunz, Richard D; Sima, Adam P

    2015-04-01

    The existing gold standard for diagnosing a suspected previous mild traumatic brain injury (mTBI) is clinical interview. But it is prone to bias, especially for parsing the physical versus psychological effects of traumatic combat events, and its inter-rater reliability is unknown. Several standardized TBI interview instruments have been developed for research use but have similar limitations. Therefore, we developed the Virginia Commonwealth University (VCU) retrospective concussion diagnostic interview, blast version (VCU rCDI-B), and undertook this cross-sectional study aiming to 1) measure agreement among clinicians' mTBI diagnosis ratings, 2) using clinician consensus develop a fully structured diagnostic algorithm, and 3) assess accuracy of this algorithm in a separate sample. Two samples (n = 66; n = 37) of individuals within 2 years of experiencing blast effects during military deployment underwent semistructured interview regarding their worst blast experience. Five highly trained TBI physicians independently reviewed and interpreted the interview content and gave blinded ratings of whether or not the experience was probably an mTBI. Paired inter-rater reliability was extremely variable, with kappa ranging from 0.194 to 0.825. In sample 1, the physician consensus prevalence of probable mTBI was 84%. Using these diagnosis ratings, an algorithm was developed and refined from the fully structured portion of the VCU rCDI-B. The final algorithm considered certain symptom patterns more specific for mTBI than others. For example, an isolated symptom of "saw stars" was deemed sufficient to indicate mTBI, whereas an isolated symptom of "dazed" was not. The accuracy of this algorithm, when applied against the actual physician consensus in sample 2, was almost perfect (correctly classified = 97%; Cohen's kappa = 0.91). In conclusion, we found that highly trained clinicians often disagree on historical blast-related mTBI determinations. A fully structured interview

  8. Inter-Rater Agreement of Pressure Ulcer Risk and Prevention Measures in the National Database of Nursing Quality Indicators(®) (NDNQI).

    PubMed

    Waugh, Shirley Moore; Bergquist-Beringer, Sandra

    2016-06-01

    In this descriptive multi-site study, we examined inter-rater agreement on 11 National Database of Nursing Quality Indicators(®) (NDNQI(®) ) pressure ulcer (PrU) risk and prevention measures. One hundred twenty raters at 36 hospitals captured data from 1,637 patient records. At each hospital, agreement between the most experienced rater and each other team rater was calculated for each measure. In the ratings studied, 528 patients were rated as "at risk" for PrU and, therefore, were included in calculations of agreement for the prevention measures. Prevalence-adjusted kappa (PAK) was used to interpret inter-rater agreement because prevalence of single responses was high. The PAK values for eight measures indicated "substantial" to "near perfect" agreement between most experienced and other team raters: Skin assessment on admission (.977, 95% CI [.966-.989]), PrU risk assessment on admission (.978, 95% CI [.964-.993]), Time since last risk assessment (.790, 95% CI [.729-.852]), Risk assessment method (.997, 95% CI [.991-1.0]), Risk status (.877, 95% CI [.838-.917]), Any prevention (.856, 95% CI [.76-.943]), Skin assessment (.956, 95% CI [.904-1.0]), and Pressure-redistribution surface use (.839, 95% CI [.763-.916]). For three intervention measures, PAK values fell below the recommended value of ≥.610: Routine repositioning (.577, 95% CI [.494-.661]), Nutritional support (.500, 95% CI [.418-.581]), and Moisture management (.556, 95% CI [.469-.643]). Areas of disagreement were identified. Findings provide support for the reliability of 8 of the 11 measures. Further clarification of data collection procedures is needed to improve reliability for the less reliable measures. © 2016 Wiley Periodicals, Inc. PMID:27038340

  9. Inter-Rater Reliability of the Diagnoses of Psychosis and Depression in Individuals with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Einfeld, S.; Tonge, B.; Chapman, L.; Mohr, C.; Taffe, J.; Horstead, S.

    2007-01-01

    Background: There is a history of over-prescription of antipsychotics to individuals with intellectual disability (ID), while antidepressants may be under-prescribed. However, appropriate treatment is best supported when the diagnosis of psychosis or depression is valid and carries good predictive validity. The present authors report a study…

  10. Inter-Rater Reliability of the Developmental Behaviour Checklist for Adults in Community Accommodation Settings

    ERIC Educational Resources Information Center

    Mohr, C.; Tonge, B. J.; Taffe, J.; Rymill, A.; Collins, D.; Keating, C.; Einfeld, S. L.

    2011-01-01

    Background: With the publication of the Developmental Behaviour Checklist for Adults (DBC-A), people of all ages with intellectual disability (ID) can now be assessed using a carer-completed screening checklist of emotional and behavioural disturbance. This provides a broad assessment framework across the life span, assists the process of clinical…

  11. Validation of a modified Bristol stool scale - inter-rater reliability amongst pediatric gastroenterologists

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Stool form and changes in stool form are important criteria in both clinical practice and clinical research. However, descriptions of stool form from both patients and physicians alike may be subjective and objective measurements of stool form are not well developed. Although the Bristol stool scale...

  12. Inter-rater reliability of the EEG reading in patients with childhood idiopathic epilepsy.

    PubMed

    Piccinelli, Paolo; Viri, Maurizio; Zucca, Claudio; Borgatti, Renato; Romeo, Antonino; Giordano, Laura; Balottin, Umberto; Beghi, Ettore

    2005-01-01

    The level of agreement in the interpretation of EEG records by different experienced readers working in three child neurology tertiary centers has been evaluated. EEG recordings randomly chosen from patients with idiopathic epilepsy were included. Optimal or suboptimal agreement was found for presence of ictal and interictal discharges. Contrary to ictal discharges, the distribution and location of interictal discharges was not unanimously interpreted and agreement was unsatisfactory when assessing the background activity. PMID:16118044

  13. The Reliability of Environmental Measures of the College Alcohol Environment.

    ERIC Educational Resources Information Center

    Clapp, John D.; Whitney, Mike; Shillington, Audrey M.

    2002-01-01

    Assesses the inter-rater reliability of two environmental scanning tools designed to identify alcohol-related advertisements targeting college students. Inter-rater reliability for these forms varied across different rating categories and ranged from poor to excellent. Suggestions for future research are addressed. (Contains 26 references and 6…

  14. Assessing the rhinoplasty outcome: inter-rater variability of aesthetic perception in the light of objective facial analysis.

    PubMed

    Ozturk, Kerem; Gode, Sercan; Karahan, Ceyda; Midilli, Rasit

    2015-12-01

    The aim of this study was to assess the success of rhinoplasty by evaluating the inter-rater variability in the light of primary indication as functional or cosmetic. Subjective aesthetic perception was compared with objective facial analysis. 45 rhinoplasty patients were included in the study. 25 had cosmetic plus functional reasons with septal deviation (group 1) and 20 had pure cosmetic reasons without septal deviation (group 2). Preoperatively and 6 months postoperatively, four individuals (patient, surgeon, 2 independent surgeons) rated the aesthetic appearance of the nose with visual analogue scale. Facial photogrammetric analysis was applied. The patient's aesthetic perception score was significantly correlated with the two independent surgeons (p < 0.05) whereas not with the primary surgeons. Regarding the objective parameters, patient's aesthetic perception was significantly correlated with the dorsal alignment in both groups (p < 0.05). General satisfaction score was significantly correlated with the nasal breathing as well as with the aesthetic perception scores in both groups. This correlation was higher for aesthetic perception in group 1 and nasal breathing in group 2. Inter-rater variability of outcome perception was higher in cosmetic patients. Nasal dorsal alignment was the only objective parameter which was correlated with the patient's perception. Patient's perception of outcome has better represented the objective photogrammetric analysis rather than the primary surgeons. An interesting finding was the more significant correlation of general satisfaction with aesthetic perception in the functional group whereas nasal breathing in the cosmetic group. PMID:25563240

  15. RELIABILITY OF THE SITTING HAND PRESS-UP TEST FOR IDENTIFYING AND QUANTIFYING THE LEVEL OF SCAPULAR MEDIAL BORDER POSTERIOR DISPLACEMENT IN OVERHEAD ATHLETES

    PubMed Central

    Barnes, Meredith J.; Leddon, Charles E.; Van Ryssegem, Guido; Alamar, Benjamin

    2011-01-01

    Background: The lack of proper scapular kinematics can limit the function of the entire shoulder complex.1,3 Many forms of scapular dyskinesis have been proposed along with tests to measure for the position and motion associated with those positional and movement faults (2,4-6). While scapular internal rotation has been listed among the forms of scapular dyskinesis there has not been a reliable test documented in the literature that examines this motion. The purpose of this study was to determine whether an innovative scapular medial border posterior displacement measurement device has adequate inter-rater and intra-rater reliability when used at rest and during the sitting hand press up test. Methods: 16 male Division III baseball players free of upper limb injury for the previous 12 months participated in the study. Posterior scapular displacement measures were taken on each subject in a resting static posture and while performing a sitting hand press up test. Subjects were tested twice within 24 hours by two separate examiners. Intraclass correlation coefficients (ICC) were calculated to determine intra-rater and inter-rater reliability. Results: The intra-rater reliability for rater 1 was .97 (95% confidence interval [CI]= .91-.98), for the rest position and .95 (95% CI= .86-.98) for the sitting hand press-up position. Intra-rater reliability for rater 2 was .99 (95% CI= .97-.99) for the rest position and .98 (95% CI=. 95-.99) for the sitting hand press-up position. The ICCs for inter-rater reliability of the scapular medial border posterior displacement measurement in at the rest position and the sitting hand press-up position were .89 (95% CI= .81-.96) and .89 (95% CI= .80-.96) respectively. Conclusions: The findings of this study indicate that the measurement of medial border posterior displacement using this device demonstrates good to excellent inter-rater and intra-rater reliability. PMID:22163092

  16. High Intra- and Inter-Rater Chance Variation of the Movement Assessment Battery for Children 2, Ageband 2

    ERIC Educational Resources Information Center

    Holm, Inger; Tveter, Anne Therese; Aulie, Vibeke Smith; Stuge, Britt

    2013-01-01

    The aim of the present study was to evaluate the intra- and inter-tester reliability of the movement assessment battery for children-second edition (MABC-2), ageband 2. We wanted to analyze the collected data, with adequate statistical methods, to provide relevant recommendations for physical therapists who are interpreting changes in the context…

  17. The Individualized Classroom Assessment Scoring System (inCLASS): Preliminary Reliability and Validity of a System for Observing Preschoolers’ Competence in Classroom Interactions

    PubMed Central

    Downer, Jason T.; Booren, Leslie M.; Lima, Olivia K.; Luckner, Amy E.; Pianta, Robert C.

    2012-01-01

    This paper introduces the Individualized Classroom Assessment Scoring System (inCLASS), an observation tool that targets children’s interactions in preschool classrooms with teachers, peers, and tasks. In particular, initial evidence is reported of the extent to which the inCLASS meets the following psychometric criteria: inter-rater reliability, normal distributions and adequate range, construct validity, and criterion-related validity. These initial findings suggest that the inCLASS has the potential to provide an authentic, contextualized assessment of young children’s classroom behaviors. Future directions for research with the inCLASS are discussed. PMID:23175598

  18. Reliability of Multi-Category Rating Scales

    ERIC Educational Resources Information Center

    Parker, Richard I.; Vannest, Kimberly J.; Davis, John L.

    2013-01-01

    The use of multi-category scales is increasing for the monitoring of IEP goals, classroom and school rules, and Behavior Improvement Plans (BIPs). Although they require greater inference than traditional data counting, little is known about the inter-rater reliability of these scales. This simulation study examined the performance of nine…

  19. Harmonization Process and Reliability Assessment of Anthropometric Measurements in the Elderly EXERNET Multi-Centre Study

    PubMed Central

    Gómez-Cabello, Alba; Vicente-Rodríguez, Germán; Albers, Ulrike; Mata, Esmeralda; Rodriguez-Marroyo, Jose A.; Olivares, Pedro R.; Gusi, Narcis; Villa, Gerardo; Aznar, Susana; Gonzalez-Gross, Marcela; Casajús, Jose A.; Ara, Ignacio

    2012-01-01

    Background The elderly EXERNET multi-centre study aims to collect normative anthropometric data for old functionally independent adults living in Spain. Purpose To describe the standardization process and reliability of the anthropometric measurements carried out in the pilot study and during the final workshop, examining both intra- and inter-rater errors for measurements. Materials and Methods A total of 98 elderly from five different regions participated in the intra-rater error assessment, and 10 different seniors living in the city of Toledo (Spain) participated in the inter-rater assessment. We examined both intra- and inter-rater errors for heights and circumferences. Results For height, intra-rater technical errors of measurement (TEMs) were smaller than 0.25 cm. For circumferences and knee height, TEMs were smaller than 1 cm, except for waist circumference in the city of Cáceres. Reliability for heights and circumferences was greater than 98% in all cases. Inter-rater TEMs were 0.61 cm for height, 0.75 cm for knee-height and ranged between 2.70 and 3.09 cm for the circumferences measured. Inter-rater reliabilities for anthropometric measurements were always higher than 90%. Conclusion The harmonization process, including the workshop and pilot study, guarantee the quality of the anthropometric measurements in the elderly EXERNET multi-centre study. High reliability and low TEM may be expected when assessing anthropometry in elderly population. PMID:22860013

  20. Analysis of the reliability of the make test in young adults by using a hand-held dynamometer

    PubMed Central

    Kim, Seong-Gil; Lim, Dong-Ho; Cho, Yong Ho

    2016-01-01

    [Purpose] The purpose of this study was to analyze intra-rater and inter-rater reliabilities of the make test, a manual muscle testing measurement method, using a hand-held dynamometer in Korean young adults. [Subjects and Methods] A total of 42 university students participated in this study. The make test, a manual muscle testing method, was conducted. A hand-held dynamometer was used to measure elbow joint flexion during the make test. [Results] Both intra-rater (the intraclass correlation coefficient=0.992) and inter-rater reliabilities (the intraclass correlation coefficient=0.949) were excellent, with values over 0.9. [Conclusion] The make test is a useful manual muscle testing method with high intra-rater and inter-rater reliability.

  1. Rating Format Effects on Rater Agreement and Reliability.

    ERIC Educational Resources Information Center

    Littlefield, John H.; Troendle, G. Roger

    This study compares intra- and inter-rater agreement and reliability when using three different rating form formats to assess the same stimuli. One format requests assessment by marking detailed criteria without an overall judgement; the second format requests only an overall judgement without the use of detailed criteria; and the third format…

  2. Translation, cross-cultural adaptation to Brazilian- Portuguese and reliability analysis of the instrument Rapid Entire Body Assessment-REBA

    PubMed Central

    Lamarão, Andressa M.; Costa, Lucíola C. M.; Comper, Maria L. C.; Padula, Rosimeire S.

    2014-01-01

    Background: Observational instruments, such as the Rapid Entire Body Assessment, quickly assess biomechanical risks present in the workplace. However, in order to use these instruments, it is necessary to conduct the translational/cross-cultural adaptation of the instrument and test its measurement properties. Objectives: To perform the translation and the cross-cultural adaptation to Brazilian-Portuguese and test the reliability of the REBA instrument. Method: The procedures of translation and cross-cultural adaptation to Brazilian-Portuguese were conducted following proposed guidelines that involved translation, synthesis of translations, back translation, committee review and testing of the pre-final version. In addition, reliability and the intra- and inter-rater percent agreement were obtained with the Linear Weighted Kappa Coefficient that was associated with the 95% Confidence Interval and the cross tabulation 2×2. Results : The procedures for translation and adaptation were adequate and the necessary adjustments were conducted on the instrument. The intra- and inter-rater reliability showed values of 0.104 to 0.504, respectively, ranging from very poor to moderate. The percentage agreement values ranged from 5.66% to 69.81%. The percentage agreement was closer to 100% at the item 'upper arm' (69.81%) for the Intra-rater 1 and at the items 'legs' and 'upper arm' for the Intra-rater 2 (62.26%). Conclusions: The processes of translation and cross-cultural adaptation were conducted on the REBA instrument and the Brazilian version of the instrument was obtained. However, despite the reliability of the tests used to correct the translated and adapted version, the reliability values are unacceptable according to the guidelines standard, indicating that the reliability must be re-evaluated. Therefore, caution in the interpretation of the biomechanical risks measured by this instrument should be taken. PMID:25003273

  3. Reliability of the Matson Evaluation of Social Skills with Youngsters (MESSY) for Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Matson, Johnny L.; Horovitz, Max; Mahan, Sara; Fodstad, Jill

    2013-01-01

    The purpose of this paper was to update the psychometrics of the "Matson Evaluation of Social Skills for Youngsters" ("MESSY") with children with Autism Spectrum Disorders (ASD), specifically with respect to internal consistency, split-half reliability, and inter-rater reliability. In Study 1, 114 children with ASD (Autistic Disorder, Asperger's…

  4. North Carolina Assessment of Risk (NCAR): Reliability and Predictive Validity with Juvenile Offenders

    ERIC Educational Resources Information Center

    Schwalbe, Craig S.; Fraser, Mark W.; Day, Steven H.; Arnold, Elizabeth Mayfield

    2004-01-01

    Actuarial risk assessment instruments are used increasingly in juvenile justice to classify youths according to their risk of recidivism. The purpose of this article is to describe the results of two studies of one instrument: the North Carolina Assessment of Risk (NCAR). In the first study, the inter-rater reliability of the risk assessment…

  5. Reliability of the Functional Mobility Scale for Children with Cerebral Palsy

    ERIC Educational Resources Information Center

    Harvey, Adrienne R.; Morris, Meg E.; Graham, H. Kerr; Wolfe, Rory; Baker, Richard

    2010-01-01

    This study examined inter-rater reliability of the Functional Mobility Scale (FMS) for children with cerebral palsy (CP) and the presence of rater bias. A consecutive sample of 118 children with CP, 2-18 years old (mean 10.3 years, SD 3.6), was recruited from a hospital setting. Children were classified using the gross motor function…

  6. Reliability and Validity of Autism Diagnostic Interview-Revised, Japanese Version

    ERIC Educational Resources Information Center

    Tsuchiya, Kenji J.; Matsumoto, Kaori; Yagi, Atsuko; Inada, Naoko; Kuroda, Miho; Inokuchi, Eiko; Koyama, Tomonori; Kamio, Yoko; Tsujii, Masatsugu; Sakai, Saeko; Mohri, Ikuko; Taniike, Masako; Iwanaga, Ryoichiro; Ogasahara, Kei; Miyachi, Taishi; Nakajima, Shunji; Tani, Iori; Ohnishi, Masafumi; Inoue, Masahiko; Nomura, Kazuyo; Hagiwara, Taku; Uchiyama, Tokio; Ichikawa, Hironobu; Kobayashi, Shuji; Miyamoto, Ken; Nakamura, Kazuhiko; Suzuki, Katsuaki; Mori, Norio; Takei, Nori

    2013-01-01

    To examine the inter-rater reliability of Autism Diagnostic Interview-Revised, Japanese Version (ADI-R-JV), the authors recruited 51 individuals aged 3-19 years, interviewed by two independent raters. Subsequently, to assess the discriminant and diagnostic validity of ADI-R-JV, the authors investigated 317 individuals aged 2-19 years, who were…

  7. Reliability of a Measure of Muscle Extensibility in Fullterm and Preterm Newborns

    ERIC Educational Resources Information Center

    Beuttler, Marybeth Grant; Leininger, Peter M.; Palisano, Robert J.

    2004-01-01

    Purpose: The purpose of this study was to examine the test-retest and inter-rater reliability of a measure of muscle extensibility developed by Tardieu, de la Tour, Bret, and Tardieu (1982) in fullterm and preterm newborns. Method: Twenty-one fullterm infants and twenty preterm infants were examined by two physical therapists. Each physical…

  8. Reliability and Validity of Web-Based Portfolio Peer Assessment: A Case Study for a Senior High School's Students Taking Computer Course

    ERIC Educational Resources Information Center

    Chang, Chi-Cheng; Tseng, Kuo-Hung; Chou, Pao-Nan; Chen, Yi-Hui

    2011-01-01

    This study examined the reliability and validity of Web-based portfolio peer assessment. Participants were 72 second-grade students from a senior high school taking a computer course. The results indicated that: 1) there was a lack of consistency across various student raters on a portfolio, or inter-rater reliability; 2) two-thirds of the raters…

  9. Reliability Assessment of Various Sonographic Techniques for Evaluating Carpal Tunnel Syndrome.

    PubMed

    Junck, Anthony D; Escobedo, Eva M; Lipa, Bethany M; Cronan, Michael; Anthonisen, Colleen; Poltavskiy, Eduard; Bang, Heejung; Han, Jay J

    2015-11-01

    Objectives-The aim of this study was to determine the intra- and inter-rater reliability of sonographic measurements of the median nerve cross-sectional area in individuals with carpal tunnel syndrome and healthy control participants.Methods-The median nerve cross-sectional area was evaluated by sonography in 18 participants with carpal tunnel syndrome (18 upper extremities) and 9 control participants (18 upper extremities) at 2 visits 1 week apart. Two examiners, both blinded to the presence or absence of carpal tunnel syndrome, captured independent sonograms of the median nerve at the levels of the carpal tunnel inlet, pronator quadratus, and mid-forearm. The cross-sectional area was later measured by each examiner independently. Each also traced images that were captured by the other examiner.Results-Both the intra- and inter-rater reliability rates were highest for images taken at the carpal tunnel inlet (radiologist, r = 0.86; sonographer, r = 0.87; inter-rater, r = 0.95; all P < .0001), whereas they was lowest for the pronator quadratus (r = 0.49, 0.29, and 0.72, respectively; all P < .0001). At the mid-forearm, the intra-rater reliability was lower for both the radiologist and sonographer, whereas the inter-rater reliability was relatively high (r = 0.54, 0.55, and 0.81; all P < .0001). Tracing of captured images by different examiners showed high concordance for the median cross-sectional area at the carpal tunnel inlet (r = 0.96-0.98; P < .0001).Conclusions-The highest intra- and inter-rater reliability was found at the carpal tunnel inlet. The results also demonstrate that tracing of the median nerve cross-sectional area from captured images by different examiners does not contribute significantly to measurement variability. PMID:26453123

  10. Utility and Reliability of an App for the System for Observing Play and Recreation in Communities (iSOPARC®)

    ERIC Educational Resources Information Center

    Santos, Maria P. M.; Rech, Cassiano R.; Alberico, Claudia O.; Fermino, Rogério C.; Rios, Ana P.; David, João; Reis, Rodrigo S.; Sarmiento, Olga L.; McKenzie, Thomas L.; Mota, Jorge

    2016-01-01

    The app for the System for Observing Play and Recreation in Communities (iSOPARC®) was developed to enhance System for Observing Play and Recreation in Communities data collection and management. The study aim was to examine the usability and inter-rater reliability of iSOPARC®. Trained observers collected data in 16 park areas in two Latin…

  11. Evaluating Rural Progress in Mathematics Achievement: Is "Adequate Yearly Progress" (AYP) Feasible, Valid, Reliable, and Fair? Working Paper.

    ERIC Educational Resources Information Center

    Lee, Jaekyung

    The No Child Left Behind Act requires standards-based accountability for school districts and schools receiving Title I funds. A major component of this policy is to report whether districts and schools are making "adequate yearly progress" (AYP) based on their performance goals. This paper raises questions for rural schools using the National…

  12. Reliability of a Retail Food Store Survey and Development of an Accompanying Retail Scoring System to Communicate Survey Findings and Identify Vendors for Healthful Food and Marketing Initiatives

    ERIC Educational Resources Information Center

    Ghirardelli, Alyssa; Quinn, Valerie; Sugerman, Sharon

    2011-01-01

    Objective: To develop a retail grocery instrument with weighted scoring to be used as an indicator of the food environment. Participants/Setting: Twenty six retail food stores in low-income areas in California. Intervention: Observational. Main Outcome Measure(s): Inter-rater reliability for grocery store survey instrument. Description of store…

  13. Additional Evidence for the Reliability and Validity of the Student Risk Screening Scale at the High School Level: A Replication and Extension

    ERIC Educational Resources Information Center

    Lane, Kathleen Lynne; Oakes, Wendy P.; Ennis, Robin Parks; Cox, Meredith Lucille; Schatschneider, Christopher; Lambert, Warren

    2013-01-01

    This study reports findings from a validation study of the Student Risk Screening Scale for use with 9th- through 12th-grade students (N = 1854) attending a rural fringe school. Results indicated high internal consistency, test-retest stability, and inter-rater reliability. Predictive validity was established across two academic years, with Spring…

  14. Brief Report: "Quick and (Not So) Dirty" Assessment of Change in Autism--Cross-Cultural Reliability of the Developmental Disabilities CGAS and the OSU Autism CGI

    ERIC Educational Resources Information Center

    Choque Olsson, Nora; Bölte, Sven

    2014-01-01

    There are few evaluated economic tools to assess change in autism. This study examined the inter-rater reliability of the Developmental Disabilities Children's Global Assessment Scale (DD-CGAS), and the OSU Autism Clinical Global Impression (OSU Autism CGI) in a European setting. Using these scales, 16 clinicians with multidisciplinary…

  15. The effect of physician experience on the measurement reliability of the Reimers’ hip migration percentage in children with cerebral palsy

    PubMed Central

    Analan, Pınar Doruk; Yilmaz, Emine Ece; Adam, Mehmet; Leblebici, Berrin

    2015-01-01

    [Purpose] Reimers’ hip migration percentage (MP) is commonly used to document the extent of hip displacement in children with cerebral palsy (CP). However, factors such as poor administration of pelvic radiographs, a lack of concentration, inexperience, or a busy clinical environment may result in variations in the MP measurements. The aim of this study was to compare the differences in the MP results of two physiatrists with varying levels of experience to determine the role of experience in the measurement’s accuracy. [Subjects and Methods] This retrospective study included 62 hip radiographs of 31 children with spastic CP. Two physiatrists with different experience levels calculated the baseline MP on two occasions six weeks apart. Correlations, intra- and inter-rater reliabilities, and differences in the MPs were compared. [Results] Correlations and inter- and intra-rater reliabilities of the measurements were excellent. There were no statistically significant intra- or inter-rater differences for either of the two measurement points. Inter-rater correlations for each session were 0.94. [Conclusion] Experience does not appear to be a factor in the evaluation of MP, and inter-rater differences do not cause problems regarding patient follow-up. Therefore, repeated pelvic radiographs are not necessary in the evaluation of MP in children with CP unless indicated. PMID:26644686

  16. Tutorial on use of intraclass correlation coefficients for assessing intertest reliability and its application in functional near-infrared spectroscopy-based brain imaging

    NASA Astrophysics Data System (ADS)

    Li, Lin; Zeng, Li; Lin, Zi-Jing; Cazzell, Mary; Liu, Hanli

    2015-05-01

    Test-retest reliability of neuroimaging measurements is an important concern in the investigation of cognitive functions in the human brain. To date, intraclass correlation coefficients (ICCs), originally used in inter-rater reliability studies in behavioral sciences, have become commonly used metrics in reliability studies on neuroimaging and functional near-infrared spectroscopy (fNIRS). However, as there are six popular forms of ICC, the adequateness of the comprehensive understanding of ICCs will affect how one may appropriately select, use, and interpret ICCs toward a reliability study. We first offer a brief review and tutorial on the statistical rationale of ICCs, including their underlying analysis of variance models and technical definitions, in the context of assessment on intertest reliability. Second, we provide general guidelines on the selection and interpretation of ICCs. Third, we illustrate the proposed approach by using an actual research study to assess intertest reliability of fNIRS-based, volumetric diffuse optical tomography of brain activities stimulated by a risk decision-making protocol. Last, special issues that may arise in reliability assessment using ICCs are discussed and solutions are suggested.

  17. The four square step test in children with Down syndrome: Reliability and concurrent validity

    PubMed Central

    Verma, Ajai; Samuel, Asir John; Aranha, Vencita Priyanka

    2014-01-01

    Purpose: To estimate test-retest reliability, inter-rater reliability and validation of a method for measuring balance by stepping over four squares, four square step test (FSST) in children with Down syndrome (DS). Methods: A sample of 13 children with DS was recruited for the cross-sectional study. They were asked to perform FSST and the time taken was noted. For estimating test-retest reliability, FSST was done by principal investigator twice and Inter-rater reliability was assessed by principal investigator and second investigator with an interval of 7 days. FRT was used as the criterion dynamic balance measure to validate FSST. The data was tabulated and analysed statistically. Results: The test-retest reliability and inter-rater reliability of FSST are ICC(1,1) = 0.70 (0.64-0.90) and ICC(2,1) = 0.78 (0.62-0.91) respectively. The Bland-Altman limits of agreement were also satisfied. Concurrent validity between FRT and FSST with Spearman's ρ = −0.58 (−0.86 to −0.13). Conclusion: FSST has moderate to good concurrent validity and good reliability among the children with Down syndrome. PMID:25624923

  18. Reliability of the modified Tufts Lumbar Degenerative Disc Classification between neurosurgeons and neuroradiologists.

    PubMed

    Burke, Shane M; Hwang, Steven W; Mehan, William A; Bedi, Harprit S; Ogbuji, Richard; Riesenburger, Ron I

    2016-07-01

    Cross-specialty inter-rater reliability has not been explicitly reported for imaging characteristics that are thought to be important in lumbar intervertebral disc degeneration. Sufficient cross-specialty reliability is an essential consideration if radiographic stratification of symptomatic patients to specific treatment modalities is to ever be realized. Therefore the purpose of this study was to directly compare the assessment of such characteristics between neurosurgeons and neuroradiologists. Sixty consecutive patients with a diagnosis of lumbago and appropriate imaging were selected for inclusion. Lumbar MRI were evaluated using the Tufts Degenerative Disc Classification by two neurosurgeons and two neuroradiologists. Inter-rater reliability was assessed using Cohen's κ values both within and between specialties. A sensitivity analysis was performed for a modified grading system, which excluded high intensity zones (HIZ), due to poor cross-specialty inter-rater reliability of HIZ between specialties. The reliability of HIZ between neurosurgeons and neuroradiologists was fair in two of the four cross-specialty comparisons in this study (neurosurgeon 1 versus both radiologists κ=0.364 and κ=0.290). Removing HIZ from the classification improved inter-rater reliability for all comparisons within and between specialties (0.465⩽κ⩽0.576). In addition, intra-rater reliability remained in the moderate to substantial range (0.523⩽κ⩽0.649). Given our findings and corroboration with previous studies, identification of HIZ seems to have a markedly variable reliability. Thus we recommend modification of the original Tufts Degenerative Disc Classification by removing HIZ in order to make the overall grade provided by this classification more reproducible when scored by practitioners of different training backgrounds. PMID:27021223

  19. Reliability of capturing foot parameters using digital scanning and the neutral suspension casting technique

    PubMed Central

    2011-01-01

    Background A clinical study was conducted to determine the intra and inter-rater reliability of digital scanning and the neutral suspension casting technique to measure six foot parameters. The neutral suspension casting technique is a commonly utilised method for obtaining a negative impression of the foot prior to orthotic fabrication. Digital scanning offers an alternative to the traditional plaster of Paris techniques. Methods Twenty one healthy participants volunteered to take part in the study. Six casts and six digital scans were obtained from each participant by two raters of differing clinical experience. The foot parameters chosen for investigation were cast length (mm), forefoot width (mm), rearfoot width (mm), medial arch height (mm), lateral arch height (mm) and forefoot to rearfoot alignment (degrees). Intraclass correlation coefficients (ICC) with 95% confidence intervals (CI) were calculated to determine the intra and inter-rater reliability. Measurement error was assessed through the calculation of the standard error of the measurement (SEM) and smallest real difference (SRD). Results ICC values for all foot parameters using digital scanning ranged between 0.81-0.99 for both intra and inter-rater reliability. For neutral suspension casting technique inter-rater reliability values ranged from 0.57-0.99 and intra-rater reliability values ranging from 0.36-0.99 for rater 1 and 0.49-0.99 for rater 2. Conclusions The findings of this study indicate that digital scanning is a reliable technique, irrespective of clinical experience, with reduced measurement variability in all foot parameters investigated when compared to neutral suspension casting. PMID:21375757

  20. Test-retest, inter- and intra-rater reliability of the flexicurve for evaluation of the spine in children

    PubMed Central

    Sedrez, Juliana A.; Candotti, Cláudia T.; Rosa, Maria I. Z.; Medeiros, Fernanda S.; Marques, Mariana T.; Loss, Jefferson F.

    2016-01-01

    Introduction: The early evaluation of the spine in children is desirable because it is at this stage of development that the greatest changes in the body structures occur. Objective: To determine the test-retest, intra- and inter-rater reliability of the Flexicurve instrument for the evaluation of spinal curvatures in children. Method: Forty children ranging from 5 to 15 years of age were evaluated by two independent evaluators using the Flexicurve to model the spine. The agreement was evaluated using Intraclass Correlation Coefficients (ICC), Standard Error of the Measurement (SEM), and Minimal Detectable Change (MDC). Results: In relation to thoracic kyphosis, the Flexicurve was shown to have excellent correlation in terms of test-retest reliability (ICC2,2=0.87) and moderate correlation in terms of intra-(ICC2,2=0.68) and inter-rater reliability (ICC2,2=0.72). In relation to lumbar lordosis, it was shown to have moderate correlation in terms of test-retest reliability (ICC2,2=0.66) and intra- (ICC2,2=0.50) and inter-rater reliability (ICC=0.56). Conclusion: This evaluation of the reliability of the Flexicurve allows its use in school screening. However, to monitor spinal curvatures in the sagittal plane in children, complementary clinical measures are necessary. Further studies are required to investigate the concurrent validity of the instrument in order to identify its diagnostic capacity. PMID:26786078

  1. Evaluating Written Patient Information for Eczema in German: Comparing the Reliability of Two Instruments, DISCERN and EQIP

    PubMed Central

    McCool, Megan E.; Wahl, Josepha; Schlecht, Inga; Apfelbacher, Christian

    2015-01-01

    Patients actively seek information about how to cope with their health problems, but the quality of the information available varies. A number of instruments have been developed to assess the quality of patient information, primarily though in English. Little is known about the reliability of these instruments when applied to patient information in German. The objective of our study was to investigate and compare the reliability of two validated instruments, DISCERN and EQIP, in order to determine which of these instruments is better suited for a further study pertaining to the quality of information available to German patients with eczema. Two independent raters evaluated a random sample of 20 informational brochures in German. All the brochures addressed eczema as a disorder and/or therapy options and care. Intra-rater and inter-rater reliability were assessed by calculating intra-class correlation coefficients, agreement was tested with weighted kappas, and the correlation of the raters’ scores for each instrument was measured with Pearson’s correlation coefficient. DISCERN demonstrated substantial intra- and inter-rater reliability. It also showed slightly better agreement than EQIP. There was a strong correlation of the raters’ scores for both instruments. The findings of this study support the reliability of both DISCERN and EQIP. However, based on the results of the inter-rater reliability, agreement and correlation analyses, we consider DISCERN to be the more precise tool for our project on patient information concerning the treatment and care of eczema. PMID:26440612

  2. Objective assessment of urban built environment related to physical activity — development, reliability and validity of the China Urban Built Environment Scan Tool (CUBEST)

    PubMed Central

    2014-01-01

    Background Some aspects of the neighborhood built environment may influence residents’ physical activity, which in turn, affects their health. This study aimed to develop an urban built environment evaluation tool and conduct necessary reliability and validity tests. Methods A 41-item urban built environment scan tool was developed to objectively assess the neighborhood built environment features related to physical activity. Six neighborhoods in Hangzhou were selected from three types of administrative planning units. A pair of auditors independently assessed all of the 205 street segments at the same time. Half of the segments (n = 104) were audited twice by the same auditor after a two-week time interval. Inter-rater reliability was assessed by comparing the audits of paired observers, while intra-rater reliability was evaluated by comparing an auditor’s repeated assessments of the same segments. The construct validity was tested using factor analysis. Results The inter-rater reliability for most items was above 0.8. The intra-rater reliability for most items was above 0.4, and was lower than corresponding inter-rater reliability. Six factors were extracted by factor analysis and the factor loading matrix showed good construct validity. Conclusions The CUBEST is a reliable and valid instrument that can be used to assess the physical activity-related built environment in Hangzhou, and potentially other cities in China. PMID:24495676

  3. Reliability of measuring the passive range of shoulder horizontal adduction using a smartphone in the supine versus the side-lying position

    PubMed Central

    Lim, Jin-Yong; Kim, Tae-Ho; Lee, Jung-Seok

    2015-01-01

    [Purpose] The purpose of this study was to compare the reliability of the measurement of the passive range of motion (PROM) of shoulder horizontal adduction (SHA) measurements using a smartphone for the assessment posterior shoulder tightness (PST) between the side-lying and supine test positions. [Subjects and Methods] Forty-seven subjects (mean ± age, 24.9 ± 3.5 years) without shoulder pathology were included in this study. Intra-rater and inter-rater reliabilities were determined using intraclass correlation coefficients. The SHA PROM of each subject’s dominant shoulder was measured using a smartphone by two investigators in two positions: the standard supine position, and a side-lying position on the tested side. [Results] The intra-rater reliability of the supine measurements was fair to good (ICC3,1 = 0.72–0.89), and for the side-lying measurements was excellent (ICC3,1 = 0.95–0.97). The inter-rater reliability of the supine measurements was fair (ICC2,2 = 0.79) and for the side-lying measurements was excellent (ICC2,2 = 0.94). [Conclusion] These results suggest that for healthy subjects, measurements of SHA using smartphones in the side-lying position has superior intra-rater and inter-rater reliabilities compared to the standard supine position. PMID:26644657

  4. Food and Beverage Environment Analysis and Monitoring System (FoodBEAMS™): A Reliability Study in the School Food and Beverage Environment

    PubMed Central

    Bullock, Sally Lawrence; Craypo, Lisa; Clark, Sarah E.; Barry, Jason; Samuels, Sarah E.

    2010-01-01

    States and school districts around the country are developing policies that set nutrition standards for competitive foods and beverages sold outside of the United States Department of Agriculture reimbursable school lunch program. However, few tools exist for monitoring the implementation of these new policies. The objective of this research was to develop a computerized assessment tool, the Food and Beverage Environment Analysis and Monitoring System (FoodBEAMS™), to collect data on the competitive school food environment and to test the inter-rater reliability of the tool among research and non-research professionals. FoodBEAMS was used to collect data in spring 2007, on the competitive foods and beverages sold in 21 California high schools. Adherence of the foods and beverages to California's competitive food and beverage nutrition policies for schools (Senate Bills 12 and 965) was determined using the data collected by both research and non-research professionals. The inter-rater reliability between the data collectors was assessed using the intraclass correlation coefficient (ICC). Researcher versus researcher and researcher versus non-researcher inter-rater reliability was high for both foods and beverages, with ICCs ranging from .972 to .987. The results of this study provide evidence that FoodBEAMS is a promising tool for assessing and monitoring adherence to nutrition standards for competitive foods sold on school campuses and can be used reliably by both research and non-research professionals. PMID:20630167

  5. The importance of establishing reliability and validity of assessment instruments for mental health problems: An example from Somali children and adolescents living in three refugee camps in Ethiopia

    PubMed Central

    Hall, Brian J.; Puffer, Eve; Murray, Laura K.; Ismael, Abdulkadir; Bass, Judith K.; Sim, Amanda; Bolton, Paul A.

    2014-01-01

    Assessing mental health problems cross-culturally for children exposed to war and violence presents a number of unique challenges. One of the most important issues is the lack of validated symptom measures to assess these problems. The present study sought to evaluate the psychometric properties of two measures to assess mental health problems: the Achenbach Youth Self-Report and the Child Posttraumatic Stress Disorder Symptom Scale. We conducted a validity study in three refugee camps in Eastern Ethiopia in the outskirts of Jijiga, the capital of the Somali region. A total of 147 child and caregiver pairs were assessed, and scores obtained were submitted to rigorous psychometric evaluation. Excellent internal consistency reliability was obtained for symptom measures for children and their caregivers. Validation of study instruments based on local case definitions was obtained for the caregivers but not consistently for the children. Sensitivity and specificity of study measures were generally low, indicating that these scales would not perform adequately as screening instruments. Combined test-retest and inter-rater reliability was low for all scales. This study illustrates the need for validation and testing of existing measures cross-culturally. Methodological implications for future cross-cultural research studies in low- and middle-income countries are discussed. PMID:24955147

  6. Reliability and Convergent Validity of the Cutaneous Sarcoidosis Activity and Morphology Instrument for Assessing Cutaneous Sarcoidosis

    PubMed Central

    Chu, Emily Y.; Kim, Ellen J.; Payne, Aimee S.; Takeshita, Junko; Vittorio, Carmela C.; Wanat, Karolyn A.; Werth, Victoria P.; Gelfand, Joel M.

    2013-01-01

    Objective To assess the reliability and convergent validity of two outcome instruments for assessing cutaneous sarcoidosis: Cutaneous Sarcoidosis Activity and Morphology Instrument (CSAMI) and Sarcoidosis Activity and Severity Index (SASI). Design Cross-sectional study evaluating cutaneous sarcoidosis disease severity using CSAMI, SASI, and Physician's Global Assessment (PGA) as reference. Setting Cutaneous sarcoidosis clinic. Participants 8 dermatologists evaluated 11 patients with cutaneous sarcoidosis. Main Outcome Measures Primary outcomes: Inter- and intra-rater reliability and convergent validity. Secondary outcomes: Correlation with quality of life measures and time required for completion. Results All instruments demonstrated good to excellent intra-rater reliability. Inter-rater reliability was excellent for CSAMI Activity scores (intraclass correlation coefficient [ICC], 0.82; 95% CI, 0.66-0.94), and fair to poor for CSAMI Damage (0.42; 0.21-0.72), modified Facial SASI (0.40; 0.17-0.72), and PGA scores (0.40; 0.18-0.70). CSAMI Activity, Damage, and modified Facial SASI scores all demonstrated convergent validity with statistically significant correlations with PGA scores. Trends for correlations were seen between CSAMI scores and specific Skindex-29 quality of life domains. While CSAMI required longer time to complete than SASI, both were scored within adequate time for use in clinical trials. Conclusions CSAMI appears to be a reliable and valid outcome instrument to measure cutaneous sarcoidosis and may capture a wide range of body surface and cutaneous morphologies. Future research is necessary to demonstrate its sensitivity to change and to confirm its correlation with quality of life measures. PMID:23677081

  7. Validity and reliability of balance assessment software using the Nintendo Wii balance board: usability and validation

    PubMed Central

    2014-01-01

    Background A balance test provides important information such as the standard to judge an individual’s functional recovery or make the prediction of falls. The development of a tool for a balance test that is inexpensive and widely available is needed, especially in clinical settings. The Wii Balance Board (WBB) is designed to test balance, but there is little software used in balance tests, and there are few studies on reliability and validity. Thus, we developed a balance assessment software using the Nintendo Wii Balance Board, investigated its reliability and validity, and compared it with a laboratory-grade force platform. Methods Twenty healthy adults participated in our study. The participants participated in the test for inter-rater reliability, intra-rater reliability, and concurrent validity. The tests were performed with balance assessment software using the Nintendo Wii balance board and a laboratory-grade force platform. Data such as Center of Pressure (COP) path length and COP velocity were acquired from the assessment systems. The inter-rater reliability, the intra-rater reliability, and concurrent validity were analyzed by an intraclass correlation coefficient (ICC) value and a standard error of measurement (SEM). Results The inter-rater reliability (ICC: 0.89-0.79, SEM in path length: 7.14-1.90, SEM in velocity: 0.74-0.07), intra-rater reliability (ICC: 0.92-0.70, SEM in path length: 7.59-2.04, SEM in velocity: 0.80-0.07), and concurrent validity (ICC: 0.87-0.73, SEM in path length: 5.94-0.32, SEM in velocity: 0.62-0.08) were high in terms of COP path length and COP velocity. Conclusion The balance assessment software incorporating the Nintendo Wii balance board was used in our study and was found to be a reliable assessment device. In clinical settings, the device can be remarkably inexpensive, portable, and convenient for the balance assessment. PMID:24912769

  8. Reliability of ultrasound imaging in the assessment of the dorsal Lisfranc ligament

    PubMed Central

    2013-01-01

    Background The Lisfranc ligament plays an integral role in providing stability to the midfoot. Variable clinical presentations and radiographic findings make injuries to the Lisfranc ligament notoriously difficult to diagnose. Currently, radiographic evaluation is the mainstay in imaging such injuries; however, ultrasound has been suggested as a viable alternative. The objective of this study was to evaluate the intra-rater and inter-rater reliability in the measurement of the length of the dorsal Lisfranc ligament using ultrasound imaging in healthy, asymptomatic subjects. Methods The dorsal Lisfranc ligaments of fifty asymptomatic subjects (n = 100 feet) were imaged using a Siemens SONOLINE Antares Ultrasound Imaging System© under low, medium, and high stress loads at 0° and 15° abducted foot positions. The lengths of the ligaments were measured, and Interclass correlation coefficients were used to calculate within-session intra-rater reliability (n = 100 feet) as well as between-session intra-rater reliability (n = 40 feet) and between-session inter-rater reliability (n = 40 feet). Results The within-session intra-rater reliability results for dorsal Lisfranc ligament length had an average ICC of 0.889 (min 0.873 max 0.913). The average ICC for between-session intra-rater reliability was 0.747 (min 0.607 max 0.811). The average ICC for between-session inter-rater reliability was 0.685 (min 0.638 max 0.776). Conclusions The measurement of the dorsal Lisfranc ligament length using ultrasound imaging shows substantial to almost perfect reliability when evaluating asymptomatic subjects. This imaging modality methodology shows promise and lays the foundation for further work in technique development towards the diagnostic identification of pathology within the Lisfranc ligament complex. PMID:23453037

  9. Assessing Reliability of Medical Record Reviews for the Detection of Hospital Adverse Events

    PubMed Central

    Ock, Minsu; Lee, Sang-il; Jo, Min-Woo; Lee, Jin Yong; Kim, Seon-Ha

    2015-01-01

    Objectives: The purpose of this study was to assess the inter-rater reliability and intra-rater reliability of medical record review for the detection of hospital adverse events. Methods: We conducted two stages retrospective medical records review of a random sample of 96 patients from one acute-care general hospital. The first stage was an explicit patient record review by two nurses to detect the presence of 41 screening criteria (SC). The second stage was an implicit structured review by two physicians to identify the occurrence of adverse events from the positive cases on the SC. The inter-rater reliability of two nurses and that of two physicians were assessed. The intra-rater reliability was also evaluated by using test-retest method at approximately two weeks later. Results: In 84.2% of the patient medical records, the nurses agreed as to the necessity for the second stage review (kappa, 0.68; 95% confidence interval [CI], 0.54 to 0.83). In 93.0% of the patient medical records screened by nurses, the physicians agreed about the absence or presence of adverse events (kappa, 0.71; 95% CI, 0.44 to 0.97). When assessing intra-rater reliability, the kappa indices of two nurses were 0.54 (95% CI, 0.31 to 0.77) and 0.67 (95% CI, 0.47 to 0.87), whereas those of two physicians were 0.87 (95% CI, 0.62 to 1.00) and 0.37 (95% CI, -0.16 to 0.89). Conclusions: In this study, the medical record review for detecting adverse events showed intermediate to good level of inter-rater and intra-rater reliability. Well organized training program for reviewers and clearly defining SC are required to get more reliable results in the hospital adverse event study. PMID:26429290

  10. Validity and Reliability of the Clinical Competency Evaluation Instrument for Use among Physiotherapy Students

    PubMed Central

    Muhamad, Zailani; Ramli, Ayiesah; Amat, Salleh

    2015-01-01

    Objectives: The aim of this study was to determine the content validity, internal consistency, test-retest reliability and inter-rater reliability of the Clinical Competency Evaluation Instrument (CCEVI) in assessing the clinical performance of physiotherapy students. Methods: This study was carried out between June and September 2013 at University Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia. A panel of 10 experts were identified to establish content validity by evaluating and rating each of the items used in the CCEVI with regards to their relevance in measuring students’ clinical competency. A total of 50 UKM undergraduate physiotherapy students were assessed throughout their clinical placement to determine the construct validity of these items. The instrument’s reliability was determined through a cross-sectional study involving a clinical performance assessment of 14 final-year undergraduate physiotherapy students. Results: The content validity index of the entire CCEVI was 0.91, while the proportion of agreement on the content validity indices ranged from 0.83–1.00. The CCEVI construct validity was established with factor loading of ≥0.6, while internal consistency (Cronbach’s alpha) overall was 0.97. Test-retest reliability of the CCEVI was confirmed with a Pearson’s correlation range of 0.91–0.97 and an intraclass coefficient correlation range of 0.95–0.98. Inter-rater reliability of the CCEVI domains ranged from 0.59 to 0.97 on initial and subsequent assessments. Conclusion: This pilot study confirmed the content validity of the CCEVI. It showed high internal consistency, thereby providing evidence that the CCEVI has moderate to excellent inter-rater reliability. However, additional refinement in the wording of the CCEVI items, particularly in the domains of safety and documentation, is recommended to further improve the validity and reliability of the instrument. PMID:26052461

  11. Reliability and validity of a tool to assess airway management skills in anesthesia trainees

    PubMed Central

    Ahmed, Aliya; Khan, Fauzia Anis; Ismail, Samina

    2016-01-01

    Background and Aims: Gaining expertise in procedural skills is essential for achieving clinical competence during anesthesia training. Supervisors have the important responsibility of deciding when the trainee can be allowed to perform various procedures without direct supervision while ensuring patient safety. This requires robust and reliable assessment techniques. Airway management with bag-mask ventilation and tracheal intubation are routinely performed by anesthesia trainees at induction of anesthesia and to save lives during a cardiorespiratory arrest. The purpose of this study was to evaluate the construct validity, and inter-rater and test-retest reliability of a tool designed to assess competence in bag-mask ventilation followed by tracheal intubation in anesthesia trainees. Material and Methods: Informed consent was obtained from all participants. Tracheal intubation and bag-mask ventilation skills in 10 junior and 10 senior anesthesia trainees were assessed by two investigators on two occasions at a 3-4 weeks interval, using a procedure-specific assessment tool. Results: Average kappa value for inter-rater reliability was 0.91 and 0.99 for the first and second assessments, respectively, with an average agreement of 95%. The average agreement for test-retest reliability was 82% with a kappa value of 0.39. Senior trainees obtained higher scores compared to junior trainees in all areas of assessment, with a significant difference for patient positioning, preoxygenation, and laryngoscopy technique, depicting good construct validity. Conclusion: The tool designed to assess bag-mask ventilation and tracheal intubation skills in anesthesia trainees demonstrated excellent inter-rater reliability, fair test-retest reliability, and good construct validity. The authors recommend its use for formative and summative assessment of junior anesthesia trainees.

  12. The reliability of the Brazilian version of the Composite International Diagnostic Interview (CIDI 2.1).

    PubMed

    Quintana, M I; Andreoli, S B; Jorge, M R; Gastal, F L; Miranda, C T

    2004-11-01

    The objective of the present study was to determine the reliability of the Brazilian version of the Composite International Diagnostic Interview 2.1 (CIDI 2.1) in clinical psychiatry. The CIDI 2.1 was translated into Portuguese using WHO guidelines and reliability was studied using the inter-rater reliability method. The study sample consisted of 186 subjects from psychiatric hospitals and clinics, primary care centers and community services. The interviewers consisted of a group of 13 lay and three non-lay interviewers submitted to the CIDI training. The average interview time was 2 h and 30 min. General reliability ranged from kappa 0.50 to 1. For lifetime diagnoses the reliability ranged from kappa 0.77 (Bipolar Affective Disorder) to 1 (Substance-Related Disorder, Alcohol-Related Disorder, Eating Disorders). Previous year reliability ranged from kappa 0.66 (Obsessive-Compulsive Disorder) to 1 (Dissociative Disorders, Maniac Disorders, Eating Disorders). The poorest reliability rate was found for Mild Depressive Episode (kappa = 0.50) during the previous year. Training proved to be a fundamental factor for maintaining good reliability. Technical knowledge of the questionnaire compensated for the lack of psychiatric knowledge of the lay personnel. Inter-rater reliability was good to excellent for persons in psychiatric practice. PMID:15517091

  13. Inter- and intra-rater reliability of the GAITRite system among individuals with sub-acute stroke.

    PubMed

    Wong, Jennifer S; Jasani, Hardika; Poon, Vivien; Inness, Elizabeth L; McIlroy, William E; Mansfield, Avril

    2014-01-01

    Technology-based assessment tools with semi-automated processing, such as pressure-sensitive mats used for gait assessment, may be considered to be objective; therefore it may be assumed that rater reliability is not a concern. However, user input is often required and rater reliability must be determined. The purpose of this study was to assess the inter- and intra-rater reliability of spatial and temporal characteristics of gait in stroke patients using the GAITRite system. Forty-six individuals with stroke attending in-patient rehabilitation walked across the pressure-sensitive mat 2-4 times at preferred walking speeds, with or without a gait aid. Five raters independently processed gait data. Three raters re-processed the data after a delay of at least one month. The intraclass correlation coefficients (ICC) and 95% confidence intervals of the ICC were determined for velocity, step time, step length, and step width. Inter-rater reliability for velocity, step time, and step length were high (ICC>0.90). Intra-rater reliability was generally greater than inter-rater reliability (from 0.81 to >0.99 for inter-rater versus 0.77 to >0.99 for intra-rater reliability). Overall, this study suggests that GAITRite is a reliable assessment tool; however, there still remains subjectivity in processing the data, resulting in no patients with perfect agreement between raters. Additional logic checking within the processing software or standardization of training could help to reduce potential errors in processing. PMID:24630463

  14. Reliability and criterion-related validity of the 20-yard shuttle test in competitive junior tennis players

    PubMed Central

    Eriksson, Anna; Johansson, Fredrik R; Bäck, Maria

    2015-01-01

    Purpose This study adds to the previous work in the field of sport-specific fitness testing by evaluating a tennis-specific agility test called “the 20-yard shuttle test”. The aim of the study was to evaluate the test–retest reliability, the inter-rater reliability, and the criterion-related validity of the 20-yard shuttle test on competitive junior tennis players. Participants and methods Totally, 34 Swedish tennis players (13 girls), mean age 14±1.6 years, participated in the study. To examine test–retest reliability, the subjects performed the 20-yard shuttle test three times on the same day and then the same procedure was repeated after 3 days. To test the inter-rater reliability, the time was measured with a stopwatch simultaneously by two different raters. The time recorded manually was compared to the gold standard of digital timing to evaluate the criterion-related validity. Results Excellent test–retest reliability was found both within the same day (intraclass correlation coefficient [ICC] 0.95) and between days (ICC 0.91). Furthermore, the results showed excellent inter-rater reliability (ICC 0.99) and criterion-related validity on both test occasions (ICC 0.99). Conclusion We have provided introductory support for the 20-yard shuttle test as a reliable and valid test for use in competitive junior tennis players. The ease of administration makes this test a practical alternative to evaluate physical fitness in order to optimally train the athletes. PMID:26316829

  15. Reliability of 3D laser-based anthropometry and comparison with classical anthropometry

    PubMed Central

    Kuehnapfel, Andreas; Ahnert, Peter; Loeffler, Markus; Broda, Anja; Scholz, Markus

    2016-01-01

    Anthropometric quantities are widely used in epidemiologic research as possible confounders, risk factors, or outcomes. 3D laser-based body scans (BS) allow evaluation of dozens of quantities in short time with minimal physical contact between observers and probands. The aim of this study was to compare BS with classical manual anthropometric (CA) assessments with respect to feasibility, reliability, and validity. We performed a study on 108 individuals with multiple measurements of BS and CA to estimate intra- and inter-rater reliabilities for both. We suggested BS equivalents of CA measurements and determined validity of BS considering CA the gold standard. Throughout the study, the overall concordance correlation coefficient (OCCC) was chosen as indicator of agreement. BS was slightly more time consuming but better accepted than CA. For CA, OCCCs for intra- and inter-rater reliability were greater than 0.8 for all nine quantities studied. For BS, 9 of 154 quantities showed reliabilities below 0.7. BS proxies for CA measurements showed good agreement (minimum OCCC > 0.77) after offset correction. Thigh length showed higher reliability in BS while upper arm length showed higher reliability in CA. Except for these issues, reliabilities of CA measurements and their BS equivalents were comparable. PMID:27225483

  16. Reliability of 3D laser-based anthropometry and comparison with classical anthropometry.

    PubMed

    Kuehnapfel, Andreas; Ahnert, Peter; Loeffler, Markus; Broda, Anja; Scholz, Markus

    2016-01-01

    Anthropometric quantities are widely used in epidemiologic research as possible confounders, risk factors, or outcomes. 3D laser-based body scans (BS) allow evaluation of dozens of quantities in short time with minimal physical contact between observers and probands. The aim of this study was to compare BS with classical manual anthropometric (CA) assessments with respect to feasibility, reliability, and validity. We performed a study on 108 individuals with multiple measurements of BS and CA to estimate intra- and inter-rater reliabilities for both. We suggested BS equivalents of CA measurements and determined validity of BS considering CA the gold standard. Throughout the study, the overall concordance correlation coefficient (OCCC) was chosen as indicator of agreement. BS was slightly more time consuming but better accepted than CA. For CA, OCCCs for intra- and inter-rater reliability were greater than 0.8 for all nine quantities studied. For BS, 9 of 154 quantities showed reliabilities below 0.7. BS proxies for CA measurements showed good agreement (minimum OCCC > 0.77) after offset correction. Thigh length showed higher reliability in BS while upper arm length showed higher reliability in CA. Except for these issues, reliabilities of CA measurements and their BS equivalents were comparable. PMID:27225483

  17. Reliability of Hip Migration Index in Children with Cerebral Palsy: The Classic and Modified Methods

    PubMed Central

    Kim, Sun Mi; Sim, Eun Geol; Lim, Seong Gyu

    2012-01-01

    Objective To determine reliability and clinical use of two methods of migration index (MI) in CP patients with or without hip dysplasia. Method The materials included radiographs of 200 hips of children with cerebral palsy. Conventional anteroposterior radiographs of the pelvis were taken with the child in the supine position with standardized methods. Two rehabilitation doctors measured the migration index using two methods. In the classic method, the lateral margin of the acetabular roof was used as a landmark and in the modified method the lateral margin of the sourcil was used as a landmark. Each rater measured the migration index at three separate times with a time interval of at least one week. Intraclass correlation (ICC) was used to test the inter- and intra-rater reliability. Results MI shows excellent intra-rater reliability in both the classic and modified methods, but the inter-rater reliability was higher in the classic method than in the modified method. When categorized according to the sourcil classification, inter-rater reliability was higher in the normal sourcil type and lower in the dysplastic sourcil types. Conclusion Generally, the classic method showed higher reliability than the modified method, even though the reliability of the MI measurement was relatively high with both methods. PMID:22506233

  18. Reliability of photographic posture analysis of adolescents

    PubMed Central

    Hazar, Zeynep; Karabicak, Gul Oznur; Tiftikci, Ugur

    2015-01-01

    [Purpose] Postural problems of adolescents needs to be evaluated accurately because they may lead to greater problems in the musculoskeletal system as they develop. Although photographic posture analysis has been frequently used, more simple and accessible methods are still needed. The purpose of this study was to investigate the inter- and intra-rater reliability of photographic posture analysis using MB-ruler software. [Subjects and Methods] Subjects were 30 adolescents (15 girls and 15 boys, mean age: 16.4±0.4 years, mean height 166.3±6.7 cm, mean weight 63.8±15.1 kg) and photographs of their habitual standing posture photographs were taken in the sagittal plane. For the evaluation of postural angles, reflective markers were placed on anatomical landmarks. For angular measurements, MB-ruler (Markus Bader- MB Software Solutions, triangular screen ruler) was used. Photographic evaluations were performed by two observers with a repetition after a week. Test-retest and inter-rater reliability evaluations were calculated using intra-class correlation coefficients (ICC). [Results] Inter-rater (ICC>0.972) and test-retest (ICC>0.774) reliability were found to be in the range of acceptable to excellent. [Conclusion] Reference angles for postural evaluation were found to be reliable and repeatable. The present method was found to be an easy and non-invasive method and it may be utilized by researchers who are in search of an alternative method for photographic postural assessments. PMID:26644658

  19. Reliability of different methodologies of infrared image analysis of myofascial trigger points in the upper trapezius muscle

    PubMed Central

    Dibai-Filho, Almir V.; Guirro, Elaine C. O.; Ferreira, Vânia T. K.; Brandino, Hugo E.; Vaz, Maíta M. O. L. L.; Guirro, Rinaldo R. J.

    2015-01-01

    BACKGROUND: Infrared thermography is recognized as a viable method for evaluation of subjects with myofascial pain. OBJECTIVE: The aim of the present study was to assess the intra- and inter-rater reliability of infrared image analysis of myofascial trigger points in the upper trapezius muscle. METHOD: A reliability study was conducted with 24 volunteers of both genders (23 females) between 18 and 30 years of age (22.12±2.54), all having cervical pain and presence of active myofascial trigger point in the upper trapezius muscle. Two trained examiners performed analysis of point, line, and area of the infrared images at two different periods with a 1-week interval. The intra-class correlation coefficient (ICC2,1) was used to assess the intra- and inter-rater reliability. RESULTS: With regard to the intra-rater reliability, ICC values were between 0.591 and 0.993, with temperatures between 0.13 and 1.57 °C for values of standard error of measurement (SEM) and between 0.36 and 4.35 °C for the minimal detectable change (MDC). For the inter-rater reliability, ICC ranged from 0.615 to 0.918, with temperatures between 0.43 and 1.22 °C for the SEM and between 1.19 and 3.38 °C for the MDC. CONCLUSION: The methods of infrared image analyses of myofascial trigger points in the upper trapezius muscle employed in the present study are suitable for clinical and research practices. PMID:25993626

  20. Validity and reliability of criterion based clinical audit to assess obstetrical quality of care in West Africa

    PubMed Central

    2012-01-01

    Background In Mali and Senegal, over 1% of women die giving birth in hospital. At some hospitals, over a third of infants are stillborn. Many deaths are due to substandard medical practices. Criterion-based clinical audits (CBCA) are increasingly used to measure and improve obstetrical care in resource-limited settings, but their measurement properties have not been formally evaluated. In 2011, we published a systematic review of obstetrical CBCA highlighting insufficient considerations of validity and reliability. The objective of this study is to develop an obstetrical CBCA adapted to the West African context and assess its reliability and validity. This work was conducted as a sub-study within a cluster randomized trial known as QUARITE. Methods Criteria were selected based on extensive literature review and expert opinion. Early 2010, two auditors applied the CBCA to identical samples at 8 sites in Mali and Senegal (n = 185) to evaluate inter-rater reliability. In 2010–11, we conducted CBCA at 32 hospitals to assess construct validity (n = 633 patients). We correlated hospital characteristics (resource availability, facility perinatal and maternal mortality) with mean hospital CBCA scores. We used generalized estimating equations to assess whether patient CBCA scores were associated with perinatal mortality. Results Results demonstrate substantial (ICC = 0.67, 95% CI 0.54; 0.76) to elevated inter-rater reliability (ICC = 0.84, 95% CI 0.77; 0.89) in Senegal and Mali, respectively. Resource availability positively correlated with mean hospital CBCA scores and maternal and perinatal mortality were inversely correlated with hospital CBCA scores. Poor CBCA scores, adjusted for hospital and patient characteristics, were significantly associated with perinatal mortality (OR 1.84, 95% CI 1.01-3.34). Conclusion Our CBCA has substantial inter-rater reliability and there is compelling evidence of its validity as the tool performs according to theory. Trial registration

  1. Building a reliable measure for unobtrusive observations of street-connecting pedestrian walkways.

    PubMed

    Wilson, Nick; Brander, Bill; Mansoor, Osman D; Pearson, Amber L

    2014-12-01

    There is evidence that good urban design, including street connectivity, facilitates walking for transport. We, therefore, piloted a short survey on 118 such walkways in nine suburbs in Wellington, New Zealand's capital. The instrument appeared feasible to use and performed well in terms of inter-rater reliability (median Kappa score for 15 items: 0.88). The study identified both favorable features (e.g., railings by steps), but also problematic ones (e.g., concerning graffiti, litter, and insufficient lighting and signage). There is scope for routinising the monitoring of walkway quality so that citizens and government agencies can work together to enhance urban walkability. PMID:25008121

  2. Reliability and criterion validity of two applications of the iPhone™ to measure cervical range of motion in healthy participants

    PubMed Central

    2013-01-01

    Summary of background data Recent smartphones, such as the iPhone, are often equipped with an accelerometer and magnetometer, which, through software applications, can perform various inclinometric functions. Although these applications are intended for recreational use, they have the potential to measure and quantify range of motion. The purpose of this study was to estimate the intra and inter-rater reliability as well as the criterion validity of the clinometer and compass applications of the iPhone in the assessment cervical range of motion in healthy participants. Methods The sample consisted of 28 healthy participants. Two examiners measured cervical range of motion of each participant twice using the iPhone (for the estimation of intra and inter-reliability) and once with the CROM (for the estimation of criterion validity). Estimates of reliability and validity were then established using the intraclass correlation coefficient (ICC). Results We observed a moderate intra-rater reliability for each movement (ICC = 0.65-0.85) but a poor inter-rater reliability (ICC < 0.60). For the criterion validity, the ICCs are moderate (>0.50) to good (>0.65) for movements of flexion, extension, lateral flexions and right rotation, but poor (<0.50) for the movement left rotation. Conclusion We found good intra-rater reliability and lower inter-rater reliability. When compared to the gold standard, these applications showed moderate to good validity. However, before using the iPhone as an outcome measure in clinical settings, studies should be done on patients presenting with cervical problems. PMID:23829201

  3. Validity and Reliability of A-Mode Ultrasound for Body Composition Assessment of NCAA Division I Athletes

    PubMed Central

    Wagner, Dale R.; Cain, Dustin L.; Clark, Nicolas W.

    2016-01-01

    This study evaluated the validity and reliability of the BodyMetrix™ BX2000 A-mode ultrasound for estimating percent body fat (%BF) in athletes by comparing it to skinfolds and the BOD POD. Forty-five (22 males, 23 females) National Collegiate Athletic Association (NCAA) Division-I athletes volunteered for this study. Subjects were measured once in the BOD POD then twice by two technicians for skinfolds and ultrasound. A one-way repeated-measures ANOVA revealed significant differences between body composition methods (F = 13.24, p < 0.01, η² = 0.24). This difference was further explained by a sex-specific effect such that the mean difference between ultrasound and BOD POD was large for females (~ 5% BF) but small for males (~ 1.5% BF). Linear regression using the %BF estimate from ultrasound to predict %BF from BOD POD resulted in an R2 = 0.849, SEE = 2.6% BF and a TE = 4.4% BF. The inter-rater intraclass correlation (ICC) for skinfold was 0.966 with a large 95% confidence interval (CI) of 0.328 to 0.991. The inter-rater ICC for ultrasound was 0.987 with a much smaller 95% CI of 0.976 to 0.993. Both skinfolds and ultrasound had test-retest ICCs ≥ 0.996. The BX2000 ultrasound device had excellent test-retest reliability, and its inter-rater reliability was superior to the skinfold method. The validity of this method is questionable, particularly for female athletes. However, due to its excellent reliability, coaches and trainers should consider this portable and easy to use A-mode ultrasound to assess body composition changes in athletes. PMID:27073854

  4. The reliability, validity and correlation of two observational gait scales assessed by video tape for Chinese subjects with hemiplegia

    PubMed Central

    Lu, Xi; Hu, Nan; Deng, Siyu; Li, Jun; Qi, Shuyan; Bi, Sheng

    2015-01-01

    To test the reliability of the Wisconsin Gait Scale (WGS) and the Gait Abnormality Rating Scale (GARS) for hemiplegic Chinese subjects, as well as to establish the concurrent validity of these two scales with clinical measurements. [Subjects] Twenty hemiplegic stroke subjects were recruited for this study. [Methods] The subjects walked along a 10-meter walkway and their gait was videotaped from 4 directions. Two physical therapists assessed the subjects’ gait using the aforementioned scales by watching the video tape. The Intraclass Correlation Coefficient (ICC) was calculated for the two physiotherapists’ scores for each category and the total scores to assess the reliability. Concurrent validity was tested by comparing the total scores to subjects’ walking speed, the Fugl-Meyer assessment, the Motricity Index of the lower limb, and the Composite Spasticity Index of the lower limb. [Results] The ICC of WGS was 0.961 for intra-rater reliability, and 0.945 for inter-rater reliability. The ICC of GARS was 0.708 for intra-rater reliability and 0.875 for inter-rater reliability. The correlations of the two scales with walking speed, the Fugl-Meyer assessment and the Motricity Index were statistically significant. [Conclusion] Both the Wisconsin Gait Scale and the Gait Abnormality Rating Scale are reliable and valid protocols for measuring the hemiplegic gait of stroke patients. PMID:26834338

  5. The reliability, validity and correlation of two observational gait scales assessed by video tape for Chinese subjects with hemiplegia.

    PubMed

    Lu, Xi; Hu, Nan; Deng, Siyu; Li, Jun; Qi, Shuyan; Bi, Sheng

    2015-12-01

    To test the reliability of the Wisconsin Gait Scale (WGS) and the Gait Abnormality Rating Scale (GARS) for hemiplegic Chinese subjects, as well as to establish the concurrent validity of these two scales with clinical measurements. [Subjects] Twenty hemiplegic stroke subjects were recruited for this study. [Methods] The subjects walked along a 10-meter walkway and their gait was videotaped from 4 directions. Two physical therapists assessed the subjects' gait using the aforementioned scales by watching the video tape. The Intraclass Correlation Coefficient (ICC) was calculated for the two physiotherapists' scores for each category and the total scores to assess the reliability. Concurrent validity was tested by comparing the total scores to subjects' walking speed, the Fugl-Meyer assessment, the Motricity Index of the lower limb, and the Composite Spasticity Index of the lower limb. [Results] The ICC of WGS was 0.961 for intra-rater reliability, and 0.945 for inter-rater reliability. The ICC of GARS was 0.708 for intra-rater reliability and 0.875 for inter-rater reliability. The correlations of the two scales with walking speed, the Fugl-Meyer assessment and the Motricity Index were statistically significant. [Conclusion] Both the Wisconsin Gait Scale and the Gait Abnormality Rating Scale are reliable and valid protocols for measuring the hemiplegic gait of stroke patients. PMID:26834338

  6. Reliability and Validity of a Chinese version of the Diagnostic Interview for Borderlines-Revised (DIB-R)

    PubMed Central

    Wang, Lanlan; Yuan, Chenmei; Qiu, Jianying; Gunderson, John; Zhang, Min; Jiang, Kaida; Leung, Freedom; Zhong, Jie; Xiao, Zeping

    2014-01-01

    Background Borderline personality disorder (BPD) is the most studied of the Axis II disorders. One of the most widely used diagnostic instruments is the Diagnostic Interview for Borderline Patients - Revised (DIB-R). The aim of this study was to test the reliability and validity of DIB-R for use in the Chinese culture. Methods The reliability and validity of the DIB-R Chinese version were assessed in a sample of 236 outpatients with a probable BPD diagnosis. The Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) was used as a standard. Test/re-test reliability was tested at 6 months later with 20 patients and inter-rater reliability was tested on 32 patients. Results The Chinese version of the DIB-R showed good internal global consistency (Cronbach’s alpha of 0.916), good test-retest reliability (Pearson correlation of 0.704), good inter-raters reliability (ICC of 0.892 and Kappa of 0.861). When compared to the DSM-IV diagnosis as measured by the SCID-II, the DIB-R showed relatively good sensitivity (0.768) and specificity (0.891) at the cutoff of 7; moderate diagnostic convergence (Kappa of 0.631), as well as good discriminating validity. Conclusion The Chinese version of the DIB-R has good psychometric properties, which renders it a valuable method for examining the presence, the severity and component phenotypes of BPD in Chinese samples. PMID:24302703

  7. Reliability of Health-Related Physical Fitness Tests among Colombian Children and Adolescents: The FUPRECOL Study

    PubMed Central

    Ramírez-Vélez, Robinson; Rodrigues-Bezerra, Diogo; Correa-Bautista, Jorge Enrique; Izquierdo, Mikel; Lobelo, Felipe

    2015-01-01

    Substantial evidence indicates that youth physical fitness levels are an important marker of lifestyle and cardio-metabolic health profiles and predict future risk of chronic diseases. The reliability physical fitness tests have not been explored in Latino-American youth population. This study’s aim was to examine the reliability of health-related physical fitness tests that were used in the Colombian health promotion “Fuprecol study”. Participants were 229 Colombian youth (boys n = 124 and girls n = 105) aged 9 to 17.9 years old. Five components of health-related physical fitness were measured: 1) morphological component: height, weight, body mass index (BMI), waist circumference, triceps skinfold, subscapular skinfold, and body fat (%) via impedance; 2) musculoskeletal component: handgrip and standing long jump test; 3) motor component: speed/agility test (4x10 m shuttle run); 4) flexibility component (hamstring and lumbar extensibility, sit-and-reach test); 5) cardiorespiratory component: 20-meter shuttle-run test (SRT) to estimate maximal oxygen consumption. The tests were performed two times, 1 week apart on the same day of the week, except for the SRT which was performed only once. Intra-observer technical errors of measurement (TEMs) and inter-rater (reliability) were assessed in the morphological component. Reliability for the Musculoskeletal, motor and cardiorespiratory fitness components was examined using Bland–Altman tests. For the morphological component, TEMs were small and reliability was greater than 95% of all cases. For the musculoskeletal, motor, flexibility and cardiorespiratory components, we found adequate reliability patterns in terms of systematic errors (bias) and random error (95% limits of agreement). When the fitness assessments were performed twice, the systematic error was nearly 0 for all tests, except for the sit and reach (mean difference: -1.03% [95% CI = -4.35% to -2.28%]. The results from this study indicate that the

  8. Reliability and validity of the Wolfram Unified Rating Scale (WURS)

    PubMed Central

    2012-01-01

    Background Wolfram syndrome (WFS) is a rare, neurodegenerative disease that typically presents with childhood onset insulin dependent diabetes mellitus, followed by optic atrophy, diabetes insipidus, deafness, and neurological and psychiatric dysfunction. There is no cure for the disease, but recent advances in research have improved understanding of the disease course. Measuring disease severity and progression with reliable and validated tools is a prerequisite for clinical trials of any new intervention for neurodegenerative conditions. To this end, we developed the Wolfram Unified Rating Scale (WURS) to measure the severity and individual variability of WFS symptoms. The aim of this study is to develop and test the reliability and validity of the Wolfram Unified Rating Scale (WURS). Methods A rating scale of disease severity in WFS was developed by modifying a standardized assessment for another neurodegenerative condition (Batten disease). WFS experts scored the representativeness of WURS items for the disease. The WURS was administered to 13 individuals with WFS (6-25 years of age). Motor, balance, mood and quality of life were also evaluated with standard instruments. Inter-rater reliability, internal consistency reliability, concurrent, predictive and content validity of the WURS were calculated. Results The WURS had high inter-rater reliability (ICCs>.93), moderate to high internal consistency reliability (Cronbach’s α = 0.78-0.91) and demonstrated good concurrent and predictive validity. There were significant correlations between the WURS Physical Assessment and motor and balance tests (rs>.67, p<.03), between the WURS Behavioral Scale and reports of mood and behavior (rs>.76, p<.04) and between WURS Total scores and quality of life (rs=-.86, p=.001). The WURS demonstrated acceptable content validity (Scale-Content Validity Index=0.83). Conclusions These preliminary findings demonstrate that the WURS has acceptable reliability and validity and

  9. Reliability of Abdominal Muscle Stiffness Measured Using Elastography during Trunk Rehabilitation Exercises.

    PubMed

    MacDonald, David; Wan, Alan; McPhee, Megan; Tucker, Kylie; Hug, François

    2016-04-01

    The aim of this study was to assess the intra-session and inter-rater reliability of shear modulus measured in abdominal muscles during two commonly used trunk stability exercises. Thirty healthy volunteers performed a series of abdominal hollow and abdominal brace tasks. Supersonic shear imaging was used to measure the shear modulus (considered an index of muscle tension) of the four anterior trunk muscles: obliquus externus abdominis, obliquus internus abdominis, transversus abdominis and rectus abdominis. Because of measurement artifacts, internus abdominis and transversus abdominis data were not analyzed for 36.7% and 26.7% of the participants, respectively. These participants exhibited thicker superficial fat layers than the others. For the remaining participants, fair to excellent intra-session and inter-rater reliability was observed with moderate to high intra-class coefficients (0.45-0.97) and low to moderate standard error of measurement values (0.38-3.53 kPa). Reliability values were consistently greater for superficial than for deeper muscles. PMID:26746381

  10. An initial reliability and validity study of the Interaction, Communication, and Literacy Skills Audit.

    PubMed

    El-Choueifati, Nisrine; Purcell, Alison; McCabe, Patricia; Heard, Robert; Munro, Natalie

    2014-06-01

    Early childhood educators (ECEs) have an important role in promoting positive outcomes for children's language and literacy development. This paper reports the development of a new tool, The Interaction Communication and Literacy (ICL) Skills Audit, and pilots its reliability and validity. Intra- and inter-rater reliability was examined by three speech-language pathologists (SLPs). Five skill areas relating to ECE language and literacy practice were rated. The face and content validity of the ICL Skills Audit was examined by expert SLPs (n = 8) and expert ECEs (n = 4) via questionnaire. The overall intra-rater reliability for the ICL Skills Audit was excellent with percentage close agreement (PCA) of 91-94. Inter-rater agreement was PCA 68-80. Expert SLPs and ECEs agreed that the content was comprehensive and practical. Based on this preliminary study, the ICL Skills Audit appears to be a promising tool that can be used by SLPs and ECEs in collaboration to measure the skills of ECEs in the areas of language and literacy support. Future psychometric and outcome research on the revised ICL Skills Audit is warranted. PMID:24635410

  11. Reliability and validity of the sideways step test and its correlation with motor function after stroke

    PubMed Central

    Pang, Eva Y.F.; Fong, Shirley S.M.; Tse, Mimi M.Y.; Tam, Eric W.C.; Ng, Shamay SM; So, Billy C.L.

    2015-01-01

    [Purpose] This study investigated the intra-rater, inter-rater and test-retest reliability of the sideways step test (SST), its correlation with other indicators of stroke-specific impairment, and the cut-off count best discriminating subjects with stroke from their healthy counterparts. [Subjects and Methods] Forty-three subjects with chronic stroke and 41 healthy subjects older than 50 years participated in this study. The SST was administered along with the Fugl-Meyer motor assessment for the lower extremities (FMA-LE), the five-times sit to stand (5TSTS) test, the Berg Balance Scale (BBS), the movement velocity (MVL) by the limits of stability (LOS) test, the ten-metre walk (10mW) test, the timed “Up and Go” (TUG) test and the Activities-specific Balance Confidence (ABC) scale. [Results] The SST showed good to excellent intra-rater, inter-rater and test-retest reliability. The SST counts correlated with 5TSTS times, 10mW times, TUG times, and the FMA-LE and BBS scores. SST counts of 11 for the paretic leg and 14 for the non-paretic leg were found to distinguish the healthy adults from subjects with stroke. [Conclusion] The sideways step test is a reliable clinical test, which correlates with the functional strength, gait speed, and functional balance of people with chronic stroke. PMID:26180332

  12. Reliability and Diagnostic Performance of CT Imaging Criteria in the Diagnosis of Tuberculous Meningitis

    PubMed Central

    Botha, Hugo; Ackerman, Christelle; Candy, Sally; Carr, Jonathan A.; Griffith-Richards, Stephanie; Bateman, Kathleen J.

    2012-01-01

    Introduction Abnormalities on CT imaging may contribute to the diagnosis of tuberculous meningitis (TBM). Recently, an expert consensus case definition (CCD) and set of imaging criteria for diagnosing basal meningeal enhancement (BME) have been proposed. This study aimed to evaluate the sensitivity, specificity and reliability of these in a prospective cohort of adult meningitis patients. Methods Initial diagnoses were based on the CCD, classifying patients into: ‘Definite TBM’ (microbiological confirmation), ‘Probable TBM’ (diagnostic score ≥10), ‘Possible TBM’ (diagnostic score 6–9), ‘Not TBM’ (confirmation of an alternative diagnosis) or ‘Uncertain’ (diagnostic score of <6). CT images were evaluated independently on two occasions by four experienced reviewers. Intra-rater and inter-rater agreement were calculated using the kappa statistic. Sensitivities and specificities were calculated using both ‘Definite TBM’ and either ‘Definite TBM’ or ‘Probable TBM’ as gold standards. Results CT scan criteria for BME had good intra-rater agreement (κ range 0.35–0.78) and fair to moderate inter-rater agreement (κ range 0.20–0.52). Intra- and inter-rater agreement on the CCD components were good to fair (κ  =  ranges 0.47–0.81 and 0.21–0.63). Using ‘Definite TBM’ as a gold standard, the criteria for BME were very specific (61.5%–100%), but insensitive (5.9%–29.4%). Similarly, the imaging components of the CCD were highly specific (69.2–100%) but lacked sensitivity (0–56.7%). Similar values were found when using ‘Definite TBM’ or ‘Probable TBM’ as a gold standard. Discussion The fair to moderate inter-rater agreement and poor sensitivities of the criteria for BME suggest that little reliance should be placed in these features in isolation. While the presence of the CCD criteria of acute infarction or tuberculoma(s) appears useful as rule-in criteria, their absence is of little help in excluding TBM. The

  13. Measurement of patient safety: a systematic review of the reliability and validity of adverse event detection with record review

    PubMed Central

    Hanskamp-Sebregts, Mirelle; Zegers, Marieke; Vincent, Charles; van Gurp, Petra J; de Vet, Henrica C W; Wollersheim, Hub

    2016-01-01

    Objectives Record review is the most used method to quantify patient safety. We systematically reviewed the reliability and validity of adverse event detection with record review. Design A systematic review of the literature. Methods We searched PubMed, EMBASE, CINAHL, PsycINFO and the Cochrane Library and from their inception through February 2015. We included all studies that aimed to describe the reliability and/or validity of record review. Two reviewers conducted data extraction. We pooled κ values (κ) and analysed the differences in subgroups according to number of reviewers, reviewer experience and training level, adjusted for the prevalence of adverse events. Results In 25 studies, the psychometric data of the Global Trigger Tool (GTT) and the Harvard Medical Practice Study (HMPS) were reported and 24 studies were included for statistical pooling. The inter-rater reliability of the GTT and HMPS showed a pooled κ of 0.65 and 0.55, respectively. The inter-rater agreement was statistically significantly higher when the group of reviewers within a study consisted of a maximum five reviewers. We found no studies reporting on the validity of the GTT and HMPS. Conclusions The reliability of record review is moderate to substantial and improved when a small group of reviewers carried out record review. The validity of the record review method has never been evaluated, while clinical data registries, autopsy or direct observations of patient care are potential reference methods that can be used to test concurrent validity. PMID:27550650

  14. Preliminary reliability and repeatability of the Brazilian version of the Revised Knox Preschool Play Scale.

    PubMed

    Pacciulio, Amanda M; Pfeifer, Luzia I; Santos, Jair L F

    2010-06-01

    The aim of this study was to create an adaptation of the Revised Knox Preschool Play Scale (RKPPS) for the Brazilian population, as well as to apply the instrument with statistical analysis to verify the preliminary intra-rater and inter-rater reliability and repeatability of the instrument. The instructions presented by Beaton et al. regarding adaptation of instruments were followed to perform a cross-cultural adaptation of the RKPPS. A preliminary test of the Portuguese version was performed on 18 children with no motor, cognitive or sensory impairment. The video recordings of this administration were analysed on two separate occasions by two examiners within a 5-month interval, using the scores suggested by Pfeifer. The Spearman's test was used in the statistical analysis of the obtained data. The author of the RKPPS agreed with the small necessary cultural adaptations. The Spearman test revealed a high correlation coefficient and good significance levels for both intra- and inter-raters values. This study demonstrated the reliability and repeatability of the Brazilian version of the RKPPS. This is a preliminary study and further studies are needed in order to validate the scale to be administered in the Brazilian population. PMID:20099245

  15. The Effects of Rater Training on Inter-Rater Agreement

    ERIC Educational Resources Information Center

    Pufpaff, Lisa A.; Clarke, Laura; Jones, Ruth E.

    2015-01-01

    This paper addresses the effects of rater training on the rubric-based scoring of three preservice teacher candidate performance assessments. This project sought to evaluate the consistency of ratings assigned to student learning outcome measures being used for program accreditation and to explore the need for rater training in order to increase…

  16. Reliability of Magnetic Resonance Imaging Assessment of Rotator Cuff: The ROW Study

    PubMed Central

    Jain, Nitin B.; Collins, Jamie; Newman, Joel S.; Katz, Jeffrey N.; Losina, Elena; Higgins, Laurence D.

    2014-01-01

    Background Physiatrists encounter patients with rotator cuff disorders and imaging is frequently an important component of their diagnostic assessment. However, there is paucity of literature on reliability of MRI assessment between shoulder specialists and musculoskeletal radiologists. Objective We assessed inter- and intra-rater reliability of MRI characteristics of the rotator cuff. Design Cross-sectional secondary analyses in a prospective cohort study Setting Academic tertiary care centers Patients Subjects with shoulder pain recruited from orthopedic and physiatry clinics Methods Two shoulder fellowship trained physicians (a physiatrist and a shoulder surgeon) jointly performed a blinded composite MRI review by consensus on 31 subjects with shoulder pain. Subsequently, MRI was reviewed by one fellowship trained musculoskeletal radiologist. Main Outcome Measures We calculated Cohen’s kappa coefficients and percent agreement among the two reviews (composite review of two shoulder specialists versus that of the musculoskeletal radiologist). Intra-rater reliability was assessed among the shoulder specialists by performing a repeat blinded composite MRI review. In addition to this repeat composite review, only one of the physiatry shoulder specialists performed an additional review. Results Inter-rater reliability (shoulder specialists versus musculoskeletal radiologist) was substantial for the presence or absence of tear (kappa=0.90; 95% CI=0.72, 1.00), tear-thickness (kappa=0.84;95% CI=0.70, 0.99), longitudinal size of tear (kappa=0.75;95% CI=0.44, 1.00), fatty infiltration (kappa=0.62; 95% CI=0.45, 0.79), and muscle atrophy (kappa=0.68; 95% CI=0.50, 0.86). There was only fair inter-rater reliability of transverse size of tear (kappa=0.20; 95% CI=0.00, 0.51). The kappa for intra-rater reliability was high for tear thickness (0.88; 95% CI=0.72, 1.00), longitudinal tear size (0.61; 95% CI=0.22, 0.99), fatty infiltration (0.89; 95% CI=0.80, 0.98), and muscle

  17. Measurement Issues in Anthropometric Measures of Limb Volume Change in Persons at Risk for and Living with Lymphedema: A Reliability Study

    PubMed Central

    Tidhar, Dorit; Armer, Jane M.; Deutscher, Daniel; Shyu, Chi-Ren; Azuri, Josef; Madsen, Richard

    2015-01-01

    Understanding whether a true change has occurred during the process of care is of utmost importance in lymphedema management secondary to cancer treatments. Decisions about when to order a garment, start an exercise program, and begin or end therapy are based primarily on measurements of limb volume, based on circumferences taken by physiotherapists using a flexible tape. This study aimed to assess intra-rater and inter-rater reliability of measurements taken by physiotherapists of legs and arms with and without lymphedema and to evaluate whether there is a difference in reliability when measuring a healthy versus a lymphedematous limb. The intra-rater reliability of arm and leg measurements by trained physiotherapist were very high (scaled standard error of measurements (SEMs) for an arm and a leg volume were 0.82% and 0.64%, respectively) and a cut-point of 1% scaled SEM may be recommended as a threshold for acceptable reliability. Physiotherapists can rely on the same error when assessing lymphedematous or healthy limbs. For those who work in teams and share patients, practice is needed in synchronizing the measurements and regularly monitoring their inter-rater reliability. PMID:26437431

  18. [Trauma scores: reproducibility and reliability].

    PubMed

    Waydhas, C; Nast-Kolb, D; Trupka, A; Kerim-Sade, C; Kanz, G; Zoller, J; Schweiberer, L

    1992-02-01

    The inter-rater reliability of the Injury Severity Score (ISS) and the Polytraumaschlüssel (PTS) [multiple trauma code] was studied using diagnosis sheets filled in for 107 multiple injured patients. The scoring was performed by eight physicians with different levels of qualification. The scores for individual patients varied widely depending on the scorer, with extremes differing from the mean by about 80% and 70% for the ISS and PTS, respectively. The mean ISS and PTS for the whole study population also varied significantly between the scorers (P less than 0.0001, one-way analysis of variance). Raters with experience in trauma scoring calculated significantly higher scores (P less than 0.01, t-test) Neither the ISS nor the PTS seem reliable enough to describe injury severity in an individual patient. Treatment decisions must not be based on such grounds. Even for larger groups, caution must be exercised in comparison of different populations of multiple traumatized patients. PMID:1570531

  19. A Tool to Assess the Signs and Symptoms of Catheter-Associated Urinary Tract Infection: Development and Reliability.

    PubMed

    Blodgett, Tom J; Gardner, Sue E; Blodgett, Nicole P; Peterson, Lisa V; Pietraszak, Melissa

    2015-08-01

    The purpose of this pilot study was to determine the inter-rater reliability of four clinical manifestations of catheter-associated urinary tract infections (CAUTI) among hospitalized adults with short-term indwelling urinary catheters using a tool developed for this purpose: the CAUTI Assessment Profile (CAP). Study participants included 30 non-pregnant English-speaking adults, recruited from two community hospitals. Three nurses assessed each participant for fever, suprapubic tenderness, flank tenderness, and delirium using standardized techniques. Based on the generalized Kappa statistic and 95% confidence intervals, there was evidence of strong inter-rater reliability for fever (K = 1.00, 0.793-1.207), suprapubic tenderness (K = 0.39, 0.185-0.598), and delirium (K = 0.58, 0.379-0.792), but not for flank tenderness (K = 0.29, -0.036 to 0.617). This study provides preliminary evidence that the CAP can be used to consistently identify these clinical signs and symptoms of CAUTI in hospitalized adults. PMID:25246536

  20. Validity and Reliability of the European Portuguese Version of Neuropsychiatric Inventory in an Institutionalized Sample

    PubMed Central

    Ferreira, Ana Rita; Martins, Sonia; Ribeiro, Orquidea; Fernandes, Lia

    2015-01-01

    Background Neuropsychiatric symptoms are very common in dementia and have been associated with patient and caregiver distress, increased risk of institutionalization and higher costs of care. In this context, the neuropsychiatric inventory (NPI) is the most widely used comprehensive tool designed to measure neuropsychiatric Symptoms in geriatric patients with dementia. The aim of this study was to present the validity and reliability of the European Portuguese version of NPI. Methods A cross-sectional study was carried out with a convenience sample of institutionalized patients (≥ 50 years old) in three nursing homes in Portugal. All patients were also assessed with mini-mental state examination (MMSE) (cognition), geriatric depression scale (GDS) (depression) and adults and older adults functional assessment inventory (IAFAI) (functionality). NPI was administered to a formal caregiver, usually from the clinical staff. Inter-rater and test-retest reliability were assessed in a subsample of 25 randomly selected subjects. Results The sample included 166 elderly, with a mean age of 80.9 (standard deviation: 10.2) years. Three out of the NPI behavioral items had negative correlations with MMSE: delusions (rs = -0.177, P = 0.024), disinhibition (rs = -0.174, P = 0.026) and aberrant motor activity (rs = -0.182, P = 0.020). The NPI subsection of depression/dysphoria correlated positively with GDS total score (rs = 0.166, P = 0.038). NPI showed good internal consistency (overall α = 0.766; frequency α = 0.737; severity α = 0.734). The inter-rater reliability was excellent (intraclass correlation coefficient (ICC): 1.00, 95% confidence interval (CI) 1.00 - 1.00), as well as test-retest reliability (ICC: 0.91, 95% CI 0.80 - 0.96). Conclusion The results found for convergent validity, inter-rater and test-retest reliability, showed that this version appears to be a valid and reliable instrument for evaluation of neuropsychiatric symptoms in institutionalized elderly

  1. [Reliability and factorial structure of a rating scale for amyotrophic lateral sclerosis].

    PubMed

    Oda, E; Ohashi, Y; Tashiro, K; Mizuno, Y; Kowa, H; Yanagisawa, N

    1996-11-01

    The Modified Norris Scale is a rating scale for amyotrophic lateral sclerosis (ALS), which consists of two parts, the Limb Norris Scale and the Norris Bulbar Scale. The Limb Scale has 21 items to evaluate extremity function and the Bulbar Scale has 13 items to evaluate bulbar function. Each item is rated in 4 ordinal categories. Considering the habitual difference, we translated the English scale into Japanese one with minor modification, and added more detailed explanations for all categories of each item. Then we examined reliability and factorial structure of the translated scale. The subjects were 23 patients with motor disturbance and each subject was rated twice by 2-4 neurologists. As a measure of reliability, the Kappa coefficient proposed by Cohen (1960) and Kraemer (1980) was calculated for each item and the intraclass correlation coefficient (ICC) was evaluated for total scores of each of two scales. To analyze the factorial structure, the factor analysis was carried out. The minimum and the maximum Kappa values were .70 and .97 for intra-rater reliability of the Limb Scale's items, .60 and .83 for inter-rater reliability of the Limb Scale's items, .41 and 1.00 for intra-rater reliability of the Bulbar Scale's items and .26 and .81 for inter-rater reliability of the Bulbar Scale's items, respectively. Concerning the factorial structure, the contribution of the first factor was 83.6% for the Limb Scale and that for the Bulbar Scale was 66.7%. This indicates unidimensionality of both Scales. The ICCs for the total scores were .97 (95%C.I. .95-.99) for the Limb Scale and .86 (.73-.93) for the Bulbar Scale, respectively. On the basis of these results, the Scale has unidimensionality and high reliability enough for practical use. PMID:8951891

  2. Reliability of Quality Assessments in Research Synthesis: Securing the Highest Quality Bioinformation for HIT.

    PubMed

    Chiappelli, Francesco; Phil, André Barkhordarian C; Arora, Rashi; Phi, Linda; Giroux, Amy; Uyeda, Molly; Kung, Jason; Ramchandani, Manisha

    2012-01-01

    Current trends in bio-medicine include research synthesis and dissemination of bioinformation by means of health (bio) information technology (H[b] IT). Research must secure the validity and reliability of assessment tools to quantify research quality in the pursuit of the best available evidence. Our concerted work in this domain led to the revision of three instruments for that purpose, including the stringent characterization of inter-rater reliability and coefficient of agreement. It is timely and critical to advance the methodological development of the science of research synthesis by strengthening the reliability of existing measure of research quality in order to ensure H[b] IT efficacy and effectiveness. PMID:23055612

  3. Reliability of an Electronic Inspiratory Loading Device for Assessing Pulmonary Function in Post-Stroke Patients

    PubMed Central

    Lee, Kyeong-Bong; Kim, Min-Kyu; Jeong, Ju-Ri; Lee, Wan-Hee

    2016-01-01

    Background The purpose of this study was to examine the inter- and intra-rater reliability of an electronic inspiratory loading device for the assessment of pulmonary functions: maximum inspiratory pressure, peak inspiratory flow, and vital capacity. Material/Methods Subjects were 50 patient volunteers in a rehabilitation hospital who had experienced their first episode of unilateral stroke with hemiparesis during the previous 6 months (26 men, 24 women; mean age [±SD], 55.96 [±12.81] years), with no use of medications that could induce drowsiness, evidence of restrictive lung disease, history of asthma, use of psychotropic drugs, or alcohol consumption habit. Maximum inspiratory pressure, peak inspiratory flow, and vital capacity for pulmonary functions were assessed using an electronic inspiratory loading device (PowerBreathe, K5, 2010) by 2 examiners, with patients in an unassisted sitting position, and 1 examiner re-assessed with same patients at the same time of a day after 1 week. Intra-class correlation coefficients were used to assess reliability. Results Intra-rater reliability ranged from intra-class correlation coefficients (ICCs)=0.959 to 0.986 in variables. For the inter-rater reliability between 2 examiners, the ICCs ranged from 0.933 to 0.985. Intra-rater and inter-rater reliability were good in variables (maximal inspiratory pressure, peak inspiratory flow, and vital capacity). Conclusions The intra- and inter-examiner reliability of the pulmonary function measurements, maximum inspiratory pressure, peak inspiratory flow, and vital capacity, for the post-stroke patients was very high. The results suggest that the electronic inspiratory loading device would be useful for clinical rehabilitative assessment of pulmonary function. PMID:26782369

  4. Reliability and Validity of a Survey of Cat Caregivers on Their Cats' Socialization Level in the Cat's Normal Environment.

    PubMed

    Slater, Margaret; Garrison, Laurie; Miller, Katherine; Weiss, Emily; Makolinski, Kathleen; Drain, Natasha

    2013-01-01

    Stray cats routinely enter animal welfare organizations each year and shelters are challenged with determining the level of human socialization these cats may possess as quickly as possible. However, there is currently no standard process to guide this determination. This study describes the development and validation of a caregiver survey designed to be filled out by a cat's caregiver so it accurately describes a cat's personality, background, and full range of behavior with people when in its normal environment. The results from this survey provided the basis for a socialization score that ranged from unsocialized to well socialized with people. The quality of the survey was evaluated based on inter-rater and test-retest reliability and internal consistency and estimates of construct and criterion validity. In general, our results showed moderate to high levels of inter-rater (median of 0.803, range 0.211-0.957) and test-retest agreement (median 0.92, range 0.211-0.999). Cronbach's alpha showed high internal consistency (0.962). Estimates of validity did not highlight any major shortcomings. This survey will be used to develop and validate an effective assessment process that accurately differentiates cats by their socialization levels towards humans based on direct observation of cats' behavior in an animal shelter. PMID:26479758

  5. The Bruininks-Oseretsky Test of Motor Proficiency-Short Form is reliable in children living in remote Australian Aboriginal communities

    PubMed Central

    2013-01-01

    Background The Lililwan Project is the first population-based study to determine Fetal Alcohol Spectrum Disorders (FASD) prevalence in Australia and was conducted in the remote Fitzroy Valley in North Western Australia. The diagnostic process for FASD requires accurate assessment of gross and fine motor functioning using standardised cut-offs for impairment. The Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) is a norm-referenced assessment of motor function used worldwide and in FASD clinics in North America. It is available in a Complete Form with 53 items or a Short Form with 14 items. Its reliability in measuring motor performance in children exposed to alcohol in utero or living in remote Australian Aboriginal communities is unknown. Methods A prospective inter-rater and test-retest reliability study was conducted using the BOT-2 Short Form. A convenience sample of children (n = 30) aged 7 to 9 years participating in the Lililwan Project cohort (n = 108) study, completed the reliability study. Over 50% of mothers of Lililwan Project children drank alcohol during pregnancy. Two raters simultaneously scoring each child determined inter-rater reliability. Test-retest reliability was determined by assessing each child on a second occasion using predominantly the same rater. Reliability was analysed by calculating Intra-Class correlation Coefficients, ICC(2,1), Percentage Exact Agreement (PEA) and Percentage Close Agreement (PCA) and measures of Minimal Detectable Change (MDC) were calculated. Results Thirty Aboriginal children (18 male, 12 female: mean age 8.8 years) were assessed at eight remote Fitzroy Valley communities. The inter-rater reliability for the BOT-2 Short Form score sheet outcomes ranged from 0.88 (95%CI, 0.77 – 0.94) to 0.92 (95%CI, 0.84 – 0.96) indicating excellent reliability. The test-retest reliability (median interval between tests being 45.5 days) for the BOT-2 Short Form score sheet outcomes ranged from

  6. Assessment of Lower Limb Muscle Strength and Power Using Hand-Held and Fixed Dynamometry: A Reliability and Validity Study

    PubMed Central

    Perraton, Luke G.; Bower, Kelly J.; Adair, Brooke; Pua, Yong-Hao; Williams, Gavin P.; McGaw, Rebekah

    2015-01-01

    Introduction Hand-held dynamometry (HHD) has never previously been used to examine isometric muscle power. Rate of force development (RFD) is often used for muscle power assessment, however no consensus currently exists on the most appropriate method of calculation. The aim of this study was to examine the reliability of different algorithms for RFD calculation and to examine the intra-rater, inter-rater, and inter-device reliability of HHD as well as the concurrent validity of HHD for the assessment of isometric lower limb muscle strength and power. Methods 30 healthy young adults (age: 23±5yrs, male: 15) were assessed on two sessions. Isometric muscle strength and power were measured using peak force and RFD respectively using two HHDs (Lafayette Model-01165 and Hoggan microFET2) and a criterion-reference KinCom dynamometer. Statistical analysis of reliability and validity comprised intraclass correlation coefficients (ICC), Pearson correlations, concordance correlations, standard error of measurement, and minimal detectable change. Results Comparison of RFD methods revealed that a peak 200ms moving window algorithm provided optimal reliability results. Intra-rater, inter-rater, and inter-device reliability analysis of peak force and RFD revealed mostly good to excellent reliability (coefficients ≥ 0.70) for all muscle groups. Concurrent validity analysis showed moderate to excellent relationships between HHD and fixed dynamometry for the hip and knee (ICCs ≥ 0.70) for both peak force and RFD, with mostly poor to good results shown for the ankle muscles (ICCs = 0.31–0.79). Conclusions Hand-held dynamometry has good to excellent reliability and validity for most measures of isometric lower limb strength and power in a healthy population, particularly for proximal muscle groups. To aid implementation we have created freely available software to extract these variables from data stored on the Lafayette device. Future research should examine the reliability

  7. Comparison of Assertive Community Treatment Fidelity Assessment Methods: Reliability and Validity.

    PubMed

    Rollins, Angela L; McGrew, John H; Kukla, Marina; McGuire, Alan B; Flanagan, Mindy E; Hunt, Marcia G; Leslie, Doug L; Collins, Linda A; Wright-Berryman, Jennifer L; Hicks, Lia J; Salyers, Michelle P

    2016-03-01

    Assertive community treatment is known for improving consumer outcomes, but is difficult to implement. On-site fidelity measurement can help ensure model adherence, but is costly in large systems. This study compared reliability and validity of three methods of fidelity assessment (on-site, phone-administered, and expert-scored self-report) using a stratified random sample of 32 mental health intensive case management teams from the Department of Veterans Affairs. Overall, phone, and to a lesser extent, expert-scored self-report fidelity assessments compared favorably to on-site methods in inter-rater reliability and concurrent validity. If used appropriately, these alternative protocols hold promise in monitoring large-scale program fidelity with limited resources. PMID:25721146

  8. Accuracy and Reliability of Haptic Spasticity Assessment Using HESS (Haptic Elbow Spasticity Simulator)

    PubMed Central

    Kim, Jonghyun; Park, Hyung-Soon; Damiano, Diane L.

    2013-01-01

    Clinical assessment of spasticity tends to be subjective because of the nature of the in-person assessment; severity of spasticity is judged based on the muscle tone felt by a clinician during manual manipulation of a patient’s limb. As an attempt to standardize the clinical assessment of spasticity, we developed HESS (Haptic Elbow Spasticity Simulator), a programmable robotic system that can provide accurate and consistent haptic responses of spasticity and thus can be used as a training tool for clinicians. The aim of this study is to evaluate the accuracy and reliability of the recreated haptic responses. Based on clinical data collected from children with cerebral palsy, four levels of elbow spasticity (1, 1+, 2, and 3 in the Modified Ashworth Scale [MAS]) were recreated by HESS. Seven experienced clinicians manipulated HESS to score the recreated haptic responses. The accuracy of the recreation was assessed by the percent agreement between intended and determined MAS scores. The inter-rater reliability among the clinicians was analyzed by using Fleiss’s kappa. In addition, the level of realism with the recreation was evaluated by a questionnaire on “how realistic” this felt in a qualitative way. The percent agreement was high (85.7±11.7%), and for inter-rater reliability, there was substantial agreement (κ=0.646) among the seven clinicians. The level of realism was 7.71±0.95 out of 10. These results show that the haptic recreation of spasticity by HESS has the potential to be used as a training tool for standardizing and enhancing reliability of clinical assessment. PMID:22256328

  9. Reliability and validity of a modified gait scoring system and its use in assessing tibial dyschondroplasia in broilers.

    PubMed

    Garner, J P; Falcone, C; Wakenell, P; Martin, M; Mench, J A

    2002-07-01

    1. The gait scoring system for broilers developed by Kestin et al. (Veterinary Record, 131: 190-194, 1992) has been widely used to evaluate leg problems. The many factors and measures associated with this scale have empirically established its external (biological) validity. However, published test-retest (within-observer) reliabilities are poor, and inter-observer reliabilities are unknown. We evaluated several modifications to this scale aimed at improving its objectivity and reliability. 2. Eighteen naïve observers scored a standardised video of birds exhibiting varying degrees of lameness, either using Kestin et al.'s system, or our modified system. 3. Test-retest reliability (0.906) for Kestin et al.'s system was higher than previously reported. Inter-rater reliability was also good (0.892). The modified system offered significantly better test-retest (0.948) and inter-rater reliabilities (0.943), without incurring costs in terms of time taken or difficulty of use. The systems were consistent, assigning individual birds the same score on average. 4. It is concluded that the modified system offers the advantages of reduced error within and between studies. 5. In a second experiment, we used our modified scoring system to examine the relationship between tibial dyschondroplasia (TD) and gait score in 267 selected broilers. 6. Neither the presence nor severity of TD affected gait score, suggesting that, at least in this strain of broilers, other leg problems like slipped tendons or torsional deformities had more influence on gait impairment than did TD. PMID:12195794

  10. Probing the effect of OSCE checklist length on inter-observer reliability and observer accuracy

    PubMed Central

    Hurley, Katrina F.; Giffin, Nick A.; Stewart, Samuel A.; Bullock, Graham B.

    2015-01-01

    Purpose The Objective Structured Clinical Examination (OSCE) is a widely employed tool for measuring clinical competence. In the drive toward comprehensive assessment, OSCE stations and checklists may become increasingly complex. The objective of this study was to probe inter-observer reliability and observer accuracy as a function of OSCE checklist length. Method Study participants included emergency physicians and senior residents in Emergency Medicine at Dalhousie University. Participants watched an identical series of four, scripted, standardized videos enacting 10-min OSCE stations and completed corresponding assessment checklists. Each participating observer was provided with a random combination of two 40-item and two 20-item checklists. A panel of physicians scored the scenarios through repeated video review to determine the ‘gold standard’ checklist scores. Results Fifty-seven observers completed 228 assessment checklists. Mean observer accuracy ranged from 73 to 93% (14.6–18.7/20), with an overall accuracy of 86% (17.2/20), and inter-rater reliability range of 58–78%. After controlling for station and individual variation, no effect was observed regarding the number of checklist items on overall accuracy (p=0.2305). Consistency in ratings was calculated using intraclass correlation coefficient and demonstrated no significant difference in consistency between the 20- and 40-item checklists (ranged from 0.432 to 0.781, p-values from 0.56 to 0.73). Conclusions The addition of 20 checklist items to a core list of 20 items in an OSCE assessment checklist does not appear to impact observer accuracy or inter-rater reliability. PMID:26490948

  11. Development, scoring, and reliability of the Microscale Audit of Pedestrian Streetscapes (MAPS)

    PubMed Central

    2013-01-01

    Background Streetscape (microscale) features of the built environment can influence people’s perceptions of their neighborhoods’ suitability for physical activity. Many microscale audit tools have been developed, but few have published systematic scoring methods. We present the development, scoring, and reliability of the Microscale Audit of Pedestrian Streetscapes (MAPS) tool and its theoretically-based subscales. Methods MAPS was based on prior instruments and was developed to assess details of streetscapes considered relevant for physical activity. MAPS sections (route, segments, crossings, and cul-de-sacs) were scored by two independent raters for reliability analyses. There were 290 route pairs, 516 segment pairs, 319 crossing pairs, and 53 cul-de-sac pairs in the reliability sample. Individual inter-rater item reliability analyses were computed using Kappa, intra-class correlation coefficient (ICC), and percent agreement. A conceptual framework for subscale creation was developed using theory, expert consensus, and policy relevance. Items were grouped into subscales, and subscales were analyzed for inter-rater reliability at tiered levels of aggregation. Results There were 160 items included in the subscales (out of 201 items total). Of those included in the subscales, 80 items (50.0%) had good/excellent reliability, 41 items (25.6%) had moderate reliability, and 18 items (11.3%) had low reliability, with limited variability in the remaining 21 items (13.1%). Seventeen of the 20 route section subscales, valence (positive/negative) scores, and overall scores (85.0%) demonstrated good/excellent reliability and 3 demonstrated moderate reliability. Of the 16 segment subscales, valence scores, and overall scores, 12 (75.0%) demonstrated good/excellent reliability, three demonstrated moderate reliability, and one demonstrated poor reliability. Of the 8 crossing subscales, valence scores, and overall scores, 6 (75.0%) demonstrated good/excellent reliability, and

  12. Reliability and Validity of Standing Back Extension Test for Detecting Motor Control Impairment in Subjects with Low Back Pain

    PubMed Central

    Kumar, Senthil P; Eapen, Charu; Mahale, Ajit

    2016-01-01

    Introduction Low back pain is a chronic health problem with high socioeconomic impact. Specific diagnosis or treatment approach has not yet effectively established to treat chronic low back pain. Standing Back Extension Test is one of the clinical measures to detect the passive extension subgroup of Motor Control Impairment (MCI); which could have an impact on spinal stability leading to recurrent chronic low back pain. Reliability and validity of this test is not fully established. Aim To determine the intra-rater and inter-rater reliability and concurrent validity of the Standing Back Extension Test for detecting MCI of the lumbar spine. Materials and Methods A total of 50 subjects were included in the study, 25 patients with Non Specific Low Back Pain (NSLBP) (12 men, 13 women) and 25 healthy controls (12 men, 13 women) were recruited into the study. All subjects performed the test movement. Two raters blinded to the subjects rated the test performance as either ‘Positive’ or ‘Negative’ based on the predetermined rating protocol. The thickness of Transverse Abdominis (TrA) muscle was assessed using Rehabilitative Ultrasound Imaging (RUSI). Statistical test used For reliability, the kappa coefficient with percent agreement was calculated and for assessing the validity Receiver Operator Characteristic (ROC) curves and Area under the Curve (AUC) were constructed. Results The standing back extension test showed very good intra-rater (k=0.87 with an agreement of 96%) and good inter-rater (k=0.78 with an agreement of 94%) reliability and high AUC for TrA muscle. Conclusion The standing back extension test was found to be a reliable and a valid measure to detect passive extension subgroup for MCI in subjects with low back pain. PMID:26894091

  13. Optimizing Reliability of Digital Inclinometer and Flexicurve Ruler Measures of Spine Curvatures in Postmenopausal Women with Osteoporosis of the Spine: An Illustration of the Use of Generalizability Theory

    PubMed Central

    MacIntyre, Norma J.; Bennett, Lisa; Bonnyman, Alison M.; Stratford, Paul W.

    2011-01-01

    The study illustrates the application of generalizability theory (G-theory) to identify measurement protocols that optimize reliability of two clinical methods for assessing spine curvatures in women with osteoporosis. Triplicate measures of spine curvatures were acquired for 9 postmenopausal women with spine osteoporosis by two raters during a single visit using a digital inclinometer and a flexicurve ruler. G-coefficients were estimated using a G-study, and a measurement protocol that optimized inter-rater and inter-trial reliability was identified using follow-up decision studies. The G-theory provides reliability estimates for measurement devices which can be generalized to different clinical contexts and/or measurement designs. PMID:22482067

  14. Reliability and Validity of the Chinese Version Appropriateness Evaluation Protocol

    PubMed Central

    Wei, Fengqing; Yang, Jing; Zhang, Zhe; Zhu, Changbin; Ma, Jin

    2015-01-01

    Objective To adapt the Appropriateness Evaluation Protocol (AEP) to the specific settings of health care in China and to validate the Chinese version AEP (C-AEP). Methods Forward and backward translations were carried out to the original criteria. Twenty experts participated in the consultancy to form a preliminary version of the C-AEP. To ensure applicability, tests of reliability and validity were performed on 350 admissions and 3,226 hospital days of acute myocardial infraction patients and total hip replacement patients in two tertiary hospitals by two C-AEP reviewers and two physician reviewers. Overall agreement, specific agreement, and Cohen’s Kappa were calculated to compare the concordance of decisions between pairs of reviewers to test inter-rater reliability and convergent validity. The use of “overrides” and opinions of experts were recorded as measurements of content validity. Face validity was tested through collecting perspectives of nonprofessionals. Sensitivity, specificity, and predictive values were also reported. Results There are 14 admission and 24 days of care criteria in the initial version of C-AEP. Kappa coefficients indicate substantial agreement between reviewers: with regard to inter-rater reliability, Kappa (κ) coefficients are 0.746 (95% confidence interval [CI] 0.644–0.834) and 0.743 (95% CI 0.698–0.767) of admission and hospital days, respectively; for convergent validity, the κ statistics are 0.678 (95% CI 0.567–0.778) and 0.691 (95% CI 0.644–0.717), respectively. Overrides account for less than 2% of all judgments. Content validity and face validity were confirmed by experts and nonprofessionals, respectively. According to the C-AEP reviewers, 18.3% of admissions and 28.5% of inpatient days were deemed inappropriate. Conclusions The C-AEP is a reliable and valid screening tool in China’s tertiary hospitals. The prevalence of inappropriateness is substantial in our research. To reduce inappropriate utilization

  15. The Physical Abilities and Mobility Scale (PAMS): reliability and validity in children receiving inpatient brain injury rehabilitation

    PubMed Central

    Trovato, Melissa K.; Bradley, Elena; Slomine, Beth S.; Salorio, Cynthia F.; Christensen, James R.; Suskauer, Stacy J.

    2013-01-01

    Objective To investigate the psychometric properties of the Physical Abilities and Mobility Scale (PAMS) in children receiving inpatient rehabilitation for acquired brain injury. Design Admission and discharge PAMS item and total scores were evaluated. The Functional Independence Measure for Children (WeeFIM) was used as the criterion standard. A case study was used to illustrate the complementary nature of the PAMS and WeeFIM. Setting A single free-standing academically-affiliated pediatric rehabilitation hospital Participants 107 children aged two through eighteen years receiving inpatient rehabilitation for acquired brain injury between March 2009 and March 2012. 42 additional children treated during this time were excluded due to missing PAMS data. Interventions Not applicable Main Outcome Measures Internal consistency was evaluated using Cronbach alpha. Inter-rater reliability was evaluated through overall agreement, Pearson correlations, and intraclass correlations. Construct validity was examined through exploratory factor analysis. Criterion validity was explored through correlations of PAMS overall and factor scores with WeeFIM total and subscale scores. Sensitivity to recovery was examined using paired t tests examining differences between admission and discharge scores for each item and for the total score. Results Internal consistency and inter-rater reliability were high. Factor analysis revealed two factors: lower level skills and higher level mobility skills. Correlations with the WeeFIM ranged from moderate to very strong; total PAMS score most strongly correlated with the WeeFIM mobility subscore. Total PAMS score and each item score significantly increased between admission and discharge. Conclusions The PAMS is a reliable and valid measure of progress during inpatient rehabilitation for children with acquired brain injury. By capturing fine grain progress toward both lower level and higher level mobility skills, the PAMS complements the WeeFIM in

  16. Validity and reliability of chronic tic disorder and obsessive-compulsive disorder diagnoses in the Swedish National Patient Register

    PubMed Central

    Rück, Christian; Larsson, K Johan; Lind, Kristina; Perez-Vigil, Ana; Isomura, Kayoko; Sariaslan, Amir; Lichtenstein, Paul; Mataix-Cols, David

    2015-01-01

    Objectives The usefulness of cases diagnosed in administrative registers for research purposes is dependent on diagnostic validity. This study aimed to investigate the validity and inter-rater reliability of recorded diagnoses of tic disorders and obsessive-compulsive disorder (OCD) in the Swedish National Patient Register (NPR). Design Chart review of randomly selected register cases and controls. Method 100 tic disorder cases and 100 OCD cases were randomly selected from the NPR based on codes from the International Classification of Diseases (ICD) 8th, 9th and 10th editions, together with 50 epilepsy and 50 depression control cases. The obtained psychiatric records were blindly assessed by 2 senior psychiatrists according to the criteria of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) and ICD-10. Primary outcome measurement Positive predictive value (PPV; cases diagnosed correctly divided by the sum of true positives and false positives). Results Between 1969 and 2009, the NPR included 7286 tic disorder and 24 757 OCD cases. The vast majority (91.3% of tic cases and 80.1% of OCD cases) are coded with the most recent ICD version (ICD-10). For tic disorders, the PPV was high across all ICD versions (PPV=89% in ICD-8, 86% in ICD-9 and 97% in ICD-10). For OCD, only ICD-10 codes had high validity (PPV=91–96%). None of the epilepsy or depression control cases were wrongly diagnosed as having tic disorders or OCD, respectively. Inter-rater reliability was outstanding for both tic disorders (κ=1) and OCD (κ=0.98). Conclusions The validity and reliability of ICD codes for tic disorders and OCD in the Swedish NPR is generally high. We propose simple algorithms to further increase the confidence in the validity of these codes for epidemiological research. PMID:26100027

  17. Interrater Reliability of Chinese Medicine Diagnosis in People with Prediabetes

    PubMed Central

    Grant, Suzanne J.; Schnyer, Rosa N.; Chang, Dennis Hsu-Tung; Fahey, Paul; Bensoussan, Alan

    2013-01-01

    Background. Achieving reproducibility in research design is challenging when patient cohorts under study are inconsistently defined. Traditional Chinese medicine (TCM) diagnosis is one example where inconsistency between practitioners has been found. We hypothesise that the use of a validated instrument may improve consistency. Biochemical biomarkers may also be used enhance reliability. Methods. Twenty-seven participants with prediabetes were assessed by two TCM practitioners using a validated instrument (TEAMSI-TCM). Inter-rater reliability was summarised using percentage agreement and the kappa coefficient. One-way ANOVA and Tukey's post hoc test were used to test links between TCM diagnosis and biomarkers. Results. The two practitioners agreed on primary diagnosis of 70% of participants. kappa = 0.56 (P < 0.001). The three predominant TCM diagnostic patterns for people with prediabetes were Yin deficiency, Qi and Yin deficiency and Spleen qi deficiency. The Spleen Qi deficiency with Damp cohort had statistically significant higher fasting glucose, higher insulin, higher insulin resistance, higher HbA1c and lower HDL than those with Qi and Yin deficiency. Conclusions. Using the TEAMSI-TCM resulted in moderate interrater reliability between TCM practitioners. This study provides initial evidence of variation in the biomarkers of people with prediabetes according to the different TCM patterns which may suggest a route to further improving interrater reliability. PMID:23762155

  18. Identification of Reliable Sulcal Patterns of the Human Rolandic Region.

    PubMed

    Mellerio, Charles; Lapointe, Marie-Noël; Roca, Pauline; Charron, Sylvain; Legrand, Laurence; Meder, Jean-François; Oppenheim, Catherine; Cachia, Arnaud

    2016-01-01

    A major feature of the human cortex is its huge morphological variability. Although a comprehensive literature about the sulco-gyral pattern of the central region is available from post-mortem data, a reliable and reproducible characterization from in vivo data is still lacking. The aim of this study is to test the reliability of morphological criteria of the central region sulci used in post-mortem data, when applied to in vivo magnetic resonance imaging (MRI) data. Thirty right-handed healthy individuals were included in the study. Automated segmentation and three dimensional (3D) surface-based rendering were obtained from clinical 3D T1-weighted MRI. Two senior radiologists labeled the three sulci composing the central region (precentral [PreCS], central [CS] and postcentral [PostCS]) and analyzed their morphological variations using 47 standard criteria derived from Ono's atlas based on post-mortem data. For each criterion, inter-rater concordance and comparison with the occurrence frequency provided in Ono's atlas were estimated. Overall, the sulcal pattern criteria derived from MRI data were highly reproducible between the raters with a high mean inter-rater concordance in the three sulci (CS: κ = 0.92 in left hemisphere/κ = 0.91 in right hemisphere; PreCS: κ = 0.91/κ = 0.93; PostCS: κ = 0.84/0.79). Only a very limited number of sulcal criteria significantly differed between the in vivo and the post-mortem data (CS: 2 criteria in the left hemisphere/3 criteria in the right hemisphere; PreCS: 3 in the left and right hemispheres; PostCS: 3 in the left hemisphere and 5 in the right hemisphere). Our study provides a comprehensive description of qualitative sulcal patterns in the central region from in vivo clinical MRI with high agreement with previous post-mortem data. Such identification of reliable sulcal patterns of the central region visible with standard clinical MRI data paves the way for the detection of subtle variations of the central sulcation

  19. Identification of Reliable Sulcal Patterns of the Human Rolandic Region

    PubMed Central

    Mellerio, Charles; Lapointe, Marie-Noël; Roca, Pauline; Charron, Sylvain; Legrand, Laurence; Meder, Jean-François; Oppenheim, Catherine; Cachia, Arnaud

    2016-01-01

    A major feature of the human cortex is its huge morphological variability. Although a comprehensive literature about the sulco-gyral pattern of the central region is available from post-mortem data, a reliable and reproducible characterization from in vivo data is still lacking. The aim of this study is to test the reliability of morphological criteria of the central region sulci used in post-mortem data, when applied to in vivo magnetic resonance imaging (MRI) data. Thirty right-handed healthy individuals were included in the study. Automated segmentation and three dimensional (3D) surface-based rendering were obtained from clinical 3D T1-weighted MRI. Two senior radiologists labeled the three sulci composing the central region (precentral [PreCS], central [CS] and postcentral [PostCS]) and analyzed their morphological variations using 47 standard criteria derived from Ono’s atlas based on post-mortem data. For each criterion, inter-rater concordance and comparison with the occurrence frequency provided in Ono’s atlas were estimated. Overall, the sulcal pattern criteria derived from MRI data were highly reproducible between the raters with a high mean inter-rater concordance in the three sulci (CS: κ = 0.92 in left hemisphere/κ = 0.91 in right hemisphere; PreCS: κ = 0.91/κ = 0.93; PostCS: κ = 0.84/0.79). Only a very limited number of sulcal criteria significantly differed between the in vivo and the post-mortem data (CS: 2 criteria in the left hemisphere/3 criteria in the right hemisphere; PreCS: 3 in the left and right hemispheres; PostCS: 3 in the left hemisphere and 5 in the right hemisphere). Our study provides a comprehensive description of qualitative sulcal patterns in the central region from in vivo clinical MRI with high agreement with previous post-mortem data. Such identification of reliable sulcal patterns of the central region visible with standard clinical MRI data paves the way for the detection of subtle variations of the central sulcation

  20. Poor Reliability between Cochrane Reviewers and Blinded External Reviewers When Applying the Cochrane Risk of Bias Tool in Physical Therapy Trials

    PubMed Central

    Armijo-Olivo, Susan; Ospina, Maria; da Costa, Bruno R.; Egger, Matthias; Saltaji, Humam; Fuentes, Jorge; Ha, Christine; Cummings, Greta G.

    2014-01-01

    Objectives To test the inter-rater reliability of the RoB tool applied to Physical Therapy (PT) trials by comparing ratings from Cochrane review authors with those of blinded external reviewers. Methods Randomized controlled trials (RCTs) in PT were identified by searching the Cochrane Database of Systematic Reviews for meta-analysis of PT interventions. RoB assessments were conducted independently by 2 reviewers blinded to the RoB ratings reported in the Cochrane reviews. Data on RoB assessments from Cochrane reviews and other characteristics of reviews and trials were extracted. Consensus assessments between the two reviewers were then compared with the RoB ratings from the Cochrane reviews. Agreement between Cochrane and blinded external reviewers was assessed using weighted kappa (κ). Results In total, 109 trials included in 17 Cochrane reviews were assessed. Inter-rater reliability on the overall RoB assessment between Cochrane review authors and blinded external reviewers was poor (κ  =  0.02, 95%CI: −0.06, 0.06]). Inter-rater reliability on individual domains of the RoB tool was poor (median κ  = 0.19), ranging from κ  =  −0.04 (“Other bias”) to κ  =  0.62 (“Sequence generation”). There was also no agreement (κ  =  −0.29, 95%CI: −0.81, 0.35]) in the overall RoB assessment at the meta-analysis level. Conclusions Risk of bias assessments of RCTs using the RoB tool are not consistent across different research groups. Poor agreement was not only demonstrated at the trial level but also at the meta-analysis level. Results have implications for decision making since different recommendations can be reached depending on the group analyzing the evidence. Improved guidelines to consistently apply the RoB tool and revisions to the tool for different health areas are needed. PMID:24824199

  1. Determinants of the reliability of ultrasound tomography sound speed estimates as a surrogate for volumetric breast density

    SciTech Connect

    Khodr, Zeina G.; Pfeiffer, Ruth M.; Gierach, Gretchen L.; Sak, Mark A.; Bey-Knight, Lisa; Duric, Nebojsa; Littrup, Peter; Ali, Haythem; Vallieres, Patricia; Sherman, Mark E.

    2015-10-15

    Purpose: High breast density, as measured by mammography, is associated with increased breast cancer risk, but standard methods of assessment have limitations including 2D representation of breast tissue, distortion due to breast compression, and use of ionizing radiation. Ultrasound tomography (UST) is a novel imaging method that averts these limitations and uses sound speed measures rather than x-ray imaging to estimate breast density. The authors evaluated the reproducibility of measures of speed of sound and changes in this parameter using UST. Methods: One experienced and five newly trained raters measured sound speed in serial UST scans for 22 women (two scans per person) to assess inter-rater reliability. Intrarater reliability was assessed for four raters. A random effects model was used to calculate the percent variation in sound speed and change in sound speed attributable to subject, scan, rater, and repeat reads. The authors estimated the intraclass correlation coefficients (ICCs) for these measures based on data from the authors’ experienced rater. Results: Median (range) time between baseline and follow-up UST scans was five (1–13) months. Contributions of factors to sound speed variance were differences between subjects (86.0%), baseline versus follow-up scans (7.5%), inter-rater evaluations (1.1%), and intrarater reproducibility (∼0%). When evaluating change in sound speed between scans, 2.7% and ∼0% of variation were attributed to inter- and intrarater variation, respectively. For the experienced rater’s repeat reads, agreement for sound speed was excellent (ICC = 93.4%) and for change in sound speed substantial (ICC = 70.4%), indicating very good reproducibility of these measures. Conclusions: UST provided highly reproducible sound speed measurements, which reflect breast density, suggesting that UST has utility in sensitively assessing change in density.

  2. Reliability of the Hazelbaker Assessment Tool for Lingual Frenulum Function

    PubMed Central

    Amir, Lisa H; James, Jennifer P; Donath, Susan M

    2006-01-01

    Background About 3% of infants are born with a tongue-tie which may lead to breastfeeding problems such as ineffective latch, painful attachment or poor weight gain. The Hazelbaker Assessment Tool for Lingual Frenulum Function (HATLFF) has been developed to give a quantitative assessment of the tongue-tie and recommendation about frenotomy (release of the frenulum). The aim of this study was to assess the inter-rater reliability of the HATLFF. Methods Fifty-eight infants referred to the Breastfeeding Education and Support Services (BESS) at The Royal Women's Hospital for assessment of tongue-tie and 25 control infants were assessed by two clinicians independently. Results The Appearance items received kappas between about 0.4 to 0.6, which represents "moderate" reliability. The first three Function items (lateralization, lift and extension of tongue) had kappa values over 0.65 which indicates "substantial" agreement. The four Function items relating to infant sucking (spread, cupping, peristalsis and snapback) received low kappa values with insignificant p values. There was 96% agreement between the two assessors on the recommendation for frenotomy (kappa 0.92, excellent agreement). The study found that the Function Score can be more simply assessed using only the first three function items (ie not scoring the sucking items), with a cut-off of ≤4 for recommendation of frenotomy. Conclusion We found that the HATLFF has a high reliability in a study of infants with tongue-tie and control infants PMID:16722609

  3. Absolute and relative reliability of lumbar interspinous process ultrasound imaging measurements

    PubMed Central

    Tozawa, Ryosuke; Katoh, Munenori; Aramaki, Hidefumi; Kawasaki, Tsubasa; Nishikawa, Yuichi; Kumamoto, Tsuneo; Fujinawa, Osamu

    2016-01-01

    [Purpose] The intra- and inter-examiner reliabilities of lumbar interspinous process distances measured by ultrasound imaging were examined. [Subjects and Methods] The subjects were 10 males who had no history of orthopedic diseases or dysfunctions. Ten lumbar interspinous images from 360 images captured from 10 subjects were selected. The 10 images were measured by nine examiners. The lumbar interspinous process distance measurements were performed five times by each examiner. In addition, four of the nine examiners measured the distances again after 4 days for test-retest analysis. In statistical analysis, the intraclass correlation coefficient was used to investigate relative reliability, and Bland-Altman analysis was used to investigate absolute reliability. [Results] The intraclass correlation coefficients (1, 1) for intra-examiner reliability ranged from 0.985 to 0.998. For inter-rater reliability, the intraclass correlation coefficient (2, 1) was 0.969. The intraclass correlation coefficients (1, 2) for test-retest reliability ranged from 0.991 to 0.999. The Bland-Altman analysis results indicated no systematic error. [Conclusion] The results indicate that ultrasound measurements of interspinous process distance are highly reliable even when measured only once by a single person.

  4. Validity and reliability of the Spanish version of the DN4 (Douleur Neuropathique 4 questions) questionnaire for differential diagnosis of pain syndromes associated to a neuropathic or somatic component

    PubMed Central

    Perez, Concepcion; Galvez, Rafael; Huelbes, Silvia; Insausti, Joaquin; Bouhassira, Didier; Diaz, Silvia; Rejas, Javier

    2007-01-01

    Background This study assesses the validity and reliability of the Spanish version of DN4 questionnaire as a tool for differential diagnosis of pain syndromes associated to a neuropathic (NP) or somatic component (non-neuropathic pain, NNP). Methods A study was conducted consisting of two phases: cultural adaptation into the Spanish language by means of conceptual equivalence, including forward and backward translations in duplicate and cognitive debriefing, and testing of psychometric properties in patients with NP (peripheral, central and mixed) and NNP. The analysis of psychometric properties included reliability (internal consistency, inter-rater agreement and test-retest reliability) and validity (ROC curve analysis, agreement with the reference diagnosis and determination of sensitivity, specificity, and positive and negative predictive values in different subsamples according to type of NP). Results A sample of 164 subjects (99 women, 60.4%; age: 60.4 ± 16.0 years), 94 (57.3%) with NP (36 with peripheral, 32 with central, and 26 with mixed pain) and 70 with NNP was enrolled. The questionnaire was reliable [Cronbach's alpha coefficient: 0.71, inter-rater agreement coefficient: 0.80 (0.71–0.89), and test-retest intra-class correlation coefficient: 0.95 (0.92–0.97)] and valid for a cut-off value ≥ 4 points, which was the best value to discriminate between NP and NNP subjects. Discussion This study, representing the first validation of the DN4 questionnaire into another language different than the original, not only supported its high discriminatory value for identification of neuropathic pain, but also provided supplemental psychometric validation (i.e. test-retest reliability, influence of educational level and pain intensity) and showed its validity in mixed pain syndromes. PMID:18053212

  5. Reliability and validity of an iPhone® application for the measurement of lumbar spine flexion and extension range of motion

    PubMed Central

    Pourahmadi, Mohammad Reza; Jannati, Elham; Mohseni-Bandpei, Mohammad Ali; Ebrahimi Takamjani, Ismail; Rajabzadeh, Fatemeh

    2016-01-01

    Background Measurement of lumbar spine range of motion (ROM) is often considered to be an essential component of lumbar spine physiotherapy and orthopedic assessment. The measurement can be carried out through various instruments such as inclinometers, goniometers, and etc. Recent smartphones have been equipped with accelerometers and magnetometers, which, through specific software applications (apps) can be used for inclinometric functions. Purpose The main purpose was to investigate the reliability and validity of an iPhone® app (TiltMeter© -advanced level and inclinometer) for measuring standing lumbar spine flexion–extension ROM in asymptomatic subjects. Design A cross-sectional study was carried out. Setting This study was conducted in a physiotherapy clinic located at School of Rehabilitation Sciences, Iran University of Medical Science and Health Services, Tehran, Iran. Subjects A convenience sample of 30 asymptomatic adults (15 males; 15 females; age range = 18–55 years) was recruited between August 2015 and December 2015. Methods Following a 2–minute warm-up, the subjects were asked to stand in a relaxed position and their skin was marked at the T12–L1 and S1–S2 spinal levels. From this position, they were asked to perform maximum lumbar flexion followed by maximum lumbar extension with their knees straight. Two blinded raters each used an inclinometer and the iPhone ® app to measure lumbar spine flexion–extension ROM. A third rater read the measured angles. To calculate total lumbar spine flexion–extension ROM, the measurement from S1–S2 was subtracted from T12–L1. The second (2 hours later) and third (48 hours later) sessions were carried out in the same manner as the first session. All of the measurements were conducted 3 times and the mean value of 3 repetitions for each measurement was used for analysis. Intraclass correlation coefficient (ICC) models (3, k) and (2, k) were used to determine the intra-rater and inter-rater

  6. Reliability and validity of mobile teledermatology in HIV positive patients in Botswana: a pilot study

    PubMed Central

    Azfar, Rahat S; Lee, Robert A.; Castelo-Soccio, Leslie; Greenberg, Martin S.; Bilker, Warren B; Gelfand, Joel M; Kovarik, Carrie L

    2014-01-01

    Importance Mobile teledermatology may increase access to care. Objective To determine if mobile teledermatology in HIV positive patients in Gaborone, Botswana was reliable and produced valid consultations in comparison to face-to-face dermatology consultations. Design Cross-sectional study Setting Outpatient clinics and public inpatient settings in Botswana. Participants 76 HIV positive patients aged 18 years and up with a skin or mucosal complaint that had not been previously evaluated by a dermatologist. Main Outcome(s) and Measure(s) We calculated Cohen's kappa coefficient for diagnosis, diagnostic category and management for test-retest reliability and for inter-rater reliability. We also calculated sensitivity and specificity for each diagnosis. Results Cohen's kappa for test-retest reliability ranged from 0.47 (95% CI 0.35-0.59) to 0.78 (95% CI 0.67-0.88) for the primary diagnosis, 0.29 (95% CI 0.18-0.42) to 0.73 (95% CI 0.61-0.84) for diagnostic category, and 0.17 (95% CI -0.01-0.36) to 0.54 (95% CI 0.38-0.70) for management. Cohen's kappa for inter-rater reliability ranged from 0.41 (95% CI 0.31-0.52) to 0.51 (95% CI 0.41-0.61) for the primary diagnosis, from 0.22 (95% CI 0.14-0.31) to 0.43 (95% CI 0.34-0.53) for the diagnostic category for the primary diagnosis and from 0.08 (95% CI 0.02-0.15) to 0.12 (95% CI 0.01-0.23) for management. Sensitivity and specificity for the top ten diagnoses ranged from 0 to 0.88 and from 0.84 to 1 respectively. Conclusions and Relevance Our results suggest that while the use of mobile teledermatology technology in HIV-positive patients in Botswana has significant potential for improving access to care, additional work is needed to improve reliability and validity of this technology on a larger scale in this population. PMID:24622778

  7. Reliability of MR-Based Volumetric 3-D Analysis of Pelvic Muscles among Subjects with Low Back with Leg Pain and Healthy Volunteers

    PubMed Central

    Skorupska, Elżbieta; Keczmer, Przemysław; Łochowski, Rafał M.; Tomal, Paulina; Rychlik, Michał; Samborski, Włodzimierz

    2016-01-01

    Aim Lately, the diagnostic value of magnetic resonance imaging, Lasègue sign and classic neurological signs have been considered not accurate enough to distinguish the radicular from non-radicular low back with leg pain (LBLP) and a calculation of the symptomatic side muscle volume has been indicated as a probable valuable marker. However, only the multifidus muscle volume has been calculated so far. The main objective of the study was to verify whether LBLP subjects presented symptomatic side pelvic muscle atrophy compared to healthy volunteers. The second aim was to assess the inter-rater reliability of 3-D manual method for segmenting and measuring the volume of the gluteus maximus, gluteus medius, gluteus minimus and piriformis muscles in both LBLP patients and healthy subjects. Method Two independent raters analyzed MR images of LBLP and healthy subjects towards muscle volume of four pelvic muscles, i.e. the piriformis, gluteus minimus, gluteus medius and gluteus maximus. For both sides, the MR images of the muscles without adipose tissue infiltration were manually segmented in 3-D medical images. Results Symptomatic muscle atrophy was confirmed in only over 50% of LBLP subjects (gluteus maximus (p<0.001), gluteus minimus (p<0.01) and piriformis (p<0.05)). The ICC values indicated that the inter-rater reproducibility was greater than 0.90 for all measurements (LBLP and healthy subjects), except for the measurement of the right gluteus medius muscle in LBLP patients, which was equal to 0.848. Conclusion More than 50% of LBLP subjects presented symptomatic gluteus maximus, gluteus minimus and piriformis muscle atrophy. 3-D manual segmentation reliably measured muscle volume in all the measured pelvic muscles in both healthy and LBLP subjects. To answer the question of what kind of muscle atrophy is indicative of radicular or non-radicular pain further studies are required. PMID:27459688

  8. Development and reliability of an audit tool to assess the school physical activity environment across 12 countries

    PubMed Central

    Broyles, S T; Drazba, K T; Church, T S; Chaput, J-P; Fogelholm, M; Hu, G; Kuriyan, R; Kurpad, A; Lambert, E V; Maher, C; Maia, J; Matsudo, V; Olds, T; Onywera, V; Sarmiento, O L; Standage, M; Tremblay, M S; Tudor-Locke, C; Zhao, P; Katzmarzyk, P T

    2015-01-01

    Objectives: Schools are an important setting to enable and promote physical activity. Researchers have created a variety of tools to perform objective environmental assessments (or ‘audits') of other settings, such as neighborhoods and parks; yet, methods to assess the school physical activity environment are less common. The purpose of this study is to describe the approach used to objectively measure the school physical activity environment across 12 countries representing all inhabited continents, and to report on the reliability and feasibility of this methodology across these diverse settings. Methods: The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) school audit tool (ISAT) data collection required an in-depth training (including field practice and certification) and was facilitated by various supporting materials. Certified data collectors used the ISAT to assess the environment of all schools enrolled in ISCOLE. Sites completed a reliability audit (simultaneous audits by two independent, certified data collectors) for a minimum of two schools or at least 5% of their school sample. Item-level agreement between data collectors was assessed with both the kappa statistic and percent agreement. Inter-rater reliability of school summary scores was measured using the intraclass correlation coefficient. Results: Across the 12 sites, 256 schools participated in ISCOLE. Reliability audits were conducted at 53 schools (20.7% of the sample). For the assessed environmental features, inter-rater reliability (kappa) ranged from 0.37 to 0.96; 18 items (42%) were assessed with almost perfect reliability (κ=0.80–0.96), and a further 24 items (56%) were assessed with substantial reliability (κ=0.61–0.79). Likewise, scores that summarized a school's support for physical activity were highly reliable, with the exception of scores assessing aesthetics and perceived suitability of the school grounds for sport, informal games and general

  9. Reliability of clinical competency evaluation list for novice physical and occupational therapists requiring assistance

    PubMed Central

    Kanada, Yoshikiyo; Sakurai, Hiroaki; Sugiura, Yoshito; Hirano, Yudai; Koyama, Soichiro; Tanabe, Shigeo

    2015-01-01

    [Purpose] This study examined the reliability of a clinical ability evaluation table developed in a previous study with the aim of clarifying the abilities necessary for therapists to independently implement their duties. [Subjects and Methods] Forty-eight physical therapists with less than 2 years of clinical experience were targeted for evaluation, 48 main supervisors, and 48 sub-supervisors, 144 in total, were studied. [Results] The total score was lower when the evaluation was conducted by the target therapists themselves than when it was conducted by the main or sub-supervisors. Regarding the reliability of the total scores for the entire scale and each category, values representing the intra-rater reliability were higher when the evaluation was conducted by the target therapists or main supervisors, while there were marked differences between high and low values for each item. Regarding the inter-rater reliability, both the total scores for the entire scale and each category, as well as values for each item, were low. [Conclusion] Values representing the intra-rater reliability of the study table were low, indicating the necessity of further improvement. PMID:26644669

  10. Content validity and reliability of test of gross motor development in Chilean children

    PubMed Central

    Cano-Cappellacci, Marcelo; Leyton, Fernanda Aleitte; Carreño, Joshua Durán

    2016-01-01

    ABSTRACT OBJECTIVE To validate a Spanish version of the Test of Gross Motor Development (TGMD-2) for the Chilean population. METHODS Descriptive, transversal, non-experimental validity and reliability study. Four translators, three experts and 92 Chilean children, from five to 10 years, students from a primary school in Santiago, Chile, have participated. The Committee of Experts has carried out translation, back-translation and revision processes to determine the translinguistic equivalence and content validity of the test, using the content validity index in 2013. In addition, a pilot implementation was achieved to determine test reliability in Spanish, by using the intraclass correlation coefficient and Bland-Altman method. We evaluated whether the results presented significant differences by replacing the bat with a racket, using T-test. RESULTS We obtained a content validity index higher than 0.80 for language clarity and relevance of the TGMD-2 for children. There were significant differences in the object control subtest when comparing the results with bat and racket. The intraclass correlation coefficient for reliability inter-rater, intra-rater and test-retest reliability was greater than 0.80 in all cases. CONCLUSIONS The TGMD-2 has appropriate content validity to be applied in the Chilean population. The reliability of this test is within the appropriate parameters and its use could be recommended in this population after the establishment of normative data, setting a further precedent for the validation in other Latin American countries. PMID:26815160

  11. Reliability and validity of the modified functional ambulation category scale in patients with hemiparalysis

    PubMed Central

    Park, Chang Sik; An, Seung Heon

    2016-01-01

    [Purpose] This study aimed to examine the inter- and intra-rater reliability and validity of the modified functional ambulation category (mFAC) scale. [Subjects and Methods] The participants were 66 stroke patients with hemiparalysis. The inter- and intra-rater validity of the mFAC was calculated using the Spearman correlation coefficient. A score comparison of the stable or maximum gait speed with regard to mFAC and modified Rivermead Mobility Index (mRMI) performances was performed as a univariate linear regression analysis to determine how the Kruskal-Wallis test affects the mRMI and stable/maximum gait speed with regard to mFAC. [Results] The inter-rater reliability of the mFAC (intraclass coefficient [ICC]) was 0.982 (0.971–0.989), with a kappa coefficient of 0.923 and a consistency ratio of 94%. In contrast, the intra-rater reliability of the mFAC (ICC) was 0.991 (0.986–0.995), with a kappa coefficient of 0.961 and a consistency ratio of 96%, showing higher reliability. Moreover, there was a significant difference in stable/maximum gait speed between the mFAC and the mRMI. [Conclusion] Since the mFAC has sufficient inter- and intra-reliability and high validity, it can be used as an assessment tool that reflects the gait performance and mobility of stroke patients.

  12. The Reliability of Oral and Pharyngeal Dimensions Captured with Acoustic Pharyngometry.

    PubMed

    Molfenter, Sonja M

    2016-08-01

    Acoustic Pharyngometry (APh) is a method for quantifying oropharyngeal tract configuration using sound wave reflection and is commonly used in diagnostics and research of sleep apnea. The standard preset output of APh (minimal cross-sectional area) has been established as reliable. However, by conducting post-processing measures on specific breathing tasks, APh data can also reveal oral length, oral volume, pharyngeal length, and pharyngeal volume. Given that these measures may have utility in dysphagia research, the reliability of these measures is unknown and is the focus of the current study. Ten young healthy female volunteers completed two sessions of APh data collection to obtain measures of oral length, oral volume, pharyngeal length, and pharyngeal volume 1 week apart. Two-way mixed intraclass correlation coefficients were calculated to establish intra-rater reliability, inter-rater reliability, and test-retest reliability. Results revealed excellent levels of agreement within and across raters for all oropharyngeal tract parameters. Levels of test-retest agreement for oral length and oral volume indicated these parameters are appropriate for monitoring change within an individual. All parameters were deemed to have acceptable test-retest values as outcome measures in group-level analysis. PMID:27262868

  13. A new MRI rating scale for progressive supranuclear palsy and multiple system atrophy: validity and reliability

    PubMed Central

    Rolland, Yan; Vérin, Marc; Payan, Christine A; Duchesne, Simon; Kraft, Eduard; Hauser, Till K; Jarosz, Josef; Deasy, Neil; Defevbre, Luc; Delmaire, Christine; Dormont, Didier; Ludolph, Albert C; Bensimon, Gilbert

    2011-01-01

    Aim To evaluate a standardised MRI acquisition protocol and a new image rating scale for disease severity in patients with progressive supranuclear palsy (PSP) and multiple systems atrophy (MSA) in a large multicentre study. Methods The MRI protocol consisted of two-dimensional sagittal and axial T1, axial PD, and axial and coronal T2 weighted acquisitions. The 32 item ordinal scale evaluated abnormalities within the basal ganglia and posterior fossa, blind to diagnosis. Among 760 patients in the study population (PSP=362, MSA=398), 627 had per protocol images (PSP=297, MSA=330). Intra-rater (n=60) and inter-rater (n=555) reliability were assessed through Cohen's statistic, and scale structure through principal component analysis (PCA) (n=441). Internal consistency and reliability were checked. Discriminant and predictive validity of extracted factors and total scores were tested for disease severity as per clinical diagnosis. Results Intra-rater and inter-rater reliability were acceptable for 25 (78%) of the items scored (≥0.41). PCA revealed four meaningful clusters of covarying parameters (factor (F) F1: brainstem and cerebellum; F2: midbrain; F3: putamen; F4: other basal ganglia) with good to excellent internal consistency (Cronbach α 0.75–0.93) and moderate to excellent reliability (intraclass coefficient: F1: 0.92; F2: 0.79; F3: 0.71; F4: 0.49). The total score significantly discriminated for disease severity or diagnosis; factorial scores differentially discriminated for disease severity according to diagnosis (PSP: F1–F2; MSA: F2–F3). The total score was significantly related to survival in PSP (p<0.0007) or MSA (p<0.0005), indicating good predictive validity. Conclusions The scale is suitable for use in the context of multicentre studies and can reliably and consistently measure MRI abnormalities in PSP and MSA. Clinical Trial Registration Number The study protocol was filed in the open clinical trial registry (http://www.clinicaltrials.gov) with

  14. Reliability and Validity Study of Clinical Ultrasound Imaging on Lateral Curvature of Adolescent Idiopathic Scoliosis

    PubMed Central

    Wang, Q.; Li, M.; Lou, Edmond H. M.; Wong, M. S.

    2015-01-01

    Background Non-ionizing radiation imaging assessment has been advocated for the patients with adolescent idiopathic scoliosis (AIS). As one of the radiation-free methods, ultrasound imaging has gained growing attention in scoliosis assessment over the past decade. The center of laminae (COL) method has been proposed to measure the spinal curvature in the coronal plane of ultrasound image. However, the reliability and validity of this ultrasound method have not been validated in the clinical setting. Objectives To evaluate the reliability and validity of clinical ultrasound imaging on lateral curvature measurements of AIS with their corresponding magnetic resonance imaging (MRI) measurements. Methods Thirty curves (ranged 10.2°–68.2°) from sixteen patients with AIS were eligible for this study. The ultrasound scan was performed using a 3-D ultrasound unit within the same morning of MRI examination. Two researchers were involved in data collection of these two examinations. The COL method was used to measure the coronal curvature in ultrasound image, compared with the Cobb method in MRI. The intra- and inter-rater reliability of the COL method was evaluated by intra-class correlation coefficient (ICC). The validity of this method was analyzed by paired Student’s t-test, Bland–Altman statistics and Pearson correlation coefficient. The level of significance was set as 0.05. Results The COL method showed high intra- and inter-rater reliabilities (both with ICC (2, K) >0.9, p<0.05) to measure the coronal curvature. Compared with Cobb method, COL method showed no significant difference (p<0.05) when measuring coronal curvature. Furthermore, Bland-Altman method demonstrated an agreement between these two methods, and Pearson’s correlation coefficient (r) was high (r>0.9, p<0.05). Conclusion The ultrasound imaging could provide a reliable and valid measurement of spinal curvature in the coronal plane using the COL method. Further research is needed to validate the

  15. Reliability of the Eight Guiding Principles and Syndrome Diagnosis in Chinese Medicine Diagnosis of Patients with Knee Osteoarthritis.

    PubMed

    Hua, Bin; Abbas, Estelle; Hayes, Alan; Ryan, Peter F; Nelson, Lisa; O'Brien, Kylie

    2012-08-21

    Abstract Background: A Chinese medicine (CM) "Syndrome" or "pattern of disharmony" is a diagnostic subcategory of a disease/disorder or symptom, characterized by particular symptoms and signs, and indicative of the etiology and the state of pathogenesis at that point in time. In CM, treatment is aimed at addressing the disease/disorder and the underlying CM Syndrome. A few studies have assessed reliability of CM Syndrome diagnosis according to one of the major CM theories, Zang-Fu theory, but only 1 study has investigated the reliability of diagnosis according to a fundamental theory, that of the Eight Guiding Principles. Given that treatment follows diagnosis, if diagnosis is not reliable there will be lower confidence that optimal treatment is received. There have not yet been any reliability studies in osteoarthritis (OA). Little is known about the characteristics or Syndromes of OA with respect to the Eight Guiding Principles and Zang-Fu theory. Objectives: The objectives of this study were to characterize diagnostic subcategories of OA according to the Eight Guiding Principles and Zang-Fu theory and to investigate the inter-rater reliability of CM diagnosis according to these two theories. Methods: An inter-rater reliability study was conducted as a substudy of a clinical trial investigating the treatment of knee OA with Chinese herbal medicine. Two (2) experienced CM practitioners conducted a CM examination separately, within 2 hours of each other, of 40 participants. A CM assessment form was utilized to record the diagnostic data. Cohen's κ coefficient was used as a measure of reliability. Results: Results support the concept that knee OA is more likely a disease with characteristics of Interior, Deficiency, and Yin according to the Eight Guiding Principles. There was no clear agreement on CM Syndromes of knee OA according to Zang-Fu theory. The main Zang Organs involved were broadly agreed on; they were Kidney, Liver, and Spleen. Conclusions: Results lend

  16. Practices in adequate structural design

    NASA Astrophysics Data System (ADS)

    Ryan, Robert S.

    An account is given of the guidelines for safe and reliable space vehicle design, especially in the structural engineering area, which have been formulated by NASA in the aftermath of the Space Shuttle Challenger accident in 1986. Illustrative examples are presented from state-of-the-art, performance-driven hardware whose design ineluctably gives rise to a high sensitivity to small variations and uncertainties. It is recommended that such hardware be designed with a view to easy inspectability and manufacturability, with emphasis on the role played in system structures by fracture mechanics. Static and dynamic coupling effects must be precluded wherever possible.

  17. Field reliability of the SAVRY with juvenile probation officers: Implications for training.

    PubMed

    Vincent, Gina M; Guy, Laura S; Fusco, Samantha L; Gershenson, Bernice G

    2012-06-01

    Two complimentary studies were conducted to investigate the inter-rater reliability and performance of juvenile justice personnel when conducting the Structured Assessment of Violence Risk for Youth (SAVRY). Study 1 reports the performance on four standardized vignettes of 408 juvenile probation officers (JPOs) and social workers rating the SAVRY as part of their training. JPOs had high agreement with the expert consensus on the SAVRY rating of overall risk and total scores, but those trained by a peer master trainer outperformed those trained by an expert. Study 2 examined the field reliability of the SAVRY on 80 young offender cases rated by a JPO and a trained research assistant. In the field, intra-class correlation coefficients were 'excellent' for SAVRY total and most domain scores, and were 'good' for overall risk ratings. Results suggest that the SAVRY and structured professional judgment can be used reliably in the field by juvenile justice personnel and is comparable to reliability indices reported in more lab-like research studies; however, replication is essential. PMID:22667812

  18. Reliability of the direct observation of procedural skills assessment tool for ultrasound-guided regional anaesthesia.

    PubMed

    Chuan, A; Thillainathan, S; Graham, P L; Jolly, B; Wong, D M; Smith, N; Barrington, M J

    2016-03-01

    The Direct Observation of Procedural Skills (DOPS) form is used as a workplace-based assessment tool in the current Australian and New Zealand College of Anaesthetists curriculum. The objective of this study was to evaluate the reliability of DOPS when used to score trainees performing ultrasound-guided regional anaesthesia. Reliability of an assessment tool is defined as the reproducibility of scores given by different assessors viewing the same trainee. Forty-nine anaesthetists were recruited to score two scripted videos of trainees performing a popliteal sciatic nerve block and an axillary brachial plexus block. Reliability, as measured by intraclass correlation coefficients, was -0.01 to 0.43 for the individual items in DOPS, and 0.15 for the 'Overall Performance for this Procedure' item. Assessors demonstrated consistency of scoring within DOPS, with significant correlation of sum of individual item scores with the 'Overall Performance for this Procedure' item (r=0.78 to 0.80, P<0.001), and with yes versus no responses to the 'Was the procedure completed satisfactorily?' item (W=24, P=0.0004, Video 1, and W=65, P=0.003, Video 2). While DOPS demonstrated a good degree of internal consistency in this setting, inter-rater reliability did not reach levels generally recommended for formative assessment tools. Feasibility of the form could be improved by removing the 'Was the procedure completed satisfactorily?' item without loss of information. PMID:27029652

  19. A sensitive and reliable test instrument to assess swimming in rats with spinal cord injury.

    PubMed

    Xu, Ning; Åkesson, Elisabet; Holmberg, Lena; Sundström, Erik

    2015-09-15

    For clinical translation of experimental spinal cord injury (SCI) research, evaluation of animal SCI models should include several sensorimotor functions. Validated and reliable assessment tools should be applicable to a wide range of injury severity. The BBB scale is the most widely used test instrument, but similar to most others it is used to assess open field ambulation. We have developed an assessment tool for swimming in rats with SCI, with high discriminative power and sensitivity to functional recovery after mild and severe injuries, without need for advanced test equipment. We studied various parameters of swimming in four groups of rats with thoracic SCI of different severity and a control group, for 8 weeks after surgery. Six parameters were combined in a multiple item scale, the Karolinska Institutet Swim Assessment Tool (KSAT). KSAT scores for all SCI groups showed consistent functional improvement after injury, and significant differences between the five experimental groups. The internal consistency, the inter-rater and the test-retest reliability were very high. The KSAT score was highly correlated to the cross-section area of white matter spared at the injury epicenter. Importantly, even after 8 weeks of recovery the KSAT score reliably discriminated normal animals from those inflicted by the mildest injury, and also displayed the recovery of the most severely injured rats. We conclude that this swim scale is an efficient and reliable tool to assess motor activity during swimming, and an important addition to the methods available for evaluating rat models of SCI. PMID:25986406

  20. Assessment of self-disorders in a non-clinical population: Reliability and association with schizotypy.

    PubMed

    Torbet, Georgina; Schulze, Dani; Fiedler, Anna; Reuter, Benedikt

    2015-08-30

    This study explores whether self-disorders occur and can be assessed reliably in a non-clinical sample, and whether the prevalence of these anomalies depends upon the degree of psychometrically defined schizotypy. Participants with either high (n=30) or low (n=20) schizotypy scores were interviewed using a modified version of the Examination of Anomalous Self-Experience (EASE). The degree to which interviewees experienced self-disorder symptoms was rated by the interviewer and an independent rater. Inter-rater reliability was calculated for each item, domain scores and the total score. For the total, sample most items (=66) showed substantial or perfect agreement (κ>0.61), with a few (=6) showing moderate agreement (κ>0.41). Reliability scores were only slightly lower when just the more homogeneous group of individuals with high Schizotypal Personality Questionnaire (SPQ) scores were examined. As expected, high SPQ scores were associated with a high level of self-disorders. In sum, the results suggest that self-disorders can be measured reliably in non-clinical samples and are particularly frequent in individuals with pronounced schizotypical traits. PMID:26032462

  1. Reliability of the universal goniometer for assessing active cervical range of motion in asymptomatic healthy persons

    PubMed Central

    Farooq, Muhammad Nazim; Bandpei, Mohammad A. Mohseni; Ali, Mudassar; Khan, Ghazanfar Ali

    2016-01-01

    Objective: To determine within-rater and between-rater reliability of the universal goniometer (UG) for measuring active cervical range of motion (ACROM) in asymptomatic healthy subjects. Methods: Nineteen healthy subjects were tested in an identical seated position. Two raters used UG to measure active cervical movements of flexion, extension, right side flexion, left side flexion, right rotation and left rotation. Each motion was measured twice by each of the two raters and was re-measured all over again after one week. Data analysis was performed using the intraclass correlation coefficient (ICC). Results: The results demonstrated excellent within-session (ICC2,1 = 0.83 to 0.98) and between-session (ICC2,2 = 0.79 to 0.97) intra-rater reliability and excellent inter-rater reliability (ICC2,2 = 0.79 to 0.92). Conclusion: Considering above results it is concluded that UG is a reliable tool for assessing ACROM in a clinical setting for healthy subjects. PMID:27182261

  2. Brief Assessment of Motor Function: Content Validity and Reliability of the Upper Extremity Gross Motor Scale

    PubMed Central

    Cintas, Holly Lea; Parks, Rebecca; Don, Sarah; Gerber, Lynn

    2011-01-01

    Content validity and reliability of the Brief Assessment of Motor Function (BAMF) Upper Extremity Gross Motor Scale (UEGMS) were evaluated in this prospective, descriptive study. The UEGMS is one of five ordinal scales designed for quick documentation of gross, fine and oral motor skill levels. Designed to be independent of age and diagnosis, it is intended for use for infants through young adults. An expert panel of 17 physical therapists and 13 occupational therapists refined the content by responding to a standard questionnaire comprised of questions which asked whether each item should be included, is clearly worded, should be reordered higher or lower, is functionally relevant, and is easily discriminated. Ratings of content validity exceeded the criterion except for two items which may represent different perspectives of physical and occupational therapists. The UEGMS was modified using the quantitative and qualitative feedback from the questionnaires. For reliability, five raters scored videotaped motor performances of ten children. Coefficients for inter-rater (0.94) and intra-rater (0.95) reliability were high. The results provide evidence of content validity and reliability of the UEGMS for assessment of upper extremity gross motor skill. PMID:21599568

  3. Practices in Adequate Structural Design

    NASA Technical Reports Server (NTRS)

    Ryan, Robert S.

    1989-01-01

    Structural design and verification of space vehicles and space systems is a very tricky and awe inspiring business, particularly for manned missions. Failures in the missions with loss of life is devastating personally and nationally. The scope of the problem is driven by high performance requirements which push state-of-the-art technologies, creating high sensitivites to small variations and uncertainties. Insurance of safe, reliable flight dictates the use of sound principles, procedures, analysis, and testing. Many of those principles which were refocused by the Space Shuttle Challenger (51-L) accident on January 26, 1986, and the activities conducted to insure safe shuttle reflights are discussed. The emphasis will be focused on engineering, while recognizing that project and project management are also key to success.

  4. Practices in adequate structural design

    NASA Astrophysics Data System (ADS)

    Ryan, Robert S.

    1989-01-01

    Structural design and verification of space vehicles and space systems is a very tricky and awe inspiring business, particularly for manned missions. Failures in the missions with loss of life is devastating personally and nationally. The scope of the problem is driven by high performance requirements which push state-of-the-art technologies, creating high sensitivites to small variations and uncertainties. Insurance of safe, reliable flight dictates the use of sound principles, procedures, analysis, and testing. Many of those principles which were refocused by the Space Shuttle Challenger (51-L) accident on January 26, 1986, and the activities conducted to insure safe shuttle reflights are discussed. The emphasis will be focused on engineering, while recognizing that project and project management are also key to success.

  5. Are improved rater reliability results associated with faster reaction times after rater training for judgments of laryngeal mucus?

    NASA Astrophysics Data System (ADS)

    Bonilha, Heather S.; Dawson, Amy; McGrattan, Katlyn

    2012-02-01

    Mucus aggregation on the vocal folds, a common complaint amongst persons with voice disorders, has been visually rated on four parameters: type, pooling, thickness, and location. Rater training is used to improve the reliability and accuracy of these ratings. The goal of this study was to evaluate the effect of training on rater reliability, accuracy and response time. Two raters scored mucus aggregation from 120 stroboscopic exams after a brief introductory session and again after a thorough training session. Reliability and accuracy were calculated in percent agreement. Two-tail paired t-tests were used to assess differences in reaction time for ratings before and after training. Inter-rater reliability improved from 79% pre-training to 92% post-training. Intra-rater reliability improved from 77% to 91% for Rater 1 and 80% to 88% for Rater 2 following training. Accuracy improved from 80% to 96% for Rater 1 and 76% to 95% for Rater 2 from pre- to post-training. Reaction time decreased for both raters (p=0.025). These findings further our understanding of observer performance on judgments of laryngeal mucus. These results suggest that rater training increases reliability and accuracy while decreasing reaction time. Future studies should assess the relationship of these judgments and voice changes.

  6. Reliability of a New Radiographic Classification for Developmental Dysplasia of the Hip

    PubMed Central

    Narayanan, Unni; Mulpuri, Kishore; Sankar, Wudbhav N.; Clarke, Nicholas M.P.; Hosalkar, Harish

    2015-01-01

    Background: Existing radiographic classification schemes (eg, Tönnis criteria) for DDH quantify the severity of disease based on the position of the ossific nucleus relative to Hilgenreiner’s and Perkin’s lines. By definition, this method requires the presence of an ossification centre, which can be delayed in appearance and eccentric in location within the femoral head. A new radiographic classification system has been developed by the International Hip Dysplasia Institute (IHDI), which uses the mid-point of the proximal femoral metaphysis as a reference landmark, and can therefore be applied to children of all ages. The purpose of this study was to compare the reliability of this new method with that of Tönnis, as the first step in establishing its validity and clinical utility. Methods: Twenty standardized anteroposterior pelvic radiographs of children with untreated DDH were selected purposefully to capture the spectrum of age (range, 3 to 32 mo) at presentation and disease severity. Each of the hips was classified separately by the IHDI and Tönnis methods by 6 experienced pediatric orthopaedists from the United States, Canada, Mexico, United Kingdom, and by 2 orthopaedic senior residents. The inter-rater reliability was tested using the Intra Class Correlation coefficient (ICC) to measure concordance between raters. Results: All 40 hips were classifiable by the IHDI method by all raters. Ten of the 40 hips could not be classified by the Tönnis method because of the absence of the ossific nucleus on one or both sides. The ICC (95% confidence interval) for the IHDI method for all raters was 0.90 (0.83-0.95) and 0.95 (0.91-0.98) for the right and left hips, respectively. The corresponding ICCs for the Tönnis method were 0.63 (0.46-0.80) and 0.60 (0.43-0.78), respectively. There was no significant difference between the ICCs of the 6 experts and 2 trainees. Conclusions: The IHDI method of classification has excellent inter-rater reliability, both among

  7. Reliability and utility of the Behaviour Support Plan Quality Evaluation tool (BSP-QEII) for auditing and quality development in services for adults with intellectual disability and challenging behaviour.

    PubMed

    McVilly, K; Webber, L; Paris, M; Sharp, G

    2013-08-01

    Background  Having an objective means of evaluating the quality of behaviour support plans (BSPs) could assist service providers and statutory authorities to monitor and improve the quality of support provided to people with intellectual disability (ID) who exhibit challenging behaviour. The Behaviour Support Plan Quality Evaluation Guide II (BSP-QEII) was developed to monitor and assess BSPs prepared by teachers to support children with disability in the school system. This study investigated the application of the BSP-QEII to the assessment of BSPs for adults with ID in community support services. Method  The inter-rater reliability of the BSP-QEII was assessed. The utility of the BPS-QEII was then investigated with reference to a time series study of matched pairs of BSPs, developed for the same clients over a period of approximately 3 years. Differences in plan quality measured across a number of service and systemic variables were also investigated. Results  The BSP-QEII was found to have good inter-rater reliability and good utility for audit purposes. It was able to discriminate changes in plan quality over time. Differences in plan quality were also evident across different service types, where specialist staff had or had not been involved, and in some instances where a statutory format for the plan had or had not been used. There were no differences between plans developed by government and community sector agencies, nor were there any regional differences across the jurisdiction. Conclusions  The BSP-QEII could usefully be adopted as an audit tool for measuring the quality of BSPs for adults with ID. In addition to being used for research and administrative auditing, the principles underpinning the BSP-QEII could also be useful to guide policy and educational activities for staff in community based services for adults with ID. PMID:22845772

  8. Macroscopic technique for the evaluation of oral tongue tumour thickness: a reliable intraoperative method.

    PubMed

    Pandey, M; Vidhyadharan, S; Puthalath, U; Veeraraghavan, R; Sukumaran, S V; Prasad, C; Iyer, S; Thankappan, K

    2016-08-01

    There is no reliable method to assess tumour thickness preoperatively or intraoperatively in cases of oral tongue squamous cell carcinoma (SCC). The purpose of this study was to evaluate the efficacy of a macroscopic technique to measure tumour thickness. This was a prospective study of 51 consecutive patients with T1/T2 primary SCC of the oral tongue. All patients underwent primary resection with ipsilateral neck dissection. Thickness measurements were obtained using Vernier calipers on the fresh specimen. The technique was correlated with the microscopic evaluation statistically using (1) Pearson's correlation coefficient, (2) intra-class correlation, and (3) Bland-Altman plot with 95% confidence intervals. On comparing the macroscopic technique to the microscopic evaluation, Pearson's correlation (r) was 0.915 (P<0.001). The inter-rater reliability using the intra-class correlation coefficient was 0.955. The Bland-Altman plot to test the agreement between the techniques showed the average difference between macroscopic thickness and microscopic thickness (bias) to be -0.421, with 95% limits of agreement of -3.166 and 2.82. There was a significant correlation and agreement between the macroscopic and microscopic measures of tumour thickness. The macroscopic technique could be used as a reliable tool to measure tumour thickness intraoperatively, prior to neck dissection. PMID:27034158

  9. Validity and reliability of upper extremity three-dimensional kinematics during a typing task.

    PubMed

    Levanon, Yafa; Gefen, Amit; Lerman, Yehuda; Givon, Uri; Ratzon, Navah Z

    2010-10-01

    Computer use continues to be considered a risk factor for work-related musculoskeletal disorders despite a greater awareness of the risk associated with excessive use, the implementation of safety features and the introduction of extensive interventional programs. Better understanding of risk factors in movement patterns is needed. This study identified the most suitable variable for work-related upper extremity motion analysis as being peak-to-peak range of motion. Assessment was by three-dimensional motion analysis for upper extremity ergonomics. The study was designed to validate and examine the reliability of these parameters in the setting of keyboarding. Sixty-two right-hand dominant participants (non-skilled typists) were recruited. Motion analysis was performed using the Cartesian Optoelectronic Dynamic Anthropometric CX-1 (CODA) system with markers which were attached to the right hand, elbow, wrist and fingers. Range of motion and angular velocity were recorded while the subjects repeatedly typed a predetermined sentence five times. The re-test examination was repeated after an interval of one week. The findings clearly demonstrated discriminative validity in wrist range of motion (p<.01), test-re-test, reliability (.83>ICC>.70) and inter-rater reliability (.95>ICC>.70) for most variables. The CODA system has considerable potential for understanding movement patterns in the upper extremities. These findings can provide the basis for future studies on the efficacy of ergonomic intervention programs. PMID:20678936

  10. Scales for rating motor impairment in Parkinson's disease: studies of reliability and convergent validity.

    PubMed Central

    Henderson, L; Kennard, C; Crawford, T J; Day, S; Everitt, B S; Goodrich, S; Jones, F; Park, D M

    1991-01-01

    Study 1 examined the reliability of the ratings assigned to the performance of five sign-and-symptom items drawn from tests of motor impairment in Parkinson's disease. Patients with Parkinson's disease of varying severity performed gait, rising from chair, and hand function items. Video recordings of these performances were rated by a large sample of experienced and inexperienced neurologists and by psychology undergraduates, using a four point scale. Inter-rater reliability was moderately high, being higher for gait than hand function items. Clinical experience proved to have no systematic effect on ratings or their reliability. The idiosyncrasy of particular performances was a major source of unreliable ratings. Study 2 examined the intercorrelation of several standard rating scales, comprised of sign-and-symptom items as well as activities of daily living. The correlation between scales was high, ranging from 0.70 to 0.83, despite considerable differences in item composition. Inter-item correlations showed that the internal cohesion of the tests was high, especially for the self-care scale. Regression analysis showed that the relationship between the scales could be efficiently captured by a small selection of test items, allowing the construction of a much briefer test. PMID:2010754

  11. Reliability and validity of the Korean version of the community balance and mobility scale in patients with hemiplegia after stroke

    PubMed Central

    Lee, Kyoung-bo; Lee, Paul; Yoo, Sang-won; Kim, Young-dong

    2016-01-01

    [Purpose] The aim of this study was to translate and adapt the Community Balance and Mobility Scale (CB&M) into Korean (K-CB&M) and to verify the reliability and validity of scores obtained with Korean patients. [Subjects and Methods] A total of 16 subjects were recruited from St. Vincent’s Hospital in South Korea. At each testing session, subjects completed the K-CB&M, Berg balance scale (BBS), timed up and go test (TUG), and functional reaching test. All tests were administered by a physical therapist, and subjects completed the tests in an identical standardized order during all testing sessions. [Results] The inter- and intra-rater reliability coefficients were high for most subscores, while moderate inter-rater reliability was observed for the items “walking and looking” and “walk, look, and carry”, and moderate intra-rater reliability was observed for “forward to backward walking”. There was a positive correlation between the K-CB&M and BBS and a negative correlation between the K-CB&M and TUG in the convergent validity assessments. [Conclusion] The reliability and validity of the K-CB&M was high, suggesting that clinical practitioners treating Korean patients with hemiplegia can use this material for assessing static and dynamic balance.

  12. Converting Three General-Cognitive Function Scales into Persian and Assessment of Their Validity and Reliability

    PubMed Central

    Moin, Payam; Khalighinejad, Nima; Yusefi, Arash; Farajzadegan, Ziba; Barekatain, Majid

    2011-01-01

    Objectives: Glasgow Outcome Scale Extended (GOSE), Galveston Amnesia and orientation Test (GOAT) and Disability Rating Scale (DRS) are three popular outcome measure tools used principally in traumatic brain injury (TBI) patients. We conducted this study to provide a Farsi version of these outcome scales for use in Iran. Methods: Following a comprehensive literature review, Farsi transcripts were prepared by “forward-backward” translation and reviewed by subject experts. After a pretest on a few patients, the final versions were obtained. 38 patients with closed head injury were interviewed simultaneously by two interviewers. Main statistics used to assess validity and reliability included “Factor analysis” for construct validity, Cronbach’s alpha for internal consistency, and Pearson Correlation and Kappa Coefficient for inter-rater agreement. Results: Factor analysis for Farsi-GOAT (FGOAT) revealed 5 independent factors with a total distribution variance of 80.2%. For Farsi-DRS (FDRS), 3 independent factors were found with a 92.3% variance. The Cronbach’s alpha (95% confidence interval) was 0.84 (0.763- 0.919) and 0.91 (0.901-0.919) for FGOAT and FDRS, respectively. Pearson Correlation between total scores of two raters was 0.98 and 0.97 for FGOAT and FDRS, in order. Kappa coefficient (95% CI) between outcome rankings of raters was 0.73 (0.618-0.852) and 0.68 (0.594-0.770) for FGOAT and FDRS, respectively. As for Farsi-GOSE scale, Kappa value was 0.4 (0.285-0.507) for 8-level outcome ranking and improved to 0.7 (0.585-0.817) for 5-level scale. We found a good correlation between FDRS and FGOSE predicted prognoses (Spearman’s rho= 0.74, 95% CI: 0.676-0.802). Conclusions: FDRS and FGOAT had appropriate validity and reliability. The 8-level outcome FGOSE scale disclosed a low inter-rater agreement, but a suitable observer agreement was achieved when the 5-level outcome was applied. PMID:21603013

  13. 21 CFR 1404.900 - Adequate evidence.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Adequate evidence. 1404.900 Section 1404.900 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 1404.900 Adequate evidence. Adequate evidence means information sufficient to support the reasonable belief that a particular...

  14. 29 CFR 98.900 - Adequate evidence.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Adequate evidence. 98.900 Section 98.900 Labor Office of the Secretary of Labor GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 98.900 Adequate evidence. Adequate evidence means information sufficient to support the reasonable belief that a...

  15. Development of a Haptic Elbow Spasticity Simulator (HESS) for Improving Accuracy and Reliability of Clinical Assessment of Spasticity

    PubMed Central

    Park, Hyung-Soon; Kim, Jonghyun; Damiano, Diane L.

    2013-01-01

    This paper presents the framework for developing a robotic system to improve accuracy and reliability of clinical assessment. Clinical assessment of spasticity tends to have poor reliability because of the nature of the in-person assessment. To improve accuracy and reliability of spasticity assessment, a haptic device, named the HESS (Haptic Elbow Spasticity Simulator) has been designed and constructed to recreate the clinical “feel” of elbow spasticity based on quantitative measurements. A mathematical model representing the spastic elbow joint was proposed based on clinical assessment using the Modified Ashworth Scale (MAS) and quantitative data (position, velocity, and torque) collected on subjects with elbow spasticity. Four haptic models (HMs) were created to represent the haptic feel of MAS 1, 1+, 2, and 3. The four HMs were assessed by experienced clinicians; three clinicians performed both in-person and haptic assessments, and had 100% agreement in MAS scores; and eight clinicians who were experienced with MAS assessed the four HMs without receiving any training prior to the test. Inter-rater reliability among the eight clinicians had substantial agreement (κ = 0.626). The eight clinicians also rated the level of realism (7.63 ± 0.92 out of 10) as compared to their experience with real patients. PMID:22562769

  16. The reliability of the Personal and Social Performance scale - informing its training and use.

    PubMed

    White, Sarah; Dominise, Christianne; Naik, Dhruv; Killaspy, Helen

    2016-09-30

    Social functioning is as an important outcome in studies of people with schizophrenia. Most measures of social function include a person's ability to manage everyday activities as well as their abilities to engage in leisure and occupational activities. The Personal Social Performance (PSP) scale assesses functioning across four dimensions (socially useful activities, personal and social relationships, self-care, disturbing and aggressive behaviours) rather than one global score and thus has been reported to be easier to use. In a pan-European study of people with severe mental illness a team of 26 researchers received training in rating the scale, after which the inter-rater reliability (IRR) was assessed and found to be not sufficiently high. A brief survey of the researchers elicited information with which to explore the low IRR and their experience of using the PSP. Clinicians were found to have higher IRR, in particular, psychologists. Patients' employment status was found to be the most important predictor of PSP. Researchers used multiple sources of information when rating the scale. Sufficient training is required to ensure IRR, particularly for non-clinical researchers, if the PSP is to be established as a reliable research tool. PMID:27428085

  17. Reliability of the hospital nutrition environment scan for cafeterias, vending machines, and gift shops.

    PubMed

    Winston, Courtney P; Sallis, James F; Swartz, Michael D; Hoelscher, Deanna M; Peskin, Melissa F

    2013-08-01

    According to ecological models, the physical environment plays a major role in determining individual health behaviors. As such, researchers have started targeting the consumer nutrition environment of large-scale foodservice operations when implementing obesity-prevention programs. In 2010, the American Hospital Association released a call-to-action encouraging health care facilities to join in this movement and improve their facilities' consumer nutrition environments. The Hospital Nutrition Environment Scan (HNES) for Cafeterias, Vending Machines, and Gift Shops was developed in 2011, and the present study evaluated the inter-rater reliability of this instrument. Two trained raters visited 39 hospitals in southern California and completed the HNES. Percent agreement, kappa statistics, and intraclass correlation coefficients were calculated. Percent agreement between raters ranged from 74.4% to 100% and kappa statistics ranged from 0.458 to 1.0. The intraclass correlation coefficient for the overall nutrition composite scores was 0.961. Given these results, the HNES demonstrated acceptable reliability metrics and can now be disseminated to assess the current state of hospital consumer nutrition environments. PMID:23747171

  18. Reliability of screening tests for health-related problems among low-income elderly.

    PubMed

    Lino, Valéria Teresa Saraiva; Portela, Margareth Crisóstomo; Camacho, Luiz Antônio Bastos; Rodrigues, Nádia Cristina Pinheiro

    2014-12-01

    Screening tests for health problems can identify elderly people who should undergo the Comprehensive Geriatric Assessment, enabling the planning of actions to prevent disability. The aim of this study was to analyze the inter-rater reliability (IRR) of self-assessment questions (SAQ) and performance tests (PT) recommended in Brazil, in a sample of low-income elderly people, through an exploratory study performed with 165 elderly assessed by two professionals on different days. IRR was evaluated using the intraclass correlation coefficient (ICC) for continuous variables and the kappa statistic for categorical ones. The IRR for the PT (muscle strength, mobility body mass index, vision) was excellent and presented ICC values greater than 0.75. By contrast, the IRR for SAQ (urinary incontinence, self-perceived health and hearing impairment) was intermediate. Only the fall-related item presented a good IRR. In this study single SAQ had poor reliability when compared to PT, suggesting the necessity of revision of subjective self-assessment items with low reproducibility before implementation. PMID:26247997

  19. Development of a clinical assessment test of 180-degree standing turn strategy (CAT-STS) and investigation of its reliability and validity

    PubMed Central

    Kobayashi,, Masaki; Usuda,, Shigeru

    2016-01-01

    [Purpose] To develop a clinical assessment test of 180-degree standing turn strategy (CAT-STS) and quantify its reliability and construct validity. [Subjects] Outpatients with stroke that occurred at least 6 months previously (N = 27) who could walk 10 m without physical assistance were included. [Methods] The CAT-STS was based on the literature and discussion with four physical therapists. The final version of the CAT-STS includes seven items: direction, use of space, foot movement, initiation, termination, instability, and non-fluidity. Patients were videotaped performing a 180-degree turn while standing. The Motricity Index, gait speed and Functional Ambulation Category were also evaluated. Two raters evaluated the turn on two occasions, and inter- and intra-rater reliability were calculated. Construct validity was also calculated. [Results] Inter-rater reliability was fair or moderate for many items (kappa = 0.221–0.746). Intra-rater reliability was good-to-excellent for all items (kappa = 0.681–0.846) except direction and termination. Inter- and intra-rater reliability of the total CAT-STS score were substantial and excellent, respectively (intraclass correlation coefficient = 0.725 and 0.865, respectively). The total CAT-STS score was associated with walking ability and the time and number of steps taken to turn. [Conclusion] The total CAT-STS score is a reliable and valid measure. PMID:27065557

  20. Development of a clinical assessment test of 180-degree standing turn strategy (CAT-STS) and investigation of its reliability and validity.

    PubMed

    Kobayashi, Masaki; Usuda, Shigeru

    2016-01-01

    [Purpose] To develop a clinical assessment test of 180-degree standing turn strategy (CAT-STS) and quantify its reliability and construct validity. [Subjects] Outpatients with stroke that occurred at least 6 months previously (N = 27) who could walk 10 m without physical assistance were included. [Methods] The CAT-STS was based on the literature and discussion with four physical therapists. The final version of the CAT-STS includes seven items: direction, use of space, foot movement, initiation, termination, instability, and non-fluidity. Patients were videotaped performing a 180-degree turn while standing. The Motricity Index, gait speed and Functional Ambulation Category were also evaluated. Two raters evaluated the turn on two occasions, and inter- and intra-rater reliability were calculated. Construct validity was also calculated. [Results] Inter-rater reliability was fair or moderate for many items (kappa = 0.221-0.746). Intra-rater reliability was good-to-excellent for all items (kappa = 0.681-0.846) except direction and termination. Inter- and intra-rater reliability of the total CAT-STS score were substantial and excellent, respectively (intraclass correlation coefficient = 0.725 and 0.865, respectively). The total CAT-STS score was associated with walking ability and the time and number of steps taken to turn. [Conclusion] The total CAT-STS score is a reliable and valid measure. PMID:27065557

  1. Reliability of Health Information on the Internet: An Examination of Experts' Ratings

    PubMed Central

    Craigie, Mark; Loader, Brian; Burrows, Roger

    2002-01-01

    Background The use of medical experts in rating the content of health-related sites on the Internet has flourished in recent years. In this research, it has been common practice to use a single medical expert to rate the content of the Web sites. In many cases, the expert has rated the Internet health information as poor, and even potentially dangerous. However, one problem with this approach is that there is no guarantee that other medical experts will rate the sites in a similar manner. Objectives The aim was to assess the reliability of medical experts' judgments of threads in an Internet newsgroup related to a common disease. A secondary aim was to show the limitations of commonly-used statistics for measuring reliability (eg, kappa). Method The participants in this study were 5 medical doctors, who worked in a specialist unit dedicated to the treatment of the disease. They each rated the information contained in newsgroup threads using a 6-point scale designed by the experts themselves. Their ratings were analyzed for reliability using a number of statistics: Cohen's kappa, gamma, Kendall's W, and Cronbach's alpha. Results Reliability was absent for ratings of questions, and low for ratings of responses. The various measures of reliability used gave conflicting results. No measure produced high reliability. Conclusions The medical experts showed a low agreement when rating the postings from the newsgroup. Hence, it is important to test inter-rater reliability in research assessing the accuracy and quality of health-related information on the Internet. A discussion of the different measures of agreement that could be used reveals that the choice of statistic can be problematic. It is therefore important to consider the assumptions underlying a measure of reliability before using it. Often, more than one measure will be needed for "triangulation" purposes. PMID:11956034

  2. Reliability and Criterion Validity of a Novel Clinical Test of Simple and Complex Reaction Time in Athletes1

    PubMed Central

    Eckner, James T.; Richardson, James K.; Kim, Hogene; Joshi, Monica S.; Oh, Youkeun K.; Ashton-Miller, James A.

    2015-01-01

    Summary Slowed reaction time (RT) represents both a risk factor for and a consequence of sport concussion. The purpose of this study was to determine the reliability and criterion validity of a novel clinical test of simple and complex RT, called RTclin, in contact sport athletes. Both tasks were adapted from the well-known ruler drop test of RT and involve manually grasping a falling vertical shaft upon its release, with the complex task employing a go/no-go paradigm based on a slight cue. In 46 healthy contact sport athletes (24 males; M = 16.3 yr., SD = 5.0; 22 women: M age= 15.0 yr., SD = 4.0) whose sports included soccer, ice hockey, American football, martial arts, wrestling, and lacrosse, the latency and accuracy of simple and complex RTclin had acceptable test-retest and inter-rater reliabilities and correlated with a computerized criterion standard, the Axon Computerized Cognitive Assessment Tool. Medium to large effect sizes were found. The novel RTclin tests have acceptable reliability and criterion validity for clinical use and hold promise as concussion assessment tools. PMID:26106803

  3. RELIABILITY AND CRITERION VALIDITY OF A NOVEL CLINICAL TEST OF SIMPLE AND COMPLEX REACTION TIME IN ATHLETES.

    PubMed

    Eckner, James T; Richardson, James K; Kim, Hogene; Joshi, Monica S; Oh, Youkeun K; Ashton-Miller, James A

    2015-06-01

    Slowed reaction time (RT) represents both a risk factor for and a consequence of sport concussion. The purpose of this study was to determine the reliability and criterion validity of a novel clinical test of simple and complex RT, called RT(clin), in contact sport athletes. Both tasks were adapted from the well-known ruler drop test of RT and involve manually grasping a falling vertical shaft upon its release, with the complex task employing a go/no-go paradigm based on a light cue. In 46 healthy contact sport athletes (24 men; M = 16.3 yr., SD = 5.0; 22 women: M age = 15.0 yr., SD = 4.0) whose sports included soccer, ice hockey, American football, martial arts, wrestling, and lacrosse, the latency and accuracy of simple and complex RT(clin) had acceptable test-retest and inter-rater reliabilities and correlated with a computerized criterion standard, the Axon Computerized Cognitive Assessment Tool. Medium to large effect sizes were found. The novel RT(clin) tests have acceptable reliability and criterion validity for clinical use and hold promise as concussion assessment tools. PMID:26106803

  4. Assessing juvenile sex offenders to determine adequate levels of supervision.

    PubMed

    Gerdes, K E; Gourley, M M; Cash, M C

    1995-08-01

    The present study analyzed the internal consistency of four inventories currently being used by probation officers in the state of Utah to determine adequate and efficacious supervision levels and placement for juvenile sex offenders. The internal consistency or reliability of the inventories ranged from moderate to good. Factor analysis was utilized to significantly increase the reliability of the four inventories by collapsing them into the following three factors: (a) Custodian's and Juvenile's Attitude Toward Intervention; (b) Offense Characteristics; and (c) Historical Risk Factors. These three inventories/factors explained 41.2% of the variance in the combined inventories' scores. Suggestions are made regarding the creation of an additional inventory. "Characteristics of the Victim" to account for more of the variance. In addition, suggestions as to how these inventories can be used by probation officers to make objective and consistent decisions about adequate supervision levels and placement for juvenile sex offenders are discussed. PMID:7583754

  5. 34 CFR 85.900 - Adequate evidence.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) Definitions § 85.900 Adequate evidence. Adequate evidence means information sufficient to support the reasonable belief that a particular act or omission has occurred. Authority: E.O. 12549 (3 CFR, 1986 Comp., p. 189); E.O 12689 (3 CFR, 1989 Comp., p. 235); 20 U.S.C. 1082, 1094, 1221e-3 and 3474; and Sec....

  6. 29 CFR 452.110 - Adequate safeguards.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 2 2010-07-01 2010-07-01 false Adequate safeguards. 452.110 Section 452.110 Labor... DISCLOSURE ACT OF 1959 Election Procedures; Rights of Members § 452.110 Adequate safeguards. (a) In addition to the election safeguards discussed in this part, the Act contains a general mandate in section...

  7. 29 CFR 452.110 - Adequate safeguards.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 2 2011-07-01 2011-07-01 false Adequate safeguards. 452.110 Section 452.110 Labor... DISCLOSURE ACT OF 1959 Election Procedures; Rights of Members § 452.110 Adequate safeguards. (a) In addition to the election safeguards discussed in this part, the Act contains a general mandate in section...

  8. Reliability of the Clinical Dementia Rating with a traumatic brain injury population: a preliminary study.

    PubMed

    Webber, Dana; Collins, Melina; DeFilippis, Nick; Hill, Fiona

    2013-01-01

    This study examined the inter-rater reliability (IRR) of the Clinical Dementia Rating (CDR) for patients with traumatic brain injury (TBI). The CDR is a commonly used rating of impairment, but there has been no research examining its utility in patients with TBI. It was hypothesized that the CDR would have good IRR when used with patients with TBI. Two hundred and fifty U.S. neuropsychologists were randomly selected from the National Academy of Neuropsychology's membership list and were mailed packets of information (e.g., CDR, patient vignette, mental status, neuropsychological test information, and history). Professionals were asked to complete the CDR for the described patient and return the information. IRR was calculated for the Global CDR score and each of the six CDR domains. Of those packets mailed, 53 were returned and completed as instructed (21.2% response rate). Clinician experience varied from 0 to 31 years. Global CDR score IRR was 73.6%. Domain IRRs were as follows: Orientation, 79.2%; Home and Hobbies, 71.7%; Personal Care, 71.7%; Memory, 56.6%; Judgment and Problem Solving, 49.1%; and Community Affairs, 54.7%. Results suggest the CDR Global score has acceptable IRR (>.70). Overall concordance (W = .527) among raters was significant with moderate-to-strong agreement. Further research to improve the utility of this instrument is discussed. PMID:23398000

  9. The reliability and validity of an obstacle course as a measure of gait and balance in older adults.

    PubMed

    Rubenstein, L Z; Josephson, K R; Trueblood, P R; Yeung, K; Harker, J O; Robbins, A S

    1997-01-01

    The use of an obstacle course to quantify gait, balance and functional mobility in elderly persons, particularly to assess objectively changes following exercise and rehabilitation interventions, has not been extensively developed or tested. In this study, we describe an 18-item obstacle course developed as an outcome measure for an exercise intervention among fall-prone elderly men. Reliability and validity of the obstacle course was tested in a group of 58 community-living elderly men (mean age = 75 years). Each subject's performance was videotaped and timed. The videotapes were scored by a physical therapist and a physician. Inter-rater reliability between the raters was high (Kappa = 0.96, p < 0.0001). Both the obstacle course score and time correlated significantly with gait velocity, a 6-minute walk test, and a performance-oriented instrument of gait and balance. Obstacle course scores showed significant improvement among the most impaired subjects, but not among higher functioning subjects following a 3-month exercise intervention. These results suggest that an obstacle course may be a useful and valid method for measuring outcomes related to mobility tasks in selected elderly populations. Further work is needed to determine in which populations, and for which outcomes, an obstacle course is better than simpler performance-based measures. PMID:9177596

  10. Evaluation of the ToxRTool's ability to rate the reliability of toxicological data for human health hazard assessments.

    PubMed

    Segal, D; Makris, S L; Kraft, A D; Bale, A S; Fox, J; Gilbert, M; Bergfelt, D R; Raffaele, K C; Blain, R B; Fedak, K M; Selgrade, M K; Crofton, K M

    2015-06-01

    Regulatory agencies often utilize results from peer reviewed publications for hazard assessments. A problem in doing so is the lack of well-accepted tools to objectively, efficiently and systematically assess the quality of published toxicological studies. Herein, we evaluated the publicly available software-based ToxRTool (Toxicological data Reliability assessment Tool) for use in human health hazard assessments. The ToxRTool was developed by the European Commission's Joint Research Center in 2009. It builds on Klimisch categories, a rating system established in 1997, by providing additional criteria and guidance for assessing the reliability of toxicological studies. It also transparently documents the study-selection process. Eight scientists used the ToxRTool to rate the same 20 journal articles on thyroid toxicants. Results were then compared using the Finn coefficient and "AC1" to determine inter-rater consistency. Ratings were most consistent for high-quality journal articles, but less consistent as study quality decreased. Primary reasons for inconsistencies were that some criteria were subjective and some were not clearly described. It was concluded, however, that the ToxRTool has potential and, with refinement, could provide a more objective approach for screening published toxicology studies for use in health risk evaluations, although the ToxRTool ratings are primarily based on study reporting quality. PMID:25777839

  11. Assessing the reliability and validity of direct observation and traffic camera streams to measure helmet and motorcycle use.

    PubMed

    Zaccaro, Heather N; Carbone, Emily C; Dsouza, Nishita; Xu, Michelle R; Byrne, Mary C; Kraemer, John D

    2015-12-01

    There is a need to develop motorcycle helmet surveillance approaches that are less labour intensive than direct observation (DO), which is the commonly recommended but never formally validated approach, particularly in developing settings. This study sought to assess public traffic camera feeds as an alternative to DO, in addition to the reliability of DO under field conditions. DO had high inter-rater reliability, κ=0.88 and 0.84, respectively, for cycle type and helmet type, which reinforces its use as a gold standard. However, traffic camera-based data collection was found to be unreliable, with κ=0.46 and 0.53 for cycle type and helmet type. When bicycles, motorcycles and scooters were classified based on traffic camera streams, only 68.4% of classifications concurred with those made via DO. Given the current technology, helmet surveillance via traffic camera streams is infeasible, and there remains a need for innovative traffic safety surveillance approaches in low-income urban settings. PMID:25617341

  12. Americans Getting Adequate Water Daily, CDC Finds

    MedlinePlus

    ... medlineplus/news/fullstory_158510.html Americans Getting Adequate Water Daily, CDC Finds Men take in an average ... new government report finds most are getting enough water each day. The data, from the U.S. National ...

  13. Americans Getting Adequate Water Daily, CDC Finds

    MedlinePlus

    ... gov/news/fullstory_158510.html Americans Getting Adequate Water Daily, CDC Finds Men take in an average ... new government report finds most are getting enough water each day. The data, from the U.S. National ...

  14. Direct Observation Assessment of Milestones: Problems with Reliability

    PubMed Central

    Schott, Meghan; Kedia, Raashee; Promes, Susan B.; Swoboda, Thomas; O’Rourke, Kevin; Green, Walter; Liu, Rachel; Stansfield, Brent; Santen, Sally A.

    2015-01-01

    reliability of the current EM milestone assessment tools have yet to be determined. This study is a rigorous attempt to collect validity evidence in the development of a direct observation assessment instrument. However, despite strict attention to validity evidence, inter-rater reliability was low. The potential sources of reducible variance include rater- and instrument-based error. Based on this study, there may be concerns for the reliability of other EM milestone assessment tools that are currently in use. PMID:26594281

  15. Validity and reliability of the persian (Farsi) version of the DN4 (Douleur Neuropathique 4 Questions) questionnaire for differential diagnosis of neuropathic from non-neuropathic pains.

    PubMed

    Madani, Seyed Pezhman; Fateh, Hamid R; Forogh, Bijan; Fereshtehnejad, Seyed-Mohammad; Ahadi, Tannaz; Ghaboussi, Pouya; Bouhassira, Didier; Raissi, Gholam Reza

    2014-06-01

    The aim of our study was translation and assessment of validity and reliability of the Persian version of DN4 questionnaire. The goal was to fill the gap caused by the absence of a validated instrument in Persian to facilitate discrimination of neuropathic pain. In this study, the adaptation and validation of the questionnaire was carried out in 4 steps, including translation, retranslation, semantic, and literal assessments, and a pilot study for practicability and potential perception difficulties of the final Persian version on 45 patient samples. The questionnaire validation performed on 175 patients, 112 (64%) females with the mean age of 52.53 (SD = 14.98) ranging from 22 to 87 years of age with neuropathic (N = 86) and non-neuropathic pain (NNP) (N = 89). Sensitivity, specificity, and Youden Index in cut-off point ≥ 4 were 90%, 95%, and 0.85, respectively, which are noteworthy findings among other validation studies. The Cronbach's alpha coefficient of the whole questionnaire was 0.852. Inter-rater agreement and test-retest reliability were significant intraclass coefficient (ICC = 0.957 and ICC = 0.918, respectively). The Persian version of DN4 questionnaire is a reliable, valid, feasible, and easily administered tool for precise discrimination neuropathic pain from NNP in Farsi. The characteristics of this test can assist practitioner to diagnose neuropathic pain accurately for both clinical and research purposes. PMID:23763722

  16. Reliability and clinical utility of a Portuguese version of the Abnormal Involuntary Movements Scale (AIMS) for tardive dyskinesia in Brazilian patients.

    PubMed

    Tonelli, H; Tonelli, D; Poiani, G R; Vital, M A B F; Andreatini, R

    2003-04-01

    The objective of the present study was to evaluate the reliability and clinical utility of a Portuguese version of the Abnormal Involuntary Movements Scale (AIMS). Videotaped interviews with 16 psychiatric inpatients treated with antipsychotic drugs for at least 5 years were evaluated. Reliability was assessed by the intraclass correlation coefficient (ICC) between three raters, two with and one without clinical training in psychopathology. Clinical utility was assessed by the difference between the scores of patients with (N = 11) and without (N = 5) tardive dyskinesia (TD). Patients with TD exhibited a higher severity of global evaluation by the AIMS (sum of scores: 4.2 +/- 0.9 vs 0.4 +/- 0.2; score on item 8: 2.3 +/- 0.3 vs 0.4 +/- 0.2, TD vs controls). The ICC for the global evaluation was fair between the two skilled raters (0.58-0.62) and poor between these raters and the rater without clinical experience (0.05-0.29). Thus, we concluded that the Portuguese version of the AIMS shows an acceptable inter-rater reliability, but only between clinically skilled raters, and that it is clinically useful. PMID:12700830

  17. Reliability and accuracy of real-time visualization techniques for measuring school cafeteria tray waste: validating the quarter-waste method.

    PubMed

    Hanks, Andrew S; Wansink, Brian; Just, David R

    2014-03-01

    Measuring food waste is essential to determine the impact of school interventions on what children eat. There are multiple methods used for measuring food waste, yet it is unclear which method is most appropriate in large-scale interventions with restricted resources. This study examines which of three visual tray waste measurement methods is most reliable, accurate, and cost-effective compared with the gold standard of individually weighing leftovers. School cafeteria researchers used the following three visual methods to capture tray waste in addition to actual food waste weights for 197 lunch trays: the quarter-waste method, the half-waste method, and the photograph method. Inter-rater and inter-method reliability were highest for on-site visual methods (0.90 for the quarter-waste method and 0.83 for the half-waste method) and lowest for the photograph method (0.48). This low reliability is partially due to the inability of photographs to determine whether packaged items (such as milk or yogurt) are empty or full. In sum, the quarter-waste method was the most appropriate for calculating accurate amounts of tray waste, and the photograph method might be appropriate if researchers only wish to detect significant differences in waste or consumption of selected, unpackaged food. PMID:24135053

  18. Asbestos/NESHAP adequately wet guidance

    SciTech Connect

    Shafer, R.; Throwe, S.; Salgado, O.; Garlow, C.; Hoerath, E.

    1990-12-01

    The Asbestos NESHAP requires facility owners and/or operators involved in demolition and renovation activities to control emissions of particulate asbestos to the outside air because no safe concentration of airborne asbestos has ever been established. The primary method used to control asbestos emissions is to adequately wet the Asbestos Containing Material (ACM) with a wetting agent prior to, during and after demolition/renovation activities. The purpose of the document is to provide guidance to asbestos inspectors and the regulated community on how to determine if friable ACM is adequately wet as required by the Asbestos NESHAP.

  19. The Turkish version of the pregnancy physical activity questionnaire: cross-cultural adaptation, reliability, and validity

    PubMed Central

    Tosun, Ozge Celiker; Solmaz, Ulas; Ekin, Atalay; Tosun, Gokhan; Mutlu, Ebru Kaya; Okyay, Emre; Adiyeke, Mehmet; Gezer, Cenk; Mat, Emre; Malkoc, Mehtap

    2015-01-01

    [Purpose] The aim of this study was to translate the Pregnancy Physical Activity Questionnaire, adapt it for use with Turkish subjects and determine its reliability and validity. [Subjects and Methods] The Pregnancy Physical Activity Questionnaire was translated into Turkish and administered twice at 7–14-day intervals to pregnant women to assess the test-retest reliability. Cronbach’s α was used for internal consistency, and the inter-rater correlation coefficient was used to calculate the test-retest reliability. The Turkish Short Form 36 Health Survey (SF-36) and the International Physical Activity Questionnaire were used to estimate validity. [Results] The internal consistency during the first and third trimesters of pregnancy was excellent, with Cronbach’s α values of 0.93 and 0.95, respectively. The mean interval between the two assessments was 11.1 ± 2.1 days. The correlation coefficient between the total activity measured by the Turkish version of the Pregnancy Physical Activity Questionnaire and the International Physical Activity Questionnaire estimates of the total metabolic equivalent were fair to poor during the first, second, and third trimesters of pregnancy (r = 0.17, r = 0.17, r = 0.21, respectively). The Turkish version of the Pregnancy Physical Activity Questionnaire showed fair correlations with the Short Form 36 Health Survey physical component score (r = −0.30) and mental component score (r = −0.37) for the first trimester of pregnancy. [Conclusion] The Turkish version of the Pregnancy Physical Activity Questionnaire was found to be reliable and valid for assessing a pregnant woman’s physical activity. PMID:26644678

  20. The Turkish version of the pregnancy physical activity questionnaire: cross-cultural adaptation, reliability, and validity.

    PubMed

    Tosun, Ozge Celiker; Solmaz, Ulas; Ekin, Atalay; Tosun, Gokhan; Mutlu, Ebru Kaya; Okyay, Emre; Adiyeke, Mehmet; Gezer, Cenk; Mat, Emre; Malkoc, Mehtap

    2015-10-01

    [Purpose] The aim of this study was to translate the Pregnancy Physical Activity Questionnaire, adapt it for use with Turkish subjects and determine its reliability and validity. [Subjects and Methods] The Pregnancy Physical Activity Questionnaire was translated into Turkish and administered twice at 7-14-day intervals to pregnant women to assess the test-retest reliability. Cronbach's α was used for internal consistency, and the inter-rater correlation coefficient was used to calculate the test-retest reliability. The Turkish Short Form 36 Health Survey (SF-36) and the International Physical Activity Questionnaire were used to estimate validity. [Results] The internal consistency during the first and third trimesters of pregnancy was excellent, with Cronbach's α values of 0.93 and 0.95, respectively. The mean interval between the two assessments was 11.1 ± 2.1 days. The correlation coefficient between the total activity measured by the Turkish version of the Pregnancy Physical Activity Questionnaire and the International Physical Activity Questionnaire estimates of the total metabolic equivalent were fair to poor during the first, second, and third trimesters of pregnancy (r = 0.17, r = 0.17, r = 0.21, respectively). The Turkish version of the Pregnancy Physical Activity Questionnaire showed fair correlations with the Short Form 36 Health Survey physical component score (r = -0.30) and mental component score (r = -0.37) for the first trimester of pregnancy. [Conclusion] The Turkish version of the Pregnancy Physical Activity Questionnaire was found to be reliable and valid for assessing a pregnant woman's physical activity. PMID:26644678

  1. Adequate supervision for children and adolescents.

    PubMed

    Anderst, James; Moffatt, Mary

    2014-11-01

    Primary care providers (PCPs) have the opportunity to improve child health and well-being by addressing supervision issues before an injury or exposure has occurred and/or after an injury or exposure has occurred. Appropriate anticipatory guidance on supervision at well-child visits can improve supervision of children, and may prevent future harm. Adequate supervision varies based on the child's development and maturity, and the risks in the child's environment. Consideration should be given to issues as wide ranging as swimming pools, falls, dating violence, and social media. By considering the likelihood of harm and the severity of the potential harm, caregivers may provide adequate supervision by minimizing risks to the child while still allowing the child to take "small" risks as needed for healthy development. Caregivers should initially focus on direct (visual, auditory, and proximity) supervision of the young child. Gradually, supervision needs to be adjusted as the child develops, emphasizing a safe environment and safe social interactions, with graduated independence. PCPs may foster adequate supervision by providing concrete guidance to caregivers. In addition to preventing injury, supervision includes fostering a safe, stable, and nurturing relationship with every child. PCPs should be familiar with age/developmentally based supervision risks, adequate supervision based on those risks, characteristics of neglectful supervision based on age/development, and ways to encourage appropriate supervision throughout childhood. PMID:25369578

  2. Small Rural Schools CAN Have Adequate Curriculums.

    ERIC Educational Resources Information Center

    Loustaunau, Martha

    The small rural school's foremost and largest problem is providing an adequate curriculum for students in a changing world. Often the small district cannot or is not willing to pay the per-pupil cost of curriculum specialists, specialized courses using expensive equipment no more than one period a day, and remodeled rooms to accommodate new…

  3. Funding the Formula Adequately in Oklahoma

    ERIC Educational Resources Information Center

    Hancock, Kenneth

    2015-01-01

    This report is a longevity, simulational study that looks at how the ratio of state support to local support effects the number of school districts that breaks the common school's funding formula which in turns effects the equity of distribution to the common schools. After nearly two decades of adequately supporting the funding formula, Oklahoma…

  4. Reliability and validity of the SPAID-G checklist for detecting psychiatric disorders in adults with intellectual disability.

    PubMed

    Bertelli, Marco; Scuticchio, Daniela; Ferrandi, Angela; Lassi, Stefano; Mango, Francesco; Ciavatta, Claudio; Porcelli, Cesare; Bianco, Annamaria; Monchieri, Sergio

    2012-01-01

    SPAID (Psychiatric Instrument for the Intellectually Disabled Adult) is the first Italian tool-package for carrying out psychiatric diagnosis in adults with Intellectual Disabilities (ID). It includes the "G" form, for general diagnostic orientation, and specific checklists for all groups of syndromes stated by the available classification systems. SPAID was established to provide an easy and quick tool for daily practice of the personnel working with ID. The present study was aimed at evaluating psychometric and psychodiagnostic characteristics of the SPAID-G and at supplying new data on the prevalence rate of psychiatric disorders in a multicentric Italian sample of people with ID living in different settings. The SPAID-G was randomly applied to 304 participants with ID attending residential facilities or assessment services across Italy. A part of the sample was also consecutively assessed through the use of DASH, PDD-MRS and by the clinical application of the DSM-IV TR criteria. The correlation between SPAID-G scores and those provided by other evaluation tools was over 60%. Additionally, the internal consistency and inter-rater reliability resulted to be good. Psychopathological symptoms were detected in approximately 40% of the sample. Respectively, autistic spectrum disorders, impulse control disorders, mood disorders, and dramatic personality disorders were the diagnostic orientations providing the most prevalent over-threshold scores. SPAID-G seems to be a valid diagnostic tool, quick and easy to use in psychiatric disorders assessment within the Italian population with ID. PMID:22119685

  5. The intra-rater reliability and agreement of compensatory stepping thresholds of healthy subjects.

    PubMed

    Crenshaw, Jeremy R; Kaufman, Kenton R

    2014-02-01

    The purpose of this study was to evaluate the test-retest, intra-rater reliability and agreement of compensatory stepping thresholds. A protocol was developed to establish anteroposterior single-stepping thresholds, anteroposterior multiple-stepping thresholds, and lateral single-stepping thresholds. Healthy, young subjects stood on a microprocessor-controlled treadmill, and responded to three series of progressively challenging surface translations. Subjects were instructed to "try not to step" when establishing single-stepping thresholds or "try to take only one step" when establishing multiple-stepping thresholds. Stepping thresholds were defined as the minimum disturbance magnitude that consistently elicited a single or second compensatory step. Thresholds were expressed as the ankle torque necessary to maintain upright posture. Thresholds studied included anterior single-stepping thresholds (τ = 273.0 ± 82.3 N m), posterior single-stepping, thresholds (τ = 235.5 ± 98.0 N m), anterior multiple-stepping thresholds (τ = 977.0 ± 416.3 N m), posterior multiple-stepping thresholds (τ = 701.9 ± 237.5 N m), stability-side lateral single-stepping thresholds (τ = 225.7 ± 77.7 Nm), and mobility-side lateral single-stepping thresholds (τ = 236.8 ± 85.4 N m). Based on intraclass correlation coefficients (ICC) and Bland-Altman plots, all thresholds demonstrated excellent reliability (ICC(2,1) = 0.87-0.97) and agreement. These results suggest that compensatory stepping thresholds have sufficient repeatability to be used in clinical and research-related assessments of fall-risk. Additional study is needed to determine the intra- and inter-rater reliabilities and validity of thresholds specific to the patient populations of interest. PMID:24300837

  6. Preliminary Validation and Reliability Testing of the Montreal Instrument for Cat Arthritis Testing, for Use by Veterinarians, in a Colony of Laboratory Cats.

    PubMed

    Klinck, Mary P; Rialland, Pascale; Guillot, Martin; Moreau, Maxim; Frank, Diane; Troncy, Eric

    2015-01-01

    Subtle signs and conflicting physical and radiographic findings make feline osteoarthritis (OA) challenging to diagnose. A physical examination-based assessment was developed, consisting of eight items: Interaction, Exploration, Posture, Gait, Body Condition, Coat and Claws, (joint) Palpation-Findings, and Palpation-Cat Reaction. Content (experts) and face (veterinary students) validity were excellent. Construct validity, internal consistency, and intra- and inter-rater reliability were assessed via a pilot and main study, using laboratory-housed cats with and without OA. Gait distinguished OA status in the pilot ( p = 0.05) study. In the main study, no scale item achieved statistically significant OA detection. Forelimb peak vertical ground reaction force (PVF) correlated inversely with Gait (Rho s = -0.38 ( p = 0.03) to -0.41 ( p = 0.02)). Body Posture correlated with Gait, and inversely with forelimb PVF at two of three time points (Rho s = -0.38 ( p = 0.03) to -0.43 ( p = 0.01)). Palpation (Findings, Cat Reaction) did not distinguish OA from non-OA cats. Palpation-Cat Reaction (Forelimbs) correlated inversely with forelimb PVF at two time points (Rho s = -0.41 ( p = 0.02) to -0.41 ( p = 0.01)), but scores were highly variable, and poorly reliable. Gait and Posture require improved sensitivity, and Palpation should be interpreted cautiously, in diagnosing feline OA. PMID:26633524

  7. Reliability and Validity of the Clinical Dementia Rating for Community-Living Elderly Subjects without an Informant

    PubMed Central

    Nyunt, Ma Shwe Zin; Chong, Mei Sian; Lim, Wee Shiong; Lee, Tih Shih; Yap, Philip; Ng, Tze Pin

    2013-01-01

    Background The Clinical Dementia Rating (CDR) scale is widely used to assess cognitive impairment in Alzheimer's disease. It requires collateral information from a reliable informant who is not available in many instances. We adapted the original CDR scale for use with elderly subjects without an informant (CDR-NI) and evaluated its reliability and validity for assessing mild cognitive impairment (MCI) and dementia among community-dwelling elderly subjects. Method At two consecutive visits 1 week apart, nurses trained in CDR assessment interviewed, observed and rated cognitive and functional performance according to a protocol in 90 elderly subjects with suboptimal cognitive performance [Mini-Mental State Examination (MMSE) <26 and/or Montreal Cognitive Assessment (MOCA) <26] and without informants according to a protocol. CDR domains and global scores were assigned after the second visit based upon corroborative information from the subjects' responses to questions, role-play, and observed performance in specifically assigned tasks at home and within the community. Results The CDR-NI scores (0, 0.5, 1) showed good internal consistency (Crohnbach's α 0.83-0.84), inter-rater reliability (κ 0.77-1.00 for six domains and 0.95 for global rating) and test-retest reliability (κ 0.75-1.00 for six domains and 0.80 for global rating), good agreement (κ 0.79) with the clinical assessment status of MCI (n = 37) and dementia (n = 4) and significant differences in the mean scores for MMSE, MOCA and Instrumental Activities of Daily Living (ANOVA global p < 0.001). Conclusion Owing to the protocol of the interviews, assessments and structured observations gathered during the two visits, CDR-NI provides valid and reliable assessment of MCI and dementia in community-living elderly subjects without an informant. PMID:24348502

  8. Quality Control of Motor Unit Number Index (MUNIX) Measurements in 6 Muscles in a Single-Subject “Round-Robin” Setup

    PubMed Central

    Neuwirth, Christoph; Burkhardt, Christian; Alix, James; Castro, José; de Carvalho, Mamede; Gawel, Malgorzata; Goedee, Stephan; Grosskreutz, Julian; Lenglet, Timothée; Moglia, Cristina; Omer, Taha; Schrooten, Maarten; Weber, Markus

    2016-01-01

    Background Motor Unit Number Index (MUNIX) is a neurophysiological measure that provides an index of the number of lower motor neurons in a muscle. Its performance across centres in healthy subjects and patients with Amyotrophic Lateral Sclerosis (ALS) has been established, but inter-rater variability between multiple raters in one single subject has not been investigated. Objective To assess reliability in a set of 6 muscles in a single subject among 12 examiners (6 experienced with MUNIX, 6 less experienced) and to determine variables associated with variability of measurements. Methods Twelve raters applied MUNIX in six different muscles (abductor pollicis brevis (APB), abductor digiti minimi (ADM), biceps brachii (BB), tibialis anterior (TA), extensor dig. brevis (EDB), abductor hallucis (AH)) twice in one single volunteer on consecutive days. All raters visited at least one training course prior to measurements. Intra- and inter-rater variability as determined by the coefficient of variation (COV) between different raters and their levels of experience with MUNIX were compared. Results Mean intra-rater COV of MUNIX was 14.0% (±6.4) ranging from 5.8 (APB) to 30.3% (EDB). Mean inter-rater COV was 18.1 (±5.4) ranging from 8.0 (BB) to 31.7 (AH). No significant differences of variability between experienced and less experienced raters were detected. Conclusion We provide evidence that quality control for neurophysiological methods can be performed with similar standards as in laboratory medicine. Intra- and inter-rater variability of MUNIX is muscle-dependent and mainly below 20%. Experienced neurophysiologists can easily adopt MUNIX and adequate teaching ensures reliable utilization of this method. PMID:27135747

  9. Reliability and Validity of a Survey of Cat Caregivers on Their Cats’ Socialization Level in the Cat’s Normal Environment

    PubMed Central

    Slater, Margaret; Garrison, Laurie; Miller, Katherine; Weiss, Emily; Makolinski, Kathleen; Drain, Natasha

    2013-01-01

    Simple Summary Many animal welfare organizations accept cats with no known behavioral history. It can be difficult to differentiate between a frightened but well-socialized cat and an unsocialized cat in an animal shelter environment. Making this distinction can save lives, yet currently there is no valid tool. Here we measured the quality of a survey designed to determine socialization level using information from the cat’s caregiver about a cat’s usual behavior around people in the cat’s normal environment. This survey will be used to help develop an effective process that accurately differentiates cats by their socialization levels in animal shelters. Abstract Stray cats routinely enter animal welfare organizations each year and shelters are challenged with determining the level of human socialization these cats may possess as quickly as possible. However, there is currently no standard process to guide this determination. This study describes the development and validation of a caregiver survey designed to be filled out by a cat’s caregiver so it accurately describes a cat’s personality, background, and full range of behavior with people when in its normal environment. The results from this survey provided the basis for a socialization score that ranged from unsocialized to well socialized with people. The quality of the survey was evaluated based on inter-rater and test-retest reliability and internal consistency and estimates of construct and criterion validity. In general, our results showed moderate to high levels of inter-rater (median of 0.803, range 0.211–0.957) and test-retest agreement (median 0.92, range 0.211–0.999). Cronbach’s alpha showed high internal consistency (0.962). Estimates of validity did not highlight any major shortcomings. This survey will be used to develop and validate an effective assessment process that accurately differentiates cats by their socialization levels towards humans based on direct observation of cats

  10. Development and Reliability Testing of the FEDS System for Classifying Glenohumeral Instability

    PubMed Central

    Kuhn, John E.; Helmer, Tara T.; Dunn, Warren R.; Throckmorton V, Thomas W.

    2010-01-01

    Background Classification systems for glenohumeral instability (GHI) are opinion based, not validated, and poorly defined. This study is designed to methodologically develop and test a GHI classification system. Methods: Classification System Development A systematic literature review identified 18 systems for classifying GHI. The frequency characteristics used was recorded. Additionally 31 members of the American Shoulder and Elbow Surgeons responded to a survey to identify features important to characterize GHI. Frequency, Etiology, Direction, and Severity (FEDS), were found to be most important. Frequency was defined as solitary (one episode), occasional (2–5x/year), or frequent (>5x/year). Etiology was defined as traumatic or atraumatic. Direction referred to the primary direction of instability (anterior, posterior, or inferior). Severity was defined as either subluxation or dislocation. Methods: Reliability Testing Fifty GHI patients completed a questionnaire at their initial visit. One of six sports medicine fellowship trained physicians completed a similar questionnaire after examining the patient. Patients returned after two weeks and were examined by the original physician and two other physicians. Inter- and intra-rater agreement for the FEDS classification system was calculated. Results Agreement between patients and physicians was lowest for frequency (39%; k=0.130) and highest for direction (82%; k=0.636). Physician intra-rater agreement was 84– 97% for the individual FEDS characteristics (k=0.69 to 0.87)). Physician inter-rater agreement ranged from 82–90% (k=0.44 to 0.76). Conclusions The FEDS system has content validity and is highly reliable for classifying GHI. Physical examination using provocative testing to determine the primary direction of instability produces very high levels of inter- and intra-rater agreement. Level of evidence Level II, Development of Diagnostic Criteria with Consecutive Series of Patients, Diagnosis Study. PMID

  11. Observational skills assessment score: reliability in measuring amount and quality of use of the affected hand in unilateral cerebral palsy

    PubMed Central

    2013-01-01

    Background The Observational Skills Assessment Score (OSAS) measures amount and quality of use of the affected hand in children with unilateral Cerebral Palsy (CP) in bimanual activities and could therefore be a valuable addition to existing assessment tools. The OSAS consists of tasks that are age appropriate and require use of the affected hand. Methods To measure the agreement and reliability of the OSAS a convenience sample of two groups of 16 children with unilateral spastic CP (2.5-6 and 12–16 years old), performed age specific bimanual tasks in 2 measurement sessions. Three experienced raters took part in testing and 8 in scoring. Intra class correlation (ICC) values for intra- and inter-rater reliability, and the mean and standard deviation of the differences between measurements were calculated. For test-retest reliability beside ICC scores, Smallest Detectable Differences (SDDs) were calculated in 16 older and 10 younger children. Results Generally, there seems to be good agreement between repeated measurements of the OSAS, as indicated by the small SDDs on most scales for quality of movement, compared to the range of their scales. This indicates potentially good sensitivity to change if used for patient evaluation purposes. The exceptions were the ‘quality of reach’ score for all tasks, and all quality scores for the stacking blocks task for the young children. As used in the present study, the OSAS has good discriminative capacity within patient populations as indicated by the high ICCs for most quality scores. Measuring the amount of use does not seem to be useful for either discrimination or evaluation. Conclusion In general, the OSAS seems to be a reliable tool for assessing the quality of use of the affected hand in bimanual activities in younger and older children with unilateral CP. Some modifications may improve its usefulness and efficiency. PMID:24139170

  12. Reliability of delirium rating scale (DRS) and delirium rating scale-revised-98 (DRS-R98) using variance-based multivariate modelling.

    PubMed

    Adamis, Dimitrios; Slor, Chantal J; Leonard, Maeve; Witlox, Joost; de Jonghe, Jos F M; Macdonald, Alastair J D; Trzepacz, Paula; Meagher, David

    2013-07-01

    Delirium's characteristic fluctuation in symptom severity complicates the assessment of test-retest reliability of scales using classical analyses, but application of modelling to longitudinal data offers a new approach. We evaluated test-retest reliability of the delirium rating scale (DRS) and delirium rating scale-revised-98 (DRS-R98), two widely used instruments with high validity and inter-rater reliability. Two existing longitudinal datasets for each scale included DSM-IV criteria for delirium diagnosis and repeated measurements using the DRS or DRS-R98. To estimate the reliability coefficients RT and RΛ for each scale we used a macros provided by Dr. Laenen at http://www.ibiostat.be/software/measurement.asp. For each dataset a linear mixed-effects model was fitted to estimate the variance-covariance parameters. A total of 531 cases with between 4 and 9 measurement points across studies including both delirious and non-delirious patients. Comorbid dementia in the datasets varied from 27% to 55%. Overall RT for the DRS were 0.71 and 0.50 and for DRS-R98 0.75 and 0.84. RΛ values for DRS were 0.99 and 0.98 and for DRS-R98 were 0.92 and 0.96. Individual RT measures for DRS-R98 and DRS across visits within studies showed more range than overall values. Our models found high overall reliability for both scales. Multiple factors impact a scale's reliability values including sample size, repeated measurements, patient population, etc in addition to rater variability. PMID:23522935

  13. Cutting costs of multiple mini-interviews – changes in reliability and efficiency of the Hamburg medical school admission test between two applications

    PubMed Central

    2014-01-01

    Background Multiple mini-interviews (MMIs) are a valuable tool in medical school selection due to their broad acceptance and promising psychometric properties. With respect to the high expenses associated with this procedure, the discussion about its feasibility should be extended to cost-effectiveness issues. Methods Following a pilot test of MMIs for medical school admission at Hamburg University in 2009 (HAM-Int), we took several actions to improve reliability and to reduce costs of the subsequent procedure in 2010. For both years, we assessed overall and inter-rater reliabilities based on multilevel analyses. Moreover, we provide a detailed specification of costs, as well as an extrapolation of the interrelation of costs, reliability, and the setup of the procedure. Results The overall reliability of the initial 2009 HAM-Int procedure with twelve stations and an average of 2.33 raters per station was ICC=0.75. Following the improvement actions, in 2010 the ICC remained stable at 0.76, despite the reduction of the process to nine stations and 2.17 raters per station. Moreover, costs were cut down from $915 to $495 per candidate. With the 2010 modalities, we could have reached an ICC of 0.80 with 16 single rater stations ($570 per candidate). Conclusions With respect to reliability and cost-efficiency, it is generally worthwhile to invest in scoring, rater training and scenario development. Moreover, it is more beneficial to increase the number of stations instead of raters within stations. However, if we want to achieve more than 80 % reliability, a minor improvement is paid with skyrocketing costs. PMID:24645665

  14. Is a vegetarian diet adequate for children.

    PubMed

    Hackett, A; Nathan, I; Burgess, L

    1998-01-01

    The number of people who avoid eating meat is growing, especially among young people. Benefits to health from a vegetarian diet have been reported in adults but it is not clear to what extent these benefits are due to diet or to other aspects of lifestyles. In children concern has been expressed concerning the adequacy of vegetarian diets especially with regard to growth. The risks/benefits seem to be related to the degree of restriction of he diet; anaemia is probably both the main and the most serious risk but this also applies to omnivores. Vegan diets are more likely to be associated with malnutrition, especially if the diets are the result of authoritarian dogma. Overall, lacto-ovo-vegetarian children consume diets closer to recommendations than omnivores and their pre-pubertal growth is at least as good. The simplest strategy when becoming vegetarian may involve reliance on vegetarian convenience foods which are not necessarily superior in nutritional composition. The vegetarian sector of the food industry could do more to produce foods closer to recommendations. Vegetarian diets can be, but are not necessarily, adequate for children, providing vigilance is maintained, particularly to ensure variety. Identical comments apply to omnivorous diets. Three threats to the diet of children are too much reliance on convenience foods, lack of variety and lack of exercise. PMID:9670174

  15. The reliability and validity of the Japanese version of the Levels of Emotional Awareness Scale (LEAS-J)

    PubMed Central

    2011-01-01

    Background The Levels of Emotional Awareness Scale (LEAS) was developed to assess five levels of emotional awareness: bodily sensations, action tendencies, single emotions, blends of emotion, and combinations of blends. It is a paper and pencil performance questionnaire that presents 20 emotion-evoking scenes. We developed a Japanese version of the LEAS (LEAS-J), and its reliability and validity were examined. Methods The LEAS-J level was independently assessed by two researchers who scored each response according to the LEAS scoring manual. High inter-rater reliability and internal consistency were obtained for the LEAS-J. Measures were socioeconomic status, LEAS-J, Toronto Alexithymia Scale-20 (TAS-20), Interpersonal Reactivity Index (IRI), and NEO Five-Factor Inventory (NEO-FFI). TAS-20, IRI and NEO-FFI were the measures used to explore the construct validity of LEAS-J, as it was predicted that higher scores on the LEAS-J would be related to fewer alexithymic features, greater empathetic ability, and a greater sense of cooperation with others. Questionnaires were completed by 344 university students. Results The criterion-referenced validity was determined: a significant negative relationship was found with the externally-oriented thinking scores of TAS-20, and positive relationships were found with fantasy, perspective taking, and empathic concern on IRI and with extraversion, openness to experience, and agreeableness on NEO-FFI. Conclusions Consistent with our expectations, the findings provide evidence that the LEAS-J has good reliability and validity. In addition, women had significantly higher scores than men on LEAS-J, showing that the gender difference identified in the original LEAS was cross-culturally consistent. PMID:21281491

  16. Site-specific landslide assessment in Alpine area using a reliable integrated monitoring system

    NASA Astrophysics Data System (ADS)

    Romeo, Saverio; Di Matteo, Lucio; Kieffer, Daniel Scott

    2016-04-01

    temperature values recorded in the valley and on the slope show a good relationship indicating that the climatic monitoring is reliable. In addition, the landslide displacement monitoring is reliable as well: the comparison between displacements in depth by extensometers and in surface by GBInSAR - referred to March-December 2013 - shows ad high reliability as confirmed by the inter-rater reliability analysis (Pearson correlation coefficient higher than 0.9). In conclusion, the reliability of the monitoring system confirms that data can be useful to improve the knowledge on rockfall kinematic and to develop an accurate early warning system useful for civil protection issues.

  17. Systematic social observation of children’s neighborhoods using Google Street View: a reliable and cost-effective method

    PubMed Central

    Odgers, Candice L.; Caspi, Avshalom; Bates, Christopher J.; Sampson, Robert J.; Moffitt, Terrie E.

    2012-01-01

    Background Children growing up in poor versus affluent neighborhoods are more likely to spend time in prison, develop health problems and die at an early age. The question of how neighborhood conditions influence our behavior and health has attracted the attention of public health officials and scholars for generations. Online tools are now providing new opportunities to measure neighborhood features and may provide a cost effective way to advance our understanding of neighborhood effects on child health. Method A virtual systematic social observation (SSO) study was conducted to test whether Google Street View could be used to reliably capture the neighborhood conditions of families participating in the Environmental-Risk (E-Risk) Longitudinal Twin Study. Multiple raters coded a subsample of 120 neighborhoods and convergent and discriminant validity was evaluated on the full sample of over 1,000 neighborhoods by linking virtual SSO measures to: (a) consumer based geo-demographic classifications of deprivation and health, (b) local resident surveys of disorder and safety, and (c) parent and teacher assessments of children’s antisocial behavior, prosocial behavior, and body mass index. Results High levels of observed agreement were documented for signs of physical disorder, physical decay, dangerousness and street safety. Inter-rater agreement estimates fell within the moderate to substantial range for all of the scales (ICCs ranged from .48 to .91). Negative neighborhood features, including SSO-rated disorder and decay and dangerousness corresponded with local resident reports, demonstrated a graded relationship with census-defined indices of socioeconomic status, and predicted higher levels of antisocial behavior among local children. In addition, positive neighborhood features, including SSO-rated street safety and the percentage of green space, were associated with higher prosocial behavior and healthy weight status among children. Conclusions Our results

  18. DARHT - an `adequate` EIS: A NEPA case study

    SciTech Connect

    Webb, M.D.

    1997-08-01

    The Dual Axis Radiographic Hydrodynamic Test (DARHT) Facility Environmental Impact Statement (EIS) provides a case study that is interesting for many reasons. The EIS was prepared quickly, in the face of a lawsuit, for a project with unforeseen environmental impacts, for a facility that was deemed urgently essential to national security. Following judicial review the EIS was deemed to be {open_quotes}adequate.{close_quotes} DARHT is a facility now being built at Los Alamos National Laboratory (LANL) as part of the Department of Energy (DOE) nuclear weapons stockpile stewardship program. DARHT will be used to evaluate the safety and reliability of nuclear weapons, evaluate conventional munitions and study high-velocity impact phenomena. DARHT will be equipped with two accelerator-driven, high-intensity X-ray machines to record images of materials driven by high explosives. DARHT will be used for a variety of hydrodynamic tests, and DOE plans to conduct some dynamic experiments using plutonium at DARHT as well.

  19. Reliable Detection of Respiratory Syncytial Virus Infection in Children for Adequate Hospital Infection Control Management

    PubMed Central

    Abels, Susanne; Nadal, David; Stroehle, Angelika; Bossart, Walter

    2001-01-01

    By using a rapid test for respiratory syncytial virus (RSV) detection (Abbott TestPack RSV), a number of patients were observed, showing repeatedly positive results over a period of up to 10 weeks. A prospective study was initiated to compare the rapid test with an antigen capture enzyme immunoassay (EIA) and a nested reverse transcriptase PCR (RT-PCR) protocol for detection of RSV serotypes A and B. Only respiratory samples from children exhibiting the prolonged presence of RSV (≥5 days) as determined by the rapid test were considered. A total of 134 specimens from 24 children was investigated by antigen capture EIA and nested RT-PCR. Using RT-PCR as the reference method, we determined the RSV rapid test to have a specificity of 63% and a sensitivity of 66% and the antigen capture EIA to have a specificity of 96% and a sensitivity of 69% for acute-phase samples and the homologous virus serotype A. In 7 (29%) of 24 patients, the positive results of the RSV rapid test could not be confirmed by either nested RT-PCR or antigen capture EIA. In these seven patients a variety of other respiratory viruses were detected. For general screening the RSV rapid test was found to be a reasonable tool to get quick results. However, its lack of specificity in some patients requires confirmation by additional tests to rule out false-positive results and/or detection of other respiratory viruses. PMID:11526141

  20. 21 CFR 201.5 - Drugs; adequate directions for use.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Drugs; adequate directions for use. 201.5 Section...) DRUGS: GENERAL LABELING General Labeling Provisions § 201.5 Drugs; adequate directions for use. Adequate directions for use means directions under which the layman can use a drug safely and for the purposes...

  1. 21 CFR 201.5 - Drugs; adequate directions for use.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Drugs; adequate directions for use. 201.5 Section...) DRUGS: GENERAL LABELING General Labeling Provisions § 201.5 Drugs; adequate directions for use. Adequate directions for use means directions under which the layman can use a drug safely and for the purposes...

  2. 4 CFR 200.14 - Responsibility for maintaining adequate safeguards.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 4 Accounts 1 2010-01-01 2010-01-01 false Responsibility for maintaining adequate safeguards. 200.14 Section 200.14 Accounts RECOVERY ACCOUNTABILITY AND TRANSPARENCY BOARD PRIVACY ACT OF 1974 § 200.14 Responsibility for maintaining adequate safeguards. The Board has the responsibility for maintaining adequate technical, physical, and...

  3. 10 CFR 1304.114 - Responsibility for maintaining adequate safeguards.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Responsibility for maintaining adequate safeguards. 1304.114 Section 1304.114 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PRIVACY ACT OF 1974 § 1304.114 Responsibility for maintaining adequate safeguards. The Board has the responsibility for maintaining adequate technical, physical, and security...

  4. 10 CFR 1304.114 - Responsibility for maintaining adequate safeguards.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Responsibility for maintaining adequate safeguards. 1304.114 Section 1304.114 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PRIVACY ACT OF 1974 § 1304.114 Responsibility for maintaining adequate safeguards. The Board has the responsibility for maintaining adequate technical, physical, and security...

  5. 4 CFR 200.14 - Responsibility for maintaining adequate safeguards.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 4 Accounts 1 2011-01-01 2011-01-01 false Responsibility for maintaining adequate safeguards. 200....14 Responsibility for maintaining adequate safeguards. The Board has the responsibility for maintaining adequate technical, physical, and security safeguards to prevent unauthorized disclosure...

  6. Bony abnormalities of the hip joint: a new comprehensive, reliable and radiation-free measurement method using magnetic resonance imaging

    PubMed Central

    Harris-Hayes, Marcie; Commean, Paul K.; Patterson, Jacqueline D.; Clohisy, John C.; Hillen, Travis J.

    2014-01-01

    The objective of this study was to develop comprehensive and reliable radiation-free methods to quantify femoral and acetabular morphology using magnetic resonance imaging (MRI). Thirty-two hips [16 subjects, 6 with intra-articular hip disorder (IAHD); 10 controls] were included. A 1.5-T magnetic resonance system was used to obtain three-dimensional fat-suppressed gradient-echo images at the pelvis and distal femora. After acquisition, pelvic images were post-processed to correct for coronal, axial and sagittal rotation. Measurements performed included acetabular version (AV), femoral version (FV), lateral center-edge angle (LCEA), femoral neck angle (FNA) and alpha angle (AA) at 3, 2, 1 and 12 a.m. Two experienced raters, a musculoskeletal radiologist and an orthopedic physical therapist, and a novice rater, a research assistant, completed reliability testing. Raters measured all hips twice with minimum 2 weeks between sessions. Intra-class Correlation Coefficients (ICCs) were used to determine rater reliability; standard error of measurements was reported to estimate the reasonable limits of the expected error in the different raters’ scores. Inter-rater reliability was good to excellent for all raters for AV, FV, FNA and LCEA (ICCs: 0.82–0.98); good to excellent between experienced raters (ICCs: 0.78–0.86) and poor to good between novice and experienced raters (ICCs: 0.23–0.78) for AA. Intra-rater reliability was good to excellent for all raters for AV, FV and FNA (ICCs: 0.93–0.99); for one experienced and novice rater for LCEA (ICCs: 0.84–0.89); moderate to excellent for the experienced raters for AA (ICCs: 0.72-0.89). Intra-rater reliability was poor for the second experienced rater for LCEA (ICC: 0.56), due to a single measurement error and for the novice rater for AA (ICCs: 0.17–0.38). We described MRI methods to comprehensively assess femoral and acetabular morphology. Measurements such as AV, FV and FNA and the LCEA can be made reliably by

  7. Reliability of the Brazilian Portuguese version of the fatigue severity scale and its correlation with pulmonary function, dyspnea, and functional capacity in patients with COPD*

    PubMed Central

    Valderramas, Silvia; Camelier, Aquiles Assunção; da Silva, Sinara Alves; Mallmann, Renata; de Paulo, Hanna Karine; Rosa, Fernanda Warken

    2013-01-01

    OBJECTIVE: To describe the intra-rater and inter-rater reliability of the Brazilian Portuguese version of the fatigue severity scale (FSS) in patients with COPD and to identify the presence of its association with parameters of pulmonary function, dyspnea, and functional capacity. METHODS: This was an observational cross-sectional study involving 50 patients with COPD, who completed the FSS in interviews with two researchers in two visits. The FSS scores were correlated with those of the Medical Research Council (MRC) scale, as well as with FEV1, FVC, and six-minute walk distance (6MWD). RESULTS: The mean age of the patients was 69.4 ± 8.23 years, whereas the mean FEV1 was 46.5 ± 20.4% of the predicted value. The scale was reliable, with an intraclass correlation coefficient of 0.90 (95% CI, 0.81-0.94; p < 0.01). The FSS scores showed significant correlations with those of MRC scale (r = 0.70; p < 0.01), as well as with 6MWD (r = –0.77; p < 0.01), FEV1 (r = –0.38; p < 0.01), FVC (r = –0.35; p < 0.01), and stage of the disease in accordance with the Global Initiative for Chronic Obstructive Lung Disease criteria (r = 0.37; p < 0.01). CONCLUSIONS: The Brazilian Portuguese version of the FSS proved reliable for use in COPD patients in Brazil and showed significant correlations with sensation of dyspnea, functional capacity, pulmonary function, and stage of the disease. PMID:24068263

  8. The Autism Psychodynamic Evaluation of Changes (APEC) scale: a reliability and validity study on a newly developed standardized psychodynamic assessment for youth with Pervasive Developmental Disorders.

    PubMed

    Haag, Geneviève; Botbol, Michel; Graignic, Rozenn; Perez-Diaz, Fernando; Bronsard, Guillaume; Kermarrec, Solenn; Clement, Marie-Christine; Cukierman, Annick; Druon, Catherine; Duprat, Andrée; Jardin, Françoise; du Chatellier, Anik Maufras; Tricaud, Jacqueline; Urwand, Simone; Guilé, Jean-Marc; Cohen, David; Tordjman, Sylvie

    2010-12-01

    The present study was designed to examine the reliability and validity of the Autism Psychodynamic Evaluation of Changes (APEC) scale, developed to assess the evolution in individuals with autism under treatment. The APEC scale focuses on the key role of impairment in body image construction, which requires cross-modal sensory integration through emotional communication with motor representations. Thus, the body image construction is associated simultaneously with spatial and temporal organization and allows the emergence of self- and others-representations. The use of the APEC scale, with its seven domains (expression of emotion in relationships, eye contact, body image, graphic productions, exploration of space and objects, time perception, and verbal language), underlines the importance in autistic disorder of anxieties related to body and spatial representations, and of impairment in the body ego construction which is closely linked to the emergence of individuation/separation processes. This study was conducted on 73 children and adolescents with autistic disorder. They were recruited in day care facilities where two caregivers independently gave their ratings based on their clinical observation on a daily basis during the same month. Analyses included assessing construct validity through correspondence analyses and inter-rater reliability using kappa coefficients. The APEC scale offers a reliable and validated psychodynamic assessment of interest for professionals (such as child psychiatrists, caregivers, therapists or teachers) and researchers working with children, adolescents and adults with autistic disorder, especially in the follow-up of their evolution. The APEC scale provides an approach at the interface of psychoanalysis and neuroscience, and is also of interest for clinical and developmental psychology. Using the APEC scale in a range of different practical and research settings will foster links between psychoanalytic perspectives and educational

  9. The clubfoot assessment protocol (CAP); description and reliability of a structured multi-level instrument for follow-up

    PubMed Central

    Andriesse, Hanneke; Hägglund, Gunnar; Jarnlo, Gun-Britt

    2005-01-01

    Background In most clubfoot studies, the outcome instruments used are designed to evaluate classification or long-term cross-sectional results. Variables deal mainly with factors on body function/structure level. Wide scorings intervals and total sum scores increase the risk that important changes and information are not detected. Studies of the reliability, validity and responsiveness of these instruments are sparse. The lack of an instrument for longitudinal follow-up led the investigators to develop the Clubfoot Assessment Protocol (CAP). The aim of this article is to introduce and describe the CAP and evaluate the items inter- and intra reliability in relation to patient age. Methods The CAP was created from 22 items divided between body function/structure (three subgroups) and activity (one subgroup) levels according to the International Classification of Function, Disability and Health (ICF). The focus is on item and subgroup development. Two experienced examiners assessed 69 clubfeet in 48 children who had a median age of 2.1 years (range, 0 to 6.7 years). Both treated and untreated feet with different grades of severity were included. Three age groups were constructed for studying the influence of age on reliability. The intra- rater study included 32 feet in 20 children who had a median age of 2.5 years (range, 4 months to 6.8 years). The Unweighted Kappa statistics, percentage observer agreement, and amount of categories defined how reliability was to be interpreted. Results The inter-rater reliability was assessed as moderate to good for all but one item. Eighteen items had kappa values > 0.40. Three items varied from 0.35 to 0.38. The mean percentage observed agreement was 82% (range, 62 to 95%). Different age groups showed sufficient agreement. Intra- rater; all items had kappa values > 0.40 [range, 0.54 to 1.00] and a mean percentage agreement of 89.5%. Categories varied from 3 to 5. Conclusion The CAP contains more detailed information than previous

  10. Trials and tribulations of conducting medication trials: pediatric bipolar disorder as prototype

    PubMed Central

    Pavuluri, Mani

    2015-01-01

    “In reality, it is the interpretation of symptomatology that leads to accurate diagnosis, rather than the short-term training and inter-rater reliability attained by conducting semi-structured research diagnostic interviews.” PMID:25642317

  11. 7 CFR 4290.200 - Adequate capital for RBICs.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 15 2011-01-01 2011-01-01 false Adequate capital for RBICs. 4290.200 Section 4290.200 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND... Qualifications for the RBIC Program Capitalizing A Rbic § 4290.200 Adequate capital for RBICs. You must meet...

  12. 13 CFR 107.200 - Adequate capital for Licensees.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Adequate capital for Licensees... INVESTMENT COMPANIES Qualifying for an SBIC License Capitalizing An Sbic § 107.200 Adequate capital for... Licensee, and to receive Leverage. (a) You must have enough Regulatory Capital to provide...

  13. 13 CFR 107.200 - Adequate capital for Licensees.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Adequate capital for Licensees... INVESTMENT COMPANIES Qualifying for an SBIC License Capitalizing An Sbic § 107.200 Adequate capital for... Licensee, and to receive Leverage. (a) You must have enough Regulatory Capital to provide...

  14. 7 CFR 4290.200 - Adequate capital for RBICs.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Adequate capital for RBICs. 4290.200 Section 4290.200 Agriculture Regulations of the Department of Agriculture (Continued) RURAL BUSINESS-COOPERATIVE SERVICE AND... Qualifications for the RBIC Program Capitalizing A Rbic § 4290.200 Adequate capital for RBICs. You must meet...

  15. 10 CFR 1304.114 - Responsibility for maintaining adequate safeguards.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Responsibility for maintaining adequate safeguards. 1304.114 Section 1304.114 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PRIVACY ACT OF 1974 § 1304.114 Responsibility for maintaining adequate safeguards. The Board has the responsibility for maintaining...

  16. 40 CFR 716.25 - Adequate file search.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Adequate file search. 716.25 Section 716.25 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of...

  17. 40 CFR 51.354 - Adequate tools and resources.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 2 2011-07-01 2011-07-01 false Adequate tools and resources. 51.354... Requirements § 51.354 Adequate tools and resources. (a) Administrative resources. The program shall maintain the administrative resources necessary to perform all of the program functions including...

  18. 40 CFR 51.354 - Adequate tools and resources.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 2 2012-07-01 2012-07-01 false Adequate tools and resources. 51.354... Requirements § 51.354 Adequate tools and resources. (a) Administrative resources. The program shall maintain the administrative resources necessary to perform all of the program functions including...

  19. 40 CFR 51.354 - Adequate tools and resources.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 2 2014-07-01 2014-07-01 false Adequate tools and resources. 51.354... Requirements § 51.354 Adequate tools and resources. (a) Administrative resources. The program shall maintain the administrative resources necessary to perform all of the program functions including...

  20. 40 CFR 51.354 - Adequate tools and resources.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 2 2013-07-01 2013-07-01 false Adequate tools and resources. 51.354... Requirements § 51.354 Adequate tools and resources. (a) Administrative resources. The program shall maintain the administrative resources necessary to perform all of the program functions including...

  1. 40 CFR 716.25 - Adequate file search.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Adequate file search. 716.25 Section... ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of a person's responsibility to search records is limited to records in the location(s) where the...

  2. 40 CFR 716.25 - Adequate file search.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 32 2013-07-01 2013-07-01 false Adequate file search. 716.25 Section... ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of a person's responsibility to search records is limited to records in the location(s) where the...

  3. 40 CFR 716.25 - Adequate file search.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 31 2014-07-01 2014-07-01 false Adequate file search. 716.25 Section... ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of a person's responsibility to search records is limited to records in the location(s) where the...

  4. 40 CFR 716.25 - Adequate file search.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 32 2012-07-01 2012-07-01 false Adequate file search. 716.25 Section... ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.25 Adequate file search. The scope of a person's responsibility to search records is limited to records in the location(s) where the...

  5. 10 CFR 1304.114 - Responsibility for maintaining adequate safeguards.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Responsibility for maintaining adequate safeguards. 1304.114 Section 1304.114 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PRIVACY ACT OF 1974 § 1304.114 Responsibility for maintaining adequate safeguards. The Board has the responsibility for maintaining...

  6. 10 CFR 1304.114 - Responsibility for maintaining adequate safeguards.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Responsibility for maintaining adequate safeguards. 1304.114 Section 1304.114 Energy NUCLEAR WASTE TECHNICAL REVIEW BOARD PRIVACY ACT OF 1974 § 1304.114 Responsibility for maintaining adequate safeguards. The Board has the responsibility for maintaining...

  7. 10 CFR 503.35 - Inability to obtain adequate capital.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Inability to obtain adequate capital. 503.35 Section 503.35 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS NEW FACILITIES Permanent Exemptions for New Facilities § 503.35 Inability to obtain adequate capital. (a) Eligibility. Section 212(a)(1)(D)...

  8. 10 CFR 503.35 - Inability to obtain adequate capital.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Inability to obtain adequate capital. 503.35 Section 503.35 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS NEW FACILITIES Permanent Exemptions for New Facilities § 503.35 Inability to obtain adequate capital. (a) Eligibility. Section 212(a)(1)(D)...

  9. 15 CFR 970.404 - Adequate exploration plan.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR EXPLORATION LICENSES Certification of Applications § 970.404 Adequate exploration plan. Before he may certify an application, the Administrator must find... 15 Commerce and Foreign Trade 3 2011-01-01 2011-01-01 false Adequate exploration plan....

  10. 15 CFR 970.404 - Adequate exploration plan.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR EXPLORATION LICENSES Certification of Applications § 970.404 Adequate exploration plan. Before he may certify an application, the Administrator must find... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Adequate exploration plan....

  11. "Something Adequate"? In Memoriam Seamus Heaney, Sister Quinlan, Nirbhaya

    ERIC Educational Resources Information Center

    Parker, Jan

    2014-01-01

    Seamus Heaney talked of poetry's responsibility to represent the "bloody miracle", the "terrible beauty" of atrocity; to create "something adequate". This article asks, what is adequate to the burning and eating of a nun and the murderous gang rape and evisceration of a medical student? It considers Njabulo…

  12. Reliability training

    NASA Technical Reports Server (NTRS)

    Lalli, Vincent R. (Editor); Malec, Henry A. (Editor); Dillard, Richard B.; Wong, Kam L.; Barber, Frank J.; Barina, Frank J.

    1992-01-01

    Discussed here is failure physics, the study of how products, hardware, software, and systems fail and what can be done about it. The intent is to impart useful information, to extend the limits of production capability, and to assist in achieving low cost reliable products. A review of reliability for the years 1940 to 2000 is given. Next, a review of mathematics is given as well as a description of what elements contribute to product failures. Basic reliability theory and the disciplines that allow us to control and eliminate failures are elucidated.

  13. 34 CFR 200.20 - Making adequate yearly progress.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... number of students in the group must be sufficient to yield statistically reliable information under... the reading/language arts and mathematics assessments in the three grade spans required under § 200.5... disabilities, respectively, is sufficient to yield statistically reliable information under § 200.7(a); or...

  14. 34 CFR 200.20 - Making adequate yearly progress.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... number of students in the group must be sufficient to yield statistically reliable information under... disabilities, respectively, is sufficient to yield statistically reliable information under § 200.7(a); or (B... students. (iii) For the purpose of reporting information on report cards under section 1111(h) of the...

  15. 34 CFR 200.20 - Making adequate yearly progress.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... number of students in the group must be sufficient to yield statistically reliable information under... disabilities, respectively, is sufficient to yield statistically reliable information under § 200.7(a); or (B... students. (iii) For the purpose of reporting information on report cards under section 1111(h) of the...

  16. 34 CFR 200.20 - Making adequate yearly progress.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... number of students in the group must be sufficient to yield statistically reliable information under... disabilities, respectively, is sufficient to yield statistically reliable information under § 200.7(a); or (B... students. (iii) For the purpose of reporting information on report cards under section 1111(h) of the...

  17. Reliability physics

    NASA Technical Reports Server (NTRS)

    Cuddihy, E. F.; Ross, R. G., Jr.

    1984-01-01

    Speakers whose topics relate to the reliability physics of solar arrays are listed and their topics briefly reviewed. Nine reports are reviewed ranging in subjects from studies of photothermal degradation in encapsulants and polymerizable ultraviolet stabilizers to interface bonding stability to electrochemical degradation of photovoltaic modules.

  18. Arabidopsis: An Adequate Model for Dicot Root Systems?

    PubMed

    Zobel, Richard W

    2016-01-01

    The Arabidopsis root system is frequently considered to have only three classes of root: primary, lateral, and adventitious. Research with other plant species has suggested up to eight different developmental/functional classes of root for a given plant root system. If Arabidopsis has only three classes of root, it may not be an adequate model for eudicot plant root systems. Recent research, however, can be interpreted to suggest that pre-flowering Arabidopsis does have at least five (5) of these classes of root. This then suggests that Arabidopsis root research can be considered an adequate model for dicot plant root systems. PMID:26904040

  19. Validity and Reliability of Two-Dimensional Motion Analysis for Quantifying Postural Deficits in Adults With and Without Neurological Impairment.

    PubMed

    Paul, S S; Lester, M E; Foreman, K B; Dibble, L E

    2016-09-01

    Frequently, clinical balance outcome measures are limited by floor or ceiling effects and provide insufficient resolution to determine subtle deficits. Detailed assessment of postural control obtained through posturography may be cost-prohibitive or logistically infeasible in some clinical settings. Two-dimensional (2D) motion analysis may provide a clinically feasible means of obtaining detailed quantification of balance deficits. Forty-five participants aged 18-80 years, with and without Parkinson disease, performed the Push and Release (PR) test, sit-to-stand (STS), and timed single leg stance (SLS). Performance was captured simultaneously using a three-dimensional (3D) (10-camera laboratory-based 3D motion capture system and 3D motion analysis software) and 2D (two commercially available video cameras and 2D motion analysis software) system. Agreement was excellent between 2D and 3D systems for all outcomes of the PR and SLS (intraclass correlation coefficients [ICC2,1 ] 0.96-0.99, 95% CIs 0.92-0.98 to 0.99-1.0), and ranged from fair to excellent for STS outcomes (ICC2,1 0.59-0.93, 95% CIs 0.36-0.75 to 0.87-0.96). Test-retest reliability (ICC3,1 0.89-1.0, 95% CIs 0.76-0.96 to 1.0-1.0) and inter-rater reliability (ICC2,1 0.77-1.0, 95% CIs 0.61-0.87 to 1.0-1.0) of the 2D obtained outcomes were excellent. A technology package of commonly available video cameras and 2D motion analysis software was a valid and reliable method for quantifying outcomes of postural control tasks in people with a range of balance abilities. Two-dimensional analysis can be used in clinical practice to provide balance assessments as a cost-effective alternative to 3D motion capture. Anat Rec, 299:1165-1173, 2016. © 2016 Wiley Periodicals, Inc. PMID:27314922

  20. Working group on the “adequate minimum” V=volcanic observatory

    USGS Publications Warehouse

    Tilling, R.I.

    1982-01-01

    A working group consisting of R. I. Tilling (United States, Chairman), M. Espendola (Mexico), E. Malavassi (Costa Rica), L. Villari (Italy), and J.P Viode (France) met on the island of Guadeloupe on February 20, 1981, to discuss informally the requirements for a "Minimum" volcano observatory, one which would have the essential monitoring equipment and staff to provide reliable information on the state of an active volcno. Given the premise that any monitoring of a volcano is better than none at all, the owrking group then proceeded to consider the concept of an "adequate minimum" observatory. 

  1. Is the Marketing Concept Adequate for Continuing Education?

    ERIC Educational Resources Information Center

    Rittenburg, Terri L.

    1984-01-01

    Because educators have a social responsibility to those they teach, the marketing concept may not be adequate as a philosophy for continuing education. In attempting to broaden the audience for continuing education, educators should consider a societal marketing concept to meet the needs of the educationally disadvantaged. (SK)

  2. 9 CFR 305.3 - Sanitation and adequate facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Sanitation and adequate facilities. 305.3 Section 305.3 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND CERTIFICATION...

  3. Understanding Your Adequate Yearly Progress (AYP), 2011-2012

    ERIC Educational Resources Information Center

    Missouri Department of Elementary and Secondary Education, 2011

    2011-01-01

    The "No Child Left Behind Act (NCLB) of 2001" requires all schools, districts/local education agencies (LEAs) and states to show that students are making Adequate Yearly Progress (AYP). NCLB requires states to establish targets in the following ways: (1) Annual Proficiency Target; (2) Attendance/Graduation Rates; and (3) Participation Rates.…

  4. Assessing Juvenile Sex Offenders to Determine Adequate Levels of Supervision.

    ERIC Educational Resources Information Center

    Gerdes, Karen E.; And Others

    1995-01-01

    This study analyzed the internal consistency of four inventories used by Utah probation officers to determine adequate and efficacious supervision levels and placement for juvenile sex offenders. Three factors accounted for 41.2 percent of variance (custodian's and juvenile's attitude toward intervention, offense characteristics, and historical…

  5. 34 CFR 200.13 - Adequate yearly progress in general.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 1 2011-07-01 2011-07-01 false Adequate yearly progress in general. 200.13 Section 200.13 Education Regulations of the Offices of the Department of Education OFFICE OF ELEMENTARY AND SECONDARY EDUCATION, DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE...

  6. 34 CFR 200.20 - Making adequate yearly progress.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 1 2011-07-01 2011-07-01 false Making adequate yearly progress. 200.20 Section 200.20 Education Regulations of the Offices of the Department of Education OFFICE OF ELEMENTARY AND SECONDARY EDUCATION, DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE DISADVANTAGED...

  7. Do Beginning Teachers Receive Adequate Support from Their Headteachers?

    ERIC Educational Resources Information Center

    Menon, Maria Eliophotou

    2012-01-01

    The article examines the problems faced by beginning teachers in Cyprus and the extent to which headteachers are considered to provide adequate guidance and support to them. Data were collected through interviews with 25 school teachers in Cyprus, who had recently entered teaching (within 1-5 years) in public primary schools. According to the…

  8. Do measures commonly used in body image research perform adequately with African American college women?

    PubMed

    Kashubeck-West, Susan; Coker, Angela D; Awad, Germine H; Stinson, Rebecca D; Bledman, Rashanta; Mintz, Laurie

    2013-07-01

    This study examines reliability and validity estimates for 3 widely used measures in body image research in a sample of African American college women (N = 278). Internal consistency estimates were adequate (α coefficients above .70) for all measures, and evidence of convergent and discriminant validity was found. Confirmatory factor analyses failed to replicate the hypothesized factor structures of these measures. Exploratory factor analyses indicated that 4 factors found for the Sociocultural Attitudes Toward Appearance Questionnaire were similar to the hypothesized subscales, with fewer items. The factors found for the Multidimensional Body-Self Relations Questionnaire-Appearance Scales and the Body Dissatisfaction subscale of the Eating Disorders Inventory-3 were not similar to the subscales developed by the scale authors. Validity and reliability evidence is discussed for the new factors. PMID:23731233

  9. Assessment of Interpersonal Motivation in Transcripts (AIMIT): an inter- and intra-rater reliability study of a new method of detection of interpersonal motivational systems in psychotherapy.

    PubMed

    Fassone, G; Valcella, F; Pallini, S; Scarcella, F; Tombolini, L; Ivaldi, A; Prunetti, E; Manaresi, F; Liotti, G

    2012-01-01

    Assessing Interpersonal Motivations in Transcripts (AIMIT) is a coding system aiming to systematically detect the activity of interpersonal motivational systems (IMS) in the therapeutic dialogue. An inter- and intra-rater reliability study has been conducted. Sixteen video-recorded psychotherapy sessions were selected and transcribed according to the AIMIT criteria. Sessions relate to 16 patients with an Axis II diagnosis, with a mean Global Assessment of Functioning of 51. For the intra-rater reliability evaluation, five sessions have been selected and assigned to five independent coders who where asked to make a first evaluation, and then a second independent one 14 days later. For the inter-rater reliability study, the sessions coded by the therapist-coder were jointly revised with another coder and finally classified as gold standard. The 16 standard sessions were sent to other evaluators for the independent coding. The agreement (κ) was estimated according to the following parameters for each coding unit: evaluation units supported by the 'codable' activation of one or more IMS; motivational interaction with reference to the ongoing relation between patient and therapist; an interaction between the patient and another person reported/narrated by the patient; detection of specific IMS: attachment (At), caregiving (CG), rank (Ra), sexuality (Se), peer cooperation (PC); and transitions from one IMS to another were also scored. The intra-rater agreement was evaluated through the parameters 'cod', 'At', 'CG', 'Ra', 'Se' and 'PC' described above. A total of 2443 coding units were analysed. For the nine parameters on which the agreement was calculated, eight ['coded (Cod)', 'ongoing relation (Rel)', 'narrated relation (Nar)', 'At', 'CG', 'Ra', 'Se' and 'PC'] have κ values comprised between 0.62 (CG) and 0.81 (Cod) and were therefore satisfactory. The scoring of 'transitions' showed agreement values slightly below desired cut-off (0.56). Intra-rater reliability was

  10. Maintaining adequate hydration and nutrition in adult enteral tube feeding.

    PubMed

    Dunn, Sasha

    2015-01-01

    Predicting the nutritional and fluid requirements of enterally-fed patients can be challenging and the practicalities of ensuring adequate delivery must be taken into consideration. Patients who are enterally fed can be more reliant on clinicians, family members and carers to meet their nutrition and hydration needs and identify any deficiencies, excesses or problems with delivery. Estimating a patient's requirements can be challenging due to the limitations of using predictive equations in the clinical setting. Close monitoring by all those involved in the patient's care, as well as regular review by a dietitian, is therefore required to balance the delivery of adequate feed and fluids to meet each patient's individual needs and prevent the complications of malnutrition and dehydration. Increasing the awareness of the signs of malnutrition and dehydration in patients receiving enteral tube feeding among those involved in a patient's care will help any deficiencies to be detected early on and rectified before complications occur. PMID:26087203

  11. Network reliability

    NASA Technical Reports Server (NTRS)

    Johnson, Marjory J.

    1985-01-01

    Network control (or network management) functions are essential for efficient and reliable operation of a network. Some control functions are currently included as part of the Open System Interconnection model. For local area networks, it is widely recognized that there is a need for additional control functions, including fault isolation functions, monitoring functions, and configuration functions. These functions can be implemented in either a central or distributed manner. The Fiber Distributed Data Interface Medium Access Control and Station Management protocols provide an example of distributed implementation. Relative information is presented here in outline form.

  12. Affect Consciousness in children with internalizing problems: Assessment of affect integration.

    PubMed

    Taarvig, Eva; Solbakken, Ole André; Grova, Bjørg; Monsen, Jon T

    2015-10-01

    Affect integration was operationalized through the Affect Consciousness (AC) construct as degrees of awareness, tolerance, nonverbal expression and conceptual expression of 11 affects. These aspects are assessed through a semi-structured Affect Consciousness Interview (ACI) and separate rating scales (Affect Consciousness Scales (ACSs)) developed for use in research and clinical work with adults with psychopathological disorders. Age-adjusted changes were made in the interview and rating system. This study explored the applicability of the adjusted ACI to a sample of 11-year-old children with internalizing problems through examining inter-rater reliability of the adjusted ACI, along with relationships between the AC aspects and aspects of mental health as symptoms of depression, symptoms of anxiety, social competence, besides general intelligence. Satisfactory inter-rater reliability was found, as well as consistent relationships between the AC aspects and the various aspects of mental health, a finding which coincides with previous research. The finding indicates that the attainment of the capacity to deal adaptively with affect is probably an important contributor to the development of adequate social competence and maybe in the prevention of psychopathology in children. The results indicate that the adjusted ACI and rating scales are useful tools in treatment planning with children at least from the age of 11 years. PMID:24941941

  13. Development of the Children's Communication Checklist (CCC): a method for assessing qualitative aspects of communicative impairment in children.

    PubMed

    Bishop, D V

    1998-09-01

    The Children's Communication Checklist (CCC) was developed to assess aspects of communicative impairment that are not adequately evaluated by contemporary standardised language tests. These are predominantly pragmatic abnormalities seen in social communication, although other qualitative aspects of speech and language were also included. Some items covering social relationships and restricted interests were incorporated, so that the relationship between pragmatic difficulties and other characteristics of pervasive developmental disorders could be explored. Checklist ratings were obtained for 76 children aged 7 to 9 years, all of whom had received special education for language impairment. In 71 cases, 2 raters (usually a teacher and speech-language therapist) independently completed the checklist, making it possible to establish inter-rater reliability. From an initial pool of 93 items, 70 items, grouped into 9 scales, were retained. Five of the subscales were concerned with pragmatic aspects of communication. A composite pragmatic impairment scale formed from these subscales had inter-rater reliability and internal consistency of around .80. This composite discriminated between children with a school diagnosis of semantic-pragmatic disorder and those with other types of specific language impairment (SLI). The majority of children with pragmatic language impairments did not have any evidence of restricted interests or significant difficulties in the domains of social relationships. PMID:9758196

  14. Adequation of mini satellites to oceanic altimetry missions

    NASA Astrophysics Data System (ADS)

    Bellaieche, G.; Aguttes, J. P.

    1993-01-01

    Association of the mini satellite concept and oceanic altimetry missions is discussed. Mission definition and most constraining requirements (mesoscale for example) demonstrate mini satellites to be quite adequate for such missions. Progress in altimeter characteristics, orbit determination, and position reporting allow consideration of oceanic altimetry missions using low Earth orbit satellites. Satellite constellation, trace keeping and orbital period, and required payload characteristics are exposed. The mission requirements covering Sun synchronous orbit, service area, ground system, and launcher characteristics as well as constellation maintenance strategy are specified. Two options for the satellite, orbital mechanics, propulsion, onboard power and stabilizing subsystems, onboard management, satellite ground linkings, mechanical and thermal subsystems, budgets, and planning are discussed.

  15. The reliability of a 10-test package for patients with prolonged back and neck pain: could an examiner without formal medical education be used without loss of quality? A methodological study

    PubMed Central

    Lindell, Odd; Eriksson, Lars; Strender, Lars-Erik

    2007-01-01

    Background In the rehabilitation of patients with prolonged back and neck pain, the physical impairment should be assessed. Previous research has exclusively engaged medically educated examiners, mostly physiotherapists. However, less biased evaluations of efforts at rehabilitation might be achieved by personnel standing outside the treatment work itself. Therefore, if medically untrained examiners could be used without cost to the quality, this might produce a better evaluation at defensible cost and could also be useful in a research context. The aim of this study was to answer the question: given a 10-test package for patients with prolonged back and neck pain, could an examiner without formal medical education be used without loss of quality? Five of the ten tests required the examiner to keep a firm hold against the foundation of those parts of the participant's body that were not supposed to move during the test. Methods Examination by an experienced physiotherapist (A) in performing the package was compared with that by a research assistant (B) without formal medical education. The reliability, including inter- and intra-rater reliability, was assessed. In the inter-rater reliability study, 50 participants (30 patients + 20 healthy subjects) were tested once each by A and B. In the intra-rater reliability study, the 20 healthy subjects were tested twice by A or B. One-way ANOVA intra-class-correlation coefficient (ICC) was calculated and its possible systematic error was determined using a t-test. Results All five tests that required no manual fixation had acceptable reliability (ICC > .60 and no indication of systematic error). Only one of the five tests that required fixation had acceptable reliability. The difference (five vs. one) was significant (p = .01). Conclusion In a 10-test package for patients with prolonged back and neck pain, an examiner without formal medical education could be used without loss of quality, at least for the five tests

  16. Quantifying dose to the reconstructed breast: Can we adequately treat?

    SciTech Connect

    Chung, Eugene; Marsh, Robin B.; Griffith, Kent A.; Moran, Jean M.; Pierce, Lori J.

    2013-04-01

    To evaluate how immediate reconstruction (IR) impacts postmastectomy radiotherapy (PMRT) dose distributions to the reconstructed breast (RB), internal mammary nodes (IMN), heart, and lungs using quantifiable dosimetric end points. 3D conformal plans were developed for 20 IR patients, 10 autologous reconstruction (AR), and 10 expander-implant (EI) reconstruction. For each reconstruction type, 5 right- and 5 left-sided reconstructions were selected. Two plans were created for each patient, 1 with RB coverage alone and 1 with RB + IMN coverage. Left-sided EI plans without IMN coverage had higher heart Dmean than left-sided AR plans (2.97 and 0.84 Gy, p = 0.03). Otherwise, results did not vary by reconstruction type and all remaining metrics were evaluated using a combined AR and EI dataset. RB coverage was adequate regardless of laterality or IMN coverage (Dmean 50.61 Gy, D95 45.76 Gy). When included, IMN Dmean and D95 were 49.57 and 40.96 Gy, respectively. Mean heart doses increased with left-sided treatment plans and IMN inclusion. Right-sided treatment plans and IMN inclusion increased mean lung V{sub 20}. Using standard field arrangements and 3D planning, we observed excellent coverage of the RB and IMN, regardless of laterality or reconstruction type. Our results demonstrate that adequate doses can be delivered to the RB with or without IMN coverage.

  17. Purchasing a cycle helmet: are retailers providing adequate advice?

    PubMed Central

    Plumridge, E.; McCool, J.; Chetwynd, J.; Langley, J. D.

    1996-01-01

    OBJECTIVES: The aim of this study was to examine the selling of cycle helmets in retail stores with particular reference to the adequacy of advice offered about the fit and securing of helmets. METHODS: All 55 retail outlets selling cycle helmets in Christchurch, New Zealand were studied by participant observation. A research entered each store as a prospective customer and requested assistance to purchase a helmet. She took detailed field notes of the ensuing encounter and these were subsequently transcribed, coded, and analysed. RESULTS: Adequate advice for helmet purchase was given in less than half of the stores. In general the sales assistants in specialist cycle shops were better informed and gave more adequate advice than those in department stores. Those who have good advice also tended to be more good advice also tended to be more active in helping with fitting the helmet. Knowledge about safety standards was apparent in one third of sales assistants. Few stores displayed information for customers about the correct fit of cycle helmets. CONCLUSIONS: These findings suggest that the advice and assistance being given to ensure that cycle helmets fit properly is often inadequate and thus the helmets may fail to fulfil their purpose in preventing injury. Consultation between retailers and policy makers is a necessary first step to improving this situation. PMID:9346053

  18. Adequate drainage system design for heap leaching structures.

    PubMed

    Majdi, Abbas; Amini, Mehdi; Nasab, Saeed Karimi

    2007-08-17

    The paper describes an optimum design of a drainage system for a heap leaching structure which has positive impacts on both mine environment and mine economics. In order to properly design a drainage system the causes of an increase in the acid level of the heap which in turn produces severe problems in the hydrometallurgy processes must be evaluated. One of the most significant negative impacts induced by an increase in the acid level within a heap structure is the increase of pore acid pressure which in turn increases the potential of a heap-slide that may endanger the mine environment. In this paper, initially the thickness of gravelly drainage layer is determined via existing empirical equations. Then by assuming that the calculated thickness is constant throughout the heap structure, an approach has been proposed to calculate the required internal diameter of the slotted polyethylene pipes which are used for auxiliary drainage purposes. In order to adequately design this diameter, the pipe's cross-sectional deformation due to stepped heap structure overburden pressure is taken into account. Finally, a design of an adequate drainage system for the heap structure 2 at Sarcheshmeh copper mine is presented and the results are compared with those calculated by exiting equations. PMID:17321044

  19. Preliminary Validation and Reliability Testing of the Montreal Instrument for Cat Arthritis Testing, for Use by Veterinarians, in a Colony of Laboratory Cats

    PubMed Central

    Klinck, Mary P.; Rialland, Pascale; Guillot, Martin; Moreau, Maxim; Frank, Diane; Troncy, Eric

    2015-01-01

    Simple Summary Feline osteoarthritis (OA) is challenging to diagnose. A pain scale was developed for use by veterinarians, in association with their physical examination, and tested for reliability and validity. The scale items were: Interaction with the examiner, Exploration of the room, Body Posture, Gait, Body Condition, condition of Coat and Claws, and abnormal Findings or Cat Reaction upon joint Palpation. Expert review supported the scale content. Two studies using laboratory-housed cats found the most promising results for Gait and Body Posture, in terms of distinguishing between OA and non-OA cats, repeatability of results, and correlations with objectively measured kinetics (weight-bearing). Abstract Subtle signs and conflicting physical and radiographic findings make feline osteoarthritis (OA) challenging to diagnose. A physical examination-based assessment was developed, consisting of eight items: Interaction, Exploration, Posture, Gait, Body Condition, Coat and Claws, (joint) Palpation–Findings, and Palpation–Cat Reaction. Content (experts) and face (veterinary students) validity were excellent. Construct validity, internal consistency, and intra- and inter-rater reliability were assessed via a pilot and main study, using laboratory-housed cats with and without OA. Gait distinguished OA status in the pilot (p = 0.05) study. In the main study, no scale item achieved statistically significant OA detection. Forelimb peak vertical ground reaction force (PVF) correlated inversely with Gait (Rhos = −0.38 (p = 0.03) to −0.41 (p = 0.02)). Body Posture correlated with Gait, and inversely with forelimb PVF at two of three time points (Rhos = −0.38 (p = 0.03) to −0.43 (p = 0.01)). Palpation (Findings, Cat Reaction) did not distinguish OA from non-OA cats. Palpation—Cat Reaction (Forelimbs) correlated inversely with forelimb PVF at two time points (Rhos = −0.41 (p = 0.02) to −0.41 (p = 0.01)), but scores were highly variable, and poorly reliable

  20. Are PPS payments adequate? Issues for updating and assessing rates

    PubMed Central

    Sheingold, Steven H.; Richter, Elizabeth

    1992-01-01

    Declining operating margins under Medicare's prospective payment system (PPS) have focused attention on the adequacy of payment rates. The question of whether annual updates to the rates have been too low or cost increases too high has become important. In this article we discuss issues relevant to updating PPS rates and judging their adequacy. We describe a modification to the current framework for recommending annual update factors. This framework is then used to retrospectively assess PPS payment and cost growth since 1985. The preliminary results suggest that current rates are more than adequate to support the cost of efficient care. Also discussed are why using financial margins to evaluate rates is problematic and alternative methods that might be employed. PMID:10127450

  1. Maintaining Adequate CO2 Washout for an Advanced EMU via a New Rapid Cycle Amine Technology

    NASA Technical Reports Server (NTRS)

    Chullen, Cinda; Conger, Bruce

    2012-01-01

    Over the past several years, NASA has realized tremendous progress in Extravehicular Activity (EVA) technology development. This has been evidenced by the progressive development of a new Rapid Cycle Amine (RCA) system for the Advanced Extravehicular Mobility Unit (AEMU) Portable Life Support Subsystem (PLSS). The PLSS is responsible for the life support of the crew member in the spacesuit. The RCA technology is responsible for carbon dioxide (CO2) and humidity control. Another aspect of the RCA is that it is on-back vacuum-regenerable, efficient, and reliable. The RCA also simplifies the PLSS schematic by eliminating the need for a condensing heat exchanger for humidity control in the current EMU. As development progresses on the RCA, it is important that the sizing be optimized so that the demand on the PLSS battery is minimized. As well, maintaining the CO2 washout at adequate levels during an EVA is an absolute requirement of the RCA and associated ventilation system. Testing has been underway in-house at NASA Johnson Space Center and analysis has been initiated to evaluate whether the technology provides exemplary performance in ensuring that the CO2 is removed sufficiently and the ventilation flow is adequate for maintaining CO2 washout in the AEMU spacesuit helmet of the crew member during an EVA. This paper will review the recent developments of the RCA unit, testing planned in-house with a spacesuit simulator, and the associated analytical work along with insights from the medical aspect on the testing. 1

  2. Combination of structural reliability and interval analysis

    NASA Astrophysics Data System (ADS)

    Qiu, Zhiping; Yang, Di; Elishakoff, Isaac

    2008-02-01

    In engineering applications, probabilistic reliability theory appears to be presently the most important method, however, in many cases precise probabilistic reliability theory cannot be considered as adequate and credible model of the real state of actual affairs. In this paper, we developed a hybrid of probabilistic and non-probabilistic reliability theory, which describes the structural uncertain parameters as interval variables when statistical data are found insufficient. By using the interval analysis, a new method for calculating the interval of the structural reliability as well as the reliability index is introduced in this paper, and the traditional probabilistic theory is incorporated with the interval analysis. Moreover, the new method preserves the useful part of the traditional probabilistic reliability theory, but removes the restriction of its strict requirement on data acquisition. Example is presented to demonstrate the feasibility and validity of the proposed theory.

  3. Dose Limits for Man do not Adequately Protect the Ecosystem

    SciTech Connect

    Higley, Kathryn A.; Alexakhin, Rudolf M.; McDonald, Joseph C.

    2004-08-01

    It has been known for quite some time that different organisms display differing degrees of sensitivity to the effects of ionizing radiations. Some microorganisms such as the bacterium Micrococcus radiodurans, along with many species of invertebrates, are extremely radio-resistant. Humans might be categorized as being relatively sensitive to radiation, and are a bit more resistant than some pine trees. Therefore, it could be argued that maintaining the dose limits necessary to protect humans will also result in the protection of most other species of flora and fauna. This concept is usually referred to as the anthropocentric approach. In other words, if man is protected then the environment is also adequately protected. The ecocentric approach might be stated as; the health of humans is effectively protected only when the environment is not unduly exposed to radiation. The ICRP is working on new recommendations dealing with the protection of the environment, and this debate should help to highlight a number of relevant issues concerning that topic.

  4. ENSURING ADEQUATE SAFETY WHEN USING HYDROGEN AS A FUEL

    SciTech Connect

    Coutts, D

    2007-01-22

    Demonstration projects using hydrogen as a fuel are becoming very common. Often these projects rely on project-specific risk evaluations to support project safety decisions. This is necessary because regulations, codes, and standards (hereafter referred to as standards) are just being developed. This paper will review some of the approaches being used in these evolving standards, and techniques which demonstration projects can implement to bridge the gap between current requirements and stakeholder desires. Many of the evolving standards for hydrogen-fuel use performance-based language, which establishes minimum performance and safety objectives, as compared with prescriptive-based language that prescribes specific design solutions. This is being done for several reasons including: (1) concern that establishing specific design solutions too early will stifle invention, (2) sparse performance data necessary to support selection of design approaches, and (3) a risk-adverse public which is unwilling to accept losses that were incurred in developing previous prescriptive design standards. The evolving standards often contain words such as: ''The manufacturer shall implement the measures and provide the information necessary to minimize the risk of endangering a person's safety or health''. This typically implies that the manufacturer or project manager must produce and document an acceptable level of risk. If accomplished using comprehensive and systematic process the demonstration project risk assessment can ease the transition to widespread commercialization. An approach to adequately evaluate and document the safety risk will be presented.

  5. Adequate peritoneal dialysis: theoretical model and patient treatment.

    PubMed

    Tast, C

    1998-01-01

    The objective of this study was to evaluate the relationship between adequate PD with sufficient weekly Kt/V (2.0) and Creatinine clearance (CCR) (60l) and necessary daily dialysate volume. This recommended parameter was the result of a recent multi-centre study (CANUSA). For this there were 40 patients in our hospital examined and compared in 1996, who carried out PD for at least 8 weeks and up to 6 years. These goals (CANUSA) are easily attainable in the early treatment of many individuals with a low body surface area (BSA). With higher BSA or missing RRF (Residual Renal Function) the daily dose of dialysis must be adjusted. We found it difficult to obtain the recommended parameters and tried to find a solution to this problem. The simplest method is to increase the volume or exchange rate. The most expensive method is to change from CAPD to APD with the possibility of higher volume or exchange rates. Selection of therapy must take into consideration: 1. patient preference, 2. body mass, 3. peritoneal transport rates, 4. ability to perform therapy, 5. cost of therapy and 6. risk of peritonitis. With this information in mind, an individual prescription can be formulated and matched to the appropriate modality of PD. PMID:10392062

  6. Reliability and Confidence.

    ERIC Educational Resources Information Center

    Test Service Bulletin, 1952

    1952-01-01

    Some aspects of test reliability are discussed. Topics covered are: (1) how high should a reliability coefficient be?; (2) two factors affecting the interpretation of reliability coefficients--range of talent and interval between testings; (3) some common misconceptions--reliability of speed tests, part vs. total reliability, reliability for what…

  7. On Adequate Comparisons of Antenna Phase Center Variations

    NASA Astrophysics Data System (ADS)

    Schoen, S.; Kersten, T.

    2013-12-01

    One important part for ensuring the high quality of the International GNSS Service's (IGS) products is the collection and publication of receiver - and satellite antenna phase center variations (PCV). The PCV are crucial for global and regional networks, since they introduce a global scale factor of up to 16ppb or changes in the height component with an amount of up to 10cm, respectively. Furthermore, antenna phase center variations are also important for precise orbit determination, navigation and positioning of mobile platforms, like e.g. the GOCE and GRACE gravity missions, or for the accurate Precise Point Positioning (PPP) processing. Using the EUREF Permanent Network (EPN), Baire et al. (2012) showed that individual PCV values have a significant impact on the geodetic positioning. The statements are further supported by studies of Steigenberger et al. (2013) where the impact of PCV for local-ties are analysed. Currently, there are five calibration institutions including the Institut für Erdmessung (IfE) contributing to the IGS PCV file. Different approaches like field calibrations and anechoic chamber measurements are in use. Additionally, the computation and parameterization of the PCV are completely different within the methods. Therefore, every new approach has to pass a benchmark test in order to ensure that variations of PCV values of an identical antenna obtained from different methods are as consistent as possible. Since the number of approaches to obtain these PCV values rises with the number of calibration institutions, there is the necessity for an adequate comparison concept, taking into account not only the numerical values but also stochastic information and computational issues of the determined PCVs. This is of special importance, since the majority of calibrated receiver antennas published by the IGS origin from absolute field calibrations based on the Hannover Concept, Wübbena et al. (2000). In this contribution, a concept for the adequate

  8. Improving access to adequate pain management in Taiwan.

    PubMed

    Scholten, Willem

    2015-06-01

    There is a global crisis in access to pain management in the world. WHO estimates that 4.65 billion people live in countries where medical opioid consumption is near to zero. For 2010, WHO considered a per capita consumption of 216.7 mg morphine equivalents adequate, while Taiwan had a per capita consumption of 0.05 mg morphine equivalents in 2007. In Asia, the use of opioids is sensitive because of the Opium Wars in the 19th century and for this reason, the focus of controlled substances policies has been on the prevention of diversion and dependence. However, an optimal public health outcome requires that also the beneficial aspects of these substances are acknowledged. Therefore, WHO recommends a policy based on the Principle of Balance: ensuring access for medical and scientific purposes while preventing diversion, harmful use and dependence. Furthermore, international law requires that countries ensure access to opioid analgesics for medical and scientific purposes. There is evidence that opioid analgesics for chronic pain are not associated with a major risk for developing dependence. Barriers for access can be classified in the categories of overly restrictive laws and regulations; insufficient medical training on pain management and problems related to assessment of medical needs; attitudes like an excessive fear for dependence or diversion; and economic and logistical problems. The GOPI project found many examples of such barriers in Asia. Access to opioid medicines in Taiwan can be improved by analysing the national situation and drafting a plan. The WHO policy guidelines Ensuring Balance in National Policies on Controlled Substances can be helpful for achieving this purpose, as well as international guidelines for pain treatment. PMID:26068436

  9. Relating design and environmental variables to reliability

    NASA Astrophysics Data System (ADS)

    Kolarik, William J.; Landers, Thomas L.

    The combination of space application and nuclear power source demands high reliability hardware. The possibilities of failure, either an inability to provide power or a catastrophic accident, must be minimized. Nuclear power experiences on the ground have led to highly sophisticated probabilistic risk assessment procedures, most of which require quantitative information to adequately assess such risks. In the area of hardware risk analysis, reliability information plays a key role. One of the lessons learned from the Three Mile Island experience is that thorough analyses of critical components are essential. Nuclear grade equipment shows some reliability advantages over commercial. However, no statistically significant difference has been found. A recent study pertaining to spacecraft electronics reliability, examined some 2500 malfunctions on more than 300 aircraft. The study classified the equipment failures into seven general categories. Design deficiencies and lack of environmental protection accounted for about half of all failures. Within each class, limited reliability modeling was performed using a Weibull failure model.

  10. Maintaining Adequate CO2 Washout for an Advanced EMU via a New Rapid Cycle Amine Technology

    NASA Technical Reports Server (NTRS)

    Chullen, Cinda

    2011-01-01

    Over the past several years, NASA has realized tremendous progress in Extravehicular Activity (EVA) technology development. This has been evidenced by the progressive development of a new Rapic Cycle Amine (RCA) system for the Advanced Extravehicular Mobility Unit (AEMU) Portable Life Support Subsystem (PLSS). The PLSS is responsible for the life support of the crew member in the spacesuit. The RCA technology is responsible for carbon dioxide (CO2) and humidity control. Another aspect of the RCA is that it is on-back vacuum-regenerable, efficient, and reliable. The RCA also simplifies the PLSS schematic by eliminating the need for a condensing heat exchanger for humidity control in the current EMU. As development progresses on the RCA, it is important that the sizing be optimized so that the demand on the PLSS battery is minimized. As well, maintaining the CO2 washout at adequate levels during an EVA is an absolute requirement of the RCA and associated ventilation system. Testing has been underway in-house at NASA Johnson Space Center and analysis has been initiated to evaluate whether the technology provides exemplary performance in ensuring that the CO2 is removed sufficiently enough and the ventilation flow is adequate enough to maintain CO2 1 Project Engineer, Space Suit and Crew Survival Systems Branch, Crew and Thermal Systems Division, 2101 NASA Parkway, Houston, TX 77058/EC5. washout in the AEMU spacesuit helmet of the crew member during an EVA. This paper will review the recent developments of the RCA unit, the testing results performed in-house with a spacesuit simulator, and the associated analytical work along with insights from the medical aspect on the testing.

  11. Reliability model generator

    NASA Technical Reports Server (NTRS)

    McMann, Catherine M. (Inventor); Cohen, Gerald C. (Inventor)

    1991-01-01

    An improved method and system for automatically generating reliability models for use with a reliability evaluation tool is described. The reliability model generator of the present invention includes means for storing a plurality of low level reliability models which represent the reliability characteristics for low level system components. In addition, the present invention includes means for defining the interconnection of the low level reliability models via a system architecture description. In accordance with the principles of the present invention, a reliability model for the entire system is automatically generated by aggregating the low level reliability models based on the system architecture description.

  12. Percentage of Adults with High Blood Pressure Whose Hypertension Is Adequately Controlled

    MedlinePlus

    ... is Adequately Controlled Percentage of Adults with High Blood Pressure Whose Hypertension is Adequately Controlled Heart disease ... Survey. Age Group Percentage of People with High Blood Pressure that is Controlled by Age Group f94q- ...

  13. Reliability Generalization: "Lapsus Linguae"

    ERIC Educational Resources Information Center

    Smith, Julie M.

    2011-01-01

    This study examines the proposed Reliability Generalization (RG) method for studying reliability. RG employs the application of meta-analytic techniques similar to those used in validity generalization studies to examine reliability coefficients. This study explains why RG does not provide a proper research method for the study of reliability,…

  14. 21 CFR 514.117 - Adequate and well-controlled studies.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... production performance, or biased observation. One or more adequate and well-controlled studies are required... 21 Food and Drugs 6 2013-04-01 2013-04-01 false Adequate and well-controlled studies. 514.117... Applications § 514.117 Adequate and well-controlled studies. (a) Purpose. The primary purpose of...

  15. 21 CFR 514.117 - Adequate and well-controlled studies.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... production performance, or biased observation. One or more adequate and well-controlled studies are required... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Adequate and well-controlled studies. 514.117... Applications § 514.117 Adequate and well-controlled studies. (a) Purpose. The primary purpose of...

  16. 21 CFR 514.117 - Adequate and well-controlled studies.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... production performance, or biased observation. One or more adequate and well-controlled studies are required... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Adequate and well-controlled studies. 514.117... Applications § 514.117 Adequate and well-controlled studies. (a) Purpose. The primary purpose of...

  17. 21 CFR 514.117 - Adequate and well-controlled studies.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... production performance, or biased observation. One or more adequate and well-controlled studies are required... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Adequate and well-controlled studies. 514.117... Applications § 514.117 Adequate and well-controlled studies. (a) Purpose. The primary purpose of...

  18. 21 CFR 514.117 - Adequate and well-controlled studies.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... production performance, or biased observation. One or more adequate and well-controlled studies are required... 21 Food and Drugs 6 2014-04-01 2014-04-01 false Adequate and well-controlled studies. 514.117... Applications § 514.117 Adequate and well-controlled studies. (a) Purpose. The primary purpose of...

  19. 21 CFR 801.5 - Medical devices; adequate directions for use.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Medical devices; adequate directions for use. 801... (CONTINUED) MEDICAL DEVICES LABELING General Labeling Provisions § 801.5 Medical devices; adequate directions for use. Adequate directions for use means directions under which the layman can use a device...

  20. 21 CFR 801.5 - Medical devices; adequate directions for use.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Medical devices; adequate directions for use. 801... (CONTINUED) MEDICAL DEVICES LABELING General Labeling Provisions § 801.5 Medical devices; adequate directions for use. Adequate directions for use means directions under which the layman can use a device...

  1. 21 CFR 801.5 - Medical devices; adequate directions for use.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Medical devices; adequate directions for use. 801... (CONTINUED) MEDICAL DEVICES LABELING General Labeling Provisions § 801.5 Medical devices; adequate directions for use. Adequate directions for use means directions under which the layman can use a device...

  2. 21 CFR 801.5 - Medical devices; adequate directions for use.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Medical devices; adequate directions for use. 801... (CONTINUED) MEDICAL DEVICES LABELING General Labeling Provisions § 801.5 Medical devices; adequate directions for use. Adequate directions for use means directions under which the layman can use a device...

  3. 21 CFR 801.5 - Medical devices; adequate directions for use.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Medical devices; adequate directions for use. 801... (CONTINUED) MEDICAL DEVICES LABELING General Labeling Provisions § 801.5 Medical devices; adequate directions for use. Adequate directions for use means directions under which the layman can use a device...

  4. 76 FR 51041 - Hemoglobin Standards and Maintaining Adequate Iron Stores in Blood Donors; Public Workshop

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-17

    ... HUMAN SERVICES Food and Drug Administration Hemoglobin Standards and Maintaining Adequate Iron Stores in... Standards and Maintaining Adequate Iron Stores in Blood Donors.'' The purpose of this public workshop is to... donor safety and blood availability, and potential measures to maintain adequate iron stores in...

  5. 36 CFR 13.960 - Who determines when there is adequate snow cover?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... adequate snow cover? 13.960 Section 13.960 Parks, Forests, and Public Property NATIONAL PARK SERVICE... Preserve Snowmachine (snowmobile) Operations § 13.960 Who determines when there is adequate snow cover? The superintendent will determine when snow cover is adequate for snowmachine use. The superintendent will follow...

  6. 36 CFR 13.960 - Who determines when there is adequate snow cover?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... adequate snow cover? 13.960 Section 13.960 Parks, Forests, and Public Property NATIONAL PARK SERVICE... Preserve Snowmachine (snowmobile) Operations § 13.960 Who determines when there is adequate snow cover? The superintendent will determine when snow cover is adequate for snowmachine use. The superintendent will follow...

  7. 36 CFR 13.960 - Who determines when there is adequate snow cover?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... adequate snow cover? 13.960 Section 13.960 Parks, Forests, and Public Property NATIONAL PARK SERVICE... Preserve Snowmachine (snowmobile) Operations § 13.960 Who determines when there is adequate snow cover? The superintendent will determine when snow cover is adequate for snowmachine use. The superintendent will follow...

  8. 36 CFR 13.960 - Who determines when there is adequate snow cover?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... adequate snow cover? 13.960 Section 13.960 Parks, Forests, and Public Property NATIONAL PARK SERVICE... Preserve Snowmachine (snowmobile) Operations § 13.960 Who determines when there is adequate snow cover? The superintendent will determine when snow cover is adequate for snowmachine use. The superintendent will follow...

  9. 36 CFR 13.960 - Who determines when there is adequate snow cover?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... adequate snow cover? 13.960 Section 13.960 Parks, Forests, and Public Property NATIONAL PARK SERVICE... Preserve Snowmachine (snowmobile) Operations § 13.960 Who determines when there is adequate snow cover? The superintendent will determine when snow cover is adequate for snowmachine use. The superintendent will follow...

  10. Can There Be Reliability without "Reliability?"

    ERIC Educational Resources Information Center

    Mislevy, Robert J.

    2004-01-01

    An "Educational Researcher" article by Pamela Moss (1994) asks the title question, "Can there be validity without reliability?" Yes, she answers, if by reliability one means "consistency among independent observations intended as interchangeable" (Moss, 1994, p. 7), quantified by internal consistency indices such as KR-20 coefficients and…

  11. HELIOS Critical Design Review: Reliability

    NASA Technical Reports Server (NTRS)

    Benoehr, H. C.; Herholz, J.; Prem, H.; Mann, D.; Reichert, L.; Rupp, W.; Campbell, D.; Boettger, H.; Zerwes, G.; Kurvin, C.

    1972-01-01

    This paper presents Helios Critical Design Review Reliability form October 16-20, 1972. The topics include: 1) Reliability Requirement; 2) Reliability Apportionment; 3) Failure Rates; 4) Reliability Assessment; 5) Reliability Block Diagram; and 5) Reliability Information Sheet.

  12. Conversational characteristics of children with semantic-pragmatic disorder. I: Exchange structure, turntaking, repairs and cohesion.

    PubMed

    Adams, C; Bishop, D V

    1989-12-01

    Conversational samples were obtained from 57 children aged from 8 to 12 years with specific language impairment, and 67 control children aged from 4 to 12 years. Fourteen of the language-impaired children fitted the clinical description of semantic-pragmatic disorder. It was found that exchange structure, turntaking, conversational repair and use of cohesive devices could be assessed with adequate inter-rater and test-retest reliability. Children with semantic-pragmatic disorder produced more initiations than other children. Some of these children also violated turntaking rules by interrupting the conversational partner to an unusual degree. Use of cohesion was normal for children with semantic-pragmatic disorder, but limited in other language-impaired children. Analysis of conversations may be more useful than conventional language tests for identifying linguistic abnormalities in children with semantic-pragmatic disorder. PMID:2627544

  13. Barriers to help-seeking, detection, and adequate treatment for anxiety and mood disorders: implications for health care policy.

    PubMed

    Mechanic, David

    2007-01-01

    Recently, the focus of health policies and initiatives has been directed toward mental health. More precisely, depressive and anxiety disorders have received particular attention because of their disabling outcomes and prevalence among most populations. Despite this increased interest, numerous issues regarding patients' willingness to seek treatment and the adequate recognition and treatment of these disorders by clinicians remain to be addressed. This article considers the factors that influence patients and physicians in their reticence to acknowledge and adequately treat depression and anxiety disorders. It also reviews the impact of society and the media, together with other factors relating to health care organization and administration that affect the treatment of depression and anxiety. In view of the multifaceted challenge involved, efforts to achieve a consensus in determining treatment for those with depressive and anxiety disorders are essential. A consensus will require easy, measurable, and reliable disability indicators; evidence that treatment of patients with varying levels of need is cost effective; and that persons who most need and would benefit from care can be reliably identified among the highly prevalent population of persons with more transient symptoms. Governments and other policymakers should be encouraged to provide appropriate coverage for access to primary and secondary care, the treatments required, and sufficient resources so that care is available when necessary. An important aspect of the challenge is to incorporate these efforts within the realistic constraints of primary care. PMID:17288503

  14. Reliability computation from reliability block diagrams

    NASA Technical Reports Server (NTRS)

    Chelson, P. O.; Eckstein, R. E.

    1971-01-01

    A method and a computer program are presented to calculate probability of system success from an arbitrary reliability block diagram. The class of reliability block diagrams that can be handled include any active/standby combination of redundancy, and the computations include the effects of dormancy and switching in any standby redundancy. The mechanics of the program are based on an extension of the probability tree method of computing system probabilities.

  15. Power electronics reliability analysis.

    SciTech Connect

    Smith, Mark A.; Atcitty, Stanley

    2009-12-01

    This report provides the DOE and industry with a general process for analyzing power electronics reliability. The analysis can help with understanding the main causes of failures, downtime, and cost and how to reduce them. One approach is to collect field maintenance data and use it directly to calculate reliability metrics related to each cause. Another approach is to model the functional structure of the equipment using a fault tree to derive system reliability from component reliability. Analysis of a fictitious device demonstrates the latter process. Optimization can use the resulting baseline model to decide how to improve reliability and/or lower costs. It is recommended that both electric utilities and equipment manufacturers make provisions to collect and share data in order to lay the groundwork for improving reliability into the future. Reliability analysis helps guide reliability improvements in hardware and software technology including condition monitoring and prognostics and health management.

  16. Human Reliability Program Overview

    SciTech Connect

    Bodin, Michael

    2012-09-25

    This presentation covers the high points of the Human Reliability Program, including certification/decertification, critical positions, due process, organizational structure, program components, personnel security, an overview of the US DOE reliability program, retirees and academia, and security program integration.

  17. Reliable Design Versus Trust

    NASA Technical Reports Server (NTRS)

    Berg, Melanie; LaBel, Kenneth A.

    2016-01-01

    This presentation focuses on reliability and trust for the users portion of the FPGA design flow. It is assumed that the manufacturer prior to hand-off to the user tests FPGA internal components. The objective is to present the challenges of creating reliable and trusted designs. The following will be addressed: What makes a design vulnerable to functional flaws (reliability) or attackers (trust)? What are the challenges for verifying a reliable design versus a trusted design?

  18. Predicting software reliability

    NASA Technical Reports Server (NTRS)

    Littlewood, B.

    1989-01-01

    A detailed look is given to software reliability techniques. A conceptual model of the failure process is examined, and some software reliability growth models are discussed. Problems for which no current solutions exist are addressed, emphasizing the very difficult problem of safety-critical systems for which the reliability requirements can be enormously demanding.

  19. Reliability model generator specification

    NASA Technical Reports Server (NTRS)

    Cohen, Gerald C.; Mccann, Catherine

    1990-01-01

    The Reliability Model Generator (RMG), a program which produces reliability models from block diagrams for ASSIST, the interface for the reliability evaluation tool SURE is described. An account is given of motivation for RMG and the implemented algorithms are discussed. The appendices contain the algorithms and two detailed traces of examples.

  20. The Evaluation of a Screening Tool for Children with an Intellectual Disability: The Child and Adolescent Intellectual Disability Screening Questionnaire

    ERIC Educational Resources Information Center

    McKenzie, Karen; Paxton, Donna; Murray, George; Milanesi, Paula; Murray, Aja Louise

    2012-01-01

    The study outlines the evaluation of an intellectual disability screening tool, the "Child and Adolescent Intellectual Disability Screening Questionnaire" ("CAIDS-Q"), with two age groups. A number of aspects of the reliability and validity of the "CAIDS-Q" were assessed for these two groups, including inter-rater reliability, convergent and…

  1. Evaluating "The Safe Living Guide": A Home Hazard Checklist for Seniors

    ERIC Educational Resources Information Center

    Sorcinelli, Andrea; Shaw, Lynn; Freeman, Andrew; Cooper, Kim

    2007-01-01

    Purpose: The purpose of this study was to evaluate the utility and reliability of a home hazard checklist published in Health Canada, "The Safe Living Guide: A Guide to Home Safety for Seniors" (2003). Methods: 76 community-dwelling seniors evaluated the guide, and inter-rater reliability was determined through comparison of ratings of seniors and…

  2. Psychometrics and utility of Psycho-Educational Profile-Revised as a developmental quotient measure among children with the dual disability of intellectual disability and autism.

    PubMed

    Alwinesh, Merlin Thanka Jemi; Joseph, Rachel Beulah Jansirani; Daniel, Anna; Abel, Julie Sandra; Shankar, Satya Raj; Mammen, Priya; Russell, Sushila; Russell, Paul Swamidhas Sudhakar

    2012-09-01

    There is no agreement about the measure to quantify the intellectual/developmental level in children with the dual disability of intellectual disability and autism. Therefore, we studied the psychometric properties and utility of Psycho-Educational Profile-Revised (PEP-R) as a developmental test in this population. We identified 116 children with dual disability from the day care and inpatient database of a specialised Autism Clinic. Scale and domain level scores of PEP-R were collected and analyzed. We examined the internal consistency, domain-total correlation of PEP-R and concurrent validity of PEP-R against Gesell's Developmental Schedule, inter-rater and test-retest reliability and utility of PEP-R among children with dual disability in different ages, functional level and severity of autism. Besides the adequate face and content validity, PEP-R demonstrates a good internal consistency (Cronbach's α ranging from 0.91 to 0.93) and domain-total correlation (ranging from 0.75 to 0.90). The inter-rater reliability (intraclass correlation coefficient, ICC = 0.96) and test-retest reliability (ICC = 0.87) for PEP-R is good. There is moderate-to-high concurrent validity with GDS (r ranging from 0.61 to 0.82; all Ps = 0.001). The utility of PEP-R as a developmental measure was good with infants, toddlers, pre-school and primary school children. The ability of PEP-R to measure the developmental age was good, irrespective of the severity of autism but was better with high-functioning children. The PEP-R as an intellectual/developmental test has strong psychometric properties in children with dual disability. It could be used in children with different age groups and severity of autism. PEP-R should be used with caution as a developmental test in children with dual disability who are low functioning. PMID:22833108

  3. Psychometric evaluation of the Dutch version of the Mood, Interest and Pleasure Questionnaire (MIPQ).

    PubMed

    Petry, Katja; Kuppens, Sofie; Vos, Pieter; Maes, Bea

    2010-01-01

    Recently, several instruments have been developed to measure the subjective component of the quality of life (QOL) of people with profound intellectual and multiple disabilities (PIMD). A next step, however, must be the further validation of these instruments. The present study aimed at evaluating the psychometric properties of one of these instruments, the Dutch version of the Mood, Interest and Pleasure Questionnaire (MIPQ). The MIPQ is a 25-item Likert scale questionnaire with two subscales (Mood and Interest and Pleasure). The MIPQ and the Aberrant Behavior Checklist were completed on 360 participants with severe or profound intellectual disabilities. About 27% of these participants were included in an examination of test-retest of and the inter-rater reliability of the MIPQ. The results suggest that the proposed two-factor structure did not show an adequate fit to our data. An exploratory factor analysis revealed a three-factor structure with positive mood, negative mood and interest as three correlated but distinct subscales. These results are in concurrence with the literature on positive emotions. High internal consistency (α ≥ .80), high inter-rater (r ≥ .69) and high test-retest reliability (r ≥ .86) were found, which indicates the reliable use of the MIPQ in the population of people with PIMD. Strong negative correlations between the MIPQ total score and the Aberant Behavior Checklist's 'lethargy, social withdrawal' subscale provides some evidence of the construct validity of the MIPQ. However, further validation of the MIPQ including other measures of subjective well-being is warranted. PMID:20923725

  4. Norming a VALUE rubric to assess graduate information literacy skills

    PubMed Central

    Turbow, David J.; Evener, Julie

    2016-01-01

    Objective The study evaluated whether a modified version of the information literacy Valid Assessment of Learning in Undergraduate Education (VALUE) rubric would be useful for assessing the information literacy skills of graduate health sciences students. Methods Through facilitated calibration workshops, an interdepartmental six-person team of librarians and faculty engaged in guided discussion about the meaning of the rubric criteria. They applied the rubric to score student work for a peer-review essay assignment in the “Information Literacy for Evidence-Based Practice” course. To determine inter-rater reliability, the raters participated in a follow-up exercise in which they independently applied the rubric to ten samples of work from a research project in the doctor of physical therapy program: the patient case report assignment. Results For the peer-review essay, a high level of consistency in scoring was achieved for the second workshop, with statistically significant intra-class correlation coefficients above 0.8 for 3 criteria: “Determine the extent of evidence needed,” “Use evidence effectively to accomplish a specific purpose,” and “Access the needed evidence.” Participants concurred that the essay prompt and rubric criteria adequately discriminated the quality of student work for the peer-review essay assignment. When raters independently scored the patient case report assignment, inter-rater agreement was low and statistically insignificant for all rubric criteria (kappa=−0.16, p>0.05–kappa=0.12, p>0.05). Conclusions While the peer-review essay assignment lent itself well to rubric calibration, scorers had a difficult time with the patient case report. Lack of familiarity among some raters with the specifics of the patient case report assignment and subject matter might have accounted for low inter-rater reliability. When norming, it is important to hold conversations about search strategies and expectations of performance. Overall

  5. 21 CFR 314.126 - Adequate and well-controlled studies.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...-evident (general anesthetics, drug metabolism). (3) The method of selection of subjects provides adequate... respect to pertinent variables such as age, sex, severity of disease, duration of disease, and use of... 21 Food and Drugs 5 2011-04-01 2011-04-01 false Adequate and well-controlled studies....

  6. 40 CFR 152.20 - Exemptions for pesticides adequately regulated by another Federal agency.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 24 2011-07-01 2011-07-01 false Exemptions for pesticides adequately... PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS PESTICIDE REGISTRATION AND CLASSIFICATION PROCEDURES Exemptions § 152.20 Exemptions for pesticides adequately regulated by another Federal agency. The...

  7. 40 CFR 152.20 - Exemptions for pesticides adequately regulated by another Federal agency.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 24 2014-07-01 2014-07-01 false Exemptions for pesticides adequately... PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS PESTICIDE REGISTRATION AND CLASSIFICATION PROCEDURES Exemptions § 152.20 Exemptions for pesticides adequately regulated by another Federal agency. The...

  8. Calculation of the Cost of an Adequate Education in Kentucky: A Professional Judgment Approach

    ERIC Educational Resources Information Center

    Verstegen, Deborah A.

    2004-01-01

    What is an adequate education and how much does it cost? In 1989, Kentucky's State Supreme Court found the entire system of education unconstitutional--"all of its parts and parcels". The Court called for all children to have access to an adequate education, one that is uniform and has as its goal the development of seven capacities, including:…

  9. 9 CFR 2.33 - Attending veterinarian and adequate veterinary care.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Attending veterinarian and adequate veterinary care. 2.33 Section 2.33 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Research Facilities § 2.33 Attending veterinarian and adequate veterinary care. (a)...

  10. 9 CFR 2.40 - Attending veterinarian and adequate veterinary care (dealers and exhibitors).

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Attending veterinarian and adequate veterinary care (dealers and exhibitors). 2.40 Section 2.40 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Attending Veterinarian and Adequate Veterinary Care §...

  11. 75 FR 69648 - Safety Analysis Requirements for Defining Adequate Protection for the Public and the Workers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-15

    ... SAFETY BOARD Safety Analysis Requirements for Defining Adequate Protection for the Public and the Workers... TO THE SECRETARY OF ENERGY Safety Analysis Requirements for Defining Adequate Protection for the... safety analysis, or DSA, is to be prepared for every DOE nuclear facility. This DSA, once approved by...

  12. 42 CFR 417.568 - Adequate financial records, statistical data, and cost finding.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Adequate financial records, statistical data, and....568 Adequate financial records, statistical data, and cost finding. (a) Maintenance of records. (1) An HMO or CMP must maintain sufficient financial records and statistical data for proper determination...

  13. 42 CFR 417.568 - Adequate financial records, statistical data, and cost finding.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Adequate financial records, statistical data, and....568 Adequate financial records, statistical data, and cost finding. (a) Maintenance of records. (1) An HMO or CMP must maintain sufficient financial records and statistical data for proper determination...

  14. 42 CFR 417.568 - Adequate financial records, statistical data, and cost finding.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Adequate financial records, statistical data, and....568 Adequate financial records, statistical data, and cost finding. (a) Maintenance of records. (1) An HMO or CMP must maintain sufficient financial records and statistical data for proper determination...

  15. Human reliability analysis

    SciTech Connect

    Dougherty, E.M.; Fragola, J.R.

    1988-01-01

    The authors present a treatment of human reliability analysis incorporating an introduction to probabilistic risk assessment for nuclear power generating stations. They treat the subject according to the framework established for general systems theory. Draws upon reliability analysis, psychology, human factors engineering, and statistics, integrating elements of these fields within a systems framework. Provides a history of human reliability analysis, and includes examples of the application of the systems approach.

  16. Bovine hemoglobin as the sole source of dietary iron does not support adequate iron status in copper-adequate or copper-deficient rats

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This experiment was designed to determine whether hemoglobin as the sole source of dietary iron (Fe) could sustain normal Fe status in growing rats. Because adequate copper (Cu) status is required for efficient Fe absorption in the rat, we also determined the effects of Cu deficiency on Fe status of...

  17. Recalibrating software reliability models

    NASA Technical Reports Server (NTRS)

    Brocklehurst, Sarah; Chan, P. Y.; Littlewood, Bev; Snell, John

    1989-01-01

    In spite of much research effort, there is no universally applicable software reliability growth model which can be trusted to give accurate predictions of reliability in all circumstances. Further, it is not even possible to decide a priori which of the many models is most suitable in a particular context. In an attempt to resolve this problem, techniques were developed whereby, for each program, the accuracy of various models can be analyzed. A user is thus enabled to select that model which is giving the most accurate reliability predictions for the particular program under examination. One of these ways of analyzing predictive accuracy, called the u-plot, in fact allows a user to estimate the relationship between the predicted reliability and the true reliability. It is shown how this can be used to improve reliability predictions in a completely general way by a process of recalibration. Simulation results show that the technique gives improved reliability predictions in a large proportion of cases. However, a user does not need to trust the efficacy of recalibration, since the new reliability estimates produced by the technique are truly predictive and so their accuracy in a particular application can be judged using the earlier methods. The generality of this approach would therefore suggest that it be applied as a matter of course whenever a software reliability model is used.

  18. Software Reliability 2002

    NASA Technical Reports Server (NTRS)

    Wallace, Dolores R.

    2003-01-01

    In FY01 we learned that hardware reliability models need substantial changes to account for differences in software, thus making software reliability measurements more effective, accurate, and easier to apply. These reliability models are generally based on familiar distributions or parametric methods. An obvious question is 'What new statistical and probability models can be developed using non-parametric and distribution-free methods instead of the traditional parametric method?" Two approaches to software reliability engineering appear somewhat promising. The first study, begin in FY01, is based in hardware reliability, a very well established science that has many aspects that can be applied to software. This research effort has investigated mathematical aspects of hardware reliability and has identified those applicable to software. Currently the research effort is applying and testing these approaches to software reliability measurement, These parametric models require much project data that may be difficult to apply and interpret. Projects at GSFC are often complex in both technology and schedules. Assessing and estimating reliability of the final system is extremely difficult when various subsystems are tested and completed long before others. Parametric and distribution free techniques may offer a new and accurate way of modeling failure time and other project data to provide earlier and more accurate estimates of system reliability.

  19. Recalibrating software reliability models

    NASA Technical Reports Server (NTRS)

    Brocklehurst, Sarah; Chan, P. Y.; Littlewood, Bev; Snell, John

    1990-01-01

    In spite of much research effort, there is no universally applicable software reliability growth model which can be trusted to give accurate predictions of reliability in all circumstances. Further, it is not even possible to decide a priori which of the many models is most suitable in a particular context. In an attempt to resolve this problem, techniques were developed whereby, for each program, the accuracy of various models can be analyzed. A user is thus enabled to select that model which is giving the most accurate reliability predicitons for the particular program under examination. One of these ways of analyzing predictive accuracy, called the u-plot, in fact allows a user to estimate the relationship between the predicted reliability and the true reliability. It is shown how this can be used to improve reliability predictions in a completely general way by a process of recalibration. Simulation results show that the technique gives improved reliability predictions in a large proportion of cases. However, a user does not need to trust the efficacy of recalibration, since the new reliability estimates prodcued by the technique are truly predictive and so their accuracy in a particular application can be judged using the earlier methods. The generality of this approach would therefore suggest that it be applied as a matter of course whenever a software reliability model is used.

  20. Reliability of fluid systems

    NASA Astrophysics Data System (ADS)

    Kopáček, Jaroslav; Fojtášek, Kamil; Dvořák, Lukáš

    2016-03-01

    This paper focuses on the importance of detection reliability, especially in complex fluid systems for demanding production technology. The initial criterion for assessing the reliability is the failure of object (element), which is seen as a random variable and their data (values) can be processed using by the mathematical methods of theory probability and statistics. They are defined the basic indicators of reliability and their applications in calculations of serial, parallel and backed-up systems. For illustration, there are calculation examples of indicators of reliability for various elements of the system and for the selected pneumatic circuit.

  1. 45 CFR 1159.15 - Who has the responsibility for maintaining adequate technical, physical, and security safeguards...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... adequate technical, physical, and security safeguards to prevent unauthorized disclosure or destruction of... adequate technical, physical, and security safeguards to prevent unauthorized disclosure or destruction of... of maintaining adequate technical, physical, and security safeguards to prevent...

  2. Comparison of neck tension palpation rating systems with surface electromyographic and acoustic measures in vocal hyperfunction

    PubMed Central

    Stepp, Cara E.; Heaton, James T.; Braden, Maia N.; Jetté, Marie E.; Stadelman-Cohen, Tara K.; Hillman, Robert E.

    2010-01-01

    Objectives/Hypothesis The purpose of this study was to evaluate current neck tension palpation rating systems to determine inter-rater reliability and possible correlation with neck surface electromyography (sEMG, collected from three electrode recording locations) and measures of the third formant for /a/ during various vocal behaviors. Study Design This prospective study examined the neck muscle tension of 16 participants before and after a single session of voice therapy. Methods Inter-rater reliability and relationships between palpation ratings and objective measures of sEMG (anterior neck) and the third formant for /a/ were assessed using Pearson’s correlations (r). Results Inter-rater reliability was relatively low as measured by Pearson’s correlations, although Wilcoxon Signed Rank Test results were similar as those in a previous study. Correlations between palpation ratings and sEMG, and between ratings of laryngeal height and the third formant for /a/ were generally low. Correlations increased between anterior neck sEMG and ratings of suprahyoid muscle tension when examined in a reduced set of individuals with higher inter-rater reliability. Conclusions Palpation rating scales do not reliably capture changes that may occur in neck muscle tension of typical voice therapy patients over one session. Consequently, little can be concluded from correlations between sEMG and palpation ratings. PMID:20347260

  3. Hawaii electric system reliability.

    SciTech Connect

    Silva Monroy, Cesar Augusto; Loose, Verne William

    2012-09-01

    This report addresses Hawaii electric system reliability issues; greater emphasis is placed on short-term reliability but resource adequacy is reviewed in reference to electric consumers' views of reliability %E2%80%9Cworth%E2%80%9D and the reserve capacity required to deliver that value. The report begins with a description of the Hawaii electric system to the extent permitted by publicly available data. Electrical engineering literature in the area of electric reliability is researched and briefly reviewed. North American Electric Reliability Corporation standards and measures for generation and transmission are reviewed and identified as to their appropriateness for various portions of the electric grid and for application in Hawaii. Analysis of frequency data supplied by the State of Hawaii Public Utilities Commission is presented together with comparison and contrast of performance of each of the systems for two years, 2010 and 2011. Literature tracing the development of reliability economics is reviewed and referenced. A method is explained for integrating system cost with outage cost to determine the optimal resource adequacy given customers' views of the value contributed by reliable electric supply. The report concludes with findings and recommendations for reliability in the State of Hawaii.

  4. Inferential Processing among Adequate and Struggling Adolescent Comprehenders and Relations to Reading Comprehension

    PubMed Central

    Barth, Amy E.; Barnes, Marcia; Francis, David J.; Vaughn, Sharon; York, Mary

    2015-01-01

    Separate mixed model analyses of variance (ANOVA) were conducted to examine the effect of textual distance on the accuracy and speed of text consistency judgments among adequate and struggling comprehenders across grades 6–12 (n = 1203). Multiple regressions examined whether accuracy in text consistency judgments uniquely accounted for variance in comprehension. Results suggest that there is considerable growth across the middle and high school years, particularly for adequate comprehenders in those text integration processes that maintain local coherence. Accuracy in text consistency judgments accounted for significant unique variance for passage-level, but not sentence-level comprehension, particularly for adequate comprehenders. PMID:26166946

  5. The Japanese version of the revised Life Orientation Test: reliability and construct validity.

    PubMed

    Sumi, Katsunori

    2004-08-01

    The Japanese translation of the revised Life Orientation Test was completed by 223 Japanese college students. Factor analysis yielded two factors, namely, Optimism and Pessimism. These factor scales showed adequate reliability and construct validity. PMID:15460361

  6. Thinking Clearly about Reliability: More Critical Corrections Regarding the Rorschach Comprehensive System.

    ERIC Educational Resources Information Center

    Meyer, Gregory J.

    1997-01-01

    Replies to Wood et al. and documents limitations of their conclusions about the Rorschach Comprehensive System (CS), supporting Meyer's own meta-analysis, which finds adequate interrater reliability for the CS. (SLD)

  7. Validity and Reliability of a Scale Assessing Attitudes toward Mainstreaming.

    ERIC Educational Resources Information Center

    Green, Kathy; And Others

    1983-01-01

    In a study involving 50 undergraduate and graduate education students the Attitudes Toward Mainstreaming Scale was found to have a large first factor with adequate reliability. There was a low correlation between knowledge and ATMS scores, although knowledge was more strongly related to classroom acceptance of exceptional students. (CL)

  8. How Effective Are Self- and Peer Assessment of Oral Presentation Skills Compared with Teachers' Assessments?

    ERIC Educational Resources Information Center

    De Grez, Luc; Valcke, Martin; Roozen, Irene

    2012-01-01

    Assessment of oral presentation skills is an underexplored area. The study described here focuses on the agreement between professional assessment and self- and peer assessment of oral presentation skills and explores student perceptions about peer assessment. The study has the merit of paying attention to the inter-rater reliability of the…

  9. The Development and Initial Testing of the AIM2 Framework to Assess Risk and Strengths in Young People Who Sexually Offend

    ERIC Educational Resources Information Center

    Griffin, Helen Louise; Beech, Anthony; Print, Bobbie; Bradshaw, Helen; Quayle, Jeremy

    2008-01-01

    This paper describes the AIM2 assessment framework and the process of its development and initial testing. AIM2 is used to assess areas of concerns and strengths of young people. Some preliminary analysis is described, including the correlation of assessment items, their ability to discriminate between cases, their inter-rater reliability and a…

  10. Does a Rater's Familiarity with a Candidate's Pronunciation Affect the Rating in Oral Proficiency Interviews?

    ERIC Educational Resources Information Center

    Carey, Michael D.; Mannell, Robert H.; Dunn, Peter K.

    2011-01-01

    This study investigated factors that could affect inter-examiner reliability in the pronunciation assessment component of speaking tests. We hypothesized that the rating of pronunciation is susceptible to variation in assessment due to the amount of exposure examiners have to nonnative English accents. An inter-rater variability analysis was…

  11. Validity of the Consensual Assessment Technique--Evidence with Three Groups of Judges and an Elementary School Student Sample

    ERIC Educational Resources Information Center

    Long, Haiying

    2012-01-01

    As one of the most widely used creativity assessment tools, the Consensual Assessment Technique (CAT) has been praised as a valid tool to assess creativity. In Amabile's (1982) seminal work, the inter-rater reliability was defined as construct validity of the CAT. During the past three decades, researchers followed this definition and…

  12. A Comparative Study of ESL Writers' Performance in a Paper-Based and a Computer-Delivered Writing Test

    ERIC Educational Resources Information Center

    Lee, H. K.

    2004-01-01

    This study aimed to comprehensively investigate the impact of a word-processor on an ESL writing assessment, covering comparison of inter-rater reliability, the quality of written products, the writing process across different testing occasions using different writing media, and students' perception of a computer-delivered test. Writing samples of…

  13. Development of a Chinese Version of the Suicide Intent Scale

    ERIC Educational Resources Information Center

    Gau, Susan S. F.; Chen, Chin-Hung; Lee, Charles T. C.; Chang, Jung-Chen; Cheng, Andrew T. A.

    2009-01-01

    This study established the psychometric properties of the Chinese version of the Suicide Intent Scale (SIS) in a clinic- and community-based sample of 36 patients and 592 respondents, respectively. Results showed that the Chinese SIS demonstrated good inter-rater and test-retest reliability. Factor analysis generated three factors (Precautions,…

  14. Psychometric Properties of the Manchester Child Attachment Story Task: An Italian Multicentre Study

    ERIC Educational Resources Information Center

    Barone, Lavinia; Del Giudice, Marco; Fossati, Andrea; Manaresi, Francesca; Perinetti, Barbara Actis; Colle, Livia; Veglia, Fabio

    2009-01-01

    The paper describes a multicentre study of the psychometric properties of the Manchester Child Attachment Story Task in a sample of 230 Italian children aged 4 to 8 years. The task's internal consistency and inter-rater reliability were investigated; in addition, multiple discriminant analysis was used to explore the contribution of individual…

  15. Development and validation of standard area diagrams to aide assessment of pecan scab symptoms on pecan fruit

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Pecan scab (Fusicladium effusum) causes losses of pecan nutmeat yield and quality in the southeastern U.S. Disease assessment relies on visual rating, which can be inaccurate, imprecise with poor inter-rater reliability. A standard area diagram (SAD) set for pecan scab on fruit valves was develope...

  16. Standards Performance Continuum: Development and Validation of a Measure of Effective Pedagogy.

    ERIC Educational Resources Information Center

    Doherty, R. William; Hilberg, R. Soleste; Epaloose, Georgia; Tharp, Roland G.

    2002-01-01

    Describes the development and validation of the Standards Performance Continuum (SPC) for assessing teacher performance of the Standards for Effective Pedagogy. Three studies involving Florida, California, and New Mexico public school teachers provided evidence of inter-rater reliability, concurrent validity, and criterion-related validity…

  17. How the Collapsing of Categories Impacts the Item Information Function in Polytomous Item Response Theory.

    ERIC Educational Resources Information Center

    Lecointe, Darius A.

    The purpose of this Item Response Theory study was to investigate how the expected reduction in item information, due to the collapsing of response categories in performance assessment data, was affected by varying testing conditions: item difficulty, item discrimination, inter-rater reliability, and direction of collapsing. The investigation used…

  18. Photovoltaic system reliability

    SciTech Connect

    Maish, A.B.; Atcitty, C.; Greenberg, D.

    1997-10-01

    This paper discusses the reliability of several photovoltaic projects including SMUD`s PV Pioneer project, various projects monitored by Ascension Technology, and the Colorado Parks project. System times-to-failure range from 1 to 16 years, and maintenance costs range from 1 to 16 cents per kilowatt-hour. Factors contributing to the reliability of these systems are discussed, and practices are recommended that can be applied to future projects. This paper also discusses the methodology used to collect and analyze PV system reliability data.

  19. Are currently GFR estimating equations and standard Kt/V value adequate for advanced chronic kidney disease (CKD) frail elderly patients?

    PubMed

    Musso, Carlos G; Alvarez-Gregori, Joaquin; Jauregui, Jose; Núñez, Juan F Macías

    2015-07-01

    Chronic kidney disease (CKD) elderly patients have a reduced glomerular filtration rate (GFR) due to the combination of ageing and chronic nephropathy damage. This situation is very important to be taken into account in order to prescribe an adequate medication and dialysis dose in this aged group. Besides, cognitive and urinary incontinence problems make difficult to obtain an adequate 24-h urine collection in order to evaluate creatinine clearance in this group. Thus, a reliable GFR estimating equation would be very useful for assisting elderly CKD patients. Additionally, Kt/V is the main parameter currently used for dosing dialysis in stage V CKD young and elderly patients. However, frailty and sarcopenia are prevalent disorders usually suffered by old people, who also present many physiological changes that could make GFR estimating equations and standard Kt/V value to become unreliable in this particular group. In conclusion, based on all these facts, it seems crucial for clinical geriatric nephrology to carefully evaluate how reliable current GFR estimating equations are, as well as which would be an adequate Kt/V value in CKD frail elderly patients. PMID:25993909

  20. Software reliability studies

    NASA Technical Reports Server (NTRS)

    Wilson, Larry W.

    1989-01-01

    The longterm goal of this research is to identify or create a model for use in analyzing the reliability of flight control software. The immediate tasks addressed are the creation of data useful to the study of software reliability and production of results pertinent to software reliability through the analysis of existing reliability models and data. The completed data creation portion of this research consists of a Generic Checkout System (GCS) design document created in cooperation with NASA and Research Triangle Institute (RTI) experimenters. This will lead to design and code reviews with the resulting product being one of the versions used in the Terminal Descent Experiment being conducted by the Systems Validations Methods Branch (SVMB) of NASA/Langley. An appended paper details an investigation of the Jelinski-Moranda and Geometric models for software reliability. The models were given data from a process that they have correctly simulated and asked to make predictions about the reliability of that process. It was found that either model will usually fail to make good predictions. These problems were attributed to randomness in the data and replication of data was recommended.

  1. Multidisciplinary System Reliability Analysis

    NASA Technical Reports Server (NTRS)

    Mahadevan, Sankaran; Han, Song; Chamis, Christos C. (Technical Monitor)

    2001-01-01

    The objective of this study is to develop a new methodology for estimating the reliability of engineering systems that encompass multiple disciplines. The methodology is formulated in the context of the NESSUS probabilistic structural analysis code, developed under the leadership of NASA Glenn Research Center. The NESSUS code has been successfully applied to the reliability estimation of a variety of structural engineering systems. This study examines whether the features of NESSUS could be used to investigate the reliability of systems in other disciplines such as heat transfer, fluid mechanics, electrical circuits etc., without considerable programming effort specific to each discipline. In this study, the mechanical equivalence between system behavior models in different disciplines are investigated to achieve this objective. A new methodology is presented for the analysis of heat transfer, fluid flow, and electrical circuit problems using the structural analysis routines within NESSUS, by utilizing the equivalence between the computational quantities in different disciplines. This technique is integrated with the fast probability integration and system reliability techniques within the NESSUS code, to successfully compute the system reliability of multidisciplinary systems. Traditional as well as progressive failure analysis methods for system reliability estimation are demonstrated, through a numerical example of a heat exchanger system involving failure modes in structural, heat transfer and fluid flow disciplines.

  2. Measurement Practices for Reliability and Power Quality

    SciTech Connect

    Kueck, JD

    2005-05-06

    to support activities to develop and share information among industry and regulatory participants about critical resources and practices. The toolkit has been developed by investigating the status of indices and definitions, surveying utility organizations on information sharing, and preparing summaries of reliability standards and monitoring requirements--the issues, needs, work under way, existing standards, practices and guidelines--for the following three classifications: (1) terms and definitions of reliability; (2) power quality standards, guidelines, and measurements; and (3) activities and organizations developing and sharing information on distribution reliability. As these synopses of reliability measurement practices are provided, it must be noted that an economic penalty may be associated with requiring too high a reliability level from the distribution system for all customers. It may be appropriate for the distribution system to supply only some base, generally accepted level of reliability. This base level would be adequate for the majority of customers. Users who need a higher level may find it economical to supply using distributed energy resources (DER) and other local solutions to reliability and power quality needs. Local solutions implemented by the customer may be the most cost-effective method for addressing the more stringent needs of a digital economy. These local solutions include energy storage, small distributed generators, and microgrids. This report also considers the market's role in addressing reliability issues and requirements. The customer's needs are discussed in view of issues such as power quality requirements of digital electronic equipment, the cost of outages, the cost of storage and new infrastructure, and natural gas prices. The market role in addressing these issues and requirements is explored. The economic considerations associated with the reliability issues are discussed, as well as the levels at which these economic

  3. In vitro validation of a hand-held optical reflectometer to measure clinically observed erosive tooth wear.

    PubMed

    Carvalho, Thiago Saads; Assunção, Cristiane Meira; Jost, Fabian; Bürgin, Walter Bruno; Rodrigues, Jonas Almeida; Lussi, Adrian

    2016-08-01

    In this study, we analyzed a newly developed optical reflectometer for measuring erosive tooth wear (ETW) in vitro. Three examiners independently assessed the labial surface of 80 deciduous canines and 75 permanent incisors. One examiner performed visual examinations (BEWE), and the other two used the optical pen-size reflectometer to measure surface reflection intensity (SRI) on the same labial surfaces. The examinations were made in duplicate with at least 1 week interval. Intra- and inter-rater agreements were calculated using weighted kappa analysis for BEWE, and intra-class correlation coefficients (ICC) as well as Bland-Altman plots for SRI. The teeth were separated into without (BEWE 0) or with (BEWE 1-3) ETW, and SRI cut-off points were calculated. Intra-rater agreement for the visual examination was 0.46 and 0.82 for deciduous and permanent teeth, respectively. Inter-rater and intra-rater agreement for SRI were good (ICC > 0.7; p < 0.001). SRI measurements produced high specificity values for deciduous and permanent teeth (≥0.74 and ≥ 0.84, respectively), and lower sensitivity values (≥0.37 and ≥ 0.64, respectively), but permanent teeth had generally higher SRI values (p < 0.05). We observed a significant association between BEWE and SRI (p < 0.05). The optical pen-size reflectometer was able to adequately differentiate ETW on permanent teeth, with highly reliable and reproducible measurements, but ETW on deciduous teeth was less accurately differentiated. The reflectometer is a good candidate for clinical research. PMID:27184156

  4. Statistical modelling of software reliability

    NASA Technical Reports Server (NTRS)

    Miller, Douglas R.

    1991-01-01

    During the six-month period from 1 April 1991 to 30 September 1991 the following research papers in statistical modeling of software reliability appeared: (1) A Nonparametric Software Reliability Growth Model; (2) On the Use and the Performance of Software Reliability Growth Models; (3) Research and Development Issues in Software Reliability Engineering; (4) Special Issues on Software; and (5) Software Reliability and Safety.

  5. Photovoltaic module reliability workshop

    NASA Astrophysics Data System (ADS)

    Mrig, L.

    The paper and presentations compiled in this volume form the Proceedings of the fourth in a series of Workshops sponsored by Solar Energy Research Institute (SERI/DOE) under the general theme of photovoltaic module reliability during the period 1986 to 1990. The reliability photovoltaic (PV) modules/systems is exceedingly important along with the initial cost and efficiency of modules if the PV technology has to make a major impact in the power generation market, and for it to compete with the conventional electricity producing technologies. The reliability of photovoltaic modules has progressed significantly in the last few years as evidenced by warrantees available on commercial modules of as long as 12 years. However, there is still need for substantial research and testing required to improve module field reliability to levels of 30 years or more. Several small groups of researchers are involved in this research, development, and monitoring activity around the world. In the U.S., PV manufacturers, DOE laboratories, electric utilities and others are engaged in the photovoltaic reliability research and testing. This group of researchers and others interested in this field were brought together under SERI/DOE sponsorship to exchange the technical knowledge and field experience as related to current information in this important field. The papers presented here reflect this effort.

  6. Proposed reliability cost model

    NASA Technical Reports Server (NTRS)

    Delionback, L. M.

    1973-01-01

    The research investigations which were involved in the study include: cost analysis/allocation, reliability and product assurance, forecasting methodology, systems analysis, and model-building. This is a classic example of an interdisciplinary problem, since the model-building requirements include the need for understanding and communication between technical disciplines on one hand, and the financial/accounting skill categories on the other. The systems approach is utilized within this context to establish a clearer and more objective relationship between reliability assurance and the subcategories (or subelements) that provide, or reenforce, the reliability assurance for a system. Subcategories are further subdivided as illustrated by a tree diagram. The reliability assurance elements can be seen to be potential alternative strategies, or approaches, depending on the specific goals/objectives of the trade studies. The scope was limited to the establishment of a proposed reliability cost-model format. The model format/approach is dependent upon the use of a series of subsystem-oriented CER's and sometimes possible CTR's, in devising a suitable cost-effective policy.

  7. Orbiter Autoland reliability analysis

    NASA Technical Reports Server (NTRS)

    Welch, D. Phillip

    1993-01-01

    The Space Shuttle Orbiter is the only space reentry vehicle in which the crew is seated upright. This position presents some physiological effects requiring countermeasures to prevent a crewmember from becoming incapacitated. This also introduces a potential need for automated vehicle landing capability. Autoland is a primary procedure that was identified as a requirement for landing following and extended duration orbiter mission. This report documents the results of the reliability analysis performed on the hardware required for an automated landing. A reliability block diagram was used to evaluate system reliability. The analysis considers the manual and automated landing modes currently available on the Orbiter. (Autoland is presently a backup system only.) Results of this study indicate a +/- 36 percent probability of successfully extending a nominal mission to 30 days. Enough variations were evaluated to verify that the reliability could be altered with missions planning and procedures. If the crew is modeled as being fully capable after 30 days, the probability of a successful manual landing is comparable to that of Autoland because much of the hardware is used for both manual and automated landing modes. The analysis indicates that the reliability for the manual mode is limited by the hardware and depends greatly on crew capability. Crew capability for a successful landing after 30 days has not been determined yet.

  8. Photovoltaic module reliability workshop

    SciTech Connect

    Mrig, L.

    1990-01-01

    The paper and presentations compiled in this volume form the Proceedings of the fourth in a series of Workshops sponsored by Solar Energy Research Institute (SERI/DOE) under the general theme of photovoltaic module reliability during the period 1986--1990. The reliability Photo Voltaic (PV) modules/systems is exceedingly important along with the initial cost and efficiency of modules if the PV technology has to make a major impact in the power generation market, and for it to compete with the conventional electricity producing technologies. The reliability of photovoltaic modules has progressed significantly in the last few years as evidenced by warranties available on commercial modules of as long as 12 years. However, there is still need for substantial research and testing required to improve module field reliability to levels of 30 years or more. Several small groups of researchers are involved in this research, development, and monitoring activity around the world. In the US, PV manufacturers, DOE laboratories, electric utilities and others are engaged in the photovoltaic reliability research and testing. This group of researchers and others interested in this field were brought together under SERI/DOE sponsorship to exchange the technical knowledge and field experience as related to current information in this important field. The papers presented here reflect this effort.

  9. Reliability of the Modified Ashworth Scale in the Assessment of Plantarflexor Muscle Spasticity in Patients with Traumatic Brain Injury.

    ERIC Educational Resources Information Center

    Allison, S. C.; And Others

    1996-01-01

    This attempt to determine the reliability of the Modified Ashworth Scale for assessing the severity of muscle spasticity for ankle plantarflexors in 30 patients with traumatic brain injury concluded that the reliability was minimally adequate to support the scale's continued use. Interrater reliability was less than that previously reported for…

  10. A method for determining adequate resistance form of complete cast crown preparations.

    PubMed

    Weed, R M; Baez, R J

    1984-09-01

    A diagram with various degrees of occlusal convergence, which takes into consideration the length and diameter of complete crown preparations, was designed as a guide to assist the dentist to obtain adequate resistance form. To test the validity of the diagram, five groups of complete cast crown stainless steel dies were prepared (3.5 mm long, occlusal convergence 10, 13, 16, 19, and 22 degrees). Gold copings were cast for each of the 50 preparations. Displacement force was applied to the casting perpendicularly to a simulated 30-degree cuspal incline until the casting was displaced. Castings were deformed at margins except for the 22-degree group. Castings from this group were displaced without deformation, and it was concluded that there was a lack of adequate resistance form as predicted by the diagram. The hypothesis that the diagram could be used to predict adequate or inadequate resistance form was confirmed by this study. PMID:6384470

  11. Reliability Centered Maintenance - Methodologies

    NASA Technical Reports Server (NTRS)

    Kammerer, Catherine C.

    2009-01-01

    Journal article about Reliability Centered Maintenance (RCM) methodologies used by United Space Alliance, LLC (USA) in support of the Space Shuttle Program at Kennedy Space Center. The USA Reliability Centered Maintenance program differs from traditional RCM programs because various methodologies are utilized to take advantage of their respective strengths for each application. Based on operational experience, USA has customized the traditional RCM methodology into a streamlined lean logic path and has implemented the use of statistical tools to drive the process. USA RCM has integrated many of the L6S tools into both RCM methodologies. The tools utilized in the Measure, Analyze, and Improve phases of a Lean Six Sigma project lend themselves to application in the RCM process. All USA RCM methodologies meet the requirements defined in SAE JA 1011, Evaluation Criteria for Reliability-Centered Maintenance (RCM) Processes. The proposed article explores these methodologies.

  12. Software reliability perspectives

    NASA Technical Reports Server (NTRS)

    Wilson, Larry; Shen, Wenhui

    1987-01-01

    Software which is used in life critical functions must be known to be highly reliable before installation. This requires a strong testing program to estimate the reliability, since neither formal methods, software engineering nor fault tolerant methods can guarantee perfection. Prior to the final testing software goes through a debugging period and many models have been developed to try to estimate reliability from the debugging data. However, the existing models are poorly validated and often give poor performance. This paper emphasizes the fact that part of their failures can be attributed to the random nature of the debugging data given to these models as input, and it poses the problem of correcting this defect as an area of future research.

  13. Comparison of four standards for determining adequate water intake of nursing home residents.

    PubMed

    Gaspar, Phyllis M

    2011-01-01

    Adequate hydration for nursing home residents is problematic. The purpose of this study was to compare four standards used to determine a recommended water intake among nursing home residents. Inconsistencies in the amount of water intake recommended based on the standards compared were identified. The standard based on height and weight provides the most individualized recommendation. An individualized recommendation would facilitate goal setting for the care plan of each older person and assist in the prevention of dehydration. It is essential that a cost-effective and clinically feasible approach to determine adequate water intake be determined for this population to prevent the adverse outcomes associated with dehydration. PMID:21469538

  14. Gearbox Reliability Collaborative Update (Presentation)

    SciTech Connect

    Sheng, S.

    2013-10-01

    This presentation was given at the Sandia Reliability Workshop in August 2013 and provides information on current statistics, a status update, next steps, and other reliability research and development activities related to the Gearbox Reliability Collaborative.

  15. Materials reliability issues in microelectronics

    SciTech Connect

    Lloyd, J.R. ); Yost, F.G. ); Ho, P.S. )

    1991-01-01

    This book covers the proceedings of a MRS symposium on materials reliability in microelectronics. Topics include: electromigration; stress effects on reliability; stress and packaging; metallization; device, oxide and dielectric reliability; new investigative techniques; and corrosion.

  16. Reliability Analyses for the ADSI: Test-Retest and Internal Consistency

    ERIC Educational Resources Information Center

    Corrigan, M. J.; Gurdineer, E. E.

    2012-01-01

    Objective: This article reports on two separate studies of reliability of the Adolescent Domain Screening Inventory (ADSI), test-retest and internal consistency analyses. The ADSI has shown adequate validity, although reliability has not been established. Methods: Study 1: Students were recruited from two undergraduate courses (N = 29).…

  17. Designing reliability into accelerators

    SciTech Connect

    Hutton, A.

    1992-08-01

    For the next generation of high performance, high average luminosity colliders, the ``factories,`` reliability engineering must be introduced right at the inception of the project and maintained as a central theme throughout the project. There are several aspects which will be addressed separately: Concept; design; motivation; management techniques; and fault diagnosis.

  18. Designing reliability into accelerators

    SciTech Connect

    Hutton, A.

    1992-08-01

    For the next generation of high performance, high average luminosity colliders, the factories,'' reliability engineering must be introduced right at the inception of the project and maintained as a central theme throughout the project. There are several aspects which will be addressed separately: Concept; design; motivation; management techniques; and fault diagnosis.

  19. Software reliability report

    NASA Technical Reports Server (NTRS)

    Wilson, Larry

    1991-01-01

    There are many software reliability models which try to predict future performance of software based on data generated by the debugging process. Unfortunately, the models appear to be unable to account for the random nature of the data. If the same code is debugged multiple times and one of the models is used to make predictions, intolerable variance is observed in the resulting reliability predictions. It is believed that data replication can remove this variance in lab type situations and that it is less than scientific to talk about validating a software reliability model without considering replication. It is also believed that data replication may prove to be cost effective in the real world, thus the research centered on verification of the need for replication and on methodologies for generating replicated data in a cost effective manner. The context of the debugging graph was pursued by simulation and experimentation. Simulation was done for the Basic model and the Log-Poisson model. Reasonable values of the parameters were assigned and used to generate simulated data which is then processed by the models in order to determine limitations on their accuracy. These experiments exploit the existing software and program specimens which are in AIR-LAB to measure the performance of reliability models.

  20. Software Reliability Measurement Experience

    NASA Technical Reports Server (NTRS)

    Nikora, A. P.

    1993-01-01

    In this chapter, we describe a recent study of software reliability measurement methods that was conducted at the Jet Propulsion Laboratory. The first section of the chapter, sections 8.1, summarizes the study, characterizes the participating projects, describes the available data, and summarizes the tudy's results.

  1. Reliable solar cookers

    SciTech Connect

    Magney, G.K.

    1992-12-31

    The author describes the activities of SERVE, a Christian relief and development agency, to introduce solar ovens to the Afghan refugees in Pakistan. It has provided 5,000 solar cookers since 1984. The experience has demonstrated the potential of the technology and the need for a durable and reliable product. Common complaints about the cookers are discussed and the ideal cooker is described.

  2. Parametric Mass Reliability Study

    NASA Technical Reports Server (NTRS)

    Holt, James P.

    2014-01-01

    The International Space Station (ISS) systems are designed based upon having redundant systems with replaceable orbital replacement units (ORUs). These ORUs are designed to be swapped out fairly quickly, but some are very large, and some are made up of many components. When an ORU fails, it is replaced on orbit with a spare; the failed unit is sometimes returned to Earth to be serviced and re-launched. Such a system is not feasible for a 500+ day long-duration mission beyond low Earth orbit. The components that make up these ORUs have mixed reliabilities. Components that make up the most mass-such as computer housings, pump casings, and the silicon board of PCBs-typically are the most reliable. Meanwhile components that tend to fail the earliest-such as seals or gaskets-typically have a small mass. To better understand the problem, my project is to create a parametric model that relates both the mass of ORUs to reliability, as well as the mass of ORU subcomponents to reliability.

  3. Nonparametric Methods in Reliability

    PubMed Central

    Hollander, Myles; Peña, Edsel A.

    2005-01-01

    Probabilistic and statistical models for the occurrence of a recurrent event over time are described. These models have applicability in the reliability, engineering, biomedical and other areas where a series of events occurs for an experimental unit as time progresses. Nonparametric inference methods, in particular, the estimation of a relevant distribution function, are described. PMID:16710444

  4. The Relationship between Parental Involvement and Adequate Yearly Progress among Urban, Suburban, and Rural Schools

    ERIC Educational Resources Information Center

    Ma, Xin; Shen, Jianping; Krenn, Huilan Y.

    2014-01-01

    Using national data from the 2007-08 School and Staffing Survey, we compared the relationships between parental involvement and school outcomes related to adequate yearly progress (AYP) in urban, suburban, and rural schools. Parent-initiated parental involvement demonstrated significantly positive relationships with both making AYP and staying off…

  5. Influenza 2005-2006: vaccine supplies adequate, but bird flu looms.

    PubMed

    Mossad, Sherif B

    2005-11-01

    Influenza vaccine supplies appear to be adequate for the 2005-2006 season, though delivery has been somewhat delayed. However, in the event of a pandemic of avian flu-considered inevitable by most experts, although no one knows when it will happen-the United States would be woefully unprepared. PMID:16315443

  6. Calculating and Reducing Errors Associated with the Evaluation of Adequate Yearly Progress.

    ERIC Educational Resources Information Center

    Hill, Richard

    In the Spring, 1996, issue of "CRESST Line," E. Baker and R. Linn commented that, in efforts to measure the progress of schools, "the fluctuations due to differences in the students themselves could conceal differences in instructional effects." This is particularly true in the context of the evaluation of adequate yearly progress required by…

  7. How Much and What Kind? Identifying an Adequate Technology Infrastructure for Early Childhood Education. Policy Brief

    ERIC Educational Resources Information Center

    Daugherty, Lindsay; Dossani, Rafiq; Johnson, Erin-Elizabeth; Wright, Cameron

    2014-01-01

    To realize the potential benefits of technology use in early childhood education (ECE), and to ensure that technology can help to address the digital divide, providers, families of young children, and young children themselves must have access to an adequate technology infrastructure. The goals for technology use in ECE that a technology…

  8. Prenatal zinc supplementation of zinc-adequate rats adversely affects immunity in offspring

    Technology Transfer Automated Retrieval System (TEKTRAN)

    We previously showed that zinc (Zn) supplementation of Zn-adequate dams induced immunosuppressive effects that persist in the offspring after weaning. We investigated whether the immunosuppressive effects were due to in utero exposure and/or mediated via milk using a cross-fostering design. Pregnant...

  9. 75 FR 5893 - Suspension of Community Eligibility for Failure To Maintain Adequate Floodplain Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-05

    ... FR 51735. Executive Order 13132, Federalism. This rule involves no policies that have ] federalism....C. 4001 et seq., Reorganization Plan No. 3 of 1978, 3 CFR, 1978 Comp., p. 329; E.O. 12127, 44 FR... To Maintain Adequate Floodplain Management Regulations AGENCY: Federal Emergency Management...

  10. 26 CFR 1.467-2 - Rent accrual for section 467 rental agreements without adequate interest.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... provide for a variable rate of interest. For purposes of the adequate interest test under paragraph (b)(1) of this section, if a section 467 rental agreement provides for variable interest, the rental... date as the issue date) for the variable rates called for by the rental agreement. For purposes of...

  11. The Unequal Effect of Adequate Yearly Progress: Evidence from School Visits

    ERIC Educational Resources Information Center

    Brown, Abigail B.; Clift, Jack W.

    2010-01-01

    The authors report insights, based on annual site visits to elementary and middle schools in three states from 2004 to 2006, into the incentive effect of the No Child Left Behind Act's requirement that increasing percentages of students make Adequate Yearly Progress (AYP) in every public school. They develop a framework, drawing on the physics…

  12. 9 CFR 2.33 - Attending veterinarian and adequate veterinary care.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Attending veterinarian and adequate veterinary care. 2.33 Section 2.33 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Research Facilities § 2.33 Attending veterinarian...

  13. 9 CFR 2.33 - Attending veterinarian and adequate veterinary care.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Attending veterinarian and adequate veterinary care. 2.33 Section 2.33 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Research Facilities § 2.33 Attending veterinarian...

  14. Perceptions of Teachers in Their First Year of School Restructuring: Failure to Make Adequate Yearly Progress

    ERIC Educational Resources Information Center

    Moser, Sharon

    2010-01-01

    The 2007-2008 school year marked the first year Florida's Title I schools that did not made Adequate Yearly Progress (AYP) for five consecutive years entered into restructuring as mandated by the "No Child Left Behind Act" of 2001. My study examines the perceptions of teacher entering into their first year of school restructuring due to failure to…

  15. A Model for Touch Technique and Computation of Adequate Cane Length.

    ERIC Educational Resources Information Center

    Plain-Switzer, Karen

    1993-01-01

    This article presents a model for the motion of a long-cane executing the touch technique and presents formulas for the projected length of a cane adequate to protect an individual with blindness against wall-type and pole-type hazards. The paper concludes that the long-cane should reach from the floor to the user's armpit. (JDD)

  16. Towards Defining Adequate Lithium Trials for Individuals with Mental Retardation and Mental Illness.

    ERIC Educational Resources Information Center

    Pary, Robert J.

    1991-01-01

    Use of lithium with mentally retarded individuals with psychiatric conditions and/or behavior disturbances is discussed. The paper describes components of an adequate clinical trial and reviews case studies and double-blind cases. The paper concludes that aggression is the best indicator for lithium use, and reviews treatment parameters and…

  17. 9 CFR 2.33 - Attending veterinarian and adequate veterinary care.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... animal health, behavior, and well-being is conveyed to the attending veterinarian; (4) Guidance to... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Attending veterinarian and adequate veterinary care. 2.33 Section 2.33 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION...

  18. 9 CFR 2.40 - Attending veterinarian and adequate veterinary care (dealers and exhibitors).

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... on problems of animal health, behavior, and well-being is conveyed to the attending veterinarian; (4... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Attending veterinarian and adequate veterinary care (dealers and exhibitors). 2.40 Section 2.40 Animals and Animal Products ANIMAL AND...

  19. 9 CFR 2.40 - Attending veterinarian and adequate veterinary care (dealers and exhibitors).

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... on problems of animal health, behavior, and well-being is conveyed to the attending veterinarian; (4... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Attending veterinarian and adequate veterinary care (dealers and exhibitors). 2.40 Section 2.40 Animals and Animal Products ANIMAL AND...

  20. 9 CFR 2.40 - Attending veterinarian and adequate veterinary care (dealers and exhibitors).

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... on problems of animal health, behavior, and well-being is conveyed to the attending veterinarian; (4... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Attending veterinarian and adequate veterinary care (dealers and exhibitors). 2.40 Section 2.40 Animals and Animal Products ANIMAL AND...

  1. 9 CFR 2.33 - Attending veterinarian and adequate veterinary care.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... animal health, behavior, and well-being is conveyed to the attending veterinarian; (4) Guidance to... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Attending veterinarian and adequate veterinary care. 2.33 Section 2.33 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION...

  2. 9 CFR 2.40 - Attending veterinarian and adequate veterinary care (dealers and exhibitors).

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... on problems of animal health, behavior, and well-being is conveyed to the attending veterinarian; (4... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Attending veterinarian and adequate veterinary care (dealers and exhibitors). 2.40 Section 2.40 Animals and Animal Products ANIMAL AND...

  3. Special or Not so Special: Special Education Background Experiences of Principals and Adequate Yearly Progress

    ERIC Educational Resources Information Center

    Wilcox, Jennifer E.

    2011-01-01

    This mixed-methods study researched the special education background experience of principals and the effect on students in the subgroup of Students with Disabilities in making Adequate Yearly Progress (AYP). In the state of Ohio, schools and districts are expected to make AYP as a whole and additionally make AYP for each subgroup (various…

  4. Inferential Processing among Adequate and Struggling Adolescent Comprehenders and Relations to Reading Comprehension

    ERIC Educational Resources Information Center

    Barth, Amy E.; Barnes, Marcia; Francis, David; Vaughn, Sharon; York, Mary

    2015-01-01

    Separate mixed model analyses of variance were conducted to examine the effect of textual distance on the accuracy and speed of text consistency judgments among adequate and struggling comprehenders across grades 6-12 (n = 1,203). Multiple regressions examined whether accuracy in text consistency judgments uniquely accounted for variance in…

  5. 42 CFR 438.207 - Assurances of adequate capacity and services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... with the State's requirements for availability of services, as set forth in § 438.206. (e) CMS' right... HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and Performance... 42 Public Health 4 2010-10-01 2010-10-01 false Assurances of adequate capacity and services....

  6. 42 CFR 438.207 - Assurances of adequate capacity and services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... requirements: (1) Offers an appropriate range of preventive, primary care, and specialty services that is adequate for the anticipated number of enrollees for the service area. (2) Maintains a network of providers... enrollment in its service area in accordance with the State's standards for access to care under this...

  7. 42 CFR 438.207 - Assurances of adequate capacity and services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... requirements: (1) Offers an appropriate range of preventive, primary care, and specialty services that is adequate for the anticipated number of enrollees for the service area. (2) Maintains a network of providers... enrollment in its service area in accordance with the State's standards for access to care under this...

  8. 42 CFR 438.207 - Assurances of adequate capacity and services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... requirements: (1) Offers an appropriate range of preventive, primary care, and specialty services that is adequate for the anticipated number of enrollees for the service area. (2) Maintains a network of providers... enrollment in its service area in accordance with the State's standards for access to care under this...

  9. Effect of tranquilizers on animal resistance to the adequate stimuli of the vestibular apparatus

    NASA Technical Reports Server (NTRS)

    Maksimovich, Y. B.; Khinchikashvili, N. V.

    1980-01-01

    The effect of tranquilizers on vestibulospinal reflexes and motor activity was studied in 900 centrifuged albino mice. Actometric studies have shown that the tranquilizers have a group capacity for increasing animal resistance to the action of adequate stimuli to the vestibular apparatus.

  10. 21 CFR 314.126 - Adequate and well-controlled studies.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... conducting clinical investigations of a drug is to distinguish the effect of a drug from other influences... recognized by the scientific community as the essentials of an adequate and well-controlled clinical... randomization and blinding of patients or investigators, or both. If the intent of the trial is to...

  11. Final 2004 Report on Adequate Yearly Progress in the Montgomery County Public Schools

    ERIC Educational Resources Information Center

    Stevenson, Jose W.

    2005-01-01

    The vast majority of Montgomery County public schools made sufficient progress on state testing and accountability standards in 2004 to comply with the adequate yearly progress (AYP) requirements under the "No Child Left Behind (NCLB) Act of 2001." Information released by the Maryland State Department of Education (MSDE) in October 2004 shows that…

  12. 42 CFR 417.568 - Adequate financial records, statistical data, and cost finding.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Adequate financial records, statistical data, and... financial records, statistical data, and cost finding. (a) Maintenance of records. (1) An HMO or CMP must maintain sufficient financial records and statistical data for proper determination of costs payable by...

  13. 42 CFR 417.568 - Adequate financial records, statistical data, and cost finding.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Adequate financial records, statistical data, and... financial records, statistical data, and cost finding. (a) Maintenance of records. (1) An HMO or CMP must maintain sufficient financial records and statistical data for proper determination of costs payable by...

  14. Estimates of Adequate School Spending by State Based on National Average Service Levels.

    ERIC Educational Resources Information Center

    Miner, Jerry

    1983-01-01

    Proposes a method for estimating expenditures per student needed to provide educational adequacy in each state. Illustrates the method using U.S., Arkansas, New York, Texas, and Washington State data, covering instruction, special needs, operations and maintenance, administration, and other costs. Estimates ratios of "adequate" to actual spending…

  15. Leadership Style and Adequate Yearly Progress: A Correlational Study of Effective Principal Leadership

    ERIC Educational Resources Information Center

    Leapley-Portscheller, Claudia Iris

    2008-01-01

    Principals are responsible for leading efforts to reach increasingly higher levels of student academic proficiency in schools associated with adequate yearly progress (AYP) requirements. The purpose of this quantitative, correlational study was to identify the degree to which perceptions of principal transformational, transactional, and…

  16. Percentage of Adults with High Cholesterol Whose LDL Cholesterol Levels Are Adequately Controlled

    MedlinePlus

    ... of Adults with High Cholesterol Whose LDL Cholesterol Levels are Adequately Controlled High cholesterol can double a ... with High Cholesterol that is Controlled by Education Level 8k4c-k22f Download these data » Click on legends ...

  17. 42 CFR 413.24 - Adequate cost data and cost finding.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Adequate cost data and cost finding. 413.24 Section 413.24 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY...

  18. Principals' Perceptions of Effective Strategies in Meeting Adequate Yearly Progress in Special Education

    ERIC Educational Resources Information Center

    Meyer, Jadie K.

    2012-01-01

    The purpose of this study was to examine the perceptions of principals who have met Adequate Yearly Progress (AYP) with the special education subgroup. This was a qualitative study, utilizing interviews to answer the research questions. The first three research questions analyzed the areas of assessment, building-level leadership, and curriculum…

  19. Human milk feeding supports adequate growth in infants

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Despite current nutritional strategies, premature infants remain at high risk for extrauterine growth restriction. The use of an exclusive human milk-based diet is associated with decreased incidence of necrotizing enterocolitis (NEC), but concerns exist about infants achieving adequate growth. The ...

  20. 75 FR 74022 - Safety Analysis Requirements for Defining Adequate Protection for the Public and the Workers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-30

    ... November 15, 2010 (75 FR 69648). The corrected text of the recommendation approved by the Board is below... or telephone number (202) 694-7000. Correction: In the Federal Register of November 15, 2010 (75 FR... SAFETY BOARD Safety Analysis Requirements for Defining Adequate Protection for the Public and the...

  1. Evaluating Rural Progress in Mathematics Achievement: Threats to the Validity of "Adequate Yearly Progress"

    ERIC Educational Resources Information Center

    Lee, Jaekyung

    2003-01-01

    This article examines major threats to the validity of Adequate Yearly Progress (AYP) in the context of rural schools. Although rural students and their schools made significant academic progress in the past on national and state assessments, the current goal of AYP turns out to be highly unrealistic for them unless states set far lower…

  2. 40 CFR 152.20 - Exemptions for pesticides adequately regulated by another Federal agency.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Exemptions for pesticides adequately regulated by another Federal agency. 152.20 Section 152.20 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS PESTICIDE REGISTRATION AND CLASSIFICATION...

  3. 40 CFR 152.20 - Exemptions for pesticides adequately regulated by another Federal agency.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 25 2013-07-01 2013-07-01 false Exemptions for pesticides adequately regulated by another Federal agency. 152.20 Section 152.20 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS PESTICIDE REGISTRATION AND CLASSIFICATION...

  4. 40 CFR 152.20 - Exemptions for pesticides adequately regulated by another Federal agency.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 25 2012-07-01 2012-07-01 false Exemptions for pesticides adequately regulated by another Federal agency. 152.20 Section 152.20 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS PESTICIDE REGISTRATION AND CLASSIFICATION...

  5. What Is the Cost of an Adequate Vermont High School Education?

    ERIC Educational Resources Information Center

    Rucker, Frank D.

    2010-01-01

    Access to an adequate education has been widely considered an undeniable right since Chief Justice Warren stated in his landmark decision that "Today, education is perhaps the most important function of state and local governments...it is doubtful that any child may reasonably be expected to succeed in life if he is denied the opportunity of an…

  6. Fatigue reliability based on residual strength model with hybrid uncertain parameters

    NASA Astrophysics Data System (ADS)

    Wang, Jun; Qiu, Zhi-Ping

    2012-02-01

    The aim of this paper is to evaluate the fatigue reliability with hybrid uncertain parameters based on a residual strength model. By solving the non-probabilistic set-based reliability problem and analyzing the reliability with randomness, the fatigue reliability with hybrid parameters can be obtained. The presented hybrid model can adequately consider all uncertainties affecting the fatigue reliability with hybrid uncertain parameters. A comparison among the presented hybrid model, non-probabilistic set-theoretic model and the conventional random model is made through two typical numerical examples. The results show that the presented hybrid model, which can ensure structural security, is effective and practical.

  7. Space Shuttle Propulsion System Reliability

    NASA Technical Reports Server (NTRS)

    Welzyn, Ken; VanHooser, Katherine; Moore, Dennis; Wood, David

    2011-01-01

    This session includes the following sessions: (1) External Tank (ET) System Reliability and Lessons, (2) Space Shuttle Main Engine (SSME), Reliability Validated by a Million Seconds of Testing, (3) Reusable Solid Rocket Motor (RSRM) Reliability via Process Control, and (4) Solid Rocket Booster (SRB) Reliability via Acceptance and Testing.

  8. Reliable broadcast protocols

    NASA Technical Reports Server (NTRS)

    Joseph, T. A.; Birman, Kenneth P.

    1989-01-01

    A number of broadcast protocols that are reliable subject to a variety of ordering and delivery guarantees are considered. Developing applications that are distributed over a number of sites and/or must tolerate the failures of some of them becomes a considerably simpler task when such protocols are available for communication. Without such protocols the kinds of distributed applications that can reasonably be built will have a very limited scope. As the trend towards distribution and decentralization continues, it will not be surprising if reliable broadcast protocols have the same role in distributed operating systems of the future that message passing mechanisms have in the operating systems of today. On the other hand, the problems of engineering such a system remain large. For example, deciding which protocol is the most appropriate to use in a certain situation or how to balance the latency-communication-storage costs is not an easy question.

  9. Data networks reliability

    NASA Astrophysics Data System (ADS)

    Gallager, Robert G.

    1988-10-01

    The research from 1984 to 1986 on Data Network Reliability had the objective of developing general principles governing the reliable and efficient control of data networks. The research was centered around three major areas: congestion control, multiaccess networks, and distributed asynchronous algorithms. The major topics within congestion control were the use of flow control algorithms. The major topics within congestion control were the use of flow control to reduce congestion and the use of routing to reduce congestion. The major topics within multiaccess networks were the communication properties of multiaccess channels, collision resolution, and packet radio networks. The major topics within asynchronous distributed algorithms were failure recovery, time vs. communication tradeoffs, and the general theory of distributed algorithms.

  10. Human Reliability Program Workshop

    SciTech Connect

    Landers, John; Rogers, Erin; Gerke, Gretchen

    2014-05-18

    A Human Reliability Program (HRP) is designed to protect national security as well as worker and public safety by continuously evaluating the reliability of those who have access to sensitive materials, facilities, and programs. Some elements of a site HRP include systematic (1) supervisory reviews, (2) medical and psychological assessments, (3) management evaluations, (4) personnel security reviews, and (4) training of HRP staff and critical positions. Over the years of implementing an HRP, the Department of Energy (DOE) has faced various challenges and overcome obstacles. During this 4-day activity, participants will examine programs that mitigate threats to nuclear security and the insider threat to include HRP, Nuclear Security Culture (NSC) Enhancement, and Employee Assistance Programs. The focus will be to develop an understanding of the need for a systematic HRP and to discuss challenges and best practices associated with mitigating the insider threat.

  11. Reliability of photovoltaic modules

    NASA Technical Reports Server (NTRS)

    Ross, R. G., Jr.

    1986-01-01

    In order to assess the reliability of photovoltaic modules, four categories of known array failure and degradation mechanisms are discussed, and target reliability allocations have been developed within each category based on the available technology and the life-cycle-cost requirements of future large-scale terrestrial applications. Cell-level failure mechanisms associated with open-circuiting or short-circuiting of individual solar cells generally arise from cell cracking or the fatigue of cell-to-cell interconnects. Power degradation mechanisms considered include gradual power loss in cells, light-induced effects, and module optical degradation. Module-level failure mechanisms and life-limiting wear-out mechanisms are also explored.

  12. Compact, Reliable EEPROM Controller

    NASA Technical Reports Server (NTRS)

    Katz, Richard; Kleyner, Igor

    2010-01-01

    A compact, reliable controller for an electrically erasable, programmable read-only memory (EEPROM) has been developed specifically for a space-flight application. The design may be adaptable to other applications in which there are requirements for reliability in general and, in particular, for prevention of inadvertent writing of data in EEPROM cells. Inadvertent writes pose risks of loss of reliability in the original space-flight application and could pose such risks in other applications. Prior EEPROM controllers are large and complex and do not provide all reasonable protections (in many cases, few or no protections) against inadvertent writes. In contrast, the present controller provides several layers of protection against inadvertent writes. The controller also incorporates a write-time monitor, enabling determination of trends in the performance of an EEPROM through all phases of testing. The controller has been designed as an integral subsystem of a system that includes not only the controller and the controlled EEPROM aboard a spacecraft but also computers in a ground control station, relatively simple onboard support circuitry, and an onboard communication subsystem that utilizes the MIL-STD-1553B protocol. (MIL-STD-1553B is a military standard that encompasses a method of communication and electrical-interface requirements for digital electronic subsystems connected to a data bus. MIL-STD- 1553B is commonly used in defense and space applications.) The intent was to both maximize reliability while minimizing the size and complexity of onboard circuitry. In operation, control of the EEPROM is effected via the ground computers, the MIL-STD-1553B communication subsystem, and the onboard support circuitry, all of which, in combination, provide the multiple layers of protection against inadvertent writes. There is no controller software, unlike in many prior EEPROM controllers; software can be a major contributor to unreliability, particularly in fault

  13. Spacecraft transmitter reliability

    NASA Technical Reports Server (NTRS)

    1980-01-01

    A workshop on spacecraft transmitter reliability was held at the NASA Lewis Research Center on September 25 and 26, 1979, to discuss present knowledge and to plan future research areas. Since formal papers were not submitted, this synopsis was derived from audio tapes of the workshop. The following subjects were covered: users' experience with space transmitters; cathodes; power supplies and interfaces; and specifications and quality assurance. A panel discussion ended the workshop.

  14. Reliability and testing

    NASA Technical Reports Server (NTRS)

    Auer, Werner

    1996-01-01

    Reliability and its interdependence with testing are important topics for development and manufacturing of successful products. This generally accepted fact is not only a technical statement, but must be also seen in the light of 'Human Factors.' While the background for this paper is the experience gained with electromechanical/electronic space products, including control and system considerations, it is believed that the content could be also of interest for other fields.

  15. Software reliability studies

    NASA Technical Reports Server (NTRS)

    Hoppa, Mary Ann; Wilson, Larry W.

    1994-01-01

    There are many software reliability models which try to predict future performance of software based on data generated by the debugging process. Our research has shown that by improving the quality of the data one can greatly improve the predictions. We are working on methodologies which control some of the randomness inherent in the standard data generation processes in order to improve the accuracy of predictions. Our contribution is twofold in that we describe an experimental methodology using a data structure called the debugging graph and apply this methodology to assess the robustness of existing models. The debugging graph is used to analyze the effects of various fault recovery orders on the predictive accuracy of several well-known software reliability algorithms. We found that, along a particular debugging path in the graph, the predictive performance of different models can vary greatly. Similarly, just because a model 'fits' a given path's data well does not guarantee that the model would perform well on a different path. Further we observed bug interactions and noted their potential effects on the predictive process. We saw that not only do different faults fail at different rates, but that those rates can be affected by the particular debugging stage at which the rates are evaluated. Based on our experiment, we conjecture that the accuracy of a reliability prediction is affected by the fault recovery order as well as by fault interaction.

  16. General Aviation Aircraft Reliability Study

    NASA Technical Reports Server (NTRS)

    Pettit, Duane; Turnbull, Andrew; Roelant, Henk A. (Technical Monitor)

    2001-01-01

    This reliability study was performed in order to provide the aviation community with an estimate of Complex General Aviation (GA) Aircraft System reliability. To successfully improve the safety and reliability for the next generation of GA aircraft, a study of current GA aircraft attributes was prudent. This was accomplished by benchmarking the reliability of operational Complex GA Aircraft Systems. Specifically, Complex GA Aircraft System reliability was estimated using data obtained from the logbooks of a random sample of the Complex GA Aircraft population.

  17. The concept of adequate causation and Max Weber's comparative sociology of religion.

    PubMed

    Buss, A

    1999-06-01

    Max Weber's The Protestant Ethic and the Spirit of Capitalism, studied in isolation, shows mainly an elective affinity or an adequacy on the level of meaning between the Protestant ethic and the 'spirit' of capitalism. Here it is suggested that Weber's subsequent essays on 'The Economic Ethics of World Religions' are the result of his opinion that adequacy on the level of meaning needs and can be verified by causal adequacy. After some introductory remarks, particularly on elective affinity, the paper tries to develop the concept of adequate causation and the related concept of objective possibility on the basis of the work of v. Kries on whom Weber heavily relied. In the second part, this concept is used to show how the study of the economic ethics of India, China, Rome and orthodox Russia can support the thesis that the 'spirit' of capitalism, although it may not have been caused by the Protestant ethic, was perhaps adequately caused by it. PMID:15260028

  18. A novel strategy to overcome resistance in stent placement at lesion site after adequate predilatation.

    PubMed

    Jain, D; Tolg, R; Katus, H A; Richardt, G

    2000-12-01

    Resistance was encountered in passing a 3 x 18 mm stent across a lesion in the proximal left anterior descending coronary artery. Successive changes in stent with repeated balloon dilatations did not succeed. Finally, a 9 mm stent was passed across the lesion and deployed at the site of maximal resistance. The 18 mm stent was then placed through this stent. A novel strategy to overcome resistance in the stent passage through the lesion after an adequate balloon predilatation is reported. PMID:11103034

  19. Myth 19: Is Advanced Placement an Adequate Program for Gifted Students?

    ERIC Educational Resources Information Center

    Gallagher, Shelagh A.

    2009-01-01

    Is it a myth that Advanced Placement (AP) is an adequate program for gifted students? AP is so covered with myths and assumptions that it is hard to get a clear view of the issues. In this article, the author finds the answer about AP by looking at current realties. First, AP is hard for gifted students to avoid. Second, AP never was a program…

  20. Global risk assessment of aflatoxins in maize and peanuts: are regulatory standards adequately protective?

    PubMed

    Wu, Felicia; Stacy, Shaina L; Kensler, Thomas W

    2013-09-01

    The aflatoxins are a group of fungal metabolites that contaminate a variety of staple crops, including maize and peanuts, and cause an array of acute and chronic human health effects. Aflatoxin B1 in particular is a potent liver carcinogen, and hepatocellular carcinoma (HCC) risk is multiplicatively higher for individuals exposed to both aflatoxin and chronic infection with hepatitis B virus (HBV). In this work, we sought to answer the question: do current aflatoxin regulatory standards around the world adequately protect human health? Depending upon the level of protection desired, the answer to this question varies. Currently, most nations have a maximum tolerable level of total aflatoxins in maize and peanuts ranging from 4 to 20ng/g. If the level of protection desired is that aflatoxin exposures would not increase lifetime HCC risk by more than 1 in 100,000 cases in the population, then most current regulatory standards are not adequately protective even if enforced, especially in low-income countries where large amounts of maize and peanuts are consumed and HBV prevalence is high. At the protection level of 1 in 10,000 lifetime HCC cases in the population, however, almost all aflatoxin regulations worldwide are adequately protective, with the exception of several nations in Africa and Latin America. PMID:23761295

  1. Global Risk Assessment of Aflatoxins in Maize and Peanuts: Are Regulatory Standards Adequately Protective?

    PubMed Central

    Wu, Felicia

    2013-01-01

    The aflatoxins are a group of fungal metabolites that contaminate a variety of staple crops, including maize and peanuts, and cause an array of acute and chronic human health effects. Aflatoxin B1 in particular is a potent liver carcinogen, and hepatocellular carcinoma (HCC) risk is multiplicatively higher for individuals exposed to both aflatoxin and chronic infection with hepatitis B virus (HBV). In this work, we sought to answer the question: do current aflatoxin regulatory standards around the world adequately protect human health? Depending upon the level of protection desired, the answer to this question varies. Currently, most nations have a maximum tolerable level of total aflatoxins in maize and peanuts ranging from 4 to 20ng/g. If the level of protection desired is that aflatoxin exposures would not increase lifetime HCC risk by more than 1 in 100,000 cases in the population, then most current regulatory standards are not adequately protective even if enforced, especially in low-income countries where large amounts of maize and peanuts are consumed and HBV prevalence is high. At the protection level of 1 in 10,000 lifetime HCC cases in the population, however, almost all aflatoxin regulations worldwide are adequately protective, with the exception of several nations in Africa and Latin America. PMID:23761295

  2. Self-esteem, social support, and satisfaction differences in women with adequate and inadequate prenatal care.

    PubMed

    Higgins, P; Murray, M L; Williams, E M

    1994-03-01

    This descriptive, retrospective study examined levels of self-esteem, social support, and satisfaction with prenatal care in 193 low-risk postpartal women who obtained adequate and inadequate care. The participants were drawn from a regional medical center and university teaching hospital in New Mexico. A demographic questionnaire, the Coopersmith self-esteem inventory, the personal resource questionnaire part 2, and the prenatal care satisfaction inventory were used for data collection. Significant differences were found in the level of education, income, insurance, and ethnicity between women who received adequate prenatal care and those who received inadequate care. Women who were likely to seek either adequate or inadequate prenatal care were those whose total family income was $10,000 to $19,999 per year and high school graduates. Statistically significant differences were found in self-esteem, social support, and satisfaction between the two groups of women. Strategies to enhance self-esteem and social support have to be developed to reach women at risk for receiving inadequate prenatal care. PMID:8155221

  3. Interrater Reliability of the Record of Driving Errors (RODE)

    PubMed Central

    Carr, David B.; Rutkoski, Kathleen; Xiong, Chengjie; Roe, Catherine M.

    2015-01-01

    The Record of Driving Errors (RODE) is a novel standardized tool designed to quantitatively document the specific types of driving errors that occur during a standardized performance-based road test. The purpose of this study was to determine interrater reliability between two occupational therapy driver rehabilitation specialists who quantitatively scored specific driving errors using the RODE in a sample of older adults diagnosed with dementia (n = 24). Intraclass correlation coefficients of major driving error and intervention categories indicated almost perfect agreement between raters. Using raters with adequate training and similar professional backgrounds, it is possible to have good interrater reliability using the RODE on a standardized road test. PMID:26122691

  4. Ultimately Reliable Pyrotechnic Systems

    NASA Technical Reports Server (NTRS)

    Scott, John H.; Hinkel, Todd

    2015-01-01

    This paper presents the methods by which NASA has designed, built, tested, and certified pyrotechnic devices for high reliability operation in extreme environments and illustrates the potential applications in the oil and gas industry. NASA's extremely successful application of pyrotechnics is built upon documented procedures and test methods that have been maintained and developed since the Apollo Program. Standards are managed and rigorously enforced for performance margins, redundancy, lot sampling, and personnel safety. The pyrotechnics utilized in spacecraft include such devices as small initiators and detonators with the power of a shotgun shell, detonating cord systems for explosive energy transfer across many feet, precision linear shaped charges for breaking structural membranes, and booster charges to actuate valves and pistons. NASA's pyrotechnics program is one of the more successful in the history of Human Spaceflight. No pyrotechnic device developed in accordance with NASA's Human Spaceflight standards has ever failed in flight use. NASA's pyrotechnic initiators work reliably in temperatures as low as -420 F. Each of the 135 Space Shuttle flights fired 102 of these initiators, some setting off multiple pyrotechnic devices, with never a failure. The recent landing on Mars of the Opportunity rover fired 174 of NASA's pyrotechnic initiators to complete the famous '7 minutes of terror.' Even after traveling through extreme radiation and thermal environments on the way to Mars, every one of them worked. These initiators have fired on the surface of Titan. NASA's design controls, procedures, and processes produce the most reliable pyrotechnics in the world. Application of pyrotechnics designed and procured in this manner could enable the energy industry's emergency equipment, such as shutoff valves and deep-sea blowout preventers, to be left in place for years in extreme environments and still be relied upon to function when needed, thus greatly enhancing

  5. CR reliability testing

    NASA Astrophysics Data System (ADS)

    Honeyman-Buck, Janice C.; Rill, Lynn; Frost, Meryll M.; Staab, Edward V.

    1998-07-01

    The purpose of this work was to develop a method for systematically testing the reliability of a CR system under realistic daily loads in a non-clinical environment prior to its clinical adoption. Once digital imaging replaces film, it will be very difficult to revert back should the digital system become unreliable. Prior to the beginning of the test, a formal evaluation was performed to set the benchmarks for performance and functionality. A formal protocol was established that included all the 62 imaging plates in the inventory for each 24-hour period in the study. Imaging plates were exposed using different combinations of collimation, orientation, and SID. Anthropomorphic phantoms were used to acquire images of different sizes. Each combination was chosen randomly to simulate the differences that could occur in clinical practice. The tests were performed over a wide range of times with batches of plates processed to simulate the temporal constraints required by the nature of portable radiographs taken in the Intensive Care Unit (ICU). Current patient demographics were used for the test studies so automatic routing algorithms could be tested. During the test, only three minor reliability problems occurred, two of which were not directly related to the CR unit. One plate was discovered to cause a segmentation error that essentially reduced the image to only black and white with no gray levels. This plate was removed from the inventory to be replaced. Another problem was a PACS routing problem that occurred when the DICOM server with which the CR was communicating had a problem with disk space. The final problem was a network printing failure to the laser cameras. Although the units passed the reliability test, problems with interfacing to workstations were discovered. The two issues that were identified were the interpretation of what constitutes a study for CR and the construction of the look-up table for a proper gray scale display.

  6. Reliable VLSI sequential controllers

    NASA Technical Reports Server (NTRS)

    Whitaker, S.; Maki, G.; Shamanna, M.

    1990-01-01

    A VLSI architecture for synchronous sequential controllers is presented that has attractive qualities for producing reliable circuits. In these circuits, one hardware implementation can realize any flow table with a maximum of 2(exp n) internal states and m inputs. Also all design equations are identical. A real time fault detection means is presented along with a strategy for verifying the correctness of the checking hardware. This self check feature can be employed with no increase in hardware. The architecture can be modified to achieve fail safe designs. With no increase in hardware, an adaptable circuit can be realized that allows replacement of faulty transitions with fault free transitions.

  7. Ferrite logic reliability study

    NASA Technical Reports Server (NTRS)

    Baer, J. A.; Clark, C. B.

    1973-01-01

    Development and use of digital circuits called all-magnetic logic are reported. In these circuits the magnetic elements and their windings comprise the active circuit devices in the logic portion of a system. The ferrite logic device belongs to the all-magnetic class of logic circuits. The FLO device is novel in that it makes use of a dual or bimaterial ferrite composition in one physical ceramic body. This bimaterial feature, coupled with its potential for relatively high speed operation, makes it attractive for high reliability applications. (Maximum speed of operation approximately 50 kHz.)

  8. Fault Tree Reliability Analysis and Design-for-reliability

    1998-05-05

    WinR provides a fault tree analysis capability for performing systems reliability and design-for-reliability analyses. The package includes capabilities for sensitivity and uncertainity analysis, field failure data analysis, and optimization.

  9. On Component Reliability and System Reliability for Space Missions

    NASA Technical Reports Server (NTRS)

    Chen, Yuan; Gillespie, Amanda M.; Monaghan, Mark W.; Sampson, Michael J.; Hodson, Robert F.

    2012-01-01

    This paper is to address the basics, the limitations and the relationship between component reliability and system reliability through a study of flight computing architectures and related avionics components for NASA future missions. Component reliability analysis and system reliability analysis need to be evaluated at the same time, and the limitations of each analysis and the relationship between the two analyses need to be understood.

  10. Integrated circuit reliability testing

    NASA Technical Reports Server (NTRS)

    Buehler, Martin G. (Inventor); Sayah, Hoshyar R. (Inventor)

    1990-01-01

    A technique is described for use in determining the reliability of microscopic conductors deposited on an uneven surface of an integrated circuit device. A wafer containing integrated circuit chips is formed with a test area having regions of different heights. At the time the conductors are formed on the chip areas of the wafer, an elongated serpentine assay conductor is deposited on the test area so the assay conductor extends over multiple steps between regions of different heights. Also, a first test conductor is deposited in the test area upon a uniform region of first height, and a second test conductor is deposited in the test area upon a uniform region of second height. The occurrence of high resistances at the steps between regions of different height is indicated by deriving the measured length of the serpentine conductor using the resistance measured between the ends of the serpentine conductor, and comparing that to the design length of the serpentine conductor. The percentage by which the measured length exceeds the design length, at which the integrated circuit will be discarded, depends on the required reliability of the integrated circuit.

  11. Integrated circuit reliability testing

    NASA Technical Reports Server (NTRS)

    Buehler, Martin G. (Inventor); Sayah, Hoshyar R. (Inventor)

    1988-01-01

    A technique is described for use in determining the reliability of microscopic conductors deposited on an uneven surface of an integrated circuit device. A wafer containing integrated circuit chips is formed with a test area having regions of different heights. At the time the conductors are formed on the chip areas of the wafer, an elongated serpentine assay conductor is deposited on the test area so the assay conductor extends over multiple steps between regions of different heights. Also, a first test conductor is deposited in the test area upon a uniform region of first height, and a second test conductor is deposited in the test area upon a uniform region of second height. The occurrence of high resistances at the steps between regions of different height is indicated by deriving the measured length of the serpentine conductor using the resistance measured between the ends of the serpentine conductor, and comparing that to the design length of the serpentine conductor. The percentage by which the measured length exceeds the design length, at which the integrated circuit will be discarded, depends on the required reliability of the integrated circuit.

  12. Load Control System Reliability

    SciTech Connect

    Trudnowski, Daniel

    2015-04-03

    This report summarizes the results of the Load Control System Reliability project (DOE Award DE-FC26-06NT42750). The original grant was awarded to Montana Tech April 2006. Follow-on DOE awards and expansions to the project scope occurred August 2007, January 2009, April 2011, and April 2013. In addition to the DOE monies, the project also consisted of matching funds from the states of Montana and Wyoming. Project participants included Montana Tech; the University of Wyoming; Montana State University; NorthWestern Energy, Inc., and MSE. Research focused on two areas: real-time power-system load control methodologies; and, power-system measurement-based stability-assessment operation and control tools. The majority of effort was focused on area 2. Results from the research includes: development of fundamental power-system dynamic concepts, control schemes, and signal-processing algorithms; many papers (including two prize papers) in leading journals and conferences and leadership of IEEE activities; one patent; participation in major actual-system testing in the western North American power system; prototype power-system operation and control software installed and tested at three major North American control centers; and, the incubation of a new commercial-grade operation and control software tool. Work under this grant certainly supported the DOE-OE goals in the area of “Real Time Grid Reliability Management.”

  13. Understanding the Elements of Operational Reliability: A Key for Achieving High Reliability

    NASA Technical Reports Server (NTRS)

    Safie, Fayssal M.

    2010-01-01

    This viewgraph presentation reviews operational reliability and its role in achieving high reliability through design and process reliability. The topics include: 1) Reliability Engineering Major Areas and interfaces; 2) Design Reliability; 3) Process Reliability; and 4) Reliability Applications.

  14. Adequate Iodine Status in New Zealand School Children Post-Fortification of Bread with Iodised Salt

    PubMed Central

    Jones, Emma; McLean, Rachael; Davies, Briar; Hawkins, Rochelle; Meiklejohn, Eva; Ma, Zheng Feei; Skeaff, Sheila

    2016-01-01

    Iodine deficiency re-emerged in New Zealand in the 1990s, prompting the mandatory fortification of bread with iodised salt from 2009. This study aimed to determine the iodine status of New Zealand children when the fortification of bread was well established. A cross-sectional survey of children aged 8–10 years was conducted in the cities of Auckland and Christchurch, New Zealand, from March to May 2015. Children provided a spot urine sample for the determination of urinary iodine concentration (UIC), a fingerpick blood sample for Thyroglobulin (Tg) concentration, and completed a questionnaire ascertaining socio-demographic information that also included an iodine-specific food frequency questionnaire (FFQ). The FFQ was used to estimate iodine intake from all main food sources including bread and iodised salt. The median UIC for all children (n = 415) was 116 μg/L (females 106 μg/L, males 131 μg/L) indicative of adequate iodine status according to the World Health Organisation (WHO, i.e., median UIC of 100–199 μg/L). The median Tg concentration was 8.7 μg/L, which was <10 μg/L confirming adequate iodine status. There was a significant difference in UIC by sex (p = 0.001) and ethnicity (p = 0.006). The mean iodine intake from the food-only model was 65 μg/day. Bread contributed 51% of total iodine intake in the food-only model, providing a mean iodine intake of 35 μg/day. The mean iodine intake from the food-plus-iodised salt model was 101 μg/day. In conclusion, the results of this study confirm that the iodine status in New Zealand school children is now adequate. PMID:27196925

  15. Adequate Iodine Status in New Zealand School Children Post-Fortification of Bread with Iodised Salt.

    PubMed

    Jones, Emma; McLean, Rachael; Davies, Briar; Hawkins, Rochelle; Meiklejohn, Eva; Ma, Zheng Feei; Skeaff, Sheila

    2016-01-01

    Iodine deficiency re-emerged in New Zealand in the 1990s, prompting the mandatory fortification of bread with iodised salt from 2009. This study aimed to determine the iodine status of New Zealand children when the fortification of bread was well established. A cross-sectional survey of children aged 8-10 years was conducted in the cities of Auckland and Christchurch, New Zealand, from March to May 2015. Children provided a spot urine sample for the determination of urinary iodine concentration (UIC), a fingerpick blood sample for Thyroglobulin (Tg) concentration, and completed a questionnaire ascertaining socio-demographic information that also included an iodine-specific food frequency questionnaire (FFQ). The FFQ was used to estimate iodine intake from all main food sources including bread and iodised salt. The median UIC for all children (n = 415) was 116 μg/L (females 106 μg/L, males 131 μg/L) indicative of adequate iodine status according to the World Health Organisation (WHO, i.e., median UIC of 100-199 μg/L). The median Tg concentration was 8.7 μg/L, which was <10 μg/L confirming adequate iodine status. There was a significant difference in UIC by sex (p = 0.001) and ethnicity (p = 0.006). The mean iodine intake from the food-only model was 65 μg/day. Bread contributed 51% of total iodine intake in the food-only model, providing a mean iodine intake of 35 μg/day. The mean iodine intake from the food-plus-iodised salt model was 101 μg/day. In conclusion, the results of this study confirm that the iodine status in New Zealand school children is now adequate. PMID:27196925

  16. Do Clinical Clerks Provide Candidates with Adequate Formative Assessment during Objective Structured Clinical Examinations?

    ERIC Educational Resources Information Center

    Reiter, Harold I.; Rosenfeld, Jack; Nandagopal, Kiruthiga; Eva, Kevin W.

    2004-01-01

    Context: Various research studies have examined the question of whether expert or non-expert raters, faculty or students, evaluators or standardized patients, give more reliable and valid summative assessments of performance on Objective Structured Clinical Examinations (OSCEs). Less studied has been the question of whether or not non-faculty…

  17. Chronic leg ulcer: does a patient always get a correct diagnosis and adequate treatment?

    PubMed

    Mooij, Michael C; Huisman, Laurens C

    2016-03-01

    Patients with chronic leg ulcers have severely impaired quality of life and account for a high percentage of annual healthcare costs. To establish the cause of a chronic leg ulcer, referral to a center with a multidisciplinary team of professionals is often necessary. Treating the underlying cause diminishes healing time and reduces costs. In venous leg ulcers adequate compression therapy is still a problem. It can be improved by training the professionals with pressure measuring devices. A perfect fitting of elastic stockings is important to prevent venous leg ulcer recurrence. In most cases, custom-made stockings are the best choice for this purpose. PMID:26916772

  18. Determining Adequate Margins in Head and Neck Cancers: Practice and Continued Challenges.

    PubMed

    Williams, Michelle D

    2016-09-01

    Margin assessment remains a critical component of oncologic care for head and neck cancer patients. As an integrated team, both surgeons and pathologists work together to assess margins in these complex patients. Differences in method of margin sampling can impact obtainable information and effect outcomes. Additionally, what distance is an "adequate or clear" margin for patient care continues to be debated. Ultimately, future studies and potentially secondary modalities to augment pathologic assessment of margin assessment (i.e., in situ imaging or molecular assessment) may enhance local control in head and neck cancer patients. PMID:27469263

  19. Family Structure Types and Adequate Utilization of Antenatal Care in Kenya.

    PubMed

    Owili, Patrick Opiyo; Muga, Miriam Adoyo; Chou, Yiing-Jenq; Hsu, Yi-Hsin Elsa; Huang, Nicole; Chien, Li-Yin

    2016-01-01

    Features of the health care delivery system may not be the only expounding factors of adequate utilization of antenatal care among women. Other social factors such as the family structure and its environment contribute toward pregnant women's utilization of antenatal care. An understanding of how women in different family structure types and social groups use basic maternal health services is important toward developing and implementing maternal health care policy in the post-Millennium Development Goal era, especially in the sub-Saharan Africa where maternal mortality still remains high. PMID:27214674

  20. Formal methods and software reliability

    NASA Technical Reports Server (NTRS)

    Holzmann, Gerard J.

    2004-01-01

    In this position statement I briefly describe how the software reliability problem has changed over the years, and the primary reasons for the recent creation of the Laboratory for Reliable Software at JPL.

  1. Recent advances in computational structural reliability analysis methods

    NASA Technical Reports Server (NTRS)

    Thacker, Ben H.; Wu, Y.-T.; Millwater, Harry R.; Torng, Tony Y.; Riha, David S.

    1993-01-01

    The goal of structural reliability analysis is to determine the probability that the structure will adequately perform its intended function when operating under the given environmental conditions. Thus, the notion of reliability admits the possibility of failure. Given the fact that many different modes of failure are usually possible, achievement of this goal is a formidable task, especially for large, complex structural systems. The traditional (deterministic) design methodology attempts to assure reliability by the application of safety factors and conservative assumptions. However, the safety factor approach lacks a quantitative basis in that the level of reliability is never known and usually results in overly conservative designs because of compounding conservatisms. Furthermore, problem parameters that control the reliability are not identified, nor their importance evaluated. A summary of recent advances in computational structural reliability assessment is presented. A significant level of activity in the research and development community was seen recently, much of which was directed towards the prediction of failure probabilities for single mode failures. The focus is to present some early results and demonstrations of advanced reliability methods applied to structural system problems. This includes structures that can fail as a result of multiple component failures (e.g., a redundant truss), or structural components that may fail due to multiple interacting failure modes (e.g., excessive deflection, resonate vibration, or creep rupture). From these results, some observations and recommendations are made with regard to future research needs.

  2. Further discussion on reliability: the art of reliability estimation.

    PubMed

    Yang, Yanyun; Green, Samuel B

    2015-01-01

    Sijtsma and van der Ark (2015) focused in their lead article on three frameworks for reliability estimation in nursing research: classical test theory (CTT), factor analysis (FA), and generalizability theory. We extend their presentation with particular attention to CTT and FA methods. We first consider the potential of yielding an overly negative or an overly positive assessment of reliability based on coefficient alpha. Next, we discuss other CTT methods for estimating reliability and how the choice of methods affects the interpretation of the reliability coefficient. Finally, we describe FA methods, which not only permit an understanding of a measure's underlying structure but also yield a variety of reliability coefficients with different interpretations. On a more general note, we discourage reporting reliability as a two-choice outcome--unsatisfactory or satisfactory; rather, we recommend that nursing researchers make a conceptual and empirical argument about when a measure might be more or less reliable, depending on its use. PMID:25738627

  3. Making Reliability Arguments in Classrooms

    ERIC Educational Resources Information Center

    Parkes, Jay; Giron, Tilia

    2006-01-01

    Reliability methodology needs to evolve as validity has done into an argument supported by theory and empirical evidence. Nowhere is the inadequacy of current methods more visible than in classroom assessment. Reliability arguments would also permit additional methodologies for evidencing reliability in classrooms. It would liberalize methodology…

  4. Testing for PV Reliability (Presentation)

    SciTech Connect

    Kurtz, S.; Bansal, S.

    2014-09-01

    The DOE SUNSHOT workshop is seeking input from the community about PV reliability and how the DOE might address gaps in understanding. This presentation describes the types of testing that are needed for PV reliability and introduces a discussion to identify gaps in our understanding of PV reliability testing.

  5. Business of reliability

    NASA Astrophysics Data System (ADS)

    Engel, Pierre

    1999-12-01

    The presentation is organized around three themes: (1) The decrease of reception equipment costs allows non-Remote Sensing organization to access a technology until recently reserved to scientific elite. What this means is the rise of 'operational' executive agencies considering space-based technology and operations as a viable input to their daily tasks. This is possible thanks to totally dedicated ground receiving entities focusing on one application for themselves, rather than serving a vast community of users. (2) The multiplication of earth observation platforms will form the base for reliable technical and financial solutions. One obstacle to the growth of the earth observation industry is the variety of policies (commercial versus non-commercial) ruling the distribution of the data and value-added products. In particular, the high volume of data sales required for the return on investment does conflict with traditional low-volume data use for most applications. Constant access to data sources supposes monitoring needs as well as technical proficiency. (3) Large volume use of data coupled with low- cost equipment costs is only possible when the technology has proven reliable, in terms of application results, financial risks and data supply. Each of these factors is reviewed. The expectation is that international cooperation between agencies and private ventures will pave the way for future business models. As an illustration, the presentation proposes to use some recent non-traditional monitoring applications, that may lead to significant use of earth observation data, value added products and services: flood monitoring, ship detection, marine oil pollution deterrent systems and rice acreage monitoring.

  6. Adequately-Sized Nanocarriers Allow Sustained Targeted Drug Delivery to Neointimal Lesions in Rat Arteries.

    PubMed

    Taniguchi, Ryosuke; Miura, Yutaka; Koyama, Hiroyuki; Chida, Tsukasa; Anraku, Yasutaka; Kishimura, Akihiro; Shigematsu, Kunihiro; Kataoka, Kazunori; Watanabe, Toshiaki

    2016-06-01

    In atherosclerotic lesions, the endothelial barrier against the bloodstream can become compromised, resulting in the exposure of the extracellular matrix (ECM) and intimal cells beneath. In theory, this allows adequately sized nanocarriers in circulation to infiltrate into the intimal lesion intravascularly. We sought to evaluate this possibility using rat carotid arteries with induced neointima. Cy5-labeled polyethylene glycol-conjugated polyion complex (PIC) micelles and vesicles, with diameters of 40, 100, or 200 nm (PICs-40, PICs-100, and PICs-200, respectively) were intravenously administered to rats after injury to the carotid artery using a balloon catheter. High accumulation and long retention of PICs-40 in the induced neointima was confirmed by in vivo imaging, while the accumulation of PICs-100 and PICs-200 was limited, indicating that the size of nanocarriers is a crucial factor for efficient delivery. Furthermore, epirubicin-incorporated polymeric micelles with a diameter similar to that of PICs-40 showed significant curative effects in rats with induced neointima, in terms of lesion size and cell number. Specific and effective drug delivery to pre-existing neointimal lesions was demonstrated with adequate size control of the nanocarriers. We consider that this nanocarrier-based drug delivery system could be utilized for the treatment of atherosclerosis. PMID:27183493

  7. Adequate Systemic Perfusion Maintained by a CentriMag during Acute Heart Failure

    PubMed Central

    Favaloro, Roberto R.; Bertolotti, Alejandro; Diez, Mirta; Favaloro, Liliana; Gomez, Carmen; Peradejordi, Margarita; Trentadue, Julio; Hellman, Lorena; Arzani, Yanina; Otero, Pilar Varela

    2008-01-01

    Mechanical circulatory support during severe acute heart failure presents options for myocardial recovery or cardiac replacement. Short-term circulatory support with the newest generation of magnetically levitated centrifugal-flow pumps affords several potential advantages. Herein, we present our experience with such a pump—the CentriMag® (Levitronix LLC; Waltham, Mass) centrifugal-flow ventricular assist device—in 4 critically ill patients who were in cardiogenic shock. From November 2007 through March 2008, 3 patients were supported after cardiac surgery, and 1 after chronic heart failure worsened. Two patients were bridged to heart transplantation, and 2 died during support. Perfusion during support was evaluated in terms of serum lactic acid levels and oxygenation values. In all of the patients, the CentriMag's pump flow was adequate, and continuous mechanical ventilation support was provided. Lactic acid levels substantially improved with CentriMag support and were maintained at near-normal levels throughout. At the same time, arterial pH, PO2, and carbon dioxide levels remained within acceptable ranges. No thromboembolic events or mechanical failures occurred. Our experience indicates that short-term use of the CentriMag ventricular assist device during acute heart failure can restore and adequately support circulation until recovery or until the application of definitive therapy. PMID:18941648

  8. Critical Assessment of the Foundations of Power Transmission and Distribution Reliability Metrics and Standards.

    PubMed

    Nateghi, Roshanak; Guikema, Seth D; Wu, Yue Grace; Bruss, C Bayan

    2016-01-01

    The U.S. federal government regulates the reliability of bulk power systems, while the reliability of power distribution systems is regulated at a state level. In this article, we review the history of regulating electric service reliability and study the existing reliability metrics, indices, and standards for power transmission and distribution networks. We assess the foundations of the reliability standards and metrics, discuss how they are applied to outages caused by large exogenous disturbances such as natural disasters, and investigate whether the standards adequately internalize the impacts of these events. Our reflections shed light on how existing standards conceptualize reliability, question the basis for treating large-scale hazard-induced outages differently from normal daily outages, and discuss whether this conceptualization maps well onto customer expectations. We show that the risk indices for transmission systems used in regulating power system reliability do not adequately capture the risks that transmission systems are prone to, particularly when it comes to low-probability high-impact events. We also point out several shortcomings associated with the way in which regulators require utilities to calculate and report distribution system reliability indices. We offer several recommendations for improving the conceptualization of reliability metrics and standards. We conclude that while the approaches taken in reliability standards have made considerable advances in enhancing the reliability of power systems and may be logical from a utility perspective during normal operation, existing standards do not provide a sufficient incentive structure for the utilities to adequately ensure high levels of reliability for end-users, particularly during large-scale events. PMID:25976848

  9. Reliability of anxiety assessment. II. Symptom agreement.

    PubMed

    Fyer, A J; Mannuzza, S; Martin, L Y; Gallops, M S; Endicott, J; Schleyer, B; Gorman, J M; Liebowitz, M R; Klein, D F

    1989-12-01

    Accurate assessment of "subdisorder" anxiety symptoms, ie, anxiety symptoms central to DSM-III-R-diagnosed anxiety disorders but not meeting disorder criteria because of insufficient frequency, duration, or accompanying subjective distress or impairment, may be critical to case identification in genetic, epidemiologic, and high-risk studies. However, concerns that the mild and often transient nature of these phenomena will foster unreliability have discouraged their use. We assessed the test-retest reliability of "subdisorder" anxiety symptoms in 104 outpatients with anxiety. Good to excellent agreement was found for lifetime occurrence of any panic attack, the spontaneous and situationally predisposed subtypes of panic, and five nonsocial irrational fears (public transportation, driving oneself, crowds, situations associated with death [eg, dead bodies and funerals], and cats and dogs). Four social and three additional nonsocial fears were considered to have adequate reliability. However, agreement on stimulus-bound panic, "near" panic attacks, persistent generalized anxiety, and the remaining nine nonsocial and six social irrational fears was only fair to poor. The major source of unreliability was variation in information reported by the subject to the rater. PMID:2589924

  10. Computational methods for efficient structural reliability and reliability sensitivity analysis

    NASA Technical Reports Server (NTRS)

    Wu, Y.-T.

    1993-01-01

    This paper presents recent developments in efficient structural reliability analysis methods. The paper proposes an efficient, adaptive importance sampling (AIS) method that can be used to compute reliability and reliability sensitivities. The AIS approach uses a sampling density that is proportional to the joint PDF of the random variables. Starting from an initial approximate failure domain, sampling proceeds adaptively and incrementally with the goal of reaching a sampling domain that is slightly greater than the failure domain to minimize over-sampling in the safe region. Several reliability sensitivity coefficients are proposed that can be computed directly and easily from the above AIS-based failure points. These probability sensitivities can be used for identifying key random variables and for adjusting design to achieve reliability-based objectives. The proposed AIS methodology is demonstrated using a turbine blade reliability analysis problem.

  11. Esmolol in a case of severe tetanus. Adequate haemodynamic control achieved despite markedly elevated catecholamine levels.

    PubMed

    Beards, S C; Lipman, J; Bothma, P A; Joynt, G M

    1994-03-01

    A patient with severe tetanus, who had a sympathetic crisis while sedated with 30 mg/h diazepam and 30 mg/h morphine, is described. Satisfactory control of the haemodynamic crisis was achieved with bolus doses of esmolol to a total of 180 mg. A disturbing finding was that although there was adequate control of the tachycardia and hypertension, arterial catecholamine levels remained markedly elevated. Adrenaline levels of 531 pg/ml (normal 10-110 pg/ml) and noradrenaline levels of 1,036 pg/ml (normal 100-500 pg/ml) were recorded when the patient had a systolic arterial pressure of 110 mmHg and a heart rate of 97/min. The implications of this finding are discussed. PMID:11218441

  12. Overcome of Carbon Catabolite Repression of Bioinsecticides Production by Sporeless Bacillus thuringiensis through Adequate Fermentation Technology.

    PubMed

    Ben Khedher, Saoussen; Jaoua, Samir; Zouari, Nabil

    2014-01-01

    The overcoming of catabolite repression, in bioinsecticides production by sporeless Bacillus thuringiensis strain S22 was investigated into fully controlled 3 L fermenter, using glucose based medium. When applying adequate oxygen profile throughout the fermentation period (75% oxygen saturation), it was possible to partially overcome the catabolite repression, normally occurring at high initial glucose concentrations (30 and 40 g/L glucose). Moreover, toxin production yield by sporeless strain S22 was markedly improved by the adoption of the fed-batch intermittent cultures technology. With 22.5 g/L glucose used into culture medium, toxin production was improved by about 36% when applying fed-batch culture compared to one batch. Consequently, the proposed fed-batch strategy was efficient for the overcome of the carbon catabolite repression. So, it was possible to overproduce insecticidal crystal proteins into highly concentrated medium. PMID:25309756

  13. Adequate bases of phase space master integrals for gg → h at NNLO and beyond

    NASA Astrophysics Data System (ADS)

    Höschele, Maik; Hoff, Jens; Ueda, Takahiro

    2014-09-01

    We study master integrals needed to compute the Higgs boson production cross section via gluon fusion in the infinite top quark mass limit, using a canonical form of differential equations for master integrals, recently identified by Henn, which makes their solution possible in a straightforward algebraic way. We apply the known criteria to derive such a suitable basis for all the phase space master integrals in afore mentioned process at next-to-next-to-leading order in QCD and demonstrate that the method is applicable to next-to-next-to-next-to-leading order as well by solving a non-planar topology. Furthermore, we discuss in great detail how to find an adequate basis using practical examples. Special emphasis is devoted to master integrals which are coupled by their differential equations.

  14. Are the Psychological Needs of Adolescent Survivors of Pediatric Cancer Adequately Identified and Treated?

    PubMed Central

    Kahalley, Lisa S.; Wilson, Stephanie J.; Tyc, Vida L.; Conklin, Heather M.; Hudson, Melissa M.; Wu, Shengjie; Xiong, Xiaoping; Stancel, Heather H.; Hinds, Pamela S.

    2012-01-01

    Objectives To describe the psychological needs of adolescent survivors of acute lymphoblastic leukemia (ALL) or brain tumor (BT), we examined: (a) the occurrence of cognitive, behavioral, and emotional concerns identified during a comprehensive psychological evaluation, and (b) the frequency of referrals for psychological follow-up services to address identified concerns. Methods Psychological concerns were identified on measures according to predetermined criteria for 100 adolescent survivors. Referrals for psychological follow-up services were made for concerns previously unidentified in formal assessment or not adequately addressed by current services. Results Most survivors (82%) exhibited at least one concern across domains: behavioral (76%), cognitive (47%), and emotional (19%). Behavioral concerns emerged most often on scales associated with executive dysfunction, inattention, learning, and peer difficulties. CRT was associated with cognitive concerns, χ2(1,N=100)=5.63, p<0.05. Lower income was associated with more cognitive concerns for ALL survivors, t(47)=3.28, p<0.01, and more behavioral concerns for BT survivors, t(48)=2.93, p<0.01. Of survivors with concerns, 38% were referred for psychological follow-up services. Lower-income ALL survivors received more referrals for follow-up, χ2(1,N=41)=8.05, p<0.01. Referred survivors had more concerns across domains than non-referred survivors, ALL: t(39)=2.96, p<0.01, BT: t(39)=3.52, p<0.01. Trends suggest ALL survivors may be at risk for experiencing unaddressed cognitive needs. Conclusions Many adolescent survivors of cancer experience psychological difficulties that are not adequately managed by current services, underscoring the need for long-term surveillance. In addition to prescribing regular psychological evaluations, clinicians should closely monitor whether current support services appropriately meet survivors’ needs, particularly for lower-income survivors and those treated with CRT. PMID:22278930

  15. Development of the Environmental Assessment Tool (EAT) to Measure Organizational Physical and Social Support for Worksite Obesity Prevention Programs

    PubMed Central

    DeJoy, David M.; Wilson, Mark G.; Goetzel, Ron Z.; Ozminkowski, Ronald J.; Wang, Shaohung; Baker, Kristin M.; Bowen, Heather M.; Tully, Karen J.

    2010-01-01

    Objective To describe the development, reliability, and validity of the Environmental Assessment Tool (EAT) for assessing worksite physical and social environmental support for obesity prevention. Methods The EAT was developed using a multi-step process. Inter-rater reliability was estimated via Kappa and other measures. Concurrent and predictive validity were estimated using site-level correlations and person-level multiple regression analyses comparing EAT scores and employee absenteeism and healthcare expenditures. Results Results show high inter-rater reliability and concurrent validity for many measures and predictive validity for absenteeism expenditures. Conclusions The primary use of the EAT is as a physical and social environment assessment tool for worksite obesity prevention efforts. It can be used as a reliable and valid means to estimate relationships between environmental interventions and absenteeism and medical expenditures, provided those expenditures are for the same year that the EAT is administered. PMID:18301169

  16. 41 CFR 102-75.150 - What happens when GSA determines that the report of excess is adequate?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... determines that the report of excess is adequate? 102-75.150 Section 102-75.150 Public Contracts and Property... PROPERTY 75-REAL PROPERTY DISPOSAL Utilization of Excess Real Property Examination for Acceptability § 102-75.150 What happens when GSA determines that the report of excess is adequate? When GSA...

  17. 41 CFR 102-75.150 - What happens when GSA determines that the report of excess is adequate?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... determines that the report of excess is adequate? 102-75.150 Section 102-75.150 Public Contracts and Property... PROPERTY 75-REAL PROPERTY DISPOSAL Utilization of Excess Real Property Examination for Acceptability § 102-75.150 What happens when GSA determines that the report of excess is adequate? When GSA...

  18. 41 CFR 102-75.150 - What happens when GSA determines that the report of excess is adequate?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... determines that the report of excess is adequate? 102-75.150 Section 102-75.150 Public Contracts and Property... PROPERTY 75-REAL PROPERTY DISPOSAL Utilization of Excess Real Property Examination for Acceptability § 102-75.150 What happens when GSA determines that the report of excess is adequate? When GSA...

  19. 41 CFR 102-75.150 - What happens when GSA determines that the report of excess is adequate?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... determines that the report of excess is adequate? 102-75.150 Section 102-75.150 Public Contracts and Property... PROPERTY 75-REAL PROPERTY DISPOSAL Utilization of Excess Real Property Examination for Acceptability § 102-75.150 What happens when GSA determines that the report of excess is adequate? When GSA...

  20. 41 CFR 102-75.150 - What happens when GSA determines that the report of excess is adequate?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... determines that the report of excess is adequate? 102-75.150 Section 102-75.150 Public Contracts and Property... PROPERTY 75-REAL PROPERTY DISPOSAL Utilization of Excess Real Property Examination for Acceptability § 102-75.150 What happens when GSA determines that the report of excess is adequate? When GSA...