The effect of simulation-based crew resource management training on measurable teamwork and communication among interprofessional teams caring for postoperative patients.

PubMed

Paull, Douglas E; Deleeuw, Lori D; Wolk, Seth; Paige, John T; Neily, Julia; Mills, Peter D

2013-11-01

Many adverse events in health care are caused by teamwork and communication breakdown. This study was conducted to investigate the effect of a point-of-care simulation-based team training curriculum on measurable teamwork and communication skills in staff caring for postoperative patients. Twelve facilities involving 334 perioperative surgical staff underwent simulation-based training. Pretest and posttest self-report data included the Self-Efficacy of Teamwork Competencies Scale. Observational data were captured with the Clinical Teamwork Scale. Teamwork scores (measured on a five-point Likert scale) improved for all eight survey questions by an average of 18% (3.7 to 4.4, p < .05). The observed communication rating (scale of 1 to 10) increased by 16% (5.6 to 6.4, p < .05). Simulation-based team training for staff caring for perioperative patients is associated with measurable improvements in teamwork and communication. Copyright 2013, SLACK Incorporated.

Measuring Response Styles Across the Big Five: A Multiscale Extension of an Approach Using Multinomial Processing Trees.

PubMed

Khorramdel, Lale; von Davier, Matthias

2014-01-01

This study shows how to address the problem of trait-unrelated response styles (RS) in rating scales using multidimensional item response theory. The aim is to test and correct data for RS in order to provide fair assessments of personality. Expanding on an approach presented by Böckenholt (2012), observed rating data are decomposed into multiple response processes based on a multinomial processing tree. The data come from a questionnaire consisting of 50 items of the International Personality Item Pool measuring the Big Five dimensions administered to 2,026 U.S. students with a 5-point rating scale. It is shown that this approach can be used to test if RS exist in the data and that RS can be differentiated from trait-related responses. Although the extreme RS appear to be unidimensional after exclusion of only 1 item, a unidimensional measure for the midpoint RS is obtained only after exclusion of 10 items. Both RS measurements show high cross-scale correlations and item response theory-based (marginal) reliabilities. Cultural differences could be found in giving extreme responses. Moreover, it is shown how to score rating data to correct for RS after being proved to exist in the data.

Rasch Analysis of the Malaysian Secondary School Student Leadership Inventory (M3SLI).

PubMed

Ling, Mei-Teng

The importance of instilling leadership skills in students has always been a main subject of discussion in Malaysia. Malaysian Secondary School Students Leadership Inventory (M3SLI) is an instrument which has been piloted tested in year 2013. The main purpose of this study is to examine and optimize the functioning of the rating scale categories in M3SLI by investigating the rating scale category counts, average and expected rating scale category measures, and steps calibrations. In detail, the study was aimed to (1) identify whether the five-point rating scale was functioning as intended and (2) review the effect of a rating scale category revision on the psychometric characteristics of M3SLI. The study was carried out on students aged between 13 to 18 years (2183 students) by stratified random sampling in 26 public schools in Sabah, Malaysia, with the results analysed using Winsteps. This study found that the rating scale of Personality and Values constructs needed to be modified while the scale for Leadership Skills was maintained. For future studies, other aspects of psychometric properties like differential item functioning (DIF) based on demographic variables such as gender, school locations and forms should be researched on prior to the use of the instrument.

Assessment of Competence in EVAR Procedures: A Novel Rating Scale Developed by the Delphi Technique.

PubMed

Strøm, M; Lönn, L; Bech, B; Schroeder, T V; Konge, L

2017-07-01

To develop a procedure specific global rating scale for assessment of operator competence in endovascular aortic repair (EVAR). A Delphi approach was used to achieve expert consensus. A panel of 32 international experts (median 300 EVAR procedures, range 200-3000) from vascular surgery (n = 21) and radiology (n = 11) was established. The first Delphi round was based on a review of endovascular skills assessment papers, stent graft instructions for use, and structured interviews. It led to a primary pool of 83 items that were formulated as global rating scale items with tentative anchors. Iterative Delphi rounds were executed. The panellists rated the importance of each item on a 5 point Likert scale. Consensus was defined as 80% of the panel rating an item 4 or 5 in the primary round and 90% in subsequent rounds. Consensus on the final assessment tool was defined as Cronbach's alpha > .8 after a minimum of three rounds. Thirty-two of 35 invited experts participated. Three rounds of surveys were completed with a completion rate of 100% in the first two rounds and 91% in round three. The 83 primary assessment items were supplemented with five items suggested by the panel and reduced to seven pivotal assessment items that reached consensus, Cronbach's alpha = 0.82. The seven item rating scale covers key elements of competence in EVAR stent placement and deployment. Each item has well defined grades with explicit anchors at unacceptable, acceptable, and superior performance on a 5 point Likert scale. The Delphi methodology allowed for international consensus on a new procedure specific global rating scale for assessment of competence in EVAR. The resulting scale, EndoVascular Aortic Repair Assessment of Technical Expertise (EVARATE), represents key elements in the procedure. EVARATE constitutes an assessment tool for providing structured feedback to endovascular operators in training. Copyright © 2017 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Realisation of Strategic Leadership in Leadership Teams' Work as Experienced by the Leadership Team Members of Basic Education Schools

ERIC Educational Resources Information Center

Lahtero, Tapio Juhani; Kuusilehto-Awale, Lea

2013-01-01

This article introduces a quantitative research into how the leadership team members of 49 basic education schools in the city of Vantaa, Finland, experienced the realisation of strategic leadership in their leadership teams' work. The data were collected by a survey of 24 statements, rated on a five-point Likert scale, and analysed with the…

The Effect of Verb Semantic Class and Verb Frequency (Entrenchment) on Children's and Adults' Graded Judgements of Argument-Structure Overgeneralization Errors

ERIC Educational Resources Information Center

Ambridge, Ben; Pine, Julian M.; Rowland, Caroline F.; Young, Chris R.

2008-01-01

Participants (aged 5-6 yrs, 9-10 yrs and adults) rated (using a five-point scale) grammatical (intransitive) and overgeneralized (transitive causative) uses of a high frequency, low frequency and novel intransitive verb from each of three semantic classes [Pinker, S. (1989a). "Learnability and cognition: the acquisition of argument structure."…

The relationship between subjective appetite sensations, markers of inflammation and appetite in dialysis patients.

PubMed

Zabel, R; Ash, S; King, N; Bauer, J

2009-08-01

Poor appetite is a marker of morbidity and mortality in haemodialysis patients, making it an important area for research. Visual analogue scales (VAS) can capture a range of subjective sensations related to appetite (such as hunger, desire to eat or fullness), but have not been commonly used to measure appetite in dialysis patients. The present study aimed to explore the association between retrospective ratings of appetite using VAS and a range of clinical variables, as well as biomarkers of appetite in haemodialysis patients. Twenty-eight haemodialysis patients [mean age 61 +/- 17 years, 50% male, median dialysis vintage 19.5 (4-101) months] rated their appetite using VAS for hunger, fullness and desire to eat and a five-point categorical scale measuring general appetite. Blood levels of the appetite peptides leptin, ghrelin and peptide YY were also measured. Hunger ratings measured by VAS were significantly (P < 0.05) correlated with a range of clinical, nutritional and inflammatory markers: age (r = -0.376), co-morbidities, (r = -0.380) Patient-Generated Subjective Global Assessment score (r = -0.451), weight (r = -0.375), fat-free mass (r = -0.435), C-reactive protein (r = -0.383) and intercellular adhesion molecule (r = -0.387). There was a consistent relationship between VAS and appetite on a five-point categorical scale for questions of hunger, and a similar trend for desire to eat, but not for fullness. Neither method for measuring subjective appetite correlated with appetite peptides. Retrospective ratings of hunger on a VAS are associated with a range of clinical variables and further studies are warranted to support their use as a method for measuring appetite in dialysis patients.

Reliability and Validity of Five Mental Health Scales in Older Persons.

ERIC Educational Resources Information Center

Himmelfarb, Samuel; Murrell, Stanley A.

1983-01-01

Assessed five scales as mental health measures for older persons (N=318). The internal consistency reliabilities for the anxiety, depression, and well-being scales were moderately high to high, but the reliabilities for the affect balance scale suggest some caution. Cutting points for the well-being and depression scales are suggested. (Author/JAC)

Exercise for osteoarthritis of the hip.

PubMed

Fransen, Marlene; McConnell, Sara; Hernandez-Molina, Gabriela; Reichenbach, Stephan

2014-04-22

Current international treatment guidelines recommending therapeutic exercise for people with symptomatic hip osteoarthritis (OA) report are based on limited evidence. To determine whether land-based therapeutic exercise is beneficial for people with hip OA in terms of reduced joint pain and improved physical function and quality of life. We searched five databases from inception up to February 2013. All randomised controlled trials (RCTs) recruiting people with hip OA and comparing some form of land-based therapeutic exercise (as opposed to exercises conducted in water) with a non-exercise group. Four review authors independently selected studies for inclusion. We resolved disagreements through consensus. Two review authors independently extracted data, assessed risk of bias and the quality of the body of evidence for each outcome using the GRADE approach. We conducted analyses on continuous outcomes (pain, physical function and quality of life) and dichotomous outcomes (proportion of study withdrawals). We considered that seven of the 10 included RCTs had a low risk of bias. However, the results may be vulnerable to performance and detection bias as none of the RCTs were able to blind participants to treatment allocation and, while most RCTs reported blinded outcome assessment, pain, physical function and quality of life were participant self reported. One of the 10 RCTs was only reported as a conference abstract and did not provide sufficient data for the evaluation of bias risk.High-quality evidence from nine trials (549 participants) indicated that exercise reduced pain (standardised mean difference (SMD) -0.38, 95% confidence interval (CI) -0.55 to -0.20) and improved physical function (SMD -0.38, 95% CI -0.54 to -0.05) immediately after treatment. Pain and physical function were estimated to be 29 points on a 0- to 100-point scale (0 was no pain or loss of physical function) in the control group; exercise reduced pain by an equivalent of 8 points (95% CI 4 to 11 points; number needed to treat for an additional beneficial outcome (NNTB) 6) and improved physical function by an equivalent of 7 points (95% CI 1 to 12 points; NNTB 6). Only three small studies (183 participants) evaluated quality of life, with overall low quality evidence, with no benefit of exercise demonstrated (SMD -0.07, 95% CI -0.23 to 0.36). Quality of life was estimated to be 50 points on a norm-based mean (standard deviation (SD)) score of 50 (10) in the general population in the control group; exercise improved quality of life by 0 points. Moderate-quality evidence from seven trials (715 participants) indicated an increased likelihood of withdrawal from the exercise allocation (event rate 6%) compared with the control group (event rate 3%), but this difference was not significant (risk difference 1%; 95% CI -1% to 4%). Of the five studies reporting adverse events, each study reported only one or two events and all were related to increased pain attributed to the exercise programme.The reduction in pain was sustained at least three to six months after ceasing monitored treatment (five RCTs, 391 participants): pain (SMD -0.38, 95% CI -0.58 to -0.18). Pain was estimated to be 29 points on a 0- to 100-point scale (0 was no pain) in the control group, the improvement in pain translated to a sustained reduction in pain intensity of 8 points (95% CI 4 to 12 points) compared with the control group (0 to 100 scale). The improvement in physical function was also sustained (five RCTs, 367 participants): physical function (SMD -0.37, 95% CI -0.57 to -0.16). Physical function was estimated to be 24 points on a 0- to 100-point scale (0 was no loss of physical function) in the control group, the improvement translated to a mean of 7 points (95% CI 4 to 13) compared with the control group.Only five of the 10 RCTs exclusively recruited people with symptomatic hip OA (419 participants). There was no significant difference in pain or physical function outcomes compared with five studies recruiting participants with hip or knee OA (130 participants). Pooling the results of these 10 RCTs demonstrated that land-based therapeutic exercise programmes can reduce pain and improve physical function among people with symptomatic hip OA.

An objective approach to determining the weight ranges of prey preferred by and accessible to the five large African carnivores.

PubMed

Clements, Hayley S; Tambling, Craig J; Hayward, Matt W; Kerley, Graham I H

2014-01-01

Broad-scale models describing predator prey preferences serve as useful departure points for understanding predator-prey interactions at finer scales. Previous analyses used a subjective approach to identify prey weight preferences of the five large African carnivores, hence their accuracy is questionable. This study uses a segmented model of prey weight versus prey preference to objectively quantify the prey weight preferences of the five large African carnivores. Based on simulations of known predator prey preference, for prey species sample sizes above 32 the segmented model approach detects up to four known changes in prey weight preference (represented by model break-points) with high rates of detection (75% to 100% of simulations, depending on number of break-points) and accuracy (within 1.3±4.0 to 2.7±4.4 of known break-point). When applied to the five large African carnivores, using carnivore diet information from across Africa, the model detected weight ranges of prey that are preferred, killed relative to their abundance, and avoided by each carnivore. Prey in the weight ranges preferred and killed relative to their abundance are together termed "accessible prey". Accessible prey weight ranges were found to be 14-135 kg for cheetah Acinonyx jubatus, 1-45 kg for leopard Panthera pardus, 32-632 kg for lion Panthera leo, 15-1600 kg for spotted hyaena Crocuta crocuta and 10-289 kg for wild dog Lycaon pictus. An assessment of carnivore diets throughout Africa found these accessible prey weight ranges include 88±2% (cheetah), 82±3% (leopard), 81±2% (lion), 97±2% (spotted hyaena) and 96±2% (wild dog) of kills. These descriptions of prey weight preferences therefore contribute to our understanding of the diet spectrum of the five large African carnivores. Where datasets meet the minimum sample size requirements, the segmented model approach provides a means of determining, and comparing, the prey weight range preferences of any carnivore species.

A Comparison of Obsessive-Compulsive Personality Disorder Scales

PubMed Central

Samuel, Douglas B.; Widiger, Thomas A.

2010-01-01

The current study utilized a large undergraduate sample (n = 536), oversampled for DSM-IV-TR obsessive-compulsive personality disorder (OCPD) pathology, to compare eight self-report measures of OCPD. No prior study has compared more than three measures and the results indicated that the scales had only moderate convergent validity. We also went beyond the existing literature to compare these scales to two external reference points: Their relationships with a well established measure of the five-factor model of personality (FFM) and clinicians' ratings of their coverage of the DSM-IV-TR criterion set. When the FFM was used as a point of comparison the results suggested important differences among the measures with respect to their divergent representation of conscientiousness, neuroticism, and agreeableness. Additionally, an analysis of the construct coverage indicated that the measures also varied in terms of their representation of particular diagnostic criteria. For example, while some scales contained items distributed across the diagnostic criteria, others were concentrated more heavily on particular features of the DSM-IV-TR disorder. PMID:20408023

[Observation of the effects of warming-up and role-playing in psychodrama in terms of mood rating].

PubMed

Kawai, S

1993-04-01

The purpose is to make an appropriate list of terms that describe person's moment-to-moment changes in moods during psychodrama sessions. Seventy nurse students participated in a series of psychodrama sessions, consisting of a session of warming-up and two sessions of role playing. They rated their moods at the beginning of the sessions and after each session, on a five-point scale for each of the 55 terms, which were supposed to cover all kinds of moods during psychodrama sessions. After analyzing variations (using factor analyses) of subjects' ratings, three factors were found to be sufficient for describing their moods, and the terms in the list were eventually reduced to sixteen. Changes of moods analyzed through the ratings of sixteen scales were related significantly with subjects' performances of warming-up and role playing.

Sources of male chauvinism in the TAT.

PubMed

Potkay, C R; Merrens, M R

1975-10-01

Potential sources of antifemale bias in TAT stimuli were evaluated by having 358 undergraduate subjects rate 17 male and 17 female TAT figures on 7-point anchored scales. Data from the five independent rating conditions were examined by 2 x 2 ANOVA. Biases toward greater Mental Health and Intelligence for female figures were seen to be insufficient counterbalancers of biases toward greater Cultural Favorability and Identification for male figures. Achievement status was rated equivalently. TAT stimuli appeared to show a "built in" source of male chauvinism systematically "pulling" male-sex identification. Potential for unfavorable clinical evaluation was seen to be greater for female TAT subjects compared with male subjects.

Rating Scales for Dystonia in Cerebral Palsy: Reliability and Validity

ERIC Educational Resources Information Center

Monbaliu, E.; Ortibus, E.; Roelens, F.; Desloovere, K.; Deklerck, J.; Prinzie, P.; De Cock, P.; Feys, H.

2010-01-01

Aim: This study investigated the reliability and validity of the Barry-Albright Dystonia Scale (BADS), the Burke-Fahn-Marsden Movement Scale (BFMMS), and the Unified Dystonia Rating Scale (UDRS) in patients with bilateral dystonic cerebral palsy (CP). Method: Three raters independently scored videotapes of 10 patients (five males, five females;…

Computational Aerodynamic Simulations of a 1215 ft/sec Tip Speed Transonic Fan System Model for Acoustic Methods Assessment and Development

NASA Technical Reports Server (NTRS)

Tweedt, Daniel L.

2014-01-01

Computational Aerodynamic simulations of a 1215 ft/sec tip speed transonic fan system were performed at five different operating points on the fan operating line, in order to provide detailed internal flow field information for use with fan acoustic prediction methods presently being developed, assessed and validated. The fan system is a sub-scale, low-noise research fan/nacelle model that has undergone extensive experimental testing in the 9- by 15-foot Low Speed Wind Tunnel at the NASA Glenn Research Center. Details of the fan geometry, the computational fluid dynamics methods, the computational grids, and various computational parameters relevant to the numerical simulations are discussed. Flow field results for three of the five operating points simulated are presented in order to provide a representative look at the computed solutions. Each of the five fan aerodynamic simulations involved the entire fan system, which for this model did not include a split flow path with core and bypass ducts. As a result, it was only necessary to adjust fan rotational speed in order to set the fan operating point, leading to operating points that lie on a fan operating line and making mass flow rate a fully dependent parameter. The resulting mass flow rates are in good agreement with measurement values. Computed blade row flow fields at all fan operating points are, in general, aerodynamically healthy. Rotor blade and fan exit guide vane flow characteristics are good, including incidence and deviation angles, chordwise static pressure distributions, blade surface boundary layers, secondary flow structures, and blade wakes. Examination of the flow fields at all operating conditions reveals no excessive boundary layer separations or related secondary-flow problems.

Validation of buoyancy driven spectral tensor model using HATS data

NASA Astrophysics Data System (ADS)

Chougule, A.; Mann, J.; Kelly, M.; Larsen, G. C.

2016-09-01

We present a homogeneous spectral tensor model for wind velocity and temperature fluctuations, driven by mean vertical shear and mean temperature gradient. Results from the model, including one-dimensional velocity and temperature spectra and the associated co-spectra, are shown in this paper. The model also reproduces two-point statistics, such as coherence and phases, via cross-spectra between two points separated in space. Model results are compared with observations from the Horizontal Array Turbulence Study (HATS) field program (Horst et al. 2004). The spectral velocity tensor in the model is described via five parameters: the dissipation rate (ɛ), length scale of energy-containing eddies (L), a turbulence anisotropy parameter (Γ), gradient Richardson number (Ri) representing the atmospheric stability and the rate of destruction of temperature variance (ηθ).

The development of an outcome measure for liaison mental health services.

PubMed

Guthrie, Else; Harrison, Mathew; Brown, Richard; Sandhu, Rajdeep; Trigwell, Peter; Abraham, Seri; Nawaz, Shazada; Kelsall, Peter; Thomasson, Rachel

2018-06-01

Aims and methodTo develop and pilot a clinician-rated outcome scale to evaluate symptomatic outcomes in liaison psychiatry services. Three hundred and sixty patient contacts with 207 separate individuals were rated using six subscales (mood, psychosis, cognition, substance misuse, mind-body problems and behavioural disturbance) plus two additional items (side-effects of medication and capacity to consent for medical treatment). Each item was rated on a five-point scale from 0 to 5 (nil, mild, moderate, severe and very severe). The liaison outcome measure was acceptable and easy to use. All subscales showed acceptable interrater reliability, with the exception of the mind-body subscale. Overall, the measure appears to show stability and sensitivity to change.Clinical implicationsThe measure provides a useful and robust way to determine symptomatic change in a liaison mental health setting, although the mind-body subscale requires modification.Declaration of interestNone.

Mammalian basal metabolic rate is proportional to body mass2/3

PubMed Central

White, Craig R.; Seymour, Roger S.

2003-01-01

The relationship between mammalian basal metabolic rate (BMR, ml of O2 per h) and body mass (M, g) has been the subject of regular investigation for over a century. Typically, the relationship is expressed as an allometric equation of the form BMR = aMb. The scaling exponent (b) is a point of contention throughout this body of literature, within which arguments for and against geometric (b = 2/3) and quarter-power (b = 3/4) scaling are made and rebutted. Recently, interest in the topic has been revived by published explanations for quarter-power scaling based on fractal nutrient supply networks and four-dimensional biology. Here, a new analysis of the allometry of mammalian BMR that accounts for variation associated with body temperature, digestive state, and phylogeny finds no support for a metabolic scaling exponent of 3/4. Data encompassing five orders of magnitude variation in M and featuring 619 species from 19 mammalian orders show that BMR ∝ M2/3. PMID:12637681

Reliability of Untrained and Experienced Raters on FEES: Rating Overall Residue is a Simple Task.

PubMed

Pisegna, Jessica M; Borders, James C; Kaneoka, Asako; Coster, Wendy J; Leonard, Rebecca; Langmore, Susan E

2018-03-07

The purpose of this study was to investigate the reliability of residue ratings on Fiberoptic Endoscopic Evaluation of Swallowing (FEES). We also examined rating differences based on experience to determine if years of experience influenced residue ratings. A group of 44 raters watched 81 FEES videos representing a wide range of residue severities for thin liquid, applesauce, and cracker boluses. Raters were untrained on the rating scales and simply rated their overall impression of residue amount on a visual analog scale (VAS) and a five-point ordinal scale in a randomized fashion across two sessions. Intra-class correlation coefficients, kappa coefficients, and ANOVAs were used to analyze agreement and differences in ratings. Residue ratings on both the VAS and ordinal scales had acceptable inter- and intra-rater reliability. Inter-rater agreement was acceptable (ICC > 0.7) for all comparisons. Intra-rater agreement was excellent on the VAS scale (r c  = 0.9) and good on the ordinal scale (k = 0.78). There was no significant difference between expert ratings and other raters based on years of experience for cracker ratings (p = 0.2119) and applesauce ratings (p = 0.2899), but there was a significant difference between clinicians on thin liquid ratings (p = 0.0005). Without any specific training, raters demonstrated high reliability when rating the overall amount of residue on FEES. Years of experience with FEES did not influence residue ratings, suggesting that expert ratings of overall residue amount are not unique or specialized. Rating the overall amount of residue on FEES appears to be a simple visual-perceptual task for puree and cracker boluses.

Development and validation of the simulation-based learning evaluation scale.

PubMed

Hung, Chang-Chiao; Liu, Hsiu-Chen; Lin, Chun-Chih; Lee, Bih-O

2016-05-01

The instruments that evaluate a student's perception of receiving simulated training are English versions and have not been tested for reliability or validity. The aim of this study was to develop and validate a Chinese version Simulation-Based Learning Evaluation Scale (SBLES). Four stages were conducted to develop and validate the SBLES. First, specific desired competencies were identified according to the National League for Nursing and Taiwan Nursing Accreditation Council core competencies. Next, the initial item pool was comprised of 50 items related to simulation that were drawn from the literature of core competencies. Content validity was established by use of an expert panel. Finally, exploratory factor analysis and confirmatory factor analysis were conducted for construct validity, and Cronbach's coefficient alpha determined the scale's internal consistency reliability. Two hundred and fifty students who had experienced simulation-based learning were invited to participate in this study. Two hundred and twenty-five students completed and returned questionnaires (response rate=90%). Six items were deleted from the initial item pool and one was added after an expert panel review. Exploratory factor analysis with varimax rotation revealed 37 items remaining in five factors which accounted for 67% of the variance. The construct validity of SBLES was substantiated in a confirmatory factor analysis that revealed a good fit of the hypothesized factor structure. The findings tally with the criterion of convergent and discriminant validity. The range of internal consistency for five subscales was .90 to .93. Items were rated on a 5-point scale from 1 (strongly disagree) to 5 (strongly agree). The results of this study indicate that the SBLES is valid and reliable. The authors recommend that the scale could be applied in the nursing school to evaluate the effectiveness of simulation-based learning curricula. Copyright © 2016 Elsevier Ltd. All rights reserved.

Distance-Learning, ADHD Quality Improvement in Primary Care: A Cluster-Randomized Trial.

PubMed

Fiks, Alexander G; Mayne, Stephanie L; Michel, Jeremy J; Miller, Jeffrey; Abraham, Manju; Suh, Andrew; Jawad, Abbas F; Guevara, James P; Grundmeier, Robert W; Blum, Nathan J; Power, Thomas J

2017-10-01

To evaluate a distance-learning, quality improvement intervention to improve pediatric primary care provider use of attention-deficit/hyperactivity disorder (ADHD) rating scales. Primary care practices were cluster randomized to a 3-part distance-learning, quality improvement intervention (web-based education, collaborative consultation with ADHD experts, and performance feedback reports/calls), qualifying for Maintenance of Certification (MOC) Part IV credit, or wait-list control. We compared changes relative to a baseline period in rating scale use by study arm using logistic regression clustered by practice (primary analysis) and examined effect modification by level of clinician participation. An electronic health record-linked system for gathering ADHD rating scales from parents and teachers was implemented before the intervention period at all sites. Rating scale use was ascertained by manual chart review. One hundred five clinicians at 19 sites participated. Differences between arms were not significant. From the baseline to intervention period and after implementation of the electronic system, clinicians in both study arms were significantly more likely to administer and receive parent and teacher rating scales. Among intervention clinicians, those who participated in at least 1 feedback call or qualified for MOC credit were more likely to give parents rating scales with differences of 14.2 (95% confidence interval [CI], 0.6-27.7) and 18.8 (95% CI, 1.9-35.7) percentage points, respectively. A 3-part clinician-focused distance-learning, quality improvement intervention did not improve rating scale use. Complementary strategies that support workflows and more fully engage clinicians may be needed to bolster care. Electronic systems that gather rating scales may help achieve this goal. Index terms: ADHD, primary care, quality improvement, clinical decision support.

A comparison of obsessive-compulsive personality disorder scales.

PubMed

Samuel, Douglas B; Widiger, Thomas A

2010-05-01

In this study, we utilized a large undergraduate sample (N = 536), oversampled for the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision [DSM-IV-TR]; American Psychiatric Association, 2000) obsessive-compulsive personality disorder (OCPD) pathology, to compare 8 self-report measures of OCPD. No prior study has compared more than 3 measures, and the results indicate that the scales had only moderate convergent validity. We also went beyond the existing literature to compare these scales to 2 external reference points: their relationships with a well-established measure of the five-factor model of personality (FFM) and clinicians' ratings of their coverage of the DSM-IV-TR criterion set. When the FFM was used as a point of comparison, the results suggest important differences among the measures with respect to their divergent representation of conscientiousness, neuroticism, and agreeableness. Additionally, an analysis of the construct coverage indicated that the measures also varied in terms of their representation of particular diagnostic criteria. For example, whereas some scales contained items distributed across the diagnostic criteria, others were concentrated more heavily on particular features of the DSM-IV-TR disorder.

An Objective Approach to Determining the Weight Ranges of Prey Preferred by and Accessible to the Five Large African Carnivores

PubMed Central

Clements, Hayley S.; Tambling, Craig J.; Hayward, Matt W.; Kerley, Graham I. H.

2014-01-01

Broad-scale models describing predator prey preferences serve as useful departure points for understanding predator-prey interactions at finer scales. Previous analyses used a subjective approach to identify prey weight preferences of the five large African carnivores, hence their accuracy is questionable. This study uses a segmented model of prey weight versus prey preference to objectively quantify the prey weight preferences of the five large African carnivores. Based on simulations of known predator prey preference, for prey species sample sizes above 32 the segmented model approach detects up to four known changes in prey weight preference (represented by model break-points) with high rates of detection (75% to 100% of simulations, depending on number of break-points) and accuracy (within 1.3±4.0 to 2.7±4.4 of known break-point). When applied to the five large African carnivores, using carnivore diet information from across Africa, the model detected weight ranges of prey that are preferred, killed relative to their abundance, and avoided by each carnivore. Prey in the weight ranges preferred and killed relative to their abundance are together termed “accessible prey”. Accessible prey weight ranges were found to be 14–135 kg for cheetah Acinonyx jubatus, 1–45 kg for leopard Panthera pardus, 32–632 kg for lion Panthera leo, 15–1600 kg for spotted hyaena Crocuta crocuta and 10–289 kg for wild dog Lycaon pictus. An assessment of carnivore diets throughout Africa found these accessible prey weight ranges include 88±2% (cheetah), 82±3% (leopard), 81±2% (lion), 97±2% (spotted hyaena) and 96±2% (wild dog) of kills. These descriptions of prey weight preferences therefore contribute to our understanding of the diet spectrum of the five large African carnivores. Where datasets meet the minimum sample size requirements, the segmented model approach provides a means of determining, and comparing, the prey weight range preferences of any carnivore species. PMID:24988433

[Efficacy of Arnica in varicose vein surgery: results of a randomized, double-blind, placebo-controlled pilot study].

PubMed

Wolf, M; Tamaschke, C; Mayer, W; Heger, M

2003-10-01

In homeopathy ARNICA is widely used as a woundhealing medication and for the treatment of hematomas. In this pilot study the efficacy and safety of ARNICA D12 in patients following varicose vein surgery were investigated. Prospective, randomized, double-blind, placebo-controlled pilot trial according to ICH GCP guidelines. The study was conducted by a surgeon at the Angiosurgical Clinic, Berlin- Buch. After randomized allocation, 60 patients received either ARNICA D12 or placebo. Start of medication occurred the evening before operation with 5 globules. On the operation day one preoperative and hourly postoperative dosages after awakening were given. On days 2-14 of the study 5 globules 3 times a day were given. OUTCOME CRITERIA: Surface (in cm(2) and using a three-point verbal rating scale) and intensity of hematomas induced by operation, complications of wound healing, and intensity of pain (five-point verbal rating scale) as well as efficacy and safety of the study medication were assessed. Hematoma surface was reduced (from day 7 to day 14) under ARNICA by 75.5% and under placebo by 71.5% (p = 0.4726). The comparison of hematoma surface (small, medium, large) using the verbal rating scale yielded a value of p = 0.1260. Pain score decreased by 1.0 +/- 2.2 points under ARNICA and 0.3 +/- 0.8 points under placebo (p = 0.1977). Remission or improvement of pain was observed in 43.3% of patients in the ARNICA group and in 27.6% of patients in the placebo group. Tolerability was rated as very good in all cases. The results of this pilot study showed a trend towards a beneficial effect of ARNICA D12 with regard to reduction of hematoma and pain during the postoperative course. For a statistically significant proof of efficacy of ARNICA D12 in patients following varicose vein surgery a larger sample size is necessary. Copyright 2003 S. Karger GmbH, Freiburg

A Teacher-Friendly Instrument in Identifying Learning Styles in the Classroom.

ERIC Educational Resources Information Center

Pitts, Joseph I.

This report describes a reliability and validity study on a learning styles instrument that was developed based on the Dunn, Dunn, & Price model. That model included 104 Likert five-point scale items for investigating 24 scales grouped into five categories considered likely to affect learning. The Learning Style Preference Inventory (LSPI)…

Development of life story experience (LSE) scales for migrant dentists in Australia: a sequential qualitative-quantitative study.

PubMed

Balasubramanian, M; Spencer, A J; Short, S D; Watkins, K; Chrisopoulos, S; Brennan, D S

2016-09-01

The integration of qualitative and quantitative approaches introduces new avenues to bridge strengths, and address weaknesses of both methods. To develop measure(s) for migrant dentist experiences in Australia through a mixed methods approach. The sequential qualitative-quantitative design involved first the harvesting of data items from qualitative study, followed by a national survey of migrant dentists in Australia. Statements representing unique experiences in migrant dentists' life stories were deployed the survey questionnaire, using a five-point Likert scale. Factor analysis was used to examine component factors. Eighty-two statements from 51 participants were harvested from the qualitative analysis. A total of 1,022 of 1,977 migrant dentists (response rate 54.5%) returned completed questionnaires. Factor analysis supported an initial eight-factor solution; further scale development and reliability analysis led to five scales with a final list of 38 life story experience (LSE) items. Three scales were based on home country events: health system and general lifestyle concerns (LSE1; 10 items), society and culture (LSE4; 4 items) and career development (LSE5; 4 items). Two scales included migrant experiences in Australia: appreciation towards Australian way of life (LSE2; 13 items) and settlement concerns (LSE3; 7 items). The five life story experience scales provided necessary conceptual clarity and empirical grounding to explore migrant dentist experiences in Australia. Being based on original migrant dentist narrations, these scales have the potential to offer in-depth insights for policy makers and support future research on dentist migration. Copyright© 2016 Dennis Barber Ltd

Validity, Sensitivity, and Responsiveness of the 11-Face Faces Pain Scale to Postoperative Pain in Adult Orthopedic Surgery Patients.

PubMed

Van Giang, Nguyen; Chiu, Hsiao-Yean; Thai, Duong Hong; Kuo, Shu-Yu; Tsai, Pei-Shan

2015-10-01

Pain is common in patients after orthopedic surgery. The 11-face Faces Pain Scale has not been validated for use in adult patients with postoperative pain. To assess the validity of the 11-face Faces Pain Scale and its ability to detect responses to pain medications, and to determine whether the sensitivity of the 11-face Faces Pain Scale for detecting changes in pain intensity over time is associated with gender differences in adult postorthopedic surgery patients. The 11-face Faces Pain Scale was translated into Vietnamese using forward and back translation. Postoperative pain was assessed using an 11-point numerical rating scale and the 11-face Faces Pain Scale on the day of surgery, and before (Time 1) and every 30 minutes after (Times 2-5) the patients had taken pain medications on the first postoperative day. The 11-face Faces Pain Scale highly correlated with the numerical rating scale (r = 0.78, p < .001). When the scores from each follow-up test (Times 2-5) were compared with those from the baseline test (Time 1), the effect sizes were -0.70, -1.05, -1.20, and -1.31, and the standardized response means were -1.17, -1.59, -1.66, and -1.82, respectively. The mean change in pain intensity, but not gender-time interaction effect, over the five time points was significant (F = 182.03, p < .001). Our results support that the 11-face Faces Pain Scale is appropriate for measuring acute postoperative pain in adults. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Explanatory factors and predictors of fatigue in persons with rheumatoid arthritis: A longitudinal study.

PubMed

Feldthusen, Caroline; Grimby-Ekman, Anna; Forsblad-d'Elia, Helena; Jacobsson, Lennart; Mannerkorpi, Kaisa

2016-04-28

To investigate the impact of disease-related aspects on long-term variations in fatigue in persons with rheumatoid arthritis. Observational longitudinal study. Sixty-five persons with rheumatoid arthritis, age range 20-65 years, were invited to a clinical examination at 4 time-points during the 4 seasons. Outcome measures were: general fatigue rated on visual analogue scale (0-100) and aspects of fatigue assessed by the Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire. Disease-related variables were: disease activity (erythrocyte sedimentation rate), pain threshold (pressure algometer), physical capacity (six-minute walk test), pain (visual analogue scale (0-100)), depressive mood (Hospital Anxiety and Depression scale, depression subscale), personal factors (age, sex, body mass index) and season. Multivariable regression analysis, linear mixed effects models were applied. The strongest explanatory factors for all fatigue outcomes, when recorded at the same time-point as fatigue, were pain threshold and depressive mood. Self-reported pain was an explanatory factor for physical aspects of fatigue and body mass index contributed to explaining the consequences of fatigue on everyday living. For predicting later fatigue pain threshold and depressive mood were the strongest predictors. Pain threshold and depressive mood were the most important factors for fatigue in persons with rheumatoid arthritis.

Reliability of sonographic assessment of tendinopathy in tennis elbow.

PubMed

Poltawski, Leon; Ali, Syed; Jayaram, Vijay; Watson, Tim

2012-01-01

To assess the reliability and compute the minimum detectable change using sonographic scales to quantify the extent of pathology and hyperaemia in the common extensor tendon in people with tennis elbow. The lateral elbows of 19 people with tennis elbow were assessed sonographically twice, 1-2 weeks apart. Greyscale and power Doppler images were recorded for subsequent rating of abnormalities. Tendon thickening, hypoechogenicity, fibrillar disruption and calcification were each rated on four-point scales, and scores were summed to provide an overall rating of structural abnormality; hyperaemia was scored on a five point scale. Inter-rater reliability was established using the intraclass correlation coefficient (ICC) to compare scores assigned independently to the same set of images by a radiologist and a physiotherapist with training in musculoskeletal imaging. Test-retest reliability was assessed by comparing scores assigned by the physiotherapist to images recorded at the two sessions. The minimum detectable change (MDC) was calculated from the test-retest reliability data. ICC values for inter-rater reliability ranged from 0.35 (95% CI: 0.05, 0.60) for fibrillar disruption to 0.77 (0.55, 0.88) for overall greyscale score, and 0.89 (0.79, 0.95) for hyperaemia. Test-retest reliability ranged from 0.70 (0.48, 0.84) for tendon thickening to 0.82 (0.66, 0.90) for overall greyscale score and 0.86 (0.73, 0.93) for calcification. The MDC for the greyscale total score was 2.0/12 and for the hyperaemia score was 1.1/5. The sonographic scoring system used in this study may be used reliably to quantify tendon abnormalities and change over time. A relatively inexperienced imager can conduct the assessment and use the rating scales reliably.

Rethinking Residue: Determining the Perceptual Continuum of Residue on FEES to Enable Better Measurement.

PubMed

Pisegna, Jessica M; Kaneoka, Asako; Leonard, Rebecca; Langmore, Susan E

2018-02-01

The goal of this work was to better understand perceptual judgments of pharyngeal residue on flexible endoscopic evaluation of swallowing (FEES) and the influence of a visual analog scale (VAS) versus an ordinal scale on clinician ratings. The intent was to determine if perceptual judgments of residue were more accurately described by equal or unequal intervals. Thirty-three speech language pathologists rated pharyngeal residue from 75 FEES videos representing a wide range of residue severities for thin liquid, applesauce, and cracker boluses. Clinicians rated their impression of the overall residue amount in each video on a VAS and, in a different session, on a five-point ordinal scale. Residue ratings were made in two separate sessions separated by several weeks. Statistical correlations of the two rating methods were carried out and best-fit models were determined for each bolus type. A total of 2475 VAS ratings and 2473 ordinal ratings were collected. Residue ratings from both methods (VAS and ordinal) were strongly correlated for all bolus types. The best fit for the data was a quadratic model representing unequal intervals, which significantly improved the r 2 values for each bolus type (cracker r 2  = 0.98, applesauce r 2  = 0.99, thin liquid r 2  = 0.98, all p < 0.0001). Perceptual ratings of pharyngeal residue demonstrated a statistical relationship consistent with unequal intervals. The present findings support the use of a VAS to rate residue on FEES, allowing for greater precision as compared to traditional ordinal rating scales. Perceptual judgments of pharyngeal residue reflected unequal intervals, an important concept that should be considered in future rating scales.

Spatially Resolved Spectroscopy of Narrow-line Seyfert 1 Host Galaxies

NASA Astrophysics Data System (ADS)

Scharwächter, J.; Husemann, B.; Busch, G.; Komossa, S.; Dopita, M. A.

2017-10-01

We present optical integral field spectroscopy for five z< 0.062 narrow-line Seyfert 1 (NLS1) galaxies, probing their host galaxies at ≳ 2{--}3 {kpc} scales. Emission lines from the active galactic nucleus (AGN) and the large-scale host galaxy are analyzed separately, based on an AGN-host decomposition technique. The host galaxy gas kinematics indicates large-scale gas rotation in all five sources. At the probed scales of ≳ 2{--}3 {kpc}, the host galaxy gas is found to be predominantly ionized by star formation without any evidence of a strong AGN contribution. None of the five objects shows specific star formation rates (SFRs) exceeding the main sequence of low-redshift star-forming galaxies. The specific SFRs for MCG-05-01-013 and WPVS 007 are roughly consistent with the main sequence, while ESO 399-IG20, MS 22549-3712, and TON S180 show lower specific SFRs, intermediate to the main sequence and the red quiescent galaxies. The host galaxy metallicities, derived for the two sources with sufficient data quality (ESO 399-IG20 and MCG-05-01-013), indicate central oxygen abundances just below the low-redshift mass-metallicity relation. Based on this initial case study, we outline a comparison of AGN and host galaxy parameters as a starting point for future extended NLS1 studies with similar methods.

South African child deaths 1990–2011: have HIV services reversed the trend enough to meet Millennium Development Goal 4?

PubMed Central

Kerber, Kate J.; Lawn, Joy E.; Johnson, Leigh F.; Mahy, Mary; Dorrington, Rob E.; Phillips, Heston; Bradshaw, Debbie; Nannan, Nadine; Msemburi, William; Oestergaard, Mikkel Z.; Walker, Neff P.; Sanders, David; Jackson, Debra

2013-01-01

Objective: To analyse trends in under-five mortality rate in South Africa (1990–2011), particularly the contribution of AIDS deaths. Methods: Three nationally used models for estimating AIDS deaths in children were systematically reviewed. The model outputs were compared with under-five mortality rate estimates for South Africa from two global estimation models. All estimates were compared with available empirical data. Results: Differences between the models resulted in varying point estimates for under-five mortality but the trends were similar, with mortality increasing to a peak around 2005. The three models showing the contribution of AIDS suggest a maximum of 37–39% of child deaths were due to AIDS in 2004–2005 which has since declined. Although the rate of progress from 1990 is not the 4.4% needed to meet Millennium Development Goal 4 for child survival, South Africa's average annual rate of under-five mortality decline between 2006 and 2011 was between 6.3 and 10.2%. Conclusion: In 2005, South Africa was one of only four countries globally with an under-five mortality rate higher than the 1990 Millennium Development Goal baseline. Over the past 5 years, the country has achieved a rate of child mortality reduction exceeded by only three other countries. This rapid turnaround is likely due to scale-up of prevention of mother-to-child transmission of HIV, and to a lesser degree, the expanded roll-out of antiretroviral therapy. Emphasis on these programmes must continue, but failure to address other aspects of care including integrated high-quality maternal and neonatal care means that the decline in child mortality could stall. PMID:23863402

Cause or effect? The relationship between student perception of the medical school learning environment and academic performance on USMLE Step 1.

PubMed

Wayne, Sharon J; Fortner, Sally A; Kitzes, Judith A; Timm, Craig; Kalishman, Summers

2013-05-01

A school's learning environment is believed to influence academic performance yet few studies have evaluated this association controlling for prior academic ability, an important factor since students who do well in school tend to rate their school's environment more highly than students who are less academically strong. To evaluate the effect of student perception of the learning environment on their performance on a standardized licensing test while controlling for prior academic ability. We measured perception of the learning environment after the first year of medical school in 267 students from five consecutive classes and related that measure to performance on United States Medical Licensing Examination (USMLE) Step 1, taken approximately six months later. We controlled for prior academic performance by including Medical College Admission Test score and undergraduate grade point average in linear regression models. Three of the five learning environment subscales were statistically associated with Step 1 performance (p < 0.05): meaningful learning environment, emotional climate, and student-student interaction. A one-point increase in the rating of the subscales (scale of 1-4) was associated with increases of 6.8, 6.6, and 4.8 points on the Step 1 exam. Our findings provide some evidence for the widely held assumption that a positively perceived learning environment contributes to better academic performance.

A brief educational intervention to teach residents shared decision making in the intensive care unit.

PubMed

Yuen, Jacqueline K; Mehta, Sonal S; Roberts, Jordan E; Cooke, Joseph T; Reid, M Carrington

2013-05-01

Effective communication is essential for shared decision making with families of critically ill patients in the intensive care unit (ICU), yet there is limited evidence on effective strategies to teach these skills. The study's objective was to pilot test an educational intervention to teach internal medicine interns skills in discussing goals of care and treatment decisions with families of critically ill patients using the shared decision making framework. The intervention consisted of a PowerPoint online module followed by a four-hour workshop implemented at a retreat for medicine interns training at an urban, academic medical center. Participants (N=33) completed post-intervention questionnaires that included self-assessed skills learned, an open-ended question on the most important learning points from the workshop, and retrospective pre- and post-workshop comfort level with ICU communication skills. Participants rated their satisfaction with the workshop. Twenty-nine interns (88%) completed the questionnaires. Important self-assessed communication skills learned reflect key components of shared decision making, which include assessing the family's understanding of the patient's condition (endorsed by 100%) and obtaining an understanding of the patient/family's perspectives, values, and goals (100%). Interns reported significant improvement in their comfort level with ICU communication skills (pre 3.26, post 3.73 on a five-point scale, p=0.004). Overall satisfaction with the intervention was high (mean 4.45 on a five-point scale). The findings suggest that a brief intervention designed to teach residents communication skills in conducting goals of care and treatment discussions in the ICU is feasible and can improve their comfort level with these conversations.

Validation of Digital Spiral Analysis as Outcome Parameter for Clinical Trials in Essential Tremor

PubMed Central

Haubenberger, Dietrich; Kalowitz, Daniel; Nahab, Fatta B.; Toro, Camilo; Ippolito, Dominic; Luckenbaugh, David A.; Wittevrongel, Loretta; Hallett, Mark

2014-01-01

Essential tremor, one of the most prevalent movement disorders, is characterized by kinetic and postural tremor affecting activities of daily living. Spiral drawing is commonly used to visually rate tremor intensity, as part of the routine clinical assessment of tremor and as a tool in clinical trials. We present a strategy to quantify tremor severity from spirals drawn on a digitizing tablet. We validate our method against a well-established visual spiral rating method and compare both methods on their capacity to capture a therapeutic effect, as defined by the change in clinical essential tremor rating scale after an ethanol challenge. Fifty-four Archimedes spirals were drawn using a digitizing tablet by nine ethanol-responsive patients with essential tremor before and at five consecutive time points after the administration of ethanol in a standardized treatment intervention. Quantitative spiral tremor severity was estimated from the velocity tremor peak amplitude after numerical derivation and Fourier transformation of pen-tip positions. In randomly ordered sets, spirals were scored by seven trained raters, using Bain and Findley’s 0 to 10 rating scale. Computerized scores correlated with visual ratings (P < 0.0001). The correlation was significant at each time point before and after ethanol (P < 0.005). Quantitative ratings provided better sensitivity than visual rating to capture the effects of an ethanol challenge (P < 0.05). Using a standardized treatment approach, we were able to demonstrate that spirography time-series analysis is a valid, reliable method to document tremor intensity and a more sensitive measure for small effects than currently available visual spiral rating methods. PMID:21714004

The aesthetic impact of enamel fluorosis on Irish adolescents.

PubMed

Browne, Deirdre; Whelton, Helen; O'Mullane, Denis; Tavener, Jacqueline; Flannery, Edel

2011-04-01

To assess the impact of differing degrees of enamel fluorosis on dental aesthetics according to Irish adolescents. The same participants also aesthetically rated other variations in dental appearances including a carious lesion, bleached teeth and a demarcated opacity. One hundred and fifty adolescents examined seven identical template photographs of an attractive dental smile displaying varying levels of enamel fluorosis (TF1, TF2, TF3), a demarcated opacity, no fluorosis (TF0), anterior caries and very white or bleached teeth. By indicating their level of agreement or disagreement with five statements on a five-point Likert scale, the participants rated the aesthetic acceptability of each of the photographs. Using paired t-tests with the Bonferroni correction, it was found that the photographs depicting the very white teeth and anterior caries were rated as the most and least aesthetically pleasing images, respectively. There was no significant difference in the ratings of the photographs displaying TF0, TF1 and TF2 levels of fluorosis indicating that these photographs were viewed similarly (P>0.002). The remaining two photographs (TF3 and the demarcated opacity) were rated similarly and significantly worse (P<0.002) than the photographs showing no or low grades of fluorosis (TF0, TF1 and TF2). TF3 level of fluorosis represented the break point at which enamel fluorosis became aesthetically objectionable to these participants. Low grades of fluorosis (TF1 and TF2) were rated similarly to the photograph depicting no fluorosis (TF0). © 2011 John Wiley & Sons A/S.

Scaling Relations of Starburst-driven Galactic Winds

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tanner, Ryan; Cecil, Gerald; Heitsch, Fabian, E-mail: rytanner@augusta.edu

2017-07-10

Using synthetic absorption lines generated from 3D hydrodynamical simulations, we explore how the velocity of a starburst-driven galactic wind correlates with the star formation rate (SFR) and SFR density. We find strong correlations for neutral and low ionized gas, but no correlation for highly ionized gas. The correlations for neutral and low ionized gas only hold for SFRs below a critical limit set by the mass loading of the starburst, above which point the scaling relations flatten abruptly. Below this point the scaling relations depend on the temperature regime being probed by the absorption line, not on the mass loading.more » The exact scaling relation depends on whether the maximum or mean velocity of the absorption line is used. We find that the outflow velocity of neutral gas can be up to five times lower than the average velocity of ionized gas, with the velocity difference increasing for higher ionization states. Furthermore, the velocity difference depends on both the SFR and mass loading of the starburst. Thus, absorption lines of neutral or low ionized gas cannot easily be used as a proxy for the outflow velocity of the hot gas.« less

Uncertainty in BRCA1 cancer susceptibility testing.

PubMed

Baty, Bonnie J; Dudley, William N; Musters, Adrian; Kinney, Anita Y

2006-11-15

This study investigated uncertainty in individuals undergoing genetic counseling/testing for breast/ovarian cancer susceptibility. Sixty-three individuals from a single kindred with a known BRCA1 mutation rated uncertainty about 12 items on a five-point Likert scale before and 1 month after genetic counseling/testing. Factor analysis identified a five-item total uncertainty scale that was sensitive to changes before and after testing. The items in the scale were related to uncertainty about obtaining health care, positive changes after testing, and coping well with results. The majority of participants (76%) rated reducing uncertainty as an important reason for genetic testing. The importance of reducing uncertainty was stable across time and unrelated to anxiety or demographics. Yet, at baseline, total uncertainty was low and decreased after genetic counseling/testing (P = 0.004). Analysis of individual items showed that after genetic counseling/testing, there was less uncertainty about the participant detecting cancer early (P = 0.005) and coping well with their result (P < 0.001). Our findings support the importance to clients of genetic counseling/testing as a means of reducing uncertainty. Testing may help clients to reduce the uncertainty about items they can control, and it may be important to differentiate the sources of uncertainty that are more or less controllable. Genetic counselors can help clients by providing anticipatory guidance about the role of uncertainty in genetic testing. (c) 2006 Wiley-Liss, Inc.

Clinical comparison between two hyaluronic acid-derived fillers in the treatment of nasolabial folds in Chinese subjects: BioHyalux versus Restylane.

PubMed

Wu, Yan; Sun, Nan; Xu, Yue; Liu, Huixian; Zhong, Shaomin; Chen, Liyang; Li, Dong

2016-04-01

Hyaluronic acid fillers are used to improve the appearance of nasolabial folds (NLF). This study aimed to compare the efficacy, safety, and durability of a new hyaluronic acid gel (BioHyalux) versus Restylane for the correction of NLF. This was a multicenter, double-blinded, randomized, controlled, non-inferiority clinical trial involving 88 subjects with moderate to severe NLF. Subjects were randomized to BioHyalux and Restylane on either sides of the NLF. NLF was assessed before and right after injection, and at 1 week, 1, 3, and 6 months. Patients were followed up for 13-15 months to evaluate the durability and long-term safety. A clinically meaningful response was predefined as at least one-point improvement on the Wrinkle Severity Rating Scale, which is a five-point scale. At 6 months, the response rate of BioHyalux was not inferior to that of Restylane (P < 0.05). At the 13-15 months follow-up, the response rate by investigators was 58.0 % on the BioHyalux side versus 63.8 % on the Restylane side. The response rate by subjects showed similar results, which was 56.5 % on the BioHyalux side versus 60.9 % on the Restylane side at 13-15 months. The subjects' Global Aesthetic Improvement Scale (GAIS) showed that most subjects felt improvements on both sides of NLF (P > 0.05) at all time points. At 6 months, 100 % reported improvements on both side; at 13-15 months, 60 % of subjects reported improvements with BioHyalux versus 64 % with Restylane. Adverse events were transient and predominantly mild or moderate in severity including injection site swelling, pain, itching, bruising, and tenderness. BioHyalux had reliable safety and tolerance, and could be an effective injectable filler for correcting NLF.

To What Extent Can the Big Five and Learning Styles Predict Academic Achievement

ERIC Educational Resources Information Center

Köseoglu, Yaman

2016-01-01

Personality traits and learning styles play defining roles in shaping academic achievement. 202 university students completed the Big Five personality traits questionnaire and the Inventory of Learning Processes Scale and self-reported their grade point averages. Conscientiousness and agreeableness, two of the Big Five personality traits, related…

A Bayesian Hierarchical Modeling Scheme for Estimating Erosion Rates Under Current Climate Conditions

NASA Astrophysics Data System (ADS)

Lowman, L.; Barros, A. P.

2014-12-01

Computational modeling of surface erosion processes is inherently difficult because of the four-dimensional nature of the problem and the multiple temporal and spatial scales that govern individual mechanisms. Landscapes are modified via surface and fluvial erosion and exhumation, each of which takes place over a range of time scales. Traditional field measurements of erosion/exhumation rates are scale dependent, often valid for a single point-wise location or averaging over large aerial extents and periods with intense and mild erosion. We present a method of remotely estimating erosion rates using a Bayesian hierarchical model based upon the stream power erosion law (SPEL). A Bayesian approach allows for estimating erosion rates using the deterministic relationship given by the SPEL and data on channel slopes and precipitation at the basin and sub-basin scale. The spatial scale associated with this framework is the elevation class, where each class is characterized by distinct morphologic behavior observed through different modes in the distribution of basin outlet elevations. Interestingly, the distributions of first-order outlets are similar in shape and extent to the distribution of precipitation events (i.e. individual storms) over a 14-year period between 1998-2011. We demonstrate an application of the Bayesian hierarchical modeling framework for five basins and one intermontane basin located in the central Andes between 5S and 20S. Using remotely sensed data of current annual precipitation rates from the Tropical Rainfall Measuring Mission (TRMM) and topography from a high resolution (3 arc-seconds) digital elevation map (DEM), our erosion rate estimates are consistent with decadal-scale estimates based on landslide mapping and sediment flux observations and 1-2 orders of magnitude larger than most millennial and million year timescale estimates from thermochronology and cosmogenic nuclides.

The effects of divided attention on implicit and explicit memory performance.

PubMed

Schmitter-Edgecombe, M

1996-03-01

This study explored the nature of the relationship between attention available at learning and subsequent implicit and explicit memory performance. One hundred neurologically normal subjects rated their liking of target words on a five-point scale. Half of the subjects completed the word-rating task in a full attention condition and the other half performed the task in a divided attention condition. Following administration of the word-rating task, all subjects completed five memory tests, three implicit (category association, tachistoscopic identification, and perceptual clarification) and two explicit (semantic-cued recall and graphemic-cued recall), each bearing on a different subset of the list of previously presented target words. The results revealed that subjects in the divided attention condition performed significantly more poorly than subjects in the full attention condition on the explicit memory measures. In contrast, there were no significant group differences in performance on the implicit memory measures. These findings suggest that the attention to an episode that is necessary to produce later explicit memory may differ from that necessary to produce unconscious influences. The relationship between implicit memory, neurologic injury and automatic processes is discussed.

Student Practice Evaluation Form-Revised Edition online comment bank: development and reliability analysis.

PubMed

Rodger, Sylvia; Turpin, Merrill; Copley, Jodie; Coleman, Allison; Chien, Chi-Wen; Caine, Anne-Maree; Brown, Ted

2014-08-01

The reliable evaluation of occupational therapy students completing practice education placements along with provision of appropriate feedback is critical for both students and for universities from a quality assurance perspective. This study describes the development of a comment bank for use with an online version of the Student Practice Evaluation Form-Revised Edition (SPEF-R Online) and investigates its reliability. A preliminary bank of 109 individual comments (based on previous students' placement performance) was developed via five stages. These comments reflected all 11 SPEF-R domains. A purpose-designed online survey was used to examine the reliability of the comment bank. A total of 37 practice educators returned surveys, 31 of which were fully completed. Participants were asked to rate each individual comment using the five-point SPEF-R rating scale. One hundred and two of 109 comments demonstrated satisfactory agreement with their respective default ratings that were determined by the development team. At each domain level, the intra-class correlation coefficients (ranging between 0.86 and 0.96) also demonstrated good to excellent inter-rater reliability. There were only seven items that required rewording prior to inclusion in the final SPEF-R Online comment bank. The development of the SPEF-R Online comment bank offers a source of reliable comments (consistent with the SPEF-R rating scale across different domains) and aims to assist practice educators in providing reliable and timely feedback to students in a user-friendly manner. © 2014 Occupational Therapy Australia.

Analysis of 4999 online physician ratings indicates that most patients give physicians a favorable rating.

PubMed

Kadry, Bassam; Chu, Larry F; Kadry, Bayan; Gammas, Danya; Macario, Alex

2011-11-16

Many online physician-rating sites provide patients with information about physicians and allow patients to rate physicians. Understanding what information is available is important given that patients may use this information to choose a physician. The goals of this study were to (1) determine the most frequently visited physician-rating websites with user-generated content, (2) evaluate the available information on these websites, and (3) analyze 4999 individual online ratings of physicians. On October 1, 2010, using Google Trends we identified the 10 most frequently visited online physician-rating sites with user-generated content. We then studied each site to evaluate the available information (eg, board certification, years in practice), the types of rating scales (eg, 1-5, 1-4, 1-100), and dimensions of care (eg, recommend to a friend, waiting room time) used to rate physicians. We analyzed data from 4999 selected physician ratings without identifiers to assess how physicians are rated online. The 10 most commonly visited websites with user-generated content were HealthGrades.com, Vitals.com, Yelp.com, YP.com, RevolutionHealth.com, RateMD.com, Angieslist.com, Checkbook.org, Kudzu.com, and ZocDoc.com. A total of 35 different dimensions of care were rated by patients in the websites, with a median of 4.5 (mean 4.9, SD 2.8, range 1-9) questions per site. Depending on the scale used for each physician-rating website, the average rating was 77 out of 100 for sites using a 100-point scale (SD 11, median 76, range 33-100), 3.84 out of 5 (77%) for sites using a 5-point scale (SD 0.98, median 4, range 1-5), and 3.1 out of 4 (78%) for sites using a 4-point scale (SD 0.72, median 3, range 1-4). The percentage of reviews rated ≥75 on a 100-point scale was 61.5% (246/400), ≥4 on a 5-point scale was 57.74% (2078/3599), and ≥3 on a 4-point scale was 74.0% (740/1000). The patient's single overall rating of the physician correlated with the other dimensions of care that were rated by patients for the same physician (Pearson correlation, r = .73, P < .001). Most patients give physicians a favorable rating on online physician-rating sites. A single overall rating to evaluate physicians may be sufficient to assess a patient's opinion of the physician. The optimal content and rating method that is useful to patients when visiting online physician-rating sites deserves further study. Conducting a qualitative analysis to compare the quantitative ratings would help validate the rating instruments used to evaluate physicians.

Analysis of 4999 Online Physician Ratings Indicates That Most Patients Give Physicians a Favorable Rating

PubMed Central

Chu, Larry F; Kadry, Bayan; Gammas, Danya; Macario, Alex

2011-01-01

Background Many online physician-rating sites provide patients with information about physicians and allow patients to rate physicians. Understanding what information is available is important given that patients may use this information to choose a physician. Objectives The goals of this study were to (1) determine the most frequently visited physician-rating websites with user-generated content, (2) evaluate the available information on these websites, and (3) analyze 4999 individual online ratings of physicians. Methods On October 1, 2010, using Google Trends we identified the 10 most frequently visited online physician-rating sites with user-generated content. We then studied each site to evaluate the available information (eg, board certification, years in practice), the types of rating scales (eg, 1–5, 1–4, 1–100), and dimensions of care (eg, recommend to a friend, waiting room time) used to rate physicians. We analyzed data from 4999 selected physician ratings without identifiers to assess how physicians are rated online. Results The 10 most commonly visited websites with user-generated content were HealthGrades.com, Vitals.com, Yelp.com, YP.com, RevolutionHealth.com, RateMD.com, Angieslist.com, Checkbook.org, Kudzu.com, and ZocDoc.com. A total of 35 different dimensions of care were rated by patients in the websites, with a median of 4.5 (mean 4.9, SD 2.8, range 1–9) questions per site. Depending on the scale used for each physician-rating website, the average rating was 77 out of 100 for sites using a 100-point scale (SD 11, median 76, range 33–100), 3.84 out of 5 (77%) for sites using a 5-point scale (SD 0.98, median 4, range 1–5), and 3.1 out of 4 (78%) for sites using a 4-point scale (SD 0.72, median 3, range 1–4). The percentage of reviews rated ≥75 on a 100-point scale was 61.5% (246/400), ≥4 on a 5-point scale was 57.74% (2078/3599), and ≥3 on a 4-point scale was 74.0% (740/1000). The patient’s single overall rating of the physician correlated with the other dimensions of care that were rated by patients for the same physician (Pearson correlation, r = .73, P < .001). Conclusions Most patients give physicians a favorable rating on online physician-rating sites. A single overall rating to evaluate physicians may be sufficient to assess a patient’s opinion of the physician. The optimal content and rating method that is useful to patients when visiting online physician-rating sites deserves further study. Conducting a qualitative analysis to compare the quantitative ratings would help validate the rating instruments used to evaluate physicians. PMID:22088924

Development and Validation of the Faceted Inventory of the Five-Factor Model (FI-FFM).

PubMed

Watson, David; Nus, Ericka; Wu, Kevin D

2017-06-01

The Faceted Inventory of the Five-Factor Model (FI-FFM) is a comprehensive hierarchical measure of personality. The FI-FFM was created across five phases of scale development. It includes five facets apiece for neuroticism, extraversion, and conscientiousness; four facets within agreeableness; and three facets for openness. We present reliability and validity data obtained from three samples. The FI-FFM scales are internally consistent and highly stable over 2 weeks (retest rs ranged from .64 to .82, median r = .77). They show strong convergent and discriminant validity vis-à-vis the NEO, the Big Five Inventory, and the Personality Inventory for DSM-5. Moreover, self-ratings on the scales show moderate to strong agreement with corresponding ratings made by informants ( rs ranged from .26 to .66, median r = .42). Finally, in joint analyses with the NEO Personality Inventory-3, the FI-FFM neuroticism facet scales display significant incremental validity in predicting indicators of internalizing psychopathology.

Computational Aerodynamic Simulations of an 840 ft/sec Tip Speed Advanced Ducted Propulsor Fan System Model for Acoustic Methods Assessment and Development

NASA Technical Reports Server (NTRS)

Tweedt, Daniel L.

2014-01-01

Computational Aerodynamic simulations of an 840 ft/sec tip speed, Advanced Ducted Propulsor fan system were performed at five different operating points on the fan operating line, in order to provide detailed internal flow field information for use with fan acoustic prediction methods presently being developed, assessed and validated. The fan system is a sub-scale, lownoise research fan/nacelle model that has undergone extensive experimental testing in the 9- by 15- foot Low Speed Wind Tunnel at the NASA Glenn Research Center, resulting in quality, detailed aerodynamic and acoustic measurement data. Details of the fan geometry, the computational fluid dynamics methods, the computational grids, and various computational parameters relevant to the numerical simulations are discussed. Flow field results for three of the five operating conditions simulated are presented in order to provide a representative look at the computed solutions. Each of the five fan aerodynamic simulations involved the entire fan system, excluding a long core duct section downstream of the core inlet guide vane. As a result, only fan rotational speed and system bypass ratio, set by specifying static pressure downstream of the core inlet guide vane row, were adjusted in order to set the fan operating point, leading to operating points that lie on a fan operating line and making mass flow rate a fully dependent parameter. The resulting mass flow rates are in good agreement with measurement values. The computed blade row flow fields for all five fan operating points are, in general, aerodynamically healthy. Rotor blade and fan exit guide vane flow characteristics are good, including incidence and deviation angles, chordwise static pressure distributions, blade surface boundary layers, secondary flow structures, and blade wakes. Examination of the computed flow fields reveals no excessive boundary layer separations or related secondary-flow problems. A few spanwise comparisons between computational and measurement data in the bypass duct show that they are in good agreement, thus providing a partial validation of the computational results.

Viscous Three-Dimensional Simulation of Flow in an Axial Low Pressure Compressor at Engine Icing Operating Points

NASA Technical Reports Server (NTRS)

Rigby, David L.; Ameri, Ali A.; Veres, Joe; Jorgenson, Philip C. E.

2017-01-01

Viscous three-dimensional simulations of the Honeywell ALF502R-5 low pressure compressor (sometimes called a booster) using the NASA Glenn code GlennHT have been carried out. A total of ten simulations were produced. Five operating points are investigated, with each point run with two different wall thermal conditions. These operating points are at, or near, points where engine icing has been determined to be likely. In the future, the results of this study will be used for further analysis such as predicting collection efficiency of ice particles and ice growth rates at various locations in the compressor. A mixing plane boundary condition is used between each blade row, resulting in convergence to steady state within each blade row. The k-omega turbulence model of Wilcox, combined with viscous grid spacing near the wall on the order of one, is used to resolve the turbulent boundary layers. For each of the operating points, heat transfer coefficients are generated on the blades and walls. The heat transfer coefficients are produced by running the operating point with two different wall thermal conditions and then solving simultaneously for the heat transfer coefficient and adiabatic wall temperature at each point. Average Nusselt numbers are calculated for the most relevant surfaces. The values are seen to scale with Reynolds number to approximately a power of 0.7. Additionally, images of surface distribution of Nusselt number are presented. Qualitative comparison between the five operating points show that there is relatively little change in the character of the distribution. The dominant observed effect is that of an overall scaling, which is expected due to Reynolds number differences. One interesting aspect about the Nusselt number distribution is observed on the casing (outer diameter) downstream of the exit guide vanes (EGVs). The Nusselt number is relatively high between the pairs of EGVs, with two lower troughs downstream of each EGV trailing edge. This is of particular interest since rather complex ice shapes have been observed in that region.

Derivation and evaluation of a labeled hedonic scale.

PubMed

Lim, Juyun; Wood, Alison; Green, Barry G

2009-11-01

The objective of this study was to develop a semantically labeled hedonic scale (LHS) that would yield ratio-level data on the magnitude of liking/disliking of sensation equivalent to that produced by magnitude estimation (ME). The LHS was constructed by having 49 subjects who were trained in ME rate the semantic magnitudes of 10 common hedonic descriptors within a broad context of imagined hedonic experiences that included tastes and flavors. The resulting bipolar scale is statistically symmetrical around neutral and has a unique semantic structure. The LHS was evaluated quantitatively by comparing it with ME and the 9-point hedonic scale. The LHS yielded nearly identical ratings to those obtained using ME, which implies that its semantic labels are valid and that it produces ratio-level data equivalent to ME. Analyses of variance conducted on the hedonic ratings from the LHS and the 9-point scale gave similar results, but the LHS showed much greater resistance to ceiling effects and yielded normally distributed data, whereas the 9-point scale did not. These results indicate that the LHS has significant semantic, quantitative, and statistical advantages over the 9-point hedonic scale.

Rating scale for the assessment of competence in ultrasound-guided peripheral vascular access - a Delphi Consensus Study.

PubMed

Primdahl, Stine C; Todsen, Tobias; Clemmesen, Louise; Knudsen, Lars; Weile, Jesper

2016-09-21

Peripheral vascular access is vital for treatment and diagnostics of hospitalized patients. Ultrasound-guided vascular access (UGVA) is superior to the landmark technique. To ensure competence-based education, an assessment tool of UGVA competence is needed. We aimed to develop a global rating scale (RS) for assessment of UGVA competence based on opinions on the content from ultrasound experts in a modified Delphi consensus study. We included experts from anesthesiology, emergency medicine and radiology across university hospitals in Denmark. Nine elements were drafted based on existing literature and recommendations from international societies. In a multi-round survey, the experts rated the elements on a five-point Likert scale according to importance, and suggested missing elements. The final Delphi round occurred when >80% of the experts rated all elements ≥4 on the Likert scale. Sixteen experts consented to participate in the study, one withdrew consent prior to the first Delphi round, and 14 completed all three Delphi rounds. In the first Delphi round the experts excluded one element from the scale and changed the content of two elements. In the second Delphi round, the experts excluded one element from the scale. In the third Delphi round, consensus was obtained on the eight elements: preparation of utensils, ergonomics, preparation of the ultrasound device, identification of blood vessels, anatomy, hygiene, coordination of the needle, and completion of the procedure. We developed an RS for assessment of UGVA competence based on opinions of ultrasound experts through a modified Delphi consensus study.

A comparison of the scaling properties of the English, Spanish, French, and Chinese EQ-5D descriptive systems.

PubMed

Luo, Nan; Li, Minghui; Chevalier, Julie; Lloyd, Andrew; Herdman, Michael

2013-10-01

To compare the scaling properties of the English, Spanish, French, and Chinese versions of the EQ-5D-3L and EQ-5D-5L descriptive systems. Members of the general populations in the UK, Spain, France, and China were interviewed to measure the severity of health problems represented by the response labels used in the EQ-5D descriptive systems using a visual analog scale. Multiple linear regression models were used to compare the perceived label severity across the four language groups. Severity scores for labels from each EQ-5D-5L dimension scale were compared with each other to assess ordinality. EQ-5D-5L and EQ-5D-3L labels used for describing different levels of health problems were rated differently, while those describing the same level of health problems were rated similarly. For example, the deviation of any group mean from the grand severity mean score for the label 'slight(ly)' was no larger than 5 points on a 0-100 scale for all five EQ-5D dimensions (p > 0.05 for all, t tests). Label ratings violating hypothesized ordinality of the EQ-5D-5L scales were observed in only a small proportion of respondents. Our study provided some preliminary evidence supporting the ordinality and equivalence of the EQ-5D-5L and EQ-5D-3L descriptive systems across four major languages.

Psychometric properties of the Multidimensional Assessment of Fatigue scale in traumatic brain injury: an NIDRR Traumatic Brain Injury Model Systems study.

PubMed

Lequerica, Anthony; Bushnik, Tamara; Wright, Jerry; Kolakowsky-Hayner, Stephanie A; Hammond, Flora M; Dijkers, Marcel P; Cantor, Joshua

2012-01-01

To investigate the psychometric properties of the Multidimensional Assessment of Fatigue (MAF) scale in a traumatic brain injury (TBI) sample. Prospective survey study. Community. One hundred sixty-seven individuals with TBI admitted for inpatient rehabilitation, enrolled into the TBI Model Systems national database, and followed up at either the first or second year postinjury. Not applicable. Multidimensional Assessment of Fatigue. The initial analysis, using items 1 to 14, which are based on a 10-point rating scale, found that only 1 item ("walking") misfit the overall construct of fatigue in this TBI population. However, this 10-point rating scale was found to have disordered thresholds. When ratings were collapsed into 4 response categories, all MAF items used to calculate the Global Fatigue Index formed a unidimensional scale. Findings generally support the unidimensionality of the MAF when used in a TBI population but call into question the use of a 10-point rating scale for items 1 to 14. Further study is needed to investigate the use of a 4-category rating scale across all items and the fit of the "walking" item for a measure of fatigue among individuals with TBI.

Five-Point Likert Items: t Test versus Mann-Whitney-Wilcoxon

ERIC Educational Resources Information Center

de Winter, Joost C. F.; Dodou, Dimitra

2010-01-01

Likert questionnaires are widely used in survey research, but it is unclear whether the item data should be investigated by means of parametric or nonparametric procedures. This study compared the Type I and II error rates of the "t" test versus the Mann-Whitney-Wilcoxon (MWW) for five-point Likert items. Fourteen population…

Understanding resident ratings of teaching in the workplace: a multi-centre study.

PubMed

Fluit, Cornelia R M G; Feskens, Remco; Bolhuis, Sanneke; Grol, Richard; Wensing, Michel; Laan, Roland

2015-08-01

Providing clinical teachers with feedback about their teaching skills is a powerful tool to improve teaching. Evaluations are mostly based on questionnaires completed by residents. We investigated to what extent characteristics of residents, clinical teachers, and the clinical environment influenced these evaluations, and the relation between residents' scores and their teachers' self-scores. The evaluation and feedback for effective clinical teaching questionnaire (EFFECT) was used to (self)assess clinical teachers from 12 disciplines (15 departments, four hospitals). Items were scored on a five-point Likert scale. Main outcome measures were residents' mean overall scores (MOSs), specific scale scores (MSSs), and clinical teachers' self-evaluation scores. Multilevel regression analysis was used to identify predictors. Residents' scores and self-evaluations were compared. Residents filled in 1,013 questionnaires, evaluating 230 clinical teachers. We received 160 self-evaluations. 'Planning Teaching' and 'Personal Support' (4.52, SD .61 and 4.53, SD .59) were rated highest, 'Feedback Content' (CanMEDS related) (4.12, SD .71) was rated lowest. Teachers in affiliated hospitals showed highest MOS and MSS. Medical specialty did not influence MOS. Female clinical teachers were rated higher for most MSS, achieving statistical significance. Residents in year 1-2 were most positive about their teachers. Residents' gender did not affect the mean scores, except for role modeling. At group level, self-evaluations and residents' ratings correlated highly (Kendall's τ 0.859). Resident evaluations of clinical teachers are influenced by teacher's gender, year of residency training, type of hospital, and to a lesser extent teachers' gender. Clinical teachers and residents agree on strong and weak points of clinical teaching.

The Development of a Recycling Awareness Scale for Prospective Science Teachers

ERIC Educational Resources Information Center

Aksan, Zeynep; Çelikler, Dilek

2017-01-01

The purpose of this study was to develop a scale for measuring prospective science teachers' awareness of waste recycling. The study was conducted with the participation of 382 prospective teachers attending a university located in northern Turkey. The five-point Likert type scale that was developed contained 82 items relating to prospective…

Computational Aerodynamic Simulations of a 1484 ft/sec Tip Speed Quiet High-Speed Fan System Model for Acoustic Methods Assessment and Development

NASA Technical Reports Server (NTRS)

Tweedt, Daniel L.

2014-01-01

Computational Aerodynamic simulations of a 1484 ft/sec tip speed quiet high-speed fan system were performed at five different operating points on the fan operating line, in order to provide detailed internal flow field information for use with fan acoustic prediction methods presently being developed, assessed and validated. The fan system is a sub-scale, low-noise research fan/nacelle model that has undergone experimental testing in the 9- by 15-foot Low Speed Wind Tunnel at the NASA Glenn Research Center. Details of the fan geometry, the computational fluid dynamics methods, the computational grids, and various computational parameters relevant to the numerical simulations are discussed. Flow field results for three of the five operating points simulated are presented in order to provide a representative look at the computed solutions. Each of the five fan aerodynamic simulations involved the entire fan system, which includes a core duct and a bypass duct that merge upstream of the fan system nozzle. As a result, only fan rotational speed and the system bypass ratio, set by means of a translating nozzle plug, were adjusted in order to set the fan operating point, leading to operating points that lie on a fan operating line and making mass flow rate a fully dependent parameter. The resulting mass flow rates are in good agreement with measurement values. Computed blade row flow fields at all fan operating points are, in general, aerodynamically healthy. Rotor blade and fan exit guide vane flow characteristics are good, including incidence and deviation angles, chordwise static pressure distributions, blade surface boundary layers, secondary flow structures, and blade wakes. Examination of the computed flow fields reveals no excessive or critical boundary layer separations or related secondary-flow problems, with the exception of the hub boundary layer at the core duct entrance. At that location a significant flow separation is present. The region of local flow recirculation extends through a mixing plane, however, which for the particular mixing-plane model used is now known to exaggerate the recirculation. In any case, the flow separation has relatively little impact on the computed rotor and FEGV flow fields.

Quantitative data analysis of perceived barriers and motivators to physical activity in stroke survivors.

PubMed

Nicholson, S L; Greig, C A; Sniehotta, F; Johnston, M; Lewis, S J; McMurdo, M E; Johnston, D; Scopes, J; Mead, G E

2017-09-01

Levels of physical activity after stroke are low, despite multiple health benefits. We explored stroke survivors' perceived barriers, motivators, self-efficacy and intention to physical activity. Fifty independently mobile stroke survivors were recruited prior to hospital discharge. Participants rated nine possible motivators and four possible barriers based on the Mutrie Scale, as having 'no influence', 'some influence' or 'a major influence' on physical activity. Participants also rated their self-efficacy and intention to increasing walking. The most common motivator was 'physical activity is good for health' [34 (68%)]. The most common barrier was 'feeling too tired' [24 (48%)]. Intention and self-efficacy were high. Self-efficacy was graded as either 4 or 5 (highly confident) on a five-point scale by [34 (68%)] participants, while 42 (84%) 'strongly agreed' or 'agreed' that they intended to increase their walking. Participants felt capable of increasing physical activity but fatigue was often perceived as a barrier to physical activity. This needs to be considered when encouraging stroke survivors to be more active.

Pain point system scale (PPSS): a method for postoperative pain estimation in retrospective studies

PubMed Central

Gkotsi, Anastasia; Petsas, Dimosthenis; Sakalis, Vasilios; Fotas, Asterios; Triantafyllidis, Argyrios; Vouros, Ioannis; Saridakis, Evangelos; Salpiggidis, Georgios; Papathanasiou, Athanasios

2012-01-01

Purpose Pain rating scales are widely used for pain assessment. Nevertheless, a new tool is required for pain assessment needs in retrospective studies. Methods The postoperative pain episodes, during the first postoperative day, of three patient groups were analyzed. Each pain episode was assessed by a visual analog scale, numerical rating scale, verbal rating scale, and a new tool – pain point system scale (PPSS) – based on the analgesics administered. The type of analgesic was defined based on the authors’ clinic protocol, patient comorbidities, pain assessment tool scores, and preadministered medications by an artificial neural network system. At each pain episode, each patient was asked to fill the three pain scales. Bartlett’s test and Kaiser–Meyer–Olkin criterion were used to evaluate sample sufficiency. The proper scoring system was defined by varimax rotation. Spearman’s and Pearson’s coefficients assessed PPSS correlation to the known pain scales. Results A total of 262 pain episodes were evaluated in 124 patients. The PPSS scored one point for each dose of paracetamol, three points for each nonsteroidal antiinflammatory drug or codeine, and seven points for each dose of opioids. The correlation between the visual analog scale and PPSS was found to be strong and linear (rho: 0.715; P < 0.001 and Pearson: 0.631; P < 0.001). Conclusion PPSS correlated well with the known pain scale and could be used safely in the evaluation of postoperative pain in retrospective studies. PMID:23152699

Rating disease progression of Friedreich’s ataxia by the International Cooperative Ataxia Rating Scale: analysis of a 603-patient database

PubMed Central

Coppard, Nicholas; Cooper, Jonathon M.; Delatycki, Martin B.; Dürr, Alexandra; Di Prospero, Nicholas A.; Giunti, Paola; Lynch, David R.; Schulz, J. B.; Rummey, Christian; Meier, Thomas

2013-01-01

The aim of this cross-sectional study was to analyse disease progression in Friedreich’s ataxia as measured by the International Cooperative Ataxia Rating Scale. Single ratings from 603 patients with Friedreich’s ataxia were analysed as a function of disease duration, age of onset and GAA repeat lengths. The relative contribution of items and subscales to the total score was studied as a function of disease progression. In addition, the scaling properties were assessed using standard statistical measures. Average total scale progression per year depends on the age of disease onset, the time since diagnosis and the GAA repeat length. The age of onset inversely correlates with increased GAA repeat length. For patients with an age of onset ≤14 years associated with a longer repeat length, the average yearly rate of decline was 2.5 ± 0.18 points in the total International Cooperative Ataxia Rating Scale for the first 20 years of disease duration, whereas patients with a later onset progress more slowly (1.8 ± 0.27 points/year). Ceiling effects in posture, gait and lower limb scale items lead to a reduced sensitivity of the scale in the severely affected population with a total score of >60 points. Psychometric scaling analysis shows generally favourable properties for the total scale, but the subscale grouping could be improved. This cross-sectional study provides a detailed characterization of the International Cooperative Ataxia Rating Scale. The analysis further provides rates of change separated for patients with early and late disease onset, which is driven by the GAA repeat length. Differences in the subscale dynamics merit consideration in the design of future clinical trials applying this scale as a neurological assessment instrument in Friedreich’s ataxia. PMID:23365101

Symptoms and impact of COPD assessed by an electronic diary in patients with moderate-to-severe COPD: psychometric results from the SHINE study.

PubMed

Kulich, Károly; Keininger, Dorothy L; Tiplady, Brian; Banerji, Donald

2015-01-01

Symptoms, particularly dyspnea, and activity limitation, have an impact on the health status and the ability to function normally in patients with chronic obstructive pulmonary disease (COPD). To develop an electronic patient diary (eDiary), qualitative patient interviews were conducted from 2009 to 2010 to identify relevant symptoms and degree of bother due to symptoms. The eDiary was completed by a subset of 209 patients with moderate-to-severe COPD in the 26-week QVA149 SHINE study. Two morning assessments (since awakening and since the last assessment) and one evening assessment were made each day. Assessments covered five symptoms ("shortness of breath," "phlegm/mucus," "chest tightness," "wheezing," and "coughing") and two impact items ("bothered by COPD" and "difficulty with activities") and were scored on a 10-point numeric scale. Patient compliance with the eDiary was 90.4% at baseline and 81.3% at week 26. Correlations between shortness of breath and impact items were >0.95. Regression analysis showed that shortness of breath was a highly significant (P<0.0001) predictor of impact items. Exploratory factor analysis gave a single factor comprising all eDiary items, including both symptoms and impact items. Shortness of breath, the total score (including five symptoms and two impact items), and the five-item symptom score from the eDiary performed well, with good consistency and reliability. The eDiary showed good sensitivity to change, with a 0.6 points reduction in the symptoms scores (on a 0-10 point scale) representing a meaningful change. The eDiary was found to be valid, reliable, and responsive. The high correlations obtained between "shortness of breath" and the ratings of "bother" and "difficulty with activities" confirmed the relevance of this symptom in patients with COPD. Future studies will be required to explore further psychometric properties and their ability to differentiate between COPD treatments.

Standardized reporting guidelines for emergency department syncope risk-stratification research.

PubMed

Sun, Benjamin C; Thiruganasambandamoorthy, Venkatesh; Cruz, Jeffrey Dela

2012-06-01

There is increasing research interest in the risk stratification of emergency department (ED) syncope patients. A major barrier to comparing and synthesizing existing research is wide variation in the conduct and reporting of studies. The authors wanted to create standardized reporting guidelines for ED syncope risk-stratification research using an expert consensus process. In that pursuit, a panel of syncope researchers was convened and a literature review was performed to identify candidate reporting guideline elements. Candidate elements were grouped into four sections: eligibility criteria, outcomes, electrocardiogram (ECG) findings, and predictors. A two-round, modified Delphi consensus process was conducted using an Internet-based survey application. In the first round, candidate elements were rated on a five-point Likert scale. In the second round, panelists rerated items after receiving information about group ratings from the first round. Items that were rated by >80% of the panelists at the two highest levels of the Likert scale were included in the final guidelines. There were 24 panelists from eight countries who represented five clinical specialties. The panel identified an initial set of 183 candidate elements. After two survey rounds, the final reporting guidelines included 92 items that achieved >80% consensus. These included 10 items for study eligibility, 23 items for outcomes, nine items for ECG abnormalities, and 50 items for candidate predictors. Adherence to these guidelines should facilitate comparison of future research in this area. © 2012 by the Society for Academic Emergency Medicine.

Role of the Big Five Personality Traits in Predicting College Students' Academic Motivation and Achievement

ERIC Educational Resources Information Center

Komarraju, Meera; Karau, Steven J.; Schmeck, Ronald R.

2009-01-01

College students (308 undergraduates) completed the Five Factor Inventory and the Academic Motivations Scale, and reported their college grade point average (GPA). A correlation analysis revealed an interesting pattern of significant relationships. Further, regression analyses indicated that conscientiousness and openness explained 17% of the…

Measuring Cognitive Load with Subjective Rating Scales during Problem Solving: Differences between Immediate and Delayed Ratings

ERIC Educational Resources Information Center

Schmeck, Annett; Opfermann, Maria; van Gog, Tamara; Paas, Fred; Leutner, Detlev

2015-01-01

Subjective cognitive load (CL) rating scales are widely used in educational research. However, there are still some open questions regarding the point of time at which such scales should be applied. Whereas some studies apply rating scales directly after each step or task and use an average of these ratings, others assess CL only once after the…

Choice of rating scale labels: implication for minimizing patient satisfaction response ceiling effect in telemedicine surveys.

PubMed

Masino, Caterina; Lam, Tony C M

2014-12-01

Lack of response variability is problematic in surveys because of its detrimental effects on sensitivity and consequently reliability of the responses. In satisfaction surveys, this problem is caused by the ceiling effect resulting from high satisfaction ratings. A potential solution strategy is to manipulate the labels of the rating scale to create greater discrimination of responses on the high end of the response continuum. This study examined the effects of a positive-centered scale on the distribution and reliability of telemedicine satisfaction responses in a highly positive respondent population. In total, 216 telemedicine participants were randomly assigned to one of three experimental conditions as defined by the form of Likert scale: (1) 5-point Balanced Equal-Interval, (2) 5-point Positive-Packed, and (3) 5-point Positive-Centered Equal-Interval. Although the study findings were not statistically significant, partially because of sample size, the distribution and internal consistency reliability of responses occurred in the direction hypothesized. Loading the rating scale with more positive labels appears to be a useful strategy for reducing the ceiling effect and increases the discrimination ability of survey responses. The current research provides a survey design strategy to minimize ceiling effects. Although the findings provide some evidence suggesting the benefit of using rating scales loaded with positive labels, more research is needed to confirm this, as well as extend it to examine other types of rating scales and the interaction between rating scale formats and respondent characteristics.

Immediate effects of foot orthoses on pain during functional tasks in people with patellofemoral osteoarthritis: A cross-over, proof-of-concept study.

PubMed

Collins, Natalie J; Hinman, Rana S; Menz, Hylton B; Crossley, Kay M

2017-01-01

The purpose of the study was to determine whether prefabricated foot orthoses immediately reduce pain during functional tasks in people with patellofemoral osteoarthritis, compared to flat insoles and shoes alone. Eighteen people with predominant lateral patellofemoral osteoarthritis (nine women; mean [SD] age 59 [10]years; body mass index 27.9 [3.2]kg/m 2 ) performed functional tasks wearing running sandals, and then wearing foot orthoses and flat insoles (random order). Participants rated knee pain during each task (11-point numerical rating scales), ease of performance and knee stability (five-point Likert scales), and comfort (100mm visual analogue scales). Compared to shoes alone, foot orthoses (p=0.002; median difference 1.5 [IQR 3]) and flat insoles (p<0.001; 2 [3]) significantly reduced pain during step-downs; foot orthoses reduced pain during walking (p=0.008; 1 [1.25]); and flat insoles reduced pain during stair ambulation (p=0.001; 1 [1.75]). No significant differences between foot orthoses and flat insoles were observed for pain severity, ease of performance or knee stability. Foot orthoses were less comfortable than flat insoles and shoes alone (p<0.05). In people with patellofemoral osteoarthritis, immediate pain-relieving effects of prefabricated, contoured foot orthoses are equivalent to flat insoles. Further studies should investigate whether similar outcomes occur with longer-term wear or different orthosis designs. Copyright © 2016 Elsevier B.V. All rights reserved.

Designing questionnaires: healthcare survey to compare two different response scales.

PubMed

Dell-Kuster, Salome; Sanjuan, Esteban; Todorov, Atanas; Weber, Heidemarie; Heberer, Michael; Rosenthal, Rachel

2014-08-03

A widely discussed design issue in patient satisfaction questionnaires is the optimal length and labelling of the answering scale. The aim of the present study was to compare intra-individually the answers on two response scales to five general questions evaluating patients' perception of hospital care. Between November 2011 and January 2012, all in-hospital patients at a Swiss University Hospital received a patient satisfaction questionnaire on an adjectival scale with three to four labelled categories (LS) and five redundant questions displayed on an 11-point end-anchored numeric scale (NS). The scales were compared concerning ceiling effect, internal consistency (Cronbach's alpha), individual item answers (Spearman's rank correlation), and concerning overall satisfaction by calculating an overall percentage score (sum of all answers related to the maximum possible sum). The response rate was 41% (2957/7158), of which 2400 (81%) completely filled out all questions. Baseline characteristics of the responders and non-responders were similar. Floor and ceiling effect were high on both response scales, but more pronounced on the LS than on the NS. Cronbach's alpha was higher on the NS than on the LS. There was a strong individual item correlation between both answering scales in questions regarding the intent to return, quality of treatment and the judgement whether the patient was treated with respect and dignity, but a lower correlation concerning satisfactory information transfer by physicians or nurses, where only three categories were available in the LS. The overall percentage score showed a comparable distribution, but with a wider spread of lower satisfaction in the NS. Since the longer scale did not substantially reduce the ceiling effect, the type of questions rather than the type of answering scale could be addressed with a focus on specific questions about concrete situations instead of general questions. Moreover, the low correlation in questions about information provision suggests that only three possible response choices are insufficient. Further investigations are needed to find a more sensitive scale discriminating high-end ratings. Otherwise, a longitudinal within-hospital or a cross-sectional between-hospital comparison of patient care is questionable.

Designing questionnaires: healthcare survey to compare two different response scales

PubMed Central

2014-01-01

Background A widely discussed design issue in patient satisfaction questionnaires is the optimal length and labelling of the answering scale. The aim of the present study was to compare intra-individually the answers on two response scales to five general questions evaluating patients’ perception of hospital care. Methods Between November 2011 and January 2012, all in-hospital patients at a Swiss University Hospital received a patient satisfaction questionnaire on an adjectival scale with three to four labelled categories (LS) and five redundant questions displayed on an 11-point end-anchored numeric scale (NS). The scales were compared concerning ceiling effect, internal consistency (Cronbach’s alpha), individual item answers (Spearman’s rank correlation), and concerning overall satisfaction by calculating an overall percentage score (sum of all answers related to the maximum possible sum). Results The response rate was 41% (2957/7158), of which 2400 (81%) completely filled out all questions. Baseline characteristics of the responders and non-responders were similar. Floor and ceiling effect were high on both response scales, but more pronounced on the LS than on the NS. Cronbach’s alpha was higher on the NS than on the LS. There was a strong individual item correlation between both answering scales in questions regarding the intent to return, quality of treatment and the judgement whether the patient was treated with respect and dignity, but a lower correlation concerning satisfactory information transfer by physicians or nurses, where only three categories were available in the LS. The overall percentage score showed a comparable distribution, but with a wider spread of lower satisfaction in the NS. Conclusions Since the longer scale did not substantially reduce the ceiling effect, the type of questions rather than the type of answering scale could be addressed with a focus on specific questions about concrete situations instead of general questions. Moreover, the low correlation in questions about information provision suggests that only three possible response choices are insufficient. Further investigations are needed to find a more sensitive scale discriminating high-end ratings. Otherwise, a longitudinal within-hospital or a cross-sectional between-hospital comparison of patient care is questionable. PMID:25086869

Development and Validation of a Rating Scale for Wind Jazz Improvisation Performance

ERIC Educational Resources Information Center

Smith, Derek T.

2009-01-01

The purpose of this study was to construct and validate a rating scale for collegiate wind jazz improvisation performance. The 14-item Wind Jazz Improvisation Evaluation Scale (WJIES) was constructed and refined through a facet-rational approach to scale development. Five wind jazz students and one professional jazz educator were asked to record…

Social Shyness among Mothers of Children with Disabilities Based on Some Variables in Riyadh, Saudi Arabia

ERIC Educational Resources Information Center

Allala, Saeb; Alzubairi, Sharefa

2016-01-01

The current study is an attempt to identify social shyness among mothers of children with disabilities based on (Disability type, mother's academic qualification, and family's economic level) in Riyadh. Thus, Social Shyness Scale was prepared of (28) paragraphs according to five-point Likert Scale. The reliability coefficient of the scale rated…

Difference in the effects of tandospirone on ataxia in various types of spinocerebellar degeneration: an open-label study.

PubMed

Takei, Asako; Hamada, Shinsuke; Homma, Sanae; Hamada, Keiko; Tashiro, Kunio; Hamada, Takeshi

2010-12-01

The aim of this study was to investigate the effects of tandospirone on ataxia in various types of spinocerebellar degeneration (SCD). Fifteen milligram per day of tandospirone was administered to 39 patients with SCD (spinocerebellar atrophy (SCA) 1, five patients; SCA2, six patients; Machado-Joseph disease (MJD), 14 patient; SCA6, five patients; multiple system atrophy-cerebellar type (MSA-C), seven patients; and multiple system atrophy-Parkinson type (MSA-P), two patients). All patients were assessed before and 4 weeks after administration of the drug using the international cooperative ataxia rating scale total score (ARS), total length traveled (TLT) of body stabilometry, and a self-rating depression scale. Statistically, ARS showed a significant difference in MJD (p = 0.005) and SCA6 (p = 0.043). TLT also showed a significant difference in MJD (p = 0.002) and SCA6 (p = 0.043). Eight of 39 patients (SCA1, 1/5; SCA2, 0/6; MJD, 4/14; SCA6, 3/5; MSA-C, 0/7; and MSA-P, 0/2) showed more than a five point reduction in ARS, and 13 of 39 patients (SCA1, 0/5; SCA2, 1/6; MJD, 8/14; SCA6, 4/5; MSA-C, 0/7; and MSA-P, 0/2) showed a reduction of TLT. Our data indicate that the effects of tandospirone on ataxia are different between types of SCD. Therefore, tandospirone is useful for cerebellar ataxia in patients with MJD and SCA6.

Passenger comfort response times as a function of aircraft motion

NASA Technical Reports Server (NTRS)

Rinalducci, E. J.

1975-01-01

The relationship between a passenger's response time of changes in level of comfort experienced as a function of aircraft motion was examined. The aircraft used in this investigation was capable of providing a wide range of vertical and transverse accelerations by means of direct lift flap control surfaces and side force generator surfaces in addition to normal control surfaces. Response times to changes in comfort were recorded along with the passenger's rating of comfort on a five point scale. In addition, a number of aircraft motion variables including vertical and transverse accelerations were also recorded. Results indicate some relationship between human comfort response times to reaction time data.

Pilot Testing Behavior Therapy for Chronic Tic Disorders in Neurology and Developmental Pediatrics Clinics.

PubMed

Ricketts, Emily J; Gilbert, Donald L; Zinner, Samuel H; Mink, Jonathan W; Lipps, Tara D; Wiegand, Geoffrey A; Vierhile, Amy E; Ely, Laura J; Piacentini, John; Walkup, John T; Woods, Douglas W

2016-03-01

Comprehensive Behavioral Intervention for Tics (CBIT) is an efficacious treatment with limited regional availability. As neurology and pediatric clinics are often the first point of therapeutic contact for individuals with tics, the present study assessed preliminary treatment response, acceptability, and feasibility of an abbreviated version, modified for child neurology and developmental pediatrics clinics. Fourteen youth (9-17) with Tourette disorder across 2 child neurology clinics and one developmental pediatrics clinic participated in a small case series. Clinician-rated tic severity (Yale Global Tic Severity Scale) decreased from pre- to posttreatment, z = -2.0, P < .05, r = -.48, as did tic-related impairment, z = -2.4, P < .05, r = -.57. Five of the 9 completers (56%) were classified as treatment responders. Satisfaction ratings were high, and therapeutic alliance ratings were moderately high. Results provide guidance for refinement of this modified CBIT protocol. © The Author(s) 2015.

Attitude Formation, Novel Stimuli, and Exposure Effects.

ERIC Educational Resources Information Center

Grush, Joseph E.

Ten Turkish words were used as stimuli in an exposure experiment. Twenty-five students from the University of Illinois subject pool were divided into five subgroups, differing only with respect to which stimuli occurred in which exposure conditions. After the stimuli were evaluated on 7-point "good-bad" scales, subjects completed a questionnaire…

The Impact of Mutation and Gene Conversion on the Local Diversification of Antigen Genes in African Trypanosomes

PubMed Central

Gjini, Erida; Haydon, Daniel T.; Barry, J. David; Cobbold, Christina A.

2012-01-01

Patterns of genetic diversity in parasite antigen gene families hold important information about their potential to generate antigenic variation within and between hosts. The evolution of such gene families is typically driven by gene duplication, followed by point mutation and gene conversion. There is great interest in estimating the rates of these processes from molecular sequences for understanding the evolution of the pathogen and its significance for infection processes. In this study, a series of models are constructed to investigate hypotheses about the nucleotide diversity patterns between closely related gene sequences from the antigen gene archive of the African trypanosome, the protozoan parasite causative of human sleeping sickness in Equatorial Africa. We use a hidden Markov model approach to identify two scales of diversification: clustering of sequence mismatches, a putative indicator of gene conversion events with other lower-identity donor genes in the archive, and at a sparser scale, isolated mismatches, likely arising from independent point mutations. In addition to quantifying the respective probabilities of occurrence of these two processes, our approach yields estimates for the gene conversion tract length distribution and the average diversity contributed locally by conversion events. Model fitting is conducted using a Bayesian framework. We find that diversifying gene conversion events with lower-identity partners occur at least five times less frequently than point mutations on variant surface glycoprotein (VSG) pairs, and the average imported conversion tract is between 14 and 25 nucleotides long. However, because of the high diversity introduced by gene conversion, the two processes have almost equal impact on the per-nucleotide rate of sequence diversification between VSG subfamily members. We are able to disentangle the most likely locations of point mutations and conversions on each aligned gene pair. PMID:22735079

Amisulpride versus moclobemide in treatment of clozapine-induced hypersalivation.

PubMed

Kreinin, Anatoly; Miodownik, Chanoch; Sokolik, Shmuel; Shestakova, Diana; Libov, Igor; Bergman, Joseph; Lerner, Vladimir

2011-12-01

Previous publications demonstrated substitute benzamides as effective agents in treatment of clozapine-induced sialorrhea (CIS). The aim of this study was to compare efficacy of amisulpride and moclobemide (both from the substitute benzamide group) in controlling, or at least minimizing, CIS. The study was designed as a 6-week, two-center, fixed-dose, comparison study of 400 mg/day of amisulpride versus 300 mg/day of moclobemide as an adjunctive treatment in 53 schizophrenia and schizoaffective disorder patients (diagnosed according to DSM-IV) suffering from CIS. The patients were treated with each medication during 2 weeks, followed by a washout period of 2 weeks. Primary outcome measures included the reduction in the five-point Nocturnal Hypersalivation Rating Scale (NHRS). Secondary outcomes included the Positive and Negative Syndrome Scale (PANSS), Manic State Assessment Scale, and Extrapyramidal Symptom Rating Scale (ESRS). Both amisulpride and moclobemide were very effective in reducing CIS. Almost 74% of patients treated with amisulpride and 83% of patients treated with moclobemide showed some level of improvement on NHRS. Only in one patient treated with amisulpride, CIS worsened. Both medications were safe and effective as treatment of CIS. Although moclobemide exceeded amisulpride in antisalivation activity, treatment of CIS with amisulpride leads to improvement in psychotic symptoms.

Postoperative pain assessment based on numeric ratings is not the same for patients and professionals: a cross-sectional study.

PubMed

van Dijk, Jacqueline F M; van Wijck, Albert J M; Kappen, Teus H; Peelen, Linda M; Kalkman, Cor J; Schuurmans, Marieke J

2012-01-01

Numeric pain scores have become important in clinical practice to assess postoperative pain and to help develop guidelines for treating pain. Professionals need the patients' pain scores to administer analgesic medication. However, do professionals interpret the pain scores in line with the actual perception of pain by the patients? The study aim was to assess which Numerical Rating Scale (NRS) pain score was considered bearable on a Verbal Rating Scale (VRS) by patients and professionals. This prospective study examined the relationship between the Numerical Rating Scale and a Verbal Rating Scale. The patients (n=10,434) rated their pain the day after surgery on the 11-point NRS (0=no pain and 10=worst imaginable pain) and a VRS comprising five descriptors: "no pain"; "little pain"; "painful but bearable"; "considerable pain"; and "terrible pain". The first three categories together ("no pain", "little pain" and "painful but bearable") were considered "bearable" and the last two categories ("considerable pain" and "terrible pain") were deemed as "unbearable" pain. The professionals (n=303) were asked to relate the numbers of the NRS to the words of the VRS. Most patients considered NRS 4-6 as "bearable" pain. Among professionals, anesthesiologists, Post Anaesthesia Care nurses, and ward nurses interpreted NRS scores in the same way as the patients. Only the Acute Pain Nurses interpreted the scores differently; they considered NRS of 5 and higher to be not bearable. Some care providers and patients differ in their interpretation of the postoperative NRS scores. A risk of overtreatment might arise when health care providers rigidly follow guidelines that prescribe strong analgesics for pain scores above 3 or 4 without probing the patient's preference for pharmacological treatment. Copyright © 2011 Elsevier Ltd. All rights reserved.

Attitude, Gender and Achievement in Computer Programming

ERIC Educational Resources Information Center

Baser, Mustafa

2013-01-01

The aim of this research was to explore the relationship among students' attitudes toward programming, gender and academic achievement in programming. The scale used for measuring students' attitudes toward programming was developed by the researcher and consisted of 35 five-point Likert type items in four subscales. The scale was administered to…

Long-term follow-up of a randomized controlled trial on additional core stability exercises training for improving dynamic sitting balance and trunk control in stroke patients.

PubMed

Cabanas-Valdés, Rosa; Bagur-Calafat, Caritat; Girabent-Farrés, Montserrat; Caballero-Gómez, Fernanda Mª; du Port de Pontcharra-Serra, Helena; German-Romero, Ana; Urrútia, Gerard

2017-11-01

Analyse the effect of core stability exercises in addition to conventional physiotherapy training three months after the intervention ended. A randomized controlled trial. Outpatient services. Seventy-nine stroke survivors. In the intervention period, both groups underwent conventional physiotherapy performed five days/week for five weeks, and in addition the experimental group performed core stability exercises for 15 minutes/day. Afterwards, during a three-month follow-up period, both groups underwent usual care that could eventually include conventional physiotherapy or physical exercise but not in a controlled condition. Primary outcome was trunk control and dynamic sitting balance assessed by the Spanish-Version of Trunk Impairment Scale 2.0 and Function in Sitting Test. Secondary outcomes were standing balance and gait evaluated by the Berg Balance Scale, Tinetti Test, Brunel Balance Assessment, Spanish-Version of Postural Assessment Scale for Stroke and activities of daily living using the Barthel Index. A total of 68 subjects out of 79 completed the three-month follow-up period. The mean difference (SD) between groups was 0.78 (1.51) points ( p = 0.003) for total score on the Spanish-Version of Trunk Impairment Scale 2.0, 2.52 (6.46) points ( p = 0.009) for Function in Sitting Test, dynamic standing balance was 3.30 (9.21) points ( p= 0.009) on the Berg Balance Scale, gait was 0.82 (1.88) points ( p = 0.002) by Brunel Balance Assessment (stepping), and 1.11 (2.94) points ( p = 0.044) by Tinetti Test (gait), all in favour of core stability exercises. Core stability exercises plus conventional physiotherapy have a positive long-term effect on improving dynamic sitting and standing balance and gait in post-stroke patients.

Validity of the Japanese Orthopaedic Association scoring system based on patient-reported improvement after posterior lumbar interbody fusion.

PubMed

Fujimori, Takahito; Okuda, Shinya; Iwasaki, Motoki; Yamasaki, Ryoji; Maeno, Takafumi; Yamashita, Tomoya; Matsumoto, Tomiya; Wada, Eiji; Oda, Takenori

2016-06-01

The Japanese Orthopaedic Association (JOA) scoring system is a physician-based outcome that has been used to evaluate treatment effectiveness after lumbar surgery. However, patient-centered evaluation becomes increasingly important. There is no study that has examined the relationship between the JOA scoring system and patients' self-reported improvement. The purpose of the present study was to validate the JOA scoring system for assessment of patient-reported improvement after lumbar surgery. This is a retrospective review of prospectively collected data. The patient sample included 273 mail-in responders of the 466 consecutive patients who underwent posterior lumbar interbody fusion for spondylolisthesis between 1996 and 2008 in a single hospital. The outcome measures were the JOA scoring system and patients' self-reported improvement. Two hundred seventy three patients were divided into five anchoring groups based on self-reported improvement from "Much better" to "Much worse." Outcomes (ie, recovery rate, amount of change from preoperative condition, and postoperative score) based on the JOA scoring system were compared among groups. Using the patient's self-reported improvement scale as an anchor, the association among each of the outcomes was examined. The cutoff point and the area under the curve (AUC) that differentiated "Improved" from "Neither improved nor worse" was calculated using receiver operating characteristic (ROC) curve analysis. The recovery rate and postoperative score were significantly different in 9 of 10 pairs of anchoring groups. The amount of change was significantly different in six pairs. Spearman correlation coefficient for the 5-point scale anchors of patients' self-reported improvement was 0.20 (p=.001) for the baseline score, 0.31 (p<.001) for the amount of change, 0.55 (p<.001) for the recovery rate, and 0.56 (p<.001) for the postoperative score. According to ROC analysis, the best cutoff points and AUCs were 13 points and 0.69, respectively, for the amount of change, 67% and 0.73, respectively, for recovery rate, and 23 points and 0.72, respectively, for postoperative score. The JOA scoring system is a valid method for assessment of patients' self-reported improvement. Patients' self-reported improvement is more likely to be associated with the final condition, such as postoperative score or recovery rate, rather than the change from the preoperative condition. Copyright © 2016 Elsevier Inc. All rights reserved.

"Reactivity to Stimuli” Is a Temperamental Factor Contributing to Canine Aggression

PubMed Central

Arata, Sayaka; Takeuchi, Yukari; Inoue, Mai; Mori, Yuji

2014-01-01

Canine aggression is one of the most frequent problems in veterinary behavioral medicine, which in severe cases may result in relinquishment or euthanasia. As it is important to reveal underlying factors of aggression for both treatment and prevention, we recently developed a questionnaire on aggression and temperamental traits and found that “reactivity to stimuli” was associated with aggression toward owners, children, strangers, and other dogs of the Shiba Inu breed. In order to examine whether these associations were consistent in other breeds, we asked the owners of insured dogs of Anicom Insurance Inc. to complete our questionnaire. The top 17 contracted breeds were included. The questionnaire consisted of dogs' general information, four items related to aggression toward owners, children, strangers, and other dogs, and 20 other behavioral items. Aggression-related and behavioral items were rated on a five-point frequency scale. Valid responses (n = 5610) from owners of dogs aged 1 through 10 years were collected. Factor analyses on 18 behavioral items (response rate over 95%) extracted five largely consistent factors in 14 breeds: “sociability with humans,” “fear of sounds,” “chase proneness,” “reactivity to stimuli,” and “avoidance of aversive events.” By stepwise multiple regression analyses, using the Schwartz's Bayesian information criterion (BIC) method with aggression points as objective variables and general information and temperamental factor points as explanatory variables, “reactivity to stimuli,” i.e., physical reactivity to sudden movement or sound at home, was shown to be significantly associated with owner-directed aggression in 13 breeds, child-directed aggression in eight breeds, stranger-directed aggression in nine breeds, and dog-directed aggression in five breeds. These results suggest that “reactivity to stimuli” is simultaneously involved in several types of aggression. Therefore, it would be worth taking “reactivity to stimuli” into account in the treatment and prevention of canine aggression. PMID:24972077

Detection of depression in acute schizophrenia: sensitivity and specificity of 2 standard observer rating scales.

PubMed

Müller, Matthias J; Müller, Kay-Maria; Fellgiebel, Andreas

2006-05-01

To compare the psychometric properties of the Calgary Depression Rating Scale (CDRS) and the Hamilton Depression Rating Scale (HDRS) for severity assessment of depression in acute schizophrenia. During clinical routine treatment, we investigated 119 inpatients with acute schizophrenia, using the CDRS, the HDRS, and a global 4-point Depression Severity Scale (DEP-SEV). We compared CDRS and HDRS sum scores regarding their diagnostic accuracy, with global severity of depression as the criterion. We estimated sensitivity and specificity on the basis of receiver operating characteristic curves. According to global clinical ratings (DEP-SEV), 31% of patients had no depression, 19% had mild, 31% had moderate, and 19% had severe depression. Sensitivity was significantly higher (P < 0.05) for the CDRS than for the HDRS to assess mild (0.94 vs 0.76, cut-off 3 vs 10 points) or severe depression (1.00 vs 0.78, cut-off 11 vs 22 points); specificity was comparably high (> or = 0.88) for both scales. Despite the fact that both scales were effective in separating mild, moderate, and severe depression, significant advantages emerged for the CDRS to detect mild or severe depression in schizophrenia.

The efficacy of intravenous ketorolac for pain relief in single-stage adjustable strabismus surgery: a prospective, randomized, placebo-controlled trial

PubMed Central

Rhiu, S; Chung, S A; Kim, W K; Chang, J H; Bae, S J; Lee, J B

2011-01-01

Purpose To determine the efficacy of preoperative intravenous ketorolac in reducing intraoperative and postoperative pain and improving patient satisfaction in patients undergoing single-stage adjustable strabismus surgery. Methods A prospective, randomized, placebo-controlled clinical trial was performed with 67 patients who underwent horizontal recti muscle surgery with adjustable sutures. The test group received intravenous ketorolac (60 mg) before surgery, and the control group received intravenous normal saline. Topical 0.5% proparacaine was administered to both groups during surgery. Vital signs including heart rate and blood pressure were recorded every 10 min throughout the surgery. The patients were asked to rate their maximum intraoperative and postoperative pain scores using a numerical pain rating scale. Patient satisfaction was also assessed using a five-point analogue scale. Results The ketorolac-premedicated patients had less pain both during and after surgery (P=0.033 and P=0.024, respectively). There were no differences in vital signs during surgery and patient satisfaction between the two groups. Conclusions Intravenous ketorolac, when administered preoperatively for single-stage adjustable strabismus surgery under topical anaesthesia, was effective in reducing pain during and after surgery. PMID:21102493

Validity of the Children's Orientation to Book Reading Rating Scale

ERIC Educational Resources Information Center

Kaderavek, Joan N.; Guo, Ying; Justice, Laura M.

2014-01-01

The present study investigates the validity of a 4-point rating scale used to measure the level of preschool children's orientation to literacy during shared book reading. Validity was explored by (a) comparing the children's level of literacy orientation as measured with the "Children's Orientation to Book Reading Rating Scale" (COB)…

Cassava flour slurry as a low-cost alternative to commercially available gel for obstetrical ultrasound: a blinded non-inferiority trial comparison of image quality.

PubMed

Aziz, A; Dar, P; Hughes, F; Solorzano, C; Muller, M M; Salmon, C; Salmon, M; Benfield, N

2018-01-12

To evaluate the quality of ultrasound images obtained with cassava flour slurry (CFS) compared with conventional gel in order to determine objectively whether CFS could be a true low-cost alternative. Blinded non-inferiority trial. Obstetrical ultrasound unit in an academic medical centre. Women with a singleton pregnancy, undergoing anatomy ultrasounds. Thirty pregnant women had standard biometry measures obtained with CFS and conventional gel. Images were compared side-by-side in random order by two blinded sonologists and rated for image resolution, detail and total image quality using a 10-cm visual analogue scale. Ratings were compared using paired t-tests. Participant and sonographer experience was measured using five-point Likert scales. Image resolution, detail, and total image quality. Participant experience of gel regarding irritation, messiness, and ease of removal. We found no significant difference between perceived image quality obtained with CFS (mean = 6.2, SD = 1.2) and commercial gel (mean = 6.4, SD = 1.2) [t (28) = -1.1; P = 0.3]. Images were not rated significantly differently for either reviewer in any measure, any standardized image or any view of a specific anatomic structure. All five sonographers rated CFS as easy to obtain clear images and easy for patient and machine cleanup. Only one participant reported itching with CFS. CFS produces comparable image quality to commercial ultrasound gel. The dissemination of these results and the simple CFS recipe could significantly increase access to ultrasound for screening, monitoring and diagnostic purposes in resource-limited settings. This study was internally funded by our department. Low-cost homemade cassava flour slurry creates images equal to commercial ultrasound gel, improving access. © 2018 Royal College of Obstetricians and Gynaecologists.

39 CFR 3002.3 - Official seal.

Code of Federal Regulations, 2012 CFR

2012-07-01

... inscribed at top POSTAL RATE COMMISSION and in base, between two small five-pointed stars, 1970, all in gold, the shield of the coat of arms in full color blazoned as follows: Five blue stars on a white stripe...

Large scale wind tunnel investigation of a folding tilt rotor

NASA Technical Reports Server (NTRS)

1972-01-01

A twenty-five foot diameter folding tilt rotor was tested in a large scale wind tunnel to determine its aerodynamic characteristics in unfolded, partially folded, and fully folded configurations. During the tests, the rotor completed over forty start/stop sequences. After completing the sequences in a stepwise manner, smooth start/stop transitions were made in approximately two seconds. Wind tunnel speeds up through seventy-five knots were used, at which point the rotor mast angle was increased to four degrees, corresponding to a maneuver condition of one and one-half g.

Extended general relativity: Large-scale antigravity and short-scale gravity with ω=-1 from five-dimensional vacuum

NASA Astrophysics Data System (ADS)

Madriz Aguilar, José Edgar; Bellini, Mauricio

2009-08-01

Considering a five-dimensional (5D) Riemannian spacetime with a particular stationary Ricci-flat metric, we obtain in the framework of the induced matter theory an effective 4D static and spherically symmetric metric which give us ordinary gravitational solutions on small (planetary and astrophysical) scales, but repulsive (anti gravitational) forces on very large (cosmological) scales with ω=-1. Our approach is an unified manner to describe dark energy, dark matter and ordinary matter. We illustrate the theory with two examples, the solar system and the great attractor. From the geometrical point of view, these results follow from the assumption that exists a confining force that make possible that test particles move on a given 4D hypersurface.

Development and Validity of the Rating Scales of Academic Skills for Reading Comprehension

ERIC Educational Resources Information Center

Shapiro, Edward S.; Gebhardt, Sarah; Flatley, Katie; Guard, Kirra B.; Fu, Qiong; Leichman, Erin S.; Calhoon, Mary Beth; Hojnoski, Robin

2017-01-01

The development and psychometric qualities of a measure using teacher judgment to rate performance in reading comprehension for narrative text is described--the Rating Scales for Academic Skills-Reading Comprehension Narrative (RSAS-RCN). Sixty-five teachers from the third, fourth, and fifth grades of 8 elementary schools completed the measure on…

Measuring pain in children with cognitive impairment: pain response to surgical procedures.

PubMed

Terstegen, Chantal; Koot, Hans M; de Boer, Josien B; Tibboel, Dick

2003-05-01

This study investigated post-surgical pain in children with profound cognitive impairment (PCI), searching for a core set of cues these children use to express their pain. Fifty-two children were observed while they were admitted to the Sophia Children's Hospital for surgery, twice before and five times after surgery. All observations were scored with the item pool consisting of 134 possible pain indicators, using a five-point scale ranging from 0 (never shown) to 4 (always shown). Second, we used the visual analogue scale (VAS) to give a general impression of the severity of the children's pain during the episodes they were observed. Several analyses provided evidence that 23 observable behaviors are sensitive to post-surgical pain in children with PCI, regardless of the pain intensity of the surgical procedures they underwent. The finding that all indicators, except for one, were scored significantly higher on episodes with VAS ratings >or=4, indicates the sensitivity of these indicators concerning absence versus presence of clinically meaningful levels of pain. This study reveals the potential clinical utility of a core set of indicators which can be used to assess post-surgical pain in children with PCI.

Development and Validation of a Photonumeric Scale for Assessment of Chin Retrusion.

PubMed

Sykes, Jonathan M; Carruthers, Alastair; Hardas, Bhushan; Murphy, Diane K; Jones, Derek; Carruthers, Jean; Donofrio, Lisa; Creutz, Lela; Marx, Ann; Dill, Sara

2016-10-01

A validated scale is needed for objective and reproducible comparisons of chin appearance before and after chin augmentation in practice and clinical studies. To describe the development and validation of the 5-point photonumeric Allergan Chin Retrusion Scale. The Allergan Chin Retrusion Scale was developed to include an assessment guide, verbal descriptors, morphed images, and real subject images for each scale grade. The clinical significance of a 1-point score difference was evaluated in a review of multiple image pairs representing varying differences in severity. Interrater and intrarater reliability was evaluated in a live-subject validation study (N = 298) completed during 2 sessions occurring 3 weeks apart. A difference of ≥1 point on the scale was shown to reflect a clinically meaningful difference (mean [95% confidence interval] absolute score difference, 1.07 [0.94-1.20] for clinically different image pairs and 0.51 [0.39-0.63] for not clinically different pairs). Intrarater agreement between the 2 live-subject validation sessions was substantial (mean weighted kappa = 0.79). Interrater agreement was substantial during the second rating session (0.68, primary end point). The Allergan Chin Retrusion Scale is a validated and reliable scale for physician rating of severity of chin retrusion.

Dissimilarity of yellow-blue surfaces under neutral light sources differing in intensity: separate contributions of light intensity and chroma.

PubMed

Tokunaga, Rumi; Logvinenko, Alexander D; Maloney, Laurence T

2008-01-01

Observers viewed two side-by-side arrays each of which contained three yellow Munsell papers, three blue, and one neutral Munsell. Each array was illuminated uniformly and independently of the other. The neutral light source intensities were 1380, 125, or 20 lux. All six possible combinations of light intensities were set as illumination conditions. On each trial, observers were asked to rate the dissimilarity between each chip in one array and each chip in the other by using a 30-point scale. Each pair of surfaces in each illumination condition was judged five times. We analyzed this data using non-metric multi-dimensional scaling to determine how light intensity and surface chroma contributed to dissimilarity and how they interacted. Dissimilarities were captured by a three-dimensional configuration in which one dimension corresponded to differences in light intensity.

Measuring leader perceptions of school readiness for reforms: use of an iterative model combining classical and Rasch methods.

PubMed

Chatterji, Madhabi

2002-01-01

This study examines validity of data generated by the School Readiness for Reforms: Leader Questionnaire (SRR-LQ) using an iterative procedure that combines classical and Rasch rating scale analysis. Following content-validation and pilot-testing, principal axis factor extraction and promax rotation of factors yielded a five factor structure consistent with the content-validated subscales of the original instrument. Factors were identified based on inspection of pattern and structure coefficients. The rotated factor pattern, inter-factor correlations, convergent validity coefficients, and Cronbach's alpha reliability estimates supported the hypothesized construct properties. To further examine unidimensionality and efficacy of the rating scale structures, item-level data from each factor-defined subscale were subjected to analysis with the Rasch rating scale model. Data-to-model fit statistics and separation reliability for items and persons met acceptable criteria. Rating scale results suggested consistency of expected and observed step difficulties in rating categories, and correspondence of step calibrations with increases in the underlying variables. The combined approach yielded more comprehensive diagnostic information on the quality of the five SRR-LQ subscales; further research is continuing.

A Five-Year Evolution of a Student-led Elective on Health Disparities at The Alpert Medical School.

PubMed

Leung, Lucinda B; Simmons, James E; Ho, Julius; Anselin, Emma; Yalamanchili, Rian; Rabatin, Joseph S

2016-10-04

Medical students are often unprepared for social challenges in caring for safety net patients. We aim to evaluate and chronicle the evolution of a pre-clinical elective alongside medical disparities curriculum. Medical students designed the course to supplement clinical training on care of vulnerable patients. From 2011-2015, there have been 80 first-year medical student participants, five cohorts of second-year course leaders, and two supporting faculty advisors for this 10-12 session evening elective. Students (n=67) rated the course extremely highly (ranging from 4.4-4.6 on a five-point Likert scale). Medical students reported having significantly more knowledge of underserved populations after taking the course (difference=0.72, SE=0.16, P <0.001). Career interests and attitudes toward health disparities remained strong after taking the course. This student-created elective equipped participants with improved knowledge in caring for underserved patients and contributed to the incorporation of health disparities in medical curriculum. [Full article available at http://rimed.org/rimedicaljournal-2016-10.asp].

Evaluation of high fidelity patient simulator in assessment of performance of anaesthetists.

PubMed

Weller, J M; Bloch, M; Young, S; Maze, M; Oyesola, S; Wyner, J; Dob, D; Haire, K; Durbridge, J; Walker, T; Newble, D

2003-01-01

There is increasing emphasis on performance-based assessment of clinical competence. The High Fidelity Patient Simulator (HPS) may be useful for assessment of clinical practice in anaesthesia, but needs formal evaluation of validity, reliability, feasibility and effect on learning. We set out to assess the reliability of a global rating scale for scoring simulator performance in crisis management. Using a global rating scale, three judges independently rated videotapes of anaesthetists in simulated crises in the operating theatre. Five anaesthetists then independently rated subsets of these videotapes. There was good agreement between raters for medical management, behavioural attributes and overall performance. Agreement was high for both the initial judges and the five additional raters. Using a global scale to assess simulator performance, we found good inter-rater reliability for scoring performance in a crisis. We estimate that two judges should provide a reliable assessment. High fidelity simulation should be studied further for assessing clinical performance.

Tipping the scales: educating surgeons about medical malpractice.

PubMed

Raper, Steven E; Joseph, Johncy; Seymour, Wilda G; Sullivan, Patricia G

2016-11-01

In Pennsylvania, medical malpractice premiums are a major cost to surgeons. Yet surgeons often have little if any education in the basics of tort litigation or how to manage their risk. This work describes one approach for educating academic faculty surgeons on current concepts of medical malpractice and provide some guidance on how to "tip the scales of justice"; or minimize the risks of being named in a malpractice claim. The course had five parts: the basics of medical malpractice, the cost of malpractice insurance, current departmental claims experience, strategies for decreasing the risk of being named in a claim, and an overview of malpractice reforms. An anonymous seven question survey was cast in a five-point Likert scale format. A weighted average of 4.5 or above was considered satisfactory. Two free text questions asked about positive and negative aspects of the course. Eighty of 95 (84%) faculty attended either in person or by reviewing a web-based video. Quantitatively, five of seven questions had a weighted average of more than 4.5 (n = 48, response rate = 60%). Qualitatively, the course was reviewed very favorably. The high percentage of participation and overall survey results suggest that the course was successful. This course was one facet of an approach to decrease the risk of malpractice claims. Unique aspects of this course include an emphasis on state law, department-specific data, and strategies to minimize risk of future claims. Given the state-specific nature of malpractice claims and litigation, individual departments must particularize similar presentations. Copyright © 2016 Elsevier Inc. All rights reserved.

The effects of spiritual practices on recovery from substance abuse.

PubMed

Carter, T M

1998-10-01

Twelve-step programs have stressed the importance of spiritual practices for over four decades. The spiritual principles embodied in the twelve-step programs may be key in their success of recovering addicts/alcoholics with an overall recovery rate of 34%. A literature search revealed little available data on spiritual principles and practices and their effects on long-term recovery from substance abuse. This study compared two groups of recovering addicts, those with one year of recovery and those with less than one year and a history of relapse. Spiritual practices were measured using a five-point Likert scale questionnaire. The results of the study indicated a relationship between spiritual practices and long-term recovery from substance abuse.

Trends in tans and skin protection in Australian fashion magazines, 1982 through 1991.

PubMed Central

Chapman, S; Marks, R; King, M

1992-01-01

We rated 3971 photographs of models from midsummer editions of six Australian fashion magazines from 1982-1983 to 1990-1991 for tan on a 9-point scale, for the presence of hats, for sun-protective clothing, and for shade setting. With the exception of the 1990-1991 sample, there was an increasing proportion of light tans over the years. Men were more likely to be deeply tanned than were women. The proportion of models wearing hats followed an increasing linear trend across the five periods. Three quarters of the outdoor photographs were taken in unshaded settings. In unshaded settings, 17% of the women and 5% of the men wore hats. PMID:1456348

Marathon Group Counseling with Illicit Drug Abusers: Effects on Self-Perceptions.

ERIC Educational Resources Information Center

Page, Richard C.; And Others

1987-01-01

Compared effects, for illicit drug abusers, of five 16-hour unstructured marathon groups, and five matched, randomly selected control groups. Used semantic differential consisting of the specific adjective pairs and the evaluative scale of the concept My Real Self. Marathon group members rated some adjective pairs differently and rated the…

Using Contact Forces and Robot Arm Accelerations to Automatically Rate Surgeon Skill at Peg Transfer.

PubMed

Brown, Jeremy D; O Brien, Conor E; Leung, Sarah C; Dumon, Kristoffel R; Lee, David I; Kuchenbecker, Katherine J

2017-09-01

Most trainees begin learning robotic minimally invasive surgery by performing inanimate practice tasks with clinical robots such as the Intuitive Surgical da Vinci. Expert surgeons are commonly asked to evaluate these performances using standardized five-point rating scales, but doing such ratings is time consuming, tedious, and somewhat subjective. This paper presents an automatic skill evaluation system that analyzes only the contact force with the task materials, the broad-bandwidth accelerations of the robotic instruments and camera, and the task completion time. We recruited N = 38 participants of varying skill in robotic surgery to perform three trials of peg transfer with a da Vinci Standard robot instrumented with our Smart Task Board. After calibration, three individuals rated these trials on five domains of the Global Evaluative Assessment of Robotic Skill (GEARS) structured assessment tool, providing ground-truth labels for regression and classification machine learning algorithms that predict GEARS scores based on the recorded force, acceleration, and time signals. Both machine learning approaches produced scores on the reserved testing sets that were in good to excellent agreement with the human raters, even when the force information was not considered. Furthermore, regression predicted GEARS scores more accurately and efficiently than classification. A surgeon's skill at robotic peg transfer can be reliably rated via regression using features gathered from force, acceleration, and time sensors external to the robot. We expect improved trainee learning as a result of providing these automatic skill ratings during inanimate task practice on a surgical robot.

Uncertainty of exploitation estimates made from tag returns

USGS Publications Warehouse

Miranda, L.E.; Brock, R.E.; Dorr, B.S.

2002-01-01

Over 6,000 crappies Pomoxis spp. were tagged in five water bodies to estimate exploitation rates by anglers. Exploitation rates were computed as the percentage of tags returned after adjustment for three sources of uncertainty: postrelease mortality due to the tagging process, tag loss, and the reporting rate of tagged fish. Confidence intervals around exploitation rates were estimated by resampling from the probability distributions of tagging mortality, tag loss, and reporting rate. Estimates of exploitation rates ranged from 17% to 54% among the five study systems. Uncertainty around estimates of tagging mortality, tag loss, and reporting resulted in 90% confidence intervals around the median exploitation rate as narrow as 15 percentage points and as broad as 46 percentage points. The greatest source of estimation error was uncertainty about tag reporting. Because the large investments required by tagging and reward operations produce imprecise estimates of the exploitation rate, it may be worth considering other approaches to estimating it or simply circumventing the exploitation question altogether.

Cut points on 0-10 numeric rating scales for symptoms included in the Edmonton Symptom Assessment Scale in cancer patients: a systematic review.

PubMed

Oldenmenger, Wendy H; de Raaf, Pleun J; de Klerk, Cora; van der Rijt, Carin C D

2013-06-01

To improve the management of cancer-related symptoms, systematic screening is necessary, often performed by using 0-10 numeric rating scales. Cut points are used to determine if scores represent clinically relevant burden. The aim of this systematic review was to explore the evidence on cut points for the symptoms of the Edmonton Symptom Assessment Scale. Relevant literature was searched in PubMed, CINAHL®, Embase, and PsycINFO®. We defined a cut point as the lower bound of the scores representing moderate or severe burden. Eighteen articles were eligible for this review. Cut points were determined using the interference with daily life, another symptom-related method, or a verbal scale. For pain, cut point 5 and, to a lesser extent, cut point 7 were found as the optimal cut points for moderate pain and severe pain, respectively. For moderate tiredness, the best cut point seemed to be cut point 4. For severe tiredness, both cut points 7 and 8 were suggested frequently. A lack of evidence exists for nausea, depression, anxiety, drowsiness, appetite, well-being, and shortness of breath. Few studies suggested a cut point below 4. For many symptoms, there is no clear evidence as to what the optimal cut points are. In daily clinical practice, a symptom score ≥4 is recommended as a trigger for a more comprehensive symptom assessment. Until there is more evidence on the optimal cut points, we should hold back using a certain cut point in quality indicators and be cautious about strongly recommending a certain cut point in guidelines. Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

The Aachen Mobility and Balance Index to measure physiological falls risk: a comparison with the Tinetti POMA Scale.

PubMed

Knobe, M; Giesen, M; Plate, S; Gradl-Dietsch, G; Buecking, B; Eschbach, D; van Laack, W; Pape, H-C

2016-10-01

The most commonly used mobility assessments for screening risk of falls among older adults are rating scales such as the Tinetti performance oriented mobility assessment (POMA). However, its correlation with falls is not always predictable and disadvantages of the scale include difficulty to assess many of the items on a 3-point scale and poor specificity. The purpose of this study was to describe the ability of the new Aachen Mobility and Balance Index (AMBI) to discriminate between subjects with a fall history and subjects without such events in comparison to the Tinetti POMA Scale. For this prospective cohort study, 24 participants in the study group and 10 in the control group were selected from a population of patients in our hospital who had met the stringent inclusion criteria. Both groups completed the Tinetti POMA Scale (gait and balance component) and the AMBI (tandem stance, tandem walk, ten-meter-walk-test, sit-to-stand with five repetitions, 360° turns, timed-up-and-go-test and measurement of the dominant hand grip strength). A history of falls and hospitalization in the past year were evaluated retrospectively. The relationships among the mobility tests were examined with Bland-Altmananalysis. Receiver-operated characteristics curves, sensitivity and specificity were calculated. The study showed a strong negative correlation between the AMBI (17 points max., highest fall risk) and Tinetti POMA Scale (28 points max., lowest fall risk; r = -0.78, p < 0.001) with an excellent discrimination between community-dwelling older people and a younger control group. However, there were no differences in any of the mobility and balance measurements between participants with and without a fall history with equal characteristics in test comparison (AMBI vs. Tinetti POMA Scale: AUC 0.570 vs. 0.598; p = 0.762). The Tinetti POMA Scale (cut-off <20 points) showed a sensitivity of 0.45 and a specificity of 0.69, the AMBI a sensitivity of 0.64 and a specificity of 0.46 (cut-off >5 points). The AMBI comprises mobility and balance tasks with increasing difficulty as well as a measurement of the dominant hand-grip strength. Its ability to identify fallers was comparable to the Tinetti POMA Scale. However, both measurement sets showed shortcomings in discrimination between fallers and non-fallers based on a self-reported retrospective falls-status.

The recognition of mental health disorders and its association with psychiatric scepticism, knowledge of psychiatry, and the Big Five personality factors: an investigation using the overclaiming technique.

PubMed

Swami, Viren; Persaud, Raj; Furnham, Adrian

2011-03-01

The present study examined the general public's ability to recognise mental health disorders and this ability's association with psychiatric scepticism, knowledge of psychiatry, and the Big Five personality factors. A total of 477 members of the British general public completed an overclaiming scale, in which they were asked to rate the degree to which they believed 20 mental health disorders (of which five were foils designed to resemble real disorders) were real or fake. Participants also completed a novel scale measuring psychiatric scepticism, a single-item measure of knowledge of psychiatry, and a measure of the Big Five personality factors. Results showed that participants were significantly more likely to rate foils as fake disorders than real disorders. In addition, the difference between real and foil ratings was significantly predicted by knowledge of psychiatry, psychiatric scepticism, and the Big Five personality factors of agreeableness and openness to experience. These results are discussed in relation to the overclaiming technique as a novel method to study mental health literacy.

Effects of interactive instructional techniques in a web-based peripheral nervous system component for human anatomy.

PubMed

Allen, Edwin B; Walls, Richard T; Reilly, Frank D

2008-02-01

This study investigated the effects of interactive instructional techniques in a web-based peripheral nervous system (PNS) component of a first year medical school human anatomy course. Existing data from 9 years of instruction involving 856 students were used to determine (1) the effect of web-based interactive instructional techniques on written exam item performance and (2) differences between student opinions of the benefit level of five different types of interactive learning objects used. The interactive learning objects included Patient Case studies, review Games, Simulated Interactive Patients (SIP), Flashcards, and unit Quizzes. Exam item analysis scores were found to be significantly higher (p < 0.05) for students receiving the instructional treatment incorporating the web-based interactive learning objects than for students not receiving this treatment. Questionnaires using a five-point Likert scale were analysed to determine student opinion ratings of the interactive learning objects. Students reported favorably on the benefit level of all learning objects. Students rated the benefit level of the Simulated Interactive Patients (SIP) highest, and this rating was significantly higher (p < 0.05) than all other learning objects. This study suggests that web-based interactive instructional techniques improve student exam performance. Students indicated a strong acceptance of Simulated Interactive Patient learning objects.

Reaffirming normal: the high risk of pathologizing healthy adults when interpreting the MMPI-2-RF.

PubMed

Odland, Anthony P; Lammy, Andrew B; Perle, Jonathan G; Martin, Phillip K; Grote, Christopher L

2015-01-01

Monte Carlo simulations were utilized to determine the proportion of the normal population expected to have scale elevations on the MMPI-2-RF when multiple scores are interpreted. Results showed that when all 40 MMPI-2-RF scales are simultaneously considered, approximately 70% of normal adults are likely to have at least one scale elevation at or above 65 T, and as many as 20% will have five or more elevated scales. When the Restructured Clinical (RC) Scales are under consideration, 34% of normal adults have at least one elevated score. Interpretation of the Specific Problem Scales and Personality Psychopathology Five Scales--Revised also yielded higher than expected rates of significant scores, with as many as one in four normal adults possibly being miscategorized as having features of a personality disorder by the latter scales. These findings are consistent with the growing literature on rates of apparently abnormal scores in the normal population due to multiple score interpretation. Findings are discussed in relation to clinical assessment, as well as in response to recent work suggesting that the MMPI-2-RF's multiscale composition does not contribute to high rates of elevated scores.

75 FR 30370 - Certain Coated Paper Suitable For High-Quality Print Graphics Using Sheet-Fed Presses from the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-01

...) a change of at least five absolute percentage points in, but not less than 25 percent of, the... between a countervailable subsidy rate of zero (or de minimis) and a countervailable subsidy rate of... absolute points and not less than 25 percent of the originally calculated margin. Thus, the ministerial...

Application of spatial and non-spatial data analysis in determination of the factors that impact municipal solid waste generation rates in Turkey

DOE Office of Scientific and Technical Information (OSTI.GOV)

Keser, Saniye; Duzgun, Sebnem; Department of Geodetic and Geographic Information Technologies, Middle East Technical University, 06800 Ankara

Highlights: Black-Right-Pointing-Pointer Spatial autocorrelation exists in municipal solid waste generation rates for different provinces in Turkey. Black-Right-Pointing-Pointer Traditional non-spatial regression models may not provide sufficient information for better solid waste management. Black-Right-Pointing-Pointer Unemployment rate is a global variable that significantly impacts the waste generation rates in Turkey. Black-Right-Pointing-Pointer Significances of global parameters may diminish at local scale for some provinces. Black-Right-Pointing-Pointer GWR model can be used to create clusters of cities for solid waste management. - Abstract: In studies focusing on the factors that impact solid waste generation habits and rates, the potential spatial dependency in solid waste generation datamore » is not considered in relating the waste generation rates to its determinants. In this study, spatial dependency is taken into account in determination of the significant socio-economic and climatic factors that may be of importance for the municipal solid waste (MSW) generation rates in different provinces of Turkey. Simultaneous spatial autoregression (SAR) and geographically weighted regression (GWR) models are used for the spatial data analyses. Similar to ordinary least squares regression (OLSR), regression coefficients are global in SAR model. In other words, the effect of a given independent variable on a dependent variable is valid for the whole country. Unlike OLSR or SAR, GWR reveals the local impact of a given factor (or independent variable) on the waste generation rates of different provinces. Results show that provinces within closer neighborhoods have similar MSW generation rates. On the other hand, this spatial autocorrelation is not very high for the exploratory variables considered in the study. OLSR and SAR models have similar regression coefficients. GWR is useful to indicate the local determinants of MSW generation rates. GWR model can be utilized to plan waste management activities at local scale including waste minimization, collection, treatment, and disposal. At global scale, the MSW generation rates in Turkey are significantly related to unemployment rate and asphalt-paved roads ratio. Yet, significances of these variables may diminish at local scale for some provinces. At local scale, different factors may be important in affecting MSW generation rates.« less

Oxford NOTECHS II: a modified theatre team non-technical skills scoring system.

PubMed

Robertson, Eleanor R; Hadi, Mohammed; Morgan, Lauren J; Pickering, Sharon P; Collins, Gary; New, Steve; Griffin, Damian; Griffin, Damien; McCulloch, Peter; Catchpole, Ken C

2014-01-01

We previously developed and validated the Oxford NOTECHS rating system for evaluating the non-technical skills of an entire operating theatre team. Experience with the scale identified the need for greater discrimination between levels of performance within the normal range. We report here the development of a modified scale (Oxford NOTECHS II) to facilitate this. The new measure uses an eight-point instead of a four point scale to measure each dimension of non-technical skills, and begins with a default rating of 6 for each element. We evaluated this new scale in 297 operations at five NHS sites in four surgical specialities. Measures of theatre process reliability (glitch count) and compliance with the WHO surgical safety checklist were scored contemporaneously, and relationships with NOTECHS II scores explored. Mean team Oxford NOTECHS II scores was 73.39 (range 37-92). The means for surgical, anaesthetic and nursing sub-teams were 24.61 (IQR 23, 27); 24.22 (IQR 23, 26) and 24.55 (IQR 23, 26). Oxford NOTECHS II showed good inter-rater reliability between human factors and clinical observers in each of the four domains. Teams with high WHO compliance had higher mean Oxford NOTECHS II scores (74.5) than those with low compliance (71.1) (p = 0.010). We observed only a weak correlation between Oxford NOTECHS II scores and glitch count; r = -0.26 (95% CI -0.36 to -0.15). Oxford NOTECHS II scores did not vary significantly between 5 different hospital sites, but a significant difference was seen between specialities (p = 0.001). Oxford NOTECHS II provides good discrimination between teams while retaining reliability and correlation with other measures of teamwork performance, and is not confounded by technical performance. It is therefore suitable for combined use with a technical performance scale to provide a global description of operating theatre team performance.

Mental Illness Stigma Expressed by Police to Police.

PubMed

Stuart, Heather

2017-01-01

This paper describes mental health related stigma expressed by police to police using a newly developed 11-item Police Officer Stigma Scale and reports on the preliminary psychometric properties (factor structure and internal reliability) of this scale. The scale used an indirect measurement approach adapted from the Perceived Devaluation and Discrimination Scale. Five themes appropriate to police culture were adapted and six additional items were added. Responses were rated on a 5-point agreement scale with an additional don't know option. Data were collected from officers attending a mandatory workshop (90.5% response). Exploratory factor analysis showed the scale to be unidimensional and internally reliable (Cronbach's alpha was 0.82). The most endorsed items pertained to avoiding disclosure to a supervisor/manager or to a colleague (85% agreement), that most officers would expect discrimination at work (62%), and that most officers would not want a supervisor or manager who had a mental illness (62%). Findings highlight that (a) Police-to-police mental illness stigma may be a particularly strong feature of police cultures; (b) police should be a focus for targeted anti-stigma interventions; and (c) though further psychometric testing is needed, the Police Office Stigma Scale may provide important insights into the nature and functioning of police-to-police stigma in police cultures in future research.

Rating of personality disorder features in popular movie characters.

PubMed

Hesse, Morten; Schliewe, Sanna; Thomsen, Rasmus R

2005-12-08

Tools for training professionals in rating personality disorders are few. We present one such tool: rating of fictional persons. However, before ratings of fictional persons can be useful, we need to know whether raters get the same results, when rating fictional characters. Psychology students at the University of Copenhagen (N = 8) rated four different movie characters from four movies based on three systems: Global rating scales representing each of the 10 personality disorders in the DSM-IV, a criterion list of all criteria for all DSM-IV personality disorders in random order, and the Ten Item Personality Inventory for rating the five-factor model. Agreement was estimated based on intraclass-correlation. Agreement for rating scales for personality disorders ranged from 0.04 to 0.54. For personality disorder features based on DSM-IV criteria, agreement ranged from 0.24 to 0.89, and agreement for the five-factor model ranged from 0.05 to 0.88. The largest multivariate effect was observed for criteria count followed by the TIPI, followed by rating scales. Raters experienced personality disorder criteria as the easiest, and global personality disorder scales as the most difficult, but with significant variation between movies. Psychology students with limited or no clinical experience can agree well on the personality traits of movie characters based on watching the movie. Rating movie characters may be a way to practice assessment of personality.

Rating of personality disorder features in popular movie characters

PubMed Central

Hesse, Morten; Schliewe, Sanna; Thomsen, Rasmus R

2005-01-01

Background Tools for training professionals in rating personality disorders are few. We present one such tool: rating of fictional persons. However, before ratings of fictional persons can be useful, we need to know whether raters get the same results, when rating fictional characters. Method Psychology students at the University of Copenhagen (N = 8) rated four different movie characters from four movies based on three systems: Global rating scales representing each of the 10 personality disorders in the DSM-IV, a criterion list of all criteria for all DSM-IV personality disorders in random order, and the Ten Item Personality Inventory for rating the five-factor model. Agreement was estimated based on intraclass-correlation. Results Agreement for rating scales for personality disorders ranged from 0.04 to 0.54. For personality disorder features based on DSM-IV criteria, agreement ranged from 0.24 to 0.89, and agreement for the five-factor model ranged from 0.05 to 0.88. The largest multivariate effect was observed for criteria count followed by the TIPI, followed by rating scales. Raters experienced personality disorder criteria as the easiest, and global personality disorder scales as the most difficult, but with significant variation between movies. Conclusion Psychology students with limited or no clinical experience can agree well on the personality traits of movie characters based on watching the movie. Rating movie characters may be a way to practice assessment of personality. PMID:16336663

An Investigation of the Validity and Reliability of the Adapted Mathematics Anxiety Rating Scale-Short Version (MARS-SV) among Turkish Students

ERIC Educational Resources Information Center

Baloglu, Mustafa

2010-01-01

This study adapted the Mathematics Anxiety Rating Scale-Short Version (MARS-SV) into Turkish and investigated the validity and reliability of the adapted instrument. Twenty-five bilingual experts agreed on the language validity, and 49 Turkish language experts agreed on the conformity and understandability of the scale's items. Thirty-two subject…

Key issues affecting quality of life and patient-reported outcomes in prostate cancer: an analysis conducted in 2128 patients with initial psychometric assessment of the prostate cancer symptom scale (PCSS).

PubMed

Msaouel, Pavlos; Gralla, Richard J; Jones, Randy A; Hollen, Patricia J

2017-09-01

Evidence-based quality of life (QL) questionnaires require the identification of issues of importance to patients. The primary aim of this study was to inform providers on patient-expressed issues while enhancing the content validity of instruments assessing QL and patient-reported outcomes (PROs) in prostate cancer. The study provided additional psychometric properties for the new PRO and QL instrument, the Prostate Cancer Symptom Scale (PCSS). An anonymous web-based survey of 2128 patients with prostate cancer was conducted with patients rating 18 QL items on a five-point scale. Most respondents (74%) were aged 55-74 years, had early stage disease at diagnosis (81%) and were diagnosed within 2 years of the survey (81%). The top five-rated issues were: overall QL, ability to perform normal activities, maintaining independence, ability to sleep and not being a burden. These items were ranked as either 'very important' or 'important' by at least 88% of patients. None of the most highly ranked issues were symptoms. Instead, the highest ranked items were global issues reflecting the impact of symptoms on patients. In addition to the enhanced content validity findings, good reliability results and initial support for construct validity are reported for the PCSS. This is the largest survey providing patient-expressed background for content validity for QL and PRO measures. The findings of this study should aid development of newer practical questionnaires, such as the PCSS, which can be adapted to electronic platforms enhancing rapid and accurate PRO and QL evaluation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Evaluation of Computer Based Foreign Language Learning Software by Teachers and Students

ERIC Educational Resources Information Center

Baz, Fatih Çagatay; Tekdal, Mehmet

2014-01-01

The aim of this study is to evaluate Computer Based Foreign Language Learning software called Dynamic Education (DYNED) by teachers and students. The study is conducted with randomly chosen ten primary schools with the participants of 522 7th grade students and 7 English teachers. Three points Likert scale for teachers and five points Likert scale…

Using Simulation Technology to Teach Diabetes Care Management Skills to Resident Physicians

PubMed Central

Sperl-Hillen, John; O’Connor, Patrick; Ekstrom, Heidi; Rush, William; Asche, Stephen; Fernandes, Omar; Appana, Deepika; Amundson, Gerald; Johnson, Paul

2013-01-01

Background Simulation is widely used to teach medical procedures. Our goal was to develop and implement an innovative virtual model to teach resident physicians the cognitive skills of type 1 and type 2 diabetes management. Methods A diabetes educational activity was developed consisting of (a) a curriculum using 18 explicit virtual cases, (b) a web-based interactive interface, (c) a simulation model to calculate physiologic outcomes of resident actions, and (d) a library of programmed feedback to critique and guide resident actions between virtual encounters. Primary care residents in 10 U.S. residency programs received the educational activity. Satisfaction and changes in knowledge and confidence in managing diabetes were analyzed with mixed quantitative and qualitative methods. Results Pre- and post-education surveys were completed by 92/142 (65%) of residents. Likert scale (five-point) responses were favorably higher than neutral for general satisfaction (94%), recommending to colleagues (91%), training adequacy (91%), and navigation ease (92%). Finding time to complete cases was difficult for 50% of residents. Mean ratings of knowledge (on a five-point scale) posteducational activity improved by +0.5 (p < .01) for use of all available drug classes, +0.9 (p < .01) for how to start and adjust insulin, +0.8 (p < .01) for interpreting blood glucose values, +0.8 (p < .01) for individualizing treatment goals, and +0.7 (p < .01) for confidence in managing diabetes patients. Conclusions A virtual diabetes educational activity to teach cognitive skills to manage diabetes to primary care residents was successfully developed, implemented, and well liked. It significantly improved self-assessed knowledge and confidence in diabetes management. PMID:24124951

Flurbiprofen 8.75 mg lozenges for treating sore throat symptoms: a randomized, double-blind, placebo-controlled study.

PubMed

Schachtel, Bernard P; Shephard, Adrian; Shea, Timothy; Sanner, Kathleen; Savino, Laurie; Rezuke, Jeanne; Schachtel, Emily; Aspley, Sue

2016-11-01

This study assessed multiple doses of flurbiprofen 8.75 mg lozenges for the relief of three prominent symptoms of acute pharyngitis: pain intensity (primary end point), difficulty swallowing and swollen throat. A total of 204 patients (102 in each group) with confirmed pharyngitis (onset ≤4 days) were randomly assigned to take up to five flurbiprofen or placebo lozenges every 3-6 h, for 7 days. Using validated rating scales (sore throat pain intensity, difficulty swallowing and swollen throat) patients rated their symptoms for the duration of the study. Over the first 24 h, patients treated with flurbiprofen lozenges reported significantly greater reductions in sore throat pain (47%) as well as difficulty swallowing (66%) and swollen throat (40%) compared with placebo (all p < 0.05). Multiple doses of flurbiprofen lozenges provide effective relief of sore throat pain intensity as well as difficulty swallowing and swollen throat.

[Nursing outcomes for ineffective breathing patterns and impaired spontaneous ventilation in intensive care].

PubMed

do Canto, Débora Francisco; Almeida, Miriam de Abreu

2013-12-01

This study aimed to validate the results of Nursing selected from the link NANDA-I-NOC (Nursing Outcomes Classification--NANDA--International) for diagnosis Ineffective Breathing Pattern and Impaired Spontaneous Ventilation in adult intensive care unit. This is a content validation study conducted in a university hospital in southern Brazil with 15 expert nurses with clinical experience and knowledge of the ratings. The instruments contained five-point Likert scales to rate the importance of each outcome (1st step) and indicator (Step 2) for the diagnoses studied. We calculated weighted averages for each outcome/indicator, considering) 1 = 0. 2 = 0.25, 3 = 0.50 4 = 0.75 and 5 = 1. The outcomes suggested by the NOC with averages above 0.8 were considered validated as well as the indicators. The results Respiratory State--airway permeability (Ineffective Breathing Patterns) and 11 indicators, and Response to mechanical ventilation: adult (Impaired Spontaneous Ventilation) with 26 indicators were validated.

[Total reverse shoulder replacement. Evaluation of the clinical results and complications in a series of 52 cases].

PubMed

Cáceres-Sánchez, L; Mesa-Mateo, A; Barrionuevo-Sánchez, F J; García-Benítez, B; Expósito-Triano, S

2015-01-01

To evaluate the clinical results and analyse the complications of total reverse shoulder replacement performed in our centre over an 8 year period. A retrospective study was conducted on 50 patients (52 shoulders), with a mean age of 70.15 years (range 51 to 84 years) between December 2004 and December 2012, who received a total reverse shoulder replacement, all performed by the same surgeon. The results have been evaluated according to clinical data, radiography study, a satisfaction scale, and the Constant scale, with a minimum follow-up of 16 months. Five of the cases (9.62%) had been intervened due to fractures of the proximal end of the humerus, 6 cases (11.53%) as surgical consequence of a prosthesis revision, 10 cases (19.23%) due to fracture sequelae, and 30 cases (59.62%) were patients with arthropathy due to a massive fracture of the rotator cuff. After a mean follow up of 35.78 months (range, 16-82), satisfactory clinical results were obtained in 80% of cases, with a mean preoperative Constant of 27.7 points, and reaching 67.1 points 12 months after the operation. On the visual analogue scale, 8.25 points were obtained before the surgery, which decreased to 2.25 points 12 months later. The complications rate was 15.38%, which were due to an intra-operative fracture (1.92%), deep infection (3.84%), instability (3.84%), and early mechanical loosening (3.84%). Scapular notching was observed in the radiographic study in 9 (17.3%) cases. After the results obtained, it could be said that total reverse shoulder replacement achieved encouraging results in the short term for the treatment of glenohumeral arthrosis and massive tears of the rotary cuff. On analysing our series, it can be seen that the complications rate is much higher when it is used to treat fracture sequelae in which there is a loss of proximal humerus bone stock. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

The Wender Utah Rating Scale: Adult ADHD Diagnostic Tool or Personality Index?

ERIC Educational Resources Information Center

Hill, B.D.; Pella, Russell D.; Singh, Ashvind N.; Jones, Glenn N.; Gouvier, Wm. Drew

2009-01-01

Objective: The Wender Utah Rating Scale (WURS) is used to retroactively assess ADHD symptoms. This study sought to determine whether the WURS actually functions as an index of dysfunctional personality traits. Method: Five hundred twenty-two adult participants completed the WURS and at least one of the following measures: Wechsler Adult…

Image quality assessment of automatic three-segment MR attenuation correction vs. CT attenuation correction.

PubMed

Partovi, Sasan; Kohan, Andres; Gaeta, Chiara; Rubbert, Christian; Vercher-Conejero, Jose L; Jones, Robert S; O'Donnell, James K; Wojtylak, Patrick; Faulhaber, Peter

2013-01-01

The purpose of this study is to systematically evaluate the usefulness of Positron emission tomography/Magnetic resonance imaging (PET/MRI) images in a clinical setting by assessing the image quality of Positron emission tomography (PET) images using a three-segment MR attenuation correction (MRAC) versus the standard CT attenuation correction (CTAC). We prospectively studied 48 patients who had their clinically scheduled FDG-PET/CT followed by an FDG-PET/MRI. Three nuclear radiologists evaluated the image quality of CTAC vs. MRAC using a Likert scale (five-point scale). A two-sided, paired t-test was performed for comparison purposes. The image quality was further assessed by categorizing it as acceptable (equal to 4 and 5 on the five-point Likert scale) or unacceptable (equal to 1, 2, and 3 on the five-point Likert scale) quality using the McNemar test. When assessing the image quality using the Likert scale, one reader observed a significant difference between CTAC and MRAC (p=0.0015), whereas the other readers did not observe a difference (p=0.8924 and p=0.1880, respectively). When performing the grouping analysis, no significant difference was found between CTAC vs. MRAC for any of the readers (p=0.6137 for reader 1, p=1 for reader 2, and p=0.8137 for reader 3). All three readers more often reported artifacts on the MRAC images than on the CTAC images. There was no clinically significant difference in quality between PET images generated on a PET/MRI system and those from a Positron emission tomography/Computed tomography (PET/CT) system. PET images using the automatic three-segmented MR attenuation method provided diagnostic image quality. However, future research regarding the image quality obtained using different MR attenuation based methods is warranted before PET/MRI can be used clinically.

Sensitivity and specificity of the Geriatric Anxiety Inventory and the Hospital Anxiety and Depression Scale in the detection of anxiety disorders in older people with chronic obstructive pulmonary disease.

PubMed

Cheung, Gary; Patrick, Colin; Sullivan, Glenda; Cooray, Manisha; Chang, Catherina L

2012-01-01

Anxiety and depression are prevalent in patients with chronic obstructive pulmonary disease (COPD). This study evaluates the sensitivity and specificity of two self-administered anxiety rating scales in older people with COPD. The Geriatric Anxiety Inventory (GAI) and the Hospital Anxiety and Depression Scale (HADS) are established useful screening tools but they have not been previously validated in this population. Older people with COPD completed the GAI and the HADS along with a structured diagnostic psychiatric interview, the Mini International Neuropsychiatric Interview (MINI). The outcomes of both rating scales were compared against the diagnosis of anxiety disorders based on the MINI. Receiver operating characteristic (ROC) curves were used to identify the optimal diagnostic cut points for each scale. Fourteen (25.5%) of the 55 participants, were diagnosed with an anxiety disorder. Mean GAI and HADS-anxiety subscale scores were significantly higher in subjects with an anxiety disorder than those without the diagnosis (p = 0.002 and 0.005 respectively). Both scales demonstrated moderate diagnostic value (area under the ROC curve was 0.83 for GAI and 0.79 for HADS). Optimal cut points were ≥3 (GAI) and ≥4 (HADS-anxiety subscale). At these cut-points, the GAI had a sensitivity of 85.7%, specificity of 78.0% and the HADS had a sensitivity of 78.6%, specificity 70.7%. Our results support the use of the GAI and HADS as screening instruments for anxiety disorders in older people with COPD. The optimal cut points in this population were lower than previously recommended for both rating scales. The results of this study should be replicated before these cut points can be recommended for general use in older people with COPD.

Comparison of morphine and carprofen administered alone or in combination for analgesia in dogs undergoing ovariohysterectomy.

PubMed

Dzikiti, T B; Joubert, K E; Venter, L J; Dzikiti, L N

2006-09-01

In this study the analgesic efficacy of the pure agonistic opioid morphine and the cyclo-oxygenase type-2-selective carprofen were compared since there is no previous specific comparative study for these two common analgesics. Forty-five bitches undergoing elective ovariohysterectomy were randomly assigned to one of three groups; receiving morphine 0.4 mg/kg bodyweight pre-operatively and 0.2 mg/kg every 4-6 hours thereafter (Morphine group), receiving a once-off carprofen 4 mg/kg injection (Carprofen group) or receiving both morphine and carprofen (MorphCarp group). The dogs were premedicated with acepromazine 0.01 mg/kg and induced with either thiopentone 5-10 mg/kg or propofol 4-6 mg/kg. General anaesthesia was maintained with halothane in oxygen. The degree of pain was assessed over a 24-hour period under blinded conditions using a pain scale modified from the University of Melbourne pain scale and the Glasgow composite pain tool. Physiological parameters such as respiratory rate, pulse rate and body temperature were also assessed over the same time period. There was no significant difference in pain-scores and thus analgesia offered by the three analgesia protocols at any assessment point across the three groups, but there were differences within groups across time points. Baseline total pain-scores were lower than scores at all post-operative points within all three groups. Both morphine and carprofen provided good analgesia without any obvious adverse effects. This study indicates that at the dosages indicated above, carprofen administered on its own produces analgesia equal to that produced by morphine and that the two drugs administered together do not produce better analgesia than either drug administered on its own.

The impact of comorbid anxiety disorders on the course of dysthymic disorder: a 5-year prospective longitudinal study.

PubMed

Shankman, Stewart A; Klein, Daniel N

2002-07-01

Few studies have examined the impact of comorbid anxiety disorder on the course of dysthymic disorder despite the high rate of comorbidity between these disorders. This research prospectively examines the naturalistic course of dysthymic disorder in patients with and without a comorbid anxiety disorder over a 5-year period. Thirty-two comorbid patients and 54 non-comorbid patients with dysthymic disorder were assessed at three different time points (baseline, 30 months, and 60 months). Follow-up assessments included the Longitudinal Interval Follow-Up Evaluation and Hamilton Rating Scale for Depression (HRSD). The rate of recovery from dysthymic disorder was significantly lower in patients with (31.3%) than without (61.1%) comorbid anxiety disorders and, at all three time points, patients with comorbid anxiety had significantly higher HRSD scores. The estimated recovery rate from anxiety disorders was 53.8%. Only five of the comorbid patients recovered from both dysthymic disorder and all anxiety disorders during follow-up. Including new onsets, 72.1% of patients experienced an episode of an anxiety disorder during the 5 years. There was no pure anxiety disorder group and patients were asked to report on relatively lengthy follow-up intervals. While the course of dysthymic disorder is debilitating, these results suggest that the prognosis for patients with a comorbid anxiety disorder is even poorer.

Effect of deposition rate on melting point of copper film catalyst substrate at atomic scale

NASA Astrophysics Data System (ADS)

Marimpul, Rinaldo; Syuhada, Ibnu; Rosikhin, Ahmad; Winata, Toto

2018-03-01

Annealing process of copper film catalyst substrate was studied by molcular dynamics simulation. This copper film catalyst substrate was produced using thermal evaporation method. The annealing process was limited in nanosecond order to observe the mechanism at atomic scale. We found that deposition rate parameter affected the melting point of catalyst substrate. The change of crystalline structure of copper atoms was observed before it had been already at melting point. The optimum annealing temperature was obtained to get the highest percentage of fcc structure on copper film catalyst substrate.

Initial Study of Neutral Post-Instruction Responses on the Maryland Physics Expectation Survey

ERIC Educational Resources Information Center

Saltzman, J.; Price, M. F.; Rogers, M. B.

2016-01-01

Epistemological studies generally focus on how students think about their construction of knowledge compared to how experts think about the same ideas. Instruments such as the MPEX and CLASS use a Likert scale to gauge whether students agree or disagree with how experts think about the same ideas. During analysis, five point scale responses are…

Procedural and interpretive skills of medical students: experiences and attitudes of fourth-year students.

PubMed

Wu, Edward H; Elnicki, D Michael; Alper, Eric J; Bost, James E; Corbett, Eugene C; Fagan, Mark J; Mechaber, Alex J; Ogden, Paul E; Sebastian, James L; Torre, Dario M

2008-10-01

Recent data do not exist regarding fourth-year medical students' performance of and attitudes toward procedural and interpretive skills, and how these differ from third-year students'. Cross-sectional survey conducted in February 2006 of 122 fourth-year students from seven U.S. medical schools, compared with their responses in summer 2005. Students estimated their cumulative performance of 22 skills and reported self-confidence and perceived importance using a five-point Likert-type scale. The response rate was 79% (96/122). A majority reported never having performed cardioversion, thoracentesis, cardiopulmonary resuscitation, blood culture, purified protein derivative placement, or paracentesis. One fifth of students had never performed peripheral intravenous catheter insertion, phlebotomy, or arterial blood sampling. Students reported increased cumulative performance of 17 skills, increased self-confidence in five skills, and decreased perceived importance in three skills (two-sided P < .05). A majority of fourth-year medical students still have never performed important procedures, and a substantial minority have not performed basic procedures.

Testing the impact of morphological rate heterogeneity on ancestral state reconstruction of five floral traits in angiosperms.

PubMed

Reyes, Elisabeth; Nadot, Sophie; von Balthazar, Maria; Schönenberger, Jürg; Sauquet, Hervé

2018-06-21

Ancestral state reconstruction is an important tool to study morphological evolution and often involves estimating transition rates among character states. However, various factors, including taxonomic scale and sampling density, may impact transition rate estimation and indirectly also the probability of the state at a given node. Here, we test the influence of rate heterogeneity using maximum likelihood methods on five binary perianth characters, optimized on a phylogenetic tree of angiosperms including 1230 species sampled from all families. We compare the states reconstructed by an equal-rate (Mk1) and a two-rate model (Mk2) fitted either with a single set of rates for the whole tree or as a partitioned model, allowing for different rates on five partitions of the tree. We find strong signal for rate heterogeneity among the five subdivisions for all five characters, but little overall impact of the choice of model on reconstructed ancestral states, which indicates that most of our inferred ancestral states are the same whether heterogeneity is accounted for or not.

Performance characterization of a Bosch CO sub 2 reduction subsystem

NASA Technical Reports Server (NTRS)

Heppner, D. B.; Hallick, T. M.; Schubert, F. H.

1980-01-01

The performance of Bosch hardware at the subsystem level (up to five-person capacity) in terms of five operating parameters was investigated. The five parameters were: (1) reactor temperature, (2) recycle loop mass flow rate, (3) recycle loop gas composition (percent hydrogen), (4) recycle loop dew point and (5) catalyst density. Experiments were designed and conducted in which the five operating parameters were varied and Bosch performance recorded. A total of 12 carbon collection cartridges provided over approximately 250 hours of operating time. Generally, one cartridge was used for each parameter that was varied. The Bosch hardware was found to perform reliably and reproducibly. No startup, reaction initiation or carbon containment problems were observed. Optimum performance points/ranges were identified for the five parameters investigated. The performance curves agreed with theoretical projections.

Psychometric assessment of the Behavior and Attitudes Questionnaire for Healthy Habits: measuring parents' views on food and physical activity.

PubMed

Henry, Beverly W; Smith, Thomas J; Ahmad, Saadia

2014-05-01

To assess parents' perspectives of their home environments to establish the validity of scores from the Behavior and Attitudes Questionnaire for Healthy Habits (BAQ-HH). In the present descriptive study, we surveyed a cross-sectional sample of parents of pre-school children. Questionnaire items developed in an iterative process with community-based programming addressed parents' knowledge/awareness, attitudes/concerns and behaviours about healthy foods and physical activity habits with 6-point rating scales. Exploratory and confirmatory factor analyses were used to psychometrically evaluate scores from the scales. English and Spanish versions of the BAQ-HH were administered at parent-teacher conferences for pre-school children at ten Head Start centres across a five-county agency in autumn 2010. From 672 families with pre-school children, 532 parents provided responses to the BAQ-HH (79 % response rate). The majority was female (83 %), Hispanic (66 %) or white (16 %), and ages ranged from 20 to 39 years (85 %). Exploratory and confirmatory analyses revealed a knowledge scale (seven items), an attitude scale (four items) and three behaviour subscales (three items each). Correlations were identified between parents' perceptions of home activities and reports of children's habits. Differences were identified by gender and ethnicity groupings. As a first step in psychometric testing, the dimensionality of each of the three scales (Knowledge, Attitudes and Behaviours) was identified and scale scores were related to other indicators of child behaviours and parents' demographic characteristics. This questionnaire offers a method to measure parents' views to inform planning and monitoring of obesity-prevention education programmes.

Factors affecting choice of sponsoring institution for residency among medical students in Singapore.

PubMed

Ng, Chew Lip; Liu, Xuan Dao; Murali Govind, Renuka; Tan, Jonathan Wei Jian; Ooi, Shirley Beng Suat; Archuleta, Sophia

2018-03-16

Postgraduate medical education in Singapore underwent major transition recently, from a British-style system and accreditation to a competency-based residency programme modelled after the American system. We aimed to identify the relative importance of factors influencing the choice of residency sponsoring institutions (SIs) among medical students during this transition period. A questionnaire-based cross-sectional study of Singaporean undergraduate medical students across all years of study was performed in 2011. Participants rated 45 factors (including research, academia and education, marketing, reputation of faculty, working conditions, posting experience and influence by peers/seniors) for degree of importance to their choice of SIs on a five-point Likert scale. Differences with respect to gender and seniority were compared. 705 of 1,274 students completed the survey (response rate 55.3%). The top five influencing factors were guidance by mentor (4.48 ± 0.74), reputation for good teaching (4.46 ± 0.76), personal overall experience in SIs (4.41 ± 0.88), quality of mentorship and supervision (4.41 ± 0.75), and quality and quantity of teaching (4.37 ± 0.78). The five lowest-rated factors were social networking (2.91 ± 1.00), SI security (3.01 ± 1.07), open house impact (3.15 ± 0.96), advertising paraphernalia (3.17 ± 0.95) and research publications (3.21 ± 1.00). Female students attributed more importance to security and positive work environment. Preclinical students rated research and marketing aspects more highly while clinical students valued positive work environment more. Quality of education, mentorship, experiences during clerkship and positive working environment were the most important factors influencing the choice of SIs.

Breaking bad news in clinical setting - health professionals' experience and perceived competence in Southwestern Nigeria: a cross sectional study.

PubMed

Adebayo, Philip Babatunde; Abayomi, Olukayode; Johnson, Peter O; Oloyede, Taofeeq; Oyelekan, Abimbola A A

2013-01-01

Communication skills are vital in clinical settings because the manner in which bad news is delivered could be a huge determinant of responses to such news; as well as compliance with beneficial treatment option. Information on training, institutional guidelines and protocols for breaking bad news (BBN) is scarce in Nigeria. We assessed the training, experience and perceived competence of BBN among medical personnel in southwestern Nigeria. The study was a cross-sectional descriptive study conducted out among doctors and nurses in two healthcare institutions in southwestern Nigeria using an anonymous questionnaire (adapted from the survey by Horwitz et al.), which focused on the respondents training, awareness of protocols in BBN; and perceived competence (using a Five-Point Likert Scale) in five clinical scenarios. We equally asked the respondents about an instance of BBN they have recently witnessed. A total of 113 of 130 selected (response rate 86.9%) respondents were studied. Eight (7.1%) of the respondents knew of the guidelines on BBN in the hospital in which they work. Twenty-three (20.3%) respondents claimed knowledge of a protocol. The median perceived competence rating was 4 out of 5 in all the clinical scenarios. Twenty-five (22.1%) respondents have had a formal training in BBN and they generally had significant higher perceived competence rating (P = 0.003-0.021). There is poor support from fellow workers during instances of BBN. It appears that the large proportion of the respondents in this study were unconsciously incompetent in BBN in view of the low level of training and little or no knowledge of well known protocols for BBN even though self-rated competence is high. Continuous medical education in communication skills among health personnel in Nigeria is advocated.

An Independent Investigation into the Psychometric Properties of the Adult Scale of Hostility and Aggression (A-SHARP)

ERIC Educational Resources Information Center

Rojahn, Johannes; Rick-Betancourt, Brittney; Barnard-Brak, Lucy; Moore, Linda

2017-01-01

Background: The Adult Scale of Hostility and Aggression (A-SHARP) rating scale assesses the frequency/severity (problem scale) and the reactive-proactive motivation (provocation scale) of aggressive behaviors in adults with intellectual disabilities (ID). Items are assigned to five subscales (Verbal Aggression, Physical Aggression, Hostile Affect,…

Visual judgements of steadiness in one-legged stance: reliability and validity.

PubMed

Haupstein, T; Goldie, P

2000-01-01

There is a paucity of information about the validity and reliability of clinicians' visual judgements of steadiness in one-legged stance. Such judgements are used frequently in clinical practice to support decisions about treatment in the fields of neurology, sports medicine, paediatrics and orthopaedics. The aim of the present study was to address the validity and reliability of visual judgements of steadiness in one-legged stance in a group of physiotherapists. A videotape of 20 five-second performances was shown to 14 physiotherapists with median clinical experience of 6.75 years. Validity of visual judgement was established by correlating scores obtained from an 11-point rating scale with criterion scores obtained from a force platform. In addition, partial correlations were used to control for the potential influence of body weight on the relationship between the visual judgements and criterion scores. Inter-observer reliability was quantified between the physiotherapists; intra-observer reliability was quantified between two tests four weeks apart. Mean criterion-related validity was high, regardless of whether body weight was controlled for statistically (Pearson's r = 0.84, 0.83, respectively). The standard error of estimating the criterion score was 3.3 newtons. Inter-observer reliability was high (ICC (2,1) = 0.81 at Test 1 and 0.82 at Test 2). Intra-observer reliability was high (on average ICC (2,1) = 0.88; Pearson's r = 0.90). The standard error of measurement for the 11-point scale was one unit. The finding of higher accuracy of making visual judgements than previously reported may be due to several aspects of design: use of a criterion score derived from the variability of the force signal which is more discriminating than variability of centre of pressure; use of a discriminating visual rating scale; specificity and clear definition of the phenomenon to be rated.

rTMS: A Treatment to Restore Function After Severe TBI

DTIC Science & Technology

2016-10-01

of rTMS-induced neurobehavioral effects measured with the Disability Rating Scale. Aim II will determine the presence, direction and sustainability...Aim IV addresses the need to confirm rTMS safety for severe TBI. 15. SUBJECT TERMS Disability Rating Scale (DRS), Neurobehavioral, Repetitive...rTMS sessions. The Disability Rating Scale (DRS) will be used at four time points to measure neurobehavioral recovery slopes. Net neural effects

The reliability of a severity rating scale to measure stuttering in an unfamiliar language.

PubMed

Hoffman, Laura; Wilson, Linda; Copley, Anna; Hewat, Sally; Lim, Valerie

2014-06-01

With increasing multiculturalism, speech-language pathologists (SLPs) are likely to work with stuttering clients from linguistic backgrounds that differ from their own. No research to date has estimated SLPs' reliability when measuring severity of stuttering in an unfamiliar language. Therefore, this study was undertaken to estimate the reliability of SLPs' use of a 9-point severity rating (SR) scale, to measure severity of stuttering in a language that was different from their own. Twenty-six Australian SLPs rated 20 speech samples (10 Australian English [AE] and 10 Mandarin) of adults who stutter using a 9-point SR scale on two separate occasions. Judges showed poor agreement when using the scale to measure stuttering in Mandarin samples. Results also indicated that 50% of individual judges were unable to reliably measure the severity of stuttering in AE. The results highlight the need for (a) SLPs to develop intra- and inter-judge agreement when using the 9-point SR scale to measure severity of stuttering in their native language (in this case AE) and in unfamiliar languages; and (b) research into the development and evaluation of practice and/or training packages to assist SLPs to do so.

Final Pilot Performance Rating Scales.

ERIC Educational Resources Information Center

Horner, Walter R.; And Others

These rating scales are intended for evaluation of student pilot performance. Each student is evaluated individually on the basis of video recordings of the student in flight. Ten point rating lines are used for the ten criterion performance elements of each of three maneuvers, (1) Final Turn to Landing, (2) Lazy Eight, and (3) Vertical S "A".…

Community structure of aquatic insects in the Esparza River, Costa Rica.

PubMed

Herrera-Vásquez, Jonathan

2009-01-01

This study focused on the structure of the aquatic insect community in spatial and temporal scales in the Esparza River. The river was sampled for one full year throughout 2007. During the dry season low flow months, five sampling points were selected in two different habitats (currents and pools), with five replicates per sample site. During the wet season with peak rain, only the data in the "current habitat" were sampled at each site. Specimens present in the different substrates were collected and preserved in situ. A nested ANOVA was then applied to the data to determine richness and density as the response variables. The variations in temporal and spatial scales were analyzed using width, depth and discharge of the river, and then analyzed using a nested ANOVA. Only a correlation of 51% similarity in richness was found, while in spatial scale, richness showed significant variation between sampling sites, but not between habitats. However, the temporal scale showed significant differences between habitats. Density showed differences between sites and habitats during the dry season in the spatial scale, while in the temporal scale significant variation was found between sampling sites. Width varied between habitats during the dry season, but not between sampling points. Depth showed differences between sampling sites and season. This work studies the importance of community structure of aquatic insects in rivers, and its relevance for the quality of water in rivers and streams.

Technical Analysis of the Disruptive Behavior Rating Scale--Second Edition--Teacher Version

ERIC Educational Resources Information Center

Erford, Bradley T.; Clark, Kelly

2011-01-01

The reliability and validity of scores on the Disruptive Behavior Rating Scale-second edition-teacher version (DBRS-II-T) was analyzed. The DBRS-II-T was designed to assess teacher observations of students referred for behavioral difficulties. The five-factor model fit the data poorly, but convergent and diagnostic validities were excellent.…

Assessing the Quality of Problems in Problem-Based Learning

ERIC Educational Resources Information Center

Sockalingam, Nachamma; Rotgans, Jerome; Schmidt, Henk

2012-01-01

This study evaluated the construct validity and reliability of a newly devised 32-item problem quality rating scale intended to measure the quality of problems in problem-based learning. The rating scale measured the following five characteristics of problems: the extent to which the problem (1) leads to learning objectives, (2) is familiar, (3)…

The Bereaved Parent Needs Assessment: a new instrument to assess the needs of parents whose children died in the pediatric intensive care unit*.

PubMed

Meert, Kathleen L; Templin, Thomas N; Michelson, Kelly N; Morrison, Wynne E; Hackbarth, Richard; Custer, Joseph R; Schim, Stephanie M; Briller, Sherylyn H; Thurston, Celia S

2012-11-01

To evaluate the reliability and validity of the Bereaved Parent Needs Assessment, a new instrument to measure parents' needs and need fulfillment around the time of their child's death in the pediatric intensive care unit. We hypothesized that need fulfillment would be negatively related to complicated grief and positively related to quality of life during bereavement. Cross-sectional survey. Five U.S. children's hospital pediatric intensive care units. Parents (n = 121) bereaved in a pediatric intensive care unit 6 months earlier. Surveys included the 68-item Bereaved Parent Needs Assessment, the Inventory of Complicated Grief, and the abbreviated version of the World Health Organization Quality of Life questionnaire. Each Bereaved Parent Needs Assessment item described a potential need and was rated on two scales: 1) a 5-point rating of importance (1 = not at all important, 5 = very important) and 2) a 5-point rating of fulfillment (1 = not at all met, 5 = completely met). Three composite scales were computed: 1) total importance (percentage of all needs rated ≥4 for importance), 2) total fulfillment (percentage of all needs rated ≥4 for fulfillment), and 3) percent fulfillment (percentage of important needs that were fulfilled). Internal consistency reliability was assessed by Cronbach's α and Spearman-Brown-corrected split-half reliability. Generalized estimating equations were used to test predictions between composite scales and the Inventory of Complicated Grief and World Health Organization Quality of Life questionnaire. Two items had mean importance ratings <3, and 55 had mean ratings >4. Reliability of composite scores ranged from 0.92 to 0.94. Total fulfillment was negatively correlated with Inventory of Complicated Grief (r = -.29; p < .01) and positively correlated with World Health Organization Quality of Life questionnaire (r = .21; p < .05). Percent fulfillment was also significantly correlated with both outcomes. Adjusting for parent's age, education, and loss of an only child, percent fulfillment remained significantly correlated with Inventory of Complicated Grief but not with World Health Organization Quality of Life questionnaire. The Bereaved Parent Needs Assessment demonstrated reliability and validity to assess the needs of parents bereaved in the pediatric intensive care unit. Meeting parents' needs around the time of their child's death may promote adjustment to loss.

[Validation of the Montgomery-Åsberg Depression Rating Scale (MADRS) in Colombia].

PubMed

Cano, Juan Fernando; Gomez Restrepo, Carlos; Rondón, Martín

2016-01-01

To adapt and to validate the Montgomery-Åsberg Depression Rating Scale (MADRS) in Colombia. Observational study for scale validation. Validity criteria were used to determine the severity cut-off points of the tool. Taking into account sensitivity and specificity values, those cut points were contrasted with ICD-10 criteria for depression severity. A a factor analysis was performed. The internal consistencY was determined with the same sample of patients used for the validity criteria. Inter-rater reliability was assessed by evaluating the 22 records of the patients that consented to a video interview. Sensitivity to change was established through a second application of the scale in 28 subjects after a lapse of 14 to 28 days. The study was performed in Bogotá, the tool was applied in 150 patients suffering from major depressive disorder. The cut-off point for moderate depression was 20 (sensitivity, 98%; specificity, 96%), and the cut-off point for severe depression was 34 (sensitivity, 98%; specificity, 92%). The tool appears as a unidimensional scale, which possesses a good internal consistency with (α=.9168). The findings of inter-rater reliability evaluation showed the scale as highly reliable (intraclass correlation coefficient=.9833). The instrument has a good sensitivity to change. The Colombian version of the Montgomery-Åsberg Depression Rating Scale has good psychometric properties and can be used in clinical practice and in clinical research in the field of depressive disorder. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

A new type of single-phase five-level inverter

NASA Astrophysics Data System (ADS)

Xu, Zhi; Li, Shengnan; Qin, Risheng; Zhao, Yanhang

2017-11-01

At present, Neutral Point Clamped (NPC) multilevel inverter is widely applied in new energy field. However, it has some disadvantages including low utilization rate of direct current (DC) voltage source and the unbalance of neutral potential. Therefore, a new single-phase five level inverter is proposed in this paper. It has two stage structure, the former stage is equivalent to three level DC/DC converter, and the back stage uses H bridge to realize inverter. Compared with the original central clamp type inverter, the new five level inverter can improve the utilization of DC voltage, and realize the neutral point potential balance with hysteresis comparator.

PROP (6-n-Propylthiouracil) tasting and sensory responses to caffeine,sucrose, neohesperidin dihydrochalcone and chocolate.

PubMed

Ly, A; Drewnowski, A

2001-01-01

The genetically determined ability to taste 6-n-propylthiouracil (PROP) has been linked with lowered acceptance of some bitter foods. Fifty-four women, aged 18-30 years, tasted and rated PROP-impregnated filter paper and seven solutions of PROP. Summed bitterness intensity ratings for PROP solutions determined PROP taster status. Respondents also tasted five sucrose and seven caffeine solutions, as well as seven solutions each of caffeine and PROP that had been sweetened with 0.3 mmol/l neohesperidin dihydrochalcone (NHDC). Respondents also rated three kinds of chocolate using 9-point category scales. PROP tasters rated caffeine solutions as more bitter than did non-tasters and liked them less. PROP tasters did not rate either sucrose or NHDC as more sweet. The addition of NHDC to PROP and caffeine solutions suppressed bitterness intensity more effectively for tasters than for non-tasters and improved hedonic ratings among both groups. PROP tasters and non-tasters showed the same hedonic response to sweetened caffeine solutions and did not differ in their sensory responses to chocolate. Genetic taste markers may have only a minor impact on the consumption of such foods as sweetened coffee or chocolate.

Prediction of drug indications based on chemical interactions and chemical similarities.

PubMed

Huang, Guohua; Lu, Yin; Lu, Changhong; Zheng, Mingyue; Cai, Yu-Dong

2015-01-01

Discovering potential indications of novel or approved drugs is a key step in drug development. Previous computational approaches could be categorized into disease-centric and drug-centric based on the starting point of the issues or small-scaled application and large-scale application according to the diversity of the datasets. Here, a classifier has been constructed to predict the indications of a drug based on the assumption that interactive/associated drugs or drugs with similar structures are more likely to target the same diseases using a large drug indication dataset. To examine the classifier, it was conducted on a dataset with 1,573 drugs retrieved from Comprehensive Medicinal Chemistry database for five times, evaluated by 5-fold cross-validation, yielding five 1st order prediction accuracies that were all approximately 51.48%. Meanwhile, the model yielded an accuracy rate of 50.00% for the 1st order prediction by independent test on a dataset with 32 other drugs in which drug repositioning has been confirmed. Interestingly, some clinically repurposed drug indications that were not included in the datasets are successfully identified by our method. These results suggest that our method may become a useful tool to associate novel molecules with new indications or alternative indications with existing drugs.

Prediction of Drug Indications Based on Chemical Interactions and Chemical Similarities

PubMed Central

Huang, Guohua; Lu, Yin; Lu, Changhong; Cai, Yu-Dong

2015-01-01

Discovering potential indications of novel or approved drugs is a key step in drug development. Previous computational approaches could be categorized into disease-centric and drug-centric based on the starting point of the issues or small-scaled application and large-scale application according to the diversity of the datasets. Here, a classifier has been constructed to predict the indications of a drug based on the assumption that interactive/associated drugs or drugs with similar structures are more likely to target the same diseases using a large drug indication dataset. To examine the classifier, it was conducted on a dataset with 1,573 drugs retrieved from Comprehensive Medicinal Chemistry database for five times, evaluated by 5-fold cross-validation, yielding five 1st order prediction accuracies that were all approximately 51.48%. Meanwhile, the model yielded an accuracy rate of 50.00% for the 1st order prediction by independent test on a dataset with 32 other drugs in which drug repositioning has been confirmed. Interestingly, some clinically repurposed drug indications that were not included in the datasets are successfully identified by our method. These results suggest that our method may become a useful tool to associate novel molecules with new indications or alternative indications with existing drugs. PMID:25821813

Hormone Replacement Therapy and Opioid Tapering for Opioid-Induced Hypogonadism Among Patients with Chronic Noncancer Pain: A Systematic Review.

PubMed

AminiLari, Mahmood; Manjoo, Priya; Craigie, Samantha; Couban, Rachel; Wang, Li; Busse, Jason W

2018-05-02

To systematically review evidence addressing the efficacy of testosterone replacement therapy (TRT) and opioid tapering for opioid-induced hypogonadism among patients with chronic noncancer pain. Systematic review of randomized controlled trials (RCTs) and observational studies. We searched MEDLINE, CINAHL, AMED, CENTRAL, CINAHL, DARE, EMBASE, and PsycINFO through August 2017. Eligible studies enrolled ≥10 patients with chronic noncancer pain and opioid-induced hypogonadism and reported the effect of TRT or opioid tapering on a patient-important outcome collected ≥14 days after treatment. Pairs of reviewers independently screened for eligible studies, assessed risk of bias, and extracted data. We used the GRADE approach to rate quality of evidence. Of 666 abstracts reviewed, five studies including one RCT (N = 84) and four observational studies (N = 157) were eligible. No studies explored the effect of opioid tapering for opioid-induced hypogonadism. Very low-quality evidence found that TRT was associated with improvements in pain (median reduction of 2 points on the 11-point numerical rating scale for pain; 95% confidence interval [CI] = -1.4 to -2.6; minimally important difference [MID] = 2 points), and emotional functioning (mean increase of 9 points on the 100-point SF-36 Mental Component Summary score; 95% CI = 4.40 to 13.60; MID = 5 points). Low-quality evidence suggested that TRT had no effect on sleep quality, sexual function, physical functioning, role functioning, or social functioning; very low-quality evidence suggested no association with depressive symptoms. Low-quality to very low-quality evidence suggests that TRT may improve pain and emotional functioning, but not other outcomes, in chronic noncancer pain patients with opioid-induced hypogonadism.

Profiling medical school learning environments in Malaysia: a validation study of the Johns Hopkins Learning Environment Scale.

PubMed

Tackett, Sean; Bakar, Hamidah Abu; Shilkofski, Nicole A; Coady, Niamh; Rampal, Krishna; Wright, Scott

2015-01-01

While a strong learning environment is critical to medical student education, the assessment of medical school learning environments has confounded researchers. Our goal was to assess the validity and utility of the Johns Hopkins Learning Environment Scale (JHLES) for preclinical students at three Malaysian medical schools with distinct educational and institutional models. Two schools were new international partnerships, and the third was school leaver program established without international partnership. First- and second-year students responded anonymously to surveys at the end of the academic year. The surveys included the JHLES, a 28-item survey using five-point Likert scale response options, the Dundee Ready Educational Environment Measure (DREEM), the most widely used method to assess learning environments internationally, a personal growth scale, and single-item global learning environment assessment variables. The overall response rate was 369/429 (86%). After adjusting for the medical school year, gender, and ethnicity of the respondents, the JHLES detected differences across institutions in four out of seven domains (57%), with each school having a unique domain profile. The DREEM detected differences in one out of five categories (20%). The JHLES was more strongly correlated than the DREEM to two thirds of the single-item variables and the personal growth scale. The JHLES showed high internal reliability for the total score (α=0.92) and the seven domains (α, 0.56-0.85). The JHLES detected variation between learning environment domains across three educational settings, thereby creating unique learning environment profiles. Interpretation of these profiles may allow schools to understand how they are currently supporting trainees and identify areas needing attention.

Profiling medical school learning environments in Malaysia: a validation study of the Johns Hopkins Learning Environment Scale

PubMed Central

Tackett, Sean; Bakar, Hamidah Abu; Shilkofski, Nicole A.; Coady, Niamh; Rampal, Krishna; Wright, Scott

2015-01-01

Purpose: While a strong learning environment is critical to medical student education, the assessment of medical school learning environments has confounded researchers. Our goal was to assess the validity and utility of the Johns Hopkins Learning Environment Scale (JHLES) for preclinical students at three Malaysian medical schools with distinct educational and institutional models. Two schools were new international partnerships, and the third was school leaver program established without international partnership. Methods: First- and second-year students responded anonymously to surveys at the end of the academic year. The surveys included the JHLES, a 28-item survey using five-point Likert scale response options, the Dundee Ready Educational Environment Measure (DREEM), the most widely used method to assess learning environments internationally, a personal growth scale, and single-item global learning environment assessment variables. Results: The overall response rate was 369/429 (86%). After adjusting for the medical school year, gender, and ethnicity of the respondents, the JHLES detected differences across institutions in four out of seven domains (57%), with each school having a unique domain profile. The DREEM detected differences in one out of five categories (20%). The JHLES was more strongly correlated than the DREEM to two thirds of the single-item variables and the personal growth scale. The JHLES showed high internal reliability for the total score (α=0.92) and the seven domains (α, 0.56-0.85). Conclusion: The JHLES detected variation between learning environment domains across three educational settings, thereby creating unique learning environment profiles. Interpretation of these profiles may allow schools to understand how they are currently supporting trainees and identify areas needing attention. PMID:26165949

Outbreak statistics and scaling laws for externally driven epidemics.

PubMed

Singh, Sarabjeet; Myers, Christopher R

2014-04-01

Power-law scalings are ubiquitous to physical phenomena undergoing a continuous phase transition. The classic susceptible-infectious-recovered (SIR) model of epidemics is one such example where the scaling behavior near a critical point has been studied extensively. In this system the distribution of outbreak sizes scales as P(n)∼n-3/2 at the critical point as the system size N becomes infinite. The finite-size scaling laws for the outbreak size and duration are also well understood and characterized. In this work, we report scaling laws for a model with SIR structure coupled with a constant force of infection per susceptible, akin to a "reservoir forcing". We find that the statistics of outbreaks in this system fundamentally differ from those in a simple SIR model. Instead of fixed exponents, all scaling laws exhibit tunable exponents parameterized by the dimensionless rate of external forcing. As the external driving rate approaches a critical value, the scale of the average outbreak size converges to that of the maximal size, and above the critical point, the scaling laws bifurcate into two regimes. Whereas a simple SIR process can only exhibit outbreaks of size O(N1/3) and O(N) depending on whether the system is at or above the epidemic threshold, a driven SIR process can exhibit a richer spectrum of outbreak sizes that scale as O(Nξ), where ξ∈(0,1]∖{2/3} and O((N/lnN)2/3) at the multicritical point.

Patient satisfaction with intravenous acetaminophen: a pooled analysis of five randomized, placebo-controlled studies in the acute postoperative setting.

PubMed

Apfel, Christian C; Souza, Kimberly; Portillo, Juan; Dalal, Poorvi; Bergese, Sergio D

2015-01-01

Intravenous (IV) acetaminophen has been shown to reduce postoperative pain and opioid consumption, which may lead to increased patient satisfaction. To determine the effect IV acetaminophen has on patient satisfaction, a pooled analysis from methodologically homogenous studies was conducted. We obtained patient-level data from five randomized, placebo-controlled studies in adults undergoing elective surgery in which patient satisfaction was measured using a 4-point categorical rating scale. The primary endpoint was "excellent" satisfaction and the secondary endpoint was "good" or "excellent" satisfaction at 24 hr after first study drug administration. Bivariate analyses were conducted using the chi-square test and Student's t-test and multivariable analyses were conducted using logistic regression analysis. Patients receiving IV acetaminophen were more than twice as likely as those who received placebo to report "excellent" patient satisfaction ratings (32.3% vs. 15.9%, respectively). Of all variables that remained statistically significant in the multivariable analysis (i.e., type of surgery, duration of anesthesia, last pain rating, and opioid consumption), IV acetaminophen had the strongest positive effect on "excellent" patient satisfaction with an odds ratio of 2.76 (95% CI 1.81-4.23). Results for "excellent" or "good" satisfaction were similar. When given as part of a perioperative analgesic regimen, IV acetaminophen was associated with significantly improved patient satisfaction.

Specific treatment of problems of the spine (STOPS): design of a randomised controlled trial comparing specific physiotherapy versus advice for people with subacute low back disorders

PubMed Central

2011-01-01

Background Low back disorders are a common and costly cause of pain and activity limitation in adults. Few treatment options have demonstrated clinically meaningful benefits apart from advice which is recommended in all international guidelines. Clinical heterogeneity of participants in clinical trials is hypothesised as reducing the likelihood of demonstrating treatment effects, and sampling of more homogenous subgroups is recommended. We propose five subgroups that allow the delivery of specific physiotherapy treatment targeting the pathoanatomical, neurophysiological and psychosocial components of low back disorders. The aim of this article is to describe the methodology of a randomised controlled trial comparing specific physiotherapy treatment to advice for people classified into five subacute low back disorder subgroups. Methods/Design A multi-centre parallel group randomised controlled trial is proposed. A minimum of 250 participants with subacute (6 weeks to 6 months) low back pain and/or referred leg pain will be classified into one of five subgroups and then randomly allocated to receive either physiotherapy advice (2 sessions over 10 weeks) or specific physiotherapy treatment (10 sessions over 10 weeks) tailored according to the subgroup of the participant. Outcomes will be assessed at 5 weeks, 10 weeks, 6 months and 12 months following randomisation. Primary outcomes will be activity limitation measured with a modified Oswestry Disability Index as well as leg and back pain intensity measured on separate 0-10 Numerical Rating Scales. Secondary outcomes will include a 7-point global rating of change scale, satisfaction with physiotherapy treatment, satisfaction with treatment results, the Sciatica Frequency and Bothersomeness Scale, quality of life (EuroQol-5D), interference with work, and psychosocial risk factors (Orebro Musculoskeletal Pain Questionnaire). Adverse events and co-interventions will also be measured. Data will be analysed according to intention to treat principles, using linear mixed models for continuous outcomes, Mann Whitney U tests for ordinal outcomes, and Chi-square, risk ratios and risk differences for dichotomous outcomes. Discussion This trial will determine the difference in outcomes between specific physiotherapy treatment tailored to each of the five subgroups versus advice which is recommended in guidelines as a suitable treatment for most people with a low back disorder. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12609000834257. PMID:21599941

Perceived impact and feasibility of strategies to improve access to healthy foods in Washington State, USA.

PubMed

Johnson, Donna B; Quinn, Emilee L; Podrabsky, Mary; Beckwith-Stanley, Nadia; Chan, Nadine; Ellings, Amy; Kovacs, Tricia; Lane, Claire

2013-12-01

The present study measured the perceived impact and political and implementation feasibility of state-level policy strategies related to increasing access to healthy foods and limiting unhealthy foods. Potential state-level policy strategies to improve access to healthy foods were identified through a review of evidence-based literature and policy recommendations. Respondents rated the perceived impact and political and implementation feasibility of each policy on a five-point scale using online surveys. Washington State policy process. Forty-nine content experts (national researchers and subject experts), forty policy experts (state elected officials or their staff, gubernatorial or legislative policy analysts) and forty-five other stakeholders (state-level advocates, programme administrators, food producers). In aggregate, respondents rated policy impact and implementation feasibility higher than political feasibility. Policy experts rated policy strategies as less politically feasible compared with content experts (P < 0·02) or other stakeholders (P < 0·001). Eight policy strategies were rated above the median for impact and political and implementation feasibility. These included policies related to nutrition standards in schools and child-care facilities, food distribution systems, urban planning projects, water availability, joint use agreements and breast-feeding supports. Although they may be perceived as potentially impactful, some policies will be more difficult to enact than others. Information about the potential feasibility of policies to improve access to healthy foods can be used to focus limited policy process resources on strategies with the highest potential for enactment, implementation and impact.

An investigation of ride quality rating scales

NASA Technical Reports Server (NTRS)

Dempsey, T. K.; Coates, G. D.; Leatherwood, J. D.

1977-01-01

An experimental investigation was conducted for the combined purposes of determining the relative merits of various category scales for the prediction of human discomfort response to vibration and for determining the mathematical relationships whereby subjective data are transformed from one scale to other scales. There were 16 category scales analyzed representing various parametric combinations of polarity, that is, unipolar and bipolar, scale type, and number of scalar points. Results indicated that unipolar continuous-type scales containing either seven or nine scalar points provide the greatest reliability and discriminability. Transformations of subjective data between category scales were found to be feasible with unipolar scales of a larger number of scalar points providing the greatest accuracy of transformation. The results contain coefficients for transformation of subjective data between the category scales investigated. A result of particular interest was that the comfort half of a bipolar scale was seldom used by subjects to describe their subjective reaction to vibration.

Motivational Differences in Seeking Out Evaluative Categorization Information.

PubMed

Smallman, Rachel; Becker, Brittney

2017-07-01

Previous research shows that people draw finer evaluative distinctions when rating liked versus disliked objects (e.g., wanting a 5-point scale to evaluate liked cuisines and a 3-point scale to rate disliked cuisines). Known as the preference-categorization effect, this pattern may exist not only in how individuals form evaluative distinctions but also in how individuals seek out evaluative information. The current research presents three experiments that examine motivational differences in evaluative information seeking (rating scales and attributes). Experiment 1 found that freedom of choice (the ability to avoid undesirable stimuli) and sensitivity to punishment (as measured by the Behavior Inhibition System/Behavioral Approach System [BIS/BAS] scale) influenced preferences for desirable and undesirable evaluative information in a health-related decision. Experiment 2 examined choice optimization, finding that maximizers prefer finer evaluative information for both liked and disliked options in a consumer task. Experiment 3 found that this pattern generalizes to another type of evaluative categorization, attributes.

Development and Validation of a Photonumeric Scale for Evaluation of Facial Skin Texture

PubMed Central

Carruthers, Alastair; Hardas, Bhushan; Murphy, Diane K.; Carruthers, Jean; Jones, Derek; Sykes, Jonathan M.; Creutz, Lela; Marx, Ann; Dill, Sara

2016-01-01

BACKGROUND A validated scale is needed for objective and reproducible comparisons of facial skin roughness before and after aesthetic treatment in practice and in clinical studies. OBJECTIVE To describe the development and validation of the 5-point photonumeric Allergan Skin Roughness Scale. METHODS The scale was developed to include an assessment guide, verbal descriptors, morphed images, and real subject images for each grade. The clinical significance of a 1-point score difference was evaluated in a review of image pairs representing varying differences in severity. Interrater and intrarater reliability was evaluated in a live-subject validation study (N = 290) completed during 2 sessions occurring 3 weeks apart. RESULTS A score difference of ≥1 point was shown to reflect a clinically meaningful difference (mean [95% confidence interval] absolute score difference 1.09 [0.96–1.23] for clinically different image pairs and 0.53 [0.38–0.67] for not clinically different pairs). Intrarater agreement between the 2 validation sessions was almost perfect (weighted kappa = 0.83). Interrater agreement was almost perfect during the second rating session (0.81, primary end point). CONCLUSION The Allergan Skin Roughness Scale is a validated and reliable scale for physician rating of midface skin roughness. PMID:27661744

The influence of first impressions on subsequent ratings within an OSCE station.

PubMed

Wood, Timothy J; Chan, James; Humphrey-Murto, Susan; Pugh, Debra; Touchie, Claire

2017-10-01

Competency-based assessment is placing increasing emphasis on the direct observation of learners. For this process to produce valid results, it is important that raters provide quality judgments that are accurate. Unfortunately, the quality of these judgments is variable and the roles of factors that influence the accuracy of those judgments are not clearly understood. One such factor is first impressions: that is, judgments about people we do not know, made quickly and based on very little information. This study explores the influence of first impressions in an OSCE. Specifically, the purpose is to begin to examine the accuracy of a first impression and its influence on subsequent ratings. We created six videotapes of history-taking performance. Each video was scripted from a real performance by six examinee residents within a single OSCE station. Each performance was re-enacted with six different actors playing the role of the examinees and one actor playing the role of the patient and videotaped. A total of 23 raters (i.e., physician examiners) reviewed each video and were asked to make a global judgment of the examinee's clinical abilities after 60 s (First Impression GR) by providing a rating on a six-point global rating scale and then to rate their confidence in the accuracy of that judgment by providing a rating on a five-point rating scale (Confidence GR). After making these ratings, raters then watched the remainder of the examinee's performance and made another global rating of performance (Final GR) before moving on to the next video. First impression ratings of ability varied across examinees and were moderately correlated to expert ratings (r = .59, 95% CI [-.13, .90]). There were significant differences in mean ratings for three examinees. Correlations ranged from .05 to .56 but were only significant for three examinees. Rater confidence in their first impression was not related to the likelihood of a rater changing their rating between the first impression and a subsequent rating. The findings suggest that first impressions could play a role in explaining variability in judgments, but their importance was determined by the videotaped performance of the examinees. More work is needed to clarify conditions that support or discourage the use of first impressions.

Developing a Teacher Administered Anxiety Rating Scale Suitable for Five to Seven-Year-Old Children

ERIC Educational Resources Information Center

Goulet, Joseph

2013-01-01

This paper presents results of twin studies pertinent to the development of a rating scale designed for use by teachers to identify anxious and shy children, aged 5 to 7 years, in Kindergarten and Grade One. Currently, no instruments designed specifically for this purpose exist. Children experiencing difficulty with internalizing disorders such as…

Retrospective Assessment of ADHD Symptoms in Childhood: Discriminatory Validity of Finnish Translation of the Wender Utah Rating Scale

ERIC Educational Resources Information Center

Kivisaari, Sasa; Laasonen, Marja; Leppamaki, Sami; Tani, Pekka; Hokkanen, Laura

2012-01-01

Objective: To examine the discriminatory validity of the Wender Utah Rating Scale (WURS) and its five suggested subscales (Conduct Problems, Impulsivity Problems, Mood Difficulties, Inattention/Anxiety, Academic Concerns) in a Finnish sample. Method: WURS was administered to 114 adults, aged 18 to 55 years. Participants with ADHD (n = 37) and…

Development and validation of a professionalism assessment scale for medical students

PubMed Central

Klemenc-Ketis, Zalika; Vrecko, Helena

2014-01-01

Objectives To develop and validate a scale for the assess-ment of professionalism in medical students based on students' perceptions of and attitudes towards professional-ism in medicine. Methods This was a mixed methods study with under-graduate medical students. Two focus groups were carried out with 12 students, followed by a transcript analysis (grounded theory method with open coding). Then, a 3-round Delphi with 20 family medicine experts was carried out. A psychometric assessment of the scale was performed with a group of 449 students. The items of the Professional-ism Assessment Scale could be answered on a five-point Likert scale. Results After the focus groups, the first version of the PAS consisted of 56 items and after the Delphi study, 30 items remained. The final sample for quantitative study consisted of 122 students (27.2% response rate). There were 95 (77.9%) female students in the sample. The mean age of the sample was 22.1 ± 2.1 years. After the principal component analysis, we removed 8 items and produced the final version of the PAS (22 items). The Cronbach's alpha of the scale was 0.88. Factor analysis revealed three factors: empathy and humanism, professional relationships and development and responsibility. Conclusions The new Professionalism Assessment Scale proved to be valid and reliable. It can be used for the assessment of professionalism in undergraduate medical students. PMID:25382090

Development of a scale to measure individuals’ ratings of peace

PubMed Central

2014-01-01

Background The evolving concept of peace-building and the interplay between peace and health is examined in many venues, including at the World Health Assembly. However, without a metric to determine effectiveness of intervention programs all efforts are prone to subjective assessment. This paper develops a psychometric index that lays the foundation for measuring community peace stemming from intervention programs. Methods After developing a working definition of ‘peace’ and delineating a Peace Evaluation Across Cultures and Environments (PEACE) scale with seven constructs comprised of 71 items, a beta version of the index was pilot-tested. Two hundred and fifty subjects in three sites in the U.S. were studied using a five-point Likert scale to evaluate the psychometric functioning of the PEACE scale. Known groups validation was performed using the SOS-10. In addition, test-retest reliability was performed on 20 subjects. Results The preliminary data demonstrated that the scale has acceptable psychometric properties for measuring an individual’s level of peacefulness. The study also provides reliability and validity data for the scale. The data demonstrated internal consistency, correlation between data and psychological well-being, and test-retest reliability. Conclusions The PEACE scale may serve as a novel assessment tool in the health sector and be valuable in monitoring and evaluating the peace-building impact of health initiatives in conflict-affected regions. PMID:25298781

Adapting the McMaster-Ottawa scale and developing behavioral anchors for assessing performance in an interprofessional Team Observed Structured Clinical Encounter.

PubMed

Lie, Désirée; May, Win; Richter-Lagha, Regina; Forest, Christopher; Banzali, Yvonne; Lohenry, Kevin

2015-01-01

Current scales for interprofessional team performance do not provide adequate behavioral anchors for performance evaluation. The Team Observed Structured Clinical Encounter (TOSCE) provides an opportunity to adapt and develop an existing scale for this purpose. We aimed to test the feasibility of using a retooled scale to rate performance in a standardized patient encounter and to assess faculty ability to accurately rate both individual students and teams. The 9-point McMaster-Ottawa Scale developed for a TOSCE was converted to a 3-point scale with behavioral anchors. Students from four professions were trained a priori to perform in teams of four at three different levels as individuals and teams. Blinded faculty raters were trained to use the scale to evaluate individual and team performances. G-theory was used to analyze ability of faculty to accurately rate individual students and teams using the retooled scale. Sixteen faculty, in groups of four, rated four student teams, each participating in the same TOSCE station. Faculty expressed comfort rating up to four students in a team within a 35-min timeframe. Accuracy of faculty raters varied (38-81% individuals, 50-100% teams), with errors in the direction of over-rating individual, but not team performance. There was no consistent pattern of error for raters. The TOSCE can be administered as an evaluation method for interprofessional teams. However, faculty demonstrate a 'leniency error' in rating students, even with prior training using behavioral anchors. To improve consistency, we recommend two trained faculty raters per station.

Beyond student ratings: peer observation of classroom and clinical teaching.

PubMed

Berk, Ronald A; Naumann, Phyllis L; Appling, Susan E

2004-01-01

Peer observation of classroom and clinical teaching has received increased attention over the past decade in schools of nursing to augment student ratings of teaching effectiveness. One essential ingredient is the scale used to evaluate performance. A five-step systematic procedure for adapting, writing, and building any peer observation scale is described. The differences between the development of a classroom observation scale and an appraisal scale to observe clinical instructors are examined. Psychometric issues peculiar to observation scales are discussed in terms of content validity, eight types of response bias, and interobserver reliability. The applications of the scales in one school of nursing as part of the triangulation of methods with student ratings and the teaching portfolio are illustrated. Copies of the scales are also provided.

Global measures of outcome in a controlled comparison of pharmacological and psychological treatment of panic disorder and agoraphobia in primary care.

PubMed Central

Sharp, D M; Power, K G; Simpson, R J; Swanson, V; Anstee, J A

1997-01-01

BACKGROUND: Panic disorder, with and without agoraphobia, is a prevalent condition which presents primarily in general practice. Previous clinical outcome studies have been conducted mainly in specialist university departments or hospital settings, and have tended to employ complex rating scales that are not well suited for use as outcome measures in primary care. AIM: To evaluate the outcome, in a primary care setting, of fluvoxamine versus cognitive behaviour therapy, each used alone and in combination in a double-blind placebo-controlled framework, balanced for therapist contact. METHOD: A total of 149 patients satisfying DSMIII-R criteria for panic disorder were randomly allocated to receive one of the following: fluvoxamine, placebo, fluvoxamine plus cognitive behaviour therapy, placebo plus cognitive behaviour therapy, and cognitive behaviour therapy alone. These five treatment groups represent the minimum number acceptable for such a comparison to be made. All patients received an identical schedule of contact over 13 weeks. Measures of symptom severity, general health and social disruption were taken at entry point and end point; measures of change in symptoms were taken at end point only. Outcome was reported in terms of brief global ratings of severity of illness and change in symptoms, and of ratings of general health and social disruption that are suitable for use in general practice. RESULTS: All active treatment groups showed statistically significant advantages over placebo over a range of outcome ratings. The groups employing cognitive behaviour therapy showed the most robust and consistent response. CONCLUSION: The brief global measures reported here proved adequate to the task of assessing treatment outcome. Results indicate that treatments including cognitive behaviour therapy can be effective in the treatment of panic disorder and agoraphobia in primary care. PMID:9167318

A comparison of global rating scale and checklist scores in the validation of an evaluation tool to assess performance in the resuscitation of critically ill patients during simulated emergencies (abbreviated as "CRM simulator study IB").

PubMed

Kim, John; Neilipovitz, David; Cardinal, Pierre; Chiu, Michelle

2009-01-01

Crisis resource management (CRM) skills are a set of nonmedical skills required to manage medical emergencies. There is currently no gold standard for evaluation of CRM performance. A prior study examined the use of a global rating scale (GRS) to evaluate CRM performance. This current study compared the use of a GRS and a checklist as formal rating instruments to evaluate CRM performance during simulated emergencies. First-year and third-year residents participated in two simulator scenarios each. Three raters then evaluated resident performance in CRM using edited video recordings using both a GRS and a checklist. The Ottawa GRS provides a seven-point anchored ordinal scale for performance in five categories of CRM, and an overall performance score. The Ottawa CRM checklist provides 12 items in the five categories of CRM, with a maximum cumulative score of 30 points. Construct validity was measured on the basis of content validity, response process, internal structure, and response to other variables. T-test analysis of Ottawa GRS scores was conducted to examine response to the variable of level of training. Intraclass correlation coefficient (ICC) scores were used to measure inter-rater reliability for both scenarios. Thirty-two first-year and 28 third-year residents participated in the study. Third-year residents produced higher mean scores for overall CRM performance than first-year residents (P < 0.05), and in all individual categories within the Ottawa GRS (P < 0.05) and the Ottawa CRM checklist (P < 0.05). This difference was noted for both scenarios and for each individual rater (P < 0.05). No statistically significant difference in resident scores was observed between scenarios for both instruments. ICC scores of 0.59 and 0.61 were obtained for Scenarios 1 and 2 with the Ottawa GRS, whereas ICC scores of 0.63 and 0.55 were obtained with the Ottawa CRM checklist. Users indicated a strong preference for the Ottawa GRS given ease of scoring, presence of an overall score, and the potential for formative evaluation. Construct validity seems to be present when using both the Ottawa GRS and CRM checklist to evaluate CRM performance during simulated emergencies. Data also indicate the presence of moderate inter-rater reliability when using both the Ottawa GRS and CRM checklist.

Can low-resolution airborne laser scanning data be used to model stream rating curves?

USGS Publications Warehouse

Lyon, Steve; Nathanson, Marcus; Lam, Norris; Dahlke, Helen; Rutzinger, Martin; Kean, Jason W.; Laudon, Hjalmar

2015-01-01

This pilot study explores the potential of using low-resolution (0.2 points/m2) airborne laser scanning (ALS)-derived elevation data to model stream rating curves. Rating curves, which allow the functional translation of stream water depth into discharge, making them integral to water resource monitoring efforts, were modeled using a physics-based approach that captures basic geometric measurements to establish flow resistance due to implicit channel roughness. We tested synthetically thinned high-resolution (more than 2 points/m2) ALS data as a proxy for low-resolution data at a point density equivalent to that obtained within most national-scale ALS strategies. Our results show that the errors incurred due to the effect of low-resolution versus high-resolution ALS data were less than those due to flow measurement and empirical rating curve fitting uncertainties. As such, although there likely are scale and technical limitations to consider, it is theoretically possible to generate rating curves in a river network from ALS data of the resolution anticipated within national-scale ALS schemes (at least for rivers with relatively simple geometries). This is promising, since generating rating curves from ALS scans would greatly enhance our ability to monitor streamflow by simplifying the overall effort required.

RESPONSIVENESS OF THE ACTIVITIES OF DAILY LIVING SCALE OF THE KNEE OUTCOME SURVEY AND NUMERIC PAIN RATING SCALE IN PATIENTS WITH PATELLOFEMORAL PAIN

PubMed Central

Piva, Sara R.; Gil, Alexandra B.; Moore, Charity G.; Fitzgerald, G. Kelley

2016-01-01

Objective To assess internal and external responsiveness of the Activity of Daily Living Scale of the Knee Outcome Survey and Numeric Pain Rating Scale on patients with patellofemoral pain. Design One group pre-post design. Subjects A total of 60 individuals with patellofemoral pain (33 women; mean age 29.9 (standard deviation 9.6) years). Methods The Activity of Daily Living Scale and the Numeric Pain Rating Scale were assessed before and after 8 weeks of physical therapy program. Patients completed a global rating of change scale at the end of therapy. The standardized effect size, Guyatt responsiveness index, and the minimum clinical important difference were calculated. Results Standardized effect size of the Activity of Daily Living Scale was 0.63, Guyatt responsiveness index was 1.4, area under the curve was 0.83 (95% confidence interval: 0.72, 0.94), and the minimum clinical important difference corresponded to an increase of 7.1 percentile points. Standardized effect size of the Numeric Pain Rating Scale was 0.72, Guyatt responsiveness index was 2.2, area under the curve was 0.80 (95% confidence interval: 0.70, 0.92), and the minimum clinical important difference corresponded to a decrease of 1.16 points. Conclusion Information from this study may be helpful to therapists when evaluating the effectiveness of rehabilitation intervention on physical function and pain, and to power future clinical trials on patients with patellofemoral pain. PMID:19229444

Responsiveness of the activities of daily living scale of the knee outcome survey and numeric pain rating scale in patients with patellofemoral pain.

PubMed

Piva, Sara R; Gil, Alexandra B; Moore, Charity G; Fitzgerald, G Kelley

2009-02-01

To assess internal and external responsiveness of the Activity of Daily Living Scale of the Knee Outcome Survey and Numeric Pain Rating Scale on patients with patellofemoral pain. One group pre-post design. A total of 60 individuals with patellofemoral pain (33 women; mean age 29.9 (standard deviation 9.6) years). The Activity of Daily Living Scale and the Numeric Pain Rating Scale were assessed before and after 8 weeks of physical therapy program. Patients completed a global rating of change scale at the end of therapy. The standardized effect size, Guyatt responsiveness index, and the minimum clinical important difference were calculated. Standardized effect size of the Activity of Daily Living Scale was 0.63, Guyatt responsiveness index was 1.4, area under the curve was 0.83 (95% confidence interval: 0.72, 0.94), and the minimum clinical important difference corresponded to an increase of 7.1 percentile points. Standardized effect size of the Numeric Pain Rating Scale was 0.72, Guyatt responsiveness index was 2.2, area under the curve was 0.80 (95% confidence interval: 0.70, 0.92), and the minimum clinical important difference corresponded to a decrease of 1.16 points. Information from this study may be helpful to therapists when evaluating the effectiveness of rehabilitation intervention on physical function and pain, and to power future clinical trials on patients with patellofemoral pain.

Connecticut Graduation Rates. A ConnCAN Issue Brief

ERIC Educational Resources Information Center

Alexander, Jennifer; Spurrier, Alex; Sauer, Jordan

2011-01-01

For the past five years, ConnCAN (Connecticut Coalition for Achievement Now) has analyzed the state's graduation rates; this Issue Brief provides a more detailed examination of the latest data. In addition to relatively flat graduation rates across the board in Connecticut, the data reveal dramatic, persistent gaps by race. These numbers point to…

The Effects of Specialization and Sex on Anterior Y-Balance Performance in High School Athletes.

PubMed

Miller, Madeline M; Trapp, Jessica L; Post, Eric G; Trigsted, Stephanie M; McGuine, Timothy A; Brooks, M Alison; Bell, David R

Sport specialization and movement asymmetry have been separately discussed as potential risk factors for lower extremity injury. Early specialization may lead to the development of movement asymmetries that can predispose an athlete to injury, but this has not been thoroughly examined. Athletes rated as specialized would exhibit greater between-limb anterior reach asymmetry and decreased anterior reach distance on the Y-balance test (YBT) as compared with nonspecialized high school athletes, and these differences would not be dependent on sex. Cross-sectional study. Level 3. Two hundred ninety-five athletes (117 male, 178 female; mean age, 15.6 ± 1.2 years) from 2 local high schools participating in basketball, soccer, volleyball, and tennis responded to a questionnaire regarding sport specialization status and performed trials of the YBT during preseason testing. Specialization was categorized according to 3 previously utilized specialization classification methods (single/multisport, 3-point scale, and 6-point scale), and interactions between specialization and sex with Y-balance performance were calculated using 2-way analyses of variance. Single-sport male athletes displayed greater anterior reach asymmetry than other interaction groups. A consistent main effect was observed for sex, with men displaying greater anterior asymmetry and decreased anterior reach distance than women. However, the interaction effects of specialization and sex on anterior Y-balance performance varied based on the classification method used. Single-sport male athletes displayed greater anterior reach asymmetry on the YBT than multisport and female athletes. Specialization classification method is important because the 6- and 3-point scales may not accurately identify balance abnormalities. Male athletes performed worse than female athletes on both of the Y-balance tasks. Clinicians should be aware that single-sport male athletes may display deficits in dynamic balance, potentially increasing their risk of injury.

Attention deficit hyperactivity disorder: From parents to children.

PubMed

Vélez-van-Meerbeke, A; Talero-Gutiérrez, C; Zamora-Miramón, I; Guzmán-Ramírez, G M

2017-04-01

Multiple studies of attention deficit hyperactivity disorder (ADHD) have recognised a heritability factor in that a higher frequency of the disorder is observed in children with an affected relative. Our aim was to determine the association between ADHD symptoms in young children enrolled in five schools in Bogota and a history of ADHD symptoms in their parents using the Wender-Utah Rating Scale. Case-control study of participants selected according to DSM-IV criteria for ADHD and the Behavioral Assessment System for Children (BASC) completed by parents and teachers; the WISC-IV scale was used to exclude children with cognitive deficit. Parents completed the Wender-Utah Rating Scale to retrospectively identify any ADHD symptoms in childhood. A score of 36 was used as a cutoff point. The study included 202 children: 117 cases and 85 controls. A positive history of ADHD symptoms in childhood was identified for 16% of 175 mothers and 20.6% of 141 fathers. The presence of symptoms in either parent, especially the mother, constitutes a significant risk factor for ADHD in children and this relationship persists after controlling for different variables. If both parents have the disorder, the risk tends to increase. Although ADHD has been linked to a genetic component, other environmental factors may be involved in the disorder. Copyright © 2015 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Just-About-Right and ideal scaling provide similar insights into the influence of sensory attributes on liking.

PubMed

Li, Bangde; Hayes, John E; Ziegler, Gregory R

2014-10-01

Just-about-right (JAR) scaling is criticized for measuring attribute intensity and acceptability simultaneously. Using JAR scaling, an attribute is evaluated for its appropriateness relative to one's hypothetical ideal level that is pre-defined at the middle of a continuum. Alternatively, ideal scaling measures these two constructs separately. Ideal scaling allows participants to rate their ideal freely on the scale (i.e., without assuming the "Too Little" and "Too Much" regions are equal in size). We hypothesized that constraining participants' ideal to the center point, as is done in the JAR scale, may cause a scaling bias and, thereby, influence the magnitude of "Too Little" and "Too Much". Furthermore, we hypothesized that the magnitude of "Too Little" and "Too Much" would influence liking to different extents. Coffee-flavored dairy beverages (n=20) were formulated using a fractional, constrained-mixture design that varied the ratio of water, milk, coffee extract, and sucrose. Participants tasted 4 of 20 prototypes that were served in a monadic sequential order using a balanced incomplete block design. Data reported here are for participants randomly assigned to one of two research conditions: ideal scaling (n=129) or JAR scaling (n=132). For both conditions, participants rated overall liking using a 9-point hedonic scale. Four attributes ( sweetness, milk flavor, coffee flavor and thickness ) were evaluated. The reliability of an individual participant's ideal rating for an attribute was evaluated using the standard deviation of their ideal ratings (n=4). All data from a participant were eliminated from further analyses when his/her standard deviation of the ideal ratings for any of the four rated attributes was identified as a statistical outlier. This resulted in the elimination of 15 of 129 (12 %) of participants in the ideal scaling group. Multiple linear regression was employed to model liking as a function of "Too Little" or "Too Much" attribute intensities. Mean ideal ratings (averaged across participants) for all four attributes were significantly different from the central point of the scale (i.e., 50). However, Coffee flavor was the only attribute for which the mean ideal rating (57.2) fell outside the central 10% (45.0-55.0). Even so, the magnitude of "Too Little" and "Too Much" was not affected by the scaling method. The influence of the magnitude of "Too Little" and "Too Much" on liking was asymmetrical. Both scaling methods agreed that sweetness and coffee flavor were the main sensory attributes affecting liking . Overall, JAR scaling and ideal scaling were comparable for measuring "Too Little" and "Too Much", and identifying the main factors affecting liking.

Just-About-Right and ideal scaling provide similar insights into the influence of sensory attributes on liking

PubMed Central

Li, Bangde; Hayes, John E.; Ziegler, Gregory R.

2014-01-01

Just-about-right (JAR) scaling is criticized for measuring attribute intensity and acceptability simultaneously. Using JAR scaling, an attribute is evaluated for its appropriateness relative to one’s hypothetical ideal level that is pre-defined at the middle of a continuum. Alternatively, ideal scaling measures these two constructs separately. Ideal scaling allows participants to rate their ideal freely on the scale (i.e., without assuming the “Too Little” and “Too Much” regions are equal in size). We hypothesized that constraining participants’ ideal to the center point, as is done in the JAR scale, may cause a scaling bias and, thereby, influence the magnitude of “Too Little” and “Too Much”. Furthermore, we hypothesized that the magnitude of “Too Little” and “Too Much” would influence liking to different extents. Coffee-flavored dairy beverages (n=20) were formulated using a fractional, constrained-mixture design that varied the ratio of water, milk, coffee extract, and sucrose. Participants tasted 4 of 20 prototypes that were served in a monadic sequential order using a balanced incomplete block design. Data reported here are for participants randomly assigned to one of two research conditions: ideal scaling (n=129) or JAR scaling (n=132). For both conditions, participants rated overall liking using a 9-point hedonic scale. Four attributes (sweetness, milk flavor, coffee flavor and thickness) were evaluated. The reliability of an individual participant’s ideal rating for an attribute was evaluated using the standard deviation of their ideal ratings (n=4). All data from a participant were eliminated from further analyses when his/her standard deviation of the ideal ratings for any of the four rated attributes was identified as a statistical outlier. This resulted in the elimination of 15 of 129 (12 %) of participants in the ideal scaling group. Multiple linear regression was employed to model liking as a function of “Too Little” or “Too Much” attribute intensities. Mean ideal ratings (averaged across participants) for all four attributes were significantly different from the central point of the scale (i.e., 50). However, Coffee flavor was the only attribute for which the mean ideal rating (57.2) fell outside the central 10% (45.0–55.0). Even so, the magnitude of “Too Little” and “Too Much” was not affected by the scaling method. The influence of the magnitude of “Too Little” and “Too Much” on liking was asymmetrical. Both scaling methods agreed that sweetness and coffee flavor were the main sensory attributes affecting liking. Overall, JAR scaling and ideal scaling were comparable for measuring “Too Little” and “Too Much”, and identifying the main factors affecting liking. PMID:25061258

Using Multivariate Regression Model with Least Absolute Shrinkage and Selection Operator (LASSO) to Predict the Incidence of Xerostomia after Intensity-Modulated Radiotherapy for Head and Neck Cancer

PubMed Central

Ting, Hui-Min; Chang, Liyun; Huang, Yu-Jie; Wu, Jia-Ming; Wang, Hung-Yu; Horng, Mong-Fong; Chang, Chun-Ming; Lan, Jen-Hong; Huang, Ya-Yu; Fang, Fu-Min; Leung, Stephen Wan

2014-01-01

Purpose The aim of this study was to develop a multivariate logistic regression model with least absolute shrinkage and selection operator (LASSO) to make valid predictions about the incidence of moderate-to-severe patient-rated xerostomia among head and neck cancer (HNC) patients treated with IMRT. Methods and Materials Quality of life questionnaire datasets from 206 patients with HNC were analyzed. The European Organization for Research and Treatment of Cancer QLQ-H&N35 and QLQ-C30 questionnaires were used as the endpoint evaluation. The primary endpoint (grade 3+ xerostomia) was defined as moderate-to-severe xerostomia at 3 (XER3m) and 12 months (XER12m) after the completion of IMRT. Normal tissue complication probability (NTCP) models were developed. The optimal and suboptimal numbers of prognostic factors for a multivariate logistic regression model were determined using the LASSO with bootstrapping technique. Statistical analysis was performed using the scaled Brier score, Nagelkerke R2, chi-squared test, Omnibus, Hosmer-Lemeshow test, and the AUC. Results Eight prognostic factors were selected by LASSO for the 3-month time point: Dmean-c, Dmean-i, age, financial status, T stage, AJCC stage, smoking, and education. Nine prognostic factors were selected for the 12-month time point: Dmean-i, education, Dmean-c, smoking, T stage, baseline xerostomia, alcohol abuse, family history, and node classification. In the selection of the suboptimal number of prognostic factors by LASSO, three suboptimal prognostic factors were fine-tuned by Hosmer-Lemeshow test and AUC, i.e., Dmean-c, Dmean-i, and age for the 3-month time point. Five suboptimal prognostic factors were also selected for the 12-month time point, i.e., Dmean-i, education, Dmean-c, smoking, and T stage. The overall performance for both time points of the NTCP model in terms of scaled Brier score, Omnibus, and Nagelkerke R2 was satisfactory and corresponded well with the expected values. Conclusions Multivariate NTCP models with LASSO can be used to predict patient-rated xerostomia after IMRT. PMID:24586971

Using multivariate regression model with least absolute shrinkage and selection operator (LASSO) to predict the incidence of Xerostomia after intensity-modulated radiotherapy for head and neck cancer.

PubMed

Lee, Tsair-Fwu; Chao, Pei-Ju; Ting, Hui-Min; Chang, Liyun; Huang, Yu-Jie; Wu, Jia-Ming; Wang, Hung-Yu; Horng, Mong-Fong; Chang, Chun-Ming; Lan, Jen-Hong; Huang, Ya-Yu; Fang, Fu-Min; Leung, Stephen Wan

2014-01-01

The aim of this study was to develop a multivariate logistic regression model with least absolute shrinkage and selection operator (LASSO) to make valid predictions about the incidence of moderate-to-severe patient-rated xerostomia among head and neck cancer (HNC) patients treated with IMRT. Quality of life questionnaire datasets from 206 patients with HNC were analyzed. The European Organization for Research and Treatment of Cancer QLQ-H&N35 and QLQ-C30 questionnaires were used as the endpoint evaluation. The primary endpoint (grade 3(+) xerostomia) was defined as moderate-to-severe xerostomia at 3 (XER3m) and 12 months (XER12m) after the completion of IMRT. Normal tissue complication probability (NTCP) models were developed. The optimal and suboptimal numbers of prognostic factors for a multivariate logistic regression model were determined using the LASSO with bootstrapping technique. Statistical analysis was performed using the scaled Brier score, Nagelkerke R(2), chi-squared test, Omnibus, Hosmer-Lemeshow test, and the AUC. Eight prognostic factors were selected by LASSO for the 3-month time point: Dmean-c, Dmean-i, age, financial status, T stage, AJCC stage, smoking, and education. Nine prognostic factors were selected for the 12-month time point: Dmean-i, education, Dmean-c, smoking, T stage, baseline xerostomia, alcohol abuse, family history, and node classification. In the selection of the suboptimal number of prognostic factors by LASSO, three suboptimal prognostic factors were fine-tuned by Hosmer-Lemeshow test and AUC, i.e., Dmean-c, Dmean-i, and age for the 3-month time point. Five suboptimal prognostic factors were also selected for the 12-month time point, i.e., Dmean-i, education, Dmean-c, smoking, and T stage. The overall performance for both time points of the NTCP model in terms of scaled Brier score, Omnibus, and Nagelkerke R(2) was satisfactory and corresponded well with the expected values. Multivariate NTCP models with LASSO can be used to predict patient-rated xerostomia after IMRT.

Dystonia rating scales: critique and recommendations

PubMed Central

Albanese, Alberto; Sorbo, Francesca Del; Comella, Cynthia; Jinnah, H.A.; Mink, Jonathan W.; Post, Bart; Vidailhet, Marie; Volkmann, Jens; Warner, Thomas T.; Leentjens, Albert F.G.; Martinez-Martin, Pablo; Stebbins, Glenn T.; Goetz, Christopher G.; Schrag, Anette

2014-01-01

Background Many rating scales have been applied to the evaluation of dystonia, but only few have been assessed for clinimetric properties. The Movement Disorders Society commissioned this task force to critique existing dystonia rating scales and place them in the clinical and clinimetric context. Methods A systematic literature review was conducted to identify rating scales that have either been validated or used in dystonia. Results Thirty six potential scales were identified. Eight were excluded because they did not meet review criteria, leaving twenty-eight scales that were critiqued and rated by the task force. Seven scales were found to meet criteria to be “recommended”: the Blepharospasm Disability Index is recommended for rating blepharospasm; the Cervical Dystonia Impact Scale and the Toronto Western Spasmodic Torticollis Rating Scale for rating cervical dystonia; the Craniocervical Dystonia Questionnaire for blepharospasm and cervical dystonia; the Voice Handicap Index (VHI) and the Vocal Performance Questionnaire (VPQ) for laryngeal dystonia; and the Fahn-Marsden Dystonia Rating Scale for rating generalized dystonia. Two “recommended” scales (VHI and VPQ) are generic scales validated on few patients with laryngeal dystonia, whereas the others are disease-specific scales. Twelve scales met criteria for “suggested” and seven scales met criteria for “listed”. All the scales are individually reviewed in the online appendix. Conclusion The task force recommends five specific dystonia scales and suggests to further validate in dystonia two recommended generic voice-disorder scales. Existing scales for oromandibular, arm and task-specific dystonia should be refined and fully assessed. Scales should be developed for body regions where no scales are available, such as lower limbs and trunk. PMID:23893443

Color Degradation of Textiles with Natural Dyes and of Blue Scale Standards Exposed to White LED Lamps:Evaluation of White LED Lamps for Effectiveness as Museum Lighting

NASA Astrophysics Data System (ADS)

Ishii, Mie; Moriyama, Takayoshi; Toda, Masahiro; Kohmoto, Kohtaro; Saito, Masako

White light-emitting diodes (LED) are well suited for museum lighting because they emit neither UV nor IR radiation, which damage artifacts. The color degradation of natural dyes and blue scale standards (JIS L 0841) by white LED lamps are examined, and the performance of white LED lamps for museum lighting is evaluated. Blue scale standard grades 1-6 and silk fabrics dyed with 22 types of natural dyes classified as mid to highly responsive in a CIE technical report (CIE157:2004) were exposed to five types of white LED lamps using different luminescence methods and color temperatures. Color changes were measured at each 15000 lx·hr (500 lx at fabric surface × 300 hr) interval ten times. The accumulated exposure totaled 150000 lx·hr. The data on conventional white LED lamps and previously reported white fluorescent (W) and museum fluorescent (NU) lamps was evaluated. All the white LED lamps showed lower fading rates compared with a W lamp on a blue scale grade 1. The fading rate of natural dyes in total was the same between an NU lamp (3000 K) and a white LED lamp (2869 K). However, yellow natural dyes showed higher fading rates with the white LED lamp. This tendency is due to the high power characteristic of the LED lamp around 400-500 nm, which possibly contributes to the photo-fading action on the dyes. The most faded yellow dyes were Ukon (Curcuma longa L.) and Kihada (Phellodendron amurense Rupr.), and these are frequently used in historic artifacts such as kimono, wood-block prints, and scrolls. From a conservation point of view, we need to continue research on white LED lamps for use in museum lighting.

A randomised controlled trial to compare the effectiveness of ice-packs and Epifoam with cooling maternity gel pads at alleviating postnatal perineal trauma.

PubMed

Steen, M; Cooper, K; Marchant, P; Griffiths-Jones, M; Walker, J

2000-03-01

To evaluate the effectiveness of standard regimes (ice packs and Epifoam) at relieving perineal trauma and compare these with a new cooling device (maternity gel pad). A randomised controlled trial involving three treatment groups. The women were free to choose the time of initial application (within four hours after delivery) in all treatment groups and the number of subsequent treatments up to 48 hours after suturing. A midwifery unit in the north of England and then continued in the women's own homes. 120 women who had undergone an instrumental delivery and had a 48 hours post-delivery stay in a postnatal ward. The ordinal scale of none, mild, moderate and severe was used to determine the levels of perineal oedema and bruising at initial assessment (less than 4 hours), 24 hours and at 48 hours, by use of a newly developed visual evaluating tool. Self-assessed pain was recorded using a 10-point visual analogue scale within four hours, at 24 hours, 48 hours, and finally at five days after suturing. Women's opinions as to the effectiveness of their treatment was rated by use of a 5-point scale describing the categories; poor, fair, good, very good and excellent. A high proportion of women had some perineal oedema at initial assessment. A statistically significant difference in the proportion of women with oedema was found between treatment groups at 48 hours (p = 0.01), which was in favour of the maternity gel pad group. This was particularly noticeable for women with initial levels of mild oedema (p = 0.017). Localised treatment with the gel pad caused a significant decrease in reported pain at 48 hours in women who initially demonstrated moderate or severe pain (p = 0.048). A significant increase in the proportion of women with some bruising was seen across all treatment groups from initial assessment, through 24 hours to 48 hours (p < 0.0005). The bruising was significantly less in the gel-pad group in women who initially had no bruising (p = 0.021). There was no statistically significant effect of treatment at other initial levels of severity for oedema, bruising or pain at 24 hours, 48 hours and five days (for pain). Women in the gel-pad group rated the effectiveness of their localised treatment to be significantly higher than women in the other two treatment groups (p < 0.0005). This trial demonstrated that a high proportion of women experience perineal oedema, bruising and pain following an instrumental delivery, which continues for at least five days for perineal pain, despite oral analgesia. Maternity gel pads, which were specially designed to cool the perineal region, were more effective in alleviating perineal trauma when compared with hospital standard regimens and were more highly rated by women.

Developing Multidimensional Likert Scales Using Item Factor Analysis: The Case of Four-Point Items

ERIC Educational Resources Information Center

Asún, Rodrigo A.; Rdz-Navarro, Karina; Alvarado, Jesús M.

2016-01-01

This study compares the performance of two approaches in analysing four-point Likert rating scales with a factorial model: the classical factor analysis (FA) and the item factor analysis (IFA). For FA, maximum likelihood and weighted least squares estimations using Pearson correlation matrices among items are compared. For IFA, diagonally weighted…

Manual for the Extrapyramidal Symptom Rating Scale (ESRS).

PubMed

Chouinard, Guy; Margolese, Howard C

2005-07-15

The Extrapyramidal Symptom Rating Scale (ESRS) was developed to assess four types of drug-induced movement disorders (DIMD): Parkinsonism, akathisia, dystonia, and tardive dyskinesia (TD). Comprehensive ESRS definitions and basic instructions are given. Factor analysis provided six ESRS factors: 1) hypokinetic Parkinsonism; 2) orofacial dyskinesia; 3) trunk/limb dyskinesia; 4) akathisia; 5) tremor; and 6) tardive dystonia. Two pivotal studies found high inter-rater reliability correlations in both antipsychotic-induced movement disorders and idiopathic Parkinson disease. For inter-rater reliability and certification of raters, >or=80% of item ratings of the complete scale should be +/-1 point of expert ratings and >or=70% of ratings on individual items of each ESRS subscale should be +/-1 point of expert ratings. During a cross-scale comparison, AIMS and ESRS were found to have a 96% (359/374) agreement between TD-defined cases by DSM-IV TD criteria. Two recent international studies using the ESRS included over 3000 patients worldwide and showed an incidence of TD ranging from 10.2% (2000) to 12% (1998). ESRS specificity was investigated through two different approaches, path analyses and ANCOVA PANSS factors changes, which found that ESRS measurement of drug-induced EPS is valid and discriminative from psychiatric symptoms.

Dusty: an assistive mobile manipulator that retrieves dropped objects for people with motor impairments.

PubMed

King, Chih-Hung; Chen, Tiffany L; Fan, Zhengqin; Glass, Jonathan D; Kemp, Charles C

2012-03-01

People with physical disabilities have ranked object retrieval as a high-priority task for assistive robots. We have developed Dusty, a teleoperated mobile manipulator that fetches objects from the floor and delivers them to users at a comfortable height. In this paper, we first demonstrate the robot's high success rate (98.4%) when autonomously grasping 25 objects considered being important by people with amyotrophic lateral sclerosis (ALS). We tested the robot with each object in five different configurations on five types of flooring. We then present the results of an experiment in which 20 people with ALS operated Dusty. Participants teleoperated Dusty to move around an obstacle, pick up an object and deliver the object to themselves. They successfully completed this task in 59 out of 60 trials (3 trials each) with a mean completion time of 61.4 SD = 20.5 seconds), and reported high overall satisfaction using Dusty (7-point Likert scale; 6.8 SD = 0.6). Participants rated Dusty to be significantly easier to use than their own hands, asking family members, and using mechanical reachers (p < 0.03, paired t-tests). Fourteen of the 20 participants reported that they would prefer using Dusty over their current methods. [Box: see text].

Dusty: an assistive mobile manipulator that retrieves dropped objects for people with motor impairments

PubMed Central

King, Chih-Hung; Chen, Tiffany L; Fan, Zhengqin; Glass, Jonathan D; Kemp, Charles C

2012-01-01

People with physical disabilities have ranked object retrieval as a high priority task for assistive robots. We have developed Dusty, a teleoperated mobile manipulator that fetches objects from the floor and delivers them to users at a comfortable height. In this paper, we first demonstrate the robot's high success rate (98.4%) when autonomously grasping 25 objects considered important by people with amyotrophic lateral sclerosis (ALS). We tested the robot with each object in five different configurations on five types of flooring. We then present the results of an experiment in which 20 people with ALS operated Dusty. Participants teleoperated Dusty to move around an obstacle, pick up an object, and deliver the object to themselves. They successfully completed this task in 59 out of 60 trials (3 trials each) with a mean completion time of 61.4 seconds (SD=20.5 seconds), and reported high overall satisfaction using Dusty (7-point Likert scale; 6.8 SD=0.6). Participants rated Dusty to be significantly easier to use than their own hands, asking family members, and using mechanical reachers (p < 0.03, paired t-tests). 14 of the 20 participants reported that they would prefer using Dusty over their current methods. PMID:22013888

Reducing Stock-Outs of Life Saving Malaria Commodities Using Mobile Phone Text-Messaging: SMS for Life Study in Kenya

PubMed Central

Githinji, Sophie; Kigen, Samwel; Memusi, Dorothy; Nyandigisi, Andrew; Mbithi, Agneta M.; Wamari, Andrew; Muturi, Alex N.; Jagoe, George; Barrington, Jim; Snow, Robert W.; Zurovac, Dejan

2013-01-01

Background Health facility stock-outs of life saving malaria medicines are common across Africa. Innovative ways of addressing this problem are urgently required. We evaluated whether SMS based reporting of stocks of artemether-lumefantrine (AL) and rapid diagnostic tests (RDT) can result in reduction of stock-outs at peripheral facilities in Kenya. Methods/Findings All 87 public health facilities in five Kenyan districts were included in a 26 week project. Weekly facility stock counts of four AL packs and RDTs were sent via structured incentivized SMS communication process from health workers’ personal mobile phones to a web-based system accessed by district managers. The mean health facility response rate was 97% with a mean formatting error rate of 3%. Accuracy of stock count reports was 79% while accuracy of stock-out reports was 93%. District managers accessed the system 1,037 times at an average of eight times per week. The system was accessed in 82% of the study weeks. Comparing weeks 1 and 26, stock-out of one or more AL packs declined by 38 percentage-points. Total AL stock-out declined by 5 percentage-points and was eliminated by the end of the project. Stock-out declines of individual AL packs ranged from 14 to 32 percentage-points while decline in RDT stock-outs was 24 percentage-points. District managers responded to 44% of AL and 73% of RDT stock-out signals by redistributing commodities between facilities. In comparison with national trends, stock-out declines in study areas were greater, sharper and more sustained. Conclusions Use of simple SMS technology ensured high reporting rates of reasonably accurate, real-time facility stock data that were used by district managers to undertake corrective actions to reduce stock-outs. Future work on stock monitoring via SMS should focus on assessing response rates without use of incentives and demonstrating effectiveness of such interventions on a larger scale. PMID:23349786

[Valuating public health in some zoos in Colombia. Phase 1: designing and validating instruments].

PubMed

Agudelo-Suárez, Angela N; Villamil-Jiménez, Luis C

2009-10-01

Designing and validating instruments for identifying public health problems in some zoological parks in Colombia, thereby allowing them to be evaluated. Four instruments were designed and validated along with the participation of five zoos. The instruments were validated regarding appearance, content, sensitivity to change, reliability tests and determining the tools' usefulness. An evaluation scale was created which assigned a maximum of 400 points, having the following evaluation intervals: 350-400 points meant good public health management, 100-349 points for regular management and 0-99 points for deficient management. The instruments were applied to the five zoos as part of the validation, forming a base-line for future evaluation of public health in them. Four valid and useful instruments were obtained for evaluating public health in zoos in Colombia. The five zoos presented regular public health management. The base-line obtained when validating the instruments led to identifying strengths and weaknesses regarding public health management in the zoos. The instruments obtained generally and specifically evaluated public health management; they led to diagnosing, identifying, quantifying and scoring zoos in Colombia in terms of public health. The base-line provided a starting point for making comparisons and enabling future follow-up of public health in Colombian zoos.

Self-reported illness from chemical odors in young adults without clinical syndromes or occupational exposures

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bell, I.R.; Schwartz, G.E.; Peterson, J.M.

The present survey of young adult college students investigated the prevalence of self-reported illness from the smell of five common environmental chemicals (cacosmia): (1) pesticide, (2) automobile exhaust, (3) paint, (4) new carpet, and (5) perfume. Sixty-six percent of 643 students reported feeling ill from one or more of the five chemicals; 15% identified the smell of at least four chemicals as making them ill. Ratings of illness from pesticide correlated weakly but significantly with ratings for the largest number of individual symptoms (9 of 11); daytime tiredness and daytime grogginess both correlated at high levels of significance with illnessmore » ratings (on a 5-point scale) for four of the five chemicals. The most cacosmic group (CS) included significantly more women (79%) than the noncacosmic group (NS) (49%); women overall were more cacosmic than men (p < .001), even with the significant covariate of depression. Ratings of cacosmia correlated only weakly with scores for depression (r = 0.16), anxiety (r = 0.08), and trait shyness (r = 0.18) in the total sample. On stepwise multiple regression with cacosmia score as the dependent measure, shyness accounted for 5.8% of the variance, while depression, anxiety, sense of mastery, and repression did not enter the equation. Histories of physician-diagnosed hay fever, but not asthma, were more frequent in the CS (16%) than in the NS group (5%). Without the confounds of chronic illness or specific treatment programs, these data are similar to patterns described clinically for a subset of patients with multiple chemical sensitivities (MCS), including previous data on increased nasal resistance in MCS. The findings also suggest a limited relationship between degree of self-reported cacosmia and trait shyness, possibly on the basis of limbic hyper-reactivity. Psychological variables did not otherwise account for any of the variance in self-rated illness from chemical odors in this sample. 56 refs., 1 fig., 3 tabs.« less

The diagnostic value of the numeric pain rating scale in older postoperative patients.

PubMed

van Dijk, Jacqueline F M; Kappen, Teus H; van Wijck, Albert J M; Kalkman, Cor J; Schuurmans, Marieke J

2012-11-01

To measure the diagnostic value of the Numeric Rating Scale by comparing it to a Verbal Rating Scale in older patients. Pain management in older patients is an important challenge because of their greater susceptibility to adverse effects of analgesics. Nurses play an important role in applying guidelines for postoperative pain treatment. However, effective pain management is dependent upon valid and reliable pain assessment. Cross-sectional study. In total, 2674 older patients scored their postoperative pain on an 11-point numeric rating scale (NRS) and an adjective scale (VRS) including no pain, little pain, painful but bearable, considerable pain and terrible pain. The diagnostic value of different NRS cut-off values for administering analgesics is determined by an ROC curve. Sensitivity of NRS > 3 for 'unbearable' pain in older patients was 72% with a specificity of 97·2%. With a cut-off point NRS > 4, sensitivity increased to 83%, while specificity was 96·7%. With a cut-off point NRS > 5, sensitivity was 94%, while specificity was 85%. A high proportion (75%) of older old patients (≥ 75 years) with 'painful but bearable' considers NRS 4, 5 and 6 to this VRS category. Using an NRS cut-off point > 3 or > 4, a large group of older patients with 'bearable' pain would incorrectly classified as 'unbearable'. When we make the assumption that bearable pain means no wish for additional analgesics, this misclassification might result in overtreatment with analgesics, while 3% would be undertreated. With NRS cut-off point > 5, 6% have a risk of overtreatment and 15% of undertreatment. Nurses should not rely solely on the NRS score in determining pain treatment; they need to communicate with older patients about their pain, the need for analgesics and eventual misconceptions about analgesics. © 2012 Blackwell Publishing Ltd.

Consistent and reproducible positioning in longitudinal imaging for phenotyping genetically modified swine

NASA Astrophysics Data System (ADS)

Hammond, Emily; Dilger, Samantha K. N.; Stoyles, Nicholas; Judisch, Alexandra; Morgan, John; Sieren, Jessica C.

2015-03-01

Recent growth of genetic disease models in swine has presented the opportunity to advance translation of developed imaging protocols, while characterizing the genotype to phenotype relationship. Repeated imaging with multiple clinical modalities provides non-invasive detection, diagnosis, and monitoring of disease to accomplish these goals; however, longitudinal scanning requires repeatable and reproducible positioning of the animals. A modular positioning unit was designed to provide a fixed, stable base for the anesthetized animal through transit and imaging. Post ventilation and sedation, animals were placed supine in the unit and monitored for consistent vitals. Comprehensive imaging was performed with a computed tomography (CT) chest-abdomen-pelvis scan at each screening time point. Longitudinal images were rigidly registered, accounting for rotation, translation, and anisotropic scaling, and the skeleton was isolated using a basic thresholding algorithm. Assessment of alignment was quantified via eleven pairs of corresponding points on the skeleton with the first time point as the reference. Results were obtained with five animals over five screening time points. The developed unit aided in skeletal alignment within an average of 13.13 +/- 6.7 mm for all five subjects providing a strong foundation for developing qualitative and quantitative methods of disease tracking.

Acceptance and practicability of a visual communication tool in smoking cessation counselling: a randomised controlled trial.

PubMed

Neuner-Jehle, Stefan; Knecht, Marianne I; Stey-Steurer, Claudia; Senn, Oliver

2013-12-01

Smoking cessation advice is important for reducing the worldwide burden of disease resulting from tobacco smoking. Appropriate risk communication formats improve the success of counselling interventions in primary care. To test the feasibility and acceptance of a smoking cessation counselling tool with different cardiovascular risk communication formats including graphs, in comparison with the International Primary Care Respiratory Group (IPCRG) 'quit smoking assistance' tool. GPs were randomised into an intervention group (using our communication tool in addition to the IPCRG sheet) and a control group (using the IPCRG sheet only). We asked participants for socioeconomic data, smoking patterns, understanding of information, motivation, acceptance and feasibility, and measured the duration and frequency of counselling sessions. Twenty-five GPs performed 2.8 counselling sessions per month in the intervention group and 1.7 in the control group (p=0.3) with 114 patients. The median duration of a session was 10 mins (control group 11 mins, p=0.09 for difference). Median patients' motivation for smoking cessation was 7 on a 10-point visual analogue scale with no significant difference before and after the intervention (p=0.2) or between groups (p=0.73 before and p=0.15 after the intervention). Median patients' ratings of motivation, selfconfidence, understanding of information, and satisfaction with the counselling were 3-5 on a 5-point Likert scale, similar to GPs' ratings of acceptance and feasibility, with no significant difference between groups. Among Swiss GPs and patients, both our innovative communication tool and the IPCRG tool were well accepted and both merit further dissemination and application in research.

An approach for detecting five typical vegetation types on the Chinese Loess Plateau using Landsat TM data.

PubMed

Wang, Zhi-Jie; Jiao, Ju-Ying; Lei, Bo; Su, Yuan

2015-09-01

Remote sensing can provide large-scale spatial data for the detection of vegetation types. In this study, two shortwave infrared spectral bands (TM5 and TM7) and one visible spectral band (TM3) of Landsat 5 TM data were used to detect five typical vegetation types (communities dominated by Bothriochloa ischaemum, Artemisia gmelinii, Hippophae rhamnoides, Robinia pseudoacacia, and Quercus liaotungensis) using 270 field survey data in the Yanhe watershed on the Loess Plateau. The relationships between 200 field data points and their corresponding radiance reflectance were analyzed, and the equation termed the vegetation type index (VTI) was generated. The VTI values of five vegetation types were calculated, and the accuracy was tested using the remaining 70 field data points. The applicability of VTI was also tested by the distribution of vegetation type of two small watersheds in the Yanhe watershed and field sample data collected from other regions (Ziwuling Region, Huangling County, and Luochuan County) on the Loess Plateau. The results showed that the VTI can effectively detect the five vegetation types with an average accuracy exceeding 80 % and a representativeness above 85 %. As a new approach for monitoring vegetation types using remote sensing at a larger regional scale, VTI can play an important role in the assessment of vegetation restoration and in the investigation of the spatial distribution and community diversity of vegetation on the Loess Plateau.

Bright points and ejections observed on the sun by the KORONAS-FOTON instrument TESIS

NASA Astrophysics Data System (ADS)

Ulyanov, A. S.; Bogachev, S. A.; Kuzin, S. V.

2010-10-01

Five-second observations of the solar corona carried out in the FeIX 171 Å line by the KORONAS-FOTON instrument TESIS are used to study the dynamics of small-scale coronal structures emitting in and around coronal bright points. The small-scale structures of the lower corona display complex dynamics similar to those of magnetic loops located at higher levels of the solar corona. Numerous detected oscillating structures with sizes below 10 000 km display oscillation periods from 50 to 350 s. The period distributions of these structures are different for P < 150 s and P > 150 s, which implies that different oscillation modes are excited at different periods. The small-scale structures generate numerous flare-like events with energies 1024-1026 erg (nanoflares) and with a spatial density of one event per arcsecond or more observed over an area of 4 × 1011 km2. Nanoflares are not associated with coronal bright points, and almost uniformly cover the solar disk in the observation region. The ejections of solar material from the coronal bright points demonstrate velocities of 80-110 km/s.

Smouldering Remediation (STAR) Technology: Field Pilot Tests and First Full Scale Application

NASA Astrophysics Data System (ADS)

Gerhard, J.; Kinsman, L.; Torero, J. L.

2015-12-01

STAR (Self-sustaining Treatment for Active Remediation) is an innovative remediation technology based on the principles of smoldering combustion where the contaminants are the fuel. The self-sustaining aspect means that a single, local ignition event can result in many days of contaminant destruction in situ. Presented research to date has focused on bench scale experiments, numerical modelling and process understanding. Presented here is the maturation of the in situ technology, including three field pilot tests and a full-scale implementation to treat coal tar-impacted soils. The first pilot determined a Radius of Influence (ROI) for a single ignition of approximately eight feet with an average propagation rate of the reaction of approximately one foot per day. TPH concentrations in soils were reduced from 10,000 milligrams per kilogram to a few hundred milligrams per kilogram. The second pilot was conducted in an area of significant void spaces created through the anthropogenic deposition of clay bricks and tiles. The void spaces led to pre-mature termination of the combustion reaction, limiting ROI and the effectiveness of the technology in this setting. The third case study involved the pilot testing, design, and full-scale implementation of STAR at a 37-acre former chemical manufacturing facility. Three phases of pilot testing were conducted within two hydrogeologic units at the site (i.e., surficial fill and deep alluvial sand units). Pilot testing within the fill demonstrated self-sustained coal tar destruction rates in excess of 800 kg/day supported through air injection at a single well. Deep sand unit testing (twenty-five feet below the water table) resulted in the treatment of a targeted six-foot layer of impacted fine sands to a radial distance of approximately twelve feet. These results (and additional parameters) were used to develop a full-scale STAR design consisting of approximately 1500 surficial fill ignition points and 500 deep sand ignition points and two treatment (air distribution and vapor collection / treatment) systems to remediate an approximately 14-acre footprint of contaminated soils within the project timelines (i.e., by mid-2016). Field activities began in 2014 and progress is currently on-schedule.

Responses to antismoking radio and television advertisements among adult smokers and non-smokers across Africa: message-testing results from Senegal, Nigeria and Kenya.

PubMed

Perl, Rebecca; Murukutla, Nandita; Occleston, Jessica; Bayly, Megan; Lien, Mego; Wakefield, Melanie; Mullin, Sandra

2015-11-01

This study examined whether adaptation of existing antitobacco television and radio advertisements (ads) from high-income countries is a viable tobacco control strategy for Africa. 1078 male and female adult smokers and non-smokers, aged 18-40 years, from major and smaller urban locations in Kenya, Nigeria and Senegal, were recruited into groups using locally appropriate convenience sampling methods and stratified by smoking status, gender, age and socioeconomic status. Eligibility criteria included age, smoking status and literacy. Each participant rated five radio and five TV antismoking ads on five-point scales, which were later aggregated into measures of perceived effectiveness, potential behaviour change and antitobacco industry sentiment/support for government actions. For radio ads across all three countries, two health harms-focused ads-Coughing Child followed by Suffering-had the highest odds of a positive rating on the Perceived Effectiveness measure among smokers and non-smokers. For television ads, the strong graphic ad Baby Alive tended to be rated most positively across the majority of measures by all subgroups. This first systematic study of tobacco control advertisements in Africa is consistent with findings from other countries, suggesting that graphic health-harms ads developed and used in other countries could also be effective in African countries. This implies that adaptation would be a successful approach in Africa, where scarce resources for tobacco control communications can be focused on advertising dissemination, saving programmes from the cost, time and technical expertise required for development of new materials. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Assessing Psychodynamic Conflict.

PubMed

Simmonds, Joshua; Constantinides, Prometheas; Perry, J Christopher; Drapeau, Martin; Sheptycki, Amanda R

2015-09-01

Psychodynamic psychotherapies suggest that symptomatic relief is provided, in part, with the resolution of psychic conflicts. Clinical researchers have used innovative methods to investigate such phenomenon. This article aims to review the literature on quantitative psychodynamic conflict rating scales. An electronic search of the literature was conducted to retrieve quantitative observer-rated scales used to assess conflict noting each measure's theoretical model, information source, and training and clinical experience required. Scales were also examined for levels of reliability and validity. Five quantitative observer-rated conflict scales were identified. Reliability varied from poor to excellent with each measure demonstrating good validity. However a small number of studies and limited links to current conflict theory suggest further clinical research is needed.

Video-augmented feedback for procedural performance.

PubMed

Wittler, Mary; Hartman, Nicholas; Manthey, David; Hiestand, Brian; Askew, Kim

2016-06-01

Resident programs must assess residents' achievement of core competencies for clinical and procedural skills. Video-augmented feedback may facilitate procedural skill acquisition and promote more accurate self-assessment. A randomized controlled study to investigate whether video-augmented verbal feedback leads to increased procedural skill and improved accuracy of self-assessment compared to verbal only feedback. Participants were evaluated during procedural training for ultrasound guided internal jugular central venous catheter (US IJ CVC) placement. All participants received feedback based on a validated 30-point checklist for US IJ CVC placement and validated 6-point procedural global rating scale. Scores in both groups improved by a mean of 9.6 points (95% CI: 7.8-11.4) on the 30-point checklist, with no difference between groups in mean score improvement on the global rating scale. In regards to self-assessment, participant self-rating diverged from faculty scoring, increasingly so after receiving feedback. Residents rated highly by faculty underestimated their skill, while those rated more poorly demonstrated increasing overestimation. Accuracy of self-assessment was not improved by addition of video. While feedback advanced the skill of the resident, video-augmented feedback did not enhance skill acquisition or improve accuracy of resident self-assessment compared to standard feedback.

Memory impairment is not sufficient for choice blindness to occur.

PubMed

Sagana, Anna; Sauerland, Melanie; Merckelbach, Harald

2014-01-01

Choice blindness refers to the phenomenon that people can be easily misled about the choices they made in the recent past. The aim of this study was to explore the cognitive mechanisms underlying choice blindness. Specifically, we tested whether memory impairment may account for choice blindness. A total of N = 88 participants provided sympathy ratings on 10-point scales for 20 female faces. Subsequently, participants motivated some of their ratings. However, on three trials, they were presented with sympathy ratings that deviated from their original ratings by three full scale points. On nearly 41% of the trials, participants failed to detect (i.e., were blind) the manipulation. After a short interval, participants were informed that some trials had been manipulated and were asked to recall their original ratings. Participants adopted the manipulated outcome in only 3% of the trials. Furthermore, the extent to which the original ratings were accurately remembered was not higher for detected as compared with non-detected trials. From a theoretical point of view our findings indicate that memory impairment does not fully account for blindness phenomena.

Memory impairment is not sufficient for choice blindness to occur

PubMed Central

Sagana, Anna; Sauerland, Melanie; Merckelbach, Harald

2014-01-01

Choice blindness refers to the phenomenon that people can be easily misled about the choices they made in the recent past. The aim of this study was to explore the cognitive mechanisms underlying choice blindness. Specifically, we tested whether memory impairment may account for choice blindness. A total of N = 88 participants provided sympathy ratings on 10-point scales for 20 female faces. Subsequently, participants motivated some of their ratings. However, on three trials, they were presented with sympathy ratings that deviated from their original ratings by three full scale points. On nearly 41% of the trials, participants failed to detect (i.e., were blind) the manipulation. After a short interval, participants were informed that some trials had been manipulated and were asked to recall their original ratings. Participants adopted the manipulated outcome in only 3% of the trials. Furthermore, the extent to which the original ratings were accurately remembered was not higher for detected as compared with non-detected trials. From a theoretical point of view our findings indicate that memory impairment does not fully account for blindness phenomena. PMID:24904467

The Behavioural Assessment of Self-Structuring (BASS): psychometric properties in a post-acute brain injury rehabilitation programme.

PubMed

Jackson, Howard F; Tunstall, Victoria; Hague, Gemma; Daniels, Leanne; Crompton, Stacey; Taplin, Kimberly

2014-01-01

Jackson et al. (this edition) argue that structure is an important component in reducing the handicaps caused by cognitive impairments following acquired brain injury and that post-acute neuropsychological brain injury rehabilitation programmes should not only endeavour to provide structure but also aim to develop self-structuring. However, at present there is no standardized device for assessing self-structuring. To provide preliminary analysis of the psychometric properties of the Behavioural Assessment of Self-Structuring (BASS) staff rating scale (a 26 item informant five point rating scale based on the degree of support client requires to achieve self-structuring item). BASS data was utilised for clients attending residential rehabilitation. Reliability (inter-rarer and intra-rater), validity (construct, concurrent and discriminate) and sensitivity to change were investigated. Initial results indicate that the BASS has reasonably good reliability, good construct validity (via principal components analysis), good discriminant validity, and good concurrent validity correlating well with a number of other outcome measures (HoNOS; NPDS, Supervision Rating Scale, MPAI, FIM and FAM). The BASS did not correlate well with the NPCNA. Finally, the BASS was shown to demonstrate sensitivity to change. Although some caution is required in drawing firm conclusions at the present time and further exploration of the psychometric properties of the BASS is required, initial results are encouraging for the use of the BASS in assessing rehabilitation progress. These findings are discussed in terms of the value of the concept of self-structuring to the rehabilitation process for individuals with neuropsychological impairments consequent on acquired brain injury.

Optimizing the compatibility between rating scales and measures of productive second language competence.

PubMed

Weaver, Christopher

2011-01-01

This study presents a systematic investigation concerning the performance of different rating scales used in the English section of a university entrance examination to assess 1,287 Japanese test takers' ability to write a third-person introduction speech. Although the rating scales did not conform to all of the expectations of the Rasch model, they successfully defined a meaningful continuum of English communicative competence. In some cases, the expectations of the Rasch model needed to be weighed against the specific assessment needs of the university entrance examination. This investigation also found that the degree of compatibility between the number of points allotted to the different rating scales and the various requirements of an introduction speech played a considerable role in determining the extent to which the different rating scales conformed to the expectations of the Rasch model. Compatibility thus becomes an important factor to consider for optimal rating scale performance.

Phenomenological Reliving and Visual Imagery During Autobiographical Recall in Alzheimer's Disease.

PubMed

El Haj, Mohamad; Kapogiannis, Dimitrios; Antoine, Pascal

2016-03-16

Multiple studies have shown compromise of autobiographical memory and phenomenological reliving in Alzheimer's disease (AD). We investigated various phenomenological features of autobiographical memory to determine their relative vulnerability in AD. To this aim, participants with early AD and cognitively normal older adult controls were asked to retrieve an autobiographical event and rate on a five-point scale metacognitive judgments (i.e., reliving, back in time, remembering, and realness), component processes (i.e., visual imagery, auditory imagery, language, and emotion), narrative properties (i.e., rehearsal and importance), and spatiotemporal specificity (i.e., spatial details and temporal details). AD participants showed lower general autobiographical recall than controls, and poorer reliving, travel in time, remembering, realness, visual imagery, auditory imagery, language, rehearsal, and spatial detail-a decrease that was especially pronounced for visual imagery. Yet, AD participants showed high rating for emotion and importance. Early AD seems to compromise many phenomenological features, especially visual imagery, but also seems to preserve some other features.

Occupational Stress and Turnover Intention: Implications for Nursing Management

PubMed Central

Mosadeghrad, Ali Mohammad

2013-01-01

Background: The main purpose of this study was to explore the status of occupational stress among hospital nurses in Isfahan, Iran. It also aimed to examine the relationship between nurses’ occupational stress and their intention to leave the hospital. Methods: The study employed a cross-sectional research design. A validated questionnaire was used to collect data from 296 nurses. Respondents were asked to rate the intensity of 30 common occupational stressors using a five-point scale. Results: A third of hospital nurses rated their occupational stress high. The major sources of stress were inadequate pay, inequality at work, too much work, staff shortage, lack of promotion, job insecurity and lack of management support. More than 35% of nurses stated that they are considering leaving the hospital, if they could find another job opportunity. Occupational stress was positively associated with nurses’ turnover intentions. Conclusion: Hospital managers should develop and apply appropriate policies and strategies to reduce occupational stress and consequently nurses’ turnover intention. PMID:24596858

Depression and anxiety in patients with rheumatoid arthritis: prevalence rates based on a comparison of the Depression, Anxiety and Stress Scale (DASS) and the hospital, Anxiety and Depression Scale (HADS).

PubMed

Covic, Tanya; Cumming, Steven R; Pallant, Julie F; Manolios, Nick; Emery, Paul; Conaghan, Philip G; Tennant, Alan

2012-01-24

While it is recognised that depression is prevalent in Rheumatoid Arthritis (RA), recent studies have also highlighted significant levels of anxiety in RA patients. This study compared two commonly used scales, the Depression Anxiety and Stress Scale (DASS) and the Hospital Anxiety and Depression Scale (HADS), in relation to their measurement range and cut points to consider the relative prevalence of both constructs, and if prevalence rates may be due to scale-specific case definition. Patients meeting the criteria for RA were recruited in Leeds, UK and Sydney, Australia and asked to complete a survey that included both scales. The data was analysed using the Rasch measurement model. A total of 169 RA patients were assessed, with a repeat subsample, resulting in 323 cases for analysis. Both scales met Rasch model expectations. Using the 'possible+probable' cut point from the HADS, 58.3% had neither anxiety nor depression; 13.5% had anxiety only; 6.4% depression only and 21.8% had both 'possible+probable' anxiety and depression. Cut points for depression were comparable across the two scales while a lower cut point for anxiety in the DASS was required to equate prevalence. This study provides further support for high prevalence of depression and anxiety in RA. It also shows that while these two scales provide a good indication of possible depression and anxiety, the estimates of prevalence so derived could vary, particularly for anxiety. These findings are discussed in terms of comparisons across studies and selection of scales for clinical use.

Depression and anxiety in patients with rheumatoid arthritis: prevalence rates based on a comparison of the Depression, Anxiety and Stress Scale (DASS) and the hospital, Anxiety and Depression Scale (HADS)

PubMed Central

2012-01-01

Background While it is recognised that depression is prevalent in Rheumatoid Arthritis (RA), recent studies have also highlighted significant levels of anxiety in RA patients. This study compared two commonly used scales, the Depression Anxiety and Stress Scale (DASS) and the Hospital Anxiety and Depression Scale (HADS), in relation to their measurement range and cut points to consider the relative prevalence of both constructs, and if prevalence rates may be due to scale-specific case definition. Methods Patients meeting the criteria for RA were recruited in Leeds, UK and Sydney, Australia and asked to complete a survey that included both scales. The data was analysed using the Rasch measurement model. Results A total of 169 RA patients were assessed, with a repeat subsample, resulting in 323 cases for analysis. Both scales met Rasch model expectations. Using the 'possible+probable' cut point from the HADS, 58.3% had neither anxiety nor depression; 13.5% had anxiety only; 6.4% depression only and 21.8% had both 'possible+probable' anxiety and depression. Cut points for depression were comparable across the two scales while a lower cut point for anxiety in the DASS was required to equate prevalence. Conclusions This study provides further support for high prevalence of depression and anxiety in RA. It also shows that while these two scales provide a good indication of possible depression and anxiety, the estimates of prevalence so derived could vary, particularly for anxiety. These findings are discussed in terms of comparisons across studies and selection of scales for clinical use. PMID:22269280

A comparison between the original and Tablet-based Symbol Digit Modalities Test in patients with schizophrenia: Test-retest agreement, random measurement error, practice effect, and ecological validity.

PubMed

Tang, Shih-Fen; Chen, I-Hui; Chiang, Hsin-Yu; Wu, Chien-Te; Hsueh, I-Ping; Yu, Wan-Hui; Hsieh, Ching-Lin

2017-11-27

We aimed to compare the test-retest agreement, random measurement error, practice effect, and ecological validity of the original and Tablet-based Symbol Digit Modalities Test (T-SDMT) over five serial assessments, and to examine the concurrent validity of the T-SDMT in patients with schizophrenia. Sixty patients with chronic schizophrenia completed five serial assessments (one week apart) of the SDMT and T-SDMT and one assessment of the Activities of Daily Living Rating Scale III at the first time point. Both measures showed high test-retest agreement, similar levels of random measurement error over five serial assessments. Moreover, the practice effects of the two measures did not reach a plateau phase after five serial assessments in young and middle-aged participants. Nevertheless, only the practice effect of the T-SDMT became trivial after the first assessment. Like the SDMT, the T-SDMT had good ecological validity. The T-SDMT also had good concurrent validity with the SDMT. In addition, only the T-SDMT had discriminative validity to discriminate processing speed in young and middle-aged participants. Compared to the SDMT, the T-SDMT had overall slightly better psychometric properties, so it can be an alternative measure to the SDMT for assessing processing speed in patients with schizophrenia. Copyright © 2017 Elsevier B.V. All rights reserved.

Adjuvant therapy with pegylated interferon alfa-2b versus observation in resected stage III melanoma: a phase III randomized controlled trial of health-related quality of life and symptoms by the European Organisation for Research and Treatment of Cancer Melanoma Group.

PubMed

Bottomley, Andrew; Coens, Corneel; Suciu, Stefan; Santinami, Mario; Kruit, Willem; Testori, Alessandro; Marsden, Jeremy; Punt, Cornelis; Salès, François; Gore, Martin; Mackie, Rona; Kusic, Zvonko; Dummer, Reinhard; Patel, Poulam; Schadendorf, Dirk; Spatz, Alain; Keilholz, Ulrich; Eggermont, Alexander

2009-06-20

Interferon (IFN) -based adjuvant therapy in melanoma is associated with significant side effects, which necessitates evaluation of health-related quality of life (HRQOL). Our trial examined the HRQOL effects of adjuvant pegylated IFN-alpha-2b (PEG-IFN-alpha-2b) versus observation in patients with stage III melanoma. A total of 1,256 patients with stage III melanoma were randomly assigned after full lymphadenectomy to receive either observation (n = 629) or PEG-IFN-alpha-2b (n = 627): induction 6 micrograms/kg/wk [DOSAGE ERROR CORRECTED] for 8 weeks then maintenance 3 micrograms/kg/wk [DOSAGE ERROR CORRECTED] for an intended total duration of 5 years. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 was used to assess HRQOL. At 3.8 years of median follow-up, for the primary end point, recurrence-free survival (RFS), risk was reduced by 18% (hazard rate = 0.82; P = .01) in the PEG-IFN-alpha-2b arm compared with observation. Significant and clinically meaningful differences occurred with the PEG-IFN-alpha-2b treatment arm compared with the observation group, showing decreased global HRQOL at month 3 (-11.6 points; 99% CI, -8.2 to -15.0) and year 2 (-10.5 points; 99% CI, -6.6 to -14.4). Many of the other scales showed statistically significant differences between scores when comparing the two arms. From a clinical point of view, important differences were found for five scales: two functioning scales (social and role functioning) and three symptom scales (appetite loss, fatigue, and dyspnea), with the PEG-IFN-alpha-2b arm being most impaired. PEG-IFN-alpha-2b leads to a significant and sustained improvement in RFS. There is an expected negative effect on global HRQOL and selected symptoms when patients undergo PEG-IFN-alpha-2b treatment.

Development and testing of a scale to assess physician attitudes about handheld computers with decision support.

PubMed

Ray, Midge N; Houston, Thomas K; Yu, Feliciano B; Menachemi, Nir; Maisiak, Richard S; Allison, Jeroan J; Berner, Eta S

2006-01-01

The authors developed and evaluated a rating scale, the Attitudes toward Handheld Decision Support Software Scale (H-DSS), to assess physician attitudes about handheld decision support systems. The authors conducted a prospective assessment of psychometric characteristics of the H-DSS including reliability, validity, and responsiveness. Participants were 82 Internal Medicine residents. A higher score on each of the 14 five-point Likert scale items reflected a more positive attitude about handheld DSS. The H-DSS score is the mean across the fourteen items. Attitudes toward the use of the handheld DSS were assessed prior to and six months after receiving the handheld device. Cronbach's Alpha was used to assess internal consistency reliability. Pearson correlations were used to estimate and detect significant associations between scale scores and other measures (validity). Paired sample t-tests were used to test for changes in the mean attitude scale score (responsiveness) and for differences between groups. Internal consistency reliability for the scale was alpha = 0.73. In testing validity, moderate correlations were noted between the attitude scale scores and self-reported Personal Digital Assistant (PDA) usage in the hospital (correlation coefficient = 0.55) and clinic (0.48), p < 0.05 for both. The scale was responsive, in that it detected the expected increase in scores between the two administrations (3.99 (s.d. = 0.35) vs. 4.08, (s.d. = 0.34), p < 0.005). The authors' evaluation showed that the H-DSS scale was reliable, valid, and responsive. The scale can be used to guide future handheld DSS development and implementation.

40 CFR 211.204-2 - Primary label size, print and color.

Code of Federal Regulations, 2011 CFR

2011-07-01

... each area shall be as follows, based upon a scale of 72 points=1 inch: (1) Area A—2.8 millimeters (mm) or 8 point. (2) Area B—7.6 mm or 22 point for the Rating;—1.7 mm or 5 point for -“Decibels”. (3) Area...

Self-Assessment of competence during post-graduate training in general medicine: A preliminary study to develop a portfolio for further education

PubMed Central

Huenges, Bert; Woestmann, Barbara; Ruff-Dietrich, Susanne; Rusche, Herbert

2017-01-01

Awareness of one’s own strengths and weaknesses is a key qualification for the specialist physician. We examined how physicians undergoing specialist training in general medicine rate themselves in different areas. For this purpose, 139 participants receiving post-graduate training in general practice offered by the Medical Association of Westfalen-Lippe assessed themselves regarding their subjective confidence in 20 core competencies and 47 situations involving patient counseling in general practice. Their self-assessments were recorded on a five-point Likert scale. The study questions addressed acceptance and practicability of self-assessment, mean values, reliability, stratification and plausibility of the results in group comparison. On average participants rated their subjective confidence with 3.4 out of 5 points. The results are self-consistent (Cronbach’s alpha >0.8), although there are considerable differences among competencies and among participants. The latter can be explained partly by biographical data, which supports the plausibility of the data. Participants stated that regularly gathering data on subjective learning needs and the discussion of these needs with mentors and trainers contributes to improving their specialist training. Elements for self-assessment are suitable for integration into a postgraduate training portfolio. These should be supplemented by formative assessment procedures. PMID:29226236

Self-Assessment of competence during post-graduate training in general medicine: A preliminary study to develop a portfolio for further education.

PubMed

Huenges, Bert; Woestmann, Barbara; Ruff-Dietrich, Susanne; Rusche, Herbert

2017-01-01

Awareness of one's own strengths and weaknesses is a key qualification for the specialist physician. We examined how physicians undergoing specialist training in general medicine rate themselves in different areas. For this purpose, 139 participants receiving post-graduate training in general practice offered by the Medical Association of Westfalen-Lippe assessed themselves regarding their subjective confidence in 20 core competencies and 47 situations involving patient counseling in general practice. Their self-assessments were recorded on a five-point Likert scale. The study questions addressed acceptance and practicability of self-assessment, mean values, reliability, stratification and plausibility of the results in group comparison. On average participants rated their subjective confidence with 3.4 out of 5 points. The results are self-consistent (Cronbach's alpha >0.8), although there are considerable differences among competencies and among participants. The latter can be explained partly by biographical data, which supports the plausibility of the data. Participants stated that regularly gathering data on subjective learning needs and the discussion of these needs with mentors and trainers contributes to improving their specialist training. Elements for self-assessment are suitable for integration into a postgraduate training portfolio. These should be supplemented by formative assessment procedures.

Quench in the 1D Bose-Hubbard model: Topological defects and excitations from the Kosterlitz-Thouless phase transition dynamics

PubMed Central

Dziarmaga, Jacek; Zurek, Wojciech H.

2014-01-01

Kibble-Zurek mechanism (KZM) uses critical scaling to predict density of topological defects and other excitations created in second order phase transitions. We point out that simply inserting asymptotic critical exponents deduced from the immediate vicinity of the critical point to obtain predictions can lead to results that are inconsistent with a more careful KZM analysis based on causality – on the comparison of the relaxation time of the order parameter with the “time distance” from the critical point. As a result, scaling of quench-generated excitations with quench rates can exhibit behavior that is locally (i.e., in the neighborhood of any given quench rate) well approximated by the power law, but with exponents that depend on that rate, and that are quite different from the naive prediction based on the critical exponents relevant for asymptotically long quench times. Kosterlitz-Thouless scaling (that governs e.g. Mott insulator to superfluid transition in the Bose-Hubbard model in one dimension) is investigated as an example of this phenomenon. PMID:25091996

Simulation-based Assessment of the Management of Critical Events by Board-certified Anesthesiologists.

PubMed

Weinger, Matthew B; Banerjee, Arna; Burden, Amanda R; McIvor, William R; Boulet, John; Cooper, Jeffrey B; Steadman, Randolph; Shotwell, Matthew S; Slagle, Jason M; DeMaria, Samuel; Torsher, Laurence; Sinz, Elizabeth; Levine, Adam I; Rask, John; Davis, Fred; Park, Christine; Gaba, David M

2017-09-01

We sought to determine whether mannequin-based simulation can reliably characterize how board-certified anesthesiologists manage simulated medical emergencies. Our primary focus was to identify gaps in performance and to establish psychometric properties of the assessment methods. A total of 263 consenting board-certified anesthesiologists participating in existing simulation-based maintenance of certification courses at one of eight simulation centers were video recorded performing simulated emergency scenarios. Each participated in two 20-min, standardized, high-fidelity simulated medical crisis scenarios, once each as primary anesthesiologist and first responder. Via a Delphi technique, an independent panel of expert anesthesiologists identified critical performance elements for each scenario. Trained, blinded anesthesiologists rated video recordings using standardized rating tools. Measures included the percentage of critical performance elements observed and holistic (one to nine ordinal scale) ratings of participant's technical and nontechnical performance. Raters also judged whether the performance was at a level expected of a board-certified anesthesiologist. Rater reliability for most measures was good. In 284 simulated emergencies, participants were rated as successfully completing 81% (interquartile range, 75 to 90%) of the critical performance elements. The median rating of both technical and nontechnical holistic performance was five, distributed across the nine-point scale. Approximately one-quarter of participants received low holistic ratings (i.e., three or less). Higher-rated performances were associated with younger age but not with previous simulation experience or other individual characteristics. Calling for help was associated with better individual and team performance. Standardized simulation-based assessment identified performance gaps informing opportunities for improvement. If a substantial proportion of experienced anesthesiologists struggle with managing medical emergencies, continuing medical education activities should be reevaluated.

Smoked cannabis for chronic neuropathic pain: a randomized controlled trial

PubMed Central

Ware, Mark A.; Wang, Tongtong; Shapiro, Stan; Robinson, Ann; Ducruet, Thierry; Huynh, Thao; Gamsa, Ann; Bennett, Gary J.; Collet, Jean-Paul

2010-01-01

Background Chronic neuropathic pain affects 1%–2% of the adult population and is often refractory to standard pharmacologic treatment. Patients with chronic pain have reported using smoked cannabis to relieve pain, improve sleep and improve mood. Methods Adults with post-traumatic or postsurgical neuropathic pain were randomly assigned to receive cannabis at four potencies (0%, 2.5%, 6% and 9.4% tetrahydrocannabinol) over four 14-day periods in a crossover trial. Participants inhaled a single 25-mg dose through a pipe three times daily for the first five days in each cycle, followed by a nine-day washout period. Daily average pain intensity was measured using an 11-point numeric rating scale. We recorded effects on mood, sleep and quality of life, as well as adverse events. Results We recruited 23 participants (mean age 45.4 [standard deviation 12.3] years, 12 women [52%]), of whom 21 completed the trial. The average daily pain intensity, measured on the 11-point numeric rating scale, was lower on the prespecified primary contrast of 9.4% v. 0% tetrahydrocannabinol (5.4 v. 6.1, respectively; difference = 0.7, 95% confidence interval [CI] 0.02–1.4). Preparations with intermediate potency yielded intermediate but nonsignificant degrees of relief. Participants receiving 9.4% tetrahydrocannabinol reported improved ability to fall asleep (easier, p = 0.001; faster, p < 0.001; more drowsy, p = 0.003) and improved quality of sleep (less wakefulness, p = 0.01) relative to 0% tetrahydrocannabinol. We found no differences in mood or quality of life. The most common drug-related adverse events during the period when participants received 9.4% tetrahydrocannabinol were headache, dry eyes, burning sensation in areas of neuropathic pain, dizziness, numbness and cough. Conclusion A single inhalation of 25 mg of 9.4% tetrahydrocannabinol herbal cannabis three times daily for five days reduced the intensity of pain, improved sleep and was well tolerated. Further long-term safety and efficacy studies are indicated. (International Standard Randomised Controlled Trial Register no. ISRCTN68314063) PMID:20805210

Transformational, transactional among physician and laissez-faire leadership among physician executives.

PubMed

Xirasagar, Sudha

2008-01-01

The purpose of this paper is to examine the empirical validity of transformational, transactional and laissez-faire leadership and their sub-scales among physician managers. A nation-wide, anonymous mail survey was carried out in the United States, requesting community health center executive directors to provide ratings of their medical director's leadership behaviors (34 items) and effectiveness (nine items), using the Multifactor Leadership Questionnaire 5X-Short, on a five-point Likert scale. The survey response rate was 40.9 percent, for a total 269 responses. Exploratory factor analysis was done, using principal factor extraction, followed by promax rotation). The data yielded a three-factor structure, generally aligned with Bass and Avolio's constructs of transformational, transactional and laissez-faire leadership. Data do not support the factorial independence of their subscales (idealized influence, inspirational motivation, individualized consideration, and intellectual stimulation under transformational leadership; contingent reward, management-by-exception active, and management-by-exception passive under transactional leadership). Two contingent reward items loaded on transformational leadership, and all items of management-by-exception passive loaded on laissez-faire. A key limitation is that supervisors were surveyed for ratings of the medical directors' leadership style. Although past research in other fields has shown that supervisor ratings are strongly correlated with subordinate ratings, further research is needed to validate the findings by surveying physician and other clinical subordinates. Such research will also help to develop appropriate content of leadership training for clinical leaders. This study represents an important step towards establishing the empirical evidence for the full range of leadership constructs among physician leaders.

Focus on Adaptation. Final Report.

ERIC Educational Resources Information Center

Focus, 1997

1997-01-01

A panel of state staff, Professional Development Center directors, and other experts reviewed current or previous exemplary projects in Pennsylvania and in the U.S. and published project descriptions in a newsletter ("FOCUS" bulletin). Twenty-two special projects were selected as exemplary based on a five-point scale for innovation,…

Assessing Domestic vs. International Student Perceptions and Attitudes of Plagiarism

ERIC Educational Resources Information Center

Doss, Daniel Adrian; Henley, Russ; Gokaraju, Balakrishna; McElreath, David; Lackey, Hilliard; Hong, Qiuqi; Miller, Lauren

2016-01-01

The authors examined students' perceptions of plagiarism from a higher education teaching institution within the U.S. southeast. This study employed a five-point Likert-scale to examine differences of perceptions between domestic versus international students. Statistically significant outcomes were observed regarding the notions that plagiarism…

The semantic differential in landscape research

Treesearch

H. E. Echelberger

1979-01-01

On-site reactions of groups of viewers to six timber harvesting procedures were measured by direct and indirect measuring techniques. Using the direct technique, groups recorded their overall impressions of harvested tracts on five-point scales ranging from very favorable to very unfavorable. For the indirect technique, semantic differential procedures were used....

Assessing value-based health care delivery for haemodialysis.

PubMed

Parra, Eduardo; Arenas, María Dolores; Alonso, Manuel; Martínez, María Fernanda; Gamen, Ángel; Aguarón, Juan; Escobar, María Teresa; Moreno-Jiménez, José María; Alvarez-Ude, Fernando

2017-06-01

Disparities in haemodialysis outcomes among centres have been well-documented. Besides, attempts to assess haemodialysis results have been based on non-comprehensive methodologies. This study aimed to develop a comprehensive methodology for assessing haemodialysis centres, based on the value of health care. The value of health care is defined as the patient benefit from a specific medical intervention per monetary unit invested (Value = Patient Benefit/Cost). This study assessed the value of health care and ranked different haemodialysis centres. A nephrology quality management group identified the criteria for the assessment. An expert group composed of stakeholders (patients, clinicians and managers) agreed on the weighting of each variable, considering values and preferences. Multi-criteria methodology was used to analyse the data. Four criteria and their weights were identified: evidence-based clinical performance measures = 43 points; yearly mortality = 27 points; patient satisfaction = 13 points; and health-related quality of life = 17 points (100-point scale). Evidence-based clinical performance measures included five sub-criteria, with respective weights, including: dialysis adequacy; haemoglobin concentration; mineral and bone disorders; type of vascular access; and hospitalization rate. The patient benefit was determined from co-morbidity-adjusted results and corresponding weights. The cost of each centre was calculated as the average amount expended per patient per year. The study was conducted in five centres (1-5). After adjusting for co-morbidity, value of health care was calculated, and the centres were ranked. A multi-way sensitivity analysis that considered different weights (10-60% changes) and costs (changes of 10% in direct and 30% in allocated costs) showed that the methodology was robust. The rankings: 4-5-3-2-1 and 4-3-5-2-1 were observed in 62.21% and 21.55%, respectively, of simulations, when weights were varied by 60%. Value assessments may integrate divergent stakeholder perceptions, create a context for improvement and aid in policy-making decisions. © 2015 John Wiley & Sons, Ltd.

NASA/GE Energy Efficient Engine low pressure turbine scaled test vehicle performance report

NASA Technical Reports Server (NTRS)

Bridgeman, M. J.; Cherry, D. G.; Pedersen, J.

1983-01-01

The low pressure turbine for the NASA/General Electric Energy Efficient Engine is a highly loaded five-stage design featuring high outer wall slope, controlled vortex aerodynamics, low stage flow coefficient, and reduced clearances. An assessment of the performance of the LPT has been made based on a series of scaled air-turbine tests divided into two phases: Block 1 and Block 2. The transition duct and the first two stages of the turbine were evaluated during the Block 1 phase from March through August 1979. The full five-stage scale model, representing the final integrated core/low spool (ICLS) design and incorporating redesigns of stages 1 and 2 based on Block 1 data analysis, was tested as Block 2 in June through September 1981. Results from the scaled air-turbine tests, reviewed herein, indicate that the five-stage turbine designed for the ICLS application will attain an efficiency level of 91.5 percent at the Mach 0.8/10.67-km (35,000-ft), max-climb design point. This is relative to program goals of 91.1 percent for the ICLS and 91.7 percent for the flight propulsion system (FPS).

Tibio-talo-calcaneal arthrodesis with retrograde compression intramedullary nail fixation for salvage of failed total ankle replacement: a systematic review.

PubMed

Donnenwerth, Michael P; Roukis, Thomas S

2013-04-01

Failed total ankle replacement is a complex problem that should only be treated by experienced foot and ankle surgeons. Significant bone loss can preclude revision total ankle replacement and obligate revision though a complex tibio-talo-calcaneal arthrodesis. A systematic review of the world literature reveals a nonunion rate of 24.2%. A weighted mean of modified American Orthopaedic Foot and Ankle Society Ankle and Hindfoot Scale demonstrated fair patient outcomes of 58.1 points on an 86-point scale (67.6 points on a 100-point scale). Complications were observed in 38 of 62 (62.3%) patients reviewed, with the most common complication being nonunion. Copyright © 2013 Elsevier Inc. All rights reserved.

Validity and Reliability of Trichotomous Achievement Goal Scale

ERIC Educational Resources Information Center

Ilker, Gokce Erturan; Arslan, Yunus; Demirhan, Giyasettin

2011-01-01

The Trichotomous Achievement Goal Scale was developed by Agbuga and Xiang (2008) by including selected items from the scales of Duda and Nicholls (1992), Elliot (1999), and Elliot and Church (1997) and adapting them into Turkish. The scale consists of 18 items, and students rated each item on a 7-point Likert scale. To ascertain the validity and…

Pilot-scale anaerobic co-digestion of municipal biomass waste and waste activated sludge in China: Effect of organic loading rate

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu Xiao, E-mail: liuxiao07@mails.tsinghua.edu.cn; Wang Wei; Shi Yunchun

2012-11-15

Highlights: Black-Right-Pointing-Pointer Co-digestion of municipal biomass waste (MBW) and waste activated sludge (WAS) was examined on a pilot-scale reactor. Black-Right-Pointing-Pointer System performance and stability under OLR of 1.2, 2.4, 3.6, 4.8, 6.0 and 8.0 kg VS (m{sup 3} d){sup -1} were analyzed. Black-Right-Pointing-Pointer A maximum methane production rate of 2.94 m{sup 3} (m{sup 3} d){sup -1} was achieved at OLR of 8.0 kg VS (m{sup 3} d){sup -1} and HRT of 15d. Black-Right-Pointing-Pointer With the increasing OLRs, pH values, VS removal rate and methane concentration decreased and VFA increased. Black-Right-Pointing-Pointer The changing of biogas production rate can be a practicalmore » approach to monitor and control anaerobic digestion system. - Abstract: The effects of organic loading rate on the performance and stability of anaerobic co-digestion of municipal biomass waste (MBW) and waste activated sludge (WAS) were investigated on a pilot-scale reactor. The results showed that stable operation was achieved with organic loading rates (OLR) of 1.2-8.0 kg volatile solid (VS) (m{sup 3} d){sup -1}, with VS reduction rates of 61.7-69.9%, and volumetric biogas production of 0.89-5.28 m{sup 3} (m{sup 3} d){sup -1}. A maximum methane production rate of 2.94 m{sup 3} (m{sup 3} d){sup -1} was achieved at OLR of 8.0 kg VS (m{sup 3} d){sup -1} and hydraulic retention time of 15 days. With increasing OLRs, the anaerobic reactor showed a decrease in VS removal rate, average pH value and methane concentration, and a increase of volatile fatty acid concentration. By monitoring the biogas production rate (BPR), the anaerobic digestion system has a higher acidification risk under an OLR of 8.0 kg VS (m{sup 3} d){sup -1}. This result remarks the possibility of relating bioreactor performance with BPR in order to better understand and monitor anaerobic digestion process.« less

The relationship between suicide and five climate issues in a large-scale and long-term study in Japan.

PubMed

Inoue, K; Nishimura, Y; Fujita, Y; Ono, Y; Fukunaga, T

2012-08-01

Suicide rates in Japan were high in 1998 and have remained high since then. Many researchers have discussed the current state of suicide in Japan and the world; however, there are various opinions about the relationship between suicide and climate. In the present study, we report on long-term data of suicide and examine five climatic issues in Japan as a whole and in 10 selected prefectures: the five with the highest suicide rates in 2006 (Akita, Iwate, Shimane, Yamagata and Miyazaki Prefectures) and the five with the lowest (Nara, Tokushima, Okayama, Kanagawa and Kyoto Prefectures). Annual age-adjusted suicide rates were found to have a significant inverse correlation with annual mean air temperature in the five prefectures with the highest suicide rates and in the three prefectures with the lowest suicide rates among women. Annual age-adjusted suicide rates were significantly correlated with annual mean relative humidity in the three prefectures with the highest suicide rates among women and with the annual total sunshine duration in the three prefectures with the highest suicide rates among women. It is important that these associations between suicide and climatic factors be discussed further from various viewpoints, including those of many researchers and relevant organizations.

Quality of anaesthesia-related information accessed via Internet searches.

PubMed

Caron, S; Berton, J; Beydon, L

2007-08-01

We conducted a study to examine the quality and stability of information available from the Internet on four anaesthesia-related topics. In January 2006, we searched using four key words (porphyria, scleroderma, transfusion risk, and epidural analgesia risk) with five search engines (Google, HotBot, AltaVista, Excite, and Yahoo). We used a published scoring system (NetScoring) to evaluate the first 15 sites identified by each of these 20 searches. We also used a simple four-point scale to assess the first 100 sites in the Google search on one of our four topics ('epidural analgesia risk'). In November 2006, we conducted a second evaluation, using three search engines (Google, AltaVista, and Yahoo) with 14 synonyms for 'epidural analgesia risk'. The five search engines performed similarly. NetScoring scores were lower for transfusion risk (P < 0.001). One or more high-quality sites was identified consistently among the first 15 sites in each search. Quality scored using the simple scale correlated closely with medical content and design by NetScoring and with the number of references (P < 0.05). Synonyms of 'epidural analgesia risk' yielded similar results. The quality of accessed information improved somewhat over the 11 month period with Yahoo and AltaVista, but declined with Google. The Internet is a valuable tool for obtaining medical information, but the quality of websites varies between different topics. A simple rating scale may facilitate the quality scoring on individual websites. Differences in precise search terms used for a given topic did not appear to affect the quality of the information obtained.

Personality Factors and Depressive Configurations. An Exploratory Study in an Italian Clinical Sample

PubMed Central

Straccamore, Francesca; Ruggi, Simona; Lingiardi, Vittorio; Zanardi, Raffaella; Vecchi, Sara; Oasi, Osmano

2017-01-01

Introduction: This study focuses on the relationship between personality configurations and depressive experiences. More specifically, the aim of this study is to investigate the relationship between self-criticism and dependency and personality styles or disorders, exploring the association between personality features and depressive symptoms. The two-configurations model of personality developed by Blatt (2004, 2008) is adopted as a reference point in sharing a valid framework and in understanding the results. Methods: Five instruments are administered to 51 participants with a diagnosis of depressive disorder, in accordance with DSM-IV-TR (American Psychiatric Association, 2000): Self-criticism and dependency dimensions of depression are measured with the Depressive Experiences Questionnaire (DEQ); self-reported depression is assessed with the Beck Depression Inventory-II (BDI-II); observer-rated depression is assessed with the Hamilton Depression Rating Scale (HDRS); personality is assessed with the Clinical Diagnostic Interview (CDI) and the Shedler Westen Assessment Procedure-200 (SWAP-200). Results: Only self-criticism, and not dependency, is associated with depressive symptoms. In addition, the SWAP Borderline PD Scale and the Dysphoric: Emotionally dysregulated Q-factor emerge as significant in predicting depression. Conclusions: Findings support the assumption that depressive personality configurations can enhance the vulnerability to developing depression. Theoretical and clinical implications of these results are discussed. PMID:28316575

Assessment of change in dynamic psychotherapy.

PubMed

Høglend, P; Bøgwald, K P; Amlo, S; Heyerdahl, O; Sørbye, O; Marble, A; Sjaastad, M C; Bentsen, H

2000-01-01

Five scales have been developed to assess changes that are consistent with the therapeutic rationales and procedures of dynamic psychotherapy. Seven raters evaluated 50 patients before and 36 patients again after brief dynamic psychotherapy. A factor analysis indicated that the scales represent a dimension that is discriminable from general symptoms. A summary measure, Dynamic Capacity, was rated with acceptable reliability by a single rater. However, average scores of three raters were needed for good reliability of change ratings. The scales seem to be sufficiently fine-grained to capture statistically and clinically significant changes during brief dynamic psychotherapy.

A High Resolution Scale-of-four

DOE R&D Accomplishments Database

Fitch, V.

1949-08-25

A high resolution scale-of-four has been developed to be used in conjunction with the nuclear particle detection devices in applications where the counting rate is unusually high. Specifically, it is intended to precede the commercially available medium resolution scaling circuits and so decrease the resolving time of the counting system. The circuit will function reliably on continuously recurring pulses separated by less than 0.1 microseconds. It will resolve two pulses (occurring at a moderate repetition rate) which are spaced at 0.04 microseconds. A five-volt input signal is sufficient to actuate the device.

Multidimensional change in psychotherapy.

PubMed

Jones, E E

1980-04-01

Assessed psychotherapy outcome for 177 patients who were seen for an average of 31 therapy hours with the Rating Scales for Outcome of Therapy and a Therapist Questionnaire. Results of a components analysis did not support Storrow's rational groupings of the Rating Scales into five dimensions and suggested that two general areas of psychological adjustment underlie the 11 scales. A second components analysis that included both outcome measures supports only in part the contention that when results from diverse outcome measures are factor analyzed, the factors necessarily are associated with method of measurement rather than substantive dimensions of change.

Category Rating Is Based on Prototypes and Not Instances: Evidence from Feedback-Dependent Context Effects

ERIC Educational Resources Information Center

Petrov, Alexander A.

2011-01-01

Context effects in category rating on a 7-point scale are shown to reverse direction depending on feedback. Context (skewed stimulus frequencies) was manipulated between and feedback within subjects in two experiments. The diverging predictions of prototype- and exemplar-based scaling theories were tested using two representative models: ANCHOR…

THE VALIDITY OF CLINICAL DIFFERENTIATION BETWEEN ANXIETY AND DEPRESSIVE NEUROSES BY FACTOR ANALYSIS

PubMed Central

Singh, Gurmeet; Sharma, Ravinder Kumar

1986-01-01

SUMMARY Ninety subjects consisting of 30 patients of generalized anxiety disorder, 30 of dysthymic disorder (depressive neurosis) according to D. S. M. III criteria and 30 patients of mixed anxiety-depressive disorder were given a detailed psychiatric examination, in addition, they were administered the Humilton rating scales for anxiety and depression, and also the Taylor manifest anxiety scale and Amritsar depressive inventory. All the symptoms elicited were then subjected to factor analysis, five factors were isolated-two of them co-relating with the depressive rating scales and three with the anxiety rating scales. However there was considerable overlap with anxious mood having highest loading on the depressive factor. Thus anxiety and depression could not be isolated as distinct entities factorially. PMID:21927176

Comparison of the hedonic general Labeled Magnitude Scale with the hedonic 9-point scale.

PubMed

Kalva, Jaclyn J; Sims, Charles A; Puentes, Lorenzo A; Snyder, Derek J; Bartoshuk, Linda M

2014-02-01

The hedonic 9-point scale was designed to compare palatability among different food items; however, it has also been used occasionally to compare individuals and groups. Such comparisons can be invalid because scale labels (for example, "like extremely") can denote systematically different hedonic intensities across some groups. Addressing this problem, the hedonic general Labeled Magnitude Scale (gLMS) frames affective experience in terms of the strongest imaginable liking/disliking of any kind, which can yield valid group comparisons of food palatability provided extreme hedonic experiences are unrelated to food. For each scale, 200 panelists rated affect for remembered food products (including favorite and least favorite foods) and sampled foods; they also sampled taste stimuli (quinine, sucrose, NaCl, citric acid) and rated their intensity. Finally, subjects identified experiences representing the endpoints of the hedonic gLMS. Both scales were similar in their ability to detect within-subject hedonic differences across a range of food experiences, but group comparisons favored the hedonic gLMS. With the 9-point scale, extreme labels were strongly associated with extremes in food affect. In contrast, gLMS data showed that scale extremes referenced nonfood experiences. Perceived taste intensity significantly influenced differences in food liking/disliking (for example, those experiencing the most intense tastes, called supertasters, showed more extreme liking and disliking for their favorite and least favorite foods). Scales like the hedonic gLMS are suitable for across-group comparisons of food palatability. © 2014 Institute of Food Technologists®

Improving quit rates of web-delivered interventions for smoking cessation: full-scale randomized trial of WebQuit.org versus Smokefree.gov.

PubMed

Bricker, Jonathan B; Mull, Kristin E; McClure, Jennifer B; Watson, Noreen L; Heffner, Jaimee L

2018-05-01

Millions of people world-wide use websites to help them quit smoking, but effectiveness trials have an average 34% follow-up data retention rate and an average 9% quit rate. We compared the quit rates of a website using a new behavioral approach called Acceptance and Commitment Therapy (ACT; WebQuit.org) with the current standard of the National Cancer Institute's (NCI) Smokefree.gov website. A two-arm stratified double-blind individually randomized trial (n = 1319 for WebQuit; n = 1318 for Smokefree.gov) with 12-month follow-up. United States. Adults (n = 2637) who currently smoked at least five cigarettes per day were recruited from March 2014 to August 2015. At baseline, participants were mean [standard deviation (SD)] age 46.2 years (13.4), 79% women and 73% white. WebQuit.org website (experimental) provided ACT for smoking cessation; Smokefree.gov website (comparison) followed US Clinical Practice Guidelines for smoking cessation. The primary outcome was self-reported 30-day point prevalence abstinence at 12 months. The 12-month follow-up data retention rate was 88% (2309 of 2637). The 30-day point prevalence abstinence rates at the 12-month follow-up were 24% (278 of 1141) for WebQuit.org and 26% (305 of 1168) for Smokefree.gov [odds ratio (OR) = 0.91; 95% confidence interval (CI) = 0.76, 1.10; P = 0.334] in the a priori complete case analysis. Abstinence rates were 21% (278 of 1319) for WebQuit.org and 23% (305 of 1318) for Smokefree.gov (OR = 0.89 (0.74, 1.07; P = 0.200) when missing cases were imputed as smokers. The Bayes factor comparing the primary abstinence outcome was 0.17, indicating 'substantial' evidence of no difference between groups. WebQuit.org and Smokefree.gov had similar 30-day point prevalence abstinence rates at 12 months that were descriptively higher than those of prior published website-delivered interventions and telephone counselor-delivered interventions. © 2017 Society for the Study of Addiction.

The impact of perceived intensity and frequency of police work occupational stressors on the cortisol awakening response (CAR): Findings from the BCOPS study.

PubMed

Violanti, John M; Fekedulegn, Desta; Andrew, Michael E; Hartley, Tara A; Charles, Luenda E; Miller, Diane B; Burchfiel, Cecil M

2017-01-01

Police officers encounter unpredictable, evolving, and escalating stressful demands in their work. Utilizing the Spielberger Police Stress Survey (60-item instrument for assessing specific conditions or events considered to be stressors in police work), the present study examined the association of the top five highly rated and bottom five least rated work stressors among police officers with their awakening cortisol pattern. Participants were police officers enrolled in the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) study (n=338). For each group, the total stress index (product of rating and frequency of the stressor) was calculated. Participants collected saliva by means of Salivettes at four time points: on awakening, 15, 30 and 45min after waking to examine the cortisol awakening response (CAR). Saliva samples were analyzed for free cortisol concentrations. A slope reflecting the awakening pattern of cortisol over time was estimated by fitting a linear regression model relating cortisol in log-scale to time of collection. The slope served as the outcome variable. Analysis of covariance, regression, and repeated measures models were used to determine if there was an association of the stress index with the waking cortisol pattern. There was a significant negative linear association between total stress index of the five highest stressful events and slope of the awakening cortisol regression line (trend p-value=0.0024). As the stress index increased, the pattern of the awakening cortisol regression line tended to flatten. Officers with a zero stress index showed a steep and steady increase in cortisol from baseline (which is often observed) while officers with a moderate or high stress index showed a dampened or flatter response over time. Conversely, the total stress index of the five least rated events was not significantly associated with the awakening cortisol pattern. The study suggests that police events or conditions considered highly stressful by the officers may be associated with disturbances of the typical awakening cortisol pattern. The results are consistent with previous research where chronic exposure to stressors is associated with a diminished awakening cortisol response pattern. Copyright © 2016 Elsevier Ltd. All rights reserved.

The impact of perceived intensity and frequency of police work occupational stressors on the cortisol awakening response (CAR): Findings from the BCOPS study

PubMed Central

Violanti, John M.; Fekedulegn, Desta; Andrew, Michael E.; Hartley, Tara A.; Charles, Luenda E.; Miller, Diane B.; Burchfiel, Cecil M.

2016-01-01

Police officers encounter unpredictable, evolving, and escalating stressful demands in their work. Utilizing the Spielberger Police Stress Survey (60-item instrument for assessing specific conditions or events considered to be stressors in police work), the present study examined the association of the top five highly rated and bottom five least rated work stressors among police officers with their awakening cortisol pattern. Participants were police officers enrolled in the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) study (n = 338). For each group, the total stress index (product of rating and frequency of the stressor) was calculated. Participants collected saliva by means of Salivettes at four time points: on awakening, 15, 30 and 45 min after waking to examine the cortisol awakening response (CAR). Saliva samples were analyzed for free cortisol concentrations. A slope reflecting the awakening pattern of cortisol over time was estimated by fitting a linear regression model relating cortisol in log-scale to time of collection. The slope served as the outcome variable. Analysis of covariance, regression, and repeated measures models were used to determine if there was an association of the stress index with the waking cortisol pattern. There was a significant negative linear association between total stress index of the five highest stressful events and slope of the awakening cortisol regression line (trend p-value = 0.0024). As the stress index increased, the pattern of the awakening cortisol regression line tended to flatten. Officers with a zero stress index showed a steep and steady increase in cortisol from baseline (which is often observed) while officers with a moderate or high stress index showed a dampened or flatter response over time. Conversely, the total stress index of the five least rated events was not significantly associated with the awakening cortisol pattern. The study suggests that police events or conditions considered highly stressful by the officers may be associated with disturbances of the typical awakening cortisol pattern. The results are consistent with previous research where chronic exposure to stressors is associated with a diminished awakening cortisol response pattern. PMID:27816820

Effects of Scale, Question Location, Order of Response Alternatives, and Season on Self-Reported Noise Annoyance Using ICBEN Scales: A Field Experiment.

PubMed

Brink, Mark; Schreckenberg, Dirk; Vienneau, Danielle; Cajochen, Christian; Wunderli, Jean-Marc; Probst-Hensch, Nicole; Röösli, Martin

2016-11-23

The type of noise annoyance scale and aspects of its presentation such as response format or location within a questionnaire and other contextual factors may affect self-reported noise annoyance. By means of a balanced experimental design, the effect of type of annoyance question and corresponding scale (5-point verbal vs. 11-point numerical ICBEN (International Commission on Biological Effects of Noise) scale), presentation order of scale points (ascending vs. descending), question location (early vs. late within the questionnaire), and survey season (autumn vs. spring) on reported road traffic noise annoyance was investigated in a postal survey with a stratified random sample of 2386 Swiss residents. Our results showed that early appearance of annoyance questions was significantly associated with higher annoyance scores. Questionnaires filled out in autumn were associated with a significantly higher annoyance rating than in the springtime. No effect was found for the order of response alternatives. Standardized average annoyance scores were slightly higher using the 11-point numerical scale whereas the percentage of highly annoyed respondents was higher based on the 5-point scale, using common cutoff points. In conclusion, placement and presentation of annoyance questions within a questionnaire, as well as the time of the year a survey is carried out, have small but demonstrable effects on the degree of self-reported noise annoyance.

Effects of Scale, Question Location, Order of Response Alternatives, and Season on Self-Reported Noise Annoyance Using ICBEN Scales: A Field Experiment

PubMed Central

Brink, Mark; Schreckenberg, Dirk; Vienneau, Danielle; Cajochen, Christian; Wunderli, Jean-Marc; Probst-Hensch, Nicole; Röösli, Martin

2016-01-01

The type of noise annoyance scale and aspects of its presentation such as response format or location within a questionnaire and other contextual factors may affect self-reported noise annoyance. By means of a balanced experimental design, the effect of type of annoyance question and corresponding scale (5-point verbal vs. 11-point numerical ICBEN (International Commission on Biological Effects of Noise) scale), presentation order of scale points (ascending vs. descending), question location (early vs. late within the questionnaire), and survey season (autumn vs. spring) on reported road traffic noise annoyance was investigated in a postal survey with a stratified random sample of 2386 Swiss residents. Our results showed that early appearance of annoyance questions was significantly associated with higher annoyance scores. Questionnaires filled out in autumn were associated with a significantly higher annoyance rating than in the springtime. No effect was found for the order of response alternatives. Standardized average annoyance scores were slightly higher using the 11-point numerical scale whereas the percentage of highly annoyed respondents was higher based on the 5-point scale, using common cutoff points. In conclusion, placement and presentation of annoyance questions within a questionnaire, as well as the time of the year a survey is carried out, have small but demonstrable effects on the degree of self-reported noise annoyance. PMID:27886110

Cooled Radiofrequency Ablation of the Genicular Nerves for Chronic Pain due to Knee Osteoarthritis: Six-Month Outcomes.

PubMed

McCormick, Zachary L; Korn, Marc; Reddy, Rajiv; Marcolina, Austin; Dayanim, David; Mattie, Ryan; Cushman, Daniel; Bhave, Meghan; McCarthy, Robert J; Khan, Dost; Nagpal, Geeta; Walega, David R

2017-09-01

Determine outcomes of cooled radiofrequency ablation (C-RFA) of the genicular nerves for treatment of chronic knee pain due to osteoarthritis (OA). Cross-sectional survey. Academic pain medicine center. Consecutive patients with knee OA and 50% or greater pain relief following genicular nerve blocks who underwent genicular nerve C-RFA. Survey administration six or more months after C-RFA. Pain numeric rating scale (NRS), Medication Quantification Scale III (MQSIII), Patient Global Impression of Change (PGIC), and total knee arthroplasty (TKA) data were collected. Logistic regression was used to identify factors that predicted treatment success. Thirty-three patients (52 discrete knees) met inclusion criteria. Thirty-five percent (95% confidence interval [CI] = 22-48) of procedures resulted in the combined outcome of 50% or greater reduction in NRS score, reduction of 3.4 or more points in MQSIII score, and PGIC score consistent with "very much improved/improved." Nineteen percent (95% CI = 10-33) of procedures resulted in complete pain relief. Greater duration of pain and greater than 80% pain relief from diagnostic blocks were identified as predictors of treatment success. The accuracy of the model was 0.88 (95% CI = 0.78-0.97, P  <   0.001). Genicular C-RFA demonstrated a success rate of 35% based on a robust combination of outcome measures, and 19% of procedures resulted in complete relief of pain at a minimum of six months of follow-up. Report of 80% or greater relief from diagnostic blocks and duration of pain of less than five years are associated with high accuracy in predicting treatment success. Further prospective study is needed to optimize the patient selection protocol and success rate of this procedure. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Automatic generation of nursing narratives from entity-attribute-value triplet for electronic nursing records system.

PubMed

Min, Yul Ha; Park, Hyeoun-Ae; Lee, Joo Yun; Jo, Soo Jung; Jeon, Eunjoo; Byeon, Namsoo; Choi, Seung Yong; Chung, Eunja

2014-01-01

The aim of this study is to develop and evaluate a natural language generation system to populate nursing narratives using detailed clinical models. Semantic, contextual, and syntactical knowledges were extracted. A natural language generation system linking these knowledges was developed. The quality of generated nursing narratives was evaluated by the three nurse experts using a five-point rating scale. With 82 detailed clinical models, in total 66,888 nursing narratives in four different types of statement were generated. The mean scores for overall quality was 4.66, for content 4.60, for grammaticality 4.40, for writing style 4.13, and for correctness 4.60. The system developed in this study generated nursing narratives with different levels of granularity. The generated nursing narratives can improve semantic interoperability of nursing data documented in nursing records.

Improved medical student perception of ultrasound using a paired anatomy teaching assistant and clinician teaching model.

PubMed

Smith, Jacob P; Kendall, John L; Royer, Danielle F

2018-03-01

This study describes a new teaching model for ultrasound (US) training, and evaluates its effect on medical student attitudes toward US. First year medical students participated in hands-on US during human gross anatomy (2014 N = 183; 2015 N = 182). The sessions were facilitated by clinicians alone in 2014, and by anatomy teaching assistant (TA)-clinician pairs in 2015. Both cohorts completed course evaluations which included five US-related items on a four-point scale; cohort responses were compared using Mann-Whitney U tests with significance threshold set at 0.05. The 2015 survey also evaluated the TAs (three items, five-point scale). With the adoption of the TA-clinician teaching model, student ratings increased significantly for four out of five US-items: "US advanced my ability to learn anatomy" increased from 2.91 ± 0.77 to 3.35 ± 0.68 (P < 0.0001), "Incorporating US increased my interest in anatomy" from 3.05 ± 0.84 to 3.50 ± 0.71 (P < 0.0001), "US is relevant to my current educational needs" from 3.36 ± 0.63 to 3.54 ± 0.53 (P = 0.015), and "US training should start in Phase I" from 3.36 ± 0.71 to 3.56 ± 0.59 (P = 0.010). Moreover, more than 84% of students reported that TAs enhanced their understanding of anatomy (mean 4.18 ± 0.86), were a valuable part of US training (mean 4.23 ± 0.89), and deemed the TAs proficient in US (mean 4.24 ± 0.86). By using an anatomy TA-clinician teaching team, this study demonstrated significant improvements in student perceptions of the impact of US on anatomy education and the relevancy of US training to the early stages of medical education. Anat Sci Educ 11: 175-184. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.

Language support for linguistic minority chronic hepatitis B/C patients: an exploratory study of availability and clinicians' perceptions of language barriers in six European countries.

PubMed

Falla, Abby M; Veldhuijzen, Irene K; Ahmad, Amena A; Levi, Miriam; Richardus, Jan Hendrik

2017-02-20

Language support for linguistic minorities can improve patient safety, clinical outcomes and the quality of health care. Most chronic hepatitis B/C infections in Europe are detected among people born in endemic countries mostly in Africa, Asia and Central/Eastern Europe, groups that may experience language barriers when accessing health care services in their host countries. We investigated availability of interpreters and translated materials for linguistic minority hepatitis B/C patients. We also investigated clinicians' agreement that language barriers are explanations of three scenarios: the low screening uptake of hepatitis B/C screening, the lack of screening in primary care, and why cases do not reach specialist care. An online survey was developed, translated and sent to experts in five health care services involved in screening or treating viral hepatitis in six European countries: Germany, Hungary, Italy, the Netherlands, Spain and the United Kingdom (UK). The five areas of health care were: general practice/family medicine, antenatal care, health care for asylum seekers, sexual health and specialist secondary care. We measured availability using a three-point ordinal scale ('very common', 'variable or not routine' and 'rarely or never'). We measured agreement using a five-point Likert scale. We received 238 responses (23% response rate, N = 1026) from representatives in each health care field in each country. Interpreters are common in the UK, the Netherlands and Spain but variable or rare in Germany, Hungary and Italy. Translated materials are rarely/never available in Hungary, Italy and Spain but commonly or variably available in the Netherlands, Germany and the UK. Differing levels of agreement that language barriers explain the three scenarios are seen across the countries. Professionals in countries with most infrequent availability (Hungary and Italy) disagree strongest that language barriers are explanations. Our findings show pronounced differences between countries in availability of interpreters, differences that mirror socio-cultural value systems of 'difference-sensitive' and 'difference-blindness'. Improved language support is needed given the complex natural history of hepatitis B/C, the recognised barriers to screening and care, and the large undiagnosed burden among (potentially) linguistic minority migrant groups.

Type A behavior and the thallium stress test

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kahn, J.P.; Kornfeld, D.S.; Blood, D.K.

1982-11-01

Several recent studies have examined the association between Type A personality and coronary artery disease (CAD) by coronary angiography. Most of these studies have reported a significant association. The present study is an attempt at further confirmation, using a new non-invasive technique for measuring CAD. Subjects were 53 patients undergoing routine exercise stress tests with concomitant thallium-201 myocardial perfusion studies. Five aspects of Type A behavior were assessed by the use of the Rosenman-Friedman Semistructured Interview, and each was rated on a three-point scale. Severity of CAD was independently estimated on a four-point scale. Pearson correlation coefficients were separately computedmore » for patients with and without reported history of myocardial infarction (MI). For 37 patients without reported MI, CAD severity was significantly correlated with Overall Type A (r . -0.53), Vocal Characteristics (r . -0.53), Job Involvement (r . -0.36) and Aggressiveness (r . -0.48), but not Time Urgency (r . -0.25). For 16 patients with reported MI, CAD severity was significantly correlated with Job Involvement only (r . +0.49). The data are consistent with the association of Type A personality and coronary atherogenesis, but may also reflect Type A psychological and physiological characteristics. Future studies may be able to examine these and other aspects of Type A behavior using this noninvasive technique in more diverse patient populations.« less

Effect of Adding Interferential Current in an Exercise and Manual Therapy Program for Patients With Unilateral Shoulder Impingement Syndrome: A Randomized Clinical Trial.

PubMed

Gomes, Cid André Fidelis de Paula; Dibai-Filho, Almir Vieira; Moreira, William Arruda; Rivas, Shirley Quispe; Silva, Emanuela Dos Santos; Garrido, Ana Claudia Bogik

The purpose of this study was to measure the additional effect of adding interferential current (IFC) to an exercise and manual therapy program for patients with unilateral shoulder impingement syndrome. Forty-five participants were randomly assigned to group 1 (exercise and manual therapy), group 2 (exercise and manual therapy + IFC), or group 3 (exercise and manual therapy + placebo ultrasound). Individuals participated in 16 treatment sessions, twice a week for 8 weeks. The primary outcome of the study was total score of the Shoulder Pain and Disability Index (SPADI). The secondary outcomes were the pain and disability subscales of SPADI, Numeric Rating Scale, and Pain-Related Self-Statement Scale. Adjusted between-group mean differences (MDs) and 95% confidence intervals (CIs) were calculated using linear mixed models. After 16 treatment sessions, statistically significant but not clinically important differences were identified in favor of the exercise and manual therapy program alone in the SPADI-total (group 1 vs group 2, MD 11.12 points, 95% CI 5.90-16.35; group 1 vs group 3, MD 13.43 points, 95% CI 8.21-18.65). Similar results were identified for secondary outcomes. The addition of IFC does not generate greater clinical effects in an exercise and manual therapy program for individuals with unilateral shoulder impingement syndrome. Copyright © 2018. Published by Elsevier Inc.

Using Subjective and Objective Measures to Predict Level of Reading Fluency at the End of First Grade

ERIC Educational Resources Information Center

Morris, Darrell; Pennell, Ashley M.; Perney, Jan; Trathen, Woodrow

2018-01-01

This study compared reading rate to reading fluency (as measured by a rating scale). After listening to first graders read short passages, we assigned an overall fluency rating (low, average, or high) to each reading. We then used predictive discriminant analyses to determine which of five measures--accuracy, rate (objective); accuracy, phrasing,…

Self-assessment of competencies in dental education in Germany - a multicentred survey.

PubMed

Bitter, K; Rüttermann, S; Lippmann, M; Hahn, P; Giesler, M

2016-11-01

The aim was to assess the competencies of undergraduate dental students in Germany in the domains team competence, communicative competence, learning competence and scholarship. The survey was conducted at 11 dental schools that are equally distributed all over Germany. Competencies were assessed with the Freiburg Questionnaire to Assess Competencies in Medicine (FCM). A short version of the FCM was used in this study. This short form included the four domains: team competence (three items), communicative competence (eight items), learning competence (five items) and scholarship (four items). Students had to rate each item twice: first with regard to the respondent's current level of competence and second with regard to the level of competence that respondents think is required by their job. All items were rated on a five-point Likert scale (1 'very much' and 5 'not at all'). Responsible lecturers from all selected dental schools received another questionnaire to answer the questions whether the FCM domain corresponding learning objectives were taught at the respective dental school. A total of 317 undergraduate students from 11 dental schools in their last clinical year participated. The response rate varied between 48% and 92%. Cronbach's α for the FCM scales addressing the current level of competencies ranged from 0.70 to 0.89 and for the scales measuring the presumed level of competencies demanded by their job ranged from 0.72 to 0.82. The mean values of the scales for the assessment of the presumed level of competencies demanded by the job were significantly lower compared to the mean values of the scales for the current level of competencies (P < 0.001 in all analyses). We found large differences between the two levels - in terms of 'standardised response means' (SRM) - in the domains team competence (SRM 1.34), learning competence (SRM 1.27) and communicative competence (SRM 1.18). Overall, the learning objectives that correspond to the assessed domains of competencies were taught to 19.6% completely, to 55.4% partially and to 25% not at all at the participating dental schools. The results of the present survey revealed that the participating students perceived deficiencies in all domains of competencies. These results indicate that the assessed domains are still barely integrated into dental medicine curricula in Germany and that further research in this field is needed. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Factors Leading to Self-Removal from the Bariatric Surgery Program After Attending the Orientation Session.

PubMed

Yang, Kai; Zhang, Binghao; Kastanias, Patti; Wang, Wei; Okraniec, Allan; Sockalingam, Sanjeev

2017-01-01

Bariatric surgery orientation sessions are often the first point of contact and a recommended component of pre-bariatric surgery assessment. Self-removal rates after bariatric program orientation are as high as 25 % despite the proven efficacy of this procedure. The objective of this study was to identify factors contributing to patient self-removal after orientation using a mixed method approach. Patients who attended the Toronto Western Hospital Bariatric Surgery Program orientation between 2012 and 2013 and then self-removed from the program (N = 216) were included in the study. Subjects were interviewed via telephone using a semi-structured interview guide, generating both quantitative and qualitative data. Factors leading to discontinuation were rated on a five-point Likert scale. Qualitative data was analyzed using constant comparative methodology. The response rate was 59 % with a 40.7 % completion rate (N = 88). Concerns about potential surgical risks and complications and the ability to adapt to changes in eating and drinking post-operatively were identified as the top two factors for patients' self-removal from the program. Thematic analysis uncovered 11 major themes related to patient self-removal. Unexpected themes include perceived personal suitability for the surgery, family impact of surgery, miscommunication with the family physician, and fears related to the orientation information. This is one of the first studies examining barriers to bariatric surgery in the pre-operative setting and offers new insights into the reasons patients self-remove from bariatric surgery programs. This study may inform bariatric orientation program changes resulting in improved access to this effective surgical intervention.

What causes increasing and unnecessary use of radiological investigations? a survey of radiologists' perceptions

PubMed Central

Lysdahl, Kristin B; Hofmann, Bjørn M

2009-01-01

Background Growth in use and overuse of diagnostic imaging significantly impacts the quality and costs of health care services. What are the modifiable factors for increasing and unnecessary use of radiological services? Various factors have been indentified, but little is known about their relative impact. Radiologists hold key positions for providing such knowledge. Therefore the purpose of this study was to obtain radiologists' perspective on the causes of increasing and unnecessary use of radiological investigations. Methods In a mailed questionnaire radiologist members of the Norwegian Medical Association were asked to rate potential causes of increased investigation volume (fifteen items) and unnecessary investigations (six items), using five-point-scales. Responses were analysed by using summary statistics and Factor Analysis. Associations between variables were determined using Students' t-test, Spearman rank correlation and Chi-Square tests. Results The response rate was 70% (374/537). The highest rated causes of increasing use of radiological investigations were: a) new radiological technology, b) peoples' demands, c) clinicians' intolerance for uncertainty, d) expanded clinical indications, and e) availability. 'Over-investigation' and 'insufficient referral information' were reported the most frequent causes of unnecessary investigations. Correlations between causes of increasing and unnecessary radiology use were identified. Conclusion In order to manage the growth in radiological imaging and curtail inappropriate investigations, the study findings point to measures that influence the supply and demand of services, specifically to support the decision-making process of physicians. PMID:19723302

Changes of the Human Mind.

ERIC Educational Resources Information Center

Hill, Lilian H.

Five books, representing a small selection of possible readings on necessary changes of the human mind, point to a convergence of interest from different fields of study toward the need for modern society to develop the capacity to respond to the complexity of modern life and the newly acquired ability to destroy life on an unprecedented scale.…

Adolescents' Perceptions of Foreign-Made Products: Implications for Advertising Strategy.

ERIC Educational Resources Information Center

Reid, Leonard N.; Vanden Bergh, Bruce G.

A five-point, seven-item semantic differential scale was used to collect data from 130 high school students about their perceptions of foreign-made products and the relation of national stereotypes to product stereotypes. To assure consistency, the same product classes (all products, automobiles, cameras, and mechanical toys) and foreign countries…

Students' Perceptions of Their ICT-Based College English Course in China: A Case Study

ERIC Educational Resources Information Center

Zinan, Wen; Sai, George Teoh Boon

2017-01-01

This study investigated foreign language students' perceptions about their Information and Communication Technology (ICT)-based College English Course (CEC) in China. The research used a five-point Likert-scale questionnaire based on Simsek (2008). A factor analysis confirmed the construct validity of the questionnaire and 6 factors were…

An Empirical Investigation of Campus Portal Usage

ERIC Educational Resources Information Center

Saghapour, Mohsen; Iranmanesh, Mohammad; Zailani, Suhaiza; Goh, Gerald Guan Gan

2018-01-01

This study has determined the determinants of the perceived ease of use and perceived usefulness and their influence on campus portal usage. A quantitative approach was employed, using a five-point Likert scale questionnaire, adapted from previous studies. Data were gathered through a survey conducted with 341 staff working in the University of…

Differential Trust between Parents and Teachers of Children from Low-Income and Immigrant Backgrounds

ERIC Educational Resources Information Center

Janssen, Marije; Bakker, Joep T. A.; Bosman, Anna M. T.; Rosenberg, Kirsten; Leseman, Paul P. M.

2012-01-01

This study was designed to investigate the trust relationship between parents and teachers in first grade. Additional research questions were whether trust was related to ethnicity and reading performance. The five facets of trust; benevolence, reliability, competence, honesty and openness, were measured on a 4-point Likert scale. Reading…

Effects of changes in palatability on food intake and the cumulative food intake curve in man.

PubMed

Bobroff, E M; Kissileff, H R

1986-03-01

This study was undertaken to quantify the relationship between palatability ratings and food consumption and to determine whether the initial rate of eating was affected by changes in food palatability without a change in nutrient content. Both men and women were given small samples of foods at a brief exposure taste test and asked to rate how much they liked or disliked them on a 9-point scale (like extremely to dislike extremely). Those who gave at least a 2-point difference in rating between a banana colada frozen yogurt drink with and without adulteration with cumin were given these foods to eat to satiety on non-consecutive days, and the same 9-point scale was used to rate these foods after they had been eaten as meals. Cumin was used as an adulterant because it is not intrinsically unpalatable, but is not liked by many individuals in yogurt-based foods. Intake was approximately 100 g different for every unit of difference on the scale, and higher for liked than disliked food. Intake was significantly different between the adulterated and unadulterated meals. The percentage of variance explained by the difference in palatability was 34% of the total variance but was 67% of the variance within subjects. Correlation between intake and ratings were poor across subjects for both palatability levels (i.e. adulterated and unadulterated). The initial rate of eating was significantly higher under the better liked than under the less liked food. These results indicate that quantification of effects of hedonic ratings on intake within subjects is possible, but that hedonic ratings may not be good discriminators of intake differences between subjects. The initial rate of eating reflects partly on palatability.

Personality change following head injury: assessment with the NEO Five-Factor Inventory.

PubMed

Lannoo, E; de Deyne, C; Colardyn, F; de Soete, G; Jannes, C

1997-11-01

We evaluated personality change following head injury in 68 patients at 6 months postinjury using the NEO Five-Factor Inventory to assess the five personality dimensions of the Five-Factor Model of Personality. All items had to be rated twice, once for the preinjury and once for the current status. Twenty-eight trauma patients with injuries to other parts of the body than the head were used as controls. For the head-injured group, 63 relatives also completed the questionnaire. The results showed no differences between the ratings of head-injured patients and the ratings of trauma control patients. Both groups showed significant change in the personality dimensions Neuroticism, Extraversion, and Conscientiousness. Compared to their relatives, head-injured patients report a smaller change in Extraversion and Conscientiousness. Changes were not reported on the Openness and Agreeableness scales, by neither the head-injured or their relatives, nor by the trauma controls.

Decision tree rating scales for workload estimation: Theme and variations

NASA Technical Reports Server (NTRS)

Wierwille, W. W.; Skipper, J. H.; Rieger, C. A.

1984-01-01

The Modified Cooper-Harper (MCH) scale which is a sensitive indicator of workload in several different types of aircrew tasks was examined. The study determined if variations of the scale might provide greater sensitivity and the reasons for the sensitivity of the scale. The MCH scale and five newly devised scales were examined in two different aircraft simulator experiments in which pilot loading was treated as an independent variable. It is indicated that while one of the new scales may be more sensitive in a given experiment, task dependency is a problem. The MCH scale exhibits consistent senstivity and remains the scale recommended for general use. The MCH scale results are consistent with earlier experiments. The rating scale experiments are reported and the questionnaire results which were directed to obtain a better understanding of the reasons for the relative sensitivity of the MCH scale and its variations are described.

Decision Tree Rating Scales for Workload Estimation: Theme and Variations

NASA Technical Reports Server (NTRS)

Wietwille, W. W.; Skipper, J. H.; Rieger, C. A.

1984-01-01

The modified Cooper-Harper (MCH) scale has been shown to be a sensitive indicator of workload in several different types of aircrew tasks. The MCH scale was examined to determine if certain variations of the scale might provide even greater sensitivity and to determine the reasons for the sensitivity of the scale. The MCH scale and five newly devised scales were studied in two different aircraft simulator experiments in which pilot loading was treated as an independent variable. Results indicate that while one of the new scales may be more sensitive in a given experiment, task dependency is a problem. The MCH scale exhibits consistent sensitivity and remains the scale recommended for general use. The results of the rating scale experiments are presented and the questionnaire results which were directed at obtaining a better understanding of the reasons for the relative sensitivity of the MCH scale and its variations are described.

Comparison of the accuracy of steroid placement with clinical outcome in patients with shoulder symptoms

PubMed Central

Eustace, J; Brophy, D; Gibney, R; Bresnihan, B; FitzGerald, O

1997-01-01

OBJECTIVE—To study the effect of accuracy on the clinical outcome of local steroid injections to the shoulder.
METHODS—37 patients with shoulder symptoms of at least two months' duration received local injections of a mixture of triamcinolone and radiographic contrast material using a standardised technique. Radiographs of the joint were taken immediately afterwards. Details of the patients' symptoms (assessed by visual analogue scales) and range of movement at the joint were obtained before and two weeks after the injection. At follow up the patients were also assessed by means of a five point global rating scale of maximum and current benefit.
RESULTS—14 of the 38 procedures (37%) were judged to be accurately placed: four of the 14 attempted subacromial injections (29%) and 10 of the 24 attempted glenohumeral injections (42%). There were significant differences in relation to outcome between the accurately placed and the inaccurately placed groups.
CONCLUSIONS—Accuracy of steroid placement by injection in patients with shoulder symptoms may significantly affect the clinical outcome.

 PMID:9059143

The current level of shared decision-making in anesthesiology: an exploratory study.

PubMed

Stubenrouch, F E; Mus, E M K; Lut, J W; Hesselink, E M; Ubbink, D T

2017-07-12

Shared decision-making (SDM) seeks to involve both patients and clinicians in decision-making about possible health management strategies, using patients' preferences and best available evidence. SDM seems readily applicable in anesthesiology. We aimed to determine the current level of SDM among preoperative patients and anesthesiology clinicians. We invited 115 consecutive preoperative patients, visiting the pre-assessment outpatient clinic of the department of Anesthesiology at the Academic Medical Center of Amsterdam. Inclusion criteria were patients who needed surgery in the arms, lower abdomen or legs, and in whom three anesthesia techniques were feasible. The SDM-level of the consultation was scored objectively by independent observers who judged audio-recordings of the consultation using the OPTION 5 -scale, ranging from 0% (no SDM) to 100% (optimum SDM), as well as subjectively by patients (using the SDM-Q-9 and CollaboRATE questionnaires) and clinicians (SDM-Q-Doc questionnaire). Objective and subjective SDM-levels were assessed on five-point and six-point Likert scales, respectively. Both scores were expressed as percentages. Data of 80 patients could be analysed. Objective SDM-scores were low (30.5%). Subjective scores of the SDM-Q-9 and CollaboRATE were high among patients (91.7% and 96.3%, respectively) and among clinicians (SDM-Q-Doc; 84.3%). Apparently, they appreciated satisfaction rather than SDM, being poorly aware of what SDM entails. The level of SDM in an outpatient anesthesiology clinic where preoperative patients receive information about various possible anesthesia options, was found to be low. Thus, there is room for improving the level of SDM. Some suggestions are given how this can be achieved.

Educational climate seems unrelated to leadership skills of clinical consultants responsible of postgraduate medical education in clinical departments.

PubMed

Malling, Bente; Mortensen, Lene S; Scherpbier, Albert J J; Ringsted, Charlotte

2010-09-21

The educational climate is crucial in postgraduate medical education. Although leaders are in the position to influence the educational climate, the relationship between leadership skills and educational climate is unknown. This study investigates the relationship between the educational climate in clinical departments and the leadership skills of clinical consultants responsible for education. The study was a trans-sectional correlation study. The educational climate was investigated by a survey among all doctors (specialists and trainees) in the departments. Leadership skills of the consultants responsible for education were measured by multi-source feedback scores from heads of departments, peer consultants, and trainees. Doctors from 42 clinical departments representing 21 specialties participated. The response rate of the educational climate investigation was moderate 52% (420/811), Response rate was high in the multisource-feedback process 84.3% (420/498). The educational climate was scored quite high mean 3.9 (SD 0.3) on a five-point Likert scale. Likewise the leadership skills of the clinical consultants responsible for education were considered good, mean 5.4 (SD 0.6) on a seven-point Likert scale. There was no significant correlation between the scores concerning the educational climate and the scores on leadership skills, r = 0.17 (p = 0.29). This study found no relation between the educational climate and the leadership skills of the clinical consultants responsible for postgraduate medical education in clinical departments with the instruments used. Our results indicate that consultants responsible for education are in a weak position to influence the educational climate in the clinical department. Further studies are needed to explore, how heads of departments and other factors related to the clinical organisation could influence the educational climate.

Diagnostic ultrasound imaging for lateral epicondylalgia: a case-control study.

PubMed

Heales, Luke James; Broadhurst, Nathan; Mellor, Rebecca; Hodges, Paul William; Vicenzino, Bill

2014-11-01

Lateral epicondylalgia (LE) is clinically diagnosed as pain over the lateral elbow that is provoked by gripping. Usually, LE responds well to conservative intervention; however, those who fail such treatment require further evaluation, including musculoskeletal ultrasound. Previous studies of musculoskeletal ultrasound have methodological flaws, such as lack of assessor blinding and failure to control for participant age, sex, and arm dominance. The purpose of this study was to assess the diagnostic use of blinded ultrasound imaging in people with clinically diagnosed LE compared with that in a control group matched for age, sex, and arm dominance. Participants (30 with LE and 30 controls) underwent clinical examination as the criterion standard test. Unilateral LE was defined as pain over the lateral epicondyle, which was provoked by palpation, resisted wrist and finger extension, and gripping. Controls without symptoms were matched for age, sex, and arm dominance. Ultrasound investigations were performed by two sonographers using a standardized protocol. Grayscale images were assessed for signs of tendon pathology and rated on a four-point ordinal scale. Power Doppler was used to assess neovascularity and rated on a five-point ordinal scale. The combination of grayscale and power Doppler imaging revealed an overall sensitivity of 90% and specificity of 47%. The positive and negative likelihood ratios for combined grayscale and power Doppler imaging were 1.69 and 0.21, respectively. Although ultrasound imaging helps confirm the absence of LE, when findings are negative for tendinopathic changes, the high prevalence of tendinopathic changes in pain-free controls challenges the specificity of the measure. The validity of ultrasound imaging to confirm tendon pathology in clinically diagnosed LE requires further study with strong methodology.

Exploring the perceived usefulness of practical food groups in day treatment for individuals with eating disorders.

PubMed

Biddiscombe, Rachel J; Scanlan, Justin Newton; Ross, Jessica; Horsfield, Sarah; Aradas, Jessica; Hart, Susan

2018-04-01

Recovery from eating disorders is a challenging process. Emerging literature suggests that occupational therapists may provide a useful contribution in delivering purposeful eating-related interventions as a potential treatment to support sustained cognitive and behavioural changes for individuals with eating disorders. This study aimed to evaluate participants' perceptions of the contribution of occupational therapy practical food groups (food based outings and cooking groups) in supporting their functional recovery. Individuals attended practical food groups as part of standard treatment at an outpatient eating disorders day program. Ninety-nine participants completed questionnaires at discharge and up to three follow-up points (6, 12 and 24 months). Questions related to practical food groups were analysed, exploring participants' experiences and perceived usefulness of groups using rating-scale and open-ended questions. Open-ended responses were analysed using thematic analysis. Descriptive statistics were calculated for responses to rating-scale questions. At discharge, participants rated the importance and usefulness of practical food groups as high (4.73 and 4.43 on 5-point scales, respectively), but tended to rate their enjoyment of the groups lower (3.50 on a 5-point scale). Some skill transfer was typically reported by participants at discharge (3.92 on a 5-point scale). One core theme, 'success through participation', emerged from qualitative comments. Six subthemes were also identified: helpful components of practical food groups; perceived benefit of exposure; impact of applying cognitive and behavioural skills; challenges affecting participation; facilitating adaptation; and influence of eating disorders on challenging feared foods. This study highlights that participation in practical food groups was perceived as useful in assisting individuals to improve eating behaviours and, in some circumstances, transfer these skills into their lives outside of day program. Results suggest that occupational therapists may have an important contribution in delivering these interventions to support recovery and facilitate application of adaptive coping strategies. © 2017 Occupational Therapy Australia.

Assessment of Peer-Led Team Learning in Calculus I: A Five-Year Study

ERIC Educational Resources Information Center

Merkel, John Conrad; Brania, Abdelkrim

2015-01-01

This five-year study of the peer-led team learning (PLTL) paradigm examined its implementation in a Calculus I course at an all-male HBCU institution. For this study we set up a strong control group and measured the effect of PLTL in the teaching and learning of Calculus I through two points of measure: retention and success rates and learning…

Value-Eroding Teacher Behaviors Scale: A Validity and Reliability Study

ERIC Educational Resources Information Center

Arseven, Zeynep; Kiliç, Abdurrahman; Sahin, Seyma

2016-01-01

In the present study, it is aimed to develop a valid and reliable scale for determining value-eroding behaviors of teachers, hence their values of judgment. The items of the "Value-eroding Teacher Behaviors Scale" were designed in the form of 5-point likert type rating scale. The exploratory factor analysis (EFA) was conducted to…

Loewenstein communication scale for the minimally responsive patient.

PubMed

Borer-Alafi, Nurit; Gil, Mali; Sazbon, Leon; Korn, Cecilia

2002-07-01

Any sign of communicative ability in patients in vegetative state can provide information about regain of consciousness and conservation of cognitive abilities. The aim of this study was to test the reliability and validity of an instrument designed to measure the degree of communication in minimally responsive patients. The Loewenstein Communication Scale (LCS) measures five hierarchical functions - mobility, respiration, visual responsiveness, auditory comprehension and linguistic skills (verbal or alternative) - which are divided into five parameters and rated in developmental order on a 5-point scale by level of difficulty. Scores for each function are summed to obtain a quantitative communication profile. Forty-two adult patients in vegetative state, as a result of acquired brain injury, were examined with the proposed LCS for the minimally responsive patients by two speech and language clinicians at admission to the Intensive Care Unit (ICU) for brain injured patients and, thereafter, at least once weekly. At the end of the ICU stay, 27 patients who showed signs of recovery and were referred for continued rehabilitation were compared to a group of 15 patients who were not referred for continued rehabilitation, for functional and general LCS scores. The predictive power of the LCS in differentiating between these groups was tested. The LCS was found to have very good reliability with good inter-rater agreement. Patients who eventually continued rehabilitation had significantly higher total scores as well as in the motor, visual and auditory sub-scales. Logistic regression results indicated that these parameters successfully differentiated between the two groups of patients, even after adjusting for age and for scores on the Glasgow Coma Scale. The LCS for the minimally responsive patients proved to be reliable and predictive of rehabilitation progress of minimally responsive patients. It may be useful for the interdisciplinary rehabilitation team in planning early individually targeted therapeutic programmes. 2002 Taylor & Francis Ltd

Development and validation of Big Four personality scales for the Schedule for Nonadaptive and Adaptive Personality--Second Edition (SNAP-2).

PubMed

Calabrese, William R; Rudick, Monica M; Simms, Leonard J; Clark, Lee Anna

2012-09-01

Recently, integrative, hierarchical models of personality and personality disorder (PD)--such as the Big Three, Big Four, and Big Five trait models--have gained support as a unifying dimensional framework for describing PD. However, no measures to date can simultaneously represent each of these potentially interesting levels of the personality hierarchy. To unify these measurement models psychometrically, we sought to develop Big Five trait scales within the Schedule for Nonadaptive and Adaptive Personality--Second Edition (SNAP-2). Through structural and content analyses, we examined relations between the SNAP-2, the Big Five Inventory (BFI), and the NEO Five-Factor Inventory (NEO-FFI) ratings in a large data set (N = 8,690), including clinical, military, college, and community participants. Results yielded scales consistent with the Big Four model of personality (i.e., Neuroticism, Conscientiousness, Introversion, and Antagonism) and not the Big Five, as there were insufficient items related to Openness. Resulting scale scores demonstrated strong internal consistency and temporal stability. Structural validity and external validity were supported by strong convergent and discriminant validity patterns between Big Four scale scores and other personality trait scores and expectable patterns of self-peer agreement. Descriptive statistics and community-based norms are provided. The SNAP-2 Big Four Scales enable researchers and clinicians to assess personality at multiple levels of the trait hierarchy and facilitate comparisons among competing big-trait models. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Development and Validation of Big Four Personality Scales for the Schedule for Nonadaptive and Adaptive Personality-2nd Edition (SNAP-2)

PubMed Central

Calabrese, William R.; Rudick, Monica M.; Simms, Leonard J.; Clark, Lee Anna

2012-01-01

Recently, integrative, hierarchical models of personality and personality disorder (PD)—such as the Big Three, Big Four and Big Five trait models—have gained support as a unifying dimensional framework for describing PD. However, no measures to date can simultaneously represent each of these potentially interesting levels of the personality hierarchy. To unify these measurement models psychometrically, we sought to develop Big Five trait scales within the Schedule for Adaptive and Nonadaptive Personality–2nd Edition (SNAP-2). Through structural and content analyses, we examined relations between the SNAP-2, Big Five Inventory (BFI), and NEO-Five Factor Inventory (NEO-FFI) ratings in a large data set (N = 8,690), including clinical, military, college, and community participants. Results yielded scales consistent with the Big Four model of personality (i.e., Neuroticism, Conscientiousness, Introversion, and Antagonism) and not the Big Five as there were insufficient items related to Openness. Resulting scale scores demonstrated strong internal consistency and temporal stability. Structural and external validity was supported by strong convergent and discriminant validity patterns between Big Four scale scores and other personality trait scores and expectable patterns of self-peer agreement. Descriptive statistics and community-based norms are provided. The SNAP-2 Big Four Scales enable researchers and clinicians to assess personality at multiple levels of the trait hierarchy and facilitate comparisons among competing “Big Trait” models. PMID:22250598

Development and validation of a tool to assess knowledge and attitudes towards generic medicines among students in Greece: The ATtitude TOwards GENerics (ATTOGEN) questionnaire.

PubMed

Domeyer, Philip J; Aletras, Vassilis; Anagnostopoulos, Fotios; Katsari, Vasiliki; Niakas, Dimitris

2017-01-01

The use of generic medicines is a cost-effective policy, often dictated by fiscal restraints. To our knowledge, no fully validated tool exploring the students' knowledge and attitudes towards generic medicines exists. The aim of our study was to develop and validate a questionnaire exploring the knowledge and attitudes of M.Sc. in Health Care Management students and recent alumni's towards generic drugs in Greece. The development of the questionnaire was a result of literature review and pilot-testing of its preliminary versions to researchers and students. The final version of the questionnaire contains 18 items measuring the respondents' knowledge and attitude towards generic medicines on a 5-point Likert scale. Given the ordinal nature of the data, ordinal alpha and polychoric correlations were computed. The sample was randomly split into two halves. Exploratory factor analysis, performed in the first sample, was used for the creation of multi-item scales. Confirmatory factor analysis and Generalized Linear Latent and Mixed Model analysis (GLLAMM) with the use of the rating scale model were used in the second sample to assess goodness of fit. An assessment of internal consistency reliability, test-retest reliability, and construct validity was also performed. Among 1402 persons contacted, 986 persons completed our questionnaire (response rate = 70.3%). Overall Cronbach's alpha was 0.871. The conjoint use of exploratory and confirmatory factor analysis resulted in a six-scale model, which seemed to fit the data well. Five of the six scales, namely trust, drug quality, state audit, fiscal impact and drug substitution were found to be valid and reliable, while the knowledge scale suffered only from low inter-scale correlations and a ceiling effect. However, the subsequent confirmatory factor and GLLAMM analyses indicated a good fit of the model to the data. The ATTOGEN instrument proved to be a reliable and valid tool, suitable for assessing students' knowledge and attitudes towards generic medicines.

Nurse-patient assignment models considering patient acuity metrics and nurses' perceived workload.

PubMed

Sir, Mustafa Y; Dundar, Bayram; Barker Steege, Linsey M; Pasupathy, Kalyan S

2015-06-01

Patient classification systems (PCSs) are commonly used in nursing units to assess how many nursing care hours are needed to care for patients. These systems then provide staffing and nurse-patient assignment recommendations for a given patient census based on these acuity scores. Our hypothesis is that such systems do not accurately capture workload and we conduct an experiment to test this hypothesis. Specifically, we conducted a survey study to capture nurses' perception of workload in an inpatient unit. Forty five nurses from oncology and surgery units completed the survey and rated the impact of patient acuity indicators on their perceived workload using a six-point Likert scale. These ratings were used to calculate a workload score for an individual nurse given a set of patient acuity indicators. The approach offers optimization models (prescriptive analytics), which use patient acuity indicators from a commercial PCS as well as a survey-based nurse workload score. The models assign patients to nurses in a balanced manner by distributing acuity scores from the PCS and survey-based perceived workload. Numerical results suggest that the proposed nurse-patient assignment models achieve a balanced assignment and lower overall survey-based perceived workload compared to the assignment based solely on acuity scores from the PCS. This results in an improvement of perceived workload that is upwards of five percent. Copyright © 2015 Elsevier Inc. All rights reserved.

Acceptance of Nordic snack bars in children aged 8-11 years.

PubMed

Holmer, Anna; Hausner, Helene; Reinbach, Helene C; Bredie, Wender L P; Wendin, Karin

2012-01-01

A health promoting diet is suggested to be tailored to regional circumstances to preserve the cultural diversity in eating habits, as well as contribute to more environmentally friendly eating. It may influence consumer acceptance, however, if the components of the diet differs considerably from their habitual food. This study aimed to investigate whether snack bars composed of Nordic ingredients were accepted by 8-11 year-old Danish (n=134) and Swedish (n=109) children. A seven-point hedonic scale was used to measure the children's acceptance of five snack bars that varied in their composition of whole grains, berries and nuts. A preference rank ordering of the five bars was also performed. The results showed that samples that were rated highest in liking and were most preferred in both countries were a kamut/pumpkin bar and an oat/cranberry bar. The sample with the lowest rating that was also least preferred was a pumpernickel/sea buckthorn bar. Flavour was the most important determinant of overall liking followed by texture, odour and appearance. Children's acceptances and preferences were highly influenced by the sensory characteristics of the bars, mainly flavour. In agreement with earlier studies, the novel food ingredients seemed to influence children's preferences. The Nordic snack bars may have a potential to be a snack option for Danish and Swedish school children, but repeated exposures to the products are recommended to increase children's acceptance.

Using a systematic conceptual model for a process evaluation of a middle school obesity risk-reduction nutrition curriculum intervention: choice, control & change.

PubMed

Lee, Heewon; Contento, Isobel R; Koch, Pamela

2013-03-01

To use and review a conceptual model of process evaluation and to examine the implementation of a nutrition education curriculum, Choice, Control & Change, designed to promote dietary and physical activity behaviors that reduce obesity risk. A process evaluation study based on a systematic conceptual model. Five middle schools in New York City. Five hundred sixty-two students in 20 classes and their science teachers (n = 8). Based on the model, teacher professional development, teacher implementation, and student reception were evaluated. Also measured were teacher characteristics, teachers' curriculum evaluation, and satisfaction with teaching the curriculum. Descriptive statistics and Spearman ρ correlation for quantitative analysis and content analysis for qualitative data were used. Mean score of the teacher professional development evaluation was 4.75 on a 5-point scale. Average teacher implementation rate was 73%, and the student reception rate was 69%. Ongoing teacher support was highly valued by teachers. Teacher satisfaction with teaching the curriculum was highly correlated with student satisfaction (P < .05). Teacher perception of amount of student work was negatively correlated with implementation and with student satisfaction (P < .05). Use of a systematic conceptual model and comprehensive process measures improves understanding of the implementation process and helps educators to better implement interventions as designed. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

An open-label pilot study of aripiprazole for male and female veterans with chronic post-traumatic stress disorder who respond suboptimally to antidepressants.

PubMed

Youssef, Nagy A; Marx, Christine E; Bradford, Daniel W; Zinn, Sandra; Hertzberg, Michael A; Kilts, Jason D; Naylor, Jennifer C; Butterfield, Marian I; Strauss, Jennifer L

2012-07-01

Emerging data suggest that second-generation antipsychotics such as aripiprazole may be effective in the treatment of post-traumatic stress disorder (PTSD). However, few clinical trials have used aripiprazole in PTSD, and data are limited on its use in Veterans with PTSD. The objective of this pilot trial was to investigate the safety and efficacy of aripiprazole in Veterans with PTSD. Ten individuals (five men and five women) meeting the Diagnostic and statistical manual of mental disorders, 4th ed., PTSD criteria participated in this 12-week, open-label, flexibly dosed monotherapy trial. The dose range of aripiprazole was 5-30 mg/day, titrated to tolerability and clinical response. The primary outcome measure was the Clinician-Administered PTSD Scale. Additional outcomes included the Short PTSD Rating Interview, the Treatment Outcome PTSD Scale (Top-8), the Davidson Trauma Scale, the Positive and Negative Syndrome Scale, the Beck Depression Inventory-Fast Screen, and Clinical Global Impressions-Improvement. Eight participants completed the study, and aripiprazole was generally well tolerated and associated with a significant improvement in PTSD symptoms, as measured by the Clinician-Administered PTSD Scale (primary outcome measure) and by the Short PTSD Rating Interview, the Treatment Outcome PTSD Scale, and the Davidson Trauma Scale. An improvement was also observed on all three Positive and Negative Syndrome Scale subscales and the Beck Depression Inventory-Fast Screen, and the average Clinical Global Impressions-Improvement ratings indicated that patients were 'much improved'. These promising initial results merit further investigation in a larger, randomized-controlled trial.

What Is the Apgar Score?

MedlinePlus

... newborns soon after birth. This test checks a baby's heart rate, muscle tone, and other signs to see ... test, five things are used to check a baby's health. Each is scored on a scale of 0 to 2, ... P ulse (heart rate) G rimace response (reflexes) A ctivity (muscle ...

Short-term effect (ATR, Kasperczyk's Scale, chest's mobility) of using of physiotherapy method in the treatment of AIS - pilot study.

PubMed

Blicharska, I; Brzek, A; Durmala, J

2012-01-01

The assessment of influence physiotherapy (DoboMed) to the chest's mobility and the morphology of the ribcage and the posture in short-term intensive physiotherapy in the Department of Rehabilitation. Forty five girls with AIS (mean age- 14.9y.; Cobb angle-range 11-40 degree) were examined. The physiotherapy was been continued for 3 weeks. The angle of trunk rotation (ATR) (Bunnell scoliometer), the posture's morphology (Kasperczyk's Scale) and the chest's mobility index were estimated twice- before and after therapy. After therapy values of ATR decreased by 2°, the chest mobility index increased by 1.3 and total point obtained in the Kasperczyk's Scale has decreased by 1.9 point- which indicates the improvement body posture. All differences are statistically significantly. Also, reported correlations between Cobb angle and ATR and the sum of the points obtained by Kapserczyk's Scale in first exam. Using of physiotherapeutic method in the treatment of AIS provides to the functionally improvement of the chest's mobility, the angle of trunk rotation and the posture in the short time. A used measurement's tools were practical for PT in everyday's work.

The 4-Item Negative Symptom Assessment (NSA-4) Instrument: A Simple Tool for Evaluating Negative Symptoms in Schizophrenia Following Brief Training.

PubMed

Alphs, Larry; Morlock, Robert; Coon, Cheryl; van Willigenburg, Arjen; Panagides, John

2010-07-01

Objective. To assess the ability of mental health professionals to use the 4-item Negative Symptom Assessment instrument, derived from the Negative Symptom Assessment-16, to rapidly determine the severity of negative symptoms of schizophrenia.Design. Open participation.Setting. Medical education conferences.Participants. Attendees at two international psychiatry conferences.Measurements. Participants read a brief set of the 4-item Negative Symptom Assessment instructions and viewed a videotape of a patient with schizophrenia. Using the 1 to 6 4-item Negative Symptom Assessment severity rating scale, they rated four negative symptom items and the overall global negative symptoms. These ratings were compared with a consensus rating determination using frequency distributions and Chi-square tests for the proportion of participant ratings that were within one point of the expert rating.Results. More than 400 medical professionals (293 physicians, 50% with a European practice, and 55% who reported past utilization of schizophrenia ratings scales) participated. Between 82.1 and 91.1 percent of the 4-items and the global rating determinations by the participants were within one rating point of the consensus expert ratings. The differences between the percentage of participant rating scores that were within one point versus the percentage that were greater than one point different from those by the consensus experts was significant (p<0.0001). Participants rating of negative symptoms using the 4-item Negative Symptom Assessment did not generally differ among the geographic regions of practice, the professional credentialing, or their familiarity with the use of schizophrenia symptom rating instruments.Conclusion. These findings suggest that clinicians from a variety of geographic practices can, after brief training, use the 4-item Negative Symptom Assessment effectively to rapidly assess negative symptoms in patients with schizophrenia.

A similarity hypothesis for the two-point correlation tensor in a temporally evolving plane wake

NASA Technical Reports Server (NTRS)

Ewing, D. W.; George, W. K.; Moser, R. D.; Rogers, M. M.

1995-01-01

The analysis demonstrated that the governing equations for the two-point velocity correlation tensor in the temporally evolving wake admit similarity solutions, which include the similarity solutions for the single-point moment as a special case. The resulting equations for the similarity solutions include two constants, beta and Re(sub sigma), that are ratios of three characteristic time scales of processes in the flow: a viscous time scale, a time scale characteristic of the spread rate of the flow, and a characteristic time scale of the mean strain rate. The values of these ratios depend on the initial conditions of the flow and are most likely measures of the coherent structures in the initial conditions. The occurrences of these constants in the governing equations for the similarity solutions indicates that these solutions, in general, will only be the same for two flows if these two constants are equal (and hence the coherent structures in the flows are related). The comparisons between the predictions of the similarity hypothesis and the data presented here and elsewhere indicate that the similarity solutions for the two-point correlation tensors provide a good approximation of the measures of those motions that are not significantly affected by the boundary conditions caused by the finite extent of real flows. Thus, the two-point similarity hypothesis provides a useful tool for both numerical and physical experimentalist that can be used to examine how the finite extent of real flows affect the evolution of the different scales of motion in the flow.

The effect of intra-operative transcutaneous electrical nerve stimulation on posterior neck pain following thyroidectomy.

PubMed

Park, C; Choi, J B; Lee, Y-S; Chang, H-S; Shin, C S; Kim, S; Han, D W

2015-04-01

Posterior neck pain following thyroidectomy is common because full neck extension is required during the procedure. We evaluated the effect of intra-operative transcutaneous electrical nerve stimulation on postoperative neck pain in patients undergoing total thyroidectomy under general anaesthesia. One hundred patients were randomly assigned to one of two groups; 50 patients received transcutaneous electrical nerve stimulation applied to the trapezius muscle and 50 patients acted as controls. Postoperative posterior neck pain and anterior wound pain were evaluated using an 11-point numerical rating scale at 30 min, 6 h, 24 h and 48 h following surgery. The numerical rating scale for posterior neck pain was significantly lower in the transcutaneous electrical nerve stimulation group compared with the control group at all time points (p < 0.05). There were no significant differences in the numerical rating scale for anterior wound pain at any time point. No adverse effects related to transcutaneous electrical nerve stimulation were observed. We conclude that intra-operative transcutaneous electrical nerve stimulation applied to the trapezius muscle reduced posterior neck pain following thyroidectomy. © 2014 The Association of Anaesthetists of Great Britain and Ireland.

A Method for Automatic Surface Inspection Using a Model-Based 3D Descriptor.

PubMed

Madrigal, Carlos A; Branch, John W; Restrepo, Alejandro; Mery, Domingo

2017-10-02

Automatic visual inspection allows for the identification of surface defects in manufactured parts. Nevertheless, when defects are on a sub-millimeter scale, detection and recognition are a challenge. This is particularly true when the defect generates topological deformations that are not shown with strong contrast in the 2D image. In this paper, we present a method for recognizing surface defects in 3D point clouds. Firstly, we propose a novel 3D local descriptor called the Model Point Feature Histogram (MPFH) for defect detection. Our descriptor is inspired from earlier descriptors such as the Point Feature Histogram (PFH). To construct the MPFH descriptor, the models that best fit the local surface and their normal vectors are estimated. For each surface model, its contribution weight to the formation of the surface region is calculated and from the relative difference between models of the same region a histogram is generated representing the underlying surface changes. Secondly, through a classification stage, the points on the surface are labeled according to five types of primitives and the defect is detected. Thirdly, the connected components of primitives are projected to a plane, forming a 2D image. Finally, 2D geometrical features are extracted and by a support vector machine, the defects are recognized. The database used is composed of 3D simulated surfaces and 3D reconstructions of defects in welding, artificial teeth, indentations in materials, ceramics and 3D models of defects. The quantitative and qualitative results showed that the proposed method of description is robust to noise and the scale factor, and it is sufficiently discriminative for detecting some surface defects. The performance evaluation of the proposed method was performed for a classification task of the 3D point cloud in primitives, reporting an accuracy of 95%, which is higher than for other state-of-art descriptors. The rate of recognition of defects was close to 94%.

A Method for Automatic Surface Inspection Using a Model-Based 3D Descriptor

PubMed Central

Branch, John W.

2017-01-01

Automatic visual inspection allows for the identification of surface defects in manufactured parts. Nevertheless, when defects are on a sub-millimeter scale, detection and recognition are a challenge. This is particularly true when the defect generates topological deformations that are not shown with strong contrast in the 2D image. In this paper, we present a method for recognizing surface defects in 3D point clouds. Firstly, we propose a novel 3D local descriptor called the Model Point Feature Histogram (MPFH) for defect detection. Our descriptor is inspired from earlier descriptors such as the Point Feature Histogram (PFH). To construct the MPFH descriptor, the models that best fit the local surface and their normal vectors are estimated. For each surface model, its contribution weight to the formation of the surface region is calculated and from the relative difference between models of the same region a histogram is generated representing the underlying surface changes. Secondly, through a classification stage, the points on the surface are labeled according to five types of primitives and the defect is detected. Thirdly, the connected components of primitives are projected to a plane, forming a 2D image. Finally, 2D geometrical features are extracted and by a support vector machine, the defects are recognized. The database used is composed of 3D simulated surfaces and 3D reconstructions of defects in welding, artificial teeth, indentations in materials, ceramics and 3D models of defects. The quantitative and qualitative results showed that the proposed method of description is robust to noise and the scale factor, and it is sufficiently discriminative for detecting some surface defects. The performance evaluation of the proposed method was performed for a classification task of the 3D point cloud in primitives, reporting an accuracy of 95%, which is higher than for other state-of-art descriptors. The rate of recognition of defects was close to 94%. PMID:28974037

How do patients choose private in vitro fertilization treatment? A customer survey in a tertiary fertility center in the United Kingdom.

PubMed

Lass, A; Brinsden, P

2001-05-01

To assess the relevant factors affecting patients' decision when choosing a clinic for private, self-funded IVF treatment. Prospective anonymous closed questionnaires. Single tertiary-care private IVF center. New patients attending primary consultation in a period of 7 months from September 1999 to March 2000. None. Primary knowledge about the clinic, source of referral, knowledge of, availability of information pack, and familiarity with the clinic's success rates and treatment's price. The last question assessed the relative importance of each factor in the decision-making process according to the SERVQUAL model, modified version. All items were measured as perceptions on a 5-point Likert scale. 1 = not important, 3 = neutral, and 5 = very important. One hundred seventy-five patients completed the questionnaire. They were well informed and investigated the market before making their final choice. Patients collect information from many sources, including new channels such as the Internet. Up to one third of patients do not consult their doctor before treatment. By far the most relevant factor in decision making is the success rate (i.e., delivery rates) of the clinic, followed by recommendation by general practitioner (GP) or consultant (respectively, Likert scale score, 4.6; 95% confidence interval [CI], 4.5-4.7; and Likert scale score, 4.0; 95% CI, 3.9-4.2; P<.01). Other factors, such as cost of the treatment, friends and relatives' opinions, and distance from home were not relevant. Units that wish to thrive and increase their market share should deliver high-quality service and concentrate their efforts on excelling in performance.

Efficacy and safety of dextromethorphan/quinidine at two dosage levels for diabetic neuropathic pain: a double-blind, placebo-controlled, multicenter study.

PubMed

Shaibani, Aziz I; Pope, Laura E; Thisted, Ronald; Hepner, Adrian

2012-02-01

To evaluate dextromethorphan coadministered with quinidine as treatment of diabetic peripheral neuropathic pain. In a 13-week, phase 3, randomized controlled trial, 379 adults with daily symmetric diabetic peripheral neuropathy (DPN) leg pain for ≥3 months received double-blind placebo, dextromethorphan/quinidine (DMQ) 45/30 mg, or DMQ 30/30 mg, administered once daily for 7 days and twice daily thereafter. Efficacy measures included four pain rating scales applied daily using patient diaries, and another two applied at five clinic visits. On all six scales, DMQ 45/30 mg was significantly superior to placebo, including the primary efficacy analysis, which utilized mixed-effects modeling to test all scores on an 11-point numerical Pain Rating Scale (P < 0.0001). Sensitivity analyses gave consistent results. Efficacy vs placebo was also seen for diary ratings of present pain intensity, and pain interference with sleep and with activities (all P < 0.0001). Among clinic visit assessments, DMQ 45/30 mg demonstrated greater leg pain relief (P = 0.0002) and greater reduction of leg pain intensity (P = 0.0286) vs placebo. The efficacy of DMQ 30/30 mg was numerically less than for 45/30 mg but for most outcomes remained significantly greater vs placebo. Adverse events were mostly mild or moderate and of expected types. Discontinuation for adverse events in the DMQ groups was at least twice as common as placebo. Throughout a 13-week trial, DMQ was effective, with an acceptable safety profile, for treatment of DPN pain. Other fixed-dose combinations of DMQ should be studied to improve overall tolerability while maintaining significant efficacy. Wiley Periodicals, Inc.

Analysis of Temporal and Spatial Distributions of Ammonia Nitrogen in the Huaihe River Basin from 1998 to 2014

NASA Astrophysics Data System (ADS)

Xu, J.; Jin, G.; Tang, H.; Li, L.

2016-12-01

To assess the effectiveness of water pollution control measures taken in the Huaihe River Basin (HRB) in China, we analyzed the temporal and spatial distributions of ammonia nitrogen (NH3-N) in the river water from 1998 to 2014 (three Chinese Five-year Plan periods).Analysis of measured NH3-N concentrations from various monitoring stations using the STL (seasonal trend decomposition using loess) method and a modified log-linear model revealed that: (1) The rate of NH3-N concentration reduction over the whole period was 70% 81% in the main stream of Huaihe River, but reached 88% in two major tributaries - the Shaying River and Guo River. (2) The NH3-N concentrations decreased significantly particularly between the tenth Five-year Plan and eleventh Five-year Plan periods in the main stream. In comparison, significant NH3-N reduction occurred over all three Five-year Plan periods in the Shaying and Guo tributaries. The concentration in the first year of a Five-year Plan period tended to much higher than that in the last year of the same period, likely due to the difference in implementing the pollution control measures. (3) The NH3-N concentrations were higher in the spring (fertilization period) and winter (low discharge) than in the summer and autumn. (4) With the implementation of pollution control measures, the contribution rate of NH3-N in the two major tributaries from point sources has decreased from 74% 93% in earlier years to 3% 28% in later years. However, NH3-N input from non-point sources appeared to remain stable and largely depend on runoff. To further reduce the NH3-N concentration in the river, policies and control measures should focus on non-point sources.

Effects of Cooking End-point Temperature and Muscle Part on Sensory 'Hardness' and 'Chewiness' Assessed Using Scales Presented in ISO11036:1994.

PubMed

Sasaki, Keisuke; Motoyama, Michiyo; Narita, Takumi; Chikuni, Koichi

2013-10-01

Texture and 'tenderness' in particular, is an important sensory characteristic for consumers' satisfaction of beef. Objective and detailed sensory measurements of beef texture have been needed for the evaluation and management of beef quality. This study aimed to apply the sensory scales defined in ISO11036:1994 to evaluate the texture of beef. Longissimus and Semitendinosus muscles of three Holstein steers cooked to end-point temperatures of 60°C and 72°C were subjected to sensory analyses by a sensory panel with expertise regarding the ISO11036 scales. For the sensory analysis, standard scales of 'chewiness' (9-points) and 'hardness' (7-points) were presented to the sensory panel with reference materials defined in ISO11036. As a result, both 'chewiness' and 'hardness' assessed according to the ISO11036 scales increased by increasing the cooking end-point temperature, and were different between Longissimus and Semitendinosus muscles. The sensory results were in good agreement with instrumental texture measurements. However, both texture ratings in this study were in a narrower range than the full ISO scales. For beef texture, ISO11036 scales for 'chewiness' and 'hardness' are useful for basic studies, but some alterations are needed for practical evaluation of muscle foods.

Assessment of Change in Dynamic Psychotherapy

PubMed Central

Høglend, Per; Bøgwald, Kjell-Petter; Amlo, Svein; Heyerdahl, Oscar; Sørbye, Øystein; Marble, Alice; Sjaastad, Mary Cosgrove; Bentsen, Håvard

2000-01-01

Five scales have been developed to assess changes that are consistent with the therapeutic rationales and procedures of dynamic psychotherapy. Seven raters evaluated 50 patients before and 36 patients again after brief dynamic psychotherapy. A factor analysis indicated that the scales represent a dimension that is discriminable from general symptoms. A summary measure, Dynamic Capacity, was rated with acceptable reliability by a single rater. However, average scores of three raters were needed for good reliability of change ratings. The scales seem to be sufficiently fine-grained to capture statistically and clinically significant changes during brief dynamic psychotherapy. PMID:11069131

Construction and Validation of an Observational Scale of Neighborhood Characteristics

ERIC Educational Resources Information Center

McDonell, James R.; Waters, Tracy J.

2011-01-01

This paper reports the development and validation of the Neighborhood Observation Scale, a 41 item measure of neighborhood physical appearance, social appearance, safety, and amenities. Three independent ratings were collected on each of 244 neighborhoods in 132 census block groups in five South Carolina counties, for a total of 732 observations.…

Stress and depression scales in aphasia: relation between the aphasia depression rating scale, stroke aphasia depression questionnaire-10, and the perceived stress scale.

PubMed

Laures-Gore, Jacqueline S; Farina, Matthew; Moore, Elliot; Russell, Scott

2017-03-01

Assessment and diagnosis of post-stroke depression (PSD) among patients with aphasia presents unique challenges. A gold standard assessment of PSD among this population has yet to be identified. The first aim was to investigate the association between two depression scales developed for assessing depressive symptoms among patients with aphasia. The second aim was to evaluate the relation between these scales and a measure of perceived stress. Twenty-five (16 male; 9 female) individuals with history of left hemisphere cerebrovascular accident (CVA) were assessed for depression and perceived stress using the Stroke Aphasic Depression Questionnaire-10 (SADQ-10), the Aphasia Depression Rating Scale (ADRS), and the Perceived Stress Scale (PSS). SADQ-10 and ADRS ratings were strongly correlated with each other (r = 0.708, p < 0.001). SADQ-10 ratings were strongly correlated with PSS ratings (r = 0.620, p = 0.003), while ADRS ratings were moderately correlated (r = 0.492, p = 0.027). Item analysis of each scale identified items which increased both inter-scale correlation and intra-scale consistency when excluded. The SADQ-10 and ADRS appear to be acceptable measures of depressive symptoms in aphasia patients. Measurements of perceived stress may also be an important factor in assessment of depressive symptoms.

Item Response Theory Modeling and Categorical Regression Analyses of the Five-Factor Model Rating Form: A Study on Italian Community-Dwelling Adolescent Participants and Adult Participants.

PubMed

Fossati, Andrea; Widiger, Thomas A; Borroni, Serena; Maffei, Cesare; Somma, Antonella

2017-06-01

To extend the evidence on the reliability and construct validity of the Five-Factor Model Rating Form (FFMRF) in its self-report version, two independent samples of Italian participants, which were composed of 510 adolescent high school students and 457 community-dwelling adults, respectively, were administered the FFMRF in its Italian translation. Adolescent participants were also administered the Italian translation of the Borderline Personality Features Scale for Children-11 (BPFSC-11), whereas adult participants were administered the Italian translation of the Triarchic Psychopathy Measure (TriPM). Cronbach α values were consistent with previous findings; in both samples, average interitem r values indicated acceptable internal consistency for all FFMRF scales. A multidimensional graded item response theory model indicated that the majority of FFMRF items had adequate discrimination parameters; information indices supported the reliability of the FFMRF scales. Both categorical (i.e., item-level) and scale-level regression analyses suggested that the FFMRF scores may predict a nonnegligible amount of variance in the BPFSC-11 total score in adolescent participants, and in the TriPM scale scores in adult participants.

Listeners' Perceptions of Speech and Language Disorders

ERIC Educational Resources Information Center

Allard, Emily R.; Williams, Dale F.

2008-01-01

Using semantic differential scales with nine trait pairs, 445 adults rated five audio-taped speech samples, one depicting an individual without a disorder and four portraying communication disorders. Statistical analyses indicated that the no disorder sample was rated higher with respect to the trait of employability than were the articulation,…

Transient Point Infiltration In The Unsaturated Zone

NASA Astrophysics Data System (ADS)

Buecker-Gittel, M.; Mohrlok, U.

The risk assessment of leaking sewer pipes gets more and more important due to urban groundwater management and environmental as well as health safety. This requires the quantification and balancing of transport and transformation processes based on the water flow in the unsaturated zone. The water flow from a single sewer leakage could be described as a point infiltration with time varying hydraulic conditions externally and internally. External variations are caused by the discharge in the sewer pipe as well as the state of the leakage itself. Internal variations are the results of microbiological clogging effects associated with the transformation processes. Technical as well as small scale laboratory experiments were conducted in order to investigate the water transport from an transient point infiltration. From the technical scale experiment there was evidence that the water flow takes place under transient conditions when sewage infiltrates into an unsaturated soil. Whereas the small scale experiments investigated the hydraulics of the water transport and the associated so- lute and particle transport in unsaturated soils in detail. The small scale experiment was a two-dimensional representation of such a point infiltration source where the distributed water transport could be measured by several tensiometers in the soil as well as by a selective measurement of the discharge at the bottom of the experimental setup. Several series of experiments were conducted varying the boundary and initial con- ditions in order to derive the important parameters controlling the infiltration of pure water from the point source. The results showed that there is a significant difference between the infiltration rate in the point source and the discharge rate at the bottom, that could be explained by storage processes due to an outflow resistance at the bottom. This effect is overlayn by a decreasing water content decreases over time correlated with a decreasing infiltration rate. As expected the initial conditions mainly affects the time scale for the water transport. Additionally, the influence of preferential flow paths on the discharge distribution could be found due to the heterogenieties caused by the filling and compaction process of the sandy soil.

Older adults with poor self-rated memory have less depressive symptoms and better memory performance when perceived self-efficacy is high.

PubMed

O'Shea, Deirdre M; Dotson, Vonetta M; Fieo, Robert A; Tsapanou, Angeliki; Zahodne, Laura; Stern, Yaakov

2016-07-01

To investigate whether self-efficacy moderates the association between self-rated memory and depressive symptoms in a large sample of older adults. The influence of self-efficacy and depressive symptoms on memory performance was also examined in a subsample of individuals who reported poor memory. Non-demented participants (n = 3766) were selected from the 2012 wave of the Health and Retirement Study. Depressive symptomatology was assessed with the 8-item Center for Epidemiologic Studies Depression Scale. A modified version of the Midlife Developmental Inventory Questionnaire was used as the measure of self-efficacy. Participants were asked to rate their memory presently on a five-point scale from Excellent (1) to Poor (5). Immediate memory and delayed memory (after a 5-min interval) were measured by the number of correct words recalled from a 10-item word list. Multiple regression analyses revealed that negative ratings of memory were significantly associated with greater levels of depressive symptoms, with this effect being greatest in those with low levels of self-efficacy. Additionally, greater self-efficacy was associated with optimal objective memory performances but only when depressive symptoms were low in individuals who reported poor memory function (n = 1196). Self-efficacy moderates the relationship between self-rated memory function and depressive symptoms. Higher self-efficacy may buffer against the impact of subjective memory difficulty on one's mood and thereby mitigating the effect of depressive symptoms on memory. Interventions should focus on increasing perceived self-efficacy in older adults reporting poor memory function to potentially minimize memory impairment. Copyright © 2015 John Wiley & Sons, Ltd.

Impact of spatial variability and sampling design on model performance

NASA Astrophysics Data System (ADS)

Schrape, Charlotte; Schneider, Anne-Kathrin; Schröder, Boris; van Schaik, Loes

2017-04-01

Many environmental physical and chemical parameters as well as species distributions display a spatial variability at different scales. In case measurements are very costly in labour time or money a choice has to be made between a high sampling resolution at small scales and a low spatial cover of the study area or a lower sampling resolution at the small scales resulting in local data uncertainties with a better spatial cover of the whole area. This dilemma is often faced in the design of field sampling campaigns for large scale studies. When the gathered field data are subsequently used for modelling purposes the choice of sampling design and resulting data quality influence the model performance criteria. We studied this influence with a virtual model study based on a large dataset of field information on spatial variation of earthworms at different scales. Therefore we built a virtual map of anecic earthworm distributions over the Weiherbach catchment (Baden-Württemberg in Germany). First of all the field scale abundance of earthworms was estimated using a catchment scale model based on 65 field measurements. Subsequently the high small scale variability was added using semi-variograms, based on five fields with a total of 430 measurements divided in a spatially nested sampling design over these fields, to estimate the nugget, range and standard deviation of measurements within the fields. With the produced maps, we performed virtual samplings of one up to 50 random points per field. We then used these data to rebuild the catchment scale models of anecic earthworm abundance with the same model parameters as in the work by Palm et al. (2013). The results of the models show clearly that a large part of the non-explained deviance of the models is due to the very high small scale variability in earthworm abundance: the models based on single virtual sampling points on average obtain an explained deviance of 0.20 and a correlation coefficient of 0.64. With increasing sampling points per field, we averaged the measured abundance of the sampling within each field to obtain a more representative value of the field average. Doubling the samplings per field strongly improved the model performance criteria (explained deviance 0.38 and correlation coefficient 0.73). With 50 sampling points per field the performance criteria were 0.91 and 0.97 respectively for explained deviance and correlation coefficient. The relationship between number of samplings and performance criteria can be described with a saturation curve. Beyond five samples per field the model improvement becomes rather small. With this contribution we wish to discuss the impact of data variability at sampling scale on model performance and the implications for sampling design and assessment of model results as well as ecological inferences.

40 CFR 211.204-2 - Primary label size, print and color.

Code of Federal Regulations, 2013 CFR

2013-07-01

... each area shall be as follows, based upon a scale of 72 points=1 inch: (1) Area A—2.8 millimeters (mm) or 8 point. (2) Area B—7.6 mm or 22 point for the Rating;—1.7 mm or 5 point for -“Decibels”. (3) Area A-B—1.5 mm or 4 point. (4) Area C—1.5 mm or 4 point. (5) Area D—0.7 mm or 2 point. (6) Area E—0.7 mm...

40 CFR 211.204-2 - Primary label size, print and color.

Code of Federal Regulations, 2014 CFR

2014-07-01

... each area shall be as follows, based upon a scale of 72 points=1 inch: (1) Area A—2.8 millimeters (mm) or 8 point. (2) Area B—7.6 mm or 22 point for the Rating;—1.7 mm or 5 point for -“Decibels”. (3) Area A-B—1.5 mm or 4 point. (4) Area C—1.5 mm or 4 point. (5) Area D—0.7 mm or 2 point. (6) Area E—0.7 mm...

40 CFR 211.204-2 - Primary label size, print and color.

Code of Federal Regulations, 2012 CFR

2012-07-01

... each area shall be as follows, based upon a scale of 72 points=1 inch: (1) Area A—2.8 millimeters (mm) or 8 point. (2) Area B—7.6 mm or 22 point for the Rating;—1.7 mm or 5 point for -“Decibels”. (3) Area A-B—1.5 mm or 4 point. (4) Area C—1.5 mm or 4 point. (5) Area D—0.7 mm or 2 point. (6) Area E—0.7 mm...

Exercise therapy, patient education, and patellar taping in the treatment of adolescents with patellofemoral pain: a prospective pilot study with 6 months follow-up.

PubMed

Rathleff, Michael S; Rathleff, Camilla R; Holden, Sinead; Thorborg, Kristian; Olesen, Jens L

2018-01-01

Patellofemoral pain (PFP) is the most common knee condition among adolescents, with a prevalence of 6-7% resulting in reduced function and quality of life. Exercise therapy is recommended for treating PFP, but has only been tested in older adolescents (15-19 years). This pilot study aimed to investigate the adherence to, and clinical effects of, exercise and patient education in young adolescents (12-16 years), with PFP. Twenty adolescents (16 females) with PFP were recruited from a population-based cohort to undergo a 3-month multimodal intervention. This comprised of a 30-min patient education and group-based exercise therapy. Exercises included supervised lower extremity strength exercises three times per week, in addition to similar home-based strength exercises. Outcomes included a 7-point global rating of change scale (ranging from "completely recovered" to "worse than ever"), the Knee injury and Osteoarthritis Outcome Score (KOOS), physical activity scale (PAS), weekly sports participation and health-related quality of life measured by European Quality of Life 5 dimensions Youth (EQ-5DY) and isometric knee and hip muscle strength. Pain was measured on a visual analogue scale (VAS), and satisfaction treatment was measured on a five-point Likert scale ranging from "highly satisfied" to "not satisfied at all". These were collected at 3- and 6-month follow-ups. Adherence to supervised exercise was measured as session attendance, and adolescent self-reported adherence to home-based exercises. Adherence to the exercise therapy was poor, with adolescents participating in a median of 16 (IQR 5.5-25) out of 39 possible supervised training session. Five out of 18 adolescents had a successful outcome after both 3 and 6 months. There were no relevant changes in isometric muscle strength. This was the first study to investigate adherence to, and clinical effects of, exercise therapy and patient education in young adolescents with patellofemoral pain. Adherence to the exercise therapy was low with little to no clinical effects making a full clinical trial impractical. Future studies need to explore how an intervention can be successfully tailored to young adolescents with patellofemoral pain to obtain good adherence while improving pain and function.

Individualized homeopathic treatment and fluoxetine for moderate to severe depression in peri- and postmenopausal women (HOMDEP-MENOP study): a randomized, double-dummy, double-blind, placebo-controlled trial.

PubMed

Macías-Cortés, Emma Del Carmen; Llanes-González, Lidia; Aguilar-Faisal, Leopoldo; Asbun-Bojalil, Juan

2015-01-01

Perimenopausal period refers to the interval when women's menstrual cycles become irregular and is characterized by an increased risk of depression. Use of homeopathy to treat depression is widespread but there is a lack of clinical trials about its efficacy in depression in peri- and postmenopausal women. The aim of this study was to assess efficacy and safety of individualized homeopathic treatment versus placebo and fluoxetine versus placebo in peri- and postmenopausal women with moderate to severe depression. A randomized, placebo-controlled, double-blind, double-dummy, superiority, three-arm trial with a 6 week follow-up study was conducted. The study was performed in a public research hospital in Mexico City in the outpatient service of homeopathy. One hundred thirty-three peri- and postmenopausal women diagnosed with major depression according to DSM-IV (moderate to severe intensity) were included. The outcomes were: change in the mean total score among groups on the 17-item Hamilton Rating Scale for Depression, Beck Depression Inventory and Greene Scale, after 6 weeks of treatment, response and remission rates, and safety. Efficacy data were analyzed in the intention-to-treat population (ANOVA with Bonferroni post-hoc test). After a 6-week treatment, homeopathic group was more effective than placebo by 5 points in Hamilton Scale. Response rate was 54.5% and remission rate, 15.9%. There was a significant difference among groups in response rate definition only, but not in remission rate. Fluoxetine-placebo difference was 3.2 points. No differences were observed among groups in the Beck Depression Inventory. Homeopathic group was superior to placebo in Greene Climacteric Scale (8.6 points). Fluoxetine was not different from placebo in Greene Climacteric Scale. Homeopathy and fluoxetine are effective and safe antidepressants for climacteric women. Homeopathy and fluoxetine were significantly different from placebo in response definition only. Homeopathy, but not fluoxetine, improves menopausal symptoms scored by Greene Climacteric Scale. ClinicalTrials.gov NCT01635218. https://clinicaltrials.gov/ct2/show/NCT01635218 [corrected].

Individualized Homeopathic Treatment and Fluoxetine for Moderate to Severe Depression in Peri- and Postmenopausal Women (HOMDEP-MENOP Study): A Randomized, Double-Dummy, Double-Blind, Placebo-Controlled Trial

PubMed Central

Macías-Cortés, Emma del Carmen; Llanes-González, Lidia; Aguilar-Faisal, Leopoldo; Asbun-Bojalil, Juan

2015-01-01

Background Perimenopausal period refers to the interval when women's menstrual cycles become irregular and is characterized by an increased risk of depression. Use of homeopathy to treat depression is widespread but there is a lack of clinical trials about its efficacy in depression in peri- and postmenopausal women. The aim of this study was to assess efficacy and safety of individualized homeopathic treatment versus placebo and fluoxetine versus placebo in peri- and postmenopausal women with moderate to severe depression. Methods/Design A randomized, placebo-controlled, double-blind, double-dummy, superiority, three-arm trial with a 6 week follow-up study was conducted. The study was performed in a public research hospital in Mexico City in the outpatient service of homeopathy. One hundred thirty-three peri- and postmenopausal women diagnosed with major depression according to DSM-IV (moderate to severe intensity) were included. The outcomes were: change in the mean total score among groups on the 17-item Hamilton Rating Scale for Depression, Beck Depression Inventory and Greene Scale, after 6 weeks of treatment, response and remission rates, and safety. Efficacy data were analyzed in the intention-to-treat population (ANOVA with Bonferroni post-hoc test). Results After a 6-week treatment, homeopathic group was more effective than placebo by 5 points in Hamilton Scale. Response rate was 54.5% and remission rate, 15.9%. There was a significant difference among groups in response rate definition only, but not in remission rate. Fluoxetine-placebo difference was 3.2 points. No differences were observed among groups in the Beck Depression Inventory. Homeopathic group was superior to placebo in Greene Climacteric Scale (8.6 points). Fluoxetine was not different from placebo in Greene Climacteric Scale. Conclusion Homeopathy and fluoxetine are effective and safe antidepressants for climacteric women. Homeopathy and fluoxetine were significantly different from placebo in response definition only. Homeopathy, but not fluoxetine, improves menopausal symptoms scored by Greene Climacteric Scale. Trial Registration ClinicalTrials.gov NCT01635218 Protocol Publication http://www.trialsjournal.com/content/14/1/105. PMID:25768800

Aircrew coordination and decisionmaking: Peer ratings of video tapes made during a full mission simulation

NASA Technical Reports Server (NTRS)

Murphy, M. R.; Awe, C. A.

1986-01-01

Six professionally active, retired captains rated the coordination and decisionmaking performances of sixteen aircrews while viewing videotapes of a simulated commercial air transport operation. The scenario featured a required diversion and a probable minimum fuel situation. Seven point Likert-type scales were used in rating variables on the basis of a model of crew coordination and decisionmaking. The variables were based on concepts of, for example, decision difficulty, efficiency, and outcome quality; and leader-subordin ate concepts such as person and task-oriented leader behavior, and competency motivation of subordinate crewmembers. Five-front-end variables of the model were in turn dependent variables for a hierarchical regression procedure. The variance in safety performance was explained 46%, by decision efficiency, command reversal, and decision quality. The variance of decision quality, an alternative substantive dependent variable to safety performance, was explained 60% by decision efficiency and the captain's quality of within-crew communications. The variance of decision efficiency, crew coordination, and command reversal were in turn explained 78%, 80%, and 60% by small numbers of preceding independent variables. A principle component, varimax factor analysis supported the model structure suggested by regression analyses.

Administration of ketamine for unipolar and bipolar depression.

PubMed

Kraus, Christoph; Rabl, Ulrich; Vanicek, Thomas; Carlberg, Laura; Popovic, Ana; Spies, Marie; Bartova, Lucie; Gryglewski, Gregor; Papageorgiou, Konstantinos; Lanzenberger, Rupert; Willeit, Matthäus; Winkler, Dietmar; Rybakowski, Janusz K; Kasper, Siegfried

2017-03-01

Clinical trials demonstrated that ketamine exhibits rapid antidepressant efficacy when administered in subanaesthetic dosages. We reviewed currently available literature investigating efficacy, response rates and safety profile. Twelve studies investigating unipolar, seven on bipolar depression were included after search in medline, scopus and web of science. Randomized, placebo-controlled or open-label trials reported antidepressant response rates after 24 h on primary outcome measures at 61%. The average reduction of Hamilton Depression Rating Scale (HAM-D) was 10.9 points, Beck Depression Inventory (BDI) 15.7 points and Montgomery-Asberg Depression Rating Scale (MADRS) 20.8 points. Ketamine was always superior to placebo. Most common side effects were dizziness, blurred vision, restlessness, nausea/vomiting and headache, which were all reversible. Relapse rates ranged between 60% and 92%. To provide best practice-based information to patients, a consent-form for application and modification in local language is included. Ketamine constitutes a novel, rapid and efficacious treatment option for patients suffering from treatment resistant depression and exhibits rapid and significant anti-suicidal effects. New administration routes might serve as alternative to intravenous regimes for potential usage in outpatient settings. However, long-term side effects are not known and short duration of antidepressant response need ways to prolong ketamine's efficacy.

The Stanford Microsurgery and Resident Training (SMaRT) Scale: validation of an on-line global rating scale for technical assessment.

PubMed

Satterwhite, Thomas; Son, Ji; Carey, Joseph; Echo, Anthony; Spurling, Terry; Paro, John; Gurtner, Geoffrey; Chang, James; Lee, Gordon K

2014-05-01

We previously reported results of our on-line microsurgery training program, showing that residents who had access to our website significantly improved their cognitive and technical skills. In this study, we report an objective means for expert evaluators to reliably rate trainees' technical skills under the microscope, with the use of our novel global rating scale. "Microsurgery Essentials" (http://smartmicrosurgery.com) is our on-line training curriculum. Residents were randomly divided into 2 groups: 1 group reviewed this online resource and the other did not. Pre- and post-tests consisted of videotaped microsurgical sessions in which the trainee performed "microsurgery" on 3 different models: latex glove, penrose drain, and the dorsal vessel of a chicken foot. The SMaRT (Stanford Microsurgery and Resident Training) scale, consisting of 9 categories graded on a 5-point Likert scale, was used to assess the trainees. Results were analyzed with ANOVA and Student t test, with P less than 0.05 indicating statistical significance. Seventeen residents participated in the study. The SMaRT scale adequately differentiated the performance of more experienced senior residents (PGY-4 to PGY-6, total average score=3.43) from less experienced junior residents (PGY-1 to PGY-3, total average score=2.10, P<0.0001). Residents who viewed themselves as being confident received a higher score on the SMaRT scale (average score 3.5), compared to residents who were not as confident (average score 2.1) (P<0.001). There were no significant differences in scoring among all 3 evaluators (P>0.05). Additionally, junior residents who had access to our website showed a significant increase in their graded technical performance by 0.7 points when compared to residents who did not have access to the website who showed an improvement of only 0.2 points (P=0.01). Our SMaRT scale is valid and reliable in assessing the microsurgical skills of residents and other trainees. Current trainees are more likely to use self-directed on-line education because of its easy accessibility and interactive format. Our global rating scale can help ensure residents are achieving appropriate technical milestones.

Reducing diarrhoea deaths in South Africa: costs and effects of scaling up essential interventions to prevent and treat diarrhoea in under-five children.

PubMed

Chola, Lumbwe; Michalow, Julia; Tugendhaft, Aviva; Hofman, Karen

2015-04-17

Diarrhoea is one of the leading causes of morbidity and mortality in South African children, accounting for approximately 20% of under-five deaths. Though progress has been made in scaling up multiple interventions to reduce diarrhoea in the last decade, challenges still remain. In this paper, we model the cost and impact of scaling up 13 interventions to prevent and treat childhood diarrhoea in South Africa. Modelling was done using the Lives Saved Tool (LiST). Using 2014 as the baseline, intervention coverage was increased from 2015 until 2030. Three scale up scenarios were compared: by 2030, 1) coverage of all interventions increased by ten percentage points; 2) intervention coverage increased by 20 percentage points; 3) and intervention coverage increased to 99%. The model estimates 13 million diarrhoea cases at baseline. Scaling up intervention coverage averted between 3 million and 5.3 million diarrhoea cases. In 2030, diarrhoeal deaths are expected to reduce from an estimated 5,500 in 2014 to 2,800 in scenario one, 1,400 in scenario two and 100 in scenario three. The additional cost of implementing all 13 interventions will range from US$510 million (US$9 per capita) to US$960 million (US$18 per capita), of which the health system costs range between US$40 million (less than US$1 per capita) and US$170 million (US$3 per capita). Scaling up 13 essential interventions could have a substantial impact on reducing diarrhoeal deaths in South African children, which would contribute toward reducing child mortality in the post-MDG era. Preventive measures are key and the government should focus on improving water, sanitation and hygiene. The investments required to achieve these results seem feasible considering current health expenditure.

Does the Numeric Rating Scale (NRS) represent the optimal tool for evaluating pain in the triage process of patients presenting to the ED? Results of a muticenter study.

PubMed

Capponi, Rebecca; Loguercio, Valentina; Guerrini, Stefania; Beltrami, Giampietro; Vesprini, Andrea; Giostra, Fabrizio

2017-01-16

Pain evaluation at triage in Emergency Department (ED) is fundamental, as it influences significantly patients color code determination. Different scales have been proposed to quantify pain but they are not always reliable. This study aims to determine a) how important is for triage nurses pain measurement b) reliability of Numeric Rating Scale (NRS), the most used instrument to evaluate pain in Italian EDs, because it frequently shows higher pain scores than others scales. End point 1: a questionnaire was administered to triage nurses in some hospitals of northern Italy. End point 2: 250 patients arriving at the ED referring pain have been evaluated using, randomly, either the NRS or a fake "30-50" scale. End point 1: Triage nurses acknowledge to modify frequently the referred pain intensity. This for several reasons: nurses think that patients may exaggerate to obtain a higher priority color code; they may be influenced by specific patients categories (non EU citizens, drugs-addicted, elderly); the pain score referred by patients is not correspondent to nurse perception. End point 2: Data show that the mean value obtained with NRS is significantly (p<0.05) higher that the mean obtained with the "30-50" scale. Manipulation on pain evaluation performed by nurses might result in a dangerous underestimation of this symptom. At the same time, the use of NRS seems to allow patients to exaggerate pain perception with consequent altered attribution of color code at triage.

Penetrating injuries to the duodenum: An analysis of 879 patients from the National Trauma Data Bank, 2010 to 2014.

PubMed

Phillips, Bradley; Turco, Lauren; McDonald, Dan; Mause, Alison; Walters, Ryan W

2017-11-01

Despite wide belief that the duodenal Organ Injury Scale has been validated, this has not been reported in the published literature. Based on clinical experience, we hypothesize that the American Association for Surgery of Trauma Organ Injury Scale (AAST-OIS) for duodenal injuries can independently predict mortality. Our objectives were threefold: (1) describe the national profile of penetrating duodenal injuries, (2) identify predictors of morbidity and mortality, and (3) validate the duodenum AAST-OIS as a statistically significant predictor of mortality. Using the Abbreviated Injury Scale 2005 and International Classification of Diseases-9th Rev.-Clinical Modification (ICD-9-CM) E-codes, we identified 879 penetrating duodenal trauma patients from the National Trauma Data Bank between 2010 and 2014. We controlled patient-level covariates of age, biological sex, systolic blood pressure (SBP), Glasgow Coma Scale (GCS) score, pulse, Injury Severity Score (ISS), and Organ Injury Scale (OIS) grade. We estimated multivariable generalized linear mixed models to account for the nesting of patients within trauma centers. Our results indicated an overall mortality rate of 14.4%. Approximately 10% of patients died within 24 hours of admission, of whom 76% died in the first 6 hours. Patients averaged approximately five associated injuries, 45% of which involved the liver and colon. Statistically significant independent predictors of mortality were firearm mechanism, SBP, GCS, pulse, ISS, and AAST-OIS grade. Specifically, odds of death were decreased with 10 mm Hg higher admission SBP (13% decreased odds), one point higher GCS (14.4%), 10-beat lower pulse (8.2%), and 10-point lower ISS (51.0%). This study is the first to report the national profile of penetrating duodenal injuries. Using the National Trauma Data Bank, we identified patterns of injury, predictors of outcome, and validated the AAST-OIS for duodenal injuries as a statistically significant predictor of morbidity and mortality. Epidemiologic/Prognostic, level IV.

Perception of tobacco use prevention and cessation among faculty members in Latin American and Caribbean dental schools.

PubMed

Tamí-Maury, Irene; Aigner, Carrie J; Hong, Judy; Strom, Sara; Chambers, Mark S; Gritz, Ellen R

2014-12-01

Rates of tobacco use are increasing in the regions of Latin America and the Caribbean (LAC). Unfortunately, tobacco cessation education is not a standard component of the dental curriculum in LAC dental schools. The objective of this study was to identify the perceptions of LAC dental faculty members regarding the tobacco use prevention and cessation (TUPAC) competencies that should be addressed in the dental curricula. Dental deans and faculty completed a web-based questionnaire in Spanish, Portuguese, French, or English. The questionnaire contained 32 competencies grouped into the five A's (Ask, Advise, Assess, Assist, and Arrange) of tobacco cessation and six supplementary questions for identifying barriers to providing TUPAC education to dental students. Respondents indicated the degree to which they believed each competency should be incorporated into the dental curricula using a five-point Likert scale ("1" = strongly disagree to "5" = strongly agree). Responses were obtained from 390 faculty members (66 % South America, 18 % Mexico/Central America, 16 % the Caribbean). Of the respondents, 2, 12, and 83 % reported that smoking was allowed in clinical environments, other indoor environments, and outdoor environments of their dental schools, respectively. Mean importance ratings for each of the competencies were as follows: Ask (4.71), Advise (4.54), Assess (4.41), Assist (4.07), and Arrange (4.01). Overall, LAC dental educators agree that TUPAC training should be incorporated into the dental curricula. Assist and Arrange competencies were rated lower, relative to other competencies. Tobacco use among dental educators and high rates of on-campus smoking could potentially pose barriers to promoting cessation interventions in the LAC dental schools.

Attitude toward Mathematics among the Students at Nazarbayev University Foundation Year Programme

ERIC Educational Resources Information Center

Karjanto, N.

2017-01-01

This article investigates the attitude toward mathematics among the students enrolled in the Foundation Year Programme at Nazarbayev University. The study is conducted quantitatively and an inventory developed by Tapia and Marsh II is adopted in this research. The inventory consists of 40 statements on the five-point Likert scale. Gender,…

Item Response Modeling: An Evaluation of the Children's Fruit and Vegetable Self-Efficacy Questionnaire

ERIC Educational Resources Information Center

Watson, Kathy; Baranowski, Tom; Thompson, Debbe

2006-01-01

Perceived self-efficacy (SE) for eating fruit and vegetables (FV) is a key variable mediating FV change in interventions. This study applies item response modeling (IRM) to a fruit, juice and vegetable self-efficacy questionnaire (FVSEQ) previously validated with classical test theory (CTT) procedures. The 24-item (five-point Likert scale) FVSEQ…

Family Socialization Perceptions Among Black and White High School Students in Rutherford County, Tennessee: Comparison and Contrast.

ERIC Educational Resources Information Center

Aseltine, Gwendolyn Pamenter

A questionnaire formulated from sections of the Inventory on Family Life, prepared by the Tennessee Commission on Children and Youth, was administered to over two thousand high school students in Rutherford County, Tennessee. The questionnaire was designed to gather responses on a five point scale regarding stable and unstable family…

Accessibility Considerations for e-Learning in Ghana

ERIC Educational Resources Information Center

Boateng, John Kwame

2016-01-01

This paper reports on a study that explored the best ways to design e-learning in order to provide better access for adult learners with disabilities. Two districts from the Central Region of Ghana were selected and two major research questions guided the study. The five-point Likert scale was employed between May and August of 2014. The two…

Compulsory Book Reading at School and within Leisure

ERIC Educational Resources Information Center

Pavlovic, Slavica

2015-01-01

This paper deals with attitudes of secondary school pupils towards compulsory book reading at school, being the integral part of the subject Croat language and literature teaching subject, and its possible impact on their book (not-)reading in their leisure time. It is based on the research carried out through five-point Likert-type scale in…

Values in Prime Time Alcoholic Beverage Commercials.

ERIC Educational Resources Information Center

Frazer, Charles F.

Content analysis was used to study the values evident in televised beer and wine commercials. Seventy-seven prime time commercials, 7.6% of a week's total, were analyzed along value dimensions adapted from Gallup's measure of popular social values. The intensity of each value was coded on a five-point scale. None of the commercials in the beer and…

A Study of Student-Teachers' Readiness to Use Computers in Teaching: An Empirical Study

ERIC Educational Resources Information Center

Padmavathi, M.

2016-01-01

This study attempts to analyze student-teachers' attitude towards the use of computers for classroom teaching. Four dimensions of computer attitude on a Likert-type five-point scale were used: Affect (liking), Perceived usefulness, Perceived Control, and Behaviour Intention to use computers. The effect of student-teachers' subject area, years of…

Validation of a Visionary Leadership Attitude Instrument Using Factor Analysis.

ERIC Educational Resources Information Center

LeSourd, Sandra J.; And Others

Findings from a study to develop and validate an instrument for the measurement of principals' attitudes toward visionary leadership are presented in this paper. Two leadership styles--visionary and managerial--were measured by a 35-item five-point Likert attitude scale. Questionnaires mailed to a random sample of 250 K-12 Nebraska and 250…

Reasons for cannabis use in first-episode psychosis: does strength of endorsement change over 12 months?

PubMed

Kolliakou, A; Castle, D; Sallis, H; Joseph, C; O'Connor, J; Wiffen, B; Gayer-Anderson, C; McQueen, G; Taylor, H; Bonaccorso, S; Gaughran, F; Smith, S; Greenwood, K; Murray, R M; Di Forti, M; Atakan, Z; Ismail, K

2015-01-01

Why patients with psychosis use cannabis remains debated. The self-medication hypothesis has received some support but other evidence points towards an alleviation of dysphoria model. This study investigated the reasons for cannabis use in first-episode psychosis (FEP) and whether strength in their endorsement changed over time. FEP inpatients and outpatients at the South London and Maudsley, Oxleas and Sussex NHS Trusts UK, who used cannabis, rated their motives at baseline (n=69), 3 months (n=29) and 12 months (n=36). A random intercept model was used to test the change in strength of endorsement over the 12 months. Paired-sample t-tests assessed the differences in mean scores between the five subscales on the Reasons for Use Scale (enhancement, social motive, coping with unpleasant affect, conformity and acceptance and relief of positive symptoms and side effects), at each time-point. Time had a significant effect on scores when controlling for reason; average scores on each subscale were higher at baseline than at 3 months and 12 months. At each time-point, patients endorsed 'enhancement' followed by 'coping with unpleasant affect' and 'social motive' more highly for their cannabis use than any other reason. 'Conformity and acceptance' followed closely. 'Relief of positive symptoms and side effects' was the least endorsed motive. Patients endorsed their reasons for use at 3 months and 12 months less strongly than at baseline. Little support for the self-medication or alleviation of dysphoria models was found. Rather, patients rated 'enhancement' most highly for their cannabis use. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Correlations between sexual dysfunction, depression, anxiety, and somatic symptoms among patients with major depressive disorder.

PubMed

Lin, Chiao-Fan; Juang, Yeong-Yuh; Wen, Jung-Kwang; Liu, Chia-Yih; Hung, Ching-I

2012-01-01

The purpose of this study was to investigate the degree of correlation between sexual dysfunction and depression, anxiety, and somatic symptoms among patients with major depressive disorder (MDD) and to identify the dimension most predictive of sexual dysfunction. One-hundred and thirty-five outpatients with MDD were enrolled and were treated with open-label venlafaxine 75 mg daily for one month. The Arizona Sexual Experience Scale-Chinese Version (ASEX-CV), Depression and Somatic Symptoms Scale (DSSS), Hamilton Depression Rating Scale, and Hospital Anxiety and Depression Scale (HADS) were administered at baseline and at one-month follow-up and the improvement percentage (IP) of each scale posttreatment was calculated. Multiple linear regression was used to determine the dimension most predictive of the total ASEX-CV score. Seventy subjects (20 men, 50 women) completed the one-month pharmacotherapy and the four scales. The depression subscale of the HADS was most strongly correlated with the ASEX-CV scale and was the only subscale to independently predict the total ASEX-CV score at the two points. However, the somatic subscale of the DSSS was not correlated with any ASEX-CV item. At the endpoint, depression, anxiety, and somatic symptoms were significantly improved (IP 48.5% to 26.0%); however, very little improvement was observed in the total ASEX-CV score (IP -1.6%). The severity of sexual dysfunction among patients with MDD was most correlated with the severity of the depressive dimension, but not the severity of the somatic dimension. Further studies are indicated to explore the relationships between sexual dysfunction, depression, anxiety, and somatic symptoms.

[The psychometric properties of the Turkish version of Myocardial Infarction Dimensional Assessment Scale (MIDAS)].

PubMed

Yılmaz, Emel; Eser, Erhan; Şekuri, Cevad; Kültürsay, Hakan

2011-08-01

The purpose of this study was to describe the psychometric properties of the Myocardial Infarction Dimensional Assessment Scale (MIDAS). This is a methodological cultural adaptation study. The MIDAS consists of 35-items covering seven domains: physical activity, insecurity, emotional reaction, dependency, diet, concerns over medication, and side effects which are rated on a five-point Likert scale from 1: never to 5:always. The highest score of MIDAS is 100.Quality of life (QOL) decreases as the score of scale increases. Overall 185 myocardial infarction (MI) patients were enrolled in this study. Cronbach alpha was used for the reliability analysis. The criterion validity, structural validity, and sensitivity analysis approach was used for validity analysis. New York Heart Association (NYHA) and the Canadian Cardiovascular Society Functional Classifications (CCSFC) for testing the criterion validity; SF-36 for construct validity testing of the Turkish version of the MIDAS were used. The range of Cronbach alpha values is 0.79-0.90 for seven domains of the scale. No problematic items were observed for the entire scale. Medication related domains of the MIDAS showed considerable floor effects (35.7%-22.7%). Confirmatory Factor analysis indicators [Comparative Fit Index (CFI) =0.95 and Root Mean Square Error of Approximation (RMSEA) =0.075] supported the construct validity of MIDAS. Convergent validity of the MIDAS was confirmed with correlation of SF-36 scale where appropriate. Criterion validity results was also satisfactory by comparing different stages of the NYHA and the CCSFC (p<0.05). Overall results revealed that Turkish version of the MIDAS is a reliable and valid instrument.

The Visual Analog Scale as a Comprehensible Patient-Reported Outcome Measure (PROM) in Septorhinoplasty.

PubMed

Spiekermann, Christoph; Amler, Susanne; Rudack, Claudia; Stenner, Markus

2018-06-01

The patient's satisfaction with the esthetic result is a major criterion of success in septorhinoplasty. However, the idea of esthetic perfection varies greatly and primarily depends on subjective perception. Hence, patient-reported instruments are important and necessary to assess the outcome in septorhinoplasty. To analyze the potential of the visual analog scale (VAS) as a patient-reported outcome measure in septorhinoplasty, the perception of the nasal appearance was assessed by a VAS pre- and postoperatively in 213 patients undergoing septorhinoplasty. Furthermore, in this prospective study, the patients' satisfaction concerning the procedure's result was analyzed using a five-point Likert scale. Females had lower preoperative VAS scores but a higher increase compared to males. Patients with lower initial VAS scores showed a higher improvement in the VAS score postoperatively compared to patients with higher initial VAS scores. Satisfaction with the result depends on the increase in the VAS score value. The VAS scale is a short and comprehensible tool to assess patients' perception of nasal appearance preoperatively and represents an appropriate instrument to assess the esthetic patient-reported outcome in septorhinoplasty.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A randomized controlled trial of single point acupuncture in primary dysmenorrhea.

PubMed

Liu, Cun-Zhi; Xie, Jie-Ping; Wang, Lin-Peng; Liu, Yu-Qi; Song, Jia-Shan; Chen, Yin-Ying; Shi, Guang-Xia; Zhou, Wei; Gao, Shu-Zhong; Li, Shi-Liang; Xing, Jian-Min; Ma, Liang-Xiao; Wang, Yan-Xia; Zhu, Jiang; Liu, Jian-Ping

2014-06-01

Acupuncture is often used for primary dysmenorrhea. But there is no convincing evidence due to low methodological quality. We aim to assess immediate effect of acupuncture at specific acupoint compared with unrelated acupoint and nonacupoint on primary dysmenorrhea. The Acupuncture Analgesia Effect in Primary Dysmenorrhoea-II is a multicenter controlled trial conducted in six large hospitals of China. Patients who met inclusion criteria were randomly assigned to classic acupoint (N = 167), unrelated acupoint (N = 167), or non-acupoint (N = 167) group on a 1:1:1 basis. They received three sessions with electro-acupuncture at a classic acupoint (Sanyinjiao, SP6), or an unrelated acupoint (Xuanzhong, GB39), or nonacupoint location, respectively. The primary outcome was subjective pain as measured by a 100-mm visual analog scale (VAS). Measurements were obtained at 0, 5, 10, 30, and 60 minutes following the first intervention. In addition, patients scored changes of general complaints using Cox retrospective symptom scales (RSS-Cox) and 7-point verbal rating scale (VRS) during three menstrual cycles. Secondary outcomes included VAS score for average pain, pain total time, additional in-bed time, and proportion of participants using analgesics during three menstrual cycles. Five hundred and one people underwent random assignment. The primary comparison of VAS scores following the first intervention demonstrated that classic acupoint group was more effective both than unrelated acupoint (-4.0 mm, 95% CI -7.1 to -0.9, P = 0.010) and nonacupoint (-4.0 mm, 95% CI -7.0 to -0.9, P = 0.012) groups. However, no significant differences were detected among the three acupuncture groups for RSS-Cox or VRS outcomes. The per-protocol analysis showed similar pattern. No serious adverse events were noted. Specific acupoint acupuncture produced a statistically, but not clinically, significant effect compared with unrelated acupoint and nonacupoint acupuncture in primary dysmenorrhea patients. Future studies should focus on effects of multiple points acupuncture on primary dysmenorrhea. Wiley Periodicals, Inc.

The Effects of Specialization and Sex on Anterior Y-Balance Performance in High School Athletes

PubMed Central

Miller, Madeline M.; Trapp, Jessica L.; Post, Eric G.; Trigsted, Stephanie M.; McGuine, Timothy A.; Brooks, M. Alison; Bell, David R.

2017-01-01

Background: Sport specialization and movement asymmetry have been separately discussed as potential risk factors for lower extremity injury. Early specialization may lead to the development of movement asymmetries that can predispose an athlete to injury, but this has not been thoroughly examined. Hypothesis: Athletes rated as specialized would exhibit greater between-limb anterior reach asymmetry and decreased anterior reach distance on the Y-balance test (YBT) as compared with nonspecialized high school athletes, and these differences would not be dependent on sex. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: Two hundred ninety-five athletes (117 male, 178 female; mean age, 15.6 ± 1.2 years) from 2 local high schools participating in basketball, soccer, volleyball, and tennis responded to a questionnaire regarding sport specialization status and performed trials of the YBT during preseason testing. Specialization was categorized according to 3 previously utilized specialization classification methods (single/multisport, 3-point scale, and 6-point scale), and interactions between specialization and sex with Y-balance performance were calculated using 2-way analyses of variance. Results: Single-sport male athletes displayed greater anterior reach asymmetry than other interaction groups. A consistent main effect was observed for sex, with men displaying greater anterior asymmetry and decreased anterior reach distance than women. However, the interaction effects of specialization and sex on anterior Y-balance performance varied based on the classification method used. Conclusion: Single-sport male athletes displayed greater anterior reach asymmetry on the YBT than multisport and female athletes. Specialization classification method is important because the 6- and 3-point scales may not accurately identify balance abnormalities. Male athletes performed worse than female athletes on both of the Y-balance tasks. Clinical Relevance: Clinicians should be aware that single-sport male athletes may display deficits in dynamic balance, potentially increasing their risk of injury. PMID:28447871

Determining Performance Levels of Competencies for Job Entry Required of Beginning Farm Operators. Final Report.

ERIC Educational Resources Information Center

Avery, John H.

A sample of 145 people representing eighty farm operations and a statewide sample of 233 agricultural and agribusiness workers participated in a study to identify competencies, their importance (on a one to five rating scale), and the performance level required of a beginning farm operator in each of the following five cluster areas considered…

Five Alzheimer's disease cases with refractory behavioural psychological symptoms of dementia treated with blonanserin.

PubMed

Hamuro, Atsushi; Saito, Satona

2010-12-01

The aim of the present study was to determine the efficacy, side-effects and tolerability of blonanserin for treating refractory behavioural psychological symptoms of dementia (BPSD). The present study was a 12-week, prospective, structured clinical trial of blonanserin for the treatment of BPSD. The degree of cognitive function, activities of daily living score, and the degree of BPSD were determined using the Mini-Mental State Examination (MMSE), Disability Assessment for Dementia (DAD), Neuropsychiatric Inventory (NPI) and the Rating Scale for Aggressive Behaviour in the Elderly (RAGE). The severity of extrapyramidal symptoms was assessed using the Drug-Induced Extrapyramidal Symptoms scale (DIEEPS). Five patients were enrolled. These patients met the NINCDS-ADRDA criteria. The patients were prescribed more than two kinds of existing antipsychotic drugs and were considered refractory cases; the drugs were discontinued because they were ineffectual and side-effects appeared. Each drug was prescribed independently for at least 2 weeks. The mean changes (at baseline and at the last week, respectively) in the MMSE (12.25, 9.25), in the DAD (6.5, 6.75), in the RAGE (5.5, 5.3) and in the DIEEPS (0.5, 1.5) were minimal. The mean changes in the NPI were two or fewer points. Some side-effects (one gait abnormality and one pneumonia) were observed. The results of this preliminary study show that blonanserin does not have adequate efficacy for the treatment of refractory BPSD. © 2010 The Authors. Psychogeriatrics © 2010 Japanese Psychogeriatric Society.

Curriculum development for a national cardiotocography education program: a Delphi survey to obtain consensus on learning objectives.

PubMed

Thellesen, Line; Hedegaard, Morten; Bergholt, Thomas; Colov, Nina P; Hoegh, Stinne; Sorensen, Jette L

2015-08-01

To define learning objectives for a national cardiotocography (CTG) education program based on expert consensus. A three-round Delphi survey. One midwife and one obstetrician from each maternity unit in Denmark were appointed based on CTG teaching experience and clinical obstetric experience. Following national and international guidelines, the research group determined six topics as important when using CTG: fetal physiology, equipment, indication, interpretation, clinical management, and communication/responsibility. In the first Delphi round, participants listed one to five learning objectives within the predefined topics. Responses were analyzed by a directed approach to content analysis. Phrasing was modified in accordance with Bloom's taxonomy. In the second and third Delphi rounds, participants rated each objective on a five-point relevance scale. Consensus was predefined as objectives with a mean rating value of ≥ 3. A prioritized list of CTG learning objectives. A total of 42 midwives and obstetricians from 21 maternity units were invited to participate, of whom 26 completed all three Delphi rounds, representing 18 maternity units. The final prioritized list included 40 objectives. The highest ranked objectives emphasized CTG interpretation and clinical management. The lowest ranked objectives emphasized fetal physiology. Mean ratings of relevance ranged from 3.15 to 5.00. National consensus on CTG learning objectives was achieved using the Delphi methodology. This was an initial step in developing a valid CTG education program. A prioritized list of objectives will clarify which topics to emphasize in a CTG education program. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

The definition of polytrauma revisited: An international consensus process and proposal of the new 'Berlin definition'

PubMed

Pape, Hans-Christoph; Lefering, Rolf; Butcher, Nerida; Peitzman, Andrew; Leenen, Luke; Marzi, Ingo; Lichte, Philip; Josten, Christoph; Bouillon, Bertil; Schmucker, Uli; Stahel, Philip; Giannoudis, Peter; Balogh, Zsolt

2014-11-01

The nomenclature for patients with multiple injuries with high mortality rates is highly variable, and there is a lack of a uniform definition of the term polytrauma. A consensus process was therefore initiated by a panel of international experts with the goal of assessing an improved, database-supported definition for the polytraumatized patient. The consensus process involved the following: RESULTS: A total of 28,211 patients in the trauma registry met the inclusion criteria. The mean (SD) age of the study cohort was 42.9 (20.2) years (72% males, 28% females). The mean (SD) ISS was 30.5 (12.2), with an overall mortality rate of 18.7% (n = 5,277) and an incidence of 3% of penetrating injuries (n = 886). Five independent physiologic variables were identified, and their individual cutoff values were calculated based on a set mortality rate of 30%: hypotension (systolic blood pressure ≤ 90 mm Hg), level of consciousness (Glasgow Coma Scale [GCS] score ≤ 8), acidosis (base excess ≤ -6.0), coagulopathy (international normalized ratio ≥ 1.4/partial thromboplastin time ≥ 40 seconds), and age (≥70 years). Based on several consensus meetings and a database analysis, the expert panel proposes the following parameters for a definition of "polytrauma": significant injuries of three or more points in two or more different anatomic AIS regions in conjunction with one or more additional variables from the five physiologic parameters. Further validation of this proposal should occur, favorably by mutivariate analyses of these parameters in a separate data set.

Development of key performance indicators to evaluate centralized intake for patients with osteoarthritis and rheumatoid arthritis.

PubMed

Barber, Claire E; Patel, Jatin N; Woodhouse, Linda; Smith, Christopher; Weiss, Stephen; Homik, Joanne; LeClercq, Sharon; Mosher, Dianne; Christiansen, Tanya; Howden, Jane Squire; Wasylak, Tracy; Greenwood-Lee, James; Emrick, Andrea; Suter, Esther; Kathol, Barb; Khodyakov, Dmitry; Grant, Sean; Campbell-Scherer, Denise; Phillips, Leah; Hendricks, Jennifer; Marshall, Deborah A

2015-11-14

Centralized intake is integral to healthcare systems to support timely access to appropriate health services. The aim of this study was to develop key performance indicators (KPIs) to evaluate centralized intake systems for patients with osteoarthritis (OA) and rheumatoid arthritis (RA). Phase 1 involved stakeholder meetings including healthcare providers, managers, researchers and patients to obtain input on candidate KPIs, aligned along six quality dimensions: appropriateness, accessibility, acceptability, efficiency, effectiveness, and safety. Phase 2 involved literature reviews to ensure KPIs were based on best practices and harmonized with existing measures. Phase 3 involved a three-round, online modified Delphi panel to finalize the KPIs. The panel consisted of two rounds of rating and a round of online and in-person discussions. KPIs rated as valid and important (≥7 on a 9-point Likert scale) were included in the final set. Twenty-five KPIs identified and substantiated during Phases 1 and 2 were submitted to 27 panellists including healthcare providers, managers, researchers, and patients in Phase 3. After the in-person meeting, three KPIs were removed and six were suggested. The final set includes 9 OA KPIs, 10 RA KPIs and 9 relating to centralized intake processes for both conditions. All 28 KPIs were rated as valid and important. Arthritis stakeholders have proposed 28 KPIs that should be used in quality improvement efforts when evaluating centralized intake for OA and RA. The KPIs measure five of the six dimensions of quality and are relevant to patients, practitioners and health systems.

Does technique matter; a pilot study exploring weighting techniques for a multi-criteria decision support framework.

PubMed

van Til, Janine; Groothuis-Oudshoorn, Catharina; Lieferink, Marijke; Dolan, James; Goetghebeur, Mireille

2014-01-01

There is an increased interest in the use of multi-criteria decision analysis (MCDA) to support regulatory and reimbursement decision making. The EVIDEM framework was developed to provide pragmatic multi-criteria decision support in health care, to estimate the value of healthcare interventions, and to aid in priority-setting. The objectives of this study were to test 1) the influence of different weighting techniques on the overall outcome of an MCDA exercise, 2) the discriminative power in weighting different criteria of such techniques, and 3) whether different techniques result in similar weights in weighting the criteria set proposed by the EVIDEM framework. A sample of 60 Dutch and Canadian students participated in the study. Each student used an online survey to provide weights for 14 criteria with two different techniques: a five-point rating scale and one of the following techniques selected randomly: ranking, point allocation, pairwise comparison and best worst scaling. The results of this study indicate that there is no effect of differences in weights on value estimates at the group level. On an individual level, considerable differences in criteria weights and rank order occur as a result of the weight elicitation method used, and the ability of different techniques to discriminate in criteria importance. Of the five techniques tested, the pair-wise comparison of criteria has the highest ability to discriminate in weights when fourteen criteria are compared. When weights are intended to support group decisions, the choice of elicitation technique has negligible impact on criteria weights and the overall value of an innovation. However, when weights are used to support individual decisions, the choice of elicitation technique influences outcome and studies that use dissimilar techniques cannot be easily compared. Weight elicitation through pairwise comparison of criteria is preferred when taking into account its superior ability to discriminate between criteria and respondents' preferences.

Factors influencing pharmacy students’ attitudes towards pharmacy practice research and strategies for promoting research interest in pharmacy practice

PubMed Central

Kritikos, Vicky S.; Saini, Bandana; Carter, Stephen; Moles, Rebekah J.; Krass, Ines

2015-01-01

Objectives: To (1) investigate the relationships between students’ characteristics and their (a) perceptions of research in general and (b) attitudes towards pharmacy practice research; (2) identify strategies that could be used by pharmacy educators to promote research interest in pharmacy practice; and (3) identify perceived barriers to the pursuit or completion of a pharmacy practice research degree. Methods: A survey was administered to all students enrolled in each year of the four-year pharmacy undergraduate program, University of Sydney, Australia. Perceptions of research in general were measured using 4 items on a five-point semantic-differential scale and attitudes towards pharmacy practice research were measured using 16 items on a five-point Likert scale. Student characteristics were also collected as were responses to open-ended questions which were analysed using content analysis. Results: In total 853 students participated and completed the survey (83% response rate). Participants’ characteristics were associated with some but not all aspects of research and pharmacy practice research. It appeared that positive attitudes and perspectives were influenced strongly by exposure to the ‘research’ process through projects, friends or mentors, previous degrees or having future intentions to pursue a research degree. Results from both the quantitative and qualitative analyses suggest positive attitudes and perceptions of research can be nurtured through the formal inclusion in research processes, particularly the utility of practice research in clinical practice across the four years of study. Participants indicated there was a lack of awareness of the needs, benefits and career opportunities associated with pharmacy practice research and voiced clear impediments in their career path with respect to the choice of practice research-related careers. Conclusions: Future research should investigate changes in perceptions and attitudes in a single cohort over the four-year degree, other factors influencing students’ perceptions and attitudes, and evaluate the effectiveness of research promoting strategies and programs. PMID:26445620

Potential effectiveness of specific anti-smoking mass media advertisements among Australian Indigenous smokers.

PubMed

Stewart, Harold S; Bowden, Jacqueline A; Bayly, Megan C; Sharplin, Greg R; Durkin, Sarah J; Miller, Caroline L; Givans, Sharon E; Warne, Charles D; Wakefield, Melanie A

2011-12-01

Aboriginal and Torres Strait Islander Australians (Indigenous Australians) have more than twice the smoking prevalence of non-Indigenous Australians. Anti-smoking campaigns have demonstrated success in the general population but little is known about their impact among Indigenous people. A total of 143 Indigenous and a comparison group of 156 non-Indigenous smokers from South Australia were shown 10 anti-smoking advertisements representing a range of advertisements typically aired in Australia. Participants rated advertisements on a five-point Likert scale assessing factors including message acceptance and personalized effectiveness. On average, Indigenous people rated the mainstream advertisements higher than non-Indigenous people and were more likely to report that they provided new information. Advertisements with strong graphic imagery depicting the health effects of smoking were rated highest by Indigenous smokers. Advertisements featuring real people describing the serious health consequences of smoking received mixed responses. Those featuring an ill person were rated higher by Indigenous people than those featuring the family of the person affected by a smoking-related disease. With limited Indigenous-specific messages available and given the finite resources of most public health campaigns, exposure to mainstream strong graphic and emotive first-person narratives about the health effects of smoking are likely to be highly motivating for Indigenous smokers.

Multimedia telehomecare system using standard TV set.

PubMed

Guillén, S; Arredondo, M T; Traver, V; García, J M; Fernández, C

2002-12-01

Nowadays, there are a very large number of patients that need specific health support at home. The deployment of broadband communication networks is making feasible the provision of home care services with a proper quality of service. This paper presents a telehomecare multimedia platform that runs over integrated services digital network and internet protocol using videoconferencing standards H.320 and H.323, and standard TV set for patient interaction. This platform allows online remote monitoring: ECG, heart sound, blood pressure. Usability, affordability, and interoperability were considered for the design and development of its hardware and software components. A first evaluation of technical and usability aspects were carried forward with 52 patients of a private clinic and 10 students in the University. Results show a high rate (mean = 4.33, standard deviation--SD = 1.63 in a five-points Likert scale) in the global perception of users on the quality of images, voice, and feeling of virtual presence.

[Perceptual categorization of emotional expression cued by ones back posture].

PubMed

Sogon, S; Doi, K

1986-04-01

Subjects looked at 8 mm motion pictures of the bodily movement from rear view perspective of male and female communicators, who faced to emotionally-toned scenes. If the subjects detected some sign of emotional expression, they rated the relevance of expression on five point scale. Varimax rotated factor analysis yielded three factors: F1 rejection-acceptance, F2 avoidance-approach, and F3 sadness. Rejection was categorized as expressions of anger, disgust, and contempt, while anger was categorized when a clenched fist with forward and extended arm were observed. Disgust and contempt were categorized when stationary posture was observed. Acceptance was categorized when the signs of affection, anticipation, and acceptance were observed. Avoidance was categorized when signs of fear and surprise were observed. A typical fear was categorized when signs of freezing was observed, surprise was categorized by stepping back, and sadness was categorized by crouching and self attachment.

Development of a radiology faculty appraisal instrument by using critical incident interviewing.

PubMed

Collins, J; Albanese, M A; Thakor, S K; Propeck, P A; Scanlan, K A

1997-12-01

To develop a valid and reliable radiology faculty appraisal instrument based on scientific methods. Fifteen radiology residents participated in critical incident interviewing. During a 1-hour interview, a resident was asked to describe five incidents each of effective and ineffective faculty behavior. Two investigators independently listened to the tape-recorded interviews, and two different investigators sorted the incidents into broad categories. A faculty appraisal instrument was developed by listing similar incidents under broad categories. A five-point rating scale was applied to each item. Content validity was assessed by resident and faculty critique of the appraisal instrument. A total of 168 incidents of faculty behavior were generated. The frequency with which similar incidents were reported was recorded. The most common behaviors reported were related to staff expertise and teaching. Interjudge reliability was good, as determined by computing K indices of agreement (overall K = 0.59). There was good agreement regarding instrument content validity among residents but not among faculty. Residents supported the use of the new appraisal instrument, but further tests of validity and reliability and faculty acceptance of the instrument will determine its usefulness as a tool for monitoring faculty teaching performance and making decisions regarding faculty promotion.

The Use of Biodegradable Stents in Malignant Oesophageal Strictures for the Treatment of Dysphagia Before Neoadjuvant Treatment or Radical Radiotherapy: A Feasibility Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Krokidis, Miltiadis, E-mail: mkrokidis@hotmail.com; Burke, Chris; Spiliopoulos, Stavros

PurposeTo evaluate the clinical results of the use of biodegradable oesophageal stents in malignant strictures.MethodsEleven patients were included in this prospective analysis in which a woven polydioxanone biodegradable oesophageal stent was used. The inclusion criterion was that the patient underwent neoadjuvant treatment or radical radiotherapy after the stent insertion. Primary end points were dysphagia score at discharge, stent patency, and complication rate. Secondary end points were overall survival and surgical outcome of surgery.ResultsThere was a 100 % procedure technical success rate. Early complications occurred in three patients resulting in failure to restore oral nutrition. In the remaining eight patients, dysphagiamore » was significantly improved at discharge. Mean stent patency rate in this group was 71.5 days. Stent dysfunction occurred in five of eight patients (62.5 %); in two of five patients this was due to local inflammatory reaction, and in three of five patients it was due to tumour growth after a mean time of 97.8 days, and a new metallic stent was consequently placed in four of five patients. One patient was successfully treated with esophagectomy. At the end of follow-up (mean time 102.1 days), three of eight stents were patent. The overall patient survival rate was 81.8 %.ConclusionAlthough short-term dysphagia scores improved, biodegradable stents do not appear to offer a clear beneficial effect in most cases of malignant strictures, particularly due to a local inflammatory reaction that may be induced. Technical improvement of the device and delineation of the patient group that would benefit from its use is necessary if further studies are to be conducted in the future.« less

A Methodology for Assessing Parental Perception of Infant Temperament.

ERIC Educational Resources Information Center

Pedersen, Frank A.; And Others

The Perception of Baby Temperament Scales (PBT) were used to elicit parental perceptions of infant temperament, with the results rated for internal consistency and congruence between parents. Data was obtained from 26 families, with both father and mother describing their first-born infants at five months of age. The PBT Scales deal with a range…

Hackneyed, Acned, or Just Plain Good: Perceiving Quality in Young Adult Fiction.

ERIC Educational Resources Information Center

Agee, Hugh

A rating scale was developed by Stephen Dunning for evaluating adolescent literature objectively. The distinguishing features of the scale's five categories are designed to produce a numerical score between 5 and 25 (each category a 1-to-5 ranking for poor/excellent quality), indicating the relative worth of a specific literary work. The first…

A preliminary psychometric evaluation of Music in Dementia Assessment Scales (MiDAS).

PubMed

McDermott, Orii; Orgeta, Vasiliki; Ridder, Hanne Mette; Orrell, Martin

2014-06-01

Music in Dementia Assessment Scales (MiDAS), an observational outcome measure for music therapy with people with moderate to severe dementia, was developed from qualitative data of focus groups and interviews. Expert and peer consultations were conducted at each stage of the scale development to maximize its content validity. This study aimed to evaluate the psychometric properties of MiDAS. Care home residents with dementia attended weekly group music therapy for up to ten sessions. Music therapists and care home staff were requested to complete weekly MiDAS ratings. The Quality of Life Scale (QoL-AD) was completed at three time-points. A total of 629 (staff = 306, therapist = 323) MiDAS forms were completed. The statistical analysis revealed that MiDAS has high therapist inter-rater reliability, low staff inter-rater reliability, adequate staff test-retest reliability, adequate concurrent validity, and good construct validity. High factor loadings between the five MiDAS Visual Analogue Scale (VAS) items, levels of Interest, Response, Initiation, Involvement, and Enjoyment, were found. This study indicates that MiDAS has good psychometric properties despite the small sample size. Future research with a larger sample size could provide a more in-depth psychometric evaluation, including further exploration of the underlying factors. MiDAS provides a measure of engagement with musical experience and offers insight into who is likely to benefit on other outcomes such as quality of life or reduction in psychiatric symptoms.

A modest start, but a steady rise in research use: a longitudinal study of nurses during the first five years in professional life

PubMed Central

2012-01-01

Background Newly graduated nurses are faced with a challenging work environment that may impede their ability to provide evidence-based practice. However, little is known about the trajectory of registered nurses' use of research during the first years of professional life. Thus, the aim of the current study was to prospectively examine the extent of nurses' use of research during the first five years after undergraduate education and specifically assess changes over time. Method Survey data from a prospective cohort of 1,501 Swedish newly graduated nurses within the national LANE study (Longitudinal Analyses of Nursing Education and Entry in Worklife) were used to investigate perceived use of research over the first five years as a nurse. The dependent variables consisted of three single items assessing instrumental, conceptual, and persuasive research use, where the nurses rated their use on a five-point scale, from 'never' (1) to 'on almost every shift' (5). These data were collected annually and analyzed both descriptively and by longitudinal growth curve analysis. Results Instrumental use of research was most frequently reported, closely followed by conceptual use, with persuasive use occurring to a considerably lower extent. The development over time showed a substantial general upward trend, which was most apparent for conceptual use, increasing from a mean of 2.6 at year one to 3.6 at year five (unstandardized slope +0.25). However, the descriptive findings indicated that the increase started only after the second year. Instrumental use had a year one mean of 2.8 and a year five mean of 3.5 (unstandardized slope +0.19), and persuasive use showed a year one mean of 1.7 and a year five mean of 2.0 (unstandardized slope +0.09). Conclusion There was a clear trend of increasing research use by nurses during their first five years of practice. The level of the initial ratings also indicated the level of research use in subsequent years. However, it took more than two years of professional development before this increase 'kicked in.' These findings support previous research claiming that newly graduated nurses go through a 'transition shock,' reducing their ability to use research findings in clinical work. PMID:22429884

Naltrexone for impulse control disorders in Parkinson disease

PubMed Central

Papay, Kimberly; Xie, Sharon X.; Stern, Matthew; Hurtig, Howard; Siderowf, Andrew; Duda, John E.; Minger, James

2014-01-01

Objective: Impulse control disorders (ICDs) in Parkinson disease (PD) are common and can be difficult to manage. The objective of this study was to determine the efficacy and tolerability of naltrexone, an opioid antagonist, for the treatment of ICDs in PD. Methods: Patients with PD (n = 50) and an ICD were enrolled in an 8-week, randomized (1:1), double-blind, placebo-controlled study of naltrexone 50–100 mg/d (flexible dosing). The primary outcome measure was response based on the Clinical Global Impression–Change score, and the secondary outcome measure was change in symptom severity using the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease–Rating Scale (QUIP-RS) ICD score. Results: Forty-five patients (90%) completed the study. The Clinical Global Impression–Change response rate difference favoring naltrexone in completers was 19.8% (95% confidence interval [CI] −8.7% to 44.2%). While this difference was not significant (odds ratio = 1.6, 95% CI 0.5–5.2, Wald χ2 [df] = 0.5 [1], p = 0.5), naltrexone treatment led to a significantly greater decrease in QUIP-RS ICD score over time compared with placebo (regression coefficient for interaction term in linear mixed-effects model = −7.37, F[df] = 4.3 [1, 49], p = 0.04). The estimated changes in QUIP-RS ICD scores from baseline to week 8 were 14.9 points (95% CI 9.9–19.9) for naltrexone and 7.5 points (95% CI 2.5–12.6) for placebo. Conclusions: Naltrexone treatment was not efficacious for the treatment of ICDs in PD using a global assessment of response, but findings using a PD-specific ICD rating scale support further evaluation of opioid antagonists for the treatment of ICD symptoms in PD. Classification of evidence: This study provides Class I evidence that in patients with PD and an ICD, naltrexone does not significantly increase the probability of achieving response. However, the study lacked the precision to exclude an important difference in response rates. PMID:25037206

Men With a Terminal Illness Relax Their Criteria for Facial Attractiveness

PubMed Central

Danel, Dariusz P.; Siennicka, Agnieszka E.; Fedurek, Pawel; Frackowiak, Tomasz; Sorokowski, Piotr; Jankowska, Ewa A.; Pawlowski, Boguslaw

2017-01-01

According to the life history paradigm, in life-threatening conditions, sexual selection criteria are relaxed in order to increase the probability of a last resort reproduction, ultimately contributing to reproductive success. This should be reflected in loosened mating preferences — a process observed in nonhuman animals. Studies investigating this aspect in humans, however, are scarce. This study explored the aesthetic preferences towards facial and nonfacial stimuli in terminally ill patients with heart failure (HF) and their healthy, same-sex peers. The aim was to examine if these two groups of men demonstrate different patterns of aesthetic judgments. Using a 7-point scale, 65 male patients with HF and 143 healthy men evaluated the perceived attractiveness of 15 photographs (five adult male faces, five adult female faces, and five nonfacial pictures). A mixed-design analysis of variance was run to assess group differences in aesthetic preferences. Compared to healthy controls, stimuli. HF patients rated the pictures using significantly higher scores, but this applied only to male and female, but not nonfacial, stimuli. We propose that lower criteria for facial attractiveness in HF patients are linked to relaxation of mate preferences as a result of a life-threatening conditions, and that this process can be an adaptive mating strategy from an ultimate, evolutionary perspective. However, other mechanisms (e.g., seeking social support) may be also responsible for the observed patterns. PMID:28625113

Men With a Terminal Illness Relax Their Criteria for Facial Attractiveness.

PubMed

Danel, Dariusz P; Siennicka, Agnieszka E; Fedurek, Pawel; Frackowiak, Tomasz; Sorokowski, Piotr; Jankowska, Ewa A; Pawlowski, Boguslaw

2017-07-01

According to the life history paradigm, in life-threatening conditions, sexual selection criteria are relaxed in order to increase the probability of a last resort reproduction, ultimately contributing to reproductive success. This should be reflected in loosened mating preferences - a process observed in nonhuman animals. Studies investigating this aspect in humans, however, are scarce. This study explored the aesthetic preferences towards facial and nonfacial stimuli in terminally ill patients with heart failure (HF) and their healthy, same-sex peers. The aim was to examine if these two groups of men demonstrate different patterns of aesthetic judgments. Using a 7-point scale, 65 male patients with HF and 143 healthy men evaluated the perceived attractiveness of 15 photographs (five adult male faces, five adult female faces, and five nonfacial pictures). A mixed-design analysis of variance was run to assess group differences in aesthetic preferences. Compared to healthy controls, stimuli. HF patients rated the pictures using significantly higher scores, but this applied only to male and female, but not nonfacial, stimuli. We propose that lower criteria for facial attractiveness in HF patients are linked to relaxation of mate preferences as a result of a life-threatening conditions, and that this process can be an adaptive mating strategy from an ultimate, evolutionary perspective. However, other mechanisms (e.g., seeking social support) may be also responsible for the observed patterns.

ADHD and nicotine use in schizophrenia or Asperger syndrome: a controlled study.

PubMed

Hallerbäck, Maria Unenge; Lugnegård, Tove; Gillberg, Christopher

2014-07-01

To examine ADHD prevalence, rating scales, and relationship to nicotine use in adults with schizophrenia or Asperger syndrome. Ninety-five individuals, 41 with schizophrenia and 54 with Asperger syndrome, were included. Self-rating of adult ADHD symptoms with the Wender-Reimherr Adult Attention Deficit Diagnostic Rating Scale (WRAADDS), parent rating of proband's ADHD childhood and adult life symptoms using the Swanson, Nolan, and Pelham Questionnaire (SNAP), and report of clinical ADHD diagnosis were included as ADHD measures. Nicotine use data were compared with data from a population sample. In all, 10% of the schizophrenia group and 30% of the Asperger syndrome group had a clinical ADHD diagnosis. Nicotine dependency in the whole sample was closely linked to ADHD. The prevalence of comorbid ADHD was high in schizophrenia and Asperger syndrome. The WRAADDS self-rating scale for ADHD can be one useful tool for assessing comorbid ADHD in these patient groups. © 2012 SAGE Publications.

40 CFR 60.424 - Test methods and procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... weigh scales, or the result of computations using a material balance, shall be used to determine the rate (P) of the ammonium sulfate production. If production rate is determined by material balance, the... combined feed stream flow rate to the ammonium crystallizer before the point where any recycle streams...

Direct reading of electrocardiograms and respiration rates

NASA Technical Reports Server (NTRS)

Wise, J. P.

1969-01-01

Technique for reading heart and respiration rates is more accurate and direct than the previous method. Index of a plastic calibrated card is aligned with a point on the electrocardiogram. Complexes are counted as indicated on the card and heart or respiration rate is read directly from the appropriate scale.

Resistance exercise training for fibromyalgia.

PubMed

Busch, Angela J; Webber, Sandra C; Richards, Rachel S; Bidonde, Julia; Schachter, Candice L; Schafer, Laurel A; Danyliw, Adrienne; Sawant, Anuradha; Dal Bello-Haas, Vanina; Rader, Tamara; Overend, Tom J

2013-12-20

Fibromyalgia is characterized by chronic widespread pain that leads to reduced physical function. Exercise training is commonly recommended as a treatment for management of symptoms. We examined the literature on resistance training for individuals with fibromyalgia. Resistance training is exercise performed against a progressive resistance with the intention of improving muscle strength, muscle endurance, muscle power, or a combination of these. To evaluate the benefits and harms of resistance exercise training in adults with fibromyalgia. We compared resistance training versus control and versus other types of exercise training. We searched nine electronic databases (The Cochrane Library, MEDLINE, EMBASE, CINAHL, PEDro, Dissertation Abstracts, Current Controlled Trials, World Health Organization (WHO) International Clinical Trials Registry Platform, AMED) and other sources for published full-text articles. The date of the last search was 5 March 2013. Two review authors independently screened 1856 citations, 766 abstracts and 156 full-text articles. We included five studies that met our inclusion criteria. Selection criteria included: a) randomized clinical trial, b) diagnosis of fibromyalgia based on published criteria, c) adult sample, d) full-text publication, and e) inclusion of between-group data comparing resistance training versus a control or other physical activity intervention. Pairs of review authors independently assessed risk of bias and extracted intervention and outcome data. We resolved disagreements between the two review authors and questions regarding interpretation of study methods by discussion within the pairs or when necessary the issue was taken to the full team of 11 members. We extracted 21 outcomes of which seven were designated as major outcomes: multidimensional function, self reported physical function, pain, tenderness, muscle strength, attrition rates, and adverse effects. We evaluated benefits and harms of the interventions using standardized mean differences (SMD) or mean differences (MD) or risk ratios or Peto odds ratios and 95% confidence intervals (CI). Where two or more studies provided data for an outcome, we carried out a meta-analysis. The literature search yielded 1865 citations with five studies meeting the selection criteria. One of the studies that had three arms contributed data for two comparisons. In the included studies, there were 219 women participants with fibromyalgia, 95 of whom were assigned to resistance training programs. Three randomized trials compared 16 to 21 weeks of moderate- to high-intensity resistance training versus a control group. Two studies compared eight weeks of progressive resistance training (intensity as tolerated) using free weights or body weight resistance exercise versus aerobic training (ie, progressive treadmill walking, indoor and outdoor walking), and one study compared 12 weeks of low-intensity resistance training using hand weights (1 to 3 lbs (0.45 to 1.36 kg)) and elastic tubing versus flexibility exercise (static stretches to major muscle groups).Statistically significant differences (MD; 95% CI) favoring the resistance training interventions over control group(s) were found in multidimensional function (Fibromyalgia Impact Questionnaire (FIQ) total decreased 16.75 units on a 100-point scale; 95% CI -23.31 to -10.19), self reported physical function (-6.29 units on a 100-point scale; 95% CI -10.45 to -2.13), pain (-3.3 cm on a 10-cm scale; 95% CI -6.35 to -0.26), tenderness (-1.84 out of 18 tender points; 95% CI -2.6 to -1.08), and muscle strength (27.32 kg force on bilateral concentric leg extension; 95% CI 18.28 to 36.36).Differences between the resistance training group(s) and the aerobic training groups were not statistically significant for multidimensional function (5.48 on a 100-point scale; 95% CI -0.92 to 11.88), self reported physical function (-1.48 units on a 100-point scale; 95% CI -6.69 to 3.74) or tenderness (SMD -0.13; 95% CI -0.55 to 0.30). There was a statistically significant reduction in pain (0.99 cm on a 10-cm scale; 95% CI 0.31 to 1.67) favoring the aerobic groups.Statistically significant differences were found between a resistance training group and a flexibility group favoring the resistance training group for multidimensional function (-6.49 FIQ units on a 100-point scale; 95% CI -12.57 to -0.41) and pain (-0.88 cm on a 10-cm scale; 95% CI -1.57 to -0.19), but not for tenderness (-0.46 out of 18 tender points; 95% CI -1.56 to 0.64) or strength (4.77 foot pounds torque on concentric knee extension; 95% CI -2.40 to 11.94). This evidence was classified low quality due to the low number of studies and risk of bias assessment. There were no statistically significant differences in attrition rates between the interventions. In general, adverse effects were poorly recorded, but no serious adverse effects were reported. Assessment of risk of bias was hampered by poor written descriptions (eg, allocation concealment, blinding of outcome assessors). The lack of a priori protocols and lack of care provider blinding were also identified as methodologic concerns. The evidence (rated as low quality) suggested that moderate- and moderate- to high-intensity resistance training improves multidimensional function, pain, tenderness, and muscle strength in women with fibromyalgia. The evidence (rated as low quality) also suggested that eight weeks of aerobic exercise was superior to moderate-intensity resistance training for improving pain in women with fibromyalgia. There was low-quality evidence that 12 weeks of low-intensity resistance training was superior to flexibility exercise training in women with fibromyalgia for improvements in pain and multidimensional function. There was low-quality evidence that women with fibromyalgia can safely perform moderate- to high-resistance training.

19 CFR 351.224 - Disclosure of calculations and procedures for the correction of ministerial errors.

Code of Federal Regulations, 2012 CFR

2012-04-01

... least five absolute percentage points in, but not less than 25 percent of, the weighted-average dumping... margin or countervailable subsidy rate (whichever is applicable) of zero (or de minimis) and a weighted...

19 CFR 351.224 - Disclosure of calculations and procedures for the correction of ministerial errors.

Code of Federal Regulations, 2010 CFR

2010-04-01

... least five absolute percentage points in, but not less than 25 percent of, the weighted-average dumping... margin or countervailable subsidy rate (whichever is applicable) of zero (or de minimis) and a weighted...

19 CFR 351.224 - Disclosure of calculations and procedures for the correction of ministerial errors.

Code of Federal Regulations, 2014 CFR

2014-04-01

... least five absolute percentage points in, but not less than 25 percent of, the weighted-average dumping... margin or countervailable subsidy rate (whichever is applicable) of zero (or de minimis) and a weighted...

19 CFR 351.224 - Disclosure of calculations and procedures for the correction of ministerial errors.

Code of Federal Regulations, 2013 CFR

2013-04-01

... least five absolute percentage points in, but not less than 25 percent of, the weighted-average dumping... margin or countervailable subsidy rate (whichever is applicable) of zero (or de minimis) and a weighted...

19 CFR 351.224 - Disclosure of calculations and procedures for the correction of ministerial errors.

Code of Federal Regulations, 2011 CFR

2011-04-01

... least five absolute percentage points in, but not less than 25 percent of, the weighted-average dumping... margin or countervailable subsidy rate (whichever is applicable) of zero (or de minimis) and a weighted...

Validity of personality measurement in adults with anxiety disorders: psychometric properties of the Spanish NEO-FFI-R using Rasch analyses

PubMed Central

Inchausti, Felix; Mole, Joe; Fonseca-Pedrero, Eduardo; Ortuño-Sierra, Javier

2015-01-01

The aim of this study was to analyse the psychometric properties of the Spanish NEO Five Factor Inventory–Revised (NEO-FFI-R) using Rasch analyses, in order to test its rating scale functioning, the reliability of scores, internal structure, and differential item functioning (DIF) by gender in a psychiatric sample. The NEO-FFI-R responses of 433 Spanish adults (154 males) with an anxiety disorder as primary diagnosis were analysed using the Rasch model for rating scales. Two intermediate categories of response (‘neutral’ and ‘agree’) malfunctioned in the Neuroticism and Conscientiousness scales. In addition, model reliabilities were lower than expected in Agreeableness and Neuroticism, and the item fit values indicated each scale had items that did not achieve moderate to high discrimination on its dimension, particularly in the Agreeableness scale. Concerning unidimensionality, the five NEO-FFI-R scales showed large first components of unexplained variance. Finally, DIF by gender was detected in many items. The results suggest that the scores of the Spanish NEO-FFI-R are unreliable in psychiatric samples and cannot be generalized between males and females, especially in the Openness, Conscientiousness, and Agreeableness scales. Future directions for testing and refinement should be developed before the NEO-FFI-R can be used reliably in clinical samples. PMID:25954224

Measurement of self-evaluative motives: a shopping scenario.

PubMed

Wajda, Theresa A; Kolbe, Richard; Hu, Michael Y; Cui, Annie Peng

2008-08-01

To develop measures of consumers' self-evaluative motives of Self-verification, Self-enhancement, and Self-improvement within the context of a mall shopping environment, an initial set of 49 items was generated by conducting three focus-group sessions. These items were subsequently converted into shopping-dependent motive statements. 250 undergraduate college students responded on a 7-point scale to each statement as these related to the acquisition of recent personal shopping goods. An exploratory factor analysis yielded five factors, accounting for 57.7% of the variance, three of which corresponded to the Self-verification motive (five items), Self-enhancement motive (three items), and Self-improvement motive (six items). These 14 items, along with 9 reconstructed items, yielded 23 items retained and subjected to additional testing. In a final round of data collection, 169 college students provided data for exploratory factor analysis. 11 items were used in confirmatory factor analysis. Analysis indicated that the 11-item scale adequately captured measures of the three self-evaluative motives. However, further data reduction produced a 9-item scale with marked improvement in statistical fit over the 11-item scale.

Validation of Scratching Severity as an Objective Assessment for Itch.

PubMed

Udkoff, Jeremy; Silverberg, Jonathan I

2018-05-01

There are currently no simple, standardized, objective assessments of itch for clinical trials and practice. We sought to validate and test the severity of scratching as an objective measure of itch (4-point ordinal scale ranging from 0 [not present] to 3 [very prominent] based on the observation of scratching lesions). We performed a prospective outpatient study using questionnaires and evaluations by a dermatologist in adults with atopic dermatitis (n = 261). Severity of scratching best correlated with patient-reported global atopic dermatitis severity (Kendall τ = 0.336, P < 0.0001), numeric rating scale of itch in the past 24 hours (τ = 0.266, P = 0.0010) and 3 days (τ = 0.296, P < 0.0001). Severity of scratching showed responsiveness over time. Patients experiencing improvement of scratching severity of 1 point or greater had significantly lower itch based on numeric rating scale in the past 3 days (Wilcoxon rank sum test, P = 0.0175), 5-D itch scale (P = 0.0146), and Patient-Oriented Eczema Measure scores (P = 0.0146). There was a significant decrease in scratching severity for patients experiencing itch improvement of 4 points or greater in the past 3 days on the numeric rating scale (Fisher exact test, P = 0.0026), Patient-Oriented Eczema Measure (P < 0.0001), and Dermatology Life Quality Index (P = 0.0285). Severity of scratching may be a useful endpoint in clinical trials and practice across the gamut of pruritic disorders. Future studies are needed to validate severity of scratching in other pruritic disease. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Integration of Massage Therapy in Outpatient Cancer Care

PubMed Central

Cowen, Virginia S.; Tafuto, Barbara

2018-01-01

Background Massage therapy can be helpful in alleviating cancer-related symptoms and cancer treatment-related symptoms. While surveys have noted that cancer patients seek out massage as a nonpharmacologic approach during cancer treatment, little is known about the integration of massage in outpatient cancer care. Purpose The purpose of this study was to examine the extent to which massage is being integrated into outpatient cancer care at NCI-designated Cancer Centers. Setting This study used descriptive methods to analyze the integration of massage in NCI-designated Cancer Centers providing clinical services to patients (n = 62). Design Data were collected from 91.1% of the centers (n = 59) using content analysis and a telephone survey. A dataset was developed and coded for analysis. Main Outcome Measure The integration of massage was assessed by an algorithm that was developed from a set of five variables: 1) acceptance of treatment as therapeutic, 2) institution offers treatment to patients, 3) clinical practice guidelines in place, 4) use of evidence-based resources to inform treatment, and 5) shared knowledge about treatment among health care team. All centers were scored against all five variables using a six-point scale, with all variables rated equally. Results The integration of massage ranged from not at all (0) to very high (5) with all five levels of integration evident. Only 11 centers (17.7% of total) rated a very high level of integration; nearly one-third of the centers (n = 22) were found to have no integration of massage at all—not even provision of information about massage to patients through the center website. Conclusions The findings of this analysis suggest that research on massage is not being leveraged to integrate massage into outpatient cancer care. PMID:29593842

Integration of Massage Therapy in Outpatient Cancer Care.

PubMed

Cowen, Virginia S; Tafuto, Barbara

2018-03-01

Massage therapy can be helpful in alleviating cancer-related symptoms and cancer treatment-related symptoms. While surveys have noted that cancer patients seek out massage as a nonpharmacologic approach during cancer treatment, little is known about the integration of massage in outpatient cancer care. The purpose of this study was to examine the extent to which massage is being integrated into outpatient cancer care at NCI-designated Cancer Centers. This study used descriptive methods to analyze the integration of massage in NCI-designated Cancer Centers providing clinical services to patients (n = 62). Data were collected from 91.1% of the centers (n = 59) using content analysis and a telephone survey. A dataset was developed and coded for analysis. The integration of massage was assessed by an algorithm that was developed from a set of five variables: 1) acceptance of treatment as therapeutic, 2) institution offers treatment to patients, 3) clinical practice guidelines in place, 4) use of evidence-based resources to inform treatment, and 5) shared knowledge about treatment among health care team. All centers were scored against all five variables using a six-point scale, with all variables rated equally. The integration of massage ranged from not at all (0) to very high (5) with all five levels of integration evident. Only 11 centers (17.7% of total) rated a very high level of integration; nearly one-third of the centers (n = 22) were found to have no integration of massage at all-not even provision of information about massage to patients through the center website. The findings of this analysis suggest that research on massage is not being leveraged to integrate massage into outpatient cancer care.

Pharmacy executive leadership issues and associated skills, knowledge, and abilities.

PubMed

Meadows, Andrew B; Maine, Lucinda L; Keyes, Elizabeth K; Pearson, Kathy; Finstuen, Kenn

2005-01-01

To identify challenges that current and future pharmacy executives are facing or will face in the future and to define what skills, knowledge, and abilities (SKAs) are required to successfully negotiate these challenges. Delphi method for executive decision making. Civilian pharmacy profession. 110 pharmacists who graduated from the GlaxoSmithKline Executive Management Program for Pharmacy Leaders. Two iterations of the Delphi method for executive decision making separated by an expert panel content analysis. Round 1--participants were asked to identify five major issues they believed to be of greatest importance to pharmacy leaders in the next 5-10 years and name specific SKAs that might be needed by future leaders to successfully deal with those issues. An expert panel reviewed the issues, classified issues into specific domains, and titled each domain. Round 2-participants rated the SKAs on a 7-point scale according to their individual assessment of importance in each domain. For Delphi rounds 1 and 2, response rates were 21.8% and 18.2%, respectively. More than 100 total issue statements were identified. The expert panel sorted the issues into five domains: management and development of the pharmacy workforce, pharmacy finance, total quality management of work-flow systems, influences on the practice of pharmacy, and professional pharmacy leadership. Five of the top 15 SKAs-and all four highest ranked items--came from the professional pharmacy leadership domain, including ability to see the big picture, ability to demonstrate the value of pharmacy services, ability to lead and manage in an ethical manner, and skills for influencing an organization's senior leadership. Through successful integration of communication skills, critical thinking, and problem solving techniques, future public-sector pharmacy executives will be better equipped to effectively position their organizations and the profession for the challenges that lie ahead.

Scales of degree of facial paralysis: analysis of agreement.

PubMed

Fonseca, Kércia Melo de Oliveira; Mourão, Aline Mansueto; Motta, Andréa Rodrigues; Vicente, Laelia Cristina Caseiro

2015-01-01

It has become common to use scales to measure the degree of involvement of facial paralysis in phonoaudiological clinics. To analyze the inter- and intra-rater agreement of the scales of degree of facial paralysis and to elicit point of view of the appraisers regarding their use. Cross-sectional observational clinical study of the Chevalier and House & Brackmann scales performed by five speech therapists with clinical experience, who analyzed the facial expression of 30 adult subjects with impaired facial movements two times, with a one week interval between evaluations. The kappa analysis was employed. There was excellent inter-rater agreement for both scales (kappa>0.80), and on the Chevalier scale a substantial intra-rater agreement in the first assessment (kappa=0.792) and an excellent agreement in the second assessment (kappa=0.928). The House & Brackmann scale showed excellent agreement at both assessments (kappa=0.850 and 0.857). As for the appraisers' point of view, one appraiser thought prior training is necessary for the Chevalier scale and, four appraisers felt that training is important for the House & Brackmann scale. Both scales have good inter- and intra-rater agreement and most of the appraisers agree on the ease and relevance of the application of these scales. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Evaluation of respiratory impairment in patients with systemic lupus erythematosus with the six-minute walk test.

PubMed

Leite, Marivone Arruda; Pereira, Mônica Corso; Costallat, Lílian Tereza Lavras; Villalba, Wander de Oliveira; Moreira, Marcos Mello; Paschoal, Ilma Aparecida

2014-01-01

Evaluate SLE stable patients, without overt respiratory compromise, by means of 6MWT. Forty-five stable SLE patients were enrolled. The ATS/ERS protocol for 6MWT, was used and two parameters with cut-off points were chosen. Forty-two patients were women. The mean age was 39 ± 11.4 years; mean duration of disease, 121 ± 93.1 months; mean value of MRC, 2 ± 0; mean FVC, 85.9 ± 34.2%; mean FEV1, 67.5 ± 21.6%; mean MIP, 82 ± 58.4%; mean MEP, 78 ± 37.3%; mean heart rate at rest, 75 ± 12.8 bpm; mean respiratory rate at rest, 19 ± 5.3 bpm; mean 6MWD, 478 ± 82 m; mean SpO2 at rest was 98 ± 0.8%; mean fall in SpO2, 4 ± 6 points. When the study population was divided according to the 400-m walk distance cut-off value, the heart rate immediately before the test was significant lower in those participants who walked less than 400 m (p = 0.0043), just like the value of Borg scale (p = 0.0036); according to the presence of saturation ≥ 4, heart rate at the end of the test was significantly higher in those participants who were showing desaturation (p = 0.0170); MEP (p = 0.0282) and 6MWD (p = 0.0291) were significantly lower, and MIP showed a tendency towards being smaller (p = 0.0504). FVC < normal inferior limit was significantly associated with the group with desaturation (p = 0.0274). Compared to 6MWD, desaturation was better suited to find the patients with the most compromised indexes in respiratory function tests.

Assessment of outcome after severe brain damage.

PubMed

Jennett, B; Bond, M

1975-03-01

Persisting disability after brain damage usually comprises both mental and physical handicap. The mental component is often the more important in contributing to overall social disability. Lack of an objective scale leads to vague and over-optimistic estimates of outcome, which obscure the ultimate results of early management. A five-point scale is described--death, persistent vegetative state, severe disability, moderate disability, and good recovery. Duration as well as intensity of disability should be included in an index of ill-health; this applies particularly after head injury, because many disabled survivors are young.

Entrenched geographical and socioeconomic disparities in child mortality: trends in absolute and relative inequalities in Cambodia.

PubMed

Jimenez-Soto, Eliana; Durham, Jo; Hodge, Andrew

2014-01-01

Cambodia has made considerable improvements in mortality rates for children under the age of five and neonates. These improvements may, however, mask considerable disparities between subnational populations. In this paper, we examine the extent of the country's child mortality inequalities. Mortality rates for children under-five and neonates were directly estimated using the 2000, 2005 and 2010 waves of the Cambodian Demographic Health Survey. Disparities were measured on both absolute and relative scales using rate differences and ratios, and where applicable, slope and relative indices of inequality by levels of rural/urban location, regions and household wealth. Since 2000, considerable reductions in under-five and to a lesser extent in neonatal mortality rates have been observed. This mortality decline has, however, been accompanied by an increase in relative inequality in both rates of child mortality for geography-related stratifying markers. For absolute inequality amongst regions, most trends are increasing, particularly for neonatal mortality, but are not statistically significant. The only exception to this general pattern is the statistically significant positive trend in absolute inequality for under-five mortality in the Coastal region. For wealth, some evidence for increases in both relative and absolute inequality for neonates is observed. Despite considerable gains in reducing under-five and neonatal mortality at a national level, entrenched and increased geographical and wealth-based inequality in mortality, at least on a relative scale, remain. As expected, national progress seems to be associated with the period of political and macroeconomic stability that started in the early 2000s. However, issues of quality of care and potential non-inclusive economic growth might explain remaining disparities, particularly across wealth and geography markers. A focus on further addressing key supply and demand side barriers to accessing maternal and child health care and on the social determinants of health will be essential in narrowing inequalities.

Validation of the Intelligibility in Context Scale for Jamaican Creole-Speaking Preschoolers.

PubMed

Washington, Karla N; McDonald, Megan M; McLeod, Sharynne; Crowe, Kathryn; Devonish, Hubert

2017-08-15

To describe validation of the Intelligibility in Context Scale (ICS; McLeod, Harrison, & McCormack, 2012a) and ICS-Jamaican Creole (ICS-JC; McLeod, Harrison, & McCormack, 2012b) in a sample of typically developing 3- to 6-year-old Jamaicans. One-hundred and forty-five preschooler-parent dyads participated in the study. Parents completed the 7-item ICS (n = 145) and ICS-JC (n = 98) to rate children's speech intelligibility (5-point scale) across communication partners (parents, immediate family, extended family, friends, acquaintances, strangers). Preschoolers completed the Diagnostic Evaluation of Articulation and Phonology (DEAP; Dodd, Hua, Crosbie, Holm, & Ozanne, 2006) in English and Jamaican Creole to establish speech-sound competency. For this sample, we examined validity and reliability (interrater, test-rest, internal consistency) evidence using measures of speech-sound production: (a) percentage of consonants correct, (b) percentage of vowels correct, and (c) percentage of phonemes correct. ICS and ICS-JC ratings showed preschoolers were always (5) to usually (4) understood across communication partners (ICS, M = 4.43; ICS-JC, M = 4.50). Both tools demonstrated excellent internal consistency (α = .91), high interrater, and test-retest reliability. Significant correlations between the two tools and between each measure and language-specific percentage of consonants correct, percentage of vowels correct, and percentage of phonemes correct provided criterion-validity evidence. A positive correlation between the ICS and age further strengthened validity evidence for that measure. Both tools show promising evidence of reliability and validity in describing functional speech intelligibility for this group of typically developing Jamaican preschoolers.

Predicting dimensions of personality disorder from domains and facets of the Five-Factor Model.

PubMed

Reynolds, S K; Clark, L A

2001-04-01

We compared the utility of several trait models for describing personality disorder in a heterogeneous clinical sample (N = 94). Participants completed the Schedule for Nonadaptive and Adaptive Personality (SNAP; Clark, 1993b), a self-report measure that assesses traits relevant to personality disorder, and two measures of the Five-Factor Model: the Revised NEO Personality Inventory (NEO-PI-R; Costa and McCrae, 1992) and the Big Five Inventory (BFI; John, Donahue, & Kentle, 1991). Regression analyses indicated substantial overlap between the SNAP scales and the NEO-PI-R facets. In addition, use of the NEO-PI-R facets afforded substantial improvement over the Five-Factor Model domains in predicting interview-based ratings of DSM-IV personality disorder (American Psychiatric Association, 1994), such that the NEO facets and the SNAP scales demonstrated roughly equivalent levels of predictive power. Results support assessment of the full range of NEO-PI-R facets over the Five-Factor Model domains for both research and clinical use.

[Visual circle scale (VCS)--a patient-friendly scale to measure pain compared to VAS and Likert scale].

PubMed

Huber, J F; Hüsler, J; Zumstein, M D; Ruflin, G; Lüscher, M

2007-01-01

The visual analogue scale (VAS) and Likert scale (LS) are widely used but the patients might have difficulties to work with these scales and there might be errors in calculation. The visual circle scale (VCS) is a graphic construct with a simple grading to augment the understanding and ease for calculation. This study compares the different scales in orthopaedic patients for pain assessment postoperatively. In addition, the scales were rated by the patients for simplicity, understanding and global rating. Included were 65 patients (40 women) with an average age of 66 years with 330 pain assessments and 65 questionnaire ratings. The average pain was LS 42.7, VAS 39.3, VCS 44. The correlation coefficients r (Spearman) between all scales were > 0.89 and the same held also for sensitivity for change. The VCS was the scale preferred by > 50 % of the orthopaedic patients to assess the pain. The VCS is able to measure pain comparably to the known scales (VAS, Likert scale). From the patients point of view it is the preferred scale to work with.

Rasch Validation of a Measure of Reform-Oriented Science Teaching Practices

NASA Astrophysics Data System (ADS)

You, Hye Sun

2016-06-01

Growing evidence from recent curriculum documents and previous research suggests that reform-oriented science teaching practices promote students' conceptual understanding, levels of achievement, and motivation to learn, especially when students are actively engaged in constructing their ideas through scientific inquiries. However, it is difficult to identify to what extent science teachers engage students in reform-oriented teaching practices (RTPs) in their science classrooms. In order to exactly diagnose the current status of science teachers' implementation of the RTPs, a valid and reliable instrument tool is needed. The principles of validity and reliability are fundamental cornerstones in developing a robust measurement tool. As such, this study was motivated by the desire to point out the limitations of the existing statistical and psychometric analyses and to further examine the validation of the RTP survey instrument. This paper thus aims at calibrating the items of the RTPs for science teachers using the Rasch model. The survey instrument scale was adapted from the 2012 National Survey of Science and Mathematics Education (NSSME) data. A total of 3701 science teachers from 1403 schools from across the USA participated in the NSSME survey. After calibrating the RTP items and persons on the same scale, the RTP instrument well represented the population of US science teachers. Model-data fit determined by Infit and Outfit statistics was within an appropriate range (0.5-1.5), supporting the unidimensional structure of the RTPs. The ordered category thresholds and the probability of the thresholds showed that the five-point rating scale functioned well. The results of this study support the use of the RTP measure from the 2012 NSSME in assessing usage of RTPs.

Different Oils and Health Benefit Statements Affect Physicochemical Properties, Consumer Liking, Emotion, and Purchase Intent: A Case of Sponge Cake.

PubMed

Poonnakasem, Naratip; Pujols, Kairy Dharali; Chaiwanichsiri, Saiwarun; Laohasongkram, Kalaya; Prinyawiwatkul, Witoon

2016-01-01

Effects of different oils on physicochemical properties, consumer liking, emotion, and purchase intent of sponge cakes were evaluated. Three healthy oils (extra virgin coconut oil, EVCO; extra virgin olive oil, EVOO; rice bran oil, RBO) compared with butter (the control), were used at 20% (w/w, wheat flour basis) in sponge cake formulations. Five positive (calm, good, happy, pleased, satisfied) and 3 negative (guilty, unsafe, worried) emotion terms, selected from the EsSense Profile(®) with slight modification using an online (N = 234) check-all-that-apply questionnaire, were used for consumer testing. Consumers (N = 148) evaluated acceptability of 9 sensory attributes on a 9-point hedonic scale, 8 emotion responses on a 5-point rating scale, and purchase intent on a binomial scale. Overall liking, emotion, and purchase intent were evaluated before compared with after health benefit statement of oils had been given to consumers. Overall liking and positive emotion (except calm) scores of sponge cake made with EVCO were higher than those made with EVOO and RBO. Specific volume, expansion ratio, and moisture content of control, EVCO, and EVOO were not significantly different, but higher than RBO sponge cake. JAR results showed that sponge cake made with RBO had the least softness that was reflected by the highest hardness (6.61 to 9.69 compared with. 12.76N). Oil (EVCO/EVOO/RBO) health benefit statement provided to consumer significantly increased overall liking, positive emotion, and purchase intent scores while decreased negative emotion scores. Overall liking and pleased emotion were critical attributes influencing purchase intent (odds ratio = 2.06 to 3.75), whereas calm and happy became not critical after health benefit statement had been given. © 2015 Institute of Food Technologists®

A Study of the Perceptions of Performance Skills of Middle School Principals by Selected Teachers and Principals.

ERIC Educational Resources Information Center

Meyer, Calvin F.; Van Hoose, John J.

This study investigates hypotheses about differences in the perceptions of middle school principals and teachers concerning those principal performance skills that are practiced and those that should be practiced. A survey instrument consisting of 37 principal performance skills on a five-point Likert-like scale was sent to the principals and…

The Impact of Using Mobile Social Network Applications on Students' Social-Life

ERIC Educational Resources Information Center

Abdelraheem, Ahmed Yousif; Ahmed, Abdelrahman Mohammed

2018-01-01

The aim of the study was to investigate the impact of using Mobile Social Network Applications (MSNAs) on students' social life (social relations, family relations and social awareness). The study was designed as a survey study using a five-point Likert-type scale to collect data from the students. A sample of 211 students' response was analyzed.…

An analysis of neural receptive field plasticity by point process adaptive filtering

PubMed Central

Brown, Emery N.; Nguyen, David P.; Frank, Loren M.; Wilson, Matthew A.; Solo, Victor

2001-01-01

Neural receptive fields are plastic: with experience, neurons in many brain regions change their spiking responses to relevant stimuli. Analysis of receptive field plasticity from experimental measurements is crucial for understanding how neural systems adapt their representations of relevant biological information. Current analysis methods using histogram estimates of spike rate functions in nonoverlapping temporal windows do not track the evolution of receptive field plasticity on a fine time scale. Adaptive signal processing is an established engineering paradigm for estimating time-varying system parameters from experimental measurements. We present an adaptive filter algorithm for tracking neural receptive field plasticity based on point process models of spike train activity. We derive an instantaneous steepest descent algorithm by using as the criterion function the instantaneous log likelihood of a point process spike train model. We apply the point process adaptive filter algorithm in a study of spatial (place) receptive field properties of simulated and actual spike train data from rat CA1 hippocampal neurons. A stability analysis of the algorithm is sketched in the Appendix. The adaptive algorithm can update the place field parameter estimates on a millisecond time scale. It reliably tracked the migration, changes in scale, and changes in maximum firing rate characteristic of hippocampal place fields in a rat running on a linear track. Point process adaptive filtering offers an analytic method for studying the dynamics of neural receptive fields. PMID:11593043

Hypohydration and Acute Thermal Stress Affect Mood State but not Cognition or Dynamic Postural

DTIC Science & Technology

2012-10-12

of the feet and ankles . The LCD screen presented a cursor interfaced with the movement of the platform. Balance scores were given based on three...Vol- unteers were asked to rate their thermal sensation (TS) using an 8-point Likert scale with verbal anchors from 0 (unbearably cold) to 8...unbearably hot). Thirst was asses- sed using a similar 8-point Likert scale with verbal anchors from 1 (not thirst at all) to 9 (very, very thirsty) (Gagge

Five challenges in evolution and infectious diseases.

PubMed

Metcalf, C J E; Birger, R B; Funk, S; Kouyos, R D; Lloyd-Smith, J O; Jansen, V A A

2015-03-01

Evolution is a key aspect of the biology of many pathogens, driving processes ranging from immune escape to changes in virulence. Because evolution is inherently subject to feedbacks, and because pathogen evolution plays out at scales ranging from within-host to between-host and beyond, evolutionary questions provide special challenges to the modelling community. In this article, we provide an overview of five challenges in modelling the evolution of pathogens and their hosts, and point to areas for development, focussing in particular on the issue of linking theory and data. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

Listening to the Shepard-Risset Glissando: the Relationship between Emotional Response, Disruption of Equilibrium, and Personality

PubMed Central

Vernooij, Eveline; Orcalli, Angelo; Fabbro, Franco; Crescentini, Cristiano

2016-01-01

The endless scale illusion, obtained by cyclically repeating a chromatic scale made up of Shepard tones, has been used in a variety of musical works. Music psychology and neuroscience has been interested in this particular psychoacoustic phenomenon mainly for studying the cognitive processes of pitch perception involved. In the present study, we investigated the emotional states induced by the Shepard-Risset glissando, a variant of the Shepard scale. For this purpose we chose three musical stimuli: a Matlab-generated Shepard Risset glissando, Jean-Claude Risset's Computer Suite from Little Boy, which presents a Shepard-Risset glissando integrated in the aesthetic context of a composition, and an ordinary orchestral glissando taken from the opening of Iannis Xenakis's Metastasis. Seventy-three volunteers completed a listening experiment during which they rated their emotional response to these stimuli on a seven-point Likert scale and indicated whether they had experienced a disruption of equilibrium. Personality was also measured with the Five-Factor Model of personality traits. The results show that negative emotions were most strongly evoked during listening to each of the stimuli. We also found that the Shepard-Risset glissando illusion, both within the aesthetic context of a musical composition and on its own, was capable of evoking disruption of equilibrium, frequently leading to the associated feeling of falling. Moreover, generally for the Shepard-Risset glissando illusion, higher negative emotional ratings were given by individuals who had experienced a feeling of disturbance of equilibrium relative to those who had not had this experience. Finally, we found a complex pattern of relationships between personality and the subjective experience of the glissando. Openness to experience correlated positively with positive emotion ratings for the Computer Suite, while agreeableness correlated negatively with positive emotion ratings for the Matlab stimulus. Moreover, results indicated higher (Bonferroni-uncorrected) neuroticism for those who experienced an equilibrium disturbance relative to subjects who did not have this experience during listening to the Computer Suite. These findings suggest that musical paradoxes may be of interest not only for the insights they provide on our perceptual system, but also for the richness of the emotional experience elicited during listening. PMID:26973584

Listening to the Shepard-Risset Glissando: the Relationship between Emotional Response, Disruption of Equilibrium, and Personality.

PubMed

Vernooij, Eveline; Orcalli, Angelo; Fabbro, Franco; Crescentini, Cristiano

2016-01-01

The endless scale illusion, obtained by cyclically repeating a chromatic scale made up of Shepard tones, has been used in a variety of musical works. Music psychology and neuroscience has been interested in this particular psychoacoustic phenomenon mainly for studying the cognitive processes of pitch perception involved. In the present study, we investigated the emotional states induced by the Shepard-Risset glissando, a variant of the Shepard scale. For this purpose we chose three musical stimuli: a Matlab-generated Shepard Risset glissando, Jean-Claude Risset's Computer Suite from Little Boy, which presents a Shepard-Risset glissando integrated in the aesthetic context of a composition, and an ordinary orchestral glissando taken from the opening of Iannis Xenakis's Metastasis. Seventy-three volunteers completed a listening experiment during which they rated their emotional response to these stimuli on a seven-point Likert scale and indicated whether they had experienced a disruption of equilibrium. Personality was also measured with the Five-Factor Model of personality traits. The results show that negative emotions were most strongly evoked during listening to each of the stimuli. We also found that the Shepard-Risset glissando illusion, both within the aesthetic context of a musical composition and on its own, was capable of evoking disruption of equilibrium, frequently leading to the associated feeling of falling. Moreover, generally for the Shepard-Risset glissando illusion, higher negative emotional ratings were given by individuals who had experienced a feeling of disturbance of equilibrium relative to those who had not had this experience. Finally, we found a complex pattern of relationships between personality and the subjective experience of the glissando. Openness to experience correlated positively with positive emotion ratings for the Computer Suite, while agreeableness correlated negatively with positive emotion ratings for the Matlab stimulus. Moreover, results indicated higher (Bonferroni-uncorrected) neuroticism for those who experienced an equilibrium disturbance relative to subjects who did not have this experience during listening to the Computer Suite. These findings suggest that musical paradoxes may be of interest not only for the insights they provide on our perceptual system, but also for the richness of the emotional experience elicited during listening.

Women's Education and Health Inequalities in Under-Five Mortality in Selected Sub-Saharan African Countries, 1990–2015

PubMed Central

Bado, Aristide Romaric; Sathiya Susuman, A.

2016-01-01

Background The aim of the study was to analyse trends in the relationship between mother’s educational level and mortality of children under the year of five in Sub-Saharan Africa, from 1990 to 2015. Data and Methods Data used in this study came from different waves of Demographic and Health Surveys (DHS) of Sub-Saharan countries. Logistic regression and Buis’s decomposition method were used to explore the effect of mother’s educational level on the mortality of children under five years. Results Although the results of our study in the selected countries show that under-five mortality rates of children born to mothers without formal education are higher than the mortality rates of children of educated mothers, it appears that differences in mortality were reduced over the past two decades. In selected countries for our study, we noticed a significant decline in mortality among children of non-educated mothers compared to the decrease in mortality rates among children of educated mothers during the period of 1990–2010. The results show that the decline in mortality of children under five years was much higher among the children born to mothers who have never received formal education—112 points drop in Malawi, over 80 in Zambia and Zimbabwe, 65 points in Burkina Faso, 56 in Congo, 43 in Namibia, 27 in Guinea, Cameroon, and 22 to 15 in Niger. However, we noted a variation in results among the countries selected for the study—in Burkina Faso (OR = 0.7), in Cameroon (OR = 0.8), in Guinea (OR = 0.8) and Niger (OR = 0.8). It is normally observed that children of mothers with 0–6 years of education are about 20% more likely to survive until their fifth year compared to children of mothers who have not been to school. Conversely, the results did not reveal significant differences between the under-five deaths of children born to non-educated mothers and children of low-level educated mothers in Congo, Malawi and Namibia. Conclusion The decline in under-five mortality rates, during last two decades, can be partly due to the government policies on women’s education. It is evident that women’s educational level has resulted in increased maternal awareness about infant health and hygiene, thereby bringing about a decline in the under-five mortality rates. This reduction is due to improved supply of health care programmes and health policies in reducing economic inequalities and increasing access to health care. PMID:27442118

Effects of point defect concentrations of the reactive element oxides on the oxidation kinetics of pure Ni and Ni-Cr alloys

NASA Astrophysics Data System (ADS)

Yan, Ruey-Fong

The addition of some reactive element oxides, e.g. Ysb2Osb3 or ZrOsb2, has significant effects, e.g. improvement in scale adhesion and reduction in oxidation rate, on the oxidation behavior of chromia and alumina scale forming alloys at high temperatures. However, there is little agreement about how a small addition of an oxygen-active element can cause such profound effects. It was the goal of this project to study the growth kinetics of an oxide scale when different reactive-element oxides were added to pure Ni and Ni-Cr alloys and, consequently, to aid in clarifying the mechanism of reactive element effects. The oxidation kinetics were measured using a thermogravimetric analysis (TGA) method and the material characterization of oxide scale was conducted. The relationship between point defect structures and oxidation kinetics was discussed. The results in this research showed that Ysb2Osb3 and ZrOsb2 exhibited the reactive element effects on the oxidation behaviors of Ni and Ni-Cr alloys. In addition, the point defect concentrations of the reactive element oxide, Ysb2Osb3, were changed by doping of different valent oxides. The modification of point defect concentrations of the reactive element oxide dispersed phases did change the oxidation kinetics of the pure Ni and Ni-Cr alloys containing Ysb2Osb3. These results indicate that the transport properties of the reactive element oxide dispersed phases are one of the important factors in determining the growth rate of an oxide scale.

A Kinematically Consistent Two-Point Correlation Function

NASA Technical Reports Server (NTRS)

Ristorcelli, J. R.

1998-01-01

A simple kinematically consistent expression for the longitudinal two-point correlation function related to both the integral length scale and the Taylor microscale is obtained. On the inner scale, in a region of width inversely proportional to the turbulent Reynolds number, the function has the appropriate curvature at the origin. The expression for two-point correlation is related to the nonlinear cascade rate, or dissipation epsilon, a quantity that is carried as part of a typical single-point turbulence closure simulation. Constructing an expression for the two-point correlation whose curvature at the origin is the Taylor microscale incorporates one of the fundamental quantities characterizing turbulence, epsilon, into a model for the two-point correlation function. The integral of the function also gives, as is required, an outer integral length scale of the turbulence independent of viscosity. The proposed expression is obtained by kinematic arguments; the intention is to produce a practically applicable expression in terms of simple elementary functions that allow an analytical evaluation, by asymptotic methods, of diverse functionals relevant to single-point turbulence closures. Using the expression devised an example of the asymptotic method by which functionals of the two-point correlation can be evaluated is given.

Kohut's Psychology of the Self: Theory and Measures of Counseling Outcome.

ERIC Educational Resources Information Center

Patton, Michael J.; And Others

1982-01-01

Introduces Heinz Kohut's psychology of the self and its counseling implications and reports on the development of 10 eight-point rating scales of counseling outcome that are derived for his theory. Reports data on interrater reliability and agreement for the 10 scales. (Author)

The development of a scale to discover outpatients' perceptions of the relative desirability of different elements of doctors' communication behaviours.

PubMed

Leckie, Jackie; Bull, Ray; Vrij, Aldert

2006-12-01

The objective of the study was to discover which aspects of doctor communication behaviours are more or less desirable to patients who are attending medical outpatients clinics. Two hundred and twenty patients took part in the study, which was undertaken in four phases. In phase one, patients completed a 10-item questionnaire where they indicated, by means of a five-point scale, their preferences for doctor communication behaviours. In phases two and three patients qualitatively expressed the meaning that they ascribed to terminology that is used by some researchers to define doctor communication behaviours. In the final phase of the study a 12-item questionnaire was developed by integrating the phase one questionnaire and patients' report from phases two and three. Patients indicated, by means of a five-point scale, their preferences for different communication behaviours that might be used by doctors. Patient's preferences were ranked in terms of the most to the least preferred behaviours. The findings suggest that patients most prefer consultations where doctors give information spontaneously and display affective behaviours. They least preferred consultations where medical matters are discussed and where information is not forthcoming. Furthermore, the finding suggests that the use of blanket terms by researches in defining doctor communication can lead to differences in interpretation by patients. The methods developed in the study appear to provide a useful tool to discover patients' desires in terms of doctor communication. The rank scale developed in the study could prove useful to medical practice. It could, for example, provide a straightforward method whereby doctors could readily access researcher's recommendations about communication. Furthermore, the scale could be used in various healthcare settings in order to discover if different patient groups vary in terms of the doctor communication they desire.

A quasi-Newton algorithm for large-scale nonlinear equations.

PubMed

Huang, Linghua

2017-01-01

In this paper, the algorithm for large-scale nonlinear equations is designed by the following steps: (i) a conjugate gradient (CG) algorithm is designed as a sub-algorithm to obtain the initial points of the main algorithm, where the sub-algorithm's initial point does not have any restrictions; (ii) a quasi-Newton algorithm with the initial points given by sub-algorithm is defined as main algorithm, where a new nonmonotone line search technique is presented to get the step length [Formula: see text]. The given nonmonotone line search technique can avoid computing the Jacobian matrix. The global convergence and the [Formula: see text]-order convergent rate of the main algorithm are established under suitable conditions. Numerical results show that the proposed method is competitive with a similar method for large-scale problems.

Enhancing target variance in personality impressions: highlighting the person in person perception.

PubMed

Paulhus, D L; Reynolds, S

1995-12-01

D. A. Kenny (1994) estimated the components of personality rating variance to be 15, 20, and 20% for target, rater, and relationship, respectively. To enhance trait variance and minimize rater variance, we designed a series of studies of personality perception in discussion groups (N = 79, 58, and 59). After completing a Big Five questionnaire, participants met 7 times in small groups. After Meetings 1 and 7, group members rated each other. By applying the Social Relations Model (D. A. Kenny and L. La Voie, 1984) to each Big Five dimension at each point in time, we were able to evaluate 6 rating effects as well as rating validity. Among the findings were that (a) target variance was the largest component (almost 30%), whereas rater variance was small (less than 11%); (b) rating validity improved significantly with acquaintance, although target variance did not; and (c) no reciprocity was found, but projection was significant for Agreeableness.

Generic finite size scaling for discontinuous nonequilibrium phase transitions into absorbing states

NASA Astrophysics Data System (ADS)

de Oliveira, M. M.; da Luz, M. G. E.; Fiore, C. E.

2015-12-01

Based on quasistationary distribution ideas, a general finite size scaling theory is proposed for discontinuous nonequilibrium phase transitions into absorbing states. Analogously to the equilibrium case, we show that quantities such as response functions, cumulants, and equal area probability distributions all scale with the volume, thus allowing proper estimates for the thermodynamic limit. To illustrate these results, five very distinct lattice models displaying nonequilibrium transitions—to single and infinitely many absorbing states—are investigated. The innate difficulties in analyzing absorbing phase transitions are circumvented through quasistationary simulation methods. Our findings (allied to numerical studies in the literature) strongly point to a unifying discontinuous phase transition scaling behavior for equilibrium and this important class of nonequilibrium systems.

THE BRIEF PSYCHIATRIC RATING SCALE IN POSITIVE AND NEGATIVE SUBTYPES OF SCHIZOPHRENIA

PubMed Central

Kulhara, P.; Mattoo, S.K.; Avasthi, A.; Malhotra, A.

1987-01-01

SUMMARY Usefulness of the Brief Psychiatric Rating Scale (BPRS) in distinguishing positive and negative subtypes of schizophrenia is presented. Ninety five schizophrenic patients were assessed on BPRS. Significant differences emerged between positive and negative subtypes of schizophrenia on items like emotional withdrawal, guilt feelings, tension, hallucinatory behaviour, motor retardation, blunted affect and excitement. Discriminant function equation generated by these items had a high rate of prediction of group membership either to positive or negative schizophrenia group. Principal components analysis of BPRS scores yielded factors which favour categorization of patients in positive, negative subtypes. The study provides support for classification of schizophrenia into these subtypes. PMID:21927241

Accuracy and reliability of forensic latent fingerprint decisions

PubMed Central

Ulery, Bradford T.; Hicklin, R. Austin; Buscaglia, JoAnn; Roberts, Maria Antonia

2011-01-01

The interpretation of forensic fingerprint evidence relies on the expertise of latent print examiners. The National Research Council of the National Academies and the legal and forensic sciences communities have called for research to measure the accuracy and reliability of latent print examiners’ decisions, a challenging and complex problem in need of systematic analysis. Our research is focused on the development of empirical approaches to studying this problem. Here, we report on the first large-scale study of the accuracy and reliability of latent print examiners’ decisions, in which 169 latent print examiners each compared approximately 100 pairs of latent and exemplar fingerprints from a pool of 744 pairs. The fingerprints were selected to include a range of attributes and quality encountered in forensic casework, and to be comparable to searches of an automated fingerprint identification system containing more than 58 million subjects. This study evaluated examiners on key decision points in the fingerprint examination process; procedures used operationally include additional safeguards designed to minimize errors. Five examiners made false positive errors for an overall false positive rate of 0.1%. Eighty-five percent of examiners made at least one false negative error for an overall false negative rate of 7.5%. Independent examination of the same comparisons by different participants (analogous to blind verification) was found to detect all false positive errors and the majority of false negative errors in this study. Examiners frequently differed on whether fingerprints were suitable for reaching a conclusion. PMID:21518906

Accuracy and reliability of forensic latent fingerprint decisions.

PubMed

Ulery, Bradford T; Hicklin, R Austin; Buscaglia, Joann; Roberts, Maria Antonia

2011-05-10

The interpretation of forensic fingerprint evidence relies on the expertise of latent print examiners. The National Research Council of the National Academies and the legal and forensic sciences communities have called for research to measure the accuracy and reliability of latent print examiners' decisions, a challenging and complex problem in need of systematic analysis. Our research is focused on the development of empirical approaches to studying this problem. Here, we report on the first large-scale study of the accuracy and reliability of latent print examiners' decisions, in which 169 latent print examiners each compared approximately 100 pairs of latent and exemplar fingerprints from a pool of 744 pairs. The fingerprints were selected to include a range of attributes and quality encountered in forensic casework, and to be comparable to searches of an automated fingerprint identification system containing more than 58 million subjects. This study evaluated examiners on key decision points in the fingerprint examination process; procedures used operationally include additional safeguards designed to minimize errors. Five examiners made false positive errors for an overall false positive rate of 0.1%. Eighty-five percent of examiners made at least one false negative error for an overall false negative rate of 7.5%. Independent examination of the same comparisons by different participants (analogous to blind verification) was found to detect all false positive errors and the majority of false negative errors in this study. Examiners frequently differed on whether fingerprints were suitable for reaching a conclusion.

Structural approaches to knowledge exchange: comparing practices across five centres of excellence in public health.

PubMed

Van der Graaf, P; Francis, O; Doe, E; Barrett, E; O'Rorke, M; Docherty, G

2018-03-01

In 2008, five UKCRC Public Health Research Centres of Excellence were created to develop a coordinated approach to policy and practice engagement and knowledge exchange. The five Centres have developed their own models and practices for achieving these aims, which have not been compared in detail to date. We applied an extended version of Saner's model for the interface between science and policy to compare five case studies of knowledge exchanges, one from each centre. We compared these practices on three dimensions within our model (focus, function and type/scale) to identify barriers and facilitators for knowledge exchange. The case studies shared commonalities in their range of activities (type) but illustrated different ways of linking these activities (function). The Centres' approaches ranged from structural to more organic, and varied in the extent that they engaged internal audiences (focus). Each centre addressed policymakers at different geographical levels and scale. This article emphasizes the importance of linking a range of activities that engage policymakers at different levels, intensities and points in their decision-making processes to build relationships. Developing a structural approach to knowledge exchange activities in different contexts presents challenges of resource, implementation and evaluation.

Converting positive and negative symptom scores between PANSS and SAPS/SANS.

PubMed

van Erp, Theo G M; Preda, Adrian; Nguyen, Dana; Faziola, Lawrence; Turner, Jessica; Bustillo, Juan; Belger, Aysenil; Lim, Kelvin O; McEwen, Sarah; Voyvodic, James; Mathalon, Daniel H; Ford, Judith; Potkin, Steven G; Fbirn

2014-01-01

The Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS), and the Positive and Negative Syndrome Scale for Schizophrenia (PANSS) are the most widely used schizophrenia symptom rating scales, but despite their co-existence for 25 years no easily usable between-scale conversion mechanism exists. The aim of this study was to provide equations for between-scale symptom rating conversions. Two-hundred-and-five schizophrenia patients [mean age±SD=39.5±11.6, 156 males] were assessed with the SANS, SAPS, and PANSS. Pearson's correlations between symptom scores from each of the scales were computed. Linear regression analyses, on data from 176 randomly selected patients, were performed to derive equations for converting ratings between the scales. Intraclass correlations, on data from the remaining 29 patients, not part of the regression analyses, were performed to determine rating conversion accuracy. Between-scale positive and negative symptom ratings were highly correlated. Intraclass correlations between the original positive and negative symptom ratings and those obtained via conversion of alternative ratings using the conversion equations were moderate to high (ICCs=0.65 to 0.91). Regression-based equations may be useful for conversion between schizophrenia symptom severity as measured by the SANS/SAPS and PANSS, though additional validation is warranted. This study's conversion equations, implemented at http:/converteasy.org, may aid in the comparison of medication efficacy studies, in meta- and mega-analyses examining symptoms as moderator variables, and in retrospective combination of symptom data in multi-center data sharing projects that need to pool symptom rating data when such data are obtained using different scales. Copyright © 2013 Elsevier B.V. All rights reserved.

Communication and cooperation in underwater acoustic networks

NASA Astrophysics Data System (ADS)

Yerramalli, Srinivas

In this thesis, we present a study of several problems related to underwater point to point communications and network formation. We explore techniques to improve the achievable data rate on a point to point link using better physical layer techniques and then study sensor cooperation which improves the throughput and reliability in an underwater network. Robust point-to-point communications in underwater networks has become increasingly critical in several military and civilian applications related to underwater communications. We present several physical layer signaling and detection techniques tailored to the underwater channel model to improve the reliability of data detection. First, a simplified underwater channel model in which the time scale distortion on each path is assumed to be the same (single scale channel model in contrast to a more general multi scale model). A novel technique, which exploits the nature of OFDM signaling and the time scale distortion, called Partial FFT Demodulation is derived. It is observed that this new technique has some unique interference suppression properties and performs better than traditional equalizers in several scenarios of interest. Next, we consider the multi scale model for the underwater channel and assume that single scale processing is performed at the receiver. We then derive optimized front end pre-processing techniques to reduce the interference caused during single scale processing of signals transmitted on a multi-scale channel. We then propose an improvised channel estimation technique using dictionary optimization methods for compressive sensing and show that significant performance gains can be obtained using this technique. In the next part of this thesis, we consider the problem of sensor node cooperation among rational nodes whose objective is to improve their individual data rates. We first consider the problem of transmitter cooperation in a multiple access channel and investigate the stability of the grand coalition of transmitters using tools from cooperative game theory and show that the grand coalition in both the asymptotic regimes of high and low SNR. Towards studying the problem of receiver cooperation for a broadcast channel, we propose a game theoretic model for the broadcast channel and then derive a game theoretic duality between the multiple access and the broadcast channel and show that how the equilibria of the broadcast channel are related to the multiple access channel and vice versa.

Metastable Distributions of Markov Chains with Rare Transitions

NASA Astrophysics Data System (ADS)

Freidlin, M.; Koralov, L.

2017-06-01

In this paper we consider Markov chains X^\\varepsilon _t with transition rates that depend on a small parameter \\varepsilon . We are interested in the long time behavior of X^\\varepsilon _t at various \\varepsilon -dependent time scales t = t(\\varepsilon ). The asymptotic behavior depends on how the point (1/\\varepsilon , t(\\varepsilon )) approaches infinity. We introduce a general notion of complete asymptotic regularity (a certain asymptotic relation between the ratios of transition rates), which ensures the existence of the metastable distribution for each initial point and a given time scale t(\\varepsilon ). The technique of i-graphs allows one to describe the metastable distribution explicitly. The result may be viewed as a generalization of the ergodic theorem to the case of parameter-dependent Markov chains.

Clinical outcomes following manual physical therapy and exercise for hip osteoarthritis: A case series.

PubMed

MacDonald, Cameron W; Whitman, Julie M; Cleland, Joshua A; Smith, Marcia; Hoeksma, Hugo L

2006-08-01

Case series describing the outcomes of individual patients with hip osteoarthritis treated with manual physical therapy and exercise. Seven patients referred to physical therapy with hip osteoarthritis and/or hip pain were included in this case series. All patients were treated with manual physical therapy followed by exercises to maximize strength and range of motion. Six of 7 patients completed a Harris Hip Score at initial examination and discharge from physical therapy, and 1 patient completed a Global Rating of Change Scale at discharge. Three males and 4 females with a median age of 62 years (range, 52-80 years) and median duration of symptoms of 9 months (range, 2-60 months) participated in this case series. The median number of physical therapy sessions attended was 5 (range, 4-12). The median increase in total passive range of motion of the hip was 82 degrees (range, 70 degrees-86 degrees). The median improvement on the Harris Hip Score was 25 points (range, 15-38 points). The single patient who completed the Global Rating of Change Scale at discharge reported being "a great deal better." Numeric pain rating scores decreased by a mean of 5 points (range, 2-7 points) on 0-to-10-point scale. All patients exhibited reductions in pain and increases in passive range of motion, as well as a clinically meaningful improvement in function. Although we can not infer a cause and effect relationship from a case series, the outcomes with these patients are similar to others reported in the literature that have demonstrated superior clinical outcomes associated with manual physical therapy and exercise for hip osteoarthritis compared to exercise alone.

Motivation and personality: relationships between putative motive dimensions and the five factor model of personality.

PubMed

Bernard, Larry C

2010-04-01

There are few multidimensional measures of individual differences in motivation available. The Assessment of Individual Motives-Questionnaire assesses 15 putative dimensions of motivation. The dimensions are based on evolutionary theory and preliminary evidence suggests the motive scales have good psychometric properties. The scales are reliable and there is evidence of their consensual validity (convergence of self-other ratings) and behavioral validity (relationships with self-other reported behaviors of social importance). Additional validity research is necessary, however, especially with respect to current models of personality. The present study tested two general and 24 specific hypotheses based on proposed evolutionary advantages/disadvantages and fitness benefits/costs of the five-factor model of personality together with the new motive scales in a sample of 424 participants (M age=28.8 yr., SD=14.6). Results were largely supportive of the hypotheses. These results support the validity of new motive dimensions and increase understanding of the five-factor model of personality.

Preliminary evaluation of a measure for reliable assessment of need for constant visual observation in adults with traumatic brain injury.

PubMed

Moessner, Anne; Malec, James F; Beveridge, Scott; Reddy, Cara Camiolo; Huffman, Tracy; Marton, Julia; Schmerzler, Audrey J

2016-01-01

To develop and provide initial validation of a measure for accurately determining the need for Constant Visual Observation (CVO) in patients with traumatic brain injury (TBI) admitted to inpatient rehabilitation. Rating scale development and evaluation through Rasch analysis and assessment of concurrent validity. One hundred and thirty-four individuals with moderate-severe TBI were studied in seven inpatient brain rehabilitation units associated with the National Institute for Disability, Independent Living and Rehabilitation Research (NIDILRR) TBI Model System. Participants were rated on the preliminary version of the CVO Needs Assessment scale (CVONA) and, by independent raters, on the Levels of Risk (LoR) and Supervision Rating Scale (SRS) at four time points during inpatient rehabilitation: admission, Days 2-3, Days 5-6 and Days 8-9. After pruning misfitting items, the CVONA showed satisfactory internal consistency (Person Reliability = 0.85-0.88) across time points. With reference to the LoR and SRS, low false negative rates (sensitivity > 90%) were associated with moderate-to-high false positive rates (29-56%). The CVONA may be a useful objective metric to complement clinical judgement regarding the need for CVO; however, further prospective study is desirable to further assess its utility in identifying at-risk patients, reducing adverse events and decreasing CVO costs.

Venous thromboembolism and cancer: guidelines of the Italian Association of Medical Oncology (AIOM).

PubMed

Mandalà, M; Falanga, A; Piccioli, A; Prandoni, P; Pogliani, E M; Labianca, R; Barni, S

2006-09-01

Thromboembolic complications represent one of the most important cause of morbidity and mortality in cancer patients. Although several data have been published demonstrating the strong association between cancer and venous thromboembolism (VTE), there is poor perception, among oncologists, of the level of risk of thrombosis and of relevance of managing VTE in these patients. The Associazione Italiana di Oncologia Medica (AIOM) has provided some recommendations to direct clinical practice according to evidence-based data concerning cancer and VTE. In fact, we conducted an extensive literature review (1996-2005) to produce evidence-based recommendations to improve perceptions of the magnitude of this risk among Italian medical and surgical oncologists and alert on the new approaches to prophylaxis and treatment of VTE in cancer patients. Levels of evidence are given according to a five-point rating system, and similarly for each key recommendation a five-point rating system suggests if the evidence is strong and indicate that the benefits do, or do not, outweigh risks and burden.

Factors associated with remission of post-traumatic brain injury fatigue in the years following traumatic brain injury (TBI): a TBI model systems module study.

PubMed

Lequerica, Anthony H; Botticello, Amanda L; Lengenfelder, Jean; Chiaravalloti, Nancy; Bushnik, Tamara; Dijkers, Marcel P; Hammond, Flora M; Kolakowsky-Hayner, Stephanie A; Rosenthal, Joseph

2017-10-01

Post-traumatic brain injury fatigue (PTBIF) is a major problem in the years after traumatic brain injury (TBI), yet little is known about its persistence and resolution. The objective of the study was to identify factors related to PTBIF remission and resolution. TBI Model System registrants at five centres participated in interviews at either one and two years post-injury (Y1-2 Cohort), or two and five years post-injury (Y2-5 Cohort). Characteristics of participants with PTBIF remission were compared to those with PTBIF persistence. Variables studied included the presence of and changes in disability, sleep dysfunction, mood, and community participation. The Functional Independence Measure did not differ significantly between groups or over time. In the Y1-2 Cohort the Fatigue Resolved group scored significantly better on the Disability Rating Scale and Pittsburgh Sleep Quality Index. In the Y2-5 Cohort the Fatigue Resolved group scored significantly higher on a measure of community participation. It was concluded that fewer than half of the sample in each cohort experienced a remission of PTBIF between time points. Persistence of PTBIF 1-2 years post-injury is associated with disability, sleep disturbance, and depression while persistence of fatigue beyond 2 years post-injury appears to be related to participation level, underscoring the potential impact of effective surveillance, assessment, and treatment of this condition in optimising life after TBI. Differences in fatigue progression may point to the presence of different types of PTBIF.

Specific training program improves oncologists' palliative care communication skills in a randomized controlled trial.

PubMed

Goelz, Tanja; Wuensch, Alexander; Stubenrauch, Sara; Ihorst, Gabriele; de Figueiredo, Marcelo; Bertz, Hartmut; Wirsching, Michael; Fritzsche, Kurt

2011-09-01

The aim of the study was to demonstrate that COM-ON-p, concise and individualized communication skills training (CST), improves oncologists' communication skills in consultations focusing on the transition to palliative care. Forty-one physicians were randomly assigned to a control (CG) or intervention group (IG). At t(0), all physicians held two video-recorded consultations with actor-patient pairs. Afterward, physicians in the IG participated in COM-ON-p. Five weeks after t(0), a second assessment took place (t(1)). COM-ON-p consists of an 11-hour workshop (1.5 days), pre- and postassessment (2 hours), and coaching (0.5 hours). Physicians focused on practicing individual learning goals with actor patients in small groups. To evaluate the training, blinded raters assessed communication behavior of the physicians in video-recorded actor-patient consultations using a specific checklist. Data were analyzed using a mixed model with baseline levels as covariates. Participants in the IG improved significantly more than those in the CG in all three sections of the COM-ON-Checklist: skills specific to the transition to palliative care, global communication skills, and involvement of significant others (all P < .01). Differences between the CG and IG on the global items of communication skills and involvement of significant others were also significant (P < .01). Effect sizes were medium to large, with a 0.5-point improvement on average on a five-point rating scale. Physicians can be trained to meet better core challenges during the transition to palliative care through developed concise CST. Generalization and transfer into clinical practice must be proven in additional studies.

Neighborhood effects on use of African-American Vernacular English

PubMed Central

Rickford, John R.; Duncan, Greg J.; Gennetian, Lisa A.; Gou, Ray Yun; Greene, Rebecca; Katz, Lawrence F.; Kessler, Ronald C.; Kling, Jeffrey R.; Sanbonmatsu, Lisa; Sanchez-Ordoñez, Andres E.; Sciandra, Matthew; Thomas, Ewart; Ludwig, Jens

2015-01-01

African-American Vernacular English (AAVE) is systematic, rooted in history, and important as an identity marker and expressive resource for its speakers. In these respects, it resembles other vernacular or nonstandard varieties, like Cockney or Appalachian English. But like them, AAVE can trigger discrimination in the workplace, housing market, and schools. Understanding what shapes the relative use of AAVE vs. Standard American English (SAE) is important for policy and scientific reasons. This work presents, to our knowledge, the first experimental estimates of the effects of moving into lower-poverty neighborhoods on AAVE use. We use data on non-Hispanic African-American youth (n = 629) from a large-scale, randomized residential mobility experiment called Moving to Opportunity (MTO), which enrolled a sample of mostly minority families originally living in distressed public housing. Audio recordings of the youth were transcribed and coded for the use of five grammatical and five phonological AAVE features to construct a measure of the proportion of possible instances, or tokens, in which speakers use AAVE rather than SAE speech features. Random assignment to receive a housing voucher to move into a lower-poverty area (the intention-to-treat effect) led youth to live in neighborhoods (census tracts) with an 11 percentage point lower poverty rate on average over the next 10–15 y and reduced the share of AAVE tokens by ∼3 percentage points compared with the MTO control group youth. The MTO effect on AAVE use equals approximately half of the difference in AAVE frequency observed between youth whose parents have a high school diploma and those whose parents do not. PMID:26351663

Neighborhood effects on use of African-American Vernacular English.

PubMed

Rickford, John R; Duncan, Greg J; Gennetian, Lisa A; Gou, Ray Yun; Greene, Rebecca; Katz, Lawrence F; Kessler, Ronald C; Kling, Jeffrey R; Sanbonmatsu, Lisa; Sanchez-Ordoñez, Andres E; Sciandra, Matthew; Thomas, Ewart; Ludwig, Jens

2015-09-22

African-American Vernacular English (AAVE) is systematic, rooted in history, and important as an identity marker and expressive resource for its speakers. In these respects, it resembles other vernacular or nonstandard varieties, like Cockney or Appalachian English. But like them, AAVE can trigger discrimination in the workplace, housing market, and schools. Understanding what shapes the relative use of AAVE vs. Standard American English (SAE) is important for policy and scientific reasons. This work presents, to our knowledge, the first experimental estimates of the effects of moving into lower-poverty neighborhoods on AAVE use. We use data on non-Hispanic African-American youth (n = 629) from a large-scale, randomized residential mobility experiment called Moving to Opportunity (MTO), which enrolled a sample of mostly minority families originally living in distressed public housing. Audio recordings of the youth were transcribed and coded for the use of five grammatical and five phonological AAVE features to construct a measure of the proportion of possible instances, or tokens, in which speakers use AAVE rather than SAE speech features. Random assignment to receive a housing voucher to move into a lower-poverty area (the intention-to-treat effect) led youth to live in neighborhoods (census tracts) with an 11 percentage point lower poverty rate on average over the next 10-15 y and reduced the share of AAVE tokens by ∼3 percentage points compared with the MTO control group youth. The MTO effect on AAVE use equals approximately half of the difference in AAVE frequency observed between youth whose parents have a high school diploma and those whose parents do not.

An open-label trial of enhanced brief interpersonal psychotherapy in depressed mothers whose children are receiving psychiatric treatment.

PubMed

Swartz, Holly A; Zuckoff, Allan; Frank, Ellen; Spielvogle, Heather N; Shear, M Katherine; Fleming, M A Dana; Scott, John

2006-01-01

Major depression affects one out of five women during her lifetime. Depressed mothers with psychiatrically ill children represent an especially vulnerable population. Challenged by the demands of caring for ill children, these mothers often put their own needs last; consequently, their depressions remain untreated. This population is especially difficult to engage in treatment. We have developed a nine-session intervention, an engagement session followed by eight sessions of brief interpersonal psychotherapy designed to increase maternal participation in their own psychotherapy, resolve symptoms of maternal depression, and enhance relationships (IPT-MOMS). This open-label trial assesses the feasibility and acceptability of providing this treatment to depressed mothers. Thirteen mothers meeting DSM-IV criteria for major depression were recruited from a pediatric mental health clinic where their school-age children were receiving psychiatric treatment. Subjects (mothers) were treated openly with IPT-MOMS. Eighty-five percent (11/13) completed the study. Subjects were evaluated with the Hamilton Rating Scale for Depression, and completed self-report measures of quality of life and functioning at three time points: baseline, after treatment completion, and 6-months posttreatment. A signed rank test was used to compare measurement changes between assessment time points. Subjects showed significant improvement from baseline to posttreatment on measures of maternal symptoms and functioning. These gains were maintained at 6-month follow-up. Therapy was well tolerated and accepted by depressed mothers, who are typically difficult to engage in treatment. A high proportion of subjects completed treatment and experienced improvements in functioning. Future randomized clinical trials are needed to establish the efficacy of this approach.

Effect of brief training on reliability and applicability of Global Assessment of functioning scale by Psychiatric clinical officers in Uganda.

PubMed

Abbo, C; Okello, E S; Nakku, J

2013-03-01

The Global Assessment of Functioning (GAF) is the standard method and an essential tool for representing a clinician's judgment of a patient's overall level of psychological, social and occupational functioning. As such, it is probably the single most widely used method for assessing impairment among the patients with psychiatric illnesses. To assess the effects of one-hour training on application of the GAF by Psychiatric Clinical Officers' in a Ugandan setting. Five Psychiatrists and five Psychiatric Clinical Officers (PCOs) or Assistant Medical Officers who hold a 2 year diploma in Clinical Psychiatry were randomly selected to independently rate a video-recorded psychiatric interview according to the DSM IV-TR. The PCOs were then offered a one-hour training on how to rate the GAF scale and asked to rate the video case interview again. All ratings were assigned on the basis of past one year, at admission and current functioning. Interclass correlations (ICC) were computed using two-way mixed models. The ICC between the psychiatrists and the PCOs before training in the past one year, at admission and current functioning were +0.48, +0.51 and +0.59 respectively. After training, the ICC coefficients were +0.60, +0.82 and +0.83. Brief training given to PCOs improved the applications of their ratings of GAF scale to acceptable levels. There is need for formal training to this cadre of psychiatric practitioners in the use of the GAF.

Evaluating the diagnostic sensitivity of computed diffusion-weighted MR imaging in the detection of breast cancer.

PubMed

O'Flynn, Elizabeth A M; Blackledge, Matthew; Collins, David; Downey, Katherine; Doran, Simon; Patel, Hardik; Dumonteil, Sam; Mok, Wing; Leach, Martin O; Koh, Dow-Mu

2016-07-01

To evaluate the diagnostic sensitivity of computed diffusion-weighted (DW)-MR imaging for the detection of breast cancer. Local research ethics approval was obtained. A total of 61 women (median 48 years) underwent dynamic contrast enhanced (DCE)- and DW-MR between January 2011 and March 2012, including 27 with breast cancer on core biopsy and 34 normal cases. Standard ADC maps using all four b values (0, 350, 700, 1150) were used to generate computed DW-MR images at b = 1500 s/mm(2) and b = 2000 s/mm(2) . Four image sets were read sequentially by two readers: acquired b = 1150 s/mm(2) , computed b = 1500 s/mm(2) and b = 2000 s/mm(2) , and DCE-MR at an early time point. Cancer detection was rated using a five-point scale; image quality and background suppression were rated using a four-point scale. The diagnostic sensitivity for breast cancer detection was compared using the McNemar test and inter-reader agreement with a Kappa value. Computed DW-MR resulted in higher overall diagnostic sensitivity with b = 2000 s/mm(2) having a mean diagnostic sensitivity of 76% (range 49.8-93.7%) and b = 1500 s/mm(2) having a mean diagnostic sensitivity of 70.3% (range 32-97.7%) compared with 44.4% (range 25.5-64.7%) for acquired b = 1150 s/mm(2) (both p = 0.0001). Computed DW-MR images produced better image quality and background suppression (mean scores for both readers: 2.55 and 2.9 for b 1500 s/mm(2) ; 2.55 and 3.15 for b 2000 s/mm(2) , respectively) than the acquired b value 1150 s/mm(2) images (mean scores for both readers: 2.4 and 2.45, respectively). Computed DW-MR imaging has the potential to improve the diagnostic sensitivity of breast cancer detection compared to acquired DW-MR. J. Magn. Reson. Imaging 2016;44:130-137. © 2016 Wiley Periodicals, Inc.

Design of rocker switches for work-vehicles--an application of Kansei Engineering.

PubMed

Schütte, Simon; Eklund, Jörgen

2005-09-01

Rocker switches used in vehicles meet high demands partly due to the increased focus on customer satisfaction. Previous studies focused on ergonomics and usability rather than design for emotions and affection. The aim of this study was to determine how and to what extent engineering properties influence the perception of rocker switches. Secondary aims were to compare two types of rating scales and to determine consistency over time of the ratings. As a method Kansei Engineering was used, describing a product domain from a physical and semantic point of view. A model was built and validated, and recommendations for new designs were given. It was seen that the subjective impressions of robustness, precision and design are strongly influenced by the zero position, the contact position, the form-ratio, shape and the surface of rocker switches. A 7-point scale was found suitable. The Kansei ratings were consistent over time.

How Do Observational Scales Correlate the Ratings of Children's Behavior during Pediatric Procedural Sedation?

PubMed Central

Moura, Larissa da Silva

2016-01-01

Background. There is little information regarding the ability of observational scales to properly assess children's behavior during procedural sedation. Aim. To evaluate the characteristics of the Houpt scales, the Ohio State University Behavioral Rating Scale (OSUBRS) and the Venham Behavior Rating Scale when applied to preschool children undergoing conscious dental sedation. Design. This study included 27 children, 4–6 years old with early childhood caries that participated in a clinical trial (NCT02284204) that investigated two sedative regimes using oral midazolam/ketamine. Dental appointments were video-recorded; five calibrated observers assessed 1,209 minutes of video recording to score the children's behavior, following the instructions of the investigated scales. Data were analyzed by descriptive analysis and Spearman correlation tests (P < 0.05). Results. The Houpt overall behavior and the Venham scale were highly correlated (rho = −0.87; P < 0.001). OSUBRS scores were better correlated with Houpt overall behavior and Venham ratings, when compared to Houpt scores in the categories for movement and crying. Conclusions. The Houpt overall behavior and the Venham scores are global scales that properly measure children's behavior during dental sedation. Continuous assessment with OSUBRS through videos has a chance to give more precise data, while the Houpt categories can easily demonstrate children's behavior during procedures. PMID:28116299

Somatic symptoms: an important index in predicting the outcome of depression at six-month and two-year follow-up points among outpatients with major depressive disorder.

PubMed

Hung, Ching-I; Liu, Chia-Yih; Wang, Shuu-Jiun; Juang, Yeong-Yuh; Yang, Ching-Hui

2010-09-01

Few studies have simultaneously compared the ability of depression, anxiety, and somatic symptoms to predict the outcome of major depressive disorder (MDD). This study aimed to compare the MDD outcome predictive ability of depression, anxiety, and somatic severity at 6-month and 2-year follow-ups. One-hundred and thirty-five outpatients (men/women=34/101) with MDD were enrolled. Depression and anxiety were evaluated by the Hamilton Depression Rating Scale, Hospital Anxiety and Depression Scale, and depression subscale of the Depression and Somatic Symptoms Scale (DSSS). Somatic severity was evaluated by the somatic subscale of the DSSS. Subjects undergoing pharmacotherapy in the follow-up month were categorized into the treatment group; the others were categorized into the no-treatment group. Multiple linear regressions were used to identify the scales most powerful in predicting MDD outcome. Among the 135 subjects, 119 and 106 completed the 6-month and 2-year follow-ups, respectively. Somatic severity at baseline was correlated with the outcomes of the three scales at the two follow-ups. After controlling for demographic variables, somatic severity independently predicted most outcomes of the three scales at the two follow-ups in the no-treatment group and the cost of pharmacotherapy and DSSS score at the 6-month follow-up in the treatment group. Division of the subjects into treatment and no-treatment groups was not based on randomization and bias might have been introduced. Somatic severity was the most powerful index in predicting MDD outcome. Psychometric scales with appropriate somatic symptom items may be more accurate in predicting MDD outcome. 2010 Elsevier B.V. All rights reserved.

Anisotropic evolution of 5D Friedmann-Robertson-Walker spacetime

DOE Office of Scientific and Technical Information (OSTI.GOV)

Middleton, Chad A.; Stanley, Ethan

2011-10-15

We examine the time evolution of the five-dimensional Einstein field equations subjected to a flat, anisotropic Robertson-Walker metric, where the 3D and higher-dimensional scale factors are allowed to dynamically evolve at different rates. By adopting equations of state relating the 3D and higher-dimensional pressures to the density, we obtain an exact expression relating the higher-dimensional scale factor to a function of the 3D scale factor. This relation allows us to write the Friedmann-Robertson-Walker field equations exclusively in terms of the 3D scale factor, thus yielding a set of 4D effective Friedmann-Robertson-Walker field equations. We examine the effective field equations inmore » the general case and obtain an exact expression relating a function of the 3D scale factor to the time. This expression involves a hypergeometric function and cannot, in general, be inverted to yield an analytical expression for the 3D scale factor as a function of time. When the hypergeometric function is expanded for small and large arguments, we obtain a generalized treatment of the dynamical compactification scenario of Mohammedi [Phys. Rev. D 65, 104018 (2002)] and the 5D vacuum solution of Chodos and Detweiler [Phys. Rev. D 21, 2167 (1980)], respectively. By expanding the hypergeometric function near a branch point, we obtain the perturbative solution for the 3D scale factor in the small time regime. This solution exhibits accelerated expansion, which, remarkably, is independent of the value of the 4D equation of state parameter w. This early-time epoch of accelerated expansion arises naturally out of the anisotropic evolution of 5D spacetime when the pressure in the extra dimension is negative and offers a possible alternative to scalar field inflationary theory.« less

Oral anticancer agent medication adherence by outpatients.

PubMed

Kimura, Michio; Usami, Eiseki; Iwai, Mina; Nakao, Toshiya; Yoshimura, Tomoaki; Mori, Hiromi; Sugiyama, Tadashi; Teramachi, Hitomi

2014-11-01

In the present study, medication adherence and factors affecting adherence were examined in patients taking oral anticancer agents. In June 2013, 172 outpatients who had been prescribed oral anticancer agents by Ogaki Municipal Hospital (Ogaki, Gifu, Japan) completed a questionnaire survey, with answers rated on a five-point Likert scale. The factors that affect medication adherence were evaluated using a customer satisfaction (CS) analysis. For patients with good and insufficient adherence to medication, the median ages were 66 years (range, 21-85 years) and 73 years (range, 30-90 years), respectively (P=0.0004), while the median dosing time was 131 days (range, 3-3,585 days) and 219 days (24-3,465 days), respectively (P=0.0447). In 36.0% (62 out of 172) of the cases, there was insufficient medication adherence; 64.5% of those cases (40 out of 62) showed good medication compliance (4-5 point rating score). However, these patients did not fully understand the effects or side-effects of the drugs, giving a score of three points or less. The percentage of patients with good medication compliance was 87.2% (150 out of 172). Through the CS analysis, three items, the interest in the drug, the desire to consult about the drug and the condition of the patient, were extracted as items for improvement. Overall, the medication compliance of the patients taking the oral anticancer agents was good, but the medication adherence was insufficient. To improve medication adherence, a better understanding of the effectiveness and necessity of drugs and their side-effects is required. In addition, the interest of patients in their medication should be encouraged and intervention should be tailored to the condition of the patient. These steps should lead to improved medication adherence.

Improving safety climate through a communication and recognition program for construction: a mixed-methods study

PubMed Central

Sparer, Emily H; Catalano, Paul J; Herrick, Robert F; Dennerlein, Jack T

2016-01-01

Objectives This study aimed to evaluate the efficacy of a safety communication and recognition program (B-SAFE), designed to encourage improvement of physical working conditions and hazard reduction in construction. Methods A matched pair cluster randomized controlled trial was conducted on eight worksites (four received the B-SAFE intervention, four served as control sites) for approximately five months per site. Pre- and post-exposure worker surveys were collected at all sites (N=615, pre-exposure response rate of 74%, post-exposure response rate of 88%). Multi-level mixed-effect regression models evaluated the effect of B-SAFE on safety climate as assessed from surveys. Focus groups (N=6–8 workers/site) were conducted following data collection. Transcripts were coded and analyzed for thematic content using Atlas.ti (version 6). Results The mean safety climate score at intervention sites, as measured on a 0–50 point scale, increased 0.5 points (1%) between pre- and post-B-SAFE exposure, compared to control sites that decreased 0.8 points (1.6%). The intervention effect size was 1.64 (3.28%) (P-value=0.01) when adjusted for month the worker started on-site, total length of time on-site, as well as individual characteristics (trade, title, age, and race/ethnicity). At intervention sites, workers noted increased levels of safety awareness, communication, and teamwork compared to control sites. Conclusions B-SAFE led to many positive changes, including an improvement in safety climate, awareness, teambuilding, and communication. B-SAFE was a simple intervention that engaged workers through effective communication infrastructures and had a significant, positive effect on worksite safety. PMID:27158914

The Relationship of the Component Skills of Reading to IALS Performance: Tipping Points and Five Classes of Adult Literacy Learners. NCSALL Reports #29

ERIC Educational Resources Information Center

Strucker, John; Yamamoto, Kentaro; Kirsch, Irwin

2007-01-01

This study's aim was to understand the relationship of the component skills of reading, such as word recognition, vocabulary, and spelling, to large-scale measures of literacy, such as the 1992 National Adult Literacy Survey (NALS) (Kirsch, Jungleblut, Jenkins, & Kolstad, 1993) and the closely related International Adult Literacy Survey (IALS)…

Evidence for the Need to Support Adolescents Dealing with Harassment and Cyber-Harassment: Prevalence, Progression, and Impact

ERIC Educational Resources Information Center

Beran, Tanya N.; Rinaldi, Christina; Bickham, David S.; Rich, Michael

2012-01-01

The aim of this study was to determine the prevalence of harassment in high school and into university, and the impact of one particular form of harassment: cyber-harassment. Participants were 1,368 students at one US and two Canadian universities (mean age = 21.1 years, 676 female students). They responded on five-point scales to questions about…

Simulation-based Assessment to Reliably Identify Key Resident Performance Attributes.

PubMed

Blum, Richard H; Muret-Wagstaff, Sharon L; Boulet, John R; Cooper, Jeffrey B; Petrusa, Emil R; Baker, Keith H; Davidyuk, Galina; Dearden, Jennifer L; Feinstein, David M; Jones, Stephanie B; Kimball, William R; Mitchell, John D; Nadelberg, Robert L; Wiser, Sarah H; Albrecht, Meredith A; Anastasi, Amanda K; Bose, Ruma R; Chang, Laura Y; Culley, Deborah J; Fisher, Lauren J; Grover, Meera; Klainer, Suzanne B; Kveraga, Rikante; Martel, Jeffrey P; McKenna, Shannon S; Minehart, Rebecca D; Mitchell, John D; Mountjoy, Jeremi R; Pawlowski, John B; Pilon, Robert N; Shook, Douglas C; Silver, David A; Warfield, Carol A; Zaleski, Katherine L

2018-04-01

Obtaining reliable and valid information on resident performance is critical to patient safety and training program improvement. The goals were to characterize important anesthesia resident performance gaps that are not typically evaluated, and to further validate scores from a multiscenario simulation-based assessment. Seven high-fidelity scenarios reflecting core anesthesiology skills were administered to 51 first-year residents (CA-1s) and 16 third-year residents (CA-3s) from three residency programs. Twenty trained attending anesthesiologists rated resident performances using a seven-point behaviorally anchored rating scale for five domains: (1) formulate a clear plan, (2) modify the plan under changing conditions, (3) communicate effectively, (4) identify performance improvement opportunities, and (5) recognize limits. A second rater assessed 10% of encounters. Scores and variances for each domain, each scenario, and the total were compared. Low domain ratings (1, 2) were examined in detail. Interrater agreement was 0.76; reliability of the seven-scenario assessment was r = 0.70. CA-3s had a significantly higher average total score (4.9 ± 1.1 vs. 4.6 ± 1.1, P = 0.01, effect size = 0.33). CA-3s significantly outscored CA-1s for five of seven scenarios and domains 1, 2, and 3. CA-1s had a significantly higher proportion of worrisome ratings than CA-3s (chi-square = 24.1, P < 0.01, effect size = 1.50). Ninety-eight percent of residents rated the simulations more educational than an average day in the operating room. Sensitivity of the assessment to CA-1 versus CA-3 performance differences for most scenarios and domains supports validity. No differences, by experience level, were detected for two domains associated with reflective practice. Smaller score variances for CA-3s likely reflect a training effect; however, worrisome performance scores for both CA-1s and CA-3s suggest room for improvement.

The MMPI-2-RF Personality Psychopathology Five (PSY-5-RF) scales: development and validity research.

PubMed

Harkness, Allan R; McNulty, John L; Finn, Jacob A; Reynolds, Shannon M; Shields, Susan M; Arbisi, Paul

2014-01-01

This article describes the development, internal psychometric, and external validation studies on scales designed to measure the Personality Psychopathology Five (PSY-5) from MMPI-2 Restructured Form (MMPI-2-RF) items. Diverse and comprehensive data sets, representing various clinical and nonclinical populations, were classified into development and validation research samples. Item selection, retention, and exclusion procedures are detailed. The final set of PSY-5-RF scales contain 104 items, with no item overlap between scales (same as the original MMPI-2 PSY-5 scales), and no item overlap with the Demoralization scale. Internal consistency estimates are comparable to the longer MMPI-2 PSY-5 scales. Appropriate convergent and discriminant validity findings utilizing various self-report, collateral rating, and record review data are reported and discussed. A particular emphasis is offered for the unique aspects of the PSY-5 model: psychoticism and disconstraint. The findings are connected to the broader PSY-5 literature and the recommended review of systems (Harkness, Reynolds, & Lilienfeld, this issue) presented in this series of articles.

Five years of experience teaching pathology to dental students using the WebMicroscope

PubMed Central

2011-01-01

Background We describe development and evaluation of the user-friendly web based virtual microscopy - WebMicroscope for teaching and learning dental students basic and oral pathology. Traditional students microscopes were replaced by computer workstations. Methods The transition of the basic and oral pathology courses from light to virtual microscopy has been completed gradually over a five-year period. A pilot study was conducted in academic year 2005/2006 to estimate the feasibility of integrating virtual microscopy into a traditional light microscopy-based pathology course. The entire training set of glass slides was subsequently converted to virtual slides and placed on the WebMicroscope server. Giving access to fully digitized slides on the web with a browser and a viewer plug-in, the computer has become a perfect companion of the student. Results The study material consists now of over 400 fully digitized slides which covering 15 entities in basic and systemic pathology and 15 entities in oral pathology. Digitized slides are linked with still macro- and microscopic images, organized with clinical information into virtual cases and supplemented with text files, syllabus, PowerPoint presentations and animations on the web, serving additionally as material for individual studies. After their examinations, the students rated the use of the software, quality of the images, the ease of handling the images, and the effective use of virtual slides during the laboratory practicals. Responses were evaluated on a standardized scale. Because of the positive opinions and support from the students, the satisfaction surveys had shown a progressive improvement over the past 5 years. The WebMicroscope as a didactic tool for laboratory practicals was rated over 8 on a 1-10 scale for basic and systemic pathology and 9/10 for oral pathology especially as various students’ suggestions were implemented. Overall, the quality of the images was rated as very good. Conclusions An overwhelming majority of our students regarded a possibility of using virtual slides at their convenience as highly desirable. Our students and faculty consider the use of the virtual microscope for the study of basic as well as oral pathology as a significant improvement over the light microscope. PMID:21489183

Observers' response to facial disfigurement from head and neck cancer.

PubMed

Cho, Joowon; Fingeret, Michelle Cororve; Huang, Sheng-Cheng; Liu, Jun; Reece, Gregory P; Markey, Mia K

2018-05-30

Our long-term goal is to develop a normative feedback intervention to support head and neck cancer patients in forming realistic expectations about how other people in non-social group settings will respond to their appearance. This study aimed to evaluate the relationship between observer ratings of facial disfigurement and observer ratings of emotional response when viewing photographs of faces of head and neck cancer patients. Seventy-five (75) observers rated their emotional response to each of 144 facial photographs of head and neck cancer patients using the Self-Assessment-Manikin and rated severity of facial disfigurement on a 9-point scale. Body image investment of the observers was measured using the Appearance Schemas Inventory-Revised. A standardized multiple regression model was used to assess the relationship between observer ratings of facial disfigurement and observer ratings of emotional response, taking into consideration the age and sex of the patient depicted in the stimulus photograph, as well as the age, sex, and body image investment of the observer. Observers who had a strong emotional response to a patient's facial photograph tended to rate the patient's facial disfigurement as more severe (standardized regression coefficient β = 0.328, P < 0.001). Sex and age of the observer had more influence on the rating of facial disfigurement than did the patient's demographic characteristics. Observers more invested in their own body image tended to rate the facial disfigurement as more severe. This study lays the groundwork for a normative database of emotional response to facial disfigurement. Copyright © 2018 John Wiley & Sons, Ltd.

A nutrient profiling assessment of packaged foods using two star-based front-of-pack labels.

PubMed

Carrad, Amy M; Louie, Jimmy Chun Yu; Yeatman, Heather R; Dunford, Elizabeth K; Neal, Bruce C; Flood, Victoria M

2016-08-01

To compare two front-of-pack nutrition labelling systems for the assessment of packaged foods and drinks with Australian Dietary Guidelines. A cross-sectional nutrient profiling assessment. Food and drink products (n 20 225) were categorised into scoring levels using criteria for the Institute of Medicine (IOM) three-star system and the five-star Australian Health Star Rating (HSR). The effectiveness of these systems to categorise foods in accordance with Australian Dietary Guidelines was explored. The study was conducted in Australia, using a comprehensive food database. Packaged food and drink products (n 20 225) available in Australia. Using the IOM three-star system, the majority (55 %) of products scored the minimum 0 points and 25·5 % scored the maximum 3 points. Using HSR criteria, the greatest proportion of products (15·2 %) scored three-and-a-half stars from a possible five and 12·5 % received the lowest rating of a half-star. Very few products (4·1 %) scored five stars. Products considered core foods and drinks in Australian Dietary Guidelines received higher scores than discretionary foods in all food categories for both labelling systems (all P<0·05; Mann-Whitney U test), with the exception of fish products using IOM three-star criteria (P=0·603). The largest discrepancies in median score between the two systems were for the food categories edible oils, convenience foods and dairy. Both the IOM three-star and Australian HSR front-of-pack labelling systems rated packaged foods and drinks broadly in line with Australian Dietary Guidelines by assigning core foods higher ratings and discretionary foods lower ratings.

Improving the evaluation of therapeutic interventions in multiple sclerosis: the role of new psychometric methods.

PubMed

Hobart, J; Cano, S

2009-02-01

In this monograph we examine the added value of new psychometric methods (Rasch measurement and Item Response Theory) over traditional psychometric approaches by comparing and contrasting their psychometric evaluations of existing sets of rating scale data. We have concentrated on Rasch measurement rather than Item Response Theory because we believe that it is the more advantageous method for health measurement from a conceptual, theoretical and practical perspective. Our intention is to provide an authoritative document that describes the principles of Rasch measurement and the practice of Rasch analysis in a clear, detailed, non-technical form that is accurate and accessible to clinicians and researchers in health measurement. A comparison was undertaken of traditional and new psychometric methods in five large sets of rating scale data: (1) evaluation of the Rivermead Mobility Index (RMI) in data from 666 participants in the Cannabis in Multiple Sclerosis (CAMS) study; (2) evaluation of the Multiple Sclerosis Impact Scale (MSIS-29) in data from 1725 people with multiple sclerosis; (3) evaluation of test-retest reliability of MSIS-29 in data from 150 people with multiple sclerosis; (4) examination of the use of Rasch analysis to equate scales purporting to measure the same health construct in 585 people with multiple sclerosis; and (5) comparison of relative responsiveness of the Barthel Index and Functional Independence Measure in data from 1400 people undergoing neurorehabilitation. Both Rasch measurement and Item Response Theory are conceptually and theoretically superior to traditional psychometric methods. Findings from each of the five studies show that Rasch analysis is empirically superior to traditional psychometric methods for evaluating rating scales, developing rating scales, analysing rating scale data, understanding and measuring stability and change, and understanding the health constructs we seek to quantify. There is considerable added value in using Rasch analysis rather than traditional psychometric methods in health measurement. Future research directions include the need to reproduce our findings in a range of clinical populations, detailed head-to-head comparisons of Rasch analysis and Item Response Theory, and the application of Rasch analysis to clinical practice.

Systematic review of rehabilitation intervention outcomes of adult and paediatric patients with infectious encephalitis

PubMed Central

Christie, Shanice; Chan, Vincy; Mollayeva, Tatyana; Colantonio, Angela

2018-01-01

Objective Although a range of rehabilitation interventions have been applied to restore function after infectious encephalitis, there is a lack of literature summarising the benefits of these interventions. This systematic review aims to synthesise current scientific knowledge on outcome measures following rehabilitative interventions among children and adults with infectious encephalitis, with a specific focus on the influence of the age, sex, baseline status and intervention type. Search strategy Five scholarly databases (MEDLINE, Embase, PsycINFO, CINAHL and Cochrane Central Register of Controlled Trials), three sources of grey literature (Google, Google Scholar and Grey Matters) and reference lists of included publications were systematically searched. Literature published before 15 December 2017 and focused on patients with infectious encephalitis in any rehabilitation setting were included. Quality assessment was completed using the Downs and Black rating scale. Results Of the 12 737 reference titles screened, 20 studies were included in this review. All of the studies had sample sizes of less than 25 patients and received a score of less than 15 out of 31 points on the Downs and Black rating scale. Findings showed a variety of interventions has been applied to alleviate sequelae from infectious encephalitis, including using cognitive therapy (nine studies), behavioural therapy (five studies), physical therapy (two studies) or two or more therapies (four studies). There was inconclusive evidence on the effect of sex, age and baseline functional abilities on outcomes. Due to clinical and methodological heterogeneity between studies, meta-analyses were not performed. Conclusion Evidence suggests the potential for a beneficial effect of rehabilitation interventions in patients with infectious encephalitis. Future research is required to identify all effect modifiers and to determine the effect of time in the natural course of recovery. An enhanced set of known effect modifiers will support the process of future evaluation of a client-centred rehabilitation intervention. Trial registration number CRD42015029217. PMID:29764868

A standardized review of smartphone applications to promote balance for older adults.

PubMed

Reyes, Angelica; Qin, Pei; Brown, Cary A

2018-03-01

Balance is one of the risk factors for falls in older adults. The use of smartphone applications (apps) related to health (mHealth) is increasing and, while there is potential for apps to be used as a self-managed balance intervention, many healthcare providers are concerned about the content and credibility of mHealth apps overall. This study evaluates the quality of balance promoting apps and identifies strengths and areas of concern to assist healthcare providers in recommending these resources. Balance apps for the general public, offered on the iPhone Operating System (iOS) and Android platforms, were evaluated using the Mobile Application Rating Scale (MARS). Five iOS apps met the inclusion criteria. The mean scores for each of the domains in MARS were: Engagement (3.32), Information (3.7), Functionality (3.8), and Esthetics (3.8). Overall, one app (UStabilize) received a rating of 4.43 in MARS five-point scale, which was considered "good". Other apps in the review demonstrated acceptable quality. The reviewed balance apps targeted to improve or maintain physical balance were of acceptable quality. Apps address many current issues older adults have to accessing rehabilitation services and, as such, may be particularly useful for this group. Future research should focus on assessing and comparing app efficacy. Development of balance apps for the Android platform is also necessary. Implications for Rehabilitation Given the availability and accessibility of various mHealth apps and the increasing mobile device usage among older adults, mobile apps are a promising avenue for delivering rehabilitation interventions, such as balance training, to older adults. Smartphone apps exist for balance training but overall confidence in health apps within the healthcare community is low and rigorous evaluation is required. A range of apps exist that demonstrate acceptable to good quality and stakeholders should work towards having these apps listed in credible mHealth clearinghouses.

Development and Validation of a Photonumeric Scale for Evaluation of Volume Deficit of the Hand

PubMed Central

Donofrio, Lisa; Hardas, Bhushan; Murphy, Diane K.; Carruthers, Jean; Carruthers, Alastair; Sykes, Jonathan M.; Creutz, Lela; Marx, Ann; Dill, Sara

2016-01-01

BACKGROUND A validated scale is needed for objective and reproducible comparisons of hand appearance before and after treatment in practice and clinical studies. OBJECTIVE To describe the development and validation of the 5-point photonumeric Allergan Hand Volume Deficit Scale. METHODS The scale was developed to include an assessment guide, verbal descriptors, morphed images, and real-subject images for each grade. The clinical significance of a 1-point score difference was evaluated in a review of image pairs representing varying differences in severity. Interrater and intrarater reliability was evaluated in a live-subject validation study (N = 296) completed during 2 sessions occurring 3 weeks apart. RESULTS A score difference of ≥1 point was shown to reflect a clinically significant difference (mean [95% confidence interval] absolute score difference, 1.12 [0.99–1.26] for clinically different image pairs and 0.45 [0.33–0.57] for not clinically different pairs). Intrarater agreement between the 2 validation sessions was almost perfect (mean weighted kappa = 0.83). Interrater agreement was almost perfect during the second session (0.82, primary end point). CONCLUSION The Allergan Hand Volume Deficit Scale is a validated and reliable scale for physician rating of hand volume deficit. PMID:27661741

Beacon: a web portal to high-quality mental health websites for use by health professionals and the public.

PubMed

Christensen, Helen; Murray, Kristen; Calear, Alison L; Bennett, Kylie; Bennett, Anthony; Griffiths, Kathleen M

2010-06-07

To describe the Beacon web portal, which lists and rates quality health websites, collects user characteristics and publishes user feedback; and to report summary data on Beacon's highest-rated (best evidence-based) sites for mental health. A systematic search was undertaken in February 2009 for potentially relevant websites through a review of research papers and a recently published book, an internet search of Open Directory Project medical categories, a review of material on a high-profile mental health portal, and a survey of international researchers. All sites were ranked on a 7-point scale from -1 to 5, with negative scores indicating evidence of no effect and scores of 2 or more indicating evidence of efficacy based on reports in the scientific literature. By March 2010, 183 sites had been identified, of which 122 focused on physical health or wellbeing, 40 targeted anxiety, and 23 targeted depression. Of the eight generalised anxiety disorder sites identified, four achieved ratings of 2 or above. Two social anxiety disorder sites achieved scores higher than 2. Ten panic disorder sites were identified, with three achieving ratings of 2 or above; and five post-traumatic stress disorder sites were identified, with two achieving ratings of 2 or above. Of the 23 identified depression sites, four achieved a rating of 2 or above. There are a number of high-quality mental health websites on the internet, and Beacon provides a portal to enable the wide dissemination of these resources.

Overcoming Stagnation in the Levels and Distribution of Child Mortality: The Case of the Philippines.

PubMed

Bermejo, Raoul; Firth, Sonja; Hodge, Andrew; Jimenez-Soto, Eliana; Zeck, Willibald

2015-01-01

Health-related within-country inequalities continue to be a matter of great interest and concern to both policy makers and researchers. This study aims to assess the level and the distribution of child mortality outcomes in the Philippines across geographical and socioeconomic indicators. Data on 159,130 children ever borne were analysed from five waves of the Philippine Demographic and Health Survey. Direct estimation was used to construct under-five and neonatal mortality rates for the period 1980-2013. Rate differences and ratios, and where possible, slope and relative indices of inequality were calculated to measure disparities on absolute and relative scales. Stratification was undertaken by levels of rural/urban location, island groups and household wealth. National under-five and neonatal mortality rates have shown considerable albeit differential reductions since 1980. Recently released data suggests that neonatal mortality has declined following a period of stagnation. Declines in under-five mortality have been accompanied by decreases in wealth and geography-related absolute inequalities. However, relative inequalities for the same markers have remained stable over time. For neonates, mixed evidence suggests that absolute and relative inequalities have remained stable or may have risen. In addition to continued reductions in under-five mortality, new data suggests that the Philippines have achieved success in addressing the commonly observed stagnated trend in neonatal mortality. This success has been driven by economic improvement since 2006 as well as efforts to implement a nationwide universal health care campaign. Yet, such patterns, nonetheless, accorded with persistent inequalities, particularly on a relative scale. A continued focus on addressing universal coverage, the influence of decentralisation and armed conflict, and issues along the continuum of care is advocated.

Overcoming Stagnation in the Levels and Distribution of Child Mortality: The Case of the Philippines

PubMed Central

Bermejo, Raoul; Firth, Sonja; Hodge, Andrew; Jimenez-Soto, Eliana; Zeck, Willibald

2015-01-01

Background Health-related within-country inequalities continue to be a matter of great interest and concern to both policy makers and researchers. This study aims to assess the level and the distribution of child mortality outcomes in the Philippines across geographical and socioeconomic indicators. Methodology Data on 159,130 children ever borne were analysed from five waves of the Philippine Demographic and Health Survey. Direct estimation was used to construct under-five and neonatal mortality rates for the period 1980–2013. Rate differences and ratios, and where possible, slope and relative indices of inequality were calculated to measure disparities on absolute and relative scales. Stratification was undertaken by levels of rural/urban location, island groups and household wealth. Findings National under-five and neonatal mortality rates have shown considerable albeit differential reductions since 1980. Recently released data suggests that neonatal mortality has declined following a period of stagnation. Declines in under-five mortality have been accompanied by decreases in wealth and geography-related absolute inequalities. However, relative inequalities for the same markers have remained stable over time. For neonates, mixed evidence suggests that absolute and relative inequalities have remained stable or may have risen. Conclusion In addition to continued reductions in under-five mortality, new data suggests that the Philippines have achieved success in addressing the commonly observed stagnated trend in neonatal mortality. This success has been driven by economic improvement since 2006 as well as efforts to implement a nationwide universal health care campaign. Yet, such patterns, nonetheless, accorded with persistent inequalities, particularly on a relative scale. A continued focus on addressing universal coverage, the influence of decentralisation and armed conflict, and issues along the continuum of care is advocated. PMID:26431409

Improved Cerebral Time-of-Flight Magnetic Resonance Angiography at 7 Tesla – Feasibility Study and Preliminary Results Using Optimized Venous Saturation Pulses

PubMed Central

Wrede, Karsten H.; Johst, Sören; Dammann, Philipp; Özkan, Neriman; Mönninghoff, Christoph; Kraemer, Markus; Maderwald, Stefan; Ladd, Mark E.; Sure, Ulrich; Umutlu, Lale; Schlamann, Marc

2014-01-01

Purpose Conventional saturation pulses cannot be used for 7 Tesla ultra-high-resolution time-of-flight magnetic resonance angiography (TOF MRA) due to specific absorption rate (SAR) limitations. We overcome these limitations by utilizing low flip angle, variable rate selective excitation (VERSE) algorithm saturation pulses. Material and Methods Twenty-five neurosurgical patients (male n = 8, female n = 17; average age 49.64 years; range 26–70 years) with different intracranial vascular pathologies were enrolled in this trial. All patients were examined with a 7 Tesla (Magnetom 7 T, Siemens) whole body scanner system utilizing a dedicated 32-channel head coil. For venous saturation pulses a 35° flip angle was applied. Two neuroradiologists evaluated the delineation of arterial vessels in the Circle of Willis, delineation of vascular pathologies, presence of artifacts, vessel-tissue contrast and overall image quality of TOF MRA scans in consensus on a five-point scale. Normalized signal intensities in the confluence of venous sinuses, M1 segment of left middle cerebral artery and adjacent gray matter were measured and vessel-tissue contrasts were calculated. Results Ratings for the majority of patients ranged between good and excellent for most of the evaluated features. Venous saturation was sufficient for all cases with minor artifacts in arteriovenous malformations and arteriovenous fistulas. Quantitative signal intensity measurements showed high vessel-tissue contrast for confluence of venous sinuses, M1 segment of left middle cerebral artery and adjacent gray matter. Conclusion The use of novel low flip angle VERSE algorithm pulses for saturation of venous vessels can overcome SAR limitations in 7 Tesla ultra-high-resolution TOF MRA. Our protocol is suitable for clinical application with excellent image quality for delineation of various intracranial vascular pathologies. PMID:25232868

Dual-energy CT in patients with abdominal malignant lymphoma: impact of noise-optimised virtual monoenergetic imaging on objective and subjective image quality.

PubMed

Lenga, L; Czwikla, R; Wichmann, J L; Leithner, D; Albrecht, M H; D'Angelo, T; Arendt, C T; Booz, C; Hammerstingl, R; Vogl, T J; Martin, S S

2018-06-05

To investigate the impact of noise-optimised virtual monoenergetic imaging (VMI+) reconstructions on quantitative and qualitative image parameters in patients with malignant lymphoma at dual-energy computed tomography (DECT) examinations of the abdomen. Thirty-five consecutive patients (mean age, 53.8±18.6 years; range, 21-82 years) with histologically proven malignant lymphoma of the abdomen were included retrospectively. Images were post-processed with standard linear blending (M_0.6), traditional VMI, and VMI+ technique at energy levels ranging from 40 to 100 keV in 10 keV increments. Signal-to-noise (SNR) and contrast-to-noise ratios (CNR) were objectively measured in lymphoma lesions. Image quality, lesion delineation, and image noise were rated subjectively by three blinded observers using five-point Likert scales. Quantitative image quality parameters peaked at 40-keV VMI+ (SNR, 15.77±7.74; CNR, 18.27±8.04) with significant differences compared to standard linearly blended M_0.6 (SNR, 7.96±3.26; CNR, 13.55±3.47) and all traditional VMI series (p<0.001). Qualitative image quality assessment revealed significantly superior ratings for image quality at 60-keV VMI+ (median, 5) in comparison with all other image series (p<0.001). Assessment of lesion delineation showed the highest rating scores for 40-keV VMI+ series (median, 5), while lowest subjective image noise was found for 100-keV VMI+ reconstructions (median, 5). Low-keV VMI+ reconstructions led to improved image quality and lesion delineation of malignant lymphoma lesions compared to standard image reconstruction and traditional VMI at abdominal DECT examinations. Copyright © 2018 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Space closing versus space opening for bilateral missing upper laterals - aesthetic judgments of laypeople: a web-based survey.

PubMed

Qadri, Salim; Parkin, Nicola A; Benson, Philip E

2016-06-01

To investigate the opinions of laypeople regarding the aesthetic outcome of treating patients with developmental absence of both maxillary lateral incisors using either orthodontic space closure (OSC) or space opening and prosthetic replacement (PR). Cross sectional, web-based survey. A panel of five orthodontists and five restorative dentists examined post-treatment intra-oral images of 21 patients with developmental absence of both upper lateral incisors. A consensus view was obtained about the 10 most attractive images (5 OSC; 5 PR). The 10 selected images were used in a web-based survey involving staff and students at the University of Sheffield. In the first section, the participants were asked to evaluate the attractiveness of the 10 randomly arranged single images using a 5-point Likert scale. In the second section, an image of OSC was paired with an image of PR according to their attractiveness ranking by the clinician panel, and the participants were asked to indicate which of the two images they preferred. The survey received 959 completed responses with 9590 judgements. The images of OSC were perceived to be more attractive (mean rating 3·34 out of 5; SD 0·56) compared with the images of PR (mean rating 3·14 out of 5; SD 0·58) (mean diff 0·21; P < 0·001). Female and staff judges tended to give higher attractiveness ratings. Both females and males preferred the OSC images closing in 3 out of 4 paired images. Space closing was perceived to be more attractive than space opening by lay people. The findings have implications for advising patients about the best aesthetic outcome when both maxillary lateral incisors are missing.

The Economic Benefits of Reducing the Dropout Rate for Students of Color in the Nation's Forty-Five Largest Metropolitan Areas. Summary of Findings

ERIC Educational Resources Information Center

Alliance for Excellent Education, 2010

2010-01-01

Years of data have consistently underscored the persistent graduation gap between America's students of color and their peers. The most recent estimate shows that high school graduation rates for African American, Latino, and American Indian students hover only slightly higher than 50 percent. This is more than 20 percentage points lower than that…

26 CFR 1.401(a)(9)-6 - Required minimum distributions for defined benefit plans and annuity contracts.

Code of Federal Regulations, 2014 CFR

2014-04-01

... interest rate and the Mortality Table provided in Rev. Rul. 2001-62 (2001-2 C.B. 632), illustrate the...-quarters age 79 rate. 6 Five percent discounted 18 months (1.05+(−1.5)). 7 Blended age 79/age 80 mortality... mortality tables applicable to such date); and (4) The end point of the period certain, if any, for any...

26 CFR 1.401(a)(9)-6 - Required minimum distributions for defined benefit plans and annuity contracts.

Code of Federal Regulations, 2013 CFR

2013-04-01

... interest rate and the Mortality Table provided in Rev. Rul. 2001-62 (2001-2 C.B. 632), illustrate the...-quarters age 79 rate. 6 Five percent discounted 18 months (1.05+(−1.5)). 7 Blended age 79/age 80 mortality... mortality tables applicable to such date); and (4) The end point of the period certain, if any, for any...

26 CFR 1.401(a)(9)-6 - Required minimum distributions for defined benefit plans and annuity contracts.

Code of Federal Regulations, 2012 CFR

2012-04-01

... interest rate and the Mortality Table provided in Rev. Rul. 2001-62 (2001-2 C.B. 632), illustrate the...-quarters age 79 rate. 6 Five percent discounted 18 months (1.05∧(−1.5)). 7 Blended age 79/age 80 mortality... mortality tables applicable to such date); and (4) The end point of the period certain, if any, for any...

Short term clinical efficacy of new meridol HALITOSIS tooth & tongue gel in combination with a tongue cleaner to reduce oral malodor.

PubMed

Wilhelm, D; Himmelmann, A; Krause, C; Wilhelm, K-P

2013-01-01

This study evaluated the short term efficacy of tongue cleaning with meridol HALITOSIS tooth & tongue gel in comparison to mechanical tongue cleaning alone and untreated after five and 60 minutes in patients with an oral cause of bad breath. Fifty-four male and female subjects with an intra-oral cause of halitosis (organoleptic ratings > or = 2 and volatile sulphur compounds > or = 50 ppb) participated in this crossover study and were assigned to six different treatment sequences (ABC, ACB, BAC, BCA, CAB, CBA) with no treatment (A), mechanical tongue cleaning alone (B), and tongue cleaning with tooth & tongue gel applied to the tongue cleaner (C). Efficacy was assessed by organoleptic ratings and volatile sulphur compound measurements five and 60 minutes after treatment Cleaning the tongue with tooth & tongue gel applied onto the tongue cleaner resulted in significantly reduced organoleptic ratings (p < 0.001 for the five-minute assessment; p = 0.001 for the 60-minute assessment) and volatile sulphur compounds (H2S + CH3SH: p = 0.005 for the five-minute assessment; p = 0.003 for the 60-minute assessment) compared to no treatment at the five- and 60-minute assessment time points, while mechanical tongue cleaning alone was less effective in reducing organoleptic ratings (p = 0.008 for the five-minute assessment; p = 0.144 for the 60-minute assessment) and volatile sulphur compounds (H2S + CH3SH: p = 0.261 for the five-minute assessment; p = 0.365 for the 60-minute assessment). Single tongue cleaning with meridol HALITOSIS tooth & tongue gel had a positive effect on halitosis five and 60 minutes after treatment. Tongue cleaning with tooth & tongue gel in combination with other oral hygiene procedures is a promising approach to control halitosis.

Development of the Hand Assessment for Infants: evidence of internal scale validity.

PubMed

Krumlinde-Sundholm, Lena; Ek, Linda; Sicola, Elisa; Sjöstrand, Lena; Guzzetta, Andrea; Sgandurra, Giuseppina; Cioni, Giovanni; Eliasson, Ann-Christin

2017-12-01

The aim of this study was to develop a descriptive and evaluative assessment of upper limb function for infants aged 3 to 12 months and to investigate its internal scale validity for use with infants at risk of unilateral cerebral palsy. The concepts of the test items and scoring criteria were developed. Internal scale validity and aspects of reliability were investigated on the basis of 156 assessments of infants at 3 to 12 months corrected age (mean 7.2mo, SD 2.5) with signs of asymmetric hand use. Rasch measurement model analysis and non-parametric statistics were used. The new test, the Hand Assessment for Infants (HAI), consists of 12 unimanual and five bimanual items, each scored on a 3-point rating scale. It demonstrated a unidimensional construct and good fit to the Rasch model requirements. The excellent person reliability enabled person separation to six significant ability strata. The HAI produced an interval-level measure of bilateral hand use as well as unimanual scores of each hand, allowing a quantification of possible asymmetry expressed as an asymmetry index. The HAI can be considered a valid assessment tool for measuring bilateral hand use and quantifying side difference between hands among infants at risk of developing unilateral cerebral palsy. The Hand Assessment for Infants (HAI) measures the use of both hands and quantifies a possible asymmetry of hand use. HAI is valid for infants at 3 to 12 months corrected age at risk of unilateral cerebral palsy. © 2017 Mac Keith Press.

Preliminary validation and reliability of the Short Form Chronic Respiratory Disease Questionnaire in a lung cancer population.

PubMed

Charalambous, A; Molassiotis, A

2017-01-01

The Short Form Chronic Respiratory Questionnaire (SF-CRQ) is frequently used in patients with obstructive pulmonary disease and it has demonstrated excellent psychometric properties. Since there is no psychometric information for its use with lung cancer patients, this study explored its validity and reliability in this population. Forty-six patients were assessed at two time points (with a 4-week interval) using the SF-CRQ, the modified Borg Scale, five numerical rating scales related to Perceived Severity of Breathlessness, and the Hospital Anxiety and Depression Scale. Internal consistency reliability was investigated by Cronbach's alpha reliability coefficient, test-retest reliability by Spearman-Brown reliability coefficient (P), content validity as well as convergent validity by Pearson's correlation coefficient between the SF-CRQ, and the conceptual similar scales mentioned above were explored. A principal component factor analysis was performed. The internal consistency was high [α = 0.88 (baseline) and 0.91 (after 1 month)]. The SF-CRQ had good stability with test-retest reliability ranging from r = 0.64 to 0.78, P < 0.001. Factor analysis suggests a single construct in this population. The preliminary data analyses supported the convergent, content, and construct validity of the SF-CRQ providing promising evidence that this can be a valid and reliable instrument for the assessment of quality of life related to breathlessness in lung cancer patients. © 2015 John Wiley & Sons Ltd.

Proposal of a short-form version of the Brazilian Food Insecurity Scale

PubMed Central

dos Santos, Leonardo Pozza; Lindemann, Ivana Loraine; Motta, Janaína Vieira dos Santos; Mintem, Gicele; Bender, Eliana; Gigante, Denise Petrucci

2014-01-01

OBJECTIVE To propose a short version of the Brazilian Food Insecurity Scale. METHODS Two samples were used to test the results obtained in the analyses in two distinct scenarios. One of the studies was composed of 230 low income families from Pelotas, RS, Southern Brazil, and the other was composed of 15,575 women, whose data were obtained from the 2006 National Survey on Demography and Health. Two models were tested, the first containing seven questions, and the second, the five questions that were considered the most relevant ones in the concordance analysis. The models were compared to the Brazilian Food Insecurity Scale, and the sensitivity, specificity and accuracy parameters were calculated, as well as the kappa agreement test. RESULTS Comparing the prevalence of food insecurity between the Brazilian Food Insecurity Scale and the two models, the differences were around 2 percentage points. In the sensitivity analysis, the short version of seven questions obtained 97.8% and 99.5% in the Pelotas sample and in the National Survey on Demography and Health sample, respectively, while specificity was 100% in both studies. The five-question model showed similar results (sensitivity of 95.7% and 99.5% in the Pelotas sample and in the National Survey on Demography and Health sample, respectively). In the Pelotas sample, the kappa test of the seven-question version totaled 97.0% and that of the five-question version, 95.0%. In the National Survey on Demography and Health sample, the two models presented a 99.0% kappa. CONCLUSIONS We suggest that the model with five questions should be used as the short version of the Brazilian Food Insecurity Scale, as its results were similar to the original scale with a lower number of questions. This version needs to be administered to other populations in Brazil in order to allow for the adequate assessment of the validity parameters. PMID:25372169

Effects of Accreditation Council for Graduate Medical Education work hour restrictions on medical student experience.

PubMed

Nixon, L James; Benson, Bradley J; Rogers, Tyson B; Sick, Brian T; Miller, Wesley J

2007-07-01

Residents have a major role in teaching students, yet little has been written about the effects of resident work hour restrictions on medical student education. Our objective was to determine the effects of resident work hour restrictions on medical student education. We compared student responses pre work hour restrictions with those completed post work hour restrictions. Students on required Internal Medicine, Surgery, and Pediatric clerkships at the University of Minnesota. Two thousand eight hundred twenty-five student responses on end-of-clerkship surveys. Students reported 1.6 more hours per week of teaching by residents (95%CI 0.8-2.6) in the post work hours era. Students' ratings of the overall quality of their teaching on the ward did not change appreciably, 0.05 points' decline on a 5-point scale (P = .05). Like the residents, students worked fewer hours per week (avg. 1.5 hours less, 95%CI 0.4-2.6). There was no change in quality or quantity of attending teaching, students' relationships with their patients, or the overall value of the clerkships. Whereas resident duty hour restrictions at our institution have had minimal effect on students' ratings of the overall teaching quality, they do report being taught more by their residents. This may be a factor of decreased resident fatigue or an increased sense of well-being; but more study is needed to clarify the causes of our observations.

"Doing what I do best": The association between skill utilization and employee health with healthy behavior as a mediator.

PubMed

Fujishiro, Kaori; Heaney, Catherine A

2017-02-01

Skill utilization, defined as having the opportunity to do one's best at work, has been examined as a contributor to productivity, organizational efficiency, job satisfaction, and mental health. Drawing from self-determination theory, we postulate that high levels of skill utilization are positively associated with physical health and that some of the effect is mediated by health behavior. Using the 2014 Gallup Daily Tracking Survey data (n = 87,316), a nationally representative sample of working adults in the United States, we examine the associations between perceived skill utilization and five health outcomes (self-rated health, hypertension, high cholesterol, cancer, asthma) with healthy behavior (regular exercising, fruits and vegetable consumption) as a mediator of the associations. The regression results showed that a one-point increase in skill utilization (on a three-point scale) was associated with 20% lower odds of reporting poor or fair health, 3% and 8% lower odds of reporting hypertension and high cholesterol, but had no significant association with cancer or asthma. Health behavior mediated 10% of the association between skill utilization and self-rated health, 46% for hypertension, and 18% for high cholesterol. The findings suggest that providing employees the opportunities to use their skills well at work improves health in general, and the effect is partly through enhancing the likelihood of engaging in healthy behaviors. Implications for organizational practice as well as future research directions are discussed. Published by Elsevier Ltd.

Development and validation of a tool to assess knowledge and attitudes towards generic medicines among students in Greece: The ATtitude TOwards GENerics (ATTOGEN) questionnaire

PubMed Central

Katsari, Vasiliki; Niakas, Dimitris

2017-01-01

Introduction The use of generic medicines is a cost-effective policy, often dictated by fiscal restraints. To our knowledge, no fully validated tool exploring the students’ knowledge and attitudes towards generic medicines exists. The aim of our study was to develop and validate a questionnaire exploring the knowledge and attitudes of M.Sc. in Health Care Management students and recent alumni’s towards generic drugs in Greece. Materials and methods The development of the questionnaire was a result of literature review and pilot-testing of its preliminary versions to researchers and students. The final version of the questionnaire contains 18 items measuring the respondents’ knowledge and attitude towards generic medicines on a 5-point Likert scale. Given the ordinal nature of the data, ordinal alpha and polychoric correlations were computed. The sample was randomly split into two halves. Exploratory factor analysis, performed in the first sample, was used for the creation of multi-item scales. Confirmatory factor analysis and Generalized Linear Latent and Mixed Model analysis (GLLAMM) with the use of the rating scale model were used in the second sample to assess goodness of fit. An assessment of internal consistency reliability, test-retest reliability, and construct validity was also performed. Results Among 1402 persons contacted, 986 persons completed our questionnaire (response rate = 70.3%). Overall Cronbach’s alpha was 0.871. The conjoint use of exploratory and confirmatory factor analysis resulted in a six-scale model, which seemed to fit the data well. Five of the six scales, namely trust, drug quality, state audit, fiscal impact and drug substitution were found to be valid and reliable, while the knowledge scale suffered only from low inter-scale correlations and a ceiling effect. However, the subsequent confirmatory factor and GLLAMM analyses indicated a good fit of the model to the data. Conclusions The ATTOGEN instrument proved to be a reliable and valid tool, suitable for assessing students’ knowledge and attitudes towards generic medicines. PMID:29186163

Mandibular molar with five root canals.

PubMed

Barletta, Fernando Branco; Dotto, Sidney Ricardo; Reis, Magda de Sousa; Ferreira, Ronise; Travassos, Rosana Maria Coelho

2008-12-01

The purpose of this study was to demonstrate the importance of knowledge of the internal anatomy of root canals for the success of endodontic treatment. Lack of knowledge of anatomic variations and their characteristics in different teeth has been pointed out as one of the main causes of endodontic therapy failure. In this report, the authors describe the endodontic treatment of a mandibular first molar with five root canals, evaluate the rate of occurrence of this number of canals, and discuss the importance of their identification and treatment.

Relationship Between the Functional Status Scale and the Pediatric Overall Performance Category and Pediatric Cerebral Performance Category Scales FREE

PubMed Central

Pollack, Murray M.; Holubkov, Richard; Funai, Tomohiko; Clark, Amy; Moler, Frank; Shanley, Thomas; Meert, Kathy; Newth, Christopher J. L.; Carcillo, Joseph; Berger, John T.; Doctor, Allan; Berg, Robert A.; Dalton, Heidi; Wessel, David L.; Harrison, Rick E.; Dean, J. Michael; Jenkins, Tammara L.

2015-01-01

Importance Functional status assessment methods are important as outcome measures for pediatric critical care studies. Objective To investigate the relationships between the 2 functional status assessment methods appropriate for large-sample studies, the Functional Status Scale (FSS) and the Pediatric Overall Performance Category and Pediatric Cerebral Performance Category (POPC/PCPC) scales. Design, Setting, and Participants Prospective cohort study with random patient selection at 7 sites and 8 children’s hospitals with general/medical and cardiac/cardiovascular pediatric intensive care units (PICUs) in the Collaborative Pediatric Critical Care Research Network. Participants included all PICU patients younger than 18 years. Main Outcomes and Measures Functional Status Scale and POPC/PCPC scores determined at PICU admission (baseline) and PICU discharge. We investigated the association between the baseline and PICU discharge POPC/PCPC scores and the baseline and PICU discharge FSS scores, the dispersion of FSS scores within each of the POPC/PCPC ratings, and the relationship between the FSS neurologic components (FSS-CNS) and the PCPC. Results We included 5017 patients. We found a significant (P < .001) difference between FSS scores in each POPC or PCPC interval, with an FSS score increase with each worsening POPC/PCPC rating. The FSS scores for the good and mild disability POPC/PCPC ratings were similar and increased by 2 to 3 points for the POPC/PCPC change from mild to moderate disability, 5 to 6 points for moderate to severe disability, and 8 to 9 points for severe disability to vegetative state or coma. The dispersion of FSS scores within each POPC and PCPC rating was substantial and increased with worsening POPC and PCPC scores. We also found a significant (P < .001) difference between the FSS-CNS scores between each of the PCPC ratings with increases in the FSS-CNS score for each higher PCPC rating. Conclusions and Relevance The FSS and POPC/PCPC system are closely associated. Increases in FSS scores occur with each higher POPC and PCPC rating and with greater magnitudes of change as the dysfunction severity increases. However, the dispersion of the FSS scores indicated a lack of precision in the POPC/PCPC system when compared with the more objective and granular FSS. The relationship between the PCPC and the FSS-CNS paralleled the relationship between the FSS and POPC/PCPC system. PMID:24862461

Coping strategies among patients with newly diagnosed amyotrophic lateral sclerosis.

PubMed

Jakobsson Larsson, Birgitta; Nordin, Karin; Askmark, Håkan; Nygren, Ingela

2014-11-01

To prospectively identify different coping strategies among newly diagnosed amyotrophic lateral sclerosis patients and whether they change over time and to determine whether physical function, psychological well-being, age and gender correlated with the use of different coping strategies. Amyotrophic lateral sclerosis is a fatal disease with impact on both physical function and psychological well-being. Different coping strategies are used to manage symptoms and disease progression, but knowledge about coping in newly diagnosed amyotrophic lateral sclerosis patients is scarce. This was a prospective study with a longitudinal and descriptive design. A total of 33 patients were included and evaluation was made at two time points, one to three months and six months after diagnosis. Patients were asked to complete the Motor Neuron Disease Coping Scale and the Hospital Anxiety and Depression Scale. Physical function was estimated using the revised Amyotrophic Lateral Sclerosis Functional Rating Scale. The most commonly used strategies were support and independence. Avoidance/venting and information seeking were seldom used at both time points. The use of information seeking decreased between the two time points. Men did not differ from women, but patients ≤64 years used positive action more often than older patients. Amyotrophic Lateral Sclerosis Functional Rating Scale was positively correlated with positive action at time point 1, but not at time point 2. Patients' psychological well-being was correlated with the use of different coping strategies. Support and independence were the most used coping strategies, and the use of different strategies changed over time. Psychological well-being was correlated with different coping strategies in newly diagnosed amyotrophic lateral sclerosis patients. The knowledge about coping strategies in early stage of the disease may help the nurses to improve and develop the care and support for these patients. © 2014 John Wiley & Sons Ltd.

A gas-tracer injection for evaluating the fate of methane in a coastal plain stream: Degassing versus in-stream oxidation

USGS Publications Warehouse

Heilweil, Victor M.; Solomon, D. Kip; Darrah, Thomas H.; Gilmore, Troy E.; Genereux, David P.

2016-01-01

Methane emissions from streams and rivers have recently been recognized as an important component of global greenhouse budgets. Stream methane is lost as evasion to the atmosphere or in-stream methane oxidation. Previous studies have quantified evasion and oxidation with point-scale measurements. In this study, dissolved gases (methane, krypton) were injected into a coastal plain stream in North Carolina to quantify stream CH4 losses at the watershed scale. Stream-reach modeling yielded gas transfer and oxidation rate constants of 3.2 ± 0.5 and 0.5 ± 1.5 d–1, respectively, indicating a ratio of about 6:1. The resulting evasion and oxidation rates of 2.9 mmol m–2 d–1 and 1,140 nmol L–1 d–1, respectively, lie within ranges of published values. Similarly, the gas transfer velocity (K600) of 2.1 m d–1 is consistent with other gas tracer studies. This study illustrates the utility of dissolved-gas tracers for evaluating stream methane fluxes. In contrast to point measurements, this approach provides a larger watershed-scale perspective. Further work is needed to quantify the magnitude of these fluxes under varying conditions (e.g., stream temperature, nutrient load, gradient, flow rate) at regional and global scales before reliable bottom-up estimates of methane evasion can be determined at global scales.

Assessing Communication Skills of Medical Students in Objective Structured Clinical Examinations (OSCE) - A Systematic Review of Rating Scales

PubMed Central

Cömert, Musa; Zill, Jördis Maria; Christalle, Eva; Dirmaier, Jörg; Härter, Martin; Scholl, Isabelle

2016-01-01

Background Teaching and assessment of communication skills have become essential in medical education. The Objective Structured Clinical Examination (OSCE) has been found as an appropriate means to assess communication skills within medical education. Studies have demonstrated the importance of a valid assessment of medical students’ communication skills. Yet, the validity of the performance scores depends fundamentally on the quality of the rating scales used in an OSCE. Thus, this systematic review aimed at providing an overview of existing rating scales, describing their underlying definition of communication skills, determining the methodological quality of psychometric studies and the quality of psychometric properties of the identified rating scales. Methods We conducted a systematic review to identify psychometrically tested rating scales, which have been applied in OSCE settings to assess communication skills of medical students. Our search strategy comprised three databases (EMBASE, PsycINFO, and PubMed), reference tracking and consultation of experts. We included studies that reported psychometric properties of communication skills assessment rating scales used in OSCEs by examiners only. The methodological quality of included studies was assessed using the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. The quality of psychometric properties was evaluated using the quality criteria of Terwee and colleagues. Results Data of twelve studies reporting on eight rating scales on communication skills assessment in OSCEs were included. Five of eight rating scales were explicitly developed based on a specific definition of communication skills. The methodological quality of studies was mainly poor. The psychometric quality of the eight rating scales was mainly intermediate. Discussion Our results reveal that future psychometric evaluation studies focusing on improving the methodological quality are needed in order to yield psychometrically sound results of the OSCEs assessing communication skills. This is especially important given that most OSCE rating scales are used for summative assessment, and thus have an impact on medical students’ academic success. PMID:27031506

Assessing Communication Skills of Medical Students in Objective Structured Clinical Examinations (OSCE)--A Systematic Review of Rating Scales.

PubMed

Cömert, Musa; Zill, Jördis Maria; Christalle, Eva; Dirmaier, Jörg; Härter, Martin; Scholl, Isabelle

2016-01-01

Teaching and assessment of communication skills have become essential in medical education. The Objective Structured Clinical Examination (OSCE) has been found as an appropriate means to assess communication skills within medical education. Studies have demonstrated the importance of a valid assessment of medical students' communication skills. Yet, the validity of the performance scores depends fundamentally on the quality of the rating scales used in an OSCE. Thus, this systematic review aimed at providing an overview of existing rating scales, describing their underlying definition of communication skills, determining the methodological quality of psychometric studies and the quality of psychometric properties of the identified rating scales. We conducted a systematic review to identify psychometrically tested rating scales, which have been applied in OSCE settings to assess communication skills of medical students. Our search strategy comprised three databases (EMBASE, PsycINFO, and PubMed), reference tracking and consultation of experts. We included studies that reported psychometric properties of communication skills assessment rating scales used in OSCEs by examiners only. The methodological quality of included studies was assessed using the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. The quality of psychometric properties was evaluated using the quality criteria of Terwee and colleagues. Data of twelve studies reporting on eight rating scales on communication skills assessment in OSCEs were included. Five of eight rating scales were explicitly developed based on a specific definition of communication skills. The methodological quality of studies was mainly poor. The psychometric quality of the eight rating scales was mainly intermediate. Our results reveal that future psychometric evaluation studies focusing on improving the methodological quality are needed in order to yield psychometrically sound results of the OSCEs assessing communication skills. This is especially important given that most OSCE rating scales are used for summative assessment, and thus have an impact on medical students' academic success.

Understanding Disproportionate Representation in Special Education by Examining Group Differences in Behavior Ratings

ERIC Educational Resources Information Center

Peters, Christina D.; Kranzler, John H.; Algina, James; Smith, Stephen W.; Daunic, Ann P.

2014-01-01

The aim of the current study was to examine mean-group differences on behavior rating scales and variables that may predict such differences. Sixty-five teachers completed the Clinical Assessment of Behavior-Teacher Form (CAB-T) for a sample of 982 students. Four outcome variables from the CAB-T were assessed. Hierarchical linear modeling was used…

Relationship between the clinical global impression of severity for schizoaffective disorder scale and established mood scales for mania and depression.

PubMed

Turkoz, Ibrahim; Fu, Dong-Jing; Bossie, Cynthia A; Sheehan, John J; Alphs, Larry

2013-08-15

This analysis explored the relationship between ratings on HAM-D-17 or YMRS and those on the depressive or manic subscale of CGI-S for schizoaffective disorder (CGI-S-SCA). This post hoc analysis used the database (N=614) from two 6-week, randomized, placebo-controlled studies of paliperidone ER versus placebo in symptomatic subjects with schizoaffective disorder assessed using HAM-D-17, YMRS, and CGI-S-SCA scales. Parametric and nonparametric regression models explored the relationships between ratings on YMRS and HAM-D-17 and on depressive and manic domains of the CGI-S-SCA from baseline to the 6-week end point. A clinically meaningful improvement was defined as a change of 1 point in the CGI-S-SCA score. No adjustment was made for multiplicity. Multiple linear regression models suggested that a 1-point change in the depressive domain of CGI-S-SCA corresponded to an average 3.6-point (SE=0.2) change in HAM-D-17 score. Similarly, a 1-point change in the manic domain of CGI-S-SCA corresponded to an average 5.8-point (SE=0.2) change in YMRS score. Results were confirmed using local and cumulative logistic regression models in addition to equipercentile linking. Lack of subjects scoring over the complete range of possible scores may limit broad application of the analyses. Clinically meaningful score changes in depressive and manic domains of CGI-S-SCA corresponded to approximately 4- and 6-point score changes on HAM-D-17 and YMRS, respectively, in symptomatic subjects with schizoaffective disorder. Copyright © 2013 Elsevier B.V. All rights reserved.

GRACE-Based Estimates of GPS Satellite Antenna Phase Variations: Impact on Determining the Scale of the Terrestrial Reference Frame

NASA Astrophysics Data System (ADS)

Haines, B. J.; Bar-Sever, Y. E.; Bertiger, W.; Desai, S.; Owen, S.; Sibois, A.; Webb, F.

2007-12-01

Treating the GRACE tandem mission as an orbiting fiducial laboratory, we have developed new estimates of the phase and group-delay variations of the GPS transmitter antennas. Application of these antenna phase variation (APV) maps have shown great promise in reducing previously unexplained errors in our realization of GPS measurements from the TOPEX/POSEIDON (T/P; 1992--2005) and Jason-1 (2001--) missions. In particular, a 56 mm vertical offset in the solved-for position of the T/P receiver antenna is reduced to insignificance (less than 1 mm). For Jason-1, a spurious long-term (4-yr) drift in the daily antenna offset estimates is reduced from +3.7 to +0.1 mm/yr. Prior ground-based results, based on precise point positioning, also hint at the potential of the GRACE-based APV maps for scale determination, reducing the spurious scale rate by one half. In this paper, we report on the latest APV estimates from GRACE, and provide a further assessment of the impact of the APV maps on realizing the scale of the terrestrial reference frame (TRF) from GPS alone. To address this, we re-analyze over five years of data from a global (40+ station) ground network in a fiducial-free approach, using the new APV maps. A specialized multi-day GPS satellite orbit determination (OD) strategy is employed to better capitalize on dynamical constraints. The resulting estimates of TRF scale are compared to ITRF2005 in order to assess the quality of the solutions.

The Rothschild Scale for Antidepressant Tachyphylaxis: reliability and validity.

PubMed

Rothschild, Anthony J

2008-01-01

After successful treatment of an episode of major depression, many patients complain of symptoms of apathy or decreased motivation (described by patients as "the blahs"), fatigue, dullness in cognitive function, sleep disturbance, weight gain, and sexual dysfunction; however, the characterization of this phenomenon of antidepressant tachyphylaxis has been hampered by the lack of an accepted definition and a reliable and valid assessment tool. To address this problem, the development and assessment of the Rothschild Scale for Antidepressant Tachyphylaxis (RSAT) are described. The RSAT consists of 6 self-report items assessing energy level, motivation and interest, cognitive functioning, weight gain, sleep, and sexual functioning. A seventh item, affect, is assessed by the interviewer. Each item is measured within a 5-point ordinal scale with anchor points developed to illustrate each rating. This study assesses the internal consistency, test-retest reliability, convergent and discriminant validity, sensitivity, specificity, and positive and negative predictive values of the RSAT. The RSAT demonstrated excellent internal consistency and scale reliability (Cronbach alpha = .902). The RSAT also demonstrated strong test-retest reliability (for depressed patients: r = 0.822, P < .01; for control subjects: r = 0.887, P < .01). The total RSAT score did not correlate with severity of depression as measured by the total Hamilton Depression Rating Scale score or the Hamilton Depression Rating Scale item 1 (depressed mood), supporting the discriminant validity of the RSAT for use in antidepressant tachyphylaxis. The RSAT is a reliable measure of antidepressant tachyphylaxis.

Memory persistency and nonlinearity in daily mean dew point across India

NASA Astrophysics Data System (ADS)

Ray, Rajdeep; Khondekar, Mofazzal Hossain; Ghosh, Koushik; Bhattacharjee, Anup Kumar

2016-04-01

Enterprising endeavour has been taken in this work to realize and estimate the persistence in memory of the daily mean dew point time series obtained from seven different weather stations viz. Kolkata, Chennai (Madras), New Delhi, Mumbai (Bombay), Bhopal, Agartala and Ahmedabad representing different geographical zones in India. Hurst exponent values reveal an anti-persistent behaviour of these dew point series. To affirm the Hurst exponent values, five different scaling methods have been used and the corresponding results are compared to synthesize a finer and reliable conclusion out of it. The present analysis also bespeaks that the variation in daily mean dew point is governed by a non-stationary process with stationary increments. The delay vector variance (DVV) method has been exploited to investigate nonlinearity, and the present calculation confirms the presence of deterministic nonlinear profile in the daily mean dew point time series of the seven stations.

Multi-scale calculation based on dual domain material point method combined with molecular dynamics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dhakal, Tilak Raj

This dissertation combines the dual domain material point method (DDMP) with molecular dynamics (MD) in an attempt to create a multi-scale numerical method to simulate materials undergoing large deformations with high strain rates. In these types of problems, the material is often in a thermodynamically non-equilibrium state, and conventional constitutive relations are often not available. In this method, the closure quantities, such as stress, at each material point are calculated from a MD simulation of a group of atoms surrounding the material point. Rather than restricting the multi-scale simulation in a small spatial region, such as phase interfaces, or crackmore » tips, this multi-scale method can be used to consider non-equilibrium thermodynamic e ects in a macroscopic domain. This method takes advantage that the material points only communicate with mesh nodes, not among themselves; therefore MD simulations for material points can be performed independently in parallel. First, using a one-dimensional shock problem as an example, the numerical properties of the original material point method (MPM), the generalized interpolation material point (GIMP) method, the convected particle domain interpolation (CPDI) method, and the DDMP method are investigated. Among these methods, only the DDMP method converges as the number of particles increases, but the large number of particles needed for convergence makes the method very expensive especially in our multi-scale method where we calculate stress in each material point using MD simulation. To improve DDMP, the sub-point method is introduced in this dissertation, which provides high quality numerical solutions with a very small number of particles. The multi-scale method based on DDMP with sub-points is successfully implemented for a one dimensional problem of shock wave propagation in a cerium crystal. The MD simulation to calculate stress in each material point is performed in GPU using CUDA to accelerate the computation. The numerical properties of the multiscale method are investigated as well as the results from this multi-scale calculation are compared of particles needed for convergence makes the method very expensive especially in our multi-scale method where we calculate stress in each material point using MD simulation. To improve DDMP, the sub-point method is introduced in this dissertation, which provides high quality numerical solutions with a very small number of particles. The multi-scale method based on DDMP with sub-points is successfully implemented for a one dimensional problem of shock wave propagation in a cerium crystal. The MD simulation to calculate stress in each material point is performed in GPU using CUDA to accelerate the computation. The numerical properties of the multiscale method are investigated as well as the results from this multi-scale calculation are compared with direct MD simulation results to demonstrate the feasibility of the method. Also, the multi-scale method is applied for a two dimensional problem of jet formation around copper notch under a strong impact.« less

Who gains and who loses with community rating for small business?

PubMed

Buchanan, J L; Marquis, M S

1999-01-01

This paper compares community rating with experience rating for small businesses using a microsimulation model to determine what firms offer and who within these firms purchases insurance. We generate four years of data and find that our results are remarkably stable through time. Both offer and purchase rates are about five percentage points higher under experience rating, but community rating leads to more stable offerings. Under community rating, high-risk firms and families purchase insurance, whereas under experience rating, it is the low-risk firms and families who are the purchasers. Young families and poor families have the lowest purchase rates, with these rates being disproportionately low under community rating.

Development and validation of the short version of the diabetes obstacles questionnaire (DOQ-30) in six European countries.

PubMed

Pilv, Liina; Vermeire, Etienne; Rätsep, Anneli; Moreau, Alain; Nikolić, Dragica; Petek, Davorina; Yaman, Hakan; Oona, Marje; Kalda, Ruth

2016-01-01

Patients with type 2 diabetes reveal different obstacles in living with the disease. The EGPRN initiated a qualitative research EUROBSTACLE to create a broadly conceptualized diabetes-related quality of life (DR-QoL) instrument. It led to the development of the diabetes obstacle questionnaire (DOQ), a five-point Likert-scaled measure, consisting of 78 items in eight scales. To develop and validate a short, easy-to-use version of the DOQ. A cross-sectional study with the DOQ was carried out. Participants answered the DOQ and GPs added some clinical data from their medical records. Data of 853 patients from Belgium, France, Estonia, Serbia, Slovenia, and Turkey were included in the analysis. The selection of items for the short version of the DOQ was achieved with exploratory factor analysis (EFA). Construct validity was proved with EFA and Pearson correlations between the DOQ and the new DOQ-30. Internal reliability was established with Cronbach's alpha. DOQ-30 resulted in 30 items in nine subscales. It explained 49.8% of items' variance. It shows a considerable good internal reliability and construct validity. The DOQ-30 is a five-point Likert-scaled broadly conceptualized measure of DR-QoL. It addresses a variety of obstacles, such as social, psychological, cognitive and behavioural. The DOQ-30 is ready for implementation in general practice and research in Europe as a valuable instrument to assess DR-QoL.

Temporal scaling of episodic point estimates of weed seed predation to long-term predation rates

USDA-ARS?s Scientific Manuscript database

Weed seed predation is an important ecosystem service supporting weed management in low-external-input agroecosystems. For convenience, measurements of seed predation are often made at very short time scales (< 3 d). However, one of the primary uses of such data, the parameterization of models of cr...

Determinants of patient-rated and clinician-rated illness severity in schizophrenia.

PubMed

Fervaha, Gagan; Takeuchi, Hiroyoshi; Agid, Ofer; Lee, Jimmy; Foussias, George; Remington, Gary

2015-07-01

The contribution of specific symptoms on ratings of global illness severity in patients with schizophrenia is not well understood. The present study examined the clinical determinants of clinician and patient ratings of overall illness severity. This study included 1,010 patients with a DSM-IV diagnosis of schizophrenia who participated in the baseline visit of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study conducted between January 2001 and December 2004 and who had available symptom severity, side effect burden, cognition, and community functioning data. Both clinicians and patients completed the 7-point Clinical Global Impressions-Severity of Illness scale (CGI-S), the primary measure of interest in the present study. Symptoms were rated using the Positive and Negative Syndrome Scale and the Calgary Depression Scale for Schizophrenia, and functional status with the Quality of Life Scale. Neurocognition, insight, and medication-related side effects were also evaluated. Clinicians rated illness severity significantly higher than patients (P < .001). There was moderate overlap between CGI-S ratings made by clinicians and patients, with almost one third of patients showing substantial (ie, greater than 1 point) discrepancies with clinician ratings. Clinician-rated CGI-S scores were most strongly associated with positive symptoms, with additional independent contributions made by negative, disorganized, and depressive symptoms, as well as functional outcome (all P values < .01). Patient-rated CGI-S scores, on the other hand, were most closely related to depressive symptoms, with additional independent contributions made by positive and anxiety symptoms, clinical insight, and neurocognition (all P values < .01). Depressive symptoms were the strongest predictor of patient-rated CGI-S scores even in patients with good clinical insight (P < .001). Patient and clinician views of overall illness severity are not necessarily interchangeable and differ in their clinical correlates. Taking these differences into account may enhance patient engagement in care and improve outcomes. ClinicalTrials.gov identifier: NCT00014001. © Copyright 2014 Physicians Postgraduate Press, Inc.

Retrospective analysis of facial dog bite injuries at a Level I trauma center in the Denver metro area.

PubMed

Gurunluoglu, Raffi; Glasgow, Mark; Arton, Jamie; Bronsert, Michael

2014-05-01

Facial dog bite injuries pose a significant public health problem. Seventy-five consecutive patients (45 males, 30 females) treated solely by plastic surgery service for facial dog bite injuries at a Level I trauma center in the Denver Metro area between 2006 and 2012 were retrospectively reviewed. The following information were recorded: breed, relationship of patient to dog, location and number of wounds, the duration between injury and surgical repair and dog bite incident, type of repair, and antibiotic prophylaxis. Primary end points measured were wound infection, the need for revision surgery, and patient satisfaction. Ninety-eight wounds in the head and neck region were repaired (46 children; mean age, 6.8 years) and (29 adults; mean age, 47.3 years). Twelve different breeds were identified. There was no significant association between the type of dog breed and the number of bite injuries. The duration between injury and repair ranged from 4 hours to 72 hours (mean [SD], 13.7 [10.9] hours). The majority of bite wounds (76 of 98) involved the cheek, lip, nose, and chin region. Direct repair was the most common surgical approach (60 of 98 wounds) (p < 0.05). There was no statistically significant association between wounds needing reconstruction versus direct repair according to dog breed (p = 0.25). Ten wounds required grafting. Twenty-five wounds were managed by one-stage or two-stage flaps. Only three patients (3.06 %) underwent replantation/revascularization of amputated partial lip (n = 2) and of cheek (n = 1). There was one postoperative infection. Data from five-point Likert scale were available for fifty-two patients. Forty patients were satisfied (5) with the outcome, while five patients were somewhat satisfied (4), and seven were neutral. Availability of the plastic surgery service at a Level I trauma center is vital for the optimal treatment of facial dog bite injuries. Direct repair and reconstruction of facial dog bite injuries at the earliest opportunity resulted in good outcomes as evidenced by the satisfaction survey data and low complication rate. Therapeutic study, level V. Epidemiologic study, level III.

Boeing Smart Rotor Full-scale Wind Tunnel Test Data Report

NASA Technical Reports Server (NTRS)

Kottapalli, Sesi; Hagerty, Brandon; Salazar, Denise

2016-01-01

A full-scale helicopter smart material actuated rotor technology (SMART) rotor test was conducted in the USAF National Full-Scale Aerodynamics Complex 40- by 80-Foot Wind Tunnel at NASA Ames. The SMART rotor system is a five-bladed MD 902 bearingless rotor with active trailing-edge flaps. The flaps are actuated using piezoelectric actuators. Rotor performance, structural loads, and acoustic data were obtained over a wide range of rotor shaft angles of attack, thrust, and airspeeds. The primary test objective was to acquire unique validation data for the high-performance computing analyses developed under the Defense Advanced Research Project Agency (DARPA) Helicopter Quieting Program (HQP). Other research objectives included quantifying the ability of the on-blade flaps to achieve vibration reduction, rotor smoothing, and performance improvements. This data set of rotor performance and structural loads can be used for analytical and experimental comparison studies with other full-scale rotor systems and for analytical validation of computer simulation models. The purpose of this final data report is to document a comprehensive, highquality data set that includes only data points where the flap was actively controlled and each of the five flaps behaved in a similar manner.

Estimates of performance in the rate of decline of under-five mortality for 113 low- and middle-income countries, 1970-2010.

PubMed

Verguet, Stéphane; Jamison, Dean T

2014-03-01

BACKGROUND; Measuring country performance in health has focused on assessing predicted vs observed levels of outcomes, an indicator that varies slowly over time. An alternative is to measure performance in terms of the rate of change in how a selected outcome compares to what would be expected given contextual determinants. Rates of change in health indicators can prove more sensitive than levels to changes in social, intersectoral or health policy context. It is thus similar to the growth rate of gross domestic product in the economic context. We assess performance in the rate of change (decline) of under-five mortality for 113 low- and middle-income countries. For 1970-2010, we study the evolution in rates of decline of under-five mortality. For each decade, we define performance as the average of the difference between the observed rate of decline and a rate of decline predicted by a model controlling for the contextual factors of income, female education levels, decade and geographical location. In the 1970s, the top performer in the rate of decline of under-five mortality was Costa Rica. In the 2000s, the top performer was Turkey. Overall, performance in rates of decline correlated little with performance in levels of under-five mortality. A major transition in performance between decades suggests a change in underlying determinants and we report the magnitude of these transitions. For example, heavily AIDS impacted countries, such as Botswana, experienced major drops in performance between the 1980s and the 1990s and some, including Botswana, experienced major compensatory improvements between the 1990s and the 2000s. Rate-based measures of country performance in health provide a starting point for assessments of the importance of health system, social and intersectoral determinants of performance.

Cross-cultural adaptation of the Posttraumatic Stress Disorder Checklist 5 (PCL-5) and Life Events Checklist 5 (LEC-5) for the Brazilian context.

PubMed

Lima, Eduardo de Paula; Vasconcelos, Alina Gomide; Berger, William; Kristensen, Christian Haag; Nascimento, Elizabeth do; Figueira, Ivan; Mendlowicz, Mauro Vitor

2016-01-01

To describe the process of cross-cultural adaptation of the Posttraumatic Stress Disorder Checklist 5 (PCL-5) and the Life Events Checklist 5 (LEC-5) for the Brazilian sociolinguistic context. The adaptation process sought to establish conceptual, semantic, and operational equivalence between the original items of the questionnaire and their translated versions, following standardized protocols. Initially, two researchers translated the original version of the scale into Brazilian Portuguese. Next, a native English speaker performed the back-translation. Quantitative and qualitative criteria were used to evaluate the intelligibility of items. Five specialists compared the original and translated versions and assessed the degree of equivalence between them in terms of semantic, idiomatic, cultural and conceptual aspects. The degree of agreement between the specialists was measured using the content validity coefficient (CVC). Finally, 28 volunteers from the target population were interviewed in order to assess their level of comprehension of the items. CVCs for items from both scales were satisfactory for all criteria. The mean comprehension scores were above the cutoff point established. Overall, the results showed that the adapted versions' items had adequate rates of equivalence in terms of concepts and semantics. The translation and adaptation processes were successful for both scales, resulting in versions that are not only equivalent to the originals, but are also intelligible for the population at large.

Once-daily high-dose pindolol for SSRI-refractory depression.

PubMed

Sokolski, Kenneth N; Conney, Janet C; Brown, Brenda J; DeMet, Edward M

2004-02-15

Selective serotonin reuptake inhibitor (SSRI) augmentation with the 5-HT1A antagonist pindolol has met with mixed results. Recent studies using positron emission tomography (PET) suggest that pindolol doses used in these studies were too low to effect 5-HT1A autoreceptor blockade. To test the hypothesis that a single higher dose of pindolol would effectively augment antidepressant responses in SSRI-refractory patients, nine subjects with major depression unresponsive to paroxetine 40 mg/day given for 2 months or more were randomized to AM pindolol 7.5 mg (n=4) or placebo (n=5). Subjects were administered the Hamilton Depression Scale (HAM-D), the Hamilton Anxiety Scale (HAM-A), the Bech-Rafaelsen Melancholia Scale, and the Zung Depression Inventory at baseline and weeks 1, 2, 3, and 4. Subjects receiving pindolol exhibited significant improvements in all ratings beginning at week 2 which continued through week 4. Aside from transient dizziness and a five-point decrease in systolic/diastolic blood pressure associated with pindolol, no adverse effects were reported. Although results must be verified in a larger sample, these findings support previous studies indicating that pindolol can accelerate antidepressant responses during SSRI therapy. In addition, results reported here suggest that a single high dose of pindolol (7.5 mg) is a more effective augmentation strategy in SSRI-refractory patients compared with the same total dose given at 2.5 mg tid.

Can teachers' global ratings identify children with academic problems?

PubMed

Glascoe, F P

2001-06-01

Physicians often elicit ratings from teachers when making diagnostic, treatment, or referral decisions. The purpose of this study was to view the relationship between teachers' ratings and children's academic skills, assess the utility of teacher ratings in detecting academic problems, and thus determine whether physicians can depend on teacher ratings when making decisions about patients' needs. Subjects were a national sample of 80 teachers and 934 children between 6 and 13 years of age participating in a test standardization study. Families were representative of United States demographics in terms of parental level of education, income, and ethnicity, and sites were geographically diverse elementary schools. Children were administered the Comprehensive Inventory of Basic Skills--Revised (CIBS-R), a diagnostic academic achievement test. Teachers rated children's academic performance on a five-point scale ranging from far above average to far below average and were blinded to the results of the CIBS-R. Teacher ratings varied significantly with children's performance for all academic domains. Logistic regression revealed that teacher ratings were best predicted by children's performance in basic reading skills, followed by math skills, and were not influenced by race, parents' level of education, history of retention, or gender. Participation in Title I services, testing in winter or spring, and parents who spoke a language other than English produced significantly lower ratings. Nevertheless, teachers rated as average many students with mild to moderate academic difficulties. School system personnel and health care providers should avoid sole dependence on global teacher ratings when deciding which students need special education referrals or other services. Supplementing teacher ratings with standardized screening test results is needed to ensure accurate decision-making.

Can the Hospital Anxiety and Depression (HAD) Scale be used on Chinese elderly in general practice?

PubMed

Lam, C L; Pan, P C; Chan, A W; Chan, S Y; Munro, C

1995-06-01

A study was carried out in a general practice in Hong Kong to find out if the Hospital Anxiety and Depression (HAD) Scale could be used to detect psychological problems in Chinese elderly. The HAD Scale was translated into Cantonese and administered by an interviewer to 298 Chinese aged 60 or above before their doctor consultations. The acceptance rate of the Scale was 96% and each interview took only 5-10 min to complete. All 298 elderly understood and completed the HAD Scale. Validation of the results of the HAD Scale by the Clinical Interview Schedule (CIS) was done on a random sample of 100 elderly. Relative operating characteristic (ROC) analysis showed that the optimal cut-off points of the HAD Scale was a depression score of 6 and an anxiety score of 3. The sensitivity was 80%, specificity was 90%, OMR (overall misclassification rate) was 12%, positive predictive value was 67% and negative predictive value was 95%. Thirty-six per cent of the elderly had scores above these cut-off points. More females than males had high anxiety scores. Nearly half of those with positive HAD scores were not known to have any psychological illness. The HAD Scale has great potential to be used as a screening instrument for psychological illnesses in Cantonese-speaking Chinese elderly all over the world.

Novel Augmentation Strategies in Major Depression.

PubMed

Martiny, Klaus

2017-04-01

Hypothesis The hypotheses of all the four included studies share the common idea that it is possible to augment the effect of antidepressant drug treatment by applying different interventions and with each intervention attain a clinically meaningful better effect compared to a control condition, and with minor side effects, thus improving the short- and medium-term outcome in major depression. Procedures Study design The basic study design has been the double blind randomised controlled trial (RCT). In the light therapy study, all patients were treated with sertraline for the whole of the study duration. In the first five weeks of the study, patients were randomised to treatment with either 60 minutes of bright white or 30 minutes of dim red light (sham condition). In the four weeks follow-up period, patients were treated with sertraline alone. In the Pindolol study, all patients were treated with venlafaxine and randomised to augmentation with either active or placebo matching pindolol tablets. In the PEMF study patients were continued on ongoing medication and randomised to augmentation with active or inactive (sham) 30 minutes daily PEMF treatment on weekdays. In the Chronos study all patients were treated with duloxetine and randomized to either a combination of three wake therapies with daily bright light treatment and sleep time stabilisation (wake group) or to daily exercise of minimum 30 minutes as an active control intervention (exercise group). The Chronos study was divided into: (1) a one-week run-in phase where duloxetine were started (and continued for the whole 29 week study period), (2) a one-week inpatient intervention phase where patient in the wake group did three wake therapies (sleep abstinence for the whole night and the following day until evening) in combination with daily light therapy and guidance on sleep time stabilisation and patients in the exercise group started a daily exercise program, (3) a seven week continuation phase where patient in the wake group continued light therapy and sleep time stabilisation and patients in the exercise group continued an individual exercise program, and (4) a 20 week follow-up phase with the same treatment elements but where duloxetine dosage could be adjusted or changed to other antidepressants. Recruitment Patients recruited for these studies were allocated from general practitioners, psychiatric specialist practices and for the lesser part from open psychiatric wards. Only a few patients were re-cruited through advertisements (in the PEMF and Chronos studies).   Inclusion criteria Inclusion criteria were major depression according to the DSM-IV, including a depressive episode as part of a bipolar disorder. For the PEMF study, treatment resistance was a specific inclusion criterion. Duration of studies Study duration was nine weeks for the light therapy study, 19 days for the Pindolol study, five weeks for the PEMF study, and 29 weeks for the Chronos study. Assessments In all studies, assessments were done with clinician rated scales, patient self-assessment scales, including quality of life scales and a side effect scale. As clinician rated scales we used the Hamilton depression rating scale: the HAM-D17 and its 6 item subscale: the HAM-D6, the Bech Rafaelsen Melancholia scale (MES), and the Bech Rafaelsen Mania scale (MAS). As self-assessment scales we used the Major Depression Inventory (MDI), the Symptom Check-list (SCL-92), and the Preskorn scale. For side effects we used the UKU scale. Further scales used are mentioned in the specific study sections. Assessments in the light therapy study were done weekly for the first six weeks and finally after nine weeks; at four time points in the Pindolol study (baseline, days 6, 11 and 19), weekly for five weeks in the PEMF study and weekly for the first nine weeks of the Chronos study and thereafter every four weeks. The clinical setting for evaluation has been the Psychiatric Research Unit at Mental Health Centre North Zealand. For the Bright Light study, Pindolol and PEMF study patients were also seen at a psychiatric specialist practice in Copenhagen. Biochemical measures In the Light therapy study saliva cortisol was collected at baseline before start of light therapy and sertraline and blood was drawn for thyroid analysis. In the Chronos study saliva and 24 hour urine cortisol was collected in the patients randomised to the exercise group. Main results The main results from the Bright Light study covering the first five weeks of the study are given in the PhD thesis "Adjunctive bright light in nonseasonal major depression" defended and awarded on the 18 November 2004 at the University of Copenhagen. Results from the cortisol measurement and for the four weeks extension period were published in separate papers after the PhD thesis and are included in this thesis. Results from the Bright Light study Analysis of the saliva cortisol measurements taken at baseline of the study as cortisol awakening profiles (CAR) showed that patients responded differentially to light treatment according to their CAR levels (dichotomized to high or low about the mean). Thus, in the bright light group HAM-D17 scores were reduced by 15.7 (4.2) points for patients with a low CAR (below mean), and 11.4 (4.8) points for patients with a high CAR (above mean). In the dim light group the corresponding values were 11.1 (5.2) for patients with a low CAR and 11.3 (5.3) for patients with a high CAR. This interaction between CAR and treatment group was statistically significant (p = 0.006). Survival analysis, for the first five weeks of the study period, showed a statistically significant higher response rate (χ2= 9.6, p =0.002) and higher remission rate (χ2 = 12.5, p = 0.0004) for the bright light treated group versus the dim light treated group. At end of the five weeks of light treatment response rates were 66.7% versus 40.7 % and remission rates were 41.7 % versus 14.8 % for the bright versus dim light treated group. In the subsequent publication that covered the four weeks extension period where light treatment was discontinued, data showed that the attained differences in response and remission rates between groups were not sustained. The offset of effect was nearly complete after four weeks of continued treatment on sertraline only. Thus, at end-point, response rates were 79.2 % versus 75.9 % and remission rates were 60 .4 % versus 55.6% in the bright versus dim light groups. The conclusion reached was that bright light in non-seasonal depression should be used to achieve an earlier antidepressant response and that light therapy probably should be of longer duration. Results from the Pindolol study The results from the Pindolol study showed that pindolol did not augment the effect of venlafaxine for the whole sample. However, for those patients classified as slow metabolizers, based on their O-desmethylvenlafaxine/venlafaxine ratio (ODV/V), pindolol did augment the antidepressant effect. For patients classified as fast metabolizers, pindolol worsened the outcome. This interaction between ODV/V ratio and treatment group was statistically significant (p = 0.01). Results from the PEMF study The results from the PEMF Study showed that treatment with active versus sham PEMF augmented the effect of the ongoing anti-depressant medication treatment. Thus, patients in the active PEMF group attained a statistically significant greater score reduction from week one and at all subsequent assessments compared to the sham treated group (p < 0.01). Response and remission rates in the active PEMF group were also larger than in the sham treated group with response rates at endpoint of 61.0 % versus 12.9 % (p < 0.01) and remission rates of 33.9 % versus 4.1 % (p < 0.05). Results from the Chronos study The Chronos study, published in three papers, covers a one-week intervention phase, a seven weeks continuation phase, and a 20 weeks follow-up phase. Results from the intervention week showed that patient treated in the wake group, from the day after the first wake therapy, had en clinically and statistically significant better antidepressant effect compared to the exercise group. On the HAM-D6 scale (which does not contains sleep items), patients in the wake group had a response rate after the first wake therapy of 58.7% versus 13.7% i the exercise group (p <0.0001) and a remission rate of 38.6% versus 2.9% (p <0.0001). After the second recovery sleep (the night after the second wake therapy = dag 5) patients in the wake group had a response rate of 75.0% versus 25.1% in the exercise group (p <0.0001) and remission rates of 58.6% versus 6.0% (p <0.0001). Results from the continuation phase showed, on the HAM-D17 scale which was used at all the following assessments, at week two response rates of 41.4% in the wake group and 12.8% in the exercise group (p = 0.003) and remission rates of 23.9% versus 5.4% (p = 0,004). This clinically relevant and statistically significant difference between the wake and exercise groups was maintained at all the subsequent assessments with response rates of 71.4% versus 47.3% (p = 0.04) and remission rates of 45.6% versus 23.1% (p = 0.04), at week nine. Results from the 20 weeks follow-up phase showed a continued better effect in the wake group at all visits with HAM-D17 depression scored at week 29 of 7.5 (SE = 0.9) in the wake group versus 10.1 (SE = 0.9), (p = 0.02) in the exercise group. Remission rates were higher in the wake group with endpoint rates of 61.9% versus 37.9% (p = 0.01) in the exercise group. Response rates was only numerically, but not statistically, higher in the wake group with 74.6% versus 64.4% in the exercise group (p = 0.22). The sleep diary data showed a statistically smaller day-to-day variation in sleep onset, sleep midpoint, sleep offset and sleep duration in the wake group compared to the exercise group as a sign of better day-to-day sleep-wake cycle control in the wake group (p < 0.01). In the first nine weeks of the study patients in the wake group had a moderate sleep phase advance that diminished during the follow-up period. The hypothesised predictors for response to wake therapy were confirmed. Thus, in the wake group, a positive diurnal variation (morning worst, evening best) was associated with a better out-come, after the wake therapies, compared to a negative diurnal variation (morning best, evening worst). In the exercise group, the reverse was found, as a positive diurnal variation was associated with worse outcome, compared to a negative diurnal variation. This interaction between group and diurnal variation was statistically significant (p = 0.0004). The positive predictive value of response to the first wake therapy (i.e. maintaining response also at week two) was 56.3 % and the negative predictive value of non-response to the first wake therapy (i.e. maintaining no response also at week two) was 75.0 %. The impact of naps on depression severity was examined. In the wake group, patients who napped on the days after wake therapy compared to those patients not napping, had a more severe deterioration at the following assessment at week two (p = 0.02). Patients in the exercise group were able to perform exercise with a mean of 63.0 minutes/day (55.3) for the first eight weeks. Articles published in the Danish Medical Journal are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

A prospective study to assess the palatability of analgesic medicines in children.

PubMed

Smith, Coral June; Sammons, Helen M; Fakis, Apostolos; Conroy, Sharon

2013-03-01

This study examined children's opinions on the taste of three analgesic medicines: paracetamol, ibuprofen and codeine. Many medicines for children are unpleasant and unacceptable. Research has shown that children's taste preferences differ to adults, in whom palatability is often tested. Little British research exists on children's opinions on the palatability of medicines. This study aimed to address this gap in knowledge. Prospective observational study. Between May-September 2008, hospital inpatients aged 5-16 years rated the taste of required analgesics on a 100-mm visual analogue scale. This incorporated a 5-point facial hedonic scale. They were also asked their favourite flavour and colour for a medicine. A total of 159 children took part. Eighty-five males (53·5%) and 74 females (46·5%). The median age was 8 years (Inter-quartile range 6-11). The taste of ibuprofen was significantly preferred to paracetamol or codeine. Significant differences were observed depending if the medicine rated was taken first or second (for example pre-medication with paracetamol and ibuprofen). Younger children (5-8 years) were more likely to choose the extremes of the scale when grading than older children were. Preferred flavours on questioning were strawberry 44% and banana 17%. Favourite colours were pink 25·8% and red 20·8%, with girls more likely to choose pink and boys blue. Ibuprofen was the most palatable analgesic medicine tested. Children reported they preferred fruit flavours and colour was sex dependent. Nurses when administering two medicines together should consider giving the least palatable first, for example paracetamol before ibuprofen for pre-medication. © 2012 Blackwell Publishing Ltd.

The emergency department treatment of dyspepsia with antacids and oral lidocaine.

PubMed

Welling, L R; Watson, W A

1990-07-01

The treatment of dyspepsia in the emergency department often consists of antacid in combination with viscous lidocaine, even though the specific etiology of the pain is frequently unknown. The efficacy of lidocaine as a component of symptomatic therapy was evaluated in a randomized, patient-blinded protocol. Patients presenting to the ED with dyspeptic symptoms were randomized to receive 30 mL of antacid (Mylanta II), or 30 mL of antacid plus 15 mL of 2% viscous lidocaine (GI cocktail). Patients recorded their pain score on an 11-cm linear analog scale prior to and 30 minutes after treatment. Seventy-six patients were enrolled; three were excluded from analysis due to incomplete data. Thirty-four patients were randomized to receive antacid and 39 to receive GI cocktail. Patients rated their baseline pain at 6.4 +/- 2.8 cm in the antacid group and 6.7 +/- 2.7 cm in the cocktail group (P greater than .50). Improvement in pain score with treatment was 0.9 +/- 2.9 cm in the antacid group compared with 4.0 +/- 3.4 cm in the GI cocktail group (P less than .0001). Assessment of pain relief using a five-point rating scale also indicated greater relief with GI cocktail therapy compared with antacid alone (P = .004). No adverse effects were noted with either treatment. We conclude that a single dose of antacid and viscous lidocaine provides a significantly greater degree of immediate pain relief than antacid alone in patients with dyspepsia.

Standardised clients as assessors in a veterinary communication OSCE: a reliability and validity study.

PubMed

Artemiou, E; Adams, C L; Hecker, K G; Vallevand, A; Violato, C; Coe, J B

2014-11-22

In human medicine, standardised patients (SP) have been shown to reliably and accurately assess learners' communication performance in high-stakes certification Objective Structured Clinical Examinations (OSCE), offering a feasible way to reduce the need for recruitment, time commitment and coordination of faculty assessors. In this study, we evaluated the use of standardised clients (SC) as a viable option for assessing veterinary students' communication performance. We designed a four-station, two-track communication skills OSCE. SC assessors used an adapted nine-item Liverpool Undergraduate Communication Assessment Scale (LUCAS). Faculty used a 21-item checklist derived from the Calgary-Cambridge Guide (CCG) and a five-point global rating scale. Participants were second year veterinary students (n=96). For the four stations, intrastation reliability (α) ranged from 0.63 to 0.82 for the LUCAS, and 0.73 to 0.87 for the CCG. The interstation reliability coefficients were 0.85 for the LUCAS and 0.89 for the CGG. The calculated Generalisability (G) coefficients were 0.62 for the LUCAS and 0.60 for the CGG. Supporting construct validity, SC and faculty assessors showed a significant correlation between the LUCAS and CCG total percent scores (r=0.45, P<0.001), and likewise between the LUCAS and global rating scores (r=0.49, P<0.001).Study results support that SC assessors offer a reliable and valid approach for assessing veterinary communication OSCE. British Veterinary Association.

Placement, support, and retention of health professionals: national, cross-sectional findings from medical and dental community service officers in South Africa.

PubMed

Hatcher, Abigail M; Onah, Michael; Kornik, Saul; Peacocke, Julia; Reid, Stephen

2014-02-26

In South Africa, community service following medical training serves as a mechanism for equitable distribution of health professionals and their professional development. Community service officers are required to contribute a year towards serving in a public health facility while receiving supervision and remuneration. Although the South African community service programme has been in effect since 1998, little is known about how placement and practical support occur, or how community service may impact future retention of health professionals. National, cross-sectional data were collected from community service officers who served during 2009 using a structured self-report questionnaire. A Supervision Satisfaction Scale (SSS) was created by summing scores of five questions rated on a three-point Likert scale (orientation, clinical advising, ongoing mentorship, accessibility of clinic leadership, and handling of community service officers' concerns). Research endpoints were guided by community service programmatic goals and analysed as dichotomous outcomes. Bivariate and multivariate logistical regressions were conducted using Stata 12. The sample population comprised 685 doctors and dentists (response rate 44%). Rural placement was more likely among unmarried, male, and black practitioners. Rates of self-reported professional development were high (470 out of 539 responses; 87%). Participants with higher scores on the SSS were more likely to report professional development. Although few participants planned to continue work in rural, underserved communities (n = 171 out of 657 responses, 25%), those serving in a rural facility during the community service year had higher intentions of continuing rural work. Those reporting professional development during the community service year were twice as likely to report intentions to remain in rural, underserved communities. Despite challenges in equitable distribution of practitioners, participant satisfaction with the compulsory community service programme appears to be high among those who responded to a 2009 questionnaire. These data offer a starting point for designing programmes and policies that better meet the health needs of the South African population through more appropriate human resource management. An emphasis on professional development and supervision is crucial if South Africa is to build practitioner skills, equitably distribute health professionals, and retain the medical workforce in rural, underserved areas.

From acute to persistent low back pain: a longitudinal investigation of somatosensory changes using quantitative sensory testing—an exploratory study

PubMed Central

Marcuzzi, Anna; Wrigley, Paul J.; Dean, Catherine M.; Graham, Petra L.; Hush, Julia M.

2018-01-01

Abstract Introduction: Chronic low back pain (LBP) is commonly associated with generalised pain hypersensitivity. It is suggested that such somatosensory alterations are important determinants for the transition to persistent pain from an acute episode of LBP. Although cross-sectional research investigating somatosensory function in the acute stage is developing, no longitudinal studies designed to evaluate temporal changes have been published. Objectives: This exploratory study aimed to investigate the temporal development of somatosensory changes from the acute stage of LBP to up to 4 months from onset. Methods: Twenty-five people with acute LBP (<3 weeks' duration) and 48 pain-free controls were prospectively assessed at baseline using quantitative sensory testing with the assessor blinded to group allocation, and again at 2 and 4 months. Psychological variables were concurrently assessed. People with acute LBP were classified based on their average pain severity over the previous week at 4 months as recovered (≤1/10 numeric rating scale) or persistent (≥2/10 numeric rating scale) LBP. Results: In the persistent LBP group, (1) there was a significant decrease in pressure pain threshold between 2 and 4 months (P < 0.013), and at 4 months, pressure pain threshold was significantly different from the recovered LBP group (P < 0.001); (2) a trend towards increased temporal summation was found at 2 months and 4 months, at which point it exceeded 2 SDs beyond the pain-free control reference value. Pain-related psychological variables were significantly higher in those with persistent LBP compared with the recovered LBP group at all time points (P < 0.05). Conclusion: Changes in mechanical pain sensitivity occurring in the subacute stage warrant further longitudinal evaluation to better understand the role of somatosensory changes in the development of persistent LBP. Pain-related cognitions at baseline distinguished persistent from the recovered LBP groups, emphasizing the importance of concurrent evaluation of psychological contributors in acute LBP. PMID:29756087

From acute to persistent low back pain: a longitudinal investigation of somatosensory changes using quantitative sensory testing-an exploratory study.

PubMed

Marcuzzi, Anna; Wrigley, Paul J; Dean, Catherine M; Graham, Petra L; Hush, Julia M

2018-03-01

Chronic low back pain (LBP) is commonly associated with generalised pain hypersensitivity. It is suggested that such somatosensory alterations are important determinants for the transition to persistent pain from an acute episode of LBP. Although cross-sectional research investigating somatosensory function in the acute stage is developing, no longitudinal studies designed to evaluate temporal changes have been published. This exploratory study aimed to investigate the temporal development of somatosensory changes from the acute stage of LBP to up to 4 months from onset. Twenty-five people with acute LBP (<3 weeks' duration) and 48 pain-free controls were prospectively assessed at baseline using quantitative sensory testing with the assessor blinded to group allocation, and again at 2 and 4 months. Psychological variables were concurrently assessed. People with acute LBP were classified based on their average pain severity over the previous week at 4 months as recovered (≤1/10 numeric rating scale) or persistent (≥2/10 numeric rating scale) LBP. In the persistent LBP group, (1) there was a significant decrease in pressure pain threshold between 2 and 4 months ( P < 0.013), and at 4 months, pressure pain threshold was significantly different from the recovered LBP group ( P < 0.001); (2) a trend towards increased temporal summation was found at 2 months and 4 months, at which point it exceeded 2 SDs beyond the pain-free control reference value. Pain-related psychological variables were significantly higher in those with persistent LBP compared with the recovered LBP group at all time points ( P < 0.05). Changes in mechanical pain sensitivity occurring in the subacute stage warrant further longitudinal evaluation to better understand the role of somatosensory changes in the development of persistent LBP. Pain-related cognitions at baseline distinguished persistent from the recovered LBP groups, emphasizing the importance of concurrent evaluation of psychological contributors in acute LBP.

Face and Construct Validation of a Virtual Peg Transfer Simulator

PubMed Central

Arikatla, Venkata S; Sankaranarayanan, Ganesh; Ahn, Woojin; Chellali, Amine; De, Suvranu; Caroline, GL; Hwabejire, John; DeMoya, Marc; Schwaitzberg, Steven; Jones, Daniel B.

2013-01-01

Background The Fundamentals of Laparascopic Surgery (FLS) trainer box is now established as a standard for evaluating minimally invasive surgical skills. A particularly simple task in this trainer box is the peg transfer task which is aimed at testing the surgeon’s bimanual dexterity, hand-eye coordination, speed and precision. The Virtual Basic Laparoscopic Skill Trainer (VBLaST©) is a virtual version of the FLS tasks which allows automatic scoring and real time, subjective quantification of performance without the need of a human proctor. In this paper we report validation studies of the VBLaST© peg transfer (VBLaST-PT©) simulator. Methods Thirty-five subjects with medical background were divided into two groups: experts (PGY 4-5, fellows and practicing surgeons) and novices (PGY 1-3). The subjects were asked to perform the peg transfer task on both the FLS trainer box and the VBLaST-PT© simulator and their performance was evaluated based on established metrics of error and time. A new length of trajectory (LOT) metric has also been introduced for offline analysis. A questionnaire was used to rate the realism of the virtual system on a 5-point Likert scale. Results Preliminary face validation of the VBLaST-PT© with 34 subjects rated on a 5-point Likert scale questionnaire revealed high scores for all aspects of simulation, with 3.53 being the lowest mean score across all questions. A two-tailed Mann-Whitney performed on the total scores showed significant (p=0.001) difference between the groups. A similar test performed on the task time (p=0.002) and the length of trajectory (p=0.004) separately showed statistically significant differences between the experts and novice groups (p<0.05). The experts appear to be traversing shorter overall trajectories in less time than the novices. Conclusion VBLaST-PT© showed both face and construct validity and has promise as a substitute for the FLS to training peg transfer skills. PMID:23263645

Managing Contextual Complexity in an Experiential Learning Course: A Dynamic Systems Approach through the Identification of Turning Points in Students' Emotional Trajectories

PubMed Central

Nogueiras, Gloria; Kunnen, E. Saskia; Iborra, Alejandro

2017-01-01

This study adopts a dynamic systems approach to investigate how individuals successfully manage contextual complexity. To that end, we tracked individuals' emotional trajectories during a challenging training course, seeking qualitative changes–turning points—and we tested their relationship with the perceived complexity of the training. The research context was a 5-day higher education course based on process-oriented experiential learning, and the sample consisted of 17 students. The students used a five-point Likert scale to rate the intensity of 16 emotions and the complexity of the training on 8 measurement points. Monte Carlo permutation tests enabled to identify 30 turning points in the 272 emotional trajectories analyzed (17 students * 16 emotions each). 83% of the turning points indicated a change of pattern in the emotional trajectories that consisted of: (a) increasingly intense positive emotions or (b) decreasingly intense negative emotions. These turning points also coincided with particularly complex periods in the training as perceived by the participants (p = 0.003, and p = 0.001 respectively). The relationship between positively-trended turning points in the students' emotional trajectories and the complexity of the training may be interpreted as evidence of a successful management of the cognitive conflict arising from the clash between the students' prior ways of meaning-making and the challenging demands of the training. One of the strengths of this study is that it provides a relatively simple procedure for identifying turning points in developmental trajectories, which can be applied to various longitudinal experiences that are very common in educational and developmental contexts. Additionally, the findings contribute to sustaining that the assumption that complex contextual demands lead unfailingly to individuals' learning is incomplete. Instead, it is how individuals manage complexity which may or may not lead to learning. Finally, this study can also be considered a first step in research on the developmental potential of process-oriented experiential learning training. PMID:28515703

Pattern analysis of total item score and item response of the Kessler Screening Scale for Psychological Distress (K6) in a nationally representative sample of US adults

PubMed Central

Kawasaki, Yohei; Ide, Kazuki; Akutagawa, Maiko; Yamada, Hiroshi; Yutaka, Ono; Furukawa, Toshiaki A.

2017-01-01

Background Several recent studies have shown that total scores on depressive symptom measures in a general population approximate an exponential pattern except for the lower end of the distribution. Furthermore, we confirmed that the exponential pattern is present for the individual item responses on the Center for Epidemiologic Studies Depression Scale (CES-D). To confirm the reproducibility of such findings, we investigated the total score distribution and item responses of the Kessler Screening Scale for Psychological Distress (K6) in a nationally representative study. Methods Data were drawn from the National Survey of Midlife Development in the United States (MIDUS), which comprises four subsamples: (1) a national random digit dialing (RDD) sample, (2) oversamples from five metropolitan areas, (3) siblings of individuals from the RDD sample, and (4) a national RDD sample of twin pairs. K6 items are scored using a 5-point scale: “none of the time,” “a little of the time,” “some of the time,” “most of the time,” and “all of the time.” The pattern of total score distribution and item responses were analyzed using graphical analysis and exponential regression model. Results The total score distributions of the four subsamples exhibited an exponential pattern with similar rate parameters. The item responses of the K6 approximated a linear pattern from “a little of the time” to “all of the time” on log-normal scales, while “none of the time” response was not related to this exponential pattern. Discussion The total score distribution and item responses of the K6 showed exponential patterns, consistent with other depressive symptom scales. PMID:28289560

Content validation of an interprofessional learning video peer assessment tool.

PubMed

Nisbet, Gillian; Jorm, Christine; Roberts, Chris; Gordon, Christopher J; Chen, Timothy F

2017-12-16

Large scale models of interprofessional learning (IPL) where outcomes are assessed are rare within health professional curricula. To date, there is sparse research describing robust assessment strategies to support such activities. We describe the development of an IPL assessment task based on peer rating of a student generated video evidencing collaborative interprofessional practice. We provide content validation evidence of an assessment rubric in the context of large scale IPL. Two established approaches to scale development in an educational setting were combined. A literature review was undertaken to develop a conceptual model of the relevant domains and issues pertaining to assessment of student generated videos within IPL. Starting with a prototype rubric developed from the literature, a series of staff and student workshops were undertaken to integrate expert opinion and user perspectives. Participants assessed five-minute videos produced in a prior pilot IPL activity. Outcomes from each workshop informed the next version of the rubric until agreement was reached on anchoring statements and criteria. At this point the rubric was declared fit to be used in the upcoming mandatory large scale IPL activity. The assessment rubric consisted of four domains: patient issues, interprofessional negotiation; interprofessional management plan in action; and effective use of video medium to engage audience. The first three domains reflected topic content relevant to the underlying construct of interprofessional collaborative practice. The fourth domain was consistent with the broader video assessment literature calling for greater emphasis on creativity in education. We have provided evidence for the content validity of a video-based peer assessment task portraying interprofessional collaborative practice in the context of large-scale IPL activities for healthcare professional students. Further research is needed to establish the reliability of such a scale.

Effect size measures in a two-independent-samples case with nonnormal and nonhomogeneous data.

PubMed

Li, Johnson Ching-Hong

2016-12-01

In psychological science, the "new statistics" refer to the new statistical practices that focus on effect size (ES) evaluation instead of conventional null-hypothesis significance testing (Cumming, Psychological Science, 25, 7-29, 2014). In a two-independent-samples scenario, Cohen's (1988) standardized mean difference (d) is the most popular ES, but its accuracy relies on two assumptions: normality and homogeneity of variances. Five other ESs-the unscaled robust d (d r * ; Hogarty & Kromrey, 2001), scaled robust d (d r ; Algina, Keselman, & Penfield, Psychological Methods, 10, 317-328, 2005), point-biserial correlation (r pb ; McGrath & Meyer, Psychological Methods, 11, 386-401, 2006), common-language ES (CL; Cliff, Psychological Bulletin, 114, 494-509, 1993), and nonparametric estimator for CL (A w ; Ruscio, Psychological Methods, 13, 19-30, 2008)-may be robust to violations of these assumptions, but no study has systematically evaluated their performance. Thus, in this simulation study the performance of these six ESs was examined across five factors: data distribution, sample, base rate, variance ratio, and sample size. The results showed that A w and d r were generally robust to these violations, and A w slightly outperformed d r . Implications for the use of A w and d r in real-world research are discussed.

The current theoretical assumptions of the Bobath concept as determined by the members of BBTA.

PubMed

Raine, Sue

2007-01-01

The Bobath concept is a problem-solving approach to the assessment and treatment of individuals following a lesion of the central nervous system that offers therapists a framework for their clinical practice. The aim of this study was to facilitate a group of experts in determining the current theoretical assumptions underpinning the Bobath concept.A four-round Delphi study was used. The expert sample included all 15 members of the British Bobath Tutors Association. Initial statements were identified from the literature with respondents generating additional statements. Level of agreement was determined by using a five-point Likert scale. Level of consensus was set at 80%. Eighty-five statements were rated from the literature along with 115 generated by the group. Ninety-three statements were identified as representing the theoretical underpinning of the Bobath concept. The Bobath experts agreed that therapists need to be aware of the principles of motor learning such as active participation, opportunities for practice and meaningful goals. They emphasized that therapy is an interactive process between individual, therapist, and the environment and aims to promote efficiency of movement to the individual's maximum potential rather than normal movement. Treatment was identified by the experts as having "change of functional outcome" at its center.

A Survey Study of Pre-Professionals' Understanding of the Canadian Music Therapy Internship Experience.

PubMed

Clements-Cortes, Amy

2015-01-01

There is limited research to date on the clinical music therapy internship experience from the perspective of the pre-professional. Further study is required to advance this significant stage in clinician development, as it is an intense period when pre-professionals apply and integrate theoretical knowledge about music therapy into their clinical practice. This study aimed to: (1) assess the skills, competence, comfort, concerns, issues, challenges, and anxieties of Canadian undergraduate students at two stages in the internship process (pre- and post-internship); and (2) examine whether these perceptions are consistent with published research on internship. Thirty-five pre-professionals, from a pool of 50 eligible respondents (70% response rate), completed a 57-question survey using a five-point Likert scale ranking pre- and post-internship experience and participated in an interview post-study. Survey results indicate a statistically significant increase in pre-professionals' perceived clinical, music, and personal skill development from pre- to post-internship. Areas of desired skill development included counseling, functional guitar, and clinical improvisation. Recommendations for educators and supervisors are provided with respect to areas of focus in undergraduate education and during clinical internship. © the American Music Therapy Association 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Effects of acupressure on fatigue and depression in hepatocellular carcinoma patients treated with transcatheter arterial chemoembolization: a quasi-experimental study.

PubMed

Lan, Su-Chen; Lin, Yueh-E; Chen, Shu-Ching; Lin, Yu-Fang; Wang, Yu-Jen

2015-01-01

This study was to examine the effects of acupressure on fatigue and depression in HCC patients undergoing TACE. A quasiexperimental study design was used. Patients were evaluated at five time points: before treatment (T1) and 2, 3, 4, and 5 days after treating TACE (T2, T3, T4, and T5). Fatigue and depression were assessed by a VAS fatigue scale and a VAS depression scale at each time point. TFRS and BDI were administered at T1 and T5. Patients' fatigue and depression were significantly higher at T5 than at T1 in two groups. Fatigue and depression increased in both the experimental and control groups' patients over the five days of hospitalization during which TACE and chemotherapy were administered. The experimental group had significantly less fatigue than the control group, with lower subscale scores on physical, psychosocial, daily, and overall fatigue. There were no differences between the groups on depression. At posttest, the experimental group experienced lower physical, psychosocial, daily, and overall fatigue than the control group. Acupressure can improve fatigue in HCC patients during treatment with TACE but did not alleviate depression. Discharge planning should include home care for management of fatigue and depression.

Effects of Acupressure on Fatigue and Depression in Hepatocellular Carcinoma Patients Treated with Transcatheter Arterial Chemoembolization: A Quasi-Experimental Study

PubMed Central

Lan, Su-Chen; Lin, Yueh-E; Chen, Shu-Ching; Lin, Yu-Fang; Wang, Yu-Jen

2015-01-01

This study was to examine the effects of acupressure on fatigue and depression in HCC patients undergoing TACE. A quasiexperimental study design was used. Patients were evaluated at five time points: before treatment (T1) and 2, 3, 4, and 5 days after treating TACE (T2, T3, T4, and T5). Fatigue and depression were assessed by a VAS fatigue scale and a VAS depression scale at each time point. TFRS and BDI were administered at T1 and T5. Patients' fatigue and depression were significantly higher at T5 than at T1 in two groups. Fatigue and depression increased in both the experimental and control groups' patients over the five days of hospitalization during which TACE and chemotherapy were administered. The experimental group had significantly less fatigue than the control group, with lower subscale scores on physical, psychosocial, daily, and overall fatigue. There were no differences between the groups on depression. At posttest, the experimental group experienced lower physical, psychosocial, daily, and overall fatigue than the control group. Acupressure can improve fatigue in HCC patients during treatment with TACE but did not alleviate depression. Discharge planning should include home care for management of fatigue and depression. PMID:25802540

Simulator-Based Angiography and Endovascular Neurosurgery Curriculum: A Longitudinal Evaluation of Performance Following Simulator-Based Angiography Training.

PubMed

Pannell, J Scott; Santiago-Dieppa, David R; Wali, Arvin R; Hirshman, Brian R; Steinberg, Jeffrey A; Cheung, Vincent J; Oveisi, David; Hallstrom, Jon; Khalessi, Alexander A

2016-08-29

This study establishes performance metrics for angiography and neuroendovascular surgery procedures based on longitudinal improvement in individual trainees with differing levels of training and experience. Over the course of 30 days, five trainees performed 10 diagnostic angiograms, coiled 10 carotid terminus aneurysms in the setting of subarachnoid hemorrhage, and performed 10 left middle cerebral artery embolectomies on a Simbionix Angio Mentor™ simulator. All procedures were nonconsecutive. Total procedure time, fluoroscopy time, contrast dose, heart rate, blood pressures, medications administered, packing densities, the number of coils used, and the number of stent-retriever passes were recorded. Image quality was rated, and the absolute value of technically unsafe events was recorded. The trainees' device selection, macrovascular access, microvascular access, clinical management, and the overall performance of the trainee was rated during each procedure based on a traditional Likert scale score of 1=fail, 2=poor, 3=satisfactory, 4=good, and 5=excellent. These ordinal values correspond with published assessment scales on surgical technique. After performing five diagnostic angiograms and five embolectomies, all participants demonstrated marked decreases in procedure time, fluoroscopy doses, contrast doses, and adverse technical events; marked improvements in image quality, device selection, access scores, and overall technical performance were additionally observed (p < 0.05). Similarly, trainees demonstrated marked improvement in technical performance and clinical management after five coiling procedures (p < 0.05). However, trainees with less prior experience deploying coils continued to experience intra-procedural ruptures up to the eighth embolization procedure; this observation likely corresponded with less tactile procedural experience to an exertion of greater force than appropriate for coil placement. Trainees across all levels of training and prior experience demonstrated a significant performance improvement after completion of our simulator curriculum consisting of five diagnostic angiograms, five embolectomy cases, and 10 aneurysm coil embolizations.

Another quasi-experimental study of understanding/appreciation of editorial satire.

PubMed

Gruner, C R; Gruner, M W; Travillion, L J

1991-12-01

College students completed a 17-item scale measuring the "propensity to argue controversial topics" and 7 other nominal-scale independent variables. They then read three editorial satires and checked which of five statements was the intended thesis of each satire's author. They also rated each satire on interestingness and funniness. Analysis indicated dependence between understanding of satire and sex and regular readership of "The Far Side."

A study of the topology of dissipating motions in direct numerical simulations of time-developing compressible and incompressible mixing layers

NASA Technical Reports Server (NTRS)

Chen, J. H.; Chong, M. S.; Soria, J.; Sondergaard, R.; Perry, A. E.; Rogers, M.; Moser, R.; Cantwell, B. J.

1990-01-01

A preliminary investigation of the geometry of flow patterns in numerically simulated compressible and incompressible mixing layers was carried out using 3-D critical point methodology. Motions characterized by high rates of kinetic energy dissipation and/or high enstrophy were of particular interest. In the approach the partial derivatives of the velocity field are determined at every point in the flow. These are used to construct the invariants of the velocity gradient tensor and the rate-of-strain tensor (P, Q, R, and P(sub s), Q(sub s), R(sub s) respectively). For incompressible flow the first invariant is zero. For the conditions of the compressible simulation, the first invariant is found to be everywhere small, relative to the second and third invariants, and so in both cases the local topology at a point is mainly determined by the second and third invariants. The data at every grid point is used to construct scatter plots of Q versus R and Q(sub s) versus R(sub s). Most points map to a cluster near the origin in Q-R space. However, fine scale motions, that is motions which are characterized by velocity derivatives which scale with the square root of R(sub delta), tend to map to regions which lie far from the origin. Definite trends are observed for motions characterized by high enstrophy and/or high dissipation. The observed trends suggest that, for these motions, the second and third invariants of the velocity gradient and rate-of-strain tensors are strongly correlated. The second and third invariants of the rate-of-strain tensor are related by K(-Q(sub s))(exp 3/2), which is consistent with the above scaling of velocity derivatives. The quantity K appears to depend on Reynolds number with an upper limit K = 2(the square root of 3)/9 corresponding to locally axisymmetric flow. For both the compressible and incompressible mixing layer, regions corresponding to high rates of dissipation are found to be characterized by comparable magnitudes of R(sub ij)R(sub ij) and S(sub ij)S(sub ij). For the incompressible mixing layer, regions characterized by the highest values of enstrophy are found to have relatively low strain rates.

Diagnosis, assessment and management of delusional jealousy in Parkinson's disease with and without dementia.

PubMed

Perugi, Giulio; Poletti, Michele; Logi, Chiara; Berti, Caterina; Romano, Anna; Del Dotto, Paolo; Lucetti, Claudio; Ceravolo, Roberto; Dell'Osso, Liliana; Bonuccelli, Ubaldo

2013-09-01

Patients with Parkinson's disease (PD) may present delusional jealousy (DJ). In a previous cross-sectional prevalence study we identified 15 cognitively preserved and five demented PD patients with DJ. The current study aimed at evaluating their clinical (motor and non-motor) characteristics and the pharmacological treatments associated with DJ, and its subsequent pharmacological management. Patients were assessed by neurologists and psychiatrists using the Hoehn and Yahr scale, the Unified Parkinson's Disease Rating Scale, the Brief Psychiatric Rating Scale, the Beck Depression Inventory, the Hamilton Anxiety Scale and the Neuropsychiatric Inventory. Efficacy of DJ management was evaluated in follow-up visits. All patients were in therapy with dopamine agonists. A subgroup of five cognitively preserved patients developed DJ after a short period of treatment of therapy with dopamine agonists, while other patients developed DJ after a longer period of dopaminergic treatment. Psychiatric comorbidities were common in cognitively preserved and in demented patients. The pharmacological management included the interruption of dopamine agonists in two patients and the reduction of dopamine agonist dose plus the use of antipsychotics in other patients. These clinical data suggest that the management of medicated PD patients should include investigation for the presence of DJ and the evaluation of clinical characteristics potentially relevant to the prevention or the early recognition of delusions.

The development of an instrument for evaluating clinical teachers: involving stakeholders to determine content validity.

PubMed

Stalmeijer, Renée E; Dolmans, Diana H J M; Wolfhagen, Ineke H A P; Muijtjens, Arno M M; Scherpbier, Albert J J A

2008-01-01

Research indicates that the quality of supervision strongly influences the learning of medical students in clinical practice. Clinical teachers need feedback to improve their supervisory skills. The available instruments either lack a clear theoretical framework or are not suitable for providing feedback to individual teachers. We developed an evaluation instrument based on the 'cognitive apprenticeship model'. The aim was to estimate the content validity of the developed instrument. Item relevance was rated on a five-point scale (1 = highly irrelevant, 5 = highly relevant) by three groups of stakeholders in undergraduate clinical teaching: educationalists (N = 12), doctors (N = 16) and students (N = 12). Additionally, stakeholders commented on content, wording and omission of items. The items were generally rated as very relevant (Mean = 4.3, SD = 0.38, response = 95%) and any differences between the stakeholder groups were small. The results led to elimination of 4 items, rewording of 13 items and addition of 1 item. The cognitive apprenticeship model appears to offer a useful framework for the development of an evaluation instrument aimed at providing feedback to individual clinical teachers on the quality of student supervision. Further studies in larger populations will have to establish the instrument's statistical validity and generalizability.

Refractive Index of III-metal-polar and N-polar AlGaN Waveguides Grown by Metal Organic Chemical Vapor Deposition

DTIC Science & Technology

2013-06-03

traditional birefringent materials is the wide bandgap semiconductor AlGaN. This semiconductor belongs to the 6 mm point group, and thus, has five non...effi- ciency of the SHG structure. As the two different polar surfa- ces incorporate point defects at a different rate during growth,25,26 the...diffraction in a triple axis geometry to determine the c-lattice parameter through the use of the (002) symmetric reflection and relating it to com

Apparently abnormal Wechsler Memory Scale index score patterns in the normal population.

PubMed

Carrasco, Roman Marcus; Grups, Josefine; Evans, Brittney; Simco, Edward; Mittenberg, Wiley

2015-01-01

Interpretation of the Wechsler Memory Scale-Fourth Edition may involve examination of multiple memory index score contrasts and similar comparisons with Wechsler Adult Intelligence Scale-Fourth Edition ability indexes. Standardization sample data suggest that 15-point differences between any specific pair of index scores are relatively uncommon in normal individuals, but these base rates refer to a comparison between a single pair of indexes rather than multiple simultaneous comparisons among indexes. This study provides normative data for the occurrence of multiple index score differences calculated by using Monte Carlo simulations and validated against standardization data. Differences of 15 points between any two memory indexes or between memory and ability indexes occurred in 60% and 48% of the normative sample, respectively. Wechsler index score discrepancies are normally common and therefore not clinically meaningful when numerous such comparisons are made. Explicit prior interpretive hypotheses are necessary to reduce the number of index comparisons and associated false-positive conclusions. Monte Carlo simulation accurately predicts these false-positive rates.

Mental Health and Childhood Adversities: A Longitudinal Study in Kabul, Afghanistan

PubMed Central

Panter-Brick, Catherine; Goodman, Anna; Tol, Wietse; Eggerman, Mark

2011-01-01

Objective To identify prospective predictors of mental health in Kabul, Afghanistan. Method Using stratified random-sampling in schools, mental health and life events for 11-to 16-year-old students and their caregivers were assessed. In 2007, 1 year after baseline, the retention rate was 64% (n = 115 boys, 119 girls, 234 adults) with no evidence of selection bias. Self- and caregiver-rated child mental health (Strengths and Difficulties Questionnaire), depressive (Depression Self-Rating Scale), and posttraumatic stress (Child Revised Impact of Events Scale) symptoms and caregiver mental health (Self-Report Questionnaire) were assessed. Lifetime trauma and past-year traumatic, stressful, and protective experiences were assessed. Results With the exception of posttraumatic stress, one-year trajectories for all mental health outcomes showed significant improvement (p < .001). Family violence had a striking impact on the Strengths and Difficulties Questionnaire data, raising caregiver-rated scores by 3.14 points (confidence interval [CI] 2.21–4.08) or half a standard deviation, and self-rated scores by 1.26 points (CI 0.50–2.03); past-year traumatic beatings independently raised self-rated scores by 1.85 points (CI 0.03–3.66). A major family conflict raised depression scores by 2.75 points (CI 0.89–4.61), two thirds of a standard deviation, whereas improved family life had protective effects. Posttraumatic stress symptom scores, however, were solely contingent on lifetime trauma, with more than three events raising scores by 5.38 points (CI 1.76–9.00). Conclusions Family violence predicted changes in mental health problems other than posttraumatic stress symptoms in a cohort that showed resilience to substantial socioeconomic and war-related stressors. The importance of prospectively identifying impacts of specific types of childhood adversities on mental health outcomes is highlighted to strengthen evidence on key modifiable factors for intervention in war-affected populations. PMID:21421175

Validity and Reliability of Visual Analog Scaling for Assessment of Hypernasality and Audible Nasal Emission in Children With Repaired Cleft Palate.

PubMed

Baylis, Adriane; Chapman, Kathy; Whitehill, Tara L; Group, The Americleft Speech

2015-11-01

To investigate the validity and reliability of multiple listener judgments of hypernasality and audible nasal emission, in children with repaired cleft palate, using visual analog scaling (VAS) and equal-appearing interval (EAI) scaling. Prospective comparative study of multiple listener ratings of hypernasality and audible nasal emission. Multisite institutional. Five trained and experienced speech-language pathologist listeners from the Americleft Speech Project. Average VAS and EAI ratings of hypernasality and audible nasal emission/turbulence for 12 video-recorded speech samples from the Americleft Speech Project. Intrarater and interrater reliability was computed, as well as linear and polynomial models of best fit. Intrarater and interrater reliability was acceptable for both rating methods; however, reliability was higher for VAS as compared to EAI ratings. When VAS ratings were plotted against EAI ratings, results revealed a stronger curvilinear relationship. The results of this study provide additional evidence that alternate rating methods such as VAS may offer improved validity and reliability over EAI ratings of speech. VAS should be considered a viable method for rating hypernasality and nasal emission in speech in children with repaired cleft palate.

Neuroimaging correlates of parent ratings of working memory in typically developing children

PubMed Central

Mahone, E. Mark; Martin, Rebecca; Kates, Wendy R.; Hay, Trisha; Horská, Alena

2009-01-01

The purpose of the present study was to investigate construct validity of parent ratings of working memory in children, using a multi-trait/multi-method design including neuroimaging, rating scales, and performance-based measures. Thirty-five typically developing children completed performance-based tests of working memory and nonexecutive function (EF) skills, received volumetric MRI, and were rated by parents on both EF-specific and broad behavior rating scales. After controlling for total cerebral volume and age, parent ratings of working memory were significantly correlated with frontal gray, but not temporal, parietal, or occipital gray, or any lobar white matter volumes. Performance-based measures of working memory were also moderately correlated with frontal lobe gray matter volume; however, non-EF parent ratings and non-EF performance-based measures were not correlated with frontal lobe volumes. Results provide preliminary support for the convergent and discriminant validity of parent ratings of working memory, and emphasize their utility in exploring brain–behavior relationships in children. Rating scales that directly examine EF skills may potentially have ecological validity, not only for “everyday” function, but also as correlates of brain volume. PMID:19128526

Multidisciplinary Delphi Development of a Scale to Evaluate Team Function in Obstetric Emergencies: The PETRA Scale.

PubMed

Balki, Mrinalini; Hoppe, David; Monks, David; Cooke, Mary Ellen; Sharples, Lynn; Windrim, Rory

2017-06-01

The objective of this study was to develop a new interdisciplinary teamwork scale, the Perinatal Emergency: Team Response Assessment (PETRA), for the management of obstetric crises, through consensus agreement of obstetric caregivers. This prospective study was performed using expert consensus, based on a Delphi method. The study investigators developed a new PETRA tool, specifically related to obstetric crisis management, based on the existing literature and discussions among themselves. The scale was distributed to a selected panel of experts in the field for the Delphi process. After each round of Delphi, every component of the scale was analyzed quantitatively by the percentage of agreement ratings and each comment reviewed by the blinded investigators. The assessment scale was then modified, with components of less than 80% agreement removed from the scale. The process was repeated on three occasions to reach a consensus and final PETRA scale. Fourteen of 24 invited experts participated in the Delphi process. The original PETRA scale included six categories and 48 items, one global scale item, and a 3-point rubric for rating. The overall percentage agreement by experts in the first, second, and third rounds was 95.0%, 93.2%, and 98.5%, respectively. The final scale after the third round of Delphi consisted of the following seven categories: shared mental model, communication, situational awareness, leadership, followership, workload management, and positive/effective behaviours and attitudes. There were 34 individual items within these categories, each with a 5-point rating rubric (1 = unacceptable to 5 = perfect). Using a structured Delphi method, we established the face and content validity of this assessment scale that focuses on important aspects of interdisciplinary teamwork in the management of obstetric crises. Copyright © 2017 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.

Impact of the use of an endorectal coil for 3 T prostate MRI on image quality and cancer detection rate

NASA Astrophysics Data System (ADS)

Gawlitza, Josephin; Reiss-Zimmermann, Martin; Thörmer, Gregor; Schaudinn, Alexander; Linder, Nicolas; Garnov, Nikita; Horn, Lars-Christian; Minh, Do Hoang; Ganzer, Roman; Stolzenburg, Jens-Uwe; Kahn, Thomas; Moche, Michael; Busse, Harald

2017-02-01

This work aims to assess the impact of an additional endorectal coil on image quality and cancer detection rate within the same patients. At a single academic medical center, this transversal study included 41 men who underwent T2- and diffusion-weighted imaging at 3 T using surface coils only or in combination with an endorectal coil in the same session. Two blinded readers (A and B) randomly evaluated all image data in separate sessions. Image quality with respect to localization and staging was rated on a five-point scale. Lesions were classified according to their prostate imaging reporting and data system (PIRADS) score version 1. Standard of reference was provided by whole-mount step-section analysis. Mean image quality scores averaged over all localization-related items were significantly higher with additional endorectal coil for both readers (p < 0.001), corresponding staging-related items were only higher for reader B (p < 0.001). With an endorectal coil, the rate of correctly detecting cancer per patient was significantly higher for reader B (p < 0.001) but not for reader A (p = 0.219). The numbers of histologically confirmed tumor lesions were rather similar for both settings. The subjectively rated 3-T image quality was improved with an endorectal coil. In terms of diagnostic performance, the use of an additional endorectal coil was not superior.

Customer assessment of long-term care pharmacy provider services.

PubMed

Clark, Thomas R

2008-09-01

Assess performance of long-term care pharmacy providers on key services offered to nursing facilities. Cross-sectional; nursing facility team. Random phone survey of nursing facility team members. 485 nursing facility team members (practicing in nursing facilities, interacting with > or = 1 consultant pharmacist); 46 members excluded, unable to identify facility's pharmacy provider. Directors of nursing, medical directors, and administrators were asked to rate long-term care pharmacy provider performance of eight commonly offered pharmacy services. All groups evaluated pharmacy provider performance of these services using a five-point scale. Results are broken down by employer type. Average rating for eight pharmacy services was 3.64. Top two services: "Labeling medications accurately" ranked in top 1-2 services for all groups (combined rating of 3.97) and "Provides medication administration system" ranked in top 1-3 services for all groups (combined rating of 3.95). One service, "Provides educational inservices," ranked lowest for all groups (combined rating of 3.54). In general, when looking at the eight services in combination for all providers, all services were ranked between Good and Very Good (average score of 3.64). Therefore, while the pharmacy provider is performing above average for these services, there is room for improvement in all of these services. These results can be used as a benchmark. Detailed data results and sample surveys are available online at www.ascp.com/supplements. These surveys can be used by the pharmacy provider to solicit assessments from their own facilities on these services.

Impact of the use of an endorectal coil for 3 T prostate MRI on image quality and cancer detection rate

PubMed Central

Gawlitza, Josephin; Reiss-Zimmermann, Martin; Thörmer, Gregor; Schaudinn, Alexander; Linder, Nicolas; Garnov, Nikita; Horn, Lars-Christian; Minh, Do Hoang; Ganzer, Roman; Stolzenburg, Jens-Uwe; Kahn, Thomas; Moche, Michael; Busse, Harald

2017-01-01

This work aims to assess the impact of an additional endorectal coil on image quality and cancer detection rate within the same patients. At a single academic medical center, this transversal study included 41 men who underwent T2- and diffusion-weighted imaging at 3 T using surface coils only or in combination with an endorectal coil in the same session. Two blinded readers (A and B) randomly evaluated all image data in separate sessions. Image quality with respect to localization and staging was rated on a five-point scale. Lesions were classified according to their prostate imaging reporting and data system (PIRADS) score version 1. Standard of reference was provided by whole-mount step-section analysis. Mean image quality scores averaged over all localization-related items were significantly higher with additional endorectal coil for both readers (p < 0.001), corresponding staging-related items were only higher for reader B (p < 0.001). With an endorectal coil, the rate of correctly detecting cancer per patient was significantly higher for reader B (p < 0.001) but not for reader A (p = 0.219). The numbers of histologically confirmed tumor lesions were rather similar for both settings. The subjectively rated 3-T image quality was improved with an endorectal coil. In terms of diagnostic performance, the use of an additional endorectal coil was not superior. PMID:28145525

Impact of the use of an endorectal coil for 3 T prostate MRI on image quality and cancer detection rate.

PubMed

Gawlitza, Josephin; Reiss-Zimmermann, Martin; Thörmer, Gregor; Schaudinn, Alexander; Linder, Nicolas; Garnov, Nikita; Horn, Lars-Christian; Minh, Do Hoang; Ganzer, Roman; Stolzenburg, Jens-Uwe; Kahn, Thomas; Moche, Michael; Busse, Harald

2017-02-01

This work aims to assess the impact of an additional endorectal coil on image quality and cancer detection rate within the same patients. At a single academic medical center, this transversal study included 41 men who underwent T2- and diffusion-weighted imaging at 3 T using surface coils only or in combination with an endorectal coil in the same session. Two blinded readers (A and B) randomly evaluated all image data in separate sessions. Image quality with respect to localization and staging was rated on a five-point scale. Lesions were classified according to their prostate imaging reporting and data system (PIRADS) score version 1. Standard of reference was provided by whole-mount step-section analysis. Mean image quality scores averaged over all localization-related items were significantly higher with additional endorectal coil for both readers (p < 0.001), corresponding staging-related items were only higher for reader B (p < 0.001). With an endorectal coil, the rate of correctly detecting cancer per patient was significantly higher for reader B (p < 0.001) but not for reader A (p = 0.219). The numbers of histologically confirmed tumor lesions were rather similar for both settings. The subjectively rated 3-T image quality was improved with an endorectal coil. In terms of diagnostic performance, the use of an additional endorectal coil was not superior.

Rasch analysis of the Mini-Mental Adjustment to Cancer Scale (mini-MAC) among a heterogeneous sample of long-term cancer survivors: A cross-sectional study

PubMed Central

2012-01-01

Background The mini-Mental Adjustment to Cancer Scale (mini-MAC) is a well-recognised, popular measure of coping in psycho-oncology and assesses five cancer-specific coping strategies. It has been suggested that these five subscales could be grouped to form the over-arching adaptive and maladptive coping subscales to facilitate the interpretation and clinical application of the scale. Despite the popularity of the mini-MAC, few studies have examined its psychometric properties among long-term cancer survivors, and further validation of the mini-MAC is needed to substantiate its use with the growing population of survivors. Therefore, this study examined the psychometric properties and dimensionality of the mini-MAC in a sample of long-term cancer survivors using Rasch analysis. Methods RUMM 2030 was used to analyse the mini-MAC data (n=851). Separate Rasch analyses were conducted for each of the original mini-MAC subscales as well as the over-arching adaptive and maladaptive coping subscales to examine summary and individual model fit statistics, person separation index (PSI), response format, local dependency, targeting, item bias (or differential item functioning -DIF), and dimensionality. Results For the fighting spirit, fatalism, and helplessness-hopelessness subscales, a revised three-point response format seemed more optimal than the original four-point response. To achieve model fit, items were deleted from four of the five subscales – Anxious Preoccupation items 7, 25, and 29; Cognitive Avoidance items 11 and 17; Fighting Spirit item 18; and Helplessness-Hopelessness items 16 and 20. For those subscales with sufficient items, analyses supported unidimensionality. Combining items to form the adaptive and maladaptive subscales was partially supported. Conclusions The original five subscales required item deletion and/or rescaling to improve goodness of fit to the Rasch model. While evidence was found for overarching subscales of adaptive and maladaptive coping, extensive modifications were necessary to achieve this result. Further exploration and validation of over-arching subscales assessing adaptive and maladaptive coping is necessary with cancer survivors. PMID:22607052

Application of psychometric theory to the measurement of voice quality using rating scales.

PubMed

Shrivastav, Rahul; Sapienza, Christine M; Nandur, Vuday

2005-04-01

Rating scales are commonly used to study voice quality. However, recent research has demonstrated that perceptual measures of voice quality obtained using rating scales suffer from poor interjudge agreement and reliability, especially in the mid-range of the scale. These findings, along with those obtained using multidimensional scaling (MDS), have been interpreted to show that listeners perceive voice quality in an idiosyncratic manner. Based on psychometric theory, the present research explored an alternative explanation for the poor interlistener agreement observed in previous research. This approach suggests that poor agreement between listeners may result, in part, from measurement errors related to a variety of factors rather than true differences in the perception of voice quality. In this study, 10 listeners rated breathiness for 27 vowel stimuli using a 5-point rating scale. Each stimulus was presented to the listeners 10 times in random order. Interlistener agreement and reliability were calculated from these ratings. Agreement and reliability were observed to improve when multiple ratings of each stimulus from each listener were averaged and when standardized scores were used instead of absolute ratings. The probability of exact agreement was found to be approximately .9 when using averaged ratings and standardized scores. In contrast, the probability of exact agreement was only .4 when a single rating from each listener was used to measure agreement. These findings support the hypothesis that poor agreement reported in past research partly arises from errors in measurement rather than individual differences in the perception of voice quality.

Kinematics of prehension and pointing movements in C6 quadriplegic patients.

PubMed

Laffont, I; Briand, E; Dizien, O; Combeaud, M; Bussel, B; Revol, M; Roby-Brami, A

2000-06-01

C6 quadriplegic patients lack voluntary control of their triceps muscle but can still perform reaching movements to grasp objects or point to targets. The present study documents the kinematic properties of reaching in these patients. We investigated the kinematics of prehension and pointing movements in four quadriplegic patients and five control subjects. Prehension and pointing movements were recorded for each subject using various object positions (ie different directions and distances from the subject). The 3D motion was analyzed with Fastrack Polhemus sensors. During prehension tasks the velocity profile of control subjects showed two peaks (go and return); the first velocity peak was scaled to the distance of the object. In quadriplegic patients there was a third intermediary peak corresponding to the grasping of the object. The amplitude of the first peak was slightly smaller than in control subjects. Velocity was scaled to the distance of the object, but with a greater dispersion than in control subjects. Total movement time was longer in quadriplegics because of the prolonged grasping phase. There were few differences in the pointing movements of normal and quadriplegic subjects. The scapula contributed more to the reaching phase of both movements in quadriplegic patients. In spite of some quantitative differences, the kinematics of the hand during reaching and pointing in quadriplegic patients are surprisingly similar to those of control subjects. Spinal Cord (2000) 38, 354 - 362.