Sample records for objectively measured health

  1. Adaptation or recovery after health shocks? Evidence using subjective and objective health measures.

    PubMed

    Baji, Petra; Bíró, Anikó

    2018-05-01

    In this paper, we analyse the effect of an onset of a health shock on subjective survival probability and compare it with objective survival probability and self-reported health measures. In particular, we are interested in whether expectations of people respond to health shocks and whether these follow the evolution of objective life expectations and self-reported health measures over time. Using longitudinal data from the Health and Retirement Study, we estimate fixed effects models of adaptation for the objective and subjective survival probabilities and for some self-reported health measures. The results show that after cancer diagnosis, conditional on surviving, both the objective and subjective longevity and self-reported health measures drift back to the before diagnosis trajectories. For stroke and heart attack, in spite of their persistent negative effect on survival, subjective life expectations and self-reported health measures seem to indicate only a transient effect of the health shock. The differences between the objective and subjective measures are in line with the concept of adaptation. We discuss the policy implications of our results. Copyright © 2018 John Wiley & Sons, Ltd.

  2. Does job satisfaction improve the health of workers? New evidence using panel data and objective measures of health.

    PubMed

    Fischer, Justina A V; Sousa-Poza, Alfonso

    2009-01-01

    This paper evaluates the relationship between job satisfaction and measures of health of workers using the German Socio-Economic Panel. Methodologically, it addresses two important design problems encountered frequently in the literature: (a) cross-sectional causality problems and (b) the absence of objective measures of physical health that complement self-reported measures of health status. Not only does using the panel structure with individual fixed effects mitigate the bias from omitting unobservable personal psycho-social characteristics, but employing more objective health measures such as health-system contacts and disability addresses such measurement problems relating to self-report assessments of health status.We find a positive link between job satisfaction (and changes over time therein) and subjective health measures (and changes therein); that is, employees with higher or improved job satisfaction levels feel healthier and are more satisfied with their health. This observation also holds true for more objective measures of health. Particularly, improvements in job satisfaction over time appear to prevent workers from (further) health deterioration. Copyright (c) 2008 John Wiley & Sons, Ltd.

  3. Wealth, justice and freedom: Objective and subjective measures predicting poor mental health in a study across eight countries.

    PubMed

    Scholten, Saskia; Velten, Julia; Neher, Torsten; Margraf, Jürgen

    2017-12-01

    Macro-level factors (MF) such as wealth, justice and freedom measured with objective country-level indicators (objective MF), for instance the Gross Domestic Product (GDP), have been investigated in relation to health and well-being, but rarely in connection with depression, anxiety and stress subsumed as poor mental health. Also, a combination of different objective MF and of how individuals perceive those MF (subjective MF) has not been taken into consideration. In the present study, we combined subjective and objective measures of wealth, justice and freedom and examined their relationship with poor mental health. Population-based interviews were conducted in France, Germany, Poland, Russia, Spain, Sweden, U.K. and U.S.A. (n ≈ 1000 per country). GDP, GINI coefficient, Justice Index and Freedom Index were used as objective MF, whereas subjective MF were perceived wealth, justice and freedom measured at the individual level. Poor mental health was assessed as a combination of symptoms of depression, anxiety and stress. In a random-intercept-model, GINI coefficient and Freedom Index were significant positive country-level, and perceived wealth, justice, and freedom significant negative individual-level predictors of symptoms of poor mental health. Multiple subjective and objective MF should be combined to assess the macrosystem's relationship with poor mental health more precisely. The relationship between MF and poor mental health indicates that the macrosystem should be taken into account as relevant context for mental health problems, too.

  4. Validity of Questionnaire and Representativeness of Objective Methods for Measurements of Mechanical Exposures in Construction and Health Care Work

    PubMed Central

    Koch, Markus; Lunde, Lars-Kristian; Gjulem, Tonje; Knardahl, Stein; Veiersted, Kaj Bo

    2016-01-01

    Objectives To determine the criterion validity of a questionnaire on physical exposures compared to objective measurements at construction and health care sites and to examine exposure variation over several working days. Methods Five hundred ninety-four construction and health care workers answered a baseline questionnaire. The daily activities (standing, moving, sitting, number of steps), postures (inclination of the arm and the trunk), and relative heart rate of 125 participants were recorded continuously over 3–4 working days. At the end of the first measurement day, the participants answered a second questionnaire (workday questionnaire). Results All objective activity measurements had significant correlations to their respective questions. Among health care workers, there were no correlations between postures and relative heart rate and the baseline questionnaire. The questionnaires overestimated the exposure durations. The highest explained variance in the adjusted models with self-reported variables were found for objectively measured sitting (R2 = 0.559) and arm inclination > 60° (R2 = 0.420). Objective measurements over several days showed a higher reliability compared to single day measurements. Conclusions Questionnaires cannot provide an accurate description of mechanical exposures. Objective measurements over several days are recommended in occupations with varying tasks. PMID:27649499

  5. Validity of Questionnaire and Representativeness of Objective Methods for Measurements of Mechanical Exposures in Construction and Health Care Work.

    PubMed

    Koch, Markus; Lunde, Lars-Kristian; Gjulem, Tonje; Knardahl, Stein; Veiersted, Kaj Bo

    2016-01-01

    To determine the criterion validity of a questionnaire on physical exposures compared to objective measurements at construction and health care sites and to examine exposure variation over several working days. Five hundred ninety-four construction and health care workers answered a baseline questionnaire. The daily activities (standing, moving, sitting, number of steps), postures (inclination of the arm and the trunk), and relative heart rate of 125 participants were recorded continuously over 3-4 working days. At the end of the first measurement day, the participants answered a second questionnaire (workday questionnaire). All objective activity measurements had significant correlations to their respective questions. Among health care workers, there were no correlations between postures and relative heart rate and the baseline questionnaire. The questionnaires overestimated the exposure durations. The highest explained variance in the adjusted models with self-reported variables were found for objectively measured sitting (R2 = 0.559) and arm inclination > 60° (R2 = 0.420). Objective measurements over several days showed a higher reliability compared to single day measurements. Questionnaires cannot provide an accurate description of mechanical exposures. Objective measurements over several days are recommended in occupations with varying tasks.

  6. The Need to Objectively Measure Physical Activity During Pregnancy: Considerations for Clinical Research and Public Health Impact.

    PubMed

    Guérin, Eva; Ferraro, Zachary M; Adamo, Kristi B; Prud'homme, Denis

    2018-05-01

    Engaging in recommended levels of physical activity during pregnancy can provide a host of physical and mental health benefits for the expecting mother and her child. However, methodological issues related to physical activity measurement have plagued many studies examining the effects of physical activity during this important life stage. Burgeoning support exists for the more widespread use of objective methods, and accelerometers specifically, for an accurate appraisal of maternal physical activity. In this commentary, we highlight discrepancies between activity estimates obtained via self-report and objective measures and describe the implications of erroneous measurement when making clinical recommendations and in conducting future physical activity and pregnancy research. Most importantly, we aim to foster academic discussion and propose a call to action requiring a paradigm shift where we acknowledge the shortcomings of self-report and move toward an empirically driven approach for physical activity measurement. Results from more high-quality research studies will help support public health messaging and facilitate trust among health care providers, clinical researchers, and expecting mothers regarding the health benefits of physical activity recommendations.

  7. Relationship between Objectively Measured Transportation Behaviors and Health Characteristics in Older Adults.

    PubMed

    Takemoto, Michelle; Carlson, Jordan A; Moran, Kevin; Godbole, Suneeta; Crist, Katie; Kerr, Jacqueline

    2015-10-30

    This study used objective Global Positioning Systems (GPS) to investigate the relationship between pedestrian and vehicle trips to physical, cognitive, and psychological functioning in older adults living in retirement communities. Older adults (N = 279; mean age = 83 ± 6 years) wore a GPS and accelerometer for 6 days. Participants completed standard health measures. The Personal Activity and Location Measurement System (PALMS) was used to calculate the average daily number of trips, distance, and minutes traveled for pedestrian and vehicle trips from the combined GPS and accelerometer data. Linear mixed effects regression models explored relationships between these transportation variables and physical, psychological and cognitive functioning. Number, distance, and minutes of pedestrian trips were positively associated with physical and psychological functioning but not cognitive functioning. Number of vehicle trips was negatively associated with fear of falls; there were no other associations between the vehicle trip variables and functioning. Vehicle travel did not appear to be related to functioning in older adults in retirement communities except that fear of falling was related to number of vehicle trips. Pedestrian trips had moderate associations with multiple physical and psychological functioning measures, supporting a link between walking and many aspects of health in older adults.

  8. The book availability study as an objective measure of performance in a health sciences library.

    PubMed Central

    Kolner, S J; Welch, E C

    1985-01-01

    In its search for an objective overall diagnostic evaluation, the University of Illinois Library of the Health Sciences' Program Evaluation Committee selected a book availability measure; it is easy to administer and repeat, results are reproducible, and comparable data exist for other academic and health sciences libraries. The study followed the standard methodology in the literature with minor modifications. Patrons searching for particular books were asked to record item(s) needed and the outcome of the search. Library staff members then determined the reasons for failures in obtaining desired items. The results of the study are five performance scores. The first four represent the percentage probability of a library's operating with ideal effectiveness; the last provides an overall performance score. The scores of the Library of the Health Sciences demonstrated no unusual availability problems. The study was easy to implement and provided meaningful, quantitative, and objective data. PMID:3995202

  9. Does Occupational Mobility Influence Health among Working Women? Comparing Objective and Subjective Measures of Work Trajectories

    ERIC Educational Resources Information Center

    Wilkinson, Lindsay R.; Shippee, Tetyana P.; Ferraro, Kenneth F.

    2012-01-01

    Occupational mobility is highly valued in American society, but is it consequential to women's health? Previous studies have yielded inconsistent results, but most measured occupational mobility by identifying transitions across occupational categories. Drawing from cumulative inequality theory, this study (1) compares objective and subjective…

  10. Development of a Novel, Objective Measure of Health Care–Related Financial Burden for U.S. Families with Children

    PubMed Central

    Wisk, Lauren E; Gangnon, Ronald; Vanness, David J; Galbraith, Alison A; Mullahy, John; Witt, Whitney P

    2014-01-01

    Objective To develop and validate a theoretically based and empirically driven objective measure of financial burden for U.S. families with children. Data Sources The measure was developed using 149,021 families with children from the National Health Interview Survey, and it was validated using 18,488 families with children from the Medical Expenditure Panel Survey. Study Design We estimated the marginal probability of unmet health care need due to cost using a bivariate tensor product spline for family income and out-of-pocket health care costs (OOPC; e.g., deductibles, copayments), while adjusting for confounders. Recursive partitioning was performed on these probabilities, as a function of income and OOPC, to establish thresholds demarcating levels of predicted risk. Principal Findings We successfully generated a novel measure of financial burden with four categories that were associated with unmet need (vs. low burden: midlow OR: 1.93, 95 percent CI: 1.78–2.09; midhigh OR: 2.78, 95 percent CI: 2.49–3.10; high OR: 4.38, 95 percent CI: 3.99–4.80). The novel burden measure demonstrated significantly better model fit and less underestimation of financial burden compared to an existing measure (OOPC/income ≥10 percent). Conclusion The newly developed measure of financial burden establishes thresholds based on different combinations of family income and OOPC that can be applied in future studies of health care utilization and expenditures and in policy development and evaluation. PMID:25328073

  11. Explaining significant differences in subjective and objective measures of cardiovascular health: evidence for the socioeconomic gradient in a population-based study

    PubMed Central

    2013-01-01

    Background To assess prevalence rates of subjective and objective reports of two cardiovascular disorders (hypertension and hypercholesterolemia) for the same subset of respondents in a large-scale study. To determine whether and the extent to which the socioeconomic health gradient differed in the subjective and objective reports of the two cardiovascular disorders. Methods Data from the first wave (2009/2011) of The Irish Longitudinal Study on Ageing were used (n = 4,179). This is a nationally representative study of community-dwelling adults aged 50+ residing in Ireland. Subjective measures were derived from self-reports of doctor-diagnosed hypertension and high cholesterol. Objective measure of hypertension was defined as: systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg and/or on antihypertensive medication. Objective measure of hypercholesterolemia was defined as: total cholesterol ≥5.2 mmol/L and/or on cholesterol-lowering medication. Objective measures of low-density-lipoprotein cholesterol and high-density-lipoprotein cholesterol were also used. Two measures of socioeconomic gradient were employed: education and wealth. Binary and multinomial logistic and linear regression analyses were used. Analyses were adjusted for an extensive battery of covariates, including demographics and measures of physical/behavioural health and health care utilization. Results Prevalence of cardiovascular disorders: prevalence of hypertension and hypercholesterolemia was significantly higher when the cardiovascular disorders were measured objectively as compared to self-reports (64% and 72.1% versus 37% and 41.1%, respectively). Socioeconomic gradient in hypertension: the odds of being objectively hypertensive were significantly lower for individuals with tertiary/higher education (OR, 0.74; 95% CI, 0.60-0.92) and in the highest tertile of the wealth distribution (OR, 0.77; 95% CI, 0.62-0.95). In contrast, the associations between

  12. Objectivity in Quantum Measurement

    NASA Astrophysics Data System (ADS)

    Li, Sheng-Wen; Cai, C. Y.; Liu, X. F.; Sun, C. P.

    2018-06-01

    The objectivity is a basic requirement for the measurements in the classical world, namely, different observers must reach a consensus on their measurement results, so that they believe that the object exists "objectively" since whoever measures it obtains the same result. We find that this simple requirement of objectivity indeed imposes an important constraint upon quantum measurements, i.e., if two or more observers could reach a consensus on their quantum measurement results, their measurement basis must be orthogonal vector sets. This naturally explains why quantum measurements are based on orthogonal vector basis, which is proposed as one of the axioms in textbooks of quantum mechanics. The role of the macroscopicality of the observers in an objective measurement is discussed, which supports the belief that macroscopicality is a characteristic of classicality.

  13. Objectivity in Quantum Measurement

    NASA Astrophysics Data System (ADS)

    Li, Sheng-Wen; Cai, C. Y.; Liu, X. F.; Sun, C. P.

    2018-05-01

    The objectivity is a basic requirement for the measurements in the classical world, namely, different observers must reach a consensus on their measurement results, so that they believe that the object exists "objectively" since whoever measures it obtains the same result. We find that this simple requirement of objectivity indeed imposes an important constraint upon quantum measurements, i.e., if two or more observers could reach a consensus on their quantum measurement results, their measurement basis must be orthogonal vector sets. This naturally explains why quantum measurements are based on orthogonal vector basis, which is proposed as one of the axioms in textbooks of quantum mechanics. The role of the macroscopicality of the observers in an objective measurement is discussed, which supports the belief that macroscopicality is a characteristic of classicality.

  14. [Life quality parameters in prenosologic evaluation of health state in residents of protective measures area near objects of storage and destruction of chemical weapons].

    PubMed

    Filippov, V L; Nechaeva, E N

    2014-01-01

    The article presents results of life quality assessment and subjective evaluation data on health state, used for prenosologic evaluation of health state in residents of protective measures area near objects of storage and destruction of chemical weapons. Considering specific features of residence near potentially dangerous objects, the authors conducted qualitative evaluation of satisfaction with various life facets, with taking into account the objects specificity, established correlation between life quality and self-evaluation of health with factors influencing public health state.

  15. Well-Being With Objects: Evaluating a Museum Object-Handling Intervention for Older Adults in Health Care Settings.

    PubMed

    Thomson, Linda J M; Chatterjee, Helen J

    2016-03-01

    The extent to which a museum object-handling intervention enhanced older adult well-being across three health care settings was examined. The program aimed to determine whether therapeutic benefits could be measured objectively using clinical scales. Facilitator-led, 30 to 40 min sessions handling and discussing museum objects were conducted in acute and elderly care (11 one-to-ones), residential (4 one-to-ones and 1 group of five), and psychiatric (4 groups of five) settings. Pre-post measures of psychological well-being (Positive Affect and Negative Affect Schedule) and subjective wellness and happiness (Visual Analogue Scales) were compared. Positive affect and wellness increased significantly in acute and elderly and residential care though not psychiatric care whereas negative affect decreased and happiness increased in all settings. Examination of audio recordings revealed enhanced confidence, social interaction, and learning. The program allowed adults access to a museum activity who by virtue of age and ill health would not otherwise have engaged with museum objects. © The Author(s) 2014.

  16. Assessing and improving health in the workplace: an integration of subjective and objective measures with the STress Assessment and Research Toolkit (St.A.R.T.) method.

    PubMed

    Panari, Chiara; Guglielmi, Dina; Ricci, Aurora; Tabanelli, Maria Carla; Violante, Francesco Saverio

    2012-09-20

    The aim of this work was to introduce a new combined method of subjective and objective measures to assess psychosocial risk factors at work and improve workers' health and well-being. In the literature most of the research on work-related stress focuses on self-report measures and this work represents the first methodology capable of integrating different sources of data. An integrated method entitled St.A.R.T. (STress Assessment and Research Toolkit) was used in order to assess psychosocial risk factors and two health outcomes. In particular, a self-report questionnaire combined with an observational structured checklist was administered to 113 workers from an Italian retail company. The data showed a correlation between subjective data and the rating data of the observational checklist for the psychosocial risk factors related to work contexts such as customer relationship management and customer queue. Conversely, the factors related to work content (workload and boredom) measured with different methods (subjective vs. objective) showed a discrepancy. Furthermore, subjective measures of psychosocial risk factors were more predictive of workers' psychological health and exhaustion than rating data. The different objective measures played different roles, however, in terms of their influence on the two health outcomes considered. It is important to integrate self-related assessment of stressors with objective measures for a better understanding of workers' conditions in the workplace. The method presented could be considered a useful methodology for combining the two measures and differentiating the impact of different psychological risk factors related to work content and context on workers' health.

  17. Assessing and improving health in the workplace: an integration of subjective and objective measures with the STress Assessment and Research Toolkit (St.A.R.T.) method

    PubMed Central

    2012-01-01

    Background The aim of this work was to introduce a new combined method of subjective and objective measures to assess psychosocial risk factors at work and improve workers’ health and well-being. In the literature most of the research on work-related stress focuses on self-report measures and this work represents the first methodology capable of integrating different sources of data. Method An integrated method entitled St.A.R.T. (STress Assessment and Research Toolkit) was used in order to assess psychosocial risk factors and two health outcomes. In particular, a self-report questionnaire combined with an observational structured checklist was administered to 113 workers from an Italian retail company. Results The data showed a correlation between subjective data and the rating data of the observational checklist for the psychosocial risk factors related to work contexts such as customer relationship management and customer queue. Conversely, the factors related to work content (workload and boredom) measured with different methods (subjective vs. objective) showed a discrepancy. Furthermore, subjective measures of psychosocial risk factors were more predictive of workers’ psychological health and exhaustion than rating data. The different objective measures played different roles, however, in terms of their influence on the two health outcomes considered. Conclusions It is important to integrate self-related assessment of stressors with objective measures for a better understanding of workers’ conditions in the workplace. The method presented could be considered a useful methodology for combining the two measures and differentiating the impact of different psychological risk factors related to work content and context on workers’ health. PMID:22995286

  18. Objective measures of situation awareness in a simulated medical environment

    PubMed Central

    Wright, M; Taekman, J; Endsley, M

    2004-01-01

    One major limitation in the use of human patient simulators is a lack of objective, validated measures of human performance. Objective measures are necessary if simulators are to be used to evaluate the skills and training of medical practitioners and teams or to evaluate the impact of new processes or equipment design on overall system performance. Situation awareness (SA) refers to a person's perception and understanding of their dynamic environment. This awareness and comprehension is critical in making correct decisions that ultimately lead to correct actions in medical care settings. An objective measure of SA may be more sensitive and diagnostic than traditional performance measures. This paper reviews a theory of SA and discusses the methods required for developing an objective measure of SA within the context of a simulated medical environment. Analysis and interpretation of SA data for both individual and team performance in health care are also presented. PMID:15465958

  19. Objectively-measured outdoor time and physical and psychological function among older adults.

    PubMed

    Harada, Kazuhiro; Lee, Sangyoon; Lee, Sungchul; Bae, Seongryu; Harada, Kenji; Suzuki, Takao; Shimada, Hiroyuki

    2017-10-01

    Objective measurements of outdoor time are essential to establishing evidence about the health benefits of going outdoors among older adults. To better understanding the health benefits of going outdoors, clarification of potential mediators to connect going outdoors with health benefits is necessary. The present study aimed to investigate associations of objectively-measured outdoor time with older adults' physical and psychological function, and examine the mediating role of physical activity on these associations. Baseline data from a randomized control trial of physical activity among older adults with global cognitive impairment was used. Data from 192 participants were analyzed. Measures included steps-per-day, objectively-measured outdoor time per day using global positioning systems, physical function (cardiorespiratory fitness, lower-extremity strength), psychological function (depression, well-being) and basic factors. Path analysis showed that outdoor time was significantly associated with steps-per-day (path coefficient = 0.23) and depression (path coefficient = -0.16). Outdoor time was not directly associated with cardiorespiratory fitness, lower-extremity strength and well-being. However, steps-per-day was associated with cardiorespiratory fitness (path coefficient = 0.18), lower-extremity strength (path coefficient = -0.22) and well-being (path coefficient = 0.14). We found that objectively-measured outdoor time was indirectly associated with physical function, and both directly and indirectly with psychological function through physical activity among older adults. This finding indicates that going outdoors influences older adults' health outcomes, and is mainly mediated by physical activity. Geriatr Gerontol Int 2017; 17: 1455-1462. © 2016 Japan Geriatrics Society.

  20. Measurement Issues in Health Disparities Research

    PubMed Central

    Ramírez, Mildred; Ford, Marvella E; Stewart, Anita L; A Teresi, Jeanne

    2005-01-01

    Background Racial and ethnic disparities in health and health care have been documented; the elimination of such disparities is currently part of a national agenda. In order to meet this national objective, it is necessary that measures identify accurately the true prevalence of the construct of interest across diverse groups. Measurement error might lead to biased results, e.g., estimates of prevalence, magnitude of risks, and differences in mean scores. Addressing measurement issues in the assessment of health status may contribute to a better understanding of health issues in cross-cultural research. Objective To provide a brief overview of issues regarding measurement in diverse populations. Findings Approaches used to assess the magnitude and nature of bias in measures when applied to diverse groups include qualitative analyses, classic psychometric studies, as well as more modern psychometric methods. These approaches should be applied sequentially, and/or iteratively during the development of measures. Conclusions Investigators performing comparative studies face the challenge of addressing measurement equivalence, crucial for obtaining accurate results in cross-cultural comparisons. PMID:16179000

  1. Happiness, subjective and objective oral health status, and oral health behaviors among Korean elders.

    PubMed

    Yoon, Hyun-Seo; Kim, Hae-Young; Patton, Lauren L; Chun, Jin-Ho; Bae, Kwang-Hak; Lee, Mi-Ok

    2013-10-01

    This study aims to comprehensively assess the association of subjective and objective oral health status and oral health behaviors with happiness, under consideration of demographic, socioeconomic, and general health-related factors. This study also aims to test whether subjective oral health outcomes are better predictors of happiness compared with objective oral health outcomes. The data were collected from 479 community-dwelling elders aged 65 years or over selected by a cluster sampling method. A questionnaire and an oral examination were implemented. A multiple regression method was conducted to assess associations with happiness index (HI). The mean age of the elders was 74.6 years. Mean (standard deviation, SD) HI, EuroQol-visual analog scale (EQ-VAS) and 14-item oral health impact profile (OHIP-14) index were 5.7 (SD 2.3), 59.8 (SD 21.1), and 16.3 (SD 13.1). In the final model, a significant association with HI of the OHIP-14 index (P = 0.091) among all the participants and significant associations of oral symptoms (P = 0.038), wearing a removable denture (P = 0.039), and of the oral health behavior of daily toothbrushing (P = 0.007) among poorer oral health QoL group were confirmed under consideration of other related factors. While correlations of HI to subjective measures of health, EQ-VAS and OHIP-14 score were moderate to weak, those to objective measures of health were only weak or insignificant. Oral impacts which might persistently affect one's daily life need to be considered in designing and delivering public services aimed to promote people's happiness. With oral health impacts and behaviors accounting for 10% of happiness among elders, public and community services for the elderly that support oral health and daily toothbrushing for the dentate are critical for the well-being of our elders. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Libyan National Health Services The Need to Move to Management-by-Objectives

    PubMed Central

    El Taguri, A; Elkhammas, EA; Bakoush, O; Ashammakhi, N; Baccoush, M; Betilmal, I

    2008-01-01

    In the last four decades, there has been a substantial horizontal expansion of health services in Libya. This resulted in improvement in morbidity and mortality, in particularly those related to infectious disease. However, measures such as the national performance gap indicator reveal an underperforming health system. In this article, we discuss aspects related to the Libyan health system and its current status including areas of weakness. Overcoming current failures and further improvement are unlikely to occur spontaneously without proper planning. Defining community health problems, identifying unmet needs, surveying resources to meet them, establishing SMART (specific, measurable, achievable, and realistic and time specific) objectives, and projecting administrative action to accomplish the proposed programs, are a must. The health system should rely on newer approaches such as management-by-objectives and risk-management rather than the prevailing crisis-management attitude. PMID:21499467

  3. Generally objective measurement of human temperature and reading ability: some corollaries.

    PubMed

    Stenner, A Jackson; Stone, Mark

    2010-01-01

    We argue that a goal of measurement is general objectivity: point estimates of a person's measure (height, temperature, and reader ability) should be independent of the instrument and independent of the sample in which the person happens to find herself. In contrast, Rasch's concept of specific objectivity requires only differences (i.e., comparisons) between person measures to be independent of the instrument. We present a canonical case in which there is no overlap between instruments and persons: each person is measured by a unique instrument. We then show what is required to estimate measures in this degenerate case. The canonical case encourages a simplification and reconceptualization of validity and reliability. Not surprisingly, this reconceptualization looks a lot like the way physicists and chemometricians think about validity and measurement error. We animate this presentation with a technology that blurs the distinction between instruction, assessment, and generally objective measurement of reader ability. We encourage adaptation of this model to health outcomes measurement.

  4. Fuzzy bi-objective preventive health care network design.

    PubMed

    Davari, Soheil; Kilic, Kemal; Ertek, Gurdal

    2015-09-01

    Preventive health care is unlike health care for acute ailments, as people are less alert to their unknown medical problems. In order to motivate public and to attain desired participation levels for preventive programs, the attractiveness of the health care facility is a major concern. Health economics literature indicates that attractiveness of a facility is significantly influenced by proximity of the clients to it. Hence attractiveness is generally modelled as a function of distance. However, abundant empirical evidence suggests that other qualitative factors such as perceived quality, attractions nearby, amenities, etc. also influence attractiveness. Therefore, a realistic measure should incorporate the vagueness in the concept of attractiveness to the model. The public policy makers should also maintain the equity among various neighborhoods, which should be considered as a second objective. Finally, even though the general tendency in the literature is to focus on health benefits, the cost effectiveness is still a factor that should be considered. In this paper, a fuzzy bi-objective model with budget constraints is developed. Later, by modelling the attractiveness by means of fuzzy triangular numbers and treating the budget constraint as a soft constraint, a modified (and more realistic) version of the model is introduced. Two solution methodologies, namely fuzzy goal programming and fuzzy chance constrained optimization are proposed as solutions. Both the original and the modified models are solved within the framework of a case study in Istanbul, Turkey. In the case study, the Microsoft Bing Map is utilized in order to determine more accurate distance measures among the nodes.

  5. Improving Objective Measures of Mobility.

    ERIC Educational Resources Information Center

    Dodds, Allan G.; And Others

    1983-01-01

    The article examines shortcomings in existing objective measures of mobility for blind persons in the light of evaluative experiences and demonstrates improvements in reliability, together with a new technique for tracking pavement position. It refutes the idea that it is not possible to measure improvement in performance objectively. (Author/CL)

  6. Tracking Success: Outputs Versus Outcomes-A Comparison of Accredited and Non-Accredited Public Health Agencies' Community Health Improvement Plan objectives.

    PubMed

    Perrault, Evan K; Inderstrodt-Stephens, Jill; Hintz, Elizabeth A

    2018-06-01

    With funding for public health initiatives declining, creating measurable objectives that are focused on tracking and changing population outcomes (i.e., knowledge, attitudes, or behaviors), instead of those that are focused on health agencies' own outputs (e.g., promoting services, developing communication messages) have seen a renewed focus. This study analyzed 4094 objectives from the Community Health Improvement Plans (CHIPs) of 280 local PHAB-accredited and non-accredited public health agencies across the United States. Results revealed that accredited agencies were no more successful at creating outcomes-focused objectives (35% of those coded) compared to non-accredited agencies (33% of those coded; Z = 1.35, p = .18). The majority of objectives were focused on outputs (accredited: 61.2%; non-accredited: 63.3%; Z = 0.72, p = .47). Outcomes-focused objectives primarily sought to change behaviors (accredited: 85.43%; non-accredited: 80.6%), followed by changes in knowledge (accredited: 9.75%; non-accredited: 10.8%) and attitudes (accredited: 1.6%; non-accredited: 5.1%). Non-accredited agencies had more double-barreled objectives (49.9%) compared to accredited agencies (32%; Z = 11.43, p < .001). The authors recommend that accreditation procedures place a renewed focus on ensuring that public health agencies strive to achieve outcomes. It is also advocated that public health agencies work with interdisciplinary teams of Health Communicators who can help them develop procedures to effectively and efficiently measure outcomes of knowledge and attitudes that are influential drivers of behavioral changes.

  7. Monitoring the athlete training response: subjective self-reported measures trump commonly used objective measures: a systematic review

    PubMed Central

    Saw, Anna E; Main, Luana C; Gastin, Paul B

    2016-01-01

    Background Monitoring athlete well-being is essential to guide training and to detect any progression towards negative health outcomes and associated poor performance. Objective (performance, physiological, biochemical) and subjective measures are all options for athlete monitoring. Objective We systematically reviewed objective and subjective measures of athlete well-being. Objective measures, including those taken at rest (eg, blood markers, heart rate) and during exercise (eg, oxygen consumption, heart rate response), were compared against subjective measures (eg, mood, perceived stress). All measures were also evaluated for their response to acute and chronic training load. Methods The databases Academic search complete, MEDLINE, PsycINFO, SPORTDiscus and PubMed were searched in May 2014. Fifty-six original studies reported concurrent subjective and objective measures of athlete well-being. The quality and strength of findings of each study were evaluated to determine overall levels of evidence. Results Subjective and objective measures of athlete well-being generally did not correlate. Subjective measures reflected acute and chronic training loads with superior sensitivity and consistency than objective measures. Subjective well-being was typically impaired with an acute increase in training load, and also with chronic training, while an acute decrease in training load improved subjective well-being. Summary This review provides further support for practitioners to use subjective measures to monitor changes in athlete well-being in response to training. Subjective measures may stand alone, or be incorporated into a mixed methods approach to athlete monitoring, as is current practice in many sport settings. PMID:26423706

  8. A Taxonomy of Object-Oriented Measures Modeling the Object-Oriented Space

    NASA Technical Reports Server (NTRS)

    Neal, Ralph D.; Weistroffer, H. Roland; Coppins, Richard J.

    1997-01-01

    In order to control the quality of software and the software development process, it is important to understand the measurement of software. A first step toward a better comprehension of software measurement is the categorization of software measures by some meaningful taxonomy. The most worthwhile taxonomy would capture the fundamental nature of the object-oriented (O-O) space. The principal characteristics of object-oriented software offer a starting point for such a categorization of measures. This paper introduces a taxonomy of measures based upon fourteen characteristics of object-oriented software gathered from the literature. This taxonomy allows us to easily see gaps or redundancies in the existing O-O measures. The taxonomy also clearly differentiates among taxa so that there is no ambiguity as to the taxon to which a measure belongs. The taxonomy has been populated with measures taken from the literature.

  9. A Taxonomy of Object-Oriented Measures Modeling the Object Oriented Space

    NASA Technical Reports Server (NTRS)

    Neal, Ralph D.; Weistroffer, H. Roland; Coppins, Richard J.

    1997-01-01

    In order to control the quality of software and the software development process, it is important to understand the measurement of software. A first step toward a better comprehension of software measurement is the categorization of software measures by some meaningful taxonomy. The most worthwhile taxonomy would capture the fundamental nature of the object-oriented (O-O) space. The principal characteristics of object-oriented software offer a starting point for such a categorization of measures. This paper introduces a taxonomy of measures based upon fourteen characteristics of object-oriented software gathered from the literature. This taxonomy allows us to easily see gaps or redundancies in the existing O-O measures. The taxonomy also clearly differentiates among taxa so that there is no ambiguity as to the taxon to which a measure belongs. The taxonomy has been populated with measures taken from the literature.

  10. Self-rated health among pregnant women: associations with objective health indicators, psychological functioning, and serum inflammatory markers.

    PubMed

    Christian, Lisa M; Iams, Jay; Porter, Kyle; Leblebicioglu, Binnaz

    2013-12-01

    Biobehavioral correlates of self-rated health in pregnancy are largely unknown. The goals of this study were to examine, in pregnant women, associations of self-rated health with (1) demographics, objective health status, health behaviors, and psychological factors, and (2) serum inflammatory markers. In the second trimester of pregnancy, 101 women provided a blood sample, completed measures of psychosocial stress, health status, and health behaviors, and received a comprehensive periodontal examination. The following independently predicted poorer self-rated health: (1) greater psychological stress, (2) greater objective health diagnoses, (3) higher body mass index, and (4) past smoking (versus never smoking). Poorer self-rated health was associated with higher serum interleukin-1β (p = 0.02) and marginally higher macrophage migration inhibitory factor (p = 0.06). These relationships were not fully accounted for by behavioral/psychological factors. This study provides novel data regarding factors influencing subjective ratings of health and the association of self-rated health with serum inflammatory markers in pregnant women.

  11. Objective Sleep Duration Is Prospectively Associated With Endothelial Health.

    PubMed

    Hall, Martica H; Mulukutla, Suresh; Kline, Christopher E; Samuelsson, Laura B; Taylor, Briana J; Thayer, Julian F; Krafty, Robert T; Frank, Ellen; Kupfer, David J

    2017-01-01

    The mechanisms linking short sleep duration to cardiovascular disease (CVD) are poorly understood. Emerging evidence suggests that endothelial dysregulation may lie along the causal pathway linking sleep duration to cardiovascular risk, although current evidence in humans is based on cross-sectional studies. Our objective was to evaluate the prospective association between objectively assessed sleep duration and clinical indices of endothelial health. A total of 141 medically healthy adults underwent an overnight laboratory sleep study when they were between the ages of 21 and 60 years. Total sleep time was objectively assessed by polysomnography at study entry. Endothelial health, including brachial artery diameter (BAD) and flow-mediated dilation (FMD), was measured 18.9 ± 4.6 years later. Medical health and psychiatric status were assessed at both time points. Approximately half of the sample had a lifetime history of major depressive disorder. In univariate analyses, shorter sleep duration was associated with increased BAD (β = -0.24, p = .004) and decreased FMD (β = 0.17, p = .042). BAD, but not FMD, remained significantly associated with sleep duration after adjusting for sex, age, body mass index (BMI), smoking, diabetes, hypertension, and lifetime history of major depressive disorder (MDD) at T2. The association between sleep duration and BAD was stronger than the association between BAD and an aggregate measure of CVD risk including three or more of the following risk factors: male sex, age ≥ 65 years, smoker, BMI ≥ 30, diabetes, hypertension, and MDD. Objectively assessed short sleep duration was prospectively associated with increased BAD over a 12- to 30-year period. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  12. Mental health and social networks in early adolescence: a dynamic study of objectively-measured social interaction behaviors.

    PubMed

    Pachucki, Mark C; Ozer, Emily J; Barrat, Alain; Cattuto, Ciro

    2015-01-01

    How are social interaction dynamics associated with mental health during early stages of adolescence? The goal of this study is to objectively measure social interactions and evaluate the roles that multiple aspects of the social environment--such as physical activity and food choice--may jointly play in shaping the structure of children's relationships and their mental health. The data in this study are drawn from a longitudinal network-behavior study conducted in 2012 at a private K-8 school in an urban setting in California. We recruited a highly complete network sample of sixth-graders (n = 40, 91% of grade, mean age = 12.3), and examined how two measures of distressed mental health (self-esteem and depressive symptoms) are positionally distributed in an early adolescent interaction network. We ascertained how distressed mental health shapes the structure of relationships over a three-month period, adjusting for relevant dimensions of the social environment. Cross-sectional analyses of interaction networks revealed that self-esteem and depressive symptoms are differentially stratified by gender. Specifically, girls with more depressive symptoms have interactions consistent with social inhibition, while boys' interactions suggest robustness to depressive symptoms. Girls higher in self-esteem tended towards greater sociability. Longitudinal network behavior models indicate that gender similarity and perceived popularity are influential in the formation of social ties. Greater school connectedness predicts the development of self-esteem, though social ties contribute to more self-esteem improvement among students who identify as European-American. Cross-sectional evidence shows associations between distressed mental health and students' network peers. However, there is no evidence that connected students' mental health status becomes more similar in their over time because of their network interactions. These findings suggest that mental health during early

  13. Self-rated Health among Pregnant Women: Associations with Objective Health Indicators, Psychological Functioning, and Serum Inflammatory Markers

    PubMed Central

    Christian, Lisa M.; Iams, Jay; Porter, Kyle; Leblebicioglu, Binnaz

    2013-01-01

    Background Biobehavioral correlates of self-rated health in pregnancy are largely unknown. Purpose The goals of this study were to examine, in pregnant women, associations of self-rated health with 1) demographics, objective health status, health behaviors and psychological factors and 2) serum inflammatory markers. Methods In the 2nd trimester of pregnancy, 101 women provided a blood sample, completed measures of psychosocial stress, health status, and health behaviors, and received a comprehensive periodontal examination. Results The following independently predicted poorer self-rated health: 1) greater psychological stress, 2) greater objective health diagnoses, 3) higher body mass index, and 4) past smoking (versus never smoking). Poorer self-rated health was associated with higher serum interleukin-1β (p = .02) and marginally higher macrophage migration inhibitory factor (p = .06). These relationships were not fully accounted for by behavioral/psychological factors. Conclusions This study provides novel data regarding factors influencing subjective ratings of health and the association of self-rated health with serum inflammatory markers in pregnant women. PMID:23765366

  14. DATA QUALITY OBJECTIVES AND MEASUREMENT QUALITY OBJECTIVES FOR RESEARCH PROJECTS

    EPA Science Inventory

    The paper provides assistance with systematic planning using measurement quality objectives to those working on research projects. These performance criteria are more familiar to researchers than data quality objectives because they are more closely associated with the measuremen...

  15. Measuring competition in health care markets.

    PubMed Central

    Baker, L C

    2001-01-01

    OBJECTIVE: Measuring competition is increasingly important for analysis of health care markets and policies. Measurement of competition in health care is made complex by the breadth of potential issues under study, by the lack of necessary data, and by rapid changes in health care financing and delivery. This study reviews key issues in the measurement of competition and is designed to familiarize researchers and policymakers interested in competition measurement, but not steeped in its practice, with key concepts, data sources, and ways of adapting measures to fit ongoing changes in health care markets. PRINCIPAL FINDINGS: Attention to several key issues will strengthen measurement. Important components of successful measurement are: careful identification of the products and market areas for study; selection of Herfindahl-Hirschman or other indices to fit the issues being considered; consideration of econometric problems, like endogeneity, with common measures; and attention to the ways that current marketplace changes, like growth in managed care, affect the performance of classic measures. Data needed for constructing measures are also frequently scarce, insufficient, or both. Measurement could be improved with access to better data. PMID:11327175

  16. Well-being measurement and the WHO health policy Health 2010: systematic review of measurement scales.

    PubMed

    Lindert, Jutta; Bain, Paul A; Kubzansky, Laura D; Stein, Claudia

    2015-08-01

    Subjective well-being (SWB) contributes to health and mental health. It is a major objective of the new World Health Organization health policy framework, 'Health 2020'. Various approaches to defining and measuring well-being exist. We aimed to identify, map and analyse the contents of self-reported well-being measurement scales for use with individuals more than 15 years of age to help researchers and politicians choose appropriate measurement tools. We conducted a systematic literature search in PubMed for studies published between 2007 and 2012, with additional hand-searching, to identify empirical studies that investigated well-being using a measurement scale. For each eligible study, we identified the measurement tool and reviewed its components, number of items, administration time, validity, reliability, responsiveness and sensitivity. The literature review identified 60 unique measurement scales. Measurement scales were either multidimensional (n = 33) or unidimensional (n = 14) and assessed multiple domains. The most frequently encountered domains were affects (39 scales), social relations (17 scales), life satisfaction (13 scales), physical health (13 scales), meaning/achievement (9 scales) and spirituality (6 scales). The scales included between 1 and 100 items; the administration time varied from 1 to 15 min. Well-being is a higher order construct. Measures seldom reported testing for gender or cultural sensitivity. The content and format of scales varied considerably. Effective monitoring and comparison of SWB over time and across geographic regions will require further work to refine definitions of SWB. We recommend concurrent evaluation of at least three self-reported SWB measurement scales, including evaluation for gender or cultural sensitivity. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  17. Measuring what matters: does 'objectivity' mean good science?

    PubMed

    Kayes, Nicola M; McPherson, Kathryn M

    2010-01-01

    While the limitations of self-report measures are clearly acknowledged, less apparent is attention to the potential limitations of their 'objective' counterparts leading to the assumption that objectivity results in more robust and scientifically valid measurement tools. This article aims to: (1) test this assumption; (2) consider the implications of advocating for a measure on the basis of its objectivity; (3) propose an alternative approach to measure selection. A critical evaluation of one 'objective' measure highlights a number of potential limitations suggesting that the apparent willingness to adopt 'objective' measures with little questioning may be misguided. The possible implications of this are discussed and include a risk to the advancement of, and capacity for, knowledge in rehabilitation; or worse, of making clinical decisions based on erroneous conclusions. Characterising a measure on the basis of objectivity (or not) assumes an overly simplistic dichotomy that is unhelpful and perhaps misleading. We argue that assessing whether a measure is fit for purpose and makes mathematical sense is the key consideration. Indeed, in some cases, using both an 'objective' measure and a subjective rating scale may be appropriate and the only way of truly capturing the phenomenon of interest.

  18. Development of the Health Insurance Literacy Measure (HILM): Conceptualizing and Measuring Consumer Ability to Choose and Use Private Health Insurance

    PubMed Central

    Paez, Kathryn A.; Mallery, Coretta J.; Noel, HarmoniJoie; Pugliese, Christopher; McSorley, Veronica E.; Lucado, Jennifer L.; Ganachari, Deepa

    2014-01-01

    Understanding health insurance is central to affording and accessing health care in the United States. Efforts to support consumers in making wise purchasing decisions and using health insurance to their advantage would benefit from the development of a valid and reliable measure to assess health insurance literacy. This article reports on the development of the Health Insurance Literacy Measure (HILM), a self-assessment measure of consumers' ability to select and use private health insurance. The authors developed a conceptual model of health insurance literacy based on formative research and stakeholder guidance. Survey items were drafted using the conceptual model as a guide then tested in two rounds of cognitive interviews. After a field test with 828 respondents, exploratory factor analysis revealed two HILM scales, choosing health insurance and using health insurance, each of which is divided into a confidence subscale and likelihood of behavior subscale. Correlations between the HILM scales and an objective measure of health insurance knowledge and skills were positive and statistically significant which supports the validity of the measure. PMID:25315595

  19. Development of the Health Insurance Literacy Measure (HILM): conceptualizing and measuring consumer ability to choose and use private health insurance.

    PubMed

    Paez, Kathryn A; Mallery, Coretta J; Noel, HarmoniJoie; Pugliese, Christopher; McSorley, Veronica E; Lucado, Jennifer L; Ganachari, Deepa

    2014-01-01

    Understanding health insurance is central to affording and accessing health care in the United States. Efforts to support consumers in making wise purchasing decisions and using health insurance to their advantage would benefit from the development of a valid and reliable measure to assess health insurance literacy. This article reports on the development of the Health Insurance Literacy Measure (HILM), a self-assessment measure of consumers' ability to select and use private health insurance. The authors developed a conceptual model of health insurance literacy based on formative research and stakeholder guidance. Survey items were drafted using the conceptual model as a guide then tested in two rounds of cognitive interviews. After a field test with 828 respondents, exploratory factor analysis revealed two HILM scales, choosing health insurance and using health insurance, each of which is divided into a confidence subscale and likelihood of behavior subscale. Correlations between the HILM scales and an objective measure of health insurance knowledge and skills were positive and statistically significant which supports the validity of the measure.

  20. Objectivity in psychosocial measurement: what, why, how.

    PubMed

    Fisher, W P

    2000-01-01

    This article raises and tries to answer questions concerning what objectivity in psychosocial measurement is, why it is important, and how it can be achieved. Following in the tradition of the Socratic art of maiuetics, objectivity is characterized by the separation of meaning from the geometric, metaphoric, or numeric figure carrying it, allowing an ideal and abstract entity to take on a life of its own. Examples of objective entities start from anything teachable and learnable, but for the purposes of measurement, the meter, gram, volt, and liter are paradigmatic because of their generalizability across observers, instruments, laboratories, samples, applications, etc. Objectivity is important because it is only through it that distinct conceptual entities are meaningfully distinguished. Seen from another angle, objectivity is important because it defines the conditions of the possibility of shared meaning and community. Full objectivity in psychosocial measurement can be achieved only by attending to both its methodological and its social aspects. The methodological aspect has recently achieved some notice in psychosocial measurement, especially in the form of Rasch's probabilistic conjoint models. Objectivity's social aspect has only recently been noticed by historians of science, and has not yet been systematically incorporated in any psychosocial science. An approach to achieving full objectivity in psychosocial measurement is adapted from the ASTM Standard Practice for Conducting an Interlaboratory Study to Determine the Precision of a Test Method (ASTM Committee E-11 on Statistical Methods, 1992).

  1. Effect of a grounded object on radon measurement using AlphaGUARD.

    PubMed

    Ichitsubo, Hirokazu; Yamada, Yuji

    2004-07-01

    ABSTRACT-: The effects on radon concentration measurement of a grounded object near the opening of a cylindrical ionization chamber were studied using AlphaGUARD. AlphaGUARD comes with a flow measurement adapter that fits on the front of the AlphaGUARD ionization chamber. If the adapter nozzle is grounded, the radon concentration is falsely measured at 0 Bq m. A metal connector for use between the AlphaGUARD and the air duct wall was manufactured in our laboratory. When the connector is grounded, the radon concentration is again falsely measured as 0 Bq m. If the nozzle or connector is ungrounded, the AlphaGUARD measures radon concentration accurately. Health Phys.

  2. Health Care Financial Management: Curriculum Objectives and Bibliography.

    ERIC Educational Resources Information Center

    Zelman, William N., Ed.; And Others

    Curriculum objectives for health care financial management, a bibliography and examples of financial management curricula are presented. The outline of curriculum objectives identifies a core of knowledge and skills in financial management that health administration students might obtain in their academic training. The outline's content is divided…

  3. 42 CFR 495.6 - Meaningful use objectives and measures for EPs, eligible hospitals, and CAHs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM General Provisions § 495.6 Meaningful use objectives and... their first payment year. For Medicaid EPs who adopt, implement, or upgrade certified EHR technology in... certified EHR technology in their first payment year, the meaningful use objectives and associated measures...

  4. Object strength--an accurate measure for small objects that is insensitive to partial volume effects.

    PubMed

    Tofts, P S; Silver, N C; Barker, G J; Gass, A

    2005-07-01

    There are currently four problems in characterising small nonuniform lesions or other objects in Magnetic Resonance images where partial volume effects are significant. Object size is over- or under-estimated; boundaries are often not reproducible; mean object value cannot be measured; and fuzzy borders cannot be accommodated. A new measure, Object Strength, is proposed. This is the sum of all abnormal intensities, above a uniform background value. For a uniform object, this is simply the product of the increase in intensity and the size of the object. Biologically, this could be at least as relevant as existing measures of size or mean intensity. We hypothesise that Object Strength will perform better than traditional area measurements in characterising small objects. In a pilot study, the reproducibility of object strength measurements was investigated using MR images of small multiple sclerosis (MS) lesions. In addition, accuracy was investigated using artificial lesions of known volume (0.3-6.2 ml) and realistic appearance. Reproducibility approached that of area measurements (in 33/90 lesion reports the difference between repeats was less than for area measurements). Total lesion volume was accurate to 0.2%. In conclusion, Object Strength has potential for improved characterisation of small lesions and objects in imaging and possibly spectroscopy.

  5. Creating objective and measurable postgraduate year 1 residency graduation requirements.

    PubMed

    Starosta, Kaitlin; Davis, Susan L; Kenney, Rachel M; Peters, Michael; To, Long; Kalus, James S

    2017-03-15

    The process of developing objective and measurable postgraduate year 1 (PGY1) residency graduation requirements and a progress tracking system is described. The PGY1 residency accreditation standard requires that programs establish criteria that must be met by residents for successful completion of the program (i.e., graduation requirements), which should presumably be aligned with helping residents to achieve the purpose of residency training. In addition, programs must track a resident's progress toward fulfillment of residency goals and objectives. Defining graduation requirements and establishing the process for tracking residents' progress are left up to the discretion of the residency program. To help standardize resident performance assessments, leaders of an academic medical center-based PGY1 residency program developed graduation requirement criteria that are objective, measurable, and linked back to residency goals and objectives. A system for tracking resident progress relative to quarterly progress targets was instituted. Leaders also developed a focused, on-the-spot skills assessment termed "the Thunderdome," which was designed for objective evaluation of direct patient care skills. Quarterly data on residents' progress are used to update and customize each resident's training plan. Implementation of this system allowed seamless linkage of the training plan, the progress tracking system, and the specified graduation requirement criteria. PGY1 residency requirements that are objective, that are measurable, and that attempt to identify what skills the resident must demonstrate in order to graduate from the program were developed for use in our residency program. A system for tracking the residents' progress by comparing residents' performance to predetermined quarterly benchmarks was developed. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  6. 42 CFR 495.6 - Meaningful use objectives and measures for EPs, eligible hospitals, and CAHs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM General Provisions § 495.6 Meaningful use objectives and... year. For Medicaid EPs who adopt, implement, or upgrade certified EHR technology in their first payment... technology in their first payment year, the meaningful use objectives and associated measures of the Stage 1...

  7. 42 CFR 495.6 - Meaningful use objectives and measures for EPs, eligible hospitals, and CAHs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM General Provisions § 495.6 Meaningful use objectives and... year. For Medicaid EPs who adopt, implement, or upgrade certified EHR technology in their first payment... technology in their first payment year, the meaningful use objectives and associated measures of the Stage 1...

  8. 42 CFR 495.6 - Meaningful use objectives and measures for EPs, eligible hospitals, and CAHs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM General Provisions § 495.6 Meaningful use objectives and... year. For Medicaid EPs who adopt, implement, or upgrade certified EHR technology in their first payment... technology in their first payment year, the meaningful use objectives and associated measures of the Stage 1...

  9. [Mental Health: Concepts, Measures, Determinants].

    PubMed

    Doré, Isabelle; Caron, Jean

    Objectives This article aims to situate the concept of mental health in a historical perspective. This article presents the most commonly used measurement tools in Canada and elsewhere in the world to assess specific and multiple dimensions of mental health; when available, psychometric properties are discussed. Finally, research findings on quality of life and mental health determinants are presented.Methods A literature review of concepts, measurement and determinants of mental health is presented in this paper. The selection of measurement scales presented is based on the findings of the research reports conducted by the second author, an expert on mental health measures, for Health Canada and Statistics Canada.Results Mental health is more than the absence of mental illness; rather it is a state of complete well-being, which refers to our ability to enjoy life and deal with the challenges we face. Accordingly, mental health and mental illness are not extremes of the same continuum, but distinct yet correlated concepts. The traditional conceptualization suggesting that mental health represents simply the absence of mental illness has been replaced, in the last few decades, by a more holistic characterization, which directly concerns public health. The components of mental health include emotional well-being/quality of life (QOL) and psychological and social well-being. Mental health influences the personal and social functioning of individuals, justifying the importance of intervening upstream to promote mental health. Specific scales are relevant for obtaining a detailed measure of one aspect of well-being in particular (emotional/quality of life, psychological or social well-being); however, to account for the global mental health status, measurement tools that integrate all three forms of well-being (emotional, psychological and social) should be privileged. A diversity of determinants at the individual, social and neighbourhood levels influence quality of

  10. Objectively measured physical activity and balance among U.S. adults.

    PubMed

    Loprinzi, Paul D; Brosky, Joseph A

    2014-08-01

    The purpose of this study was to examine the association between objectively measured physical activity (PA) and balance in a nationally representative sample of U.S. adults 40 years of age and older. Data from the 2003-2004 National Health and Nutrition Examination Survey were used. Physical activity was measured over a 7-day period using accelerometry, and balance was assessed using the Romberg test. Participants completed a questionnaire regarding their subjective views on difficulty with falling in the past 12 months. For every 60-minute increase in light-intensity PA, participants were 10% (p = 0.04) more likely to have functional balance. Similarly, for every 1-minute increase in log-transformed moderate-to-vigorous physical activity, participants were 23% (p = 0.04) more likely to have functional balance. Regular PA, regardless of intensity, may have health benefits for older adults and is associated with functional balance.

  11. Relationship between objectively measured sedentary behavior and health outcomes in schizophrenia patients: The PsychiActive project.

    PubMed

    Bueno-Antequera, Javier; Oviedo-Caro, Miguel Ángel; Munguía-Izquierdo, Diego

    2017-11-21

    This study aimed to investigate possible relationships between sedentary behavior and body mass index (BMI), cardiorespiratory fitness (CRF), and health-related quality of life (HRQoL) in schizophrenia patients. Variables contributing to the variability in sedentary behavior were identified. Eighty-two schizophrenia outpatients (mean age±SD: 41.0±8.7years, 87% men, mean illness duration±SD: 17.1±8.9years) wore a multisensor armband for 7 consecutive full days to objectively measure sedentary behavior. BMI, walking capacity (6-minute walking test) as a proxy for CRF estimation and HRQoL (Short Form 36-Item Health Survey questionnaire version 2) were also assessed. Correlation (Pearson or Spearman coefficients) and multiple regression analysis were used. Sedentary behavior was significantly associated with BMI, CRF, and the physical component summary score of HRQoL (r values, -0.34-0.41; all P<0.001) and remained significant after adjustments for age, illness duration, symptom severity, adherence to Mediterranean diet, smoking, and antipsychotic medication (all P<0.05). BMI, CRF and vitality were identified as determinants of sedentary behavior. Consistent relationships between sedentary behavior and BMI, CRF, and the physical component summary score of HRQoL were found in schizophrenia patients. All the identified determinants of sedentary behavior are modifiable and may be important areas for future interventions in this population. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Objectively measured sedentary behavior and moderate-to-vigorous physical activity on the health-related quality of life in US adults: The National Health and Nutrition Examination Survey 2003-2006.

    PubMed

    Kim, Junghoon; Im, Jeong-Soo; Choi, Yoon-Hyeong

    2017-05-01

    Health-related quality of life (HRQOL) represents an individual's perception of physical, mental, and social well-being and is a strong predictor of health status. Few studies have examined associations of sedentary behavior (SB) and moderate-to-vigorous physical activity (MVPA) with HRQOL in the general population. This study aimed to determine combined associations of objectively measured SB and MVPA on the risk of poor HRQOL in the general US population, after controlling for potential confounding factors. We analyzed data from 5359 adults from the National Health and Nutrition Examination Survey 2003-2006. HRQOL was measured using a HRQOL-4 consisting of four questions focused on the self-perception of general health, physical health, mental health, and activity limitation. We dichotomized each HRQOL-4 component as good versus poor and defined poor overall HRQOL when participants had any poor HRQOL components. SB and MVPA were measured using an accelerometer. Survey logistic models were examined to estimate the odds ratio (OR) and 95% confidence interval (CI) for poor HRQOL by SB and MVPA as tertiles. When examined as a combination of SB and MVPA, a substantial decrease in the risk of poor overall HRQOL was found in individuals with low SB/high MVPA [OR 0.69 (95% CI 0.51-0.94) and moderate SB/high MVPA (OR 0.56 (95% CI 0.40-0.78)], but no significant decrease was found in individuals with high SB/high MVPA (vs. high SB/low MVPA). Our findings suggest that both increasing MVPA and reducing time spent in SB may be useful strategies to improve HRQOL.

  13. Association of chronic widespread pain with objectively measured physical activity in adults: findings from the National Health and Nutrition Examination survey.

    PubMed

    Dansie, Elizabeth J; Turk, Dennis C; Martin, Kathryn R; Van Domelen, Dane R; Patel, Kushang V

    2014-05-01

    Chronic widespread pain (CWP) is a common and potentially debilitating disorder. Patterns of physical activity (PA) in adults with CWP have primarily been investigated using subjective, self-report measures. The current study sought to characterize PA among community-dwelling individuals with CWP, chronic regional pain, or no chronic pain using objective measurements obtained via accelerometry in the 2003 to 2004 National Health and Nutrition Examination Survey. Data from 3,952 participants ages 20 and older were analyzed to assess relationships between pain status and objective measurements of PA. Prevalence of CWP was 3.3% and 5.4% in men and women, respectively. In men and women, the average activity counts per minute and time spent in moderate-to-vigorous PA were significantly lower for the CWP group than for the no chronic pain group. Interestingly, time spent in sedentary, light, and lifestyle activities was not associated with pain status. Statistical interaction tests indicated that the effects of chronic pain on counts per minute were stronger in men than in women. Despite recommendations for increased moderate-to-vigorous PA as a pain management strategy for CWP, results from this nationally representative study indicate that adults with CWP participate in less moderate-to-vigorous PA than individuals without chronic pain. Using objective measurement of PA in a nationally representative sample, this study demonstrates that adults with CWP participate in reduced daily and moderate-to-vigorous PA in comparison to people with no chronic pain. Findings indicate that clinicians should emphasize the importance of increasing PA in patients with CWP. Copyright © 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.

  14. Population Health Measurement: Applying Performance Measurement Concepts in Population Health Settings

    PubMed Central

    Stoto, Michael A.

    2014-01-01

    Introduction: Whether the focus of population-health improvement efforts, the measurement of health outcomes, risk factors, and interventions to improve them are central to achieving collective impact in the population health perspective. And because of the importance of a shared measurement system, appropriate measures can help to ensure the accountability of and ultimately integrate the efforts of public health, the health care delivery sector, and other public and private entities in the community to improve population health. Yet despite its importance, population health measurement efforts in the United States are poorly developed and uncoordinated. Collaborative Measurement Development: To achieve the potential of the population health perspective, public health officials, health system leaders, and others must work together to develop sets of population health measures that are suitable for different purposes yet are harmonized so that together they can help to improve a community’s health. This begins with clearly defining the purpose of a set of measures, distinguishing between outcomes for which all share responsibility and actions to improve health for which the health care sector, public health agencies, and others should be held accountable. Framework for Population Health Measurement: Depending on the purpose of the analysis, then, measurement systems should clearly specify what to measure—in particular the population served (the denominator), what the critical health dimensions are in a measurement framework, and how the measures can be used to ensure accountability. Building on a clear understanding of the purpose and dimensions of population health that must be measured, developers can then choose specific measures using existing data or developing new data sources if necessary, with established validity, reliability, and other scientific characteristics. Rather than indiscriminately choosing among the proliferating data streams, this

  15. Issues Related to Measuring and Interpreting Objectively Measured Sedentary Behavior Data

    ERIC Educational Resources Information Center

    Janssen, Xanne; Cliff, Dylan P.

    2015-01-01

    The use of objective measures of sedentary behavior has increased over the past decade; however, as is the case for objectively measured physical activity, methodological decisions before and after data collection are likely to influence the outcomes. The aim of this article is to review the evidence on different methodological decisions made by…

  16. Measuring Geographic Inequalities: Dealing with Multiple Health Resources by Data Envelopment Analysis

    PubMed Central

    Dlouhý, Martin

    2018-01-01

    The existence of geographic differences in health resources, health expenditures, the utilization of health services, and health outcomes have been documented by a lot of studies from various countries of the world. In a publicly financed health system, equal access is one of the main objectives of the national health policy. That is why inequalities in the geographic allocation of health resources are an important health policy issue. Measures of inequality express the complexity of variation in the observed variable by a single number, and there is a variety of inequality measures available. The objective of this study is to develop a measure of the geographic inequality in the case of multiple health resources. The measure uses data envelopment analysis (DEA), which is a non-parametric method of production function estimation, to transform multiple resources into a single virtual health resource. The study shows that the DEA originally developed for measuring efficiency can be used successfully to measure inequality. For the illustrative purpose, the inequality measure is calculated for the Czech Republic. The values of separate Robin Hood Indexes (RHIs) are 6.64% for physicians and 3.96% for nurses. In the next step, we use combined RHI for both health resources. Its value 5.06% takes into account that the combinations of two health resources serve regional populations. PMID:29541631

  17. Measuring Geographic Inequalities: Dealing with Multiple Health Resources by Data Envelopment Analysis.

    PubMed

    Dlouhý, Martin

    2018-01-01

    The existence of geographic differences in health resources, health expenditures, the utilization of health services, and health outcomes have been documented by a lot of studies from various countries of the world. In a publicly financed health system, equal access is one of the main objectives of the national health policy. That is why inequalities in the geographic allocation of health resources are an important health policy issue. Measures of inequality express the complexity of variation in the observed variable by a single number, and there is a variety of inequality measures available. The objective of this study is to develop a measure of the geographic inequality in the case of multiple health resources. The measure uses data envelopment analysis (DEA), which is a non-parametric method of production function estimation, to transform multiple resources into a single virtual health resource. The study shows that the DEA originally developed for measuring efficiency can be used successfully to measure inequality. For the illustrative purpose, the inequality measure is calculated for the Czech Republic. The values of separate Robin Hood Indexes (RHIs) are 6.64% for physicians and 3.96% for nurses. In the next step, we use combined RHI for both health resources. Its value 5.06% takes into account that the combinations of two health resources serve regional populations.

  18. APPLICATION OF DATA QUALITY OBJECTIVES AND MEASUREMENT QUALITY OBJECTIVES TO RESEARCH PROJECTS

    EPA Science Inventory

    The paper assists systematic planning for research projects. It presents planning concepts in terms that have some utility for researchers. For example, measurement quality objectives are more familiar to researchers than data quality objectives because these quality criteria are...

  19. Subjective and objective measures of socioeconomic status: predictors of cardiovascular risk in college students in Mumbai, India.

    PubMed

    Suchday, Sonia; Chhabra, Rosy; Wylie-Rosett, Judith; Almeida, Maureen

    2008-01-01

    The relationship between socioeconomic status (SES) and health changes as a society develops. In developed countries, high SES is associated with better health, but in developing countries, high SES is associated with poorer health. However, measuring SES is difficult in countries like India, where the traditional class and caste system are interwoven and complex. The current study explored the relationship between subjective and objective indices of SES and between SES and the metabolic syndrome among Asian Indians residing in Mumbai, India. Participants were a subset of young adults (N = 112, median age 19 years, 24% male) who were part of larger study assessing psychosocial correlates of the metabolic syndrome. SES was assessed through objective (father's education) and subjective (SES ladder) indices. Data indicated that high subjective SES was correlated with fasting blood sugar (r = .28, P < .003), and father's education was correlated with high cholesterol (r = .32, P < .005). Subjective and objective indices of SES were also correlated with each other (r = .24, P < .04). These data reiterate that the link between SES and health is obvious from an early age, regardless of the measures used to assess SES. Given the complexity of assessing SES in developing countries, objective subjective indices should be used in assessing SES.

  20. Measuring systems of hard to get objects: problems with analysis of measurement results

    NASA Astrophysics Data System (ADS)

    Gilewska, Grazyna

    2005-02-01

    The problem accessibility of metrological parameters features of objects appeared in many measurements. Especially if it is biological object which parameters very often determined on the basis of indirect research. Accidental component predominate in forming of measurement results with very limited access to measurement objects. Every measuring process has a lot of conditions limiting its abilities to any way processing (e.g. increase number of measurement repetition to decrease random limiting error). It may be temporal, financial limitations, or in case of biological object, small volume of sample, influence measuring tool and observers on object, or whether fatigue effects e.g. at patient. It's taken listing difficulties into consideration author worked out and checked practical application of methods outlying observation reduction and next innovative methods of elimination measured data with excess variance to decrease of mean standard deviation of measured data, with limited aomunt of data and accepted level of confidence. Elaborated methods wee verified on the basis of measurement results of knee-joint width space got from radiographs. Measurements were carried out by indirectly method on the digital images of radiographs. Results of examination confirmed legitimacy to using of elaborated methodology and measurement procedures. Such methodology has special importance when standard scientific ways didn't bring expectations effects.

  1. What should we measure? Conceptualizing usage in health information exchange

    PubMed Central

    Jasperson, Jon

    2010-01-01

    Under the provisions of the Health Information Technology for Economic & Clinical Health act providers need to demonstrate their ‘meaningful use’ of electronic health record systems' health information exchange (HIE) capability. HIE usage is not a simple construct, but the choice of its measurement must attend to the users, context, and objectives of the system being examined. This review examined how usage is reported in the existing literature and also what conceptualizations of usage might best reflect the nature and objectives of HIE. While existing literature on HIE usage included a diverse set of measures, most were theoretically weak, did not attend to the interplay of measure, level of analysis and architectural strategy, and did not reflect how HIE usage affected the actual process of care. Attention to these issues will provide greater insight into the effects of previously inaccessible information on medical decision-making and the process of care. PMID:20442148

  2. A systematic review of objective burn scar measurements.

    PubMed

    Lee, Kwang Chear; Dretzke, Janine; Grover, Liam; Logan, Ann; Moiemen, Naiem

    2016-01-01

    Problematic scarring remains a challenging aspect to address in the treatment of burns and can significantly affect the quality of life of the burn survivor. At present, there are few treatments available in the clinic to control adverse scarring, but experimental pharmacological anti-scarring strategies are now beginning to emerge. Their comparative success must be based on objective measurements of scarring, yet currently the clinical assessment of scars is not carried out systematically and is mostly based on subjective review of patients. However, several techniques and devices are being introduced that allow objective analysis of the burn scar. The aim of this article is to evaluate various objective measurement tools currently available and recommend a useful panel that is suitable for use in clinical trials of anti-scarring therapies. A systematic literature search was done using the Web of Science, PubMed and Cochrane databases. The identified devices were then classified and grouped according to the parameters they measured. The tools were then compared and assessed in terms of inter- and intra-rater reproducibility, ease of use and cost. After duplicates were removed, 5062 articles were obtained in the search. After further screening, 157 articles which utilised objective burn scar measurement systems or tools were obtained. The scar measurement devices can be broadly classified into those measuring colour, metric variables, texture, biomechanical properties and pathophysiological disturbances. Objective scar measurement tools allow the accurate and reproducible evaluation of scars, which is important for both clinical and scientific use. However, studies to evaluate their relative performance and merits of these tools are scarce, and there remain factors, such as itch and pain, which cannot be measured objectively. On reviewing the available evidence, a panel of devices for objective scar measurement is recommended consisting of the 3D cameras (Eykona

  3. An Improved Suite of Object Oriented Software Measures

    NASA Technical Reports Server (NTRS)

    Neal, Ralph D.; Weistroffer, H. Roland; Coppins, Richard J.

    1997-01-01

    In the pursuit of ever increasing productivity, the need to be able to measure specific aspects of software is generally agreed upon. As object oriented programming languages are becoming more and more widely used, metrics specifically designed for object oriented software are required. In recent years there has been an explosion of new, object oriented software metrics proposed in the literature. Unfortunately, many or most of these proposed metrics have not been validated to measure what they claim to measure. In fact, an analysis of many of these metrics shows that they do not satisfy basic properties of measurement theory, and thus their application has to be suspect. In this paper ten improved metrics are proposed and are validated using measurement theory.

  4. Measuring Health Literacy in Individuals with Diabetes: A Systematic Review and Evaluation of Available Measures

    ERIC Educational Resources Information Center

    Al Sayah, Fatima; Williams, Beverly; Johnson, Jeffrey A.

    2013-01-01

    Objective: To identify instruments used to measure health literacy and numeracy in people with diabetes; evaluate their use, measurement scope, and properties; discuss their strengths and weaknesses; and propose the most useful, reliable, and applicable measure for use in research and practice settings. Methods" A systematic literature review…

  5. Objectively Measured Sedentary Time and Cardiometabolic Biomarkers in US Hispanic/Latino Adults: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

    PubMed

    Qi, Qibin; Strizich, Garrett; Merchant, Gina; Sotres-Alvarez, Daniela; Buelna, Christina; Castañeda, Sheila F; Gallo, Linda C; Cai, Jianwen; Gellman, Marc D; Isasi, Carmen R; Moncrieft, Ashley E; Sanchez-Johnsen, Lisa; Schneiderman, Neil; Kaplan, Robert C

    2015-10-20

    Sedentary behavior is recognized as a distinct construct from lack of moderate-vigorous physical activity and is associated with deleterious health outcomes. Previous studies have primarily relied on self-reported data, whereas data on the relationship between objectively measured sedentary time and cardiometabolic biomarkers are sparse, especially among US Hispanics/Latinos. We examined associations of objectively measured sedentary time (via Actical accelerometers for 7 days) and multiple cardiometabolic biomarkers among 12 083 participants, aged 18 to 74 years, from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Hispanics/Latinos of diverse backgrounds (Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American) were recruited from 4 US cities between 2008 and 2011. Sedentary time (<100 counts/min) was standardized to 16 hours/d of wear time. The mean sedentary time was 11.9 hours/d (74% of accelerometer wear time). After adjustment for moderate-vigorous physical activity and confounding variables, prolonged sedentary time was associated with decreased high-density lipoprotein cholesterol (P=0.04), and increased triglycerides, 2-hour glucose, fasting insulin, and homeostatic model assessment of insulin resistance (all P<0.0001). These associations were generally consistent across age, sex, Hispanic/Latino backgrounds, and physical activity levels. Even among individuals meeting physical activity guidelines, sedentary time was detrimentally associated with several cardiometabolic biomarkers (diastolic blood pressure, high-density lipoprotein cholesterol, fasting and 2-hour glucose, fasting insulin and homeostatic model assessment of insulin resistance; all P<0.05). Our large population-based, objectively derived data showed deleterious associations between sedentary time and cardiometabolic biomarkers, independent of physical activity, in US Hispanics/Latinos. Our findings emphasize the importance of reducing sedentary

  6. Evaluating a measure of social health derived from two mental health recovery measures: the California Quality of Life (CA-QOL) and Mental Health Statistics Improvement Program Consumer Survey (MHSIP).

    PubMed

    Carlson, Jordan A; Sarkin, Andrew J; Levack, Ashley E; Sklar, Marisa; Tally, Steven R; Gilmer, Todd P; Groessl, Erik J

    2011-08-01

    Social health is important to measure when assessing outcomes in community mental health. Our objective was to validate social health scales using items from two broader commonly used measures that assess mental health outcomes. Participants were 609 adults receiving psychological treatment services. Items were identified from the California Quality of Life (CA-QOL) and Mental Health Statistics Improvement Program (MHSIP) outcome measures by their conceptual correspondence with social health and compared to the Social Functioning Questionnaire (SFQ) using correlational analyses. Pearson correlations for the identified CA-QOL and MSHIP items with the SFQ ranged from .42 to .62, and the identified scale scores produced Pearson correlation coefficients of .56, .70, and, .70 with the SFQ. Concurrent validity with social health was supported for the identified scales. The current inclusion of these assessment tools allows community mental health programs to include social health in their assessments.

  7. Differential evolution-based multi-objective optimization for the definition of a health indicator for fault diagnostics and prognostics

    NASA Astrophysics Data System (ADS)

    Baraldi, P.; Bonfanti, G.; Zio, E.

    2018-03-01

    The identification of the current degradation state of an industrial component and the prediction of its future evolution is a fundamental step for the development of condition-based and predictive maintenance approaches. The objective of the present work is to propose a general method for extracting a health indicator to measure the amount of component degradation from a set of signals measured during operation. The proposed method is based on the combined use of feature extraction techniques, such as Empirical Mode Decomposition and Auto-Associative Kernel Regression, and a multi-objective Binary Differential Evolution (BDE) algorithm for selecting the subset of features optimal for the definition of the health indicator. The objectives of the optimization are desired characteristics of the health indicator, such as monotonicity, trendability and prognosability. A case study is considered, concerning the prediction of the remaining useful life of turbofan engines. The obtained results confirm that the method is capable of extracting health indicators suitable for accurate prognostics.

  8. Competency-Based Objectives in Global Underserved Women's Health for Medical Trainees.

    PubMed

    Chen, Chi Chiung Grace; Dougherty, Anne; Whetstone, Sara; Mama, Saifuddin T; Larkins-Pettigrew, Margaret; Raine, Susan P; Autry, Amy M

    2017-10-01

    The Association of Professors of Gynecology and Obstetrics Committee on Global Health developed an inclusive definition of global women's health and competency-based objectives that reflected work internationally, as well as with U.S. vulnerable and underserved populations, such as refugee and immigrant populations or those who would otherwise have compromised access to health care. The knowledge, skill, and attitude-based competencies required to fulfill each learning objective were mapped to the Accreditation Council for Graduate Medical Education Outcomes Project's educational domains and the Consortium of Universities for Global Health competency domains. The proposed global women's health definition and competency-based learning objective framework is a first step in ensuring quality standards for educating trainees to address global women's health needs. By proposing these objectives, we hope to guide future program development and spark a broader conversation that will improve health for vulnerable women and shape educational, ethical, and equitable global health experiences for medical trainees.

  9. The METER: A Brief, Self-Administered Measure of Health Literacy

    PubMed Central

    Gunstad, John; Hughes, Joel; Spitznagel, Mary Beth; Potter, Vanessa; Waechter, Donna; Rosneck, James

    2009-01-01

    Background Given rapidly accumulating evidence that health literacy is correlated with important health-related measures, assessing patients’ health literacy level is of increasing concern for researchers and practitioners. Practical limitations for use of existing health literacy measures include length of time and practitioner involvement in administration. Objective To develop and validate a brief, self-administered measure of health literacy, the Medical Term Recognition Test (METER). Participants 155 participants were recruited from an outpatient cardiology program at an urban hospital. Measures Patients completed measures of health literacy (METER and REALM), neuropsychological function, psychosocial health, and self-report questionnaires about health behaviors. Indicators of cardiovascular health were also recorded from patients’ medical charts. Key results The measure took 2 min to complete. The internal consistency of the METER was 0.93, and it correlated highly with REALM (r = 0.74). Regarding sensitivity and specificity for identifying individuals below REALM’s cutoff for functional literacy, METER resulted in 75% correct identifications and 8% false positives. METER and REALM were both associated with various health-related measures (including significant correlations with measures of neuropsychological function and cardiovascular health). Conclusions These initial findings show that the METER is a quick and practical measure of health literacy for use in clinical settings. PMID:19885705

  10. [Implicit value judgments in the measurement of health inequalities].

    PubMed

    Harper, Sam; King, Nicholas B; Meersman, Stephen C; E Reichman, Marsha; Breen, Nancy; Lynch, John

    2014-04-01

    Quantitative estimates of the magnitude, direction, and rate of change of health inequalities play a crucial role in creating and assessing policies aimed at eliminating the disproportionate burden of disease in disadvantaged populations. It is generally assumed that the measurement of health inequalities is a value-neutral process, providing objective data that are then interpreted using normative judgments about whether a particular distribution of health is just, fair, or socially acceptable. We discuss five examples in which normative judgments play a role in the measurement process itself, through either the selection of one measurement strategy to the exclusion of others or the selection of the type, significance, or weight assigned to the variables being measured. Overall, we find that many commonly used measures of inequality are value laden and that the normative judgments implicit in these measures have important consequences for interpreting and responding to health inequalities. Because values implicit in the generation of health inequality measures may lead to radically different interpretations of the same underlying data,we urge researchers to explicitly consider and transparently discuss the normative judgments underlying their measures. We also urge policymakers and other consumers of health inequalities data to pay close attention to the measures on which they base their assessments of current and future health policies.

  11. Implicit value judgments in the measurement of health inequalities.

    PubMed

    Harper, Sam; King, Nicholas B; Meersman, Stephen C; Reichman, Marsha E; Breen, Nancy; Lynch, John

    2010-03-01

    Quantitative estimates of the magnitude, direction, and rate of change of health inequalities play a crucial role in creating and assessing policies aimed at eliminating the disproportionate burden of disease in disadvantaged populations. It is generally assumed that the measurement of health inequalities is a value-neutral process, providing objective data that are then interpreted using normative judgments about whether a particular distribution of health is just, fair, or socially acceptable. We discuss five examples in which normative judgments play a role in the measurement process itself, through either the selection of one measurement strategy to the exclusion of others or the selection of the type, significance, or weight assigned to the variables being measured. Overall, we find that many commonly used measures of inequality are value laden and that the normative judgments implicit in these measures have important consequences for interpreting and responding to health inequalities. Because values implicit in the generation of health inequality measures may lead to radically different interpretations of the same underlying data, we urge researchers to explicitly consider and transparently discuss the normative judgments underlying their measures. We also urge policymakers and other consumers of health inequalities data to pay close attention to the measures on which they base their assessments of current and future health policies.

  12. First ultraviolet reflectance measurements of several Kuiper Belt objects, Kuiper Belt object satellites, and new ultraviolet measurements of A Centaur

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

    Stern, S. A.; Schindhelm, E.; Cunningham, N. J., E-mail: astern@swri.edu

    We observed the 2600-3200 Å (hereafter, mid-UV) reflectance of two Kuiper Belt Objects (KBOs), two KBO satellites, and a Centaur, using the Hubble Space Telescope (HST) Cosmic Origins Spectrograph (COS). Other than measurements of the Pluto system, these constitute the first UV measurements obtained of KBOs, and KBO satellites, and new HST UV measurements of the Centaur 2060 Chiron. We find significant differences among these objects, constrain the sizes and densities of Haumea's satellites, and report the detection of a possible spectral absorption band in Haumea's spectrum near 3050 Å. Comparisons of these objects to previously published UV reflectance measurementsmore » of Pluto and Charon are also made here.« less

  13. A systematic review of the relationship between objective measurements of the urban environment and psychological distress.

    PubMed

    Gong, Yi; Palmer, Stephen; Gallacher, John; Marsden, Terry; Fone, David

    2016-11-01

    The urban environment has become the main place that people live and work. As a result it can have profound impacts on our health. While much of the literature has focused on physical health, less attention has been paid to the possible psychological impacts of the urban environment. In order to understand the potential relevance and importance of the urban environment to population mental health, we carried out a systematic review to examine the associations between objective measurements of the urban environment and psychological distress, independently of the individual's subjective perceptions of the urban environment. 11 peer-reviewed papers published in English between January 2000 and February 2012 were identified. All studies were cross-sectional. Despite heterogeneity in study design, the overall findings suggested that the urban environment has measurable associations with psychological distress, including housing with deck access, neighbourhood quality, the amount of green space, land-use mix, industry activity and traffic volume. The evidence supports the need for development of interventions to improve mental health through changing the urban environment. We also conclude that new methods for measuring the urban environment objectively are needed which are meaningful to planners. In particular, future work should look at the spatial-temporal dynamic of the urban environment measured in Geographical Information System (GIS) in relation to psychological distress. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. Healthy Volunteer 2020: Comparing Peace Corps Volunteers' health metrics with Healthy People 2020 national objectives.

    PubMed

    Henderson, Susan J; Newman, Jeannette; Ferguson, Rennie W; Jung, Paul

    2016-12-01

    Healthy People 2020 (HP2020) provides a set of quantifiable objectives for improving the health and well-being of Americans. This study examines Peace Corps Volunteers' health metrics in comparison with the Leading Health Indicators (LHIs) in order to set baseline measures for Volunteers' health care and align our measurements with Healthy People 2020 standards. Health data from multiple internal Peace Corps datasets were compared with relevant LHIs and analyzed using descriptive statistics. Seventeen (65%) of the 26 LHIs were relevant to Peace Corps Volunteers. Of these, Volunteers' health measures met or were more favorable than the goals of 13 (76%) of the LHIs. There were no data available for 4 (24%) of the LHIs. The entire Volunteer population has full access to primary care, oral health, and reproductive health services. No suicides or homicides were reported among Volunteers during the analyzed time period. Utilizing the LHIs, we have identified high-priority public health issues relevant for the Peace Corps Volunteer population. We discuss the need for quality data to measure and monitor Volunteers' health progress and outcomes over time, and also to standardize our measurements with Healthy People 2020 benchmarks. This framework may foster greater collaboration to engage in health promotion and disease prevention activities driven by evidence-based information, which may, in turn, encourage healthy behavior among Volunteers.

  15. Mismatch between perceived and objectively measured environmental obesogenic features in European neighbourhoods.

    PubMed

    Roda, C; Charreire, H; Feuillet, T; Mackenbach, J D; Compernolle, S; Glonti, K; Ben Rebah, M; Bárdos, H; Rutter, H; McKee, M; De Bourdeaudhuij, I; Brug, J; Lakerveld, J; Oppert, J-M

    2016-01-01

    Findings from research on the association between the built environment and obesity remain equivocal but may be partly explained by differences in approaches used to characterize the built environment. Findings obtained using subjective measures may differ substantially from those measured objectively. We investigated the agreement between perceived and objectively measured obesogenic environmental features to assess (1) the extent of agreement between individual perceptions and observable characteristics of the environment and (2) the agreement between aggregated perceptions and observable characteristics, and whether this varied by type of characteristic, region or neighbourhood. Cross-sectional data from the SPOTLIGHT project (n = 6037 participants from 60 neighbourhoods in five European urban regions) were used. Residents' perceptions were self-reported, and objectively measured environmental features were obtained by a virtual audit using Google Street View. Percent agreement and Kappa statistics were calculated. The mismatch was quantified at neighbourhood level by a distance metric derived from a factor map. The extent to which the mismatch metric varied by region and neighbourhood was examined using linear regression models. Overall, agreement was moderate (agreement < 82%, kappa < 0.3) and varied by obesogenic environmental feature, region and neighbourhood. Highest agreement was found for food outlets and outdoor recreational facilities, and lowest agreement was obtained for aesthetics. In general, a better match was observed in high-residential density neighbourhoods characterized by a high density of food outlets and recreational facilities. Future studies should combine perceived and objectively measured built environment qualities to better understand the potential impact of the built environment on health, particularly in low residential density neighbourhoods. © 2016 World Obesity.

  16. Increased objectively assessed vigorous-intensity exercise is associated with reduced stress, increased mental health and good objective and subjective sleep in young adults.

    PubMed

    Gerber, Markus; Brand, Serge; Herrmann, Christian; Colledge, Flora; Holsboer-Trachsler, Edith; Pühse, Uwe

    2014-08-01

    The role of physical activity as a factor that protects against stress-related mental disorders is well documented. Nevertheless, there is still a dearth of research using objective measures of physical activity. The present study examines whether objectively assessed vigorous physical activity (VPA) is associated with mental health benefits beyond moderate physical activity (MPA). Particularly, this study examines whether young adults who accomplish the American College of Sports Medicine's (ACSM) vigorous-intensity exercise recommendations differ from peers below these standards with regard to their level of perceived stress, depressive symptoms, perceived pain, and subjective and objective sleep. A total of 42 undergraduate students (22 women, 20 men; M=21.24years, SD=2.20) volunteered to take part in the study. Stress, pain, depressive symptoms, and subjective sleep were assessed via questionnaire, objective sleep via sleep-EEG assessment, and VPA via actigraphy. Meeting VPA recommendations had mental health benefits beyond MPA. VPA was associated with less stress, pain, subjective sleep complaints and depressive symptoms. Moreover, vigorous exercisers had more favorable objective sleep pattern. Especially, they had increased total sleep time, more stage 4 and REM sleep, more slow wave sleep and a lower percentage of light sleep. Vigorous exercisers also reported fewer mental health problems if exposed to high stress. This study provides evidence that meeting the VPA standards of the ACSM is associated with improved mental health and more successful coping among young people, even compared to those who are meeting or exceeding the requirements for MPA. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. The Value of a Well-Being Improvement Strategy: Longitudinal Success across Subjective and Objective Measures Observed in a Firm Adopting a Consumer-Driven Health Plan.

    PubMed

    Guo, Xiaobo; Coberley, Carter; Pope, James E; Wells, Aaron

    2015-10-01

    The objective of this study is to evaluate effectiveness of a firm's 5-year strategy toward improving well-being while lowering health care costs amidst adoption of a Consumer-Driven Health Plan. Repeated measures statistical models were employed to test and quantify association between key demographic factors, employment type, year, individual well-being, and outcomes of health care costs, obesity, smoking, absence, and performance. Average individual well-being trended upward by 13.5% over 5 years, monthly allowed amount health care costs declined 5.2% on average per person per year, and obesity and smoking rates declined by 4.8 and 9.7%, respectively, on average each year. The results show that individual well-being was significantly associated with each outcome and in the expected direction. The firm's strategy was successful in driving statistically significant, longitudinal well-being, biometric and productivity improvements, and health care cost reduction.

  18. Planning and the "Measurable Objective."

    ERIC Educational Resources Information Center

    Miller, Ronald H.

    1973-01-01

    Accountability is being required of all America's institutions of higher education. Gallaudet College, an institution for the deaf in Washington, D.C., feels it has found a solution to the accountability problem in the use of "measurable objectives" in its program planning. The first phase from January 1 through June 30, 1972 of…

  19. Objective food environments and health outcomes.

    PubMed

    Minaker, Leia M; Raine, Kim D; Wild, T Cameron; Nykiforuk, Candace I J; Thompson, Mary E; Frank, Lawrence D

    2013-09-01

    Pathways by which food environments affect residents' diet-related outcomes are still unclear. Understanding pathways may help decision makers identify food environment strategies to promote healthy diets. To examine the hypothesis that residents' perceptions mediate the relationship between objective food environment and residents' diet quality and weight status. In the Waterloo Region, Ontario, objective food environment data were collected from 422 food stores and 912 restaurants using the Nutrition Environment Measure Survey in Stores and Restaurants, a shelf-space measure of fruits and vegetables, and the Retail Food Environment Index. Waterloo Region households (n=2223) completed a subjective food environment perception survey; household members (n=4102) self-reported weight, height, and waist circumference. A subsample (1170 individuals within 690 households) completed diet records. Food environment data were collected in 2010; respondent data were collected from 2009-2010; and data were analyzed in 2012. A series of gender-specific models were conducted to test mediation, adjusting for household income, car ownership, age, and education level. Residents' perceptions did not mediate the relationship between objective measures and diet-related outcomes; instead, results revealed the direct effect of several objectively measured factors of the food environment (notably food access and relative food affordability) on outcomes. Perceptions generally were not associated with diet-related outcomes. These results reveal that in this setting, strategies aimed at improving residents' perceptions may be less effective than those acting directly on food environments to improve food access and relative food affordability. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  20. The auditory nerve overlapped waveform (ANOW): A new objective measure of low-frequency hearing

    NASA Astrophysics Data System (ADS)

    Lichtenhan, Jeffery T.; Salt, Alec N.; Guinan, John J.

    2015-12-01

    One of the most pressing problems today in the mechanics of hearing is to understand the mechanical motions in the apical half of the cochlea. Almost all available measurements from the cochlear apex of basilar membrane or other organ-of-Corti transverse motion have been made from ears where the health, or sensitivity, in the apical half of the cochlea was not known. A key step in understanding the mechanics of the cochlear base was to trust mechanical measurements only when objective measures from auditory-nerve compound action potentials (CAPs) showed good preparation sensitivity. However, such traditional objective measures are not adequate monitors of cochlear health in the very low-frequency regions of the apex that are accessible for mechanical measurements. To address this problem, we developed the Auditory Nerve Overlapped Waveform (ANOW) that originates from auditory nerve output in the apex. When responses from the round window to alternating low-frequency tones are averaged, the cochlear microphonic is canceled and phase-locked neural firing interleaves in time (i.e., overlaps). The result is a waveform that oscillates at twice the probe frequency. We have demonstrated that this Auditory Nerve Overlapped Waveform - called ANOW - originates from auditory nerve fibers in the cochlear apex [8], relates well to single-auditory-nerve-fiber thresholds, and can provide an objective estimate of low-frequency sensitivity [7]. Our new experiments demonstrate that ANOW is a highly sensitive indicator of apical cochlear function. During four different manipulations to the scala media along the cochlear spiral, ANOW amplitude changed when either no, or only small, changes occurred in CAP thresholds. Overall, our results demonstrate that ANOW can be used to monitor cochlear sensitivity of low-frequency regions during experiments that make apical basilar membrane motion measurements.

  1. The Assignment of Scale to Object-Oriented Software Measures

    NASA Technical Reports Server (NTRS)

    Neal, Ralph D.; Weistroffer, H. Roland; Coppins, Richard J.

    1997-01-01

    In order to improve productivity (and quality), measurement of specific aspects of software has become imperative. As object oriented programming languages have become more widely used, metrics designed specifically for object-oriented software are required. Recently a large number of new metrics for object- oriented software has appeared in the literature. Unfortunately, many of these proposed metrics have not been validated to measure what they purport to measure. In this paper fifty (50) of these metrics are analyzed.

  2. Canadian Health Measures Survey pre-test: design, methods, results.

    PubMed

    Tremblay, Mark; Langlois, Renée; Bryan, Shirley; Esliger, Dale; Patterson, Julienne

    2007-01-01

    The Canadian Health Measures Survey (CHMS) pre-test was conducted to provide information about the challenges and costs associated with administering a physical health measures survey in Canada. To achieve the specific objectives of the pre-test, protocols were developed and tested, and methods for household interviewing and clinic testing were designed and revised. The cost, logistics and suitability of using fixed sites for the CHMS were assessed. Although data collection, transfer and storage procedures are complex, the pre-test experience confirmed Statistics Canada's ability to conduct a direct health measures survey and the willingness of Canadians to participate in such a health survey. Many operational and logistical procedures worked well and, with minor modifications, are being employed in the main survey. Fixed sites were problematic, and survey costs were higher than expected.

  3. [Conscientious objection for health professionals in ethics and deontology].

    PubMed

    Martínez León, Mercedes; Rabadán Jiménez, José

    2010-01-01

    The main objective of this paper is to highlight the numerous conflicts enters the consciousness and the laws are becoming more frequent health professionals in daily clinical practice. Clarify and define concepts such as ″conscientious objection for health professionals, to avoid confusion with other terms. This is work that aims to address the objection of conscience, not from the law but from the ethics and deontology, reviewing existing regulations both internationally and nationally. In addition to complete the studio, in a last part we discuss the state of the ″conscientious objection″ tars the recent passage of the organic law 2 / 2010, 3 march, sexual and reproductive health and the interruption of pregnancy. As a final conclusion we can say that ″conscientious objection″ is recognized in international declarations and even in the european constitution. in spain, the code of ethics and medical ethics, is one of the places where the objection of conscience of health professionals has great development for years, states that the doctor can refrain from the practice of certain professional acts such as abortion, in vitro fertilization or sterilization, if they are in contradiction with its ethical and scientific beliefs. Also recently, the general assembly of october 24, 2009, the central committee of ethics has made a declaration on ″conscientious objection″, insisting on its recognition. Finally, the organic law 2 / 2010, 3 march, sexual and reproductive health and the interruption of pregnancy, seems to be recognized ″the right to exercise conscientious objection″ of health professionals directly involved in the voluntary termination of pregnancy, after much discussion, but it is still early to assess the implementation of this right because, until july 5, 2010, will come into force this law, what will the future that we clarify the development of this important right for health professionals.

  4. A Fuzzy Description Logic with Automatic Object Membership Measurement

    NASA Astrophysics Data System (ADS)

    Cai, Yi; Leung, Ho-Fung

    In this paper, we propose a fuzzy description logic named f om -DL by combining the classical view in cognitive psychology and fuzzy set theory. A formal mechanism used to determine object memberships automatically in concepts is also proposed, which is lacked in previous work fuzzy description logics. In this mechanism, object membership is based on the defining properties of concept definition and properties in object description. Moreover, while previous works cannot express the qualitative measurements of an object possessing a property, we introduce two kinds of properties named N-property and L-property, which are quantitative measurements and qualitative measurements of an object possessing a property respectively. The subsumption and implication of concepts and properties are also explored in our work. We believe that it is useful to the Semantic Web community for reasoning the fuzzy membership of objects for concepts in fuzzy ontologies.

  5. National Quality Measures for Child Mental Health Care: Background, Progress, and Next Steps

    PubMed Central

    Murphy, J. Michael; Scholle, Sarah Hudson; Hoagwood, Kimberly Eaton; Sachdeva, Ramesh C.; Mangione-Smith, Rita; Woods, Donna; Kamin, Hayley S.; Jellinek, Michael

    2013-01-01

    OBJECTIVE: To review recent health policies related to measuring child health care quality, the selection processes of national child health quality measures, the nationally recommended quality measures for child mental health care and their evidence strength, the progress made toward developing new measures, and early lessons learned from these national efforts. METHODS: Methods used included description of the selection process of child health care quality measures from 2 independent national initiatives, the recommended quality measures for child mental health care, and the strength of scientific evidence supporting them. RESULTS: Of the child health quality measures recommended or endorsed during these national initiatives, only 9 unique measures were related to child mental health. CONCLUSIONS: The development of new child mental health quality measures poses methodologic challenges that will require a paradigm shift to align research with its accelerated pace. PMID:23457148

  6. Objective and automated measurement of dynamic vision functions

    NASA Technical Reports Server (NTRS)

    Flom, M. C.; Adams, A. J.

    1976-01-01

    A phoria stimulus array and electro-oculographic (EOG) arrangements for measuring motor and sensory responses of subjects subjected to stress or drug conditions are described, along with experimental procedures. Heterophoria (as oculomotor function) and glare recovery time (time required for photochemical and neural recovery after exposure to a flash stimulus) are measured, in research aimed at developing automated objective measurement of dynamic vision functions. Onset of involuntary optokinetic nystagmus in subjects attempting to track moving stripes (while viewing through head-mounted binocular eyepieces) after exposure to glare serves as an objective measure of glare recovery time.

  7. Electronic Health Record (EHR)-Based Community Health Measures: An Exploratory Assessment of Perceived Usefulness by Local Health Departments.

    PubMed

    Comer, Karen F; Gibson, P Joseph; Zou, Jian; Rosenman, Marc; Dixon, Brian E

    2018-05-22

    Given the widespread adoption of electronic health record (EHR) systems in health care organizations, public health agencies are interested in accessing EHR data to improve health assessment and surveillance. Yet there exist few examples in the U.S. of governmental health agencies using EHR data routinely to examine disease prevalence and other measures of community health. The objective of this study was to explore local health department (LHD) professionals' perceptions of the usefulness of EHR-based community health measures, and to examine these perceptions in the context of LHDs' current access and use of sub-county data, data aggregated at geographic levels smaller than county. To explore perceived usefulness, we conducted an online survey of LHD professionals in Indiana. One hundred and thirty-three (133) individuals from thirty-one (31) LHDs participated. The survey asked about usefulness of specific community health measures as well as current access to and uses of sub-county population health data. Descriptive statistics were calculated to examine respondents' perceptions, access, and use. A one-way ANOVA (with pairwise comparisons) test was used to compare average scores by LHD size. Respondents overall indicated moderate agreement on which community health measures might be useful. Perceived usefulness of specific EHR-based community health measures varied by size of respondent's LHD [F(3, 88) = 3.56, p = 0.017]. Over 70% of survey respondents reported using community health data, but of those < 30% indicated they had access to sub-county level data. Respondents generally preferred familiar community health measures versus novel, EHR-based measures that are not in widespread use within health departments. Access to sub-county data is limited but strongly desired. Future research and development is needed as LHD staff gain access to EHR data and apply these data to support the core function of health assessment.

  8. Development of a Conceptual Model and Survey Instrument to Measure Conscientious Objection to Abortion Provision.

    PubMed

    Harris, Laura Florence; Awoonor-Williams, John Koku; Gerdts, Caitlin; Gil Urbano, Laura; González Vélez, Ana Cristina; Halpern, Jodi; Prata, Ndola; Baffoe, Peter

    2016-01-01

    Conscientious objection to abortion, clinicians' refusal to perform legal abortions because of their religious or moral beliefs, has been the subject of increasing debate among bioethicists, policymakers, and public health advocates in recent years. Conscientious objection policies are intended to balance reproductive rights and clinicians' beliefs. However, in practice, clinician objection can act as a barrier to abortion access-impinging on reproductive rights, and increasing unsafe abortion and related morbidity and mortality. There is little information about conscientious objection from a medical or public health perspective. A quantitative instrument is needed to assess prevalence of conscientious objection and to provide insight on its practice. This paper describes the development of a survey instrument to measure conscientious objection to abortion provision. A literature review, and in-depth formative interviews with stakeholders in Colombia were used to develop a conceptual model of conscientious objection. This model led to the development of a survey, which was piloted, and then administered, in Ghana. The model posits three domains of conscientious objection that form the basis for the survey instrument: 1) beliefs about abortion and conscientious objection; 2) actions related to conscientious objection and abortion; and 3) self-identification as a conscientious objector. The instrument is intended to be used to assess prevalence among clinicians trained to provide abortions, and to gain insight on how conscientious objection is practiced in a variety of settings. Its results can inform more effective and appropriate strategies to regulate conscientious objection.

  9. Health and labour force participation of older people in Europe: what do objective health indicators add to the analysis?

    PubMed

    Kalwij, Adriaan; Vermeulen, Frederic

    2008-05-01

    This paper studies labour force participation of older individuals in 11 European countries. The data are drawn from the new Survey of Health, Ageing and Retirement in Europe (SHARE). We examine the value added of objective health indicators in relation to potentially endogenous self-reported health. We approach the endogeneity of self-reported health as an omitted variables problem. In line with the literature on the reliability of self-reported health ambiguous results are obtained. In some countries self-reported health does a fairly good job and controlling for objective health indicators does not add much to the analysis. In other countries, however, the results show that objective health indicators add significantly to the analysis and that self-reported health is endogenous due to omitted objective health indicators. These latter results illustrate the multi-dimensional nature of health and the need to control for objective health indicators when analysing the relation between health status and labour force participation. This makes an instrumental variables approach to deal with the endogeneity of self-reported health less appropriate.

  10. [Mexico health care system's objectives: importance to its population and determining factors].

    PubMed

    Tapia-Cruz, José Antonio

    2006-01-01

    To document the importance to Mexico's population of the five intrinsic objectives of Mexico's present health care system (SS) and describe some of the determinants of its evaluation; the purpose is to contribute elements for defining priorities and to support the fulfillment of said objectives. This is a cross-sectional study to the importance for Mexican population of the five objectives of SS, considered intrinsic or final in the National Evaluation and Performance Survey. The dependent variable was the ranking given by the population surveyed to each one of the objectives, based on the question: Which SS objective do you believe is most important? The independent variables (nominal and categorical) were: state of residence, type of locality, gender, age, education, present employment, quality of present state of health, last occurrence when medical assistance was needed but not received, grade of satisfaction with the operation of the country's medical care system and satisfaction with one's own health. A univaried analysis was conducted and summarized using percentages. The chi square test was used to validate or reject the hypothesis according to whether the rank assigned by the population to the SS objectives is the same, regardless of which variables were used in the comparison. A multinomial (politomic) logistical regression model was also developed to correlate the effect of the independent variables employed in the study with the importance assigned by the population to the SS objectives. The reference category of the model was the objective of improving the health of the population. The analysis was conducted using the statistical package STATA version 7.0. From the population studied, 31.8% reported that the most important objective is to improve treatment within the health care system. In rural areas, 31.46% of the population thinks the most important objective is to improve health, a result related with the self-perception of one's present state of

  11. Influence of the mental health status on a new measure of objective functional impairment in lumbar degenerative disc disease.

    PubMed

    Stienen, Martin N; Smoll, Nicolas R; Joswig, Holger; Snagowski, Jan; Corniola, Marco V; Schaller, Karl; Hildebrandt, Gerhard; Gautschi, Oliver P

    2017-06-01

    The Timed Up and Go (TUG) test has recently been proposed as a simple and standardized measure for objective functional impairment (OFI) in patients with lumbar degenerative disc disease (DDD). The study aimed to explore the relationship between a patient's mental health status and both patient-reported outcome measures (PROMs) and TUG test results. This is a prospective institutional review board-approved two-center study. The sample was composed of 375 consecutive patients scheduled for lumbar spine surgery and a healthy cohort of 110 control subjects. Patients and control subjects were assessed with the TUG test and a comprehensive panel of subjective PROMs of pain intensity (visual analog scale [VAS]), functional impairment (Roland-Morris Disability Index [RMDI]), Oswestry Disability Index [ODI]), as well as health-related quality of life (hrQoL; Euro-Qol [EQ]-5D). Standardized age- and sex-adjusted TUG test T-scores were calculated. The dependent variable was the short-form (SF)-12 mental component summary (MCS) quartiles, and the independent variables were the TUG T-scores and PROMs. Direct and adjusted analyses of covariance were performed to estimate the interaction between the SF-12 MCS quartiles and the independent variables. In patients, there was a significant decrease in the subjective PROMs, notably the VAS back pain (p=.001) and VAS leg pain (p=.035), as well as significant increase in the RMDI (p<.001), ODI (p<.001), and the EQ-5D index (p<.001) with every increase in the quartile of the SF-12 MCS. There were no significant group differences of OFI as measured by the TUG T-scores across the SF-12 MCS quartiles (p=.462). In the healthy control group, a significant decrease in VAS leg pain (p=.028), RMDI (p=.013), and ODI (p<.001), as well as a significant increase in the EQ-5D index (p<.001), was seen across the SF-12 MCS quartiles, whereas TUG T-scores remained stable (p=.897). There are significant influences of mental hrQoL on subjective measures

  12. Persistent Insomnia: the Role of Objective Short Sleep Duration and Mental Health

    PubMed Central

    Vgontzas, Alexandros N.; Fernandez-Mendoza, Julio; Bixler, Edward O.; Singareddy, Ravi; Shaffer, Michele L.; Calhoun, Susan L.; Liao, Duanping; Basta, Maria; Chrousos, George P.

    2012-01-01

    Study Objectives: Few population-based, longitudinal studies have examined risk factors for persistent insomnia, and the results are inconsistent. Furthermore, none of these studies have examined the role of polysomnographic (PSG) variables such as sleep duration or sleep apnea on the persistence of insomnia. Design: Representative longitudinal study. Setting: Sleep laboratory. Participants: From a random, general population sample of 1741 individuals of the adult Penn State Cohort, 1395 were followed-up after 7.5 years. Measurements: Individuals underwent one-night PSG and full medical evaluation at baseline and a telephone interview at follow-up. PSG sleep duration was analyzed as a continuous variable and as a categorical variable: < 6 h sleep (short sleep duration) and ≥ 6 h sleep (longer sleep duration). Results: The rates of insomnia persistence, partial remission, and full remission were 44.0%, 30.0%, and 26.0%, respectively. Objective short sleep duration significantly increased the odds of persistent insomnia as compared to normal sleep (OR = 3.19) and to fully remitted insomnia (OR = 4.92). Mental health problems at baseline were strongly associated with persistent insomnia as compared to normal sleep (OR = 9.67) and to a lesser degree compared to fully remitted insomnia (OR = 3.68). Smoking, caffeine, and alcohol consumption and sleep apnea did not predict persistent insomnia. Conclusions: Objective short sleep duration and mental health problems are the strongest predictors of persistent insomnia. These data further support the validity and clinical utility of objective short sleep duration as a novel marker of the biological severity of insomnia. Citation: Vgontzas AN; Fernandez-Mendoza J; Bixler EO; Singareddy R; Shaffer ML; Calhoun SL; Liao D; Basta M; Chrousos GP. Persistent insomnia: the role of objective short sleep duration and mental health. SLEEP 2012;35(1):61-68. PMID:22215919

  13. Objective and subjective measures of neighborhood environment (NE): relationships with transportation physical activity among older persons.

    PubMed

    Nyunt, Ma Shwe Zin; Shuvo, Faysal Kabir; Eng, Jia Yen; Yap, Keng Bee; Scherer, Samuel; Hee, Li Min; Chan, Siew Pang; Ng, Tze Pin

    2015-09-15

    This study examined the associations of subjective and objective measures of the neighbourhood environment with the transportation physical activity of community-dwelling older persons in Singapore. A modified version of the Neighborhood Environment Walkability Scale (NEWS) and Geographical Information System (GIS) measures of the built environment characteristics were related to the frequency of walking for transportation purpose in a study sample of older persons living in high-density apartment blocks within a public housing estate in Singapore. Relevant measured variables to assess the complex relationships among built environment measures and transportation physical activity were examined using structural equation modelling and multiple regression analyses. The subjective measures of residential density, street connectivity, land use mix diversity and aesthetic environment and the objective GIS measure of Accessibility Index have positively significant independent associations with transportation physical activity, after adjusting for demographics, socio-economic and health status. Subjective and objective measures are non-overlapping measures complementing each other in providing information on built environment characteristics. For elderly living in a high-density urban neighborhood, well connected street, diversity of land use mix, close proximity to amenities and facilities, and aesthetic environment were associated with higher frequency of walking for transportation purposes.

  14. Reach and Validity of An Objective Medication Adherence Measure among Safety Net Health Plan Members with Diabetes: A Cross-Sectional Study

    PubMed Central

    Ratanawongsa, Neda; Karter, Andrew J.; Quan, Judy; Parker, Melissa M.; Handley, Margaret; Sarkar, Urmimala; Schmittdiel, Julie A.; Schillinger, Dean

    2015-01-01

    Background With the expansion of Medicaid and low-cost health insurance plans among diverse patient populations, objective measures of medication adherence using pharmacy claims could advance clinical care and translational research for safety net care. However, safety net patients may experience fluctuating prescription drug coverage, affecting the performance of adherence measures. Objective To evaluate the performance of continuous medication gap (CMG) for diverse, low-income managed care members with diabetes. Methods We conducted this cross-sectional analysis using administrative and clinical data for 680 members eligible for a self-management support trial at a non-profit, government-sponsored managed care plan. We applied CMG methodology to cardiometabolic medication claims for English-, Cantonese-, or Spanish-speaking members with diabetes. We examined inclusiveness (the proportion with calculable CMG) and selectivity (sociodemographic and medical differences from members without CMG). To examine validity, we examined unadjusted associations of suboptimal adherence (CMG>20%) with suboptimal cardiometabolic control. Results 429 members (63%) had calculable CMG. Compared to members without CMG, members with CMG were younger; more likely employed; and had poorer glycemic control, but better blood pressure and lipid control. Suboptimal adherence occurred more frequently among members with poor cardiometabolic control than among members with optimal control (28% vs. 12%, p=0.02). Conclusions CMG demonstrated acceptable inclusiveness and validity in a diverse, low-income safety net population, comparable to its performance in studies among other insured populations. CMG may provide a useful tool to measure adherence among increasingly diverse Medicaid populations, complemented by other strategies to reach those not captured by CMG. Trial Registration NCT00683020 PMID:26233541

  15. Modeling the Object-Oriented Space Through Validated Measures

    NASA Technical Reports Server (NTRS)

    Neal, Ralph D.

    1996-01-01

    In order to truly understand software and the software development process, software measurement must be better understood. A beginning step toward a better understanding of software measurement is the categorization of the measurements by some meaningful taxonomy. The most meaningful taxonomy would capture the basic nature of the subject oriented (O-O) space. The interesting characteristics of object oriented software offer a starting point for such a categorization of measures. A taxonomy has been developed based on fourteen characteristics of object-oriented software gathered from the literature This taxonomy allows us to easily see gaps and redundancies in the O-O measures. The taxonomy also clearly differentiates among taxa so that there is no ambiguity as to the taxon to which a measure belongs. The taxonomy has been populated with thirty-two measures that have been validated in the narrow sense of Fenton, using measurement theory with Zuse's augmentation.

  16. Objective physical activity measurement in the osteoarthritis initiative: Are guidelines being met?

    PubMed

    Dunlop, Dorothy D; Song, Jing; Semanik, Pamela A; Chang, Rowland W; Sharma, Leena; Bathon, Joan M; Eaton, Charles B; Hochberg, Marc C; Jackson, Rebecca D; Kwoh, C Kent; Mysiw, W Jerry; Nevitt, Michael C; Hootman, Jennifer M

    2011-11-01

    Osteoarthritis (OA) clinical practice guidelines identify a substantial therapeutic role for physical activity, but objective information about the physical activity of this population is lacking. The aim of this study was to objectively measure levels of physical activity in adults with knee OA and report the prevalence of meeting public health physical activity guidelines. Cross-sectional accelerometry data from 1,111 adults with radiographic knee OA (49-84 years old) participating in the Osteoarthritis Initiative accelerometry monitoring ancillary study were assessed for meeting the aerobic component of the 2008 Physical Activity Guidelines for Americans (≥150 minutes/week moderate-to-vigorous-intensity activity lasting ≥10 minutes). Quantile regression was used to test median sex differences in physical activity levels. Aerobic physical activity guidelines were met by 12.9% of men and 7.7% of women with knee OA. A substantial proportion of men and women (40.1% and 56.5%, respectively) were inactive, having done no moderate-to-vigorous activity that lasted 10 minutes or more during the 7 days. Although men engaged in significantly more moderate-to-vigorous activity (average daily minutes 20.7 versus 12.3), they also spent more time in no or very-low-intensity activity than women (average daily minutes 608.2 versus 585.8). Despite substantial health benefits from physical activity, adults with knee OA were particularly inactive based on objective accelerometry monitoring. The proportions of men and women who met public health physical activity guidelines were substantially less than those previously reported based on self-reported activity in arthritis populations. These findings support intensified public health efforts to increase physical activity levels among people with knee OA. Copyright © 2011 by the American College of Rheumatology.

  17. Measuring Contextual Characteristics for Community Health

    PubMed Central

    Hillemeier, Marianne M; Lynch, John; Harper, Sam; Casper, Michele

    2003-01-01

    Objective To conceptualize and measure community contextual influences on population health and health disparities. Data Sources We use traditional and nontraditional secondary sources of data comprising a comprehensive array of community characteristics. Study Design Using a consultative process, we identify 12 overarching dimensions of contextual characteristics that may affect community health, as well as specific subcomponents relating to each dimension. Data Collection An extensive geocoded library of data indicators relating to each dimension and subcomponent for metropolitan areas in the United States is assembled. Principal Findings We describe the development of community contextual health profiles, present the rationale supporting each of the profile dimensions, and provide examples of relevant data sources. Conclusions Our conceptual framework for community contextual characteristics, including a specified set of dimensions and components, can provide practical ways to monitor health-related aspects of the economic, social, and physical environments in which people live. We suggest several guiding principles useful for understanding how aspects of contextual characteristics can affect health and health disparities. PMID:14727793

  18. Effects of Wind Turbine Noise on Self-Reported and Objective Measures of Sleep

    PubMed Central

    Michaud, David S.; Feder, Katya; Keith, Stephen E.; Voicescu, Sonia A.; Marro, Leonora; Than, John; Guay, Mireille; Denning, Allison; Murray, Brian J.; Weiss, Shelly K.; Villeneuve, Paul J.; van den Berg, Frits; Bower, Tara

    2016-01-01

    Study Objectives: To investigate the association between self-reported and objective measures of sleep and wind turbine noise (WTN) exposure. Methods: The Community Noise and Health Study, a cross-sectional epidemiological study, included an in-house computer-assisted interview and sleep pattern monitoring over a 7 d period. Outdoor WTN levels were calculated following international standards for conditions that typically approximate the highest long-term average levels at each dwelling. Study data were collected between May and September 2013 from adults, aged 18–79 y (606 males, 632 females) randomly selected from each household and living between 0.25 and 11.22 kilometers from operational wind turbines in two Canadian provinces. Self-reported sleep quality over the past 30 d was assessed using the Pittsburgh Sleep Quality Index. Additional questions assessed the prevalence of diagnosed sleep disorders and the magnitude of sleep disturbance over the previous year. Objective measures for sleep latency, sleep efficiency, total sleep time, rate of awakening bouts, and wake duration after sleep onset were recorded using the wrist worn Actiwatch2® from a subsample of 654 participants (289 males, 365 females) for a total of 3,772 sleep nights. Results: Participant response rate for the interview was 78.9%. Outdoor WTN levels reached 46 dB(A) with an arithmetic mean of 35.6 and a standard deviation of 7.4. Self-reported and objectively measured sleep outcomes consistently revealed no apparent pattern or statistically significant relationship to WTN levels. However, sleep was significantly influenced by other factors, including, but not limited to, the use of sleep medication, other health conditions (including sleep disorders), caffeine consumption, and annoyance with blinking lights on wind turbines. Conclusions: Study results do not support an association between exposure to outdoor WTN up to 46 dB(A) and an increase in the prevalence of disturbed sleep

  19. Perceived and Objectively Measured Physical Activity and Sedentary Time among South Asian Women in the UK

    PubMed Central

    Curry, Whitney Babakus; Duda, Joan L.; Thompson, Janice L.

    2015-01-01

    Introduction: Limited self-report data suggest that South Asian (SA) women fail to meet physical activity (PA) recommendations. Recent research using objective measures reveals SA women living in the UK have higher PA levels than previously reported, and a pattern of under-reporting PA and sedentary time (ST). There is limited research on SA women’s understanding and experiences of PA/ST, and the cultural contexts and conditions within which they occur. Therefore the aims of this mixed-methods study were to compare perceived PA and ST to objectively measured data and explore PA- and ST-specific contexts, experiences, and sources of PA and ST amongst SA women in the UK. Methods: 24 women were purposively sampled to participate in a semi-structured interview from a larger study of 140 women who wore an accelerometer for 7 days. Demographic and anthropometric data were also collected. Results: Notable qualitative themes on contextualisation were of adequate PA as “keeping busy” or “being healthy”, and of ST as “lazy” or “resting in old age”. Few participants reported being sedentary, and most believed they were sufficiently physically active. Objectively measured PA/ST indicated that 66% women were less active than perceived (with regard to duration and intensity), with none able to estimate duration of ST. Discussion: Findings suggest that overall, SA women have contextualisations of PA/ST that may not coincide with those of researchers, health professionals and policy makers, and lack awareness of the intensity of PA in which they engage and the health risks of high levels of ST. These findings highlight the need for objective measures of PA and ST in this population combined with in-depth qualitative assessments to provide more accurate assessments of these behaviours. This information can subsequently be used to develop health promotion messages and interventions focusing on increasing duration and/or intensity levels of daily activities (e

  20. Perceived and objectively measured physical activity and sedentary time among South Asian women in the UK.

    PubMed

    Curry, Whitney Babakus; Duda, Joan L; Thompson, Janice L

    2015-03-16

    Limited self-report data suggest that South Asian (SA) women fail to meet physical activity (PA) recommendations. Recent research using objective measures reveals SA women living in the UK have higher PA levels than previously reported, and a pattern of under-reporting PA and sedentary time (ST). There is limited research on SA women's understanding and experiences of PA/ST, and the cultural contexts and conditions within which they occur. Therefore the aims of this mixed-methods study were to compare perceived PA and ST to objectively measured data and explore PA- and ST-specific contexts, experiences, and sources of PA and ST amongst SA women in the UK. 24 women were purposively sampled to participate in a semi-structured interview from a larger study of 140 women who wore an accelerometer for 7 days. Demographic and anthropometric data were also collected. Notable qualitative themes on contextualisation were of adequate PA as "keeping busy" or "being healthy", and of ST as "lazy" or "resting in old age". Few participants reported being sedentary, and most believed they were sufficiently physically active. Objectively measured PA/ST indicated that 66% women were less active than perceived (with regard to duration and intensity), with none able to estimate duration of ST. Findings suggest that overall, SA women have contextualisations of PA/ST that may not coincide with those of researchers, health professionals and policy makers, and lack awareness of the intensity of PA in which they engage and the health risks of high levels of ST. These findings highlight the need for objective measures of PA and ST in this population combined with in-depth qualitative assessments to provide more accurate assessments of these behaviours. This information can subsequently be used to develop health promotion messages and interventions focusing on increasing duration and/or intensity levels of daily activities (e.g., walking, housework) and reducing ST in this population.

  1. Speckle correlation method used to measure object's in-plane velocity.

    PubMed

    Smíd, Petr; Horváth, Pavel; Hrabovský, Miroslav

    2007-06-20

    We present a measurement of an object's in-plane velocity in one direction by the use of the speckle correlation method. Numerical correlations of speckle patterns recorded periodically during motion of the object under investigation give information used to evaluate the object's in-plane velocity. The proposed optical setup uses a detection plane in the image field and enables one to detect the object's velocity within the interval (10-150) microm x s(-1). Simulation analysis shows a way of controlling the measuring range. The presented theory, simulation analysis, and setup are verified through an experiment of measurement of the velocity profile of an object.

  2. Inter-relationships between objective and subjective measures of the residential environment among urban African American women

    PubMed Central

    Sealy-Jefferson, Shawnita; Messer, Lynne; Slaughter-Acey, Jaime; Misra, Dawn P.

    2016-01-01

    Background The inter-relationships between objective (census-based) and subjective (resident reported) measures of the residential environment is understudied in African American (AA) populations. Methods Using data from the Life Influences on Fetal Environments Study (2009–2011) (n=1,387) of AA women, we quantified the area-level variation in subjective reports of residential healthy food availability, walkability, safety and disorder that can be accounted for with an objective neighborhood disadvantage index (NDI). Two-level generalized linear models estimated associations between objective and subjective measures of the residential environment, accounting for individual-level covariates. Results In unconditional models, intraclass correlation coefficients for block-group variance in subjective reports ranged from 11% (healthy food availability) to 30% (safety). Models accounting for the NDI (versus both NDI and individual level covariates) accounted for more variance in healthy food availability (23% versus 8%) and social disorder (40% versus 38%). The NDI and individual level variables accounted for 39% and 51% of the area-level variation in walkability and safety. Associations between subjective and objective measures of the residential environment were significant and in the expected direction. Conclusions Future studies on neighborhood effects on health, especially among AAs, should include a wide range of residential environment measures, including subjective, objective and spatial contextual variables. PMID:28160971

  3. Inter-relationships between objective and subjective measures of the residential environment among urban African American women.

    PubMed

    Sealy-Jefferson, Shawnita; Messer, Lynne; Slaughter-Acey, Jaime; Misra, Dawn P

    2017-03-01

    The inter-relationships between objective (census based) and subjective (resident reported) measures of the residential environment is understudied in African American (AA) populations. Using data from the Life Influences on Fetal Environments Study (2009-2011; n = 1387) of AA women, we quantified the area-level variation in subjective reports of residential healthy food availability, walkability, safety, and disorder that can be accounted for with an objective neighborhood disadvantage index (NDI). Two-level generalized linear models estimated associations between objective and subjective measures of the residential environment, accounting for individual-level covariates. In unconditional models, intraclass correlation coefficients for block-group variance in subjective reports ranged from 11% (healthy food availability) to 30% (safety). Models accounting for the NDI (vs. both NDI and individual-level covariates) accounted for more variance in healthy food availability (23% vs. 8%) and social disorder (40% vs. 38%). The NDI and individual-level variables accounted for 39% and 51% of the area-level variation in walkability and safety, respectively. Associations between subjective and objective measures of the residential environment were significant and in the expected direction. Future studies on neighborhood effects on health, especially among AAs, should include a wide range of residential environment measures, including subjective, objective, and spatial contextual variables. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Occupational safety and health: progress toward the 1990 objectives for the nation.

    PubMed Central

    Millar, J D; Myers, M L

    1983-01-01

    Occupational safety and health is 1 of 15 areas addressed in the Public Health Service's Objectives for the Nation. This area represents 104 million working men and women and the deaths, diseases, and injuries that result from exposures to hazards in their work environment. Characteristics of public health practice are compared with characteristics of occupational safety and health practice. The National Institute for Occupational Safety and Health (NIOSH), created by the Occupational Safety and Health Act, is discussed. NIOSH has developed a list of 10 leading work-related diseases and injuries. The list is headed by occupational lung diseases. Twenty Objectives for the Nation in the area of occupational safety and health are reviewed, and the status of NIOSH efforts toward their attainment is discussed. Five categories of objectives are covered: (a) improved health status, (b) reduced risk factors, (c) improved public and professional awareness, (d) improved service and protection, and (e) improved surveillance and evaluation. The potential for achieving these objectives is discussed, with special attention given to the lack of a data base for monitoring progress. A major conclusion is that surveillance in occupational safety and health needs to be strengthened. PMID:6310668

  5. The role of perceived barriers and objectively measured physical activity in adults aged 65-100.

    PubMed

    Gellert, Paul; Witham, Miles D; Crombie, Iain K; Donnan, Peter T; McMurdo, Marion E T; Sniehotta, Falko F

    2015-05-01

    to test the predictive utility of perceived barriers to objectively measured physical activity levels in a stratified sample of older adults when accounting for social-cognitive determinants proposed by the Theory of Planned Behaviour (TPB), and economic and demographic factors. data were analysed from the Physical Activity Cohort Scotland survey, a representative and stratified (65-80 and 80+ years; deprived and affluent) sample of 584 community-dwelling older people, resident in Tayside, Scotland. Physical activity was measured objectively by accelerometry. perceived barriers clustered around the areas of poor health, lack of interest, lack of safety and lack of access. Perceived poor health and lack of interest, but not lack of access or concerns about personal safety, predicted physical activity after controlling for demographic, economic and TPB variables. perceived person-related barriers (poor health and lack of interest) seem to be more strongly associated with physical activity levels than perceived environmental barriers (safety and access) in a large sample of older adults. Perceived barriers are modifiable and may be a target for future interventions. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Disability and Fatigue Can Be Objectively Measured in Multiple Sclerosis

    PubMed Central

    Motta, Caterina; Palermo, Eduardo; Studer, Valeria; Germanotta, Marco; Germani, Giorgio; Centonze, Diego; Cappa, Paolo

    2016-01-01

    Background The available clinical outcome measures of disability in multiple sclerosis are not adequately responsive or sensitive. Objective To investigate the feasibility of inertial sensor-based gait analysis in multiple sclerosis. Methods A cross-sectional study of 80 multiple sclerosis patients and 50 healthy controls was performed. Lower-limb kinematics was evaluated by using a commercially available magnetic inertial measurement unit system. Mean and standard deviation of range of motion (mROM, sROM) for each joint of lower limbs were calculated in one minute walking test. A motor performance index (E) defined as the sum of sROMs was proposed. Results We established two novel observer-independent measures of disability. Hip mROM was extremely sensitive in measuring lower limb motor impairment, being correlated with muscle strength and also altered in patients without clinically detectable disability. On the other hand, E index discriminated patients according to disability, being altered only in patients with moderate and severe disability, regardless of walking speed. It was strongly correlated with fatigue and patient-perceived health status. Conclusions Inertial sensor-based gait analysis is feasible and can detect clinical and subclinical disability in multiple sclerosis. PMID:26863109

  7. Learning object correspondences with the observed transport shape measure.

    PubMed

    Pitiot, Alain; Delingette, Hervé; Toga, Arthur W; Thompson, Paul M

    2003-07-01

    We propose a learning method which introduces explicit knowledge to the object correspondence problem. Our approach uses an a priori learning set to compute a dense correspondence field between two objects, where the characteristics of the field bear close resemblance to those in the learning set. We introduce a new local shape measure we call the "observed transport measure", whose properties make it particularly amenable to the matching problem. From the values of our measure obtained at every point of the objects to be matched, we compute a distance matrix which embeds the correspondence problem in a highly expressive and redundant construct and facilitates its manipulation. We present two learning strategies that rely on the distance matrix and discuss their applications to the matching of a variety of 1-D, 2-D and 3-D objects, including the corpus callosum and ventricular surfaces.

  8. Contributions to Objective Measurement and Evaluation of Trainee Competency.

    ERIC Educational Resources Information Center

    Moonan, William J.

    The purpose of this paper is to lay a basis for and discuss the components of a system, called COMET, designed to objectively measure and evaluate the competency of trainees in military training enterprises. COMET is an acronym for "Computerized Objective Measurement and Evaluation of Trainees." These goals will be accomplished by: (a)…

  9. Photogrammetric Measurements of Heritage Objects

    NASA Astrophysics Data System (ADS)

    Tumeliene, E.; Nareiko, V.; Suziedelyte Visockiene, J.

    2017-12-01

    Cultural heritage is an invaluable example of human culture and creativity. The majority of them can become unstable or can be destroyed due to a combination of human and natural disturbances. In order to restore, preserve, and systematize data about architectural heritage objects, it is necessary to have geodetic, photogrammetric measurements of such data and to constantly monitor condition of the objects. The data of immovable cultural objects for many years are stored in photogrammetric data archives. Such archives have Germany, Lithuania, England and other countries. The article gives a brief introduction of the history of data archives formation and presents a photogrammetric and modern methods of modelling the spatial geometric properties of objects currently used to reveal immovable cultural properties and to evaluate geometric sizes. The pilot work was done with the Concept Capture simulation program that was developed by the Bentley company with photos of the Blessed Virgin Mary painting in Pivašiūnai of Trakai district. A shot from the ground with 12.4 MP resolution Pentax K-x camera was done using lenses with different focal lengths. The painting of the Blessed Virgin Mary is coordinated by 4 reference geodesic points and therefore after the modelling work it was possible to evaluate the accuracy of the created model. Based on the results of the spatial (3D) model, photo shooting and modelling recommendations are presented, the advantages of the new technology are distinguished.

  10. ASUPT Automated Objective Performance Measurement System.

    ERIC Educational Resources Information Center

    Waag, Wayne L.; And Others

    To realize its full research potential, a need exists for the development of an automated objective pilot performance evaluation system for use in the Advanced Simulation in Undergraduate Pilot Training (ASUPT) facility. The present report documents the approach taken for the development of performance measures and also presents data collected…

  11. The Relationship between Health Plan Performance Measures and Physician Network Overlap: Implications for Measuring Plan Quality

    PubMed Central

    Maeng, Daniel D; Scanlon, Dennis P; Chernew, Michael E; Gronniger, Tim; Wodchis, Walter P; McLaughlin, Catherine G

    2010-01-01

    Objective To examine the extent to which health plan quality measures capture physician practice patterns rather than plan characteristics. Data Source We gathered and merged secondary data from the following four sources: a private firm that collected information on individual physicians and their health plan affiliations, The National Committee for Quality Assurance, InterStudy, and the Dartmouth Atlas. Study Design We constructed two measures of physician network overlap for all health plans in our sample and linked them to selected measures of plan performance. Two linear regression models were estimated to assess the relationship between the measures of physician network overlap and the plan performance measures. Principal Findings The results indicate that in the presence of a higher degree of provider network overlap, plan performance measures tend to converge to a lower level of quality. Conclusions Standard health plan performance measures reflect physician practice patterns rather than plans' effort to improve quality. This implies that more provider-oriented measurement, such as would be possible with accountable care organizations or medical homes, may facilitate patient decision making and provide further incentives to improve performance. PMID:20403064

  12. Association of objectively measured arm inclination with shoulder pain: A 6-month follow-up prospective study of construction and health care workers

    PubMed Central

    Koch, Markus; Lunde, Lars-Kristian; Veiersted, Kaj Bo; Knardahl, Stein

    2017-01-01

    Objectives The aim was to determine the association of occupational arm inclination with shoulder pain in construction and health care workers. Methods Arm inclination relative to the vertical was measured with an accelerometer placed on the dominant upper arm for up to four full days at baseline in 62 construction workers and 63 health care workers. The pain intensity in the shoulder and mechanical and psychosocial work factors were measured by self-reports at baseline and prospectively after 6 months. The associations between exposures and shoulder pain were analyzed with multilevel mixed-effects linear regressions. Results For the total study population working with the dominant arm at inclinations > 30° and >120° was associated with lower levels of shoulder pain both cross-sectionally and after 6 months. Associations were attenuated when adjusting for individual and social factors, psychological state, and exposure during leisure time, especially for the high inclination levels. Analyses, only including subjects with no pain at baseline revealed no significant associations. While stratified analysis showed negative associations in the construction worker group, there were no significant association in health care workers. Compared to the number of hypotheses tested, the number of significant findings was low. Adjustment by Bonferroni-correction made almost all findings insignificant. Conclusions All analyses reflected a negative association between arm inclination and shoulder pain, but few analyses showed these associations to be statistically significant. If there is a relationship between arm inclination and shoulder pain, these findings could indicate that pain-avoidance may modify how workers perform their tasks. PMID:29176761

  13. Physical activity measurement in older adults: relationships with mental health.

    PubMed

    Parker, Sarah J; Strath, Scott J; Swartz, Ann M

    2008-10-01

    This study examined the relationship between physical activity (PA) and mental health among older adults as measured by objective and subjective PA-assessment instruments. Pedometers (PED), accelerometers (ACC), and the Physical Activity Scale for the Elderly (PASE) were administered to measure 1 week of PA among 84 adults age 55-87 (mean = 71) years. General mental health was measured using the Positive and Negative Affect Scale (PANAS) and the Satisfaction With Life Scale (SWL). Linear regressions revealed that PA estimated by PED significantly predicted 18.1%, 8.3%, and 12.3% of variance in SWL and positive and negative affect, respectively, whereas PA estimated by the PASE did not predict any mental health variables. Results from ACC data were mixed. Hotelling-William tests between correlation coefficients revealed that the relationship between PED and SWL was significantly stronger than the relationship between PASE and SWL. Relationships between PA and mental health might depend on the PA measure used.

  14. The cross-sectional associations between objectively measured sedentary time and cardiometabolic health markers in adults - a systematic review with meta-analysis component.

    PubMed

    Powell, C; Herring, M P; Dowd, K P; Donnelly, A E; Carson, B P

    2018-03-01

    Sedentary time is viewed as an independent risk factor for adverse cardiometabolic health (CMH). No systematic review and meta-analysis on the cross-sectional associations between objectively measured sedentary time and CMH markers has been conducted. PubMed, Scopus and Web of Science Core Collection were searched for papers that examined the cross-sectional association between objectively measured sedentary time and CMH markers in adults. Forty-six papers met the inclusion criteria. The included papers had a combined sample size of 70,576 and an age range of 18-87 years. To examine the effect of increased levels of sedentary time on CMH markers, data on effect sizes and moderators were extracted, where possible. By pooling the unadjusted data from the included papers, increased sedentary time was shown to have a significant detrimental association with fasting glucose (Δ = 0.12, 95% confidence interval [CI]: 0.02, 0.23), fasting insulin (Δ = 0.19, 95% CI: 0.06, 0.32), triglycerides (Δ = 0.25, 95% CI: 0.14, 0.37), high-density lipoprotein cholesterol (Δ = -0.20, 95% CI: -0.28, -0.13) and waist circumference (Δ = 0.25, 95% CI: 0.15, 0.35). How sedentary time was quantified and the device used to measure sedentary time significantly influence the size of the effect reported. Future interventions focused on both decreasing sedentary time and increasing physical activity may be the most effective strategy to improve CMH. © 2017 World Obesity Federation.

  15. Long-Term Correlates of Objectively Measured Physical Activity and Sedentary Time in Norwegian Men and Women.

    PubMed

    Solbraa, Ane Kristiansen; Ekelund, Ulf; Holme, Ingar M; Graff-Iversen, Sidsel; Steene-Johannessen, Jostein; Aadland, Eivind; Anderssen, Sigmund Alfred

    2015-11-01

    Sex, age, body mass index (BMI), perceived health and health behavior are correlates known to affect physical activity and sedentary time. However, studies have often been cross-sectional, and less is known about long-term correlates. Thus, the aims were to investigate 1) the associations between a set of characteristics (demographic, biological, psychological, and behavioral) and objectively measured physical activity and sedentary time at 13-year follow-up, and 2) the association between changes in these characteristics over time and physical activity and sedentary time. Baseline characteristics were collected in 40-year-olds in 1996, and follow-up data on objectively measured physical activity and sedentary time were obtained in 2009 (n = 240). Data were analyzed by multiple linear regressions. Self-reported physical activity (P < .001) and improved perceived health (P = .046) were positively associated with moderate-to-vigorous physical activity (MVPA) whereas BMI (P = .034) and increased BMI (P = .014) were negatively associated with MVPA at follow-up. Women spent less time being sedentary than men (P = .019). Education (P < .001) was positively associated and improved perceived health (P = .010) was negatively associated with sedentary time at follow-up. MVPA and sedentary time at follow-up were associated with behavioral, biological and demographic correlates. However, the nature of our analyses prevents us from inferring causality.

  16. Productivity and health: best practices for better measures of productivity.

    PubMed

    Schwartz, Steven M; Riedel, John

    2010-09-01

    Interest in quantifying the relationship between health status and lost productivity has accelerated among employers, researchers, and benefits advisors. Our objective was to engage a dialogue to highlight important productivity measurement issues for consideration in an overall business strategy. Critical review of selected topical literature. Four functions of productivity measurement are described: 1) the purposes of a measurement initiative, 2) norms and benchmarking, 3) health and productivity cost estimators, and 4) reporting results. Each function is described in detail; challenges are noted; examples are provided. This article supports the Integrated Benefits Institute consensus statements on productivity, underscoring the need to develop a conceptual framework of productivity measurement that guides the maturation of instruments and sets forth recommendations for their application consistent with the descriptive, comparative, and evaluative functions that foster health, well-being, and work performance.

  17. Measurements Conducted on an Unknown Object Labeled Pu-239

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

    Hoteling, Nathan

    Measurements were carried out on 12 November 2013 to determine whether Pu-239 was present on an object discovered in a plastic bag with label “Pu-­239 6 uCi.” Following initial survey measurements to verify that the object was not leaking or contaminated, spectra were collected with a High Purity Germanium (HPGe) detector with object positioned in two different configurations. Analysis of the spectra did not yield any direct evidence of Pu-­239. From the measured spectra, minimum detectable activity (MDA) was determined to be approximately 2 uCi for the gamma-­ray measurements. Although there was no direct evidence of Pu-239, a peak atmore » 60 keV characteristic of Am-­241 decay was observed. Since it is very likely that Am-­241 would be present in aged plutonium samples, this was interpreted as indirect evidence for the presence of plutonium on the object. Analysis of this peak led to an estimated Pu-­239 activity of 0.02–0.04 uCi, or <1x10 -6 grams.« less

  18. Measuring the Speed of Newborn Object Recognition in Controlled Visual Worlds

    ERIC Educational Resources Information Center

    Wood, Justin N.; Wood, Samantha M. W.

    2017-01-01

    How long does it take for a newborn to recognize an object? Adults can recognize objects rapidly, but measuring object recognition speed in newborns has not previously been possible. Here we introduce an automated controlled-rearing method for measuring the speed of newborn object recognition in controlled visual worlds. We raised newborn chicks…

  19. Is Behavior Change a Legitimate Objective for the Health Educator?

    ERIC Educational Resources Information Center

    Russell, Robert D.

    1983-01-01

    Pros and cons of making behavior change a primary objective of health education are summarized. The individual's right to choose his/her lifestyle is emphasized; health educators are encouraged to use holistic approaches to health education, emphasizing not only physical consequences of behavior but emotional and social factors as well. (PP)

  20. Objective Community Integration of Mental Health Consumers Living in Supported Housing and of Others in the Community

    PubMed Central

    Yanos, Philip T.; Stefancic, Ana; Tsemberis, Sam

    2015-01-01

    Objective Housing programs for people with severe mental illnesses aim to maximize community integration. However, little is known about how the community integration of mental health consumers living in supported housing compares with that of other community residents in the socially disadvantaged communities where supported housing is often located. The purpose of this study was to examine predictors of objective community integration of mental health consumers living in supported housing and of other persons living in the same communities. Methods Participants were 124 adults (60 mental health consumers and 64 other community residents) residing in designated zip codes in the Bronx, New York. Participants were administered measures of psychiatric symptoms, substance use, physical community integration (participation in local activities), social integration (interactions with community members), and citizenship (political activism or volunteering). Results Mental health consumers living in supported independent housing had significantly lower scores on indicators of objective community integration than other community members. However, differences were relatively small. Among mental health consumers, African-American race, education, and length of time in current residence were associated with better community integration. Conclusions Findings suggest that mental health consumers living in supported housing may not achieve levels of objective community integration that are comparable with other community members; however, psychiatric factors did not account for this difference. Length of time in neighborhoods appears to be an important factor in facilitating social integration. PMID:22549530

  1. Objectively measured sedentary time and academic achievement in schoolchildren.

    PubMed

    Lopes, Luís; Santos, Rute; Mota, Jorge; Pereira, Beatriz; Lopes, Vítor

    2017-03-01

    This study aimed to evaluate the relationship between objectively measured total sedentary time and academic achievement (AA) in Portuguese children. The sample comprised of 213 children (51.6% girls) aged 9.46 ± 0.43 years, from the north of Portugal. Sedentary time was measured with accelerometry, and AA was assessed using the Portuguese Language and Mathematics National Exams results. Multilevel linear regression models were fitted to assess regression coefficients predicting AA. The results showed that objectively measured total sedentary time was not associated with AA, after adjusting for potential confounders.

  2. Acoustic Measurement Of Periodic Motion Of Levitated Object

    NASA Technical Reports Server (NTRS)

    Watkins, John L.; Barmatz, Martin B.

    1992-01-01

    Some internal vibrations, oscillations in position, and rotations of acoustically levitated object measured by use of microphone already installed in typical levitation chamber for tuning chamber to resonance and monitoring operation. Levitating acoustic signal modulated by object motion of lower frequency. Amplitude modulation detected and analyzed spectrally to determine amplitudes and frequencies of motions.

  3. Generic health literacy measurement instruments for children and adolescents: a systematic review of the literature.

    PubMed

    Okan, Orkan; Lopes, Ester; Bollweg, Torsten Michael; Bröder, Janine; Messer, Melanie; Bruland, Dirk; Bond, Emma; Carvalho, Graça S; Sørensen, Kristine; Saboga-Nunes, Luis; Levin-Zamir, Diane; Sahrai, Diana; Bittlingmayer, Uwe H; Pelikan, Jürgen M; Thomas, Malcolm; Bauer, Ullrich; Pinheiro, Paulo

    2018-01-22

    Health literacy is an important health promotion concern and recently children and adolescents have been the focus of increased academic attention. To assess the health literacy of this population, researchers have been focussing on developing instruments to measure their health literacy. Compared to the wider availability of instruments for adults, only a few tools are known for younger age groups. The objective of this study is to systematically review the field of generic child and adolescent health literacy measurement instruments that are currently available. A systematic literature search was undertaken in five databases (PubMed, CINAHL, PsycNET, ERIC, and FIS) on articles published between January 1990 and July 2015, addressing children and adolescents ≤18 years old. Eligible articles were analysed, data was extracted, and synthesised according to review objectives. Fifteen generic health literacy measurement instruments for children and adolescents were identified. All, except two, are self-administered instruments. Seven are objective measures (performance-based tests), seven are subjective measures (self-reporting), and one uses a mixed-method measurement. Most instruments applied a broad and multidimensional understanding of health literacy. The instruments were developed in eight different countries, with most tools originating in the United States (n = 6). Among the instruments, 31 different components related to health literacy were identified. Accordingly, the studies exhibit a variety of implicit or explicit conceptual and operational definitions, and most instruments have been used in schools and other educational contexts. While the youngest age group studied was 7-year-old children within a parent-child study, there is only one instrument specifically designed for primary school children and none for early years. Despite the reported paucity of health literacy research involving children and adolescents, an unexpected number of health

  4. Measurement equivalence: a glossary for comparative population health research.

    PubMed

    Morris, Katherine Ann

    2018-03-06

    Comparative population health studies are becoming more common and are advancing solutions to crucial public health problems, but decades-old measurement equivalence issues remain without a common vocabulary to identify and address the biases that contribute to non-equivalence. This glossary defines sources of measurement non-equivalence. While drawing examples from both within-country and between-country studies, this glossary also defines methods of harmonisation and elucidates the unique opportunities in addition to the unique challenges of particular harmonisation methods. Its primary objective is to enable population health researchers to more clearly articulate their measurement assumptions and the implications of their findings for policy. It is also intended to provide scholars and policymakers across multiple areas of inquiry with tools to evaluate comparative research and thus contribute to urgent debates on how to ameliorate growing health disparities within and between countries. © 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.

  5. Three-Dimensional Shape Measurements of Specular Objects Using Phase-Measuring Deflectometry.

    PubMed

    Zhang, Zonghua; Wang, Yuemin; Huang, Shujun; Liu, Yue; Chang, Caixia; Gao, Feng; Jiang, Xiangqian

    2017-12-07

    The fast development in the fields of integrated circuits, photovoltaics, the automobile industry, advanced manufacturing, and astronomy have led to the importance and necessity of quickly and accurately obtaining three-dimensional (3D) shape data of specular surfaces for quality control and function evaluation. Owing to the advantages of a large dynamic range, non-contact operation, full-field and fast acquisition, high accuracy, and automatic data processing, phase-measuring deflectometry (PMD, also called fringe reflection profilometry) has been widely studied and applied in many fields. Phase information coded in the reflected fringe patterns relates to the local slope and height of the measured specular objects. The 3D shape is obtained by integrating the local gradient data or directly calculating the depth data from the phase information. We present a review of the relevant techniques regarding classical PMD. The improved PMD technique is then used to measure specular objects having discontinuous and/or isolated surfaces. Some influential factors on the measured results are presented. The challenges and future research directions are discussed to further advance PMD techniques. Finally, the application fields of PMD are briefly introduced.

  6. Three-Dimensional Shape Measurements of Specular Objects Using Phase-Measuring Deflectometry

    PubMed Central

    Wang, Yuemin; Huang, Shujun; Liu, Yue; Chang, Caixia; Gao, Feng; Jiang, Xiangqian

    2017-01-01

    The fast development in the fields of integrated circuits, photovoltaics, the automobile industry, advanced manufacturing, and astronomy have led to the importance and necessity of quickly and accurately obtaining three-dimensional (3D) shape data of specular surfaces for quality control and function evaluation. Owing to the advantages of a large dynamic range, non-contact operation, full-field and fast acquisition, high accuracy, and automatic data processing, phase-measuring deflectometry (PMD, also called fringe reflection profilometry) has been widely studied and applied in many fields. Phase information coded in the reflected fringe patterns relates to the local slope and height of the measured specular objects. The 3D shape is obtained by integrating the local gradient data or directly calculating the depth data from the phase information. We present a review of the relevant techniques regarding classical PMD. The improved PMD technique is then used to measure specular objects having discontinuous and/or isolated surfaces. Some influential factors on the measured results are presented. The challenges and future research directions are discussed to further advance PMD techniques. Finally, the application fields of PMD are briefly introduced. PMID:29215600

  7. A cluster analysis of patterns of objectively measured physical activity in Hong Kong.

    PubMed

    Lee, Paul H; Yu, Ying-Ying; McDowell, Ian; Leung, Gabriel M; Lam, T H

    2013-08-01

    The health benefits of exercise are clear. In targeting interventions it would be valuable to know whether characteristic patterns of physical activity (PA) are associated with particular population subgroups. The present study used cluster analysis to identify characteristic hourly PA patterns measured by accelerometer. Cross-sectional design. Objectively measured PA in Hong Kong adults. Four-day accelerometer data were collected during 2009 to 2011 for 1714 participants in Hong Kong (mean age 44?2 years, 45?9% male). Two clusters were identified, one more active than the other. The ‘active cluster’ (n 480) was characterized by a routine PA pattern on weekdays and a more active and varied pattern on weekends; the other, the ‘less active cluster’ (n 1234), by a consistently low PA pattern on both weekdays and weekends with little variation from day to day. Demographic, lifestyle, PA level and health characteristics of the two clusters were compared. They differed in age, sex, smoking, income and level of PA required at work. The odds of having any chronic health conditions was lower for the active group (adjusted OR50?62, 95% CI 0?46, 0?84) but the two groups did not differ in terms of specific chronic health conditions or obesity. Implications are drawn for targeting exercise promotion programmes at the population level.

  8. Adiponectin, Leptin and Objectively Measured Physical Activity in Adults: A Narrative Review

    PubMed Central

    Nurnazahiah, Ali; Lua, Pei Lin; Shahril, Mohd Razif

    2016-01-01

    The objective of this study was to compile and analyse existing scientific evidences reporting the effects of objectively measured physical activity on the levels of adiponectin and leptin. Articles related to the effects of objectively measured physical activity on the levels of adiponectin and leptin were searched from the Medline and PubMed databases. The search was limited to ‘objectively measured’ physical activity, and studies that did not objectively measure the physical activity were excluded. Only English articles were included in the search and review. A total of 18 articles encompassing 2,026 respondents met the inclusion criteria. The eligible articles included all forms of evidence (e.g., cross-sectional and intervention). Seventeen and 11 studies showed the effects of objectively measured physical activity on adiponectin and leptin, respectively. Five and four cross-sectional studies showed the effects of objectively measured physical activity on adiponectin and leptin, respectively. Two out of five studies showed a weak to moderate positive association between adiponectin and objectively measured physical activity, while three out of four studies showed a weak to moderate inverse association between leptin and objectively measured physical activity. For intervention studies, six out of 12 studies involving adiponectin and five out of seven studies involving leptin showed a significant effect between the proteins and objectively measured physical activity. However, a definitive conclusion could not be drawn due to several methodological flaws in the existing articles and the acute lack of additional research in this area. In conclusion, the existing evidences are encouraging but yet not compelling. Hence, further well-designed large trials are needed before the effectiveness of objectively measured physical activity in elevating adiponectin levels and in decreasing leptin levels could be strongly confirmed. PMID:28090175

  9. Migrant and Seasonal Farmworker Health Objectives for the Year 2000. Document in Progress.

    ERIC Educational Resources Information Center

    National Migrant Resource Program, Inc., Austin, TX.

    Compared to the U.S. population, migrant farmworkers have a low life expectancy, high infant mortality rate, and high incidence of malnutrition and parasitic infection. Drawing on Public Health Service health objectives for the nation, this document proposes farmworker-specific objectives for a health promotion and disease prevention agenda. While…

  10. Sleep Disturbances in Child and Adolescent Mental Health Disorders: A Review of the Variability of Objective Sleep Markers.

    PubMed

    Baddam, Suman K R; Canapari, Craig A; van Noordt, Stefon J R; Crowley, Michael J

    2018-06-04

    Sleep disturbances are often observed in child and adolescent mental health disorders. Although previous research has identified consistent subjective reports of sleep disturbances, specific objective sleep markers have not yet been identified. We evaluated the current research on subjective and objective sleep markers in relation to attention deficit hyperactivity disorders, autism spectrum disorders, anxiety and depressive disorders. Subjective sleep markers are more consistent than objective markers of actigraphy, polysomnography, and circadian measures. We discuss the causes of variability in objective sleep findings and suggest future directions for research.

  11. Cross-Validating Chinese Language Mental Health Recovery Measures in Hong Kong

    ERIC Educational Resources Information Center

    Bola, John; Chan, Tiffany Hill Ching; Chen, Eric HY; Ng, Roger

    2016-01-01

    Objectives: Promoting recovery in mental health services is hampered by a shortage of reliable and valid measures, particularly in Hong Kong. We seek to cross validate two Chinese language measures of recovery and one of recovery-promoting environments. Method: A cross-sectional survey of people recovering from early episode psychosis (n = 121)…

  12. Executive function in fibromyalgia: Comparing subjective and objective measures.

    PubMed

    Gelonch, Olga; Garolera, Maite; Valls, Joan; Rosselló, Lluís; Pifarré, Josep

    2016-04-01

    There is evidence to suggest the existence of an executive dysfunction in people diagnosed with fibromyalgia, although there are certain inconsistencies between studies. Here, we aim to compare executive performance between patients with fibromyalgia and a control group by using subjective and objective cognitive tests, analyzing the influence of patient mood on the results obtained, and studying associations between the two measures. 82 patients diagnosed with fibromyalgia and 42 healthy controls, matched by age and years of education, were assessed using the Behavioral Rating Inventory of Executive Function - Adult Version (BRIEF-A) as a subjective measure of executive functioning. A selection of objective cognitive tests were also used to measure a series of executive functions and to identify symptoms of depression and anxiety. Patients with fibromyalgia perceived greater difficulties than the control group on all of the BRIEF-A scales. However, after adjustments were made for depression and anxiety the only differences that remained were those associated with the working memory scale and the Metacognition and Global Executive Composite index. In the case of the objective cognitive tests, a significantly worse overall performance was evidenced for the fibromyalgia patients. However, this also disappeared when adjustments were made for depression and anxiety. After this adjustment, fibromyalgia patients only performed significantly worse for the interference effect in the Stroop Test. Although there were no significant associations between most of the objective cognitive tests and the BRIEF-A scales, depression and anxiety exhibited strong associations with almost all of the BRIEF-A scales and with several of the objective cognitive tests. Patients with fibromyalgia showed executive dysfunction in subjective and objective measures, although most of this impairment was associated with mood disturbances. Exceptions to this general rule were observed in the

  13. Quantitative method for measuring heat flux emitted from a cryogenic object

    DOEpatents

    Duncan, Robert V.

    1993-01-01

    The present invention is a quantitative method for measuring the total heat flux, and of deriving the total power dissipation, of a heat-fluxing object which includes the steps of placing an electrical noise-emitting heat-fluxing object in a liquid helium bath and measuring the superfluid transition temperature of the bath. The temperature of the liquid helium bath is thereafter reduced until some measurable parameter, such as the electrical noise, exhibited by the heat-fluxing object or a temperature-dependent resistive thin film in intimate contact with the heat-fluxing object, becomes greatly reduced. The temperature of the liquid helum bath is measured at this point. The difference between the superfluid transition temperature of the liquid helium bath surrounding the heat-fluxing object, and the temperature of the liquid helium bath when the electrical noise emitted by the heat-fluxing object becomes greatly reduced, is determined. The total heat flux from the heat-fluxing object is determined as a function of this difference between these temperatures. In certain applications, the technique can be used to optimize thermal design parameters of cryogenic electronics, for example, Josephson junction and infra-red sensing devices.

  14. Quantitative method for measuring heat flux emitted from a cryogenic object

    DOEpatents

    Duncan, R.V.

    1993-03-16

    The present invention is a quantitative method for measuring the total heat flux, and of deriving the total power dissipation, of a heat-fluxing object which includes the steps of placing an electrical noise-emitting heat-fluxing object in a liquid helium bath and measuring the superfluid transition temperature of the bath. The temperature of the liquid helium bath is thereafter reduced until some measurable parameter, such as the electrical noise, exhibited by the heat-fluxing object or a temperature-dependent resistive thin film in intimate contact with the heat-fluxing object, becomes greatly reduced. The temperature of the liquid helum bath is measured at this point. The difference between the superfluid transition temperature of the liquid helium bath surrounding the heat-fluxing object, and the temperature of the liquid helium bath when the electrical noise emitted by the heat-fluxing object becomes greatly reduced, is determined. The total heat flux from the heat-fluxing object is determined as a function of this difference between these temperatures. In certain applications, the technique can be used to optimize thermal design parameters of cryogenic electronics, for example, Josephson junction and infrared sensing devices.

  15. Objective community integration of mental health consumers living in supported housing and of others in the community.

    PubMed

    Yanos, Philip T; Stefancic, Ana; Tsemberis, Sam

    2012-01-01

    Housing programs for people with severe mental illnesses aim to maximize community integration. However, little is known about how the community integration of mental health consumers living in supported housing compares with that of other community residents in the socially disadvantaged communities where supported housing is often located. The purpose of this study was to examine predictors of objective community integration of mental health consumers living in supported housing and of other persons living in the same communities. Participants were 124 adults (60 mental health consumers and 64 other community residents) residing in designated zip codes in the Bronx, New York. Participants were administered measures of psychiatric symptoms, substance use, physical community integration (participation in local activities), social integration (interactions with community members), and citizenship (political activism or volunteering). Mental health consumers living in supported independent housing had significantly lower scores on indicators of objective community integration than other community members. However, differences were relatively small. Among mental health consumers, African-American race, education, and length of time in current residence were associated with better community integration. Findings suggest that mental health consumers living in supported housing may not achieve levels of objective community integration that are comparable with other community members; however, psychiatric factors did not account for this difference. Length of time in neighborhoods appears to be an important factor in facilitating social integration.

  16. Electronic Health Object

    PubMed Central

    Almunawar, Mohammad Nabil; Anshari, Muhammad; Younis, Mustafa Z.; Kisa, Adnan

    2015-01-01

    Electronic health records (EHRs) store health-related patient information in an electronic format, improving the quality of health care management and increasing efficiency of health care processes. However, in existing information systems, health-related records are generated, managed, and controlled by health care organizations. Patients are perceived as recipients of care and normally cannot directly interact with the system that stores their health-related records; their participation in enriching this information is not possible. Many businesses now allow customers to participate in generating information for their systems, strengthening customer relationships. This trend is supported by Web 2.0, which enables interactivity through various means, including social networks. Health care systems should be able to take advantage of this development. This article proposes a novel framework in addressing the emerging need for interactivity while preserving and extending existing electronic medical data. The framework has 3 dimensions of patient health record: personal, social, and medical dimensions. The framework is designed to empower patients, changing their roles from static recipient of health care services to dynamic and active partners in health care processes. PMID:26660486

  17. Relative hardness measurement of soft objects by a new fiber optic sensor

    NASA Astrophysics Data System (ADS)

    Ahmadi, Roozbeh; Ashtaputre, Pranav; Abou Ziki, Jana; Dargahi, Javad; Packirisamy, Muthukumaran

    2010-06-01

    The measurement of relative hardness of soft objects enables replication of human finger tactile perception capabilities. This ability has many applications not only in automation and robotics industry but also in many other areas such as aerospace and robotic surgery where a robotic tool interacts with a soft contact object. One of the practical examples of interaction between a solid robotic instrument and a soft contact object occurs during robotically-assisted minimally invasive surgery. Measuring the relative hardness of bio-tissue, while contacting the robotic instrument, helps the surgeons to perform this type of surgery more reliably. In the present work, a new optical sensor is proposed to measure the relative hardness of contact objects. In order to measure the hardness of a contact object, like a human finger, it is required to apply a small force/deformation to the object by a tactile sensor. Then, the applied force and resulting deformation should be recorded at certain points to enable the relative hardness measurement. In this work, force/deformation data for a contact object is recorded at certain points by the proposed optical sensor. Recorded data is used to measure the relative hardness of soft objects. Based on the proposed design, an experimental setup was developed and experimental tests were performed to measure the relative hardness of elastomeric materials. Experimental results verify the ability of the proposed optical sensor to measure the relative hardness of elastomeric samples.

  18. Is self-rated health a valid measure to use in social inequities and health research? Evidence from the PAPFAM women's data in six Arab countries.

    PubMed

    Abdulrahim, Sawsan; El Asmar, Khalil

    2012-09-17

    Some evidence from high-income countries suggests that self-rated health (SRH) is not a consistent predictor of objective health across social groups, and that its use may lead to inaccurate estimates of the effects of inequities on health. Given increased interest in studying and monitoring social inequities in health worldwide, the aim of the present study was to evaluate the validity of SRH as a consistent measure of health across socioeconomic categories in six Arab countries. We employed the PAPFAM population-based survey data on women from Morocco, Algeria, Tunisia, Lebanon, Syria, and the Occupied Palestinian Territories (OPT). Multivariate logistic regression analyses were performed to assess the strength of the association between fair/poor SRH and objective health (reporting at least one chronic condition), adjusting for available socio-demographic and health-related variables. Analyses were then stratified by two socioeconomic indicators: education and household economic status. The association between SRH and objective health is strong in Algeria, Tunisia, Lebanon, Syria, and OPT, but weak in Morocco. The strength of the association between reporting fair/poor health and objective health was not moderated by education or household economic status in any of the six countries. As the SRH-objective health association does not vary across social categories, the use of the measure in social inequities in health research is justified. These results should not preclude the need to carry out other validation studies using longitudinal data on men and women, or the need to advocate for improving the quality of morbidity and mortality data in the Arab region.

  19. Association between Accelerometer-Assessed Physical Activity and Objectively Measured Hearing Sensitivity among U.S. Adults with Diabetes

    ERIC Educational Resources Information Center

    Loprinzi, Paul D.; Gilham, Ben; Cardinal, Bradley J.

    2014-01-01

    Purpose: The purpose of this study was to examine the association between objectively measured physical activity and hearing sensitivity among a nationally representative sample of U.S. adults with diabetes. Method: Data from the 2003-2006 National Health and Nutrition Examination Survey were used. One hundred eighty-four U.S. adults with diabetes…

  20. An examination of presenteeism measures: the association of three scoring methods with health, work life, and consumer activation.

    PubMed

    Terry, Paul E; Xi, Min

    2010-12-01

    The objective of this study was to assess the validity of 3 scoring techniques for presenteeism measures by exploring their relationship with patient activation, health, job satisfaction, and socioeconomic characteristics. The sample consisted of 631 employees from 2 predominantly white-collar employee groups in the northern Midwest. Employees completed the World Health Organization's Health and Work Performance Questionnaire, a wellness profile, and the Patient Activation Measure. Absolute measures reflect self-rated performance, while relative and stratified measures compare self-rated performance to that of co-workers. Multivariate analyses were used to validate scoring measures. All measures of presenteeism were positively correlated with being nonwhite, income, and smoking. The significance of age, employment, mental health, and patient activation depends on how presenteeism is defined. Practitioners must carefully consider which scoring method best addresses their program goals and objectives. Clearer measurement guidelines are needed.

  1. Development and initial assessment of objective fatigue measures for apple harvest work.

    PubMed

    Earle-Richardson, Giulia; Jenkins, Paul L; Strogatz, David; Bell, Erin M; May, John J

    2006-11-01

    Previous research has shown that neck, back and shoulder musculoskeletal strain is a major occupational health problem affecting migrant orchard harvest workers. Researchers seek to measure the effect of an ergonomic modification to the apple picking bucket on muscle fatigue, however objective measures for use in the orchard are not yet available. The purpose of this study is to develop simple back, shoulder or arm strength measures, which detect statistically significant drops in strength over one workday. Candidate muscle strength measures were piloted in the laboratory, adapted for the orchard and evaluated (n=102). Data were analyzed for morning to afternoon fatigue, and for correlation between fatigue score and hours worked. In the laboratory, the timed arm hold (35.7% time reduction, 95% CI: 21.81-49.61), and the timed spinal extension (31.8% time reduction, 95% CI: 23.54-39.96) showed significant fatigue. In the orchard (n=102), only the timed arm hold showed significant (11.4%, p<.0001) fatigue. The potential effect of field conditions and subject motivation on these results needs further exploration.

  2. 34 CFR 200.18 - Annual measurable objectives.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Annual measurable objectives. 200.18 Section 200.18 Education Regulations of the Offices of the Department of Education OFFICE OF ELEMENTARY AND SECONDARY EDUCATION, DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE DISADVANTAGED Improving...

  3. Moire measuring technology for three-dimensional profile of the object

    NASA Astrophysics Data System (ADS)

    Fu, Yanjun; Yang, Kuntao

    2006-02-01

    An optical system is designed to get projection of the transmission grating, the deformed grating is obtained on surface of the object. The image of the deformed grating is given by the lens, the reference grating is put on the place of the image, and then the moire fringe is obtained. The amplify principle of the moire fringe is used to measure the profile of the object. The optical principle of the projection is analyzed. And the relation between the phase and the height of object is deduced. From the different point of geometry optics and the physics opticsl, the optical system is analyzed, the factors that influence the image equality and the measuring result are obtained. So the betterment of improving the measuring precision is brought forward, and in the later information processing, because of the diffuse reflection, the image equality is not very well. In order to get a good image, the digital filter is used to filter the noise and smooth the image firstly. Then in order to improve the measure precision, the subdivision technology is applied. The Fourier transform profilometry and phase shifting technology is used in the calculation. A detail analyses is done both in time field and frequency field. And the method of improving the measuring precision is put forward. A good digital filter algorithm is brought forward in the Fourier transform profilometry. In the phase shifting technology, the detail formula of three-step and four-step is given. At last the phase that is relational with the high information of the object is get, but the phase is disconnected phase, after the unwrapping algorithm,the disconnected phase is changed to be the continuous phase. Taking use of the relation between the phase and height, the height is obtained. Then the three-dimensional profile of the measured object can be reconstructed. The system is very convenient for non-contact measure of profile of some objects.

  4. Measuring Racial/Ethnic Disparities in Health Care: Methods and Practical Issues

    PubMed Central

    Cook, Benjamin Lê; McGuire, Thomas G; Zaslavsky,, Alan M

    2012-01-01

    Objective To review methods of measuring racial/ethnic health care disparities. Study Design Identification and tracking of racial/ethnic disparities in health care will be advanced by application of a consistent definition and reliable empirical methods. We have proposed a definition of racial/ethnic health care disparities based in the Institute of Medicine's (IOM) Unequal Treatment report, which defines disparities as all differences except those due to clinical need and preferences. After briefly summarizing the strengths and critiques of this definition, we review methods that have been used to implement it. We discuss practical issues that arise during implementation and expand these methods to identify sources of disparities. We also situate the focus on methods to measure racial/ethnic health care disparities (an endeavor predominant in the United States) within a larger international literature in health outcomes and health care inequality. Empirical Application We compare different methods of implementing the IOM definition on measurement of disparities in any use of mental health care and mental health care expenditures using the 2004–2008 Medical Expenditure Panel Survey. Conclusion Disparities analysts should be aware of multiple methods available to measure disparities and their differing assumptions. We prefer a method concordant with the IOM definition. PMID:22353147

  5. Development and Validation of a Taxonomy for Characterizing Measurements in Health Self-Quantification

    PubMed Central

    2017-01-01

    Background The use of wearable tools for health self-quantification (SQ) introduces new ways of thinking about one’s body and about how to achieve desired health outcomes. Measurements from individuals, such as heart rate, respiratory volume, skin temperature, sleep, mood, blood pressure, food consumed, and quality of surrounding air can be acquired, quantified, and aggregated in a holistic way that has never been possible before. However, health SQ still lacks a formal common language or taxonomy for describing these kinds of measurements. Establishing such taxonomy is important because it would enable systematic investigations that are needed to advance in the use of wearable tools in health self-care. For a start, a taxonomy would help to improve the accuracy of database searching when doing systematic reviews and meta-analyses in this field. Overall, more systematic research would contribute to build evidence of sufficient quality to determine whether and how health SQ is a worthwhile health care paradigm. Objective The aim of this study was to investigate a sample of SQ tools and services to build and test a taxonomy of measurements in health SQ, titled: the classification of data and activity in self-quantification systems (CDA-SQS). Methods Eight health SQ tools and services were selected to be examined: Zeo Sleep Manager, Fitbit Ultra, Fitlinxx Actipressure, MoodPanda, iBGStar, Sensaris Senspod, 23andMe, and uBiome. An open coding analytical approach was used to find all the themes related to the research aim. Results This study distinguished three types of measurements in health SQ: body structures and functions, body actions and activities, and around the body. Conclusions The CDA-SQS classification should be applicable to align health SQ measurement data from people with many different health objectives, health states, and health conditions. CDA-SQS is a critical contribution to a much more consistent way of studying health SQ. PMID:29101092

  6. Cross-sectional associations of active transport, employment status and objectively measured physical activity: analyses from the National Health and Nutrition Examination Survey.

    PubMed

    Yang, Lin; Hu, Liang; Hipp, J Aaron; Imm, Kellie R; Schutte, Rudolph; Stubbs, Brendon; Colditz, Graham A; Smith, Lee

    2018-05-05

    To investigate associations between active transport, employment status and objectively measured moderate-to-vigorous physical activity (MVPA) in a representative sample of US adults. Cross-sectional analyses of data from the National Health and Nutrition Examination Survey. A total of 5180 adults (50.2 years old, 49.0% men) were classified by levels of active transportation and employment status. Outcome measure was weekly time spent in MVPA as recorded by the Actigraph accelerometer. Associations between active transport, employment status and objectively measured MVPA were examined using multivariable linear regression models adjusted for age, body mass index, race and ethnicity, education level, marital status, smoking status, working hour duration (among the employed only) and self-reported leisure time physical activity. Patterns of active transport were similar between the employed (n=2897) and unemployed (n=2283), such that 76.0% employed and 77.5% unemployed engaged in no active transport. For employed adults, those engaging in high levels of active transport (≥90 min/week) had higher amount of MVPA than those who did not engage in active transport. This translated to 40.8 (95% CI 15.7 to 65.9) additional minutes MVPA per week in men and 57.9 (95% CI 32.1 to 83.7) additional minutes MVPA per week in women. Among the unemployed adults, higher levels of active transport were associated with more MVPA among men (44.8 min/week MVPA, 95% CI 9.2 to 80.5) only. Findings from the present study support interventions to promote active transport to increase population level physical activity. Additional strategies are likely required to promote physical activity among unemployed women. © 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.

  7. Finding the Density of Objects without Measuring Mass and Volume

    ERIC Educational Resources Information Center

    Mumba, Frackson; Tsige, Mesfin

    2007-01-01

    A simple method based on the moment of forces and Archimedes' principle is described for finding density without measuring the mass and volume of an object. The method involves balancing two unknown objects of masses M[subscript 1] and M[subscript 2] on each side of a pivot on a metre rule and measuring their corresponding moment arms. The object…

  8. An objective measure of physical function of elderly outpatients. The Physical Performance Test.

    PubMed

    Reuben, D B; Siu, A L

    1990-10-01

    Direct observation of physical function has the advantage of providing an objective, quantifiable measure of functional capabilities. We have developed the Physical Performance Test (PPT), which assesses multiple domains of physical function using observed performance of tasks that simulate activities of daily living of various degrees of difficulty. Two versions are presented: a nine-item scale that includes writing a sentence, simulated eating, turning 360 degrees, putting on and removing a jacket, lifting a book and putting it on a shelf, picking up a penny from the floor, a 50-foot walk test, and climbing stairs (scored as two items); and a seven-item scale that does not include stairs. The PPT can be completed in less than 10 minutes and requires only a few simple props. We then tested the validity of PPT using 183 subjects (mean age, 79 years) in six settings including four clinical practices (one of Parkinson's disease patients), a board-and-care home, and a senior citizens' apartment. The PPT was reliable (Cronbach's alpha = 0.87 and 0.79, interrater reliability = 0.99 and 0.93 for the nine-item and seven-item tests, respectively) and demonstrated concurrent validity with self-reported measures of physical function. Scores on the PPT for both scales were highly correlated (.50 to .80) with modified Rosow-Breslau, Instrumental and Basic Activities of Daily Living scales, and Tinetti gait score. Scores on the PPT were more moderately correlated with self-reported health status, cognitive status, and mental health (.24 to .47), and negatively with age (-.24 and -.18). Thus, the PPT also demonstrated construct validity. The PPT is a promising objective measurement of physical function, but its clinical and research value for screening, monitoring, and prediction will have to be determined.

  9. Objective Measurement of Emerging Affective Traits in Preschool Children.

    ERIC Educational Resources Information Center

    Adkins, Dorothy C.

    An objective measure of motivation to achieve for preschool children called Gumpgookies is described. It is an objective-projective technique that requires choice between two alternate types of behavior portrayed in pictures and accompanying verbal descriptions. Gumpgookies are amoeba-like creatures who behave in ways intended to show differences…

  10. Objectively measured physical activity in Finnish employees: a cross-sectional study.

    PubMed

    Mutikainen, Sara; Helander, Elina; Pietilä, Julia; Korhonen, Ilkka; Kujala, Urho M

    2014-12-10

    To objectively measure the amount of intensity-specific physical activity by gender and age with respect to body mass index (BMI) during workdays and days off among Finnish employees. A cross-sectional study. Primary care occupational healthcare units. A sample of 9554 Finnish employees (4221 men and 5333 women; age range 18-65 years; BMI range 18.5-40 kg/m(2)) who participated in health assessments related to occupational health promotion. The amount of moderate-to-vigorous (MVPA) and vigorous (VPA) physical activity (≥3 and ≥6 metabolic equivalents, respectively) was assessed by estimating the minute-to-minute oxygen consumption from the recorded beat-to-beat R-R interval data. The estimation method used heart rate, respiration rate and on/off response information from R-R interval data calibrated by age, gender, height, weight and self-reported physical activity class. The proportion of participants fulfilling the aerobic physical activity recommendation of ≥150 min/week was calculated on the basis of ≥10 min bouts, by multiplying the VPA minutes by 2. Both MVPA and VPA were higher among men and during days off, and decreased with increasing age and BMI (p<0.001 for all). Similar results were observed when the probability of having a bout of MVPA or VPA lasting continuously for ≥10 min per measurement day was studied. The total amount of VPA was low among overweight (mean ≤2.6 min/day), obese (mean ≤0.6 min/day) and all women in the age group 51-65 years (mean ≤2.5 min/day) during both types of days. The proportion of participants fulfilling the aerobic physical activity recommendation was highest for normal weight men (65%; 95% CI 62% to 67%) and lowest for obese women (10%; 95% CI 8% to 12%). Objectively measured physical activity is higher among men and during days off, and decreases with increasing age and BMI. The amount of VPA is very low among obese, overweight and older women. Published by the BMJ Publishing Group

  11. Objections to routine clinical outcomes measurement in mental health services: any evidence so far?

    PubMed

    MacDonald, Alastair J D; Trauer, Tom

    2010-12-01

    Routine clinical outcomes measurement (RCOM) is gaining importance in mental health services. To examine whether criticisms published in advance of the development of RCOM have been borne out by data now available from such a programme. This was an observational study of routine ratings using HoNOS65+ at inception/admission and again at discharge in an old age psychiatry service from 1997 to 2008. Testable hypotheses were generated from each criticism amenable to empirical examination. Inter-rater reliability estimates were applied to observed differences between scores between community and ward patients using resampling. Five thousand one hundred eighty community inceptions and 862 admissions had HoNOS65+ ratings at referral/admission and discharge. We could find no evidence of gaming (artificially worse scores at inception and better at discharge), selection, attrition or detection bias, and ratings were consistent with diagnosis and level of service. Anticipated low levels of inter-rater reliability did not vitiate differences between levels of service. Although only hypotheses testable from within RCOM data were examined, and only 46% of eligible episodes had complete outcomes data, no evidence of the alleged biases were found. RCOM seems valid and practical in mental health services.

  12. Rural-urban differences in objective and subjective measures of physical activity: findings from the National Health and Nutrition Examination Survey (NHANES) 2003-2006.

    PubMed

    Fan, Jessie X; Wen, Ming; Kowaleski-Jones, Lori

    2014-08-21

    Lower levels of physical activity among rural relative to urban residents have been suggested as an important contributor to rural-urban health disparity; however, empirical evidence is sparse. We examined rural-urban differences in 4 objective physical activity measures (2 intensity thresholds by 2 bout lengths) and 4 subjective measures (total, leisure, household, and transportation) in a nationally representative sample of participants in the National Health and Nutrition Examination Survey (NHANES) 2003-2006. The sample comprised 5,056 adults aged 20 to 75 years. Rural-Urban Commuting Area (RUCA) codes were matched with NHANES subjects to identify urban status and 2 types of rural status. Rural-urban and within-rural differences in physical activity were estimated without and with controls for demographic and socioeconomic variables. Rural residents were less active than urban residents in high-intensity long bout (2,020 counts per minute threshold and 10 miniutes or longer bout length) accelerometer-measured physical activity (42.5 ± 6.2 min/wk vs 55.9 ± 2.8 min/wk) but the difference disappeared with a lower-intensity threshold (760 counts per minute). Rural residents reported more total physical activity than urban residents (438.3 ± 35.3min/wk vs 371.2 ± 12.5 min/wk), with differences primarily attributable to household physical activity. Within rural areas, micropolitan residents were less active than residents in smaller rural areas. Controlling for other variables reduced the size of the differences. The direction and significance of rural-urban difference in physical activity varied by the method of physical activity measurement, likely related to rural residents spending more time in low-intensity household physical activity but less time in high-intensity physical activity. Micropolitan residents were substantially less active than residents in smaller rural areas, indicating that physical activity did not vary unidirectionally with degree of

  13. Who Take Naps? Self-Reported and Objectively Measured Napping in Very Old Women.

    PubMed

    Leng, Yue; Stone, Katie; Ancoli-Israel, Sonia; Covinsky, Kenneth; Yaffe, Kristine

    2018-03-02

    Despite the widespread belief that napping is common among older adults, little is known about the correlates of napping. We examined the prevalence and correlates of self-reported and objectively measured napping among very old women. We studied 2,675 community-dwelling women (mean age 84.5 ± 3.7 years; range 79-96). Self-reported napping was defined as a report of regular napping for ≥1 hour per day. Individual objective naps were defined as ≥5 consecutive minutes of inactivity as measured by actigraphy and women were characterized as "objective nappers" if they had at least 60 minutes of naps per day. Seven percent of the women only had self-reported napping, 29% only had objective napping, and 14% met the criteria for both. Multinomial logistic regression showed that the independent correlates of "both subjective and objective napping" were age (per 5 year odds ratio [OR] = 1.59; 95% CI: 1.31-1.93), depressive symptoms (per SD of score, OR = 1.53; 1.32-1.77), obesity (OR =1.93; 1.42-2.61), current smoking (OR = 3.37; 1.56-7.30), heavier alcohol drinking (OR = 0.49; 0.34-0.71), history of stroke (OR = 1.56; 1.08-2.26), diabetes (OR = 2.40; 1.61-3.57), dementia (OR = 3.31; 1.27-8.62), and Parkinson's disease (OR = 7.43; 1.87-29.50). Besides, having objective napping alone was associated with age and diabetes, whereas subjective napping was associated with stroke and myocardial infarction. These associations were independent of nighttime sleep duration and fragmentation. Daytime napping is very common in women living in their ninth decade and both subjective and objective napping were significantly related to age and comorbidities. Future studies are needed to better understand napping and its health implications. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. Effects of Wind Turbine Noise on Self-Reported and Objective Measures of Sleep.

    PubMed

    Michaud, David S; Feder, Katya; Keith, Stephen E; Voicescu, Sonia A; Marro, Leonora; Than, John; Guay, Mireille; Denning, Allison; Murray, Brian J; Weiss, Shelly K; Villeneuve, Paul J; van den Berg, Frits; Bower, Tara

    2016-01-01

    To investigate the association between self-reported and objective measures of sleep and wind turbine noise (WTN) exposure. The Community Noise and Health Study, a cross-sectional epidemiological study, included an in-house computer-assisted interview and sleep pattern monitoring over a 7 d period. Outdoor WTN levels were calculated following international standards for conditions that typically approximate the highest long-term average levels at each dwelling. Study data were collected between May and September 2013 from adults, aged 18-79 y (606 males, 632 females) randomly selected from each household and living between 0.25 and 11.22 kilometers from operational wind turbines in two Canadian provinces. Self-reported sleep quality over the past 30 d was assessed using the Pittsburgh Sleep Quality Index. Additional questions assessed the prevalence of diagnosed sleep disorders and the magnitude of sleep disturbance over the previous year. Objective measures for sleep latency, sleep efficiency, total sleep time, rate of awakening bouts, and wake duration after sleep onset were recorded using the wrist worn Actiwatch2® from a subsample of 654 participants (289 males, 365 females) for a total of 3,772 sleep nights. Participant response rate for the interview was 78.9%. Outdoor WTN levels reached 46 dB(A) with an arithmetic mean of 35.6 and a standard deviation of 7.4. Self-reported and objectively measured sleep outcomes consistently revealed no apparent pattern or statistically significant relationship to WTN levels. However, sleep was significantly influenced by other factors, including, but not limited to, the use of sleep medication, other health conditions (including sleep disorders), caffeine consumption, and annoyance with blinking lights on wind turbines. Study results do not support an association between exposure to outdoor WTN up to 46 dB(A) and an increase in the prevalence of disturbed sleep. Conclusions are based on WTN levels averaged over 1 y and, in

  15. Personal Career Orientation. Performance Objectives. Criterion Measures. Home Economics.

    ERIC Educational Resources Information Center

    Allen, Alveta; And Others

    Several intermediate performance objectives and corresponding criterion measures are listed for each of six terminal objectives for a personal career orientation course for seventh grade students. This 6- to 9-week course is designed to acquaint the student with personal qualities and characteristics necessary for success in the world of work.…

  16. An object-oriented mobile health system with usability features.

    PubMed

    Escarfullet, Krystle; Moore, Cantera; Tucker, Shari; Wei, June

    2012-01-01

    Mobile health (m-health) comprises the concept of utilising mobile devices to carry out the task of viewing electronic medical records, reserving medical appointments with a patient's medical provider and electronically refilling prescriptions. This paper aims at developing a m-health system to improve usability from a user's perspective. Specifically, it first developed a m-health model by logically linking characteristics of the m-health system together based on information flows. Then, the system requirements were collected by using a developed questionnaire. These requirements were structured and further in-depth analysis was conducted by using an object-oriented approach based on unified modelling language, such as use-case, sequence and analysis class diagrams. This research will be beneficial to decision makers and developers in the mobile healthcare industry.

  17. Object-oriented analysis and design of a health care management information system.

    PubMed

    Krol, M; Reich, D L

    1999-04-01

    We have created a prototype for a universal object-oriented model of a health care system compatible with the object-oriented approach used in version 3.0 of the HL7 standard for communication messages. A set of three models has been developed: (1) the Object Model describes the hierarchical structure of objects in a system--their identity, relationships, attributes, and operations; (2) the Dynamic Model represents the sequence of operations in time as a collection of state diagrams for object classes in the system; and (3) functional Diagram represents the transformation of data within a system by means of data flow diagrams. Within these models, we have defined major object classes of health care participants and their subclasses, associations, attributes and operators, states, and behavioral scenarios. We have also defined the major processes and subprocesses. The top-down design approach allows use, reuse, and cloning of standard components.

  18. Assessing ADHD symptoms in children and adults: evaluating the role of objective measures.

    PubMed

    Emser, Theresa S; Johnston, Blair A; Steele, J Douglas; Kooij, Sandra; Thorell, Lisa; Christiansen, Hanna

    2018-05-18

    Diagnostic guidelines recommend using a variety of methods to assess and diagnose ADHD. Applying subjective measures always incorporates risks such as informant biases or large differences between ratings obtained from diverse sources. Furthermore, it has been demonstrated that ratings and tests seem to assess somewhat different constructs. The use of objective measures might thus yield valuable information for diagnosing ADHD. This study aims at evaluating the role of objective measures when trying to distinguish between individuals with ADHD and controls. Our sample consisted of children (n = 60) and adults (n = 76) diagnosed with ADHD and matched controls who completed self- and observer ratings as well as objective tasks. Diagnosis was primarily based on clinical interviews. A popular pattern recognition approach, support vector machines, was used to predict the diagnosis. We observed relatively high accuracy of 79% (adults) and 78% (children) applying solely objective measures. Predicting an ADHD diagnosis using both subjective and objective measures exceeded the accuracy of objective measures for both adults (89.5%) and children (86.7%), with the subjective variables proving to be the most relevant. We argue that objective measures are more robust against rater bias and errors inherent in subjective measures and may be more replicable. Considering the high accuracy of objective measures only, we found in our study, we think that they should be incorporated in diagnostic procedures for assessing ADHD.

  19. Online phase measuring profilometry for rectilinear moving object by image correction

    NASA Astrophysics Data System (ADS)

    Yuan, Han; Cao, Yi-Ping; Chen, Chen; Wang, Ya-Pin

    2015-11-01

    In phase measuring profilometry (PMP), the object must be static for point-to-point reconstruction with the captured deformed patterns. While the object is rectilinearly moving online, the size and pixel position differences of the object in different captured deformed patterns do not meet the point-to-point requirement. We propose an online PMP based on image correction to measure the three-dimensional shape of the rectilinear moving object. In the proposed method, the deformed patterns captured by a charge-coupled diode camera are reprojected from the oblique view to an aerial view first and then translated based on the feature points of the object. This method makes the object appear stationary in the deformed patterns. Experimental results show the feasibility and efficiency of the proposed method.

  20. Measuring health: a practical challenge with a philosophical solution?

    PubMed

    Shroufi, Amir; Chowdhury, Rajiv; Aston, Louise M; Pashayan, Nora; Franco, Oscar H

    2011-03-01

    ' (1971), in which he employed a thought experiment called 'the veil of ignorance' as a means of overcoming this problem. In this thought experiment an individual is asked to make decisions about distributive justice by imagining they are behind a 'veil of ignorance', whereby they are unaware of their own position in society. Here we discuss how current methods for deriving health state values may incorporate a veil of ignorance approach, and how this may benefit the comparability of the health state valuations produced. We also propose how such methods may be operationalized. Considering these issues, we propose that a new society with new needs and a progressively growing interest in maintaining adequate health requires appropriate measures of health. These measures should facilitate derivation of objective measures of health that are comparable to those acquired in other populations, irrespective of age, gender, disease status, ethnicity and geographical location. Promoting and improving health demands adequate measures of health and the application of the Rawlsian veil of ignorance approach could be an effective alternative. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  1. Test-Retest Reliability of Self-Reported Sexual Health Measures among US Hispanic Adolescents

    ERIC Educational Resources Information Center

    Jerman, Petra; Berglas, Nancy F.; Rohrbach, Louise A.; Constantine, Norman A.

    2016-01-01

    Objective: Although Hispanic adolescents in the USA are often the focus of sexual health interventions, their response to survey measures has rarely been assessed within evaluation studies. This study documents the test-retest reliability of a wide range of self-reported sexual health values, attitudes, knowledge and behaviours among Hispanic…

  2. Measuring Positions of Objects using Two or More Cameras

    NASA Technical Reports Server (NTRS)

    Klinko, Steve; Lane, John; Nelson, Christopher

    2008-01-01

    An improved method of computing positions of objects from digitized images acquired by two or more cameras (see figure) has been developed for use in tracking debris shed by a spacecraft during and shortly after launch. The method is also readily adaptable to such applications as (1) tracking moving and possibly interacting objects in other settings in order to determine causes of accidents and (2) measuring positions of stationary objects, as in surveying. Images acquired by cameras fixed to the ground and/or cameras mounted on tracking telescopes can be used in this method. In this method, processing of image data starts with creation of detailed computer- aided design (CAD) models of the objects to be tracked. By rotating, translating, resizing, and overlaying the models with digitized camera images, parameters that characterize the position and orientation of the camera can be determined. The final position error depends on how well the centroids of the objects in the images are measured; how accurately the centroids are interpolated for synchronization of cameras; and how effectively matches are made to determine rotation, scaling, and translation parameters. The method involves use of the perspective camera model (also denoted the point camera model), which is one of several mathematical models developed over the years to represent the relationships between external coordinates of objects and the coordinates of the objects as they appear on the image plane in a camera. The method also involves extensive use of the affine camera model, in which the distance from the camera to an object (or to a small feature on an object) is assumed to be much greater than the size of the object (or feature), resulting in a truly two-dimensional image. The affine camera model does not require advance knowledge of the positions and orientations of the cameras. This is because ultimately, positions and orientations of the cameras and of all objects are computed in a coordinate

  3. Different Measures of Structural Similarity Tap Different Aspects of Visual Object Processing

    PubMed Central

    Gerlach, Christian

    2017-01-01

    The structural similarity of objects has been an important variable in explaining why some objects are easier to categorize at a superordinate level than to individuate, and also why some patients with brain injury have more difficulties in recognizing natural (structurally similar) objects than artifacts (structurally distinct objects). In spite of its merits as an explanatory variable, structural similarity is not a unitary construct, and it has been operationalized in different ways. Furthermore, even though measures of structural similarity have been successful in explaining task and category-effects, this has been based more on implication than on direct empirical demonstrations. Here, the direct influence of two different measures of structural similarity, contour overlap and within-item structural diversity, on object individuation (object decision) and superordinate categorization performance is examined. Both measures can account for performance differences across objects, but in different conditions. It is argued that this reflects differences between the measures in whether they tap: (i) global or local shape characteristics, and (ii) between- or within-category structural similarity. PMID:28861027

  4. Association of Objectively Measured Physical Activity and Metabolic Syndrome Among US Adults With Osteoarthritis.

    PubMed

    Liu, Shao-Hsien; Waring, Molly E; Eaton, Charles B; Lapane, Kate L

    2015-10-01

    To investigate the association between objectively measured physical activity and metabolic syndrome among adults with osteoarthritis (OA). Using cross-sectional data from the 2003-2006 National Health and Nutrition Examination Survey, we identified 566 adults with OA with available accelerometer data assessed using Actigraph AM-7164 and measurements necessary to determine metabolic syndrome by the Adult Treatment Panel III. Analysis of variance was conducted to examine the association between continuous variables in each activity level and metabolic syndrome components. Logistic models estimated the relationship of quartile of daily minutes of different physical activity levels to odds of metabolic syndrome adjusted for socioeconomic and health factors. Among persons with OA, most were women average age of 62.1 years and average disease duration of 12.9 years. Half of adults with OA had metabolic syndrome (51.0%; 95% confidence interval [95% CI] 44.2%-57.8%), and only 9.6% engaged in the recommended 150 minutes per week of moderate/vigorous physical activity. Total sedentary time was associated with higher rates of metabolic syndrome and its components, while light and objectively measured moderate/vigorous physical activity was inversely associated with metabolic syndrome and its components. Higher levels of light activity were associated with lower prevalence of metabolic syndrome (quartile 4 versus quartile 1: adjusted odds ratio 0.45, 95% CI 0.24-0.84, P for linear trend < 0.005). Most US adults with OA are sedentary. Increased daily minutes in physical activity, especially in light intensity, is more likely to be associated with decreasing prevalence of metabolic syndrome among persons with OA. © 2015, American College of Rheumatology.

  5. Occupational safety and health objectives of Healthy People 2010: a systematic approach for occupational health nurses--Part II.

    PubMed

    Olszewski, Kimberly; Parks, Carol; Chikotas, Noreen E

    2007-03-01

    Occupational safety and health objectives 20.6 through 20.11 focus on reducing work-related assaults, lead exposure, skin diseases and disorders, needlestick injuries, and work-related, noise-induced hearing loss and promoting worksite stress reduction programs. Using the intervention strategies provided, occupational health nurses can play a key role in reducing workplace-related injury, disease, disability, and death. variety of resources pertaining to occupational health and safety from the federal, national, health care, nursing, and environmental realms can assist occupational health nurses in developing and implementing programs appropriate for their workplaces. Through the Healthy People 2010 occupational health and safety objectives, occupational health nurses have the opportunity to develop and implement workplace policies and programs promoting not only a safe and healthy work environment but also improved health and disease prevention. Occupational health nurses can implement strategies to increase quality and years of life and eliminate health disparities in the American work force.

  6. A Survey of Health Management User Objectives Related to Diagnostic and Prognostic Metrics

    NASA Technical Reports Server (NTRS)

    Wheeler, Kevin R.; Kurtoglu, Tolga; Poll, Scott D.

    2010-01-01

    One of the most prominent technical challenges to effective deployment of health management systems is the vast difference in user objectives with respect to engineering development. In this paper, a detailed survey on the objectives of different users of health management systems is presented. These user objectives are then mapped to the metrics typically encountered in the development and testing of two main systems health management functions: diagnosis and prognosis. Using this mapping, the gaps between user goals and the metrics associated with diagnostics and prognostics are identified and presented with a collection of lessons learned from previous studies that include both industrial and military aerospace applications.

  7. Measuring the effect of workplace health promotion interventions on "presenteeism": a potential role for biomarkers.

    PubMed

    Yamamoto, Shelby; Loerbroks, Adrian; Terris, Darcey D

    2009-05-01

    Health promotion activities to improve employee health to reduce health care costs and increase productivity are of particular importance for organizations and society. The evaluation of employee health and health promotion programs has typically focused on absenteeism, disability and increasingly, "presenteeism", which refers to an employee's presence at work with reduced performance due to illness. Existing psychometric measures of presenteeism may be subject to the effects of recall bias as they typically rely on questionnaires. Biomarkers such as heart rate variability and salivary cortisol can provide additional objective measures of illness and stress. Combining such physiologic measures of stress with assessments of presenteeism may offer a more comprehensive way to assess workplace productivity when developing health promotion programs.

  8. [Contamination of health care institutions environmental objects by Legionella pneumophila].

    PubMed

    Shkarin, V V; Blagonravova, A S; Chubukova, O A; Korotaeva, S V

    2011-01-01

    AIM. The extent of environmental objects contamination by Legionella pneumophila in Nizhny Novgorod and Nizhny Novgorod region hospitals evaluation, and detection of potentially hazardous objects. 433 swabs of environmental objects, and 43 hot water supply and pool water samples from various departments of 4 multi-disciplinary hospitals were studies. DNA from environmental samples was detected by using real time PCR. L. pneumophila DNA was detected in 41 (9,47%) samples from environmental objects and in 2 (4,65%) samples from hot water supply. These bacteria were more frequently detected in environmental samples from physiotherapy departments. Repeated detection of legionellae from the same objects was registered. Circulation of legionellae in multidisciplinary hospitals was determined. Circulation high risk departments and risk objects--reservoirs of L. pneumophila in health care institutions were determined.

  9. Association between objectively measured physical activity, chronic stress and leukocyte telomere length.

    PubMed

    von Känel, Roland; Bruwer, Erna J; Hamer, Mark; de Ridder, J Hans; Malan, Leoné

    2017-10-01

    Physical activity (PA) attenuates chronic stress and age-related and cardiovascular disease risks, whereby potentially slowing telomere shortening. We aimed to study the association between seven-day objectively measured habitual PA, chronic stress and leukocyte telomere length. Study participants were African (N.=96) and Caucasian (N.=107) school teachers of the Sympathetic activity and Ambulatory Blood Pressure in Africans study. All lifestyle characteristics (including PA) were objectively measured. The general health questionnaire and serum cortisol were assessed as psychological and physical measures of chronic stress. Leukocyte telomere length was measured using the quantitative real-time polymerase chain reaction. Africans had significantly shorter telomeres (P<.0001) and greater psychological distress (P=0.001) than Caucasians, whereas no group difference was seen for cortisol levels. Higher age (ß=-0.28 [-0.40, -0.16, P≤0.000), higher alcohol consumption (ß=-0.21 [-0.36, -0.08], P=0.003) and increased central obesity (ß=-0.17 [-0.30, -0.03], P=0.017) were all significantly associated with shorter telomeres. Habitual PA of different intensity was not significantly associated with markers of chronic stress or telomere length. However, more time spent with light intensity PA time was significantly and independently correlated with lower waist circumference (r=-0.21, P=0.004); in turn, greater waist circumference was significantly associated shorter telomeres (β=-0.17 [-0.30, -0.03], P=0.017). Habitual PA of different intensity was not directly associated with markers of chronic stress and leukocyte telomere length in this biethnic cohort. However, our findings suggest that light intensity PA could contribute to lowered age-related disease risk and healthy ageing by facilitating maintenance of a normal waist circumference.

  10. Objective Measures of Visual Function in Papilledema

    PubMed Central

    Moss, Heather E.

    2016-01-01

    Synopsis Visual function is an important parameter to consider when managing patients with papilledema. Though the current standard of care uses standard automated perimetry (SAP) to obtain this information, this test is inherently subjective and prone to patient errors. Objective visual function tests including the visual evoked potential, pattern electroretinogram, photopic negative response of the full field electroretinogram, and pupillary light response have the potential to replace or supplement subjective visual function tests in papilledema management. This article reviews the evidence for use of objective visual function tests to assess visual function in papilledema and discusses future investigations needed to develop them as clinically practical and useful measures for this purpose. PMID:28451649

  11. Is self-rated health a valid measure to use in social inequities and health research? Evidence from the PAPFAM women’s data in six Arab countries

    PubMed Central

    2012-01-01

    Introduction Some evidence from high-income countries suggests that self-rated health (SRH) is not a consistent predictor of objective health across social groups, and that its use may lead to inaccurate estimates of the effects of inequities on health. Given increased interest in studying and monitoring social inequities in health worldwide, the aim of the present study was to evaluate the validity of SRH as a consistent measure of health across socioeconomic categories in six Arab countries. Methods We employed the PAPFAM population-based survey data on women from Morocco, Algeria, Tunisia, Lebanon, Syria, and the Occupied Palestinian Territories (OPT). Multivariate logistic regression analyses were performed to assess the strength of the association between fair/poor SRH and objective health (reporting at least one chronic condition), adjusting for available socio-demographic and health-related variables. Analyses were then stratified by two socioeconomic indicators: education and household economic status. Results The association between SRH and objective health is strong in Algeria, Tunisia, Lebanon, Syria, and OPT, but weak in Morocco. The strength of the association between reporting fair/poor health and objective health was not moderated by education or household economic status in any of the six countries. Conclusion As the SRH-objective health association does not vary across social categories, the use of the measure in social inequities in health research is justified. These results should not preclude the need to carry out other validation studies using longitudinal data on men and women, or the need to advocate for improving the quality of morbidity and mortality data in the Arab region. PMID:22985471

  12. Background oriented schlieren measurement of the refractive index field of air induced by a hot, cylindrical measurement object.

    PubMed

    Beermann, Rüdiger; Quentin, Lorenz; Pösch, Andreas; Reithmeier, Eduard; Kästner, Markus

    2017-05-10

    To optically capture the topography of a hot measurement object with high precision, the light deflection by the inhomogeneous refractive index field-induced by the heat transfer from the measurement object to the ambient medium-has to be considered. We used the 2D background oriented schlieren method with illuminated wavelet background, an optical flow algorithm, and Ciddor's equation to quantify the refractive index field located directly above a red-glowing, hot measurement object. A heat transfer simulation has been implemented to verify the magnitude and the shape of the measured refractive index field. Provided that no forced external flow is disturbing the shape of the convective flow originating from the hot object, a laminar flow can be observed directly above the object, resulting in a sharply bounded, inhomogeneous refractive index field.

  13. Maximum human objectively measured pharmacologically stimulated accommodative amplitude.

    PubMed

    Grzybowski, Andrzej; Schachar, Ronald A; Gaca-Wysocka, Magdalena; Schachar, Ira H; Pierscionek, Barbara K

    2018-01-01

    To measure the maximum, objectively measured, accommodative amplitude, produced by pharmacologic stimulation. Thirty-seven healthy subjects were enrolled, with a mean age of 20.2±1.1 years, corrected visual acuity of 20/20, and mean spherical equivalent refraction (SER) =-0.83±1.60 diopters. For each subject, the right pupil was dilated with phenylephrine 10%. After 30 minutes, the pupil was measured, the left eye was patched, and the right eye was autorefracted. Pilocarpine 4% was then instilled in the right eye, followed by phenylephrine. At 45 minutes after the pilocarpine, autorefraction and pupil size were again measured. Mean pupil size pre- and postpilocarpine was 8.0±0.8 mm and 4.4±1.9 mm, respectively. Pre- and postpilocarpine, the mean SER was -0.83±1.60 and -10.55±4.26 diopters, respectively. The mean pilocarpine-induced accommodative amplitude was 9.73±3.64 diopters. Five subjects had accommodative amplitudes ≥14.00 diopters. Accommodative amplitude was not significantly related to baseline SER ( p -value =0.24), pre- or postpilocarpine pupil size ( p -values =0.13 and 0.74), or change in pupil size ( p -value =0.37). Iris color did not statistically significantly affect accommodative amplitude ( p -value =0.83). Following topically applied pilocarpine, the induced objectively measured accommodation in the young eye is greater than or equal to the reported subjectively measured voluntary maximum accommodative amplitude.

  14. e-Labs and Work Objects: Towards Digital Health Economies

    NASA Astrophysics Data System (ADS)

    Ainsworth, John D.; Buchan, Iain E.

    The optimal provision of healthcare and public health services requires the synthesis of evidence from multiple disciplines. It is necessary to understand the genetic, environmental, behavioural and social determinants of disease and health-related states; to balance the effectiveness of interventions with their costs; to ensure the maximum safety and acceptability of interventions; and to provide fair access to care services for given populations. Ever expanding databases of knowledge and local health information, and the ability to employ computationally expensive methods, promises much for decisions to be both supported by best evidence and locally relevant. This promise will, however, not be realised without providing health professionals with the tools to make sense of this information rich environment and to collaborate across disciplines. We propose, as a solution to this problem, the e-Lab and Work Objects model as a sense-making platform for digital health economies - bringing together data, methods and people for timely health intelligence.

  15. If You're Not Measuring, You're Guessing: The Advent of Objective Concussion Assessments.

    PubMed

    Broglio, Steven P; Guskiewicz, Kevin M; Norwig, John

    2017-03-01

    Sport-related concussion remains one of the most complex injuries presented to sports medicine professionals. Although the injury has been recognized since ancient times, the concussion-assessment process has seen significant advances over the last 30 years. This review outlines the addition of objective measures to the clinical evaluation of the concussed athlete, beginning in the 1980s and continuing through the modern age. International and domestic organizations now describe standardized symptom reports, neurostatus and neurocognitive-function evaluations, and postural-control measures as standards of medical care, a significant shift from a short time ago. Despite this progression, much about the injury remains unknown, including new clinical and research-based assessment techniques and how the injury may influence the athlete's cognitive health over the long term.

  16. Research on measurement method of optical camouflage effect of moving object

    NASA Astrophysics Data System (ADS)

    Wang, Juntang; Xu, Weidong; Qu, Yang; Cui, Guangzhen

    2016-10-01

    Camouflage effectiveness measurement as an important part of the camouflage technology, which testing and measuring the camouflage effect of the target and the performance of the camouflage equipment according to the tactical and technical requirements. The camouflage effectiveness measurement of current optical band is mainly aimed at the static target which could not objectively reflect the dynamic camouflage effect of the moving target. This paper synthetical used technology of dynamic object detection and camouflage effect detection, the digital camouflage of the moving object as the research object, the adaptive background update algorithm of Surendra was improved, a method of optical camouflage effect detection using Lab-color space in the detection of moving-object was presented. The binary image of moving object is extracted by this measurement technology, in the sequence diagram, the characteristic parameters such as the degree of dispersion, eccentricity, complexity and moment invariants are constructed to construct the feature vector space. The Euclidean distance of moving target which through digital camouflage was calculated, the results show that the average Euclidean distance of 375 frames was 189.45, which indicated that the degree of dispersion, eccentricity, complexity and moment invariants of the digital camouflage graphics has a great difference with the moving target which not spray digital camouflage. The measurement results showed that the camouflage effect was good. Meanwhile with the performance evaluation module, the correlation coefficient of the dynamic target image range 0.1275 from 0.0035, and presented some ups and down. Under the dynamic condition, the adaptability of target and background was reflected. In view of the existing infrared camouflage technology, the next step, we want to carry out the camouflage effect measurement technology of the moving target based on infrared band.

  17. A Consensus-Based Set of Measures for Oral Health Care.

    PubMed

    Baâdoudi, F; Trescher, A; Duijster, D; Maskrey, N; Gabel, F; van der Heijden, G J M G; Listl, S

    2017-04-01

    Increasingly more responsive and accountable health care systems are demanded, which is characterized by transparency and explicit demonstration of competence by health care providers and the systems in which they work. This study aimed to establish measures of oral health for transparent and explicit reporting of routine data to facilitate more patient-centered and prevention-oriented oral health care. To accomplish this, an intermediate objective was to develop a comprehensive list of topics that a range of stakeholders would perceive as valid, important, and relevant for describing oral health and oral health care. A 4-stage approach was used to develop the list of topics: 1) scoping of literature and its appraisal, 2) a meeting of experts, 3) a 2-stage Delphi process (online), and 4) a World Café discussion. The aim was to create consensus through structured conversations via a range of stakeholders (general dental practitioners, patients, insurers, and policy makers) from the Netherlands, Germany, the United Kingdom, Ireland, Hungary, and Denmark. The study was part of the ADVOCATE project, and it resulted in a list of 48 topics grouped into 6 clusters: 1) access to dental care, 2) symptoms and diagnosis, 3) health behaviors, 4) oral treatments, 5) oral prevention, and 6) patient perception. All topics can be measured, as they all have a data source with defined numerators and denominators. This study is the first to establish a comprehensive and multiple-stakeholder consented topic list designed for guiding the implementation of transparent and explicit measurement of routine data of oral health and oral health care. Successful measurement within oral health care systems is essential to facilitate learning from variation in practice and outcomes within and among systems, and it potentiates improvement toward more patient-centered and prevention-oriented oral health care.

  18. 76 FR 53255 - Responsibility of Applicants for Promoting Objectivity in Research for which Public Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-25

    ... Part 50 45 CFR Part 94 Responsibility of Applicants for Promoting Objectivity in Research for Which...-AA53 Responsibility of Applicants for Promoting Objectivity in Research for which Public Health Service... of Applicants for Promoting Objectivity in Research for which Public Health Service Funding is Sought...

  19. Cross-sectional associations of objectively measured physical activity with brain-derived neurotrophic factor in adolescents.

    PubMed

    Huang, Tao; Gejl, Anne Kær; Tarp, Jakob; Andersen, Lars Bo; Peijs, Lone; Bugge, Anna

    2017-03-15

    The purpose of this study was to examine the associations between objectively measured physical activity and serum brain-derived neurotrophic factor (BDNF) in adolescents. Cross-sectional analyses were performed using data from 415 adolescents who participated in the 2015 follow-up of the Childhood Health Activity and Motor Performance School Study Denmark (the CHAMPS-study DK). Physical activity was objectively measured by accelerometry monitors. Serum BDNF levels were analyzed using the Enzyme-linked immunosorbent assay (ELISA). Anthropometrics and pubertal status were measured using standardized procedures. With adjustment for age, pubertal status and body mass index, mean physical activity (counts per minute) was negatively associated with serum BDNF in boys (P=0.013). Similarly, moderate-to-vigorous physical activity (MVPA) was negatively associated with serum BDNF in boys (P=0.035). In girls, mean physical activity and MVPA were not associated with serum BDNF. Without adjustment for wear time, sedentary time was not associated with serum BDNF in either sex. These findings indicate that higher physical activity is associated with lower serum BDNF in boys, but not in girls. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Process for the reconstruction of three-dimensional images of an area of interest of an object comprising the combination of measurements over the entire object with measurements of an area of interest of said object, and appropriate installation

    DOEpatents

    Azevedo, Stephen; Grangeat, Pierre; Rizo, Philippe

    1995-01-01

    Process and installation making it possible to reconstitute precise images of an area of interest (2) of an object (1) by reducing the errors produced by the contribution of the compliment of the object. A first series of measurements is carried out, where a conical beam (10) only takes in the area of interest of the object (2) and this is followed by a second series of measurements in which the beam takes in the entire object. A combination of the measurements of the two series is carried out in order to make them compatible and obtain a more accurate image of the area of interest (2).

  1. Objective measurement of bread crumb texture

    NASA Astrophysics Data System (ADS)

    Wang, Jian; Coles, Graeme D.

    1995-01-01

    Evaluation of bread crumb texture plays an important role in judging bread quality. This paper discusses the application of image analysis methods to the objective measurement of the visual texture of bread crumb. The application of Fast Fourier Transform and mathematical morphology methods have been discussed by the authors in their previous work, and a commercial bread texture measurement system has been developed. Based on the nature of bread crumb texture, we compare the advantages and disadvantages of the two methods, and a third method based on features derived directly from statistics of edge density in local windows of the bread image. The analysis of various methods and experimental results provides an insight into the characteristics of the bread texture image and interconnection between texture measurement algorithms. The usefulness of the application of general stochastic process modelling of texture is thus revealed; it leads to more reliable and accurate evaluation of bread crumb texture. During the development of these methods, we also gained useful insights into how subjective judges form opinions about bread visual texture. These are discussed here.

  2. Ecosystem health: I. Measuring ecosystem health

    NASA Astrophysics Data System (ADS)

    Schaeffer, David J.; Herricks, Edwin E.; Kerster, Harold W.

    1988-07-01

    Ecosystem analysis has been advanced by an improved understanding of how ecosystems are structured and how they function. Ecology has advanced from an emphasis on natural history to consideration of energetics, the relationships and connections between species, hierarchies, and systems theory. Still, we consider ecosystems as entities with a distinctive character and individual characteristics. Ecosystem maintenance and preservation form the objective of impact analysis, hazard evaluation, and other management or regulation activities. In this article we explore an approach to ecosystem analysis which identifies and quantifies factors which define the condition or state of an ecosystem in terms of health criteria. We relate ecosystem health to human/nonhuman animal health and explore the difficulties of defining ecosystem health and suggest criteria which provide a functional definition of state and condition. We suggest that, as has been found in human/nonhuman animal health studies, disease states can be recognized before disease is of clinical magnitude. Example disease states for ecosystems are functionally defined and discussed, together with test systems for their early detection.

  3. Measuring subjective well-being for policy purposes: The example of well-being indicators in the WHO "Health 2020" framework.

    PubMed

    Vik, Mari Hagtvedt; Carlquist, Erik

    2018-03-01

    This article discusses the rationale for measuring national well-being, and examines the use of subjectively oriented well-being measures in the context of public policy. Recent years have witnessed growing attention towards the concept and measurement of well-being, both within academic disciplines, intergovernmental organizations such as the World Health Organization (WHO) as well as in many governments across Europe, including the Nordic countries. Economic indicators have commonly been regarded as proxies of societal progress of nations, but indicators of well-being have increasingly been applied in order to complement or replace these measures. Well-being indicators of the WHO "Health 2020" framework are critically examined with particular attention given to the subjective aspects of well-being. Literature discussing the rationale for subjective indicators is reviewed. As a background, central theoretical and measurement perspectives on well-being are outlined, including hedonic, eudaimonic and objective list approaches. The WHO refers to well-being in definitions of health and mental health, but has primarily reported on disease. The "Health 2020" framework marked a shift in this concern. One of the main targets of "Health 2020" concerns well-being, involving six core indicators. Only one indicator refers to well-being as subjective experience. Literature supports more extensive use of subjective indicators in combination with objective measures. Although consensus on definitions and instruments is lacking, subjective and objective measures of national well-being may jointly contribute to a more comprehensive understanding of societal progress, as well as a broader conception of health. Further research is required, particularly with regard to eudaimonic indicators.

  4. Performance Measurement and Investment Objectives for Educational Endowment Funds.

    ERIC Educational Resources Information Center

    Williamson, J. Peter

    This book is one of a series of projects developed to increase understanding of the management of educational endowment funds. Specifics of performance measurement and the setting of objectives are emphasized. Part one deals with measurement of the rate of return, or profitability, of an endowment fund. Part two reviews some statistical measures…

  5. Cross-Validation of Mental Health Recovery Measures in a Hong Kong Chinese Sample

    ERIC Educational Resources Information Center

    Ye, Shengquan; Pan, Jia-Yan; Wong, Daniel Fu Keung; Bola, John Robert

    2013-01-01

    Objectives: The concept of recovery has begun shifting mental health service delivery from a medical perspective toward a client-centered recovery orientation. This shift is also beginning in Hong Kong, but its development is hampered by a dearth of available measures in Chinese. Method: This article translates two measures of recovery (mental…

  6. Invoking conscientious objection in reproductive health care: evolving issues in Peru, Mexico and Chile.

    PubMed

    Casas, Lidia

    2009-11-01

    As Latin American countries seek to guarantee sexual and reproductive health and rights, opponents of women's rights and reproductive choice have become more strident in their opposition, and are increasingly claiming conscientious objection to providing these services. Conscientious objection must be seen in the context of the rights and interests at stake, including women's health needs and right to self-determination. An analysis of law and policy on conscientious objection in Peru, Mexico and Chile shows that it is being used to erode women's rights, especially where it is construed to have no limits, as in Peru. Conscientious objection must be distinguished from politically-motivated attempts to undermine the law; otherwise, the still fragile re-democratisation processes underway in Latin America may be placed at risk. True conscientious objection requires that a balance be struck between the rights of the objector and the health rights of patients, in this case women. Health care providers are entitled to their beliefs and to have those beliefs accommodated, but it is neither viable nor ethically acceptable for conscientious objectors to exercise this right without regard for the right to health care of others, or for policy and services to be rendered ineffectual because of individual objectors.

  7. A comprehensive review of the Healthy People 2020 Occupational Safety And Health Objectives: Part 1. Tools for the occupational health nurse in goal attainment.

    PubMed

    Parks, Carol I; Chikotas, Noreen E; Olszewski, Kimberly

    2012-01-01

    This is the first part of a two-part series introducing Healthy People 2020 and the foundational categories that are linked to overarching goals and corresponding measures for progress within the Healthy People 2020 initiative. The two articles together will review the 10 objectives for occupational safety and health within the American workplace, provide a resource guide for occupational health nurses, and discuss MAP-IT, the suggested implementation format to reach the Healthy People 2020 goals. The articles are intended to inform occupational health nurses about the current agenda for safety and health of the U.S. work force as articulated in Healthy People 2020 and provide a foundation for better understanding the requirements of a safe work environment in 2020 and beyond. Copyright 2012, SLACK Incorporated.

  8. A comprehensive review of the healthy people 2020 occupational safety and health objectives: part 2. Tools for the occupational health nurse in goal attainment.

    PubMed

    Chikotas, Noreen E; Parks, Carol I; Olszewski, Kimberly

    2012-02-01

    This is the second part of a two-part series introducing Healthy People 2020 and the foundational categories that are linked to overarching goals and corresponding measures of progress within the Healthy People 2020 initiative. The two articles together review the 10 objectives for occupational safety and health within the American workplace, provide a resource guide for occupational health nurses, and discuss MAP-IT, the suggested implementation format to reach the Healthy People 2020 goals. The articles are intended to inform occupational health nurses about the current agenda for safety and health of the U.S. work force as articulated in Healthy People 2020 and provide a foundation for better understanding the requirements of a safe work environment in 2020 and beyond. Copyright 2012, SLACK Incorporated.

  9. Neighbourhood crime and smoking: the role of objective and perceived crime measures

    PubMed Central

    2011-01-01

    Background Smoking is a major public health problem worldwide. Research has shown that neighbourhood of residence is independently associated with the likelihood of individuals' smoking. However, a fine comprehension of which neighbourhood characteristics are involved and how remains limited. In this study we examine the relative contribution of objective (police-recorded) and subjective (resident-perceived) measures of neighbourhood crime on residents' smoking behaviours. Methods Data from 2,418 men and women participating in the 2007/8 sweep of the West of Scotland Twenty-07 Study were analyzed. Smoking status and perceived crime were collected through face-to-face interviews with participants. Police-recorded crime rates were obtained from the Scottish Neighbourhood Statistics website at the datazone scale. Adjusted odds ratios and 95% confidence intervals were estimated for the likelihood of current smoking using logistic regression models. Adjusted mean daily amount smoked and F statistics were calculated using general linear models. Analyses were conducted for all respondents and stratified by sex and age cohort. Results Compared to individuals living in low crime areas, those residing in an area characterized by high police-recorded crime rates or those perceiving high crime in their neighbourhood were more likely to be current smokers, after controlling for individual characteristics. The association with smoking was somewhat stronger for police-recorded crime than for perceived crime. Associations were only slightly attenuated when adjusting for either the objective or subjective crime measures, suggesting that these indicators may exert an independent influence on the risk of smoking. Stronger effects were observed for women compared to men. Police-recorded crime rates were more strongly related to smoking status among older respondents than among the younger cohort, whereas the strongest effect for perceived crime was observed among younger participants

  10. Development of the Digital Health Literacy Instrument: Measuring a Broad Spectrum of Health 1.0 and Health 2.0 Skills

    PubMed Central

    van der Vaart, Rosalie

    2017-01-01

    Background With the digitization of health care and the wide availability of Web-based applications, a broad set of skills is essential to properly use such facilities; these skills are called digital health literacy or eHealth literacy. Current instruments to measure digital health literacy focus only on information gathering (Health 1.0 skills) and do not pay attention to interactivity on the Web (Health 2.0). To measure the complete spectrum of Health 1.0 and Health 2.0 skills, including actual competencies, we developed a new instrument. The Digital Health Literacy Instrument (DHLI) measures operational skills, navigation skills, information searching, evaluating reliability, determining relevance, adding self-generated content, and protecting privacy. Objective Our objective was to study the distributional properties, reliability, content validity, and construct validity of the DHLI’s self-report scale (21 items) and to explore the feasibility of an additional set of performance-based items (7 items). Methods We used a paper-and-pencil survey among a sample of the general Dutch population, stratified by age, sex, and educational level (T1; N=200). The survey consisted of the DHLI, sociodemographics, Internet use, health status, health literacy and the eHealth Literacy Scale (eHEALS). After 2 weeks, we asked participants to complete the DHLI again (T2; n=67). Cronbach alpha and intraclass correlation analysis between T1 and T2 were used to investigate reliability. Principal component analysis was performed to determine content validity. Correlation analyses were used to determine the construct validity. Results Respondents (107 female and 93 male) ranged in age from 18 to 84 years (mean 46.4, SD 19.0); 23.0% (46/200) had a lower educational level. Internal consistencies of the total scale (alpha=.87) and the subscales (alpha range .70-.89) were satisfactory, except for protecting privacy (alpha=.57). Distributional properties showed an approximately normal

  11. Reach and Validity of an Objective Medication Adherence Measure Among Safety Net Health Plan Members with Diabetes: A Cross-Sectional Study.

    PubMed

    Ratanawongsa, Neda; Karter, Andrew J; Quan, Judy; Parker, Melissa M; Handley, Margaret; Sarkar, Urmimala; Schmittdiel, Julie A; Schillinger, Dean

    2015-08-01

    With the expansion of Medicaid and low-cost health insurance plans among diverse patient populations, objective measures of medication adherence using pharmacy claims could advance clinical care and translational research for safety net care. However, safety net patients may experience fluctuating prescription drug coverage, affecting the performance of adherence measures. To evaluate the performance of continuous medication gap (CMG) for diverse, low-income managed care members with diabetes. We conducted this cross-sectional analysis using administrative and clinical data for 680 members eligible for a self-management support trial at a nonprofit, government-sponsored managed care plan. We applied CMG methodology to cardiometabolic medication claims for English- , Cantonese- , or Spanish-speaking members with diabetes. We examined inclusiveness (the proportion with calculable CMG) and selectivity (sociodemographic and medical differences from members without CMG). For validity, we examined unadjusted associations of suboptimal adherence (CMG >  20%) with suboptimal cardiometabolic control. 429 members (63%) had calculable CMG. Compared with members without CMG, members with CMG were younger, more likely employed, and had poorer glycemic control but had better blood pressure and lipid control. Suboptimal adherence occurred more frequently among members with poor cardiometabolic control than among members with optimal control (28% vs. 12%, P = 0.02). CMG demonstrated acceptable inclusiveness and validity in a diverse, low-income safety net population, comparable with its performance in studies among other insured populations. CMG may provide a useful tool to measure adherence among increasingly diverse Medicaid populations, complemented by other strategies to reach those not captured by CMG.

  12. Communication in Health Professions: A European consensus on inter- and multi-professional learning objectives in German.

    PubMed

    Bachmann, Cadja; Kiessling, Claudia; Härtl, Anja; Haak, Rainer

    2016-01-01

    Communication is object of increasing attention in the health professions. Teaching communication competencies should already begin in undergraduate education or pre-registration training. The aim of this project was to translate the Health Professions Core Communication Curriculum (HPCCC), an English catalogue of learning objectives, into German to make its content widely accessible in the German-speaking countries. This catalogue lists 61 educational objectives and was agreed on by 121 international communication experts. A European reference framework for inter- and multi-professional curriculum development for communication in the health professions in German-speaking countries should be provided. The German version of the HPCCC was drafted by six academics and went through multiple revisions until consensus was reached. The learning objectives were paired with appropriate teaching and assessment tools drawn from the database of the teaching Committee of the European Association for Communication Health Care (tEACH). The HPCCC learning objectives are now available in German and can be applied for curriculum planning and development in the different German-speaking health professions, the educational objectives can also be used for inter-professional purposes. Examples for teaching methods and assessment tools are given for using and implementing the objectives. The German version of the HPCCC with learning objectives for communication in health professions can contribute significantly to inter- and multi-professional curriculum development in the health care professions in the German-speaking countries. Examples for teaching methods and assessment tools from the materials compiled by tEACH supplement the curricular content and provide suggestions for practical implementation of the learning objectives in teaching and assessment. The relevance of the German HPCCC to the processes of curriculum development for the various health professions and inter

  13. Implementing and using quality measures for children's health care: perspectives on the state of the practice.

    PubMed

    Shaller, Dale

    2004-01-01

    The objective of this study was to identify issues, obstacles, and priorities related to implementing and using child health care quality measures from the perspectives of 4 groups: 1) funders of quality-measurement development and implementation; 2) developers of quality measures; 3) users of quality measures (including Medicaid and the State Children's Health Insurance Program, employer coalitions, and consumer groups); and 4) health plans and providers (in their role as both subjects and users of quality measures). A series of semistructured interviews was conducted with approximately 40 opinion leaders drawn from these 4 groups. The interviews were conducted by telephone between September and December of 2001. Major topic areas covered in the interviews were similar across the groups. Topic areas included 1) strategic vision and/or objectives for funding, developing, or using quality measures for children's health care; 2) a brief summary of the specific quality measures funded, developed, or used; 3) issues and challenges facing funders and developers of measures; 4) major successes achieved; 5) obstacles to implementation and use of measures; and 6) priority needs for future funding. Leaders from all 4 groups acknowledge the importance of developing a robust set of quality measures that can serve multiple objectives and multiple audiences. Standardization of measures is viewed as a critical feature related to all objectives. An assessment of specific quality measures funded, developed, or used by strategic objective shows a high correlation between the uses intended by funders and developers and the actual applications of the various users. The most commonly cited measures across all groups are the Consumer Assessment of Health Plans Survey and Health Plan Employer Data and Information Set, followed by the Child and Adolescent Health Measurement Initiative and special topic studies to support quality-improvement applications (eg, asthma, diabetes, etc). The

  14. Application of an IRT Polytomous Model for Measuring Health Related Quality of Life

    ERIC Educational Resources Information Center

    Tejada, Antonio J. Rojas; Rojas, Oscar M. Lozano

    2005-01-01

    Background: The Item Response Theory (IRT) has advantages for measuring Health Related Quality of Life (HRQOL) as opposed to the Classical Tests Theory (CTT). Objectives: To present the results of the application of a polytomous model based on IRT, specifically, the Rating Scale Model (RSM), to measure HRQOL with the EORTC QLQ-C30. Methods: 103…

  15. Theory-Guided Selection of Discrimination Measures for Racial/Ethnic Health Disparities Research among Older Adults

    PubMed Central

    Thrasher, Angela D.; Clay, Olivio J.; Ford, Chandra L.; Stewart, Anita L.

    2013-01-01

    Objectives Discrimination may contribute to health disparities among older adults. Existing measures of perceived discrimination have provided important insights but may have limitations when used in studies of older adults. This paper illustrates the process of assessing the appropriateness of existing measures for theory-based research on perceived discrimination and health. Methods First we describe three theoretical frameworks that are relevant to the study of perceived discrimination and health – stress-process models, life course models, and the Public Health Critical Race praxis. We then review four widely-used measures of discrimination, comparing their content and describing how well they address key aspects of each theory, and discussing potential areas of modification. Discussion Using theory to guide measure selection can help improve understanding of how perceived discrimination may contribute to racial/ethnic health disparities among older adults. PMID:22451527

  16. The Objective Assessment of Cough Frequency in Bronchiectasis.

    PubMed

    Spinou, Arietta; Lee, Kai K; Sinha, Aish; Elston, Caroline; Loebinger, Michael R; Wilson, Robert; Chung, Kian Fan; Yousaf, Nadia; Pavord, Ian D; Matos, Sergio; Garrod, Rachel; Birring, Surinder S

    2017-10-01

    Cough in bronchiectasis is associated with significant impairment in health status. This study aimed to quantify cough frequency objectively with a cough monitor and investigate its relationship with health status. A secondary aim was to identify clinical predictors of cough frequency. Fifty-four patients with bronchiectasis were compared with thirty-five healthy controls. Objective 24-h cough, health status (cough-specific: Leicester Cough Questionnaire LCQ and bronchiectasis specific: Bronchiectasis Health Questionnaire BHQ), cough severity and lung function were measured. The clinical predictors of cough frequency in bronchiectasis were determined in a multivariate analysis. Objective cough frequency was significantly raised in patients with bronchiectasis compared to healthy controls [geometric mean (standard deviation)] 184.5 (4.0) vs. 20.6 (3.2) coughs/24-h; mean fold-difference (95% confidence interval) 8.9 (5.2, 15.2); p < 0.001 and they had impaired health status. There was a significant correlation between objective cough frequency and subjective measures; LCQ r = -0.52 and BHQ r = -0.62, both p < 0.001. Sputum production, exacerbations (between past 2 weeks to 12 months) and age were significantly associated with objective cough frequency in multivariate analysis, explaining 52% of the variance (p < 0.001). There was no statistically significant association between cough frequency and lung function. Cough is a common and significant symptom in patients with bronchiectasis. Sputum production, exacerbations and age, but not lung function, were independent predictors of cough frequency. Ambulatory objective cough monitoring provides novel insights and should be further investigated as an outcome measure in bronchiectasis.

  17. Active Transportation to and on Campus is Associated With Objectively Measured Fitness Outcomes Among College Students.

    PubMed

    Bopp, Melissa; Bopp, Christopher; Schuchert, Megan

    2015-03-01

    Active transportation (AT) has been associated with positive health outcomes, yet limited research has addressed this with college students, a population at-risk for inactivity. The purpose of this study was to examine the relationship between AT behavior and objectively measured fitness outcomes. A volunteer, convenience sample (n = 299) of college students from a large northeastern university completed a survey about their AT habits to and on campus and psychosocial constructs related to AT and participated in a laboratory-based fitness assessment (cardiovascular endurance, muscular strength and endurance, flexibility, body composition).Off-campus students were dichotomized as nonactive (0-1 AT trips/day) or active travelers (> 1 AT trips/day) to campus; t-tests compared nonactive and active travelers for psychosocial and fitness variables. Students were 56.3% male, 79.2% non-Hispanic White, and primarily living off-campus (87%). Most students (n = 177, 59.2%) reported active travel between classes. Off-campus students were primarily active travelers (76.1%). Active travelers to campus had greater cardiovascular fitness (P = .005), were more flexible (P = .006) and had lower systolic blood pressure (P = .05) compared with nonactive travelers. This study documents a relationship between AT behavior and objectively measured fitness among college students and provides a rationale for targeting this behavior as a method for improving health outcomes.

  18. Measuring virtues--development of a scale to measure employee virtues and their influence on health.

    PubMed

    Wärnå-Furu, Carola; Sääksjärvi, Maria; Santavirta, Nina

    2010-12-01

    The objectives of this article are to present a measurement instrument for virtues, and to examine the link between virtues and health. The instrument was tested by the occupational health care at a large Finnish pulp and paper manufacturer and was shown to be consistent, valid and reliable. In developing the scale, we had two samples of employees and used factor analysis and partial least squares modelling (PLS) on both samples. Factor analysis showed that pride is the most important virtue, followed by love and generosity. In the PLS analysis, we found virtues to significantly reduce the number of sick days. In addition, we found significant relationships between virtues and fatigue, depression and happiness. Virtuous behaviour decreased sick leave and depression. The virtues had a positive influence on happiness and on improvement in one's health. The results show that by taking into account virtues in working life, companies can significantly improve their employees' well-being. The measurement instrument helps broaden the traditional view on health and is meant to be used by health care professionals in their daily practice. By addressing a person's physical, mental and virtual well-being, health care practitioners can take care of employees on a broader level than before. © 2010 The Authors. Journal compilation © 2010 Nordic College of Caring Science.

  19. The beam stop array method to measure object scatter in digital breast tomosynthesis

    NASA Astrophysics Data System (ADS)

    Lee, Haeng-hwa; Kim, Ye-seul; Park, Hye-Suk; Kim, Hee-Joung; Choi, Jae-Gu; Choi, Young-Wook

    2014-03-01

    Scattered radiation is inevitably generated in the object. The distribution of the scattered radiation is influenced by object thickness, filed size, object-to-detector distance, and primary energy. One of the investigations to measure scatter intensities involves measuring the signal detected under the shadow of the lead discs of a beam-stop array (BSA). The measured scatter by BSA includes not only the scattered radiation within the object (object scatter), but also the external scatter source. The components of external scatter source include the X-ray tube, detector, collimator, x-ray filter, and BSA. Excluding background scattered radiation can be applied to different scanner geometry by simple parameter adjustments without prior knowledge of the scanned object. In this study, a method using BSA to differentiate scatter in phantom (object scatter) from external background was used. Furthermore, this method was applied to BSA algorithm to correct the object scatter. In order to confirm background scattered radiation, we obtained the scatter profiles and scatter fraction (SF) profiles in the directions perpendicular to the chest wall edge (CWE) with and without scattering material. The scatter profiles with and without the scattering material were similar in the region between 127 mm and 228 mm from chest wall. This result indicated that the measured scatter by BSA included background scatter. Moreover, the BSA algorithm with the proposed method could correct the object scatter because the total radiation profiles of object scatter correction corresponded to original image in the region between 127 mm and 228 mm from chest wall. As a result, the BSA method to measure object scatter could be used to remove background scatter. This method could apply for different scanner geometry after background scatter correction. In conclusion, the BSA algorithm with the proposed method is effective to correct object scatter.

  20. Objectively measured physical activity has a negative but weak association with academic performance in children and adolescents.

    PubMed

    Esteban-Cornejo, Irene; Tejero-González, Carlos M; Martinez-Gomez, David; Cabanas-Sánchez, Verónica; Fernández-Santos, Jorge R; Conde-Caveda, Julio; Sallis, James F; Veiga, Oscar L

    2014-11-01

    There is an emerging body of evidence on the potential effects of regular physical activity on academic performance. The aim of this study was to add to the debate, by examining the association between objectively measured physical activity and academic performance in a relatively large sample of children and adolescents. The Spanish UP & DOWN study is a 3-year longitudinal study designed to assess the impact, overtime, of physical activity and sedentary behaviours on health indicators. This present analysis was conducted with 1778 children and adolescents aged 6-18 years. Physical activity was objectively measured by accelerometry. Academic performance was assessed using school grades. Physical activity was inversely associated with all academic performance indicators after adjustment for potential confounders, including neonatal variables, fatness and fitness (all p < 0.05). This association became nonsignificant among quartiles of physical activity. There were only slight differences in academic performance between the lowest and the second quartile of physical activity, compared to the highest quartile, with very small effect size (d < 0.20). Objectively measured physical activity may influence academic performance during both childhood and adolescence, but this association was negative and very weak. Longitudinal and intervention studies are necessary to further our understanding. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  1. Consumer Education--Home Economics. Performance Objectives. Criterion Measures. Home Economics.

    ERIC Educational Resources Information Center

    Duval County School Board, Jacksonville, FL.

    Several intermediate performance objectives and corresponding criterion measures are listed for each of six terminal objectives for an 18-week consumer education-home economics course for 10th, 11th, and 12th grade students. Purposes listed for the course are to develop an understanding of the American market system, and how the individual affects…

  2. Domain-Specific Self-Reported and Objectively Measured Physical Activity in Children.

    PubMed

    Sprengeler, Ole; Wirsik, Norman; Hebestreit, Antje; Herrmann, Diana; Ahrens, Wolfgang

    2017-03-01

    Little is known about the extent that different domains contribute to total sedentary (SED), light (LPA) and moderate-to-vigorous physical activity (MVPA). We aimed to identify domain-specific physical activity (PA) patterns in school-aged children who were assessed by questionnaire and accelerometry. For the study, 298 German school children and adolescents aged 6-17 years wore an accelerometer for one week and completed a PA recall-questionnaire for the same period. Spearman coefficients (r) were used to evaluate the agreement between self-reported and objectively measured PA in five domains (transport, school hours, physical education, leisure-time, organized sports activities). School hours mainly contributed to the total objectively measured SED, LPA and MVPA (55%, 53% and 46%, respectively), whilst sports activities contributed only 24% to total MVPA. Compared to accelerometry, the proportion of self-reported LPA and MVPA during school hours was substantially underestimated but overestimated during leisure-time. The agreement of self-reported and objectively measured PA was low for total LPA (r = 0.09, 95% CI (confidence interval): -0.03-0.20) and total MVPA (r = 0.21, 95% CI: 0.10-0.32), while moderate agreement was only found for total SED (r = 0.44, 95% CI: 0.34-0.53), LPA during transport (r = 0.59; 95% CI: 0.49-0.67) and MVPA during organized sports activities (r = 0.54; 95% CI: 0.38-0.67). Since school hours mainly contribute to total SED, LPA and MVPA and self-reported LPA and MVPA during school were importantly underestimated compared to objectively measured LPA and MVPA, the application of objective measurements is compulsory to characterize the entire activity pattern of school-aged children.

  3. Measurement issues in research on social support and health.

    PubMed Central

    Dean, K; Holst, E; Kreiner, S; Schoenborn, C; Wilson, R

    1994-01-01

    STUDY OBJECTIVE--The aims were: (1) to identify methodological problems that may explain the inconsistencies and contradictions in the research evidence on social support and health, and (2) to validate a frequently used measure of social support in order to determine whether or not it could be used in multivariate analyses of population data in research on social support and health. DESIGN AND METHODS--Secondary analysis of data collected in a cross sectional survey of a multistage cluster sample of the population of the United States, designed to study relationships in behavioural, social support and health variables. Statistical models based on item response theory and graph theory were used to validate the measure of social support to be used in subsequent analyses. PARTICIPANTS--Data on 1755 men and women aged 20 to 64 years were available for the scale validation. RESULTS--Massive evidence of item bias was found for all items of a group membership subscale. The most serious problems were found in relationship to an item measuring membership in work related groups. Using that item in the social network scale in multivariate analyses would distort findings on the statistical effects of education, employment status, and household income. Evidence of item bias was also found for a sociability subscale. When marital status was included to create what is called an intimate contacts subscale, the confounding grew worse. CONCLUSIONS--The composite measure of social network is not valid and would seriously distort the findings of analyses attempting to study relationships between the index and other variables. The findings show that valid measurement is a methodological issue that must be addressed in scientific research on population health. PMID:8189179

  4. Correlational Analysis of Objective and Subjective Measures of Cataract Quantification.

    PubMed

    Cochener, Béatrice; Patel, Sunni R; Galliot, Florence

    2016-02-01

    To evaluate whether correlations exist between objective and subjective measures of vision quality as a consequence of cataract and whether this may qualify the Objective Scatter Index as a supplementary means of cataract assessment. A prospective multicenter, cross-sectional study was conducted in 10 centers across France in patients undergoing cataract extraction surgery (lens opacity evaluated with the Lens Opacities Classification System III). A quality of life assessment using the Visual Function Index-14 (VF-14) (14 questions scored from 0 to 4) and measurement of visual acuity and evaluation of the Objective Scatter Index (HD Analyzer, Visiometrics SL, Terrassa, Spain) to assess the alteration of light scatter were used as measures in the study. The study included 1,768 eyes of 1,768 patients (mean age: 72.5 years; range: 28 to 93 years). The average OSI score was 4.97 ± 3.13 (range: 0.4 to 20.5). There was good correlation between visual acuity and OSI (r = -0.47, P < .001) and between OSI and VF-14 (r = -0.11, P < .001). The results presented in this study confirm that the Objective Scatter Index has sufficient correlations with visual acuity and VF-14 to supplement existing cataract diagnosis in a large population encompassing a broad spectrum of cataract presentations. Copyright 2016, SLACK Incorporated.

  5. The construction of learning objects on communicable diseases for community health agents.

    PubMed

    Pacheco, Kátia Cilene Ferreira; Azambuja, Marcelo Schenk de; Bonamigo, Andrea Wander

    2018-06-07

    To describe the creation of a learning object about communicable diseases and their identification, monitoring, and prevention for community health agents. The qualitative, exploratory, case study conducted in the North District Management Zone - Baltazar of the Universidade Federal de Ciências da Saúde de Porto Alegre, from October to January 2015 2016. The study had 58 participants and consisted of the stages field research, Bardin's content analysis, and design of the learning object. The profile of the professionals working in the location was established. These agents identified the most commonly found diseases and stressed their needs in relation to a technological resource. The identified needs were considered to define the content and structure the learning object. The learning object is an alternative method for sharing knowledge on communicable diseases. The tool allows the combination of technology with teaching, which makes the learning process and the work of the community health agents more rewarding and productive.

  6. Relationship Between Objectively Measured Physical Activity, Cardiovascular Disease Biomarkers, and Hearing Sensitivity Using Data From the National Health and Nutrition Examination Survey 2003-2006.

    PubMed

    Loprinzi, Paul D; Joyner, Chelsea

    2017-06-13

    Limited research has examined the interrelationships among cardiometabolic parameters, physical activity, and hearing function, which was this study's purpose. Data from the National Health and Nutrition Examination Survey (NHANES) 2003-2006 were used in the path analyses. Physical activity and hearing function were both objectively measured. Various cardiometabolic parameters were assessed from a blood sample. Adults 30-85 years (N = 1,070) constituted the analytic sample. Physical activity was negatively associated with triglycerides (β = -0.11, p < .05) and insulin (β = -0.27, p < .05); triglycerides (β = 0.01, p < .05), and insulin (β = 0.05, p < .05) were positively associated with high-frequency pure-tone average (HPTA). The direct path from physical activity to HPTA was nonsignificant (β = 0.01, p = .99). Physical activity was associated with select cardiovascular disease risk factors. Several cardiovascular disease risk factors were associated with hearing function.

  7. Creating and validating GIS measures of urban design for health research.

    PubMed

    Purciel, Marnie; Neckerman, Kathryn M; Lovasi, Gina S; Quinn, James W; Weiss, Christopher; Bader, Michael D M; Ewing, Reid; Rundle, Andrew

    2009-12-01

    Studies relating urban design to health have been impeded by the unfeasibility of conducting field observations across large areas and the lack of validated objective measures of urban design. This study describes measures for five dimensions of urban design - imageability, enclosure, human scale, transparency, and complexity - created using public geographic information systems (GIS) data from the US Census and city and state government. GIS measures were validated for a sample of 588 New York City block faces using a well-documented field observation protocol. Correlations between GIS and observed measures ranged from 0.28 to 0.89. Results show valid urban design measures can be constructed from digital sources.

  8. Using Actigraphy and mHealth Systems for an Objective Analysis of Sleep Quality on Systemic Lupus Erythematosus Patients.

    PubMed

    Balderas-Díaz, Sara; Martínez, M Pilar; Guerrero-Contreras, Gabriel; Miró, Elena; Benghazi, Kawtar; Sánchez, Ana I; Garrido, José Luis; Prados, Germán

    2017-03-23

    , actigraphy measures, and variables related to environmental conditions are analysed with Spearman's rank correlation coefficient. The SLE group showed poorer sleep quality, and more pain intensity, fatigue and depression than the healthy controls. Significant differences between SLE women and healthy controls in measures of actigraphy were not found. However, the fusion of the measures of the environmental conditions that were collected by the mobile system and actigraphy, has shown that light, and more specifically temperature have a direct relation with several measures of actigraphy which are related to sleep quality. It should be emphasize this result because usually the sleep problems are assessment through self-reported measures which had not revealed this association. Moreover, there are no previous studies that analyse these aspects in bedroom environments of SLE patients directly from objective measures. The results indicate the need to complement the subjective evaluation of sleep with objective measures. The use of actigraphy in combination with a new mHealth system provides a complete assessment especially relevant to chronic conditions as SLE. Both systems incorporate this objective information directly from objective measures in a non-intrusive way. Moreover, the measures of bedroom environmental variables provide useful and relevant clinical information to assess what is happening daily and not occasionally. This could lead to more customized interventions and adapt the treatment to each individual.

  9. [Reviewing the shared strategy health bill: further measures to meet the structural challenges of the health system].

    PubMed

    Lombrail, Pierre

    2014-01-01

    This article reviews the draft health bill entitled "Federate health professionals around a shared strategy", currently submitted for consultation in the context of the national health strategy in France. This bill comprises innovative measures for prevention and health care in France. In particular, it is designed to develop, strengthen and structure the prevention sector, especially in children and young people. It is also designed to organize health care trajectories and acquire the necessary tools to promote their development. However, the bill sometimes presents limited ambitions in terms of objectives and means. In particular, the project comprises almost none of the necessary actions on the social determinants of health. Overall, the orientations of this bill represent a first major step towards a health policy in France beyond the field of health care. However, we must remain vigilant concerning application of these orientations in the process of elaboration of the bill and its related regulations, and implementation of the national health strategy.

  10. Perceived and Objective Measures of Neighborhood Environment for Physical Activity Among Mexican Adults, 2011

    PubMed Central

    Salvo, Deborah; Lamadrid-Figueroa, Héctor; Hernández, Bernardo; Rivera-Dommarco, Juan A.; Pratt, Michael

    2016-01-01

    Introduction Environmental supports for physical activity may help residents to be physically active. However, such supports might not help if residents’ perceptions of the built environment do not correspond with objective measures. We assessed the associations between objective and perceived measures of the built environment among adults in Cuernavaca, Mexico, and examined whether certain variables modified this relationship. Methods We conducted a population-based (n = 645) study in 2011 that used objective (based on geographic information systems) and perceived (by questionnaire) measures of the following features of the built environment: residential density, mixed-land use, intersection density, and proximity to parks and transit stops. We used linear regression to assess the adjusted associations between these measures and to identify variables modifying these relationships. Results Adjusted associations were significant for all features (P < .05) except intersection density and proximity to transit stops. Significantly stronger associations between perceived and objective measures were observed among participants with low socioeconomic status, participants who did not own a motor vehicle or did not meet physical activity recommendations, and participants perceiving parks as safe. Conclusion Perceived measures of residential density, mixed-land use, and proximity to parks are associated with objective environmental measures related to physical activity. However, in Mexico, it should not be assumed that perceived measures of intersection density and proximity to transit stops are the same as objective measures. Our results are consistent with those from high-income countries in that associations between perceived and objective measures are modified by individual sociodemographic and psychosocial factors. PMID:27281391

  11. Domain-Specific Self-Reported and Objectively Measured Physical Activity in Children

    PubMed Central

    Sprengeler, Ole; Wirsik, Norman; Hebestreit, Antje; Herrmann, Diana; Ahrens, Wolfgang

    2017-01-01

    Little is known about the extent that different domains contribute to total sedentary (SED), light (LPA) and moderate-to-vigorous physical activity (MVPA). We aimed to identify domain-specific physical activity (PA) patterns in school-aged children who were assessed by questionnaire and accelerometry. For the study, 298 German school children and adolescents aged 6–17 years wore an accelerometer for one week and completed a PA recall-questionnaire for the same period. Spearman coefficients (r) were used to evaluate the agreement between self-reported and objectively measured PA in five domains (transport, school hours, physical education, leisure-time, organized sports activities). School hours mainly contributed to the total objectively measured SED, LPA and MVPA (55%, 53% and 46%, respectively), whilst sports activities contributed only 24% to total MVPA. Compared to accelerometry, the proportion of self-reported LPA and MVPA during school hours was substantially underestimated but overestimated during leisure-time. The agreement of self-reported and objectively measured PA was low for total LPA (r = 0.09, 95% CI (confidence interval): −0.03–0.20) and total MVPA (r = 0.21, 95% CI: 0.10–0.32), while moderate agreement was only found for total SED (r = 0.44, 95% CI: 0.34–0.53), LPA during transport (r = 0.59; 95% CI: 0.49–0.67) and MVPA during organized sports activities (r = 0.54; 95% CI: 0.38–0.67). Since school hours mainly contribute to total SED, LPA and MVPA and self-reported LPA and MVPA during school were importantly underestimated compared to objectively measured LPA and MVPA, the application of objective measurements is compulsory to characterize the entire activity pattern of school-aged children. PMID:28257046

  12. Speckle interferometry with temporal phase evaluation for measuring large-object deformation.

    PubMed

    Joenathan, C; Franze, B; Haible, P; Tiziani, H J

    1998-05-01

    We propose a new method for measuring large-object deformations byusing temporal evolution of the speckles in speckleinterferometry. The principle of the method is that by deformingthe object continuously, one obtains fluctuations in the intensity ofthe speckle. A large number of frames of the object motion arecollected to be analyzed later. The phase data for whole-objectdeformation are then retrieved by inverse Fourier transformation of afiltered spectrum obtained by Fourier transformation of thesignal. With this method one is capable of measuring deformationsof more than 100 mum, which is not possible using conventionalelectronic speckle pattern interferometry. We discuss theunderlying principle of the method and the results of theexperiments. Some nondestructive testing results are alsopresented.

  13. Female reproductive factors are associated with objectively measured physical activity in middle-aged women

    PubMed Central

    Kulmala, Janne; Aukee, Pauliina; Hakonen, Harto; Kujala, Urho M.; Lowe, Dawn A.; Kovanen, Vuokko; Tammelin, Tuija; Sipilä, Sarianna

    2017-01-01

    Physical activity improves health and may delay the onset of several chronic diseases. For women in particular, the rate of these diseases accelerates at middle age; therefore it is important to identify the determinants of health-enhancing physical activity during midlife in this population. In this study, we focused on determinants that are unique to the female sex, such as childbearing and menopause. The main objective was to characterize the level of physical activity and differences between active and inactive middle-aged Finnish women. In addition, we examined the association of physical activity with female reproductive factors at midlife. The study population consisted of 647 women aged 48 to 55 years who participated in our Estrogenic Regulation of Muscle Apoptosis (ERMA) study during the period from 2015 to 2016. Physical activity was measured objectively using hip-worn accelerometers for seven consecutive days. The outcome measures included the amounts of light intensity physical activity and moderate to vigorous intensity physical activity accumulated in bouts of at least 10 minutes (MVPA10). MVPA10 was used to determine whether women were placed in the active (≥150 min/week) or inactive (<150 min/week) group. Multiple linear regression models were performed with physical activity measures as dependent variables and cumulative reproductive history index, menopausal symptoms, and pelvic floor dysfunction as independent variables. We found that a large portion (61%) of Finnish middle-aged women did not meet the physical activity recommendations of 150 minutes of MVPA10 per week. In the studied cohort, 78% of women experienced menopausal symptoms, and 54% exhibited pelvic floor dysfunction. Perceived menopausal symptoms were associated with greater light physical activity. Perceived pelvic floor dysfunction was associated with lower MVPA10. According to the fully adjusted multiple linear regression models, reproductive factors explained 6.0% of the

  14. Anthrax vaccination in the Millennium Cohort: validation and measures of health.

    PubMed

    Smith, Besa; Leard, Cynthia A; Smith, Tyler C; Reed, Robert J; Ryan, Margaret A K

    2007-04-01

    In 1998, the United States Department of Defense initiated the Anthrax Vaccine Immunization Program. Concerns about vaccine-related adverse health effects followed, prompting several studies. Although some studies used self-reported vaccination data, the reliability of such data has not been established. The purpose of this study was to compare self-reported anthrax vaccination to electronic vaccine records among a large military cohort and to evaluate the relationship between vaccine history and health outcome data. Between September 2005 and February 2006 self-reported anthrax vaccination was compared to electronic records for 67,018 participants enrolled in the Millennium Cohort Study between 2001 and 2003 using kappa statistics. Multivariable modeling investigated vaccination concordance as it pertains to subjective health (functional status) and objective health (hospitalization) metrics. Greater than substantial agreement (kappa=0.80) was found between self-report and electronic recording of anthrax vaccination. Of all participants with electronic documentation of anthrax vaccination, 98% self-reported being vaccinated; and of all participants with no electronic record of vaccination, 90% self-reported not receiving a vaccination. There were no differences between vaccinated and unvaccinated participants in overall measures of health. Only the subset of participants who self-reported anthrax vaccination, but had no electronic confirmation, differed from others in the cohort, with consistently lower measures of health as indicated by Medical Outcomes Study 36-Item Short Form Health Survey for Veterans (SF-36V) scores. These results indicate that military members accurately recall their anthrax vaccinations. Results also suggest that anthrax vaccination among Millennium Cohort participants is not associated with self-reported health problems or broad measures of health problems severe enough to require hospitalization. Service members who self

  15. Objective measurement of accommodative biometric changes using ultrasound biomicroscopy

    PubMed Central

    Ramasubramanian, Viswanathan; Glasser, Adrian

    2015-01-01

    PURPOSE To demonstrate that ultrasound biomicroscopy (UBM) can be used for objective quantitative measurements of anterior segment accommodative changes. SETTING College of Optometry, University of Houston, Houston, Texas, USA. DESIGN Prospective cross-sectional study. METHODS Anterior segment biometric changes in response to 0 to 6.0 diopters (D) of accommodative stimuli in 1.0 D steps were measured in eyes of human subjects aged 21 to 36 years. Imaging was performed in the left eye using a 35 MHz UBM (Vumax) and an A-scan ultrasound (A-5500) while the right eye viewed the accommodative stimuli. An automated Matlab image-analysis program was developed to measure the biometry parameters from the UBM images. RESULTS The UBM-measured accommodative changes in anterior chamber depth (ACD), lens thickness, anterior lens radius of curvature, posterior lens radius of curvature, and anterior segment length were statistically significantly (P < .0001) linearly correlated with accommodative stimulus amplitudes. Standard deviations of the UBM-measured parameters were independent of the accommodative stimulus demands (ACD 0.0176 mm, lens thickness 0.0294 mm, anterior lens radius of curvature 0.3350 mm, posterior lens radius of curvature 0.1580 mm, and anterior segment length 0.0340 mm). The mean difference between the A-scan and UBM measurements was −0.070 mm for ACD and 0.166 mm for lens thickness. CONCLUSIONS Accommodating phakic eyes imaged using UBM allowed visualization of the accommodative response, and automated image analysis of the UBM images allowed reliable, objective, quantitative measurements of the accommodative intraocular biometric changes. PMID:25804579

  16. Rural–Urban Differences in Objective and Subjective Measures of Physical Activity: Findings From the National Health and Nutrition Examination Survey (NHANES) 2003–2006

    PubMed Central

    Wen, Ming; Kowaleski-Jones, Lori

    2014-01-01

    Introduction Lower levels of physical activity among rural relative to urban residents have been suggested as an important contributor to rural–urban health disparity; however, empirical evidence is sparse. Methods We examined rural–urban differences in 4 objective physical activity measures (2 intensity thresholds by 2 bout lengths) and 4 subjective measures (total, leisure, household, and transportation) in a nationally representative sample of participants in the National Health and Nutrition Examination Survey (NHANES) 2003–2006. The sample comprised 5,056 adults aged 20 to 75 years. Rural-Urban Commuting Area (RUCA) codes were matched with NHANES subjects to identify urban status and 2 types of rural status. Rural–urban and within–rural differences in physical activity were estimated without and with controls for demographic and socioeconomic variables. Results Rural residents were less active than urban residents in high-intensity long bout (2,020 counts per minute threshold and 10 miniutes or longer bout length) accelerometer-measured physical activity (42.5 ± 6.2 min/wk vs 55.9 ± 2.8 min/wk) but the difference disappeared with a lower-intensity threshold (760 counts per minute). Rural residents reported more total physical activity than urban residents (438.3 ± 35.3min/wk vs 371.2 ± 12.5 min/wk), with differences primarily attributable to household physical activity. Within rural areas, micropolitan residents were less active than residents in smaller rural areas. Controlling for other variables reduced the size of the differences. Conclusion The direction and significance of rural–urban difference in physical activity varied by the method of physical activity measurement, likely related to rural residents spending more time in low-intensity household physical activity but less time in high-intensity physical activity. Micropolitan residents were substantially less active than residents in smaller rural areas, indicating that physical

  17. Health disparities and health equity: concepts and measurement.

    PubMed

    Braveman, Paula

    2006-01-01

    There is little consensus about the meaning of the terms "health disparities," "health inequalities," or "health equity." The definitions can have important practical consequences, determining the measurements that are monitored by governments and international agencies and the activities that will be supported by resources earmarked to address health disparities/inequalities or health equity. This paper aims to clarify the concepts of health disparities/inequalities (used interchangeably here) and health equity, focusing on the implications of different definitions for measurement and hence for accountability. Health disparities/inequalities do not refer to all differences in health. A health disparity/inequality is a particular type of difference in health (or in the most important influences on health that could potentially be shaped by policies); it is a difference in which disadvantaged social groups-such as the poor, racial/ethnic minorities, women, or other groups who have persistently experienced social disadvantage or discrimination-systematically experience worse health or greater health risks than more advantaged social groups. ("Social advantage" refers to one's relative position in a social hierarchy determined by wealth, power, and/or prestige.) Health disparities/inequalities include differences between the most advantaged group in a given category-e.g., the wealthiest, the most powerful racial/ethnic group-and all others, not only between the best- and worst-off groups. Pursuing health equity means pursuing the elimination of such health disparities/inequalities.

  18. Non-contact local temperature measurement inside an object using an infrared point detector

    NASA Astrophysics Data System (ADS)

    Hisaka, Masaki

    2017-04-01

    Local temperature measurement in deep areas of objects is an important technique in biomedical measurement. We have investigated a non-contact method for measuring temperature inside an object using a point detector for infrared (IR) light. An IR point detector with a pinhole was constructed and the radiant IR light emitted from the local interior of the object is photodetected only at the position of pinhole located in imaging relation. We measured the thermal structure of the filament inside the miniature bulb using the IR point detector, and investigated the temperature dependence at approximately human body temperature using a glass plate positioned in front of the heat source.

  19. International Service and Public Health Learning Objectives for Medical Students

    ERIC Educational Resources Information Center

    Block, Robert C.; Duron, Vincent; Creigh, Peter; McIntosh, Scott

    2013-01-01

    Objective: We aimed to improve the education of medical students involved in a longitudinal perinatal health improvement project in Gowa, Malawi. Design: We conducted qualitative interviews with students who participated in the project, reviewed their quantitative reports, and assessed the application of methodologies consonant with the learning…

  20. Measuring and managing progress in the establishment of basic health services: the Afghanistan health sector balanced scorecard.

    PubMed

    Hansen, Peter M; Peters, David H; Niayesh, Haseebullah; Singh, Lakhwinder P; Dwivedi, Vikas; Burnham, Gilbert

    2008-01-01

    The Ministry of Public Health (MOPH) of Afghanistan has adopted the Balanced Scorecard (BSC) as a tool to measure and manage performance in delivery of a Basic Package of Health Services. Based on results from the 2004 baseline round, the MOPH identified eight of the 29 indicators on the BSC as priority areas for improvement. Like the 2004 round, the 2005 and 2006 BSCs involved a random selection of more than 600 health facilities, 1700 health workers and 5800 patient-provider interactions. The 2005 and 2006 BSCs demonstrated substantial improvements in all eight of the priority areas compared to 2004 baseline levels, with increases in median provincial scores for presence of active village health councils, availability of essential drugs, functional laboratories, provider knowledge, health worker training, use of clinical guidelines, monitoring of tuberculosis treatment, and provision of delivery care. For three of the priority indicators-drug availability, health worker training and provider knowledge-scores remained unchanged or decreased between 2005 and 2006. This highlights the need to ensure that early gains achieved in establishment of health services in Afghanistan are maintained over time. The use of a coherent and balanced monitoring framework to identify priority areas for improvement and measure performance over time reflects an objectives-based approach to management of health services that is proving to be effective in a difficult environment. 2007 John Wiley & Sons, Ltd

  1. Patterns of objectively assessed physical activity and sedentary time: Are Nigerian health professional students complying with public health guidelines?

    PubMed Central

    Muhammed, Suleiman; Oyeyemi, Adetoyeje Y.; Adegoke, Babatunde O. A.

    2017-01-01

    Background Understanding patterns of physical activity and sedentary time is important to effective population-wide primary prevention and control of non-communicable diseases. This study examined the patterns of objectively assessed physical activity and sedentary time, and the prevalence of compliance with physical activity guidelines according to different public health recommendations in a sub-population of health professional students in Nigeria. Methods A cross-sectional study was conducted among 102 health professional students (age = 19–34 years old, 43.1% women) of the University of Maiduguri, Nigeria. Participants wore Actigraph accelerometers on their waist for minimum of 5 days/week to objectively measure intensity and duration of physical activity and sedentary time. Prevalence and demographic patterns of physical activity and sedentary time were examined using descriptive and inferential statistics. Results The students spent most time in sedentary activity (458.6 ± minutes/day, about 61% of daily time) and the least in vigorous-intensity activity (2.1 ± 4.4 minutes/day, about 0.3% of daily time). Sedentary time was higher among older than younger students (P<0.038) and among medical laboratory science students than physiotherapy and nursing students (P = 0.046). Total physical activity was higher among nursing and medical students than medical laboratory science students (P = 0.041). Although, 85.3% of the students engaged in 150 minutes/week of moderate-to-vigorous physical activity, only 2.9% met the guideline of 75 minutes/week of vigorous intensity activity. Conclusions Prevalence of sedentary time was high while that of vigorous-intensity activity was very low among health professional students in Nigeria. Compliance with physical activity guidelines was mainly through accumulation of moderate intensity activity. The results suggest that age and academic programme may influence physical activity level and sedentary behaviour of health

  2. Small Schools Health Curriculum, K-3: Scope, Objectives, Activities, Resources, Monitoring Procedures.

    ERIC Educational Resources Information Center

    McInerney, Mike, Ed.; Destito, Therese, Ed.

    The K-3 health curriculum developed during 1975-77 by teachers in small school districts working with district and state health education specialists presents student learning objectives and suggested activities, monitoring procedures and resources which are correlated to the 10 Goals for Washington Common Schools and the nine Small Schools Health…

  3. Variation in US outpatient antibiotic prescribing quality measures according to health plan and geography.

    PubMed

    Roberts, Rebecca M; Hicks, Lauri A; Bartoces, Monina

    2016-08-01

    Antibiotic prescribing has become increasingly viewed as an issue related to patient safety and quality of care. The objective of this study was to better understand the differences between health plan reporting and the geographic variation seen in quality measures related to antibiotic use. We focused on 3 measures from the Healthcare Effectiveness Data and Information Set (HEDIS) related to antibiotic prescribing and testing to guide antibiotic prescribing. We analyzed data for 3 relevant measures for the years 2008 to 2012, including only commercial health plans. We analyzed the following 3 HEDIS measures: 1) "Appropriate Testing for Children With Pharyngitis," 2) "Appropriate Treatment for Children With Upper Respiratory Infections," and 3) "Avoidance of Antibiotic Treatment in Adults With Acute Bronchitis." Out of these 3 measures, health plans consistently performed poorly on the adult bronchitis measure. Performance was better on the 2 measures focused on the pediatric population. We also saw geographic variation between measures when looking at Census divisions across all years. There is wide variation between individual health plan performance on the measures related to antibiotic use. Geographic differences were also observed on these measures, with health plans in the South Central Census division performing worse than other parts of the country. Stakeholders, such as public health, advocacy groups, foundations, and professional societies, interested in improving the quality of care that patients receive related to antibiotic use in the outpatient setting should consider how existing measures and working with health plans could be used to improve prescribing.

  4. Measurement of Cognitive Load in Multimedia Learning: A Comparison of Different Objective Measures

    ERIC Educational Resources Information Center

    Korbach, Andreas; Brünken, Roland; Park, Babette

    2017-01-01

    Different indicators are interesting for analyzing human learning processes. Recent studies analyze learning performance in combination with cognitive load, as an indicator for learners' invested mental effort. In order to compare different measures of cognitive load research, the present study uses three different objective methods and one…

  5. Psychometric Properties of Patient-Facing eHealth Evaluation Measures: Systematic Review and Analysis

    PubMed Central

    Turvey, Carolyn L; Nazi, Kim M; Holman, John E; Hogan, Timothy P; Shimada, Stephanie L; Kennedy, Diana R

    2017-01-01

    Background Significant resources are being invested into eHealth technology to improve health care. Few resources have focused on evaluating the impact of use on patient outcomes A standardized set of metrics used across health systems and research will enable aggregation of data to inform improved implementation, clinical practice, and ultimately health outcomes associated with use of patient-facing eHealth technologies. Objective The objective of this project was to conduct a systematic review to (1) identify existing instruments for eHealth research and implementation evaluation from the patient’s point of view, (2) characterize measurement components, and (3) assess psychometrics. Methods Concepts from existing models and published studies of technology use and adoption were identified and used to inform a search strategy. Search terms were broadly categorized as platforms (eg, email), measurement (eg, survey), function/information use (eg, self-management), health care occupations (eg, nurse), and eHealth/telemedicine (eg, mHealth). A computerized database search was conducted through June 2014. Included articles (1) described development of an instrument, or (2) used an instrument that could be traced back to its original publication, or (3) modified an instrument, and (4) with full text in English language, and (5) focused on the patient perspective on technology, including patient preferences and satisfaction, engagement with technology, usability, competency and fluency with technology, computer literacy, and trust in and acceptance of technology. The review was limited to instruments that reported at least one psychometric property. Excluded were investigator-developed measures, disease-specific assessments delivered via technology or telephone (eg, a cancer-coping measure delivered via computer survey), and measures focused primarily on clinician use (eg, the electronic health record). Results The search strategy yielded 47,320 articles. Following

  6. Waist Circumference and Objectively Measured Sedentary Behavior in Rural School Adolescents.

    PubMed

    Machado-Rodrigues, Aristides M; Coelho E Silva, Manuel J; Ribeiro, Luís P; Fernandes, Romulo; Mota, Jorge; Malina, Robert M

    2016-01-01

    Research on relationships between lifestyle behaviors and adiposity in school youth is potentially important for identifying subgroups at risk. This study evaluates the associations between waist circumference (WC) and objective measures of sedentary behavior (SB) in a sample of rural school adolescents. The sample included 254 students (114 boys, 140 girls), 13-16 years of age, from rural regions of the Portuguese midlands. Height, weight, and WC were measured. Cardiorespiratory fitness (CRF) was assessed with the 20-m shuttle-run test. An uniaxial GT1M accelerometer was used to obtain 5 consecutive days of physically activity (PA) and SB. Multiple linear regression was used to test associations between WC and SB, adjusted for several potential confounders (age, sex, PA, CRF, parental education). SB was not significantly associated with the WC, neither in the unadjusted model nor after adjustment for all potential confounders. In the final model, the unique significant predictor of the WC was cardiorespiratory fitness (β = -0.82; 95% confidence interval [CI], -1.02 to -0.62). WC was not independently associated with SB time in rural school adolescents. Future research is claimed among rural adolescents in different geographic contexts to try to clarify recent findings of less studied communities. © 2015, American School Health Association.

  7. Creating and validating GIS measures of urban design for health research

    PubMed Central

    Purciel, Marnie; Neckerman, Kathryn M.; Lovasi, Gina S.; Quinn, James W.; Weiss, Christopher; Bader, Michael D.M.; Ewing, Reid; Rundle, Andrew

    2012-01-01

    Studies relating urban design to health have been impeded by the unfeasibility of conducting field observations across large areas and the lack of validated objective measures of urban design. This study describes measures for five dimensions of urban design – imageability, enclosure, human scale, transparency, and complexity – created using public geographic information systems (GIS) data from the US Census and city and state government. GIS measures were validated for a sample of 588 New York City block faces using a well-documented field observation protocol. Correlations between GIS and observed measures ranged from 0.28 to 0.89. Results show valid urban design measures can be constructed from digital sources. PMID:22956856

  8. Associations between self-reported and objectively measured physical activity, sedentary behavior and overweight/obesity in NHANES 2003-2006.

    PubMed

    Wanner, M; Richard, A; Martin, B; Faeh, D; Rohrmann, S

    2017-01-01

    To investigate associations between self-reported and objectively measured physical activity, sedentary behavior and overweight/obesity based on percent body fat measured with Dual Energy X-Ray Absorptiometry (DXA), waist circumference (WC), waist-to-height ratio and body mass index, focusing on different intensities and domains of physical activity. Data from NHANES 2003-2006 were analyzed using linear and ordered logistic regression analyses. A total of 4794 individuals aged 18-69 years with valid physical activity and DXA data were included. Objectively measured physical activity and sedentary behavior were assessed using accelerometers, self-reported physical activity using the NHANES physical activity questionnaire. Weight, height, WC and DXA measures were assessed in the mobile examination centers. We observed statistically significant associations between objectively measured moderate and vigorous physical activity and all definitions of overweight/obesity. For total physical activity, the odds of being in the higher percent body fat category were 0.56 (95% confidence interval (CI) 0.41, 0.77) for the medium and 0.30 (95% CI 0.22, 0.40) for the highest physical activity tertile compared with the lowest. For light activities, lifestyle activities and sedentary behavior, associations were only observed in the linear models with percent total body fat but not in the ordered logistic regression models. Regarding self-reported physical activity, consistent significant associations with overweight/obesity were only observed for vigorous and for transport activity. Regarding moderate and vigorous physical activity, more active individuals were less affected by overweight/obesity than less active individuals, emphasizing the public health effect of physical activity in the prevention of overweight/obesity. The fact that associations were more consistent for objectively measured than for self-reported physical activity may be due to bias related to self

  9. Objective measurements to evaluate glottal space segmentation from laryngeal images.

    PubMed

    Gutiérrez-Arriola, J M; Osma-Ruiz, V; Sáenz-Lechón, N; Godino-Llorente, J I; Fraile, R; Arias-Londoño, J D

    2012-01-01

    Objective evaluation of the results of medical image segmentation is a known problem. Applied to the task of automatically detecting the glottal area from laryngeal images, this paper proposes a new objective measurement to evaluate the quality of a segmentation algorithm by comparing with the results given by a human expert. The new figure of merit is called Area Index, and its effectiveness is compared with one of the most used figures of merit found in the literature: the Pratt Index. Results over 110 laryngeal images presented high correlations between both indexes, demonstrating that the proposed measure is comparable to the Pratt Index and it is a good indicator of the segmentation quality.

  10. Predicting physical health: implicit mental health measures versus self-report scales.

    PubMed

    Cousineau, Tara McKee; Shedler, Jonathan

    2006-06-01

    Researchers have traditionally relied on self-report questionnaires to assess psychological well-being, but such measures may be unable to differentiate individuals who are genuinely psychologically healthy from those who maintain a facade or illusion of mental health based on denial and self-deception. Prior research suggests that clinically derived assessment procedures that assess implicit psychological processes may have advantages over self-report mental health measures. This prospective study compared the Early Memory Index, an implicit measure of mental health/distress, with a range of familiar self-report scales as predictors of physical health. The Early Memory Index showed significant prospective associations with health service utilization and clinically verified illness. In contrast, self-report measures of mental health, perceived stress, life events stress, and mood states did not predict health outcomes. The findings highlight the limitations of self-report questionnaires and suggest that implicit measures have an important role to play in mental health research.

  11. Reliability of a single objective measure in assessing sleepiness.

    PubMed

    Sunwoo, Bernie Y; Jackson, Nicholas; Maislin, Greg; Gurubhagavatula, Indira; George, Charles F; Pack, Allan I

    2012-01-01

    To evaluate reliability of single objective tests in assessing sleepiness. Subjects who completed polysomnography underwent a 4-nap multiple sleep latency test (MSLT) the following day. Prior to each nap opportunity on MSLT, subjects performed the psychomotor vigilance test (PVT) and divided attention driving task (DADT). Results of single versus multiple test administrations were compared using the intraclass correlation coefficient (ICC) and adjusted for test administration order effects to explore time of day effects. Measures were explored as continuous and binary (i.e., impaired or not impaired). Community-based sample evaluated at a tertiary, university-based sleep center. 372 adult commercial vehicle operators oversampled for increased obstructive sleep apnea risk. N/A. AS CONTINUOUS MEASURES, ICC WERE AS FOLLOWS: MSLT 0.45, PVT median response time 0.69, PVT number of lapses 0.51, 10-min DADT tracking error 0.87, 20-min DADT tracking error 0.90. Based on binary outcomes, ICC were: MSLT 0.63, PVT number of lapses 0.85, 10-min DADT 0.95, 20-min DADT 0.96. Statistically significant time of day effects were seen in both the MSLT and PVT but not the DADT. Correlation between ESS and different objective tests was strongest for MSLT, range [-0.270 to -0.195] and persisted across all time points. Single DADT and PVT administrations are reliable measures of sleepiness. A single MSLT administration can reasonably discriminate individuals with MSL < 8 minutes. These results support the use of a single administration of some objective tests of sleepiness when performed under controlled conditions in routine clinical care.

  12. Thickness and air gap measurement of assembled IR objectives

    NASA Astrophysics Data System (ADS)

    Lueerss, B.; Langehanenberg, P.

    2015-05-01

    A growing number of applications like surveillance, thermography, or automotive demand for infrared imaging systems. Their imaging performance is significantly influenced by the alignment of the individual lens elements. Besides the lateral orientation of lenses, the air spacing between the lenses is a crucial parameter. Because of restricted mechanical accessibility within an assembled objective, a non-contact technique is required for the testing of these parameters. So far commercial measurement systems were not available for testing of IR objectives since many materials used for infrared imaging are non-transparent at wavelengths below 2 μm. We herewith present a time-domain low coherent interferometer capable of measuring any kind of infrared material (e.g., Ge, Si, etc.) as well as VIS materials. The fiber-optic set-up is based on a Michelson-Interferometer in which the light from a broadband super-luminescent diode is split into a reference arm with a variable optical delay and a measurement arm where the sample is placed. On a photo detector, the reflected signals from both arms are superimposed and recorded as a function of the variable optical path. Whenever the group delay difference is zero, a coherence peak occurs and the relative lens' surface distances are derived from the optical delay. In order to penetrate IR materials, the instrument operates at 2.2 μm. The set-up allows the contactless determination of thicknesses and air gaps inside of assembled infrared objective lenses with accuracy in the micron range. It therefore is a tool for the precise manufacturing or quality control.

  13. Thickness and air gap measurement of assembled IR objectives

    NASA Astrophysics Data System (ADS)

    Lueerss, B.; Langehanenberg, P.

    2015-10-01

    A growing number of applications like surveillance, thermography, or automotive demand for infrared imaging systems. Their imaging performance is significantly influenced by the alignment of the individual lenses. Besides the lateral orientation of lenses, the air spacing between the lenses is a crucial parameter. Because of restricted mechanical accessibility within an assembled objective, a non-contact technique is required for the testing of these parameters. So far, commercial measurement systems were not available for testing of IR objectives since most materials used for infrared imaging are non-transparent at wavelengths below 2 μm. We herewith present a time-domain low coherent interferometer capable of measuring any kind of infrared material (e.g., Ge, Si, etc.) as well as VIS materials. The set-up is based on a Michelson interferometer in which the light from a broadband superluminescent diode is split into a reference arm with a variable optical delay and a measurement arm where the sample is placed. On a detector, the reflected signals from both arms are superimposed and recorded as a function of the variable optical path. Whenever the group delay difference is zero, a coherence peak occurs and the relative distances of the lens surfaces are derived from the optical delay. In order to penetrate IR materials, the instrument operates at 2.2 μm. Together with an LWIR autocollimator, this technique allows for the determination of centering errors, lens thicknesses and air spacings of assembled IR objective lenses with a micron accuracy. It is therefore a tool for precision manufacturing and quality control.

  14. Measuring the circular motion of small objects using laser stroboscopic images.

    PubMed

    Wang, Hairong; Fu, Y; Du, R

    2008-01-01

    Measuring the circular motion of a small object, including its displacement, speed, and acceleration, is a challenging task. This paper presents a new method for measuring repetitive and/or nonrepetitive, constant speed and/or variable speed circular motion using laser stroboscopic images. Under stroboscopic illumination, each image taken by an ordinary camera records multioutlines of an object in motion; hence, processing the stroboscopic image will be able to extract the motion information. We built an experiment apparatus consisting of a laser as the light source, a stereomicroscope to magnify the image, and a normal complementary metal oxide semiconductor camera to record the image. As the object is in motion, the stroboscopic illumination generates a speckle pattern on the object that can be recorded by the camera and analyzed by a computer. Experimental results indicate that the stroboscopic imaging is stable under various conditions. Moreover, the characteristics of the motion, including the displacement, the velocity, and the acceleration can be calculated based on the width of speckle marks, the illumination intensity, the duty cycle, and the sampling frequency. Compared with the popular high-speed camera method, the presented method may achieve the same measuring accuracy, but with much reduced cost and complexity.

  15. Functional Requirements: 2014 No Child Left Behind--Annual Measurable Achievement Objectives

    ERIC Educational Resources Information Center

    Minnesota Department of Education, 2014

    2014-01-01

    This document describes the Minnesota No Child Left Behind (NCLB) calculation as it relates to measuring Title III districts for Annual Measurable Achievement Objectives (AMAO). In 2012, a new assessment was used to measure language proficiency skills for English Learners. New AMAO targets were created, and new values for determining individual…

  16. Math: Figure and Object Characteristics. Measurement and Geometry. Grades K-9. Revised Edition.

    ERIC Educational Resources Information Center

    Instructional Objectives Exchange, Los Angeles, CA.

    To help classroom teachers construct mathematics tests, thirty-seven general objectives, corresponding sub-objectives, sample test items, and answers are presented. In general, sub-objectives are arranged in increasing order of difficulty. The objectives were written to comprehensively cover two categories: measurement and geometry. Measurement…

  17. Exploring the Measurement Properties of the eHealth Literacy Scale (eHEALS) Among Baby Boomers: A Multinational Test of Measurement Invariance

    PubMed Central

    2017-01-01

    Background The eHealth Literacy Scale (eHEALS) is one of only a few available measurement scales to assess eHealth literacy. Perhaps due to the relative paucity of such measures and the rising importance of eHealth literacy, the eHEALS is increasingly a choice for inclusion in a range of studies across different groups, cultures, and nations. However, despite its growing popularity, questions have been raised over its theoretical foundations, and the factorial validity and multigroup measurement properties of the scale are yet to be investigated fully. Objective The objective of our study was to examine the factorial validity and measurement invariance of the eHEALS among baby boomers (born between 1946 and 1964) in the United States, United Kingdom, and New Zealand who had used the Internet to search for health information in the last 6 months. Methods Online questionnaires collected data from a random sample of baby boomers from the 3 countries of interest. The theoretical underpinning to eHEALS comprises social cognitive theory and self-efficacy theory. Close scrutiny of eHEALS with analysis of these theories suggests a 3-factor structure to be worth investigating, which has never before been explored. Structural equation modeling tested a 3-factor structure based on the theoretical underpinning to eHEALS and investigated multinational measurement invariance of the eHEALS. Results We collected responses (N=996) to the questionnaires using random samples from the 3 countries. Results suggest that the eHEALS comprises a 3-factor structure with a measurement model that falls within all relevant fit indices (root mean square error of approximation, RMSEA=.041, comparative fit index, CFI=.986). Additionally, the scale demonstrates metric invariance (RMSEA=.040, CFI=.984, ΔCFI=.002) and even scalar invariance (RMSEA=.042, CFI=.978, ΔCFI=.008). Conclusions To our knowledge, this is the first study to demonstrate multigroup factorial equivalence of the eHEALS, and did

  18. 3D shape measurement of moving object with FFT-based spatial matching

    NASA Astrophysics Data System (ADS)

    Guo, Qinghua; Ruan, Yuxi; Xi, Jiangtao; Song, Limei; Zhu, Xinjun; Yu, Yanguang; Tong, Jun

    2018-03-01

    This work presents a new technique for 3D shape measurement of moving object in translational motion, which finds applications in online inspection, quality control, etc. A low-complexity 1D fast Fourier transform (FFT)-based spatial matching approach is devised to obtain accurate object displacement estimates, and it is combined with single shot fringe pattern prolometry (FPP) techniques to achieve high measurement performance with multiple captured images through coherent combining. The proposed technique overcomes some limitations of existing ones. Specifically, the placement of marks on object surface and synchronization between projector and camera are not needed, the velocity of the moving object is not required to be constant, and there is no restriction on the movement trajectory. Both simulation and experimental results demonstrate the effectiveness of the proposed technique.

  19. Objective Measure of Nasal Air Emission Using Nasal Accelerometry

    ERIC Educational Resources Information Center

    Cler, Meredith J.; Lien, Yu-An, S.; Braden, Maia N.; Mittleman, Talia; Downing, Kerri; Stepp, Cara, E.

    2016-01-01

    Purpose: This article describes the development and initial validation of an objective measure of nasal air emission (NAE) using nasal accelerometry. Method: Nasal acceleration and nasal airflow signals were simultaneously recorded while an expert speech language pathologist modeled NAEs at a variety of severity levels. In addition, microphone and…

  20. Distance Between Sets as an Objective Measure of Retrieval Effectiveness

    ERIC Educational Resources Information Center

    Heine, M. H.

    1973-01-01

    The Marczewski-Steinhaus metric provides what appears to be an objective general measure of retrieval effectiveness within the framework of set theory and the theory of metric spaces. (19 references) (Author/SJ)

  1. Combination of optically measured coordinates and displacements for quantitative investigation of complex objects

    NASA Astrophysics Data System (ADS)

    Andrae, Peter; Beeck, Manfred-Andreas; Jueptner, Werner P. O.; Nadeborn, Werner; Osten, Wolfgang

    1996-09-01

    Holographic interferometry makes it possible to measure high precision displacement data in the range of the wavelength of the used laser light. However, the determination of 3D- displacement vectors of objects with complex surfaces requires the measurement of 3D-object coordinates not only to consider local sensitivities but to distinguish between in-plane deformation, i.e. strains, and out-of-plane components, i.e. shears, too. To this purpose both the surface displacement and coordinates have to be combined and it is advantageous to make the data available for CAE- systems. The object surface has to be approximated analytically from the measured point cloud to generate a surface mesh. The displacement vectors can be assigned to the nodes of this surface mesh for visualization of the deformation of the object under test. They also can be compared to the results of FEM-calculations or can be used as boundary conditions for further numerical investigations. Here the 3D-object coordinates are measured in a separate topometric set-up using a modified fringe projection technique to acquire absolute phase values and a sophisticated geometrical model to map these phase data onto coordinates precisely. The determination of 3D-displacement vectors requires the measurement of several interference phase distributions for at least three independent sensitivity directions depending on the observation and illumination directions as well as the 3D-position of each measuring point. These geometric quantities have to be transformed into a reference coordinate system of the interferometric set-up in order to calculate the geometric matrix. The necessary transformation can be realized by means of a detection of object features in both data sets and a subsequent determination of the external camera orientation. This paper presents a consistent solution for the measurement and combination of shape and displacement data including their transformation into simulation systems. The

  2. Objectively measured physical activity of young Canadian children using accelerometry.

    PubMed

    Borkhoff, Cornelia M; Heale, Liane D; Anderson, Laura N; Tremblay, Mark S; Maguire, Jonathon L; Parkin, Patricia C; Birken, Catherine S

    2015-12-01

    The objective of the study was to describe objectively measured physical activity (PA) and sedentary time of infants, toddlers, and preschoolers and determine the proportion meeting Canadian age-specific PA guidelines. Ninety children (47 girls, 43 boys; mean age 32 (range, 4-70) months) attending scheduled health supervision visits and in the TARGet Kids! (The Applied Research Group for Kids) cohort wore an Actical accelerometer for 7 days. Participants with 4 or more valid days were included in the analysis. Time, in mean minutes per day (min/day), spent sedentary and in light PA, moderate to vigorous PA (MVPA), and total PA was determined using published cut-points; age groups were compared using ANOVA. Twenty-three percent of children <18 months (n = 28) and 76% of children aged 18-59 months (n = 45) met the guideline of 180 min/day of total PA; 13% of children ≥60 months (n = 17) met the guideline of 60 min/day of MVPA. Children <18 months spent more of their waking time per day engaged in sedentary behaviours (79%; ∼7.3 h) compared with children aged 18-59 months (63%; ∼6.6 h) and children ≥60 months (58%; ∼6.6 h). In conclusion, most children aged 18-59 months met the Canadian PA guidelines for children aged 0-4 years, whereas few younger than 18 months met the same guidelines. Only 13% of children ≥5 years met their age-specific PA guidelines. Further research is needed to develop, test, and implement effective strategies to promote PA and reduce sedentary behaviour in very young children.

  3. Measurement of health outcomes.

    PubMed

    Thavorncharoensap, Montarat

    2014-05-01

    Health outcomes are one of the most important components of health technology assessments (HTAs). All HTA outcomes should be measured from a relevant sample using a properly designed study and method. A number of recommendations on health outcome measurements are made in this second edition of Thailand's HTA guidelines. In particular the use of final outcomes, rather than surrogate outcomes, in HTAs is stressed. Where surrogate outcomes are used, strong justification and evidence must be provided. Effectiveness is preferred over efficacy. The relative treatment effect (the difference between health outcome that would be experienced by patients receiving the technology and that experienced by the same group were they to receive an alternative technology) should be derived from a systematic review of head-to-head RCTs. Mixed treatment comparison (MTC) should be used only to provide supplementary data that cannot be obtained from a head-to-head comparison. Where no direct comparison evidence exists, indirect comparison and observational study data can be used.

  4. Self-report vs. objectively assessed physical activity: which is right for public health?

    PubMed

    Loney, Tom; Standage, Martyn; Thompson, Dylan; Sebire, Simon J; Cumming, Sean

    2011-01-01

    To examine the agreement between self-reported and objectively assessed physical activity (PA) according to current public health recommendations. One-hundred and fourteen British University students wore a combined accelerometer and heart rate monitor (Actiheart; AHR) to estimate 24-hour energy expenditure over 7 consecutive days. Data were extracted based on population-based MET-levels recommended to improve and maintain health. On day 8, participants were randomly assigned to complete either the short-form International Physical Activity Questionnaire (IPAQ) or the Leisure-Time Exercise Questionnaire (LTEQ). Estimates of duration (IPAQ; N = 46) and frequency (LTEQ; N = 41) of PA were compared with those recorded by the AHR. Bland-Altman analysis showed the mean bias between the IPAQ and AHR to be small for moderate-intensity and total PA, however the 95% limits of agreement (LOA) were wide. The mean number of moderate bouts of PA estimated by the LTEQ was similar to those derived by the AHR but the 95% LOA between the 2 measures were large. Although self-report questionnaires may provide an approximation of PA at a population level, they may not determine whether an individual is participating in the type, intensity, and amount of PA advocated in current public health recommendations. ©2011 Human Kinetics, Inc.

  5. Diagnostic, pharmacy-based, and self-reported health measures in risk equalization models.

    PubMed

    Stam, Pieter J A; van Vliet, René C J A; van de Ven, Wynand P M M

    2010-05-01

    Current research on the added value of self-reported health measures for risk equalization modeling does not include all types of self-reported health measures; and/or is compared with a limited set of medically diagnosed or pharmacy-based diseases; and/or is limited to specific populations of high-risk individuals. The objective of our study is to determine the predictive power of all types of self-reported health measures for prospective modeling of health care expenditures in a general population of adult Dutch sickness fund enrollees, given that pharmacy and diagnostic data from administrative records are already included in the risk equalization formula. We used 4 models of 2002 total, inpatient and outpatient expenditures to evaluate the separate and combined predictive ability of 2 kinds of data: (1) Pharmacy-based (PCGs) and Diagnosis-based (DCGs) Cost Groups and (2) summarized self-reported health information. Model performance is measured at the total population level using R2 and mean absolute prediction error; also, by examining mean discrepancies between model-predicted and actual expenditures (ie, expected over- or undercompensation) for members of potentially "mispriced" subgroups. These subgroups are identified by self-reports from prior-year health surveys and utilization and expenditure data from 5 preceding years. Subjects were 18,617 respondents to a health survey, held among a stratified sample of adult members of the largest Dutch sickness fund in 2002, with an overrepresentation of people in poor health. The data were extracted from a claims database and a health survey. The claims-based data are the outcomes of total, inpatient, and outpatient annualized expenditures in 2002; age, gender, PCGs, DCGs in 2001; and health care expenditures and hospitalizations during the years 1997 to 2001. The SF-36, Organization for Economic Cooperation and Development items, and long-term diseases and conditions were collected by a special purpose health

  6. Multiple wavelength interferometry for distance measurements of moving objects with nanometer uncertainty

    NASA Astrophysics Data System (ADS)

    Kuschmierz, R.; Czarske, J.; Fischer, A.

    2014-08-01

    Optical measurement techniques offer great opportunities in diverse applications, such as lathe monitoring and microfluidics. Doppler-based interferometric techniques enable simultaneous measurement of the lateral velocity and axial distance of a moving object. However, there is a complementarity between the unambiguous axial measurement range and the uncertainty of the distance. Therefore, we present an extended sensor setup, which provides an unambiguous axial measurement range of 1 mm while achieving uncertainties below 100 nm. Measurements at a calibration system are performed. When using a pinhole for emulating a single scattering particle, the tumbling motion of the rotating object is resolved with a distance uncertainty of 50 nm. For measurements at the rough surface, the distance uncertainty amounts to 280 nm due to a lower signal-to-noise ratio. Both experimental results are close to the respective Cramér-Rao bound, which is derived analytically for both surface and single particle measurements.

  7. [A Triage Scale for Mental Health, an Emerging Practice, a Value-Add for Measuring Demand for Mental Health Services].

    PubMed

    Boucher, Lucie

    Objectives The article aims to present two studies supporting the development of l'Échelle brève de triage RIFCAS en santé mentale 0-99 ans, a measuring instrument used to determine - based on the level of customer demand, seriousness, and urgent need for intervention - the priority of a mental health service across all age groups.Methods Both versions have been subject to a measurement interjudge agreement that is compared against the judgment of professionals and other comparison tools.Results The results produced by the interjudge agreement reflect significant correlations with the priorities established by l'Échelle brève de triage RIFCAS en santé mentale 0-99 ans, the judgment of professional experts and the usual instruments used.Conclusion The final version of the triage scale provides an objective measure for the priority that should be given to all mental health service requests - these encompass all recognized and essential clinical information. Clinicians can rely on a reliable and proven instrument to prioritize service requests before placing them on the waiting list. The use of this instrument facilitates the development of a common procedure between professionals and ensures a fair and safe treatment of users.

  8. Conscientious objection to sexual and reproductive health services: international human rights standards and European law and practice.

    PubMed

    Zampas, Christina; Andión-Ibañez, Ximena

    2012-06-01

    The practice of conscientious objection often arises in the area of individuals refusing to fulfil compulsory military service requirements and is based on the right to freedom of thought, conscience and religion as protected by national, international and regional human rights law. The practice of conscientious objection also arises in the field of health care, when individual health care providers or institutions refuse to provide certain health services based on religious, moral or philosophical objections. The use of conscientious objection by health care providers to reproductive health care services, including abortion, contraceptive prescriptions, and prenatal tests, among other services is a growing phenomena throughout Europe. However, despite recent progress from the European Court of Human Rights on this issue (RR v. Poland, 2011), countries and international and regional bodies generally have failed to comprehensively and effectively regulate this practice, denying many women reproductive health care services they are legally entitled to receive. The Italian Ministry of Health reported that in 2008 nearly 70% of gynaecologists in Italy refuse to perform abortions on moral grounds. It found that between 2003 and 2007 the number of gynaecologists invoking conscientious objection in their refusal to perform an abortion rose from 58.7 percent to 69.2 percent. Italy is not alone in Europe, for example, the practice is prevalent in Poland, Slovakia, and is growing in the United Kingdom. This article outlines the international and regional human rights obligations and medical standards on this issue, and highlights some of the main gaps in these standards. It illustrates how European countries regulate or fail to regulate conscientious objection and how these regulations are working in practice, including examples of jurisprudence from national level courts and cases before the European Court of Human Rights. Finally, the article will provide recommendations

  9. Objective and subjective measurement of sleep disturbance in female trauma survivors with posttraumatic stress disorder.

    PubMed

    Werner, Kimberly B; Griffin, Michael G; Galovski, Tara E

    2016-06-30

    Sleep disturbance may be the most often endorsed symptom of posttraumatic stress disorder (PTSD). Much of this research is based on subjective reports from trauma survivors; however, objective measures of sleep-related impairment have yielded findings inconsistent with self-report data. More studies investigating subjective and objective assessments concordantly are needed to understand sleep impairment in PTSD. The current study examined PTSD-related sleep disturbance in a female interpersonal violence cohort with full PTSD diagnoses (N=51) assessing subjective (global and daily diary measures) and objective (actigraphy) sleep measures concurrently. PTSD severity was positively associated with global, subjective reports of sleep impairment and insomnia. Subjective measures of sleep (including global sleep impairment, insomnia, and daily sleep diary reports of total sleep time, sleep efficiency, and sleep onset latency) were moderately to strongly correlated. However, no significant correlations between subjective and objective reports of sleep impairment were found in this cohort. Analyses demonstrated an overall elevation in subjectively reported sleep impairment when compared to objective measurement assessed concurrently. Findings demonstrate a lack of agreement between subjective and objective measurements of sleep in a PTSD-positive female cohort, suggesting objective and subjective sleep impairments are distinct sleep parameters that do not necessarily directly co-vary. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Subjective versus objective measures of tic severity in Tourette syndrome - The influence of environment.

    PubMed

    Barnea, Meirav; Benaroya-Milshtein, Noa; Gilboa-Sechtman, Eva; Woods, Douglas W; Piacentini, John; Fennig, Silvana; Apter, Alan; Steinberg, Tamar

    2016-08-30

    The objective of this study was to examine the influence of environmental challenges on tic expression by subjective and objective measures. The study group consisted of 41 children aged 6-18 years (M=10.15, SD=2.73) with a primary diagnosis of Tourette syndrome. Subjective measures included the Functional Assessment Interview developed for this study and three standard validated instruments. The objective measure was a video-recording of the patients in five daily-life situations: watching television, doing homework, being alone, receiving attention when ticcing, and talking to a stranger. In addition, the effect of premonitory urges on assessment of tic expression was evaluated. The associations between the subjective and objective measures of tic expression were moderate to low. A significantly higher number of tics were observed in the television situation, and a significantly lower number in the alone situation, compared to the other situations. Higher levels of premonitory urge were associated with greater awareness of objectively measured tic expression. In conclusion, tic expression is significantly influenced by the environment. Subjective measures of tic expression may be misleading. These results have implications for refining the clinical assessment of tics, improving research methodology, and developing new therapeutic strategies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Measuring and understanding motivation among community health workers in rural health facilities in India-a mixed method study.

    PubMed

    Tripathy, Jaya Prasad; Goel, Sonu; Kumar, Ajay M V

    2016-08-09

    Motivated human resource is the key to improve health system performance and retention of health workers. There is scanty literature on measuring motivation of health workers in India. Thus, the objective of this study was to measure and identify important aspects of health workers' motivation in North India. A mixed method study design was adopted. Under the quantitative component, we interviewed randomly selected 62 community health workers (CHWs) in 18 sub-centres in two blocks of District Ambala, Haryana, India using a structured motivation scale. In-depth interviews were also carried out with 18 CHWs to explore the sources of motivation. The age of respondents and training in the past 12 months were found to be significantly associated with motivation. Job burnout, poor personal health, job insecurity and less career development opportunities were the individual level de-motivators, whereas not being able to fulfil family roles and poor supportive supervision were identified as environmental factors for poor motivation. Love for work, and financial incentives were individual level motivators, while community support and recognition, organizational commitment and pride, regular training were identified as environmental level motivators. Non-financial motivators such as interpersonal relations, family support, skill and career development opportunities require more attention. Regular need-based training is essential to maintain high levels of motivation.

  12. The prevalence of implementation of mental health measures in companies and its association with sickness absence.

    PubMed

    Pas, L Willemijn; Boot, Cécile R L; van der Beek, Allard J; Proper, Karin I

    2016-03-01

    The main objective was to determine the prevalence of implementation of mental health measures aimed at the prevention of high workload (workload measures) and the promotion of work engagement (engagement measures) in companies and sectors. Additionally, its associations with sickness absence was explored. Cross-sectional survey. An internet-based survey among 12,894 company representatives in the Netherlands. Descriptive analyses were performed to determine the prevalence, and differences between sectors were tested using Chi-squared tests. ANOVA was performed to examine the association between companies with or without mental health measures and sickness absence rates. 32.8% and 21.7% of the companies reported to have implemented 'continuously or often' workload measures and engagement measures, respectively. The sectors 'health care and welfare' and 'education' reported to have implemented measures most often. Having implemented engagement measures was significantly associated with lower sickness absence (4.1% vs 4.5%). Overall, workload measures were more often implemented than engagement measures. Future research is recommended to determine reasons for implementation as well as causality in the association between mental health measures and sickness absence. Copyright © 2015. Published by Elsevier Ltd.

  13. Relationship between parental estimate and an objective measure of child television watching

    PubMed Central

    Robinson, Jodie L; Winiewicz, Dana D; Fuerch, Janene H; Roemmich, James N; Epstein, Leonard H

    2006-01-01

    Many young children have televisions in their bedrooms, which may influence the relationship between parental estimate and objective measures of child television usage/week. Parental estimates of child television time of eighty 4–7 year old children (6.0 ± 1.2 years) at the 75th BMI percentile or greater (90.8 ± 6.8 BMI percentile) were compared to an objective measure of television time obtained from TV Allowance™ devices attached to every television in the home over a three week period. Results showed that parents overestimate their child's television time compared to an objective measure when no television is present in the bedroom by 4 hours/week (25.4 ± 11.5 vs. 21.4 ± 9.1) in comparison to underestimating television time by over 3 hours/week (26.5 ± 17.2 vs. 29.8 ± 14.4) when the child has a television in their bedroom (p = 0.02). Children with a television in their bedroom spend more objectively measured hours in television time than children without a television in their bedroom (29.8 ± 14.2 versus 21.4 ± 9.1, p = 0.003). Research on child television watching should take into account television watching in bedrooms, since it may not be adequately assessed by parental estimates. PMID:17129381

  14. Automatic trajectory measurement of large numbers of crowded objects

    NASA Astrophysics Data System (ADS)

    Li, Hui; Liu, Ye; Chen, Yan Qiu

    2013-06-01

    Complex motion patterns of natural systems, such as fish schools, bird flocks, and cell groups, have attracted great attention from scientists for years. Trajectory measurement of individuals is vital for quantitative and high-throughput study of their collective behaviors. However, such data are rare mainly due to the challenges of detection and tracking of large numbers of objects with similar visual features and frequent occlusions. We present an automatic and effective framework to measure trajectories of large numbers of crowded oval-shaped objects, such as fish and cells. We first use a novel dual ellipse locator to detect the coarse position of each individual and then propose a variance minimization active contour method to obtain the optimal segmentation results. For tracking, cost matrix of assignment between consecutive frames is trainable via a random forest classifier with many spatial, texture, and shape features. The optimal trajectories are found for the whole image sequence by solving two linear assignment problems. We evaluate the proposed method on many challenging data sets.

  15. Development and Validation of a Taxonomy for Characterizing Measurements in Health Self-Quantification.

    PubMed

    Almalki, Manal; Gray, Kathleen; Martin-Sanchez, Fernando

    2017-11-03

    The use of wearable tools for health self-quantification (SQ) introduces new ways of thinking about one's body and about how to achieve desired health outcomes. Measurements from individuals, such as heart rate, respiratory volume, skin temperature, sleep, mood, blood pressure, food consumed, and quality of surrounding air can be acquired, quantified, and aggregated in a holistic way that has never been possible before. However, health SQ still lacks a formal common language or taxonomy for describing these kinds of measurements. Establishing such taxonomy is important because it would enable systematic investigations that are needed to advance in the use of wearable tools in health self-care. For a start, a taxonomy would help to improve the accuracy of database searching when doing systematic reviews and meta-analyses in this field. Overall, more systematic research would contribute to build evidence of sufficient quality to determine whether and how health SQ is a worthwhile health care paradigm. The aim of this study was to investigate a sample of SQ tools and services to build and test a taxonomy of measurements in health SQ, titled: the classification of data and activity in self-quantification systems (CDA-SQS). Eight health SQ tools and services were selected to be examined: Zeo Sleep Manager, Fitbit Ultra, Fitlinxx Actipressure, MoodPanda, iBGStar, Sensaris Senspod, 23andMe, and uBiome. An open coding analytical approach was used to find all the themes related to the research aim. This study distinguished three types of measurements in health SQ: body structures and functions, body actions and activities, and around the body. The CDA-SQS classification should be applicable to align health SQ measurement data from people with many different health objectives, health states, and health conditions. CDA-SQS is a critical contribution to a much more consistent way of studying health SQ. ©Manal Almalki, Kathleen Gray, Fernando Martin-Sanchez. Originally

  16. Active travel and adults' health: The 2007-to-2011 Canadian Health Measures Surveys.

    PubMed

    Larouche, Richard; Faulkner, Guy; Tremblay, Mark S

    2016-04-01

    Active travel may be a means of integrating physical activity into an individual's routine. This analysis investigates the relationship between utilitarian walking and cycling and objectively measured physical activity and health-related outcomes in a nationally representative sample of Canadian adults. Adults aged 20 to 79 who participated in the 2007-to-2011 Canadian Health Measures Surveys (N = 7,160) reported the weekly time spent in utilitarian walking and cycling and wore an Actical accelerometer for seven days. They underwent a series of tests to measure physical fitness, body composition, blood pressure, and biomarkers. Differences in physical activity and health-related outcomes across levels of utilitarian walking and cycling were assessed with ANCOVA analyses adjusted for age, sex, education, household income, self-reported usual daily physical activity, and the complex survey design. Utilitarian walking and cycling were associated with moderate-to-vigorous physical activity in a graded manner. Compared with respondents who reported walking 1 to 5 hours a week, those who walked more than 5 hours a week had lower skinfold thickness. Respondents who reported cycling 1 or more hours a week had greater aerobic fitness and lower BMI, waist circumference, total cholesterol/HDL ratio, glycohemoglobin, C-reactive protein, and triglycerides than did those who did not cycle. They also had higher aerobic fitness and lower BMI and waist circumference than those who reported cycling less than an hour a week. Cycling at least an hour a week is associated with improved fitness and reduced cardiovascular disease risk factors. Both utilitarian walking and cycling may be means of increasing adults' moderate-to-vigorous physical activity.

  17. [Measurement and health economic evaluation of informal care].

    PubMed

    Zrubka, Zsombor

    2017-09-01

    Informal care is non-financed care outside the realm of formal healthcare, which represents an increasing challenge for aging societies. Informal care has frequently been neglected in health economic analyses, while in recent years its coverage has increased considerably in the international scientific literature. This review summarizes the methodology of the health-economic assessment of informal care, including the objective and subjective metrics of caregiver burden, its financial and non-financial valuation and practical applications, with special emphasis on the introduction of care-related quality of life instruments (e.g. Care Related Quality of Life - CarerQoL instrument). Care-related quality of life is a different entity from health-related quality of life, the two cannot be combined, so their joint evaluation requires multi-criteria decision analysis methods. Therefore, it is important to determine the societal preferences of care-related quality of life versus health-related quality of life, and map the relationship of care-related quality of life with time. The local validation of tools measuring care-related quality of life, its more widespread practical application and the analysis of its effect on decision making are also important part of the future research agenda. Orv Hetil. 2017; 158(35): 1363-1372.

  18. Everyday objects of learning about health and healing and implications for science education

    NASA Astrophysics Data System (ADS)

    Gitari, Wanja

    2006-02-01

    The role of science education in rural development is of great interest to science educators. In this study I investigated how residents of rural Kirumi, Kenya, approach health and healing, through discussions and semistructured and in-depth interviews with 150 residents, 3 local herbalists, and 2 medical researchers over a period of 6 months. I constructed objects of learning by looking for similarities and differences within interpretive themes. Objects of learning found comprise four types of personal learning tools, three types of relational learning tools, three genres of moral obligation, and five genres of knowledge guarding. Findings show that rural people use (among other learning tools) inner sensing to engage thought processes that lead to health and healing knowledge. The sociocultural context is also an important component in learning. Inner sensing and residents' sociocultural context are not presently emphasized in Kenyan science teaching. I discuss the potential use of rural objects of learning in school science, with specific reference to a health topic in the Kenyan science curriculum. In addition, the findings add to the literature in the Science, Technology, Society, and Environment (STSE) approach to science education, and cross-cultural and global science education.

  19. A comparison of the effect of different surgical gloves on objective measurement of fingertip cutaneous sensibility

    PubMed Central

    Bucknor, A; Karthikesalingam, A; Markar, SR; Holt, PJ; Jones, I; Allen-Mersh, TG

    2010-01-01

    INTRODUCTION The prudent selection of surgical gloves can deliver significant efficiency savings. However, objective data are lacking to compare differences in cutaneous sensibility between competing gloves. Therefore, the present study examined the use of a single comparable model of sterile surgical glove from two competing providers, Gammex PF HyGrip® (Ansell Limited, Red Bank, NJ, USA) with Biogel® (Mölnlycke Health Care AB, Göteborg, Sweden). SUBJECTS AND METHODS Cutaneous pressure threshold, static and moving two-point discrimination were measured as indices of objective surgical glove performance in 52 blinded healthcare professionals. RESULTS The mean cutaneous pressure threshold was 0.0680 ± 0.0923 g for skin, 0.411 ± 0.661 g for Ansell gloves and 0.472 ± 0.768 g for Biogel gloves. Skin was significantly more sensitive than Ansell (P< 0.0001) or Biogel (P< 0.0001) gloves (Wilcoxon signed rank test). There was no statistical difference between Biogel and Ansell gloves (P = 0.359). There was no significant difference between static or moving 2-point discrimination of skin and Ansell gloves (P= 0.556, P = 0.617; Wilcoxon signed rank test), skin and Biogel gloves (P= 0.486, P= 0.437; Wilcoxon signed rank test) or Ansell and Biogel gloves (P= 0.843, P= 0.670; Wilcoxon signed rank test). CONCLUSIONS No demonstrable objective difference was found between competing gloves in the outcome measures of cutaneous sensibility and two-point discrimination. However, a difference in subjective preference was noted. Untested factors may underlie this discrepancy, and further research should employ more sophisticated measurements of surgical performance using competing models of surgical glove. PMID:21118618

  20. The better way to determine the validity, reliability, objectivity and accuracy of measuring devices.

    PubMed

    Pazira, Parvin; Rostami Haji-Abadi, Mahdi; Zolaktaf, Vahid; Sabahi, Mohammadfarzan; Pazira, Toomaj

    2016-06-08

    In relation to statistical analysis, studies to determine the validity, reliability, objectivity and precision of new measuring devices are usually incomplete, due in part to using only correlation coefficient and ignoring the data dispersion. The aim of this study was to demonstrate the best way to determine the validity, reliability, objectivity and accuracy of an electro-inclinometer or other measuring devices. Another purpose of this study is to answer the question of whether reliability and objectivity represent accuracy of measuring devices. The validity of an electro-inclinometer was examined by mechanical and geometric methods. The objectivity and reliability of the device was assessed by calculating Cronbach's alpha for repeated measurements by three raters and by measurements on the same person by mechanical goniometer and the electro-inclinometer. Measurements were performed on "hip flexion with the extended knee" and "shoulder abduction with the extended elbow." The raters measured every angle three times within an interval of two hours. The three-way ANOVA was used to determine accuracy. The results of mechanical and geometric analysis showed that validity of the electro-inclinometer was 1.00 and level of error was less than one degree. Objectivity and reliability of electro-inclinometer was 0.999, while objectivity of mechanical goniometer was in the range of 0.802 to 0.966 and the reliability was 0.760 to 0.961. For hip flexion, the difference between raters in joints angle measurement by electro-inclinometer and mechanical goniometer was 1.74 and 16.33 degree (P<0.05), respectively. The differences for shoulder abduction measurement by electro-inclinometer and goniometer were 0.35 and 4.40 degree (P<0.05). Although both the objectivity and reliability are acceptable, the results showed that measurement error was very high in the mechanical goniometer. Therefore, it can be concluded that objectivity and reliability alone cannot determine the accuracy

  1. Association Between Objectively Measured Physical Activity and Erectile Dysfunction among a Nationally Representative Sample of American Men.

    PubMed

    Loprinzi, Paul D; Edwards, Meghan

    2015-09-01

    Emerging work suggests an inverse association between physical activity and erectile dysfunction (ED). The majority of this cross-sectional research comes from convenience samples and all studies on this topic have employed self-report physical activity methodology. Therefore, the purpose of this brief-report, confirmatory research study was to examine the association between objectively measured physical activity and ED in a national sample of Americans. Data from the 2003-2004 National Health and Nutrition Examination Survey were used. Six hundred ninety-two adults between the ages of 50 and 85 years (representing 33.2 million adults) constituted the analytic sample. Participants wore an ActiGraph 7164 accelerometer (ActiGraph, Pensacola, FL, USA) for up to 7 days with ED assessed via self-report. The main outcome measure used was ED assessed via self-report. After adjustments, for every 30 min/day increase in moderate-to-vigorous physical activity, participants had a 43% reduced odds of having ED (odds ratioadjusted  = 0.57; 95% confidence interval: 0.40-0.81; P = 0.004). This confirmatory study employing an objective measure of physical activity in a national sample suggests an inverse association between physical activity and ED. © 2015 International Society for Sexual Medicine.

  2. Associations between Patterns of Objectively Measured Physical Activity and Risk Factors for the Metabolic Syndrome

    PubMed Central

    Metzger, Jesse S.; Catellier, Diane J.; Evenson, Kelly R.; Treuth, Margarita S.; Rosamond, Wayne D.; Siega-Riz, Anna Maria

    2017-01-01

    Purpose Determine whether certain patterns of objectively measured physical activity (PA) are associated with the risk factors for or the diagnosis of the metabolic syndrome (MS). Design Latent class analysis, including the assessment of the associations between latent PA classes and the risk factors for MS. Setting Random sample from throughout the United States (US) using data from 2003–2004 National Health and Nutrition Examination Survey. Subjects A total of 3,458 adult, civilian, non-institutionalized US citizens. Measures Daily minutes of moderate-to-vigorous PA across a 7-day week, based on accelerometer measurements, as well ashigh blood pressure, blood glucose levels, triglyceride levels, and body mass index, along with low levels of high density lipoproteins, using clinical cut points. Results Membership in the more active PA classes was consistently associated with lower odds of all of the risk factors for the MS. However, when participants were categorized into quartiles of the coefficient of variation of PA across 7 days, few differences were seen in any of the risk factors. Conclusion Accumulating the total recommended amount of PA for a week is consistently associated with positive health profiles, and more PA than the recommended amounts may suggest. However, the manner in which this activity is accumulated, either spread over most days of the week or compressed into just a couple of days, may have similar associations with the risk factors for the MS. PMID:20073381

  3. Yes we can! Successful examples of disallowing 'conscientious objection' in reproductive health care.

    PubMed

    Fiala, Christian; Gemzell Danielsson, Kristina; Heikinheimo, Oskari; Guðmundsson, Jens A; Arthur, Joyce

    2016-06-01

    Reproductive health care is the only field in medicine where health care professionals (HCPs) are allowed to limit a patient's access to a legal medical treatment - usually abortion or contraception - by citing their 'freedom of conscience.' However, the authors' position is that 'conscientious objection' ('CO') in reproductive health care should be called dishonourable disobedience because it violates medical ethics and the right to lawful health care, and should therefore be disallowed. Three countries - Sweden, Finland, and Iceland - do not generally permit HCPs in the public health care system to refuse to perform a legal medical service for reasons of 'CO' when the service is part of their professional duties. The purpose of investigating the laws and experiences of these countries was to show that disallowing 'CO' is workable and beneficial. It facilitates good access to reproductive health services because it reduces barriers and delays. Other benefits include the prioritisation of evidence-based medicine, rational arguments, and democratic laws over faith-based refusals. Most notably, disallowing 'CO' protects women's basic human rights, avoiding both discrimination and harms to health. Finally, holding HCPs accountable for their professional obligations to patients does not result in negative impacts. Almost all HCPs and medical students in Sweden, Finland, and Iceland who object to abortion or contraception are able to find work in another field of medicine. The key to successfully disallowing 'CO' is a country's strong prior acceptance of women's civil rights, including their right to health care.

  4. A comparison of subjective and objective measures of physical activity and fitness in identifying associations with cardiometabolic risk factors.

    PubMed

    Schmidt, Michael D; Cleland, Verity J; Thomson, Russell J; Dwyer, Terence; Venn, Alison J

    2008-05-01

    To compare the ability of alternative measures of physical activity and fitness to quantify associations with health outcomes. Associations between a range of subjective and objective physical activity and fitness measures and cardiometabolic risk factors were examined using data from 1,631 Australians aged 26-36 years. Anthropometry, fitness, blood pressure, and fasting blood glucose, insulin, and lipids were measured at study clinics. Participants completed the International Physical Activity Questionnaire (IPAQ) and 7-day pedometer diaries; they also reported sedentary behavior (sitting, television viewing). In men and women, associations were strongest for fitness, with those in the highest (vs. lowest) fitness quarter having a 75% to 80% lower prevalence of two or more primary risk factors (waist circumference, high-density lipoprotein cholesterol, and insulin resistance). In men, a 60% to 70% reduced prevalence of two or more risk factors was observed across extreme quarters of IPAQ leisure, IPAQ vigorous, sitting duration, and pedometer measures. Similar reductions in prevalence were observed only across extreme quarters of pedometer activity and television viewing in women. Associations between alternative measures and cardiometabolic risk were relatively independent, suggesting that a range of physical activity and fitness measures may be needed to most accurately quantify associations between physical activity and health.

  5. Total Worker Health® Intervention for Construction Workers Alters Safety, Health, Well-being Measures.

    PubMed

    Anger, Wyndham Kent; Kyler-Yano, Jason; Vaughn, Katie; Wipfli, Bradley; Olson, Ryan; Blanco, Magali

    2018-02-26

    The aim of this study was to evaluate the effectiveness of a 14-week Total Worker Health (TWH) intervention designed for construction crews. Supervisors (n = 22) completed computer-based training and self-monitoring activities on team building, work-life balance, and reinforcing targeted behaviors. Supervisors and workers (n = 13) also completed scripted safety and health education in small groups with practice activities. The intervention led to significant (P < 0.05) improvements in family-supportive supervisory behaviors (d = 0.72). Additional significant improvements included reported frequency of exercising 30 minutes/day and muscle toning exercise (d = 0.50 and 0.59), family and coworker healthy diet support (d = 0.53 and 0.59), team cohesion (d = 0.38), reduced sugary snacks and drinks (d = 0.46 and d = 0.46), sleep duration (d = 0.38), and objectively-measured systolic blood pressure (d = 0.27). A TWH intervention tailored for construction crews can simultaneously improve safety, health, and well-being.

  6. Conceptual foundation for measures of physical function and behavioral health function for Social Security work disability evaluation.

    PubMed

    Marfeo, Elizabeth E; Haley, Stephen M; Jette, Alan M; Eisen, Susan V; Ni, Pengsheng; Bogusz, Kara; Meterko, Mark; McDonough, Christine M; Chan, Leighton; Brandt, Diane E; Rasch, Elizabeth K

    2013-09-01

    Physical and mental impairments represent the 2 largest health condition categories for which workers receive Social Security disability benefits. Comprehensive assessment of physical and mental impairments should include aspects beyond medical conditions such as a person's underlying capabilities as well as activity demands relevant to the context of work. The objective of this article is to describe the initial conceptual stages of developing new measurement instruments of behavioral health and physical functioning relevant for Social Security work disability evaluation purposes. To outline a clear conceptualization of the constructs to be measured, 2 content models were developed using structured and informal qualitative approaches. We performed a structured literature review focusing on work disability and incorporating aspects of the International Classification of Functioning, Disability and Health as a unifying taxonomy for framework development. Expert interviews provided advice and consultation to enhance face validity of the resulting content models. The content model for work-related behavioral health function identifies 5 major domains: (1) behavior control, (2) basic interactions, (3) temperament and personality, (4) adaptability, and (5) workplace behaviors. The content model describing physical functioning includes 3 domains: (1) changing and maintaining body position, (2) whole-body mobility, and (3) carrying, moving, and handling objects. These content models informed subsequent measurement properties including item development and measurement scale construction, and provided conceptual coherence guiding future empirical inquiry. The proposed measurement approaches show promise to comprehensively and systematically assess physical and behavioral health functioning relevant to work. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  7. Objectivity applied to embodied subjects in health care and social security medicine: definition of a comprehensive concept of cognitive objectivity and criteria for its application.

    PubMed

    Solli, Hans Magnus; Barbosa da Silva, António

    2018-03-02

    The article defines a comprehensive concept of cognitive objectivity (CCCO) applied to embodied subjects in health care. The aims of this study were: (1) to specify some necessary conditions for the definition of a CCCO that will allow objective descriptions and assessments in health care, (2) to formulate criteria for application of such a CCCO, and (3) to investigate the usefulness of the criteria in work disability assessments in medical certificates from health care provided for social security purposes. The study design was based on a philosophical conceptual analysis of objectivity and subjectivity, the phenomenological notions 'embodied subject', 'life-world', 'phenomenological object' and 'empathy', and an interpretation of certificates as texts. The study material consisted of 18 disability assessments from a total collection of 86 medical certificates provided for social security purposes, written in a Norwegian hospital-based mental health clinic. Four necessary conditions identified for defining a CCCO were: (A) acknowledging the patient's social context and life-world, (B) perceiving patients as cognitive objects providing a variety of meaningful data (clinical, psychometric, and behavioural data - i.e. activities and actions, meaningful expressions and self-reflection), (C) interpreting data in context, and (D) using general epistemological principles. The criteria corresponding to these conditions were: (a) describing the patient's social context and recognizing the patient's perspective, (b) taking into consideration a variety of quantitative and qualitative data drawn from the clinician's perceptions of the patient as embodied subject, (c) being aware of the need to interpret the data in context, and (d) applying epistemological principles (professional expertise, dialogical intersubjectivity, impartiality, accuracy and correctness). Genuine communication is presupposed. These criteria were tested in the work disability assessments of medical

  8. Full-field 3D shape measurement of specular object having discontinuous surfaces

    NASA Astrophysics Data System (ADS)

    Zhang, Zonghua; Huang, Shujun; Gao, Nan; Gao, Feng; Jiang, Xiangqian

    2017-06-01

    This paper presents a novel Phase Measuring Deflectometry (PMD) method to measure specular objects having discontinuous surfaces. A mathematical model is established to directly relate the absolute phase and depth, instead of the phase and gradient. Based on the model, a hardware measuring system has been set up, which consists of a precise translating stage, a projector, a diffuser and a camera. The stage locates the projector and the diffuser together to a known position during measurement. By using the model-based and machine vision methods, system calibration is accomplished to provide the required parameters and conditions. The verification tests are given to evaluate the effectiveness of the developed system. 3D (Three-Dimensional) shapes of a concave mirror and a monolithic multi-mirror array having multiple specular surfaces have been measured. Experimental results show that the proposed method can obtain 3D shape of specular objects having discontinuous surfaces effectively

  9. A Conceptual Foundation for Measures of Physical Function and Behavioral Health Function for Social Security Work Disability Evaluation

    PubMed Central

    Marfeo, Elizabeth E.; Haley, Stephen M.; Jette, Alan M.; Eisen, Susan V.; Ni, Pengsheng; Bogusz, Kara; Meterko, Mark; McDonough, Christine M.; Chan, Leighton; Brandt, Diane E.; Rasch, Elizabeth K.

    2014-01-01

    Physical and mental impairments represent the two largest health condition categories for which workers receive Social Security disability benefits. Comprehensive assessment of physical and mental impairments should include aspects beyond medical conditions such as a person’s underlying capabilities as well as activity demands relevant to the context of work. The objective of this paper is to describe the initial conceptual stages of developing new measurement instruments of behavioral health and physical functioning relevant for Social Security work disability evaluation purposes. To outline a clear conceptualization of the constructs to be measured, two content models were developed using structured and informal qualitative approaches. We performed a structured literature review focusing on work disability and incorporating aspects of the International Classification of Functioning, Disability, and Health (ICF) as a unifying taxonomy for framework development. Expert interviews provided advice and consultation to enhance face validity of the resulting content models. The content model for work-related behavioral health function identifies five major domains (1) Behavior Control, (2) Basic Interactions, (3) Temperament and Personality, (4) Adaptability, and (5) Workplace Behaviors. The content model describing physical functioning includes three domains (1) Changing and Maintaining Body Position, (2) Whole Body Mobility, and (3) Carrying, Moving and Handling Objects. These content models informed subsequent measurement properties including item development, measurement scale construction, and provided conceptual coherence guiding future empirical inquiry. The proposed measurement approaches show promise to comprehensively and systematically assess physical and behavioral health functioning relevant to work. PMID:23548543

  10. Standardized Approach to Quantitatively Measure Residual Limb Skin Health in Individuals with Lower Limb Amputation.

    PubMed

    Rink, Cameron L; Wernke, Matthew M; Powell, Heather M; Tornero, Mark; Gnyawali, Surya C; Schroeder, Ryan M; Kim, Jayne Y; Denune, Jeffrey A; Albury, Alexander W; Gordillo, Gayle M; Colvin, James M; Sen, Chandan K

    2017-07-01

    Objective: (1) Develop a standardized approach to quantitatively measure residual limb skin health. (2) Report reference residual limb skin health values in people with transtibial and transfemoral amputation. Approach: Residual limb health outcomes in individuals with transtibial ( n  = 5) and transfemoral ( n  = 5) amputation were compared to able-limb controls ( n  = 4) using noninvasive imaging (hyperspectral imaging and laser speckle flowmetry) and probe-based approaches (laser doppler flowmetry, transcutaneous oxygen, transepidermal water loss, surface electrical capacitance). Results: A standardized methodology that employs noninvasive imaging and probe-based approaches to measure residual limb skin health are described. Compared to able-limb controls, individuals with transtibial and transfemoral amputation have significantly lower transcutaneous oxygen tension, higher transepidermal water loss, and higher surface electrical capacitance in the residual limb. Innovation: Residual limb health as a critical component of prosthesis rehabilitation for individuals with lower limb amputation is understudied in part due to a lack of clinical measures. Here, we present a standardized approach to measure residual limb health in people with transtibial and transfemoral amputation. Conclusion: Technology advances in noninvasive imaging and probe-based measures are leveraged to develop a standardized approach to quantitatively measure residual limb health in individuals with lower limb loss. Compared to able-limb controls, resting residual limb physiology in people that have had transfemoral or transtibial amputation is characterized by lower transcutaneous oxygen tension and poorer skin barrier function.

  11. Health-Related Measures of Children's Physical Fitness.

    ERIC Educational Resources Information Center

    Pate, Russell R.

    1991-01-01

    Summarizes health-related physical fitness measurement procedures for children, emphasizing field measures. Health-related physical fitness encompasses cardiorespiratory endurance, body composition, muscular strength and endurance, and flexibility. The article presents several issues pertinent to research on health-related fitness testing. (SM)

  12. Measure Once, Cut Twice – Adding Patient-Reported Outcome Measures to the Electronic Health Record for Comparative Effectiveness Research

    PubMed Central

    Wu, Albert W.; Kharrazi, Hadi; Boulware, L. Ebony; Snyder, Claire F.

    2013-01-01

    Objective This paper presents the current state of patient-reported outcome measures, and explains new opportunities for leveraging the recent adoption of electronic health records to expand the application of patient-reported outcomes in both clinical care and comparative effectiveness research. Study Design and Setting Historic developments of patient-reported outcome, electronic health record, and comparative effectiveness research are analyzed in two dimensions: patient-centeredness and digitization. We pose the question: “What needs to be standardized around the collection of patient-reported outcomes in electronic health records for comparative effectiveness research?” Results We identified three converging trends: the progression of patient-reported outcomes toward greater patient centeredness and electronic adaptation; the evolution of electronic health records into personalized and fully digitized solutions; the shift toward patient-oriented comparative effectiveness research. Related to this convergence, we propose an architecture for patient-reported outcome standardization that could serve as a first step toward a more comprehensive integration of patient-reported outcomes with electronic health record for both practice and research. Conclusion The science of patient-reported outcome measurement has matured sufficiently to be integrated routinely into electronic health records and other e-health solutions to collect data on an ongoing basis for clinical care and comparative effectiveness research. Further efforts and ideally coordinated efforts from various stakeholders are needed to refine the details of the proposed framework for standardization. PMID:23849145

  13. Quality of life, health status, and health service utilization related to a new measure of health literacy: FLIGHT/VIDAS.

    PubMed

    Ownby, Raymond L; Acevedo, Amarilis; Jacobs, Robin J; Caballero, Joshua; Waldrop-Valverde, Drenna

    2014-09-01

    Researchers have identified significant limitations in some currently used measures of health literacy. The purpose of this paper is to present data on the relation of health-related quality of life, health status, and health service utilization to performance on a new measure of health literacy in a nonpatient population. The new measure was administered to 475 English- and Spanish-speaking community-dwelling volunteers along with existing measures of health literacy and assessments of health-related quality of life, health status, and healthcare service utilization. Relations among measures were assessed via correlations and health status and utilization was tested across levels of health literacy using ANCOVA models. The new health literacy measure is significantly related to existing measures of health literacy as well as to participants' health-related quality of life. Persons with lower levels of health literacy reported more health conditions, more frequent physical symptoms, and greater healthcare service utilization. The new measure of health literacy is valid and shows relations to measures of conceptually related constructs such as quality of life and health behaviors. FLIGHT/VIDAS may be useful to researchers and clinicians interested in a computer administered and scored measure of health literacy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. Imbalance: Objective measures versus subjective self-report in clinical practice.

    PubMed

    Chiarovano, Elodie; Wang, Wei; Reynolds, Pam; MacDougall, Hamish G

    2018-01-01

    Dizziness and imbalance are very common complaints in clinical practice. One of the challenges is to evaluate the 'real' risk of falls. Two tools are available: the patient's self-report and the measure of the patient's balance. We evaluated the relationship between these methods using the Dizziness Handicap Inventory (DHI) and measures of balance while visual inputs are perturbed with Virtual Reality (VR). 90 consecutive patients underwent the DHI questionnaire and the balance test. The DHI questionnaire was used to measure the subject's perception of handicap associated with dizziness. The balance test measured the postural sway in several visual conditions: eyes open, eyes closed, and with an unpredictable visual perturbation using VR at several amplitudes of movement. No correlation was found between the DHI score and the balance measurement. The visual perturbations allow us to characterize patients into three groups: one group with a high DHI score who did not fall on the balance test (5.5%), one group with a low DHI score who failed eyes closed on a compliant surface (9.0%), and one group of the remaining patients (85.5%). The correlation between the DHI score and the balance performance became significant on the remaining group of patients. Both subjective self-report and objective measure are important to characterize a patient. The use of VR visual perturbations allowed us to define three important groups of patients. VR visual perturbations provided additional information that helps explain the lack of correlation between DHI and objective test results. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Comparison of self-report and objective measures of driving behavior and road safety: A systematic review.

    PubMed

    Kaye, Sherrie-Anne; Lewis, Ioni; Freeman, James

    2018-06-01

    This research systematically reviewed the existing literature in regards to studies which have used both self-report and objective measures of driving behavior. The objective of the current review was to evaluate disparities or similarities between self-report and objective measures of driving behavior. Searches were undertaken in the following electronic databases, PsycINFO, PubMed, and Scopus, for peer-reviewed full-text articles that (1) focused on road safety, and (2) compared both subjective and objective measures of driving performance or driver safety. A total of 22,728 articles were identified, with 19 articles, comprising 20 studies, included as part of the review. The research reported herein suggested that for some behaviors (e.g., driving in stressful situations) there were similarities between self-report and objective measures while for other behaviors (e.g., sleepiness and vigilance states) there were differences between these measurement techniques. In addition, findings from some studies suggested that in-vehicle devices may be a valid measurement tool to assess driving exposure in older drivers. Further research is needed to examine the correspondence between self-report and objective measures of driving behavior. In particular, there is a need to increase the number of studies which compare "like with like" as it is difficult to draw comparisons when there are variations in measurement tools used. Incorporating a range of objective and self-report measurements tools in research would help to ensure that the methods used offer the most reliable measures of assessing on-road behaviors. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

  16. A comparison of subjective and objective measures of physical activity from the Newcastle 85+ study.

    PubMed

    Innerd, Paul; Catt, Michael; Collerton, Joanna; Davies, Karen; Trenell, Michael; Kirkwood, Thomas B L; Jagger, Carol

    2015-07-01

    Little is known about physical activity (PA) in the very old, the fastest growing age group in the population. We aimed to examine the convergent validity of subjective and objective measures of PA in adults aged over 85 years. A total of 484 participants aged 87-89 years recruited to the Newcastle 85+ study completed a purpose-designed physical activity questionnaire (PAQ), which categorised participants as mildly active, moderately active and very active. Out of them, 337 participants wore a triaxial, raw accelerometer on the right wrist over a 5-7-day period to obtain objective measures of rest/activity, PA intensity and PA type. Data from subjective and objective measurement methods were compared. Self-reported PA was significantly associated with objective measures of the daily sedentary time, low-intensity PA and activity type classified as sedentary, activities of daily living and walking. Objective measures of PA were significantly different when low, moderate and high self-reported PA categories were compared (all P < 0.001). The Newcastle 85+ PAQ demonstrated convergent validity with objective measures of PA. Our findings suggest that this PAQ can be used in the very old to rank individuals according to their level of total PA. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society.

  17. Evaluating the results of stress urinary incontinence surgery with objective and subjective outcome measures.

    PubMed

    Diez-Itza, I; Espuña-Pons, M

    2014-09-01

    To assess the outcomes of stress urinary incontinence (SUI) surgery using objective and subjective measures in women with pure SUI and mixed urinary incontinence (MUI). The degree of correlation between the different outcome measures was also evaluated for both groups. A multicentre prospective cohort study of women who underwent surgery for SUI. A standardized cough stress test was used as the objective outcome measure, and specific items of the Epidemiology of Prolapse and Incontinence Questionnaire were used as the subjective outcome measure. The International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and the Patient Global Impression of Improvement (PGI-I) questionnaires were used for global assessment. Kappa test was used to measure the degree of correlation between the outcome measures. The participants were categorized into two groups before surgery: pure SUI (n=116) and MUI (n=161). Six months after surgery, the cure rate of the SUI component was high in both groups according to the objective and subjective outcome measures. Global assessment showed lower cure rates. The degree of agreement between objective and subjective outcome measures was moderate (kappa 0.541, p<0.001) for women with pure SUI, and fair (kappa 0.377, p<0.001) for women with MUI. Correlation between the change in ICIQ-UI SF score (pre to post surgery) and the degree of satisfaction (PGI-I) was significant (p<0.01) for both the pure SUI group (0.43) and the MUI group (0.48). Both objective and subjective cure rates are high for women with pure SUI and MUI following SUI surgery in Spain. The degree of agreement between different outcome measures varies. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. 2013 AMAOs Guide: Annual Measurable Achievement Objectives (AMAOs). Title III, Part A Accountability System

    ERIC Educational Resources Information Center

    Texas Education Agency, 2013

    2013-01-01

    Under Title III of the No Child Left Behind Act of 2001 (NCLB), the Texas Education Agency is required to establish Annual Measurable Achievement Objectives (AMAOs) for the English language acquisition and academic achievement of limited English proficient (LEP) students. This 2013 Guide to Annual Measurable Achievement Objectives provides AMAO…

  19. Motion measurement of acoustically levitated object

    NASA Technical Reports Server (NTRS)

    Watkins, John L. (Inventor); Barmatz, Martin B. (Inventor)

    1993-01-01

    A system is described for determining motion of an object that is acoustically positioned in a standing wave field in a chamber. Sonic energy in the chamber is sensed, and variation in the amplitude of the sonic energy is detected, which is caused by linear motion, rotational motion, or drop shape oscillation of the object. Apparatus for detecting object motion can include a microphone coupled to the chamber and a low pass filter connected to the output of the microphone, which passes only frequencies below the frequency of sound produced by a transducer that maintains the acoustic standing wave field. Knowledge about object motion can be useful by itself, can be useful to determine surface tension, viscosity, and other information about the object, and can be useful to determine the pressure and other characteristics of the acoustic field.

  20. Understanding and Measuring Health Care Insecurity

    PubMed Central

    Tomsik, Philip E.; Smith, Samantha; Mason, Mary Jane; Zyzanski, Stephen J.; Stange, Kurt C.; Werner, James J.; Flocke, Susan A.

    2015-01-01

    Purpose To define the concept of “health care insecurity,” validate a new self-report measure, and examine the impact of beginning care at a free clinic on uninsured patients’ health care insecurity. Methods Consecutive new patients presenting at a free clinic completed 15 items assessing domains of health care insecurity (HCI) at their first visit and again four to eight weeks later. Psychometrics and change of the HCI measure were examined. Results The HCI measure was found to have high internal consistency (α=0.94). Evidence of concurrent validity was indicated by negative correlation with VR-12 health-related quality of life physical and mental health components and positive correlation with the Perceived Stress Scale. Predictive validity was shown among the 83% of participants completing follow-up: HCI decreased after beginning care at a free clinic (p<.001). Conclusion Reliably assessing patient experience of health care insecurity is feasible and has potential to inform efforts to improve quality and access to care among underserved populations. PMID:25418245

  1. An examination of objectively-measured sedentary behavior and mental well-being in adults across week days and weekends.

    PubMed

    Gibson, Ann-Marie; Muggeridge, David J; Hughes, Adrienne R; Kelly, Louise; Kirk, Alison

    2017-01-01

    Limited research has explored the links between sedentary behaviour, mental health and quality of life. This study examines objectively measured sedentary behaviour and perceived mental health and quality of life across week days and weekends. 42 adults (19M, 23F; mean age 38yrs (range 18-67) & BMI 24.8kg/m2 (range 18.7-33.8) wore an activPAL monitor 24h/day for one week and completed the Hospital Anxiety and Depression Scale (HADS) and SF12 Health Survey. Average weekday and weekend day sitting time was computed. Differences between sitting (Group 1 = <8hrs/day, Group 2 = 8-10 hrs/day, Group 3 = >10hrs/day) and components of the HADS and SF12 health survey were examined using an ANCOVA with a measure of physical activity (step count) included as a covariate. Average sitting time on a weekday was 9hrs 29mins (range 5hrs 52mins to 12hrs 55mins) and 8hrs 59mins (range 4hrs, 07mins to 14hrs, 40mins) on a weekend day. There was a main effect (p<0.05) for weekday sitting time on total anxiety and depression (HADS) and mental health and vitality (SF12). Planned contrasts identified individuals in group 1 had lower anxiety and depression and higher mental health and vitality scores than individuals in groups 2 or 3 (p<0.05). No difference was found between individuals in group 2 and group 3 (p>0.05). No main effects were found for weekend sitting (p>0.05). Weekday sitting time below 8 hours/day is associated with better perceived mental health and quality of life.

  2. Lies, Damned Lies, and Health Inequality Measurements

    PubMed Central

    Gerdtham, Ulf-G; Petrie, Dennis

    2015-01-01

    Measuring and monitoring socioeconomic health inequalities are critical for understanding the impact of policy decisions. However, the measurement of health inequality is far from value neutral, and one can easily present the measure that best supports one’s chosen conclusion or selectively exclude measures. Improving people’s understanding of the often implicit value judgments is therefore important to reduce the risk that researchers mislead or policymakers are misled. While the choice between relative and absolute inequality is already value laden, further complexities arise when, as is often the case, health variables have both a lower and upper bound, and thus can be expressed in terms of either attainments or shortfalls, such as for mortality/survival. We bring together the recent parallel discussions from epidemiology and health economics regarding health inequality measurement and provide a deeper understanding of the different value judgments within absolute and relative measures expressed both in attainments and shortfalls, by graphically illustrating both hypothetical and real examples. We show that relative measures in terms of attainments and shortfalls have distinct value judgments, highlighting that for health variables with two bounds the choice is no longer only between an absolute and a relative measure but between an absolute, an attainment- relative and a shortfall-relative one. We illustrate how these three value judgments can be combined onto a single graph which shows the rankings according to all three measures, and illustrates how the three measures provide ethical benchmarks against which to judge the difference in inequality between populations. PMID:26133019

  3. Measuring health care process quality with software quality measures.

    PubMed

    Yildiz, Ozkan; Demirörs, Onur

    2012-01-01

    Existing quality models focus on some specific diseases, clinics or clinical areas. Although they contain structure, process, or output type measures, there is no model which measures quality of health care processes comprehensively. In addition, due to the not measured overall process quality, hospitals cannot compare quality of processes internally and externally. To bring a solution to above problems, a new model is developed from software quality measures. We have adopted the ISO/IEC 9126 software quality standard for health care processes. Then, JCIAS (Joint Commission International Accreditation Standards for Hospitals) measurable elements were added to model scope for unifying functional requirements. Assessment (diagnosing) process measurement results are provided in this paper. After the application, it was concluded that the model determines weak and strong aspects of the processes, gives a more detailed picture for the process quality, and provides quantifiable information to hospitals to compare their processes with multiple organizations.

  4. Measurement of Health Disparities, Health Inequities, and Social Determinants of Health to Support the Advancement of Health Equity.

    PubMed

    Penman-Aguilar, Ana; Talih, Makram; Huang, David; Moonesinghe, Ramal; Bouye, Karen; Beckles, Gloria

    2016-01-01

    Reduction of health disparities and advancement of health equity in the United States require high-quality data indicative of where the nation stands vis-à-vis health equity, as well as proper analytic tools to facilitate accurate interpretation of these data. This article opens with an overview of health equity and social determinants of health. It then proposes a set of recommended practices in measurement of health disparities, health inequities, and social determinants of health at the national level to support the advancement of health equity, highlighting that (1) differences in health and its determinants that are associated with social position are important to assess; (2) social and structural determinants of health should be assessed and multiple levels of measurement should be considered; (3) the rationale for methodological choices made and measures chosen should be made explicit; (4) groups to be compared should be simultaneously classified by multiple social statuses; and (5) stakeholders and their communication needs can often be considered in the selection of analytic methods. Although much is understood about the role of social determinants of health in shaping the health of populations, researchers should continue to advance understanding of the pathways through which they operate on particular health outcomes. There is still much to learn and implement about how to measure health disparities, health inequities, and social determinants of health at the national level, and the challenges of health equity persist. We anticipate that the present discussion will contribute to the laying of a foundation for standard practice in the monitoring of national progress toward achievement of health equity.

  5. Ability of College Students to Simulate ADHD on Objective Measures of Attention

    ERIC Educational Resources Information Center

    Booksh, Randee Lee; Pella, Russell D.; Singh, Ashvind N.; Gouvier, William Drew

    2010-01-01

    Objective: The authors examined the ability of college students to simulate ADHD symptoms on objective and self-report measures and the relationship between knowledge of ADHD and ability to simulate ADHD. Method: Undergraduate students were assigned to a control or a simulated ADHD malingering condition and compared with a clinical AD/HD group.…

  6. Combined incentives versus no-incentive exercise programs on objectively measured physical activity and health-related variables.

    PubMed

    Fennell, Curtis; Gerhart, Hayden; Seo, Yongsuk; Hauge, Kimberly; Glickman, Ellen L

    2016-09-01

    Incentivized exercise program interventions have recently led to mixed findings with regard to increasing physical activity, attendance, and improving healthy lifestyles. However, in this area limited research exists on implementing a combined negative reinforcement strategy, using a "buy-in" and positive reinforcement system. To determine the effect of comparing a non-incentivized reward system with an incentivized reward system using combined positive and negative rewards on physical activity, attendance, and health and performance outcomes. 15 Previously sedentary faculty and staff of a large public research university participated in two separate 12-week exercise interventions and wore a program accelerometer throughout the entire day during the 12weeks. During the first intervention, there were no incentives offered to participants. The second intervention consisted of an incentivized program. Positive reinforcements included various rewards for meeting achievements related to physical activity levels. A program rebate worth $25 for achieving 450miles was used as the negative reinforcement "buy-in" incentive. A two-way repeated measures ANOVA demonstrated a main effect of time for percent body fat (p<0.001) and push-ups (p=0.018). All other variables revealed no differences between conditions or from pre to post testing. There was no difference between conditions with physical activity or attendance. No differences in physical activity or health-related variables were found within the incentivized and non-incentivized conditions. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Socioeconomic Status and Age Variations in Health-Related Quality of Life: Results From the National Health Measurement Study

    PubMed Central

    Cherepanov, Dasha; Palta, Mari; Dunham, Nancy Cross; Feeny, David; Fryback, Dennis G.

    2009-01-01

    Objectives We examine whether multiple health-related quality of life (HRQoL) measures are stratified by socioeconomic status (SES) and age in the United States. Methods Data are from the 2005/2006 National Health Measurement Study, a telephone survey of a nationally representative sample of U.S. adults. We plot mean HRQoL scores by SES within age groups. Regression analyses test whether education, income, and assets each have independent associations with three “preference-based” HRQoL measures and self-rated health (SRH). We test whether these associations vary by age. Results There are SES disparities in HRQoL and SRH among adults in the United States at all age groups. Income differentials in HRQoL are strong across current adult age cohorts, except the 75–89 age cohort. Education and assets have statistically significant but weaker associations with HRQoL. All three SES measures are associated with SRH (net of each other) at every age group. Those in the lowest income and education groups in the 35–44 age cohort have worse HRQoL and SRH than those in higher SES groups in the 65+ age cohort. Discussion Significant improvements in HRQoL at the population level will only be possible if we improve the HRQoL of people at the lowest end of the socioeconomic distribution. PMID:19307286

  8. Detection and Purging of Specular Reflective and Transparent Object Influences in 3d Range Measurements

    NASA Astrophysics Data System (ADS)

    Koch, R.; May, S.; Nüchter, A.

    2017-02-01

    3D laser scanners are favoured sensors for mapping in mobile service robotics at indoor and outdoor applications, since they deliver precise measurements at a wide scanning range. The resulting maps are detailed since they have a high resolution. Based on these maps robots navigate through rough terrain, fulfil advanced manipulation, and inspection tasks. In case of specular reflective and transparent objects, e.g., mirrors, windows, shiny metals, the laser measurements get corrupted. Based on the type of object and the incident angle of the incoming laser beam there are three results possible: a measurement point on the object plane, a measurement behind the object plane, and a measurement of a reflected object. It is important to detect such situations to be able to handle these corrupted points. This paper describes why it is difficult to distinguish between specular reflective and transparent surfaces. It presents a 3DReflection- Pre-Filter Approach to identify specular reflective and transparent objects in point clouds of a multi-echo laser scanner. Furthermore, it filters point clouds from influences of such objects and extract the object properties for further investigations. Based on an Iterative-Closest-Point-algorithm reflective objects are identified. Object surfaces and points behind surfaces are masked according to their location. Finally, the processed point cloud is forwarded to a mapping module. Furthermore, the object surface corners and the type of the surface is broadcasted. Four experiments demonstrate the usability of the 3D-Reflection-Pre-Filter. The first experiment was made in a empty room containing a mirror, the second experiment was made in a stairway containing a glass door, the third experiment was made in a empty room containing two mirrors, the fourth experiment was made in an office room containing a mirror. This paper demonstrate that for single scans the detection of specular reflective and transparent objects in 3D is possible. It

  9. New Jersey College Students' High-Risk Behavior: Will We Meet the Health Objectives for the Year 2000?

    ERIC Educational Resources Information Center

    Lewis, Deborah Fisch; And Others

    1996-01-01

    A survey of college students' risk behaviors (sexual, substance use, and behaviors leading to injuries) found that, when compared with relevant national health objectives, students will meet the health objectives regarding tobacco and cocaine use but not condom and birth control use, alcohol and marijuana use, or bicycle helmet use. (SM)

  10. Advancing Health Literacy Measurement: A Pathway to Better Health and Health System Performance

    PubMed Central

    Pleasant, Andrew

    2014-01-01

    The concept of health literacy initially emerged and continues to gain strength as an approach to improving health status and the performance of health systems. Numerous studies clearly link low levels of education, literacy, and health literacy with poor health, poor health care utilization, increased barriers to care, and early death. However, theoretical understandings and methods of measuring the complex social construct of health literacy have experienced a continual evolution that remains incomplete. As a result, the seemingly most-cited definition of health literacy proposed in the now-decade-old Institute of Medicine report on health literacy is long overdue for updating. Such an effort should engage a broad and diverse set of health literacy researchers, practitioners, and members of the public in creating a definition that can earn broad consensus through validation testing in a rigorous scientific approach. That effort also could produce the basis for a new universally applicable measure of health literacy. Funders, health systems, and policymakers should reconsider their timid approach to health literacy. Although the field and corresponding evidence base are not perfect, health literacy—especially when combined with a focus on prevention and integrative health—is one of the most promising approaches to advancing public health. PMID:25491583

  11. Public use of electronic personal health information: Measuring progress of the Healthy People 2020 Objectives.

    PubMed

    Greenberg, Alexandra J; Serrano, Katrina J; Thai, Chan L; Blake, Kelly D; Moser, Richard P; Hesse, Bradford W; Ahern, David K

    2017-03-01

    Use of the internet for seeking and managing health information in the U.S., Europe, and emerging and developing nations is growing. Recent global trends indicate more interactive uses of the internet including online communication with providers. In the U.S., The Healthy People 2020 (HP2020) initiative was created by the Department of Health and Human Services to provide 10-year goals for improving the health of American citizens. Two goals of HP2020 were to increase the proportion of individuals who use the Internet to keep track of their personal health information (PHI) online and to increase the proportion of individuals who use the internet to communicate with their healthcare provider. In the present study, we use data from the seven administrations of the Health Information National Trends Survey (HINTS) to assess progress towards these goals. These data were analyzed using descriptive, bivariate, and logistic regression analytic techniques. Results of this study suggested that the HP2020 target of having 15.7% of individuals manage their PHI online by 2020 has already been exceeded (28.1%); similarly, the goal for proportion of individuals communicating with their provider using the internet (15.0%) was exceeded by 2014 (29.7%). While progress towards these goals was positive in all sociodemographic groups for both goals, differences in the rate of progress were seen by gender, race/ethnicity, income, and education, but not by age group. The rapidly increasing proportion of individuals globally who use the internet to manage their health information provides unique opportunities for patient-centered health information technology interventions.

  12. Ultrasonic Measurement of Strain Distribution Inside Object Cyclically Compressed by Dual Acoustic Radiation Force

    NASA Astrophysics Data System (ADS)

    Odagiri, Yoshitaka; Hasegawa, Hideyuki; Kanai, Hiroshi

    2008-05-01

    One possible way to evaluate acupuncture therapy quantitatively is to measure the change in the elastic property of muscle after application of the therapy. Many studies have been conducted to measure mechanical properties of tissues using ultrasound-induced acoustic radiation force. To assess mechanical properties, strain must be generated in an object. However, a single radiation force is not effective because it mainly generates translational motion when the object is much harder than the surrounding medium. In this study, two cyclic radiation forces are simultaneously applied to a muscle phantom from two opposite horizontal directions so that the object is cyclically compressed in the horizontal direction. By the horizontal compression, the object is expanded vertically based on its incompressibility. The resultant vertical displacement is measured using another ultrasound pulse. Two ultrasonic transducers for actuation were both driven by the sum of two continuous sinusoidal signals at two slightly different frequencies [1 MHz and (1 M + 5) Hz]. The displacement of several micrometers in amplitude, which fluctuated at 5 Hz, was measured by the ultrasonic phased tracking method. Increase in thickness inside the object was observed just when acoustic radiation forces increased. Such changes in thickness correspond to vertical expansion due to horizontal compression.

  13. Occupational Safety and Health Measures in Micro-scale Enterprises (MSEs) in Shiraz, Iran

    PubMed Central

    Jahangiri, Mehdi; Rostamabadi, Akbar; Malekzadeh, Gholamreza; Sadi, Amin Fahandej; Hamzavi, Golnar; Rasooli, Javad; Momeni, Zahra; Ghaem, Haleh

    2016-01-01

    Objectives: This study aimed to determine the extent of implementation of occupational safety and health measures in micro-scale enterprises (MSEs) and to assess the prevalence of occupational injuries and accidents and its relationship with occupational safety and health measures provided in the MSEs. Method: A cross-sectional study was conducted among 595 of MSEs. An index called the Safety and Health Requirement Index (SHRI) was created and used to calculate the percentage of provided occupational safety and health measures. The relationship between the SHRI and the occurrence of occupational accidents and injuries was investigated with the independent samples t-test and one-way ANOVA. Results: The mean SHRI score was 60.43%, which was categorized into moderate level. Of the 30.9% of enterprises that had experienced accidents and injuries, the most common types of injuries were musculoskeletal disorders and cuts, and the least common types were pulmonary and hearing problems. Results of one-way ANOVA revealed a statistically significant relationship between the mean SHRI score and industrial branch, enterprise size, and type of accident and injury. The independent samples t-test showed that the occurrence of occupational accidents and injuries was not significantly influenced by provided health and safety measures in MSEs. Conclusion: Given the high percentage of enterprises with very poor to poor levels for the SHRI and the high prevalence of occupational accidents and injuries among the studied MSEs, feasible protective strategies and job safety training programs are required to promote occupational health and safety in the studied MSEs. PMID:27010083

  14. The Association of Sexual Orientation Measures With Young Adults’ Health-Related Outcomes

    PubMed Central

    Walsemann, Katrina M.; Carter, Jarvis W.

    2012-01-01

    Objectives. We examined associations among 3 dimensions of sexual orientation (identity, behavior, and attraction) and key health-related indicators commonly studied among sexual minority populations: depressive symptoms, perceived stress, smoking, binge drinking, and victimization. Methods. We analyzed data from the National Longitudinal Study of Adolescent Health, Wave IV (2007–2008) when respondents were aged 24 to 32 years (n = 14 412). We used multivariate linear and logistic regressions to examine consistency of associations between sexual orientation measures and health-related indicators. Results. Strength of associations differed by gender and sexual orientation measure. Among women, being attracted to both sexes, identifying as “mostly straight” or “bisexual,” and having mostly opposite-sex sexual partners was associated with greater risk for all indicators. Among men, sexual attraction was unrelated to health indicators. Men who were “mostly straight” were at greater risk for some, but not all, indicators. Men who had sexual partners of the same-sex or both sexes were at lower risk for binge drinking. Conclusions. Using all 3 dimensions of sexual orientation provides a more complete picture of the association between sexual orientation and health among young adults than does using any 1 dimension alone. PMID:22021310

  15. Two Scales for Measuring International Health Status.

    ERIC Educational Resources Information Center

    Larson, James S.

    1991-01-01

    Two scales for measuring international health status are proposed as alternatives to the current measure--infant mortality rate. Health Status 1 is an interval scale combining infant mortality and literacy rate. Health Status 2 comprises these statistics, plus death rate for persons 65 years and older, and mental hospital admissions. (SLD)

  16. Utilising the Intel RealSense Camera for Measuring Health Outcomes in Clinical Research.

    PubMed

    Siena, Francesco Luke; Byrom, Bill; Watts, Paul; Breedon, Philip

    2018-02-05

    Applications utilising 3D Camera technologies for the measurement of health outcomes in the health and wellness sector continues to expand. The Intel® RealSense™ is one of the leading 3D depth sensing cameras currently available on the market and aligns itself for use in many applications, including robotics, automation, and medical systems. One of the most prominent areas is the production of interactive solutions for rehabilitation which includes gait analysis and facial tracking. Advancements in depth camera technology has resulted in a noticeable increase in the integration of these technologies into portable platforms, suggesting significant future potential for pervasive in-clinic and field based health assessment solutions. This paper reviews the Intel RealSense technology's technical capabilities and discusses its application to clinical research and includes examples where the Intel RealSense camera range has been used for the measurement of health outcomes. This review supports the use of the technology to develop robust, objective movement and mobility-based endpoints to enable accurate tracking of the effects of treatment interventions in clinical trials.

  17. National Health Objectives for the Year 2000: The Demographic Impact of Health Promotion and Disease Prevention.

    ERIC Educational Resources Information Center

    Stoto, Michael A.; Durch, Jane S.

    1991-01-01

    Demographic impacts of meeting the National Health Objectives for 2000 were studied using life-table methods. Meeting the targets would increase life expectancy at birth by 1.5-2.1 years to 76.6-77.2 years. Modifying the coronary heart disease and unintentional injury targets to be more optimistic would further increase life expectancy. (SLD)

  18. Probing optimal measurement configuration for optical scatterometry by the multi-objective genetic algorithm

    NASA Astrophysics Data System (ADS)

    Chen, Xiuguo; Gu, Honggang; Jiang, Hao; Zhang, Chuanwei; Liu, Shiyuan

    2018-04-01

    Measurement configuration optimization (MCO) is a ubiquitous and important issue in optical scatterometry, whose aim is to probe the optimal combination of measurement conditions, such as wavelength, incidence angle, azimuthal angle, and/or polarization directions, to achieve a higher measurement precision for a given measuring instrument. In this paper, the MCO problem is investigated and formulated as a multi-objective optimization problem, which is then solved by the multi-objective genetic algorithm (MOGA). The case study on the Mueller matrix scatterometry for the measurement of a Si grating verifies the feasibility of the MOGA in handling the MCO problem in optical scatterometry by making a comparison with the Monte Carlo simulations. Experiments performed at the achieved optimal measurement configuration also show good agreement between the measured and calculated best-fit Mueller matrix spectra. The proposed MCO method based on MOGA is expected to provide a more general and practical means to solve the MCO problem in the state-of-the-art optical scatterometry.

  19. Development of the Digital Health Literacy Instrument: Measuring a Broad Spectrum of Health 1.0 and Health 2.0 Skills.

    PubMed

    van der Vaart, Rosalie; Drossaert, Constance

    2017-01-24

    With the digitization of health care and the wide availability of Web-based applications, a broad set of skills is essential to properly use such facilities; these skills are called digital health literacy or eHealth literacy. Current instruments to measure digital health literacy focus only on information gathering (Health 1.0 skills) and do not pay attention to interactivity on the Web (Health 2.0). To measure the complete spectrum of Health 1.0 and Health 2.0 skills, including actual competencies, we developed a new instrument. The Digital Health Literacy Instrument (DHLI) measures operational skills, navigation skills, information searching, evaluating reliability, determining relevance, adding self-generated content, and protecting privacy. Our objective was to study the distributional properties, reliability, content validity, and construct validity of the DHLI's self-report scale (21 items) and to explore the feasibility of an additional set of performance-based items (7 items). We used a paper-and-pencil survey among a sample of the general Dutch population, stratified by age, sex, and educational level (T1; N=200). The survey consisted of the DHLI, sociodemographics, Internet use, health status, health literacy and the eHealth Literacy Scale (eHEALS). After 2 weeks, we asked participants to complete the DHLI again (T2; n=67). Cronbach alpha and intraclass correlation analysis between T1 and T2 were used to investigate reliability. Principal component analysis was performed to determine content validity. Correlation analyses were used to determine the construct validity. Respondents (107 female and 93 male) ranged in age from 18 to 84 years (mean 46.4, SD 19.0); 23.0% (46/200) had a lower educational level. Internal consistencies of the total scale (alpha=.87) and the subscales (alpha range .70-.89) were satisfactory, except for protecting privacy (alpha=.57). Distributional properties showed an approximately normal distribution. Test-retest analysis was

  20. Objectively measuring pain using facial expression: is the technology finally ready?

    PubMed

    Dawes, Thomas Richard; Eden-Green, Ben; Rosten, Claire; Giles, Julian; Governo, Ricardo; Marcelline, Francesca; Nduka, Charles

    2018-03-01

    Currently, clinicians observe pain-related behaviors and use patient self-report measures in order to determine pain severity. This paper reviews the evidence when facial expression is used as a measure of pain. We review the literature reporting the relevance of facial expression as a diagnostic measure, which facial movements are indicative of pain, and whether such movements can be reliably used to measure pain. We conclude that although the technology for objective pain measurement is not yet ready for use in clinical settings, the potential benefits to patients in improved pain management, combined with the advances being made in sensor technology and artificial intelligence, provide opportunities for research and innovation.

  1. The association of two productivity measures with health risks and medical conditions in an Australian employee population.

    PubMed

    Musich, Shirley; Hook, Dan; Baaner, Stephanie; Edington, Dee W

    2006-01-01

    To investigate the impact of health on job performance using two measures of productivity loss: (1) a self-reported measure of health-related presenteeism and (2) an objective measure of absenteeism. A cross-sectional survey using a Health Risk Appraisal (HRA) to evaluate self-reported presenteeism and the prevalence of 12 health risks and eight medical conditions. Employees (n=224) of a private insurance provider in Australia. A Health Risk Appraisal (HRA) questionnaire was used to evaluate self-reported presenteeism on different aspects of job demands and to assess the prevalence of 12 health risks and eight medical conditions. Illness absent hours were obtained from company administrative records. Increased presenteeism was significantly associated with high stress, life dissatisfaction, and back pain, while increased illness absenteeism was significantly associated with overweight, poor perception of health, and diabetes. Excess presenteeism associated with excess health risks (productivity loss among those with medium- or high-risk status compared to those with low-risk status) was independently calculated at 19.0% for presenteeism and 12.8% for illness absenteeism. This study demonstrates an association between health metrics and self-reported work impairment (presenteeism) and measured absenteeism. The study provides a first indication of the potential benefits of health promotion programming to Australian employees in improving health and to the corporation in minimizing health-related productivity loss.

  2. Apparatus for measuring surface movement of an object that is subjected to external vibrations

    DOEpatents

    Kotidis, Petros A.; Woodroffe, Jaime A.; Rostler, Peter S.

    1997-01-01

    A system for non-destructively measuring an object and controlling industrial processes in response to the measurement is disclosed in which an impulse laser generates a plurality of sound waves over timed increments in an object. A polarizing interferometer is used to measure surface movement of the object caused by the sound waves and sensed by phase shifts in the signal beam. A photon multiplier senses the phase shift and develops an electrical signal. A signal conditioning arrangement modifies the electrical signals to generate an average signal correlated to the sound waves which in turn is correlated to a physical or metallurgical property of the object, such as temperature, which property may then be used to control the process. External, random vibrations of the workpiece are utilized to develop discernible signals which can be sensed in the interferometer by only one photon multiplier. In addition the interferometer includes an arrangement for optimizing its sensitivity so that movement attributed to various waves can be detected in opaque objects. The interferometer also includes a mechanism for sensing objects with rough surfaces which produce speckle light patterns. Finally the interferometer per se, with the addition of a second photon multiplier is capable of accurately recording beam length distance differences with only one reading.

  3. Method and apparatus for measuring surface movement of an object using a polarizing interfeometer

    DOEpatents

    Schultz, Thomas J.; Kotidis, Petros A.; Woodroffe, Jaime A.; Rostler, Peter S.

    1995-01-01

    A system for non-destructively measuring an object and controlling industrial processes in response to the measurement is disclosed in which an impulse laser generates a plurality of sound waves over timed increments in an object. A polarizing interferometer is used to measure surface movement of the object caused by the sound waves and sensed by phase shifts in the signal beam. A photon multiplier senses the phase shift and develops an electrical signal. A signal conditioning arrangement modifies the electrical signals to generate an average signal correlated to the sound waves which in turn is correlated to a physical or metallurgical property of the object, such as temperature, which property may then be used to control the process. External, random vibrations of the workpiece are utilized to develop discernible signals which can be sensed in the interferometer by only one photon multiplier. In addition the interferometer includes an arrangement for optimizing its sensitivity so that movement attributed to various waves can be detected in opaque objects. The interferometer also includes a mechanism for sensing objects with rough surfaces which produce speckle light patterns. Finally the interferometer per se, with the addition of a second photon multiplier is capable of accurately recording beam length distance differences with only one reading.

  4. Method and apparatus for measuring surface movement of an object using a polarizing interferometer

    DOEpatents

    Schultz, T.J.; Kotidis, P.A.; Woodroffe, J.A.; Rostler, P.S.

    1995-05-09

    A system for non-destructively measuring an object and controlling industrial processes in response to the measurement is disclosed in which an impulse laser generates a plurality of sound waves over timed increments in an object. A polarizing interferometer is used to measure surface movement of the object caused by the sound waves and sensed by phase shifts in the signal beam. A photon multiplier senses the phase shift and develops an electrical signal. A signal conditioning arrangement modifies the electrical signals to generate an average signal correlated to the sound waves which in turn is correlated to a physical or metallurgical property of the object, such as temperature, which property may then be used to control the process. External, random vibrations of the workpiece are utilized to develop discernible signals which can be sensed in the interferometer by only one photon multiplier. In addition the interferometer includes an arrangement for optimizing its sensitivity so that movement attributed to various waves can be detected in opaque objects. The interferometer also includes a mechanism for sensing objects with rough surfaces which produce speckle light patterns. Finally the interferometer per se, with the addition of a second photon multiplier is capable of accurately recording beam length distance differences with only one reading. 38 figs.

  5. Apparatus for measuring surface movement of an object that is subjected to external vibrations

    DOEpatents

    Kotidis, P.A.; Woodroffe, J.A.; Rostler, P.S.

    1997-04-22

    A system for non-destructively measuring an object and controlling industrial processes in response to the measurement is disclosed in which an impulse laser generates a plurality of sound waves over timed increments in an object. A polarizing interferometer is used to measure surface movement of the object caused by the sound waves and sensed by phase shifts in the signal beam. A photon multiplier senses the phase shift and develops an electrical signal. A signal conditioning arrangement modifies the electrical signals to generate an average signal correlated to the sound waves which in turn is correlated to a physical or metallurgical property of the object, such as temperature, which property may then be used to control the process. External, random vibrations of the workpiece are utilized to develop discernible signals which can be sensed in the interferometer by only one photon multiplier. In addition the interferometer includes an arrangement for optimizing its sensitivity so that movement attributed to various waves can be detected in opaque objects. The interferometer also includes a mechanism for sensing objects with rough surfaces which produce speckle light patterns. Finally the interferometer per se, with the addition of a second photon multiplier is capable of accurately recording beam length distance differences with only one reading. 38 figs.

  6. Associations Between Parental SES and Children's Health-Related Quality of Life: The Role of Objective and Subjective Social Status.

    PubMed

    Kim, Kay W; Wallander, Jan L; Peskin, Melissa; Cuccaro, Paula; Elliott, Marc N; Schuster, Mark A

    2018-06-01

    We examined (1) the relationship that parental objective social status (OSS) and subjective social status (SSS) have with children's health-related quality of life (HRQOL), (2) whether SSS mediates the association between OSS and HRQOL, and (3) whether these associations differ among Black, Latino, and White children. Data came from 4,824 Black, Latino, and White 5th graders in the Healthy PassagesTM study. OSS was measured as parent educational attainment and net equivalent household income. SSS was measured by parent rating of community and national standing on the MacArthur Scale of Subjective Social Status. Child HRQOL was measured with child report on the Pediatric Quality of Life Inventory (PedsQL) physical and psychosocial scales. Structural equation modeling path analysis was conducted using Mplus version 7.4. The data supported the hypothesized measurement and structural models. Whereas parental OSS was positively related to psychosocial HRQOL for all three racial/ethnic groups and to physical HRQOL for Latino children, parental SSS was not related to either for any of the racial/ethnic groups. Therefore, mediation by SSS was not supported for any group. OSS was confirmed to have stronger association with children's HRQOL than parental SSS. This is in contrast to some research on adults, raising the questions of how best to assess SSS relevant to children and at what point in development SSS may influence children's health and well-being. The persistent relationship found between parental OSS and child health suggests that efforts to improve low socioeconomic resources in families may contribute to improve children's health.

  7. Assessing alternative measures of wealth in health research.

    PubMed

    Cubbin, Catherine; Pollack, Craig; Flaherty, Brian; Hayward, Mark; Sania, Ayesha; Vallone, Donna; Braveman, Paula

    2011-05-01

    We assessed whether it would be feasible to replace the standard measure of net worth with simpler measures of wealth in population-based studies examining associations between wealth and health. We used data from the 2004 Survey of Consumer Finances (respondents aged 25-64 years) and the 2004 Health and Retirement Survey (respondents aged 50 years or older) to construct logistic regression models relating wealth to health status and smoking. For our wealth measure, we used the standard measure of net worth as well as 9 simpler measures of wealth, and we compared results among the 10 models. In both data sets and for both health indicators, models using simpler wealth measures generated conclusions about the association between wealth and health that were similar to the conclusions generated by models using net worth. The magnitude and significance of the odds ratios were similar for the covariates in multivariate models, and the model-fit statistics for models using these simpler measures were similar to those for models using net worth. Our findings suggest that simpler measures of wealth may be acceptable in population-based studies of health.

  8. Evaluating Robotic Surgical Skills Performance Under Distractive Environment Using Objective and Subjective Measures.

    PubMed

    Suh, Irene H; LaGrange, Chad A; Oleynikov, Dmitry; Siu, Ka-Chun

    2016-02-01

    Distractions are recognized as a significant factor affecting performance in safety critical domains. Although operating rooms are generally full of distractions, the effect of distractions on robot-assisted surgical (RAS) performance is unclear. Our aim was to investigate the effect of distractions on RAS performance using both objective and subjective measures. Fifteen participants performed a knot-tying task using the da Vinci Surgical System and were exposed to 3 distractions: (1) passive distraction entailed listening to noise with a constant heart rate, (2) active distraction included listening to noise and acknowledging a change of random heart rate from 60 to 120 bpm, and (3) interactive distraction consisted of answering math questions. The objective kinematics of the surgical instrument tips were used to evaluate performance. Electromyography (EMG) of the forearm and hand muscles of the participants were collected. The median EMG frequency (EMG(fmed)) and the EMG envelope (EMG(env)) were analyzed. NASA Task Load Index and Fundamentals of Laparoscopic Surgery score were used to evaluate the subjective performance. One-way repeated analysis of variance was applied to examine the effects of distraction on skills performance. Spearman's correlations were conducted to compare objective and subjective measures. Significant distraction effect was found for all objective kinematics measures (P < .05). There were significant distraction effects for EMG measures (EMG(env), P < .004; EMG(fmed), P = .031). Significant distraction effects were also found for subjective measurements. Distraction impairs surgical skills performance and increases muscle work. Understanding how the surgeons cope with distractions is important in developing surgical education. © The Author(s) 2015.

  9. The Biomedicine Convention as an object and a stimulus for comparative research in the European Journal of Health Law.

    PubMed

    Nys, Herman

    2008-09-01

    The European Association for Health Law has ambitious objectives. Two of them are "to encourage and facilitate co-operation among health lawyers throughout Europe" and "to encourage and support the development of health law in European and international relations". Comparative legal research will be an important means to reach these objectives. In this contribution the author takes a closer look at this Convention as an object but also as a stimulus for comparative research in health law. To this end relevant articles have been analyzed that have been published in this journal from its creation in 1994 until the end of 2007.

  10. Measuring health systems strength and its impact: experiences from the African Health Initiative.

    PubMed

    Sherr, Kenneth; Fernandes, Quinhas; Kanté, Almamy M; Bawah, Ayaga; Condo, Jeanine; Mutale, Wilbroad

    2017-12-21

    Health systems are essential platforms for accessible, quality health services, and population health improvements. Global health initiatives have dramatically increased health resources; however, funding to strengthen health systems has not increased commensurately, partially due to concerns about health system complexity and evidence gaps demonstrating health outcome improvements. In 2009, the African Health Initiative of the Doris Duke Charitable Foundation began supporting Population Health Implementation and Training Partnership projects in five sub-Saharan African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) to catalyze significant advances in strengthening health systems. This manuscript reflects on the experience of establishing an evaluation framework to measure health systems strength, and associate measures with health outcomes, as part of this Initiative. Using the World Health Organization's health systems building block framework, the Partnerships present novel approaches to measure health systems building blocks and summarize data across and within building blocks to facilitate analytic procedures. Three Partnerships developed summary measures spanning the building blocks using principal component analysis (Ghana and Tanzania) or the balanced scorecard (Zambia). Other Partnerships developed summary measures to simplify multiple indicators within individual building blocks, including health information systems (Mozambique), and service delivery (Rwanda). At the end of the project intervention period, one to two key informants from each Partnership's leadership team were asked to list - in rank order - the importance of the six building blocks in relation to their intervention. Though there were differences across Partnerships, service delivery and information systems were reported to be the most common focus of interventions, followed by health workforce and leadership and governance. Medical products, vaccines and technologies, and

  11. Measuring and improving patient safety through health information technology: The Health IT Safety Framework

    PubMed Central

    Singh, Hardeep

    2016-01-01

    Health information technology (health IT) has potential to improve patient safety but its implementation and use has led to unintended consequences and new safety concerns. A key challenge to improving safety in health IT-enabled healthcare systems is to develop valid, feasible strategies to measure safety concerns at the intersection of health IT and patient safety. In response to the fundamental conceptual and methodological gaps related to both defining and measuring health IT-related patient safety, we propose a new framework, the Health IT Safety (HITS) measurement framework, to provide a conceptual foundation for health IT-related patient safety measurement, monitoring, and improvement. The HITS framework follows both Continuous Quality Improvement (CQI) and sociotechnical approaches and calls for new measures and measurement activities to address safety concerns in three related domains: 1) concerns that are unique and specific to technology (e.g., to address unsafe health IT related to unavailable or malfunctioning hardware or software); 2) concerns created by the failure to use health IT appropriately or by misuse of health IT (e.g. to reduce nuisance alerts in the electronic health record (EHR)), and 3) the use of health IT to monitor risks, health care processes and outcomes and identify potential safety concerns before they can harm patients (e.g. use EHR-based algorithms to identify patients at risk for medication errors or care delays). The framework proposes to integrate both retrospective and prospective measurement of HIT safety with an organization's existing clinical risk management and safety programs. It aims to facilitate organizational learning, comprehensive 360 degree assessment of HIT safety that includes vendor involvement, refinement of measurement tools and strategies, and shared responsibility to identify problems and implement solutions. A long term framework goal is to enable rigorous measurement that helps achieve the safety

  12. Objectively measured physical activity in Brazilians with visual impairment: description and associated factors.

    PubMed

    Barbosa Porcellis da Silva, Rafael; Marques, Alexandre Carriconde; Reichert, Felipe Fossati

    2017-05-19

    Low level of physical activity is a serious health issue in individuals with visual impairment. Few studies have objectively measured physical activity in this population group, particularly outside high-income countries. The aim of this study was to describe physical activity measured by accelerometry and its associated factors in Brazilian adults with visual impairment. In a cross-sectional design, 90 adults (18-95 years old) answered a questionnaire and wore an accelerometer for at least 3 days (including one weekend day) to measure physical activity (min/day). Sixty percent of the individuals practiced at least 30 min/day of moderate-to-vigorous physical activity. Individuals who were blind were less active, spent more time in sedentary activities and spent less time in moderate and vigorous activities than those with low vision. Individuals who walked mainly without any assistance were more active, spent less time in sedentary activities and spent more time in light and moderate activities than those who walked with a long cane or sighted guide. Our data highlight factors associated with lower levels of physical activity in people with visual impairment. These factors, such as being blind and walking without assistance should be tackled in interventions to increase physical activity levels among visual impairment individuals. Implications for Rehabilitation Physical inactivity worldwide is a serious health issue in people with visual impairments and specialized institutions and public policies must work to increase physical activity level of this population. Those with lower visual acuity and walking with any aid are at a higher risk of having low levels of physical activity. The association between visual response profile, living for less than 11 years with visual impairment and PA levels deserves further investigations Findings of the present study provide reliable data to support rehabilitation programs, observing the need of taking special attention to

  13. Cardiovascular health metrics and accelerometer-measured physical activity levels: National Health and Nutrition Examination Survey, 2003-2006.

    PubMed

    Barreira, Tiago V; Harrington, Deirdre M; Katzmarzyk, Peter T

    2014-01-01

    To determine whether relationships exist between accelerometer-measured moderate-to-vigorous physical activity (MVPA) and other cardiovascular (CV) health metrics in a large sample. Data from the 2003-2006 National Health and Nutrition Examination Survey (NHANES) collected from January 1, 2003, through December 31, 2006, were used. Overall, 3454 nonpregnant adults 20 years or older who fasted for 6 hours or longer, with valid accelerometer data and with CV health metrics, were included in the study. Blood pressure (BP), body mass index (BMI), smoking status, diet, fasting plasma glucose level, and total cholesterol level were defined as ideal, intermediate, and poor on the basis of American Heart Association criteria. Results were weighted to account for sampling design, oversampling, and nonresponse. Significant increasing linear trends in mean daily MVPA were observed across CV health levels for BMI, BP, and fasting plasma glucose (P<.001). Those with a poor BMI and BP had significantly lower mean daily MVPA than those with intermediate and ideal BMIs and BPs (all P<.001). In addition, individuals with an intermediate fasting plasma glucose level had significantly lower mean daily MVPA than individuals at the ideal levels (P<.001). No significant linear trends were observed for cholesterol, smoking, and diet. A significant linear trend was observed for mean daily MVPA and the overall number of other CV health metrics (P<.001). Objectively measured MVPA was related to other CV health metrics in this large sample. These results support the inclusion of physical activity in the overall definition of ideal CV health. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  14. Impact of Personalised Feedback about Physical Activity on Change in Objectively Measured Physical Activity (the FAB Study): A Randomised Controlled Trial

    PubMed Central

    Godino, Job G.; Watkinson, Clare; Corder, Kirsten; Marteau, Theresa M.; Sutton, Stephen; Sharp, Stephen J.; Griffin, Simon J.; van Sluijs, Esther M. F.

    2013-01-01

    Background Low levels of physical activity are a major public health concern, and interventions to promote physical activity have had limited success. Whether or not personalised feedback about physical activity following objective measurement motivates behaviour change has yet to be rigorously examined. Methods And Findings: In a parallel group, open randomised controlled trial, 466 healthy adults aged 32 to 54 years were recruited from the ongoing population-based Fenland Study (Cambridgeshire, UK). Participants were randomised to receive either no feedback until the end of the trial (control group, n=120) or one of three different types of feedback: simple, visual, or contextualised (intervention groups, n=346). The primary outcome was physical activity (physical activity energy expenditure (PAEE) in kJ/kg/day and average body acceleration (ACC) in m/s2) measured objectively using a combined heart rate monitor and accelerometer (Actiheart®). The main secondary outcomes included self-reported physical activity, intention to increase physical activity, and awareness of physical activity (the agreement between self-rated and objectively measured physical activity). At 8 weeks, 391 (83.9%) participants had complete physical activity data. The intervention had no effect on objectively measured physical activity (PAEE: β=-0.92, 95% CI=-3.50 to 1.66, p=0.48 and ACC: β=0.01, 95% CI=-0.00 to 0.02, p=0.21), self-reported physical activity (β=-0.39, 95% CI=-1.59 to 0.81), or intention to increase physical activity (β=-0.05, 95% CI=-0.22 to 0.11). However, it was associated with an increase in awareness of physical activity (OR=1.74, 95% CI=1.05 to 2.89). Results did not differ according to the type of feedback. Conclusions Personalised feedback about physical activity following objective measurement increased awareness but did not result in changes in physical activity in the short term. Measurement and feedback may have a role in promoting behaviour change but are

  15. Impact of personalised feedback about physical activity on change in objectively measured physical activity (the FAB study): a randomised controlled trial.

    PubMed

    Godino, Job G; Watkinson, Clare; Corder, Kirsten; Marteau, Theresa M; Sutton, Stephen; Sharp, Stephen J; Griffin, Simon J; van Sluijs, Esther M F

    2013-01-01

    Low levels of physical activity are a major public health concern, and interventions to promote physical activity have had limited success. Whether or not personalised feedback about physical activity following objective measurement motivates behaviour change has yet to be rigorously examined. And Findings: In a parallel group, open randomised controlled trial, 466 healthy adults aged 32 to 54 years were recruited from the ongoing population-based Fenland Study (Cambridgeshire, UK). Participants were randomised to receive either no feedback until the end of the trial (control group, n=120) or one of three different types of feedback: simple, visual, or contextualised (intervention groups, n=346). The primary outcome was physical activity (physical activity energy expenditure (PAEE) in kJ/kg/day and average body acceleration (ACC) in m/s(2)) measured objectively using a combined heart rate monitor and accelerometer (Actiheart(®)). The main secondary outcomes included self-reported physical activity, intention to increase physical activity, and awareness of physical activity (the agreement between self-rated and objectively measured physical activity). At 8 weeks, 391 (83.9%) participants had complete physical activity data. The intervention had no effect on objectively measured physical activity (PAEE: β=-0.92, 95% CI=-3.50 to 1.66, p=0.48 and ACC: β=0.01, 95% CI=-0.00 to 0.02, p=0.21), self-reported physical activity (β=-0.39, 95% CI=-1.59 to 0.81), or intention to increase physical activity (β=-0.05, 95% CI=-0.22 to 0.11). However, it was associated with an increase in awareness of physical activity (OR=1.74, 95% CI=1.05 to 2.89). Results did not differ according to the type of feedback. Personalised feedback about physical activity following objective measurement increased awareness but did not result in changes in physical activity in the short term. Measurement and feedback may have a role in promoting behaviour change but are ineffective on their own

  16. Self-perceived versus objectively measured competence in performing clinical practical procedures by final year medical students

    PubMed Central

    Banda, Sekelani

    2016-01-01

    Objectives To determine and compare the self-perceived and objectively measured competence in performing 14 core-clinical practical procedures by Final Year Medical Students of the University of Zambia. Methods The study included 56 out of 60 graduating University of Zambia Medical Students of the 2012/2013 academic year. Self-perceived competence: students rated their competence on 14 core- clinical practical procedures using a self-administered questionnaire on a 5-point Likert scale. Objective competence: it was measured by Objective Structured Clinical Examination (OSCE) by faculty using predetermined rating scales. Rank order correlation test was performed for self-perceived and objectively measured competence. Results Two thirds 36 (66.7%) of the participants perceived themselves as moderately competent, 15 (27.8%) rated themselves as highly competent while 3 (5.6%) had low self-perception. With objective competence, the majority 52 (92.8%) were barely competent while 4 (7.2%) were absolutely competent. When overall self-perception was compared to objectively measured competence, there was a discordance which was demonstrated by a negative correlation (Spearman rho -.123). Conclusions Significant numbers of students reported low self-competence in performing procedures such as endotracheal intubation, gastric lavage and cardiopulmonary resuscitation which most never performed during the clinical years of medical education. In addition, the negative correlation between self-perceived and objectively measured competence demonstrated the inability of students to assess and rate themselves objectively due to fear that others may know their weaknesses and realize that they are not as competent as expected at a specific level of training. PMID:27132255

  17. Perceptions of Race/Ethnicity-Based Discrimination: A Review of Measures and Evaluation of their Usefulness for the Health Care Setting

    PubMed Central

    Kressin, Nancy R.; Raymond, Kristal L.; Manze, Meredith

    2010-01-01

    Background To assess discrimination in health care, reliable, valid, and comprehensive measures of racism/discrimination are needed. Objective To review literature on measures of perceived race/ethnicity-based discrimination and evaluate their characteristics and usefulness in assessing discrimination from health care providers. Methods Literature review of measures of perceived race/ethnicity-based discrimination (1966–2007), using MEDLINE, PsycINFO, and Social Science Citation Index. Results We identified 34 measures of racism/discrimination; 16 specifically assessed dynamics in the health care setting. Few measures were theoretically based; most assessed only general dimensions of racism and focused specifically on the experiences of African American patients. Acceptable psychometric properties were documented for about half of the instruments. Conclusions Additional measures are needed for detailed assessments of perceived discrimination in the health care setting; they should be relevant for a wide variety of racial/ethnic groups, and they must assess how racism/discrimination affects health care decision making and treatments offered. PMID:18677066

  18. A Critique of Health System Performance Measurement.

    PubMed

    Lynch, Thomas

    2015-01-01

    Health system performance measurement is a ubiquitous phenomenon. Many authors have identified multiple methodological and substantive problems with performance measurement practices. Despite the validity of these criticisms and their cross-national character, the practice of health system performance measurement persists. Theodore Marmor suggests that performance measurement invokes an "incantatory response" wrapped within "linguistic muddle." In this article, I expand upon Marmor's insights using Pierre Bourdieu's theoretical framework to suggest that, far from an aberration, the "linguistic muddle" identified by Marmor is an indicator of a broad struggle about the representation and classification of public health services as a public good. I present a case study of performance measurement from Alberta, Canada, examining how this representational struggle occurs and what the stakes are. © The Author(s) 2015.

  19. An objective measure of hyperactivity aspects with compressed webcam video.

    PubMed

    Wehrmann, Thomas; Müller, Jörg Michael

    2015-01-01

    Objective measures of physical activity are currently not considered in clinical guidelines for the assessment of hyperactivity in the context of Attention-Deficit/Hyperactivity Disorder (ADHD) due to low and inconsistent associations between clinical ratings, missing age-related norm data and high technical requirements. This pilot study introduces a new objective measure for physical activity using compressed webcam video footage, which should be less affected by age-related variables. A pre-test established a preliminary standard procedure for testing a clinical sample of 39 children aged 6-16 years (21 with a clinical ADHD diagnosis, 18 without). Subjects were filmed for 6 min while solving a standardized cognitive performance task. Our webcam video-based video-activity score was compared with respect to two independent video-based movement ratings by students, ratings of Inattentiveness, Hyperactivity and Impulsivity by clinicians (DCL-ADHS) giving a clinical diagnosis of ADHD and parents (FBB-ADHD) and physical features (age, weight, height, BMI) using mean scores, correlations and multiple regression. Our video-activity score showed a high agreement (r = 0.81) with video-based movement ratings, but also considerable associations with age-related physical attributes. After controlling for age-related confounders, the video-activity score showed not the expected association with clinicians' or parents' hyperactivity ratings. Our preliminary conclusion is that our video-activity score assesses physical activity but not specific information related to hyperactivity. The general problem of defining and assessing hyperactivity with objective criteria remains.

  20. Association between maternal education and objectively measured physical activity and sedentary time in adolescents

    PubMed Central

    Sherar, Lauren B; Griffin, Tom P; Ekelund, Ulf; Cooper, Ashley R; Esliger, Dale W; van Sluijs, Esther M F; Bo Andersen, Lars; Cardon, Greet; Davey, Rachel; Froberg, Karsten; Hallal, Pedro C; Janz, Kathleen F; Kordas, Katarzyna; Kriemler, Susi; Pate, Russell R; Puder, Jardena J; Sardinha, Luis B; Timperio, Anna F; Page, Angie S

    2016-01-01

    Background Investigating socioeconomic variation in physical activity (PA) and sedentary time is important as it may represent a pathway by which socioeconomic position (SEP) leads to ill health. Findings on the association between children's SEP and objectively assessed PA and/or sedentary time are mixed, and few studies have included international samples. Objective Examine the associations between maternal education and adolescent's objectively assessed PA and sedentary time. Methods This is an observational study of 12 770 adolescents (10–18 years) pooled from 10 studies from Europe, Australia, Brazil and the USA. Original PA data were collected between 1997 and 2009. The associations between maternal education and accelerometer variables were examined using robust multivariable regression, adjusted for a priori confounders (ie, body mass index, monitor wear time, season, age and sex) and regression coefficients combined across studies using random effects meta-analyses. Analyses were conducted in March 2014. Results Adolescents of university educated mothers spent more time sedentary (9.5 min/day, p=0.005) and less time in light activity (10 min/day, p<0.001) compared with adolescents of high school educated mothers. Pooled analysis across two studies from Brazil and Portugal (analysed separately because of the different coding of maternal education) showed that children of higher educated mothers (tertiary vs primary/secondary) spent less time in moderate to vigorous PA (MVPA) (6.6 min/day, p=0.001) and in light PA (39.2 min/day: p<0.001), and more time sedentary (45.9 min/day, p<0.001). Conclusions Across a number of international samples, adolescents of mothers with lower education may not be at a disadvantage in terms of overall objectively measured PA. PMID:26802168

  1. Measurement properties of tools measuring mental health knowledge: a systematic review.

    PubMed

    Wei, Yifeng; McGrath, Patrick J; Hayden, Jill; Kutcher, Stan

    2016-08-23

    Mental health literacy has received great attention recently to improve mental health knowledge, decrease stigma and enhance help-seeking behaviors. We conducted a systematic review to critically appraise the qualities of studies evaluating the measurement properties of mental health knowledge tools and the quality of included measurement properties. We searched PubMed, PsycINFO, EMBASE, CINAHL, the Cochrane Library, and ERIC for studies addressing psychometrics of mental health knowledge tools and published in English. We applied the COSMIN checklist to assess the methodological quality of each study as "excellent", "good", "fair", or "indeterminate". We ranked the level of evidence of the overall quality of each measurement property across studies as "strong", "moderate", "limited", "conflicting", or "unknown". We identified 16 mental health knowledge tools in 17 studies, addressing reliability, validity, responsiveness or measurement errors. The methodological quality of included studies ranged from "poor" to "excellent" including 6 studies addressing the content validity, internal consistency or structural validity demonstrating "excellent" quality. We found strong evidence of the content validity or internal consistency of 6 tools; moderate evidence of the internal consistency, the content validity or the reliability of 8 tools; and limited evidence of the reliability, the structural validity, the criterion validity, or the construct validity of 12 tools. Both the methodological qualities of included studies and the overall evidence of measurement properties are mixed. Based on the current evidence, we recommend that researchers consider using tools with measurement properties of strong or moderate evidence that also reached the threshold for positive ratings according to COSMIN checklist.

  2. Prediction of objectively measured physical activity and sedentariness among blue-collar workers using survey questionnaires.

    PubMed

    Gupta, Nidhi; Heiden, Marina; Mathiassen, Svend Erik; Holtermann, Andreas

    2016-05-01

    We aimed at developing and evaluating statistical models predicting objectively measured occupational time spent sedentary or in physical activity from self-reported information available in large epidemiological studies and surveys. Two-hundred-and-fourteen blue-collar workers responded to a questionnaire containing information about personal and work related variables, available in most large epidemiological studies and surveys. Workers also wore accelerometers for 1-4 days measuring time spent sedentary and in physical activity, defined as non-sedentary time. Least-squares linear regression models were developed, predicting objectively measured exposures from selected predictors in the questionnaire. A full prediction model based on age, gender, body mass index, job group, self-reported occupational physical activity (OPA), and self-reported occupational sedentary time (OST) explained 63% (R (2)adjusted) of the variance of both objectively measured time spent sedentary and in physical activity since these two exposures were complementary. Single-predictor models based only on self-reported information about either OPA or OST explained 21% and 38%, respectively, of the variance of the objectively measured exposures. Internal validation using bootstrapping suggested that the full and single-predictor models would show almost the same performance in new datasets as in that used for modelling. Both full and single-predictor models based on self-reported information typically available in most large epidemiological studies and surveys were able to predict objectively measured occupational time spent sedentary or in physical activity, with explained variances ranging from 21-63%.

  3. Measurement of Sexual Health in the U.S.: An Inventory of Nationally Representative Surveys and Surveillance Systems

    PubMed Central

    Ivankovich, Megan B.; Leichliter, Jami S.; Douglas, John M.

    2013-01-01

    Objectives To identify opportunities within nationally representative surveys and surveillance systems to measure indicators of sexual health, we reviewed and inventoried existing data systems that include variables relevant to sexual health. Methods We searched for U.S. nationally representative surveys and surveillance systems that provided individual-level sexual health data. We assessed the methods of each data system and catalogued them by their measurement of the following domains of sexual health: knowledge, communication, attitudes, service access and utilization, sexual behaviors, relationships, and adverse health outcomes. Results We identified 18 U.S.-focused, nationally representative data systems: six assessing the general population, seven focused on special populations, and five addressing health outcomes. While these data systems provide a rich repository of information from which to assess national measures of sexual health, they present several limitations. Most importantly, apart from data on service utilization, routinely gathered, national data are currently focused primarily on negative aspects of sexual health (e.g., risk behaviors and adverse health outcomes) rather than more positive attributes (e.g., healthy communication and attitudes, and relationship quality). Conclusion Nationally representative data systems provide opportunities to measure a broad array of domains of sexual health. However, current measurement gaps indicate the need to modify existing surveys, where feasible and appropriate, and develop new tools to include additional indicators that address positive domains of sexual health of the U.S. population across the life span. Such data can inform the development of effective policy actions, services, prevention programs, and resource allocation to advance sexual health. PMID:23450886

  4. Associations of Perceived and Objectively Measured Neighborhood Environmental Attributes With Leisure-Time Sitting for Transport.

    PubMed

    Liao, Yung; Sugiyama, Takemi; Shibata, Ai; Ishii, Kaori; Inoue, Shigeru; Koohsari, Mohammad Javad; Owen, Neville; Oka, Koichiro

    2016-12-01

    This study examined associations of perceived and objectively measured neighborhood environmental attributes with leisure-time sitting for transport among middle-to-older aged Japanese adults. Data were collected using a postal survey of 998 adults aged 40 to 69 years. Generalized linear modeling with a gamma distribution and a log link was used to examine associations of perceived (International Physical Activity Questionnaire-Environmental module) and Geographic Information Systems (GIS)-derived built environment attributes with self-reported leisure-time sitting for transport. Mean leisure-time sitting time for transport was 20.4 min/day. After adjusting for potential confounders, perceived higher residential density, GIS-measured higher population density, better access to destinations, better access to public transport, longer sidewalk length, and higher street connectivity, were associated significantly with lower sitting time for transport. Residents living in neighborhoods with attributes previously found to be associated with more walking tended to spend less time sitting for transport during leisure-time. The health benefits of walkability-related attributes may accrue not only through increased physical activity, but also through less sedentary time.

  5. Object and technologies in the working process of an itinerant team in mental health.

    PubMed

    Eslabão, Adriane Domingues; Pinho, Leandro Barbosa de; Coimbra, Valéria Cristina Christello; Lima, Maria Alice Dias da Silva; Camatta, Marcio Wagner; Santos, Elitiele Ortiz Dos

    2017-01-01

    Objective To analyze the work object and the technologies in the working process of a Mental Health Itinerant Team in the attention to drug users. Methods Qualitative case study, carried out in a municipality in the South of Brazil. The theoretical framework was the Healthcare Labor Process. The data was collected through participant observation and semi-structured interviews with the professionals of an itinerant team in the year of 2015. For data analysis we used the Thematic Content Analysis. Results In the first empirical category - work object - the user is considered as a focus, bringing new challenges in the team's relationship with the network. In the second category - technologies of the work process - potentialities and contradictions of the team work tools are highlighted. Conclusions As an innovation in the mental health context, the itinerant team brings real possibilities to reinvent the care for the drug user as well as new institutional challenges.

  6. Developing measures of educational change for academic health care teams implementing the chronic care model in teaching practices.

    PubMed

    Bowen, Judith L; Stevens, David P; Sixta, Connie S; Provost, Lloyd; Johnson, Julie K; Woods, Donna M; Wagner, Edward H

    2010-09-01

    The Chronic Care Model (CCM) is a multidimensional framework designed to improve care for patients with chronic health conditions. The model strives for productive interactions between informed, activated patients and proactive practice teams, resulting in better clinical outcomes and greater satisfaction. While measures for improving care may be clear, measures of residents' competency to provide chronic care do not exist. This report describes the process used to develop educational measures and results from CCM settings that used them to monitor curricular innovations. Twenty-six academic health care teams participating in the national and California Academic Chronic Care Collaboratives. Using successive discussion groups and surveys, participants engaged in an iterative process to identify desirable and feasible educational measures for curricula that addressed educational objectives linked to the CCM. The measures were designed to facilitate residency programs' abilities to address new accreditation requirements and tested with teams actively engaged in redesigning educational programs. Field notes from each discussion and lists from work groups were synthesized using the CCM framework. Descriptive statistics were used to report survey results and measurement performance. Work groups generated educational objectives and 17 associated measurements. Seventeen (65%) teams provided feasibility and desirability ratings for the 17 measures. Two process measures were selected for use by all teams. Teams reported variable success using the measures. Several teams reported use of additional measures, suggesting more extensive curricular change. Using an iterative process in collaboration with program participants, we successfully defined a set of feasible and desirable education measures for academic health care teams using the CCM. These were used variably to measure the results of curricular changes, while simultaneously addressing requirements for residency

  7. Measuring and improving patient safety through health information technology: The Health IT Safety Framework.

    PubMed

    Singh, Hardeep; Sittig, Dean F

    2016-04-01

    Health information technology (health IT) has potential to improve patient safety but its implementation and use has led to unintended consequences and new safety concerns. A key challenge to improving safety in health IT-enabled healthcare systems is to develop valid, feasible strategies to measure safety concerns at the intersection of health IT and patient safety. In response to the fundamental conceptual and methodological gaps related to both defining and measuring health IT-related patient safety, we propose a new framework, the Health IT Safety (HITS) measurement framework, to provide a conceptual foundation for health IT-related patient safety measurement, monitoring, and improvement. The HITS framework follows both Continuous Quality Improvement (CQI) and sociotechnical approaches and calls for new measures and measurement activities to address safety concerns in three related domains: 1) concerns that are unique and specific to technology (e.g., to address unsafe health IT related to unavailable or malfunctioning hardware or software); 2) concerns created by the failure to use health IT appropriately or by misuse of health IT (e.g. to reduce nuisance alerts in the electronic health record (EHR)), and 3) the use of health IT to monitor risks, health care processes and outcomes and identify potential safety concerns before they can harm patients (e.g. use EHR-based algorithms to identify patients at risk for medication errors or care delays). The framework proposes to integrate both retrospective and prospective measurement of HIT safety with an organization's existing clinical risk management and safety programs. It aims to facilitate organizational learning, comprehensive 360 degree assessment of HIT safety that includes vendor involvement, refinement of measurement tools and strategies, and shared responsibility to identify problems and implement solutions. A long term framework goal is to enable rigorous measurement that helps achieve the safety

  8. The Validation by Measurement Theory of Proposed Object-Oriented Software Metrics

    NASA Technical Reports Server (NTRS)

    Neal, Ralph D.

    1996-01-01

    Moving software development into the engineering arena requires controllability, and to control a process, it must be measurable. Measuring the process does no good if the product is not also measured, i.e., being the best at producing an inferior product does not define a quality process. Also, not every number extracted from software development is a valid measurement. A valid measurement only results when we are able to verify that the number is representative of the attribute that we wish to measure. Many proposed software metrics are used by practitioners without these metrics ever having been validated, leading to costly but often useless calculations. Several researchers have bemoaned the lack of scientific precision in much of the published software measurement work and have called for validation of software metrics by measurement theory. This dissertation applies measurement theory to validate fifty proposed object-oriented software metrics.

  9. Temperature grid sensor for the measurement of spatial temperature distributions at object surfaces.

    PubMed

    Schäfer, Thomas; Schubert, Markus; Hampel, Uwe

    2013-01-25

    This paper presents results of the development and application of a new temperature grid sensor based on the wire-mesh sensor principle. The grid sensor consists of a matrix of 256 Pt1000 platinum chip resistors and an associated electronics that measures the grid resistances with a multiplexing scheme at high speed. The individual sensor elements can be spatially distributed on an object surface and measure transient temperature distributions in real time. The advantage compared with other temperature field measurement approaches such as infrared cameras is that the object under investigation can be thermally insulated and the radiation properties of the surface do not affect the measurement accuracy. The sensor principle is therefore suited for various industrial monitoring applications. Its applicability for surface temperature monitoring has been demonstrated through heating and mixing experiments in a vessel.

  10. [Comparison study on subjective and objective measurements of the accommodative convergence to accommodation ratio].

    PubMed

    Xu, Jing-jing; Xu, Dan; Huang, Tao; Jiang, Jian; Lü, Fan

    2012-05-01

    To detect the accommodative convergence to accommodation (AC/A) ratios measured respectively by objective and subjective methods. The differences and its relative factors were explored. Forty young volunteers were measured by eye tracker to get the amount of convergence when fixating at the target at 100 cm, 50 cm, 33 cm and 25 cm and were measured by infrared auto-refractor to get corresponding accommodative responses. AC/A ratio based on these two measurements were compared with the calculated and the gradient AC/A ratio from Von Graefe tests. Mean value of stimulated AC/A ratio measured by eye tracker was higher than the calculated and gradient AC/A ratio by Von Graefe method (P = 0.003, 0.001). There are statistic correlation (r = 0.871, P = 0.000) and difference (P = 0.000) between stimulated AC/A ratio and response AC/A ratios both measured by eye tracker, and the difference trends to be greater with the higher AC/A ratio. The objective AC/A ratio is usually higher than the clinical subjective measurement because of more proximal effect. The response AC/A ratio measured objectively may reveal realistically the mutual effect and relationship between accommodation and convergence and it seems to be more credible to be the monitor parameter on progression of myopia in clinics.

  11. Measurement characteristics for two health-related quality of life measures in older adults: The SF-36 and the CDC Healthy Days items

    PubMed Central

    Barile, John P.; Horner-Johnson, Willi; Krahn, Gloria; Zack, Matthew; Miranda, David; DeMichele, Kimberly; Ford, Derek; Thompson, William W.

    2017-01-01

    Background The Short Form Health Survey (SF-36) and the Centers for Disease Control and Prevention (CDC) Healthy Days items are well known measures of health-related quality of life. The validity of the SF-36 for older adults and those with disabilities has been questioned. Objective Assess the extent to which the SF-36 and the Centers for Disease Control and Prevention (CDC) Healthy Days items measure the same aspects of health; whether the SF-36 and the CDC unhealthy days items are invariant across gender, functional status, or the presence of chronic health conditions of older adults; and whether each of the SF-36’s eight subscales is independently associated with the CDC Healthy Days items. Methods We analyzed data from 66,269 adult Medicare advantage members age 65 and older. We used confirmatory factor analyses and regression modeling to test associations between the CDC Healthy Days items and subscales of the SF-36. Results The CDC Healthy Days items were associated with the SF-36 global measures of physical and mental health. The CDC physically unhealthy days item was associated with the SF-36 subscales for bodily pain, physical role limitations, and general health, while the CDC mentally unhealthy days item was associated with the SF-36 subscales for mental health, emotional role limitations, vitality and social functioning. The SF-36 physical functioning subscale was not independently associated with either of the CDC Healthy Days items. Conclusions The CDC Healthy Days items measure similar domains as the SF-36 but appear to assess HRQOL without regard to limitations in functioning. PMID:27259343

  12. Archimedes Revisited: A Faster, Better, Cheaper Method of Accurately Measuring the Volume of Small Objects

    ERIC Educational Resources Information Center

    Hughes, Stephen W.

    2005-01-01

    A little-known method of measuring the volume of small objects based on Archimedes' principle is described, which involves suspending an object in a water-filled container placed on electronic scales. The suspension technique is a variation on the hydrostatic weighing technique used for measuring volume. The suspension method was compared with two…

  13. Self-perceived versus objectively measured competence in performing clinical practical procedures by final year medical students.

    PubMed

    Katowa-Mukwato, Patricia; Banda, Sekelani

    2016-04-30

    To determine and compare the self-perceived and objectively measured competence in performing 14 core-clinical practical procedures by Final Year Medical Students of the University of Zambia. The study included 56 out of 60 graduating University of Zambia Medical Students of the 2012/2013 academic year. Self-perceived competence: students rated their competence on 14 core- clinical practical procedures using a self-administered questionnaire on a 5-point Likert scale. Objective competence: it was measured by Objective Structured Clinical Examination (OSCE) by faculty using predetermined rating scales. Rank order correlation test was performed for self-perceived and objectively measured competence. Two thirds 36 (66.7%) of the participants perceived themselves as moderately competent, 15 (27.8%) rated themselves as highly competent while 3 (5.6%) had low self-perception. With objective competence, the majority 52 (92.8%) were barely competent while 4 (7.2%) were absolutely competent. When overall self-perception was compared to objectively measured competence, there was a discordance which was demonstrated by a negative correlation (Spearman rho -.123). Significant numbers of students reported low self-competence in performing procedures such as endotracheal intubation, gastric lavage and cardiopulmonary resuscitation which most never performed during the clinical years of medical education. In addition, the negative correlation between self-perceived and objectively measured competence demonstrated the inability of students to assess and rate themselves objectively due to fear that others may know their weaknesses and realize that they are not as competent as expected at a specific level of training.

  14. Psychometric properties of health related quality of life measures in acute coronary syndrome patients: a systematic review protocol.

    PubMed

    Brasil, Virginia; Oliveira, Gabriela; Moraes, Katarinne Lima

    2018-02-01

    The objective of this systematic review is to evaluate the psychometric properties and clinical utility of patient-reported outcome measures that assess health-related quality of life in patients with a clinical diagnosis of acute coronary syndrome.

  15. A Multi-Case Study of Research Using Mobile Imaging, Sensing and Tracking Technologies to Objectively Measure Behavior: Ethical Issues and Insights to Guide Responsible Research Practice

    ERIC Educational Resources Information Center

    Nebeker, Camille; Linares-Orozco, Rubi; Crist, Katie

    2015-01-01

    Introduction: The increased availability of mobile sensing technologies is creating a paradigm shift for health research by creating new opportunities for measuring and monitoring behavior. For example, researchers can now collect objective information about a participant's daily activity using wearable devices that have: 1- Global Positioning…

  16. Measuring health literacy in individuals with diabetes: a systematic review and evaluation of available measures.

    PubMed

    Al Sayah, Fatima; Williams, Beverly; Johnson, Jeffrey A

    2013-02-01

    To identify instruments used to measure health literacy and numeracy in people with diabetes; evaluate their use, measurement scope, and properties; discuss their strengths and weaknesses; and propose the most useful, reliable, and applicable measure for use in research and practice settings. A systematic literature review was conducted to identify the instruments. Nutbeam's domains of health literacy and a diabetes health literacy skill set were used to evaluate the measurement scope of the identified instruments and to evaluate their applicability in people with diabetes. Fifty-six studies were included, from which one diabetes-specific (LAD) and eight generic measures of health literacy (REALM, REALM-R, TOFHLA, s-TOFHLA, NVS, 3-brief SQ, 3-level HL Scale, SILS) and one diabetes-specific (DNT) and two generic measures of numeracy (SNS, WRAT) were identified. These instruments were categorized into direct measures, that is, instruments that assess the performance of individuals on health literacy skills and indirect measures that rely on self-report of these skills. The most commonly used instruments measure selective domains of health literacy, focus mainly on reading and writing skills, and do not address other important skills such as verbal communication, health care system navigation, health-related decision making, and numeracy. The structure, mode, and length of administration and measurement properties were found to affect the applicability of these instruments in clinical and research settings. Indirect self- or clinician-administered measures are the most useful in both clinical and research settings. This review provides an evaluation of available health literacy measures and guidance to practitioners and researchers for selecting the appropriate measures for use in clinical settings and research applications.

  17. Development of a measure of health care affordability applicable in a publicly funded universal health care system.

    PubMed

    Haggerty, Jeannie L; Levesque, Jean-Frédéric

    2015-02-04

    Direct measures of health care affordability from the user perspective are needed to monitor equitable access to publicly funded health care in Canada. The objective of our study was to develop a survey-based measure of healthcare affordability applicable to the Canadian context. We developed items after focus group exploration of access and cost barriers in the healthcare trajectory. We administered an initial instrument by telephone to a randomly-selected sample of 750 respondents in metropolitan, rural, and remote settings in Quebec. After analysis we developed a new, self-administered version eliciting the frequency of problem access due to five affordability dimensions. This version was mailed to a subset of participants. We conducted exploratory and confirmatory factor analysis. We used ordinal logistic regression modelling to examine how individual items and the subscale score predicted indicators of difficult access. We looked for effect modification by income categories. The five items load on a single construct with good internal consistency (α = 0.77). The overall score, 0 to 5, reflects the sum of problems with healthcare affordability due to direct and indirect costs. The item and subscale scores are sensitive to income status, with affordability problems more prevalent among low-income than high-income respondents. Each unit increase in the subscale score predicts increased likelihood of unmet needs (OR = 1.54), emergency room use (OR = 1.41), and health problem aggravation (OR = 1.80). This subscale reliably and validly measures cost barriers to medically necessary services in Canada, and can potentially be applied in other settings with publicly funded health systems. It can be used to monitor and compare healthcare equity.

  18. Objective measures of prospective memory do not correlate with subjective complaints in schizophrenia.

    PubMed

    Chan, Raymond C K; Wang, Ya; Ma, Zheng; Hong, Xiao-hong; Yuan, Yanbo; Yu, Xin; Li, Zhanjiang; Shum, David; Gong, Qi-yong

    2008-08-01

    While a number of studies have shown that individuals with schizophrenia are impaired on various types of prospective memory, few studies have examined the relationship between subjective and objective measures of this construct in this clinical group. The purpose of the current study was to explore the relationship between computer-based prospective memory tasks and the corresponding subjective complaints in patients with schizophrenia, individuals with schizotypal personality features, and healthy volunteers. The findings showed that patients with schizophrenia demonstrated significantly poorer performance in all domains of memory function except visual memory than individuals with schizotypal personality disorder and healthy controls. More importantly, there was a significant interaction effect of prospective memory type and group. Although patients with schizophrenia were found to show significantly poorer performance on computer-based measures of prospective memory than controls, their level of subjective complaint was not found to be significantly higher. While subjective complaints of prospective memory were found to associate significantly with self-reported executive dysfunctions, significant relationships were not found between these complaints and performance on a computer-based task of prospective memory and other objective measures of memory. Taken together, these findings suggest that subjective and objective measures of prospective memory are two distinct domains that might need to be assessed and addressed separately.

  19. Measuring the quality of interprofessional collaboration in child mental health collaborative care

    PubMed Central

    Rousseau, Cécile; Laurin-Lamothe, Audrey; Nadeau, Lucie; Deshaies, Suzanne; Measham, Toby

    2012-01-01

    Objective This pilot study examines the potential utility of the Perception of Interprofessional Collaboration Model and the shared decision-making scales in evaluating the quality of partnership in child mental health collaborative care. Methods Ninety-six primary care professionals working with children and youth responded to an internet survey which included the Perception of Interprofessional Collaboration Model scale (PINCOM-Q) and an adapted version of a shared decision-making scale (Échelle de confort décisionnel, partenaire—ECD-P). The perceptions of child mental health professionals were compared with those of other professionals working with children. Results The PINCOM-Q and the ECD-P scales had an excellent internal consistency and they were moderately correlated. Child mental health professionals’ Individual Interprofessional Collaboration scores from the PINCOM-Q individual aspects subscale were better than that of other child professionals. Conclusion These scales may be interesting instruments to measure the quality of partnership in child mental health collaborative care settings. Research needs to replicate these findings and to determine whether the quality of collaboration is a predictor of mental health outcome.

  20. Measuring the quality of interprofessional collaboration in child mental health collaborative care

    PubMed Central

    Rousseau, Cécile; Laurin-Lamothe, Audrey; Nadeau, Lucie; Deshaies, Suzanne; Measham, Toby

    2012-01-01

    Objective This pilot study examines the potential utility of the Perception of Interprofessional Collaboration Model and the shared decision-making scales in evaluating the quality of partnership in child mental health collaborative care. Methods Ninety-six primary care professionals working with children and youth responded to an internet survey which included the Perception of Interprofessional Collaboration Model scale (PINCOM-Q) and an adapted version of a shared decision-making scale (Échelle de confort décisionnel, partenaire—ECD-P). The perceptions of child mental health professionals were compared with those of other professionals working with children. Results The PINCOM-Q and the ECD-P scales had an excellent internal consistency and they were moderately correlated. Child mental health professionals’ Individual Interprofessional Collaboration scores from the PINCOM-Q individual aspects subscale were better than that of other child professionals. Conclusion These scales may be interesting instruments to measure the quality of partnership in child mental health collaborative care settings. Research needs to replicate these findings and to determine whether the quality of collaboration is a predictor of mental health outcome. PMID:22371692

  1. Optical derotator alignment using image-processing algorithm for tracking laser vibrometer measurements of rotating objects.

    PubMed

    Khalil, Hossam; Kim, Dongkyu; Jo, Youngjoon; Park, Kyihwan

    2017-06-01

    An optical component called a Dove prism is used to rotate the laser beam of a laser-scanning vibrometer (LSV). This is called a derotator and is used for measuring the vibration of rotating objects. The main advantage of a derotator is that it works independently from an LSV. However, this device requires very specific alignment, in which the axis of the Dove prism must coincide with the rotational axis of the object. If the derotator is misaligned with the rotating object, the results of the vibration measurement are imprecise, owing to the alteration of the laser beam on the surface of the rotating object. In this study, a method is proposed for aligning a derotator with a rotating object through an image-processing algorithm that obtains the trajectory of a landmark attached to the object. After the trajectory of the landmark is mathematically modeled, the amount of derotator misalignment with respect to the object is calculated. The accuracy of the proposed method for aligning the derotator with the rotating object is experimentally tested.

  2. Creating a Screening Measure of Health Literacy for the Health Information National Trends Survey.

    PubMed

    Champlin, Sara; Mackert, Michael

    2016-03-01

    Create a screening measure of health literacy for use with the Health Information National Trends Survey (HINTS). Participants completed a paper-based survey. Items from the survey were used to construct a health literacy screening measure. A population-based survey conducted in geographic areas of high and low minority frequency and in Central Appalachia. Two thousand nine hundred four English-speaking participants were included in this study: 66% white, 93% completed high school, mean age = 52.53 years (SD = 16.24). A health literacy screening measure was created using four items included in the HINTS survey. Scores could range from 0 (no questions affirmative/correct) to 4 (all questions answered affirmatively/correctly). Multiple regression analysis was used to determine whether demographic variables known to predict health literacy were indeed associated with the constructed health literacy screening measure. The weighted average health literacy score was 2.63 (SD = 1.00). Those who were nonwhite (p = .0005), were older (p < .0005), or had not completed high school (p < .0001) tended to have lower health literacy screening measure scores. This study highlights the need to assess health literacy in national surveys, but also serves as evidence that screening measures can be created within existing datasets to give researchers the ability to consider the impact of health literacy. © The Author(s) 2016.

  3. The validation by measurement theory of proposed object-oriented software metrics

    NASA Technical Reports Server (NTRS)

    Neal, Ralph D.

    1994-01-01

    Moving software development into the engineering arena requires controllability, and to control a process, it must be measurable. Measuring the process does no good if the product is not also measured, i.e., being the best at producing an inferior product does not define a quality process. Also, not every number extracted from software development is a valid measurement. A valid measurement only results when we are able to verify that the number is representative of the attribute that we wish to measure. Many proposed software metrics are used by practitioners without these metrics ever having been validated, leading to costly but often useless calculations. Several researchers have bemoaned the lack of scientific precision in much of the published software measurement work and have called for validation of software metrics by measurement theory. This dissertation applies measurement theory to validate fifty proposed object-oriented software metrics (Li and Henry, 1993; Chidamber and Kemerrer, 1994; Lorenz and Kidd, 1994).

  4. Quality of life assessment in children: a review of conceptual and methodological issues in multidimensional health status measures.

    PubMed Central

    Pal, D K

    1996-01-01

    STUDY OBJECTIVE: To clarify concepts and methodological problems in existing multidimensional health status measures for children. DESIGN: Thematic review of instruments found by computerised and manual searches, 1979-95. SUBJECTS: Nine health status instruments. MAIN RESULTS: Many instruments did not satisfy criteria of being child centered or family focussed; few had sufficient psychometric properties for research or clinical use; underlying conceptual assumptions were rarely explicit. CONCLUSIONS: Quality of life measures should be viewed cautiously. Interdisciplinary discussion is required, as well as discussion with children and parents, to establish constructs that are truly useful. PMID:8882220

  5. On the correlation between objective measurements and subjectively felt disturbance from traffic

    NASA Technical Reports Server (NTRS)

    Lans, J.

    1981-01-01

    Measurements of traffic noise during the day were taken at 90 measurement points over the urban area of Vienna; in addition, the vehicle frequency ascertained at the individual measurement points was also noted. Results of these objective measurements or various characteristic single values derived from them are compared with the results of the environmental survey of 1973 on the subjective noise stress experienced within buildings but caused by outside factors. Suggestions for suitable measures to describe the traffic noise and to derive limit values are given considering the relationship between number of vehicles and noise and annoyance.

  6. The impact of parenthood on Canadians' objectively measured physical activity: an examination of cross-sectional population-based data.

    PubMed

    Gaston, Anca; Edwards, Sarah A; Doelman, Amy; Tober, Jo Ann

    2014-11-03

    Parenthood has been associated with declines in leisure-time exercise and moderate-to-vigorous physical activity (MVPA), but less is known about its impact on sedentary time and light-intensity activity. Although the health benefits of MVPA are well established, a growing body of research has been showing that even after controlling for MVPA levels, a detrimental dose-response association exists between sedentary time and adverse health outcomes and a beneficial dose-response association exists for light-intensity activity. This study examined the impact of parenthood, the number of children in the home, and the age of the youngest child on objectively measured physical activity (i.e., accelerometer derived daily minutes of sedentary, light, and MVPA) among a nationally representative cross-sectional sample of 2234 men and women who participated in the 2009-2011 Canadian Health Measures Survey. After controlling for sociodemographic variables, ANCOVAs indicated that parents engaged in more light activity but less MVPA than non-parents and women whose youngest child was aged 12-15 years were more sedentary than women without children. Among both men and women, having a child <6 years of age in the home was associated with the greatest amount of light activity and lowest MVPA. Modest differences emerged between the physical activity level of parents and non-parents for both genders and across intensity levels. In general, parenthood was associated with less MVPA and more light-intensity activity, and more differences emerged among women compared to men. More research is needed before conclusions can be drawn regarding the health consequences of these differences.

  7. Waist Circumference and Objectively Measured Sedentary Behavior in Rural School Adolescents

    ERIC Educational Resources Information Center

    Machado-Rodrigues, Aristides M.; Coelho e Silva, Manuel J.; Ribeiro, Luís P.; Fernandes, Romulo; Mota, Jorge; Malina, Robert M.

    2016-01-01

    Background: Research on relationships between lifestyle behaviors and adiposity in school youth is potentially important for identifying subgroups at risk. This study evaluates the associations between waist circumference (WC) and objective measures of sedentary behavior (SB) in a sample of rural school adolescents. Methods: The sample included…

  8. Colors of Outer Solar System Objects Measured with VATT

    NASA Astrophysics Data System (ADS)

    Romanishin, William; Tegler, S. C.; Consolmagno, G. J.

    2010-10-01

    Over the past 7 years, we have measured optical B-V and V-R colors for about 40 minor outer solar system objects using the 1.8-m Vatican Advanced Technology Telescope (VATT) located on Mt. Graham in southeast Arizona. We will present these colors and use them to update the discussion of colors of minor bodies in the outer solar system. We gratefully acknowledge funding from the NASA Planetary Astronomy Program to Northern Arizona University and the U. of Oklahoma which helped support this work.

  9. Objective quantification of the tinnitus decompensation by synchronization measures of auditory evoked single sweeps.

    PubMed

    Strauss, Daniel J; Delb, Wolfgang; D'Amelio, Roberto; Low, Yin Fen; Falkai, Peter

    2008-02-01

    Large-scale neural correlates of the tinnitus decompensation might be used for an objective evaluation of therapies and neurofeedback based therapeutic approaches. In this study, we try to identify large-scale neural correlates of the tinnitus decompensation using wavelet phase stability criteria of single sweep sequences of late auditory evoked potentials as synchronization stability measure. The extracted measure provided an objective quantification of the tinnitus decompensation and allowed for a reliable discrimination between a group of compensated and decompensated tinnitus patients. We provide an interpretation for our results by a neural model of top-down projections based on the Jastreboff tinnitus model combined with the adaptive resonance theory which has not been applied to model tinnitus so far. Using this model, our stability measure of evoked potentials can be linked to the focus of attention on the tinnitus signal. It is concluded that the wavelet phase stability of late auditory evoked potential single sweeps might be used as objective tinnitus decompensation measure and can be interpreted in the framework of the Jastreboff tinnitus model and adaptive resonance theory.

  10. Temperature measurements on fast-rotating objects using a thermographic camera with an optomechanical image derotator

    NASA Astrophysics Data System (ADS)

    Altmann, Bettina; Pape, Christian; Reithmeier, Eduard

    2017-08-01

    Increasing requirements concerning the quality and lifetime of machine components in industrial and automotive applications require comprehensive investigations of the components in conditions close to the application. Irregularities in heating of mechanical parts reveal regions with increased loading of pressure, draft or friction. In the long run this leads to damage and total failure of the machine. Thermographic measurements of rotating objects, e.g., rolling bearings, brakes, and clutches provide an approach to investigate those defects. However, it is challenging to measure fast-rotating objects accurately. Currently one contact-free approach is performing stroboscopic measurements using an infrared sensor. The data acquisition is triggered so that the image is taken once per revolution. This leads to a huge loss of information on the majority of the movement and to motion blur. The objective of this research is showing the potential of using an optomechanical image derotator together with a thermographic camera. The derotator follows the rotation of the measurement object so that quasi-stationary thermal images during motion can be acquired by the infrared sensor. Unlike conventional derotators which use a glass prism to achieve this effect, the derotator within this work is equipped with a sophisticated reflector assembly. These reflectors are made of aluminum to transfer infrared radiation emitted by the rotating object. Because of the resulting stationary thermal image, the operation can be monitored continuously even for fast-rotating objects. The field of view can also be set to a small off-axis region of interest which then can be investigated with higher resolution or frame rate. To depict the potential of this approach, thermographic measurements on a rolling bearings in different operating states are presented.

  11. Sampling in health geography: reconciling geographical objectives and probabilistic methods. An example of a health survey in Vientiane (Lao PDR)

    PubMed Central

    Vallée, Julie; Souris, Marc; Fournet, Florence; Bochaton, Audrey; Mobillion, Virginie; Peyronnie, Karine; Salem, Gérard

    2007-01-01

    Background Geographical objectives and probabilistic methods are difficult to reconcile in a unique health survey. Probabilistic methods focus on individuals to provide estimates of a variable's prevalence with a certain precision, while geographical approaches emphasise the selection of specific areas to study interactions between spatial characteristics and health outcomes. A sample selected from a small number of specific areas creates statistical challenges: the observations are not independent at the local level, and this results in poor statistical validity at the global level. Therefore, it is difficult to construct a sample that is appropriate for both geographical and probability methods. Methods We used a two-stage selection procedure with a first non-random stage of selection of clusters. Instead of randomly selecting clusters, we deliberately chose a group of clusters, which as a whole would contain all the variation in health measures in the population. As there was no health information available before the survey, we selected a priori determinants that can influence the spatial homogeneity of the health characteristics. This method yields a distribution of variables in the sample that closely resembles that in the overall population, something that cannot be guaranteed with randomly-selected clusters, especially if the number of selected clusters is small. In this way, we were able to survey specific areas while minimising design effects and maximising statistical precision. Application We applied this strategy in a health survey carried out in Vientiane, Lao People's Democratic Republic. We selected well-known health determinants with unequal spatial distribution within the city: nationality and literacy. We deliberately selected a combination of clusters whose distribution of nationality and literacy is similar to the distribution in the general population. Conclusion This paper describes the conceptual reasoning behind the construction of the

  12. Sampling in health geography: reconciling geographical objectives and probabilistic methods. An example of a health survey in Vientiane (Lao PDR).

    PubMed

    Vallée, Julie; Souris, Marc; Fournet, Florence; Bochaton, Audrey; Mobillion, Virginie; Peyronnie, Karine; Salem, Gérard

    2007-06-01

    Geographical objectives and probabilistic methods are difficult to reconcile in a unique health survey. Probabilistic methods focus on individuals to provide estimates of a variable's prevalence with a certain precision, while geographical approaches emphasise the selection of specific areas to study interactions between spatial characteristics and health outcomes. A sample selected from a small number of specific areas creates statistical challenges: the observations are not independent at the local level, and this results in poor statistical validity at the global level. Therefore, it is difficult to construct a sample that is appropriate for both geographical and probability methods. We used a two-stage selection procedure with a first non-random stage of selection of clusters. Instead of randomly selecting clusters, we deliberately chose a group of clusters, which as a whole would contain all the variation in health measures in the population. As there was no health information available before the survey, we selected a priori determinants that can influence the spatial homogeneity of the health characteristics. This method yields a distribution of variables in the sample that closely resembles that in the overall population, something that cannot be guaranteed with randomly-selected clusters, especially if the number of selected clusters is small. In this way, we were able to survey specific areas while minimising design effects and maximising statistical precision. We applied this strategy in a health survey carried out in Vientiane, Lao People's Democratic Republic. We selected well-known health determinants with unequal spatial distribution within the city: nationality and literacy. We deliberately selected a combination of clusters whose distribution of nationality and literacy is similar to the distribution in the general population. This paper describes the conceptual reasoning behind the construction of the survey sample and shows that it can be

  13. Measuring Socioeconomic Differences in Use of Health Care Services by Wealth Versus by Income

    PubMed Central

    Allin, Sara; Masseria, Cristina

    2009-01-01

    Objectives. We compared the extent of socioeconomic differences in use of health care services based on wealth (i.e., accumulated assets) as the socioeconomic ranking variable with the extent of differences based on income to explore the sensitivity of the estimates of equity to the choice of the socioeconomic indicator. Methods. We used data from the Health and Retirement Study in the United States and the Survey of Health, Ageing, and Retirement in Europe to estimate levels of income- and wealth-related disparity in use of physician and dental services among adults 50 or older in 12 countries. Results. We found socioeconomic differences in use of physician services after standardizing for need in about half of the countries studied. No consistent pattern in levels of disparity measured by wealth versus those measured by income was found. However, the rich were significantly more likely to use dental services in all countries. Wealth-related differences in dental service use were consistently higher than were income-related differences. Conclusions. We found some support for wealth as a more sensitive indicator of socioeconomic status among older adults than was income. Wealth may thus allow more accurate measurements of socioeconomic differences in use of health care services for this population. PMID:19150899

  14. A framework for developing objective and measurable recovery criteria for threatened and endangered species.

    PubMed

    Himes Boor, Gina K

    2014-02-01

    For species listed under the U.S. Endangered Species Act (ESA), the U.S. Fish and Wildlife Service and National Marine Fisheries Service are tasked with writing recovery plans that include "objective, measurable criteria" that define when a species is no longer at risk of extinction, but neither the act itself nor agency guidelines provide an explicit definition of objective, measurable criteria. Past reviews of recovery plans, including one published in 2012, show that many criteria lack quantitative metrics with clear biological rationale and are not meeting the measureable and objective mandate. I reviewed how objective, measureable criteria have been defined implicitly and explicitly in peer-reviewed literature, the ESA, other U.S. statutes, and legal decisions. Based on a synthesis of these sources, I propose the following 6 standards be used as minimum requirements for objective, measurable criteria: contain a quantitative threshold with calculable units, stipulate a timeframe over which they must be met, explicitly define the spatial extent or population to which they apply, specify a sampling procedure that includes sample size, specify a statistical significance level, and include justification by providing scientific evidence that the criteria define a species whose extinction risk has been reduced to the desired level. To meet these 6 standards, I suggest that recovery plans be explicitly guided by and organized around a population viability modeling framework even if data or agency resources are too limited to complete a viability model. When data and resources are available, recovery criteria can be developed from the population viability model results, but when data and resources are insufficient for model implementation, extinction risk thresholds can be used as criteria. A recovery-planning approach centered on viability modeling will also yield appropriately focused data-acquisition and monitoring plans and will facilitate a seamless transition

  15. Making Quality Health Websites a National Public Health Priority: Toward Quality Standards.

    PubMed

    Devine, Theresa; Broderick, Jordan; Harris, Linda M; Wu, Huijuan; Hilfiker, Sandra Williams

    2016-08-02

    Most US adults have limited health literacy skills. They struggle to understand complex health information and services and to make informed health decisions. The Internet has quickly become one of the most popular places for people to search for information about their health, thereby making access to quality information on the Web a priority. However, there are no standardized criteria for evaluating Web-based health information. Every 10 years, the US Department of Health and Human Services' Office of Disease Prevention and Health Promotion (ODPHP) develops a set of measurable objectives for improving the health of the nation over the coming decade, known as Healthy People. There are two objectives in Healthy People 2020 related to website quality. The first is objective Health Communication and Health Information Technology (HC/HIT) 8.1: increase the proportion of health-related websites that meet 3 or more evaluation criteria for disclosing information that can be used to assess information reliability. The second is objective HC/HIT-8.2: increase the proportion of health-related websites that follow established usability principles. The ODPHP conducted a nationwide assessment of the quality of Web-based health information using the Healthy People 2020 objectives. The ODPHP aimed to establish (1) a standardized approach to defining and measuring the quality of health websites; (2) benchmarks for measurement; (3) baseline data points to capture the current status of website quality; and (4) targets to drive improvement. The ODPHP developed the National Quality Health Website Survey instrument to assess the quality of health-related websites. The ODPHP used this survey to review 100 top-ranked health-related websites in order to set baseline data points for these two objectives. The ODPHP then set targets to drive improvement by 2020. This study reviewed 100 health-related websites. For objective HC/HIT-8.1, a total of 58 out of 100 (58.0%) websites met 3 or

  16. Light sensors for objective light measurement in ambulatory polysomnography.

    PubMed

    Schembri, Rachel; Spong, Jo; Peters, Allison; Rochford, Peter; Wilksch, Philip; O'Donoghue, Fergal J; Greenwood, Kenneth M; Barnes, Maree; Kennedy, Gerard A; Berlowitz, David J

    2017-01-01

    Ambulatory polysomnography (PSG) does not commonly include an objective measure of light to determine the time of lights off (Loff), and thus cannot be used to calculate important indices such as sleep onset latency and sleep efficiency. This study examined the technical specifications and appropriateness of a prototype light sensor (LS) for use in ambulatory Compumedics Somte PSG.Two studies were conducted. The first examined the light measurement characteristics of the LS when used with a portable PSG device, specifically recording trace range, linearity, sensitivity, and stability. This involved the LS being exposed to varying incandescent and fluorescent light levels in a light controlled room. Secondly, the LS was trialled in 24 home and 12 hospital ambulatory PSGs to investigate whether light levels in home and hospital settings were within the recording range of the LS, and to quantify the typical light intensity reduction at the time of Loff. A preliminary exploration of clinical utility was also conducted. Linearity between LS voltage and lux was demonstrated, and the LS trace was stable over 14 hours of recording. The observed maximum voltage output of the LS/PSG device was 250 mV, corresponding to a maximum recording range of 350 lux and 523 lux for incandescent and fluorescent light respectively. At the time of Loff, light levels were within the recording range of the LS, and on average dropped by 72 lux (9-245) in the home and 76 lux (4-348) in the hospital setting. Results suggest that clinical utility was greatest in hospital settings where patients are less mobile. The LS was a simple and effective objective marker of light level in portable PSG, which can be used to identify Loff in ambulatory PSG. This allows measurement of additional sleep indices and support with clinical decisions.

  17. No Measured Effect of a Familiar Contextual Object on Color Constancy.

    PubMed

    Kanematsu, Erika; Brainard, David H

    2014-08-01

    Some familiar objects have a typical color, such as the yellow of a banana. The presence of such objects in a scene is a potential cue to the scene illumination, since the light reflected from them should on average be consistent with their typical surface reflectance. Although there are many studies on how the identity of an object affects how its color is perceived, little is known about whether the presence of a familiar object in a scene helps the visual system stabilize the color appearance of other objects with respect to changes in illumination. We used a successive color matching procedure in three experiments designed to address this question. Across the experiments we studied a total of 6 subjects (2 in Experiment 1, 3 in Experiment 2, and 4 in Experiment 3) with partial overlap of subjects between experiments. We compared measured color constancy across conditions in which a familiar object cue to the illuminant was available with conditions in which such a cue was not present. Overall, our results do not reveal a reliable improvement in color constancy with the addition of a familiar object to a scene. An analysis of the experimental power of our data suggests that if there is such an effect, it is small: less than approximately a change of 0.09 in a constancy index where an absence of constancy corresponds to an index value of 0 and perfect constancy corresponds to an index value of 1.

  18. No Measured Effect of a Familiar Contextual Object on Color Constancy

    PubMed Central

    Kanematsu, Erika; Brainard, David H.

    2013-01-01

    Some familiar objects have a typical color, such as the yellow of a banana. The presence of such objects in a scene is a potential cue to the scene illumination, since the light reflected from them should on average be consistent with their typical surface reflectance. Although there are many studies on how the identity of an object affects how its color is perceived, little is known about whether the presence of a familiar object in a scene helps the visual system stabilize the color appearance of other objects with respect to changes in illumination. We used a successive color matching procedure in three experiments designed to address this question. Across the experiments we studied a total of 6 subjects (2 in Experiment 1, 3 in Experiment 2, and 4 in Experiment 3) with partial overlap of subjects between experiments. We compared measured color constancy across conditions in which a familiar object cue to the illuminant was available with conditions in which such a cue was not present. Overall, our results do not reveal a reliable improvement in color constancy with the addition of a familiar object to a scene. An analysis of the experimental power of our data suggests that if there is such an effect, it is small: less than approximately a change of 0.09 in a constancy index where an absence of constancy corresponds to an index value of 0 and perfect constancy corresponds to an index value of 1. PMID:25313267

  19. Validity of self-reported solar UVR exposure compared with objectively measured UVR exposure.

    PubMed

    Glanz, Karen; Gies, Peter; O'Riordan, David L; Elliott, Tom; Nehl, Eric; McCarty, Frances; Davis, Erica

    2010-12-01

    Reliance on verbal self-report of solar exposure in skin cancer prevention and epidemiologic studies may be problematic if self-report data are not valid due to systematic errors in recall, social desirability bias, or other reasons. This study examines the validity of self-reports of exposure to ultraviolet radiation (UVR) compared to objectively measured exposure among children and adults in outdoor recreation settings in 4 regions of the United States. Objective UVR exposures of 515 participants were measured using polysulfone film badge UVR dosimeters on 2 days. The same subjects provided self-reported UVR exposure data on surveys and 4-day sun exposure diaries, for comparison to their objectively measured exposure. Dosimeter data showed that lifeguards had the greatest UVR exposure (24.5% of weekday ambient UVR), children the next highest exposures (10.3% ambient weekday UVR), and parents had the lowest (6.6% ambient weekday UVR). Similar patterns were observed in self-report data. Correlations between diary reports and dosimeter findings were fair to good and were highest for lifeguards (r = 0.38-0.57), followed by parents (r = 0.28-0.29) and children (r = 0.18-0.34). Correlations between survey and diary measures were moderate to good for lifeguards (r = 0.20-0.54) and children (r = 0.35-0.53). This is the largest study of its kind to date, and supports the utility of self-report measures of solar UVR exposure. Overall, self-reports of sun exposure produce valid measures of UVR exposure among parents, children, and lifeguards who work outdoors. ©2010 AACR.

  20. [Quality concept in health care. Methodology for its measurement].

    PubMed

    Morera Guitart, J

    2003-12-01

    It is increasingly necessary that the neurologists achieve basic knowledgement in clinical management and medical care quality. We will review the concepts of medical care quality (MCQ). Of the definitions checked, we want to emphasize the following aspects. a) application of current scientific knowledge; b) interpersonal relationship; c) environment where the assistance is dispensed; d) results in health; e) cost of assistance; f) risks for the patient and g) patient satisfaction. For the analysis of the MCQ we could distinguish several components: scientific-technical component, efficacy, effectiveness, efficiency, accessibility, continuity, equity, appropriateness, and satisfaction of the patient and of the professional. One of the main objectives to measure the MCQ is to improve the assistance itself. For its measurement we can employ diverse methods depending on our objective: to improve the process, to do Benchmarking, to know the satisfaction of the patients or to guarantee the quality of the medical attention. The most used tools for this measurement are: establishment of criteria-indicator-standard for quality, elaboration of satisfaction questionnaires, interviews to key informant, analysis of complaints and claims of patients and professionals, and clinical audits. The role of the neurologist in the achievement of a high quality neurological attention if fundamental. Therefore, it is necessary some specific formation on: scientific and technical matter, communicative abilities, teamworking, management and organisation of tasks and pharmaco-economic evaluation, and a cultural change that involves every professional on the co-responsibility of the continuous improvement of the processes and of the results of his work, advancing gradually towards the excellence of medical assistance.

  1. Does Commuting Affect Health?

    PubMed

    Künn-Nelen, Annemarie

    2016-08-01

    This paper analyzes the relation between commuting time and health in the UK. I focus on four different types of health outcomes: subjective health measures, objective health measures, health behavior, and healthcare utilization. Fixed effect models are estimated with British Household Panel Survey data. I find that whereas objective health and health behavior are barely affected by commuting time, subjective health measures are clearly lower for people who commute longer. A longer commuting time is, moreover, related to more visits to the general practitioner. Effects turn out to be more pronounced for women and for commuters driving a car. For women, commuting time is also negatively related to regular exercise and positively to calling in sick. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  2. Health care quality measures for children and adolescents in Foster Care: feasibility testing in electronic records.

    PubMed

    Deans, Katherine J; Minneci, Peter C; Nacion, Kristine M; Leonhart, Karen; Cooper, Jennifer N; Scholle, Sarah Hudson; Kelleher, Kelly J

    2018-02-22

    Preventive quality measures for the foster care population are largely untested. The objective of the study is to identify healthcare quality measures for young children and adolescents in foster care and to test whether the data required to calculate these measures can be feasibly extracted and interpreted within an electronic health records or within the Statewide Automated Child Welfare Information System. The AAP Recommendations for Preventive Pediatric Health Care served as the guideline for determining quality measures. Quality measures related to well child visits, developmental screenings, immunizations, trauma-related care, BMI measurements, sexually transmitted infections and depression were defined. Retrospective chart reviews were performed on a cohort of children in foster care from a single large pediatric institution and related county. Data available in the Ohio Statewide Automated Child Welfare Information System was compared to the same population studied in the electronic health record review. Quality measures were calculated as observed (received) to expected (recommended) ratios (O/E ratios) to describe the actual quantity of recommended health care that was received by individual children. Electronic health records and the Statewide Automated Child Welfare Information System data frequently lacked important information on foster care youth essential for calculating the measures. Although electronic health records were rich in encounter specific clinical data, they often lacked custodial information such as the dates of entry into and exit from foster care. In contrast, Statewide Automated Child Welfare Information System included robust data on custodial arrangements, but lacked detailed medical information. Despite these limitations, several quality measures were devised that attempted to accommodate these limitations. In this feasibility testing, neither the electronic health records at a single institution nor the county level Statewide

  3. Direct measurement of health care costs.

    PubMed

    Smith, Mark W; Barnett, Paul G

    2003-09-01

    Cost identification is fundamental to many economic analyses of health care. Health care costs are often derived from administrative databases. Unit costs may also be obtained from published studies. When these sources will not suffice (e.g., in evaluating interventions or programs), data may be gathered directly through observation and surveys. This article describes how to use direct measurement to estimate the cost of an intervention. The authors review the elements of cost determination, including study perspective, the range of elements to measure, and short-run versus long-run costs. They then discuss the advantages and drawbacks of alternative direct measurement methods such as time-and-motion studies, activity logs, and surveys of patients and managers. A parsimonious data collection effort is desirable, although study hypotheses and perspective should guide the endeavor. Special reference is made to data sources within the Department of Veterans Affairs (VA) health care system.

  4. Non-destructive 3D shape measurement of transparent and black objects with thermal fringes

    NASA Astrophysics Data System (ADS)

    Brahm, Anika; Rößler, Conrad; Dietrich, Patrick; Heist, Stefan; Kühmstedt, Peter; Notni, Gunther

    2016-05-01

    Fringe projection is a well-established optical method for the non-destructive contactless three-dimensional (3D) measurement of object surfaces. Typically, fringe sequences in the visible wavelength range (VIS) are projected onto the surfaces of objects to be measured and are observed by two cameras in a stereo vision setup. The reconstruction is done by finding corresponding pixels in both cameras followed by triangulation. Problems can occur if the properties of some materials disturb the measurements. If the objects are transparent, translucent, reflective, or strongly absorbing in the VIS range, the projected patterns cannot be recorded properly. To overcome these challenges, we present a new alternative approach in the infrared (IR) region of the electromagnetic spectrum. For this purpose, two long-wavelength infrared (LWIR) cameras (7.5 - 13 μm) are used to detect the emitted heat radiation from surfaces which is induced by a pattern projection unit driven by a CO2 laser (10.6 μm). Thus, materials like glass or black objects, e.g. carbon fiber materials, can be measured non-destructively without the need of any additional paintings. We will demonstrate the basic principles of this heat pattern approach and show two types of 3D systems based on a freeform mirror and a GOBO wheel (GOes Before Optics) projector unit.

  5. The conceptualization and measurement of cognitive health sophistication.

    PubMed

    Bodie, Graham D; Collins, William B; Jensen, Jakob D; Davis, Lashara A; Guntzviller, Lisa M; King, Andy J

    2013-01-01

    This article develops a conceptualization and measure of cognitive health sophistication--the complexity of an individual's conceptual knowledge about health. Study 1 provides initial validity evidence for the measure--the Healthy-Unhealthy Other Instrument--by showing its association with other cognitive health constructs indicative of higher health sophistication. Study 2 presents data from a sample of low-income adults to provide evidence that the measure does not depend heavily on health-related vocabulary or ethnicity. Results from both studies suggest that the Healthy-Unhealthy Other Instrument can be used to capture variability in the sophistication or complexity of an individual's health-related schematic structures on the basis of responses to two simple open-ended questions. Methodological advantages of the Healthy-Unhealthy Other Instrument and suggestions for future research are highlighted in the discussion.

  6. mHealth Series: mHealth project in Zhao County, rural China – Description of objectives, field site and methods

    PubMed Central

    van Velthoven, Michelle Helena; Li, Ye; Wang, Wei; Du, Xiaozhen; Wu, Qiong; Chen, Li; Majeed, Azeem; Rudan, Igor; Zhang, Yanfeng; Car, Josip

    2013-01-01

    Background We set up a collaboration between researchers in China and the UK that aimed to explore the use of mHealth in China. This is the first paper in a series of papers on a large mHealth project part of this collaboration. This paper included the aims and objectives of the mHealth project, our field site, and the detailed methods of two studies. Field site The field site for this mHealth project was Zhao County, which lies 280 km south of Beijing in Hebei Province, China. Methods We described the methodology of two studies: (i) a mixed methods study exploring factors influencing sample size calculations for mHealth–based health surveys and (ii) a cross–over study determining validity of an mHealth text messaging data collection tool. The first study used mixed methods, both quantitative and qualitative, including: (i) two surveys with caregivers of young children, (ii) interviews with caregivers, village doctors and participants of the cross–over study, and (iii) researchers’ views. We combined data from caregivers, village doctors and researchers to provide an in–depth understanding of factors influencing sample size calculations for mHealth–based health surveys. The second study, a cross–over study, used a randomised cross–over study design to compare the traditional face–to–face survey method to the new text messaging survey method. We assessed data equivalence (intrarater agreement), the amount of information in responses, reasons for giving different responses, the response rate, characteristics of non–responders, and the error rate. Conclusions This paper described the objectives, field site and methods of a large mHealth project part of a collaboration between researchers in China and the UK. The mixed methods study evaluating factors that influence sample size calculations could help future studies with estimating reliable sample sizes. The cross–over study comparing face–to–face and text message survey data collection

  7. Procurement performance measurement system in the health care industry.

    PubMed

    Kumar, Arun; Ozdamar, Linet; Ng, Chai Peng

    2005-01-01

    The rising operating cost of providing healthcare is of concern to health care providers. As such, measurement of procurement performance will enable competitive advantage and provide a framework for continuous improvement. The objective of this paper is to develop a procurement performance measurement system. The paper reviews the existing literature in procurement performance measurement to identify the key areas of purchasing performance. By studying the three components in the supply chain collectively with the resources, procedures and output, a model is been developed. Additionally, a balanced scorecard is proposed by establishing a set of generic measures and six perspectives. A case study conducted at the Singapore Hospital applies the conceptual model to describe the purchasing department and the activities within and outside the department. The results indicate that the material management department has already made a good start in measuring the procurement process through the implementation of the balanced scorecard. There are many data that are collected but not properly collated and utilized. Areas lacking measurement include cycle time of delivery, order processing time, effectiveness, efficiency and reliability. Though a lot of hard work was involved, the advantages of establishing a measurement system outweigh the costs and efforts involved in its implementation. Results of balanced scorecard measurements provide decision-makers with critical information on efficiency and effectiveness of the purchasing department's work. The measurement model developed could be used for any hospital procurement system.

  8. Is objectively measured sitting at work associated with low-back pain? A cross sectional study in the DPhacto cohort.

    PubMed

    Korshøj, Mette; Hallman, David M; Mathiassen, Svend Erik; Aadahl, Mette; Holtermann, Andreas; Jørgensen, Marie Birk

    2018-01-01

    Objectives Low-back pain (LBP) is a substantial health challenge due to the risk for long-term sickness absence and early retirement. Several biomechanical exposures at work, including sitting, have been suggested to increase the risk for LBP. The objectives of this study were to determine (i) the extent to which temporal patterns and total amount of objectively measured sitting is associated with LBP intensity and (ii) whether selected modifiers influence these associations. Methods This cross sectional study uses baseline data from the Danish PHysical ACTivity cohort with Objective measurements (DPhacto) of physical activities in the cleaning, transport and manufacturing sectors. Peak intensity of LBP was collected by questionnaire on a 0-10 scale and sitting was expressed in terms of total duration and temporal pattern, ie, time spent in brief bursts (≤5 minutes), moderate periods (>5-≤20 minutes), and prolonged periods of sitting (>20 minutes); both during work and whole day (waking hours only). Associations were determined using linear regression in models accounting for moderation and confounding. Factors evaluated as moderators or confounders were assessed by questionnaire. Results The population consisted of 704 participants. No significant associations were found between total duration or temporal patterns of sitting and LBP intensity, neither during work nor for the whole day. Body mass index (BMI) significantly moderated the association between sitting and LBP; participants with a high and low BMI showing a negative and positive association, respectively. Conclusion Sitting was not independently associated with peak LBP intensity, suggesting other exposures are more powerful risk factors for LBP.

  9. The Neighborhood Social Environment and Objective Measures of Sleep in the Multi-Ethnic Study of Atherosclerosis.

    PubMed

    Johnson, Dayna A; Simonelli, Guido; Moore, Kari; Billings, Martha; Mujahid, Mahasin S; Rueschman, Michael; Kawachi, Ichiro; Redline, Susan; Diez Roux, Ana V; Patel, Sanjay R

    2017-01-01

    To investigate cross-sectional associations of neighborhood social environment (social cohesion, safety) with objective measures of sleep duration, timing, and disturbances. A racially/ethnically diverse population of men and women (N = 1949) aged 54 to 93 years participating in the Multi-Ethnic Study of Atherosclerosis Sleep and Neighborhood Ancillary studies. Participants underwent 1-week actigraphy between 2010 and 2013. Measures of sleep duration, timing, and disruption were averaged over all days. Neighborhood characteristics were assessed via questionnaires administered to participants and an independent sample within the same neighborhood and aggregated at the neighborhood (census tract, N = 783) level using empirical Bayes estimation. Multilevel linear regression models were used to assess the association between the neighborhood social environment and each sleep outcome. Neighborhood social environment characterized by higher levels of social cohesion and safety were associated with longer sleep duration and earlier sleep midpoint. Each 1 standard deviation higher neighborhood social environment score was associated with 6.1 minutes longer [95% confidence interval (CI): 2.0, 10.2] sleep duration and 6.4 minutes earlier (CI: 2.2, 10.6) sleep midpoint after adjustment for age, sex, race, socioeconomic status, and marital status. These associations persisted after adjustment for other risk factors. Neighborhood social factors were not associated with sleep efficiency or sleep fragmentation index. A more favorable neighborhood social environment is associated with longer objectively measured sleep duration and earlier sleep timing. Intervening on the neighborhood environment may improve sleep and subsequent health outcomes. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  10. Objective measurement of paranormal belief: a rebuttal to Vitulli.

    PubMed

    Lange, R; Irwin, H J; Houran, J

    2001-06-01

    Effects of age and sex in paranormal belief remain controversial because issues of scaling and differential item function are not given due attention. Therefore, in response to the recent debate between Irwin and Vitulli, these issues are reviewed and validated as crucial approaches for obtaining an objective measure of paranormal belief. A Rasch version of Tobacyk's Paranormal Belief Scale has been developed, but research with this scale suggests that--contrary to past literature and recently refined studies--age and sex are neither consistent nor crucial factors mediating paranormal belief.

  11. Physical functioning in patients with ankylosing spondylitis: comparing approaches of experienced ability with self-reported and objectively measured physical activity.

    PubMed

    van Genderen, Simon; van den Borne, Carlie; Geusens, Piet; van der Linden, Sjef; Boonen, Annelies; Plasqui, Guy

    2014-04-01

    Physical functioning can be assessed by different approaches that are characterized by increasing levels of individual appraisal. There is insufficient insight into which approach is the most informative in patients with ankylosing spondylitis (AS) compared with control subjects. The objective of this study was to compare patients with AS and control subjects regarding 3 approaches of functioning: experienced ability to perform activities (Bath Ankylosing Spondylitis Functional Index [BASFI]), self-reported amount of physical activity (PA) (Baecke questionnaire), and the objectively measured amount of PA (triaxial accelerometer). This case-control study included 24 AS patients and 24 control subjects (matched for age, gender, and body mass index). Subjects completed the BASFI and Baecke questionnaire and wore a triaxial accelerometer. Subjects also completed other self-reported measures on disease activity (Bath AS Disease Activity Index), fatigue (Multidimensional Fatigue Inventory), and overall health (EuroQol visual analog scale). Both groups included 14 men (58%), and the mean age was 48 years. Patients scored significantly worse on the BASFI (3.9 vs 0.2) than their healthy peers, whereas PA assessed by Baecke and the accelerometer did not differ between groups. Correlations between approaches of physical functioning were low to moderate. Bath Ankylosing Spondylitis Functional Index was associated with disease activity (r = 0.49) and physical fatigue (0.73) and Baecke with physical and activity related fatigue (r = 0.54 and r = 0.54), but total PA assessed by accelerometer was not associated with any of these experience-based health outcomes. Different approaches of the concept physical functioning in patients with AS provide different information. Compared with matched control subjects, patients with AS report more difficulties but report and objectively perform the same amount of PA.

  12. Measures of Local Segregation for Monitoring Health Inequities by Local Health Departments.

    PubMed

    Krieger, Nancy; Waterman, Pamela D; Batra, Neelesh; Murphy, Johnna S; Dooley, Daniel P; Shah, Snehal N

    2017-06-01

    To assess the use of local measures of segregation for monitoring health inequities by local health departments. We analyzed preterm birth and premature mortality (death before the age of 65 years) rates for Boston, Massachusetts, for 2010 to 2012, using the Index of Concentration at the Extremes (ICE) and the poverty rate at both the census tract and neighborhood level. For premature mortality at the census tract level, the rate ratios comparing the worst-off and best-off terciles were 1.58 (95% confidence interval [CI] = 1.36, 1.83) for the ICE for income, 1.66 (95% CI = 1.43, 1.93) for the ICE for race/ethnicity, and 1.63 (95% CI = 1.40, 1.90) for the ICE combining income and race/ethnicity, as compared with 1.47 (95% CI = 1.27, 1.71) for the poverty measure. Results for the ICE and poverty measures were more similar for preterm births than for premature mortality. The ICE, a measure of social spatial polarization, may be useful for analyzing health inequities at the local level. Public Health Implications. Local health departments in US cities can meaningfully use the ICE to monitor health inequities associated with racialized economic segregation.

  13. On measuring inequalities in health.

    PubMed Central

    Wolfson, M.; Rowe, G.

    2001-01-01

    In a recent series of papers, Murray et al. have put forward a number of important ideas regarding the measurement of inequalities in health. In this paper we agree with some of these ideas but draw attention to one key aspect of their approach--measuring inequalities on the basis of small area data--which is flawed. A numerical example is presented to illustrate the problem. An alternative approach drawing on longitudinal data is outlined, which preserves and enhances the most desirable aspects of their proposal. These include the use of a life course perspective, and the consideration of non-fatal health outcomes as well as the more usual information on mortality patterns. PMID:11436478

  14. Making Quality Health Websites a National Public Health Priority: Toward Quality Standards

    PubMed Central

    2016-01-01

    Background Most US adults have limited health literacy skills. They struggle to understand complex health information and services and to make informed health decisions. The Internet has quickly become one of the most popular places for people to search for information about their health, thereby making access to quality information on the Web a priority. However, there are no standardized criteria for evaluating Web-based health information. Every 10 years, the US Department of Health and Human Services' Office of Disease Prevention and Health Promotion (ODPHP) develops a set of measurable objectives for improving the health of the nation over the coming decade, known as Healthy People. There are two objectives in Healthy People 2020 related to website quality. The first is objective Health Communication and Health Information Technology (HC/HIT) 8.1: increase the proportion of health-related websites that meet 3 or more evaluation criteria for disclosing information that can be used to assess information reliability. The second is objective HC/HIT-8.2: increase the proportion of health-related websites that follow established usability principles. Objective The ODPHP conducted a nationwide assessment of the quality of Web-based health information using the Healthy People 2020 objectives. The ODPHP aimed to establish (1) a standardized approach to defining and measuring the quality of health websites; (2) benchmarks for measurement; (3) baseline data points to capture the current status of website quality; and (4) targets to drive improvement. Methods The ODPHP developed the National Quality Health Website Survey instrument to assess the quality of health-related websites. The ODPHP used this survey to review 100 top-ranked health-related websites in order to set baseline data points for these two objectives. The ODPHP then set targets to drive improvement by 2020. Results This study reviewed 100 health-related websites. For objective HC/HIT-8.1, a total of 58 out

  15. Measuring the electronic transport properties of individual nano-objects under high pressures

    NASA Astrophysics Data System (ADS)

    Caillier, C.; Ayari, A.; Le Floch, S.; Féret, H.; Guiraud, G.; San-Miguel, A.

    2011-09-01

    We describe a setup to carry out electronic transport measurements under high pressures on individual nano-objects. It is based on a home-automated three-stage gas compressor working with argon or helium up to 1 GPa. The setup was successfully tested on contacted individual nanotubes, for which we evidence strong evolutions of the transport properties. These evolutions are related to fundamental issues such as the modification of the nano-object contact resistance, the pressure-induced modification of the nano-object geometry or pressure-induced changes in the intrinsic electronic properties of the nanosystem. A cryostat has also been adapted to the pressure cell, allowing combined pressure and temperature experiments down to 12 K.

  16. Implementing health management information systems: measuring success in Korea's health centers.

    PubMed

    Chae, Y M; Kim, S I; Lee, B H; Choi, S H; Kim, I S

    1994-01-01

    This article analyses the effects that the introduction and adoption of a health management information system (HMIS) can have on both the productivity of health center staff as well as on user-satisfaction. The focus is upon the service provided by the Kwonsun Health Center located in Suwon City, Korea. Two surveys were conducted to measure the changes in productivity and adoption (knowledge, persuasion, decision, implementation and confirmation) of health center staff over time. In addition, a third survey was conducted to measure the effects of HMIS on the level of satisfaction perceived by the visitors, by comparing the satisfaction level between the study health center and a similar health center identified as a control. The results suggest that HMIS increased the productivity and satisfaction of the staff but did not increase their persuasion and decision levels; and, that is also succeeded in increasing the levels of visitors' satisfaction with the services provided.

  17. Comparison of an objective method of measuring bulbar redness to the use of traditional grading scales.

    PubMed

    Sorbara, Luigina; Simpson, Trefford; Duench, Stephanie; Schulze, Marc; Fonn, Desmond

    2007-03-01

    The primary objective was to compare measures of bulbar redness objectively using a photometric method with standard grading methods. Measures of redness were made on 24 participants wearing a silicone hydrogel contact lens in one eye for overnight wear. This report compares hyperaemia after 1 week of daily wear (baseline) with redness measured after 6 months of overnight wear. A new method of objectively measuring bulbar conjunctival redness was performed using the Spectrascan650 Photometer by Photo Research under fixed illumination. Photometric measures in CIEu(*) chromaticity values involve the measurement of chromaticity, a physical analogue of redness, greenness and blueness in the image. This method was validated in Part 1 of the study using repeated measurements on the photographic CCLRU scale. In Part 2 of the study, the photographic grading scale (CCLRU) from 0 (none) to 100 (extreme) was used to make the comparison. Part 1 indicated that the photometer provides a repeatable and reliable measure of bulbar redness (CCC=0.989). A moderately strong and significant correlation was found between the CIEu(*) chromaticity values and the analogue data (R=0.795, p=0.000) at each measurement session (from baseline to 1 day, 1 week, and 1, 3 and 6 months of overnight wear). This new standardized and objective method of measuring bulbar redness has great potential to replace subjective grading scales, especially with multi-centre studies, where variability between investigators occurs. This method may also detect smaller changes between visits or between eyes.

  18. Association of diabetic peripheral arterial disease and objectively-measured physical activity: NHANES 2003-2004

    PubMed Central

    2014-01-01

    Background Although much is known about the management of peripheral arterial disease among adults in the general population, the management of this disease among those with diabetes, and the effects of diabetic-induced peripheral arterial disease on objectively-measured physical activity, is unclear. Here, we examined the association between accelerometer-assessed physical activity and peripheral arterial disease among a national sample of U.S. adults with diabetes. Methods Data from the 2003–2004 National Health and Nutrition Examination Survey were used. Physical activity was measured using an accelerometer in 254 adults with diabetes. Peripheral arterial disease was assessed via ankle brachial index. Negative binomial regression analysis was used to examine the association between physical activity and peripheral arterial disease. Results Results were adjusted for age, gender, race-ethnicity, comorbidity index, smoking, HgbA1C, C-reactive protein, homocysteine, glomerular filtration rate, microalbuminuria, peripheral neuropathy, physical functioning, and medication use. After adjustments, participants with peripheral arterial disease engaged in 23% less physical activity (RR = 0.77, 95% CI: 0.62-0.96) than those without peripheral arterial disease. Conclusions These findings demonstrate an inverse association between accelerometer-assessed physical activity and peripheral arterial disease in a national sample of U.S adults with diabetes. PMID:24967220

  19. Persistent insomnia: the role of objective short sleep duration and mental health.

    PubMed

    Vgontzas, Alexandros N; Fernandez-Mendoza, Julio; Bixler, Edward O; Singareddy, Ravi; Shaffer, Michele L; Calhoun, Susan L; Liao, Duanping; Basta, Maria; Chrousos, George P

    2012-01-01

    Few population-based, longitudinal studies have examined risk factors for persistent insomnia, and the results are inconsistent. Furthermore, none of these studies have examined the role of polysomnographic (PSG) variables such as sleep duration or sleep apnea on the persistence of insomnia. Representative longitudinal study. Sleep laboratory. From a random, general population sample of 1741 individuals of the adult Penn State Cohort, 1395 were followed-up after 7.5 years. Individuals underwent one-night PSG and full medical evaluation at baseline and a telephone interview at follow-up. PSG sleep duration was analyzed as a continuous variable and as a categorical variable: < 6 h sleep (short sleep duration) and ≥ 6 h sleep (longer sleep duration). The rates of insomnia persistence, partial remission, and full remission were 44.0%, 30.0%, and 26.0%, respectively. Objective short sleep duration significantly increased the odds of persistent insomnia as compared to normal sleep (OR = 3.19) and to fully remitted insomnia (OR = 4.92). Mental health problems at baseline were strongly associated with persistent insomnia as compared to normal sleep (OR = 9.67) and to a lesser degree compared to fully remitted insomnia (OR = 3.68). Smoking, caffeine, and alcohol consumption and sleep apnea did not predict persistent insomnia. Objective short sleep duration and mental health problems are the strongest predictors of persistent insomnia. These data further support the validity and clinical utility of objective short sleep duration as a novel marker of the biological severity of insomnia.

  20. What Factors Influence States' Capacity to Report Children's Health Care Quality Measures? A Multiple-Case Study.

    PubMed

    Christensen, Anna L; Petersen, Dana M; Burton, Rachel A; Forsberg, Vanessa C; Devers, Kelly J

    2017-01-01

    Objectives The objective of this study was to describe factors that influence the ability of state Medicaid agencies to report the Centers for Medicare & Medicaid Services' (CMS) core set of children's health care quality measures (Child Core Set). Methods We conducted a multiple-case study of four high-performing states participating in the Children's Health Insurance Program Reauthorization Act (CHIPRA) Quality Demonstration Grant Program: Illinois, Maine, Pennsylvania, and Oregon. Cases were purposively selected for their diverse measurement approaches and used data from 2010 to 2015, including 154 interviews, semiannual grant progress reports, and annual public reports on Child Core Set measures. We followed Yin's multiple-case study methodology to describe how and why each state increased the number of measures reported to CMS. Results All four states increased the number of Child Core Set measures reported to CMS during the grant period. Each took a different approach to reporting, depending on the available technical, organizational, and behavioral inputs in the state. Reporting capacity was influenced by a state's Medicaid data availability, ability to link to other state data systems, past experience with quality measurement, staff time and technical expertise, and demand for the measures. These factors were enhanced by CHIPRA Quality Demonstration grant funding and other federal capacity building activities, as hypothesized in our conceptual framework. These and other states have made progress reporting the Child Core Set since 2010. Conclusion With financial support and investment in state data systems and organizational factors, states can overcome challenges to reporting most of the Child Core Set measures.

  1. Validation of a questionnaire to measure sexual health knowledge and understanding (Sexual Health Questionnaire) in Nepalese secondary school: A psychometric process

    PubMed Central

    Acharya, Dev Raj; Thomas, Malcolm; Cann, Rosemary

    2016-01-01

    Background: School-based sex education has the potential to prevent unwanted pregnancy and to promote positive sexual health at the individual, family and community level. Objectives: To develop and validate a sexual health questionnaire to measure young peoples’ sexual health knowledge and understanding (SHQ) in Nepalese secondary school. Materials and Methods: Secondary school students (n = 259, male = 43.63%, female = 56.37%) and local experts (n = 9, male = 90%, female = 10%) were participated in this study. Evaluation processes were; content validity (>0.89), plausibility check (>95), item-total correlation (>0.3), factor loading (>0.4), principal component analysis (4 factors Kaiser's criterion), Chronbach's alpha (>0.65), face validity and internal consistency using test-retest reliability (P > 0.05). Results: The principal component analysis revealed four factors to be extracted; sexual health norms and beliefs, source of sexual health information, sexual health knowledge and understanding, and level of sexual awareness. Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy demonstrated that the patterns of correlations are relatively compact (>0.80). Chronbach's alpha for each factors were above the cut-off point (0.65). Face validity indicated that the questions were clear to the majority of the respondent. Moreover, there were no significant differences (P > 0.05) in the responses to the items at two time points at seven weeks later. Conclusions: The finding suggests that SHQ is a valid and reliable instrument to be used in schools to measure sexual health knowledge and understanding. Further analysis such as structured equation modelling (SEM) and confirmatory factor analysis could make the questionnaire more robust and applicable to the wider school population. PMID:27500171

  2. Routine measurement of outcomes in Australia's public sector mental health services

    PubMed Central

    Pirkis, Jane; Burgess, Philip; Coombs, Tim; Clarke, Adam; Jones-Ellis, David; Dickson, Rosemary

    2005-01-01

    Objective This paper describes the Australian experience to date with a national 'roll out' of routine outcome measurement in public sector mental health services. Methods Consultations were held with 123 stakeholders representing a range of roles. Results Australia has made an impressive start to nationally implementing routine outcome measurement in mental health services, although it still has a long way to go. All States/Territories have established data collection systems, although some are more streamlined than others. Significant numbers of clinicians and managers have been trained in the use of routine outcome measures, and thought is now being given to ongoing training strategies. Outcome measurement is now occurring 'on the ground'; all States/Territories will be reporting data for 2003–04, and a number have been doing so for several years. Having said this, there is considerable variability regarding data coverage, completeness and compliance. Some States/Territories have gone to considerable lengths to 'embed' outcome measurement in day-to-day practice. To date, reporting of outcome data has largely been limited to reports profiling individual consumers and/or aggregate reports that focus on compliance and data quality issues, although a few States/Territories have begun to turn their attention to producing aggregate reports of consumers by clinician, team or service. Conclusion Routine outcome measurement is possible if it is supported by a co-ordinated, strategic approach and strong leadership, and there is commitment from clinicians and managers. The Australian experience can provide lessons for other countries. PMID:15840170

  3. Wearable sensors objectively measure gait parameters in Parkinson’s disease

    PubMed Central

    Marxreiter, Franz; Gossler, Julia; Kohl, Zacharias; Reinfelder, Samuel; Gassner, Heiko; Aminian, Kamiar; Eskofier, Bjoern M.; Winkler, Jürgen; Klucken, Jochen

    2017-01-01

    Distinct gait characteristics like short steps and shuffling gait are prototypical signs commonly observed in Parkinson’s disease. Routinely assessed by observation through clinicians, gait is rated as part of categorical clinical scores. There is an increasing need to provide quantitative measurements of gait, e.g. to provide detailed information about disease progression. Recently, we developed a wearable sensor-based gait analysis system as diagnostic tool that objectively assesses gait parameter in Parkinson’s disease without the need of having a specialized gait laboratory. This system consists of inertial sensor units attached laterally to both shoes. The computed target of measures are spatiotemporal gait parameters including stride length and time, stance phase time, heel-strike and toe-off angle, toe clearance, and inter-stride variation from gait sequences. To translate this prototype into medical care, we conducted a cross-sectional study including 190 Parkinson’s disease patients and 101 age-matched controls and measured gait characteristics during a 4x10 meter walk at the subjects’ preferred speed. To determine intraindividual changes in gait, we monitored the gait characteristics of 63 patients longitudinally. Cross-sectional analysis revealed distinct spatiotemporal gait parameter differences reflecting typical Parkinson’s disease gait characteristics including short steps, shuffling gait, and postural instability specific for different disease stages and levels of motor impairment. The longitudinal analysis revealed that gait parameters were sensitive to changes by mirroring the progressive nature of Parkinson’s disease and corresponded to physician ratings. Taken together, we successfully show that wearable sensor-based gait analysis reaches clinical applicability providing a high biomechanical resolution for gait impairment in Parkinson’s disease. These data demonstrate the feasibility and applicability of objective wearable sensor

  4. The use of objective measurements in the evaluation of therapy programs

    NASA Technical Reports Server (NTRS)

    Chaplin, H.

    1974-01-01

    The importance of objective measurements is discussed as a means of assessing the efficacy of physical and occupational therapy programs applied to patients recovering from neurological diseases. Considered are three primary categories of neurologically injured patients: patients with hemiplegia, patients with spinal cord injuries, and the heterogeneous group of cerebral palsy patients.

  5. Multi-pollutant surface objective analyses and mapping of air quality health index over North America.

    PubMed

    Robichaud, Alain; Ménard, Richard; Zaïtseva, Yulia; Anselmo, David

    2016-01-01

    Air quality, like weather, can affect everyone, but responses differ depending on the sensitivity and health condition of a given individual. To help protect exposed populations, many countries have put in place real-time air quality nowcasting and forecasting capabilities. We present in this paper an optimal combination of air quality measurements and model outputs and show that it leads to significant improvements in the spatial representativeness of air quality. The product is referred to as multi-pollutant surface objective analyses (MPSOAs). Moreover, based on MPSOA, a geographical mapping of the Canadian Air Quality Health Index (AQHI) is also presented which provides users (policy makers, public, air quality forecasters, and epidemiologists) with a more accurate picture of the health risk anytime and anywhere in Canada and the USA. Since pollutants can also behave as passive atmospheric tracers, they provide information about transport and dispersion and, hence, reveal synoptic and regional meteorological phenomena. MPSOA could also be used to build air pollution climatology, compute local and national trends in air quality, and detect systematic biases in numerical air quality (AQ) models. Finally, initializing AQ models at regular time intervals with MPSOA can produce more accurate air quality forecasts. It is for these reasons that the Canadian Meteorological Centre (CMC) in collaboration with the Air Quality Research Division (AQRD) of Environment Canada has recently implemented MPSOA in their daily operations.

  6. Single-beam, dual-view digital holographic interferometry for biomechanical strain measurements of biological objects

    NASA Astrophysics Data System (ADS)

    Pantelić, Dejan V.; Grujić, Dušan Ž.; Vasiljević, Darko M.

    2014-12-01

    We describe a method for dual-view biomechanical strain measurements of highly asymmetrical biological objects, like teeth or bones. By using a spherical mirror, we were able to simultaneously record a digital hologram of the object itself and the mirror image of its (otherwise invisible) rear side. A single laser beam was sufficient to illuminate both sides of the object, and to provide a reference beam. As a result, the system was mechanically very stable, enabling long exposure times (up to 2 min) without the need for vibration isolation. The setup is simple to construct and adjust, and can be used to interferometrically observe any object that is smaller than the mirror diameter. Parallel data processing on a CUDA-enabled (compute unified device architecture) graphics card was used to reconstruct digital holograms and to further correct image distortion. We used the setup to measure the deformation of a tooth due to mastication forces. The finite-element method was used to compare experimental results and theoretical predictions.

  7. Single-beam, dual-view digital holographic interferometry for biomechanical strain measurements of biological objects.

    PubMed

    Pantelić, Dejan V; Grujić, Dušan Ž; Vasiljević, Darko M

    2014-12-01

    We describe a method for dual-view biomechanical strain measurements of highly asymmetrical biological objects, like teeth or bones. By using a spherical mirror, we were able to simultaneously record a digital hologram of the object itself and the mirror image of its (otherwise invisible) rear side. A single laser beam was sufficient to illuminate both sides of the object, and to provide a reference beam. As a result, the system was mechanically very stable, enabling long exposure times (up to 2 min) without the need for vibration isolation. The setup is simple to construct and adjust, and can be used to interferometrically observe any object that is smaller than the mirror diameter. Parallel data processing on a CUDA-enabled (compute unified device architecture) graphics card was used to reconstruct digital holograms and to further correct image distortion. We used the setup to measure the deformation of a tooth due to mastication forces. The finite-element method was used to compare experimental results and theoretical predictions.

  8. The Wisconsin Assessment of the Social and Built Environment (WASABE): a multi-dimensional objective audit instrument for examining neighborhood effects on health.

    PubMed

    Malecki, Kristen C; Engelman, Corinne D; Peppard, Paul E; Nieto, F Javier; Grabow, Maggie L; Bernardinello, Milena; Bailey, Erin; Bersch, Andrew J; Walsh, Matthew C; Lo, Justin Y; Martinez-Donate, Ana

    2014-11-13

    Growing evidence suggests that mixed methods approaches to measuring neighborhood effects on health are needed. The Wisconsin Assessment of the Social and Built Environment (WASABE) is an objective audit tool designed as an addition to a statewide household-based health examination survey, the Survey of the Health of Wisconsin (SHOW), to objectively measure participant's neighborhoods. This paper describes the development and implementation of the WASABE and examines the instrument's ability to capture a range of social and built environment features in urban and rural communities. A systematic literature review and formative research were used to create the tool. Inter-rater reliability parameters across items were calculated. Prevalence and density of features were estimated for strata formed according to several sociodemographic and urbanicity factors. The tool is highly reliable with over 81% of 115 derived items having percent agreement above 95%. It captured variance in neighborhood features in for a diverse sample of SHOW participants. Sidewalk density in neighborhoods surrounding households of participants living at less than 100% of the poverty level was 67% (95% confidence interval, 55-80%) compared to 34% (25-44%) for those living at greater than 400% of the poverty level. Walking and biking trails were present in 29% (19-39%) of participant buffer in urban areas compared to only 7% (2-12%) in rural communities. Significant environmental differences were also observed for white versus non-white, high versus low income, and college graduates versus individuals with lower level of education. The WASABE has strong inter-rater reliability and validity properties. It builds on previous work to provide a rigorous and standardized method for systematically gathering objective built and social environmental data in a number of geographic settings. Findings illustrate the complex milieu of built environment features found in participants neighborhoods and have

  9. Effects of Objective 3-Dimensional Measures of Facial Shape and Symmetry on Perceptions of Facial Attractiveness.

    PubMed

    Hatch, Cory D; Wehby, George L; Nidey, Nichole L; Moreno Uribe, Lina M

    2017-09-01

    Meeting patient desires for enhanced facial esthetics requires that providers have standardized and objective methods to measure esthetics. The authors evaluated the effects of objective 3-dimensional (3D) facial shape and asymmetry measurements derived from 3D facial images on perceptions of facial attractiveness. The 3D facial images of 313 adults in Iowa were digitized with 32 landmarks, and objective 3D facial measurements capturing symmetric and asymmetric components of shape variation, centroid size, and fluctuating asymmetry were obtained from the 3D coordinate data using geo-morphometric analyses. Frontal and profile images of study participants were rated for facial attractiveness by 10 volunteers (5 women and 5 men) on a 5-point Likert scale and a visual analog scale. Multivariate regression was used to identify the effects of the objective 3D facial measurements on attractiveness ratings. Several objective 3D facial measurements had marked effects on attractiveness ratings. Shorter facial heights with protrusive chins, midface retrusion, faces with protrusive noses and thin lips, flat mandibular planes with deep labiomental folds, any cants of the lip commissures and floor of the nose, larger faces overall, and increased fluctuating asymmetry were rated as significantly (P < .001) less attractive. Perceptions of facial attractiveness can be explained by specific 3D measurements of facial shapes and fluctuating asymmetry, which have important implications for clinical practice and research. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Subjective and objective measurements of postoperative pain in cats.

    PubMed

    Cambridge, A J; Tobias, K M; Newberry, R C; Sarkar, D K

    2000-09-01

    To evaluate the ability of various subjective and objective measurements to determine the presence and degree of postoperative pain in cats. Randomized controlled prospective clinical study. 18 healthy client-owned cats. Cats were randomly assigned to 3 groups of 6: control, tenectomy, and onychectomy. Jugular catheters were placed the day prior to surgery. All surgeries were performed by the same surgeon, and all observations were made by the same blinded trained observer. One hour prior to surgery and at assigned intervals for 36 hours after surgery, heart rate, respiratory rate, and rectal temperature were measured. Scores were assigned for 3 interaction responses, including response to palpation, by use of simple descriptive scales, and to 2 pain assessments by use of visual analogue scales. Blood was collected to measure plasma beta-endorphin and cortisol concentrations. Butorphanol was administered to all cats before surgery and to any cat subjectively assessed to be experiencing pain after surgery. Only visual analogue scale scores and response to palpation scores differed significantly between control and surgical groups. Determination of the presence of pain in cats can be made on the basis of observation and interaction by a trained observer. Physiologic measurements, including plasma cortisol and beta-endorphin concentrations, did not differentiate between control cats and cats that underwent surgery.

  11. Objectively measured sedentary time among five ethnic groups in Amsterdam: The HELIUS study

    PubMed Central

    Nicolaou, Mary; Snijder, Marieke B.; Peters, Ron J. G.; Stronks, Karien; Langøien, Lars J.; van der Ploeg, Hidde P.; Brug, Johannes; Lakerveld, Jeroen

    2017-01-01

    Introduction Sedentary behaviour is increasingly recognised as a health risk. While differences in this behaviour might help explain ethnic differences in disease profiles, studies on sedentary behaviour in ethnic minorities are scarce. The aim of this study was to compare the levels and the socio-demographic and lifestyle-related correlates of objectively measured sedentary time among five ethnic groups in Amsterdam, the Netherlands. Methods Data were collected as part of the HELIUS study. The sample consisted of adults from a Dutch, Moroccan, African Surinamese, South-Asian Surinamese and Turkish ethnic origin. Data were collected by questionnaire, physical examination, and a combined heart rate and accelerometry monitor (Actiheart). Sedentary time was defined as waking time spent on activities of <1.5 metabolic equivalents. Ethnic differences in the levels of sedentary time were tested using ANOVA and ANCOVA analyses, while ethnic differences in the correlates of sedentary time were tested with interactions between ethnicity and potential correlates using general linear models. Associations between these correlates and sedentary time were explored using linear regression analyses stratified by ethnicity (pre-determined). All analyses were adjusted for gender and age. Results 447 participants were included in the analyses, ranging from 73 to 109 participants per ethnic group. Adjusted levels of sedentary time ranged from 569 minutes/day (9.5 hours/day) for participants with a Moroccan and Turkish origin to 621 minutes/day (10.3 hours/day) in African Surinamese participants. There were no statistically significant differences in the levels or correlates of sedentary time between the ethnic groups. Meeting the physical activity recommendations (150 minutes/week) was consistently inversely associated with sedentary time across all ethnic groups, while age was positively associated with sedentary time in most groups. Conclusions No statistically significant

  12. Nanoscale reference materials for environmental, health and safety measurements: needs, gaps and opportunities.

    PubMed

    Stefaniak, Aleksandr B; Hackley, Vincent A; Roebben, Gert; Ehara, Kensei; Hankin, Steve; Postek, Michael T; Lynch, Iseult; Fu, Wei-En; Linsinger, Thomas P J; Thünemann, Andreas F

    2013-12-01

    The authors critically reviewed published lists of nano-objects and their physico-chemical properties deemed important for risk assessment and discussed metrological challenges associated with the development of nanoscale reference materials (RMs). Five lists were identified that contained 25 (classes of) nano-objects; only four (gold, silicon dioxide, silver, titanium dioxide) appeared on all lists. Twenty-three properties were identified for characterisation; only (specific) surface area appeared on all lists. The key themes that emerged from this review were: 1) various groups have prioritised nano-objects for development as "candidate RMs" with limited consensus; 2) a lack of harmonised terminology hinders accurate description of many nano-object properties; 3) many properties identified for characterisation are ill-defined or qualitative and hence are not metrologically traceable; 4) standardised protocols are critically needed for characterisation of nano-objects as delivered in relevant media and as administered to toxicological models; 5) the measurement processes being used to characterise a nano-object must be understood because instruments may measure a given sample in a different way; 6) appropriate RMs should be used for both accurate instrument calibration and for more general testing purposes (e.g., protocol validation); 7) there is a need to clarify that where RMs are not available, if "(representative) test materials" that lack reference or certified values may be useful for toxicology testing and 8) there is a need for consensus building within the nanotechnology and environmental, health and safety communities to prioritise RM needs and better define the required properties and (physical or chemical) forms of the candidate materials.

  13. Including health insurance in poverty measurement: The impact of Massachusetts health reform on poverty.

    PubMed

    Korenman, Sanders D; Remler, Dahlia K

    2016-12-01

    We develop and implement what we believe is the first conceptually valid health-inclusive poverty measure (HIPM) - a measure that includes health care or insurance in the poverty needs threshold and health insurance benefits in family resources - and we discuss its limitations. Building on the Census Bureau's Supplemental Poverty Measure, we construct a pilot HIPM for the under-65 population under ACA-like health reform in Massachusetts. This pilot demonstrates the practicality, face validity and value of a HIPM. Results suggest that public health insurance benefits and premium subsidies accounted for a substantial, one-third reduction in the health inclusive poverty rate. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Evaluation of the measurement properties of self-reported health-related work-functioning instruments among workers with common mental disorders.

    PubMed

    Abma, Femke I; van der Klink, Jac J L; Terwee, Caroline B; Amick, Benjamin C; Bültmann, Ute

    2012-01-01

    During the past decade, common mental disorders (CMD) have emerged as a major public and occupational health problem in many countries. Several instruments have been developed to measure the influence of health on functioning at work. To select appropriate instruments for use in occupational health practice and research, the measurement properties (eg, reliability, validity, responsiveness) must be evaluated. The objective of this study is to appraise critically and compare the measurement properties of self-reported health-related work-functioning instruments among workers with CMD. A systematic review was performed searching three electronic databases. Papers were included that: (i) mainly focused on the development and/or evaluation of the measurement properties of a self-reported health-related work-functioning instrument; (ii) were conducted in a CMD population; and (iii) were fulltext original papers. Quality appraisal was performed using the consensus-based standards for the selection of health status measurement instruments (COSMIN) checklist. Five papers evaluating measurement properties of five self-reported health-related work-functioning instruments in CMD populations were included. There is little evidence available for the measurement properties of the identified instruments in this population, mainly due to low methodological quality of the included studies. The available evidence on measurement properties is based on studies of poor-to-fair methodological quality. Information on a number of measurement properties, such as measurement error, content validity, and cross-cultural validity is still lacking. Therefore, no evidence-based decisions and recommendations can be made for the use of health-related work functioning instruments. Studies of high methodological quality are needed to properly assess the existing instruments' measurement properties.

  15. Ethical Issues in Measuring Biomarkers in Children’s Environmental Health

    PubMed Central

    Sly, Peter D.; Eskenazi, Brenda; Pronczuk, Jenny; Šrám, Radim; Diaz-Barriga, Fernando; Machin, Diego Gonzalez; Carpenter, David O.; Surdu, Simona; Meslin, Eric M.

    2009-01-01

    Background Studying the impact of environmental exposures is important in children because they are more vulnerable to adverse effects on growth, development, and health. Assessing exposure in children is difficult, and measuring biomarkers is potentially useful. Research measuring biomarkers in children raises a number of ethical issues, some of which relate to children as research subjects and some of which are specific to biomarker research. Objective As an international group with experience in pediatric research, biomarkers, and the ethics of research in children, we highlight the ethical issues of undertaking biomarker research in children in these environments. Discussion Significant issues include undertaking research in vulnerable communities, especially in developing countries; managing community expectations; obtaining appropriate consent to conduct the research; the potential conflicts of obtaining permission from an ethics review board in an economically developed country to perform research in a community that may have different cultural values; returning research results to participants and communities when the researchers are uncertain of how to interpret the results; and the conflicting ethical obligations of maintaining participant confidentiality when information about harm or illegal activities mandate reporting to authorities. Conclusion None of these challenges are insurmountable and all deserve discussion. Pediatric biomarker research is necessary for advancing child health. PMID:19672395

  16. Exploring the state of health and safety management system performance measurement in mining organizations.

    PubMed

    Haas, Emily Joy; Yorio, Patrick

    2016-03-01

    Complex arguments continue to be articulated regarding the theoretical foundation of health and safety management system (HSMS) performance measurement. The culmination of these efforts has begun to enhance a collective understanding. Despite this enhanced theoretical understanding, however, there are still continuing debates and little consensus. The goal of the current research effort was to empirically explore common methods to HSMS performance measurement in mining organizations. The purpose was to determine if value and insight could be added into the ongoing approaches of the best ways to engage in health and safety performance measurement. Nine site-level health and safety management professionals were provided with 133 practices corresponding to 20 HSMS elements, each fitting into the plan, do, check, act phases common to most HSMS. Participants were asked to supply detailed information as to how they (1) assess the performance of each practice in their organization, or (2) would assess each practice if it were an identified strategic imperative. Qualitative content analysis indicated that the approximately 1200 responses provided could be described and categorized into interventions , organizational performance , and worker performance . A discussion of how these categories relate to existing indicator frameworks is provided. The analysis also revealed divergence in two important measurement issues; (1) quantitative vs qualitative measurement and reporting; and (2) the primary use of objective or subjective metrics. In lieu of these findings we ultimately recommend a balanced measurement and reporting approach within the three metric categories and conclude with suggestions for future research.

  17. The Sensitivity of Derived Estimates to the Measurement Quality Objectives for Independent Variables

    Treesearch

    Francis A. Roesch

    2005-01-01

    The effect of varying the allowed measurement error for individual tree variables upon county estimates of gross cubic-foot volume was examined. Measurement Quality Objectives (MQOs) for three forest tree variables (biological identity, diameter, and height) used in individual tree gross cubic-foot volume equations were varied from the current USDA Forest Service...

  18. Household Air Pollution from Coal and Biomass Fuels in China: Measurements, Health Impacts, and Interventions

    PubMed Central

    Zhang, Junfeng (Jim); Smith, Kirk R.

    2007-01-01

    Objective Nearly all China’s rural residents and a shrinking fraction of urban residents use solid fuels (biomass and coal) for household cooking and/or heating. Consequently, global meta-analyses of epidemiologic studies indicate that indoor air pollution from solid fuel use in China is responsible for approximately 420,000 premature deaths annually, more than the approximately 300,000 attributed to urban outdoor air pollution in the country. Our objective in this review was to help elucidate the extent of this indoor air pollution health hazard. Data sources We reviewed approximately 200 publications in both Chinese- and English-language journals that reported health effects, exposure characteristics, and fuel/stove intervention options. Conclusions Observed health effects include respiratory illnesses, lung cancer, chronic obstructive pulmonary disease, weakening of the immune system, and reduction in lung function. Arsenic poisoning and fluorosis resulting from the use of “poisonous” coal have been observed in certain regions of China. Although attempts have been made in a few studies to identify specific coal smoke constituents responsible for specific adverse health effects, the majority of indoor air measurements include those of only particulate matter, carbon monoxide, sulfur dioxide, and/or nitrogen dioxide. These measurements indicate that pollution levels in households using solid fuel generally exceed China’s indoor air quality standards. Intervention technologies ranging from simply adding a chimney to the more complex modernized bioenergy program are available, but they can be viable only with coordinated support from the government and the commercial sector. PMID:17589590

  19. Objectively measured physical activity in obese women with and without migraine.

    PubMed

    Bond, Dale S; Thomas, J Graham; O'Leary, Kevin C; Lipton, Richard B; Peterlin, B Lee; Roth, Julie; Rathier, Lucille; Wing, Rena R

    2015-09-01

    The aim of this article is to cross-sectionally compare objectively measured physical activity (PA) levels and their association with migraine characteristics in obese women with and without migraine. Obese women seeking weight loss treatment were divided into migraine (n = 25) and control (n = 25) groups matched by age and body mass index (BMI). Participants wore the SenseWear Armband monitor for seven days to objectively evaluate daily light-(LPA) and moderate-to-vigorous intensity PA (MVPA). Migraine diagnosis was confirmed by a neurologist using ICHD-3-beta criteria. Migraine characteristics were tracked daily using a smartphone-based diary over a four-week period immediately preceding the objective PA assessment. Migraine participants spent 57.9 fewer minutes/day in LPA (141.1 ± 56.4 vs. 199.1 ± 87.7, p = 0.019) and 24.5 fewer minutes/day in MVPA (27.8 ± 17.0 vs. 52.3 ± 26.0, p < 0.001), compared to controls. Migraine participants reported 4.8 ± 3.1 migraine days/month (mean duration = 17.1 ± 8.9 hours; mean maximum pain severity = 6.4 ± 1.7 on a 0-10 scale). Higher BMI (p < 0.05), but not migraine characteristics, were related to lower total PA. Additionally, total objectively measured PA was not associated with how often PA was reported to exacerbate migraine attacks during the four-week diary assessment. Obese women with migraine spent nearly 1.5 hours/day less in PA compared to controls; however, lower PA was not related to migraine characteristics. Further research is needed to identify PA barriers and effective interventions in obese women with migraine. © International Headache Society 2014.

  20. The Relation between Adolescent Self Assessment of Health and Risk Behaviours: Could a Global Measure of Health Provide Indications of Health Risk Exposures?

    ERIC Educational Resources Information Center

    Nkansah-Amankra, Stephen; Walker, Ashley Dawn

    2012-01-01

    Objective: Self-rated health (SRH) has become a key organizing construct for assessing multiple dimensions of populations' physical and psychosocial health functioning. However, it is unclear how adolescents' subjective self assessment of health reflects health risk exposures, co-occurring health risks (problem behaviours) and other pre-existing…

  1. Work-related measures of Physical and Behavioral Health Function: Test-Retest Reliability

    PubMed Central

    Marino, Molly Elizabeth; Meterko, Mark; Marfeo, Elizabeth E.; McDonough, Christine M.; Jette, Alan M.; Ni, Pengsheng; Bogusz, Kara; Rasch, Elizabeth K.; Brandt, Diane E.; Chan, Leighton

    2015-01-01

    Background The Work Disability Functional Assessment Battery (WD-FAB), developed for potential use by the US Social Security Administration to assess work-related function, currently consists of five multi-item scales assessing physical function and four multi-item scales assessing behavioral health function; the WD-FAB scales are administered as Computerized Adaptive Tests (CATs). Objective The goal of this study was to evaluate the test-retest reliability of the WD-FAB Physical Function and Behavioral Health CATs. Methods We administered the WD-FAB scales twice, 7–10 days apart, to a sample of 376 working age adults and 316 adults with work-disability. Intraclass correlation coefficients were calculated to measure the consistency of the scores between the two administrations. Standard error of measurement (SEM) and minimal detectable change (MDC90) were also calculated to measure the scales precision and sensitivity. Results For the Physical Function CAT scales, the ICCs ranged from 0.76–0.89 in the working age adult sample, and 0.77–0.86 in the sample of adults with work-disability. ICCs for the Behavioral Health CAT scales ranged from 0.66–0.70 in the working age adult sample, and 0.77–0.80 in the adults with work-disability. The SEM ranged from 3.25–4.55 for the Physical Function scales and 5.27–6.97 for the Behavioral Health function scales. For all scales in both samples, the MDC90 ranged from 7.58–16.27. Conclusion Both the Physical Function and Behavioral Health CATs of the WD-FAB demonstrated good test-retest reliability in adults with work-disability and general adult samples, a critical requirement for assessing work related functioning in disability applicants and in other contexts. PMID:25991419

  2. Measuring three aspects of motivation among health workers at primary level health facilities in rural Tanzania

    PubMed Central

    Mwingira, Upendo John; Leshabari, Melkidezek T.; Ohnishi, Mayumi

    2017-01-01

    Background The threshold of 2.3 skilled health workers per 1,000 population, published in the World Health Report in 2006, has galvanized resources and efforts to attain high coverage of skilled birth attendance. With the inception of the Sustainable Development Goals (SDGs), a new threshold of 4.45 doctors, nurses, and midwives per 1,000 population has been identified. This SDG index threshold indicates the minimum density to respond to the needs of health workers to deliver a much broader range of health services, such as management of non-communicable diseases to meet the targets under Goal 3: Ensure healthy lives and promote well-being for all people of all ages. In the United Republic of Tanzania, the density of skilled health workers in 2012 was 0.5 per 1,000 population, which more than doubled from 0.2 per 1,000 in 2002. However, this showed that Tanzania still faced a critical shortage of skilled health workers. While training, deployment, and retention are important, motivation is also necessary for all health workers, particularly those who serve in rural areas. This study measured the motivation of health workers who were posted at government-run rural primary health facilities. Objectives We sought to measure three aspects of motivation—Management, Performance, and Individual Aspects—among health workers deployed in rural primary level government health facilities. In addition, we also sought to identify the job-related attributes associated with each of these three aspects. Two regions in Tanzania were selected for our research. In each region, we further selected two districts in which we carried out our investigation. The two regions were Lindi, where we carried out our study in the Nachingwea District and the Ruangwa District, and Mbeya, within which the Mbarali and Rungwe Districts were selected for research. All four districts are considered rural. Methods This cross-sectional study was conducted by administering a two-part questionnaire in

  3. The impact of health changes on labor supply: evidence from merged data on individual objective medical diagnosis codes and early retirement behavior.

    PubMed

    Christensen, Bent Jesper; Kallestrup-Lamb, Malene

    2012-06-01

    The justification bias in the estimated impact of health shocks on retirement is mitigated by using objective health measures from a large, register-based longitudinal data set including medical diagnosis codes, along with labor market status, financial, and socio-economic variables. The duration until retirement is modeled using single and competing risk specifications, observed and unobserved heterogeneity, and flexible baseline hazards. Wealth is used as a proxy for elapsed duration to mitigate the potential selection bias stemming from conditioning on initial participation. The competing risk specification distinguishes complete multiperiod routes to retirement, such as unemployment followed by early retirement. A result on comparison of coefficients across all states is offered. The empirical results indicate a strong impact of health changes on retirement and hence a large potential for public policy measures intended to retain older workers longer in the labor force. Disability responds more to health shocks than early retirement, especially to diseases of the circulatory, respiratory, and musculoskeletal systems, as well as mental and behavioral disorders. Some unemployment spells followed by early retirement appear voluntary and spurred by life style diseases. Copyright © 2012 John Wiley & Sons, Ltd.

  4. Objective measurements for grading the nasal esthetics on Basal view in individuals with secondary cleft nasal deformity.

    PubMed

    He, Xing; Li, Hua; Shao, Yan; Shi, Bing

    2015-01-01

    The purpose of this study is to ascertain objective nasal measurements from the basal view that are predictive of nasal esthetics in individuals with secondary cleft nasal deformity. Thirty-three patients who had undergone unilateral cleft lip repair were retrospectively reviewed in this study. The degree of nasal deformity was subjectively ranked by seven surgeons using standardized basal-view measurements. Nine physical objective parameters including angles and ratios were measured. Correlations and regressions between these objective and subjective measurements were then analyzed. There was high concordance in subjective measurements by different surgeons (Kendall's harmonious coefficient = W = .825, P = .006). The strongest predictive factors for nasal aesthetics were the ratio of length of nasal alar (r = .370, P = .034) and the degree of deviation of the columnar axis (r = .451, P = .008). The columellar angle had a more powerful effect in rating nasal esthetics. There was reliable concordance in subjective ranking of nasal esthetics by surgeons. Measurement of the columnar angle may serve as an independent, objective predictor of esthetics of the nose.

  5. Rural Clinician Evaluation of Children's Health Care Quality Measures: An Oregon Rural Practice-based Research Network (ORPRN) Study.

    PubMed

    Fagnan, Lyle J; Michaels, LeAnn; Ramsey, Katrina; Shearer, Stefan; Droppers, Oliver; Gallia, Charles

    2015-01-01

    Responding to quality metrics is an accepted and expected component of the current health care environment. Little is known about which measures physicians identify as a priority when reporting the quality of care to their patients, especially the care of children in rural settings. The objective of this study is for physicians caring for children in rural communities to identify which of the initial core sets of 24 child health quality measures are useful and are a priority for reporting and improving care. A survey was sent to rural Oregon physicians who provide care to children. Of 955 eligible physicians, 172 (18%) completed the survey. The majority of respondents were family physicians (84%), and most respondents (58%) were in private practice. The child health measures stratified into 3 priority tiers: high, medium, and low priority. The top-tier priority measures included childhood immunization status, well-child visits, adolescent immunization status, body mass index assessment, and developmental screening. Dental treatment services, adequate prenatal care, and lower-birth-weight infants were among the lower-tier measures. The priority measures identified by rural family physicians reflect the relevance of the selected measures to their daily practice responsibilities, with missed opportunities to improve community health. © Copyright 2015 by the American Board of Family Medicine.

  6. Using Computer-Extracted Data from Electronic Health Records to Measure the Quality of Adolescent Well-Care

    PubMed Central

    Gardner, William; Morton, Suzanne; Byron, Sepheen C; Tinoco, Aldo; Canan, Benjamin D; Leonhart, Karen; Kong, Vivian; Scholle, Sarah Hudson

    2014-01-01

    Objective To determine whether quality measures based on computer-extracted EHR data can reproduce findings based on data manually extracted by reviewers. Data Sources We studied 12 measures of care indicated for adolescent well-care visits for 597 patients in three pediatric health systems. Study Design Observational study. Data Collection/Extraction Methods Manual reviewers collected quality data from the EHR. Site personnel programmed their EHR systems to extract the same data from structured fields in the EHR according to national health IT standards. Principal Findings Overall performance measured via computer-extracted data was 21.9 percent, compared with 53.2 percent for manual data. Agreement measures were high for immunizations. Otherwise, agreement between computer extraction and manual review was modest (Kappa = 0.36) because computer-extracted data frequently missed care events (sensitivity = 39.5 percent). Measure validity varied by health care domain and setting. A limitation of our findings is that we studied only three domains and three sites. Conclusions The accuracy of computer-extracted EHR quality reporting depends on the use of structured data fields, with the highest agreement found for measures and in the setting that had the greatest concentration of structured fields. We need to improve documentation of care, data extraction, and adaptation of EHR systems to practice workflow. PMID:24471935

  7. Psychometric Properties of Patient-Facing eHealth Evaluation Measures: Systematic Review and Analysis.

    PubMed

    Wakefield, Bonnie J; Turvey, Carolyn L; Nazi, Kim M; Holman, John E; Hogan, Timothy P; Shimada, Stephanie L; Kennedy, Diana R

    2017-10-11

    Significant resources are being invested into eHealth technology to improve health care. Few resources have focused on evaluating the impact of use on patient outcomes A standardized set of metrics used across health systems and research will enable aggregation of data to inform improved implementation, clinical practice, and ultimately health outcomes associated with use of patient-facing eHealth technologies. The objective of this project was to conduct a systematic review to (1) identify existing instruments for eHealth research and implementation evaluation from the patient's point of view, (2) characterize measurement components, and (3) assess psychometrics. Concepts from existing models and published studies of technology use and adoption were identified and used to inform a search strategy. Search terms were broadly categorized as platforms (eg, email), measurement (eg, survey), function/information use (eg, self-management), health care occupations (eg, nurse), and eHealth/telemedicine (eg, mHealth). A computerized database search was conducted through June 2014. Included articles (1) described development of an instrument, or (2) used an instrument that could be traced back to its original publication, or (3) modified an instrument, and (4) with full text in English language, and (5) focused on the patient perspective on technology, including patient preferences and satisfaction, engagement with technology, usability, competency and fluency with technology, computer literacy, and trust in and acceptance of technology. The review was limited to instruments that reported at least one psychometric property. Excluded were investigator-developed measures, disease-specific assessments delivered via technology or telephone (eg, a cancer-coping measure delivered via computer survey), and measures focused primarily on clinician use (eg, the electronic health record). The search strategy yielded 47,320 articles. Following elimination of duplicates and non

  8. 42 CFR 457.710 - State plan requirements: Strategic objectives and performance goals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    .... The State's strategic objectives, performance goals and performance measures must include a common... 42 Public Health 4 2010-10-01 2010-10-01 false State plan requirements: Strategic objectives and...) ALLOTMENTS AND GRANTS TO STATES Strategic Planning, Reporting, and Evaluation § 457.710 State plan...

  9. Objective-subjective disparity in cancer-related cognitive impairment: does the use of change measures help reconcile the difference?

    PubMed

    O'Farrell, Erin; Smith, Andra; Collins, Barbara

    2017-10-01

    Studies to date have found little correlation between subjective and objective measures of cognitive function in cancer patients, making it difficult to interpret the significance of their cognitive complaints. The purpose of this study was to determine if a stronger correlation would be obtained using measures of cognitive change rather than static scores. Sixty women with early stage breast cancer underwent repeated cognitive assessment over the course of chemotherapy with a neuropsychological test battery (objective measure) and with the FACT-Cog (subjective measure). Their results were compared to 60 healthy women matched on age and education and assessed at similar intervals. We used multilevel modeling, with FACT-Cog as the dependent measure and ordinary least squares slopes of a neuropsychological summary score as the independent variable, to evaluate the co-variation between the subjective and objective measures over time RESULTS: Measures of both objective and subjective cognitive function declined over the course of chemotherapy in the breast cancer patients but there was no significant relationship between them, even when using change measures. Change in objective cognitive function was not related to change in anxiety or fatigue scores but the decline in perceived cognitive function was associated with greater anxiety and fatigue. The discrepancy in objective and subjective measures of cognition in breast cancer patients cannot be accounted for in terms of a failure to use change measures. Although the results are negative, we contend that this is the more appropriate methodology for analyzing cancer-related changes in cognition. Copyright © 2016 John Wiley & Sons, Ltd.

  10. Home Economics. Exploration of Clothing Management, Production and Service Occupations. Performance Objectives. Criterion Measures.

    ERIC Educational Resources Information Center

    Duval County School Board, Jacksonville, FL.

    Several intermediate performance objectives and corresponding criterion measures are presented for each of five terminal objectives for a 12- to 18-week course designed to provide students in grades 8 or 9 with opportunities to explore a broad range of clothing management, production, and service occupations. The course was designed to provide…

  11. Twin Study on Heritability of Activity, Attention, and Impulsivity as Assessed by Objective Measures

    ERIC Educational Resources Information Center

    Heiser, Philip; Heinzel-Gutenbrunner, Monika; Frey, Joachim; Smidt, Judith; Grabarkiewicz, Justyna; Friedel, Susann; Kuhnau, Wolfgang; Schmidtke, Jorg; Remschmidt, Helmut; Hebebrand, Johannes

    2006-01-01

    Objective: The purpose of this study was to assess heritability of activity, attention, and impulsivity by comparing young monozygotic (MZ) twins with dizygotic (DZ) twins using objective measures. Method: The OPTAx test is an infrared motion analysis to record the movement pattern during a continuous performance test. Seventeen MZ and 12 same…

  12. Objective Versus Subjective Measures of Executive Functions: Predictors of Participation and Quality of Life in Parkinson Disease?

    PubMed

    Vlagsma, Thialda T; Koerts, Janneke; Tucha, Oliver; Dijkstra, Hilde T; Duits, Annelien A; van Laar, Teus; Spikman, Jacoba M

    2017-11-01

    To determine whether objective (neuropsychological tests) and subjective measures (questionnaires) of executive functions (EFs) are associated in patients with Parkinson disease (PD), and to determine to what extent level of participation and quality of life (QoL) of patients with PD can be predicted by these measures of EFs. Correlational research design (case-control and prediction design). Departments of neuropsychology of 3 medical centers. A sample (N=136) of patients with PD (n=42) and their relatives, and controls without PD (n=94). Not applicable. A test battery measuring EFs. In addition, patients, their relatives, and controls completed the Dysexecutive Questionnaire, Brock Adaptive Functioning Questionnaire, and Barkley Deficits in Executive Functioning Scale - time management questionnaires measuring complaints about EFs. Participation and QoL were measured with the Impact on Participation and Autonomy scale and the Parkinson's Disease Questionnaire-39, respectively. Patients with PD showed impairments in EFs on objective tests and reported significantly more complaints about EFs than did controls without PD. No associations were found between patients' performances on objective and subjective measures of EFs. However, both objective and subjective measures predicted patients' level of participation. In addition, subjective measures of EFs predicted QoL in patients with PD. These findings show that objective and subjective measures of EFs are not interchangeable and that both approaches predict level of participation and QoL in patients with PD. However, within this context, sex needs to be taken into account. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  13. Association between maternal education and objectively measured physical activity and sedentary time in adolescents.

    PubMed

    Sherar, Lauren B; Griffin, Tom P; Ekelund, Ulf; Cooper, Ashley R; Esliger, Dale W; van Sluijs, Esther M F; Bo Andersen, Lars; Cardon, Greet; Davey, Rachel; Froberg, Karsten; Hallal, Pedro C; Janz, Kathleen F; Kordas, Katarzyna; Kriemler, Susi; Pate, Russell R; Puder, Jardena J; Sardinha, Luis B; Timperio, Anna F; Page, Angie S

    2016-06-01

    Investigating socioeconomic variation in physical activity (PA) and sedentary time is important as it may represent a pathway by which socioeconomic position (SEP) leads to ill health. Findings on the association between children's SEP and objectively assessed PA and/or sedentary time are mixed, and few studies have included international samples. Examine the associations between maternal education and adolescent's objectively assessed PA and sedentary time. This is an observational study of 12 770 adolescents (10-18 years) pooled from 10 studies from Europe, Australia, Brazil and the USA. Original PA data were collected between 1997 and 2009. The associations between maternal education and accelerometer variables were examined using robust multivariable regression, adjusted for a priori confounders (ie, body mass index, monitor wear time, season, age and sex) and regression coefficients combined across studies using random effects meta-analyses. Analyses were conducted in March 2014. Adolescents of university educated mothers spent more time sedentary (9.5 min/day, p=0.005) and less time in light activity (10 min/day, p<0.001) compared with adolescents of high school educated mothers. Pooled analysis across two studies from Brazil and Portugal (analysed separately because of the different coding of maternal education) showed that children of higher educated mothers (tertiary vs primary/secondary) spent less time in moderate to vigorous PA (MVPA) (6.6 min/day, p=0.001) and in light PA (39.2 min/day: p<0.001), and more time sedentary (45.9 min/day, p<0.001). Across a number of international samples, adolescents of mothers with lower education may not be at a disadvantage in terms of overall objectively measured PA. 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/

  14. Measuring Sexual and Gender Minority Populations in Health Surveillance.

    PubMed

    Patterson, Joanne G; Jabson, Jennifer M; Bowen, Deborah J

    2017-04-01

    Sexual and gender minorities (SGMs) are underrepresented and information about SGMs is difficult to locate in national health surveillance data, and this limits identification and resolution of SGM health disparities. It is also not known how measures of sexual orientation and transgender-inclusive gender identity in health surveillance compare with best practice recommendations. This article reviews and summarizes the publicly available, English language, large-scale, rigorously sampled, national, international, and regional data sources that include sexual orientation or transgender-inclusive gender identity and compares measures with best practice guidelines. A systematic review was undertaken of national, international, state, and regional health surveillance data sources. Data sources that measured sexual orientation or transgender-inclusive gender identity and met seven inclusion criteria were included. Forty-three publicly accessible national, international, and regional data sources included measures of sexual orientation and transgender-inclusive gender identity and health. For each data source, sampling design, sample characteristics, study years, survey questions, contact persons, and data access links are provided. Few data sources met best practice recommendations for SGM measurement: 14% measured all three dimensions of sexual orientation (identity, behavior, attraction) as recommended by the Sexual Minority Assessment Research Team. No data sources measured transgender-inclusive gender identity according to the Gender Identity in U.S. Surveillance-recommended two-step method of measuring sex assigned at birth and current gender identity. This article provides a much needed detailed summary of extant health surveillance data sources that can be used to inform research about health risks and disparities among SGM populations. Future recommendations are for more rigorous measurement and oversampling to advance what is known about SGM health disparities

  15. Measuring Sexual and Gender Minority Populations in Health Surveillance

    PubMed Central

    Jabson, Jennifer M.; Bowen, Deborah J.

    2017-01-01

    Abstract Purpose: Sexual and gender minorities (SGMs) are underrepresented and information about SGMs is difficult to locate in national health surveillance data, and this limits identification and resolution of SGM health disparities. It is also not known how measures of sexual orientation and transgender-inclusive gender identity in health surveillance compare with best practice recommendations. This article reviews and summarizes the publicly available, English language, large-scale, rigorously sampled, national, international, and regional data sources that include sexual orientation or transgender-inclusive gender identity and compares measures with best practice guidelines. Methods: A systematic review was undertaken of national, international, state, and regional health surveillance data sources. Data sources that measured sexual orientation or transgender-inclusive gender identity and met seven inclusion criteria were included. Results: Forty-three publicly accessible national, international, and regional data sources included measures of sexual orientation and transgender-inclusive gender identity and health. For each data source, sampling design, sample characteristics, study years, survey questions, contact persons, and data access links are provided. Few data sources met best practice recommendations for SGM measurement: 14% measured all three dimensions of sexual orientation (identity, behavior, attraction) as recommended by the Sexual Minority Assessment Research Team. No data sources measured transgender-inclusive gender identity according to the Gender Identity in U.S. Surveillance-recommended two-step method of measuring sex assigned at birth and current gender identity. Conclusions: This article provides a much needed detailed summary of extant health surveillance data sources that can be used to inform research about health risks and disparities among SGM populations. Future recommendations are for more rigorous measurement and oversampling to

  16. Subjectively and objectively measured sleep with and without posttraumatic stress disorder and trauma exposure.

    PubMed

    Kobayashi, Ihori; Huntley, Edward; Lavela, Joseph; Mellman, Thomas A

    2012-07-01

    Although reports of sleep disturbances are common among individuals with posttraumatic stress disorder (PTSD), results of polysomnographic (PSG) studies have inconsistently documented abnormalities and have therefore suggested "sleep state misperception." The authors' study objectives were to compare sleep parameters measured objectively and subjectively in the laboratory and at home in civilians with and without trauma exposure and PTSD. Cross-sectional study. PSG recordings in a sleep laboratory and actigraphic recordings in participants' homes. One hundred three urban-residing African Americans with and without trauma exposure and PTSD who participated in a larger study. N/A. Sleep parameters (total sleep time [TST], sleep onset latency [SOL], and wake after sleep onset [WASO]) were assessed using laboratory PSG and home actigraphy. A sleep diary was completed in the morning after PSG and actigraphy recordings. Habitual TST, SOL, and WASO were assessed using a sleep questionnaire. The Clinician Administered PTSD Scale was administered to assess participants' trauma exposure and PTSD diagnostic status. Participants, regardless of their trauma exposure/PTSD status, underestimated WASO in the diary and questionnaire relative to actigraphy and overestimated SOL in the diary relative to PSG. Among participants with current PTSD, TST diary estimates did not differ from the actigraphy measure in contrast with those without current PTSD who overestimated TST. No other significant group differences in discrepancies between subjective and objective sleep measures were found. Discrepancies between subjectively and objectively measured sleep parameters were not associated with trauma exposure or PTSD. This challenges prior assertions that individuals with PTSD overreport their sleep disturbances.

  17. Children’s sedentary behaviour: descriptive epidemiology and associations with objectively-measured sedentary time

    PubMed Central

    2013-01-01

    Background Little is known regarding the patterning and socio-demographic distribution of multiple sedentary behaviours in children. The aims of this study were to: 1) describe the leisure-time sedentary behaviour of 9–10 year old British children, and 2) establish associations with objectively-measured sedentary time. Methods Cross-sectional analysis in the SPEEDY study (Sport, Physical activity and Eating behaviour: Environmental Determinants in Young people) (N=1513, 44.3% boys). Twelve leisure-time sedentary behaviours were assessed by questionnaire. Objectively-measured leisure-time sedentary time (Actigraph GT1M, <100 counts/minute) was assessed over 7 days. Differences by sex and socioeconomic status (SES) in self-reported sedentary behaviours were tested using Kruskal-Wallis tests. The association between objectively-measured sedentary time and the separate sedentary behaviours (continuous (minutes) and categorised into 'none’ 'low’ or 'high’ participation) was assessed using multi-level linear regression. Results Sex differences were observed for time spent in most sedentary behaviours (all p ≤ 0.02), except computer use. Girls spent more time in combined non-screen sedentary behaviour (median, interquartile range: girls: 770.0 minutes, 390.0-1230.0; boys: 725.0, 365.0 - 1182.5; p = 0.003), whereas boys spent more time in screen-based behaviours (girls: 540.0, 273.0 - 1050.0; boys: 885.0, 502.5 - 1665.0; p < 0.001). Time spent in five non-screen behaviours differed by SES, with higher values in those of higher SES (all p ≤ 0.001). Regression analyses with continuous exposures indicated that reading (β = 0.1, p < 0.001) and watching television (β = 0.04, p < 0.01) were positively associated with objectively-measured sedentary time, whilst playing board games (β = -0.12, p < 0.05) was negatively associated. Analysed in categorical form, sitting and talking (vs. none: 'low’ β = 26.1,ns

  18. High-Accuracy Measurement of Small Movement of an Object behind Cloth Using Airborne Ultrasound

    NASA Astrophysics Data System (ADS)

    Hoshiba, Kotaro; Hirata, Shinnosuke; Hachiya, Hiroyuki

    2013-07-01

    The acoustic measurement of vital information such as breathing and heartbeat in the standing position whilst the subject is wearing clothes is a difficult problem. In this paper, we present the basic experimental results to measure small movement of an object behind cloth. We measured acoustic characteristics of various types of cloth to obtain the transmission loss through cloth. To observe the relationship between measurement error and target speed under a low signal-to-noise ratio (SNR), we tried to measure the movement of an object behind cloth. The target was placed apart from the cloth to separate the target reflection from the cloth reflection. We found that a small movement of less than 6 mm/s could be observed using the M-sequence, moving target indicator (MTI) filter, and tracking phase difference, when the SNR was less than 0 dB. We also present the results of theoretical error analysis in the MTI filter and phase tracking for high-accuracy measurement. Characteristics of the systematic error were clarified.

  19. Associations Between the Built Environment and Objective Measures of Sleep: The Multi-Ethnic Study of Atherosclerosis.

    PubMed

    Johnson, Dayna A; Hirsch, Jana A; Moore, Kari A; Redline, Susan; Diez Roux, Ana V

    2018-05-01

    Although dense neighborhood built environments support increased physical activity and lower obesity, these features may also disturb sleep. Therefore, we sought to understand the association between the built environment and objectively measured sleep. From 2010 to 2013, we analyzed data from examination 5 of the Multi-Ethnic Study of Atherosclerosis, a diverse population from 6 US cities. We fit multilevel models that assessed the association between the built environment (Street Smart Walk Score, social engagement destinations, street intersections, and population density) and sleep duration or efficiency from 1-week wrist actigraphy in 1,889 individuals. After adjustment for covariates, a 1-standard-deviation increase in Street Smart Walk Score was associated with 23% higher odds of short sleep duration (≤6 hours; odds ratio = 1.2, 95% confidence interval: 1.0, 1.4), as well as shorter average sleep duration (mean difference = -8.1 minutes, 95% confidence interval: -12.1, -4.2). Results were consistent across other built environment measures. Associations were attenuated after adjustment for survey-based measure of neighborhood noise. Dense neighborhood development may have multiple health consequence. In promoting denser neighborhoods to increase walkability, it is important to also implement strategies that reduce the adverse impacts of this development on sleep, such as noise reductions efforts.

  20. Measuring success in creating a "culture of health".

    PubMed

    Crimmins, Timothy J; Halberg, Julia

    2009-03-01

    To develop and test methodology to measure employees attitudes regarding worksite health promotion. These values and attitudes are described as a "culture of health" and are believed to motivate behavior changes toward improved health outcomes. This survey tool was designed to determine the value and degree of support that employees have for health improvement initiatives at a large food company. The "Total You Health Values Survey" administered by an outside vendor (Sirota) was sent by e-mail to 4674 headquarters and research and development employees with an explanation of the survey and instructions for completion. The survey was open 14 days and there were no incentives for completion. The survey consisted of three demographic questions, one open ended comment section and 14 core questions in three categories: Supportive Environment, Healthy Lifestyle Attitudes, and Knowledge and Behavior. Employees were guaranteed confidentiality and anonymity. There were 3339 responses, a 71% response rate. Ninety-one percent of respondents said that encouraging healthy lifestyles is a General Mills priority and 97% said they know the steps needed to stay healthy. We were able to develop and implement a simple measurement tool to measure the success of our health promotion activities using an e-mail based questionnaire. In the employee population surveyed, we found that there was broad support for health promotion. We believe that this simple survey tool can be used by other employers to measure their organizational "culture of health."

  1. Measuring the Value of Public Health Systems: The Disconnect Between Health Economists and Public Health Practitioners

    PubMed Central

    Jacobson, Peter D.; Palmer, Jennifer A.

    2008-01-01

    We investigated ways of defining and measuring the value of services provided by governmental public health systems. Our data sources included literature syntheses and qualitative interviews of public health professionals. Our examination of the health economic literature revealed growing attempts to measure value of public health services explicitly, but few studies have addressed systems or infrastructure. Interview responses demonstrated no consensus on metrics and no connection to the academic literature. Key challenges for practitioners include developing rigorous, data-driven methods and skilled staff; being politically willing to base allocation decisions on economic evaluation; and developing metrics to capture “intangibles” (e.g., social justice and reassurance value). Academic researchers evaluating the economics of public health investments should increase focus on the working needs of public health professionals. PMID:18923123

  2. Effects of modifications to the health and social sector's collective agreement on the objective characteristics of working hours.

    PubMed

    Ropponen, Annina; Vanttola, Päivi; Koskinen, Aki; Hakola, Tarja; Puttonen, Sampsa; Härmä, Mikko

    2017-08-08

    This study aimed to evaluate the effects of an intervention on objective working-hour characteristics. The intervention involved making modifications to the collective agreement that would limit employees' entitlement to time off as compensation. The intervention group consisted of 493 and the control group of 2,303 health and social care shift workers, respectively. We analysed the objective pay roll-based working-hour data for 2012-2013, which we obtained from employers' records, using the repeated measures mixed model. The changes in objective working-hour characteristics were small, but systematic. The intervention had some positive effects: the amount of short recovery periods (<28 h) after the last night shift decreased from 5% to 3%, and the amount of working weeks of over 48 h decreased from 19% to 17%. The realization of employees' shift preferences increased from 18% to 20%. However, in contrast, consecutive work shifts and the number of scheduled absences increased and days off decreased, suggesting less time for recovery and thus a negative trend in shift ergonomics. When planning shifts, nursing management should avoid regulations that promote specific unhealthy shift characteristics, that is, consecutive work shifts and less days off.

  3. Comparison of objective texture measurements in raw and cooked wooden breast meat.

    USDA-ARS?s Scientific Manuscript database

    Broiler breast meat exhibiting the wooden breast condition is characterized as having an abnormally hard or rigid texture. The efficacy of using objective texture measurements to characterize the texture attributes of breast meat exhibiting this condition before and after cooking are not well under...

  4. Health inequalities and social group differences: what should we measure?

    PubMed Central

    Murray, C. J.; Gakidou, E. E.; Frenk, J.

    1999-01-01

    Both health inequalities and social group health differences are important aspects of measuring population health. Despite widespread recognition of their magnitude in many high- and low-income countries, there is considerable debate about the meaning and measurement of health inequalities, social group health differences and inequities. The lack of standard definitions, measurement strategies and indicators has and will continue to limit comparisons--between and within countries, and over time--of health inequalities, and perhaps more importantly comparative analyses of their determinants. Such comparative work, however, will be essential to find effective policies for governments to reduce health inequalities. This article addresses the question of whether we should be measuring health inequalities or social group health differences. To help clarify the strengths and weaknesses of these two approaches, we review some of the major arguments for and against each of them. PMID:10444876

  5. Utility and limitations of measures of health inequities: a theoretical perspective

    PubMed Central

    Alonge, Olakunle; Peters, David H.

    2015-01-01

    Summary box What is already known on this subject? Various measures have been used in quantifying health inequities among populations in recent times; most of these measures were derived to capture the socioeconomic inequalities in health. These different measures do not always lend themselves to common interpretation by policy makers and health managers because they each reflect limited aspects of the concept of health inequities. What does this study add? To inform a more appropriate application of the different measures currently used in quantifying health inequities, this article explicates common theories underlying the definition of health inequities and uses this understanding to show the utility and limitations of these different measures. It also suggests some key features of an ideal indicator based on the conceptual understanding, with the hope of influencing future efforts in developing more robust measures of health inequities. The article also provides a conceptual ‘product label’ for the common measures of health inequities to guide users and ‘consumers’ in making more robust inferences and conclusions. This paper examines common approaches for quantifying health inequities and assesses the extent to which they incorporate key theories necessary for explicating the definition of health inequity. The first theoretical analysis examined the distinction between inter-individual and inter-group health inequalities as measures of health inequities. The second analysis considered the notion of fairness in health inequalities from different philosophical perspectives. To understand the extent to which different measures of health inequities incorporate these theoretical explanations, four criteria were used to assess each measure: 1) Does the indicator demonstrate inter-group or inter-individual health inequalities or both; 2) Does it reflect health inequalities in relation to socioeconomic position; 3) Is it sensitive to the absolute transfer of

  6. Improving coverage measurement for reproductive, maternal, neonatal and child health: gaps and opportunities.

    PubMed

    Munos, Melinda K; Stanton, Cynthia K; Bryce, Jennifer

    2017-06-01

    Regular monitoring of coverage for reproductive, maternal, neonatal, and child health (RMNCH) is central to assessing progress toward health goals. The objectives of this review were to describe the current state of coverage measurement for RMNCH, assess the extent to which current approaches to coverage measurement cover the spectrum of RMNCH interventions, and prioritize interventions for a novel approach to coverage measurement linking household surveys with provider assessments. We included 58 interventions along the RMNCH continuum of care for which there is evidence of effectiveness against cause-specific mortality and stillbirth. We reviewed household surveys and provider assessments used in low- and middle-income countries (LMICs) to determine whether these tools generate measures of intervention coverage, readiness, or quality. For facility-based interventions, we assessed the feasibility of linking provider assessments to household surveys to provide estimates of intervention coverage. Fewer than half (24 of 58) of included RMNCH interventions are measured in standard household surveys. The periconceptional, antenatal, and intrapartum periods were poorly represented. All but one of the interventions not measured in household surveys are facility-based, and 13 of these would be highly feasible to measure by linking provider assessments to household surveys. We found important gaps in coverage measurement for proven RMNCH interventions, particularly around the time of birth. Based on our findings, we propose three sets of actions to improve coverage measurement for RMNCH, focused on validation of coverage measures and development of new measurement approaches feasible for use at scale in LMICs.

  7. Computing Health Quality Measures Using Informatics for Integrating Biology and the Bedside

    PubMed Central

    Murphy, Shawn N

    2013-01-01

    Background The Health Quality Measures Format (HQMF) is a Health Level 7 (HL7) standard for expressing computable Clinical Quality Measures (CQMs). Creating tools to process HQMF queries in clinical databases will become increasingly important as the United States moves forward with its Health Information Technology Strategic Plan to Stages 2 and 3 of the Meaningful Use incentive program (MU2 and MU3). Informatics for Integrating Biology and the Bedside (i2b2) is one of the analytical databases used as part of the Office of the National Coordinator (ONC)’s Query Health platform to move toward this goal. Objective Our goal is to integrate i2b2 with the Query Health HQMF architecture, to prepare for other HQMF use-cases (such as MU2 and MU3), and to articulate the functional overlap between i2b2 and HQMF. Therefore, we analyze the structure of HQMF, and then we apply this understanding to HQMF computation on the i2b2 clinical analytical database platform. Specifically, we develop a translator between two query languages, HQMF and i2b2, so that the i2b2 platform can compute HQMF queries. Methods We use the HQMF structure of queries for aggregate reporting, which define clinical data elements and the temporal and logical relationships between them. We use the i2b2 XML format, which allows flexible querying of a complex clinical data repository in an easy-to-understand domain-specific language. Results The translator can represent nearly any i2b2-XML query as HQMF and execute in i2b2 nearly any HQMF query expressible in i2b2-XML. This translator is part of the freely available reference implementation of the QueryHealth initiative. We analyze limitations of the conversion and find it covers many, but not all, of the complex temporal and logical operators required by quality measures. Conclusions HQMF is an expressive language for defining quality measures, and it will be important to understand and implement for CQM computation, in both meaningful use and population

  8. Objectively Measured Total and Occupational Sedentary Time in Three Work Settings

    PubMed Central

    van Dommelen, Paula; Coffeng, Jennifer K.; van der Ploeg, Hidde P.; van der Beek, Allard J.; Boot, Cécile R. L.; Hendriksen, Ingrid J. M.

    2016-01-01

    Background Sedentary behaviour increases the risk for morbidity. Our primary aim is to determine the proportion and factors associated with objectively measured total and occupational sedentary time in three work settings. Secondary aim is to study the proportion of physical activity and prolonged sedentary bouts. Methods Data were obtained using ActiGraph accelerometers from employees of: 1) a financial service provider (n = 49 men, 31 women), 2) two research institutes (n = 30 men, 57 women), and 3) a construction company (n = 38 men). Total (over the whole day) and occupational sedentary time, physical activity and prolonged sedentary bouts (lasting ≥30 minutes) were calculated by work setting. Linear regression analyses were performed to examine general, health and work-related factors associated with sedentary time. Results The employees of the financial service provider and the research institutes spent 76–80% of their occupational time in sedentary behaviour, 18–20% in light intensity physical activity and 3–5% in moderate-to-vigorous intensity physical activity. Occupational time in prolonged sedentary bouts was 27–30%. Total time was less sedentary (64–70%), and had more light intensity physical activity (26–33%). The employees of the construction company spent 44% of their occupational time in sedentary behaviour, 49% in light, and 7% in moderate intensity physical activity, and spent 7% in sedentary bouts. Total time spent in sedentary behavior was 56%, 40% in light, and 4% in moderate intensity physical behaviour, and 12% in sedentary bouts. For women, low to intermediate education was the only factor that was negatively associated with occupational sedentary time. Conclusions Sedentary behaviour is high among white-collar employees, especially in highly educated women. A relatively small proportion of sedentary time was accrued in sedentary bouts. It is recommended that worksite health promotion efforts should focus on reducing sedentary

  9. Wavefront-aberration measurement and systematic-error analysis of a high numerical-aperture objective

    NASA Astrophysics Data System (ADS)

    Liu, Zhixiang; Xing, Tingwen; Jiang, Yadong; Lv, Baobin

    2018-02-01

    A two-dimensional (2-D) shearing interferometer based on an amplitude chessboard grating was designed to measure the wavefront aberration of a high numerical-aperture (NA) objective. Chessboard gratings offer better diffraction efficiencies and fewer disturbing diffraction orders than traditional cross gratings. The wavefront aberration of the tested objective was retrieved from the shearing interferogram using the Fourier transform and differential Zernike polynomial-fitting methods. Grating manufacturing errors, including the duty-cycle and pattern-deviation errors, were analyzed with the Fourier transform method. Then, according to the relation between the spherical pupil and planar detector coordinates, the influence of the distortion of the pupil coordinates was simulated. Finally, the systematic error attributable to grating alignment errors was deduced through the geometrical ray-tracing method. Experimental results indicate that the measuring repeatability (3σ) of the wavefront aberration of an objective with NA 0.4 was 3.4 mλ. The systematic-error results were consistent with previous analyses. Thus, the correct wavefront aberration can be obtained after calibration.

  10. Prevalence of Hand-transmitted Vibration Exposure among Grass-cutting Workers using Objective and Subjective Measures

    NASA Astrophysics Data System (ADS)

    Azmir, N. A.; Yahya, M. N.

    2017-01-01

    Extended exposure to hand-transmitted vibration from vibrating machine is associated with an increased occurrence of symptoms of occupational disease related to hand disorder. The present case study is to determine the prevalence and correlation of significant subjective as well as objective variables that induce to hand arm vibration syndrome (HAVS) among hand-held grass-cutting workers in Malaysia. Thus, recommendations are made for grass-cutting workers and grass maintenance service management based on findings. A cross sectional study using adopted subjective Hand Arm Vibration Exposure Risk Assessment (HAVERA) questionnaire from Vibration Injury Network on hand disorder signs and symptoms was distributed to a sample of one hundred and sixty eight male workers from grass and turf maintenance industry that use vibrating machine as part of their work. For objective measure, hand-transmitted vibration measurement was collected on site during operation by the following ISO 5349-1, 2001. Two groups were identified in this research comprising of high exposure group and low-moderate exposure group. Workers also gave information about their personal identification, social history, workers’ health, occupational history and machine safety inspection. There was positive HAVS symptoms relationship between the low-moderate exposure group and high exposure group among hand-held grass-cutting workers. The prevalence ratio (PR) was considered high for experiencing white colour change at fingers and fingers go numb which are 3.63 (1.41 to 9.39) and 4.24 (2.18 to 8.27), respectively. The estimated daily vibration exposure, A(8) differs between 2.1 to 20.7 ms-2 for right hand while 2.7 to 29.1 ms-2 for left hand. The subjects claimed that the feel of numbness at left hand is much stronger compared to right hand. The results suggest that HAVS is diagnosed in Malaysia especially in agriculture sector. The A(8) indicates that the exposure value is more than exposure limit value

  11. Objectively measured physical activity and sedentary time in south Asian women: a cross-sectional study.

    PubMed

    Curry, Whitney B; Thompson, Janice L

    2014-12-13

    South Asian (SA) women in the United Kingdom (UK) are known to be at high risk for developing chronic diseases, and to have low levels of physical activity (PA). Increasing levels of PA and reducing sedentary time (ST) are recognized as factors to target in an effort to curb chronic disease morbidity and mortality. There is limited evidence documenting objectively measured PA/ST and their correlates in SA women. Therefore the purpose of this cross-sectional study was to objectively measure and report patterns of PA/ST among SA women in the UK and examine potential socio-demographic correlates of PA/ST. 140 UK SA women (Pakistani and Bangladeshi) wore an accelerometer for 7 consecutive days. Anthropometric measurements and self-reported socio-demographic information were taken. Mean daily moderate-to-vigorous PA (MVPA) was 34.66 ± 21.52 minutes and mean daily ST was 530.20 ± 81.76 minutes, with an inverse correlation (r = -.270, N = 140, p < .001) showing that higher ST was associated with lower MVPA. The same was seen for light intensity PA (LPA) (r = -.610, N = 140, p < .001). MVPA was significantly higher for younger women (18-64.5 yrs), with 64.7% of older women (≥65 yrs) failing to meet PA guidelines (t = 3.101, p < 0.05). Overweight/obese women had lower levels of LPA, MVPA and higher ST (p < .001). Multiple linear regression analyses indicated 14.9% of the variance in MVPA was explained by age and waist circumference (F(2,138) = 6.41, p < 0.002). LPA and ST were significantly higher on weekend days than weekdays (p < .001), and MVPA was significantly higher on weekdays than weekend days. Results indicate higher levels of PA in this sample than previously assumed. High levels of LPA in this sample indicate the need for health promotion interventions to target not only duration, but also intensity of activity in this population to achieve PA recommendations.

  12. New Summary Measures of Population Health and Well-Being for Implementation by Health Plans and Accountable Care Organizations

    PubMed Central

    Gallagher, Jason M.; Rauri, Sachin; Tillema, Juliana O.; Pronk, Nicolaas P.; Knudson, Susan M.

    2016-01-01

    Health plans and accountable care organizations measure many indicators of patient health, with standard metrics that track factors such as patient experience and cost. They lack, however, a summary measure of the third leg of the Triple Aim, population health. In response, HealthPartners has developed summary measures that align with the recommendations of the For the Public’s Health series of reports from the Institute of Medicine. (The series comprises the following 3 reports: For the Public’s Health: Investing in a Healthier Future, For the Public’s Health: Revitalizing Law and Policy to Meet New Challenges, and For the Public’s Health: The Role of Measurement in Action and Accountability.) The summary measures comprise 3 components: current health, sustainability of health, and well-being. The measure of current health is disability-adjusted life years (DALYs) calculated from health care claims and death records. The sustainability of health measure comprises member reporting of 6 behaviors associated with health plus a clinical preventive services index that indicates adherence to evidence-based preventive care guidelines. Life satisfaction represents the summary measure of subjective well-being. HealthPartners will use the summary measures to identify and address conditions and factors that have the greatest impact on the health and well-being of its patients, members, and community. The method could easily be implemented by other institutions and organizations in the United States, helping to address a persistent need in population health measurement for improvement. PMID:27390075

  13. New Summary Measures of Population Health and Well-Being for Implementation by Health Plans and Accountable Care Organizations.

    PubMed

    Kottke, Thomas E; Gallagher, Jason M; Rauri, Sachin; Tillema, Juliana O; Pronk, Nicolaas P; Knudson, Susan M

    2016-07-07

    Health plans and accountable care organizations measure many indicators of patient health, with standard metrics that track factors such as patient experience and cost. They lack, however, a summary measure of the third leg of the Triple Aim, population health. In response, HealthPartners has developed summary measures that align with the recommendations of the For the Public's Health series of reports from the Institute of Medicine. (The series comprises the following 3 reports: For the Public's Health: Investing in a Healthier Future, For the Public's Health: Revitalizing Law and Policy to Meet New Challenges, and For the Public's Health: The Role of Measurement in Action and Accountability.) The summary measures comprise 3 components: current health, sustainability of health, and well-being. The measure of current health is disability-adjusted life years (DALYs) calculated from health care claims and death records. The sustainability of health measure comprises member reporting of 6 behaviors associated with health plus a clinical preventive services index that indicates adherence to evidence-based preventive care guidelines. Life satisfaction represents the summary measure of subjective well-being. HealthPartners will use the summary measures to identify and address conditions and factors that have the greatest impact on the health and well-being of its patients, members, and community. The method could easily be implemented by other institutions and organizations in the United States, helping to address a persistent need in population health measurement for improvement.

  14. Workplace air measurements and likelihood of exposure to manufactured nano-objects, agglomerates, and aggregates

    NASA Astrophysics Data System (ADS)

    Brouwer, Derk H.; van Duuren-Stuurman, Birgit; Berges, Markus; Bard, Delphine; Jankowska, Elzbieta; Moehlmann, Carsten; Pelzer, Johannes; Mark, Dave

    2013-11-01

    Manufactured nano-objects, agglomerates, and aggregates (NOAA) may have adverse effect on human health, but little is known about occupational risks since actual estimates of exposure are lacking. In a large-scale workplace air-monitoring campaign, 19 enterprises were visited and 120 potential exposure scenarios were measured. A multi-metric exposure assessment approach was followed and a decision logic was developed to afford analysis of all results in concert. The overall evaluation was classified by categories of likelihood of exposure. At task level about 53 % showed increased particle number or surface area concentration compared to "background" level, whereas 72 % of the TEM samples revealed an indication that NOAA were present in the workplace. For 54 out of the 120 task-based exposure scenarios, an overall evaluation could be made based on all parameters of the decision logic. For only 1 exposure scenario (approximately 2 %), the highest level of potential likelihood was assigned, whereas in total in 56 % of the exposure scenarios the overall evaluation revealed the lowest level of likelihood. However, for the remaining 42 % exposure to NOAA could not be excluded.

  15. 75 FR 51831 - Request for Measures of Health Plan Efforts To Address Health Plan Members' Health Literacy Needs

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-23

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Request for Measures of Health Plan Efforts To Address Health Plan Members' Health Literacy Needs AGENCY: Agency for... well health plans and health providers address health plan enrollees' health literacy needs and how...

  16. Subjective and objective assessment of physical activity in multiple sclerosis and their relation to health-related quality of life.

    PubMed

    Krüger, Theresa; Behrens, Janina R; Grobelny, Anuschka; Otte, Karen; Mansow-Model, Sebastian; Kayser, Bastian; Bellmann-Strobl, Judith; Brandt, Alexander U; Paul, Friedemann; Schmitz-Hübsch, Tanja

    2017-01-13

    Physical activity (PA) is frequently restricted in people with multiple sclerosis (PwMS) and aiming to enhance PA is considered beneficial in this population. We here aimed to explore two standard methods (subjective plus objective) to assess PA reduction in PwMS and to describe the relation of PA to health-related quality of life (hrQoL). PA was objectively measured over a 7-day period in 26 PwMS (EDSS 1.5-6.0) and 30 matched healthy controls (HC) using SenseWear mini® armband (SWAmini) and reported as step count, mean total and activity related energy expenditure (EE) as well as time spent in PA of different intensities. Measures of EE were also derived from self-assessment with IPAQ (International Physical Activity Questionnaire) long version, which additionally yielded information on the context of PA and a classification into subjects' PA levels. To explore the convergence between both types of assessment, IPAQ categories (low, moderate, high) were related to selected PA parameters from objective assessment using ANOVA. Group differences and associated effect sizes for all PA parameters as well as their relation to clinical and hrQoL measures were determined. Both, SWAmini and IPAQ assessment, captured differences in PA between PwMS and HC. IPAQ categories fit well with common cut-offs for step count (p = 0.002) and mean METs (p = 0.004) to determine PA levels with objective devices. Correlations between specifically matched pairs of IPAQ and SWAmini parameters ranged between r .288 and r .507. Concerning hrQoL, the lower limb mobility subscore was related to four PA measures, while a relation with patients' report of general contentment was only seen for one. Both methods of assessment seem applicable in PwMS and able to describe reductions in daily PA at group level. Whether they can be used to track individual effects of interventions to enhance PA levels needs further exploration. The relation of PA measures with hrQoL seen with lower limb

  17. The paradox of conscientious objection and the anemic concept of 'conscience': downplaying the role of moral integrity in health care.

    PubMed

    Giubilini, Alberto

    2014-06-01

    Conscientious objection in health care is a form of compromise whereby health care practitioners can refuse to take part in safe, legal, and beneficial medical procedures to which they have a moral opposition (for instance abortion). Arguments in defense of conscientious objection in medicine are usually based on the value of respect for the moral integrity of practitioners. I will show that philosophical arguments in defense of conscientious objection based on respect for such moral integrity are extremely weak and, if taken seriously, lead to consequences that we would not (and should not) accept. I then propose that the best philosophical argument that defenders of conscientious objection in medicine can consistently deploy is one that appeals to (some form of) either moral relativism or subjectivism. I suggest that, unless either moral relativism or subjectivism is a valid theory--which is exactly what many defenders of conscientious objection (as well as many others) do not think--the role of moral integrity and conscientious objection in health care should be significantly downplayed and left out of the range of ethically relevant considerations.

  18. Stochastic multi-objective auto-optimization for resource allocation decision-making in fixed-input health systems.

    PubMed

    Bastian, Nathaniel D; Ekin, Tahir; Kang, Hyojung; Griffin, Paul M; Fulton, Lawrence V; Grannan, Benjamin C

    2017-06-01

    The management of hospitals within fixed-input health systems such as the U.S. Military Health System (MHS) can be challenging due to the large number of hospitals, as well as the uncertainty in input resources and achievable outputs. This paper introduces a stochastic multi-objective auto-optimization model (SMAOM) for resource allocation decision-making in fixed-input health systems. The model can automatically identify where to re-allocate system input resources at the hospital level in order to optimize overall system performance, while considering uncertainty in the model parameters. The model is applied to 128 hospitals in the three services (Air Force, Army, and Navy) in the MHS using hospital-level data from 2009 - 2013. The results are compared to the traditional input-oriented variable returns-to-scale Data Envelopment Analysis (DEA) model. The application of SMAOM to the MHS increases the expected system-wide technical efficiency by 18 % over the DEA model while also accounting for uncertainty of health system inputs and outputs. The developed method is useful for decision-makers in the Defense Health Agency (DHA), who have a strategic level objective of integrating clinical and business processes through better sharing of resources across the MHS and through system-wide standardization across the services. It is also less sensitive to data outliers or sampling errors than traditional DEA methods.

  19. The measurement of ultrasound scattering from individual micron-sized objects and its application in single cell scattering.

    PubMed

    Falou, Omar; Rui, Min; El Kaffas, Ahmed; Kumaradas, J Carl; Kolios, Michael C

    2010-08-01

    The measurement of the ultrasound backscatter from individual micron-sized objects such as cells is required for various applications such as tissue characterization. However, performing such a measurement remains a challenge. For example, the presence of air bubbles in a suspension of cells during the measurements may lead to the incorrect interpretation of the acoustic signals. This work introduces a technique for measuring the ultrasound backscatter from individual micron-sized objects by combining a microinjection system with a co-registered optical microscope and an ultrasound imaging device. This allowed the measurement of the ultrasound backscatter response from a single object under optical microscope guidance. The optical and ultrasonic data were used to determine the size of the object and to deduce its backscatter responses, respectively. In order to calibrate the system, the backscatter frequency responses from polystyrene microspheres were measured and compared to theoretical predictions. A very good agreement was found between the measured backscatter responses of individual microspheres and theoretical predictions of an elastic sphere. The backscatter responses from single OCI-AML-5 cells were also investigated. It was found that the backscatter responses from AML cells are best modeled using the fluid sphere model. The advantages, limitations, and future applications of the developed technique are discussed.

  20. Development of the Workplace Health Savings Calculator: a practical tool to measure economic impact from reduced absenteeism and staff turnover in workplace health promotion.

    PubMed

    Baxter, Siyan; Campbell, Sharon; Sanderson, Kristy; Cazaly, Carl; Venn, Alison; Owen, Carole; Palmer, Andrew J

    2015-09-18

    Workplace health promotion is focussed on improving the health and wellbeing of workers. Although quantifiable effectiveness and economic evidence is variable, workplace health promotion is recognised by both government and business stakeholders as potentially beneficial for worker health and economic advantage. Despite the current debate on whether conclusive positive outcomes exist, governments are investing, and business engagement is necessary for value to be realised. Practical tools are needed to assist decision makers in developing the business case for workplace health promotion programs. Our primary objective was to develop an evidence-based, simple and easy-to-use resource (calculator) for Australian employers interested in workplace health investment figures. Three phases were undertaken to develop the calculator. First, evidence from a literature review located appropriate effectiveness measures. Second, a review of employer-facilitated programs aimed at improving the health and wellbeing of employees was utilised to identify change estimates surrounding these measures, and third, currently available online evaluation tools and models were investigated. We present a simple web-based calculator for use by employers who wish to estimate potential annual savings associated with implementing a successful workplace health promotion program. The calculator uses effectiveness measures (absenteeism and staff turnover rates) and change estimates sourced from 55 case studies to generate the annual savings an employer may potentially gain. Australian wage statistics were used to calculate replacement costs due to staff turnover. The calculator was named the Workplace Health Savings Calculator and adapted and reproduced on the Healthy Workers web portal by the Australian Commonwealth Government Department of Health and Ageing. The Workplace Health Savings Calculator is a simple online business tool that aims to engage employers and to assist participation

  1. Measurement-based management of mental health quality and access in VHA: SAIL mental health domain.

    PubMed

    Lemke, Sonne; Boden, Matthew Tyler; Kearney, Lisa K; Krahn, Dean D; Neuman, Matthew J; Schmidt, Eric M; Trafton, Jodie A

    2017-02-01

    We outline the development of a Mental Health Domain to track accessibility and quality of mental health care in the United States Veterans Health Administration (VHA) as part of a broad-based performance measurement system. This domain adds an important element to national performance improvement efforts by targeting regional and facility leadership and providing them a concise yet comprehensive measure to identify facilities facing challenges in their mental health programs. We present the conceptual framework and rationale behind measure selection and development. The Mental Health Domain covers three important aspects of mental health treatment: Population Coverage, Continuity of Care, and Experience of Care. Each component is a composite of existing and newly adapted measures with moderate to high internal consistency; components are statistically independent or moderately related. Development and dissemination of the Mental Health Domain involved a variety of approaches and benefited from close collaboration between local, regional, and national leadership and from coordination with existing quality-improvement initiatives. During the first year of use, facilities varied in the direction and extent of change. These patterns of change were generally consistent with qualitative information, providing support for the validity of the domain and its component measures. Measure maintenance remains an iterative process as the VHA mental health system and potential data resources continue to evolve. Lessons learned may be helpful to the broader mental health-provider community as mental health care consolidates and becomes increasingly integrated within healthcare systems. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  2. Exploring the state of health and safety management system performance measurement in mining organizations

    PubMed Central

    Haas, Emily Joy; Yorio, Patrick

    2016-01-01

    Complex arguments continue to be articulated regarding the theoretical foundation of health and safety management system (HSMS) performance measurement. The culmination of these efforts has begun to enhance a collective understanding. Despite this enhanced theoretical understanding, however, there are still continuing debates and little consensus. The goal of the current research effort was to empirically explore common methods to HSMS performance measurement in mining organizations. The purpose was to determine if value and insight could be added into the ongoing approaches of the best ways to engage in health and safety performance measurement. Nine site-level health and safety management professionals were provided with 133 practices corresponding to 20 HSMS elements, each fitting into the plan, do, check, act phases common to most HSMS. Participants were asked to supply detailed information as to how they (1) assess the performance of each practice in their organization, or (2) would assess each practice if it were an identified strategic imperative. Qualitative content analysis indicated that the approximately 1200 responses provided could be described and categorized into interventions, organizational performance, and worker performance. A discussion of how these categories relate to existing indicator frameworks is provided. The analysis also revealed divergence in two important measurement issues; (1) quantitative vs qualitative measurement and reporting; and (2) the primary use of objective or subjective metrics. In lieu of these findings we ultimately recommend a balanced measurement and reporting approach within the three metric categories and conclude with suggestions for future research. PMID:26823642

  3. Objective measurement of daytime napping, cognitive dysfunction and subjective sleepiness in Parkinson's disease.

    PubMed

    Bolitho, Samuel J; Naismith, Sharon L; Salahuddin, Pierre; Terpening, Zoe; Grunstein, Ron R; Lewis, Simon J G

    2013-01-01

    Sleep-wake disturbances and concomitant cognitive dysfunction in Parkinson's disease (PD) contribute significantly to morbidity in patients and their carers. Subjectively reported daytime sleep disturbance is observed in over half of all patients with PD and has been linked to executive cognitive dysfunction. The current study used daytime actigraphy, a novel objective measure of napping and related this to neuropsychological performance in a sample of PD patients and healthy, age and gender-matched controls. Furthermore this study aimed to identify patients with PD who may benefit from pharmacologic and behavioural intervention to improve these symptoms. Eighty-five PD patients and 21 healthy, age-matched controls completed 14 days of wrist actigraphy within two weeks of neuropsychological testing. Objective napping measures were derived from actigraphy using a standardised protocol and subjective daytime sleepiness was recorded by the previously validated Epworth Sleepiness Scale. Patients with PD had a 225% increase in the mean nap time per day (minutes) as recorded by actigraphy compared to age matched controls (39.2 ± 35.2 vs. 11.5 ± 11.0 minutes respectively, p < 0.001). Significantly, differences in napping duration between patients, as recorded by actigraphy were not distinguished by their ratings on the subjective measurement of excessive daytime sleepiness. Finally, those patients with excessive daytime napping showed greater cognitive deficits in the domains of attention, semantic verbal fluency and processing speed. This study confirms increased levels of napping in PD, a finding that is concordant with subjective reports. However, subjective self-report measures of excessive daytime sleepiness do not robustly identify excessive napping in PD. Fronto-subcortical cognitive dysfunction was observed in those patients who napped excessively. Furthermore, this study suggests that daytime actigraphy, a non-invasive and inexpensive objective measure of

  4. The SF36 health survey questionnaire: an outcome measure suitable for routine use within the NHS?

    PubMed Central

    Garratt, A M; Ruta, D A; Abdalla, M I; Buckingham, J K; Russell, I T

    1993-01-01

    OBJECTIVE--To assess the validity, reliability, and acceptability of the short form 36 (SF 36) health survey questionnaire (a shortened version of a battery of 149 health status questions) as a measure of patient outcome in a broad sample of patients suffering from four common clinical conditions. DESIGN--Postal questionnaire, followed up by two reminders at two week intervals. SETTING--Clinics and four training practices in north east Scotland. SUBJECTS--Over 1700 patients aged 16-86 with one of four conditions--low back pain, menorrhagia, suspected peptic ulcer, or varicose veins--and a comparison sample of 900 members of the general population. MAIN OUTCOME MEASURES--The eight scales within the SF36 health profile. RESULTS--The response rate exceeded 75% in the patient population (1310 respondents). The SF36 satisfied rigorous psychometric criteria for validity and internal consistency. Clinical validity was shown by the distinctive profiles generated for each condition, each of which differed from that in the general population in a predictable manner. Furthermore, SF36 scores were lower in referred patients than in patients not referred and were closely related to general practitioners' perceptions of severity. CONCLUSIONS--These results provide support for the SF36 as a potential measure of patient outcome within the NHS. The SF36 seems acceptable to patients, internally consistent, and a valid measure of the health status of a wide range of patients. Before it can be used in the new health service, however, its sensitivity to changes in health status over time must also be tested. PMID:8518640

  5. Assessment of antitussive efficacy of dextromethorphan in smoking related cough: objective vs. subjective measures

    PubMed Central

    Ramsay, James; Wright, Caroline; Thompson, Rachel; Hull, David; Morice, Alyn H

    2008-01-01

    AIMS Using an established model of smokers cough we measured the antitussive effects of dextromethorphan compared with placebo. METHODS The study was a randomized, double-blind placebo controlled, crossover comparison of 22 mg 0.8 ml−1 dextromethorphan delivered pregastrically with matched placebo. Objective and subjective measurements of cough were recorded. Subjective measures included a daily diary record of cough symptoms and the Leicester quality of life questionnaire. Cough frequency was recorded using a manual cough counter. The objective measure of cough reflex sensitivity was the citric acid, dose–response cough challenge. RESULTS Dextromethorphan was significantly associated with an increase in the concentration of citric acid eliciting an average of two coughs/inhalation (C2) when compared with placebo, 1 h post dose by 0.49 mM (95% CI 0.05, 0.45, geometric mean 3.09) compared with placebo 0.24 mM (geometric mean 1.74) P < 0.05 and at 2 h 0.57 mM (95% CI 0.01, 0.43, geometric mean 3.75) compared with placebo 0.34 mM (geometric mean 2.19) P < 0.05). There was a highly significant improvement in the subjective data when compared with baseline. However, there was no significant difference between placebo and active treatment. No correlation was seen between cough sensitivity to citric acid and recorded cough counts or symptoms. When both subjective and objective data were compared with screening data there was evidence of a marked ‘placebo’ effect. CONCLUSIONS The objective measure of cough sensitivity demonstrates dextromethorphan effectively diminishes the cough reflex sensitivity. However, subjective measures do not support this. Other studies support these findings, which may represent a profound sensitivity of the cough reflex to higher influences. WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT Dextromethorphan is widely used as a cough suppressant in over the counter medications. Its efficacy in altering cough reflex sensitivity has been shown in

  6. Measures of Social Deprivation That Predict Health Care Access and Need within a Rational Area of Primary Care Service Delivery

    PubMed Central

    Butler, Danielle C; Petterson, Stephen; Phillips, Robert L; Bazemore, Andrew W

    2013-01-01

    Objective To develop a measure of social deprivation that is associated with health care access and health outcomes at a novel geographic level, primary care service area. Data Sources/Study Setting Secondary analysis of data from the Dartmouth Atlas, AMA Masterfile, National Provider Identifier data, Small Area Health Insurance Estimates, American Community Survey, Area Resource File, and Behavioural Risk Factor Surveillance System. Data were aggregated to primary care service areas (PCSAs). Study Design Social deprivation variables were selected from literature review and international examples. Factor analysis was used. Correlation and multivariate analyses were conducted between index, health outcomes, and measures of health care access. The derived index was compared with poverty as a predictor of health outcomes. Data Collection/Extraction Methods Variables not available at the PCSA level were estimated at block level, then aggregated to PCSA level. Principal Findings Our social deprivation index is positively associated with poor access and poor health outcomes. This pattern holds in multivariate analyses controlling for other measures of access. A multidimensional measure of deprivation is more strongly associated with health outcomes than a measure of poverty alone. Conclusions This geographic index has utility for identifying areas in need of assistance and is timely for revision of 35-year-old provider shortage and geographic underservice designation criteria used to allocate federal resources. PMID:22816561

  7. The Health-Related Quality of Life in Long-Term Colorectal Cancer Survivors Study: objectives, methods, and patient sample

    PubMed Central

    Mohler, M. Jane; Coons, Stephen Joel; Hornbrook, Mark C.; Herrinton, Lisa J.; Wendel, Christopher S.; Grant, Marcia; Krouse, Robert S.

    2008-01-01

    Objectives The objective of this paper is to describe the complex mixed-methods design of a study conducted to assess health-related quality of life (HRQOL) outcomes and ostomy-related obstacles and adjustments among long-term (>five years) colorectal cancer (CRC) survivors with ostomies (cases) and without ostomies (controls). In addition, details are provided regarding the study sample and the psychometric properties of the quantitative data collection measures used. Subsequent manuscripts will present the study findings. Research Design and Methods The study design involved a cross-sectional mail survey for collecting quantitative data and focus groups for collecting qualitative data. The study subjects were individuals identified as long-term CRC survivors within a community-based health maintenance organization's enrolled population. Focus groups comprised of cases and divided by gender and HRQOL high and low quartile contrasts (based on the mail survey data) were conducted. Main Outcome Measures The modified City of Hope Quality of Life (mCOH-QOL)-Ostomy and SF-36v2 questionnaires were used in the mail survey. An abridged version of the mCOH-QOL-Ostomy was used for the control subjects. Focus groups explored ostomy-related barriers to self-care, adaptation methods/skills, and advice for others with an ostomy. Results The survey response rate was 52% (679/1308) and 34 subjects participated in focus groups. The internal consistency reliability estimates for the mCOH-QOL-Ostomy and SF-36v2 questionnaires were very acceptable for group comparisons. In addition, evidence supports the construct validity of the abridged version of the mCOH-QOL-Ostomy. Study limitations include potential non-response bias and limited minority participation. Conclusions We were able to successfully recruit long-term CRC survivors into this study and the psychometric properties of the quantitative measures used were quite acceptable. Mixed-methods designs, such as the one used in this

  8. Theory and practice for measuring health care quality

    PubMed Central

    Berwick, Donald M.; Knapp, Marian Gilbert

    1987-01-01

    As competition, cost control, and new modes of delivery emerge in health care, there is a need to reexamine both the traditional definitions of health care quality and the methods by which it is measured. Industries other than health care have much to teach regarding the methods for obtaining, analyzing, and displaying data; techniques for problem identification, problem solving, and reassessment; and ideas about organizational factors that produce a high quality product or service. The Quality-of-Care Measurement Department at the Harvard Community Health Plan has built a program that draws from a distinguished health care quality assurance tradition and incorporates techniques that have been successful in other industries. PMID:10312319

  9. Measuring Angular Rate of Celestial Objects Using the Space Surveillance Telescope

    DTIC Science & Technology

    2015-03-01

    is not subject to copyright protection in the United States. AFIT-ENG-MS-15-M-019 MEASURING ANGULAR RATE OF CELESTIAL OBJECTS USING THE SPACE ...Hypothesis Test MHTOR Multi-Hypothesis Test with Outlier Removal NEAs Near Earth Asteroids NASA National Aeronautics and Space Administration OTF...capabilities to warfighters, protecting them from collision with space debris, meteors and microsatellites has become a top priority [19]. In general, EO

  10. Relationships between perceived chewing ability, objective masticatory function and oral health-related quality of life in mandibulectomy or glossectomy patients with a dento-maxillary prosthesis.

    PubMed

    Aimaijiang, Yiliyaer; Otomaru, Takafumi; Taniguchi, Hisashi

    2016-04-01

    This preliminary study examined whether the type of surgery performed for head and neck lesion was associated perceived chewing ability, objective masticatory function, and oral health-related quality of life (OHRQoL) in patients who required a dento-maxillary prosthesis postoperatively. Thirty-eight patients with a dento-maxillary prosthesis were divided into three groups according to the type of surgery received: marginal mandibulectomy, segmental mandibulectomy with bony reconstruction, or glossectomy. Perceived chewing ability, objective mixing ability, and OHRQoL were evaluated using a food intake questionnaire, color-changeable chewing gum, and the Geriatric Oral Health Assessment Index (GOHAI), respectively. Differences in the scores obtained by the three measures were compared between the surgical groups using the Kruskal-Wallis test, and associations between the scores in each group were analyzed by Spearman's rank correlation analysis. Objective mixing ability was found to be significantly low only in patients who underwent glossectomy. No other measures differed significantly between the surgical groups. Perceived chewing ability and objective mixing ability were significantly associated in the marginal mandibulectomy and glossectomy groups but not in the segmental mandibulectomy group. Furthermore, GOHAI score was significantly associated with perceived chewing ability and objective mixing ability in the marginal mandibulectomy group. Within the limitations of this study, the present findings suggest that the type of surgery received might influence food mixing ability. Associations among food mixing ability, perceived chewing and OHRQoL are not accountable depending on the type of surgery received, indicating the presence of other contributing factors to be considered. Copyright © 2015 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  11. Association of Environmental Indicators with Teen Alcohol Use and Problem Behavior: Teens’ Observations vs. Objectively-Measured Indicators

    PubMed Central

    Byrnes, Hilary F.; Miller, Brenda A.; Morrison, Christopher N.; Wiebe, Douglas J.; Woychik, Marcie; Wiehe, Sarah E.

    2017-01-01

    Most prior studies use objectively measured data (e.g., census-based indicators) to assess contextual risks. However, teens’ observations might be more important for their risk behavior. Objectives: 1) determine relationships between observed and objective indicators of contextual risks 2) determine relations of observed and objective indicators with teen alcohol use and problem behavior. Teens aged 14–16 (N=170) carried GPS-enabled smartphones for one month, with locations documented. Ecological momentary assessment (EMA) measured teens’ observations via texts regarding risk behaviors and environmental observations. Objective indicators of alcohol outlets and disorganization were spatially joined to EMAs based on teens’ location at the time of the texts. Observed and objective disorganization, and objective indicators of alcohol outlets were related to alcohol use. Observed disorganization was related to problem behavior, while objective indicators were unrelated. Findings suggest the importance of considering teens’ observations of contextual risk for understanding influences on risk behavior and suggest future directions for research and prevention strategies. PMID:28061392

  12. Association of objectively measured arm inclination with shoulder pain: A 6-month follow-up prospective study of construction and health care workers.

    PubMed

    Koch, Markus; Lunde, Lars-Kristian; Veiersted, Kaj Bo; Knardahl, Stein

    2017-01-01

    The aim was to determine the association of occupational arm inclination with shoulder pain in construction and health care workers. Arm inclination relative to the vertical was measured with an accelerometer placed on the dominant upper arm for up to four full days at baseline in 62 construction workers and 63 health care workers. The pain intensity in the shoulder and mechanical and psychosocial work factors were measured by self-reports at baseline and prospectively after 6 months. The associations between exposures and shoulder pain were analyzed with multilevel mixed-effects linear regressions. For the total study population working with the dominant arm at inclinations > 30° and >120° was associated with lower levels of shoulder pain both cross-sectionally and after 6 months. Associations were attenuated when adjusting for individual and social factors, psychological state, and exposure during leisure time, especially for the high inclination levels. Analyses, only including subjects with no pain at baseline revealed no significant associations. While stratified analysis showed negative associations in the construction worker group, there were no significant association in health care workers. Compared to the number of hypotheses tested, the number of significant findings was low. Adjustment by Bonferroni-correction made almost all findings insignificant. All analyses reflected a negative association between arm inclination and shoulder pain, but few analyses showed these associations to be statistically significant. If there is a relationship between arm inclination and shoulder pain, these findings could indicate that pain-avoidance may modify how workers perform their tasks.

  13. Understanding Health Literacy Measurement Through Eye Tracking

    PubMed Central

    Mackert, Michael; Champlin, Sara E.; Pasch, Keryn E.; Weiss, Barry D.

    2013-01-01

    This study used eye-tracking technology to explore how individuals with different levels of health literacy visualize health-related information. The authors recruited 25 university administrative staff (more likely to have adequate health literacy skills) and 25 adults enrolled in an adult literacy program (more likely to have limited health literacy skills). The authors administered the Newest Vital Sign (NVS) health literacy assessment to each participant. The assessment involves having individuals answer questions about a nutrition label while viewing the label. The authors used computerized eye-tracking technology to measure the amount of time each participant spent fixing their view at nutrition label information that was relevant to the questions being asked and the amount of time they spent viewing nonrelevant information. Results showed that lower NVS scores were significantly associated with more time spent on information not relevant for answering the NVS items. This finding suggests that efforts to improve health literacy measurement should include the ability to differentiate not just between individuals who have difficulty interpreting and using health information, but also between those who have difficulty finding relevant information. In addition, this finding suggests that health education material should minimize the inclusion of nonrelevant information. PMID:24093355

  14. Object permanence and method of disappearance: looking measures further contradict reaching measures.

    PubMed

    Charles, Eric P; Rivera, Susan M

    2009-11-01

    Piaget proposed that understanding permanency, understanding occlusion events, and forming mental representations were synonymous; however, accumulating evidence indicates that those concepts are not unified in development. Infants reach for endarkened objects at younger ages than for occluded objects, and infants' looking patterns suggest that they expect occluded objects to reappear at younger ages than they reach for them. We reaffirm the latter finding in 5- to 6-month-olds and find similar responses to faded objects, but we fail to find that pattern in response to endarkened objects. This suggests that looking behavior and reaching behavior are both sensitive to method of disappearance, but with opposite effects. Current cognition-oriented (i.e. representation-oriented) explanations of looking behavior cannot easily accommodate these results; neither can perceptual-preference explanations, nor the traditional ecological reinterpretations of object permanence. A revised ecological hypothesis, invoking affordance learning, suggests how these differences could arise developmentally.

  15. Neighborhood Environments and Objectively Measured Physical Activity in 11 Countries

    PubMed Central

    Cerin, Ester; Cain, Kelli L; Conway, Terry L; Dyck, Delfien Van; Hinckson, Erica; Schipperijn, Jasper; Bourdeaudhuij, Ilse De; Owen, Neville; Davey, Rachel C; Hino, Adriano Akira Ferreira; Mitáš, Josef; Orzanco-Garralda, Rosario; Salvo, Deborah; Sarmiento, Olga L; Christiansen, Lars B; Macfarlane, Duncan J; Schofield, Grant; Sallis, James F

    2014-01-01

    Purpose Environmental changes are potentially effective population-level physical activity (PA) promotion strategies. However, robust multi-site evidence to guide international action for developing activity-supportive environments is lacking. We estimated pooled associations of perceived environmental attributes with objectively-measured PA outcomes; between-site differences in such associations; and, the extent to which perceived environmental attributes explain between-site differences in PA. Methods This was a cross-sectional study conducted in 16 cities located in Belgium, Brazil, Colombia, Czech Republic, Denmark, China, Mexico, New Zealand, Spain, United Kingdom, and USA. Participants were 6,968 adults residing in administrative units stratified by socio-economic status and transport-related walkability. Predictors were 10 perceived neighborhood environmental attributes. Outcome measures were accelerometry-assessed weekly minutes of moderate-to-vigorous PA (MVPA) and meeting the PA guidelines for cancer/weight gain prevention (420 min/week of MVPA). Results Most perceived neighborhood attributes were positively associated with the PA outcomes in the pooled, site-adjusted, single-predictor models. Associations were generalizable across geographical locations. Aesthetics and land use mix – access were significant predictors of both PA outcomes in the fully-adjusted models. Environmental attributes accounted for within-site variability in MVPA corresponding to a 3 min/d or 21 min/week standard deviation. Large between-site differences in PA outcomes were observed: 15.9% to 16.8% of these differences were explained by perceived environmental attributes. All neighborhood attributes were associated with between-site differences in the total effects of the perceived environment on PA outcomes. Conclusions Residents’ perceptions of neighborhood attributes that facilitate walking were positively associated with objectively-measured MVPA and meeting the guidelines

  16. Developing a Questionnaire to Measure Perceived Attributes of eHealth Innovations

    ERIC Educational Resources Information Center

    Atkinson, Nancy L.

    2007-01-01

    Objectives: To design a valid and reliable questionnaire to assess perceived attributes of technology-based health education innovations. Methods: College students in 12 personal health courses reviewed a prototype eHealth intervention using a 30-item instrument based upon diffusion theory's perceived attributes of an innovation. Results:…

  17. Objectively Measured Daily Steps and Subsequent Long Term All-Cause Mortality: The Tasped Prospective Cohort Study.

    PubMed

    Dwyer, Terence; Pezic, Angela; Sun, Cong; Cochrane, Jenny; Venn, Alison; Srikanth, Velandai; Jones, Graeme; Shook, Robin P; Shook, Robin; Sui, Xuemei; Ortaglia, Andrew; Blair, Steven; Ponsonby, Anne-Louise

    2015-01-01

    Self-reported physical activity has been inversely associated with mortality but the effect of objectively measured step activity on mortality has never been evaluated. The objective is to determine the prospective association of daily step activity on mortality among free-living adults. Cohort study of free-living adults residing in Tasmania, Australia between 2000 and 2005 who participated in one of three cohort studies (n = 2 576 total participants). Daily step activity by pedometer at baseline at a mean of 58.8 years of age, and for a subset, repeated monitoring was available 3.7 (SD 1.3) years later (n = 1 679). All-cause mortality (n = 219 deaths) was ascertained by record-linkage to the Australian National Death Index; 90% of participants were followed-up over ten years, until June 2011. Higher daily step count at baseline was linearly associated with lower all-cause mortality (adjusted hazard ratio AHR, 0.94; 95% CI, 0.90 to 0.98 per 1 000 steps; P = 0.004). Risk was altered little by removing deaths occurring in the first two years. Increasing baseline daily steps from sedentary to 10 000 steps a day was associated with a 46% (95% CI, 18% to 65%; P = 0.004) lower risk of mortality in the decade of follow-up. In addition, those who increased their daily steps over the monitoring period had a substantial reduction in mortality risk, after adjusting for baseline daily step count (AHR, 0.39; 95% CI, 0.22 to 0.72; P = 0.002), or other factors (AHR, 0.38; 95% CI, 0.21-0.70; P = 0.002). Higher daily step count was linearly associated with subsequent long term mortality among free living adults. These data are the first to quantify mortality reductions using an objective measure of physical activity in a free living population. They strongly underscore the importance of physical inactivity as a major public health problem.

  18. Spiritual Health Scale 2011: Defining and Measuring 4th Dimension of Health

    PubMed Central

    Dhar, Neera; Chaturvedi, SK; Nandan, Deoki

    2011-01-01

    In the midst of physical comforts provided by the unprecedented developments in all spheres of life, the humanity is at cross roads and looking at something beyond these means. Spirituality has now been identified globally as an important aspect for providing answers to many questions related to health and happiness. The World Health Organization is also keen at looking beyond physical, mental and social dimensions of the health, and the member countries are actively exploring the 4th Dimension of the health i.e. the spiritual health and its impact on the overall health and happiness of an individual. National Institute of Health and Family Welfare (NIHFW), realized this need and initiated a research study in this direction. In this study, an effort was made to define this 4th Dimension of health from a common worldly person's perspective and measure it. 3 Domains, 6 Constructs and 27 Determinants of spiritual health were identified through a scientific process. A statistically reliable and valid Spiritual Health Scale (SHS 2011) containing 114 items has been developed. Construct validity and test- retest reliability has been established for urban educated adult population. The scale is first of its kind in the world to measure the spiritual health of a common worldly person, which is devoid of religious and cultural bias. Its items have universal applicability. PMID:22279257

  19. Gaming of performance measurement in health care: parallels with tax compliance.

    PubMed

    Mears, Alex; Webley, Paul

    2010-10-01

    Gaming of performance measurement in health care distorts performance, making it appear better than it is. This can conceal potentially hazardous practice and endanger patients and staff. Research has investigated and categorized this behaviour but as yet has offered little in the way of potential solutions as the drivers are still not well understood. Studies of the psychology of tax behaviour, specifically tax avoidance and evasion, reveal some insights into what the underlying causes are. Looking at health care and tax compliance, seven similarities in response can be detected: negative view of those subject to it; not salient except for specific classes of people; general understanding of the need versus resentment of actuality; cognitive dissonance; moral versus legal grey areas; two levels of objective non-compliance; and four categories of subjective behaviour and attitude. We suggest a model of reaction and compliance for gaming and offer some suggestions as to how this phenomenon might be minimized.

  20. Measuring the size and charge of single nanoscale objects in solution using an electrostatic fluidic trap.

    PubMed

    Mojarad, Nassiredin; Krishnan, Madhavi

    2012-06-24

    Measuring the size and charge of objects suspended in solution, such as dispersions of colloids or macromolecules, is a significant challenge. Measurements based on light scattering are inherently biased to larger entities, such as aggregates in the sample, because the intensity of light scattered by a small object scales as the sixth power of its size. Techniques that rely on the collective migration of species in response to external fields (electric or hydrodynamic, for example) are beset with difficulties including low accuracy and dispersion-limited resolution. Here, we show that the size and charge of single nanoscale objects can be directly measured with high throughput by analysing their thermal motion in an array of electrostatic traps. The approach, which is analogous to Millikan's oil drop experiment, could in future be used to detect molecular binding events with high sensitivity or carry out dynamic single-charge resolved measurements at the solid/liquid interface.

  1. Near real-time measurement of forces applied by an optical trap to a rigid cylindrical object

    NASA Astrophysics Data System (ADS)

    Glaser, Joseph; Hoeprich, David; Resnick, Andrew

    2014-07-01

    An automated data acquisition and processing system is established to measure the force applied by an optical trap to an object of unknown composition in real time. Optical traps have been in use for the past 40 years to manipulate microscopic particles, but the magnitude of applied force is often unknown and requires extensive instrument characterization. Measuring or calculating the force applied by an optical trap to nonspherical particles presents additional difficulties which are also overcome with our system. Extensive experiments and measurements using well-characterized objects were performed to verify the system performance.

  2. 42 CFR 495.6 - Meaningful use objectives and measures for EPs, eligible hospitals, and CAHs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM General Provisions § 495.6 Meaningful use objectives and... their first payment year. For Medicaid EPs who adopt, implement, or upgrade certified EHR technology in... first payment year. (4) Flexible options for using certified EHR technology in 2014. For an EHR...

  3. Verification of micro-scale photogrammetry for smooth three-dimensional object measurement

    NASA Astrophysics Data System (ADS)

    Sims-Waterhouse, Danny; Piano, Samanta; Leach, Richard

    2017-05-01

    By using sub-millimetre laser speckle pattern projection we show that photogrammetry systems are able to measure smooth three-dimensional objects with surface height deviations less than 1 μm. The projection of laser speckle patterns allows correspondences on the surface of smooth spheres to be found, and as a result, verification artefacts with low surface height deviations were measured. A combination of VDI/VDE and ISO standards were also utilised to provide a complete verification method, and determine the quality parameters for the system under test. Using the proposed method applied to a photogrammetry system, a 5 mm radius sphere was measured with an expanded uncertainty of 8.5 μm for sizing errors, and 16.6 μm for form errors with a 95 % confidence interval. Sphere spacing lengths between 6 mm and 10 mm were also measured by the photogrammetry system, and were found to have expanded uncertainties of around 20 μm with a 95 % confidence interval.

  4. The measurement of quality of care in the Veterans Health Administration.

    PubMed

    Halpern, J

    1996-03-01

    The Veterans Health Administration (VHA) is committed to continual refinement of its system of quality measurement. The VHA organizational structure for quality measurement has three levels. At the national level, the Associate Chief Medical Director for Quality Management provides leadership, sets policy, furnishes measurement tools, develops and distributes measures of quality, and delivers educational programs. At the intermediate level, VHA has four regional offices with staff responsible for reviewing risk management data, investigating quality problems, and ensuring compliance with accreditation requirements. At the hospital level, staff reporting directly to the chief of staff or the hospital director are responsible for implementing VHA quality management policy. The Veterans Health Administration's philosophy of quality measurement recognizes the agency's moral imperative to provide America's veterans with care that meets accepted standards. Because the repair of faulty systems is more efficient than the identification of poor performers, VHA has integrated the techniques of total quality into a multifaceted improvement program that also includes the accreditation program and traditional quality assurance activities. VHA monitors its performance by maintaining adverse incident databases, conducting patient satisfaction surveys, contracting for external peer review of 50,000 records per year, and comparing process and outcome rates internally and when possible with external benchmarks. The near-term objectives of VHA include providing medical centers with a quality matrix that will permit local development of quality indicators, construction of a report card for VHA's customers, and implementing the Malcolm W. Baldrige system for quality improvement as the road map for systemwide continuous improvement. Other goals include providing greater access to data, creating a patient-centered database, providing real-time clinical decision support, and expanding the

  5. Correlates of non-concordance between perceived and objective measures of walkability.

    PubMed

    Gebel, Klaus; Bauman, Adrian; Owen, Neville

    2009-04-01

    to those who lived in a high walkable environment that was perceived as low walkable. Adults with lower educational attainment and lower incomes, who were overweight, or who were less physically active for transportation purposes, were more likely to misperceive their high walkable neighborhood as low walkable. There is the potential for physical activity promotion and persuasion strategies to address non-concordant perceptions, especially among those who live in high walkable environments but perceive them to be low and also among those who are socially disadvantaged and are less active. Perceptions of environmental attributes may be more strongly correlated with cognitive antecedents and with behavior than are objective measures.

  6. Objectively Measured Sedentary Behavior, Obesity, and Psychological Well-Being: A Cross-Sectional Study of Japanese Schoolchildren.

    PubMed

    Ishii, Kaori; Shibata, Ai; Adachi, Minoru; Mano, Yoshiyuki; Oka, Koichiro

    2017-04-01

    Sedentary behaviors (SB) are associated with health indicators; however, there are currently very few studies that have examined these associations, especially in conjunction with psychological factors, in children. The current study examined the independent relationship between objectively assessed SB, and indicators of obesity and psychological well-being, among Japanese children. A total of 967 elementary-school children completed a cross-sectional survey. SB was measured with accelerometers for 7 consecutive days. Psychological well-being data (eg, anxiety and behavior problems) were collected via a self-report questionnaire. To determine the relationship of SB with degree of obesity and psychological well-being, linear regression analyses were conducted to relate the indicators of obesity and psychological well-being on SB, adjusted by gender, grade, percentage of moderate-to-vigorous physical activity per day, duration spent wearing the accelerometer, and degree of obesity. SB was significantly related to behavioral/emotional problems (β = .280, P = .010, R 2 = .015). There was a statistically significant relationship between SB and anxiety (β = .206, P = .059, R 2 = .007). No significant association with degree of obesity was found. Excess SB relates higher levels of behavioral/emotional problems and anxiety. These results can inspire the development of interventions that promote well-being and enhance psychological health, by focusing on SB in Japanese children.

  7. Planetary and Primitive Object Strength Measurement and Sampling Apparatus

    NASA Technical Reports Server (NTRS)

    Ahrens, Thomas J.

    1995-01-01

    Support is requested for continuation of a program of dynamic impact (harpoon) coring of planetary, comet, or asteroid surface materials. We have previously demonstrated that good quality cores are obtainable for planetary materials with compressive strengths less than 200 MPa. Since the dynamics of penetration are observable on a Discovery class spacecraft, which images the sampling operation, these data can be used with a model developed under this project, to measure in-situ strength and frictional strength of the crust of the object. During the last year we have developed a detailed analytic model of penetrator mechanics. Progress is reported for the solid penetrators experiments, the CIT penetrator model, and the impact spall sampling apparatus.

  8. [Metrological analysis of measuring systems in testing an anticipatory reaction to the position of a moving object].

    PubMed

    Aksiuta, E F; Ostashev, A V; Sergeev, E V; Aksiuta, V E

    1997-01-01

    The methods of the information (entropy) error theory were used to make a metrological analysis of the well-known commercial measuring systems for timing an anticipative reaction (AR) to the position of a moving object, which is based on the electromechanical, gas-discharge, and electron principles. The required accuracy of measurement was ascertained to be achieved only by using the systems based on the electron principle of moving object simulation and AR measurement.

  9. [Conscientious objection of health personnel in the recent Organic Law 2/2010, about sexual and reproductive health and voluntary interruption of pregnancy].

    PubMed

    Martínez Otero, Juan María

    2010-01-01

    The main goal of the paper is to analyse and evaluate the recent Organic Law 2/2010, and its prescriptions referring to the conscientious objection of health personnel in relation to the voluntary interruption of pregnancy. The paper starts studying conscientious objection: its raison d'être, its delimitation, its recognition by the Spanish regulation. Further on, the paper focuses on the article 19.2° of the Organic Law 2/2010, underlining on the one hand the positive aspects (such as the formal requirements for the objection), and on the other hand the negative ones (such as suspicion over objectors).

  10. Association of environmental indicators with teen alcohol use and problem behavior: Teens' observations vs. objectively-measured indicators.

    PubMed

    Byrnes, Hilary F; Miller, Brenda A; Morrison, Christopher N; Wiebe, Douglas J; Woychik, Marcie; Wiehe, Sarah E

    2017-01-01

    Most prior studies use objectively measured data (e.g., census-based indicators) to assess contextual risks. However, teens' observations might be more important for their risk behavior. 1) determine relationships between observed and objective indicators of contextual risks 2) determine relations of observed and objective indicators with teen alcohol use and problem behavior. Teens aged 14-16 (N=170) carried GPS-enabled smartphones for one month, with locations documented. Ecological momentary assessment (EMA) measured teens' observations via texts regarding risk behaviors and environmental observations. Objective indicators of alcohol outlets and disorganization were spatially joined to EMAs based on teens' location at the time of the texts. Observed and objective disorganization, and objective indicators of alcohol outlets were related to alcohol use. Observed disorganization was related to problem behavior, while objective indicators were unrelated. Findings suggest the importance of considering teens' observations of contextual risk for understanding influences on risk behavior and suggest future directions for research and prevention strategies. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Improving the Rank Precision of Population Health Measures for Small Areas with Longitudinal and Joint Outcome Models

    PubMed Central

    Athens, Jessica K.; Remington, Patrick L.; Gangnon, Ronald E.

    2015-01-01

    Objectives The University of Wisconsin Population Health Institute has published the County Health Rankings since 2010. These rankings use population-based data to highlight health outcomes and the multiple determinants of these outcomes and to encourage in-depth health assessment for all United States counties. A significant methodological limitation, however, is the uncertainty of rank estimates, particularly for small counties. To address this challenge, we explore the use of longitudinal and pooled outcome data in hierarchical Bayesian models to generate county ranks with greater precision. Methods In our models we used pooled outcome data for three measure groups: (1) Poor physical and poor mental health days; (2) percent of births with low birth weight and fair or poor health prevalence; and (3) age-specific mortality rates for nine age groups. We used the fixed and random effects components of these models to generate posterior samples of rates for each measure. We also used time-series data in longitudinal random effects models for age-specific mortality. Based on the posterior samples from these models, we estimate ranks and rank quartiles for each measure, as well as the probability of a county ranking in its assigned quartile. Rank quartile probabilities for univariate, joint outcome, and/or longitudinal models were compared to assess improvements in rank precision. Results The joint outcome model for poor physical and poor mental health days resulted in improved rank precision, as did the longitudinal model for age-specific mortality rates. Rank precision for low birth weight births and fair/poor health prevalence based on the univariate and joint outcome models were equivalent. Conclusion Incorporating longitudinal or pooled outcome data may improve rank certainty, depending on characteristics of the measures selected. For measures with different determinants, joint modeling neither improved nor degraded rank precision. This approach suggests a simple

  12. Objectively measured physical activity and sedentary time of breast cancer survivors, and associations with adiposity: findings from NHANES (2003-2006).

    PubMed

    Lynch, Brigid M; Dunstan, David W; Healy, Genevieve N; Winkler, Elisabeth; Eakin, Elizabeth; Owen, Neville

    2010-02-01

    Obesity and physical inactivity are poor prognostic indicators for breast cancer. Studies to date have relied on self-report measures of physical activity, which tend mainly to assess moderate-to-vigorous intensity leisure-time physical activity. We report the cross-sectional associations of objectively assessed physical activity and sedentary time with adiposity in a sample of breast cancer survivors from the United States. One hundred and eleven women from the National Health and Nutrition Examination Survey (NHANES) 2003-2004 and 2005-2006 reported a history of breast cancer. Participants wore an accelerometer for 7 days, and activity levels were summarized as moderate-to-vigorous intensity (accelerometer counts/min > or =1,952), light intensity (counts/min 100-1,951), and sedentary time (counts/min <100). Anthropometric measures were taken by study staff at examination centers. Participants spent the majority of their day in sedentary time (66%) or in light intensity activities (33%). Log moderate-to-vigorous intensity physical activity was negatively associated with adiposity (waist circumference beta = -9.805 [95% CI: -15.836, -3.775]; BMI beta = -3.576 [95% CI: -6.687, -0.464]). Light intensity physical activity was negatively associated with adiposity; however, the fully adjusted models did not retain statistical significance. Similarly, sedentary time was positively associated with adiposity, but the fully adjusted models were not statistically significant. This is the first study to describe the objectively assessed physical activity and sedentary time of breast cancer survivors. Increasing moderate-to-vigorous and light intensity physical activity, and decreasing sedentary time, may assist with weight management and improve other metabolic health outcomes for breast cancer survivors.

  13. Measuring positive mental health in Canada: construct validation of the Mental Health Continuum-Short Form.

    PubMed

    Orpana, Heather; Vachon, Julie; Dykxhoorn, Jennifer; Jayaraman, Gayatri

    2017-04-01

    Positive mental health is increasingly recognized as an important focus for public health policies and programs. In Canada, the Mental Health Continuum-Short Form (MHC-SF) was identified as a promising measure to include on population surveys to measure positive mental health. It proposes to measure a three-factor model of positive mental health including emotional, social and psychological well-being. The purpose of this study was to examine whether the MHC-SF is an adequate measure of positive mental health for Canadian adults. We conducted confirmatory factor analysis (CFA) using data from the 2012 Canadian Community Health Survey (CCHS)-Mental Health Component (CCHS-MH), and cross-validated the model using data from the CCHS 2011-2012 annual cycle. We examined criterion-related validity through correlations of MHC-SF subscale scores with positively and negatively associated concepts (e.g. life satisfaction and psychological distress, respectively). We confirmed the validity of the three-factor model of emotional, social and psychological well-being through CFA on two independent samples, once four correlated errors between items on the social well-being scale were added. We observed significant correlations in the anticipated direction between emotional, psychological and social well-being scores and related concepts. Cronbach's alpha for both emotional and psychological well-being subscales was 0.82; for social well-being it was 0.77. Our study suggests that the MHC-SF measures a three-factor model of positive mental health in the Canadian population. However, caution is warranted when using the social well-being scale, which did not function as well as the other factors, as evidenced by the need to add several correlated error terms to obtain adequate model fit, a higher level of missing data on these questions and weaker correlations with related constructs. Social well-being is important in a comprehensive measure of positive mental health, and further

  14. Patterns and correlates of objectively measured free-living physical activity in adults in rural and urban Cameroon.

    PubMed

    Assah, Felix; Mbanya, Jean Claude; Ekelund, Ulf; Wareham, Nicholas; Brage, Soren

    2015-07-01

    Urbanisation in sub-Saharan Africa is changing lifestyles and raising non-communicable disease burden. Understanding the underlying pattern of physical activity and its correlates may inform preventive interventions. We examined correlates of objectively-measured physical activity in rural and urban Cameroon. Participants were 544 adults resident in rural (W-156, M-89) or urban (W-189, M-110) regions. Physical activity was measured using individually-calibrated combined heart rate and movement sensing over seven continuous days. Sociodemographic data were collected by self-report. Independent associations of sociodemographic correlates with physical activity energy expenditure (PAEE) or moderate-to-vigorous physical activity (MVPA) were analysed in multivariate regression models. Rural dwellers were significantly more active than their urban counterparts (PAEE: 58.0 vs 42.9 kJ/kg/day; MVPA: 107 vs 62 min/day; MVPA of 150 min/week in >10 min bouts: 62 vs 39%) and less sedentary (923 vs 1026 min/day); p<0.001. There was no significant seasonal difference (dry vs rainy) in activity in urban dwellers whereas in rural dwellers activity was higher during dry seasons compared to rainy seasons (p<0.001). Age, obesity and education showed significant inverse associations with activity. Urban dwellers who considered themselves adequately active were only as active as rural dwellers who thought they were not adequately active. This is the first study providing data on sociodemographic patterning of objectively-measured physical activity in rural and urban sub-Saharan Africa. Age, urban residence, obesity and higher educational level are important correlates of lower levels of physical activity. These suggest targets for public health interventions to improve physical activity in Cameroon. 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.

  15. Are objective measures of physical capability related to accelerated epigenetic age? Findings from a British birth cohort

    PubMed Central

    Cooper, Rachel; Howe, Laura D; Relton, Caroline L; Davey Smith, George; Teschendorff, Andrew; Widschwendter, Martin; Wong, Andrew; Kuh, Diana; Hardy, Rebecca

    2017-01-01

    Objectives Our aim was to investigate the association of epigenetic age and physical capability in later life. Having a higher epigenetic than chronological age (known as age acceleration (AA)) has been found to be associated with an increased rate of mortality. Similarly, physical capability has been proposed as a marker of ageing due to its consistent associations with mortality. Setting The MRC National Survey of Health and Development (NSHD) cohort study. Participants We used data from 790 women from the NSHD who had DNA methylation data available. Design Epigenetic age was calculated using buccal cell (n=790) and matched blood tissue (n=152) from 790 female NSHD participants. We investigated the association of AA at age 53 with changes in physical capability in women from ages 53 to 60–64. Regression models of change in each measure of physical capability on AA were conducted. Secondary analysis focused on the relationship between AA and smoking, alcohol, body mass index (BMI) and socioeconomic position. Outcome measures Three objective measures of physical capability were used: grip strength, standing balance time and chair rise speed. Results Epigenetic age was lower than chronological age (mean 53.4) for both blood (50.3) and buccal cells (42.8). AA from blood was associated with a greater decrease in grip strength from ages 53 to 60–64 (0.42 kg decrease per year of AA, 95% CI 0.03, 0.82 kg; p=0.03, n=152), but no associations were observed with standing balance time or chair rise speed. Current smoking and lower BMI were associated with lower epigenetic age from buccal cells. Conclusions We found evidence that AA in blood is associated with a greater decrease in grip strength in British females aged between 53 and 60–64, but no association with standing balance time or chair rise speed was found. PMID:29092899

  16. Healthy People 2020 Objectives for Violence Prevention and the Role of Nursing.

    PubMed

    Simon, Thomas R; Hurvitz, Kimberly

    2014-01-31

    Violence, including child maltreatment, youth violence, intimate partner violence, and sexual violence, is a significant public health problem in the United States. A public health approach can help providers understand the health burden from violence, evaluate evidence for prevention strategies, and learn where to turn for information about planning and implementing prevention strategies for this preventable problem. For the past three decades, the U.S. Department of Health and Human Services has published "Healthy People" objectives for the next decade. The Healthy People 2020 initiative includes 13 measurable objectives related to violence prevention, one of which was selected as a Healthy People 2020 Leading Health Indicator. Progress to achieve these objectives can save thousands of lives, reduce the suffering of victims and their families, and decrease financial cost to the law enforcement and healthcare systems. The role that nurses can and do play in violence prevention is critical and extends beyond just caring for victims to also include preventing violence before it happens. This article summarizes the violence prevention objectives in Healthy People 2020 and the resources for prevention available to support nurses and others as they move prevention efforts forward in communities to stop violence before it starts.

  17. Potential objective biomarkers for fatigue among working women

    PubMed Central

    Ebata, Chie; Tatsuta, Hitomi; Tatemichi, Masayuki

    2017-01-01

    Objective: The prediction of health impairment due to work overload is subjectively assessed based on recognized symptoms; however, objective evaluation is primarily ideal in the field of occupational health. Recently, some biomarkers of autonomic function and/or oxidative stress were reported to be associated with fatigue. This study aimed to preliminarily investigate whether these biomarkers could be objective indicators for fatigue and stress among working women. Method: Participants included 118 full-time female workers (mean age 37.8 years), including 55 shift workers. Self-administered questionnaires, such as visual analog scale (VAS) for general health, a lifestyle questionnaire, SF-8 for health-related quality of life, and K6 for mental health screening, were used. In addition, biomarkers such as acceleration plethysmogram (APG), reactive oxygen metabolites-derived compounds (d-ROMs), and biological antioxidant potential (BAP) were measured. Results: A significant association was observed between BAP and VAS (r=0.482, p<0.01) among shift workers. However, other biomarkers such as APG and d-ROMs were not significantly associated with symptoms. d-ROMs were significantly correlated with age and body mass index. There was a significant negative correlation between BAP and smoking. Results of the APG (low-frequency (LF) /high-frequency (HF) ratio) were significantly correlated with BAP, but not with d-ROMs. The LF/HF ratio and BAP for shift workers were significantly higher than those for day-time workers. Conclusions: Our results suggest that APG and BAP are potential objective biomarkers for fatigue among working women, although further follow-up studies are needed to clarify the scope of usefulness of the biomarkers for fatigue. PMID:28163282

  18. Exploring the Measurement Properties of the eHealth Literacy Scale (eHEALS) Among Baby Boomers: A Multinational Test of Measurement Invariance.

    PubMed

    Sudbury-Riley, Lynn; FitzPatrick, Mary; Schulz, Peter J

    2017-02-27

    The eHealth Literacy Scale (eHEALS) is one of only a few available measurement scales to assess eHealth literacy. Perhaps due to the relative paucity of such measures and the rising importance of eHealth literacy, the eHEALS is increasingly a choice for inclusion in a range of studies across different groups, cultures, and nations. However, despite its growing popularity, questions have been raised over its theoretical foundations, and the factorial validity and multigroup measurement properties of the scale are yet to be investigated fully. The objective of our study was to examine the factorial validity and measurement invariance of the eHEALS among baby boomers (born between 1946 and 1964) in the United States, United Kingdom, and New Zealand who had used the Internet to search for health information in the last 6 months. Online questionnaires collected data from a random sample of baby boomers from the 3 countries of interest. The theoretical underpinning to eHEALS comprises social cognitive theory and self-efficacy theory. Close scrutiny of eHEALS with analysis of these theories suggests a 3-factor structure to be worth investigating, which has never before been explored. Structural equation modeling tested a 3-factor structure based on the theoretical underpinning to eHEALS and investigated multinational measurement invariance of the eHEALS. We collected responses (N=996) to the questionnaires using random samples from the 3 countries. Results suggest that the eHEALS comprises a 3-factor structure with a measurement model that falls within all relevant fit indices (root mean square error of approximation, RMSEA=.041, comparative fit index, CFI=.986). Additionally, the scale demonstrates metric invariance (RMSEA=.040, CFI=.984, ΔCFI=.002) and even scalar invariance (RMSEA=.042, CFI=.978, ΔCFI=.008). To our knowledge, this is the first study to demonstrate multigroup factorial equivalence of the eHEALS, and did so based on data from 3 diverse nations and

  19. Effects of modifications to the health and social sector’s collective agreement on the objective characteristics of working hours

    PubMed Central

    ROPPONEN, Annina; VANTTOLA, Päivi; KOSKINEN, Aki; HAKOLA, Tarja; PUTTONEN, Sampsa; HÄRMÄ, Mikko

    2017-01-01

    This study aimed to evaluate the effects of an intervention on objective working-hour characteristics. The intervention involved making modifications to the collective agreement that would limit employees’ entitlement to time off as compensation. The intervention group consisted of 493 and the control group of 2,303 health and social care shift workers, respectively. We analysed the objective pay roll-based working-hour data for 2012–2013, which we obtained from employers’ records, using the repeated measures mixed model. The changes in objective working-hour characteristics were small, but systematic. The intervention had some positive effects: the amount of short recovery periods (<28 h) after the last night shift decreased from 5% to 3%, and the amount of working weeks of over 48 h decreased from 19% to 17%. The realization of employees’ shift preferences increased from 18% to 20%. However, in contrast, consecutive work shifts and the number of scheduled absences increased and days off decreased, suggesting less time for recovery and thus a negative trend in shift ergonomics. When planning shifts, nursing management should avoid regulations that promote specific unhealthy shift characteristics, that is, consecutive work shifts and less days off. PMID:28420807

  20. Measuring up: Implementing a dental quality measure in the electronic health record context.

    PubMed

    Bhardwaj, Aarti; Ramoni, Rachel; Kalenderian, Elsbeth; Neumann, Ana; Hebballi, Nutan B; White, Joel M; McClellan, Lyle; Walji, Muhammad F

    2016-01-01

    Quality improvement requires using quality measures that can be implemented in a valid manner. Using guidelines set forth by the Meaningful Use portion of the Health Information Technology for Economic and Clinical Health Act, the authors assessed the feasibility and performance of an automated electronic Meaningful Use dental clinical quality measure to determine the percentage of children who received fluoride varnish. The authors defined how to implement the automated measure queries in a dental electronic health record. Within records identified through automated query, the authors manually reviewed a subsample to assess the performance of the query. The automated query results revealed that 71.0% of patients had fluoride varnish compared with the manual chart review results that indicated 77.6% of patients had fluoride varnish. The automated quality measure performance results indicated 90.5% sensitivity, 90.8% specificity, 96.9% positive predictive value, and 75.2% negative predictive value. The authors' findings support the feasibility of using automated dental quality measure queries in the context of sufficient structured data. Information noted only in free text rather than in structured data would require using natural language processing approaches to effectively query electronic health records. To participate in self-directed quality improvement, dental clinicians must embrace the accountability era. Commitment to quality will require enhanced documentation to support near-term automated calculation of quality measures. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

  1. Clinical simulation as a boundary object in design of health IT-systems.

    PubMed

    Rasmussen, Stine Loft; Jensen, Sanne; Lyng, Karen Marie

    2013-01-01

    Healthcare organizations are very complex, holding numerous stakeholders with various approaches and goals towards the design of health IT-systems. Some of these differences may be approached by applying the concept of boundary objects in a participatory IT-design process. Traditionally clinical simulation provides the opportunity to evaluate the design and the usage of clinical IT-systems without endangering the patients and interrupting clinical work. In this paper we present how clinical simulation additionally holds the potential to function as a boundary object in the design process. The case points out that clinical simulation provides an opportunity for discussions and mutual learning among the various stakeholders involved in design of standardized electronic clinical documentation templates. The paper presents and discusses the use of clinical simulation in the translation, transfer and transformation of knowledge between various stakeholders in a large healthcare organization.

  2. "Chips with Everything": A Laboratory Exercise for Comparing Subjective and Objective Measurements of Potato Chips

    ERIC Educational Resources Information Center

    Davies, Cathy

    2005-01-01

    The following laboratory exercise was designed to aid student understanding of the differences between subjective and objective measurements. Students assess the color and texture of different varieties of potato chip (crisps) by means of an intensity rating scale and a rank test and objectively with a colorimeter and texture analyzer. For data…

  3. Systematic review of empowerment measures in health promotion.

    PubMed

    Cyril, Sheila; Smith, Ben J; Renzaho, Andre M N

    2016-12-01

    Empowerment, a multi-level construct comprising individual, community and organizational domains, is a fundamental value and goal in health promotion. While a range of scales have been developed for the measurement of empowerment, the qualities of these have not been rigorously assessed. The aim of this study was to evaluate the measurement properties of quantitative empowerment scales and their applicability in health promotion programs. A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was done to evaluate empowerment scales across three dimensions: item development, reliability and validity. This was followed by assessment of measurement properties using a ratings scale with criteria addressing an a priori explicit theoretical framework, assessment of content validity, internal consistency and factor analysis to test structural validity. Of the 20 studies included in this review, only 8 (40%) used literature reviews, expert panels and empirical studies to develop scale items and 9 (45%) of studies fulfilled ≥5 criteria on the ratings scale. Two studies (10%) measured community empowerment and one study measured organizational empowerment, the rest (85%) measured individual empowerment. This review highlights important gaps in the measurement of community and organizational domains of empowerment using quantitative scales. A priority for future empowerment research is to investigate and explore approaches such as mixed methods to enable adequate measurement of empowerment across all three domains. This would help health promotion practitioners to effectively measure empowerment as a driver of change and an outcome in health promotion programs. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Shifting attention from objective risk factors to patients' self-assessed health resources: a clinical model for general practice.

    PubMed

    Hollnagel, H; Malterud, K

    1995-12-01

    The study was designed to present and apply theoretical and empirical knowledge for the construction of a clinical model intended to shift the attention of the general practitioner from objective risk factors to self-assessed health resources in male and female patients. Review, discussion and analysis of selected theoretical models about personal health resources involving assessing existing theories according to their emphasis concerning self-assessed vs. doctor-assessed health resources, specific health resources vs. life and coping in general, abstract vs. clinically applicable theory, gender perspective explicitly included or not. Relevant theoretical models on health and coping (salutogenesis, coping and social support, control/demand, locus of control, health belief model, quality of life), and the perspective of the underprivileged Other (critical theory, feminist standpoint theory, the patient-centred clinical method) were presented and assessed. Components from Antonovsky's salutogenetic perspective and McWhinney's patient-centred clinical method, supported by gender perspectives, were integrated to a clinical model which is presented. General practitioners are recommended to shift their attention from objective risk factors to self-assessed health resources by means of the clinical model. The relevance and feasibility of the model should be explored in empirical research.

  5. Measuring outcomes for neurological disorders: a review of disease-specific health status instruments for three degenerative neurological conditions.

    PubMed

    Heffernan, Catherine; Jenkinson, Crispin

    2005-06-01

    Health-related quality-of-life measures have been increasingly used in research into neurological disorders in recent years. The aim of this paper is to provide an objective appraisal of the evidence in regard to disease-specific quality-of-life measures used in research on health interventions for three degenerative neurological disorders: multiple sclerosis, motor neurone disease/amyotrophic lateral sclerosis and Parkinson's disease. A comprehensive search strategy was developed to include nine relevant electronic databases. Only studies pertaining to patient-based outcome measurements in multiple sclerosis, motor neurone disease and Parkinson's disease were included. We identified 76 eligible studies. As studies consisted of descriptive and cross-sectional survey study designs, results were reported qualitatively rather than in the form of a meta-analysis. Four disease-specific measures were found for Parkinson's disease, 11 for multiple sclerosis and one for motor neurone disease. We conclude that health-related quality-of-life measures are useful in assessing the impact of treatments and interventions for neurological disorders. However, further research is needed on the development of instruments using psychometric methods and on the validation, utilization and responsiveness of instruments to change.

  6. Improving the home health acute-care hospitalization quality measure.

    PubMed

    Schade, Charles P; Brehm, John G

    2010-06-01

    (1) To demonstrate average length of service (ALOS) bias in the currently used acute-care hospitalization (ACH) home health quality measure, limiting comparability across agencies, and (2) to propose alternative ACH measures. Secondary analysis of Medicare home health service data 2004-2007; convenience sample of Medicare fee-for-service hospital discharges. Cross-sectional analysis and patient-level simulation. We aggregated outcome and ALOS data from 2,347 larger Medicare-certified home health agencies (HHAs) in the United States between 2004 and 2007, and calculated risk-adjusted monthly ACH rates. We used multiple regression to identify agency characteristics associated with ACH. We simulated ACH during and immediately after home health care using patient and agency characteristics similar to those in the actual data, comparing the existing measure with alternative fixed-interval measures. Of agency characteristics studied, ALOS had by far the highest partial correlation with the current ACH measure (r(2)=0.218, p<.0001). We replicated the correlation between ACH and ALOS in the patient-level simulation. We found no correlation between ALOS and the alternative measures. Alternative measures do not exhibit ALOS bias and would be appropriate for comparing HHA ACH rates with one another or over time.

  7. Moving through Life-Space Areas and Objectively Measured Physical Activity of Older People.

    PubMed

    Portegijs, Erja; Tsai, Li-Tang; Rantanen, Taina; Rantakokko, Merja

    2015-01-01

    Physical activity-an important determinant of health and function in old age-may vary according to the life-space area reached. Our aim was to study how moving through greater life-space areas is associated with greater physical activity of community-dwelling older people. The association between objectively measured physical activity and life-space area reached on different days by the same individual was studied using one-week longitudinal data, to provide insight in causal relationships. One-week surveillance of objectively assessed physical activity of community-dwelling 70-90-year-old people in central Finland from the "Life-space mobility in old age" cohort substudy (N = 174). In spring 2012, participants wore an accelerometer for 7 days and completed a daily diary including the largest life-space area reached (inside home, outside home, neighborhood, town, and beyond town). The daily step count, and the time in moderate (incl. walking) and low activity and sedentary behavior were assessed. Differences in physical activity between days on which different life-space areas were reached were tested using Generalized Estimation Equation models (within-group comparison). Participants' mean age was 80.4±4.2 years and 63.5% were female. Participants had higher average step counts (p < .001) and greater moderate and low activity time (p < .001) on days when greater life-space areas were reached, from the home to the town area. Only low activity time continued to increase when moving beyond the town. Community-dwelling older people were more physically active on days when they moved through greater life-space areas. While it is unknown whether physical activity was a motivator to leave the home, intervention studies are needed to determine whether facilitation of daily outdoor mobility, regardless of the purpose, may be beneficial in terms of promoting physical activity.

  8. Validation of Self-Reported Cognitive Problems with Objective Neuropsychological Performance in Manganese-Exposed Residents

    EPA Science Inventory

    There is a lack of validation of self-reported cognitive problems with objective neuropsychological measures. The validity of four self-reported cognitive items from a health questionnaire (HQ) and the Symptoms Checklist 90-Revised (SCL-90-R) was examined with objective clinical ...

  9. Scale Development of Individual and Organisation Infrastructure for Heart Health Promotion in Regional Health Authorities

    ERIC Educational Resources Information Center

    Plotnikoff, Ronald C.; Anderson, Donna; Raine, Kim; Cook, Kay; Barrett, Linda; Prodaniuk, Tricia R.

    2005-01-01

    Objective: The purpose of this study was to validate measures of individual and organisational infrastructure for health promotion within Alberta's (Canada) 17 Regional Health Authorities (RHAs). Design: A series of phases were conducted to develop individual and organisational scales to measure health promotion infrastructure. Instruments were…

  10. Promoting Health Equity And Eliminating Disparities Through Performance Measurement And Payment.

    PubMed

    Anderson, Andrew C; O'Rourke, Erin; Chin, Marshall H; Ponce, Ninez A; Bernheim, Susannah M; Burstin, Helen

    2018-03-01

    Current approaches to health care quality have failed to reduce health care disparities. Despite dramatic increases in the use of quality measurement and associated payment policies, there has been no notable implementation of measurement strategies to reduce health disparities. The National Quality Forum developed a road map to demonstrate how measurement and associated policies can contribute to eliminating disparities and promote health equity. Specifically, the road map presents a four-part strategy whose components are identifying and prioritizing areas to reduce health disparities, implementing evidence-based interventions to reduce disparities, investing in the development and use of health equity performance measures, and incentivizing the reduction of health disparities and achievement of health equity. To demonstrate how the road map can be applied, we present an example of how measurement and value-based payment can be used to reduce racial disparities in hypertension among African Americans.

  11. Objective measurements of excess skin in post bariatric patients--inter-rater reliability.

    PubMed

    Biörserud, Christina; Fagevik Olsén, Monika; Elander, Anna; Wiklund, Malin

    2016-01-01

    An ability to reliably assess excess skin after massive weight loss using well-described and transferrable methods is important. The aim of this trial was to evaluate inter-rater reliability of ptosis and circumference measurements in patients with excess skin after bariatric surgery. Twenty-five postbariatric patients were included in the study, and their excess skin was measured 18 months after surgery. A protocol was designed to measure excess skin in a standardised way. To evaluate the inter-rater reliability in the measuring protocol, all patients were measured twice, by a specialist nurse and a specialist physiotherapist. All circumference measurements on different body parts had an ICC > 0.9, indicating high reliability. Furthermore, all breast and abdominal ptosis measurements had high reliability. In contrast, visual evaluation of abdominal ptosis had poor reliability. Measurements of ptoses on different body parts had an ICC > 0.6. There were no systematic differences between the results of the two testers, except for measurements of the buttocks and maximal knee circumference. The measuring protocol presented in this study has high reliability and, therefore, represents a useful instrument to provide a consistent and objective assessment of excess skin in the postbariatric patient.

  12. Harmonization of measurement strategies for exposure to manufactured nano-objects; report of a workshop.

    PubMed

    Brouwer, Derk; Berges, Markus; Virji, Mohammed Abbas; Fransman, Wouter; Bello, Dhimiter; Hodson, Laura; Gabriel, Stefan; Tielemans, Erik

    2012-01-01

    The present paper summarizes the outcome of the discussions at the First International Scientific Workshop on Harmonization of Strategies to Measure and Analyze Exposure to (Manufactured) Nano-objects in Workplace Air that was organized and hosted by the Netherlands Organization for Applied Scientific Research (TNO) and the Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA) (Zeist, The Netherlands, December 2010). It reflects the discussions by 25 international participants in the area of occupational (nano) exposure assessment from Europe, USA, Japan, and Korea on nano-specific issues related to the three identified topics: (i) measurement strategies; (ii) analyzing, evaluating, and reporting of exposure data; and (iii) core information for (exposure) data storage. Preliminary recommendations were achieved with respect to (i) a multimetric approach to exposure assessment, a minimal set of data to be collected, and basic data analysis and reporting as well as (ii) a minimum set of contextual information to be collected and reported. Other issues that have been identified and are of great interest include (i) the need for guidance on statistical approaches to analyze time-series data and on electron microscopy analysis and its reporting and (ii) the need for and possible structure of a (joint) database to store and merge data. To make progress in the process of harmonization, it was concluded that achieving agreement among researchers on the preliminary recommendations of the workshop is urgent.

  13. To measure the chemical composition of a Near Earth Object

    NASA Astrophysics Data System (ADS)

    Gasnault, 0.; Ball, A.; Biele, J.; D'Uston, C.; Forni, O.; Klingelhofer, G.; Maurice, S.; Ulamec, S.

    Introduction. Scenarios for a Near Earth Object (NEO) rendezvous mission were discussed recently in Europe. Such a mission would address scientific questions about the initial conditions and evolutionary history of the solar nebula, as well as mitigation considerations to prevent impact with the Earth. In our opinion the measurement of the elemental composition and the distribution of volatiles in the shallow sub-surface are two of the key observations to be conducted, either from an orbiter or a lander. These measurements are also valuable for documentation (landing site candidates and sample context). This report is limited to the chemical composition, but we assume that remote and/or in-situ observations of physical characteristics, interior, morphology, mineralogy, and organic compounds will also be made as essential complements to achieve the mission scientific objectives. Scientific Interest. The analysis of the bulk composition addresses three fundamental aspects of the scientific mission: (1) the formation of the asteroid or the comet; (2) the evolution of the object; (3) the relation between the parent body and collected meteorites on Earth. Classification of an asteroid/comet can be based on its global composition (abundances of Mg, Si, Fe, Al, Ca, etc. along with its mineralogy), which bears the signature of the feeding zone where it formed. For example the K/U and K/Th ratios seem to increase with distance from the Sun (decreasing temperature). The hydrogen content is another measurable to study the distribution of volatiles in the Solar System. The surface composition is also the result of the degree of evolution of the object and of the interactions with its environment. Building a compositional map of the major elements is necessary to identify and characterize the processes that influenced the asteroid along its history. Finally, knowing the chemical composition will obviously help to relate the parent 1 body to meteorites. Ideally the measurement

  14. Method and apparatus for measuring surface movement of a solid object that is subjected to external vibrations

    DOEpatents

    Schultz, Thomas J.; Kotidis, Petros A.; Woodroffe, Jaime A.; Rostler, Peter S.

    1995-01-01

    A system for non-destructively measuring an object and controlling industrial processes in response to the measurement is disclosed in which an impulse laser generates a plurality of sound waves over timed increments in an object. A polarizing interferometer is used to measure surface movement of the object caused by the sound waves and sensed by phase shifts in the signal beam. A photon multiplier senses the phase shift and develops an electrical signal. A signal conditioning arrangement modifies the electrical signals to generate an average signal correlated to the sound waves which in turn is correlated to a physical or metallurgical property of the object, such as temperature, which property may then be used to control the process. External, random vibrations of the workpiece are utilized to develop discernible signals which can be sensed in the interferometer by only one photon multiplier. In addition the interferometer includes an arrangement for optimizing its sensitivity so that movement attributed to various waves can be detected in opaque objects. The interferometer also includes a mechanism for sensing objects with rough surfaces which produce speckle light patterns. Finally the interferometer per se, with the addition of a second photon multiplier is capable of accurately recording beam length distance differences with only one reading.

  15. Method and apparatus for measuring surface movement of a solid object that is subjected to external vibrations

    DOEpatents

    Schultz, T.J.; Kotidis, P.A.; Woodroffe, J.A.; Rostler, P.S.

    1995-04-25

    A system for non-destructively measuring an object and controlling industrial processes in response to the measurement is disclosed in which an impulse laser generates a plurality of sound waves over timed increments in an object. A polarizing interferometer is used to measure surface movement of the object caused by the sound waves and sensed by phase shifts in the signal beam. A photon multiplier senses the phase shift and develops an electrical signal. A signal conditioning arrangement modifies the electrical signals to generate an average signal correlated to the sound waves which in turn is correlated to a physical or metallurgical property of the object, such as temperature, which property may then be used to control the process. External, random vibrations of the workpiece are utilized to develop discernible signals which can be sensed in the interferometer by only one photon multiplier. In addition the interferometer includes an arrangement for optimizing its sensitivity so that movement attributed to various waves can be detected in opaque objects. The interferometer also includes a mechanism for sensing objects with rough surfaces which produce speckle light patterns. Finally the interferometer per se, with the addition of a second photon multiplier is capable of accurately recording beam length distance differences with only one reading. 38 figs.

  16. Objectively Measured Activity Patterns among Adults in Residential Aged Care

    PubMed Central

    Reid, Natasha; Eakin, Elizabeth; Henwood, Timothy; Keogh, Justin W. L.; Senior, Hugh E.; Gardiner, Paul A.; Winkler, Elisabeth; Healy, Genevieve N.

    2013-01-01

    Objectives: To determine the feasibility of using the activPAL3TM activity monitor, and, to describe the activity patterns of residential aged care residents. Design: Cross-sectional. Setting: Randomly selected aged care facilities within 100 km of the Gold Coast, Queensland, Australia. Participants: Ambulatory, older (≥60 years) residential aged care adults without cognitive impairment. Measurements: Feasibility was assessed by consent rate, sleep/wear diary completion, and through interviews with staff/participants. Activity patterns (sitting/lying, standing, and stepping) were measured via activPAL3TM monitors worn continuously for seven days. Times spent in each activity were described and then compared across days of the week and hours of the day using linear mixed models. Results: Consent rate was 48% (n = 41). Activity patterns are described for the 31 participants (mean age 84.2 years) who provided at least one day of valid monitor data. In total, 14 (45%) completed the sleep/wear diary. Participants spent a median (interquartile range) of 12.4 (1.7) h sitting/lying (with 73% of this accumulated in unbroken bouts of ≥30 min), 1.9 (1.3) h standing, and 21.4 (36.7) min stepping during their monitored waking hours per day. Activity did not vary significantly by day of the week (p ≥ 0.05); stepping showed significant hourly variation (p = 0.018). Conclusions: Older adults in residential aged care were consistently highly sedentary. Feasibility considerations for objective activity monitoring identified for this population include poor diary completion and lost monitors. PMID:24304508

  17. Development and Dissemination of the El Centro Health Disparities Measures Library.

    PubMed

    Mitrani, Victoria Behar; O'Day, Joanne E; Norris, Timothy B; Adebayo, Oluwamuyiwa Winifred

    2017-09-01

    This report describes the development and dissemination of a library of English measures, with Spanish translations, on constructs relevant to social determinants of health and behavioral health outcomes. The El Centro Measures Library is a product of the Center of Excellence for Health Disparities Research: El Centro, a program funded by the National Institute on Minority Health and Health Disparities of the U.S. National Institutes of Health. The library is aimed at enhancing capacity for minority health and health disparities research, particularly for Hispanics living in the United States and abroad. The open-access library of measures (available through www.miami.edu/sonhs/measureslibrary) contains brief descriptions of each measure, scoring information (where available), links to related peer-reviewed articles, and measure items in both languages. Links to measure websites where commercially available measures can be purchased are included, as is contact information for measures that require author permission. Links to several other measures libraries are hosted on the library website. Other researchers may contribute to the library. El Centro investigators began the library by electing to use a common set of measures across studies to assess demographic information, culture-related variables, proximal outcomes of interest, and major outcomes. The collection was expanded to include other health disparity research studies. In 2012, a formal process was developed to organize, expand, and centralize the library in preparation for a gradual process of dissemination to the national and international community of researchers. The library currently contains 61 measures encompassing 12 categories of constructs. Thus far, the library has been accessed 8,883 times (unique page views as generated by Google Analytics), and responses from constituencies of users and measure authors have been favorable. With the paucity of availability and accessibility of translated

  18. Perceived Barriers to Adherence to Tuberculosis Infection Control Measures among Health Care Workers in the Dominican Republic.

    PubMed

    Chapman, Helena J; Veras-Estévez, Bienvenido A; Pomeranz, Jamie L; Pérez-Then, Eddy N; Marcelino, Belkys; Lauzardo, Michael

    2017-01-01

    INTRODUCTION Health care workers have an increased risk of infection due to occupational Mycobacterium tuberculosis exposure, including multidrug-resistant strains. Health care workers' risk of developing tuberculosis is greater than that of the general population, whether in low-, intermediate- or high-incidence countries. Adherence to infection control measures (administrative controls, environmental controls, and personal respiratory protection) is essential to reduce risk of disease transmission between suspected tuberculosis patients and health care workers, but for different reasons, both objective and subjective, adherence is low. Identifying the causes of low adherence is a prerequisite to effective programming to reduce risk. OBJECTIVE Identify perceived barriers to adherence to tuberculosis infection control measures among health care workers in the Dominican Republic. METHODS During August 2014, a qualitative study was conducted in two tertiary-level hospitals in different regions of the Dominican Republic. A semi-structured interview guide of nine questions was developed, based on the scientific literature and with consensus of clinical experts. Nine semi-structured interviews were conducted with a purposive sample of seven physicians (five men, two women) and two baccalaureate nurses (both women) working in the emergency medicine, internal medicine or nursing departments of those institutions. Question topics included clinical experience of M. tuberculosis infection and disease; knowledge of disease transmission and preventive practices; clinical management strategies; and perceptions of effectiveness of directly observed treatment, short-course, and disease coping strategies. RESULTS Perceived barriers were described as: 1) sense of invincibility of health care workers; 2) personal beliefs of health care workers related to direct patient communication; 3) low provider-to-patient ratios in hospitals; 4) absence of tuberculosis isolation units for

  19. Determining the benefits and objectives of a child health residency program for Canadian rural family physicians: An international qualitative research study

    PubMed Central

    Keegan, David; Bannister, Susan

    2010-01-01

    OBJECTIVES: To clarify the need for an advanced child health training program for Canadian rural family physicians, and to determine the key learning objectives to enable graduates to become community leaders in child and youth health care. DESIGN: Qualitative educational research study. Setting: Canada and Australia. METHODS: To gather data, the authors carried out semistructured interviews and focus groups with child care consultants, Canadian rural family physicians, child patients and parents, family medicine residents and Australian rural family physicians. Standards of qualitative methodology were applied to identify themes and subthemes. RESULTS: It was determined that a family medicine child health program would provide the following benefits: enhanced care by family physicians, improved access to child care, increased attractiveness of family medicine as a career and reduced ‘specialty burden’. Five key learning objectives for graduates were identified: the ability to provide child-centred care, to care for acutely or critically ill children, to care for children with complex needs, to recognize and act on ‘red flags’, and to provide behavioural and mental health care. The Australian general practitioners confirmed that their training provided most of these benefits, and enabled them to achieve the objectives identified. CONCLUSION: The present study showed that multiple stakeholders believed that advanced training in child health for rural family physicians would provide better care for children. The study also identified key learning objectives for the program. The present research led to the establishment of a Family Medicine Child Health Residency Program (www.familymedicineuwo.ca/PostGrad/PGY3/ChildHealth.aspx) at The University of Western Ontario (London, Ontario). PMID:21731414

  20. A Framework for Monitoring Progress Using Summary Measures of Health.

    PubMed

    Madans, Jennifer H; Weeks, Julie D

    2016-10-01

    Initiatives designed to monitor health typically incorporate numerous specific measures of health and the health system to assess improvements, or lack thereof, for policy and program purposes. The addition of summary measures provides overarching information which is essential for determining whether the goals of such initiatives are met. Summary measures are identified that relate to the individual indicators but that also reflect movement in the various parts of the system. A hierarchical framework that is conceptually consistent and which utilizes a succinct number of summary measures incorporating indicators of functioning and participation is proposed. While a large set of individual indicators can be useful for monitoring progress, these individual indicators do not provide an overall evaluation of health, defined broadly, at the population level. A hierarchical framework consisting of summary measures is important for monitoring the success of health improvement initiatives. © The Author(s) 2016.