Sample records for icf core set

  1. How to apply the ICF and ICF core sets for low back pain.

    PubMed

    Stier-Jarmer, Marita; Cieza, Alarcos; Borchers, Michael; Stucki, Gerold

    2009-01-01

    To introduce the International Classification of Functioning, Disability and Health (ICF) as conceptual model and classification and the ICF Core Sets as a way to specify functioning for a specific health condition such as Low Back Pain, and to illustrate the application of the ICF and ICF Core Sets in the context of clinical practice, the planning and reporting of studies and the comparison of health status measures. A decision-making and consensus process was performed to develop the ICF Core Sets for Low Back Pain, the linking procedure was applied as basis for the content comparison of health-status measures and the Rehab-Cycle was used to exemplify the application of the ICE and ICF Core Sets in clinical practice. Two different ICF Core Sets, namely, a comprehensive and a brief, are presented, three different health-status measures were linked to the ICF and compared and a case example of a patient with Low back Pain was described based on the Rehab-Cycle. The ICF is a promising new framework and classification to assess the impact of Low Back Pain. The ICF and practical tools, such as the ICF Core Sets for Low Back Pain, are useful for clinical practice, outcome and rehabilitation research, education, health statistics, and regulation.

  2. Classification of functioning and impairment: the development of ICF core sets for autism spectrum disorder.

    PubMed

    Bölte, Sven; de Schipper, Elles; Robison, John E; Wong, Virginia C N; Selb, Melissa; Singhal, Nidhi; de Vries, Petrus J; Zwaigenbaum, Lonnie

    2014-02-01

    Given the variability seen in Autism Spectrum Disorder (ASD), accurate quantification of functioning is vital to studying outcome and quality of life in affected individuals. The International Classification of Functioning, Disability and Health (ICF) provides a comprehensive, universally accepted framework for the description of health-related functioning. ICF Core Sets are shortlists of ICF categories that are selected to capture those aspects of functioning that are most relevant when describing a person with a specific condition. In this paper, the authors preview the process for developing ICF Core Sets for ASD, a collaboration with the World Health Organization and the ICF Research Branch. The ICF Children and Youth version (ICF-CY) was derived from the ICF and designed to capture the specific situation of the developing child. As ASD affects individuals throughout the life span, and the ICF-CY includes all ICF categories, the ICF-CY will be used in this project ("ICF(-CY)" from now on). The ICF(-CY) categories to be included in the ICF Core Sets for ASD will be determined at an ICF Core Set Consensus Conference, where evidence from four preparatory studies (a systematic review, an expert survey, a patient and caregiver qualitative study, and a clinical cross-sectional study) will be integrated. Comprehensive and Brief ICF Core Sets for ASD will be developed with the goal of providing useful standards for research and clinical practice and generating a common language for functioning and impairment in ASD in different areas of life and across the life span. © 2013 International Society for Autism Research, Wiley Periodicals, Inc.

  3. Standardised assessment of functioning in ADHD: consensus on the ICF Core Sets for ADHD.

    PubMed

    Bölte, Sven; Mahdi, Soheil; Coghill, David; Gau, Susan Shur-Fen; Granlund, Mats; Holtmann, Martin; Karande, Sunil; Levy, Florence; Rohde, Luis A; Segerer, Wolfgang; de Vries, Petrus J; Selb, Melissa

    2018-02-12

    Attention-deficit/hyperactivity disorder (ADHD) is associated with significant impairments in social, educational, and occupational functioning, as well as specific strengths. Currently, there is no internationally accepted standard to assess the functioning of individuals with ADHD. WHO's International Classification of Functioning, Disability and Health-child and youth version (ICF) can serve as a conceptual basis for such a standard. The objective of this study is to develop a comprehensive, a common brief, and three age-appropriate brief ICF Core Sets for ADHD. Using a standardised methodology, four international preparatory studies generated 132 second-level ICF candidate categories that served as the basis for developing ADHD Core Sets. Using these categories and following an iterative consensus process, 20 ADHD experts from nine professional disciplines and representing all six WHO regions selected the most relevant categories to constitute the ADHD Core Sets. The consensus process resulted in 72 second-level ICF categories forming the comprehensive ICF Core Set-these represented 8 body functions, 35 activities and participation, and 29 environmental categories. A Common Brief Core Set that included 38 categories was also defined. Age-specific brief Core Sets included a 47 category preschool version for 0-5 years old, a 55 category school-age version for 6-16 years old, and a 52 category version for older adolescents and adults 17 years old and above. The ICF Core Sets for ADHD mark a milestone toward an internationally standardised functional assessment of ADHD across the lifespan, and across educational, administrative, clinical, and research settings.

  4. Validation of the Comprehensive ICF Core Set for obstructive pulmonary diseases from the patient's perspective.

    PubMed

    Marques, Alda; Jácome, Cristina; Gonçalves, Ana; Silva, Sara; Lucas, Carla; Cruz, Joana; Gabriel, Raquel

    2014-06-01

    This study aimed to validate the Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for obstructive pulmonary diseases (OPDs) from the perspective of patients with chronic obstructive pulmonary disease. A cross-sectional qualitative study was carried out with outpatients with chronic obstructive pulmonary disease using focus groups with an ICF-based approach. Qualitative data were analysed using the meaning condensation procedure by two researchers with expertise in the ICF. Thirty-two participants (37.5% women; 63.8 ± 11.3 years old) were included in six focus groups. A total of 61 (86%) ICF categories of the Comprehensive ICF Core Set for OPD were confirmed. Thirty-nine additional second-level categories not included in the Core Set were identified: 15 from the body functions component, four from the body structures, nine from the activities and participation and 11 from the environmental factors. The majority of the categories included in the Comprehensive ICF Core Set for OPD were confirmed from the patients' perspective. However, additional categories, not included in the Core Set, were also reported. The categories included in the Core Set were not confirmed and the additional categories need to be investigated further to develop an instrument tailored to patients' needs. This will promote patient-centred assessments and rehabilitation interventions.

  5. Mapping of a standard documentation template to the ICF core sets for arthritis and low back pain.

    PubMed

    Escorpizo, Reuben; Davis, Kandace; Stumbo, Teri

    2010-12-01

    To identify the contents of a documentation template in The Guide to Physical Therapist Practice using the International Classification of Functioning, Disability, and Health (ICF) Core Sets for rheumatoid arthritis, osteoarthritis, and low back pain (LBP) as reference. Concepts were identified from items of an outpatient documentation template and mapped to the ICF using established linking rules. The ICF categories that were linked were compared with existing arthritis and LBP Core Sets. Based on the ICF, the template had the highest number (29%) of linked categories under Activities and participation while Body structures had the least (17%). ICF categories in the arthritis and LBP Core Sets had a 37-55% match with the ICF categories found in the template. We found 164 concepts that were not classified or not defined and 37 as personal factors. The arthritis and LBP Core Sets were reflected in the contents of the template. ICF categories in the Core Sets were reflected in the template (demonstrating up to 55% match). Potential integration of ICF in documentation templates could be explored and examined in the future to enhance clinical encounters and multidisciplinary communication. Copyright © 2010 John Wiley & Sons, Ltd.

  6. Development of ICF Core Sets to standardize assessment of functioning and impairment in ADHD: the path ahead.

    PubMed

    Bölte, Sven; de Schipper, Elles; Holtmann, Martin; Karande, Sunil; de Vries, Petrus J; Selb, Melissa; Tannock, Rosemary

    2014-12-01

    In the study of health and quality of life in attention deficit/hyperactivity disorder (ADHD), it is of paramount importance to include assessment of functioning. The International Classification of Functioning, Disability and Health (ICF) provides a comprehensive, universally accepted framework for the description of functioning in relation to health conditions. In this paper, the authors outline the process to develop ICF Core Sets for ADHD. ICF Core Sets are subgroups of ICF categories selected to capture the aspects of functioning that are most likely to be affected in specific disorders. The ICF categories that will be included in the ICF Core Sets for ADHD will be determined at an ICF Core Set Consensus Conference, wherein evidence from four preliminary studies (a systematic review, an expert survey, a patient and caregiver qualitative study, and a clinical cross-sectional study) will be integrated. Comprehensive and Brief ICF Core Sets for ADHD will be developed with the goal of providing useful standards for research and clinical practice, and to generate a common language for the description of functioning in ADHD in different areas of life and across the lifespan.

  7. Content validity of the Comprehensive ICF Core Set for multiple sclerosis from the perspective of speech and language therapists.

    PubMed

    Renom, Marta; Conrad, Andrea; Bascuñana, Helena; Cieza, Alarcos; Galán, Ingrid; Kesselring, Jürg; Coenen, Michaela

    2014-11-01

    The Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for Multiple Sclerosis (MS) is a comprehensive framework to structure the information obtained in multidisciplinary clinical settings according to the biopsychosocial perspective of the International Classification of Functioning, Disability and Health (ICF) and to guide the treatment and rehabilitation process accordingly. It is now undergoing validation from the user perspective for which it has been developed in the first place. To validate the content of the Comprehensive ICF Core Set for MS from the perspective of speech and language therapists (SLTs) involved in the treatment of persons with MS (PwMS). Within a three-round e-mail-based Delphi Study 34 SLTs were asked about PwMS' problems, resources and aspects of the environment treated by SLTs. Responses were linked to ICF categories. Identified ICF categories were compared with those included in the Comprehensive ICF Core Set for MS to examine its content validity. Thirty-four SLTs named 524 problems and resources, as well as aspects of environment. Statements were linked to 129 ICF categories (60 Body-functions categories, two Body-structures categories, 42 Activities-&-participation categories, and 25 Environmental-factors categories). SLTs confirmed 46 categories in the Comprehensive ICF Core Set. Twenty-one ICF categories were identified as not-yet-included categories. This study contributes to the content validity of the Comprehensive ICF Core Set for MS from the perspective of SLTs. Study participants agreed on a few not-yet-included categories that should be further discussed for inclusion in a revised version of the Comprehensive ICF Core Set to strengthen SLTs' perspective in PwMS' neurorehabilitation. © 2014 Royal College of Speech and Language Therapists.

  8. Validation of the Comprehensive ICF Core Set for Vocational Rehabilitation From the Perspective of Physical Therapists: International Delphi Survey.

    PubMed

    Kaech Moll, Veronika M; Escorpizo, Reuben; Portmann Bergamaschi, Ruth; Finger, Monika E

    2016-08-01

    The Comprehensive ICF Core Set for vocational rehabilitation (VR) is a list of essential categories on functioning based on the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF), which describes a standard for interdisciplinary assessment, documentation, and communication in VR. The aim of this study was to examine the content validity of the Comprehensive ICF Core Set for VR from the perspective of physical therapists. A 3-round email survey was performed using the Delphi method. A convenience sample of international physical therapists working in VR with work experience of ≥2 years were asked to identify aspects they consider as relevant when evaluating or treating clients in VR. Responses were linked to the ICF categories and compared with the Comprehensive ICF Core Set for VR. Sixty-two physical therapists from all 6 WHO world regions responded with 3,917 statements that were subsequently linked to 338 ICF categories. Fifteen (17%) of the 90 categories in the Comprehensive ICF Core Set for VR were confirmed by the physical therapists in the sample. Twenty-two additional ICF categories were identified that were not included in the Comprehensive ICF Core Set for VR. Vocational rehabilitation in physical therapy is not well defined in every country and might have resulted in the small sample size. Therefore, the results cannot be generalized to all physical therapists practicing in VR. The content validity of the ICF Core Set for VR is insufficient from solely a physical therapist perspective. The results of this study could be used to define a physical therapy-specific set of ICF categories to develop and guide physical therapist clinical practice in VR. © 2016 American Physical Therapy Association.

  9. [The International Classification of Functioning, Disability and Health (ICF) : The implementation of the ICF Core Sets for Hand Conditions in clinical routine as an example of application].

    PubMed

    Coenen, Michaela; Rudolf, Klaus-Dieter; Kus, Sandra; Dereskewitz, Caroline

    2018-05-24

    The International Classification of Functioning, Disability and Health (ICF) provides a standardized language of almost 1500 ICF categories for coding information about functioning and contextual factors. Short lists (ICF Core Sets) are helpful tools to support the implementation of the ICF in clinical routine. In this paper we report on the implementation of ICF Core Sets in clinical routine using the "ICF Core Sets for Hand Conditions" and the "Lighthouse Project Hand" as an example. Based on the ICF categories of the "Brief ICF Core Set for Hand Conditions", the ICF-based assessment tool (ICF Hand A ) was developed aiming to guide the assessment and treatment of patients with injuries and diseases located at the hand. The ICF Hand A facilitates the standardized assessment of functioning - taking into consideration of a holistic view of the patients - along the continuum of care ranging from acute care to rehabilitation and return to work. Reference points for the assessment of the ICF Hand A are determined in treatment guidelines for selected injuries and diseases of the hand along with recommendations for acute treatment and care, procedures and interventions of subsequent treatment and rehabilitation. The assessment of the ICF Hand A according to the defined reference points can be done using electronic clinical assessment tools and allows for an automatic generation of a timely medical report of a patient's functioning. In the future, the ICF Hand A can be used to inform the coding of functioning in ICD-11.

  10. Developing comprehensive and Brief ICF core sets for morbid obesity for disability assessment in Taiwan: a preliminary study.

    PubMed

    Lin, Y-N; Chang, K-H; Lin, C-Y; Hsu, M-I; Chen, H-C; Chen, H-H; Liou, T-H

    2014-04-01

    The International Classification of Functioning, Disability, and Health (ICF) provides a framework for measuring functioning and disability based on a biopsychosocial model. The aim of this study was to develop comprehensive and brief ICF core sets for morbid obesity for disability assessment in Taiwan. Observational Other Twenty-nine multidisciplinary experts of ICF METHODS: The questionnaire contained 112 obesity-relevant and second-level ICF categories. Using a 5-point Likert scale, the participants rated the significance of the effects of each category on the heath status of people with obesity. Correlation between an individual's score and the average score of the group indicated consensus. The categories were selected for the comprehensive core set for obesity if more than 50% of the experts rated them as "important" in the third round of the Delphi exercise, and for the brief core set if more than 80% of the experts rated them "very important." Twenty-nine experts participated in the study. These included 18 physicians, 4 dieticians, 3 physical therapists, 2 nurses, and 2 ICF experts. The comprehensive core set for morbid obesity contained 61 categories. Of these, 26 categories were from the component body function, 8 were from body structure, 18 were from activities and participation, and 9 were from environmental factors. The brief core set for obesity disability contained 29 categories. Of these, 19 categories were from the component body function, 3 were from body structure, 6 were from activities and participation, and one was from environmental factors. The comprehensive and brief ICF core sets provide comprehensive information on the health effects of morbid obesity and concise information for clinical practice. Comprehensive and brief core sets were created after three rounds of Delphi technique. Further validation study of these core sets by applying to patients with morbid obesity is needed. The comprehensive ICF core set for morbid obesity

  11. The International Classification of Functioning (ICF) core set for breast cancer from the perspective of women with the condition.

    PubMed

    Cooney, Marese; Galvin, Rose; Connolly, Elizabeth; Stokes, Emma

    2013-05-01

    The ICF Core Set for breast cancer was generated by international experts for women who have had surgery and radiation but it has not yet been validated. The objective of the study was to validate the ICF Core Set from the perspective of women with breast cancer. A qualitative focus group methodology was used. The sessions were transcribed verbatim. Meaning units were identified by two independent researchers. The agreed list was subsequently linked to ICF categories by two independent researchers according to pre-defined linking rules. Data saturation determined the number of focus groups conducted. Quality of the data analyses was assured by multiple coding and peer review. Thirty-four women participated in seven focus groups. A total of 1621 meaning units were identified which were linked to 74 of the existing 80 Core Set categories. Additional ICF categories not currently included in the Core Set were identified by the women. The validity of the Core Set was largely supported. However, some categories currently not covered by the ICF Core Set for Breast Cancer will need to be considered for inclusion if the Core Set is to reflect all women who have had treatment for breast cancer

  12. [Can ICF core sets be helpful in preparing a social-medical expert report due to incapacity to work?--a first proposal].

    PubMed

    Kirschneck, M; Legner, R; Armbrust, W; Nowak, D; Cieza, A

    2015-04-01

    Social-medical expert reports from the German statutory pension insurance are essential for the German statutory pension regulatory authority to decide whether to grant services regarding participation as well as retirement pensions due to incapacity to work.The objective of this investigation is to determine whether the ICF Core Sets and other international approaches, such as the EUMASS Core Sets or ICF Core Set for vocational rehabilitation cover the content of the social-medical expert reports as well as to propose an approach how the ICF can be economically used by the social medicine practitioner when writing a social-medical expert report. A retrospective quantitative study design was used to translate a total of 294 social-medical expert reports from patients with low back pain (LBP) or chronic widespread pain (CWP) into the language of the ICF (linking) by 2 independent health professionals and compare the results with the ICF Core Sets for specific health conditions and other international approaches. The content of social-medical expert reports was largely reflected by the condition specific brief ICF Core Sets, brief ICF Core Sets for vocational rehabilitation and EUMASS Core Sets. The weighted Kappa statistic for the agreement between the 2 health professionals who translated the expert reports were in CWP 0.69 with a bootstrapped confidence interval of 0.67-0.71 and in LBP 0.73 (0.71-0.74). The analyses show that the content of social-medical expert reports varies enormously. A combination of a condition specific brief ICF Core Set as well as vocational rehabilitation and EUMASS ICF Core Sets as well as all ICF-categories from the expert reports that were named at least in 50% of it can largely provide a basis for preparing expert reports. Within the scope of implementation the need for a specific ICF Core Set for expert reports of the German statutory pension insurance should be further analyzed and discussed. © Georg Thieme Verlag KG Stuttgart

  13. Low back pain in 17 countries, a Rasch analysis of the ICF core set for low back pain.

    PubMed

    Røe, Cecilie; Bautz-Holter, Erik; Cieza, Alarcos

    2013-03-01

    Previous studies indicate that a worldwide measurement tool may be developed based on the International Classification of Functioning Disability and Health (ICF) Core Sets for chronic conditions. The aim of the present study was to explore the possibility of constructing a cross-cultural measurement of functioning for patients with low back pain (LBP) on the basis of the Comprehensive ICF Core Set for LBP and to evaluate the properties of the ICF Core Set. The Comprehensive ICF Core Set for LBP was scored by health professionals for 972 patients with LBP from 17 countries. Qualifier levels of the categories, invariance across age, sex and countries, construct validity and the ordering of the categories in the components of body function, body structure, activities and participation were explored by Rasch analysis. The item-trait χ2-statistics showed that the 53 categories in the ICF Core Set for LBP did not fit the Rasch model (P<0.001). The main challenge was the invariance in the responses according to country. Analysis of the four countries with the largest sample sizes indicated that the data from Germany fit the Rasch model, and the data from Norway, Serbia and Kuwait in terms of the components of body functions and activities and participation also fit the model. The component of body functions and activity and participation had a negative mean location, -2.19 (SD 1.19) and -2.98 (SD 1.07), respectively. The negative location indicates that the ICF Core Set reflects patients with a lower level of function than the present patient sample. The present results indicate that it may be possible to construct a clinical measure of function on the basis of the Comprehensive ICF Core Set for LBP by calculating country-specific scores before pooling the data.

  14. ICF Core Set for Head and Neck Cancer: Do the Categories Discriminate Among Clinically Relevant Subgroups of Patients?

    ERIC Educational Resources Information Center

    Tschiesner, Uta; Oberhauser, Cornelia; Cieza, Alarcos

    2011-01-01

    The multidisciplinary assessment of functioning in patients with head and neck cancer (HNC) according to the "ICF Core Set for Head and Neck Cancer" (ICF-HNC) was developed in an international and multi-disciplinary approach. The ICF-HNC is an application of the ICF that was adopted by the World Health Organization. The objective of this study was…

  15. Two steps forward, one step back? A commentary on the disease-specific core sets of the International Classification of Functioning, Disability and Health (ICF).

    PubMed

    McIntyre, Anne; Tempest, Stephanie

    2007-09-30

    The International Classification of Functioning, Disability and Health (ICF) has been received favourably by health care professionals, disability rights organizations and proponents of the social model of disability. The success of the ICF largely depends on its uptake in practice and is considered unwieldy in its full format. To enhance the application of the ICF in practice, disease and site-specific core sets have been developed. The objective of this paper is to stimulate thought and discussion about the place of the ICF core sets in rehabilitation practice. The authors' review of the literature uses the ICF core sets (especially stroke), to debate if the ICF is at risk of taking two steps forward, one step back in its holistic portrayal of health. ICF disease specific core sets could be seen as taking two steps forward to enhance the user friendliness of the ICF and evidence-based practice in rehabilitation. However, there is a danger of taking one step back in reverting to a disease-specific classification. It is too early to conclude the efficacy of the disease-specific core sets, but there is an opportunity to debate where the next steps may lead.

  16. Explanatory power does not equal clinical importance: study of the use of the Brief ICF Core Sets for Spinal Cord Injury with a purely statistical approach.

    PubMed

    Ballert, C; Oberhauser, C; Biering-Sørensen, F; Stucki, G; Cieza, A

    2012-10-01

    Psychometric study analyzing the data of a cross-sectional, multicentric study with 1048 persons with spinal cord injury (SCI). To shed light on how to apply the Brief Core Sets for SCI of the International Classification of Functioning, Disability and Health (ICF) by determining whether the ICF categories contained in the Core Sets capture differences in overall health. Lasso regression was applied using overall health, rated by the patients and health professionals, as dependent variables and the ICF categories of the Comprehensive ICF Core Sets for SCI as independent variables. The ICF categories that best capture differences in overall health refer to areas of life such as self-care, relationships, economic self-sufficiency and community life. Only about 25% of the ICF categories of the Brief ICF Core Sets for the early post-acute and for long-term contexts were selected in the Lasso regression and differentiate, therefore, among levels of overall health. ICF categories such as d570 Looking after one's health, d870 Economic self-sufficiency, d620 Acquisition of goods and services and d910 Community life, which capture changes in overall health in patients with SCI, should be considered in addition to those of the Brief ICF Core Sets in clinical and epidemiological studies in persons with SCI.

  17. The Geriatric ICF Core Set reflecting health-related problems in community-living older adults aged 75 years and older without dementia: development and validation.

    PubMed

    Spoorenberg, Sophie L W; Reijneveld, Sijmen A; Middel, Berrie; Uittenbroek, Ronald J; Kremer, Hubertus P H; Wynia, Klaske

    2015-01-01

    The aim of the present study was to develop a valid Geriatric ICF Core Set reflecting relevant health-related problems of community-living older adults without dementia. A Delphi study was performed in order to reach consensus (≥70% agreement) on second-level categories from the International Classification of Functioning, Disability and Health (ICF). The Delphi panel comprised 41 older adults, medical and non-medical experts. Content validity of the set was tested in a cross-sectional study including 267 older adults identified as frail or having complex care needs. Consensus was reached for 30 ICF categories in the Delphi study (fourteen Body functions, ten Activities and Participation and six Environmental Factors categories). Content validity of the set was high: the prevalence of all the problems was >10%, except for d530 Toileting. The most frequently reported problems were b710 Mobility of joint functions (70%), b152 Emotional functions (65%) and b455 Exercise tolerance functions (62%). No categories had missing values. The final Geriatric ICF Core Set is a comprehensive and valid set of 29 ICF categories, reflecting the most relevant health-related problems among community-living older adults without dementia. This Core Set may contribute to optimal care provision and support of the older population. Implications for Rehabilitation The Geriatric ICF Core Set may provide a practical tool for gaining an understanding of the relevant health-related problems of community-living older adults without dementia. The Geriatric ICF Core Set may be used in primary care practice as an assessment tool in order to tailor care and support to the needs of older adults. The Geriatric ICF Core Set may be suitable for use in multidisciplinary teams in integrated care settings, since it is based on a broad range of problems in functioning. Professionals should pay special attention to health problems related to mobility and emotional functioning since these are the most

  18. Validation of the comprehensive ICF core sets for diabetes mellitus:a Malaysian perspective.

    PubMed

    Abdullah, Mohd Faudzi; Nor, Norsiah Mohd; Mohd Ali, Siti Zubaidah; Ismail Bukhary, Norizzati Bukhary; Amat, Azlin; Latif, Lydia Abdul; Hasnan, Nazirah; Omar, Zaliha

    2011-04-01

    Diabetes mellitus (DM) is a chronic disease that is prevalent in many countries. The prevalence of DM is on the rise, and its complications pose a heavy burden on the healthcare systems and on the patients' quality of life worldwide. This is a multicentre, cross-sectional study involving 5 Health Clinics conducted by Family Medicine Specialists in Malaysia. Convenience sampling of 100 respondents with DM were selected. The International Classifi cation of Functioning, Disability and Health (ICF) based measures were collected using the Comprehensive Core Set for DM. SF-36 and self-administered forms and comorbidity questionnaire (SCQ) were also used. Ninety-seven percent had Type 2 DM and 3% had Type 1 DM. The mean period of having DM was 6 years. Body functions related to physical health including exercise tolerance (b455), general physical endurance (b4550), aerobic capacity (b4551) and fatiguability (b4552) were the most affected. For body structures, the structure of pancreas (s550) was the most affected. In the ICF component of activities and participation, limitation in sports (d9201) was the highest most affected followed by driving (d475), intimate relationships (d770), handling stress and other psychological demands (d240) and moving around (d455). Only 7% (e355 and e450) in the environmental category were documented as being a relevant factor by more than 90% of the patients. The content validity of the comprehensive ICF Core set DM for Malaysian population were identified and the results show that physical and mental functioning were impaired in contrast to what the respondents perceived as leading healthy lifestyles.

  19. [Use of ICF Core Sets for medical reports concerning patients with low back pain and chronic widespread pain syndrome].

    PubMed

    Kirschneck, M; Winkelmann, A; Kirchberger, I; Glässel, A; Ewert, T; Stucki, G; Cieza, A

    2008-11-01

    Medical reports of the national pension insurance are essential for the national pension regulatory authority to decide on granting services regarding participation as well as retirement pensions due to inability to work. There are guidelines regarding the content of medical reports. It is also generally accepted that the evaluation of functioning is an essential component of them. However, it is still an open question to what extent the standardisation and the objectiveness of medical reports can be improved. The ICF (International Classification of Functioning, Disability and Health) is a framework as well as a common language for describing functioning and disability. ICF Core Sets are lists of disease-specific relevant ICF categories and can be a useful practicable tool for medical reports for national pension insurance. They could support the standardization of the medical reports. The aim of this planned project is to examine whether the ICF Core Sets for low back pain and chronic widespread pain could serve as a useful basis for medical reports for national pension insurance regarding the patients suffering low back pain or chronic widespread pain. Six hundred medical reports from patients with low back pain or chronic widespread pain, respectively, will be translated into the language of the ICF using a retrospective qualitative study design. For this translation ('linking') process specialised physicians from the national pension insurance and members of the Institute for Health and Rehabilitations Science will be trained to use established linking rules. STATE OF THE PROJECT: Currently, a total of 244 medical reports from the national pension insurance with the health conditions low back pain or chronic widespread pain were selected by members of the national pension insurance. The medical reports are anonymised in different federal states according to the appropriate requirements. The first 10 medical reports have already being analysed. First analyses

  20. Content Validity of the Comprehensive ICF Core Set for Multiple Sclerosis from the Perspective of Speech and Language Therapists

    ERIC Educational Resources Information Center

    Renom, Marta; Conrad, Andrea; Bascuñana, Helena; Cieza, Alarcos; Galán, Ingrid; Kesselring, Jürg; Coenen, Michaela

    2014-01-01

    Background: The Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for Multiple Sclerosis (MS) is a comprehensive framework to structure the information obtained in multidisciplinary clinical settings according to the biopsychosocial perspective of the International Classification of Functioning,…

  1. A transversal multicenter study assessing functioning, disability and environmental factors with the comprehensive ICF core set for low back pain in Brazil.

    PubMed

    Riberto, M; Chiappetta, L M; Lopes, K A; Chiappetta, L R

    2014-04-01

    Low back pain is a leading cause of disability in Brazil. The multiple aspects of disability in these patients require comprehensive tools for their assessment. The International Classification of Functioning, Disability, and Health (ICF) core set for low back pain is designed to comprehensively describe the experience of such patients with their functioning. This study aimed to describe functioning and contextual factors and to empirically validate the ICF core set for low back pain. Cross sectional study. Three outpatient clinics in Manaus, Maceio and São Paulo, Brazil. Population. 135 low back pain outpatients under rehabilitation. Data concerning diagnosis, personal features, and the 78 ICF core set categories for low back pain were collected from clinical charts, physical examinations, tests, and interviews with patients from rehabilitation services in three parts of Brazil. 7.7% of the categories (6 body functions and 10 activity and participation) were affected in less than 20% of the sample, and were thus considered not validated. Pain and other sensations related to the musculoskeletal system were the body most frequently impaired functions. Mobility and domestic life were the chapters of activity and limitation most often described as limited. All environmental factors were qualified as either facilitators or barriers and acted as modulators of disability. The comprehensive ICF core sets for low back pain can be used to describe the living experience of such individuals, although efforts to make it operational and enhance the reproducibility of the results are needed to warrant its reliable routine use. This study highlights the importance of a complete assessment of chronic low back pain and demonstrate the need for multidisciplinary approach.

  2. Can the ICF osteoarthritis core set represent a future clinical tool in measuring functioning in persons with osteoarthritis undergoing hip and knee joint replacement?

    PubMed

    Alviar, Maria Jenelyn; Olver, John; Pallant, Julie F; Brand, Caroline; de Steiger, Richard; Pirpiris, Marinis; Bucknill, Andrew; Khan, Fary

    2012-11-01

    To determine the dimensionality, reliability, model fit, adequacy of the qualifier levels, response patterns across different factors, and targeting of the International Classification of Functioning, Disability and Health (ICF) osteoarthritis core set categories in people with osteoarthritis undergoing hip and knee arthroplasty. The osteoarthritis core set was rated in 316 persons with osteoarthritis who were either in the pre-operative or within one year post-operative stage. Rasch analyses were performed using the RUMM 2030 program. Twelve of the 13 body functions categories and 13 of the 19 activity and participation categories had good model fit. The qualifiers displayed disordered thresholds necessitating rescoring. There was uneven spread of ICF categories across the full range of the patients' scores indicating off--targeting. Subtest analysis of the reduced ICF categories of body functions and activity and participation showed that the two components could be integrated to form one measure. The results suggest that it is possible to measure functioning using a unidimensional construct based on ICF osteoarthritis core set categories of body functions and activity and participation in this population. However, omission of some categories and reduction in qualifier levels are necessary. Further studies are needed to determine whether better targeting is achieved, particularly during the pre-operative and during the sub-acute care period.

  3. Low Back Pain in 17 Countries, a Rasch Analysis of the ICF Core Set for Low Back Pain

    ERIC Educational Resources Information Center

    Roe, Cecilie; Bautz-Holter, Erik; Cieza, Alarcos

    2013-01-01

    Previous studies indicate that a worldwide measurement tool may be developed based on the International Classification of Functioning Disability and Health (ICF) Core Sets for chronic conditions. The aim of the present study was to explore the possibility of constructing a cross-cultural measurement of functioning for patients with low back pain…

  4. International Classification of Functioning, Disability and Health Core Sets for cerebral palsy, autism spectrum disorder, and attention-deficit-hyperactivity disorder.

    PubMed

    Schiariti, Verónica; Mahdi, Soheil; Bölte, Sven

    2018-05-30

    Capturing functional information is crucial in childhood disability. The International Classification of Functioning, Disability and Health (ICF) Core Sets promote assessments of functional abilities and disabilities in clinical practice regarding circumscribed diagnoses. However, the specificity of ICF Core Sets for childhood-onset disabilities has been doubted. This study aimed to identify content commonalities and differences among the ICF Core Sets for cerebral palsy (CP), and the newly developed Core Sets for autism spectrum disorder (ASD) and attention-deficit-hyperactivity disorder (ADHD). The categories within each Core Set were aggregated at the ICF component and chapter levels. Content comparison was conducted using descriptive analyses. The activities and participation component of the ICF was the most covered across all Core Sets. Main differences included representation of ICF components and coverage of ICF chapters within each component. CP included all ICF components, while ADHD and ASD predominantly focused on activities and participation. Environmental factors were highly represented in the ADHD Core Sets (40.5%) compared to the ASD (28%) and CP (27%) Core Sets. International Classification of Functioning, Disability and Health Core Sets for CP, ASD, and ADHD capture both common but also unique functional information, showing the importance of creating condition-specific, ICF-based tools to build functional profiles of individuals with childhood-onset disabilities. The International Classification of Functioning, Disability and Health (ICF) Core Sets for cerebral palsy (CP), autism spectrum disorder (ASD), and attention-deficit-hyperactivity disorder (ADHD) include unique functional information. The ICF-based tools for CP, ASD, and ADHD differ in terms of representation and coverage of ICF components and ICF chapters. Representation of environmental factors uniquely influences functioning and disability across ICF Core Sets for CP, ASD and ADHD.

  5. Feasibility of using the International Classification of Functioning, Disability and Health Core Set for evaluation of fall-related risk factors in acute rehabilitation settings.

    PubMed

    Huang, Shih W; Lin, Li F; Chou, Lin C; Wu, Mei J; Liao, Chun D; Liou, Tsan H

    2016-04-01

    Previously, we reported the use of an International Classification of Functioning (ICF) core set that can provide a holistic framework for evaluating the risk factors of falls; however, data on the feasibility of applying this core set are lacking. To investigate the feasibility of applying the fall-related ICF risk-factor core set in the case of patients in an acute-rehabilitation setting. A cross-sectional and descriptive correlational design. Acute-rehabilitation ward. A total of 273 patients who experienced fall at acute-rehabilitation ward. The data on falls were collected from the hospital's Nursing Information System (NIS) and the fall-reporting system (Adverse Event Reporting System, AERS) between 2010 and 2013. The relationship of both systems to the fall-related ICF core set was analyzed to assess the feasibility of their clinical application. We evaluated the feasibility of using the fall-related ICF risk-factor core set by using the frequency and the percentage of the fall patients in of the listed categories. The fall-related ICF risk-factor core set category b735 (muscle tone functions) exhibited a high feasibility (85.95%) for clinical application, and the category b730 (muscle power functions) covered 77.11% of the patients. The feasibility of application of the category d410 (change basic body position) was also high in the case of all fall patients (81.69%). In the acute-rehabilitation setting, the feasibility of application of the fall-related ICF risk-factor core set is high. The fall-related ICF risk-factor core set can help multidisciplinary teams develop fall-prevention strategies in acute rehabilitation wards.

  6. Content validation of the international classification of functioning, disability and health core set for stroke from gender perspective using a qualitative approach.

    PubMed

    Glässel, A; Coenen, M; Kollerits, B; Cieza, A

    2014-06-01

    The extended ICF Core Set for stroke is an application of the International Classification of Functioning, Disability and Health (ICF) of the World Health Organisation (WHO) with the purpose to represent the typical spectrum of functioning of persons with stroke. The objective of the study is to add evidence to the content validity of the extended ICF Core Set for stroke from persons after stroke taking into account gender perspective. A qualitative study design was conducted by using individual interviews with women and men after stroke in an in- and outpatient rehabilitation setting. The sampling followed the maximum variation strategy. Sample size was determined by saturation. Concepts from qualitative data analysis were linked to ICF categories and compared to the extended ICF Core Set for stroke. Twelve women and 12 men participated in 24 individual interviews. In total, 143 out of 166 ICF categories included in the extended ICF Core Set for stroke were confirmed (women: N.=13; men: N.=17; both genders: N.=113). Thirty-eight additional categories that are not yet included in the extended ICF Core Set for stroke were raised by women and men. This study confirms that the experience of functioning and disability after stroke shows communalities and differences for women and men. The validity of the extended ICF Core Set for stroke could be mostly confirmed, since it does not only include those areas of functioning and disability relevant to both genders but also those exclusively relevant to either women or men. Further research is needed on ICF categories not yet included in the extended ICF Core Set for stroke.

  7. Development of the International Classification of Functioning, Disability and Health core sets for bipolar disorders: results of an international consensus process.

    PubMed

    Ayuso-Mateos, José L; Avila, Carolina C; Anaya, Celia; Cieza, Alarcos; Vieta, Eduard

    2013-01-01

    The International Classification of Functioning, Disability and Health (ICF) is a tool of the World Health Organization (WHO) designed to be a guide to identify and classify relevant domains of human experience affected by health conditions. The purpose of this article is to describe the process for the development of two Core Sets for bipolar disorder (BD) in the framework of the ICF. The Comprehensive ICF Core Set for BD intends to be a guide for multidisciplinary assessment of patients diagnosed with this condition, while the Brief ICF Core Set for BD will be useful when rating aspects of patient's experience for clinical practice or epidemiological studies. An international consensus conference involving a sample of experts with different professional backgrounds was performed using the nominal group technique. Various preparatory studies identified a set of 743 potential ICF categories to be included in the Core Sets. A total of 38 ICF categories were selected to be included in the Comprehensive Core Set for BD. A total of 19 ICF categories from the Comprehensive Core Set were chosen as the most significant to constitute the Brief Core Set for BD. The formal consensus process integrating evidence and expert opinion on the ICF led to the formal adoption of the ICF Core Sets for BD. The most important categories included are representative of the characteristics usually associated with BD. The next phase of this ICF project is to conduct a formal validation process to establish its applicability in clinical settings. Implications for Rehabilitation Bipolar disorder (BD) is a prevalent condition that has a great impact on people who suffer it, not only in health but also in daily functioning and quality of life. No standard has been defined so far regarding the problems in functioning of persons with BDs. The process described in this article defines the set of areas of functioning to be addressed in clinical assessments of persons with BD and establish the

  8. [Functioning and disability: the International Classification of Functioning, Disability and Health (ICF)].

    PubMed

    Fernández-López, Juan Antonio; Fernández-Fidalgo, María; Geoffrey, Reed; Stucki, Gerold; Cieza, Alarcos

    2009-01-01

    The World Health Organization's International Classification of Functioning, Disability and Health (ICF) has provided a new foundation for our understanding of health, functioning, and disability. It covers most of the health and health-related domains that make up the human experience, and the most environmental factors that influence that experience of functioning and disability. With the exhaustive ICF, patients' functioning -including its components body functions and structures and activities and participation-, becomes a central perspective in medicine. To implement the ICF in medicine and other fields, practical tools (= ICF Core Sets) have been developed. They are selected sets of categories out of the whole classification which serve as minimal standards for the assessment and reporting of functioning and health for clinical studies and clinical encounters (Brief ICF Core Set) or as standards for multiprofessional comprehensive assessment (Comprehensive ICF Core Set). Different from generic and condition-specific health-status measures, the ICF Core Sets include important body functions and structures and contextual factors. The use of the ICF Core Sets provides an important step towards improved communications between healthcare providers and professionals, and will enable patients and their families to understand and communicate with health professionals about their functioning and treatment goals. Specific applications include multi- and interdisciplinary assessment in clinical settings and in legal expert evaluations and use in disease or functioning-management programs. The ICF has also a potential as a conceptual framework to clarify an interrelated universe of health-related concepts which can be elucidated based on the ICF and therefore will be an ideal tool for teaching students in all medical fields and may open doors to multi-professional learning.

  9. Examining the similarities and differences of OMERACT core sets using the ICF: first step towards an improved domain specification and development of an item pool to measure functioning and health.

    PubMed

    Escorpizo, Reuben; Boers, Maarten; Stucki, Gerold; Boonen, Annelies

    2011-08-01

    To contribute to the discussion on a common approach for domain selection in the Outcomes in Rheumatology Clinical Trials (OMERACT) process. First, this article reports on the consistency in the selection and names of the domains of the current OMERACT core set, and next on the comparability of the specifications of concepts that are relevant within the domains. For this purpose, a convenience sample of 4 OMERACT core sets was used: rheumatoid arthritis (RA), psoriatic arthritis (PsA), longitudinal observational studies (LOS) in rheumatology, and ankylosing spondylitis (AS). Domains from the different core sets were compared directly. To be able to compare the specific content of the domains, the concepts contained in the questionnaires that were considered or proposed to measure the domains were identified and linked to the category of the International Classification of Functioning, Disability, and Health (ICF) that best fit that construct. Large differences in the domains, and lack of domain definitions, were noted among the 4 OMERACT core sets. When comparing the concepts in the questionnaires that represent the domains, core sets differed also in the number and type of constructs that were addressed within each of the domains. Especially for the specification of the concepts within the domains Discomfort and Disability, the ICF proved to be useful as external reference to classify the different constructs. Our exercise suggests that the OMERACT process could benefit from a standardized approach to select, define, and specify domains, and demonstrated that the ICF is useful for further classification of the more specific concepts of "what to measure" within the domains. A clear definition and classification of domains and their specification can be useful as a starting point to build a pool of items that could then be used to develop new instruments to assess functioning and health for rheumatological conditions.

  10. International Classification of Functioning, Disability and Health core set for physical health of older adults.

    PubMed

    Ruaro, João A; Ruaro, Marinêz B; Guerra, Ricardo O

    2014-01-01

    To facilitate a systematic, comprehensive description of functioning and to enable the use of the International Classification of Functioning, Disability and Health (ICF) in clinical practice and research, core sets have been developed. The aim of this study was to propose a version of the ICF core set to classify the physical health of older adults. The proposition of the ICF core set was based on the Delphi technique. The panel of experts included 8 Brazilian researchers (physical therapists, medical doctors, nurses, and physical educators). The communication was wholly electronic. In total, there were 5 rounds of interactivity between the participants to arrive at the final version of the construct. The ICF core set presented 30 categories (14 on body functions, 4 on body structures, 9 on activities or participation, and 3 on environmental factors) and had a Cronbach α of 0.964. The presented core set is a secure, fast, and accurate instrument for assessing the physical health and engagement of older adults. It defines points related to functioning and health that are relevant when evaluating this population, as well as when reevaluating it and monitoring changes.

  11. Development of the International Classification of Functioning, Disability and Health core sets for hand conditions--results of the World Health Organization International Consensus process.

    PubMed

    Rudolf, Klaus-Dieter; Kus, Sandra; Chung, Kevin C; Johnston, Marie; LeBlanc, Monique; Cieza, Alarcos

    2012-01-01

    A formal decision-making and consensus process was applied to develop the first version of the International Classification on Functioning, Disability and Health (ICF) Core Sets for Hand Conditions. To convene an international panel to develop the ICF Core Sets for Hand Conditions (HC), preparatory studies were conducted, which included an expert survey, a systematic literature review, a qualitative study and an empirical data collection process involving persons with hand conditions. A consensus conference was convened in Switzerland in May 2009 that was attended by 23 healthcare professionals, who treat hand conditions, representing 22 countries. The preparatory studies identified a set of 743 ICF categories at the second, third or fourth hierarchical level. Altogether, 117 chapter-, second-, or third-level categories were included in the comprehensive ICF Core Set for HC. The brief ICF Core Set for HC included a total of 23 chapter- and second-level categories. A formal consensus process integrating evidence and expert opinion based on the ICF led to the formal adoption of the ICF Core Sets for Hand Conditions. The next phase of this ICF project is to conduct a formal validation process to establish its applicability in clinical settings.

  12. A comparison of participation outcome measures and the International Classification of Functioning, Disability and Health Core Sets for traumatic brain injury.

    PubMed

    Chung, Pearl; Yun, Sarah Jin; Khan, Fary

    2014-02-01

    To compare the contents of participation outcome measures in traumatic brain injury with the International Classification of Functioning, Disability and Health (ICF) Core Sets for traumatic brain injury. A systematic search with an independent review process selected relevant articles to identify outcome measures in participation in traumatic brain injury. Instruments used in two or more studies were linked to the ICF categories, which identified categories in participation for comparison with the ICF Core Sets for traumatic brain injury. Selected articles (n = 101) identified participation instruments used in two or more studies (n = 9): Community Integration Questionnaire, Craig Handicap Assessment and Reporting Technique, Mayo-Portland Adaptability Inventory-4 Participation Index, Sydney Psychosocial Reintegration Scale Version-2, Participation Assessment with Recombined Tool-Objective, Community Integration Measure, Participation Objective Participation Subjective, Community Integration Questionnaire-2, and Quality of Community Integration Questionnaire. Each instrument was linked to 4-35 unique second-level ICF categories, of which 39-100% related to participation. Instruments addressed 86-100% and 50-100% of the participation categories in the Comprehensive and Brief ICF Core Sets for traumatic brain injury, respectively. Participation measures in traumatic brain injury were compared with the ICF Core Sets for traumatic brain injury. The ICF Core Sets for traumatic brain injury could contribute to the development and selection of participation measures.

  13. Identification of ICF categories relevant for nursing in the situation of acute and early post-acute rehabilitation

    PubMed Central

    Mueller, Martin; Boldt, Christine; Grill, Eva; Strobl, Ralf; Stucki, Gerold

    2008-01-01

    Background The recovery of patients after an acute episode of illness or injury depends both on adequate medical treatment and on the early identification of needs for rehabilitation care. The process of early beginning rehabilitation requires efficient communication both between health professionals and the patient in order to effectively address all rehabilitation goals. The currently used nursing taxonomies, however, are not intended for interdisciplinary use and thus may not contribute to efficient rehabilitation management and an optimal patient outcome. The ICF might be the missing link in this communication process. The objective of this study was to identify the categories of the International Classification of Functioning, Disability and Health (ICF) categories relevant for nursing care in the situation of acute and early post-acute rehabilitation. Methods First, in a consensus process, "Leistungserfassung in der Pflege" (LEP) nursing interventions relevant for the situation of acute and early post-acute rehabilitation were selected. Second, in an integrated two-step linking process, two nursing experts derived goals of LEP nursing interventions from their practical knowledge and selected corresponding ICF categories most relevant for patients in acute and post-acute rehabilitation (ICF Core Sets). Results Eighty-seven percent of ICF Core Set categories could be linked to goals of at least one nursing intervention variable of LEP. The ICF categories most frequently linked with LEP nursing interventions were respiration functions, experience of self and time functions and focusing attention. Thirteen percent of ICF Core Set categories could not be linked with LEP nursing interventions. The LEP nursing interventions which were linked with the highest number of different ICF-categories of all were "therapeutic intervention", "patient-nurse communication/information giving" and "mobilising". Conclusion The ICF Core Sets for the acute hospital and early post

  14. ICF-CY code set for infants with early delay and disabilities (EDD Code Set) for interdisciplinary assessment: a global experts survey.

    PubMed

    Pan, Yi-Ling; Hwang, Ai-Wen; Simeonsson, Rune J; Lu, Lu; Liao, Hua-Fang

    2015-01-01

    Comprehensive description of functioning is important in providing early intervention services for infants with developmental delay/disabilities (DD). A code set of the International Classification of Functioning, Disability and Health: Children and Youth Version (ICF-CY) could facilitate the practical use of the ICF-CY in team evaluation. The purpose of this study was to derive an ICF-CY code set for infants under three years of age with early delay and disabilities (EDD Code Set) for initial team evaluation. The EDD Code Set based on the ICF-CY was developed on the basis of a Delphi survey of international professionals experienced in implementing the ICF-CY and professionals in early intervention service system in Taiwan. Twenty-five professionals completed the Delphi survey. A total of 82 ICF-CY second-level categories were identified for the EDD Code Set, including 28 categories from the domain Activities and Participation, 29 from body functions, 10 from body structures and 15 from environmental factors. The EDD Code Set of 82 ICF-CY categories could be useful in multidisciplinary team evaluations to describe functioning of infants younger than three years of age with DD, in a holistic manner. Future validation of the EDD Code Set and examination of its clinical utility are needed. The EDD Code Set with 82 essential ICF-CY categories could be useful in the initial team evaluation as a common language to describe functioning of infants less than three years of age with developmental delay/disabilities, with a more holistic view. The EDD Code Set including essential categories in activities and participation, body functions, body structures and environmental factors could be used to create a functional profile for each infant with special needs and to clarify the interaction of child and environment accounting for the child's functioning.

  15. Toward the International Classification of Functioning, Disability and Health (ICF) Rehabilitation Set: A Minimal Generic Set of Domains for Rehabilitation as a Health Strategy.

    PubMed

    Prodinger, Birgit; Cieza, Alarcos; Oberhauser, Cornelia; Bickenbach, Jerome; Üstün, Tevfik Bedirhan; Chatterji, Somnath; Stucki, Gerold

    2016-06-01

    To develop a comprehensive set of the International Classification of Functioning, Disability and Health (ICF) categories as a minimal standard for reporting and assessing functioning and disability in clinical populations along the continuum of care. The specific aims were to specify the domains of functioning recommended for an ICF Rehabilitation Set and to identify a minimal set of environmental factors (EFs) to be used alongside the ICF Rehabilitation Set when describing disability across individuals and populations with various health conditions. Secondary analysis of existing data sets using regression methods (Random Forests and Group Lasso regression) and expert consultations. Along the continuum of care, including acute, early postacute, and long-term and community rehabilitation settings. Persons (N=9863) with various health conditions participated in primary studies. The number of respondents for whom the dependent variable data were available and used in this analysis was 9264. Not applicable. For regression analyses, self-reported general health was used as a dependent variable. The ICF categories from the functioning component and the EF component were used as independent variables for the development of the ICF Rehabilitation Set and the minimal set of EFs, respectively. Thirty ICF categories to be complemented with 12 EFs were identified as relevant to the identified ICF sets. The ICF Rehabilitation Set constitutes of 9 ICF categories from the component body functions and 21 from the component activities and participation. The minimal set of EFs contains 12 categories spanning all chapters of the EF component of the ICF. The identified sets proposed serve as minimal generic sets of aspects of functioning in clinical populations for reporting data within and across heath conditions, time, clinical settings including rehabilitation, and countries. These sets present a reference framework for harmonizing existing information on disability across

  16. A case study on the application of International Classification of Functioning, Disability and Health (ICF)-based tools for vocational rehabilitation in spinal cord injury.

    PubMed

    Glässel, Andrea; Rauch, Alexandra; Selb, Melissa; Emmenegger, Karl; Lückenkemper, Miriam; Escorpizo, Reuben

    2012-01-01

    Vocational rehabilitation (VR) plays a key role in bringing persons with acquired disabilities back to work, while encouraging employment participation. The purpose of this case study is to illustrate the systematic application of International Classification of Functioning, Disability, and Health (ICF)-based documentation tools by using ICF Core Sets in VR shown with a case example of a client with traumatic spinal cord injury (SCI). The client was a 26-year-old male with paraplegia (7th thoracic level), working in the past as a mover. This case study describes the integration of the ICF Core Sets for VR into an interdisciplinary rehabilitation program by using ICF-based documentation tools. Improvements in the client's impairments, activity limitations, and participation restrictions were observed following rehabilitation. Goals in different areas of functioning were achieved. The use of the ICF Core Sets in VR allows a comprehensive assessment of the client's level of functioning and intervention planning. Specifically, the Brief ICF Core Set in VR can provide domains for intervention relevant to each member of an interdisciplinary team and hence, can facilitate the VR management process in a SCI center in Switzerland.

  17. Conceptual Underpinnings of the Quality of Life in Neurological Disorders (Neuro-QoL): Comparisons of Core Sets for Stroke, Multiple Sclerosis, Spinal Cord Injury, and Traumatic Brain Injury.

    PubMed

    Wong, Alex W K; Lau, Stephen C L; Fong, Mandy W M; Cella, David; Lai, Jin-Shei; Heinemann, Allen W

    2018-04-03

    To determine the extent to which the content of the Quality of Life in Neurological Disorders (Neuro-QoL) covers the International Classification of Functioning, Disability and Health (ICF) Core Sets for multiple sclerosis (MS), stroke, spinal cord injury (SCI), and traumatic brain injury (TBI) using summary linkage indicators. Content analysis by linking content of the Neuro-QoL to corresponding ICF codes of each Core Set for MS, stroke, SCI, and TBI. Three academic centers. None. None. Four summary linkage indicators proposed by MacDermid et al were estimated to compare the content coverage between Neuro-QoL and the ICF codes of Core Sets for MS, stroke, MS, and TBI. Neuro-QoL represented 20% to 30% Core Set codes for different conditions in which more codes in Core Sets for MS (29%), stroke (28%), and TBI (28%) were covered than those for SCI in the long-term (20%) and early postacute (19%) contexts. Neuro-QoL represented nearly half of the unique Activity and Participation codes (43%-49%) and less than one third of the unique Body Function codes (12%-32%). It represented fewer Environmental Factors codes (2%-6%) and no Body Structures codes. Absolute linkage indicators found that at least 60% of Neuro-QoL items were linked to Core Set codes (63%-95%), but many items covered the same codes as revealed by unique linkage indicators (7%-13%), suggesting high concept redundancy among items. The Neuro-QoL links more closely to ICF Core Sets for stroke, MS, and TBI than to those for SCI, and primarily covers activity and participation ICF domains. Other instruments are needed to address concepts not measured by the Neuro-QoL when a comprehensive health assessment is needed. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  18. Investigating the International Classification of Functioning, Disability, and Health (ICF) Framework to Capture User Needs in the Concept Stage of Rehabilitation Technology Development.

    PubMed

    Sivan, Manoj; Gallagher, Justin; Holt, Ray; Weightman, Andy; Levesley, Martin; Bhakta, Bipin

    2014-01-01

    This study evaluates whether the International Classification of Functioning, Disability, and Health (ICF) framework provides a useful basis to ensure that key user needs are identified in the development of a home-based arm rehabilitation system for stroke patients. Using a qualitative approach, nine people with residual arm weakness after stroke and six healthcare professionals with expertise in stroke rehabilitation were enrolled in the user-centered design process. They were asked, through semi-structured interviews, to define the needs and specification for a potential home-based rehabilitation device to facilitate self-managed arm exercise. The topic list for the interviews was derived by brainstorming ideas within the clinical and engineering multidisciplinary research team based on previous experience and existing literature in user-centered design. Meaningful concepts were extracted from questions and responses of these interviews. These concepts obtained were matched to the categories within the ICF comprehensive core set for stroke using ICF linking rules. Most of the concepts extracted from the interviews matched to the existing ICF Core Set categories. Person factors like gender, age, interest, compliance, motivation, choice, and convenience that might determine device usability are yet to be categorized within the ICF comprehensive core set. The results suggest that the categories of the comprehensive ICF Core Set for stroke provide a useful basis for structuring interviews to identify most users needs. However some personal factors (related to end users and healthcare professionals) need to be considered in addition to the ICF categories.

  19. Towards system-wide implementation of the International Classification of Functioning, Disability and Health (ICF) in routine practice: Developing simple, intuitive descriptions of ICF categories in the ICF Generic and Rehabilitation Set.

    PubMed

    Prodinger, Birgit; Reinhardt, Jan D; Selb, Melissa; Stucki, Gerold; Yan, Tiebin; Zhang, Xia; Li, Jianan

    2016-06-13

    A national, multi-phase, consensus process to develop simple, intuitive descriptions of International Classification of Functioning, Disability and Health (ICF) categories contained in the ICF Generic and Rehabilitation Sets, with the aim of enhancing the utility of the ICF in routine clinical practice, is presented in this study. A multi-stage, national, consensus process was conducted. The consensus process involved 3 expert groups and consisted of a preparatory phase, a consensus conference with consecutive working groups and 3 voting rounds (votes A, B and C), followed by an implementation phase. In the consensus conference, participants first voted on whether they agreed that an initially developed proposal for simple, intuitive descriptions of an ICF category was in fact simple and intuitive. The consensus conference was held in August 2014 in mainland China. Twenty-one people with a background in physical medicine and rehabilitation participated in the consensus process. Four ICF categories achieved consensus in vote A, 16 in vote B, and 8 in vote C. This process can be seen as part of a larger effort towards the system-wide implementation of the ICF in routine clinical and rehabilitation practice to allow for the regular and comprehensive evaluation of health outcomes most relevant for the monitoring of quality of care.

  20. The ICF Core Sets for hearing loss--researcher perspective. Part I: Systematic review of outcome measures identified in audiological research.

    PubMed

    Granberg, Sarah; Dahlström, Jennie; Möller, Claes; Kähäri, Kim; Danermark, Berth

    2014-02-01

    To review the literature in order to identify outcome measures used in research on adults with hearing loss (HL) as part of the ICF Core Sets development project, and to describe study and population characteristics of the reviewed studies. A systematic review methodology was applied using multiple databases. A comprehensive search was conducted and two search pools were created, pool I and pool II. The study population included adults (≥ 18 years of age) with HL and oral language as the primary mode of communication. 122 studies were included. Outcome measures were distinguished by 'instrument type', and 10 types were identified. In total, 246 (pool I) and 122 (pool II) different measures were identified, and only approximately 20% were extracted twice or more. Most measures were related to speech recognition. Fifty-one different questionnaires were identified. Many studies used small sample sizes, and the sex of participants was not revealed in several studies. The low prevalence of identified measures reflects a lack of consensus regarding the optimal outcome measures to use in audiology. Reflections and discussions are made in relation to small sample sizes and the lack of sex differentiation/descriptions within the included articles.

  1. An International Clinical Study of Ability and Disability in Autism Spectrum Disorder Using the WHO-ICF Framework.

    PubMed

    Mahdi, Soheil; Albertowski, Katja; Almodayfer, Omar; Arsenopoulou, Vaia; Carucci, Sara; Dias, José Carlos; Khalil, Mohammad; Knüppel, Ane; Langmann, Anika; Lauritsen, Marlene Briciet; da Cunha, Graccielle Rodrigues; Uchiyama, Tokio; Wolff, Nicole; Selb, Melissa; Granlund, Mats; de Vries, Petrus J; Zwaigenbaum, Lonnie; Bölte, Sven

    2018-06-01

    This is the fourth international preparatory study designed to develop International Classification of Functioning, Disability and Health (ICF, and Children and Youth version, ICF-CY) Core Sets for Autism Spectrum Disorder (ASD). Examine functioning of individuals diagnosed with ASD as documented by the ICF-CY in a variety of clinical settings. A cross-sectional study was conducted, involving 11 units from 10 countries. Clinical investigators assessed functioning of 122 individuals with ASD using the ICF-CY checklist. In total, 139 ICF-CY categories were identified: 64 activities and participation, 40 body functions and 35 environmental factors. The study results reinforce the heterogeneity of ASD, as evidenced by the many functional and contextual domains impacting on ASD from a clinical perspective.

  2. Beyond diagnosis: the Core Sets for persons with schizophrenia based on the World Health Organization's International Classification of Functioning, Disability, and Health.

    PubMed

    Gómez-Benito, Juana; Guilera, Georgina; Barrios, Maite; Rojo, Emilio; Pino, Oscar; Gorostiaga, Arantxa; Balluerka, Nekane; Hidalgo, María Dolores; Padilla, José Luis; Benítez, Isabel; Selb, Melissa

    2017-07-30

    Based on the International Classification of Functioning, Disability and Health (ICF), this paper presents the results of the process to develop the Comprehensive and Brief Core Sets for schizophrenia that allow to comprehensively describe functioning in persons with schizophrenia. Twenty health professionals from diverse backgrounds participated in a formal and iterative decision-making process during an international consensus conference to develop these Core Sets. The conference was carried out based on evidence gathered from four preparatory studies (systematic literature review, qualitative study, expert survey, and empirical study). The first step of this decision-making and consensus process comprised of discussions and voting in working groups and plenary sessions to develop the comprehensive version. The categories of the Comprehensive ICF Core Set for schizophrenia served as the basis for the second step -a ranking and cutoff procedure to decide on the brief version. Of the 184 candidate categories identified in the preparatory studies, 97 categories were included in the Comprehensive Core Set for schizophrenia. A total of 25 categories were selected to constitute the Brief Core Set. The formal decision-making and consensus process integrating evidence from four preparatory studies and expert opinion led to the first version of the Core Sets for schizophrenia. Comprehensive and Brief Core Sets for schizophrenia may provide a common language among different health professionals and researchers, and a basic international standard of what to measure, report, and assess the functioning of persons with schizophrenia. Implications for rehabilitation Schizophrenia is a chronic mental disorder that has a tremendous impact on functioning and daily life of persons living with the disorder. The International Classification of Functioning, Disability and Health (ICF) offers an internationally recognized standard for describing the functioning status of these

  3. An international qualitative study of ability and disability in ADHD using the WHO-ICF framework.

    PubMed

    Mahdi, Soheil; Viljoen, Marisa; Massuti, Rafael; Selb, Melissa; Almodayfer, Omar; Karande, Sunil; de Vries, Petrus J; Rohde, Luis; Bölte, Sven

    2017-10-01

    This is the third in a series of four cross-cultural empirical studies designed to develop International Classification of Functioning, Disability and Health (ICF, and Children and Youth version, ICF(-CY) Core Sets for Attention-Deficit Hyperactivity Disorder (ADHD). To explore the perspectives of individuals diagnosed with ADHD, self-advocates, immediate family members and professional caregivers on relevant areas of impairment and functional abilities typical for ADHD across the lifespan as operationalized by the ICF(-CY). A qualitative study using focus group discussions or semi-structured interviews of 76 participants, divided into 16 stakeholder groups. Participants from five countries (Brazil, India, Saudi Arabia, South Africa and Sweden) were included. A deductive qualitative content analysis was conducted to extract meaningful functioning and disability concepts from verbatim material. Extracted concepts were then linked to ICF(-CY) categories by independent researchers using a standardized linking procedure. In total, 82 ICF(-CY) categories were identified, of which 32 were related to activities and participation, 25 to environmental factors, 23 to body functions and 2 to body structures. Participants also provided opinions on experienced positive sides to ADHD. A high level of energy and drive, creativity, hyper-focus, agreeableness, empathy, and willingness to assist others were the most consistently reported strengths associated with ADHD. Stakeholder perspectives highlighted the need to appraise ADHD in a broader context, extending beyond diagnostic criteria into many areas of ability and disability as well as environmental facilitators and barriers. This qualitative study, along with three other studies (comprehensive scoping review, expert survey and clinical study), will provide the scientific basis to define ICF(-CY) Core Sets for ADHD, from which assessment tools can be derived for use in clinical and research setting, as well as in health care

  4. The selection of core International Classification of Functioning, Disability, and Health (ICF) categories for patient-reported outcome measurement in spine trauma patients-results of an international consensus process.

    PubMed

    Sadiqi, Said; Lehr, A Mechteld; Post, Marcel W; Jacobs, Wilco C H; Aarabi, Bizhan; Chapman, Jens R; Dunn, Robert N; Dvorak, Marcel F; Fehlings, Michael G; Rajasekaran, S; Vialle, Luiz R; Vaccaro, Alexander R; Oner, F Cumhur

    2016-08-01

    list of ICF categories presented at the consensus conference included 159 different ICF categories. Based on voting and discussion, 11 experts from 6 countries selected a total of 25 ICF categories as core categories for patient-reported outcome measurement in adult traumatic spinal column injury patients (9 body functions, 14 activities and participation, and 2 environmental factors). The experts also agreed to use the Numeric Rating Scale 0-100 as response scale in the future universal outcome instrument. A formal consensus process integrating evidence and expert opinion led to a set of 25 core ICF categories for patient-reported outcome measurement in adult traumatic spinal column injury patients, as well as the response scale for use in the future universal disease-specific outcome instrument. The adopted core ICF categories could also serve as a benchmark for assessing the content validity of existing and future outcome instruments used in this specific patient population. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Health measurement using the ICF: Test-retest reliability study of ICF codes and qualifiers in geriatric care

    PubMed Central

    Okochi, Jiro; Utsunomiya, Sakiko; Takahashi, Tai

    2005-01-01

    Background The International Classification of Functioning, Disability and Health (ICF) was published by the World Health Organization (WHO) to standardize descriptions of health and disability. Little is known about the reliability and clinical relevance of measurements using the ICF and its qualifiers. This study examines the test-retest reliability of ICF codes, and the rate of immeasurability in long-term care settings of the elderly to evaluate the clinical applicability of the ICF and its qualifiers, and the ICF checklist. Methods Reliability of 85 body function (BF) items and 152 activity and participation (AP) items of the ICF was studied using a test-retest procedure with a sample of 742 elderly persons from 59 institutional and at home care service centers. Test-retest reliability was estimated using the weighted kappa statistic. The clinical relevance of the ICF was estimated by calculating immeasurability rate. The effect of the measurement settings and evaluators' experience was analyzed by stratification of these variables. The properties of each item were evaluated using both the kappa statistic and immeasurability rate to assess the clinical applicability of WHO's ICF checklist in the elderly care setting. Results The median of the weighted kappa statistics of 85 BF and 152 AP items were 0.46 and 0.55 respectively. The reproducibility statistics improved when the measurements were performed by experienced evaluators. Some chapters such as genitourinary and reproductive functions in the BF domain and major life area in the AP domain contained more items with lower test-retest reliability measures and rated as immeasurable than in the other chapters. Some items in the ICF checklist were rated as unreliable and immeasurable. Conclusion The reliability of the ICF codes when measured with the current ICF qualifiers is relatively low. The result in increase in reliability according to evaluators' experience suggests proper education will have positive

  6. Comparing contents of outcome measures in cerebral palsy using the International Classification of Functioning (ICF-CY): a systematic review.

    PubMed

    Schiariti, Veronica; Klassen, Anne F; Cieza, Alarcos; Sauve, Karen; O'Donnell, Maureen; Armstrong, Robert; Mâsse, Louise C

    2014-01-01

    The International Classification of Functioning children and youth version (ICF-CY) provides a universal framework for defining and classifying functioning and disability in children worldwide. To facilitate the application of the ICF in practice, ICF based-tools like the "ICF Core Sets" are being developed. In the context of the development of the ICF-CY Core Sets for children with Cerebral Palsy (CP), the aims of this study were as follows: to identify and compare the content of outcome measures used in studies of children with CP using the ICF-CY coding system; and to describe the most frequently addressed areas of functioning in those studies. We searched multiple databases likely to capture studies involving children with CP from January 1998 to March 2012. We included all English language articles that studied children aged 2-18 years and described an interventional or observational study. Constructs of the outcome measures identified in studies were linked to the ICF-CY by two trained professionals. We found 231 articles that described 238 outcome measures. The outcome measures contained 2193 concepts that were linked to the ICF-CY and covered 161 independent ICF-CY categories. Out of the 161 categories, 53 (33.5%) were related to body functions, 75 (46%) were related to activities/participation, 26 (16.1%) were related to environmental factors, and 7 (4.3%) were related to body structures. This systematic review provides information about content of measures that may guide researchers and clinicians in their selection of an outcome measure for use in a study and/or clinical practice with children with CP. Copyright © 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  7. The impact of age and gender on the ICF-based assessment of chronic low back pain.

    PubMed

    Fehrmann, Elisabeth; Kotulla, Simone; Fischer, Linda; Kienbacher, Thomas; Tuechler, Kerstin; Mair, Patrick; Ebenbichler, Gerold; Paul, Birgit

    2018-01-12

    To evaluate the impact of age and gender on the international classification of functioning, disability and health (ICF)-based assessment for chronic low back pain. Two hundred forty-four chronic low back pain patients (52% female) with a mean age of 49 years (SD =17.64) were interviewed with the comprehensive ICF core set for activities and participation, and environmental factors. After conducting explorative factor analysis, the impact of age and gender on the different factors was analyzed using analyzes of variances. Results revealed that older patients experienced more limitations within "self-care and mobility" and "walking" but less problems with "transportation" compared to younger patients. Older or middle-aged low back pain patients further perceived more facilitation through "architecture and products for communication", "health services", and "social services and products for mobility" than younger patients. Regarding gender differences, women reported more restriction in "housework" than men. An interaction effect between age and gender was found for "social activities and recreation" with young male patients reporting the highest impairment. The study demonstrated that the comprehensive ICF core set classification for chronic low back pain is influenced by age and gender. This impact is relevant for ICF-based assessments in clinical practice, and should be considered in intervention planning for rehabilitative programs. Implications for rehabilitation It is important to consider age and gender differences when classifying with the ICF. The intervention planning based on the ICF should focus on improvement of bodily functioning and mobility in older patients, facilitation of household activities in women, consideration of work-life balance and recreation (e.g., through mindfulness based stress reduction), and reduction of dissatisfaction with rehabilitation in younger patients. It is important to offer patients the opportunity to participate in

  8. Identification of relevant ICF categories for indication, intervention planning and evaluation of health resort programs: a Delphi exercise

    NASA Astrophysics Data System (ADS)

    Morita, E.; Weigl, M.; Schuh, A.; Stucki, G.

    2006-01-01

    Health resort programs have a long tradition, mainly in European countries and Japan. They rely on local resources and the physical environment, physical medicine interventions and traditional medicine to optimise functioning and health. Arguably because of the long tradition, there is only a limited number of high-quality studies that examine the effectiveness of health resort programs. Specific challenges to the evaluation of health resort programs are to randomise the holistic approach with a varying number of specific interventions but also the reliance on the effect of the physical environment. Reference standards for the planning and reporting of health resort studies would be highly beneficial. With the International Classification of Functioning Disability and Health (ICF), we now have such a standard that allows us to describe body functions and structures, activities and participation and interaction with environmental factors. A major challenge when applying the ICF in practice is its length. Therefore, the objective of this project was to identify the ICF categories most relevant for health resort programs. We conducted a consensus-building, three-round, e-mail survey using the Delphi technique. Based on the consensus of the experts, it was possible to come up with an ICF Core Set that can serve as reference standards for the indication, intervention planning and evaluation of health resort programs. This preliminary ICF Core Set should be tested in different regions and in subsets of health resort visitors with varying conditions.

  9. Multiprofessional evaluation in clinical practice: establishing a core set of outcome measures for children with cerebral palsy.

    PubMed

    Mäenpää, Helena; Autti-Rämö, Ilona; Varho, Tarja; Forsten, Wivi; Haataja, Leena

    2017-03-01

    To develop a national consensus on outcome measures that define functional ability in children with cerebral palsy (CP) according to the International Classification of Functioning, Disability and Health (ICF) framework. The project started in 2008 in neuropaediatric units of two university hospitals and one outpatient clinic. Each professional group selected representatives to be knowledge brokers for their own specialty. Based on the evidence, expert opinion, and the ICF framework, multiprofessional teams selected the most valid measures used in clinical practice (2009-2010). Data from 269 children with CP were analysed, classified by the Gross Motor Function Classification System, Manual Ability Classification System, and Communication Function Classification System, and evaluated. The process aimed at improving and unifying clinical practice in Finland through a national consensus on the core set of measures. The selected measures were presented by professional groups, and consensus was reached on the recommended core set of measures to be used in all hospitals treating children with CP in Finland. A national consensus on relevant and feasible measures is essential for identifying differences in the effectiveness of local practices, and for conducting multisite intervention studies. This project showed that multiprofessional rehabilitation practices can be improved through respect for and inclusion of everyone involved. © 2016 Mac Keith Press.

  10. Goals Set by Patients Using the ICF Model before Receiving Botulinum Injections and Their Relation to Spasticity Distribution

    PubMed Central

    Choi, Kevin; Peters, Jaclyn; Tri, Andrew; Chapman, Elizabeth; Sasaki, Ayako; Ismail, Farooq; Boulias, Chris; Reid, Shannon

    2017-01-01

    Purpose: Goal Attainment Scaling (GAS) is used to assess functional gains in response to treatment. Specific characteristics of the functional goals set by individuals receiving botulinum toxin type A (BoNTA) injections for spasticity management are unknown. The primary objectives of this study were to describe the characteristics of the goals set by patients before receiving BoNTA injections using the International Classification of Functioning, Disability and Health (ICF) and to determine whether the pattern of spasticity distribution affected the goals set. Methods: A cross-sectional retrospective chart review was carried out in an outpatient spasticity-management clinic in Toronto. A total of 176 patients with a variety of neurological lesions attended the clinic to receive BoNTA injections and completed GAS from December 2012 to December 2013. The main outcome measures were the characteristics of the goals set by the participants on the basis of ICF categories (body functions and structures, activity and participation) and the spasticity distribution using Modified Ashworth Scale scores. Results: Of the patients, 73% set activity and participation goals, and 27% set body functions and structures goals (p<0.05). In the activity and participation category, 30% of patients set moving and walking goals, 28% set self-care and dressing goals, and 12% set changing and maintaining body position goals. In the body functions and structures category, 18% set neuromuscular and movement-related goals, and 8% set pain goals. The ICF goal categories were not related to the patterns of spasticity (upper limb vs. lower limb or unilateral vs. bilateral spasticity) or type of upper motor neuron (UMN) lesion (p>0.05). Conclusion: Our results show that patients receiving BoNTA treatment set a higher percentage of activity and participation goals than body functions and structures goals. Goal classification was not affected by type of spasticity distribution or type of UMN disorder

  11. A comprehensive scoping review of ability and disability in ADHD using the International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY).

    PubMed

    de Schipper, Elles; Lundequist, Aiko; Wilteus, Anna Löfgren; Coghill, David; de Vries, Petrus J; Granlund, Mats; Holtmann, Martin; Jonsson, Ulf; Karande, Sunil; Levy, Florence; Al-Modayfer, Omar; Rohde, Luis; Tannock, Rosemary; Tonge, Bruce; Bölte, Sven

    2015-08-01

    This is the first in a series of four empirical investigations to develop International Classification of Functioning, Disability and Health (ICF) Core Sets for Attention Deficit Hyperactivity Disorder (ADHD). The objective here was to use a comprehensive scoping review approach to identify the concepts of functional ability and disability used in the scientific ADHD literature and link these to the nomenclature of the ICF-CY. Systematic searches were conducted using Medline/PubMed, PsycINFO, ERIC and Cinahl, to extract the relevant concepts of functional ability and disability from the identified outcome studies of ADHD. These concepts were then linked to ICF-CY by two independent researchers using a standardized linking procedure. Data from identified studies were analysed until saturation of ICF-CY categories was reached. Eighty studies were included in the final analysis. Concepts contained in these studies were linked to 128 ICF-CY categories. Of these categories, 68 were considered to be particularly relevant to ADHD (i.e., identified in at least 5 % of the studies). Of these, 32 were related to Activities and participation, 31 were related to Body functions, and five were related to environmental factors. The five most frequently identified categories were school education (53 %), energy and drive functions (50 %), psychomotor functions (50 %), attention functions (49 %), and emotional functions (45 %). The broad variety of ICF-CY categories identified in this study underlines the necessity to consider ability and disability in ADHD across all dimensions of life, for which the ICF-CY provides a valuable and universally applicable framework. These results, in combination with three additional preparatory studies (expert survey, focus groups, clinical study), will provide a scientific basis to define the ICF Core Sets for ADHD for multi-purpose use in basic and applied research, and every day clinical practice.

  12. Can we decide which outcomes should be measured in every clinical trial? A scoping review of the existing conceptual frameworks and processes to develop core outcome sets.

    PubMed

    Idzerda, Leanne; Rader, Tamara; Tugwell, Peter; Boers, Maarten

    2014-05-01

    The usefulness of randomized control trials to advance clinical care depends upon the outcomes reported, but disagreement on the choice of outcome measures has resulted in inconsistency and the potential for reporting bias. One solution to this problem is the development of a core outcome set: a minimum set of outcome measures deemed critical for clinical decision making. Within rheumatology the Outcome Measures in Rheumatology (OMERACT) initiative has pioneered the development of core outcome sets since 1992. As the number of diseases addressed by OMERACT has increased and its experience in formulating core sets has grown, clarification and update of the conceptual framework and formulation of a more explicit process of area/domain core set development has become necessary. As part of the update process of the OMERACT Filter criteria to version 2, a literature review was undertaken to compare and contrast the OMERACT conceptual framework with others within and outside rheumatology. A scoping search was undertaken to examine the extent, range, and nature of conceptual frameworks for core set outcome selection in health. We searched the following resources: Cochrane Library Methods Group Register; Medline; Embase; PsycInfo; Environmental Studies and Policy Collection; and ABI/INFORM Global. We also conducted a targeted Google search. Five conceptual frameworks were identified: the WHO tripartite definition of health; the 5 Ds (discomfort, disability, drug toxicity, dollar cost, and death); the International Classification of Functioning (ICF); PROMIS (Patient-Reported Outcomes Measurement System); and the Outcomes Hierarchy. Of these, only the 5 Ds and ICF frameworks have been systematically applied in core set development. Outside the area of rheumatology, several core sets were identified; these had been developed through a limited range of consensus-based methods with varying degrees of methodological rigor. None applied a framework to ensure content validity of

  13. Content comparison of haemophilia specific patient-rated outcome measures with the international classification of functioning, disability and health (ICF, ICF-CY)

    PubMed Central

    2010-01-01

    Background Patient-Reported Outcomes (PROs) are considered important outcomes because they reflect the patient's experience in clinical trials. PROs have been included in the field of haemophilia only recently. Purpose Comparing the contents of PROs measures used in haemophilia, based on the ICF/ICF-CY as frame of reference. Methods Haemophilia-specific PROs for adults and children were selected on the grounds of international accessibility. The content of the selected instruments were examined by linking the concepts within the items of these instruments to the ICF/ICF-CY. Results Within the 5 selected instruments 365 concepts were identified, of which 283 concepts were linked to the ICF/ICF CY and mapped into 70 different categories. The most frequently used categories were "b152: Emotional functions" and "e1101: Drugs". Conclusions The present paper provides an overview on current PROs in haemophilia and facilitates the selection of appropriate instruments for specific purposes in clinical and research settings. This work was made possible by the grant of the European Murinet Project (Multidisciplinary Research Network on Health and Disability in Europe). PMID:21108796

  14. ICF-CY: A Universal Tool for Documentation of Disability

    ERIC Educational Resources Information Center

    Simeonsson, Rune J.

    2009-01-01

    The "International Classification of Functioning, Disability and Health--ICF" (ICF-CY) conceptual framework offers a new paradigm and taxonomy of human functioning disability, which can be used to guide holistic and interdisciplinary approaches to assessment and intervention. In settings serving children, youth, or adults with disabilities, the…

  15. Health promotion and education: application of the ICF in the US and Canada using an ecological perspective.

    PubMed

    Howard, David; Nieuwenhuijsen, Els R; Saleeby, Patricia

    2008-01-01

    Health promotion is an issue comprised of complex and multi-layered concepts that involves a process of enabling people to increase control over and improve their health. The aims and applications of the World Health Organization's International Classification of Functioning, Disability and Health (ICF), with its focus on components of functioning, activities and participation, and environmental factors are salient to health promotion and health education efforts. For individuals with or without disabilities, health promotion occurs within the community in which they reside and is influenced by a complex interaction of personal and environmental factors. The aim of this paper is to discuss how the ICF can be useful in enhancing social change through health promotion and health education for all people, in particular those with disabilities and chronic conditions. In doing so health promotion concepts and the ecological approach linked with the ICF, the relationship of social change and social support to the ICF, the potential role of the ICF for national and local (city) policies, and the role of health professionals in this process will be examined. Building on this body of knowledge, the authors recommend that future research should focus on the relationship between policies and the social participation of people with disabilities in the community, the use of ICF measurement tools to improve the indicators established by the National Organization on Disability, the development of a new ICF core set for community accessibility and inclusion, better interventions to enhance social support, and enhancing the role of professionals in health promotion for people with disabilities or chronic health conditions.

  16. Using the International Classification of Functioning, Disability and Health (ICF) to Describe Children Referred to Special Care or Paediatric Dental Services

    PubMed Central

    Faulks, Denise; Norderyd, Johanna; Molina, Gustavo; Macgiolla Phadraig, Caoimhin; Scagnet, Gabriela; Eschevins, Caroline; Hennequin, Martine

    2013-01-01

    Children in dentistry are traditionally described in terms of medical diagnosis and prevalence of oral disease. This approach gives little information regarding a child’s capacity to maintain oral health or regarding the social determinants of oral health. The biopsychosocial approach, embodied in the International Classification of Functioning, Disability and Health - Child and Youth version (ICF-CY) (WHO), provides a wider picture of a child’s real-life experience, but practical tools for the application of this model are lacking. This article describes the preliminary empirical study necessary for development of such a tool - an ICF-CY Core Set for Oral Health. An ICF-CY questionnaire was used to identify the medical, functional, social and environmental context of 218 children and adolescents referred to special care or paediatric dental services in France, Sweden, Argentina and Ireland (mean age 8 years ±3.6yrs). International Classification of Disease (ICD-10) diagnoses included disorders of the nervous system (26.1%), Down syndrome (22.0%), mental retardation (17.0%), autistic disorders (16.1%), and dental anxiety alone (11.0%). The most frequently impaired items in the ICF Body functions domain were ‘Intellectual functions’, ‘High-level cognitive functions’, and ‘Attention functions’. In the Activities and Participation domain, participation restriction was frequently reported for 25 items including ‘Handling stress’, ‘Caring for body parts’, ‘Looking after one’s health’ and ‘Speaking’. In the Environment domain, facilitating items included ‘Support of friends’, ‘Attitude of friends’ and ‘Support of immediate family’. One item was reported as an environmental barrier – ‘Societal attitudes’. The ICF-CY can be used to highlight common profiles of functioning, activities, participation and environment shared by children in relation to oral health, despite widely differing medical, social and geographical

  17. Using the International Classification of Functioning, Disability and Health (ICF) to describe children referred to special care or paediatric dental services.

    PubMed

    Faulks, Denise; Norderyd, Johanna; Molina, Gustavo; Macgiolla Phadraig, Caoimhin; Scagnet, Gabriela; Eschevins, Caroline; Hennequin, Martine

    2013-01-01

    Children in dentistry are traditionally described in terms of medical diagnosis and prevalence of oral disease. This approach gives little information regarding a child's capacity to maintain oral health or regarding the social determinants of oral health. The biopsychosocial approach, embodied in the International Classification of Functioning, Disability and Health - Child and Youth version (ICF-CY) (WHO), provides a wider picture of a child's real-life experience, but practical tools for the application of this model are lacking. This article describes the preliminary empirical study necessary for development of such a tool - an ICF-CY Core Set for Oral Health. An ICF-CY questionnaire was used to identify the medical, functional, social and environmental context of 218 children and adolescents referred to special care or paediatric dental services in France, Sweden, Argentina and Ireland (mean age 8 years ± 3.6 yrs). International Classification of Disease (ICD-10) diagnoses included disorders of the nervous system (26.1%), Down syndrome (22.0%), mental retardation (17.0%), autistic disorders (16.1%), and dental anxiety alone (11.0%). The most frequently impaired items in the ICF Body functions domain were 'Intellectual functions', 'High-level cognitive functions', and 'Attention functions'. In the Activities and Participation domain, participation restriction was frequently reported for 25 items including 'Handling stress', 'Caring for body parts', 'Looking after one's health' and 'Speaking'. In the Environment domain, facilitating items included 'Support of friends', 'Attitude of friends' and 'Support of immediate family'. One item was reported as an environmental barrier - 'Societal attitudes'. The ICF-CY can be used to highlight common profiles of functioning, activities, participation and environment shared by children in relation to oral health, despite widely differing medical, social and geographical contexts. The results of this empirical study might

  18. Plasma photonics in ICF & HED conditions

    NASA Astrophysics Data System (ADS)

    Michel, Pierre; Turnbull, David; Divol, Laurent; Pollock, Bradley; Chen, Cecilia Y.; Tubman, Eleanor; Goyon, Clement S.; Moody, John D.

    2015-11-01

    Interactions between multiple high-energy laser beams and plasma can be used to imprint refractive micro-structures in plasmas via the lasers' ponderomotive force. For example, Inertial confinement fusion (ICF) experiments at the National Ignition Facility already rely on the use of plasma gratings to redirect laser light inside an ICF target and tune the symmetry of the imploded core. More recently, we proposed new concepts of plasma polarizer and waveplate, based on two-wave mixing schemes and laser-induced plasma birefringence. In this talk, we will present new experimental results showing the first demonstration of a fully tunable plasma waveplate, which achieved near-perfect circular laser polarization. We will discuss further prospects for novel ``plasma photonics'' concepts based on two- and four-wave mixing, such as optical switches, bandpass filters, anti-reflection blockers etc. These might find applications in ICF and HED experiments by allowing to manipulate the lasers directly in-situ (i.e. inside the targets), as well as for the design of high power laser systems. This work was performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344.

  19. Choice-making among Medicaid HCBS and ICF/MR recipients in six states.

    PubMed

    Lakin, K Charlie; Doljanac, Robert; Byun, Soo-Yong; Stancliffe, Roger; Taub, Sarah; Chiri, Giuseppina

    2008-09-01

    Choice in everyday decisions and in support-related decisions was addressed among 2,398 adults with intellectual and developmental disabilities receiving Medicaid Home and Community Based Services (HCBS) and Intermediate Care Facility (ICF/MR) services and living in non family settings in six states. Everyday choice in daily life and in support-related choice was considerably higher on average for HCBS than for ICF/MR recipients, but after controlling for level of intellectual disability, medical care needs, mobility, behavioral and psychiatric conditions, and self-reporting, we found that choice was more strongly associated with living in a congregate setting than whether that setting was HCBS- or ICF/MR-financed. Marked differences in choice were also evident between states.

  20. Assessment of functional outcomes in patients with head and neck cancer according to the International Classification of Functioning, Disability and Health Core Sets from the perspective of the multi-professional team: results of 4 Delphi surveys.

    PubMed

    Kirschneck, Michaela; Sabariego, Carla; Singer, Susanne; Tschiesner, Uta

    2014-07-01

    The International Classification of Functioning, Disability and Health Core Set for Head and Neck Cancer (ICF-HNC) covers the typical spectrum of problems in functioning in head and neck cancer. This study is part of a multistep process to develop practical guidelines in Germany. The purpose of this study was to identify instruments for the assessment of functioning using the ICF-HNC as reference. Four Delphi surveys with physicians, physiotherapists, psychologists, and social workers were performed to identify which aspects of the ICF-HNC are being treated and which assessment tools are recommended for the assessment of functioning. Ninety-seven percent categories of the ICF-HNC were treated by healthcare professionals participating in the current study. Altogether, 33 assessment tools were recommended for therapy monitoring, food intake, pain, further organic problems/laboratory tests, and psychosocial areas. Although the ICF-HNC is being currently implemented by the head and neck cancer experts, several areas are not covered regularly. Additionally, validated tools were rarely recommended. Copyright © 2013 Wiley Periodicals, Inc.

  1. Comparison of subjective and objective assessments of outcome after traumatic brain injury using the International Classification of Functioning, Disability and Health (ICF).

    PubMed

    Koskinen, Sanna; Hokkinen, Eeva-Maija; Wilson, Lindsay; Sarajuuri, Jaana; Von Steinbüchel, Nicole; Truelle, Jean-Luc

    2011-01-01

    The aim is to examine two aspects of outcome after traumatic brain injury (TBI). Functional outcome was assessed by the Glasgow Outcome Scale - Extended (GOSE) and by clinician ratings, while health-related quality of life (HRQoL) was assessed by the Quality of Life after Brain Injury (QOLIBRI). The GOSE and the QOLIBRI were linked to the International Classification of Functioning, Disability and Health (ICF) to analyse their content. Functional outcome on ICF categories was assessed by rehabilitation clinicians in 55 participants with TBI and was compared to the participants' own judgements of their HRQoL. The QOLIBRI was linked to 42 and the GOSE to 57 two-level ICF categories covering 78% of the categories on the ICF brief core set for TBI. The closest agreement in the views of the professionals and the participants was found on the Physical Problems and Cognition scales of the QOLIBRI. The problems encountered after TBI are well covered by the QOLIBRI and the GOSE. They capture important domains that are not traditionally sufficiently documented, especially in the domains of interpersonal relationships, social and leisure activities, self and the environment. The findings indicate that they are useful and complementary outcome measures for TBI. In rehabilitation, they can serve as tools in assessment, setting meaningful goals and creating therapeutic alliance.

  2. ICF Annual Report 1997

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

    Correll, D

    The continuing objective of Lawrence Livermore National Laboratory's (LLNL's) Inertial Confinement Fusion (ICF) Program is the demonstration of thermonuclear fusion ignition and energy gain in the laboratory and to support the nuclear weapons program in its use of ICF facilities. The underlying theme of all ICF activities as a science research and development program is the Department of Energy's (DOE's) Defense Programs (DP) science-based Stockpile Stewardship Program (SSP). The mission of the US Inertial Fusion Program is twofold: (1) to address high-energy-density physics issues for the SSP and (2) to develop a laboratory microfusion capability for defense and energy applications.more » In pursuit of this mission, the ICF Program has developed a state-of-the-art capability to investigate high-energy-density physics in the laboratory. The near-term goals pursued by the ICF Program in support of its mission are demonstrating fusion ignition in the laboratory and expanding the Program's capabilities in high-energy-density science. The National Ignition Facility (NIF) project is a cornerstone of this effort.« less

  3. Engaging with clinicians to implement and evaluate the ICF in neurorehabilitation practice.

    PubMed

    Tempest, Stephanie; Jefferson, Richard

    2015-01-01

    Although deemed a globally accepted framework, there remains scare evidence on the process and outcome of implementing the International Classification of Functioning, Disability and Health (ICF) within neurorehabilitation. This review briefly explores the existing, broader literature and then reports on two action research projects, undertaken in England, specifically within stroke and neurorehabilitation. Working with participants, including clinicians from in-patient and community settings, there are now 35 different ways identified for the use of the ICF. The outcome of the first project highlights that using the ICF enhances communication within and beyond the acute stroke service, fosters holistic thinking and clarifies team roles. To adopt it into clinical practice, the ICF must be adapted to meet local service needs. The use of action research has facilitated the knowledge translation process which has enabled the ICF to become a clinical reality in neurorehabilitation, with clinicians identifying a range of potential uses.

  4. Type C investigation of electrical fabrication projects in ICF Kaiser shops

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

    Huckfeldt, R.A.

    1995-06-01

    A Type C Investigation Board was convened to investigate an electrical miswiring problem found during the operation of the electrical distribution trailer for the TWRS Rotary Mode Core Sampling Truck {number_sign}2. The trailer was designed by WHC and fabricated ICF KH on site for use in the Characterization Program. This problem resulted in a serious safety hazard since the support truck frame/chassis became electrically energized. This final report provides results of the ``Type C Investigation, Electrical Fabrication Projects in ICF KH Shops, June, 1995.`` It contains the investigation scope, executive summary, relevant facts, analysis, conclusions and corrective actions. DOE Ordermore » 5484.1, ``Environmental Protection, Safety and Health Protection Information Reporting Requirements,`` was followed in preparation of this report. Because the incident was electrical in nature and involved both Westinghouse Hanford Company and ICF Kaiser Hanford organizations, the board included members from both contractors and members with considerable electrical expertise.« less

  5. The ICF has made a difference to functioning and disability measurement and statistics.

    PubMed

    Madden, Rosamond H; Bundy, Anita

    2018-02-12

    Fifteen years after the publication of the International Classification of Functioning, Disability and Health (ICF), we investigated: How ICF applications align with ICF aims, contents and principles, and how the ICF has been used to improve measurement of functioning and related statistics. In a scoping review, we investigated research published 2001-2015 relating to measurement and statistics for evidence of: a change in thinking; alignment of applications with ICF specifications and philosophy; and the emergence of new knowledge. The ICF is used in diverse applications, settings and countries, with processes largely aligned with the ICF and intended to improve measurement and statistics: new national surveys, information systems and ICF-based instruments; and international efforts to improve disability data. Knowledge is growing about the components and interactions of the ICF model, the diverse effects of the environment on functioning, and the meaning and measurement of participation. The ICF provides specificity and a common language in the complex world of functioning and disability and is stimulating new thinking, new applications in measurement and statistics, and the assembling of new knowledge. Nevertheless, the field needs to mature. Identified gaps suggest ways to improve measurement and statistics to underpin policies, services and outcomes. Implications for Rehabilitation The ICF offers a conceptualization of functioning and disability that can underpin assessment and documentation in rehabilitation, with a growing body of experience to draw on for guidance. Experience with the ICF reminds practitioners to consider all the domains of participation, the effect of the environment on participation and the importance of involving clients/patients in assessment and service planning. Understanding the variability of functioning within everyday environments and designing interventions for removing barriers in various environments is a vital part of

  6. Using the WHO-ICF with talking mats to enable adults with long-term communication difficulties to participate in goal setting.

    PubMed

    Murphy, Joan; Boa, Sally

    2012-03-01

    The World Health Organization International Classification of Functioning, Disability and Health (WHO-ICF) provides a framework that helps rehabilitation staff to take a holistic view of the patient. However, it is used predominantly by professionals rather than by active participation on behalf of the person with the disability. In addition, the language used within the framework can be difficult for patients to understand. In order to address these issues the Activities and Participation section of the ICF has been adapted by using graphic symbols. It has been used in conjunction with Talking Mats(™ 1 ), a low-tech communication framework, to help adults with long-term conditions participate in goal setting. This paper describes how this was done and provides examples from clinical practice. The paper discusses how this combined framework can empower people with communication difficulties and long-term conditions to become active participants in the rehabilitation process by identifying their own goals, indicating changing priorities and tracking their progress.

  7. The ICF-CY and Goal Attainment Scaling: benefits of their combined use for pediatric practice.

    PubMed

    McDougall, Janette; Wright, Virginia

    2009-01-01

    There is much heterogeneity and disconnect in the approaches used by service providers to conduct needs assessments, set goals and evaluate outcomes for clients receiving pediatric rehabilitation services. The purpose of this article is to describe how the International Classification of Functioning, Disability and Health-Child and Youth (ICF-CY) can be used in combination with Goal Attainment Scaling (GAS), an individualised measure of change, to connect the various phases of the therapeutic process to provide consistent clinical care that is family-centred, collaborative, well directed and accountable. A brief description of both the ICF-CY and GAS as they pertain to pediatric rehabilitation is provided as background. An explanation is given of how the ICF-CY offers a framework through which clients, families and service providers can together identify the areas of clients' needs. In addition, the article discusses how the use of GAS facilitates translation of clients' identified needs into distinct, measurable goals set collaboratively by clients, their families and service providers. Examples of integrated GAS goals set for the various components of the ICF-CY are provided. The utility of GAS as a measure of clinical outcomes for individual clients is also discussed. Used in combination, the ICF-CY and GAS can serve to coordinate, simplify and standardise assessment and outcome evaluation practices for individual clients receiving pediatric rehabilitation services.

  8. Fluorescence and absorption spectroscopy for warm dense matter studies and ICF plasma diagnostics

    NASA Astrophysics Data System (ADS)

    Hansen, Stephanie

    2017-10-01

    The burning core of an inertial confinement fusion (ICF) plasma at stagnation is surrounded by a shell of warm, dense matter whose properties are difficult both to model (due to a complex interplay of thermal, degeneracy, and strong coupling effects) and to diagnose (due to low emissivity and high opacity). We demonstrate a promising technique to study the warm dense shells of ICF plasmas based on the fluorescence emission of dopants or impurities in the shell material. This emission, which is driven by x-rays produced in the hot core, exhibits signature changes in response to compression and heating. High-resolution measurements of absorption and fluorescence features can refine our understanding of the electronic structure of material under high compression, improve our models of density-driven phenomena such as ionization potential depression and plasma polarization shifts, and help diagnose shell density, temperature, mass distribution, and residual motion in ICF plasmas at stagnation. Sandia National Laboratories is a multi-mission laboratory managed and operated by National Technology and Engineering Solutions of Sandia, LLC., a wholly owned subsidiary of Honeywell International, Inc., for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-NA-0003525. This work was supported by the U.S. Department of Energy, Office of Science Early Career Research Program, Office of Fusion Energy Sciences under FWP-14-017426.

  9. Exploring use of the ICF in health education.

    PubMed

    Bornbaum, Catherine C; Day, Adam M B; Izaryk, Kristen; Morrison, Stephanie J; Ravenek, Michael J; Sleeth, Lindsay E; Skarakis-Doyle, Elizabeth

    2015-01-01

    Currently, little is known regarding use of the International Classification of Functioning, Disability and Health (ICF) in health education applications. Therefore, this review sought to examine the scope of work that has been conducted regarding the application of the ICF in health education. A review of the current literature related to use of the ICF in health education programs was conducted. Twelve electronic databases were searched in accordance with a search protocol developed by a health sciences librarian. In total, 17,878 records were reviewed, and 18 articles met the criteria for inclusion in this review. Current evidence regarding use of the ICF in healthcare education revealed that program and participant properties can be essential facilitators or barriers to successful education programs. In addition, gaps in comprehensive outcome measurement were revealed as areas for future attention. Educational applications of the ICF are very much a work in progress as might be expected given the ICF's existence for only a little over a decade. To advance use of the ICF in education, it is important to incorporate the measurement of both knowledge acquisition and behavior change related to ICF-based programs. Ultimately, widespread implementation of the ICF represents not only a substantial opportunity but also poses a significant challenge.

  10. Which outcomes are most important to people with aphasia and their families? an international nominal group technique study framed within the ICF.

    PubMed

    Wallace, Sarah J; Worrall, Linda; Rose, Tanya; Le Dorze, Guylaine; Cruice, Madeline; Isaksen, Jytte; Kong, Anthony Pak Hin; Simmons-Mackie, Nina; Scarinci, Nerina; Gauvreau, Christine Alary

    2017-07-01

    To identify important treatment outcomes from the perspective of people with aphasia and their families using the ICF as a frame of reference. The nominal group technique was used with people with aphasia and their family members in seven countries to identify and rank important treatment outcomes from aphasia rehabilitation. People with aphasia identified outcomes for themselves; and family members identified outcomes for themselves and for the person with aphasia. Outcomes were analysed using qualitative content analysis and ICF linking. A total of 39 people with aphasia and 29 family members participated in one of 16 nominal groups. Inductive qualitative content analysis revealed the following six themes: (1) Improved communication; (2) Increased life participation; (3) Changed attitudes through increased awareness and education about aphasia; (4) Recovered normality; (5) Improved physical and emotional well-being; and (6) Improved health (and support) services. Prioritized outcomes for both participant groups linked to all ICF components; primary activity/participation (39%) and body functions (36%) for people with aphasia, and activity/participation (49%) and environmental factors (28%) for family members. Outcomes prioritized by family members relating to the person with aphasia, primarily linked to body functions (60%). People with aphasia and their families identified treatment outcomes which span all components of the ICF. This has implications for research outcome measurement and clinical service provision which currently focuses on the measurement of body function outcomes. The wide range of desired outcomes generated by both people with aphasia and their family members, highlights the importance of collaborative goal setting within a family-centred approach to rehabilitation. These results will be combined with other stakeholder perspectives to establish a core outcome set for aphasia treatment research. Implications for Rehabilitation Important

  11. Dilemmas of Korean Athletes With a Spinal Cord Injury to Participate in Sports: A Survey Based on the ICF Core Set for Spinal Cord Injury

    PubMed Central

    2016-01-01

    Objective To explore the experiences of athletes with spinal cord injury (SCI) in Korea with respect to dilemmas of participating in sports with regards to the facilitators and barriers, using the International Classification of Functioning, Disability and Health (ICF). Methods The facilitators and barriers to sports participation of individuals with SCI were examined using 112 ICF categories. A questionnaire in dichotomous scale was answered, which covered the subjects 'Body functions', 'Body structures', 'Activity and participation' and 'Environmental factors'. Data analysis included the use of descriptive statistics to examine the frequency and magnitude of reported issues. Results Sixty-two community-dwelling participants were recruited. Frequently addressed barriers in 'Body functions' were mobility related problems such as muscle and joint problems, bladder and bowel functions, pressure ulcers, and pain. In 'Activity and participation', most frequently reported were mobility and self-care problems. Highly addressed barriers in 'Environmental factors' were sports facilities, financial cost, transportation problems and lack of information. Relationships such as peer, family and friends were the most important facilitators. Conclusion Numerous barriers still exist for SCI survivors to participate in sports, especially in the area of health care needs and environmental factors. Our results support the need for a multidisciplinary approach to promote sports participation. PMID:27847720

  12. Applying the ICF to identify requirements for students with Asperger syndrome in higher education.

    PubMed

    Adolfsson, Margareta; Simmeborn Fleischer, Ann

    2015-06-01

    Higher education requires more than academic skills and everyday student-life can be stressful. Students with Asperger syndrome (AS) may need support to manage their education due to difficulties in social functioning. As preparation for the development of a structured tool to guide student and coordinator dialogues at Swedish universities, this study aimed to identify ICF categories that reflect requirements in everyday student-life for students with AS. Using descriptive qualitative approach, information in documents reflecting the perspectives of university students, international classifications, user/health organisations and education authorities were linked to ICF codes. In total, 114 ICF categories were identified, most of which related to learning, tasks and demands, communication and interactions. Students with AS need varying accommodations to be successful in higher education. In the future, ICF-based code sets, including demands on student roles, can be used as checklists to describe functioning and needs for support.

  13. Patients' functioning as predictor of nursing workload in acute hospital units providing rehabilitation care: a multi-centre cohort study

    PubMed Central

    2010-01-01

    Background Management decisions regarding quality and quantity of nurse staffing have important consequences for hospital budgets. Furthermore, these management decisions must address the nursing care requirements of the particular patients within an organizational unit. In order to determine optimal nurse staffing needs, the extent of nursing workload must first be known. Nursing workload is largely a function of the composite of the patients' individual health status, particularly with respect to functioning status, individual need for nursing care, and severity of symptoms. The International Classification of Functioning, Disability and Health (ICF) and the derived subsets, the so-called ICF Core Sets, are a standardized approach to describe patients' functioning status. The objectives of this study were to (1) examine the association between patients' functioning, as encoded by categories of the Acute ICF Core Sets, and nursing workload in patients in the acute care situation, (2) compare the variance in nursing workload explained by the ICF Core Set categories and with the Barthel Index, and (3) validate the Acute ICF Core Sets by their ability to predict nursing workload. Methods Patients' functioning at admission was assessed using the respective Acute ICF Core Set and the Barthel Index, whereas nursing workload data was collected using an established instrument. Associations between dependent and independent variables were modelled using linear regression. Variable selection was carried out using penalized regression. Results In patients with neurological and cardiopulmonary conditions, selected ICF categories and the Barthel Index Score explained the same variance in nursing workload (44% in neurological conditions, 35% in cardiopulmonary conditions), whereas ICF was slightly superior to Barthel Index Score for musculoskeletal conditions (20% versus 16%). Conclusions A substantial fraction of the variance in nursing workload in patients with rehabilitation

  14. Using the ICF to clarify team roles and demonstrate clinical reasoning in stroke rehabilitation.

    PubMed

    Tempest, Stephanie; McIntyre, Anne

    2006-05-30

    The International Classification of Functioning, Disability and Health (ICF) is advocated as a tool to structure rehabilitation and a universal language to aid communication, within the multi-disciplinary team (MDT). The ICF may also facilitate clarification of team roles and clinical reasoning for intervention. This article aims to explore both factors in stroke rehabilitation. Following a review of the literature, a summary was presented and discussed with clinicians working within stroke rehabilitation, to gather expert opinions. The discussions were informal, being part of service development and on-going education. The clinicians summarised key themes for the potential use of the ICF within clinical practice. Two key themes emerged from the literature and expert opinion for the potential use of the ICF in stroke rehabilitation: (i) to aid communication and structure service provision, (ii) to clarify team roles and aid clinical reasoning. Expert opinion was that clarification of team roles needs to occur at a local level due to the skill mix, particular interests, setting and staffing levels within individual teams. The ICF has the potential to demonstrate/facilitate clinical reasoning, especially when different MDT members are working on the same intervention. There is potential for the ICF to be used to clarify team roles and demonstrate clinical reasoning within stroke rehabilitation. Further experiential research is required to substantiate this view.

  15. Core outcome sets and trial registries.

    PubMed

    Clarke, Mike; Williamson, Paula

    2015-05-14

    Some reasons for registering trials might be considered as self-serving, such as satisfying the requirements of a journal in which the researchers wish to publish their eventual findings or publicising the trial to boost recruitment. Registry entries also help others, including systematic reviewers, to know about ongoing or unpublished studies and contribute to reducing research waste by making it clear what studies are ongoing. Other sources of research waste include inconsistency in outcome measurement across trials in the same area, missing data on important outcomes from some trials, and selective reporting of outcomes. One way to reduce this waste is through the use of core outcome sets: standardised sets of outcomes for research in specific areas of health and social care. These do not restrict the outcomes that will be measured, but provide the minimum to include if a trial is to be of the most use to potential users. We propose that trial registries, such as ISRCTN, encourage researchers to note their use of a core outcome set in their entry. This will help people searching for trials and those worried about selective reporting in closed trials. Trial registries can facilitate these efforts to make new trials as useful as possible and reduce waste. The outcomes section in the entry could prompt the researcher to consider using a core outcome set and facilitate the specification of that core outcome set and its component outcomes through linking to the original core outcome set. In doing this, registries will contribute to the global effort to ensure that trials answer important uncertainties, can be brought together in systematic reviews, and better serve their ultimate aim of improving health and well-being through improving health and social care.

  16. Density-based cluster algorithms for the identification of core sets

    NASA Astrophysics Data System (ADS)

    Lemke, Oliver; Keller, Bettina G.

    2016-10-01

    The core-set approach is a discretization method for Markov state models of complex molecular dynamics. Core sets are disjoint metastable regions in the conformational space, which need to be known prior to the construction of the core-set model. We propose to use density-based cluster algorithms to identify the cores. We compare three different density-based cluster algorithms: the CNN, the DBSCAN, and the Jarvis-Patrick algorithm. While the core-set models based on the CNN and DBSCAN clustering are well-converged, constructing core-set models based on the Jarvis-Patrick clustering cannot be recommended. In a well-converged core-set model, the number of core sets is up to an order of magnitude smaller than the number of states in a conventional Markov state model with comparable approximation error. Moreover, using the density-based clustering one can extend the core-set method to systems which are not strongly metastable. This is important for the practical application of the core-set method because most biologically interesting systems are only marginally metastable. The key point is to perform a hierarchical density-based clustering while monitoring the structure of the metric matrix which appears in the core-set method. We test this approach on a molecular-dynamics simulation of a highly flexible 14-residue peptide. The resulting core-set models have a high spatial resolution and can distinguish between conformationally similar yet chemically different structures, such as register-shifted hairpin structures.

  17. European validation of The Comprehensive International Classification of Functioning, Disability and Health Core Set for Osteoarthritis from the perspective of patients with osteoarthritis of the knee or hip.

    PubMed

    Weigl, Martin; Wild, Heike

    2017-09-15

    To validate the International Classification of Functioning, Disability and Health Comprehensive Core Set for Osteoarthritis from the patient perspective in Europe. This multicenter cross-sectional study involved 375 patients with knee or hip osteoarthritis. Trained health professionals completed the Comprehensive Core Set, and patients completed the Short-Form 36 questionnaire. Content validity was evaluated by calculating prevalences of impairments in body function and structures, limitations in activities and participation and environmental factors, which were either barriers or facilitators. Convergent construct validity was evaluated by correlating the International Classification of Functioning, Disability and Health categories with the Short-Form 36 Physical Component Score and the SF-36 Mental Component Score in a subgroup of 259 patients. The prevalences of all body function, body structure and activities and participation categories were >40%, >32% and >20%, respectively, and all environmental factors were relevant for >16% of patients. Few categories showed relevant differences between knee and hip osteoarthritis. All body function categories and all but two activities and participation categories showed significant correlations with the Physical Component Score. Body functions from the ICF chapter Mental Functions showed higher correlations with the Mental Component Score than with the Physical Component Score. This study supports the validity of the International Classification of Functioning, Disability and Health Comprehensive Core Set for Osteoarthritis. Implications for Rehabilitation Comprehensive International Classification of Functioning, Disability and Health Core Sets were developed as practical tools for application in multidisciplinary assessments. The validity of the Comprehensive International Classification of Functioning, Disability and Health Core Set for Osteoarthritis in this study supports its application in European patients with

  18. Heterogeneous clinical presentation in ICF syndrome: correlation with underlying gene defects

    PubMed Central

    Weemaes, Corry MR; van Tol, Maarten JD; Wang, Jun; van Ostaijen-ten Dam, Monique M; van Eggermond, Marja CJA; Thijssen, Peter E; Aytekin, Caner; Brunetti-Pierri, Nicola; van der Burg, Mirjam; Graham Davies, E; Ferster, Alina; Furthner, Dieter; Gimelli, Giorgio; Gennery, Andy; Kloeckener-Gruissem, Barbara; Meyn, Stephan; Powell, Cynthia; Reisli, Ismail; Schuetz, Catharina; Schulz, Ansgar; Shugar, Andrea; van den Elsen, Peter J; van der Maarel, Silvère M

    2013-01-01

    Immunodeficiency with centromeric instability and facial anomalies (ICF) syndrome is a primary immunodeficiency, predominantly characterized by agammaglobulinemia or hypoimmunoglobulinemia, centromere instability and facial anomalies. Mutations in two genes have been discovered to cause ICF syndrome: DNMT3B and ZBTB24. To characterize the clinical features of this syndrome, as well as genotype–phenotype correlations, we compared clinical and genetic data of 44 ICF patients. Of them, 23 had mutations in DNMT3B (ICF1), 13 patients had mutations in ZBTB24 (ICF2), whereas for 8 patients, the gene defect has not yet been identified (ICFX). While at first sight these patients share the same immunological, morphological and epigenetic hallmarks of the disease, systematic evaluation of all reported informative cases shows that: (1) the humoral immunodeficiency is generally more pronounced in ICF1 patients, (2) B- and T-cell compartments are both involved in ICF1 and ICF2, (3) ICF2 patients have a significantly higher incidence of intellectual disability and (4) congenital malformations can be observed in some ICF1 and ICF2 cases. It is expected that these observations on prevalence and clinical presentation will facilitate mutation-screening strategies and help in diagnostic counseling. PMID:23486536

  19. Core information set for oesophageal cancer surgery.

    PubMed

    Blazeby, J M; Macefield, R; Blencowe, N S; Jacobs, M; McNair, A G K; Sprangers, M; Brookes, S T

    2015-07-01

    Surgeons provide patients with information before surgery, although standards of information are lacking and practice varies. The development and use of a 'core information set' as baseline information before surgery may improve understanding. A core set is a minimum set of information to use in all consultations before a specific procedure. This study developed a core information set for oesophageal cancer surgery. Information was identified from the literature, observations of clinical consultations and patient interviews. This was integrated to create a questionnaire survey. Stakeholders (patients and professionals) were surveyed twice to assess views on importance of information from 'not essential' to 'absolutely essential' using Delphi methods. Items not meeting predefined criteria were discarded after each survey and the final retained items were voted on, in separate patient and professional stakeholder meetings, to agree the core set. Some 67 information items were identified initially from multiple sources. Survey response rates were 76·5 per cent (185 of 242) and 54·8 per cent (126 of 230) for patients and professionals respectively (first round), and over 83 per cent in both groups thereafter. Health professionals rated short-term clinical outcomes most highly (technical complications), whereas patients prioritized information related to long-term benefits. The consensus meetings agreed the final set, which consisted of: in-hospital milestones to recovery, rates of open-and-close surgery, in-hospital mortality, major complications (reoperation), milestones in recovery after discharge, longer-term eating and drinking and overall quality of life, and chances of survival. This study has established a core information set for surgery for oesophageal cancer. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

  20. Recommendation for measuring clinical outcome in distal radius fractures: a core set of domains for standardized reporting in clinical practice and research.

    PubMed

    Goldhahn, Jörg; Beaton, Dorcas; Ladd, Amy; Macdermid, Joy; Hoang-Kim, Amy

    2014-02-01

    Lack of standardization of outcome measurement has hampered an evidence-based approach to clinical practice and research. We adopted a process of reviewing evidence on current use of measures and appropriate theoretical frameworks for health and disability to inform a consensus process that was focused on deriving the minimal set of core domains in distal radius fracture. We agreed on the following seven core recommendations: (1) pain and function were regarded as the primary domains, (2) very brief measures were needed for routine administration in clinical practice, (3) these brief measures could be augmented by additional measures that provide more detail or address additional domains for clinical research, (4) measurement of pain should include measures of both intensity and frequency as core attributes, (5) a numeric pain scale, e.g. visual analogue scale or visual numeric scale or the pain subscale of the patient-reported wrist evaluation (PRWE) questionnaires were identified as reliable, valid and feasible measures to measure these concepts, (6) for function, either the Quick Disability of the arm, shoulder and hand questionnaire or PRWE-function subscale was identified as reliable, valid and feasible measures, and (7) a measure of participation and treatment complications should be considered core outcomes for both clinical practice and research. We used a sound methodological approach to form a comprehensive foundation of content for outcomes in the area of distal radius fractures. We recommend the use of symptom and function as separate domains in the ICF core set in clinical research or practice for patients with wrist fracture. Further research is needed to provide more definitive measurement properties of measures across all domains.

  1. Progress on core outcome sets for critical care research.

    PubMed

    Blackwood, Bronagh; Marshall, John; Rose, Louise

    2015-10-01

    Appropriate selection and definition of outcome measures are essential for clinical trials to be maximally informative. Core outcome sets (an agreed, standardized collection of outcomes measured and reported in all trials for a specific clinical area) were developed due to established inconsistencies in trial outcome selection. This review discusses the rationale for, and methods of, core outcome set development, as well as current initiatives in critical care. Recent systematic reviews of reported outcomes and measurement instruments relevant to the critically ill highlight inconsistencies in outcome selection, definition, and measurement, thus establishing the need for core outcome sets. Current critical care initiatives include development of core outcome sets for trials aimed at reducing mechanical ventilation duration; rehabilitation following critical illness; long-term outcomes in acute respiratory failure; and epidemic and pandemic studies of severe acute respiratory infection. Development and utilization of core outcome sets for studies relevant to the critically ill is in its infancy compared to other specialties. Notwithstanding, core outcome set development frameworks and guidelines are available, several sets are in various stages of development, and there is strong support from international investigator-led collaborations including the International Forum for Acute Care Trialists.

  2. CONSIDER - Core Outcome Set in IAD Research: study protocol for establishing a core set of outcomes and measurements in incontinence-associated dermatitis research.

    PubMed

    Van den Bussche, Karen; De Meyer, Dorien; Van Damme, Nele; Kottner, Jan; Beeckman, Dimitri

    2017-10-01

    This study protocol describes the methodology for the development of a core set of outcomes and a core set of measurements for incontinence-associated dermatitis. Incontinence is a widespread disorder with an important impact on quality of life. One of the most common complications is incontinence-associated dermatitis, resulting from chemical and physical irritation of the skin barrier, triggering inflammation and skin damage. Managing incontinence-associated dermatitis is an important challenge for nurses. Several interventions have been assessed in clinical trials, but heterogeneity in study outcomes complicates the comparability and standardization. To overcome this challenge, the development of a core outcome set, a minimum set of outcomes and measurements to be assessed in clinical research, is needed. A project team, International Steering Committee and panelists will be involved to guide the development of the core outcome set. The framework of the Harmonizing Outcomes Measures for Eczema roadmap endorsed by Cochrane Skin Group Core Outcomes Set Initiative, is used to inform the project design. A systematic literature review, interviews to integrate the patients' perspective and a consensus study with healthcare researchers and providers using the Delphi procedure will be performed. The project was approved by the Ethics review Committee (April 2016). This is the first project that will identify a core outcome set of outcomes and measurements for incontinence-associated dermatitis research. A core outcome set will reduce possible reporting bias, allow results comparisons and statistical pooling across trials and strengthen evidence-based practice and decision-making. This project has been registered in the Core Outcome Measures in Effectiveness Trials (COMET) database and is part of the Cochrane Skin Group Core Outcomes Set Initiative (CSG-COUSIN). © 2016 John Wiley & Sons Ltd.

  3. Developing applications of the ICF in education systems: addressing issues of knowledge creation, management and transfer.

    PubMed

    Hollenweger, Judith

    2013-06-01

    Since its endorsement, the International Classification of Functioning, Disability and Health (ICF) has been applied in many policy contexts, including education. While so far the focus has been on showing ways in which it can be used to describe functioning and disability, this article seeks to focus on its value to represent knowledge. Two applications of the ICF and ICF-CY in the context of the Swiss education system highlight ways in which the classification can be used to assist multidisciplinary teams in acquiring and mapping existing knowledge, in creating new knowledge and in applying it for specific purposes. The conceptual analysis illustrates that "disability in education" is a hybrid conceptual world that needs to bridge disability-related information with information relevant for learning and education. The ICF can be used to adequately map such knowledge in complex social settings. More attention needs to be paid to the ICF as an information system to help negotiate between different views on reality and different areas of expertise. The selection of content and ways of representing it need to be considered in the light of the specific purposes during collaborative knowledge creation processes.

  4. Toward an International Classification of Functioning, Disability and Health clinical data collection tool: the Italian experience of developing simple, intuitive descriptions of the Rehabilitation Set categories.

    PubMed

    Selb, Melissa; Gimigliano, Francesca; Prodinger, Birgit; Stucki, Gerold; Pestelli, Germano; Iocco, Maurizio; Boldrini, Paolo

    2017-04-01

    As part of international efforts to develop and implement national models including the specification of ICF-based clinical data collection tools, the Italian rehabilitation community initiated a project to develop simple, intuitive descriptions of the ICF Rehabilitation Set, highlighting the core concept of each category in user-friendly language. This paper outlines the Italian experience in developing simple, intuitive descriptions of the ICF Rehabilitation Set as an ICF-based clinical data collection tool for Italy. Consensus process. Expert conference. Multidisciplinary group of rehabilitation professionals. The first of a two-stage consensus process involved developing an initial proposal for simple, intuitive descriptions of each ICF Rehabilitation Set category based on descriptions generated in a similar process in China. Stage two involved a consensus conference. Divided into three working groups, participants discussed and voted (vote A) whether the initially proposed descriptions of each ICF Rehabilitation Set category was simple and intuitive enough for use in daily practice. Afterwards the categories with descriptions considered ambiguous i.e. not simple and intuitive enough, were divided among the working groups, who were asked to propose a new description for the allocated categories. These proposals were then voted (vote B) on in a plenary session. The last step of the consensus conference required each working group to develop a new proposal for each and the same categories with descriptions still considered ambiguous. Participants then voted (final vote) for which of the three proposed descriptions they preferred. Nineteen clinicians from diverse rehabilitation disciplines from various regions of Italy participated in the consensus process. Three ICF categories already achieved consensus in vote A, while 20 ICF categories were accepted in vote B. The remaining 7 categories were decided in the final vote. The findings were discussed in light of

  5. Fluorescence and absorption spectroscopy for warm dense matter studies and ICF plasma diagnostics

    NASA Astrophysics Data System (ADS)

    Hansen, S. B.; Harding, E. C.; Knapp, P. F.; Gomez, M. R.; Nagayama, T.; Bailey, J. E.

    2018-05-01

    The burning core of an inertial confinement fusion (ICF) plasma produces bright x-rays at stagnation that can directly diagnose core conditions essential for comparison to simulations and understanding fusion yields. These x-rays also backlight the surrounding shell of warm, dense matter, whose properties are critical to understanding the efficacy of the inertial confinement and global morphology. We show that the absorption and fluorescence spectra of mid-Z impurities or dopants in the warm dense shell can reveal the optical depth, temperature, and density of the shell and help constrain models of warm, dense matter. This is illustrated by the example of a high-resolution spectrum collected from an ICF plasma with a beryllium shell containing native iron impurities. Analysis of the iron K-edge provides model-independent diagnostics of the shell density (2.3 × 1024 e/cm3) and temperature (10 eV), while a 12-eV red shift in Kβ and 5-eV blue shift in the K-edge discriminate among models of warm dense matter: Both shifts are well described by a self-consistent field model based on density functional theory but are not fully consistent with isolated-atom models using ad-hoc density effects.

  6. Fluorescence and absorption spectroscopy for warm dense matter studies and ICF plasma diagnostics

    DOE PAGES

    Hansen, Stephanie B.; Harding, Eric C.; Knapp, Patrick F.; ...

    2018-03-07

    The burning core of an inertial confinement fusion (ICF) plasma produces bright x-rays at stagnation that can directly diagnose core conditions essential for comparison to simulations and understanding fusion yields. These x-rays also backlight the surrounding shell of warm, dense matter, whose properties are critical to understanding the efficacy of the inertial confinement and global morphology. In this work, we show that the absorption and fluorescence spectra of mid-Z impurities or dopants in the warm dense shell can reveal the optical depth, temperature, and density of the shell and help constrain models of warm, dense matter. This is illustrated bymore » the example of a high-resolution spectrum collected from an ICF plasma with a beryllium shell containing native iron impurities. Lastly, analysis of the iron K-edge provides model-independent diagnostics of the shell density (2.3 × 10 24 e/cm 3) and temperature (10 eV), while a 12-eV red shift in Kβ and 5-eV blue shift in the K-edge discriminate among models of warm dense matter: Both shifts are well described by a self-consistent field model based on density functional theory but are not fully consistent with isolated-atom models using ad-hoc density effects.« less

  7. Core outcome sets in women's and newborn health: a systematic review.

    PubMed

    Duffy, Jmn; Rolph, R; Gale, C; Hirsch, M; Khan, K S; Ziebland, S; McManus, R J

    2017-09-01

    Variation in outcome collection and reporting is a serious hindrance to progress in our specialty; therefore, over 80 journals have come together to support the development, dissemination, and implementation of core outcome sets. This study systematically reviewed and characterised registered, progressing, or completed core outcome sets relevant to women's and newborn health. Systematic search using the Core Outcome Measures in Effectiveness Trial initiative and the Core Outcomes in Women's and Newborn Health initiative databases. Registry entries, protocols, systematic reviews, and core outcome sets. Descriptive statistics to describe characteristics and results. There were 49 core outcome sets registered in maternal and newborn health, with the majority registered in 2015 (n = 22; 48%) or 2016 (n = 16; 32%). Benign gynaecology (n = 8; 16%) and newborn health (n = 3; 6%) are currently under-represented. Twenty-four (52%) core outcome sets were funded by international (n = 1; <1%), national (n = 18; 38%), and regional (n = 4; 8%) bodies. Seven protocols were published. Twenty systematic reviews have characterised the inconsistency in outcome reporting across a broad range of relevant healthcare conditions. Four core outcome sets were completed: reconstructive breast surgery (11 outcomes), preterm birth (13 outcomes), epilepsy in pregnancy (29 outcomes), and maternity care (48 outcomes). The quantitative, qualitative, and consensus methods used to develop core outcome sets varied considerably. Core outcome sets are currently being developed across women's and newborn health, although coverage of topics is variable. Development of further infrastructure to develop, disseminate, and implement core outcome sets is urgently required. Forty-nine women's and newborn core outcome sets registered. 50% funded. 7 protocols, 20 systematic reviews, and 4 core outcome sets published. @coreoutcomes @jamesmnduffy. © 2017 Royal College of Obstetricians and

  8. The ICF and Postsurgery Occupational Therapy after Traumatic Hand Injury

    ERIC Educational Resources Information Center

    Fitinghoff, Helene; Lindqvist, Birgitta; Nygard, Louise; Ekholm, Jan; Schult, Marie-Louise

    2011-01-01

    Recent studies have examined the effectiveness of hand rehabilitation programmes and have linked the outcomes to the concept of ICF but not to specific ICF category codes. The objective of this study was to gain experience using ICF concepts to describe occupational therapy interventions during postsurgery hand rehabilitation, and to describe…

  9. Using the International Classification of Functioning, Disability, and Health to identify outcome domains for a core outcome set for aphasia: a comparison of stakeholder perspectives.

    PubMed

    Wallace, Sarah J; Worrall, Linda; Rose, Tanya; Le Dorze, Guylaine

    2017-11-12

    This study synthesised the findings of three separate consensus processes exploring the perspectives of key stakeholder groups about important aphasia treatment outcomes. This process was conducted to generate recommendations for outcome domains to be included in a core outcome set for aphasia treatment trials. International Classification of Functioning, Disability, and Health codes were examined to identify where the groups of: (1) people with aphasia, (2) family members, (3) aphasia researchers, and (4) aphasia clinicians/managers, demonstrated congruence in their perspectives regarding important treatment outcomes. Codes were contextualized using qualitative data. Congruence across three or more stakeholder groups was evident for ICF chapters: Mental functions; Communication; and Services, systems, and policies. Quality of life was explicitly identified by clinicians/managers and researchers, while people with aphasia and their families identified outcomes known to be determinants of quality of life. Core aphasia outcomes include: language, emotional wellbeing, communication, patient-reported satisfaction with treatment and impact of treatment, and quality of life. International Classification of Functioning, Disability, and Health coding can be used to compare stakeholder perspectives and identify domains for core outcome sets. Pairing coding with qualitative data may ensure important nuances of meaning are retained. Implications for rehabilitation The outcomes measured in treatment research should be relevant to stakeholders and support health care decision making. Core outcome sets (agreed, minimum set of outcomes, and outcome measures) are increasingly being used to ensure the relevancy and consistency of the outcomes measured in treatment studies. Important aphasia treatment outcomes span all components of the International Classification of Functioning, Disability, and Health. Stakeholders demonstrated congruence in the identification of important

  10. 42 CFR 440.150 - Intermediate care facility (ICF/MR) services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Intermediate care facility (ICF/MR) services. 440....150 Intermediate care facility (ICF/MR) services. (a) “ICF/MR services” means those items and services furnished in an intermediate care facility for the mentally retarded if the following conditions are met: (1...

  11. The Health and Functioning ICF-60: Development and Psychometric Properties

    PubMed Central

    Tutelyan, V A; Chatterji, S; Baturin, A K; Pogozheva, A V; Kishko, O N; Akolzina, S E

    2014-01-01

    Background This paper describes the development and psychometric properties of the Health and Functioning ICF-60 (HF-ICF-60) measure, based on the World Health Organization (WHO) ‘International Classification of Functioning, Disability and Health: ICF’ (2001). The aims of the present study were to test psychometric properties of the HF-ICF-60, developed as a measure that would be responsive to change in functioning through changes in health and nutritional status, as a prospective measure to monitor health and nutritional status of populations and to explore the relationship of the HF-ICF-60 with quality of life measures such as the World Health Organization WHOQOL-BREF quality of life assessment in relation to non-communicable diseases. Methods The HF-ICF-60 measure consists of 60 items selected from the ICF by an expert panel, which included 18 items that cover Body Functions, 21 items that cover Activities and Participation, rated on five-point scales, and 21 items that cover Environmental Factors (seven items cover Individual Environmental Factors and 14 items cover Societal Environmental Factors), rated on nine-point scales. The HF-ICF-60 measure was administered to the Russian nationally representative sample within the Russian National Population Quality of Life, Health and Nutrition Survey, in 2004 (n = 9807) and 2005 (n = 9560), as part of the two waves of the Russian Longitudinal Monitoring Survey (RLMS). The statistical analyses were carried out with the use of both classical and modern psychometric methods, such as factor analysis, and based on Item Response Theory, respectively. Results The HF-ICF-60 questionnaire is a new measure derived directly from the ICF and covers the ICF components as follows: Body Functions, Activities and Participation, and Environmental Factors (Individual Environmental Factors and Societal Environmental Factors). The results from the factor analyses (both Exploratory Factor Analyses and Confirmatory Factor

  12. HIV/AIDS: use of the ICF in Brazil and South Africa--comparative data from four cross-sectional studies.

    PubMed

    Myezwa, H; Buchalla, C M; Jelsma, J; Stewart, A

    2011-03-01

    Human immunodeficiency virus (HIV) is a serious disease which can be associated with various activity limitations and participation restrictions. The aim of this paper was to describe how HIV affects the functioning and health of people within different environmental contexts, particularly with regard to access to medication. Four cross-sectional studies, three in South Africa and one in Brazil, had applied the International Classification of Functioning, Disability and Health (ICF) as a classification instrument to participants living with HIV. Each group was at a different stage of the disease. Only two groups had had continuing access to antiretroviral therapy. The existence of these descriptive sets enabled comparison of the disability experienced by people living with HIV at different stages of the disease and with differing access to antiretroviral therapy. Common problems experienced in all groups related to weight maintenance, with two-thirds of the sample reporting problems in this area. Mental functions presented the most problems in all groups, with sleep (50%, 92/185), energy and drive (45%, 83/185), and emotional functions (49%, 90/185) being the most affected. In those on long-term therapy, body image affected 93% (39/42) and was a major problem. The other groups reported pain as a problem, and those with limited access to treatment also reported mobility problems. Cardiopulmonary functions were affected in all groups. Functional problems occurred in the areas of impairment and activity limitation in people at advanced stages of HIV, and more limitations occurred in the area of participation for those on antiretroviral treatment. The ICF provided a useful framework within which to describe the functioning of those with HIV and the impact of the environment. Given the wide spectrum of problems found, consideration could be given to a number of ICF core sets that are relevant to the different stages of HIV disease. Copyright © 2010 Chartered Society of

  13. Enhanced clarity and holism: the outcome of implementing the ICF with an acute stroke multidisciplinary team in England.

    PubMed

    Tempest, Stephanie; Harries, Priscilla; Kilbride, Cherry; De Souza, Lorraine

    2013-01-01

    Although it is recommended that the ICF (International Classification of Functioning, Disability and Health) should be implemented to aid communication within multidisciplinary stroke services, there is no empirical evidence to demonstrate the outcomes of such implementation. Working with one stroke service, this project aimed to address this gap and sought to evaluate the outcomes of implementing an ICF-based clinical tool into practice. Using an action research framework with mixed methods, data were collected from individual interviews, a focus group, questionnaires, email communications, minutes from relevant meetings and field notes. Thematic analysis was undertaken, using immersion and crystallisation, to define overall themes. Descriptive statistics were used to analyse quantitative data. Data from both sources were combined to create key findings. Three findings were determined from the data analysis. The ICF (1) fosters communication within and beyond the multidisciplinary stroke team; (2) promotes holistic thinking; and (3) helps to clarify team roles. The ICF enhanced clarity of communication and team roles within the acute stroke multidisciplinary team as well as with other clinicians, patients and their relatives. In addition, the ICF challenged stroke clinicians to think holistically, thereby appropriately extending their domain of concern beyond their traditional remit. The ICF is a globally accepted framework to describe functioning and is in use in a variety of clinical settings. Yet, the outcomes of using it in clinical practice have yet to be fully explored. This study found that the ICF enhanced clarity of communication and team roles within an acute stroke multidisciplinary team and to others beyond the team, including clinicians, patients and their relatives. Using the ICF also challenged clinicians to think holistically about patient needs following a stroke.

  14. Choice-Making among Medicaid HCBS and ICF/MR Recipients in Six States

    ERIC Educational Resources Information Center

    Lakin, K. Charlie; Doljanac, Robert; Byun, Soo-Yong; Stancliffe, Roger; Taub, Sarah; Chiri, Giuseppina

    2008-01-01

    Choice in everyday decisions and in support-related decisions was addressed among 2,398 adults with intellectual and developmental disabilities receiving Medicaid Home and Community Based Services (HCBS) and Intermediate Care Facility (ICF/MR) services and living in nonfamily settings in six states. Everyday choice in daily life and in…

  15. 42 CFR 440.150 - Intermediate care facility (ICF/IIDICF/IID) services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Intermediate care facility (ICF/IIDICF/IID... Definitions § 440.150 Intermediate care facility (ICF/IIDICF/IID) services. (a) “ICF/IIDICF/IID services” means those items and services furnished in an intermediate care facility for Individuals with...

  16. 42 CFR 440.150 - Intermediate care facility (ICF/IIDICF/IID) services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Intermediate care facility (ICF/IIDICF/IID... Definitions § 440.150 Intermediate care facility (ICF/IIDICF/IID) services. (a) “ICF/IIDICF/IID services” means those items and services furnished in an intermediate care facility for Individuals with...

  17. Enhanced clarity and holism: the outcome of implementing the ICF with an acute stroke multidisciplinary team in England

    PubMed Central

    Harries, Priscilla; Kilbride, Cherry; De Souza, Lorraine

    2013-01-01

    Purpose: Although it is recommended that the ICF (International Classification of Functioning, Disability and Health) should be implemented to aid communication within multidisciplinary stroke services, there is no empirical evidence to demonstrate the outcomes of such implementation. Working with one stroke service, this project aimed to address this gap and sought to evaluate the outcomes of implementing an ICF-based clinical tool into practice. Method: Using an action research framework with mixed methods, data were collected from individual interviews, a focus group, questionnaires, email communications, minutes from relevant meetings and field notes. Thematic analysis was undertaken, using immersion and crystallisation, to define overall themes. Descriptive statistics were used to analyse quantitative data. Data from both sources were combined to create key findings. Results: Three findings were determined from the data analysis. The ICF (1) fosters communication within and beyond the multidisciplinary stroke team; (2) promotes holistic thinking; and (3) helps to clarify team roles. Conclusions: The ICF enhanced clarity of communication and team roles within the acute stroke multidisciplinary team as well as with other clinicians, patients and their relatives. In addition, the ICF challenged stroke clinicians to think holistically, thereby appropriately extending their domain of concern beyond their traditional remit. Implications for Rehabilitation The ICF is a globally accepted framework to describe functioning and is in use in a variety of clinical settings. Yet, the outcomes of using it in clinical practice have yet to be fully explored. This study found that the ICF enhanced clarity of communication and team roles within an acute stroke multidisciplinary team and to others beyond the team, including clinicians, patients and their relatives. Using the ICF also challenged clinicians to think holistically about patient needs following a stroke. PMID:23530624

  18. The Nova Upgrade Facility for ICF ignition and gain

    NASA Astrophysics Data System (ADS)

    Lowdermilk, W. H.; Campbell, E. M.; Hunt, J. T.; Murray, J. R.; Storm, E.; Tobin, M. T.; Trenholme, J. B.

    1992-01-01

    Research on Inertial Confinement Fusion (ICF) is motivated by its potential defense and civilian applications, including ultimately the generation of electric power. The U.S. ICF Program was reviewed recently by the National Academy of Science (NAS) and the Fusion Policy Advisory Committee (FPAC). Both committees issued final reports in 1991 which recommended that first priority in the ICF program be placed on demonstrating fusion ignition and modest gain (G less than 10). The U.S. Department of Energy and Lawrence Livermore National Laboratory (LLNL) have proposed an upgrade of the existing Nova Laser Facility at LLNL to accomplish these goals. Both the NAS and FPAC have endorsed the upgrade of Nova as the optimal path to achieving ignition and gain. Results from Nova Upgrade Experiments will be used to define requirements for driver and target technology both for future high-yield military applications, such as the Laboratory Microfusion Facility (LMF) proposed by the Department of Energy, and for high-gain energy applications leading to an ICF engineering test facility. The central role and modifications which Nova Upgrade would play in the national ICF strategy are described.

  19. Core outcome sets for research and clinical practice.

    PubMed

    Chiarotto, Alessandro; Ostelo, Raymond W; Turk, Dennis C; Buchbinder, Rachelle; Boers, Maarten

    This masterclass introduces the topic of core outcome sets, describing rationale and methods for developing them, and providing some examples that are relevant for clinical research and practice. A core outcome set is a minimum consensus-based set of outcomes that should be measured and reported in all clinical trials for a specific health condition and/or intervention. Issues surrounding outcome assessment, such as selective reporting and inconsistency across studies, can be addressed by the development of a core set. As suggested by key initiatives in this field (i.e. OMERACT and COMET), the development requires achieving consensus on: (1) core outcome domains and (2) core outcome measurement instruments. Different methods can be used to reach consensus, including: literature systematic reviews to inform the process, qualitative research with clinicians and patients, group discussions (e.g. nominal group technique), and structured surveys (e.g. Delphi technique). Various stakeholders should be involved in the process, with particular attention to patients. Several COSs have been developed for musculoskeletal conditions including a longstanding one for low back pain, IMMPACT recommendations on outcomes for chronic pain, and OMERACT COSs for hip, knee and hand osteoarthritis. There is a lack of COSs for neurological, geriatric, cardio-respiratory and pediatric conditions, therefore, future research could determine the value of developing COSs for these conditions. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

  20. A Preliminary Core Domain Set for Clinical Trials of Shoulder Disorders: A Report from the OMERACT 2016 Shoulder Core Outcome Set Special Interest Group.

    PubMed

    Buchbinder, Rachelle; Page, Matthew J; Huang, Hsiaomin; Verhagen, Arianne P; Beaton, Dorcas; Kopkow, Christian; Lenza, Mario; Jain, Nitin B; Richards, Bethan; Richards, Pamela; Voshaar, Marieke; van der Windt, Danielle; Gagnier, Joel J

    2017-12-01

    The Outcome Measures in Rheumatology (OMERACT) Shoulder Core Outcome Set Special Interest Group (SIG) was established to develop a core outcome set (COS) for clinical trials of shoulder disorders. In preparation for OMERACT 2016, we systematically examined all outcome domains and measurement instruments reported in 409 randomized trials of interventions for shoulder disorders published between 1954 and 2015. Informed by these data, we conducted an international Delphi consensus study including shoulder trial experts, clinicians, and patients to identify key domains that should be included in a shoulder disorder COS. Findings were discussed at a stakeholder premeeting of OMERACT. At OMERACT 2016, we sought consensus on a preliminary core domain set and input into next steps. There were 13 and 15 participants at the premeeting and the OMERACT 2016 SIG meeting, respectively (9 attended both meetings). Consensus was reached on a preliminary core domain set consisting of an inner core of 4 domains: pain, physical function/activity, global perceived effect, and adverse events including death. A middle core consisted of 3 domains: emotional well-being, sleep, and participation (recreation and work). An outer core of research required to inform the final COS was also formulated. Our next steps are to (1) analyze whether participation (recreation and work) should be in the inner core, (2) conduct a third Delphi round to finalize definitions and wording of domains and reach final endorsement for the domains, and (3) determine which instruments fulfill the OMERACT criteria for measuring each domain.

  1. The implementation of the ICF among Israeli rehabilitation centers--the case of physical therapy.

    PubMed

    Jacob, Tamar

    2013-10-01

    The extent of the implementation of the International Classification of Functioning, Disability and Health (ICF), developed by the WHO, in rehabilitation units and in physical therapy (PT) departments is unknown. The study aims to describe the extent to which the ICF has been implemented in PT services within rehabilitation units in Israel. To update data on ICF implementation since its inception. An online semi-structured survey was administered to 25 physiotherapists in charge of PT departments in all rehabilitation units throughout Israel. Rehabilitation units were grouped into three categories: general, geriatric and pediatric. The questionnaire included items regarding the ICF implementation, its strengths, and weaknesses. Twenty two physiotherapists (88%) completed the questionnaire. The majority was familiar with the ICF and nearly two thirds reported partial implementation in their units. Implementation focused mostly on adopting the biopsychosocial concepts and using ICF terms. The ICF was not used either for evaluating patients, or for reporting or encoding patient information. Physiotherapists, directors of most Israeli PT departments in rehabilitation units are familiar with the ICF; however, its clinical implementation is very limited. There is need for further research into the processes of knowledge transfer and implementation of the ICF, in order to better understand the factors that facilitate and those that impede ICF implementation.

  2. Core outcome sets in dermatology: report from the second meeting of the International Cochrane Skin Group Core Outcome Set Initiative.

    PubMed

    Kottner, J; Jacobi, L; Hahnel, E; Alam, M; Balzer, K; Beeckman, D; Busard, C; Chalmers, J; Deckert, S; Eleftheriadou, V; Furlan, K; Horbach, S E R; Kirkham, J; Nast, A; Spuls, P; Thiboutot, D; Thorlacius, L; Weller, K; Williams, H C; Schmitt, J

    2018-04-01

    Results of clinical trials are the most important information source for generating external clinical evidence. The use of different outcomes across trials, which investigate similar interventions for similar patient groups, significantly limits the interpretation, comparability and clinical application of trial results. Core outcome sets (COSs) aim to overcome this limitation. A COS is an agreed standardized collection of outcomes that should be measured and reported in all clinical trials for a specific clinical condition. The Core Outcome Set Initiative within the Cochrane Skin Group (CSG-COUSIN) supports the development of core outcomes in dermatology. In the second CSG-COUSIN meeting held in 2017, 11 COS development groups working on skin diseases presented their current work. The presentations and discussions identified the following overarching methodological challenges for COS development in dermatology: it is not always easy to define the disease focus of a COS; the optimal method for outcome domain identification and level of detail needed to specify such domains is challenging to many; decision rules within Delphi surveys need to be improved; appropriate ways of patient involvement are not always clear. In addition, there appear to be outcome domains that may be relevant as potential core outcome domains for the majority of skin diseases. The close collaboration between methodologists in the Core Outcome Set Initiative and the international Cochrane Skin Group has major advantages for trialists, systematic reviewers and COS developers. © 2018 British Association of Dermatologists.

  3. ICF-Based Analysis of Communication Disorders in Dementia of Alzheimer's Type

    PubMed Central

    Badarunisa, Mohamad Basheer; Sebastian, Daly; Rangasayee, Raghunath Rao; Kala, Baby

    2015-01-01

    Purpose Dementia of Alzheimer's type (DAT) is a major cognitive communication disorder. The present study attempted to analyse communication disorders in DAT in the International Classification of Functions (ICF) framework. The study investigated the impact of the severity of communication disorders in persons with DAT on activity participation and environment components of the ICF. Method Thirty bilingual individuals with DAT in the age range of 65-88 years were classified into three groups of mild, moderate and severe degree of dementia. Forty-three items of the American Speech-Language-Hearing Association Functional Assessment of Communication Skills for Adults (ASHA FACS) were linked to the ICF framework. A few additional items were also added for a complete profiling of DAT. A total of 50 (ASHA FACS + ICF) items were rated and administered for the purpose of the study. Results The study revealed a disproportionate impact of the severity of DAT on activity participation and environment components of the ICF. Conclusion The present study investigated the utility of the ICF framework for profiling the functionality of persons with DAT. This profiling highlighted the need for ensuring effective communication and quality of life in the DAT population. PMID:26955380

  4. Factors associated with expenditures for medicaid home and community based services (HCBS) and intermediate care facilities for persons with mental retardation (ICF/MR) services for persons with intellectual and developmental disabilities.

    PubMed

    Lakin, K Charlie; Doljanac, Robert; Byun, Soo-Yong; Stancliffe, Roger J; Taub, Sarah; Chiri, Giuseppina

    2008-06-01

    This article examines expenditures for a random sample of 1,421 adult Home and Community Based Services (HCBS) and Intermediate Care Facility/Mental Retardation (ICF/MR) recipients in 4 states. The article documents variations in expenditures for individuals with different characteristics and service needs and, controlling for individual characteristics, by residential setting type, Medicaid program (ICF/MR or HCBS), and state. Annual average per-person Medicaid expenditures for HCBS recipients were less than those of ICF/MR residents ($61,770 and $128,275, respectively). HCBS recipients had less severe disability (intellectual, physical, health service needs) than ICF/MR residents. Controlling these differences, and for congregate settings, HCBS were less costly than ICFs/MR, but this distinction accounted for only 3.3% of variation in expenditures. Persons living with families receiving HCBS ($25,072) and in host families (including foster, companion, or shared living arrangements; $44,112) had the lowest Medicaid expenditures.

  5. How a Regression Artifact Makes ICFs/MR Look Ineffective.

    ERIC Educational Resources Information Center

    Crinella, Francis M.; McCleary, Richard; Swanson, James M.

    1998-01-01

    Criticizes the research design in "The Small ICF/MR program: Dimensions of Quality and Cost" (Conroy), that found small Intermediate Care Facilities (ICF) for individuals with mental retardation are inferior to other community programs. Discusses the problem in selecting a control group on the basis of pretest matching. (CR)

  6. State Medicaid ICF-MR Utilization and Expenditures in the 1980-1984 Period.

    ERIC Educational Resources Information Center

    Harrington, Charlene; Swan, James H.

    1990-01-01

    State Medicaid expenditures for Intermediate Care Facilities for the Mentally Retarded (ICF-MR) increased sharply between 1980 and 1984. The ICF-MR bed capacity declined relative to the total state population, while numbers of ICF-MR Medicaid recipients increased. Trends among states are examined, emphasizing changes in demographic factors,…

  7. Application of the ICF in fluency disorders.

    PubMed

    Yaruss, J Scott

    2007-11-01

    Stuttering is a complicated communication disorder that can affect many aspects of a speaker's life. In addition to exhibiting observable disruptions in speech (e.g., part-word repetitions, prolongations, blocks), many people who stutter also experience broader consequences in their lives because of their stuttering. Examples include difficulty with social communication (e.g., speaking with other people, making introductions) and job-related tasks (e.g., talking on the phone, participating in meetings). Because it incorporates these types of daily experiences, the World Health Organization's International Classification of Functioning, Disability and Health (ICF) provides an ideal framework for considering the overall experience of the stuttering disorder. The purpose of this article is to highlight the ways in which the ICF can help clinicians, people who stutter, and the general public understand the multifaceted nature of stuttering. The article will also describe how clinicians can use the ICF as a framework for developing comprehensive evaluations and providing individualized treatment plans for people who stutter.

  8. Core Health Outcomes In Childhood Epilepsy (CHOICE): protocol for the selection of a core outcome set.

    PubMed

    Morris, Christopher; Dunkley, Colin; Gibbon, Frances M; Currier, Janet; Roberts, Deborah; Rogers, Morwenna; Crudgington, Holly; Bray, Lucy; Carter, Bernie; Hughes, Dyfrig; Tudur Smith, Catrin; Williamson, Paula R; Gringras, Paul; Pal, Deb K

    2017-11-28

    There is increasing recognition that establishing a core set of outcomes to be evaluated and reported in trials of interventions for particular conditions will improve the usefulness of health research. There is no established core outcome set for childhood epilepsy. The aim of this work is to select a core outcome set to be used in evaluative research of interventions for children with rolandic epilepsy, as an exemplar of common childhood epilepsy syndromes. First we will identify what outcomes should be measured; then we will decide how to measure those outcomes. We will engage relevant UK charities and health professional societies as partners, and convene advisory panels for young people with epilepsy and parents of children with epilepsy. We will identify candidate outcomes from a search for trials of interventions for childhood epilepsy, statutory guidance and consultation with our advisory panels. Families, charities and health, education and neuropsychology professionals will be invited to participate in a Delphi survey following recommended practices in the development of core outcome sets. Participants will be able to recommend additional outcome domains. Over three rounds of Delphi survey participants will rate the importance of candidate outcome domains and state the rationale for their decisions. Over the three rounds we will seek consensus across and between families and health professionals on the more important outcomes. A face-to-face meeting will be convened to ratify the core outcome set. We will then review and recommend ways to measure the shortlisted outcomes using clinical assessment and/or patient-reported outcome measures. Our methodology is a proportionate and pragmatic approach to expediently produce a core outcome set for evaluative research of interventions aiming to improve the health of children with epilepsy. A number of decisions have to be made when designing a study to develop a core outcome set including defining the scope

  9. Basis sets for the calculation of core-electron binding energies

    NASA Astrophysics Data System (ADS)

    Hanson-Heine, Magnus W. D.; George, Michael W.; Besley, Nicholas A.

    2018-05-01

    Core-electron binding energies (CEBEs) computed within a Δ self-consistent field approach require large basis sets to achieve convergence with respect to the basis set limit. It is shown that supplementing a basis set with basis functions from the corresponding basis set for the element with the next highest nuclear charge (Z + 1) provides basis sets that give CEBEs close to the basis set limit. This simple procedure provides relatively small basis sets that are well suited for calculations where the description of a core-ionised state is important, such as time-dependent density functional theory calculations of X-ray emission spectroscopy.

  10. Developing, implementing and disseminating a core outcome set for neonatal medicine.

    PubMed

    Webbe, James; Brunton, Ginny; Ali, Shohaib; Duffy, James Mn; Modi, Neena; Gale, Chris

    2017-01-01

    In high resource settings, 1 in 10 newborn babies require admission to a neonatal unit. Research evaluating neonatal care involves recording and reporting many different outcomes and outcome measures. Such variation limits the usefulness of research as studies cannot be compared or combined. To address these limitations, we aim to develop, disseminate and implement a core outcome set for neonatal medicine. A steering group that includes parents and former patients, healthcare professionals and researchers has been formed to guide the development of the core outcome set. We will review neonatal trials systematically to identify previously reported outcomes. Additionally, we will specifically identify outcomes of importance to parents, former patients and healthcare professionals through a systematic review of qualitative studies. Outcomes identified will be entered into an international, multi-perspective eDelphi survey. All key stakeholders will be invited to participate. The Delphi method will encourage individual and group stakeholder consensus to identify a core outcome set. The core outcome set will be mapped to existing, routinely recorded data where these exist. Use of a core set will ensure outcomes of importance to key stakeholders, including former patients and parents, are recorded and reported in a standard fashion in future research. Embedding the core outcome set within future clinical studies will extend the usefulness of research to inform practice, enhance patient care and ultimately improve outcomes. Using routinely recorded electronic data will facilitate implementation with minimal addition burden. Core Outcome Measures in Effectiveness Trials (COMET) database: 842 (www.comet-initiative.org/studies/details/842).

  11. [¹²³I]ICF01012 melanoma imaging and [¹³¹I]ICF01012 dosimetry allow adapted internal targeted radiotherapy in preclinical melanoma models.

    PubMed

    Viallard, Claire; Perrot, Yann; Boudhraa, Zied; Jouberton, Elodie; Miot-Noirault, Elisabeth; Bonnet, Mathilde; Besse, Sophie; Mishellany, Florence; Cayre, Anne; Maigne, Lydia; Rbah-Vidal, Latifa; D'Incan, Michel; Cachin, Florent; Chezal, Jean-Michel; Degoul, Françoise

    2015-01-01

    Melanin-targeting radiotracers are interesting tools for imaging and treatment of pigmented melanoma metastases. However, variation of the pigment concentration may alter the efficiency of such targeting. A clear assessment of both tumor melanin status and dosimetry are therefore prerequisites for internal radiotherapy of disseminated melanoma. The melanin tracer ICF01012 was labelled with iodine-123 for melanoma imaging in pigmented murine B16F0 and human SK-Mel 3 melanomas. In vivo imaging showed that the uptake of [(123)I]ICF01012 to melanomas correlated significantly with melanin content. Schedule treatment of 3 × 25 MBq [(131)I]ICF01012 significantly reduced SK-Mel 3 tumor growth and significantly increased the median survival in treated mice. For this protocol, the calculated delivered dose was 53.2 Gy. Radio-iodinated ICF01012 is a good candidate for both imaging and therapeutic purposes for patients with metastatic pigmented melanomas.

  12. Application of the International Classification of Functioning, Disability and Health (ICF) to people with dysphagia following non-surgical head and neck cancer management.

    PubMed

    Nund, Rebecca L; Scarinci, Nerina A; Cartmill, Bena; Ward, Elizabeth C; Kuipers, Pim; Porceddu, Sandro V

    2014-12-01

    The International Classification of Functioning, Disability, and Health (ICF) is an internationally recognized framework which allows its user to describe the consequences of a health condition on an individual in the context of their environment. With growing recognition that dysphagia can have broad ranging physical and psychosocial impacts, the aim of this paper was to identify the ICF domains and categories that describe the full functional impact of dysphagia following non-surgical head and neck cancer (HNC) management, from the perspective of the person with dysphagia. A secondary analysis was conducted on previously published qualitative study data which explored the lived experiences of dysphagia of 24 individuals with self-reported swallowing difficulties following HNC management. Categories and sub-categories identified by the qualitative analysis were subsequently mapped to the ICF using the established linking rules to develop a set of ICF codes relevant to the impact of dysphagia following HNC management. The 69 categories and sub-categories that had emerged from the qualitative analysis were successfully linked to 52 ICF codes. The distribution of these codes across the ICF framework revealed that the components of Body Functions, Activities and Participation, and Environmental Factors were almost equally represented. The findings confirm that the ICF is a valuable framework for representing the complexity and multifaceted impact of dysphagia following HNC. This list of ICF codes, which reflect the diverse impact of dysphagia associated with HNC on the individual, can be used to guide more holistic assessment and management for this population.

  13. Hybrid-drive implosion system for ICF targets

    DOEpatents

    Mark, J.W.K.

    1987-10-14

    Hybrid-drive implosion systems for ICF targets are described which permit a significant increase in target gain at fixed total driver energy. The ICF target is compressed in two phases, an initial compression phase and a final peak power phase, with each phase driven by a separate, optimized driver. The targets comprise a hollow spherical ablator surroundingly disposed around fusion fuel. The ablator is first compressed to higher density by a laser system, or by an ion beam system, that in each case is optimized for this initial phase of compression of the target. Then, following compression of the ablator, energy is directly delivered into the compressed ablator by an ion beam driver system that is optimized for this second phase of operation of the target. The fusion fuel is driven, at high gain, to conditions wherein fusion reactions occur. This phase separation allows hydrodynamic efficiency and energy deposition uniformity to be individually optimized, thereby securing significant advantages in energy gain. In additional embodiments, the same or separate drivers supply energy for ICF target implosion. 3 figs.

  14. Standardized reporting of functioning information on ICF-based common metrics.

    PubMed

    Prodinger, Birgit; Tennant, Alan; Stucki, Gerold

    2018-02-01

    In clinical practice and research a variety of clinical data collection tools are used to collect information on people's functioning for clinical practice and research and national health information systems. Reporting on ICF-based common metrics enables standardized documentation of functioning information in national health information systems. The objective of this methodological note on applying the ICF in rehabilitation is to demonstrate how to report functioning information collected with a data collection tool on ICF-based common metrics. We first specify the requirements for the standardized reporting of functioning information. Secondly, we introduce the methods needed for transforming functioning data to ICF-based common metrics. Finally, we provide an example. The requirements for standardized reporting are as follows: 1) having a common conceptual framework to enable content comparability between any health information; and 2) a measurement framework so that scores between two or more clinical data collection tools can be directly compared. The methods needed to achieve these requirements are the ICF Linking Rules and the Rasch measurement model. Using data collected incorporating the 36-item Short Form Health Survey (SF-36), the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), and the Stroke Impact Scale 3.0 (SIS 3.0), the application of the standardized reporting based on common metrics is demonstrated. A subset of items from the three tools linked to common chapters of the ICF (d4 Mobility, d5 Self-care and d6 Domestic life), were entered as "super items" into the Rasch model. Good fit was achieved with no residual local dependency and a unidimensional metric. A transformation table allows for comparison between scales, and between a scale and the reporting common metric. Being able to report functioning information collected with commonly used clinical data collection tools with ICF-based common metrics enables clinicians

  15. 42 CFR 440.150 - Intermediate care facility (ICF/IID) services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Intermediate care facility (ICF/IID) services. 440.150 Section 440.150 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.150 Intermediate care facility (ICF/IID)...

  16. Implications of the International Classification of Functioning, Disability and Health (ICF) for Test Development and Use

    ERIC Educational Resources Information Center

    Carlson, Janet F.; Benson, Nicholas; Oakland, Thomas

    2010-01-01

    Implications of the International Classification of Functioning, Disability and Health (ICF) on the development and use of tests in school settings are enumerated. We predict increased demand for behavioural assessments that consider a person's activities, participation and person-environment interactions, including measures that: (a) address…

  17. Updating the OMERACT filter: core areas as a basis for defining core outcome sets.

    PubMed

    Kirwan, John R; Boers, Maarten; Hewlett, Sarah; Beaton, Dorcas; Bingham, Clifton O; Choy, Ernest; Conaghan, Philip G; D'Agostino, Maria-Antonietta; Dougados, Maxime; Furst, Daniel E; Guillemin, Francis; Gossec, Laure; van der Heijde, Désirée M; Kloppenburg, Margreet; Kvien, Tore K; Landewé, Robert B M; Mackie, Sarah L; Matteson, Eric L; Mease, Philip J; Merkel, Peter A; Ostergaard, Mikkel; Saketkoo, Lesley Ann; Simon, Lee; Singh, Jasvinder A; Strand, Vibeke; Tugwell, Peter

    2014-05-01

    The Outcome Measures in Rheumatology (OMERACT) Filter provides guidelines for the development and validation of outcome measures for use in clinical research. The "Truth" section of the OMERACT Filter presupposes an explicit framework for identifying the relevant core outcomes that are universal to all studies of the effects of intervention effects. There is no published outline for instrument choice or development that is aimed at measuring outcome, was derived from broad consensus over its underlying philosophy, or includes a structured and documented critique. Therefore, a new proposal for defining core areas of measurement ("Filter 2.0 Core Areas of Measurement") was presented at OMERACT 11 to explore areas of consensus and to consider whether already endorsed core outcome sets fit into this newly proposed framework. Discussion groups critically reviewed the extent to which case studies of current OMERACT Working Groups complied with or negated the proposed framework, whether these observations had a more general application, and what issues remained to be resolved. Although there was broad acceptance of the framework in general, several important areas of construction, presentation, and clarity of the framework were questioned. The discussion groups and subsequent feedback highlighted 20 such issues. These issues will require resolution to reach consensus on accepting the proposed Filter 2.0 framework of Core Areas as the basis for the selection of Core Outcome Domains and hence appropriate Core Outcome Sets for clinical trials.

  18. A core outcome set for clinical trials on non-specific low back pain: study protocol for the development of a core domain set.

    PubMed

    Chiarotto, Alessandro; Terwee, Caroline B; Deyo, Richard A; Boers, Maarten; Lin, Chung-Wei Christine; Buchbinder, Rachelle; Corbin, Terry P; Costa, Leonardo O P; Foster, Nadine E; Grotle, Margreth; Koes, Bart W; Kovacs, Francisco M; Maher, Chris G; Pearson, Adam M; Peul, Wilco C; Schoene, Mark L; Turk, Dennis C; van Tulder, Maurits W; Ostelo, Raymond W

    2014-12-26

    Low back pain (LBP) is one of the most disabling and costly disorders affecting modern society, and approximately 90% of patients are labelled as having non-specific LBP (NSLBP). Several interventions for patients with NSLBP have been assessed in clinical trials, but heterogeneous reporting of outcomes in these trials has hindered comparison of results and performance of meta-analyses. Moreover, there is a risk of selective outcome reporting bias. To address these issues, the development of a core outcome set (COS) that should be measured in all clinical trials for a specific health condition has been recommended. A standardized set of outcomes for LBP was proposed in 1998, however, with evolution in COS development methodology, new instruments, interventions, and understanding of measurement properties, it is appropriate to update that proposal. This protocol describes the methods used in the initial step in developing a COS for NSLBP, namely, establishing a core domain set that should be measured in all clinical trials. An International Steering Committee including researchers, clinicians, and patient representatives from four continents was formed to guide the development of this COS. The approach of initiatives like Core Outcome Measures in Effectiveness Trials (COMET) and Outcome Measures in Rheumatology (OMERACT) was followed. Participants were invited to participate in a Delphi study aimed at generating a consensus-based core domain set for NSLBP. A list of potential core domains was drafted and presented to the Delphi participants who were asked to judge which domains were core. Participant suggestions about overlap, aggregation, or addition of potential core domains were addressed during the study. The patients' responses were isolated to assess whether there was substantial disagreement with the rest of the Delphi panel. A priori thresholds for consensus were established before each Delphi round. All participants' responses were analysed from a

  19. Prevalence and features of ICF-disability in Spain as captured by the 2008 National Disability Survey

    PubMed Central

    2011-01-01

    when measured by reference to performance. Moreover, global scores indicated that severe/complete disability in these same domains was frequent among the moderately disabled group. Conclusions The EDAD 2008 affords an insufficient data set to be ICF-framed when it comes to the Activity and Participation domains. Notwithstanding their unknown validity, ratings for available ICF domains may, however, be suitable for consideration under the ADL model of functional dependency, suggesting that there are approximately 500,000 persons suffering from severe/complete disability and 1,000,000 suffering from moderate disability, with half the latter being severely disabled in domains capable of benefiting from technical or personal aid. Application of EDAD data to the planning of services for regions and other subpopulations means that need for personal help must be assessed, unmet needs ascertained, and knowledge of social participation and support, particularly for the mentally ill, improved. International, WHO-supported co-operation in ICF planning and use of NDSs in Spain and other countries is needed. PMID:22122806

  20. 42 CFR 440.150 - Intermediate care facility (ICF/MR) services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Intermediate care facility (ICF/MR) services. 440.150 Section 440.150 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.150 Intermediate care facility (ICF/MR) service...

  1. Clinical application of ICF key codes to evaluate patients with dysphagia following stroke

    PubMed Central

    Dong, Yi; Zhang, Chang-Jie; Shi, Jie; Deng, Jinggui; Lan, Chun-Na

    2016-01-01

    Abstract This study was aimed to identify and evaluate the International Classification of Functioning (ICF) key codes for dysphagia in stroke patients. Thirty patients with dysphagia after stroke were enrolled in our study. To evaluate the ICF dysphagia scale, 6 scales were used as comparisons, namely the Barthel Index (BI), Repetitive Saliva Swallowing Test (RSST), Kubota Water Swallowing Test (KWST), Frenchay Dysarthria Assessment, Mini-Mental State Examination (MMSE), and the Montreal Cognitive Assessment (MoCA). Multiple regression analysis was performed to quantitate the relationship between the ICF scale and the other 7 scales. In addition, 60 ICF scales were analyzed by the least absolute shrinkage and selection operator (LASSO) method. A total of 21 ICF codes were identified, which were closely related with the other scales. These included 13 codes from Body Function, 1 from Body Structure, 3 from Activities and Participation, and 4 from Environmental Factors. A topographic network map with 30 ICF key codes was also generated to visualize their relationships. The number of ICF codes identified is in line with other well-established evaluation methods. The network topographic map generated here could be used as an instruction tool in future evaluations. We also found that attention functions and biting were critical codes of these scales, and could be used as treatment targets. PMID:27661012

  2. Compiling standardized information from clinical practice: using content analysis and ICF Linking Rules in a goal-oriented youth rehabilitation program.

    PubMed

    Lustenberger, Nadia A; Prodinger, Birgit; Dorjbal, Delgerjargal; Rubinelli, Sara; Schmitt, Klaus; Scheel-Sailer, Anke

    2017-09-23

    To illustrate how routinely written narrative admission and discharge reports of a rehabilitation program for eight youths with chronic neurological health conditions can be transformed to the International Classification of Functioning, Disability and Health. First, a qualitative content analysis was conducted by building meaningful units with text segments assigned of the reports to the five elements of the Rehab-Cycle ® : goal; assessment; assignment; intervention; evaluation. Second, the meaningful units were then linked to the ICF using the refined ICF Linking Rules. With the first step of transformation, the emphasis of the narrative reports changed to a process oriented interdisciplinary layout, revealing three thematic blocks of goals: mobility, self-care, mental, and social functions. The linked 95 unique ICF codes could be grouped in clinically meaningful goal-centered ICF codes. Between the two independent linkers, the agreement rate was improved after complementing the rules with additional agreements. The ICF Linking Rules can be used to compile standardized health information from narrative reports if prior structured. The process requires time and expertise. To implement the ICF into common practice, the findings provide the starting point for reporting rehabilitation that builds upon existing practice and adheres to international standards. Implications for Rehabilitation This study provides evidence that routinely collected health information from rehabilitation practice can be transformed to the International Classification of Functioning, Disability and Health by using the "ICF Linking Rules", however, this requires time and expertise. The Rehab-Cycle ® , including assessments, assignments, goal setting, interventions and goal evaluation, serves as feasible framework for structuring this rehabilitation program and ensures that the complexity of local practice is appropriately reflected. The refined "ICF Linking Rules" lead to a standardized

  3. Developing core outcome measurement sets for clinical trials: OMERACT filter 2.0.

    PubMed

    Boers, Maarten; Kirwan, John R; Wells, George; Beaton, Dorcas; Gossec, Laure; d'Agostino, Maria-Antonietta; Conaghan, Philip G; Bingham, Clifton O; Brooks, Peter; Landewé, Robert; March, Lyn; Simon, Lee S; Singh, Jasvinder A; Strand, Vibeke; Tugwell, Peter

    2014-07-01

    Lack of standardization of outcome measures limits the usefulness of clinical trial evidence to inform health care decisions. This can be addressed by agreeing on a minimum core set of outcome measures per health condition, containing measures relevant to patients and decision makers. Since 1992, the Outcome Measures in Rheumatology (OMERACT) consensus initiative has successfully developed core sets for many rheumatologic conditions, actively involving patients since 2002. Its expanding scope required an explicit formulation of its underlying conceptual framework and process. Literature searches and iterative consensus process (surveys and group meetings) of stakeholders including patients, health professionals, and methodologists within and outside rheumatology. To comprehensively sample patient-centered and intervention-specific outcomes, a framework emerged that comprises three core "Areas," namely Death, Life Impact, and Pathophysiological Manifestations; and one strongly recommended Resource Use. Through literature review and consensus process, core set development for any specific health condition starts by identifying at least one core "Domain" within each of the Areas to formulate the "Core Domain Set." Next, at least one applicable measurement instrument for each core Domain is identified to formulate a "Core Outcome Measurement Set." Each instrument must prove to be truthful (valid), discriminative, and feasible. In 2012, 96% of the voting participants (n=125) at the OMERACT 11 consensus conference endorsed this model and process. The OMERACT Filter 2.0 explicitly describes a comprehensive conceptual framework and a recommended process to develop core outcome measurement sets for rheumatology likely to be useful as a template in other areas of health care. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  4. The Rocket Equation Improvement under ICF Implosion Experiment

    NASA Astrophysics Data System (ADS)

    Wang, Yanbin; Zheng, Zhijian

    2013-10-01

    The ICF explosion process has been studied in details. The rocket equation has been improved in explosive process by introducing the pressure parameter of fuel. Some methods could be drawn by the improved rocket equation. And the methods could be used to improve ICF target design, driving pulse design and experimental design. The First is to increase ablation pressure. The second is to decrease pressure of fuel. The third is to use larger diameter of target sphere. And the forth is to a shorten driving pulse.

  5. Hybrid-drive implosion system for ICF targets

    DOEpatents

    Mark, James W.

    1988-08-02

    Hybrid-drive implosion systems (20,40) for ICF targets (10,22,42) are described which permit a significant increase in target gain at fixed total driver energy. The ICF target is compressed in two phases, an initial compression phase and a final peak power phase, with each phase driven by a separate, optimized driver. The targets comprise a hollow spherical ablator (12) surroundingly disposed around fusion fuel (14). The ablator is first compressed to higher density by a laser system (24), or by an ion beam system (44), that in each case is optimized for this initial phase of compression of the target. Then, following compression of the ablator, energy is directly delivered into the compressed ablator by an ion beam driver system (30,48) that is optimized for this second phase of operation of the target. The fusion fuel (14) is driven, at high gain, to conditions wherein fusion reactions occur. This phase separation allows hydrodynamic efficiency and energy deposition uniformity to be individually optimized, thereby securing significant advantages in energy gain. In additional embodiments, the same or separate drivers supply energy for ICF target implosion.

  6. Hybrid-drive implosion system for ICF targets

    DOEpatents

    Mark, James W.

    1988-01-01

    Hybrid-drive implosion systems (20,40) for ICF targets (10,22,42) are described which permit a significant increase in target gain at fixed total driver energy. The ICF target is compressed in two phases, an initial compression phase and a final peak power phase, with each phase driven by a separate, optimized driver. The targets comprise a hollow spherical ablator (12) surroundingly disposed around fusion fuel (14). The ablator is first compressed to higher density by a laser system (24), or by an ion beam system (44), that in each case is optimized for this initial phase of compression of the target. Then, following compression of the ablator, energy is directly delivered into the compressed ablator by an ion beam driver system (30,48) that is optimized for this second phase of operation of the target. The fusion fuel (14) is driven, at high gain, to conditions wherein fusion reactions occur. This phase separation allows hydrodynamic efficiency and energy deposition uniformity to be individually optimized, thereby securing significant advantages in energy gain. In additional embodiments, the same or separate drivers supply energy for ICF target implosion.

  7. Characterization of inertial confinement fusion (ICF) targets using PIXE, RBS, and STIM analysis.

    PubMed

    Li, Yongqiang; Liu, Xue; Li, Xinyi; Liu, Yiyang; Zheng, Yi; Wang, Min; Shen, Hao

    2013-08-01

    Quality control of the inertial confinement fusion (ICF) target in the laser fusion program is vital to ensure that energy deposition from the lasers results in uniform compression and minimization of Rayleigh-Taylor instabilities. The technique of nuclear microscopy with ion beam analysis is a powerful method to provide characterization of ICF targets. Distribution of elements, depth profile, and density image of ICF targets can be identified by particle-induced X-ray emission, Rutherford backscattering spectrometry, and scanning transmission ion microscopy. We present examples of ICF target characterization by nuclear microscopy at Fudan University in order to demonstrate their potential impact in assessing target fabrication processes.

  8. Mapping SAGE questionnaire to the International Classification of Functioning, Disability and Health (ICF).

    PubMed

    Raggi, Alberto; Quintas, Rui; Russo, Emanuela; Martinuzzi, Andrea; Costardi, Daniela; Frisoni, Giovanni Battista; Franco, Maria Grazia; Andreotti, Alessandra; Ojala, Matti; Peña, Sebastián; Perales, Jaime; Chatterji, Somnath; Miret, Marta; Tobiasz-Adamczyk, Beata; Koskinen, Seppo; Frattura, Lucilla; Leonardi, Matilde

    2014-01-01

    The collaborative research on ageing in Europe protocol was based on that of the World Health Organization Study on global AGEing and adult health (SAGE) project that investigated the relationship between health and well-being and provided a set of instruments that can be used across countries to monitor health and health-related outcomes of older populations as well as the strategies for addressing issues concerning the ageing process. To evaluate the degree to which SAGE protocol covered the spectrum of disability given the scope of the World Health Organization International Classification of Functioning, Disability and Health (ICF), a mapping exercise was performed with SAGE protocol. Results show that the SAGE protocol covers ICF domains in a non-uniform way, with environmental factors categories being underrepresented, whereas mental, cardiovascular, sensory functions and mobility were overrepresented. To overcome this partial coverage of ICF functioning categories, new assessment instruments have been developed. PRACTITIONER MESSAGE: Mapping exercises are valid procedures to understand the extent to which a survey protocol covers the spectrum of functioning. The mapping exercise with SAGE protocol shows that it provides only a partial representation of body functions and activities and participation domains, and the coverage of environmental factors is poor. New instruments are therefore needed for researchers to properly understand the health and disability of ageing populations. Copyright © 2013 John Wiley & Sons, Ltd.

  9. A core outcome set for clinical trials in acute diarrhoea.

    PubMed

    Karas, Jacek; Ashkenazi, Shai; Guarino, Alfredo; Lo Vecchio, Andrea; Shamir, Raanan; Vandenplas, Yvan; Szajewska, Hania

    2015-04-01

    Core outcome sets are the baseline for what should be measured in clinical research and, thus, should serve as a guide for what should be collected and reported. The Consensus Group on Outcome Measures Made in Pediatric Enteral Nutrition Clinical Trials, established in 2012, agreed that consensus on a core set of outcomes with agreed-upon definitions that should be measured and reported in clinical trials was needed. To achieve this goal, six working groups (WGs) were setup, including WG on acute diarrhoea, whose main goal was to develop a core outcome set for trials in acute diarrhoea. The first step identified how published outcomes related to acute diarrhoea were reported. The second focused on the methodology for determining which outcomes to measure in clinical trials. The third employed a two-phase questionnaire study using the Delphi technique to define clinically important outcomes to clinicians and parents. For therapeutic studies, the five most important outcome measures were diarrhoea duration, degree of dehydration, need for hospitalisation (or duration of hospitalisation for inpatients), the proportion of patients recovered by 48 h and adverse effects. The prophylactic core outcome set included prevention of diarrhoea, prevention of dehydration, prevention of hospitalisation and adverse effects. The outcome sets for therapy and prevention can be recommended for use in future trials of patients with gastroenteritis. Their envisioned goal is to decrease study heterogeneity and to ease the comparability of studies. WG's next step is to determine how to measure the outcomes included in the core set. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. The International Classification of Functioning, Disability and Health (ICF) in Electronic Health Records. A Systematic Literature Review.

    PubMed

    Maritz, Roxanne; Aronsky, Dominik; Prodinger, Birgit

    2017-09-20

    The International Classification of Functioning, Disability and Health (ICF) is the World Health Organization's standard for describing health and health-related states. Examples of how the ICF has been used in Electronic Health Records (EHRs) have not been systematically summarized and described yet. To provide a systematic review of peer-reviewed literature about the ICF's use in EHRs, including related challenges and benefits. Peer-reviewed literature, published between January 2001 and July 2015 was retrieved from Medline ® , CINAHL ® , Scopus ® , and ProQuest ® Social Sciences using search terms related to ICF and EHR concepts. Publications were categorized according to three groups: Requirement specification, development and implementation. Information extraction was conducted according to a qualitative content analysis method, deductively informed by the evaluation framework for Health Information Systems: Human, Organization and Technology-fit (HOT-fit). Of 325 retrieved articles, 17 publications were included; 4 were categorized as requirement specification, 7 as development, and 6 as implementation publications. Information regarding the HOT-fit evaluation framework was summarized. Main benefits of using the ICF in EHRs were its unique comprehensive perspective on health and its interdisciplinary focus. Main challenges included the fact that the ICF is not structured as a formal terminology as well as the need for a reduced number of ICF codes for more feasible and practical use. Different approaches and technical solutions exist for integrating the ICF in EHRs, such as combining the ICF with other existing standards for EHR or selecting ICF codes with natural language processing. Though the use of the ICF in EHRs is beneficial as this review revealed, the ICF could profit from further improvements such as formalizing the knowledge representation in the ICF to support and enhance interoperability.

  11. The Communication Supports Inventory-Children & Youth (CSI-CY), a new instrument based on the ICF-CY.

    PubMed

    Rowland, Charity; Fried-Oken, Melanie; Bowser, Gayl; Granlund, Mats; Lollar, Donald; Phelps, Randall; Simeonsson, Rune J; Steiner, Sandra A M

    2016-09-01

    Two studies are presented that evaluated the Communication Supports Inventory-Children & Youth (CSI-CY), an instrument designed to facilitate the development of communication-related educational goals for students with complex communication needs (CCN). The CSI-CY incorporates a code set based on the ICF-CY. The studies were designed to determine the effect of using the CSI-CY on IEP goals for students with CCN and to evaluate consumer satisfaction. In Study 1, sixty-one educators and speech-language pathologists were randomly assigned to either (a) provide a student's current IEP (control group) or (b) complete the CSI-CY prior to preparing a student's next IEP and to submit the new IEP (experimental group). Study 2 was a field test to generate consumer satisfaction data. Study 1 showed that IEP goals submitted by participants in the experimental group referenced CSI-CY-related content significantly more frequently than did those submitted by control participants. Study 2 revealed high satisfaction with the instrument. The code set basis of the CSI-CY extends the common language of the ICF-CY to practical educational use for children with CCN across diagnostic groups. The CSI-CY is well regarded as an instrument to inform the content of communication goals related to CCN. Implications for Rehabilitation The CSI-CY will guide rehabilitation professionals to develop goals for children with complex communication impairments. The CSI-CY is a new instrument that is based on the ICF-CY for documentation of communication goals.

  12. Looking at the ICF and human communication through the lens of classification theory.

    PubMed

    Walsh, Regina

    2011-08-01

    This paper explores the insights that classification theory can provide about the application of the International Classification of Functioning, Disability and Health (ICF) to communication. It first considers the relationship between conceptual models and classification systems, highlighting that classification systems in speech-language pathology (SLP) have not historically been based on conceptual models of human communication. It then overviews the key concepts and criteria of classification theory. Applying classification theory to the ICF and communication raises a number of issues, some previously highlighted through clinical application. Six focus questions from classification theory are used to explore these issues, and to propose the creation of an ICF-related conceptual model of communicating for the field of communication disability, which would address some of the issues raised. Developing a conceptual model of communication for SLP purposes closely articulated with the ICF would foster productive intra-professional discourse, while at the same time allow the profession to continue to use the ICF for purposes in inter-disciplinary discourse. The paper concludes by suggesting the insights of classification theory can assist professionals to apply the ICF to communication with the necessary rigour, and to work further in developing a conceptual model of human communication.

  13. Employing the International Classification of Functioning, Disability and Health framework to capture user feedback in the design and testing stage of development of home-based arm rehabilitation technology.

    PubMed

    Sivan, Manoj; Gallagher, Justin; Holt, Ray; Weightman, Andrew; O'Connor, Rory; Levesley, Martin

    2016-01-01

    The purpose of this study was to evaluate the International Classification of Functioning, Disability and Health (ICF) as a framework to ensure that key aspects of user feedback are identified in the design and testing stages of development of a home-based upper limb rehabilitation system. Seventeen stroke survivors with residual upper limb weakness, and seven healthcare professionals with expertise in stroke rehabilitation, were enrolled in the user-centered design process. Through semi-structured interviews, they provided feedback on the hardware, software and impact of a home-based rehabilitation device to facilitate self-managed arm exercise. Members of the multidisciplinary clinical and engineering research team, based on previous experience and existing literature in user-centred design, developed the topic list for the interviews. Meaningful concepts were extracted from participants' interviews based on existing ICF linking rules and matched to categories within the ICF Comprehensive Core Set for stroke. Most of the interview concepts (except personal factors) matched the existing ICF Comprehensive Core Set categories. Personal factors that emerged from interviews e.g. gender, age, interest, compliance, motivation, choice and convenience that might determine device usability are yet to be categorised within the ICF framework and hence could not be matched to a specific Core Set category.

  14. Improved AFM Mapping of ICF Target Surfaces

    NASA Astrophysics Data System (ADS)

    Olson, D. K.; Drake, T.; Frey, D.; Huang, H.; Stephens, R. B.

    2003-10-01

    Targets for Inertial Confinement Fusion (ICF) research are made from spherical shells with very strict requirements on surface smoothness. Hydrodynamic instabilities are amplified by the presence of surface defects, greatly reducing the gain of ICF targets. Sub-micron variations in the surface can be examined using an Atomic Force Microscope. The current sphere mapping assembly at General Atomics is designed to trace near the equator of a rotating sphere under the AFM head. Spheres are traced on three mutually orthogonal planes. The ˜10 mm piezo-electric actuator range limits how far off the equator we can scan spheres of millimeter diameter. Because only a small fraction of the target's surface can be covered, localized high-mode defects are difficult to detect. In order to meet the needs of ICF research, we need to scan more surface area of the sphere with the AFM. By integrating an additional stepping motor to the sphere mapping assembly, we will be able to recenter the piezo driver of the AFM while mapping. This additional ability allows us to increase the amount of the sphere's surface we are able to scan with the AFM by extending the range of the AFM from the sphere's equator.

  15. Rhetoric and Realities in Today's ICF/MR: Control out of Control.

    ERIC Educational Resources Information Center

    Holburn, C. Steve

    1992-01-01

    This paper contrasts the rhetoric of quality assurance with the realities of poor quality in today's Intermediate Care Facilities for the Mentally Retarded (ICF/MR). The ICF/MR operational model is described as paper oriented, failure based, and insensitive to the effects of its own practices. Recommendations include the establishment of local…

  16. Use of the International Classification of Functioning, Disability and Health Generic-30 Set for the characterization of outpatients: Italian Society of Physical and Rehabilitative Medicine Residents Section Project.

    PubMed

    Gimigliano, Francesca; De Sire, Alessandro; Gastaldo, Marco; Maghini, Irene; Paoletta, Marco; Pasquini, Andrea; Boldrini, Paolo; Selb, Melissa; Prodinger, Birgit

    2018-06-11

    The International Classification of Functioning, Disability and Health (ICF) Generic- 30 Set (previously referred to as Rehabilitation Set) is a minimal set of ICF categories for reporting and assessing functioning and disability in clinical populations with different health conditions along the continuum of care. Recently, the Italian Society of Physical and Rehabilitation Medicine (SIMFER) developed an Italian modification of the simple and intuitive descriptions (SID) of these categories. This study was the first one to implement the use of the SID in practice. 1) To implement the use of the ICF in clinical practice and research among Italian Residents in PRM. 2) To verify if the SID made the application of ICF Generic 30 Set more user-friendly than the original descriptions. 3) To examine the prevalence of functioning problems of patients accessing Rehabilitation Services to serve as reference for the development of an ICF-based clinical data collection tool. Multicenter cross-sectional study. Italian Physical Medicine and Rehabilitation (PRM) outpatient rehabilitation services. Patients referring to Italian PRM outpatient rehabilitation services and Italian Residents in PRM. Each School of Specialization involved, randomly, received the ICF Generic-30 Set with the original descriptions or with the SID. Residents collected over a 4-month period (April-July 2016) patients data related to the ICF Generic-30 Set categories. Moreover, the residents self- assessed their difficulty in using the ICF Generic-30 Set with the original descriptions or with the SID, through a Numeric Rating Scale (NRS). Ninety-three residents collected functioning data of 864 patients (mean aged 57.7±19.3) with ICF Generic-30 Set: 304 with the original descriptions and 560 with SID. The difficulty in using the ICF Generic-30 Set with SID was rated as lower than using the original descriptions (NRS = 2.8±2.5 vs 3.5±3.1; p<0.001). The most common disease was the back pain (9.6%) and

  17. Italian ICF training programs: describing and promoting human functioning and research.

    PubMed

    Francescutti, Carlo; Fusaro, Guido; Leonardi, Matilde; Martinuzzi, Andrea; Sala, Marina; Russo, Emanuela; Frare, Mara; Pradal, Monica; Zampogna, Daniela; Cosentino, Alessandro; Raggi, Alberto

    2009-01-01

    Purpose of the article is to report on 5 years of ICF training experiences in Italy aimed at promoting a consistent approach to ICF's field application. More than 7000 persons participated in around 150 training events: almost half were organised by political bodies, at national, regional or local level, directly linked to implementation experiences. Few training events were organised by the school sector, while training commissioned by NGOs represent a relevant area and, in our opinion, constitute the first step towards a full inclusion of persons with disabilities. Central pillars of our training modules are: the inclusion of all ICF components in the description of functional profiles, the need of providing brief theoretical background information before moving to practical aspects and the importance of providing personalised face to face training modules, in contrast to self-administered learning modules, or web-based protocols. On the basis of our experience, we can conclude that training's objectives are generally reached: trainees improved their knowledge of the ICF and its related tools, and are able to begin practical applications in their contexts.

  18. A Common Set of Core Values - The Foundation for a More Effective Joint Force

    DTIC Science & Technology

    2015-05-18

    these codes stopped short of codifying a set of core values and instead focused on right and wrong behaviors. This adherence to sets of rules and...Armed Forces independently recognized the limitations of compliance-based rules and the criticality of establishing a strong foundation with core...institutional values vice core values? The knee -jerk reaction of the 1990s and a subsequent lack of a formal effort to institute a single set of core

  19. Satisfaction and sense of well being among Medicaid ICF/MR and HCBS recipients in six states.

    PubMed

    Stancliffe, Roger J; Lakin, K Charlie; Taub, Sarah; Chiri, Giuseppina; Byun, Soo-Yong

    2009-04-01

    Self-reported satisfaction and sense of well-being were assessed in a sample of 1,885 adults with intellectual and developmental disabilities receiving Medicaid Home and Community Based Services (HCBS) and Intermediate Care Facility (ICF/MR) services in 6 states. Questions dealt with such topics as loneliness, feeling afraid at home and in one's neighborhood, feeling happy, feeling that staff are nice and polite, and liking one's home and work/day program. Loneliness was the most widespread problem, and there were also small percentages of people who reported negative views in other areas. Few differences were evident by HCBS and ICF/MR status. The findings document consistent benefits of residential support provided in very small settings-with choices of where and with whom to live-and to individuals living with family.

  20. Measuring body structures and body functions from the International Classification of Functioning, Disability, and Health perspective: considerations for biomedical parameters in spinal cord injury research.

    PubMed

    Eriks-Hoogland, Inge E; Brinkhof, Martin W G; Al-Khodairy, Abdul; Baumberger, Michael; Brechbühl, Jörg; Curt, Armin; Mäder, Mark; Stucki, Gerold; Post, Marcel W M

    2011-11-01

    The aims of this study were to provide a selection of biomedical domains based on the comprehensive International Classification of Functioning, Disability, and Health (ICF) core sets for spinal cord injury (SCI) and to present an overview of the corresponding measurement instruments. Based on the Biomedical Domain Set, the SCI literature, the International Spinal Cord Society international data sets, and the Spinal Cord Injury Rehabilitation Evidence project publications were used to derive category specifications for use in SCI research. Expert opinion was used to derive a priority selection. The same sources were used to determine candidate measurement instruments for the specification of body functions and body structures using an example, and guiding principles were applied to select the most appropriate biomedical measurement instrument(s) for use in an SCI research project. Literature searches were performed for 41 second-level ICF body functions categories and for four second-level ICF body structures categories. For some of these categories, only a few candidate measurement instruments were found with limited variation in the type of measurement instruments. An ICF-based measurement set for biomedical aspects of functioning with SCI was established. For some categories of the ICF core sets for SCI, there is a need to develop measurement instruments.

  1. Disability and Functional Profiles of Patients with Migraine Measured with ICF Classification

    ERIC Educational Resources Information Center

    Raggi, Alberto

    2010-01-01

    To describe the functional profiles of patients with migraine, and the relationships between symptoms, activities and environmental factors, using WHO's International Classification of Functioning (ICF). Patients were consecutively enrolled at the Besta Institute of Milan. The ICF checklist was administered and two count-based indexes developed:…

  2. Towards a standardized nutrition and dietetics terminology for clinical practice: An Austrian multicenter clinical documentation analysis based on the International Classification of Functioning, Disability and Health (ICF)-Dietetics.

    PubMed

    Gäbler, Gabriele; Coenen, Michaela; Lycett, Deborah; Stamm, Tanja

    2018-03-03

    High quality, continuity and safe interdisciplinary healthcare is essential. Nutrition and dietetics plays an important part within the interdisciplinary team in many health conditions. In order to work more effectively as an interdisciplinary team, a common terminology is needed. This study investigates which categories of the ICF-Dietetics are used in clinical dietetic care records in Austria and which are most relevant to shared language in different medical areas. A national multicenter retrospective study was conducted to collect clinical dietetic care documentation reports. The analysis included the "best fit" framework synthesis, and a mapping exercise using the ICF Linking Rules. Medical diagnosis and intervention concepts were excluded from the mapping, since they are not supposed to be classified by the ICF. From 100 dietetic records, 307 concepts from 1807 quotations were extracted. Of these, 241 assessment, dietetics diagnosis, goal setting and evaluation concepts were linked to 153 ICF-Dietetics categories. The majority (91.3%) could be mapped to a precise ICF-Dietetics category. The highest number of ICF-Dietetics categories was found in the medical area of diabetes and metabolism and belonged to the ICF component Body Function, while very few categories were used from the component Participation and Environmental Factors. The integration of the ICF-Dietetics in nutrition and dietetic care process is possible. Moreover, it could be considered as a conceptual framework for interdisciplinary nutrition and dietetics care. However, a successful implementation of the ICF-Dietetics in clinical practice requires a paradigm shift from medical diagnosis-focused health care to a holistic perspective of functioning with more attention on Participation and Environmental Factors. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  3. Beam wavefront and farfield control for ICF laser driver

    NASA Astrophysics Data System (ADS)

    Dai, Wanjun; Deng, Wu; Zhang, Xin; Jiang, Xuejun; Zhang, Kun; Zhou, Wei; Zhao, Junpu; Hu, Dongxia

    2010-10-01

    Five main problems of beam wavefront and farfield control in ICF laser driver are synthetically discussed, including control requirements, beam propagation principle, distortions source control, system design and adjustment optimization, active wavefront correction technology. We demonstrate that beam can be propagated well and the divergence angle of the TIL pulses can be improved to less than 60μrad with solving these problems, which meets the requirements of TIL. The results can provide theoretical and experimental support for wavefront and farfield control designing requirements of the next large scale ICF driver.

  4. [ICF-Checklist to Evaluate Inclusion of Elderlies with Intellectual Disability - Psychometric Properties].

    PubMed

    Queri, Silvia; Eggart, Michael; Wendel, Maren; Peter, Ulrike

    2017-11-28

    Background An instrument should have been developed to measure participation as one possible criterion to evaluate inclusion of elderly people with intellectual disability. The ICF was utilized, because participation is one part of health related functioning, respectively disability. Furthermore ICF includes environmental factors (contextual factors) and attaches them an essentially influence on health related functioning, in particular on participation. Thus ICF Checklist additionally identifies environmental barriers for elimination. Methodology A linking process with VINELAND-II yielded 138 ICF items for the Checklist. The sample consists of 50 persons with a light or moderate intellectual disability. Two-thirds are female and the average age is 68. They were directly asked about their perceived quality of life. Additionally, proxy interviews were carried out with responsible staff members concerning necessary support and behavioral deviances. The ICF Checklist was administered twice, once (t2) the current staff member should rate health related functioning at the given time and in addition, a staff member who knows the person at least 10 years before (t1) should rate the former functioning. Content validity was investigated with factor analysis and criterion validity with correlational analysis related to supports need, behavioral deviances and perceived quality of life. Quantitative analysis was validated by qualitative content analysis of patient documentation. Results Factor analysis shows logical variable clusters across the extracted factors but neither interpretable factors. The Checklist is reliable, valid related to the chosen criterions and shows the expected age-related shifts. Qualitative analysis corresponds with quantitative data. Consequences/Conclusion ICF Checklist is appropriate to manage and evaluate patient-centered care. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Simplified bipartite concepts of functioning and disability recommended for interdisciplinary use of the ICF.

    PubMed

    Thyberg, Mikael; Arvidsson, Patrik; Thyberg, Ingrid; Nordenfelt, Lennart

    2015-01-01

    To argue for and propose bipartite concepts of functioning and disability, to tally with the structure of the ICF classification list, concepts of social models and clinical needs. The ICF concepts are discussed in relation to the history of ideas regarding disability concepts and the needs for such concepts in interdisciplinary rehabilitation. Bipartite concepts are presented; they refer to actual functioning, simply body functions/structures and participation, including functioning in standardized environments. Participation refers to actually performed "activities", with "activities" simply denoting things that people may do. Bipartite concepts are congruent with the ICF classification and the structure of social models of disability, suitable for clinical and interdisciplinary use and easy to understand. The issue of standardized environments represents a methodological issue rather than the conceptual issue of defining functioning and disability. An individual perspective on activity and activity limitations, i.e. the middle part of the tripartite ICF concept, is somewhat similar to concepts of traditional language that were regarded as too generalizing already in 1912, when the interactional concept of "disability in a social sense" was introduced in rehabilitation practices. Bipartite concepts of functioning and disability are recommended for interdisciplinary use of the ICF. The ICF classification is useful, but the ICF concept of activities in an individual perspective is confusing. We suggest a use of the term "activities" simply to denote things that people may do and "participation" to denote actually performed activities. Estimations of ability should be explicit about how they are related to environmental factors.

  6. When shape matters: Correcting the ICFs to derive the chemical abundances of bipolar and elliptical PNe

    NASA Astrophysics Data System (ADS)

    Gonçalves, Denise R.; Wesson, Roger; Morisset, Cristophe; Barlow, Michael; Ercolano, Barbara

    2012-08-01

    The extraction of chemical abundances of ionised nebulae from a limited spectral range is usually hampered by the lack of emission lines corresponding to certain ionic stages. So far, the missing emission lines have been accounted for by the ionisation correction factors (ICFs), constructed under simplistic assumptions like spherical geometry by using 1-D photoionisation modelling. In this contribution we discuss the results (Gonçalves et al. 2011, in prep.) of our ongoing project to find a new set of ICFs to determine total abundances of N, O, Ne, Ar, and S, with optical spectra, in the case of non-spherical PNe. These results are based on a grid of 3-D photoionisation modelling of round, elliptical and bipolar shaped PNe, spanning the typical PN luminosities, effective temperatures and densities. We show that the additional corrections to the widely used Kingsburgh & Barlow (1994) ICFs are always higher for bipolars than for ellipticals. Moreover, these additional corrections are, for bipolars, up to: 17% for oxygen, 33% for nitrogen, 40% for neon, 28% for argon and 50% for sulphur. Finally, on top of the fact that corrections change greatly with shape, they vary also greatly with the central star temperature, while the luminosity is a less important parameter.

  7. Developing core outcome sets for clinical trials: issues to consider

    PubMed Central

    2012-01-01

    The selection of appropriate outcomes or domains is crucial when designing clinical trials in order to compare directly the effects of different interventions in ways that minimize bias. If the findings are to influence policy and practice then the chosen outcomes need to be relevant and important to key stakeholders including patients and the public, health care professionals and others making decisions about health care. There is a growing recognition that insufficient attention has been paid to the outcomes measured in clinical trials. These issues could be addressed through the development and use of an agreed standardized collection of outcomes, known as a core outcome set, which should be measured and reported, as a minimum, in all trials for a specific clinical area. Accumulating work in this area has identified the need for general guidance on the development of core outcome sets. Key issues to consider in the development of a core outcome set include its scope, the stakeholder groups to involve, choice of consensus method and the achievement of a consensus. PMID:22867278

  8. Accommodation Outcomes and the ICF Framework

    ERIC Educational Resources Information Center

    Schreuer, Naomi

    2009-01-01

    Accommodation of the environment and technology is one of the key mediators of adjustment to disability and participation in community. In this article, accommodations are tested empirically as facilitators of return to work and participation, as defined by the "International Classification of Disability, Function, and Health" (ICF) and…

  9. Psychometric properties of the International Classification of Functioning, Disability and Health set for spinal cord injury nursing based on Rasch analysis.

    PubMed

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

    2018-02-01

    To examine the psychometric properties of the International Classification of Functioning, Disability and Health (ICF) set for spinal cord injury nursing (ICF-SCIN) using Rasch analysis. A total of 140 spinal cord injury patients were recruited between December 2013 and March 2014 through convenience sampling. Nurses used the components body functions (BF), body structures (BS), and activities and participation (AP) of the ICF-SCIN to rate the patients' functioning. Rasch analysis was performed using RUMM 2030 software. In each component, categories were rescored from 01234 to 01112 because of reversed thresholds. Nine testlets were created to overcome local dependency. Four categories which fit to the Rasch model poorly were deleted. After modification, the components BF, BS, and AP showed good fit to the Rasch model with a Bonferroni-adjusted significant level (χ 2  =   86.29, p = 0.006; χ 2  =   22.44, p = 0.130; χ 2  =   39.92, p = 0.159). The person separation indices (PSIs) for the three components were 0.80, 0.54, and 0.97, respectively. No differential item functioning (DIF) was detected across age, gender, or educational level. The fit properties of the ICF set were satisfactory after modifications. The ICF-SCIN has the potential as a nursing assessment instrument for measuring the functioning of patients with spinal cord injury. Implications for rehabilitation The International Classification of Functioning, Disability and Health (ICF) set for spinal cord injury nursing contains a group of categories which can reflect the functioning of spinal cord injury patients from the perspective of nurses. The components body functions (BF), body structures (BS), and activities and participation (AP) of the ICF set for spinal cord injury achieved the fit to the Rasch model through rescoring, generating testlets, and deleting categories with poor fit. The ICF set for spinal cord injury nursing (ICF-SCIN) has the potential to be used as a

  10. Wetted Foam Liquid DT Layer ICF Experiments at the NIF

    NASA Astrophysics Data System (ADS)

    Olson, R. E.; Leeper, R. J.; Peterson, R. R.; Yi, S. A.; Zylstra, A. B.; Kline, J. L.; Bradley, P. A.; Yin, L.; Wilson, D. C.; Haines, B. M.; Batha, S. H.

    2016-10-01

    A key physics issue in indirect-drive ICF relates to the understanding of the limitations on hot spot convergence ratio (CR), principally set by the hohlraum drive symmetry, the capsule mounting hardware (the ``tent''), and the capsule fill tube. An additional key physics issue relates to the complex process by which a hot spot must be dynamically formed from the inner ice surface in a DT ice-layer implosion. These physics issues have helped to motivate the development of a new liquid DT layer wetted foam platform at the NIF that provides an ability to form the hot spot from DT vapor and experimentally study and understand hot spot formation at a variety of CR's in the range of 12ICF ignition. This work was performed under the auspices of the U. S. DOE by LANL under contract DE-AC52-06NA25396.

  11. An antiproton driver for ICF propulsion

    NASA Technical Reports Server (NTRS)

    Chiang, Pi-Ren; Lewis, R. A.; Smith, G. A.; Gazze, C.; Higman, K.; Newton, R.; Chiaverini, M.; Dailey, J.; Surratt, M.; Werthman, W. Lance

    1993-01-01

    Inertial confinement fusion (ICF) utilizing an anitprotoncatalyzed target is discussed as a possible source of propulsion for rapid interplanetary manned space missions. The relevant compression, ignition, and thrust mechanisms are presented. Progress on an experiment presently in progress at the Phillips Laboratory, Kirtland AFB, NM to demonstrate proof-of-principle is reviewed.

  12. The VISTA spacecraft: Advantages of ICF (Inertial Confinement Fusion) for interplanetary fusions propulsion applications

    NASA Technical Reports Server (NTRS)

    Orth, Charles D.; Klein, Gail; Sercel, Joel; Hoffman, Nate; Murray, Kathy; Chang-Diaz, Franklin

    1987-01-01

    Inertial Confinement Fusion (ICF) is an attractive engine power source for interplanetary manned spacecraft, especially for near-term missions requiring minimum flight duration, because ICF has inherent high power-to-mass ratios and high specific impulses. We have developed a new vehicle concept called VISTA that uses ICF and is capable of round-trip manned missions to Mars in 100 days using A.D. 2020 technology. We describe VISTA's engine operation, discuss associated plasma issues, and describe the advantages of DT fuel for near-term applications. Although ICF is potentially superior to non-fusion technologies for near-term interplanetary transport, the performance capabilities of VISTA cannot be meaningfully compared with those of magnetic-fusion systems because of the lack of a comparable study of the magnetic-fusion systems. We urge that such a study be conducted.

  13. Kinetic physics in ICF: present understanding and future directions

    NASA Astrophysics Data System (ADS)

    Rinderknecht, Hans G.; Amendt, P. A.; Wilks, S. C.; Collins, G.

    2018-06-01

    Kinetic physics has the potential to impact the performance of indirect-drive inertial confinement fusion (ICF) experiments. Systematic anomalies in the National Ignition Facility implosion dataset have been identified in which kinetic physics may play a role, including inferred missing energy in the hohlraum, drive asymmetry in near-vacuum hohlraums, low areal density and high burn-averaged ion temperatures (〈Ti 〉) compared with mainline simulations, and low ratios of the DD-neutron and DT-neutron yields and inferred 〈Ti 〉. Several components of ICF implosions are likely to be influenced or dominated by kinetic physics: laser-plasma interactions in the LEH and hohlraum interior; the hohlraum wall blowoff, blowoff/gas and blowoff/ablator interfaces; the ablator and ablator/ice interface; and the DT fuel all present conditions in which kinetic physics can significantly affect the dynamics. This review presents the assembled experimental data and simulation results to date, which indicate that the effects of long mean-free-path plasma phenomena and self-generated electromagnetic fields may have a significant impact in ICF targets. Simulation and experimental efforts are proposed to definitively quantify the importance of these effects at ignition-relevant conditions, including priorities for ongoing study.

  14. ICF and casemix models for healthcare funding: use of the WHO family of classifications to improve casemix.

    PubMed

    Madden, Richard; Marshall, Ric; Race, Susan

    2013-06-01

    Casemix models for funding activity in health care and assessing performance depend on data based on uniformity of resource utilisation. It has long been an ideal to relate the measure of value more to patient outcome than output. A problem frequently expressed by clinicians is that measures of activity such as Functional Independence Measure (FIM) and Barthel Index scores may not sufficiently represent the aspirations of patients in many care programs. Firstly, the key features of the International Classification of Functioning, Disability and Health are outlined. Secondly, the use of ICF dimensions in Australia and other countries is reviewed. Thirdly, a broader set of domains with potential for casemix funding models and performance reporting is considered. In recent years, the ICF has provided a more developed set of domains against which outcome goals can be expressed. Additional dimensions could be used to supplement existing data. Instances of developments in this area are identified and their potential discussed. A well-selected set of data items representing the broader dimensions of outcome goals may provide the ability to more meaningfully and systematically measure the goals of both curative and rehabilitation care against which outcome should be measured. More information about patient goals may be needed.

  15. Eligibility, the ICF and the UN Convention: Australian perspectives

    PubMed Central

    2011-01-01

    The UN Convention on the Rights of Persons with Disabilities, in Australia, acts as a philosophical and moral statement and framework guiding integrated and strategic policy across the nation. Broad policy agreement has been reached by governments, and both the government and non-government sectors are developing strategies for implementation or evaluation. There is however a need for a more integrated approach to disability policy and information, reflecting all three components of the Italian project: • legislation and a high level philosophical framework and policy guide; • a technical framework that can underpin specific policies and programs aiming to achieve the major goals; and , • a language and set of tools, relating to both the above, that provide infrastructure for assessment methods and information systems. The International Classification of Functioning, Disability and Health (ICF) is the ideal tool to support the latter two components, consistent with the UN Convention. While the ICF has been used as the basis for national data standards, in population surveys and in the national data collection on disability support services, there is considerable scope for greater use of it, including using all domains of the Activities and Participation and the Environmental Factors component for policy, information and service provision, to advance a disability-inclusive society. Information available from the income support system and from generic services could be enhanced by reference to the ICF components. It would be of significant national value in Australia, especially as a ‘continuum of care’ is desired, if consistency of concepts and information were expanded across health and social welfare sectors. It would then be possible to obtain consistent data from health, aged care, disability and community services systems about key aspects of health and functioning, building a consolidated picture of access and experience across these sectors. Without

  16. A protocol for developing, disseminating, and implementing a core outcome set for pre-eclampsia.

    PubMed

    Duffy, James M N; van 't Hooft, Janneke; Gale, Chris; Brown, Mark; Grobman, William; Fitzpatrick, Ray; Karumanchi, S Ananth; Lucas, Nuala; Magee, Laura; Mol, Ben; Stark, Michael; Thangaratinam, Shakila; Wilson, Mathew; von Dadelszen, Peter; Williamson, Paula; Khan, Khalid S; Ziebland, Sue; McManus, Richard J

    2016-10-01

    Pre-eclampsia is a serious complication of pregnancy and contributes to maternal and offspring mortality and morbidity. Randomised controlled trials evaluating therapeutic interventions for pre-eclampsia have reported many different outcomes and outcome measures. Such variation contributes to an inability to compare, contrast, and combine individual studies, limiting the usefulness of research to inform clinical practice. The development and use of a core outcome set would help to address these issues ensuring outcomes important to all stakeholders, including patients, will be collected and reported in a standardised fashion. An international steering group including healthcare professionals, researchers, and patients, has been formed to guide the development of this core outcome set. Potential outcomes will be identified through a comprehensive literature review and semi-structured interviews with patients. Potential core outcomes will be entered into an international, multi-perspective online Delphi survey. All key stakeholders, including healthcare professionals, researchers, and patients will be invited to participate. The modified Delphi method encourages whole and stakeholder group convergence towards consensus 'core' outcomes. Once core outcomes have been agreed upon it is important to determine how they should be measured. The truth, discrimination, and feasibility assessment framework will assess the quality of potential outcome measures. High quality outcome measures will be associated with core outcomes. Mechanisms exist to disseminate and implement the resulting core outcome set within an international context. Embedding the core outcome set within future clinical trials, systematic reviews, and clinical practice guidelines could make a profound contribution to advancing the usefulness of research to inform clinical practice, enhance patient care, and improve maternal and offspring outcomes. The infrastructure created by developing a core outcome set

  17. Wetted foam liquid fuel ICF target experiments

    DOE PAGES

    Olson, R. E.; Leeper, R. J.; Yi, S. A.; ...

    2016-05-26

    We are developing a new NIF experimental platform that employs wetted foam liquid fuel layer ICF capsules. We will use the liquid fuel layer capsules in a NIF sub-scale experimental campaign to explore the relationship between hot spot convergence ratio (CR) and the predictability of hot spot formation. DT liquid layer ICF capsules allow for flexibility in hot spot CR via the adjustment of the initial cryogenic capsule temperature and, hence, DT vapor density. Our hypothesis is that the predictive capability of hot spot formation is robust and 1D-like for a relatively low CR hot spot (CR~15), but will becomemore » less reliable as hot spot CR is increased to CR>20. Simulations indicate that backing off on hot spot CR is an excellent way to reduce capsule instability growth and to improve robustness to low-mode x-ray flux asymmetries. In the initial experiments, we will test our hypothesis by measuring hot spot size, neutron yield, ion temperature, and burn width to infer hot spot pressure and compare to predictions for implosions with hot spot CR's in the range of 12 to 25. Larger scale experiments are also being designed, and we will advance from sub-scale to full-scale NIF experiments to determine if 1D-like behavior at low CR is retained as the scale-size is increased. The long-term objective is to develop a liquid fuel layer ICF capsule platform with robust thermonuclear burn, modest CR, and significant α-heating with burn propagation.« less

  18. Regulating Professional Services in ICFs/MR: Remembering the Past and Looking to the Future.

    ERIC Educational Resources Information Center

    Sparr, Margaret P.; Smith, Wayne

    1990-01-01

    This article reviews regulations governing Intermediate Care Facilities for the Mentally Retarded (ICF/MR), including 1971 ICF/MR Medicaid funding legislation, standards development by professional consensus, development of federal regulations, intergovernmental roles, and possible directions for the future. A need is seen for professionals to…

  19. ICF syndrome with variable expression in sibs.

    PubMed Central

    Gimelli, G; Varone, P; Pezzolo, A; Lerone, M; Pistoia, V

    1993-01-01

    We describe a new familial case of ICF syndrome (immunodeficiency, centromeric instability, facial anomalies) in a woman of 29 years and in her brother of 30 years. The proband showed mental retardation, facial anomalies, recurrent respiratory infections, combined deficit of IgM and IgE immunoglobulin classes, and paracentromeric heterochromatin instability of chromosomes 1, 9, and 16. The brother had minor signs of the syndrome and had an apparently normal phenotype. Their parents were healthy and non-consanguineous. Chromosome anomalies consisted of homologous and non-homologous associations, chromatid and isochromatid breaks, deletions of whole arms, interchanges in the paracentromeric region, and multibranched configurations of chromosomes 1, 9, and 16. CD bands and fluorescence in situ hybridisation with alphoid DNA sequence probes specific for the centromeres of chromosomes 1 and 16 showed that the centromere was not directly implicated in the formation of multibranched configurations. These cases indicate the autosomal recessive mode of inheritance and the variable expressivity of the ICF syndrome. Images PMID:8320711

  20. The International Classification of Functioning, Disability and Health (ICF) and nursing.

    PubMed

    Kearney, Penelope M; Pryor, Julie

    2004-04-01

    Nursing conceptualizes disability from largely medical and individual perspectives that do not consider its social dimensions. Disabled people are critical of this paradigm and its impact on their health care. The aims of this paper are to review the International Classification of Functioning, Disability and Health (ICF), including its history and the theoretical models upon which it is based and to discuss its relevance as a conceptual framework for nursing. The paper presents a critical overview of concepts of disability and their implications for nursing and argues that a broader view is necessary. It examines ICF and its relationship to changing paradigms of disability and presents some applications for nursing. The ICF, with its acknowledgement of the interaction between people and their environments in health and disability, is a useful conceptual framework for nursing education, practice and research. It has the potential to expand nurses' thinking and practice by increasing awareness of the social, political and cultural dimensions of disability.

  1. Patient Core Data Set. Standard for a longitudinal health/medical record.

    PubMed

    Renner, A L; Swart, J C

    1997-01-01

    Blue Chip Computers Company, in collaboration with Wright State University-Miami Valley College of Nursing and Health, with support from the Agency for Health Care Policy and Research, Public Health Service, completed Small Business innovative Research research to design a comprehensive integrated Patient information System. The Wright State University consultants undertook the development of a Patient Core Data Set (PCDS) in response to the lack of uniform standards of minimum data sets, and lack of standards in data transfer for continuity of care. The purpose of the Patient Core Data Set is to develop a longitudinal patient health record and medical history using a common set of standard data elements with uniform definitions and coding consistent with Health Level 7 (HL7) protocol and the American Society for Testing and Materials (ASTM) standards. The PCDS, intended for transfer across all patient-care settings, is essential information for clinicians, administrators, researchers, and health policy makers.

  2. Kinetic physics in ICF: present understanding and future directions

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

    Rinderknecht, Hans G.; Amendt, P. A.; Wilks, S. C.

    Kinetic physics has the potential to impact the performance of indirect-drive inertial confinement fusion (ICF) experiments. Systematic anomalies in the National Ignition Facility implosion dataset have been identified in which kinetic physics may play a role, including inferred missing energy in the hohlraum, drive asymmetry in near-vacuum hohlraums, low areal density and high burn-averaged ion temperatures (T i ) compared with mainline simulations, and low ratios of the DD-neutron and DT-neutron yields and inferred T i . Several components of ICF implosions are likely to be influenced or dominated by kinetic physics: laser-plasma interactions in the LEH and hohlraum interior;more » the hohlraum wall blowoff, blowoff/gas and blowoff/ablator interfaces; the ablator and ablator/ice interface; and the DT fuel all present conditions in which kinetic physics can significantly affect the dynamics. This review presents the assembled experimental data and simulation results to date, which indicate that the effects of long mean-free-path plasma phenomena and self-generated electromagnetic fields may have a significant impact in ICF targets. Finally, simulation and experimental efforts are proposed to definitively quantify the importance of these effects at ignition-relevant conditions, including priorities for ongoing study.« less

  3. Kinetic physics in ICF: present understanding and future directions

    DOE PAGES

    Rinderknecht, Hans G.; Amendt, P. A.; Wilks, S. C.; ...

    2018-03-19

    Kinetic physics has the potential to impact the performance of indirect-drive inertial confinement fusion (ICF) experiments. Systematic anomalies in the National Ignition Facility implosion dataset have been identified in which kinetic physics may play a role, including inferred missing energy in the hohlraum, drive asymmetry in near-vacuum hohlraums, low areal density and high burn-averaged ion temperatures (T i ) compared with mainline simulations, and low ratios of the DD-neutron and DT-neutron yields and inferred T i . Several components of ICF implosions are likely to be influenced or dominated by kinetic physics: laser-plasma interactions in the LEH and hohlraum interior;more » the hohlraum wall blowoff, blowoff/gas and blowoff/ablator interfaces; the ablator and ablator/ice interface; and the DT fuel all present conditions in which kinetic physics can significantly affect the dynamics. This review presents the assembled experimental data and simulation results to date, which indicate that the effects of long mean-free-path plasma phenomena and self-generated electromagnetic fields may have a significant impact in ICF targets. Finally, simulation and experimental efforts are proposed to definitively quantify the importance of these effects at ignition-relevant conditions, including priorities for ongoing study.« less

  4. Core services and priority-setting: the New Zealand experience.

    PubMed

    Cumming, J

    1994-01-01

    Like people in other countries, New Zealanders have been struggling with the issue of how to decide which health services should be delivered and to whom. The government has established a Core Services Committee to advise on core services, that is, those health care and disability support services to be made available on affordable terms and without unreasonable waiting time. Such a core has a similar role to a standard package of benefits within a managed competition framework. Services not in the core would be left to individuals' own responsibility. Specific objectives for a core are to promote accountability of purchasers, to make explicit the services that are core and those that are not, to promote an efficient and equitable allocation of resources, to limit government expenditure on health care and to involve the public in decision-making. A number of different options for defining a core are identified, and the work undertaken so far is discussed. The original concept of a core has not been implemented in New Zealand. The Core Services Committee has established broad priorities and facilitated a series of consensus development conferences to provide advice on the effectiveness of services. Some of the committee's recommendations have been incorporated into policy guidelines, which set out what the government expects of purchasers. These guidelines include priority areas for health gains, service obligations and principles for purchasing. Service obligations are not sufficiently detailed to meet the specific objectives of a core and do not meet equity objectives, as they allow in effect each of the four purchasers to develop their own core of services. The key issue for the government now is to decide whether to allow RHAs flexibility in determining their own priorities or whether a national approach to efficiency and equity is to be preferred.

  5. [Patient orientation and reference to the ICF as challenges in outcome assessment in rehabilitation].

    PubMed

    Farin, E

    2008-04-01

    Measuring the results of rehabilitation interventions presents a number of issues regarding content and method, two of which have been selected for discussion in view of the findings of current research--the significance of patient orientation and the relation to the International Classification of Functioning, Disability and Health, ICF. Compilation of patients' treatment goals, expectations and preferences, patient participation in the development of assessment instruments, compilation of patients' evaluations of treatment results and consideration of the subjectivity of the physician as well as interaction between patient and physician were discussed with respect to involving patients in measuring results. The ICF is a terminology system presenting a uniform international classification for describing health conditions that could assume the function of a common language for the members of various occupations involved in medical rehabilitation. Orienting the measurement of results to the ICF is an obvious next step. This can promote patient orientation, as the categories used by the ICF--in particular for the domains of activities and participation--are formulated in terms relevant to daily routine and are thus pertinent to the patients' lifestyle. The consequences resulting from this overview concern future research needs on the one hand, and on the other hand tips for carrying out a patient-oriented, ICF-based measurement of results. The need for research becomes especially clear regarding the measurement of results based on patient preferences, the determination of the participation relevance perceived by the patient as a criterion for "patient significance" (analogous to "clinical significance"), the integration and weighting of patient and physician assessments of success, the consideration of physicians' subjective concepts and patients' communication preferences, and the design of new, ICF-oriented assessment instruments.

  6. Participation and environmental aspects in education and the ICF and the ICF-CY: findings from a systematic literature review.

    PubMed

    Maxwell, Gregor; Alves, Ines; Granlund, Mats

    2012-01-01

    This paper presents findings from a systematic review of the literature related to participation and the ICF/ICF-CY in educational research. To analyse how and investigate the application of participation in educational research. Specifically, how participation is related to the environmental dimensions availability, accessibility, affordability, accommodability and acceptability. A systematic literature review using database keyword searches and refinement protocols using inclusion and exclusion criteria at abstract, full-text and extraction. Four hundred and twenty-one initial works were found. Twenty-three met the inclusion criteria. Availability and accommodations are the most investigated dimensions. Operationalization of participation is not always consistent with definitions used. Research is developing a holistic approach to investigating participation as, although all papers reference at least one environmental dimension, only four of the 11 empirical works reviewed present a fully balanced approach when theorizing and operationalizing participation; hopefully this balanced approach will continue and influence educational policy and school practice.

  7. Compact torus accelerator as a driver for ICF

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

    Tobin, M.T.; Meier, W.R.; Morse, E.C.

    1986-01-01

    The authors have carried out further investigations of the technical issues associated with using a compact torus (CT) accelerator as a driver for inertial confinement fusion (ICF). In a CT accelerator, a magnetically confined, torus-shaped plasma is compressed, accelerated, and focused by two concentric electrodes. After its initial formation, the torus shape is maintained for lifetimes exceeding 1 ms by inherent poloidal and toroidal currents. Hartman suggests acceleration and focusing of such a plasma ring will not cause dissolution within certain constraints. In this study, we evaluated a point design based on an available capacitor bank energy of 9.2 MJ.more » This accelerator, which was modeled by a zero-dimensional code, produces a xenon plasma ring with a 0.73-cm radius, a velocity of 4.14 x 10/sup 9/ cm/s, and a mass of 4.42 ..mu..g. The energy of the plasma ring as it leaves the accelerator is 3.8 MJ, or 41% of the capacitor bank energy. Our studies confirm the feasibility of producing a plasma ring with the characteristics required to induce fusion in an ICF target with a gain greater than 50. The low cost and high efficiency of the CT accelerator are particularly attractive. Uncertainties concerning propagation, accelerator lifetime, and power supply must be resolved to establish the viability of the accelerator as an ICF driver.« less

  8. To adopt is to adapt: the process of implementing the ICF with an acute stroke multidisciplinary team in England.

    PubMed

    Tempest, Stephanie; Harries, Priscilla; Kilbride, Cherry; De Souza, Lorraine

    2012-01-01

    The success of the International Classification of Functioning, Disability and Health (ICF) depends on its uptake in clinical practice. This project aimed to explore ways the ICF could be used with an acute stroke multidisciplinary team and identify key learning from the implementation process. Using an action research approach, iterative cycles of observe, plan, act and evaluate were used within three phases: exploratory; innovatory and reflective. Thematic analysis was undertaken, using a model of immersion and crystallisation, on data collected via interview and focus groups, e-mail communications, minutes from relevant meetings, field notes and a reflective diary. Two overall themes were determined from the data analysis which enabled implementation. There is a need to: (1) adopt the ICF in ways that meet local service needs; and (2) adapt the ICF language and format. The empirical findings demonstrate how to make the ICF classification a clinical reality. First, we need to adopt the ICF as a vehicle to implement local service priorities e.g. to structure a multidisciplinary team report, thus enabling ownership of the implementation process. Second, we need to adapt the ICF terminology and format to make it acceptable for use by clinicians.

  9. Intense ion beam diagnostics for ICF

    NASA Astrophysics Data System (ADS)

    Yasuike, K.; Cuneo, M. E.; Wenger, D. F.; Bailey, J. E.; Hanson, D. L.; Mehlhorn, T. A.; Imasaki, K.; Nakai, S.; Mima, K.

    1998-11-01

    Development of diagnostic methods for high intensity ion beams for ICF is crucial for understanding the ion diode physics. At Osaka University, an arrayed pinhole camera (APC) diagnostic method had been developed to measure the proton beams with an energy of 1 MeV and a J_i. of 100 A/cm^2. on Reiden-SHVS. The APC measures spatial distributions of the beam divergence in r and θ drection and the intensity distribution. An ion image detector capable to acquire a whole temporal evolution within a shot is necessary to measure the higher intensity beams. A fast scintillator with photo-multiplier tubes has been chosen as the image detector. The detector is being tested on a single pinhole camera using a Lithium beam with a particle energy of 5 MeV, a J_i. of 0.5-1 kA/cm^2. and duration of 50 ns, which are very close to the parameters required from ICF, on the SABRE at Sandia National Labs. We will present the diagnostic design and preliminary experiments from SABRE and also present the experimental results from Reiden-SHVS.

  10. 42 CFR 442.118 - Denial of payments for new admissions to an ICF/MR.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... facility is out of compliance with the conditions of participation for ICFs/MR. (ii) A written decision... participation specified under subpart I of part 483 of this chapter. (b) Agency procedures. Before denying... participation for ICFs/MR. (2) If at the end of the specified period the facility has not achieved compliance...

  11. Downscattered Neutron Imaging for ICF

    NASA Astrophysics Data System (ADS)

    Moran, Michael; Haan, Steven; Hatchett, Stephen; Izumi, Nobuhiko; Koch, Jeffrey; Lerche, Richard; Phillips, Thomas

    2002-11-01

    Diagnostics which measure the performance of implosions are critical for the success of ignition. Neutron yield, fusion-burn time history, and images are examples of important diagnostics. Neutron and x-ray images will record the geometries of compressed targets during the fusion-burn process. Such images provide a critical test of the accuracy of numerical modeling of ICF experiments. Imaging of downscattered neutrons, by using energy-resolved detection, offers the intriguing advantage of being able to provide independent images of burning and non-burning regions of the nuclear fuel. The usefulness of downscattered neutron imaging depends on both the information content of the data and on the quality of the data that can be recorded. The information content will relate to the characteristic neutron spectra that are associated with emission from different regions of the source. Numerical modeling of ICF fusion burn will be required to interpret the corresponding energy-dependent images. The exercise will be useful only if the images can be recorded with sufficient definition to reveal the spatial and energy-dependent features of interest. Several options are being evaluated with respect to the feasibility of providing the desired simultaneous spatial and energy resolution. This work was performed under the auspices of the U.S. Department of Energy by the University of California, Lawrence Livermore National Laboratory under contract No. W-7405-Eng-48.

  12. Health behaviour change theories: contributions to an ICF-based behavioural exercise therapy for individuals with chronic diseases.

    PubMed

    Geidl, Wolfgang; Semrau, Jana; Pfeifer, Klaus

    2014-01-01

    The purpose of this perspective is (1) to incorporate recent psychological health behaviour change (HBC) theories into exercise therapeutic programmes, and (2) to introduce the International Classification of Functioning (ICF)-based concept of a behavioural exercise therapy (BET). Relevant personal modifiable factors of physical activity (PA) were identified based on three recent psychological HBC theories. Following the principles of intervention mapping, a matrix of proximal programme objectives specifies desirable parameter values for each personal factor. As a result of analysing reviews on behavioural techniques and intervention programmes of the German rehabilitation setting, we identified exercise-related techniques that impact the personal determinants. Finally, the techniques were integrated into an ICF-based BET concept. Individuals' attitudes, skills, emotions, beliefs and knowledge are important personal factors of PA behaviour. BET systematically addresses these personal factors by a systematic combination of adequate exercise contents with related behavioural techniques. The presented 28 intervention techniques serve as a theory-driven "tool box" for designing complex BET programmes to promote PA. The current paper highlights the usefulness of theory-based integrative research in the field of exercise therapy, offers explicit methods and contents for physical therapists to promote PA behaviour, and introduces the ICF-based conceptual idea of a BET. Implications for Rehabilitation Irrespective of the clients' indication, therapeutic exercise programmes should incorporate effective, theory-based approaches to promote physical activity. Central determinants of physical activity behaviour are a number of personal factors: individuals' attitudes, skills, emotions, beliefs and knowledge. Clinicians implementing exercise therapy should set it within a wider theoretical framework including the personal factors that influence physical activity. To increase

  13. The impact of the EUSCLE Core Set Questionnaire for the assessment of cutaneous lupus erythematosus.

    PubMed

    Kuhn, A; Patsinakidis, N; Bonsmann, G

    2010-08-01

    Epidemiological data and standard European guidelines for the diagnosis and treatment of cutaneous lupus erythematosus (CLE) are lacking in the current literature. In order to provide a standardized tool for an extensive consistent data collection, a study group of the European Society of Cutaneous Lupus Erythematosus (EUSCLE) recently developed a Core Set Questionnaire for the assessment of patients with different subtypes of CLE. The EUSCLE Core Set Questionnaire includes six sections on patient data, diagnosis, skin involvement, activity and damage of disease, laboratory analysis, and treatment. An instrument like the EUSCLE Core Set Questionnaire is essential to gain a broad and comparable data collection of patients with CLE from different European centres and to achieve consensus concerning clinical standards for the disease. The data will also be important for further characterization of the different CLE subtypes and the evaluation of therapeutic strategies; moreover, the EUSCLE Core Set Questionnaire might also be useful for the comparison of data in clinical trials. In this review, the impact of the EUSCLE Core Set Questionnaire is discussed in detail with regard to clinical and serological features as well as therapeutic modalities in CLE.

  14. To adopt is to adapt: the process of implementing the ICF with an acute stroke multidisciplinary team in England

    PubMed Central

    Tempest, Stephanie; Harries, Priscilla; Kilbride, Cherry; De Souza, Lorraine

    2012-01-01

    Purpose: The success of the International Classifcation of Functioning, Disability and Health (ICF) depends on its uptake in clinical practice. This project aimed to explore ways the ICF could be used with an acute stroke multidisciplinary team and identify key learning from the implementation process. Method: Using an action research approach, iterative cycles of observe, plan, act and evaluate were used within three phases: exploratory; innovatory and refective. Thematic analysis was undertaken, using a model of immersion and crystallisation, on data collected via interview and focus groups, e-mail communications, minutes from relevant meetings, feld notes and a refective diary. Results: Two overall themes were determined from the data analysis which enabled implementation. There is a need to: (1) adopt the ICF in ways that meet local service needs; and (2) adapt the ICF language and format. Conclusions: The empirical fndings demonstrate how to make the ICF classifcation a clinical reality. First, we need to adopt the ICF as a vehicle to implement local service priorities e.g. to structure a multidisciplinary team report, thus enabling ownership of the implementation process. Second, we need to adapt the ICF terminology and format to make it acceptable for use by clinicians. PMID:22372376

  15. Nature and the natural environment as health facilitators: the need to reconceptualize the ICF environmental factors.

    PubMed

    Day, Adam M B; Theurer, Julie A; Dykstra, Allyson D; Doyle, Philip C

    2012-01-01

    This work examines the environmental factors component of the International Classification of Functioning, Disability, and Health (ICF) relative to current health-facilitating evidence about natural environmental factors. We argue that the environmental factors component warrants reconceptualization in order to offer an extended and more systematic framework for identifying and measuring health-facilitating natural environmental factors. Current evidence highlighting the potential health-facilitating benefits of natural environmental factors is synthesized and considered in the context of the ICF framework and its coding system. In its current form, the ICF's conceptual framework and coding system are inadequate for identifying and measuring natural environmental factors in individuals and groups with and/or without health conditions. The ICF provides an advanced framework for health and disability that reflects contemporary conceptualizations about health. However, given the scope of emerging evidence highlighting positive health and well-being outcomes associated with natural environmental factors, we believe the environmental factors component requires further advancement to reflect this current knowledge. Reconceptualizing the environmental factors component supports a more holistic interpretation of the continuum of environmental factors as both facilitators and barriers. In doing so, it strengthens the ICF's utility in identifying and measuring health-facilitating natural environmental factors.

  16. Positron Radiography of Ignition-Relevant ICF Capsules

    NASA Astrophysics Data System (ADS)

    Williams, Jackson; Chen, Hui; Field, John; Landen, Nino; Strozzi, David

    2017-10-01

    X-ray and neutron radiography are currently used to infer residual ICF shell and fuel asymmetries and areal density non-uniformities near and at peak compression that can impede ignition. Charged particles offer an alternative probe source that, in principle, are capable of radiographing the shell shape and areal density at arbitrary times, even in the presence of large x-ray self-emission. Laser-generated positrons are evaluated as a source to radiograph ICF capsules where current ultraintense laser facilities are capable of producing 2 ×1012 relativistic positrons in a narrow energy bandwidth and short duration. Monte Carlo simulations suggest that both the areal density and shell radius can be reconstructed for ignition-relevant capsules conditions between 0.002-2 g/cm2, and that this technique might be better suited to direct-drive. This work was performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344 and funded by the LDRD Program under project tracking code 17-ERD-010.

  17. Vesicourethral reflux-induced renal failure in a patient with ICF syndrome due to a novel DNMT3B mutation.

    PubMed

    Kutluğ, Seyhan; Ogur, Gönül; Yilmaz, Aysegül; Thijssen, Peter E; Abur, Ummet; Yildiran, Alisan

    2016-12-01

    ICF syndrome is a primary immunodeficiency disease characterized by hypo- or agammaglobulinemia, centromeric instability mainly on chromosomes 1, 9, and 16 and facial anomalies. ICF syndrome presents with frequent respiratory tract infections in infancy. A 20-month-old female patient was referred to our clinic due to frequent lower respiratory tract infections. ICF syndrome was considered because of comorbidity of hypogammaglobulinemia, facial anomalies, and neuromotor growth retardation. Metaphase chromosome analysis revealed centromeric instability on chromosomes 1, 9, and 16 and through Sanger a previously unreported homozygous missense mutation (c.1805T>C; [p.V602A]) was identified in the DNMT3B, confirming ICF1. The patient was found to have a breakdown in renal function 1 year later; the urinary system was examined and bilateral vesicoureteral reflux was found, warranting the need for dialysis in time. This report expands the mutation spectrum of ICF1 and is the first to describe bilateral vesicoureteral reflux accompanying ICF syndrome. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  18. Core-core and core-valence correlation

    NASA Technical Reports Server (NTRS)

    Bauschlicher, Charles W., Jr.; Langhoff, Stephen R.; Taylor, Peter R.

    1988-01-01

    The effect of (1s) core correlation on properties and energy separations was analyzed using full configuration-interaction (FCI) calculations. The Be 1 S - 1 P, the C 3 P - 5 S and CH+ 1 Sigma + or - 1 Pi separations, and CH+ spectroscopic constants, dipole moment and 1 Sigma + - 1 Pi transition dipole moment were studied. The results of the FCI calculations are compared to those obtained using approximate methods. In addition, the generation of atomic natural orbital (ANO) basis sets, as a method for contracting a primitive basis set for both valence and core correlation, is discussed. When both core-core and core-valence correlation are included in the calculation, no suitable truncated CI approach consistently reproduces the FCI, and contraction of the basis set is very difficult. If the (nearly constant) core-core correlation is eliminated, and only the core-valence correlation is included, CASSCF/MRCI approached reproduce the FCI results and basis set contraction is significantly easier.

  19. Coleman performs a CFE ICF-2 Test

    NASA Image and Video Library

    2011-01-18

    ISS026-E-018760 (18 Jan. 2011) --- NASA astronaut Catherine (Cady) Coleman, Expedition 26 flight engineer, performs a Capillary Flow Experiment (CFE) Interior Corner Flow 2 (ICF-2) test. The CFE is positioned on a Maintenance Work Area in the Destiny laboratory of the International Space Station. CFE observes the flow of fluid, in particular capillary phenomena, in microgravity.

  20. Coleman performs a CFE ICF-2 Test

    NASA Image and Video Library

    2011-01-18

    ISS026-E-018749 (18 Jan. 2011) --- NASA astronaut Catherine (Cady) Coleman, Expedition 26 flight engineer, performs a Capillary Flow Experiment (CFE) Interior Corner Flow 2 (ICF-2) test. The CFE is positioned on a Maintenance Work Area in the Destiny laboratory of the International Space Station. CFE observes the flow of fluid, in particular capillary phenomena, in microgravity.

  1. Coleman performs a CFE ICF-2 Test

    NASA Image and Video Library

    2011-01-18

    ISS026-E-018751 (18 Jan. 2011) --- NASA astronaut Catherine (Cady) Coleman, Expedition 26 flight engineer, performs a Capillary Flow Experiment (CFE) Interior Corner Flow 2 (ICF-2) test. The CFE is positioned on a Maintenance Work Area in the Destiny laboratory of the International Space Station. CFE observes the flow of fluid, in particular capillary phenomena, in microgravity.

  2. The International Classification of Functioning, Disability and Health (ICF) in vocational rehabilitation and disability assessment in Slovenia: state of law and users' perspective.

    PubMed

    Ptyushkin, Pavel; Vidmar, Gaj; Burger, Helena; Marinček, Crt; Escorpizo, Reuben

    2011-01-01

    This study illustrates the use of the ICF in vocational rehabilitation and disability assessment in Slovenia. A review of the Slovenian law about vocational rehabilitation was performed. A survey was developed and group and individual interviews were conducted with professionals involved in vocational rehabilitation who use the ICF. The vast majority of the respondents believe that ICF helps to create a common language for multidisciplinary communication. The main advantages of the ICF identified by the respondents are that it provides a holistic view of the person, assesses complexities of functioning, provides a unified language and offers a quick and easy insight into functioning. The disadvantages of ICF are complicated terminology and subjectivity of the assessor. A difficulty encountered by the users is that by law, only body functions of the ICF are assessed. Additional qualitative analysis of the users' understanding of ICF and its purpose revealed heterogeneity. Significant differences between public and private organisations were found. ICF is a promising tool for use in vocational rehabilitation and disability assessment in Slovenia. A major challenge is the lack of interface between ICF and policies on vocational rehabilitation in Slovenia.

  3. Development of a core outcome set for clinical trials in facial aging: study protocol for a systematic review of the literature and identification of a core outcome set using a Delphi survey.

    PubMed

    Schlessinger, Daniel I; Iyengar, Sanjana; Yanes, Arianna F; Henley, Jill K; Ashchyan, Hovik J; Kurta, Anastasia O; Patel, Payal M; Sheikh, Umar A; Franklin, Matthew J; Hanna, Courtney C; Chen, Brian R; Chiren, Sarah G; Schmitt, Jochen; Deckert, Stefanie; Furlan, Karina C; Poon, Emily; Maher, Ian A; Cartee, Todd V; Sobanko, Joseph F; Alam, Murad

    2017-08-01

    Facial aging is a concern for many patients. Wrinkles, loss of volume, and discoloration are common physical manifestations of aging skin. Genetic heritage, prior ultraviolet light exposure, and Fitzpatrick skin type may be associated with the rate and type of facial aging. Although many clinical trials assess the correlates of skin aging, there is heterogeneity in the outcomes assessed, which limits the quality of evaluation and comparison of treatment modalities. To address the inconsistency in outcomes, in this project we will develop a core set of outcomes that are to be evaluated in all clinical trials relevant to facial aging. A long list of measureable outcomes will be created from four sources: (1) systematic medical literature review, (2) patient interviews, (3) other published sources, and (4) stakeholder involvement. Two rounds of Delphi processes with homogeneous groups of physicians and patients will be performed to prioritize and condense the list. At a consensus meeting attended by physicians, patients, and stakeholders, outcomes will be further condensed on the basis of participant scores. By the end of the meeting, members will vote and decide on a final recommended set of core outcomes. Subsequent to this, specific measures will be selected or created to assess these outcomes. The aim of this study is to develop a core outcome set and relevant measures for clinical trials relevant to facial aging. We hope to improve the reliability and consistency of outcome reporting of skin aging, thereby enabling improved evaluation of treatment efficacy and patient satisfaction. Core Outcome Measures in Effectiveness Trials (COMET) Initiative, accessible at http://www.comet-initiative.org/studies/details/737 . Core Outcomes Set Initiative, (CSG-COUSIN) accessible at https://www.uniklinikum-dresden.de/de/das-klinikum/universitaetscentren/zegv/cousin/meet-the-teams/project-groups/core-outcome-set-for-the-appearance-of-facial-aging . Protocol version date is 28

  4. Relationship between work-related attitudes, performance and capacities according to the ICF in patients with mental disorders.

    PubMed

    Linden, Michael; Baron, Stefanie; Muschalla, Beate

    2010-01-01

    The International Classification of Functioning Disability and Health (ICF) differentiates between functions, activities/capacities, contextual factors and participation. Dysfunctions can result in impaired capacities, which in turn can lead to problems with participation depending on the context. Motivational and volitional deficits are intervening factors. The question is to what degree work performance (i.e. participation), motivational factors, and the inability to perform activities (i.e. dysfunctions) interact. Incapacities were measured in 213 patients (70% women) admitted to the Department of Behavioral Medicine using the Mini-ICF-Rating for Mental Disorders (Mini-ICF-APP), work performance was measured with the Endicott Work Productivity Scale (EWPS), and volitional and motivational problems in regard to work were assessed with the Arbeitsbezogenes Verhaltens- und Erlebensmuster (AVEM). Sick leave prior to admission and work-related problems were assessed in a special clinical interview. The mean global score of the Mini-ICF-APP across all patients was 0.84 +/- 0.56 (SD), corresponding to 'mild disability'. The highest disabilities in this patient population were found for 'flexibility' (item 3, 1.64 +/- 0.94); the lowest disabilities were found for 'self maintenance' (item 11, 0.19 +/- 0.44) and 'mobility' (item 12, 0.43 +/- 0.85). Partial correlations between the Mini-ICF-APP, AVEM and EWPS showed highly significant correlations between the Mini-ICF-APP and EWPS and no or weak correlations between the AVEM and the Mini-ICF-APP or EWPS. Work performance is primarily related to the inability to perform activities and incapacities, and only due to attitudes or volitional/motivational factors to a much lesser degree. Therefore, capacity and motivation can and must be separated. Copyright (c) 2010 S. Karger AG, Basel.

  5. Ion kinetic dynamics in strongly-shocked plasmas relevant to ICF

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

    Rinderknecht, H. G.; Amendt, P. A.; Rosenberg, M. J.

    Implosions of thin-shell capsules produce strongly-shocked (M > 10), low-density (ρ ~1 mg/cc -1), high-temperature (T i ~keV) plasmas, comparable to those produced in the strongly-shocked DT-vapor in inertial confinement fusion (ICF) experiments. A series of thin-glass targets filled with mixtures of deuterium and Helium-3 gas ranging from 7% to 100% deuterium was imploded to investigate the impact of multi-species ion kinetic mechanisms in ICF-relevant plasmas over a wide range of Knudsen numbers (N K ≡ λ ii/R). Anomalous trends in nuclear yields and burn-averaged ion temperatures in implosions with N K > 0.5, which have been interpreted as signaturesmore » of ion species separation and ion thermal decoupling, are found not to be consistent with single-species ion kinetic effects alone. Experimentally inferred Knudsen numbers predict an opposite yield trend to those observed, confirming the dominance of multi-species physics in these experiments. In contrast, implosions with N K ~ 0.01 follow the expected yield trend, suggesting single-species kinetic effects are dominant. In conclusion, the impact of the observed kinetic physics mechanisms on the formation of the hotspot in ICF experiments is discussed.« less

  6. Ion kinetic dynamics in strongly-shocked plasmas relevant to ICF

    DOE PAGES

    Rinderknecht, H. G.; Amendt, P. A.; Rosenberg, M. J.; ...

    2017-04-20

    Implosions of thin-shell capsules produce strongly-shocked (M > 10), low-density (ρ ~1 mg/cc -1), high-temperature (T i ~keV) plasmas, comparable to those produced in the strongly-shocked DT-vapor in inertial confinement fusion (ICF) experiments. A series of thin-glass targets filled with mixtures of deuterium and Helium-3 gas ranging from 7% to 100% deuterium was imploded to investigate the impact of multi-species ion kinetic mechanisms in ICF-relevant plasmas over a wide range of Knudsen numbers (N K ≡ λ ii/R). Anomalous trends in nuclear yields and burn-averaged ion temperatures in implosions with N K > 0.5, which have been interpreted as signaturesmore » of ion species separation and ion thermal decoupling, are found not to be consistent with single-species ion kinetic effects alone. Experimentally inferred Knudsen numbers predict an opposite yield trend to those observed, confirming the dominance of multi-species physics in these experiments. In contrast, implosions with N K ~ 0.01 follow the expected yield trend, suggesting single-species kinetic effects are dominant. In conclusion, the impact of the observed kinetic physics mechanisms on the formation of the hotspot in ICF experiments is discussed.« less

  7. Core Outcome Set-STAndards for Development: The COS-STAD recommendations.

    PubMed

    Kirkham, Jamie J; Davis, Katherine; Altman, Douglas G; Blazeby, Jane M; Clarke, Mike; Tunis, Sean; Williamson, Paula R

    2017-11-01

    The use of core outcome sets (COS) ensures that researchers measure and report those outcomes that are most likely to be relevant to users of their research. Several hundred COS projects have been systematically identified to date, but there has been no formal quality assessment of these studies. The Core Outcome Set-STAndards for Development (COS-STAD) project aimed to identify minimum standards for the design of a COS study agreed upon by an international group, while other specific guidance exists for the final reporting of COS development studies (Core Outcome Set-STAndards for Reporting [COS-STAR]). An international group of experienced COS developers, methodologists, journal editors, potential users of COS (clinical trialists, systematic reviewers, and clinical guideline developers), and patient representatives produced the COS-STAD recommendations to help improve the quality of COS development and support the assessment of whether a COS had been developed using a reasonable approach. An open survey of experts generated an initial list of items, which was refined by a 2-round Delphi survey involving nearly 250 participants representing key stakeholder groups. Participants assigned importance ratings for each item using a 1-9 scale. Consensus that an item should be included in the set of minimum standards was defined as at least 70% of the voting participants from each stakeholder group providing a score between 7 and 9. The Delphi survey was followed by a consensus discussion with the study management group representing multiple stakeholder groups. COS-STAD contains 11 minimum standards that are the minimum design recommendations for all COS development projects. The recommendations focus on 3 key domains: the scope, the stakeholders, and the consensus process. The COS-STAD project has established 11 minimum standards to be followed by COS developers when planning their projects and by users when deciding whether a COS has been developed using reasonable

  8. Applying the ICF framework to study changes in quality-of-life for youth with chronic conditions

    PubMed Central

    McDougall, Janette; Wright, Virginia; Schmidt, Jonathan; Miller, Linda; Lowry, Karen

    2011-01-01

    Objective The objective of this paper is to describe how the ICF framework was applied as the foundation for a longitudinal study of changes in quality-of-life (QoL) for youth with chronic conditions. Method This article will describe the study’s aims, methods, measures and data analysis techniques. It will point out how the ICF framework was used—and expanded upon—to provide a model for studying the impact of factors on changes in QoL for youth with chronic conditions. Further, it will describe the instruments that were chosen to measure the components of the ICF framework and the data analysis techniques that will be used to examine the impact of factors on changes in youths’ QoL. Conclusions Qualitative and longitudinal designs for studying QoL based on the ICF framework can be useful for unraveling the complex ongoing inter-relationships among functioning, contextual factors and individuals’ perceptions of their QoL. PMID:21034288

  9. Stroke patients communicating their healthcare needs in hospital: a study within the ICF framework.

    PubMed

    O'Halloran, Robyn; Worrall, Linda; Hickson, Louise

    2012-01-01

    Previous research has identified that many patients admitted into acute hospital stroke units have communication-related impairments such as hearing, vision, speech, language and/or cognitive communicative impairment. However, no research has identified how many patients in acute hospital stroke units have difficulty actually communicating their healthcare needs. The World Health Organization's International Classification of Functioning, Disability and Health (ICF) conceptualizes difficulty communicating about healthcare needs as a type of activity limitation, within the Activity and Participation component. The ICF proposes that activity limitation can be measured in four different ways. The first aim of this research was to measure a patient's difficulty communicating his or her healthcare needs, that is, activity limitation, in two of the four ways suggested by the ICF when interacting with healthcare providers. The second aim was to investigate whether communication-related impairments in hearing, vision, speech, language and/or cognitive communicative impairment predict difficulty communicating healthcare needs, measured in these ways. A total of 65 patients consecutively admitted into two acute hospital stroke units in Melbourne, Australia, who consented to this research participated in this study. Early in their admission participants were screened for hearing, vision, speech, language and cognitive communicative impairment. Participants were also assessed for difficulty communicating about healthcare needs in two ways proposed by the ICF: 'capacity with assistance' and 'performance'. Relationships between communication-related impairment and both capacity with assistance and performance were explored through Spearman's correlations and binary logistic regression. A total of 87% of patients had one or more communication-related impairments. Half of the patients (51%) had difficulty communicating their healthcare needs when assessed in terms of capacity with

  10. The effectiveness of rehabilitation on pain-free farming in agriculture workers with low back pain in India.

    PubMed

    Ganesh, Shankar; Chhabra, Deepak; Kumari, Nitika

    2016-10-17

    Studies have shown that farming is associated with many agricultural workers experiencing low back pain (LBP). The rehabilitation of these workers should facilitate their functioning, activities and level of participation in an adequate way. The objectives of this study were to identify the health components associated with LBP and to evaluate the effectiveness of the interventions in returning agricultural workers with LBP to their vocation using the International Classification of Function (ICF) -based tools. Thirty-one full time agricultural workers from 3 different Indian states were prospectively assessed using the ICF core set for LBP. ICF core sets permitted analysis of limitations of function from both the participant and rehabilitation team's perspectives. Each ICF category was rated using an ICF qualifier. The components identified were linked to the ICF categorical profile and assessment sheet. The clinicians identified the global, service program and cycle goals based on ICF. The participants' functioning was followed over a 4-month period. After intervention, the participants were able to undergo their routine activities without increases in pain. However, on returning to active farming, participants noted few improvements in the components d410 (changing basic body position), d415 (maintaining body position), d430 (lifting and carrying objects), d465 (moving around using equipment), d850 (remunerative employment) and d859 (work and employment, other specified and unspecified). The results of the study conclude that the current interventions for LBP are not effective in returning agriculture workers with LBP in India to pain-free farming. There is an urgent need to individualize the health needs of agriculture workers.

  11. The development of the ICF vestibular environmental scale.

    PubMed

    Whitney, Susan L; Alghadir, Ahmad; Alghwiri, Alia; Alshebber, Kefah M; Alshehri, Mohammed; Furman, Joseph M; Mueller, Martin; Grill, Eva

    2016-07-02

    People with vestibular disorders report changes in symptoms based on their environment with many situations increasing their symptoms. The purpose of this paper was to utilize the International Classification of Functioning Disability and Health (ICF) from the World Health Organization (WHO) to describe common environmental triggers for dizziness in persons living with balance and vestibular disorders. A multi-centre cross-sectional study was conducted with four different centres on three different continents, including patients from the United States (Pittsburgh), Germany (Munich), Jordan (Amman) and Saudi Arabia (Riyadh). Three hundred eighty one persons with vestibular disorders participated. A 9-item questionnaire (the Vestibular Environmental Scale) was developed from existing ICF items, which were compared to Dizziness Handicap Inventory (DHI) scores. Sixty-five percent of participants reported that "quick movements in the vicinity" increased symptoms, "crowds" at 45%, and "design of buildings, e.g. narrow hallways, stairs, elevators" at 42%. The "crowds" item was a good positive predictor of psychogenic vertigo (OR 1.8, 95% Confidence Interval 1.03-3.16), while "food" (OR 0.47, 95% Confidence Interval 0.17-1.29) and "light" (OR 0.41 95% Confidence Interval 0.23-0.75) were negative predictors of psychogenic vertigo. There also was a positive correlation between the number of triggers and DHI score (Spearman correlation coefficient 0.47, p < 0.0001). Sixty-eight percent of the subjects reported an increase in symptoms with between 1 and 4 environmental triggers. In our cross cultural sample, environmental triggers affect dizziness in persons living with balance and vestibular disorders. The use of items from the ICF of the WHO may help to promote cross cultural sharing of information in persons with dizziness.

  12. Twin-Twin Transfusion Syndrome: study protocol for developing, disseminating, and implementing a core outcome set.

    PubMed

    Khalil, Asma; Perry, Helen; Duffy, James; Reed, Keith; Baschat, Ahmet; Deprest, Jan; Hecher, Kurt; Lewi, Liesbeth; Lopriore, Enrico; Oepkes, Dick

    2017-07-14

    Twin-Twin Transfusion Syndrome (TTTS) is associated with an increased risk of perinatal mortality and morbidity. Several treatment interventions have been described for TTTS, including fetoscopic laser surgery, amnioreduction, septostomy, expectant management, and pregnancy termination. Over the last decade, fetoscopic laser surgery has become the primary treatment. The literature to date reports on many different outcomes, making it difficult to compare results or combine data from individual studies, limiting the value of research to guide clinical practice. With the advent and ongoing development of new therapeutic techniques, this is more important than ever. The development and use of a core outcome set has been proposed to address these issues, prioritising outcomes important to the key stakeholders, including patients. We aim to produce, disseminate, and implement a core outcome set for TTTS. An international steering group has been established to oversee the development of this core outcome set. This group includes healthcare professionals, researchers and patients. A systematic review is planned to identify previously reported outcomes following treatment for TTTS. Following completion, the identified outcomes will be evaluated by stakeholders using an international, multi-perspective online modified Delphi method to build consensus on core outcomes. This method encourages the participants towards consensus 'core' outcomes. All key stakeholders will be invited to participate. The steering group will then hold a consensus meeting to discuss results and form a core outcome set to be introduced and measured. Once core outcomes have been agreed, the next step will be to determine how they should be measured, disseminated, and implemented within an international context. The development, dissemination, and implementation of a core outcome set in TTTS will enable its use in future clinical trials, systematic reviews and clinical practice guidelines. This is

  13. Development of Eulerian Code Modeling for ICF Experiments

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

    Bradley, Paul A.

    2014-02-27

    One of the most pressing unexplained phenomena standing in the way of ICF ignition is understanding mix and how it interacts with burn. Experiments were being designed and fielded as part of the Defect-Induced Mix Experiment (DIME) project to obtain data about the extent of material mix and how this mix influenced burn. Experiments on the Omega laser and National Ignition Facility (NIF) provided detailed data for comparison to the Eulerian code RAGE1. The Omega experiments were able to resolve the mix and provide “proof of principle” support for subsequent NIF experiments, which were fielded from July 2012 through Junemore » 2013. The Omega shots were fired at least once per year between 2009 and 2012. RAGE was not originally designed to model inertial confinement fusion (ICF) implosions. It still lacks lasers, so the code has been validated using an energy source. To test RAGE, the simulation output is compared to data and by means of postprocessing tools that were developed. Here, the various postprocessing tools are described with illustrative examples.« less

  14. Lymphoedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphoedema (Lymph-ICF-LL): reliability and validity.

    PubMed

    Devoogdt, Nele; De Groef, An; Hendrickx, Ad; Damstra, Robert; Christiaansen, Anke; Geraerts, Inge; Vervloesem, Nele; Vergote, Ignace; Van Kampen, Marijke

    2014-05-01

    Patients may develop primary (congenital) or secondary (acquired) lymphedema, causing significant physical and psychosocial problems. To plan treatment for lymphedema and monitor a patient's progress, swelling, and problems in functioning associated with lymphedema development should be assessed at baseline and follow-up. The purpose of this study was to investigate the reliability (test-retest, internal consistency, and measurement variability) and validity (content and construct) of data obtained with the Lymphoedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphoedema (Lymph-ICF-LL). This was a multicenter, cross-sectional study. The Lymph-ICF-LL is a descriptive, evaluative tool containing 28 questions about impairments in function, activity limitations, and participation restrictions in patients with lower limb lymphedema. The questionnaire has 5 domains: physical function, mental function, general tasks/household activities, mobility activities, and life domains/social life. The reliability and validity of the Lymph-ICF-LL were examined in 30 participants with objective lower limb lymphedema. Intraclass correlation coefficients for test-retest reliability ranged from .69 to .94, and Cronbach alpha coefficients for internal consistency ranged from .82 to .97. Measurement variability was acceptable (standard error of measurement=5.9-12.6). Content validity was good because all questions were understandable for 93% of participants, the scoring system (visual analog scale) was clear, and the questionnaire was comprehensive for 90% of participants. Construct validity was good. All hypotheses for assessing convergent validity and divergent validity were accepted. The known-groups validity and responsiveness of the Dutch Lymph-ICF-LL and the cross-cultural validity of the English version of the Lymph-ICF-LL were not investigated. The Lymph-ICF-LL is a Dutch questionnaire with evidence of reliability and validity for assessing impairments in

  15. Possibilities and Implications of Using the ICF and Other Vocabulary Standards in Electronic Health Records.

    PubMed

    Vreeman, Daniel J; Richoz, Christophe

    2015-12-01

    There is now widespread recognition of the powerful potential of electronic health record (EHR) systems to improve the health-care delivery system. The benefits of EHRs grow even larger when the health data within their purview are seamlessly shared, aggregated and processed across different providers, settings and institutions. Yet, the plethora of idiosyncratic conventions for identifying the same clinical content in different information systems is a fundamental barrier to fully leveraging the potential of EHRs. Only by adopting vocabulary standards that provide the lingua franca across these local dialects can computers efficiently move, aggregate and use health data for decision support, outcomes management, quality reporting, research and many other purposes. In this regard, the International Classification of Functioning, Disability, and Health (ICF) is an important standard for physiotherapists because it provides a framework and standard language for describing health and health-related states. However, physiotherapists and other health-care professionals capture a wide range of data such as patient histories, clinical findings, tests and measurements, procedures, and so on, for which other vocabulary standards such as Logical Observation Identifiers Names and Codes and Systematized Nomenclature Of Medicine Clinical Terms are crucial for interoperable communication between different electronic systems. In this paper, we describe how the ICF and other internationally accepted vocabulary standards could advance physiotherapy practise and research by enabling data sharing and reuse by EHRs. We highlight how these different vocabulary standards fit together within a comprehensive record system, and how EHRs can make use of them, with a particular focus on enhancing decision-making. By incorporating the ICF and other internationally accepted vocabulary standards into our clinical information systems, physiotherapists will be able to leverage the potent

  16. Surveying Unstructured Time of Adults with Mental Retardation Living in Two Community Settings: A Search for Normalization.

    ERIC Educational Resources Information Center

    Pierce, Thomas B., Jr.; And Others

    1990-01-01

    A survey assessed time spent in the community and/or on unstructured activities by randomly selected individuals in Intermediate Care Facilities for the Mentally Retarded (ICF/MR) (N=20) or minigroup home settings (N=20). Individuals in ICF/MR homes spent more time in the community with staff and made fewer choices of unstructured activities.…

  17. COS-STAR: a reporting guideline for studies developing core outcome sets (protocol).

    PubMed

    Kirkham, Jamie J; Gorst, Sarah; Altman, Douglas G; Blazeby, Jane; Clarke, Mike; Devane, Declan; Gargon, Elizabeth; Williamson, Paula R

    2015-08-22

    Core outcome sets can increase the efficiency and value of research and, as a result, there are an increasing number of studies looking to develop core outcome sets (COS). However, the credibility of a COS depends on both the use of sound methodology in its development and clear and transparent reporting of the processes adopted. To date there is no reporting guideline for reporting COS studies. The aim of this programme of research is to develop a reporting guideline for studies developing COS and to highlight some of the important methodological considerations in the process. The study will include a reporting guideline item generation stage which will then be used in a Delphi study. The Delphi study is anticipated to include two rounds. The first round will ask stakeholders to score the items listed and to add any new items they think are relevant. In the second round of the process, participants will be shown the distribution of scores for all stakeholder groups separately and asked to re-score. A final consensus meeting will be held with an expert panel and stakeholder representatives to review the guideline item list. Following the consensus meeting, a reporting guideline will be drafted and review and testing will be undertaken until the guideline is finalised. The final outcome will be the COS-STAR (Core Outcome Set-STAndards for Reporting) guideline for studies developing COS and a supporting explanatory document. To assess the credibility and usefulness of a COS, readers of a COS development report need complete, clear and transparent information on its methodology and proposed core set of outcomes. The COS-STAR guideline will potentially benefit all stakeholders in COS development: COS developers, COS users, e.g. trialists and systematic reviewers, journal editors, policy-makers and patient groups.

  18. Health problems and disability in long-term sickness absence: ICF coding of medical certificates.

    PubMed

    Morgell, Roland; Backlund, Lars G; Arrelöv, Britt; Strender, Lars-Erik; Nilsson, Gunnar H

    2011-11-11

    The purpose of this study was to test the feasibility of International Classification of Functioning, Disability and Health (ICF) and to explore the distribution, including gender differences, of health problems and disabilities as reflected in long-term sickness absence certificates. A total of 433 patients with long sick-listing periods, 267 women and 166 men, were included in the study. All certificates exceeding 28 days of sick-listing sent to the local office of the Swedish Social Insurance Administration of a municipality in the Stockholm area were collected during four weeks in 2004-2005. ICD-10 medical diagnosis codes in the certificates were retrieved and free text information on disabilities in body function, body structure or activity and participation were coded according to ICF short version. In 89.8% of the certificates there were descriptions of disabilities that readily could be classified according to ICF. In a reliability test 123/131 (94%) items of randomly chosen free text information were identically classified by two of the authors. On average 2.4 disability categories (range 0-9) were found per patient; the most frequent were 'Sensation of pain' (35.1% of the patients), 'Emotional functions' (34.1%), 'Energy and drive functions' (22.4%), and 'Sleep functions' (16.9%). The dominating ICD-10 diagnostic groups were 'Mental and behavioural disorders' (34.4%) and 'Diseases of the musculoskeletal system and connective tissue' (32.8%). 'Reaction to severe stress and adjustment disorders' (14.7%), and 'Depressive episode' (11.5%) were the most frequent diagnostic codes. Disabilities in mental functions and activity/participation were more commonly described among women, while disabilities related to the musculoskeletal system were more frequent among men. Both ICD-10 diagnoses and ICF categories were dominated by mental and musculoskeletal health problems, but there seems to be gender differences, and ICF classification as a complement to ICD-10

  19. Core Outcomes in Ventilation Trials (COVenT): protocol for a core outcome set using a Delphi survey with a nested randomised trial and observational cohort study.

    PubMed

    Blackwood, Bronagh; Ringrow, Suzanne; Clarke, Mike; Marshall, John; Rose, Louise; Williamson, Paula; McAuley, Danny

    2015-08-20

    Among clinical trials of interventions that aim to modify time spent on mechanical ventilation for critically ill patients there is considerable inconsistency in chosen outcomes and how they are measured. The Core Outcomes in Ventilation Trials (COVenT) study aims to develop a set of core outcomes for use in future ventilation trials in mechanically ventilated adults and children. We will use a mixed methods approach that incorporates a randomised trial nested within a Delphi study and a consensus meeting. Additionally, we will conduct an observational cohort study to evaluate uptake of the core outcome set in published studies at 5 and 10 years following core outcome set publication. The three-round online Delphi study will use a list of outcomes that have been reported previously in a review of ventilation trials. The Delphi panel will include a range of stakeholder groups including patient support groups. The panel will be randomised to one of three feedback methods to assess the impact of the feedback mechanism on subsequent ranking of outcomes. A final consensus meeting will be held with stakeholder representatives to review outcomes. The COVenT study aims to develop a core outcome set for ventilation trials in critical care, explore the best Delphi feedback mechanism for achieving consensus and determine if participation increases use of the core outcome set in the long term.

  20. Health professionals identify components of the International Classification of Functioning, Disability and Health (ICF) in questionnaires for the upper limb

    PubMed Central

    Philbois, Stella V.; Martins, Jaqueline; Souza, Cesário S.; Sampaio, Rosana F.; Oliveira, Anamaria S.

    2016-01-01

    BACKGROUND: Several Brazilian studies have addressed the International Classification of Functioning, Disability and Health (ICF), but few have analyzed the knowledge of the health professionals with regards to the ICF. OBJECTIVE: To verify whether the classification of the items in the Brazilian-Portuguese versions of The Shoulder Pain and Disability Index (SPADI) and The Disabilities Arm, Shoulder and Hand (DASH) questionnaires, obtained from health professionals who worked with patients having upper limb injuries, could be related to ICF components as defined by others studies. METHOD: There were 4 participants for the group "professionals with high familiarity of the ICF (PHF)" and 19 for the group of "professionals with some or no familiarity of the ICF (PSNF)". The participants judged whether the items on the two questionnaires belonged to the ICF body function, body structure or activity-participation component, and marked a confidence level for each trial using a numerical scale ranging from zero to 10. The items were classified by the discriminant content validity method using the Student'st-test and the Hochberg correction. The ratings were compared to the literature by the percentage of agreement and Kappa coefficient. RESULTS: The percentage of agreement of the rating from the PSNF and the PHF groups with the literature was equal to or greater than 77%. For the DASH, the agreement of the PSNF and PHF groups with the literature were, respectively, moderate (Kappa=0.46 to 0.48) and substantial (Kappa=0.62 to 0.70). CONCLUSIONS: Health professionals were able to correlate the three components of the ICF for most items on the 2 questionnaires, demonstrating some ease of understanding the ICF components. However, the relation of concept of pain with body function component is not clear for professional and deserves a more attentive approach. PMID:26786076

  1. Oral health of 65-year olds in Sweden and Norway: a global question and ICF, the latest conceptual model from WHO.

    PubMed

    Ekbäck, Gunnar; Åstrøm, Anne Nordrehaug; Klock, Kristin; Ordell, Sven; Unell, Lennart

    2012-07-01

    The aims of this study were to identify explanatory factors of satisfaction with oral health among Norwegian and Swedish 65 year olds in terms of items from four different domains of ICF and to compare the strengths of the various ICF domains in explaining satisfaction with oral health. Further it was to assess whether the explanatory factors of ICF domains vary between Norway and Sweden. In 2007, standardized questionnaires were mailed to all the residents in certain counties of Sweden and Norway who were born in 1942. Response rates were 73.1% (n = 6078) in Sweden and 56.0% (n = 4062) in Norway. In total, 33 questions based on four different ICF domains were chosen to explain satisfaction with oral health. Logistic regression showed that four different ICF domains in terms of body function, body structure, activity/participation and environmental factors explained, respectively, 53%, 31%, 12% and 34% of the explanatory variance in the satisfaction with oral health. In the final analysis, only nine items were statistically significant (p < 0.05). This study indicates that ICF as a conceptual model could cover a broad spectrum of factors embedded in OHRQoL measured by a global question in Sweden and Norway. Nine items, representing four ICF domains, were important in the final model for explaining satisfaction with oral health.

  2. Clustering algorithms for identifying core atom sets and for assessing the precision of protein structure ensembles.

    PubMed

    Snyder, David A; Montelione, Gaetano T

    2005-06-01

    An important open question in the field of NMR-based biomolecular structure determination is how best to characterize the precision of the resulting ensemble of structures. Typically, the RMSD, as minimized in superimposing the ensemble of structures, is the preferred measure of precision. However, the presence of poorly determined atomic coordinates and multiple "RMSD-stable domains"--locally well-defined regions that are not aligned in global superimpositions--complicate RMSD calculations. In this paper, we present a method, based on a novel, structurally defined order parameter, for identifying a set of core atoms to use in determining superimpositions for RMSD calculations. In addition we present a method for deciding whether to partition that core atom set into "RMSD-stable domains" and, if so, how to determine partitioning of the core atom set. We demonstrate our algorithm and its application in calculating statistically sound RMSD values by applying it to a set of NMR-derived structural ensembles, superimposing each RMSD-stable domain (or the entire core atom set, where appropriate) found in each protein structure under consideration. A parameter calculated by our algorithm using a novel, kurtosis-based criterion, the epsilon-value, is a measure of precision of the superimposition that complements the RMSD. In addition, we compare our algorithm with previously described algorithms for determining core atom sets. The methods presented in this paper for biomolecular structure superimposition are quite general, and have application in many areas of structural bioinformatics and structural biology.

  3. Outcome measures in older persons with acquired joint contractures: a systematic review and content analysis using the ICF (International Classification of Functioning, Disability and Health) as a reference.

    PubMed

    Bartoszek, Gabriele; Fischer, Uli; Müller, Martin; Strobl, Ralf; Grill, Eva; Nadolny, Stephan; Meyer, Gabriele

    2016-02-09

    Joint contractures are a common health problem in older persons with significant impact on activities of daily living. We aimed to retrieve outcome measures applied in studies on older persons with joint contractures and to identify and categorise the concepts contained in these outcome measures using the ICF (International Classification of Functioning, Disability and Health) as a reference. Electronic searches of Medline, EMBASE, CINAHL, Pedro and the Cochrane Library were conducted (1/2002-8/2012). We included studies in the geriatric rehabilitation and nursing home settings with participants aged ≥ 65 years and with acquired joint contractures. Two independent reviewers extracted the outcome measures and transferred them to concepts using predefined conceptual frameworks. Concepts were subsequently linked to the ICF categories. From the 1057 abstracts retrieved, 60 studies met the inclusion criteria. We identified 52 single outcome measures and 24 standardised assessment instruments. A total of 1353 concepts were revealed from the outcome measures; 96.2% could be linked to 50 ICF categories in the 2nd level; 3.8% were not categorised. Fourteen of the 50 categories (28%) belonged to the component Body Functions, 4 (8%) to the component Body Structures, 26 (52%) to the component Activities and Participation, and 6 (12%) to the component Environmental Factors. The ICF is a valuable reference for identifying and quantifying the concepts of outcome measures on joint contractures in older people. The revealed ICF categories remain to be validated in populations with joint contractures in terms of clinical relevance and personal impact.

  4. Metal Alloy ICF Capsules Created by Electrodeposition

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

    Horwood, Corie; Stadermann, Michael; Bunn, Thomas L.

    Electrochemical deposition is an attractive alternative to physical vapor deposition and micromachining to produce metal capsules for inertial confinement fusion (ICF). Electrochemical deposition (also referred to as electrodeposition or plating) is expected to produce full-density metal capsules without seams or inclusions of unwanted atomic constituents, the current shortcomings of micromachine and physical vapor deposition, respectively. In this paper, we discuss new cathode designs that allow for the rapid electrodeposition of gold and copper alloys on spherical mandrels by making transient contact with the constantly moving spheres. Electrodeposition of pure gold, copper, platinum, and alloys of gold-copper and gold-silver are demonstrated,more » with nonporous coatings of >40 µm achieved in only a few hours of plating. The surface roughness of the spheres after electrodeposition is comparable to the starting mandrel, and the coatings appear to be fully dense with no inclusions. A detailed understanding of the electrodeposition conditions that result in different alloy compositions and plating rates will allow for the electrodeposition of graded alloys on spheres in the near future. Finally, this report on the electrodeposition of metals on spherical mandrels is an important first step toward the fabrication of graded-density metal capsules for ICF experiments at the National Ignition Facility.« less

  5. Metal Alloy ICF Capsules Created by Electrodeposition

    DOE PAGES

    Horwood, Corie; Stadermann, Michael; Bunn, Thomas L.

    2017-12-04

    Electrochemical deposition is an attractive alternative to physical vapor deposition and micromachining to produce metal capsules for inertial confinement fusion (ICF). Electrochemical deposition (also referred to as electrodeposition or plating) is expected to produce full-density metal capsules without seams or inclusions of unwanted atomic constituents, the current shortcomings of micromachine and physical vapor deposition, respectively. In this paper, we discuss new cathode designs that allow for the rapid electrodeposition of gold and copper alloys on spherical mandrels by making transient contact with the constantly moving spheres. Electrodeposition of pure gold, copper, platinum, and alloys of gold-copper and gold-silver are demonstrated,more » with nonporous coatings of >40 µm achieved in only a few hours of plating. The surface roughness of the spheres after electrodeposition is comparable to the starting mandrel, and the coatings appear to be fully dense with no inclusions. A detailed understanding of the electrodeposition conditions that result in different alloy compositions and plating rates will allow for the electrodeposition of graded alloys on spheres in the near future. Finally, this report on the electrodeposition of metals on spherical mandrels is an important first step toward the fabrication of graded-density metal capsules for ICF experiments at the National Ignition Facility.« less

  6. Protocol for developing, disseminating and implementing a core outcome set for endometriosis.

    PubMed

    Hirsch, Martin; Duffy, James M N; Barker, Claire; Hummelshoj, Lone; Johnson, Neil P; Mol, Ben; Khan, Khalid S; Farquhar, Cindy

    2016-12-21

    Endometriosis is a common gynaecological disease characterised by pain and subfertility. Randomised controlled trials evaluating treatments for endometriosis have reported many different outcomes and outcome measures. This variation restricts effective data synthesis limiting the usefulness of research to inform clinical practice. To address these methodological concerns, we aim to develop, disseminate and implement a core outcome set for endometriosis engaging with key stakeholders, including healthcare professionals, researchers and women with endometriosis. An international steering group has been established, including healthcare professionals, researchers and patient representatives. Potential outcomes identified from a systematic review of the literature will be entered into a modified Delphi method. Key stakeholders will be invited to participate including healthcare professionals, researchers and women with endometriosis. Participants will be invited to score individual outcomes on a nine-point Likert scale anchored between 1 (not important) and 9 (critical). Repeated reflection and rescoring should promote whole and individual stakeholder group converge towards consensus, 'core', outcomes. High-quality outcome measures will be associated with core outcomes. The implementation of a core outcome set for endometriosis within future clinical trials, systematic reviews and clinical guidelines will enhance the availability of comparable data to facilitate evidence-based patient care. This study was prospectively registered with Core Outcome Measures in Effectiveness Trials Initiative; number: 691. 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/.

  7. Developing a set of consensus indicators to support maternity service quality improvement: using Core Outcome Set methodology including a Delphi process.

    PubMed

    Bunch, K J; Allin, B; Jolly, M; Hardie, T; Knight, M

    2018-05-16

    To develop a core metric set to monitor the quality of maternity care. Delphi process followed by a face-to-face consensus meeting. English maternity units. Three representative expert panels: service designers, providers and users. Maternity care metrics judged important by participants. Participants were asked to complete a two-phase Delphi process, scoring metrics from existing local maternity dashboards. A consensus meeting discussed the results and re-scored the metrics. In all, 125 distinct metrics across six domains were identified from existing dashboards. Following the consensus meeting, 14 metrics met the inclusion criteria for the final core set: smoking rate at booking; rate of birth without intervention; caesarean section delivery rate in Robson group 1 women; caesarean section delivery rate in Robson group 2 women; caesarean section delivery rate in Robson group 5 women; third- and fourth-degree tear rate among women delivering vaginally; rate of postpartum haemorrhage of ≥1500 ml; rate of successful vaginal birth after a single previous caesarean section; smoking rate at delivery; proportion of babies born at term with an Apgar score <7 at 5 minutes; proportion of babies born at term admitted to the neonatal intensive care unit; proportion of babies readmitted to hospital at <30 days of age; breastfeeding initiation rate; and breastfeeding rate at 6-8 weeks. Core outcome set methodology can be used to incorporate the views of key stakeholders in developing a core metric set to monitor the quality of care in maternity units, thus enabling improvement. Achieving consensus on core metrics for monitoring the quality of maternity care. © 2018 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

  8. Development of a core outcome set for clinical trials in squamous cell carcinoma: study protocol for a systematic review of the literature and identification of a core outcome set using a Delphi survey.

    PubMed

    Schlessinger, Daniel I; Iyengar, Sanjana; Yanes, Arianna F; Chiren, Sarah G; Godinez-Puig, Victoria; Chen, Brian R; Kurta, Anastasia O; Schmitt, Jochen; Deckert, Stefanie; Furlan, Karina C; Poon, Emily; Cartee, Todd V; Maher, Ian A; Alam, Murad; Sobanko, Joseph F

    2017-07-12

    Squamous cell carcinoma (SCC) is a common skin cancer that poses a risk of metastasis. Clinical investigations into SCC treatment are common, but the outcomes reported are highly variable, omitted, or clinically irrelevant. The outcome heterogeneity and reporting bias of these studies leave clinicians unable to accurately compare studies. Core outcome sets (COSs) are an agreed minimum set of outcomes recommended to be measured and reported in all clinical trials of a given condition or disease. Although COSs are under development for several dermatologic conditions, work has yet to be done to identify core outcomes specific for SCC. Outcome extraction for COS generation will occur via four methods: (1) systematic literature review; (2) patient interviews; (3) other published sources; and (4) input from stakeholders in medicine, pharmacy, and other relevant industries. The list of outcomes will be revaluated by the Measuring PRiority Outcome Variables via Excellence in Dermatologic surgery (IMPROVED) Steering Committee. Delphi processes will be performed separately by expert clinicians and patients to condense the list of outcomes generated. A consensus meeting with relevant stakeholders will be conducted after the Delphi exercise to further select outcomes, taking into account participant scores. At the end of the meeting, members will vote and decide on a final recommended set of core outcomes. The Core Outcome Measures in Effectiveness Trials (COMET) organization and the Cochrane Skin Group - Core Outcome Set Initiative (CSG-COUSIN) will serve as advisers throughout the COS generation process. Comparison of clinical trials via systematic reviews and meta-analyses is facilitated when investigators study outcomes that are relevant and similar. The aim of this project is to develop a COS to guide use for future clinical trials.

  9. Quality of life in older individuals with joint contractures in geriatric care settings.

    PubMed

    Heise, Marco; Müller, Martin; Fischer, Uli; Grill, Eva

    2016-09-01

    The purpose of this study was to analyze the association between functioning and disability and quality of life (QoL) in older individuals with joint contractures in the geriatric care setting. More specifically, this study aimed to identify determinants of QoL out of a defined set of contracture-related categories of the International Classification of Functioning, Disability and Health (ICF). Participants for this multicenter cross-sectional survey were recruited from acute geriatric rehabilitation hospitals, nursing homes, and community nursing facilities in Germany between February and October 2013. QoL was assessed using the validated German version of the EQ-5D index score and the EQ-5D visual analog scale (VAS). Manual and automatic variable selection methods were used to identify the most relevant variables out of 125 contracture-related ICF categories. A total of 241 eligible participants (34.9 % male, mean age 80.1 years) were included. The final models contained 14 ICF categories as predictors of the EQ-5D index score and 15 categories as predictors of the EQ-5D VAS. The statistically significant ICF categories from both models were 'muscle power functions (b730),' 'memory functions (b144),' 'taking care of plants (d6505),' 'recreation and leisure (d920),' 'religion and spirituality (d930),' 'drugs (e1101),' and 'products and technology for personal use in daily living (e115).' We identified the most relevant ICF categories for older individuals with joint contractures and their health-related quality of life. These items describe potential determinants of QoL which may provide the basis for future health interventions aiming to improve QoL for the patients with joint contractures.

  10. The International Disability Rights Movement and the ICF.

    PubMed

    Hurst, Rachel

    To outline the thinking of disabled people about their situation and status before the formulation of the ICIDH (International Classification of Impairment, Disability and Handicap) in 1980, the growth of the international disability rights movement since 1980, its subsequent involvement in the revision process and then its hopes as to the effectiveness of the ICF (the International Classification of Functioning, Disability and Health-the revised ICIDH) in the future. This is a personal analysis based on the author's experience as a disability rights activist and as a member of the World Council of Disabled Peoples' International (DPI), elected in 1987 to represent DPI in the revision process and who later became Chair of the Environmental Task Force. These are shown to be a major shift from the medical model of disability to the adoption of the interactive model and the impacts of environmental factors in all aspects of health and functioning. That proper use of the environmental factors within the ICF will ensure appropriate policies, systems and services for health care and support, provide measurable indicators for health status and sustainable development and underpin the recognition that disability is a human rights issue.

  11. Developing core economic outcome sets for asthma studies: a protocol for a systematic review.

    PubMed

    Hounsome, Natalia; Fitzsimmons, Deborah; Phillips, Ceri; Patel, Anita

    2017-08-11

    Core outcome sets are standardised lists of outcomes, which should be measured and reported in all clinical studies of a specific condition. This study aims to develop core outcome sets for economic evaluations in asthma studies. Economic outcomes include items such as costs, resource use or quality-adjusted life years. The starting point in developing core outcome sets will be conducting a systematic literature review to establish a preliminary list of reporting items to be considered for inclusion in the core outcome set. We will conduct literature searches of peer-reviewed studies published from January 1990 to January 2017. These will include any comparative or observational studies (including economic models) and systematic reviews reporting economic outcomes. All identified economic outcomes will be tabulated together with the major study characteristics, such as population, study design, the nature and intensity of the intervention, mode of data collection and instrument(s) used to derive an outcome. We will undertake a 'realist synthesis review' to analyse the identified economic outcomes. The outcomes will be summarised in the context of evaluation perspectives, types of economic evaluation and methodological approaches. Parallel to undertaking a systematic review, we will conduct semistructured interviews with stakeholders (including people with personal experience of asthma, health professionals, researchers and decision makers) in order to explore additional outcomes which have not been considered, or used, in published studies. The list of outcomes generated from the systematic review and interviews with stakeholders will form the basis of a Delphi survey to refine the identified outcomes into a core outcome set. The review will not involve access to individual-level data. Findings from our systematic review will be communicated to a broad range of stakeholders including clinical guideline developers, research funders, trial registries, ethics

  12. Exploring changes over time in habilitation professionals' perceptions and applications of the International Classification of Functioning, Disability and Health, version for Children and Youth (ICF-CY).

    PubMed

    Adolfsson, Margareta; Granlund, Mats; Björck-Akesson, Eva; Ibragimova, Nina; Pless, Mia

    2010-07-01

    This study explored how professionals in inter-disciplinary teams perceived the implementation of the World Health Organization's International Classification of Functioning, Disability and Health, version for Children and Youth (ICF-CY) in Swedish habilitation services. Descriptive longitudinal mixed-methods design. Following participation in a 2-day in-service training on the ICF-CY, 113 professionals from 14 interdisciplinary teams described their perceptions of the implementation of the ICF-CY at 3 consecutive time-points: during in-service training, after 1 year, and after 2.5 years. Implementation of the ICF-CY in daily work focused on assessment and habilitation planning and required adaptations of routines and materials. The ICF-CY was perceived as useful in supporting analyses and in communication about children's needs. Professionals also perceived it as contributing to new perspectives on problems and a sharpened focus on participation. Professionals indicated that the ICF-CY enhanced their awareness of families' views of child participation, which corresponded to organizational goals for habilitation services. An implementation finding was a lack of tools fitting the comprehensive ICF-CY perspective. The study points to the need for ICF-CY-based assessment and intervention methods focusing on child participation.

  13. Detection and use of HT and DT gamma rays to diagnose mix in ICF capsules

    NASA Astrophysics Data System (ADS)

    Schmitt, M. J.; Kim, Y. H.; Herrmann, H. W.; McEvoy, A. M.; Zylstra, A.; Leatherland, A.; Gales, S.

    2015-11-01

    Recent results from Omega capsule implosion experiments containing HT-rich gas mixtures indicate that the 19.8 MeV gamma ray from aneutronic HT fusion can be measured using existing time-resolved gas Cherenkov detectors (GCDs). Additional dedicated experiments to characterize HT- γ emission in ICF experiments already have been planned. The concurrent temporally-resolved measurement of both HT- γs and DT- γs opens the door for in-depth exploration of interface mix in gas-filled ICF capsules. We propose a method to temporally resolve and observe the evolution of shell material into the capsule core as a function of fuel/shell interface temperature (which can be varied by varying the capsule shell thickness). Our proposed method uses a CD-lined plastic capsule filled with 50/50 HT gas and diagnosed using GCDs to temporally resolve both the HT ``clean'' and DT ``mix'' gamma ray burn histories. It will be shown that these burn history profiles are sensitive to the depth to which shell material mixes into the gas region. An experiment to observe these differences as a function of capsule shell thickness is proposed to determine if interface mixing is consistent with thermal diffusion (λion ~Tion2 /Zion2 ρ) at the gas/shell interface. Since hydrodynamic mixing from shell perturbations, such as the mounting stalk and glue, could complicate these types of capsule-averaged temporal measurements, simulations including their effects also will be shown. This research supported by the US DOE/NNSA, performed in part at LANL, operated by LANS LLC under contract DE-AC52-06NA25396.

  14. Utility of the International Classification of Functioning, Disability and Health (ICF) for educational psychologists’ work

    PubMed Central

    Aljunied, Mariam; Frederickson, Norah

    2014-01-01

    Despite embracing a bio-psycho-social perspective, the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) assessment framework has had limited application to date with children who have special educational needs (SEN). This study examines its utility for educational psychologists’ work with children who have Autism Spectrum Disorders (ASD). Mothers of 40 children with ASD aged eight to 12 years were interviewed using a structured protocol based on the ICF framework. The Diagnostic Interview for Social and Communication Disorder (DISCO) was completed with a subset of 19 mothers. Internal consistency and inter-rater reliability of the interview assessments were found to be acceptable and there was evidence for concurrent and discriminant validity. Despite some limitations, initial support for the utility of the ICF model suggests its potential value across educational, health and care fields. Further consideration of its relevance to educational psychologists in new areas of multi-agency working is warranted. PMID:26157197

  15. Ability and Disability in Autism Spectrum Disorder: A Systematic Literature Review Employing the International Classification of Functioning, Disability and Health-Children and Youth Version.

    PubMed

    de Schipper, Elles; Lundequist, Aiko; Coghill, David; de Vries, Petrus J; Granlund, Mats; Holtmann, Martin; Jonsson, Ulf; Karande, Sunil; Robison, John E; Shulman, Cory; Singhal, Nidhi; Tonge, Bruce; Wong, Virginia C N; Zwaigenbaum, Lonnie; Bölte, Sven

    2015-12-01

    This study is the first in a series of four empirical investigations to develop International Classification of Functioning, Disability and Health (ICF) Core Sets for Autism Spectrum Disorder (ASD). The objective was to use a systematic review approach to identify, number, and link functional ability and disability concepts used in the scientific ASD literature to the nomenclature of the ICF-CY (Children and Youth version of the ICF, covering the life span). Systematic searches on outcome studies of ASD were carried out in Medline/PubMed, PsycINFO, ERIC and Cinahl, and relevant functional ability and disability concepts extracted from the included studies. These concepts were then linked to the ICF-CY by two independent researchers using a standardized linking procedure. New concepts were extracted from the studies until saturation of identified ICF-CY categories was reached. Seventy-one studies were included in the final analysis and 2475 meaningful concepts contained in these studies were linked to 146 ICF-CY categories. Of these, 99 categories were considered most relevant to ASD (i.e., identified in at least 5% of the studies), of which 63 were related to Activities and Participation, 28 were related to Body functions, and 8 were related to Environmental factors. The five most frequently identified categories were basic interpersonal interactions (51%), emotional functions (49%), complex interpersonal interactions (48%), attention functions (44%), and mental functions of language (44%). The broad variety of ICF-CY categories identified in this study reflects the heterogeneity of functional differences found in ASD--both with respect to disability and exceptionality--and underlines the potential value of the ICF-CY as a framework to capture an individual's functioning in all dimensions of life. The current results in combination with three additional preparatory studies (expert survey, focus groups, and clinical study) will provide the scientific basis for

  16. Review Article: Mapping of children's health and development data on population level using the classification system ICF-CY.

    PubMed

    Ståhl, Ylva; Granlund, Mats; Gäre-Andersson, Boel; Enskär, Karin

    2011-02-01

    The aim of this study was to investigate if essential health and development data of all children in Sweden in the Child Health Service (CHS) and School Health Service (SHS) can be linked to the classification system International Classification of Functioning, Disability and Health--Children and Youth (ICF-CY). Lists of essential health terms, compiled by professionals from CHS and SHS, expected to be used in the national standardised records form the basis for the analysis in this study. The essential health terms have been linked to the codes of ICF-CY by using linking rules and a verification procedure. After exclusion of terms not directly describing children's health, a majority of the health terms could be linked into the ICF-CY with a high proportion of terms in body functions and a lower proportion in activity/participation and environment respectively. Some health terms had broad description and were linked to several ICF-CY codes. The precision of the health terms was at a medium level of detail. ICF-CY can be useful as a tool for documenting child health. It provides not only a code useful for statistical purposes but also a language useful for the CHS and SHS in their work on individual as well as population levels. It was noted that the health terms used by services mainly focused on health related to body function. This indicates that more focus is needed on health data related to child's functioning in everyday life situations.

  17. Recommended Patient-Reported Core Set of Symptoms to Measure in Adult Cancer Treatment Trials

    PubMed Central

    Mitchell, Sandra A.; Dueck, Amylou C.; Basch, Ethan; Cella, David; Reilly, Carolyn Miller; Minasian, Lori M.; Denicoff, Andrea M.; O’Mara, Ann M.; Fisch, Michael J.; Chauhan, Cynthia; Aaronson, Neil K.; Coens, Corneel; Bruner, Deborah Watkins

    2014-01-01

    Background The National Cancer Institute’s Symptom Management and Health-Related Quality of Life Steering Committee held a clinical trials planning meeting (September 2011) to identify a core symptom set to be assessed across oncology trials for the purposes of better understanding treatment efficacy and toxicity and to facilitate cross-study comparisons. We report the results of an evidence-synthesis and consensus-building effort that culminated in recommendations for core symptoms to be measured in adult cancer clinical trials that include a patient-reported outcome (PRO). Methods We used a data-driven, consensus-building process. A panel of experts, including patient representatives, conducted a systematic review of the literature (2001–2011) and analyzed six large datasets. Results were reviewed at a multistakeholder meeting, and a final set was derived emphasizing symptom prevalence across diverse cancer populations, impact on health outcomes and quality of life, and attribution to either disease or anticancer treatment. Results We recommend that a core set of 12 symptoms—specifically fatigue, insomnia, pain, anorexia (appetite loss), dyspnea, cognitive problems, anxiety (includes worry), nausea, depression (includes sadness), sensory neuropathy, constipation, and diarrhea—be considered for inclusion in clinical trials where a PRO is measured. Inclusion of symptoms and other patient-reported endpoints should be well justified, hypothesis driven, and meaningful to patients. Conclusions This core set will promote consistent assessment of common and clinically relevant disease- and treatment-related symptoms across cancer trials. As such, it provides a foundation to support data harmonization and continued efforts to enhance measurement of patient-centered outcomes in cancer clinical trials and observational studies. PMID:25006191

  18. Practice, science and governance in interaction: European effort for the system-wide implementation of the International Classification of Functioning, Disability and Health (ICF) in Physical and Rehabilitation Medicine.

    PubMed

    Stucki, Gerold; Zampolini, Mauro; Juocevicius, Alvydas; Negrini, Stefano; Christodoulou, Nicolas

    2017-04-01

    Since its launch in 2001, relevant international, regional and national PRM bodies have aimed to implement the International Classification of Functioning, Disability and Health (ICF) in Physical and Rehabilitation Medicine (PRM), whereby contributing to the development of suitable practical tools. These tools are available for implementing the ICF in day-to-day clinical practice, standardized reporting of functioning outcomes in quality management and research, and guiding evidence-informed policy. Educational efforts have reinforced PRM physicians' and other rehabilitation professionals' ICF knowledge, and numerous implementation projects have explored how the ICF is applied in clinical practice, research and policy. Largely lacking though is the system-wide implementation of ICF in day-to-day practice across all rehabilitation services of national health systems. In Europe, system-wide implementation of ICF requires the interaction between practice, science and governance. Considering its mandate, the UEMS PRM Section and Board have decided to lead a European effort towards system-wide ICF implementation in PRM, rehabilitation and health care at large, in interaction with governments, non-governmental actors and the private sector, and aligned with ISPRM's collaboration plan with WHO. In this paper we present the current PRM internal and external policy agenda towards system-wide ICF implementation and the corresponding implementation action plan, while highlighting priority action steps - promotion of ICF-based standardized reporting in national quality management and assurance programs, development of unambiguous rehabilitation service descriptions using the International Classification System for Service Organization in Health-related Rehabilitation, development of Clinical Assessment Schedules, qualitative linkage and quantitative mapping of data to the ICF, and the cultural adaptation of the ICF Clinical Data Collection Tool in European languages.

  19. A Global Oral Health Survey of professional opinion using the International Classification of Functioning, Disability and Health.

    PubMed

    Dougall, Alison; Molina, Gustavo F; Eschevins, Caroline; Faulks, Denise

    2015-06-01

    The concept of oral health is frequently reduced to the absence of disease, despite existing conceptual models exploring the wider determinants of oral health and quality of life. The International Classification of Functioning, Disability and Health (ICF) (WHO) is designed to qualify functional, social and environmental aspects of health. This survey aimed to reach a consensual description of adult oral health, derived from the ICF using international professional opinion. The Global Oral Health Survey involved a two-round, online survey concerning factors related to oral health including functioning, participation and social environment. Four hundred eighty-six oral health professionals from 74 countries registered online. Professionals were pooled into 18 groups of six WHO world regions and three professional groups. In a randomised stratification process, eight professionals from each pool (n=144) completed the survey. The first round consisted of eight open-ended questions. Open expression replies were analysed for meaningful concepts and linked using established rules to the ICF. In Round 2, items were rated for their relevance to oral health (88% response rate). Eighty-nine ICF items and 30 other factors were considered relevant by at least 80% of participants. International professionals reached consensus on a holistic description of oral health, which could be qualified and quantified using the ICF. These results represent the first step towards developing an ICF Core Set in Oral Health, which would provide a practical tool for reporting outcome measures in clinical practice, for research and epidemiology, and for the improvement of interdisciplinary communication regarding oral health. Professional consensus reached in this survey is the foundation stone for developing an ICF Core Set in Oral Health, allowing the holistic aspects of oral health to be qualified and quantified. This tool is necessary to widen our approach to clinical decision making

  20. Medicaid: Methods for Setting Nursing Home Rates Should be Improved.

    DTIC Science & Technology

    1986-05-01

    care facility SNF skilled nursing facility Page 7 GAO/HRJD.W626 Medicaid Nursing Home Rate Setting A,, I-?A -WI...consumer price index GNP Gross National Product HCFA Health Care Financing Administration HHS Department of Health and Human Services ICF intermediate

  1. Lawrence Livermore National Laboratories Perspective on Code Development and High Performance Computing Resources in Support of the National HED/ICF Effort

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

    Clouse, C. J.; Edwards, M. J.; McCoy, M. G.

    2015-07-07

    Through its Advanced Scientific Computing (ASC) and Inertial Confinement Fusion (ICF) code development efforts, Lawrence Livermore National Laboratory (LLNL) provides a world leading numerical simulation capability for the National HED/ICF program in support of the Stockpile Stewardship Program (SSP). In addition the ASC effort provides high performance computing platform capabilities upon which these codes are run. LLNL remains committed to, and will work with, the national HED/ICF program community to help insure numerical simulation needs are met and to make those capabilities available, consistent with programmatic priorities and available resources.

  2. Patient Endorsement of the Outcome Measures in Rheumatology (OMERACT) Total Joint Replacement (TJR) clinical trial draft core domain set.

    PubMed

    Singh, Jasvinder A; Dowsey, Michelle; Choong, Peter F

    2017-03-15

    A patient- and surgeon-Delphi-derived Outcome Measures in Rheumatology (OMERACT) draft core domain set for total joint arthroplasty (TJR) trials was recently developed. Our objective was to obtain further patient stakeholder endorsement of draft core domain set for TJR clinical trials. We surveyed two patient groups: (1) OMERACT patient partners; and (2) patients who had undergone hip or knee TJR. Patients received an introductory email with explanations about the core domain set and instructions to rate the core domains, i.e., important aspects, of OMERACT TJR clinical trial draft core domain set. Rating was on a nominal scale, where 1-3 indicated a domain of limited importance, 4-6 an important, but not critical domain, and 7-9 a critical domain. We used Mann-Whitney test (a non-parametric test) to compare the distribution of ratings between the two groups. Thirty one survey participants from the OMERACT patient partner group and 118 knee/hip TJR patients responded with response rates of 66 and 80%, respectively. Majority of the survey respondents were female, 87 vs. 53%, and were 55 years or older, 57 vs. 94%. Median (interquartile range [IQR]) scores for six core domains by OMERACT and knee/hip TJR patient groups were, respectively: pain, 8 [8, 9] and 9 [8, 9]; function, 9 [8, 9] and 9 [8, 9]; patient satisfaction, 8 [8, 9] and 8 [7, 9]; revision surgery, 7 [7, 8] and 7 [5, 9]; adverse events, 8 [7, 9] and 8 [6, 9]; and death, 9 [6, 9] and 9 [4, 9]. No statistically significant differences in rating were noted for any of the six core domains between the two groups (p ≥ 0.31). Among the additional domains, ratings for patient participation did not differ by group (p = 0.98), but ratings for cost were significantly different (p = 0.005). Patients provided qualitative feedback regarding core domains, and did not propose any modifications to the draft core domain set. Two separate patient stakeholder groups endorsed the OMERACT TJR draft core domain

  3. Physiotherapy in rheumatoid arthritis: development of a practice guideline.

    PubMed

    Hurkmans, E J; van der Giesen, F J; Bloo, H; Boonman, D C; van der Esch, M; Fluit, M; Hilberdink, W K; Peter, W F; van der Stegen, H P; Veerman, E A; Verhoef, J; Vermeulen, H M; Hendriks, H M; Schoones, J W; Vliet Vlieland, T P

    2011-01-01

    To improve the quality of the physiotherapy management in patients with rheumatoid arthritis (RA) a Dutch practice guideline, based on current scientific evidence and best practice, was developed. This guideline comprised all elements of a structured approach (assessment, treatment and evaluation) and was based on the Internatio-nal Classification of Functioning, disability and Health (ICF) and the ICF core sets for RA. A guideline steering committee, comprising 10 expert physiotherapists, selected topics concerning the guideline chapters initial assessment, treatment and evaluation. With respect to treatment a systematic literature search was performed using various databases, and the evidence was graded (1-4). For the initial assessment and evaluation mainly review papers and textbooks were used. Based on evidence and expert opinion, recommendations were formulated. A first draft of the guideline was reviewed by 10 experts from different professional backgrounds resulting in the final guideline. In total 7 topics were selected. For the initial assessment, three recommendations were made. Based on the ICF core sets for RA a list of health problems relevant for the physiotherapist was made and completed with red flags and points of attention. Concerning treatment, three recommendations were formulated; both exercise therapy and education on physiotherapy were recommended, whereas passive interventions (delivery of heat or cold, mechanical, electric and electromagnetic energy, massage, passive mobilization/manipulation and balneotherapy) were neither recommended nor discouraged. For treatment evaluation at the level of activities and participation, the Health Assessment Questionnaire was recommended. For evaluating specific body structures and functions the handheld dynamometer, 6-minute walk test or Ästrand bicycle test (including Borg-scale for rating the perceived exertion), Escola Paulista de Medicina Range of Motion Scale and a Visual Analog Scale for pain and

  4. Measurement of activity limitations and participation restrictions: examination of ICF-linked content and scale properties of the FIM and PC-PART instruments.

    PubMed

    Darzins, Susan W; Imms, Christine; Di Stefano, Marilyn

    2017-05-01

    To explore the operationalization of activity and participation-related measurement constructs through comparison of item phrasing, item response categories and scoring (scale properties) for two separate instruments targeting activities of daily living. Personal Care Participation Assessment and Resource Tool (PC-PART) item content was linked to ICF categories using established linking rules. Previously reported ICF-linked FIM content categories and ICF-linked PC-PART content categories were compared to identify common ICF categories between the instruments. Scale properties of both instruments were compared using a patient scenario to explore the instruments' separate measurement constructs. The PC-PART and FIM shared 15 of the 53 level two ICF-linked categories identified across both instruments. Examination of the instruments' scale properties for items with overlapping ICF content, and exploration through a patient scenario, provided supportive evidence that the instruments measure different constructs. While the PC-PART and FIM share common ICF-linked content, they measure separate constructs. Measurement construct was influenced by the instruments' scale properties. The FIM was observed to measure activity limitations and the PC-PART measured participation restrictions. Scrutiny of instruments' scale properties in addition to item content is critical in the operationalization of activity and participation-related measurement constructs. Implications for Rehabilitation When selecting outcome measures for use in rehabilitation it is necessary to examine both the content of the instruments' items and item phrasing, response categories and scoring, to clarify the construct being measured. Measurement of activity limitations as well as participation restrictions in activities of daily living required for community life provides a more comprehensive measurement of rehabilitation outcomes than measurement of either construct alone. To measure the effects of

  5. Nova Upgrade: A proposed ICF facility to demonstrate ignition and gain, revision 1

    NASA Astrophysics Data System (ADS)

    1992-07-01

    The present objective of the national Inertial Confinement Fusion (ICF) Program is to determine the scientific feasibility of compressing and heating a small mass of mixed deuterium and tritium (DT) to conditions at which fusion occurs and significant energy is released. The potential applications of ICF will be determined by the resulting fusion energy yield (amount of energy produced) and gain (ratio of energy released to energy required to heat and compress the DT fuel). Important defense and civilian applications, including weapons physics, weapons effects simulation, and ultimately the generation of electric power will become possible if yields of 100 to 1,000 MJ and gains exceeding approximately 50 can be achieved. Once ignition and propagating bum producing modest gain (2 to 10) at moderate drive energy (1 to 2 MJ) has been achieved, the extension to high gain (greater than 50) is straightforward. Therefore, the demonstration of ignition and modest gain is the final step in establishing the scientific feasibility of ICF. Lawrence Livermore National Laboratory (LLNL) proposes the Nova Upgrade Facility to achieve this demonstration by the end of the decade. This facility would be constructed within the existing Nova building at LLNL for a total cost of approximately $400 M over the proposed FY 1995-1999 construction period. This report discusses this facility.

  6. Young adults with intellectual disability transitioning from school to post-school: a literature review framed within the ICF.

    PubMed

    Foley, K-R; Dyke, P; Girdler, S; Bourke, J; Leonard, H

    2012-01-01

    The purpose of this review was to describe literature relating to transition for young people with an intellectual disability and identify gaps within the current knowledge base. A narrative literature review was undertaken. Searches of databases Medline, CINAHL, PsycINFO, ERIC, ISI Web of Science and ProQuest 500 International provided relevant research articles. The search terms used were intellectual disability, transition, employment, and ICF as well as other terms derived from the ICF. Manual searches of reference lists identified additional studies. Furthermore, government websites were searched for relevant reports and policies. Transition literature was explored by ICF domains; body functions and structures, activity and participation and contextual factors. Studies were identified in some but not all areas and included literature describing self-determination and participation in leisure activities for those with mild intellectual disability. However, significant gaps were found particularly for those with severe intellectual disability. The ICF is a useful tool in framing a review of transition literature for young people with intellectual disability due to the complexity and multi-faceted nature of transition. The important influence of environmental factors including family systems, post-school services and access to transport were highlighted as having considerable impacts on transition outcomes.

  7. Development of a core outcome set for research and audit studies in reconstructive breast surgery.

    PubMed

    Potter, S; Holcombe, C; Ward, J A; Blazeby, J M

    2015-10-01

    Appropriate outcome selection is essential if research is to guide decision-making and inform policy. Systematic reviews of the clinical, cosmetic and patient-reported outcomes of reconstructive breast surgery, however, have demonstrated marked heterogeneity, and results from individual studies cannot be compared or combined. Use of a core outcome set may improve the situation. The BRAVO study developed a core outcome set for reconstructive breast surgery. A long list of outcomes identified from systematic reviews and stakeholder interviews was used to inform a questionnaire survey. Key stakeholders defined as individuals involved in decision-making for reconstructive breast surgery, including patients, breast and plastic surgeons, specialist nurses and psychologists, were sampled purposively and sent the questionnaire (round 1). This asked them to rate the importance of each outcome on a 9-point Likert scale from 1 (not important) to 9 (extremely important). The proportion of respondents rating each item as very important (score 7-9) was calculated. This was fed back to participants in a second questionnaire (round 2). Respondents were asked to reprioritize outcomes based on the feedback received. Items considered very important after round 2 were discussed at consensus meetings, where the core outcome set was agreed. A total of 148 items were combined into 34 domains within six categories. Some 303 participants (51·4 per cent) (215 (49·5 per cent) of 434 patients; 88 (56·4 per cent) of 156 professionals) completed and returned the round 1 questionnaire, and 259 (85·5 per cent) reprioritized outcomes in round 2. Fifteen items were excluded based on questionnaire scores and 19 were carried forward to the consensus meetings, where a core outcome set containing 11 key outcomes was agreed. The BRAVO study has used robust consensus methodology to develop a core outcome set for reconstructive breast surgery. Widespread adoption by the reconstructive community will

  8. Assessment of chronic post-surgical pain after knee replacement: development of a core outcome set.

    PubMed

    Wylde, V; MacKichan, F; Bruce, J; Gooberman-Hill, R

    2015-05-01

    Approximately 20% of patients experience chronic post-surgical pain (CPSP) after total knee replacement (TKR). There is scope to improve assessment of CPSP after TKR, and this study aimed to develop a core outcome set. Eighty patients and 43 clinicians were recruited into a three-round modified Delphi study. In Round 1, participants were presented with 56 pain features identified from a systematic review, structured interviews with patients and focus groups with clinicians. Participants assigned importance ratings, using a 1-9 scale, to individual pain features; those features rated as most important were retained in subsequent rounds. Consensus that a pain feature should be included in the core outcome set was defined as the feature having a rating of 7-9 by ≥70% of both panels (patients and clinicians) and 1-3 by ≤15% of both panels or rated as 7-9 by ≥90% of one panel. Round 1 was completed by 71 patients and 39 clinicians, and Round 3 by 62 patients and 33 clinicians. The final consensus was that 33 pain features were important. These were grouped into an 8-item core outcome set comprising: pain intensity, pain interference with daily living, pain and physical functioning, temporal aspects of pain, pain description, emotional aspects of pain, use of pain medication, and improvement and satisfaction with pain relief. This core outcome set serves to guide assessment of CPSP after TKR. Consistency in assessment can promote standardized reporting and facilitate comparability between studies that address a common but understudied type of CPSP. © 2014 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC®.

  9. Updating the Psoriatic Arthritis (PsA) Core Domain Set: A Report from the PsA Workshop at OMERACT 2016.

    PubMed

    Orbai, Ana-Maria; de Wit, Maarten; Mease, Philip J; Callis Duffin, Kristina; Elmamoun, Musaab; Tillett, William; Campbell, Willemina; FitzGerald, Oliver; Gladman, Dafna D; Goel, Niti; Gossec, Laure; Hoejgaard, Pil; Leung, Ying Ying; Lindsay, Chris; Strand, Vibeke; van der Heijde, Désirée M; Shea, Bev; Christensen, Robin; Coates, Laura; Eder, Lihi; McHugh, Neil; Kalyoncu, Umut; Steinkoenig, Ingrid; Ogdie, Alexis

    2017-10-01

    To include the patient perspective in accordance with the Outcome Measures in Rheumatology (OMERACT) Filter 2.0 in the updated Psoriatic Arthritis (PsA) Core Domain Set for randomized controlled trials (RCT) and longitudinal observational studies (LOS). At OMERACT 2016, research conducted to update the PsA Core Domain Set was presented and discussed in breakout groups. The updated PsA Core Domain Set was voted on and endorsed by OMERACT participants. We conducted a systematic literature review of domains measured in PsA RCT and LOS, and identified 24 domains. We conducted 24 focus groups with 130 patients from 7 countries representing 5 continents to identify patient domains. We achieved consensus through 2 rounds of separate surveys with 50 patients and 75 physicians, and a nominal group technique meeting with 12 patients and 12 physicians. We conducted a workshop and breakout groups at OMERACT 2016 in which findings were presented and discussed. The updated PsA Core Domain Set endorsed with 90% agreement by OMERACT 2016 participants included musculoskeletal disease activity, skin disease activity, fatigue, pain, patient's global assessment, physical function, health-related quality of life, and systemic inflammation, which were recommended for all RCT and LOS. These were important, but not required in all RCT and LOS: economic cost, emotional well-being, participation, and structural damage. Independence, sleep, stiffness, and treatment burden were on the research agenda. The updated PsA Core Domain Set was endorsed at OMERACT 2016. Next steps for the PsA working group include evaluation of PsA outcome measures and development of a PsA Core Outcome Measurement Set.

  10. Families' perception of children / adolescents with language impairment through the International Classification of Functioning, Disability, and Health (ICF-CY).

    PubMed

    Ostroschi, Daniele Theodoro; Zanolli, Maria de Lurdes; Chun, Regina Yu Shon

    2017-05-22

    To investigate the perception of family members regarding linguistic conditions and social participation of children and adolescents with speech and language impairments using the International Classification of Functioning, Disability and Health - Children and Youth Version (ICF-CY). Quali-quantitative approach research, in which a survey of medical records of 24 children/adolescents undergoing speech-language therapy and interviews with their family members was conducted. A descriptive analysis of the participants' profiles was performed, followed by a categorization of responses using the ICF-CY. All family members mentioned various aspects of speech/language categorized by the ICF-CY. Initially, they approached it as an organic issue, categorized under the component of Body Functions and Structures. Most reported different repercussions of the speech-language impairments on the domains, such as dealing with stress and speaking, qualified from mild to severe. Participants reported Environmental Factors categorized as facilitators in the immediate family's attitudes and as barriers in the social attitudes. These findings, according to the use of the ICF-CY, demonstrate that the children/adolescents' speech-language impairments, from the families' perception, are primarily understood in the body dimension. However, guided by a broader approach to health, the findings in the Activities and Participation and Environmental Factors demonstrate a broader understanding of the participants of the speech-language impairments. The results corroborate the importance of using the ICF-CY as a health care analysis tool, by incorporating functionality and participation aspects and providing subsidies for the construction of unique therapeutic projects in a broader approach to the health of the group studied.

  11. Implosion Dynamics and Mix in Double-Shell ICF Capsule Designs

    NASA Astrophysics Data System (ADS)

    Gunderson, Mark; Daughton, William; Simakov, Andrei; Wilson, Douglas; Watt, Robert; Delamater, Norman; Montgomery, David

    2015-11-01

    From an implosion dynamics perspective, double-shell ICF capsule designs have several advantages over the single-shell NIF ICF capsule point design. Double shell designs do not require precise shock sequencing, do not rely on hot spot ignition, have lower peak implosion speed requirements, and have lower convergence ratio requirements. However, there are still hurdles that must be overcome. The timing of the two main shocks in these designs is important in achieving sufficient compression of the DT fuel. Instability of the inner gold shell due to preheat from the hohlraum environment can disrupt the implosion of the inner pill. Mix, in addition to quenching burn in the DT fuel, also decreases the transfer of energy between the beryllium ablator and the inner gold shell during collision thus decreasing the implosion speed of the inner shell along with compression of the DT fuel. Herein, we will discuss practical implications of these effects on double-shell design we carry out in preparation for the NIF double-shell campaign. Work performed under the auspices of DOE by LANL under contract DE-AC52-06NA25396.

  12. Proposal for a candidate core-set of fitness and strength tests for patients with childhood or adult idiopathic inflammatory myopathies

    PubMed Central

    van der Stap, Djamilla K.D.; Rider, Lisa G.; Alexanderson, Helene; Huber, Adam M.; Gualano, Bruno; Gordon, Patrick; van der Net, Janjaap; Mathiesen, Pernille; Johnson, Liam G.; Ernste, Floranne C.; Feldman, Brian M.; Houghton, Kristin M.; Singh-Grewal, Davinder; Kutzbach, Abraham Garcia; Munters, Li Alemo; Takken, Tim

    2015-01-01

    OBJECTIVES Currently there are no evidence-based recommendations regarding which fitness and strength tests to use for patients with childhood or adult idiopathic inflammatory myopathies (IIM). This hinders clinicians and researchers in choosing the appropriate fitness- or muscle strength-related outcome measures for these patients. Through a Delphi survey, we aimed to identify a candidate core-set of fitness and strength tests for children and adults with IIM. METHODS Fifteen experts participated in a Delphi survey that consisted of five stages to achieve a consensus. Using an extensive search of published literature and through the expertise of the experts, a candidate core-set based on expert opinion and clinimetric properties was developed. Members of the International Myositis Assessment and Clinical Studies Group (IMACS) were invited to review this candidate core-set during the final stage, which led to a final candidate core-set. RESULTS A core-set of fitness- and strength-related outcome measures was identified for children and adults with IIM. For both children and adults, different tests were identified and selected for maximal aerobic fitness, submaximal aerobic fitness, anaerobic fitness, muscle strength tests and muscle function tests. CONCLUSIONS The core-set of fitness and strength-related outcome measures provided by this expert consensus process will assist practitioners and researchers in deciding which tests to use in IIM patients. This will improve the uniformity of fitness and strength tests across studies, thereby facilitating the comparison of study results and therapeutic exercise program outcomes among patients with IIM. PMID:26568594

  13. Patient-Centered Goal Setting in a Hospital-Based Outpatient Stroke Rehabilitation Center.

    PubMed

    Rice, Danielle B; McIntyre, Amanda; Mirkowski, Magdalena; Janzen, Shannon; Viana, Ricardo; Britt, Eileen; Teasell, Robert

    2017-09-01

    Goal-setting can have a positive impact on stroke recovery during rehabilitation. Patient participation in goal formulation can ensure that personally relevant goals are set, and can result in greater satisfaction with the rehabilitation experience, along with improved recovery of stroke deficits. This, however, not yet been studied in a stroke outpatient rehabilitation setting. To assess patient satisfaction of meeting self-selected goals during outpatient rehabilitation following a stroke. Retrospective chart review. Stroke patients enrolled in a multidisciplinary outpatient rehabilitation program, who set at least 1 goal during rehabilitation. Patients recovering from a stroke received therapy through the outpatient rehabilitation program between January 2010 and December 2013. Upon admission and discharge from rehabilitation, patients rated their satisfaction with their ability to perform goals that they wanted to achieve. Researchers independently sorted and labeled recurrent themes of goals. Goals were further sorted into International Classification of Functioning, Disability and Health (ICF) categories. To compare the perception of patients' goal satisfaction, repeated-measures analysis of variance was conducted across the 3 ICF goal categorizations. Goal satisfaction scores. A total of 286 patients were included in the analysis. Patient goals concentrated on themes of improving hand function, mobility, and cognition. Goals were also sorted into ICF categories in which impairment-based and activity limitation-based goals were predominant. Compared to activity-based and participation-based goals, patients with impairment-based goals perceived greater satisfaction with meeting their goals at admission and discharge (P < .001). Patient satisfaction in meeting their first-, second-, and third-listed goals each significantly improved by discharge from the rehabilitation program (P < .001). Within an outpatient stroke rehabilitation setting, patients set

  14. Recommendations for a first Core Outcome Measurement set for complex regional PAin syndrome Clinical sTudies (COMPACT)

    PubMed Central

    Grieve, Sharon; Perez, Roberto SGM; Birklein, Frank; Brunner, Florian; Bruehl, Stephen; Harden R, Norman; Packham, Tara; Gobeil, Francois; Haigh, Richard; Holly, Janet; Terkelsen, Astrid; Davies, Lindsay; Lewis, Jennifer; Thomassen, Ilona; Connett, Robyn; Worth, Tina; Vatine, Jean-Jacques; McCabe, Candida S

    2017-01-01

    Complex Regional Pain Syndrome (CRPS) is a persistent pain condition that remains incompletely understood and challenging to treat. Historically, a wide range of different outcome measures have been used to capture the multidimensional nature of CRPS. This has been a significant limiting factor in the advancement of our understanding of the mechanisms and management of CRPS. In 2013, an international consortium of patients, clinicians, researchers and industry representatives was established, to develop and agree on a minimum core set of standardised outcome measures for use in future CRPS clinical research, including but not limited to clinical trials within adult populations The development of a core measurement set was informed through workshops and supplementary work, using an iterative consensus process. ‘What is the clinical presentation and course of CRPS, and what factors influence it?’ was agreed as the most pertinent research question that our standardised set of patient-reported outcome measures should be selected to answer. The domains encompassing the key concepts necessary to answer the research question were agreed as: pain, disease severity, participation and physical function, emotional and psychological function, self efficacy, catastrophizing and patient's global impression of change. The final core measurement set included the optimum generic or condition-specific patient-reported questionnaire outcome measures, which captured the essence of each domain, and one clinician reported outcome measure to capture the degree of severity of CRPS. The next step is to test the feasibility and acceptability of collecting outcome measure data using the core measurement set in the CRPS population internationally. PMID:28178071

  15. LANL Q2 2016 Quarterly Progress Report. Science Campaign and ICF

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

    Douglas, Melissa Rae

    2016-04-07

    This progress report includes highlights for the Science Campaign and ICF about Advanced Certification and Assessment Methodologies, Implosion Hydrodynamics (C-1, SCE), Materials and Nuclear Science (C-1, C-2), Capabilities for Nuclear Intelligence, and High Energy Density Science (C-1, C-4, C-10). Upcoming meetings, briefings, and experiments are then listed for April and May.

  16. Development of a core outcome set for medication review in older patients with multimorbidity and polypharmacy: a study protocol.

    PubMed

    Beuscart, Jean-Baptiste; Dalleur, Olivia; Boland, Benoit; Thevelin, Stefanie; Knol, Wilma; Cullinan, Shane; Schneider, Claudio; O'Mahony, Denis; Rodondi, Nicolas; Spinewine, Anne

    2017-01-01

    Medication review has been advocated to address the challenge of polypharmacy in older patients, yet there is no consensus on how best to evaluate its efficacy. Heterogeneity of outcomes reported in clinical trials can hinder the comparison of clinical trial findings in systematic reviews. Moreover, the outcomes that matter most to older patients might be under-reported or disregarded altogether. A core outcome set can address this issue as it defines a minimum set of outcomes that should be reported in all clinical trials in any particular field of research. As part of the European Commission-funded project, called OPtimising thERapy to prevent Avoidable hospital admissions in the Multimorbid elderly, this paper describes the methods used to develop a core outcome set for clinical trials of medication review in older patients with multimorbidity. The study was designed in several steps. First, a systematic review established which outcomes were measured in published and ongoing clinical trials of medication review in older patients. Second, we undertook semistructured interviews with older patients and carers aimed at identifying additional relevant outcomes. Then, a multilanguage European Delphi survey adapted to older patients was designed. The international Delphi survey was conducted with older patients, health care professionals, researchers, and clinical experts in geriatric pharmacotherapy to validate outcomes to be included in the core outcome set. Consensus meetings were conducted to validate the results. We present the method for developing a core outcome set for medication review in older patients with multimorbidity. This study protocol could be used as a basis to develop core outcome sets in other fields of geriatric research.

  17. Identification of relevant functional issues for the care of patients with acute arthritis by health professionals, using the ICF framework and a multi-disciplinary focus group approach.

    PubMed

    Zochling, J; Grill, E; Alten, R; Ernst, J; Stucki, G; Braun, J

    2007-01-01

    To identify the most relevant problems to be addressed in the multi-disciplinary care of patients with acute arthritis using focus groups of health professionals followed by a Delphi process. Focus group and Delphi methodology were applied. The focus groups were conducted at three specialist rheumatology hospital clinics in Germany, each group comprising rheumatologists, nurses, physiotherapists, occupational therapists, psychologists and social workers. The participants were asked to decide which categories of the International Classification of Functioning, Disability and Health (ICF) are relevant to the care of patients with acute inflammatory arthritis. The results from the focus groups were then followed by an anonymous Delphi process. Twenty-six health professionals participated in the 3 focus groups. 167 of the second-level ICF categories (63% of all second-level categories) were considered as relevant by the rheumatology health professionals. Items from all four components, Body Functions, Body Structures, Activities and Participation and Environmental Factors were represented. Agreement between focus groups and between different health professional groups was substantial for all components with the exception of Environmental Factors (Cohen's kappa 0.23). The involvement of experts from different health professions is a valuable tool to identify typical patient characteristics, expressed as distinct ICF categories, to aid in patient care in the acute rheumatology setting. Acute patient care cannot and should not be separated from ongoing long-term management.

  18. Mapping the rehabilitation interventions of a community stroke team to the extended International Classification of Functioning, Disability and Health Core Set for Stroke.

    PubMed

    Evans, Melissa; Hocking, Clare; Kersten, Paula

    2017-12-01

    This study aim was to evaluate whether the Extended International Classification of Functioning, Disability and Health Core Set for Stroke captured the interventions of a community stroke rehabilitation team situated in a large city in New Zealand. It was proposed that the results would identify the contribution of each discipline, and the gaps and differences in service provision to Māori and non-Māori. Applying the Extended International Classification of Functioning, Disability and Health Core Set for Stroke in this way would also inform whether this core set should be adopted in New Zealand. Interventions were retrospectively extracted from 18 medical records and linked to the International Classification of Functioning, Disability and Health and the Extended International Classification of Functioning, Disability and Health Core Set for Stroke. The frequencies of linked interventions and the health discipline providing the intervention were calculated. Analysis revealed that 98.8% of interventions provided by the rehabilitation team could be linked to the Extended International Classification of Functioning, Disability and Health Core Set for Stroke, with more interventions for body function and structure than for activities and participation; no interventions for emotional concerns; and limited interventions for community, social and civic life. Results support previous recommendations for additions to the EICSS. The results support the use of the Extended International Classification of Functioning, Disability and Health Core Set for Stroke in New Zealand and demonstrates its use as a quality assurance tool that can evaluate the scope and practice of a rehabilitation service. Implications for Rehabilitation The Extended International Classification of Functioning Disability and Health Core Set for Stroke appears to represent the stroke interventions of a community stroke rehabilitation team in New Zealand. As a result, researchers and clinicians may have

  19. An algorithm for deriving core magnetic field models from the Swarm data set

    NASA Astrophysics Data System (ADS)

    Rother, Martin; Lesur, Vincent; Schachtschneider, Reyko

    2013-11-01

    In view of an optimal exploitation of the Swarm data set, we have prepared and tested software dedicated to the determination of accurate core magnetic field models and of the Euler angles between the magnetic sensors and the satellite reference frame. The dedicated core field model estimation is derived directly from the GFZ Reference Internal Magnetic Model (GRIMM) inversion and modeling family. The data selection techniques and the model parameterizations are similar to what were used for the derivation of the second (Lesur et al., 2010) and third versions of GRIMM, although the usage of observatory data is not planned in the framework of the application to Swarm. The regularization technique applied during the inversion process smoothes the magnetic field model in time. The algorithm to estimate the Euler angles is also derived from the CHAMP studies. The inversion scheme includes Euler angle determination with a quaternion representation for describing the rotations. It has been built to handle possible weak time variations of these angles. The modeling approach and software have been initially validated on a simple, noise-free, synthetic data set and on CHAMP vector magnetic field measurements. We present results of test runs applied to the synthetic Swarm test data set.

  20. Site support program plan for ICF Kaiser Hanford Company, Revision 1

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

    NONE

    1995-10-01

    This document is the general administrative plan implemented by the Hanford Site contractor, ICF Kaiser Hanford Company. It describes the mission, administrative structure, projected staffing, to be provided by the contractor. The report breaks out the work responsibilities within the different units of the company, a baseline schedule for the different groups, and a cost summary for the different operating units.

  1. Core Self-Evaluations as Personal Factors in the World Health Organization's International Classification of Functioning, Disability and Health Model: An Application in Persons with Spinal Cord Injury

    ERIC Educational Resources Information Center

    Yaghmanian, Rana; Smedema, Susan Miller; Thompson, Kerry

    2017-01-01

    Purpose: To evaluate Chan, Gelman, Ditchman, Kim, and Chiu's (2009) revised World Health Organization's International Classification of Functioning, Disability and Health (ICF) model using core self-evaluations (CSE) to account for Personal Factors in persons with spinal cord injury (SCI). Method: One hundred eighty-seven adults with SCI were…

  2. Field precision machining technology of target chamber in ICF lasers

    NASA Astrophysics Data System (ADS)

    Xu, Yuanli; Wu, Wenkai; Shi, Sucun; Duan, Lin; Chen, Gang; Wang, Baoxu; Song, Yugang; Liu, Huilin; Zhu, Mingzhi

    2016-10-01

    In ICF lasers, many independent laser beams are required to be positioned on target with a very high degree of accuracy during a shot. The target chamber provides a precision platform and datum reference for final optics assembly and target collimation and location system. The target chamber consists of shell with welded flanges, reinforced concrete pedestal, and lateral support structure. The field precision machining technology of target chamber in ICF lasers have been developed based on ShenGuangIII (SGIII). The same center of the target chamber is adopted in the process of design, fabrication, and alignment. The technologies of beam collimation and datum reference transformation are developed for the fabrication, positioning and adjustment of target chamber. A supporting and rotating mechanism and a special drilling machine are developed to bore the holes of ports. An adjustment mechanism is designed to accurately position the target chamber. In order to ensure the collimation requirements of the beam leading and focusing and the target positioning, custom-machined spacers are used to accurately correct the alignment error of the ports. Finally, this paper describes the chamber center, orientation, and centering alignment error measurements of SGIII. The measurements show the field precision machining of SGIII target chamber meet its design requirement. These information can be used on similar systems.

  3. ICF quarterly report January - March 1997 volume 7, number 3

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

    Murray, J

    The National Ignition Facility Project The mission of the National Ignition Facility (NIF) is to produce ignition and modest energy gain in inertial confinement fusion (ICF) targets. Achieving these goals will maintain U.S. world leadership in ICF and will directly benefit the U.S. Department of Energy (DOE) missions in national security, science and technology, energy resources, and industrial competitiveness. Development and operation of the NIF are consistent with DOE goals for environmental quality, openness to the community, and nuclear nonproliferation and arms control. Although the primary mission of inertial fusion is for defense applications, inertial fusion research will provide criticalmore » information for the development of inertial fusion energy. The NIF, under construction at Lawrence Livermore National Laboratory (LLNL), is a cornerstone of the DOE's science-based Stockpile Stewardship Program for addressing high-energy-density physics issues in the absence of nuclear weapons testing. In pursuit of this mission, the DOE's Defense Programs has developed a state-of-the-art capability with the NIF to investigate high-energy-density physics in the laboratory with a microfusion capability for defense and energy applications. As a Strategic System Acquisition, the NIF Project has a separate and disciplined reporting chain to DOE as shown below.« less

  4. After Common Core, States Set Rigorous Standards

    ERIC Educational Resources Information Center

    Peterson, Paul E.; Barrows, Samuel; Gift, Thomas

    2016-01-01

    In spite of Tea Party criticism, union skepticism, and anti-testing outcries, the campaign to implement Common Core State Standards (otherwise known as Common Core) has achieved phenomenal success in statehouses across the country. Since 2011, 45 states have raised their standards for student proficiency in reading and math, with the greatest…

  5. Determinants of school activity performance in children with cerebral palsy: a multidimensional approach using the ICF-CY as a framework.

    PubMed

    Huang, Chien-Yu; Tseng, Mei-Hui; Chen, Kuan-Lin; Shieh, Jeng-Yi; Lu, Lu

    2013-11-01

    This study aimed to identify the determinants of activity performance in children with cerebral palsy (CP) in school by considering factors from the entire scope of the International Classification of Functioning, Disability, and Health for Child and Youth (ICF-CY). A sample of 167 school-aged children with CP and their caregivers were recruited in the study. Activity performance in school settings was assessed with part 3 of the School Functional Assessment - Chinese version, which divides activity performance into performance of physical activities and cognitive/behavioral activities. Possible determinants were collected according to all dimensions of the ICF-CY. Multiple regression analyses showed that the determinants of performance of physical activities were receiving speech therapy in school, diplegia, having a domestic helper, and severity of gross and fine motor impairments, explaining 83% of the total variance; the determinants of performance of cognitive/behavioral activities were intellectual impairment, prosocial behavior, having an assistant in school, educational placement, severity of fine motor impairment, accounting for 73% of the total variance. Results of the study provide clinicians a holistic understanding of factors influencing school activity performance, and enable clinicians to make appropriate evaluations and interventions targeted at the determinants to enhance children's activity performance in school. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. International Spinal Cord Injury Core Data Set (version 2.0)-including standardization of reporting.

    PubMed

    Biering-Sørensen, F; DeVivo, M J; Charlifue, S; Chen, Y; New, P W; Noonan, V; Post, M W M; Vogel, L

    2017-08-01

    The study design includes expert opinion, feedback, revisions and final consensus. The objective of the study was to present the new knowledge obtained since the International Spinal Cord Injury (SCI) Core Data Set (Version 1.0) published in 2006, and describe the adjustments made in Version 2.0, including standardization of data reporting. International. Comments received from the SCI community were discussed in a working group (WG); suggestions from the WG were reviewed and revisions were made. All suggested revisions were considered, and a final version was circulated for final approval. The International SCI Core Data Set (Version 2.0) consists of 25 variables. Changes made to this version include the deletion of one variable 'Total Days Hospitalized' and addition of two variables 'Date of Rehabilitation Admission' and 'Date of Death.' The variable 'Injury Etiology' was extended with six non-traumatic categories, and corresponding 'Date of Injury' for non-traumatic cases, was defined as the date of first physician visit for symptoms related to spinal cord dysfunction. A category reflecting transgender was added. A response category was added to the variable on utilization of ventilatory assistance to document the use of continuous positive airway pressure for sleep apnea. Other clarifications were made to the text. The reporting of the pediatric SCI population was updated as age groups 0-5, 6-12, 13-14, 15-17 and 18-21. Collection of the core data set should be a basic requirement of all studies of SCI to facilitate accurate descriptions of patient populations and comparison of results across published studies from around the world.

  7. Evidence for Updating the Core Domain Set of Outcome Measures for Juvenile Idiopathic Arthritis: Report from a Special Interest Group at OMERACT 2016.

    PubMed

    Morgan, Esi M; Riebschleger, Meredith P; Horonjeff, Jennifer; Consolaro, Alessandro; Munro, Jane E; Thornhill, Susan; Beukelman, Timothy; Brunner, Hermine I; Creek, Emily L; Harris, Julia G; Horton, Daniel B; Lovell, Daniel J; Mannion, Melissa L; Olson, Judyann C; Rahimi, Homaira; Gallo, Maria Chiara; Calandra, Serena; Ravelli, Angelo; Ringold, Sarah; Shenoi, Susan; Stinson, Jennifer; Toupin-April, Karine; Strand, Vibeke; Bingham, Clifton O

    2017-12-01

    The current Juvenile Idiopathic Arthritis (JIA) Core Set was developed in 1997 to identify the outcome measures to be used in JIA clinical trials using statistical and consensus-based techniques, but without patient involvement. The importance of patient/parent input into the research process has increasingly been recognized over the years. An Outcome Measures in Rheumatology (OMERACT) JIA Core Set Working Group was formed to determine whether the outcome domains of the current core set are relevant to those involved or whether the core set domains should be revised. Twenty-four people from the United States, Canada, Australia, and Europe, including patient partners, formed the working group. Guided by the OMERACT Filter 2.0 process, we performed (1) a systematic literature review of outcome domains, (2) a Web-based survey (142 patients, 343 parents), (3) an idea-generation study (120 parents), (4) 4 online discussion boards (24 patients, 20 parents), and (5) a Special Interest Group (SIG) activity at the OMERACT 13 (2016) meeting. A MEDLINE search of outcome domains used in studies of JIA yielded 5956 citations, of which 729 citations underwent full-text review, and identified additional domains to those included in the current JIA Core Set. Qualitative studies on the effect of JIA identified multiple additional domains, including pain and participation. Twenty-one participants in the SIG achieved consensus on the need to revise the entire JIA Core Set. The results of qualitative studies and literature review support the need to expand the JIA Core Set, considering, among other things, additional patient/parent-centered outcomes, clinical data, and imaging data.

  8. Effects of inhomogeneity at stagnation in 3D simulations of ICF implosions

    NASA Astrophysics Data System (ADS)

    Appelbe, Brian

    2016-10-01

    The stagnation phase of an ICF implosion is characterized by a hotspot and dense fuel layer that are spatially and temporally inhomogeneous. Perturbation growth during the implosion results in significant asymmetry at stagnation while the hotspot size, density and temperature change rapidly, even in non-igniting capsules. Diagnosing these inhomogeneities is necessary to increase yield in ICF experiments. In this work, 3D radiation hydrodynamic simulations of perturbed indirect drive ICF capsules are carried out using the CHIMERA code. During the stagnation phase a suite of novel and computationally efficient simulation tools are used to produce synthetic time-resolved neutron spectra and images. These tools allow a detailed study of the effects of hotspot inhomogeneities on diagnostic signals. Results show that the burn-averaged ion temperature drops rapidly during thermonuclear burn as the hotspot evolves from a localised, shock-heated region to a more massive, non-uniform plasma. Primary DD and DT neutron spectra show that there is significant residual bulk fluid motion at stagnation, complicating the measurement of ion temperature. Different perturbation modes cause different levels of anisotropic spectra shifts and broadening. However, in all cases the discrepancies between the DD and DT spectra are a reliable indicator of residual motion at stagnation. The simulations are used to examine the relationship between neutron scattering and areal density (ρR). Three measures of areal density are simulated: downscattered neutron ratio, attenuated primary neutron yield and nT backscatter edge. Each of these diagnoses the magnitude and anisotropy of the ρR with varying success, with accuracy decreasing for higher mode perturbations. Contributions to the neutron energy spectra from T +T reactions, secondary DT reactions and deuteron break-up are also evaluated.

  9. The Harmonizing Outcome Measures for Eczema (HOME) roadmap: a methodological framework to develop core sets of outcome measurements in dermatology.

    PubMed

    Schmitt, Jochen; Apfelbacher, Christian; Spuls, Phyllis I; Thomas, Kim S; Simpson, Eric L; Furue, Masutaka; Chalmers, Joanne; Williams, Hywel C

    2015-01-01

    Core outcome sets (COSs) are consensus-derived minimum sets of outcomes to be assessed in a specific situation. COSs are being increasingly developed to limit outcome-reporting bias, allow comparisons across trials, and strengthen clinical decision making. Despite the increasing interest in outcomes research, methods to develop COSs have not yet been standardized. The aim of this paper is to present the Harmonizing Outcomes Measures for Eczema (HOME) roadmap for the development and implementation of COSs, which was developed on the basis of our experience in the standardization of outcome measurements for atopic eczema. Following the establishment of a panel representing all relevant stakeholders and a research team experienced in outcomes research, the scope and setting of the core set should be defined. The next steps are the definition of a core set of outcome domains such as symptoms or quality of life, followed by the identification or development and validation of appropriate outcome measurement instruments to measure these core domains. Finally, the consented COS needs to be disseminated, implemented, and reviewed. We believe that the HOME roadmap is a useful methodological framework to develop COSs in dermatology, with the ultimate goal of better decision making and promoting patient-centered health care.

  10. A tool to enhance occupational therapy reasoning from ICF perspective: The Hasselt Occupational Performance Profile (H-OPP).

    PubMed

    Ghysels, R; Vanroye, E; Westhovens, M; Spooren, A

    2017-03-01

    In order to enhance occupational therapy reasoning in clinical practice, different elements such as client-centred approach, evidence-based care and interdisciplinary work should be taken into account, but is a challenge. To describe the development of the digital Hasselt Occupational Performance Profile (H-OPP © ) that enhances occupational therapy reasoning from ICF perspective. A participative qualitative design was used to create the H-OPP © in an iterative way in which occupational therapy lectures, ICF experts, students and occupational therapists in the field were involved. After linking occupational therapy terminology to the ICF, different stages of the H-OPP were identified and elaborated with main features: generating an occupational performance profile based on inventarization of problems and possibilities, formulating an occupational performance diagnosis and enabling to create an intervention plan. In all stages, both the perspectives of the client and the occupational therapist were taken into account. To increase practical use, the tool was further elaborated and digitalized. The H-OPP © is a digital coach that guides and facilitates professional reasoning in (novice) occupational therapists. It augments involvement of the client system. Furthermore, it enhances interdisciplinary communication and evidence-based care.

  11. Disability and Functional Profiles of Patients with Myasthenia Gravis Measured with ICF Classification

    ERIC Educational Resources Information Center

    Leonardi, Matilde; Raggi, Alberto; Antozzi, Carlo; Confalonieri, Paolo; Maggi, Lorenzo; Cornelio, Ferdinando; Mantegazza, Renato

    2009-01-01

    The objective of this study is to describe functional profiles of patients with myasthenia gravis (MG), and the relationships among symptoms, activities and environmental factors (EF), by using WHO's International Classification of Functioning Disability and Health (ICF). Patients were consecutively enrolled at the Besta Institute of Milan, Italy.…

  12. A Dutch ICF version of the Activity Inventory: results from focus groups with visually impaired persons and experts.

    PubMed

    Bruijning, Janna; van Nispen, Ruth; Verstraten, Peter; van Rens, Ger

    2010-12-01

    To develop a valid and reliable instrument to systematically investigate visual rehabilitation needs of visually impaired older adults, which is compatible with the "International Classification of Functioning, Disability and Health" (ICF) structure: a new Dutch ICF version of the Activity Inventory (D-AI). The original AI was translated, adjusted and expanded. After studying literature and investigating patient records, focus group discussions were conducted until the input was just confirmatory. Six (n = 41) and seven (n = 50) discussions with patients and professionals respectively contributed to the first draft of the D-AI, which was further improved by professionals. The D-AI now consists of 10 domains, 68 goals and 813 tasks. Goals are organized into the "Activities and Participation" domains of the ICF. The original routing was maintained; only tasks organized under important (0 [not important] to 3 [very important]) and difficult (0 [not difficult] to 4 [impossible]) goals were assessed. Rehabilitation needs can be organized in the "Activities and Participation" domains of the ICF. The D-AI offers a way of systematically assessing and measuring functional limitations and disabilities, and provides detailed information about activities that are needed to perform a certain goal. Focus group discussions with Dutch patients and experts revealed additional items that will probably be relevant for other populations. Involving patients in the first step of the developing process is important to provide face and content validity. The D-AI can prioritize rehabilitation goals by multiplying importance and difficulty scores, which is helpful in formulating a rehabilitation plan.

  13. Measuring patterns of disability using the International Classification of Functioning, Disability and Health in the post-acute stroke rehabilitation setting.

    PubMed

    Goljar, Nika; Burger, Helena; Vidmar, Gaj; Leonardi, Matilde; Marincek, Crt

    2011-06-01

    To determine whether the International Classification of Functioning, Disability and Health (ICF) model is adequate for assessing disability patterns in stroke survivors in the sub-acute rehabilitation setting in terms of potential changes in functional profiles over time. Functional profiles of 197 stroke patients were assessed using the ICF Checklist and the Functional Independence Measure (FIMTM) at admission and discharge from rehabilitation hospital. The ICF Checklist was applied based on medical documentation and rehabilitation team meetings. Descriptive analyses were performed to identify changes in ICF categories and qualifiers from admission to discharge, and correlations between different improvement measures were calculated. Mean rehabilitation duration was 60 days; patients' mean age was 60 years, with mean FIM-score 75 at admission. Mean FIM-score improvement at discharge was 12.5. Within Body Functions, changes in at least 10% of patients were found regarding 13 categories; no categories within Body Structures, 24 within Activities and Participation, and 2 within Environmental Factors. Changes were mostly due to improvement in qualifiers, except for within Environmental Factors, where they were due to use of additional categories. Correlations between improvements in Body Functions and Activities and Participation (regarding capacity and performance), as well as between capacity and performance within Activities and Participation, were approximately 0.4. Rating ICF categories with qualifiers enables the detection of changes in functional profiles of stroke patients who underwent an inpatient rehabilitation programme. :

  14. Damage behavior of Nd:glass of high-power disk amplifier medium in ICF Facility

    NASA Astrophysics Data System (ADS)

    He, Shaobo; Chen, Lin; Yuan, Xiaodong; Chen, Yuanbin; Cheng, Xiaofeng; Xie, Xudong; Wang, Wenyi; Zu, Xiaotao

    2016-12-01

    Large aperture Nd:glass disk is often used as the amplifier medium in the inertial confinement fusion (ICF) facilities. The typical size of Nd:glass is up to 810mm×460mm×40mm and more than 3,000 Nd:glass components are needed in the ICF facility. At present, the 3ω fused silica glass and DKDP crystal are mainly responsible for the damage of driver used for ICF. However, with the enlargement of the facility and increase of laser shot number, the laser damage of Nd:glass at 1ω waveband is still an important problem to limit the stable operation of facility and improvement of laser beam quality. In this work, the influence of Nd:glass material itself, mechanical processing, service environment, and laser beam quality on its damage behavior is investigated experimentally and theoretically. The results and conclusions can be summarized as follows: (1) It is very important to control the concentration of platinum impurity particles during melting and the sputtering effect of the cladding materials. (2) The number and length of fractural and brittle scratches should be strictly suppressed during mechanical processing of Nd:glass. (3) The B-integral of high power laser beam should be rigorously controlled. Particularly, the top shape of pulses must be well controlled when operating at high peak laser power. (4) The service environment should be well managed to make sure the cleanness of the surface of Nd:glass better than 100/A level during mounting and running. (5) The service environment and beam quality should be monitored during operation.

  15. Three nested randomized controlled trials of peer-only or multiple stakeholder group feedback within Delphi surveys during core outcome and information set development.

    PubMed

    Brookes, Sara T; Macefield, Rhiannon C; Williamson, Paula R; McNair, Angus G; Potter, Shelley; Blencowe, Natalie S; Strong, Sean; Blazeby, Jane M

    2016-08-17

    Methods for developing a core outcome or information set require involvement of key stakeholders to prioritise many items and achieve agreement as to the core set. The Delphi technique requires participants to rate the importance of items in sequential questionnaires (or rounds) with feedback provided in each subsequent round such that participants are able to consider the views of others. This study examines the impact of receiving feedback from different stakeholder groups, on the subsequent rating of items and the level of agreement between stakeholders. Randomized controlled trials were nested within the development of three core sets each including a Delphi process with two rounds of questionnaires, completed by patients and health professionals. Participants rated items from 1 (not essential) to 9 (absolutely essential). For round 2, participants were randomized to receive feedback from their peer stakeholder group only (peer) or both stakeholder groups separately (multiple). Decisions as to which items to retain following each round were determined by pre-specified criteria. Whilst type of feedback did not impact on the percentage of items for which a participant subsequently changed their rating, or the magnitude of change, it did impact on items retained at the end of round 2. Each core set contained discordant items retained by one feedback group but not the other (3-22 % discordant items). Consensus between patients and professionals in items to retain was greater amongst those receiving multiple group feedback in each core set (65-82 % agreement for peer-only feedback versus 74-94 % for multiple feedback). In addition, differences in round 2 scores were smaller between stakeholder groups receiving multiple feedback than between those receiving peer group feedback only. Variability in item scores across stakeholders was reduced following any feedback but this reduction was consistently greater amongst the multiple feedback group. In the development of

  16. Including patients in core outcome set development: issues to consider based on three workshops with around 100 international delegates.

    PubMed

    Young, Bridget; Bagley, Heather

    2016-01-01

    This commentary article describes three interactive workshops that explored how patients can contribute to decisions about what outcomes are measured in clinical trials across the world. Outcomes like quality of life, side-effects and pain are used in trials to measure whether a treatment is effective. Here, we outline how research groups are increasingly coming together to develop 'core outcomes sets' for particular conditions. Core outcome sets are lists of agreed outcomes. Their use will help in identifying which treatments are effective by enabling people to compare the findings of different clinical trials in the same condition. Currently, it is often very difficult to make these comparisons because different studies often measure different outcomes. Delegates attending the workshops included patients, clinicians and researchers. They discussed ways of making core outcome set development more meaningful and accessible for patients, and ensuring that they have a genuine say in the development process. This article summarises these discussions and concludes by identifying three distinctive challenges in securing patient input to core outcome set development: the process and objectives can seem far removed from the immediate concerns of patients, difficulties can arise in securing patient input on an international scale, and difficulties can also arise in bringing multiple stakeholder groups together to achieve consensus. While patient participation, involvement and engagement in core outcome set development can draw on lessons from other research areas, these distinctive challenges point to the need for distinctive solutions to enable meaningful patient input to core outcome set development. Background This article describes three workshops that explored how patients can contribute to decisions about what outcomes are measured in clinical trials. People need evidence about what treatments are best for particular health conditions. The strongest evidence comes

  17. Disability and Profiles of Functioning of Patients with Parkinson's Disease Described with ICF Classification

    ERIC Educational Resources Information Center

    Raggi, Alberto; Leonardi, Matilde; Ajovalasit, Daniela; Carella, Francesco; Soliveri, Paola; Albanese, Alberto; Romito, Luigi

    2011-01-01

    The objective of this study was to describe the functional profiles of patients with Parkinson's disease (PD), and the relationships between impairment in body functions, limitations in activities, and environmental factors, using the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). Patients…

  18. Correlation consistent valence basis sets for use with the Stuttgart-Dresden-Bonn relativistic effective core potentials: The atoms Ga-Kr and In-Xe

    NASA Astrophysics Data System (ADS)

    Martin, Jan M. L.; Sundermann, Andreas

    2001-02-01

    We propose large-core correlation-consistent (cc) pseudopotential basis sets for the heavy p-block elements Ga-Kr and In-Xe. The basis sets are of cc-pVTZ and cc-pVQZ quality, and have been optimized for use with the large-core (valence-electrons only) Stuttgart-Dresden-Bonn (SDB) relativistic pseudopotentials. Validation calculations on a variety of third-row and fourth-row diatomics suggest them to be comparable in quality to the all-electron cc-pVTZ and cc-pVQZ basis sets for lighter elements. Especially the SDB-cc-pVQZ basis set in conjunction with a core polarization potential (CPP) yields excellent agreement with experiment for compounds of the later heavy p-block elements. For accurate calculations on Ga (and, to a lesser extent, Ge) compounds, explicit treatment of 13 valence electrons appears to be desirable, while it seems inevitable for In compounds. For Ga and Ge, we propose correlation consistent basis sets extended for (3d) correlation. For accurate calculations on organometallic complexes of interest to homogenous catalysis, we recommend a combination of the standard cc-pVTZ basis set for first- and second-row elements, the presently derived SDB-cc-pVTZ basis set for heavier p-block elements, and for transition metals, the small-core [6s5p3d] Stuttgart-Dresden basis set-relativistic effective core potential combination supplemented by (2f1g) functions with exponents given in the Appendix to the present paper.

  19. Creation of a core outcome set for clinical trials of people with shoulder pain: a study protocol.

    PubMed

    Gagnier, Joel J; Page, Matthew J; Huang, Hsiaomin; Verhagen, Arianne P; Buchbinder, Rachelle

    2017-07-20

    The selection of appropriate outcomes or domains is crucial when designing clinical trials, to appreciate the effects of different interventions, pool results, and make valid comparisons between trials. If the findings are to influence policy and practice, then the chosen outcomes need to be relevant and important to key stakeholders, including patients and the public, healthcare professionals and others making decisions about health care. There is a growing recognition that insufficient attention has been paid to the outcomes measured in clinical trials. Recent reviews of the measurement properties of patient-reported outcome measures for shoulder disorders revealed a large selection of diverse measures, many with questionable validity, reliability, and responsiveness. These issues could be addressed through the development and use of an agreed standardized collection of outcomes, known as a core outcome set (COS), which should be measured and reported in all trials of shoulder disorders. The purpose of the present project is to develop and disseminate a COS for clinical trials in shoulder disorders. The methods for the COS development will include 3 phases: (1) a comprehensive review of the core domains used in shoulder disorder trials; (2) an international Delphi study involving relevant stakeholders (patients, clinicians, scientists) to define which domains should be core; and (3) an international focus group informed by the evidence identified in phases 1 and 2, to determine which measurement instruments best measure the core domains and identification of any evidence gaps that require further empiric evidence. The aim of the current proposal is to convene several meetings of international experts and patients to develop a COS for clinical trials of shoulder disorders and to develop an implementation strategy to ensure rapid uptake of the core set of outcomes in clinical trials. There would be an expectation that the core set of outcomes would always be

  20. Development of a core set of outcome measures for OAB treatment.

    PubMed

    Foust-Wright, Caroline; Wissig, Stephanie; Stowell, Caleb; Olson, Elizabeth; Anderson, Anita; Anger, Jennifer; Cardozo, Linda; Cotterill, Nikki; Gormley, Elizabeth Ann; Toozs-Hobson, Philip; Heesakkers, John; Herbison, Peter; Moore, Kate; McKinney, Jessica; Morse, Abraham; Pulliam, Samantha; Szonyi, George; Wagg, Adrian; Milsom, Ian

    2017-12-01

    Standardized measures enable the comparison of outcomes across providers and treatments giving valuable information for improving care quality and efficacy. The aim of this project was to define a minimum standard set of outcome measures and case-mix factors for evaluating the care of patients with overactive bladder (OAB). The International Consortium for Health Outcomes Measurement (ICHOM) convened an international working group (WG) of leading clinicians and patients to engage in a structured method for developing a core outcome set. Consensus was determined by a modified Delphi process, and discussions were supported by both literature review and patient input. The standard set measures outcomes of care for adults seeking treatment for OAB, excluding residents of long-term care facilities. The WG focused on treatment outcomes identified as most important key outcome domains to patients: symptom burden and bother, physical functioning, emotional health, impact of symptoms and treatment on quality of life, and success of treatment. Demographic information and case-mix factors that may affect these outcomes were also included. The standardized outcome set for evaluating clinical care is appropriate for use by all health providers caring for patients with OAB, regardless of specialty or geographic location, and provides key data for quality improvement activities and research.

  1. An international qualitative study of functioning in autism spectrum disorder using the World Health Organization international classification of functioning, disability and health framework

    PubMed Central

    Mahdi, Soheil; Viljoen, Marisa; Yee, Tamara; Selb, Melissa; Singhal, Nidhi; Almodayfer, Omar; Granlund, Mats; de Vries, Petrus J.; Zwaigenbaum, Lonnie

    2017-01-01

    This is the third in a series of four empirical studies designed to develop International Classification of Functioning, Disability and Health (ICF) Core Sets for Autism Spectrum Disorder (ASD). The present study aimed to describe functioning in ASD (as operationalized by the ICF) derived from the perspectives of diagnosed individuals, family members, and professionals. A qualitative study using focus groups and semi‐structured interviews were conducted with 19 stakeholder groups (N = 90) from Canada, India, Saudi Arabia, South Africa, and Sweden. Meaningful concepts from the focus groups and individual interviews were linked to ICF categories using a deductive qualitative approach with standardized linking procedures. The deductive qualitative content analysis yielded meaningful functioning concepts that were linked to 110 ICF categories across all four ICF components. Broad variation of environmental factors and activities and participation categories were identified in this study, while body functions consisted mainly of mental functions. Body structures were sparsely mentioned by the participants. Positive aspects of ASD included honesty, attention to detail, and memory. The experiences provided by international stakeholders support the need to understand individuals with ASD in a broader perspective, extending beyond diagnostic criteria into many areas of functioning and environmental domains. This study is part of a larger systematic effort that will provide the basis to define ICF Core Sets for ASD, from which assessment tools can be generated for use in clinical practice, research, and health care policy making. Autism Res 2018, 11: 463–475. © 2017 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. Lay Summary The study findings support the need to understand the living experiences of individuals with Autism Spectrum Disorder (ASD) from a broader perspective, taking into account many areas

  2. Functioning and disability in autism spectrum disorder: A worldwide survey of experts

    PubMed Central

    de Schipper, Elles; Mahdi, Soheil; de Vries, Petrus; Granlund, Mats; Holtmann, Martin; Karande, Sunil; Almodayfer, Omar; Shulman, Cory; Tonge, Bruce; Wong, Virginia V.C.N.; Zwaigenbaum, Lonnie

    2016-01-01

    Objective: This study is the second of four to prepare International Classification of Functioning, Disability and Health (ICF; and Children and Youth version, ICF(‐CY)) Core Sets for Autism Spectrum Disorder (ASD).The objective of this study was to survey the opinions and experiences of international experts on functioning and disability in ASD. Methods: Using a protocol stipulated by the World Health Organization (WHO) and monitored by the ICF Research Branch, an email‐based questionnaire was circulated worldwide among ASD experts, and meaningful functional ability and disability concepts were extracted from their responses. These concepts were then linked to the ICF(‐CY) by two independent researchers using a standardized linking procedure. Results: N = 225 experts from 10 different disciplines and all six WHO‐regions completed the survey. Meaningful concepts from the responses were linked to 210 ICF(‐CY) categories. Of these, 103 categories were considered most relevant to ASD (i.e., identified by at least 5% of the experts), of which 37 were related to Activities and Participation, 35 to Body functions, 22 to Environmental factors, and 9 to Body structures. A variety of personal characteristics and ASD‐related functioning skills were provided by experts, including honesty, loyalty, attention to detail and creative talents. Reported gender differences in ASD comprised more externalizing behaviors among males and more internalizing behaviors in females. Conclusion: The ICF(‐CY) categories derived from international expert opinions indicate that the impact of ASD on functioning extends far beyond core symptom domains. Autism Res 2016, 9: 959–969. © 2016 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research PMID:26749373

  3. Modeling ICF With RAGE, BHR, And The New Laser Package

    NASA Astrophysics Data System (ADS)

    Cliche, Dylan; Welser-Sherrill, Leslie; Haines, Brian; Mancini, Roberto

    2017-10-01

    Inertial Confinement Fusion (ICF) is one method used to obtain thermonuclear burn through the either direct or indirect ablation of a millimeter-scale capsule with several lasers. Although progress has been made in theory, experiment, and diagnostics, the community has yet to reach ignition. A way of investigating this is through the use of high performance computer simulations of the implosion. RAGE is an advanced 1D, 2D, and 3D radiation adaptive grid Eulerian code used to simulate hydrodynamics of a system. Due to the unstable nature of two unequal densities accelerating into one another, it is important to include a turbulence model. BHR is a turbulence model which uses Reynolds-averaged Navier-Stokes (RANS) equations to model the mixing that occurs between the shell and fusion fuel material. Until recently, it was still difficult to model direct drive experiments because there was no laser energy deposition model in RAGE. Recently, a new laser energy deposition model has been implemented using the same ray tracing method as the Mazinisin laser package used at the OMEGA laser facility at the Laboratory for Laser Energetics (LLE) in Rochester, New York. Using the new laser package along with BHR for mixing allows us to more accurately simulate ICF implosions and obtain spatially and temporally resolved information (e.g. position, temperature, density, and mix concentrations) to give insight into what is happening inside the implosion.

  4. Examining Functioning and Contextual Factors in Individuals with Joint Contractures from the Health Professional Perspective Using the ICF: An International Internet-Based Qualitative Expert Survey.

    PubMed

    Fischer, Uli; Müller, Martin; Strobl, Ralf; Bartoszek, Gabriele; Meyer, Gabriele; Grill, Eva

    2016-01-01

    The aim of this study was to identify disease-related aspects of functioning and disability in people with joint contractures from a health professionals' perspective and to describe the findings, using categories of the International Classification of Functioning, Disability, and Health (ICF). An Internet-based expert survey. We asked international health professionals for typical problems in functioning and important contextual factors of individuals with joint contractures using an Internet-based open-ended questionnaire. All answers were linked to the ICF according to established rules. Absolute and relative frequencies of the linked ICF categories were reported. Eighty experts named 1785 meaning units which could be linked to 256 ICF categories. Among the categories, 24.2% belonged to the component Body Functions, 20.7% to Body Structures, 36.3% to Activities and Participation, and 18.8% to Environmental Factors. Health professionals addressed a large variety of functional problems and multifaceted aspects due to the symptom joint contractures. International health professionals reported a large variety of aspects of functioning and health, which are related to joint contractures. © 2014 Association of Rehabilitation Nurses.

  5. A Core Outcome Set for Evaluation of Interventions to Prevent Preterm Birth.

    PubMed

    van ʼt Hooft, Janneke; Duffy, James M N; Daly, Mandy; Williamson, Paula R; Meher, Shireen; Thom, Elizabeth; Saade, George R; Alfirevic, Zarko; Mol, Ben Willem J; Khan, Khalid S

    2016-01-01

    To develop a consensus on a set of key clinical outcomes for the evaluation of preventive interventions for preterm birth in asymptomatic pregnant women. A two-stage web-based Delphi survey and a face-to-face meeting of key stakeholders were used to develop a consensus on a set of critical and important outcomes. We approached five stakeholder groups (parents, midwives, obstetricians, neonatologists, and researchers) from middle- and high-income countries. Outcomes subjected to the Delphi survey were identified by systematic literature review and stakeholder input. Survey participants scored each outcome on a 9-point Likert scale anchored between 1 (limited importance) and 9 (critical importance). They had the opportunity to reflect on total and stakeholder subgroup feedback between survey stages. For consensus, defined a priori, outcomes required at least 70% of participants of each stakeholder group to score them as "critical" and less than 15% as "limited." A total of 228 participants from five stakeholder groups from three lower middle-income countries, seven upper middle-income countries, and 17 high-income countries were asked to score 31 outcomes. Of these participants, 195 completed the first survey and 174 the second. Consensus was reached on 13 core outcomes: four were related to pregnant women: maternal mortality, maternal infection or inflammation, prelabor rupture of membranes, and harm to mother from intervention. Nine were related to offspring: gestational age at birth, offspring mortality, birth weight, early neurodevelopmental morbidity, late neurodevelopmental morbidity, gastrointestinal morbidity, infection, respiratory morbidity, and harm to offspring from intervention. This core outcome set for studies that evaluate prevention of preterm birth developed with an international multidisciplinary perspective will ensure that data from trials that assess prevention of preterm birth can be compared and combined. COMET Initiative, http

  6. Development of a krypton-doped gas symmetry capsule platform for x-ray spectroscopy of implosion cores on the NIF.

    PubMed

    Ma, T; Chen, H; Patel, P K; Schneider, M B; Barrios, M A; Casey, D T; Chung, H-K; Hammel, B A; Berzak Hopkins, L F; Jarrott, L C; Khan, S F; Lahmann, B; Nora, R; Rosenberg, M J; Pak, A; Regan, S P; Scott, H A; Sio, H; Spears, B K; Weber, C R

    2016-11-01

    The electron temperature at stagnation of an ICF implosion can be measured from the emission spectrum of high-energy x-rays that pass through the cold material surrounding the hot stagnating core. Here we describe a platform developed on the National Ignition Facility where trace levels of a mid-Z dopant (krypton) are added to the fuel gas of a symcap (symmetry surrogate) implosion to allow for the use of x-ray spectroscopy of the krypton line emission.

  7. Development of a krypton-doped gas symmetry capsule platform for x-ray spectroscopy of implosion cores on the NIF

    NASA Astrophysics Data System (ADS)

    Ma, T.; Chen, H.; Patel, P. K.; Schneider, M. B.; Barrios, M. A.; Casey, D. T.; Chung, H.-K.; Hammel, B. A.; Berzak Hopkins, L. F.; Jarrott, L. C.; Khan, S. F.; Lahmann, B.; Nora, R.; Rosenberg, M. J.; Pak, A.; Regan, S. P.; Scott, H. A.; Sio, H.; Spears, B. K.; Weber, C. R.

    2016-11-01

    The electron temperature at stagnation of an ICF implosion can be measured from the emission spectrum of high-energy x-rays that pass through the cold material surrounding the hot stagnating core. Here we describe a platform developed on the National Ignition Facility where trace levels of a mid-Z dopant (krypton) are added to the fuel gas of a symcap (symmetry surrogate) implosion to allow for the use of x-ray spectroscopy of the krypton line emission.

  8. Utility of the International Classification of Functioning, Disability and Health (ICF) for Educational Psychologists' Work

    ERIC Educational Resources Information Center

    Aljunied, Mariam; Frederickson, Norah

    2014-01-01

    Despite embracing a bio-psycho-social perspective, the World Health Organization's International Classification of Functioning, Disability and Health (ICF) assessment framework has had limited application to date with children who have special educational needs (SEN). This study examines its utility for educational psychologists' work with…

  9. Development of a core outcome set for studies involving patients undergoing major lower limb amputation for peripheral arterial disease: study protocol for a systematic review and identification of a core outcome set using a Delphi survey.

    PubMed

    Ambler, Graeme K; Bosanquet, David C; Brookes-Howell, Lucy; Thomas-Jones, Emma; Waldron, Cherry-Ann; Edwards, Adrian G K; Twine, Christopher P

    2017-12-28

    The development of a standardised reporting set is important to ensure that research is directed towards the most important outcomes and that data is comparable. To ensure validity, the set must be agreed by a consensus of stakeholders including patients, healthcare professionals and lay representatives. There is currently no agreed core outcome set for patients undergoing major lower limb amputation for peripheral arterial disease (PAD) for either short- or medium-term research outcomes. By developing these sets we aim to rationalise future trial outcomes, facilitate meta-analysis and improve the quality and applicability of amputation research. We will undertake a comprehensive systematic review of studies of patients undergoing major lower limb amputation for PAD. Data regarding all primary and secondary outcomes reported in relevant studies will be extracted and summarised as outcome domains. We will then undertake focus groups with key stakeholders (patients, carers, health and social care workers) to collect qualitative data to identify the main short- and medium-term research outcomes for patients undergoing major lower limb amputation. Results of the systematic review and focus groups will be combined to create a comprehensive list of potential key outcomes. Stakeholders (patients, researchers and health and social care workers) will then be polled to determine which of the outcomes are considered to be important in a general context using a three-phase Delphi process. After preliminary analysis, results will be presented at a face-to-face meeting of key stakeholders for discussion and voting on the final set of core outcomes. This project is being run in parallel with a feasibility trial assessing perineural catheters in patients undergoing lower limb amputation (the PLACEMENT trial). Full ethical approval has been granted for the study (Wales REC 3 reference number 16/WA/0353). Core outcome sets will be developed for short- and medium-term outcomes of

  10. Numerical Simulation of Doped Targets for ICF

    NASA Astrophysics Data System (ADS)

    Phillips, Lee; Gardner, John H.; Bodner, Stephen E.; Colombant, Denis; Klapisch, Marcel; Bar-Shalom, Avraham

    1997-11-01

    The ablative Rayleigh-Taylor (RT) instability can be reduced by preheating the ablator, thereby reducing the peak density and increasing the mass ablation velocity. The ablator can be preheated with radiation from higher Z dopants.(Gardner, J.H., Bodner, S.E., Dahlburg, J.P., Phys. Fluids 3), 1070 (1991) Dopants also reduce the density gradient at the ablator, which provides a second mechanism to reduce the RT growth rate. We have recently developed a more sophisticated and detailed radiation package that uses opacities generated by an STA code, with non-LTE radiation transport based on the Busquet method. This radiation package has been incorporated into NRL's FAST2D radiation hydrodynamics code, which has been used to evaluate and optimize the use of various dopants that can provide interesting levels of preheat for an ICF target.

  11. The ICF: International Classification of Functioning, Disability and Health (ICF)--a Swiss army knife? Accessibility and disability in a Scandinavian disability magazine (SDM)--a quantitative content analysis.

    PubMed

    Lundälv, Jörgen; Larsson, Per-Olof; Törnbom, Marie; Sunnerhagen, Katharina Stibrant

    2012-11-01

    The study describes the extent to which the concept of accessibility and accessibility issues has been reported in a national Scandinavian disability magazine. In this study particular attention is paid to how the compatibility between the various domains of the international classification - International Classification of Functioning, Disability and Health (ICF) - has been covered in the magazine over a decade. Furthermore, other types of descriptions that the magazine has made of accessibility for people with physical disabilities are considered. The study is based on a quantitative content analysis of a total of 326 articles from the Swedish disability magazine (SDM); 450 text pages published during the years 2000-2009. The magazine's coverage has been comprehensive. More than half of the studied texts were news items about various accessibility issues. Every third article can be characterised as a news article or feature article. The most frequently reported of the ICF domains consist of two perspectives: environmental accessibility and civil rights. Public opinion articles in the form of letters to editors and editorials focused on accessibility have a low frequency. Likewise, research reports are few. The study has included a review of illustrations and photographs. The illustrations are generally of high quality, reinforcing the disability message of the article. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

  12. International patient and physician consensus on a psoriatic arthritis core outcome set for clinical trials.

    PubMed

    Orbai, Ana-Maria; de Wit, Maarten; Mease, Philip; Shea, Judy A; Gossec, Laure; Leung, Ying Ying; Tillett, William; Elmamoun, Musaab; Callis Duffin, Kristina; Campbell, Willemina; Christensen, Robin; Coates, Laura; Dures, Emma; Eder, Lihi; FitzGerald, Oliver; Gladman, Dafna; Goel, Niti; Grieb, Suzanne Dolwick; Hewlett, Sarah; Hoejgaard, Pil; Kalyoncu, Umut; Lindsay, Chris; McHugh, Neil; Shea, Bev; Steinkoenig, Ingrid; Strand, Vibeke; Ogdie, Alexis

    2017-04-01

    To identify a core set of domains (outcomes) to be measured in psoriatic arthritis (PsA) clinical trials that represent both patients' and physicians' priorities. We conducted (1) a systematic literature review (SLR) of domains assessed in PsA; (2) international focus groups to identify domains important to people with PsA; (3) two international surveys with patients and physicians to prioritise domains; (4) an international face-to-face meeting with patients and physicians using the nominal group technique method to agree on the most important domains; and (5) presentation and votes at the Outcome Measures in Rheumatology (OMERACT) conference in May 2016. All phases were performed in collaboration with patient research partners. We identified 39 unique domains through the SLR (24 domains) and international focus groups (34 domains). 50 patients and 75 physicians rated domain importance. During the March 2016 consensus meeting, 12 patients and 12 physicians agreed on 10 candidate domains. Then, 49 patients and 71 physicians rated these domains' importance. Five were important to >70% of both groups: musculoskeletal disease activity, skin disease activity, structural damage, pain and physical function. Fatigue and participation were important to >70% of patients. Patient global and systemic inflammation were important to >70% of physicians. The updated PsA core domain set endorsed by 90% of OMERACT 2016 participants includes musculoskeletal disease activity, skin disease activity, pain, patient global, physical function, health-related quality of life, fatigue and systemic inflammation. The updated PsA core domain set incorporates patients' and physicians' priorities and evolving PsA research. Next steps include identifying outcome measures that adequately assess these domains. 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/.

  13. The CONSENSUS study: protocol for a mixed methods study to establish which outcomes should be included in a core outcome set for oropharyngeal cancer.

    PubMed

    Waters, Aoife Mi; Tudur Smith, Catrin; Young, Bridget; Jones, Terry M

    2014-05-13

    The incidence of oropharyngeal cancer is increasing in the developed world. This has led to a large rise in research activity and clinical trials in this area, yet there is no consensus on which outcomes should be measured. As a result, the outcomes measured often differ between trials of comparable interventions, making the combination or comparison of results between trials impossible. Outcomes may also be 'cherry-picked', such that favourable results are reported, and less favourable results withheld. The development of a minimum outcome reporting standard, known as a core outcome set, goes some way to addressing these problems. Core outcome sets are ideally developed using a patient-centred approach so that the outcomes measured are relevant to patients and clinical practice. Core outcome sets drive up the quality and relevance of research by ensuring that the right outcomes are consistently measured and reported in trials in specific areas of health or healthcare. This is a mixed methods study involving three phases to develop a core outcome set for oropharyngeal cancer clinical trials. Firstly, a systematic review will establish which outcomes are measured in published oropharyngeal cancer randomised controlled trials (RCTs). Secondly, qualitative interviews with patients and carers in the UK and the USA will aim to establish which outcomes are important to these stakeholders. Data from these first two stages will be used to develop a comprehensive list of outcomes to be considered for inclusion in the core outcome set. In the third stage, patients and clinicians will participate in an iterative consensus exercise known as a Delphi study to refine the contents of the core outcome set. This protocol lays out the methodology to be implemented in the CONSENSUS study. A core outcome set defines a minimum outcome reporting standard for clinical trials in a particular area of health or healthcare. Its consistent implementation in oropharyngeal cancer clinical

  14. Biochemical reconstitution and phylogenetic comparison of human SET1 family core complexes involved in histone methylation.

    PubMed

    Shinsky, Stephen A; Monteith, Kelsey E; Viggiano, Susan; Cosgrove, Michael S

    2015-03-06

    Mixed lineage leukemia protein-1 (MLL1) is a member of the SET1 family of histone H3 lysine 4 (H3K4) methyltransferases that are required for metazoan development. MLL1 is the best characterized human SET1 family member, which includes MLL1-4 and SETd1A/B. MLL1 assembles with WDR5, RBBP5, ASH2L, DPY-30 (WRAD) to form the MLL1 core complex, which is required for H3K4 dimethylation and transcriptional activation. Because all SET1 family proteins interact with WRAD in vivo, it is hypothesized they are regulated by similar mechanisms. However, recent evidence suggests differences among family members that may reflect unique regulatory inputs in the cell. Missing is an understanding of the intrinsic enzymatic activities of different SET1 family complexes under standard conditions. In this investigation, we reconstituted each human SET1 family core complex and compared subunit assembly and enzymatic activities. We found that in the absence of WRAD, all but one SET domain catalyzes at least weak H3K4 monomethylation. In the presence of WRAD, all SET1 family members showed stimulated monomethyltransferase activity but differed in their di- and trimethylation activities. We found that these differences are correlated with evolutionary lineage, suggesting these enzyme complexes have evolved to accomplish unique tasks within metazoan genomes. To understand the structural basis for these differences, we employed a "phylogenetic scanning mutagenesis" assay and identified a cluster of amino acid substitutions that confer a WRAD-dependent gain-of-function dimethylation activity on complexes assembled with the MLL3 or Drosophila trithorax proteins. These results form the basis for understanding how WRAD differentially regulates SET1 family complexes in vivo. © 2015 by The American Society for Biochemistry and Molecular Biology, Inc.

  15. Development of a krypton-doped gas symmetry capsule platform for x-ray spectroscopy of implosion cores on the NIF

    DOE PAGES

    Ma, T.; Chen, H.; Patel, P. K.; ...

    2016-08-18

    The electron temperature at stagnation of an ICF implosion can be measured from the emission spectrum of high-energy x-rays that pass through the cold material surrounding the hot stagnating core. We describe a platform developed on the National Ignition Facility where trace levels of a mid-Z dopant (krypton) are added to the fuel gas of a symcap (symmetry surrogate) implosion to allow for the use of x-ray spectroscopy of the krypton line emission.Published by AIP Publishing

  16. Using the International Classification of Functioning, Disability and Health (ICF) to address facilitators and barriers to participation at work.

    PubMed

    Martins, Anabela Correia

    2015-01-01

    The International Classification of Functioning, Disability and Health (ICF) was approved by the World Health Assembly in 2001. Ten years later, strong arguments have arisen regarding the added value of ICF to the policies on employment and the outcomes at the workplace. As a conceptual framework, ICF has universality because of its inclusive and comprehensive view of human functioning. At a practical level ICF can be used to quantify the impact of impairment on an individual's ability to act in his/her environment and to assess interventions to minimize the impact of disability and maximize functioning. To explore key indicators of social participation (life habits) of persons with disabilities, particularly related to work, among environmental and personal factors. Data were collected by self-administered questionnaires from a convenience sample of 149 working-age persons with disabilities. Social participation is a construct composed by multiple components and employment domain is the strongest indicator of participation. Correlations between social participation and personal factors, such as self-efficacy and attitudes towards disability were moderate. Those who are employed scored higher quality of life in terms of satisfaction with life, more positive attitudes toward disabilities and higher self-efficacy than the ones who are retired or unemployed. Persons using adapted wheelchair and those who were involved in wheelchair selection scored higher in social participation in general, performance at work, and quality of life. Age and disability duration were not associated with participants' employment status. These findings suggest that rehabilitation and vocational agents, like physiotherapists and other professionals, should have knowledge and understanding of the multiple factors that influence persons with disabilities' participation at work. Programs should provide appropriate wheelchairs, skills training, empowerment and problem-solving strategies in

  17. A Close-Coupled, Heavy Ion ICF Target

    NASA Astrophysics Data System (ADS)

    Callahan-Miller, Debra A.; Tabak, Max

    1998-11-01

    A ``close-coupled'' version of the distributed radiator, heavy ion ICF target has produced gain > 130 from 3.1 MJ of ion beam energy. To achieve these results, we reduced the hohlraum dimensions by 27% from our previous designs(M. Tabak, D. Callahan-Miller, D. D.-M. Ho, G. B. Zimmerman, Nuc. Fusion, 38, 509 (1998)) (M. Tabak, D. A. Callahan-Miller, Phys. Plasmas, 5, 1895 (1998).) while driving the same capsule. This reduced the beam energy required from 5.9-6.5 MJ to 3.1 MJ. The smaller hohlraum resulted in a smaller beam spot; elliptically shaped beams with effective radius 1.7 mm were used in this design. In addition to describing this target, we will discuss the effect of the close-coupled hohlraum on the Rayleigh-Taylor instability and scaling this design down to 1.5-2 MJ for an ETF (Engineering Test Facility).

  18. Using the ICF to develop the capability-oriented database of persons with disabilities: a case study in Nakornpanom province, Thailand.

    PubMed

    Tongsiri, Sirinart; Riewpaiboon, Wachara

    2013-06-01

    This study aims to determine functioning information, rehabilitation needs, and environmental barriers of persons with disabilities (PWDs) using a developed ICF-based questionnaire with community survey approach in Thailand. A systematic review of the use of ICF and disability surveys from January 2000- June 2010 was undertaken. A questionnaire was then developed and tested in two pilot studies before using in a face-to-face interview conducted with legally registered PWDs in Nakornpanom province. Forty-six ICF codes were used in the questionnaire; two second-level codes in body functions, 18 second-level and six third-level codes in activities & participation and 14 second-level and six third-level codes in environmental factors. Each code had 2-6 qualifiers. One thousand and seven PWDs (56.6% male, mean age = 48.4 ± 0.64 years) were interviewed by 16 trained-interviewers. Interview duration was approximately 17 min. The functioning profile could be revealed for both individual and population. These reflected the need for rehabilitation. Several cut-off points to identify "disabled persons" were offered. Regarding participation, PWDs were concerned more about environmental barriers. One-fourth of PWDs needed home environment adaptation, almost 13% were uneducated and 23% had limited chance to participate in social activities. ICF framework and codes can be used to develop a questionnaire to measure population functioning profile and rehabilitation needs of PWDs by community survey. Results can be used to develop a capability-oriented disability database to identify prevalence of disabilities and rehabilitation needs. Policy makers may use this database to plan, monitor and evaluate rehabilitation service programs and removal of environmental barriers.

  19. Improved algorithm of ray tracing in ICF cryogenic targets

    NASA Astrophysics Data System (ADS)

    Zhang, Rui; Yang, Yongying; Ling, Tong; Jiang, Jiabin

    2016-10-01

    The high precision ray tracing inside inertial confinement fusion (ICF) cryogenic targets plays an important role in the reconstruction of the three-dimensional density distribution by algebraic reconstruction technique (ART) algorithm. The traditional Runge-Kutta methods, which is restricted by the precision of the grid division and the step size of ray tracing, cannot make an accurate calculation in the case of refractive index saltation. In this paper, we propose an improved algorithm of ray tracing based on the Runge-Kutta methods and Snell's law of refraction to achieve high tracing precision. On the boundary of refractive index, we apply Snell's law of refraction and contact point search algorithm to ensure accuracy of the simulation. Inside the cryogenic target, the combination of the Runge-Kutta methods and self-adaptive step algorithm are employed for computation. The original refractive index data, which is used to mesh the target, can be obtained by experimental measurement or priori refractive index distribution function. A finite differential method is performed to calculate the refractive index gradient of mesh nodes, and the distance weighted average interpolation methods is utilized to obtain refractive index and gradient of each point in space. In the simulation, we take ideal ICF target, Luneberg lens and Graded index rod as simulation model to calculate the spot diagram and wavefront map. Compared the simulation results to Zemax, it manifests that the improved algorithm of ray tracing based on the fourth-order Runge-Kutta methods and Snell's law of refraction exhibits high accuracy. The relative error of the spot diagram is 0.2%, and the peak-to-valley (PV) error and the root-mean-square (RMS) error of the wavefront map is less than λ/35 and λ/100, correspondingly.

  20. Impact of new-generation agents on antiepileptic drug prescribing patterns in a residential ICF-MR facility.

    PubMed

    Smith, Stacey Allison; McKee, Jerry R

    2004-06-01

    Describe the impact of newer antiepileptic drugs (AEDs) on prescribing practices in a large, residential intermediate-care facility for the mentally retarded (ICF-MR), with onsite clinical pharmacist support services, over a 15-year period. All residents at the facility receiving AEDs for management of seizure disorder were included in this retrospective assessment. Number and type of AEDs used per individual were recorded and analyzed over the 15-year interval. Current prescribing practices were evaluated regarding rational polytherapy prescribing trends. 400-bed residential ICF-MR for the severe to profoundly mentally retarded. All individuals residing at the ICF-MR facility receiving AED therapy for a seizure disorder. Residents were primarily in the severe to profound range of developmental disability, with multiple medical comorbidities. Clinical pharmacists actively participate in all treatment teams and monthly neurology clinic to promote and encourage rational pharmacotherapy. Prescribing trends related to AED therapy were followed over a 15-year period. Comparisons were made regarding monotherapy and polytherapy at multiple-year intervals, with specific emphasis on how the newer generation AEDs have affected use of older medications. Overall trend from 1988 suggests more monotherapy and less use of barbiturates. Introduction of a new generation of AEDs has not affected the overall trend toward one- or two-drug regimens over the period in review. The relative stability of the number of AEDs per resident during the introduction of a new generation of AEDs suggests that as new drugs are added, ineffective or problem-prone drugs are discontinued.

  1. The holistic claims of the biopsychosocial conception of WHO's International Classification of Functioning, Disability, and Health (ICF): a conceptual analysis on the basis of a pluralistic-holistic ontology and multidimensional view of the human being.

    PubMed

    Solli, Hans Magnus; da Silva, António Barbosa

    2012-06-01

    The International Classification of Functioning, Disability and Health (ICF), designed by the WHO, attempts to provide a holistic model of functioning and disability by integrating a medical model with a social one. The aim of this article is to analyze the ICF's claim to holism. The following components of the ICF's complexity are analyzed: (1) health condition, (2) body functions and structures, (3) activity, (4) participation, (5) environmental factors, (6) personal factors, and (7) health. Although the ICF claims to be holistic, it presupposes a monistic materialistic ontology. We indicate some limitations of this ontology, proposing instead: (a) a pluralistic-holistic ontology (PHO) and (b) a multidimensional view of the human being, with individual and environmental aspects, in relation to three levels of reality implied by the PHO. For the ICF to attain its holistic claim, the interactions between its components should be based on (a) and (b).

  2. 34. DESPATCH CORE OVENS, GREY IRON FOUNDRY CORE ROOM, BAKES ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    34. DESPATCH CORE OVENS, GREY IRON FOUNDRY CORE ROOM, BAKES CORES THAT ARE NOT MADE ON HEATED OR COLD BOX CORE MACHINES, TO SET BINDING AGENTS MIXED WITH THE SAND CREATING CORES HARD ENOUGH TO WITHSTAND THE FLOW OF MOLTEN IRON INSIDE A MOLD. - Stockham Pipe & Fittings Company, Grey Iron Foundry, 4000 Tenth Avenue North, Birmingham, Jefferson County, AL

  3. 2017 EULAR recommendations for a core data set to support observational research and clinical care in rheumatoid arthritis.

    PubMed

    Radner, Helga; Chatzidionysiou, Katerina; Nikiphorou, Elena; Gossec, Laure; Hyrich, Kimme L; Zabalan, Condruta; van Eijk-Hustings, Yvonne; Williamson, Paula R; Balanescu, Andra; Burmester, Gerd R; Carmona, Loreto; Dougados, Maxime; Finckh, Axel; Haugeberg, Glenn; Hetland, Merete Lund; Oliver, Susan; Porter, Duncan; Raza, Karim; Ryan, Patrick; Santos, Maria Jose; van der Helm-van Mil, Annette; van Riel, Piet; von Krause, Gabrielle; Zavada, Jakub; Dixon, William G; Askling, Johan

    2018-04-01

    Personalised medicine, new discoveries and studies on rare exposures or outcomes require large samples that are increasingly difficult for any single investigator to obtain. Collaborative work is limited by heterogeneities, both what is being collected and how it is defined. To develop a core set for data collection in rheumatoid arthritis (RA) research which (1) allows harmonisation of data collection in future observational studies, (2) acts as a common data model against which existing databases can be mapped and (3) serves as a template for standardised data collection in routine clinical practice to support generation of research-quality data. A multistep, international multistakeholder consensus process was carried out involving voting via online surveys and two face-to-face meetings. A core set of 21 items ('what to collect') and their instruments ('how to collect') was agreed: age, gender, disease duration, diagnosis of RA, body mass index, smoking, swollen/tender joints, patient/evaluator global, pain, quality of life, function, composite scores, acute phase reactants, serology, structural damage, treatment and comorbidities. The core set should facilitate collaborative research, allow for comparisons across studies and harmonise future data from clinical practice via electronic medical record systems. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Development of a Draft Core Set of Domains for Measuring Shared Decision Making in Osteoarthritis: An OMERACT Working Group on Shared Decision Making.

    PubMed

    Toupin-April, Karine; Barton, Jennifer; Fraenkel, Liana; Li, Linda; Grandpierre, Viviane; Guillemin, Francis; Rader, Tamara; Stacey, Dawn; Légaré, France; Jull, Janet; Petkovic, Jennifer; Scholte-Voshaar, Marieke; Welch, Vivian; Lyddiatt, Anne; Hofstetter, Cathie; De Wit, Maarten; March, Lyn; Meade, Tanya; Christensen, Robin; Gaujoux-Viala, Cécile; Suarez-Almazor, Maria E; Boonen, Annelies; Pohl, Christoph; Martin, Richard; Tugwell, Peter S

    2015-12-01

    Despite the importance of shared decision making for delivering patient-centered care in rheumatology, there is no consensus on how to measure its process and outcomes. The aim of this Outcome Measures in Rheumatology (OMERACT) working group is to determine the core set of domains for measuring shared decision making in intervention studies in adults with osteoarthritis (OA), from the perspectives of patients, health professionals, and researchers. We followed the OMERACT Filter 2.0 method to develop a draft core domain set by (1) forming an OMERACT working group; (2) conducting a review of domains of shared decision making; and (3) obtaining opinions of all those involved using a modified nominal group process held at a session activity at the OMERACT 12 meeting. In all, 26 people from Europe, North America, and Australia, including 5 patient research partners, participated in the session activity. Participants identified the following domains for measuring shared decision making to be included as part of the draft core set: (1) identifying the decision, (2) exchanging information, (3) clarifying views, (4) deliberating, (5) making the decision, (6) putting the decision into practice, and (7) assessing the effect of the decision. Contextual factors were also suggested. We proposed a draft core set of shared decision-making domains for OA intervention research studies. Next steps include a workshop at OMERACT 13 to reach consensus on these proposed domains in the wider OMERACT group, as well as to detail subdomains and assess instruments to develop a core outcome measurement set.

  5. Development of a Draft Core Set of Domains for Measuring Shared Decision Making in Osteoarthritis: An OMERACT Working Group on Shared Decision Making

    PubMed Central

    Toupin April, Karine; Barton, Jennifer; Fraenkel, Liana; Li, Linda; Grandpierre, Viviane; Guillemin, Francis; Rader, Tamara; Stacey, Dawn; Légaré, France; Jull, Janet; Petkovic, Jennifer; Scholte Voshaar, Marieke; Welch, Vivian; Lyddiatt, Anne; Hofstetter, Cathie; De Wit, Maarten; March, Lyn; Meade, Tanya; Christensen, Robin; Gaujoux-Viala, Cécile; Suarez-Almazor, Maria E.; Boonen, Annelies; Pohl, Christoph; Martin, Richard; Tugwell, Peter

    2015-01-01

    Objective Despite the importance of shared decision making for delivering patient-centred care in rheumatology, there is no consensus on how to measure its process and outcomes. The aim of this OMERACT working group is to determine the core set of domains for measuring shared decision making in intervention studies in adults with osteoarthritis (OA), from the perspective of patients, health professionals and researchers. Methods We followed the OMERACT Filter 2.0 to develop a draft core domain set, which consisted of: (i) forming an OMERACT working group; (ii) conducting a review of domains of shared decision making; and (iii) obtaining the opinions of stakeholders using a modified nominal group process held at a session activity at the OMERACT 2014 meeting. Results 26 stakeholders from Europe, North America and Australia, including 5 patient research partners, participated in the session activity. Participants identified the following domains for measuring shared decision making to be included as part of the Draft Core Set: 1) Identifying the decision; 2) Exchanging Information; 3) Clarifying views; 4) Deliberating; 5) Making the decision; 6) Putting the decision into practice; and 7) Assessing the impact of the decision. Contextual factors were also suggested. Conclusion We propose a Draft Core Set of shared decision making domains for OA intervention research studies. Next steps include a workshop at OMERACT 2016 to reach consensus on these proposed domains in the wider OMERACT group, as well as detail sub-domains and assess instruments to develop a Core Outcome Measurement Set. PMID:25877502

  6. The CONSENSUS study: protocol for a mixed methods study to establish which outcomes should be included in a core outcome set for oropharyngeal cancer

    PubMed Central

    2014-01-01

    Background The incidence of oropharyngeal cancer is increasing in the developed world. This has led to a large rise in research activity and clinical trials in this area, yet there is no consensus on which outcomes should be measured. As a result, the outcomes measured often differ between trials of comparable interventions, making the combination or comparison of results between trials impossible. Outcomes may also be ‘cherry-picked’, such that favourable results are reported, and less favourable results withheld. The development of a minimum outcome reporting standard, known as a core outcome set, goes some way to addressing these problems. Core outcome sets are ideally developed using a patient-centred approach so that the outcomes measured are relevant to patients and clinical practice. Core outcome sets drive up the quality and relevance of research by ensuring that the right outcomes are consistently measured and reported in trials in specific areas of health or healthcare. Methods/Design This is a mixed methods study involving three phases to develop a core outcome set for oropharyngeal cancer clinical trials. Firstly, a systematic review will establish which outcomes are measured in published oropharyngeal cancer randomised controlled trials (RCTs). Secondly, qualitative interviews with patients and carers in the UK and the USA will aim to establish which outcomes are important to these stakeholders. Data from these first two stages will be used to develop a comprehensive list of outcomes to be considered for inclusion in the core outcome set. In the third stage, patients and clinicians will participate in an iterative consensus exercise known as a Delphi study to refine the contents of the core outcome set. This protocol lays out the methodology to be implemented in the CONSENSUS study. Discussion A core outcome set defines a minimum outcome reporting standard for clinical trials in a particular area of health or healthcare. Its consistent

  7. Meeting the criteria of a nursing diagnosis classification: Evaluation of ICNP, ICF, NANDA and ZEFP.

    PubMed

    Müller-Staub, Maria; Lavin, Mary Ann; Needham, Ian; van Achterberg, Theo

    2007-07-01

    Few studies described nursing diagnosis classification criteria and how classifications meet these criteria. The purpose was to identify criteria for nursing diagnosis classifications and to assess how these criteria are met by different classifications. First, a literature review was conducted (N=50) to identify criteria for nursing diagnoses classifications and to evaluate how these criteria are met by the International Classification of Nursing Practice (ICNP), the International Classification of Functioning, Disability and Health (ICF), the International Nursing Diagnoses Classification (NANDA), and the Nursing Diagnostic System of the Centre for Nursing Development and Research (ZEFP). Using literature review based general and specific criteria, the principal investigator evaluated each classification, applying a matrix. Second, a convenience sample of 20 nursing experts from different Swiss care institutions answered standardized interview forms, querying current national and international classification state and use. The first general criterion is that a diagnosis classification should describe the knowledge base and subject matter for which the nursing profession is responsible. ICNP) and NANDA meet this goal. The second general criterion is that each class fits within a central concept. The ICF and NANDA are the only two classifications built on conceptually driven classes. The third general classification criterion is that each diagnosis possesses a description, diagnostic criteria, and related etiologies. Although ICF and ICNP describe diagnostic terms, only NANDA fulfils this criterion. The analysis indicated that NANDA fulfilled most of the specific classification criteria in the matrix. The nursing experts considered NANDA to be the best-researched and most widely implemented classification in Switzerland and internationally. The international literature and the opinion of Swiss expert nurses indicate that-from the perspective of classifying

  8. Identification of the Core Set of Carbon-Associated Genes in a Bioenergy Grassland Soil

    DOE PAGES

    Howe, Adina; Yang, Fan; Williams, Ryan J.; ...

    2016-11-17

    Despite the central role of soil microbial communities in global carbon (C) cycling, little is known about soil microbial community structure and even less about their metabolic pathways. Efforts to characterize soil communities often focus on identifying differences in gene content across environmental gradients, but an alternative question is what genes are similar in soils. These genes may indicate critical species or potential functions that are required in all soils. Here we identified the “core” set of C cycling sequences widely present in multiple soil metagenomes from a fertilized prairie (FP). Of 226,887 sequences associated with known enzymes involved inmore » the synthesis, metabolism, and transport of carbohydrates, 843 were identified to be consistently prevalent across four replicate soil metagenomes. This core metagenome was functionally and taxonomically diverse, representing five enzyme classes and 99 enzyme families within the CAZy database. Though it only comprised 0.4% of all CAZy-associated genes identified in FP metagenomes, the core was found to be comprised of functions similar to those within cumulative soils. The FP CAZy-associated core sequences were present in multiple publicly available soil metagenomes and most similar to soils sharing geographic proximity. As a result, in soil ecosystems, where high diversity remains a key challenge for metagenomic investigations, these core genes represent a subset of critical functions necessary for carbohydrate metabolism, which can be targeted to evaluate important C fluxes in these and other similar soils.« less

  9. A Phoswich Detector System to Measure Sub-Second Half-Lives using ICF Reactions

    NASA Astrophysics Data System (ADS)

    Coats, Micah; Cook, Katelyn; Yuly, Mark; Padalino, Stephen; Sangster, Craig; Regan, Sean

    2017-10-01

    The 3H(t,γ)6He cross section has not been measured at any bombarding energy due to the difficulties of simultaneously producing both a tritium beam and target at accelerator labs. An alternative technique may be to use an ICF tt implosion at the OMEGA Laser Facility. The 3H(t,γ)6He cross section could be determined in situ by measuring the beta decay of 6He beginning a few milliseconds after the shot along with other ICF diagnostics. A dE-E phoswich system capable of surviving in the OMEGA target chamber was tested using the SUNY Geneseo pelletron to create neutrons via 2H(d,n)3He and subsequently 6He via 9Be(n,α)6He in a beryllium target. The phoswich dE-E detector system was used to select beta decay events and measure the 807 ms half-life of 6He. It is composed of a thin, 2 ns decay time dE scintillator optically coupled to a thick, 285 ns E scintillator, with a linear gate to separate the short dE pulse from the longer E tail. Funded in part by a Grant from the DOE through the Laboratory for Laser Energetics.

  10. Aspects relevant for functioning in patients with ankylosing spondylitis according to the health professionals: a Delphi study with the ICF as reference.

    PubMed

    Boonen, Annelies; van Berkel, Monique; Kirchberger, Inge; Cieza, Alarcos; Stucki, Gerald; van der Heijde, Désirée

    2009-08-01

    In AS there is no agreed definition of which aspects are important when describing functioning. This limits the possibility to classify, evaluate and investigate the consequences of the disease. This study aimed to achieve consensus among health professionals on which aspects of functioning are typical and relevant for AS patients using the International Classification of Functioning, Disability and Health (ICF) as reference. An international Delphi study through e-mail was performed among different health professions. Answers to open questions on areas relevant for functioning in the first round were linked to ICF categories and analysed in the two following two rounds for the degree of consensus. Of the 267 experts invited, 126 agreed to participate and 74 participated in all rounds; 28 were rheumatologists, 6 rheumatology nurses, 24 physiotherapists, 2 occupational therapists, 4 psychologists, 8 rehabilitation physicians and 2 social workers. More than 80% agreement was reached on 141 ICF categories, of which 30 (21%) were part of Body functions; 27 (19%) of Body structures; 56 (40%) of Activities and Participation; and 28 (20%) of Environmental factors. In addition, two Personal factors-illness knowledge and coping-were agreed upon. 141 ICF categories and two personal factors represent the reference of functioning in AS from the perspective of health professional. The largest number of categories concerned restrictions in activities. Also, the impact of AS on participation in life situations and the role of environmental factors were underscored. This broadens the view on functioning in AS and has implications for future research into functioning.

  11. A methodological approach for assessing the uptake of core outcome sets using ClinicalTrials.gov: findings from a review of randomised controlled trials of rheumatoid arthritis.

    PubMed

    Kirkham, Jamie J; Clarke, Mike; Williamson, Paula R

    2017-05-17

    Objective  To assess the uptake of the rheumatoid arthritis core outcome set using a new assessment method of calculating uptake from data in clinical trial registry entries. Design  Review of randomised trials. Setting  ClinicalTrials.gov. Subjects  273 randomised trials of drug interventions for the treatment of rheumatoid arthritis and registered in ClinicalTrials.gov between 2002 and 2016. Full publications were identified for completed studies from information in the trial registry or from an internet search using Google and the citation database Web of Science. Main outcome measure  The percentage of trials reporting or planning to measure the rheumatoid arthritis core outcome set calculated from the information presented in the trial registry and compared with the percentage reporting the rheumatoid arthritis core outcome set in the resulting trial publications. Results  The full rheumatoid arthritis core outcome set was reported in 81% (116/143) of trials identified on the registry as completed (or terminated) for which results were found in either the published literature or the registry. For trials identified on the registry as completed (or terminated), using information only available in the registry gives an estimate for uptake of 77% (145/189). Conclusions  The uptake of the rheumatoid arthritis core outcome set in clinical trials has continued to increase over time. Using the information on outcomes listed for completed or terminated studies in a trial registry provides a reasonable estimate of the uptake of a core outcome set and is a more efficient and up-to-date approach than examining the outcomes in published trial reports. The method proposed may provide an efficient approach for an up-to-date assessment of the uptake of the 300 core outcome sets already published. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. Validated Outcomes in the Grafting of Autologous Fat to the Breast: The VOGUE Study. Development of a Core Outcome Set for Research and Audit.

    PubMed

    Agha, Riaz A; Pidgeon, Thomas E; Borrelli, Mimi R; Dowlut, Naeem; Orkar, Ter-Er K; Ahmed, Maziyah; Pujji, Ojas; Orgill, Dennis P

    2018-05-01

    Autologous fat grafting is an important part of the reconstructive surgeon's toolbox when treating women affected by breast cancer and subsequent tumor extirpation. The debate over safety and efficacy of autologous fat grafting continues within the literature. However, work performed by the authors' group has shown significant heterogeneity in outcome reporting. Core outcome sets have been shown to reduce heterogeneity in outcome reporting. The authors' goal was to develop a core outcome set for autologous fat grafting in breast reconstruction. The authors published their protocol a priori. A Delphi consensus exercise among key stakeholders was conducted using a list of outcomes generated from their previous work. These outcomes were divided into six domains: oncologic, clinical, aesthetic and functional, patient-reported, process, and radiologic. In the first round, 55 of 78 participants (71 percent) completed the Delphi consensus exercise. Consensus was reached on nine of the 13 outcomes. The clarity of the results and lack of additional suggested outcomes deemed further rounds to be unnecessary. The VOGUE Study has led to the development of a much-needed core outcome set in the active research front and clinical area of autologous fat grafting. The authors hope that clinicians will use this core outcome set to audit their practice, and that researchers will implement these outcomes in their study design and reporting of autologous fat grafting outcomes. The authors encourage journals and surgical societies to endorse and encourage use of this core outcome set to help refine the scientific quality of the debate, the discourse, and the literature. Therapeutic, V.

  13. Synthesis: Deriving a Core Set of Recommendations to Optimize Diabetes Care on a Global Scale.

    PubMed

    Mechanick, Jeffrey I; Leroith, Derek

    2015-01-01

    Diabetes afflicts 382 million people worldwide, with increasing prevalence rates and adverse effects on health, well-being, and society in general. There are many drivers for the complex presentation of diabetes, including environmental and genetic/epigenetic factors. The aim was to synthesize a core set of recommendations from information from 14 countries that can be used to optimize diabetes care on a global scale. Information from 14 papers in this special issue of Annals of Global Health was reviewed, analyzed, and sorted to synthesize recommendations. PubMed was searched for relevant studies on diabetes and global health. Key findings are as follows: (1) Population-based transitions distinguish region-specific diabetes care; (2) biological drivers for diabetes differ among various populations and need to be clarified scientifically; (3) principal resource availability determines quality-of-care metrics; and (4) governmental involvement, independent of economic barriers, improves the contextualization of diabetes care. Core recommendations are as follows: (1) Each nation should assess region-specific epidemiology, the scientific evidence base, and population-based transitions to establish risk-stratified guidelines for diagnosis and therapeutic interventions; (2) each nation should establish a public health imperative to provide tools and funding to successfully implement these guidelines; and (3) each nation should commit to education and research to optimize recommendations for a durable effect. Systematic acquisition of information about diabetes care can be analyzed, extrapolated, and then used to provide a core set of actionable recommendations that may be further studied and implemented to improve diabetes care on a global scale. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  14. Large-scale 3D simulations of ICF and HEDP targets

    NASA Astrophysics Data System (ADS)

    Marinak, Michael M.

    2000-10-01

    The radiation hydrodynamics code HYDRA continues to be developed and applied to 3D simulations of a variety of targets for both inertial confinement fusion (ICF) and high energy density physics. Several packages have been added enabling this code to perform ICF target simulations with similar accuracy as two-dimensional codes of long-time historical use. These include a laser ray trace and deposition package, a heavy ion deposition package, implicit Monte Carlo photonics, and non-LTE opacities, derived from XSN or the linearized response matrix approach.(R. More, T. Kato, Phys. Rev. Lett. 81, 814 (1998), S. Libby, F. Graziani, R. More, T. Kato, Proceedings of the 13th International Conference on Laser Interactions and Related Plasma Phenomena, (AIP, New York, 1997).) LTE opacities can also be calculated for arbitrary mixtures online by combining tabular values generated by different opacity codes. Thermonuclear burn, charged particle transport, neutron energy deposition, electron-ion coupling and conduction, and multigroup radiation diffusion packages are also installed. HYDRA can employ ALE hydrodynamics; a number of grid motion algorithms are available. Multi-material flows are resolved using material interface reconstruction. Results from large-scale simulations run on up to 1680 processors, using a combination of massively parallel processing and symmetric multiprocessing, will be described. A large solid angle simulation of Rayleigh-Taylor instability growth in a NIF ignition capsule has resolved simultaneously the full spectrum of the most dangerous modes that grow from surface roughness. Simulations of a NIF hohlraum illuminated with the initial 96 beam configuration have also been performed. The effect of the hohlraum’s 3D intrinsic drive asymmetry on the capsule implosion will be considered. We will also discuss results from a Nova experiment in which a copper sphere is crushed by a planar shock. Several interacting hydrodynamic instabilities, including

  15. Creation of a Unified Set of Core-Collapse Supernovae for Training of Photometric Classifiers

    NASA Astrophysics Data System (ADS)

    D'Arcy Kenworthy, William; Scolnic, Daniel; Kessler, Richard

    2017-01-01

    One of the key tasks for future supernova cosmology analyses is to photometrically distinguish type Ia supernovae (SNe) from their core collapse (CC) counterparts. In order to train programs for this purpose, it is necessary to train on a large number of core-collapse SNe. However, there are only a handful used for current programs. We plan to use the large amount of CC lightcurves available on the Open Supernova Catalog (OSC). Since this data is scraped from many different surveys, it is given in a number of photometric systems with different calibration and filters. We therefore created a program to fit smooth lightcurves (as a function of time) to photometric observations of arbitrary SNe. The Supercal method is then used to translate the smoothed lightcurves to a single photometric system. We can thus compile a training set of 782 supernovae, of which 127 are not type Ia. These smoothed lightcurves are also being contributed upstream to the OSC as derived data.

  16. Satisfaction and Sense of Well Being among Medicaid ICF/MR and HCBS Recipients in Six States

    ERIC Educational Resources Information Center

    Stancliffe, Roger J.; Lakin, K. Charlie; Taub, Sarah; Chiri, Giuseppina; Byun, Soo-yong

    2009-01-01

    Self-reported satisfaction and sense of well-being were assessed in a sample of 1,885 adults with intellectual and developmental disabilities receiving Medicaid Home and Community Based Services (HCBS) and Intermediate Care Facility (ICF/MR) services in 6 states. Questions dealt with such topics as loneliness, feeling afraid at home and in one's…

  17. The Development of an ICF-Oriented, Adaptive Physician Assessment Instrument of Mobility, Self-care, and Domestic Life

    ERIC Educational Resources Information Center

    Farin, Erik; Fleitz, Annette

    2009-01-01

    The objective of this study was development and psychometric testing of an adaptive, International Classification of Functioning, Disability, and Health (ICF)-oriented questionnaire to be processed by the rehabilitation physician that aids in assessing mobility, self-care, and domestic life (Moses-Physician). The intent is to develop a physician…

  18. [Scientific-professional production on the ICF disability model in Spain. A literature review (2001-2010)].

    PubMed

    Comín Comín, Magdalena; Ruiz Garrós, Cristina; Franco, Esther; Damian, Javier; Ruiz Tovar, Maria; de Pedro-Cuesta, Jesús

    2011-12-01

    To quantify the use of the International Classification of Functioning, Disability and Health (ICF) in Spain on the basis of published reports, and to compare this use with that in other European countries. We reviewed the scientific literature published by, or with the participation of, authors having Spanish institutional affiliations in Spanish or international journals between May 2001 and June 2010. A total of 47 papers were identified, with a recent annual increase in those published in English. There was a predominance of theoretical journals (53.1%) and those specializing in mental health, rehabilitation and disability, with a medium or low impact factor. The World Health Organization-Disability Assessment Schedule (WHODAS-II) was used in 27.6% of publications. Most studies addressed adult populations with mental illness. Spain ranked midway in the table of European countries (fifth by Medline references). This review suggests that the effective application of the ICF in Spain is limited but is increasing and is internationally co-ordinated. The main fields of application are theoretical and diagnostic, in various clinical, rehabilitation and population-based contexts and, to a much lesser extent, in health services. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

  19. Towards the system-wide implementation of the International Classification of Functioning, Disability and Health in routine practice: Lessons from a pilot study in China.

    PubMed

    Li, Jianan; Prodinger, Birgit; Reinhardt, Jan D; Stucki, Gerold

    2016-06-13

    In 2011 the Chinese leadership in rehabilitation, in collaboration with the International Classification of Functioning, Disability and Health (ICF) Research Branch, embarked on an effort towards the system-wide implementation of the ICF in the healthcare system in China. We report here on the lessons learned from the pilot phase of testing the ICF Generic Set, a parsimonious set of 7 ICF categories, which have been shown to best describe functioning across the general population and people with various health conditions, for use in routine clinical practice in China. The paper discusses whether classification and measurement are compatible, what number of ICF categories should be included in data collection in routine practice, and the usefulness of a functioning profile and functioning score in clinical practice and health research planning. In addition, the paper reflects on the use of ICF qualifiers in a rating scale and the particularities of certain ICF categories contained in the ICF Generic Set when used as items in the context of Chinese rehabilitation and healthcare. Finally, the steps required to enhance the utility of system-wide implementation of the ICF in rehabilitation and healthcare services are set out.

  20. DUBLIN CORE

    EPA Science Inventory

    The Dublin Core is a metadata element set intended to facilitate discovery of electronic resources. It was originally conceived for author-generated descriptions of Web resources, and the Dublin Core has attracted broad ranging international and interdisciplinary support. The cha...

  1. Comparison of the ICF Core Set for Cardiopulmonary Conditions in the Acute Hospital Setting among Different Types of Transplant Patients

    ERIC Educational Resources Information Center

    Ding, Xinhua

    2010-01-01

    To compare the functioning profiles of patients receiving different types of organ transplants using the International Classification of Functioning, Disability, and Health. The patients (n=102) were enrolled between days 5 and 10 after discharge following receipt of an organ transplant, and assessed for sociodemographic variables, the Functional…

  2. Achieving Consensus on Total Joint Replacement Trial Outcome Reporting Using the OMERACT Filter: Endorsement of the Final Core Domain Set for Total Hip and Total Knee Replacement Trials for Endstage Arthritis.

    PubMed

    Singh, Jasvinder A; Dowsey, Michelle M; Dohm, Michael; Goodman, Susan M; Leong, Amye L; Scholte Voshaar, Marieke M J H; Choong, Peter F

    2017-11-01

    Discussion and endorsement of the OMERACT total joint replacement (TJR) core domain set for total hip replacement (THR) and total knee replacement (TKR) for endstage arthritis; and next steps for selection of instruments. The OMERACT TJR working group met at the 2016 meeting at Whistler, British Columbia, Canada. We summarized the previous systematic reviews, the preliminary OMERACT TJR core domain set and results from previous surveys. We discussed preliminary core domains for TJR clinical trials, made modifications, and identified challenges with domain measurement. Working group participants (n = 26) reviewed, clarified, and endorsed each of the inner and middle circle domains and added a range of motion domain to the research agenda. TJR were limited to THR and TKR but included all endstage hip and knee arthritis refractory to medical treatment. Participants overwhelmingly endorsed identification and evaluation of top instruments mapping to the core domains (100%) and use of subscales of validated multidimensional instruments to measure core domains for the TJR clinical trial core measurement set (92%). An OMERACT core domain set for hip/knee TJR trials has been defined and we are selecting instruments to develop the TJR clinical trial core measurement set to serve as a common foundation for harmonizing measures in TJR clinical trials.

  3. Standardised outcomes in nephrology - Haemodialysis (SONG-HD): study protocol for establishing a core outcome set in haemodialysis.

    PubMed

    Tong, Allison; Manns, Braden; Hemmelgarn, Brenda; Wheeler, David C; Tugwell, Peter; Winkelmayer, Wolfgang C; van Biesen, Wim; Crowe, Sally; Kerr, Peter G; Polkinghorne, Kevan R; Howard, Kirsten; Pollock, Carol; Hawley, Carmel M; Johnson, David W; McDonald, Stephen P; Gallagher, Martin P; Urquhart-Secord, Rachel; Craig, Jonathan C

    2015-08-19

    Chronic kidney disease is a significant contributor to mortality and morbidity worldwide, and the number of people who require dialysis or transplantation continues to increase. People on dialysis are 15 times more likely to die than the general population. Dialysis is also costly, intrusive, and time-consuming and imposes an enormous burden on patients and their families. This escalating problem has spurred a proliferation of trials in dialysis, yet health and quality of life remain poor. The reasons for this are complex and varied but are attributable in part to problems in the design and reporting of studies, particularly outcome selection. Problems related to outcomes include use of unvalidated surrogates, outcomes of little or no relevance to patients, highly variable outcome selection limiting comparability across studies, and bias in reporting outcomes. The aim of the Standardised Outcomes in Nephrology-Haemodialysis (SONG-HD) study is to establish a core outcome set for haemodialysis trials, to improve the quality of reporting, and the relevance of trials conducted in people on haemodialysis. SONG-HD is a five-phase project that includes the following: a systematic review to identify outcomes that have been reported in haemodialysis systematic reviews and trials; nominal group technique with patients and caregivers to identify, rank, and describe reasons for their choices; qualitative stakeholder interviews with patients, caregivers, clinicians, researchers, and policy makers to elicit individual values and perspectives on outcomes for haemodialysis trials; a three-round Delphi survey with stakeholder groups to distil and generate a prioritised list of core outcomes; and a consensus workshop to establish a core outcome set for haemodialysis trials. Establishing a core outcome set to be consistently measured and reported in haemodialysis trials will improve the integrity, transparency, usability, and contribution of research relevant to patients requiring

  4. Core information sets for informed consent to surgical interventions: baseline information of importance to patients and clinicians.

    PubMed

    Main, Barry G; McNair, Angus G K; Huxtable, Richard; Donovan, Jenny L; Thomas, Steven J; Kinnersley, Paul; Blazeby, Jane M

    2017-04-26

    Consent remains a crucial, yet challenging, cornerstone of clinical practice. The ethical, legal and professional understandings of this construct have evolved away from a doctor-centred act to a patient-centred process that encompasses the patient's values, beliefs and goals. This alignment of consent with the philosophy of shared decision-making was affirmed in a recent high-profile Supreme Court ruling in England. The communication of information is central to this model of health care delivery but it can be difficult for doctors to gauge the information needs of the individual patient. The aim of this paper is to describe 'core information sets' which are defined as a minimum set of consensus-derived information about a given procedure to be discussed with all patients. Importantly, they are intended to catalyse discussion of subjective importance to individuals. The model described in this paper applies health services research and Delphi consensus-building methods to an idea orginally proposed 30 years ago. The hypothesis is that, first, large amounts of potentially-important information are distilled down to discrete information domains. These are then, secondly, rated by key stakeholders in multiple iterations, so that core information of agreed importance can be defined. We argue that this scientific approach is key to identifying information important to all stakeholders, which may otherwise be communicated poorly or omitted from discussions entirely. Our methods apply systematic review, qualitative, survey and consensus-building techniques to define this 'core information'. We propose that such information addresses the 'reasonable patient' standard for information disclosure but, more importantly, can serve as a spring board for high-value discussion of importance to the individual patient. The application of established research methods can define information of core importance to informed consent. Further work will establish how best to incorporate

  5. Can we teach core clinical obstetrics and gynaecology skills using low fidelity simulation in an interprofessional setting?

    PubMed

    Kumar, Arunaz; Gilmour, Carole; Nestel, Debra; Aldridge, Robyn; McLelland, Gayle; Wallace, Euan

    2014-12-01

    Core clinical skills acquisition is an essential component of undergraduate medical and midwifery education. Although interprofessional education is an increasingly common format for learning efficient teamwork in clinical medicine, its value in undergraduate education is less clear. We present a collaborative effort from the medical and midwifery schools of Monash University, Melbourne, towards the development of an educational package centred around a core skills-based workshop using low fidelity simulation models in an interprofessional setting. Detailed feedback on the package was positive with respect to the relevance of the teaching content, whether the topic was well taught by task trainers and simulation models used, pitch of level of teaching and perception of confidence gained in performing the skill on a real patient after attending the workshop. Overall, interprofessional core skills training using low fidelity simulation models introduced at an undergraduate level in medicine and midwifery had a good acceptance. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  6. The Importance of Motor Functional Levels from the Activity Limitation Perspective of ICF in Children with Cerebral Palsy

    ERIC Educational Resources Information Center

    Mutlu, Akmer

    2010-01-01

    Our purpose in this study was to evaluate performance and capacity as defined by Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) from the "activity limitation" perspective of International Classification of Functioning, Disability, and Health (ICF) and to investigate the relationship between the…

  7. Validating Inertial Confinement Fusion (ICF) predictive capability using perturbed capsules

    NASA Astrophysics Data System (ADS)

    Schmitt, Mark; Magelssen, Glenn; Tregillis, Ian; Hsu, Scott; Bradley, Paul; Dodd, Evan; Cobble, James; Flippo, Kirk; Offerman, Dustin; Obrey, Kimberly; Wang, Yi-Ming; Watt, Robert; Wilke, Mark; Wysocki, Frederick; Batha, Steven

    2009-11-01

    Achieving ignition on NIF is a monumental step on the path toward utilizing fusion as a controlled energy source. Obtaining robust ignition requires accurate ICF models to predict the degradation of ignition caused by heterogeneities in capsule construction and irradiation. LANL has embarked on a project to induce controlled defects in capsules to validate our ability to predict their effects on fusion burn. These efforts include the validation of feature-driven hydrodynamics and mix in a convergent geometry. This capability is needed to determine the performance of capsules imploded under less-than-optimum conditions on future IFE facilities. LANL's recently initiated Defect Implosion Experiments (DIME) conducted at Rochester's Omega facility are providing input for these efforts. Recent simulation and experimental results will be shown.

  8. Block Ignition Inertial Confinement Fusion (ICF) with Condensed Matter Cluster Type Targets for p-B11 Powered Space Propulsion

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

    Miley, George H.; Hora, H.; Badziak, J.

    The use of laser-driven Inertial Confinement Fusion (ICF) for space propulsion has been the subject of several earlier conceptual design studies, (see: Orth, 1998; and other references therein). However, these studies were based on older ICF technology using either 'direct' or 'in-direct x-ray driven' type target irradiation. Important new directions have opened for laser ICF in recent years following the development of 'chirped' lasers capable of ultra short pulses with powers of TW up to few PW which leads to the concept of 'fast ignition (FI)' to achieve higher energy gains from target implosions. In a recent publication the authorsmore » showed that use of a modified type of FI, termed 'block ignition' (Miley et al., 2008), could meet many of the requirements anticipated (but not then available) by the designs of the Vehicle for Interplanetary Space Transport Applications (VISTA) ICF fusion propulsion ship (Orth, 2008) for deep space missions. Subsequently the first author devised and presented concepts for imbedding high density condensed matter 'clusters' of deuterium into the target to obtain ultra high local fusion reaction rates (Miley, 2008). Such rates are possible due to the high density of the clusters (over an order of magnitude above cryogenic deuterium). Once compressed by the implosion, the yet higher density gives an ultra high reaction rate over the cluster volume since the fusion rate is proportional to the square of the fuel density. Most recently, a new discovery discussed here indicates that the target matrix could be composed of B{sup 11} with proton clusters imbedded. This then makes p-B{sup 11} fusion practical, assuming all of the physics issues such as stability of the clusters during compression are resolved. Indeed, p-B{sup 11} power is ideal for fusion propulsion since it has a minimum of unwanted side products while giving most of the reaction energy to energetic alpha particles which can be directed into an exhaust (propulsion

  9. User Friendly Processing of Sediment CT Data: Software and Application in High Resolution Non-Destructive Sediment Core Data Sets

    NASA Astrophysics Data System (ADS)

    Reilly, B. T.; Stoner, J. S.; Wiest, J.; Abbott, M. B.; Francus, P.; Lapointe, F.

    2015-12-01

    Computed Tomography (CT) of sediment cores allow for high resolution images, three dimensional volumes, and down core profiles, generated through the attenuation of X-rays as a function of density and atomic number. When using a medical CT-Scanner, these quantitative data are stored in pixels using the Hounsfield scale, which are relative to the attenuation of X-rays in water and air at standard temperature and pressure. Here we present MATLAB based software specifically designed for sedimentary applications with a user friendly graphical interface to process DICOM files and stitch overlapping CT scans. For visualization, the software allows easy generation of core slice images with grayscale and false color relative to a user defined Hounsfield number range. For comparison to other high resolution non-destructive methods, down core Hounsfield number profiles are extracted using a method robust to coring imperfections, like deformation, bowing, gaps, and gas expansion. We demonstrate the usefulness of this technique with lacustrine sediment cores from the Western United States and Canadian High Arctic, including Fish Lake, Oregon, and Sawtooth Lake, Ellesmere Island. These sites represent two different depositional environments and provide examples for a variety of common coring defects and lithologies. The Hounsfield profiles and images can be used in combination with other high resolution data sets, including sediment magnetic parameters, XRF core scans and many other types of data, to provide unique insights into how lithology influences paleoenvironmental and paleomagnetic records and their interpretations.

  10. A neuropsychological rehabilitation program for patients with Multiple Sclerosis based on the model of the ICF.

    PubMed

    Pusswald, Gisela; Mildner, Christa; Zebenholzer, Karin; Auff, Eduard; Lehrner, Johann

    2014-01-01

    Forty to sixty percent of MS patients suffer from cognitive impairments. Cognitive deficits are a great burden for patients affected. In particular they may lead to a reduced quality of life, loss of work and problems with the social environment. The aim of this study was to evaluate a specific neuropsychological rehabilitation program for MS patients according to the ICF to be able to meet more properly individual requirements on the therapy level of function as well as of activities and participation. Forty patients with MS were randomised in an intervention (IG) - and a control group (CG). The outcome measure of the IG, who started an intensive computer based home training of attention and attended psychological counselling was compared to the untrained CG. In specific domains of attention (simple and cued alertness and divided attention) significant group differences between CG and IG could be found. The IG reported an improvement of mental fatigue and retardation. These findings support the idea that a neuropsychological rehabilitation program, which based on the model of ICF, could improve cognitive impairment and could also have a positive influence of activities and participation.

  11. An empirical exploration of the relations between the health components of the International Classification of Functioning, Disability and Health (ICF).

    PubMed

    Perenboom, Rom J M; Wijlhuizen, Gert Jan; Garre, Francisca Galindo; Heerkens, Yvonne F; van Meeteren, Nico L U

    2012-01-01

    The aim of this study was to investigate the relations between the ICF components from a subjective perspective. Data on health condition and perceived functioning were collected among 2941 individuals with at least one chronic disease or disorder. Path analysis was used with perceived level of participation as the final denominator. Three models were tested: one with the number of chronic diseases and disorders as an indicator of health condition, one with perceived health as indicator of health condition, and one with perceived health as part of the personal factors. Although all models showed a good fit, the model with the best fit was that with perceived health as an indicator of health condition. From a patient's perspective, components of the ICF scheme appear to be associated with each other, with perceived health being the best indicator of the health condition.

  12. Understanding Yield Anomalies in ICF Implosions via Fully Kinetic Simulations

    NASA Astrophysics Data System (ADS)

    Taitano, William

    2017-10-01

    In the quest towards ICF ignition, plasma kinetic effects are among prime candidates for explaining some significant discrepancies between experimental observations and rad-hydro simulations. To assess their importance, high-fidelity fully kinetic simulations of ICF capsule implosions are needed. Owing to the extremely multi-scale nature of the problem, kinetic codes have to overcome nontrivial numerical and algorithmic challenges, and very few options are currently available. Here, we present resolutions of some long-standing yield discrepancy conundrums using a novel, LANL-developed, 1D-2V Vlasov-Fokker-Planck code iFP. iFP possesses an unprecedented fidelity and features fully implicit time-stepping, exact mass, momentum, and energy conservation, and optimal grid adaptation in phase space, all of which are critically important for ensuring long-time numerical accuracy of the implosion simulations. Specifically, we concentrate on several anomalous yield degradation instances observed in Omega campaigns, with the so-called ``Rygg effect'', or an anomalous yield scaling with the fuel composition, being a prime example. Understanding the physical mechanisms responsible for such degradations in non-ignition-grade Omega experiments is of great interest, as such experiments are often used for platform and diagnostic development, which are then used in ignition-grade experiments on NIF. In the case of Rygg's experiments, effects of a kinetic stratification of fuel ions on the yield have been previously proposed as the anomaly explanation, studied with a kinetic code FPION, and found unimportant. We have revisited this issue with iFP and obtained excellent yield-over-clean agreement with the original Rygg results, and several subsequent experiments. This validates iFP and confirms that the kinetic fuel stratification is indeed at the root of the observed yield degradation. This work was sponsored by the Metropolis Postdoctoral Fellowship, LDRD office, Thermonuclear Burn

  13. Assembly of large metagenome data sets using a Convey HC-1 hybrid core computer (7th Annual SFAF Meeting, 2012)

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

    Copeland, Alex

    2012-06-01

    Alex Copeland on "Assembly of large metagenome data sets using a Convey HC-1 hybrid core computer" at the 2012 Sequencing, Finishing, Analysis in the Future Meeting held June 5-7, 2012 in Santa Fe, New Mexico.

  14. Assembly of large metagenome data sets using a Convey HC-1 hybrid core computer (7th Annual SFAF Meeting, 2012)

    ScienceCinema

    Copeland, Alex [DOE JGI

    2017-12-09

    Alex Copeland on "Assembly of large metagenome data sets using a Convey HC-1 hybrid core computer" at the 2012 Sequencing, Finishing, Analysis in the Future Meeting held June 5-7, 2012 in Santa Fe, New Mexico.

  15. Hydrodynamic Instabilities in High-Energy-Density Settings

    NASA Astrophysics Data System (ADS)

    Smalyuk, Vladimir

    2016-10-01

    Our understanding of hydrodynamic instabilities, such as the Rayleigh-Taylor (RT), Richtmyer-Meshkov (RM), and Kelvin-Helmholtz (KH) instabilities, in high-energy-density (HED) settings over past two decades has progressed enormously. The range of conditions where hydrodynamic instabilities are experimentally observed now includes direct and indirect drive inertial confinement fusion (ICF) where surprises continue to emerge, linear and nonlinear regimes, classical interfaces vs. stabilized ablation fronts, tenuous ideal plasmas vs. high density Fermi degenerate plasmas, bulk fluid interpenetration vs. mixing down to the atomic level, in the presence of magnetic fields and/or intense radiation, and in solid state plastic flow at high pressures and strain rates. Regimes in ICF can involve extreme conditions of matter with temperatures up to kilovolts, densities of a thousand times solid densities, and time scales of nanoseconds. On the other hand, scaled conditions can be generated that map to exploding stars (supernovae) with length and time scales of millions of kilometers and hours to days or even years of instability evolution, planetary formation dynamics involving solid-state plastic flow which severely modifies the RT growth and continues to challenge reliable theoretical descriptions. This review will look broadly at progress in probing and understanding hydrodynamic instabilities in these very diverse HED settings, and then will examine a few cases in more depth to illustrate the detailed science involved. Experimental results on large-scale HED facilities such as the Omega, Nike, Gekko, and Shenguang lasers will be reviewed and the latest developments at the National Ignition Facility (NIF) and Z machine will be covered. Finally, current overarching questions and challenges will be summarized to motivate research directions for future. This work was performed under the auspices of the U.S. Department of Energy by LLNL under Contract DE-AC52-07NA27344.

  16. Investigating inertial confinement fusion target fuel conditions through x-ray spectroscopya)

    NASA Astrophysics Data System (ADS)

    Hansen, Stephanie B.

    2012-05-01

    Inertial confinement fusion (ICF) targets are designed to produce hot, dense fuel in a neutron-producing core that is surrounded by a shell of compressing material. The x-rays emitted from ICF plasmas can be analyzed to reveal details of the temperatures, densities, gradients, velocities, and mix characteristics of ICF targets. Such diagnostics are critical to understand the target performance and to improve the predictive power of simulation codes.

  17. Development of a core outcome set for orthodontic trials using a mixed-methods approach: protocol for a multicentre study.

    PubMed

    Tsichlaki, Aliki; O'Brien, Kevin; Johal, Ama; Marshman, Zoe; Benson, Philip; Colonio Salazar, Fiorella B; Fleming, Padhraig S

    2017-08-04

    Orthodontic treatment is commonly undertaken in young people, with over 40% of children in the UK needing treatment and currently one third having treatment, at a cost to the National Health Service in England and Wales of £273 million each year. Most current research about orthodontic care does not consider what patients truly feel about, or want, from treatment, and a diverse range of outcomes is being used with little consistency between studies. This study aims to address these problems, using established methodology to develop a core outcome set for use in future clinical trials of orthodontic interventions in children and young people. This is a mixed-methods study incorporating four distinct stages. The first stage will include a scoping review of the scientific literature to identify primary and secondary outcome measures that have been used in previous orthodontic clinical trials. The second stage will involve qualitative interviews and focus groups with orthodontic patients aged 10 to 16 years to determine what outcomes are important to them. The outcomes elicited from these two stages will inform the third stage of the study in which a long-list of outcomes will be ranked in terms of importance using electronic Delphi surveys involving clinicians and patients. The final stage of the study will involve face-to-face consensus meetings with all stakeholders to discuss and agree on the outcome measures that should be included in the final core outcome set. This research will help to inform patients, parents, clinicians and commissioners about outcomes that are important to young people undergoing orthodontic treatment. Adoption of the core outcome set in future clinical trials of orthodontic treatment will make it easier for results to be compared, contrasted and combined. This should translate into improved decision-making by all stakeholders involved. The project has been registered on the Core Outcome Measures in Effectiveness Trials ( COMET ) website

  18. Intermediate Care Facilities for Persons with Mental Retardation (ICFs-MR): Program Utilization and Resident Characterstics. Project Report #31.

    ERIC Educational Resources Information Center

    Minnesota Univ., Minneapolis. Center for Residential and Community Services.

    This report on the Intermediate Care Facility for the Mentally Retarded (ICF-MR) and related programs under Title XIX (Medicaid) of the Social Security Act aims to assist in consideration of improvements to Medicaid services. The report begins with a background description of the key Medicaid programs of interest, discussing: federal involvement…

  19. Development of the first disability index for inflammatory bowel disease based on the international classification of functioning, disability and health

    PubMed Central

    Peyrin-Biroulet, Laurent; Cieza, Alarcos; Sandborn, William J; Coenen, Michaela; Chowers, Yehuda; Hibi, Toshifumi; Kostanjsek, Nenad; Stucki, Gerold

    2011-01-01

    Objective The impact of inflammatory bowel disease (IBD) on disability remains poorly understood. The World Health Organization's integrative model of human functioning and disability in the International Classification of Functioning, Disability and Health (ICF) makes disability assessment possible. The ICF is a hierarchical coding system with four levels of details that includes over 1400 categories. The aim of this study was to develop the first disability index for IBD by selecting most relevant ICF categories that are affected by IBD. Methods Relevant ICF categories were identified through four preparatory studies (systematic literature review, qualitative study, expert survey and cross-sectional study), which were presented at a consensus conference. Based on the identified ICF categories, a questionnaire to be filled in by clinicians, called the ‘IBD disability index’, was developed. Results The four preparatory studies identified 138 second-level categories: 75 for systematic literature review (153 studies), 38 for qualitative studies (six focus groups; 27 patients), 108 for expert survey (125 experts; 37 countries; seven occupations) and 98 for cross-sectional study (192 patients; three centres). The consensus conference (20 experts; 17 countries) led to the selection of 19 ICF core set categories that were used to develop the IBD disability index: seven on body functions, two on body structures, five on activities and participation and five on environmental factors. Conclusions The IBD disability index is now available. It will be used in studies to evaluate the long-term effect of IBD on patient functional status and will serve as a new endpoint in disease-modification trials. PMID:21646246

  20. The Impact of Speech Impairment in Early Childhood: Investigating Parents' and Speech-Language Pathologists' Perspectives Using the ICF-CY

    ERIC Educational Resources Information Center

    McCormack, Jane; McLeod, Sharynne; Harrison, Linda J.; McAllister, Lindy

    2010-01-01

    Purpose: To explore the application of the Activities and Participation component of the International Classification of Functioning, Disability and Health - Children and Youth (ICF-CY, World Health Organization, 2007) as a framework for investigating the perceived impact of speech impairment in childhood. Method: A 32-item questionnaire based on…

  1. Current Methods of Evaluating Speech-Language Outcomes for Preschoolers with Communication Disorders: A Scoping Review Using the ICF-CY

    ERIC Educational Resources Information Center

    Cunningham, Barbara Jane; Washington, Karla N.; Binns, Amanda; Rolfe, Katelyn; Robertson, Bernadette; Rosenbaum, Peter

    2017-01-01

    Purpose: The purpose of this scoping review was to identify current measures used to evaluate speech-language outcomes for preschoolers with communication disorders within the framework of the International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY; World Health Organization, 2007). Method: The review…

  2. Development of core outcome sets for effectiveness trials of interventions to prevent and/or treat delirium (Del-COrS): study protocol.

    PubMed

    Rose, Louise; Agar, Meera; Burry, Lisa D; Campbell, Noll; Clarke, Mike; Lee, Jacques; Siddiqi, Najma; Page, Valerie J

    2017-09-18

    Delirium is a common, serious and potentially preventable condition with devastating impact on the quality of life prompting a proliferation of interventional trials. Core outcome sets aim to standardise outcome reporting by identifying outcomes perceived fundamental for measurement in trials of a specific interest area. Our aim is to develop international consensus on two core outcome sets for trials of interventions to prevent and/or treat delirium, irrespective of study population. We aim to identify additional core outcomes specific to the critically ill, acutely hospitalised patients, palliative care and older adults. We will conduct a systematic review of published and ongoing delirium trials (1980 onwards) and one-on-one interviews of patients who have experienced delirium and family members. These data will inform Delphi round 1 of a two-stage consensus process. In round 2, we will provide participants their own response, summarised group responses and those of patient/family participants for rescoring. We will randomise participants to receive feedback as proportion scoring the outcome as critical or as group mean responses. We will hold a consensus meeting using nominal group technique to finalise outcomes for inclusion. We will repeat the Delphi process and consensus meeting to select measures for each core outcome. We will recruit 240 Delphi participants giving us 80% power to detect a 1.0-1.5 point (9-point scale) difference by feedback method between rounds. We will analyse differences for subsequent scores, magnitude of opinion change, items retained and level of agreement. We are obtaining research ethics approvals according to local governance. Participation will be voluntary and data deidentified. Support from three international delirium organisations will be instrumental in dissemination and core outcome set uptake. We will disseminate through peer-reviewed open access publications and present at conferences selected to reach a wide range of

  3. Measuring the ICF components of impairment, activity limitation and participation restriction: an item analysis using classical test theory and item response theory

    PubMed Central

    Pollard, Beth; Dixon, Diane; Dieppe, Paul; Johnston, Marie

    2009-01-01

    Background The International Classification of Functioning, Disability and Health (ICF) proposes three main health outcomes, Impairment (I), Activity Limitation (A) and Participation Restriction (P), but good measures of these constructs are needed The aim of this study was to use both Classical Test Theory (CTT) and Item Response Theory (IRT) methods to carry out an item analysis to improve measurement of these three components in patients having joint replacement surgery mainly for osteoarthritis (OA). Methods A geographical cohort of patients about to undergo lower limb joint replacement was invited to participate. Five hundred and twenty four patients completed ICF items that had been previously identified as measuring only a single ICF construct in patients with osteoarthritis. There were 13 I, 26 A and 20 P items. The SF-36 was used to explore the construct validity of the resultant I, A and P measures. The CTT and IRT analyses were run separately to identify items for inclusion or exclusion in the measurement of each construct. The results from both analyses were compared and contrasted. Results Overall, the item analysis resulted in the removal of 4 I items, 9 A items and 11 P items. CTT and IRT identified the same 14 items for removal, with CTT additionally excluding 3 items, and IRT a further 7 items. In a preliminary exploration of reliability and validity, the new measures appeared acceptable. Conclusion New measures were developed that reflect the ICF components of Impairment, Activity Limitation and Participation Restriction for patients with advanced arthritis. The resulting Aberdeen IAP measures (Ab-IAP) comprising I (Ab-I, 9 items), A (Ab-A, 17 items), and P (Ab-P, 9 items) met the criteria of conventional psychometric (CTT) analyses and the additional criteria (information and discrimination) of IRT. The use of both methods was more informative than the use of only one of these methods. Thus combining CTT and IRT appears to be a valuable tool in

  4. Social network analysis identified central outcomes for core outcome sets using systematic reviews of HIV/AIDS.

    PubMed

    Saldanha, Ian J; Li, Tianjing; Yang, Cui; Ugarte-Gil, Cesar; Rutherford, George W; Dickersin, Kay

    2016-02-01

    Methods to develop core outcome sets, the minimum outcomes that should be measured in research in a topic area, vary. We applied social network analysis methods to understand outcome co-occurrence patterns in human immunodeficiency virus (HIV)/AIDS systematic reviews and identify outcomes central to the network of outcomes in HIV/AIDS. We examined all Cochrane reviews of HIV/AIDS as of June 2013. We defined a tie as two outcomes (nodes) co-occurring in ≥2 reviews. To identify central outcomes, we used normalized node betweenness centrality (nNBC) (the extent to which connections between other outcomes in a network rely on that outcome as an intermediary). We conducted a subgroup analysis by HIV/AIDS intervention type (i.e., clinical management, biomedical prevention, behavioral prevention, and health services). The 140 included reviews examined 1,140 outcomes, 294 of which were unique. The most central outcome overall was all-cause mortality (nNBC = 23.9). The most central and most frequent outcomes differed overall and within subgroups. For example, "adverse events (specified)" was among the most central but not among the most frequent outcomes, overall. Social network analysis methods are a novel application to identify central outcomes, which provides additional information potentially useful for developing core outcome sets. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. MUTILS - a set of efficient modeling tools for multi-core CPUs implemented in MEX

    NASA Astrophysics Data System (ADS)

    Krotkiewski, Marcin; Dabrowski, Marcin

    2013-04-01

    The need for computational performance is common in scientific applications, and in particular in numerical simulations, where high resolution models require efficient processing of large amounts of data. Especially in the context of geological problems the need to increase the model resolution to resolve physical and geometrical complexities seems to have no limits. Alas, the performance of new generations of CPUs does not improve any longer by simply increasing clock speeds. Current industrial trends are to increase the number of computational cores. As a result, parallel implementations are required in order to fully utilize the potential of new processors, and to study more complex models. We target simulations on small to medium scale shared memory computers: laptops and desktop PCs with ~8 CPU cores and up to tens of GB of memory to high-end servers with ~50 CPU cores and hundereds of GB of memory. In this setting MATLAB is often the environment of choice for scientists that want to implement their own models with little effort. It is a useful general purpose mathematical software package, but due to its versatility some of its functionality is not as efficient as it could be. In particular, the challanges of modern multi-core architectures are not fully addressed. We have developed MILAMIN 2 - an efficient FEM modeling environment written in native MATLAB. Amongst others, MILAMIN provides functions to define model geometry, generate and convert structured and unstructured meshes (also through interfaces to external mesh generators), compute element and system matrices, apply boundary conditions, solve the system of linear equations, address non-linear and transient problems, and perform post-processing. MILAMIN strives to combine the ease of code development and the computational efficiency. Where possible, the code is optimized and/or parallelized within the MATLAB framework. Native MATLAB is augmented with the MUTILS library - a set of MEX functions that

  6. Spectroscopic diagnostics of NIF ICF implosions using line ratios of Kr dopant in the ignition capsule

    NASA Astrophysics Data System (ADS)

    Dasgupta, Arati; Ouart, Nicholas; Giuiani, John; Clark, Robert; Schneider, Marilyn; Scott, Howard; Chen, Hui; Ma, Tammy

    2017-10-01

    X ray spectroscopy is used on the NIF to diagnose the plasma conditions in the ignition target in indirect drive ICF implosions. A platform is being developed at NIF where small traces of krypton are used as a dopant to the fuel gas for spectroscopic diagnostics using krypton line emissions. The fraction of krypton dopant was varied in the experiments and was selected so as not to perturb the implosion. Our goal is to use X-ray spectroscopy of dopant line ratios produced by the hot core that can provide a precise measurement of electron temperature. Simulations of the krypton spectra using a 1 in 104 atomic fraction of krypton in direct-drive exploding pusher with a range of electron temperatures and densities show discrepancies when different atomic models are used. We use our non-LTE atomic model with a detailed fine-structure level atomic structure and collisional-radiative rates to investigate the krypton spectra at the same conditions. Synthetic spectra are generated with a detailed multi-frequency radiation transport scheme from the emission regions of interest to analyze the experimental data with 0.02% Kr concentration and compare and contrast with the existing simulations at LLNL. Work supported by DOE/NNSA; Part of this work was also done under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract No. DE-AC52-07NA27344.

  7. CORE_TF: a user-friendly interface to identify evolutionary conserved transcription factor binding sites in sets of co-regulated genes

    PubMed Central

    Hestand, Matthew S; van Galen, Michiel; Villerius, Michel P; van Ommen, Gert-Jan B; den Dunnen, Johan T; 't Hoen, Peter AC

    2008-01-01

    Background The identification of transcription factor binding sites is difficult since they are only a small number of nucleotides in size, resulting in large numbers of false positives and false negatives in current approaches. Computational methods to reduce false positives are to look for over-representation of transcription factor binding sites in a set of similarly regulated promoters or to look for conservation in orthologous promoter alignments. Results We have developed a novel tool, "CORE_TF" (Conserved and Over-REpresented Transcription Factor binding sites) that identifies common transcription factor binding sites in promoters of co-regulated genes. To improve upon existing binding site predictions, the tool searches for position weight matrices from the TRANSFACR database that are over-represented in an experimental set compared to a random set of promoters and identifies cross-species conservation of the predicted transcription factor binding sites. The algorithm has been evaluated with expression and chromatin-immunoprecipitation on microarray data. We also implement and demonstrate the importance of matching the random set of promoters to the experimental promoters by GC content, which is a unique feature of our tool. Conclusion The program CORE_TF is accessible in a user friendly web interface at . It provides a table of over-represented transcription factor binding sites in the users input genes' promoters and a graphical view of evolutionary conserved transcription factor binding sites. In our test data sets it successfully predicts target transcription factors and their binding sites. PMID:19036135

  8. Perspectives on the International Classification of Functioning, Disability, and Health: Child and Youth Version (ICF-CY) and Occupational Therapy Practice

    ERIC Educational Resources Information Center

    Cramm, Heidi; Aiken, Alice B.; Stewart, Debra

    2012-01-01

    Classifying disability for children and youth has typically meant describing a diagnosis or developmental lag. The publication of the "International Classification of Functioning, Disability and Health: Child & Youth" version (ICF-CY) marks a global paradigm shift in the conceptualization and classification of childhood disability. Knowledge and…

  9. Research and Implementation Issues in Developing a Reimbursement System for ICFs/MR Program Costs Based on Client Resource Use.

    ERIC Educational Resources Information Center

    Chapin, Rosemary; Rotegard, Lisa

    Under the current Medicaid reimbursement system in Minnesota for intermediate care facilities for the mentally retarded (ICFs/MR), payments are not targeted properly because there is no uniform assessment and resource use information to determine those clients for whom services are most costly to provide. A project was mandated by the state…

  10. Characterizing and Understanding the Remarkably Slow Basis Set Convergence of Several Minnesota Density Functionals for Intermolecular Interaction Energies

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

    Mardirossian, Narbe; Head-Gordon, Martin

    2013-08-22

    For a set of eight equilibrium intermolecular complexes, it is discovered in this paper that the basis set limit (BSL) cannot be reached by aug-cc-pV5Z for three of the Minnesota density functionals: M06-L, M06-HF, and M11-L. In addition, the M06 and M11 functionals exhibit substantial, but less severe, difficulties in reaching the BSL. By using successively finer grids, it is demonstrated that this issue is not related to the numerical integration of the exchange-correlation functional. In addition, it is shown that the difficulty in reaching the BSL is not a direct consequence of the structure of the augmented functions inmore » Dunning’s basis sets, since modified augmentation yields similar results. By using a very large custom basis set, the BSL appears to be reached for the HF dimer for all of the functionals. As a result, it is concluded that the difficulties faced by several of the Minnesota density functionals are related to an interplay between the form of these functionals and the structure of standard basis sets. It is speculated that the difficulty in reaching the basis set limit is related to the magnitude of the inhomogeneity correction factor (ICF) of the exchange functional. A simple modification of the M06-L exchange functional that systematically reduces the basis set superposition error (BSSE) for the HF dimer in the aug-cc-pVQZ basis set is presented, further supporting the speculation that the difficulty in reaching the BSL is caused by the magnitude of the exchange functional ICF. In conclusion, the BSSE is plotted with respect to the internuclear distance of the neon dimer for two of the examined functionals.« less

  11. Improved participants' understanding of research information in real settings using the SIDCER informed consent form: a randomized-controlled informed consent study nested with eight clinical trials.

    PubMed

    Koonrungsesomboon, Nut; Tharavanij, Thipaporn; Phiphatpatthamaamphan, Kittichet; Vilaichone, Ratha-Korn; Manuwong, Sudsayam; Curry, Parichat; Siramolpiwat, Sith; Punchaipornpon, Thanachai; Kanitnate, Supakit; Tammachote, Nattapol; Yamprasert, Rodsarin; Chanvimalueng, Waipoj; Kaewkumpai, Ruchirat; Netanong, Soiphet; Kitipawong, Peerapong; Sritipsukho, Paskorn; Karbwang, Juntra

    2017-02-01

    This study aimed to test the applicability and effectiveness of the principles and informed consent form (ICF) template proposed by the Strategic Initiative for Developing Capacity in Ethical Review (SIDCER) across multiple clinical trials involving Thai research participants with various conditions. A single-center, randomized-controlled study nested with eight clinical trials was conducted at Thammasat University Hospital, Thailand. A total of 258 participants from any of the eight clinical trials were enrolled and randomly assigned to read either the SIDCER ICF (n = 130) or the conventional ICF (n = 128) of the respective trial. Their understanding of necessary information was assessed using the post-test questionnaire; they were allowed to consult a given ICF while completing the questionnaire. The primary endpoint was the proportion of the participants who had the post-test score of ≥80%, and the secondary endpoint was the total score of the post-test. The proportion of the participants in the SIDCER ICF group who achieved the primary endpoint was significantly higher than that of the conventional ICF group (60.8 vs. 41.4%, p = 0.002). The total score of the post-test was also significantly higher among the participants who read the SIDCER ICF than those who read the conventional ICF (83.3 vs. 76.0%, p < 0.001). The present study demonstrated that the SIDCER ICF was applicable and effective to improve Thai research participants' understanding of research information in diverse clinical trials. Using the SIDCER ICF methodology, clinical researchers can improve the quality of ICFs for their trials.

  12. Genome-Wide Temporal Expression Profiling in Caenorhabditis elegans Identifies a Core Gene Set Related to Long-Term Memory.

    PubMed

    Freytag, Virginie; Probst, Sabine; Hadziselimovic, Nils; Boglari, Csaba; Hauser, Yannick; Peter, Fabian; Gabor Fenyves, Bank; Milnik, Annette; Demougin, Philippe; Vukojevic, Vanja; de Quervain, Dominique J-F; Papassotiropoulos, Andreas; Stetak, Attila

    2017-07-12

    The identification of genes related to encoding, storage, and retrieval of memories is a major interest in neuroscience. In the current study, we analyzed the temporal gene expression changes in a neuronal mRNA pool during an olfactory long-term associative memory (LTAM) in Caenorhabditis elegans hermaphrodites. Here, we identified a core set of 712 (538 upregulated and 174 downregulated) genes that follows three distinct temporal peaks demonstrating multiple gene regulation waves in LTAM. Compared with the previously published positive LTAM gene set (Lakhina et al., 2015), 50% of the identified upregulated genes here overlap with the previous dataset, possibly representing stimulus-independent memory-related genes. On the other hand, the remaining genes were not previously identified in positive associative memory and may specifically regulate aversive LTAM. Our results suggest a multistep gene activation process during the formation and retrieval of long-term memory and define general memory-implicated genes as well as conditioning-type-dependent gene sets. SIGNIFICANCE STATEMENT The identification of genes regulating different steps of memory is of major interest in neuroscience. Identification of common memory genes across different learning paradigms and the temporal activation of the genes are poorly studied. Here, we investigated the temporal aspects of Caenorhabditis elegans gene expression changes using aversive olfactory associative long-term memory (LTAM) and identified three major gene activation waves. Like in previous studies, aversive LTAM is also CREB dependent, and CREB activity is necessary immediately after training. Finally, we define a list of memory paradigm-independent core gene sets as well as conditioning-dependent genes. Copyright © 2017 the authors 0270-6474/17/376661-12$15.00/0.

  13. Development of a core outcome set for use in determining the overall success of gastroschisis treatment.

    PubMed

    Allin, Benjamin; Ross, Andrew; Marven, Sean; J Hall, Nigel; Knight, Marian

    2016-07-27

    Gastroschisis research is limited in quality by the presence of significant heterogeneity in outcome measure reporting (PloS One 10(1):e0116908, 2015). Using core outcome sets in research is one proposed method for addressing this problem (Trials 13:103, 2012; Clin Rheumatol 33(9):1313-1322, 2014; Health Serv Res Policy 17(1):1-2, 2012). Ultimately, standardising outcome measure reporting will improve research quality and translate into improvements in patient care. Candidate outcome measures have been identified through systematic reviews. These outcome measures will form the starting point for an online, three-phase Delphi process that will be carried out in parallel by three panels of experts. Panel 1 is a neonatal panel, panel 2 is a non-neonatal panel and panel 3 is a lay panel. In round 1, experts will be asked to score the previously identified outcome measures from 1-9 based on how important they think the measures are in determining the overall success of their/their child's/their patient's gastroschisis treatment. In round 2, experts will be presented with the same list of outcome measures and with graphical representations of how their panel scored that outcome in round 1. They will be asked to re-score the outcome measure taking into account how important other members of their panel felt it to be. In round 3, experts will again be asked to re-score each outcome measure, but this time they will receive a graphical representation of the distribution of scores from all three panels which they should take into account when re-scoring. Following round 3 of the Delphi process, 40 experts will be invited to attend a face-to-face consensus meeting. Participants will be invited in a purposive manner to obtain balance between the different panels. The results of the Delphi process will be discussed, and outcomes re-scored. Outcome measures where > 70 % of the participants at the meeting scored them as 7-9 and < 15 % scored them as 1-3 will form the

  14. How to select outcome measurement instruments for outcomes included in a "Core Outcome Set" - a practical guideline.

    PubMed

    Prinsen, Cecilia A C; Vohra, Sunita; Rose, Michael R; Boers, Maarten; Tugwell, Peter; Clarke, Mike; Williamson, Paula R; Terwee, Caroline B

    2016-09-13

    In cooperation with the Core Outcome Measures in Effectiveness Trials (COMET) initiative, the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) initiative aimed to develop a guideline on how to select outcome measurement instruments for outcomes (i.e., constructs or domains) included in a "Core Outcome Set" (COS). A COS is an agreed minimum set of outcomes that should be measured and reported in all clinical trials of a specific disease or trial population. Informed by a literature review to identify potentially relevant tasks on outcome measurement instrument selection, a Delphi study was performed among a panel of international experts, representing diverse stakeholders. In three consecutive rounds, panelists were asked to rate the importance of different tasks in the selection of outcome measurement instruments, to justify their choices, and to add other relevant tasks. Consensus was defined as being achieved when 70 % or more of the panelists agreed and when fewer than 15 % of the panelists disagreed. Of the 481 invited experts, 120 agreed to participate of whom 95 (79 %) completed the first Delphi questionnaire. We reached consensus on four main steps in the selection of outcome measurement instruments for COS: Step 1, conceptual considerations; Step 2, finding existing outcome measurement instruments, by means of a systematic review and/or a literature search; Step 3, quality assessment of outcome measurement instruments, by means of the evaluation of the measurement properties and feasibility aspects of outcome measurement instruments; and Step 4, generic recommendations on the selection of outcome measurement instruments for outcomes included in a COS (consensus ranged from 70 to 99 %). This study resulted in a consensus-based guideline on the methods for selecting outcome measurement instruments for outcomes included in a COS. This guideline can be used by COS developers in defining how to measure core outcomes.

  15. Large Survey of Neutron Spectrum Moments Due to ICF Drive Asymmetry

    NASA Astrophysics Data System (ADS)

    Field, J. E.; Munro, D.; Spears, B.; Peterson, J. L.; Brandon, S.; Gaffney, J. A.; Hammer, J.; Langer, S.; Nora, R. C.; Springer, P.; ICF Workflow Collaboration Collaboration

    2016-10-01

    We have recently completed the largest HYDRA simulation survey to date ( 60 , 000 runs) of drive asymmetry on the new Trinity computer at LANL. The 2D simulations covered a large space of credible perturbations to the drive of ICF implosions on the NIF. Cumulants of the produced birth energy spectrum for DD and DT reaction neutrons were tallied using new methods. Comparison of the experimental spectra with our map of predicted spectra from simulation should provide a wealth of information about the burning plasma region. We report on our results, highlighting areas of agreement (and disagreement) with experimental spectra. We also identify features in the predicted spectra that might be amenable to measurement with improved diagnostics. Prepared by LLNL under Contract DE-AC52-07NA27344. IM release #: LLNL-PROC-697321.

  16. Non-LTE Equation of State for ICF simulations

    NASA Astrophysics Data System (ADS)

    Klapisch, Marcel; Bar-Shalom, Avraham; Colombant, Denis

    2002-11-01

    SCROLL is a collisional radiative model able to deal with complex spectra[1]. It is used to generate opacity/emissivity databases [2] compatible with the hydrocode FAST[3] for all elements of interest in the simulation of ICF targets, including high-Z. It is now modified to yield tables of EOS data for FAST, in the whole range of interest (T=1 to 25000eV, rho=10-6 to 100g/cc). SCROLL contributes the electronic -free and bound- part of the EOS, replacing Busquet's model of an ionization temperature. Ionization energies include contributions of all excited states. Energies and Z* go smoothly to the high density regime, where a "jellium" model is assumed. The free electrons are self consistent with the bound electrons. Examples of runs will be shown. Supported by USDOE through a contract with the Naval Research Laboratory. [1] A. Bar-Shalom, J. Oreg, and M. Klapisch, J. Quant. Spectrosc. Radiat. Transfer 65, 43 (2000). [2] A. Bar-shalom, M. Klapisch, J. Oreg, and D. Colombant, Bull. Am. Phys. Soc. 46, 295 (2001). [3] J. H. Gardner, A. J. Schmitt, J. P. Dahlburg, et al, Phys. Plasmas 5, 1935 (1998).

  17. 42 CFR 418.112 - Condition of participation: Hospices that provide hospice care to residents of a SNF/NF or ICF/MR.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...; counseling (including spiritual, dietary and bereavement); social work; provision of medical supplies... hospice must: (1) Designate a member of each interdisciplinary group that is responsible for a patient who is a resident of a SNF/NF or ICF/MR. The designated interdisciplinary group member is responsible for...

  18. Outcome Measures in Rheumatology - Interventions for medication Adherence (OMERACT-Adherence) Core Domain Set for Trials of Interventions for Medication Adherence in Rheumatology: 5 Phase Study Protocol.

    PubMed

    Kelly, Ayano; Tong, Allison; Tymms, Kathleen; March, Lyn; Craig, Jonathan C; De Vera, Mary; Evans, Vicki; Hassett, Geraldine; Toupin-April, Karine; van den Bemt, Bart; Teixeira-Pinto, Armando; Alten, Rieke; Bartlett, Susan J; Campbell, Willemina; Dawson, Therese; Gill, Michael; Hebing, Renske; Meara, Alexa; Nieuwlaat, Robby; Shaw, Yomei; Singh, Jasvinder A; Suarez-Almazor, Maria; Sumpton, Daniel; Wong, Peter; Christensen, Robin; Beaton, Dorcas; de Wit, Maarten; Tugwell, Peter

    2018-03-27

    Over the last 20 years, there have been marked improvements in the availability of effective medications for rheumatic conditions such as gout, osteoporosis and rheumatoid arthritis (RA), which have led to a reduction in disease flares and the risk of re-fracture in osteoporosis, and the slowing of disease progression in RA. However, medication adherence remains suboptimal, as treatment regimens can be complex and difficult to continue long term. Many trials have been conducted to improve adherence to medication. Core domains, which are the outcomes of most relevance to patients and clinicians, are a pivotal component of any trial. These core domains should be measured consistently, so that all relevant trials can be combined in systematic reviews and meta-analyses to reach conclusions that are more valid. Failure to do this severely limits the potential for trial-based evidence to inform decisions on how to support medication adherence. The Outcome Measures in Rheumatology (OMERACT) - Interventions for Medication Adherence study by the OMERACT-Adherence Group aims to develop a core domain set for interventions that aim to support medication adherence in rheumatology. This OMERACT-Adherence study has five phases: (1) a systematic review to identify outcome domains that have been reported in interventions focused on supporting medication adherence in rheumatology; (2) semi-structured stakeholder interviews with patients and caregivers to determine their views on the core domains; (3) focus groups using the nominal group technique with patients and caregivers to identify and rank domains that are relevant to them, including the reasons for their choices; (4) an international three-round modified Delphi survey involving patients with diverse rheumatic conditions, caregivers, health professionals, researchers and other stakeholders to develop a preliminary core domain set; and (5) a stakeholder workshop with OMERACT members to review, vote on and reach a consensus on

  19. Practical Recommendations for Robot-Assisted Treadmill Therapy (Lokomat) in Children with Cerebral Palsy: Indications, Goal Setting, and Clinical Implementation within the WHO-ICF Framework.

    PubMed

    Aurich-Schuler, Tabea; Warken, Birgit; Graser, Judith V; Ulrich, Thilo; Borggraefe, Ingo; Heinen, Florian; Meyer-Heim, Andreas; van Hedel, Hubertus J A; Schroeder, A Sebastian

    2015-08-01

    Active participation and the highest level of independence during daily living are primary goals in neurorehabilitation. Therefore, standing and walking are key factors in many rehabilitation programs. Despite inconclusive evidence considering the best application and efficacy of robotic tools in the field of pediatric neurorehabilitation, robotic technologies have been implemented to complement conventional therapies in recent years. A group of experienced therapists and physicians joined in an "expert panel." They compared their clinical application protocols, discussed recurring open questions, and developed experience-based recommendations for robot-assisted treadmill therapy (exemplified by the Lokomat, Hocoma, Volketswil, Switzerland) with a focus on children with cerebral palsy. Specific indications and therapeutic goals were defined considering the severity of motor impairments and the International Classification of Functioning, Disability and Health framework (ICF). After five meetings, consensus was found and recommendations for the implementation of robot-assisted treadmill therapy including postsurgery rehabilitation were proposed. This article aims to provide a comprehensive overview on therapeutical applications in a fast developing field of medicine, where scientific evidence is still scarce. These recommendations can help physicians and therapists to plan the child's individual therapy protocol of robot-assisted treadmill therapy. Georg Thieme Verlag KG Stuttgart · New York.

  20. Palaeointensity, core thermal conductivity and the unknown age of the inner core

    NASA Astrophysics Data System (ADS)

    Smirnov, Aleksey V.; Tarduno, John A.; Kulakov, Evgeniy V.; McEnroe, Suzanne A.; Bono, Richard K.

    2016-05-01

    Data on the evolution of Earth's magnetic field intensity are important for understanding the geodynamo and planetary evolution. However, the paleomagnetic record in rocks may be adversely affected by many physical processes, which must be taken into account when analysing the palaeointensity database. This is especially important in the light of an ongoing debate regarding core thermal conductivity values, and how these relate to the Precambrian geodynamo. Here, we demonstrate that several data sets in the Precambrian palaeointensity database overestimate the true paleofield strength due to the presence of non-ideal carriers of palaeointensity signals and/or viscous re-magnetizations. When the palaeointensity overestimates are removed, the Precambrian database does not indicate a robust change in geomagnetic field intensity during the Mesoproterozoic. These findings call into question the recent claim that the solid inner core formed in the Mesoproterozoic, hence constraining the thermal conductivity in the core to `moderate' values. Instead, our analyses indicate that the presently available palaeointensity data are insufficient in number and quality to constrain the timing of solid inner core formation, or the outstanding problem of core thermal conductivity. Very young or very old inner core ages (and attendant high or low core thermal conductivity values) are consistent with the presently known history of Earth's field strength. More promising available data sets that reflect long-term core structure are geomagnetic reversal rate and field morphology. The latter suggests changes that may reflect differences in Archean to Proterozoic core stratification, whereas the former suggest an interval of geodynamo hyperactivity at ca. 550 Ma.

  1. Participation restrictions in patients with psychiatric and/or cognitive disabilities: preliminary results for an ICF-derived assessment tool.

    PubMed

    Belio, C; Prouteau, A; Koleck, M; Saada, Y; Merceron, K; Dayre, E; Destaillats, J M; Barral, C; Mazaux, J M

    2014-03-01

    Participation in community life is a major challenge for most people with psychiatric and/or cognitive disabilities. Current assessments of participation lack a theoretical basis. However, the new International Classification of Functioning, Disability and Health (ICF) provides a relevant framework. The present study used an ICF-derived assessment tool to activity limitations and participation restrictions in two groups of participants with disabilities linked to schizophrenia or traumatic brain injury respectively. Twenty-six items (related to six ICF sections) were selected by reviewing the literature and gathering the clinician's opinions and representatives of patient associations. These items, yielded an ordinal rating of activity limitations, participation restrictions and contextual factors (social support, attitudes and, systems & politics). Special attention was paid to contextual and environmental factors. The final checklist (called the Grid for Measurements of Activity and Participation, G-MAP) was administered to 16 participants with traumatic brain injury (the TBI group) and 15 participants with schizophrenic disorders (the SD group). Psychometric assessments of cognition and, neurobehavioural, psychological and psychosocial functioning were also performed. The internal consistencies for activity limitations (Cronbach's alpha coefficient=0.89) and participation restriction (Cronbach's alpha coefficient=0.89) were satisfactory. We did not observe any significant differences between the two groups in terms of the psychometric test results. The G-MAP scores demonstrated that the two groups were confronted with the same limitations in self care, domestic life, leisure and community life (i.e., the intergroup differences were not statistically significant in Mann-Whitney tests). However, interpersonal relationships and economic and social productivity appeared to be more severely limited in the SD group than in the TBI group. Similarly, participation

  2. Development of a Core Set of Outcome Measures for Large-vessel Vasculitis: Report from OMERACT 2016.

    PubMed

    Sreih, Antoine G; Alibaz-Oner, Fatma; Kermani, Tanaz A; Aydin, Sibel Z; Cronholm, Peter F; Davis, Trocon; Easley, Ebony; Gul, Ahmet; Mahr, Alfred; McAlear, Carol A; Milman, Nataliya; Robson, Joanna C; Tomasson, Gunnar; Direskeneli, Haner; Merkel, Peter A

    2017-12-01

    Among the challenges in conducting clinical trials in large-vessel vasculitis (LVV), including both giant cell arteritis (GCA) and Takayasu arteritis (TA), is the lack of standardized and meaningful outcome measures. The Outcome Measures in Rheumatology (OMERACT) Vasculitis Working Group initiated an international effort to develop and validate data-driven outcome tools for clinical investigation in LVV. An international Delphi exercise was completed to gather opinions from clinical experts on LVV-related domains considered important to measure in trials. Patient interviews and focus groups were completed to identify outcomes of importance to patients. The results of these activities were presented and discussed in a "Virtual Special Interest Group" using telephone- and Internet-based conferences, discussions through electronic mail, and an in-person session at the 2016 OMERACT meeting. A preliminary core set of domains common for all forms of LVV with disease-specific elements was proposed. The majority of experts agree with using common outcome measures for GCA and TA, with the option of supplementation with disease-specific items. Following interviews and focus groups, pain, fatigue, and emotional effect emerged as health-related quality of life domains important to patients. Current disease assessment tools, including the Birmingham Vasculitis Activity Score, were found to be inadequate to assess disease activity in GCA and standardized assessment of imaging tests were felt crucial to study LVV, especially TA. Initial data from a clinician Delphi exercise and structured patient interviews have provided themes toward an OMERACT-endorsed core set of domains and outcome measures.

  3. A set of tetra-nucleotide core motif SSR markers for efficient identification of potato (Solanum tuberosum) cultivars.

    PubMed

    Kishine, Masahiro; Tsutsumi, Katsuji; Kitta, Kazumi

    2017-12-01

    Simple sequence repeat (SSR) is a popular tool for individual fingerprinting. The long-core motif (e.g. tetra-, penta-, and hexa-nucleotide) simple sequence repeats (SSRs) are preferred because they make it easier to separate and distinguish neighbor alleles. In the present study, a new set of 8 tetra-nucleotide SSRs in potato ( Solanum tuberosum ) is reported. By using these 8 markers, 72 out of 76 cultivars obtained from Japan and the United States were clearly discriminated, while two pairs, both of which arose from natural variation, showed identical profiles. The combined probability of identity between two random cultivars for the set of 8 SSR markers was estimated to be 1.10 × 10 -8 , confirming the usefulness of the proposed SSR markers for fingerprinting analyses of potato.

  4. Auxiliary basis sets for density-fitting second-order Møller-Plesset perturbation theory: weighted core-valence correlation consistent basis sets for the 4d elements Y-Pd.

    PubMed

    Hill, J Grant

    2013-09-30

    Auxiliary basis sets (ABS) specifically matched to the cc-pwCVnZ-PP and aug-cc-pwCVnZ-PP orbital basis sets (OBS) have been developed and optimized for the 4d elements Y-Pd at the second-order Møller-Plesset perturbation theory level. Calculation of the core-valence electron correlation energies for small to medium sized transition metal complexes demonstrates that the error due to the use of these new sets in density fitting is three to four orders of magnitude smaller than that due to the OBS incompleteness, and hence is considered negligible. Utilizing the ABSs in the resolution-of-the-identity component of explicitly correlated calculations is also investigated, where it is shown that i-type functions are important to produce well-controlled errors in both integrals and correlation energy. Benchmarking at the explicitly correlated coupled cluster with single, double, and perturbative triple excitations level indicates impressive convergence with respect to basis set size for the spectroscopic constants of 4d monofluorides; explicitly correlated double-ζ calculations produce results close to conventional quadruple-ζ, and triple-ζ is within chemical accuracy of the complete basis set limit. Copyright © 2013 Wiley Periodicals, Inc.

  5. Moderators, mediators, and bidirectional relationships in the International Classification of Functioning, Disability and Health (ICF) framework: An empirical investigation using a longitudinal design and Structural Equation Modeling (SEM).

    PubMed

    Rouquette, Alexandra; Badley, Elizabeth M; Falissard, Bruno; Dub, Timothée; Leplege, Alain; Coste, Joël

    2015-06-01

    The International Classification of Functioning, Disability and Health (ICF) published in 2001 describes the consequences of health conditions with three components of impairments in body structures or functions, activity limitations and participation restrictions. Two of the new features of the conceptual model were the possibility of feedback effects between each ICF component and the introduction of contextual factors conceptualized as moderators of the relationship between the components. The aim of this longitudinal study is to provide empirical evidence of these two kinds of effect. Structural equation modeling was used to analyze data from a French population-based cohort of 548 patients with knee osteoarthritis recruited between April 2007 and March 2009 and followed for three years. Indicators of the body structure and function, activity and participation components of the ICF were derived from self-administered standardized instruments. The measurement model revealed four separate factors for body structures impairments, body functions impairments, activity limitations and participation restrictions. The classic sequence from body impairments to participation restrictions through activity limitations was found at each assessment time. Longitudinal study of the ICF component relationships showed a feedback pathway indicating that the level of participation restrictions at baseline was predictive of activity limitations three years later. Finally, the moderating role of personal (age, sex, mental health, etc.) and environmental factors (family relationships, mobility device use, etc.) was investigated. Three contextual factors (sex, family relationships and walking stick use) were found to be moderators for the relationship between the body impairments and the activity limitations components. Mental health was found to be a mediating factor of the effect of activity limitations on participation restrictions. Copyright © 2015 Elsevier Ltd. All rights

  6. Most common problems across health conditions as described by the International Classification of Functioning, Disability, and Health.

    PubMed

    Ptyushkin, Pavel; Cieza, Alarcos; Stucki, Gerold

    2015-09-01

    Health conditions are associated with a variety of functional outcomes. Even though functional outcomes are diverse for different health conditions, they can have important commonalities. The aim of this study was to identify the most common problems in functioning across the wide range of health conditions using the International Classification of Functioning (ICF). Existing databases created for the 21 ICF Core Sets studies were descriptively analyzed. These included data collected in 44 countries on 9978 patients with one of 21 health conditions as the main diagnosis. A frequency cutoff of 50% was used to identify the most common problems in functioning when looking at single health conditions and across them. No category was identified as common to all health conditions included in the study. Fifteen most frequent categories were common in 10 to 13 health conditions out of 21. Eleven categories correspond to the list of activities and participation, and four to the list of body functions. These are related to mobility, daily routine, mental functions, intimate relations, employment, and leisure. Some health conditions have more commonalities between each other. The most common problems across health conditions are therefore related to mental functions, mobility, daily life, intimate relations, employment, and leisure. The results contribute toward the identification of the universal set of ICF categories that can be used in clinical practice for the general assessment of functioning.

  7. Core outcome sets for prevention and treatment of postpartum haemorrhage: an international Delphi consensus study.

    PubMed

    Meher, Shireen; Cuthbert, Anna; Kirkham, Jamie J; Williamson, Paula; Abalos, Edgardo; Aflaifel, Nasreen; Bhutta, Zulfiqar A; Bishop, Alina; Blum, Jennifer; Collins, Peter; Devane, Declan; Ducloy-Bouthors, Anne-Sophie; Fawole, Bukola; Gülmezoglu, A Metin; Gutteridge, Kathryn; Gyte, Gill; Homer, Caroline S E; Mallaiah, Shuba; Smith, Jeffrey M; Weeks, Andrew D; Alfirevic, Zarko

    2018-06-19

    To develop core outcome sets (COS) for studies evaluating interventions for (1) prevention and (2) treatment of PPH, and recommendations on how to report the COS. A two-round Delphi survey and face-to-face meeting. Health care professionals and women's representatives. Outcomes were identified from systematic reviews of PPH studies and stakeholder consultation. Participants scored each outcome in the Delphi on a Likert scale between 1 (not important) and 9 (critically important). Results were discussed at the face-to-face meeting to agree the final COS. Consensus at the meeting was defined as ≥ 70% of participants scoring the outcome as critically important (7-9). Lectures, discussion and voting were used to agree how to report COS outcomes. outcomes from systematic reviews and consultations. Both Delphi rounds were completed by 152/205 (74%) participants for prevention and 143/197 (73%) for treatment. For prevention of PPH, nine core outcomes were selected: blood loss, shock, maternal death, use of additional uterotonics, blood transfusion, transfer for higher level of care, women's sense of wellbeing, acceptability and satisfaction with the intervention, breastfeeding and adverse effects. For treatment of PPH, 12 core outcomes were selected: blood loss, shock, coagulopathy, hysterectomy, organ dysfunction, maternal death, blood transfusion, use of additional haemostatic intervention, transfer for higher level of care, women's sense of wellbeing, acceptability and satisfaction with the intervention, breastfeeding and adverse effects. Recommendations were developed on how to report these outcomes where possible. These COS will help standardise outcome reporting in PPH trials. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  8. What Do Clinicians Consider when Assessing Chronic Low Back Pain? A Content Analysis of Multidisciplinary Pain Centre Team Assessments of Functioning, Disability, and Health.

    PubMed

    Bagraith, Karl S; Strong, Jenny; Meredith, Pamela J; McPhail, Steven M

    2018-05-22

    Beyond expert suggestions as to the appropriate subject matter for chronic pain assessments, little is known about the actual content of multidisciplinary pain centre (MPC) clinical assessments. The International Classification of Functioning, Disability and Health Low Back Pain Core Set (ICF LBP-CS) provides a universal language to support the consistent description of LBP-related assessments across disciplines within multidisciplinary teams (MDT). This study sought to map the content of MPC clinical assessments to the ICF to: 1) identify and compare the content of clinical MDT assessments using a cross-disciplinary framework and, 2) examine the content validity of the LBP-CS. A qualitative examination of MPC team clinical assessments of CLBP was undertaken. MDT (pain medicine, psychiatry, nursing, physiotherapy, occupational therapy, and psychology) assessments were audio-recorded and transcribed. Concepts were extracted from transcripts using a meaning condensation procedure and then linked to the ICF. Across seven MDT assessments, comprised of 42 discipline-specific assessments and 241,209 transcribed words, 8596 concepts were extracted. Contextual factors (i.e., the person and environment), except for physiotherapy, accounted for almost half of each discipline's assessments (range: 49% - 58%) Concepts spanned 113 second-level ICF categories, including 73/78 LBP-CS categories. Overall, the findings revealed novel insights into the content of MPC clinical assessments that can be used to improve healthcare delivery. ICF-based assessment profiles demonstrated unique contributions from each discipline to CLBP assessment. Finally, users of the LBP-CS can be confident that the tool exhibits sound content validity from the perceptive of MDT assessments of functioning, disability, and health.

  9. Validity and measurement precision of the PROMIS physical function item bank and a content validity-driven 20-item short form in rheumatoid arthritis compared with traditional measures.

    PubMed

    Oude Voshaar, Martijn A H; Ten Klooster, Peter M; Glas, Cees A W; Vonkeman, Harald E; Taal, Erik; Krishnan, Eswar; Bernelot Moens, Hein J; Boers, Maarten; Terwee, Caroline B; van Riel, Piet L C M; van de Laar, Mart A F J

    2015-12-01

    To evaluate the content validity and measurement properties of the Patient-Reported Outcome Measurement Information System (PROMIS) physical function item bank and a 20-item short form in patients with RA in comparison with the HAQ disability index (HAQ-DI) and 36-item Short Form Health Survey (SF-36) physical functioning scale (PF-10). The content validity of the instruments was evaluated by linking their items to the International Classification of Functioning, Disability and Health (ICF) core set for RA. The measures were administered to 690 RA patients enrolled in the Dutch Rheumatoid Arthritis Monitoring registry. Measurement precision was evaluated using item response theory methods and construct validity was evaluated by correlating physical function scores with other clinical and patient-reported outcome measures. All 207 health concepts identified in the physical function measures referred to activities that are featured in the ICF. Twenty-three of 26 ICF RA core set domains are featured in the full PROMIS physical function item bank compared with 13 and 8 for the HAQ-DI and PF-10, respectively. As hypothesized, all three physical function instruments were highly intercorrelated (r 0.74-0.84), moderately correlated with disease activity measures (r 0.44-0.63) and weakly correlated with age (rs 0.07-0.14). Item response theory-based analysis revealed that a 20-item PROMIS physical function short form covered a wider range of physical function levels than the HAQ-DI or PF-10. The PROMIS physical function item bank demonstrated excellent measurement properties in RA. A content-driven 20-item short form may be a useful tool for assessing physical function in RA. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Integrating the ICF with positive psychology: Factors predicting role participation for mothers with multiple sclerosis.

    PubMed

    Farber, Ruth S; Kern, Margaret L; Brusilovsky, Eugene

    2015-05-01

    Being a mother has become a realizable life role for women with disabilities and chronic illnesses, including multiple sclerosis (MS). Identifying psychosocial factors that facilitate participation in important life roles-including motherhood-is essential to help women have fuller lives despite the challenge of their illness. By integrating the International Classification of Functioning, Disability, and Health (ICF) and a positive psychology perspective, this study examined how environmental social factors and positive personal factors contribute to daily role participation and satisfaction with parental participation. One hundred and 11 community-dwelling mothers with MS completed Ryff's Psychological Well-Being Scales, the Medical Outcome Study Social Support Survey, the Short Form-36, and the Parental Participation Scale. Hierarchical regression analyses examined associations between social support and positive personal factors (environmental mastery, self-acceptance, purpose in life) with daily role participation (physical and emotional) and satisfaction with parental participation. One-way ANOVAs tested synergistic combinations of social support and positive personal factors. Social support predicted daily role participation (fewer limitations) and greater satisfaction with parental participation. Positive personal factors contributed additional unique variance. Positive personal factors and social support synergistically predicted better function and greater satisfaction than either alone. Integrating components of the ICF and positive psychology provides a useful model for understanding how mothers with MS can thrive despite challenge or impairment. Both positive personal factors and environmental social factors were important contributors to positive role functioning. Incorporating these paradigms into treatment may help mothers with MS participate more fully in meaningful life roles. (c) 2015 APA, all rights reserved).

  11. Nonlinear core deflection in injection molding

    NASA Astrophysics Data System (ADS)

    Poungthong, P.; Giacomin, A. J.; Saengow, C.; Kolitawong, C.; Liao, H.-C.; Tseng, S.-C.

    2018-05-01

    Injection molding of thin slender parts is often complicated by core deflection. This deflection is caused by molten plastics race tracking through the slit between the core and the rigid cavity wall. The pressure of this liquid exerts a lateral force of the slender core causing the core to bend, and this bending is governed by a nonlinear fifth order ordinary differential equation for the deflection that is not directly in the position along the core. Here we subject this differential equation to 6 sets of boundary conditions, corresponding to 6 commercial core constraints. For each such set of boundary conditions, we develop an explicit approximate analytical solution, including both a linear term and a nonlinear term. By comparison with finite difference solutions, we find our new analytical solutions to be accurate. We then use these solutions to derive explicit analytical approximations for maximum deflections and for the core position of these maximum deflections. Our experiments on the base-gated free-tip boundary condition agree closely with our new explicit approximate analytical solution.

  12. Development of a core outcome set for disease modification trials in mild to moderate dementia: a systematic review, patient and public consultation and consensus recommendations.

    PubMed Central

    Webster, Lucy; Groskreutz, Derek; Grinbergs-Saull, Anna; Howard, Rob; O'Brien, John T; Mountain, Gail; Banerjee, Sube; Woods, Bob; Perneczky, Robert; Lafortune, Louise; Roberts, Charlotte; McCleery, Jenny; Pickett, James; Bunn, Frances; Challis, David; Charlesworth, Georgina; Featherstone, Katie; Fox, Chris; Goodman, Claire; Jones, Roy; Lamb, Sallie; Moniz-Cook, Esme; Schneider, Justine; Shepperd, Sasha; Surr, Claire; Thompson-Coon, Jo; Ballard, Clive; Brayne, Carol; Burke, Orlaith; Burns, Alistair; Clare, Linda; Garrard, Peter; Kehoe, Patrick; Passmore, Peter; Holmes, Clive; Maidment, Ian; Murtagh, Fliss; Robinson, Louise; Livingston, Gill

    2017-01-01

    BACKGROUND There is currently no disease-modifying treatment available to halt or delay the progression of the disease pathology in dementia. An agreed core set of the best-available and most appropriate outcomes for disease modification would facilitate the design of trials and ensure consistency across disease modification trials, as well as making results comparable and meta-analysable in future trials. OBJECTIVES To agree a set of core outcomes for disease modification trials for mild to moderate dementia with the UK dementia research community and patient and public involvement (PPI). DATA SOURCES We included disease modification trials with quantitative outcomes of efficacy from (1) references from related systematic reviews in workstream 1; (2) searches of the Cochrane Dementia and Cognitive Improvement Group study register, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Latin American and Caribbean Health Sciences Literature and PsycINFO on 11 December 2015, and clinical trial registries [International Standard Randomised Controlled Trial Number (ISRCTN) and clinicaltrials.gov] on 22 and 29 January 2016; and (3) hand-searches of reference lists of relevant systematic reviews from database searches. REVIEW METHODS The project consisted of four workstreams. (1) We obtained related core outcome sets and work from co-applicants. (2) We systematically reviewed published and ongoing disease modification trials to identify the outcomes used in different domains. We extracted outcomes used in each trial, recording how many used each outcome and with how many participants. We divided outcomes into the domains measured and searched for validation data. (3) We consulted with PPI participants about recommended outcomes. (4) We presented all the synthesised information at a conference attended by the wider body of National Institute for Health Research (NIHR) dementia researchers to reach consensus on a

  13. Core body temperature in obesity.

    PubMed

    Heikens, Marc J; Gorbach, Alexander M; Eden, Henry S; Savastano, David M; Chen, Kong Y; Skarulis, Monica C; Yanovski, Jack A

    2011-05-01

    A lower core body temperature set point has been suggested to be a factor that could potentially predispose humans to develop obesity. We tested the hypothesis that obese individuals have lower core temperatures than those in normal-weight individuals. In study 1, nonobese [body mass index (BMI; in kg/m(2)) <30] and obese (BMI ≥30) adults swallowed wireless core temperature-sensing capsules, and we measured core temperatures continuously for 24 h. In study 2, normal-weight (BMI of 18-25) and obese subjects swallowed temperature-sensing capsules to measure core temperatures continuously for ≥48 h and kept activity logs. We constructed daily, 24-h core temperature profiles for analysis. Mean (±SE) daily core body temperature did not differ significantly between the 35 nonobese and 46 obese subjects (36.92 ± 0.03°C compared with 36.89 ± 0.03°C; P = 0.44). Core temperature 24-h profiles did not differ significantly between 11 normal-weight and 19 obese subjects (P = 0.274). Women had a mean core body temperature ≈0.23°C greater than that of men (36.99 ± 0.03°C compared with 36.76 ± 0.03°C; P < 0.0001). Obesity is not generally associated with a reduced core body temperature. It may be necessary to study individuals with function-altering mutations in core temperature-regulating genes to determine whether differences in the core body temperature set point affect the regulation of human body weight. These trials were registered at clinicaltrials.gov as NCT00428987 and NCT00266500.

  14. International classification of functioning, disability and health categories for spinal cord injury nursing in China.

    PubMed

    Li, Kun; Yan, Tiebin; You, Liming; Li, Rui; Ross, Amy Miner

    2015-01-01

    To explore a set of International Classification of Functioning, Disability and Health (ICF) categories that cover the spinal cord injury (SCI) nursing practice in China through a national expert survey. An internet-based email survey was used. An original set of ICF categories specifically for SCI nursing has been developed from the preliminary studies based on an international perspective. For cultural adaptation in China, a national expert survey was conducted with Chinese experts on SCI nursing to identify the ICF categories that were specifically for SCI nursing in China. The ICF categories which received more than 80% support from the experts would be reported. Twenty-nine Chinese experts on SCI nursing participated. There were 81 ICF categories which received more than 80% agreement among the experts, including 33 Body Functions categories, eight Body Structures, 24 Activities and Participation, six Environmental Factors and 10 Personal Factors items. A set of ICF categories that cover the SCI nursing practice in China was identified. It reflects the main issues that Chinese nurses focus on in caring SCI patients. These categories can facilitate Chinese nurses to use the ICF in multidisciplinary teamwork and improve the participation of nurses in the team. Implications for Rehabilitation In China, nurses lack of an effective model or tool to communicate with the other health professionals in the rehabilitation team for spinal cord injury (SCI) patients. International Classification of Functioning, Disability and Health (ICF) is a tool for multidisciplinary use, which can promote the communication and collaboration in the healthcare team by establishing a common language across different disciplines and sectors. This set of ICF categories developed from this study can serve as a roadmap for important items for use in clinical practice of Chinese SCI nursing.

  15. Developing a core outcome set for infant colic for primary, secondary and tertiary care settings: a prospective study.

    PubMed

    Steutel, Nina F; Benninga, Marc A; Langendam, Miranda W; Korterink, Judith J; Indrio, Flavia; Szajewska, Hania; Tabbers, Merit M

    2017-05-29

    Infant colic (IC) is defined as recurrent and prolonged crying without an obvious cause or evidence of failure to thrive or illness. It is a common problem with a prevalence of 5%-25%. The unknown aetiology results in a wide variety in interventions and use of heterogeneous outcome measures across therapeutic trials. Our aim was to develop a core outcome set (COS) for IC to facilitate and improve evidence synthesis. Prospective study design; primary, secondary and tertiary care. The COS was developed using a modified Delphi technique. First, healthcare professionals (HCPs) and parents of infants with IC were asked to list up to five outcomes they considered relevant in the treatment of IC. Outcomes mentioned by >10% of participants were forwarded to a shortlist. In the second round, outcomes on this shortlist were rated and prioritised. The final COS was defined in a face-to-face expert meeting of paediatricians. F of invited stakeholders (133 HCPs and 55 parents of infants with IC) completed both Delphi rounds. Duration of crying, family stress, sleeping time of infant, quality of life (of family), discomfort of infant and hospital admission/duration were rated as most important outcomes in IC, framing the final COS. The use of this COS should serve as a minimum of outcomes to be measured and reported. This will benefit evidence synthesis, by enhancing homogeneity of outcomes, and enable evaluation of success in therapeutic trials on IC. Researchers are strongly encouraged to use this COS when setting up a clinical trial in primary, secondary and/or tertiary care or performing a systematic review on IC. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. A core outcome set for evaluating self-management interventions in people with comorbid diabetes and severe mental illness: study protocol for a modified Delphi study and systematic review.

    PubMed

    Taylor, Johanna; Böhnke, Jan R; Wright, Judy; Kellar, Ian; Alderson, Sarah L; Hughes, Tom; Holt, Richard I G; Siddiqi, Najma

    2017-02-14

    People with diabetes and comorbid severe mental illness (SMI) form a growing population at risk of increased mortality and morbidity compared to those with diabetes or SMI alone. There is increasing interest in interventions that target diabetes in SMI in order to help to improve physical health and reduce the associated health inequalities. However, there is a lack of consensus about which outcomes are important for this comorbid population, with trials differing in their focus on physical and mental health. A core outcome set, which includes outcomes across both conditions that are relevant to patients and other key stakeholders, is needed. This study protocol describes methods to develop a core outcome set for use in effectiveness trials of self-management interventions for adults with comorbid type-2 diabetes and SMI. We will use a modified Delphi method to identify, rank, and agree core outcomes. This will comprise a two-round online survey and multistakeholder workshops involving patients and carers, health and social care professionals, health care commissioners, and other experts (e.g. academic researchers and third sector organisations). We will also select appropriate measurement tools for each outcome in the proposed core set and identify gaps in measures, where these exist. The proposed core outcome set will provide clear guidance about what outcomes should be measured, as a minimum, in trials of interventions for people with coexisting type-2 diabetes and SMI, and improve future synthesis of trial evidence in this area. We will also explore the challenges of using online Delphi methods for this hard-to-reach population, and examine differences in opinion about which outcomes matter to diverse stakeholder groups. COMET registration: http://www.comet-initiative.org/studies/details/911 . Registered on 1 July 2016.

  17. Core Today! Rationale and Implications. Revised Edition.

    ERIC Educational Resources Information Center

    Vars, Gordon, Ed.; Larson, Craig, Ed.

    This pamphlet is designed to help educators apply the core concept to current problems and situations in educational settings. The preface establishes the position of the National Association for Core Curriculum. A definition of the core curriculum concept is stated in the introduction. Ten assumptions and beliefs on which the core concept is…

  18. Classical and Ablative Richtmyer-Meshkov Instability and Other ICF-Relevant Plasma Flows Diagnosed With Monochromatic X-Ray Imaging

    DTIC Science & Technology

    2007-08-01

    5] Our experiments on the 3 kJ Nike KrF laser at NRL [6] seek detailed understanding of laser plasma interactions and the physical processes...Research Laboratory (NRL). It has been first used in our ICF-related hydrodynamic experiments on the NRL’s Nike KrF laser [17], and later implemented...as implemented on Nike . In Section 3 we present some results of our hydrodynamic experiments, which have been made possible by this diagnostics. In

  19. A Comparative Analysis of the Functional Disability Levels of Adult Day Care, Adult Day Health and ICF-Level Nursing Home Elderly in Hawaii.

    ERIC Educational Resources Information Center

    Hayashida, Cullen T.

    This study compared the functional disability levels of participants in adult day centers with patients in intermediate care facilities (ICFs). A three-page questionnaire measuring demographics, social resources, physical health, mental health, and activities of daily living as assessed by the Activities of Daily Living scale and the Instrumental…

  20. Iowa Core Annual Report

    ERIC Educational Resources Information Center

    Iowa Department of Education, 2015

    2015-01-01

    One central component of a great school system is a clear set of expectations, or standards, that educators help all students reach. In Iowa, that effort is known as the Iowa Core. The Iowa Core represents the statewide academic standards, which describe what students should know and be able to do in math, science, English language arts, and…

  1. Identification of a core set of rhizobial infection genes using data from single cell-types.

    PubMed

    Chen, Da-Song; Liu, Cheng-Wu; Roy, Sonali; Cousins, Donna; Stacey, Nicola; Murray, Jeremy D

    2015-01-01

    Genome-wide expression studies on nodulation have varied in their scale from entire root systems to dissected nodules or root sections containing nodule primordia (NP). More recently efforts have focused on developing methods for isolation of root hairs from infected plants and the application of laser-capture microdissection technology to nodules. Here we analyze two published data sets to identify a core set of infection genes that are expressed in the nodule and in root hairs during infection. Among the genes identified were those encoding phenylpropanoid biosynthesis enzymes including Chalcone-O-Methyltransferase which is required for the production of the potent Nod gene inducer 4',4-dihydroxy-2-methoxychalcone. A promoter-GUS analysis in transgenic hairy roots for two genes encoding Chalcone-O-Methyltransferase isoforms revealed their expression in rhizobially infected root hairs and the nodule infection zone but not in the nitrogen fixation zone. We also describe a group of Rhizobially Induced Peroxidases whose expression overlaps with the production of superoxide in rhizobially infected root hairs and in nodules and roots. Finally, we identify a cohort of co-regulated transcription factors as candidate regulators of these processes.

  2. Design and fabrication of x-ray Kirkpatrick-Baez microscope for ICF

    NASA Astrophysics Data System (ADS)

    Mu, Baozhong; Wang, Zhanshan; Huang, Shengling; Yi, Shengzhen; Shen, Zhengxiang

    2007-12-01

    A hard x-ray (8 keV, Kα line of Cu) Kirkpatrick-Baez (KB) microscope was designed for the diagnostics of inertial confinement fusion (ICF). Three main parts including optical design, fabrication of multilayers, and alignment method were discussed in this paper. According to the deduced equation of aberration in whole field, an optical system was designed, which gives attention to not only spatial resolution but also the collection efficiency. Tungsten (W) and boron carbide (B4C) were chosen as multilayer materials and the non-periodic multilayer with 40 layers was deposited. The measured reflectivity by XRD is better than 18% in the bandwidth range of about 0.3%. Super accurately alignment is another difficulty in the application of KB microscope. To meet the requirements of pointing and co-focusing, a binocular laser pointer which is flexible enough was designed. Finally, an 8keV x-ray tube was used as source in x-ray imaging experiment and images with magnification of 2× were obtained.

  3. Comparison of physical activity questionnaires for the elderly with the International Classification of Functioning, Disability and Health (ICF)--an analysis of content.

    PubMed

    Eckert, Katharina G; Lange, Martin A

    2015-03-14

    Physical activity questionnaires (PAQ) have been extensively used to determine physical activity (PA) levels. Most PAQ are derived from an energy expenditure-based perspective and assess activities with a certain intensity level. Activities with a moderate or vigorous intensity level are predominantly used to determine a person's PA level in terms of quantity. Studies show that the time spent engaging in moderate and vigorous intensity PA does not appropriately reflect the actual PA behavior of older people because they perform more functional, everyday activities. Those functional activities are more likely to be considered low-intense and represent an important qualitative health-promoting activity. For the elderly, functional, light intensity activities are of special interest but are assessed differently in terms of quantity and quality. The aim was to analyze the content of PAQ for the elderly. N = 18 sufficiently validated PAQ applicable to adults (60+) were included. Each item (N = 414) was linked to the corresponding code of the International Classification of Functioning, Disability and Health (ICF) using established linking rules. Kappa statistics were calculated to determine rater agreement. Items were linked to 598 ICF codes and 62 different ICF categories. A total of 43.72% of the codes were for sports-related activities and 14.25% for walking-related activities. Only 9.18% of all codes were related to household tasks. Light intensity, functional activities are emphasized differently and are underrepresented in most cases. Additionally, sedentary activities are underrepresented (5.55%). κ coefficients were acceptable for n = 16 questionnaires (0.48-1.00). There is a large inconsistency in the understandings of PA in elderly. Further research should focus (1) on a conceptual understanding of PA in terms of the behavior of the elderly and (2) on developing questionnaires that inquire functional, light intensity PA, as well as sedentary

  4. Identification of a Core Set of Exercise Tests for Children and Adolescents with Cerebral Palsy: A Delphi Survey of Researchers and Clinicians

    ERIC Educational Resources Information Center

    Verschuren, Olaf; Ketelaar, Marjolijn; Keefer, Daniel; Wright, Virginia; Butler, Jane; Ada, Louise; Maher, Carol; Reid, Siobhan; Wright, Marilyn; Dalziel, Blythe; Wiart, Lesley; Fowler, Eileen; Unnithan, Viswanath; Maltais, Desiree B.; van den Berg-Emons, Rita; Takken, Tim

    2011-01-01

    Aim: Evidence-based recommendations regarding which exercise tests to use in children and adolescents with cerebral palsy (CP) are lacking. This makes it very difficult for therapists and researchers to choose the appropriate exercise-related outcome measures for this group. This study aimed to identify a core set of exercise tests for children…

  5. Using absolute x-ray spectral measurements to infer stagnation conditions in ICF implosions

    NASA Astrophysics Data System (ADS)

    Patel, Pravesh; Benedetti, L. R.; Cerjan, C.; Clark, D. S.; Hurricane, O. A.; Izumi, N.; Jarrott, L. C.; Khan, S.; Kritcher, A. L.; Ma, T.; Macphee, A. G.; Landen, O.; Spears, B. K.; Springer, P. T.

    2016-10-01

    Measurements of the continuum x-ray spectrum emitted from the hot-spot of an ICF implosion can be used to infer a number thermodynamic properties at stagnation including temperature, pressure, and hot-spot mix. In deuterium-tritium (DT) layered implosion experiments on the National Ignition Facility (NIF) we field a number of x-ray diagnostics that provide spatial, temporal, and spectrally-resolved measurements of the radiated x-ray emission. We report on analysis of these measurements using a 1-D hot-spot model to infer thermodynamic properties at stagnation. We compare these to similar properties that can be derived from DT fusion neutron measurements. This work was performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344.

  6. A core outcome set for localised prostate cancer effectiveness trials: protocol for a systematic review of the literature and stakeholder involvement through interviews and a Delphi survey.

    PubMed

    MacLennan, Steven; Bekema, Hendrika J; Williamson, Paula R; Campbell, Marion K; Stewart, Fiona; MacLennan, Sara J; N'Dow, James M O; Lam, Thomas B L

    2015-03-04

    Prostate cancer is a growing health problem worldwide. The management of localised prostate cancer is controversial. It is unclear which of several surgical, radiotherapeutic, ablative, and surveillance treatments is the most effective. All have cost, process and recovery, and morbidity implications which add to treatment decision-making complexity for patients and healthcare professionals. Evidence from randomised controlled trials (RCTs) is not optimal because of uncertainty as to what constitutes important outcomes. Another issue hampering evidence synthesis is heterogeneity of outcome definition, measurement, and reporting. This project aims to determine which outcomes are the most important to patients and healthcare professionals, and use these findings to recommend a standardised core outcome set for comparative effectiveness trials of treatments for localised prostate cancer, to optimise decision-making. The range of potentially important outcomes and measures will be identified through systematic reviews of the literature and semi-structured interviews with patients. A consultation exercise involving representatives from two key stakeholder groups (patients and healthcare professionals) will ratify the list of outcomes to be entered into a three round Delphi study. The Delphi process will refine and prioritise the list of identified outcomes. A methodological substudy (nested RCT design) will also be undertaken. Participants will be randomised after round one of the Delphi study to one of three feedback groups, based on different feedback strategies, in order to explore the potential impact of feedback strategies on participant responses. This may assist the design of a future core outcome set and Delphi studies. Following the Delphi study, a final consensus meeting attended by representatives from both stakeholder groups will determine the final recommended core outcome set. This study will inform clinical practice and future trials of interventions of

  7. Core body temperature in obesity123

    PubMed Central

    Heikens, Marc J; Gorbach, Alexander M; Eden, Henry S; Savastano, David M; Chen, Kong Y; Skarulis, Monica C

    2011-01-01

    Background: A lower core body temperature set point has been suggested to be a factor that could potentially predispose humans to develop obesity. Objective: We tested the hypothesis that obese individuals have lower core temperatures than those in normal-weight individuals. Design: In study 1, nonobese [body mass index (BMI; in kg/m2) <30] and obese (BMI ≥30) adults swallowed wireless core temperature–sensing capsules, and we measured core temperatures continuously for 24 h. In study 2, normal-weight (BMI of 18–25) and obese subjects swallowed temperature-sensing capsules to measure core temperatures continuously for ≥48 h and kept activity logs. We constructed daily, 24-h core temperature profiles for analysis. Results: Mean (±SE) daily core body temperature did not differ significantly between the 35 nonobese and 46 obese subjects (36.92 ± 0.03°C compared with 36.89 ± 0.03°C; P = 0.44). Core temperature 24-h profiles did not differ significantly between 11 normal-weight and 19 obese subjects (P = 0.274). Women had a mean core body temperature ≈0.23°C greater than that of men (36.99 ± 0.03°C compared with 36.76 ± 0.03°C; P < 0.0001). Conclusions: Obesity is not generally associated with a reduced core body temperature. It may be necessary to study individuals with function-altering mutations in core temperature–regulating genes to determine whether differences in the core body temperature set point affect the regulation of human body weight. These trials were registered at clinicaltrials.gov as NCT00428987 and NCT00266500. PMID:21367952

  8. Recommended patient-reported core set of symptoms to measure in prostate cancer treatment trials.

    PubMed

    Chen, Ronald C; Chang, Peter; Vetter, Richard J; Lukka, Himansu; Stokes, William A; Sanda, Martin G; Watkins-Bruner, Deborah; Reeve, Bryce B; Sandler, Howard M

    2014-07-01

    The National Cancer Institute (NCI) Symptom Management and Health-Related Quality of Life Steering Committee convened four working groups to recommend core sets of patient-reported outcomes to be routinely incorporated in clinical trials. The Prostate Cancer Working Group included physicians, researchers, and a patient advocate. The group's process included 1) a systematic literature review to determine the prevalence and severity of symptoms, 2) a multistakeholder meeting sponsored by the NCI to review the evidence and build consensus, and 3) a postmeeting expert panel synthesis of findings to finalize recommendations. Five domains were recommended for localized prostate cancer: urinary incontinence, urinary obstruction and irritation, bowel-related symptoms, sexual dysfunction, and hormonal symptoms. Four domains were recommended for advanced prostate cancer: pain, fatigue, mental well-being, and physical well-being. Additional domains for consideration include decisional regret, satisfaction with care, and anxiety related to prostate cancer. These recommendations have been endorsed by the NCI for implementation. © The Author 2014. Published by Oxford University Press. All rights reserved.

  9. Protocol for the development of a Core Outcome Set (COS) for hemorrhoidal disease: an international Delphi study.

    PubMed

    van Tol, R R; Melenhorst, J; Dirksen, C D; Stassen, L P S; Breukink, S O

    2017-07-01

    Over the last decade, many studies were performed regarding treatment options for hemorrhoidal disease. Randomised controlled trials (RCTs) should have well-defined primary and secondary outcomes. However, the reported outcome measures are numerous and diverse. The heterogeneity of outcome definition in clinical trials limits transparency and paves the way for bias. The development of a core outcome set (COS) helps minimizing this problem. A COS is an agreed minimum set of outcomes that should be measured and reported in all clinical trials of a specific disease. The aim of this project is to generate a COS regarding the outcome of treatment after hemorrhoidal disease. A Delphi study will be performed by an international steering group healthcare professionals and patients with the intention to create a standard outcome set for future clinical trials for the treatment of hemorrhoidal disease. First, a literature review will be conducted to establish which outcomes are used in clinical trials for hemorrhoidal disease. Secondly, both healthcare professionals and patients will participate in several consecutive rounds of online questionnaires and a face-to-face meeting to refine the content of the COS. Development of a COS for hemorrhoidal disease defines a minimum outcome-reporting standard and will improve the quality of research in the future.

  10. Spent Fuel Test-Climax: core logging for site investigation and instrumentation

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

    Wilder, D.G.; Yow, J.L. Jr.; Thorpe, R.K.

    1982-05-28

    As an integral part of the Spent Fuel Test-Climax 5150 ft (1570 m) of granite core was obtained. This core was diamond drilled in various sizes, mainly 38-mm and 76-mm diameters. The core was teken with single tube core barrels and was unoriented. Techniques used to drill and log this core are discussed, as well as techniques to orient the core. Of the 5150 ft (1570 m) of core more than 3645 ft (1111 m) was retained and logged in some detail. As a result of the core logging, geologic discontinuities were identified, joint frequency and spacing characterized. Discontinuities identifiedmore » included several joint sets, shear zones and faults. Correlations based on coring along were generally found to be impossible, even for the more prominent features. The only feature properly correlated from the exploratory drilling was the fault system at the end of the facility, but it was not identified from the exploratory core as a fault. Identification of discontinuities was later helped by underground mapping that identified several different joint sets with different characteristics. It was found that joint frequency varied from 0.3 to 1.1 joint per foot of core for open fractures and from 0.3 to 3.3/ft for closed or healed fractures. Histograms of fracture spacing indicate that there is likely a random distribution of spacing superimposed upon uniformly spaced fractures. It was found that a low angle joint set had a persistent mean orientation. These joints were healed and had pervasive wall rock alteration which made identification of joints in this set possible. The recognition of a joint set with known attitude allowed orientation of much of the core. This orientation technique was found to be effective. 10 references, 25 figures, 4 tables.« less

  11. Kernel-Smoothing Estimation of Item Characteristic Functions for Continuous Personality Items: An Empirical Comparison with the Linear and the Continuous-Response Models

    ERIC Educational Resources Information Center

    Ferrando, Pere J.

    2004-01-01

    This study used kernel-smoothing procedures to estimate the item characteristic functions (ICFs) of a set of continuous personality items. The nonparametric ICFs were compared with the ICFs estimated (a) by the linear model and (b) by Samejima's continuous-response model. The study was based on a conditioned approach and used an error-in-variables…

  12. Multi-species ion transport in ICF relevant conditions

    NASA Astrophysics Data System (ADS)

    Vold, Erik; Kagan, Grigory; Simakov, Andrei; Molvig, Kim; Yin, Lin; Albright, Brian

    2017-10-01

    Classical transport theory based on Chapman-Enskog methods provides self consistent approximations for kinetic fluxes of mass, heat and momentum for each ion species in a multi-ion plasma characterized with a small Knudsen number. A numerical method for solving the classic forms of multi-ion transport, self-consistently including heat and species mass fluxes relative to the center of mass, is given in [Kagan-Baalrud, arXiv '16] and similar transport coefficients result from recent derivations [Simakov-Molvig, PoP, '16]. We have implemented a combination of these methods in a standalone test code and in xRage, an adaptive-mesh radiation hydrodynamics code, at LANL. Transport mixing is examined between a DT fuel and a CH capsule shell in ICF conditions. The four ion species develop individual self-similar density profiles under the assumption of P-T equilibrium in 1D and show interesting early time transient pressure and center of mass velocity behavior when P-T equilibrium is not enforced. Some 2D results are explored to better understand the transport mix in combination with convective flow driven by macroscopic fluid instabilities at the fuel-capsule interface. Early transient and some 2D behaviors from the fluid transport are compared to kinetic code results. Work performed under the auspices of the U.S. DOE by the LANS, LLC, Los Alamos National Laboratory under Contract No. DE-AC52-06NA25396. Funding provided by the Advanced Simulation and Computing (ASC) Program.

  13. Return current instability driven by a temperature gradient in ICF plasmas

    DOE PAGES

    Rozmus, W.; Brantov, A. V.; Sherlock, M.; ...

    2017-10-12

    Here, hot plasmas with strong temperature gradients in inertial confinement fusion (ICF) experiments are examined for ion acoustic instabilities produced by electron heat flow. The return current instability (RCI) due to a neutralizing current of cold electrons arising in response to a large electron heat flux has been considered. First, the linear threshold and growth rates are derived in the nonlocal regime of thermal transport. They are compared with the results of Vlasov-Fokker-Planck (VFP) simulations in one spatial dimension. Very good agreement has been found between kinetic VFP simulations and the linear theory of the RCI. A quasi-stationary state ofmore » ion acoustic turbulence produced by the RCI is achieved in the VFP simulations. Saturation of the RCI involves heating of ions in the tail of the ion distribution function and convection of the enhanced ion acoustic fluctuations from the unstable region of the plasma. Further evolution of the ion acoustic turbulence and its effects on absorption and transport are also discussed.« less

  14. Ice core carbonyl sulfide measurements from a new South Pole ice core (SPICECORE)

    NASA Astrophysics Data System (ADS)

    Aydin, M.; Nicewonger, M. R.; Saltzman, E. S.

    2017-12-01

    Carbonyl sulfide (COS) is the most abundant sulfur gas in the troposphere with a present-day mixing ratio of about 500 ppt. Direct and indirect emissions from the oceans are the predominant sources of atmospheric COS. The primary removal mechanism is uptake by terrestrial plants during photosynthesis. Because plants do not respire COS, atmospheric COS levels are linked to terrestrial gross primary productivity (GPP). Ancient air trapped in polar ice cores has been used to reconstruct COS records of the past atmosphere, which can be used to infer past GPP variability and potential changes in oceanic COS emission. We are currently analyzing samples from a newly drilled intermediate depth ice core from South Pole, Antarctica (SPICECORE). This core is advantageous for studying COS because the cold temperatures of South Pole ice lead to very slow rates of in situ loss due to hydrolysis. One hundred and eighty-four bubbly ice core samples have been analyzed to date with gas ages ranging from about 9.2 thousand (733 m depth) to 75 years (126 m depth) before present. After a 2% correction for gravitational enrichment in the firn, the mean COS mixing ratio for the data set is 312±15 ppt (±1s), with the data set median also equal to 312 ppt. The only significant long-term trend in the record is a 5-10% increase in COS during the last 2-3 thousand years of the Holocene. The SPICECORE data agree with previously published ice core COS records from other Antarctic sites during times of overlap, confirming earlier estimates of COS loss rates to in situ hydrolysis in ice cores. Antarctic ice core data place strict constraints on the COS mixing ratio and its range of variability in the southern hemisphere atmosphere during the last several millennia. Implications for the atmospheric COS budget will be discussed.

  15. Standardised Outcomes in Nephrology-Children and Adolescents (SONG-Kids): a protocol for establishing a core outcome set for children with chronic kidney disease.

    PubMed

    Tong, Allison; Samuel, Susan; Zappitelli, Michael; Dart, Allison; Furth, Susan; Eddy, Allison; Groothoff, Jaap; Webb, Nicholas J A; Yap, Hui-Kim; Bockenhauer, Detlef; Sinha, Aditi; Alexander, Stephen I; Goldstein, Stuart L; Gipson, Debbie S; Hanson, Camilla S; Evangelidis, Nicole; Crowe, Sally; Harris, Tess; Hemmelgarn, Brenda R; Manns, Braden; Gill, John; Tugwell, Peter; Van Biesen, Wim; Wheeler, David C; Winkelmayer, Wolfgang C; Craig, Jonathan C

    2016-08-12

    Children with chronic kidney disease (CKD), requiring dialysis or kidney transplantation, have a mortality rate of up to 30-fold higher than the general aged-matched population, and severely impaired quality of life. Symptoms such as fatigue and pain are prevalent and debilitating. Children with CKD are at risk of cognitive impairment, and poorer educational, vocational, and psychosocial outcomes compared with their well peers, which have consequences through to adulthood. Treatment regimens for children with CKD are long-term, complex, and highly intrusive. While many trials have been conducted to improve outcomes in children with CKD, the outcomes measured and reported are often not relevant to patients and clinicians, and are highly variable. These problems can diminish the value of trials as a means to improve the lives of children with CKD. The Standardised Outcomes in Nephrology-Children and Adolescents (SONG-Kids) study aims to develop a core outcome set for trials in children and adolescents with any stage of CKD that is based on the shared priorities of all stakeholders. SONG-Kids involves five phases: a systematic review to identify outcomes (both domains and measures) that have been reported in randomised controlled trials involving children aged up to 21 years with CKD; focus groups (using nominal group technique) with adolescent patients and caregivers of paediatric patients (all ages) to identify outcomes that are relevant and important to patients and their family and the reasons for their choices; semistructured key informant interviews with health professionals involved in the care of children with CKD to ascertain their views on establishing core outcomes in paediatric nephrology; an international three-round online Delphi survey with patients, caregivers, clinicians, researchers, policy-makers, and members from industry to develop consensus on important outcome domains; and a stakeholder workshop to review and finalise the set of core outcome

  16. Multi-Fluid Interpenetration Mixing in X-ray and Directly Laser driven ICF Capsule Implosions

    NASA Astrophysics Data System (ADS)

    Wilson, Douglas

    2003-10-01

    Mix between a surrounding shell and the fuel leads to degradation in ICF capsule performance. Both indirectly (X-ray) and directly laser driven implosions provide a wealth of data to test mix models. One model, the multi-fluid interpenetration mix model of Scannapieco and Cheng (Phys. Lett. A., 299, 49, 2002), was implemented in an ICF code and applied to a wide variety of experiments (e.g. J. D. Kilkenny et al., Proc. Conf Plasm. Phys. Contr. Nuc. Fus. Res. 3, 29(1988), P. Amendt, R. E. Turner, O. L. Landen, Phy. Rev. Lett., 89, 165001 (2002), or Li et al., Phy. Rev. Lett, 89, 165002 (2002)). With its single adjustable parameter fixed, it replicates well the yield degradation with increasing convergence ratio for both directly and indirectly driven capsules. Often, but not always the ion temperatures with mixing are calculated to be higher than in an unmixed implosion, agreeing with observations. Comparison with measured directly driven implosion yield rates ( from the neutron temporal diagnostic or NTD) shows mixing increases rapidly during the burn. The model also reproduces the decrease of the fuel "rho-r" with fill gas pressure, measured by observing escaping deuterons or secondary neutrons. The mix model assumes fully atomically mixed constituents, but when experiments with deuterated plastic layers and 3He fuel are modeled, less that full atomic mix is appropriate. Applying the mix model to the ablator - solid DT interface in indirectly driven ignition capsules for the NIF or LMJ suggests that the capsules will ignite, but that burn after ignition may be somewhat degraded. Situations in which the Scannapieco and Cheng model fails to agree with experiments can guide us to improvements or the development of other models. Some directly driven symmetric implosions suggest that in highly mixed situations, a higher value of the mix parameter may needed. Others show the model underestimating the fuel burn temperature. This work was performed by the Los Alamos

  17. Transcriptional differences between normal and glioma-derived glial progenitor cells identify a core set of dysregulated genes.

    PubMed

    Auvergne, Romane M; Sim, Fraser J; Wang, Su; Chandler-Militello, Devin; Burch, Jaclyn; Al Fanek, Yazan; Davis, Danielle; Benraiss, Abdellatif; Walter, Kevin; Achanta, Pragathi; Johnson, Mahlon; Quinones-Hinojosa, Alfredo; Natesan, Sridaran; Ford, Heide L; Goldman, Steven A

    2013-06-27

    Glial progenitor cells (GPCs) are a potential source of malignant gliomas. We used A2B5-based sorting to extract tumorigenic GPCs from human gliomas spanning World Health Organization grades II-IV. Messenger RNA profiling identified a cohort of genes that distinguished A2B5+ glioma tumor progenitor cells (TPCs) from A2B5+ GPCs isolated from normal white matter. A core set of genes and pathways was substantially dysregulated in A2B5+ TPCs, which included the transcription factor SIX1 and its principal cofactors, EYA1 and DACH2. Small hairpin RNAi silencing of SIX1 inhibited the expansion of glioma TPCs in vitro and in vivo, suggesting a critical and unrecognized role of the SIX1-EYA1-DACH2 system in glioma genesis or progression. By comparing the expression patterns of glioma TPCs with those of normal GPCs, we have identified a discrete set of pathways by which glial tumorigenesis may be better understood and more specifically targeted. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

  18. Temporal Change of Seismic Earth's Inner Core Phases: Inner Core Differential Rotation Or Temporal Change of Inner Core Surface?

    NASA Astrophysics Data System (ADS)

    Yao, J.; Tian, D.; Sun, L.; Wen, L.

    2017-12-01

    Since Song and Richards [1996] first reported seismic evidence for temporal change of PKIKP wave (a compressional wave refracted in the inner core) and proposed inner core differential rotation as its explanation, it has generated enormous interests in the scientific community and the public, and has motivated many studies on the implications of the inner core differential rotation. However, since Wen [2006] reported seismic evidence for temporal change of PKiKP wave (a compressional wave reflected from the inner core boundary) that requires temporal change of inner core surface, both interpretations for the temporal change of inner core phases have existed, i.e., inner core rotation and temporal change of inner core surface. In this study, we discuss the issue of the interpretation of the observed temporal changes of those inner core phases and conclude that inner core differential rotation is not only not required but also in contradiction with three lines of seismic evidence from global repeating earthquakes. Firstly, inner core differential rotation provides an implausible explanation for a disappearing inner core scatterer between a doublet in South Sandwich Islands (SSI), which is located to be beneath northern Brazil based on PKIKP and PKiKP coda waves of the earlier event of the doublet. Secondly, temporal change of PKIKP and its coda waves among a cluster in SSI is inconsistent with the interpretation of inner core differential rotation, with one set of the data requiring inner core rotation and the other requiring non-rotation. Thirdly, it's not reasonable to invoke inner core differential rotation to explain travel time change of PKiKP waves in a very small time scale (several months), which is observed for repeating earthquakes in Middle America subduction zone. On the other hand, temporal change of inner core surface could provide a consistent explanation for all the observed temporal changes of PKIKP and PKiKP and their coda waves. We conclude that

  19. Fractographic logging for determination of pre-core and core-induced fractures: Nicholas Combs No. 7239 well, Hazard, Kentucky

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

    Kulander, B.R.; Dean, S.L.; Barton, C.C.

    1977-01-01

    Methods results, and conclusions formulated during a prototype fractographic logging study of seventy-five feet of oriented Devonian shale core are summarized. The core analyzed is from the Nicholas Combs No. 7239 well located twelve miles due north of Hazard, Kentucky. The seventy-five foot core length was taken from a cored section lying between 2369.0 feet (subsea) and 2708.0 feet (subsea). Total core length is 339.0 feet. The core was extracted from the upper Devonian Ohio and Olentangy shale formations. Results indicate that there are few tectonic (pre-core) fractures within the studied core section. The region may nevertheless be cut atmore » core sample depth by well-defined vertical or inclined tectonic fractures that the vertically drilled test core didn't intersect. This is likely since surface Plateau systematic fractures in other Plateau areas are vertical to sub-vertical and seldom have a frequency of less than one major fracture per foot. The remarkable directional preference of set three fractures about strikes of N 40/sup 0/ E, N 10/sup 0/ W, N 45/sup 0/ W, suggests some incipient pre-core rock anisotropy or stored directional strain energy. If this situation exists, the anisotropy strike change or stored strain variance from N 40/sup 0/ E to N 45/sup 0/ W downcore remains an unanswered question. Tectonic features, indicating local and/or regional movement plans, are present on and within the tectonichorizontal fracture set one. Slickensides had a preferred orientation within several core levels, and fibrous-nonfibrous calcite serves as fracture fillings.« less

  20. Independent evolution of the core and accessory gene sets in the genus Neisseria: insights gained from the genome of Neisseria lactamica isolate 020-06

    PubMed Central

    2010-01-01

    Background The genus Neisseria contains two important yet very different pathogens, N. meningitidis and N. gonorrhoeae, in addition to non-pathogenic species, of which N. lactamica is the best characterized. Genomic comparisons of these three bacteria will provide insights into the mechanisms and evolution of pathogenesis in this group of organisms, which are applicable to understanding these processes more generally. Results Non-pathogenic N. lactamica exhibits very similar population structure and levels of diversity to the meningococcus, whilst gonococci are essentially recent descendents of a single clone. All three species share a common core gene set estimated to comprise around 1190 CDSs, corresponding to about 60% of the genome. However, some of the nucleotide sequence diversity within this core genome is particular to each group, indicating that cross-species recombination is rare in this shared core gene set. Other than the meningococcal cps region, which encodes the polysaccharide capsule, relatively few members of the large accessory gene pool are exclusive to one species group, and cross-species recombination within this accessory genome is frequent. Conclusion The three Neisseria species groups represent coherent biological and genetic groupings which appear to be maintained by low rates of inter-species horizontal genetic exchange within the core genome. There is extensive evidence for exchange among positively selected genes and the accessory genome and some evidence of hitch-hiking of housekeeping genes with other loci. It is not possible to define a 'pathogenome' for this group of organisms and the disease causing phenotypes are therefore likely to be complex, polygenic, and different among the various disease-associated phenotypes observed. PMID:21092259

  1. Simulating an Exploding Fission-Bomb Core

    NASA Astrophysics Data System (ADS)

    Reed, Cameron

    2016-03-01

    A time-dependent desktop-computer simulation of the core of an exploding fission bomb (nuclear weapon) has been developed. The simulation models a core comprising a mixture of two isotopes: a fissile one (such as U-235) and an inert one (such as U-238) that captures neutrons and removes them from circulation. The user sets the enrichment percentage and scattering and fission cross-sections of the fissile isotope, the capture cross-section of the inert isotope, the number of neutrons liberated per fission, the number of ``initiator'' neutrons, the radius of the core, and the neutron-reflection efficiency of a surrounding tamper. The simulation, which is predicated on ordinary kinematics, follows the three-dimensional motions and fates of neutrons as they travel through the core. Limitations of time and computer memory render it impossible to model a real-life core, but results of numerous runs clearly demonstrate the existence of a critical mass for a given set of parameters and the dramatic effects of enrichment and tamper efficiency on the growth (or decay) of the neutron population. The logic of the simulation will be described and results of typical runs will be presented and discussed.

  2. 75 FR 52596 - Financial Education Core Competencies; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-26

    ... DEPARTMENT OF THE TREASURY Financial Education Core Competencies; Comment Request AGENCY..., in its capacity as Chairperson of the Financial Literacy and Education Commission (``Commission''), invites the public to comment on a proposed set of financial education core competencies (``Core...

  3. Inner Core Structure Behind the PKP Core Phase Triplication

    NASA Astrophysics Data System (ADS)

    Blom, N.; Paulssen, H.; Deuss, A. F.; Waszek, L.

    2015-12-01

    Despite its small size, the Earth's inner core plays an important role in the Earth's dynamics. Because it is slowly growing, its structure - and the variation thereof with depth - may reveal important clues about the history of the core, its convection and the resulting geodynamo. Learning more about this structure has been a prime effort in the past decades, leading to discoveries about anisotropy, hemispheres and heterogeneity in the inner core in general. In terms of detailed structure, mainly seismic body waves have contributed to these advances. However, at depths between ~100-200 km, the seismic structure is relatively poorly known. This is a result of the PKP core phase triplication and the existence of strong precursors to PKP phases, whose simultaneous arrival hinders the measurement of inner core waves PKIKP at epicentral distances between roughly 143-148°. As a consequence, the interpretation of deeper structure also remains difficult. To overcome these issues, we stack seismograms in slowness and time, separating PKP and PKIKP phases which arrive simultaneously, but with different slowness. We apply this method to study the inner core's Western hemisphere between South and Central America using paths travelling in the quasi-polar direction between epicentral distances of 140-150°. This enables us to measure PKiKP-PKIKP differential travel times up to greater epicentral distance than has previously been done. The resulting differential travel time residuals increase with epicentral distance, indicating a marked increase in seismic velocity with depth compared to reference model AK135 for the studied polar paths. Assuming a homogeneous outer core, these findings can be explained by either (i) inner core heterogeneity due to an increase in isotropic velocity, or (ii) increase in anisotropy over the studied depth range. Our current data set cannot distinguish between the two hypotheses, but in light of previous work we prefer the latter interpretation.

  4. Understanding recovery: changes in the relationships of the International Classification of Functioning (ICF) components over time.

    PubMed

    Davis, A M; Perruccio, A V; Ibrahim, S; Hogg-Johnson, S; Wong, R; Badley, E M

    2012-12-01

    The International Classification of Functioning, Disability and Health framework describes human functioning through body structure and function, activity and participation in the context of a person's social and physical environment. This work tested the temporal relationships of these components. Our hypotheses were: 1) there would be associations among physical impairment, activity limitations and participation restrictions within time; 2) prior status of a component would be associated with future status; 3) prior status of one component would influence status of a second component (e.g. prior activity limitations would be associated with current participation restrictions); and, 4) the magnitude of the within time relationships of the components would vary over time. Participants from Canada with primary hip or knee joint replacement (n = 931), an intervention with predictable improvement in pain and disability, completed standardized outcome measures pre-surgery and five times in the first year post-surgery. These included physical impairment (pain), activity limitations and participation restrictions. ICF component relationships were evaluated cross-sectionally and longitudinally using path analysis adjusting for age, sex, BMI, hip vs. knee, low back pain and mood. All component scores improved significantly over time. The path coefficients supported the hypotheses in that both within and across time, physical impairment was associated with activity limitation and activity limitation was associated with participation restriction; prior status and change in a component were associated with current status in another component; and, the magnitude of the path coefficients varied over time with stronger associations among components to three months post surgery than later in recovery with the exception of the association between impairment and participation restrictions which was of similar magnitude at all times. This work enhances understanding of the

  5. Adolescents with disabilities participate in the shopping mall: facilitators and barriers framed according to the ICF.

    PubMed

    Dahan-Oliel, Noémi; Shikako-Thomas, Keiko; Mazer, Barbara; Majnemer, Annette

    2016-10-01

    Community participation is restricted for youth with disabilities. The mall is an important gathering place where adolescents often socialise and develop community living skills, yet participation may be restricted. The aim of this study was to evaluate the facilitators and barriers to participation in a shopping mall through the perspectives of adolescents with disabilities. Semi-structured individual interviews were conducted with adolescents aged 12-19 years with a physical and/or sensory disability. Audio recordings were transcribed verbatim and coded following a template analysis using the International Classification of Functioning Disability and Health (ICF). Eleven youth (six females, mean age = 17.0 years) participated. Medical conditions included visual impairment, hearing impairment, cerebral palsy, hemiplegia, osteogenesis imperfecta and congenital amputations. Six themes were identified by the adolescents: what the shopping mall means to me, physical environment, transportation, social factors, attitudes and the person. The majority of themes mapped to the ICF's 'environmental factors'. Facilitators and barriers identified were either generic or disability-specific, implying that some modifications to shopping malls may be beneficial across disability types. Changes made to the physical, social and attitudinal environment are required to enable full participation of youth with disabilities within a shopping mall and other built environments of high public access. Implications for Rehabilitation The meaning of the shopping mall according to youth with disabilities includes socialisation, shopping, getting out of the home and employment. The majority of themes mapped to 'environmental factors' indicating that most obstacles to participation are caused by environmental barriers. Facilitators and barriers identified were either generic or disability-specific implying that some modifications to shopping malls may be beneficial across disability types

  6. Introducing the ICF: the development of an online resource to support learning, teaching and curriculum design.

    PubMed

    Jones, Lester E

    2011-03-01

    The International Classification of Functioning, Disability and Health (ICF) was adopted as one of the key models to support early health professional learning across a suite of new preregistration health science courses. It was decided that an online resource should be developed to enable students, course designers and teaching staff, across all disciplines, to have access to the same definitions, government policies and other supporting information on disability. As part of the comprehensive curriculum review, enquiry-based learning was adopted as the educational approach. Enquiry-based learning promotes deeper learning by encouraging students to engage in authentic challenges. As such, it was important that the online resource was not merely a site for accessing content, but enabled students to make decisions about where else to explore for credible information about the ICF. The selection of a host location that all students and staff could access meant that the resource could not be located in the existing online learning management system. Construction using software being trialled by the library at La Trobe University allowed for the required access, as well as alignment with an enquiry-based learning approach. Consultation for the content of the online resource included formal and informal working groups on curriculum review. The published version included resources from the World Health Organization, examples of research completed within different disciplines, a test of knowledge and a preformatted search page. The format of the online resource allows for updating of information, and feedback on the utilisation of the software has been used to enhance the student experience. The key issues for the development of this online resource were accessibility for students and staff, alignment with the adopted educational approach, consultation with all disciplines, and ease of modification of information and format once published. Copyright © 2010 Chartered

  7. Estimation and Control for Autonomous Coring from a Rover Manipulator

    NASA Technical Reports Server (NTRS)

    Hudson, Nicolas; Backes, Paul; DiCicco, Matt; Bajracharya, Max

    2010-01-01

    A system consisting of a set of estimators and autonomous behaviors has been developed which allows robust coring from a low-mass rover platform, while accommodating for moderate rover slip. A redundant set of sensors, including a force-torque sensor, visual odometry, and accelerometers are used to monitor discrete critical and operational modes, as well as to estimate continuous drill parameters during the coring process. A set of critical failure modes pertinent to shallow coring from a mobile platform is defined, and autonomous behaviors associated with each critical mode are used to maintain nominal coring conditions. Autonomous shallow coring is demonstrated from a low-mass rover using a rotary-percussive coring tool mounted on a 5 degree-of-freedom (DOF) arm. A new architecture of using an arm-stabilized, rotary percussive tool with the robotic arm used to provide the drill z-axis linear feed is validated. Particular attention to hole start using this architecture is addressed. An end-to-end coring sequence is demonstrated, where the rover autonomously detects and then recovers from a series of slip events that exceeded 9 cm total displacement.

  8. Evaluation of Ceramic Honeycomb Core Compression Behavior at Room Temperature

    NASA Technical Reports Server (NTRS)

    Bird, Richard K.; Lapointe, Thomas S.

    2013-01-01

    Room temperature flatwise compression tests were conducted on two varieties of ceramic honeycomb core specimens that have potential for high-temperature structural applications. One set of specimens was fabricated using strips of a commercially-available thin-gage "ceramic paper" sheet molded into a hexagonal core configuration. The other set was fabricated by machining honeycomb core directly from a commercially available rigid insulation tile material. This paper summarizes the results from these tests.

  9. Examining the Disability Model From the International Classification of Functioning, Disability, and Health Using a Large Data Set of Community-Dwelling Malaysian Older Adults

    PubMed Central

    Loke, Seng Cheong; Lim, Wee Shiong; Someya, Yoshiko; Hamid, Tengku A.; Nudin, Siti S. H.

    2015-01-01

    Objective: This study examines the International Classification of Functioning, Disability, and Health model (ICF) using a data set of 2,563 community-dwelling elderly with disease-independent measures of mobility, physical activity, and social networking, to represent ICF constructs. Method: The relationship between chronic disease and disability (independent and dependent variables) was examined using logistic regression. To demonstrate variability in activity performance with functional impairment, graphing was used. The relationship between functional impairment, activity performance, and social participation was examined graphically and using ANOVA. The impact of cognitive deficits was quantified through stratifying by dementia. Results: Disability is strongly related to chronic disease (Wald 25.5, p < .001), functional impairment with activity performance (F = 34.2, p < .001), and social participation (F= 43.6, p < .001). With good function, there is considerable variability in activity performance (inter-quartile range [IQR] = 2.00), but diminishes with high impairment (IQR = 0.00) especially with cognitive deficits. Discussion: Environment modification benefits those with moderate functional impairment, but not with higher grades of functional loss. PMID:26472747

  10. TREatment of ATopic eczema (TREAT) Registry Taskforce: protocol for an international Delphi exercise to identify a core set of domains and domain items for national atopic eczema registries.

    PubMed

    Gerbens, Louise A A; Boyce, Aaron E; Wall, Dmitri; Barbarot, Sebastien; de Booij, Richard J; Deleuran, Mette; Middelkamp-Hup, Maritza A; Roberts, Amanda; Vestergaard, Christian; Weidinger, Stephan; Apfelbacher, Christian J; Irvine, Alan D; Schmitt, Jochen; Williamson, Paula R; Spuls, Phyllis I; Flohr, Carsten

    2017-02-27

    Patients with moderate-to-severe atopic eczema (AE) often require photo- or systemic immunomodulatory therapies to induce disease remission and maintain long-term control. The current evidence to guide clinical management is small, despite the frequent and often off-label use of these treatments. Registries of patients on photo- and systemic immunomodulatory therapies could fill this gap, and the collection of a core set concerning these therapies in AE will allow direct comparisons across registries as well as data sharing and pooling. Using an eDelphi approach, the international TREatment of ATopic eczema (TREAT) Registry Taskforce aims to seek consensus between key stakeholders internationally on a core set of domains and domain items for AE patient registries with a research focus that collect data of children and adults on photo- and systemic immunomodulatory therapies. Participants from six stakeholder groups will be invited: doctors, nurses, non-clinical researchers, patients, as well as industry and regulatory body representatives. The eDelphi will comprise three sequential online rounds, requesting participants to rate the importance of each proposed domain and domain items. Participants will be able to add domains and domain items to the proposed list in round 1. A final consensus meeting will be held with representatives of each stakeholder group. Identifying a uniform core set of domains and domain items to be captured by AE patient registries will increase the utility of individual registries, and provide greater insight into the effectiveness, safety and cost-effectiveness of photo- and systemic immunomodulatory therapies to guide clinical management across dermatology centres and country borders. Not applicable. This eDelphi study was registered in the Core Outcome Measures for Effectiveness Trials (COMET) database.

  11. Using the International Classification of Functioning, Disability and Health in Assessment and Intervention of School-Aged Children With Language Impairments.

    PubMed

    Westby, Carol; Washington, Karla N

    2017-07-26

    The aim of this tutorial is to support speech-language pathologists' (SLPs') application of the International Classification of Functioning, Disability and Health (ICF) in assessment and treatment practices with children with language impairment. This tutorial reviews the framework of the ICF, describes the implications of the ICF for SLPs, distinguishes between students' capacity to perform a skill in a structured context and the actual performance of that skill in naturalistic contexts, and provides a case study of an elementary school child to demonstrate how the principles of the ICF can guide assessment and intervention. The Scope of Practice and Preferred Practice documents for the American Speech-Language-Hearing Association identify the ICF as the framework for practice in speech-language pathology. This tutorial will facilitate clinicians' ability to identify personal and environmental factors that influence students' skill capacity and skill performance, assess students' capacity and performance, and develop impairment-based and socially based language goals linked to Common Core State Standards that build students' language capacity and their communicative performance in naturalistic contexts.

  12. Exploring the relationships between International Classification of Functioning, Disability and Health (ICF) constructs of Impairment, Activity Limitation and Participation Restriction in people with osteoarthritis prior to joint replacement.

    PubMed

    Pollard, Beth; Johnston, Marie; Dieppe, Paul

    2011-05-16

    The International Classification of Functioning, Disability and Health (ICF) proposes three main constructs, impairment (I), activity limitation (A) and participation restriction (P). The ICF model allows for all paths between the constructs to be explored, with significant paths likely to vary for different conditions. The relationships between I, A and P have been explored in some conditions but not previously in people with osteoarthritis prior to joint replacement. The aim of this paper is to examine these relationships using separate measures of each construct and structural equation modelling. A geographical cohort of 413 patients with osteoarthritis about to undergo hip and knee joint replacement completed the Aberdeen measures of Impairment, Activity Limitation and Participation Restriction (Ab-IAP). Confirmatory factor analysis was used to test the three factor (I, A, P) measurement model. Structural equation modelling was used to explore the I, A and P pathways in the ICF model. There was support from confirmatory factor analysis for the three factor I, A, P measurement model. The structural equation model had good fit [S-B Chi-square = 439.45, df = 149, CFI robust = 0.91, RMSEA robust = 0.07] and indicated significant pathways between I and A (standardised coefficient = 0.76 p < 0.0001) and between A and P (standardised coefficient = 0.75 p < 0.0001). However, the path between I and P was not significant (standardised coefficient = 0.01). The significant pathways suggest that treatments and interventions aimed at reducing impairment, such as joint replacement, may only affect P indirectly, through A, however, longitudinal data would be needed to establish this.

  13. Adolescents with Hearing Loss and the International Classification of Functioning, Health, and Disability: Children & Youth Version

    PubMed Central

    English, Kris; Pajevic, Emily

    2016-01-01

    In 2007, the World Health Organization published a set of International Classification of Functioning, Disability and Health (ICF) codes designed for children and youth (ICF-CY version). The ICF-CY considers typical developmental changes associated with childhood while describing health status and the effects of intervention. In this article we will describe how a specific intervention (transition planning for adolescents) can be documented with the ICF-CY. Transition planning in health care prepares adolescents and their families for the transfer from pediatric to adult health services and has been demonstrated to be an effective practice for adolescents with many types of chronic health conditions (e.g., cystic fibrosis, epilepsy, diabetes). Audiology has not yet addressed transition planning for adolescents with hearing loss; therefore, we propose using the ICF-CY to design a pathway of care. The ICF-CY can standardize transition planning to the benefit of both teen patients and audiologists: teens and their families would gradually acquire necessary knowledge and skills, and audiologists would develop a meaningful data set to help further inform our pediatric practices, as well as give more structure, depth, and accountability to our role in rehabilitation. PMID:27489402

  14. Hardware/software codesign for embedded RISC core

    NASA Astrophysics Data System (ADS)

    Liu, Peng

    2001-12-01

    This paper describes hardware/software codesign method of the extendible embedded RISC core VIRGO, which based on MIPS-I instruction set architecture. VIRGO is described by Verilog hardware description language that has five-stage pipeline with shared 32-bit cache/memory interface, and it is controlled by distributed control scheme. Every pipeline stage has one small controller, which controls the pipeline stage status and cooperation among the pipeline phase. Since description use high level language and structure is distributed, VIRGO core has highly extension that can meet the requirements of application. We take look at the high-definition television MPEG2 MPHL decoder chip, constructed the hardware/software codesign virtual prototyping machine that can research on VIRGO core instruction set architecture, and system on chip memory size requirements, and system on chip software, etc. We also can evaluate the system on chip design and RISC instruction set based on the virtual prototyping machine platform.

  15. The AVRDC - The World Vegetable Center mungbean (Vigna radiata) core and mini core collections.

    PubMed

    Schafleitner, Roland; Nair, Ramakrishnan Madhavan; Rathore, Abhishek; Wang, Yen-wei; Lin, Chen-yu; Chu, Shu-hui; Lin, Pin-yun; Chang, Jian-Cheng; Ebert, Andreas W

    2015-04-29

    Large ex situ germplasm collections generally harbor a wide range of crop diversity. AVRDC--The World Vegetable Center is holding in trust the world's second largest mungbean (Vigna radiata) germplasm collection with more than 6,700 accessions. Screening large collections for traits of interest is laborious and expensive. To enhance the access of breeders to the diversity of the crop, mungbean core and mini core collections have been established. The core collection of 1,481 entries has been built by random selection of 20% of the accessions after geographical stratification and subsequent cluster analysis of eight phenotypic descriptors in the whole collection. Summary statistics, especially the low differences of means, equal variance of the traits in both the whole and core collection and the visual inspection of quantile-quantile plots comparing the variation of phenotypic traits present in both collections indicated that the core collection well represented the pattern of diversity of the whole collection. The core collection was genotyped with 20 simple sequence repeat markers and a mini core set of 289 accessions was selected, which depicted the allele and genotype diversity of the core collection. The mungbean core and mini core collections plus their phenotypic and genotypic data are available for distribution to breeders. It is expected that these collections will enhance the access to biodiverse mungbean germplasm for breeding.

  16. Scaling of Liquid DT Layer Capsules to an ICF Burning Plasma

    NASA Astrophysics Data System (ADS)

    Olson, R. E.; Peterson, R. R.; Haines, B. M.; Yi, S. A.; Bradley, P. A.; Zylstra, A. B.; Kline, J. L.; Leeper, R. J.; Batha, S. H.

    2017-10-01

    Recent experiments at the NIF demonstrated cryogenic liquid DT layer ICF implosions. Unlike DT ice layer implosions, DT liquid layer designs can operate with low-to-moderate convergence ratio (12

  17. Common Core State Standards 101

    ERIC Educational Resources Information Center

    Rothman, Robert

    2013-01-01

    The Common Core State Standards (CCSS) represent the first time that nearly every state has set common expectations for what students should know and be able to do. In the past, each state set its own standards, and the results varied widely. And while states collectively developed these common standards, decisions about the curriculum and…

  18. Developing a core outcome set for chronic rhinosinusitis: a systematic review of outcomes utilised in the current literature.

    PubMed

    Soni-Jaiswal, Archana; Lakhani, Raj; Hopkins, Claire

    2017-07-11

    A core outcome set (COS) is an agreed standardised collection of outcomes that should be measured and reported by all trials for a specific clinical area, in this case chronic rhinosinusitis. These are not restrictive and researchers may continue to explore other outcomes alongside these that they feel are relevant to their intervention. The aim of this systematic review was to identify the need for a COS for chronic rhinosinusitis. A sensitive search strategy was used to identify all published Cochrane systematic reviews and randomised control trials of intervention for adult patients with chronic rhinosinusitis. Two independent authors reviewed these to obtain a list of outcomes and outcome measures reported by each clinical trial. Sixty-nine randomised control trials and eight Cochrane systematic reviews were included in this study. They reported 68 individual outcomes and outcome measures, with an average of four to ten outcomes per clinical trial. These outcomes were mapped to 23 subcategories belonging to eight core categories. The key finding of this review was the heterogeneity of outcomes reported and measured by clinical trials of patients with chronic rhinosinusitis, precluding meaningful meta-analysis of data. This review supports the need for development of a COS, to be used in future trials on adult patients with chronic rhinosinusitis.

  19. Unique capabilities for ICF and HEDP research with the KrF laser

    NASA Astrophysics Data System (ADS)

    Obenschain, Stephen; Bates, Jason; Chan, Lop-Yung; Karasik, Max; Kehne, David; Sethian, John; Serlin, Victor; Weaver, James; Oh, Jaechul; Jenkins, Bruce; Lehmberg, Robert; Hegeler, Frank; Terrell, Stephen; Aglitskiy, Yefim; Schmitt, Andrew

    2014-10-01

    The krypton-fluoride (KrF) laser provides the shortest wavelength, broadest bandwidth and most uniform target illumination of all developed high-energy lasers. For directly driven targets these characteristics result in higher and more uniform ablation pressures as well as higher intensity thresholds for laser-plasma instability. The ISI beam smoothing scheme implemented on the NRL Nike KrF facility allows easy implementation of focal zooming where the laser radial profile is varied during the laser pulse. The capability for near continuous zooming with KrF would be valuable towards minimizing the effects of cross beam energy transport (CBET) in directly driven capsule implosions. The broad bandwidth ISI beam smoothing that is utilized with the Nike KrF facility may further inhibit certain laser plasma instability. In this presentation we will summarize our current understanding of laser target interaction with the KrF laser and the benefits it provides for ICF and certain HEDP experiments. Status and progress in high-energy KrF laser technology will also be discussed. Work supported by the Deparment of Energy, NNSA.

  20. TREatment of ATopic eczema (TREAT) Registry Taskforce: An international Delphi exercise to identify a core set of domains and domain items for national atopic eczema photo- and systemic therapy registries.

    PubMed

    Gerbens, L A A; Apfelbacher, C J; Irvine, A D; Barbarot, S; de Booij, R J; Boyce, A E; Deleuran, M; Eichenfield, L F; Hof, M H; Middelkamp-Hup, M A; Roberts, A; Schmitt, J; Vestergaard, C; Wall, D; Weidinger, S; Williamson, P R; Flohr, C; Spuls, P I

    2018-05-15

    Evidence of immunomodulatory therapies to guide clinical management for atopic eczema (AE) is scarce, despite frequent and often off-label use. Patient registries provide valuable evidence for the effects of treatments under real world conditions which can inform treatment guidelines, give the opportunity for health economic evaluation and the evaluation of quality of care, as well as pharmacogenetic and -dynamic research which cannot be adequately addressed in clinical trials. The TREatment of ATopic eczema (TREAT) Registry Taskforce aims to seek international consensus on a core set of domains and items ('what to measure') for AE research registries, using a Delphi approach. Participants from six stakeholder groups were included: doctors, nurses, non-clinical researchers, patients, industry and regulatory body representatives. The eDelphi comprised 3 sequential online rounds, requesting participants to rate the importance of each proposed domain item. Participants could add domain items to the proposed list in round 1. A final consensus meeting was held to ratify the core set. 479 participants from 36 countries accessed the eDelphi platform, of whom 86%, 79% and 74% completed rounds 1, 2, and 3 respectively. At the face-to-face consensus meeting attended by 42 participants the final core set was established containing 19 domains with 69 domain items (49 baseline and 20 follow-up items). This core set of domains and items to be captured by national AE systemic therapy registries will standardise data collection and thereby allow direct comparability across registries and facilitate data pooling between countries. Ultimately, it will provide greater insight into the effectiveness, safety and cost-effectiveness of photo- and systemic immunomodulatory therapies. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  1. Synthetic enzyme mixtures for biomass deconstruction: production and optimization of a core set.

    PubMed

    Banerjee, Goutami; Car, Suzana; Scott-Craig, John S; Borrusch, Melissa S; Aslam, Nighat; Walton, Jonathan D

    2010-08-01

    The high cost of enzymes is a major bottleneck preventing the development of an economically viable lignocellulosic ethanol industry. Commercial enzyme cocktails for the conversion of plant biomass to fermentable sugars are complex mixtures containing more than 80 proteins of suboptimal activities and relative proportions. As a step toward the development of a more efficient enzyme cocktail for biomass conversion, we have developed a platform, called GENPLAT, that uses robotic liquid handling and statistically valid experimental design to analyze synthetic enzyme mixtures. Commercial enzymes (Accellerase 1000 +/- Multifect Xylanase, and Spezyme CP +/- Novozyme 188) were used to test the system and serve as comparative benchmarks. Using ammonia-fiber expansion (AFEX) pretreated corn stover ground to 0.5 mm and a glucan loading of 0.2%, an enzyme loading of 15 mg protein/g glucan, and 48 h digestion at 50 degrees C, commercial enzymes released 53% and 41% of the available glucose and xylose, respectively. Mixtures of three, five, and six pure enzymes of Trichoderma species, expressed in Pichia pastoris, were systematically optimized. Statistical models were developed for the optimization of glucose alone, xylose alone, and the average of glucose + xylose for two digestion durations, 24 and 48 h. The resulting models were statistically significant (P < 0.0001) and indicated an optimum composition for glucose release (values for optimized xylose release are in parentheses) of 29% (5%) cellobiohydrolase 1, 5% (14%) cellobiohydrolase 2, 25% (25%) endo-beta1,4-glucanase 1, 14% (5%) beta-glucosidase, 22% (34%) endo-beta1,4-xylanase 3, and 5% (17%) beta-xylosidase in 48 h at a protein loading of 15 mg/g glucan. Comparison of two AFEX-treated corn stover preparations ground to different particle sizes indicated that particle size (100 vs. 500 microm) makes a large difference in total digestibility. The assay platform and the optimized "core" set together provide a starting

  2. Supplemental materials for the ICDP-USGS Eyreville A, B, and C core holes, Chesapeake Bay impact structure: Core-box photographs, coring-run tables, and depth-conversion files

    USGS Publications Warehouse

    Durand, C.T.; Edwards, L.E.; Malinconico, M.L.; Powars, D.S.

    2009-01-01

    During 2005-2006, the International Continental Scientific Drilling Program and the U.S. Geological Survey drilled three continuous core holes into the Chesapeake Bay impact structure to a total depth of 1766.3 m. A collection of supplemental materials that presents a record of the core recovery and measurement data for the Eyreville cores is available on CD-ROM at the end of this volume and in the GSA Data Repository. The supplemental materials on the CD-ROM include digital photographs of each core box from the three core holes, tables of the three coring-run logs, as recorded on site, and a set of depth-conversion programs. In this chapter, the contents, purposes, and basic applications of the supplemental materials are briefly described. With this information, users can quickly decide if the materials will apply to their specific research needs. ?? 2009 The Geological Society of America.

  3. Core Outcome Measures in Effectiveness Trials (COMET) initiative: protocol for an international Delphi study to achieve consensus on how to select outcome measurement instruments for outcomes included in a 'core outcome set'.

    PubMed

    Prinsen, Cecilia A C; Vohra, Sunita; Rose, Michael R; King-Jones, Susanne; Ishaque, Sana; Bhaloo, Zafira; Adams, Denise; Terwee, Caroline B

    2014-06-25

    The Core Outcome Measures in Effectiveness Trials (COMET) initiative aims to facilitate the development and application of 'core outcome sets' (COS). A COS is an agreed minimum set of outcomes that should be measured and reported in all clinical trials of a specific disease or trial population. The overall aim of the Core Outcome Measurement Instrument Selection (COMIS) project is to develop a guideline on how to select outcome measurement instruments for outcomes included in a COS. As part of this project, we describe our current efforts to achieve a consensus on the methods for selecting outcome measurement instruments for outcomes to be included in a COS. A Delphi study is being performed by a panel of international experts representing diverse stakeholders with the intention that this will result in a guideline for outcome measurement instrument selection. Informed by a literature review, a Delphi questionnaire was developed to identify potentially relevant tasks on instrument selection. The Delphi study takes place in a series of rounds. In the first round, panelists were asked to rate the importance of different tasks in the selection of outcome measurement instruments. They were encouraged to justify their choices and to add other relevant tasks. Consensus was reached if at least 70% of the panelists considered a task 'highly recommended' or 'desirable' and if no opposing arguments were provided. These tasks will be included in the guideline. Tasks that at least 50% of the panelists considered 'not relevant' will be excluded from the guideline. Tasks that were indeterminate will be taken to the second round. All responses of the first round are currently being aggregated and will be fed back to panelists in the second round. A third round will only be performed if the results of the second round require it. Since the Delphi method allows a large group of international experts to participate, we consider it to be the preferred consensus-based method for our

  4. Multiple genome alignment for identifying the core structure among moderately related microbial genomes.

    PubMed

    Uchiyama, Ikuo

    2008-10-31

    Identifying the set of intrinsically conserved genes, or the genomic core, among related genomes is crucial for understanding prokaryotic genomes where horizontal gene transfers are common. Although core genome identification appears to be obvious among very closely related genomes, it becomes more difficult when more distantly related genomes are compared. Here, we consider the core structure as a set of sufficiently long segments in which gene orders are conserved so that they are likely to have been inherited mainly through vertical transfer, and developed a method for identifying the core structure by finding the order of pre-identified orthologous groups (OGs) that maximally retains the conserved gene orders. The method was applied to genome comparisons of two well-characterized families, Bacillaceae and Enterobacteriaceae, and identified their core structures comprising 1438 and 2125 OGs, respectively. The core sets contained most of the essential genes and their related genes, which were primarily included in the intersection of the two core sets comprising around 700 OGs. The definition of the genomic core based on gene order conservation was demonstrated to be more robust than the simpler approach based only on gene conservation. We also investigated the core structures in terms of G+C content homogeneity and phylogenetic congruence, and found that the core genes primarily exhibited the expected characteristic, i.e., being indigenous and sharing the same history, more than the non-core genes. The results demonstrate that our strategy of genome alignment based on gene order conservation can provide an effective approach to identify the genomic core among moderately related microbial genomes.

  5. Diversity captured in the USDA-ARS National Plant Germplasm System apple core collection

    USDA-ARS?s Scientific Manuscript database

    Core collections have been used widely in genetic resources to provide a representative and compact sample to use in breeding evaluation. In the 1990s a core set was developed by the USDA-ARS Plant Genetic Resources Unit (PGRU) in Geneva, NY. Using data available at the time, a core set was develo...

  6. The Use of the International Classification of Functioning, Disability and Health, Version for Children and Youth (ICF-CY), in Portuguese Special Education Assessment and Eligibility Procedures: The Professionals' Perceptions

    ERIC Educational Resources Information Center

    Sanches-Ferreira, Manuela; Silveira-Maia, Mónica; Alves, Sílvia

    2014-01-01

    Portugal was the first country decreeing the mandatory use of the International Classification of Functioning, Disability and Health: Child and Youth (ICF-CY) framework for guiding special education assessment process and to base eligibility decision-making on students' functioning profiles--in contrast with traditional approaches centred on…

  7. The severity and associated factors of participation restriction among community-dwelling frail older people: an application of the International Classification of Functioning, Disability and Health (WHO-ICF).

    PubMed

    Liu, Justina Yat Wa

    2017-01-31

    The International Classification of Functioning, Disability, and Health (WHO-ICF) describes participation restriction as one aspect of disability. Participation restriction refers to health problems that can hinder people's involvement in different life events. It is rational to believe that the prevalence of participation restriction increases among a frail population. However, information about the level of participation restriction among older people, particularly the pre-frail or frail, remains scant. The aim of this study was to identify the prevalence and underlying risk factors associated with participation restriction among community-dwelling frail and pre-frail older people. A cross-section of 299 community-dwelling frail older people with a mean age of 79.5 participated in this study. They had to have been identified as being either pre-frail or frail based on the five common characteristics of the frailty phenotype. Their level of participation restriction was assessed based on the Chinese Reintegration to Nursing Living Index (C-RNLI). All other independent variables were identified and systematically linked to different components in the WHO-ICF framework. Among all participants, 207 (69.2%) were identified as encountering participation restrictions in at least one aspect of their life, with a mean C-RNLI score of 68.3 (SD 19.43). A multivariate regression analysis showed that the participants' status of frailty, self-perceived social status, level of exhibited depressive mood, sleep quality, mobility, level of fear of falling, and physical activity levels had a significant association with participation restriction. When all of the variables, regardless of significance, were included, the factors together explained 67.1% of the variance in the participants' participation restriction. Participation restriction was prevalent among community-dwelling frail older people and was associated with factors across different components in the WHO-ICF. This

  8. Kinetic studies of ICF implosions

    DOE PAGES

    Kagan, Grigory; Herrmann, H. W.; Kim, Y. -H.; ...

    2016-05-26

    Here, kinetic effects on inertial confinement fusion have been investigated. In particular, inter-ion-species diffusion and suprathermal ion distribution have been analyzed. The former drives separation of the fuel constituents in the hot reacting core and governs mix at the shell/fuel interface. The latter underlie measurements obtained with nuclear diagnostics, including the fusion yield and inferred ion burn temperatures. Basic mechanisms behind and practical consequences from these effects are discussed.

  9. Laser Hole Boring into Overdense Plasma and Relativistic Electron Currents for Fast Ignition of ICF Targets

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

    Pukhov, A.; Meyer-ter-Vehn, J.

    Laser hole boring and relativistic electron transport into plasma of 10 times critical density is studied by means of 2D particle-in-cell simulation. At intensities of I{sub 0}{lambda}{sup 2}=10{sup 20} W(cm){sup {minus}2} {mu}m{sup 2}, a channel 12{lambda} deep and 3{lambda} in diameter has formed after 200 laser cycles. The laser driven electron current carries up to 40{percent} of the incident laser power. When penetrating the overdense region, it breaks up into several filaments at early times, but is channeled into a single magnetized jet later on. These features are essential for fast ignition of targets for inertial confinement fusion (ICF). {copyright}more » {ital 1997} {ital The American Physical Society}« less

  10. Photodissociation of CF2ICF2I in solid para-hydrogen: infrared spectra of anti- and gauche-˙C2F4I radicals.

    PubMed

    Haupa, Karolina Anna; Lim, Manho; Lee, Yuan-Pern

    2018-05-09

    The photolysis of 1,2-diiodotetrafluoroethane (CF2ICF2I) has served as a prototypical system in ultrafast reaction dynamics. Even though the intermediates, anti- and gauche-iodotetrafluoroethyl (˙C2F4I) radicals, have been characterized with electron diffraction and X-ray diffraction, their infrared spectra are unreported. We report the formation and infrared identification of these radical intermediates upon ultraviolet photodissociation of CF2ICF2I in solid para-hydrogen (p-H2) at 3.3 K. Lines at 1364.9/1358.5, 1283.2, 1177.1, 1162.2, 1126.8, 837.3, 658.0, 574.2, and 555.2 cm-1 are assigned to anti-˙C2F4I, and lines at 1325.9, 1259.7, 1143.4, 1063.4, 921.0, and 765.3 cm-1 to gauche-˙C2F4I. A secondary photodissociation leading to C2F4 was also observed. The assignments were derived according to behavior on secondary photolysis, comparison of the vibrational wavenumbers and the IR intensities of the observed lines with values predicted with the B3PW91/aug-cc-pVTZ-pp method. This spectral identification provides valuable information for future direct spectral probes of these important intermediates.

  11. NETS1HD: study protocol for development of a core outcome set for use in determining the overall success of Hirschsprung's disease treatment.

    PubMed

    Allin, Benjamin; Bradnock, Timothy; Kenny, Simon; Walker, Gregor; Knight, Marian

    2016-12-07

    Use of core outcome sets in research has been proposed as a method for countering the problems caused by heterogeneity of outcome measure reporting. Heterogeneity of outcome measure reporting occurs in Hirschsprung's disease (HD) research and is limiting the development of a robust evidence base to support clinical practice. Candidate outcome measures have been identified through a systematic review. These outcome measures will form the starting point for a three-phase online Delphi process to be carried out in parallel by three panels of experts. Panel 1 is a neonatal panel; panel 2 is a non-neonatal panel; and panel 3 is a lay panel. In round 1, experts will be asked to score the previously identified outcome measures from 1 to 9 based on how important they think the measures are in determining the overall success of their/their child's/their patient's HD. In round 2, experts will be presented with the same list of outcome measures and graphical representations of how their panel scored that outcome in round 1. They will be asked to re-score the outcome measure, taking into account how important other members of their panel felt it to be. In round 3, experts will again be asked to re-score each outcome measure, but this time they will receive a graphical representation of the distribution of scores from all three panels, which they should take into account when re-scoring. Following round 3 of the Delphi process, 40 experts will be invited to attend a face-to-face consensus meeting. Participants will be invited in a purposive manner to obtain balance between the different panels. Results of the Delphi process will be discussed, and outcomes will be re-scored. Outcome measures where >70% of participants at the meeting scored it 7-9 and <15% scored it 1-3 will form the core outcome set. Development of a core outcome set will help to reduce heterogeneity of outcome measure reporting in HD. This will increase the quality of research taking place and ultimately

  12. Improving core outcome set development: qualitative interviews with developers provided pointers to inform guidance.

    PubMed

    Gargon, Elizabeth; Williamson, Paula R; Young, Bridget

    2017-06-01

    The objective of the study was to explore core outcome set (COS) developers' experiences of their work to inform methodological guidance on COS development and identify areas for future methodological research. Semistructured, audio-recorded interviews with a purposive sample of 32 COS developers. Analysis of transcribed interviews was informed by the constant comparative method and framework analysis. Developers found COS development to be challenging, particularly in relation to patient participation and accessing funding. Their accounts raised fundamental questions about the status of COS development and whether it is consultation or research. Developers emphasized how the absence of guidance had affected their work and identified areas where guidance or evidence about COS development would be useful including, patient participation, ethics, international development, and implementation. They particularly wanted guidance on systematic reviews, Delphi, and consensus meetings. The findings raise important questions about the funding, status, and process of COS development and indicate ways that it could be strengthened. Guidance could help developers to strengthen their work, but over specification could threaten quality in COS development. Guidance should therefore highlight common issues to consider and encourage tailoring of COS development to the context and circumstances of particular COS. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  13. A dual-PIXE tomography setup for reconstruction of Germanium in ICF target

    NASA Astrophysics Data System (ADS)

    Guo, N.; Lu, H. Y.; Wang, Q.; Meng, J.; Gao, D. Z.; Zhang, Y. J.; Liang, X. X.; Zhang, W.; Li, J.; Ma, X. J.; Shen, H.

    2017-08-01

    Inertial Confinement Fusion (ICF) is one type of fusion energy research which could initiate nuclear fusion reactions through heating and compressing thermonuclear fuel. Compared to a pure plastic target, Germanium doping into the CH ablator layer by Glow Discharge Polymer (GDP) technique can increase the ablation velocity and the standoff distance between the ablation front and laser-deposition region. During target fabrication process, quantitative doping of Ge should be accurately controlled. Particle Induced X-ray Emission Tomography (PIXE-T) can make not only quantification of the concentration, but also reconstruction of the spatial distribution of doped element. The Si (Li) detector for PIXE tomography technique had a disadvantage of low counting rate. To make up this deficiency, another detector of Si (Li) with the same configuration positioned at the opposite side with the same detective angle 135° have been implemented. Simultaneously acquired elemental maps of Ge obtained using two detectors may be different because of the X-ray absorption along the X-ray exit route in the target. In this paper, the X-ray detection efficiency is drastically improved by this dual-PIXE tomography system.

  14. Approach to numerical safety guidelines based on a core melt criterion. [PWR; BWR

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

    Azarm, M.A.; Hall, R.E.

    1982-01-01

    A plausible approach is proposed for translating a single level criterion to a set of numerical guidelines. The criterion for core melt probability is used to set numerical guidelines for various core melt sequences, systems and component unavailabilities. These guidelines can be used as a means for making decisions regarding the necessity for replacing a component or improving part of a safety system. This approach is applied to estimate a set of numerical guidelines for various sequences of core melts that are analyzed in Reactor Safety Study for the Peach Bottom Nuclear Power Plant.

  15. Measuring spatial distributions of nuclear burn in ICF implosions at OMEGA and the NIF using proton emission imaging

    NASA Astrophysics Data System (ADS)

    Seguin, Fredrick; Rinderknecht, H. G.; Zylstra, A.; Sio, H.; Frenje, J.; Li, C. K.; Petrasso, R.; Rosenberg, M.; Marshall, F. J.; Sangster, T. C.; McKenty, P.; Craxton, S.; Rygg, J. R.; Le Pape, S.; Smalyuk, V.; Amendt, P. A.; Wilks, S. C.; MacKinnon, A.; Hoffman, N. M.

    2015-11-01

    Fusion reactions in ICF implosions of D3He-filled capsules produce 14.7-MeV D3He protons and 3-MeV DD protons. Spatial distributions of the D3He and DD reactions are studied with a penumbral imaging camera that utilizes a CR-39-based imaging detector to detect the protons. Up to three orthogonal cameras have been used simultaneously at OMEGA to study the 3-D structure of asymmetric implosions, and two orthogonal cameras have now been used to study an exploding-pusher implosion at the NIF. Recent data from OMEGA and from the NIF will be shown. This work was supported in part by NLUF, US DOE, and LLE.

  16. No Common Opinion on the Common Core

    ERIC Educational Resources Information Center

    Henderson, Michael B.; Peterson, Paul E.; West, Martin R.

    2015-01-01

    According to the three authors of this article, the 2014 "EdNext" poll yields four especially important new findings: (1) Opinion with respect to the Common Core has yet to coalesce. The idea of a common set of standards across the country has wide appeal, and the Common Core itself still commands the support of a majority of the public.…

  17. Functioning and Disability Profile of Children with Microcephaly Associated with Congenital Zika Virus Infection.

    PubMed

    Ferreira, Haryelle Náryma Confessor; Schiariti, Veronica; Regalado, Isabelly Cristina Rodrigues; Sousa, Klayton Galante; Pereira, Silvana Alves; Fechine, Carla Patrícia Novaes Dos Santos; Longo, Egmar

    2018-05-29

    The increase in the number of cases of microcephaly in Brazil and its association with the Zika virus (ZIKV) is a global public health problem. The International Classification of Functioning Disability and Health (ICF) model is a powerful tool and extremely relevant in managing disability. Describe the functioning profile of children with microcephaly associated with ZIKV in two states of northeastern Brazil. This is a descriptive cross-sectional study. The sociodemographic characteristics, head circumference, and other clinical data were collected from medical charts, physical examinations, measuring instruments, and interviews with the children and their parents. The Brazilian Portuguese version of the Brief Common ICF Core Set for cerebral palsy (CP) was used. Each ICF category was assigned a qualifier, which ranged from 0 to 4 (no problem, mild problem, moderate problem, severe problem, complete problem). For environmental factors, 0 represents no barrier and 4 represents complete barrier; +0, no facilitator and +4, complete facilitator. A total of 34 children with microcephaly caused by ZIKV were recruited (18 girls and 16 boys) at four rehabilitation facilities in Rio Grande do Norte and Paraíba states, Brazil. The average age of the participants was 21 months, monthly income was ≈USD 300.00, and head circumference z-scores ranged between 0.92 and -5.51. The functioning profile revealed complete disability in most of the body function categories (b). The activity and participation areas (d) were highly impacted, particularly in mobility-related categories. With respect to environmental factors (e), most of the sample reported a complete facilitator for the immediate family, friends, and health services, systems, and policies, as well as a complete barrier to societal attitudes. This is the first study that describes the functioning profile of children with microcephaly associated with ZIKV, using a tool based on the ICF in Brazil. Our findings reinforce

  18. Allied Health Core Curriculum: Its Time Has Come

    ERIC Educational Resources Information Center

    McPherson, M. LaCheeta

    2004-01-01

    There is lack of a clear definition regarding an allied health core curriculum. The Pew Health Professions Commission and the Bureau of Health Professions use the following to define a core curriculum: "A set of interdisciplinary courses, clinical training, and other educational exposures designed to provide allied health students at each level…

  19. Cool Core Disruption in Abell 1763

    NASA Astrophysics Data System (ADS)

    Douglass, Edmund; Blanton, Elizabeth L.; Clarke, Tracy E.; Randall, Scott W.; Edwards, Louise O. V.; Sabry, Ziad

    2017-01-01

    We present the analysis of a 20 ksec Chandra archival observation of the massive galaxy cluster Abell 1763. A model-subtracted image highlighting excess cluster emission reveals a large spiral structure winding outward from the core to a radius of ~950 kpc. We measure the gas of the inner spiral to have significantly lower entropy than non-spiral regions at the same radius. This is consistent with the structure resulting from merger-induced motion of the cluster’s cool core, a phenomenon seen in many systems. Atypical of spiral-hosting clusters, an intact cool core is not detected. Its absence suggests the system has experienced significant disruption since the initial dynamical encounter that set the sloshing core in motion. Along the major axis of the elongated ICM distribution we detect thermal features consistent with the merger event most likely responsible for cool core disruption. The merger-induced transition towards non-cool core status will be discussed. The interaction between the powerful (P1.4 ~ 1026 W Hz-1) cluster-center WAT radio source and its ICM environment will also be discussed.

  20. The ADNI PET Core: 2015

    PubMed Central

    Jagust, William J.; Landau, Susan M.; Koeppe, Robert A.; Reiman, Eric M.; Chen, Kewei; Mathis, Chester A.; Price, Julie C.; Foster, Norman L.; Wang, Angela Y.

    2015-01-01

    INTRODUCTION This paper reviews the work done in the ADNI PET core over the past 5 years, largely concerning techniques, methods, and results related to amyloid imaging in ADNI. METHODS The PET Core has utilized [18F]florbetapir routinely on ADNI participants, with over 1600 scans available for download. Four different laboratories are involved in data analysis, and have examined factors such as longitudinal florbetapir analysis, use of FDG-PET in clinical trials, and relationships between different biomarkers and cognition. RESULTS Converging evidence from the PET Core has indicated that cross-sectional and longitudinal florbetapir analyses require different reference regions. Studies have also examined the relationship between florbetapir data obtained immediately after injection, which reflects perfusion, and FDG-PET results. Finally, standardization has included the translation of florbetapir PET data to a centiloid scale. CONCLUSION The PET Core has demonstrated a variety of methods for standardization of biomarkers such as florbetapir PET in a multicenter setting. PMID:26194311

  1. Core principles of evolutionary medicine

    PubMed Central

    Grunspan, Daniel Z; Nesse, Randolph M; Barnes, M Elizabeth; Brownell, Sara E

    2018-01-01

    Abstract Background and objectives Evolutionary medicine is a rapidly growing field that uses the principles of evolutionary biology to better understand, prevent and treat disease, and that uses studies of disease to advance basic knowledge in evolutionary biology. Over-arching principles of evolutionary medicine have been described in publications, but our study is the first to systematically elicit core principles from a diverse panel of experts in evolutionary medicine. These principles should be useful to advance recent recommendations made by The Association of American Medical Colleges and the Howard Hughes Medical Institute to make evolutionary thinking a core competency for pre-medical education. Methodology The Delphi method was used to elicit and validate a list of core principles for evolutionary medicine. The study included four surveys administered in sequence to 56 expert panelists. The initial open-ended survey created a list of possible core principles; the three subsequent surveys winnowed the list and assessed the accuracy and importance of each principle. Results Fourteen core principles elicited at least 80% of the panelists to agree or strongly agree that they were important core principles for evolutionary medicine. These principles over-lapped with concepts discussed in other articles discussing key concepts in evolutionary medicine. Conclusions and implications This set of core principles will be helpful for researchers and instructors in evolutionary medicine. We recommend that evolutionary medicine instructors use the list of core principles to construct learning goals. Evolutionary medicine is a young field, so this list of core principles will likely change as the field develops further. PMID:29493660

  2. Permeability-porosity data sets for sandstones

    USGS Publications Warehouse

    Nelson, P.H.

    2004-01-01

    Due to the variable nature of permeability-porosity relations, core should be obtained and permeability (k) and porosity (??) should be determined on core plugs in the laboratory for the formation of interest. A catalog of k versus (??) data sets is now available on the Web. Examples from the catalog are considered to illustrate some aspects of k versus ?? dependencies in siliciclastic reservoirs.

  3. Nibbling at the Core.

    ERIC Educational Resources Information Center

    D'Antonio, William V.

    1983-01-01

    Outlined is a body of knowledge, the core of sociology, that belongs in the introductory sociology course. How the course is taught is also important. Class sections should be small; students should be required to write a great deal; and an informal, but structured setting should stimulate student- teacher interaction. (Author/RM)

  4. Fast-Ion Spectrometry of ICF Implosions and Laser-Foil Experiments at the Omega and MTW Laser Facilities

    NASA Astrophysics Data System (ADS)

    Sinenian, Nareg

    Fast ions generated from laser-plasma interactions (LPI) have been used to study inertial confinement fusion (ICF) implosions and laser-foil interactions. LPI, which vary in nature depending on the wavelength and intensity of the driver, generate hot electrons with temperatures ranging from tens to thousands of kilo-electron-volts. These electrons, which accelerate the ions measured in this work, can be either detrimental or essential to implosion performance depending on the ICF scheme employed. In direct-drive hot-spot ignition, hot electrons can preheat the fuel and raise the adiabat, potentially degrading compression in the implosion. The amount of preheat depends on the hot-electron source characteristics and the time duration over which electrons can deposit energy into the fuel. This time duration is prescribed by the evolution of a sheath that surrounds the implosion and traps electrons. Fast-ion measurements have been used to develop a circuit model that describes the time decay of the sheath voltage for typical OMEGA implosions. In the context of electron fast ignition, the produced fast ions are considered a loss channel that has been characterized for the first time. These ions have also been used as a diagnostic tool to infer the temperature of the hot electrons in fast-ignition experiments. It has also been shown that the hot-electron temperature scales with laser intensity as expected, but is enhanced by a factor of 2-3. This enhancement is possibly due to relativistic effects and leads to poor implosion performance. Finally, fast-ion generation by ultra-intense lasers has also been studied using planar targets. The mean and maximum energies of protons and heavy ions has been measured, and it has been shown that a two-temperature hot-electron distribution affects the energies of heavy ions and protons. This work is important for advanced fusion concepts that utilize ion beams and also has applications in medicine. (Copies available exclusively from

  5. Consequences of rheumatoid arthritis for performance of social roles--a literature review.

    PubMed

    Geuskens, Goedele A; Burdorf, Alex; Hazes, Johanna M W

    2007-06-01

    To obtain quantitative estimates of restrictions in participation, i.e., the performance of social roles, in patients with rheumatoid arthritis (RA). Participation categories were selected from the International Classification of Functioning, Disability and Health (ICF) (preliminary) Comprehensive Core Set for RA. A literature search was performed utilizing PubMed and PsychInfo. Articles were included if: (1) performance in at least one of the participation categories was described; (2) patients with RA were compared to a healthy reference population or their performance over time was described; (3) published between 1995 and 2005; and (4) written in English. Seven participation categories were selected from the Comprehensive Core Set for RA, resulting in 50 articles included in the review. Almost all studies focused on remunerative employment (n = 30), recreation and leisure (n = 17), or both (n = 3). RA patients had an increased risk of being without a paid job compared to well adjusted reference groups (absolute difference 4% to 28%, odds ratios 1.2 to 3.4). Restrictions in employment occurred already within the early phase of RA and varied greatly among studies. Two years after diagnosis, disability benefits increased up to roughly 30% in some European cohorts. In the category of recreation and leisure most studies focused on socializing (n = 16). Patients with longstanding RA experienced a decrease in socializing (range, Cohen's d, -0.46 to -1.0), but changes over time were minor. RA patients experience restrictions in the performance of remunerative employment and in recreation and leisure (socializing). Due to the lack of studies, no conclusions on other ICF categories describing social roles could be made.

  6. Interpretation of the results of the CORA-33 dry core BWR test

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

    Ott, L.J.; Hagen, S.

    All BWR degraded core experiments performed prior to CORA-33 were conducted under ``wet`` core degradation conditions for which water remains within the core and continuous steaming feeds metal/steam oxidation reactions on the in-core metallic surfaces. However, one dominant set of accident scenarios would occur with reduced metal oxidation under ``dry`` core degradation conditions and, prior to CORA-33, this set had been neglected experimentally. The CORA-33 experiment was designed specifically to address this dominant set of BWR ``dry`` core severe accident scenarios and to partially resolve phenomenological uncertainties concerning the behavior of relocating metallic melts draining into the lower regions ofmore » a ``dry`` BWR core. CORA-33 was conducted on October 1, 1992, in the CORA tests facility at KfK. Review of the CORA-33 data indicates that the test objectives were achieved; that is, core degradation occurred at a core heatup rate and a test section axial temperature profile that are prototypic of full-core nuclear power plant (NPP) simulations at ``dry`` core conditions. Simulations of the CORA-33 test at ORNL have required modification of existing control blade/canister materials interaction models to include the eutectic melting of the stainless steel/Zircaloy interaction products and the heat of mixing of stainless steel and Zircaloy. The timing and location of canister failure and melt intrusion into the fuel assembly appear to be adequately simulated by the ORNL models. This paper will present the results of the posttest analyses carried out at ORNL based upon the experimental data and the posttest examination of the test bundle at KfK. The implications of these results with respect to degraded core modeling and the associated safety issues are also discussed.« less

  7. [Introduction of an accreditation system for hospital informed consent forms].

    PubMed

    López-Picazo, J J; Tomás-Garcia, N; Calle-Urra, J E; Parra-Hidalgo, P; Valverde-Iniesta, J J

    2015-01-01

    To describe an accreditation system for informed consent forms (ICF) in a tertiary hospital, as an intervention to improve their quality, and to check the improvements achieved. Following an external evaluation of the ICF quality in a public hospital in Murcia (Spain), an accreditation committee set the ICF requirements and associated procedures. Effectiveness is assessed by comparing two external evaluations carried out by the EMCA Program (2011 and 2013) and based on 19 criteria and a sample of 60 ICF for every public hospital in Murcia Region. To be accredited, every ICF must meet the 19 external criteria plus 5 based on legibility, readability and scientific and technical validity. A form to fill in the contents of every ICF was agreed, which would be reviewed, approved and validated for five years. Before the implementation, 8.2 defects/ICF were detected. The accreditation system obtained an 89% improvement (0.9 defects/ICF) and achieved significant improvements in 18 criteria, 16 of which are benchmarked. The accreditation system achieved a substantial improvement in the ICF (obtaining a better result in external evaluations) and guarantees their contents, legibility and readability. This system needs to be extended to other hospitals, since it is not clear whether common ICFs would be suitable. However, this improvement is structural and does not guarantee that the overall information/consent procedure is done properly, thus complementary strategies for measurement and improvement are required. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  8. Kinematic fingerprint of core-collapsed globular clusters

    NASA Astrophysics Data System (ADS)

    Bianchini, P.; Webb, J. J.; Sills, A.; Vesperini, E.

    2018-03-01

    Dynamical evolution drives globular clusters towards core collapse, which strongly shapes their internal properties. Diagnostics of core collapse have so far been based on photometry only, namely on the study of the concentration of the density profiles. Here, we present a new method to robustly identify core-collapsed clusters based on the study of their stellar kinematics. We introduce the kinematic concentration parameter, ck, the ratio between the global and local degree of energy equipartition reached by a cluster, and show through extensive direct N-body simulations that clusters approaching core collapse and in the post-core collapse phase are strictly characterized by ck > 1. The kinematic concentration provides a suitable diagnostic to identify core-collapsed clusters, independent from any other previous methods based on photometry. We also explore the effects of incomplete radial and stellar mass coverage on the calculation of ck and find that our method can be applied to state-of-art kinematic data sets.

  9. Development of the re-emit technique for ICF foot symmetry tuning for indirect drive ignition on NIF

    NASA Astrophysics Data System (ADS)

    Dewald, Eduard; Milovich, Jose; Edwards, John; Thomas, Cliff; Kalantar, Dan; Meeker, Don; Jones, Ogden

    2007-11-01

    Tuning of the the symmetry of the hohlraum radiation drive for the first 2 ns of the ICF pulse on NIF will be assessed by the re-emit technique [1] which measures the instantaneous x-ray drive asymmetry based on soft x-ray imaging of the re-emission of a high-Z sphere surrogate capsule. We will discuss the design of re-emit foot symmetry tuning measurements planned on NIF and their surrogacy for ignition experiments, including assessing the residual radiation asymmetry of the patches required for soft x-ray imaging. We will present the tuning strategy and expected accuracies based on calculations, analytical estimates and first results from scaled experiments performed at the Omega laser facility. [1] N. Delamater, G. Magelssen, A. Hauer, Phys. Rev. E 53, 5241 (1996.)

  10. Factors Associated with Expenditures for Medicaid Home and Community Based Services (HCBS) and Intermediate Care Facilities for Persons with Mental Retardation (ICF/MR) Services for Persons with Intellectual and Developmental Disabilities

    ERIC Educational Resources Information Center

    Lakin, K. Charlie; Doljanac, Robert; Byun, Soo-Yong; Stancliffe, Roger J.; Taub, Sarah; Chiri, Giuseppina

    2008-01-01

    This article examines expenditures for a random sample of 1,421 adult Home and Community Based Services (HCBS) and Intermediate Care Facility/Mental Retardation (ICF/MR) recipients in 4 states. The article documents variations in expenditures for individuals with different characteristics and service needs and, controlling for individual…

  11. Linking of the quality of life in neurological disorders (Neuro-QoL) to the international classification of functioning, disability and health.

    PubMed

    Wong, Alex W K; Lau, Stephen C L; Cella, David; Lai, Jin-Shei; Xie, Guanli; Chen, Lidian; Chan, Chetwyn C H; Heinemann, Allen W

    2017-09-01

    The quality of life in neurological disorders (Neuro-QoL) is a U.S. National Institutes of Health initiative that produced a set of self-report measures of physical, mental, and social health experienced by adults or children who have a neurological condition or disorder. To describe the content of the Neuro-QoL at the item level using the World Health Organization's international classification of functioning, disability and health (ICF). We assessed the Neuro-QoL for its content coverage of functioning and disability relative to each of the four ICF domains (i.e., body functions, body structures, activities and participation, and environment). We used second-level ICF three-digit codes to classify items into categories within each ICF domain and computed the percentage of categories within each ICF domain that were represented in the Neuro-QoL items. All items of Neuro-QoL could be mapped to the ICF categories at the second-level classification codes. The activities and participation domain and the mental functions category of the body functions domain were the areas most often represented by Neuro-QoL. Neuro-QoL provides limited coverage of the environmental factors and body structure domains. Neuro-QoL measures map well to the ICF. The Neuro-QoL-ICF-mapped items provide a blueprint for users to select appropriate measures in ICF-based measurement applications.

  12. Protocol for the development of a core domain set for hidradenitis suppurativa trial outcomes.

    PubMed

    Thorlacius, Linnea; Ingram, John R; Garg, Amit; Villumsen, Bente; Esmann, Solveig; Kirby, Joslyn S; Gottlieb, Alice B; Merola, Joseph F; Dellavalle, Robert; Christensen, Robin; Jemec, Gregor B E

    2017-02-20

    Randomised controlled trials (RCTs) should have well-defined primary and secondary outcomes to answer questions generated by the main hypotheses. However, for the chronic, inflammatory skin disease hidradenitis suppurativa (HS), the reported outcome measures are numerous and diverse. A recent systematic review found a total of 30 outcome measure instruments in 12 RCTs. This use of a broad range of outcome measures can increase difficulties in interpretation and comparison of results and may potentially obstruct appropriate evidence synthesis by causing reporting bias. One strategy for dealing with these problems is to develop a core outcome set (COS). A COS is a list of outcomes that are meant as mandatory and should be measured and reported in all clinical trials. The aim of this study is to develop a COS for the management of HS. An international steering group of researchers, clinicians and a patient research partner will guide the COS development. 6 stakeholder groups are involved: patients, dermatologists, surgeons, nurses, industry representatives and drug regulatory authorities. A 1:1 ratio of patients:healthcare professionals is aimed for. The initial list of candidate items will be obtained by combining three data sets: (1) a systematic review of the literature, (2) US and Danish qualitative interview studies involving patients with HS and (3) an online healthcare professional (HCP) item generation survey. To reach consensus on the COS, 4 anonymous online Delphi rounds are then planned together with 2 face-to-face consensus meetings (1 in Europe and 1 in the USA) to ensure global representation. The study will be performed according to the Helsinki declaration. All results from the study, including inconclusive or negative results, will be published in peer-reviewed indexed journals. The study will involve different stakeholder groups to ensure that the developed COS will be suitable and well accepted. Published by the BMJ Publishing Group Limited. For

  13. Multiple core computer processor with globally-accessible local memories

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

    Shalf, John; Donofrio, David; Oliker, Leonid

    A multi-core computer processor including a plurality of processor cores interconnected in a Network-on-Chip (NoC) architecture, a plurality of caches, each of the plurality of caches being associated with one and only one of the plurality of processor cores, and a plurality of memories, each of the plurality of memories being associated with a different set of at least one of the plurality of processor cores and each of the plurality of memories being configured to be visible in a global memory address space such that the plurality of memories are visible to two or more of the plurality ofmore » processor cores.« less

  14. Spinal cord injury (SCI) rehabilitation: systematic analysis of communication from the biopsychosocial perspective.

    PubMed

    Hartley, Naomi A

    2015-07-02

    . Therapeutic and research endeavors guided by existing ICF core sets are at risk of failing to consider communication, thereby limiting rehabilitation outcomes. Tapping the potential of communication as a relative strength within SCI rehabilitation holds considerable promise, within integrative, strengths-based, multidisciplinary approaches to clinical practice and future research.

  15. Inferences of Shell Asymmetry in ICF Implosions using Fluence Compensated Neutron Images at the NIF

    NASA Astrophysics Data System (ADS)

    Casey, D.; Fittinghoff, D.; Bionta, R.; Smalyuk, V.; Grim, G.; Munro, D.; Spears, B.; Raman, K.; Clark, D.; Kritcher, A.; Hinkel, D.; Hurricane, O.; Callahan, D.; Döppner, T.; Landen, O.; Ma, T.; Le Pape, S.; Ross, S.; Meezan, N.; Pak, A.; Park, H.-S.; Volegov, P.; Merill, F.

    2016-10-01

    In ICF experiments, a dense shell is imploded and used to compress and heat a hotspot of DT fuel. Controlling the symmetry of this process is both important and challenging. It is therefore important to observe the symmetry of the stagnated shell assembly. The Neutron Imaging System at the NIF is used to observe the primary 14 MeV neutrons from the hotspot and the down-scattered neutrons (6-12 MeV), from the assembled shell but with a strong imprint from the primary-neutron fluence. Using a characteristic scattering angle approximation, we have compensated the image for this fluence effect, revealing information about shell asymmetry that is otherwise difficult to extract without models. Preliminary observations with NIF data show asymmetries in imploded shell, which will be compared with other nuclear diagnostics and postshot simulations. This work was performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344.

  16. Acoustic detection of air shower cores

    NASA Technical Reports Server (NTRS)

    Gao, X.; Liu, Y.; Du, S.

    1985-01-01

    At an altitude of 1890m, a pre-test with an Air shower (AS) core selector and a small acoustic array set up in an anechoic pool with a volume of 20x7x7 cu m was performed, beginning in Aug. 1984. In analyzing the waveforms recorded during the effective working time of 186 hrs, three acoustic signals which cannot be explained as from any source other than AS cores were obtained, and an estimation of related parameters was made.

  17. A model for enhancing Internet medical document retrieval with "medical core metadata".

    PubMed

    Malet, G; Munoz, F; Appleyard, R; Hersh, W

    1999-01-01

    Finding documents on the World Wide Web relevant to a specific medical information need can be difficult. The goal of this work is to define a set of document content description tags, or metadata encodings, that can be used to promote disciplined search access to Internet medical documents. The authors based their approach on a proposed metadata standard, the Dublin Core Metadata Element Set, which has recently been submitted to the Internet Engineering Task Force. Their model also incorporates the National Library of Medicine's Medical Subject Headings (MeSH) vocabulary and MEDLINE-type content descriptions. The model defines a medical core metadata set that can be used to describe the metadata for a wide variety of Internet documents. The authors propose that their medical core metadata set be used to assign metadata to medical documents to facilitate document retrieval by Internet search engines.

  18. Lining up: The Relationship between the Common Core State Standards and Five Sets of Comparison Standards

    ERIC Educational Resources Information Center

    Conley, David T.; Drummond, Kathryn V.; de Gonzalez, Alicia; Seburn, Mary; Stout, Odile; Rooseboom, Jennifer

    2011-01-01

    In June 2010, the National Governors Association Center for Best Practices (NGA Center) and the Council of Chief State School Offices (CCSSO) released the Common Core State Standards. The stated aim of the Common Core standards is to define the knowledge and skills students should achieve in order to graduate from high school ready to succeed in a…

  19. Characterizing ICF Neutron Diagnostics on the nTOF line at SUNY Geneseo

    NASA Astrophysics Data System (ADS)

    Simone, Angela; Padalino, Stephen; Turner, Ethan; Ginnane, Mary Kate; Dubois, Natalie; Fletcher, Kurtis; Giordano, Michael; Lawson-Keister, Patrick; Harrison, Hannah; Visca, Hannah; Sangster, Craig; Regan, Sean

    2014-10-01

    Charged particle beams from the Geneseo 1.7 MV tandem Pelletron accelerator produce nuclear reactions that emit neutrons in the range of 0.5 to 17.9 MeV via the d(d,n)3He and 11B(d,n)12C reactions. The neutron energy and flux can be adjusted by controlling the accelerator beam current and potential. This adjustable neutron source makes it possible to calibrate ICF and HEDP neutron scintillator diagnostics. However, gamma rays which are often present during an accelerator-based calibration are difficult to differentiate from neutron signals in scintillators. To identify neutrons from gamma rays and to determine their energy, a permanent neutron time-of-flight (nTOF) line is being constructed. By detecting the scintillator signal in coincidence with an associated charged particle (ACP) produced in the reaction, the identity of the neutron can be known and its energy determined by time of flight. Using a 100% efficient surface barrier detector to count the ACPs, the absolute efficiency of the scintillator as a function of neutron energy can be determined. This is done by determining the ratio of the ACP counts in the singles spectrum to coincidence counts for matched solid angles of the SBD and scintillator. Funded in part by a LLE contract through the DOE.

  20. Planarization of Isolated Defects on ICF Target Capsule Surfaces by Pulsed Laser Ablation

    DOE PAGES

    Alfonso, Noel; Carlson, Lane C.; Bunn, Thomas L.

    2016-08-09

    Demanding surface quality requirements for inertial confinement fusion (ICF) capsules motivated the development of a pulsed laser ablation method to reduce or eliminate undesirable surface defects. The pulsed laser ablation technique takes advantage of a full surface (4π) capsule manipulation system working in combination with an optical profiling (confocal) microscope. Based on the defect topography, the material removal rate, the laser pulse energy and its beam profile, a customized laser raster pattern is derived to remove the defect. The pattern is a table of coordinates and number of pulses that dictate how the defect will be vaporized until its heightmore » is level with the capsule surface. This paper explains how the raster patterns are optimized to minimize surface roughness and how surface roughness after laser ablation is simulated. The simulated surfaces are compared with actual ablated surfaces. Large defects are reduced to a size regime where a tumble finishing process produces very high quality surfaces devoid of high mode defects. The combined polishing processes of laser ablation and tumble finishing have become routine fabrication steps for National Ignition Facility capsule production.« less

  1. caCORE: a common infrastructure for cancer informatics.

    PubMed

    Covitz, Peter A; Hartel, Frank; Schaefer, Carl; De Coronado, Sherri; Fragoso, Gilberto; Sahni, Himanso; Gustafson, Scott; Buetow, Kenneth H

    2003-12-12

    Sites with substantive bioinformatics operations are challenged to build data processing and delivery infrastructure that provides reliable access and enables data integration. Locally generated data must be processed and stored such that relationships to external data sources can be presented. Consistency and comparability across data sets requires annotation with controlled vocabularies and, further, metadata standards for data representation. Programmatic access to the processed data should be supported to ensure the maximum possible value is extracted. Confronted with these challenges at the National Cancer Institute Center for Bioinformatics, we decided to develop a robust infrastructure for data management and integration that supports advanced biomedical applications. We have developed an interconnected set of software and services called caCORE. Enterprise Vocabulary Services (EVS) provide controlled vocabulary, dictionary and thesaurus services. The Cancer Data Standards Repository (caDSR) provides a metadata registry for common data elements. Cancer Bioinformatics Infrastructure Objects (caBIO) implements an object-oriented model of the biomedical domain and provides Java, Simple Object Access Protocol and HTTP-XML application programming interfaces. caCORE has been used to develop scientific applications that bring together data from distinct genomic and clinical science sources. caCORE downloads and web interfaces can be accessed from links on the caCORE web site (http://ncicb.nci.nih.gov/core). caBIO software is distributed under an open source license that permits unrestricted academic and commercial use. Vocabulary and metadata content in the EVS and caDSR, respectively, is similarly unrestricted, and is available through web applications and FTP downloads. http://ncicb.nci.nih.gov/core/publications contains links to the caBIO 1.0 class diagram and the caCORE 1.0 Technical Guide, which provide detailed information on the present caCORE architecture

  2. European initiative for the application of the International Classification of Functioning, Disability and Health: development of Clinical Assessment Schedules for specified rehabilitation services.

    PubMed

    Prodinger, Birgit; Scheel-Sailer, Anke; Escorpizo, Reuben; Stucki, Gerold

    2017-04-01

    Clinical assessment schedule (CLAS) is a core part of the ICF-based implementation of functioning reporting across health conditions and along the continuum of care. The Physical and Rehabilitation Medicine Section and Board of the European Union of Medical Specialists (UEMS PRM) workshop held in January 2016 aimed to develop and specify a CLAS within the context of rehabilitation services. UEMS PRM Workshop in Nottwil, Switzerland, January 2016. PRM physicians representatives from 12 European countries, as well as Israel and Japan, mostly delegates of UEMS PRM Section and Board, and experts with other rehabilitation professional backgrounds. Participants were divided into 6 working groups and asked to specify what functioning aspects would be essential to document using the available ICF sets for the identified rehabilitation services contained in the newly developed service classification (ICSO-R): acute, post-acute and long-term rehabilitation services. The 7 ICF Generic and 23 Rehabilitation Set categories were confirmed as well as specific health condition categories for acute rehabilitation services (mobile team), for postacute rehabilitation services (general outpatient rehabilitation, musculoskeletal and neurological rehabilitation, as well as specialized SCI rehabilitation), and for long-term rehabilitation services (day clinic and rehabilitation provided in the community). While general principles of the CLAS were defined, the need to align the CLAS for a specific service, as well as across services along the continuum of care was highlighted. All groups deliberated on this topic; however, no conclusive statement was presented yet. The groups recognized a need for a systematic effort to identify data collection tools currently used. CLASs will serve in the future to ensure that functioning information is systematically and consistently collected across services, and thus respond also to various global reports and initiatives which stress the need for

  3. Cardiac rehabilitation delivery model for low-resource settings

    PubMed Central

    Grace, Sherry L; Turk-Adawi, Karam I; Contractor, Aashish; Atrey, Alison; Campbell, Norm; Derman, Wayne; Melo Ghisi, Gabriela L; Oldridge, Neil; Sarkar, Bidyut K; Yeo, Tee Joo; Lopez-Jimenez, Francisco; Mendis, Shanthi; Oh, Paul; Hu, Dayi; Sarrafzadegan, Nizal

    2016-01-01

    Objective Cardiovascular disease is a global epidemic, which is largely preventable. Cardiac rehabilitation (CR) is demonstrated to be cost-effective and efficacious in high-income countries. CR could represent an important approach to mitigate the epidemic of cardiovascular disease in lower-resource settings. The purpose of this consensus statement was to review low-cost approaches to delivering the core components of CR, to propose a testable model of CR which could feasibly be delivered in middle-income countries. Methods A literature review regarding delivery of each core CR component, namely: (1) lifestyle risk factor management (ie, physical activity, diet, tobacco and mental health), (2) medical risk factor management (eg, lipid control, blood pressure control), (3) education for self-management and (4) return to work, in low-resource settings was undertaken. Recommendations were developed based on identified articles, using a modified GRADE approach where evidence in a low-resource setting was available, or consensus where evidence was not. Results Available data on cost of CR delivery in low-resource settings suggests it is not feasible to deliver CR in low-resource settings as is delivered in high-resource ones. Strategies which can be implemented to deliver all of the core CR components in low-resource settings were summarised in practice recommendations, and approaches to patient assessment proffered. It is suggested that CR be adapted by delivery by non-physician healthcare workers, in non-clinical settings. Conclusions Advocacy to achieve political commitment for broad delivery of adapted CR services in low-resource settings is needed. PMID:27181874

  4. European core curriculum in neurorehabilitation

    PubMed Central

    Sandrini, Giorgio; Binder, Heinrich; Hömberg, Volker; Saltuari, Leopold; Tarkka, Ina; Smania, Nicola; Corradini, Claudio; Giustini, Alessandro; Kätterer, Christian; Picari, Ledina; Diserens, Karin; Koenig, Eberhard; Geurts, Alexander; Anghelescu, Aurelian; Opara, Józef; Tonin, Paolo; Kwakkel, Gert; Golyk, Volodymyr; Onose, Gelu; Pérennou, Dominique; Picelli, Alessandro

    2017-01-01

    Summary To date, medical education lacks Europe-wide standards on neurorehabilitation. To address this, the European Federation of NeuroRehabilitation Societies (EFNR) here proposes a postgraduate neurorehabilitation training scheme. In particular, the European medical core curriculum in neurorehabilitation should include a two-year residency in a neurorehabilitation setting where trainees can gain practical experience. Furthermore, it should comprise six modules of classroom training organized as weekend seminars or summer/winter schools. In conclusion, after defining the European medical core curriculum in neurorehabilitation, the next activities of the EFNR will be to try and reach the largest possible consensus on its content among all national societies across Europe in order to further validate it and try to extend it to the other, non-medical, professionals on the neurorehabilitation team in line with their core curricula defined by each professional association. PMID:28676138

  5. Feasibility of the Dutch ICF Activity Inventory: a pilot study

    PubMed Central

    2010-01-01

    Background Demographic ageing will lead to increasing pressure on visual rehabilitation services, which need to be efficiently organised in the near future. The Dutch ICF Activity Inventory (D-AI) was developed to assess the rehabilitation needs of visually impaired persons. This pilot study tests the feasibility of the D-AI using a computer-assisted telephone interview. Methods In addition to the regular intake, the first version of the D-AI was assessed in 20 patients. Subsequently, patients and intake assessors were asked to fill in an evaluation form. Based on these evaluations, a new version of the D-AI was developed. Results Mean administration time of the D-AI was 88.8 (± 41.0) minutes. Overall, patients and assessors were positive about the D-AI assessment. However, professionals and 60% of the patients found the administration time to be too long. All included items were considered relevant and only minor adjustments were recommended. Conclusion The systematic character of the revised D-AI will prevent topics from being overlooked and indicate which needs have the highest priority from a patient-centred perspective. Moreover, ongoing assessment of the D-AI will enhance evaluation of the rehabilitation process. To decrease administration time, in the revised D-AI only the top priority goals will be fully assessed. Using the D-AI, a rehabilitation plan based on individual needs can be developed for each patient. Moreover, it enables better evaluation of the effects of rehabilitation. A larger validation study is planned. PMID:21110871

  6. PALS laser-driven radiative jets for astrophysical and ICF applications

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

    Pisarczyk, T.; Kasperczuk, A.; Stenz, Ch.

    2008-03-19

    High speed, well-collimated plasma jets were generated in the interaction of defocused single laser beam with planar, massive Cu target. The experiment was carried out at the iodine laser facility (Prague Asterix Laser System--PALS) using the third harmonic beam (0.438 {mu}m) with a pulse duration of 250 ps (FWHM) and an energy of 100 J. The information about geometry of plasma expansion, plasma dynamics and electron density were obtained by means of a 3-frame interferometric system. The plasma jet parameters reach the following values: the velocity up to 7x10{sup 7} cm/s, the internal Mach number greater than 10 and themore » electron density above 10{sup 19} cm{sup -3}. The jet characteristics are appropriate for the astrophysical and ICF applications. To ensure the interaction of this jet with gas or plasma as an ambient medium, a high-pressure supersonic gas nozzle was used, which created a cylindrical column of Ar or He. The results of first experiments dedicated to studies of collision of such a jet with a gas cloud are also presented. They clearly show the effect of shocks formation in ambient gases (He and Ar) due to the jet action. In the case of He the shock waves have usually a conical shape with a thickness of 1-1.5 mm, whereas in the case of Ar, the shock wave configuration is more complex and its thickness is less than 1 mm.« less

  7. Does cortisol influence core executive functions? A meta-analysis of acute cortisol administration effects on working memory, inhibition, and set-shifting.

    PubMed

    Shields, Grant S; Bonner, Joseph C; Moons, Wesley G

    2015-08-01

    The hormone cortisol is often believed to play a pivotal role in the effects of stress on human cognition. This meta-analysis is an attempt to determine the effects of acute cortisol administration on core executive functions. Drawing on both rodent and stress literatures, we hypothesized that acute cortisol administration would impair working memory and set-shifting but enhance inhibition. Additionally, because cortisol is thought to exert different nongenomic (rapid) and genomic (slow) effects, we further hypothesized that the effects of cortisol would differ as a function of the delay between cortisol administration and cognitive testing. Although the overall analyses were nonsignificant, after separating the rapid, nongenomic effects of cortisol from the slower, genomic effects of cortisol, the rapid effects of cortisol enhanced response inhibition, g+ = 0.113, p=.016, but impaired working memory, g+ = -0.315, p=.008, although these effects reversed over time. Contrary to our hypotheses, there was no effect of cortisol administration on set-shifting. Thus, although we did not find support for the idea that increases in cortisol influence set-shifting, we found that acute increases in cortisol exert differential effects on working memory and inhibition over time. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Subannual layer variability in Greenland firn cores

    NASA Astrophysics Data System (ADS)

    Kjær, Helle Astrid; Vallelonga, Paul; Vinther, Bo; Winstrup, Mai; Simonsen, Marius; Maffezzoli, Niccoló; Jensen, Camilla Marie

    2017-04-01

    Ice cores are used to infer information about the past and modern techniques allow for high resolution (< cm) continuous flow analysis (CFA) of the ice. Such analysis is often used to inform on annual layers to constrain dating of ice cores, but can also be extended to provide information on sub-annual deposition patterns. In this study we use available high resolution data from multiple shallow cores around Greenland to investigate the seasonality and trends in the most often continuously measured components sodium, insoluble dust, calcium, ammonium and conductivity (or acidity) from 1800 AD to today. We evaluate the similarities and differences between the records and discuss the causes from different sources and transport to deposition and post-deposition effects over differences in measurement set up. Further we add to the array of cores already published with measurements from the newly drilled ReCAP ice core from a coastal ice cap in eastern Greenland and from a shallow core drilled at the high accumulation site at the Greenland South Dome.

  9. Psychometric analyses to improve the Dutch ICF Activity Inventory.

    PubMed

    Bruijning, Janna E; van Rens, Ger; Knol, Dirk; van Nispen, Ruth

    2013-08-01

    In the past, rehabilitation centers for the visually impaired used unstructured or semistructured methods to assess rehabilitation needs of their patients. Recently, an extensive instrument, the Dutch ICF Activity Inventory (D-AI), was developed to systematically investigate rehabilitation needs of visually impaired adults and to evaluate rehabilitation outcomes. The purpose of this study was to investigate the underlying factor structure and other psychometric properties to shorten and improve the D-AI. The D-AI was administered to 241 visually impaired persons who recently enrolled in a multidisciplinary rehabilitation center. The D-AI uses graded scores to assess the importance and difficulty of 65 rehabilitation goals. For high-priority goals (e.g., daily meal preparation), the difficulty of underlying tasks (e.g., read recipes, cut vegetables) was assessed. To reduce underlying task items (>950), descriptive statistics were investigated and factor analyses were performed for several goals. The internal consistency reliability and test-retest reliability of the D-AI were investigated by calculating Cronbach α and Cohen (weighted) κ. Finally, consensus-based discussions were used to shorten and improve the D-AI. Except for one goal, factor analysis model parameters were at least reasonable. Internal consistency reliability was satisfactory (range, 0.74 to 0.93). In total, 60% of the 65 goal importance items and 84.4% of the goal difficulty items showed moderate to almost perfect κ values (≥0.40). After consensus-based discussions, a new D-AI was produced, containing 48 goals and less than 500 tasks. The analyses were an important step in the validation process of the D-AI and to develop a more feasible assessment tool to investigate rehabilitation needs of visually impaired persons in a systematic way. The D-AI is currently implemented in all Dutch rehabilitation centers serving all visually impaired adults with various rehabilitation needs.

  10. Neural networks within multi-core optic fibers.

    PubMed

    Cohen, Eyal; Malka, Dror; Shemer, Amir; Shahmoon, Asaf; Zalevsky, Zeev; London, Michael

    2016-07-07

    Hardware implementation of artificial neural networks facilitates real-time parallel processing of massive data sets. Optical neural networks offer low-volume 3D connectivity together with large bandwidth and minimal heat production in contrast to electronic implementation. Here, we present a conceptual design for in-fiber optical neural networks. Neurons and synapses are realized as individual silica cores in a multi-core fiber. Optical signals are transferred transversely between cores by means of optical coupling. Pump driven amplification in erbium-doped cores mimics synaptic interactions. We simulated three-layered feed-forward neural networks and explored their capabilities. Simulations suggest that networks can differentiate between given inputs depending on specific configurations of amplification; this implies classification and learning capabilities. Finally, we tested experimentally our basic neuronal elements using fibers, couplers, and amplifiers, and demonstrated that this configuration implements a neuron-like function. Therefore, devices similar to our proposed multi-core fiber could potentially serve as building blocks for future large-scale small-volume optical artificial neural networks.

  11. A core handling device for the Mars Sample Return Mission

    NASA Technical Reports Server (NTRS)

    Gwynne, Owen

    1989-01-01

    A core handling device for use on Mars is being designed. To provide a context for the design study, it was assumed that a Mars Rover/Sample Return (MRSR) Mission would have the following characteristics: a year or more in length; visits by the rover to 50 or more sites; 100 or more meter-long cores being drilled by the rover; and the capability of returning about 5 kg of Mars regolith to Earth. These characteristics lead to the belief that in order to bring back a variegated set of samples that can address the range of scientific objetives for a MRSR mission to Mars there needs to be considerable analysis done on board the rover. Furthermore, the discrepancy between the amount of sample gathered and the amount to be returned suggests that there needs to be some method of choosing the optimal set of samples. This type of analysis will require pristine material-unaltered by the drilling process. Since the core drill thermally and mechanically alters the outer diameter (about 10 pct) of the core sample, this outer area cannot be used. The primary function of the core handling device is to extract subsamples from the core and to position these subsamples, and the core itself if needed, with respect to the various analytical instruments that can be used to perform these analyses.

  12. "Functional" Inspiratory and Core Muscle Training Enhances Running Performance and Economy.

    PubMed

    Tong, Tomas K; McConnell, Alison K; Lin, Hua; Nie, Jinlei; Zhang, Haifeng; Wang, Jiayuan

    2016-10-01

    Tong, TK, McConnell, AK, Lin, H, Nie, J, Zhang, H, and Wang, J. "Functional" inspiratory and core muscle training enhances running performance and economy. J Strength Cond Res 30(10): 2942-2951, 2016-We compared the effects of two 6-week high-intensity interval training interventions. Under the control condition (CON), only interval training was undertaken, whereas under the intervention condition (ICT), interval training sessions were followed immediately by core training, which was combined with simultaneous inspiratory muscle training (IMT)-"functional" IMT. Sixteen recreational runners were allocated to either ICT or CON groups. Before the intervention phase, both groups undertook a 4-week program of "foundation" IMT to control for the known ergogenic effect of IMT (30 inspiratory efforts at 50% maximal static inspiratory pressure [P0] per set, 2 sets per day, 6 days per week). The subsequent 6-week interval running training phase consisted of 3-4 sessions per week. In addition, the ICT group undertook 4 inspiratory-loaded core exercises (10 repetitions per set, 2 sets per day, inspiratory load set at 50% post-IMT P0) immediately after each interval training session. The CON group received neither core training nor functional IMT. After the intervention phase, global inspiratory and core muscle functions increased in both groups (p ≤ 0.05), as evidenced by P0 and a sport-specific endurance plank test (SEPT) performance, respectively. Compared with CON, the ICT group showed larger improvements in SEPT, running economy at the speed of the onset of blood lactate accumulation, and 1-hour running performance (3.04% vs. 1.57%, p ≤ 0.05). The changes in these variables were interindividually correlated (r ≥ 0.57, n = 16, p ≤ 0.05). Such findings suggest that the addition of inspiratory-loaded core conditioning into a high-intensity interval training program augments the influence of the interval program on endurance running performance and that this may be

  13. Catalog of Dense Cores in the Orion A Giant Molecular Cloud

    NASA Astrophysics Data System (ADS)

    Shimajiri, Yoshito; Kitamura, Y.; Nakamura, F.; Momose, M.; Saito, M.; Tsukagoshi, T.; Hiramatsu, M.; Shimoikura, T.; Dobashi, K.; Hara, C.; Kawabe, R.

    2015-03-01

    We present Orion A giant molecular cloud core catalogs, which are based on a 1.1 mm map with an angular resolution of 36″ (˜0.07 pc) and C18O (J = 1-0) data with an angular resolution of 26.4″ (˜0.05 pc). We have cataloged 619 dust cores in the 1.1 mm map using the Clumpfind method. The ranges of the radius, mass, and density of these cores are estimated to be 0.01-0.20 pc, 0.6-1.2 × 102 {{M}⊙ }, and 0.3 × 104-9.2 × 106 cm-3, respectively. We have identified 235 cores from the C18O data. The ranges of the radius, velocity width, LTE mass, and density are 0.13-0.34 pc, 0.31-1.31 km s-1, 1.0-61.8 {{M}⊙ }, and (0.8-17.5) × 103 cm-3, respectively. From the comparison of the spatial distributions between the dust and C18O cores, four types of spatial relations were revealed: (1) the peak positions of the dust and C18O cores agree with each other (32.4% of the C18O cores), (2) two or more C18O cores are distributed around the peak position of one dust core (10.8% of the C18O cores), (3) 56.8% of the C18O cores are not associated with any dust cores, and (4) 69.3% of the dust cores are not associated with any C18O cores. The data sets and analysis are public. The data sets and annotation files for MIRIAD and KARMA of Tables 2 and 4 are available at the NRO star formation project web site via http://th.nao.ac.jp/MEMBER/nakamrfm/sflegacy/data.html

  14. MOMENT--Management of Otitis Media with Effusion in Cleft Palate: protocol for a systematic review of the literature and identification of a core outcome set using a Delphi survey.

    PubMed

    Harman, Nicola L; Bruce, Iain A; Callery, Peter; Tierney, Stephanie; Sharif, Mohammad Owaise; O'Brien, Kevin; Williamson, Paula R

    2013-03-12

    Cleft palate (CP) has an incidence of approximately 1 in 700. Children with CP are also susceptible to otitis media with effusion (OME), with approximately 90% experiencing nontrivial OME. There are several approaches to the management of OME in children with CP. The Management of Otitis Media with Effusion in Children with Cleft Palate (MOMENT) study is a feasibility study that includes the development of a core outcome set for use in future trials of the management of OME in children with CP. The MOMENT study will include a systematic review of the literature to identify a list of outcomes that have previously been reported. This list of outcomes will be used in a Delphi study with cleft clinicians. The Delphi study is anticipated to include three rounds. The first round will ask clinicians to score the outcome list and to add any outcomes they think are relevant. The second round involves presentation of scores according to stakeholder group and the opportunity for participants to rescore outcomes. To ensure that the opinion of parents and children are sought, qualitative interviews will be completed with a purposive sample in parallel. In the final round of the Delphi process, participants will be shown the distribution of scores, for each outcome, for all stakeholder groups separately as well as a summary of the results concerning outcomes from the qualitative interviews with parents. A final consensus meeting will be held with all stakeholders, including parents and children, to review outcomes. A core outcome set represents the minimum that should be measured in a clinical trial for a particular condition. The MOMENT study will aim to identify a core outcome set that can be used in future trials of the management of OME, improving the consistency of research in this clinical area.

  15. Identification of a core-periphery structure among participants of a business climate survey. An investigation based on the ZEW survey data

    NASA Astrophysics Data System (ADS)

    Stolzenburg, U.; Lux, T.

    2011-12-01

    Processes of social opinion formation might be dominated by a set of closely connected agents who constitute the cohesive `core' of a network and have a higher influence on the overall outcome of the process than those agents in the more sparsely connected `periphery'. Here we explore whether such a perspective could shed light on the dynamics of a well known economic sentiment index. To this end, we hypothesize that the respondents of the survey under investigation form a core-periphery network, and we identify those agents that define the core (in a discrete setting) or the proximity of each agent to the core (in a continuous setting). As it turns out, there is significant correlation between the so identified cores of different survey questions. Both the discrete and the continuous cores allow an almost perfect replication of the original series with a reduced data set of core members or weighted entries according to core proximity. Using a monthly time series on industrial production in Germany, we also compared experts' predictions with the real economic development. The core members identified in the discrete setting showed significantly better prediction capabilities than those agents assigned to the periphery of the network.

  16. Capturing haplotypes in germplasm core collections

    USDA-ARS?s Scientific Manuscript database

    Genomewide data sets of single nucleotide polymorphisms (SNPs) offer great potential to improve ex situ conservation. Two factors impede their use for producing core collections. First, due to the large number of SNPs, the assembly of collections that maximize diversity may be intractable using ex...

  17. The International Classification of Functioning, Disability and Health and the version for children and youth as a tool in child habilitation/early childhood intervention--feasibility and usefulness as a common language and frame of reference for practice.

    PubMed

    Björck-Åkesson, Eva; Wilder, Jenny; Granlund, Mats; Pless, Mia; Simeonsson, Rune; Adolfsson, Margareta; Almqvist, Lena; Augustine, Lilly; Klang, Nina; Lillvist, Anne

    2010-01-01

    Early childhood intervention and habilitation services for children with disabilities operate on an interdisciplinary basis. It requires a common language between professionals, and a shared framework for intervention goals and intervention implementation. The International Classification of Functioning, Disability and Health (ICF) and the version for children and youth (ICF-CY) may serve as this common framework and language. This overview of studies implemented by our research group is based on three research questions: Do the ICF-CY conceptual model have a valid content and is it logically coherent when investigated empirically? Is the ICF-CY classification useful for documenting child characteristics in services? What difficulties and benefits are related to using ICF-CY model as a basis for intervention when it is implemented in services? A series of studies, undertaken by the CHILD researchers are analysed. The analysis is based on data sets from published studies or master theses. Results and conclusion show that the ICF-CY has a useful content and is logically coherent on model level. Professionals find it useful for documenting children's body functions and activities. Guidelines for separating activity and participation are needed. ICF-CY is a complex classification, implementing it in services is a long-term project.

  18. St. Petersburg Coastal and Marine Science Center's Core Archive Portal

    USGS Publications Warehouse

    Reich, Chris; Streubert, Matt; Dwyer, Brendan; Godbout, Meg; Muslic, Adis; Umberger, Dan

    2012-01-01

    This Web site contains information on rock cores archived at the U.S. Geological Survey (USGS) St. Petersburg Coastal and Marine Science Center (SPCMSC). Archived cores consist of 3- to 4-inch-diameter coral cores, 1- to 2-inch-diameter rock cores, and a few unlabeled loose coral and rock samples. This document - and specifically the archive Web site portal - is intended to be a 'living' document that will be updated continually as additional cores are collected and archived. This document may also contain future references and links to a catalog of sediment cores. Sediment cores will include vibracores, pushcores, and other loose sediment samples collected for research purposes. This document will: (1) serve as a database for locating core material currently archived at the USGS SPCMSC facility; (2) provide a protocol for entry of new core material into the archive system; and, (3) set the procedures necessary for checking out core material for scientific purposes. Core material may be loaned to other governmental agencies, academia, or non-governmental organizations at the discretion of the USGS SPCMSC curator.

  19. A Model for Enhancing Internet Medical Document Retrieval with “Medical Core Metadata”

    PubMed Central

    Malet, Gary; Munoz, Felix; Appleyard, Richard; Hersh, William

    1999-01-01

    Objective: Finding documents on the World Wide Web relevant to a specific medical information need can be difficult. The goal of this work is to define a set of document content description tags, or metadata encodings, that can be used to promote disciplined search access to Internet medical documents. Design: The authors based their approach on a proposed metadata standard, the Dublin Core Metadata Element Set, which has recently been submitted to the Internet Engineering Task Force. Their model also incorporates the National Library of Medicine's Medical Subject Headings (MeSH) vocabulary and Medline-type content descriptions. Results: The model defines a medical core metadata set that can be used to describe the metadata for a wide variety of Internet documents. Conclusions: The authors propose that their medical core metadata set be used to assign metadata to medical documents to facilitate document retrieval by Internet search engines. PMID:10094069

  20. What Is the International Classification of Functioning, Disability and Health and Why Is It Relevant to Audiology?

    PubMed Central

    Meyer, Carly; Grenness, Caitlin; Scarinci, Nerina; Hickson, Louise

    2016-01-01

    The World Health Organization's International Classification of Functioning, Disability and Health (ICF) is widely used in disability and health sectors as a framework to describe the far-reaching effects of a range of health conditions on individuals. This biopsychosocial framework can be used to describe the experience of an individual in the components of body functions, body structures, and activities and participation, and it considers the influence of contextual factors (environmental and personal) on these components. Application of the ICF in audiology allows the use of a common language between health care professionals in both clinical and research settings. Furthermore, the ICF is promoted as a means of facilitating patient-centered care. In this article, the relevance and application of the ICF to audiology is described, along with clinical examples of its application in the assessment and management of children and adults with hearing loss. Importantly, the skills necessary for clinicians to apply the ICF effectively are discussed. PMID:27489397

  1. COBRA accelerator for Sandia ICF diode research at Cornell University

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

    Smith, D.L.; Ingwersen, P.; Bennett, L.F.

    1995-05-01

    The new COBRA accelerator is being built in stages at the Laboratory of Plasma Studies in Cornell University where its applications will include extraction diode and ion beam research in support of the light ion inertial confinement fusion (ICF) program at Sandia National Laboratories. The 4- to 5-MV, 125- to 250-kA accelerator is based on a four-cavity inductive voltage adder (IVA) design. It is a combination of new ferromagnetically-isolated cavities and self magnetically insulated transmission line (MITL) hardware and components from existing Sandia and Cornell facilities: Marx generator capacitors, hardware, and power supply from the DEMON facility; water pulse formingmore » lines (PFL) and gas switch from the Subsystem Test Facility (STF); a HERMES-III intermediate store capacitor (ISC); and a modified ion diode from Cornell`s LION. The present accelerator consists of a single modified cavity similar to those of the Sandia SABRE accelerator and will be used to establish an operating system for the first stage initial lower voltage testing. Four new cavities will be fabricated and delivered in the first half of FY96 to complete the COBRA accelerator. COBRA is unique in the sense that each cavity is driven by a single pulse forming line, and the IVA output polarity may be reversed by rotating the cavities 180{degrees} about their vertical axis. The site preparations, tank construction, and diode design and development are taking place at Cornell with growing enthusiasm as this machine becomes a reality. Preliminary results with the single cavity and short positive inner cylinder MITL configuration will soon be available.« less

  2. Rapid measurement and compensation method of eccentricity in automatic profile measurement of the ICF capsule.

    PubMed

    Li, Shaobai; Wang, Yun; Wang, Qi; Ma, Xianxian; Wang, Longxiao; Zhao, Weiqian; Zhang, Xusheng

    2018-05-10

    In this paper, we propose a new measurement and compensation method for the eccentricity of the inertial confinement fusion (ICF) capsule, which combines computer vision and the laser differential confocal method to align the capsule in rotation measurement. This technique measures the eccentricity of the capsule by obtaining the sub-pixel profile with a moment-based algorithm, then performs the preliminary alignment by the two-dimensional adjustment. Next, we use the laser differential confocal sensor to measure the height data of the equatorial surface of the capsule by turning it around, then obtain and compensate the remaining eccentricity ultimately. This method is a non-contact, automatic, rapid, high-precision measurement and compensation technique of eccentricity for the capsule. Theoretical analyses and preliminary experiments indicate that the maximum measurement range of eccentricity of this proposed method is 1.8 mm for the capsule with a diameter of 1 mm, and it could eliminate the eccentricity to less than 0.5 μm in 30 s.

  3. Simulation of alternate hohlraum shapes for improved inner beam propagation in indirectly-driven ICF implosions

    NASA Astrophysics Data System (ADS)

    Robey, H. F.; Berzak Hopkins, L. F.

    2017-10-01

    Recent indirectly-driven ICF experiments performed on the National Ignition Facility have shown that the propagation of the inner beam cones is impeded late in the laser pulse by the growth of a gold bubble, which is initiated at the location where the outer beams hit the hohlraum wall and which expands radially inward into the hohlraum as the implosion progresses. Late in time, this gold bubble intercepts a significant portion of the inner beams reducing the available energy reaching the waist of the hohlraum and affecting the implosion symmetry. Integrated hohlraum simulations of alternate hohlraum shapes using HYDRA are performed to explore options for reducing the impact of the gold bubble on inner beam propagation. The simulations are based on recent NIF implosions using High-Density Carbon (HDC) ablators, which have shown good performance, but which could benefit from improved inner beam propagation. This work was performed under the auspices of the Lawrence Livermore National Security, LLC, (LLNS) under Contract No. DE-AC52-07NA27344.

  4. Design process for applying the nonlocal thermal transport iSNB model to a Polar-Drive ICF simulation

    NASA Astrophysics Data System (ADS)

    Cao, Duc; Moses, Gregory; Delettrez, Jacques; Collins, Timothy

    2014-10-01

    A design process is presented for the nonlocal thermal transport iSNB (implicit Schurtz, Nicolai, and Busquet) model to provide reliable nonlocal thermal transport in polar-drive ICF simulations. Results from the iSNB model are known to be sensitive to changes in the SNB ``mean free path'' formula, and the latter's original form required modification to obtain realistic preheat levels. In the presented design process, SNB mean free paths are first modified until the model can match temperatures from Goncharov's thermal transport model in 1D temperature relaxation simulations. Afterwards the same mean free paths are tested in a 1D polar-drive surrogate simulation to match adiabats from Goncharov's model. After passing the two previous steps, the model can then be run in a full 2D polar-drive simulation. This research is supported by the University of Rochester Laboratory for Laser Energetics.

  5. BioCore Guide: A Tool for Interpreting the Core Concepts of Vision and Change for Biology Majors

    PubMed Central

    Freeman, Scott; Wenderoth, Mary Pat; Crowe, Alison J.

    2014-01-01

    Vision and Change in Undergraduate Biology Education outlined five core concepts intended to guide undergraduate biology education: 1) evolution; 2) structure and function; 3) information flow, exchange, and storage; 4) pathways and transformations of energy and matter; and 5) systems. We have taken these general recommendations and created a Vision and Change BioCore Guide—a set of general principles and specific statements that expand upon the core concepts, creating a framework that biology departments can use to align with the goals of Vision and Change. We used a grassroots approach to generate the BioCore Guide, beginning with faculty ideas as the basis for an iterative process that incorporated feedback from more than 240 biologists and biology educators at a diverse range of academic institutions throughout the United States. The final validation step in this process demonstrated strong national consensus, with more than 90% of respondents agreeing with the importance and scientific accuracy of the statements. It is our hope that the BioCore Guide will serve as an agent of change for biology departments as we move toward transforming undergraduate biology education. PMID:26086653

  6. Describing the clinical reasoning process: application of a model of enablement to a pediatric case.

    PubMed

    Furze, Jennifer; Nelson, Kelly; O'Hare, Megan; Ortner, Amanda; Threlkeld, A Joseph; Jensen, Gail M

    2013-04-01

    Clinical reasoning is a core tenet of physical therapy practice leading to optimal patient care. The purpose of this case was to describe the outcomes, subjective experience, and reflective clinical reasoning process for a child with cerebral palsy using the International Classification of Functioning, Disability, and Health (ICF) model. Application of the ICF framework to a 9-year-old boy with spastic triplegic cerebral palsy was utilized to capture the interwoven factors present in this case. Interventions in the pool occurred twice weekly for 1 h over a 10-week period. Immediately post and 4 months post-intervention, the child made functional and meaningful gains. The family unit also developed an enjoyment of exercising together. Each individual family member described psychological, emotional, or physical health improvements. Reflection using the ICF model as a framework to discuss clinical reasoning can highlight important factors contributing to effective patient management.

  7. Using a Z-pinch precursor plasma to produce a cylindrical, hotspot ignition, ICF

    NASA Astrophysics Data System (ADS)

    Chittenden, Jeremy

    2005-10-01

    We show that if the same precursor plasma that exists in metal wire arrays can be generated with a Deuterium-Tritium plasma then this precursor provides an ideal target for a cylindrical magneto-inertial ICF scheme. The precursor is generated from a fraction of the mass of the array which arrives on the axis early in time and remains confined at high density by the inertia of further material bombarding the axis. Later on, the main implosion of the DT Z-pinch produces a dense, low temperature shell which compressively heats the precursor target to high temperatures and tamps its expansion. The azimuthal magnetic field in the hotspot is sufficient to reduce the Larmor radius for the alpha particles to much less than the hotspot size, which dramatically reduces the ρR required for ignition. A computational analysis of this approach is presented, including a study of the thermonuclear burn wave propagation. The robustness of the scheme with respect to instabilities, confinement time and drive parameters is examined. The results indicate that a high energy gain can be achieved using Z-pinches with 50-100 MA currents and a few hundred nanosecond rise-times. This work was partially supported by the U.S. Department of Energy through cooperative agreement DE-FC03-02NA00057.

  8. Attentional Set-Shifting in Fragile X Syndrome

    ERIC Educational Resources Information Center

    Van der Molen, M. J. W.; Van der Molen, M. W.; Ridderinkhof, K. R.; Hamel, B. C. J.; Curfs, L. M. G.; Ramakers, G. J. A.

    2012-01-01

    The ability to flexibly adapt to the changing demands of the environment is often reported as a core deficit in fragile X syndrome (FXS). However, the cognitive processes that determine this attentional set-shifting deficit remain elusive. The present study investigated attentional set-shifting ability in fragile X syndrome males with the…

  9. A volatile-rich Earth's core inferred from melting temperature of core materials

    NASA Astrophysics Data System (ADS)

    Morard, G.; Andrault, D.; Antonangeli, D.; Nakajima, Y.; Auzende, A. L.; Boulard, E.; Clark, A. N.; Lord, O. T.; Cervera, S.; Siebert, J.; Garbarino, G.; Svitlyk, V.; Mezouar, M.

    2016-12-01

    Planetary cores are mainly constituted of iron and nickel, alloyed with lighter elements (Si, O, C, S or H). Understanding how these elements affect the physical and chemical properties of solid and liquid iron provides stringent constraints on the composition of the Earth's core. In particular, melting curves of iron alloys are key parameter to establish the temperature profile in the Earth's core, and to asses the potential occurrence of partial melting at the Core-Mantle Boundary. Core formation models based on metal-silicate equilibration suggest that Si and O are the major light element components1-4, while the abundance of other elements such as S, C and H is constrained by arguments based on their volatility during planetary accretion5,6. Each compositional model implies a specific thermal state for the core, due to the different effect that light elements have on the melting behaviour of Fe. We recently measured melting temperatures in Fe-C and Fe-O systems at high pressures, which complete the data sets available both for pure Fe7 and other binary alloys8. Compositional models with an O- and Si-rich outer core are suggested to be compatible with seismological constraints on density and sound velocity9. However, their crystallization temperatures of 3650-4050 K at the CMB pressure of 136 GPa are very close to, if not higher than the melting temperature of the silicate mantle and yet mantle melting above the CMB is not a ubiquitous feature. This observation requires significant amounts of volatile elements (S, C or H) in the outer core to further reduce the crystallisation temperature of the core alloy below that of the lower mantle. References 1. Wood, B. J., et al Nature 441, 825-833 (2006). 2. Siebert, J., et al Science 339, 1194-7 (2013). 3. Corgne, A., et al Earth Planet. Sc. Lett. 288, 108-114 (2009). 4. Fischer, R. a. et al. Geochim. Cosmochim. Acta 167, 177-194 (2015). 5. Dreibus, G. & Palme, H. Geochim. Cosmochim. Acta 60, 1125-1130 (1995). 6. Mc

  10. Perspectives on Teaching the International Classification of Functioning, Disability, and Health Model to Physical Therapy Students.

    PubMed

    Peters-Brinkerhoff, Cheryl

    2016-01-01

    During a reaccreditation visit, deficiencies were discovered in the clinical education curriculum regarding patient-centered care in a Doctorate of Physical Therapy program. To understand the problem and address those deficiencies, the clinical internship experience was examined using the International Classification of Functioning, Disability, and Health (ICF) model as a conceptual framework for clinical reasoning. This qualitative case study aimed to study (1) perceptions of physical therapy (PT) students regarding their knowledge and learning experiences during clinical affiliations and what knowledge they acquired of the ICF as applied to patient-centered care during their internship, and (2) the perceptions of clinical instructors (CIs) of their knowledge of the ICF model, its integration into their practice, barriers to its use, and the learning experiences the CIs provided to students regarding the ICF model. Data were collected using questionnaires sent to 42 CIs and at focus groups of 22 PT students conducted at the study site. Data were also collected from student evaluations on the Clinical Performance Instrument. Data were analyzed using coding techniques and themes based on the use of the ICF model in the clinical setting by students and CIs. Most CIs reported a poor understanding of the ICF model or how it relates to patient-centered care; both CIs and students reported none to minimal learning experience related to the ICF model. Document analysis of the student evaluations revealed no assessment of the ICF model was mentioned. Learning experiences of all domains of the ICF model are generally not being presented to PT students during their clinical affiliations.

  11. Cardiac rehabilitation delivery model for low-resource settings.

    PubMed

    Grace, Sherry L; Turk-Adawi, Karam I; Contractor, Aashish; Atrey, Alison; Campbell, Norm; Derman, Wayne; Melo Ghisi, Gabriela L; Oldridge, Neil; Sarkar, Bidyut K; Yeo, Tee Joo; Lopez-Jimenez, Francisco; Mendis, Shanthi; Oh, Paul; Hu, Dayi; Sarrafzadegan, Nizal

    2016-09-15

    Cardiovascular disease is a global epidemic, which is largely preventable. Cardiac rehabilitation (CR) is demonstrated to be cost-effective and efficacious in high-income countries. CR could represent an important approach to mitigate the epidemic of cardiovascular disease in lower-resource settings. The purpose of this consensus statement was to review low-cost approaches to delivering the core components of CR, to propose a testable model of CR which could feasibly be delivered in middle-income countries. A literature review regarding delivery of each core CR component, namely: (1) lifestyle risk factor management (ie, physical activity, diet, tobacco and mental health), (2) medical risk factor management (eg, lipid control, blood pressure control), (3) education for self-management and (4) return to work, in low-resource settings was undertaken. Recommendations were developed based on identified articles, using a modified GRADE approach where evidence in a low-resource setting was available, or consensus where evidence was not. Available data on cost of CR delivery in low-resource settings suggests it is not feasible to deliver CR in low-resource settings as is delivered in high-resource ones. Strategies which can be implemented to deliver all of the core CR components in low-resource settings were summarised in practice recommendations, and approaches to patient assessment proffered. It is suggested that CR be adapted by delivery by non-physician healthcare workers, in non-clinical settings. Advocacy to achieve political commitment for broad delivery of adapted CR services in low-resource settings is needed. 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/

  12. Collection of LAI and FPAR Data Over The Terra Core Sites

    NASA Technical Reports Server (NTRS)

    Myneni, Ranga B.; Knjazihhin, J.; Tian, Y.; Wang, Y.

    2001-01-01

    The objective of our effort was to collect and archive data on LAI (leaf area index) and FPAR (Fraction of Photosynthetically active Radiation absorbed by vegetation) at the EOS Core validation sites as well as to validate and evaluate global fields of LAI and FPAR derived from atmospherically corrected MODIS (Moderate Resolution Imaging Spectrometer) surface reflectance data by comparing these fields with the EOS Core validation data set. The above has been accomplished by: (a) the participation in selected field campaigns within the EOS Validation Program; (b) the processing of the collected data so that suitable comparison between field measurements and the MODIS LAI/FPAR fields can be made; (c) the comparison of the MODAS LAI/FRAM fields with the EOS Terra Core validation data set.

  13. Outcome Measurement in the Treatment of Spasmodic Dysphonia: A Systematic Review of the Literature.

    PubMed

    Rumbach, Anna; Aiken, Patrick; Novakovic, Daniel

    2018-04-11

    The aim of this review was to systematically identify all available studies reporting outcomes measures to assess treatment outcomes for people with spasmodic dysphonia (SD). Full-text journal articles were identified through searches of PubMed, Embase, CINAHL, and Cochrane databases and hand searching of journals. A total of 4,714 articles were retrieved from searching databases; 1,165 were duplicates. Titles and abstracts of 3,549 were screened, with 171 being selected for full-text review. During full-text review, 101 articles were deemed suitable for inclusion. An additional 24 articles were identified as suitable for inclusion through a hand search of reference lists. Data were extracted from 125 studies. A total of 220 outcome measures were identified. Considered in reference to the World Health Organization International Classification of Functioning, Disability and Health (ICF), the majority of outcomes were measured at a Body Function level (n = 212, 96%). Outcomes that explored communication and participation in everyday life and attitudes toward communication (ie, activity and participation domains) were infrequent (n = 8; 4%). Quality of life, a construct not measured within the ICF, was also captured by four outcome measures. No instruments evaluating communication partners' perspectives or burden/disability were identified. The outcome measures used in SD treatment studies are many and varied. The outcome measures identified predominately measure constructs within the Body Functions component of the ICF. In order to facilitate data synthesis across trials, the development of a core outcome set is recommended. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

  14. Neural networks within multi-core optic fibers

    PubMed Central

    Cohen, Eyal; Malka, Dror; Shemer, Amir; Shahmoon, Asaf; Zalevsky, Zeev; London, Michael

    2016-01-01

    Hardware implementation of artificial neural networks facilitates real-time parallel processing of massive data sets. Optical neural networks offer low-volume 3D connectivity together with large bandwidth and minimal heat production in contrast to electronic implementation. Here, we present a conceptual design for in-fiber optical neural networks. Neurons and synapses are realized as individual silica cores in a multi-core fiber. Optical signals are transferred transversely between cores by means of optical coupling. Pump driven amplification in erbium-doped cores mimics synaptic interactions. We simulated three-layered feed-forward neural networks and explored their capabilities. Simulations suggest that networks can differentiate between given inputs depending on specific configurations of amplification; this implies classification and learning capabilities. Finally, we tested experimentally our basic neuronal elements using fibers, couplers, and amplifiers, and demonstrated that this configuration implements a neuron-like function. Therefore, devices similar to our proposed multi-core fiber could potentially serve as building blocks for future large-scale small-volume optical artificial neural networks. PMID:27383911

  15. Conversion of the Mini-Mental State Examination to the International Classification of Functioning, Disability and Health terminology and scoring system.

    PubMed

    De Vriendt, P; Gorus, E; Bautmans, I; Mets, T

    2012-01-01

    In older patients, evaluation of the cognitive status is crucial. The Mini-Mental State Examination (MMSE) is widely used for screening of cognition, providing fairly high sensitivity, specificity and reproducibility. Recently, a consensus emerged on the necessity of an international and transparent language, as provided by the WHO's International Classification of Functioning, Disability and Health (ICF). Most assessment tools however are not in accordance with the ICF. To reformulate the MMSE according to the ICF, both for the individual items and for the scoring system. MMSE data (scores varying from 3 to 30/30) of (1) 217 cognitively healthy elderly, (2) 60 persons with mild cognitive impairment, (3) 60 patients with mild Alzheimer's disease (AD), and (4) 60 patients with moderate/severe AD were obtained from studies at a university hospital setting. Subjects were aged 65 years or more and recruited either through advertisement (group 1), from the geriatric day hospital (groups 2 and 3), or the geriatric ward (group 4). The allocation to the groups was done after multidisciplinary evaluation. The conversion of the MMSE to ICF-MMSE was done by content comparison and by subsequent translation of the scoring system using automatic algorithms. All MMSE items were converted to the corresponding ICF categories. Three ICF domains were addressed: global and specific mental functions, general tasks and demands, divided over 6 ICF categories (orientation time/place, sustaining attention, memory functions, mental functions of language, undertaking a simple task). Scores on individual items were transformed according to their relative weight on the original MMSE scale, and a total ICF-MMSE score from 0 (no problem) to 100 (complete problem) was generated. Translation was satisfying, as illustrated by a good correlation between MMSE and ICF-MMSE. The diagnostic groups were distributed over the ICF-MMSE scores as expected. For each ICF domain, ICF-MMSE subscores were higher

  16. 26. SOME CORES, SUCH AS THESE IN THE BRASS FOUNDRY ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    26. SOME CORES, SUCH AS THESE IN THE BRASS FOUNDRY CA.1950, ARE DIPPED INTO A SOLUTION PRIOR TO BEING BAKED IN THE CORE OVEN BEHIND, TO SET THE RESIN AND CREATE A STRUCTURE STRONG ENOUGH TO HOLD UP AGAINST MOLTEN METAL. - Stockham Pipe & Fittings Company, 4000 Tenth Avenue North, Birmingham, Jefferson County, AL

  17. Constraints on Inner Core Anisotropy Using Array Observations of P'P'

    NASA Astrophysics Data System (ADS)

    Frost, Daniel A.; Romanowicz, Barbara

    2017-11-01

    Recent studies of PKPdf travel times suggest strong anisotropy (4% or more) in the quasi-western inner core hemisphere. However, the availability of paths sampling at low angles to the Earth's rotation axis (the fast axis) is limited. To augment this sampling, we collected a travel time data set for the phase P'P'df (PKPPKPdf), for which at least one inner core leg is quasi-polar, at two high latitude seismic arrays. We find that the inferred anisotropy is weak (on the order of 0.5 to 1.5%), confirming previous results based on a much smaller P'P' data set. While previous models of inner core anisotropy required very strong alignment of anisotropic iron grains, our results are more easily explained by current dynamic models of inner core growth. We observe large travel time anomalies when one leg of P'P'df is along the South Sandwich to Alaska path, consistent with PKPdf observations, and warranting further investigation.

  18. Rehabilitation interventions in multiple sclerosis: an overview.

    PubMed

    Beer, Serafin; Khan, Fary; Kesselring, Jürg

    2012-09-01

    Multiple sclerosis is a complex, heterogeneous disease associated with long-term disability. Despite the availability of advanced disease-modifying and symptomatic therapies that may decrease activity and progression of disease and alleviate complaints to a certain extent, there is still a need for comprehensive rehabilitation interventions in order to reduce sequels and symptoms of the disease on personal activities and social participation to achieve the highest possible independence and the best quality of life. Timing and setting of rehabilitation interventions should be selected individually depending on disease phase, functional deficits, personal requirements, as well as specific goals. In addition, limitations and disease-specific characteristics that may influence rehabilitation outcome should be noted. Rehabilitation interventions should be considered early for maintaining functional capacity and reducing risk for losing important abilities or independence. Due to gradual failure of adaptive compensatory mechanisms along the course of disease, benefits of rehabilitation interventions are generally higher in earlier phases of MS. Inpatient and outpatient multidisciplinary rehabilitation has been shown to be beneficial in improving disability, participation and quality of life despite progression of the disease. Good evidence exists for different specific interventions improving physical and cognitive performance. Other important issues responsible for beneficial effects of comprehensive rehabilitation in MS include education, instruction, and information of patients and caregivers. Comprehensive assessment of health domains in MS patients using standardized framework and common language for describing the impact of disease at different levels, using International Classification of Functioning, Disability and Health (ICF) core sets may increase the knowledge of needs of these patients for more efficient and adapted rehabilitation interventions meeting these

  19. Towards core outcome set (COS) development: a follow-up descriptive survey of outcomes in Cochrane reviews.

    PubMed

    Wuytack, Francesca; Smith, Valerie; Clarke, Mike; Williamson, Paula; Gargon, Elizabeth

    2015-05-19

    A core outcome set (COS) can address problems of outcome heterogeneity and outcome reporting bias in trials and systematic reviews, including Cochrane reviews, helping to reduce waste. One of the aims of the international Core Outcome Measures in Effectiveness Trials (COMET) Initiative is to link the development and use of COS with the outcomes specified and reported in Cochrane reviews, including the outcomes listed in the summary of findings (SoF) tables. As part of this work, an earlier exploratory survey of the outcomes of newly published 2007 and 2011 Cochrane reviews was performed. This survey examined the use of COS, the variety of specified outcomes, and outcome reporting in Cochrane reviews by Cochrane Review Group (CRG). To examine changes over time and to explore outcomes that were repeatedly specified over time in Cochrane reviews by CRG, we conducted a follow-up survey of outcomes in 2013 Cochrane reviews. A descriptive survey of outcomes in Cochrane reviews that were first published in 2013. Outcomes specified in the methods sections and reported in the results section of the Cochrane reviews were examined by CRG. We also explored the uptake of SoF tables, the number of outcomes included in these, and the quality of the evidence for the outcomes. Across the 50 CRGs, 375 Cochrane reviews that included at least one study specified a total of 3142 outcomes. Of these outcomes, 32 % (1008) were not reported in the results section of these reviews. For 23 % (233) of these non-reported outcomes, we did not find any reason in the text of the review for this non-report. Fifty-seven percent (216/375) of reviews included a SoF table. The proportion of specified outcomes that were reported in Cochrane reviews had increased in 2013 (68 %) compared to 2007 (61 %) and 2011 (65 %). Importantly, 2013 Cochrane reviews that did not report specified outcomes were twice as likely to provide an explanation for why the outcome was not reported. There has been an increased

  20. Observational constraints on neutron star crust-core coupling during glitches

    NASA Astrophysics Data System (ADS)

    Newton, W. G.; Berger, S.; Haskell, B.

    2015-12-01

    We demonstrate that observations of glitches in the Vela pulsar can be used to investigate the strength of the crust-core coupling in a neutron star and provide a powerful probe of the internal structure of neutron stars. We assume that glitch recovery is dominated by the torque exerted by the mutual friction-mediated recoupling of superfluid components of the core that were decoupled from the crust during the glitch. Then we use the observations of the recoveries from two recent glitches in the Vela pulsar to infer the fraction of the core that is coupled to the crust during the glitch. We then analyse whether crustal neutrons alone are sufficient to drive glitches in the Vela pulsar, taking into account crustal entrainment. We use two sets of neutron star equations of state (EOSs) which span crust and core consistently and cover a conservative range of the slope of the symmetry energy at saturation density 30 < L < 120 MeV. The two sets differ in the stiffness of the high density EOS. We find that for medium to stiff EOSs, observations imply >70 per cent of the moment of inertia of the core is coupled to the crust during the glitch, though for softer EOSs L ≈ 30 MeV as little as 5 per cent could be coupled. We find that only by extending the region where superfluid vortices are strongly pinned into the core by densities at least 0.016 fm-3 above the crust-core transition density does any EOS reproduce the observed glitch activity.

  1. Design options for reducing the impact of the fill-tube in ICF implosion experiments on the NIF

    NASA Astrophysics Data System (ADS)

    Weber, Christopher R.; Berzak Hopkins, L. F.; Casey, D. T.; Clark, D. S.; Hammel, B. A.; Le Pape, S.; Macphee, A.; Milovich, J.; Pickworth, L. A.; Robey, H. F.; Smalyuk, V. A.; Stadermann, M.; Felker, S. J.; Nikroo, A.; Thomas, C. A.; Crippen, J.; Rice, N.

    2017-10-01

    Inertial Confinement Fusion (ICF) capsules on the National Ignition Facility (NIF) are filled with thermonuclear fuel through a fill-tube. When the capsule implodes, perturbations caused by the fill-tube allow ablator material to mix into the hot spot and reduce fusion performance. This talk will explore several design options that attempt to reduce this damaging effect. Reducing the diameter of the fill-tube and its entrance hole is the obvious course and has been tested in experiments. Simulations also show sensitivity to the amount of glue holding the fill-tube to the capsule and suggest that careful control of this feature can limit the amount of injected mass. Finally, an off-axis fill-tube reduces the initial squirt of material into the fuel and may be a way of further optimizing this engineering feature. Work performed under the auspices of the U.S. D.O.E. by Lawrence Livermore National Laboratory under Contract No. DE-AC52-07NA27344.

  2. Historical ecology of the northern Adriatic Sea: Field methods and coring device

    NASA Astrophysics Data System (ADS)

    Haselmair, Alexandra; Gallmetzer, Ivo; Tomasovych, Adam; Stachowitsch, Michael; Zuschin, Martin

    2014-05-01

    For an ongoing study on the historical ecology of the northern Adriatic Sea, the objective was to retrieve a high number of sediment cores at seven sampling stations spread across the entire basin. One set of cores is intended for sediment analyses including radiometric Pb-sediment-dating, grain size, TOC, TAC and heavy metal analyses. The other set of cores delivered enough shelly remains of endo- or epibenthic hard part producers (e.g. molluscs, crustaceans, echinoderms) to enable the reconstruction of death assemblages in core layers from top to bottom. The down-core changes of such assemblages record ecological shifts in a marine environment that has endured strong human impacts over several centuries. A 1.5 m-long core could, according to the available sedimentation data for the area, cover up to 2000 or even more years of ecological history. The coring method had to meet the following requirements: a) deliver 1.5-m-long cores from different sediment settings (mud to sand, reflecting a wide range of benthic habitats in the northern Adriatic); b) enable quick and easy deployment to ensure that multiple cores can be taken at the individual sampling stations within a short time; c) be relatively affordable and allow handling by the researchers themselves, potentially using a small vessel in order to further contain the operating costs. Two types of UWITEC™ piston corers were used to meet these requirements. A model with 90 mm of diameter (samples for sediment analysis) and another one with 160 mm, specifically designed to obtain the large amount of material needed for shell analysis, successfully delivered a total of 54 cores. The device consists of a stabilizing tripod and the interchangeable coring cylinders. It is equipped with a so-called hammer action that makes it possible, at least for the smaller cylinder, to penetrate even harder sediments. A closing mechanism of the corer retains the sediment in the cylinder upon extraction; it works either

  3. Drug-resistant tuberculosis clinical trials: proposed core research definitions in adults.

    PubMed

    Furin, J; Alirol, E; Allen, E; Fielding, K; Merle, C; Abubakar, I; Andersen, J; Davies, G; Dheda, K; Diacon, A; Dooley, K E; Dravnice, G; Eisenach, K; Everitt, D; Ferstenberg, D; Goolam-Mahomed, A; Grobusch, M P; Gupta, R; Harausz, E; Harrington, M; Horsburgh, C R; Lienhardt, C; McNeeley, D; Mitnick, C D; Nachman, S; Nahid, P; Nunn, A J; Phillips, P; Rodriguez, C; Shah, S; Wells, C; Thomas-Nyang'wa, B; du Cros, P

    2016-03-01

    Drug-resistant tuberculosis (DR-TB) is a growing public health problem, and for the first time in decades, new drugs for the treatment of this disease have been developed. These new drugs have prompted strengthened efforts in DR-TB clinical trials research, and there are now multiple ongoing and planned DR-TB clinical trials. To facilitate comparability and maximise policy impact, a common set of core research definitions is needed, and this paper presents a core set of efficacy and safety definitions as well as other important considerations in DR-TB clinical trials work. To elaborate these definitions, a search of clinical trials registries, published manuscripts and conference proceedings was undertaken to identify groups conducting trials of new regimens for the treatment of DR-TB. Individuals from these groups developed the core set of definitions presented here. Further work is needed to validate and assess the utility of these definitions but they represent an important first step to ensure there is comparability in clinical trials on multidrug-resistant TB.

  4. Proposal of the School Children Support System Using ICF to Communicate with the Teachers, the Specialists and the Guardians, Requiring Special Support Education

    NASA Astrophysics Data System (ADS)

    Ogoshi, Yasuhiro; Nakai, Akio; Mitsuhashi, Yoshinori; Araki, Chikahiro

    At the present, educational support is required to the school children who confronts problems on study, life style, mental and health. For the school children who hold these problems, inference and understanding of those around adults are mandatory, for that intimate cooperation between the school, home and specialized agencies should be important. With above reason, the school children support system using ICF to communicate the school, the specialist and the guardian is developed in this works. Realization of this system, immediate support to the school children and their guardians will be possible. It is also considered to be a preventive support instead of an allopathic support.

  5. Common Core English and Language Arts K-1 Exemplar Text Set: A Critical Content Analysis of Cultural Representations

    ERIC Educational Resources Information Center

    McCaffrey, Megan

    2014-01-01

    With the implementation of Common Core State Standards (CCSS) in over forty states, teachers are putting into practice the CCSS text exemplars of text complexity. Of particular concern for the purpose of this research are the kindergarten and first grade (K-1) read aloud and independent text exemplar lists. While not intended as core reading…

  6. Measuring participation in children with Gilles de la Tourette syndrome: a pilot study with ICF-CY.

    PubMed

    Meucci, Paolo; Leonardi, Matilde; Zibordi, Federica; Nardocci, Nardo

    2009-01-01

    Environmental factors (EF) have an important role on Tourette's symptoms and the same factors can be decisive on the impact that the disease has on people with Tourette syndrome (TS) daily life. The research was carried out by the Neurological Institute Carlo Besta IRCCS Foundation with the principal objective of describing the complete range of functional profiles of children with TS, to define the functioning and the difficulties in social participation. The research protocol was composed of the ICF-CY questionnaire, WHO-DAS II proxy version, the Vineland Adaptive Behavior Scale and the Kidscreen questionnaires - Quality of life (QoL) questionnaires for children and adolescents. The research protocol involved a multidisciplinary team (medical staff, psychologist, pedagogist). The children reported higher QoL's level than the QoL attributed by parents. The Vineland scores reflected considerable difficulties in socialisation. Through the EF analysis, this study highlights the facilitating role of the immediate family and health professionals. Beyond the clinical symptoms, this study points out that the therapeutic elements must be identified by a change of environment, and not only in a child's adaptation ability.

  7. Conversational Competence in Academic Settings

    ERIC Educational Resources Information Center

    Bowman, Richard F.

    2014-01-01

    Conversational competence is a process, not a state. Ithaca does not exist, only the voyage to Ithaca. Vibrant campuses are a series of productive conversations. At its core, communicative competence in academic settings mirrors a collective search for meaning regarding the purpose and direction of a campus community. Communicative competence…

  8. Core Hunter 3: flexible core subset selection.

    PubMed

    De Beukelaer, Herman; Davenport, Guy F; Fack, Veerle

    2018-05-31

    Core collections provide genebank curators and plant breeders a way to reduce size of their collections and populations, while minimizing impact on genetic diversity and allele frequency. Many methods have been proposed to generate core collections, often using distance metrics to quantify the similarity of two accessions, based on genetic marker data or phenotypic traits. Core Hunter is a multi-purpose core subset selection tool that uses local search algorithms to generate subsets relying on one or more metrics, including several distance metrics and allelic richness. In version 3 of Core Hunter (CH3) we have incorporated two new, improved methods for summarizing distances to quantify diversity or representativeness of the core collection. A comparison of CH3 and Core Hunter 2 (CH2) showed that these new metrics can be effectively optimized with less complex algorithms, as compared to those used in CH2. CH3 is more effective at maximizing the improved diversity metric than CH2, still ensures a high average and minimum distance, and is faster for large datasets. Using CH3, a simple stochastic hill-climber is able to find highly diverse core collections, and the more advanced parallel tempering algorithm further increases the quality of the core and further reduces variability across independent samples. We also evaluate the ability of CH3 to simultaneously maximize diversity, and either representativeness or allelic richness, and compare the results with those of the GDOpt and SimEli methods. CH3 can sample equally representative cores as GDOpt, which was specifically designed for this purpose, and is able to construct cores that are simultaneously more diverse, and either are more representative or have higher allelic richness, than those obtained by SimEli. In version 3, Core Hunter has been updated to include two new core subset selection metrics that construct cores for representativeness or diversity, with improved performance. It combines and outperforms the

  9. GrowYourIC: A Step Toward a Coherent Model of the Earth's Inner Core Seismic Structure

    NASA Astrophysics Data System (ADS)

    Lasbleis, Marine; Waszek, Lauren; Day, Elizabeth A.

    2017-11-01

    A complex inner core structure has been well established from seismic studies, showing radial and lateral heterogeneities at various length scales. Yet no geodynamic model is able to explain all the features observed. One of the main limits for this is the lack of tools to compare seismic observations and numerical models successfully. We use here a new Python tool called GrowYourIC to compare models of inner core structure. We calculate properties of geodynamic models of the inner core along seismic raypaths, for random or user-specified data sets. We test kinematic models which simulate fast lateral translation, superrotation, and differential growth. We explore first the influence on a real inner core data set, which has a sparse coverage of the inner core boundary. Such a data set is however able to successfully constrain the hemispherical boundaries due to a good sampling of latitudes. Combining translation and rotation could explain some of the features of the boundaries separating the inner core hemispheres. The depth shift of the boundaries, observed by some authors, seems unlikely to be modeled by a fast translation but could be produced by slow translation associated with superrotation.

  10. Choosing outcome assessment tools in haemophilia care and research: a multidisciplinary perspective.

    PubMed

    Fischer, K; Poonnoose, P; Dunn, A L; Babyn, P; Manco-Johnson, M J; David, J A; van der Net, J; Feldman, B; Berger, K; Carcao, M; de Kleijn, P; Silva, M; Hilliard, P; Doria, A; Srivastava, A; Blanchette, V

    2017-01-01

    The implementation of early long-term, regular clotting factor concentrate (CFC) replacement therapy ('prophylaxis') has made it possible to offer boys with haemophilia a near normal life. Many different regimens have reported favourable results, but the optimum treatment regimens have not been established and the cost of prophylaxis is very high. Both for optimizing treatment and reimbursement issues, there is a need to provide objective evidence of both short- and long-term results and benefits of prophylactic regimens. This report presents a critical review of outcome measures for use in the assessment of musculoskeletal health in persons with haemophilia according to the International Classification of Functioning, Disability and Health (ICF). This framework considers structural and functional changes, activities and participation in a context of both personal and environmental factors. Results were generated by a combination of a critical review of available literature plus expert opinion derived from a two day consensus conference between 48 health care experts from different disciplines involved in haemophilia assessment and care. Outcome tools used in haemophilia were reviewed for reliability and validity in different patient groups and for resources required. Recommendations for choice of outcome tools were made according to the ICF domains, economic setting, and reason for use (clinical or research). The next step will be to identify a 'core' set of outcome measures for use in clinical care or studies evaluating treatment. © 2016 The Authors. Haemophilia Published by John Wiley & Sons Ltd.

  11. Core principles of evolutionary medicine: A Delphi study.

    PubMed

    Grunspan, Daniel Z; Nesse, Randolph M; Barnes, M Elizabeth; Brownell, Sara E

    2018-01-01

    Evolutionary medicine is a rapidly growing field that uses the principles of evolutionary biology to better understand, prevent and treat disease, and that uses studies of disease to advance basic knowledge in evolutionary biology. Over-arching principles of evolutionary medicine have been described in publications, but our study is the first to systematically elicit core principles from a diverse panel of experts in evolutionary medicine. These principles should be useful to advance recent recommendations made by The Association of American Medical Colleges and the Howard Hughes Medical Institute to make evolutionary thinking a core competency for pre-medical education. The Delphi method was used to elicit and validate a list of core principles for evolutionary medicine. The study included four surveys administered in sequence to 56 expert panelists. The initial open-ended survey created a list of possible core principles; the three subsequent surveys winnowed the list and assessed the accuracy and importance of each principle. Fourteen core principles elicited at least 80% of the panelists to agree or strongly agree that they were important core principles for evolutionary medicine. These principles over-lapped with concepts discussed in other articles discussing key concepts in evolutionary medicine. This set of core principles will be helpful for researchers and instructors in evolutionary medicine. We recommend that evolutionary medicine instructors use the list of core principles to construct learning goals. Evolutionary medicine is a young field, so this list of core principles will likely change as the field develops further.

  12. Core competencies for scientific editors of biomedical journals: consensus statement.

    PubMed

    Moher, David; Galipeau, James; Alam, Sabina; Barbour, Virginia; Bartolomeos, Kidist; Baskin, Patricia; Bell-Syer, Sally; Cobey, Kelly D; Chan, Leighton; Clark, Jocalyn; Deeks, Jonathan; Flanagin, Annette; Garner, Paul; Glenny, Anne-Marie; Groves, Trish; Gurusamy, Kurinchi; Habibzadeh, Farrokh; Jewell-Thomas, Stefanie; Kelsall, Diane; Lapeña, José Florencio; MacLehose, Harriet; Marusic, Ana; McKenzie, Joanne E; Shah, Jay; Shamseer, Larissa; Straus, Sharon; Tugwell, Peter; Wager, Elizabeth; Winker, Margaret; Zhaori, Getu

    2017-09-11

    Scientific editors are responsible for deciding which articles to publish in their journals. However, we have not found documentation of their required knowledge, skills, and characteristics, or the existence of any formal core competencies for this role. We describe the development of a minimum set of core competencies for scientific editors of biomedical journals. The 14 key core competencies are divided into three major areas, and each competency has a list of associated elements or descriptions of more specific knowledge, skills, and characteristics that contribute to its fulfillment. We believe that these core competencies are a baseline of the knowledge, skills, and characteristics needed to perform competently the duties of a scientific editor at a biomedical journal.

  13. Generation of an ICF syndrome model by efficient genome editing of human induced pluripotent stem cells using the CRISPR system.

    PubMed

    Horii, Takuro; Tamura, Daiki; Morita, Sumiyo; Kimura, Mika; Hatada, Izuho

    2013-09-30

    Genome manipulation of human induced pluripotent stem (iPS) cells is essential to achieve their full potential as tools for regenerative medicine. To date, however, gene targeting in human pluripotent stem cells (hPSCs) has proven to be extremely difficult. Recently, an efficient genome manipulation technology using the RNA-guided DNase Cas9, the clustered regularly interspaced short palindromic repeats (CRISPR) system, has been developed. Here we report the efficient generation of an iPS cell model for immunodeficiency, centromeric region instability, facial anomalies syndrome (ICF) syndrome using the CRISPR system. We obtained iPS cells with mutations in both alleles of DNA methyltransferase 3B (DNMT3B) in 63% of transfected clones. Our data suggest that the CRISPR system is highly efficient and useful for genome engineering of human iPS cells.

  14. Common Core State Standards: I Wonder?

    ERIC Educational Resources Information Center

    Tienken, Christopher H.

    2010-01-01

    On June 1, 2009, the National Governors Association Center for Best Practices (NGA Center) and the Council of Chief State School Officers (CCSSO) issued a press release stating that 49 states and territories had joined the Common Core State Standards Initiative (CCSS). That initiative proposed that all states voluntarily adopt the same set of…

  15. Quality of life of persons with severe mental illness living in an intermediate care facility.

    PubMed

    Anderson, R L; Lewis, D A

    2000-04-01

    This study examined resident characteristics, clinical factors, and mental health service utilization associated with quality of life (QOL) for residents living in an Intermediate Care Facility (ICF). This study also utilized published literature to compare the QOL of ICF residents to persons with psychiatric disorders living in other residential settings. Chart review and interviews were used to study 100 randomly selected residents living in an ICF with a chart diagnosis of schizophrenia. Multivariate analyses suggest that higher levels of QOL are associated with reports that psychological problems did not interfere with work and activities and with lower levels of being a danger to others. Also, a comparison of the QOL scores reported by ICF residents to other published mentally ill populations suggests that residents of the ICF report somewhat higher QOL scores than state hospital patients, but lower scores as compared to other community samples. Data provide insight into the types of problems faced by residents of an intermediate care facility. These findings have implications for understanding the importance of mental health service utilization on QOL.

  16. Experiences of clinical teaching for dental core trainees working in hospital.

    PubMed

    Mannion, C J; Brotherton, P

    2014-07-11

    There is recognition that the provision of excellence in education and training results in a skilled and competent workforce. However, the educational experiences of dental core trainees (DCT's) working in the hospital oral and maxillofacial surgery (OMFS) setting have not been previously investigated. In this paper, we examine DCT's learning experiences both 'formal' and 'non-formal' within the hospital setting of ward and clinic-based teaching. Are hospital dental core trainees receiving a meaningful educational experience? To conclude this paper, the authors recommend methods, based upon sound educational principles, to maximise the value of clinical sessions for teaching.

  17. Advances and Challenges In Uncertainty Quantification with Application to Climate Prediction, ICF design and Science Stockpile Stewardship

    NASA Astrophysics Data System (ADS)

    Klein, R.; Woodward, C. S.; Johannesson, G.; Domyancic, D.; Covey, C. C.; Lucas, D. D.

    2012-12-01

    Uncertainty Quantification (UQ) is a critical field within 21st century simulation science that resides at the very center of the web of emerging predictive capabilities. The science of UQ holds the promise of giving much greater meaning to the results of complex large-scale simulations, allowing for quantifying and bounding uncertainties. This powerful capability will yield new insights into scientific predictions (e.g. Climate) of great impact on both national and international arenas, allow informed decisions on the design of critical experiments (e.g. ICF capsule design, MFE, NE) in many scientific fields, and assign confidence bounds to scientifically predictable outcomes (e.g. nuclear weapons design). In this talk I will discuss a major new strategic initiative (SI) we have developed at Lawrence Livermore National Laboratory to advance the science of Uncertainty Quantification at LLNL focusing in particular on (a) the research and development of new algorithms and methodologies of UQ as applied to multi-physics multi-scale codes, (b) incorporation of these advancements into a global UQ Pipeline (i.e. a computational superstructure) that will simplify user access to sophisticated tools for UQ studies as well as act as a self-guided, self-adapting UQ engine for UQ studies on extreme computing platforms and (c) use laboratory applications as a test bed for new algorithms and methodologies. The initial SI focus has been on applications for the quantification of uncertainty associated with Climate prediction, but the validated UQ methodologies we have developed are now being fed back into Science Based Stockpile Stewardship (SSS) and ICF UQ efforts. To make advancements in several of these UQ grand challenges, I will focus in talk on the following three research areas in our Strategic Initiative: Error Estimation in multi-physics and multi-scale codes ; Tackling the "Curse of High Dimensionality"; and development of an advanced UQ Computational Pipeline to enable

  18. Sensitivities of Earth's core and mantle compositions to accretion and differentiation processes

    NASA Astrophysics Data System (ADS)

    Fischer, Rebecca A.; Campbell, Andrew J.; Ciesla, Fred J.

    2017-01-01

    The Earth and other terrestrial planets formed through the accretion of smaller bodies, with their core and mantle compositions primarily set by metal-silicate interactions during accretion. The conditions of these interactions are poorly understood, but could provide insight into the mechanisms of planetary core formation and the composition of Earth's core. Here we present modeling of Earth's core formation, combining results of 100 N-body accretion simulations with high pressure-temperature metal-silicate partitioning experiments. We explored how various aspects of accretion and core formation influence the resulting core and mantle chemistry: depth of equilibration, amounts of metal and silicate that equilibrate, initial distribution of oxidation states in the disk, temperature distribution in the planet, and target:impactor ratio of equilibrating silicate. Virtually all sets of model parameters that are able to reproduce the Earth's mantle composition result in at least several weight percent of both silicon and oxygen in the core, with more silicon than oxygen. This implies that the core's light element budget may be dominated by these elements, and is consistent with ≤1-2 wt% of other light elements. Reproducing geochemical and geophysical constraints requires that Earth formed from reduced materials that equilibrated at temperatures near or slightly above the mantle liquidus during accretion. The results indicate a strong tradeoff between the compositional effects of the depth of equilibration and the amounts of metal and silicate that equilibrate, so these aspects should be targeted in future studies aiming to better understand core formation conditions. Over the range of allowed parameter space, core and mantle compositions are most sensitive to these factors as well as stochastic variations in what the planet accreted as a function of time, so tighter constraints on these parameters will lead to an improved understanding of Earth's core composition.

  19. Hollow-core photonic-crystal-fiber-based optical frequency references

    NASA Astrophysics Data System (ADS)

    Holá, Miroslava; Hrabina, Jan; Mikel, Břetislav; Lazar, Josef; Číp, Ondřej

    2016-12-01

    This research deals with preparation of an optical frequency references based on hollow-core photonic crystal fibers (HC-PCF). This fiber-based type of absorption cells represents a effiecient way how to replace classic bulky and fragile glass made tubes references with low-weight and low-volume optical fibers. This approach allows not only to increase possible interaction length between incident light and absorption media but it also carries a possibility of manufacturing of easy-operable reference which is set up just by plugging-in of optical connectors into the optical setup. We present the results of preparation, manufacturing and filling of a set of fiber-based cells intended for lasers frequency stabilization. The work deals with setting and optimalization of HC-PCF splicing processes, minimalization of optical losses between HC-PCF and SMF fiber transitions and finishing of HC-PCF spliced ends with special care for optimal closing of hollow-core structure needed for avoiding of absorption media leakage.

  20. A catalog of porosity and permeability from core plugs in siliciclastic rocks

    USGS Publications Warehouse

    Nelson, Philip H.; Kibler, Joyce E.

    2003-01-01

    Porosity and permeability measurements on cored samples from siliciclastic formations are presented for 70 data sets, taken from published data and descriptions. Data sets generally represent specific formations, usually from a limited number of wells. Each data set is represented by a written summary, a plot of permeability versus porosity, and a digital file of the data. The summaries include a publication reference, the geologic age of the formation, location, well names, depth range, various geologic descriptions, and core measurement conditions. Attributes such as grain size or depositional environment are identified by symbols on the plots. An index lists the authors and date, geologic age, formation name, sandstone classification, location, basin or structural province, and field name.