Sample records for observational studies evaluating

  1. Evaluation of Multiclass Model Observers in PET LROC Studies

    NASA Astrophysics Data System (ADS)

    Gifford, H. C.; Kinahan, P. E.; Lartizien, C.; King, M. A.

    2007-02-01

    A localization ROC (LROC) study was conducted to evaluate nonprewhitening matched-filter (NPW) and channelized NPW (CNPW) versions of a multiclass model observer as predictors of human tumor-detection performance with PET images. Target localization is explicitly performed by these model observers. Tumors were placed in the liver, lungs, and background soft tissue of a mathematical phantom, and the data simulation modeled a full-3D acquisition mode. Reconstructions were performed with the FORE+AWOSEM algorithm. The LROC study measured observer performance with 2D images consisting of either coronal, sagittal, or transverse views of the same set of cases. Versions of the CNPW observer based on two previously published difference-of-Gaussian channel models demonstrated good quantitative agreement with human observers. One interpretation of these results treats the CNPW observer as a channelized Hotelling observer with implicit internal noise

  2. Evaluation of nursing faculty through observation.

    PubMed

    Crawford, L H

    1998-10-01

    The purpose of this study was to assess current use and faculty perceptions of classroom observation as a method of faculty evaluation in schools of nursing. Baccalaureate schools of nursing were surveyed to determine current use of classroom observation and its worth from the perception of administrators and faculty. Although most schools used classroom observation as a method of faculty evaluation, further clarification and research is needed in the following areas: purpose of classroom observation; number of observations necessary; weight given to classroom observation in relation to other evaluation methods; and tools used.

  3. Guidelines for reporting evaluations based on observational methodology.

    PubMed

    Portell, Mariona; Anguera, M Teresa; Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana

    2015-01-01

    Observational methodology is one of the most suitable research designs for evaluating fidelity of implementation, especially in complex interventions. However, the conduct and reporting of observational studies is hampered by the absence of specific guidelines, such as those that exist for other evaluation designs. This lack of specific guidance poses a threat to the quality and transparency of these studies and also constitutes a considerable publication hurdle. The aim of this study thus was to draw up a set of proposed guidelines for reporting evaluations based on observational methodology. The guidelines were developed by triangulating three sources of information: observational studies performed in different fields by experts in observational methodology, reporting guidelines for general studies and studies with similar designs to observational studies, and proposals from experts in observational methodology at scientific meetings. We produced a list of guidelines grouped into three domains: intervention and expected outcomes, methods, and results. The result is a useful, carefully crafted set of simple guidelines for conducting and reporting observational studies in the field of program evaluation.

  4. Teacher Evaluations: Do Classroom Observations and Evaluator Training Really Matter?

    ERIC Educational Resources Information Center

    Pies, Sarah J.

    2017-01-01

    The purpose of this study was to determine if the minimum number of observations stated in a district's teacher evaluation plan, observation characteristics described in a district's evaluation plan, and the characteristic of those evaluating teachers had an impact on whether a school would receive a bonus or penalty point for Indiana's A-F…

  5. Evaluating the Impact of Database Heterogeneity on Observational Study Results

    PubMed Central

    Madigan, David; Ryan, Patrick B.; Schuemie, Martijn; Stang, Paul E.; Overhage, J. Marc; Hartzema, Abraham G.; Suchard, Marc A.; DuMouchel, William; Berlin, Jesse A.

    2013-01-01

    Clinical studies that use observational databases to evaluate the effects of medical products have become commonplace. Such studies begin by selecting a particular database, a decision that published papers invariably report but do not discuss. Studies of the same issue in different databases, however, can and do generate different results, sometimes with strikingly different clinical implications. In this paper, we systematically study heterogeneity among databases, holding other study methods constant, by exploring relative risk estimates for 53 drug-outcome pairs and 2 widely used study designs (cohort studies and self-controlled case series) across 10 observational databases. When holding the study design constant, our analysis shows that estimated relative risks range from a statistically significant decreased risk to a statistically significant increased risk in 11 of 53 (21%) of drug-outcome pairs that use a cohort design and 19 of 53 (36%) of drug-outcome pairs that use a self-controlled case series design. This exceeds the proportion of pairs that were consistent across databases in both direction and statistical significance, which was 9 of 53 (17%) for cohort studies and 5 of 53 (9%) for self-controlled case series. Our findings show that clinical studies that use observational databases can be sensitive to the choice of database. More attention is needed to consider how the choice of data source may be affecting results. PMID:23648805

  6. A conceptual framework for evaluating data suitability for observational studies.

    PubMed

    Shang, Ning; Weng, Chunhua; Hripcsak, George

    2017-09-08

    To contribute a conceptual framework for evaluating data suitability to satisfy the research needs of observational studies. Suitability considerations were derived from a systematic literature review on researchers' common data needs in observational studies and a scoping review on frequent clinical database design considerations, and were harmonized to construct a suitability conceptual framework using a bottom-up approach. The relationships among the suitability categories are explored from the perspective of 4 facets of data: intrinsic, contextual, representational, and accessible. A web-based national survey of domain experts was conducted to validate the framework. Data suitability for observational studies hinges on the following key categories: Explicitness of Policy and Data Governance, Relevance, Availability of Descriptive Metadata and Provenance Documentation, Usability, and Quality. We describe 16 measures and 33 sub-measures. The survey uncovered the relevance of all categories, with a 5-point Likert importance score of 3.9 ± 1.0 for Explicitness of Policy and Data Governance, 4.1 ± 1.0 for Relevance, 3.9 ± 0.9 for Availability of Descriptive Metadata and Provenance Documentation, 4.2 ± 1.0 for Usability, and 4.0 ± 0.9 for Quality. The suitability framework evaluates a clinical data source's fitness for research use. Its construction reflects both researchers' points of view and data custodians' design features. The feedback from domain experts rated Usability, Relevance, and Quality categories as the most important considerations. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  7. Clinical Observed Performance Evaluation: A Prospective Study in Final Year Students of Surgery

    ERIC Educational Resources Information Center

    Markey, G. C.; Browne, K.; Hunter, K.; Hill, A. D.

    2011-01-01

    We report a prospective study of clinical observed performance evaluation (COPE) for 197 medical students in the pre-qualification year of clinical education. Psychometric quality was the main endpoint. Students were assessed in groups of 5 in 40-min patient encounters, with each student the focus of evaluation for 8 min. Each student had a series…

  8. Prospective clinical observational study evaluating gender-associated differences of preoperative pain intensity.

    PubMed

    Tafelski, Sascha; Kerper, Léonie F; Salz, Anna-Lena; Spies, Claudia; Reuter, Eva; Nachtigall, Irit; Schäfer, Michael; Krannich, Alexander; Krampe, Henning

    2016-07-01

    Previous studies reported conflicting results concerning different pain perceptions of men and women. Recent research found higher pain levels in men after major surgery, contrasted by women after minor procedures. This trial investigates differences in self-reported preoperative pain intensity between genders before surgery.Patients were enrolled in 2011 and 2012 presenting for preoperative evaluation at the anesthesiological assessment clinic at Charité University hospital. Out of 5102 patients completing a computer-assisted self-assessment, 3042 surgical patients with any preoperative pain were included into this prospective observational clinical study. Preoperative pain intensity (0-100 VAS, visual analog scale) was evaluated integrating psychological cofactors into analysis.Women reported higher preoperative pain intensity than men with median VAS scores of 30 (25th-75th percentiles: 10-52) versus 21 (10-46) (P < 0.001). Adjusted multiple regression analysis showed that female gender remained statistically significantly associated with higher pain intensity (P < 0.001). Gender differences were consistent across several subgroups especially with varying patterns in elderly. Women scheduled for minor and moderate surgical procedures showed largest differences in overall pain compared to men.This large clinical study observed significantly higher preoperative pain intensity in female surgical patients. This gender difference was larger in the elderly potentially contradicting the current hypothesis of a primary sex-hormone derived effect. The observed variability in specific patient subgroups may help to explain heterogeneous findings of previous studies.

  9. Evaluation of Xerostomia in Different Psychological Disorders: An Observational Study

    PubMed Central

    Chandrappa, Pramod Redder; Patil, Snehal; Roodmal, Seema Yadav; Kumarswamy, Akshay; Chappi, Mounesh Kumar

    2016-01-01

    Introduction Psychiatric diseases like anxiety, depression, schizophrenia and bipolar disorders are increasing at an alarming rate. These diseases can affect the quantity and quality of saliva leading to multiple oral diseases. Although many researchers have evaluated xerostomia in general population, its prevalence is not been assessed in patients suffering from different psychological disorders. Aim To investigate the prevalence of xerostomia and to assess the correlation between xerostomia and dryness of lip and mucosa in different psychological disorders. Materials and Methods A cross-sectional observational study was conducted over a period of six months in Department of Psychiatry and Department of Oral Medicine. Patients with anxiety, depression, schizophrenia and bipolar disorder, as diagnosed by an experienced psychiatrist, were given a questionnaire to evaluate the xerostomia. Patients with symptoms of xerostomia were subjected to oral examination by a skilled oral diagnostician to check for dryness of lips and mucosa. One hundred patients from each group of psychiatric diseases were included in the study using a consecutive sampling technique. An equal number of healthy individuals reporting to oral medicine department for routine oral screening were included as control group after initial psychiatric evaluation. Results In this study statistically significant increase in the xerostomia in psychiatric patients was recorded when compared to the control group (p<0.01). Xerostomia was significantly higher in anxiety patients (51%) followed by depression (47%), bipolar disorder (41%), schizophrenia (39%) and control group (27%). The majority of the psychiatric patients had ‘moderate’ to ‘severe’ xerostomia whereas the control group had ‘mild’ xerostomia. Xerostomia was significantly higher in younger age group (18–49 years) than in older age group and females patients had higher xerostomia than male patients. Psychiatric patients had

  10. Public availability of results of observational studies evaluating an intervention registered at ClinicalTrials.gov.

    PubMed

    Baudart, Marie; Ravaud, Philippe; Baron, Gabriel; Dechartres, Agnes; Haneef, Romana; Boutron, Isabelle

    2016-01-28

    Observational studies are essential for assessing safety. The aims of this study were to evaluate whether results of observational studies evaluating an intervention with safety outcome(s) registered at ClinicalTrials.gov were published and, if not, whether they were available through posting on ClinicalTrials.gov or the sponsor website. We identified a cohort of observational studies with safety outcome(s) registered on ClinicalTrials.gov after October 1, 2007, and completed between October 1, 2007, and December 31, 2011. We systematically searched PubMed for a publication, as well as ClinicalTrials.gov and the sponsor website for results. The main outcomes were the time to the first publication in journals and to the first public availability of the study results (i.e. published or posted on ClinicalTrials.gov or the sponsor website). For all studies with results publicly available, we evaluated the completeness of reporting (i.e. reported with the number of events per arm) of safety outcomes. We identified 489 studies; 334 (68%) were partially or completely funded by industry. Results for only 189 (39%, i.e. 65% of the total target number of participants) were published at least 30 months after the study completion. When searching other data sources, we obtained the results for 53% (n = 158; i.e. 93% of the total target number of participants) of unpublished studies; 31% (n = 94) were posted on ClinicalTrials.gov and 21% (n = 64) on the sponsor website. As compared with non-industry-funded studies, industry-funded study results were less likely to be published but not less likely to be publicly available. Of the 242 studies with a primary outcome recorded as a safety issue, all these outcomes were adequately reported in 86% (114/133) when available in a publication, 91% (62/68) when available on ClinicalTrials.gov, and 80% (33/41) when available on the sponsor website. Only 39% of observational studies evaluating an intervention with safety outcome

  11. How accurately do drivers evaluate their own driving behavior? An on-road observational study.

    PubMed

    Amado, Sonia; Arıkan, Elvan; Kaça, Gülin; Koyuncu, Mehmet; Turkan, B Nilay

    2014-02-01

    Self-assessment of driving skills became a noteworthy research subject in traffic psychology, since by knowing one's strenghts and weaknesses, drivers can take an efficient compensatory action to moderate risk and to ensure safety in hazardous environments. The current study aims to investigate drivers' self-conception of their own driving skills and behavior in relation to expert evaluations of their actual driving, by using naturalistic and systematic observation method during actual on-road driving session and to assess the different aspects of driving via comprehensive scales sensitive to different specific aspects of driving. 19-63 years old male participants (N=158) attended an on-road driving session lasting approximately 80min (45km). During the driving session, drivers' errors and violations were recorded by an expert observer. At the end of the driving session, observers completed the driver evaluation questionnaire, while drivers completed the driving self-evaluation questionnaire and Driver Behavior Questionnaire (DBQ). Low to moderate correlations between driver and observer evaluations of driving skills and behavior, mainly on errors and violations of speed and traffic lights was found. Furthermore, the robust finding that drivers evaluate their driving performance as better than the expert was replicated. Over-positive appraisal was higher among drivers with higher error/violation score and with the ones that were evaluated by the expert as "unsafe". We suggest that the traffic environment might be regulated by increasing feedback indicators of errors and violations, which in turn might increase the insight into driving performance. Improving self-awareness by training and feedback sessions might play a key role for reducing the probability of risk in their driving activity. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. Observational Studies: Cohort and Case-Control Studies

    PubMed Central

    Song, Jae W.; Chung, Kevin C.

    2010-01-01

    Observational studies are an important category of study designs. To address some investigative questions in plastic surgery, randomized controlled trials are not always indicated or ethical to conduct. Instead, observational studies may be the next best method to address these types of questions. Well-designed observational studies have been shown to provide results similar to randomized controlled trials, challenging the belief that observational studies are second-rate. Cohort studies and case-control studies are two primary types of observational studies that aid in evaluating associations between diseases and exposures. In this review article, we describe these study designs, methodological issues, and provide examples from the plastic surgery literature. PMID:20697313

  13. Performance Evaluation of New-Generation Pulse Oximeters in the NICU: Observational Study.

    PubMed

    Nizami, Shermeen; Greenwood, Kim; Barrowman, Nick; Harrold, JoAnn

    2015-09-01

    This crossover observational study compares the data characteristics and performance of new-generation Nellcor OXIMAX and Masimo SET SmartPod pulse oximeter technologies. The study was conducted independent of either original equipment manufacturer (OEM) across eleven preterm infants in a Neonatal Intensive Care Unit (NICU). The SmartPods were integrated with Dräger Infinity Delta monitors. The Delta monitor measured the heart rate (HR) using an independent electrocardiogram sensor, and the two SmartPods collected arterial oxygen saturation (SpO2) and pulse rate (PR). All patient data were non-Gaussian. Nellcor PR showed a higher correlation with the HR as compared to Masimo PR. The statistically significant difference found in their median values (1% for SpO2, 1 bpm for PR) was deemed clinically insignificant. SpO2 alarms generated by both SmartPods were observed and categorized for performance evaluation. Results for sensitivity, positive predictive value, accuracy and false alarm rates were Nellcor (80.3, 50, 44.5, 50%) and Masimo (72.2, 48.2, 40.6, 51.8%) respectively. These metrics were not statistically significantly different between the two pulse oximeters. Despite claims by OEMs, both pulse oximeters exhibited high false alarm rates, with no statistically or clinically significant difference in performance. These findings have a direct impact on alarm fatigue in the NICU. Performance evaluation studies can also impact medical device purchase decisions made by hospital administrators.

  14. Evaluating Teacher Preparation Using Graduates' Observational Ratings

    ERIC Educational Resources Information Center

    Ronfeldt, Matthew; Campbell, Shanyce L.

    2016-01-01

    Despite growing calls for more accountability of teacher education programs (TEPs), there is little consensus about how to evaluate them. This study investigates the potential for using observational ratings of program completers to evaluate TEPs. Drawing on statewide data on almost 9,500 program completers, representing 44 providers (183…

  15. An Observational Study for Evaluating the Effects of Interpersonal Problem-Solving Skills Training on Behavioural Dimensions

    ERIC Educational Resources Information Center

    Anliak, Sakire; Sahin, Derya

    2010-01-01

    The present observational study was designed to evaluate the effectiveness of the I Can Problem Solve (ICPS) programme on behavioural change from aggression to pro-social behaviours by using the DECB rating scale. Non-participant observation method was used to collect data in pretest-training-posttest design. It was hypothesised that the ICPS…

  16. "Evaluations" of Observables Versus Measurements in Quantum Theory

    NASA Astrophysics Data System (ADS)

    Nisticò, Giuseppe; Sestito, Angela

    2016-03-01

    In Quantum Physics there are circumstances where the direct measurement of a given observable encounters difficulties; in some of these cases, however, its value can be "evaluated", i.e. it can be inferred by measuring another observable characterized by perfect correlation with the observable of interest. Though an evaluation is often interpreted as a measurement of the evaluated observable, we prove that the two concepts cannot be identified in Quantum Physics, because the identification yields contradictions. Then, we establish the conceptual status of evaluations in Quantum Theory and how they are related to measurements.

  17. Evaluation of reporting quality for observational studies using routinely collected health data in pharmacovigilance.

    PubMed

    Nie, Xiaolu; Zhang, Ying; Wu, Zehao; Jia, Lulu; Wang, Xiaoling; Langan, Sinéad M; Benchimol, Eric I; Peng, Xiaoxia

    2018-06-01

    To appraise the reporting quality of studies which concerned linezolid related thrombocytopenia referring to REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement. Medline, Embase, Cochrane library and clinicaltrial.gov were searched for observational studies concerning linezolid related thrombocytopenia using routinely collected health data from 2000 to 2017. Two reviewers screened potential eligible articles and extracted data independently. Finally, reporting quality assessment was performed by two senior researchers using RECORD statement. Of 25 included studies, 11 (44.0%) mentioned the type of data in the title and/or abstract. In 38 items derived from RECORD statement, the median number of items reported in the included studies was 22 (interquartile range (IQR) 18 to 27). Inadequate reporting issues were discovered in the following aspects: validation studies of the codes or algorithms, study size estimation, quantitative variables, subgroup statistical methods, missing data, follow-up/matching or sampling strategy, sensitivity analysis and cleaning methods, funding and role of funders and accessibility of protocol, raw data. This study provides the evidence that the reporting quality of post-marketing safety evaluation studies conducted using routinely collected health data was often insufficient. Future stakeholders are encouraged to endorse the RECORD guidelines in pharmacovigilance.

  18. Evaluation of CNN as anthropomorphic model observer

    NASA Astrophysics Data System (ADS)

    Massanes, Francesc; Brankov, Jovan G.

    2017-03-01

    Model observers (MO) are widely used in medical imaging to act as surrogates of human observers in task-based image quality evaluation, frequently towards optimization of reconstruction algorithms. In this paper, we explore the use of convolutional neural networks (CNN) to be used as MO. We will compare CNN MO to alternative MO currently being proposed and used such as the relevance vector machine based MO and channelized Hotelling observer (CHO). As the success of the CNN, and other deep learning approaches, is rooted in large data sets availability, which is rarely the case in medical imaging systems task-performance evaluation, we will evaluate CNN performance on both large and small training data sets.

  19. Strengthening the reliability and credibility of observational epidemiology studies by creating an Observational Studies Register.

    PubMed

    Swaen, Gerard M H; Carmichael, Neil; Doe, John

    2011-05-01

    To evaluate the need for the creation of a system in which observational epidemiology studies are registered; an Observational Studies Register (OSR). The current scientific process for observational epidemiology studies is described. Next, a parallel is made with the clinical trials area, where the creation of clinical trial registers has greatly restored and improved their credibility and reliability. Next, the advantages and disadvantages of an OSR are compared. The advantages of an OSR outweigh its disadvantages. The creation of an OSR, similar to the existing Clinical Trials Registers, will improve the assessment of publication bias and will provide an opportunity to compare the original study protocol with the results reported in the publication. Reliability, credibility, and transparency of observational epidemiology studies are strengthened by the creation of an OSR. We propose a structured, collaborative, and coordinated approach for observational epidemiology studies that can provide solutions for existing weaknesses and will strengthen credibility and reliability, similar to the approach currently used in clinical trials, where Clinical Trials Registers have played a key role in strengthening their scientific value. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. Evaluating psychiatric case-control studies using the STROBE (STrengthening the Reporting of OBservational Studies in Epidemiology) statement.

    PubMed

    Goi, Pedro Domingues; Goi, Julia Domingues; Cordini, Kariny Larissa; Ceresér, Keila Mendes; Rocha, Neusa Sica da

    2014-01-01

    Case-control studies are important in developing clinical and public health knowledge. The STROBE statement (STrengthening the Reporting of OBservational Studies in Epidemiology) was developed to establish a checklist of items that should be included in articles reporting observational studies. Our aim was to analyze whether the psychiatric case-control articles published in Brazilian journals with CAPES Qualis rating B1/B2 in 2009 conformed with the STROBE statement. Descriptive study on psychiatric papers published in Brazilian journals, within the Postgraduate Medical Program on Psychiatry, at Universidade Federal do Rio Grande do Sul. All psychiatric case-control studies from Brazilian Qualis B1/B2 journals of psychiatry, neurology and public health in 2009 were analyzed. The four most specific items of the STROBE statement were used to evaluate whether these studies fitted within the case-control parameters: 1) selection of cases and controls; 2) controlling for bias; 3) statistical analysis; and 4) presentation of results. Sixteen case-control studies were identified, of which eleven (68.75%) were in psychiatry-focused journals. From analysis using the STROBE statement, all of the articles conformed with item 1; two (12.5%) completely conformed with item 2; none completely conformed with item 3; and only three (18.8%) conformed with item 4. The case-control studies analyzed here did not completely conform with the four STROBE statement items for case-control design. In view of the inadequate methodology of the published studies, these findings justify focusing on research and methodology and expanding the investigations on adherence of studies to their designs.

  1. Case Study Observational Research: A Framework for Conducting Case Study Research Where Observation Data Are the Focus.

    PubMed

    Morgan, Sonya J; Pullon, Susan R H; Macdonald, Lindsay M; McKinlay, Eileen M; Gray, Ben V

    2017-06-01

    Case study research is a comprehensive method that incorporates multiple sources of data to provide detailed accounts of complex research phenomena in real-life contexts. However, current models of case study research do not particularly distinguish the unique contribution observation data can make. Observation methods have the potential to reach beyond other methods that rely largely or solely on self-report. This article describes the distinctive characteristics of case study observational research, a modified form of Yin's 2014 model of case study research the authors used in a study exploring interprofessional collaboration in primary care. In this approach, observation data are positioned as the central component of the research design. Case study observational research offers a promising approach for researchers in a wide range of health care settings seeking more complete understandings of complex topics, where contextual influences are of primary concern. Future research is needed to refine and evaluate the approach.

  2. Randomized controlled trials and real-world observational studies in evaluating cardiovascular safety of inhaled bronchodilator therapy in COPD.

    PubMed

    Kardos, Peter; Worsley, Sally; Singh, Dave; Román-Rodríguez, Miguel; Newby, David E; Müllerová, Hana

    2016-01-01

    Long-acting muscarinic antagonist (LAMA) or long-acting β2-agonist (LABA) bronchodilators and their combination are recommended for the maintenance treatment of chronic obstructive pulmonary disease (COPD). Although the efficacy of LAMAs and LABAs has been well established through randomized controlled trials (RCTs), questions remain regarding their cardiovascular (CV) safety. Furthermore, while the safety of LAMA and LABA monotherapy has been extensively studied, data are lacking for LAMA/LABA combination therapy, and the majority of the studies that have reported on the CV safety of LAMA/LABA combination therapy were not specifically designed to assess this. Evaluation of CV safety for COPD treatments is important because many patients with COPD have underlying CV comorbidities. However, severe CV and other comorbidities are often exclusion criteria for RCTs, contributing to a lack in external validity and generalizability. Real-world observational studies are another important tool to evaluate the effectiveness and safety of COPD therapies in a broader population of patients and can improve upon the external validity limitations of RCTs. We examine what is already known regarding the CV and cerebrovascular safety of LAMA/LABA combination therapy from RCTs and real-world observational studies, and explore the advantages and limitations of data derived from each study type. We also describe an ongoing prospective, observational, comparative post-authorization safety study of a LAMA/LABA combination therapy (umeclidinium/vilanterol) and LAMA monotherapy (umeclidinium) versus tiotropium, with a focus on the relative merits of the study design.

  3. Evaluation of camouflage pattern performance of textiles by human observers and CAMAELEON

    NASA Astrophysics Data System (ADS)

    Heinrich, Daniela H.; Selj, Gorm K.

    2017-10-01

    Military textiles with camouflage pattern are an important part of the protection measures for soldiers. Military operational environments differ a lot depending on climate and vegetation. This requires very different camouflage pattern to achieve good protection. To find the best performing pattern for given environments we have in earlier evaluations mainly applied observer trials as evaluation method. In these camouflage evaluation test human observers were asked to search for targets (in natural settings) presented on a high resolution PC screen, and the corresponding detection times were recorded. Another possibility is to base the evaluation on simulations. CAMAELEON is a licensed tool that ranks camouflaged targets by their similarity with local backgrounds. The similarity is estimated through the parameters local contrast, orientation of structures in the pattern and spatial frequency, by mimicking the response and signal processing in the visual cortex of the human eye. Simulations have a number of advantages over observer trials, for example, that they are more flexible, cheaper, and faster. Applying these two methods to the same images of camouflaged targets we found that CAMAELEON simulation results didn't match observer trial results for targets with disruptive patterns. This finding now calls for follow up studies in order to learn more about the advantages and pitfalls of CAMAELEON. During recent observer trials we studied new camouflage patterns and the effect of additional equipment, such as combat vests. In this paper we will present the results from a study comparing evaluation results of human based observer trials and CAMAELEON.

  4. Evaluating Music Teachers: A Comparison of Evaluations by Observers with Varied Levels of Musical and Observational Background

    ERIC Educational Resources Information Center

    Hirokawa, Joy Ondra

    2013-01-01

    The purpose of this research was to examine the differences in the evaluations of music teachers conducted by individuals with varying backgrounds in music and observation techniques. Part I compared evaluations completed by school administrators and music department leadership. Part II utilized the findings of Part I to create focused and…

  5. Prenatal ultrasound and postmortem histologic evaluation of tooth germs: an observational, transversal study.

    PubMed

    Seabra, Mariana; Felino, António; Nogueira, Rosete; Valente, Francisco; Braga, Ana Cristina; Vaz, Paula

    2015-05-12

    Hypodontia is the most frequent developmental anomaly of the orofacial complex, and its detection in prenatal ultrasound may indicate the presence of congenital malformations, genetic syndromes and chromosomal abnormalities. To date, only a few studies have evaluated the histological relationship of human tooth germs identified by two-dimensional (2D) ultrasonography. In order to analyze whether two-dimensional ultrasonography of tooth germs may be successfully used for identifying genetic syndromes, prenatal ultrasound images of fetal tooth germs obtained from a Portuguese population sample were compared with histological images obtained from fetal autopsies. Observational, descriptive, transversal study. The study protocol followed the ethical principles outlined by the Helsinki Declaration and was approved by the Ethics Committee of the School of Dental Medicine, University of Porto (FMDUP, Porto, Portugal) and of the Centro Hospitalar de Vila Nova de Gaia/Espinho (CHVNG/EPE, Porto, Portugal) as well as by the CGC Genetics Embryofetal Pathology Laboratory. Eighty-five fetuses examined by prenatal ultrasound screening from May 2011 to August 2012 had an indication for autopsy following spontaneous fetal death or medical termination of pregnancy. Of the 85 fetuses, 37 (43.5%) were randomly selected for tooth germ evaluation by routine histopathological analysis. Fetuses who were up to 30 weeks of gestation, and whose histological pieces were not representative of all maxillary tooth germs was excluded. Twenty four fetus between the 13(th) and 30(th) weeks of gestation fulfilled the parameters to autopsy. Twenty four fetuses were submitted to histological evaluation and were determined the exact number, morphology, and mineralization of their tooth germs. All tooth germs were identifiable with ultrasonography as early as the 13(th) week of gestation. Of the fetuses autopsied, 41.7% had hypodontia (29.1% maxillary hypodontia and 20.9% mandibular hypodontia). This

  6. Evaluating Behavioural Observation Audiometry with Handicapped Children.

    ERIC Educational Resources Information Center

    Flexer, Carol; Gans, Donald P.

    1982-01-01

    Three observers evaluated the responses to sound with 21 mild to severely handicapped children (7 months to 10 years old) on Behavioural Observation Audiometry, an alternative to conditioning paradigms in audiometric assessment. Results showed that inter-observer agreement was high and that responsitivity was not affected by stimulus presentation…

  7. Tip of the Tongue States Increase Under Evaluative Observation.

    PubMed

    James, Lori E; Schmank, Christopher J; Castro, Nichol; Buchanan, Tony W

    2018-02-01

    We tested the frequent assumption that the difficulty of word retrieval increases when a speaker is being observed and evaluated. We modified the Trier Social Stress Test (TSST) so that participants believed that its evaluative observation components continued throughout the duration of a subsequent word retrieval task, and measured participants' reported tip of the tongue (TOT) states. Participants in this TSST condition experienced more TOTs than participants in a comparable, placebo TSST condition in which there was no suggestion of evaluative observation. This experiment provides initial evidence confirming the assumption that evaluative observation by a third party can be disruptive to word retrieval. We interpret our findings by proposing an extension to a well-supported theoretical model of TOTs.

  8. Using non-specialist observers in 4AFC human observer studies

    NASA Astrophysics Data System (ADS)

    Elangovan, Premkumar; Mackenzie, Alistair; Dance, David R.; Young, Kenneth C.; Wells, Kevin

    2017-03-01

    Virtual clinical trials (VCTs) are an emergent approach for rapid evaluation and comparison of various breast imaging technologies and techniques using computer-based modeling tools. Increasingly 4AFC (Four alternative forced choice) virtual clinical trials are used to compare detection performances of different breast imaging modalities. Most prior studies have used physicists and/or radiologists and physicists interchangeably. However, large scale use of statistically significant 4AFC observer studies is challenged by the individual time commitment and cost of such observers, often drawn from a limited local pool of specialists. This work aims to investigate whether non-specialist observers can be used to supplement such studies. A team of five specialist observers (medical physicists) and five non-specialists participated in a 4AFC study containing simulated 2D-mammography and DBT (digital breast tomosynthesis) images, produced using the OPTIMAM toolbox for VCTs. The images contained 4mm irregular solid masses and 4mm spherical targets at a range of contrast levels embedded in a realistic breast phantom background. There was no statistically significant difference between the detection performance of medical physicists and non-specialists (p>0.05). However, non-specialists took longer to complete the study than their physicist counterparts, which was statistically significant (p<0.05). Overall, the results from both observer groups indicate that DBT has a lower detectable threshold contrast than 2D-mammography for both masses and spheres, and both groups found spheres easier to detect than irregular solid masses.

  9. A Pilot Study to Evaluate California's Fossil Fuel CO2 Emissions Using Atmospheric Observations

    NASA Astrophysics Data System (ADS)

    Graven, H. D.; Fischer, M. L.; Lueker, T.; Guilderson, T.; Brophy, K. J.; Keeling, R. F.; Arnold, T.; Bambha, R.; Callahan, W.; Campbell, J. E.; Cui, X.; Frankenberg, C.; Hsu, Y.; Iraci, L. T.; Jeong, S.; Kim, J.; LaFranchi, B. W.; Lehman, S.; Manning, A.; Michelsen, H. A.; Miller, J. B.; Newman, S.; Paplawsky, B.; Parazoo, N.; Sloop, C.; Walker, S.; Whelan, M.; Wunch, D.

    2016-12-01

    Atmospheric CO2 concentration is influenced by human activities and by natural exchanges. Studies of CO2 fluxes using atmospheric CO2 measurements typically focus on natural exchanges and assume that CO2 emissions by fossil fuel combustion and cement production are well-known from inventory estimates. However, atmospheric observation-based or "top-down" studies could potentially provide independent methods for evaluating fossil fuel CO2 emissions, in support of policies to reduce greenhouse gas emissions and mitigate climate change. Observation-based estimates of fossil fuel-derived CO2 may also improve estimates of biospheric CO2 exchange, which could help to characterize carbon storage and climate change mitigation by terrestrial ecosystems. We have been developing a top-down framework for estimating fossil fuel CO2 emissions in California that uses atmospheric observations and modeling. California is implementing the "Global Warming Solutions Act of 2006" to reduce total greenhouse gas emissions to 1990 levels by 2020, and it has a diverse array of ecosystems that may serve as CO2 sources or sinks. We performed three month-long field campaigns in different seasons in 2014-15 to collect flask samples from a state-wide network of 10 towers. Using measurements of radiocarbon in CO2, we estimate the fossil fuel-derived CO2 present in the flask samples, relative to marine background air observed at coastal sites. Radiocarbon (14C) is not present in fossil fuel-derived CO2 because of radioactive decay over millions of years, so fossil fuel emissions cause a measurable decrease in the 14C/C ratio in atmospheric CO2. We compare the observations of fossil fuel-derived CO2 to simulations based on atmospheric modeling and published fossil fuel flux estimates, and adjust the fossil fuel flux estimates in a statistical inversion that takes account of several uncertainties. We will present the results of the top-down technique to estimate fossil fuel emissions for our field

  10. Ways of learning: Observational studies versus experiments

    USGS Publications Warehouse

    Shaffer, T.L.; Johnson, D.H.

    2008-01-01

    Manipulative experimentation that features random assignment of treatments, replication, and controls is an effective way to determine causal relationships. Wildlife ecologists, however, often must take a more passive approach to investigating causality. Their observational studies lack one or more of the 3 cornerstones of experimentation: controls, randomization, and replication. Although an observational study can be analyzed similarly to an experiment, one is less certain that the presumed treatment actually caused the observed response. Because the investigator does not actively manipulate the system, the chance that something other than the treatment caused the observed results is increased. We reviewed observational studies and contrasted them with experiments and, to a lesser extent, sample surveys. We identified features that distinguish each method of learning and illustrate or discuss some complications that may arise when analyzing results of observational studies. Findings from observational studies are prone to bias. Investigators can reduce the chance of reaching erroneous conclusions by formulating a priori hypotheses that can be pursued multiple ways and by evaluating the sensitivity of study conclusions to biases of various magnitudes. In the end, however, professional judgment that considers all available evidence is necessary to render a decision regarding causality based on observational studies.

  11. When the third party observer of a neuropsychological evaluation is an audio-recorder.

    PubMed

    Constantinou, Marios; Ashendorf, Lee; McCaffrey, Robert J

    2002-08-01

    The presence of third parties during neuropsychological evaluations is an issue of concern for contemporary neuropsychologists. Previous studies have reported that the presence of an observer during neuropsychological testing alters the performance of individuals under evaluation. The present study sought to investigate whether audio-recording affects the neuropsychological test performance of individuals in the same way that third party observation does. In the presence of an audio-recorder the performance of the participants on memory tests declined. Performance on motor tests, on the other hand, was not affected by the presence of an audio-recorder. The implications of these findings in forensic neuropsychological evaluations are discussed.

  12. Tip of the Tongue States Increase under Evaluative Observation

    ERIC Educational Resources Information Center

    James, Lori E.; Schmank, Christopher J.; Castro, Nichol; Buchanan, Tony W.

    2018-01-01

    We tested the frequent assumption that the difficulty of word retrieval increases when a speaker is being observed and evaluated. We modified the Trier Social Stress Test (TSST) so that participants believed that its evaluative observation components continued throughout the duration of a subsequent word retrieval task, and measured participants'…

  13. Empirical Performance of Covariates in Education Observational Studies

    ERIC Educational Resources Information Center

    Wong, Vivian C.; Valentine, Jeffrey C.; Miller-Bains, Kate

    2017-01-01

    This article summarizes results from 12 empirical evaluations of observational methods in education contexts. We look at the performance of three common covariate-types in observational studies where the outcome is a standardized reading or math test. They are: pretest measures, local geographic matching, and rich covariate sets with a strong…

  14. A multicentre observational study to evaluate a new tool to assess emergency physicians' non-technical skills.

    PubMed

    Flowerdew, Lynsey; Gaunt, Arran; Spedding, Jessica; Bhargava, Ajay; Brown, Ruth; Vincent, Charles; Woloshynowych, Maria

    2013-06-01

    To evaluate a new tool to assess emergency physicians' non-technical skills. This was a multicentre observational study using data collected at four emergency departments in England. A proportion of observations used paired observers to obtain data for inter-rater reliability. Data were also collected for test-retest reliability, observability of skills, mean ratings and dispersion of ratings for each skill, as well as a comparison of skill level between hospitals. Qualitative data described the range of non-technical skills exhibited by trainees and identified sources of rater error. 96 assessments of 43 senior trainees were completed. At a scale level, intra-class coefficients were 0.575, 0.532 and 0.419 and using mean scores were 0.824, 0.702 and 0.519. Spearman's ρ for calculating test-retest reliability was 0.70 using mean scores. All skills were observed more than 60% of the time. The skill Maintenance of Standards received the lowest mean rating (4.8 on a nine-point scale) and the highest mean was calculated for Team Building (6.0). Two skills, Supervision & Feedback and Situational Awareness-Gathering Information, had significantly different distributions of ratings across the four hospitals (p<0.04 and 0.007, respectively), and this appeared to be related to the leadership roles of trainees. This study shows the performance of the assessment tool is acceptable and provides valuable information to structure the assessment and training of non-technical skills, especially in relation to leadership. The framework of skills may be used to identify areas for development in individual trainees, as well as guide other patient safety interventions.

  15. Instructional Supervision: A Descriptive Study Focusing on the Observation and Evaluation of Teachers in Cyberschools

    ERIC Educational Resources Information Center

    Farley, Gregory Charles

    2010-01-01

    Since 1996, K-12 schools are increasingly moving from a traditional, face-to-face educational environment to an online learning environment utilizing technologies to deliver instruction primarily via the Internet. As this trend continues, administrators familiar with traditional supervisory methods will observe and evaluate teachers of online…

  16. Evaluation of Surface Flux Parameterizations with Long-Term ARM Observations

    DOE PAGES

    Liu, Gang; Liu, Yangang; Endo, Satoshi

    2013-02-01

    Surface momentum, sensible heat, and latent heat fluxes are critical for atmospheric processes such as clouds and precipitation, and are parameterized in a variety of models ranging from cloud-resolving models to large-scale weather and climate models. However, direct evaluation of the parameterization schemes for these surface fluxes is rare due to limited observations. This study takes advantage of the long-term observations of surface fluxes collected at the Southern Great Plains site by the Department of Energy Atmospheric Radiation Measurement program to evaluate the six surface flux parameterization schemes commonly used in the Weather Research and Forecasting (WRF) model and threemore » U.S. general circulation models (GCMs). The unprecedented 7-yr-long measurements by the eddy correlation (EC) and energy balance Bowen ratio (EBBR) methods permit statistical evaluation of all six parameterizations under a variety of stability conditions, diurnal cycles, and seasonal variations. The statistical analyses show that the momentum flux parameterization agrees best with the EC observations, followed by latent heat flux, sensible heat flux, and evaporation ratio/Bowen ratio. The overall performance of the parameterizations depends on atmospheric stability, being best under neutral stratification and deteriorating toward both more stable and more unstable conditions. Further diagnostic analysis reveals that in addition to the parameterization schemes themselves, the discrepancies between observed and parameterized sensible and latent heat fluxes may stem from inadequate use of input variables such as surface temperature, moisture availability, and roughness length. The results demonstrate the need for improving the land surface models and measurements of surface properties, which would permit the evaluation of full land surface models.« less

  17. An observational study to evaluate the clinical practice of cardiovascular risk management among hypertensive patients in Turkey.

    PubMed

    Kozan, Omer

    2011-09-01

    We evaluated clinical practice in cardiovascular risk management and related patient compliance among Turkish hypertensive patients. This noninterventional, observational study included 1023 patients (620 women, 403 men; mean age 58.4 ± 10.6 years) with essential hypertension, from 50 centers across Turkey. Patients were evaluated at a cross-sectional phase and a follow-up phase of nine months. Data obtained at the cross-sectional phase included patient demographics, medical and past history, cardiovascular risk status, and current practice patterns regarding cardiovascular risk management. The mean duration of hypertension was 8.1 ± 7.1 years. The mean body mass index was 30.3 ± 5.2 kg/m2 and systolic and diastolic blood pressures (BP) were 147.8 ± 22.4 and 88.9 ± 12.5 mmHg, respectively. Ten-year coronary heart disease risk and risk level were significantly higher in males, and significantly increased in the presence of diabetes, metabolic syndrome, and renal disease and/or microalbuminuria (p<0.05). In past year history of cardiovascular risk management, 7.3% of the patients did not have BP measurements; no diet was recommended to 15.6%; 79.3% had high BP levels, and patient compliance with antihypertensive drug treatment and dietary recommendations were 87.7% and 62.5%, respectively. A similar profile was observed for dyslipidemia and diabetes mellitus. The physicians' efforts to motivate the patients to quit smoking, to lose weight, and involve in physical exercise were far below satisfactory levels, and the patients' compliance rates with these recommendations were even lower. Our study demonstrates that hypertensive patients are not adequately evaluated for cardiovascular risk, which is significantly increased in the presence of various cardiovascular risk factors such as diabetes, metabolic syndrome, and renal disease.

  18. Peer Observation Reports and Student Evaluations of Teaching: Who Are the Experts?

    ERIC Educational Resources Information Center

    Ackerman, David; Gross, Barbara L.; Vigneron, Franck

    2009-01-01

    This study is an exploratory inquiry into the perceptions of university faculty regarding two forms of teaching evaluations, student evaluations of teaching (SET), and peer observation reports (POR). Which, if either, better assesses the quality of instruction? Who are the real experts in judging teaching quality: peers who are experts in their…

  19. A Regional Climate Model Evaluation System based on Satellite and other Observations

    NASA Astrophysics Data System (ADS)

    Lean, P.; Kim, J.; Waliser, D. E.; Hall, A. D.; Mattmann, C. A.; Granger, S. L.; Case, K.; Goodale, C.; Hart, A.; Zimdars, P.; Guan, B.; Molotch, N. P.; Kaki, S.

    2010-12-01

    Regional climate models are a fundamental tool needed for downscaling global climate simulations and projections, such as those contributing to the Coupled Model Intercomparison Projects (CMIPs) that form the basis of the IPCC Assessment Reports. The regional modeling process provides the means to accommodate higher resolution and a greater complexity of Earth System processes. Evaluation of both the global and regional climate models against observations is essential to identify model weaknesses and to direct future model development efforts focused on reducing the uncertainty associated with climate projections. However, the lack of reliable observational data and the lack of formal tools are among the serious limitations to addressing these objectives. Recent satellite observations are particularly useful as they provide a wealth of information on many different aspects of the climate system, but due to their large volume and the difficulties associated with accessing and using the data, these datasets have been generally underutilized in model evaluation studies. Recognizing this problem, NASA JPL / UCLA is developing a model evaluation system to help make satellite observations, in conjunction with in-situ, assimilated, and reanalysis datasets, more readily accessible to the modeling community. The system includes a central database to store multiple datasets in a common format and codes for calculating predefined statistical metrics to assess model performance. This allows the time taken to compare model simulations with satellite observations to be reduced from weeks to days. Early results from the use this new model evaluation system for evaluating regional climate simulations over California/western US regions will be presented.

  20. Observational Studies on Evaluating the Safety and Adverse Effects of Traditional Chinese Medicine

    PubMed Central

    Tang, Jin-Ling; Wang, Jung-Der

    2013-01-01

    Background. This study aims to share our experiences when carrying out observational studies of traditional Chinese medicine (TCM). Methods. We have proactively monitored the safety profiles of Duhuo Jisheng Tang (DJT), Suan Zao Ren Tang (SZRT), and TMN-1. A list of adverse events (AEs), complete blood counts, and liver and kidney function tests were obtained from the participants during their scheduled hospital visits. Retrospective observational studies were conducted based on the reimbursement database of the National Health Insurance system, Taiwan, to explore the relationship between the use of TCM that have been adulterated by aristolochic acid and the risk from both nephrotoxins and carcinogens. Results. A total of 221, 287, and 203 AEs were detected after SZRT, DJT, and TMN-1 had been taken, respectively. Dizziness, headache, stomach ache, and diarrhea were judged to be probably related to SZRT treatment. Retrospective observational studies found an association between the consumption of aristolochic acid-containing Chinese formulae such as Mu Tong and an increased risk of CKD, ESRD, and urinary tract cancer. Conclusion. Prospective and retrospective observational studies seem to have specific advantages when investigating the safety and adverse effects of TCM therapies, as well as possibly other alternative/complementary therapies. PMID:24159351

  1. Do health economic evaluations using observational data provide reliable assessment of treatment effects?

    PubMed Central

    2013-01-01

    Economic evaluation in modern health care systems is seen as a transparent scientific framework that can be used to advance progress towards improvements in population health at the best possible value. Despite the perceived superiority that trial-based studies have in terms of internal validity, economic evaluations often employ observational data. In this review, the interface between econometrics and economic evaluation is explored, with emphasis placed on highlighting methodological issues relating to the evaluation of cost-effectiveness within a bivariate framework. Studies that satisfied the eligibility criteria exemplified the use of matching, regression analysis, propensity scores, instrumental variables, as well as difference-in-differences approaches. All studies were reviewed and critically appraised using a structured template. The findings suggest that although state-of-the-art econometric methods have the potential to provide evidence on the causal effects of clinical and policy interventions, their application in economic evaluation is subject to a number of limitations. These range from no credible assessment of key assumptions and scarce evidence regarding the relative performance of different methods, to lack of reporting of important study elements, such as a summary outcome measure and its associated sampling uncertainty. Further research is required to better understand the ways in which observational data should be analysed in the context of the economic evaluation framework. PMID:24229445

  2. [Inferential evaluation of intimacy based on observation of interpersonal communication].

    PubMed

    Kimura, Masanori

    2015-06-01

    How do people inferentially evaluate others' levels of intimacy with friends? We examined the inferential evaluation of intimacy based on the observation of interpersonal communication. In Experiment 1, participants (N = 41) responded to questions after observing conversations between friends. Results indicated that participants inferentially evaluated not only goodness of communication, but also intimacy between friends, using an expressivity heuristic approach. In Experiment 2, we investigated how inferential evaluation of intimacy was affected by prior information about relationships and by individual differences in face-to-face interactional ability. Participants (N = 64) were divided into prior- and no-prior-information groups and all performed the same task as in Experiment 1. Additionally, their interactional ability was assessed. In the prior-information group, individual differences had no effect on inferential evaluation of intimacy. On the other hand, in the no-prior-information group, face-to-face interactional ability partially influenced evaluations of intimacy. Finally, we discuss the fact that to understand one's social environment, it is important to observe others' interpersonal communications.

  3. Does design matter? Systematic evaluation of the impact of analytical choices on effect estimates in observational studies

    PubMed Central

    Ryan, Patrick B.; Schuemie, Martijn

    2013-01-01

    Background: Clinical studies that use observational databases, such as administrative claims and electronic health records, to evaluate the effects of medical products have become commonplace. These studies begin by selecting a particular study design, such as a case control, cohort, or self-controlled design, and different authors can and do choose different designs for the same clinical question. Furthermore, published papers invariably report the study design but do not discuss the rationale for the specific choice. Studies of the same clinical question with different designs, however, can generate different results, sometimes with strikingly different implications. Even within a specific study design, authors make many different analytic choices and these too can profoundly impact results. In this paper, we systematically study heterogeneity due to the type of study design and due to analytic choices within study design. Methods and findings: We conducted our analysis in 10 observational healthcare databases but mostly present our results in the context of the GE Centricity EMR database, an electronic health record database containing data for 11.2 million lives. We considered the impact of three different study design choices on estimates of associations between bisphosphonates and four particular health outcomes for which there is no evidence of an association. We show that applying alternative study designs can yield discrepant results, in terms of direction and significance of association. We also highlight that while traditional univariate sensitivity analysis may not show substantial variation, systematic assessment of all analytical choices within a study design can yield inconsistent results ranging from statistically significant decreased risk to statistically significant increased risk. Our findings show that clinical studies using observational databases can be sensitive both to study design choices and to specific analytic choices within study

  4. Propensity Score Estimation With Boosted Regression for Evaluating Causal Effects in Observational Studies

    ERIC Educational Resources Information Center

    McCaffrey, Daniel F.; Ridgeway, Greg; Morral, Andrew R.

    2004-01-01

    Causal effect modeling with naturalistic rather than experimental data is challenging. In observational studies participants in different treatment conditions may also differ on pretreatment characteristics that influence outcomes. Propensity score methods can theoretically eliminate these confounds for all observed covariates, but accurate…

  5. Observational studies are complementary to randomized controlled trials.

    PubMed

    Grootendorst, Diana C; Jager, Kitty J; Zoccali, Carmine; Dekker, Friedo W

    2010-01-01

    Randomized controlled trials (RCTs) are considered the gold standard study design to investigate the effect of health interventions, including treatment. However, in some situations, it may be unnecessary, inappropriate, impossible, or inadequate to perform an RCT. In these special situations, well-designed observational studies, including cohort and case-control studies, may provide an alternative to doing nothing in order to obtain estimates of treatment effect. It should be noted that such studies should be performed with caution and correctly. The aims of this review are (1) to explain why RCTs are considered the optimal study design to evaluate treatment effects, (2) to describe the situations in which an RCT is not possible and observational studies are an adequate alternative, and (3) to explain when randomization is not needed and can be approximated in observational studies. Examples from the nephrology literature are used for illustration. Copyright 2009 S. Karger AG, Basel.

  6. Administrators' Perceptions Regarding the Effectiveness of the Teacher Observation Evaluation System

    ERIC Educational Resources Information Center

    Williams, Kathleen Riley

    2015-01-01

    This phenomenological narrative study was designed to explore public school administrators' perceptions regarding Louisiana's Compass teacher observation evaluation system as a method for assessing teacher performance. Participants were administrators with at least two years of experience as a public school administrator at the secondary level,…

  7. The value of including observational studies in systematic reviews was unclear: a descriptive study.

    PubMed

    Seida, Jennifer; Dryden, Donna M; Hartling, Lisa

    2014-12-01

    To evaluate (1) how often observational studies are included in comparative effectiveness reviews (CERs); (2) the rationale for including observational studies; (3) how data from observational studies are appraised, analyzed, and graded; and (4) the impact of observational studies on strength of evidence (SOE) and conclusions. Descriptive study of 23 CERs published through the Effective Health Care Program of the U.S. Agency for Healthcare Research and Quality. Authors searched for observational studies in 20 CERs, of which 18 included a median of 11 (interquartile range, 2-31) studies. Sixteen CERs incorporated the observational studies in their SOE assessments. Seventy-eight comparisons from 12 CERs included evidence from both trials and observational studies; observational studies had an impact on SOE and conclusions for 19 (24%) comparisons. There was diversity across the CERs regarding decisions to include observational studies; study designs considered; and approaches used to appraise, synthesize, and grade SOE. Reporting and methods guidance are needed to ensure clarity and consistency in how observational studies are incorporated in CERs. It was not always clear that observational studies added value in light of the additional resources needed to search for, select, appraise, and analyze such studies. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. From randomized controlled trials to observational studies.

    PubMed

    Silverman, Stuart L

    2009-02-01

    Randomized controlled trials are considered the gold standard in the hierarchy of research designs for evaluating the efficacy and safety of a treatment intervention. However, their results can have limited applicability to patients in clinical settings. Observational studies using large health care databases can complement findings from randomized controlled trials by assessing treatment effectiveness in patients encountered in day-to-day clinical practice. Results from these designs can expand upon outcomes of randomized controlled trials because of the use of larger and more diverse patient populations with common comorbidities and longer follow-up periods. Furthermore, well-designed observational studies can identify clinically important differences among therapeutic options and provide data on long-term drug effectiveness and safety.

  9. Reporting of methodological features in observational studies of pre-harvest food safety.

    PubMed

    Sargeant, Jan M; O'Connor, Annette M; Renter, David G; Kelton, David F; Snedeker, Kate; Wisener, Lee V; Leonard, Erin K; Guthrie, Alessia D; Faires, Meredith

    2011-02-01

    Observational studies in pre-harvest food safety may be useful for identifying risk factors and for evaluating potential mitigation strategies to reduce foodborne pathogens. However, there are no structured reporting guidelines for these types of study designs in livestock species. Our objective was to evaluate the reporting of observational studies in the pre-harvest food safety literature using guidelines modified from the human healthcare literature. We identified 100 pre-harvest food safety studies published between 1999 and 2009. Each study was evaluated independently by two reviewers using a structured checklist. Of the 38 studies that explicitly stated the observational study design, 27 were described as cross-sectional studies, eight as case-control studies, and three as cohort studies. Study features reported in over 75% of the selected studies included: description of the geographic location of the studies, definitions and sources of data for outcomes, organizational level and source of data for independent variables, description of statistical methods and results, number of herds enrolled in the study and included in the analysis, and sources of study funding. However, other features were not consistently reported, including details related to eligibility criteria for groups (such as barn, room, or pen) and individuals, numbers of groups and individuals included in various stages of the study, identification of primary outcomes, the distinction between putative risk factors and confounding variables, the identification of a primary exposure variable, the referent level for evaluation of categorical variable associations, methods of controlling confounding variables and missing variables, model fit, details of subset analysis, demographic information at the sampling unit level, and generalizability of the study results. Improvement in reporting of observational studies of pre-harvest food safety will aid research readers and reviewers in interpreting and

  10. Balancing the Role of Priors in Multi-Observer Segmentation Evaluation

    PubMed Central

    Huang, Xiaolei; Wang, Wei; Lopresti, Daniel; Long, Rodney; Antani, Sameer; Xue, Zhiyun; Thoma, George

    2009-01-01

    Comparison of a group of multiple observer segmentations is known to be a challenging problem. A good segmentation evaluation method would allow different segmentations not only to be compared, but to be combined to generate a “true” segmentation with higher consensus. Numerous multi-observer segmentation evaluation approaches have been proposed in the literature, and STAPLE in particular probabilistically estimates the true segmentation by optimal combination of observed segmentations and a prior model of the truth. An Expectation–Maximization (EM) algorithm, STAPLE’S convergence to the desired local minima depends on good initializations for the truth prior and the observer-performance prior. However, accurate modeling of the initial truth prior is nontrivial. Moreover, among the two priors, the truth prior always dominates so that in certain scenarios when meaningful observer-performance priors are available, STAPLE can not take advantage of that information. In this paper, we propose a Bayesian decision formulation of the problem that permits the two types of prior knowledge to be integrated in a complementary manner in four cases with differing application purposes: (1) with known truth prior; (2) with observer prior; (3) with neither truth prior nor observer prior; and (4) with both truth prior and observer prior. The third and fourth cases are not discussed (or effectively ignored) by STAPLE, and in our research we propose a new method to combine multiple-observer segmentations based on the maximum a posterior (MAP) principle, which respects the observer prior regardless of the availability of the truth prior. Based on the four scenarios, we have developed a web-based software application that implements the flexible segmentation evaluation framework for digitized uterine cervix images. Experiment results show that our framework has flexibility in effectively integrating different priors for multi-observer segmentation evaluation and it also

  11. Obs4MIPS: Satellite Observations for Model Evaluation

    NASA Astrophysics Data System (ADS)

    Ferraro, R.; Waliser, D. E.; Gleckler, P. J.

    2017-12-01

    This poster will review the current status of the obs4MIPs project, whose purpose is to provide a limited collection of well-established and documented datasets for comparison with Earth system models (https://www.earthsystemcog.org/projects/obs4mips/). These datasets have been reformatted to correspond with the CMIP5 model output requirements, and include technical documentation specifically targeted for their use in model output evaluation. The project holdings now exceed 120 datasets with observations that directly correspond to CMIP5 model output variables, with new additions in response to the CMIP6 experiments. With the growth in climate model output data volume, it is increasing more difficult to bring the model output and the observations together to do evaluations. The positioning of the obs4MIPs datasets within the Earth System Grid Federation (ESGF) allows for the use of currently available and planned online tools within the ESGF to perform analysis using model output and observational datasets without necessarily downloading everything to a local workstation. This past year, obs4MIPs has updated its submission guidelines to closely align with changes in the CMIP6 experiments, and is implementing additional indicators and ancillary data to allow users to more easily determine the efficacy of an obs4MIPs dataset for specific evaluation purposes. This poster will present the new guidelines and indicators, and update the list of current obs4MIPs holdings and their connection to the ESGF evaluation and analysis tools currently available, and being developed for the CMIP6 experiments.

  12. Evaluation of team lifting on work demands, workload and workers' evaluation: an observational field study.

    PubMed

    Visser, Steven; van der Molen, Henk F; Kuijer, P Paul F M; Hoozemans, Marco J M; Frings-Dresen, Monique H W

    2014-11-01

    The objective of this study was to assess differences in work demands, energetic workload and workers' discomfort and physical effort in two regularly observable workdays in ironwork; one where loads up to 50kg were handled with two persons manually (T50) and one where loads up to 100kg were handled manually with four persons (T100). Differences between these typical workdays were assessed with an observational within-subject field study of 10 ironworkers. No significant differences were found for work demands, energetic workload or discomfort between T50 and T100 workdays. During team lifts, load mass exceeded 25kg per person in 57% (T50 workday) and 68% (T100 workday) of the lifts. Seven ironworkers rated team lifting with two persons as less physically demanding compared with lifting with four persons. When loads heavier than 25kg are lifted manually with a team, regulations of the maximum mass weight are frequently violated. Loads heavier than 25kg are frequently lifted during concrete reinforcement work and should be lifted by a team of persons. However, the field study showed that loads above 25kg are most of the time not lifted with the appropriate number of workers. Therefore, loads heavier than 25kg should be lifted mechanically. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  13. 30 CFR 14.3 - Observers at tests and evaluations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Observers at tests and evaluations. 14.3 Section 14.3 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR TESTING, EVALUATION, AND APPROVAL OF MINING PRODUCTS REQUIREMENTS FOR THE APPROVAL OF FLAME-RESISTANT CONVEYOR BELTS...

  14. Reliability and Validity of Observational Risk Screening in Evaluating Dynamic Knee Valgus

    PubMed Central

    Ekegren, Christina L.; Miller, William C.; Celebrini, Richard G.; Eng, Janice J.; MacIntyre, Donna L.

    2012-01-01

    Study Design Nonexperimental methodological study. Objectives To determine the interrater and intrarater reliability and validity of using observational risk screening guidelines to evaluate dynamic knee valgus. Background A deficiency in the neuromuscular control of the hip has been identified as a key risk factor for non-contact anterior cruciate ligament (ACL) injury in post pubescent females. This deficiency can manifest itself as a valgus knee alignment during tasks involving hip and knee flexion. There are currently no scientifically tested methods to screen for dynamic knee valgus in the clinic or on the field. Methods Three physiotherapists used observational risk screening guidelines to rate 40 adolescent female soccer players according to their risk of ACL injury. The rating was based on the amount of dynamic knee valgus observed on a drop jump landing. Ratings were evaluated for intrarater and interrater agreement using kappa coefficients. Sensitivity and specificity of ratings were evaluated by comparing observational ratings with measurements obtained using 3-dimensional (3D) motion analysis. Results Kappa coefficients for intrarater and interrater agreement ranged from 0.75 to 0.85, indicating that ratings were reasonably consistent over time and between physiotherapists. Sensitivity values were inadequate, ranging from 67–87%. This indicated that raters failed to detect up to a third of “truly high risk” individuals. Specificity values ranged from 60–72% which was considered adequate for the purposes of the screen. Conclusion Observational risk screening is a practical and cost-effective method of screening for ACL injury risk. Rater agreement and specificity were acceptable for this method but sensitivity was not. To detect a greater proportion of individuals at risk of ACL injury, coaches and clinicians should ensure that they include additional tests for other high risk characteristics in their screening protocols. PMID:19721212

  15. Observational uncertainty and regional climate model evaluation: A pan-European perspective

    NASA Astrophysics Data System (ADS)

    Kotlarski, Sven; Szabó, Péter; Herrera, Sixto; Räty, Olle; Keuler, Klaus; Soares, Pedro M.; Cardoso, Rita M.; Bosshard, Thomas; Pagé, Christian; Boberg, Fredrik; Gutiérrez, José M.; Jaczewski, Adam; Kreienkamp, Frank; Liniger, Mark. A.; Lussana, Cristian; Szepszo, Gabriella

    2017-04-01

    Local and regional climate change assessments based on downscaling methods crucially depend on the existence of accurate and reliable observational reference data. In dynamical downscaling via regional climate models (RCMs) observational data can influence model development itself and, later on, model evaluation, parameter calibration and added value assessment. In empirical-statistical downscaling, observations serve as predictand data and directly influence model calibration with corresponding effects on downscaled climate change projections. Focusing on the evaluation of RCMs, we here analyze the influence of uncertainties in observational reference data on evaluation results in a well-defined performance assessment framework and on a European scale. For this purpose we employ three different gridded observational reference grids, namely (1) the well-established EOBS dataset (2) the recently developed EURO4M-MESAN regional re-analysis, and (3) several national high-resolution and quality-controlled gridded datasets that recently became available. In terms of climate models five reanalysis-driven experiments carried out by five different RCMs within the EURO-CORDEX framework are used. Two variables (temperature and precipitation) and a range of evaluation metrics that reflect different aspects of RCM performance are considered. We furthermore include an illustrative model ranking exercise and relate observational spread to RCM spread. The results obtained indicate a varying influence of observational uncertainty on model evaluation depending on the variable, the season, the region and the specific performance metric considered. Over most parts of the continent, the influence of the choice of the reference dataset for temperature is rather small for seasonal mean values and inter-annual variability. Here, model uncertainty (as measured by the spread between the five RCM simulations considered) is typically much larger than reference data uncertainty. For

  16. Observational studies and the difficult quest for causality: lessons from vaccine effectiveness and impact studies.

    PubMed

    Lipsitch, Marc; Jha, Ayan; Simonsen, Lone

    2016-12-01

    Although randomized placebo-controlled trials (RCT) are critical to establish efficacy of vaccines at the time of licensure, important remaining questions about vaccine effectiveness (VE)-used here to include individual-level measures and population-wide impact of vaccine programmes-can only be answered once the vaccine is in use, from observational studies. However, such studies are inherently at risk for bias. Using a causal framework and illustrating with examples, we review newer approaches to detecting and avoiding confounding and selection bias in three major classes of observational study design: cohort, case-control and ecological studies. Studies of influenza VE, especially in seniors, are an excellent demonstration of the challenges of detecting and reducing such bias, and so we use influenza VE as a running example. We take a fresh look at the time-trend studies often dismissed as 'ecological'. Such designs are the only observational study design that can measure the overall effect of a vaccination programme [indirect (herd) as well as direct effects], and are in fact already an important part of the evidence base for several vaccines currently in use. Despite the great strides towards more robust observational study designs, challenges lie ahead for evaluating best practices for achieving robust unbiased results from observational studies. This is critical for evaluation of national and global vaccine programme effectiveness. © The Author 2016; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

  17. Development of a Peer Teaching-Assessment Program and a Peer Observation and Evaluation Tool

    PubMed Central

    Trujillo, Jennifer M.; Barr, Judith; Gonyeau, Michael; Van Amburgh, Jenny A.; Matthews, S. James; Qualters, Donna

    2008-01-01

    Objectives To develop a formalized, comprehensive, peer-driven teaching assessment program and a valid and reliable assessment tool. Methods A volunteer taskforce was formed and a peer-assessment program was developed using a multistep, sequential approach and the Peer Observation and Evaluation Tool (POET). A pilot study was conducted to evaluate the efficiency and practicality of the process and to establish interrater reliability of the tool. Intra-class correlation coefficients (ICC) were calculated. Results ICCs for 8 separate lectures evaluated by 2-3 observers ranged from 0.66 to 0.97, indicating good interrater reliability of the tool. Conclusion Our peer assessment program for large classroom teaching, which includes a valid and reliable evaluation tool, is comprehensive, feasible, and can be adopted by other schools of pharmacy. PMID:19325963

  18. Modified directly observed treatment for tuberculosis versus self-administered therapy: an observational study in rural Greece.

    PubMed

    Charokopos, N; Tsiros, G; Foka, A; Voila, P; Chrysanthopoulos, K; Spiliopoulou, I; Jelastopulu, E

    2013-01-01

    Directly Observed Treatment (DOT) is the key element of DOTS (directly observed treatment, short course), part of the internationally recommended control strategy for tuberculosis (TB). The evaluation of DOT has not been widely evaluated in rural areas in developed settings. The aim of this pilot study was to evaluate a modified DOT program (MDOT) by a general practitioner (GP) in a rural area of southwest Greece, where there is substantial underreporting of TB cases. Thirteen new TB cases with 30 close contacts were compared with 41 past-treated TB subjects (controls) with 111 close contacts in this observational, case-control study. Home visits by a GP were conducted and comparison of various data (laboratory findings, treatment outcomes, questionnaire-based parameters, on-site recorded conditions) was performed in both newly detected pulmonary TB cases and previously treated TB cases managed without DOT intervention. MDOT by GP implementation revealed that 11 cases (84.6%) were successfully treated, one (7.7%) case died, and one (7.7%) was lost to follow up. None of the close contacts of new TB cases was infected with active TB, while 6.3% of previously-treated TB subjects were infected with active TB and had to receive a complete anti-TB regimen. Chemoprophylaxis was administered to 13.3% of close contacts of new cases; whereas 12.6% of close contacts of previously-treated patients received chemoprophylaxis. This pilot study revealed that a GP is able to implement a program based on DOT resulting in high treatment adherence and prevention of TB compared with the conventional self-administration of treatment.

  19. Complications of local anaesthesia. An observational study.

    PubMed

    Brand, H S; Bekker, W; Baart, J A

    2009-11-01

    Local anaesthesia is increasingly used by dental hygienists. As little is known about the incidence of adverse effects during and after the administration of local anaesthetics, we evaluated side-effects associated with local anaesthesia. A prospective observational study was conducted using standard criteria among a group of 103 patients receiving mandibular block anaesthesia. Physical reactions like clenching fists (14.5%), moaning (12.6%) and turning pale (7.8%) were frequently observed. Patients (3.8%) showed a painful reaction because of needle contact with a nerve or the periosteum. Systemic complications were not observed. After the injection, 41.7% said they felt tense during the administration; 4.9% of the patients reported swallowing problems and 3.9% a tachycardia. These results suggest that administration of local anaesthesia has a small risk of adverse events. Complications, if they occur, seem minor and transient in nature.

  20. NORTHERN OHIO AEROSOL STUDY: STAPHYLOCOCCUS AUREUS EVALUATION

    EPA Science Inventory

    A consortium of Universities, located in northwest Ohio have received funds to conduct a comprehensive evaluation of land applied biosolids in that state. This USDA funded study includes observing land application practices and evaluating biosolids, soils, runoff water and bioaer...

  1. A Focused Observation Tool Using Dreyfus Stages of Skill Acquisition as an Evaluative Scale.

    PubMed

    Driver, Richard; Grose, Brian; Serafini, Mario; Cottrell, Scott; Sizemore, Daniel; Vallejo, Manuel

    2017-01-01

    Focused Observartion (FO) is associated with assessing complex skills and differs from generalized observations and evaluations. We've developed a FO assessing clinical procedural skills using Hubert Dreyfus Stages of Skill Acquisition as descriptive anchors. This study sought to analyze the effectiveness of this measure of skill progression. During week 1 and week 4 of training, FO was performed repetitively on 6 residents during endotracheal intubation. Skill stage ratings were converted to numerical scores. A dependent, paired samples t-test was calculated using total mean score (dependent variable) and an effect size. (Cohen's d) was performed to ascertain the standardized mean difference between observations. A significant improvement in mean scores occurred between Week 1 (AVG 1.2, STDV ± 0.1) and Week 4 (AVG 2.0, STDV ± 0.1) (t= -3.9, p<.05) Calculated Chohen's d indicates that this difference was meaningful. This study demonstrates success in adapting a Focused Observation technique and an innovative evaluative scale based upon Dreyfus stages of skill acquisition.

  2. Multi-phenomenology Observation Network Evaluation Tool'' (MONET)

    NASA Astrophysics Data System (ADS)

    Oltrogge, D.; North, P.; Vallado, D.

    2014-09-01

    Evaluating overall performance of an SSA "system-of-systems" observational network collecting against thousands of Resident Space Objects (RSO) is very difficult for typical tasking or scheduling-based analysis tools. This is further complicated by networks that have a wide variety of sensor types and phenomena, to include optical, radar and passive RF types, each having unique resource, ops tempo, competing customer and detectability constraints. We present details of the Multi-phenomenology Observation Network Evaluation Tool (MONET), which circumvents these difficulties by assessing the ideal performance of such a network via a digitized supply-vs-demand approach. Cells of each sensors supply time are distributed among RSO targets of interest to determine the average performance of the network against that set of RSO targets. Orbit Determination heuristics are invoked to represent observation quantity and geometry notionally required to obtain the desired orbit estimation quality. To feed this approach, we derive the detectability and collection rate performance of optical, radar and passive RF sensor physical and performance characteristics. We then prioritize the selected RSO targets according to object size, active/inactive status, orbit regime, and/or other considerations. Finally, the OD-derived tracking demands of each RSO of interest are levied against remaining sensor supply until either (a) all sensor time is exhausted; or (b) the list of RSO targets is exhausted. The outputs from MONET include overall network performance metrics delineated by sensor type, objects and orbits tracked, along with likely orbit accuracies which might result from the conglomerate network tracking.

  3. [Quality analysis of observational studies on pelvic organ prolapse in China].

    PubMed

    Wang, Y T; Tao, L Y; He, H J; Han, J S

    2017-06-25

    Objective: To evaluate the quality of observational studies on pelvic organ prolapse in China. Methods: The checklist of strengthening the reporting of observational studies in epidemiology (STROBE) statement was applied to evaluate the observational studies. The articles were searched in the SinoMed database using the terms: prolapse, uterine prolapse, cystocele, rectal prolapse and pelvic floor; limited to Chinese core journals in obstetrics and gynecology from January 1996 to December 2015. With two 10-year groups (1996-2005 and 2006-2015), the χ(2) test was used to evaluate inter-group differences. Results: (1) A total of 386 observational studies were selected, including 15.5%(60/386) of case-control studies, 80.6%(311/386) of cohort studies and 3.9% (15/386) of cross-sectional studies. (2) There were totally 22 items including 34 sub-items in the checklist. There were 17 sub-items (50.0%, 17/34) had a reporting ratio less than 50% in all of aticles, including: 1a (study's design) 3.9% (15/386), 6a (participants) 24.6% (95/386), 6b (matched studies) 0 (0/386), 9 (bias) 8.3% (32/386), 10 (study size) 3.9%, 11 (quantitative variables) 41.2% (159/386), 12b-12e (statistical methods in detail) 0-2.6% (10/386), 13a (numbers of individuals at each stage of study) 18.9% (73/386), 13b (reasons for non-participation at each stage) 18.9%, 13c (flow diagram) 0, 16b and 16c (results of category boundaries and relative risk) 9.6% (37/386) and 0, 19 (limitations) 31.6% (122/386), 22 (funding) 20.5% (79/386). (3) The quality of articles published in the two decades (1996-2005 and 2006-2015) were compared, and 38.2%(13/34) of sub-items had been significantly improved in the second 10-year (all P< 0.05). The improved items were as follows: 1b (integrity of abstract), 2 (background/rationale), 6a (participants), 7 (variables), 8 (data sources/measurement), 9 (bias), 11 (quantitative variables), 12a (statistical methods), 17 (other analyses), 18 (key results), 19 (limitations

  4. The NOAA Satellite Observing System Architecture Study

    NASA Technical Reports Server (NTRS)

    Volz, Stephen; Maier, Mark; Di Pietro, David

    2016-01-01

    NOAA is beginning a study, the NOAA Satellite Observing System Architecture (NSOSA) study, to plan for the future operational environmental satellite system that will follow GOES and JPSS, beginning about 2030. This is an opportunity to design a modern architecture with no pre-conceived notions regarding instruments, platforms, orbits, etc. The NSOSA study will develop and evaluate architecture alternatives to include partner and commercial alternatives that are likely to become available. The objectives will include both functional needs and strategic characteristics (e.g., flexibility, responsiveness, sustainability). Part of this study is the Space Platform Requirements Working Group (SPRWG), which is being commissioned by NESDIS. The SPRWG is charged to assess new or existing user needs and to provide relative priorities for observational needs in the context of the future architecture. SPRWG results will serve as input to the process for new foundational (Level 0 and Level 1) requirements for the next generation of NOAA satellites that follow the GOES-R, JPSS, DSCOVR, Jason-3, and COSMIC-2 missions.

  5. Non-technical skills evaluation in the critical care air ambulance environment: introduction of an adapted rating instrument--an observational study.

    PubMed

    Myers, Julia A; Powell, David M C; Psirides, Alex; Hathaway, Karyn; Aldington, Sarah; Haney, Michael F

    2016-03-08

    In the isolated and dynamic health-care setting of critical care air ambulance transport, the quality of clinical care is strongly influenced by non-technical skills such as anticipating, recognising and understanding, decision making, and teamwork. However there are no published reports identifying or applying a non-technical skills framework specific to an intensive care air ambulance setting. The objective of this study was to adapt and evaluate a non-technical skills rating framework for the air ambulance clinical environment. In the first phase of the project the anaesthetists' non-technical skills (ANTS) framework was adapted to the air ambulance setting, using data collected directly from clinician groups, published literature, and field observation. In the second phase experienced and inexperienced inter-hospital transport clinicians completed a simulated critical care air transport scenario, and their non-technical skills performance was independently rated by two blinded assessors. Observed and self-rated general clinical performance ratings were also collected. Rank-based statistical tests were used to examine differences in the performance of experienced and inexperienced clinicians, and relationships between different assessment approaches and assessors. The framework developed during phase one was referred to as an aeromedical non-technical skills framework, or AeroNOTS. During phase two 16 physicians from speciality training programmes in intensive care, emergency medicine and anaesthesia took part in the clinical simulation study. Clinicians with inter-hospital transport experience performed more highly than those without experience, according to both AeroNOTS non-technical skills ratings (p = 0.001) and general performance ratings (p = 0.003). Self-ratings did not distinguish experienced from inexperienced transport clinicians (p = 0.32) and were not strongly associated with either observed general performance (r(s) = 0.4, p = 0

  6. The importance of standardized observations to evaluate nutritional care quality in the survey process.

    PubMed

    Schnelle, John F; Bertrand, Rosanna; Hurd, Donna; White, Alan; Squires, David; Feuerberg, Marvin; Hickey, Kelly; Simmons, Sandra F

    2009-10-01

    Guidelines written for government surveyors who assess nursing home (NH) compliance with federal standards contain instructions to observe the quality of mealtime assistance. However, these instructions are vague and no protocol is provided for surveyors to record observational data. This study compared government survey staff observations of mealtime assistance quality to observations by research staff using a standardized protocol that met basic standards for accurate behavioral measurement. Survey staff used either the observation instructions in the standard survey process or those written for the revised Quality Improvement Survey (QIS). Trained research staff observed mealtime care in 20 NHs in 5 states during the same time period that survey staff evaluated care in the same facilities, although it could not be determined if survey and research staff observed the same residents during the same meals. Ten NHs were evaluated by government surveyors using the QIS survey instructions and 10 NHs were evaluated by surveyors using the standard survey instructions. Research staff observations using a standardized observation protocol identified a higher proportion of residents receiving inadequate feeding assistance during meals relative to survey staff using either the standard or QIS survey instructions. For example, more than 50% of the residents who ate less than half of their meals based on research staff observation were not offered an alternative to the served meal, and the lack of alternatives, or meal substitutions, was common in all 20 NHs. In comparison, the QIS survey teams documented only 2 instances when meal substitutes were not offered in 10 NHs and the standard survey teams documented no instances in 10 NHs. Standardized mealtime observations by research staff revealed feeding assistance care quality issues in all 20 study NHs. Surveyors following the instructions in either the standard or revised QIS surveys did not detect most of these care quality

  7. First-Year Evaluation of Mexico's Tax on Nonessential Energy-Dense Foods: An Observational Study.

    PubMed

    Batis, Carolina; Rivera, Juan A; Popkin, Barry M; Taillie, Lindsey Smith

    2016-07-01

    In an effort to prevent continued increases in obesity and diabetes, in January 2014, the Mexican government implemented an 8% tax on nonessential foods with energy density ≥275 kcal/100 g and a peso-per-liter tax on sugar-sweetened beverages (SSBs). Limited rigorous evaluations of food taxes exist worldwide. The objective of this study was to examine changes in volume of taxed and untaxed packaged food purchases in response to these taxes in the entire sample and stratified by socioeconomic status (SES). This study uses data on household packaged food purchases representative of the Mexican urban population from The Nielsen Company's Mexico Consumer Panel Services (CPS). We included 6,248 households that participated in the Nielsen CPS in at least 2 mo during 2012-2014; average household follow-up was 32.7 mo. We analyzed the volume of purchases of taxed and untaxed foods from January 2012 to December 2014, using a longitudinal, fixed-effects model that adjusted for preexisting trends to test whether the observed post-tax trend was significantly different from the one expected based on the pre-tax trend. We controlled for household characteristics and contextual factors like minimum salary and unemployment rate. The mean volume of purchases of taxed foods in 2014 changed by -25 g (95% confidence interval = -46, -11) per capita per month, or a 5.1% change beyond what would have been expected based on pre-tax (2012-2013) trends, with no corresponding change in purchases of untaxed foods. Low SES households purchased on average 10.2% less taxed foods than expected (-44 [-72, -16] g per capita per month); medium SES households purchased 5.8% less taxed foods than expected (-28 [-46, -11] g per capita per month), whereas high SES households' purchases did not change. The main limitations of our findings are the inability to infer causality because the taxes were implemented at the national level (lack of control group), our sample is only representative of urban

  8. The Domain Five Observation Instrument: A Competency-Based Coach Evaluation Tool

    ERIC Educational Resources Information Center

    Shangraw, Rebecca

    2017-01-01

    The Domain Five Observation Instrument (DFOI) is a competency-based observation instrument recommended for sport leaders or researchers who wish to evaluate coaches' instructional behaviors. The DFOI includes 10 behavior categories and four timed categories that encompass 34 observable instructional benchmarks outlined in domain five of the…

  9. Evaluation of a Web-Based Food Record for Children Using Direct Unobtrusive Lunch Observations: A Validation Study

    PubMed Central

    Astrup, Helene; Kåsin, Britt Marlene; Andersen, Lene Frost

    2015-01-01

    Background High-quality, Web-based dietary assessment tools for children are needed to reduce cost and improve user-friendliness when studying children’s dietary practices. Objective To evaluate the first Web-based dietary assessment tool for children in Norway, the Web-based Food Record (WebFR), by comparing children’s true school lunch intake with recordings in the WebFR, using direct unobtrusive observation as the reference method. Methods A total of 117 children, 8-9 years, from Bærum, Norway, were recruited from September to December 2013. Children completed 4 days of recordings in the WebFR, with parental assistance, and were observed during school lunch in the same period by 3 observers. Interobserver reliability assessments were satisfactory. Match, omission, and intrusion rates were calculated to assess the quality of the recordings in the WebFR for different food categories, and for all foods combined. Logistic regression analyses were used to investigate whether body mass index (BMI), parental educational level, parental ethnicity or family structure were associated with having a “low match rate” (≤70%). Results Bread and milk were recorded with less bias than spreads, fruits, and vegetables. Mean (SD) for match, omission, and intrusion rates for all foods combined were 73% (27%), 27% (27%), and 19% (26%), respectively. Match rates were statistically significantly associated with parental educational level (low education 52% [32%] versus high 77% [24%], P=.008) and parental ethnicity (non-Norwegian 57% [28%] versus others 75% [26%], P=.04). Only parental ethnicity remained statistically significant in the logistic regression model, showing an adjusted odds ratio of 6.9 and a 95% confidence interval between 1.3 and 36.4. Conclusions Compared with other similar studies, our results indicate that the WebFR is in line with, or better than most of other similar tools, yet enhancements could further improve the WebFR. PMID:26680744

  10. Assessment of the quality of reporting observational studies in the pediatric dental literature.

    PubMed

    Butani, Yogita; Hartz, Arthur; Levy, Steven; Watkins, Catherine; Kanellis, Michael; Nowak, Arthur

    2006-01-01

    The purpose of this assessment was to evaluate reporting of observational studies in the pediatric dental literature. This assessment included the following steps: (1) developing a model for reporting information in clinical dentistry studies; (2) identifying treatment comparisons in pediatric dentistry that were evaluated by at least 5 observational studies; (3) abstracting from these studies any data indicated by applying the reporting model; and (4) comparing available data elements to the desired data elements in the reporting model. The reporting model included data elements related to: (1) patients; (2) providers; (3) treatment details; and (4) study design. Two treatment comparisons in pediatric dentistry were identified with 5 or more observational studies: (1) stainless steel crowns vs amalgams (10 studies); and (2) composite restorations vs amalgam (5 studies). Results from studies comparing the same treatments varied substantially. Data elements from the reporting model that could have explained some of the variation were often reported inadequately or not at all. Reporting of observational studies in the pediatric dental literature may be inadequate for an informed interpretation of the results. Models similar to that used in this study could be used for developing standards for the conduct and reporting of observational studies in pediatric dentistry.

  11. Evaluating Surface Radiation Fluxes Observed From Satellites in the Southeastern Pacific Ocean

    NASA Astrophysics Data System (ADS)

    Pinker, R. T.; Zhang, B.; Weller, R. A.; Chen, W.

    2018-03-01

    This study is focused on evaluation of current satellite and reanalysis estimates of surface radiative fluxes in a climatically important region. It uses unique observations from the STRATUS Ocean Reference Station buoy in a region of persistent marine stratus clouds 1,500 km off northern Chile during 2000-2012. The study shows that current satellite estimates are in better agreement with buoy observations than model outputs at a daily time scale and that satellite data depict well the observed annual cycle in both shortwave and longwave surface radiative fluxes. Also, buoy and satellite estimates do not show any significant trend over the period of overlap or any interannual variability. This verifies the stability and reliability of the satellite data and should make them useful to examine El Niño-Southern Oscillation variability influences on surface radiative fluxes at the STRATUS site for longer periods for which satellite record is available.

  12. Building a More Complete Understanding of Teacher Evaluation Using Classroom Observations

    ERIC Educational Resources Information Center

    Cohen, Julie; Goldhaber, Dan

    2016-01-01

    Improving teacher evaluation is one of the most pressing but also contested areas of educational policy. Value-added measures have received much of the attention in new evaluation systems, but they can only be used to evaluate a fraction of teachers. Classroom observations are almost universally used to assess teachers, yet their statistical…

  13. Model Evaluation with Multi-wavelength Satellite Observations Using a Neural Network

    NASA Astrophysics Data System (ADS)

    Kolassa, Jana; Jimenez, Carlos; Aires, Filipe

    2013-04-01

    A methodology has been developed to evaluate fields of modelled parameters against a set of satellite observations. The method employs a Neural Network (NN) to construct a statistical model capturing the relationship between the satellite observations and the parameter from a land surface model, in this case the Soil Moisture (SM). This statistical model is then used to estimate the parameter of interest from the set of satellite observations. These estimates are compared to the modelled parameter in order to detect local deviations indicating a possible problem in the model or in the satellite observations. Several synthetic tests, during which an artificial error was added to the"true" soil moisture fields, showed that the methodology is able to correct the errors (Jimenez et al., submitted, 2012). This evaluation technique is very general and can be applied to any modelled parameter for which sensitive satellite observations are available. The use of NNs simplifies the evaluation of the model against satellite observations and is particularly well-suited to utilize the synergy from the observations at different wavelengths (Aires et al., 2005, 2012). In this study the proposed methodology has been applied to evaluate SM fields from a number of land surface models against a synergy of satellite observations from passive and active microwave, infrared and visible sensors. In an inter-comparison of the performance of several land surface models (ORCHIDEE (de Rosnay et al., 2002), HTESSEL (Balsamo et al., 2009), JULES (Best et al., 2011) ) it was found that the soil moisture fields from JULES, HTESSEL and ORCHIDEE are very consistent with the observations, but ORCHIDEE soil moisture shows larger local deviations close to some river basins (Kolassa et al., in press, 2012; Jimenez et al., submitted, 2012). Differences between all models and the observations could also be observed in the Eastern US and over mountainous regions, however, the errors here are more likely

  14. Issues of reporting in observational studies in veterinary medicine.

    PubMed

    Sargeant, Jan M; O'Connor, Annette M

    2014-02-15

    Observational studies are common in veterinary medicine; the results may be used to inform decision-making, future research, or as inputs to systematic reviews or risk assessment. To be of use, the results must be published, all of the outcomes that were assessed must be included in the publication, and the research (methods and results) must be reported in sufficient detail that the reader can evaluate the internal and external validity. In human healthcare, concerns about the completeness of reporting - and evidence that poor reporting is associated with study results - have led to the creation of reporting guidelines; these include the STROBE statement for observational studies. There is evidence from a limited body of research that there also are reporting inadequacies in veterinary observational studies. There are differences between human and veterinary observational studies that might be relevant to recommendations for reporting. Such differences include: the use of observational studies in animal populations for simultaneously estimating disease frequency and risk-factor identification; the distinction between the animal owners who consent to participate and the animals that are the study subjects; and the complexity of organizational levels inherent in animal research (in particular, for studies in livestock species). In veterinary medicine, it is common to have clustering within outcomes (due to animal grouping) and clustering of predictor variables. We argue that there is a compelling need for the scientific community involved in veterinary observational studies to use the STROBE statement, use an amended version of STROBE, or to develop and use reporting guidelines that are specific to veterinary medicine to improve reporting of these studies. Copyright © 2013 Elsevier B.V. All rights reserved.

  15. The evaluation of a framework for measuring the non-technical ward round skills of final year nursing students: An observational study.

    PubMed

    Murray, Kara; McKenzie, Karen; Kelleher, Michael

    2016-10-01

    The importance of non-technical skills (NTS) to patient outcomes is increasingly being recognised, however, there is limited research into how such skills can be taught and evaluated in student nurses in relation toward rounds. This pilot study describes an evaluation of a NTS framework that could potentially be used to measure ward round skills of student nurses. The study used an observational design. Potential key NTS were identified from existing literature and NTS taxonomies. The proposed framework was then used to evaluate whether the identified NTS were evident in a series of ward round simulations that final year general nursing students undertook as part of their training. Finally, the views of a small group of qualified nurse educators, qualified nurses and general nursing students were sought about whether the identified NTS were important and relevant to practice. The proposed NTS framework included seven categories: Communication, Decision Making, Situational Awareness, Teamwork and Task Management, Student Initiative and Responsiveness to Patient. All were rated as important and relevant to practice. The pilot study suggests that the proposed NTS framework could be used as a means of evaluating student nurse competencies in respect of many non-technical skills required for a successful ward round. Further work is required to establish the validity of the framework in educational settings and to determine the extent to which it is of use in a non-simulated ward round setting. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Evaluation of surface layer flux parameterizations using in-situ observations

    NASA Astrophysics Data System (ADS)

    Katz, Jeremy; Zhu, Ping

    2017-09-01

    Appropriate calculation of surface turbulent fluxes between the atmosphere and the underlying ocean/land surface is one of the major challenges in geosciences. In practice, the surface turbulent fluxes are estimated from the mean surface meteorological variables based on the bulk transfer model combined with the Monnin-Obukhov Similarity (MOS) theory. Few studies have been done to examine the extent to which such a flux parameterization can be applied to different weather and surface conditions. A novel validation method is developed in this study to evaluate the surface flux parameterization using in-situ observations collected at a station off the coast of Gulf of Mexico. The main findings are: (a) the theoretical prediction that uses MOS theory does not match well with those directly computed from the observations. (b) The largest spread in exchange coefficients is shown in strong stable conditions with calm winds. (c) Large turbulent eddies, which depend strongly on the mean flow pattern and surface conditions, tend to break the constant flux assumption in the surface layer.

  17. Effect of formative evaluation using direct observation of procedural skills in assessment of postgraduate students of obstetrics and gynecology: Prospective study.

    PubMed

    Kumar, Naina; Singh, Namit Kant; Rudra, Samar; Pathak, Swanand

    2017-01-01

    Direct Observation of Procedural Skills (DOPS) is a way of evaluating procedural skills through observation in the workplace. The purpose of this study was to assess the role of DOPS in teaching and assessment of postgraduate students and to know the effect of repeated DOPS on improvement of the skills and confidence of the students. In both phases, significant difference was observed between the two groups on first DOPS comparison (1st phase: p=0.000; 2nd phase: p=0.002), with simulation group performing better. Comparison of sixth DOPS in the two groups revealed no difference in both phases, but significant difference on first and sixth DOPS comparison in each group (p=0.000). Repeated DOPS results in improved skills and confidence of students in managing real life obstetric emergencies irrespective of the teaching modality. Repeated DOPS results in improved skills and confidence of students in managing real life obstetric emergencies irrespective of the teaching modality.

  18. Multicenter Observational Study to Evaluate Epidemiology and Resistance Patterns of Common Intensive Care Unit-infections.

    PubMed

    Venkataraman, Ramesh; Divatia, Jigeeshu V; Ramakrishnan, Nagarajan; Chawla, Rajesh; Amin, Pravin; Gopal, Palepu; Chaudhry, Dhruva; Zirpe, Kapil; Abraham, Babu

    2018-01-01

    There is limited data regarding the microbiology of Intensive Care Unit (ICU)-acquired infections, such as ventilator-associated pneumonia (VAP), catheter-associated urinary tract infections (CAUTI), and catheter-related bloodstream infections (CRBSI) from India. To explore the microbiology and resistance patterns of ICU-acquired infections and evaluate their outcomes. This was a multicenter observational study, conducted by Indian Society of Critical Care Medicine (MOSER study) between August 2011 and October 2012. Patients in the ICU ≥48 h with any ICU-acquired infection within 14 days of index ICU stay were included. Patient demographics, relevant clinical, and microbiological details were collected. Follow-up until hospital discharge or death was done, and 6-month survival data were collected. Of the 381 patients included in the study, 346 patients had 1 ICU infection and 35 had more than one ICU infection. Among patients with single infections, 223 had VAP with Acinetobacter being the most common isolate. CAUTI was seen in 42 patients with Klebsiella as the most common organism. CRBSI was seen in 81 patients and Klebsiella was the most common causative organism. Multidrug resistance was noted in 87.5% of Acinetobacter, 75.5% of Klebsiella , 61.9% of Escherichia coli , and 58.9% of Pseudomonas isolates, respectively. Staphylococcus constituted only 2.4% of isolates. Mortality rates were 26%, 11.9%, and 34.6% in VAP, CAUTI, and CRBSI, respectively. VAP is the most common infection followed by CRBSI and CAUTI. Multidrug-resistant Gram-negative bacteria are the most common organisms. Staphylococcus aureus is uncommon in the Indian setting.

  19. A new method to evaluate image quality of CBCT images quantitatively without observers

    PubMed Central

    Shimizu, Mayumi; Okamura, Kazutoshi; Yoshida, Shoko; Weerawanich, Warangkana; Tokumori, Kenji; Jasa, Gainer R; Yoshiura, Kazunori

    2017-01-01

    Objectives: To develop an observer-free method for quantitatively evaluating the image quality of CBCT images by applying just-noticeable difference (JND). Methods: We used two test objects: (1) a Teflon (polytetrafluoroethylene) plate phantom attached to a dry human mandible; and (2) a block phantom consisting of a Teflon step phantom and an aluminium step phantom. These phantoms had holes with different depths. They were immersed in water and scanned with a CB MercuRay (Hitachi Medical Corporation, Tokyo, Japan) at tube voltages of 120 kV, 100 kV, 80 kV and 60 kV. Superimposed images of the phantoms with holes were used for evaluation. The number of detectable holes was used as an index of image quality. In detecting holes quantitatively, the threshold grey value (ΔG), which differentiated holes from the background, was calculated using a specific threshold (the JND), and we extracted the holes with grey values above ΔG. The indices obtained by this quantitative method (the extracted hole values) were compared with the observer evaluations (the observed hole values). In addition, the contrast-to-noise ratio (CNR) of the shallowest detectable holes and the deepest undetectable holes were measured to evaluate the contribution of CNR to detectability. Results: The results of this evaluation method corresponded almost exactly with the evaluations made by observers. The extracted hole values reflected the influence of different tube voltages. All extracted holes had an area with a CNR of ≥1.5. Conclusions: This quantitative method of evaluating CBCT image quality may be more useful and less time-consuming than evaluation by observation. PMID:28045343

  20. An ultrasound evaluation of laryngeal mask airway position in pediatric patients: an observational study.

    PubMed

    Kim, Jeongmin; Kim, Ji Young; Kim, Won Oak; Kil, Hae Keum

    2015-02-01

    In children, the laryngeal mask airway (LMA) is frequently displaced within the hypopharynx, resulting in repositioning of the device. When the tip of the LMA is placed in the esophageal inlet, the arytenoids are moved ventrally. When the LMA is rotated or deviated, the ventral movement of the arytenoids may result in asymmetric elevation of an arytenoid cartilage, which can be detected with ultrasound (US). In this study, we sought to estimate the incidence of LMA malposition detected with US in pediatric patients. The primary end point was to compare the incidence of LMA malposition between US and fiber optic bronchoscopy (FOB). The secondary end points were to find the interrelationship between US-detected and FOB-detected malposition of the LMA and to locate the diagnostic performance of US in detecting LMA malposition. In this observational study, 100 consecutive children were included. After anesthetic induction, US evaluation was performed before and after LMA insertion to obtain the glottic image on the anterior neck. FOB was performed to assess LMA position (FOB LMA grade and LMA rotation grade). With a post-LMA US image, the symmetry of the arytenoid cartilages was evaluated. Asymmetrical elevation of an arytenoid cartilage in reference to the glottic midline and the opposite arytenoid cartilage was graded as 0 to 3 (US arytenoid grade). The interrelationships between US arytenoid grade and FOB LMA grade or LMA rotation grade were assessed. The incidence of asymmetrical elevation of an arytenoid was 50% (95% confidence interval [CI], 40%-60%). On FOB, the incidence of LMA malposition was 78% (95% CI, 69%-86%), and that of LMA rotation was 43% (95% CI, 33%-53%). The incidence of LMA malposition was higher with FOB (P < 0.0001), but the incidence of rotation was similar (P = 0.395). US arytenoid grade did not correlate with FOB LMA grade (P = 0.611) but showed a significant correlation with LMA rotation grade (P < 0.0001; 95% CI, 60%-83%). To detect a

  1. Evaluation of Long-Range Lightning Detection Networks Using TRMM/LIS Observations

    NASA Technical Reports Server (NTRS)

    Rudlosky, Scott D.; Holzworth, Robert H.; Carey, Lawrence D.; Schultz, Chris J.; Bateman, Monte; Cecil, Daniel J.; Cummins, Kenneth L.; Petersen, Walter A.; Blakeslee, Richard J.; Goodman, Steven J.

    2011-01-01

    Recent advances in long-range lightning detection technologies have improved our understanding of thunderstorm evolution in the data sparse oceanic regions. Although the expansion and improvement of long-range lightning datasets have increased their applicability, these applications (e.g., data assimilation, atmospheric chemistry, and aviation weather hazards) require knowledge of the network detection capabilities. Toward this end, the present study evaluates data from the World Wide Lightning Location Network (WWLLN) using observations from the Lightning Imaging Sensor (LIS) aboard the Tropical Rainfall Measurement Mission (TRMM) satellite. The study documents the WWLLN detection efficiency and location accuracy relative to LIS observations, describes the spatial variability in these performance metrics, and documents the characteristics of LIS flashes that are detected by WWLLN. Improved knowledge of the WWLLN detection capabilities will allow researchers, algorithm developers, and operational users to better prepare for the spatial and temporal coverage of the upcoming GOES-R Geostationary Lightning Mapper (GLM).

  2. Tropical convection regimes in climate models: evaluation with satellite observations

    NASA Astrophysics Data System (ADS)

    Steiner, Andrea K.; Lackner, Bettina C.; Ringer, Mark A.

    2018-04-01

    High-quality observations are powerful tools for the evaluation of climate models towards improvement and reduction of uncertainty. Particularly at low latitudes, the most uncertain aspect lies in the representation of moist convection and interaction with dynamics, where rising motion is tied to deep convection and sinking motion to dry regimes. Since humidity is closely coupled with temperature feedbacks in the tropical troposphere, a proper representation of this region is essential. Here we demonstrate the evaluation of atmospheric climate models with satellite-based observations from Global Positioning System (GPS) radio occultation (RO), which feature high vertical resolution and accuracy in the troposphere to lower stratosphere. We focus on the representation of the vertical atmospheric structure in tropical convection regimes, defined by high updraft velocity over warm surfaces, and investigate atmospheric temperature and humidity profiles. Results reveal that some models do not fully capture convection regions, particularly over land, and only partly represent strong vertical wind classes. Models show large biases in tropical mean temperature of more than 4 K in the tropopause region and the lower stratosphere. Reasonable agreement with observations is given in mean specific humidity in the lower to mid-troposphere. In moist convection regions, models tend to underestimate moisture by 10 to 40 % over oceans, whereas in dry downdraft regions they overestimate moisture by 100 %. Our findings provide evidence that RO observations are a unique source of information, with a range of further atmospheric variables to be exploited, for the evaluation and advancement of next-generation climate models.

  3. Evaluation of Two Methods for Modeling Measurement Errors When Testing Interaction Effects with Observed Composite Scores

    ERIC Educational Resources Information Center

    Hsiao, Yu-Yu; Kwok, Oi-Man; Lai, Mark H. C.

    2018-01-01

    Path models with observed composites based on multiple items (e.g., mean or sum score of the items) are commonly used to test interaction effects. Under this practice, researchers generally assume that the observed composites are measured without errors. In this study, we reviewed and evaluated two alternative methods within the structural…

  4. Clinical Knowledge from Observational Studies: Everything You Wanted to Know but Were Afraid to Ask.

    PubMed

    Gershon, Andrea S; Jafarzadeh, S Reza; Wilson, Kevin C; Walkey, Allan J

    2018-05-07

    Well-done randomized trials provide accurate estimates of treatment effect by producing groups that are similar on all measures except for the intervention of interest. However, inferences of efficacy in tightly-controlled experimental settings may not translate into similar effectiveness in real-world settings. Observational studies generally enable inferences over a wider range of patient characteristics and evaluation of a broader range of outcomes over a longer period than randomized trials. However, clinicians are often reluctant to incorporate the findings of observational studies into clinical practice. Reason for uncertainty regarding observational studies include a lack of familiarity with observational research methods, occasional disagreements between results of observational studies and randomized trials, the perceived risk of spurious results from systematic bias, and prior teaching that randomized trials are the most reliable source of medical evidence. We propose that a better understanding of observational research will enhance clinicians' ability to distinguish reliable observational studies from those that are subjected to biases and, therefore, provide more confidence to apply observational research results into clinical practice when appropriate. Herein, we explain why observational studies may be perceived as less conclusive than randomized trials, address situations in which observational research and randomized trials produced different findings, and provide information on observational study design so that quality can be evaluated. We conclude that observational research is a valuable source of medical evidence and that clinical action is strongest when supported by both high quality observational studies and randomized trials.

  5. Evaluation of atmospheric dust prediction models using ground-based observations

    NASA Astrophysics Data System (ADS)

    Terradellas, Enric; María Baldasano, José; Cuevas, Emilio; Basart, Sara; Huneeus, Nicolás; Camino, Carlos; Dundar, Cinhan; Benincasa, Francesco

    2013-04-01

    An important step in numerical prediction of mineral dust is the model evaluation aimed to assess its performance to forecast the atmospheric dust content and to lead to new directions in model development and improvement. The first problem to address the evaluation is the scarcity of ground-based routine observations intended for dust monitoring. An alternative option would be the use of satellite products. They have the advantage of a large spatial coverage and a regular availability. However, they do have numerous drawbacks that make the quantitative retrievals of aerosol-related variables difficult and imprecise. This work presents the use of different ground-based observing systems for the evaluation of dust models in the Regional Center for Northern Africa, Middle East and Europe of the World Meteorological Organization (WMO) Sand and Dust Storm Warning Advisory and Assessment System (SDS-WAS). The dust optical depth at 550 nm forecast by different models is regularly compared with the AERONET measurements of Aerosol Optical Depth (AOD) for 40 selected stations. Photometric measurements are a powerful tool for remote sensing of the atmosphere allowing retrieval of aerosol properties, such as AOD. This variable integrates the contribution of different aerosol types, but may be complemented with spectral information that enables hypotheses about the nature of the particles. Comparison is restricted to cases with low Ångström exponent values in order to ensure that coarse mineral dust is the dominant aerosol type. Additionally to column dust load, it is important to evaluate dust surface concentration and dust vertical profiles. Air quality monitoring stations are the main source of data for the evaluation of surface concentration. However they are concentrated in populated and industrialized areas around the Mediterranean. In the present contribution, results of different models are compared with observations of PM10 from the Turkish air quality network for

  6. Multicenter Observational Study to Evaluate Epidemiology and Resistance Patterns of Common Intensive Care Unit-infections

    PubMed Central

    Venkataraman, Ramesh; Divatia, Jigeeshu V.; Ramakrishnan, Nagarajan; Chawla, Rajesh; Amin, Pravin; Gopal, Palepu; Chaudhry, Dhruva; Zirpe, Kapil; Abraham, Babu

    2018-01-01

    Background: There is limited data regarding the microbiology of Intensive Care Unit (ICU)-acquired infections, such as ventilator-associated pneumonia (VAP), catheter-associated urinary tract infections (CAUTI), and catheter-related bloodstream infections (CRBSI) from India. Objectives: To explore the microbiology and resistance patterns of ICU-acquired infections and evaluate their outcomes. Materials and Methods: This was a multicenter observational study, conducted by Indian Society of Critical Care Medicine (MOSER study) between August 2011 and October 2012. Patients in the ICU ≥48 h with any ICU-acquired infection within 14 days of index ICU stay were included. Patient demographics, relevant clinical, and microbiological details were collected. Follow-up until hospital discharge or death was done, and 6-month survival data were collected. Results: Of the 381 patients included in the study, 346 patients had 1 ICU infection and 35 had more than one ICU infection. Among patients with single infections, 223 had VAP with Acinetobacter being the most common isolate. CAUTI was seen in 42 patients with Klebsiella as the most common organism. CRBSI was seen in 81 patients and Klebsiella was the most common causative organism. Multidrug resistance was noted in 87.5% of Acinetobacter, 75.5% of Klebsiella, 61.9% of Escherichia coli, and 58.9% of Pseudomonas isolates, respectively. Staphylococcus constituted only 2.4% of isolates. Mortality rates were 26%, 11.9%, and 34.6% in VAP, CAUTI, and CRBSI, respectively. Conclusion: VAP is the most common infection followed by CRBSI and CAUTI. Multidrug-resistant Gram-negative bacteria are the most common organisms. Staphylococcus aureus is uncommon in the Indian setting. PMID:29422728

  7. Company observational post-marketing studies: drug risk assessment and drug research in special populations--a study-based analysis.

    PubMed

    Hasford, J; Lamprecht, T

    1998-01-01

    Company observational post-marketing studies (COPS) claim to provide essential data about drug risks and effectiveness in special populations not admitted to pre-approval clinical trials. Since COPS are often mainly regarded as a marketing activity, this study-based analysis tries to evaluate the scientific contributions of COPS. Thirty-five COPS were identified by hand-searching through medical journals, writing to pharmaceutical manufacturers and using MEDLINE. Fourteen COPS evaluated cardiovascular drugs, 9 evaluated NSAIDs and 12 evaluated various other indications. Thirty-five COPS listed effectiveness, 31 listed safety and 8 listed patient compliance as principal objectives. Not a single COPS included a control group. Seventeen of 21 evaluable COPS mentioned extensive exclusion criteria similar to those in clinical trials. Median observation time was 8 weeks, too short for chronic diseases and for adverse drug reactions with longer latency periods. One new adverse event was regarded. Global assessments of the outcomes by physicians dominated and were not based on objective clinical findings. None of the studies specified any details concerning the standardisation of observations or quality-control procedures. The current COPS scheme does not contribute significantly to our knowledge of drug safety and the effects in special populations. Despite serious criticism over the past 20 years, the poor quality of COPS compared with dramatic improvements of pre-approval trials - implies a need for detailed guidelines for non-experimental phase IV research, similar to the Good Clinical Practice-Guideline of the European Community.

  8. Leveraging Teacher Talent: Peer Observation in Educator Evaluation. Ask the Team

    ERIC Educational Resources Information Center

    Jacques, Catherine

    2013-01-01

    Many teachers are already keen observers and skilled in supporting and collaborating with their colleagues. Leveraging this rich talent among staff can be an efficient way to address capacity challenges and enrich teachers' evaluations with more targeted feedback. Teachers, however, require training to become systematic, reliable observers who can…

  9. Inside the Black Box--An Implementation Evaluation Case Study

    ERIC Educational Resources Information Center

    Rector, Patricia; Bakacs, Michele; Rowe, Amy; Barbour, Bruce

    2016-01-01

    The case study presented in this article is an example of an implementation evaluation. The evaluation investigated significant components of the implementation of a long-term environmental educational program. Direct observation, evaluation-specific survey data, and historical data were used to determine program integrity as identified by…

  10. Evaluating Clouds in Long-Term Cloud-Resolving Model Simulations with Observational Data

    NASA Technical Reports Server (NTRS)

    Zeng, Xiping; Tao, Wei-Kuo; Zhang, Minghua; Peters-Lidard, Christa; Lang, Stephen; Simpson, Joanne; Kumar, Sujay; Xie, Shaocheng; Eastman, Joseph L.; Shie, Chung-Lin; hide

    2006-01-01

    Two 20-day, continental midlatitude cases are simulated with a three-dimensional (3D) cloud-resolving model (CRM) and compared to Atmospheric Radiation Measurement (ARM) data. This evaluation of long-term cloud-resolving model simulations focuses on the evaluation of clouds and surface fluxes. All numerical experiments, as compared to observations, simulate surface precipitation well but over-predict clouds, especially in the upper troposphere. The sensitivity of cloud properties to dimensionality and other factors is studied to isolate the origins of the over prediction of clouds. Due to the difference in buoyancy damping between 2D and 3D models, surface precipitation fluctuates rapidly with time, and spurious dehumidification occurs near the tropopause in the 2D CRM. Surface fluxes from a land data assimilation system are compared with ARM observations. They are used in place of the ARM surface fluxes to test the sensitivity of simulated clouds to surface fluxes. Summertime simulations show that surface fluxes from the assimilation system bring about a better simulation of diurnal cloud variation in the lower troposphere.

  11. OSSE Evaluation of Aircraft Reconnaissance Observations and their Impact on Hurricane Analyses and Forecasts

    NASA Astrophysics Data System (ADS)

    Ryan, K. E.; Bucci, L. R.; Delgado, J.; Atlas, R. M.; Murillo, S.; Dodge, P.

    2016-12-01

    NOAA/AOML's Hurricane Research Division (HRD) annually conducts its Hurricane Field Program during which observations are collected via NOAA aircraft to improve the understanding and prediction of hurricanes. Mission experiments suggest a variety of flight patterns and sampling strategies aimed towards their respective goals described by the Intensity Forecasting Experiment (IFEX; Rogers et al., BAMS, 2006, 2013), a collaborative effort among HRD, NHC, and EMC. Evaluating the potential impact of various trade-offs in track design is valuable for determining the optimal air reconnaissance flight pattern for a prospective mission. AOML's HRD has developed a system for performing regional Observing System Simulation Experiments (OSSEs) to assess the potential impact of proposed observing systems on hurricane track and intensity forecasts and analyses. This study focuses on investigating the potential impact of proposed aircraft reconnaissance observing system designs. Aircraft instrument and flight level retrievals were simulated from a regional WRF ARW Nature Run (Nolan et al., 2013) spanning 13 days, covering the life cycle of a rapidly intensifying Atlantic tropical cyclone. The aircraft trajectories of NOAA aircraft are simulated in a variety of ways and are evaluated to examine the potential impact of aircraft reconnaissance observations on hurricane track and intensity forecasts.

  12. Evaluation and Optimization of China's Anthropogenic CO2 Emissions using Observations from Northern China (2005-2009).

    NASA Astrophysics Data System (ADS)

    Dayalu, A.; Munger, J. W.; Wang, Y.; Wofsy, S.; Zhao, Y.; Nielsen, C. P.; Nehrkorn, T.; McElroy, M. B.; Chang, R.

    2017-12-01

    China has pledged to peak carbon emissions by 2030, but there continues to be significant uncertainty in estimates of its anthropogenic carbon dioxide (CO2) emissions. In this study, we evaluate the performance of three anthropogenic CO2 inventories, two global and one regional, using five years of continuous hourly observations from a site in Northern China. We model five years of continuous hourly observations (2005 to 2009) using the Stochastic Time-Inverted Lagrangian Transport Model (STILT) run in backward time mode driven by high resolution meteorology from the Weather Research and Forecasting Model version 3.6.1 (WRF) with vegetation fluxes prescribed by a simple biosphere model. We calculate regional enhancements to advected background CO2 derived from NOAA CarbonTracker on seasonal and annual bases and use observations to optimize emissions inventories within the site's influence region at these timescales. Finally, we use annual enhancements to examine carbon intensity of provinces in and adjacent to Northern China as CO2 per unit of the region's GDP to evaluate the effects of local and global economic events on CO2 emissions. With the exception of peak growing season where discrepancies are confounded by errors in the vegetation model, we find the regional inventory agrees significantly better with observations than the global inventories at all timescales. Here we use a single measurement site; significant improvements in inventory optimizations can be achieved with a network of measurements stations. This study highlights the importance of China-specific data over global averages in emissions evaluation and demonstrates the value of top-down studies in independently evaluating inventory performance. We demonstrate the framework's ability to resolve differences of at least 20% among inventories, establishing a benchmark for ongoing efforts to decrease uncertainty in China's reported CO2 emissions estimates.

  13. Confronting the WRF and RAMS mesoscale models with innovative observations in the Netherlands: Evaluating the boundary layer heat budget

    NASA Astrophysics Data System (ADS)

    Steeneveld, G. J.; Tolk, L. F.; Moene, A. F.; Hartogensis, O. K.; Peters, W.; Holtslag, A. A. M.

    2011-12-01

    The Weather Research and Forecasting Model (WRF) and the Regional Atmospheric Mesoscale Model System (RAMS) are frequently used for (regional) weather, climate and air quality studies. This paper covers an evaluation of these models for a windy and calm episode against Cabauw tower observations (Netherlands), with a special focus on the representation of the physical processes in the atmospheric boundary layer (ABL). In addition, area averaged sensible heat flux observations by scintillometry are utilized which enables evaluation of grid scale model fluxes and flux observations at the same horizontal scale. Also, novel ABL height observations by ceilometry and of the near surface longwave radiation divergence are utilized. It appears that WRF in its basic set-up shows satisfactory model results for nearly all atmospheric near surface variables compared to field observations, while RAMS needed refining of its ABL scheme. An important inconsistency was found regarding the ABL daytime heat budget: Both model versions are only able to correctly forecast the ABL thermodynamic structure when the modeled surface sensible heat flux is much larger than both the eddy-covariance and scintillometer observations indicate. In order to clarify this discrepancy, model results for each term of the heat budget equation is evaluated against field observations. Sensitivity studies and evaluation of radiative tendencies and entrainment reveal that possible errors in these variables cannot explain the overestimation of the sensible heat flux within the current model infrastructure.

  14. Evaluation of internal noise methods for Hotelling observers

    NASA Astrophysics Data System (ADS)

    Zhang, Yani; Pham, Binh T.; Eckstein, Miguel P.

    2005-04-01

    Including internal noise in computer model observers to degrade model observer performance to human levels is a common method to allow for quantitatively comparisons of human and model performance. In this paper, we studied two different types of methods for injecting internal noise to Hotelling model observers. The first method adds internal noise to the output of the individual channels: a) Independent non-uniform channel noise, b) Independent uniform channel noise. The second method adds internal noise to the decision variable arising from the combination of channel responses: a) internal noise standard deviation proportional to decision variable's standard deviation due to the external noise, b) internal noise standard deviation proportional to decision variable's variance caused by the external noise. We tested the square window Hotelling observer (HO), channelized Hotelling observer (CHO), and Laguerre-Gauss Hotelling observer (LGHO). The studied task was detection of a filling defect of varying size/shape in one of four simulated arterial segment locations with real x-ray angiography backgrounds. Results show that the internal noise method that leads to the best prediction of human performance differs across the studied models observers. The CHO model best predicts human observer performance with the channel internal noise. The HO and LGHO best predict human observer performance with the decision variable internal noise. These results might help explain why previous studies have found different results on the ability of each Hotelling model to predict human performance. Finally, the present results might guide researchers with the choice of method to include internal noise into their Hotelling models.

  15. Evaluating Observation Influence on Regional Water Budgets in Reanalyses

    NASA Technical Reports Server (NTRS)

    Bosilovich, Michael G.; Chern, Jiun-Dar; Mocko, David; Robertson, Franklin R.; daSilva, Arlindo M.

    2014-01-01

    The assimilation of observations in reanalyses incurs the potential for the physical terms of budgets to be balanced by a term relating the fit of the observations relative to a forecast first guess analysis. This may indicate a limitation in the physical processes of the background model, or perhaps inconsistencies in the observing system and its assimilation. In the MERRA reanalysis, an area of long term moisture flux divergence over land has been identified over the Central United States. Here, we evaluate the water vapor budget in this region, taking advantage of two unique features of the MERRA diagnostic output; 1) a closed water budget that includes the analysis increment and 2) a gridded diagnostic output data set of the assimilated observations and their innovations (e.g. forecast departures). In the Central United States, an anomaly occurs where the analysis adds water to the region, while precipitation decreases and moisture flux divergence increases. This is related more to a change in the observing system than to a deficiency in the model physical processes. MERRAs Gridded Innovations and Observations (GIO) data narrow the observations that influence this feature to the ATOVS and Aqua satellites during the 06Z and 18Z analysis cycles. Observing system experiments further narrow the instruments that affect the anomalous feature to AMSUA (mainly window channels) and AIRS. This effort also shows the complexities of the observing system, and the reactions of the regional water budgets in reanalyses to the assimilated observations.

  16. Evaluation of Aerosol-cloud Interaction in the GISS Model E Using ARM Observations

    NASA Technical Reports Server (NTRS)

    DeBoer, G.; Bauer, S. E.; Toto, T.; Menon, Surabi; Vogelmann, A. M.

    2013-01-01

    Observations from the US Department of Energy's Atmospheric Radiation Measurement (ARM) program are used to evaluate the ability of the NASA GISS ModelE global climate model in reproducing observed interactions between aerosols and clouds. Included in the evaluation are comparisons of basic meteorology and aerosol properties, droplet activation, effective radius parameterizations, and surface-based evaluations of aerosol-cloud interactions (ACI). Differences between the simulated and observed ACI are generally large, but these differences may result partially from vertical distribution of aerosol in the model, rather than the representation of physical processes governing the interactions between aerosols and clouds. Compared to the current observations, the ModelE often features elevated droplet concentrations for a given aerosol concentration, indicating that the activation parameterizations used may be too aggressive. Additionally, parameterizations for effective radius commonly used in models were tested using ARM observations, and there was no clear superior parameterization for the cases reviewed here. This lack of consensus is demonstrated to result in potentially large, statistically significant differences to surface radiative budgets, should one parameterization be chosen over another.

  17. Comparison of the medical students' perceived self-efficacy and the evaluation of the observers and patients.

    PubMed

    Ammentorp, Jette; Thomsen, Janus Laust; Jarbøl, Dorte Ejg; Holst, René; Øvrehus, Anne Lindebo Holm; Kofoed, Poul-Erik

    2013-04-08

    The accuracy of self-assessment has been questioned in studies comparing physicians' self-assessments to observed assessments; however, none of these studies used self-efficacy as a method for self-assessment. The aim of the study was to investigate how medical students' perceived self-efficacy of specific communication skills corresponds to the evaluation of simulated patients and observers. All of the medical students who signed up for an Objective Structured Clinical Examination (OSCE) were included. As a part of the OSCE, the student performance in the "parent-physician interaction" was evaluated by a simulated patient and an observer at one of the stations. After the examination the students were asked to assess their self-efficacy according to the same specific communication skills. The Calgary Cambridge Observation Guide formed the basis for the outcome measures used in the questionnaires. A total of 12 items was rated on a Likert scale from 1-5 (strongly disagree to strongly agree). We used extended Rasch models for comparisons between the groups of responses of the questionnaires. Comparisons of groups were conducted on dichotomized responses. Eighty-four students participated in the examination, 87% (73/84) of whom responded to the questionnaire. The response rate for the simulated patients and the observers was 100%. Significantly more items were scored in the highest categories (4 and 5) by the observers and simulated patients compared to the students (observers versus students: -0.23; SE:0.112; p=0.002 and patients versus students:0.177; SE:0.109; p=0.037). When analysing the items individually, a statistically significant difference only existed for two items. This study showed that students scored their communication skills lower compared to observers or simulated patients. The differences were driven by only 2 of 12 items. The results in this study indicate that self-efficacy based on the Calgary Cambridge Observation guide seems to be a reliable

  18. Evaluating climate models: Should we use weather or climate observations?

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

    Oglesby, Robert J; Erickson III, David J

    2009-12-01

    Calling the numerical models that we use for simulations of climate change 'climate models' is a bit of a misnomer. These 'general circulation models' (GCMs, AKA global climate models) and their cousins the 'regional climate models' (RCMs) are actually physically-based weather simulators. That is, these models simulate, either globally or locally, daily weather patterns in response to some change in forcing or boundary condition. These simulated weather patterns are then aggregated into climate statistics, very much as we aggregate observations into 'real climate statistics'. Traditionally, the output of GCMs has been evaluated using climate statistics, as opposed to their abilitymore » to simulate realistic daily weather observations. At the coarse global scale this may be a reasonable approach, however, as RCM's downscale to increasingly higher resolutions, the conjunction between weather and climate becomes more problematic. We present results from a series of present-day climate simulations using the WRF ARW for domains that cover North America, much of Latin America, and South Asia. The basic domains are at a 12 km resolution, but several inner domains at 4 km have also been simulated. These include regions of complex topography in Mexico, Colombia, Peru, and Sri Lanka, as well as a region of low topography and fairly homogeneous land surface type (the U.S. Great Plains). Model evaluations are performed using standard climate analyses (e.g., reanalyses; NCDC data) but also using time series of daily station observations. Preliminary results suggest little difference in the assessment of long-term mean quantities, but the variability on seasonal and interannual timescales is better described. Furthermore, the value-added by using daily weather observations as an evaluation tool increases with the model resolution.« less

  19. Evaluation of NCAR CAM5 Simulated Marine Boundary Layer Cloud Properties Using a Combination of Satellite and Surface Observations

    NASA Astrophysics Data System (ADS)

    Zhang, Z.; Song, H.; Wang, M.; Ghan, S. J.; Dong, X.

    2016-12-01

    he main objective of this study is to systematically evaluate the MBL cloud properties simulated in CAM5 family models using a combination of satellite-based CloudSat/MODIS observations and ground-based observations from the ARM Azores site, with a special focus on MBL cloud microphysics and warm rain process. First, we will present a global evaluation based on satellite observations and retrievals. We will compare global cloud properties (e.g., cloud fraction, cloud vertical structure, cloud CER, COT, and LWP, as well as drizzle frequency and intensity diagnosed using the CAM5-COSP instrumental simulators) simulated in the CAM5 models with the collocated CloudSat and MODIS observations. We will also present some preliminary results from a regional evaluation based mainly on ground observations from ARM Azores site. We will compare MBL cloud properties simulated in CAM5 models over the ARM Azores site with collocated satellite (MODIS and CloudSat) and ground-based observations from the ARM site.

  20. Teacher Supervision and Evaluation: A Case Study of Administrators' and Teachers' Perceptions of Mini Observations

    ERIC Educational Resources Information Center

    Campbell, Thomas F.

    2013-01-01

    This case study will investigate teachers' and administrators' perceptions of the relationship between mini observations and teacher performance to understand what effect, if any, a system of mini observations has on teacher performance, and if mini observations influences a teacher's pedagogical practice differently than a…

  1. Evaluation of Immediate Actions Taken to Deal with Cracking Problems Observed in Wheels of Rail Commuter Cars

    DOT National Transportation Integrated Search

    1993-07-01

    The report is the first in a series of engineering studies on railroad vehicle wheel performance. Preliminary studies are summarized, involving evaluation of actions taken to respond to high rates of crack occurrence observed in the wheels of certain...

  2. First-Year Evaluation of Mexico’s Tax on Nonessential Energy-Dense Foods: An Observational Study

    PubMed Central

    Rivera, Juan A.; Popkin, Barry M.; Taillie, Lindsey Smith

    2016-01-01

    Background In an effort to prevent continued increases in obesity and diabetes, in January 2014, the Mexican government implemented an 8% tax on nonessential foods with energy density ≥275 kcal/100 g and a peso-per-liter tax on sugar-sweetened beverages (SSBs). Limited rigorous evaluations of food taxes exist worldwide. The objective of this study was to examine changes in volume of taxed and untaxed packaged food purchases in response to these taxes in the entire sample and stratified by socioeconomic status (SES). Methods and Findings This study uses data on household packaged food purchases representative of the Mexican urban population from The Nielsen Company’s Mexico Consumer Panel Services (CPS). We included 6,248 households that participated in the Nielsen CPS in at least 2 mo during 2012–2014; average household follow-up was 32.7 mo. We analyzed the volume of purchases of taxed and untaxed foods from January 2012 to December 2014, using a longitudinal, fixed-effects model that adjusted for preexisting trends to test whether the observed post-tax trend was significantly different from the one expected based on the pre-tax trend. We controlled for household characteristics and contextual factors like minimum salary and unemployment rate. The mean volume of purchases of taxed foods in 2014 changed by -25 g (95% confidence interval = -46, -11) per capita per month, or a 5.1% change beyond what would have been expected based on pre-tax (2012–2013) trends, with no corresponding change in purchases of untaxed foods. Low SES households purchased on average 10.2% less taxed foods than expected (-44 [–72, –16] g per capita per month); medium SES households purchased 5.8% less taxed foods than expected (-28 [–46, –11] g per capita per month), whereas high SES households’ purchases did not change. The main limitations of our findings are the inability to infer causality because the taxes were implemented at the national level (lack of control group

  3. Evaluation of a numerical model's ability to predict bed load transport observed in braided river experiments

    NASA Astrophysics Data System (ADS)

    Javernick, Luke; Redolfi, Marco; Bertoldi, Walter

    2018-05-01

    New data collection techniques offer numerical modelers the ability to gather and utilize high quality data sets with high spatial and temporal resolution. Such data sets are currently needed for calibration, verification, and to fuel future model development, particularly morphological simulations. This study explores the use of high quality spatial and temporal data sets of observed bed load transport in braided river flume experiments to evaluate the ability of a two-dimensional model, Delft3D, to predict bed load transport. This study uses a fixed bed model configuration and examines the model's shear stress calculations, which are the foundation to predict the sediment fluxes necessary for morphological simulations. The evaluation is conducted for three flow rates, and model setup used highly accurate Structure-from-Motion (SfM) topography and discharge boundary conditions. The model was hydraulically calibrated using bed roughness, and performance was evaluated based on depth and inundation agreement. Model bed load performance was evaluated in terms of critical shear stress exceedance area compared to maps of observed bed mobility in a flume. Following the standard hydraulic calibration, bed load performance was tested for sensitivity to horizontal eddy viscosity parameterization and bed morphology updating. Simulations produced depth errors equal to the SfM inherent errors, inundation agreement of 77-85%, and critical shear stress exceedance in agreement with 49-68% of the observed active area. This study provides insight into the ability of physically based, two-dimensional simulations to accurately predict bed load as well as the effects of horizontal eddy viscosity and bed updating. Further, this study highlights how using high spatial and temporal data to capture the physical processes at work during flume experiments can help to improve morphological modeling.

  4. Home Videophones Improve Direct Observation in Tuberculosis Treatment: A Mixed Methods Evaluation

    PubMed Central

    Wade, Victoria A.; Karnon, Jonathan; Eliott, Jaklin A.; Hiller, Janet E.

    2012-01-01

    Background The use of direct observation to monitor tuberculosis treatment is controversial: cost, practical difficulties, and lack of patient acceptability limit effectiveness. Telehealth is a promising alternative delivery method for improving implementation. This study aimed to evaluate the clinical and cost-effectiveness of a telehealth service delivering direct observation, compared to an in-person drive-around service. Methodology/Principal Findings The study was conducted within a community nursing service in South Australia. Telehealth patients received daily video calls at home on a desktop videophone provided by the nursing call center. A retrospective cohort study assessed the effectiveness of the telehealth and traditional forms of observation, defined by the proportion of missed observations recorded in case notes. This data was inputted to a model, estimating the incremental cost-effectiveness ratio (ICER) of telehealth. Semi-structured interviews were conducted with current patients, community nursing and Chest Clinic staff, concerning service acceptability, usability and sustainability. The percentage of missed observations for the telehealth service was 12.1 (n = 58), compared to 31.1 for the in-person service (n = 70). Most of the difference of 18.9% (95% CI: 12.2 – 25.4) was due to fewer pre-arranged absences. The economic analysis calculated the ICER to be AUD$1.32 (95% CI: $0.51 – $2.26) per extra day of successful observation. The video service used less staff time, and became dominant if implemented on a larger scale and/or with decreased technology costs. Qualitative analysis found enabling factors of flexible timing, high patient acceptance, staff efficiency, and Chest Clinic support. Substantial technical problems were manageable, and improved liaison between the nursing service and Chest Clinic was an unexpected side-benefit. Conclusions/Significance Home video observation is a patient-centered, resource efficient way of

  5. A Regional Climate Model Evaluation System based on contemporary Satellite and other Observations for Assessing Regional Climate Model Fidelity

    NASA Astrophysics Data System (ADS)

    Waliser, D. E.; Kim, J.; Mattman, C.; Goodale, C.; Hart, A.; Zimdars, P.; Lean, P.

    2011-12-01

    Evaluation of climate models against observations is an essential part of assessing the impact of climate variations and change on regionally important sectors and improving climate models. Regional climate models (RCMs) are of a particular concern. RCMs provide fine-scale climate needed by the assessment community via downscaling global climate model projections such as those contributing to the Coupled Model Intercomparison Project (CMIP) that form one aspect of the quantitative basis of the IPCC Assessment Reports. The lack of reliable fine-resolution observational data and formal tools and metrics has represented a challenge in evaluating RCMs. Recent satellite observations are particularly useful as they provide a wealth of information and constraints on many different processes within the climate system. Due to their large volume and the difficulties associated with accessing and using contemporary observations, however, these datasets have been generally underutilized in model evaluation studies. Recognizing this problem, NASA JPL and UCLA have developed the Regional Climate Model Evaluation System (RCMES) to help make satellite observations, in conjunction with in-situ and reanalysis datasets, more readily accessible to the regional modeling community. The system includes a central database (Regional Climate Model Evaluation Database: RCMED) to store multiple datasets in a common format and codes for calculating and plotting statistical metrics to assess model performance (Regional Climate Model Evaluation Tool: RCMET). This allows the time taken to compare model data with satellite observations to be reduced from weeks to days. RCMES is a component of the recent ExArch project, an international effort for facilitating the archive and access of massive amounts data for users using cloud-based infrastructure, in this case as applied to the study of climate and climate change. This presentation will describe RCMES and demonstrate its utility using examples

  6. Creation of an ensemble of simulated cardiac cases and a human observer study: tools for the development of numerical observers for SPECT myocardial perfusion imaging

    NASA Astrophysics Data System (ADS)

    O'Connor, J. Michael; Pretorius, P. Hendrik; Gifford, Howard C.; Licho, Robert; Joffe, Samuel; McGuiness, Matthew; Mehurg, Shannon; Zacharias, Michael; Brankov, Jovan G.

    2012-02-01

    Our previous Single Photon Emission Computed Tomography (SPECT) myocardial perfusion imaging (MPI) research explored the utility of numerical observers. We recently created two hundred and eighty simulated SPECT cardiac cases using Dynamic MCAT (DMCAT) and SIMIND Monte Carlo tools. All simulated cases were then processed with two reconstruction methods: iterative ordered subset expectation maximization (OSEM) and filtered back-projection (FBP). Observer study sets were assembled for both OSEM and FBP methods. Five physicians performed an observer study on one hundred and seventy-nine images from the simulated cases. The observer task was to indicate detection of any myocardial perfusion defect using the American Society of Nuclear Cardiology (ASNC) 17-segment cardiac model and the ASNC five-scale rating guidelines. Human observer Receiver Operating Characteristic (ROC) studies established the guidelines for the subsequent evaluation of numerical model observer (NO) performance. Several NOs were formulated and their performance was compared with the human observer performance. One type of NO was based on evaluation of a cardiac polar map that had been pre-processed using a gradient-magnitude watershed segmentation algorithm. The second type of NO was also based on analysis of a cardiac polar map but with use of a priori calculated average image derived from an ensemble of normal cases.

  7. Deployment and Evaluation of an Observations Data Model

    NASA Astrophysics Data System (ADS)

    Horsburgh, J. S.; Tarboton, D. G.; Zaslavsky, I.; Maidment, D. R.; Valentine, D.

    2007-12-01

    Environmental observations are fundamental to hydrology and water resources, and the way these data are organized and manipulated either enables or inhibits the analyses that can be performed. The CUAHSI Hydrologic Information System project is developing information technology infrastructure to support hydrologic science. This includes an Observations Data Model (ODM) that provides a new and consistent format for the storage and retrieval of environmental observations in a relational database designed to facilitate integrated analysis of large datasets collected by multiple investigators. Within this data model, observations are stored with sufficient ancillary information (metadata) about the observations to allow them to be unambiguously interpreted and used, and to provide traceable heritage from raw measurements to useable information. The design is based upon a relational database model that exposes each single observation as a record, taking advantage of the capability in relational database systems for querying based upon data values and enabling cross dimension data retrieval and analysis. This data model has been deployed, as part of the HIS Server, at the WATERS Network test bed observatories across the U.S where it serves as a repository for real time data in the observatory information system. The ODM holds the data that is then made available to investigators and the public through web services and the Data Access System for Hydrology (DASH) map based interface. In the WATERS Network test bed settings the ODM has been used to ingest, analyze and publish data from a variety of sources and disciplines. This paper will present an evaluation of the effectiveness of this initial deployment and the revisions that are being instituted to address shortcomings. The ODM represents a new, systematic way for hydrologists, scientists, and engineers to organize and share their data and thereby facilitate a fuller integrated understanding of water resources based on

  8. Lessons from cross-fleet/cross-airline observations - Evaluating the impact of CRM/LOFT training

    NASA Technical Reports Server (NTRS)

    Butler, Roy E.

    1991-01-01

    A review is presented of the crew resource management/line oriented flight training (CRM/LOFT) program to help determine the level of standardization across fleets and airlines in the critical area of evaluating crew behavior and performance. One of the goals of the project is to verify that check airmen and LOFT instructors within organizations are evaluating CRM issues consistently and that differences observed between fleets are not a function of idiosyncracies on the part of observers. Attention is given to the research tools for crew evaluation.

  9. Observation chart design features affect the detection of patient deterioration: a systematic experimental evaluation.

    PubMed

    Christofidis, Melany J; Hill, Andrew; Horswill, Mark S; Watson, Marcus O

    2016-01-01

    To systematically evaluate the impact of several design features on chart-users' detection of patient deterioration on observation charts with early-warning scoring-systems. Research has shown that observation chart design affects the speed and accuracy with which abnormal observations are detected. However, little is known about the contribution of individual design features to these effects. A 2 × 2 × 2 × 2 mixed factorial design, with data-recording format (drawn dots vs. written numbers), scoring-system integration (integrated colour-based system vs. non-integrated tabular system) and scoring-row placement (grouped vs. separate) varied within-participants and scores (present vs. absent) varied between-participants by random assignment. 205 novice chart-users, tested between March 2011-March 2014, completed 64 trials where they saw real patient data presented on an observation chart. Each participant saw eight cases (four containing abnormal observations) on each of eight designs (which represented a factorial combination of the within-participants variables). On each trial, they assessed whether any of the observations were physiologically abnormal, or whether all observations were normal. Response times and error rates were recorded for each design. Participants responded faster (scores present and absent) and made fewer errors (scores absent) using drawn-dot (vs. written-number) observations and an integrated colour-based (vs. non-integrated tabular) scoring-system. Participants responded faster using grouped (vs. separate) scoring-rows when scores were absent, but separate scoring-rows when scores were present. Our findings suggest that several individual design features can affect novice chart-users' ability to detect patient deterioration. More broadly, the study further demonstrates the need to evaluate chart designs empirically. © 2015 John Wiley & Sons Ltd.

  10. A Visual Evaluation Study of Graph Sampling Techniques

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

    Zhang, Fangyan; Zhang, Song; Wong, Pak C.

    2017-01-29

    We evaluate a dozen prevailing graph-sampling techniques with an ultimate goal to better visualize and understand big and complex graphs that exhibit different properties and structures. The evaluation uses eight benchmark datasets with four different graph types collected from Stanford Network Analysis Platform and NetworkX to give a comprehensive comparison of various types of graphs. The study provides a practical guideline for visualizing big graphs of different sizes and structures. The paper discusses results and important observations from the study.

  11. Climate Model Diagnostic and Evaluation: With a Focus on Satellite Observations

    NASA Technical Reports Server (NTRS)

    Waliser, Duane

    2011-01-01

    Each year, we host a summer school that brings together the next generation of climate scientists - about 30 graduate students and postdocs from around the world - to engage with premier climate scientists from the Jet Propulsion Laboratory and elsewhere. Our yearly summer school focuses on topics on the leading edge of climate science research. Our inaugural summer school, held in 2011, was on the topic of "Using Satellite Observations to Advance Climate Models," and enabled students to explore how satellite observations can be used to evaluate and improve climate models. Speakers included climate experts from both NASA and the National Oceanic and Atmospheric Administration (NOAA), who provided updates on climate model diagnostics and evaluation and remote sensing of the planet. Details of the next summer school will be posted here in due course.

  12. Standardized assessment of tumor-infiltrating lymphocytes in breast cancer: an evaluation of inter-observer agreement between pathologists.

    PubMed

    Tramm, Trine; Di Caterino, Tina; Jylling, Anne-Marie B; Lelkaitis, Giedrius; Lænkholm, Anne-Vibeke; Ragó, Péter; Tabor, Tomasz P; Talman, Maj-Lis M; Vouza, Emmanouela

    2018-01-01

    In breast cancer, there is a growing body of evidence that tumor-infiltrating lymphocytes (TILs) may have clinical utility and may be able to direct clinical decisions for subgroups of patients. Clinical utility is, however, not sufficient for warranting the implementation of a new biomarker in the routine practice, and evaluation of the analytical validity is needed, including testing the reproducibility of decentralized assessment of TILs. The aim of this study was to evaluate the inter-observer agreement of TILs assessment using a standardized method, as proposed by the International TILs Working Group 2014, applied to a cohort of breast cancers reflecting an average breast cancer population. Stromal TILs were assessed using full slide sections from 124 breast cancers with varying histology, malignancy grade and ER- and HER2 status. TILs were estimated by nine dedicated breast pathologists using scanned hematoxylin-eosin stainings. TILs results were categorized using various cutoffs, and the inter-observer agreement was evaluated using the intraclass coefficient (ICC), Kappa statistics as well as individual overall agreements with the median value of TILs. Evaluation of TILs led to an ICC of 0.71 (95% CI: 0.65-0.77) corresponding to an acceptable agreement. Kappa values were in the range of 0.38-0.46 corresponding to a fair to moderate agreement. The individual agreements increased, when using only two categories ('high' vs. 'low' TILs) and a cutoff of 50-60%. The results of the present study are in accordance with previous studies, and shows that the proposed methodology for standardized evaluation of TILs renders an acceptable inter-observer agreement. The findings, however, indicate that assessment of TILs needs further refinement, and is in support of the latest St. Gallen Consensus, that routine reporting of TILs for early breast cancer is not ready for implementation in a clinical setting.

  13. A note on evaluating model tidal currents against observations

    NASA Astrophysics Data System (ADS)

    Cummins, Patrick F.; Thupaki, Pramod

    2018-01-01

    The root-mean-square magnitude of the vector difference between modeled and observed tidal ellipses is a comprehensive metric to evaluate the representation of tidal currents in ocean models. A practical expression for this difference is given in terms of the harmonic constants that are routinely used to specify current ellipses for a given tidal constituent. The resulting metric is sensitive to differences in all four current ellipse parameters, including phase.

  14. SABRE observations of Pi2 pulsations: case studies

    NASA Astrophysics Data System (ADS)

    Bradshaw, E. G.; Lester, M.

    1997-01-01

    The characteristics of substorm-associated Pi2 pulsations observed by the SABRE coherent radar system during three separate case studies are presented. The SABRE field of view is well positioned to observe the differences between the auroral zone pulsation signature and that observed at mid-latitudes. During the first case study the SABRE field of view is initially in the eastward electrojet, equatorward and to the west of the substorm-enhanced electrojet current. As the interval progresses, the western, upward field-aligned current of the substorm current wedge moves westward across the longitudes of the radar field of view. The westward motion of the wedge is apparent in the spatial and temporal signatures of the associated Pi2 pulsation spectra and polarisation sense. During the second case study, the complex field-aligned and ionospheric currents associated with the pulsation generation region move equatorward into the SABRE field of view and then poleward out of it again after the third pulsation in the series. The spectral content of the four pulsations during the interval indicate different auroral zone and mid-latitude signatures. The final case study is from a period of low magnetic activity when SABRE observes a Pi2 pulsation signature from regions equatorward of the enhanced substorm currents. There is an apparent mode change between the signature observed by SABRE in the ionosphere and that on the ground by magnetometers at latitudes slightly equatorward of the radar field of view. The observations are discussed in terms of published theories of the generation mechanisms for this type of pulsation. Different signatures are observed by SABRE depending on the level of magnetic activity and the position of the SABRE field of view relative to the pulsation generation region. A twin source model for Pi2 pulsation generation provides the clearest explanation of the signatures observed Acknowledgements. The authors are grateful to Prof. D. J. Southwood

  15. The advances in airglow study and observation by the ground-based airglow observation network over China

    NASA Astrophysics Data System (ADS)

    Xu, Jiyao; Li, Qinzeng; Yuan, Wei; Liu, Xiao; Liu, Weijun; Sun, Longchang

    2017-04-01

    Ground-based airglow observation networks over China used to study airglow have been established, which contains 15 stations. Some new results were obtained using the networks. For OH airglow observations, firstly, an unusual outbreak of Concentric Gravity Wave (CGW) events were observed by the first no-gap network nearly every night during the first half of August 2013. Combination of the ground imager network with satellites provides multilevel observations of the CGWs from the troposphere to the mesopause region. Secondly, three-year OH airglow images (2012-2014) from Qujing (25.6°N, 103.7°E) were used to study how orographic features of the Tibetan Plateau (TP) affect the geographical distributions of gravity wave (GW) sources. We find the orographic forcings have a significant impact on the gravity wave propagation features. Thirdly, ground-based observations of the OH (9-4, 8-3, 6-2, 5-1, 3-0) band airglow over Xinglong (40°2N, 117°4E) in northern China from 2012 to 2014 are used to calculate rotational temperatures. By comparing the ground-based OH rotational temperature with SABER's observations, five Einstein coefficient datasets are evaluated. We find rotational temperatures determined using any of the available Einstein coefficient datasets have systematic errors. We have obtained a set of optimal Einstein coefficients ratios for rotational temperature derivation using three years data from ground-based OH spectra and SABER temperatures. For the OI 630.0 nm airglow observations, we used three-year (2011-2013) observations of thermospheric winds (at 250 km) by Fabry-Perot interferometers at Xinglong to study the climatology of atmospheric planetary wave-type oscillations (PWTOs) with periods of 4-19 days. We found these PWTOs occur more frequently in the months from May to October. They are consistent with the summertime preference of middle-latitude ionospheric electron density oscillations noted in other studies. By using an all-sky airglow imager

  16. Regulatory considerations in the design of comparative observational studies using propensity scores.

    PubMed

    Yue, Lilly Q

    2012-01-01

    In the evaluation of medical products, including drugs, biological products, and medical devices, comparative observational studies could play an important role when properly conducted randomized, well-controlled clinical trials are infeasible due to ethical or practical reasons. However, various biases could be introduced at every stage and into every aspect of the observational study, and consequently the interpretation of the resulting statistical inference would be of concern. While there do exist statistical techniques for addressing some of the challenging issues, often based on propensity score methodology, these statistical tools probably have not been as widely employed in prospectively designing observational studies as they should be. There are also times when they are implemented in an unscientific manner, such as performing propensity score model selection for a dataset involving outcome data in the same dataset, so that the integrity of observational study design and the interpretability of outcome analysis results could be compromised. In this paper, regulatory considerations on prospective study design using propensity scores are shared and illustrated with hypothetical examples.

  17. Cost-efficiency of knowledge creation: randomized controlled trials vs. observational studies.

    PubMed

    Struck, Rafael; Baumgarten, Georg; Wittmann, Maria

    2014-04-01

    This article reviews traditional and current perspectives on randomized, controlled trials (RCTs) and observational studies relative to the economic implications for public healthcare stakeholders. It takes an average of 17 years to bring 14% of original research into clinical practice. Results from high-quality observational studies may complement limited RCTs in primary and secondary literature bases, and enhance the incorporation of sound evidence-based guidelines. Observational findings from comprehensive medical databases may offer valuable clues on the effectiveness and relevance of public healthcare interventions. Major expenditures associated with RCTs relate to recruitment, inappropriate site selection, conduct and reporting. Application of business strategies and economic evaluation tools, in addition to the planning and conduct of RCTs, may enhance clinical trial site performances. Considering the strengths and limitations of each study type, clinical researchers should explore the contextual worthiness of either design in promulgating knowledge. They should focus on quality of conduct and reporting that may allow for the liberation of limited public and private clinical research funding.

  18. Evaluating performance of risk identification methods through a large-scale simulation of observational data.

    PubMed

    Ryan, Patrick B; Schuemie, Martijn J

    2013-10-01

    There has been only limited evaluation of statistical methods for identifying safety risks of drug exposure in observational healthcare data. Simulations can support empirical evaluation, but have not been shown to adequately model the real-world phenomena that challenge observational analyses. To design and evaluate a probabilistic framework (OSIM2) for generating simulated observational healthcare data, and to use this data for evaluating the performance of methods in identifying associations between drug exposure and health outcomes of interest. Seven observational designs, including case-control, cohort, self-controlled case series, and self-controlled cohort design were applied to 399 drug-outcome scenarios in 6 simulated datasets with no effect and injected relative risks of 1.25, 1.5, 2, 4, and 10, respectively. Longitudinal data for 10 million simulated patients were generated using a model derived from an administrative claims database, with associated demographics, periods of drug exposure derived from pharmacy dispensings, and medical conditions derived from diagnoses on medical claims. Simulation validation was performed through descriptive comparison with real source data. Method performance was evaluated using Area Under ROC Curve (AUC), bias, and mean squared error. OSIM2 replicates prevalence and types of confounding observed in real claims data. When simulated data are injected with relative risks (RR) ≥ 2, all designs have good predictive accuracy (AUC > 0.90), but when RR < 2, no methods achieve 100 % predictions. Each method exhibits a different bias profile, which changes with the effect size. OSIM2 can support methodological research. Results from simulation suggest method operating characteristics are far from nominal properties.

  19. Evaluation of Hospitals' Disaster Preparedness Plans in the Holy City of Makkah (Mecca): A Cross-Sectional Observation Study.

    PubMed

    Al-Shareef, Ali S; Alsulimani, Loui K; Bojan, Hattan M; Masri, Taha M; Grimes, Jennifer O; Molloy, Michael S; Ciottone, Gregory R

    2017-02-01

    considerable threat to the health of both residents and visitors to Makkah. This study demonstrated that there is significant room for improvement in most aspects of hospital Emergency Operations Plans, in particular: reviewing the plan and increasing the frequency of multi-agency and multi-hospital drills. Preparedness for terrorism utilizing chemical, biologic, radiation, nuclear, explosion (CBRNE) and infectious diseases was found to be sub-optimal and should be assessed further. Al-Shareef AS , Alsulimani LK , Bojan HM , Masri TM , Grimes JO , Molloy MS , Ciottone GR . Evaluation of hospitals' disaster preparedness plans in the holy city of Makkah (Mecca): a cross-sectional observation study. Prehosp Disaster Med. 2017;32 (1):33-45.

  20. A four-alternative forced choice (4AFC) software for observer performance evaluation in radiology

    NASA Astrophysics Data System (ADS)

    Zhang, Guozhi; Cockmartin, Lesley; Bosmans, Hilde

    2016-03-01

    Four-alternative forced choice (4AFC) test is a psychophysical method that can be adopted for observer performance evaluation in radiological studies. While the concept of this method is well established, difficulties to handle large image data, perform unbiased sampling, and keep track of the choice made by the observer have restricted its application in practice. In this work, we propose an easy-to-use software that can help perform 4AFC tests with DICOM images. The software suits for any experimental design that follows the 4AFC approach. It has a powerful image viewing system that favorably simulates the clinical reading environment. The graphical interface allows the observer to adjust various viewing parameters and perform the selection with very simple operations. The sampling process involved in 4AFC as well as the speed and accuracy of the choice made by the observer is precisely monitored in the background and can be easily exported for test analysis. The software has also a defensive mechanism for data management and operation control that minimizes the possibility of mistakes from user during the test. This software can largely facilitate the use of 4AFC approach in radiological observer studies and is expected to have widespread applicability.

  1. Evaluating lateral boundary conditions in MATCH using retrieved observations from satellites

    NASA Astrophysics Data System (ADS)

    Andersson, Emma; Kahnert, Michael; Simpson, David; Devasthale, Abhay

    2015-04-01

    The role of hemispheric transport has gained large attention in regional chemical transport models due to its impact on both climate, air quality and visibility. The hemispheric transport in regional models are represented by the lateral boundary conditions (LBCs), where the inflow boundary specifies the domain beyond the model region and the outflow region will impact the stability of the advective transport solution. This study focuses on evaluating and implement LBCs from global chemical transport models for two important atmospheric tracers: carbon monoxide (CO) and ozone (O3). LBCs are derived from the hemispheric European Monitoring and Evaluation Programme (EMEP) model and the Model for Ozone and Related chemical Tracers (MOZART-4) over the time periods 2006-2012 and 2011-2012 respectively. Evaluation is done with observational data retrieved from the satellite sensors Measurements Of the Pollution In The Troposphere (MOPITT) and the Ozone Monitoring Instrument (OMI). The implementation of the LBCs is done in the regional chemical transport model Multiple scale atmospheric transport and chemistry (MATCH), developed by the Swedish Meteorological and Hydrological Institute (SMHI). The MATCH model is mostly used in simulations of the air quality over Europe on both on regional and local scales. In this study the model the domain is set over Europe. The LBC evaluation is done for the tropospheric column by smoothing the LBCs using satellite averaging kernels and a priori information. By retrieving the average profile for each month and lateral boundary, possible biases and also what global model that might be better suited for the LBCs in MATCH. The implementation will show how these biases proliferate through the MATCH model, and it will possibly be compared to satellite retrieved data from the sensor Atmospheric InfraRed Sounder (AIRS) inboard the satellite Aqua.

  2. Pupillary Reflex for Evaluation of Thoracic Paravertebral Block: A Prospective Observational Feasibility Study.

    PubMed

    Duceau, Baptiste; Baubillier, Mélanie; Bouroche, Gaëlle; Albi-Feldzer, Aline; Jayr, Christian

    2017-10-01

    Although thoracic paravertebral block (TPVB) is recommended in major breast surgery, there is no gold standard to assess the success of TPVB. Pupillary dilation reflex (PDR) is the variation of the pupillary diameter after a noxious stimulus. The objective was to evaluate the feasibility of recording the PDR to assess analgesia in an anesthetized thoracic dermatome after TPVB. This prospective, observational, single-center study included 32 patients requiring breast surgery under general anesthesia and TPVB. TPVB was performed before surgery under ultrasound guidance with 20 mL of 0.75% ropivacaine. At the end of the surgery, remifentanil was stopped and the PDR was recorded after a 5-second tetanic stimulation (60 mA, 100 Hz) applied to the anterior chest wall. The PDR was defined as the maximal increase in pupil diameter after a standardized noxious stimulus, expressed as a percentage of the initial pupil diameter. The PDR was recorded twice in the same eye for each patient after a stimulus on both the TPVB and the control sides. Postoperative pain scores were recorded in a postanesthesia care unit. The primary outcome was the difference between the PDR on the TPVB and the control sides. The median (interquartile range) PDR was 9% (4%-13%) on the TPVB side and 41% (27%-66%) on the control side. There was a significant difference in the PDR between the TPVB and the control sides with a Hodges-Lehmann estimate of absolute difference of 37% points (95% confidence interval, 25-52, P < .001). Median postoperative pain scores (interquartile range) in the postanesthesia care unit were 1 (0-3) at rest and 1 (0-3) during mobilization, respectively. There was a linear correlation between maximal postoperative pain scores and the PDR on the TPVB side with a Pearson's correlation coefficient r = 0.40 (95% confidence interval, 0.06-0.66, P = .02). No correlation was found between the number of blocked dermatomes and maximal postoperative pain scores (P = .06) or between the

  3. Evaluation of multi-model aerosol distributions over East Asia using in-situ and satellite observations during summer 2008

    NASA Astrophysics Data System (ADS)

    Quennehen, B.; Raut, J.; Law, K.; Ancellet, G.; Bazureau, A.; Thomas, J.; Daskalakis, N.; Kim, S.; Zhu, T.

    2013-12-01

    As part of the EU ECLIPSE (Evaluating the CLimate and air quality ImPacts of Short-livEd pollutants) project, which aims to quantify the climate impact of short lived climate forcers (SLCFs), including aerosols, black carbon and ozone, the WRF-Chem regional and six global (ECHAM6, EMEP, HadGEM, OsloCTM, NORESM, TM4) models are evaluated using observations in East-Asia. Simulations are compared at horizontal and vertical scales to satellite observations, as well as data from field campaigns which took place in summer 2008, and from long-term measurement stations. Models were run with the same emissions, namely, the ECLIPSE anthropogenic (based on the GAINS model), GFED 3.1 fire and RCP 6.0 ship and aircraft emissions for 2008. The initial and boundary conditions for the WRF-Chem regional model were specified from the TM4 global chemical transport model. Firstly, this study evaluates the ability of the models to simulate aerosol physical, optical and chemical properties at a large scale, both horizontally and vertically, using monthly mean satellite observations such as CALIPSO, MODIS and IASI. Secondly, model daily and hourly results are evaluated at more regional/local scales using ground-based data and measurements from summer 2008 intensive campaigns, including aircraft data (CAPMEX and CAREBEIJING). In this study, we assess aerosol total concentrations and size distributions simulated by the model. The radiative impact of anthropogenic aerosol layers has already been investigated but less is known about the influence of vertical layering in the atmosphere. Pollution layers have different radiative impacts whether they are below or above clouds and in that sense, a better understanding of their spatial and vertical extent is critical. Information about pollution layers and cloud optical properties and locations over East-Asia are determined using observations from IASI for trace gases and CALIPSO for aerosols. The radiative impact of the aerosol layers is

  4. An Evaluation of the Effectiveness of an Automated Observation and Feedback System on Safe Sitting Postures

    ERIC Educational Resources Information Center

    Yu, Eunjeong; Moon, Kwangsu; Oah, Shezeen; Lee, Yohaeng

    2013-01-01

    This study evaluated the effectiveness of an automated observation and feedback system in improving safe sitting postures. Participants were four office workers. The dependent variables were the percentages of time participants spent in five safe body positions during experimental sessions. We used a multiple-baseline design counterbalanced across…

  5. Intra- and inter-observer reliability of ten major histological scoring systems used for the evaluation of in vivo cartilage repair.

    PubMed

    Bonasia, Davide Edoardo; Marmotti, Antongiulio; Massa, Alessandro Domenico Felice; Ferro, Andrea; Blonna, Davide; Castoldi, Filippo; Rossi, Roberto

    2015-09-01

    In the last two decades, many surgical techniques have been described for articular cartilage repair. Reliable histological scoring systems are fundamental tools to evaluate new procedures. Several histological scoring systems have been described, and these can be divided in elementary and comprehensive scores, according to the number of sub-items. The aim of this study was to test the inter- and intra-observer reliability of ten main scores used for the histological evaluation of in vivo cartilage repair. The authors tested the starting hypothesis that elementary scores would show superior intra- and inter-observer reliability compared with comprehensive scores. Fifty histological sections obtained from the trochlea of New Zealand Rabbit and stained with Safranin-O fast green were used. The histological sections were analysed by 4 observers: 2 experienced in cartilage histology and 2 inexperienced. Histological evaluations were performed at time 1 and time 2, separated by a 30-day interval. The following scores were used: Mankin, O'Driscoll, Pineda, Wakitani, Fortier, Selleres, ICRS, ICRSII, Oswestry (OsScore) and modified O'Driscoll. Intra- and inter-observer reliability were evaluated for each score. In addition, the pavement-ceiling effect and the Bland-Altman Coefficient of Repeatability were then evaluated for each sub-item of every score. Intra-observer reliability was high for all observers in every score, even though the reliability was significantly lower for non-expert observers compared with expert counterparts. In terms of Coefficient of Repeatability, some scores performed better (O'Driscoll, Modified O'Driscoll and ICRSII) than others (Fortier, Seller). Inter-observer reliability was high for all observers in every score, but significantly lower for non-expert compared with expert observers. In expert hands, all the scores showed high intra- and inter-observer reliability, independently of the complexity. Although every score has advantages and

  6. Clinical research on postoperative trauma care: has the position of observational studies changed?

    PubMed

    Smeeing, D P J; Houwert, R M; Kruyt, M C; van der Meijden, O A J; Hietbrink, F

    2017-02-01

    The postoperative care regimes of ankle fractures are studied for over 30 years and recommendations have shifted only slightly in the last decades. However, study methodology might have evolved. The aim of this study was to evaluate the changes in time in the design, quality and outcome measures of studies investigating the postoperative care of ankle fractures. The MEDLINE and EMBASE database were searched for both RCTs and cohort studies. The original studies were divided into decades of publication over the last 30 years. The methodological quality of the studies was assessed using the 'traditional' risk of bias assessment tool provided by The Cochrane Collaboration and the 'newer' MINORS criteria. The percentage of RCTs on this subject declined from 67 to 38 % in the last decades. According to the Cochrane tool, the reported quality of RCTs has improved in the last three decades whereas the reported quality of observational studies has remained unchanged. However, when quality was evaluated with the MINORS criteria, equal improvement was observed for both RCTs and observational studies. In the 80s, 67 % of all studies used the range of motion as the primary outcome measure, which decreased to 45 % in the 90s. In the 00s, none of the studies used the range of motion as the primary outcome. For postoperative care of ankle fractures, results of this study showed a relative decrease in the published number of RCTs. The overall quality of the published articles did not decline. In addition, a gradual shift from physician measured to patient-reported outcome variables was observed. However, it should be borne in mind that the findings are based on a small sample (n = 25).

  7. Evaluation of the Horizontal and Vertical Accuracy of GNSS Survey Observations from a Real-Time Network

    NASA Astrophysics Data System (ADS)

    Allahyari, M.; Olsen, M. J.; Gillins, D. T.; Dennis, M. L.

    2016-12-01

    Many current surveying standards in the United States require several long-duration, static Global Navigation Satellite System (GNSS) observations to derive high-accuracy geodetic coordinates. However, over the past decade, many entities have established real-time GNSS networks (RTNs), which could reduce the field time for establishing geodetic control from hours to minutes. To evaluate the accuracy of RTN GNSS observations, data collected from two National Geodetic Survey (NGS) surveys in South Carolina and Oregon were studied. The objectives were to: 1) determine the accuracy of a real-time observation as a function of duration; 2) examine the influence of including GLONASS (Russia's version of GPS); 3) compare results using a single base to the full RTN network solution; and 4) assess the effect of baseline length on accuracy. In South Carolina, 360 observations ranging from 5 to 600 seconds were collected on 20 passive marks using RTN and single-base solutions, both with GPS+GLONASS and GPS-only. In Oregon, 18 passive marks were observed from 5 to 900 seconds using GPS-only with the RTN, and with GPS+GLONASS and GPS-only from a single-base. To develop "truth" coordinates, at least 30 hours of static GPS data were also collected on all marks. Each static survey session was post-processed in OPUS-Projects, and the resulting vectors were used to build survey networks that were least-squares adjusted using the NGS software ADJUST. The resulting coordinates provided the basis for evaluating the accuracy of the real-time observations. Results from this study indicate great potential in the use of RTNs for accurate derivation of geodetic coordinates. Both case studies showed an optimal observation duration of 180 seconds. RTN data tended to be more accurate and consistent than single-base data, and GLONASS slightly improved accuracy. A key benefit of GLONASS was the ability to obtain more fixed solutions at longer baseline lengths than single-base solutions.

  8. Amateur boxing and risk of chronic traumatic brain injury: systematic review of observational studies.

    PubMed

    Loosemore, Mike; Knowles, Charles H; Whyte, Greg P

    2007-10-20

    To evaluate the risk of chronic traumatic brain injury from amateur boxing. Secondary research performed by combination of sport physicians and clinical academics. DESIGN, DATA SOURCES, AND METHODS: Systematic review of observational studies in which chronic traumatic brain injury was defined as any abnormality on clinical neurological examination, psychometric testing, neuroimaging studies, and electroencephalography. Studies were identified through database (1950 to date) and bibliographic searches without language restrictions. Two reviewers extracted study characteristics, quality, and data, with adherence to a protocol developed from a widely recommended method for systematic review of observational studies (MOOSE). 36 papers had relevant extractable data (from a detailed evaluation of 93 studies of 943 identified from the initial search). Quality of evidence was generally poor. The best quality studies were those with a cohort design and those that used psychometric tests. These yielded the most negative results: only four of 17 (24%) better quality studies found any indication of chronic traumatic brain injury in a minority of boxers studied. There is no strong evidence to associate chronic traumatic brain injury with amateur boxing.

  9. Use of benzodiazepine and risk of cancer: A meta-analysis of observational studies.

    PubMed

    Kim, Hong-Bae; Myung, Seung-Kwon; Park, Yon Chul; Park, Byoungjin

    2017-02-01

    Several observational epidemiological studies have reported inconsistent results on the association between the use of benzodiazepine and the risk of cancer. We investigated the association by using a meta-analysis. We searched PubMed, EMBASE, and the bibliographies of relevant articles to locate additional publications in January 2016. Three evaluators independently reviewed and selected eligible studies based on predetermined selection criteria. Of 796 articles meeting our initial criteria, a total of 22 observational epidemiological studies with 18 case-control studies and 4 cohort studies were included in the final analysis. Benzodiazepine use was significantly associated with an increased risk of cancer (odds ratio [OR] or relative risk [RR] 1.19; 95% confidence interval 1.16-1.21) in a random-effects meta-analysis of all studies. Subgroup meta-analyses by various factors such as study design, type of case-control study, study region, and methodological quality of study showed consistent findings. Also, a significant dose-response relationship was observed between the use of benzodiazepine and the risk of cancer (p for trend <0.01). The current meta-analysis of observational epidemiological studies suggests that benzodiazepine use is associated with an increased risk of cancer. © 2016 UICC.

  10. Learning from Teacher Observations: Challenges and Opportunities Posed by New Teacher Evaluation Systems

    ERIC Educational Resources Information Center

    Hill, Heather C.; Grossman, Pam

    2013-01-01

    In this article, Heather C. Hill and Pam Grossman discuss the current focus on using teacher observation instruments as part of new teacher evaluation systems being considered and implemented by states and districts. They argue that if these teacher observation instruments are to achieve the goal of supporting teachers in improving instructional…

  11. [Preliminary results of an open-label observational study evaluating the efficacy and safety of Prolia used in women with postmenopausal osteoporosis].

    PubMed

    Ershova, O B; Lesniak, O M; Belova, K Iu; Nazarova, A V; Manovitskaia, A V; Musaeva, T M; Musraev, R M; Nurlygaianov, R Z; Rozhinskaia, L Ia; Skripnikova, I A; Toroptsova, N V

    2014-01-01

    To evaluate the efficacy and safety of Denosumab (Prolia), a first-line osteoporosis (OP) medication that is a fully human monoclonal antibody to the receptor activator of nuclear factor xB ligand (RANKL), within an open-label observational study. Patients aged 50 years or older with postmenopausal OP, who were treated with Prolia in clinical practice, were examined. The concentrations of the bone resorption (BR) marker of C-terminal telopeptide and other laboratory indicators (total serum calcium, total alkaline phosphatase, and creatinine) were measured following 3 months. Adverse drug reactions were recorded. Three months after initiation of the investigation, there was a significant decrease in the BR marker C-terminal telopeptide (by 89%; p<0.0001). There were rare adverse reactions: hypocalcemia in 3 (5.9%) patients, arthralgias in 2 (3.9%), and eczema in 1 (1.9%). There were neither serious adverse events nor study withdrawal cases. The preliminary results of the open-label study of Prolia in postmenopausal OP suggest that the significantly lower BR activity determines the efficacy of this drug and its high safety.

  12. A Bayesian Approach to Evaluating Consistency between Climate Model Output and Observations

    NASA Astrophysics Data System (ADS)

    Braverman, A. J.; Cressie, N.; Teixeira, J.

    2010-12-01

    Like other scientific and engineering problems that involve physical modeling of complex systems, climate models can be evaluated and diagnosed by comparing their output to observations of similar quantities. Though the global remote sensing data record is relatively short by climate research standards, these data offer opportunities to evaluate model predictions in new ways. For example, remote sensing data are spatially and temporally dense enough to provide distributional information that goes beyond simple moments to allow quantification of temporal and spatial dependence structures. In this talk, we propose a new method for exploiting these rich data sets using a Bayesian paradigm. For a collection of climate models, we calculate posterior probabilities its members best represent the physical system each seeks to reproduce. The posterior probability is based on the likelihood that a chosen summary statistic, computed from observations, would be obtained when the model's output is considered as a realization from a stochastic process. By exploring how posterior probabilities change with different statistics, we may paint a more quantitative and complete picture of the strengths and weaknesses of the models relative to the observations. We demonstrate our method using model output from the CMIP archive, and observations from NASA's Atmospheric Infrared Sounder.

  13. Evaluation of Global Observations-Based Evapotranspiration Datasets and IPCC AR4 Simulations

    NASA Technical Reports Server (NTRS)

    Mueller, B.; Seneviratne, S. I.; Jimenez, C.; Corti, T.; Hirschi, M.; Balsamo, G.; Ciais, P.; Dirmeyer, P.; Fisher, J. B.; Guo, Z.; hide

    2011-01-01

    Quantification of global land evapotranspiration (ET) has long been associated with large uncertainties due to the lack of reference observations. Several recently developed products now provide the capacity to estimate ET at global scales. These products, partly based on observational data, include satellite ]based products, land surface model (LSM) simulations, atmospheric reanalysis output, estimates based on empirical upscaling of eddycovariance flux measurements, and atmospheric water balance datasets. The LandFlux-EVAL project aims to evaluate and compare these newly developed datasets. Additionally, an evaluation of IPCC AR4 global climate model (GCM) simulations is presented, providing an assessment of their capacity to reproduce flux behavior relative to the observations ]based products. Though differently constrained with observations, the analyzed reference datasets display similar large-scale ET patterns. ET from the IPCC AR4 simulations was significantly smaller than that from the other products for India (up to 1 mm/d) and parts of eastern South America, and larger in the western USA, Australia and China. The inter-product variance is lower across the IPCC AR4 simulations than across the reference datasets in several regions, which indicates that uncertainties may be underestimated in the IPCC AR4 models due to shared biases of these simulations.

  14. Observations on the correlation between posture and jaw position: a pilot study.

    PubMed

    Bracco, P; Deregibus, A; Piscetta, R; Ferrario, G

    1998-10-01

    The aim of this pilot study was twofold. The first was to show a method for having an objective and dynamic analysis of body posture, evaluating weight distribution and its connections with different mandibular positions. The second was to verify if a neuromuscularly stimulated occlusal position, called myocentric occlusal position, is associated with a positive or negative postural charge. For the second aim a group of 20 subjects (including both males and females), was chosen. Posture of each subject was analyzed in three different conditions: centric occlusion, rest position and myocentric position. To evaluate the dynamic of posture a platform capable of measuring the weight on the feet supporting points and the related variations during time of observation and the swinging of body barycenter was used. The data showed that there is an improvement in the position of the barycenter from the centric occlusion to the myocentric position. Such an improvement can't be observed from the intercuspal position to the rest position. The results of this pilot study are discussed.

  15. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies.

    PubMed

    von Elm, Erik; Altman, Douglas G; Egger, Matthias; Pocock, Stuart J; Gøtzsche, Peter C; Vandenbroucke, Jan P

    2014-12-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the Web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Flap monitoring after head and neck reconstruction: evaluating an observation protocol.

    PubMed

    Devine, J C; Potter, L A; Magennis, P; Brown, J S; Vaughan, E D

    2001-01-01

    This study evaluated the postoperative free-flap monitoring frequency protocol used in a maxillofacial unit for patients receiving free-tissue transfer for reconstruction following orofacial cancer. All free-tissue transfers undertaken in the unit between January 1992 and October 1998 were reviewed retrospectively. Of the 370 patients evaluated, 46 returned to theatre with compromised free flaps. The compromise was purely venous in origin in 37 of these cases, arterial in three and due to a combination of arterial and venous problems in six. Thirty-five of the flaps were successfully salvaged. On average, the clinical manifestation of the problem occurred 25.5 hours postoperatively. However, there was a significant time difference between flaps that were salvaged successfully and those that were not: in the salvaged group the compromise was identified 17.5 hours postsurgery compared with 51 hours for the unsuccessful group. The timing of the return to theatre following the identification of the compromise was a significant factor in the success rate: 71 minutes for those salvaged and 103 minutes for those not salvaged. It is recommended that flaps are monitored hourly for the first 72 postoperative hours and observations recorded on a chart.

  17. Analytical Methods for a Learning Health System: 2. Design of Observational Studies

    PubMed Central

    Stoto, Michael; Oakes, Michael; Stuart, Elizabeth; Priest, Elisa L.; Savitz, Lucy

    2017-01-01

    The second paper in a series on how learning health systems can use routinely collected electronic health data (EHD) to advance knowledge and support continuous learning, this review summarizes study design approaches, including choosing appropriate data sources, and methods for design and analysis of natural and quasi-experiments. The primary strength of study design approaches described in this section is that they study the impact of a deliberate intervention in real-world settings, which is critical for external validity. These evaluation designs address estimating the counterfactual – what would have happened if the intervention had not been implemented. At the individual level, epidemiologic designs focus on identifying situations in which bias is minimized. Natural and quasi-experiments focus on situations where the change in assignment breaks the usual links that could lead to confounding, reverse causation, and so forth. And because these observational studies typically use data gathered for patient management or administrative purposes, the possibility of observation bias is minimized. The disadvantages are that one cannot necessarily attribute the effect to the intervention (as opposed to other things that might have changed), and the results do not indicate what about the intervention made a difference. Because they cannot rely on randomization to establish causality, program evaluation methods demand a more careful consideration of the “theory” of the intervention and how it is expected to play out. A logic model describing this theory can help to design appropriate comparisons, account for all influential variables in a model, and help to ensure that evaluation studies focus on the critical intermediate and long-term outcomes as well as possible confounders. PMID:29881745

  18. Amateur boxing and risk of chronic traumatic brain injury: systematic review of observational studies

    PubMed Central

    Knowles, Charles H; Whyte, Greg P

    2007-01-01

    Objective To evaluate the risk of chronic traumatic brain injury from amateur boxing. Setting Secondary research performed by combination of sport physicians and clinical academics. Design, data sources, and methods Systematic review of observational studies in which chronic traumatic brain injury was defined as any abnormality on clinical neurological examination, psychometric testing, neuroimaging studies, and electroencephalography. Studies were identified through database (1950 to date) and bibliographic searches without language restrictions. Two reviewers extracted study characteristics, quality, and data, with adherence to a protocol developed from a widely recommended method for systematic review of observational studies (MOOSE). Results 36 papers had relevant extractable data (from a detailed evaluation of 93 studies of 943 identified from the initial search). Quality of evidence was generally poor. The best quality studies were those with a cohort design and those that used psychometric tests. These yielded the most negative results: only four of 17 (24%) better quality studies found any indication of chronic traumatic brain injury in a minority of boxers studied. Conclusion There is no strong evidence to associate chronic traumatic brain injury with amateur boxing. PMID:17916811

  19. Evaluating Land-Atmosphere Moisture Feedbacks in Earth System Models With Spaceborne Observations

    NASA Astrophysics Data System (ADS)

    Levine, P. A.; Randerson, J. T.; Lawrence, D. M.; Swenson, S. C.

    2016-12-01

    We have developed a set of metrics for measuring the feedback loop between the land surface moisture state and the atmosphere globally on an interannual time scale. These metrics consider both the forcing of terrestrial water storage (TWS) on subsequent atmospheric conditions as well as the response of TWS to antecedent atmospheric conditions. We designed our metrics to take advantage of more than one decade's worth of satellite observations of TWS from the Gravity Recovery and Climate Experiment (GRACE) along with atmospheric variables from the Atmospheric Infrared Sounder (AIRS), the Global Precipitation Climatology Project (GPCP), and Clouds and the Earths Radiant Energy System (CERES). Metrics derived from spaceborne observations were used to evaluate the strength of the feedback loop in the Community Earth System Model (CESM) Large Ensemble (LENS) and in several models that contributed simulations to Phase 5 of the Coupled Model Intercomparison Project (CMIP5). We found that both forcing and response limbs of the feedback loop were generally stronger in tropical and temperate regions in CMIP5 models and even more so in LENS compared to satellite observations. Our analysis suggests that models may overestimate the strength of the feedbacks between the land surface and the atmosphere, which is consistent with previous studies conducted across different spatial and temporal scales.

  20. Video-Based Self-Observation as a Component of Developmental Teacher Evaluation

    ERIC Educational Resources Information Center

    Mercado, Leonardo A.; Baecher, Laura

    2014-01-01

    In this paper, we explore the benefits to teacher evaluation when video-based self-observation is done by teachers as a vehicle for individual, reflective practice. We explore how it was applied systematically at the ICPNA bi-national center among hundreds of EFL teachers within two institution-wide initiatives that have relied on self-observation…

  1. Randomized clinical trials and observational studies in the assessment of drug safety.

    PubMed

    Sawchik, J; Hamdani, J; Vanhaeverbeek, M

    2018-05-01

    Randomized clinical trials are considered as the preferred design to assess the potential causal relationships between drugs or other medical interventions and intended effects. For this reason, randomized clinical trials are generally the basis of development programs in the life cycle of drugs and the cornerstone of evidence-based medicine. Instead, randomized clinical trials are not the design of choice for the detection and assessment of rare, delayed and/or unexpected effects related to drug safety. Moreover, the highly homogeneous populations resulting from restrictive eligibility criteria make randomized clinical trials inappropriate to describe comprehensively the safety profile of drugs. In that context, observational studies have a key added value when evaluating the benefit-risk balance of the drugs. However, observational studies are more prone to bias than randomized clinical trials and they have to be designed, conducted and reported judiciously. In this article, we discuss the strengths and limitations of randomized clinical trials and of observational studies, more particularly regarding their contribution to the knowledge of medicines' safety profile. In addition, we present general recommendations for the sensible use of observational data. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  2. Yogurt and Diabetes: Overview of Recent Observational Studies.

    PubMed

    Salas-Salvadó, Jordi; Guasch-Ferré, Marta; Díaz-López, Andrés; Babio, Nancy

    2017-07-01

    The effects of dairy consumption on the prevention of type 2 diabetes remain controversial and depend on the dairy subtype. Yogurt intake has received special attention because its association with health benefits is more consistent than that of other types of dairy products. In the present article, we review those observational studies that evaluated the association between yogurt consumption and type 2 diabetes. We also discuss the possible mechanisms involved in these associations. We found that 13 prospective studies evaluated the association between yogurt intake and type 2 diabetes, most of which showed an inverse association between the frequency of yogurt consumption and the risk of diabetes. In addition to the scientific evidence accumulated from individual prospective studies, several meta-analyses have shown that yogurt consumption has a potential role in diabetes prevention. The most recent analysis shows a 14% lower risk of type 2 diabetes when yogurt consumption was 80-125 g/d compared with no yogurt consumption. The intake of fermented dairy products, especially yogurt, has been inversely associated with variables of glucose metabolism. Yogurt may have probiotic effects that could modulate glucose metabolism. We conclude that yogurt consumption, in the context of a healthy dietary pattern, may reduce the risk of type 2 diabetes in healthy and older adults at high cardiovascular risk. Large-scale intervention studies and randomized clinical trials are warranted to determine if yogurt consumption has beneficial effects on insulin sensitivity and reduces the risk of type 2 diabetes. © 2017 American Society for Nutrition.

  3. X-Ray Phantom Development For Observer Performance Studies

    NASA Astrophysics Data System (ADS)

    Kelsey, C. A.; Moseley, R. D.; Mettler, F. A.; Parker, T. W.

    1981-07-01

    The requirements for radiographic imaging phantoms for observer performance testing include realistic tasks which mimic at least some portion of the diagnostic examination presented in a setting which approximates clinically derived images. This study describes efforts to simulate chest and vascular diseases for evaluation of conventional and digital radiographic systems. Images of lung nodules, pulmonary infiltrates, as well as hilar and mediastinal masses are generated with a conventional chest phantom to make up chest disease test series. Vascular images are simulated by hollow tubes embedded in tissue density plastic with widening and narrowing added to mimic aneurysms and stenoses. Both sets of phantoms produce images which allow simultaneous determination of true positive and false positive rates as well as complete ROC curves.

  4. Preliminary Checklist for Reporting Observational Studies in Sports Areas: Content Validity.

    PubMed

    Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana; Anguera, M Teresa; Losada, José L; Portell, Mariona; Lozano-Lozano, José A

    2018-01-01

    Observational studies are based on systematic observation, understood as an organized recording and quantification of behavior in its natural context. Applied to the specific area of sports, observational studies present advantages when comparing studies based on other designs, such as the flexibility for adapting to different contexts and the possibility of using non-standardized instruments as well as a high degree of development in specific software and data analysis. Although the importance and usefulness of sports-related observational studies have been widely shown, there is no checklist to report these studies. Consequently, authors do not have a guide to follow in order to include all of the important elements in an observational study in sports areas, and reviewers do not have a reference tool for assessing this type of work. To resolve these issues, this article aims to develop a checklist to measure the quality of sports-related observational studies based on a content validity study. The participants were 22 judges with at least 3 years of experience in observational studies, sports areas, and methodology. They evaluated a list of 60 items systematically selected and classified into 12 dimensions. They were asked to score four aspects of each item on 5-point Likert scales to measure the following dimensions: representativeness, relevance, utility, and feasibility. The judges also had an open-format section for comments. The Osterlind index was calculated for each item and for each of the four aspects. Items were considered appropriate when obtaining a score of at least 0.5 in the four assessed aspects. After considering these inclusion criteria and all of the open-format comments, the resultant checklist consisted of 54 items grouped into the same initial 12 dimensions. Finally, we highlight the strengths of this work. We also present its main limitation: the need to apply the resultant checklist to obtain data and, thus, increase quality indicators of

  5. Preliminary Checklist for Reporting Observational Studies in Sports Areas: Content Validity

    PubMed Central

    Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana; Anguera, M. Teresa; Losada, José L.; Portell, Mariona; Lozano-Lozano, José A.

    2018-01-01

    Observational studies are based on systematic observation, understood as an organized recording and quantification of behavior in its natural context. Applied to the specific area of sports, observational studies present advantages when comparing studies based on other designs, such as the flexibility for adapting to different contexts and the possibility of using non-standardized instruments as well as a high degree of development in specific software and data analysis. Although the importance and usefulness of sports-related observational studies have been widely shown, there is no checklist to report these studies. Consequently, authors do not have a guide to follow in order to include all of the important elements in an observational study in sports areas, and reviewers do not have a reference tool for assessing this type of work. To resolve these issues, this article aims to develop a checklist to measure the quality of sports-related observational studies based on a content validity study. The participants were 22 judges with at least 3 years of experience in observational studies, sports areas, and methodology. They evaluated a list of 60 items systematically selected and classified into 12 dimensions. They were asked to score four aspects of each item on 5-point Likert scales to measure the following dimensions: representativeness, relevance, utility, and feasibility. The judges also had an open-format section for comments. The Osterlind index was calculated for each item and for each of the four aspects. Items were considered appropriate when obtaining a score of at least 0.5 in the four assessed aspects. After considering these inclusion criteria and all of the open-format comments, the resultant checklist consisted of 54 items grouped into the same initial 12 dimensions. Finally, we highlight the strengths of this work. We also present its main limitation: the need to apply the resultant checklist to obtain data and, thus, increase quality indicators of

  6. Evaluation of observational research reports published in Turkish nursing journals.

    PubMed

    Karaçam, Z; Şen, E; Yildirim, B

    2015-09-01

    The aim of this literature-based descriptive study was to examine the reporting of the observational research studies published in peer-reviewed nursing journals in Turkey. Eleven peer-reviewed nursing journals printed on a regular basis in Turkey between 2007 and 2012 were selected. These journals were searched for observational research studies, and 502 studies were selected and examined by using the Strengthening the Reporting of Observational Studies in Epidemiology Statement. Of the 502 studies, 495 were cross-sectional, 3 were cohort, and 4 were case controlled. Summary and introduction and aim sections were sufficient in most of the studies. The methods sections of the reports were mostly not reported: 64.3% of the reports did not indicate eligibility/inclusion criteria; sampling method, 67.0%; possible sources of bias, 99.2%; ways to reach sample size, 92.6%. In the results section, the number of individuals participating in each stage of the studies (44.0%) and in other analyses made (39.2%) was not reported. In the discussion section, a main comment about research findings was partly made (97.4%), and limitations of the studies and possible sources of bias were not written in 99.0% of the studies. This study clearly revealed that the observational research studies published in nursing journals in Turkey did not fulfil the important criteria and needed to be improved. Information obtained from this study can contribute to improvement of the quality of reporting observational studies in nursing and thus using obtained findings in practice. © 2015 International Council of Nurses.

  7. Echocardiographic evaluation of myocardial changes observed after closure of patent ductus arteriosus in dogs.

    PubMed

    Hamabe, L; Kim, S; Yoshiyuki, R; Fukayama, T; Nakata, T M; Fukushima, R; Tanaka, R

    2015-01-01

    Closure of PDA can be associated with echocardiographic changes including deterioration of LV systolic function. Although PDA is commonly encountered in dogs, few comprehensive reports of echocardiographic changes in dogs with PDA closure are available. To evaluate the short-term echocardiographic changes observed after PDA closure in dogs using strain analysis. Seventeen client-owned dogs with left-to-right PDA. Echocardiographic evaluations, including standard echocardiography and two-dimensional tissue tracking (2DTT), were performed before and within 3 days of PDA closure. Preclosure examination showed LV and left atrial dilatation indicating volume overload as a result of PDA. Closure of PDA resulted in significant reduction of LVIDd (<.0001) and LA/Ao (0.01) without change in LVIDs, suggestive of decreased preload. Postclosure LV systolic dysfunction was observed with significant decreased in FS (<.0001) and strain values (P = .0039 for radial strains, P = .0005 for circumferential strains). Additionally, significant LV dyssynchrony (P = .0162) was observed after closure of PDA. Closure of PDA resulted in decreased preload as a result of alleviation of LV volume overload, which in turn caused transient deterioration of LV systolic function. Additionally, this study demonstrated that strain analysis is load dependent. Therefore, care should be taken when interpreting strain measurements as an indicator of LV systolic function. Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of American College of Veterinary Internal Medicine.

  8. Magnetic resonance evaluation of cardiac thrombi and masses by T1 and T2 mapping: an observational study.

    PubMed

    Caspar, Thibault; El Ghannudi, Soraya; Ohana, Mickaël; Labani, Aïssam; Lawson, Aubrietia; Ohlmann, Patrick; Morel, Olivier; De Mathelin, Michel; Roy, Catherine; Gangi, Afshin; Germain, Philippe

    2017-04-01

    The purpose of this work was to evaluate CMR T1 and T2 mapping sequences in patients with intracardiac thrombi and masses in order to assess T1 and T2 relaxometry usefulness and to allow better etiological diagnosis. This observational study of patients scheduled for routine CMR was performed from September 2014 to August 2015. All patients referred to our department for a 1.5 T CMR were screened to participate. T1 mapping were acquired before and after Gadolinium injection; T2 mapping images were obtained before injection. 41 patients were included. 22 presented with cardiac thrombi and 19 with cardiac masses. The native T1 of thrombi was 1037 ± 152 ms (vs 1032 ± 39 ms for myocardium, p = 0.88; vs 1565 ± 88 ms for blood pool, p < 0.0001). T2 were 74 ± 13 ms (vs 51 ± 3 ms for myocardium, p < 0.0001; vs 170 ± 32 ms for blood pool, p < 0.0001). Recent thrombi had a native T1 shorter than old thrombi (911 ± 177 vs 1169 ± 107 ms, p = 0.01). The masses having a shorter T1 than the myocardium were lipomas (278 ± 29 ms), calcifications (621 ± 218 ms), and melanoma (736 ms). All other masses showed T1 values higher than myocardial T1, with T2 consistently >70 ms. T1 and T2 mapping CMR sequences can be useful and represent a new approach for the evaluation of cardiac thrombi and masses.

  9. Critical discussion of evaluation parameters for inter-observer variability in target definition for radiation therapy.

    PubMed

    Fotina, I; Lütgendorf-Caucig, C; Stock, M; Pötter, R; Georg, D

    2012-02-01

    Inter-observer studies represent a valid method for the evaluation of target definition uncertainties and contouring guidelines. However, data from the literature do not yet give clear guidelines for reporting contouring variability. Thus, the purpose of this work was to compare and discuss various methods to determine variability on the basis of clinical cases and a literature review. In this study, 7 prostate and 8 lung cases were contoured on CT images by 8 experienced observers. Analysis of variability included descriptive statistics, calculation of overlap measures, and statistical measures of agreement. Cross tables with ratios and correlations were established for overlap parameters. It was shown that the minimal set of parameters to be reported should include at least one of three volume overlap measures (i.e., generalized conformity index, Jaccard coefficient, or conformation number). High correlation between these parameters and scatter of the results was observed. A combination of descriptive statistics, overlap measure, and statistical measure of agreement or reliability analysis is required to fully report the interrater variability in delineation.

  10. Evaluating and improving cloud phase in the Community Atmosphere Model version 5 using spaceborne lidar observations

    NASA Astrophysics Data System (ADS)

    Kay, Jennifer E.; Bourdages, Line; Miller, Nathaniel B.; Morrison, Ariel; Yettella, Vineel; Chepfer, Helene; Eaton, Brian

    2016-04-01

    Spaceborne lidar observations from the Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observation (CALIPSO) satellite are used to evaluate cloud amount and cloud phase in the Community Atmosphere Model version 5 (CAM5), the atmospheric component of a widely used state-of-the-art global coupled climate model (Community Earth System Model). By embedding a lidar simulator within CAM5, the idiosyncrasies of spaceborne lidar cloud detection and phase assignment are replicated. As a result, this study makes scale-aware and definition-aware comparisons between model-simulated and observed cloud amount and cloud phase. In the global mean, CAM5 has insufficient liquid cloud and excessive ice cloud when compared to CALIPSO observations. Over the ice-covered Arctic Ocean, CAM5 has insufficient liquid cloud in all seasons. Having important implications for projections of future sea level rise, a liquid cloud deficit contributes to a cold bias of 2-3°C for summer daily maximum near-surface air temperatures at Summit, Greenland. Over the midlatitude storm tracks, CAM5 has excessive ice cloud and insufficient liquid cloud. Storm track cloud phase biases in CAM5 maximize over the Southern Ocean, which also has larger-than-observed seasonal variations in cloud phase. Physical parameter modifications reduce the Southern Ocean cloud phase and shortwave radiation biases in CAM5 and illustrate the power of the CALIPSO observations as an observational constraint. The results also highlight the importance of using a regime-based, as opposed to a geographic-based, model evaluation approach. More generally, the results demonstrate the importance and value of simulator-enabled comparisons of cloud phase in models used for future climate projection.

  11. A pragmatic observational feasibility study on integrated treatment for musculoskeletal disorders: Design and protocol.

    PubMed

    Hu, Xiao-yang; Hughes, John; Fisher, Peter; Lorenc, Ava; Purtell, Rachel; Park, A-La; Robinson, Nicola

    2016-02-01

    Musculoskeletal disorders (MSD) comprise a wide range of conditions, associated with an enormous pain and impaired mobility, and are affecting people's lives and work. Management of musculoskeletal disorders typically involves a multidisciplinary team approach. Positive findings have been found in previous studies evaluating the effectiveness of complementary therapies, though little attention has been paid to evaluating of the effectiveness of integrated packages of care combining conventional and complementary approaches for musculoskeletal conditions in a National Health Service (NHS) setting. To determine the feasibility of all aspects of a pragmatic observational study designed: (1) to evaluate the effectiveness and cost effectiveness of integrated treatments for MSDs in an integrated NHS hospital in the UK; (2) to determine the acceptability of the study design and research process to patients; (3) to explore patients' expectation and experience of receiving integrated treatments. This is an observational feasibility study, with 1-year recruitment and 1-year follow-up, conducted in Royal London Hospital for Integrated Medicine, University College London Hospital Trust, UK. All eligible patients with MSDs newly referred to the hospital were included in the study. Interventions are integrated packages of care (conventional and complementary) as currently provided in the hospital. SF-36™ Health Survey, short form Brief Pain Inventory, Visual Analogue Scale, and modified Client Service Receipt Inventory will be assessed at 4/5 time points. Semi-structured interview/focus group will be carried out before treatment, and 1 year after commence of treatment. We intend to conduct a pragmatic observational study of integrated medical treatment of MSDs at a public sector hospital. It will inform the design of a future trial including recruitment, retention, suitability of the outcome measures and patients experiences.

  12. Evaluation of the Effect of Aneurysmal Clipping on Electrocardiography and Echocardiographic Changes in Patients With Subarachnoid Hemorrhage: A Prospective Observational Study.

    PubMed

    Jangra, Kiran; Grover, Vinod K; Bhagat, Hemant; Bhardwaj, Avanish; Tewari, Manoj K; Kumar, Bhupesh; Panda, Nidhi B; Sahu, Seelora

    2017-07-01

    Electrocardiographic (ECG) and echocardiographic changes that are subsequent to aneurysmal subarachnoid hemorrhage (a-SAH) are commonly observed with a prevalence varying from 27% to 100% and 13% to 18%, respectively. There are sparse data in the literature about the pattern of ECG and echocardiographic changes in patients with SAH after clipping of the aneurysm. Hence, we observed the effect of aneurysmal clipping on ECG and echocardiographic changes during the first week after surgery, and the impact of these changes on outcome at the end of 1 year. This prospective, observational study was conducted in 100 consecutive patients with a-SAH undergoing clipping of ruptured aneurysm. ECG and echocardiographic changes were recorded preoperatively and every day after surgery until 7 days. Outcome was evaluated using the Glasgow outcome scale at the end of 1 year. Of 100 patients, 75 had ECG changes and 17 had echocardiographic changes preoperatively. The ECG changes observed were QTc prolongation, conduction defects, ST-wave and T-wave abnormalities, tachyarrhythmias, and bradyarrhythmias. The echocardiography changes included global hypokinesia and regional wall motion abnormalities. Both echocardiographic and ECG changes showed significant recovery on the first postoperative day. Patients presenting with both echocardiographic and ECG changes were found to require higher ionotropic support to maintain the desired blood pressure, and were associated with poor outcome (Glasgow outcome scale, 1 to 2) at 1 year after surgery. There was no association of ECG and echocardiographic changes with mortality (both in-hospital or at 1 year). The ECG changes, such as QTc prolongation, bradycardia, conduction abnormality, and echocardiographic changes, recover on postoperative day-1, in most of the cases after clipping. Patients with combined ECG and echocardiographic changes tend to have poor neurological outcome at the end of 1 year.

  13. Evaluation of a randomized controlled trial in the management of chronic lower back pain in a French automotive industry: an observational study.

    PubMed

    Nassif, Hala; Brosset, Nicolas; Guillaume, Marion; Delore-Milles, Emilie; Tafflet, Muriel; Buchholz, Frédéric; Toussaint, Jean-François

    2011-12-01

    To evaluate a specific workplace intervention for the management of chronic lower back pain among employees working in assembly positions in the automotive industry. Randomized controlled trial. On site at the workplace of a French automotive manufacturer. Subjects (N=75 volunteers) were recruited on site and randomly assigned to either an experimental group (n=37) or a control group (n=38). The experimental group followed a supervised 60-minute session, 3 times per week, of muscle strengthening, flexibility, and endurance training during 2 months. The control group received no direct intervention. Evaluation took place at baseline, 2 months, and 6 months. Pain related parameters were evaluated using validated questionnaires and scales translated into French (Quebec Back Pain Disability Scale, Rolan Morris Disability Questionnaire, Dallas Pain Questionnaire, and the Tampa Scale for Kinesiophobia). Perceived pain intensity was evaluated using the numerical rating scale, and physical outcome measures were evaluated using specific indicators (flexibility, Biering-Sorensen Test, Shirado test). The multivariate analysis of variance, t test, and Wilcoxon signed-rank test were used for statistical analysis. We observed a significant beneficial effect (P<.025) for the experimental group at 2 and 6 months in pain parameters, specific flexibility, and in back functions, and a significant improvement at 6 months in the control group for the perceived pain intensity, anterior flexion, flexibility of quadriceps, and Dallas Pain Questionnaire's work recreational score. An increase in the practice of physical activity outside the workplace was noted in both groups at 2 months but persisted at 6 months for the experimental group. This study reinforces the multiple health benefits of physical activity and physical therapy modalities in the workplace by assisting individuals at risk who have chronic LBP. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by

  14. Using satellite observations in performance evaluation for regulatory air quality modeling: Comparison with ground-level measurements

    NASA Astrophysics Data System (ADS)

    Odman, M. T.; Hu, Y.; Russell, A.; Chai, T.; Lee, P.; Shankar, U.; Boylan, J.

    2012-12-01

    Regulatory air quality modeling, such as State Implementation Plan (SIP) modeling, requires that model performance meets recommended criteria in the base-year simulations using period-specific, estimated emissions. The goal of the performance evaluation is to assure that the base-year modeling accurately captures the observed chemical reality of the lower troposphere. Any significant deficiencies found in the performance evaluation must be corrected before any base-case (with typical emissions) and future-year modeling is conducted. Corrections are usually made to model inputs such as emission-rate estimates or meteorology and/or to the air quality model itself, in modules that describe specific processes. Use of ground-level measurements that follow approved protocols is recommended for evaluating model performance. However, ground-level monitoring networks are spatially sparse, especially for particulate matter. Satellite retrievals of atmospheric chemical properties such as aerosol optical depth (AOD) provide spatial coverage that can compensate for the sparseness of ground-level measurements. Satellite retrievals can also help diagnose potential model or data problems in the upper troposphere. It is possible to achieve good model performance near the ground, but have, for example, erroneous sources or sinks in the upper troposphere that may result in misleading and unrealistic responses to emission reductions. Despite these advantages, satellite retrievals are rarely used in model performance evaluation, especially for regulatory modeling purposes, due to the high uncertainty in retrievals associated with various contaminations, for example by clouds. In this study, 2007 was selected as the base year for SIP modeling in the southeastern U.S. Performance of the Community Multiscale Air Quality (CMAQ) model, at a 12-km horizontal resolution, for this annual simulation is evaluated using both recommended ground-level measurements and non-traditional satellite

  15. Experimental evaluation of nonclassical correlations between measurement outcomes and target observable in a quantum measurement

    NASA Astrophysics Data System (ADS)

    Iinuma, Masataka; Suzuki, Yutaro; Nii, Taiki; Kinoshita, Ryuji; Hofmann, Holger F.

    2016-03-01

    In general, it is difficult to evaluate measurement errors when the initial and final conditions of the measurement make it impossible to identify the correct value of the target observable. Ozawa proposed a solution based on the operator algebra of observables which has recently been used in experiments investigating the error-disturbance trade-off of quantum measurements. Importantly, this solution makes surprisingly detailed statements about the relations between measurement outcomes and the unknown target observable. In the present paper, we investigate this relation by performing a sequence of two measurements on the polarization of a photon, so that the first measurement commutes with the target observable and the second measurement is sensitive to a complementary observable. While the initial measurement can be evaluated using classical statistics, the second measurement introduces the effects of quantum correlations between the noncommuting physical properties. By varying the resolution of the initial measurement, we can change the relative contribution of the nonclassical correlations and identify their role in the evaluation of the quantum measurement. It is shown that the most striking deviation from classical expectations is obtained at the transition between weak and strong measurements, where the competition between different statistical effects results in measurement values well outside the range of possible eigenvalues.

  16. Computational and human observer image quality evaluation of low dose, knowledge-based CT iterative reconstruction

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

    Eck, Brendan L.; Fahmi, Rachid; Miao, Jun

    2015-10-15

    Purpose: Aims in this study are to (1) develop a computational model observer which reliably tracks the detectability of human observers in low dose computed tomography (CT) images reconstructed with knowledge-based iterative reconstruction (IMR™, Philips Healthcare) and filtered back projection (FBP) across a range of independent variables, (2) use the model to evaluate detectability trends across reconstructions and make predictions of human observer detectability, and (3) perform human observer studies based on model predictions to demonstrate applications of the model in CT imaging. Methods: Detectability (d′) was evaluated in phantom studies across a range of conditions. Images were generated usingmore » a numerical CT simulator. Trained observers performed 4-alternative forced choice (4-AFC) experiments across dose (1.3, 2.7, 4.0 mGy), pin size (4, 6, 8 mm), contrast (0.3%, 0.5%, 1.0%), and reconstruction (FBP, IMR), at fixed display window. A five-channel Laguerre–Gauss channelized Hotelling observer (CHO) was developed with internal noise added to the decision variable and/or to channel outputs, creating six different internal noise models. Semianalytic internal noise computation was tested against Monte Carlo and used to accelerate internal noise parameter optimization. Model parameters were estimated from all experiments at once using maximum likelihood on the probability correct, P{sub C}. Akaike information criterion (AIC) was used to compare models of different orders. The best model was selected according to AIC and used to predict detectability in blended FBP-IMR images, analyze trends in IMR detectability improvements, and predict dose savings with IMR. Predicted dose savings were compared against 4-AFC study results using physical CT phantom images. Results: Detection in IMR was greater than FBP in all tested conditions. The CHO with internal noise proportional to channel output standard deviations, Model-k4, showed the best trade

  17. Cultivating cohort studies for observational translational research.

    PubMed

    Ransohoff, David F

    2013-04-01

    "Discovery" research about molecular markers for diagnosis, prognosis, or prediction of response to therapy has frequently produced results that were not reproducible in subsequent studies. What are the reasons, and can observational cohorts be cultivated to provide strong and reliable answers to those questions? Experimental Selected examples are used to illustrate: (i) what features of research design provide strength and reliability in observational studies about markers of diagnosis, prognosis, and response to therapy? (ii) How can those design features be cultivated in existing observational cohorts, for example, within randomized controlled clinical trial (RCT), other existing observational research studies, or practice settings like health maintenance organization (HMOs)? Examples include a study of RNA expression profiles of tumor tissue to predict prognosis of breast cancer, a study of serum proteomics profiles to diagnose ovarian cancer, and a study of stool-based DNA assays to screen for colon cancer. Strengths and weaknesses of observational study design features are discussed, along with lessons about how features that help assure strength might be "cultivated" in the future. By considering these examples and others, it may be possible to develop a process of "cultivating cohorts" in ongoing RCTs, observational cohort studies, and practice settings like HMOs that have strong features of study design. Such an effort could produce sources of data and specimens to reliably answer questions about the use of molecular markers in diagnosis, prognosis, and response to therapy.

  18. Seeing beyond monitors-Critical care nurses' multiple skills in patient observation: Descriptive qualitative study.

    PubMed

    Alastalo, Mika; Salminen, Leena; Lakanmaa, Riitta-Liisa; Leino-Kilpi, Helena

    2017-10-01

    The aim of this study was to provide a comprehensive description of multiple skills in patient observation in critical care nursing. Data from semi-structured interviews were analysed using thematic analysis. Experienced critical care nurses (n=20) from three intensive care units in two university hospitals in Finland. Patient observation skills consist of: information gaining skills, information processing skills, decision-making skills and co-operation skills. The first three skills are integrated in the patient observation process, in which gaining information is a prerequisite for processing information that precedes making decisions. Co-operation has a special role as it occurs throughout the process. This study provided a comprehensive description of patient observation skills related to the three-phased patient observation process. The findings contribute to clarifying this part of the competence. The description of patient observation skills may be applied in both clinical practice and education as it may serve as a framework for orientation, ensuring clinical skills and designing learning environments. Based on this study, patient observation skills can be recommended to be included in critical care nursing education, orientation and as a part of critical care nurses' competence evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Experimental evaluation of shark detection rates by aerial observers.

    PubMed

    Robbins, William D; Peddemors, Victor M; Kennelly, Steven J; Ives, Matthew C

    2014-01-01

    Aerial surveys are a recognised technique to identify the presence and abundance of marine animals. However, the capability of aerial observers to reliably sight coastal sharks has not been previously assessed, nor have differences in sighting rates between aircraft types been examined. In this study we investigated the ability of observers in fixed-wing and helicopter aircraft to sight 2.5 m artificial shark analogues placed at known depths and positions. Initial tests revealed that the shark analogues could only be detected at shallow depths, averaging only 2.5 m and 2.7 m below the water surface for observers in fixed-wing and helicopter aircraft, respectively. We then deployed analogues at shallower depths along a 5 km-long grid, and assessed their sightability to aircraft observers through a series of transects flown within 500 m. Analogues were seen infrequently from all distances, with overall sighting rates of only 12.5% and 17.1% for fixed-wing and helicopter observers, respectively. Although helicopter observers had consistently higher success rates of sighting analogues within 250 m of their flight path, neither aircraft observers sighted more than 9% of analogues deployed over 300 m from their flight paths. Modelling of sighting rates against environmental and experimental variables indicated that observations were affected by distance, aircraft type, sun glare and sea conditions, while the range of water turbidities observed had no effect. We conclude that aerial observers have limited ability to detect the presence of submerged animals such as sharks, particularly when the sharks are deeper than ∼ 2.6 m, or over 300 m distant from the aircraft's flight path, especially during sunny or windy days. The low rates of detections found in this study cast serious doubts on the use of aerial beach patrols as an effective early-warning system to prevent shark attacks.

  20. Experimental Evaluation of Shark Detection Rates by Aerial Observers

    PubMed Central

    Robbins, William D.; Peddemors, Victor M.; Kennelly, Steven J.; Ives, Matthew C.

    2014-01-01

    Aerial surveys are a recognised technique to identify the presence and abundance of marine animals. However, the capability of aerial observers to reliably sight coastal sharks has not been previously assessed, nor have differences in sighting rates between aircraft types been examined. In this study we investigated the ability of observers in fixed-wing and helicopter aircraft to sight 2.5 m artificial shark analogues placed at known depths and positions. Initial tests revealed that the shark analogues could only be detected at shallow depths, averaging only 2.5 m and 2.7 m below the water surface for observers in fixed-wing and helicopter aircraft, respectively. We then deployed analogues at shallower depths along a 5 km-long grid, and assessed their sightability to aircraft observers through a series of transects flown within 500 m. Analogues were seen infrequently from all distances, with overall sighting rates of only 12.5% and 17.1% for fixed-wing and helicopter observers, respectively. Although helicopter observers had consistently higher success rates of sighting analogues within 250 m of their flight path, neither aircraft observers sighted more than 9% of analogues deployed over 300 m from their flight paths. Modelling of sighting rates against environmental and experimental variables indicated that observations were affected by distance, aircraft type, sun glare and sea conditions, while the range of water turbidities observed had no effect. We conclude that aerial observers have limited ability to detect the presence of submerged animals such as sharks, particularly when the sharks are deeper than ∼2.6 m, or over 300 m distant from the aircraft's flight path, especially during sunny or windy days. The low rates of detections found in this study cast serious doubts on the use of aerial beach patrols as an effective early-warning system to prevent shark attacks. PMID:24498258

  1. Informative Bayesian Type A uncertainty evaluation, especially applicable to a small number of observations

    NASA Astrophysics Data System (ADS)

    Cox, M.; Shirono, K.

    2017-10-01

    A criticism levelled at the Guide to the Expression of Uncertainty in Measurement (GUM) is that it is based on a mixture of frequentist and Bayesian thinking. In particular, the GUM’s Type A (statistical) uncertainty evaluations are frequentist, whereas the Type B evaluations, using state-of-knowledge distributions, are Bayesian. In contrast, making the GUM fully Bayesian implies, among other things, that a conventional objective Bayesian approach to Type A uncertainty evaluation for a number n of observations leads to the impractical consequence that n must be at least equal to 4, thus presenting a difficulty for many metrologists. This paper presents a Bayesian analysis of Type A uncertainty evaluation that applies for all n ≥slant 2 , as in the frequentist analysis in the current GUM. The analysis is based on assuming that the observations are drawn from a normal distribution (as in the conventional objective Bayesian analysis), but uses an informative prior based on lower and upper bounds for the standard deviation of the sampling distribution for the quantity under consideration. The main outcome of the analysis is a closed-form mathematical expression for the factor by which the standard deviation of the mean observation should be multiplied to calculate the required standard uncertainty. Metrological examples are used to illustrate the approach, which is straightforward to apply using a formula or look-up table.

  2. Medication safety research by observational study design.

    PubMed

    Lao, Kim S J; Chui, Celine S L; Man, Kenneth K C; Lau, Wallis C Y; Chan, Esther W; Wong, Ian C K

    2016-06-01

    Observational studies have been recognised to be essential for investigating the safety profile of medications. Numerous observational studies have been conducted on the platform of large population databases, which provide adequate sample size and follow-up length to detect infrequent and/or delayed clinical outcomes. Cohort and case-control are well-accepted traditional methodologies for hypothesis testing, while within-individual study designs are developing and evolving, addressing previous known methodological limitations to reduce confounding and bias. Respective examples of observational studies of different study designs using medical databases are shown. Methodology characteristics, study assumptions, strengths and weaknesses of each method are discussed in this review.

  3. Evaluation of the Relative Contribution of Observing Systems in Reanalyses: Aircraft Temperature Bias and Analysis Innovations

    NASA Technical Reports Server (NTRS)

    Bosilovich, Michael G.; Dasilva, Arindo M.

    2012-01-01

    Reanalyses have become important sources of data in weather and climate research. While observations are the most crucial component of the systems, few research projects consider carefully the multitudes of assimilated observations and their impact on the results. This is partly due to the diversity of observations and their individual complexity, but also due to the unfriendly nature of the data formats. Here, we discuss the NASA Modern-Era Retrospective analysis for Research and Applications (MERRA) and a companion dataset, the Gridded Innovations and Observations (GIO). GIO is simply a post-processing of the assimilated observations and their innovations (forecast error and analysis error) to a common spatio-temporal grid, following that of the MERRA analysis fields. This data includes in situ, retrieved and radiance observations that are assimilated and used in the reanalysis. While all these disparate observations and statistics are in a uniform easily accessible format, there are some limitations. Similar observations are binned to the grid, so that multiple observations are combined in the gridding process. The data is then implicitly thinned. Some details in the meta data may also be lost (e.g. aircraft or station ID). Nonetheless, the gridded observations should provide easy access to all the observations input to the reanalysis. To provide an example of the GIO data, a case study evaluating observing systems over the United States and statistics is presented, and demonstrates the evaluation of the observations and the data assimilation. The GIO data is used to collocate 200mb Radiosonde and Aircraft temperature measurements from 1979-2009. A known warm bias of the aircraft measurements is apparent compared to the radiosonde data. However, when larger quantities of aircraft data are available, they dominate the analysis and the radiosonde data become biased against the forecast. When AMSU radiances become available the radiosonde and aircraft analysis and

  4. Diagnostic inaccuracy and subject exclusions render placebo and observational studies of acute otitis media inconclusive.

    PubMed

    Pichichero, Michael E; Casey, Janet R

    2008-11-01

    Diagnostic accuracy and appropriate inclusion/exclusion criteria representative of children at greatest risk is of paramount importance in trials to evaluate placebo or observation as an option for acute otitis media (AOM) management. Twelve observational studies spanning the time frame 1958-2005 and 13 natural history studies spanning the time frame 1968-2006 were evaluated for the diagnostic criteria, inclusion criteria, and exclusion criteria applied within the study design. Although a bulging or full tympanic membrane (TM) with effusion is the best indication of a diagnosis of bacterial AOM based on tympanocentesis findings, few observational and natural history studies required a bulging TM. Examination of subject inclusion criteria showed that many subjects did not have AOM but rather had no middle ear disease at all or they had otitis media with effusion. Exclusion criteria of subjects were also remarkable. Frequently children <2 years old were excluded; mean age among the studies reflected an older age group, unlike the true epidemiology of AOM. Otitis prone children, those with severe disease, with a bulging TM, with fever, with a definite need for antibiotics, with recent antibiotic treatment, with recent AOM, or with perforation of the TM were often excluded. Guidelines and some authorities have overlooked or discounted the importance of the issues of inaccurate diagnosis on study entry, broad inclusion criteria, and the creation of bias in exclusion criteria among placebo/natural history trials in AOM. The current data favoring observation of children with AOM should be reconsidered until better studies are conducted.

  5. Carbon Monoxide Data Assimilation for Atmospheric Composition and Climate Science: Evaluating Performance with Current and Future Observations

    NASA Astrophysics Data System (ADS)

    Barre, J.; Edwards, D. P.; Gaubert, B.; Worden, H. M.; Arellano, A. F.; Anderson, J. L.

    2015-12-01

    vertical sensitivity and cloud cover. The impact of observing over each region is evaluated independently. Winter and summer cases studies are investigated i.e. where emissions, cloud cover and CO lifetime significantly change.

  6. Observational Versus Experimental Studies: What’s the Evidence for a Hierarchy?

    PubMed Central

    Concato, John

    2004-01-01

    Summary: The tenets of evidence-based medicine include an emphasis on hierarchies of research design (i.e., study architecture). Often, a single randomized, controlled trial is considered to provide “truth,” whereas results from any observational study are viewed with suspicion. This paper describes information that contradicts and discourages such a rigid approach to evaluating the quality of research design. Unless a more balanced strategy evolves, new claims of methodological authority may be just as problematic as the traditional claims of medical authority that have been criticized by proponents of evidence-based medicine. PMID:15717036

  7. The Alberta smoke plume observation study

    NASA Astrophysics Data System (ADS)

    Anderson, Kerry; Pankratz, Al; Mooney, Curtis; Fleetham, Kelly

    2018-02-01

    A field project was conducted to observe and measure smoke plumes from wildland fires in Alberta. This study used handheld inclinometer measurements and photos taken at lookout towers in the province. Observations of 222 plumes were collected from 21 lookout towers over a 6-year period from 2010 to 2015. Observers reported the equilibrium and maximum plume heights based on the plumes' final levelling heights and the maximum lofting heights, respectively. Observations were tabulated at the end of each year and matched to reported fires. Fire sizes at assessment times and forest fuel types were reported by the province. Fire weather conditions were obtained from the Canadian Wildland Fire Information System (CWFIS). Assessed fire sizes were adjusted to the appropriate size at plume observation time using elliptical fire-growth projections. Though a logical method to collect plume observations in principle, many unanticipated issues were uncovered as the project developed. Instrument limitations and environmental conditions presented challenges to the investigators, whereas human error and the subjectivity of observations affected data quality. Despite these problems, the data set showed that responses to fire behaviour conditions were consistent with the physical processes leading to plume rise. The Alberta smoke plume observation study data can be found on the Canadian Wildland Fire Information System datamart (Natural Resources Canada, 2018) at http://cwfis.cfs.nrcan.gc.ca/datamart.

  8. The social evaluation of faces: a meta-analysis of functional neuroimaging studies

    PubMed Central

    Mende-Siedlecki, Peter; Said, Christopher P.

    2013-01-01

    Neuroscience research on the social evaluation of faces has accumulated over the last decade, yielding divergent results. We used a meta-analytic technique, multi-level kernel density analysis (MKDA), to analyze 29 neuroimaging studies on face evaluation. Across negative face evaluations, we observed the most consistent activations in bilateral amygdala. Across positive face evaluations, we observed the most consistent activations in medial prefrontal cortex, pregenual anterior cingulate cortex (pgACC), medial orbitofrontal cortex (mOFC), left caudate and nucleus accumbens (NAcc). Based on additional analyses comparing linear and non-linear responses, we propose a ventral/dorsal dissociation within the amygdala, wherein separate populations of neurons code for face valence and intensity, respectively. Finally, we argue that some of the differences between studies are attributable to differences in the typicality of face stimuli. Specifically, extremely attractive faces are more likely to elicit responses in NAcc/caudate and mOFC. PMID:22287188

  9. Case study of a framing effect in course evaluations.

    PubMed

    Lynöe, Niels; Juth, Niklas; Helgesson, Gert

    2012-01-01

    When new elements are included in the medical curriculum and the total time frame remains unchanged, established disciplines have to shorten their courses. This might bring about frustration among the teachers and students concerned, which in turn might affect how other courses are perceived. Two course evaluations, one before and one after a major change in the curriculum were compared. Comments were also analysed. We found that the students' and teachers' frustration influenced the students' evaluations of a new course in the philosophy of medicine and accordingly brought about an unintended message effect referred to as a framing effect. The results of this observational study indicate that a negative framing effect might influence course-evaluations. We suggest that this study might be used as a point of departure for further empirical studies about negative framing effects.

  10. Efficacy and safety of long-term losartan therapy demonstrated by a prospective observational study in Japanese patients with hypertension: The Japan Hypertension Evaluation with Angiotensin II Antagonist Losartan Therapy (J-HEALTH) study.

    PubMed

    Naritomi, Hiroaki; Fujita, Toshiro; Ito, Sadayoshi; Ogihara, Toshio; Shimada, Kazuyuki; Shimamoto, Kazuaki; Tanaka, Heizo; Yoshiike, Nobuo

    2008-02-01

    The Japan Hypertension Evaluation with Angiotensin II Antagonist Losartan Therapy (J-HEALTH) study is a nationwide, prospective, multicentered, observational study that was designed to enroll 30,000 hypertensive Japanese patients from more than 3,000 private practitioners. It is the first large-scale observational study to assess the efficacy and safety of losartan, an angiotensin II receptor antagonist, in Japan. Patients were enrolled between June 2000 and May 2002, and followed up to June 2005. The data from 29,850 patients were used for the analysis of safety and efficacy. These patients were treated with losartan mostly at a daily dose of 25-50 mg. The mean follow-up period was 2.9 years. The patients were aged 62.4+/-12.1 years (mean+/-SD) and their mean systolic/diastolic blood pressure was 165.3+/-17.2/94.3+/-11.7 mmHg (mean+/-SD). Mean blood pressure in patients who were evaluated for efficacy decreased from 165.8/94.8 mmHg (n=26,512) at baseline to 145.5/84.4 mmHg after 3 months (n=21,269) and 138.6/80.0 mmHg after 36 months of treatment (n=13,879). Blood pressure was well controlled during the study period by losartan alone or losartan-based combination therapy. In nearly half of the patients, blood pressure was reduced to less than 140/90 mmHg during the study period. In addition to its antihypertensive effect, losartan reduced the uric acid level in patients whose baseline uric acid level was > or =7 mg/dL. Losartan also prevented acceleration of proteinuria. Adverse drug reactions occurred in 1,081 of the 29,850 patients. Long-term losartan therapy was effective and well tolerated in Japanese clinical practice.

  11. Cross-compartment evaluation of a fully-coupled hydrometeorological modeling system using comprehensive observation data

    NASA Astrophysics Data System (ADS)

    Fersch, Benjamin; Senatore, Alfonso; Kunstmann, Harald

    2017-04-01

    Fully-coupled hydrometeorological modeling enables investigations about the complex and often non-linear exchange mechanisms among subsurface, land, and atmosphere with respect to water and energy fluxes. The consideration of lateral redistribution of surface and subsurface water in such modeling systems is a crucial enhancement, allowing for a better representation of surface spatial patterns and providing also channel discharge predictions. However, the evaluation of fully-coupled simulations is difficult since the amount of physical detail along with feedback mechanisms leads to high degrees of freedom. Therefore, comprehensive observation data is required to obtain meaningful model configurations. We present a case study for a medium-sized river catchment in southern Germany that includes the calibration of the stand-alone and the evaluation of the fully-coupled WRF-Hydro modeling system with a horizontal resolution of 1 x 1 km2, for the period June to August 2015. ECMWF ERA-Interim reanalysis is used for model driving. Land-surface processes are represented by the Noah-MP land surface model. Land-cover is described by the EU CORINE data set. Observations for model evaluation are obtained from the TERENO Pre-Alpine observatory (http://www.imk-ifu.kit.edu/tereno.php) and are complemented by further measurements from the ScaleX campaign (http://scalex.imk-ifu.kit.edu) such as atmospheric profiles obtained from radiometer sounding and airborne systems as well as soil moisture and -temperature networks. We show how well water budgets and heat-fluxes are being reproduced by the stand-alone WRF, the stand-alone WRF-Hydro and the fully-coupled WRF-Hydro model.

  12. Training induces scapular dyskinesis in pain-free competitive swimmers: a reliability and observational study.

    PubMed

    Madsen, Pernille H; Bak, Klaus; Jensen, Susanne; Welter, Ulrik

    2011-03-01

    Scapular dyskinesis is a major etiological factor in overhead athletes' shoulder problems. Our hypotheses were to evaluate if (1) visual observation of scapular dyskinesis during scaption has substantial interobserver reliability, and (2) scapular dyskinesis may be induced by swim training in pain-free swimmers. A reliability and observational study. Bachelor project at a college institution and at a private sports orthopedic hospital. Seventy-eight competitive swimmers with no history of shoulder pain were included in the study. Fourteen swimmers were evaluated regarding reliability. Inclusion criteria were competitive swimmers with high training volume who previously had no shoulder pain. Observations of scapular dyskinesis (yes/no) during simple scaption. The interobserver reliability of scaption and wall push-up was evaluated in 14 swimmers using kappa analysis. Prevalence of scapular dyskinesis at 4 time intervals during a swim training session. The scaption test resulted in a weighted kappa value of 0.75. Scapular dyskinesis was seen in 29 shoulders (37%) after the first time interval, in another 24 (cumulated prevalence 68%) after one-half of the training session, and in an additional 4 swimmers (cumulated prevalence 73%) after three-quarters of the training session. During the last quarter of the training session, another 7 swimmers had dyskinesis, resulting in a cumulated prevalence of 82%. The prevalence of abnormal scapular kinesis during a normal training session is high in previously pain-free swimmers. The prevalence increases with more training and occurs early during the training session.

  13. Technological aspects of hospital communication challenges: an observational study.

    PubMed

    Popovici, Ilinca; Morita, Plinio P; Doran, Diane; Lapinsky, Stephen; Morra, Dante; Shier, Ashleigh; Wu, Robert; Cafazzo, Joseph A

    2015-06-01

    To gain insights into how technological communication tools impact effective communication among clinicians, which is critical for patient safety. This multi-site observational study analyzes inter-clinician communication and interaction with information technology, with a focus on the critical process of patient transfer from the Emergency Department to General Internal Medicine. Mount Sinai Hospital, Sunnybrook Health Sciences Centre and Toronto General Hospital. At least five ED and general internal medicine nurses and physicians directly involved in patient transfers were observed on separate occasions at each institution. N/A. N/A. The study provides insight into clinician workflow, evaluates current hospital communication systems and identifies key issues affecting communication: interruptions, issues with numeric pagers, lack of integrated communication tools, lack of awareness of consultation status, inefficiencies related to the paper chart, unintuitive user interfaces, mixed use of electronic and paper systems and lack of up-to-date contact information. It also identifies design trade-offs to be negotiated: synchronous communication vs. reducing interruptions, notification of patient status vs. reducing interruptions and speed vs. quality of handovers. The issues listed should be considered in the design of new technology for hospital communications. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  14. A global logrank test for adaptive treatment strategies based on observational studies.

    PubMed

    Li, Zhiguo; Valenstein, Marcia; Pfeiffer, Paul; Ganoczy, Dara

    2014-02-28

    In studying adaptive treatment strategies, a natural question that is of paramount interest is whether there is any significant difference among all possible treatment strategies. When the outcome variable of interest is time-to-event, we propose an inverse probability weighted logrank test for testing the equivalence of a fixed set of pre-specified adaptive treatment strategies based on data from an observational study. The weights take into account both the possible selection bias in an observational study and the fact that the same subject may be consistent with more than one treatment strategy. The asymptotic distribution of the weighted logrank statistic under the null hypothesis is obtained. We show that, in an observational study where the treatment selection probabilities need to be estimated, the estimation of these probabilities does not have an effect on the asymptotic distribution of the weighted logrank statistic, as long as the estimation of the parameters in the models for these probabilities is n-consistent. Finite sample performance of the test is assessed via a simulation study. We also show in the simulation that the test can be pretty robust to misspecification of the models for the probabilities of treatment selection. The method is applied to analyze data on antidepressant adherence time from an observational database maintained at the Department of Veterans Affairs' Serious Mental Illness Treatment Research and Evaluation Center. Copyright © 2013 John Wiley & Sons, Ltd.

  15. The Dependability of Classroom Observations.

    ERIC Educational Resources Information Center

    Hiatt, Diana Buell; Keesling, J. Ward

    A generalizability study of timed observations was conducted in 25 primary grade classes to observe teachers' use of time--for instruction, evaluation of instruction, and classroom management--according to the hour and day observed. Observational methods used by on-site researchers included videotape, checklists, running documentaries, frequency…

  16. Evaluation of the BISAP scoring system in prognostication of acute pancreatitis - A prospective observational study.

    PubMed

    Hagjer, Sumitra; Kumar, Nitesh

    2018-04-21

    Severe acute pancreatitis has a high mortality and its early identification is important for management and risk stratification. The bedside index for severity in acute pancreatitis (BISAP) is a simple scoring system done at admission which predicts the severity of pancreatitis. Procalcitonin is an inflammatory marker which is raised very early and helps in early prediction of the severity of disease. This study aims to evaluate the BISAP score and Procalcitonin in prognostication of acute pancreatitis. A prospective observational study of 60 patients presenting with acute pancreatitis was done at XXX Medical College and Hospital from July 2015 to June 2016. BISAP, APACHE-II, Ranson criteria, and CT severity index (CTSI) of all patients were calculated. Procalcitonin card test was done for all patients. The patients were stratified according by BISAP score and procalcitonin positivity into categories of severe pancreatitis, organ failure and pancreatic necrosis, as well as the number of deaths. The comparison of BISAP with other scoring systems, Procalcitonin (PCT), C-reactive protein (CRP), hematocrit, and body mass index (BMI) was done by the area under the receiver-operating curve (AUC) to prediction of severe acute pancreatitis, organ failure, necrosis, and death. Of the 60 patients, 14 (23.3%) developed severe acute pancreatitis, 11 (18.3%) Organ failure, 21 (35%) pancreatic necrosis and 7 (11.6%) died. A BISAP score of ≥3 was a statistically significant cutoff value. AUCs for predicting severe pancreatitis and death of BISAP were 0.875 and 0.740respectively, similar to those for Ranson criteria (0.802, 0.763) and APACHE-II (0.891, 0.769) and greater than AUCs for CTSI (0.641, 0.554). The AUC for prediction of organ failure were 0.906, 0.833, 0.874 and 0.623 for BISAP, Ranson criteria, APACHE-II, and CTSI respectively. AUCs for PCT predicting severity, organ failure, and death were 0.940, 0.923 and 0.769 respectively were similar to BISAP but greater than

  17. Inter-rater reliability of direct observations of the physical and psychosocial working conditions in eldercare: An evaluation in the DOSES project.

    PubMed

    Karstad, Kristina; Rugulies, Reiner; Skotte, Jørgen; Munch, Pernille Kold; Greiner, Birgit A; Burdorf, Alex; Søgaard, Karen; Holtermann, Andreas

    2018-05-01

    The aim of the study was to develop and evaluate the reliability of the "Danish observational study of eldercare work and musculoskeletal disorders" (DOSES) observation instrument to assess physical and psychosocial risk factors for musculoskeletal disorders (MSD) in eldercare work. During 1.5 years, sixteen raters conducted 117 inter-rater observations from 11 nursing homes. Reliability was evaluated using percent agreement and Gwet's AC1 coefficient. Of the 18 examined items, inter-rater reliability was excellent for 7 items (AC1>0.75) fair to good for 7 items (AC1 0.40-0.75) and poor for 2 items (AC1 0-0.40). For 2 items there was no agreement between the raters (AC1 <0). The reliability did not differ between the first and second half of the data collection period and the inter-rater observations were representative regarding occurrence of events in eldercare work. The instrument is appropriate for assessing physical and psychosocial risk factors for MSD among eldercare workers. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Accurate CT-MR image registration for deep brain stimulation: a multi-observer evaluation study

    NASA Astrophysics Data System (ADS)

    Rühaak, Jan; Derksen, Alexander; Heldmann, Stefan; Hallmann, Marc; Meine, Hans

    2015-03-01

    Since the first clinical interventions in the late 1980s, Deep Brain Stimulation (DBS) of the subthalamic nucleus has evolved into a very effective treatment option for patients with severe Parkinson's disease. DBS entails the implantation of an electrode that performs high frequency stimulations to a target area deep inside the brain. A very accurate placement of the electrode is a prerequisite for positive therapy outcome. The assessment of the intervention result is of central importance in DBS treatment and involves the registration of pre- and postinterventional scans. In this paper, we present an image processing pipeline for highly accurate registration of postoperative CT to preoperative MR. Our method consists of two steps: a fully automatic pre-alignment using a detection of the skull tip in the CT based on fuzzy connectedness, and an intensity-based rigid registration. The registration uses the Normalized Gradient Fields distance measure in a multilevel Gauss-Newton optimization framework and focuses on a region around the subthalamic nucleus in the MR. The accuracy of our method was extensively evaluated on 20 DBS datasets from clinical routine and compared with manual expert registrations. For each dataset, three independent registrations were available, thus allowing to relate algorithmic with expert performance. Our method achieved an average registration error of 0.95mm in the target region around the subthalamic nucleus as compared to an inter-observer variability of 1.12 mm. Together with the short registration time of about five seconds on average, our method forms a very attractive package that can be considered ready for clinical use.

  19. Prognostic factors of Bell's palsy: prospective patient collected observational study.

    PubMed

    Fujiwara, Takashi; Hato, Naohito; Gyo, Kiyofumi; Yanagihara, Naoaki

    2014-07-01

    The purpose of this study was to evaluate various parameters potentially influencing poor prognosis in Bell's palsy and to assess the predictive value for Bell's palsy. A single-center prospective patient collected observation and validation study was conducted. To evaluate the correlation between patient characteristics and poor prognosis, we performed univariate and multivariate analyzes of age, gender, side of palsy, diabetes mellitus, hypertension, and facial grading score 1 week after onset. To evaluate the accuracy of the facial grading score, we prepared a receiver operating characteristic (ROC) curve and calculated the area under the ROC curve (AUROC). We also calculated sensitivity, specificity, positive/negative likelihood ratio, and positive/negative predictive value. We included Bell's palsy patients who attended Ehime University Hospital within 1 week after onset between 1977 and 2011. We excluded patients who were less than 15 years old and lost-to-follow-up within 6 months. The main outcome was defined as non-recovery at 6 months after onset. In total, 679 adults with Bell's palsy were included. The facial grading score at 1 week showed a correlation with non-recovery in the multivariate analysis, although age, gender, side of palsy, diabetes mellitus, and hypertension did not. The AUROC of the facial grading score was 0.793. The Y-system score at 1 week moderate accurately predicted non-recovery at 6 months in Bell's palsy.

  20. [Evaluation of effect of indacaterol (Onbrez) and/or glycopyrronium (Seebri) treatment on Quality of Life of COPD patients in medical practice in Poland - observational study (OSQO)].

    PubMed

    Płusa, Tadeusz; Physicians From Medical Centers In Poland, Group Of

    2017-10-23

    Indacaterol, as well glycopyronium has been reimbursed lately in Poland, so patients have a greater access to this treatment in medical practice. Physicians do not realize the potential benefit of once daily ultra-LABA indacaterol and/or modern LAMA with fast-acting glycopyrronium on treatment results. The aim of the study was to evaluate the impact of routinely administered treatment with either indacaterol (Onbrez) or glycopyrronium (Seebri) or both on patient reported outcomes in form of the health status (CCQ score - clinical COPD questionnaire) and level of dyspnoea (mMRC - modified Medical Research Council) in treatment naive COPD patients after the change of treatment as addon from any other COPD treatment in "real life" settings. This study was designed as an observational, non-interventional and multicenter project in COPD patients being treated with Onbrez and/or Seebri in 32 medical centers in Poland. The observation period covered 6 months from the first taking of Onbrez and/or Seebri. No diagnostic or monitoring or treatment procedures have been applied to the patients, other than those which are applied in the course of standard, current practice. The total number of enrolled patients was 633. Because of inability of verification the medical records or failure to meet data collection requirements 587 patients enrolled to the registry has been evaluated. Within this number of patients 171 had delayed the time of visits or they had not second visit. Due to therapy change additional 20 patients has been withdrawn. 396 patients were taken for the final analysis. Improvement of mMRC and CCQ scores was observed in all treatment groups e.g. indacaterol solely, glycopyrronium solely and combination therapy of indacaterol and glypyrronium. The study revealed that the best results can be achieved with combination therapy accordingly with clinical recommendation for COPD treatment (GOLD). The results have been achieved in the real world settings, showing that

  1. Evaluation on surface current observing network of high frequency ground wave radars in the Gulf of Thailand

    NASA Astrophysics Data System (ADS)

    Yin, Xunqiang; Shi, Junqiang; Qiao, Fangli

    2018-05-01

    Due to the high cost of ocean observation system, the scientific design of observation network becomes much important. The current network of the high frequency radar system in the Gulf of Thailand has been studied using a three-dimensional coastal ocean model. At first, the observations from current radars have been assimilated into this coastal model and the forecast results have improved due to the data assimilation. But the results also show that further optimization of the observing network is necessary. And then, a series of experiments were carried out to assess the performance of the existing high frequency ground wave radar surface current observation system. The simulated surface current data in three regions were assimilated sequentially using an efficient ensemble Kalman filter data assimilation scheme. The experimental results showed that the coastal surface current observation system plays a positive role in improving the numerical simulation of the currents. Compared with the control experiment without assimilation, the simulation precision of surface and subsurface current had been improved after assimilated the surface currents observed at current networks. However, the improvement for three observing regions was quite different and current observing network in the Gulf of Thailand is not effective and a further optimization is required. Based on these evaluations, a manual scheme has been designed by discarding the redundant and inefficient locations and adding new stations where the performance after data assimilation is still low. For comparison, an objective scheme based on the idea of data assimilation has been obtained. Results show that all the two schemes of observing network perform better than the original network and optimal scheme-based data assimilation is much superior to the manual scheme that based on the evaluation of original observing network in the Gulf of Thailand. The distributions of the optimal network of radars could be a

  2. The presence of nonthoracic distracting injuries does not affect the initial clinical examination of the cervical spine in evaluable blunt trauma patients: a prospective observational study.

    PubMed

    Konstantinidis, Agathoklis; Plurad, David; Barmparas, Galinos; Inaba, Kenji; Lam, Lydia; Bukur, Marko; Branco, Bernardino C; Demetriades, Demetrios

    2011-09-01

    A distracting injury mandates cervical spine (c-spine) imaging in the evaluable blunt trauma patient who demonstrates no pain or tenderness over the c-spine. The purpose of this study was to examine which distracting injuries can negatively affect the sensitivity of the standard clinical examination of the c-spine. This is a prospective observational study conducted at a Level I Trauma Center from January 1, 2008, to December 31, 2009. After institutional review board approval, all evaluable (Glasgow Coma Scale score ≥13) blunt trauma patients older than 16 years sustaining a c-spine injury were enrolled. A distracting injury was defined as any immediately evident bony or soft tissue injury or a complaint of non-c-spine pain whether or not an actual injury was subsequently diagnosed. Information regarding the initial clinical examination and the presence of a distracting injury was collected from the senior resident or attending trauma surgeon involved in the initial management. During the study period, 101 evaluable patients sustained a c-spine injury. Distracting injuries were present in 88 patients (87.1%). The most common was rib fracture (21.6%), followed by lower extremity fracture (20.5%) and upper extremity fracture (12.5%). Only four (4.0%) patients had no pain or tenderness on the initial examination of the c-spine. All four patients had bruising and tenderness to the upper anterior chest. None of these four patients developed neurologic sequelae or required a surgical stabilization or immobilization. C-spine imaging may not be required in the evaluable blunt trauma patient despite distracting injuries in any body regions that do not involve the upper chest. Further definition of distracting injuries is mandated to avoid unnecessary utilization of resources and to reduce the imaging burden associated with the evaluation of the c-spine.

  3. Embedding clinical interventions into observational studies

    PubMed Central

    Newman, Anne B.; Avilés-Santa, M. Larissa; Anderson, Garnet; Heiss, Gerardo; Howard, Wm. James; Krucoff, Mitchell; Kuller, Lewis H.; Lewis, Cora E.; Robinson, Jennifer G.; Taylor, Herman; Treviño, Roberto P.; Weintraub, William

    2017-01-01

    Novel approaches to observational studies and clinical trials could improve the cost-effectiveness and speed of translation of research. Hybrid designs that combine elements of clinical trials with observational registries or cohort studies should be considered as part of a long-term strategy to transform clinical trials and epidemiology, adapting to the opportunities of big data and the challenges of constrained budgets. Important considerations include study aims, timing, breadth and depth of the existing infrastructure that can be leveraged, participant burden, likely participation rate and available sample size in the cohort, required sample size for the trial, and investigator expertise. Community engagement and stakeholder (including study participants) support are essential for these efforts to succeed. PMID:26611435

  4. Interpreting observational studies: why empirical calibration is needed to correct p-values

    PubMed Central

    Schuemie, Martijn J; Ryan, Patrick B; DuMouchel, William; Suchard, Marc A; Madigan, David

    2014-01-01

    Often the literature makes assertions of medical product effects on the basis of ‘ p < 0.05’. The underlying premise is that at this threshold, there is only a 5% probability that the observed effect would be seen by chance when in reality there is no effect. In observational studies, much more than in randomized trials, bias and confounding may undermine this premise. To test this premise, we selected three exemplar drug safety studies from literature, representing a case–control, a cohort, and a self-controlled case series design. We attempted to replicate these studies as best we could for the drugs studied in the original articles. Next, we applied the same three designs to sets of negative controls: drugs that are not believed to cause the outcome of interest. We observed how often p < 0.05 when the null hypothesis is true, and we fitted distributions to the effect estimates. Using these distributions, we compute calibrated p-values that reflect the probability of observing the effect estimate under the null hypothesis, taking both random and systematic error into account. An automated analysis of scientific literature was performed to evaluate the potential impact of such a calibration. Our experiment provides evidence that the majority of observational studies would declare statistical significance when no effect is present. Empirical calibration was found to reduce spurious results to the desired 5% level. Applying these adjustments to literature suggests that at least 54% of findings with p < 0.05 are not actually statistically significant and should be reevaluated. © 2013 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd. PMID:23900808

  5. Evaluation of Integrated Multi-satellitE Retrievals for GPM with All Weather Gauge Observations over CONUS

    NASA Astrophysics Data System (ADS)

    Chen, S.; Qi, Y.; Hu, B.; Hu, J.; Hong, Y.

    2015-12-01

    The Global Precipitation Measurement (GPM) mission is composed of an international network of satellites that provide the next-generation global observations of rain and snow. Integrated Multi-satellitE Retrievals for GPM (IMERG) is the state-of-art precipitation products with high spatio-temporal resolution of 0.1°/30min. IMERG unifies precipitation measurements from a constellation of research and operational satellites with the core sensors dual-frequency precipitation radar (DPR) and microwave imager (GMI) on board a "Core" satellite. Additionally, IMERG blends the advantages of currently most popular satellite-based quantitative precipitation estimates (QPE) algorithms, i.e. TRMM Multi-satellite Precipitation Analysis (TMPA), Climate Prediction Center morphing technique (CMORPH), Precipitation Estimation from Remotely Sensed Information using Artificial Neural Networks-Cloud Classification System (PERSIANN-CCS). The real-time and post real-time IMERG products are now available online at https://stormpps.gsfc.nasa.gov/storm. In this study, the final run post real-time IMERG is evaluated with all-weather manual gauge observations over CONUS from June 2014 through May 2015. Relative Bias (RB), Root-Mean-Squared Error (RMSE), Correlation Coefficient (CC), Probability Of Detection (POD), False Alarm Ratio (FAR), and Critical Success Index (CSI) are used to quantify the performance of IMERG. The performance of IMERG in estimating snowfall precipitation is highlighted in the study. This timely evaluation with all-weather gauge observations is expected to offer insights into performance of IMERG and thus provide useful feedback to the algorithm developers as well as the GPM data users.

  6. Effects of the Non-Nutritive Sweeteners on Glucose Metabolism and Appetite Regulating Hormones: Systematic Review of Observational Prospective Studies and Clinical Trials

    PubMed Central

    Romo-Romo, Alonso; Aguilar-Salinas, Carlos A.; Brito-Córdova, Griselda X.; Gómez Díaz, Rita A.; Vilchis Valentín, David

    2016-01-01

    Background The effects of non-nutritive sweeteners (NNS) on glucose metabolism and appetite regulating hormones are not clear. There is an ongoing debate concerning NNS use and deleterious changes in metabolism. Objectives The aim of this review is to analyze the scientific available evidence regarding the effects of NNS on glucose metabolism and appetite regulating hormones. Data Sources and Study Eligibility Criteria We identified human observational studies evaluating the relation between NNS consumption and obesity, diabetes, and metabolic syndrome, in addition to clinical trials evaluating the effects of NNS in glucose metabolism and appetite regulating hormones. Results Fourteen observational studies evaluating the association between NNS consumption and the development of metabolic diseases and twenty-eight clinical trials studying the effects of NNS on metabolism were included. Finally, two meta-analyses evaluating the association between the consumption of NNS-containing beverages and the development of type 2 diabetes were identified. Conclusions Some observational studies suggest an association between NNS consumption and development of metabolic diseases; however, adiposity is a confounder frequently found in observational studies. The effects of the NNS on glucose metabolism are not clear. The results of the identified clinical trials are contradictory and are not comparable because of the major existing differences between them. Studies evaluating specific NNS, with an adequate sample size, including a homogeneous study group, identifying significant comorbidities, with an appropriate control group, with an appropriate exposure time, and considering adjustment for confounder variables such as adiposity are needed. PMID:27537496

  7. A framework to observe and evaluate the sustainability of human-natural systems in a complex dynamic context.

    PubMed

    Satanarachchi, Niranji; Mino, Takashi

    2014-01-01

    This paper aims to explore the prominent implications of the process of observing complex dynamics linked to sustainability in human-natural systems and to propose a framework for sustainability evaluation by introducing the concept of sustainability boundaries. Arguing that both observing and evaluating sustainability should engage awareness of complex dynamics from the outset, we try to embody this idea in the framework by two complementary methods, namely, the layer view- and dimensional view-based methods, which support the understanding of a reflexive and iterative sustainability process. The framework enables the observation of complex dynamic sustainability contexts, which we call observation metastructures, and enable us to map the contexts to sustainability boundaries.

  8. [Association between chronic periodontitis and hyperlipidemia: a Meta-analysis based on observational studies].

    PubMed

    Lianhui, Yang; Meifei, Lian; Zhongyue, Hu; Yunzhi, Feng

    2017-08-01

    Objective The aim of this study is to evaluate the relationship between periodontitis and hyperlipidemia risks through Meta-analysis. Methods Two researchers conducted an electronic search on PubMed, Cochrane Library, Embase, CBM, CNKI, Wanfang and VIP databases established until July 2016 for observational studies on the association between periodontitis and hyperlipidemia. The language used was limited to Chinese and English. After data extraction and quality evaluation of included trials, Meta-analysis was conducted using the RevMan 5.3 software. The GRADE 3.6 software was used to evaluate the quality level of the evidence. Results Six case-control studies and one cohort study were included. The results of Meta-analysis showed that serum triglyceride (TG) in patients with periodontitis was significantly higher than that of the periodontal health group (MD=50.50, 95% confidence interval=39.57-61.42, P<0.000 01), as well as serum total cholesterol (TC) (MD=17.54, 95% confidence interval=10.91-24.18, P<0.000 01). Furthermore, the risks of TG and TC in the serum of patients with chronic periodontitis were 4.73 times (OR=4.73, 95% confidence interval=2.74-8.17, P<0.000 01) and 3.62 times (OR=3.62, 95% confidence interval=2.18-6.03, P<0.000 01) of that of periodontal healthy patients. No significant difference was observed between the group with high-density lipoprotein cholesterol (HDL-C) and that with low density lipoprotein cholesterol (LDL-C). Conclusion Current evidence indicates that a correlation exists between chronic periodontitis and hyperlipidemia, and chronic periodontitis is an independent risk factor for hyperlipidemia, especially for TC and TG in serum.

  9. Embedding clinical interventions into observational studies.

    PubMed

    Newman, Anne B; Avilés-Santa, M Larissa; Anderson, Garnet; Heiss, Gerardo; Howard, Wm James; Krucoff, Mitchell; Kuller, Lewis H; Lewis, Cora E; Robinson, Jennifer G; Taylor, Herman; Treviño, Roberto P; Weintraub, William

    2016-01-01

    Novel approaches to observational studies and clinical trials could improve the cost-effectiveness and speed of translation of research. Hybrid designs that combine elements of clinical trials with observational registries or cohort studies should be considered as part of a long-term strategy to transform clinical trials and epidemiology, adapting to the opportunities of big data and the challenges of constrained budgets. Important considerations include study aims, timing, breadth and depth of the existing infrastructure that can be leveraged, participant burden, likely participation rate and available sample size in the cohort, required sample size for the trial, and investigator expertise. Community engagement and stakeholder (including study participants) support are essential for these efforts to succeed. Copyright © 2015. Published by Elsevier Inc.

  10. An Evaluation of Lightning Flash Rate Parameterizations Based on Observations of Colorado Storms during DC3

    NASA Astrophysics Data System (ADS)

    Basarab, B.; Fuchs, B.; Rutledge, S. A.

    2013-12-01

    Predicting lightning activity in thunderstorms is important in order to accurately quantify the production of nitrogen oxides (NOx = NO + NO2) by lightning (LNOx). Lightning is an important global source of NOx, and since NOx is a chemical precursor to ozone, the climatological impacts of LNOx could be significant. Many cloud-resolving models rely on parameterizations to predict lightning and LNOx since the processes leading to charge separation and lightning discharge are not yet fully understood. This study evaluates predicted flash rates based on existing lightning parameterizations against flash rates observed for Colorado storms during the Deep Convective Clouds and Chemistry Experiment (DC3). Evaluating lightning parameterizations against storm observations is a useful way to possibly improve the prediction of flash rates and LNOx in models. Additionally, since convective storms that form in the eastern plains of Colorado can be different thermodynamically and electrically from storms in other regions, it is useful to test existing parameterizations against observations from these storms. We present an analysis of the dynamics, microphysics, and lightning characteristics of two case studies, severe storms that developed on 6 and 7 June 2012. This analysis includes dual-Doppler derived horizontal and vertical velocities, a hydrometeor identification based on polarimetric radar variables using the CSU-CHILL radar, and insight into the charge structure using observations from the northern Colorado Lightning Mapping Array (LMA). Flash rates were inferred from the LMA data using a flash counting algorithm. We have calculated various microphysical and dynamical parameters for these storms that have been used in empirical flash rate parameterizations. In particular, maximum vertical velocity has been used to predict flash rates in some cloud-resolving chemistry simulations. We diagnose flash rates for the 6 and 7 June storms using this parameterization and compare

  11. Evaluation of selected wells in Pennsylvania's observation-well program as of 1993

    USGS Publications Warehouse

    Conger, R.W.

    1997-01-01

    In 1993, the U.S. Geological Survey operated 62 observation wells in 60 of Pennsylvania's 67 counties in cooperation with the Pennsylvania Department of Environmental Resources. These wells attempt to monitor an aerial extent of 45,000 square miles and penetrate 39 geologic formations or water-bearing units of 14 physiographic provinces. Some wells were drilled specifically for the observation-well program, some were drilled for other U.S. Geological Survey projects, and some were drilled for other purposes and were no longer used. Approximately 3 percent of the network wells have less than 5 years of record, 5 percent have 5 to 15 years of record, and 92 percent have greater than 15 years of record. The older the observation well, the greater the possibility of water levels being affected by physical deterioration of the borehole. Therefore, it is necessary to periodically conduct a series of physical, chemical, and hydraulic tests to determine changes in the physical condition of the well and local land-use practices that may affect water-level response. Nineteen wells were selected for evaluation on the basis of past questionable water-level responses. These wells were evaluated for functionality by analyzing historical water-level fluctuations, geophysical logs, single-well aquifer tests, and water-quality analyses. These parameters indicated that well Je-23 (Jefferson County) is affected by coal-mine pumpage, well Bt-311 (Butler County) is periodically affected by strip mine activities, well Gr-118 (Greene County) and Mc-110 (McKean County exhibit unexplained fluctuations not desirable for an observation well, and 15 wells show no obvious problems or degradation that would affect their functionality to monitor natural water-level fluctuations.

  12. A concealed observational study of infection control and safe injection practices in Jordanian governmental hospitals.

    PubMed

    Al-Rawajfah, Omar M; Tubaishat, Ahmad

    2017-10-01

    The recognized international organizations on infection prevention recommend using an observational method as the gold standard procedure for assessing health care professional's compliance with standard infection control practices. However, observational studies are rarely used in Jordanian infection control studies. This study aimed to evaluate injection practices among nurses working in Jordanian governmental hospitals. A cross-sectional concealed observational design is used for this study. A convenience sampling technique was used to recruit a sample of nurses working in governmental hospitals in Jordan. Participants were unaware of the time and observer during the observation episode. A total of 384 nurses from 9 different hospitals participated in the study. A total of 835 injections events were observed, of which 73.9% were performed without handwashing, 64.5% without gloving, and 27.5% were followed by needle recapping. Handwashing rate was the lowest (18.9%) when injections were performed by beginner nurses. Subcutaneous injections were associated with the lowest rate (26.7%) of postinjection handwashing compared with other routes. This study demonstrates the need for focused and effective infection control educational programs in Jordanian hospitals. Future studies should consider exploring the whole infection control practices related to waste disposal and the roles of the infection control nurse in this process in Jordanian hospitals. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  13. Evaluating rainfall kinetic energy - intensity relationships with observed disdrometric data

    NASA Astrophysics Data System (ADS)

    Angulo-Martinez, Marta; Begueria, Santiago; Latorre, Borja

    2016-04-01

    Rainfall kinetic energy is required for determining erosivity, the ability of rainfall to detach soil particles and initiate erosion. Its determination relay on the use of disdrometers, i.e. devices capable of measuring the drop size distribution and velocity of falling raindrops. In the absence of such devices, rainfall kinetic energy is usually estimated with empirical expressions relating rainfall energy and intensity. We evaluated the performance of 14 rainfall energy equations in estimating one-minute rainfall energy and event total energy, in comparison with observed data from 821 rainfall episodes (more than 100 thousand one-minute observations) by means of an optical disdrometer. In addition, two sources of bias when using such relationships were evaluated: i) the influence of using theoretical terminal raindrop fall velocities instead of measured values; and ii) the influence of time aggregation (rainfall intensity data every 5-, 10-, 15-, 30-, and 60-minutes). Empirical relationships did a relatively good job when complete events were considered (R2 > 0.82), but offered poorer results for within-event (one-minute resolution) variation. Also, systematic biases where large for many equations. When raindrop size distribution was known, estimating the terminal fall velocities by empirical laws produced good results even at fine time resolution. The influence of time aggregation was very high in the estimated kinetic energy, although linear scaling may allow empirical correction. This results stress the importance of considering all these effects when rainfall energy needs to be estimated from more standard precipitation records. , and recommends the use of disdrometer data to locally determine rainfall kinetic energy.

  14. Distracted Biking: An Observational Study.

    PubMed

    Wolfe, Elizabeth Suzanne; Arabian, Sandra Strack; Breeze, Janis L; Salzler, Matthew J

    2016-01-01

    Commuting via bicycle is a very popular mode of transportation in the Northeastern United States. Boston, MA, has seen a rapid increase in bicycle ridership over the past decade, which has raised concerns and awareness about bicycle safety. An emerging topic in this field is distracted bicycle riding. This study was conducted to provide descriptive data on the prevalence and type of distracted bicycling in Boston at different times of day. This was a cross-sectional study in which observers tallied bicyclists at 4 high traffic intersections in Boston during various peak commuting hours for 2 types of distractions: auditory (earbuds/phones in or on ears), and visual/tactile (electronic device or other object in hand). Nineteen hundred seventy-four bicyclists were observed and 615 (31.2%), 95% CI [29, 33%], were distracted. Of those observed, auditory distractions were the most common (N = 349; 17.7%), 95% CI [16, 19], p = .0003, followed by visual/tactile distractions (N = 266; 13.5%), 95% CI [12, 15]. The highest proportion (40.7%), 95% CI [35, 46], of distracted bicyclists was observed during the midday commute (between 13:30 and 15:00). Distracted bicycling is a prevalent safety concern in the city of Boston, as almost a third of all bicyclists exhibited distracted behavior. Education and public awareness campaigns should be designed to decrease distracted bicycling behaviors and promote bicycle safety in Boston. An awareness of the prevalence of distracted biking can be utilized to promote bicycle safety campaigns dedicated to decreasing distracted bicycling and to provide a baseline against which improvements can be measured.

  15. A Numerical Climate Observing Network Design Study

    NASA Technical Reports Server (NTRS)

    Stammer, Detlef

    2003-01-01

    This project was concerned with three related questions of an optimal design of a climate observing system: 1. The spatial sampling characteristics required from an ARGO system. 2. The degree to which surface observations from ARGO can be used to calibrate and test satellite remote sensing observations of sea surface salinity (SSS) as it is anticipated now. 3. The more general design of an climate observing system as it is required in the near future for CLIVAR in the Atlantic. An important question in implementing an observing system is that of the sampling density required to observe climate-related variations in the ocean. For that purpose this project was concerned with the sampling requirements for the ARGO float system, but investigated also other elements of a climate observing system. As part of this project we studied the horizontal and vertical sampling characteristics of a global ARGO system which is required to make it fully complementary to altimeter data with the goal to capture climate related variations on large spatial scales (less thanAttachment: 1000 km). We addressed this question in the framework of a numerical model study in the North Atlantic with an 1/6 horizontal resolution. The advantage of a numerical design study is the knowledge of the full model state. Sampled by a synthetic float array, model results will therefore allow to test and improve existing deployment strategies with the goal to make the system as optimal and cost-efficient as possible. Attachment: "Optimal observations for variational data assimilation".

  16. Association between carbohydrate quality and inflammatory markers: systematic review of observational and interventional studies.

    PubMed

    Buyken, Anette E; Goletzke, Janina; Joslowski, Gesa; Felbick, Anna; Cheng, Guo; Herder, Christian; Brand-Miller, Jennie C

    2014-04-01

    Chronic low-grade inflammation is a likely intermediary between quality of carbohydrate and chronic disease risk. We conducted a systematic literature search to evaluate the relevance of carbohydrate quality on inflammatory markers in observational and intervention studies. MEDLINE, EMBASE, and the Cochrane Library were searched for studies on associations between glycemic index (GI), glycemic load (GL), dietary fiber or fiber supplements or whole grain intake, and high-sensitivity C-reactive protein (hsCRP) or interleukin 6 (IL-6). Included studies had to be conducted on adults (healthy, overweight, with type 2 diabetes or metabolic syndrome features, but without inflammatory disease) with ≥20 participants and a 3-wk duration. In total, 22 of the 60 studies that met our inclusion criteria examined GI/GL: 5 of 9 observational studies reported lower concentrations of hsCRP or IL-6 among persons with a lower dietary GI/GL; 3 of 13 intervention studies showed significant antiinflammatory effects of a low-GI/GL diet, and 4 further studies suggested beneficial effects (trends or effects in a subgroup). For fiber intake, 13 of 16 observational studies reported an inverse relation with hsCRP or IL-6, but only 1 of 11 intervention studies showed a significant antiinflammatory effect of fiber intake, and a further trial reported a beneficial trend. For whole-grain intake, 6 of 7 observational studies observed an inverse association with inflammatory markers, but only 1 of 7 intervention studies reported significant antiinflammatory effects, 1 further study was suggestive (in a subgroup) of such, and another study found an adverse effect (trend only). Evidence from intervention studies for antiinflammatory benefits is less consistent for higher-fiber or whole-grain diets than for low-GI/GL diets. Benefits of higher fiber and whole-grain intakes suggested by observational studies may reflect confounding.

  17. Direct observation of students during clerkship rotations: a multiyear descriptive study.

    PubMed

    Howley, Lisa D; Wilson, William G

    2004-03-01

    To determine how often students report that they are observed while performing physical examinations and taking histories during clerkship rotations. From 1999-2001, 397 students at the University of Virginia School of Medicine were asked at the end of their third year to report the number of times they had been observed by a resident or faculty member while taking histories and performing physical examinations on six rotations. Three hundred and forty-five students (87%) returned the survey instrument; of these, 322 (81%) returned instruments with complete information. On average, the majority reported that they had never been observed by a faculty member while taking a history (51%), performing a focused physical examination (54%), or a complete physical examination (81%). The majority (60%) reported that they had never been observed by a resident while performing a complete physical examination. Faculty observations occurred most frequently during the four-week family medicine rotation and least frequently during the 12-week surgery rotation. The length of the clerkship rotation was inversely related to the number of reported observations, chi(2) (5, n = 295) = 127.85, p <.000. Although alternative assessments of clinical skills are becoming more common in medical education, faculty ratings based on direct observation are still prominent. The data in this study reflect that these observations may actually be occurring quite infrequently, if at all. Decreasing the evaluative weight of faculty and resident ratings during the clerkship rotation may be necessary. Otherwise, efforts should be made to increase the validity of these ratings.

  18. Prospective study of recovery from copperhead snake envenomation: an observational study.

    PubMed

    Lavonas, Eric J; Gerardo, Charles J

    2015-05-15

    Although much is known about signs, symptoms, and management in the acute phase of crotaline snake envenomation, little is known about signs, symptoms, function, and quality of life during the recovery phase. The purpose of this observational pilot investigation is to evaluate the utility of several clinical outcome instruments in the setting of copperhead snakebite, and to characterize the clinical course of recovery. This is a multi-center prospective, open-label, observational study of patients envenomated by copperhead snakes. We administered the Disabilities of the Arm, Shoulder, and Hand (DASH), Lower Extremity Functional Scale (LEFS), Patient-Specific Functional Scale (PSFS), Work Productivity and Ability Impairment: Special Health Problem (WPAI: SHP), Patients' Global Impression of Change (PGIC), Patient's Global Assessment of Recovery (PGAR), and SF-36 instruments, obtained numeric pain rating scales, and measured grip strength, walking speed, and swelling prior to hospital discharge and 3, 7, 14, 21, and 28 days after envenomation. 20 subjects were enrolled; none were lost to follow-up. Most (80%) had moderate severity swelling, and most (75%) received antivenom. Across the broad range of measures, abnormalities of pain, swelling, impairments of physical and role function, and quality of life persisted for 7-14 days in most subjects. Validated self-reported outcome measures, such as the DASH, LEFS, PSFS, PGIC, SF-36, and the daily activities impairment portion of the WPAI: SHP were more responsive than measurements of swelling or walking speed. Data quality issues limited the utility of the work impairment portion of the WPAI: SHP. Residual signs, symptoms, and impairment in some subjects lasted through the 28-day study period. The study design precluded any assessment of the effectiveness of antivenom. Signs, symptoms, impaired function, and decreased quality of life typically last 7 - 14 days after copperhead envenomation. Several tools appear

  19. Ultrasound functional evaluation of fetuses with myelomeningocele: study of the interpretation of results.

    PubMed

    Maroto, A; Illescas, T; Meléndez, M; Arévalo, S; Rodó, C; Peiró, J L; Belfort, M; Cuxart, A; Carreras, E

    2017-10-01

    To assess the reliability of the interpretation of a new technique for the ultrasound evaluation of the level of neurological lesion in fetuses with myelomeningocele. Observational study including myelomeningocele fetuses, referred to our center for the sonographic assessment of the fetal lower-limb movements, made and recorded by an expert in Maternal-fetal medicine and a specialist in Rehabilitation. Two observers, with different levels of expertise and blinded to each other's results, interpreted each recorded scan two different times. The agreement for the segmental levels assigned between the observers and the gold standard, the inter-observer and intra-observer reproducibility were tested using the weighed Kappa (wκ) index. Twenty-eight scans were recorded and evaluated. The agreement between the observers and the gold standard remained constant for the expert observer (wκ = 0.82) and increased (wκ = 0.66-wκ = 0.72) for the other one. The inter-observer and the intra-observer variability for the expert observer were wκ = 0.72 and wκ = 0.94, respectively. The agreement for the prenatal evaluation of the segmental neurological level was excellent, after a short training period, for observers with different degrees of expertise. The interpretation of this technique is reproducible enough and this supports its value for the prediction of postnatal motor function in myelomeningocele fetuses.

  20. Potential New Lidar Observations for Cloud Studies

    NASA Technical Reports Server (NTRS)

    Winker, Dave; Hu, Yong; Narir, Amin; Cai, Xia

    2015-01-01

    The response of clouds to global warming represents a major uncertainty in estimating climate sensitivity. These uncertainties have been tracked to shallow marine clouds in the tropics and subtropics. CALIOP observations have already been used extensively to evaluate model predictions of shallow cloud fraction and top height (Leahy et al. 2013; Nam et al 2012). Tools are needed to probe the lowest levels of the troposphere. The large footprint of satellite lidars gives large multiple scattering from clouds which presents new possibilities for cloud retrievals to constrain model predictions.

  1. Antidepressant use and risk of coronary heart disease: meta-analysis of observational studies

    PubMed Central

    Oh, Seung-Won; Kim, Joonseok; Myung, Seung-Kwon; Hwang, Seung-Sik; Yoon, Dae-Hyun

    2014-01-01

    Aims Our goal was to evaluate the association between antidepressant use and the risk of coronary heart disease (CHD) among subjects with no history of coronary heart disease. Methods A search of Medline, EMBASE, PsycINFO and the Cochrane Library was performed in January 2013. Two authors independently reviewed and selected eligible observational studies, based on predetermined selection criteria. Pooled relative risks (RRs) with confidence intervals (CIs) were calculated using random-effects or fixed-effects models. Results Sixteen observational studies (seven case–control studies and nine cohort studies) were included in the final analysis. There was no association between selective serotonin reuptake inhibitor use and the risk of CHD overall [odds ratio (OR), 0.93; 95% CI, 0.65–1.33] or in subgroup meta-analysis of case–control studies (OR, 0.91; 95% CI, 0.60–1.37) and cohort studies (RR, 0.96; 95% CI, 0.59–1.55). The use of tricyclic antidepressant was associated with an increased risk of CHD overall (OR, 1.51; 95% CI, 1.07–2.12), but it was observed only in case–control studies (OR, 1.56; 95% CI, 1.24–1.96) and low-quality studies (OR, 1.49; 95% CI, 1.20–1.85) in the subgroup meta-analyses. Conclusions This meta-analysis of observational studies in subjects with no history of CHD suggests that neither selective serotonin reuptake inhibitor nor tricyclic antidepressant use is associated with an increased risk of CHD. PMID:24646010

  2. Evaluation of WRF PBL parameterization schemes against direct observations during a dry event over the Ganges valley

    NASA Astrophysics Data System (ADS)

    Sathyanadh, Anusha; Prabha, Thara V.; Balaji, B.; Resmi, E. A.; Karipot, Anandakumar

    2017-09-01

    Accurate representations of the planetary boundary layer (PBL) are important in all weather forecast systems, especially in simulations of turbulence, wind and air quality in the lower atmosphere. In the present study, detailed observations from the Cloud Aerosol Interaction and Precipitation Enhancement Experiment - Integrated Ground based Observational Campaign (CAIPEEX-IGOC) 2014 comprising of the complete surface energy budget and detailed boundary layer observations are used to validate Advanced Research Weather Research and Forecasting (WRF) model simulations over a diverse terrain over the Ganges valley region, Uttar Pradesh, India. A drying event in June 2014 associated with a heat wave is selected for validation.Six local and nonlocal PBL schemes from WRF at 1 km resolution are compared with hourly observations during the diurnal cycle. Near-surface observations of weather parameters, radiation components and eddy covariance fluxes from micrometeorological tower, and profiles of variables from microwave radiometer, and radiosonde observations are used for model evaluations. Models produce a warmer, drier surface layer with higher wind speed, sensible heat flux and temperature than observations. Layered boundary layer dynamics, including the residual layer structure as illustrated in the observations over the Ganges valley are missed in the model, which lead to deeper mixed layers and excessive drying.Although it is difficult to identify any single scheme as the best, the qualitative and quantitative analyses for the entire study period and overall reproducibility of the observations indicate that the MYNN2 simulations describe lower errors and more realistic simulation of spatio-temporal variations in the boundary layer height.

  3. Building the Plane Inflight: Observations from Case Studies in Wartime Flight Training for Partner Nations

    DTIC Science & Technology

    2016-05-26

    guidance on how to build an effective SC program. Whether used as pre-decisional guides or ex post facto evaluation tools, they fall short of...Building the Plane Inflight: Observations from Case Studies in Wartime Flight Training for Partner...Nations A Monograph by Major Timothy J. Day United States Air Force School of Advanced Military Studies United States Army Command and General

  4. Online health information search and evaluation: observations and semi-structured interviews with college students and maternal health experts.

    PubMed

    Kim, Hyojin; Park, Sun-Young; Bozeman, Ingrid

    2011-09-01

    While the Internet is a popular source of health information, health seekers' inadequate skills to locate and discern quality information pose a potential threat to their healthcare decision-making. We aimed to examine health information search and appraisal behaviours among young, heavy users of the Internet. In study 1, we observed and interviewed 11 college students about their search strategies and evaluation of websites. In study 2, three health experts evaluated two websites selected as the best information sources in study 1. Familiarity with health websites and confidence in search strategies were major factors affecting search and evaluation behaviours. Website quality was mostly judged by aesthetics and peripheral cues of source credibility and message credibility. In contrast to users' favourable website evaluation, the experts judged the websites to be inappropriate and untrustworthy. Our results highlight a critical need to provide young health seekers with resources and training that are specifically geared toward health information search and appraisal. The role of health seekers' knowledge and involvement with the health issue in search effort and success warrants future research. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

  5. Evaluation of the effects of chronic biomass fuel smoke exposure on peripheral endothelial functions: an observational study.

    PubMed

    Buturak, Ali; Genç, Ahmet; Ulus, Ozden Sıla; Duygu, Egemen; Okmen, Arda Sanlı; Uyarel, Hüseyin

    2011-09-01

    To evaluate the effect of chronic biomass fuel (BMF) smoke exposure on peripheral endothelial functions. Forty-seven healthy subjects who have been exposed to BMF smoke since birth (mean age 31.6±6.8 years, 21 male) were enrolled in the present cross-sectional observational study. The control group consisted of 32 healthy subjects (mean age 27.9±4.4 years, 11 male). The carotid intima media thickness (CIMT), flow associated dilatation (FAD %) and endothelium independent vasodilatation (GTN %) were assessed in all subjects. The carotid CIMT was defined as the distance between the leading edge of the lumen-intima and the media-adventitia interfaces. FAD % was defined as the percentage change in the internal diameter of the brachial artery during reactive hyperemia related to the baseline. GTN % was defined as the change in diameter in response to the application of 400 µg of glyceril trinitrate relative to the baseline scan at the end of the fourth minute. Statistical analysis was performed using Student's t-test, Chi-square test and Spearman rank order correlation analysis. The average exposure time of the subjects to biomass fuel smoke was 31.7±6.6 years. They have been exposed to dung inhalation products meanly 8.3±1.8 months in a year seasonally. The average daily exposure time was 15.7±3.3 hours. CIMT values of the two groups were not statistically different from each other (0.47±0.09 vs. 0.49±0.06 mm, p=0.138). However, a markedly reduced FAD % was determined in the study group (5.06±4.95 vs. 10.7±4.64, p<0.001). And GTN % of the BMF exposed group was significantly lower than the control group (14.41±8.47 vs. 21.85±7.87, p<0.001). FAD % and GTN % are markedly reduced in the individuals who have been exposed to BMF smoke inhalation products. Therefore, chronic BMF smoke exposure may be a risk factor for the development of endothelial dysfunction.

  6. Inter-observer and intra-observer agreement between embryologists during selection of a single Day 5 embryo for transfer: a multicenter study.

    PubMed

    Storr, Ashleigh; Venetis, Christos A; Cooke, Simon; Kilani, Suha; Ledger, William

    2017-02-01

    What is the inter-observer and intra-observer agreement between embryologists when selecting a single Day 5 embryo for transfer? The inter-observer and intra-observer agreement between embryologists when selecting a single Day 5 embryo for transfer was generally good, although not optimal, even among experienced embryologists. Previous research on the morphological assessment of early stage (two pronuclei to Day 3) embryos has shown varying levels of inter-observer and intra-observer agreement. However, single blastocyst transfer is now becoming increasingly popular and there are no published data that assess inter-observer and intra-observer agreement when selecting a single embryo for Day 5 transfer. This was a prospective study involving 10 embryologists working at five different IVF clinics within a single organization between July 2013 and November 2015. The top 10 embryologists were selected based on their yearly Quality Assurance Program scores for blastocyst grading and were asked to morphologically grade all Day 5 embryos and choose a single embryo for transfer in a survey of 100 cases using 2D images. A total of 1000 decisions were therefore assessed. For each case, Day 5 images were shown, followed by a Day 3 and Day 5 image of the same embryo. Subgroup analyses were also performed based on the following characteristics of embryologists: the level of clinical embryology experience in the laboratory; amount of research experience; number of days per week spent grading embryos. The agreement between these embryologists and the one that scored the embryos on the actual day of transfer was also evaluated. Inter-observer and intra-observer variability was assessed using the kappa coefficient to evaluate the extent of agreement. This study showed that all 10 embryologists agreed on the embryo chosen for transfer in 50 out of 100 cases. In 93 out of 100 cases, at least 6 out of the 10 embryologists agreed. The inter-observer and intra-observer agreement among

  7. Distracted Biking: An Observational Study

    PubMed Central

    Wolfe, Elizabeth Suzanne; Arabian, Sandra Strack; Breeze, Janis L; Salzler, Matthew J.

    2016-01-01

    Commuting via bicycle is a very popular mode of transportation in the Northeastern United States (US). Boston, MA has seen a rapid increase in bicycle ridership over the past decade which has raised concerns and awareness about bicycle safety. An emerging topic in this field is distracted bicycle riding. This study was conducted to provide descriptive data on the prevalence and type of distracted bicycling in Boston at different times of day. This was a cross-sectional study in which observers tallied bicyclists at four high traffic intersections in Boston during various peak commuting hours for two types of distractions: auditory (ear buds/phones in or on ears), and visual/tactile (electronic device or other object in hand). Nineteen hundred seventy-four bicyclists were observed and 615 (31.2%, 95% CI: 29%-33%) were distracted. Of those observed, auditory distractions were the most common (N= 349 [17.7%, 95% CI: 16%-19%], p=0.0003) followed by visual/tactile distractions (N= 266 [13.5%, 95% CI: 12%-15%]). The highest proportion (40.7%, 95% CI: 35%-46%) of distracted bicyclists was observed during the midday commute (between 13:30-15:00). Distracted bicycling is a prevalent safety concern in the city of Boston, as almost one-third of all bicyclists exhibited distracted behavior. Education and public awareness campaigns should be designed to decrease distracted bicycling behaviors and promote bicycle safety in Boston. An awareness of the prevalence of distracted biking can be utilized to promote bicycle safety campaigns dedicated to decreasing distracted bicycling and to provide a baseline against which improvements can be measured. PMID:26953533

  8. Objective evaluation of acute adverse events and image quality of gadolinium-based contrast agents (gadobutrol and gadobenate dimeglumine) by blinded evaluation. Pilot study.

    PubMed

    Semelka, Richard C; Hernandes, Mateus de A; Stallings, Clifton G; Castillo, Mauricio

    2013-01-01

    The purpose was to objectively evaluate a recently FDA-approved gadolinium-based contrast agent (GBCA) in comparison to our standard GBCA for acute adverse events and image quality by blinded evaluation. Evaluation was made of a recently FDA-approved GBCA, gadobutrol (Gadavist; Bayer), in comparison to our standard GBCA, gadobenate dimeglumine (MultiHance; Bracco), in an IRB- and HIPAA-compliant study. Both the imaging technologist and patient were not aware of the brand of the GBCA used. A total of 59 magnetic resonance studies were evaluated (59 patients, 31 men, 28 women, age range of 5-85 years, mean age of 52 years). Twenty-nine studies were performed with gadobutrol (22 abdominal and 7 brain studies), and 30 studies were performed with gadobenate dimeglumine (22 abdominal and 8 brain studies). Assessment was made of acute adverse events focusing on objective observations of vomiting, hives, and moderate and severe reactions. Adequacy of enhancement was rated as poor, fair and good by one of two experienced radiologists who were blinded to the type of agent evaluated. No patient experienced acute adverse events with either agent. The target minor adverse events of vomiting or hives, and moderate and severe reactions were not observed in any patient. Adequacy of enhancement was rated as good for both agents in all patients. Objective, blinded evaluation is feasible and readily performable for the evaluation of GBCAs. This proof-of-concept study showed that both GBCAs evaluated exhibited consistent good image quality and no noteworthy adverse events. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Teacher Observation: Evaluation Report and Executive Summary

    ERIC Educational Resources Information Center

    Worth, Jack; Sizmur, Juliet; Walker, Matthew; Bradshaw, Sally; Styles, Ben

    2017-01-01

    The Teacher Observation intervention aimed to improve teacher effectiveness through structured peer observation. Teachers observe and are observed by their peers a number of times over the course of two years. It was delivered by the Centre for Market and Public Organisation (CMPO) at the University of Bristol. CMPO researchers trained lead…

  10. Incidence and risk factors for oxygen desaturation during recovery from modified electroconvulsive therapy: A prospective observational study.

    PubMed

    Surve, Rohini; Bansal, Sonia; Sriganesh, Kamath; Subbakrishna, Doddaballapur Kumaraswamy; Thirthalli, Jagadisha; Umamaheswara Rao, Ganne Sesha

    2015-01-01

    Electroconvulsive therapy (ECT) is an established modality of treatment for severe psychiatric illnesses. Among the various complications associated with ECT, oxygen desaturation is often under reported. None of the previous studies has evaluated the predictive factors for oxygen desaturation during ECT. The objective of this study was to evaluate the incidence of oxygen desaturation during recovery from anesthesia for modified ECT and evaluate its risk factors in a large sample. All patients aged above 15 years who were prescribed a modified ECT for their psychiatric illness over 1 year were prospectively included in this observational study. The association between age, body mass index (BMI), doses of thiopentone and suxamethonium, stimulus current, ECT session number, pre- and post-ECT heart rate and mean arterial pressure, seizure duration, and pre- and post ECT oxygen saturation, was systematically studied. The incidence of oxygen desaturation was 29% (93/316 patients). Seizure duration and BMI were found to be significantly correlated with post ECT desaturation. In this prospective observational study, the incidence of oxygen desaturation during recovery from anesthesia for ECT was high. The study identified obesity and duration of seizure as the independent predictors of this complication. This knowledge is likely to help in identifying and optimizing such patients before subsequent ECT sessions.

  11. VIEWDEX: an efficient and easy-to-use software for observer performance studies.

    PubMed

    Håkansson, Markus; Svensson, Sune; Zachrisson, Sara; Svalkvist, Angelica; Båth, Magnus; Månsson, Lars Gunnar

    2010-01-01

    The development of investigation techniques, image processing, workstation monitors, analysing tools etc. within the field of radiology is vast, and the need for efficient tools in the evaluation and optimisation process of image and investigation quality is important. ViewDEX (Viewer for Digital Evaluation of X-ray images) is an image viewer and task manager suitable for research and optimisation tasks in medical imaging. ViewDEX is DICOM compatible and the features of the interface (tasks, image handling and functionality) are general and flexible. The configuration of a study and output (for example, answers given) can be edited in any text editor. ViewDEX is developed in Java and can run from any disc area connected to a computer. It is free to use for non-commercial purposes and can be downloaded from http://www.vgregion.se/sas/viewdex. In the present work, an evaluation of the efficiency of ViewDEX for receiver operating characteristic (ROC) studies, free-response ROC (FROC) studies and visual grading (VG) studies was conducted. For VG studies, the total scoring rate was dependent on the number of criteria per case. A scoring rate of approximately 150 cases h(-1) can be expected for a typical VG study using single images and five anatomical criteria. For ROC and FROC studies using clinical images, the scoring rate was approximately 100 cases h(-1) using single images and approximately 25 cases h(-1) using image stacks ( approximately 50 images case(-1)). In conclusion, ViewDEX is an efficient and easy-to-use software for observer performance studies.

  12. Resistance to Classroom Observation in the Context of Teacher Evaluation: Teachers' and Department Heads' Experiences and Perspectives

    ERIC Educational Resources Information Center

    de Lima, Jorge Ávila; Silva, Maria João Tavares

    2018-01-01

    This paper reports the main findings of a study that sought to understand how teachers and department heads perceived and experienced the implementation of a classroom observation system in a teacher evaluation context. The data was collected through a teacher and department head survey and interviews with department heads who were responsible for…

  13. Use of acetaminophen and risk of endometrial cancer: evidence from observational studies.

    PubMed

    Ding, Yuan-Yuan; Yao, Peng; Verma, Surya; Han, Zhen-Kai; Hong, Tao; Zhu, Yong-Qiang; Li, Hong-Xi

    2017-05-23

    Previous meta-analyses suggested that aspirin was associated with reduced risk of endometrial cancer. However, there has been no study comprehensively summarize the evidence of acetaminophen use and risk of endometrial cancer from observational studies. We systematically searched electronic databases (PubMed , EMBASE, Web of Science, and Cochrane Library) for relevant cohort or case-control studies up to February 28, 2017. Two independent authors performed the eligibility evaluation and data extraction. All differences were resolved by discussion. A random-effects model was applied to estimate summary relative risks (RRs) with 95% CIs. All statistical tests were two-sided. Seven observational studies including four prospective cohort studies and three case-control studies with 3874 endometrial cancer cases were included for final analysis. Compared with never use acetaminophen, ever use this drug was not associated with risk of endometrial cancer (summarized RR = 1.02; 95% CI: 0.93-1.13, I2 = 0%). Similar null association was also observed when compared the highest category of frequency/duration with never use acetaminophen (summarized RR = 0.88; 95% CI: 0.70-1.11, I2 = 15.2%). Additionally, the finding was robust in the subgroup analyses stratified by study characteristics and adjustment for potential confounders and risk factors. There was no evidence of publication bias by a visual inspection of a funnel plot and formal statistical tests. In summary, the present meta-analysis reveals no association between acetaminophen use and risk of endometrial cancer. More large scale prospective cohort studies are warranted to confirm our findings and carry out the dose-response analysis of aforementioned association.

  14. Photometric Redshifts with the LSST: Evaluating Survey Observing Strategies

    NASA Astrophysics Data System (ADS)

    Graham, Melissa L.; Connolly, Andrew J.; Ivezić, Željko; Schmidt, Samuel J.; Jones, R. Lynne; Jurić, Mario; Daniel, Scott F.; Yoachim, Peter

    2018-01-01

    In this paper we present and characterize a nearest-neighbors color-matching photometric redshift estimator that features a direct relationship between the precision and accuracy of the input magnitudes and the output photometric redshifts. This aspect makes our estimator an ideal tool for evaluating the impact of changes to LSST survey parameters that affect the measurement errors of the photometry, which is the main motivation of our work (i.e., it is not intended to provide the “best” photometric redshifts for LSST data). We show how the photometric redshifts will improve with time over the 10 year LSST survey and confirm that the nominal distribution of visits per filter provides the most accurate photo-z results. The LSST survey strategy naturally produces observations over a range of airmass, which offers the opportunity of using an SED- and z-dependent atmospheric affect on the observed photometry as a color-independent redshift indicator. We show that measuring this airmass effect and including it as a prior has the potential to improve the photometric redshifts and can ameliorate extreme outliers, but that it will only be adequately measured for the brightest galaxies, which limits its overall impact on LSST photometric redshifts. We furthermore demonstrate how this airmass effect can induce a bias in the photo-z results, and caution against survey strategies that prioritize high-airmass observations for the purpose of improving this prior. Ultimately, we intend for this work to serve as a guide for the expectations and preparations of the LSST science community with regard to the minimum quality of photo-z as the survey progresses.

  15. Evaluating Gridded Spring Indices Using the USA National Phenology Network's Observational Phenology Data

    NASA Astrophysics Data System (ADS)

    Crimmins, T. M.; Gerst, K.

    2017-12-01

    The USA National Phenology Network (USA-NPN; www.usanpn.org) produces and freely delivers daily and short-term forecast maps of spring onset dates at fine spatial scale for the conterminous United States and Alaska using the Spring Indices. These models, which represent the start of biological activity in the spring season, were developed using a long-term observational record of four species of lilacs and honeysuckles contributed by volunteer observers. Three of the four species continue to be tracked through the USA-NPN's phenology observation program, Nature's Notebook. The gridded Spring Index maps have utility for a wide range of natural resource planning and management applications, including scheduling invasive species and pest detection and control activities, anticipating allergy outbreaks and planning agricultural harvest dates. However, to date, there has not been a comprehensive assessment of how well the gridded Spring Index maps accurately reflect phenological activity in lilacs and honeysuckles or other species of plants. In this study, we used observational plant phenology data maintained by the USA-NPN to evaluate how well the gridded Spring Index maps match leaf and flowering onset dates in a) the lilac and honeysuckle species used to construct the models and b) in several species of deciduous trees. The Spring Index performed strongly at predicting the timing of leaf-out and flowering in lilacs and honeysuckles. The average error between predicted and observed date of onset ranged from 5.9 to 11.4 days. Flowering models performed slightly better than leaf-out models. The degree to which the Spring Indices predicted native deciduous tree leaf and flower phenology varied by year, species, and region. Generally, the models were better predictors of leaf and flowering onset dates in the Northeastern and Midwestern US. These results reveal when and where the Spring Indices are a meaningful proxy of phenological activity across the United States.

  16. Use of Patient and Observer Scar Assessment Scale for evaluation of facial scars treated with self-drying silicone gel.

    PubMed

    Bianchi, Francesca A; Roccia, Fabio; Fiorini, Paola; Berrone, Sid

    2010-05-01

    In this prospective study, we used the Patient and Observer Scar Assessment Scale (POSAS) to evaluate the outcome of the healing process of posttraumatic and surgical facial scars that were treated with self-drying silicone gel, by both the patient and the observer. In our division, the application of base cream and massage represents the standard management of facial scars after suture removal. In the current study, 15 patients (7 men and 8 women) with facial scars were treated with self-drying silicone gel that was applied without massage, and 15 patients (8 men and 7 women) were treated with base cream and massage. Both groups underwent a clinical evaluation of facial scars by POSAS at the time of suture removal (T0) and after 2 months of treatment (T1). The patient rated scar pain, itch, color, stiffness, thickness, and surface (Patient Scale), and the observer rated scar vascularity, pigmentation, thickness, relief, pliability, and surface area (Observer Scale [OS]). The Patient Scale reported the greatest improvement in the items color, stiffness, and thickness. Itch was the only item that worsened in the group self-drying silicone gel. The OS primarily reported an improvement in the items vascularization, pigmentation, and pliability. The only item in the OS that underwent no change from T0 to T1 was surface area. The POSAS revealed satisfactory healing of posttraumatic and surgical facial scars that were treated with self-drying silicone gel.

  17. Evaluating Transient Global and Regional Model Simulations: Bridging the Model/Observations Information Gap

    NASA Astrophysics Data System (ADS)

    Rutledge, G. K.; Karl, T. R.; Easterling, D. R.; Buja, L.; Stouffer, R.; Alpert, J.

    2001-05-01

    A major transition in our ability to evaluate transient Global Climate Model (GCM) simulations is occurring. Real-time and retrospective numerical weather prediction analysis, model runs, climate simulations and assessments are proliferating from a handful of national centers to dozens of groups across the world. It is clear that it is no longer sufficient for any one national center to develop its data services alone. The comparison of transient GCM results with the observational climate record is difficult for several reasons. One limitation is that the global distributions of a number of basic climate quantities, such as precipitation, are not well known. Similarly, observational limitations exist with model re-analysis data. Both the NCEP/NCAR, and the ECMWF, re-analysis eliminate the problems of changing analysis systems but observational data also contain time-dependant biases. These changes in input data are blended with the natural variability making estimates of true variability uncertain. The need for data homogeneity is critical to study questions related to the ability to evaluate simulation of past climate. One approach to correct for time-dependant biases and data sparse regions is the development and use of high quality 'reference' data sets. The primary U.S. National responsibility for the archive and service of weather and climate data rests with the National Climatic Data Center (NCDC). However, as supercomputers increase the temporal and spatial resolution of both Numerical Weather Prediction (NWP) and GCM models, the volume and varied formats of data presented for archive at NCDC, using current communications technologies and data management techniques is limiting the scientific access of these data. To address this ever expanding need for climate and NWP information, NCDC along with the National Center's for Environmental Prediction (NCEP) have initiated the NOAA Operational Model Archive and Distribution System (NOMADS). NOMADS is a

  18. Increasing community capacity for participatory evaluation of healthy eating and active living strategies through direct observations and environmental audits.

    PubMed

    Kemner, Allison L; Stachecki, Jessica R; Bildner, Michele E; Brennan, Laura K

    2015-01-01

    Local partnerships from the Healthy Kids, Healthy Communities initiative elected to participate in enhanced evaluation trainings to collect data through environmental audits and direct observations as well as to build their evaluation capacity. Environmental audit and direct observation tools and protocols were adapted for the relevant healthy eating and active living policy and environmental change approaches being conducted by the Healthy Kids, Healthy Communities partnerships. Customized trainings were conducted by the evaluation team to increase capacity and understanding for evaluation activities. A total of 87 trainings were conducted by the evaluation team in 31 Healthy Kids, Healthy Communities community partnerships. Data were collected for a total of 41 environmental audits and 17 direct observations. Community case examples illustrate how these trainings developed evaluation capacity. For instance, youth from one community presented environmental audit findings to local elected officials. The 31 partnerships participating in the community-based evaluation efforts resulted in 164 individuals trained in collecting context-specific data to assess the impact of healthy eating and active living policy and environmental strategies designed to create community change.

  19. Southeast Atmosphere Studies: learning from model-observation syntheses

    NASA Astrophysics Data System (ADS)

    Mao, Jingqiu; Carlton, Annmarie; Cohen, Ronald C.; Brune, William H.; Brown, Steven S.; Wolfe, Glenn M.; Jimenez, Jose L.; Pye, Havala O. T.; Ng, Nga Lee; Xu, Lu; McNeill, V. Faye; Tsigaridis, Kostas; McDonald, Brian C.; Warneke, Carsten; Guenther, Alex; Alvarado, Matthew J.; de Gouw, Joost; Mickley, Loretta J.; Leibensperger, Eric M.; Mathur, Rohit; Nolte, Christopher G.; Portmann, Robert W.; Unger, Nadine; Tosca, Mika; Horowitz, Larry W.

    2018-02-01

    Concentrations of atmospheric trace species in the United States have changed dramatically over the past several decades in response to pollution control strategies, shifts in domestic energy policy and economics, and economic development (and resulting emission changes) elsewhere in the world. Reliable projections of the future atmosphere require models to not only accurately describe current atmospheric concentrations, but to do so by representing chemical, physical and biological processes with conceptual and quantitative fidelity. Only through incorporation of the processes controlling emissions and chemical mechanisms that represent the key transformations among reactive molecules can models reliably project the impacts of future policy, energy and climate scenarios. Efforts to properly identify and implement the fundamental and controlling mechanisms in atmospheric models benefit from intensive observation periods, during which collocated measurements of diverse, speciated chemicals in both the gas and condensed phases are obtained. The Southeast Atmosphere Studies (SAS, including SENEX, SOAS, NOMADSS and SEAC4RS) conducted during the summer of 2013 provided an unprecedented opportunity for the atmospheric modeling community to come together to evaluate, diagnose and improve the representation of fundamental climate and air quality processes in models of varying temporal and spatial scales.This paper is aimed at discussing progress in evaluating, diagnosing and improving air quality and climate modeling using comparisons to SAS observations as a guide to thinking about improvements to mechanisms and parameterizations in models. The effort focused primarily on model representation of fundamental atmospheric processes that are essential to the formation of ozone, secondary organic aerosol (SOA) and other trace species in the troposphere, with the ultimate goal of understanding the radiative impacts of these species in the southeast and elsewhere. Here we

  20. Southeast Atmosphere Studies: learning from model-observation syntheses

    PubMed Central

    Mao, Jingqiu; Carlton, Annmarie; Cohen, Ronald C.; Brune, William H.; Brown, Steven S.; Wolfe, Glenn M.; Jimenez, Jose L.; Pye, Havala O. T.; Ng, Nga Lee; Xu, Lu; McNeill, V. Faye; Tsigaridis, Kostas; McDonald, Brian C.; Warneke, Carsten; Guenther, Alex; Alvarado, Matthew J.; de Gouw, Joost; Mickley, Loretta J.; Leibensperger, Eric M.; Mathur, Rohit; Nolte, Christopher G.; Portmann, Robert W.; Unger, Nadine; Tosca, Mika; Horowitz, Larry W.

    2018-01-01

    Concentrations of atmospheric trace species in the United States have changed dramatically over the past several decades in response to pollution control strategies, shifts in domestic energy policy and economics, and economic development (and resulting emission changes) elsewhere in the world. Reliable projections of the future atmosphere require models to not only accurately describe current atmospheric concentrations, but to do so by representing chemical, physical and biological processes with conceptual and quantitative fidelity. Only through incorporation of the processes controlling emissions and chemical mechanisms that represent the key transformations among reactive molecules can models reliably project the impacts of future policy, energy and climate scenarios. Efforts to properly identify and implement the fundamental and controlling mechanisms in atmospheric models benefit from intensive observation periods, during which collocated measurements of diverse, speciated chemicals in both the gas and condensed phases are obtained. The Southeast Atmosphere Studies (SAS, including SENEX, SOAS, NOMADSS and SEAC4RS) conducted during the summer of 2013 provided an unprecedented opportunity for the atmospheric modeling community to come together to evaluate, diagnose and improve the representation of fundamental climate and air quality processes in models of varying temporal and spatial scales. This paper is aimed at discussing progress in evaluating, diagnosing and improving air quality and climate modeling using comparisons to SAS observations as a guide to thinking about improvements to mechanisms and parameterizations in models. The effort focused primarily on model representation of fundamental atmospheric processes that are essential to the formation of ozone, secondary organic aerosol (SOA) and other trace species in the troposphere, with the ultimate goal of understanding the radiative impacts of these species in the southeast and elsewhere. Here we

  1. Southeast Atmosphere Studies: Learning from Model-Observation Syntheses

    NASA Technical Reports Server (NTRS)

    Mao, Jingqiu; Carlton, Annmarie; Cohen, Ronald C.; Brune, William H.; Brown, Steven S.; Wolfe, Glenn M.; Jimenez, Jose L.; Pye, Havala O. T.; Ng, Nga Lee; Xu, Lu; hide

    2018-01-01

    Concentrations of atmospheric trace species in the United States have changed dramatically over the past several decades in response to pollution control strategies, shifts in domestic energy policy and economics, and economic development (and resulting emission changes) elsewhere in the world. Reliable projections of the future atmosphere require models to not only accurately describe current atmospheric concentrations, but to do so by representing chemical, physical and biological processes with conceptual and quantitative fidelity. Only through incorporation of the processes controlling emissions and chemical mechanisms that represent the key transformations among reactive molecules can models reliably project the impacts of future policy, energy and climate scenarios. Efforts to properly identify and implement the fundamental and controlling mechanisms in atmospheric models benefit from intensive observation periods, during which collocated measurements of diverse, speciated chemicals in both the gas and condensed phases are obtained. The Southeast Atmosphere Studies (SAS, including SENEX, SOAS, NOMADSS and SEAC4RS) conducted during the summer of 2013 provided an unprecedented opportunity for the atmospheric modeling community to come together to evaluate, diagnose and improve the representation of fundamental climate and air quality processes in models of varying temporal and spatial scales. This paper is aimed at discussing progress in evaluating, diagnosing and improving air quality and climate modeling using comparisons to SAS observations as a guide to thinking about improvements to mechanisms and parameterizations in models. The effort focused primarily on model representation of fundamental atmospheric processes that are essential to the formation of ozone, secondary organic aerosol (SOA) and other trace species in the troposphere, with the ultimate goal of understanding the radiative impacts of these species in the southeast and elsewhere. Here we

  2. Evaluation of accuracy of IHI Trigger Tool in identifying adverse drug events: a prospective observational study.

    PubMed

    das Dores Graciano Silva, Maria; Martins, Maria Auxiliadora Parreiras; de Gouvêa Viana, Luciana; Passaglia, Luiz Guilherme; de Menezes, Renata Rezende; de Queiroz Oliveira, João Antonio; da Silva, Jose Luiz Padilha; Ribeiro, Antonio Luiz Pinho

    2018-06-06

    Adverse drug events (ADEs) can seriously compromise the safety and quality of care provided to hospitalized patients, requiring the adoption of accurate methods to monitor them. We sought to prospectively evaluate the accuracy of the triggers proposed by the Institute for Healthcare Improvement (IHI) for identifying ADEs. A prospective study was conducted in a public university hospital, in 2015, with patients ≥18 years. Triggers proposed by IHI and clinical alterations suspected to be ADEs were searched daily. The number of days in which the patient was hospitalized was considered as unit of measure to evaluate the accuracy of each trigger. Three hundred patients were included in this study. Mean age was 56.3 years (standard deviation (SD) 16.0), and 154 (51.3%) were female. The frequency of patients with ADEs was 24.7% and with at least one trigger was 53.3%. From those patients who had at least one trigger, the most frequent triggers were antiemetics (57.5%) and "abrupt medication stop" (31.8%). Triggers' sensitivity ranged from 0.3 to11.8 % and the positive predictive value ranged from 1.2 to 27.3%. Specificity and negative predictive value were greater than 86%. Most patients identified by the presence of triggers did not have ADEs (64.4%). No triggers were identified in 40 (38.5%) ADEs. IHI Trigger Tool did not show good accuracy in detecting ADEs in this prospective study. The adoption of combined strategies could enhance effectiveness in identifying patient safety flaws. Further discussion might contribute to improve trigger usefulness in clinical practice. This article is protected by copyright. All rights reserved.

  3. Evaluating Water Budget Closure Across Spatial Scales: An Observational Approach through Texas Water Observatory

    NASA Astrophysics Data System (ADS)

    Gaur, N.; Jaimes, A.; Vaughan, S.; Morgan, C.; Moore, G. W.; Miller, G. R.; Everett, M. E.; Lawing, M.; Mohanty, B.

    2017-12-01

    Applications varying from improving water conservation practices at the field scale to predicting global hydrology under a changing climate depend upon our ability to achieve water budget closure. 1) Prevalent heterogeneity in soils, geology and land-cover, 2) uncertainties in observations and 3) space-time scales of our control volume and available data are the main factors affecting the percentage of water budget closure that we can achieve. The Texas Water Observatory presents a unique opportunity to observe the major components of the water cycle (namely precipitation, evapotranspiration, root zone soil moisture, streamflow and groundwater) in varying eco-hydrological regions representative of the lower Brazos River basin at multiple scales. The soils in these regions comprise of heavy clays that swell and shrink to create complex preferential pathways in the sub-surface, thus, making the hydrology in this region difficult to quantify. This work evaluates the water budget of the region by varying the control volume in terms of 3 temporal (weekly, monthly and seasonal) and 3 different spatial scales. The spatial scales are 1) Point scale - that is typical for process understanding of water dynamics, 2) Eddy Covariance footprint scale - that is typical of most eco-hydrological applications at the field scale and, 3) Satellite footprint scale- that is typically used in regional and global hydrological analysis. We employed a simple water balance model to evaluate the water budget at all scales. The point scale water budget was assessed using direct observations from hydro-geo-thematically located observation locations within different eddy covariance footprints. At the eddy covariance footprint scale, the sub-surface of each eddy covariance footprint was intensively characterized using electromagnetic induction (EM 38) and the resultant data was used to calculate the inter-point variability to upscale the sub-surface storage while the satellite scale water budget

  4. The effectiveness, safety, and economic evaluation of Korean medicine for unexplained infertile women: A multi-center, prospective, observational study protocol.

    PubMed

    Kim, Su-Hyun; Jo, Junyoung; Kim, Dong-Il

    2017-12-01

    Infertility is a condition in which a woman has not been pregnant despite having had normal intercourse for 1 year. The number of unexplained infertile females is increasing because of late marriage customs, as well as environmental and lifestyle habits. In Korea, infertile females have been treated with Korean medicine (KM). However, these effects have not been objectively confirmed through clinical trials. Therefore, this study was conducted to demonstrate the effectiveness of herbal medicine treatment in infertile patients and to demonstrate the economic feasibility through economical evaluation with assisted reproductive technology.This study is designed as a multicenter, single-arm clinical trial. All participants included will be from 3 Korean Medicine hospitals in Korea and will voluntarily sign an informed consent agreement. All recruited patients will conduct related surveys and tests, and be provided with treatment according to their menstrual cycle. Patients will take herbal medicines for 4 menstruation cycles and receive acupuncture and moxibustion treatment at 3 times (menstrual cycle day 3, 8, 14) during 4 menstruation cycles. They will also undergo an approximately 4 menstrual cycle treatment period, and 3 menstrual cycle observation period. If pregnant during the study, participants will take the herbal medicine for implantation for about 15 days. In this study, the primary outcome will be the clinical pregnancy rate, whereas the secondary outcome will include the implantation rate, ongoing pregnancy rate, and live birth rate.Ultimately, this study will provide clinical data regarding the effectiveness and safety of KM treatment for females with unexplained infertility and important evidence for establishing standard KM treatments for unexplained infertility. Moreover, we will identify the most cost-effective way to treat unexplained infertility. Korean Clinical Trial Registry (CRIS), Republic of Korea: KCT0002235. Date: February 21, 2017

  5. Evaluation of chikungunya virus infection in children from India during 2009-2010: A cross sectional observational study.

    PubMed

    Raghavendhar, B Siva; Ray, Pratima; Ratagiri, Vinod H; Sharma, B S; Kabra, Sushil K; Lodha, Rakesh

    2016-06-01

    positive cases were from KIMS center, Hubli. Seasonally, positivity varied with number of enrolled cases at KIMS and SMS. Joint pain was significantly associated with CHIKV positivity (P = 0.0156). Presence/absence of certain clinical features varied with age (P < 0.05). Sequence analysis revealed four amino acid changes. Phylogenetic analysis with partial sequences of E1 gene from KIMS (n = 12) and SMS (n = 5) showed that the study isolates clustered with Indian Ocean Lineage strains (IOL) of East, Central and South African (ECSA) type. Evaluation of chikungunya virus infection in children from India during 2009-2010 showed high proportion of CHIKV infection in Southern region of India compared to Northern region. The circulating CHIKV strains were of Indian Ocean Lineage (IOL) group within the East, Central, and South African (ECSA) genotype. However few amino acid changes were observed in E1 polypeptide with reference to African strain S-27 (AF369024). Further studies are needed to know the implications of these changes in vector-pathogen compatibility and host-pathogen interactivity. As a whole, this study highlighted the proportion of CHIKV cases, lineage of causative strain and evolutionary pattern of circulating strain in terms of amino acid changes in the structural protein. © 2015 Wiley Periodicals, Inc.

  6. Evaluation of Quality of Lower Limb Arthroplasty Observational Studies Using the Assessment of Quality in Lower Limb Arthroplasty (AQUILA) Checklist.

    PubMed

    Cowan, James B; Mlynarek, Ryan A; Nelissen, Rob G H H; Pijls, Bart G C W; Gagnier, Joel J

    2015-09-01

    This study used the assessment of quality in lower limb arthroplasty (AQUILA) checklist to assess the quality of lower limb arthroplasty observational studies. Among 132 studies the mean reporting quality score was 5.4 (SD=1.2) out of 8 possible points. Most studies adequately reported reasons for revisions (98%) and prosthesis brand and fixation (95%) in sufficient detail. Only 3% of studies adequately reported the number of patients unwilling to participate, 15% stated a clear primary research question or hypothesis, 11% reported a worst-case analysis or competing risk analysis for endpoints, and 42% reported more than 5% of patients were lost to follow-up. There is significant room for improvement in the reporting and methodology of lower limb arthroplasty observational studies. Level III. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Values of a Patient and Observer Scar Assessment Scale to Evaluate the Facial Skin Graft Scar.

    PubMed

    Chae, Jin Kyung; Kim, Jeong Hee; Kim, Eun Jung; Park, Kun

    2016-10-01

    The patient and observer scar assessment scale (POSAS) recently emerged as a promising method, reflecting both observer's and patient's opinions in evaluating scar. This tool was shown to be consistent and reliable in burn scar assessment, but it has not been tested in the setting of skin graft scar in skin cancer patients. To evaluate facial skin graft scar applied to POSAS and to compare with objective scar assessment tools. Twenty three patients, who diagnosed with facial cutaneous malignancy and transplanted skin after Mohs micrographic surgery, were recruited. Observer assessment was performed by three independent rates using the observer component of the POSAS and Vancouver scar scale (VSS). Patient self-assessment was performed using the patient component of the POSAS. To quantify scar color and scar thickness more objectively, spectrophotometer and ultrasonography was applied. Inter-observer reliability was substantial with both VSS and the observer component of the POSAS (average measure intraclass coefficient correlation, 0.76 and 0.80, respectively). The observer component consistently showed significant correlations with patients' ratings for the parameters of the POSAS (all p -values<0.05). The correlation between subjective assessment using POSAS and objective assessment using spectrophotometer and ultrasonography showed low relationship. In facial skin graft scar assessment in skin cancer patients, the POSAS showed acceptable inter-observer reliability. This tool was more comprehensive and had higher correlation with patient's opinion.

  8. Disease Monitoring and Health Campaign Evaluation Using Google Search Activities for HIV and AIDS, Stroke, Colorectal Cancer, and Marijuana Use in Canada: A Retrospective Observational Study.

    PubMed

    Ling, Rebecca; Lee, Joon

    2016-10-12

    Infodemiology can offer practical and feasible health research applications through the practice of studying information available on the Web. Google Trends provides publicly accessible information regarding search behaviors in a population, which may be studied and used for health campaign evaluation and disease monitoring. Additional studies examining the use and effectiveness of Google Trends for these purposes remain warranted. The objective of our study was to explore the use of infodemiology in the context of health campaign evaluation and chronic disease monitoring. It was hypothesized that following a launch of a campaign, there would be an increase in information seeking behavior on the Web. Second, increasing and decreasing disease patterns in a population would be associated with search activity patterns. This study examined 4 different diseases: human immunodeficiency virus (HIV) infection, stroke, colorectal cancer, and marijuana use. Using Google Trends, relative search volume data were collected throughout the period of February 2004 to January 2015. Campaign information and disease statistics were obtained from governmental publications. Search activity trends were graphed and assessed with disease trends and the campaign interval. Pearson product correlation statistics and joinpoint methodology analyses were used to determine significance. Disease patterns and online activity across all 4 diseases were significantly correlated: HIV infection (r=.36, P<.001), stroke (r=.40, P<.001), colorectal cancer (r= -.41, P<.001), and substance use (r=.64, P<.001). Visual inspection and the joinpoint analysis showed significant correlations for the campaigns on colorectal cancer and marijuana use in stimulating search activity. No significant correlations were observed for the campaigns on stroke and HIV regarding search activity. The use of infoveillance shows promise as an alternative and inexpensive solution to disease surveillance and health campaign

  9. Disease Monitoring and Health Campaign Evaluation Using Google Search Activities for HIV and AIDS, Stroke, Colorectal Cancer, and Marijuana Use in Canada: A Retrospective Observational Study

    PubMed Central

    2016-01-01

    Background Infodemiology can offer practical and feasible health research applications through the practice of studying information available on the Web. Google Trends provides publicly accessible information regarding search behaviors in a population, which may be studied and used for health campaign evaluation and disease monitoring. Additional studies examining the use and effectiveness of Google Trends for these purposes remain warranted. Objective The objective of our study was to explore the use of infodemiology in the context of health campaign evaluation and chronic disease monitoring. It was hypothesized that following a launch of a campaign, there would be an increase in information seeking behavior on the Web. Second, increasing and decreasing disease patterns in a population would be associated with search activity patterns. This study examined 4 different diseases: human immunodeficiency virus (HIV) infection, stroke, colorectal cancer, and marijuana use. Methods Using Google Trends, relative search volume data were collected throughout the period of February 2004 to January 2015. Campaign information and disease statistics were obtained from governmental publications. Search activity trends were graphed and assessed with disease trends and the campaign interval. Pearson product correlation statistics and joinpoint methodology analyses were used to determine significance. Results Disease patterns and online activity across all 4 diseases were significantly correlated: HIV infection (r=.36, P<.001), stroke (r=.40, P<.001), colorectal cancer (r= −.41, P<.001), and substance use (r=.64, P<.001). Visual inspection and the joinpoint analysis showed significant correlations for the campaigns on colorectal cancer and marijuana use in stimulating search activity. No significant correlations were observed for the campaigns on stroke and HIV regarding search activity. Conclusions The use of infoveillance shows promise as an alternative and inexpensive solution

  10. Evaluation of a Multi-Decadal Simulation of Stratospheric Ozone by Comparison with Total Ozone Mapping Spectrometer (TOMS) Observations

    NASA Technical Reports Server (NTRS)

    Douglass, Anne R.; Stolarski, Richard S.; Steenrod, Steven; Pawson, Steven

    2003-01-01

    One key application of atmospheric chemistry and transport models is prediction of the response of ozone and other constituents to various natural and anthropogenic perturbations. These include changes in composition, such as the previous rise and recent decline in emission of man-made chlorofluorcarbons, changes in aerosol loading due to volcanic eruption, and changes in solar forcing. Comparisons of hindcast model results for the past few decades with observations are a key element of model evaluation and provide a sense of the reliability of model predictions. The 25 year data set from Total Ozone Mapping Spectrometers is a cornerstone of such model evaluation. Here we report evaluation of three-dimensional multi-decadal simulation of stratospheric composition. Meteorological fields for this off-line calculation are taken from a 50 year simulation of a general circulation model. Model fields are compared with observations from TOMS and also with observations from the Stratospheric Aerosol and Gas Experiment (SAGE), Microwave Limb Sounder (MLS), Cryogenic Limb Array Etalon Spectrometer (CLAES), and the Halogen Occultation Experiment (HALOE). This overall evaluation will emphasize the spatial, seasonal, and interannual variability of the simulation compared with observed atmospheric variability.

  11. Meta-analyses including data from observational studies.

    PubMed

    O'Connor, Annette M; Sargeant, Jan M

    2014-02-15

    Observational studies represent a wide group of studies where the disease or condition of interest is naturally occurring and the investigator does not control allocation to interventions or exposures. Observational studies are used to test hypotheses about the efficacy of interventions or about exposure-disease relationships, to estimate incidence or prevalence of conditions, and to assess the sensitivity and specificity of diagnostic assays. Experimental-study designs and randomized controlled trials (RCTs) can also contribute to the body of evidence about such questions. Meta-analyses (either with or without systematic reviews) aim to combine information from primary research studies to better describe the entire body of work. The aim of meta-analyses may be to obtain a summary effect size, or to understand factors that affect effect sizes. In this paper, we discuss the role of observational studies in meta-analysis questions and some factors to consider when deciding whether a meta-analysis should include results from such studies. Our suggestion is that one should only include studies that are not at high risk of inherent bias when calculating a summary effect size. Study design however can be a meaningful variable in assessment of outcome heterogeneity. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Vegetation-rainfall feedbacks across the Sahel: a combined observational and modeling study

    NASA Astrophysics Data System (ADS)

    Yu, Y.; Notaro, M.; Wang, F.; Mao, J.; Shi, X.; Wei, Y.

    2016-12-01

    The Sahel rainfall is characterized by large interannual variability. Past modeling studies have concluded that the Sahel rainfall variability is primarily driven by oceanic forcings and amplified by land-atmosphere interactions. However, the relative importance of oceanic versus terrestrial drivers has never been assessed from observations. The current understanding of vegetation's impacts on climate, i.e. positive vegetation-rainfall feedback through the albedo, moisture, and momentum mechanisms, comes from untested models. Neither the positive vegetation-rainfall feedback, nor the underlying mechanisms, has been fully resolved in observations. The current study fills the knowledge gap about the observed vegetation-rainfall feedbacks, through the application of the multivariate statistical method Generalized Equilibrium Feedback Assessment (GEFA) to observational data. According to GEFA, the observed oceanic impacts dominate over terrestrial impacts on Sahel rainfall, except in the post-monsoon period. Positive leaf area index (LAI) anomalies favor an extended, wetter monsoon across the Sahel, largely due to moisture recycling. The albedo mechanism is not responsible for this positive vegetation feedback on the seasonal-interannual time scale, which is too short for a grass-desert transition. A low-level stabilization and subsidence is observed in response to increased LAI - potentially responsible for a negative vegetation-rainfall feedback. However, the positive moisture feedback overwhelms the negative momentum feedback, resulting in an observed positive vegetation-rainfall feedback. We further applied GEFA to a fully-coupled Community Earth System Model (CESM) control run, as an example of evaluating climate models against the GEFA-based observational benchmark. In contrast to the observed positive vegetation-rainfall feedbacks, CESM simulates a negative vegetation-rainfall feedback across Sahel, peaking in the pre-monsoon season. The simulated negative

  13. An Observed Structured Teaching Evaluation Demonstrates the Impact of a Resident-as-Teacher Curriculum on Teaching Competency.

    PubMed

    Zackoff, Matthew; Jerardi, Karen; Unaka, Ndidi; Sucharew, Heidi; Klein, Melissa

    2015-06-01

    Residents play a critical role in the education of peers and medical students, yet attainment of teaching skills is not routinely assessed. The primary aim of this study was to develop a novel, skill-based Observed Structured Teaching Evaluation (OSTE) and self-assessment survey to measure the impact of a resident-as-teacher curriculum on teaching competency. The secondary aim was to determine interrater reliability of the OSTE. A prospective study quantitatively assessed intern teaching competency via videotaped teaching encounters (videos) before and after a month-long hospital medicine rotation and self-assessment surveys over a 5-month period. The intervention group received the resident-as-teacher curriculum. Videos were evaluated by 2 blinded faculty via an OSTE covering 9 skills within 3 core components: preparation, teaching, and reflection. Pre- to post-HM rotation month differences were evaluated within and between groups using the Wilcoxon signed rank test and Wilcoxon rank-sum test, respectively. Twenty-two of 25 (88%) control and 27 of 28 (96%) intervention interns participated; 100% of participants completed the study. The intervention group's pre-post difference for the total OSTE score and the average self-assessed competence statistically improved; however, no significant difference was seen between groups. The difference in preparation scores was significant for the intervention compared with the control. The OSTE's interrater reliability demonstrated good agreement with weighted kappas of 0.86 for preparation, 0.71 for teaching, and 0.93 for reflection. Implementation of an objective, skill-based OSTE detected observable changes in interns' teaching competency after implementation of a brief resident-as-teacher curriculum. The OSTE's good interrater reliability may allow standardized assessment of skill attainment over time. Copyright © 2015 by the American Academy of Pediatrics.

  14. Meta-evaluation of published studies on evaluation of health disaster preparedness exercises through a systematic review.

    PubMed

    Sheikhbardsiri, Hojjat; Yarmohammadian, Mohammad H; Khankeh, Hamid Reza; Nekoei-Moghadam, Mahmoud; Raeisi, Ahmad Reza

    2018-01-01

    Exercise evaluation is one of the most important steps and sometimes neglected in designing and taking exercises, in this stage of exercise, it systematically identifying, gathering, and interpreting related information to indicate how an exercise has fulfilled its objectives. The present study aimed to assess the most important evaluation techniques applied in evaluating health exercises for emergencies and disasters. This was meta-evaluation study through a systematic review. In this research, we searched papers based on specific and relevant keywords in research databases including ISI web of science, PubMed, Scopus, Science Direct, Ovid, ProQuest, Wiley, Google Scholar, and Persian database such as ISC and SID. The search keywords and strategies are followed; "simulation," "practice," "drill," "exercise," "instrument," "tool," "questionnaire," " measurement," "checklist," "scale," "test," "inventory," "battery," "evaluation," "assessment," "appraisal," "emergency," "disaster," "cricise," "hazard," "catastrophe,: "hospital", "prehospital," "health centers," "treatment centers," were used in combination with Boolean operators OR and AND. The research findings indicate that there are different techniques and methods for data collection to evaluate performance exercises of health centers and affiliated organizations in disasters and emergencies including debriefing inventories, self-report, questionnaire, interview, observation, shooting video, and photographing, electronic equipment which can be individually or collectively used depending on exercise objectives or purposes. Taking exercise in the health sector is one of the important steps in preparation and implementation of disaster risk management programs. This study can be thus utilized to improve preparedness of different sectors of health system according to the latest available evaluation techniques and methods for better implementation of disaster exercise evaluation stages.

  15. A Novel Observation-Guided Approach for Evaluating Mesoscale Convective Systems Simulated by the DOE ACME Model

    NASA Astrophysics Data System (ADS)

    Feng, Z.; Ma, P. L.; Hardin, J. C.; Houze, R.

    2017-12-01

    Mesoscale convective systems (MCSs) are the largest type of convective storms that develop when convection aggregates and induces mesoscale circulation features. Over North America, MCSs contribute over 60% of the total warm-season precipitation and over half of the extreme daily precipitation in the central U.S. Our recent study (Feng et al. 2016) found that the observed increases in springtime total and extreme rainfall in this region are dominated by increased frequency and intensity of long-lived MCSs*. To date, global climate models typically do not run at a resolution high enough to explicitly simulate individual convective elements and may not have adequate process representations for MCSs, resulting in a large deficiency in projecting changes of the frequency of extreme precipitation events in future climate. In this study, we developed a novel observation-guided approach specifically designed to evaluate simulated MCSs in the Department of Energy's climate model, Accelerated Climate Modeling for Energy (ACME). The ACME model has advanced treatments for convection and subgrid variability and for this study is run at 25 km and 100 km grid spacings. We constructed a robust MCS database consisting of over 500 MCSs from 3 warm-season observations by applying a feature-tracking algorithm to 4-km resolution merged geostationary satellite and 3-D NEXRAD radar network data over the Continental US. This high-resolution MCS database is then down-sampled to the 25 and 100 km ACME grids to re-characterize key MCS properties. The feature-tracking algorithm is adapted with the adjusted characteristics to identify MCSs from ACME model simulations. We demonstrate that this new analysis framework is useful for evaluating ACME's warm-season precipitation statistics associated with MCSs, and provides insights into the model process representations related to extreme precipitation events for future improvement. *Feng, Z., L. R. Leung, S. Hagos, R. A. Houze, C. D. Burleyson

  16. Evaluation of Bioelectrical Activity of Pelvic Floor Muscles and Synergistic Muscles Depending on Orientation of Pelvis in Menopausal Women with Symptoms of Stress Urinary Incontinence: A Preliminary Observational Study

    PubMed Central

    Halski, Tomasz; Słupska, Lucyna; Dymarek, Robert; Bartnicki, Janusz; Halska, Urszula; Król, Agata; Paprocka-Borowicz, Małgorzata; Dembowski, Janusz; Zdrojowy, Romuald

    2014-01-01

    Objectives. Evaluation of resting and functional bioelectrical activity of the pelvic floor muscles (PFM) and the synergistic muscles, depending on the orientation of the pelvis, in anterior (P1) and posterior (P2) pelvic tilt. Design. Preliminary, prospective observational study. Setting. Department and Clinic of Urology, University Hospital in Wroclaw, Poland. Participants. Thirty-two menopausal and postmenopausal women with stress urinary incontinence were recruited. Based on inclusion and exclusion criteria, sixteen women aged 55 to 70 years were enrolled in the study. Primary Outcome Measures. Evaluation of resting and functional bioelectrical activity of the pelvic floor muscles by electromyography (sEMG) and vaginal probe. Secondary Outcome Measures. Evaluation of activity of the synergistic muscles by sEMG and surface electrodes. Results. No significant differences between orientations P1 and P2 were found in functional and resting sEMG activity of the PFM. During resting and functional PFM activity, higher electrical activity in P2 than in P1 has been recorded in some of the synergistic muscles. Conclusions. This preliminary study does not provide initial evidence that pelvic tilt influences PFM activation. Although different activity of synergistic muscles occurs in various orientations of the pelvic tilt, it does not have to affect the sEMG activity of the PFM. PMID:24701567

  17. Evaluation of medical management during a mass casualty incident exercise: an objective assessment tool to enhance direct observation.

    PubMed

    Ingrassia, Pier Luigi; Prato, Federico; Geddo, Alessandro; Colombo, Davide; Tengattini, Marco; Calligaro, Sara; La Mura, Fabrizio; Franc, Jeffrey Michael; Della Corte, Francesco

    2010-11-01

    Functional exercises represent an important link between disaster planning and disaster response. Although these exercises are widely performed, no standardized method exists for their evaluation. To describe a simple and objective method to assess medical performance during functional exercise events. An evaluation tool comprising three data fields (triage, clinical maneuvers, and radio usage), accompanied by direct anecdotal observational methods, was used to evaluate a large functional mass casualty incident exercise. Seventeen medical responders managed 112 victims of a simulated building explosion. Although 81% of the patients were assigned the appropriate triage codes, evacuation from the site did not follow in priority. Required maneuvers were performed correctly in 85.2% of airway maneuvers and 78.7% of breathing maneuvers, however, significant under-treatment occurred, possibly due to equipment shortages. Extensive use of radio communication was documented. In evaluating this tool, the structured markers were informative, but further information provided by direct observation was invaluable. A three-part tool (triage, medical maneuvers, and radio usage) can provide a method to evaluate functional mass casualty incident exercises, and is easily implemented. For the best results, it should be used in conjunction with direct observation. The evaluation tool has great potential as a reproducible and internationally recognized tool for evaluating disaster management exercises. Copyright © 2010 Elsevier Inc. All rights reserved.

  18. An Ethnographic Observational Study to Evaluate and Optimize the Use of Respiratory Acoustic Monitoring in Children Receiving Postoperative Opioid Infusions.

    PubMed

    Görges, Matthias; West, Nicholas C; Christopher, Nancy A; Koch, Jennifer L; Brodie, Sonia M; Lowlaavar, Nasim; Lauder, Gillian R; Ansermino, J Mark

    2016-04-01

    Respiratory depression in children receiving postoperative opioid infusions is a significant risk because of the interindividual variability in analgesic requirement. Detection of respiratory depression (or apnea) in these children may be improved with the introduction of automated acoustic respiratory rate (RR) monitoring. However, early detection of adverse events must be balanced with the risk of alarm fatigue. Our objective was to evaluate the use of acoustic RR monitoring in children receiving opioid infusions on a postsurgical ward and identify the causes of false alarm and optimal alarm thresholds. A video ethnographic study was performed using an observational, mixed methods approach. After surgery, an acoustic RR sensor was placed on the participant's neck and attached to a Rad87 monitor. The monitor was networked with paging for alarms. Vital signs data and paging notification logs were obtained from the central monitoring system. Webcam videos of the participant, infusion pump, and Rad87 monitor were recorded, stored on a secure server, and subsequently analyzed by 2 research nurses to identify the cause of the alarm, response, and effectiveness. Alarms occurring within a 90-second window were grouped into a single-alarm response opportunity. Data from 49 patients (30 females) with median age 14 (range, 4.4-18.8) years were analyzed. The 896 bedside vital sign threshold alarms resulted in 160 alarm response opportunities (44 low RR, 74 high RR, and 42 low SpO2). In 141 periods (88% of total), for which video was available, 65% of alarms were deemed effective (followed by an alarm-related action within 10 minutes). Nurses were the sole responders in 55% of effective alarms and the patient or parent in 20%. Episodes of desaturation (SpO2 < 90%) were observed in 9 patients: At the time of the SpO2 paging trigger, the RR was >10 bpm in 6 of 9 patients. Based on all RR samples observed, the default alarm thresholds, to serve as a starting point for each

  19. Evaluation of cloud-resolving modeling of haboobs using in-situ and remotely sensed observations

    NASA Astrophysics Data System (ADS)

    Anisimov, Anatolii; Axisa, Duncan; Mostamandi, Suleiman; Kucera, Paul A.; Stenchikov, Georgiy

    2017-04-01

    Arabian Peninsula is one of the major dust generation regions that at present is severely under-sampled. In this study, we combine unique aircraft observations of aerosol and fine-resolution simulations to better quantify dust generation and transport in deep convective storms called haboobs. The aerosol observations were obtained during the "Kingdom of Saudi Arabia Assessment of Rainfall Augmentation" research program that was conducted in the Central and Southwest regions of Saudi Arabia for the years of 2006 through 2009. We ingest the observations from the first phase of the project conducted in the central Arabian Peninsula near Riyadh in April 2007 and focus on the observational cases when the aircraft sampled high concentrations of dust within haboobs. These data are indispensable for assessment of dust properties during periods of extreme aerosol loading. We perform cloud-resolving 2-km simulations using the coupled meteorology-chemistry WRF-Chem model with 8-bin MOSAIC aerosol microphysics scheme that accounts for direct and indirect aerosol effects. The model is validated using observations from surface weather stations, Doppler weather radar network, AERONET stations, MODIS and SEVIRI satellite aerosol sensors. We also compare the model results with recent MERRA-2 reanalysis that assimilates aerosols and chemical components. The model captures the spatiotemporal variability of atmospheric circulation and aerosol properties and calculates contributions of different aerosol species. We specifically compare the simulated aerosols with the aircraft measurements to evaluate the vertical extent and the structure of dust layers in haboobs. The simulated column-averaged dust size distribution compares reasonably well with AERONET and aircraft measurement. Despite total aerosol optical depth in simulations and MERRA2 reanalysis are quite similar, the vertical distribution and regional dust emission fluxes in the model and reanalysis differ significantly. The

  20. Can Principals Promote Teacher Development as Evaluators? A Case Study of Principals' Views and Experiences

    ERIC Educational Resources Information Center

    Kraft, Matthew A.; Gilmour, Allison F.

    2016-01-01

    Purpose: New teacher evaluation systems have expanded the role of principals as instructional leaders, but little is known about principals' ability to promote teacher development through the evaluation process. We conducted a case study of principals' perspectives on evaluation and their experiences implementing observation and feedback cycles to…

  1. The LIBERTY study: Design of a prospective, observational, multicenter trial to evaluate the acute and long-term clinical and economic outcomes of real-world endovascular device interventions in treating peripheral artery disease.

    PubMed

    Adams, George L; Mustapha, Jihad; Gray, William; Hargus, Nick J; Martinsen, Brad J; Ansel, Gary; Jaff, Michael R

    2016-04-01

    Most peripheral artery disease (PAD) clinical device trials are supported by commercial manufacturers and designed for regulatory device approval, with extensive inclusion/exclusion criteria to support homogeneous patient populations. High-risk patients with advanced disease, including critical limb ischemia (CLI), are often excluded leading to difficulty in translating trial results into real-world clinical practice. As a result, physicians have no direct guidance regarding the use of endovascular devices. There is a need for objectively assessed studies to evaluate clinical, functional, and economic outcomes in PAD patient populations. LIBERTY is a prospective, observational, multicenter study sponsored by Cardiovascular Systems Inc (St Paul, MN) to evaluate procedural and long-term clinical and economic outcomes of endovascular device interventions in patients with symptomatic lower extremity PAD. Approximately 1,200 patients will be enrolled and followed up to 5 years: 500 patients in the "Claudicant Rutherford 2-3" arm, 600 in the "CLI Rutherford 4-5" arm, and 100 in the "CLI Rutherford 6" arm. The study will use 4 core laboratories for independent analysis and will evaluate the following: procedural and lesion success, rates of major adverse events, duplex ultrasound interpretations, wound status, quality of life, 6-minute walk test, and economic analysis. The LIBERTY Patient Risk Score(s) will be developed as a clinical predictor of outcomes to provide guidance for interventions in this patient population. LIBERTY will investigate real-world PAD patients treated with endovascular revascularization with rigorous study guidelines and independent oversight of outcomes. This study will provide observational, all-comer patient clinical data to guide future endovascular therapy. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  2. Evaluation of Precipitation Simulated by Seven SCMs against the ARM Observations at the SGP Site

    NASA Technical Reports Server (NTRS)

    Song, Hua; Lin, Wuyin; Lin, Yanluan; Wolf, Audrey B.; Neggers, Roel; Donner, Leo J.; Del Genio, Anthony D.; Liu, Yangang

    2013-01-01

    This study evaluates the performances of seven single-column models (SCMs) by comparing simulated surface precipitation with observations at the Atmospheric Radiation Measurement Program Southern Great Plains (SGP) site from January 1999 to December 2001. Results show that although most SCMs can reproduce the observed precipitation reasonably well, there are significant and interesting differences in their details. In the cold season, the model-observation differences in the frequency and mean intensity of rain events tend to compensate each other for most SCMs. In the warm season, most SCMs produce more rain events in daytime than in nighttime, whereas the observations have more rain events in nighttime. The mean intensities of rain events in these SCMs are much stronger in daytime, but weaker in nighttime, than the observations. The higher frequency of rain events during warm-season daytime in most SCMs is related to the fact that most SCMs produce a spurious precipitation peak around the regime of weak vertical motions but rich in moisture content. The models also show distinct biases between nighttime and daytime in simulating significant rain events. In nighttime, all the SCMs have a lower frequency of moderate-to-strong rain events than the observations for both seasons. In daytime, most SCMs have a higher frequency of moderate-to-strong rain events than the observations, especially in the warm season. Further analysis reveals distinct meteorological backgrounds for large underestimation and overestimation events. The former occur in the strong ascending regimes with negative low-level horizontal heat and moisture advection, whereas the latter occur in the weak or moderate ascending regimes with positive low-level horizontal heat and moisture advection.

  3. Values of a Patient and Observer Scar Assessment Scale to Evaluate the Facial Skin Graft Scar

    PubMed Central

    Chae, Jin Kyung; Kim, Eun Jung; Park, Kun

    2016-01-01

    Background The patient and observer scar assessment scale (POSAS) recently emerged as a promising method, reflecting both observer's and patient's opinions in evaluating scar. This tool was shown to be consistent and reliable in burn scar assessment, but it has not been tested in the setting of skin graft scar in skin cancer patients. Objective To evaluate facial skin graft scar applied to POSAS and to compare with objective scar assessment tools. Methods Twenty three patients, who diagnosed with facial cutaneous malignancy and transplanted skin after Mohs micrographic surgery, were recruited. Observer assessment was performed by three independent rates using the observer component of the POSAS and Vancouver scar scale (VSS). Patient self-assessment was performed using the patient component of the POSAS. To quantify scar color and scar thickness more objectively, spectrophotometer and ultrasonography was applied. Results Inter-observer reliability was substantial with both VSS and the observer component of the POSAS (average measure intraclass coefficient correlation, 0.76 and 0.80, respectively). The observer component consistently showed significant correlations with patients' ratings for the parameters of the POSAS (all p-values<0.05). The correlation between subjective assessment using POSAS and objective assessment using spectrophotometer and ultrasonography showed low relationship. Conclusion In facial skin graft scar assessment in skin cancer patients, the POSAS showed acceptable inter-observer reliability. This tool was more comprehensive and had higher correlation with patient's opinion. PMID:27746642

  4. Observational studies of roAp stars

    NASA Astrophysics Data System (ADS)

    Sachkov, M.

    2014-11-01

    Rapidly oscillating Ap (roAp) stars are high-overtone, low-degree p-mode pulsators that are also chemically peculiar magnetic A stars. Until recently the classical asteroseismic analysis i.e. frequency analysis, of these stars was based on ground and space photometric observations. Significant progress was achieved through access to uninterrupted, ultra-high-precision data from MOST, COROT and Kepler satellites. Over the last ten years the study of roAp stars has been altered drastically from an observational point of view through studies of time-resolved, high-resolution spectra. Their unusual pulsational characteristics, caused by an interplay between the short vertical lengths of the pulsation waves and strong stratification of chemical elements, allow us to examine the upper roAp atmosphere in more detail than is possible for any star except the Sun. In this paper I review the results of recent studies of the pulsations of roAp stars.

  5. Evaluation of High Resolution Rapid Refresh-Smoke (HRRR-Smoke) model products for a case study using surface PM2.5 observations

    NASA Astrophysics Data System (ADS)

    Deanes, L. N.; Ahmadov, R.; McKeen, S. A.; Manross, K.; Grell, G. A.; James, E.

    2016-12-01

    Wildfires are increasing in number and size in the western United States as climate change contributes to warmer and drier conditions in this region. These fires lead to poor air quality and diminished visibility. The High Resolution Rapid Refresh-Smoke modeling system (HRRR-Smoke) is designed to simulate fire emissions and smoke transport with high resolution. The model is based on the Weather Research and Forecasting model, coupled with chemistry (WRF-Chem) and uses fire detection data from the Visible Infrared and Imaging Radiometer Suite (VIIRS) satellite instrument to simulate wildfire emissions and their plume rise. HRRR-Smoke is used in both real-time applications and case studies. In this study, we evaluate the HRRR-Smoke for August 2015, during one of the worst wildfire seasons on record in the United States, by focusing on wildfires that occurred in the northwestern US. We compare HRRR-Smoke simulations with hourly fine particulate matter (PM2.5) observations from the Air Quality System (https://www.epa.gov/aqs) from multiple air quality monitoring sites in Washington state. PM2.5 data includes measurements from urban, suburban and remote sites in the state. We discuss the model performance in capturing large PM2.5 enhancements detected at surface sites due to wildfires. We present various statistical parameters to demonstrate HRRR-Smoke's performance in simulating surface PM2.5 levels.

  6. Nonparametric EROC analysis for observer performance evaluation on joint detection and estimation tasks

    NASA Astrophysics Data System (ADS)

    Wunderlich, Adam; Goossens, Bart

    2014-03-01

    The majority of the literature on task-based image quality assessment has focused on lesion detection tasks, using the receiver operating characteristic (ROC) curve, or related variants, to measure performance. However, since many clinical image evaluation tasks involve both detection and estimation (e.g., estimation of kidney stone composition, estimation of tumor size), there is a growing interest in performance evaluation for joint detection and estimation tasks. To evaluate observer performance on such tasks, Clarkson introduced the estimation ROC (EROC) curve, and the area under the EROC curve as a summary figure of merit. In the present work, we propose nonparametric estimators for practical EROC analysis from experimental data, including estimators for the area under the EROC curve and its variance. The estimators are illustrated with a practical example comparing MRI images reconstructed from different k-space sampling trajectories.

  7. Observational Evaluation of Simulated Land-Atmosphere Coupling on the U.S. Southern Great Plains

    NASA Astrophysics Data System (ADS)

    Phillips, T. J.; Klein, S. A.

    2014-12-01

    In a recent study of observed features of land-atmosphere coupling (LAC) at the ARM Southern Great Plains (ARM SGP) site in northern Oklahoma (Phillips and Klein, 2014 Journal of Geophysical Research), we identified statistically significant interactions between 1997-2008 summertime daily averages of soil moisture (at 10 cm depth) and a number of surface atmospheric variables, such as surface evaporation, relative humidity, and temperature. Here we will report on an evaluation of similar features of LAC simulated by version 5 of the global Community Atmosphere Model (CAM5), coupled to its native CLM4 land model, and downscaled to the vicinity of the ARM SGP site. In these case studies, the CAM5 was initialized from a 6-hourly atmospheric reanalysis for each day of the years 2008 and 2009 (where the CLM4 land state was equilibrated to the atmospheric model state), thus permitting a close comparison of the modeled and observed summer daily average features of the LAC in these years. Correlation coefficients R and "sensitivity indices" I (a measure of the comparative change of an atmospheric variable for a one-standard-deviation change in soil moisture) provided quantitative measures of the respective coupling strengths. Such a comparison of observed versus modeled LAC is complicated by differences in atmospheric forcings of the land; for example, the CAM5's summertime precipitation is too scant, and thus the model's upper soil layer often is drier than observed. The modeled daily average covariations of soil moisture with lower atmospheric variables also display less coherence (lower R values), but sometimes greater "sensitivity" (higher I values) than are observed at the ARM SGP site. Since the observational estimate of LAC may itself be sensitive to soil moisture measurement biases, we also will report on a planned investigation of the dependence of LAC on several alternative choices of soil moisture data sets local to the ARM SGP site. AcknowledgmentsThis work was

  8. Drug Utilization on Neonatal Wards: A Systematic Review of Observational Studies

    PubMed Central

    Rosli, Rosliana; Dali, Ahmad Fauzi; Abd Aziz, Noorizan; Abdullah, Amir Heberd; Ming, Long Chiau; Manan, Mohamed Mansor

    2017-01-01

    Despite limited evidence on safety and efficacy of drug use in neonates, drugs are extensively used in this age group. However, the availability of information on drug consumption in neonates, especially inpatient neonates, is limited. This paper systematically reviews published studies on drug utilization in hospitalized neonates. A systematic literature review was carried out to identify observational studies published from inception of databases used till August 2016. Four search engines, namely Medline, CINAHL, Embase, and PubMed, were used. Publications written in English that described drug utilization in neonatal wards were selected. Assessment of the data was based on the category of the study design, the objective of study and the method used in reporting drug consumption. A total of 20 drug utilization studies were identified, 12 of which focused on all drug classes, while the other eight evaluated antimicrobials. Studies were reported in Europe (n = 7), the United States (n = 6), India (n = 5), Brazil (n = 1), and Iran (n = 1). Substantial variance with regard to study types (study design and methods), data source, and sample size were found among the selected studies. Of the studies included, 45% were cross-sectional or retrospective, 40% were prospective studies, and the remaining 15% were point prevalence surveys. More than 70% of the studies were descriptive studies, describing drug consumption patterns. Fifteen per cent of the descriptive studies evaluated changes in drug utilization patterns in neonates. Volume of units was the most prevalent method used for reporting all drug categories. The ATC/DDD system for reporting drug use was only seen in studies evaluating antimicrobials. The most commonly reported drugs across all studies are anti-infectives for systemic use, followed by drugs for the cardiovascular system, the nervous system and the respiratory system. Ampicillin and gentamicin were the most prescribed antimicrobials in hospitalized

  9. Similarity of markers identified from cancer gene expression studies: observations from GEO.

    PubMed

    Shi, Xingjie; Shen, Shihao; Liu, Jin; Huang, Jian; Zhou, Yong; Ma, Shuangge

    2014-09-01

    Gene expression profiling has been extensively conducted in cancer research. The analysis of multiple independent cancer gene expression datasets may provide additional information and complement single-dataset analysis. In this study, we conduct multi-dataset analysis and are interested in evaluating the similarity of cancer-associated genes identified from different datasets. The first objective of this study is to briefly review some statistical methods that can be used for such evaluation. Both marginal analysis and joint analysis methods are reviewed. The second objective is to apply those methods to 26 Gene Expression Omnibus (GEO) datasets on five types of cancers. Our analysis suggests that for the same cancer, the marker identification results may vary significantly across datasets, and different datasets share few common genes. In addition, datasets on different cancers share few common genes. The shared genetic basis of datasets on the same or different cancers, which has been suggested in the literature, is not observed in the analysis of GEO data. © The Author 2013. Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  10. An Observational Study to Evaluate the Usability and Intent to Adopt an Artificial Intelligence–Powered Medication Reconciliation Tool

    PubMed Central

    Yuan, Michael Juntao; Poonawala, Robina

    2016-01-01

    Background Medication reconciliation (the process of creating an accurate list of all medications a patient is taking) is a widely practiced procedure to reduce medication errors. It is mandated by the Joint Commission and reimbursed by Medicare. Yet, in practice, medication reconciliation is often not effective owing to knowledge gaps in the team. A promising approach to improve medication reconciliation is to incorporate artificial intelligence (AI) decision support tools into the process to engage patients and bridge the knowledge gap. Objective The aim of this study was to improve the accuracy and efficiency of medication reconciliation by engaging the patient, the nurse, and the physician as a team via an iPad tool. With assistance from the AI agent, the patient will review his or her own medication list from the electronic medical record (EMR) and annotate changes, before reviewing together with the physician and making decisions on the shared iPad screen. Methods In this study, we developed iPad-based software tools, with AI decision support, to engage patients to “self-service” medication reconciliation and then share the annotated reconciled list with the physician. To evaluate the software tool’s user interface and workflow, a small number of patients (10) in a primary care clinic were recruited, and they were observed through the whole process during a pilot study. The patients are surveyed for the tool’s usability afterward. Results All patients were able to complete the medication reconciliation process correctly. Every patient found at least one error or other issues with their EMR medication lists. All of them reported that the tool was easy to use, and 8 of 10 patients reported that they will use the tool in the future. However, few patients interacted with the learning modules in the tool. The physician and nurses reported the tool to be easy-to-use, easy to integrate into existing workflow, and potentially time-saving. Conclusions We have

  11. An Observational Study to Evaluate the Usability and Intent to Adopt an Artificial Intelligence-Powered Medication Reconciliation Tool.

    PubMed

    Long, Ju; Yuan, Michael Juntao; Poonawala, Robina

    2016-05-16

    Medication reconciliation (the process of creating an accurate list of all medications a patient is taking) is a widely practiced procedure to reduce medication errors. It is mandated by the Joint Commission and reimbursed by Medicare. Yet, in practice, medication reconciliation is often not effective owing to knowledge gaps in the team. A promising approach to improve medication reconciliation is to incorporate artificial intelligence (AI) decision support tools into the process to engage patients and bridge the knowledge gap. The aim of this study was to improve the accuracy and efficiency of medication reconciliation by engaging the patient, the nurse, and the physician as a team via an iPad tool. With assistance from the AI agent, the patient will review his or her own medication list from the electronic medical record (EMR) and annotate changes, before reviewing together with the physician and making decisions on the shared iPad screen. In this study, we developed iPad-based software tools, with AI decision support, to engage patients to "self-service" medication reconciliation and then share the annotated reconciled list with the physician. To evaluate the software tool's user interface and workflow, a small number of patients (10) in a primary care clinic were recruited, and they were observed through the whole process during a pilot study. The patients are surveyed for the tool's usability afterward. All patients were able to complete the medication reconciliation process correctly. Every patient found at least one error or other issues with their EMR medication lists. All of them reported that the tool was easy to use, and 8 of 10 patients reported that they will use the tool in the future. However, few patients interacted with the learning modules in the tool. The physician and nurses reported the tool to be easy-to-use, easy to integrate into existing workflow, and potentially time-saving. We have developed a promising tool for a new approach to

  12. Basal cortisol levels and metabolic syndrome: A systematic review and meta-analysis of observational studies.

    PubMed

    Garcez, Anderson; Leite, Heloísa Marquardt; Weiderpass, Elisabete; Paniz, Vera Maria Vieira; Watte, Guilherme; Canuto, Raquel; Olinto, Maria Teresa Anselmo

    2018-05-17

    To perform a qualitative synthesis (systematic review) and quantitative analysis (meta-analysis) to summarize the evidence regarding the relationship between basal cortisol levels and metabolic syndrome (MetS) in adults. A systematic search was performed in the PubMed, Embase, and PsycINFO databases for observational studies on the association between basal cortisol levels and MetS. The quality of individual studies was assessed by the Newcastle-Ottawa score. A random effects model was used to report pooled quantitative results and the I 2 statistic was used to assess heterogeneity. Egger's and Begg's tests were used to evaluate publication bias. Twenty-six studies (19 cross-sectional and seven case-control) met the inclusion criteria for the systematic review. The majority was classified as having a low risk of bias and used established criteria for the diagnosis of MetS. Twenty-one studies provided data on basal cortisol levels as continuous values and were included in the meta-analysis; they comprised 35 analyses and 11,808 subjects. Pooled results showed no significant difference in basal cortisol levels between subjects with and without MetS (standardized mean difference [SMD] = 0.02, 95% confidence interval [CI]=-0.11 to 0.14). There was high heterogeneity between the studies when all comparisons were considered (I 2  = 83.1%;p < 0.001). Paradoxically, meta-analysis of studies evaluating saliva samples showed no significantly lower basal cortisol levels among subjects with MetS (SMD=-0.18, 95% CI=-0.37 to 0.01), whereas those studies that evaluated serum samples (SMD = 0.11, 95% CI=-0.02 to 0.24) and urine samples (SMD = 0.73, 95% CI=-0.40 to 1.86) showed no significantly higher basal cortisol levels among subjects with MetS. In the subgroup and meta-regression analyses, a significant difference in basal cortisol levels was observed according to study design, population base, age, gender, cortisol level assessment method, and study quality

  13. Administrative complexities for a European observational study despite directives harmonising requirements.

    PubMed

    Gülmez, Sinem Ezgi; Lignot-Maleyran, Séverine; de Vries, Corinne S; Sturkenboom, Miriam; Micon, Sophie; Hamoud, Fatima; Blin, Patrick; Moore, Nicholas

    2012-08-01

    For pharmacoepidemiological studies in Europe, accessing data should require only authorisation by the relevant data protections committees, as expected from the 1995 Data Protection Directive (95/46/EC). Our experience from a multinational observational study across seven European countries shows that this is certainly not the case. The study was a multicentre, multinational, case-population study in European liver transplant centres in seven countries, retrospectively evaluating a 3-year period. Before data collection started, the procedures to obtain the necessary authorisations for the participating countries were defined. In France, a single opinion from a single data protection committee was enough to start the study. In Italy, Portugal, Greece and the UK, there was a national authority, but the hospitals requested the approval by their local committees/bodies irrespective of whether the authorisation of the national committee came after or before that of local ones. In Ireland, only one hospital participated, and the opinion of its ethics committee was sufficient. In the Netherlands, the opinion of the institutional review board of the local coordinating centre was necessary to obtain the opinions from the institutional review boards of the other hospitals. The information requested by the different committees and the time to obtain the approvals varied, even within the same country. This degree of complexity and disharmony, and resulting cost, was observed in a simple retrospective study. Regulators will need to be aware that these time-consuming, expensive and useless complexities must be factored in when estimating the time and cost of a study. Copyright © 2012 John Wiley & Sons, Ltd.

  14. An evaluation of video cameras for collecting observational data on sanctuary-housed chimpanzees (Pan troglodytes).

    PubMed

    Hansen, Bethany K; Fultz, Amy L; Hopper, Lydia M; Ross, Stephen R

    2018-05-01

    Video cameras are increasingly being used to monitor captive animals in zoo, laboratory, and agricultural settings. This technology may also be useful in sanctuaries with large and/or complex enclosures. However, the cost of camera equipment and a lack of formal evaluations regarding the use of cameras in sanctuary settings make it challenging for facilities to decide whether and how to implement this technology. To address this, we evaluated the feasibility of using a video camera system to monitor chimpanzees at Chimp Haven. We viewed a group of resident chimpanzees in a large forested enclosure and compared observations collected in person and with remote video cameras. We found that via camera, the observer viewed fewer chimpanzees in some outdoor locations (GLMM post hoc test: est. = 1.4503, SE = 0.1457, Z = 9.951, p < 0.001) and identified a lower proportion of chimpanzees (GLMM post hoc test: est. = -2.17914, SE = 0.08490, Z = -25.666, p < 0.001) compared to in-person observations. However, the observer could view the 2 ha enclosure 15 times faster by camera compared to in person. In addition to these results, we provide recommendations to animal facilities considering the installation of a video camera system. Despite some limitations of remote monitoring, we posit that there are substantial benefits of using camera systems in sanctuaries to facilitate animal care and observational research. © 2018 Wiley Periodicals, Inc.

  15. Evaluation of Patients’ Rights Observance According to Patients’ Rights Charter in Educational Hospitals Affiliated to Mashhad University of Medical Sciences: Medical Staffs’ Views

    PubMed Central

    Sabzevari, Alireza; Kiani, Mohammad Ali; Saeidi, Masumeh; Jafari, Seyed Ali; Kianifar, Hamidreza; Ahanchian, Hamid; Jarahi, Lida; Zakerian, Mohsen

    2016-01-01

    Introduction To supply quality services and healthcare, it is evident that medical ethics and patients’ rights, while providing medical and healthcare services need to be observed. This study was conducted to evaluate observance of the Patients’ Rights Charter among medical staff of educational hospitals affiliated to Mashhad University of Medical Sciences. Methods This cross-sectional study was conducted in four educational hospitals in Mashhad on eighty physicians, nurses, nurse aids and medical students. Data were collected using a two-part inventory of patients’ rights, including demographic data and inventory of patients’ rights observance. Data analysis was conducted using SPSS-16 as well as descriptive statistics, independent t-test, chi-square, Spearman correlation coefficient and Pearson correlation. Results Mean age of subjects was 36.3±8.3. Observance of human rights was perfect by 84.4 percent of subjects. The highest amount of observance of patients’ rights was related to the area of respecting patients’ privacy and observing the principle of confidentiality, which was evaluated to be perfect by all subjects (100%). The lowest value of patients’ rights observance was related to presenting appropriate and adequate information for patients, which was perfect among 48.1% of subjects. There was no significant relation between personal details (age, gender, education and career) and observance of patients’ rights (p>0.05). Conclusion Although in this study, the observance of patients’ rights by medical staff is optimal in most areas, the area of providing appropriate and adequate information needs to be promoted. Therefore, it is suggested that more stringent regulatory policies be compiled and implemented to the items of Patients’ Rights Charter along with training courses, to strengthen medical staff’s awareness in this regard. PMID:27957310

  16. Pharmacy Information Systems in Teaching Hospitals: A Multi-dimensional Evaluation Study.

    PubMed

    Kazemi, Alireza; Rabiei, Reza; Moghaddasi, Hamid; Deimazar, Ghasem

    2016-07-01

    In hospitals, the pharmacy information system (PIS) is usually a sub-system of the hospital information system (HIS). The PIS supports the distribution and management of drugs, shows drug and medical device inventory, and facilitates preparing needed reports. In this study, pharmacy information systems implemented in general teaching hospitals affiliated to medical universities in Tehran (Iran) were evaluated using a multi-dimensional tool. This was an evaluation study conducted in 2015. To collect data, a checklist was developed by reviewing the relevant literature; this checklist included both general and specific criteria to evaluate pharmacy information systems. The checklist was then validated by medical informatics experts and pharmacists. The sample of the study included five PIS in general-teaching hospitals affiliated to three medical universities in Tehran (Iran). Data were collected using the checklist and through observing the systems. The findings were presented as tables. Five PIS were evaluated in the five general-teaching hospitals that had the highest bed numbers. The findings showed that the evaluated pharmacy information systems lacked some important general and specific criteria. Among the general evaluation criteria, it was found that only two of the PIS studied were capable of restricting repeated attempts made for unauthorized access to the systems. With respect to the specific evaluation criteria, no attention was paid to the patient safety aspect. The PIS studied were mainly designed to support financial tasks; little attention was paid to clinical and patient safety features.

  17. Observing Protein & Energy Nutrition (OPEN) Study

    Cancer.gov

    The Observing Protein and Energy Nutrition (OPEN) Study was designed to assess dietary measurement error by comparing results from self-reported dietary intake data with four dietary biomarkers: doubly labeled water and urinary nitrogen, sodium, and potassium.

  18. Observational and Modeling Studies of Clouds and the Hydrological Cycle

    NASA Technical Reports Server (NTRS)

    Somerville, Richard C. J.

    1997-01-01

    Our approach involved validating parameterizations directly against measurements from field programs, and using this validation to tune existing parameterizations and to guide the development of new ones. We have used a single-column model (SCM) to make the link between observations and parameterizations of clouds, including explicit cloud microphysics (e.g., prognostic cloud liquid water used to determine cloud radiative properties). Surface and satellite radiation measurements were used to provide an initial evaluation of the performance of the different parameterizations. The results of this evaluation will then used to develop improved cloud and cloud-radiation schemes, which were tested in GCM experiments.

  19. Overview of the epidemiology methods and applications: strengths and limitations of observational study designs.

    PubMed

    Colditz, Graham A

    2010-01-01

    The impact of study design on the results of medical research has long been an area of both substantial debate and a smaller body of empirical research. Examples come from many disciplines within clinical and public health research. Among the early major contributions in the 1970s was work by Mosteller and colleagues (Gilbert et al., 1997), who noted that innovations in surgery and anesthesia showed greater gains than standard therapy when nonrandomized, controlled trials were evaluated compared with the gains reported in randomized, controlled trials. More recently, we and others have evaluated the impact of design in medical and surgical research, and concluded that the mean gain comparing new therapies to established therapies was biased by study design in nonrandomized trials (Colditz et al., 1989; Miller et al., 1989). Benson and Hartz (2000) conducted a study in which they focused only on studies reported after 1985. On the basis of 136 reports of 19 diverse treatments, Benson and Hartz concluded that in only 2 of the 19 analyses did the combined data from the observational studies lie outside the 95% confidence interval for the combined data from the randomized trials. A similar study drew only on data reported from 1991 to 1995, which showed remarkably similar results among observational studies and randomized, controlled trials (Concato et al., 2000). These more recent data suggest that advancing the study design and analytic methods may reduce bias in some evaluations of medical and public health interventions. Such methods apply not only to the original studies, but also to the approaches that are taken to quantitatively combine results by using meta-analytic approaches such as random effects meta-regression, Bayesian meta-analysis, and the like (Normand, 1999). By focusing attention on thorough data analysis, design issues can be understood and their impact or bias can be estimated, on average, and then ideally accounted for in the interpretation of

  20. Research Methods in Healthcare Epidemiology and Antimicrobial Stewardship-Observational Studies.

    PubMed

    Snyder, Graham M; Young, Heather; Varman, Meera; Milstone, Aaron M; Harris, Anthony D; Munoz-Price, Silvia

    2016-10-01

    Observational studies compare outcomes among subjects with and without an exposure of interest, without intervention from study investigators. Observational studies can be designed as a prospective or retrospective cohort study or as a case-control study. In healthcare epidemiology, these observational studies often take advantage of existing healthcare databases, making them more cost-effective than clinical trials and allowing analyses of rare outcomes. This paper addresses the importance of selecting a well-defined study population, highlights key considerations for study design, and offers potential solutions including biostatistical tools that are applicable to observational study designs. Infect Control Hosp Epidemiol 2016;1-6.

  1. Observational studies of the association between glucose-lowering medications and cardiovascular outcomes: addressing methodological limitations.

    PubMed

    Patorno, Elisabetta; Patrick, Amanda R; Garry, Elizabeth M; Schneeweiss, Sebastian; Gillet, Victoria G; Bartels, Dorothee B; Masso-Gonzalez, Elvira; Seeger, John D

    2014-11-01

    Recent years have witnessed a growing body of observational literature on the association between glucose-lowering treatments and cardiovascular disease. However, many of the studies are based on designs or analyses that inadequately address the methodological challenges involved. We reviewed recent observational literature on the association between glucose-lowering medications and cardiovascular outcomes and assessed the design and analysis methods used, with a focus on their ability to address specific methodological challenges. We describe and illustrate these methodological issues and their impact on observed associations, providing examples from the reviewed literature. We suggest approaches that may be employed to manage these methodological challenges. From the evaluation of 81 publications of observational investigations assessing the association between glucose-lowering treatments and cardiovascular outcomes, we identified the following methodological challenges: 1) handling of temporality in administrative databases; 2) handling of risks that vary with time and treatment duration; 3) definitions of the exposure risk window; 4) handling of exposures that change over time; and 5) handling of confounding by indication. Most of these methodological challenges may be suitably addressed through application of appropriate methods. Observational research plays an increasingly important role in the evaluation of the clinical effects of diabetes treatment. Implementation of appropriate research methods holds the promise of reducing the potential for spurious findings and the risk that the spurious findings will mislead the medical community about risks and benefits of diabetes medications.

  2. Orographic precipitation at global and regional scales: Observational uncertainty and evaluation of 25-km global model simulations

    NASA Astrophysics Data System (ADS)

    Schiemann, Reinhard; Roberts, Charles J.; Bush, Stephanie; Demory, Marie-Estelle; Strachan, Jane; Vidale, Pier Luigi; Mizielinski, Matthew S.; Roberts, Malcolm J.

    2015-04-01

    Precipitation over land exhibits a high degree of variability due to the complex interaction of the precipitation generating atmospheric processes with coastlines, the heterogeneous land surface, and orography. Global general circulation models (GCMs) have traditionally had very limited ability to capture this variability on the mesoscale (here ~50-500 km) due to their low resolution. This has changed with recent investments in resolution and ensembles of multidecadal climate simulations of atmospheric GCMs (AGCMs) with ~25 km grid spacing are becoming increasingly available. Here, we evaluate the mesoscale precipitation distribution in one such set of simulations obtained in the UPSCALE (UK on PrACE - weather-resolving Simulations of Climate for globAL Environmental risk) modelling campaign with the HadGEM-GA3 AGCM. Increased model resolution also poses new challenges to the observational datasets used to evaluate models. Global gridded data products such as those provided by the Global Precipitation Climatology Project (GPCP) are invaluable for assessing large-scale features of the precipitation distribution but may not sufficiently resolve mesoscale structures. In the absence of independent estimates, the intercomparison of different observational datasets may be the only way to get some insight into the uncertainties associated with these observations. Here, we focus on mid-latitude continental regions where observations based on higher-density gauge networks are available in addition to the global data sets: Europe/the Alps, South and East Asia, and the continental US. The ability of GCMs to represent mesoscale variability is of interest in its own right, as climate information on this scale is required by impact studies. An additional motivation for the research proposed here arises from continuing efforts to quantify the components of the global radiation budget and water cycle. Recent estimates based on radiation measurements suggest that the global mean

  3. Using observed postconstruction peak discharges to evaluate a hydrologic and hydraulic design model, Boneyard Creek, Champaign and Urbana, Illinois

    USGS Publications Warehouse

    Over, Thomas M.; Soong, David T.; Holmes, Robert R.

    2011-01-01

    Boneyard Creek—which drains an urbanized watershed in the cities of Champaign and Urbana, Illinois, including part of the University of Illinois at Urbana-Champaign (UIUC) campus—has historically been prone to flooding. Using the Stormwater Management Model (SWMM), a hydrologic and hydraulic model of Boneyard Creek was developed for the design of the projects making up the first phase of a long-term plan for flood control on Boneyard Creek, and the construction of the projects was completed in May 2003. The U.S. Geological Survey, in cooperation with the Cities of Champaign and Urbana and UIUC, installed and operated stream and rain gages in order to obtain data for evaluation of the design-model simulations. In this study, design-model simulations were evaluated by using observed postconstruction precipitation and peak-discharge data. Between May 2003 and September 2008, five high-flow events on Boneyard Creek satisfied the study criterion. The five events were simulated with the design model by using observed precipitation. The simulations were run with two different values of the parameter controlling the soil moisture at the beginning of the storms and two different ways of spatially distributing the precipitation, making a total of four simulation scenarios. The simulated and observed peak discharges and stages were compared at gaged locations along the Creek. The discharge at one of these locations was deemed to be critical for evaluating the design model. The uncertainty of the measured peak discharge was also estimated at the critical location with a method based on linear regression of the stage and discharge relation, an estimate of the uncertainty of the acoustic Doppler velocity meter measurements, and the uncertainty of the stage measurements. For four of the five events, the simulated peak discharges lie within the 95-percent confidence interval of the observed peak discharges at the critical location; the fifth was just outside the upper end of

  4. Development and evaluation of a study design typology for human research.

    PubMed

    Carini, Simona; Pollock, Brad H; Lehmann, Harold P; Bakken, Suzanne; Barbour, Edward M; Gabriel, Davera; Hagler, Herbert K; Harper, Caryn R; Mollah, Shamim A; Nahm, Meredith; Nguyen, Hien H; Scheuermann, Richard H; Sim, Ida

    2009-11-14

    A systematic classification of study designs would be useful for researchers, systematic reviewers, readers, and research administrators, among others. As part of the Human Studies Database Project, we developed the Study Design Typology to standardize the classification of study designs in human research. We then performed a multiple observer masked evaluation of active research protocols in four institutions according to a standardized protocol. Thirty-five protocols were classified by three reviewers each into one of nine high-level study designs for interventional and observational research (e.g., N-of-1, Parallel Group, Case Crossover). Rater classification agreement was moderately high for the 35 protocols (Fleiss' kappa = 0.442) and higher still for the 23 quantitative studies (Fleiss' kappa = 0.463). We conclude that our typology shows initial promise for reliably distinguishing study design types for quantitative human research.

  5. Evaluation of simulated tropical convective updraft hydrometeor properties using aircraft observations

    NASA Astrophysics Data System (ADS)

    Stanford, McKenna W.

    The High Altitude Ice Crystals - High Ice Water Content (HAIC-HIWC) field campaign produced aircraft retrievals of total condensed water content (TWC), hydrometeor particle size distributions, and vertical velocity (w) in high ice water content regions of tropical mesoscale convective systems (MCSs). These observations are used to evaluate deep convective updraft properties in high-resolution nested Weather Research and Forecasting (WRF) simulations of observed MCSs. Because simulated hydrometeor properties are highly sensitive to the parameterization of microphysics, three commonly used microphysical parameterizations are tested, including two bulk schemes (Thompson and Morrison) and one bin scheme (Fast Spectral Bin Microphysics). A commonly documented bias in cloud-resolving simulations is the exaggeration of simulated radar reflectivities aloft in tropical MCSs. This may result from overly strong convective updrafts that loft excessive condensate mass and from simplified approximations of hydrometeor size distributions, properties, species separation, and microphysical processes. The degree to which the reflectivity bias is a separate function of convective dynamics, condensate mass, and hydrometeor size has yet to be addressed. This research untangles these components by comparing simulated and observed relationships between w, TWC, and hydrometer size as a function of temperature. All microphysics schemes produce median mass diameters that are generally larger than observed for temperatures between -10 °C and -40 °C and TWC > 1 g m-3. Observations produce a prominent mode in the composite mass size distribution around 300 microm, but under most conditions, all schemes shift the distribution mode to larger sizes. Despite a much greater number of samples, all simulations fail to reproduce observed high TWC or high w conditions between -20 °C and -40 °C in which only a small fraction of condensate mass is found in relatively large particle sizes. Increasing

  6. Evaluating radiographers' diagnostic accuracy in screen-reading mammograms: what constitutes a quality study?

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

    Debono, Josephine C, E-mail: josephine.debono@bci.org.au; Poulos, Ann E; Westmead Breast Cancer Institute, Westmead, New South Wales

    The aim of this study was to first evaluate the quality of studies investigating the diagnostic accuracy of radiographers as mammogram screen-readers and then to develop an adapted tool for determining the quality of screen-reading studies. A literature search was used to identify relevant studies and a quality evaluation tool constructed by combining the criteria for quality of Whiting, Rutjes, Dinnes et al. and Brealey and Westwood. This constructed tool was then applied to the studies and subsequently adapted specifically for use in evaluating quality in studies investigating diagnostic accuracy of screen-readers. Eleven studies were identified and the constructed toolmore » applied to evaluate quality. This evaluation resulted in the identification of quality issues with the studies such as potential for bias, applicability of results, study conduct, reporting of the study and observer characteristics. An assessment of the applicability and relevance of the tool for this area of research resulted in adaptations to the criteria and the development of a tool specifically for evaluating diagnostic accuracy in screen-reading. This tool, with further refinement and rigorous validation can make a significant contribution to promoting well-designed studies in this important area of research and practice.« less

  7. Observational Case Series Evaluation of the Granisetron Transdermal Patch System (Sancuso) for the Management of Nausea/Vomiting of Pregnancy.

    PubMed

    Le, Tran N; Adler, Michael T; Ouillette, Holly; Berens, Pamela; Smith, Judith A

    2017-07-01

    Objective  The objective of this study was to observe the efficacy of antiemetic therapy (no emesis/retching episodes and no rescue medication use) when granisetron is administered via a transdermal patch system (TDS) in women who are 6 to 14 weeks pregnant when compared with oral ondansetron by evaluating the frequency of the use of rescue medications for control of nausea/vomiting of pregnancy (NVP). Methods  This was an observational case series study to observe the potential benefits of granisetron TDS compared with oral ondansetron for management of NVP in pregnant patients during the first trimester. Dates of data collection were September 1, 2014, through December 31, 2015. There was no direct contact with patient. The oral ondansetron and granisetron TDS patients were matched by age, 4:1. The proportion of patients who received rescue antiemetics was calculated from those patients who continued to experience NVP. Risk factors for NVP were identified and compared between groups. Descriptive statistics were used to describe study results. Results  Patients were prescribed rescue antiemetics in 0/3 patients in the granisetron TDS group compared with 2/12 patients in the oral ondansetron group. Conclusion  Prospective efficacy studies on the use of granisetron TDS for management of NVP are needed to confirm this clinical observation. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  8. Evaluation of Cloud Fraction and Radiative Fluxes in Recent Reanalyses over the Arctic using Surface and Satellite Observations

    NASA Astrophysics Data System (ADS)

    Zib, B.; Dong, X.; Xi, B.; Kennedy, A. D.

    2010-12-01

    Reanalysis datasets can be an essential tool for investigating numerous climate parameters, especially in data-sparse regions like the Arctic. Where long-term continuous data is limited, reanalyses offer a resource for the recognition and analysis of change in a sensitive and complex coupled Arctic climate system. A study focused on the evaluation and intercomparison of four relatively new global reanalysis datasets will be conducted. The four new reanalyses being investigated include: (i) NASA-MERRA, (ii) NCEP-CFS, (iii) NOAA-20CR, and (iv) NCEP-DOE II. In this study, the cloud fraction and TOA radiative fluxes simulated from four reanalyses over the entire Arctic region will be compared with those derived from NASA MODIS and CERES sensors during the period 2000-2008. The surface radiative fluxes derived in each reanalysis will also be compared and validated by the BSRN surface observations during the period 1994-2008. The high latitude BSRN sites used in this study are Barrow, Alaska (BAR) and Ny Alesund, Svalbard, Norway (NYA). BSRN offers high time resolution solar and atmospheric radiation measurements from high accuracy instruments that provide a baseline for validating reanalysis estimates of surface radiation. In addition to downwelling radiation fluxes, cloud fraction from the reanalyses will also be evaluated by the Vaisala ceilometer derived cloud fraction at the Barrow, AK site. The ultimate goal of this study is to quantitatively estimate the uncertainties or biases of cloud fraction and TOA and surface radiative fluxes derived from four different recent reanalyses using highly qualified long-term surface and satellite observations as ground truth over the Arctic region.

  9. A participative model for undertaking and evaluating scientific communication in Earth Observation

    NASA Astrophysics Data System (ADS)

    L'Astorina, Alba; Tomasoni, Irene

    2015-04-01

    Public communication of Science and Technology (PCST) is an integral part of the mission of the Italian National Research Council (CNR) and widely carried out among the scientific community. Recently it has also become a research field investigating practices, channels, tools and models of public engagement and their impact on the relation between Science and Society. Understanding such aspects is increasingly considered relevant for an effective and aware outreach. Within this context, CNR has adopted some innovative communication approaches addressed to different publics, such as stakeholders, users, media, young people and the general public, using participative methodologies. Besides being practices of communication promoting the scientific culture, such initiatives aim at understanding the models at the basis of the relationship between the scientific community and the public. To what extent do scientists put their communication and involvement strategies in discussion? Do they use to have a real exchange with their publics in order to evaluate the effectiveness of the participatory techniques they adopt in communicating and disseminating their activities? In this paper we present a case study of a communication and educational proposal recently developed by CNR in order to promote a mutual exchange between Education/School and Research, that are the most important actors in the production and the revision of the scientific knowledge. The proposal brings an ongoing CNR research project (its steps, subjects, tools, activities, costs etc) in classrooms, making use of interactive Earth Sciences workshops conducted directly by researchers. The ongoing CNR project shared with students studies Innovative Methodologies of Earth Observation supporting the Agricultural sector in Lombardy. It aims at exploiting the Aerospace Earth Observation (EO) tools to develop dedicated agricultural downstream services that will bring added economic value and benefits for Lombardy

  10. Comparing masked target transform volume (MTTV) clutter metric to human observer evaluation of visual clutter

    NASA Astrophysics Data System (ADS)

    Camp, H. A.; Moyer, Steven; Moore, Richard K.

    2010-04-01

    The Night Vision and Electronic Sensors Directorate's current time-limited search (TLS) model, which makes use of the targeting task performance (TTP) metric to describe image quality, does not explicitly account for the effects of visual clutter on observer performance. The TLS model is currently based on empirical fits to describe human performance for a time of day, spectrum and environment. Incorporating a clutter metric into the TLS model may reduce the number of these empirical fits needed. The masked target transform volume (MTTV) clutter metric has been previously presented and compared to other clutter metrics. Using real infrared imagery of rural images with varying levels of clutter, NVESD is currently evaluating the appropriateness of the MTTV metric. NVESD had twenty subject matter experts (SME) rank the amount of clutter in each scene in a series of pair-wise comparisons. MTTV metric values were calculated and then compared to the SME observers rankings. The MTTV metric ranked the clutter in a similar manner to the SME evaluation, suggesting that the MTTV metric may emulate SME response. This paper is a first step in quantifying clutter and measuring the agreement to subjective human evaluation.

  11. Anorexia nervosa and cancer: a protocol for a systematic review and meta-analysis of observational studies.

    PubMed

    Catalá-López, Ferrán; Hutton, Brian; Driver, Jane A; Ridao, Manuel; Valderas, José M; Gènova-Maleras, Ricard; Forés-Martos, Jaume; Alonso-Arroyo, Adolfo; Saint-Gerons, Diego Macías; Vieta, Eduard; Valencia, Alfonso; Tabarés-Seisdedos, Rafael

    2017-07-11

    Anorexia nervosa is characterized by a severe restriction of caloric intake, low body weight, fear of gaining weight or of becoming fat, and disturbance of body image. Pathogenesis of the disorder may include genetic predisposition, hormonal changes and a combination of environmental, psychosocial, and cultural factors. Cancer is the second leading cause of death worldwide. At present, no systematic reviews and meta-analyses have evaluated the risk of cancer in people with anorexia nervosa. The objective of this study will be to evaluate the association between anorexia nervosa and the risk of developing or dying from cancer. This study protocol is part of a systematic collection and assessment of multiple systematic reviews and meta-analyses (umbrella review) evaluating the association of cancer and multiple central nervous system disorders. We designed a specific protocol for a new systematic review and meta-analysis of observational studies of anorexia nervosa with risk of developing or dying from any cancer. Data sources will be PubMed, Embase, Scopus, Web of Science, and manual screening of references. Observational studies (case-control and cohort) in humans that examined the association between anorexia nervosa and risk of developing or dying from cancer will be sought. The primary outcomes will be cancer incidence and cancer mortality in association with anorexia nervosa. Secondary outcomes will be site-specific cancer incidence and mortality, respectively. Screening of abstracts and full texts, and data abstraction will be performed by two team members independently. Conflicts at all levels of screening and abstraction will be resolved through discussion. The quality of studies will be assessed by using the Ottawa-Newcastle scale by two team members independently. Random effects models will be conducted where appropriate. Subgroup and additional analyses will be conducted to explore the potential sources of heterogeneity. The World Cancer Research Fund

  12. Kalman-Filter-Based Orientation Determination Using Inertial/Magnetic Sensors: Observability Analysis and Performance Evaluation

    PubMed Central

    Sabatini, Angelo Maria

    2011-01-01

    In this paper we present a quaternion-based Extended Kalman Filter (EKF) for estimating the three-dimensional orientation of a rigid body. The EKF exploits the measurements from an Inertial Measurement Unit (IMU) that is integrated with a tri-axial magnetic sensor. Magnetic disturbances and gyro bias errors are modeled and compensated by including them in the filter state vector. We employ the observability rank criterion based on Lie derivatives to verify the conditions under which the nonlinear system that describes the process of motion tracking by the IMU is observable, namely it may provide sufficient information for performing the estimation task with bounded estimation errors. The observability conditions are that the magnetic field, perturbed by first-order Gauss-Markov magnetic variations, and the gravity vector are not collinear and that the IMU is subject to some angular motions. Computer simulations and experimental testing are presented to evaluate the algorithm performance, including when the observability conditions are critical. PMID:22163689

  13. Bias in Observational Studies of Prevalent Users: Lessons for Comparative Effectiveness Research From a Meta-Analysis of Statins

    PubMed Central

    Danaei, Goodarz; Tavakkoli, Mohammad; Hernán, Miguel A.

    2012-01-01

    Randomized clinical trials (RCTs) are usually the preferred strategy with which to generate evidence of comparative effectiveness, but conducting an RCT is not always feasible. Though observational studies and RCTs often provide comparable estimates, the questioning of observational analyses has recently intensified because of randomized-observational discrepancies regarding the effect of postmenopausal hormone replacement therapy on coronary heart disease. Reanalyses of observational data that excluded prevalent users of hormone replacement therapy led to attenuated discrepancies, which begs the question of whether exclusion of prevalent users should be generally recommended. In the current study, the authors evaluated the effect of excluding prevalent users of statins in a meta-analysis of observational studies of persons with cardiovascular disease. The pooled, multivariate-adjusted mortality hazard ratio for statin use was 0.77 (95% confidence interval (CI): 0.65, 0.91) in 4 studies that compared incident users with nonusers, 0.70 (95% CI: 0.64, 0.78) in 13 studies that compared a combination of prevalent and incident users with nonusers, and 0.54 (95% CI: 0.45, 0.66) in 13 studies that compared prevalent users with nonusers. The corresponding hazard ratio from 18 RCTs was 0.84 (95% CI: 0.77, 0.91). It appears that the greater the proportion of prevalent statin users in observational studies, the larger the discrepancy between observational and randomized estimates. PMID:22223710

  14. Prospective observational study to evaluate risk factors for falls in institutionalized elderly people: the role of cystatin C.

    PubMed

    Peláez, Verónica Centeno; Ausín, Lourdes; Mambrilla, Marta Ruiz; Gonzalez-Sagrado, Manuel; Pérez Castrillón, José Luis

    2015-08-01

    To evaluate the role of balance and gait disorders, comorbidities and laboratory abnormalities in the occurrence of falls in an institutionalized elderly population. We made a non-interventional, prospective, observational study in elderly institutionalized people. Comorbidities and information on treatments were obtained. Function and cognition were measured using the Katz Index, the Tinetti Balance and Gait, lower extremity function tests and the Mini-Mental test. At the inclusion, the analytical was made including cystatin C. Falls were recorded for 20 months after inclusion. Patients with falls were older (85 ± 7 vs. 82 ± 8, p = 0.04) and more often female (88 vs. 12 %, p = 0.01). Dyslipidemia, hypertension and antihypertensive treatment were associated with an increased risk of falls. Cystatin C was higher in patients with falls (0.96 ± 0.21 vs. 1.12 ± 0.29, p = 0.02). Functional tests showed differences in the Tinetti balance test (15 ± 2 vs. 13 ± 3, p = 0.04) and lower extremity function balance test (2.8 ± 1.2 vs. 2.2 ± 1.2, p = 0.05). The Mini-Mental State Examination (MMSE) scores were worse in patients with falls (22 ± 4 vs. 25 ± 4, p = 0.01). Only female status (6.2, p = 0.03), the MMSE scores (1.2, p = 0.02) and cystatin C (5.3, p = 0.02) were independent risk factors for falls after logistic regression. Female sex, cognitive impairment and cystatin C were risk factors for falls in non-dependent institutionalized elderly people.

  15. Zonisamide in Brain Tumor-Related Epilepsy: An Observational Pilot Study.

    PubMed

    Maschio, Marta; Dinapoli, Loredana; Zarabla, Alessia; Maialetti, Andrea; Giannarelli, Diana; Fabi, Alessandra; Vidiri, Antonello; Cantelmi, Tonino

    Epilepsy heavily affects the quality of life (QoL) of patients with brain tumor because in addition to taking treatments for the oncological illness, patients are required to live with the long-term taking of antiepileptic drugs (AEDs). The AEDs' adverse effects are common in these patients and can negatively influence their perceptions of their QoL.We conducted an observational pilot study in patients with brain tumor-related epilepsy to verify efficacy, tolerability, and impact on QoL and global neurocognitive performances of zonisamide (ZNS) in add-on. We recruited 13 patients (5 females, 8 males; mean age, 49.6 years) presenting uncontrolled seizures. At first visit and at final follow-up at 6 months, patients underwent neurological examination, evaluation of adverse events, and cognitive and QoL tests. A seizure diary was given. Eight patients underwent chemotherapy, 3 underwent radiotherapy, and 5 had disease progression. Mean dosage of ZNS at final follow-up was 300 mg/d.Of 9 patients who reached the sixth month follow-up, the mean weekly seizure number before ZNS had been 3.2 ± 5.0, and at final follow-up, the mean weekly seizure number was 0.18 ± 0.41 (P = 0.05).Compared with baseline, we observed stability in all cognitive domains, except for verbal fluency that significantly worsened.Results on QoL tests showed that QoL remained unchanged over time, which could indicate that ZNS did not influence the patients' perceived QoL. Zonisamide as add-on in our patients seems to be well tolerated and efficacious in controlling seizures. Despite having limitations represented by the fact that our study is observational, with a small study population and a short follow-up period, our results confirm that when choosing an AED, in addition to efficacy, the drug's effect on patients' QoL also needs to be considered, especially for patients facing many psychosocial challenges, such as those with brain tumor-related epilepsy.

  16. Inter-observer agreement on a checklist to evaluate scientific publications in the field of animal reproduction.

    PubMed

    Simoneit, Céline; Heuwieser, Wolfgang; Arlt, Sebastian P

    2012-01-01

    This study's objective was to determine respondents' inter-observer agreement on a detailed checklist to evaluate three exemplars (one case report, one randomized controlled study without blinding, and one blinded, randomized controlled study) of the scientific literature in the field of bovine reproduction. Fourteen international scientists in the field of animal reproduction were provided with the three articles, three copies of the checklist, and a supplementary explanation. Overall, 13 responded to more than 90% of the items. Overall repeatability between respondents using Fleiss's κ was 0.35 (fair agreement). Combining the "strongly agree" and "agree" responses and the "strongly disagree" and "disagree" responses increased κ to 0.49 (moderate agreement). Evaluation of information given in the three articles on housing of the animals (35% identical answers) and preconditions or pretreatments (42%) varied widely. Even though the overall repeatability was fair, repeatability concerning the important categories was high (e.g., level of agreement=98%). Our data show that the checklist is a reasonable and practical supporting tool to assess the quality of publications. Therefore, it may be used in teaching and practicing evidence-based veterinary medicine. It can support training in systematic and critical appraisal of information and in clinical decision making.

  17. Inter-observer variability in diagnosing radiological features of aneurysmal subarachnoid hemorrhage; a preliminary single centre study comparing observers from different specialties and levels of training.

    PubMed

    Siddiqui, Usman T; Khan, Anjum F; Shamim, Muhammad Shahzad; Hamid, Rana Shoaib; Alam, Muhammad Mehboob; Emaduddin, Muhammad

    2014-01-01

    A noncontrast computed tomography (CT) scan remains the initial radiological investigation of choice for a patient with suspected aneurysmal subarachnoid hemorrhage (aSAH). This initial scan may be used to derive key information about the underlying aneurysm which may aid in further management. The interpretation, however, is subject to the skill and experience of the interpreting individual. The authors here evaluate the interpretation of such CT scans by different individuals at different levels of training, and in two different specialties (Radiology and Neurosurgery). Initial nonontrast CT scan of 35 patients with aSAH was evaluated independently by four different observers. The observers selected for the study included two from Radiology and two from Neurosurgery at different levels of training; a resident currently in mid training and a resident who had recently graduated from training of each specialty. Measured variables included interpreter's suspicion of presence of subarachnoid blood, side of the subarachnoid hemorrhage, location of the aneurysm, the aneurysm's proximity to vessel bifurcation, number of aneurysm(s), contour of aneurysm(s), presence of intraventricular hemorrhage (IVH), intracerebral hemorrhage (ICH), infarction, hydrocephalus and midline shift. To determine the inter-observer variability (IOV), weighted kappa values were calculated. There was moderate agreement on most of the CT scan findings among all observers. Substantial agreement was found amongst all observers for hydrocephalus, IVH, and ICH. Lowest agreement rates were seen in the location of aneurysm being supra or infra tentorial. There were, however, some noteworthy exceptions. There was substantial to almost perfect agreement between the radiology graduate and radiology resident on most CT findings. The lowest agreement was found between the neurosurgery graduate and the radiology graduate. Our study suggests that although agreements were seen in the interpretation of some of

  18. Observers' Agreement on Measurements in Fiberoptic Endoscopic Evaluation of Swallowing.

    PubMed

    Pilz, Walmari; Vanbelle, Sophie; Kremer, Bernd; van Hooren, Michel R; van Becelaere, Tine; Roodenburg, Nel; Baijens, Laura W J

    2016-04-01

    This study analyzed the effect that dysphagia etiology, different observers, and bolus consistency might have on the level of agreement for measurements in FEES images reached by independent versus consensus panel rating. Sixty patients were included and divided into two groups according to dysphagia etiology: neurological or head and neck oncological. All patients underwent standardized FEES examination using thin and thick liquid consistencies. Two observers scored the same exams, first independently and then in a consensus panel. Four ordinal FEES variables were analyzed. Statistical analysis was performed using a linear weighted kappa coefficient and Bayesian multilevel model. Intra- and interobserver agreement on FEES measurements ranged from 0.76 to 0.93 and from 0.61 to 0.88, respectively. Dysphagia etiology did not influence observers' agreement level. However, bolus consistency resulted in decreased interobserver agreement for all measured FEES variables during thin liquid swallows. When rating on the consensus panel, the observers deviated considerably from the scores they had previously given on the independent rating task. Observer agreement on measurements in FEES exams was influenced by bolus consistency, not by dysphagia etiology. Therefore, observer agreement on FEES measurements should be analyzed by taking bolus consistency into account, as it might affect the interpretation of the outcome. Identifying factors that might influence agreement levels could lead to better understanding of the rating process and assist in developing a more precise measurement scale that would ensure higher levels of observer agreement for measurements in FEES exams.

  19. Social Studies. Microsift Courseware Evaluations.

    ERIC Educational Resources Information Center

    Northwest Regional Educational Lab., Portland, OR.

    This compilation of 17 courseware evaluations gives a general overview of available social studies microcomputer courseware for students in grades 1-12. Each evaluation lists title, date, producer, date of evaluation, evaluating institution, cost, ability level, topic, medium of transfer, required hardware, required software, instructional…

  20. Evaluation of diet pattern and weight gain in postmenopausal women enrolled in the Women’s Health Initiative Observational Study

    USDA-ARS?s Scientific Manuscript database

    It is unclear which of four popular contemporary diet patterns is best for weight maintenance among postmenopausal women. Four dietary patterns were characterised among postmenopausal women aged 49-81 years (mean 63.6 (sd 7.4) years) from the Women's Health Initiative Observational Study: (1) a low-...

  1. [Randomized, controlled clinical trials with observational follow-up investigations for evaluating efficacy of antihyperglycaemic treatment. I. Main results of the studies].

    PubMed

    Jermendy, György

    2018-04-01

    The effect of antihyperglycaemic (antidiabetic) treatment on the late diabetic complications is one of the most important research areas in clinical diabetology. The relationship between glycaemic control and late micro- and macrovascular complications was highlighted by the results of the DCCT (Diabetes Control and Complications Trial) with type 1 and by the UKPDS (United Kingdom Prospective Diabetes Study) with type 2 diabetic patients. In these studies, observational follow-up investigations were also performed after the close-out of the randomized phase of the trial. In addition to these landmark studies, other randomized, controlled efficacy trials were also performed with observational follow-up investigations resulting in the development of the concept of metabolic memory or metabolic legacy. In this article, the main results of the studies are summarized. Orv Hetil. 2018; 159(15): 575-582.

  2. I-Hydrate training intervention for staff working in a care home setting: An observational study.

    PubMed

    Greene, Carolynn; Canning, Deebs; Wilson, Jennie; Bak, Aggie; Tingle, Alison; Tsiami, Amalia; Loveday, Heather

    2018-05-23

    Dehydration is a complex and well-recognised problem for older people residing in care homes. Within the social care sector support staff provide the majority of direct care for residents, and yet receive minimal training. To design, deliver and evaluate a hydration specific training session for care home staff to develop their knowledge and skills in supporting the hydration of care home residents. An observational study comprising a pre-test post-test survey of staff knowledge following a training intervention. Training of care home staff took place in two care homes in North West London. An interactive training session was developed and delivered, with content informed by observations of hydration care within the two homes and evaluated using CIRO model. Participant self-evaluation forms were used to collect data after the session regarding satisfaction and usefulness of the session, and pre and post levels of self-reported knowledge across six facets of hydration care. Training facilitators captured qualitative data in the form of field notes. Observations of hydration care explored the impact of training on practice. Eighteen training sessions were delivered. A total of 161 participant evaluation forms were returned. There was a significant increase in self-reported knowledge across all six facets of hydration care (p = 0.000). The majority of participants found the training enjoyable and useful, and expressed an expected change in their practice. Participants enjoyed the interactive components of the training. A lack of reflective practice skills meant participants were unable to reflect realistically about the hydration care provided in the home. Focused training on hydration in the care home environment benefits from being interactive and experiential. Although such training can be effective in increasing staff knowledge, inclusion of skills in reflective practice is required if this knowledge is to be translated into practice. Copyright © 2018

  3. [Micronutrient deficiencies and linear growth: a systematic review of observational studies].

    PubMed

    Pedraza, Dixis Figueroa; Rocha, Ana Carolina Dantas; Sales, Márcia Cristina

    2013-11-01

    This article seeks to evaluate the association of iron, vitamin A and zinc deficiencies with linear growth retardation. A systematic review of electronic databases in PubMed, LILACS and SciELO was conducted. Scientific papers published between January 1995 and March 2010 were selected, inserting the key words: (growth OR nutritional status) AND (child, preschool OR infant) AND (zinc AND iron AND vitamin A) OR (zinc AND iron) OR (zinc AND vitamin A) OR (iron AND vitamin A). Fourteen observational design studies were reviewed. In the cohort studies (two), one indicated a statistical association between iron levels and stunting; and the other revealed a statistical association between serum ferritin concentrations and an increase in height. Ten cross-sectional studies investigated the statistical association between micronutrient deficiencies and stunting, three of which resulted in an association with iron, two with vitamin A and none with zinc. Elucidation of the association between stunting and iron, vitamin A and zinc deficiencies involves difficulties of a biological nature and also related to the magnitude of these deficiencies, indicating the importance of a methodological standardization of the studies.

  4. Value-Added and Observational Measures Used in the Teacher Evaluation Process: A Validation Study

    ERIC Educational Resources Information Center

    Guerere, Claudia

    2013-01-01

    Scores from value-added models (VAMs), as used for educational accountability, represent the educational effect teachers have on their students. The use of these scores in teacher evaluations for high-stakes decision making is new for the State of Florida. Validity evidence that supports or questions the use of these scores is critically needed.…

  5. PERICARDIAL FEATURES OF IN-HOSPITAL RHEUMATOLOGY PATIENTS: AN OBSERVATIONAL STUDY.

    PubMed

    Bakalli, Aurora; Rexhepi, Mjellma; Rexhepi, Blerta; Koçinaj, Dardan

    Rheumatic disorders can be associated with pericarditis, but severe forms of pericarditis are rare. The aim of this observational study was to evaluate pericardial features in patients with different rheumatic diseases. Thirty-five patients hospitalized at the Clinic of Rheumatology, University Clinical Center of Kosovo, from October 1 to October 21, 2014 were included in the study. Demographic data, history, laboratory, ECG, and echocardiography data, with special emphasis on the analysis of the pericardium, were obtained from each patient. Echocardiography was especially focused on the amount of pericardial fluid and pericardial thickness in the posterior wall of the heart. Mean patient age was 51.5 ± 13.8 years. 65.7% of the patients were women. Out of the patients that we analyzed, 88.6% had an inflammatory rheumatologic disease. 11.3% of the patients had mild symptoms, in 68.7% the symptoms were moderate, and in 20% severe. In all patients, pericardial hyperechogenicity was marked, with a mean pericardial thickness of 4.68 ± 1.66 mm. Pericardial effusion in a small amount was present in 57.1% of patients, with a mean pericardial fluid amount of 3.3 ± 1.9 mm. The severity of rheumatic disease had a positive and significant correlation with the presence of pericardial effusion (r= 0.29, p=0.04) and its amount (r= 0.28, p=0.05). The patients had not been aware of the pericardial involvement and did not have any clinical symptoms. In conclusion, in this short-term small observational study pericardial changes were a frequent finding in the rheumatology patients. In general, the pericarditis was subclinical and with small amounts of effusion. The disease activity of rheumatic disorders can be associated with pericarditis. Further studies with larger samples of patients and of longer duration are needed to further explore this issue.

  6. [Observational study to evaluate the impact of an educational/informative intervention in the emotional status (anxiety) of patients with atopic dermatitis (CUIDA-DEL)].

    PubMed

    Guerra-Tapia, A; Lleonart, M; Balañá, M

    2007-05-01

    One of the first therapeutic measures in atopic dermatitis should be the educational and informative approach about prophylactic aspects and evolution of the disease. This type of proceedings has been shown to be beneficial for the anxious type of emotional status in patients with atopic dermatitis. We evaluated the impact of an educational/informative intervention in the emotional status (anxiety) of patients with atopic dermatitis in Spain. Investigators were randomized into two study groups: the control group (CG) that followed current clinical practice and the intervention group (IG) that handed patients, in each visit, a booklet of information about different prophylactic aspects and care of atopic dermatitis. The duration of the study was 6 months with quarterly visits. All included patients had a diagnosis of atopic dermatitis. Anxiety was evaluated with the STAI anxiety questionnaire and clinical data regarding dermatological aspects (IGA, pruritus scale, location of the lesions) were also recorded. A total of 1,247 patients were recruited thanks to the collaboration of 158 investigators. Patients were distributed as follows: 683 (54.7 %) in the CG and 564 (45.2 %) in the IG. Both group were homogeneous with respect to basal characteristics, and were constituted by 54 % of women with a mean age of 19 years. Eighty-six percent of atopic dermatitis lesions were preferentially located in extremities. Patients of both study groups showed improvement in their emotional status (trait and state anxiety) throughout the study with significant decreases in the STAI scores compared to basal ones. Regarding improvement in the questionnaire scores, no significant differences were observed between groups except in children aged 9 to 15 years, in the pediatric version of the STAI trait where the percentage of score decrease at 6 months adjusted to the basal score was 5.5 (19.0) for the CG and 10.6 (18.9) for the IG, (p < 0.05). A higher percentage of patients finished the

  7. Evaluation of Oral Performance in Outsourced Call Centres: An Exploratory Case Study

    ERIC Educational Resources Information Center

    Friginal, Eric

    2013-01-01

    This case study discusses the development and use of an oral performance assessment instrument intended to evaluate Filipino agents' customer service transactions with callers from the United States (US). The design and applications of the instrument were based on a longitudinal, qualitative observation of language training and customer service…

  8. Evaluating Evaluation Systems: Policy Levers and Strategies for Studying Implementation of Educator Evaluation. Policy Snapshot

    ERIC Educational Resources Information Center

    Matlach, Lauren

    2015-01-01

    Evaluation studies can provide feedback on implementation, support continuous improvement, and increase understanding of evaluation systems' impact on teaching and learning. Despite the importance of educator evaluation studies, states often need support to prioritize and fund them. Successful studies require expertise, time, and a shared…

  9. Evaluation of Long-Term Cloud-Resolving Model Simulations Using Satellite Radiance Observations and Multi-Frequency Satellite Simulators

    NASA Technical Reports Server (NTRS)

    Matsui, Toshihisa; Zeng, Xiping; Tao, Wei-Kuo; Masunaga, Hirohiko; Olson, William S.; Lang, Stephen

    2008-01-01

    This paper proposes a methodology known as the Tropical Rainfall Measuring Mission (TRMM) Triple-Sensor Three-step Evaluation Framework (T3EF) for the systematic evaluation of precipitating cloud types and microphysics in a cloud-resolving model (CRM). T3EF utilizes multi-frequency satellite simulators and novel statistics of multi-frequency radiance and backscattering signals observed from the TRMM satellite. Specifically, T3EF compares CRM and satellite observations in the form of combined probability distributions of precipitation radar (PR) reflectivity, polarization-corrected microwave brightness temperature (Tb), and infrared Tb to evaluate the candidate CRM. T3EF is used to evaluate the Goddard Cumulus Ensemble (GCE) model for cases involving the South China Sea Monsoon Experiment (SCSMEX) and Kwajalein Experiment (KWAJEX). This evaluation reveals that the GCE properly captures the satellite-measured frequencies of different precipitating cloud types in the SCSMEX case but underestimates the frequencies of deep convective and deep stratiform types in the KWAJEX case. Moreover, the GCE tends to simulate excessively large and abundant frozen condensates in deep convective clouds as inferred from the overestimated GCE-simulated radar reflectivities and microwave Tb depressions. Unveiling the detailed errors in the GCE s performance provides the best direction for model improvements.

  10. Using MLT Composition Observations to Evaluate Transport in a Comprehensive High Top Model

    NASA Astrophysics Data System (ADS)

    Smith, A. K.

    2016-12-01

    Gravity waves play an outsized role in the MLT: driving the mean meridional circulation, exerting a large degree of control over the mean winds and seasonal variations in temperature, and leading to diffusive vertical transport of heat and trace species. These waves are represented using a parameterization in the NCAR Whole Atmosphere Community Climate Model (WACCM), as in many other GCMs. To evaluate their impact, we need to consider not just the mean temperature and wind but the distributions of trace species that are affected by advection due to resolved winds and waves and diffusion associated with gravity wave dissipation. The responses of chemical species to changes in the gravity wave forcing are complex and sometimes unexpected. Transport and diffusion simultaneously affect all species and the heat and momentum budgets; subsequent interactions, and the strong dependence of reaction rates on temperature, affect the net impact of transport on the composition. In evaluating the model, we evaluate the simulations using a range of available observations of composition, including O, O3, CO, CO2, NO, NO2, OH, and H2O.

  11. Psychometric Characteristics of Process Evaluation Measures for a Rural School-based Childhood Obesity Prevention Study: Louisiana Health

    PubMed Central

    Newton, R. L.; Thomson, J. L.; Rau, K.; Duhe’, S.; Sample, A.; Singleton, N.; Anton, S. D.; Webber, L. S.; Williamson, D. A.

    2011-01-01

    Purpose To evaluate the implementation of intervention components of the Louisiana Health study, which was a multi-component childhood obesity prevention program conducted in rural schools. Design Content analysis. Setting Process evaluation assessed implementation in the classrooms, gym classes, and cafeterias. Subjects Classroom teachers (n = 232), physical education teachers (n = 53), food service managers (n = 33), and trained observers (n = 9). Measures Five process evaluation measures were created: Physical Education Questionnaire (PEQ), Intervention Questionnaire (IQ), Food Service Manager Questionnaire (FSMQ), Classroom Observation (CO) and School Nutrition Environment Observation (SNEO). Analysis Inter-rater reliability and internal consistency were conducted on all measures. ANOVA and Chi-square were used to compare differences across study groups on questionnaires and observations. Results The PEQ and one sub-scale from the FSMQ were eliminated because their reliability coefficients fell below acceptable standards. The sub-scale internal consistencies for the IQ, FSMQ, CO, and SNEO (all Cronbach’s α > .60) were acceptable. Conclusions After the initial 4 months of intervention, there was evidence that the Louisiana Health intervention was being implemented as it was designed. In summary, four process evaluation measures were found to be sufficiently reliable and valid for assessing the delivery of various aspects of a school-based obesity prevention program. These process measures could be modified to evaluate the delivery of other similar school-based interventions. PMID:21721969

  12. Psychometric characteristics of process evaluation measures for a rural school-based childhood obesity prevention study: Louisiana Health.

    PubMed

    Newton, Robert L; Thomson, Jessica L; Rau, Kristi K; Ragusa, Shelly A; Sample, Alicia D; Singleton, Nakisha N; Anton, Stephen D; Webber, Larry S; Williamson, Donald A

    2011-01-01

    To evaluate the implementation of intervention components of the Louisiana Health study, which was a multicomponent childhood obesity prevention program conducted in rural schools. Content analysis. Process evaluation assessed implementation in classrooms, gym classes, and cafeterias. Classroom teachers (n  =  232), physical education teachers (n  =  53), food service managers (n  =  33), and trained observers (n  =  9). Five process evaluation measures were created: Physical Education Questionnaire (PEQ), Intervention Questionnaire (IQ), Food Service Manager Questionnaire (FSMQ), Classroom Observation (CO), and School Nutrition Environment Observation (SNEO). Interrater reliability and internal consistency were assessed on all measures. Analysis of variance and χ(2) were used to compare differences across study groups on questionnaires and observations. The PEQ and one subscale from the FSMQ were eliminated because their reliability coefficients fell below acceptable standards. The subscale internal consistencies for the IQ, FSMQ, CO, and SNEO (all Cronbach α > .60) were acceptable. After the initial 4 months of intervention, there was evidence that the Louisiana Health intervention was being implemented as it was designed. In summary, four process evaluation measures were found to be sufficiently reliable and valid for assessing the delivery of various aspects of a school-based obesity prevention program. These process measures could be modified to evaluate the delivery of other similar school-based interventions.

  13. Evaluation of Atmospheric Precipitable Water from Reanalysis Products Using Homogenized Radiosonde Observations over China

    NASA Astrophysics Data System (ADS)

    Zhao, T.; Wang, J.; Dai, A.

    2015-12-01

    Many multi-decadal atmospheric reanalysis products are avialable now, but their consistencies and reliability are far from perfect. In this study, atmospheric precipitable water (PW) from the NCEP/NCAR, NCEP/DOE, MERRA, JRA-55, JRA-25, ERA-Interim, ERA-40, CFSR and 20CR reanalyses is evaluated against homogenized radiosonde observations over China during 1979-2012 (1979-2001 for ERA-40). Results suggest that the PW biases in the reanalyses are within ˜20% for most of northern and eastern China, but the reanalyses underestimate the observed PW by 20%-40% over western China, and by ˜60% over the southwestern Tibetan Plateau. The newer-generation reanalyses (e.g., JRA25, JRA55, CFSR and ERA-Interim) have smaller root-mean-square error (RMSE) than the older-generation ones (NCEP/NCAR, NCEP/DOE and ERA-40). Most of the reanalyses reproduce well the observed PW climatology and interannual variations over China. However, few reanalyses capture the observed long-term PW changes, primarily because they show spurious wet biases before about 2002. This deficiency results mainly from the discontinuities contained in reanalysis RH fields in the mid-lower troposphere due to the wet bias in older radiosonde records that are assimilated into the reanalyses. An empirical orthogonal function (EOF) analysis revealed two leading modes that represent the long-term PW changes and ENSO-related interannual variations with robust spatial patterns. The reanalysis products, especially the MERRA and JRA-25, roughly capture these EOF modes, which account for over 50% of the total variance. The results show that even during the post-1979 satellite era, discontinuities in radiosonde data can still induce large spurious long-term changes in reanalysis PW and other related fields. Thus, more efforts are needed to remove spurious changes in input data for future long-term reanlayses.

  14. Psychiatric comorbidity in diabetes type 1: a cross-sectional observational study.

    PubMed

    Maia, Ana Claudia C de Ornelas; Braga, Arthur de Azevedo; Paes, Flávia; Machado, Sérgio; Nardi, Antonio Egidio; Silva, Adriana Cardoso da

    2014-01-01

    This study aims to investigate the prevalence of psychiatric disorders, i.e., the presence of signs and symptoms of anxiety and depression in type 1 diabetic patients, as well as to investigate the prevalence of psychiatric disorders in insulin dependent patients. A cross-sectional observational study of 110 diabetic outpatients (mean = 58.3, SD = 14.5; 50 male and 60 female) was conducted in a public health clinic with patients diagnosed with diabetes mellitus who were under the medical supervision of an endocrinologist. The patients were evaluated through the Mini International Neuropsychiatric Interview and the Hospital Anxiety and Depression Scale(HADS). With respect to anxiety symptoms, we found a prevalence of 60% (n = 66) among patients, while in depression symptoms we found a prevalence of 53.6% (n = 59) concerning the 110 patients evaluated. More specifically, we found 28.2% (n = 31) of patients without depression or anxiety, 13.6% (n = 15) of patients with depression, 16.4% (n = 18) of patients with anxiety and 41.8% (n = 46) of patients with depression combined with anxiety. The most remarkable data were generalized anxiety disorder (22.7%), dysthymia (18.2%), panic disorder (8.2%) and social phobia (5.5%). The need for accurate assessments about the presence of symptoms related to psychopathology in patients with type 1 diabetes is evident.

  15. Study on the evaluation method for fault displacement based on characterized source model

    NASA Astrophysics Data System (ADS)

    Tonagi, M.; Takahama, T.; Matsumoto, Y.; Inoue, N.; Irikura, K.; Dalguer, L. A.

    2016-12-01

    In IAEA Specific Safety Guide (SSG) 9 describes that probabilistic methods for evaluating fault displacement should be used if no sufficient basis is provided to decide conclusively that the fault is not capable by using the deterministic methodology. In addition, International Seismic Safety Centre compiles as ANNEX to realize seismic hazard for nuclear facilities described in SSG-9 and shows the utility of the deterministic and probabilistic evaluation methods for fault displacement. In Japan, it is required that important nuclear facilities should be established on ground where fault displacement will not arise when earthquakes occur in the future. Under these situations, based on requirements, we need develop evaluation methods for fault displacement to enhance safety in nuclear facilities. We are studying deterministic and probabilistic methods with tentative analyses using observed records such as surface fault displacement and near-fault strong ground motions of inland crustal earthquake which fault displacements arose. In this study, we introduce the concept of evaluation methods for fault displacement. After that, we show parts of tentative analysis results for deterministic method as follows: (1) For the 1999 Chi-Chi earthquake, referring slip distribution estimated by waveform inversion, we construct a characterized source model (Miyake et al., 2003, BSSA) which can explain observed near-fault broad band strong ground motions. (2) Referring a characterized source model constructed in (1), we study an evaluation method for surface fault displacement using hybrid method, which combines particle method and distinct element method. At last, we suggest one of the deterministic method to evaluate fault displacement based on characterized source model. This research was part of the 2015 research project `Development of evaluating method for fault displacement` by the Secretariat of Nuclear Regulation Authority (S/NRA), Japan.

  16. Evaluation of a pilot peer observation of teaching scheme for chair-side tutors at Glasgow University Dental School.

    PubMed

    Cairns, A M; Bissell, V; Bovill, C

    2013-06-01

    To introduce and examine a pilot peer observation of teaching (POT) scheme within the Department of Paediatric Dentistry at Glasgow Dental School and its associated outreach centres. All tutors teaching paediatric dentistry were invited to be involved in evaluation of the POT scheme. Participants were randomly paired with a peer, who then observed their teaching and provided constructive feedback. For those consenting to be involved in the evaluation of the scheme, semi-structured, one-to-one interviews were carried out by the principal investigator. POT was found by all participants to be a beneficial process, reassuring those of their teaching styles and giving them ideas to adapt their teaching. POT is an effective method for engaging chair-side tutors in the reflection and development of their teaching practice via observations and scholarly discussion.

  17. AIRS Observations Based Evaluation of Relative Climate Feedback Strengths on a GCM Grid-Scale

    NASA Astrophysics Data System (ADS)

    Molnar, G. I.; Susskind, J.

    2012-12-01

    Climate feedback strengths, especially those associated with moist processes, still have a rather wide range in GCMs, the primary tools to predict future climate changes associated with man's ever increasing influences on our planet. Here, we make use of the first 10 years of AIRS observations to evaluate interrelationships/correlations of atmospheric moist parameter anomalies computed from AIRS Version 5 Level-3 products, and demonstrate their usefulness to assess relative feedback strengths. Although one may argue about the possible usability of shorter-term, observed climate parameter anomalies for estimating the strength of various (mostly moist processes related) feedbacks, recent works, in particular analyses by Dessler [2008, 2010], have demonstrated their usefulness in assessing global water vapor and cloud feedbacks. First, we create AIRS-observed monthly anomaly time-series (ATs) of outgoing longwave radiation, water vapor, clouds and temperature profile over a 10-year long (Sept. 2002 through Aug. 2012) period using 1x1 degree resolution (a common GCM grid-scale). Next, we evaluate the interrelationships of ATs of the above parameters with the corresponding 1x1 degree, as well as global surface temperature ATs. The latter provides insight comparable with more traditional climate feedback definitions (e. g., Zelinka and Hartmann, 2012) whilst the former is related to a new definition of "local (in surface temperature too) feedback strengths" on a GCM grid-scale. Comparing the correlation maps generated provides valuable new information on the spatial distribution of relative climate feedback strengths. We argue that for GCMs to be trusted for predicting longer-term climate variability, they should be able to reproduce these observed relationships/metrics as closely as possible. For this time period the main climate "forcing" was associated with the El Niño/La Niña variability (e. g., Dessler, 2010), so these assessments may not be descriptive of longer

  18. Performing both propensity score and instrumental variable analyses in observational studies often leads to discrepant results: a systematic review.

    PubMed

    Laborde-Castérot, Hervé; Agrinier, Nelly; Thilly, Nathalie

    2015-10-01

    Propensity score (PS) and instrumental variable (IV) are analytical techniques used to adjust for confounding in observational research. More and more, they seem to be used simultaneously in studies evaluating health interventions. The present review aimed to analyze the agreement between PS and IV results in medical research published to date. Review of all published observational studies that evaluated a clinical intervention using simultaneously PS and IV analyses, as identified in MEDLINE and Web of Science. Thirty-seven studies, most of them published during the previous 5 years, reported 55 comparisons between results from PS and IV analyses. There was a slight/fair agreement between the methods [Cohen's kappa coefficient = 0.21 (95% confidence interval: 0.00, 0.41)]. In 23 cases (42%), results were nonsignificant for one method and significant for the other, and IV analysis results were nonsignificant in most situations (87%). Discrepancies are frequent between PS and IV analyses and can be interpreted in various ways. This suggests that researchers should carefully consider their analytical choices, and readers should be cautious when interpreting results, until further studies clarify the respective roles of the two methods in observational comparative effectiveness research. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Meta-evaluation of published studies on evaluation of health disaster preparedness exercises through a systematic review

    PubMed Central

    Sheikhbardsiri, Hojjat; Yarmohammadian, Mohammad H; Khankeh, Hamid Reza; Nekoei-Moghadam, Mahmoud; Raeisi, Ahmad Reza

    2018-01-01

    OBJECTIVE: Exercise evaluation is one of the most important steps and sometimes neglected in designing and taking exercises, in this stage of exercise, it systematically identifying, gathering, and interpreting related information to indicate how an exercise has fulfilled its objectives. The present study aimed to assess the most important evaluation techniques applied in evaluating health exercises for emergencies and disasters. METHODS: This was meta-evaluation study through a systematic review. In this research, we searched papers based on specific and relevant keywords in research databases including ISI web of science, PubMed, Scopus, Science Direct, Ovid, ProQuest, Wiley, Google Scholar, and Persian database such as ISC and SID. The search keywords and strategies are followed; “simulation,” “practice,” “drill,” “exercise,” “instrument,” “tool,” “questionnaire,” “ measurement,” “checklist,” “scale,” “test,” “inventory,” “battery,” “evaluation,” “assessment,” “appraisal,” “emergency,” “disaster,” “cricise,” “hazard,” “catastrophe,: “hospital”, “prehospital,” “health centers,” “treatment centers,” were used in combination with Boolean operators OR and AND. RESULTS: The research findings indicate that there are different techniques and methods for data collection to evaluate performance exercises of health centers and affiliated organizations in disasters and emergencies including debriefing inventories, self-report, questionnaire, interview, observation, shooting video, and photographing, electronic equipment which can be individually or collectively used depending on exercise objectives or purposes. CONCLUSION: Taking exercise in the health sector is one of the important steps in preparation and implementation of disaster risk management programs. This study can be thus utilized to improve preparedness of different sectors of health system according to the latest

  20. Work organization in hospital wards and nurses' emotional exhaustion: A multi-method study of observation-based assessment and nurses' self-reports.

    PubMed

    Stab, Nicole; Hacker, Winfried; Weigl, Matthias

    2016-09-01

    Ward organization is a major determinant for nurses' well-being on the job. The majority of previous research on this relationship is based on single source methods, which have been criticized as skewed estimations mainly due to subjectivity of the ratings and due to common source bias. To investigate the association of ward organization characteristics and nurses' exhaustion by combining observation-based assessments with nurses' self-reports. Cross-sectional study on 25 wards of four hospitals and 245 nurses. Our multi-method approach to evaluate hospital ward organization consisted of on-site observations with a standardized assessment tool and of questionnaires to evaluate nurses' self-reports and exhaustion. After establishing the reliability of our measures, we applied multi-level regression analyses to determine associations between determinant and outcome variables. We found substantial convergence in ward organization between the observation-based assessments and nurses' self-reports, which supports the validity of our external assessments. Furthermore, two observation-based characteristics, namely participation and patient-focused care, were significantly associated with lower emotional exhaustion among the nurses. Our results suggest that observation-based assessments are a valid and feasible way to assess ward organization in hospitals. Nurses' self-reported as well as observation-based ratings on ward organization were associated with nurses' emotional exhaustion. This is of interest mainly for identifying alternative measures in evaluating nurses' work environments, to inform health promotion activities and to evaluate job redesign intervention. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Evaluation of the acceptability of a vaccine against herpes zoster in the over 50 years old: an Italian observational study.

    PubMed

    Valente, Nicoletta; Lupi, Silvia; Stefanati, Armando; Cova, Marisa; Sulcaj, Najada; Piccinni, Lucia; Gabutti, Giovanni

    2016-10-18

    The aim of the study was to evaluate awareness of the varicella zoster virus and the acceptability of the newly available herpes zoster (HZ) vaccine in the over 50 years old general population. The research was observational. The study was carried out in Ferrara by administering a questionnaire to patients of the Local Health Authority (LHA), general practitioners (GPs) and Public Health Department outpatient clinics. The questionnaire was completed by 1001 residents of Ferrara Province. Of the respondents, 98% and 95% (57% female) were aware of varicella and HZ, respectively, but 91% were unaware of the HZ vaccine. Nevertheless, 58% declared that they were in favour of vaccination in this regard, and the acceptability of the vaccine was positively affected by: age (p=0.005); knowing someone who had suffered from HZ (p=0.05); being in favour of vaccination in general (p<0.0001); receiving advice to do so from their GP (p<0.0001) and willingness to get vaccinated even on a fee-paying basis (p<0.0001). Indeed, most (73%) respondents were willing to pay to get vaccinated, indicating an ideal cost of €50. Higher education (p=0.04), being in favour of vaccinations in general (p<0.0001) and GP advice (p<0.0001) positively affected this choice. Furthermore, 61% of the participants initially unfavourable (p<0.0001) to this immunisation would change their decision not to vaccinate thanks to their GP's advice. This study assessed the level of awareness and the attitudes of the population aged over 50 years, highlighting aspects to be focused on in the promotion of the HZ vaccine. 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/.

  2. "Lies, damned lies ..." and observational studies in comparative effectiveness research.

    PubMed

    Albert, Richard K

    2013-06-01

    A new federal initiative has allocated $1.1 billion to comparative effectiveness research, and many have emphasized the importance of including observational studies in this effort. The rationale for using observational studies to assess comparative effectiveness is based on concerns that randomized controlled trials (RCTs) are not "real world" because they enroll homogeneous patient populations, measure study outcomes that are not important to patients, use protocols that are overly complex, are conducted in specialized centers, and use study treatments that are not consistent with usual care, and that RCTs are not always feasible because of a lack of equipoise, the need to assess delayed endpoints, and concerns that they take years to complete and are expensive. This essay questions the validity of each of these proposed limitations, summarizes concerns raised about the accuracy of results generated by observational studies, provides some examples of discrepancies between results of observational studies and RCTs that pertain to pulmonary and critical care, and suggests that using observational studies for comparative effectiveness research may increase rather than decrease the cost of health care and may harm patients.

  3. Hidden Criteria for Out-of-Home Day-Care Centre Admission in Pokhara, Nepal: A Longitudinal Observational Study

    ERIC Educational Resources Information Center

    Nakahara, Shinji; Poudel, Krishna C.; Lopchan, Milan; Ichikawa, Masao; Poudel, Om R.; Poudel-Tandukar, Kalpana; Yoshida, Katsumi

    2010-01-01

    This longitudinal observational study evaluated whether admission priorities given to children on waiting lists for out-of-home day-care centres (DCCs), determined as being either an early or late admission to DCCs, are determined by actual childcare needs and are assigned to children of disadvantaged families, in public DCCs in Pokhara, Nepal,…

  4. STRengthening Analytical Thinking for Observational Studies: the STRATOS initiative

    PubMed Central

    Sauerbrei, Willi; Abrahamowicz, Michal; Altman, Douglas G; le Cessie, Saskia; Carpenter, James

    2014-01-01

    The validity and practical utility of observational medical research depends critically on good study design, excellent data quality, appropriate statistical methods and accurate interpretation of results. Statistical methodology has seen substantial development in recent times. Unfortunately, many of these methodological developments are ignored in practice. Consequently, design and analysis of observational studies often exhibit serious weaknesses. The lack of guidance on vital practical issues discourages many applied researchers from using more sophisticated and possibly more appropriate methods when analyzing observational studies. Furthermore, many analyses are conducted by researchers with a relatively weak statistical background and limited experience in using statistical methodology and software. Consequently, even ‘standard’ analyses reported in the medical literature are often flawed, casting doubt on their results and conclusions. An efficient way to help researchers to keep up with recent methodological developments is to develop guidance documents that are spread to the research community at large. These observations led to the initiation of the strengthening analytical thinking for observational studies (STRATOS) initiative, a large collaboration of experts in many different areas of biostatistical research. The objective of STRATOS is to provide accessible and accurate guidance in the design and analysis of observational studies. The guidance is intended for applied statisticians and other data analysts with varying levels of statistical education, experience and interests. In this article, we introduce the STRATOS initiative and its main aims, present the need for guidance documents and outline the planned approach and progress so far. We encourage other biostatisticians to become involved. PMID:25074480

  5. STRengthening analytical thinking for observational studies: the STRATOS initiative.

    PubMed

    Sauerbrei, Willi; Abrahamowicz, Michal; Altman, Douglas G; le Cessie, Saskia; Carpenter, James

    2014-12-30

    The validity and practical utility of observational medical research depends critically on good study design, excellent data quality, appropriate statistical methods and accurate interpretation of results. Statistical methodology has seen substantial development in recent times. Unfortunately, many of these methodological developments are ignored in practice. Consequently, design and analysis of observational studies often exhibit serious weaknesses. The lack of guidance on vital practical issues discourages many applied researchers from using more sophisticated and possibly more appropriate methods when analyzing observational studies. Furthermore, many analyses are conducted by researchers with a relatively weak statistical background and limited experience in using statistical methodology and software. Consequently, even 'standard' analyses reported in the medical literature are often flawed, casting doubt on their results and conclusions. An efficient way to help researchers to keep up with recent methodological developments is to develop guidance documents that are spread to the research community at large. These observations led to the initiation of the strengthening analytical thinking for observational studies (STRATOS) initiative, a large collaboration of experts in many different areas of biostatistical research. The objective of STRATOS is to provide accessible and accurate guidance in the design and analysis of observational studies. The guidance is intended for applied statisticians and other data analysts with varying levels of statistical education, experience and interests. In this article, we introduce the STRATOS initiative and its main aims, present the need for guidance documents and outline the planned approach and progress so far. We encourage other biostatisticians to become involved. © 2014 The Authors. Statistics in Medicine published by John Wiley & Sons, Ltd.

  6. Parturient perineal distensibility tolerance assessed by EPI-NO: an observational study.

    PubMed

    Nakamura, Mary Uchiyama; Sass, Nelson; Elito Júnior, Julio; Petricelli, Carla Dellabarba; Alexandre, Sandra Maria; Araujo Júnior, Edward; Zanetti, Miriam Raquel Diniz

    2014-01-01

    To determine how parturient women tolerate the use of a perineal distensibility assessment technique using the EPI-NO device. An observational study with a total of 227 full-term parturient women was performed. During the evaluation with EPI-NO, parturient patients were asked about their sensation of discomfort. The degree of discomfort was measured using the Visual Analogue Scale, with a score from zero to 10. The Mann-Whitney test was applied to assess perineal distensibility measured by EPI-NO and the degree of discomfort caused by the test according to parity. The relation between perineal distensibility and discomfort was analyzed by using the Spearman correlation test (r). The test with EPI-NO caused only slight discomfort (mean Visual Analogue Scale of 3.8), and primiparous women reported significantly greater discomfort (mean Visual Analogue Scale of 4.5) than did multiparous (mean Visual Analogue Scale=3.1), with p<0.001 women. A negative correlation was observed, in other words, the greater the perineal distensibility on the EPI-NO, the lower the pain reported by the patients (r=-0.424; p<0.001). The assessment of perineal distensibility with EPI-NO was well tolerated by the parturient women.

  7. [Preliminary study of rabbit experiment modality for evaluating cardiac fatigue].

    PubMed

    Yan, Xiaobo; Luo, Linmei; Liu, Leichu; Xiao, Shouzhong; Deng, Suyuan; Xiang, Lingli; Zhang, Cong

    2013-04-01

    This paper presents a preliminary study of rabbit experiment modality incorporating a new indicator for evaluating cardiac function changes, providing a basis for subsequent study of cardiac fatigue. Using only biochemical indicators, such as troponins, is difficult to make a distinction between exercise-induced cardiac fatigue (EICF) and exercise-induced cardiac damage (EICD). Therefore, some new indicators are needed to evaluate cardiac fatigue synthetically. In our study, we used New Zealand white rabbits to conduct a multi-step swimming experiments with load. We made the rabbits reach an exhaustive state to evaluate whether the amplitude ratio of the first to second heart sound (S1/S2) and heart rate (HR) during the exhaustive exercise would be decreased and whether they would be able to recover after the exhaustive exercise for 24 hours. During the first phase of swimming, S1/S2 and HR were increased, and then decreased at exhaustive state. They were recovered after the exhaustive exercise for 24 hours. Overloading led to deaths of three rabbis, and new phenomena from overloading and related to this kind of death were observed. The experiments proved that Multi-steps swimming experiments with loads by using New Zealand white rabbit is useful for studying cardiac fatigue and premonition of sudden cardiac death.

  8. The Effect of Observation Length and Presentation Order on the Reliability and Validity of an Observational Measure of Teaching Quality

    ERIC Educational Resources Information Center

    Mashburn, Andrew J.; Meyer, J. Patrick; Allen, Joseph P.; Pianta, Robert C.

    2014-01-01

    Observational methods are increasingly being used in classrooms to evaluate the quality of teaching. Operational procedures for observing teachers are somewhat arbitrary in existing measures and vary across different instruments. To study the effect of different observation procedures on score reliability and validity, we conducted an experimental…

  9. Treatment of Crohn's disease with cannabis: an observational study.

    PubMed

    Naftali, Timna; Lev, Lihi Bar; Yablecovitch, Doron; Yablekovitz, Doron; Half, Elisabeth; Konikoff, Fred M

    2011-08-01

    The marijuana plant cannabis is known to have therapeutic effects, including improvement of inflammatory processes. However, no report of patients using cannabis for Crohn's disease (CD) was ever published. To describe the effects of cannabis use in patients suffering from CD. In this retrospective observational study we examined disease activity, use of medication, need for surgery, and hospitalization before and after cannabis use in 30 patients (26 males) with CD. Disease activity was assessed by the Harvey Bradshaw index for Crohn's disease. Of the 30 patients 21 improved significantly after treatment with cannabis. The average Harvey Bradshaw index improved from 14 +/- 6.7 to 7 +/- 4.7 (P < 0.001). The need for other medication was significantly reduced. Fifteen of the patients had 19 surgeries during an average period of 9 years before cannabis use, but only 2 required surgery during an average period of 3 years of cannabis use. This is the first report of cannabis use in Crohn's disease in humans. The results indicate that cannabis may have a positive effect on disease activity, as reflected by reduction in disease activity index and in the need for other drugs and surgery. Prospective placebo-controlled studies are warranted to fully evaluate the efficacy and side effects of cannabis in CD.

  10. A QUESTIONNAIRE TO ASSESS THE RELEVANCE AND CREDIBILITY OF OBSERVATIONAL STUDIES TO INFORM HEALTH CARE DECISION MAKING: AN ISPOR-AMCP-NPC GOOD PRACTICE TASK FORCE REPORT

    PubMed Central

    Berger, Marc L; Martin, Bradley C; Husereau, Don; Worley, Karen; Allen, Dan; Yang, Winnie; Mullins, C. Daniel; Kahler, Kristijan; Quon, Nicole C.; Devine, Scott; Graham, John; Cannon, Eric; Crown, William

    2014-01-01

    Evidence-based healthcare decisions are best informed by comparisons of all relevant interventions used to treat conditions in specific patient populations. Observational studies are being performed to help fill evidence gaps. However, widespread adoption of evidence from observational studies has been limited due to a variety of factors, including the lack of consensus regarding accepted principles for their evaluation and interpretation. Two Task Forces were formed to develop questionnaires to assist decision makers in evaluating observational studies, with one Task Force addressing retrospective research and the other prospective research. The intent was to promote a structured approach to reduce the potential for subjective interpretation of evidence and drive consistency in decision-making. Separately developed questionnaires were combined into a single questionnaire consisting of 33 items. These were divided into two domains: relevance and credibility. Relevance addresses the extent to which findings, if accurate, apply to the setting of interest to the decision maker. Credibility addresses the extent to which the study findings accurately answer the study question. The questionnaire provides a guide for assessing the degree of confidence that should be placed from observational studies and promotes awareness of the subtleties involved in evaluating those. PMID:24636373

  11. An Observational Study of Antibiotic Prescribing Behavior and the Hawthorne Effect

    PubMed Central

    Mangione-Smith, Rita; Elliott, Marc N; McDonald, Laurie; McGlynn, Elizabeth A

    2002-01-01

    Objectives To assess whether prospective, observational study procedures, including questionnaires and audio recording, are associated with different patterns of physician diagnostic decision making and antibiotic prescribing. Data Sources/Setting (1) Survey data from a prospective observational study of treatment patterns for children with acute upper respiratory illnesses (10/96–3/97) and (2) retrospective medical record abstraction data of nonobserved encounters for the same problems occurring during (10/96–3/97) and one year after (10/97–3/98) the observational study period. Ten pediatricians in two community practices were studied. Study Design Patterns of diagnoses recorded in the medical record and antibiotics ordered for visits occurring outside of the observational study (same time period and one year later) were compared with the pattern of diagnoses and antibiotics ordered during the observational study. Data Collection/Extraction Methods For the observational study (10/96–2/97), diagnosis and treatment choices were obtained from questionnaires completed by physicians immediately following the visit. For the nonstudy encounters (10/96–3/97 and 10/97–3/98), data were abstracted from medical records one year after the observational study was completed. Principal Findings The proportion of viral cases in which an antibiotic was prescribed was 29 percentage points lower for the observational study compared to the retrospective analysis (p <.05). In one of two study sites, the proportion of cases assigned a bacterial diagnosis was 29 percentage points lower in the observational study period compared to the retrospective study (p <.05). Conclusions Observational study procedures including questionnaires and audio recording can affect antibiotic prescribing behavior. Future observational studies aimed at examining the frequency of inappropriate antibiotic prescribing should measure and adjust for the Hawthorne effect; without such adjustments, the

  12. Evaluations of Thin Cirrus Contamination and Screening in Ground Aerosol Observations Using Collocated Lidar Systems

    NASA Technical Reports Server (NTRS)

    Huang, Jingfeng; Hsu, N. Christina; Tsay, Si-Chee; Holben, Brent N.; Welton, Ellsworth J.; Smirnov, Alexander; Jeong, Myeong-Jae; Hansell, Richard A.; Berkoff, Timothy A.

    2012-01-01

    Cirrus clouds, particularly sub visual high thin cirrus with low optical thickness, are difficult to be screened in operational aerosol retrieval algorithms. Collocated aerosol and cirrus observations from ground measurements, such as the Aerosol Robotic Network (AERONET) and the Micro-Pulse Lidar Network (MPLNET), provide us with an unprecedented opportunity to examine the susceptibility of operational aerosol products to thin cirrus contamination. Quality assured aerosol optical thickness (AOT) measurements were also tested against the CALIPSO vertical feature mask (VFM) and the MODIS-derived thin cirrus screening parameters for the purpose of evaluating thin cirrus contamination. Key results of this study include: (1) Quantitative evaluations of data uncertainties in AERONET AOT retrievals are conducted. Although AERONET cirrus screening schemes are successful in removing most cirrus contamination, strong residuals displaying strong spatial and seasonal variability still exist, particularly over thin cirrus prevalent regions during cirrus peak seasons, (2) Challenges in matching up different data for analysis are highlighted and corresponding solutions proposed, and (3) Estimation of the relative contributions from cirrus contamination to aerosol retrievals are discussed. The results are valuable for better understanding and further improving ground aerosol measurements that are critical for aerosol-related climate research.

  13. Observing System Forecast Experiments at the DAO

    NASA Technical Reports Server (NTRS)

    Atlas, Robert

    2001-01-01

    Since the advent of meteorological satellites in the 1960's, numerous experiments have been conducted in order to evaluate the impact of these and other data on atmospheric analysis and prediction. Such studies have included both OSE'S and OSSE's. The OSE's were conducted to evaluate the impact of specific observations or classes of observations on analyses and forecasts. Such experiments have been performed for selected types of conventional data and for various satellite data sets as they became available. (See for example the 1989 ECMWF/EUMETSAT workshop proceedings on "The use of satellite data in operational numerical weather prediction" and the references contained therein.) The ODYSSEY were conducted to evaluate the potential for future observing systems to improve Numerical Weather Prediction NWP and to plan for the Global Weather Experiment and more recently for EVANS (Atlas et al., 1985a; Arnold and Day, 1986; Hoffman et al., 1990). In addition, OSSE's have been run to evaluate trade-offs in the design of observing systems and observing networks (Atlas and Emmitt, 1991; Rohaly and Krishnamurti, 1993), and to test new methodology for data assimilation (Atlas and Bloom, 1989).

  14. A roadside study of observable driver distractions.

    PubMed

    Sullman, Mark J M; Prat, Francesc; Tasci, Duygu Kuzu

    2015-01-01

    This study investigated the prevalence of observable distractions while driving and the effect of drivers' characteristics and time-related variables on their prevalence. Using roadside observation, 2 independent observers collected data at 4 randomly selected locations in St. Albans, UK. Of the 10,984 drivers observed, 16.8% were engaged in a secondary task, with talking to passengers being the most common distraction (8.8%), followed by smoking (1.9%) and talking on a hands-free mobile phone (1.7%). An additional 1.0% were observed talking on a handheld phone, and the rest of the distractions (e.g., texting, drinking) were recorded in less than 1% of the drivers observed. Gender-related differences were found for a number of different distractions (i.e., talking to passengers, drinking, and handheld mobile phone conversations), but age emerged as a significant predictor for most secondary tasks, including talking to passengers, smoking, hands-free mobile phone use, handheld mobile phone use, texting/keying numbers, drinking, and engagement in any type of distraction (all distractions combined). The overall pattern for age was that middle-aged and older drivers were less likely to be distracted than younger drivers. This work provides further evidence of the relatively high rate of distracted driving in the UK. The findings clearly indicate that younger drivers are more likely to drive distracted, which probably contributes to their higher crash rates.

  15. NACP Synthesis: Evaluating modeled carbon state and flux variables against multiple observational constraints (Invited)

    NASA Astrophysics Data System (ADS)

    Thornton, P. E.; Nacp Site Synthesis Participants

    2010-12-01

    The North American Carbon Program (NACP) synthesis effort includes an extensive intercomparison of modeled and observed ecosystem states and fluxes preformed with multiple models across multiple sites. The participating models span a range of complexity and intended application, while the participating sites cover a broad range of natural and managed ecosystems in North America, from the subtropics to arctic tundra, and coastal to interior climates. A unique characteristic of this collaborative effort is that multiple independent observations are available at all sites: fluxes are measured with the eddy covariance technique, and standard biometric and field sampling methods provide estimates of standing stock and annual production in multiple categories. In addition, multiple modeling approaches are employed to make predictions at each site, varying, for example, in the use of diagnostic vs. prognostic leaf area index. Given multiple independent observational constraints and multiple classes of model, we evaluate the internal consistency of observations at each site, and use this information to extend previously derived estimates of uncertainty in the flux observations. Model results are then compared with all available observations and models are ranked according to their consistency with each type of observation (high frequency flux measurement, carbon stock, annual production). We demonstrate a range of internal consistency across the sites, and show that some models which perform well against one observational metric perform poorly against others. We use this analysis to construct a hypothesis for combining eddy covariance, biometrics, and other standard physiological and ecological measurements which, as data collection proceeded over several years, would present an increasingly challenging target for next generation models.

  16. An Observational Study of Skilled Memory in Waitresses.

    ERIC Educational Resources Information Center

    Stevens, Joy

    A two-phase study about skilled memory as it is used by waitresses included a participant-observer phase and an observational phase. Participants were three experienced waitresses who had worked at a midtown Manhattan restaurant for 14, 7, and 3 years respectively and a team of 5 confederate customers. Waitresses and customers wore microphones.…

  17. Effectiveness of Vildagliptin in Clinical Practice: Pooled Analysis of Three Korean Observational Studies (the VICTORY Study).

    PubMed

    Suh, Sunghwan; Song, Sun Ok; Kim, Jae Hyeon; Cho, Hyungjin; Lee, Woo Je; Lee, Byung-Wan

    2017-01-01

    The present observational study aimed to evaluate the clinical effectiveness of vildagliptin with metformin in Korean patients with type 2 diabetes mellitus (T2DM). Data were pooled from the vildagliptin postmarketing survey (PMS), the vildagliptin/metformin fixed drug combination (DC) PMS, and a retrospective observational study of vildagliptin/metformin (fixed DC or free DC). The effectiveness endpoint was the proportion of patients who achieved a glycemic target (HbA1c) of ≤7.0% at 24 weeks. In total, 4303 patients were included in the analysis; of these, 2087 patients were eligible. The mean patient age was 56.99 ± 11.25 years. Overall, 58.94% patients achieved an HbA1c target of ≤7.0% at 24 weeks. The glycemic target achievement rate was significantly greater in patients with baseline HbA1c < 7.5% versus ≥7.5% (84.64% versus 43.97%), receiving care at the hospital versus clinic (67.95% versus 52.33%), and receiving vildagliptin/metformin fixed DC versus free DC (70.69% versus 55.42%). Multivariate logistic regression analysis indicated that disease duration ( P < 0.0001), baseline HbA1c ( P < 0.0001), and DC type ( P = 0.0103) had significant effects on drug effectiveness. Vildagliptin plus metformin appeared as an effective treatment option for patients with T2DM in clinical practice settings in Korea.

  18. Community Engagement in Observational Human Exposure Studies

    EPA Science Inventory

    Although observational human exposure studies do not deliberately expose participants to chemicals or environmental conditions, merely involving people as research participants and conducting research inside homes raises ethical issues. Community engagement offers a promising st...

  19. Development and evaluation of the "BRISK Scale," a brief observational measure of risk communication competence.

    PubMed

    Han, Paul K J; Joekes, Katherine; Mills, Greg; Gutheil, Caitlin; Smith, Kahsi; Cochran, Nancy E; Elwyn, Glyn

    2016-12-01

    To develop and evaluate a brief observational measure of clinical risk communication competence. A 4-item checklist-type measure, the BRISK (Brief Risk Information Skill) Scale, was developed by selecting and refining items from a more comprehensive measure of clinical risk communication competence. Six volunteer raters received brief training on the measure and then used the BRISK Scale to evaluate 52 video-recorded encounters between 2nd-year medical students and standardized patients conducted as part of an Observed Structured Clinical Examination (OSCE) involving a risk communication task. Internal consistency reliability, inter-rater reliability, and criterion validity were assessed. Raters reported no difficulties using the BRISK Scale; scores across all raters and subjects ranged from 0 to 16 with a mean score of 6.49 (SD=3.17). The BRISK Scale showed good internal consistency reliability (α=0.64), and inter-rater reliability at the scale level (Intraclass Correlation Coefficient (ICC)=0.79 for consistency, and 0.75 for absolute agreement) and individual-item level (ICC range: 0.62-.91). Novice raters' BRISK Scale scores were highly correlated (r=0.84, p<0.01) with expert raters' scores on the Risk Communication Content measure, a more comprehensive measure of risk communication competence. The BRISK Scale is a promising new brief observational measure of clinical risk communication competence. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. [Observation of the dysphonia severity index in evaluating curative effect of vocal cord polyp surgery].

    PubMed

    Zhou, Zhou; Ge, Pingjiang; Liu, Qian; Liu, Ming; Zhang, Wei

    2015-08-01

    To investigate the applicability of the eysphonia severity index (DSI) in evaluating effects of surgery between before and after groups of vocal polyp patients. Analyses of measurement data pre and pro-surgery of 70 vocal polyp patients and 35 no voice disorders volunteers (control group). The voice quality was measured subjectively with the voice handicap index (VHI), the GRBAS and fiber electronic laryngoscopy. Measures of maximum phonation time (MPT), shimmer and jitter were obtained for each subject by using DiVAS 2.30 (XION, Germany). The DiVAS 2.30 had spotanenously calculate the scores of DSI. Using SPSS 17.0 to find the differences of DSI scores among the three groups by one-way ANOVA variance analysis. And finding out of the correlation with DSI scores and VHI scores, GRBAS, MPT, jitter and shimmer. DSI improved significantly after surgery in the vocal polyps group (mean difference DSI -2.92 and 1.87, respectively) and also in the control group (mean difference DSI -2.92 and 2.30, respectively). However, no significant difference between the control group and the after surgery group. By using Pearson correlation analysis, this study observed a strong correlation between the DSI scores and the VHI scores, the values of GRBAS, shimmer (P < 0.01). DSI is an effective and high accuracy multi-parameter system for evaluation of vocal cord polyp patients as an independent assessment of dysphonia. DSI also can be used in evaluation of the effects of the vocal polyps surgery.

  1. Management of Pulmonary Nodules by Community Pulmonologists: A Multicenter Observational Study.

    PubMed

    Tanner, Nichole T; Aggarwal, Jyoti; Gould, Michael K; Kearney, Paul; Diette, Gregory; Vachani, Anil; Fang, Kenneth C; Silvestri, Gerard A

    2015-12-01

    Pulmonary nodules (PNs) are a common reason for referral to pulmonologists. The majority of data for the evaluation and management of PNs is derived from studies performed in academic medical centers. Little is known about the prevalence and diagnosis of PNs, the use of diagnostic testing, or the management of PNs by community pulmonologists. This multicenter observational record review evaluated 377 patients aged 40 to 89 years referred to 18 geographically diverse community pulmonary practices for intermediate PNs (8-20 mm). Study measures included the prevalence of malignancy, procedure/test use, and nodule pretest probability of malignancy as calculated by two previously validated models. The relationship between calculated pretest probability and management decisions was evaluated. The prevalence of malignancy was 25% (n = 94). Nearly one-half of the patients (46%, n = 175) had surveillance alone. Biopsy was performed on 125 patients (33.2%). A total of 77 patients (20.4%) underwent surgery, of whom 35% (n = 27) had benign disease. PET scan was used in 141 patients (37%). The false-positive rate for PET scan was 39% (95% CI, 27.1%-52.1%). Pretest probability of malignancy calculations showed that 9.5% (n = 36) were at a low risk, 79.6% (n = 300) were at a moderate risk, and 10.8% (n = 41) were at a high risk of malignancy. The rate of surgical resection was similar among the three groups (17%, 21%, 17%, respectively; P = .69). A substantial fraction of intermediate-sized nodules referred to pulmonologists ultimately prove to be lung cancer. Despite advances in imaging and nonsurgical biopsy techniques, invasive sampling of low-risk nodules and surgical resection of benign nodules remain common, suggesting a lack of adherence to guidelines for the management of PNs.

  2. Evaluation of results in aesthetic plastic surgery: preliminary observations on mammaplasty.

    PubMed

    Ferreira, M C

    2000-12-01

    Aesthetic plastic surgery has received wide public attention in the past few years. Expectations of patients regarding results have been exaggerated; the real place and medical importance of the procedures are still not clear because of a lack of more objective evidence. This study discusses the difficulties encountered related to the scientific evaluation of the aesthetic operations and proposes alternatives for assessment. A frequently performed procedure, reduction mammaplasty, is presented as an example, with its specific evaluation.

  3. Paediatric nurses' adherence to the double-checking process during medication administration in a children's hospital: an observational study.

    PubMed

    Alsulami, Zayed; Choonara, Imti; Conroy, Sharon

    2014-06-01

    To evaluate how closely double-checking policies are followed by nurses in paediatric areas and also to identify the types, frequency and rates of medication administration errors that occur despite the double-checking process. Double-checking by two nurses is an intervention used in many UK hospitals to prevent or reduce medication administration errors. There is, however, insufficient evidence to either support or refute the practice of double-checking in terms of medication error risk reduction. Prospective observational study. This was a prospective observational study of paediatric nurses' adherence to the double-checking process for medication administration from April-July 2012. Drug dose administration events (n = 2000) were observed. Independent drug dose calculation, rate of administering intravenous bolus drugs and labelling of flush syringes were the steps with lowest adherence rates. Drug dose calculation was only double-checked independently in 591 (30%) drug administrations. There was a statistically significant difference in nurses' adherence rate to the double-checking steps between weekdays and weekends in nine of the 15 evaluated steps. Medication administration errors (n = 191) or deviations from policy were observed, at a rate of 9·6% of drug administrations. These included 64 drug doses, which were left for parents to administer without nurse observation. There was variation between paediatric nurses' adherence to double-checking steps during medication administration. The most frequent type of administration errors or deviation from policy involved the medicine being given to the parents to administer to the child when the nurse was not present. © 2013 John Wiley & Sons Ltd.

  4. Is safety of childhood growth hormone therapy related to dose? Data from a large observational study.

    PubMed

    Sävendahl, Lars; Pournara, Effie; Pedersen, Birgitte Tønnes; Blankenstein, Oliver

    2016-05-01

    Concerns have been raised of increased mortality risk in adulthood in certain patients who received growth hormone treatment during childhood. This study evaluated the safety of growth hormone treatment in childhood in everyday practice. NordiNet(®) International Outcome Study (IOS) is a noninterventional, observational study evaluating safety and effectiveness of Norditropin(®) (somatropin; Novo Nordisk A/S, Bagsvaerd, Denmark). Long-term safety data (1998-2013) were collected on 13 834 growth hormone treated pediatric patients with short stature. Incidence rates (IRs) of adverse events (AEs) defined as adverse drug reactions (ADRs), serious ADRs (SADRs), and serious AEs (SAEs) were calculated by mortality risk group (low/intermediate/high). The effect of growth hormone dose on IRs and the occurrence of cerebrovascular AEs were investigated by the risk group. We found that 61.0% of patients were classified as low-risk, 33.9% intermediate-risk, and 5.1% high-risk. Three hundred and two AEs were reported in 261 (1.9%) patients during a mean (s.d.) treatment duration of 3.9 (2.8) years. IRs were significantly higher in the high- vs the low-risk group (high risk vs low risk-ADR: 9.11 vs 3.14; SAE: 13.66 vs 1.85; SADR: 4.97 vs 0.73 events/1000 patient-years of exposure; P < 0.0001 for all). Except for SAEs in the intermediate-risk group (P = 0.0486) in which an inverse relationship was observed, no association between IRs and growth hormone dose was found. No cerebrovascular events were reported. We conclude that safety data from NordiNet(®) IOS do not reveal any new safety signals and confirm a favorable overall safety profile in accordance with other pediatric observational studies. No association between growth hormone dose and the incidence of AEs during growth hormone treatment in childhood was found. © 2016 European Society of Endocrinology.

  5. Validating an Observation Protocol to Measure Special Education Teacher Effectiveness

    ERIC Educational Resources Information Center

    Johnson, Evelyn S.; Semmelroth, Carrie L.

    2015-01-01

    This study used Kane's (2013) Interpretation/Use Argument (IUA) to measure validity on the Recognizing Effective Special Education Teachers (RESET) observation tool. The RESET observation tool is designed to evaluate special education teacher effectiveness using evidence-based instructional practices as the basis for evaluation. In alignment with…

  6. Implementation Evaluation Study: Flipped Classroom Professional Development with Faculty Members to Enhance Students' Engagement in Higher Education

    ERIC Educational Resources Information Center

    Alebrahim, Fatimah Hussain

    2016-01-01

    The purpose of this qualitative study was to explore student engagement in higher education by evaluating training provided by experienced faculty members for those faculty desiring to implement a flipped classroom. A case study was utilized; data were collected in the form of online observation, in-class observation, student focus group…

  7. In-Hospital Recruitment to Observational Studies of Stroke

    ERIC Educational Resources Information Center

    Pickering, Ruth M.; Kunkel, Dorit; Fitton, Carolyn; Ashburn, Ann; Jenkinson, Damian

    2010-01-01

    The objective of this study was to examine recruitment in three observational follow-up studies of patients with stroke, focusing on reasons for nonparticipation and the role of potential factors in explaining recruitment rates. It comprised secondary analysis of the three studies. Recruitment rates varied between the studies. Between 10 and 50%…

  8. Hypoalbuminemia and acute kidney injury: a meta-analysis of observational clinical studies.

    PubMed

    Wiedermann, Christian J; Wiedermann, Wolfgang; Joannidis, Michael

    2010-10-01

    To test the hypothesis that hypoalbuminemia is independently associated with increased risk of acute kidney injury (AKI). A meta-analysis was performed of observational clinical studies evaluating the relationship between serum albumin level and the occurrence of AKI by multivariate methods. Additionally, the impact was assessed of lower serum albumin on mortality in patients who developed AKI. Eligible studies were sought by multiple methods, and adjusted odds ratios (OR) were quantitatively combined using a random effects model. Seventeen clinical studies with 3,917 total patients were included: 11 studies (6 in surgical or intensive care unit patients and 5 in other hospital settings) evaluating the influence of serum albumin on AKI incidence and 6 studies describing the relationship between serum albumin and mortality among patients who had developed AKI. Lower serum albumin was an independent predictor both of AKI and of death after AKI development. With each 10 g L(-1) serum albumin decrement, the odds of AKI increased by 134%. The pooled OR for AKI was 2.34 with a 95% confidence interval (CI) of 1.74-3.14. Among patients who had developed AKI, the odds of death rose 147% (pooled OR 2.47, 95% CI 1.51-4.05) with each 10 g L(-1) serum albumin decrement. This meta-analysis provides evidence that hypoalbuminemia is a significant independent predictor both of AKI and of death following AKI development. Serum albumin determinations may be of utility in identifying patients at increased risk for AKI or for death after AKI. Controlled studies are warranted to assess interventions aimed at correcting hypoalbuminemia.

  9. Interrater Reliability and Diagnostic Performance of Subjective Evaluation of Sublingual Microcirculation Images by Physicians and Nurses: A Multicenter Observational Study.

    PubMed

    Lima, Alexandre; López, Alejandra; van Genderen, Michel E; Hurtado, Francisco Javier; Angulo, Martin; Grignola, Juan C; Shono, Atsuko; van Bommel, Jasper

    2015-09-01

    This was a cross-sectional multicenter study to investigate the ability of physicians and nurses from three different countries to subjectively evaluate sublingual microcirculation images and thereby discriminate normal from abnormal sublingual microcirculation based on flow and density abnormalities. Forty-five physicians and 61 nurses (mean age, 36 ± 10 years; 44 males) from three different centers in The Netherlands (n = 61), Uruguay (n = 12), and Japan (n = 33) were asked to subjectively evaluate a sample of 15 microcirculation videos randomly selected from an experimental model of endotoxic shock in pigs. All videos were first analyzed offline using the A.V.A. software by an independent, experienced investigator and were categorized as good, bad, or very bad microcirculation based on the microvascular flow index, perfused capillary density, and proportion of perfused capillaries. Then, the videos were randomly assigned to the examiners, who were instructed to subjectively categorize each image as good, bad, or very bad. An interrater analysis was performed, and sensitivity and specificity tests were calculated to evaluate the proportion of A.V.A. score abnormalities that the examiners correctly identified. The κ statistics indicated moderate agreement in the evaluation of microcirculation abnormalities using three categories, i.e., good, bad, or very bad (κ = 0.48), and substantial agreement using two categories, i.e., normal (good) and abnormal (bad or very bad) (κ = 0.66). There was no significant difference between the κ three and κ two statistics. We found that the examiner's subjective evaluations had good diagnostic performance and were highly sensitive (84%; 95% confidence interval, 81%-86%) and specific (87%; 95% confidence interval, 84%-90%) for sublingual microcirculatory abnormalities as assessed using the A.V.A. software. The subjective evaluations of sublingual microcirculation by physicians and nurses agreed well with a conventional offline

  10. Inter-observer and intra-observer agreement on interpretation of uroflowmetry curves of kindergarten children.

    PubMed

    Chang, Shang-Jen; Yang, Stephen S D

    2008-12-01

    To evaluate the inter-observer and intra-observer agreement on the interpretation of uroflowmetry curves of children. Healthy kindergarten children were enrolled for evaluation of uroflowmetry. Uroflowmetry curves were classified as bell-shaped, tower, plateau, staccato and interrupted. Only the bell-shaped curves were regarded as normal. Two urodynamists evaluated the curves independently after reviewing the definitions of the different types of uroflowmetry curve. The senior urodynamist evaluated the curves twice 3 months apart. The final conclusion was made when consensus was reached. Agreement among observers was analyzed using kappa statistics. Of 190 uroflowmetry curves eligible for analysis, the intra-observer agreement in interpreting each type of curve and interpreting normalcy vs abnormality was good (kappa=0.71 and 0.68, respectively). Very good inter-observer agreement (kappa=0.81) on normalcy and good inter-observer agreement (kappa=0.73) on types of uroflowmetry were observed. Poor inter-observer agreement existed on the classification of specific types of abnormal uroflowmetry curves (kappa=0.07). Uroflowmetry is a good screening tool for normalcy of kindergarten children, while not a good tool to define the specific types of abnormal uroflowmetry.

  11. Resuscitative Hyperkalemia in Noncrush Trauma: A Prospective, Observational Study

    DTIC Science & Technology

    2006-12-01

    Resuscitative Hyperkalemia in Noncrush Trauma: A Prospective, Observational Study Robert M. Perkins,*† Matthew C. Aboudara,* Kevin C. Abbott,*† and...Surgical Research, San Antonio, Texas The trauma patient is exposed to physiologic processes and life-saving interventions that predispose to hyperkalemia ...in the care of the massively traumatized patient may or may not increase the risk for hyperkalemia . This prospective, observational study was

  12. Observation impact studies with the Mercator Ocean analysis and forecasting systems

    NASA Astrophysics Data System (ADS)

    Remy, E. D.; Le Traon, P. Y.; Lellouche, J. M.; Drevillon, M.; Turpin, V.; Benkiran, M.

    2016-02-01

    Mercator Ocean produces and delivers in real-time ocean analysis and forecasts on a daily basis. The quality of the analysis highly relies on the availability and quality of the assimilated observations.Tools are developed to estimate the impact of the present network and to help designing the future evolutions of the observing systems in the context of near real time production of ocean analysis and forecasts. OSE and OSSE are the main approaches used in this context. They allow the assessment of the efficiency of a given data set to constrain the ocean model circulation through the data assimilation process. Illustrations will mainly focus on the present and future evolution of the Argo observation network and altimetry constellation, including the potential impact of future SWOT data. Our systems show clear sensitivities to observation array changes, mainly depending on the specified observation error and regional dynamic. Impact on non observed variables can be important and are important to evaluate. Dedicated diagnostics has to be define to measure the improvements bring by each data set. Alternative approaches to OSE and OSSE are also explored: approximate computation of DFS will be presented and discussed. Limitations of each approach will be discussed in the context of real time operation.

  13. Tire pressure special study : vehicle observation data

    DOT National Transportation Integrated Search

    2001-08-01

    Twenty seven percent of passenger cars with : regular passenger car tires have at least one : tire that is underinflated by 8 psi or more. : Tire Pressure Special Study: Vehicle : Observation Data is the third in a series of : research notes co...

  14. A questionnaire to assess the relevance and credibility of observational studies to inform health care decision making: an ISPOR-AMCP-NPC Good Practice Task Force report.

    PubMed

    Berger, Marc L; Martin, Bradley C; Husereau, Don; Worley, Karen; Allen, J Daniel; Yang, Winnie; Quon, Nicole C; Mullins, C Daniel; Kahler, Kristijan H; Crown, William

    2014-03-01

    Evidence-based health care decisions are best informed by comparisons of all relevant interventions used to treat conditions in specific patient populations. Observational studies are being performed to help fill evidence gaps. Widespread adoption of evidence from observational studies, however, has been limited because of various factors, including the lack of consensus regarding accepted principles for their evaluation and interpretation. Two task forces were formed to develop questionnaires to assist decision makers in evaluating observational studies, with one Task Force addressing retrospective research and the other Task Force addressing prospective research. The intent was to promote a structured approach to reduce the potential for subjective interpretation of evidence and drive consistency in decision making. Separately developed questionnaires were combined into a single questionnaire consisting of 33 items. These were divided into two domains: relevance and credibility. Relevance addresses the extent to which findings, if accurate, apply to the setting of interest to the decision maker. Credibility addresses the extent to which the study findings accurately answer the study question. The questionnaire provides a guide for assessing the degree of confidence that should be placed from observational studies and promotes awareness of the subtleties involved in evaluating those. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  15. The Role of Scheduling in Observing Teacher-Child Interactions

    ERIC Educational Resources Information Center

    Cash, Anne H.; Pianta, Robert C.

    2014-01-01

    Observational assessment is being used on a large scale to evaluate the quality of interactions between teachers and children in classroom environments. When one performs observations at scale, features of the protocol such as the scheduling of observations can potentially influence observed scores. In this study interactions were observed for 88…

  16. Assessing validity of observational intervention studies - the Benchmarking Controlled Trials.

    PubMed

    Malmivaara, Antti

    2016-09-01

    Benchmarking Controlled Trial (BCT) is a concept which covers all observational studies aiming to assess impact of interventions or health care system features to patients and populations. To create and pilot test a checklist for appraising methodological validity of a BCT. The checklist was created by extracting the most essential elements from the comprehensive set of criteria in the previous paper on BCTs. Also checklists and scientific papers on observational studies and respective systematic reviews were utilized. Ten BCTs published in the Lancet and in the New England Journal of Medicine were used to assess feasibility of the created checklist. The appraised studies seem to have several methodological limitations, some of which could be avoided in planning, conducting and reporting phases of the studies. The checklist can be used for planning, conducting, reporting, reviewing, and critical reading of observational intervention studies. However, the piloted checklist should be validated in further studies. Key messages Benchmarking Controlled Trial (BCT) is a concept which covers all observational studies aiming to assess impact of interventions or health care system features to patients and populations. This paper presents a checklist for appraising methodological validity of BCTs and pilot-tests the checklist with ten BCTs published in leading medical journals. The appraised studies seem to have several methodological limitations, some of which could be avoided in planning, conducting and reporting phases of the studies. The checklist can be used for planning, conducting, reporting, reviewing, and critical reading of observational intervention studies.

  17. Lesion detection performance of cone beam CT images with anatomical background noise: single-slice vs. multi-slice human and model observer study

    NASA Astrophysics Data System (ADS)

    Han, Minah; Jang, Hanjoo; Baek, Jongduk

    2018-03-01

    We investigate lesion detectability and its trends for different noise structures in single-slice and multislice CBCT images with anatomical background noise. Anatomical background noise is modeled using a power law spectrum of breast anatomy. Spherical signal with a 2 mm diameter is used for modeling a lesion. CT projection data are acquired by the forward projection and reconstructed by the Feldkamp-Davis-Kress algorithm. To generate different noise structures, two types of reconstruction filters (Hanning and Ram-Lak weighted ramp filters) are used in the reconstruction, and the transverse and longitudinal planes of reconstructed volume are used for detectability evaluation. To evaluate single-slice images, the central slice, which contains the maximum signal energy, is used. To evaluate multislice images, central nine slices are used. Detectability is evaluated using human and model observer studies. For model observer, channelized Hotelling observer (CHO) with dense difference-of-Gaussian (D-DOG) channels are used. For all noise structures, detectability by a human observer is higher for multislice images than single-slice images, and the degree of detectability increase in multislice images depends on the noise structure. Variation in detectability for different noise structures is reduced in multislice images, but detectability trends are not much different between single-slice and multislice images. The CHO with D-DOG channels predicts detectability by a human observer well for both single-slice and multislice images.

  18. Rationale, design and methods for process evaluation in the HEALTHY study.

    PubMed

    Schneider, M; Hall, W J; Hernandez, A E; Hindes, K; Montez, G; Pham, T; Rosen, L; Sleigh, A; Thompson, D; Volpe, S L; Zeveloff, A; Steckler, A

    2009-08-01

    The HEALTHY study was a multi-site randomized trial designed to determine whether a 3-year school-based intervention targeting nutrition and physical activity behaviors could effectively reduce risk factors associated with type 2 diabetes in middle school children. Pilot and formative studies were conducted to inform the development of the intervention components and the process evaluation methods for the main trial. During the main trial, both qualitative and quantitative assessments monitored the fidelity of the intervention and motivated modifications to improve intervention delivery. Structured observations of physical education classes, total school food environments, classroom-based educational modules, and communications and promotional campaigns provided verification that the intervention was delivered as intended. Interviews and focus groups yielded a multidimensional assessment of how the intervention was delivered and received, as well as identifying the barriers to and facilitators of the intervention across and within participating schools. Interim summaries of process evaluation data were presented to the study group as a means of ensuring standardization and quality of the intervention across the seven participating centers. Process evaluation methods and procedures documented the fidelity with which the HEALTHY study was implemented across 21 intervention schools and identified ways in which the intervention delivery might be enhanced throughout the study.

  19. Trans-Pacific transport and evolution of aerosols: Evaluation of quasi-global WRF-Chem simulation with multiple observations

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

    Hu, Zhiyuan; Zhao, Chun; Huang, Jianping

    A fully coupled meteorology-chemistry model (WRF-Chem, the Weather Research and Forecasting model coupled with chemistry) has been configured to conduct quasi-global simulation for 5 years (2010–2014) and evaluated with multiple observation data sets for the first time. The evaluation focuses on the simulation over the trans-Pacific transport region using various reanalysis and observational data sets for meteorological fields and aerosol properties. The simulation generally captures the overall spatial and seasonal variability of satellite retrieved aerosol optical depth (AOD) and absorbing AOD (AAOD) over the Pacific that is determined by the outflow of pollutants and dust and the emissions of marine aerosols.more » The assessment of simulated extinction Ångström exponent (EAE) indicates that the model generally reproduces the variability of aerosol size distributions as seen by satellites. In addition, the vertical profile of aerosol extinction and its seasonality over the Pacific are also well simulated. The difference between the simulation and satellite retrievals can be mainly attributed to model biases in estimating marine aerosol emissions as well as the satellite sampling and retrieval uncertainties. Compared with the surface measurements over the western USA, the model reasonably simulates the observed magnitude and seasonality of dust, sulfate, and nitrate surface concentrations, but significantly underestimates the peak surface concentrations of carbonaceous aerosol likely due to model biases in the spatial and temporal variability of biomass burning emissions and secondary organic aerosol (SOA) production. A sensitivity simulation shows that the trans-Pacific transported dust, sulfate, and nitrate can make significant contribution to surface concentrations over the rural areas of the western USA, while the peaks of carbonaceous aerosol surface concentrations are dominated by the North American emissions. Both the retrievals and simulation show

  20. Trans-Pacific transport and evolution of aerosols: Evaluation of quasi-global WRF-Chem simulation with multiple observations

    DOE PAGES

    Hu, Zhiyuan; Zhao, Chun; Huang, Jianping; ...

    2016-05-10

    A fully coupled meteorology-chemistry model (WRF-Chem, the Weather Research and Forecasting model coupled with chemistry) has been configured to conduct quasi-global simulation for 5 years (2010–2014) and evaluated with multiple observation data sets for the first time. The evaluation focuses on the simulation over the trans-Pacific transport region using various reanalysis and observational data sets for meteorological fields and aerosol properties. The simulation generally captures the overall spatial and seasonal variability of satellite retrieved aerosol optical depth (AOD) and absorbing AOD (AAOD) over the Pacific that is determined by the outflow of pollutants and dust and the emissions of marine aerosols.more » The assessment of simulated extinction Ångström exponent (EAE) indicates that the model generally reproduces the variability of aerosol size distributions as seen by satellites. In addition, the vertical profile of aerosol extinction and its seasonality over the Pacific are also well simulated. The difference between the simulation and satellite retrievals can be mainly attributed to model biases in estimating marine aerosol emissions as well as the satellite sampling and retrieval uncertainties. Compared with the surface measurements over the western USA, the model reasonably simulates the observed magnitude and seasonality of dust, sulfate, and nitrate surface concentrations, but significantly underestimates the peak surface concentrations of carbonaceous aerosol likely due to model biases in the spatial and temporal variability of biomass burning emissions and secondary organic aerosol (SOA) production. A sensitivity simulation shows that the trans-Pacific transported dust, sulfate, and nitrate can make significant contribution to surface concentrations over the rural areas of the western USA, while the peaks of carbonaceous aerosol surface concentrations are dominated by the North American emissions. Both the retrievals and simulation show

  1. Trans-Pacific transport and evolution of aerosols: evaluation of quasi-global WRF-Chem simulation with multiple observations

    NASA Astrophysics Data System (ADS)

    Hu, Zhiyuan; Zhao, Chun; Huang, Jianping; Leung, L. Ruby; Qian, Yun; Yu, Hongbin; Huang, Lei; Kalashnikova, Olga V.

    2016-05-01

    A fully coupled meteorology-chemistry model (WRF-Chem, the Weather Research and Forecasting model coupled with chemistry) has been configured to conduct quasi-global simulation for 5 years (2010-2014) and evaluated with multiple observation data sets for the first time. The evaluation focuses on the simulation over the trans-Pacific transport region using various reanalysis and observational data sets for meteorological fields and aerosol properties. The simulation generally captures the overall spatial and seasonal variability of satellite retrieved aerosol optical depth (AOD) and absorbing AOD (AAOD) over the Pacific that is determined by the outflow of pollutants and dust and the emissions of marine aerosols. The assessment of simulated extinction Ångström exponent (EAE) indicates that the model generally reproduces the variability of aerosol size distributions as seen by satellites. In addition, the vertical profile of aerosol extinction and its seasonality over the Pacific are also well simulated. The difference between the simulation and satellite retrievals can be mainly attributed to model biases in estimating marine aerosol emissions as well as the satellite sampling and retrieval uncertainties. Compared with the surface measurements over the western USA, the model reasonably simulates the observed magnitude and seasonality of dust, sulfate, and nitrate surface concentrations, but significantly underestimates the peak surface concentrations of carbonaceous aerosol likely due to model biases in the spatial and temporal variability of biomass burning emissions and secondary organic aerosol (SOA) production. A sensitivity simulation shows that the trans-Pacific transported dust, sulfate, and nitrate can make significant contribution to surface concentrations over the rural areas of the western USA, while the peaks of carbonaceous aerosol surface concentrations are dominated by the North American emissions. Both the retrievals and simulation show small

  2. A Qualitative Study to Explore Ways to Observe Results of Engaging Activities in Clients with Dementia.

    PubMed

    Ogawa, Masahiro; Nishida, Seiji; Shirai, Haruna

    2017-01-01

    Many occupational therapists face the challenge of helping clients with dementia to select and perform meaningful occupations, which may be difficult due to cognitive impairment. Understanding tacit knowledge of well-experienced occupational therapists could positively affect occupational therapy practice for clients with dementia. To explore the observations of experienced occupational therapists when evaluating the effects of activities in clients with dementia. Ten occupational therapists with over 10 years of clinical experience participated in this qualitative study. In-depth interviews were conducted to ask the question, "What do you observe in clients with dementia when you assess the effectiveness of activities among these clients?" Findings . From 47 cases, we found five major themes and 18 subthemes. Main themes were "engaging activity," "emotional expression during activity," "verbal expression during activity," "social interaction through activity," and "something obtained as outcome of activity." Relevance to Clinical Practice . The 18 subthemes could be used as viewpoints to observe engagements of activity in clients with dementia. Future studies could examine which viewpoints were utilized for each type of activity and/or severity of dementia as this was not investigated in the current study.

  3. Observational Study on Safety of Prehospital BLS CPAP in Dyspnea.

    PubMed

    Sahu, Novneet; Matthews, Patrick; Groner, Kathryn; Papas, Mia A; Megargel, Ross

    2017-12-01

    Introduction Continuous positive airway pressure (CPAP) improves outcomes in patients with respiratory distress. Additional benefits are seen with CPAP application in the prehospital setting. Theoretical safety concerns regarding Basic Life Support (BLS) providers using CPAP exist. In Delaware's (USA) two-tiered Emergency Medical Service (EMS) system, BLS often arrives before Advanced Life Support (ALS). Hypothesis This study fills a gap in literature by evaluating the safety of CPAP applied by BLS prior to ALS arrival. This was a retrospective, observational study using Quality Assurance (QA) data collected from October 2009 through December 2012 throughout a state BLS CPAP pilot program; CPAP training was provided to BLS providers prior to participation. Collected data include pulse-oximetry (spO2), respiratory rate (RR), heart rate (HR), skin color, and Glasgow Coma Score (GCS) before and after CPAP application. Pre-CPAP and post-CPAP values were compared using McNemar's and t-tests. Advanced practitioners evaluated whether CPAP was correctly applied and monitored and whether the patient condition was "improved," "unchanged," or "worsened." Seventy-four patients received CPAP by BLS; CPAP was correctly indicated and applied for all 74 patients. Respiratory status and CPAP were appropriately monitored and documented in the majority of cases (98.6%). A total of 89.2% of patients improved and 4.1% worsened; CPAP significantly reduced the proportion of patients with SpO224, and cyanosis (P<.01). The GCS improved from mean (standard deviation [SD]) 13.9 (SD=1.9) to 14.1 (SD=1.9) after CPAP (mean difference [MD]=0.17; 95% CI, -0.49 to 0.83; P=.59). The HR decreased from 115.7 (SD=53) to 105.1 (SD=37) after CPAP (MD=-10.9; 95% CI, -3.2 to -18.6; P<.01). The SpO2 increased from 80.8% (SD=11.4) to 96.9% (SD=4.2) after CPAP (MD=17.8; 95% CI, 14.2-21.5; P<.01). The BLS providers were able to determine patients for whom CPAP was indicated, to apply it correctly, and to

  4. Evaluation of a chronic disease management system for the treatment and management of diabetes in primary health care practices in Ontario: an observational study.

    PubMed

    O'Reilly, D J; Bowen, J M; Sebaldt, R J; Petrie, A; Hopkins, R B; Assasi, N; MacDougald, C; Nunes, E; Goeree, R

    2014-01-01

    Computerized chronic disease management systems (CDMSs), when aligned with clinical practice guidelines, have the potential to effectively impact diabetes care. The objective was to measure the difference between optimal diabetes care and actual diabetes care before and after the introduction of a computerized CDMS. This 1-year, prospective, observational, pre/post study evaluated the use of a CDMS with a diabetes patient registry and tracker in family practices using patient enrolment models. Aggregate practice-level data from all rostered diabetes patients were analyzed. The primary outcome measure was the change in proportion of patients with up-to-date "ABC" monitoring frequency (i.e., hemoglobin A1c, blood pressure, and cholesterol). Changes in the frequency of other practice care and treatment elements (e.g., retinopathy screening) were also determined. Usability and satisfaction with the CDMS were measured. Nine sites, 38 health care providers, and 2,320 diabetes patients were included. The proportion of patients with up-to-date ABC (12%), hemoglobin A1c (45%), and cholesterol (38%) monitoring did not change over the duration of the study. The proportion of patients with up-to-date blood pressure monitoring improved, from 16% to 20%. Data on foot examinations, retinopathy screening, use of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, and documentation of self-management goals were not available or not up to date at baseline for 98% of patients. By the end of the study, attitudes of health care providers were more negative on the Training, Usefulness, Daily Practice, and Support from the Service Provider domains of the CDMS, but more positive on the Learning, Using, Practice Planning, CDMS, and Satisfaction domains. Few practitioners used the CDMS, so it was difficult to draw conclusions about its efficacy. Simply giving health care providers a potentially useful technology will not ensure its use. This real-world evaluation of a

  5. Evaluating Pretest Effects in Pre-Post Studies

    ERIC Educational Resources Information Center

    Kim, Eun Sook; Willson, Victor L.

    2010-01-01

    This article presents a method to evaluate pretest effects on posttest scores in the absence of an un-pretested control group using published results of pretesting effects due to Willson and Putnam. Confidence intervals around the expected theoretical gain due to pretesting are computed, and observed gains or differential gains are compared with…

  6. Case study on complex sporadic E layers observed by GPS radio occultations

    NASA Astrophysics Data System (ADS)

    Yue, X.; Schreiner, W. S.; Zeng, Z.; Kuo, Y.-H.; Xue, X.

    2015-01-01

    The occurrence of sporadic E (Es) layers has been a hot scientific topic for a long time. The GNSS (global navigation satellite system)-based radio occultation (RO) has proven to be a powerful technique for detecting the global Es layers. In this paper, we focus on some cases of complex Es layers based on the RO data from multiple missions processed in UCAR/CDAAC (University Corporation for Atmospheric Research (UCAR) the Constellation Observing System for Meteorology, Ionosphere, and Climate (COSMIC) Data Analysis and Archive Center (CDAAC)). We first show some examples of multiple Es layers occurred in one RO event. Based on the evaluations between colocated simultaneous RO events and between RO and lidar observations, it could be concluded that some of these do manifest the multiple Es layer structures. We then show a case of the occurrence of Es in a broad region during a certain time interval. The result is then validated by independent ionosondes observations. It is possible to explain these complex Es structures using the popular wind shear theory. We could map the global Es occurrence routinely in the near future, given that more RO data will be available. Further statistical studies will enhance our understanding of the Es mechanism. The understanding of Es should benefit both Es-based long-distance communication and accurate neutral RO retrievals.

  7. Parturient perineal distensibility tolerance assessed by EPI-NO: an observational study

    PubMed Central

    Nakamura, Mary Uchiyama; Sass, Nelson; Elito, Julio; Petricelli, Carla Dellabarba; Alexandre, Sandra Maria; Araujo, Edward; Zanetti, Miriam Raquel Diniz

    2014-01-01

    ABSTRACT Objective: To determine how parturient women tolerate the use of a perineal distensibility assessment technique using the EPI-NO device. Methods: An observational study with a total of 227 full-term parturient women was performed. During the evaluation with EPI-NO, parturient patients were asked about their sensation of discomfort. The degree of discomfort was measured using the Visual Analogue Scale, with a score from zero to 10. The Mann-Whitney test was applied to assess perineal distensibility measured by EPI-NO and the degree of discomfort caused by the test according to parity. The relation between perineal distensibility and discomfort was analyzed by using the Spearman correlation test (r). Results: The test with EPI-NO caused only slight discomfort (mean Visual Analogue Scale of 3.8), and primiparous women reported significantly greater discomfort (mean Visual Analogue Scale of 4.5) than did multiparous (mean Visual Analogue Scale=3.1), with p<0.001 women. A negative correlation was observed, in other words, the greater the perineal distensibility on the EPI-NO, the lower the pain reported by the patients (r=-0.424; p<0.001). Conclusion: The assessment of perineal distensibility with EPI-NO was well tolerated by the parturient women. PMID:24728241

  8. Observational methods in comparative effectiveness research.

    PubMed

    Concato, John; Lawler, Elizabeth V; Lew, Robert A; Gaziano, J Michael; Aslan, Mihaela; Huang, Grant D

    2010-12-01

    Comparative effectiveness research (CER) may be defined informally as an assessment of available options for treating specific medical conditions in selected groups of patients. In this context, the most prominent features of CER are the various patient populations, medical ailments, and treatment options involved in any particular project. Yet, each research investigation also has a corresponding study design or "architecture," and in patient-oriented research a common distinction used to describe such designs are randomized controlled trials (RCTs) versus observational studies. The purposes of this overview, with regard to CER, are to (1) understand how observational studies can provide accurate results, comparable to RCTs; (2) recognize strategies used in selected newer methods for conducting observational studies; (3) review selected observational studies from the Veterans Health Administration; and (4) appreciate the importance of fundamental methodological principles when conducting or evaluating individual studies. Published by Elsevier Inc.

  9. Vaginal birth after caesarean section prediction models: a UK comparative observational study.

    PubMed

    Mone, Fionnuala; Harrity, Conor; Mackie, Adam; Segurado, Ricardo; Toner, Brenda; McCormick, Timothy R; Currie, Aoife; McAuliffe, Fionnuala M

    2015-10-01

    Primarily, to assess the performance of three statistical models in predicting successful vaginal birth in patients attempting a trial of labour after one previous lower segment caesarean section (TOLAC). The statistically most reliable models were subsequently subjected to validation testing in a local antenatal population. A retrospective observational study was performed with study data collected from the Northern Ireland Maternity Service Database (NIMATs). The study population included all women that underwent a TOLAC (n=385) from 2010 to 2012 in a regional UK obstetric unit. Data was collected from the Northern Ireland Maternity Service Database (NIMATs). Area under the curve (AUC) and correlation analysis was performed. Of the three prediction models evaluated, AUC calculations for the Smith et al., Grobman et al. and Troyer and Parisi Models were 0.74, 0.72 and 0.65, respectively. Using the Smith et al. model, 52% of women had a low risk of caesarean section (CS) (predicted VBAC >72%) and 20% had a high risk of CS (predicted VBAC <60%), of whom 20% and 63% had delivery by CS. The fit between observed and predicted outcome in this study cohort using the Smith et al. and Grobman et al. models were greatest (Chi-square test, p=0.228 and 0.904), validating both within the population. The Smith et al. and Grobman et al. models could potentially be utilized within the UK to provide women with an informed choice when deciding on mode of delivery after a previous CS. Crown Copyright © 2015. Published by Elsevier Ireland Ltd. All rights reserved.

  10. Active-comparator design and new-user design in observational studies

    PubMed Central

    Yoshida, Kazuki; Solomon, Daniel H.; Kim, Seoyoung C.

    2015-01-01

    SUMMARY Over the past decade, an increasing number of observational studies have examined the effectiveness or safety of rheumatoid arthritis treatments. However, unlike randomized controlled trials (RCTs), observational studies of drug effects face methodological challenges including confounding by indication. Two design principles - active comparator design and new user design can help mitigate such challenges in observational studies. To improve validity of study findings, observational studies should be designed in such a way that makes them more closely approximate RCTs. The active comparator design compares the drug of interest to another commonly used agent for the same indication, rather than a ‘non-user’ group. This principle helps select treatment groups similar in treatment indications (both measured and unmeasured characteristics). The new user design includes a cohort of patients from the time of treatment initiation, so that it can assess patients’ pretreatment characteristics and capture all events occurring anytime during follow-up. PMID:25800216

  11. Evaluation of atmospheric precipitable water from reanalysis products using homogenized radiosonde observations over China

    NASA Astrophysics Data System (ADS)

    Zhao, Tianbao; Wang, Juanhuai; Dai, Aiguo

    2015-10-01

    Many multidecadal atmospheric reanalysis products are available now, but their consistencies and reliability are far from perfect. In this study, atmospheric precipitable water (PW) from the National Centers for Environmental Prediction/National Center for Atmospheric Research (NCEP/NCAR), NCEP/Department of Energy (DOE), Modern Era Retrospective-Analysis for Research and Applications (MERRA), Japanese 55 year Reanalysis (JRA-55), JRA-25, ERA-Interim, ERA-40, Climate Forecast System Reanalysis (CFSR), and 20th Century Reanalysis version 2 is evaluated against homogenized radiosonde observations over China during 1979-2012 (1979-2001 for ERA-40). Results suggest that the PW biases in the reanalyses are within ˜20% for most of northern and eastern China, but the reanalyses underestimate the observed PW by 20%-40% over western China and by ˜60% over the southwestern Tibetan Plateau. The newer-generation reanalyses (e.g., JRA25, JRA55, CFSR, and ERA-Interim) have smaller root-mean-square error than the older-generation ones (NCEP/NCAR, NCEP/DOE, and ERA-40). Most of the reanalyses reproduce well the observed PW climatology and interannual variations over China. However, few reanalyses capture the observed long-term PW changes, primarily because they show spurious wet biases before about 2002. This deficiency results mainly from the discontinuities contained in reanalysis relative humidity fields in the middle-lower troposphere due to the wet bias in older radiosonde records that are assimilated into the reanalyses. An empirical orthogonal function (EOF) analysis revealed two leading modes that represent the long-term PW changes and El Niño-Southern Oscillation-related interannual variations with robust spatial patterns. The reanalysis products, especially the MERRA and JRA-25, roughly capture these EOF modes, which account for over 50% of the total variance. The results show that even during the post-1979 satellite era, discontinuities in radiosonde data can still

  12. Self-rated and observer-rated measures of well-being and distress in adolescence: an exploratory study.

    PubMed

    Vescovelli, Francesca; Albieri, Elisa; Ruini, Chiara

    2014-01-01

    The evaluation of eudaimonic well-being in adolescence is hampered by the lack of specific assessment tools. Moreover, with younger populations, the assessment of positive functioning may be biased by self-report data only, and may be more accurate by adding significant adults' evaluations. The objective of this research was to measure adolescents' well-being and prosocial behaviours using self-rated and observer-rated instruments, and their pattern of associations. The sample included 150 Italian high school adolescents. Observed-evaluation was performed by their school teachers using the Strengths and Difficulties Questionnaire. Adolescents completed Ryff's Psychological Well-being Scales and Symptom Questionnaire. Pearson' r correlations and Linear regression were performed. Self-rated dimensions of psychological well-being significantly correlated with all observer-rated dimensions, but Strengths and Difficulties Emotional symptom scale. Multiple linear regression showed that the self-rated dimensions Environmental Mastery and Personal Growth, and surprisingly not Positive Relations, are related to the observer-rated dimension Prosocial Behaviour. Adolescents with higher levels of well-being in specific dimensions tend to be perceived as less problematic by their teachers. However, some dimensions of positive functioning present discrepancies between self and observer-rated instruments. Thus, the conjunct use of self-reports and observer-rated tools for a more comprehensive assessment of students' eudaimonic well-being is recommended.

  13. Study on the influence of ground and satellite observations on the numerical air-quality for PM10 over Romanian territory

    NASA Astrophysics Data System (ADS)

    Dumitrache, Rodica Claudia; Iriza, Amalia; Maco, Bogdan Alexandru; Barbu, Cosmin Danut; Hirtl, Marcus; Mantovani, Simone; Nicola, Oana; Irimescu, Anisoara; Craciunescu, Vasile; Ristea, Alina; Diamandi, Andrei

    2016-10-01

    The numerical forecast of particulate matter concentrations in general, and PM10 in particular is a theme of high socio-economic relevance. The aim of this study was to investigate the impact of ground and satellite data assimilation of PM10 observations into the Weather Research and Forecasting model coupled with Chemistry (WRF-CHEM) numerical air quality model for Romanian territory. This is the first initiative of the kind for this domain of interest. Assimilation of satellite information - e.g. AOT's in air quality models is of interest due to the vast spatial coverage of the observations. Support Vector Regression (SVR) techniques are used to estimate the PM content from heterogeneous data sources, including EO products (Aerosol Optical Thickness), ground measurements and numerical model data (temperature, humidity, wind, etc.). In this study we describe the modeling framework employed and present the evaluation of the impact from the data assimilation of PM10 observations on the forecast of the WRF-CHEM model. Integrations of the WRF-CHEM model in data assimilation enabled/disabled configurations allowed the evaluation of satellite and ground data assimilation impact on the PM10 forecast performance for the Romanian territory. The model integration and evaluation were performed for two months, one in winter conditions (January 2013) and one in summer conditions (June 2013).

  14. Quality Evaluation of Nursing Observation Based on a Survey of Nursing Documents Using NursingNAVI.

    PubMed

    Tsuru, Satoko; Omori, Miho; Inoue, Manami; Wako, Fumiko

    2016-01-01

    We have identified three foci of the nursing observation and nursing action respectively. Using these frameworks, we have developed the structured knowledge model for a number of diseases and medical interventions. We developed this structure based NursingNAVI® contents collaborated with some quality centred hospitals. Authors analysed the nursing care documentations of post-gastrectomy patients in light of the standardized nursing care plan in the "NursingNAVI®" developed by ourselves and revealed the "failure to observe" and "failure to document", which leaded to the volatility of the patients' data, conditions and some situation. This phenomenon should have been avoided if nurses had employed a standardized nursing care plan. So, we developed thinking process support system for planning, delivering, recording and evaluating in daily nursing using NursingNAVI® contents. It is important to identify the problem of the volatility of the patients' data, conditions and some situation. We developed a survey tool of nursing documents using NursingNAVI® Content for quality evaluation of nursing observation. We recommended some hospitals to use this survey tool. Fifteen hospitals participated the survey using this tool. It is estimated that the volatilizing situation. A hospital which don't participate this survey, knew the result. So the hospital decided to use NursingNAVI® contents in HIS. It was suggested that the system has availability for nursing OJT and time reduction of planning and recording without volatilizing situation.

  15. The BraveNet prospective observational study on integrative medicine treatment approaches for pain.

    PubMed

    Abrams, Donald I; Dolor, Rowena; Roberts, Rhonda; Pechura, Constance; Dusek, Jeffery; Amoils, Sandi; Amoils, Steven; Barrows, Kevin; Edman, Joel S; Frye, Joyce; Guarneri, Erminia; Kligler, Ben; Monti, Daniel; Spar, Myles; Wolever, Ruth Q

    2013-06-24

    Chronic pain affects nearly 116 million American adults at an estimated cost of up to $635 billion annually and is the No. 1 condition for which patients seek care at integrative medicine clinics. In our Study on Integrative Medicine Treatment Approaches for Pain (SIMTAP), we observed the impact of an integrative approach on chronic pain and a number of other related patient-reported outcome measures. Our prospective, non-randomized, open-label observational evaluation was conducted over six months, at nine clinical sites. Participants received a non-standardized, personalized, multimodal approach to chronic pain. Validated instruments for pain (severity and interference levels), quality of life, mood, stress, sleep, fatigue, sense of control, overall well-being, and work productivity were completed at baseline and at six, 12, and 24 weeks. Blood was collected at baseline and week 12 for analysis of high-sensitivity C-reactive protein and 25-hydroxyvitamin D levels. Repeated-measures analysis was performed on data to assess change from baseline at 24 weeks. Of 409 participants initially enrolled, 252 completed all follow-up visits during the 6 month evaluation. Participants were predominantly white (81%) and female (73%), with a mean age of 49.1 years (15.44) and an average of 8.0 (9.26) years of chronic pain. At baseline, 52% of patients reported symptoms consistent with depression. At 24 weeks, significantly decreased pain severity (-23%) and interference (-28%) were seen. Significant improvements in mood, stress, quality of life, fatigue, sleep and well-being were also observed. Mean 25-hydroxyvitamin D levels increased from 33.4 (17.05) ng/mL at baseline to 39.6 (16.68) ng/mL at week 12. Among participants completing an integrative medicine program for chronic pain, significant improvements were seen in pain as well as other relevant patient-reported outcome measures. ClinicalTrials.gov, NCT01186341.

  16. Globally Gridded Satellite observations for climate studies

    USGS Publications Warehouse

    Knapp, K.R.; Ansari, S.; Bain, C.L.; Bourassa, M.A.; Dickinson, M.J.; Funk, Chris; Helms, C.N.; Hennon, C.C.; Holmes, C.D.; Huffman, G.J.; Kossin, J.P.; Lee, H.-T.; Loew, A.; Magnusdottir, G.

    2011-01-01

    Geostationary satellites have provided routine, high temporal resolution Earth observations since the 1970s. Despite the long period of record, use of these data in climate studies has been limited for numerous reasons, among them that no central archive of geostationary data for all international satellites exists, full temporal and spatial resolution data are voluminous, and diverse calibration and navigation formats encumber the uniform processing needed for multisatellite climate studies. The International Satellite Cloud Climatology Project (ISCCP) set the stage for overcoming these issues by archiving a subset of the full-resolution geostationary data at ~10-km resolution at 3-hourly intervals since 1983. Recent efforts at NOAA's National Climatic Data Center to provide convenient access to these data include remapping the data to a standard map projection, recalibrating the data to optimize temporal homogeneity, extending the record of observations back to 1980, and reformatting the data for broad public distribution. The Gridded Satellite (GridSat) dataset includes observations from the visible, infrared window, and infrared water vapor channels. Data are stored in Network Common Data Format (netCDF) using standards that permit a wide variety of tools and libraries to process the data quickly and easily. A novel data layering approach, together with appropriate satellite and file metadata, allows users to access GridSat data at varying levels of complexity based on their needs. The result is a climate data record already in use by the meteorological community. Examples include reanalysis of tropical cyclones, studies of global precipitation, and detection and tracking of the intertropical convergence zone.

  17. Observer assessment of multi-pinhole SPECT geometries for prostate cancer imaging: a simulation study

    NASA Astrophysics Data System (ADS)

    Kalantari, Faraz; Sen, Anando; Gifford, Howard C.

    2014-03-01

    SPECT imaging using In-111 ProstaScint is an FDA-approved method for diagnosing prostate cancer metastases within the pelvis. However, conventional medium-energy parallel-hole (MEPAR) collimators produce poor image quality and we are investigating the use of multipinhole (MPH) imaging as an alternative. This paper presents a method for evaluating MPH designs that makes use of sampling-sensitive (SS) mathematical model observers for tumor detectionlocalization tasks. Key to our approach is the redefinition of a normal (or background) reference image that is used with scanning model observers. We used this approach to compare different MPH configurations for the task of small-tumor detection in the prostate and surrounding lymph nodes. Four configurations used 10, 20, 30, and 60 pinholes evenly spaced over a complete circular orbit. A fixed-count acquisition protocol was assumed. Spherical tumors were placed within a digital anthropomorphic phantom having a realistic Prostascint biodistribution. Imaging data sets were generated with an analytical projector and reconstructed volumes were obtained with the OSEM algorithm. The MPH configurations were compared in a localization ROC (LROC) study with 2D pelvic images and both human and model observers. Regular and SS versions of the scanning channelized nonprewhitening (CNPW) and visual-search (VS) model observers were applied. The SS models demonstrated the highest correlations with the average human-observer results

  18. Multidimensional Treatment Foster Care for Adolescents in English care: randomised trial and observational cohort evaluation.

    PubMed

    Green, J M; Biehal, N; Roberts, C; Dixon, J; Kay, C; Parry, E; Rothwell, J; Roby, A; Kapadia, D; Scott, S; Sinclair, I

    2014-03-01

    Children in care often have poor outcomes. There is a lack of evaluative research into intervention options. To examine the efficacy of Multidimensional Treatment Foster Care for Adolescents (MTFC-A) compared with usual care for young people at risk in foster care in England. A two-arm single (assessor) blinded randomised controlled trial (RCT) embedded within an observational quasi-experimental case-control study involving 219 young people aged 11-16 years (trial registration: ISRCTN 68038570). The primary outcome was the Child Global Assessment Scale (CGAS). Secondary outcomes were ratings of educational attendance, achievement and rate of offending. The MTFC-A group showed a non-significant improvement in CGAS outcome in both the randomised cohort (n = 34, adjusted mean difference 1.3, 95% CI -7.1 to 9.7, P = 0.75) and in the trimmed observational cohort (n = 185, adjusted mean difference 0.95, 95% CI -2.38 to 4.29, P = 0.57). No significant effects were seen in secondary outcomes. There was a possible differential effect of the intervention according to antisocial behaviour. There was no evidence that the use of MTFC-A resulted in better outcomes than usual care. The intervention may be more beneficial for young people with antisocial behaviour but less beneficial than usual treatment for those without.

  19. Observing System Evaluations Using GODAE Systems

    DTIC Science & Technology

    2009-09-01

    DISTRIBUTION/AVAILABILITY STATEMENT Approved for public release, distribution is unlimite 13. SUPPLEMENTARY NOTES 20091228151 14. ABSTRACT Global ocean...forecast systems, developed under the Global Ocean Data Assimilation Experiment (GODAE), are a powerful means of assessing the impact of different...components of the Global Ocean Observing System (GOOS). Using a range of analysis tools and approaches, GODAE systems are useful for quantifying the

  20. Social Studies. MicroSIFT Courseware Evaluations.

    ERIC Educational Resources Information Center

    Northwest Regional Educational Lab., Portland, OR.

    This compilation of 11 courseware evaluations gives a general overview of available social studies microcomputer courseware for students in grades 3-12. Each evaluation lists title, date, producer, date of evaluation, evaluating institution, cost, ability level, topic, medium of transfer, required hardware, required software, instructional…

  1. Evaluation of the Race/Human Relations Program: Observations--A Second Year's Look at Racial Mixing and Quality of Interactions at School Sites. Evaluation Department Report No. 370.

    ERIC Educational Resources Information Center

    Stein, Robert Christopher

    The evaluation of long-range goals of the Race/Human Relations Program of the San Diego City Schools consisted of observations to determine the degree to which racial mixing was occurring at school sites and the quality of interactions among students and adults. Fifty district employees were trained in the use of the Contextual Evaluation Form. A…

  2. Observational Learning among Older Adults Living in Nursing Homes

    ERIC Educational Resources Information Center

    Story, Colleen D.

    2010-01-01

    The purpose of this study was to evaluate learning by older adults living in nursing homes through observational learning based on Bandura's (1977) social learning theory. This quantitative study investigated if older adults could learn through observation. The nursing homes in the study were located in the midwestern United States. The…

  3. Effectiveness of Vildagliptin in Clinical Practice: Pooled Analysis of Three Korean Observational Studies (the VICTORY Study)

    PubMed Central

    Suh, Sunghwan; Song, Sun Ok; Kim, Jae Hyeon; Cho, Hyungjin

    2017-01-01

    The present observational study aimed to evaluate the clinical effectiveness of vildagliptin with metformin in Korean patients with type 2 diabetes mellitus (T2DM). Data were pooled from the vildagliptin postmarketing survey (PMS), the vildagliptin/metformin fixed drug combination (DC) PMS, and a retrospective observational study of vildagliptin/metformin (fixed DC or free DC). The effectiveness endpoint was the proportion of patients who achieved a glycemic target (HbA1c) of ≤7.0% at 24 weeks. In total, 4303 patients were included in the analysis; of these, 2087 patients were eligible. The mean patient age was 56.99 ± 11.25 years. Overall, 58.94% patients achieved an HbA1c target of ≤7.0% at 24 weeks. The glycemic target achievement rate was significantly greater in patients with baseline HbA1c < 7.5% versus ≥7.5% (84.64% versus 43.97%), receiving care at the hospital versus clinic (67.95% versus 52.33%), and receiving vildagliptin/metformin fixed DC versus free DC (70.69% versus 55.42%). Multivariate logistic regression analysis indicated that disease duration (P < 0.0001), baseline HbA1c (P < 0.0001), and DC type (P = 0.0103) had significant effects on drug effectiveness. Vildagliptin plus metformin appeared as an effective treatment option for patients with T2DM in clinical practice settings in Korea. PMID:29057274

  4. Large Controlled Observational Study on Remote Monitoring of Pacemakers and Implantable Cardiac Defibrillators: A Clinical, Economic, and Organizational Evaluation.

    PubMed

    Dario, Claudio; Delise, Pietro; Gubian, Lorenzo; Saccavini, Claudio; Brandolino, Glauco; Mancin, Silvia

    2016-01-13

    Patients with implantable devices such as pacemakers (PMs) and implantable cardiac defibrillators (ICDs) should be followed up every 3-12 months, which traditionally required in-clinic visits. Innovative devices allow data transmission and technical or medical alerts to be sent from the patient's home to the physician (remote monitoring). A number of studies have shown its effectiveness in timely detection and management of both clinical and technical events, and endorsed its adoption. Unfortunately, in daily practice, remote monitoring has been implemented in uncoordinated and rather fragmented ways, calling for a more strategic approach. The objective of the study was to analyze the impact of remote monitoring for PM and ICD in a "real world" context compared with in-clinic follow-up. The evaluation focuses on how this service is carried out by Local Health Authorities, the impact on the cardiology unit and the health system, and organizational features promoting or hindering its effectiveness and efficiency. A multi-center, multi-vendor, controlled, observational, prospective study was conducted to analyze the impact of remote monitoring implementation. A total of 2101 patients were enrolled in the study: 1871 patients were followed through remote monitoring of PM/ICD (I-group) and 230 through in-clinic visits (U-group). The follow-up period was 12 months. In-clinic device follow-ups and cardiac visits were significantly lower in the I-group compared with the U-group, respectively: PM, I-group = 0.43, U-group = 1.07, P<.001; ICD, I-group = 0.98, U-group = 2.14, P<.001. PM, I-group = 0.37, U-group = 0.85, P<.001; ICD, I-group = 1.58, U-group = 1.69, P=.01. Hospitalizations for any cause were significantly lower in the I-group for PM patients only (I-group = 0.37, U-group = 0.50, P=.005). There were no significant differences regarding use of the emergency department for both PM and ICD patients. In the I-group, 0.30 (PM) and 0.37 (ICD) real clinical events per

  5. Optimization of medical imaging display systems: using the channelized Hotelling observer for detecting lung nodules: experimental study

    NASA Astrophysics Data System (ADS)

    Platisa, Ljiljana; Vansteenkiste, Ewout; Goossens, Bart; Marchessoux, Cédric; Kimpe, Tom; Philips, Wilfried

    2009-02-01

    Medical-imaging systems are designed to aid medical specialists in a specific task. Therefore, the physical parameters of a system need to optimize the task performance of a human observer. This requires measurements of human performance in a given task during the system optimization. Typically, psychophysical studies are conducted for this purpose. Numerical observer models have been successfully used to predict human performance in several detection tasks. Especially, the task of signal detection using a channelized Hotelling observer (CHO) in simulated images has been widely explored. However, there are few studies done for clinically acquired images that also contain anatomic noise. In this paper, we investigate the performance of a CHO in the task of detecting lung nodules in real radiographic images of the chest. To evaluate variability introduced by the limited available data, we employ a commonly used study of a multi-reader multi-case (MRMC) scenario. It accounts for both case and reader variability. Finally, we use the "oneshot" methods to estimate the MRMC variance of the area under the ROC curve (AUC). The obtained AUC compares well to those reported for human observer study on a similar data set. Furthermore, the "one-shot" analysis implies a fairly consistent performance of the CHO with the variance of AUC below 0.002. This indicates promising potential for numerical observers in optimization of medical imaging displays and encourages further investigation on the subject.

  6. Inter-observer agreement improves with PERCIST 1.0 as opposed to qualitative evaluation in non-small cell lung cancer patients evaluated with F-18-FDG PET/CT early in the course of chemo-radiotherapy.

    PubMed

    Fledelius, Joan; Khalil, Azza; Hjorthaug, Karin; Frøkiær, Jørgen

    2016-12-01

    The purpose of this study is to determine whether a qualitative approach or a semi-quantitative approach provides the most robust method for early response evaluation with 2'-deoxy-2'-[(18)F]fluoro-D-glucose (F-18-FDG) positron emission tomography combined with whole body computed tomography (PET/CT) in non-small cell lung cancer (NSCLC). In this study eight Nuclear Medicine consultants analyzed F-18-FDG PET/CT scans from 35 patients with locally advanced NSCLC. Scans were performed at baseline and after 2 cycles of chemotherapy. Each observer used two different methods for evaluation: (1) PET response criteria in solid tumors (PERCIST) 1.0 and (2) a qualitative approach. Both methods allocate patients into one of four response categories (complete and partial metabolic response (CMR and PMR) and stable and progressive metabolic disease (SMD and PMD)). The inter-observer agreement was evaluated using Fleiss' kappa for multiple raters, Cohens kappa for comparison of the two methods, and intraclass correlation coefficients (ICC) for comparison of lean body mass corrected standardized uptake value (SUL) peak measurements. The agreement between observers when determining the percentage change in SULpeak was "almost perfect", with ICC = 0.959. There was a strong agreement among observers allocating patients to the different response categories with a Fleiss kappa of 0.76 (0.71-0.81). In 22 of the 35 patients, complete agreement was observed with PERCIST 1.0. The agreement was lower when using the qualitative method, moderate, having a Fleiss kappa of 0.60 (0.55-0.64). Complete agreement was achieved in only 10 of the 35 patients. The difference between the two methods was statistically significant (p < 0.005) (chi-squared). Comparing the two methods for each individual observer showed Cohen's kappa values ranging from 0.64 to 0.79, translating into a strong agreement between the two methods. PERCIST 1.0 provides a higher overall agreement between observers

  7. Workplace Education Initiative: Case Studies and Observations.

    ERIC Educational Resources Information Center

    Astrein, Bruce; And Others

    Seven workplace education projects funded in the first year of the Massachusetts Workplace Education Initiative are reported. This report includes both general observations and specific information in case studies of the projects. Overall information is provided on students served, the importance of partnerships, the emphasis on…

  8. Guiding the Design of Evaluations of Innovations in Health Informatics: a Framework and a Case Study of the SMArt SHARP Evaluation

    PubMed Central

    Ramly, Edmond; Brennan, Patricia Flatley

    2012-01-01

    Development of health information systems innovations is necessary to create a better future for health and health care, but evaluating them is challenging. This paper examines the problem of evaluating health IT projects in which innovation is agile, adaptive, and emergent, and in which innovation diffusion and production are interlinked. We introduce a typology of mindsets for evaluation design that are typically used in health informatics: optimality, contingency, and usefulness, and make the case for a modularity mindset. We propose a model that shifts the unit of analysis from an evaluation as a whole, to specific modules of an evaluation, such as purpose, target, and methods. We then use retrospective participant observation to illustrate the approach using a case study: the ONC SHARP Harvard project developing the SMArt platform (smartplaforms.org). We find that the proposed modular approach to evaluation design provides a balanced alternative to standard archetypical designs on the one hand, and fully custom-made designs, on the other hand. PMID:23304417

  9. Evaluation of satellite-retrieved extreme precipitation using gauge observations

    NASA Astrophysics Data System (ADS)

    Lockhoff, M.; Zolina, O.; Simmer, C.; Schulz, J.

    2012-04-01

    Precipitation extremes have already been intensively studied employing rain gauge datasets. Their main advantage is that they represent a direct measurement with a relatively high temporal coverage. Their main limitation however is their poor spatial coverage and thus a low representativeness in many parts of the world. In contrast, satellites can provide global coverage and there are meanwhile data sets available that are on one hand long enough to be used for extreme value analysis and that have on the other hand the necessary spatial and temporal resolution to capture extremes. However, satellite observations provide only an indirect mean to determine precipitation and there are many potential observational and methodological weaknesses in particular over land surfaces that may constitute doubts concerning their usability for the analysis of precipitation extremes. By comparing basic climatological metrics of precipitation (totals, intensities, number of wet days) as well as respective characteristics of PDFs, absolute and relative extremes of satellite and observational data this paper aims at assessing to which extent satellite products are suitable for analysing extreme precipitation events. In a first step the assessment focuses on Europe taking into consideration various satellite products available, e.g. data sets provided by the Global Precipitation Climatology Project (GPCP). First results indicate that satellite-based estimates do not only represent the monthly averaged precipitation very similar to rain gauge estimates but they also capture the day-to-day occurrence fairly well. Larger differences can be found though when looking at the corresponding intensities.

  10. Task Equivalence for Model and Human-Observer Comparisons in SPECT Localization Studies

    NASA Astrophysics Data System (ADS)

    Sen, Anando; Kalantari, Faraz; Gifford, Howard C.

    2016-06-01

    While mathematical model observers are intended for efficient assessment of medical imaging systems, their findings should be relevant for human observers as the primary clinical end users. We have investigated whether pursuing equivalence between the model and human-observer tasks can help ensure this goal. A localization receiver operating characteristic (LROC) study tested prostate lesion detection in simulated In-111 SPECT imaging with anthropomorphic phantoms. The test images were 2D slices extracted from reconstructed volumes. The iterative ordered sets expectation-maximization (OSEM) reconstruction algorithm was used with Gaussian postsmoothing. Variations in the number of iterations and the level of postfiltering defined the test strategies in the study. Human-observer performance was compared with that of a visual-search (VS) observer, a scanning channelized Hotelling observer, and a scanning channelized nonprewhitening (CNPW) observer. These model observers were applied with precise information about the target regions of interest (ROIs). ROI knowledge was a study variable for the human observers. In one study format, the humans read the SPECT image alone. With a dual-modality format, the SPECT image was presented alongside an anatomical image slice extracted from the density map of the phantom. Performance was scored by area under the LROC curve. The human observers performed significantly better with the dual-modality format, and correlation with the model observers was also improved. Given the human-observer data from the SPECT study format, the Pearson correlation coefficients for the model observers were 0.58 (VS), -0.12 (CH), and -0.23 (CNPW). The respective coefficients based on the human-observer data from the dual-modality study were 0.72, 0.27, and -0.11. These results point towards the continued development of the VS observer for enhancing task equivalence in model-observer studies.

  11. Can Principals Promote Teacher Development as Evaluators? A Case Study of Principals' Views and Experiences.

    PubMed

    Kraft, Matthew A; Gilmour, Allison

    2016-12-01

    New teacher evaluation systems have expanded the role of principals as instructional leaders, but little is known about principals' ability to promote teacher development through the evaluation process. We conducted a case study of principals' perspectives on evaluation and their experiences implementing observation and feedback cycles to better understand whether principals feel as though they are able to promote teacher development as evaluators. We conducted interviews with a stratified random sample of 24 principals in an urban district that recently implemented major reforms to its teacher evaluation system. We analyzed these interviews by drafting thematic summaries, coding interview transcripts, creating data-analytic matrices, and writing analytic memos. We found that the evaluation reforms provided a common framework and language that helped facilitate principals' feedback conversations with teachers. However, we also found that tasking principals with primary responsibility for conducting evaluations resulted in a variety of unintended consequences which undercut the quality of evaluation feedback they provided. We analyze five broad solutions to these challenges: strategically targeting evaluations, reducing operational responsibilities, providing principal training, hiring instructional coaches, and developing peer evaluation systems. The quality of feedback teachers receive through the evaluation process depends critically on the time and training evaluators have to provide individualized and actionable feedback. Districts that task principals with primary responsibility for conducting observation and feedback cycles must attend to the many implementation challenges associated with this approach in order for next-generation evaluation systems to successfully promote teacher development.

  12. Prospective Observational Study of Implantable Cardioverter‐Defibrillators in Primary Prevention of Sudden Cardiac Death: Study Design and Cohort Description

    PubMed Central

    Cheng, Alan; Dalal, Darshan; Butcher, Barbara; Norgard, Sanaz; Zhang, Yiyi; Dickfeld, Timm; Eldadah, Zayd A.; Ellenbogen, Kenneth A.; Guallar, Eliseo; Tomaselli, Gordon F.

    2013-01-01

    Background Primary‐prevention implantable cardioverter‐defibrillators (ICDs) reduce total mortality in patients with severe left ventricular systolic function. However, only a minority of patients benefit from these devices. We designed the Prospective Observational Study of Implantable Cardioverter‐Defibrillators (PROSE‐ICD) to identify risk factors and enhance our understanding of the biological mechanisms that predispose to arrhythmic death in patients undergoing ICD implantation for primary prevention of sudden death. Methods and Results This is a multicenter prospective cohort study with a target enrollment of 1200 patients. The primary end point is ICD shocks for adjudicated ventricular tachyarrhythmias. The secondary end point is total mortality. All patients undergo a comprehensive evaluation including history and physical examination, signal‐averaged electrocardiograms, and blood sampling for genomic, proteomic, and metabolomic analyses. Patients are evaluated every 6 months and after every known ICD shock for additional electrocardiographic and blood sampling. As of December 2011, a total of 1177 patients have been enrolled with more nonwhite and female patients compared to previous randomized trials. A total of 143 patients have reached the primary end point, whereas a total of 260 patients died over an average follow‐up of 59 months. The PROSE‐ICD study represents a real‐world cohort of individuals with systolic heart failure receiving primary‐prevention ICDs. Conclusions Extensive electrophysiological and structural phenotyping as well as the availability of serial DNA and serum samples will be important resources for evaluating novel metrics for risk stratification and identifying patients at risk for arrhythmic sudden death. Clinical Trial Registration URL: http://clinicaltrials.gov/ Unique Identifier: NCT00733590. PMID:23525420

  13. Exposure to fluoride in drinking water and hip fracture risk: a meta-analysis of observational studies.

    PubMed

    Yin, Xin-Hai; Huang, Guang-Lei; Lin, Du-Ren; Wan, Cheng-Cheng; Wang, Ya-Dong; Song, Ju-Kun; Xu, Ping

    2015-01-01

    Many observational studies have shown that exposure to fluoride in drinking water is associated with hip fracture risk. However, the findings are varied or even contradictory. In this work, we performed a meta-analysis to assess the relationship between fluoride exposure and hip fracture risk. PubMed and EMBASE databases were searched to identify relevant observational studies from the time of inception until March 2014 without restrictions. Data from the included studies were extracted and analyzed by two authors. Summary relative risks (RRs) with corresponding 95% confidence intervals (CIs) were pooled using random- or fixed-effects models as appropriate. Sensitivity analyses and meta-regression were conducted to explore possible explanations for heterogeneity. Finally, publication bias was assessed. Fourteen observational studies involving thirteen cohort studies and one case-control study were included in the meta-analysis. Exposure to fluoride in drinking water does not significantly increase the incidence of hip fracture (RRs, 1.05; 95% CIs, 0.96-1.15). Sensitivity analyses based on adjustment for covariates, effect measure, country, sex, sample size, quality of Newcastle-Ottawa Scale scores, and follow-up period validated the strength of the results. Meta-regression showed that country, gender, quality of Newcastle-Ottawa Scale scores, adjustment for covariates and sample size were not sources of heterogeneity. Little evidence of publication bias was observed. The present meta-analysis suggests that chronic fluoride exposure from drinking water does not significantly increase the risk of hip fracture. Given the potential confounding factors and exposure misclassification, further large-scale, high-quality studies are needed to evaluate the association between exposure to fluoride in drinking water and hip fracture risk.

  14. Exposure to Fluoride in Drinking Water and Hip Fracture Risk: A Meta-Analysis of Observational Studies

    PubMed Central

    Yin, Xin-Hai; Huang, Guang-Lei; Lin, Du-Ren; Wan, Cheng-Cheng; Wang, Ya-Dong; Song, Ju-Kun; Xu, Ping

    2015-01-01

    Background Many observational studies have shown that exposure to fluoride in drinking water is associated with hip fracture risk. However, the findings are varied or even contradictory. In this work, we performed a meta-analysis to assess the relationship between fluoride exposure and hip fracture risk. Methods PubMed and EMBASE databases were searched to identify relevant observational studies from the time of inception until March 2014 without restrictions. Data from the included studies were extracted and analyzed by two authors. Summary relative risks (RRs) with corresponding 95% confidence intervals (CIs) were pooled using random- or fixed-effects models as appropriate. Sensitivity analyses and meta-regression were conducted to explore possible explanations for heterogeneity. Finally, publication bias was assessed. Results Fourteen observational studies involving thirteen cohort studies and one case-control study were included in the meta-analysis. Exposure to fluoride in drinking water does not significantly increase the incidence of hip fracture (RRs, 1.05; 95% CIs, 0.96–1.15). Sensitivity analyses based on adjustment for covariates, effect measure, country, sex, sample size, quality of Newcastle–Ottawa Scale scores, and follow-up period validated the strength of the results. Meta-regression showed that country, gender, quality of Newcastle–Ottawa Scale scores, adjustment for covariates and sample size were not sources of heterogeneity. Little evidence of publication bias was observed. Conclusion The present meta-analysis suggests that chronic fluoride exposure from drinking water does not significantly increase the risk of hip fracture. Given the potential confounding factors and exposure misclassification, further large-scale, high-quality studies are needed to evaluate the association between exposure to fluoride in drinking water and hip fracture risk. PMID:26020536

  15. Evaluation of GPM candidate algorithms on hurricane observations

    NASA Astrophysics Data System (ADS)

    Le, M.; Chandrasekar, C. V.

    2012-12-01

    The observation of precipitation on a global scale by the Tropical Rain Measuring Mission (TRMM) precipitation radar (PR) and has enabled a large scale study of precipitation over ocean, especially tropical storms. The three-dimensional downward-looking observation characteristic of the TRMM-PR makes it possible to study the vertical structure of tropical storms. The global precipitation measuring mission (GPM) will be the second mission following the success of TRMM. The GPM Mission extends tropical storm tracking and forecasting capabilities into the middle and high latitudes, covering the area from 65° S to 65°N. This orbit will provide new insight into how and why some tropical storm intensify and others weaken as they move from tropical to mid-latitude systems. The GPM core satellite will be equipped with a dual-frequency precipitation radar (DPR) operating at K_u (13.6 GHz) and K_a (35.5 GHz) band. DPR on aboard the GPM core satellite is expected to improve our knowledge of precipitation processes relative to the single-frequency (K_u band) radar used in TRMM by providing greater dynamic range, more detailed information on microphysics, and better accuracies in rainfall retrievals. New K_a band channel observation of DPR will help to improve the detection thresholds for light rain and snow relative to TRMM PR [1]. The dual-frequency signals will allow us to better distinguish regions of liquid, frozen, and mixed-phase precipitation. In the GPM era, storms could be better tracked and characterized. In support the NASA GPM mission, NASA JPL (Jet Propulsion Lab) developed the 2nd generation Airborne Precipitation Radar (APR-2) as a prototype of advanced dual-frequency space radar which emulates DPR on board the GPM core satellite before it is launched. GRIP (Genesis and Rapid Intensification Processes) is the most recent campaign of APR-2 conducted in the year 2010 located in Golf of Mexico and Caribbean sea with the major goal to better understand tropical

  16. Results of scatterometer systems analysis for NASA/MSC Earth Observation Sensor Evaluation Program.

    NASA Technical Reports Server (NTRS)

    Krishen, K.; Vlahos, N.; Brandt, O.; Graybeal, G.

    1971-01-01

    Radar scatterometers have applications in the NASA/MSC Earth Observation Aircraft Program. Over a period of several years, several missions have been flown over both land and ocean. In this paper a system evaluation of the NASA/MSC 13.3-GHz Scatterometer System is presented. The effects of phase error between the Scatterometer channels, antenna pattern deviations, aircraft attitude deviations, environmental changes, and other related factors such as processing errors, system repeatability, and propeller modulation, were established. Furthermore, the reduction in system errors and calibration improvement was investigated by taking into account these parameter deviations. Typical scatterometer data samples are presented.

  17. Teacher Effectiveness and Causal Inference in Observational Studies

    ERIC Educational Resources Information Center

    Rose, Roderick A.

    2013-01-01

    An important target of education policy is to improve overall teacher effectiveness using evidence-based policies. Randomized control trials (RCTs), which randomly assign study participants or groups of participants to treatment and control conditions, are not always practical or possible and observational studies using rigorous quasi-experimental…

  18. A Randomized Controlled Study of Art Observation Training to Improve Medical Student Ophthalmology Skills.

    PubMed

    Gurwin, Jaclyn; Revere, Karen E; Niepold, Suzannah; Bassett, Barbara; Mitchell, Rebecca; Davidson, Stephanie; DeLisser, Horace; Binenbaum, Gil

    2018-01-01

    Observation and description are critical to the practice of medicine, and to ophthalmology in particular. However, medical education does not provide explicit training in these areas, and medical students are often criticized for deficiencies in these skills. We sought to evaluate the effects of formal observation training in the visual arts on the general and ophthalmologic observational skills of medical students. Randomized, single-masked, controlled trial. Thirty-six first-year medical students, randomized 1:1 into art-training and control groups. Students in the art-training group were taught by professional art educators at the Philadelphia Museum of Art, during 6 custom-designed, 1.5-hour art observation sessions over a 3-month period. All subjects completed pre- and posttesting, in which they described works of art, retinal pathology images, and external photographs of eye diseases. Grading of written descriptions for observational and descriptive abilities by reviewers using an a priori rubric and masked to group assignment and pretesting/posttesting status. Observational skills, as measured by description testing, improved significantly in the training group (mean change +19.1 points) compared with the control group (mean change -13.5 points), P = 0.001. There were significant improvements in the training vs. control group for each of the test subscores. In a poststudy questionnaire, students reported applying the skills they learned in the museum in clinically meaningful ways at medical school. Art observation training for first-year medical students can improve clinical ophthalmology observational skills. Principles from the field of visual arts, which is reputed to excel in teaching observation and descriptive abilities, can be successfully applied to medical training. Further studies can examine the impact of such training on clinical care. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  19. Review of quality assessment tools for the evaluation of pharmacoepidemiological safety studies

    PubMed Central

    Neyarapally, George A; Hammad, Tarek A; Pinheiro, Simone P; Iyasu, Solomon

    2012-01-01

    Objectives Pharmacoepidemiological studies are an important hypothesis-testing tool in the evaluation of postmarketing drug safety. Despite the potential to produce robust value-added data, interpretation of findings can be hindered due to well-recognised methodological limitations of these studies. Therefore, assessment of their quality is essential to evaluating their credibility. The objective of this review was to evaluate the suitability and relevance of available tools for the assessment of pharmacoepidemiological safety studies. Design We created an a priori assessment framework consisting of reporting elements (REs) and quality assessment attributes (QAAs). A comprehensive literature search identified distinct assessment tools and the prespecified elements and attributes were evaluated. Primary and secondary outcome measures The primary outcome measure was the percentage representation of each domain, RE and QAA for the quality assessment tools. Results A total of 61 tools were reviewed. Most tools were not designed to evaluate pharmacoepidemiological safety studies. More than 50% of the reviewed tools considered REs under the research aims, analytical approach, outcome definition and ascertainment, study population and exposure definition and ascertainment domains. REs under the discussion and interpretation, results and study team domains were considered in less than 40% of the tools. Except for the data source domain, quality attributes were considered in less than 50% of the tools. Conclusions Many tools failed to include critical assessment elements relevant to observational pharmacoepidemiological safety studies and did not distinguish between REs and QAAs. Further, there is a lack of considerations on the relative weights of different domains and elements. The development of a quality assessment tool would facilitate consistent, objective and evidence-based assessments of pharmacoepidemiological safety studies. PMID:23015600

  20. Observing position and movements in hydrotherapy: a pilot study.

    PubMed

    Stark, Mary Ann; Rudell, Barb; Haus, George

    2008-01-01

    To observe and describe the positions and movements women choose while immersed in water during the first stage of labor. Descriptive, observational pilot study. A rural community hospital that provided hydrotherapy in labor. Women (N = 7) who intended to use hydrotherapy in labor were recruited prenatally from a midwife-managed practice. For 15 minutes of each hour during the first stage of labor, position and movements of the participants were observed and recorded on a laptop computer. The observational tool was developed for this study from a review of the literature and interviews with nursing experts; 435 observations were recorded. Women were free to choose when and how long to use hydrotherapy and had no restriction on their positions and movements. Only 3 of the 7 participants labored in the tub. Women demonstrated a greater range of positions and movements in the tub than in bed, both throughout labor and during late first-stage labor (7-10 cm of dilatation). Women had more contractions and made more rhythmic movements while in the tub than in bed. Hydrotherapy may encourage upright positions and movements that facilitate labor progress and coping, helping women avoid unnecessary interventions.

  1. A Prospective, Open-Label, Observational, Postmarket Study Evaluating VYC-17.5L for the Correction of Moderate to Severe Nasolabial Folds Over 12 Months

    PubMed Central

    Sattler, Gerhard; Philipp-Dormston, Wolfgang G.; Van Den Elzen, Helga; Van Der Walt, Cornelius; Nathan, Myooran; Kerson, Graeme; Dhillon, Benjeev

    2017-01-01

    BACKGROUND VYC-17.5L (17.5 mg/mL hyaluronic acid, 0.3% lidocaine) is a dermal filler intended for deep dermis injection for the treatment of skin depressions. OBJECTIVE To evaluate 12-month effectiveness and safety of VYC-17.5L for the treatment of moderate/severe nasolabial folds (NLFs). METHODS Subjects ≥18 years old with moderate/severe NLFs were recruited (N = 70). Injected volume was aimed at achieving optimum correction; top-up treatment was given at 2 weeks if needed. The primary endpoint was investigator-assessed change in NLF severity over 12 months using the validated photonumeric NLF Severity Scale. Secondary endpoints included investigator- and subject-assessed satisfaction and safety. Adverse events judged to be more severe or prolonged than routinely observed were recorded. RESULTS Sixty-five subjects completed study requirements. Mean volume injected was 3.0 ± 1.0 mL for both NLFs combined. Significant improvement was maintained in investigator-assessed NLF severity at 12 months, and investigators and subjects reported high satisfaction with VYC-17.5L throughout the study. Two unexpected adverse events were reported: (1) redness, swelling, and decreased sensitivity (resolved after 4 days) and (2) swelling (resolved after 48 hours); neither event was serious or life threatening. CONCLUSION VYC-17.5L is effective and well tolerated for the treatment of moderate to severe NLFs for 1 year. PMID:28165349

  2. Ethics reflection groups in community health services: an evaluation study.

    PubMed

    Lillemoen, Lillian; Pedersen, Reidar

    2015-04-17

    Systematic ethics support in community health services in Norway is in the initial phase. There are few evaluation studies about the significance of ethics reflection on care. The aim of this study was to evaluate systematic ethics reflection in groups in community health (including nursing homes and residency), - from the perspectives of employees participating in the groups, the group facilitators and the service managers. The reflection groups were implemented as part of a research and development project. A mixed-methods design with qualitative focus group interviews, observations and written reports were used to evaluate. The study was conducted at two nursing homes, two home care districts and a residence for people with learning disabilities. Participants were employees, facilitators and service managers. The study was guided by ethical standard principles and was approved by the Norwegian Social Science Data Services. We found support for ethics reflection as a valuable measure to strengthen clinical practice. New and improved solutions, more cooperation between employees, and improved collaboration with patients and their families are some of the results. No negative experiences were found. Instead, the ethics reflection based on experiences and challenges in the workplace, was described as a win-win situation. The evaluation also revealed what is needed to succeed and useful tips for further development of ethics support in community health services. Ethics reflection groups focusing on ethical challenges from the participants' daily work were found to be significant for improved practice, collegial support and cooperation, personal and professional development among staff, facilitators and managers. Resources needed to succeed were managerial support, and anchoring ethics sessions in the routine of daily work.

  3. Emotion dysregulation and dyadic conflict in depressed and typical adolescents: Evaluating concordance across psychophysiological and observational measures

    PubMed Central

    Crowell, Sheila E.; Baucom, Brian R.; Yaptangco, Mona; Bride, Daniel; Hsiao, Ray; McCauley, Elizabeth; Beauchaine, Theodore P.

    2014-01-01

    Many depressed adolescents experience difficulty regulating their emotions. These emotion regulation difficulties appear to emerge in part from socialization processes within families and then generalize to other contexts. However, emotion dysregulation is typically assessed within the individual, rather than in the social relationships that shape and maintain dysregulation. In this study, we evaluated concordance of physiological and observational measures of emotion dysregulation during interpersonal conflict, using a multilevel actor-partner interdependence model (APIM). Participants were 75 mother-daughter dyads, including 50 depressed adolescents with or without a history of self-injury, and 25 typically developing controls. Behavior dysregulation was operationalized as observed aversiveness during a conflict discussion, and physiological dysregulation was indexed by respiratory sinus arrhythmia (RSA). Results revealed different patterns of concordance for control versus depressed participants. Controls evidenced a concordant partner (between-person) effect, and showed increased physiological regulation during minutes when their partner was more aversive. In contrast, clinical dyad members displayed a concordant actor (within-person) effect, becoming simultaneously physiologically and behaviorally dysregulated. Results inform current understanding of emotion dysregulation across multiple levels of analysis. PMID:24607894

  4. Advanced Earth Observation System Instrumentation Study (aeosis)

    NASA Technical Reports Server (NTRS)

    White, R.; Grant, F.; Malchow, H.; Walker, B.

    1975-01-01

    Various types of measurements were studied for estimating the orbit and/or attitude of an Earth Observation Satellite. An investigation was made into the use of known ground targets in the earth sensor imagery, in combination with onboard star sightings and/or range and range rate measurements by ground tracking stations or tracking satellites (TDRSS), to estimate satellite attitude, orbital ephemeris, and gyro bias drift. Generalized measurement equations were derived for star measurements with a particular type of star tracker, and for landmark measurements with a multispectral scanner being proposed for an advanced Earth Observation Satellite. The use of infra-red horizon measurements to estimate the attitude and gyro bias drift of a geosynchronous satellite was explored.

  5. Statins in the prevention of venous thromboembolism: a meta-analysis of observational studies.

    PubMed

    Pai, Menaka; Evans, Natalie S; Shah, Sanjiv J; Green, David; Cook, Deborah; Crowther, Mark A

    2011-11-01

    Studies have established a relationship between inflammation and venous thromboembolism (VTE). Though statins modulate inflammation, it is uncertain if they prevent VTE in heterogeneous populations. A recent randomized trial demonstrated that statins prevent VTE in healthy older adults, yet this has not been well established in other groups, including younger individuals and individuals with comorbidities. The objective of this meta-analysis was to estimate the effect of statins on VTE in a heterogeneous group of adults. We systematically reviewed the effect of statins in preventing VTE in adult inpatients and outpatients. We systematically searched MEDLINE (1966-Jan 2010), EMBASE (1980-Jan 2010), Google Scholar, Cochrane Library, PapersFirst, ProceedingsFirst, and ISI Web of Science, manually reviewed references, and contacted experts. Observational studies that compared any dose of statin to no statin or placebo, examined inpatients or outpatients, and assessed VTE, pulmonary embolism, and/or deep vein thrombosis were included. Study selection, data abstraction and study quality evaluation (using the Newcastle-Ottawa Scale) were independently conducted in duplicate. Four cohort studies and four case-control studies met criteria. Comparing statins to control, the odds ratio for VTE was 0.67 (95% confidence interval 0.53, 0.84), and for deep vein thrombosis was 0.53 (95% confidence interval 0.22, 1.29). The association was attenuated in lower-quality studies and studies enrolling older individuals. Further well-designed trials are needed to evaluate the risks and benefits of statins in preventing VTE in heterogenous populations of adults, identify high-risk subgroups, and analyze cost-effectiveness of statin use for this indication. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Robotic and clinical evaluation of upper limb motor performance in patients with Friedreich's Ataxia: an observational study.

    PubMed

    Germanotta, Marco; Vasco, Gessica; Petrarca, Maurizio; Rossi, Stefano; Carniel, Sacha; Bertini, Enrico; Cappa, Paolo; Castelli, Enrico

    2015-04-23

    Friedreich's ataxia (FRDA) is the most common hereditary autosomal recessive form of ataxia. In this disease there is early manifestation of gait ataxia, and dysmetria of the arms and legs which causes impairment in daily activities that require fine manual dexterity. To date there is no cure for this disease. Some novel therapeutic approaches are ongoing in different steps of clinical trial. Development of sensitive outcome measures is crucial to prove therapeutic effectiveness. The aim of the study was to assess the reliability and sensitivity of quantitative and objective assessment of upper limb performance computed by means of the robotic device and to evaluate the correlation with clinical and functional markers of the disease severity. Here we assess upper limb performances by means of the InMotion Arm Robot, a robot designed for clinical neurological applications, in a cohort of 14 children and young adults affected by FRDA, matched for age and gender with 18 healthy subjects. We focused on the analysis of kinematics, accuracy, smoothness, and submovements of the upper limb while reaching movements were performed. The robotic evaluation of upper limb performance consisted of planar reaching movements performed with the robotic system. The motors of the robot were turned off, so that the device worked as a measurement tool. The status of the disease was scored using the Scale for the Assessment and Rating of Ataxia (SARA). Relationships between robotic indices and a range of clinical and disease characteristics were examined. All our robotic indices were significantly different between the two cohorts except for two, and were highly and reliably discriminative between healthy and subjects with FRDA. In particular, subjects with FRDA exhibited slower movements as well as loss of accuracy and smoothness, which are typical of the disease. Duration of Movement, Normalized Jerk, and Number of Submovements were the best discriminative indices, as they were

  7. Assessing Multi-year Changes in Modeled and Observed Urban NOx Concentrations from a Dynamic Model Evaluation Perspective

    EPA Science Inventory

    An investigation of the concentrations of nitrogen oxides (NOx) from an air quality model and observations at monitoring sites was performed to assess the changes in NOx levels attributable to changes in mobile emissions. This evaluation effort focused on weekday morning rush hou...

  8. Evaluating Microphysics in Cloud-Resolving Models using TRMM and Ground-based Precipitation Radar Observations

    NASA Astrophysics Data System (ADS)

    Krueger, S. K.; Zulauf, M. A.; Li, Y.; Zipser, E. J.

    2005-05-01

    Global satellite datasets such as those produced by ISCCP, ERBE, and CERES provide strong observational constraints on cloud radiative properties. Such observations have been widely used for model evaluation, tuning, and improvement. Cloud radiative properties depend primarily on small, non-precipitating cloud droplets and ice crystals, yet the dynamical, microphysical and radiative processes which produce these small particles often involve large, precipitating hydrometeors. There now exists a global dataset of tropical cloud system precipitation feature (PF) properties, collected by TRMM and produced by Steve Nesbitt, that provides additional observational constraints on cloud system properties. We are using the TRMM PF dataset to evaluate the precipitation microphysics of two simulations of deep, precipitating, convective cloud systems: one is a 29-day summertime, continental case (ARM Summer 1997 SCM IOP, at the Southern Great Plains site); the second is a tropical maritime case: the Kwajalein MCS of 11-12 August 1999 (part of a 52-day simulation). Both simulations employed the same bulk, three-ice category microphysical parameterization (Krueger et al. 1995). The ARM simulation was executed using the UCLA/Utah 2D CRM, while the KWAJEX simulation was produced using the 3D CSU CRM (SAM). The KWAJEX simulation described above is compared with both the actual radar data and the TRMM statistics. For the Kwajalein MCS of 11 to 12 August 1999, there are research radar data available for the lifetime of the system. This particular MCS was large in size and rained heavily, but it was weak to average in measures of convective intensity, against the 5-year TRMM sample of 108. For the Kwajalein MCS simulation, the 20 dBZ contour is at 15.7 km and the 40 dBZ contour at 14.5 km! Of all 108 MCSs observed by TRMM, the highest value for the 40 dBZ contour is 8 km. Clearly, the high reflectivity cores are off scale compared with observed cloud systems in this area. A similar

  9. The no-observed-adverse-effect-level in drug safety evaluations: use, issues, and definition(s).

    PubMed

    Dorato, Michael A; Engelhardt, Jeffery A

    2005-08-01

    The no-observed-adverse-effect-level (NOAEL) is an important part of the non-clinical risk assessment. It is a professional opinion based on the design of the study, indication of the drug, expected pharmacology, and spectrum of off-target effects. There is no consistent standard definition of NOAEL. This is based, in part, on the varied definitions of what constitutes an adverse effect. Toxicologists, either investigating or reviewing, have not been consistent in defining an effect as either adverse or acceptable. The common definition of NOAEL, "the highest experimental point that is without adverse effect," serves us well in general discussions. It does not, however, address the interpretation of risk based on toxicologically relevant effects, nor does it consider the progression of effect with respect to duration and/or dose. This paper will discuss the issues and application of a functional definition of the NOAEL in toxicology evaluations.

  10. Can Plasticity Transform Functions in Neurodegeneration in Children as Well as Adults? An Observational Study

    PubMed Central

    Chandra, Sadanandavalli Retnaswami; Ahamed, Safwan; Vidhya Annapoorni, Chandra Sasitharan

    2018-01-01

    Introduction: Creativity is a physiological need based biological function very essential for survival. However, generally in disorders of progressive cognitive dysfunction creative skills are lost. However there are situations where these potentials are temporarily enhanced. Patients and Methods: We did an observational study of children and adults, 5 adults and 2 childrens, who showed extraordinary creativity evaluated based on evidence shown by patient, peers and re produced in test situation. Discussion: Our observational study reveals spontaneous interest in new and useful creative activity in our patients with various disorders causing progressive cognitive dysfunction. This observation reveals creative gain of function does take place in the face of progressive cognitive dysfunction in the setting of several diseases and it serves as a treatment option in behaviour management. Whether it is due to disinhibition of creative areas in the brain or facilitated function in regenerating data linking circuits needs further study. Conclusion: Set goals which are survival instinct based activities are probably removed by neurodegeneration and thereby the innate creativity gets disinhibited and expressed in wonderful forms of creativity. Whether special creative circuits in the brain, which causes this extraordinary creativity also needs to be studied. These creative skills in some of our patients served as effective pharmaco sparing agents during periods of aggression and agitation by engaging them in those activities, utility of which can be considered as a therapeutic option. PMID:29403132

  11. Evaluation of Biogenic and Fire Emissions in a Global Chemistry Model with NOMADSS, DC3 and SEAC4RS observations

    NASA Astrophysics Data System (ADS)

    Emmons, L. K.; Wiedinmyer, C.; Park, M.; Kaser, L.; Apel, E. C.; Guenther, A. B.

    2014-12-01

    Numerous measurements of compounds produced by biogenic and fire emissions were made during several recent field campaigns in the southeast United States, providing a unique data set for emissions and chemical model evaluation. The NCAR Community Atmosphere Model with Chemistry (CAM-chem) is coupled to the Community Land Model (CLM), which includes the biogenic emissions model MEGAN-v2.1, allowing for online calculation of emissions from vegetation for 150 compounds. Simulations of CAM-chem for summers 2012 and 2013 are evaluated with the aircraft and ground-based observations from DC3, NOMADSS and SEAC4RS. Comparison of directly emitted biogenic species, such as isoprene, terpenes, methanol and acetone, are used to evaluate the MEGAN emissions. Evaluation of oxidation products, including methyl vinyl ketone (MVK), methacrolein, formaldehyde, and other oxygenated VOCs are used to test the model chemistry mechanism. In addition, several biomass burning inventories are used in the model, including FINN, QFED, and FLAMBE, and are compared for their impact on atmospheric composition and ozone production, and evaluated with the aircraft observations.

  12. Magnetic resonance features of the feline hippocampus in epileptic and non-epileptic cats: a blinded, retrospective, multi-observer study.

    PubMed

    Claßen, Anne Christine; Kneissl, Sibylle; Lang, Johann; Tichy, Alexander; Pakozdy, Akos

    2016-08-11

    Hippocampal necrosis in cats has been reported to be associated with epileptic seizures. Magnetic resonance imaging (MRI) features of temporal lobe (TL) abnormalities in epileptic cats have been described but MR images from epileptic and non-epileptic individuals have not yet been systematically compared. TL abnormalities are highly variable in shape, size and signal, and therefore may lead to varying evaluations by different specialists. The aim of this study was to investigate whether there were differences in the appearance of the TL between epileptic and non-epileptic cats, and whether there were any relationships between TL abnormalities and seizure semiologies or other clinical findings. We also investigated interobserver agreement among three specialists. The MR images of 46 cats were reviewed independently by three observers, who were blinded to patient data, examination findings and the review of the other observers. Images were evaluated using a multiparametric scoring system developed for this study. Mann-Whitney U-tests and chi-square were used to analyse the differences between observers' evaluations. The kappa coefficient (k) and Fleiss' kappa coefficient were used to quantify interobserver agreement. The overall interobserver agreement was moderate to good (k =0.405 to 0.615). The MR scores between epileptic and non-epileptic cats did not differ significantly. However, there was a significant difference between the MR scores of epileptic cats with and without orofacial involvement according to all three observers. Likewise, MR scores of cats with cluster seizures were higher than those of cats without clusters. Cats presenting with recurrent epileptic seizures with orofacial involvement are more likely to have hippocampal pathologies, which suggests that TL abnormalities are not merely unspecific epileptic findings, but are associated with a certain type of epilepsy. TL signal alterations are more likely to be detected on FLAIR sequences. In contrast

  13. Oral implications of the vegan diet: observational study.

    PubMed

    Laffranchi, L; Zotti, F; Bonetti, S; Dalessandri, D; Fontana, P

    2010-01-01

    The aim of this study was to investigate oral changes in subjects who have assumed a vegan diet for a long time (at least 18 months), that is to say, a diet completely lacking in meat and animal derivatives. A sample of 15 subjects was analyzed, all from northern Italy and aged 24 to 60 year, composed of 11 men and 4 women who had been following a vegan diet for a minimum of 18 months to a maximum of 20 years. In parallel with the study sample, a control group (15 subjects) with the same criteria of age, sex, and place of origin all following an omnivorous diet was chosen. The sample answered a questionnaire that investigated their eating habits, the frequency with which they eat meals, the main foodstuffs assumed, oral hygiene habits, and any painful symptomatology of the teeth or more general problems in the oral cavity. The sample was then subject to objective examination in which the saliva pH was measured and the teeth were checked for demineralization of the enamel, white spots, and caries (using KaVo DIAGNOdent) with particular attention being paid to the localization of these lesions, and lastly, sounding was carried out to detect any osseous defects and periodontal pockets. The study revealed greater incidence of demineralization and white spots in the vegan subjects compared to the omnivorous ones localized at the neck of the teeth and on the vestibular surfaces of dental elements (with the exception of the lower anterior group). The saliva pH, more acid in the omnivorous patients, ranged between four and six. Changes in oral conditions in both groups of subjects were observed. In order to research into the cause-effect relationship of the vegan diet on the oral cavity effectively, the sample needs to be studied for a longer period of time and the results re-evaluated.

  14. Burden of Infantile Hemangioma on Family: An International Observational Cross-Sectional Study.

    PubMed

    Cazeau, Christine; Blei, Francine; Gonzáles Hermosa, María Del Rosario Fátima; Cavalli, Riccardo; Boccara, Olivia; Fölster-Holst, Regina; Berdeaux, Gilles; Delarue, Alain; Voisard, Jean-Jacques

    2017-05-01

    Infantile hemangioma (IH) is the most frequent benign tumor of infancy resulting from vascular proliferation. Data regarding the burden on families of children with IHs are limited. This study aimed to characterize IHs and provide a comprehensive evaluation of the burden of IHs on parents of children requiring systemic treatment in the United States and Europe. This noninterventional cross-sectional study included infants with newly diagnosed IH requiring systemic treatment. A parent or family member completed two questionnaires (Family Member questionnaire; Hemangioma Family Burden [HFB] questionnaire). A total of 693 individuals were evaluable in five countries. IHs were observed in more girls than boys (66%-83% female) and the mean age at inclusion was 0.44 to 1.4 years. Approximately half of patients had superficial IHs, approximately 70% of cases affected the head, and approximately 80% of cases were moderate or severe. Most patients received propranolol treatment. Their child's IH affected more than 70% of parents in each country, but fewer than 10% were offered psychological support. Approximately half of all parents reported that their child's IH affected their professional life. The global HFB score was significantly (p < 0.001) greater with greater IH severity. More than 90% of parents in each country were satisfied with the care of their child's disease. This international study using the validated HFB questionnaire provides further insight into the burden of IH and highlights potential areas for future focus in assisting families with affected children. © 2017 Wiley Periodicals, Inc.

  15. Airway difficulty in Mallampati 'class zero' patients: a prospective double-blind observational study.

    PubMed

    Hegde, Harihar V; Prasad, Kothegala C; Bhat, Manjunath T; Hegde, Jyothirmay S; Santhosh Mysore, C b; Yaliwal, Vijay G; Raghavendra Rao, P

    2012-07-01

    Assessment of Mallampati class is an integral part of preoperative airway evaluation. Increasing Mallampati class is known to be associated with greater difficulty with intubation, but some cases of airway difficulty in Mallampati 'class zero' patients have been reported. We undertook this study to evaluate intubation difficulty and to correlate this with indirect laryngoscopy findings in Mallampati class zero patients. The incidence of Mallampati class zero airway in Indian patients and the difficulty in mask ventilation were also evaluated. Prospective double-blind observational study. A tertiary care medical college hospital in Karnataka, India. September 2010 to April 2011. Patients of either sex, 18 years and older, presenting for preanaesthetic examination for elective surgery were evaluated. All patients with Mallampati class zero airway undergoing general anaesthesia with tracheal intubation were included. Exclusion criteria were upper airway disorder, unstable cervical spine, increased risk for aspiration, ischaemic heart disease, increased intracranial pressure, respiratory distress, those unable to sit upright, or infected with hepatitis B, hepatitis C, HIV or pulmonary tuberculosis, or requiring emergency surgery. All underwent indirect laryngoscopy performed by the otorhinolaryngologist and subsequently, direct laryngoscopy performed by the anaesthesiologist. Intubation difficulty was assessed by the Cormack & Lehane grades. Evaluation of intubation difficulty and correlation with indirect laryngoscopy findings in Mallampati class zero patients. Estimation of the incidence of Mallampati class zero airway in Indian patients and the difficulty in mask ventilation. Twenty women and thirteen men, aged 18-65 years, of Mallampati class zero were identified out of 1937 (incidence, 1.7%). The data of 27 patients were analysed. Two patients had 'difficult' mask ventilation. All had a 'predicted easy' airway on indirect laryngoscopy and 'easy' (Cormack & Lehane

  16. Dairy Products Intake and Endometrial Cancer Risk: A Meta-Analysis of Observational Studies

    PubMed Central

    2017-01-01

    Observational studies have suggested inconsistent findings on the relationship between dairy products intake and endometrial cancer risk. This study aimed to conduct a meta-analysis to evaluate this correlation; moreover, databases including PubMed, ISI Web of Science, and Embase were screened for relevant studies up to 26 February 2017. The inverse variance weighting method and random effects models were used to calculate the overall OR (odds ratio) values and 95% confidence interval (CI). A total of 2 cohort study and 16 case-control studies were included in the current analysis. No significant association was observed between endometrial cancer risk and the intake of total dairy products, milk, or cheese for the highest versus the lowest exposure category (total dairy products (14 studies): OR 1.04, 95% CI: 0.97–1.11, I2 = 73%, p = 0.000; milk (6 studies): 0.99, 95% CI: 0.89–1.10, I2 = 0.0%, p = 0.43; cheese (5 studies): 0.89, 95% CI: 0.76–1.05, I2 = 39%, p = 0.16). The only cohort study with a total of 456,513 participants reported a positive association of butter intake with endometrial cancer risk (OR = 1.14; 95% CI = 1.03–1.26, I2 = 2.6%, p = 0.31). There was a significant negative association of dairy products intake and endometrial cancer risk among women with a higher body mass index (BMI) (5 studies, OR 0.66, 95% CI = 0.46–0.96, I2 = 75.8%, p = 0.002). Stratifying the analyses by risk factors including BMI should be taken into account when exploring the association of dairy products intake with endometrial cancer risk. Further well-designed studies are needed. PMID:29283380

  17. Carboxyhemoglobin levels in medical intensive care patients: a retrospective, observational study

    PubMed Central

    2012-01-01

    Introduction Critical illness leads to increased endogenous production of carbon monoxide (CO) due to the induction of the stress-response enzyme, heme oxygenase-1 (HO-1). There is evidence for the cytoprotective and anti-inflammatory effects of CO based on animal studies. In critically ill patients after cardiothoracic surgery, low minimum and high maximum carboxyhemoglobin (COHb) levels were shown to be associated with increased mortality, which suggests that there is an 'optimal range' for HO-1 activity. Our study aimed to test whether this relationship between COHb and outcome exists in non-surgical ICU patients. Methods We conducted a retrospective, observational study in a medical ICU at a university hospital in Vienna, Austria involving 868 critically ill patients. No interventions were undertaken. Arterial COHb was measured on admission and during the course of treatment in the ICU. The association between arterial COHb levels and ICU mortality was evaluated using bivariate tests and a logistic regression model. Results Minimum COHb levels were slightly lower in non-survivors compared to survivors (0.9%, 0.7% to 1.2% versus 1.2%, 0.9% to 1.5%; P = 0.0001), and the average COHb levels were marginally lower in non-survivors compared to survivors (1.5%, 1.2% to 1.8% versus 1.6%, 1.4% to 1.9%, P = 0.003). The multivariate logistic regression analysis revealed that the association between a low minimum COHb level and increased mortality was independent of the severity of illness and the type of organ failure. Conclusions Critically ill patients surviving the admission to a medical ICU had slightly higher minimum and marginally higher average COHb levels when compared to non-survivors. Even though the observed differences are statistically significant, the minute margins would not qualify COHb as a predictive marker for ICU mortality. PMID:22236404

  18. Carboxyhemoglobin levels in medical intensive care patients: a retrospective, observational study.

    PubMed

    Fazekas, Andreas S; Wewalka, Marlene; Zauner, Christian; Funk, Georg-Christian

    2012-01-11

    Critical illness leads to increased endogenous production of carbon monoxide (CO) due to the induction of the stress-response enzyme, heme oxygenase-1 (HO-1). There is evidence for the cytoprotective and anti-inflammatory effects of CO based on animal studies. In critically ill patients after cardiothoracic surgery, low minimum and high maximum carboxyhemoglobin (COHb) levels were shown to be associated with increased mortality, which suggests that there is an 'optimal range' for HO-1 activity. Our study aimed to test whether this relationship between COHb and outcome exists in non-surgical ICU patients. We conducted a retrospective, observational study in a medical ICU at a university hospital in Vienna, Austria involving 868 critically ill patients. No interventions were undertaken. Arterial COHb was measured on admission and during the course of treatment in the ICU. The association between arterial COHb levels and ICU mortality was evaluated using bivariate tests and a logistic regression model. Minimum COHb levels were slightly lower in non-survivors compared to survivors (0.9%, 0.7% to 1.2% versus 1.2%, 0.9% to 1.5%; P=0.0001), and the average COHb levels were marginally lower in non-survivors compared to survivors (1.5%, 1.2% to 1.8% versus 1.6%, 1.4% to 1.9%, P=0.003). The multivariate logistic regression analysis revealed that the association between a low minimum COHb level and increased mortality was independent of the severity of illness and the type of organ failure. Critically ill patients surviving the admission to a medical ICU had slightly higher minimum and marginally higher average COHb levels when compared to non-survivors. Even though the observed differences are statistically significant, the minute margins would not qualify COHb as a predictive marker for ICU mortality.

  19. Statins and secondary prevention of venous thromboembolism: pooled analysis of published observational cohort studies.

    PubMed

    Kunutsor, Setor K; Seidu, Samuel; Khunti, Kamlesh

    2017-05-21

    There have been suggestions that statins may have a potential role in secondary prevention of venous thromboembolism (VTE) [which includes deep vein thrombosis (DVT) and pulmonary embolism (PE)], but the evidence is inconsistent. We aimed to evaluate the association between statin use and risk of recurrent VTE. We conducted a systematic review and meta-analysis of observational cohort studies. All relevant studies which reported associations between statin use and recurrent VTE outcomes were identified from MEDLINE, EMBASE, Web of Science, and manual search of bibliographies from inception to January 2017. Study specific relative risks (RRs) with 95% confidence intervals were aggregated using random effects models. Eight eligible studies comprising of 103 576 participants and 13 168 recurrent VTE outcomes were included in the pooled analysis. In pooled analysis of 7 studies, the RR for recurrent VTE was 0.73 (0.68-0.79) when comparing statin use with no use. There was no evidence of heterogeneity between contributing studies (I2=0%, 0-71%; P = 0.93). The RRs for recurrent PE (three studies) and DVT (two studies) comparing statin use with no statin use were 0.75 (95% CI: 0.58-0.96) and 0.66 (95% CI: 0.60-0.71) respectively. Available evidence from observational cohort studies suggests a beneficial effect of statin use on VTE recurrence. Well-designed intervention studies are needed to corroborate these findings. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  20. Using a didactic model to improve patient observation skills in neonatal intensive care nurse trainees - a pilot study.

    PubMed

    Solberg, Marianne Trygg; Tandberg, Bente Silnes; Lerdal, Anners

    2012-08-01

    To implement a didactic model for students specialising in intensive care nursing (n=12) and nurses working in neonatal intensive care units (NICU) (n=17). To evaluate nurse self-assessments following observation of children with congenital heart disease (CHD), before and after participation in the programme, as well as the usefulness of the programme. A pilot study with a pre- and post-test design, using self-administered questionnaires. The didactic model increased the number of clinical observations and assessments of physiological factors made by both students and NICU nurses during evaluation of children with suspected CHD. The majority of nurses reported that both participation in the programme and the didactic model were useful and they demonstrated high-level knowledge, according to Bloom's taxonomy for cognitive learning. In particular, subjects found that the literature provided and structured bedside guidance in the clinical setting assisted learning. Intensive care students and NICU nurses performed clinical observations and physical factor assessments more frequently after completing the programme, compared with baseline. We speculate that this didactic model may also be useful in other clinical settings. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Short-Term Temporal Stability in Observed Retail Food Characteristics

    ERIC Educational Resources Information Center

    Zenk, Shannon N.; Grigsby-Toussaint, Diana S.; Curry, Susan J.; Berbaum, Michael; Schneider, Linda

    2010-01-01

    Objective: Use of direct observation to characterize neighborhood retail food environments is increasing, but to date most studies have relied on a single observation. If food availability, prices, and quality vary over short time periods, repeated measures may be needed to portray these food characteristics. This study evaluated short-term…

  2. Analysis of causality from observational studies and its application in clinical research in Intensive Care Medicine.

    PubMed

    Coscia Requena, C; Muriel, A; Peñuelas, O

    2018-02-28

    Random allocation of treatment or intervention is the key feature of clinical trials and divides patients into treatment groups that are approximately balanced for baseline, and therefore comparable covariates except for the variable treatment of the study. However, in observational studies, where treatment allocation is not random, patients in the treatment and control groups often differ in covariates that are related to intervention variables. These imbalances in covariates can lead to biased estimates of the treatment effect. However, randomized clinical trials are sometimes not feasible for ethical, logistical, economic or other reasons. To resolve these situations, interest in the field of clinical research has grown in designing studies that are most similar to randomized experiments using observational (i.e. non-random) data. Observational studies using propensity score analysis methods have been increasing in the scientific papers of Intensive Care. Propensity score analyses attempt to control for confounding in non-experimental studies by adjusting for the likelihood that a given patient is exposed. However, studies with propensity indexes may be confusing, and intensivists are not familiar with this methodology and may not fully understand the importance of this technique. The objectives of this review are: to describe the fundamentals of propensity index methods; to present the techniques to adequately evaluate propensity index models; to discuss the advantages and disadvantages of these techniques. Copyright © 2018 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  3. Peer observation and feedback of resident teaching.

    PubMed

    Snydman, Laura; Chandler, Daniel; Rencic, Joseph; Sung, Yung-Chi

    2013-02-01

    Resident doctors (residents) play a significant role in the education of medical students. Morning work rounds provide an optimal venue to assess resident teaching. The purpose of this study was to assess the feasibility of peer observation of resident work rounds, to evaluate resident perceptions of peer observation and to evaluate resident perceptions of peer feedback.   Twenty-four internal medicine residents were simultaneously observed by an attending physician and a peer while teaching during work rounds (between August2008 and May 2009). At year-end, residents received a survey to characterise their attitudes towards peer observation and feedback. Twenty-one residents (87.5%) completed the survey. Half (52.4%) felt that participating in the peer observation study stimulated their interest in teaching during work rounds. Prior to participation in the study, fewer than half (42.9%) felt comfortable being observed by their peers, compared with 71.4 percent after participation (p=0.02). The proportion of residents who felt comfortable giving feedback to peers increased from 26.3 to 65.0percent (p=0.004), and the proportion of residents who felt comfortable receiving feedback from peers increased from 76.2 to 95.2 percent (p=0.02). Peer observation and feedback of resident teaching during work rounds is feasible and rewarding for the residents involved. Comfort with regards to being observed by peers, with receiving feedback from peers and with giving feedback to peers significantly increased after the study. Most residents reported changes in their teaching behaviour resulting from feedback. Residents felt that observing a peer teach on work rounds was one of the most useful activities to improve their own teaching on work rounds. © Blackwell Publishing Ltd 2013.

  4. Space observations for global and regional studies of the biosphere

    NASA Technical Reports Server (NTRS)

    Cihlar, J.; Li, Z.; Chen, J.; Sellers, P.; Hall, F.

    1994-01-01

    The capability to make space-based measurements of Earth at high spatial and temporal resolutions, which would not otherwise be economically or practically feasible, became available just in time to contribute to scientific understanding of the interactive processes governing the total Earth system. Such understanding has now become essential in order to take practical steps which would counteract or mitigate the pervasive impact of the growing human population on the future habitability of the Earth. The paper reviews the rationale for using space observations for studies of climate and terrestrial ecosystems at global and regional scales, as well as the requirements for such observations for studies of climate and ecosystem dynamics. The present status of these developments is reported along with initiatives under way to advance the use of satellite observations for Earth system studies. The most important contribution of space observations is the provision of physical or biophysical parameters for models representing various components of the Earth system. Examples of such parameters are given for climatic and ecosystem studies.

  5. An observational study of protective equipment use among in-line skaters

    PubMed Central

    Warda, L.; Harlos, S.; Klassen, T.; Moffatt, M.; Buchan, N.; Koop, V.

    1998-01-01

    Objectives—To describe the patterns of protective equipment use by in-line skaters in Winnipeg, Manitoba and nearby rural communities. Methods—In-line skaters were observed for three months in 1996 at 190 urban and 30 rural sites selected using a formal sampling scheme. Age, gender, protective equipment use, skating companions, correct helmet use, and use of headphones were recorded. Results—Altogether 123 in-line skaters were observed at 61 sites, including one rural site. No skaters were observed at the remaining sites. There were 37 adults and 86 children; 56% were male. Helmet use was 12.2% (95% confidence interval (CI ) = 6.4% to 18.0%), wrist guard use was 16.3% (95% CI = 9.7% to 22.8%), knee pad use was 9.8% (95% CI = 5.2% to 16.4%), and elbow pad use was 7.3% (95% CI = 3.4% to 13.4%). Children were more likely to wear a helmet than teens 12–19 years of age (relative risk (RR) = 30, 95% CI = 4.01 to 225). Adults were more likely to wear wrist guards than children (RR = 4.32, 95% CI = 1.87 to 9.94). No gender differences were found. Incorrect helmet use was documented in four skaters; three skaters were wearing headphones. Conclusions—Low rates of protective equipment use were documented in our region, significantly lower than those reported in the literature. Barriers to equipment use are not known, and should be examined by further study. In-line skating safety programs should be developed, promoted, and evaluated. Teens should be targeted for future preventive efforts. PMID:9788090

  6. Coffee and caffeine consumption and depression: A meta-analysis of observational studies.

    PubMed

    Wang, Longfei; Shen, Xiaoli; Wu, Yili; Zhang, Dongfeng

    2016-03-01

    The results from observation studies on the relationship between coffee intake and risk of depression and the relationship between caffeine consumption and depression remain controversial. We conducted a meta-analysis with a dose-response analysis to quantitatively summarize the evidence about the association between coffee and caffeine intakes and risk of depression. Relevant articles were identified by researching PubMed, Web of Science, China National Knowledge Infrastructure and WANFANG DATA in English or Chinese from 1 January 1980 to 1 May 2015. Case-control, cohort or cross-sectional studies evaluating coffee or caffeine consumption and depression were included. A random-effects model was used to combine study-specific relative risk and 95% confidence interval. Dose-response relationship was assessed by restricted cubic spline functions. Data were obtained from 11 observation articles; 330,677 participants from seven studies in seven articles were included in the coffee-depression analysis, while 38,223 participants from eight studies in seven articles were involved in the caffeine-depression analysis. Compared with the lowest level consumption, the pooled relative risk (95% confidence interval) for coffee-depression and caffeine-depression was 0.757 [0.624, 0.917] and 0.721 [0.522, 0.997], respectively. For dose-response analysis, evidence of a linear association was found between coffee consumption and depression, and the risk of depression decreased by 8% (relative risk = 0.92, 95% confidence interval = [0.87, 0.97], p = 0.002) for each cup/day increment in coffee intake; a nonlinear association was found between caffeine consumption and depression, the risk of depression decreased faster and the association became significant when the caffeine consumption was above 68 mg/day and below 509 mg/day. Coffee and caffeine consumption were significantly associated with decreased risk of depression. © The Royal Australian and New Zealand College

  7. Evaluation of Two Observational Assessment Systems for Children's Development and Learning

    ERIC Educational Resources Information Center

    Kim, Do-Hong; Smith, JaneDiane

    2010-01-01

    This study provided preliminary evidence for the reliability and validity of "Teaching Strategies GOLD", a recently developed observational system for assessing young children's development and learning. The measurement properties of "Teaching Strategies GOLD" were compared with those of an older instrument, "The Creative…

  8. Photovoltaic evaluation study

    NASA Astrophysics Data System (ADS)

    Johnson, G.; Heikkilae, M.; Melasuo, T.; Spanner, S.

    Realizing the value and potential of PV-power as well as the growing need for increased cooperation and sharing of knowledge in the field of photovoltaics, FINNIDA and UNICEF decided to undertake a study of selected PV-projects. There were two main objectives for the study: To gather, compile, evaluate and share information on the photovoltaic technology appropriate to developing countries, and to promote the interest and competence of Finnish research institutes, consultants and manufacturers in photovoltaic development. For this purpose a joint evaluation of significant, primarily UN-supported projects providing for the basic needs of rural communities was undertaken. The Gambia and Kenya offered a variety of such projects, and were chosen as target countries for the study. The projects were chosen to be both comparable and complimentary. In the Gambia, the main subject was a partially integrated health and telecommunications project, but a long-operating drinking water pumping system was also studied. In Kenya, a health project in the Turkana area was examined, and also a large scale water pumping installation for fish farming. Field visits were made in order to verify and supplement the data gathered through document research and earlier investigations. Individual data gathering sheets for the project form the core of this study and are intended to give the necessary information in an organized and accessible format. The findings could practically be condensed into one sentence: PV-systems work very well, if properly designed and installed, but the resources and requirements of the recipients must be considered to a higher degree.

  9. Can Principals Promote Teacher Development as Evaluators? A Case Study of Principals’ Views and Experiences

    PubMed Central

    Kraft, Matthew A.; Gilmour, Allison

    2017-01-01

    Purpose New teacher evaluation systems have expanded the role of principals as instructional leaders, but little is known about principals’ ability to promote teacher development through the evaluation process. We conducted a case study of principals’ perspectives on evaluation and their experiences implementing observation and feedback cycles to better understand whether principals feel as though they are able to promote teacher development as evaluators. Research Methods We conducted interviews with a stratified random sample of 24 principals in an urban district that recently implemented major reforms to its teacher evaluation system. We analyzed these interviews by drafting thematic summaries, coding interview transcripts, creating data-analytic matrices, and writing analytic memos. Findings We found that the evaluation reforms provided a common framework and language that helped facilitate principals’ feedback conversations with teachers. However, we also found that tasking principals with primary responsibility for conducting evaluations resulted in a variety of unintended consequences which undercut the quality of evaluation feedback they provided. We analyze five broad solutions to these challenges: strategically targeting evaluations, reducing operational responsibilities, providing principal training, hiring instructional coaches, and developing peer evaluation systems. Implications The quality of feedback teachers receive through the evaluation process depends critically on the time and training evaluators have to provide individualized and actionable feedback. Districts that task principals with primary responsibility for conducting observation and feedback cycles must attend to the many implementation challenges associated with this approach in order for next-generation evaluation systems to successfully promote teacher development. PMID:28729742

  10. Predicting the Mineral Composition of Dust Aerosols. Part 2; Model Evaluation and Identification of Key Processes with Observations

    NASA Technical Reports Server (NTRS)

    Perlwitz, J. P.; Garcia-Pando, C. Perez; Miller, R. L.

    2015-01-01

    A global compilation of nearly sixty measurement studies is used to evaluate two methods of simulating the mineral composition of dust aerosols in an Earth system model. Both methods are based upon a Mean Mineralogical Table (MMT) that relates the soil mineral fractions to a global atlas of arid soil type. The Soil Mineral Fraction (SMF) method assumes that the aerosol mineral fractions match the fractions of the soil. The MMT is based upon soil measurements after wet sieving, a process that destroys aggregates of soil particles that would have been emitted from the original, undisturbed soil. The second method approximately reconstructs the emitted aggregates. This model is referred to as the Aerosol Mineral Fraction (AMF) method because the mineral fractions of the aerosols differ from those of the wet-sieved parent soil, partly due to reaggregation. The AMF method remedies some of the deficiencies of the SMF method in comparison to observations. Only the AMF method exhibits phyllosilicate mass at silt sizes, where they are abundant according to observations. In addition, the AMF quartz fraction of silt particles is in better agreement with measured values, in contrast to the overestimated SMF fraction. Measurements at distinct clay and silt particle sizes are shown to be more useful for evaluation of the models, in contrast to the sum over all particles sizes that is susceptible to compensating errors, as illustrated by the SMF experiment. Model errors suggest that allocation of the emitted silt fraction of each mineral into the corresponding transported size categories is an important remaining source of uncertainty. Evaluation of both models and the MMT is hindered by the limited number of size-resolved measurements of mineral content that sparsely sample aerosols from the major dust sources. The importance of climate processes dependent upon aerosol mineral composition shows the need for global and routine mineral measurements.

  11. User-friendly tools on handheld devices for observer performance study

    NASA Astrophysics Data System (ADS)

    Matsumoto, Takuya; Hara, Takeshi; Shiraishi, Junji; Fukuoka, Daisuke; Abe, Hiroyuki; Matsusako, Masaki; Yamada, Akira; Zhou, Xiangrong; Fujita, Hiroshi

    2012-02-01

    ROC studies require complex procedures to select cases from many data samples, and to set confidence levels in each selected case to generate ROC curves. In some observer performance studies, researchers have to develop software with specific graphical user interface (GUI) to obtain confidence levels from readers. Because ROC studies could be designed for various clinical situations, it is difficult task for preparing software corresponding to every ROC studies. In this work, we have developed software for recording confidence levels during observer studies on tiny personal handheld devices such as iPhone, iPod touch, and iPad. To confirm the functions of our software, three radiologists performed observer studies to detect lung nodules by using public database of chest radiograms published by Japan Society of Radiological Technology. The output in text format conformed to the format for the famous ROC kit from the University of Chicago. Times required for the reading each case was recorded very precisely.

  12. Industrial laser welding evaluation study

    NASA Technical Reports Server (NTRS)

    Hella, R.; Locke, E.; Ream, S.

    1974-01-01

    High power laser welding was evaluated for fabricating space vehicle boosters. This evaluation was made for 1/4 in. and 1/2 in. aluminum (2219) and 1/4 in. and 1/2 in. D6AC steel. The Avco HPL 10 kW industrial laser was used to perform the evaluation. The objective has been achieved through the completion of the following technical tasks: (1) parameter study to optimize welding and material parameters; (2) preparation of welded panels for MSFC evaluation; and (3) demonstration of the repeatability of laser welding equipment. In addition, the design concept for a laser welding system capable of welding large space vehicle boosters has been developed.

  13. Milestone-specific, Observed data points for evaluating levels of performance (MODEL) assessment strategy for anesthesiology residency programs.

    PubMed

    Nagy, Christopher J; Fitzgerald, Brian M; Kraus, Gregory P

    2014-01-01

    Anesthesiology residency programs will be expected to have Milestones-based evaluation systems in place by July 2014 as part of the Next Accreditation System. The San Antonio Uniformed Services Health Education Consortium (SAUSHEC) anesthesiology residency program developed and implemented a Milestones-based feedback and evaluation system a year ahead of schedule. It has been named the Milestone-specific, Observed Data points for Evaluating Levels of performance (MODEL) assessment strategy. The "MODEL Menu" and the "MODEL Blueprint" are tools that other anesthesiology residency programs can use in developing their own Milestones-based feedback and evaluation systems prior to ACGME-required implementation. Data from our early experience with the streamlined MODEL blueprint assessment strategy showed substantially improved faculty compliance with reporting requirements. The MODEL assessment strategy provides programs with a workable assessment method for residents, and important Milestones data points to programs for ACGME reporting.

  14. [Inter-observes agreement of Ishak and Metavir scores in histological evaluation of chronic viral hepatitis B and C].

    PubMed

    Rammeh, Soumaya; Khadra, Hajer Ben; Znaidi, Nadia Sabbegh; Romdhane, Neila Attia; Najjar, Taoufik; Bouzaidi, Slim; Zermani, Rachida

    2014-01-01

    Many classification systems are currently used for histological evaluation of the severity of chronic viral hepatitis, including the Ishak and Metavir scores, but there is not a consensus classification. The objective of this work was to study the intra and inter-observers agreement of these two scores in the histopathological analysis of liver biopsies in patients with chronic viral hepatitis B or C. Fifty nine patients were included in the study, 26 had chronic hepatitis C and 33 had chronic hepatitis B. To investigate the inter-observers agreement, the liver biopsies were analyzed separately by two pathologists without prior consensus reading. The two pathologists conducted then a consensual reading before reviewing all cases independently. Cohen's kappa coefficient was calculated and in case of asymmetry Spearman's rho coefficient. Before the consensus reading, the agreement was moderate for the analysis of histological activity with both scores (Metavir: kappa=0.41, Ishak: rho=0.58). For the analysis of fibrosis, the agreement was good with both scores (Metavir: kappa=0.61, Ishak: rho=0.86). The consensus reading has improved the reproducibility of the activity that has become good with both scores (Metavir: kappa=0.77, Ishak: rho=0.76). For fibrosis improvement was observed with the Ishak score which agreement became excellent (kappa=0.81). In conclusion, we recommend in routine practice, a combined score: Metavir for activity and Ishak for fibrosis and to make a double reading for each biopsy.

  15. Large Controlled Observational Study on Remote Monitoring of Pacemakers and Implantable Cardiac Defibrillators: A Clinical, Economic, and Organizational Evaluation

    PubMed Central

    2016-01-01

    Background Patients with implantable devices such as pacemakers (PMs) and implantable cardiac defibrillators (ICDs) should be followed up every 3–12 months, which traditionally required in-clinic visits. Innovative devices allow data transmission and technical or medical alerts to be sent from the patient's home to the physician (remote monitoring). A number of studies have shown its effectiveness in timely detection and management of both clinical and technical events, and endorsed its adoption. Unfortunately, in daily practice, remote monitoring has been implemented in uncoordinated and rather fragmented ways, calling for a more strategic approach. Objective The objective of the study was to analyze the impact of remote monitoring for PM and ICD in a “real world” context compared with in-clinic follow-up. The evaluation focuses on how this service is carried out by Local Health Authorities, the impact on the cardiology unit and the health system, and organizational features promoting or hindering its effectiveness and efficiency. Methods A multi-center, multi-vendor, controlled, observational, prospective study was conducted to analyze the impact of remote monitoring implementation. A total of 2101 patients were enrolled in the study: 1871 patients were followed through remote monitoring of PM/ICD (I-group) and 230 through in-clinic visits (U-group). The follow-up period was 12 months. Results In-clinic device follow-ups and cardiac visits were significantly lower in the I-group compared with the U-group, respectively: PM, I-group = 0.43, U-group = 1.07, P<.001; ICD, I-group = 0.98, U-group = 2.14, P<.001. PM, I-group = 0.37, U-group = 0.85, P<.001; ICD, I-group = 1.58, U-group = 1.69, P=.01. Hospitalizations for any cause were significantly lower in the I-group for PM patients only (I-group = 0.37, U-group = 0.50, P=.005). There were no significant differences regarding use of the emergency department for both PM and ICD patients. In the I-group, 0.30 (PM

  16. Women's Studies Collections: A Checklist Evaluation

    ERIC Educational Resources Information Center

    Bolton, Brooke A.

    2009-01-01

    A checklist evaluation on thirty-seven Women's Studies programs conducted using the individual institutions' online public access catalogs (OPACs) is presented. Although Women's Studies collections are very difficult to build, an evaluation of existing programs shows that collections, for the most part, have managed substantial coverage of the…

  17. An Observational Study of Cataclysmic Variable Evolution

    NASA Astrophysics Data System (ADS)

    Araujo-Betancor, Sofia

    2004-03-01

    In this thesis I present an observational study of the evolution of Cataclysmic Variables (CVs). Disrupted magnetic braking has been the standard paradigm of CV evolution for the past twenty years. Unfortunately, some of its predictions are in strong disagreement with the observations. In recent years, a number of additions/alternatives to the standard model have been proposed. Yet, none have been able to explain all of the features observed in the currently known CV population. The work presented in this thesis is based mainly on a large-scale search for CVs. The primary aim of this project is to resolve the disagreement between theory and observations by eliminating the observational biases of the present CV sample. Here, I use two complementary approaches to search for CVs: (1) from the spectroscopic appearance in the Hamburg Quasar Survey (HQS), and (2) by using a combination of ROSAT and 2MASS archival data. So far, we have discovered 52 new CVs in the HQS and 11 new CVs (the majority of them magnetic) and 1 pre-CV in the ROSAT/2MASS. Follow-up observations of two newly discovered HQS CVs, 1RXS J062518.2+733433 and HS 2331+3905, resulted in the classification of the first as an Intermediate Polar, with P_orb = 283.0 min and P_spin = 19.8 min, and the second as a short orbital period system, P_orb = 81.0 min, harbouring a white dwarf pulsator. In addition, we found that the dominant ~3.5 h radial velocity variation of HS 2331+3905 does not correspond to the orbital period of the system, contrary to all other CVs. Despite its novel selection criterion, the HQS does not provide many short-period CVs -- even though tests with the known CVs included in the survey have shown that it is very sensitive to those objects. The biggest surprise in the new HQS sample is the discovery of many new SW Sex stars. The clustering of SW Sex stars in the 3-4 h period range is probably an important feature in the evolution of CVs that we currently do not understand at all. To

  18. A review of data sharing statements in observational studies published in the BMJ: A cross-sectional study

    PubMed Central

    McDonald, Laura; Schultze, Anna; Simpson, Alex; Graham, Sophie; Wasiak, Radek; Ramagopalan, Sreeram V.

    2017-01-01

    In order to understand the current state of data sharing in observational research studies, we reviewed data sharing statements of observational studies published in a general medical journal, the British Medical Journal. We found that the majority (63%) of observational studies published between 2015 and 2017 included a statement that implied that data used in the study could not be shared. If the findings of our exploratory study are confirmed, room for improvement in the sharing of real-world or observational research data exists. PMID:29167735

  19. Generation and Evaluation of a Global Land Surface Phenology Product from Suomi-NPP VIIRS Observations

    NASA Astrophysics Data System (ADS)

    Zhang, X.; Liu, L.; Yan, D.; Moon, M.; Liu, Y.; Henebry, G. M.; Friedl, M. A.; Schaaf, C.

    2017-12-01

    Land surface phenology (LSP) datasets have been produced from a variety of coarse spatial resolution satellite observations at both regional and global scales and spanning different time periods since 1982. However, the LSP product generated from NASA's MODerate Resolution Imaging Spectroradiometer (MODIS) data at a spatial resolution of 500m, which is termed Land Cover Dynamics (MCD12Q2), is the only global product operationally produced and freely accessible at annual time steps from 2001. Because MODIS instrument is aging and will be replaced by the Visible Infrared Imaging Radiometer Suite (VIIRS), this research focuses on the generation and evaluation of a global LSP product from Suomi-NPP VIIRS time series observations that provide continuity with the MCD12Q2 product. Specifically, we generate 500m VIIRS global LSP data using daily VIIRS Nadir BRDF (bidirectional reflectance distribution function)-Adjusted reflectances (NBAR) in combination with land surface temperature, snow cover, and land cover type as inputs. The product provides twelve phenological metrics (seven phenological dates and five phenological greenness magnitudes), along with six quality metrics characterizing the confidence and quality associated with phenology retrievals at each pixel. In this paper, we describe the input data and algorithms used to produce this new product, and investigate the impact of VIIRS data time series quality on phenology detections across various climate regimes and ecosystems. As part of our analysis, the VIIRS LSP is evaluated using PhenoCam imagery in North America and Asia, and using higher spatial resolution satellite observations from Landsat 8 over an agricultural area in the central USA. We also explore the impact of high frequency cloud cover on the VIIRS LSP product by comparing with phenology detected from the Advanced Himawari Imager (AHI) onboard Himawari-8. AHI is a new geostationary sensor that observes land surface every 10 minutes, which increases

  20. Evaluation of UTLS Carbon Monoxide Simulations in GMI and GEOS-Chem Chemical Transport Models using Aura MLS Observations

    NASA Technical Reports Server (NTRS)

    Huang, Lei; Jiang, Jonathan H.; Murray, Lee T.; Damon, Megan R.; Su, Hui; Livesey, Nathaniel J.

    2016-01-01

    This study evaluates the distribution and variation of carbon monoxide (CO) in the upper troposphere and lower stratosphere (UTLS) during 2004-2012 as simulated by two chemical transport models, using the latest version of Aura Microwave Limb Sounder (MLS) observations. The simulated spatial distributions, temporal variations and vertical transport of CO in the UTLS region are compared with those observed by MLS. We also investigate the impact of surface emissions and deep convection on CO concentrations in the UTLS over different regions, using both model simulations and MLS observations. Global Modeling Initiative (GMI) and GEOS-Chem simulations of UTLS CO both show similar spatial distributions to observations. The global mean CO values simulated by both models agree with MLS observations at 215 and 147 hPa, but are significantly underestimated by more than 40% at 100 hPa. In addition, the models underestimate the peak CO values by up to 70% at 100 hPa, 60% at 147 hPa and 40% at 215 hPa, with GEOS-Chem generally simulating more CO at 100 hPa and less CO at 215 hPa than GMI. The seasonal distributions of CO simulated by both models are in better agreement with MLS in the Southern Hemisphere (SH) than in the Northern Hemisphere (NH), with disagreements between model and observations over enhanced CO regions such as southern Africa. The simulated vertical transport of CO shows better agreement with MLS in the tropics and the SH subtropics than the NH subtropics. We also examine regional variations in the relationships among surface CO emission, convection and UTLS CO concentrations. The two models exhibit emission-convection- CO relationships similar to those observed by MLS over the tropics and some regions with enhanced UTLS CO.

  1. Development of an epiphyte indicator of nutrient enrichment: A critical evaluation of observational and experimental studies

    EPA Science Inventory

    An extensive review of the literature on epiphytes on submerged aquatic vegetation (SAV), primarily seagrasses but including some brackish and freshwater rooted macrophytes, was conducted in order to evaluate the evidence for response of epiphyte metrics to increased nutrients. ...

  2. Pyrolysis system evaluation study

    NASA Technical Reports Server (NTRS)

    1974-01-01

    An evaluation of two different pyrolysis concepts which recover energy from solid waste was conducted in order to determine the merits of each concept for integration into a Integrated Utility System (IUS). The two concepts evaluated were a Lead Bath Furnace Pyrolysis System and a Slagging Vertical Shaft, Partial Air Oxidation Pyrolysis System. Both concepts will produce a fuel gas from the IUS waste and sewage sludge which can be used to offset primary fuel consumption in addition to the sanitary disposal of the waste. The study evaluated the thermal integration of each concept as well as the economic impact on the IUS resulting from integrating each pyrolysis concepts. For reference, the pyrolysis concepts were also compared to incineration which was considered the baseline IUS solid waste disposal system.

  3. The impact of blood type O on mortality of severe trauma patients: a retrospective observational study.

    PubMed

    Takayama, Wataru; Endo, Akira; Koguchi, Hazuki; Sugimoto, Momoko; Murata, Kiyoshi; Otomo, Yasuhiro

    2018-05-02

    Recent studies have implicated the differences in the ABO blood system as a potential risk for various diseases, including hemostatic disorders and hemorrhage. In this study, we evaluated the impact of the difference in the ABO blood type on mortality in patients with severe trauma. A retrospective observational study was conducted in two tertiary emergency critical care medical centers in Japan. Patients with trauma with an Injury Severity Score (ISS) > 15 were included. The association between the different blood types (type O versus other blood types) and the outcomes of all-cause mortality, cause-specific mortalities (exsanguination, traumatic brain injury, and others), ventilator-free days (VFD), and total transfusion volume were evaluated using univariate and multivariate competing-risk regression models. Moreover, the impact of blood type O on the outcomes was assessed using regression coefficients in the multivariate analysis adjusted for age, ISS, and the Revised Trauma Score (RTS). A total of 901 patients were included in this study. The study population was divided based on the ABO blood type: type O, 284 (32%); type A, 285 (32%); type B, 209 (23%); and type AB, 123 (13%). Blood type O was associated with high mortality (28% in patients with blood type O versus 11% in patients with other blood types; p <  0.001). Moreover, this association was observed in a multivariate model (adjusted odds ratio = 2.86, 95% confidence interval 1.84-4.46; p <  0.001). The impact of blood type O on all-cause in-hospital mortality was comparable to 12 increases in the ISS, 1.5 decreases in the RTS, and 26 increases in age. Furthermore, blood type O was significantly associated with higher cause-specific mortalities and shorter VFD compared with the other blood types; however, a significant difference was not observed in the transfusion volume between the two groups. Blood type O was significantly associated with high mortality in severe trauma patients and

  4. Global-scale evaluation of 22 precipitation datasets using gauge observations and hydrological modeling

    NASA Astrophysics Data System (ADS)

    Beck, Hylke E.; Vergopolan, Noemi; Pan, Ming; Levizzani, Vincenzo; van Dijk, Albert I. J. M.; Weedon, Graham P.; Brocca, Luca; Pappenberger, Florian; Huffman, George J.; Wood, Eric F.

    2017-12-01

    We undertook a comprehensive evaluation of 22 gridded (quasi-)global (sub-)daily precipitation (P) datasets for the period 2000-2016. Thirteen non-gauge-corrected P datasets were evaluated using daily P gauge observations from 76 086 gauges worldwide. Another nine gauge-corrected datasets were evaluated using hydrological modeling, by calibrating the HBV conceptual model against streamflow records for each of 9053 small to medium-sized ( < 50 000 km2) catchments worldwide, and comparing the resulting performance. Marked differences in spatio-temporal patterns and accuracy were found among the datasets. Among the uncorrected P datasets, the satellite- and reanalysis-based MSWEP-ng V1.2 and V2.0 datasets generally showed the best temporal correlations with the gauge observations, followed by the reanalyses (ERA-Interim, JRA-55, and NCEP-CFSR) and the satellite- and reanalysis-based CHIRP V2.0 dataset, the estimates based primarily on passive microwave remote sensing of rainfall (CMORPH V1.0, GSMaP V5/6, and TMPA 3B42RT V7) or near-surface soil moisture (SM2RAIN-ASCAT), and finally, estimates based primarily on thermal infrared imagery (GridSat V1.0, PERSIANN, and PERSIANN-CCS). Two of the three reanalyses (ERA-Interim and JRA-55) unexpectedly obtained lower trend errors than the satellite datasets. Among the corrected P datasets, the ones directly incorporating daily gauge data (CPC Unified, and MSWEP V1.2 and V2.0) generally provided the best calibration scores, although the good performance of the fully gauge-based CPC Unified is unlikely to translate to sparsely or ungauged regions. Next best results were obtained with P estimates directly incorporating temporally coarser gauge data (CHIRPS V2.0, GPCP-1DD V1.2, TMPA 3B42 V7, and WFDEI-CRU), which in turn outperformed the one indirectly incorporating gauge data through another multi-source dataset (PERSIANN-CDR V1R1). Our results highlight large differences in estimation accuracy, and hence the importance of P

  5. Global-scale evaluation of 22 precipitation datasets using gauge observations and hydrological modeling

    NASA Astrophysics Data System (ADS)

    Beck, H.; Vergopolan, N.; Pan, M.; Levizzani, V.; van Dijk, A.; Weedon, G. P.; Brocca, L.; Huffman, G. J.; Wood, E. F.; William, L.

    2017-12-01

    We undertook a comprehensive evaluation of 22 gridded (quasi-)global (sub-)daily precipitation (P) datasets for the period 2000-2016. Twelve non-gauge-corrected P datasets were evaluated using daily P gauge observations from 76,086 gauges worldwide. Another ten gauge-corrected ones were evaluated using hydrological modeling, by calibrating the conceptual model HBV against streamflow records for each of 9053 small to medium-sized (<50,000 km2) catchments worldwide, and comparing the resulting performance. Marked differences in spatio-temporal patterns and accuracy were found among the datasets. Among the uncorrected P datasets, the satellite- and reanalysis-based MSWEP-ng V1.2 and V2.0 datasets generally showed the best temporal correlations with the gauge observations, followed by the reanalyses (ERA-Interim, JRA-55, and NCEP-CFSR), the estimates based primarily on passive microwave remote sensing of rainfall (CMORPH V1.0, GSMaP V5/6, and TMPA 3B42RT V7) or near-surface soil moisture (SM2RAIN-ASCAT), and finally, estimates based primarily on thermal infrared imagery (GridSat V1.0, PERSIANN, and PERSIANN-CCS). Two of the three reanalyses (ERA-Interim and JRA-55) unexpectedly obtained lower trend errors than the satellite datasets. Among the corrected P datasets, the ones directly incorporating daily gauge data (CPC Unified and MSWEP V1.2 and V2.0) generally provided the best calibration scores, although the good performance of the fully gauge-based CPC Unified is unlikely to translate to sparsely or ungauged regions. Next best results were obtained with P estimates directly incorporating temporally coarser gauge data (CHIRPS V2.0, GPCP-1DD V1.2, TMPA 3B42 V7, and WFDEI-CRU), which in turn outperformed those indirectly incorporating gauge data through other multi-source datasets (PERSIANN-CDR V1R1 and PGF). Our results highlight large differences in estimation accuracy, and hence, the importance of P dataset selection in both research and operational applications

  6. Evaluation of New York state's mandatory occupant restraint law. Volume 1, Observational surveys of safety restraint use in New York State

    DOT National Transportation Integrated Search

    1985-12-01

    This is the final report on the results of three observational surveys of restraint use by front seat occupants conducted as part of the evaluation of New York's Mandatory Occupant Restraint Law. Observations were conducted at a probability sample of...

  7. Observational study of Arctium lappa in the treatment of acne vulgaris.

    PubMed

    Miglani, Anjali; Manchanda, Raj K

    2014-07-01

    Arctium lappa (Lappa) is used in traditional Western and Chinese medicine for acne. It is mentioned in homeopathic literature for acne, but its effect has not previously been evaluated. To determine the effectiveness of homeopathic medicine Lappa in treatment of acne vulgaris. An uncontrolled observational interventional study was conducted on human subjects who fulfilled the inclusion criteria and gave written informed consent. Lappa was prescribed in potencies starting from 6c rising to 1M as required, over a period of 6 months. Objective assessment was change in acne lesion counts supplemented with Global Acne Grading System (GAGS) and subjective assessment by using Acne-Specific Quality of Life questionnaire (Acne-QoL). Out of 34 human subjects, 32 completed the follow-up. Statistical significant results were seen in lesion counts, GAGS and Acne-QoL score (p value <0.001). Lappa has shown positive effects in the treatment of acne especially of inflammatory type. Further controlled, randomized studies with larger sample size are desirable. Trial is registered at ClinicalTrials.gov Identifier: NCT01040390. Copyright © 2013 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.

  8. A protocol for a prospective observational study using chest and thumb ECG: transient ECG assessment in stroke evaluation (TEASE) in Sweden.

    PubMed

    Magnusson, Peter; Koyi, Hirsh; Mattsson, Gustav

    2018-04-03

    Atrial fibrillation (AF) causes ischaemic stroke and based on risk factor evaluation warrants anticoagulation therapy. In stroke survivors, AF is typically detected with short-term ECG monitoring in the stroke unit. Prolonged continuous ECG monitoring requires substantial resources while insertable cardiac monitors are invasive and costly. Chest and thumb ECG could provide an alternative for AF detection poststroke.The primary objective of our study is to assess the incidence of newly diagnosed AF during 28 days of chest and thumb ECG monitoring in cryptogenic stroke. Secondary objectives are to assess health-related quality of life (HRQoL) using short-form health survey (SF-36) and the feasibility of the Coala Heart Monitor in patients who had a stroke. Stroke survivors in Region Gävleborg, Sweden, will be eligible for the study from October 2017. Patients with a history of ischaemic stroke without documented AF before or during ECG evaluation in the stroke unit will be evaluated by the chest and thumb ECG system Coala Heart Monitor. The monitoring system is connected to a smartphone application which allows for remote monitoring and prompt advice on clinical management. Over a period of 28 days, patients will be monitored two times a day and may activate the ECG recording at symptoms. On completion, the system is returned by mail. This system offers a possibility to evaluate the presence of AF poststroke, but the feasibility of this system in patients who recently suffered from a stroke is unknown. In addition, HRQoL using SF-36 in comparison to Swedish population norms will be assessed. The feasibility of the Coala Heart Monitor will be assessed by a self-developed questionnaire. The study was approved by The Regional Ethical Committee in Uppsala (2017/321). The database will be closed after the last follow-up, followed by statistical analyses, interpretation of results and dissemination to a scientific journal. NCT03301662; Pre-results. © Article author

  9. Dextromethorphan/Quinidine in Migraine Prophylaxis: An Open-label Observational Clinical Study.

    PubMed

    Berkovich, Regina R; Sokolov, Alexey Y; Togasaki, Daniel M; Yakupova, Aida A; Cesar, Paul-Henry; Sahai-Srivastava, Soma

    This study aimed to assess potential efficacy and safety of dextromethorphan/quinidine (DMQ) in prophylactic treatment of migraine in patients with multiple sclerosis (MS) with superimposed pseudobulbar affect (PBA). Multiple sclerosis patients with superimposed PBA and comorbid migraine were enrolled into this open-label observational study at the University of Southern California Comprehensive MS Center. The baseline characteristics included, among other data, frequency and severity of acute migraine attacks and use of migraine relievers. The DMQ was used exclusively per its primary indication - PBA symptoms control - 20/10 mg orally, twice a day for the mean of 4.5 months (the shortest exposure registered was 3 months and the longest, 6 months). To determine whether treatment caused an effect on migraine frequency and severity, the baseline and posttreatment values were compared using nonparametric sign test. Thirty-three MS subjects with PBA, who also suffered from migraines, were identified. Twenty-nine subjects had improvement in headache frequency, 4 had no change, and none had worsening (P < 0.001 as compared with the baseline). Twenty-eight subjects had improvement in headache severity, 5 had no change, and none had worsening (P < 0.001). Our pilot study results provide evidence that DMQ shows promise as a candidate for larger clinical studies evaluating its efficacy for the prevention of migraine headaches.

  10. Overview of the Ocean Observer Satellite Study

    NASA Astrophysics Data System (ADS)

    Cunningham, J. D.; McGuire, J. P.; Pichel, W. G.; Gerber, A. J.

    2002-12-01

    A two-year study of ocean satellite remote sensing requirements and instrument/satellite options is nearing completion. This Ocean Observer Study was sponsored by the U.S. Dept. of Commerce/Dept. of Defense/National Aeronautics and Space Administration Integrated Program Office, whose mission is to develop the future U.S. National Polar-Orbiting Operational Environmental Satellite System (NPOESS). A comprehensive Ocean Observer User Requirements Document has been drafted by a team of over 150 government, academic, and private sector scientists, engineers, and administrators. Included are requirements for open and coastal ocean surface, cryospheric, hydrologic, and some land/hazard and atmospheric boundary layer parameters. This document was then used as input to the instrument and satellite study (conducted by the Jet Propulsion Laboratory) which produced five different instrument/satellite configuration options designed to address the maximum number of requirements which will not be met with the already-approved NPOESS instruments. Instruments studied include a synthetic aperture radar (SAR), an altimeter, and a hyper-spectral coastal infrared/visible imager. After analyzing the alternatives, it appears that one of the best options is a two-satellite system consisting of (1) an altimeter mission in the Topex/Poseidon orbit carrying both wide-swath and delayed doppler altimeters, and (2) a multi-polarization, multi-frequency, multi-mode interferometric SAR mission including a coastal imager in a polar sun-synchronous orbit. This paper summarizes the user requirements process, briefly describes the notional satellite configuration, and presents some of the capabilities of the instruments.

  11. Radiation energy budget studies using collocated AVHRR and ERBE observations

    NASA Technical Reports Server (NTRS)

    Ackerman, Steven A.; Inoue, Toshiro

    1994-01-01

    Changes in the energy balance at the top of the atmosphere are specified as a function of atmospheric and surface properties using observations from the Advanced Very High Resolution Radiometer (AVHRR) and the Earth Radiation Budget Experiment (ERBE) scanner. By collocating the observations from the two instruments, flown on NOAA-9, the authors take advantage of the remote-sensing capabilities of each instrument. The AVHRR spectral channels were selected based on regions that are strongly transparent to clear sky conditions and are therefore useful for characterizing both surface and cloud-top conditions. The ERBE instruments make broadband observations that are important for climate studies. The approach of collocating these observations in time and space is used to study the radiative energy budget of three geographic regions: oceanic, savanna, and desert.

  12. Driving performance while using cell phones: an observational study.

    PubMed

    Rosenbloom, Tova

    2006-01-01

    Through spontaneous driving observations, this study sought to examine the impact of using a hands-free cell phone while driving on speed and safe gap keeping behaviors. The study also examined the association between the measure of disturbance created by using a cell phone and the driver's awareness of the disturbance. Twenty-three male adults were observed while driving for an hour and a half each; drivers were unaware of being observed. During the session, each of the participants received a phone call, initiated by an associate of the observer. The experiment was divided into two periods during which the experimental parameters were monitored: 10 minutes during conversation on a cell phone and 10 minutes of non-conversation on a hands-free cell phone. After the experiment, the driver was questioned concerning the extent to which his/her driving was disturbed by the cell phone conversation. T-test for matched samples revealed that the gaps between the drivers' cars and those in front of them diminished when drivers were engaged in the cell phone conversations. Repeated measures ANOVA revealed that drivers that had short conversations did not change their speed, while drivers who were engaged in long (over 16 minutes) conversations drove faster. No effect of drivers' awareness toward cell phone-related disturbance on actual driving behavior monitored in the present study was found.

  13. Studying the Therapeutic Process by Observing Clinicians' In-Session Behaviour.

    PubMed

    Montaño-Fidalgo, Montserrat; Ruiz, Elena M; Calero-Elvira, Ana; Froján-Parga, María Xesús

    2015-01-01

    This paper presents a further step in the use and validation of a systematic, functional-analytic method of describing psychologists' verbal behaviour during therapy. We observed recordings from 92 clinical sessions of 19 adults (14 women and 5 men of Caucasian origin, with ages ranging from 19 to 51 years) treated by nine cognitive-behavioural therapists (eight women and one man, Caucasian as well, with ages ranging from 25 to 48 years). The therapists' verbal behaviour was codified and then classified according to its possible functionality. A cluster analysis of the data, followed by a discriminant analysis, showed that the therapists' verbal behaviour tended to aggregate around four types of session differentiated by their clinical objective (assessment, explanation, treatment and consolidation). These results confirm the validity of our method and enable us to further describe clinical phenomena by distinguishing psychologists' classes of clinically relevant activities. Specific learning mechanisms may be responsible for clinical change within each class. These issues should be analysed more closely when explaining therapeutic phenomena and when developing more effective forms of clinical intervention. We described therapists' verbal behaviour in a focused fashion so as to develop new research methods that evaluate psychological work moment by moment. We performed a cluster analysis in order to evaluate how the therapists' verbal behaviour was distributed throughout the intervention. A discriminant analysis gave us further information about the statistical significance and possible nature of the clusters we observed. The therapists' verbal behaviour depended on current clinical objectives and could be classified into four classes of clinically relevant activities: evaluation, explanation, treatment and consolidation. Some of the therapist's verbalizations were more important than others when carrying out these clinically relevant activities. The

  14. Process evaluation results of a cluster randomised controlled childhood obesity prevention trial: the WAVES study.

    PubMed

    Griffin, T L; Clarke, J L; Lancashire, E R; Pallan, M J; Adab, P

    2017-08-29

    Increasing prevalence of childhood obesity and its related consequences emphasises the importance of developing and evaluating interventions aimed at prevention. The importance of process evaluation in health intervention research is increasingly recognised, assessing implementation and participant response, and how these may relate to intervention success or failure. A comprehensive process evaluation was designed and undertaken for the West Midlands ActiVe lifestyle and healthy Eating in School children (WAVES) study that tested the effectiveness of an obesity prevention programme for children aged 6-7 years, delivered in 24 UK schools. The four intervention components were: additional daily school-time physical activity (PA); cooking workshops for children and parents; Villa Vitality (VV), a 6-week healthy lifestyle promotion programme run by a local football club; and signposting to local PA opportunities. Data relating to six dimensions (Fidelity, Reach, Recruitment, Quality, Participant Responsiveness, Context) were collected via questionnaires, logbooks, direct observations, focus groups and interviews. Multiple data collection methods allowed for data triangulation and validation of methods, comparing research observations with teacher records. The 6-stage WAVES study model ((i) Data collection, (ii) Collation, (iii) Tabulation, (iv) Score allocation and discussion, (v) Consultation, (vi) Final score allocation) was developed to guide the collection, assimilation and analysis of process evaluation data. Two researchers independently allocated school scores on a 5-point Likert scale for each process evaluation dimension. Researchers then discussed school score allocations and reached a consensus. Schools were ranked by total score, and grouped to reflect low, medium or high intervention implementation. The intervention was predominantly well-implemented and well-received by teachers, parents and children. The PA component was identified as the most

  15. The BraveNet prospective observational study on integrative medicine treatment approaches for pain

    PubMed Central

    2013-01-01

    Background Chronic pain affects nearly 116 million American adults at an estimated cost of up to $635 billion annually and is the No. 1 condition for which patients seek care at integrative medicine clinics. In our Study on Integrative Medicine Treatment Approaches for Pain (SIMTAP), we observed the impact of an integrative approach on chronic pain and a number of other related patient-reported outcome measures. Methods Our prospective, non-randomized, open-label observational evaluation was conducted over six months, at nine clinical sites. Participants received a non-standardized, personalized, multimodal approach to chronic pain. Validated instruments for pain (severity and interference levels), quality of life, mood, stress, sleep, fatigue, sense of control, overall well-being, and work productivity were completed at baseline and at six, 12, and 24 weeks. Blood was collected at baseline and week 12 for analysis of high-sensitivity C-reactive protein and 25-hydroxyvitamin D levels. Repeated-measures analysis was performed on data to assess change from baseline at 24 weeks. Results Of 409 participants initially enrolled, 252 completed all follow-up visits during the 6 month evaluation. Participants were predominantly white (81%) and female (73%), with a mean age of 49.1 years (15.44) and an average of 8.0 (9.26) years of chronic pain. At baseline, 52% of patients reported symptoms consistent with depression. At 24 weeks, significantly decreased pain severity (−23%) and interference (−28%) were seen. Significant improvements in mood, stress, quality of life, fatigue, sleep and well-being were also observed. Mean 25-hydroxyvitamin D levels increased from 33.4 (17.05) ng/mL at baseline to 39.6 (16.68) ng/mL at week 12. Conclusions Among participants completing an integrative medicine program for chronic pain, significant improvements were seen in pain as well as other relevant patient-reported outcome measures. Trial Registration ClinicalTrials.gov, NCT

  16. Evaluation of ACCMIP Outgoing Longwave Radiation from Tropospheric Ozone Using TES Satellite Observations.

    NASA Technical Reports Server (NTRS)

    Bowman, Kevin W.; Shindell, Drew Todd; Worden, H. M.; Lamarque, J. F.; Young, P. J.; Stevenson, D. S.; Qu, Z.; delaTorre, M.; Bergmann, D.; Cameron-Smith, P. J.; hide

    2013-01-01

    We use simultaneous observations of tropospheric ozone and outgoing longwave radiation (OLR) sensitivity to tropospheric ozone from the Tropospheric Emission Spectrometer (TES) to evaluate model tropospheric ozone and its effect on OLR simulated by a suite of chemistry-climate models that participated in the Atmospheric Chemistry and Climate Model Intercomparison Project (ACCMIP). The ensemble mean of ACCMIP models show a persistent but modest tropospheric ozone low bias (5-20 ppb) in the Southern Hemisphere (SH) and modest high bias (5-10 ppb) in the Northern Hemisphere (NH) relative to TES ozone for 2005-2010. These ozone biases have a significant impact on the OLR. Using TES instantaneous radiative kernels (IRK), we show that the ACCMIP ensemble mean tropospheric ozone low bias leads up to 120mW/ sq. m OLR high bias locally but zonally compensating errors reduce the global OLR high bias to 39+/- 41mW/ sq. m relative to TES data. We show that there is a correlation (Sq. R = 0.59) between the magnitude of the ACCMIP OLR bias and the deviation of the ACCMIP preindustrial to present day (1750-2010) ozone radiative forcing (RF) from the ensemble ozone RF mean. However, this correlation is driven primarily by models whose absolute OLR bias from tropospheric ozone exceeds 100mW/ sq. m. Removing these models leads to a mean ozone radiative forcing of 394+/- 42mW/ sq. m. The mean is about the same and the standard deviation is about 30% lower than an ensemble ozone RF of 384 +/- 60mW/ sq. m derived from 14 of the 16 ACCMIP models reported in a companion ACCMIP study. These results point towards a profitable direction of combining satellite observations and chemistry-climate model simulations to reduce uncertainty in ozone radiative forcing.

  17. Evaluation of a Cloud Resolving Model Using TRMM Observations for Multiscale Modeling Applications

    NASA Technical Reports Server (NTRS)

    Posselt, Derek J.; L'Ecuyer, Tristan; Tao, Wei-Kuo; Hou, Arthur Y.; Stephens, Graeme L.

    2007-01-01

    The climate change simulation community is moving toward use of global cloud resolving models (CRMs), however, current computational resources are not sufficient to run global CRMs over the hundreds of years necessary to produce climate change estimates. As an intermediate step between conventional general circulation models (GCMs) and global CRMs, many climate analysis centers are embedding a CRM in each grid cell of a conventional GCM. These Multiscale Modeling Frameworks (MMFs) represent a theoretical advance over the use of conventional GCM cloud and convection parameterizations, but have been shown to exhibit an overproduction of precipitation in the tropics during the northern hemisphere summer. In this study, simulations of clouds, precipitation, and radiation over the South China Sea using the CRM component of the NASA Goddard MMF are evaluated using retrievals derived from the instruments aboard the Tropical Rainfall Measuring Mission (TRMM) satellite platform for a 46-day time period that spans 5 May - 20 June 1998. The NASA Goddard Cumulus Ensemble (GCE) model is forced with observed largescale forcing derived from soundings taken during the intensive observing period of the South China Sea Monsoon Experiment. It is found that the GCE configuration used in the NASA Goddard MMF responds too vigorously to the imposed large-scale forcing, accumulating too much moisture and producing too much cloud cover during convective phases, and overdrying the atmosphere and suppressing clouds during monsoon break periods. Sensitivity experiments reveal that changes to ice cloud microphysical parameters have a relatively large effect on simulated clouds, precipitation, and radiation, while changes to grid spacing and domain length have little effect on simulation results. The results motivate a more detailed and quantitative exploration of the sources and magnitude of the uncertainty associated with specified cloud microphysical parameters in the CRM components of MMFs.

  18. Theoretical and Observational Studies of Meteor Interactions with the Ionosphere

    DTIC Science & Technology

    2006-06-01

    within an order of magnitude. The histograms of scattering mass, calculated from data collected at the ALTAIR rada are contained in Figure 1 . These...RTO-MP-IST-056 12 - 1 UNCLASSIFIED/UNLIMITED UNCLASSIFIED/UNLIMITED Theoretical and Observational Studies of Meteor Interactions with the...Observational Studies of Meteor Interactions with the Ionosphere. In Characterising the Ionosphere (pp. 12- 1 – 12-12). Meeting Proceedings RTO-MP-IST-056

  19. Tactile massage reduces rescue doses for pain and anxiety: an observational study.

    PubMed

    Pedersen, Karina; Björkhem-Bergman, Linda

    2018-03-01

    The aim of this study was to evaluate the effect of tactile massage (TM) on palliative care patients. An observational study at a hospice ward in Sweden was carried out. Forty-one palliative patients were offered TM, at an average of three treatments per patient. Before and after every treatment, self-assessed pain, well-being and anxiety according to the Edmonton Symptom Assessment Scale (0-10) were recorded. In addition, the number of rescue doses for pain and anxiety was monitored 24 hours before and after the treatment and in two consecutive days before the patients were offered TM (control data). TM resulted in improvement of self-assessed pain by 1.7 points (SD 1.6), anxiety by 2.3 points (SD 2.0) and well-being by 2.6 points (SD 1.4). The number of rescue doses for pain was reduced from 1.6 to 0.84 doses/patient (P<0.001) and for anxiety from 0.52 to 0.24 doses/patient (P<0.01). The number of rescue doses was not changed in the same patients in two consecutive days before the patients were offered TM. The effect was evident already after the first treatment and did not increase further with repeated treatments. No patients reported any harmful effects of the treatment. TM reduced the need for administration of rescue doses for pain and anxiety and improved well-being in palliative care patients. Larger randomised studies with parallel control groups are needed to confirm the findings from this observational pilot study. © 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.

  20. Time use and physical activity in a specialised brain injury rehabilitation unit: an observational study.

    PubMed

    Hassett, Leanne; Wong, Siobhan; Sheaves, Emma; Daher, Maysaa; Grady, Andrew; Egan, Cara; Seeto, Carol; Hosking, Talia; Moseley, Anne

    2018-04-18

    To determine what is the use of time and physical activity in people undertaking inpatient rehabilitation in a specialised brain injury unit. To determine participants' level of independence related to the use of time and physical activity. Design: Cross-sectional observation study. Fourteen people [mean (SD) age 40 (15) years] with brain injuries undertaking inpatient rehabilitation. Participants were observed every 12 minutes over 5 days (Monday to Friday from 7:30 am until 7:30 pm) using a behaviour mapping tool. Observation of location, people present, body position and activity engaged in (both therapeutic and nontherapeutic). Functional Independence Measure (FIM) scores were determined for each participant. Participants spent a large part of their time alone (34%) in sedentary positions (83%) and in their bedrooms (48%) doing non-therapeutic activities (78%). There was a positive relationship between a higher level of independence (higher FIM score) and being observed in active body positions (r=0.60; p=0.03) and participating in physically active therapeutic activities (r=0.53; p=0.05). Similar to stroke units, inpatients in a specialised brain injury unit spend large parts of the day sedentary, alone and doing non-therapeutic activities. Strategies need to be evaluated to address this problem, particularly for people with greater physical dependence.

  1. Teacher Evaluations: A Correlation of Observed Teaching Practice and Student Achievement

    ERIC Educational Resources Information Center

    Wright, Pamela D.

    2017-01-01

    This quantitative study employed a correlational research design to examine the extent to which overall teacher evaluation scores and instructional practice domain scores relate to student achievement scores in mathematics and English language arts among 3rd grade students. This research tested the theory of instruction by Jerome Bruner as it…

  2. Mycology of chronic suppurative otitis media-cholesteatoma disease: An evaluative study.

    PubMed

    Singh, Gautam Bir; Solo, Medozhanuo; Kaur, Ravinder; Arora, Rubeena; Kumar, Sunil

    To detect the prevalence of fungus in chronic suppurative otitis media-cholesteatoma disease and to evaluate its clinical significance. Prospective observational study conducted in a sample size of 46 patients at a tertiary care university teaching hospital. Forty six patients suffering from chronic suppurative otitis media-cholesteatoma disease were recruited in this prospective study. Data was duly recorded. Cholesteatoma sample was procured at the time of mastoid surgery and microbiologically analysed for fungal infestation. Clinical correlation to fungus infestation of cholesteatoma was statistically analysed. Out of the recruited 46 patients, post-operatively cholesteatoma was seen in 40 cases only. Seventeen i.e. 42.5% of these cases had fungal colonization of cholesteatoma. Further a statistically significant correlation between persistent otorrhoea and fungal infestation of cholesteatoma was observed. Three cases of fungal otomastoiditis were also recorded in this study, but a statistically significant correlation between complications and fungus infestation of cholesteatoma could not be clearly established. There is fungal colonization of cholesteatoma which is pathogenic and can cause persistent otorrhoea. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Emotion dysregulation and dyadic conflict in depressed and typical adolescents: evaluating concordance across psychophysiological and observational measures.

    PubMed

    Crowell, Sheila E; Baucom, Brian R; Yaptangco, Mona; Bride, Daniel; Hsiao, Ray; McCauley, Elizabeth; Beauchaine, Theodore P

    2014-04-01

    Many depressed adolescents experience difficulty in regulating their emotions. These emotion regulation difficulties appear to emerge in part from socialization processes within families and then generalize to other contexts. However, emotion dysregulation is typically assessed within the individual, rather than in the social relationships that shape and maintain dysregulation. In this study, we evaluated concordance of physiological and observational measures of emotion dysregulation during interpersonal conflict, using a multilevel actor-partner interdependence model (APIM). Participants were 75 mother-daughter dyads, including 50 depressed adolescents with or without a history of self-injury, and 25 typically developing controls. Behavior dysregulation was operationalized as observed aversiveness during a conflict discussion, and physiological dysregulation was indexed by respiratory sinus arrhythmia (RSA). Results revealed different patterns of concordance for control versus depressed participants. Controls evidenced a concordant partner (between-person) effect, and showed increased physiological regulation during minutes when their partner was more aversive. In contrast, clinical dyad members displayed a concordant actor (within-person) effect, becoming simultaneously physiologically and behaviorally dysregulated. Results inform current understanding of emotion dysregulation across multiple levels of analysis. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Evaluation of a Low-risk Mild Traumatic Brain Injury and Intracranial Hemorrhage Emergency Department Observation Protocol.

    PubMed

    Yun, Brian J; Borczuk, Pierre; Wang, Lulu; Dorner, Stephen; White, Benjamin A; Raja, Ali S

    2017-11-20

    Among emergency physicians, there is wide variation in admitting practices for patients who suffered a mild traumatic brain injury (TBI) with an intracranial hemorrhage (ICH). The purpose of this study was to evaluate the effects of implementing a protocol in the emergency department (ED) observation unit for patients with mild TBI and ICH. This retrospective cohort study was approved by the institutional review board. Study subjects were patients ≥ 18 years of age with an International Classification of Diseases code corresponding to a traumatic ICH and admitted to an ED observation unit (EDOU) of an urban, academic Level I trauma center between February 1, 2015, and January 31, 2017. Patient data and discharge disposition were abstracted from the electronic health record, and imaging data, from the final neuroradiologist report. To measure kappa, two abstractors independently collected data for presence of neuro deficit from a 10% random sample of the medical charts. Using a multivariable logistic regression model with a propensity score of the probability of placement in the EDOU before and after protocol implementation as a covariate, we sought to determine the pre-post effects of implementing a protocol on the composite outcome of admission to the floor, intensive care unit, or operating room from the EDOU and the proportion of patients with worsening findings on repeat computed tomography (CT) head scan in the EDOU. A total of 379 patients were identified during the study period; 83 were excluded as they were found to have no ICH on chart review. Inter-rater reliability kappa statistic was 0.63 for 30 charts. Among the 296 patients who remained eligible and comprised the study population, 143 were in the preprotocol period and 153 after protocol implementation. The EDOU protocol was associated with an independently statistically significant decreased odds ratio (OR) for admission or worsening ICH on repeat CT scan (OR = 0.45, 95% confidence interval [CI

  5. Foundation observation of teaching project--a developmental model of peer observation of teaching.

    PubMed

    Pattison, Andrew Timothy; Sherwood, Morgan; Lumsden, Colin James; Gale, Alison; Markides, Maria

    2012-01-01

    Peer observation of teaching is important in the development of educators. The foundation curriculum specifies teaching competencies that must be attained. We created a developmental model of peer observation of teaching to help our foundation doctors achieve these competencies and develop as educators. A process for peer observation was created based on key features of faculty development. The project consisted of a pre-observation meeting, the observation, a post-observation debrief, writing of reflective reports and group feedback sessions. The project was evaluated by completion of questionnaires and focus groups held with both foundation doctors and the students they taught to achieve triangulation. Twenty-one foundation doctors took part. All completed reflective reports on their teaching. Participants described the process as useful in their development as educators, citing specific examples of changes to their teaching practice. Medical students rated the sessions as better or much better quality as their usual teaching. The study highlights the benefits of the project to individual foundation doctors, undergraduate medical students and faculty. It acknowledges potential anxieties involved in having teaching observed. A structured programme of observation of teaching can deliver specific teaching competencies required by foundation doctors and provides additional benefits.

  6. [Detection of small for gestational age fetuses during third trimester ultrasound. A monocentric observational study].

    PubMed

    Peyronnet, V; Kayem, G; Mandelbrot, L; Sibiude, J

    2016-09-01

    Fetus small for gestational age (SGA) screening rate is evaluated around 21,7 % in France. Recommendations were developed to improve the efficiency of ultrasound conducted in the third trimester (T3), because neonatal consequences can be significant. This study aims to evaluate screening of SGA during T3 ultrasound and to describe causes for failure and differences with the recommendations of CNGOF. All children born between 2011 and 2012 with a birth weight below the 3rd percentile were included in this observational, retrospective, monocentric study. We noted that the diagnosis of SGA was placed on file. Then, as recommended by the CNGOF, we calculated estimated fetal weight (EFW) with Hadlock 3 and Hadlock 4, and the corresponding percentiles, using the biometrics from the ultrasound report. We thus could evaluate a new screening rate with SGA fetus identified through this technique. A total of 142 patients were included. By calculating correctly all EFW and checking abdominal circumference percentiles, the screening rate of SGA fetuses with T3 ultrasound increased from 40 % to 50 % and the overall screening rate (clinical and ultrasound) from 54 % to 66 %. By following the recommendations we found a real improvement in fetal SGA screening rates to T3 ultrasound with a potential benefit for their care. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  7. Genetic Expression in Cystic Fibrosis Related Bone Disease. An Observational, Transversal, Cross-Sectional Study.

    PubMed

    Ciuca, Ioana M; Pop, Liviu L; Rogobete, Alexandru F; Onet, Dan I; Guta-Almajan, Bogdan; Popa, Zoran; Horhat, Florin G

    2016-09-01

    Cystic fibrosis (CF) is the most frequent monogenic genetic disease with autosomal recessive transmission and characterized by important clinical polymorphism and significant lethal prospective. CF related bone disease occurs frequently in adults with CF. Childhood is the period of bone formation, and therefore, children are more susceptible to low bone density. Several factors like pancreatic insufficiency, hormone imbalance, and physical inactivity contribute to CF bone disease development. Revealing this would be important for prophylactic treatment against bone disease occurrence. The study was observational, transversal, with a cross-sectional design. The study included 68 children with cystic fibrosis, genotyped and monitored in the National CF Centre. At the annual assessment, besides clinical examination, biochemical evaluation for pancreatic insufficiency, and diabetes, they were evaluated for bone mineral density using dual energy X-ray absorptiometry (DXA). Twenty-six patients, aged over 10 years were diagnosed with CF bone disease, without significant gender gap. Bone disease was frequent in patients aged over 10 years with exocrine pancreatic insufficiency, carriers of severe mutations, and CF liver disease. CF carriers of a severe genotype which associates pancreatic insufficiency and CF liver disease, are more likely predisposed to low bone mineral density. Further studies should discover other significant influences in order to prevent the development of CF bone disease and an improved quality of life in cystic fibrosis children.

  8. Assessing validity of observational intervention studies – the Benchmarking Controlled Trials

    PubMed Central

    Malmivaara, Antti

    2016-01-01

    Abstract Background: Benchmarking Controlled Trial (BCT) is a concept which covers all observational studies aiming to assess impact of interventions or health care system features to patients and populations. Aims: To create and pilot test a checklist for appraising methodological validity of a BCT. Methods: The checklist was created by extracting the most essential elements from the comprehensive set of criteria in the previous paper on BCTs. Also checklists and scientific papers on observational studies and respective systematic reviews were utilized. Ten BCTs published in the Lancet and in the New England Journal of Medicine were used to assess feasibility of the created checklist. Results: The appraised studies seem to have several methodological limitations, some of which could be avoided in planning, conducting and reporting phases of the studies. Conclusions: The checklist can be used for planning, conducting, reporting, reviewing, and critical reading of observational intervention studies. However, the piloted checklist should be validated in further studies.Key messagesBenchmarking Controlled Trial (BCT) is a concept which covers all observational studies aiming to assess impact of interventions or health care system features to patients and populations.This paper presents a checklist for appraising methodological validity of BCTs and pilot-tests the checklist with ten BCTs published in leading medical journals. The appraised studies seem to have several methodological limitations, some of which could be avoided in planning, conducting and reporting phases of the studies.The checklist can be used for planning, conducting, reporting, reviewing, and critical reading of observational intervention studies. PMID:27238631

  9. Exposure to organochlorine pesticides and non-Hodgkin lymphoma: a meta-analysis of observational studies

    PubMed Central

    Luo, Dan; Zhou, Tingting; Tao, Yun; Feng, Yaqian; Shen, Xiaoli; Mei, Surong

    2016-01-01

    Growing evidence indicates that exposure to organochlorine pesticides (OCPs) could increase non-Hodgkin lymphoma (NHL) risk. However, results from epidemiological studies investigating this association remain controversial. We thus conducted a meta-analysis to quantitatively evaluate the association between OCP exposure and NHL risk. Relevant publications were searched in PubMed, Web of Science, and Embase and identified according to the inclusion criteria. Thirteen studies (6 nested case-control, 1 case-cohort, and 6 case-control) were selected for this meta-analysis. We used odds ratios (ORs) with 95% confidence intervals (CIs) to estimate the relationship between OCPs exposure and NHL risk. The summary OR for included studies was 1.40 (95% CI 1.27 to 1.56). No overall significant heterogeneity in the OR was observed (Ph = 0.253, I2 = 12.6%). Furthermore, OR estimates in subgroup analyses were discussed, and strong associations were observed for dichlorodiphenyldichloroethylene (DDE, OR = 1.38, 95% CI 1.14 to 1.66), hexachlorocyclohexane (HCH, OR = 1.42, 95% CI 1.08 to 1.87), chlordane (OR = 1.93, 95% CI 1.51 to 2.48), and hexachlorobenzene (HCB, OR = 1.54, 95% CI 1.20 to 1.99). This meta-analysis had suggested that total OCPs of interest was significantly positively associated with NHL risk. PMID:27185567

  10. Observed Score Equating Using a Mini-Version Anchor and an Anchor with Less Spread of Difficulty: A Comparison Study

    ERIC Educational Resources Information Center

    Liu, Jinghua; Sinharay, Sandip; Holland, Paul; Feigenbaum, Miriam; Curley, Edward

    2011-01-01

    Two different types of anchors are investigated in this study: a mini-version anchor and an anchor that has a less spread of difficulty than the tests to be equated. The latter is referred to as a midi anchor. The impact of these two different types of anchors on observed score equating are evaluated and compared with respect to systematic error…

  11. Psoriasis increases risk of new-onset atrial fibrillation: a systematic review and meta-analysis of prospective observational studies.

    PubMed

    Upala, Sikarin; Shahnawaz, Afeefa; Sanguankeo, Anawin

    2017-08-01

    Psoriasis is a common chronic immune-mediated dermatological disease that increases the risk of cardiovascular disease. We conducted a systematic review and meta-analysis to evaluate the association between psoriasis and atrial fibrillation from prospective observational studies. A comprehensive search of the databases of the MEDLINE and EMBASE was performed from inception through November 2015. The inclusion criterion was the prospective observational study that assessed the risk of new-onset atrial fibrillation in adults with psoriasis. Outcome was the adjusted hazard ratio (HR) of atrial fibrillation comparison between patients with psoriasis and controls. Pooled HR and 95% confidence intervals (CI) were calculated using a random-effects model. The initial search yielded 176 articles. Fifteen articles underwent full-length review and data were extracted from 4 observational studies. Incidence of atrial fibrillation was ascertained by cardiologist-reviewed electrocardiograms. There was a significant increased risk of new-onset atrial fibrillation in patients with psoriasis compared to controls with a pooled HR 1.42 (95%CI 1.22-1.65). Our meta-analysis of prospective studies demonstrated that patients with psoriasis have increased risk of new-onset atrial fibrillation. Future interventional studies addressing the impact of psoriasis treatment and prevention of atrial fibrillation should be performed.

  12. The reporting of observational research studies in dermatology journals: a literature-based study.

    PubMed

    Langan, Sinéad; Schmitt, Jochen; Coenraads, Pieter-Jan; Svensson, Ake; von Elm, Erik; Williams, Hywel

    2010-05-01

    To assess the quality of reporting in observational studies in dermatology. Five dermatology journals-the Archives of Dermatology, the British Journal of Dermatology, the Journal of the American Academy of Dermatology, the Journal of Investigative Dermatology, and Acta Dermato-Venereologica. Cohort, case-control, and cross-sectional studies published as original articles during the period January 2005 through December 2007. Studies were identified with a literature search of PubMed combining the journal title and the term epidemiological studies (free text) and by hand searching all of the issues of each journal to identify relevant articles. All articles were extracted by 2 reviewers independently using standardized checklists based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations. The number and proportion of reported STROBE items were analyzed for each article. The proportion of studies with good reporting for each item was also assessed. A total of 138 articles were included and analyzed. Reporting quality was very mixed. Key areas that were infrequently reported included sample size calculations (n = 10 [7%]), missing data (n = 8 [6%]), losses to follow-up (n = 17 [12%]), and statistical methods (n = 19 [14%]). Only 13 studies (9%) explained the role of funders in the research. The quality of reporting was similar across study designs for "critical" questions with the exception of reporting of participant details, which was better reported in cohort studies (96%) compared with cross-sectional (80%) and case-control (70%) studies. It is difficult to judge the quality of dermatological research unless it is reported well. This study has identified a clear need to improve the quality of reporting of observational studies in dermatology. We recommend that dermatology journals adopt the STROBE criteria.

  13. Sample of Second Grade Classroom Protocols from Special Study A of the Beginning Teacher Evaluation Study for the California Commission for Teacher Preparation and Licensing.

    ERIC Educational Resources Information Center

    Tikunoff, William J.; And Others

    Second grade classroom protocols collected within this volume are examples of the protocols developed by the ethnographers associated with Special Study A: "An Ethnographic Study of the Forty Classrooms of the Beginning Teacher Evaluation Study." Twenty teachers at both the second and fifth grades were observed for one week by an…

  14. The Evaluation of the Earth's Dynamical Flattening Based on the IAU Precession-nutation and VLBI Observations

    NASA Astrophysics Data System (ADS)

    Capitaine, Nicole; Liu, Jia-Cheng

    2014-12-01

    The dynamical flattening H_{d} is a fundamental Earth's parameter and a crucial scale factor in constructing the precession-nutation models. Its value has generally been derived from astronomical observations of the luni-solar precession in longitude at epoch, or from geophysical determinations of the Earth's moment of inertia. It should be noted that the observed precession rates in longitude and obliquity result from several theoretical contributions, some of them, as well as the nutation amplitudes, being also dependent on H_{d}. This paper discusses the rigorous procedure to be used for deriving H_{d} from the best available astronomical observations. We use the IAU 2006/2000 precession-nutation and VLBI observations of the celestial pole offsets spanning about 32 years in order to calculate the observed position of the CIP (Celestial intermediate pole) in the GCRS (Geocentric celestial reference system). Then, the value of H_{d} is evaluated by a least squares method with a careful consideration of the various theoretical contributions to the precession rates and of the largest terms of nutation. We compare the results with an indirect fit of H_{d} to the estimated corrections to the linear term in precession and the 18.6-yr nutation. We discuss the limit of accuracy, given the characteristics of the available observations and the uncertainties in the models, as well as the parameters on which H_{d} is dependent.

  15. Evaluation of tropical Pacific observing systems using NCEP and GFDL ocean data assimilation systems

    NASA Astrophysics Data System (ADS)

    Xue, Yan; Wen, Caihong; Yang, Xiaosong; Behringer, David; Kumar, Arun; Vecchi, Gabriel; Rosati, Anthony; Gudgel, Rich

    2017-08-01

    The TAO/TRITON array is the cornerstone of the tropical Pacific and ENSO observing system. Motivated by the recent rapid decline of the TAO/TRITON array, the potential utility of TAO/TRITON was assessed for ENSO monitoring and prediction. The analysis focused on the period when observations from Argo floats were also available. We coordinated observing system experiments (OSEs) using the global ocean data assimilation system (GODAS) from the National Centers for Environmental Prediction and the ensemble coupled data assimilation (ECDA) from the Geophysical Fluid Dynamics Laboratory for the period 2004-2011. Four OSE simulations were conducted with inclusion of different subsets of in situ profiles: all profiles (XBT, moorings, Argo), all except the moorings, all except the Argo and no profiles. For evaluation of the OSE simulations, we examined the mean bias, standard deviation difference, root-mean-square difference (RMSD) and anomaly correlation against observations and objective analyses. Without assimilation of in situ observations, both GODAS and ECDA had large mean biases and RMSD in all variables. Assimilation of all in situ data significantly reduced mean biases and RMSD in all variables except zonal current at the equator. For GODAS, the mooring data is critical in constraining temperature in the eastern and northwestern tropical Pacific, while for ECDA both the mooring and Argo data is needed in constraining temperature in the western tropical Pacific. The Argo data is critical in constraining temperature in off-equatorial regions for both GODAS and ECDA. For constraining salinity, sea surface height and surface current analysis, the influence of Argo data was more pronounced. In addition, the salinity data from the TRITON buoys played an important role in constraining salinity in the western Pacific. GODAS was more sensitive to withholding Argo data in off-equatorial regions than ECDA because it relied on local observations to correct model biases and

  16. Characterizing Musculoskeletal Injury among Aeromedical Evacuation Personnel: An Observational Study

    DTIC Science & Technology

    2016-09-28

    three phases: a sampling study, laboratory observations, and field observations. In Phase I, 43 active duty AECMs volunteered to complete a...was administered via SurveyMonkey to volunteers from the USAFSAM Education and Training Department and the four active duty AE squadrons. The

  17. Scientific and Ethical Approaches for Observational Exposure Studies

    EPA Science Inventory

    Researchers conduct observational human exposure studies to understand how and the extent to which people come into contact with chemicals and environmental stressors in their everyday lives, through the air they breathe, the food and liquids they consume, and the things they tou...

  18. Challenges in translating endpoints from trials to observational cohort studies in oncology

    PubMed Central

    Ording, Anne Gulbech; Cronin-Fenton, Deirdre; Ehrenstein, Vera; Lash, Timothy L; Acquavella, John; Rørth, Mikael; Sørensen, Henrik Toft

    2016-01-01

    Clinical trials are considered the gold standard for examining drug efficacy and for approval of new drugs. Medical databases and population surveillance registries are valuable resources for post-approval observational research, which are increasingly used in studies of benefits and risk of new cancer drugs. Here, we address the challenges in translating endpoints from oncology trials to observational studies. Registry-based cohort studies can investigate real-world safety issues – including previously unrecognized concerns – by examining rare endpoints or multiple endpoints at once. In contrast to clinical trials, observational cohort studies typically do not exclude real-world patients from clinical practice, such as old and frail patients with comorbidity. The observational cohort study complements the clinical trial by examining the effectiveness of interventions applied in clinical practice and by providing evidence on long-term clinical outcomes, which are often not feasible to study in a clinical trial. Various endpoints can be included in clinical trials, such as hard endpoints, soft endpoints, surrogate endpoints, and patient-reported endpoints. Each endpoint has it strengths and limitations for use in research studies. Endpoints used in oncology trials are often not applicable in observational cohort studies which are limited by the setting of standard clinical practice and by non-standardized endpoint determination. Observational studies can be more helpful moving research forward if they restrict focus to appropriate and valid endpoints. PMID:27354827

  19. Evaluation of simulated biospheric carbon dioxide fluxes and atmospheric concentrations using global in situ observations

    NASA Astrophysics Data System (ADS)

    Philip, S.; Johnson, M. S.; Potter, C. S.; Genovese, V. B.

    2016-12-01

    Atmospheric mixing ratios of carbon dioxide (CO2) are largely controlled by anthropogenic emission sources and biospheric sources/sinks. Global biospheric fluxes of CO2 are controlled by complex processes facilitating the exchange of carbon between terrestrial ecosystems and the atmosphere. These processes which play a key role in these terrestrial ecosystem-atmosphere carbon exchanges are currently not fully understood, resulting in large uncertainties in the quantification of biospheric CO2 fluxes. Current models with these inherent deficiencies have difficulties simulating the global carbon cycle with high accuracy. We are developing a new modeling platform, GEOS-Chem-CASA by integrating the year-specific NASA-CASA (National Aeronautics and Space Administration - Carnegie Ames Stanford Approach) biosphere model with the GEOS-Chem (Goddard Earth Observation System-Chemistry) chemical transport model to improve the simulation of atmosphere-terrestrial ecosystem carbon exchange. We use NASA-CASA to explicitly represent the exchange of CO2 between terrestrial ecosystem and atmosphere by replacing the baseline GEOS-Chem land net CO2 flux and forest biomass burning CO2 emissions. We will present the estimation and evaluation of these "bottom-up" land CO2 fluxes, simulated atmospheric mixing ratios, and forest disturbance changes over the last decade. In addition, we will present our initial comparison of atmospheric column-mean dry air mole fraction of CO2 predicted by the model and those retrieved from NASA's OCO-2 (Orbiting Carbon Observatory-2) satellite instrument and model-predicted surface CO2 mixing ratios with global in situ observations. This evaluation is the first step necessary for our future work planned to constrain the estimates of biospheric carbon fluxes through "top-down" inverse modeling, which will improve our understanding of the processes controlling atmosphere-terrestrial ecosystem greenhouse gas exchanges, especially over regions which lack in

  20. New Insights into the Management of Hypertension and Cardiovascular Risk with Angiotensin Receptor Blockers: Observational Studies Help Us?

    PubMed Central

    Goudev, Assen

    2014-01-01

    Post-marketing observational studies are valuable for establishing the real-world effectiveness of treatment regimens in routine clinical practice as they typically monitor a diverse population of patients over many months. This article reviews recent observational studies of angiotensin receptor blockers (ARBs) for the management of hypertension: the 6-month eprosartan POWER study (n~29,400), the 3-month valsartan translational research programme (n~19,500), the 9-month irbesartan Treat to Target study (n=14,200), the 6-month irbesartan DO-IT survey (n~3300) and the 12-week candesartan CHILI survey programme (n=4600). Reduction in blood pressure with ARBs reported across these studies appears to be comparable for the different agents, although direct comparisons between studies cannot be made owing to different treatment durations and baseline patient demographics. Of these studies, the eprosartan POWER study, 2 of the 7 studies in the valsartan translational research programme, and the candesartan CHILI Triple T study measured total cardiovascular risk, as recommended in the 2013 European Society of Cardiology-European Society of Hypertension guidelines. The POWER study confirmed the value of the Systemic Coronary Risk Evaluation (SCORE) to accurately assess total cardiovascular risk. With the advent of new healthcare practices, such as the use of electronic health records (EHRs), observational studies in larger patient populations will become possible. In the future, algorithms embedded in EHR systems could evolve as decision support tools to inform on patient care. PMID:24847388

  1. A Fresh Pair of Eyes: A Blind Observation Method for Evaluating Social Skills of Children with ASD in a Naturalistic Peer Situation in School.

    PubMed

    Dekker, Vera; Nauta, Maaike H; Mulder, Erik J; Sytema, Sjoerd; de Bildt, Annelies

    2016-09-01

    The Social skills Observation Measure (SOM) is a direct observation method for social skills used in naturalistic everyday situations in school. This study describes the development of the SOM and investigates its psychometric properties in 86 children with Autism spectrum disorder, aged 9.8-13.1 years. The interrater reliability was found to be good to excellent. The convergent validity was low in relation to parent and teacher reports of social skills, and also to parent interview on adaptive social functioning. Therefore this direct observation seems to provide additional information on the frequency and quality of social behaviors in daily life situations. As such it contributes to parent and teacher information as a blind measurement to evaluate Social Skills Training.

  2. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration

    PubMed Central

    Vandenbroucke, Jan P; von Elm, Erik; Altman, Douglas G; Gøtzsche, Peter C; Mulrow, Cynthia D; Pocock, Stuart J; Poole, Charles; Schlesselman, James J; Egger, Matthias

    2007-01-01

    Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www.strobe-statement.org/) should be helpful resources to improve reporting of observational research. PMID:17941715

  3. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration.

    PubMed

    Vandenbroucke, Jan P; von Elm, Erik; Altman, Douglas G; Gøtzsche, Peter C; Mulrow, Cynthia D; Pocock, Stuart J; Poole, Charles; Schlesselman, James J; Egger, Matthias

    2014-12-01

    Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how to improve the reporting of observational studies and facilitates critical appraisal and interpretation of studies by reviewers, journal editors and readers. This explanatory and elaboration document is intended to enhance the use, understanding, and dissemination of the STROBE Statement. The meaning and rationale for each checklist item are presented. For each item, one or several published examples and, where possible, references to relevant empirical studies and methodological literature are provided. Examples of useful flow diagrams are also included. The STROBE Statement, this document, and the associated Web site (http://www.strobe-statement.org/) should be helpful resources to improve reporting of observational research. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Class Size Reduction in a Large Urban School District: A Mixed Methodology Evaluation Research Study.

    ERIC Educational Resources Information Center

    Munoz, Marco A.

    This study evaluated the Class Size Reduction (CSR) program in 34 elementary schools in Kentucky's Jefferson County Public Schools. The CSR program is a federal initiative to help elementary schools improve student learning by hiring additional teachers. Qualitative data were collected using unstructured interviews, site observations, and document…

  5. ToF-SIMS observation for evaluating the interaction between amyloid β and lipid membranes.

    PubMed

    Aoyagi, Satoka; Shimanouchi, Toshinori; Kawashima, Tomoko; Iwai, Hideo

    2015-04-01

    The adsorption behaviour of amyloid beta (Aβ), thought to be a key peptide for understanding Alzheimer's disease, was investigated by means of time-of-flight secondary ion mass spectrometry (ToF-SIMS). Aβ aggregates depending on the lipid membrane condition though it has not been fully understood yet. In this study, Aβ samples on different lipid membranes, 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC), 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC) and 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC), were observed with ToF-SIMS and the complex ToF-SIMS data of the Aβ samples was interpreted using data analysis techniques such as principal component analysis (PCA), gentle-SIMS (G-SIMS) and g-ogram. DOPC and DMPC are liquid crystal at room temperature, while DPPC is gel at room temperature. As primary ion beams, Bi3(+) and Ar cluster ion beams were used and the effect of an Ar cluster ion for evaluating biomolecules was also studied. The secondary ion images of the peptide fragment ions indicated by G-SIMS and g-ogram were consistent with the PCA results. It is suggested that Aβ is adsorbed homogeneously on the liquid-crystalline-phase lipid membranes, while it aggregates along the lipid on the gel-phase lipid membrane. Moreover, in the results using the Ar cluster, the influence of contamination was reduced.

  6. Impacted maxillary canines and root resorption of adjacent teeth: A retrospective observational study.

    PubMed

    Guarnieri, R; Cavallini, C; Vernucci, R; Vichi, M; Leonardi, R; Barbato, E

    2016-11-01

    The prevalence of impacted maxillary canine is reported to be between 1% and 3%. The lack of monitoring and the delay in the treatment of the impacted canine can cause different complications such as: displacement of adjacent teeth, loss of vitality of neighbouring teeth, shortening of the dental arch, follicular cysts, canine ankylosis, recurrent infections, recurrent pain, internal resorption of the canine and the adjacent teeth, external resorption of the canine and the adjacent teeth, combination of these factors. An appropriate diagnosis, accurate predictive analysis and early intervention are likely to prevent such undesirable effects. The objective is to evaluate, by means of a retrospective observational study, the possibility of carrying out a predictive analysis of root resorption adjacent to the impacted canines by means of orthopantomographs, so as to limit the prescription of additional 3D radiography. 120 subjects with unilateral or bilateral maxillary impacted canine were examined and 50 patients with 69 impacted maxillary canine (22 male, 28 female; mean age: 11.7 years) satisfied the inclusion criteria of the study. These patients were subjected to a basic clinical and radiographic investigation (orthopantomographs and computerized tomography). All panoramic films were viewed under standardized conditions for the evaluation of two main variables: maxillary canine angulations (a, b, g angles) and the overlapping between the impacted teeth and the lateral incisor (Analysis of Lindauer). Binary logistic regression was used to estimate the likelihood of resorbed lateral incisors depending on sector location and angle measurements. Results indicated that b angle has the greatest influence on the prediction of root resorption (predictive value of b angle = 76%). If β angle <18° and Lindauer = I, the probability of resorption is 0.06. Evaluation of b angle and superimposition lateral incisor/impacted canine analysed on orthopantomographs could be one of

  7. Observational studies as human experimentation: the uranium mining experience in the Navajo Nation (1947-66).

    PubMed

    Moure-Eraso, R

    1999-01-01

    This article evaluates how an observational epidemiologic study of federal agencies in uranium miners became an experiment of opportunity for radiation effects. Navajo miners and communities suffered environmental exposures caused by the practices of uranium mining and milling in the Navajo reservation during the 1947 to 1966 period. A historical review of the state-of-the-art knowledge of the health effects of uranium mining and milling during the years prior to 1947 was conducted. Contemporary prevention and remediation practices also were assessed. An appraisal of the summary of findings of a comprehensive evaluation of radiation human experimentation conducted by the U.S. federal government in 1995-96 (ACHRE) demonstrates that uranium miners, including Navajo miners, were the single group that was put more seriously at risk of harm from radiation exposures, with inadequate disclosure and often with fatal consequences. Uranium miners were unwilling and unaware victims of human experimentation to evaluate the health effects of radiation. The failure of the State and U.S. Governments to issue regulations or demand installation of known mine-dust exposure control measures caused widespread environmental damage in the Navajo Nation.

  8. A combined pulmonary-radiology workshop for visual evaluation of COPD: study design, chest CT findings and concordance with quantitative evaluation.

    PubMed

    Barr, R Graham; Berkowitz, Eugene A; Bigazzi, Francesca; Bode, Frederick; Bon, Jessica; Bowler, Russell P; Chiles, Caroline; Crapo, James D; Criner, Gerard J; Curtis, Jeffrey L; Dass, Chandra; Dirksen, Asger; Dransfield, Mark T; Edula, Goutham; Erikkson, Leif; Friedlander, Adam; Galperin-Aizenberg, Maya; Gefter, Warren B; Gierada, David S; Grenier, Philippe A; Goldin, Jonathan; Han, MeiLan K; Hanania, Nicola A; Hansel, Nadia N; Jacobson, Francine L; Kauczor, Hans-Ulrich; Kinnula, Vuokko L; Lipson, David A; Lynch, David A; MacNee, William; Make, Barry J; Mamary, A James; Mann, Howard; Marchetti, Nathaniel; Mascalchi, Mario; McLennan, Geoffrey; Murphy, James R; Naidich, David; Nath, Hrudaya; Newell, John D; Pistolesi, Massimo; Regan, Elizabeth A; Reilly, John J; Sandhaus, Robert; Schroeder, Joyce D; Sciurba, Frank; Shaker, Saher; Sharafkhaneh, Amir; Silverman, Edwin K; Steiner, Robert M; Strange, Charlton; Sverzellati, Nicola; Tashjian, Joseph H; van Beek, Edwin J R; Washington, Lacey; Washko, George R; Westney, Gloria; Wood, Susan A; Woodruff, Prescott G

    2012-04-01

    The purposes of this study were: to describe chest CT findings in normal non-smoking controls and cigarette smokers with and without COPD; to compare the prevalence of CT abnormalities with severity of COPD; and to evaluate concordance between visual and quantitative chest CT (QCT) scoring. Volumetric inspiratory and expiratory CT scans of 294 subjects, including normal non-smokers, smokers without COPD, and smokers with GOLD Stage I-IV COPD, were scored at a multi-reader workshop using a standardized worksheet. There were 58 observers (33 pulmonologists, 25 radiologists); each scan was scored by 9-11 observers. Interobserver agreement was calculated using kappa statistic. Median score of visual observations was compared with QCT measurements. Interobserver agreement was moderate for the presence or absence of emphysema and for the presence of panlobular emphysema; fair for the presence of centrilobular, paraseptal, and bullous emphysema subtypes and for the presence of bronchial wall thickening; and poor for gas trapping, centrilobular nodularity, mosaic attenuation, and bronchial dilation. Agreement was similar for radiologists and pulmonologists. The prevalence on CT readings of most abnormalities (e.g. emphysema, bronchial wall thickening, mosaic attenuation, expiratory gas trapping) increased significantly with greater COPD severity, while the prevalence of centrilobular nodularity decreased. Concordances between visual scoring and quantitative scoring of emphysema, gas trapping and airway wall thickening were 75%, 87% and 65%, respectively. Despite substantial inter-observer variation, visual assessment of chest CT scans in cigarette smokers provides information regarding lung disease severity; visual scoring may be complementary to quantitative evaluation.

  9. Mobile direct observation of therapy (MDOT) - A rapid systematic review and pilot study in children with asthma

    PubMed Central

    Shields, Michael D.; ALQahtani, Fahad; Rivey, Michael P.

    2018-01-01

    We describe, for the first time, the use of a mobile device platform for remote direct observation of inhaler use and technique. The research programme commenced with a rapid systematic review of mobile device (or videophone) use for direct observation of therapy (MDOT). Ten studies (mainly pilots) were identified involving patients with tuberculosis, sickle cell disease and Alzheimer's disease. New studies are ongoing (ClinicalTrials.gov website) in TB, stroke, sickle cell disease, HIV and opioid dependence. Having identified no prior use of MDOT in inhaler monitoring, we implemented a feasibility study in 12 healthy volunteer children (2–12 years; 8 females and 4 males) over a period of 14 days, with twice daily video upload of their 'dummy' inhaler use. Two children uploaded 100% of the requested videos, with only one child having an inhaler upload rate of <75%. The quality of uploaded videos was generally good (only 1.7% of unacceptable quality for evaluation). The final aspect of the research was a pilot study using MDOT (6 weeks) in 22 children with difficult to treat asthma. Healthcare professionals evaluated inhaler technique using uploaded videos and provided telephone instruction on improving inhaler use. The main outcomes were assessed at week 12 post initiation of MDOT. By week 5, all children still engaging in MDOT (n = 18) were judged to have effective inhaler technique. Spirometry values did not vary to a significantly significant degree between baseline and 12 weeks (P>0.05), however, mean fraction of exhaled nitric oxide (FeNO) values normalised (mean 38.7 to 19.3ppm) and mean Asthma Control Test values improved (13.1 to mean 17.8). Feedback from participants was positive. Overall the findings open up a new paradigm in device independent (can be used for any type of inhaler device) monitoring, providing a platform for evaluating / improving inhaler use at home. PMID:29401500

  10. Developing digital educational materials for nursing and sustainability: The results of an observational study.

    PubMed

    Álvarez-Nieto, Carmen; Richardson, Janet; Parra-Anguita, Gema; Linares-Abad, Manuel; Huss, Norma; Grande-Gascón, M Luisa; Grose, Jane; Huynen, Maud; López-Medina, Isabel M

    2018-01-01

    There is limited European literature on nursing and sustainability; nursing students are poorly prepared on the connections between resources, climate change, sustainability, and health, so they must acquire knowledge and develop skills and competencies in this field. The use of digital technologies and teaching via E-learning has grown, and has been widely adopted as a learning method for nursing. The aim of the current study was to test and evaluate digital educational materials on environmental sustainability and health, in the context of university nursing education in different European countries. An observational cross-sectional design. University of Plymouth, University of Jaén, and University of Esslingen for Nursing Degree Studies. 299 nursing students: 161 students from University of Jaén; 106 from Plymouth; and 32 from Esslingen. 22 professional evaluators with different profiles were recruited: Teachers, Clinical professionals, Delphi Experts, and Technical Experts. We conducted a piloting and validation process. The materials were designed and adapted to the NurSusTOOLKIT Sustainability Literacy and Competency framework. Evaluation was developed by professionals and students. We used the Spanish Standard for the assessment of Digital Educational Material Quality at University level questionnaire. All students provided informed consent prior to taking part in the learning and evaluation. The overall evaluations of materials by students and professionals were 7.98±1.28 and 8.50±1.17, respectively. The Ability to generate learning was scored higher among students (mean difference: 0.84; 0.22-1.47; p=0.008). In the overall assessment by students, statistically significant differences were found between the three universities (Welch: 11.69, p<0.001). Students, professionals, and technical experts considered the materials to be very good quality, especially regarding the quality of contents, format, and design. For students, these materials can generate

  11. Sample of Fifth Grade Classroom Protocols from Special Study A of the Beginning Teacher Evaluation Study for the California Commission for Teacher Preparation and Licensing.

    ERIC Educational Resources Information Center

    Tikunoff, William J.; And Others

    Classroom protocols collected within this volume are examples of the protocols from grade 5 developed by the ethnographers associated with Special Study A: "An Ethnographic Study of the Forty Classrooms of the Beginning Teacher Evaluation Study." Twenty teachers at both the second and fifth grades were observed for one week by an…

  12. Strategies for Evaluating a Freshman Studies Program.

    ERIC Educational Resources Information Center

    Ketkar, Kusum; Bennett, Shelby D.

    1989-01-01

    The study developed an economic model for the evaluation of Seaton Hall University's freshman studies program. Two techniques used to evaluate the economic success of the program are break-even analysis and elasticity coefficient. (Author/MLW)

  13. Physiotherapists use a small number of behaviour change techniques when promoting physical activity: A systematic review comparing experimental and observational studies.

    PubMed

    Kunstler, Breanne E; Cook, Jill L; Freene, Nicole; Finch, Caroline F; Kemp, Joanne L; O'Halloran, Paul D; Gaida, James E

    2018-06-01

    Physiotherapists promote physical activity as part of their practice. This study reviewed the behaviour change techniques physiotherapists use when promoting physical activity in experimental and observational studies. Systematic review of experimental and observational studies. Twelve databases were searched using terms related to physiotherapy and physical activity. We included experimental studies evaluating the efficacy of physiotherapist-led physical activity interventions delivered to adults in clinic-based private practice and outpatient settings to individuals with, or at risk of, non-communicable diseases. Observational studies reporting the techniques physiotherapists use when promoting physical activity were also included. The behaviour change techniques used in all studies were identified using the Behaviour Change Technique Taxonomy. The behaviour change techniques appearing in efficacious and inefficacious experimental interventions were compared using a narrative approach. Twelve studies (nine experimental and three observational) were retained from the initial search yield of 4141. Risk of bias ranged from low to high. Physiotherapists used seven behaviour change techniques in the observational studies, compared to 30 behaviour change techniques in the experimental studies. Social support (unspecified) was the most frequently identified behaviour change technique across both settings. Efficacious experimental interventions used more behaviour change techniques (n=29) and functioned in more ways (n=6) than did inefficacious experimental interventions (behaviour change techniques=10 and functions=1). Physiotherapists use a small number of behaviour change techniques. Less behaviour change techniques were identified in observational studies compared to experimental studies, suggesting physiotherapists use less BCTs clinically than experimentally. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  14. Observational studies of regions of massive star formation

    NASA Astrophysics Data System (ADS)

    Cooper, Heather Danielle Blythe

    2013-03-01

    Massive stars have a profound influence on their surroundings. However, relatively little is known about their formation. The study of massive star formation is hindered by a lack of observational evidence, primarily due to difficulties observing massive stars at early stages in their development. The Red MSX Source survey (RMS survey) is a valuable tool with which to address these issues. Near-infrared H- and K-band spectra were taken for 247 candidate massive young stellar objects (MYSOs), selected from the RMS survey. 195 (∼80%) of the targets are YSOs, of which 131 are massive YSOs (LBOL>5E3L⊙, M>8 M⊙). This is the largest spectroscopic study of massive YSOs to date. This study covers minimally obscured objects right through to very red, dusty sources. Almost all YSOs show some evidence for emission lines, though there is a wide variety of observed properties, with HI, H2 Fe II, and CO among the most commonly observed lines. Evidence for disks and outflows was frequently seen. Comparisons of Brγ and H2 emission with low mass YSOs suggest that the emission mechanism for these lines is the same for low-, intermediate-, and high-mass YSOs, i.e. high-mass YSOs appear to resemble scaled-up versions of low-mass YSOs. It was found that the YSOs form an evolutionary sequence, based on their spectra, consistent with the existing theoretical models. Type I YSOs have strong H2 emission, no ionized lines, and are redder than the other two subtypes. As such, these are considered to be the youngest sources. The Type III sources are bluest, and therefore considered to be the oldest subtype. They have strong H I lines and fluorescent Fe II 1.6878 μm emission. They may also have weak H2 emission. Type III sources may even be beginning to form a mini-H II region. XSHOOTER data from 10 Herbig Be stars were analysed. The evidence suggests that winds and disks are common among Herbig stars, as they are among their main sequence classical Be star counterparts. Line

  15. Evaluating and Using Observational Evidence: The Contrasting Views of Policy Makers and Epidemiologists.

    PubMed

    O'Donoughue Jenkins, Lily; Kelly, Paul M; Cherbuin, Nicolas; Anstey, Kaarin J

    2016-01-01

    Currently, little is known about the types of evidence used by policy makers. This study aimed to investigate how policy makers in the health domain use and evaluate evidence and how this differs from academic epidemiologists. By having a better understanding of how policy makers select, evaluate, and use evidence, academics can tailor the way in which that evidence is produced, potentially leading to more effective knowledge translation. An exploratory mixed-methods study design was used. Quantitative measures were collected via an anonymous online survey ( n  = 28), with sampling from three health-related government and non-government organizations. Semi-structured interviews with policy makers ( n  = 20) and epidemiologists ( n  = 6) were conducted to gather qualitative data. Policy makers indicated systematic reviews were the preferred research resource (19%), followed closely by qualitative research (16%). Neither policy makers nor epidemiologists used grading instruments to evaluate evidence. In the web survey, policy makers reported that consistency and strength of evidence (93%), the quality of data (93%), bias in the evidence (79%), and recency of evidence (79%) were the most important factors taken into consideration when evaluating the available evidence. The same results were found in the qualitative interviews. Epidemiologists focused on the methodology used in the study. The most cited barriers to using robust evidence, according to policy makers, were political considerations (60%), time limitations (55%), funding (50%), and research not being applicable to current policies (50%). The policy maker's investigation did not report a systematic approach to evaluating evidence. Although there was some overlap between what policy makers and epidemiologists identified as high-quality evidence, there was also some important differences. This suggests that the best scientific evidence may not routinely be used in the development of policy. In

  16. Assessing video games to improve driving skills: a literature review and observational study.

    PubMed

    Sue, Damian; Ray, Pradeep; Talaei-Khoei, Amir; Jonnagaddala, Jitendra; Vichitvanichphong, Suchada

    2014-08-07

    For individuals, especially older adults, playing video games is a promising tool for improving their driving skills. The ease of use, wide availability, and interactivity of gaming consoles make them an attractive simulation tool. The objective of this study was to look at the feasibility and effects of installing video game consoles in the homes of individuals looking to improve their driving skills. A systematic literature review was conducted to assess the effect of playing video games on improving driving skills. An observatory study was performed to evaluate the feasibility of using an Xbox 360 Kinect console for improving driving skills. Twenty-nine articles, which discuss the implementation of video games in improving driving skills were found in literature. On our study, it was found the Xbox 360 with Kinect is capable of improving physical and mental activities. Xbox Video games were introduced to engage players in physical, visual and cognitive activities including endurance, postural sway, reaction time, eyesight, eye movement, attention and concentration, difficulties with orientation, and semantic fluency. However, manual dexterity, visuo-spatial perception and binocular vision could not be addressed by these games. It was observed that Xbox Kinect (by incorporating Kinect sensor facilities) combines physical, visual and cognitive engagement of players. These results were consistent with those from the literature review. From the research that has been carried out, we can conclude that video game consoles are a viable solution for improving user's physical and mental state. In future we propose to carry a thorough evaluation of the effects of video games on driving skills in elderly people.

  17. A prospective observational study assessing the feasibility of measuring blood lead levels in New Zealand hunters eating meat harvested with lead projectiles.

    PubMed

    Buenz, Eric J; Parry, Gareth J; Bauer, Brent A; Matheny, Lauren M; Breukel, Klaasz

    2017-03-01

    There is no safe level of lead exposure. Correlations suggest that hunters harvesting wild game with lead bullets may be at risk of lead exposure through eating minute lead particles from shrapnel in their wild game. This feasibility study will determine if it is possible to conduct an interventional controlled, blinded study to evaluate if there is a causal relationship between meat harvested with lead bullets and elevated blood lead levels in those who consume the meat. This is an observational case crossover study and the primary outcome is blood lead levels. Individuals will have blood lead levels measured 2-4 days after eating one serving of meat harvested with lead bullets. At three potential washout periods these same individuals will have a subsequent blood lead level analysis. This observational study will provide the data necessary to determine the washout period and sample size for a prospective interventional study to evaluate if meat harvested with lead bullets raises blood-lead levels in those who consume the meat. This study has been approved by the Health and Disabilities Ethics Committees of New Zealand. NCT02775890.

  18. Osteoporosis therapies: evidence from health-care databases and observational population studies.

    PubMed

    Silverman, Stuart L

    2010-11-01

    Osteoporosis is a well-recognized disease with severe consequences if left untreated. Randomized controlled trials are the most rigorous method for determining the efficacy and safety of therapies. Nevertheless, randomized controlled trials underrepresent the real-world patient population and are costly in both time and money. Modern technology has enabled researchers to use information gathered from large health-care or medical-claims databases to assess the practical utilization of available therapies in appropriate patients. Observational database studies lack randomization but, if carefully designed and successfully completed, can provide valuable information that complements results obtained from randomized controlled trials and extends our knowledge to real-world clinical patients. Randomized controlled trials comparing fracture outcomes among osteoporosis therapies are difficult to perform. In this regard, large observational database studies could be useful in identifying clinically important differences among therapeutic options. Database studies can also provide important information with regard to osteoporosis prevalence, health economics, and compliance and persistence with treatment. This article describes the strengths and limitations of both randomized controlled trials and observational database studies, discusses considerations for observational study design, and reviews a wealth of information generated by database studies in the field of osteoporosis.

  19. Improving visual observation skills through the arts to aid radiographic interpretation in veterinary practice: A pilot study.

    PubMed

    Beck, Cathy; Gaunt, Heather; Chiavaroli, Neville

    2017-09-01

    Radiographic interpretation is a perceptual and cognitive skill. Recently core veterinary radiology textbooks have focused on the cognitive (i.e., the clinical aspects of radiographic interpretation) rather than the features of visual observation that improve identification of abnormalities. As a result, the skill of visual observation is underemphasized and thus often underdeveloped by trainees. The study of the arts in medical education has been used to train and improve visual observation and empathy. The use of the arts to improve visual observation skills in Veterinary Science has not been previously described. Objectives of this pilot study were to adapt the existing Visual Arts in Health Education Program for medical and dental students at the University of Melbourne, Australia to third year Doctor of Veterinary Medicine students and evaluate their perceptions regarding the program's effects on visual observation skills and confidence with respect to radiographic interpretation. This adaptation took the form of a single seminar given to third year Doctor of Veterinary Medicine students. Following the seminar, students reported an improved approach to radiographic interpretation and felt they had gained skills which would assist them throughout their career. In the year following the seminar, written reports of the students who attended the seminar were compared with reports from a matched cohort of students who did not attend the seminar. This demonstrated increased identification of abnormalities and greater description of the abnormalities identified. Findings indicated that explicit training in visual observation may be a valuable adjunct to the radiology training of Doctor of Veterinary Medicine students. © 2017 American College of Veterinary Radiology.

  20. Home Start Evaluation Study. Interim Case Studies IIa.

    ERIC Educational Resources Information Center

    Fein, Robert

    This formative evaluation study of Home Start uses a case study approach. A brief case study focuses on the administrative structure and staff resources and responsibilities of National Home Start. Also included are reports on seven local programs developed after two field visits had been made to each program. In the first visit, objectives chosen…

  1. Homeopathic drug therapy. Homeopathy in Chikungunya Fever and Post-Chikungunya Chronic Arthritis: an observational study.

    PubMed

    Wadhwani, Gyandas G

    2013-07-01

    To observe the effect of homeopathic therapy in Chikungunya Fever (CF) and in Post-Chikungunya Chronic Arthritis (PCCA) in a primary health care setting. A prospective observational study was conducted at Delhi Government Homeopathic Dispensary, Aali Village, New Delhi, India, for a period of 6 months, from 1st October 2010 to 31st March 2011. 126 patients (75 CF, 51 PCCA) were enrolled based on predefined inclusion criteria. A single homeopathic medicine was prescribed for each patient after case taking with the help of Materia Medica and/or Repertory. Results were evaluated on the basis of visual analogue scale and symptom scores. Complete recovery was seen in 84.5% CF cases in a mean time of 6.8 days. 90% cases of PCCA recovered completely in a mean time of 32.5 days. Homeopathic therapy may be effective in CF and PCCA. A randomized controlled trial should be considered. Copyright © 2013 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.

  2. Study Design and Evaluation of Risk Minimization Measures: A Review of Studies Submitted to the European Medicines Agency for Cardiovascular, Endocrinology, and Metabolic Drugs.

    PubMed

    Mazzaglia, Giampiero; Straus, Sabine M J; Arlett, Peter; da Silva, Daniela; Janssen, Heidi; Raine, June; Alteri, Enrica

    2018-02-01

    Studies measuring the effectiveness of risk minimization measures (RMMs) submitted by pharmaceutical companies to the European Medicines Agency are part of the post-authorization regulatory requirements and represent an important source of data covering a range of medicinal products and safety-related issues. Their objectives, design, and the associated regulatory outcomes were reviewed, and conclusions were drawn that may support future progress in risk minimization evaluation. Information was obtained from risk management plans, study protocols, clinical study reports, and assessment reports of 157 medicinal products authorized for cardiovascular, endocrinology, and metabolic indications. We selected observational studies measuring, as outcomes of interest, the relationship between the RMMs in place and (1) implementation measures, such as clinical knowledge or physicians` compliance to recommendations contained in the RMMs; and (2) occurrence or reduced severity of the adverse drug reactions for which the RMMs were required. Of 59 eligible studies (24 completed, 35 ongoing), 44 assessed implementation measures, whereas only 15 assessed safety outcomes (1 study as a single endpoint and 14 studies with other endpoints). Fifty-one studies used non-experimental designs and 25 studies employed electronic healthcare databases for analysis. Of the 24 completed studies, 17 were considered satisfactory and supported immediate regulatory decision making, 6 were considered inconclusive and required new evaluations, and 1 was terminated early because new safety restrictions were required, thereby necessitating a new evaluation. Compliance with agreed deadlines was considered acceptable in 21 of 24 completed studies; the average time for a submission was 37 months (standard deviation ± 17), with differences observed by type of data source employed. Three important gaps in the evaluation plans of RMMs were identified: lack of early feedback on implementation, limited

  3. The Neural Substrates of Self-Evaluation of Mental Fatigue: A Magnetoencephalography Study

    PubMed Central

    Ishii, Akira; Tanaka, Masaaki; Watanabe, Yasuyoshi

    2014-01-01

    There have been several studies of the neural mechanisms underlying sensation of fatigue. However, little is known about the neural mechanisms underlying self-evaluation of the level of fatigue. The aim of this study was to identify the neural substrates involved in self-evaluation of the level of mental fatigue. We used magnetoencephalography (MEG) with high temporal resolution on 14 healthy participants. During MEG recordings, participants were asked to evaluate their level of mental fatigue in time with execution cues (evaluation trials) or to do nothing in time with execution cues (control trials). The MEG data were analyzed with equivalent current dipole (ECD) and spatial filtering methods to localize the neural activity related to the evaluation of mental fatigue. The daily level of fatigue sensation was assessed using the Checklist Individual Strength questionnaire. In evaluation trials, ECDs were observed in the posterior cingulate cortex (PCC) in seven of 14 participants, with a mean latency of 366.0 ms. The proportion of the participants with ECDs in the PCC was higher in evaluation trials than in control trials (P<0.05, McNemar test). The extent of the decreased delta band power in the PCC (Brodmann’s area 31) 600–700 ms after the onset of the execution cue and that in the dorsolateral prefrontal cortex (DLPFC; Brodmann’s area 9) 800–900 ms after the onset of the execution cue were greater in the evaluation trials than in the control trials. The decrease in delta band power in the DLPFC was positively related to that in the PCC and to the daily level of fatigue sensation. These data suggest that the PCC and DLPFC are involved in the self-evaluation of mental fatigue. PMID:24752677

  4. Evaluation of reanalysis datasets against observational soil temperature data over China

    NASA Astrophysics Data System (ADS)

    Yang, Kai; Zhang, Jingyong

    2018-01-01

    Soil temperature is a key land surface variable, and is a potential predictor for seasonal climate anomalies and extremes. Using observational soil temperature data in China for 1981-2005, we evaluate four reanalysis datasets, the land surface reanalysis of the European Centre for Medium-Range Weather Forecasts (ERA-Interim/Land), the second modern-era retrospective analysis for research and applications (MERRA-2), the National Center for Environmental Prediction Climate Forecast System Reanalysis (NCEP-CFSR), and version 2 of the Global Land Data Assimilation System (GLDAS-2.0), with a focus on 40 cm soil layer. The results show that reanalysis data can mainly reproduce the spatial distributions of soil temperature in summer and winter, especially over the east of China, but generally underestimate their magnitudes. Owing to the influence of precipitation on soil temperature, the four datasets perform better in winter than in summer. The ERA-Interim/Land and GLDAS-2.0 produce spatial characteristics of the climatological mean that are similar to observations. The interannual variability of soil temperature is well reproduced by the ERA-Interim/Land dataset in summer and by the CFSR dataset in winter. The linear trend of soil temperature in summer is well rebuilt by reanalysis datasets. We demonstrate that soil heat fluxes in April-June and in winter are highly correlated with the soil temperature in summer and winter, respectively. Different estimations of surface energy balance components can contribute to different behaviors in reanalysis products in terms of estimating soil temperature. In addition, reanalysis datasets can mainly rebuild the northwest-southeast gradient of soil temperature memory over China.

  5. Using direct clinical observation to assess the quality of cesarean delivery in Afghanistan: an exploratory study

    PubMed Central

    2014-01-01

    Background As part of a National Emergency Obstetric and Newborn Care (EmONC) Needs Assessment, a special study was undertaken in July 2010 to examine the quality of cesarean deliveries in Afghanistan and examine the utility of direct clinical observation as an assessment method in low-resource settings. Methods This cross-sectional assessment of the quality of cesareans at 14 facilities in Afghanistan included a survey of surgeons regarding their routine cesarean practices, direct observation of 29 cesarean deliveries and comparison of observations with facility records for 34 additional cesareans conducted during the 3 days prior to the observation period at each facility. For both observed cases and record reviews, we assessed time intervals between specified points of care-arrival to the ward, first evaluation, detection of a complication, decision for cesarean, incision, and birth. Results All time intervals with the exception of “decision to skin incision” were longer in the record reviews than in observed cases. Prior cesarean was the most common primary indication for all cases. All mothers in both groups observed survived through one hour postpartum. Among newborns there were two stillbirths (7%) in observed births and seven (21%) record reviews. Although our sample is too small to show statistical significance, the difference is noteworthy. In six of the reviewed cesareans resulting in stillbirth, a fetal heart rate was recorded in the operating theater, although four were recorded as macerated. For the two fresh stillbirths, the cesarean surgeries were recorded as scheduled and not urgent. Conclusions Direct observation of cesarean deliveries enabled us to assess a number of preoperative, postoperative, and intraoperative procedures that are often not described in medical records in low resource settings. Comparison of observations with findings from provider interviews and facility records allowed us to infer whether observed practices were typical

  6. A multicenter, prospective, single arm, open label, observational study of sTMS for migraine prevention (ESPOUSE Study).

    PubMed

    Starling, Amaal J; Tepper, Stewart J; Marmura, Michael J; Shamim, Ejaz A; Robbins, Matthew S; Hindiyeh, Nada; Charles, Andrew C; Goadsby, Peter J; Lipton, Richard B; Silberstein, Stephen D; Gelfand, Amy A; Chiacchierini, Richard P; Dodick, David W

    2018-05-01

    Objective To evaluate the efficacy and tolerability of single pulse transcranial magnetic stimulation (sTMS) for the preventive treatment of migraine. Background sTMS was originally developed for the acute treatment of migraine with aura. Open label experience has suggested a preventive benefit. The objective of this trial was to evaluate the efficacy and tolerability of sTMS for migraine prevention. Methods The eNeura SpringTMS Post-Market Observational U.S. Study of Migraine (ESPOUSE) Study was a multicenter, prospective, open label, observational study. From December 2014 to March 2016, patients with migraine (n = 263) were consented to complete a 1-month baseline headache diary followed by 3 months of treatment. The treatment protocol consisted of preventive (four pulses twice daily) and acute (three pulses repeated up to three times for each attack) treatment. Patients reported daily headache status, medication use, and device use with a monthly headache diary. The primary endpoint, mean reduction of headache days compared to baseline, was measured over the 28-day period during weeks 9 to 12. The primary endpoint was compared to a statistically-derived placebo estimate (performance goal). Secondary endpoints included: 50% responder rate, acute headache medication consumption, HIT-6, and mean reduction in total headache days from baseline of any intensity. Results Of a total of 263 consented subjects, 229 completed a baseline diary, and 220 were found to be eligible based on the number of headache days. The device was assigned to 217 subjects (Safety Data Set) and 132 were included in the intention to treat Full Analysis Set. For the primary endpoint, there was a -2.75 ± 0.40 mean reduction of headache days from baseline (9.06 days) compared to the performance goal (-0.63 days) ( p < 0.0001). The 50% responder rate of 46% (95% CI 37%, 56%) was also significantly higher ( p < 0.0001) than the performance goal (20%). There was a reduction of -2

  7. Ozone Lidar Observations for Air Quality Studies

    NASA Technical Reports Server (NTRS)

    Wang, Lihua; Newchurch, Mike; Kuang, Shi; Burris, John F.; Huang, Guanyu; Pour-Biazar, Arastoo; Koshak, William; Follette-Cook, Melanie B.; Pickering, Kenneth E.; McGee, Thomas J.; hide

    2015-01-01

    Tropospheric ozone lidars are well suited to measuring the high spatio-temporal variability of this important trace gas. Furthermore, lidar measurements in conjunction with balloon soundings, aircraft, and satellite observations provide substantial information about a variety of atmospheric chemical and physical processes. Examples of processes elucidated by ozone-lidar measurements are presented, and modeling studies using WRF-Chem, RAQMS, and DALES/LES models illustrate our current understanding and shortcomings of these processes.

  8. Strategies GeoCape Intelligent Observation Studies @ GSFC

    NASA Technical Reports Server (NTRS)

    Cappelaere, Pat; Frye, Stu; Moe, Karen; Mandl, Dan; LeMoigne, Jacqueline; Flatley, Tom; Geist, Alessandro

    2015-01-01

    This presentation provides information a summary of the tradeoff studies conducted for GeoCape by the GSFC team in terms of how to optimize GeoCape observation efficiency. Tradeoffs include total ground scheduling with simple priorities, ground scheduling with cloud forecast, ground scheduling with sub-area forecast, onboard scheduling with onboard cloud detection and smart onboard scheduling and onboard image processing. The tradeoffs considered optimzing cost, downlink bandwidth and total number of images acquired.

  9. Colour evaluation in scars: tristimulus colorimeter, narrow-band simple reflectance meter or subjective evaluation?

    PubMed

    Draaijers, Lieneke J; Tempelman, Fenike R H; Botman, Yvonne A M; Kreis, Robert W; Middelkoop, Esther; van Zuijlen, Paul P M

    2004-03-01

    The evaluation of scar colour is, at present, usually limited to an assessment according to a scar assessment scale. Although useful, these assessment scales only evaluate subjectively the degree of scar colour. In this study, the reliability of the subjective assessment of scar colour by observers is compared to the reliability of the measurements of two objective colour measurement instruments. Four independent observers subjectively assessed the vascularisation and pigmentation of 49 scar areas in 20 patients. The degree of vascularisation and pigmentation was scored according to a scale ranging from '1', when it appeared to be like healthy skin, to '10', which corresponds to the worst imaginable outcome of vascularisation or pigmentation. The observers also scored the pigmentation categories of the scar (hypopigmention, hyperpigmention or mixed pigmentation). Finally, each observer measured the scar areas with a tristimulus colorimeter (Minolta Chromameter) and a narrow-band simple reflectance meter (DermaSpectrometer). A single observer could reliably carry out measurements of the DermaSpectrometer and the Minolta Chromameter for the evaluation of scar colour (r = 0.72). The vascularisation of scars could also be assessed reliably with a single observer (r = 0.76) whereas for a reliable assessment of pigmentation at least three observers were necessary (r > or = 0.77). The agreement between the observers for the pigmentation categories also turned out to be unacceptably low (k = 0.349). This study shows that an overall evaluation of scar colour with the DermaSpectrometer and the Minolta Chromameter is more reliable than the evaluation of scar colour with observers. Of both instruments for measuring scar colour, we prefer, because of its feasibility, the DermaSpectrometer.

  10. Idea Evaluation: Error in Evaluating Highly Original Ideas

    ERIC Educational Resources Information Center

    Licuanan, Brian F.; Dailey, Lesley R.; Mumford, Michael D.

    2007-01-01

    Idea evaluation is a critical aspect of creative thought. However, a number of errors might occur in the evaluation of new ideas. One error commonly observed is the tendency to underestimate the originality of truly novel ideas. In the present study, an attempt was made to assess whether analysis of the process leading to the idea generation and…

  11. Postural sway, working years and BMI in healthy truck drivers: an observational study.

    PubMed

    Ohlendorf, Daniela; Troebs, Paul; Lenk, Andreas; Wanke, Eileen; Natrup, Jörg; Groneberg, David

    2017-07-12

    The following study analyses the influence of risk factors among the occupational group of truck drivers on postural control and body mass index (BMI). Observational study. One motorway station close to several highways in Germany. 180 truck drivers (177 male/3 female), aged 21-65 years old, took part in this study. Postural control was examined using a pressure plate. In order to examine the influence of body weight (BMI) and working years on postural control, subjects were divided into samples of five and three groups, respectively. Furthermore, it was evaluated whether the subjects suffered from back pain. For data analysis, the Kruskal-Wallis test was used as the data were not normally distributed. Once the p value of the Kruskal-Wallis test was p≤0.05, the Conover-Iman comparison and afterwards the Bonferroni-Holm correction were used. The significance level was set at α ≤0.05. Regarding the number of working years, a significant increase of frontal (p≤0.04) and sagittal (p≤0.001) sway were observed. The correlation of the five BMI groups with the number of working years demonstrates that an increase of the working years leads to an increase of BMI (p≤0.03). Furthermore, the majority of truck drivers participating in this study suffered from back pain (61.7%). BMI and musculoskeletal impairment are indicators of health risk factors. In this study, it is shown that an increasing number of working years and an increasing BMI lead to a decrease in frontal and sagittal postural sway. In addition, the number of working years correlates with body weight and back pain. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Correlation between human observer performance and model observer performance in differential phase contrast CT

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

    Li, Ke; Garrett, John; Chen, Guang-Hong

    2013-11-15

    Purpose: With the recently expanding interest and developments in x-ray differential phase contrast CT (DPC-CT), the evaluation of its task-specific detection performance and comparison with the corresponding absorption CT under a given radiation dose constraint become increasingly important. Mathematical model observers are often used to quantify the performance of imaging systems, but their correlations with actual human observers need to be confirmed for each new imaging method. This work is an investigation of the effects of stochastic DPC-CT noise on the correlation of detection performance between model and human observers with signal-known-exactly (SKE) detection tasks.Methods: The detectabilities of different objectsmore » (five disks with different diameters and two breast lesion masses) embedded in an experimental DPC-CT noise background were assessed using both model and human observers. The detectability of the disk and lesion signals was then measured using five types of model observers including the prewhitening ideal observer, the nonprewhitening (NPW) observer, the nonprewhitening observer with eye filter and internal noise (NPWEi), the prewhitening observer with eye filter and internal noise (PWEi), and the channelized Hotelling observer (CHO). The same objects were also evaluated by four human observers using the two-alternative forced choice method. The results from the model observer experiment were quantitatively compared to the human observer results to assess the correlation between the two techniques.Results: The contrast-to-detail (CD) curve generated by the human observers for the disk-detection experiments shows that the required contrast to detect a disk is inversely proportional to the square root of the disk size. Based on the CD curves, the ideal and NPW observers tend to systematically overestimate the performance of the human observers. The NPWEi and PWEi observers did not predict human performance well either, as the slopes of

  13. Using long-term ARM observations to evaluate Arctic mixed-phased cloud representation in the GISS ModelE GCM

    NASA Astrophysics Data System (ADS)

    Lamer, K.; Fridlind, A. M.; Luke, E. P.; Tselioudis, G.; Ackerman, A. S.; Kollias, P.; Clothiaux, E. E.

    2016-12-01

    The presence of supercooled liquid in clouds affects surface radiative and hydrological budgets, especially at high latitudes. Capturing these effects is crucial to properly quantifying climate sensitivity. Currently, a number of CGMs disagree on the distribution of cloud phase. Adding to the challenge is a general lack of observations on the continuum of clouds, from high to low-level and from warm to cold. In the current study, continuous observations from 2011 to 2014 are used to evaluate all clouds produced by the GISS ModelE GCM over the ARM North Slope of Alaska site. The International Satellite Cloud Climatology Project (ISCCP) Global Weather State (GWS) approach reveals that fair-weather (GWS 7, 32% occurrence rate), as well as mid-level storm related (GWS 5, 28%) and polar (GWS 4, 14%) clouds, dominate the large-scale cloud patterns at this high latitude site. At higher spatial and temporal resolutions, ground-based cloud radar observations reveal a majority of single layer cloud vertical structures (CVS). While clear sky and low-level clouds dominate (each with 30% occurrence rate) a fair amount of shallow ( 10%) to deep ( 5%) convection are observed. Cloud radar Doppler spectra are used along with depolarization lidar observations in a neural network approach to detect the presence, layering and inhomogeneity of supercooled liquid layers. Preliminary analyses indicate that most of the low-level clouds sampled contain one or more supercooled liquid layers. Furthermore, the relationship between CVS and the presence of supercooled liquid is established, as is the relationship between the presence of supercool liquid and precipitation susceptibility. Two approaches are explored to bridge the gap between large footprint GCM simulations and high-resolution ground-based observations. The first approach consists of comparing model output and ground-based observations that exhibit the same column CVS type (i.e. same cloud depth, height and layering

  14. ADAPTIVE MATCHING IN RANDOMIZED TRIALS AND OBSERVATIONAL STUDIES

    PubMed Central

    van der Laan, Mark J.; Balzer, Laura B.; Petersen, Maya L.

    2014-01-01

    SUMMARY In many randomized and observational studies the allocation of treatment among a sample of n independent and identically distributed units is a function of the covariates of all sampled units. As a result, the treatment labels among the units are possibly dependent, complicating estimation and posing challenges for statistical inference. For example, cluster randomized trials frequently sample communities from some target population, construct matched pairs of communities from those included in the sample based on some metric of similarity in baseline community characteristics, and then randomly allocate a treatment and a control intervention within each matched pair. In this case, the observed data can neither be represented as the realization of n independent random variables, nor, contrary to current practice, as the realization of n/2 independent random variables (treating the matched pair as the independent sampling unit). In this paper we study estimation of the average causal effect of a treatment under experimental designs in which treatment allocation potentially depends on the pre-intervention covariates of all units included in the sample. We define efficient targeted minimum loss based estimators for this general design, present a theorem that establishes the desired asymptotic normality of these estimators and allows for asymptotically valid statistical inference, and discuss implementation of these estimators. We further investigate the relative asymptotic efficiency of this design compared with a design in which unit-specific treatment assignment depends only on the units’ covariates. Our findings have practical implications for the optimal design and analysis of pair matched cluster randomized trials, as well as for observational studies in which treatment decisions may depend on characteristics of the entire sample. PMID:25097298

  15. Observer Use of Standardized Observation Protocols in Consequential Observation Systems

    ERIC Educational Resources Information Center

    Bell, Courtney A.; Yi, Qi; Jones, Nathan D.; Lewis, Jennifer M.; McLeod, Monica; Liu, Shuangshuang

    2014-01-01

    Evidence from a handful of large-scale studies suggests that although observers can be trained to score reliably using observation protocols, there are concerns related to initial training and calibration activities designed to keep observers scoring accurately over time (e.g., Bell, et al, 2012; BMGF, 2012). Studies offer little insight into how…

  16. Evaluation of a dense seismic array for acquisition of high quality data in the ACROSS observation

    NASA Astrophysics Data System (ADS)

    Tsuruga, K.; Kunitomo, T.; Hasada, Y.; Kumazawa, M.; Shigeta, N.; Kasahara, J.

    2004-12-01

    ACROSS is an active monitoring methodology to detect any subtle temporal change of physical properties in the Earth's interior. We demonstrate the potentiality of the ACROSS observation with a dense sensor array. We have conducted a dense seismic array observation at the distance of 1 km from the ACROSS source since 2003. The array is composed of 36 three-component velocity seismometers buried at 1.8 m deep in an area 25 m square. All the data are recorded accurately referring to a GPS clock. We derived and analyzed a transfer function (TF) from the source to a receiver by the following steps: (1) evaluating a force vector as source characteristics, (2) converting the observed data to the displacement vectors by incorporating all the corrections of the instruments, (3) stacking the observed data for an enough time to suppress the temporal noise, (4) extracting ACROSS signal and evaluating noise level, (5) representing TF in a tensor form with the estimated errors, (6) slant-stacking with variable ray parameters, (7) estimating the travel times and amplitudes of the wave arrivals by Sompi Event Analysis (Hasada et al., 2001) and representing the result by a pulse sequence, and (8) deriving the polarization vector for each arrival to identify all the wave modes. We analyzed TF of SH-wave component from 16 to 20 Hz as an example. We obtained good quality TF with S/N ratio up to 104 by stacking for 12 days at the step (3). The spatial noise originated from the local heterogeneity around the array was eliminated by the step (6). Several arrivals were recognized within the time windows from 0.6 to 1.8 s. The maximum amplitude of event traces was detected at the travel time of 1.064 s with a ray parameter of 7.9x10-4 s/m. We also found the scattered waves probably generated by the heterogeneities around the array. The ACROSS dense array observation would provide a lot of information on the underground heterogeneities. Consequently, we have the important and challenging

  17. Consumption of fruits and vegetables and risk of renal cell carcinoma: a meta-analysis of observational studies.

    PubMed

    Zhang, Shaojing; Jia, Zhankui; Yan, Zechen; Yang, Jinjian

    2017-04-25

    There have been inconsistent results about the association between consumption of fruits and vegetables and renal cell carcinoma (RCC) risk. We conducted a meta-analysis of the published observational studies to explore this association. Nineteen observational studies (4 cohort, 1 pooled and 14 case-control studies), involving 10,215 subjects with RCC were part of this meta-analysis. The SRR for the highest vs. the lowest intake of vegetables was 0.73 (95% CI: 0.63-0.85; Pheterogeneity = 0.004, I2 = 53.5%), whereas for fruits it was 0.86 (95% CI: 0.75-0.98; Pheterogeneity = 0.012, I2 = 47.4%). Linear dose-response analysis also showed similar results, e.g., for per 1 serving/day increment of vegetables, the SRR was 0.90 (95% CI: 0.84-0.96) and for fruits it was 0.97 (95% CI: 0.93-1.01). Nonlinear association was only observed for vegetables (Pnonlinearity = 0.001), but not for fruits (Pnonlinearity = 0.221). Eligible studies up to August 31, 2016 were identified and retrieved by searching MEDLINE and EMBASE databases along with manual review of the reference list from the retrieved studies. Quality of included studies was evaluated using Newcastle-Ottawa Quality Assessment Scale (NOS). Random-effects model was used to calculate summary relative risk (SRR) and corresponding 95% confidence interval (CI). This meta-analysis indicated a protective effect of consumption of vegetables and fruits on RCC risk. Further studies are warranted with prospective designs that use validated questionnaires and control for important confounders.

  18. Evaluation of applicability of high-resolution multiangle imaging photo-polarimetric observations for aerosol atmospheric correction

    NASA Astrophysics Data System (ADS)

    Kalashnikova, Olga; Garay, Michael; Xu, Feng; Diner, David; Seidel, Felix

    2016-07-01

    Multiangle spectro-polarimetric measurements have been advocated as an additional tool for better understanding and quantifying the aerosol properties needed for atmospheric correction for ocean color retrievals. The central concern of this work is the assessment of the effects of absorbing aerosol properties on remote sensing reflectance measurement uncertainty caused by neglecting UV-enhanced absorption of carbonaceous particles and by not accounting for dust nonsphericity. In addition, we evaluate the polarimetric sensitivity of absorbing aerosol properties in light of measurement uncertainties achievable for the next generation of multi-angle polarimetric imaging instruments, and demonstrate advantages and disadvantages of wavelength selection in the UV/VNIR range. In this work a vector Markov Chain radiative transfer code including bio-optical models was used to quantitatively evaluate in water leaving radiances between atmospheres containing realistic UV-enhanced and non-spherical aerosols and the SEADAS carbonaceous and dust-like aerosol models. The phase matrices for the spherical smoke particles were calculated using a standard Mie code, while those for non-spherical dust particles were calculated using the numerical approach developed for modeling dust for the AERONET network of ground-based sunphotometers. As a next step, we have developed a retrieval code that employs a coupled Markov Chain (MC) and adding/doubling radiative transfer method for joint retrieval of aerosol properties and water leaving radiance from Airborne Multiangle SpectroPolarimetric Imager-1 (AirMSPI-1) polarimetric observations. The AirMSPI-1 instrument has been flying aboard the NASA ER-2 high altitude aircraft since October 2010. AirMSPI typically acquires observations of a target area at 9 view angles between ±67° at 10 m resolution. AirMSPI spectral channels are centered at 355, 380, 445, 470, 555, 660, and 865 nm, with 470, 660, and 865 reporting linear polarization. We

  19. Improved staff procedure skills lead to improved managment skills: an observational study in an educational setting.

    PubMed

    Rüter, Anders; Vikstrom, Tore

    2009-01-01

    Good staff procedure skills in a management group during incidents and disasters are believed to be a prerequisite for good management of the situation. However, this has not been demonstrated scientifically. Templates for evaluation results from performance indicators during simulation exercises have previously been tested. The aim of this study was to demonstrate the possibility that these indicators can be used as a tool for studying the relationship between good management skills and good staff procedure skills. Good and structured work (staff procedure skills) in a hospital management group during simulation exercises in disaster medicine is related to good and timely decisions (good management skills). Results from 29 consecutive simulation exercises in which staff procedure skills and management skills were evaluated using quantitative measurements were included. The statistical analysis method used was simple linear regression with staff procedure skills as the response variable and management skills as the predictor variable. An overall significant relationship was identified between staff procedure skills and management skills (p(2)0.05). This study suggests that there is a relationship between staff procedure skills and management skills in the educational setting used. Future studies are needed to demonstrate if this also can be observed during actual incidents.

  20. Evaluation of 11 terrestrial carbon–nitrogen cycle models against observations from two temperate Free-Air CO2 Enrichment studies

    PubMed Central

    Zaehle, Sönke; Medlyn, Belinda E; De Kauwe, Martin G; Walker, Anthony P; Dietze, Michael C; Hickler, Thomas; Luo, Yiqi; Wang, Ying-Ping; El-Masri, Bassil; Thornton, Peter; Jain, Atul; Wang, Shusen; Warlind, David; Weng, Ensheng; Parton, William; Iversen, Colleen M; Gallet-Budynek, Anne; McCarthy, Heather; Finzi, Adrien; Hanson, Paul J; Prentice, I Colin; Oren, Ram; Norby, Richard J

    2014-01-01

    We analysed the responses of 11 ecosystem models to elevated atmospheric [CO2] (eCO2) at two temperate forest ecosystems (Duke and Oak Ridge National Laboratory (ORNL) Free-Air CO2 Enrichment (FACE) experiments) to test alternative representations of carbon (C)–nitrogen (N) cycle processes. We decomposed the model responses into component processes affecting the response to eCO2 and confronted these with observations from the FACE experiments. Most of the models reproduced the observed initial enhancement of net primary production (NPP) at both sites, but none was able to simulate both the sustained 10-yr enhancement at Duke and the declining response at ORNL: models generally showed signs of progressive N limitation as a result of lower than observed plant N uptake. Nonetheless, many models showed qualitative agreement with observed component processes. The results suggest that improved representation of above-ground–below-ground interactions and better constraints on plant stoichiometry are important for a predictive understanding of eCO2 effects. Improved accuracy of soil organic matter inventories is pivotal to reduce uncertainty in the observed C–N budgets. The two FACE experiments are insufficient to fully constrain terrestrial responses to eCO2, given the complexity of factors leading to the observed diverging trends, and the consequential inability of the models to explain these trends. Nevertheless, the ecosystem models were able to capture important features of the experiments, lending some support to their projections. PMID:24467623