Standardization of the Hare Psychopathy Checklist-Revised in a Spanish prison sample.

PubMed

Moltó, J; Poy, R; Torrubia, R

2000-01-01

This investigation examined the reliability, validity, and factor structure of the Hare Psychopathy Checklist-Revised (PCL-R) in male adult Spanish prison populations (n = 117). The interrater reliability and internal consistency coefficients were high, and similar to those obtained in other countries. This data provides support for the homogeneity and unidimensionality of the psychopathy construct in Spanish male prison samples. The analysis of factor structure also replicated the two factor solution of previous studies. The two factors showed different patterns of intercorrelations with several self-report measures of personality, demographic, and criminal history variables, which confirmed the construct validity of PCL-R. The results confirm the psychometric properties of the PCL-R as a measure of psychopathy in Spanish male inmates, and suggest that psychopathy is a construct also observed in Southern European countries.

The Use of the Autism Diagnostic Interview-Revised with a Latino Population of Adolescents and Adults with Autism

ERIC Educational Resources Information Center

Magana, Sandy; Smith, Leann E.

2013-01-01

Research shows that Latinos are less likely to be diagnosed with autism than their non-Latino counterparts. One factor that may contribute to these differences is that autism diagnostic instruments have not been adapted for the Latino population. The present study compared scores from the Autism Diagnostic Interview-Revised for two groups: 48…

Perfectionism among Chinese Gifted and Nongifted Students in Hong Kong: The Use of the Revised Almost Perfect Scale

ERIC Educational Resources Information Center

Chan, David W.

2011-01-01

This study investigated the structure of perfectionism based on the almost Perfect Scale-Revised with a sample of 320 gifted students aged 7 to 12 and a sample of 882 nongifted students of similar ages in Hong Kong. Multigroup confirmatory factor analyses across the two student groups supported a common three-dimensional model that included…

Increased revision rate with posterior tibial tunnel placement after using the 70-degree tibial guide in ACL reconstruction.

PubMed

Inderhaug, Eivind; Raknes, Sveinung; Østvold, Thomas; Solheim, Eirik; Strand, Torbjørn

2017-01-01

To map knee morphology radiographically in a population with a torn ACL and to investigate whether anatomic factors could be related to outcomes after ACL reconstruction at mid- to long-term follow-up. Further, we wanted to assess tibial tunnel placement after using the 70-degree "anti-impingement" tibial tunnel guide and investigate any relation between tunnel placement and revision surgery. Patients undergoing ACL reconstruction involving the 70-degree tibial guide from 2003 to 2008 were included. Two independent investigators analysed pre- and post-operative radiographs. Demographic data and information on revision surgery were collected from an internal database. Anatomic factors and post-operative tibial tunnel placements were investigated as predictors of revision. Three-hundred and seventy-seven patients were included in the study. A large anatomic variation with significant differences between men and women was seen. None of the anatomic factors could be related to a significant increase in revision rate. Patients with a posterior tibial tunnel placement, defined as 50 % or more posterior on the Amis and Jakob line, did, however, have a higher risk of revision surgery compared to patients with an anterior tunnel placement (P = 0.03). Use of the 70-degree tibial guide did result in a high incidence (47 %) of posterior tibial tunnel placements associated with an increased rate of revision surgery. The current study was, however, not able to identify any anatomic variation that could be related to a higher risk of revision surgery. Avoiding graft impingement from the femoral roof in anterior tibial tunnel placements is important, but the insight that overly posterior tunnel placement can lead to inferior outcome should also be kept in mind when performing ACL surgery. IV.

Factor Structure of Scores from the Conners’ Rating Scales–Revised Among Nepali Children

PubMed Central

Pendergast, Laura L.; Vandiver, Beverly J.; Schaefer, Barbara A.; Cole, Pamela M.; Murray-Kolb, Laura M.; Christian, Parul

2014-01-01

This study used exploratory and confirmatory factor analyses to examine the structures of scores from the Conners’ Teacher and Parent Rating Scales–Revised (CTRS-R and CPRS-R, respectively; Conners, 1997). The scales were administered to 1,835 parents and 1,387 teachers of children in Nepal's Sarlahi district – a region where no other measures of child psychopathology have been studied. With a Nepali sample, the findings indicate that reduced two factor models for the Conners’ scales are superior to the models identified in the scale development research. The hyperactivity and inattention factors were comparable to what has been identified in prior research, while other factors (e.g., social problems) differed substantially. Implications for use of the Conners’ scales in Nepal and cross cultural issues in the assessment of ADHD symptoms are discussed. PMID:25574454

The structure of post-traumatic stress symptoms in survivors of war: confirmatory factor analyses of the Impact of Event Scale--revised.

PubMed

Morina, Nexhmedin; Böhme, Hendryk F; Ajdukovic, Dean; Bogic, Marija; Franciskovic, Tanja; Galeazzi, Gian M; Kucukalic, Abdulah; Lecic-Tosevski, Dusica; Popovski, Mihajlo; Schützwohl, Matthias; Stangier, Ulrich; Priebe, Stefan

2010-08-01

The study aimed at establishing the factor structure of the Impact of Event Scale-Revised (IES-R) in survivors of war. A total sample of 4167 participants with potentially traumatic experiences during the war in Ex-Yugoslavia was split into three samples: two independent samples of people who stayed in the area of conflict and one sample of refugees to Western European countries. Alternative models with three, four, and five factors of post-traumatic symptoms were tested in one sample. The other samples were used for cross-validation. Results indicated that the model of best fit had five factors, i.e., intrusion, avoidance, hyperarousal, numbing, and sleep disturbance. Model superiority was cross-validated in the two other samples. These findings suggest a five-factor model of post-traumatic stress symptoms in war survivors with numbing and sleep disturbance as separate factors in addition to intrusion, avoidance and hyperarousal. (c) 2010 Elsevier Ltd. All rights reserved.

Revision total hip arthoplasty: factors associated with re-revision surgery.

PubMed

Khatod, Monti; Cafri, Guy; Inacio, Maria C S; Schepps, Alan L; Paxton, Elizabeth W; Bini, Stefano A

2015-03-04

The survivorship of implants after revision total hip arthroplasty and risk factors associated with re-revision are not well defined. We evaluated the re-revision rate with use of the institutional total joint replacement registry. The purpose of this study was to determine patient, implant, and surgeon factors associated with re-revision total hip arthroplasty. A retrospective cohort study was conducted. The total joint replacement registry was used to identify patients who had undergone revision total hip arthroplasty for aseptic reasons from April 1, 2001, to December 31, 2010. The end point of interest was re-revision total hip arthroplasty. Risk factors evaluated for re-revision total hip arthroplasty included: patient risk factors (age, sex, body mass index, race, and general health status), implant risk factors (fixation type, bearing surface, femoral head size, and component replacement), and surgeon risk factors (volume and experience). A multivariable Cox proportional hazards model was used. Six hundred and twenty-nine revision total hip arthroplasties with sixty-three (10%) re-revisions were evaluated. The mean cohort age (and standard deviation) was 57.0 ± 12.4 years, the mean body mass index (and standard deviation) was 29.5 ± 6.1 kg/m(2), and most of the patients were women (64.5%) and white (81.9%) and had an American Society of Anesthesiologists score of <3 (52.9%). The five-year implant survival after revision total hip arthroplasty was 86.8% (95% confidence interval, 83.57% to 90.25%). In adjusted models, age, total number of revision surgical procedures performed by the surgeon, fixation, and bearing surface were associated with the risk of re-revision. For every ten-year increase in patient age, the hazard ratio for re-revision decreases by a factor of 0.72 (95% confidence interval, 0.58 to 0.90). For every five revision surgical procedures performed by a surgeon, the risk of revision decreases by a factor of 0.93 (95% confidence interval, 0.86 to 0.99). At the time of revision, a new or retained cemented femoral implant or all-cemented hip implant increases the risk of revision by a factor of 3.19 (95% confidence interval, 1.22 to 8.38) relative to a retained or new uncemented hip implant. A ceramic on a highly cross-linked polyethylene bearing articulation decreases the hazard relative to metal on highly cross-linked polyethylene by a factor of 0.32 (95% confidence interval, 0.11 to 0.95). Metal on constrained bearing increases the hazard relative to metal on highly cross-linked polyethylene by a factor of 3.32 (95% confidence interval, 1.16 to 9.48). When evaluating patient, implant, and surgical factors at the time of revision total hip arthroplasty, age, surgeon experience, implant fixation, and bearing surfaces had significant impacts on the risk of re-revision. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

Validating the 11-Item Revised University of California Los Angeles Scale to Assess Loneliness Among Older Adults: An Evaluation of Factor Structure and Other Measurement Properties.

PubMed

Lee, Joonyup; Cagle, John G

2017-11-01

To examine the measurement properties and factor structure of the short version of the Revised University of California Los Angeles (R-UCLA) loneliness scale from the Health and Retirement Study (HRS). Based on data from 3,706 HRS participants aged 65 + who completed the 2012 wave of the HRS and its Psychosocial Supplement, the measurement properties and factorability of the R-UCLA were examined by conducting an exploratory factor analysis (EFA) and the confirmatory factor analysis (CFA) on randomly split halves. The average score for the 11-item loneliness scale was 16.4 (standard deviation: 4.5). An evaluation of the internal consistency produced a Cronbach's α of 0.87. Results from the EFA showed that two- and three-factor models were appropriate. However, based on the results of the CFA, only a two-factor model was determined to be suitable because there was a very high correlation between two factors identified in the three-factor model, available social connections and sense of belonging. This study provides important data on the properties of the 11-item R-UCLA scale by identifying a two-factor model of loneliness: feeling isolated and available social connections. Our findings suggest the 11-item R-UCLA has good factorability and internal reliability. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

How Mind Works To Revise Compositions.

ERIC Educational Resources Information Center

Lin, Deh-nan

This study investigated cognitive processes involved in English-as-a-Second-Language (ESL) students' correcting and revising drafts after receiving oral feedback from their teachers, noting factors that led to better written products and factors that did not improve student writing. The study examined what kinds of revision strategies students…

Measuring the Developing Therapeutic Relationship Between Pregnant Women and Community Health Workers Over the Course of the Pregnancy in a Study Intervention

PubMed Central

Lichtveld, Maureen Y.; Shankar, Arti; Mundorf, Chris; Hassan, Anna; Drury, Stacy

2016-01-01

The Scale to Assess the Therapeutic Relationship in Community Mental Health Care (STAR) is a frequently-administered tool for measuring therapeutic relationships between clinicians and patients. This manuscript tested the STAR’s psychometric properties within a community health worker (CHW)-led intervention study involving pregnant and postpartum women. Women (n = 141) enrolled in the study completed the 12-item participant STAR survey (STAR-P) at two time points over the course of pregnancy and at two time points after delivery. The factor structure of the STAR-P proved to be unstable with this population. However, a revised 9-item STAR-P revealed a two-factor model of positive and negative interactions, and demonstrated strong internal consistency at postpartum time points. The revised STAR-P shows strong psychometric properties, and is suitable for use to evaluate the relationship developed between CHWs and pregnant and postpartum women in an intervention program. PMID:27116361

Measuring the Developing Therapeutic Relationship Between Pregnant Women and Community Health Workers Over the Course of the Pregnancy in a Study Intervention.

PubMed

Lichtveld, Maureen Y; Shankar, Arti; Mundorf, Chris; Hassan, Anna; Drury, Stacy

2016-12-01

The Scale to Assess the Therapeutic Relationship in Community Mental Health Care (STAR) is a frequently-administered tool for measuring therapeutic relationships between clinicians and patients. This manuscript tested the STAR's psychometric properties within a community health worker (CHW)-led intervention study involving pregnant and postpartum women. Women (n = 141) enrolled in the study completed the 12-item participant STAR survey (STAR-P) at two time points over the course of pregnancy and at two time points after delivery. The factor structure of the STAR-P proved to be unstable with this population. However, a revised 9-item STAR-P revealed a two-factor model of positive and negative interactions, and demonstrated strong internal consistency at postpartum time points. The revised STAR-P shows strong psychometric properties, and is suitable for use to evaluate the relationship developed between CHWs and pregnant and postpartum women in an intervention program.

Poor Survivorship and Frequent Complications at a Median of 10 Years After Metal-on-Metal Hip Resurfacing Revision.

PubMed

Matharu, Gulraj S; Pandit, Hemant G; Murray, David W

2017-02-01

High short-term failure rates have been reported for several metal-on-metal hip resurfacing (MoMHR) designs. Early observations suggested that MoMHRs revised to total hip arthroplasties (THAs) for pseudotumor had more major complications and inferior patient-reported outcomes compared with other revision indications. However, little is known about implant survivorship and patient-reported outcomes at more than 5 years after MoMHR revision. (1) What are the implant survivorship, proportion of complications and abnormal radiological findings, and patient-reported outcomes at a median of 10 years after MoMHR revision surgery? (2) Are survivorship, complications, and patient-reported outcomes influenced by revision indication? (3) Do any other factors predict survivorship, complications, and patient-reported outcomes? Between 1999 and 2008, 53 MoMHR revision procedures in 51 patients (mean age, 55 years; 62% female) were performed at one center and were all included in this retrospective study. Two patients (4%) were lost to followup and two patients (4%) died before a minimum followup of 7 years (median, 10.3 years; range 7-15 years). Revision indications included pseudotumor (n = 16), femoral neck fracture (n = 21), and other causes (n = 16). In most cases (62%, n = 33) both components were revised to a non-MoM bearing THA with the remainder (38%, n = 20: fracture, loosening, or head collapse) undergoing femoral-only revision to a large-diameter MoM THA. Postrevision complications, rerevision, Oxford Hip Score (OHS), and UCLA score were determined using both a longitudinally maintained institutional database and postal questionnaire. Implant survivorship was assessed using the Kaplan-Meier method (endpoint was rerevision surgery). Radiographs at latest followup were systematically assessed for any signs of failure (loosening, migration, osteolysis) by one observer blinded to all clinical information and not involved in the revision procedures. Overall, 45% (24 of 53) experienced complications and 38% (20 of 53) underwent rerevision. Ten-year survival free from rerevision for revised MoMHRs was 63% (95% confidence interval [CI], 48%-74%). Revision indications were not associated with differences in the frequency of complications or repeat revisions. With the numbers available, 10-year survival free from rerevision for pseudotumor revisions (56%; 95% CI, 30%-76%) was not different from the fracture (68%; 95% CI, 42%-85%; p = 0.359) and other groups (63%; 95% CI, 35%-81%; p = 0.478). Pseudotumor revisions had inferior OHSs (median, 21; range, 2-46; p = 0.007) and UCLA scores (median, 2; range, 2-7; p = 0.0184) compared with fracture and other revisions. Ten-year survival free from rerevision after femoral-only revision using another large-diameter MoM bearing was lower (p = 0.0498) compared with all component revisions using non-MoM bearings. After controlling for potential confounding variables such as age, sex, and revision indication, we found femoral-only revision as the only factor predicting rerevision (hazard ratio, 5.7; 95% CI, 1.1-29; p = 0.040). Poor implant survivorship and frequent complications were observed at a median of 10 years after MoMHR revision. However, patients undergoing femoral-only revisions with large-diameter MoM bearings had the worst survivorship, whereas patients revised for pseudotumor had the most inferior patient-reported outcomes. Our findings suggest these two patient subgroups require regular surveillance after MoMHR revision. Level III, therapeutic study.

Unsatisfactory Outcome of Arthrodesis Performed After Septic Failure of Revision Total Knee Arthroplasty

PubMed Central

Röhner, Eric; Windisch, Christoph; Nuetzmann, Katy; Rau, Max; Arnhold, Michael; Matziolis, Georg

2015-01-01

Background: Periprosthetic infection is one of the most dreaded orthopaedic complications. Current treatment procedures include one-stage or two-stage revision total knee arthroplasty. If the periprosthetic infection is no longer controllable after several revision total knee arthroplasties, many surgeons regard knee arthrodesis as a promising option. The aim of our study was to ascertain whether intramedullary nailing results in the suppression or eradication of an infection and to identify risk factors for persistent infection. Methods: All patients who had undergone intramedullary nailing following septic failure of revision total knee arthroplasty between 1997 and 2013 were included in the study. Pathogens, risk factors predisposing to persistent infection, and the rate of persistent infections were recorded. In addition, a visual analog scale (VAS) and Knee injury Osteoarthritis Outcome Score (KOOS), Knee Society Score (KSS), Lysholm, Short Form-36 (SF-36), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaires were completed to assess clinical outcomes and quality of life. Results: Twenty-six patients were included in the study. Thirteen (50%) had a persistent infection requiring additional revision surgery. Nineteen patients (73%) reported persistent pain (VAS score of >3). All scores showed marked impairment of quality of life. Conclusions: Intramedullary nailing following septic failure of revision total knee arthroplasty must be regarded with skepticism, and we cannot recommend it. Repeat revision total knee arthroplasty or amputation should be considered as an alternative in such difficult cases. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. PMID:25695981

A Confirmatory Factor Analysis of the Life Orientation Test-Revised with Competitive Athletes

ERIC Educational Resources Information Center

Appaneal, Renee N.

2012-01-01

Current reviews outside of sport indicate that the Life Orientation Test-Revised (LOT-R) items load on two separate factors (optimism and pessimism) and, therefore, should be treated as independent constructs. However, researchers in the sport sciences continue to use the single composite score reflecting a unidimensional definition of optimism.…

Construct Validity of the Anxiety Sensitivity Index-3 in Clinical Samples

ERIC Educational Resources Information Center

Kemper, Christoph J.; Lutz, Johannes; Bahr, Tobias; Ruddel, Heinz; Hock, Michael

2012-01-01

Using two clinical samples of patients, the presented studies examined the construct validity of the recently revised Anxiety Sensitivity Index-3 (ASI-3). Confirmatory factor analyses established a clear three-factor structure that corresponds to the postulated subdivision of the construct into correlated somatic, social, and cognitive components.…

The role of self-perceived usefulness and competence in the self-esteem of elderly adults: confirmatory factor analyses of the Bachman revision of Rosenberg's Self-Esteem Scale.

PubMed

Ranzijn, R; Keeves, J; Luszcz, M; Feather, N T

1998-03-01

This article reports on a confirmatory analytic study of the Bachman Revision (1970) of Rosenberg's Self-Esteem Scale (1965) that was used in the Australian Longitudinal Study of Ageing (ALSA). Participants comprised 1,087 elderly people aged between 70 and 103 years (mean 77 years). Five competing factor models were tested with LISREL8. The best-fitting model was a nested one, with a General Self-Esteem second-order factor and two first-order factors, Positive Self-regard and Usefulness/Competence. This model was validated with data from a later wave of ALSA. Usefulness and competence have received little attention in the gerontological literature to date. Preliminary results indicate that usefulness/competence may be an important predictor of well-being. Further work is required on the relationships among usefulness, competence, self-esteem, and well-being in elderly people.

Effect of graft choice on the outcome of revision anterior cruciate ligament reconstruction in the Multicenter ACL Revision Study (MARS) Cohort

PubMed Central

Wright, Rick W.; Huston, Laura J.; Haas, Amanda K.; Spindler, Kurt P.; Nwosu, Sam K.; Allen, Christina R.; Anderson, Allen F.; Cooper, Daniel E.; DeBerardino, Thomas M.; Dunn, Warren R.; Lantz, Brett (Brick) A.; Stuart, Michael J.; Garofoli, Elizabeth A.; Albright, John P.; Amendola, Annunziato (Ned); Andrish, Jack T.; Annunziata, Christopher C.; Arciero, Robert A.; Bach, Bernard R.; Baker, Champ L.; Bartolozzi, Arthur R.; Baumgarten, Keith M.; Bechler, Jeffery R.; Berg, Jeffrey H.; Bernas, Geoffrey A.; Brockmeier, Stephen F.; Brophy, Robert H.; Bush-Joseph, Charles A.; Butler, J. Brad; Campbell, John D.; Carey, James L.; Carpenter, James E.; Cole, Brian J.; Cooper, Jonathan M.; Cox, Charles L.; Creighton, R. Alexander; Dahm, Diane L.; David, Tal S.; Flanigan, David C.; Frederick, Robert W.; Ganley, Theodore J.; Gatt, Charles J.; Gecha, Steven R.; Giffin, James Robert; Hame, Sharon L.; Hannafin, Jo A.; Harner, Christopher D.; Harris, Norman Lindsay; Hechtman, Keith S.; Hershman, Elliott B.; Hoellrich, Rudolf G.; Hosea, Timothy M.; Johnson, David C.; Johnson, Timothy S.; Jones, Morgan H.; Kaeding, Christopher C.; Kamath, Ganesh V.; Klootwyk, Thomas E.; Levy, Bruce A.; Ma, C. Benjamin; Maiers, G. Peter; Marx, Robert G.; Matava, Matthew J.; Mathien, Gregory M.; McAllister, David R.; McCarty, Eric C.; McCormack, Robert G.; Miller, Bruce S.; Nissen, Carl W.; O'Neill, Daniel F.; Owens, Brett D.; Parker, Richard D.; Purnell, Mark L.; Ramappa, Arun J.; Rauh, Michael A.; Rettig, Arthur C.; Sekiya, Jon K.; Shea, Kevin G.; Sherman, Orrin H.; Slauterbeck, James R.; Smith, Matthew V.; Spang, Jeffrey T.; Svoboda, Steven J.; Taft, Timothy N.; Tenuta, Joachim J.; Tingstad, Edwin M.; Vidal, Armando F.; Viskontas, Darius G.; White, Richard A.; Williams, James S.; Wolcott, Michelle L.; Wolf, Brian R.; York, James J.

2015-01-01

Background Most surgeons believe that graft choice for ACL reconstruction is an important factor related to outcome. Although graft choice may be limited in the revision setting based on previously used grafts, it is still felt to be important. Hypothesis The purpose of this study was to determine if revision ACL graft choice predicts outcomes related to sports function, activity level, OA symptoms, graft re-rupture, and reoperation at two years following revision reconstruction. We hypothesized that autograft use would result in increased sports function, increased activity level, and decreased OA symptoms (as measured by validated patient reported outcome instruments). Additionally, we hypothesized that autograft use would result in decreased graft failure and reoperation rate 2 years following revision ACL reconstruction. Study Design Prospective cohort study; Level of evidence, 2. Methods Revision ACL reconstruction patients were identified and prospectively enrolled by 83 surgeons over 52 sites. Data collected included baseline demographics, surgical technique and pathology, and a series of validated patient reported outcome instruments (IKDC, KOOS, WOMAC, and Marx activity rating score). Patients were followed up at 2 years, and asked to complete the identical set of outcome instruments. Incidence of additional surgery and reoperation due to graft failure were also recorded. Multivariate regression models were used to determine the predictors (risk factors) of IKDC, KOOS, WOMAC, Marx scores, graft re-rupture, and reoperation rate at 2 years following revision surgery. Results 1205 patients were successfully enrolled with 697 (58%) males. Median age was 26. In 88% this was their first revision. 341 (28%) were undergoing revision by the surgeon that had performed the previous reconstruction. 583 (48%) underwent revision reconstruction utilizing an autograft, 590 (49%) allograft, and 32 (3%) both autograft and allograft. Median time since their last ACL reconstruction was 3.4 years. Questionnaire follow-up was obtained on 989 subjects (82%), while phone follow-up was obtained on 1112 subjects (92%). The IKDC, KOOS, and WOMAC scores (with the exception of the WOMAC stiffness subscale) all significantly improved at the two year follow-up time point (p<0.001). In contrast, the two year MARX activity scale demonstrated a significant decrease from the initial score at enrollment (p<0.001). Graft choice proved to be a significant predictor of 2 year IKDC scores (p=0.017). Specifically, the use of an autograft for revision reconstruction predicted improved score on the IKDC [p=0.045; Odds Ratio (OR) = 1.31; 95% confidence intervals (CI) = 1.01, 1.70]. The use of an autograft predicted an improved on the KOOS subscale Sports and Recreation (p=0.037; OR=1.33; 95% CI=1.02, 1.73). Use of an autograft also predicted improved scores on the KOOS subscale Quality of Life (QOL) (p=0.031; OR=1.33; 95% CI=1.03, 1.73). For the KOOS Symptoms and ADL subscales, graft choice did not predict outcome score. Graft choice also proved to be a significant predictor of 2 year Marx activity level scores (p=0.012). Graft re-rupture was reported in 37/1112 (3.3%) of patients by their two year follow-up: 24 allografts, 12 autografts, and 1 allograft + autograft. Use of an autograft for revision resulted in patients 2.78 times less likely to sustain a subsequent graft rupture than if an allograft was utilized (p=0.047; 95% CI=1.01, 7.69). Conclusions Improved sports function and patient reported outcome measures are obtained when an autograft is utilized. Additionally, use of an autograft shows a decreased risk in graft re-rupture at two years follow-up. No differences were noted in rerupture or patient reported outcomes between soft tissue and bone-patellar tendon-bone grafts. Surgeon education regarding the findings in this study can result in potentially improved revision ACL reconstruction results for our patients. PMID:25274353

Large-diameter metal-on-metal total hip arthroplasty: dislocation infrequent but survivorship poor.

PubMed

Lombardi, Adolph V; Berend, Keith R; Morris, Michael J; Adams, Joanne B; Sneller, Michael A

2015-02-01

Use of large-diameter metal-on-metal (MoM) articulations in THA increased, at least in part, because of the possibility of achieving improved joint stability and excellent wear characteristics in vitro. However, there have been subsequent concerning reports with adverse reactions to metal debris (ARMD), pseudotumors, and systemic complications related to metal ions. The purpose of this study was to determine at a minimum of 2 years' followup (1) the proportion of patients who experienced a dislocation; (2) the short-term survivorship obtained with these implants; (3) the causes of failure and the proportion of patients who developed ARMD; and (4) whether there were any identifiable risk factors for revision. We reviewed the results of 1235 patients who underwent 1440 large-diameter MoM primary THAs at our institution using two acetabular devices from a single manufacturer with minimum 2-year followup. Large-diameter MoM devices were used in 48% (1695 of 3567) of primary THAs during the study period. We generally used these implants in younger, more active, higher-demand patients, in patients considered at higher risk of instability, and in patients with adequate bone stock to achieve stable fixation without use of screws. Clinical records and radiographs were reviewed to determine the incidence and etiology of revision. Patients whose hips were revised were compared with those not revised to identify risk factors; Kaplan-Meier survivorship analysis was performed as was multivariate analysis to account for potential confounding variables when evaluating risk factors. Minimum followup was 2 years (average, 7 years; range, 2-12 years); complete followup was available in 85% of hips (1440 of 1695). Dislocation occurred in one hip overall (<1%; one of 1440). Kaplan-Meier analysis revealed survival free of component revision was 87% at 12 years (95% confidence interval, 84%-90%). The two most common indications for revision were ARMD (48%; 47 of 108 hips revised) and loosening or failure of ingrowth (31%; 34 of 108). Risk factors for component revision were younger age at surgery (relative risk [RR] 0.98 per each increased year; p=0.02), higher cup angle of inclination (RR 1.03 per each increased degree; p=0.04), and female sex (RR 1.67; p=0.03). Large-diameter MoM THAs are associated with a very low dislocation rate, but failure secondary to ARMD and loosening or lack of ingrowth occur frequently. Patients with MoM THA should be encouraged to return for clinical and radiographic followup, and clinicians should maintain a low threshold to perform a systematic evaluation. Early diagnosis and appropriate treatment are recommended to prevent the damaging effects of advanced ARMD. Level IV, Therapeutic study.

The structure of social exchange in self-help support groups: development of a measure.

PubMed

Brown, Louis D; Tang, Xiaohui; Hollman, Ruth L

2014-03-01

Self-help support groups are indigenous community resources designed to help people manage a variety of personal challenges, from alcohol abuse to xeroderma pigmentosum. The social exchanges that occur during group meetings are central to understanding how people benefit from participation. This paper examines the different types of social exchange behaviors that occur during meetings, using two studies to develop empirically distinct scales that reliably measure theoretically important types of exchange. Resource theory informed the initial measurement development efforts. Exploratory factor analyses from the first study led to revisions in the factor structure of the social exchange scales. The revised measure captured the exchange of emotional support, experiential information, humor, unwanted behaviors, and exchanges outside meetings. Confirmatory factor analyses from a follow-up study with a different sample of self-help support groups provided good model fit, suggesting the revised structure accurately represented the data. Further, the scales demonstrated good convergent and discriminant validity with related constructs. Future research can use the scales to identify aspects of social exchange that are most important in improving health outcomes among self-help support group participants. Groups can use the scales in practice to celebrate strengths and address weaknesses in their social exchange dynamics.

The Birth Satisfaction Scale-Revised Indicator (BSS-RI).

PubMed

Martin, Colin R; Hollins Martin, Caroline; Redshaw, Maggie

2017-08-29

The current study sought to develop a short birth satisfaction indicator utilising items from the Birth Satisfaction Scale-Revised (BSS-R) for use as a brief measure of birth satisfaction and as a possible key performance indicator for perinatal service delivery evaluation. Building on the recently developed BSS-R, the study aimed to develop a simplified version of the instrument to assess birth satisfaction easily that could work as a short evaluative measure of clinical service delivery for labour and birth that is consistent with policy documents, placing women at the centre of the birth experience. The six item Birth Satisfaction Scale-Revised Indicator (BSS-RI) was embedded within the 2014 National Maternity Survey for England. A random selection of mothers who had given birth in a two week period in England were surveyed three months after the birth. Using a two-stage design and split-half dataset, exploratory factor analysis, confirmatory factor analysis, internal consistency, convergent, divergent and known-groups discriminant validity evaluation were conducted in a secondary analysis of the survey data. Using this large population based survey of recent mothers the short revised measure was found to comprise two distinct domains of birth satisfaction, 'stress and emotional response to labour and birth' and 'quality of care'. The psychometric qualities of the tool were robust as were the indices of validity and reliability evaluated. The BSS-RI represents a short easily administered and scored measure of women's satisfaction with care and the experience of labour and birth. The instrument is potentially useful for researchers, service evaluation and policy makers.

Exploratory and Confirmatory Factor Analyses of the Structured Interview for Disorders of Extreme Stress

ERIC Educational Resources Information Center

Scoboria, Alan; Ford, Julian; Lin, Hsiu-ju; Frisman, Linda

2008-01-01

Two studies were conducted to provide the first empirical examination of the factor structure of a revised version of the clinically derived Structured Interview for Disorders of Extreme Stress, a structured interview designed to assess associated features of posttraumatic stress disorder (PTSD) thought to be related to early onset, interpersonal,…

Cosmetic rhinoplasty: revision rates revisited.

PubMed

Neaman, Keith C; Boettcher, Adam K; Do, Viet H; Mulder, Corlyne; Baca, Marissa; Renucci, John D; VanderWoude, Douglas L

2013-01-01

Cosmetic rhinoplasty has great potential to change a patient's appearance. It also carries the very real risk of patient dissatisfaction and request for revision. Although there have been many published patient series studying various aspects of rhinoplasty, questions remain regarding revision rates, as well as risk factors for complications, dissatisfaction, and revision. The authors investigate the rate of cosmetic rhinoplasty revision at a plastic surgery group practice and identify risk factors for revision. Medical records were retrospectively reviewed for all patients who presented to a single multisurgeon practice for primary rhinoplasty, septorhinoplasty, and revision rhinoplasty between 1998 and 2008. Patient demographics, preoperative complaints, preoperative physical examination findings, detailed operative data, and postoperative outcomes were abstracted from the charts. Complication rates, revision rates, and postoperative patient satisfaction were calculated and analyzed for identifiable risk factors. Of 369 consecutive cosmetic rhinoplasties performed during the study period, 279 (72.7%) were conducted with an open approach. The overall complication, dissatisfaction, and revision rates were 7.9%, 15.4%, and 9.8%, respectively. Postoperatively, most patients (87%) were identified by their surgeons as having had successful anatomical correction of their nasal deformity. History of previous nasal operation or facial fracture, lack of anatomical correction, and occurrence of postoperative complications were associated with both revision and dissatisfaction (P < .05). Failure to address the nasal tip at the time of primary rhinoplasty was associated with a higher level of dissatisfaction. Cosmetic rhinoplasty is one of the most challenging procedures in plastic surgery; however, these data indicate that a high level of patient satisfaction is attainable within a plastic surgery group practice if certain factors are considered. Specifically, surgeons should be aware of risk factors that are potentially associated with dissatisfaction and revision. 4.

Demographically corrected norms for African Americans and Caucasians on the Hopkins Verbal Learning Test-Revised, Brief Visuospatial Memory Test-Revised, Stroop Color and Word Test, and Wisconsin Card Sorting Test 64-Card Version.

PubMed

Norman, Marc A; Moore, David J; Taylor, Michael; Franklin, Donald; Cysique, Lucette; Ake, Chris; Lazarretto, Deborah; Vaida, Florin; Heaton, Robert K

2011-08-01

Memory and executive functioning are two important components of clinical neuropsychological (NP) practice and research. Multiple demographic factors are known to affect performance differentially on most NP tests, but adequate normative corrections, inclusive of race/ethnicity, are not available for many widely used instruments. This study compared demographic contributions for widely used tests of verbal and visual learning and memory (Brief Visual Memory Test-Revised, Hopkins Verbal Memory Test-Revised) and executive functioning (Stroop Color and Word Test, Wisconsin Card Sorting Test-64) in groups of healthy Caucasians (n = 143) and African Americans (n = 103). Demographic factors of age, education, gender, and race/ethnicity were found to be significant factors on some indices of all four tests. The magnitude of demographic contributions (especially age) was greater for African Americans than for Caucasians on most measures. New, demographically corrected T-score formulas were calculated for each race/ethnicity. The rates of NP impairment using previously published normative standards significantly overestimated NP impairment in African Americans. Utilizing the new demographic corrections developed and presented herein, NP impairment rates were comparable between the two race/ethnicities and were unrelated to the other demographic characteristics (age, education, gender) in either race/ethnicity group. Findings support the need to consider extended demographic contributions to neuropsychological test performance in clinical and research settings.

A Comparison of Visual and Auditory Processing Tests on the Woodcock-Johnson Tests of Cognitive Ability, Revised and the Learning Efficiency Test-II.

ERIC Educational Resources Information Center

Bolen, L. M.; Kimball, D. J.; Hall, C. W.; Webster, R. E.

1997-01-01

Compares the visual and auditory processing factors of the Woodcock Johnson Tests of Cognitive Ability, Revised (WJR COG) and the visual and auditory memory factors of the Learning Efficiency Test, II (LET-II) among 120 college students. Results indicate two significant performance differences between the WJR COG and LET-II. (RJM)

Measuring the quality of life of people at the end of life: The McGill Quality of Life Questionnaire-Revised.

PubMed

Cohen, S Robin; Sawatzky, Richard; Russell, Lara B; Shahidi, Javad; Heyland, Daren K; Gadermann, Anne M

2017-02-01

The McGill Quality of Life Questionnaire has been widely used with people with life-threatening illnesses without modification since its publication in 1996. With use, areas for improvement have emerged; therefore, various minor modifications were tested over time. To revise the McGill Quality of Life Questionnaire (McGill Quality of Life Questionnaire-Revised) while maintaining or improving its psychometric properties and length, keeping it as close as possible to the McGill Quality of Life Questionnaire to enable reasonable comparison with existing McGill Quality of Life Questionnaire literature. Data sets from eight studies were used (four studies originally used to develop the McGill Quality of Life Questionnaire, two to develop new McGill Quality of Life Questionnaire versions, and two with unrelated purposes). The McGill Quality of Life Questionnaire-Revised was developed using analyses of measurement invariance, confirmatory factor analysis, and calculation of correlations with the McGill Quality of Life Questionnaire's global quality of life item. Data were from 1702 people with life-threatening illnesses recruited from acute and palliative care units, palliative home care services, and oncology and HIV/AIDS outpatient clinics. The McGill Quality of Life Questionnaire-Revised consists of 14 items (plus the global quality of life item). A new Physical subscale was created combining physical symptoms and physical well-being and a new item on physical functioning. The Existential subscale was reduced to four items. The revised Support subscale, renamed Social, focuses more on relationships. The Psychological subscale remains unchanged. Confirmatory factor analysis results provide support for the measurement structure of the McGill Quality of Life Questionnaire-Revised. The overall scale has good internal consistency reliability ( α = 0.94). The McGill Quality of Life Questionnaire-Revised improves on and can replace the McGill Quality of Life Questionnaire since it contains improved wording, a somewhat expanded repertoire of concepts with fewer items, and a single subscale for the physical domain, while retaining good psychometric properties.

A Second-Order Confirmatory Factor Analysis of the Moral Distress Scale-Revised for Nurses.

PubMed

Sharif Nia, Hamid; Shafipour, Vida; Allen, Kelly-Ann; Heidari, Mohammad Reza; Yazdani-Charati, Jamshid; Zareiyan, Armin

2017-01-01

Moral distress is a growing problem for healthcare professionals that may lead to dissatisfaction, resignation, or occupational burnout if left unattended, and nurses experience different levels of this phenomenon. This study aims to investigate the factor structure of the Persian version of the Moral Distress Scale-Revised in intensive care and general nurses. This methodological research was conducted with 771 nurses from eight hospitals in the Mazandaran Province of Iran in 2017. Participants completed the Moral Distress Scale-Revised, data collected, and factor structure assessed using the construct, convergent, and divergent validity methods. The reliability of the scale was assessed using internal consistency (Cronbach's alpha, Theta, and McDonald's omega coefficients) and construct reliability. Ethical considerations: This study was approved by the Ethics Committee of Mazandaran University of Medical Sciences. The exploratory factor analysis ( N = 380) showed that the Moral Distress Scale-Revised has five factors: lack of professional competence at work, ignoring ethical issues and patient conditions, futile care, carrying out the physician's orders without question and unsafe care, and providing care under personal and organizational pressures, which explained 56.62% of the overall variance. The confirmatory factor analysis ( N = 391) supported the five-factor solution and the second-order latent factor model. The first-order model did not show a favorable convergent and divergent validity. Ultimately, the Moral Distress Scale-Revised was found to have a favorable internal consistency and construct reliability. The Moral Distress Scale-Revised was found to be a multidimensional construct. The data obtained confirmed the hypothesis of the factor structure model with a latent second-order variable. Since the convergent and divergent validity of the scale were not confirmed in this study, further assessment is necessary in future studies.

Not throwing out the baby with the bathwater: lessons from the Fibromyalgia Impact Questionnaire.

PubMed

van Wilgen, C Paul; Vuijk, Pieter Jelle; van Ittersum, Miriam W; Nijs, Jo

2013-03-01

The Fibromyalgia Impact Questionnaire (FIQ) is the most frequently used questionnaire in patients with fibromyalgia in the last 20 years. Recently, a revised version of the FIQ has been published. In this study, we examined the factor structure of the original version using explorative and confirmative factor analyses in a representative group of about 500 Dutch and Belgian patients with fibromyalgia, in which the work-related item was excluded. The FIQ consisting of a three-factor structure with a functional domain (ten items), physical symptom domain (six items), and mental symptom domain (two items), which is the most accurate. From the data presented, it is concluded that the FIQ is a solid, worldwide-used questionnaire with a history of 20 years consisting of three domains. When constructing a revised FIQ, the results of this study can be incorporated.

Risk factors for revision surgery following isolated ulnar nerve release at the cubital tunnel: a study of 25,977 cases.

PubMed

Camp, Christopher L; Ryan, Claire B; Degen, Ryan M; Dines, Joshua S; Altchek, David W; Werner, Brian C

2017-04-01

The literature investigating risk factors for failure after decompression of the ulnar nerve at the elbow (cubital tunnel release [CuTR]) is limited. The purpose of this study was to identify risk factors for failure of isolated CuTR, defined as progression to subsequent ipsilateral revision surgery. The 100% Medicare Standard Analytic Files from 2005 to 2012 were queried for patients undergoing CuTR. Patients undergoing any concomitant procedures were excluded. A multivariate binomial logistic regression analysis was used to evaluate patient-related risk factors for ipsilateral revision surgery. Adjusted odds ratios (ORs) and 95% confidence intervals were calculated for each risk factor. A total of 25,977 patients underwent primary CuTR, and 304 (1.4%) of those with ≥2 years of follow-up required revision surgery. Although the rate of primary procedures is on the rise (P = .002), the revision rate remains steady (P = .148). Significant, independent risk factors for revision surgery included age <65 years (OR, 1.5; P < .001), obesity (OR, 1.3; P = .022), morbid obesity (OR, 1.3; P = .044), tobacco use (OR, 2.0; P < .001), diabetes (OR, 1.3; P = .011), hyperlipidemia (OR, 1.2; P = .015), chronic liver disease (OR, 1.6; P = .001), chronic anemia (OR, 1.6; P = .001), and hypercoagulable disorder (OR, 2.1; P = .001). The incidence of failure requiring ipsilateral revision surgery after CuTR remained steadily low (1.4%) during the study period. There are numerous patient-related risk factors that are independently associated with an increased risk for revision surgery, the most significant of which are tobacco use, younger age, hypercoagulable disorder, liver disease, and anemia. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Further development of the talent development environment questionnaire for sport.

PubMed

Li, Chunxiao; Wang, Chee Keng John; Pyun, Do Young; Martindale, Russell

2015-01-01

Given the significance of monitoring the critical environmental factors that facilitate athlete performance, this two-phase research aimed to validate and refine the revised talent development environment questionnaire (TDEQ). The TDEQ is a multidimensional self-report scale that assesses talented athletes' environmental experiences. Study 1 (the first phase) involved the examination of the revised TDEQ through an exploratory factor analysis (n = 363). This exploratory investigation identified a 28-item five-factor structure (i.e., TDEQ-5) with adequate internal consistency. Study 2 (the second phase) examined the factorial structure of the TDEQ-5, including convergent validity, discriminant validity, and group invariance (i.e., gender and sports type). The second phase was carried out with 496 talented athletes through the application of confirmatory factor analyses and multigroup invariance tests. The results supported the convergent validity, discriminant validity, and group invariance of the TDEQ-5. In conclusion, the TDEQ-5 with 25 items appears to be a reliable and valid scale for use in talent development environments.

Development of a Decisional Balance Scale for Young Adult Marijuana Use

PubMed Central

Elliott, Jennifer C.; Carey, Kate B.; Scott-Sheldon, Lori A. J.

2010-01-01

This study describes the development and validation of a decisional balance scale for marijuana use in young adults. Scale development was accomplished in four phases. First, 53 participants (70% female, 68% freshman) provided qualitative data that yielded content for an initial set of 47 items. In the second phase, an exploratory factor analysis on the responses of 260 participants (52% female, 68% freshman) revealed two factors, corresponding to pros and cons. Items that did not load well on the factors were omitted, resulting in a reduced set of 36 items. In the third phase, 182 participants (49% female, 37% freshmen) completed the revised scale and an evaluation of factor structure led to scale revisions and model respecification to create a good-fitting model. The final scales consisted of 8 pros (α = 0.91) and 16 cons (α = 0.93), and showed evidence of validity. In the fourth phase (N = 248, 66% female, 70% freshman), we confirmed the factor structure, and provided further evidence for reliability and validity. The Marijuana Decisional Balance Scale enhances our ability to study motivational factors associated with marijuana use among young adults. PMID:21261405

Factor structure of the Childhood Autism Rating Scale as per DSM-5.

PubMed

Park, Eun-Young; Kim, Joungmin

2016-02-01

The DSM-5 recently proposed new diagnostic criteria for autism spectrum disorder (ASD). Although many new or updated tools have been developed since the DSM-IV was published in 1994, the Childhood Autism Rating Scale (CARS) has been used consistently in ASD diagnosis and research due to its technical adequacy, cost-effectiveness, and practicality. Additionally, items in the CARS did not alter following the release of the revised DSM-IV because the CARS factor structure was found to be consistent with the revised criteria after factor analysis. For that reason, in this study confirmatory factor analysis was used to identify the factor structure of the CARS. Participants (n = 150) consisted of children with an ASD diagnosis or who met the criteria for broader autism or emotional/behavior disorder with comorbid disorders such as attention-deficit hyperactivity disorder, bipolar disorder, intellectual or developmental disabilities. Previous studies used one-, two-, and four-factor models, all of which we examined to confirm the best-fit model on confirmatory factor analysis. Appropriate comparative fit indices and root mean square errors were obtained for all four models. The two-factor model, based on DSM-5 criteria, was the most valid and reliable. The inter-item consistency of the CARS was 0.926 and demonstrated adequate reliability, thereby supporting the validity and reliability of the two-factor model of CARS. Although CARS was developed prior to the introduction of DSM-5, its psychometric properties, conceptual relevance, and flexible administration procedures support its continued role as a screening device in the diagnostic decision-making process. © 2015 Japan Pediatric Society.

The Structure of Social Exchange in Self-Help Support Groups: Development of a Measure

PubMed Central

Brown, Louis D.; Tang, Xiaohui; Hollman, Ruth L.

2014-01-01

Self-help support groups are indigenous community resources designed to help people manage a variety of personal challenges, from alcohol abuse to xeroderma pigmentosum. The social exchanges that occur during group meetings are central to understanding how people benefit from participation. This paper examines the different types of social exchange behaviors that occur during meetings, using two studies to develop empirically distinct scales that reliably measure theoretically important types of exchange. Resource theory informed the initial measurement development efforts. Exploratory factor analyses from the first study led to revisions in the factor structure of the social exchange scales. The revised measure captured the exchange of emotional support, experiential information, humor, unwanted behaviors, and exchanges outside meetings. Confirmatory factor analyses from a follow-up study with a different sample of self-help support groups provided good model fit, suggesting the revised structure accurately represented the data. Further, the scales demonstrated good convergent and discriminant validity with related constructs. Future research can use the scales to identify aspects of social exchange that are most important in improving health outcomes among self-help support group participants. Groups can use the scales in practice to celebrate strengths and address weaknesses in their social exchange dynamics. PMID:24398622

Promotion orientation explains why future-oriented people exercise and eat healthy: evidence from the two-factor consideration of future consequences-14 scale.

PubMed

Joireman, Jeff; Shaffer, Monte J; Balliet, Daniel; Strathman, Alan

2012-10-01

The authors extended research linking individual differences in consideration of future consequences (CFC) with health behaviors by (a) testing whether individual differences in regulatory focus would mediate that link and (b) highlighting the value of a revised, two-factor CFC-14 scale with subscales assessing concern with future consequences (CFC-Future) and concern with immediate consequences (CFC-Immediate) proper. Exploratory and confirmatory factor analyses of the revised CFC-14 scale supported the presence of two highly reliable factors (CFC-Future and CFC-Immediate; αs from .80 to .84). Moreover, structural equation modeling showed that those high in CFC-Future engage in exercise and healthy eating because they adopt a promotion orientation. Future use of the two-factor CFC-14 scale is encouraged to shed additional light on how concern with future and concern with immediate consequences (proper) differentially impact the way people resolve a host of intertemporal dilemmas (e.g., health, financial, and environmental behavior).

Testing Math or Testing Language? The Construct Validity of the KeyMath-Revised for Children With Intellectual Disability and Language Difficulties.

PubMed

Rhodes, Katherine T; Branum-Martin, Lee; Morris, Robin D; Romski, MaryAnn; Sevcik, Rose A

2015-11-01

Although it is often assumed that mathematics ability alone predicts mathematics test performance, linguistic demands may also predict achievement. This study examined the role of language in mathematics assessment performance for children with intellectual disability (ID) at less severe levels, on the KeyMath-Revised Inventory (KM-R) with a sample of 264 children, in grades 2-5. Using confirmatory factor analysis, the hypothesis that the KM-R would demonstrate discriminant validity with measures of language abilities in a two-factor model was compared to two plausible alternative models. Results indicated that KM-R did not have discriminant validity with measures of children's language abilities and was a multidimensional test of both mathematics and language abilities for this population of test users. Implications are considered for test development, interpretation, and intervention.

Learning Approaches of Undergraduate Computer Technology Students: Strategies for Improvement

ERIC Educational Resources Information Center

Malakolunthu, Suseela; Joshua, Alice

2012-01-01

Purpose: In recent times, quality of graduates and their performance has been questioned. Students' performance is an indicator of the kind of approach (deep or surface) that is taken. This study investigates the kind of undergraduates take in their learning processes. Methodology: This quantitative survey used Revised Two-Factor Study Process…

Elementary Unit in Italian Ethnic Studies. TM-1.

ERIC Educational Resources Information Center

Simerville, Susan; And Others

This study is considered to have been designed as an experimental plan for upper elementary grades with the hope that it would be tried, revised, expanded, and improved upon. Two factors are stressed: communication with children in the affective domain, and drawing upon resources and people from the children's immediate environment. The length of…

Predictors of unsuccessful outcome in cemented femoral revisions using bone impaction grafting; Cox regression analysis of 208 cases.

PubMed

Te Stroet, Martijn A J; Rijnen, Wim H C; Gardeniers, Jean W M; Schreurs, B Willem; Hannink, Gerjon

2016-09-29

Despite improvements in the technique of femoral impaction bone grafting, reconstruction failures still can occur. Therefore, the aim of our study was to determine risk factors for the endpoint re-revision for any reason. We used prospectively collected demographic, clinical and surgical data of all 202 patients who underwent 208 femoral revisions using the X-change Femoral Revision System (Stryker-Howmedica), fresh-frozen morcellised allograft and a cemented polished Exeter stem in our department from 1991 to 2007. Univariable and multivariable Cox regression analyses were performed to identify potential factors associated with re-revision. The mean follow-up was 10.6 (5-21) years. The cumulative re-revision rate was 6.3% (13/208). After univariable selection, sex, age, body mass index (BMI), American Association of Anesthesiologists (ASA) classification, type of removed femoral component, and mesh used for reconstruction were included in multivariable regression analysis.In the multivariable analysis, BMI was the only factor that was significantly associated with the risk of re-revision after bone impaction grafting (BMI ≥30 vs. BMI <30, HR = 6.54 [95% CI 1.89-22.65]; p = 0.003). BMI was the only factor associated with the risk of re-revision for any reason. Besides BMI also other factors, such as Endoklinik score and the type of removed femoral component, can provide guidance in the process of preclinical decision making. With the knowledge obtained from this study, preoperative patient selection, informed consent, and treatment protocols can be better adjusted to the individual patient who needs to undergo a femoral revision with impaction bone grafting.

The Epidemiology of Revision Anterior Cruciate Ligament Reconstruction in Adults from Ontario, Canada

PubMed Central

Leroux, Timothy; Wasserstein, David; Dwyer, Tim; Ogilvie-Harris, Darrell; Marks, Paul H.; Bach, Bernard R.; Townley, John; Mahomed, Nizar; Chahal, Jaskarndip

2015-01-01

Objectives: The morbidity associated with revision anterior cruciate ligament reconstruction (ACLR) is largely unknown. The objective of this study was to determine the rate of and risk factors for re-revision, re-operation, and re-admission following revision ACLR in the general population. Methods: All patients who underwent first revision ACLR in Ontario, Canada from January 2004 to December 2010 were identified and followed to December 2012. Exclusions included age (<16 years), previous osteotomy, or multi-ligament knee reconstruction. The main outcome was re-revision ACLR. Secondary outcomes included re-operation [irrigation and debridement (I&D), meniscectomy, manipulation under anesthesia (MUA), contralateral ACLR, and total knee arthroplasty (TKA)], and re-admission within 90 days of surgery. Survival to re-revision was determined using the Kaplan-Meier (KM) approach. A Cox proportional hazards model or logistic regression were used to determine the influence of patient factors (age, sex, neighborhood income quintile, and comorbidity), surgical factors (graft choice, concurrent meniscal procedure, and fixation method), and provider factors (surgeon volume, surgeon years in practice, and hospital status) on outcomes. A post-hoc analysis was performed to determine the influence of the aforementioned factors on overall post-operative infection risk, including both operative and non-operative cases. Results: Overall, 827 patients were included (median age: 30 years; 58.8% males). Single stage revisions comprised 92.9% of cases, and a meniscal procedure (repair or debridement) was performed in 45.3% of cases. The re-revision rate at a mean follow-up of 4.8±2.2 years was 4.4%, and the five-year survival rate was 95.4% (Figure 1). The rates of I&D, meniscectomy, contralateral ACLR, and re-admission were 0.8%, 3.1%, 3.4%, and 4.1%, respectively. MUA and TKA were rare. Young age significantly increased contralateral ACLR risk (risk decreased by 5.1% with each year of age above 16 years, p=0.02), but not re-revision ACLR risk. Low surgeon annual volume of revision ACLR [<4 revisions/year: odds ratio (OR) 1.2, p=0.02)] and male sex (OR 13.3, p=0.01) significantly increased overall infection risk, while male sex also influenced I&D risk. No other factors significantly influenced re-revision, re-operation, or re-admission risk. Conclusion: Re-revision, re-operation, and re-admission rates following revision ACLR are low. The risk of I&D, overall infection, and contralateral ACLR were influenced by male sex, low surgeon volume, and young age, respectively. This is the first study of this magnitude to determine rates of and risk factors for morbidity following revision ACLR, providing clinicians with reference data from the general population.

Preoperative Risk Factors Associated With Poor Outcomes of Revision Surgery for "Pseudotumors" in Patients With Metal-on-Metal Hip Arthroplasty.

PubMed

Liow, Ming Han Lincoln; Dimitriou, Dimitris; Tsai, Tsung-Yuan; Kwon, Young-Min

2016-12-01

Revision surgery of failed metal-on-metal (MoM) total hip arthroplasty (THA) for adverse tissue reaction (pseudotumor) can be challenging as a consequence of soft tissue and muscle necrosis. The aims of this study were to (1) report the revision outcomes of patients who underwent revision surgery for failed MoM hip arthroplasty due to symptomatic pseudotumor and (2) identify preoperative risk factors associated with revision outcomes. Between January 2011 and January 2013, a total of 102 consecutive large head MoM hip arthroplasties in 97 patients (male: 62, female: 35), who underwent revision surgery were identified from the database of a multidisciplinary referral center. At minimum follow-up of 2 years (range: 26-52 months), at least one complication had occurred in 14 of 102 revisions (14%). Prerevision radiographic loosening (P = .01), magnetic resonance imaging (MRI) findings of solid lesions with abductor deficiency on MRI (P < .001), and intraoperative grading of adverse tissue reactions (P = .05) were correlated with post-revision complications. The reoperation rate of revised MoM THA was 7% (7 of 102 hips). Implant survivorship was 88% at 3 years. Metal ion levels declined in most patients after removal of MoM articulation. Revision outcomes of revision surgery for failed MoM THA due to symptomatic pseudotumor demonstrated 14% complication rate and 7% re-revision rate at 30-month follow-up. Our study identified prerevision radiographic loosening, solid lesions/abductor deficiency on MRI, and high grade intraoperative tissue damage as risk factors associated with poorer revision outcomes. This provides clinically useful information for preoperative planning and perioperative counseling of MoM THA patients undergoing revision surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

Dimensional structure of DSM-5 posttraumatic stress symptoms: support for a hybrid Anhedonia and Externalizing Behaviors model.

PubMed

Armour, Cherie; Tsai, Jack; Durham, Tory A; Charak, Ruby; Biehn, Tracey L; Elhai, Jon D; Pietrzak, Robert H

2015-02-01

Several revisions to the symptom clusters of posttraumatic stress disorder (PTSD) have been made in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Central to the focus of this study was the revision of PTSD's tripartite structure in DSM-IV into four symptom clusters in DSM-5. Emerging confirmatory factor analytic (CFA) studies have suggested that DSM-5 PTSD symptoms may be best represented by one of two 6-factor models: (1) an Externalizing Behaviors model characterized by a factor which combines the irritability/anger and self-destructive/reckless behavior items; and (2) an Anhedonia model characterized by items of loss of interest, detachment, and restricted affect. The current study conducted CFAs of DSM-5 PTSD symptoms assessed using the PTSD Checklist for DSM-5 (PCL-5) in two independent and diverse trauma-exposed samples of a nationally representative sample of 1484 U.S. veterans and a sample of 497 Midwestern U.S. university undergraduate students. Relative fits of the DSM-5 model, the DSM-5 Dysphoria model, the DSM-5 Dysphoric Arousal model, the two 6-factor models, and a newly proposed 7-factor Hybrid model, which consolidates the two 6-factor models, were evaluated. Results revealed that, in both samples, both 6-factor models provided significantly better fit than the 4-factor DSM-5 model, the DSM-5 Dysphoria model and the DSM-5 Dysphoric Arousal model. Further, the 7-factor Hybrid model, which incorporates key features of both 6-factor models and is comprised of re-experiencing, avoidance, negative affect, anhedonia, externalizing behaviors, and anxious and dysphoric arousal symptom clusters, provided superior fit to the data in both samples. Results are discussed in light of theoretical and empirical support for the latent structure of DSM-5 PTSD symptoms. Copyright © 2014 Elsevier Ltd. All rights reserved.

Risk factors for total hip arthroplasty aseptic revision.

PubMed

Khatod, Monti; Cafri, Guy; Namba, Robert S; Inacio, Maria C S; Paxton, Elizabeth W

2014-07-01

The purpose of this study was to evaluate patient, operative, implant, surgeon, and hospital factors associated with aseptic revision after primary THA in patients registered in a large US Total Joint Replacement Registry. A total of 35,960 THAs registered from 4/2001-12/2010 were evaluated. The 8-year survival rate was 96.7% (95% CI 96.4%-97.0%). Females had a higher risk of aseptic revision than males. Hispanic and Asian patients had a lower risk of revision than white patients. Ceramic-on-ceramic, ceramic-on-conventional polyethylene, and metal-on-conventional polyethylene bearing surfaces had a higher risk of revision than metal-on-highly cross-linked polyethylene. Body mass index, health status, diabetes, diagnosis, fixation, approach, bilateral procedures, head size, surgeon fellowship training, surgeon and hospital volume were not revision risk factors. Copyright © 2014 Elsevier Inc. All rights reserved.

The Impact of Unstructured Case Studies on Surface Learners: A Study of Second-Year Accounting Students

ERIC Educational Resources Information Center

Wynn-Williams, Kate; Beatson, Nicola; Anderson, Cameron

2016-01-01

The empirical study described here uses the R-SPQ-2F questionnaire [Biggs, J., Kember, D., & Leung, D. Y. (2001). The revised two-factor study process questionnaire: R-SPQ-2F. "British Journal of Educational Psychology," 71(1), 133-149] to test deep and surface approaches to learning in a university intermediate-level accounting…

Cross-cultural validation of the moral sensitivity questionnaire-revised Chinese version.

PubMed

Huang, Fei Fei; Yang, Qing; Zhang, Jie; Zhang, Qing Hua; Khoshnood, Kaveh; Zhang, Jing Ping

2016-11-01

Ethical issues pose challenges for nurses who are increasingly caring for patients in complicated situations. Ethical sensitivity is a prerequisite for nurses to make decisions in the best interest of their patients in daily practice. Currently, there is no tool for assessing ethical sensitivity in Chinese language, and no empirical studies of ethical sensitivity among Chinese nurses. The study was conducted to translate the Moral Sensitivity Questionnaire-Revised Version (MSQ-R) into Chinese and establish the psychometric properties of the Moral Sensitivity Questionnaire-Revised Version into Chinese (MSQ-R-CV). This research was a methodological and descriptive study. MSQ-R was translated into Chinese using Brislin's model, and the Translation Validity Index was evaluated. MSQ-R-CV was then distributed along with a demographic questionnaire to 360 nurses working at tertiary and municipal hospitals in Changsha, China. This study was approved by the Institutional Review Boards of Yale University and Central South University. MSQ-R-CV achieved Cronbach's alpha 0.82, Spearman-Brown coefficient 0.75, significant item discrimination (p < 0.001), and item-total correlation values ranging from 0.524 to 0.717. A two-factor structure was illustrated by exploratory factor analysis, and further confirmed by confirmatory factor analysis. Chinese nurses had a mean total score of 40.22 ± 7.08 on the MSQ-R-CV, and sub-scores of 23.85 ± 4.4 for moral responsibility and strength and 16.37 ± 3.75 for sense of moral burden. The findings of this study were compared with studies from other countries to examine the structure and meaningful implications of ethical sensitivity in Chinese nurses. The two-factor MSQ-R-CV (moral responsibility and strength, and sense of moral burden) is a linguistically and culturally appropriate instrument for assessing ethical sensitivity among Chinese nurses. © The Author(s) 2015.

Personality Traits and Occupational Stress among Chinese Academics

ERIC Educational Resources Information Center

Zhang, Li-Fang

2012-01-01

The primary objective of this study was to examine the predictive power of personality traits for occupational stress among Chinese university academics. Two hundred and forty-six participants responded to the NEO Five-Factor Inventory and the Occupational Stress Inventory-Revised. Results indicated that the strongest predictor for occupational…

Effects of hydroxyapatite coating of cups used in hip revision arthroplasty

PubMed Central

2012-01-01

Background and purpose Coating of acetabular revision implants with hydroxyapatite (HA) has been proposed to improve ingrowth and stability. We investigated whether HA coating of revision cups can reduce the risk of any subsequent re-revision. Methods We studied uncemented cups either with or without HA coating that were used at a primary acetabular revision and registered in the Swedish Hip Arthroplasty Register (SHAR). 2 such cup designs were identified: Harris-Galante and Trilogy, both available either with or without HA coating. These cups had been used as revision components in 1,780 revisions of total hip arthroplasties (THA) between 1986 and 2009. A Cox proportional hazards model including the type of coating, age at index revision, sex, cause of cup revision, cup design, the use of bone graft at the revision procedure, and the type of cup fixation at primary THA were used to calculate adjusted risk ratios (RRs with 95% CI) for re-revision for any reason or due to aseptic loosening. Results 71% of the cups were coated with HA and 29% were uncoated. At a mean follow-up time of 6.9 (0–24) years, 159 (9%) of all 1,780 cups had been re-revised, mostly due to aseptic loosening (5%), dislocation (2%), or deep infection (1%). HA coating had no significant influence on the risk of re-revision of the cup for any reason (RR = 1.4, CI: 0.9–2.0) or due to aseptic loosening (RR = 1.1, 0.6–1.9). In contrast, HA coating was found to be a risk factor for isolated liner re-revision for any reason (RR = 1.8, CI: 1.01–3.3). Age below 60 years at the index cup revision, dislocation as the cause of the index cup revision, uncemented cup fixation at primary THA, and use of the Harris-Galante cup also increased the risk of re-revision of the cup. In separate analyses in which isolated liner revisions were excluded, bone grafting was found to be a risk factor for re-revision of the metal shell due to aseptic loosening (RR = 2.1, CI: 1.05–4.2). Interpretation We found no evidence to support the notion that HA coating improves the performance of the 2 studied cup designs in revision arthroplasty. In contrast, patient-related factors such as younger age and dislocation as the reason for cup revision, and technical factors such as the choice of revision cup were found to influence the risk of subsequent re-revision of the cup. The reason for inferior results after revision of uncemented cups is not known, but it is possible that these hips more often had pronounced bone loss at the index cup revision. PMID:22937978

Preferences for Deep-Surface Learning: A Vocational Education Case Study Using a Multimedia Assessment Activity

ERIC Educational Resources Information Center

Hamm, Simon; Robertson, Ian

2010-01-01

This research tests the proposition that the integration of a multimedia assessment activity into a Diploma of Events Management program promotes a deep learning approach. Firstly, learners' preferences for deep or surface learning were evaluated using the revised two-factor Study Process Questionnaire. Secondly, after completion of an assessment…

A reliability analysis of the revised competitiveness index.

PubMed

Harris, Paul B; Houston, John M

2010-06-01

This study examined the reliability of the Revised Competitiveness Index by investigating the test-retest reliability, interitem reliability, and factor structure of the measure based on a sample of 280 undergraduates (200 women, 80 men) ranging in age from 18 to 28 years (M = 20.1, SD = 2.1). The findings indicate that the Revised Competitiveness Index has high test-retest reliability, high inter-item reliability, and a stable factor structure. The results support the assertion that the Revised Competitiveness Index assesses competitiveness as a stable trait rather than a dynamic state.

Descriptive Epidemiology of the Multicenter ACL Revision Study (MARS) Cohort

PubMed Central

2013-01-01

Background Revision anterior cruciate ligament (ACL) reconstruction has worse outcomes than primary reconstructions. Predictors for these worse outcomes are not known. The Multicenter ACL Revision Study (MARS) Group was developed to perform a multisurgeon, multicenter prospective longitudinal study to obtain sufficient subjects to allow multivariable analysis to determine predictors of clinical outcome. Purpose To describe the formation of MARS and provide descriptive analysis of patient demographics and clinical features for the initial 460 enrolled patients to date in this prospective cohort. Study Design Cross-sectional study; Level of evidence, 2. Methods After training and institutional review board approval, surgeons began enrolling patients undergoing revision ACL reconstruction, recording patient demographics, previous ACL reconstruction methods, intra-articular injuries, and current revision techniques. Enrolled subjects completed a questionnaire consisting of validated patient-based outcome measures. Results As of April 1, 2009, 87 surgeons have enrolled a total of 460 patients (57% men; median age, 26 years). For 89%, the reconstruction was the first revision. Mode of failure as deemed by the revising surgeon was traumatic (32%), technical (24%), biologic (7%), combination (37%), infection (<1%), and no response (<1%). Previous graft present at the time of injury was 70% autograft, 27% allograft, 2% combination, and 1% unknown. Sixty-two percent were more than 2 years removed from their last reconstruction. Graft choice for revision ACL reconstruction was 45% autograft, 54% allograft, and more than 1% both allograft and autograft. Meniscus and/or chondral damage was found in 90% of patients. Conclusion The MARS Group has been able to quickly accumulate the largest revision ACL reconstruction cohort reported to date. Traumatic reinjury is deemed by surgeons to be the most common single mode of failure, but a combination of factors represents the most common mode of failure. Allograft graft choice is more common in the revision setting than autograft. Concomitant knee injury is extremely common in this population. PMID:20889962

Survivorship analysis of failure pattern after revision total hip arthroplasty.

PubMed

Retpen, J B; Varmarken, J E; Jensen, J S

1989-12-01

Failure, defined as established indication for or performed re-revision of one or both components, was analyzed using survivorship methods in 306 revision total hip arthroplasties. The longevity of revision total hip arthroplasties was inferior to that of previously reported primary total hip arthroplasties. The overall survival curve was two-phased, with a late failure period associated with aseptic loosening of one or both components and an early failure period associated with causes of failure other than loosening. Separate survival curves for aseptic loosening of femoral and acetabular components showed late and almost simultaneous decline, but with a tendency toward a higher rate of failure for the femoral component. No differences in survival could be found between the Stanmore, Lubinus standard, and Lubinus long-stemmed femoral components. A short interval between the index operation and the revision and intraoperative and postoperative complications were risk factors for early failure. Young age was a risk factor for aseptic loosening of the femoral component. Intraoperative fracture of the femoral shaft was not a risk factor for secondary loosening. No difference in survival was found between primary cemented total arthroplasty and primary noncemented hemiarthroplasty.

The Structure of Diagnostic and Statistical Manual of Mental Disorders (4th Edition, Text Revision) Personality Disorder Symptoms in a Large National Sample

PubMed Central

Trull, Timothy J.; Vergés, Alvaro; Wood, Phillip K.; Jahng, Seungmin; Sher, Kenneth J.

2013-01-01

We examined the latent structure underlying the criteria for DSM–IV–TR (American Psychiatric Association, 2000, Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.) personality disorders in a large nationally representative sample of U.S. adults. Personality disorder symptom data were collected using a structured diagnostic interview from approximately 35,000 adults assessed over two waves of data collection in the National Epidemiologic Survey on Alcohol and Related Conditions. Our analyses suggested that a seven-factor solution provided the best fit for the data, and these factors were marked primarily by one or at most two personality disorder criteria sets. A series of regression analyses that used external validators tapping Axis I psychopathology, treatment for mental health problems, functioning scores, interpersonal conflict, and suicidal ideation and behavior provided support for the seven-factor solution. We discuss these findings in the context of previous studies that have examined the structure underlying the personality disorder criteria as well as the current proposals for DSM-5 personality disorders. PMID:22506626

Measuring chronic condition self-management in an Australian community: factor structure of the revised Partners in Health (PIH) scale.

PubMed

Smith, David; Harvey, Peter; Lawn, Sharon; Harris, Melanie; Battersby, Malcolm

2017-01-01

To evaluate the factor structure of the revised Partners in Health (PIH) scale for measuring chronic condition self-management in a representative sample from the Australian community. A series of consultations between clinical groups underpinned the revision of the PIH. The factors in the revised instrument were proposed to be: knowledge of illness and treatment, patient-health professional partnership, recognition and management of symptoms and coping with chronic illness. Participants (N = 904) reporting having a chronic illness completed the revised 12-item scale. Two a priori models, the 4-factor and bi-factor models were then evaluated using Bayesian confirmatory factor analysis (BCFA). Final model selection was established on model complexity, posterior predictive p values and deviance information criterion. Both 4-factor and bi-factor BCFA models with small informative priors for cross-loadings provided an acceptable fit with the data. The 4-factor model was shown to provide a better and more parsimonious fit with the observed data in terms of substantive theory. McDonald's omega coefficients indicated that the reliability of subscale raw scores was mostly in the acceptable range. The findings showed that the PIH scale is a relevant and structurally valid instrument for measuring chronic condition self-management in an Australian community. The PIH scale may help health professionals to introduce the concept of self-management to their patients and provide assessment of areas of self-management. A limitation is the narrow range of validated PIH measurement properties to date. Further research is needed to evaluate other important properties such as test-retest reliability, responsiveness over time and content validity.

Are Bundled Payments a Viable Reimbursement Model for Revision Total Joint Arthroplasty?

PubMed

Courtney, P Maxwell; Ashley, Blair S; Hume, Eric L; Kamath, Atul F

2016-12-01

Alternative payment models, such as the Centers for Medicare & Medicaid Services (CMS) Bundled Payment for Care Improvement (BPCI) initiative, aim to decrease overall costs for hip and knee arthroplasties. We asked: (1) Is there any difference in the CMS episode-of-care costs, hospital length of stay, and readmission rate from before and after implementation of our bundled-payment program? (2) Is there any difference in reimbursements and resource utilization between revision THA and TKA at our institution? (3) Are there any independent risk factors for patients with high costs who may not be appropriate for a bundled-payment system for revision total joint arthroplasty (TJA)? Between October 2013 and March 2015, 218 patients underwent revision TKA or THA in one health system. Two hundred seventeen patients were reviewed as part of this study, and one patient with hemophilia was excluded from the analysis as an outlier. Our institution began a BPCI program for revision TJA during this study period. Patients' procedures done before January 1, 2014 at one hospital and January 1, 2015 at another hospital were not included in the bundled-care arrangement (70 revision TKAs and 56 revision THAs), whereas 50 revision TKAs and 41 revision THAs were performed under the BPCI initiative. Patient demographics, medical comorbidities, episode-of-care reimbursement data derived directly from CMS, length of stay, and readmission proportions were compared between the bundled and nonbundled groups. Length of stay in the group that underwent surgery before the bundled-care arrangement was longer than for patients whose procedures were done under the BPCI (mean 4.02 [SD, 3.0 days] versus mean 5.27 days [SD, 3.6 days]; p = 0.001). Index hospitalization reimbursement for the bundled group was less than for the nonbundled group (mean USD 17,754 [SD, USD 2741] versus mean USD 18,316 [SD, USD 4732]; p = 0.030). There was no difference, with the numbers available, in total episode-of-care CMS costs between the two groups (mean USD 38,107 [SD, USD 18,328] versus mean USD 37,851 [SD, USD 17,208]; p = 0.984). There was no difference, with the numbers available, in the total episode-of-care CMS costs between revision hip arthroplasties and revision knee arthroplasties (mean USD 38,627 [SD, USD 18,607] versus mean USD 37,414 [SD, USD 16,884]; p = 0.904). Disposition to rehabilitation (odds ratio [OR], 5.49; 95% CI, 1.97-15.15; p = 0.001), length of stay 4 days or greater (OR, 3.66; 95% CI, 1.60-8.38; p = 0.002), and readmission within 90 days (OR, 6.99; 95% CI, 2.58-18.91; p < 0.001) were independent risk factors for high-cost episodes. Bundled payments have the potential to be a viable reimbursement model for revision TJA. Owing to the unpredictable nature of the surgical procedures, inherent high risks of complications, and varying degrees of surgical complexity, future studies are needed to determine whether bundling patients having revision TJA will result in improved care and decreased costs. Level IV, economic and decision analysis.

Re-Infection Outcomes following One- and Two-Stage Surgical Revision of Infected Hip Prosthesis: A Systematic Review and Meta-Analysis

PubMed Central

Kunutsor, Setor K.; Whitehouse, Michael R.; Blom, Ashley W.; Beswick, Andrew D.

2015-01-01

Background The two-stage revision strategy has been claimed as being the “gold standard” for treating prosthetic joint infection. The one-stage revision strategy remains an attractive alternative option; however, its effectiveness in comparison to the two-stage strategy remains uncertain. Objective To compare the effectiveness of one- and two-stage revision strategies in treating prosthetic hip infection, using re-infection as an outcome. Design Systematic review and meta-analysis. Data Sources MEDLINE, EMBASE, Web of Science, Cochrane Library, manual search of bibliographies to March 2015, and email contact with investigators. Study Selection Cohort studies (prospective or retrospective) conducted in generally unselected patients with prosthetic hip infection treated exclusively by one- or two-stage revision and with re-infection outcomes reported within two years of revision. No clinical trials were identified. Review Methods Data were extracted by two independent investigators and a consensus was reached with involvement of a third. Rates of re-infection from 38 one-stage studies (2,536 participants) and 60 two-stage studies (3,288 participants) were aggregated using random-effect models after arcsine transformation, and were grouped by study and population level characteristics. Results In one-stage studies, the rate (95% confidence intervals) of re-infection was 8.2% (6.0–10.8). The corresponding re-infection rate after two-stage revision was 7.9% (6.2–9.7). Re-infection rates remained generally similar when grouped by several study and population level characteristics. There was no strong evidence of publication bias among contributing studies. Conclusion Evidence from aggregate published data suggest similar re-infection rates after one- or two-stage revision among unselected patients. More detailed analyses under a broader range of circumstances and exploration of other sources of heterogeneity will require collaborative pooling of individual participant data. Systematic Review Registration PROSPERO 2015: CRD42015016559 PMID:26407003

Predictors of surgical revision after in situ decompression of the ulnar nerve.

PubMed

Krogue, Justin D; Aleem, Alexander W; Osei, Daniel A; Goldfarb, Charles A; Calfee, Ryan P

2015-04-01

This study was performed to identify factors associated with the need for revision surgery after in situ decompression of the ulnar nerve for cubital tunnel syndrome. This case-control investigation examined all patients treated at one institution with open in situ decompression for cubital tunnel syndrome between 2006 and 2011. The case patients were 44 failed decompressions that required revision, and the controls were 79 randomly selected patients treated with a single operation. Demographic data and disease-specific data were extracted from the medical records. The rate of revision surgery after in situ decompression was determined from our 5-year experience. A multivariate logistic regression model was used based on univariate testing to determine predictors of revision cubital tunnel surgery. Revision surgery was required in 19% (44 of 231) of all in situ decompressions performed during the study period. Predictors of revision surgery included a history of elbow fracture or dislocation (odds ratio [OR], 7.1) and McGowan stage I disease (OR, 3.2). Concurrent surgery with in situ decompression was protective against revision surgery (OR, 0.19). The rate of revision cubital tunnel surgery after in situ nerve decompression should be weighed against the benefits of a less invasive procedure compared with transposition. When considering in situ ulnar nerve decompression, prior elbow fracture as well as patients requesting surgery for mild clinically graded disease should be viewed as risk factors for revision surgery. Patient factors often considered relevant to surgical outcomes, including age, sex, body mass index, tobacco use, and diabetes status, were not associated with a greater likelihood of revision cubital tunnel surgery. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Patterns of functional improvement after revision knee arthroplasty.

PubMed

Ghomrawi, Hassan M K; Kane, Robert L; Eberly, Lynn E; Bershadsky, Boris; Saleh, Khaled J

2009-12-01

Despite the increase in the number of total knee arthroplasty revisions, outcomes of such surgery and their correlates are poorly understood. The aim of this study was to characterize patterns of functional improvement after revision total knee arthroplasty over a two-year period and to investigate factors that affect such improvement patterns. Three hundred and eight patients in need of revision surgery were enrolled into the study, conducted at seventeen centers, and 221 (71.8%) were followed for two years. Short Form-36 (SF-36), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Lower-Extremity Activity Scale (LEAS) scores were collected at baseline and every six months for two years postoperatively. A piecewise general linear mixed model, which models correlation between repeated measures and estimates separate slopes for different follow-up time periods, was employed to examine functional improvement patterns. Separate regression slopes were estimated for the zero to twelve-month and the twelve to twenty-four-month periods. The slopes for zero to twelve months showed significant improvement in all measures in the first year. The slopes for twelve to twenty-four months showed deterioration in the scores of the WOMAC pain subscale (slope = 0.67 +/- 0.21, p < 0.01) and function subscale (slope = 1.66 +/- 0.63, p < 0.05), whereas the slopes of the other measures had plateaued. A higher number of comorbidities was consistently the strongest deterrent of functional improvement across measures. The modes of failure of the primary total knee arthroplasty were instrument-specific predictors of outcome (for example, tibial bone lysis affected only the SF-36 physical component score [coefficient = -5.46 +/- 1.91, p < 0.01], while malalignment affected both the SF-36 physical component score [coefficient = 5.41 +/- 2.35, p < 0.05] and the LEAS score [coefficient = 1.42 +/- 0.69, p < 0.05]). Factors related to the surgical technique did not predict outcomes. The onset of worsening pain and knee-specific function in the second year following revision total knee arthroplasty indicates the need to closely monitor patients, irrespective of the mode of failure of the primary procedure or the surgical technique for the revision. This information may be especially important for patients with multiple comorbidities.

Revising Lecture Notes: How Revision, Pauses, and Partners Affect Note Taking and Achievement

ERIC Educational Resources Information Center

Luo, Linlin; Kiewra, Kenneth A.; Samuelson, Lydia

2016-01-01

Note taking has been categorized as a two-stage process: the recording of notes and the review of notes. We contend that note taking might best involve a three-stage process where the missing stage is revision. This study investigated the benefits of revising lecture notes and addressed two questions: First, is revision more effective than…

Reliability, Validity, and Factor Structure of the Current Assessment Practice Evaluation-Revised (CAPER) in a National Sample.

PubMed

Lyon, Aaron R; Pullmann, Michael D; Dorsey, Shannon; Martin, Prerna; Grigore, Alexandra A; Becker, Emily M; Jensen-Doss, Amanda

2018-05-11

Measurement-based care (MBC) is an increasingly popular, evidence-based practice, but there are no tools with established psychometrics to evaluate clinician use of MBC practices in mental health service delivery. The current study evaluated the reliability, validity, and factor structure of scores generated from a brief, standardized tool to measure MBC practices, the Current Assessment Practice Evaluation-Revised (CAPER). Survey data from a national sample of 479 mental health clinicians were used to conduct exploratory and confirmatory factor analyses, as well as reliability and validity analyses (e.g., relationships between CAPER subscales and clinician MBC attitudes). Analyses revealed competing two- and three-factor models. Regardless of the model used, scores from CAPER subscales demonstrated good reliability and convergent and divergent validity with MBC attitudes in the expected directions. The CAPER appears to be a psychometrically sound tool for assessing clinician MBC practices. Future directions for development and application of the tool are discussed.

76 FR 16549 - ESBWR Design Certification

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-24

... 73350; December 2, 2008). III. Regulatory and Policy Issues Human Factors Operational Programs The NRC... proposes to exclude the two Human Factors Engineering (HFE) operational program elements in Chapter 18 of... addresses existing NRC guidelines in NUREG- 0711, Revision 2, ``Human Factors Engineering Program Review...

Learning through Social Networking Sites--The Critical Role of the Teacher

ERIC Educational Resources Information Center

Callaghan, Noelene; Bower, Matt

2012-01-01

This comparative case study examined factors affecting behaviour and learning in social networking sites (SNS). The behaviour and learning of two classes completing identical SNS based modules of work was observed and compared. All student contributions to the SNS were analysed, with the cognitive process dimension of the Revised Bloom's Taxonomy…

Students' Assessment Preferences and Approaches to Learning: Can Formative Assessment Make a Difference?

ERIC Educational Resources Information Center

Gijbels, David; Dochy, Filip

2006-01-01

The purpose of this paper is to gain insight into the relationships between hands-on experiences with formative assessment, students' assessment preferences and their approaches to learning. The sample consisted of 108 university first-year Bachelor's students studying criminology. Data were obtained using the "Revised two-factor study…

Individual and Family Perfectionism and Its Relationship to Depression, Anxiety, and Self-Esteem among Latino College Students

ERIC Educational Resources Information Center

Ortega, Norma E.

2010-01-01

This study examined the relationship between individual and family perfectionism and mental health functioning among two hundred and seven Latino college students. One aim of this study was to test the factor structure of the Almost Perfect Scale-Revised (APS-R; Slaney, Rice, Mobley, Trippi, & Ashby, 2001) with Latino college students by…

Multisite Study of New Autism Diagnostic Interview-Revised (ADI-R) Algorithms for Toddlers and Young Preschoolers

ERIC Educational Resources Information Center

Kim, So Hyun; Thurm, Audrey; Shumway, Stacy; Lord, Catherine

2013-01-01

Using two independent datasets provided by National Institute of Health funded consortia, the Collaborative Programs for Excellence in Autism and Studies to Advance Autism Research and Treatment (n = 641) and the National Institute of Mental Health (n = 167), diagnostic validity and factor structure of the new Autism Diagnostic Interview (ADI-R)…

TWO MEASURES FOR CROSS-CULTURAL RESEARCH ON MORALITY: COMPARISON AND REVISION.

PubMed

Zhang, Yanyan; Li, Sisi

2015-08-01

The current research assessed the reliability and validity of two Western measures of morality in a Chinese sample, namely the Community, Autonomy, and Divinity Scale (CADS) and the Moral Foundations Questionnaire (MFQ). Questionnaires were administered to 274 Chinese participants in Northern China (M age = 25.4 yr., SD = 8.50; 86% women). Confirmatory factor analysis using a structural equation model was conducted to evaluate the construct validity of the two scales. The results indicated a reasonable model fit of both the CADS and the MFQ after certain modifications. The revised versions of both measures had good internal consistency reliabilities. Correlation analysis indicated moderate correlations between the dimensions of the two scales. Regarding the content of morality, Chinese people endorsed more of the traditional ethics and foundations than people from Western cultures in other studies. In addition, participants who reported a religious affiliation scored higher on the Divinity subscale compared to those who claimed to be atheists.

Risk Factors for Revision Surgery After Superior Labral Anterior-Posterior Repair: A National Perspective.

PubMed

Taylor, Samuel A; Degen, Ryan M; White, Alexander E; McCarthy, Moira M; Gulotta, Lawrence V; O'Brien, Stephen J; Werner, Brian C

2017-06-01

Data regarding risk factors for revision surgery after superior labral anterior-posterior (SLAP) repair are limited to institutional series. To define risk factors for revision surgery after SLAP repair among patients in a large national database. Case-control study; Level of evidence, 3. A national insurance database was queried for patients undergoing arthroscopic SLAP repair (Current Procedural Terminology [CPT] code 29807) for the diagnosis of a SLAP tear. Patients without a CPT modifier for laterality were excluded. Revision surgery was defined as (1) subsequent ipsilateral SLAP repair (CPT 29807), (2) ipsilateral arthroscopic debridement for the diagnosis of a SLAP tear (CPT 29822 or 29823, with diagnosis code 840.7), (3) subsequent ipsilateral arthroscopic biceps tenodesis (CPT 29828), (4) subsequent ipsilateral open biceps tenodesis (CPT 23430), and (5) subsequent biceps tenotomy (CPT 23405). Multivariable binomial logistic regression analysis was performed to identify risk factors for revision surgery after SLAP repair, including patient demographics/comorbidities, concomitant diagnoses, and concomitant procedures performed. Odds ratios (ORs), 95% CIs, and P values were calculated. The estimated financial impact of revision surgery was also calculated. There were 4751 patients who met inclusion and exclusion criteria. Overall, 121 patients (2.5%) required revision surgery after SLAP repair. Regression analysis identified numerous risk factors for revision surgery, including age >40 years (OR, 1.5; 95% CI, 1.2-1.8; P = .045), female sex (OR, 1.5; 95% CI, 1.3-1.8; P = .010), obesity (OR, 1.8; 95% CI, 1.5-2.2; P = .001), smoking (OR, 2.0; 95% CI, 1.6-2.4; P < .0001), and diagnosis of biceps tendinitis (OR, 3.5; 95% CI, 3.0-4.2; P < .0001) or long head of the biceps tearing (OR, 5.1; 95% CI, 4.1-6.3; P < .0001) at or before the time of surgery. Concomitant rotator cuff repair and distal clavicle excision were not significant risk factors for revision surgery. The cost of revision surgery averaged almost $9000. Risk factors for revision surgery after SLAP repair include age >40 years, female sex, obesity, smoking, and diagnosis of biceps tendinitis or long head of the biceps tearing. The diagnosis of biceps tendinitis (OR, 3.5) or long head of the biceps tearing (OR, 5.1) at or before the time of surgery was an especially significant risk factor for revision surgery. The high cost of revision surgery highlights the importance of appropriate indications to avoid the need for subsequent procedures.

Outcome of knee revisions for osteoarthritis and inflammatory arthritis with postero-stabilized arthroplasties: a mean ten-year follow-up with 90 knee revisions.

PubMed

Hernigou, Philippe; Dubory, Arnaud; Potage, Damien; Roubineau, François; Flouzat-Lachaniette, Charles Henri

2017-04-01

Patients with rheumatoid arthritis (RA) and osteoarthritis (OA) may require revision total knee replacement. Few studies have compared post-operative complications, results and risk of re-revision in RA and OA patients. Forty-five RA patients who had undergone revision TKA from 1998 to 2010 were selected and matched with 45 OA patients who had revision during the same period. Results of the use of a revision postero-stabilized implant in osteoarthritis were compared to results of its use in inflammatory arthritis. With a mean follow-up of ten years (range, 5-17 years) we determined differences in comorbidities, risk for peri-operative adverse events, functional and radiological results, and risk of subsequent re-revision, between patients suffering from OA versus RA. There were higher comorbidities, post-operative (<30 days) adverse events, and mortality at average ten years FU in RA than in OA patients. The mean overall changes in function scores were greater for the RA revision group when compared with the OA revision group. Taking steroids (Cox's regression, p = 0.001), and methotrexate or TNFα blockers (Cox's regression, p = 0.02) were not significant factors for radiolucent lines in RA and for loosening. At average ten years followup, patients with RA undergoing revision TKAs were not more likely to have a re-revision (4 among 45 patients; 9 %) than patients with OA undergoing revision in our department (7 patients; 15 %). Similar results for the knee were observed in these two forms of arthritis in spite of the fact that the initial local joint status and general health status are worse in inflammatory rheumatoid arthritis than in "degenerative" osteoarthritis. However, complications were more frequent with RA.

Confirmatory factor analysis of the Child Oral Health Impact Profile (Korean version).

PubMed

Cho, Young Il; Lee, Soonmook; Patton, Lauren L; Kim, Hae-Young

2016-04-01

Empirical support for the factor structure of the Child Oral Health Impact Profile (COHIP) has not been fully established. The purposes of this study were to evaluate the factor structure of the Korean version of the COHIP (COHIP-K) empirically using confirmatory factor analysis (CFA) based on the theoretical framework and then to assess whether any of the factors in the structure could be grouped into a simpler single second-order factor. Data were collected through self-reported COHIP-K responses from a representative community sample of 2,236 Korean children, 8-15 yr of age. Because a large inter-factor correlation of 0.92 was estimated in the original five-factor structure, the two strongly correlated factors were combined into one factor, resulting in a four-factor structure. The revised four-factor model showed a reasonable fit with appropriate inter-factor correlations. Additionally, the second-order model with four sub-factors was reasonable with sufficient fit and showed equal fit to the revised four-factor model. A cross-validation procedure confirmed the appropriateness of the findings. Our analysis empirically supported a four-factor structure of COHIP-K, a summarized second-order model, and the use of an integrated summary COHIP score. © 2016 Eur J Oral Sci.

Improved Diagnostic Validity of the ADOS Revised Algorithms: A Replication Study in an Independent Sample

ERIC Educational Resources Information Center

Oosterling, Iris; Roos, Sascha; de Bildt, Annelies; Rommelse, Nanda; de Jonge, Maretha; Visser, Janne; Lappenschaar, Martijn; Swinkels, Sophie; van der Gaag, Rutger Jan; Buitelaar, Jan

2010-01-01

Recently, Gotham et al. ("2007") proposed revised algorithms for the Autism Diagnostic Observation Schedule (ADOS) with improved diagnostic validity. The aim of the current study was to replicate predictive validity, factor structure, and correlations with age and verbal and nonverbal IQ of the ADOS revised algorithms for Modules 1 and 2…

Results of revision anterior shoulder stabilization surgery in adolescent athletes.

PubMed

Blackman, Andrew J; Krych, Aaron J; Kuzma, Scott A; Chow, Roxanne M; Camp, Christopher; Dahm, Diane L

2014-11-01

The purpose of this study was to determine failure rates, functional outcomes, and risk factors for failure after revision anterior shoulder stabilization surgery in high-risk adolescent athletes. Adolescent athletes who underwent primary anterior shoulder stabilization were reviewed. Patients undergoing subsequent revision stabilization surgery were identified and analyzed. Failure rates after revision surgery were assessed by Kaplan-Meier analysis. Failure was defined as recurrent instability requiring reoperation. Functional outcomes included the Marx activity score; American Shoulder and Elbow Surgeons score; and University of California, Los Angeles score. The characteristics of patients who required reoperation for recurrent instability after revision surgery were compared with those of patients who required only a single revision to identify potential risk factors for failure. Of 90 patients who underwent primary anterior stabilization surgery, 15 (17%) had failure and underwent revision surgery (mean age, 16.6 years; age range, 14 to 18 years). The mean follow-up period was 5.5 years (range, 2 to 12 years). Of the 15 revision patients, 5 (33%) had recurrent dislocations and required repeat revision stabilization surgery at a mean of 50 months (range, 22 to 102 months) after initial revision. No risk factors for failure were identified. The Kaplan-Meier reoperation-free estimates were 86% (95% confidence interval, 67% to 100%) at 24 months and 78% (95% confidence interval, 56% to 100%) at 48 months after revision surgery. The mean final Marx activity score was 14.8 (range, 5 to 20); American Shoulder and Elbow Surgeons score, 82.1 (range, 33 to 100); and University of California, Los Angeles score, 30.8 (range, 16 to 35). At 5.5 years' follow-up, adolescent athletes had a high failure rate of revision stabilization surgery and modest functional outcomes. We were unable to convincingly identify specific risk factors for failure of revision surgery. Level IV, retrospective therapeutic case series. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Emphasis on Autonomy and Propensity for Suicidal Behavior in Younger and Older Adults

ERIC Educational Resources Information Center

O'Riley, Alisa A.; Fiske, Amy

2012-01-01

A cognitive style marked by emphasis on autonomy has been linked to negative outcomes throughout the life span. Two preliminary studies are presented that examined factors on a measure of autonomy (Personal Style Inventory-Revised) in relation to propensity for suicidal behavior (Suicidal Behaviors Questionnaire-14; SBQ-14). Perfectionism, B =…

Lessons learned in Liberia: preliminary examination of the psychometric properties of trust and teamwork among maternal healthcare workers.

PubMed

Lori, Jody R; Munro, Michelle L; Moore, Jennifer E; Fladger, Jessica

2013-04-11

Post-conflict Liberia has one of the fastest growing populations on the continent and one of the highest maternal mortality rates among the world. However, in the rural regions, less than half of all births are attended by a skilled birth attendant. There is a need to evaluate the relationship between trained traditional healthcare providers and skilled birth attendants to improve maternal health outcomes. This evaluation must also take into consideration the needs and desires of the patients. The purpose of this pilot study was to establish the validity and reliability of a survey tool to evaluate trust and teamwork in the working relationships between trained traditional midwives and certified midwives in a post-conflict country. A previously established scale, the Trust and Teambuilding Scale, was used with non- and low-literate trained traditional midwives (n=48) in rural Liberia to evaluate trust and teamwork with certified midwives in their communities. Initial results indicated that the scale and response keys were culturally inadequate for this population. A revised version of the scale, the Trust and Teamwork Scale - Liberia, was created and administered to an additional group of non- and low-literate, trained traditional midwives (n=42). Exploratory factor analysis using Mplus for dichotomous variables was used to determine the psychometric properties of the revised scale and was then confirmed with the full sample (n=90). Additional analyses included contrast validity, convergent validity, and Kuder-Richardson reliability. Exploratory factor analysis revealed two factors in the revised Trust and Teamwork Scale - Liberia. These two factors, labeled trust and teamwork, included eleven of the original eighteen items used in the Trust and Teamwork Scale and demonstrated contrast and convergent validity and adequate reliability. The revised scale is suitable for use with non- and low-literate, trained traditional midwives in rural Liberia. Continued cross-cultural validation of tools is essential to ensure scale adequacy across populations. Future work should continue to evaluate the use of the Trust and Teamwork Scale - Liberia across cultures and additional work is needed to confirm the factor structure.

The Health Behavior Checklist: Factor structure in community samples and validity of a revised good health practices scale.

PubMed

Hampson, Sarah E; Edmonds, Grant W; Goldberg, Lewis R

2017-01-01

This study examined the factor structure and predictive validity of the commonly used multidimensional Health Behavior Checklist. A three-factor structure was found in two community samples that included men and women. The new 16-item Good Health Practices scale and the original Wellness Maintenance scale were the only Health Behavior Checklist scales to be related to cardiovascular and metabolic risk factors. While the other Health Behavior Checklist scales require further validation, the Good Health Practices scale could be used where more objective or longer measures are not feasible.

Validation of heart failure diagnosis registered in primary care records in two primary care centres in Barcelona (Spain) and factors related. A cross-sectional study

PubMed Central

Verdú-Rotellar, Jose María; Frigola-Capell, Eva; Alvarez-Pérez, Rosa; da Silva, Daniela; Enjuanes, Cristina; Domingo, Mar; Mena, Amparo; Muñoz, Miguel-Angel

2017-01-01

Abstract Background: Heart failure (HF) diagnosis as reported in primary care medical records is not always properly confirmed and could result in over-registration. Objectives: To determine the proportion of registered HF that can be confirmed with information from primary care medical records and to analyse related factors. Methods: A cross-sectional study. The medical records of 595 HF patients attended in two primary healthcare centres in Barcelona (Spain) were revised and validated by a team of experts who classified diagnosis into confirmed, unconfirmed, and misdiagnosis. Variables potentially related to the confirmation of the diagnosis were analysed. The revision of medical records and data collection took place from 15 January to 31 March 2014. Results: Mean (standard deviation) age was 78 (10) years and 58% were women. The diagnosis could be confirmed in 53.6% of patients. Factors associated with a greater probability of having a confirmed diagnosis were age (yearly OR: 0.97, 95%CI: 0.95–0.99), cardiologist follow-up (OR: 3.66, 95%CI: 2.46–5.48), history of ischaemic heart disease (OR: 2.18, 95%CI: 1.36–2.48), atrial fibrillation (OR: 2.01, 95%CI: 1.34–3.03), and prescription of loop diuretics (OR: 3.24, 95%CI: 2.14–4.89). Conclusion: Only in half of the patients labelled as HF in primary care medical records could this diagnosis be further confirmed. Variables regularly registered in clinical practice could help general practitioners identify those patients requiring a revision of their HF diagnosis. PMID:28376668

The structure of Diagnostic and Statistical Manual of Mental Disorders (4th edition, text revision) personality disorder symptoms in a large national sample.

PubMed

Trull, Timothy J; Vergés, Alvaro; Wood, Phillip K; Jahng, Seungmin; Sher, Kenneth J

2012-10-01

We examined the latent structure underlying the criteria for DSM-IV-TR (American Psychiatric Association, 2000, Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.) personality disorders in a large nationally representative sample of U.S. adults. Personality disorder symptom data were collected using a structured diagnostic interview from approximately 35,000 adults assessed over two waves of data collection in the National Epidemiologic Survey on Alcohol and Related Conditions. Our analyses suggested that a seven-factor solution provided the best fit for the data, and these factors were marked primarily by one or at most two personality disorder criteria sets. A series of regression analyses that used external validators tapping Axis I psychopathology, treatment for mental health problems, functioning scores, interpersonal conflict, and suicidal ideation and behavior provided support for the seven-factor solution. We discuss these findings in the context of previous studies that have examined the structure underlying the personality disorder criteria as well as the current proposals for DSM-5 personality disorders. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Two-stage revision of septic knee prosthesis with articulating knee spacers yields better infection eradication rate than one-stage or two-stage revision with static spacers.

PubMed

Romanò, C L; Gala, L; Logoluso, N; Romanò, D; Drago, L

2012-12-01

The best method for treating chronic periprosthetic knee infection remains controversial. Randomized, comparative studies on treatment modalities are lacking. This systematic review of the literature compares the infection eradication rate after two-stage versus one-stage revision and static versus articulating spacers in two-stage procedures. We reviewed full-text papers and those with an abstract in English published from 1966 through 2011 that reported the success rate of infection eradication after one-stage or two-stage revision with two different types of spacers. In all, 6 original articles reporting the results after one-stage knee exchange arthoplasty (n = 204) and 38 papers reporting on two-stage revision (n = 1,421) were reviewed. The average success rate in the eradication of infection was 89.8% after a two-stage revision and 81.9% after a one-stage procedure at a mean follow-up of 44.7 and 40.7 months, respectively. The average infection eradication rate after a two-stage procedure was slightly, although significantly, higher when an articulating spacer rather than a static spacer was used (91.2 versus 87%). The methodological limitations of this study and the heterogeneous material in the studies reviewed notwithstanding, this systematic review shows that, on average, a two-stage procedure is associated with a higher rate of eradication of infection than one-stage revision for septic knee prosthesis and that articulating spacers are associated with a lower recurrence of infection than static spacers at a comparable mean duration of follow-up. IV.

Internal Structure and Clinical Utility of the Anxiety Control Questionnaire-Revised (ACQ-R) Spanish Version.

PubMed

Osma, Jorge; Barrada, Juan Ramón; García-Palacios, Azucena; Navarro-Haro, María; Aguilar, Alejandra

2016-10-03

Perceived control has shown predictive value for anxiety severity symptoms as well as cognitive-behavior therapy outcomes. The most commonly used measure of perceived control is the Anxiety Control Questionnaire (ACQ), and more recently the ACQ Revised (ACQ-R). However, both questionnaires have shown structural inconsistencies among several studies. Also, although the ACQ and ACQ-R seem to be multidimensional instruments, a single total score have been commonly used. This study examined the internal structure of the ACQ-R Spanish version using exploratory factor and exploratory bi-factor analysis in a sample of 382 college students and 52 people diagnosed of panic disorder (with or without agoraphobia). Also, in this study we assessed the preliminary diagnostic value of the ACQ-R scores. The results indicated that the ACQ-R Spanish version structure consisted of two factors: one related with perceived control of internal emotional reactions (Emotion Control) and another related with perceived control of external events (Threat and Stress Control). Both specific factors can be adequately summarized by a general factor (General Anxiety Perception of Control; CFI = .973, TLI = .954, RMSEA = .039; p = .002), which accounted for 70% of the common explained variance. The correlations between the ACQ-R scores and with variables like anxiety (r = -.66) or anxiety sensitivity (r = -.50) presented the expected pattern of results. Either the two dimensions structure or the total score have proved to be a good tool to distinguish between participants with panic disorder and non-clinical samples (area under the curve = 0.79).

The development and validation of the Physical Appearance Comparison Scale-Revised (PACS-R).

PubMed

Schaefer, Lauren M; Thompson, J Kevin

2014-04-01

The Physical Appearance Comparison Scale (PACS; Thompson, Heinberg, & Tantleff, 1991) was revised to assess appearance comparisons relevant to women and men in a wide variety of contexts. The revised scale (Physical Appearance Comparison Scale-Revised, PACS-R) was administered to 1176 college females. In Study 1, exploratory factor analysis and parallel analysis using one half of the sample suggested a single factor structure for the PACS-R. Study 2 utilized the remaining half of the sample to conduct confirmatory factor analysis, item analysis, and to examine the convergent validity of the scale. These analyses resulted in an 11-item measure that demonstrated excellent internal consistency and convergent validity with measures of body satisfaction, eating pathology, sociocultural influences on appearance, and self-esteem. Regression analyses demonstrated the utility of the PACS-R in predicting body satisfaction and eating pathology. Overall, results indicate that the PACS-R is a reliable and valid tool for assessing appearance comparison tendencies in women. Copyright © 2014. Published by Elsevier Ltd.

Increasing risk of prosthetic joint infection after total hip arthroplasty

PubMed Central

2012-01-01

Background and purpose The risk of revision due to infection after primary total hip arthroplasty (THA) has been reported to be increasing in Norway. We investigated whether this increase is a common feature in the Nordic countries (Denmark, Finland, Norway, and Sweden). Materials and methods The study was based on the Nordic Arthroplasty Register Association (NARA) dataset. 432,168 primary THAs from 1995 to 2009 were included (Denmark: 83,853, Finland 78,106, Norway 88,455, and Sweden 181,754). Adjusted survival analyses were performed using Cox regression models with revision due to infection as the endpoint. The effect of risk factors such as the year of surgery, age, sex, diagnosis, type of prosthesis, and fixation were assessed. Results 2,778 (0.6%) of the primary THAs were revised due to infection. Compared to the period 1995–1999, the relative risk (with 95% CI) of revision due to infection was 1.1 (1.0–1.2) in 2000–2004 and 1.6 (1.4–1.7) in 2005–2009. Adjusted cumulative 5–year revision rates due to infection were 0.46% (0.42–0.50) in 1995–1999, 0.54% (0.50–0.58) in 2000–2004, and 0.71% (0.66–0.76) in 2005–2009. The entire increase in risk of revision due to infection was within 1 year of primary surgery, and most notably in the first 3 months. The risk of revision due to infection increased in all 4 countries. Risk factors for revision due to infection were male sex, hybrid fixation, cement without antibiotics, and THA performed due to inflammatory disease, hip fracture, or femoral head necrosis. None of these risk factors increased in incidence during the study period. Interpretation We found increased relative risk of revision and increased cumulative 5–year revision rates due to infection after primary THA during the period 1995–2009. No change in risk factors in the NARA dataset could explain this increase. We believe that there has been an actual increase in the incidence of prosthetic joint infections after THA. PMID:23083433

The psychometric validation of the Social Problem-Solving Inventory--Revised with UK incarcerated sexual offenders.

PubMed

Wakeling, Helen C

2007-09-01

This study examined the reliability and validity of the Social Problem-Solving Inventory--Revised (SPSI-R; D'Zurilla, Nezu, & Maydeu-Olivares, 2002) with a population of incarcerated sexual offenders. An availability sample of 499 adult male sexual offenders was used. The SPSI-R had good reliability measured by internal consistency and test-retest reliability, and adequate validity. Construct validity was determined via factor analysis. An exploratory factor analysis extracted a two-factor model. This model was then tested against the theory-driven five-factor model using confirmatory factor analysis. The five-factor model was selected as the better fitting of the two, and confirmed the model according to social problem-solving theory (D'Zurilla & Nezu, 1982). The SPSI-R had good convergent validity; significant correlations were found between SPSI-R subscales and measures of self-esteem, impulsivity, and locus of control. SPSI-R subscales were however found to significantly correlate with a measure of socially desirable responding. This finding is discussed in relation to recent research suggesting that impression management may not invalidate self-report measures (e.g. Mills & Kroner, 2005). The SPSI-R was sensitive to sexual offender intervention, with problem-solving improving pre to post-treatment in both rapists and child molesters. The study concludes that the SPSI-R is a reasonably internally valid and appropriate tool to assess problem-solving in sexual offenders. However future research should cross-validate the SPSI-R with other behavioural outcomes to examine the external validity of the measure. Furthermore, future research should utilise a control group to determine treatment impact.

The Psychometric Properties of English and Spanish Versions of the Life Orientation Test-Revised in Hispanic Americans.

PubMed

Pan, Tonya M; Mills, Sarah D; Fox, Rina S; Baik, Sharon H; Harry, Kadie M; Roesch, Scott C; Sadler, Georgia Robins; Malcarne, Vanessa L

2017-12-01

The Life Orientation Test-Revised (LOT-R) is a widely used measure of optimism and pessimism, with three positively worded and three negatively worded content items. This study examined the structural validity and invariance, internal consistency reliability, and convergent and divergent validity of the English and Spanish versions of the LOT-R among Hispanic Americans. A community sample of Hispanic Americans ( N = 422) completed self-report measures, including the LOT-R, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7, in their preferred language of English or Spanish. Based on the literature, four structural models were tested: one-factor , oblique two-factor , orthogonal two-factor method effects with positive specific factor , and orthogonal two-factor method effects with negative specific factor . Baseline support for both of the English and Spanish versions was not achieved for any model; in all models, the negatively worded items in Spanish had non-significant factor loadings. Therefore, the positively worded three-item optimism subscale of the LOT-R was examined separately and fit the data, with factor loadings equivalent across language-preference groups. Coefficient alphas for the optimism subscale were consistent across both language-preference groups (αs = .61 [English] and .66 [Spanish]). In contrast, the six-item total score and three-item pessimism subscale demonstrated extremely low or inconsistent alphas. Convergent and divergent validity were established for the optimism subscale in both languages. In sum, the optimism subscale of the LOT-R demonstrated minimally acceptable to good psychometric properties across English and Spanish language-preference groups. However, neither the total score nor the pessimism subscale showed adequate psychometric properties for Spanish-speaking Hispanic Americans, likely due to translation and cultural adaptation issues, and thus are not supported for use with this population.

Cognitive Vulnerabilities and Depression in Young Adults: An ROC Curves Analysis.

PubMed

Balsamo, Michela; Imperatori, Claudio; Sergi, Maria Rita; Belvederi Murri, Martino; Continisio, Massimo; Tamburello, Antonino; Innamorati, Marco; Saggino, Aristide

2013-01-01

Objectives and Methods. The aim of the present study was to evaluate, by means of receiver operating characteristic (ROC) curves, whether cognitive vulnerabilities (CV), as measured by three well-known instruments (the Beck Hopelessness Scale, BHS; the Life Orientation Test-Revised, LOT-R; and the Attitudes Toward Self-Revised, ATS-R), independently discriminate between subjects with different severities of depression. Participants were 467 young adults (336 females and 131 males), recruited from the general population. The subjects were also administered the Beck Depression Inventory-II (BDI-II). Results. Four first-order (BHS Optimism/Low Standard; BHS Pessimism; Generalized Self-Criticism; and LOT Optimism) and two higher-order factors (Pessimism/Negative Attitudes Toward Self, Optimism) were extracted using Principal Axis Factoring analysis. Although all first-order and second-order factors were able to discriminate individuals with different depression severities, the Pessimism factor had the best performance in discriminating individuals with moderate to severe depression from those with lower depression severity. Conclusion. In the screening of young adults at risk of depression, clinicians have to pay particular attention to the expression of pessimism about the future.

Validating the Repetitive Behavior Scale-Revised in Young Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Mirenda, Pat; Smith, Isabel M.; Vaillancourt, Tracy; Georgiades, Stelios; Duku, Eric; Szatmari, Peter; Bryson, Susan; Fombonne, Eric; Roberts, Wendy; Volden, Joanne; Waddell, Charlotte; Zwaigenbaum, Lonnie

2010-01-01

This study examined the factor structure of the Repetitive Behavior Scale-Revised (RBS-R) in a sample of 287 preschool-aged children with autism spectrum disorder (ASD). A confirmatory factor analysis was used to examine six competing structural models. Spearman's rank order correlations were calculated to examine the associations between factor…

Revising the Child and Adolescent Perfectionism Scale: A Test of the Four-Factor Structure in a Chinese Sample

ERIC Educational Resources Information Center

Yang, Hongfei; Hong, Chaoqin; Tao, Xiaodan; Zhu, Lingyi

2015-01-01

This study examined the structure, reliability, and validity of the revised Chinese version of the Child and Adolescent Perfectionism Scale (N = 933). The results confirmed the four-factor structure of the Chinese version of the Child and Adolescent Perfectionism Scale. Implications, limitations, and suggestions for future research are provided.

Risk factors for revision within 10 years of total knee arthroplasty.

PubMed

Dy, Christopher J; Marx, Robert G; Bozic, Kevin J; Pan, Ting Jung; Padgett, Douglas E; Lyman, Stephen

2014-04-01

An in-depth understanding of risk factors for revision TKA is needed to minimize the burden of revision surgery. Previous studies indicate that hospital and community characteristics may influence outcomes after TKA, but a detailed investigation in a diverse population is warranted to identify opportunities for quality improvement. We asked: (1) What is the frequency of revision TKA within 10 years of primary arthroplasty? (2) Which patient demographic factors are associated with revision within 10 years of TKA? (3) Which community and institutional characteristics are associated with revision within 10 years of TKA? We identified 301,955 patients who underwent primary TKAs in New York or California from 1997 to 2005 from statewide databases. Identifier codes were used to determine whether they underwent revision TKA. Patient, community, and hospital characteristics were analyzed using multivariable regression modeling to determine predictors for revision. The frequency of revision was 4.0% at 5 years after the index arthroplasty and 8.9% at 9-years. Patients between 50 and 75 years old had a lower risk of revision than patients younger than 50 years (hazard ratio [HR], 0.47; 95% CI, 0.44, 0.50). Black patients were at increased risk for needing revision surgery (HR, 1.39; 95% CI, 1.29, 1.49) after adjustment for insurance type, poverty level, and education. Women (HR, 0.82; 95% CI, 0.79, 0.86) and Medicare recipients (HR, 0.82; 95% CI, 0.79, 0.86) were less likely to undergo revision surgery, whereas those from the most educated (HR, 1.09; 95% CI, 1.02, 1.16) and the poorest communities (HR, 1.08; 95% CI, 1.01, 1.15) had modest increases in risk of revision. Mid-volume hospitals (200-400 annual cases) had a reduction of early revision (HR, 0.91; 95% CI, 0.83, 0.99) compared with those performing less than 200 cases annually, whereas higher-volume hospitals (greater than 400 cases) showed little effect compared with low-volume hospitals. Patient, community, and institutional characteristics affect the risk for revision within 10 years of index TKA. These data can be used to develop process improvement and implant surveillance strategies among high-risk patients. Level III, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.

A short version of the revised 'experience of close relationships questionnaire': investigating non-clinical and clinical samples.

PubMed

Wongpakaran, Tinakon; Wongpakaran, Nahathai

2012-01-01

This study seeks to investigate the psychometric properties of the short version of the revised 'Experience of Close Relationships' questionnaire, comparing non-clinical and clinical samples. In total 702 subjects participated in this study, of whom 531 were non-clinical participants and 171 were psychiatric patients. They completed the short version of the revised 'Experience of Close Relationships' questionnaire (ECR-R-18), the Perceived Stress Scale-10(PSS-10), the Rosenberg Self-Esteem Scale (RSES) and the UCLA Loneliness scale. A retest of the ECR-R-18 was then performed at four-week intervals. Then, confirmatory factor analyses were performed to test the validity of the new scale. The ECR-R-18 showed a fair to good internal consistency (α 0.77 to 0.87) for both samples, and the test-retest reliability was found to be satisfactory (ICC = 0.75). The anxiety sub-scale demonstrated concurrent validity with PSS-10 and RSES, while the avoidance sub-scale showed concurrent validity with the UCLA Loneliness Scale. Confirmatory factor analysis using method factors yielded two factors with an acceptable model fit for both groups. An invariance test revealed that the ECR-R-18 when used on the clinical group differed from when used with the non-clinical group. The ECR-R-18 questionnaire revealed an overall better level of fit than the original 36 item questionnaire, indicating its suitability for use with a broader group of samples, including clinical samples. The reliability of the ECR-R- 18 might be increased if a modified scoring system is used and if our suggestions with regard to future studies are followed up.

WISC-R Factor Structures of Younger and Older Youth with Low IQs.

ERIC Educational Resources Information Center

Groff, M.; Hubble, L.

1982-01-01

Factor analyzed Wechsler Intelligence Scale for Children-Revised scores of low-IQ youths aged 9-11 and 14-16. Extracted Verbal Comprehension, Perceptual Organization and Freedom From Distractibility dimensions for each group. Coefficients of congruence indicated the two age groups were not similar on the Freedom From Distractibility factor.…

Using the Fennema-Sherman Mathematics Attitude Scales with lower-primary teachers

NASA Astrophysics Data System (ADS)

Ren, Lixin; Green, Jennifer L.; Smith, Wendy M.

2016-06-01

The Fennema-Sherman Mathematics Attitude Scales (FSMAS) are among the most popular instruments used in studies of attitudes toward mathematics. However, the FSMAS has been mainly used among student populations and rarely used with teachers. In the present study, three scales from the FSMAS— Confidence, Effectance Motivation, and Anxiety—were revised and used with lower-primary (kindergarten to third grade) teachers. This study includes three parts: (1) a pilot study to ensure the modifications made to the FSMAS were appropriate to use with teachers, (2) confirmatory factor analyses to assess the factor structure of the revised FSMAS with 225 lower-primary teachers, and (3) measurement invariance analyses using data from a similar sample of 171 lower-primary teachers to examine whether the revised FSMAS measures each construct in the same way as in the previous sample. The final three-factor model, after removing three problematic items, achieves acceptable model fit, with each construct meeting all conditions for strict measurement invariance. Additionally, repeated measures analyses were performed on data collected from 39 in-service lower-primary teachers who participated in an elementary mathematics specialist program to examine the use of the revised FSMAS in program evaluation. Overall results suggest that researchers and program evaluators may use the revised FSMAS to reliably measure lower-primary teachers' mathematical attitudes, and it can be a valuable tool for evaluating the effectiveness of professional development programs.

Factor analysis of Wechsler Adult Intelligence Scale-Revised in developmentally disabled persons.

PubMed

Di Nuovo, Santo F; Buono, Serafino

2006-12-01

The results of previous studies on the factorial structure of Wechsler Intelligence Scales are somewhat inconsistent across normal and pathological samples. To study specific clinical groups, such as developmentally disabled persons, it is useful to examine the factor structure in appropriate samples. A factor analysis was carried out using the principal component method and the Varimax orthogonal rotation on the Wechsler Adult Intelligence Scale (WAIS-R) in a sample of 203 developmentally disabled persons, with a mean age of 25 years 4 months. Developmental disability ranged from mild to moderate. Partially contrasting with previous studies on normal samples, results found a two-factor solution. Wechsler's traditional Verbal and Performance scales seems to be more appropriate for this sample than the alternative three-factor solution.

Infection after primary hip arthroplasty

PubMed Central

2011-01-01

Background and purpose The aim of the present study was to assess incidence of and risk factors for infection after hip arthroplasty in data from 3 national health registries. We investigated differences in risk patterns between surgical site infection (SSI) and revision due to infection after primary total hip arthroplasty (THA) and hemiarthroplasty (HA). Materials and methods This observational study was based on prospective data from 2005–2009 on primary THAs and HAs from the Norwegian Arthroplasty Register (NAR), the Norwegian Hip Fracture Register (NHFR), and the Norwegian Surveillance System for Healthcare–Associated Infections (NOIS). The Norwegian Patient Register (NPR) was used for evaluation of case reporting. Cox regression analyses were performed with revision due to infection as endpoint for data from the NAR and the NHFR, and with SSI as the endpoint for data from the NOIS. Results The 1–year incidence of SSI in the NOIS was 3.0% after THA (167/5,540) and 7.3% after HA (103/1,416). The 1–year incidence of revision due to infection was 0.7% for THAs in the NAR (182/24,512) and 1.5% for HAs in the NHFR (128/8,262). Risk factors for SSI after THA were advanced age, ASA class higher than 2, and short duration of surgery. For THA, the risk factors for revision due to infection were male sex, advanced age, ASA class higher than 1, emergency surgery, uncemented fixation, and a National Nosocomial Infection Surveillance (NNIS) risk index of 2 or more. For HAs inserted after fracture, age less than 60 and short duration of surgery were risk factors of revision due to infection. Interpretation The incidences of SSI and revision due to infection after primary hip replacements in Norway are similar to those in other countries. There may be differences in risk pattern between SSI and revision due to infection after arthroplasty. The risk patterns for revision due to infection appear to be different for HA and THA. PMID:22066562

A revised Thai Multi-Dimensional Scale of Perceived Social Support.

PubMed

Wongpakaran, Nahathai; Wongpakaran, Tinakon

2012-11-01

In order to ensure the construct validity of the three-factor model of the Multi-dimensional Scale of Perceived Social Support (MSPSS), and based on the assumption that it helps users differentiate between sources of social support, in this study a revised version was created and tested. The aim was to compare the level of model fit of the original version of the MSPSS against the revised version--which contains a minor change from the original. The study was conducted on 486 medical students who completed the original and revised versions of the MSPSS, as well as the Rosenberg Self-Esteem Scale (Rosenberg, 1965) and Beck Depression Inventory II (Beck, Steer, & Brown, 1996). Confirmatory factor analysis was performed to compare the results, showing that the revised version of MSPSS demonstrated a good internal consistency--with a Cronbach's alpha of .92 for the MSPSS questionnaire, and a significant correlation with the other scales, as predicted. The revised version provided better internal consistency, increasing the Cronbach's alpha for the Significant Others sub-scale from 0.86 to 0.92. Confirmatory factor analysis revealed an acceptable model fit: chi2 128.11, df 51, p < .001; TLI 0.94; CFI 0.95; GFI 0.90; PNFI 0.71; AGFI 0.85; RMSEA 0.093 (0.073-0.113) and SRMR 0.042, which is better than the original version. The tendency of the new version was to display a better level of fit with a larger sample size. The limitations of the study are discussed, as well as recommendations for further study.

Factor Structure and Item Level Psychometrics of the Social Problem Solving Inventory Revised-Short Form in Traumatic Brain Injury

PubMed Central

Li, Chih-Ying; Waid-Ebbs, Julia; Velozo, Craig A.; Heaton, Shelley C.

2016-01-01

Primary Objective Social problem solving deficits characterize individuals with traumatic brain injury (TBI). Poor social problem solving interferes with daily functioning and productive lifestyles. Therefore, it is of vital importance to use the appropriate instrument to identify deficits in social problem solving for individuals with TBI. This study investigates factor structure and item-level psychometrics of the Social Problem Solving Inventory-Revised Short Form (SPSI-R:S), for adults with moderate and severe TBI. Research Design Secondary analysis of 90 adults with moderate and severe TBI who completed the SPSI-R:S. Methods and Procedures An exploratory factor analysis (EFA), principal components analysis (PCA) and Rasch analysis examined the factor structure and item-level psychometrics of the SPSI-R:S. Main Outcomes and Results The EFA showed three dominant factors, with positively worded items represented as the most definite factor. The other two factors are negative problem solving orientation and skills; and negative problem solving emotion. Rasch analyses confirmed the three factors are each unidimensional constructs. Conclusions The total score interpretability of the SPSI-R:S may be challenging due to the multidimensional structure of the total measure. Instead, we propose using three separate SPSI-R:S subscores to measure social problem solving for the TBI population. PMID:26052731

Factor structure and item level psychometrics of the Social Problem Solving Inventory-Revised: Short Form in traumatic brain injury.

PubMed

Li, Chih-Ying; Waid-Ebbs, Julia; Velozo, Craig A; Heaton, Shelley C

2016-01-01

Social problem-solving deficits characterise individuals with traumatic brain injury (TBI), and poor social problem solving interferes with daily functioning and productive lifestyles. Therefore, it is of vital importance to use the appropriate instrument to identify deficits in social problem solving for individuals with TBI. This study investigates factor structure and item-level psychometrics of the Social Problem Solving Inventory-Revised: Short Form (SPSI-R:S), for adults with moderate and severe TBI. Secondary analysis of 90 adults with moderate and severe TBI who completed the SPSI-R:S was performed. An exploratory factor analysis (EFA), principal components analysis (PCA) and Rasch analysis examined the factor structure and item-level psychometrics of the SPSI-R:S. The EFA showed three dominant factors, with positively worded items represented as the most definite factor. The other two factors are negative problem-solving orientation and skills; and negative problem-solving emotion. Rasch analyses confirmed the three factors are each unidimensional constructs. It was concluded that the total score interpretability of the SPSI-R:S may be challenging due to the multidimensional structure of the total measure. Instead, we propose using three separate SPSI-R:S subscores to measure social problem solving for the TBI population.

Factor analysis of the Colombian translation of the Delirium Rating Scale (DRS), Revised-98.

PubMed

Franco, José G; Trzepacz, Paula T; Mejía, Mario A; Ochoa, Sol B

2009-01-01

The phenomenology of delirium needs further elucidation using validated tools. The authors sought to derive valid factors from the Delirium Rating Scale (DRS), Revised -98. A factor analysis of the DRS-R-98 was performed among 161 medical-surgical patients. Scores ranged from 0 to 7 in 120 patients (74.53%; no delirium), 8 to 13 in 19 (11.80%; subclinical/prodromal delirium), and > or = 14 in 22 (13.66%; delirium). The DSM-IV-TR delirium incidence was 19.87%. The first two rotated factors explained 63.37% of the variance and may correspond to Cognition and Psychosis/Agitation factors. The dimension of motor retardation loaded with cognitive items. Motor agitation and retardation clustered with inattention, which is the cardinal symptom of delirium. The DRS-R-98 has good construct validity in this Latino population.

Functional Assessment of School Attendance Problems: An Adapted Version of the School Refusal Assessment Scale-Revised

ERIC Educational Resources Information Center

Heyne, David A.; Vreeke, Leonie J.; Maric, Marija; Boelens, Harrie; Van Widenfelt, Brigit M.

2017-01-01

The "School Refusal Assessment Scale" (SRAS) was developed to identify four factors that might maintain a youth's school attendance problem (SAP), and thus be targeted for treatment. There is still limited support for the four-factor model inherent to the SRAS and its revision (SRAS-R). Recent studies indicate problems with the wording…

Factor Structure of Scores from the Conners' Rating Scales-Revised among Nepali Children

ERIC Educational Resources Information Center

Pendergast, Laura L.; Vandiver, Beverly J.; Schaefer, Barbara A.; Cole, Pamela M.; Murray-Kolb, Laura E.; Christian, Parul

2014-01-01

This study used exploratory and confirmatory factor analyses to examine the structures of scores from the Conners' Teacher and Parent Rating Scales-Revised (CTRS-R and CPRS-R, respectively; Conners, 1997). The scales were administered to 1,835 parents and 1,387 teachers of children in Nepal's Sarlahi district, a region where no other measures of…

Investigation of the factor structure of spirituality and religiosity in Iranian Shiite university students.

PubMed

Joshanloo, Mohsen

2012-01-01

One of the important challenges facing psychologists of religion pertains to the definition of religiosity and spirituality. One way of understanding the connection between these two concepts is to suppose that one of them is a subset of the other. Another useful and sensitive way, however, is to view spirituality and religiosity as overlapping constructs, sharing some characteristics but also retaining nonshared features. Empirical studies examining the factor structure of spirituality and religiosity are scant and almost all of them come from Western culture. These factor analytic studies generally confirm that religiosity and spirituality can best be described in terms of two distinct yet correlated factors. To date, no study has investigated the relationship between these two constructs in Islamic cultures. To redress this imbalance, confirmatory factor analysis was used to examine the factor structure of religiosity and spirituality in two Iranian Shiite samples using an extensive set of scales (including Santa Clara Strength of Religious Faith, Spiritual Involvement and Beliefs Scale - Revised, Spiritual Meaning Scale, and Spiritual Transcendence Scale). Two hypothetical models were tested: a model that viewed spirituality and religiosity as correlated but separate constructs and a model that combined the indicators of religiosity and spirituality into a single construct. In keeping with the results obtained in Western cultures, results of confirmatory factor analyses, conducted in Study 1 (N=225) and Study 2 (N=288), revealed that a two-factor model fitted the data better than a single-factor model. Implications of the results are discussed, as are study limitations and directions for further research.

Measuring Moral Distress Among Critical Care Clinicians: Validation and Psychometric Properties of the Italian Moral Distress Scale-Revised.

PubMed

Lamiani, Giulia; Setti, Ilaria; Barlascini, Luca; Vegni, Elena; Argentero, Piergiorgio

2017-03-01

Moral distress is a common experience among critical care professionals, leading to frustration, withdrawal from patient care, and job abandonment. Most of the studies on moral distress have used the Moral Distress Scale or its revised version (Moral Distress Scale-Revised). However, these scales have never been validated through factor analysis. This article aims to explore the factorial structure of the Moral Distress Scale-Revised and develop a valid and reliable scale through factor analysis. Validation study using a survey design. Eight medical-surgical ICUs in the north of Italy. A total of 184 clinicians (64 physicians, 94 nurses, and 14 residents). The Moral Distress Scale-Revised was translated into Italian and administered along with a measure of depression (Beck Depression Inventory-Second Edition) to establish convergent validity. Exploratory factor analysis was conducted to explore the Moral Distress Scale-Revised factorial structure. Items with low (less than or equal to 0.350) or multiple saturations were removed. The resulting model was tested through confirmatory factor analysis. The Italian Moral Distress Scale-Revised is composed of 14 items referring to four factors: futile care, poor teamwork, deceptive communication, and ethical misconduct. This model accounts for 59% of the total variance and presents a good fit with the data (root mean square error of approximation = 0.06; comparative fit index = 0.95; Tucker-Lewis index = 0.94; weighted root mean square residual = 0.65). The Italian Moral Distress Scale-Revised evinces good reliability (α = 0.81) and moderately correlates with Beck Depression Inventory-Second Edition (r = 0.293; p < 0.001). No significant differences were found in the moral distress total score between physicians and nurses. However, nurses scored higher on futile care than physicians (t = 2.051; p = 0.042), whereas physicians scored higher on deceptive communication than nurses (t = 3.617; p < 0.001). Moral distress was higher for those clinicians considering to give up their position (t = 2.778; p = 0.006). The Italian Moral Distress Scale-Revised is a valid and reliable instrument to assess moral distress among critical care clinicians and develop tailored interventions addressing its different components. Further research could test the generalizability of its factorial structure in other cultures.

Is Single-stage Revision Safe Following Infected Total Knee Arthroplasty? A Critical Review.

PubMed

Vaishya, Raju; Agarwal, Amit Kumar; Rawat, Sudheer K; Singh, Harsh; Vijay, Vipul

2017-08-30

With the improvement in outcomes and modern prosthesis design, total knee arthroplasty (TKA) has now become a commonly performed surgery. It is postulated that a total of 2-5% of the primary and revision TKA becomes infected every year, requiring a revision procedure which to date is the conventional two-stage revision. The diagnosis and treatment of these periprosthetic infections is a major and challenging task, as it requires precise identification of the pathogen, meticulous debridement, and postoperative rehabilitation. To date, there have been very few studies in existing literature comparing the outcomes of single-stage versus two-stage procedure in infected TKA. The aim of the review was to provide the clinicians an insight into the outcome of the single-stage procedure compared to two-stage procedures and to suggest ways to improve the results further. In the following critical review, a total of 669 cases that underwent either a single or two-stage revision for infected TKA were studied. The postoperative functional scores were comparable in most studies during the early postoperative period. Our data supports the use of a single-stage revision surgery in infected TKA as an alternative to a conventional two-stage procedure. However, larger prospective and multicentric trials are required to validate our findings.

Outcomes of cup revision for ilio-psoas impingement after total hip arthroplasty: Retrospective study of 46 patients.

PubMed

Batailler, C; Bonin, N; M Wettstein; Nogier, A; Martres, S; Ollier, E; May, O; Lustig, S

2017-12-01

Impingement of the ilio-psoas tendon on the acetabular component is a cause of pain after total hip arthroplasty (THA). Studies of cup revision for ilio-psoas impingement (IPI) are scarce and limited in size. We therefore conducted a large multicentre retrospective study with the following objectives: to assess the effectiveness of cup replacement in resolving the impingement syndrome, to determine the frequency and nature of complications after cup revision for IPI, and to identify pre-operative factors associated with good outcomes of cup revision for IPI. Cup revision is effective in resolving the pain due to IPI in selected patients. This retrospective multicentre study included 46 patients who underwent cup revision because of IPI. Before the revision, 38 (83%) patients had prominence of the anterior cup rim (mean, 9.9±4.5mm (range, 2-22mm) by radiography and 35 (76%) had cup malposition (anteversion<10° and/or inclination>50°). Mean follow-up was 21months (range, 6months to 6 years) and no patient was lost to follow-up. Outcomes at last follow-up were assessed based on the Oxford Hip Score (OHS), patient satisfaction index, complications, and revisions. At last follow-up, 39 (85%) patients were satisfied with the revision procedure, a significant improvement versus baseline was noted in the OHS (mean, 43±6; range, 25-48; P<0.001), and 41 patients were free of pain during hip flexion (P<0.001 versus baseline). Complications occurred in 3 (6.5%) patients, but only one complication was severe (deep infection). Recurrent groin pain was reported by 4 (8.7%) patients at last follow-up. None of the factors studied predicted the outcome of revision surgery. Cup revision for IPI after THA is effective in relieving the groin pain in 80% of patients with anterior cup rim prominence and/or cup malposition. However, complications can occur. Tenotomy may be preferable when the diagnosis is in doubt and/or cup position is acceptable. IV, retrospective observational study. Published by Elsevier Masson SAS.

Validating the Revised Illness Perception Questionnaire as a Measure of Parent Perceptions of Autism Spectrum Disorder

ERIC Educational Resources Information Center

Mire, Sarah S.; Tolar, Tammy D.; Brewton, Christie M.; Raff, Natalie S.; McKee, Shannon L.

2018-01-01

The illness perception questionnaire (IPQ) and its revision (IPQ-R) measure perceptions about health-related diagnoses and the influence of cognitions on coping. In this study, the factor structure of a version revised for use with autism spectrum disorder (ASD) was investigated with a sample of parents (n = 361) whose children have ASD.…

[Assessment of temperament with the Infant Behavior Questionnaire Revised (IBQ-R) - the psychometric properties of a German version].

PubMed

Vonderlin, Eva; Ropeter, Anna; Pauen, Sabina

2012-09-01

The Infant Behavior Questionnaire Revised (IBQ-R; Gartstein & Rothbart, 2003) is one of the most common parent-report instruments for assessing infant temperament. This study evaluated the psychometric properties of a German version. We studied item characteristics, internal consistency, and descriptive statistics for all 14 scales in a sample of 7- to 9-month-old infants and their mothers (N = 119). Factor analysis was conducted to identify higher-order relationships between the scales. Item analysis showed mixed corrected item-total correlations. Internal consistencies were all moderate to high. Results of the factor analysis confirmed the two dimensions of Surgency/Extraversion and Negative Affectivity, whereas the dimension Orienting/Regulation was not replicated. In contrast to the American sample, activity level in the German sample loaded on the factor Negative Affectivity. The scales low intensity pleasure and soothability, which loaded on factor Orienting/Regulation in the original version, showed substantial loadings on both dimensions Surgency/Extraversion and Negative Affectivity (inverted), whereas the scale duration of orienting was located on the factor Surgency/Extraversion. The German version of the IBQ-R provides a satisfying instrument for investigating infant temperament. However, further work is needed to improve the methodological quality of the questionnaire. Further research should especially focus on the factor structure of infant temperament. We suggest developing a shorter version and testing it with a larger and more diverse sample.

One- and two-stage surgical revision of peri-prosthetic joint infection of the hip: a pooled individual participant data analysis of 44 cohort studies.

PubMed

Kunutsor, Setor K; Whitehouse, Michael R; Blom, Ashley W; Board, Tim; Kay, Peter; Wroblewski, B Mike; Zeller, Valérie; Chen, Szu-Yuan; Hsieh, Pang-Hsin; Masri, Bassam A; Herman, Amir; Jenny, Jean-Yves; Schwarzkopf, Ran; Whittaker, John-Paul; Burston, Ben; Huang, Ronald; Restrepo, Camilo; Parvizi, Javad; Rudelli, Sergio; Honda, Emerson; Uip, David E; Bori, Guillem; Muñoz-Mahamud, Ernesto; Darley, Elizabeth; Ribera, Alba; Cañas, Elena; Cabo, Javier; Cordero-Ampuero, José; Redó, Maria Luisa Sorlí; Strange, Simon; Lenguerrand, Erik; Gooberman-Hill, Rachael; Webb, Jason; MacGowan, Alasdair; Dieppe, Paul; Wilson, Matthew; Beswick, Andrew D

2018-04-05

One-stage and two-stage revision strategies are the two main options for treating established chronic peri-prosthetic joint infection (PJI) of the hip; however, there is uncertainty regarding which is the best treatment option. We aimed to compare the risk of re-infection between the two revision strategies using pooled individual participant data (IPD). Observational cohort studies with PJI of the hip treated exclusively by one- or two-stage revision and reporting re-infection outcomes were retrieved by searching MEDLINE, EMBASE, Web of Science, The Cochrane Library, and the WHO International Clinical Trials Registry Platform; as well as email contact with investigators. We analysed IPD of 1856 participants with PJI of the hip from 44 cohorts across four continents. The primary outcome was re-infection (recurrence of infection by the same organism(s) and/or re-infection with a new organism(s)). Hazard ratios (HRs) for re-infection were calculated using Cox proportional frailty hazards models. After a median follow-up of 3.7 years, 222 re-infections were recorded. Re-infection rates per 1000 person-years of follow-up were 16.8 (95% CI 13.6-20.7) and 32.3 (95% CI 27.3-38.3) for one-stage and two-stage strategies respectively. The age- and sex-adjusted HR of re-infection for two-stage revision was 1.70 (0.58-5.00) when compared with one-stage revision. The association remained consistently absent after further adjustment for potential confounders. The HRs did not vary importantly in clinically relevant subgroups. Analysis of pooled individual patient data suggest that a one-stage revision strategy may be as effective as a two-stage revision strategy in treating PJI of the hip.

Revision of Environmental Factors for Mil-HDBK-217B

DTIC Science & Technology

1980-09-01

and directions for application have been included. Apprpriate revision sheets to MIL-OMK-217 hee been provided as an appendix to the final report. 7...ef this study. In anticipation of insufficient data for direct statistical analysis ir, r11 categories of the study, it was determined that expert...reliability was alreadv known. The resuilting mode failure rates were too low by a factor of about 8 to 1. This methid was more accurate than Lhe average part

A systematic review of the evidence for single stage and two stage revision of infected knee replacement

PubMed Central

2013-01-01

Background Periprosthetic infection about the knee is a devastating complication that may affect between 1% and 5% of knee replacement. With over 79 000 knee replacements being implanted each year in the UK, periprosthetic infection (PJI) is set to become an important burden of disease and cost to the healthcare economy. One of the important controversies in treatment of PJI is whether a single stage revision operation is superior to a two-stage procedure. This study sought to systematically evaluate the published evidence to determine which technique had lowest reinfection rates. Methods A systematic review of the literature was undertaken using the MEDLINE and EMBASE databases with the aim to identify existing studies that present the outcomes of each surgical technique. Reinfection rate was the primary outcome measure. Studies of specific subsets of patients such as resistant organisms were excluded. Results 63 studies were identified that met the inclusion criteria. The majority of which (58) were reports of two-stage revision. Reinfection rated varied between 0% and 41% in two-stage studies, and 0% and 11% in single stage studies. No clinical trials were identified and the majority of studies were observational studies. Conclusions Evidence for both one-stage and two-stage revision is largely of low quality. The evidence basis for two-stage revision is significantly larger, and further work into direct comparison between the two techniques should be undertaken as a priority. PMID:23895421

A Factor Analytic Investigation of the Person-in-Recovery and Provider Versions of the Revised Recovery Self-Assessment (RSA-R).

PubMed

Konkolÿ Thege, Barna; Ham, Elke; Ball, Laura C

2017-12-01

Recovery is understood as living a life with hope, purpose, autonomy, productivity, and community engagement despite a mental illness. The aim of this study was to provide further information on the psychometric properties of the Person-in-Recovery and Provider versions of the Revised Recovery Self-Assessment (RSA-R), a widely used measure of recovery orientation. Data from 654 individuals were analyzed, 519 of whom were treatment providers (63.6% female), while 135 were inpatients (10.4% female) of a Canadian tertiary-level psychiatric hospital. Confirmatory and exploratory techniques were used to investigate the factor structure of both versions of the instrument. Results of the confirmatory factor analyses showed that none of the four theoretically plausible models fit the data well. Principal component analyses could not replicate the structure obtained by the scale developers either and instead resulted in a five-component solution for the Provider and a four-component solution for the Person-in-Recovery version. When considering the results of a parallel analysis, the number of components to retain dropped to two for the Provider version and one for the Person-in-Recovery version. We can conclude that the RSA-R requires further revision to become a psychometrically sound instrument for assessing recovery-oriented practices in an inpatient mental health-care setting.

The Neo Personality Inventory-Revised: Factor Structure and Gender Invariance from Exploratory Structural Equation Modeling Analyses in a High-Stakes Setting

ERIC Educational Resources Information Center

Furnham, Adrian; Guenole, Nigel; Levine, Stephen Z.; Chamorro-Premuzic, Tomas

2013-01-01

This study presents new analyses of NEO Personality Inventory-Revised (NEO-PI-R) responses collected from a large British sample in a high-stakes setting. The authors show the appropriateness of the five-factor model underpinning these responses in a variety of new ways. Using the recently developed exploratory structural equation modeling (ESEM)…

Replication Study of the Milwaukee Inventory for Subtypes of Trichotillomania–Adult Version in a Clinically Characterized Sample

PubMed Central

Keuthen, Nancy J.; Tung, Esther S.; Woods, Douglas W.; Franklin, Martin E.; Altenburger, Erin M.; Pauls, David L.; Flessner, Christopher A.

2015-01-01

In the present study, we evaluated the Milwaukee Inventory for Subtypes of Trichotillomania–Adult Version (MIST-A) in a replication sample of clinically characterized hair pullers using exploratory factor analysis (EFA; N = 193). EFA eigenvalues and visual inspection of our scree plot revealed a two-factor solution. Factor structure coefficients and internal consistencies suggested a 13-item scale with an 8-item “Intention” scale and a 5-item “Emotion” scale. Both scales displayed good construct and discriminant validity. These findings indicate the need for a revised scale that provides a more refined assessment of pulling phenomenology that can facilitate future treatment advances. PMID:25868534

A novel index for quantifying the risk of early complications for patients undergoing cervical spine surgeries.

PubMed

Passias, Peter G; Diebo, Bassel G; Marascalchi, Bryan J; Jalai, Cyrus M; Horn, Samantha R; Zhou, Peter L; Paltoo, Karen; Bono, Olivia J; Worley, Nancy; Poorman, Gregory W; Challier, Vincent; Dixit, Anant; Paulino, Carl; Lafage, Virginie

2017-11-01

OBJECTIVE It is becoming increasingly necessary for surgeons to provide evidence supporting cost-effectiveness of surgical treatment for cervical spine pathology. Anticipating surgical risk is critical in accurately evaluating the risk/benefit balance of such treatment. Determining the risk and cost-effectiveness of surgery, complications, revision procedures, and mortality rates are the most significant limitations. The purpose of this study was to determine independent risk factors for medical complications (MCs), surgical complications (SCs), revisions, and mortality rates following surgery for patients with cervical spine pathology. The most relevant risk factors were used to structure an index that will help quantify risk and anticipate failure for such procedures. METHODS The authors of this study performed a retrospective review of the National Inpatient Sample (NIS) database for patients treated surgically for cervical spine pathology between 2001 and 2010. Multivariate models were performed to calculate the odds ratio (OR) of the independent risk factors that led to MCs and repeated for SCs, revisions, and mortality. The models controlled for age (< and > 65 years old), sex, race, revision status (except for revision analysis), surgical approach, number of levels fused/re-fused (2-3, 4-8, ≥ 9), and osteotomy utilization. ORs were weighted based on their predictive category: 2 times for revision surgery predictors and 4 times for mortality predictors. Fifty points were distributed among the predictors based on their cumulative OR to establish a risk index. RESULTS Discharges for 362,989 patients with cervical spine pathology were identified. The mean age was 52.65 years, and 49.47% of patients were women. Independent risk factors included medical comorbidities, surgical parameters, and demographic factors. Medical comorbidities included the following: pulmonary circulation disorder, coagulopathy, metastatic cancer, renal failure, congestive heart failure, alcohol abuse, neurological disorder, nonmetastatic cancer, liver disease, rheumatoid arthritis/collagen vascular diseases, and chronic blood loss/anemia. Surgical parameters included posterior approach to fusion/re-fusion, ≥ 9 levels fused/re-fused, corpectomy, 4-8 levels fused/re-fused, and osteotomy; demographic variables included age ≥ 65 years. These factors increased the risk of at least 1 of MC, SC, revision, or mortality (risk of death). A total of 50 points were distributed among the factors based on the cumulative risk ratio of every factor in proportion to the total risk ratios. CONCLUSIONS This study proposed an index to quantify the potential risk of morbidity and mortality prior to surgical intervention for patients with cervical spine pathology. This index may be useful for surgeons in patient counseling efforts as well as for health insurance companies and future socioeconomics studies in assessing surgical risks and benefits for patients undergoing surgical treatment of the cervical spine.

Validating survey measurement scales for AIDS-related knowledge and stigma among construction workers in South Africa.

PubMed

Bowen, Paul; Govender, Rajen; Edwards, Peter

2016-01-23

Construction workers in South Africa are regarded as a high-risk group in the context of HIV/AIDS. HIV testing is pivotal to controlling HIV transmission and providing palliative care and AIDS-related knowledge and stigma are key issues in addressing the likelihood of testing behaviour. In exploring these issues, various studies have employed an 11-item AIDS-related knowledge scale (Kalichman and Simbayi, AIDS Care 16:572-580, 2004) and a 9-item stigma scale (Kalichman et al., AIDS Behav 9:135-143, 2005), but little evidence exists confirming the psychometric properties of these scales. Using survey data from 512 construction workers in the Western Cape, South Africa, this research examines the validity and reliability of the two scales through exploratory and confirmatory factor analysis and internal consistency tests. From confirmatory factor analysis, a revised 10-item knowledge scale was developed (χ2 /df ratio = 1.675, CFI = 0.982, RMSEA = 0.038, and Hoelter (95 %) = 393). A revised 8-item stigma scale was also developed (χ2 /df ratio = 1.929, CFI = 0.974, RMSEA = 0.045, and Hoelter (95 %) = 380). Both revised scales demonstrated good model fit and all factor loadings were significant (p < 0.01). Reliability analysis demonstrated excellent to good internal consistency, with alpha values of 0.80 and 0.74, respectively. Both revised scales also demonstrated satisfactory convergent and divergent validity. Limitations of the original survey from which the data was obtained include the failure to properly account for respondent selection of language for completion of the survey, use of ethnicity as a proxy for identifying the native language of participants, the limited geographical area from which the survey data was collected, and the limitations associated with the convenience sample. A limitation of the validation study was the lack of available data for a more robust examination of reliability beyond internal consistency, such as test-retest reliability. The revised knowledge and stigma scales offered here hold considerable promise as measures of AIDS-related knowledge and stigma among South African construction workers.

Psychometric properties of the Finnish version of the Women's Health Questionnaire.

PubMed

Katainen, Riina E; Engblom, Janne R; Vahlberg, Tero J; Polo-Kantola, Päivi

2017-08-01

The Women's Health Questionnaire (WHQ) is a validated and commonly used instrument for measuring climacteric-related symptoms. A revised version was previously developed. However, validation in a Finnish population is lacking. As it is important to use qualified instruments, we performed a validation study of the WHQ in a Finnish population. In all, 3,421 women, aged 41 to 54 years, formed the study population. In the original 36-item WHQ, the items were rated on a 1 to 4 scale and on a binary scale (0-1). The scaling of the revised 23-item WHQ was 0 to 100. We evaluated the psychometric properties (internal consistency, correlations between the symptom domains, factor structure, and sampling adequacy) in all three versions. For the 1 to 4 scale and on the revised version of the WHQ, the internal consistency was acceptable (the Cronbach's α coefficients >0.70) for most of the domains. On the binary scale, the majority of the coefficient values were below the acceptable level. The original symptom domains, especially those on the revised version, were recognizable from the factors in the exploratory factor analysis, but there were some limitations. The Kaiser-Meyer-Olkin values were high. The WHQ is a valid instrument for measuring climacteric-related symptoms in Finnish middle-aged women. The psychometric properties of the revised 23-item WHQ were as good or even better than those of the original 36-item WHQ. Thus, we encourage use of the revised version.

Physics Metacognition Inventory Part II: Confirmatory factor analysis and Rasch analysis

NASA Astrophysics Data System (ADS)

Taasoobshirazi, Gita; Bailey, MarLynn; Farley, John

2015-11-01

The Physics Metacognition Inventory was developed to measure physics students' metacognition for problem solving. In one of our earlier studies, an exploratory factor analysis provided evidence of preliminary construct validity, revealing six components of students' metacognition when solving physics problems including knowledge of cognition, planning, monitoring, evaluation, debugging, and information management. The college students' scores on the inventory were found to be reliable and related to students' physics motivation and physics grade. However, the results of the exploratory factor analysis indicated that the questionnaire could be revised to improve its construct validity. The goal of this study was to revise the questionnaire and establish its construct validity through a confirmatory factor analysis. In addition, a Rasch analysis was applied to the data to better understand the psychometric properties of the inventory and to further evaluate the construct validity. Results indicated that the final, revised inventory is a valid, reliable, and efficient tool for assessing student metacognition for physics problem solving.

Economic analysis of two-stage septic revision after total hip arthroplasty: What are the relevant costs for the hospital's orthopedic department?

PubMed

Kasch, R; Assmann, G; Merk, S; Barz, T; Melloh, M; Hofer, A; Merk, H; Flessa, S

2016-03-01

The number of septic total hip arthroplasty (THA) revisions is increasing continuously, placing a growing financial burden on hospitals. Orthopedic departments performing septic THA revisions have no basis for decision making regarding resource allocation as the costs of this procedure for the departments are unknown. It is widely assumed that septic THA procedures can only be performed at a loss for the department. Therefore, the purpose of this study was to investigate whether this assumption is true by performing a detailed analysis of the costs and revenues for two-stage septic THA revision. Patients who underwent revision THA for septic loosening in two sessions from January 2009 through March 2012 were included in this retrospective, consecutive cost study from the orthopedic department's point of view. We analyzed variable and case-fixed costs for septic revision THA with special regard to implantation and explantation stay. By using marginal costing approach we neglected hospital-fixed costs. Outcome measures include reimbursement and daily contribution margins. The average direct costs (reimbursement) incurred for septic two-stage revision THA was €10,828 (€24,201). The difference in cost and contribution margins per day was significant (p < .001 and p = 0.019) for ex- and implantation (€4147 vs. €6680 and €429 vs. €306) while length of stay and reimbursement were comparable. This is the first detailed analysis of the hospital department's cost for septic revision THA performed in two sessions. Disregarding hospital-fixed costs the included variable and case fixed-costs were covered by revenues. This study provides cost data, which will be guidance for health care decision makers.

First Spanish version of the Memorial Delirium Assessment Scale: psychometric properties, responsiveness, and factor loadings.

PubMed

Noguera, Antonio; Carvajal, Ana; Alonso-Babarro, Alberto; Chisholm, Gary; Bruera, Eduardo; Centeno, Carlos

2014-01-01

The Memorial Delirium Assessment Scale (MDAS) is a reliable and validated instrument with which to assess delirium. However, MDAS responsiveness has only been investigated in an indirect way. Also, neurobehavioral and global cognitive factors seem to be the MDAS main factor loads. The primary objective of this study was to evaluate MDAS responsiveness and analyze individual factors on this scale. The secondary objective was to confirm concurrent validity and reliability of the Spanish version of the MDAS. The translation-back translation method was used to obtain the Spanish version of the MDAS. Delirium diagnosis was determined by the clinical Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria and with the Confusion Assessment Method. Responsiveness and factor loadings were determined with the Delirium Rating Scale-Revised-98, the Mini-Mental State Examination (MMSE), and the MDAS at baseline (0 hours) and at 72 hours. Variation in the scores of the Delirium Rating Scale-Revised-98 shows a correlation of r = 0.93, with variation in MDAS scores at P < 0.001. Variation in MMSE scores shows a correlation of r = -0.84, with variation in MDAS scores at P = 0.015. Factor I, neurobehavioral (reduced awareness, reduced attention, perceptual disturbance, delusions, altered psychomotor activity, and sleep-wake cycle disturbance), correlated moderately with the MMSE at -0.56. Factor II, global cognitive (disorientation, short-term memory impairment, impaired digit span, and disorganized thinking), correlated strongly with the MMSE at -0.81. Factor II was significantly more reliable than Factor I, rho = 0.7, P = 0.01. The high responsiveness confirms the value of the MDAS for ongoing delirium assessment. Two differentiated factor loadings point to a potential future need for MDAS subscales. Copyright © 2014 U.S. Cancer Pain Relief Committee. All rights reserved.

Comparison of revision surgeries for one- to two-level cervical TDR and ACDF from 2002 to 2011.

PubMed

Nandyala, Sreeharsha V; Marquez-Lara, Alejandro; Fineberg, Steven J; Singh, Kern

2014-12-01

Cervical total disc replacement (TDR) and anterior cervical discectomy and fusion (ACDF) provide comparable outcomes for degenerative cervical pathology. However, revisions of these procedures are not well characterized. The purpose of this study is to examine the rates, epidemiology, perioperative complications, and costs between the revision procedures and to compare these outcomes with those of primary cases. This study is a retrospective database analysis. A total of 3,792 revision and 183,430 primary cases from the Nationwide Inpatient Sample (NIS) database from 2002 to 2011 were included. Incidence of revision cases, patient demographics, length of stay (LOS), in-hospital costs, mortality, and perioperative complications. Patients who underwent revision for either one- to two-level cervical TDR or ACDF were identified. SPSS v.20 was used for statistical analysis with χ(2) test for categorical data and independent sample t test for continuous data. The relative risk for perioperative complications with revisions was calculated in comparison with primary cases using a 95% confidence interval. An alpha level of less than 0.05 denoted statistical significance. There were 3,536 revision one- to two-level ACDFs and 256 revision cervical TDRs recorded in the NIS database from 2002 to 2011. The revision cervical TDR cohort demonstrated a significantly greater LOS (3.18 vs. 2.25, p<.001), cost ($16,998 vs. $15,222, p=.03), and incidence of perioperative wound infections (13.6 vs. 5.3 per 1,000, p<.001) compared with the ACDF revision cohort (p<.001). There were no differences in mortality between the revision surgical cohorts. Compared with primary cases, both revision cohorts demonstrated a significantly greater LOS and cost. Furthermore, patients who underwent revision demonstrated a greater incidence and risk for perioperative wound infections, hematomas, dysphagia, and neurologic complications relative to the primary procedures. This study demonstrated a significantly greater incidence of perioperative wound infection, LOS, and costs associated with a TDR revision compared with a revision ACDF. We propose that these differences are by virtue of the inherently more invasive nature of revising TDRs. In addition, compared with primary cases, revision procedures are associated with greater costs, LOS, and complications including wound infections, dysphagia, hematomas, and neurologic events. These additional risks must be considered before opting for a revision procedure. Copyright © 2014 Elsevier Inc. All rights reserved.

Adverse Reactions to Metal on Metal Are Not Exclusive to Large Heads in Total Hip Arthroplasty.

PubMed

Lombardi, Adolph V; Berend, Keith R; Adams, Joanne B; Satterwhite, Keri L

2016-02-01

There is some suggestion that smaller diameter heads in metal-on-metal total hip arthroplasty (MoM THA) may be less prone to the adverse reactions to metal debris (ARMD) seen with large-diameter heads. We reviewed our population of patients with small head (≤ 32 mm) MoM THA to determine (1) the frequency of ARMD; (2) potential risk factors for ARMD in this population; and (3) the etiology of revision and Kaplan-Meier survivorship with revision for all causes. Small-diameter head MoM devices were used in 9% (347 of 3753) of primary THAs during the study period (January 1996 to March 2005). We generally used these implants in younger, more active, higher-demand patients. Three hundred hips (258 patients) had MoM THA using a titanium modular acetabular component with a cobalt-chromium tapered insert and were available for review with minimum 2-year followup (mean, 10 years; range, 2-19 years). Complete followup was available in 86% of hips (300 of 347). Clinical records and radiographs were reviewed to determine the frequency and etiology of revision. Kaplan-Meier survivorship analysis was performed. ARMD frequency was 5% (14 of 300 hips) and represented 70% (14 of 20) of revisions performed. Using multivariate analysis, no variable tested, including height, weight, body mass index, age, cup diameter, cup angle, use of screws, stem diameter, stem type, head diameter, preoperative clinical score, diagnosis, activity level, or sex, was significant as a risk factor for revision. Twenty hips have been revised: two for infection, four for aseptic loosening, and 14 for ARMD. Kaplan-Meier analysis revealed survival free of component revision for all causes was 95% at 10 years (95% confidence interval [CI], 91%-97%), 92% at 15 years (95% CI, 87%-95%), and 72% at 19 years (95% CI, 43%-90%), and survival free of component revision for aseptic causes was 96% at 10 years (95% CI, 92%-98%), 92% at 15 years (95% CI, 88%-95%), and 73% at 19 years (95% CI, 43%-90%). The late onset and devastating nature of metal-related failures is concerning with this small-diameter MoM device. Although the liner is modular, it cannot be exchanged and full acetabular revision is required. Patients with all MoM THA devices should be encouraged to return for clinical and radiographic followup, and clinicians should maintain a low threshold to perform a systematic evaluation. Symptomatic patients should undergo thorough investigation and vigilant observation for ARMD. Level IV, therapeutic study.

Underappreciated Factors to Consider in Revision Anterior Cruciate Ligament Reconstruction: A Current Concepts Review

PubMed Central

Southam, Brendan R.; Colosimo, Angelo J.; Grawe, Brian

2018-01-01

Primary anterior cruciate ligament (ACL) reconstructions (ACLRs) are being performed with increasing frequency. While many of these will have successful outcomes, failures will occur in a subset of patients who will require revision ACLRs. As such, the number of revision procedures will continue to rise as well. While many reviews have focused on factors that commonly contribute to failure of primary ACLR, including graft choice, patient factors, early return to sport, and technical errors, this review focused on several factors that have received less attention in the literature. These include posterior tibial slope, varus malalignment, injury to the anterolateral ligament, and meniscal injury or deficiency. This review also appraised several emerging techniques that may be useful in the context of revision ACL surgery. While outcomes of revision ACLR are generally inferior to those of primary procedures, identifying these potentially underappreciated contributing factors preoperatively will allow the surgeon to address them at the time of revision, ideally improving patient outcomes and preventing recurrent ACL failure. PMID:29399591

Assessment of dietary restraint: psychometric properties of the revised restraint scale in Hong Kong adolescents.

PubMed

Mak, Kwok-Kei; Lai, Ching-Man

2012-06-01

The psychometric properties of the Revised Restraint Scale (RRS) have been well established in western populations but not in Chinese adolescents. This study investigated the psychometric properties of RRS and its validity in different subgroups for Hong Kong Chinese adolescents. In 2007, 909 Hong Kong students aged 12 to 18 years (55.3% boys) completed a questionnaire including demographic items, RRS, Eating Attitudes Test (EAT-26), and Motivation for Eating Scale (MFES)-physical. Moreover, subjects' height and weight were measured. To examine the factor structure of RRS, the whole sample was randomly split into two groups (sample 1: N=454 and sample 2: N=455) for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), respectively. Convergent and discriminant validity of RRS were investigated by correlating the RRS with EAT-26 and MFES-physical. Multigroup CFA was conducted to test the three-factor model of RRS in different sex, age, and weight status subgroups. Results of EFA for sample 1 revealed three strongly correlated factors for the RRS construct, and were supported by the CFA results in sample 2. Multigroup CFA further suggested that the three-factor model of RRS was stable across sex, age, and weight status subgroups. A new three-factor model is proposed for Hong Kong adolescents in this study. In general, RRS is a reliable and valid measure of restrained eating for adolescents, regardless of sex, age, and weight status.

A Chinese version of the revised Nurses Professional Values Scale: reliability and validity assessment.

PubMed

Lin, Yu-Hua; Wang, Liching Sung

2010-08-01

The purpose of this study was to assess the reliability and validity of a Chinese version of the revised nurses professional values scale (NPVS-R). The convenient sampling method, including senior undergraduate nursing students (n=110) and clinical nurses (n=223), was applied to recruit appropriate samples from southern Taiwan. The revised nurses professional values scale (NPVS-R) was used in this study. Content validity, construct validity, internal consistency, and reliability were assessed. The final sample consisted of 286 subjects. three factors were detected in the results, accounting for 60.12% of the explained variance. The first factor was titled professionalism, and included 13 items. The second factor was named caring, and consisted of seven items. Activism was the third factor, which included six items. Overall Cronbach's alpha coefficient was 0.90, taken from values for each of the three factors of 0.88, 0.90, and 0.81, respectively. The Chinese version of the NPVS-R can be considered a reliable and valid scale for assigning values that can mark professionalism in Taiwanese nurses. Copyright 2009 Elsevier Ltd. All rights reserved.

Confirmatory factor analysis of the Frommelt Attitude Toward Care of the Dying Scale (FATCOD-B) among Italian medical students.

PubMed

Leombruni, Paolo; Loera, Barbara; Miniotti, Marco; Zizzi, Francesca; Castelli, Lorys; Torta, Riccardo

2015-10-01

A steady increase in the number of patients requiring end-of-life care has been observed during the last decades. The assessment of healthcare students' attitudes toward end-of-life care is an important step in their curriculum, as it provides information about their disposition to practice palliative medicine. The Frommelt Attitude Toward Care of the Dying Scale (FATCOD-B) was developed to detect such a disposition, but its psychometric properties are yet to be clearly defined. A convenience sample of 608 second-year medical students participated in our study in the 2012/2013 and 2013/2014 academic years. All participants completed the FATCOD-B. The sample was randomly divided in two subsamples. In the item analysis, reliability (Cronbach's α), internal consistency (item-total correlations), and an exploratory factor analysis (EFA) were conducted using the first subsample (n = 300). Using the second subsample (n = 308), confirmatory factor analysis (CFA) was performed using the robust ML method in the Lisrel program. Reliability for all items was 0.699. Item-total correlations, ranging from 0.03 to 0.39, were weak. EFA identified a two-dimensional orthogonal solution, explaining 20% of total variance. CFA upheld the two-dimensional model, but the loadings on the dimensions and their respective indicators were weak and equal to zero for certain items. The findings of the present study suggest that the FATCOD-B measures a two-dimensional construct and that several items seem in need of revision. Future research oriented toward building a revised version of the scale should pay attention to item ambiguity and take particular care to distinguish among items that concern emotions and beliefs related to end-of-life care, as well as their subjects (e.g., the healthcare provider, the patient, his family).

Reliability and Validity of the Korean Version of the Lifetime Stressor Checklist-Revised in Psychiatric Outpatients with Anxiety or Depressive Disorders.

PubMed

Choi, Kang Rok; Kim, Daeho; Jang, Eun Young; Bae, Hwallip; Kim, Seok Hyeon

2017-01-01

Traumatic events and adverse stressful experiences are major etiological factors in a wide variety of physical and mental disorders. Developing psychological instruments that can be easily administered and that have good psychometric properties have become an integral part for research and practice. This study investigated the reliability and validity of the Korean version of the Lifetime Stressor Checklist-Revised (LSC-R) in a consecutive sample of psychiatric outpatients. The LSC-R is a 30-item self-reporting questionnaire examining lifetime traumatic and non-traumatic stressors. A final sample of 258 outpatients with anxiety or depressive disorders was recruited at the psychiatric department of a university-affiliated teaching hospital. Self-reported data included the Life Events Checklist (LEC), the Zung Self-Rating Depression and Anxiety Scales, and the Impact of Events Scale-Revised, in addition to the LSC-R. A convenience sample of 50 college students completed the LSC-R on two occasions separated by a three week-interval for test-retest reliability. Mean kappa for temporal stability was high (κ=0.651) and Cronbach alpha was moderate (α=0.724). Convergent validity was excellent with corresponding items on the LEC. Concurrent validity was good for symptoms of post-traumatic stress disorder, depression, and anxiety. An exploratory factor analysis revealed that 11 factors explained 64.3 % of the total variance. This study demonstrated good psychometric properties of the Korean version of the LSC-R, further supporting its use in clinical research and practice with a Korean speaking population.

Psychometric properties of Conversion Disorder Scale- Revised (CDS) for children.

PubMed

Ijaz, Tazvin; Nasir, Attikah; Sarfraz, Naema; Ijaz, Shirmeen

2017-05-01

To revise conversion disorder scale and to establish the psychometric properties of the revised scale. This case-control study was conducted from February to June, 2014, at the Government College University, Lahore, Pakistan, and comprised schoolchildren and children with conversion disorder. In order to generate items for revised version of conversion disorder scale, seven practising mental health professionals were consulted. A list of 42 items was finalised for expert ratings. After empirical validation, a scale of 40 items was administered on the participants and factor analysis was conducted. Of the240 participants, 120(50%) were schoolchildren (controls group) and 120(50%)were children with conversion disorder (clinical group).The results of factor analysis revealed five factors (swallowing and speech symptoms, motor symptoms, sensory symptoms, weakness and fatigue, and mixed symptoms) and retention of all 40 items of revised version of conversion disorder scale. Concurrent validity of the revised scale was found to be 0.81 which was significantly high. Similarly, discriminant validity of the scale was also high as both clinical and control groups had significant difference (p<0.001) in scores. Cronbach's alpha of scale was a=0.91 while item total correlation ranged from 0.50 to 0.80. The sensitivity and specificity analysis indicated that the revised conversion disorder scale was 76% sensitive to predicting conversion disorder while specificity showed that the scale was 73% accurate in specifying participants of the control group. The revised version of conversion disorder scale was a reliable and valid tool to be used for screening of children with conversion disorder.

Application of a Tsunami Warning Message Metric to refine NOAA NWS Tsunami Warning Messages

NASA Astrophysics Data System (ADS)

Gregg, C. E.; Johnston, D.; Sorensen, J.; Whitmore, P.

2013-12-01

In 2010, the U.S. National Weather Service (NWS) funded a three year project to integrate social science into their Tsunami Program. One of three primary requirements of the grant was to make improvements to tsunami warning messages of the NWS' two Tsunami Warning Centers- the West Coast/Alaska Tsunami Warning Center (WCATWC) in Palmer, Alaska and the Pacific Tsunami Warning Center (PTWC) in Ewa Beach, Hawaii. We conducted focus group meetings with a purposive sample of local, state and Federal stakeholders and emergency managers in six states (AK, WA, OR, CA, HI and NC) and two US Territories (US Virgin Islands and American Samoa) to qualitatively asses information needs in tsunami warning messages using WCATWC tsunami messages for the March 2011 Tohoku earthquake and tsunami event. We also reviewed research literature on behavioral response to warnings to develop a tsunami warning message metric that could be used to guide revisions to tsunami warning messages of both warning centers. The message metric is divided into categories of Message Content, Style, Order and Formatting and Receiver Characteristics. A message is evaluated by cross-referencing the message with the operational definitions of metric factors. Findings are then used to guide revisions of the message until the characteristics of each factor are met. Using findings from this project and findings from a parallel NWS Warning Tiger Team study led by T. Nicolini, the WCATWC implemented the first of two phases of revisions to their warning messages in November 2012. A second phase of additional changes, which will fully implement the redesign of messages based on the metric, is in progress. The resulting messages will reflect current state-of-the-art knowledge on warning message effectiveness. Here we present the message metric; evidence-based rational for message factors; and examples of previous, existing and proposed messages.

Confirmatory Factor Analysis of a Family Quality of Life Scale for Taiwanese Families of Children with Intellectual Disability/Developmental Delay

ERIC Educational Resources Information Center

Chiu, Chun-Yu; Seo, Hyojeong; Turnbull, Ann P.; Summer, Jean Ann

2017-01-01

The Beach Center Family Quality of Life Scale is an internationally validated instrument for measuring family outcomes. To revise the scale for better alignment with the Family Quality of Life theory, the authors excluded non-outcome items in this revision. In this study, we examined reliability and validity of the revised scale (i.e., the FQoL…

Identification of Genetic Loci Underlying the Phenotypic Constructs of Autism Spectrum Disorders

ERIC Educational Resources Information Center

Liu, Xiao-Qing; Georgiades, Stelios; Duku, Eric; Thompson, Ann; Devlin, Bernie; Cook, Edwin H.; Wijsman, Ellen M.; Paterson, Andrew D.; Szatmari, Peter

2011-01-01

Objective: To investigate the underlying phenotypic constructs in autism spectrum disorders (ASD) and to identify genetic loci that are linked to these empirically derived factors. Method: Exploratory factor analysis was applied to two datasets with 28 selected Autism Diagnostic Interview-Revised (ADI-R) algorithm items. The first dataset was from…

Risk factors for incidental durotomy during lumbar surgery: a retrospective study by multivariate analysis.

PubMed

Chen, Zhixiang; Shao, Peng; Sun, Qizhao; Zhao, Dong

2015-03-01

The purpose of the present study was to use a prospectively collected data to evaluate the rate of incidental durotomy (ID) during lumbar surgery and determine the associated risk factors by using univariate and multivariate analysis. We retrospectively reviewed 2184 patients who underwent lumbar surgery from January 1, 2009 to December 31, 2011 at a single hospital. Patients with ID (n=97) were compared with the patients without ID (n=2019). The influences of several potential risk factors that might affect the occurrence of ID were assessed using univariate and multivariate analyses. The overall incidence of ID was 4.62%. Univariate analysis demonstrated that older age, diabetes, lumbar central stenosis, posterior approach, revision surgery, prior lumber surgery and minimal invasive surgery are risk factors for ID during lumbar surgery. However, multivariate analysis identified older age, prior lumber surgery, revision surgery, and minimally invasive surgery as independent risk factors. Older age, prior lumber surgery, revision surgery, and minimal invasive surgery were independent risk factors for ID during lumbar surgery. These findings may guide clinicians making future surgical decisions regarding ID and aid in the patient counseling process to alleviate risks and complications. Copyright © 2015 Elsevier B.V. All rights reserved.

Scar modification. Techniques for revision and camouflage.

PubMed

Horswell, B B

1998-09-01

The surgery and management of scars is a protracted and staged process that includes preparation of the skin through hygienic measures, scar softening (if indicated) with steroids, massage and pressure dressings, skilled execution of the surgical plan, and thorough postoperative wound care. This process generally covers a 1-year period for the various stages mentioned. Many general host and local skin factors will directly affect the final revision result. The two most important indirect factors that the surgeon must endeavor to control are optimal patient preparation and cutaneous health, and patient compliance with, and an ability to carry out, those wound care measures that the surgeon prescribes. Keloid and burn contracture scars represent two entities that are complicated and challenging to treat owing to their abnormal morphophysiologic features. Management of these scars is prolonged, and the patient must understand that the ultimate result will usually be a compromise. New grafting techniques, such as cultured autodermal grafts, offer improved initial management of burn wounds that may subsequently optimize scar revision in these patients. Keloids, and to a lesser extent hypertrophic scars, require steroid injections, pressure treatment, careful surgery, and protracted wound support and pressure treatment (exceeding 6 months) after surgery.

An Assessment of the Dimensionality and Factorial Structure of the Revised Paranormal Belief Scale

PubMed Central

Drinkwater, Kenneth; Denovan, Andrew; Dagnall, Neil; Parker, Andrew

2017-01-01

Since its introduction, the Revised Paranormal Belief Scale (RPBS) has developed into a principal measure of belief in the paranormal. Accordingly, the RPBS regularly appears within parapsychological research. Despite common usage, academic debates continue to focus on the factorial structure of the RPBS and its psychometric integrity. Using an aggregated heterogeneous sample (N = 3,764), the present study tested the fit of 10 factorial models encompassing variants of the most commonly proposed solutions (seven, five, two, and one-factor) plus new bifactor alternatives. A comparison of competing models revealed a seven-factor bifactor solution possessed superior data-model fit (CFI = 0.945, TLI = 0.933, IFI = 0.945, SRMR = 0.046, RMSEA = 0.058), containing strong factor loadings for a general factor and weaker, albeit acceptable, factor loadings for seven subfactors. This indicated that belief in the paranormal, as measured by the RPBS, is best characterized as a single overarching construct, comprising several related, but conceptually independent subfactors. Furthermore, women reported significantly higher paranormal belief scores than men, and tests of invariance indicated that mean differences in gender are unlikely to reflect measurement bias. Results indicate that despite concerns about the content and psychometric integrity of the RPBS the measure functions well at both a global and seven-factor level. Indeed, the original seven-factors contaminate alternative solutions. PMID:29018398

An Assessment of the Dimensionality and Factorial Structure of the Revised Paranormal Belief Scale.

PubMed

Drinkwater, Kenneth; Denovan, Andrew; Dagnall, Neil; Parker, Andrew

2017-01-01

Since its introduction, the Revised Paranormal Belief Scale (RPBS) has developed into a principal measure of belief in the paranormal. Accordingly, the RPBS regularly appears within parapsychological research. Despite common usage, academic debates continue to focus on the factorial structure of the RPBS and its psychometric integrity. Using an aggregated heterogeneous sample ( N = 3,764), the present study tested the fit of 10 factorial models encompassing variants of the most commonly proposed solutions (seven, five, two, and one-factor) plus new bifactor alternatives. A comparison of competing models revealed a seven-factor bifactor solution possessed superior data-model fit (CFI = 0.945, TLI = 0.933, IFI = 0.945, SRMR = 0.046, RMSEA = 0.058), containing strong factor loadings for a general factor and weaker, albeit acceptable, factor loadings for seven subfactors. This indicated that belief in the paranormal, as measured by the RPBS, is best characterized as a single overarching construct, comprising several related, but conceptually independent subfactors. Furthermore, women reported significantly higher paranormal belief scores than men, and tests of invariance indicated that mean differences in gender are unlikely to reflect measurement bias. Results indicate that despite concerns about the content and psychometric integrity of the RPBS the measure functions well at both a global and seven-factor level. Indeed, the original seven-factors contaminate alternative solutions.

Failure of aseptic revision total knee arthroplasties

PubMed Central

Leta, Tesfaye H; Lygre, Stein Håkon L; Skredderstuen, Arne; Hallan, Geir; Furnes, Ove

2015-01-01

Background and purpose In Norway, the proportion of revision knee arthroplasties increased from 6.9% in 1994 to 8.5% in 2011. However, there is limited information on the epidemiology and causes of subsequent failure of revision knee arthroplasty. We therefore studied survival rate and determined the modes of failure of aseptic revision total knee arthroplasties. Method This study was based on 1,016 aseptic revision total knee arthroplasties reported to the Norwegian Arthroplasty Register between 1994 and 2011. Revisions done for infections were not included. Kaplan-Meier and Cox regression analyses were used to assess the survival rate and the relative risk of re-revision with all causes of re-revision as endpoint. Results 145 knees failed after revision total knee arthroplasty. Deep infection was the most frequent cause of re-revision (28%), followed by instability (26%), loose tibial component (17%), and pain (10%). The cumulative survival rate for revision total knee arthroplasties was 85% at 5 years, 78% at 10 years, and 71% at 15 years. Revision total knee arthroplasties with exchange of the femoral or tibial component exclusively had a higher risk of re-revision (RR = 1.7) than those with exchange of the whole prosthesis. The risk of re-revision was higher for men (RR = 2.0) and for patients aged less than 60 years (RR = 1.6). Interpretation In terms of implant survival, revision of the whole implant was better than revision of 1 component only. Young age and male sex were risk factors for re-revision. Deep infection was the most frequent cause of failure of revision of aseptic total knee arthroplasties. PMID:25267502

Test-Retest Reliability of the Parent Behavior Importance Questionnaire-Revised and the Parent Behavior Frequency Questionnaire-Revised

ERIC Educational Resources Information Center

Mowder, Barbara A.; Shamah, Renee

2011-01-01

This study evaluated the test-retest reliability of two parenting measures: the Parent Behavior Importance Questionnaire-Revised (PBIQ-R) and Parent Behavior Frequency Questionnaire-Revised (PBFQ-R). These self-report parenting behavior assessment measures may be utilized as pre- and post-parent education program measures, with parents as well as…

Validity of Factors of the Psychopathy Checklist–Revised in Female Prisoners

PubMed Central

Kennealy, Patrick J.; Hicks, Brian M.; Patrick, Christopher J.

2008-01-01

The validity of the Psychopathy Checklist–Revised (PCL-R) has been examined extensively in men, but its validity for women remains understudied. Specifically, the correlates of the general construct of psychopathy and its components as assessed by PCL-R total, factor, and facet scores have yet to be examined in depth. Based on previous research conducted with male offenders, a large female inmate sample was used to examine the patterns of relations between total, factor, and facet scores on the PCL-R and various criterion variables. These variables include ratings of psychopathy based on Cleckley’s criteria, symptoms of antisocial personality disorder, and measures of substance use and abuse, criminal behavior, institutional misconduct, interpersonal aggression, normal range personality, intellectual functioning, and social background variables. Results were highly consistent with past findings in male samples and provide further evidence for the construct validity of the PCL-R two-factor and four-facet models across genders. PMID:17986651

Lecturers' Perceptions of the Implementation of the Revised English Language Nigeria Certificate in Education Curriculum

ERIC Educational Resources Information Center

Tom-Lawyer, Oris Oritsebemigho

2015-01-01

This paper examines the perceptions of English language lecturers from three colleges of education on the factors that inhibit the implementation process of the revised English Language Nigeria Certificate Education Curriculum. The study which is underpinned by the CIPP Evaluation model is part of a larger study on the evaluation of the…

NASA Space Flight Human System Standards

NASA Technical Reports Server (NTRS)

Tillman, Barry; Pickett, Lynn; Russo, Dane; Stroud, Ken; Connolly, Jan; Foley, Tico

2007-01-01

NASA has begun a new approach to human factors design standards. For years NASA-STD-3000, Manned Systems Integration Standards, has been a source of human factors design guidance for space systems. In order to better meet the needs of the system developers, NASA is revising its human factors standards system. NASA-STD-3000 will be replaced by two documents: set of broad human systems specifications (including both human factors and medical topics) and a human factors design handbook

A Measurement Invariance Examination of the Revised Child Anxiety and Depression Scale in a Southern Sample: Differential Item Functioning between African American and Caucasian Youth

ERIC Educational Resources Information Center

Trent, Lindsay Rae; Buchanan, Erin; Ebesutani, Chad; Ale, Chelsea M.; Heiden, Laurie; Hight, Terry L.; Damon, John D.; Young, John

2013-01-01

This study examined the psychometric properties of the Revised Child Anxiety and Depression Scale in a large sample of youth from the Southern United States. The authors aimed to determine (a) if the established six-factor Revised Child Anxiety and Depression Scale structure could be replicated in this Southern sample and (b) if scores were…

Risk of revision surgery for adult idiopathic scoliosis: a survival analysis of 517 cases over 25 years.

PubMed

Riouallon, Guillaume; Bouyer, Benjamin; Wolff, Stéphane

2016-08-01

Little is known about the long-term status of patients operated for spine deformities. The aim of this study was to determine the survival of primary fusion in adult idiopathic scoliosis and identify the risk factors of revision surgery. Adult patients who underwent primary fusion for idiopathic scoliosis between 1983 and 2011 were included in a continuous monocentric retrospective series. Any additional surgery was registered for survival analysis. Survival and follow-up were estimated by the Kaplan-Meier method and an analysis was performed to identify the risk factors of revision surgery. This series included 447 women (86.5 %) and 70 men (13.5 %) reviewed after a mean follow-up of 7 years (range 0-26.4). Mean age was 44.4 years. Fusion was performed on a median 11 levels (range 3-15); revision rate was 13 % (CI 10-17), 18 % (CI 14-23) and 20 % (CI 16-26) at 5, 10 and 15 years, respectively. Revision surgery was associated with age, anterior release, length of fusion, the inferior limit of fusion, post-operative sagittal balance and junctional kyphosis. The length of fusion (HR 1.13 per vertebrae fused, p = 0.007) and the lower limit of fusion (HR 5.9, p < 0.001) remained independent predictors of revision surgery on multivariate analysis. This series evaluated the risk of revision surgery following spinal fusion for idiopathic scoliosis. Our results show that the risk seemed to increase linearly with a rate of nearly 20 % after 10 years. The length and lower limit of fusion are the main risk factors for revision surgery. Level IV (e.g. case series).

Chilean Adaptation and Validation of the Early Adolescent Temperament Questionnaire-Revised Version

PubMed Central

Hoffmann, Marianela; Pérez, J. Carola; García, Catalina; Rojas, Graciela; Martínez, Vania

2017-01-01

The aim of this study was to develop an adapted version of the Early Adolescent Temperament Questionnaire-Revised (EATQ-R) that would be valid and reliable for assessing temperament and its components in Chileans between 12 and 18 years of age. Originally, Ellis and Rothbart (2001) developed this questionnaire (EATQ-R) to be used in North American adolescents. For the study in Chile, a translation protocol was developed, to maintain the original instrument's cultural and linguistic equivalence in the adapted version. Psychometric properties of the EATQ-R, such as factor structure, internal consistency, and convergent validity, were also assessed. The adaption and validation was carried out in two stages, with two different studies. The first study, which included 612 adolescent students from educational establishments in the cities of Santiago and Concepcion, Chile, developed the Chilean version of the 83-item EATQ-R, which has 13 dimensions, belonging to 4 theoretical factors with adequate internal consistency (Cronbach's alpha = 0.79–0.82). The second study assessed the questionnaire's convergent validity, through its application to 973 adolescent students in Santiago. Results show that the effortful control subscale was significantly inversely related to indicators of adolescent maladjustment, such as substance abuse and behavioral problems. In addition, it was directly associated with indicators of self-concept, including self-esteem and self-efficacy. The opposite pattern was observed when considering negative affect. These findings coincide with current knowledge on the relationship between temperament and adjustment in adolescents. PMID:29326616

Development and validation of a new knowledge, attitude, belief and practice questionnaire on leptospirosis in Malaysia.

PubMed

Zahiruddin, Wan Mohd; Arifin, Wan Nor; Mohd-Nazri, Shafei; Sukeri, Surianti; Zawaha, Idris; Bakar, Rahman Abu; Hamat, Rukman Awang; Malina, Osman; Jamaludin, Tengku Zetty Maztura Tengku; Pathman, Arumugam; Mas-Harithulfadhli-Agus, Ab Rahman; Norazlin, Idris; Suhailah, Binti Samsudin; Saudi, Siti Nor Sakinah; Abdullah, Nurul Munirah; Nozmi, Noramira; Zainuddin, Abdul Wahab; Aziah, Daud

2018-03-07

In Malaysia, leptospirosis is considered an endemic disease, with sporadic outbreaks following rainy or flood seasons. The objective of this study was to develop and validate a new knowledge, attitude, belief and practice (KABP) questionnaire on leptospirosis for use in urban and rural populations in Malaysia. The questionnaire comprised development and validation stages. The development phase encompassed a literature review, expert panel review, focus-group testing, and evaluation. The validation phase consisted of exploratory and confirmatory parts to verify the psychometric properties of the questionnaire. A total of 214 and 759 participants were recruited from two Malaysian states, Kelantan and Selangor respectively, for the validation phase. The participants comprised urban and rural communities with a high reported incidence of leptospirosis. The knowledge section of the validation phase utilized item response theory (IRT) analysis. The attitude and belief sections utilized exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The development phase resulted in a questionnaire that included four main sections: knowledge, attitude, belief, and practice. In the exploratory phase, as shown by the IRT analysis of knowledge about leptospirosis, the difficulty and discrimination values of the items were acceptable, with the exception of two items. Based on the EFA, the psychometric properties of the attitude, belief, and practice sections were poor. Thus, these sections were revised, and no further factor analysis of the practice section was conducted. In the confirmatory stage, the difficulty and discrimination values of the items in the knowledge section remained within the acceptable range. The CFA of the attitude section resulted in a good-fitting two-factor model. The CFA of the belief section retained low number of items, although the analysis resulted in a good fit in the final three-factor model. Based on the IRT analysis and factor analytic evidence, the knowledge and attitude sections of the KABP questionnaire on leptospirosis were psychometrically valid. However, the psychometric properties of the belief section were unsatisfactory, despite being revised after the initial validation study. Further development of this section is warranted in future studies.

Differences in ergonomic and workstation factors between computer office workers with and without reported musculoskeletal pain.

PubMed

Rodrigues, Mirela Sant'Ana; Leite, Raquel Descie Veraldi; Lelis, Cheila Maira; Chaves, Thaís Cristina

2017-01-01

Some studies have suggested a causal relationship between computer work and the development of musculoskeletal disorders. However, studies considering the use of specific tools to assess workplace ergonomics and psychosocial factors in computer office workers with and without reported musculoskeletal pain are scarce. The aim of this study was to compare the ergonomic, physical, and psychosocial factors in computer office workers with and without reported musculoskeletal pain (MSP). Thirty-five computer office workers (aged 18-55 years) participated in the study. The following evaluations were completed: Rapid Upper Limb Assessment (RULA), Rapid Office Strain Assessment (ROSA), and Maastricht Upper Extremity Questionnaire revised Brazilian Portuguese version (MUEQ-Br revised). Student t-tests were used to make comparisons between groups. The computer office workers were divided into two groups: workers with reported MSP (WMSP, n = 17) and workers without positive report (WOMSP, n = 18). Those in the WMSP group showed significantly greater mean values in the total ROSA score (WMSP: 6.71 [CI95% :6.20-7.21] and WOMSP: 5.88 [CI95% :5.37-6.39], p = 0.01). The WMSP group also showed higher scores in the chair section of the ROSA, workstation of MUEQ-Br revised, and in the upper limb RULA score. The chair height and armrest sections from ROSA showed the higher mean values in workers WMSP compared to workers WOMSP. A positive moderate correlation was observed between ROSA and RULA total scores (R = 0.63, p < 0.001). Our results demonstrated that computer office workers who reported MSP had worse ergonomics indexes for chair workstation and worse physical risk related to upper limb (RULA upper limb section) than workers without pain. However, there were no observed differences in workers with and without MSP regarding work-related psychosocial factors. The results suggest that inadequate workstation conditions, specifically the chair height, arm and back rest, are linked to improper upper limb postures and that these factors are contributing to MSP in computer office workers.

A hybrid online scheduling mechanism with revision and progressive techniques for autonomous Earth observation satellite

NASA Astrophysics Data System (ADS)

Li, Guoliang; Xing, Lining; Chen, Yingwu

2017-11-01

The autonomicity of self-scheduling on Earth observation satellite and the increasing scale of satellite network attract much attention from researchers in the last decades. In reality, the limited onboard computational resource presents challenge for the online scheduling algorithm. This study considered online scheduling problem for a single autonomous Earth observation satellite within satellite network environment. It especially addressed that the urgent tasks arrive stochastically during the scheduling horizon. We described the problem and proposed a hybrid online scheduling mechanism with revision and progressive techniques to solve this problem. The mechanism includes two decision policies, a when-to-schedule policy combining periodic scheduling and critical cumulative number-based event-driven rescheduling, and a how-to-schedule policy combining progressive and revision approaches to accommodate two categories of task: normal tasks and urgent tasks. Thus, we developed two heuristic (re)scheduling algorithms and compared them with other generally used techniques. Computational experiments indicated that the into-scheduling percentage of urgent tasks in the proposed mechanism is much higher than that in periodic scheduling mechanism, and the specific performance is highly dependent on some mechanism-relevant and task-relevant factors. For the online scheduling, the modified weighted shortest imaging time first and dynamic profit system benefit heuristics outperformed the others on total profit and the percentage of successfully scheduled urgent tasks.

Complications Following Primary and Revision Transsphenoidal Surgeries for Pituitary Tumors

PubMed Central

Krings, James G.; Kallogjeri, Dorina; Wineland, Andre; Nepple, Kenneth G.; Piccirillo, Jay F.; Getz, Anne E.

2014-01-01

Objective This study aimed to determine the incidence of major complications following both primary and revision transsphenoidal pituitary surgery. Major complications included endocrinopathic, skull base, orbital, hemorrhagic and thromboembolic complications, respiratory failure, and death. Secondarily, this study aimed to examine factors associated with the occurrence of complications. Study Design Retrospective cohort analysis of California and Florida all-payer databases from 2005-2008. Methods The major complication rate following both primary and revision transsphenoidal pituitary surgery was calculated. Bivariate analyses were performed to investigate the relationship of patient characteristics with complication occurrence, and a multivariate model was constructed to determine risk factors associated with these complications. Results 5,277 primary cases and 192 revision cases met inclusion criteria. There was a non-significant absolute difference of 3.09% (95% CI −11.00 to 16.14) between the rate of complications following primary (n=443; 8.39%) and revision (n=22; 11.46%) surgeries. Multivariate analyses showed that patients with Medicare (OR=1.74; 95% CI 1.17 to 2.61), Medicaid (OR=2.13; 95% CI 1.59 to 2.86), or a malignant neoplasm (OR=3.10; 95% CI 1.62 to 5.93) were more likely to have complications. Conclusions The rate of major complications following transsphenoidal pituitary surgery is lower than earlier retrospective reports. The overall complication rate following revision surgery was not significantly different from primary surgery. Insurance status and a diagnosis of a malignant neoplasm were associated with a higher rate of complications. PMID:25263939

The Impact of Participatory Safety Rules Revision on Incident Rates, Liability Claims, and Safety Culture in the U.S. Railroad Industry

DOT National Transportation Integrated Search

2007-07-01

The Federal Railroad Administration Human Factors Research and Development Program sponsored a lessons learned study to examine the impact of safety rules revision on safety culture, incident rates, and liability claims in the railroad industry. Safe...

Data-Driven Belief Revision in Children and Adults

ERIC Educational Resources Information Center

Masnick, Amy M.; Klahr, David; Knowles, Erica R.

2017-01-01

The ability to use numerical evidence to revise beliefs about the physical world is an essential component of scientific reasoning that begins to develop in middle childhood. In 2 studies, we explored how data variability and consistency with participants' initial beliefs about causal factors associated with pendulums affected their ability to…

Adaptation of the three-dimensional wisdom scale (3D-WS) for the Korean cultural context.

PubMed

Kim, Seungyoun; Knight, Bob G

2014-10-23

ABSTRACT Background: Previous research on wisdom has suggested that wisdom is comprised of cognitive, reflective, and affective components and has developed and validated wisdom measures based on samples from Western countries. To apply the measurement to Eastern cultures, the present study revised an existing wisdom scale, the three-dimensional wisdom scale (3D-WS, Ardelt, 2003) for the Korean cultural context. Methods: Participants included 189 Korean heritage adults (age range 19-96) living in Los Angeles. We added a culturally specific factor of wisdom to the 3D-WS: Modesty and Unobtrusiveness (Yang, 2001), which captures an Eastern aspect of wisdom. The structure and psychometrics of the scale were tested. By latent cluster analysis, we determined acculturation subgroups and examined group differences in the means of factors in the revised wisdom scale (3D-WS-K). Results: Three factors, Cognitive Flexibility, Viewpoint Relativism, and Empathic Modesty were found using confirmatory factor analysis. Respondents with high biculturalism were higher on Viewpoint Relativism and lower on Empathic Modesty. Conclusion: This study discovered that a revised wisdom scale had a distinct factor structure and item content in a Korean heritage sample. We also found acculturation influences on the meaning of wisdom.

Psychometric properties of the Children’s Revised Impact of Events Scale (CRIES) with Bangladeshi children and adolescents

PubMed Central

Deeba, Farah; Prvan, Tania

2014-01-01

Identification of possible cases suffering post-traumatic stress disorder (PTSD) is important, especially in developing countries where traumatic events are typically prevalent. The Children’s Revised Impact of Events Scale is a reliable and valid measure that has two brief versions (13 items and 8 items) to assess reactions to traumatic events among young people. The current study evaluated the psychometric properties of both versions of the CRIES in a sample of 1,342 children and adolescents aged 9–17 years (M = 12.3 years, SD = 2.12) recruited from six districts of Bangladesh. A sub-group of 120 children from four schools was re-tested on the measures within 3.5 weeks. Confirmatory factor analysis supported factor structures similar to those found in other studies for both versions of the CRIES. Multiple group confirmatory factor analysis showed gender and age-group differences within the sample, supporting established age and gender differences in prevalence of PTSD symptoms. Analyses also indicated moderate to excellent internal consistency and test-retest reliability and clear discriminant and convergent validity. These data support use of both the CRIES-13 and CRIES-8 to provide quick and psychometrically sound assessment of symptoms of PTSD among children and adolescents from Bangla-speaking communities. PMID:25237597

Learners' Uses of Two Types of Written Feedback on a L2 Writing Revision Task

ERIC Educational Resources Information Center

Sachs, Rebecca; Polio, Charlene

2007-01-01

This study examines the effectiveness of written error corrections versus reformulations of second language learners' writing as two means of improving learners' grammatical accuracy on a three-stage composition-comparison-revision task. Concurrent verbal protocols were employed during the comparison stage in order to study the learners' reported…

Psychometric Properties of the Persian Version of the Padua Inventory: Washington State University Revision (PI-WSUR)

PubMed Central

Kaviani, Hosein; Esmaili, Yaghob; Ebrahimkhani, Narges; Manesh, Alireza Amin

2011-01-01

Objective The psychometric properties and factor structure of the Persian Padua Inventory Washington State University Revision (PI-WSUR), a measure of obsessive- compulsive phenomena, was examined in a non-clinical sample of 348 Iranian university students. Method The PI-WSUR was translated into Persian, and its back translation was controlled by the author inventory. A pilot study based on cultural differences was carried out on twenty students. The study subjects consisted of 348 university students, and they completed PPI, OCI-R, MOCI, BAI, STAI, BDI-II and the demographic inventory. Results The factor analysis of the PI-WSUR, exhibited eight factors similar but not identical with factor structure in previous studies. as the eight factors are as follows: contamination obsessions; washing compulsions; ordering compulsions; checking compulsions; obsessional thoughts to harm self/others; obsessional thoughts about violence; obsessional impulses to harm self/others; and obsessional impulses to steal. The result also indicated excellent internal consistency (Cronbach alpha= 0.92), Spearman split test (0.95) and test- retest (r= 0.77). We assessed the concurrent validity of the PPI in relation to the Obsessive Compulsive Inventory-Revised (OCI-R), and the Maudsley Obsessive- Compulsive Inventory (MOCI). Conclusion The Iranian version of the PI to some extend remains the sound psychometric properties of the original version. PMID:22952515

Pedagogical Beliefs and Attitudes toward Information and Communication Technology: A Survey of Teachers of English as a Foreign Language in China

ERIC Educational Resources Information Center

Liu, Haixia; Lin, Chin-Hsi; Zhang, Dongbo

2017-01-01

Though pedagogical beliefs have been identified as critical factors in the success of technology integration, very few studies have included them in technology-adoption models. The present study revises the Technology Acceptance Model (TAM) by adding teachers' pedagogical beliefs, and tests the revised model among university-level…

Results of press-fit stems in revision knee arthroplasties.

PubMed

Wood, Gavin C; Naudie, Douglas D R; MacDonald, Steven J; McCalden, Richard W; Bourne, Robert B

2009-03-01

The ideal method of stem fixation in revision knee arthroplasty is controversial with advantages and disadvantages for cemented and press-fit designs. Studies have suggested cemented revision knee stems may provide better long-term survival. The aim of this study was to report our experience with press-fit uncemented stems and metaphyseal cement fixation in a selected series of patients undergoing revision total knee arthroplasty. One hundred twenty-seven patients (135 knees) who underwent revision total knee arthroplasty using a press-fit technique (press-fit diaphyseal fixation and cemented metaphyseal fixation) were reviewed. Minimum followup was 2 years (mean, 5 years; range, 2-12 years). A Kaplan-Meier survivorship analysis using an end point of revision surgery or radiographic loosening was used to determine probability of survival at 5 and 10 years. Of the 127 patients (135 knees), 31 patients (36 knees) died and two patients (two knees) were lost to followup. Six patients (six knees) had revisions at a mean of 3.5 years (range, 1-8 years). Kaplan-Meier survivorship analysis revealed a probability of survival free of revision for aseptic loosening of 98% at 12 years. Survivorship of press-fit stems for revision knee arthroplasty is comparable to reported survivorship of cemented stem revision knee arthroplasty. Radiographic analysis has shown continued satisfactory appearances regardless of constraint, stem size, and augmentations.

Outcome of prosthesis exchange for infected knee arthroplasty: the effect of treatment approach.

PubMed

Jämsen, Esa; Stogiannidis, Ioannis; Malmivaara, Antti; Pajamäki, Jorma; Puolakka, Timo; Konttinen, Yrjö T

2009-02-01

Two-stage revision remains the gold standard in the treatment of infected knee arthroplasty. Lately, good long-term results of direct exchange arthroplasty have been reported. The purpose of this literature review is to compare the clinical outcome achieved with one-stage revision and two-stage revision with different types of spacers. A thorough systematic review of literature was undertaken to idenepsy reports on the treatment alternatives. Papers written in English or including an English abstract, published from 1980 through 2005, and reporting either the success rate in eradication of infection or the clinical status achieved were reviewed. 31 original articles describing the results of 154 one-stage exchange arthoplasties and of 926 two-stage exchange arthoplasties were included. The depth of detail in the description of materials and methods varied markedly, making it impossible to perform a meta-analysis. Instead, a descriptive review of the results is presented. With a follow-up of 12-122 months, the overall success rate in eradication of infection was 73-100% after one-stage revisions and 82-100% after two-stage revisions. Reinfection rates were the lowest in series where articulating cement spacers were used, though the follow-up was relatively short. Studies using articulating spacers reported the highest average postoperative ranges of motion. Otherwise, no correlations were observed between the clinical outcome and the length of follow-up, the type of revision, or the type of spacer. The clinical outcome (knee scores and range of motion) of the one-stage revisions was no different from that of the two-stage revisions. Two-stage exchange is an effective treatment. Mobile spacers may further improve the range of motion. More experience in one-stage revision is required in order to define its role in the management of infected knee arthroplasties.

The association between bodily anxiety symptom dimensions and the scales of the Revised NEO Personality Inventory and the Temperament and Character Inventory.

PubMed

Kristensen, Ann Suhl; Mortensen, Erik Lykke; Mors, Ole

2009-01-01

The association between anxiety disorders and different measures of personality has been extensively studied to further the understanding of etiology, course, and treatment, and to possibly prevent the development of anxiety disorders. We have proposed a hierarchical model of bodily anxiety symptoms with 1 second-order severity factor and 5 first-order factors: cardio-respiratory, gastro-intestinal, autonomic, vertigo, and tension. The aim of this study was to investigate whether personality traits were differentially related to distinct symptom subdimensions or exclusively related to the general severity factor. Structural equation modeling of data on 120 patients with a primary diagnosis of social phobia and 207 patients with a primary diagnosis of panic disorder was used to examine the association between anxiety symptom dimensions and the scales of the Temperament and Character Inventory and of the Revised NEO Personality Inventory. When both sets of personality measures were simultaneously modeled as predictors, the Revised NEO Personality Inventory scales, neuroticism and extraversion, remained significantly associated with the severity factor, whereas the association between the Temperament and Character Inventory dimensions, harm avoidance and novelty seeking, and the severity factor became nonsignificant. Harm avoidance was negatively associated with the vertigo first-order factor, whereas neuroticism was negatively associated with the cardio-respiratory first-order factor, indicating that personality factors may be differentially related to specific anxiety subdimensions.

Patterns of Revision in Online Writing: A Study of Wikipedia's Featured Articles

ERIC Educational Resources Information Center

Jones, John

2008-01-01

This study examines the revision histories of 10 Wikipedia articles nominated for the site's Featured Article Class (FAC), its highest quality rating, 5 of which achieved FAC and 5 of which did not. The revisions to each article were coded, and the coding results were combined with a descriptive analysis of two representative articles in order to…

New and Revised Emissions Factors for Flares and New Emissions Factors for Certain Refinery Process Units and Determination for No Changes to VOC Emissions Factors for Tanks and Wastewater Treatment Systems

EPA Pesticide Factsheets

New and Revised Emission Factors for Flares and New Emission Factors for Certain Refinery Process Units and Determination for No Changes to VOC Emission Factors for Tanks and Wastewater Treatment Systems

Validation of the tool assessment of clinical education (AssCE): A study using Delphi method and clinical experts.

PubMed

Löfmark, Anna; Mårtensson, Gunilla

2017-03-01

The aim of the present study was to establish the validity of the tool Assessment of Clinical Education (AssCE). The tool is widely used in Sweden and some Nordic countries for assessing nursing students' performance in clinical education. It is important that the tools in use be subjected to regular audit and critical reviews. The validation process, performed in two stages, was concluded with a high level of congruence. In the first stage, Delphi technique was used to elaborate the AssCE tool using a group of 35 clinical nurse lecturers. After three rounds, we reached consensus. In the second stage, a group of 46 clinical nurse lecturers representing 12 universities in Sweden and Norway audited the revised version of the AssCE in relation to learning outcomes from the last clinical course at their respective institutions. Validation of the revised AssCE was established with high congruence between the factors in the AssCE and examined learning outcomes. The revised AssCE tool seems to meet its objective to be a validated assessment tool for use in clinical nursing education. Copyright © 2016 Elsevier Ltd. All rights reserved.

Psychometric properties of revised Thought-Action Fusion questionnaire (TAF-R) in an Iranian population.

PubMed

Pourfaraj, Majid; Mohammadi, Nourallah; Taghavi, Mohammadreza

2008-12-01

The purpose of this study is to examine the psychometric properties of Thought-Action Fusion revised scale (TAF-R; Amir, N., freshman, M., Ramsey, B., Neary, E., & Brigidi, B. (2001). Thought-action fusion in individuals with OCD symptoms. Behaviour Research and Therapy, 39, 765-776) in a sample of 565 (321 female) students of Shiraz university. The results of factor analysis with using varimax rotation yielded eight factors that explained 80% variances of total scale. These factors are labeled: moral TAF, responsibility for positive thoughts, likelihood negative events, likelihood positive events, responsibility for negative thoughts, responsibility for harm avoidance, likelihood harm avoidance and likelihood self, respectively. The reliability coefficients of total scale are calculated by two methods: internal consistency and test-retest, which were 0.81 and 0.61, respectively. Concurrent validity showed that TAF-R scores positively and significantly correlate with responsibility, guilt and obsessive-compulsive symptoms. Confirming the expectations, there were people with high obsessive-compulsive symptoms having higher TAF-R scores than those with low symptoms. Moreover, subscales-total correlations showed that the correlations between subscales were low, but subscales correlating with total score of TAF-R were moderated.

Examining the correlates of the coldheartedness factor of the Psychopathic Personality Inventory-Revised.

PubMed

Berg, Joanna M; Hecht, Lisa K; Latzman, Robert D; Lilienfeld, Scott O

2015-12-01

Coldheartedness is a subscale of the Psychopathic Personality Inventory-Revised (PPI-R) that does not load onto either of the PPI-R's two traditional higher order factors (Fearless Dominance [FD] and Self-Centered Impulsivity [SCI]). As a result, it has been omitted from analyses in many studies. However, owing to Coldheartedness's associations with lack of empathy, guilt, and deep-seated social emotions, this subscale may be highly relevant to the construct of psychopathy. In a sample of 1,158 undergraduates, we attempted to clarify Coldheartedness's correlates within the context of a nomological network of psychopathology and personality; in addition, we examined Coldheartedness's contributions to psychopathy above and beyond FD and SCI. Coldheartedness demonstrated negative correlations with the Big Five personality factors, mixed correlations with indices of impulsivity, and largely negative correlations with measures of depression and anxiety. Regressions suggested that Coldheartedness displays substantial overlap with both FD and SCI but also contains psychologically important unique variance. Although the nature of this variance requires clarification, further research and perhaps an expansion of the Coldheartedness subscale may move the field toward a clearer understanding of the construct assessed by this measure. (c) 2015 APA, all rights reserved).

The assessment of skin picking in adolescence: psychometric properties of the Skin Picking Scale-Revised (German version).

PubMed

Gallinat, Christina; Keuthen, Nancy J; Stefini, Annette; Backenstrass, Matthias

2017-02-01

Skin picking disorder has received growing attention since the release of DSM-5, yet there are no evidence-based assessment instruments for adolescent samples. The present study examines the psychometric properties of the Skin Picking Scale-Revised (SPS-R, German version) in adolescents. A total of 76 adolescents (96% female) completed the SPS-R, the Clinical Psychological Diagnostic System (KPD-38), and a questionnaire assessing demographics and clinical characteristics online. The SPS-R had high internal consistency (α = 0.89) and significant small-to-medium correlations with reduced competence skills, psychological impairment, general life satisfaction, social support, and social problems on the KPD-38. Similar to prior findings for adults, an exploratory factor analysis suggested a two-factor model for the SPS-R in adolescents. Group comparisons failed to show significant differences on SPS-R scores between participants with and without dermatological conditions. The current results suggest that the SPS-R can be useful in adolescent samples as a reliable and valid instrument for the assessment of skin picking severity. Future research investigating scale validity and factor structure in a clinical sample of adolescent skin pickers is warranted.

A Factor Analysis of The Social Interest Index--Revised.

ERIC Educational Resources Information Center

Zarski, John J.; And Others

1983-01-01

Factor analyzed the Social Interest Index-Revised (SII-R), which measures levels of social interest attained in each of four life task areas. Four factors (N=308) were defined, i.e., a self-significance factor, a love factor, a friendship factor, and a work factor. Results support the empirical validity of the scale. (Author/PAS)

A Proposal to Revise the Secondary School Curriculum in Economics

ERIC Educational Resources Information Center

Marcus, Stuart Paul; Richman, Paul Jeffrey

1978-01-01

Two high school students recommend revision of the economics component of the social studies curriculum to include study of income tax preparation, consumer fraud, investment practices, labor economics, and urban problems. (Author/DB)

Revision of the grandiosity dimension of the Dimensional Clinical Personality Inventory and verification of its psychometric properties.

PubMed

Carvalho, Lucas de Francisco; Sette, Catarina Possenti; Ferrari, Bárbara Letícia

2016-01-01

Personality disorders are among the most common disorders seen in clinical psychology. However, in Brazil there are few instruments for assessing the pathological characteristics of personality. To revise the grandiosity dimension of the Brazilian Dimensional Clinical Personality Inventory (Inventário Dimensional Clínico da Personalidade [IDCP]) and investigate its psychometric properties. A total of 225 people participated in this study. Their ages ranged from 18 to 66 years (mean [M] = 26.2, standard deviation [SD] = 8.1) and the majority were female (n = 162, 70.1%). The IDCP and the Brazilian versions of the Revised NEO Personality Inventory (NEO PI-R) and the Personality Inventory for DSM-5 (PID-5) were administered to all participants. A total of 285 new items were developed and content analysis was used to select 33 of these to comprise the final version destined for administration. The results of parallel analysis and factor analysis identified four interpretable factors. Internal consistency coefficients were deemed acceptable and varied from 0.73 to 0.84 for the factors. Additionally, the expected correlations between the IDCP Inventory and the other tests were observed. This study demonstrates the revised dimension's suitability for assessment of the pathological traits of narcissistic personality disorder.

Can Firefighters' Mental Health Be Predicted by Emotional Intelligence and Proactive Coping?

ERIC Educational Resources Information Center

Wagner, Shannon L.; Martin, Crystal A.

2012-01-01

The present study explores emotional intelligence and proactive coping as possible protective factors for both a group of paid-professional firefighters (n = 94) and a group of similar comparison participants (n = 91). Each respondent completed the Impact of Events Scale-Revised, Symptom Checklist 90-Revised, Emotional Intelligence Scale, and…

The impact of safety rules revisions on safety culture, incident rates, and liability claims in the U.S. railroad industry : a summary of lessons-learned

DOT National Transportation Integrated Search

2003-01-01

The Federal Railroad Administration (FRA) Human Factors Research and Development (R&D) Program sponsored a lessons-learned study to examine the impact of safety rules revision on safety culture, incident rates, and liability claims in the railroad in...

Temporary arthrodesis using fixator rods in two-stage revision of septic knee prothesis with severe bone and tissue defects.

PubMed

Röhner, Eric; Pfitzner, Tilman; Preininger, Bernd; Zippelius, Timo; Perka, Carsten

2016-01-01

The present study describes a new temporary arthrodesis procedure, which aims for septic knee prosthesis replacement, in particular for larger bone and soft tissue defects. Our technique offers high stability and full weight-bearing capacity of the knee joint. The study included 16 patients with major bone defects (AORI type IIb or greater) after receiving a radical debridement and a septic two-stage revision total knee arthroplasty. After removing the infected prosthesis and debridement, two AO fixator rods were positioned into the intramedullary space of the femur and tibia. Subsequently, both rods were joined tube-to-tube and adjusted in the center of the knee joint. Finally, the whole cavity of the knee joint was filled with PMMA. The number of previous surgeries, bacterial spectrum, risk factors for further infection and reinfection rates was recorded. Immediately after the temporary arthrodesis, radiographs of the knee with the enclosed spacers were taken in order to compare to previous radiographs and avoiding to miss possible spacer loosening. Nine of sixteen patients underwent more than two revision surgeries before receiving our new arthrodesis technique. No cases of spacer loosening were observed in all 16 patients; further, there were no peri-implant fractures, and four persistent infections were noted. Temporary arthrodesis using AO fixator rods offers a high stability without loosening. Its potential to replace conventional augmentation techniques should be taken into account, particularly in the case of larger bone and tissue defects. In clinical practice, the cemented spacer using AO fixator rods could be an alternative technique for temporary knee arthrodesis after septic debridement. Retrospective case series, Level IV.

Clinical characteristics, microbiology, and outcomes of prosthetic joint infection in Taiwan.

PubMed

Tsai, Jen-Chih; Sheng, Wang-Huei; Lo, Wan-Yu; Jiang, Ching-Chuan; Chang, Shan-Chwen

2015-04-01

Prosthetic joint infection (PJI) after total knee or hip replacement is a devastating complication associated with substantial morbidity and economic cost. The incidence of prosthetic joint infection is increasing as the use of mechanical joint replacement increases. The treatment approach to prosthetic joint infection is based on different clinical situations such as a patient's comorbidities, epidemic microbiology data, and surgical procedures. The aim of our study was to understand clinical characteristics of prosthetic joint infection, the microbiology of the prosthetic joint infection, and the outcomes of different treatment strategies during 2006-2011. We retrospectively collected cases of prosthetic joint infection in the National Taiwan University Hospital between January 1, 2006 and December 31, 2011. The patients' characteristics, microbiology, outcomes, and factors associated with treatment success were recorded. One hundred and forty-four patients were identified as having PJI. Of these, 92 patients were entered into per-protocol analysis. Staphylococcus aureus was the most common causative organism (29.9%), followed by coagulase-negative Staphylococci (16.7%), and Enterococci (9.7%). The overall treatment success rate was 50%. Patients who received a two-stage revision had a better outcome, compared to patients who underwent other types of surgeries (70% vs. 32.7%, respectively; p < 0.001). In multivariate analysis, the two-stage revision was significantly associated with treatment success (odds ratio = 3.923, 95% confidence interval = 1.53-10.04). Our study demonstrates that Staphylococcus aureus was the most common causative organisms in PJI. Performing two-stage revisions was significantly associated with a better outcome. Copyright © 2013. Published by Elsevier B.V.

Risk factors for baclofen pump infection in children: a multivariate analysis.

PubMed

Spader, Heather S; Bollo, Robert J; Bowers, Christian A; Riva-Cambrin, Jay

2016-06-01

OBJECTIVE Intrathecal baclofen infusion systems to manage severe spasticity and dystonia are associated with higher infection rates in children than in adults. Factors unique to this population, such as poor nutrition and physical limitations for pump placement, have been hypothesized as the reasons for this disparity. The authors assessed potential risk factors for infection in a multivariate analysis. METHODS Patients who underwent implantation of a programmable pump and intrathecal catheter for baclofen infusion at a single center between January 1, 2000, and March 1, 2012, were identified in this retrospective cohort study. The primary end point was infection. Potential risk factors investigated included preoperative (i.e., demographics, body mass index [BMI], gastrostomy tube, tracheostomy, previous spinal fusion), intraoperative (i.e., surgeon, antibiotics, pump size, catheter location), and postoperative (i.e., wound dehiscence, CSF leak, and number of revisions) factors. Univariate analysis was performed, and a multivariate logistic regression model was created to identify independent risk factors for infection. RESULTS A total of 254 patients were evaluated. The overall infection rate was 9.8%. Univariate analysis identified young age, shorter height, lower weight, dehiscence, CSF leak, and number of revisions within 6 months of pump placement as significantly associated with infection. Multivariate analysis identified young age, dehiscence, and number of revisions as independent risk factors for infection. CONCLUSIONS Young age, wound dehiscence, and number of revisions were independent risk factors for infection in this pediatric cohort. A low BMI and the presence of either a gastrostomy or tracheostomy were not associated with infection and may not be contraindications for this procedure.

A Think-Aloud Protocols Investigation of Saudi English Major Students' Writing Revision Strategies in L1 (Arabic) and L2 (English)

ERIC Educational Resources Information Center

Alhaisoni, Eid

2012-01-01

This study investigates the writing revision strategies used by 16 Saudi English as foreign language (EFL) students. Two research methods were employed. First, think-aloud reporting was used to gain insight into the thought processes utilized by the students, and to study the revision strategies that Saudi male university students make use of…

Can the presence of an infection be predicted before a revision total hip arthroplasty? Preliminary study to establish an infection score.

PubMed

Jenny, J-Y; Adamczewski, B; De Thomasson, E; Godet, J; Bonfait, H; Delaunay, C

2016-04-01

The diagnosis of periprosthetic joint infection can be challenging, in part because there is no universal diagnostic test. Current recommendations include several diagnostic criteria, and are mainly based on the results of deep microbiological samples; however, these only provide a diagnosis after surgery. A predictive infection score would improve the management of revision arthroplasty cases. The purpose of this study was to define a composite infection score using standard clinical, radiological and laboratory data that can be used to predict whether an infection is present before a total hip arthroplasty (THA) revision procedure. The infection score will make it possible to differentiate correctly between infected and non-infected patients in 75% of cases. One hundred and four records from patients who underwent THA revision for any reason were analysed retrospectively: 43 with infection and 61 without infection. There were 54 men and 50 women with an average age of 70±12 years (range 30-90). A univariate analysis was performed to look for individual discriminating factors between the data in the medical records of infected and non-infected patients. A multivariate analysis subsequently integrated these factors together. A composite score was defined and its diagnostic effectiveness was evaluated as the percentage of correctly classified records, along with its sensitivity and specificity. The score consisted of the following individually weighed factors: body mass index, presence of diabetes, mechanical complication, wound healing disturbance and fever. This composite infection score was able to distinguish correctly between the infected patients (positive score) and non-infected patients (negative score) in 78% of cases; the sensitivity was 57% and the specificity 93%. Once this score is evaluated prospectively, it could be an important tool for defining the medical - surgical strategy during THA revision, no matter the reason for revision. Level IV - retrospective study. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Effects of the Original Versus Revised Bloom's Taxonomy on Lesson Planning Skills: A Turkish Study Among Pre-Service Teachers

NASA Astrophysics Data System (ADS)

Bümen, Nilay T.

2007-07-01

The original taxonomy of educational objectives, developed by Benjamin S.␣Bloom and his associates in the 1950s, was revised several decades later by a group of educationists and cognitive psychologists, who developed a revised taxonomy (RT). This article describes a Turkish study carried out among a group of pre-service teachers in order to compare the influence of the two systems on lesson planning skills. The results confirmed other studies that have indicated a number of advantages of the revised system over the earlier one.

The psychometrics and validity of the Junior Temperament and Character Inventory in Portuguese adolescents.

PubMed

Moreira, Paulo A; Oliveira, João Tiago; Cloninger, Kevin M; Azevedo, Carla; Sousa, Alexandra; Castro, Jorge; Cloninger, C Robert

2012-11-01

Personality traits related to persistence and self-regulation of long-term goals can predict academic performance as well or better than measures of intelligence. The 5-factor model has been suggested to outperform some other personality tests in predicting academic performance, but it has not been compared to Cloninger's psychobiological model for this purpose. The aims of this study were, first, to evaluate the psychometric properties of the Junior Temperament and Character Inventory (JTCI) in adolescents in Portugal, and second, to evaluate the comparative validity of age-appropriate versions of Cloninger's 7-factor psychobiological model, Costa and McCrae's five-factor NEO-Personality Inventory-Revised, and Cattell's 16-personality-factor inventory in predicting academic achievement. All dimensions of the Portuguese JTCI had moderate to strong internal consistency. The Cattell's sixteen-personality-factor and NEO inventories provided strong construct validity for the JTCI in students younger than 17 years and for the revised adult version (TCI-Revised) in those 17 years and older. High TCI Persistence predicted school grades regardless of age as much or more than intelligence. High TCI Harm Avoidance, high Self-Transcendence, and low TCI Novelty Seeking were additional predictors in students older than 17. The psychobiological model, as measured by the JTCI and TCI-Revised, performed as well or better than other measures of personality or intelligence in predicting academic achievement. Copyright © 2012 Elsevier Inc. All rights reserved.

Investigations of Martian Impact Crater Morphologies and Morphometries

NASA Technical Reports Server (NTRS)

Barlow, Nadine G.

2002-01-01

We have made substantial progress towards completion of the original objectives and are continuing to include new data from the Mars Global Surveyor MOC and TES instruments as they become available (the MOLA instrument has ceased operation as of 2002). The project funding has been used to provide salary support to the PI and several undergraduate students, cover publication charges for two papers, reimburse travel expenses to conferences and workshops incurred by the PI and students, and cover a number of other expenses such as software upgrades and production costs of slides and color prints. This study is revising the PI's Catalog of Large Martian Impact Craters with information obtained from MGS and is utilizing data in the revised Catalog to investigate which planetary factors (such as location, elevation, terrain type, etc.) primarily affect the formation of specific ejecta morphologies and morphometries.

[Perioperative complications after total hip revision surgery and their predictive factors. A series of 181 consecutive procedures].

PubMed

de Thomasson, E; Guingand, O; Terracher, R; Mazel, C

2001-09-01

We conducted a retrospective study to assess morbidity and mortality in patients undergoing revision total hip arthroplasty (THA) procedures. Perioperative complications were recorded in 181 revision procedures (162 patients) performed between January 1995 and March 1999 (117 bipolar revisions and 64 acetabular isolated revisions). There were 86 complications (68 patients) leading to 21 new revisions. About half (50/86) were related to the surgical procedure (dislocation, femoral fracture, infection.). Life-threatening complications (3.6%) ended in patient death in 1.6% of the cases. Complications were more frequent in patients with an ASA score=3 (p<0.01) or aged over 75 years (p<0.05). Age was also predictive of femoral misalignment and fracture (p<0.05). Dislocations (8.8%) were observed more frequently in patients who had undergone more than 2 procedures prior to the revision (p<0.05) (4.8% of the dislocations in patients undergoing a first revision procedure and 14.3% in the others). In addition, peroperative blood loss and duration of the procedure were significantly greater in case of bipolar replacement than for isolated acetabular replacement (sigma > 1.96). Our experience and data in the literature point to the important age factor in the development of complications. Preservation of a well-fixed femoral component does not appear to worsen prognosis and leads to fewer complications than bipolar changes. The decision to revise a THA must take into consideration the functional impairment but also the risks inherent in revision procedures, particularly in old patients who have undergone several procedures. Revising the acetabular component alone can be an interesting option if the femoral component remains well-fixed although our follow-up is insufficient to determine whether this attitude provides better long-term outcome than complete biopolar revision. Better patient selection and improved operative technique, in particular in femur preparation, should help reduce morbidity and mortality in this type of procedure.

Outcomes following revision surgery performed for adverse reactions to metal debris in non-metal-on-metal hip arthroplasty patients

PubMed Central

Judge, A.; Murray, D. W.; Pandit, H. G.

2017-01-01

Objectives Few studies have assessed outcomes following non-metal-on-metal hip arthroplasty (non-MoMHA) revision surgery performed for adverse reactions to metal debris (ARMD). We assessed outcomes following non-MoMHA revision surgery performed for ARMD, and identified predictors of re-revision. Methods We performed a retrospective observational study using data from the National Joint Registry for England and Wales. All non-MoMHAs undergoing revision surgery for ARMD between 2008 and 2014 were included (185 hips in 185 patients). Outcome measures following ARMD revision were intra-operative complications, mortality and re-revision surgery. Predictors of re-revision were identified using Cox regression. Results Intra-operative complications occurred in 6.0% (n = 11) of the 185 cases. The cumulative four-year patient survival rate was 98.2% (95% CI 92.9 to 99.5). Re-revision surgery was performed in 13.5% (n = 25) of hips at a mean time of 1.2 years (0.1 to 3.1 years) following ARMD revision. Infection (32%; n = 8), dislocation/subluxation (24%; n = 6), and aseptic loosening (24%; n = 6) were the most common re-revision indications. The cumulative four-year implant survival rate was 83.8% (95% CI 76.7 to 88.9). Multivariable analysis identified three predictors of re-revision: multiple revision indications (hazard ratio (HR) = 2.78; 95% CI 1.03 to 7.49; p = 0.043); selective component revisions (HR = 5.76; 95% CI 1.28 to 25.9; p = 0.022); and ceramic-on-polyethylene revision bearings (HR = 3.08; 95% CI 1.01 to 9.36; p = 0.047). Conclusions Non-MoMHAs revised for ARMD have a high short-term risk of re-revision, with important predictors of future re-revision including selective component revision, multiple revision indications, and ceramic-on-polyethylene revision bearings. Our findings may help counsel patients about the risks of ARMD revision, and guide reconstructive decisions. Future studies attempting to validate the predictors identified should also assess the effects of implant design (metallurgy and modularity), given that this was an important study limitation potentially influencing the reported prognostic factors. Cite this article: G. S. Matharu, A. Judge, D. W. Murray, H. G. Pandit. Outcomes following revision surgery performed for adverse reactions to metal debris in non-metal-on-metal hip arthroplasty patients: Analysis of 185 revisions from the National Joint Registry for England and Wales. Bone Joint Res 2017;6:405–413. DOI: 10.1302/2046-3758.67.BJR-2017-0017.R2. PMID:28710154

A comparative study on assessment procedures and metric properties of two scoring systems of the Coma Recovery Scale-Revised items: standard and modified scores.

PubMed

Sattin, Davide; Lovaglio, Piergiorgio; Brenna, Greta; Covelli, Venusia; Rossi Sebastiano, Davide; Duran, Dunja; Minati, Ludovico; Giovannetti, Ambra Mara; Rosazza, Cristina; Bersano, Anna; Nigri, Anna; Ferraro, Stefania; Leonardi, Matilde

2017-09-01

The study compared the metric characteristics (discriminant capacity and factorial structure) of two different methods for scoring the items of the Coma Recovery Scale-Revised and it analysed scale scores collected using the standard assessment procedure and a new proposed method. Cross sectional design/methodological study. Inpatient, neurological unit. A total of 153 patients with disorders of consciousness were consecutively enrolled between 2011 and 2013. All patients were assessed with the Coma Recovery Scale-Revised using standard (rater 1) and inverted (rater 2) procedures. Coma Recovery Scale-Revised score, number of cognitive and reflex behaviours and diagnosis. Regarding patient assessment, rater 1 using standard and rater 2 using inverted procedures obtained the same best scores for each subscale of the Coma Recovery Scale-Revised for all patients, so no clinical (and statistical) difference was found between the two procedures. In 11 patients (7.7%), rater 2 noted that some Coma Recovery Scale-Revised codified behavioural responses were not found during assessment, although higher response categories were present. A total of 51 (36%) patients presented the same Coma Recovery Scale-Revised scores of 7 or 8 using a standard score, whereas no overlap was found using the modified score. Unidimensionality was confirmed for both score systems. The Coma Recovery Scale Modified Score showed a higher discriminant capacity than the standard score and a monofactorial structure was also supported. The inverted assessment procedure could be a useful evaluation method for the assessment of patients with disorder of consciousness diagnosis.

Does Manipulation under Anesthesia Increase the Risk of Revision Total Knee Arthroplasty? A Matched Case Control Study.

PubMed

Pierce, Todd P; Issa, Kimona; Festa, Anthony; Scillia, Anthony J; McInerney, Vincent K; Mont, Michael A

2017-09-01

Manipulation under anesthesia (MUA) can help patients regain an adequate range of motion (ROM) following total knee arthroplasty (TKA). Although there are studies reporting that MUA can assist in improving ROM, there is a paucity of studies regarding whether requiring an MUA is associated with an increased risk of revision. The purpose of this study was to assess the: (1) incidence of revision TKA and (2) outcomes of those undergoing MUA and compare it with a matched cohort who did not require MUA. A prospectively collected database of two high-volume institutions was assessed for patients who required a single MUA following TKA between 2005 and 2011. We found a total of 138 knees with a mean 8.5-year follow-up post-MUA. We compared this with a matched cohort (1:1) who underwent TKA during this same time period but did not require an MUA. Incidence of revision surgery and clinical outcomes were compared between the two cohorts. Within the MUA cohort, nine knees underwent revision, which was similar to the matched cohort that had seven revisions (93 vs. 95%; p  = 0.6). The mean KSS-functional (88 vs. 90 points; p  = 0.15) and clinical scores (87 vs. 89 points; p  = 0.1) were similar between the two cohorts. Undergoing an MUA was not associated with an increased risk of revision TKA. If patients require MUA, they may still achieve satisfactory outcomes. This information can be used in educating patients so they may be able to formulate their expectations following their MUA. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Measuring Bystander Attitudes and Behavior to Prevent Sexual Violence

ERIC Educational Resources Information Center

McMahon, Sarah; Allen, Christopher T.; Postmus, Judy L.; McMahon, Sheila M.; Peterson, N. Andrew; Lowe Hoffman, Melanie

2014-01-01

Objective: The purpose of this study is to further investigate the factor structure and strength of the Bystander Attitude Scale-Revised and Bystander Behavior Scale-Revised (BAS-R and BBS-R). Participants: First-year students (N = 4,054) at a large public university in the Northeast completed a survey in 2010 as part of a larger longitudinal…

A Psychometric Evaluation of the Achievement Goal Questionnaire-Revised in Singapore Secondary Students

ERIC Educational Resources Information Center

Ning, Hoi Kwan

2017-01-01

This study examined the psychometric properties of the Achievement Goal Questionnaire-Revised (AGQ-R) in a sample of Singapore secondary students (N = 1,171). Confirmatory factor analyses provided support for the AGQ-R in measuring the four achievements goals delineated in the 2 × 2 framework. Measurement invariance across ethnic groups was…

Measuring Change in Career Counseling: Validation of the "Career Futures Inventory-Revised"

ERIC Educational Resources Information Center

Rottinghaus, Patrick J.; Eshelman, Alec; Gore, Jonathan S.; Keller, Kari J.; Schneider, Madalyn; Harris, Kristine L.

2017-01-01

This retrospective chart review study examined the factor structure of the "Career Futures Inventory-Revised" (CFI-R; Rottinghaus et al. in "J Career Assess" 20:123-139, 2012) and its utility as a career counseling outcome measure using a sample of 332 clients from a university career center. The CFI-R examines career agency…

A Factor Analysis of the Bem Sex Role Inventory and the Personal Attributes Questionnaire.

ERIC Educational Resources Information Center

Choi, Namok; Jenkins, Stephen J.

This study investigated the dimensions of sex role orientation measured by the revised Bem Sex Role Inventory (BSRI; S. Bem, 1974) and the revised Personal Attributes Questionnaire (PAQ; J. Spence, R. Helmreich, and J. Strapp, 1975). Participants were 651 undergraduates in introductory psychology courses. The sample was approximately 50% male and…

Psychometric Characteristics of the Persian Version of the Multidimensional School Anger Inventory-Revised

ERIC Educational Resources Information Center

Aryadoust, Vahid; Akbarzadeh, Sanaz; Akbarzedeh, Sara

2011-01-01

The Multidimensional School Anger Inventory-Revised (MSAI-R) is a measurement tool to evaluate high school students' anger. Its psychometric features have been tested in the USA, Australia, Japan, Guatemala, and Italy. This study investigates the factor structure and psychometric quality of the Persian version of the MSAI-R using data from an…

A Revised Version of the Norwegian Adaptation of the Test Anxiety Inventory in a Heterogeneous Population

ERIC Educational Resources Information Center

Oktedalen, Tuva; Hagtvet, Knut A.

2011-01-01

Confirmatory factor analysis and Multiple Indicators, Multiple Causes (MIMIC) modeling were employed to investigate psychometric properties of a revised adaptation of the Norwegian version of the Test Anxiety Inventory (RTAIN) in a sample of 456 students. The study supported the Norwegian version as a useful inventory for measuring the components…

Survivorship and patient satisfaction of robotic-assisted medial unicompartmental knee arthroplasty at a minimum two-year follow-up.

PubMed

Pearle, Andrew D; van der List, Jelle P; Lee, Lily; Coon, Thomas M; Borus, Todd A; Roche, Martin W

2017-03-01

Successful clinical outcomes following unicompartmental knee arthroplasty (UKA) depend on lower limb alignment, soft tissue balance and component positioning, which can be difficult to control using manual instrumentation. Although robotic-assisted surgery more reliably controls these surgical factors, studies assessing outcomes of robotic-assisted UKA are lacking. Therefore, a prospective multicenter study was performed to assess outcomes of robotic-assisted UKA. A total of 1007 consecutive patients (1135 knees) underwent robotic-assisted medial UKA surgery from six surgeons at separate institutions between March 2009 and December 2011. All patients received a fixed-bearing metal-backed onlay implant as tibial component. Each patient was contacted at minimum two-year follow-up and asked a series of five questions to determine survivorship and patient satisfaction. Worst-case scenario analysis was performed whereby all patients were considered as revision when they declined participation in the study. Data was collected for 797 patients (909 knees) with average follow-up of 29.6months (range: 22-52months). At 2.5-years of follow-up, 11 knees were reported as revised, which resulted in a survivorship of 98.8%. Thirty-five patients declined participation in the study yielding a worst-case survivorship of 96.0%. Of all patients without revision, 92% was either very satisfied or satisfied with their knee function. In this multicenter study, robotic-assisted UKA was found to have high survivorship and satisfaction rate at short-term follow-up. Prospective comparison studies with longer follow-up are necessary in order to compare survivorship and satisfaction rates of robotic-assisted UKA to conventional UKA and total knee arthroplasty. Copyright © 2016 Elsevier B.V. All rights reserved.

77 FR 67644 - Examination Rating System

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-13

... entities are to be evaluated included a list of ``evaluative factors'' relating to the particular component... revisions or additions to the evaluative factors or the components, which are described briefly below. Under the ``Capital'' component, FHFA has revised the fourth bullet paragraph of evaluative factors...

A GIS-assisted regional screening tool to evaluate the leaching potential of volatile and non-volatile pesticides

NASA Astrophysics Data System (ADS)

Ki, Seo Jin; Ray, Chittaranjan

2015-03-01

A regional screening tool-which is useful in cases where few site-specific parameters are available for complex vadose zone models-assesses the leaching potential of pollutants to groundwater over large areas. In this study, the previous pesticide leaching tool used in Hawaii was revised to account for the release of new volatile organic compounds (VOCs) from the soil surface. The tool was modified to introduce expanded terms in the traditional pesticide ranking indices (i.e., retardation and attenuation factors), allowing the estimation of the leaching fraction of volatile chemicals based on recharge, soil, and chemical properties to be updated. Results showed that the previous tool significantly overestimated the mass fraction of VOCs leached through soils as the recharge rates increased above 0.001801 m/d. In contrast, the revised tool successfully delineated vulnerable areas to the selected VOCs based on two reference chemicals, a known leacher and non-leacher, which were determined in local conditions. The sensitivity analysis with the Latin-Hypercube-One-factor-At-a-Time method revealed that the new leaching tool was most sensitive to changes in the soil organic carbon sorption coefficient, fractional organic carbon content, and Henry's law constant; and least sensitive to parameters such as the bulk density, water content at field capacity, and particle density in soils. When the revised tool was compared to the analytical (STANMOD) and numerical (HYDRUS-1D) models as a susceptibility measure, it ranked particular VOCs well (e.g., benzene, carbofuran, and toluene) that were consistent with other two models under the given conditions. Therefore, the new leaching tool can be widely used to address intrinsic groundwater vulnerability to contamination of pesticides and VOCs, along with the DRASTIC method or similar Tier 1 models such as SCI-GROW and WIN-PST.

Accuracy of Revised and Traditional Parallel Analyses for Assessing Dimensionality with Binary Data

ERIC Educational Resources Information Center

Green, Samuel B.; Redell, Nickalus; Thompson, Marilyn S.; Levy, Roy

2016-01-01

Parallel analysis (PA) is a useful empirical tool for assessing the number of factors in exploratory factor analysis. On conceptual and empirical grounds, we argue for a revision to PA that makes it more consistent with hypothesis testing. Using Monte Carlo methods, we evaluated the relative accuracy of the revised PA (R-PA) and traditional PA…

China's position in negotiating the Framework Convention on Tobacco Control and the revised International Health Regulations.

PubMed

Huang, Y

2014-02-01

This paper examines China's position in the negotiations of the Framework Convention on Tobacco Control and the revised International Health Regulations. In particular, it explores three sets of factors shaping China's attitudes and actions in the negotiations: the aspiration to be a responsible power; concerns about sovereignty; and domestic political economy. In both cases, China demonstrated strong incentives to participate in the negotiation of legally binding international rules. Still, the sovereignty issue was a major, if not the biggest, concern for China when engaging in global health rule making. The two cases also reveal domestic political economy as an important factor in shaping China's position in international health negotiations. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

42 CFR 412.517 - Revision of LTC-DRG group classifications and weighting factors.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Revision of LTC-DRG group classifications and... classifications and weighting factors. (a) CMS adjusts the classifications and weighting factors annually to... the LTC-DRG classifications and recalibration of the weighting factors described in paragraph (a) of...

42 CFR 412.517 - Revision of LTC-DRG group classifications and weighting factors.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Revision of LTC-DRG group classifications and... classifications and weighting factors. (a) CMS adjusts the classifications and weighting factors annually to... the LTC-DRG classifications and recalibration of the weighting factors described in paragraph (a) of...

78 FR 18817 - Revisions to Reliability Standard for Transmission Vegetation Management

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-28

... related violation risk factors, except that it directs a revision to the violation risk factor... proposed assignment of a ``medium'' Violation Risk Factor to Requirement R2, which pertains to preventing..., within 60 days of the effective date of the Final Rule, assigning a ``high'' Violation Risk Factor for...

Pregnancy-specific distress: the role of maternal sense of coherence and antenatal mothering orientations.

PubMed

Staneva, Aleksandra; Morawska, Alina; Bogossian, Fiona; Wittkowski, Anja

2016-10-01

Maternal mental health during pregnancy has been identified as a key factor in the future physiological, emotional and social development of both the mother and her baby. Yet little is known about the factors that contribute to increased levels of pregnancy-specific distress. The present study investigated the role of two psychosocial and personality-based constructs, namely women's sense of coherence (SoC) and their mothering orientations, on their pregnancy-specific distress. During their second trimester of pregnancy, 293 Australian and New Zealand women participated in an online study. Hierarchical multiple regression analysis was used to determine the unique contribution of women's SoC (Sense of Coherence Scale, SoC 13) and their antenatal mothering orientation (Antenatal Mothering Orientation Measure-Revised, AMOM-R) to pregnancy-specific distress (Revised Prenatal Distress Questionnaire, NuPDQ). Low SoC was the best determinant of women's pregnancy-specific distress, accounting for over 45% of the variance (β = -0.33, p < 0.001, 95% CI [-0.43, -0.23]). A Regulator mothering orientation was correlated with distress but did not have a unique contribution in the final model. This study further highlights the importance of better understanding women's perceptions of emotional health and their mothering role while taking into consideration their wider social context.

Dealing with the predicted increase in demand for revision total knee arthroplasty: challenges, risks and opportunities.

PubMed

Hamilton, D F; Howie, C R; Burnett, R; Simpson, A H R W; Patton, J T

2015-06-01

Worldwide rates of primary and revision total knee arthroplasty (TKA) are rising due to increased longevity of the population and the burden of osteoarthritis. Revision TKA is a technically demanding procedure generating outcomes which are reported to be inferior to those of primary knee arthroplasty, and with a higher risk of complication. Overall, the rate of revision after primary arthroplasty is low, but the number of patients currently living with a TKA suggests a large potential revision healthcare burden. Many patients are now outliving their prosthesis, and consideration must be given to how we are to provide the necessary capacity to meet the rising demand for revision surgery and how to maximise patient outcomes. The purpose of this review was to examine the epidemiology of, and risk factors for, revision knee arthroplasty, and to discuss factors that may enhance patient outcomes. ©2015 The British Editorial Society of Bone & Joint Surgery.

Indications and risk factors for midurethral sling revision.

PubMed

Unger, Cecile A; Rizzo, Anthony E; Ridgeway, Beri

2016-01-01

To determine the indications and risk factors for needing midurethral sling revision in a cohort of women undergoing midurethral sling placement. This was a case-control study of all women undergoing midurethral sling placement for stress urinary incontinence (SUI) between January 2003 and December 2013. Cases were patients who underwent midurethral sling placement followed by sling revision (incision, partial or complete excision). Controls were patients who underwent sling placement only. Once all subjects had been identified, the electronic medical record was queried for demographic and perioperative and postoperative data. Of 3,307 women who underwent sling placement, 89 (2.7%, 95% CI 1.9 - 3.4) underwent sling revision for one or more of the following indications: urinary retention (43.8%), voiding dysfunction (42.7%), recurrent urinary tract infection (20.2%), mesh erosion (21.3%), vaginal pain/dyspareunia (7.9%), and groin pain (3.4%). The median time from the index to the revision surgery was 7.8 months (2.3 - 17.9 months), but was significantly shorter in patients with urinary retention. The type of sling placed (retropubic or transobturator) was not associated with indication for revision. Patients who underwent revision surgery were more likely to have had previous SUI surgery (adjusted odds ratio 4.4, 95% CI 1.7 - 6.5) and to have undergone concomitant vaginal apical suspension (adjusted odds ratio 2.4, 95% CI 1.4 - 4.5). The rate of sling revision after midurethral sling placement was 2.7%. Urinary retention and voiding dysfunction were the most common indications. Patients with a history of previous SUI surgery and concomitant apical suspension at the time of sling placement may be at higher risk of requiring revision surgery.

A health literacy and usability heuristic evaluation of a mobile consumer health application.

PubMed

Monkman, Helen; Kushniruk, Andre

2013-01-01

Usability and health literacy are two critical factors in the design and evaluation of consumer health information systems. However, methods for evaluating these two factors in conjunction remain limited. This study adapted a set of existing guidelines for the design of consumer health Web sites into evidence-based evaluation heuristics tailored specifically for mobile consumer health applications. In order to test the approach, a mobile consumer health application (app) was then evaluated using these heuristics. In addition to revealing ways to improve the usability of the system, this analysis identified opportunities to augment the content to make it more understandable by users with limited health literacy. This study successfully demonstrated the utility of converting existing design guidelines into heuristics for the evaluation of usability and health literacy. The heuristics generated could be applied for assessing and revising other existing consumer health information systems.

Sibling relationships in individuals with Angelman syndrome: a comparative study.

PubMed

Love, Victoria; Richters, Lotte; Didden, Robert; Korzilius, Hubert; Machalicek, Wendy

2012-01-01

Investigating the impact of Angelman syndrome on the sibling relationship. This study explored differences in sibling relationships between children with a typically-developing sibling (n = 55) and children with a sibling with Angelman syndrome (n = 44). Sibling relationships were compared on four factors and 16 sub-scales of the Sibling Relationship Questionnaire-Revised. Results showed significant differences in mean scores on each of the four factors (i.e. Warmth/Closeness, Conflict, Rivalry and Dominance/Nurturance) and most of the sub-scales. ANCOVAs showed that demographic variables (number of siblings, living in a two-parent vs single parent household, gender, participant's age, place of residence) did not influence significant differences in sibling relationships between the two groups. Having a brother or sister with Angelman syndrome may influence the way in which the sibling perceives the sibling relationship. This may have important implications for family-centred intervention for this population.

[Confirmative study of a French version of the Exercise Dependence Scale-revised with a French population].

PubMed

Allegre, B; Therme, P

2008-10-01

Since the first writings on excessive exercise, there has been an increased interest in exercise dependence. One of the major consequences of this increased interest has been the development of several definitions and measures of exercise dependence. The work of Veale [Does primary exercise dependence really exist? In: Annet J, Cripps B, Steinberg H, editors. Exercise addiction: Motivation for participation in sport and exercise.Leicester, UK: Br Psychol Soc; 1995. p. 1-5.] provides an advance for the definition and measure of exercise dependence. These studies have adapted the DSM-IV criteria for substance dependence to measure exercise dependence. The Exercise Dependence Scale-Revised is based on these diagnostic criteria, which are: tolerance; withdrawal effects; intention effect; lack of control; time; reductions in other activities; continuance. Confirmatory factor analyses of EDS-R provided support to present a measurement model (21 items loaded in seven factors) of EDS-R (Comparative Fit Index=0.97; Root mean Square Error of Approximation=0.05; Tucker-Lewis Index=0.96). The aim of this study was to examine the psychometric properties of a French version of the EDS-R [Factorial validity and psychometric examination of the exercise dependence scale-revised. Meas Phys Educ Exerc Sci 2004;8(4):183-201.] to test the stability of the seven-factor model of the original version with a French population. A total of 516 half-marathoners ranged in age from 17 to 74 years old (Mean age=39.02 years, ET=10.64), with 402 men (77.9%) and 114 women (22.1%) participated in the study. The principal component analysis results in a six-factor structure, which accounts for 68.60% of the total variance. Because principal component analysis presents a six-factor structure differing from the original seven-factor structure, two models were tested, using confirmatory factor analysis. The first model is the seven-factor model of the original version of the EDS-R and the second is the model produced by the principal component analysis. The results of confirmatory factor analysis presented the original model (with a seven-factor structure) as a good model and fit indices were good (X(2)/ddl=2.89, Root Mean Square Error of Approximation (RMSEA)=0.061, Expected Cross Validation Index (ECVI)=1.20, Goodness-of-Fit Index (GFI)=0.92, Comparative Fit Index (CFI)=0.94, Standardized Root Mean Square (SRMS)=0.048). These results showed that the French version of EDS-R has an identical factor structure to the original. Therefore, the French version of EDS-R was an acceptable scale to measure exercise dependence and can be used on a French population.

Reliability and validity of the Japanese version of the Organizational Justice Questionnaire.

PubMed

Inoue, Akiomi; Kawakami, Norito; Tsutsumi, Akizumi; Shimazu, Akihito; Tsuchiya, Masao; Ishizaki, Masao; Tabata, Masaji; Akiyama, Miki; Kitazume, Akiko; Kuroda, Mitsuyo; Kivimäki, Mika

2009-01-01

Previous European studies reporting low procedural justice and low interactional justice were associated with increased health problems have used a modified version of the Moorman's Organizational Justice Questionnaire (OJQ, Elovainio et al., 2002) to assess organizational justice. We translated the modified OJQ into the Japanese language and examined the internal consistency reliability, and factor-based and construct validity of this measure. A back-translation procedure confirmed that the translation was appropriate, pending a minor revision. A total of 185 men and 58 women at a manufacturing factory in Japan were surveyed using a mailed questionnaire including the OJQ and other job stressors. Cronbach alpha coefficients of the two OJQ subscales were high (0.85-0.94) for both sexes. The hypothesized two factors (i.e., procedural justice and interactional justice) were extracted by the factor analysis for men; for women, procedural justice was further split into two separate dimensions supporting a three- rather than two-factor structure. Convergent validity was supported by expected correlations of the OJQ with job control, supervisor support, effort-reward imbalance, and job future ambiguity in particular among the men. The present study shows that the Japanese version of the OJQ has acceptable levels of reliability and validity at least for male employees.

Factors of psychopathy and electrocortical response to emotional pictures: Further evidence for a two-process theory.

PubMed

Venables, Noah C; Hall, Jason R; Yancey, James R; Patrick, Christopher J

2015-05-01

The Two-Process theory of psychopathy posits that distinct etiological mechanisms contribute to the condition: (a) a weakness in defensive (fear) reactivity related to affective-interpersonal features, and (b) impaired cognitive-executive functioning, marked by reductions in brain responses such as P3, related to impulsive-antisocial features. The current study examined relations between psychopathy factors and electrocortical response to emotional and neutral pictures in male offenders (N = 139) assessed using the Psychopathy Checklist-Revised (PCL-R). Impulsive-antisocial features of the PCL-R (Factor 2) were associated with reduced amplitude of earlier P3 brain response to pictures regardless of valence, whereas the affective-interpersonal dimension (Factor 1) was associated specifically with reductions in late positive potential response to aversive pictures. Findings provide further support for the Two-Process theory and add to a growing body of evidence linking the impulsive-antisocial facet of psychopathy to the broader construct of externalizing proneness. Findings are discussed in terms of current initiatives directed at incorporating neuroscientific concepts into psychopathology classification. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Factors of Psychopathy and Electrocortical Response to Emotional Pictures: Further Evidence for a Two-Process Theory

PubMed Central

Venables, Noah C.; Hall, Jason R.; Yancey, James R.; Patrick, Christopher J.

2014-01-01

The Two-Process theory of psychopathy posits distinct etiological mechanisms contribute to the disorder: 1) a weakness in defensive (fear) reactivity related to affective-interpersonal features, and 2) impaired cognitive-executive functioning, marked by reductions in brain responses such as P3, related to impulsive-antisocial features. The current study examined relations between psychopathy factors and electrocortical response to emotional and neutral pictures in male offenders (N=139) assessed using the Psychopathy Checklist-Revised (PCL-R). Impulsive-antisocial features of the PCL-R (Factor 2) were associated with reduced amplitude of earlier P3 brain response to pictures regardless of valence, whereas the affective-interpersonal dimension (Factor 1) was associated specifically with reductions in late positive potential response to aversive pictures. Findings provide further support for the Two-Process theory and add to a growing body of evidence linking the impulsive-antisocial facet of psychopathy to the broader construct of externalizing proneness. Findings are discussed in terms of current initiatives directed at incorporating neuroscientific concepts into psychopathology classification. PMID:25603361

Factor Structure and Psychometric Properties of the Revised Home Situations Questionnaire for Autism Spectrum Disorder: The Home Situations Questionnaire-Autism Spectrum Disorder

ERIC Educational Resources Information Center

Chowdhury, Monali; Aman, Michael G.; Lecavalier, Luc; Smith, Tristram; Johnson, Cynthia; Swiezy, Naomi; McCracken, James T.; King, Bryan; McDougle, Christopher J.; Bearss, Karen; Deng, Yanhong; Scahill, Lawrence

2016-01-01

Previously, we adapted the Home Situations Questionnaire to measure behavioral non-compliance in everyday settings in children with pervasive developmental disorders. In this study, we further revised this instrument for use in autism spectrum disorder and examined its psychometric properties (referred to as the Home Situations…

Development and Application of a Message Metric for NOAA NWS Tsunami Warnings and Recommended Guidelines for the NWS TsunamiReady Program

NASA Astrophysics Data System (ADS)

Gregg, C. E.; Johnston, D. M.; Ricthie, L.; Meinhold, S.; Johnson, V.; Scott, C.; Farnham, C.; Houghton, B. F.; Horan, J.; Gill, D.

2012-12-01

Improving the quality and effectiveness of tsunami warning messages and the TsunamiReady community preparedness program of the US National Oceanic and Atmospheric Administration, National Weather Service's (NWS), Tsunami Program are two key objectives of a three year project (Award NA10NWS4670015) to help integrate social science into the NWS' Tsunami Program and improve the preparedness of member states and territories of the National Tsunami Hazard Mitigation Program (NTHMP). Research was conducted in collaboration with state and local emergency managers. Based on findings from focus group meetings with a purposive sample of local, state and Federal stakeholders and emergency managers in six states (AK, WA, OR, CA, HI and NC) and two US Territories (US Virgin Islands and American Samoa), and upon review of research literature on behavioral response to warnings, we developed a warning message metric to help guide revisions to tsunami warning messages issued by the NWS' West Coast/Alaska Tsunami Warning Center, Alaska and Pacific Tsunami Warning Center, Hawaii. The metric incorporates factors that predict response to warning information, which are divided into categories of Message Content, Style, Order and Formatting and Receiver Characteristics. A message is evaluated by cross-referencing the message with the meaning of metric factors and assigning a maximum score of one point per factor. Findings are then used to guide revisions of the message until the characteristics of each factor are met. From focus groups that gathered information on the usefulness and achievability of tsunami preparedness actions, we developed recommendations for revisions to the proposed draft guidelines of the TsunamiReady Improvement Program. Proposed key revisions include the incorporation of community vulnerability to distant (far-field) versus local (near-field) tsunamis as a primary determinant of mandatory actions, rather than community population. Our team continues to work with NWS personnel, including a NWS Tsunami Warning Improvement Team, and the focus group participants to finalize and pilot test prototype warning products and the draft TsunamiReady guidelines.

Outcomes following revision surgery performed for adverse reactions to metal debris in non-metal-on-metal hip arthroplasty patients: Analysis of 185 revisions from the National Joint Registry for England and Wales.

PubMed

Matharu, G S; Judge, A; Murray, D W; Pandit, H G

2017-07-01

Few studies have assessed outcomes following non-metal-on-metal hip arthroplasty (non-MoMHA) revision surgery performed for adverse reactions to metal debris (ARMD). We assessed outcomes following non-MoMHA revision surgery performed for ARMD, and identified predictors of re-revision. We performed a retrospective observational study using data from the National Joint Registry for England and Wales. All non-MoMHAs undergoing revision surgery for ARMD between 2008 and 2014 were included (185 hips in 185 patients). Outcome measures following ARMD revision were intra-operative complications, mortality and re-revision surgery. Predictors of re-revision were identified using Cox regression. Intra-operative complications occurred in 6.0% (n = 11) of the 185 cases. The cumulative four-year patient survival rate was 98.2% (95% CI 92.9 to 99.5). Re-revision surgery was performed in 13.5% (n = 25) of hips at a mean time of 1.2 years (0.1 to 3.1 years) following ARMD revision. Infection (32%; n = 8), dislocation/subluxation (24%; n = 6), and aseptic loosening (24%; n = 6) were the most common re-revision indications. The cumulative four-year implant survival rate was 83.8% (95% CI 76.7 to 88.9). Multivariable analysis identified three predictors of re-revision: multiple revision indications (hazard ratio (HR) = 2.78; 95% CI 1.03 to 7.49; p = 0.043); selective component revisions (HR = 5.76; 95% CI 1.28 to 25.9; p = 0.022); and ceramic-on-polyethylene revision bearings (HR = 3.08; 95% CI 1.01 to 9.36; p = 0.047). Non-MoMHAs revised for ARMD have a high short-term risk of re-revision, with important predictors of future re-revision including selective component revision, multiple revision indications, and ceramic-on-polyethylene revision bearings. Our findings may help counsel patients about the risks of ARMD revision, and guide reconstructive decisions. Future studies attempting to validate the predictors identified should also assess the effects of implant design (metallurgy and modularity), given that this was an important study limitation potentially influencing the reported prognostic factors. Cite this article: G. S. Matharu, A. Judge, D. W. Murray, H. G. Pandit. Outcomes following revision surgery performed for adverse reactions to metal debris in non-metal-on-metal hip arthroplasty patients: Analysis of 185 revisions from the National Joint Registry for England and Wales. Bone Joint Res 2017;6:405-413. DOI: 10.1302/2046-3758.67.BJR-2017-0017.R2. © 2017 Matharu et al.

Confirmatory Factor Analysis of the Delirium Rating Scale Revised-98 (DRS-R98).

PubMed

Thurber, Steven; Kishi, Yasuhiro; Trzepacz, Paula T; Franco, Jose G; Meagher, David J; Lee, Yanghyun; Kim, Jeong-Lan; Furlanetto, Leticia M; Negreiros, Daniel; Huang, Ming-Chyi; Chen, Chun-Hsin; Kean, Jacob; Leonard, Maeve

2015-01-01

Principal components analysis applied to the Delirium Rating Scale-Revised-98 contributes to understanding the delirium construct. Using a multisite pooled international delirium database, the authors applied confirmatory factor analysis to Delirium Rating Scale-Revised-98 scores from 859 adult patients evaluated by delirium experts (delirium, N=516; nondelirium, N=343). Confirmatory factor analysis found all diagnostic features and core symptoms (cognitive, language, thought process, sleep-wake cycle, motor retardation), except motor agitation, loaded onto factor 1. Motor agitation loaded onto factor 2 with noncore symptoms (delusions, affective lability, and perceptual disturbances). Factor 1 loading supports delirium as a single construct, but when accompanied by psychosis, motor agitation's role may not be solely as a circadian activity indicator.

Case studies on forecasting for innovative technologies: frequent revisions improve accuracy.

PubMed

Lerner, Jeffrey C; Robertson, Diane C; Goldstein, Sara M

2015-02-01

Health technology forecasting is designed to provide reliable predictions about costs, utilization, diffusion, and other market realities before the technologies enter routine clinical use. In this article we address three questions central to forecasting's usefulness: Are early forecasts sufficiently accurate to help providers acquire the most promising technology and payers to set effective coverage policies? What variables contribute to inaccurate forecasts? How can forecasters manage the variables to improve accuracy? We analyzed forecasts published between 2007 and 2010 by the ECRI Institute on four technologies: single-room proton beam radiation therapy for various cancers; digital breast tomosynthesis imaging technology for breast cancer screening; transcatheter aortic valve replacement for serious heart valve disease; and minimally invasive robot-assisted surgery for various cancers. We then examined revised ECRI forecasts published in 2013 (digital breast tomosynthesis) and 2014 (the other three topics) to identify inaccuracies in the earlier forecasts and explore why they occurred. We found that five of twenty early predictions were inaccurate when compared with the updated forecasts. The inaccuracies pertained to two technologies that had more time-sensitive variables to consider. The case studies suggest that frequent revision of forecasts could improve accuracy, especially for complex technologies whose eventual use is governed by multiple interactive factors. Project HOPE—The People-to-People Health Foundation, Inc.

Revision surgery of metal-on-metal hip arthroplasties for adverse reactions to metal debris.

PubMed

Matharu, Gulraj S; Eskelinen, Antti; Judge, Andrew; Pandit, Hemant G; Murray, David W

2018-06-01

Background and purpose - The initial outcomes following metal-on-metal hip arthroplasty (MoMHA) revision surgery performed for adverse reactions to metal debris (ARMD) were poor. Furthermore, robust thresholds for performing ARMD revision are lacking. This article is the second of 2. The first article considered the various investigative modalities used during MoMHA patient surveillance (Matharu et al. 2018a ). The present article aims to provide a clinical update regarding ARMD revision surgery in MoMHA patients (hip resurfacing and large-diameter MoM total hip arthroplasty), with specific focus on the threshold for performing ARMD revision, the surgical strategy, and the outcomes following revision. Results and interpretation - The outcomes following ARMD revision surgery appear to have improved with time for several reasons, among them the introduction of regular patient surveillance and lowering of the threshold for performing revision. Furthermore, registry data suggest that outcomes following ARMD revision are influenced by modifiable factors (type of revision procedure and bearing surface implanted), meaning surgeons could potentially reduce failure rates. However, additional large multi-center studies are needed to develop robust thresholds for performing ARMD revision surgery, which will guide surgeons' treatment of MoMHA patients. The long-term systemic effects of metal ion exposure in patients with these implants must also be investigated, which will help establish whether there are any systemic reasons to recommend revision of MoMHAs.

[The School Refusal Assessment Scale: Psychometric properties and validation of a modified version].

PubMed

Knollmann, Martin; Sicking, Alexander; Hebebrand, Johannes; Reissner, Volker

2017-07-01

Psychometric properties of the original and a modified version of the «Einschätzungsskala der Schulverweigerung» (German version of the School Refusal Assessment Scale, SRAS; Kearney & Silverman, 1993; Overmeyer et al., 1994) were analyzed in order to identify alternative ways to revise the SRAS/ESV compared to the existing revision SRAS-R (Kearney, 2002). The SRAS/ESV consists of a parent and a child version and measures four functions of school refusal (avoidance of negative affect related to school settings, escape from aversive social or evaluative situations, attention-getting behavior, positive tangible reinforcement). Data from N = 124 (parent version) respectively N = 156 (child version) patients of a specialized psychiatric outpatient unit for children and adolescents with school-avoiding behavior were obtained. Analyzes included characteristics of items and scales, face-, factorial-, and construct-validity (correlations with other questionnaires, e. g., YSR, CBCL were analyzed). Many items seem to measure overall anxiety instead of the functional aspects of school refusal, one item measures expansive behavior. Four factors were obtained, but they did not reflect the assumed structure of the ESV (e. g., overlap of the two avoidance-related scales). Post-hoc-analyzes with a modified version (elimination of several items with problematic content validity) suggested three factors, convergent and discriminative validity of the modified version was confirmed. Because only some of the afore-mentioned problems have been addressed in the revised version (SRAS-R; Kearney, 2002), a new revision and extension of the German version of the questionnaire covering more aspects of school avoidance behavior (e. g., bullying, depression, somatic complaints, psychosocial factors) is discussed.

Knowing-It-All but Still Learning: Perceptions of One's Own Knowledge and Belief Revision

ERIC Educational Resources Information Center

Hagá, Sara; Olson, Kristina R.

2017-01-01

Lay theories suggest that people who are overconfident in their knowledge are less likely to revise that knowledge when someone else offers an alternative belief. Similarly, one might assume that people who "are" willing to revise their beliefs might not be very confident in their knowledge to begin with. Two studies with children ages…

Evaluation of Students' Perceptions Towards An Innovative Teaching-Learning Method During Pharmacology Revision Classes: Autobiography of Drugs.

PubMed

Joshi, Anuradha; Ganjiwale, Jaishree

2015-07-01

Various studies in medical education have shown that active learning strategies should be incorporated into the teaching-learning process to make learning more effective, efficient and meaningful. The aim of this study was to evaluate student's perceptions on an innovative revision method conducted in Pharmacology i.e. in form of Autobiography of Drugs. The main objective of study was to help students revise the core topics in Pharmacology in an interesting way. Questionnaire based survey on a newer method of pharmacology revision in two batches of second year MBBS students of a tertiary care teaching medical college. Various sessions on Autobiography of Drugs were conducted amongst two batches of second year MBBS students, during their Pharmacology revision classes. Student's perceptions were documented with the help of a five point likert scale through a questionnaire regarding quality, content and usefulness of this method. Descriptive analysis. Students of both the batches appreciated the innovative method taken up for revision. The median scores in most of the domains in both batches were four out of five, indicative of good response. Feedback from open-ended questions also revealed that the innovative module on "Autobiography of Drugs" was taken as a positive learning experience by students. Autobiography of drugs has been used to help students recall topics that they have learnt through other teachings methods. Autobiography sessions in Pharmacology during revision slots, can be one of the interesting ways in helping students revise and recall topics which have already been taught in theory classes.

Exploring the use of the Dementia Management Strategies Scale in caregivers of persons with dementia in Singapore.

PubMed

Tan, Louisa; Yap, Philip; Ng, Wai Yee; Luo, Nan

2013-01-01

Well-being in persons with dementia (PWD) depends much on the quality and type of care received. The Dementia Management Strategies Scale (DMSS) is a useful instrument to appraise care styles of caregivers. The present study expanded on previous research by refining and establishing the scale's content validity and psychometric properties in the Singapore context. Five family caregivers and four dementia care professionals (nurse, occupational therapist, social worker and doctor) reviewed the DMSS for content validity. Two hundred and forty-six family caregivers completed questionnaires which assessed caregiver and patient characteristics, and dementia management strategies with DMSS. Internal consistency reliability was assessed and construct validity was evaluated through Pearson's correlation with extant instruments. Eight items from the 28-item DMSS were omitted after content review as they were deemed inappropriate in our socio-cultural setting. A factor analysis with Varimax rotation confirmed a two-factor structure (positive and negative dimensions) for the revised DMSS (rDMSS). The two subscales showed good internal consistency (Cronbach's alpha .89 and .87). Moderate to strong correlations (.35-.53) with the scales, Zarit Burden Instrument, Revised Memory and Behavioural Problems Checklist, General Health Questionnaire, Short Sense of Competence Scale, Gains in Alzheimer's Care Instrument and Positive Aspects of Caregiving established convergent and divergent construct validity of rDMSS. The shortened 20-item rDMSS is a psychometrically valid instrument which can serve as a measure of dementia care strategy from the perspective of the caregiver in Singapore.

Tibial slope correction combined with second revision ACL produces good knee stability and prevents graft rupture.

PubMed

Dejour, David; Saffarini, Mo; Demey, Guillaume; Baverel, Laurent

2015-10-01

Revision ACL reconstruction requires careful analysis of failure causes particularly in cases of two previous graft ruptures. Intrinsic factors as excessive tibial slope or narrow femoral notch increase failure risks but are rarely addressed in revision surgery. The authors report outcomes, at minimum follow-up of 2 years, for second revision ACL reconstructions combined with tibial deflexion osteotomy for correction of excessive slope (>12°). Nine patients that underwent second revision ACL reconstruction combined with tibial deflexion osteotomy were retrospectively studied. The mean age was 30.3 ± 4.4 years (median 28; range 26-37), and mean follow-up was 4.0 ± 2.0 years (median 3.6; range 2.0-7.6). Autografts were harvested from the quadriceps tendon (n = 8) or hamstrings (n = 1), and tibial osteotomy was done by anterior closing wedge, without detachment of the patellar tendon, to obtain a slope of 3° to 5°. All patients had fused osteotomies, stable knees, and there were no intraoperative or postoperative complications. The mean posterior tibial slope decreased from 13.2° ± 2.6° (median 13°; range 12°-18°) preoperatively to 4.4° ± 2.3° (median 4°; range 2°-8°) postoperatively. The mean Lysholm score was 73.8 ± 5.8 (median 74; range 65-82), and the IKDC-SKF was 71.6 ± 6.1 (median 72.8; range 62.2-78.5). The satisfactory results of second revision ACL reconstruction combined with tibial deflexion osteotomy at minimum follow-up of 2 years suggest that tibia slope correction protects reconstructed ACL from fatigue failure in this study. The authors stress the importance of careful analysis failure causes prior to revision ACL reconstruction, and recommend correction of tibial slope if it exceeds 12°, to reduce the risks of graft retear. III.

Initial description of primate-specific cystine-knot Prometheus genes and differential gene expansions of D-dopachrome tautomerase genes

PubMed Central

Premzl, Marko

2015-01-01

Using eutherian comparative genomic analysis protocol and public genomic sequence data sets, the present work attempted to update and revise two gene data sets. The most comprehensive third party annotation gene data sets of eutherian adenohypophysis cystine-knot genes (128 complete coding sequences), and d-dopachrome tautomerases and macrophage migration inhibitory factor genes (30 complete coding sequences) were annotated. For example, the present study first described primate-specific cystine-knot Prometheus genes, as well as differential gene expansions of D-dopachrome tautomerase genes. Furthermore, new frameworks of future experiments of two eutherian gene data sets were proposed. PMID:25941635

The effect of middle-age body weight and physical activity on the risk of early revision hip arthroplasty: a cohort study of 1,535 individuals.

PubMed

Flugsrud, Gunnar B; Nordsletten, Lars; Espehaug, Birgitte; Havelin, Leif I; Meyer, Haakon E

2007-02-01

Overweight and a high level of physical activity are known risk factors for loosening of a total hip arthroplasty (THA) due to primary osteoarthritis. We wanted to investigate how these factors, together with age and sex, affect the risk of revision surgery. We matched data from the Norwegian Arthroplasty Register with information on risk factors collected at a cardiovascular screening. We identified 1,535 primary THAs in the screened cohort (930 cemented implants using well-documented cement). Of the participants included, 969 were female. Mean age at screening was 49 years, at primary THA 63 years, and 69 years at the end of follow-up. We used Cox regression analysis to estimate relative risks (RRs). Event was defined as implant revision due to aseptic loosening of cup, stem or both. Follow-up was time from primary THA to event or censoring. Men were at greater risk than women of loosening of the femoral stem (RR 2.0, 95% CI 1.3-3.2). Both men and women with upper-quartile body weight were at increased risk of revision due to loosening of the stem (RR 2.5 and 2.7, respectively). Men with a high level of physical activity during leisure time were at increased risk of revision due to loosening of the cup (RR 4.8, 95% CI 1.3-18). In the multivariate model with adjustment for activity, there was little association between age at primary THA and risk of revision due to loosening. We found that body weight and physical activity recorded long before THA affected the survival of total hip arthroplasties. Controlling for these variables weakened the association between age at primary surgery and aseptic loosening. Men had an increased risk of loosening of the femoral stem, also after controlling for lifestyle factors.

Indigenous Chinese Personality Constructs: Is the Five-Factor Model Complete?

ERIC Educational Resources Information Center

Cheung, Fanny M.; Leung, Kwok; Zhang, Jian-Xin; Sun, Hai-Fa; Gan, Yi-Qun; Song, Wei-Zhen; Xie, Dong

2001-01-01

Three studies involving Chinese respondents from China and Hong Kong and diverse respondents from Hawaii compared the Chinese Personality Assessment Inventory factor structure with the Revised NEO Personality Inventory (NEO-PI-R) and NEO-Five Factor Inventory. Results supported the universality of the five-factor model, the validity of NEO-PI-R,…

Planning and Revising Written Arguments: The Effects of Two Text Structure-Based Interventions on Persuasiveness of 8th-Grade Students' Essays

ERIC Educational Resources Information Center

Midgette, Ekaterina; Haria, Priti

2016-01-01

The purpose of the study was to investigate the effects of two comprehensive argumentative writing interventions--Text Structure Instruction (TSI) and Text Structure Revision Instruction (TSRI)--on the eighth-grade students' ability to compose convincing essays that include structural elements of argumentative discourse. Both treatment groups…

Two Revised Measures of Coping for Individuals with Late-Deafness

ERIC Educational Resources Information Center

Meyer, Jill M.; Kashubeck-West, Susan; Portela, Lindsay

2018-01-01

Purpose: The present study had two goals: (a) to examine the revised structures of these measures to determine the reliability and validity when used in a sample of individuals with latedeafness, and (b) to examine differences in coping style in individuals with late-deafness across race, ethnicity, gender, age, socioeconomic status (SES), level…

The revised scale for caregiving self-efficacy: reliability and validity studies.

PubMed

Steffen, Ann M; McKibbin, Christine; Zeiss, Antonette M; Gallagher-Thompson, Dolores; Bandura, Albert

2002-01-01

Two samples of family caregivers (Study 1: N = 169; Study 2: N = 145) of cognitively impaired older adults were used to revise, extend, and evaluate a measure of perceived self-efficacy for caregiving tasks. The Revised Scale for Caregiving Self-Efficacy measures 3 domains of caregiving self-efficacy: Obtaining Respite, Responding to Disruptive Patient Behaviors, and Controlling Upsetting Thoughts. The 3 subscales show strong internal consistency and adequate test-retest reliability. Construct validity is supported by relationships between these 3 facets of perceived caregiving efficacy and depression, anxiety, anger, perceived social support, and criticism expressed in speech samples. The Revised Scale for Caregiving Self-Efficacy has potential uses for both research and clinical purposes.

Processes regulating the initiation and postejaculatory resumption of copulatory behavior in male hamsters.

PubMed

Floody, Owen R

2014-06-01

Studies using factor analysis have helped describe the organization of copulatory behavior in male rodents. However, the focus of these studies on a few traditional measures may have limited their results. To test this possibility, 74 sexually-experienced male hamsters were observed as they copulated with stimulus females. The measures collected exceeded the conventional ones in number, variety and independence. The factor analysis of these data revealed a structure with seven factors collectively accounting for 80% of the variance. Most resembled the factors in previous reports, reinforcing the contributions that the processes suggested by these factors make to the organization of male behavior. But several other factors were more novel, possibly reflecting the use of measures that were novel or revised for greater independence. The most interesting of these were two factors focusing on early steps in the progression leading to ejaculation. Importantly, both incorporated measures from each of the three copulatory series that were observed. Past work suggests that independent processes control the times required to initiate copulation and later resume it after an ejaculation. In contrast, these results suggest the existence of two processes, each of which contributes to both the initiation and reinitiation of copulation. Copyright © 2014 Elsevier B.V. All rights reserved.

Cross-cultural confirmation of bi-factor models of a symptom distress measure: Symptom Checklist-90-Revised in clinical samples.

PubMed

Urbán, Róbert; Arrindell, Willem A; Demetrovics, Zsolt; Unoka, Zsolt; Timman, Reinier

2016-05-30

Four decades have elapsed since the introduction for clinical and research purposes of the Symptom Checklist-90(-R). Yet, its underlying dimensional structure has not been clearly delineated. A shift has been observed in the methods utilized-from predominantly exploratory factor analytic in nature in the first two decades or so to different confirmatory methods in recent years. A need remains to search for a structure that remains invariant across samples and nations. In that context, the present study attempted to replicate and extend recent findings yielded in a Hungarian general population sample (N=2,874) with two psychiatric patient samples from Hungary (N=972) and The Netherlands (N=1,902). In doing so, four models were contrasted: the one-factor model, Derogatis' nine factor model, a second-ordered factor model, and a bi-factor model. The bi-factor model was shown to yield the closest fit to the data in both countries. Further studies are needed to determine the stable number and kind of subscale scores that reflect the specific (primary) symptoms best, that is, those subscales with minimal shared variance with the overall general psychological distress dimension. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Dimensional analysis of depressive, anxious and somatic symptoms presented by primary care patients and their relationship with ICD-11 PHC proposed diagnoses.

PubMed

Ziebold, Carolina; Goldberg, David P; Reed, Geoffrey M; Minhas, Fareed; Razzaque, Bushra; Fortes, Sandra; Robles, Rebeca; Lam, Tai Pong; Bobes, Julio; Iglesias, Celso; Cogo-Moreira, Hugo; García, José Ángel; Mari, Jair J

2018-06-04

A study conducted as part of the development of the Eleventh International Classification of Mental Disorders for Primary Health Care (ICD-11 PHC) provided an opportunity to test the relationships among depressive, anxious and somatic symptoms in PHC. Primary care physicians participating in the ICD-11 PHC field studies in five countries selected patients who presented with somatic symptoms not explained by known physical pathology by applying a 29-item screening on somatic complaints that were under study for bodily stress disorder. Patients were interviewed using the Clinical Interview Schedule-Revised and assessed using two five-item scales that measure depressive and anxious symptoms. Structural models of anxious-depressive symptoms and somatic complaints were tested using a bi-factor approach. A total of 797 patients completed the study procedures. Two bi-factor models fit the data well: Model 1 had all symptoms loaded on a general factor, along with one of three specific depression, anxiety and somatic factors [x2 (627) = 741.016, p < 0.0011, RMSEA = 0.015, CFI = 0.911, TLI = 0.9]. Model 2 had a general factor and two specific anxious depression and somatic factors [x2 (627) = 663.065, p = 0.1543, RMSEA = 0.008, CFI = 0.954, TLI = 0.948]. These data along with those of previous studies suggest that depressive, anxious and somatic symptoms are largely different presentations of a common latent phenomenon. This study provides support for the ICD-11 PHC conceptualization of mood disturbance, especially anxious depression, as central among patients who present multiple somatic symptoms.

Factorial and construct validity of the revised short form integrative psychotherapy alliance scales for family, couple, and individual therapy.

PubMed

Pinsof, William M; Zinbarg, Richard; Knobloch-Fedders, Lynne M

2008-09-01

The Integrative Psychotherapy Alliance model brought an interpersonal and systemic perspective to bear on theory, research, and practice on the psychotherapeutic alliance. Questions have been raised about the independence of the theoretical factors in the model and their operationalization in the Individual, Couple, and Family Therapy Alliance Scales. This paper presents results of a confirmatory factor analysis of the scales that delineated at least three distinct interpersonal factors as well as shorter versions of the three scales to facilitate their use in research and practice. The paper also presents the results of a study testing each factor's association with client retention and progress over the first eight sessions in individual and couple therapy. At least two of the interpersonal factors were uniquely associated with progress in individual and couple functioning. Implications of the results for theory, research, practice, and training in individual, couple, and family therapy are elaborated.

Pasteurella multocida non-native joint infection after a dog lick: A case report describing a complicated two-stage revision and a comprehensive review of the literature

PubMed Central

Philip W, Lam; Page, Andrea V

2015-01-01

Prosthetic joint infections (PJIs) are commonly caused by pathogens such as Staphylococcus aureus and coagulase-negative staphylococci; however, other microbial etiologies and specific risk factors are increasingly recognized. Pasteurella multocida is a Gram-negative coccobacillus that is part of the normal oral flora in many animals, and is particularly common in dogs and cats. PJIs caused by P multocida have been reported only rarely in the literature and typically occur in the context of an animal bite or scratch. The present article describes a P multocida joint infection that occurred after a dog lick and complicated a two-stage revision arthroplasty. A comprehensive review of the literature regarding P multocida PJIs follows. PMID:26361490

Visual reproduction subtest of the Wechsler Memory Scale-Revised: analysis of construct validity.

PubMed

Williams, M A; Rich, M A; Reed, L K; Jackson, W T; LaMarche, J A; Boll, T J

1998-11-01

This study assessed the construct validity of Visual Reproduction (VR) Cards A (Flags) and B (Boxes) from the original Wechsler Memory Scale (WMS) compared to Flags and Boxes from the revised edition of the WMS (WMS-R). Independent raters scored Flags and Boxes using both the original and revised scoring criteria and correlations were obtained with age, education, IQ, and four separate criterion memory measures. Results show that for Flags, there is a tendency for the revised scoring criteria to produce improved construct validity. For Boxes, however, there was a trend in the opposite direction, with the revised scoring criteria demonstrating worse construct validity. Factor analysis suggests that Flags are a more distinct measure of visual memory, whereas Boxes are more complex and significantly associated with conceptual reasoning abilities. Using the revised scoring criteria, Boxes were found to be more strongly related to IQ than Flags. This difference was not found using the original scoring criteria.

Seeing Our Way Clear: Feminist Revision of the Academy. Proceedings of the Annual GLCA Women's Studies Conference (8th, November 5-7, 1981).

ERIC Educational Resources Information Center

Loring, Katherine, Ed.; And Others

Two keynote addresses and 12 selected papers are included in these conference proceedings. The keynote address, "Seeing Our Way Clear: Feminist Re-Vision of the Academy" (Peggy McIntosh), describes the academy as a "hierarchical or layered pyramidal structure" and discusses the benefits of feminist revision. The first of 12…

Psychometrics of an original measure of barriers to providing family planning information: Implications for social service providers.

PubMed

Bell, Melissa M; Newhill, Christina E

2017-07-01

Social service professionals can face challenges in the course of providing family planning information to their clients. This article reports findings from a study that developed an original 27-item measure, the Reproductive Counseling Obstacle Scale (RCOS) designed to measure such obstacles based conceptually on Bandura's social cognitive theory (1986). We examine the reliability and factor structure of the RCOS using a sample of licensed social workers (N = 197). A 20-item revised version of the RCOS was derived using principal component factor analysis. Results indicate that barriers to discussing family planning, as measured by the RCOS, appear to be best represented by a two-factor solution, reflecting self-efficacy/interest and perceived professional obligation/moral concerns. Implications for practice and future research are discussed.

Two-Stage Cementless Revision Total Hip Arthroplasty for Infected Primary Hip Arthroplasties.

PubMed

Camurcu, Yalkin; Sofu, Hakan; Buyuk, Abdul Fettah; Gursu, Sarper; Kaygusuz, Mehmet Akif; Sahin, Vedat

2015-09-01

The main purpose of the present study was to analyze the clinical features, the most common infective agents, and the results of two-stage total hip revision using a teicoplanin-impregnated spacer. Between January 2005 and July 2011, 41 patients were included. At the clinical status analysis, physical examination was performed, Harris hip score was noted, isolated microorganisms were recorded, and the radiographic evaluation was performed. The mean Harris hip score was improved from 38.9 ± 9.6 points to 81.8 ± 5.8 points (P<0.05). Infection was eradicated in 39 hips. Radiographic evidence of stability was noted in 37 acetabular revision components, and all femoral stems. Two-stage revision of the infected primary hip arthroplasty is a time-consuming but a reliable procedure with high rates of success. Copyright © 2015 Elsevier Inc. All rights reserved.

On the measurement of thin-ideal internalization: Implications for interpretation of risk factors and treatment outcome in eating disorders research.

PubMed

Thompson, J Kevin; Schaefer, Lauren M; Dedrick, Robert F

2018-04-01

Although the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ) and Ideal Body Stereotype Scale (IBSS) are used interchangeably to assess thin ideal internalization, limited work has examined the assumption that the two measures index the same construct. The current study utilized confirmatory factor analysis to examine whether these measures capture a single construct (one-factor), two constructs (two-factor), or both shared and unique constructs (bifactor). The SATAQ-4R-Internalization: Thin/Low Body Fat subscale and IBSS-Revised were administered to 1,114 college females. A bifactor model provided the best fit to the data. Further, the SATAQ-4R was more strongly related to disordered eating and body satisfaction than the IBSS-R. Results indicate that the two most commonly used measures of internalization capture both shared and unique constructs. While both measures appear to contribute to the assessment of a global internalization factor, the SATAQ-4R may be better suited to assess personal acceptance of and desire to achieve a thin body, while the IBSS-R may be better suited to assess an awareness or acknowledgement of broader sociocultural ideals (e.g., toned, shapely bodies). Continued psychometric investigation of the scales is recommended in order to ensure targeted assessment of the intended constructs. © 2018 Wiley Periodicals, Inc.

The Anxiety Sensitivity Index--Revised: Confirmatory Factor Analyses, Structural Invariance in Caucasian and African American Samples, and Score Reliability and Validity

ERIC Educational Resources Information Center

Arnau, Randolph C.; Broman-Fulks, Joshua J.; Green, Bradley A.; Berman, Mitchell E.

2009-01-01

The most commonly used measure of anxiety sensitivity is the 36-item Anxiety Sensitivity Index--Revised (ASI-R). Exploratory factor analyses have produced several different factors structures for the ASI-R, but an acceptable fit using confirmatory factor analytic approaches has only been found for a 21-item version of the instrument. We evaluated…

VizieR Online Data Catalog: Type II Cepheid and RR Lyrae variables (Feast+, 2008)

NASA Astrophysics Data System (ADS)

Feast, M. W.; Laney, C. D.; Kinman, T. D.; van Leeuwen, F.; Whitelock, P. A.

2008-10-01

Infrared and optical absolute magnitudes are derived for the type II Cepheids kappa Pav and VY Pyx using revised Hipparcos parallaxes and for kappa Pav, V553 Cen and SW Tau from pulsational parallaxes. Revised Hipparcos and HST parallaxes for RR Lyrae agree satisfactorily and are combined in deriving absolute magnitudes. Phase-corrected J, H and Ks mags are given for 142 Hipparcos RR Lyraes based on Two-Micron All-Sky Survey observations. Pulsation and trigonometrical parallaxes for classical Cepheids are compared to establish the best value for the projection factor (p) used in pulsational analyses. (3 data files).

Thirteen-year outcomes in the Anatomique Benoist Girard II hip prosthesis.

PubMed

Catanach, Michael J M; Sorial, Rami M; Eslick, Guy D

2015-04-01

The Stryker Anatomique Benoist Girard (ABG) hip implant system was a commonly used cementless prosthesis in the early 2000s, which fell from favour after several studies emerged implicating the prosthesis in high rates of revision. This retrospective, single-surgeon clinical study examines the fracture rate, revision rate and reasons for revision in 500 consecutive ABG II primary total conventional hip replacements. Follow-up was conducted by audit of patient notes, patient mailout survey, patient phone contact and audit of the Australian National Joint Replacement Registry (NJRR) database to find instances of fracture and revision. End points were periprosthetic fracture and revision for any reason. Follow-up was 1.2-13.8 years with a mean of 6.58 years. Of the 500 hips, 17 (3.4%) had undergone a revision. Of these, 13 were due to periprosthetic fracture. Four further fractures occurred that were not revised. Eight of these periprosthetic fractures occurred within 1 year post-operatively. There were four revisions for recurrent dislocations. Kaplan-Meier survival curve demonstrates a 93.7% survivorship at 6.58 years for revision for any reason. Multivariate analysis showed the only statistically significant factor for increased risk of revision was smaller stem size. Our results were consistent with the literature in that the ABG II system has good medium-term results but is prone to periprosthetic fractures, especially in the early post-operative period. When used as a primary total hip arthroplasty, the ABG II system has an 8-year revision rate of 5.6% compared with the 4.9% of all primary total hip arthroplasties. © 2014 Royal Australasian College of Surgeons.

Hoarding symptoms among psychiatric outpatients: confirmatory factor analysis and psychometric properties of the Saving Inventory - Revised (SI-R).

PubMed

Lee, Siau Pheng; Ong, Clarissa; Sagayadevan, Vathsala; Ong, Rebecca; Abdin, Edimansyah; Lim, Susan; Vaingankar, Janhavi; Picco, Louisa; Verma, Swapna; Chong, Siow Ann; Subramaniam, Mythily

2016-10-26

The growing interest in problematic hoarding as an independent clinical condition has led to the development of the Saving Inventory-Revised (SI-R) to assess hoarding phenomenology. The SI-R is one of the most widely used instruments to measure hoarding symptoms; however, it lacks validation in non-Western samples. The current study examined the construct, convergent, and discriminant validity of the SI-R among 500 outpatients at a psychiatric hospital in Singapore. The three-factor structure solution of the SI-R was fitted in a confirmatory factor analysis. The final model achieved mediocre fit (χ2 = 1026.02, df = 186; RMSEA = 0.095, SRMR = 0.06; CFI = 0.86; NNFI = 0.85). Two reverse-coded items (items 2 and 4) were removed due to insufficient factor loadings, resulting in the modified 21-item SI-R (SIR-21). Our findings indicate the need to further examine the construct validity of the SI-R, particularly in non-Western samples. Nonetheless, correlations with other hoarding-related constructs, such as anxiety (Beck Anxiety Inventory) and depression (Beck Depression Inventory-II), supported the convergent and discriminant validity of the SIR-21 in our sample. Findings in our current majority Chinese sample were consistent with previous observations from other Chinese samples. Implications were discussed from a cross-cultural perspective, such as cultural emphasis on saving for future use and overlap between the concepts of discarding and acquiring in Chinese samples. Future studies should also examine differences among other ethnic groups (e.g., Malay, Indian).

Single-stage revision for fungal peri-prosthetic joint infection: a single-centre experience.

PubMed

Klatte, T O; Kendoff, D; Kamath, A F; Jonen, V; Rueger, J M; Frommelt, L; Gebauer, M; Gehrke, T

2014-04-01

Fungal peri-prosthetic infections of the knee and hip are rare but likely to result in devastating complications. In this study we evaluated the results of their management using a single-stage exchange technique. Between 2001 and 2011, 14 patients (ten hips, four knees) were treated for a peri-prosthetic fungal infection. One patient was excluded because revision surgery was not possible owing to a large acetabular defect. One patient developed a further infection two months post-operatively and was excluded from the analysis. Two patients died of unrelated causes. After a mean of seven years (3 to 11) a total of ten patients were available for follow-up. One patient, undergoing revision replacement of the hip, had a post-operative dislocation. Another patient, undergoing revision replacement of the knee, developed a wound infection and required revision 29 months post-operatively following a peri-prosthetic femoral fracture. The mean Harris hip score increased to 74 points (63 to 84; p < 0.02) in those undergoing revision replacement of the hip, and the mean Hospital for Special Surgery knee score increased to 75 points (70 to 80; p < 0.01) in those undergoing revision replacement of the knee. A single-stage revision following fungal peri-prosthetic infection is feasible, with an acceptable rate of a satisfactory outcome.

Evaluation of Students’ Perceptions Towards An Innovative Teaching-Learning Method During Pharmacology Revision Classes: Autobiography of Drugs

PubMed Central

Ganjiwale, Jaishree

2015-01-01

Introduction Various studies in medical education have shown that active learning strategies should be incorporated into the teaching–learning process to make learning more effective, efficient and meaningful. Objectives The aim of this study was to evaluate student’s perceptions on an innovative revision method conducted in Pharmacology i.e. in form of Autobiography of Drugs. The main objective of study was to help students revise the core topics in Pharmacology in an interesting way. Settings and Design Questionnaire based survey on a newer method of pharmacology revision in two batches of second year MBBS students of a tertiary care teaching medical college. Materials and Methods Various sessions on Autobiography of Drugs were conducted amongst two batches of second year MBBS students, during their Pharmacology revision classes. Student’s perceptions were documented with the help of a five point likert scale through a questionnaire regarding quality, content and usefulness of this method. Statistical analysis used Descriptive analysis. Results Students of both the batches appreciated the innovative method taken up for revision. The median scores in most of the domains in both batches were four out of five, indicative of good response. Feedback from open-ended questions also revealed that the innovative module on “Autobiography of Drugs” was taken as a positive learning experience by students. Conclusions Autobiography of drugs has been used to help students recall topics that they have learnt through other teachings methods. Autobiography sessions in Pharmacology during revision slots, can be one of the interesting ways in helping students revise and recall topics which have already been taught in theory classes. PMID:26393138

Degree and Direction of Multiple Career Factors: Sex Differences and Construct Validity.

ERIC Educational Resources Information Center

Shaffer, Michal; And Others

Personality, environment, and the interaction between them have been suggested as the major factors accounting for career development. Students (N=283) were asked to respond to 28 items on a recently revised self-report instrument, the Career Factor Checklist (CFC), in order to establish the construct validity of the revised CFC and to investigate…

Risk Factors and Predictors of Significant Chondral Surface Change From Primary to Revision Anterior Cruciate Ligament Reconstruction: A MOON and MARS Cohort Study.

PubMed

Magnussen, Robert A; Borchers, James R; Pedroza, Angela D; Huston, Laura J; Haas, Amanda K; Spindler, Kurt P; Wright, Rick W; Kaeding, Christopher C; Allen, Christina R; Anderson, Allen F; Cooper, Daniel E; DeBerardino, Thomas M; Dunn, Warren R; Lantz, Brett A; Mann, Barton; Stuart, Michael J; Albright, John P; Amendola, Annunziato; Andrish, Jack T; Annunziata, Christopher C; Arciero, Robert A; Bach, Bernard R; Baker, Champ L; Bartolozzi, Arthur R; Baumgarten, Keith M; Bechler, Jeffery R; Berg, Jeffrey H; Bernas, Geoffrey A; Brockmeier, Stephen F; Brophy, Robert H; Bush-Joseph, Charles A; Butler, J Brad; Campbell, John D; Carey, James L; Carpenter, James E; Cole, Brian J; Cooper, Jonathan M; Cox, Charles L; Creighton, R Alexander; Dahm, Diane L; David, Tal S; Flanigan, David C; Frederick, Robert W; Ganley, Theodore J; Garofoli, Elizabeth A; Gatt, Charles J; Gecha, Steven R; Giffin, James Robert; Hame, Sharon L; Hannafin, Jo A; Harner, Christopher D; Harris, Norman Lindsay; Hechtman, Keith S; Hershman, Elliott B; Hoellrich, Rudolf G; Hosea, Timothy M; Johnson, David C; Johnson, Timothy S; Jones, Morgan H; Kamath, Ganesh V; Klootwyk, Thomas E; Levy, Bruce A; Ma, C Benjamin; Maiers, G Peter; Marx, Robert G; Matava, Matthew J; Mathien, Gregory M; McAllister, David R; McCarty, Eric C; McCormack, Robert G; Miller, Bruce S; Nissen, Carl W; O'Neill, Daniel F; Owens, Brett D; Parker, Richard D; Purnell, Mark L; Ramappa, Arun J; Rauh, Michael A; Rettig, Arthur C; Sekiya, Jon K; Shea, Kevin G; Sherman, Orrin H; Slauterbeck, James R; Smith, Matthew V; Spang, Jeffrey T; Svoboda, Steven J; Taft, Timothy N; Tenuta, Joachim J; Tingstad, Edwin M; Vidal, Armando F; Viskontas, Darius G; White, Richard A; Williams, James S; Wolcott, Michelle L; Wolf, Brian R; York, James J

2018-03-01

Articular cartilage health is an important issue following anterior cruciate ligament (ACL) injury and primary ACL reconstruction. Factors present at the time of primary ACL reconstruction may influence the subsequent progression of articular cartilage damage. Larger meniscus resection at primary ACL reconstruction, increased patient age, and increased body mass index (BMI) are associated with increased odds of worsened articular cartilage damage at the time of revision ACL reconstruction. Case-control study; Level of evidence, 3. Subjects who had primary and revision data in the databases of the Multicenter Orthopaedics Outcomes Network (MOON) and Multicenter ACL Revision Study (MARS) were included. Reviewed data included chondral surface status at the time of primary and revision surgery, meniscus status at the time of primary reconstruction, primary reconstruction graft type, time from primary to revision ACL surgery, as well as demographics and Marx activity score at the time of revision. Significant progression of articular cartilage damage was defined in each compartment according to progression on the modified Outerbridge scale (increase ≥1 grade) or >25% enlargement in any area of damage. Logistic regression identified predictors of significant chondral surface change in each compartment from primary to revision surgery. A total of 134 patients were included, with a median age of 19.5 years at revision surgery. Progression of articular cartilage damage was noted in 34 patients (25.4%) in the lateral compartment, 32 (23.9%) in the medial compartment, and 31 (23.1%) in the patellofemoral compartment. For the lateral compartment, patients who had >33% of the lateral meniscus excised at primary reconstruction had 16.9-times greater odds of progression of articular cartilage injury than those with an intact lateral meniscus ( P < .001). For the medial compartment, patients who had <33% of the medial meniscus excised at the time of the primary reconstruction had 4.8-times greater odds of progression of articular cartilage injury than those with an intact medial meniscus ( P = .02). Odds of significant chondral surface change increased by 5% in the lateral compartment and 6% in the medial compartment for each increased year of age ( P ≤ .02). For the patellofemoral compartment, the use of allograft in primary reconstruction was associated with a 15-fold increased odds of progression of articular cartilage damage relative to a patellar tendon autograft ( P < .001). Each 1-unit increase in BMI at the time of revision surgery was associated with a 10% increase in the odds of progression of articular cartilage damage ( P = .046) in the patellofemoral compartment. Excision of the medial and lateral meniscus at primary ACL reconstruction increases the odds of articular cartilage damage in the corresponding compartment at the time of revision ACL reconstruction. Increased age is a risk factor for deterioration of articular cartilage in both tibiofemoral compartments, while increased BMI and the use of allograft for primary ACL reconstruction are associated with an increased risk of progression in the patellofemoral compartment.

Factors Associated With Revision Surgery After Internal Fixation of Hip Fractures.

PubMed

Sprague, Sheila; Schemitsch, Emil H; Swiontkowski, Marc; Della Rocca, Gregory J; Jeray, Kyle J; Liew, Susan; Slobogean, Gerard P; Bzovsky, Sofia; Heels-Ansdell, Diane; Zhou, Qi; Bhandari, Mohit

2018-05-01

Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (for every 5-point increase) (HR 1.19, 95% CI 1.02-1.39; P = 0.027), displaced fracture (HR 2.16, 95% CI 1.44-3.23; P < 0.001), unacceptable quality of implant placement (HR 2.70, 95% CI 1.59-4.55; P < 0.001), and smokers treated with cancellous screws versus smokers treated with a sliding hip screw (HR 2.94, 95% CI 1.35-6.25; P = 0.006). Additionally, for every 10-year decrease in age, participants experienced an average increased risk of 39% for hardware removal. Results of this study may inform future research by identifying high-risk patients who may be better treated with arthroplasty and may benefit from adjuncts to care (HR 1.39, 95% CI 1.05-1.85; P = 0.020). Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Psychometric properties of the revised Malay version Medical Outcome Study Social Support Survey using confirmatory factor analysis among postpartum mothers.

PubMed

Norhayati, Mohd Noor; Aniza, Abd Aziz; Nik Hazlina, Nik Hussain; Azman, Mohd Yacob

2015-12-01

Social support is an essential component for the physical and emotional well-being of postpartum mothers. The objective of this study is to determine the psychometric properties of the revised Malay version Medical Outcome Study (MOS) Social Support Survey using a confirmatory validity approach. A cross-sectional study was conducted involving 144 postpartum mothers attending Obstetric and Gynecology Clinic, Universiti Sains Malaysia Hospital. Construct validity and internal consistency assessment was performed after the translation, content validity and face validity process. The data were analyzed using SPSS 20.0 (SPSS Inc., Chicago, IL, USA) and AMOS 20.0 (SPSS Inc., Chicago, IL, USA). The original questionnaire consists of four domains (emotional/informational support, tangible support, affectionate support and positive social interaction) and 19 items. Affectionate support domain with three items only was treated as a separate construct and was not included in the factor analysis. The final confirmatory model with three constructs and 13 items demonstrated acceptable factor loadings, domain to domain correlation and best fit; (χ2[df]=1.665 [61]; P-value=0.001; Tucker-Lewis Index=0.944; comparative fit index=0.956; root mean square error of approximation=0.068). Composite reliability, average variance extracted and Cronbach's α of the domains ranged from 0.649 to 0.903; 0.390 to 0.699; 0.616 to 0.902, respectively. The study suggested that the four-factor model with 16 items (including one separate factor of affectionate) of the revised Malay version MOS Social Support Survey was acceptable to be used to measure social support after childbirth because it is valid, reliable and simple. © 2015 Wiley Publishing Asia Pty Ltd.

The Effects of Source, Revision Possibility, and Amount of Feedback on Marketing Students' Impressions of Feedback on an Assignment

ERIC Educational Resources Information Center

Ackerman, David S.; Dommeyer, Curt J.; Gross, Barbara L.

2017-01-01

This study examines how three factors affect students' reactions to critical feedback on an assignment--amount of feedback (none vs. low amount vs. high amount), source of feedback (instructor-provided feedback vs. peer-provided feedback), and the situational context of the feedback (revision of paper is or is not possible). An incomplete 3 × 2 ×…

Is Having Low Motivation the Same as Not Having High Motivation? Comparing the CSAS-R and the SAAS-R

ERIC Educational Resources Information Center

McCoach, Betsy; Newton, Sarah D.; Siegle, Del; Baslanti, Ugur; Picho, Katherine

2016-01-01

The purpose of the current study was to examine the relationships among the Challenges to Scholastic Achievement Scale-Revised (CSAS-R) and The School Attitude Assessment Survey-Revised (SAAS-R) items and factors to determine whether the negative scales on the CSAS-R seemed to be measuring the same constructs as those that are measured on the…

The Chinese Version of the Revised Creativity Domain Questionnaire (CDQ-R): First Evidence for Its Factorial Validity and Systematic Association with the Big Five

ERIC Educational Resources Information Center

Werner, Christian H.; Tang, Min; Kruse, Joachim; Kaufman, James C.; Spörrle, Matthias

2014-01-01

The present study examines the factor structure of a Chinese version of the Revised Creativity Domain Questionnaire (CDQ-R; Kaufman, Waterstreet, Ailaouni, Whitcomb, Roe, & Riggs, 2009) as well as its relation to Big Five personality traits within a Chinese sample (N = 787). Analyses indicate the appropriateness of the Chinese version of the…

Early experience with dual mobility acetabular systems featuring highly cross-linked polyethylene liners for primary hip arthroplasty in patients under fifty five years of age: an international multi-centre preliminary study.

PubMed

Epinette, Jean-Alain; Harwin, Steven F; Rowan, Fiachra E; Tracol, Philippe; Mont, Michael A; Chughtai, Morad; Westrich, Geoffrey H

2017-03-01

To evaluate early performance of contemporary dual mobility acetabular systems with second generation annealed highly cross-linked polyethylene for primary hip arthroplasty of patients under 55 years of age. A prospective observational five years study across five centers in Europe and the USA of 321 patients with a mean age of 48.1 years was performed. Patients were assessed for causes of revision, hip instability, intra-prosthetic dissociation, Harris hip score and radiological signs of osteolysis. There were no dislocations and no intra-prosthetic dissociations. Kaplan Meier analysis demonstrated 97.51% survivorship for all cause revision and 99.68% survivorship for acetabular component revision at five years. Mean Harris hip score was 93.6. Two acetabular shells were revised for neck-rim implant impingement without dislocation and ten femoral stems were revised for causes unrelated to dual mobility implants. Contemporary highly cross-linked polyethylene dual mobility systems demonstrate excellent early clinical, radiological, and survivorship results in a cohort of patients that demand high performance from their implants. It is envisaged that DM and second generation annealed HXLPE may reduce THA instability and wear, the two most common causes of THA revision in hip arthroplasty.

Confirmatory Factor Analysis of the Scales for Diagnosing Attention Deficit Hyperactivity Disorder (SCALES)

ERIC Educational Resources Information Center

Ryser, Gail R.; Campbell, Hilary L.; Miller, Brian K.

2010-01-01

The diagnostic criteria for attention deficit hyperactivity disorder have evolved over time with current versions of the "Diagnostic and Statistical Manual", (4th edition), text revision, ("DSM-IV-TR") suggesting that two constellations of symptoms may be present alone or in combination. The SCALES instrument for diagnosing attention deficit…

Comparison of mode of failure between primary and revision total knee arthroplasties.

PubMed

Liang, H; Bae, J K; Park, C H; Kim, K I; Bae, D K; Song, S J

2018-04-01

Cognizance of common reasons for failure in primary and revision TKA, together with their time course, facilitates prevention. However, there have been few reports specifically comparing modes of failure for primary vs. revision TKA using a single prosthesis. The goal of the study was to compare the survival rates, modes of failure, and time periods associated with each mode of failure, of primary vs. revision TKA. The survival rates, modes of failure, time period for each mode of failure, and risk factors would differ between primary and revision TKA. Data from a consecutive cohort comprising 1606 knees (1174 patients) of primary TKA patients, and 258 knees (224 patients) of revision TKA patients, in all of whom surgery involved a P.F.C ® prosthesis (Depuy, Johnson & Johnson, Warsaw, IN), was retrospectively reviewed. The mean follow-up periods of primary and revision TKAs were 9.2 and 9.8 years, respectively. The average 10- and 15-year survival rates for primary TKA were 96.7% (CI 95%,±0.7%) and 85.4% (CI 95%,±2.0%), and for revision TKA 91.4% (CI 95%,±2.5%) and 80.5% (CI 95%,±4.5%). Common modes of failure included polyethylene wear, loosening, and infection. The most common mode of failure was polyethylene wear in primary TKA, and infection in revision TKA. The mean periods (i.e., latencies) of polyethylene wear and loosening did not differ between primary and revision TKAs, but the mean period of infection was significantly longer for revision TKA (1.2 vs. 4.8 years, P=0.003). Survival rates decreased with time, particularly more than 10 years post-surgery, for both primary and revision TKAs. Continuous efforts are required to prevent and detect the various modes of failure during long-term follow-up. Greater attention is necessary to detect late infection-induced failure following revision TKA. Case-control study, Level III. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Confirmatory factor analysis of the Appraisal of Self-Care Agency Scale - Revised 1

PubMed Central

Stacciarini, Thaís Santos Guerra; Pace, Ana Emilia

2017-01-01

ABSTRACT Objective: to analyze the factor structure of the Appraisal of Self-Care Agency Scale-Revised (ASAS-R), adapted for Brazil. Method: methodological study conducted with 150 individuals with diabetes mellitus cared for by the Family Health Strategy, most of whom are elderly with low educational levels. The test of the hypothesis concerning the confirmatory factor composition of the ASAS-R was performed using latent variables structural equations. Results: the model’s goodness-of-fit indexes were satisfactory (χ2 = 259.19; χ2/g.l = 2.97, p < 0.001; GFI = 0.85; RMR = 0.07; RMSEA = 0.09); the factor loads were greater than 0.40; and most item-to-factor-correlations presented moderate to strong magnitude (0.34 to 0.58); total alpha value was 0.74, while the alpha of the three factors were 0.69, 0.38 and 0.69, respectively. Conclusion: the scale’s factor structure presented satisfactory validity and reliability results, with the exception of one factor. Application of this scale to samples of the general population is desirable in order to strengthen analyses of internal consistency and the dimensionality of the factor structure. This study is expected to contribute to further studies addressing the self-care agency construct and the development of the ASAS-R. PMID:28146182

Approaches to learning for the ANZCA Final Examination and validation of the revised Study Process Questionnaire in specialist medical training.

PubMed

Weller, J M; Henning, M; Civil, N; Lavery, L; Boyd, M J; Jolly, B

2013-09-01

When evaluating assessments, the impact on learning is often overlooked. Approaches to learning can be deep, surface and strategic. To provide insights into exam quality, we investigated the learning approaches taken by trainees preparing for the Australian and New Zealand College of Anaesthetists (ANZCA) Final Exam. The revised two-factor Study Process Questionnaire (R-SPQ-2F) was modified and validated for this context and was administered to ANZCA advanced trainees. Additional questions were asked about perceived value for anaesthetic practice, study time and approaches to learning for each exam component. Overall, 236 of 690 trainees responded (34%). Responses indicated both deep and surface approaches to learning with a clear preponderance of deep approaches. The anaesthetic viva was valued most highly and the multiple choice question component the least. Despite this, respondents spent the most time studying for the multiple choice questions. The traditionally low short answer questions pass rate could not be explained by limited study time, perceived lack of value or study approaches. Written responses suggested that preparation for multiple choice questions was characterised by a surface approach, with rote memorisation of past questions. Minimal reference was made to the ANZCA syllabus as a guide for learning. These findings indicate that, although trainees found the exam generally relevant to practice and adopted predominantly deep learning approaches, there was considerable variation between the four components. These results provide data with which to review the existing ANZCA Final Exam and comparative data for future studies of the revisions to the ANZCA curriculum and exam process.

Comparing Cultural Differences in Two Quality Measures in Chinese Kindergartens: The Early Childhood Environment Rating Scale-Revised and the Kindergarten Quality Rating System

ERIC Educational Resources Information Center

Hu, Bi Ying

2015-01-01

This study examined the degrees of congruence between two early childhood evaluation systems on various quality concepts: the Early Childhood Environment Rating Scale-Revised (ECERS-R) and Zhejiang's Kindergarten Quality Rating System (KQRS). Analysis of variance and post hoc least significant difference tests were employed to show the extent to…

76 FR 55213 - Technical Amendments to Federal Employees' Retirement System; Present Value Conversion Factors...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-07

...) revising the factor at 5 CFR 843.309(b)(2) used to convert a lump sum basic employee death benefit under 5... would apply to deaths occurring on or after October 1, 2004. The revised factor, however, applies to deaths occurring on or after October 1, 2011. Therefore, this document corrects the final regulation by...

Assessing field vulnerability to phosphorus loss in Beijing agricultural area using Revised Field Phosphorus Ranking Scheme.

PubMed

Li, Qi; Chen, Li-ding; Qi, Xin; Zhang, Xin-yu; Ma, Yan; Fu, Bo-jie

2007-01-01

Guanting Reservoir, one of the drinking water supply sources of Beijing, suffers from water eutrophication. It is mainly supplied by Guishui River. Thus, to investigate the reasons of phosphorus (P) loss and improve the P management strategies in Guishui River watershed are important for the safety of drinking water in this region. In this study, a Revised Field P Ranking Scheme (PRS) was developed to reflect the field vulnerability of P loss at the field scale based on the Field PRS. In this new scheme, six factors are included, and each one was assigned a relative weight and a determination method. The affecting factors were classified into transport factors and source factors, and, the standards of environmental quality on surface water and soil erosion classification and degradation of the China were used in this scheme. By the new scheme, thirty-four fields in the Guishui River were categorized as "low", "medium" or "high" potential for P loss into the runoff. The results showed that the P loss risks of orchard and vegetable fields were higher than that of corn and soybean fields. The source factors were the main factors to affect P loss from the study area. In the study area, controlling P input and improving P usage efficiency are critical to decrease P loss. Based on the results, it was suggested that more attention should be paid on the fields of vegetable and orchard since they have extremely high usage rate of P and high soil test of P. Compared with P surplus by field measurements, the Revised Field PRS was more suitable for reflecting the characteristics of fields, and had higher potential capacity to identify critical source areas of P loss than PRS.

Beyond cause to consequence: The road from possible to core self-revision

PubMed Central

Carroll, Patrick J.; Agler, Robert A.; Newhart, Daniel W.

2015-01-01

Two studies addressed the ultimate consequences and pathways running from repeated possible self-revisions to gradual revisions in core selves over time. As hypothesized, greater prior experiences of downward possible self-revision ultimately predicted greater subsequent declines in core self-integrity (e.g., greater self-doubt, lower self-esteem). However, also as hypothesized, this effect was mediated by the relative use of defensive vs. remedial attributions for past downward self-revision experiences. In closing, we unpack how the present work extends prior work by situating possible selves and motivated self-attributions as complementary systems that can slowly undermine as well as expand the integrity of core selves over time. PMID:26635509

Revisions for screw malposition and clinical outcomes after robot-guided lumbar fusion for spondylolisthesis.

PubMed

Schröder, Marc L; Staartjes, Victor E

2017-05-01

OBJECTIVE The accuracy of robot-guided pedicle screw placement has been proven to be high, but little is known about the impact of such guidance on clinical outcomes such as the rate of revision surgeries for screw malposition. In addition, there are very few data about the impact of robot-guided fusion on patient-reported outcomes (PROs). Thus, the clinical benefit for the patient is unclear. In this study, the authors analyzed revision rates for screw malposition and changes in PROs following minimally invasive robot-guided pedicle screw fixation. METHODS A retrospective cohort study of patients who had undergone minimally invasive posterior lumbar interbody fusion (MI-PLIF) or minimally invasive transforaminal lumbar interbody fusion was performed. Patients were followed up clinically at 6 weeks, 12 months, and 24 months after treatment and by mailed questionnaire in March 2016 as a final follow-up. Visual analog scale (VAS) scores for back and leg pain severity, Oswestry Disability Index (ODI), screw revisions, and socio-demographic factors were analyzed. A literature review was performed, comparing the incidence of intraoperative screw revisions and revision surgery for screw malposition in robot-guided, navigated, and freehand fusion procedures. RESULTS Seventy-two patients fit the study inclusion criteria and had a mean follow up of 32 ± 17 months. No screws had to be revised intraoperatively, and no revision surgery for screw malposition was needed. In the literature review, the authors found a higher rate of intraoperative screw revisions in the navigated pool than in the robot-guided pool (p < 0.001, OR 9.7). Additionally, a higher incidence of revision surgery for screw malposition was observed for freehand procedures than for the robot-guided procedures (p < 0.001, OR 8.1). The VAS score for back pain improved significantly from 66.9 ± 25.0 preoperatively to 30.1 ± 26.8 at the final follow-up, as did the VAS score for leg pain (from 70.6 ± 22.8 to 24.3 ± 28.3) and ODI (from 43.4 ± 18.3 to 16.2 ± 16.7; all p < 0.001). Undergoing PLIF, a high body mass index, smoking status, and a preoperative ability to work were identified as predictors of a reduction in back pain. Length of hospital stay was 2.4 ± 1.1 days and operating time was 161 ± 50 minutes. Ability to work increased from 38.9% to 78.2% of patients (p < 0.001) at the final follow-up, and 89.1% of patients indicated they would choose to undergo the same treatment again. CONCLUSIONS In adults with low-grade spondylolisthesis, the data demonstrated a benefit in using robotic guidance to reduce the rate of revision surgery for screw malposition as compared with other techniques of pedicle screw insertion described in peer-reviewed publications. Larger comparative studies are required to assess differences in PROs following a minimally invasive approach in spinal fusion surgeries compared with other techniques.

Did glacially induced TPW end the ice age? A reanalysis

NASA Astrophysics Data System (ADS)

Chan, Ngai-Ham; Mitrovica, Jerry X.; Daradich, Amy

2015-09-01

Previous studies of Earth rotation perturbations due to ice-age loading have predicted a slow secular drift of the rotation axis relative to the surface geography (i.e. true polar wander, TPW) of order of several degrees over the Plio-Pleistocene. It has been argued that this drift and the change in the geographic distribution of solar insolation that it implies may have been responsible for important transitions in ice-age climate, including the termination of ice-age cycles.We use a revised rotational stability theory that incorporates a more accurate treatment of the Earth's background ellipticity to reconsider this issue, and demonstrate that the net displacement of the pole predicted in earlier studies disappears. This more muted polar motion is due to two factors: first, the revised theory no longer predicts the permanent shift in the rotation axis, or the so-called `unidirectional TPW', that appears in the traditional stability theory; and, second, the increased background ellipticity incorporated in the revised predictions acts to reduce the normal mode amplitudes governing the motion of the pole. We conclude that ice-age-induced TPW was not responsible for the termination of the ice age. This does not preclude the possibility that TPW induced by mantle convective flow may have played a role in major Plio-Pleistocene climate transitions, including the onset of Northern Hemisphere glaciation.

Short-term Risk of Revision THA in the Medicare Population Has Not Improved With Time.

PubMed

Bozic, Kevin J; Ong, Kevin; Kurtz, Steven; Lau, Edmund; Vail, Thomas P; Rubash, Harry; Berry, Daniel

2016-01-01

Advances in surgical technique, implant design, and clinical care pathways have resulted in higher expectations for improved clinical outcomes after primary THA; however, despite these advances, it is unclear whether the risk of revision THA actually has decreased with time. Understanding trends in short- and mid-term risks of revision will be helpful in directing clinical, research, and policy efforts to improve THA outcomes. We therefore asked (1) whether there have been changes in overall short- and mid-term risks of revision THA among patients in the Medicare population who underwent primary THA between 1998 and 2010; and (2) whether there are different demographic factors associated with short- and mid- term risks of revision THA. Using the Medicare 5% national sample database, patients who underwent primary THA between 1998 and 2010 followed by subsequent revision through 2011 were identified by ICD-9-CM procedure codes 81.51 and 81.53/80.05/00.70-00.73, respectively. This dataset included a random sample of Medicare beneficiaries based on their social security number. Only patients with minimum 1-year followup after primary THA were included in our analysis. A total of 64,260 patients who underwent primary THA were identified from the 1998 to 2010 Medicare 5% dataset. Eighty-eight percent of the patients had 1-year followup providing a final study cohort of 56,700 patients. The risk of revision was evaluated at 1, 3, 5, and 7 years. Multivariate Cox regression was used to evaluate temporal trends in revision risk using two methods to account for time effects with periods 1998 to 2002, 2003 to 2007, and 2008 to 2010 for the index year of primary THA, and individual year of index of primary THA as independent variables. The analysis adjusted for patient age, sex, race, census region, Charlson score, and socioeconomic status. The 7-year crude risk of revision THA declined from 7.10% in 1998 to 2002 to 6.09% in 2008 to 2010, representing a 14.4% overall reduction in adjusted risk of revision (p = 0.0058; 95% CI, 4.4%-23%). Similarly, the 5-year crude risk of revision THA declined from 5.96% in 1998 to 2002 to 5.11% in 2008 to 2010, representing a 14.2% overall reduction in adjusted risk of revision (p = 0.0069; 95% CI, 4.1%-23%). However, the adjusted risk of revision THA at 3 years was not different from 1998 to 2002 (4.70%) and 2008 to 2010 (4.03%; p = 0.1176). Similarly, the adjusted risk of revision at 1 year did not differ from 1998 to 2002 (2.83%) and 2008 to 2010 (2.42%; p = 0.3386). Patients with more comorbidities had a greater adjusted risk of revision (p < 0.001) at all times: 94% (95% CI, 58%-138%) and 56% (95% CI, 33%-84%) at 1 year and 7 years, respectively, for Charlson score of 5+ vs 0). Although the mid-term (5 and 7 years) risk of revision THA has decreased during the past 14 years among Medicare beneficiaries who underwent primary THA, the short-term risk has not. These findings suggest that greater clinical, research, and policy emphasis is needed to identify potentially avoidable causes of early failure after primary THA in patients in the Medicare population, and multistakeholder solutions are needed to optimize short-term outcomes. Level III, therapeutic study.

Health-related quality of life in breast cancer: A cross-cultural survey of German, Japanese, and South Korean patients.

PubMed

Shim, Eun-Jung; Mehnert, Anja; Koyama, Atsuko; Cho, Seong-Jin; Inui, Hiroki; Paik, Nam-Sun; Koch, Uwe

2006-10-01

The aim of this study was to evaluate health-related quality of life (HRQOL) in breast cancer patients across countries, and to cross-culturally examine the impact of psychosocial factors on HRQOL. A total of 413 women with breast cancer from Germany (n = 195), Japan (n = 112), and Korea (n = 106) completed a survey assessing HRQOL and HRQOL-related factors. HRQOL was measured using the Short-Form Health Survey (SF-8). Measures of psychological distress (Hospital Anxiety and Depression Scale and Impact of Event Scale-Revised), coping (Dealing with Illness Inventory-German Revised), and social support (Illness-Specific Social Support Scale-German Revised) were included. The effect of the factor country on physical QOL was seen to be significant, but small (P = 0.049, ES = 0.018). The scales of General Health (P = 0.023), Vitality (P = 0.004), and Role Emotional (P = 0.003) differed across countries, with the South Korean patients having lower scores compared to the German and Japanese patients. The nature of the impact of psychosocial factors on HRQOL did not differ greatly across countries except with regard to avoidance, however, the degree to which these factors influence HRQOL did differ greatly. Overall, depression, depressive coping, and problematic support showed a strong detrimental effect on the HRQOL of breast cancer patients. Results from this study suggest that strategies which target an improvement of HRQOL in cancer patients should also consider the patients' cultural and healthcare system contexts. Interventions are needed to improve detrimental psychosocial factors.

What is the evidence base to guide surgical treatment of infected hip prostheses? systematic review of longitudinal studies in unselected patients

PubMed Central

2012-01-01

Background Prosthetic joint infection is an uncommon but serious complication of hip replacement. There are two main surgical treatment options, with the choice largely based on the preference of the surgeon. Evidence is required regarding the comparative effectiveness of one-stage and two-stage revision to prevent reinfection after prosthetic joint infection. Methods We conducted a systematic review to identify randomised controlled trials, systematic reviews and longitudinal studies in unselected patients with infection treated exclusively by one- or two-stage methods or by any method. The Embase, MEDLINE and Cochrane databases were searched up to March 2011. Reference lists were checked, and citations of key articles were identified by using the ISI Web of Science portal. Classification of studies and data extraction were performed independently by two reviewers. The outcome measure studied was reinfection within 2 years. Data were combined to produce pooled random-effects estimates using the Freeman-Tukey arc-sine transformation. Results We identified 62 relevant studies comprising 4,197 patients. Regardless of treatment, the overall rate of reinfection after any treatment was 10.1% (95% CI = 8.2 to 12.0). In 11 studies comprising 1,225 patients with infected hip prostheses who underwent exclusively one-stage revision, the rate of reinfection was 8.6% (95% CI = 4.5 to 13.9). After two-stage revision exclusively in 28 studies comprising 1,188 patients, the rate of reinfection was 10.2% (95% CI = 7.7 to 12.9). Conclusion Evidence of the relative effectiveness of one- and two-stage revision in preventing reinfection of hip prostheses is largely based on interpretation of longitudinal studies. There is no suggestion in the published studies that one- or two stage methods have different reinfection outcomes. Randomised trials are needed to establish optimum management strategies. PMID:22340795

Frontal sinus revision rate after nasal polyposis surgery including frontal recess clearance and middle turbinectomy: A long-term analysis.

PubMed

Benkhatar, Hakim; Khettab, Idir; Sultanik, Philippe; Laccourreye, Ollivier; Bonfils, Pierre

2018-08-01

To determine the frontal sinus revision rate after nasal polyposis (NP) surgery including frontal recess clearance (FRC) and middle turbinectomy (MT), to search for predictive factors and to analyse surgical management. Longitudinal analysis of 153 patients who consecutively underwent bilateral sphenoethmoidectomy with FRC and MT for NP with a minimum follow-up of 7 years. Decision of revision surgery was made in case of medically refractory chronic frontal sinusitis or frontal mucocele. Univariate and multivariate analysis incorporating clinical and radiological variables were performed. The frontal sinus revision rate was 6.5% (10/153). The mean time between the initial procedure and revision surgery was 3 years, 10 months. Osteitis around the frontal sinus outflow tract (FSOT) was associated with a higher risk of frontal sinus revision surgery (p=0.01). Asthma and aspirin intolerance did not increase the risk, as well as frontal sinus ostium diameter or residual frontoethmoid cells. Among revised patients, 60% required multiple procedures and 70% required frontal sinus ostium enlargement. Our long-term study reports that NP surgery including FRC and MT is associated with a low frontal sinus revision rate (6.5%). Patients developing osteitis around the FSOT have a higher risk of frontal sinus revision surgery. As mucosal damage can lead to osteitis, FSOT mucosa should be preserved during initial NP surgery. However, as multiple procedures are common among NP patients requiring frontal sinus revision, frontal sinus ostium enlargement should be considered during first revision in the hope of reducing the need of further revisions. Copyright © 2018 Elsevier B.V. All rights reserved.

Confirmatory factor analysis of burnout dimensions : correlations with job stressors and aspects of social support and job satisfaction.

DOT National Transportation Integrated Search

1992-02-01

This study examined the dimensionality and construct validity of Golembiewski, Munzenrider, and Stevenson (1986) revision of the Maslach and Jackson (1981) Maslach Burnout Inventory (MBI). Results of confirmatory factor analyses conducted on data col...

Dependence and physical exercise: Spanish validation of the Exercise Dependence Scale-Revised (EDS-R).

PubMed

Sicilia, Alvaro; González-Cutre, David

2011-05-01

The purpose of this study was to validate the Spanish version of the Exercise Dependence Scale-Revised (EDS-R). To achieve this goal, a sample of 531 sport center users was used and the psychometric properties of the EDS-R were examined through different analyses. The results supported both the first-order seven-factor model and the higher-order model (seven first-order factors and one second-order factor). The structure of both models was invariant across age. Correlations among the subscales indicated a related factor model, supporting construct validity of the scale. Alpha values over .70 (except for Reduction in Other Activities) and suitable levels of temporal stability were obtained. Users practicing more than three days per week had higher scores in all subscales than the group practicing with a frequency of three days or fewer. The findings of this study provided reliability and validity for the EDS-R in a Spanish context.

The Instinct Fallacy: The Metacognition of Answering and Revising during College Exams

ERIC Educational Resources Information Center

Couchman, Justin J.; Miller, Noelle E.; Zmuda, Shaun J.; Feather, Kathryn; Schwartzmeyer, Tina

2016-01-01

Students often gauge their performance before and after an exam, usually in the form of rough grade estimates or general feelings. Are these estimates accurate? Should they form the basis for decisions about study time, test-taking strategies, revisions, subject mastery, or even general competence? In two studies, undergraduates took a real…

Assessing the Relationship between Different Types of Student Feedback and the Quality of Revised Writing

ERIC Educational Resources Information Center

Diab, Nuwar Mawlawi

2011-01-01

This paper reports on a quasi-experimental study comparing the effects of peer-editing to self-editing on improving students' revised drafts. The study involved two intact classes (experimental and control groups) of an English course. The experimental group practiced peer-editing while the control group engaged in self-editing. After receiving…

Factorial Validity and Invariance Testing of the Exercise Dependence Scale-Revised in Swedish and Portuguese Exercisers

ERIC Educational Resources Information Center

Lindwall, Magnus; Palmeira, Antonio

2009-01-01

The present study investigated the factorial validity and factorial invariance of the 21-item Exercise Dependence Scale-Revised using 162 Swedish and 269 Portuguese exercisers. In addition, the prevalence of exercise dependence symptoms and links to exercise behavior, gender, and age in the two samples was also studied. Confirmatory factor…

Validating the Thinking Styles Inventory-Revised II among Chinese University Students with Hearing Impairment through Test Accommodations

ERIC Educational Resources Information Center

Cheng, Sanyin; Zhang, Li-Fang

2014-01-01

The present study pioneered in adopting test accommodations to validate the Thinking Styles Inventory-Revised II (TSI-R2; Sternberg, Wagner, & Zhang, 2007) among Chinese university students with hearing impairment. A series of three studies were conducted that drew their samples from the same two universities, in which accommodating test…

Analysis of the Revision Process by American Journal of Roentgenology Reviewers and Section Editors: Metrics of Rejected Manuscripts and Their Final Disposition.

PubMed

Cejas, Claudia

2017-06-01

The objective of this study was to evaluate metrics related to manuscripts rejected by AJR with and without review during 2014 and to determine their final disposition: no record of eventual publication, eventually published, published with modified authors and title, published with the same title but modified authors, and published with modified title but the same authors. A total of 1245 unsolicited manuscripts submitted from January to December 2014 were included in this retrospective analysis. Data were extracted from the AJR's manuscript submission system. Standard statistical analysis was used to assess the fate of a sample of 200 rejected manuscripts. Of the 200 manuscripts studied, 117 (59%) were published in other scientific journals (61 with revision, 56 without revision; Χ 2 = 0.329, p = 0.566). Thirty-two of the 61 manuscripts (52%) rejected after peer review were later published in other journals without changes in their titles or authors, 16 (26%) with changes only in authors, 10 (16%) with changes only in their titles, and three (5%) with changes in authors and titles. Twenty-six of the 56 manuscripts (46%) rejected without peer review were published without changes in their titles or authors, 17 (30%) with changes in authors, 11 (20%) with changes only in their titles, and two (4%) with changes in both authors and titles (p = 0.686). Ten articles were published in open access journals. Of the remaining articles, those that had been reviewed were published in journals with a mean impact factor ± SD of 2.37 ± 1.30, and those that had not been reviewed were published in journals with a mean impact factor of 2.04 ± 1.06. Analysis of the 25th and 75th percentiles revealed that values were also higher for the group rejected with review (Wilcoxon rank sum test: W = 1679, p = 0.1127). Out of 61 articles rejected for publication with review, 52.5% were published with changes to their abstracts, whereas the remaining 47.5% were unchanged. This analysis found that manuscripts submitted to AJR that were rejected after review were published in journals with higher impact factors than those rejected without review. The commentaries provided by AJR reviewers and section editors appear to improve the quality of rejected manuscripts and thus contribute to the scientific community.

One-stage or two-stage revision surgery for prosthetic hip joint infection--the INFORM trial: a study protocol for a randomised controlled trial.

PubMed

Strange, Simon; Whitehouse, Michael R; Beswick, Andrew D; Board, Tim; Burston, Amanda; Burston, Ben; Carroll, Fran E; Dieppe, Paul; Garfield, Kirsty; Gooberman-Hill, Rachael; Jones, Stephen; Kunutsor, Setor; Lane, Athene; Lenguerrand, Erik; MacGowan, Alasdair; Moore, Andrew; Noble, Sian; Simon, Joanne; Stockley, Ian; Taylor, Adrian H; Toms, Andrew; Webb, Jason; Whittaker, John-Paul; Wilson, Matthew; Wylde, Vikki; Blom, Ashley W

2016-02-17

Periprosthetic joint infection (PJI) affects approximately 1% of patients following total hip replacement (THR) and often results in severe physical and emotional suffering. Current surgical treatment options are debridement, antibiotics and implant retention; revision THR; excision of the joint and amputation. Revision surgery can be done as either a one-stage or two-stage operation. Both types of surgery are well-established practice in the NHS and result in similar rates of re-infection, but little is known about the impact of these treatments from the patient's perspective. The main aim of this randomised controlled trial is to determine whether there is a difference in patient-reported outcome measures 18 months after randomisation for one-stage or two-stage revision surgery. INFORM (INFection ORthopaedic Management) is an open, two-arm, multi-centre, randomised, superiority trial. We aim to randomise 148 patients with eligible PJI of the hip from approximately seven secondary care NHS orthopaedic units from across England and Wales. Patients will be randomised via a web-based system to receive either a one-stage revision or a two-stage revision THR. Blinding is not possible due to the nature of the intervention. All patients will be followed up for 18 months. The primary outcome is the WOMAC Index, which assesses hip pain, function and stiffness, collected by questionnaire at 18 months. Secondary outcomes include the following: cost-effectiveness, complications, re-infection rates, objective hip function assessment and quality of life. A nested qualitative study will explore patients' and surgeons' experiences, including their views about trial participation and randomisation. INFORM is the first ever randomised trial to compare two widely accepted surgical interventions for the treatment of PJI: one-stage and two-stage revision THR. The results of the trial will benefit patients in the future as the main focus is on patient-reported outcomes: pain, function and wellbeing in the long term. Patients state that these outcomes are more important than those that are clinically derived (such as re-infection) and have been commonly used in previous non-randomised studies. Results from the INFORM trial will also benefit clinicians and NHS managers by enabling the comparison of these key interventions in terms of patients' complication rates, health and social resource use and their overall cost-effectiveness. Current controlled trials ISRCTN10956306 (registered on 29 January 2015); UKCRN ID 18159.

Component alignment in revision total knee arthroplasty using diaphyseal engaging modular offset press-fit stems.

PubMed

Nakasone, Cass K; Abdeen, Ayesha; Khachatourians, Armond G; Sugimori, Tanzo; Vince, Kelly G

2008-12-01

We performed a retrospective study of the radiographic position of femoral and tibial components in a series of revision total knee arthroplasties using diaphyseal-engaging, press fit, modular stems. Fifty-two consecutive revision cases were performed. Femoral and tibial component alignment was measured preoperatively and postoperatively. The canal-filling ratio was measured and correlated with anatomic alignment. There was a trend toward improved alignment with increasing canal fill, suggesting that uncemented diaphyseal engaging press-fit modular stems facilitate accurate alignment for both femoral and tibial components in revision surgery.

Comparison of Revision Rates of Anterior- and Posterior-Approach Ptosis Surgery: A Retrospective Review of 1519 Cases.

PubMed

Chou, Eva; Liu, Jun; Seaworth, Cathleen; Furst, Meredith; Amato, Malena M; Blaydon, Sean M; Durairaj, Vikram D; Nakra, Tanuj; Shore, John W

To compare revision rates for ptosis surgery between posterior-approach and anterior-approach ptosis repair techniques. This is the retrospective, consecutive cohort study. All patients undergoing ptosis surgery at a high-volume oculofacial plastic surgery practice over a 4-year period. A retrospective chart review was conducted of all patients undergoing posterior-approach and anterior-approach ptosis surgery for all etiologies of ptosis between 2011 and 2014. Etiology of ptosis, concurrent oculofacial surgeries, revision, and complications were analyzed. The main outcome measure is the ptosis revision rate. A total of 1519 patients were included in this study. The mean age was 63 ± 15.4 years. A total of 1056 (70%) of patients were female, 1451 (95%) had involutional ptosis, and 1129 (74.3%) had concurrent upper blepharoplasty. Five hundred thirteen (33.8%) underwent posterior-approach ptosis repair, and 1006 (66.2%) underwent anterior-approach ptosis repair. The degree of ptosis was greater in the anterior-approach ptosis repair group. The overall revision rate for all patients was 8.7%. Of the posterior group, 6.8% required ptosis revision; of the anterior group, 9.5% required revision surgery. The main reason for ptosis revision surgery was undercorrection of one or both eyelids. Concurrent brow lifting was associated with a decreased, but not statistically significant, rate of revision surgery. Patients who underwent unilateral ptosis surgery had a 5.1% rate of Hering's phenomenon requiring ptosis repair in the contralateral eyelid. Multivariable logistic regression for predictive factors show that, when adjusted for gender and concurrent blepharoplasty, the revision rate in anterior-approach ptosis surgery is higher than posterior-approach ptosis surgery (odds ratio = 2.08; p = 0.002). The overall revision rate in patients undergoing ptosis repair via posterior-approach or anterior-approach techniques is 8.7%. There is a statistically higher rate of revision with anterior-approach ptosis repair.

Concurrent Validity of the Psychopathic Personality Inventory with Offender and Community Samples

PubMed Central

Malterer, Melanie B.; Lilienfeld, Scott O.; Neumann, Craig S.; Newman, Joseph P.

2009-01-01

The Psychopathy Checklist - Revised (PCL-R; Hare, 2003) is a frequently used and well-validated measure of psychopathy, but is relatively time-intensive and expensive to administer. The Psychopathic Personality Inventory (PPI; Lilienfeld & Andrews, 1996) is a self-report measure that provides a less time-intensive and less expensive method for identifying psychopathic individuals. Using three independent samples and two different versions of the PCL (i.e., PCL-R, PCL:SV), we evaluated the extent to which the PPI and PCL overlap in their measurement of the psychopathy construct. Across three studies, PPI total and Factor 2 scores correlated moderately to strongly with PCL total and Factor 2 scores. Results for PPI and PCL Factor 1 scores were less positive. These findings raise important questions concerning the integration of results obtained using alternative psychopathy assessments. PMID:19955107

Psychometric Properties of the Revised Mathematics Anxiety Rating Scale

ERIC Educational Resources Information Center

Baloglu, Mustafa; Zelhart, Paul F.

2007-01-01

An exploratory factor analysis and several confirmatory analyses were performed to evaluate the factorial structure of the Revised Mathematics Anxiety Rating Scale (RMARS) through the responses of 805 college students. On 559 students' scores, the instrument's construct validity was tested through a confirmatory factor analysis (CFA) and was found…

Exploring posttraumatic growth in Tamil children affected by the Indian Ocean Tsunami in 2004.

PubMed

Exenberger, Silvia; Ramalingam, Panch; Höfer, Stefan

2016-10-13

Few studies explore posttraumatic growth (PTG) in children from Eastern cultures. To help address this gap, the present study examined PTG among 177 South Indian children aged 8-17 years who were affected by the 2004 Tsunami. The study identifies the underlying factor structure of the Tamil version of the Revised Posttraumatic Growth Inventory for Children (PTGI-C-R), and aims to explore the prevalence of PTG, the relationship between distress and growth, and gender and age differences in PTG. The results of the principal component analysis indicated a two-factor structure with an interpersonal and a person-centred dimension of growth. The total scores of the Tamil PTGI-C-R were positively associated with posttraumatic stress symptoms (PTSS) and age. Moreover, there was a significant relationship between age and the person-centred growth subscale. Non-parametric tests found no gender differences in perceived growth. The role of socio-cultural factors on the nature of PTG is discussed. © 2016 International Union of Psychological Science.

A review of the revised Functional Capacity Index as a predictor of 12 month outcomes following injury.

PubMed

Palmer, Cameron S; Cameron, Peter A; Gabbe, Belinda J

2017-03-01

The measurement of functional outcomes following severe trauma has been widely recognised as a priority for countries with developed trauma systems. In this respect, the Functional Capacity Index (FCI), a multi-attribute index which has been incorporated into the most recent Abbreviated Injury Scale (AIS) dictionary, is potentially attractive as it offers 12-month functional outcome predictions for patients captured by existing AIS-coded datasets. This review paper outlines the development, construction and validation of the predictive form of the FCI (termed the pFCI), the modifications made which produced the currently available 'revised' pFCI, and the extent to which the revised pFCI has been validated and used. The original pFCI performed poorly in validation studies. The revised pFCI does not address many of the identified limitations of the original version, and despite the ready availability of a truncated version in the AIS dictionary, it has only been used in a handful of studies since its introduction several years ago. Additionally, there is little evidence for its validity. It is suggested that the pFCI should be better validated, whether in the narrow population group of young, healthy individuals for which it was developed, or in the wider population of severely injured patients. Methods for accounting for the presence of multiple injures (of which two have currently been used) should also be evaluated. Many factors other than anatomical injury are known to affect functional outcomes following trauma. However, it is intuitive that any model which attempts to predict the ongoing morbidity burden in a trauma population should consider the effects of the injuries sustained. Although the revised pFCI potentially offers a low-cost assessment of likely functional limitations resulting from anatomical injury, it must be more rigorously evaluated before more comprehensive predictive tools can be developed from it. Copyright © 2017 Elsevier Ltd. All rights reserved.

Physiologic Preoperative Knee Hyperextension Is a Predictor of Failure in an Anterior Cruciate Ligament Revision Cohort: A Report From the MARS Group.

PubMed

Cooper, Daniel E; Dunn, Warren R; Huston, Laura J; Haas, Amanda K; Spindler, Kurt P; Allen, Christina R; Anderson, Allen F; DeBerardino, Thomas M; Lantz, Brett Brick A; Mann, Barton; Stuart, Michael J; Albright, John P; Amendola, Annunziato Ned; Andrish, Jack T; Annunziata, Christopher C; Arciero, Robert A; Bach, Bernard R; Baker, Champ L; Bartolozzi, Arthur R; Baumgarten, Keith M; Bechler, Jeffery R; Berg, Jeffrey H; Bernas, Geoffrey A; Brockmeier, Stephen F; Brophy, Robert H; Bush-Joseph, Charles A; Butler V, J Brad; Campbell, John D; Carey, James L; Carpenter, James E; Cole, Brian J; Cooper, Jonathan M; Cox, Charles L; Creighton, R Alexander; Dahm, Diane L; David, Tal S; Flanigan, David C; Frederick, Robert W; Ganley, Theodore J; Garofoli, Elizabeth A; Gatt, Charles J; Gecha, Steven R; Giffin, James Robert; Hame, Sharon L; Hannafin, Jo A; Harner, Christopher D; Harris, Norman Lindsay; Hechtman, Keith S; Hershman, Elliott B; Hoellrich, Rudolf G; Hosea, Timothy M; Johnson, David C; Johnson, Timothy S; Jones, Morgan H; Kaeding, Christopher C; Kamath, Ganesh V; Klootwyk, Thomas E; Levy, Bruce A; Ma, C Benjamin; Maiers, G Peter; Marx, Robert G; Matava, Matthew J; Mathien, Gregory M; McAllister, David R; McCarty, Eric C; McCormack, Robert G; Miller, Bruce S; Nissen, Carl W; O'Neill, Daniel F; Owens, Brett D; Parker, Richard D; Purnell, Mark L; Ramappa, Arun J; Rauh, Michael A; Rettig, Arthur C; Sekiya, Jon K; Shea, Kevin G; Sherman, Orrin H; Slauterbeck, James R; Smith, Matthew V; Spang, Jeffrey T; Svoboda, Steven J; Taft, Timothy N; Tenuta, Joachim J; Tingstad, Edwin M; Vidal, Armando F; Viskontas, Darius G; White, Richard A; Williams, James S; Wolcott, Michelle L; Wolf, Brian R; York, James J; Wright, Rick W

2018-06-01

The occurrence of physiologic knee hyperextension (HE) in the revision anterior cruciate ligament reconstruction (ACLR) population and its effect on outcomes have yet to be reported. Hypothesis/Purpose: The prevalence of knee HE in revision ACLR and its effect on 2-year outcome were studied with the hypothesis that preoperative physiologic knee HE ≥5° is a risk factor for anterior cruciate ligament (ACL) graft rupture. Cohort study; Level of evidence, 2. Patients undergoing revision ACLR were identified and prospectively enrolled between 2006 and 2011. Study inclusion criteria were patients undergoing single-bundle graft reconstructions. Patients were followed up at 2 years and asked to complete an identical set of outcome instruments (International Knee Documentation Committee, Knee injury and Osteoarthritis Outcome Score, WOMAC, and Marx Activity Rating Scale) as well as provide information regarding revision ACL graft failure. A regression model with graft failure as the dependent variable included age, sex, graft type at the time of the revision ACL surgery, and physiologic preoperative passive HE ≥5° (yes/no) to assess these as potential risk factors for clinical outcomes 2 years after revision ACLR. Analyses included 1145 patients, for whom 2-year follow-up was attained for 91%. The median age was 26 years, with age being a continuous variable. Those below the median were grouped as "younger" and those above as "older" (age: interquartile range = 20, 35 years), and 42% of patients were female. There were 50% autografts, 48% allografts, and 2% that had a combination of autograft plus allograft. Passive knee HE ≥5° was present in 374 (33%) patients in the revision cohort, with 52% being female. Graft rupture at 2-year follow-up occurred in 34 cases in the entire cohort, of which 12 were in the HE ≥5° group (3.2% failure rate) and 22 in the non-HE group (2.9% failure rate). The median age of patients who failed was 19 years, as opposed to 26 years for those with intact grafts. Three variables in the regression model were significant predictors of graft failure: younger age (odds ratio [OR] = 3.6; 95% CI, 1.6-7.9; P = .002), use of allograft (OR = 3.3; 95% CI, 1.5-7.4; P = .003), and HE ≥5° (OR = 2.12; 95% CI, 1.1-4.7; P = .03). This study revealed that preoperative physiologic passive knee HE ≥5° is present in one-third of patients who undergo revision ACLR. HE ≥5° was an independent significant predictor of graft failure after revision ACLR with a >2-fold OR of subsequent graft rupture in revision ACL surgery. Registration: NCT00625885 ( ClinicalTrials.gov identifier).

The unsuspected prosthetic joint infection : incidence and consequences of positive intra-operative cultures in presumed aseptic knee and hip revisions.

PubMed

Jacobs, A M E; Bénard, M; Meis, J F; van Hellemondt, G; Goosen, J H M

2017-11-01

Positive cultures are not uncommon in cases of revision total knee and hip arthroplasty (TKA and THA) for presumed aseptic causes. The purpose of this study was to assess the incidence of positive intra-operative cultures in presumed aseptic revision of TKA and THA, and to determine whether the presence of intra-operative positive cultures results in inferior survival in such cases. A retrospective cohort study was assembled with 679 patients undergoing revision knee (340 cases) or hip arthroplasty (339 cases) for presumed aseptic causes. For all patients three or more separate intra-operative cultures were obtained. Patients were diagnosed with a previously unsuspected prosthetic joint infection (PJI) if two or more cultures were positive with the same organism. Records were reviewed for demographic details, pre-operative laboratory results and culture results. The primary outcome measure was infection-free implant survival at two years. The incidence of unsuspected PJI was 27 out of 340 (7.9%) in TKA and 41 out of 339 (12.1%) in THA. Following revision TKA, the rate of infection-free implant survival in patients with an unsuspected PJI was 88% (95% confidence intervals (CI) 60 to 97) at two years compared with 98% (95% CI 94 to 99) in patients without PJI (p = 0.001). After THA, the rate of survival was similar in those with unsuspected PJI (92% (95% CI 73 to 98) at two years) and those without (94% (95% CI 89 to 97), p = 0.31). Following revision of TKA and THA for aseptic diagnoses, around 10% of cases were found to have positive cultures. In the knee, such cases had inferior infection-free survival at two years compared with those with negative cultures; there was no difference between the groups following THA. Cite this article: Bone Joint J 2017;99-B:1482-9. ©2017 The British Editorial Society of Bone & Joint Surgery.

Evaluation of the Diagnostic Utility of the Traditional and Revised WHO Dengue Case Definitions

PubMed Central

Gutiérrez, Gamaliel; Gresh, Lionel; Pérez, María Ángeles; Elizondo, Douglas; Avilés, William; Kuan, Guillermina; Balmaseda, Ángel; Harris, Eva

2013-01-01

Dengue, a mosquito-borne viral illness, is a major public health problem worldwide, and its incidence continues to increase. In 2009, the World Health Organization published guidelines that included a revision of the dengue case definition. Compared to the traditional definition, the revised case definition relies more on signs than on symptoms, making it more applicable to young children. We evaluated the diagnostic utility of both case definitions in two studies of pediatric dengue in Managua, Nicaragua. In a community-based cohort study, we included data from 3,407 suspected dengue cases, of which 476 were laboratory-confirmed. In the second study, we collected information from 1,160 participants recruited at the national pediatric reference hospital (723 laboratory-confirmed). In the cohort study, the traditional definition had 89.3% sensitivity and 43.1% specificity, while the revised definition yielded similar sensitivity (86.6%) and higher specificity (55.2%, p<0.001). In the hospital study, the traditional case definition yielded 96.7% sensitivity and 22.0% specificity, whereas the revised case definition had higher sensitivity (99.3%, p<0.001) but lower specificity (8.5%, p<0.001). We then evaluated the performance of two diagnostic models based on the signs/symptoms included in each definition by analyzing the effect of increasing numbers of signs/symptoms on the sensitivity and specificity of case capture. Receiver operating characteristic analysis showed a slightly better performance for the revised model in both studies. Interestingly, despite containing less symptoms that cannot be readily expressed by children aged less than 4 years, the revised definition did not perform better in this age group. Overall, our results indicate that both case definitions have similar capacity to diagnose dengue. Owing to their high sensitivity and low specificity, they should be primarily used for screening purposes. However, in a primary care setting, neither of the case definitions performed well as a screening test in younger children. PMID:23991237

General and Maladaptive Traits in a Five-Factor Framework for "DSM"-5 in a University Student Sample

ERIC Educational Resources Information Center

De Fruyt, Filip; De Clercq, Barbara; De Bolle, Marleen; Wille, Bart; Markon, Kristian; Krueger, Robert F.

2013-01-01

The relationships between two measures proposed to describe personality pathology, that is the Revised NEO Personality Inventory (NEO-PI-3) and the Personality Inventory for "DSM"-5 (PID-5), are examined in an undergraduate sample (N = 240). The NEO inventories are general trait measures, also considered relevant to assess disordered…

Exploring the Dimensionality of a Brief School Readiness Screener for Use with Latino/a Children

ERIC Educational Resources Information Center

Quirk, Matthew; Rebelez, Jennica; Furlong, Michael

2014-01-01

This study contributed to the school readiness literature by examining the factor structure and reliability of a revised version of the Kindergarten Student Entrance Profile (KSEP). Teachers rated 579 Latino/a children during the first month of kindergarten using the KSEP. Factor analysis procedures (exploratory factor analysis [EFA] and…

A Factor-Analytic Study of Adaptive Behavior and Intellectual Functioning in Learning Disabled Children.

ERIC Educational Resources Information Center

Yeargan, Dollye R.

The factorial structure of intellectual functioning and adaptive behavior was examined in 160 learning disabled students (6 to 16 years old). Ss were administered the Wechsler Intelligence Scale for Children-Revised (WISC-R) and the Coping Inventory (CI). Factor analysis of WISC-R scores revealed three factors: verbal comprehenson, perceptual…

Refining a Learning Progression of Energy

ERIC Educational Resources Information Center

Yao, Jian-Xin; Guo, Yu-Ying; Neumann, Knut

2017-01-01

This paper presents a revised learning progression for the energy concept and initial findings on diverse progressions among subgroups of sample students. The revised learning progression describes how students progress towards an understanding of the energy concept along two progress variables identified from previous studies--key ideas about…

Evaluation of the revised Sense of Coherence scale in a sample of older adults: A means to assess resilience aspects.

PubMed

Mc Gee, Shauna L; Höltge, Jan; Maercker, Andreas; Thoma, Myriam V

2017-08-11

The present study evaluated the revised Sense of Coherence (SOC-R) scale in a sample of older adults, using an extended range of psychological concepts. It further examined the psychometric properties of the revised scale and tested the theoretical assumptions underpinning the SOC-R concept. The SOC-R scale was evaluated in 268 Swiss older adults (mean age = 66.9 years), including n = 15 heavily traumatized former indentured child labourers. Standardised questionnaires collected information on positive and negative life experiences, resources, current health, and well-being.  Results: Confirmatory Factor Analysis indicated good model fit for a second-order three-factor model of SOC-R with the factors manageability, balance, and reflection. Satisfactory convergent and discriminant correlations were shown with related psychological concepts, including neuroticism (r = -.32, p < .01), optimism (r = .31, p < .01), and general self-efficacy (r = .49, p < .01). SOC-R was not observed to differ by age group. Moderation analyses indicated that SOC-R moderated the relationship between certain early-life adversities and mental health. The study provides support for the psychometric properties and theoretical assumptions of SOC-R and suggests that SOC-R is a valid and reliable measure suitable for use with older adults. Future studies should employ longitudinal designs to examine the stability of SOC-R.

Mayo's Older Americans Normative Studies (MOANS): Factor Structure of a Core Battery.

ERIC Educational Resources Information Center

Smith, Glenn E.; And Others

1992-01-01

Using the Mayo Older Americans Normative Studies (MOANS) group (526 55-to 97-year-old adults), factor models were examined for the Wechsler Adult Intelligence Scale-Revised (WAIS-R); the Wechsler Memory Scale (WMS); and a core battery of the WAIS-R, the WMS, and the Rey Auditory-Verbal Learning Test. (SLD)

Over-drainage and persistent shunt-dependency in patients with idiopathic intracranial hypertension treated with shunts and bariatric surgery.

PubMed

Roth, Jonathan; Constantini, Shlomi; Kesler, Anat

2015-01-01

Idiopathic intracranial hypertension (IIH) may lead to visual impairment. Shunt surgery is indicated for refractory IIH-related symptoms that persist despite medical treatment, or those presenting with significant visual decline. Obesity is a risk factor for IIH; a reduction in weight has been shown to improve papilledema. Bariatric surgery (BS) has been suggested for treating IIH associated with morbid obesity. In this study, we describe a high rate of over-drainage (OD) seen in patients following shunts and BS. The study cohort includes 13 patients with IIH that underwent shunt surgery for treatment of the IIH-related symptoms. Six patients underwent BS in addition to the shunt surgery (but not concomitantly). Seven patients had only shunt surgeries with no BS. Data were collected retrospectively. BS effectively led to weight reduction (body mass index decreasing from 43 ± 4 to 28 ± 5). Patients undergoing BS had 1-6 (2.5 ± 1.9) shunt revisions for OD following BS, as opposed to 0-3 (1.4 ± 1.1) revisions prior to BS over similar time spans (statistically insignificant difference), and 0-6 (1.6 ± 2.5) revisions among the non-BS patients over a longer time span (statistically insignificant difference). Two patients in the BS group underwent shunt externalization and closure; however, they proved to be shunt-dependent. Patients with IIH that undergo shunt surgery and BS (not concomitantly) may suffer from OD symptoms, necessitating multiple shunt revisions, and valve upgrades. Despite BS being a valid primary treatment for some patients with IIH, among shunted patients, BS may not lead to resolution of IIH-related symptoms and patients may remain shunt-dependent.

The Family-Couple-Parenting Questionnaire: Development of a Measure for Long-Term Couples and Young Adults.

PubMed

Carli, Lucia Leonilde; Anzelmo, Elena; Gatti, Elisa; Santona, Alessandra; Pozzi, Stefania; Gallucci, Marcello

2016-06-01

This work describes the construction of family-couple-parenting (FCP) questionnaire, a new measure of three aspects related to the developmental path toward parenting choices, within the perspective of the family life cycle and attachment theory. Two studies are reported. Study 1 reports the development of the FCP questionnaire and its psychometric properties. Study 2 assesses the FCP's nomological validity by investigating group differences on FCP factors and links between FCP factors and romantic attachment (experience in close relationships-revised) and recalled parental bonding (parental bonding instrument). Participants were 791 Italian participants: 405 young adults (203 students, 202 workers) and 193 couples (91 childless-by-choice, 102 parents-to-be). The results suggest that the FCP's stable psychometric structure and strong theoretical basis make FCP a useful instrument for research related to the path to parenthood. © The Author(s) 2016.

Three-Dimensional Model of Strengths: Examination of Invariance Across Gender, Age, Education Levels, and Marriage Status.

PubMed

Duan, Wenjie; Ho, Samuel Mun Yin

2017-02-01

Strengths are positive qualities that significantly contributed to well-being of individuals and community. Therefore, a reliable and valid measure of strengths for research and practice is needed. The Brief Strengths Scale (BSS) is a newly developed tool for measuring the three-dimensional strengths model (i.e., temperance, intellectual, and interpersonal strength). However, empirical support for the measurement invariance of the BSS has not been obtained. This study examined the three-factor structure of BSS across gender, age, education, and marriage groups in a community sample (n = 375) using multi-group confirmatory factor analysis. After removing one item of each subscale from the original version, the revised model provided a good fit to the data at different subgroups. The revised nine-item BSS indicated that measurement invariance across gender and age groups was achieved. In addition, the measurement was more influenced by social-cultural factors than biological factors.

Five-Year Survival of 20,946 Unicondylar Knee Replacements and Patient Risk Factors for Failure: An Analysis of German Insurance Data.

PubMed

Jeschke, Elke; Gehrke, Thorsten; Günster, Christian; Hassenpflug, Joachim; Malzahn, Jürgen; Niethard, Fritz Uwe; Schräder, Peter; Zacher, Josef; Halder, Andreas

2016-10-19

Improvements in implant design and surgical technique of unicondylar knee arthroplasty have led to reduced revision rates, but patient selection seems to be crucial for success of such arthroplasties. The purpose of the present study was to analyze the 5-year implant survival rate of unicondylar knee replacements in Germany and to identify patient factors associated with an increased risk of revision, including >30 comorbid conditions. Using nationwide billing data of the largest German health-care insurance for inpatient hospital treatment, we identified patients who underwent unicondylar knee arthroplasty between 2006 and 2012. Kaplan-Meier survival curves with revision as the end point and log-rank tests were used to evaluate 5-year implant survival. A multivariable Cox regression model was used to determine factors associated with revision. The risk factors of age, sex, diagnosis, comorbidities, type of implant fixation, and hospital volume were analyzed. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated. During the study period, a total of 20,946 unicondylar knee arthroplasties were included. The number of unicondylar knee arthroplasties per year increased during the study period from 2,527 in 2006 to 4,036 in 2012. The median patient age was 64 years (interquartile range, 56 to 72 years), and 60.4% of patients were female. During the time evaluated, the 1-year revision rate decreased from 14.3% in 2006 to 8.7% in 2011. The 5-year survival rate was 87.8% (95% CI, 87.3% to 88.3%). Significant risk factors (p < 0.05) for unicondylar knee arthroplasty revision were younger age (the HR was 2.93 [95% CI, 2.48 to 3.46] for patient age of <55 years, 1.86 [95% CI, 1.58 to 2.19] for 55 to 64 years, and 1.52 [95% CI, 1.29 to 1.79] for 65 to 74 years; patient age of >74 years was used as the reference); female sex (HR, 1.18 [95% CI, 1.07 to 1.29]); complicated diabetes (HR, 1.47 [95% CI, 1.03 to 2.12]); depression (HR, 1.29 [95% CI, 1.06 to 1.57]); obesity, defined as a body mass index of ≥30 kg/m 2 (HR, 1.13 [95% CI, 1.02 to 1.26]); and low-volume hospitals, denoted as an annual hospital volume of ≤10 cases (HR, 1.60 [95% CI, 1.39 to 1.84]), 11 to 20 cases (HR, 1.47 [95% CI, 1.27 to 1.70]), and 21 to 40 cases (HR, 1.31 [95% CI, 1.14 to 1.51]) (>40 cases was used as the reference). Apart from known risk factors, this study showed a significant negative influence of obesity, depression, and complicated diabetes on the 5-year unicondylar knee replacement survival rate. Surgical indications and preoperative patient counseling should consider these findings. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Further Investigation of Findings Reported for the Minnesota Sex Offender Screening Tool--Revised

ERIC Educational Resources Information Center

Langton, Calvin M.; Barbaree, Howard E.; Harkins, Leigh; Peacock, Edward J.; Arenovich, Tamara

2008-01-01

Among a number of widely used risk assessment instruments with adult sexual offenders, the Minnesota Sex Offender Screening Tool-Revised (MnSOST-R) has been subject to relatively few evaluation studies. Only two independent research groups have published replication studies in the peer-reviewed literature with data not provided by the MnSOST-R's…

A Study of Entry-Level Employment Technological Competencies for the Junior College Graduates Majoring in Electronic Engineering.

ERIC Educational Resources Information Center

Chen, Woei-Kae; Chang, Liang-Te

A study examined the technological competencies of the electronic engineering departments of junior colleges in Taiwan. It used a combination of two methods--a revised DACUM (Developing a Curriculum) process and a revised V-TECS (Vocational-Technical Education Consortium of States) process--to analyze the duty/task profile and task/element list of…

Effects of perfectionism and exercise on disordered eating in college students.

PubMed

Paulson, Lauren R; Rutledge, Patricia C

2014-01-01

This study examined two dimensions of perfectionism (Standards and Discrepancy), two aspects of exercise (cardiovascular and strength), and the interaction of these variables as predictors of disordered eating in female and male college students. Recruited participants (N=314; n=204 women) completed self-report measures of disordered eating (Eating Attitudes Test), perfectionism (Almost Perfect Scale-Revised; Standards and Discrepancy subscales), and exercise (strength and cardiovascular). Among women, there was a significant three-way interaction between the two dimensions of perfectionism (Standards and Discrepancy) and cardiovascular exercise. Also among women, there was a significant two-way interaction between the Standards dimension and strength exercise and between the Discrepancy dimension and strength exercise. There were no significant main effects or interactions among men. We found some support for the hypotheses that adaptive perfectionism (higher Standards coupled with lower Discrepancy) is a protective factor for disordered eating and that maladaptive perfectionism (higher Standards coupled with higher Discrepancy) is a risk factor, although, only among women who engaged in lower, but not higher, levels of cardiovascular exercise. The findings also suggest that it may be beneficial to consider dimensions of perfectionism and exercise separately when studying disordered eating. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Career Futures Inventory-Revised: Measuring Dimensions of Career Adaptability

ERIC Educational Resources Information Center

Rottinghaus, Patrick J.; Buelow, Kristine L.; Matyja, Anna; Schneider, Madalyn R.

2012-01-01

This study reports the development and initial validation of the "Career Futures Inventory-Revised" (CFI-R) in two large samples of university students. The 28-item CFI-R assesses aspects of career adaptability, including positive career planning attitudes, general outcome expectations, and components of Parsons' tripartite model and…

Reciprocal Relationships between Mathematics Anxiety and Attitude towards Mathematics in Elementary Students

ERIC Educational Resources Information Center

Haciomeroglu, Guney

2017-01-01

This current study examined the reciprocal relationship between anxiety and attitude towards mathematics in elementary students. Two instruments (attitudes towards mathematics inventory short form [ATMI-Short Form] and the Revised Fennema-Sherman Mathematics Anxiety Scale [Revised-FSMAS]) were administered to 310 fourth grade elementary students.…

Confirming the Structural Validity of the My Class Inventory -- Short Form Revised

ERIC Educational Resources Information Center

Mariani, Melissa; Villares, Elizabeth; Sink, Christopher A.; Colvin, Kimberly; Kuba, Summer Perhay

2015-01-01

Researchers analyzed data collected from elementary school students (N = 893) to further establish the psychometric soundness of the My Class Inventory--Short Form Revised (MCI-SFR). A confirmatory factor analysis was conducted resulting in a good fit for a four-factor model, which corresponds to the instrument's four scales (Cohesion,…

Psychometric Properties of the Alabama Parenting Questionnaire-Preschool Revision

ERIC Educational Resources Information Center

Clerkin, Suzanne M.; Marks, David J.; Policaro, Katia L.; Halperin, Jeffrey M.

2007-01-01

The psychometric properties of the Alabama Parenting Questionnaire-Preschool Revision (APQ-PR) were explored in a sample of hyperactive-inattentive preschool children (N = 47) and nonimpaired controls (N = 113). A subset of parents completed the questionnaire on 2 occasions, approximately 1 year apart. Factor analysis revealed a 3-factor solution,…

Preliminary Investigation of the 1991 Medical College Admission Test Factor Structure.

ERIC Educational Resources Information Center

Li, Weichang; Mitchell, Karen J.

A substantially revised Medical College Admission Test (MCAT) was introduced in spring 1991. The new examination is designed to assess critical thinking skills, basic concepts and problem solving facility in science, and writing skills. This paper reports preliminary findings on the factor structure of the revised MCAT, which consists of four…

Structural Equation Analysis of the Wechsler Adult Intelligence Scale-Revised in a Normal Elderly Sample.

ERIC Educational Resources Information Center

Burton, D. Bradley; And Others

1994-01-01

A maximum-likelihood confirmatory factor analysis was performed by applying LISREL VII to the Wechsler Adult Intelligence Scale-Revised results of a normal elderly sample of 225 adults. Results indicate that a three-factor model fits best across all sample combinations. A mild gender effect is discussed. (SLD)

77 FR 24409 - Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment; Ambulatory Surgical...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-24

..., specifically revenue codes 790 (Extra-Corp Shock Wave Therapy), 800 (Inpatient Dialysis), 801 (Inpatient... particular, those applied to the CY 2012 conversion factor. Using the corrected revenue code-to-cost center... conversion factor. To view the revised ASC payment rates that result from the revised ASC relative payment...

Revision and Factor Analysis of a Death Anxiety Scale.

ERIC Educational Resources Information Center

Thorson, James A.; Powell, F. C.

Earlier research on death anxiety using the 34-item scale developed by Nehrke-Templer-Boyar (NTB) indicated that females and younger persons have significantly higher death anxiety. To simplify a death anxiety scale for use with different age groups, and to determine the conceptual factors actually measured by the scale, a revised 25-item…

Dimensional profiles of male to female gender identity disorder: an exploratory research.

PubMed

Fisher, Alessandra D; Bandini, Elisa; Ricca, Valdo; Ferruccio, Naika; Corona, Giovanni; Meriggiola, Maria C; Jannini, Emmanuele A; Manieri, Chiara; Ristori, Jiska; Forti, Gianni; Mannucci, Edoardo; Maggi, Mario

2010-07-01

Male-to-Female Gender Identity Disorder (MtF GID) is a complex phenomenon that could be better evaluated by using a dimensional approach. To explore the aggregation of clinical manifestations of MtF GID in order to identify meaningful variables describing the heterogeneity of the disorder. A consecutive series of 80 MtF GID subjects (mean age 37 +/- 10.3 years), referred to the Interdepartmental Center for Assistance Gender Identity Disorder of Florence and to other Italian centers from July 2008 to June 2009, was studied. Diagnosis was based on formal psychiatric classification criteria. Factor analysis was performed. Several socio-demographic and clinical parameters were investigated. Patients were asked to complete the Bem Sex Role Inventory (BSRI, a self-rating scale to evaluate gender role) and Symptom Checklist-90 Revised (SCL-90-R, a self-rating scale to measure psychological state). Factor analysis identified two dimensional factors: Factor 1 was associated with sexual orientation, and Factor 2 related to behavioral and psychological correlates of early GID development. No correlation was observed between the two factors. A positive correlation between Factor 2 and feminine BSRI score was found, along with a negative correlation between Factor 2 and undifferentiated BSRI score. Moreover, a significant association between SCL-90-R Phobic subscale score and Factor 2 was observed. A variety of other socio-demographic parameters and clinical features were associated with both factors. Behavioral and psychological correlates of Factor 1 (sexual orientation) and Factor 2 (gender identity) do not constitute the framework of two separate clinical entities, but instead represent two dimensions of the complex MtF GID structure, which can be variably intertwined in the same subject. By using factor analysis, we offer a new approach capable of delineating a psychopathological and clinical profile of MtF GID patients.

48 CFR 52.214-23 - Late submissions, modifications, revisions, and withdrawals of technical proposals under two-step...

Code of Federal Regulations, 2010 CFR

2010-10-01

... resume. (e) Technical proposals may be withdrawn by written notice received at any time before the exact..., modifications, revisions, and withdrawals of technical proposals under two-step sealed bidding. 52.214-23... Late submissions, modifications, revisions, and withdrawals of technical proposals under two-step...

Evaluation of Colorado Learning Attitudes about Science Survey

NASA Astrophysics Data System (ADS)

Douglas, K. A.; Yale, M. S.; Bennett, D. E.; Haugan, M. P.; Bryan, L. A.

2014-12-01

The Colorado Learning Attitudes about Science Survey (CLASS) is a widely used instrument designed to measure student attitudes toward physics and learning physics. Previous research revealed a fairly complex factor structure. In this study, exploratory and confirmatory factor analyses were conducted on data from an undergraduate introductory physics course (n =3844 ) to determine whether a more parsimonious factor structure exists. Exploratory factor analysis results indicate that many of the items from the original CLASS have poor psychometric properties and could not be used in a revised factor structure. The cross validation showed acceptable fit statistics for a three factor model found in the exploratory factor analysis. This research suggests that a more optimum measurement of students' attitudes about physics and learning physics is obtained with a 15-item instrument, which describes the factors of personal application, personal effort, and problem solving. The proposed revised version of the CLASS offers researchers the opportunity to test a shortened version of the instrument that may be able to provide information about students' attitudes in the areas of personal application of physics, personal effort in a physics course, and approaches to problem solving.

Perfectionism and the Five-Factor Model of Personality

ERIC Educational Resources Information Center

Rice, Kenneth G.; Ashby, Jeffrey S.; Slaney, Robert B.

2007-01-01

In this study of the discriminant, convergent, and incremental validity of the Almost Perfect Scale-Revised (APS-R), university students completed the APS-R, additional measures of perfectionism, the NEO Five-Factor Inventory-Form S, and measures of self-esteem and depression. The results revealed expected significant, but not completely…

Performance of a cognitive load inventory during simulated handoffs: Evidence for validity.

PubMed

Young, John Q; Boscardin, Christy K; van Dijk, Savannah M; Abdullah, Ruqayyah; Irby, David M; Sewell, Justin L; Ten Cate, Olle; O'Sullivan, Patricia S

2016-01-01

Advancing patient safety during handoffs remains a public health priority. The application of cognitive load theory offers promise, but is currently limited by the inability to measure cognitive load types. To develop and collect validity evidence for a revised self-report inventory that measures cognitive load types during a handoff. Based on prior published work, input from experts in cognitive load theory and handoffs, and a think-aloud exercise with residents, a revised Cognitive Load Inventory for Handoffs was developed. The Cognitive Load Inventory for Handoffs has items for intrinsic, extraneous, and germane load. Students who were second- and sixth-year students recruited from a Dutch medical school participated in four simulated handoffs (two simple and two complex cases). At the end of each handoff, study participants completed the Cognitive Load Inventory for Handoffs, Paas' Cognitive Load Scale, and one global rating item for intrinsic load, extraneous load, and germane load, respectively. Factor and correlational analyses were performed to collect evidence for validity. Confirmatory factor analysis yielded a single factor that combined intrinsic and germane loads. The extraneous load items performed poorly and were removed from the model. The score from the combined intrinsic and germane load items associated, as predicted by cognitive load theory, with a commonly used measure of overall cognitive load (Pearson's r = 0.83, p < 0.001), case complexity (beta = 0.74, p < 0.001), level of experience (beta = -0.96, p < 0.001), and handoff accuracy (r = -0.34, p < 0.001). These results offer encouragement that intrinsic load during handoffs may be measured via a self-report measure. Additional work is required to develop an adequate measure of extraneous load.

Outcome following subluxation of mobile articulating spacers in two-stage revision total knee arthroplasty.

PubMed

Lanting, Brent A; Lau, Adrian; Teeter, Matthew G; Howard, James L

2017-03-01

Infection after total knee arthroplasty (TKA) is a severe complication. It is usually treated with two-stage revision and implantation of a cement spacer. Few studies describe the complications associated with a mobile articulating spacer. This study examined the subluxation of articulating antibiotic spacers in knees and correlated it with prospectively collected early outcome scores after implantation of a revision prosthesis. Staged revisions for 72 infected primary total knee arthroplasties between 2004 and 2012 were examined. The mean age of the patients was 70.2 ± 10.8 years, with 40 right and 32 left knees. Sagittal and coronal subluxation was measured using radiographs prior to second-stage revision and grouped to be within (Group 1) or outside (Group 2) one standard deviation from the mean. Medical Outcomes Study Short Form-12 (SF-12), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee Society Score (KSS) were obtained via patient-administered questionnaire. Statistical analysis was carried out to look at the correlation between subluxation and outcome. Significant improvements were observed between the interim outcome scores prior to implantation of a revision prosthesis and scores obtained after second-stage revision. Debonding occurred in 5.6%, and one dislocation was found. Mean coronal subluxation was 4.8 ± 5.5% of the tibia width, in the lateral direction. Coronal subluxation did not affect SF12, WOMAC or KSS outcome scores. Mean sagittal subluxation was 6.1 ± 16.4% posteriorly. However, sagittal subluxation had a significant influence on Knee Society Scores, with Group 2 having a lower mean Knee Society Function Score of 39.3 than Group 1 (60.2) (p = 0.045). Sagittal subluxation did not affect SF12 or WOMAC scores. Sagittal subluxation of the knee may influence the early to midterm outcome scores following a staged revision TKA for infection.

Cochlear implant revision surgeries in children.

PubMed

Amaral, Maria Stella Arantes do; Reis, Ana Cláudia Mirândola B; Massuda, Eduardo T; Hyppolito, Miguel Angelo

2018-02-16

The surgery during which the cochlear implant internal device is implanted is not entirely free of risks and may produce problems that will require revision surgeries. To verify the indications for cochlear implantation revision surgery for the cochlear implant internal device, its effectiveness and its correlation with certain variables related to language and hearing. A retrospective study of patients under 18 years submitted to cochlear implant Surgery from 2004 to 2015 in a public hospital in Brazil. Data collected were: age at the time of implantation, gender, etiology of the hearing loss, audiological and oral language characteristics of each patient before and after Cochlear Implant surgery and any need for surgical revision and the reason for it. Two hundred and sixty-five surgeries were performed in 236 patients. Eight patients received a bilateral cochlear implant and 10 patients required revision surgery. Thirty-two surgeries were necessary for these 10 children (1 bilateral cochlear implant), of which 21 were revision surgeries. In 2 children, cochlear implant removal was necessary, without reimplantation, one with cochlear malformation due to incomplete partition type I and another due to trauma. With respect to the cause for revision surgery, of the 8 children who were successfully reimplanted, four had cochlear calcification following meningitis, one followed trauma, one exhibited a facial nerve malformation, one experienced a failure of the cochlear implant internal device and one revision surgery was necessary because the electrode was twisted. The incidence of the cochlear implant revision surgery was 4.23%. The period following the revision surgeries revealed an improvement in the subject's hearing and language performance, indicating that these surgeries are valid in most cases. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Measuring precarious employment in times of crisis: the revised Employment Precariousness Scale (EPRES) in Spain.

PubMed

Vives, Alejandra; González, Francisca; Moncada, Salvador; Llorens, Clara; Benach, Joan

2015-01-01

This study examines the psychometric properties of the revised Employment Precariousness Scale (EPRES-2010) in a context of economic crisis and growing unemployment. Data correspond to salaried workers with a contract (n=4,750) from the second Psychosocial Work Environment Survey (Spain, 2010). Analyses included acceptability, scale score distributions, Cronbach's alpha coefficient and exploratory factor analysis. Response rates were 80% or above, scores were widely distributed with reductions in floor effects for temporariness among permanent workers and for vulnerability. Cronbach's alpha coefficients were 0.70 or above; exploratory factor analysis confirmed the theoretical allocation of 21 out of 22 items. The revised version of the EPRES demonstrated good metric properties and improved sensitivity to worker vulnerability and employment instability among permanent workers. Furthermore, it was sensitive to increased levels of precariousness in some dimensions despite decreases in others, demonstrating responsiveness to the context of the economic crisis affecting the Spanish labour market. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

Why Do Older People Change Their Ratings of Childhood Health?

PubMed Central

Vuolo, Mike; Ferraro, Kenneth F.; Morton, Patricia M.; Yang, Ting-Ying

2014-01-01

A growing number of studies in life course epidemiology and biodemography make use of a retrospective question tapping self-rated childhood health to assess overall physical health status. Analyzing repeated measures of self-rated childhood health from the Health and Retirement Study (HRS), this study examines several possible explanations for why respondents might change their ratings of childhood health. Results reveal that nearly one-half of the sample revised their rating of childhood health during the 10-year observation period. Whites and relatively advantaged older adults—those with more socioeconomic resources and better memory—were less likely to revise their rating of childhood health, while those who experienced multiple childhood health problems were more likely to revise their childhood health rating, either positively or negatively. Changes in current self-rated health and several incident physical health problems were also related to the revision of one’s rating of childhood health, while the development of psychological disorders was associated with more negative revised ratings. We then illustrate the impact that these changes may have on an adult outcomes: namely, depressive symptoms. Whereas adult ratings of childhood health are likely to change over time, we recommend their use only if adjusting for factors associated with these changes, such as memory, psychological disorder, adult self-rated health, and socioeconomic resources. PMID:25359668

Risk factors for tube exposure as a late complication of glaucoma drainage implant surgery.

PubMed

Chaku, Meenakshi; Netland, Peter A; Ishida, Kyoko; Rhee, Douglas J

2016-01-01

The purpose of this study was to evaluate the risk factors for tube exposure after glaucoma drainage implant surgery. This was a retrospective case-controlled observational study of 64 eyes from 64 patients. Thirty-two eyes of 32 patients with tube erosion requiring surgical revision were compared with 32 matched control eyes of 32 patients. Univariate and multivariate risk factor analyses were performed. Mean age was significantly younger in the tube exposure group compared with the control group (48.2±28.1 years versus 67.3±18.0 years, respectively; P=0.003). The proportion of diabetic patients (12.5%) in the tube exposure group was significantly less (P=0.041) compared with the control group (37.5%). Comparisons of the type and position of the drainage implant were not significantly different between the two groups. The average time to tube exposure was 17.2±18.0 months after implantation of the drainage device. In both univariate and multivariate analyses, younger age (P=0.005 and P=0.027) and inflammation prior to tube exposure (P≤0.001 and P=0.004) were significant risk factors. Diabetes was a significant risk factor only in the univariate analysis (P=0.027). Younger age and inflammation were significant risk factors for tube exposure after drainage implant surgery.

Revision hip preservation surgery with hip arthroscopy: clinical outcomes.

PubMed

Domb, Benjamin G; Stake, Christine E; Lindner, Dror; El-Bitar, Youseff; Jackson, Timothy J

2014-05-01

To analyze and report the clinical outcomes of a cohort of patients who underwent revision hip preservation with arthroscopy and determine predictors of positive and negative outcomes. During the study period from April 2008 to December 2010, all patients who underwent revision hip preservation with arthroscopy were included. This included patients who had previous open surgery and underwent revision with arthroscopy. Patient-reported outcome (PRO) scores were obtained preoperatively and at 3-month, 1-year, 2-year, and 3-year follow-up time points. Any revision surgeries and conversions to total hip arthroplasty were noted. A multiple regression analysis was performed to look for positive and negative predictive factors for improvement in PROs after revision hip arthroscopy. Forty-seven hips in 43 patients had completed 2 years' follow-up or needed total hip arthroplasty. The mean length of follow-up was 29 months (range, 24 to 47 months). Of the hips, 31 (66%) had either unaddressed or incompletely treated femoroacetabular impingement. There was a significant improvement in all PRO scores at a mean of 29 months after revision (P < .0001). The visual analog scale score improved from 7.3 ± 1.5 to 3.9 ± 2.5 (P < .0001). Improvements in the Non-Arthritic Hip Score of at least 10 points and 20 points were found in 28 hips (65%) and 19 hips (44%), respectively. Four hips in 3 patients required conversion to total hip arthroplasty. Positive predictive factors for PRO improvement were previous open surgery, pincer impingement, cam impingement, symptomatic heterotopic ossification, and segmental labral defects treated with labral reconstruction. On the basis of multiple PROs, revision hip preservation with hip arthroscopy can achieve moderately successful outcomes and remains a viable treatment strategy after failed primary hip preservation surgery. Preoperative predictors of success after revision hip arthroscopy include segmental labral defects, unaddressed or incompletely addressed femoroacetabular impingement, heterotopic ossification, and previous open surgery. Level IV, therapeutic case series. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Failed anterior cruciate ligament reconstruction: analysis of factors leading to instability after primary surgery.

PubMed

Ma, Yong; Ao, Ying-Fang; Yu, Jia-Kuo; Dai, Ling-Hui; Shao, Zhen-Xing

2013-01-01

Revision anterior cruciate ligament (ACL) surgery can be expected to become more common as the number of primary reconstruction keeps increasing. This study aims to investigate the factors causing instability after primary ACL reconstruction, which may provide an essential scientific base to prevent surgical failure. One hundred and ten revision ACL surgeries were performed at our institute between November 2001 and July 2012. There were 74 men and 36 women, and the mean age at the time of revision was 27.6 years (range 16 - 56 years). The factors leading to instability after primary ACL reconstruction were retrospectively reviewed. Fifty-one knees failed because of bone tunnel malposition, with too anterior femoral tunnels (20 knees), posterior wall blowout (1 knee), vertical femoral tunnels (7 knees), too posterior tibial tunnels (12 knees), and too anterior tibial tunnels (10 knees). There was another knee performed with open surgery, where the femoral tunnel was drilled through the medial condyle and the tibial tunnel was too anterior. Five knees were found with malposition of the fixation. One knee with allograft was suspected of rejection and a second surgery had been made to take out the graft. Three knees met recurrent instability after postoperative infection. The other factors included traumatic (48 knees) and unidentified (12 knees). Technical errors were the main factors leading to instability after primary ACL reconstructions, while attention should also be paid to the risk factors of re-injury and failure of graft incorporation.

How often is the office visit needed? Predicting total knee arthroplasty revision risk using pain/function scores.

PubMed

Hightower, Charles D; Hightower, Lisa S; Tatman, Penny J; Morgan, Patrick M; Gioe, Terence; Singh, Jasvinder A

2016-08-24

Most patients have favorable outcomes after primary total knee arthroplasty (TKA). Well-validated methods to predict the risk of poor outcomes have not been developed or implemented. Several patients have annual clinic visits despite well-funcitoning TKA, as a routine practice, to detect early failure requiring revision surgery. It is not known whether assessment of pain and function can be used as a predictive tool for early failure and revision to guide practice. Our objective was to determine whether pain and function can predict revision after TKA. We retrospectively studied data from a large prospectively gathered TKA registry to examine changes in outcome scores for primary TKAs undergoing revision compared to those not requiring revision to determine the factors that are predictive for revision. Of the 1,012 patients, 721 had had a single-sided primary TKA and had American Knee Society (AKS) Scores for three or more visits. 46 patients underwent revision, 23 acutely (fracture, traumatic component failure or acute infection) and 23 for latent causes (late implant loosening, progressive osteolysis, or pain and indolent infection). Mean age was 70 years for the non-revision patients, and 64 years for those revised. Both AKS Clinical and AKS Function Scores for non-revised patients were higher than in revision patients, higher in acute revision compared to latent revision patients. Significant predictors of revision surgery were preoperative, 3- and 15-month postoperative AKS Clinical Scores and 3-month AKS Function Scores. At 15-month post-TKA, a patient with a low calculated probability of revision, 32 % or less, was unlikely to require revision surgery with a negative predictive value of 99 %. Time dependent interval evaluation post-TKA with the AKS outcome scores may provide the ability to assign risk of revision to patients at the 15-month follow-up visit. If these findings can be replicated using a patient-reported measure, a virtual follow-up with patient-reported outcomes and X-ray review may be an alternative to clinic visit for patients doing well.

The use of a tripolar articulation in revision total hip arthroplasty: a minimum of 24 months' follow-up.

PubMed

Levine, Brett R; Della Valle, Craig J; Deirmengian, Carl A; Breien, Kristoffer M; Weeden, Steven H; Sporer, Scott M; Paprosky, Wayne G

2008-12-01

A retrospective cohort study of 31 hips revised with a tripolar articular construct was performed. Patient demographics and preoperative and postoperative information were recorded. Indications for a tripolar construct were recurrent dislocation and the inability to attain intraoperative stability during hip revision. Nine patients (29%) were revised to the tripolar construct after failure of a constrained liner. Twenty patients (65%) had at least one episode of instability before the most recent revision. At a mean follow-up of 38 months, modified Postel scores improved from a mean of 5.28 to 9.64 (P < .01). Radiographic follow-up revealed no evidence of component loosening/migration, osteolysis, or polyethylene wear. Two patients (7%) required further revision surgery for recurrent instability. A tripolar construct was effective in eliminating or preventing instability in 93% of the complex cases treated. These early results support the use of a tripolar construct in treating recurrent instability or instability encountered at the time of revision hip arthroplasty.

77 FR 66851 - Submission for OMB Review; Comment Request The Sister Study: A Prospective Study of the Genetic...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-07

... Breast Cancer SUMMARY: Under the provisions of Section 3507(a)(1)(D) of the Paperwork Reduction Act of... Environmental Risk Factors for Breast Cancer. Type of Information Collection Request: Revision. Need and Use of... and environmental risk factors for the development of breast cancer in a high-risk cohort of sisters...

Path Analysis of the SCL-90-R: Exploring Use in Outpatient Assessment

ERIC Educational Resources Information Center

Grande, Todd L.; Newmeyer, Mark D.; Underwood, Lee A.; Williams, Cyrus R., III

2014-01-01

The Symptom Checklist-90-Revised (SCL-90-R) is a widely used assessment of mental health pathology; however, its factor structure has been called into question by numerous studies. This study assessed a community mental health outpatient sample (N = 336) with the SCL-90-R and analyzed the factor structure. The results indicated that the SCL-90-R…

High Revision Rate for Large-head Metal-on-metal THA at a Mean of 7.1 Years: A Registry Study.

PubMed

Seppänen, Matti; Laaksonen, Inari; Pulkkinen, Pekka; Eskelinen, Antti; Puhto, Ari-Pekka; Kettunen, Jukka; Leskinen, Jarkko; Manninen, Mikko; Mäkelä, Keijo

2018-06-01

Large-diameter head metal-on-metal (MoM) THA has largely been abandoned as a result of higher than anticipated revision rates. However, the majority of these implants are still in situ. Although earlier reports from the Finnish Arthroplasty Register noted similar short-term survivorship between large-diameter head MoM THA and conventional cemented THA, longer term survivorship of this population is unclear. Although reported revision rates for this implant group have been high, the majority of these implants have not been revised and followup is important to improve long-term management. The purposes of this study were (1) to compare the 10-year competing risk survivorship of large-diameter head MoM THA with the survivorship of conventional THA in the Finnish Arthroplasty Register; (2) to report the large-diameter head MoM THA survival at the manufacturer/brand level; and (3) to identify the most common reasons for revision of large-diameter head MoM THA in the Finnish Arthroplasty Register. The six most commonly used large-diameter head (≥ 38 mm) MoM THA devices in Finland between years 2004 and 2013 were selected (n = 10,959 implants). The completeness of the Finnish Registry is > 95% in primary THA and patients are censored from the date of death or at the point of emigration; followup continued until the end of 2015. The conventional THA control group consisted of the two most frequently used devices (Vision/Bimetric and ABG II/ABG II) with metal-on-polyethylene or ceramic-on-ceramic bearing surfaces implanted between 2002 and 2013 (n = 5177). The study group was formed by selecting all pairs of large-diameter head MoM and reference THA protheses within the same age group ( < 49, 50-54, 55-59, 60-64, 65-69, 70-74, and 75+ years), sex, diagnosis (osteoarthritis, other), and hospital yearly operation count (< 100 operations yearly, ≥ 100 operations yearly); 5166 matched pairs were identified. Revision for any reason was considered as the failure endpoint of followup. Implant survival (the proportion not revised) was calculated from corresponding cumulative incidence function adjusted for patient death as a competing event for revision. Large-diameter head MoM implant group revision hazard ratios with 95% confidence intervals were estimated with age group, sex, diagnosis, and hospital yearly operation count as confounding factors in a Cox regression model. Ten-year survivorship free from all-cause revision was lower for THAs that used a large-diameter femoral head than it was for the control group of conventional THA (83% [95% confidence interval {CI}, 82%-84%] versus 92% [95% CI, 91%-93%]). At the implant level, every large-diameter head MoM THA had a higher risk for revision compared with the conventional THA control group from the fourth postoperative year onward. The highest survival of MoM THA was 88% (95% CI, 86%-90%) for the ReCap/Bimetric and the lowest survival was 46% (95% CI, 41%-51%) for the recalled ASR with either the Summit® or Corail® stem. The most common revision reason in the MoM THA group was adverse reaction to metal debris, whereas dislocation was predominant in the conventional THA control group. The revision rate for all large-diameter head MoM THAs in this timeframe in the Finnish Arthroplasty Register is unacceptably high and in our view supports the decision to abandon their use. In agreement with the directives of other national organizations, we recommend regular followup of all patients with large-diameter head MoM THA. Based on our results, strict guidelines for followup should be maintained over the lifetime of the implant to assess patient symptoms and recommend revision when indicated. Level III, therapeutic study.

[Primary pyomyositis of the psoas muscles in a temperate climate. Review of two cases in children followed up over the long term].

PubMed

García-Mata, S; Hidalgo, A; Esparza, J

2006-01-01

We review two cases of primary pyomyositis of the psoas in children that occurred in Navarre, their management and long-term evolution. Primary pyomyositis of the psoas muscle is a rare infection in a temperate climate. Its diagnosis is difficult due to the similarity of the symptoms with several infectious processes, mainly septic arthritis of the hip in children and adolescents. The rarity of the present cases is due to several facts: occurrence in children, in a temperate climate (Navarre), immunocompetent patients and without subjacent pathology, besides their monofocal situation that is contrary to the more frequent multifocal presentation. These factors, besides the poor specificity of the symptoms, constitute a diagnostic challenge. We present two patients (10 and 12 years old) with fever and a painful hip. Neither of the patients had predisposing factors. Both of them showed hip flexion with limited range of motion in rotations. Confirmation of the diagnosis was made by ultrasound, CT-scan and/or MRI. Needle aspiration of the hip, under general anaesthesia, confirmed the reactive origin of the joint effusion in both patients. In neither of the two cases was there a significant diagnostic delay. Staphylococcus aureus was isolated in the purulent material in one case and in the hemoculture in the other. Both patients have been checked in a long-term revision (follow-up of 7 and 10 years). They were successfully treated by isolated antibiotherapy in one case and surgical drainage in the other. Healing was achieved in each case without relapse or sequels in a long-term revision. We carry out a global revision of this rare infection, emphasising the difficulty of its clinical diagnosis and the different treatment modalities and the proper indication. We suggest an algorithm as a clinical guide for its clinical-therapeutic management.

A Revised Framingham Stroke Risk Profile to Reflect Temporal Trends

PubMed Central

Dufouil, Carole; Beiser, Alexa; McLure, Leslie A.; Wolf, Philip A.; Tzourio, Christophe; Howard, Virginia J; Westwood, Andrew J.; Himali, Jayandra J.; Sullivan, Lisa; Aparicio, Hugo J.; Kelly-Hayes, Margaret; Ritchie, Karen; Kase, Carlos S.; Pikula, Aleksandra; Romero, Jose R.; D’Agostino, Ralph B.; Samieri, Cécilia; Vasan, Ramachandran S.; Chêne, Genevieve; Howard, George; Seshadri, Sudha

2017-01-01

Background Age-adjusted stroke incidence has decreased over the past 50 years, likely due to changes in the prevalence and impact of various stroke risk factors. An updated version of the Framingham Stroke Risk Profile (FSRP) might better predict current risks in the Framingham Heart Study (FHS) and other cohorts. We compared the accuracy of the standard (Old), and of a revised (New) version of the FSRP in predicting the risk of all-stroke and ischemic stroke, and validated this new FSRP in two external cohorts, the 3 Cities (3C) and REGARDS studies. Methods We computed the old FSRP as originally described, and a new model that used the most recent epoch-specific risk factors' prevalence and hazard-ratios for persons ≥ 55 years and for the subsample ≥ 65 years (to match the age range in REGARDS and 3C studies respectively), and compared the efficacy of these models in predicting 5- and 10-year stroke risks. Results The new FSRP was a better predictor of current stroke risks in all three samples than the old FSRP (Calibration chi-squares of new/old FSRP: in men 64.0/12.1, 59.4/30.6 and 20.7/12.5; in women 42.5/4.1, 115.4/90.3 and 9.8/6.5 in FHS, REGARDS and 3C, respectively). In the REGARDS, the new FSRP was a better predictor among whites compared to blacks. Conclusions A more contemporaneous, new FSRP better predicts current risks in 3 large community samples and could serve as the basis for examining geographic and racial differences in stroke risk and the incremental diagnostic utility of novel stroke risk factors. PMID:28159800

The development and psychometric properties of a measure of clinicians' attitudes to depression: the revised Depression Attitude Questionnaire (R-DAQ).

PubMed

Haddad, Mark; Menchetti, Marco; McKeown, Eamonn; Tylee, André; Mann, Anthony

2015-02-05

Depression is a common mental disorder associated with substantial disability. It is inadequately recognised and managed, and clinicians' attitudes to this condition and its treatment may play a part in this. Most research in this area has used the Depression Attitude Questionnaire (DAQ), but analyses have shown this measure to exhibit problems in psychometric properties and suitability for the health professionals and settings where depression recognition may occur. We revised the DAQ using a pooled review of findings from studies using this measure, together with a Delphi study which sought the opinions of a panel of relevant experts based in the UK, USA, Australia, and European countries (n = 24) using 3 rounds of questioning to consider attitude dimensions, content, and item wording. After item generation, revision and consensus (agreement >70%) using the Delphi panel, the revised DAQ (R-DAQ) was tested with 1193 health care providers to determine its psychometric properties. Finally the test-retest reliability of the R-DAQ was examined with 38 participants. The 22-item R-DAQ scale showed good internal consistency: Cronbach's alpha coefficient was 0.84; and satisfactory test-retest reliability: intraclass correlation coefficient was 0.62 (95% C.I. 0.37 to 0.78). Exploratory factor analysis favoured a three-factor structure (professional confidence, therapeutic optimism/pessimism, and a generalist perspective), which accounted for 45.3% of the variance. The R-DAQ provides a revised tool for examining clinicians' views and understanding of depression. It addresses important weaknesses in the original measure whilst retaining items and dimensions that appeared valid. This revised scale is likely to be useful in examining attitudes across the health professional workforce and beyond the confines of the UK, and may be valuable for the purpose of evaluating training that aims to address clinicians' attitudes to depression. It incorporates key dimensions of attitudes with a modest number of items making it applicable to use in busy clinical settings.

The Multigroup Ethnic Identity Measure-Revised: Measurement invariance across racial and ethnic groups

PubMed Central

Brown, Susan D.; Unger Hu, Kirsten A.; Mevi, Ashley A.; Hedderson, Monique M.; Shan, Jun; Quesenberry, Charles P.; Ferrara, Assiamira

2014-01-01

The Multigroup Ethnic Identity Measure-Revised (MEIM-R), a brief instrument assessing affiliation with one’s ethnic group, is a promising advance in the ethnic identity literature. However, equivalency of its measurement properties across specific racial and ethnic groups should be confirmed before using it in diverse samples. We examined a) the psychometric properties of the MEIM-R including factor structure, measurement invariance, and internal consistency reliability, and b) levels of and differences in ethnic identity across multiple racial and ethnic groups and subgroups. Asian (n = 630), Black/African American (n = 58), Hispanic (n = 240), multiethnic (n = 160), and White (n = 375) women completed the MEIM-R as part of the “Gestational diabetes’ Effect on Moms” diabetes prevention trial in the Kaiser Permanente Northern California health care setting (N = 1,463; M age 32.5 years, SD = 4.9). Multiple-groups confirmatory factor analyses provided provisional evidence of measurement invariance, i.e., an equal, correlated two-factor structure, equal factor loadings, and equal item intercepts across racial and ethnic groups. Latent factor means for the two MEIM-R subscales, exploration and commitment, differed across groups; effect sizes ranging from small to large generally supported the notion of ethnic identity as more salient among people of color. Pending replication, good psychometric properties in this large and diverse sample of women support the future use of the MEIM-R. Preliminary evidence of measurement invariance suggests that the MEIM-R could be used to measure and compare ethnic identity across multiple racial and ethnic groups. PMID:24188656

Two-stage revisions for culture-negative infected total knee arthroplasties: A five-year outcome in comparison with one-stage and two-stage revisions for culture-positive cases.

PubMed

Li, Heng; Ni, Ming; Li, Xiang; Zhang, Qingmeng; Li, Xin; Chen, Jiying

2017-03-01

Culture-negative periprosthetic joint infection (PJI) is very intractable when dealing with an infected total knee arthroplasty (TKA) patient. Two-stage revision has been proved to be a reliable solution for PJI patients. Whether it is still credible for culture-negative infected patients remains uncertain. Our group retrospectively reviewed all total knee revision patients from January 2003 to January 2014, 145 PJI patients were diagnosed as infection with the PJI diagnostic criteria and 129 patients were successfully followed. As different treating strategies were utilized, these patients were divided into culture-negative (18 cases, CN) group, culture-positive with one-stage revision group (CP1, 21 cases) and culture-positive with two-stage revision group (CP2, 87 cases) groups. The CN group and CP2 group underwent two-stage revision with antibiotic loaded cement spacers and intravenous antibiotics, CP1 group received one-stage revision. All the culture results and relevant medical records were thoroughly reviewed. The mean follow-up time was 59.5 ± 32.3 months (range 12-158 months). The culture-negative rate was 14.2%. The overall infection control rate was 92.12%. Infection recurrence was observed in two cases in CP1 group (9.09%), six cases in CP2 group (6.90%) and two cases in CN group (11.1%). The reinfection rate of culture-negative patients and culture-positive patients was 7.34% and 11.1% with no significant difference (p = 0.94). No statistically difference was observed between CP2 group and CN group (p = 0.90). No Spacer fracture or dislocation was observed. With combined or broad spectrum antibiotics, two-stage revision showed comparable outcome when treating culture-negative infected TKA patients at five-year follow-up. Copyright © 2016. Published by Elsevier B.V.

Textbook of Military Medicine. Part 1. Warfare, Weaponry, and the Casualty. Volume 2. Medical Consequences of Nuclear Warfare

DTIC Science & Technology

1989-04-01

following whole-body exposure of both animals in each pair."’ irradiation have been studied , but neither factor Ten-minute structured observations were made...dose conditions. In a recent study with rats, a single acute exposure to 7.5 Gy of gamma radiation dis- Another radiation factor that can influence be... factors , including the current studies are revising these ideas. Developing physical capacity of the animal, rewards or punish- cells are particularly

Investigating the impact of automated feedback on students' scientific argumentation

NASA Astrophysics Data System (ADS)

Zhu, Mengxiao; Lee, Hee-Sun; Wang, Ting; Liu, Ou Lydia; Belur, Vinetha; Pallant, Amy

2017-08-01

This study investigates the role of automated scoring and feedback in supporting students' construction of written scientific arguments while learning about factors that affect climate change in the classroom. The automated scoring and feedback technology was integrated into an online module. Students' written scientific argumentation occurred when they responded to structured argumentation prompts. After submitting the open-ended responses, students received scores generated by a scoring engine and written feedback associated with the scores in real-time. Using the log data that recorded argumentation scores as well as argument submission and revisions activities, we answer three research questions. First, how students behaved after receiving the feedback; second, whether and how students' revisions improved their argumentation scores; and third, did item difficulties shift with the availability of the automated feedback. Results showed that the majority of students (77%) made revisions after receiving the feedback, and students with higher initial scores were more likely to revise their responses. Students who revised had significantly higher final scores than those who did not, and each revision was associated with an average increase of 0.55 on the final scores. Analysis on item difficulty shifts showed that written scientific argumentation became easier after students used the automated feedback.

The implementation of a new Malaria Treatment Protocol in Timor-Leste: challenges and constraints

PubMed Central

Martins, João Soares; Zwi, Anthony B; Hobday, Karen; Bonaparte, Fernando; Kelly, Paul M

2012-01-01

Background Timor-Leste changed its malaria treatment protocol in 2007, replacing the first-line for falciparum malaria from sulphadoxine-pyrimethamine to artemether-lumefantrine. This study explored the factors affecting the implementation of the revised treatment protocol, with an emphasis on identifying key constraints. Methods A mixed method approach drew on both qualitative and quantitative data. The study included data from District Health Services in seven districts, community health centres in 14 sub-districts, four hospitals, five private clinics, one private pharmacy and the country's autonomous medical store. In-depth interviews with 36 key informants, five group interviews and 15 focus group discussions were conducted. A survey was also undertaken at community health centres and hospitals to assess the availability of a physical copy of the Malaria Treatment Protocol, as well as the availability and utilization of artemether-lumefantrine and sulphadoxine-pyrimethamine. Results Many factors impeded the implementation of the new malaria protocol. These included: inadequate introduction and training around the revised treatment protocol; unclear phasing out of sulphadoxine-pyrimethamine and phasing in of the revised treatment, artemether-lumefantrine, and the rapid diagnostic test (RDT); lack of supervision; lack of adherence to the revised guidelines by foreign health workers; lack of access to the new drug by the private sector; obstacles in the procurement process; and the use of trade names rather than generic drug description. Insufficient understanding of the rapid diagnostic test and the untimely supply of drugs further hampered implementation. Conclusion To effectively implement a revised malaria treatment protocol, barriers should be identified during the policy formulation process and those emerging during implementation should be recognized promptly and addressed. PMID:22460007

Occupational risk factors in inflammatory bowel disease.

PubMed

Leso, V; Ricciardi, W; Iavicoli, I

2015-08-01

Crohn's disease and ulcerative colitis are the two main forms of inflammatory bowel disease (IBD). Although the aetiology of IBD is not completely understood, an interaction between genetic and environmental factors has been proposed. In this context, however, environmental epidemiology lacks a comprehensive evaluation of the possible role of occupational exposures in IBD development and progression. Therefore, aim of our review was to evaluate how certain occupational risk factors may affect IBD pathogenesis, clinical history and severity of disease manifestations. A critical revision of available literature concerning exposure to groups of potential workplace hazardous agents and IBD, as it appears in Medline and Web of knowledge, was performed. The role of workplace exposures to chemical and biological agents, ionizing or non-ionizing radiations, shift-works, indoor, and sedentary works as well as job strain on IBD has been critically revised. However, the limited number of studies addressing these issues prevented us from extrapolating definite conclusions. Our review pointed out some critical aspects concerning the relationship between occupational factors and IBD, in terms of causative pathways, hazardous exposure, susceptibility and consequences of IBD functional limitations on career choice and fitness for work that need future investigations. Overall, this seems a challenging public health issue, considering the strong IBD impact on patients' quality of life, work productivity and costs to society. Moreover, this review may encourage concerted actions of health care specialists, occupational physicians, employers and IBD workers to plan preventive and protective measures for "healthier patterns of work" for IBD and to develop innovative perspectives for an integrated management of "IBD at work".

The revised Bristol Rheumatoid Arthritis Fatigue measures and the Rheumatoid Arthritis Impact of Disease scale: validation in six countries

PubMed Central

Kirwan, John; Bode, Christina; Cramp, Fiona; Carmona, Loreto; Dures, Emma; Englbrecht, Matthias; Fransen, Jaap; Greenwood, Rosemary; Hagel, Sofia; van de Laar, Maart; Molto, Anna; Nicklin, Joanna; Petersson, Ingemar F; Redondo, Marta; Schett, Georg; Gossec, Laure

2018-01-01

Abstract Objective To evaluate the Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire (BRAF-MDQ), the revised Bristol Rheumatoid Arthritis Numerical Rating Scales (BRAF-NRS V2) and the Rheumatoid Arthritis Impact of Disease (RAID) scale in six countries. Methods We surveyed RA patients in France, Germany, The Netherlands, Spain, Sweden and the UK, including the HAQ, 36-item Short Form Health Survey (SF-36) and potential revisions of the BRAF-NRS coping and Spanish RAID coping items. Factor structure and internal consistency were examined by factor analysis and Cronbach’s α and construct validity by Spearman’s correlation. Results A total of 1276 patients participated (76% female, 25% with a disease duration <5 years, median HAQ 1.0). The original BRAF-MDQ four-factor structure and RAID single-factor structure were confirmed in every country with ⩾66% of variation in items explained by each factor and all item factor loadings of 0.71–0.98. Internal consistency for the BRAF-MDQ total and subscales was a Cronbach’s α of 0.75–0.96 and for RAID, 0.93–0.96. Fatigue construct validity was shown for the BRAF-MDQ and BRAF-NRS severity and effect scales, correlated internally with SF-36 vitality and with RAID fatigue (r = 0.63–0.93). Broader construct validity for the BRAFs and RAID was shown by correlation with each other, HAQ and SF-36 domains (r = 0.46–0.82), with similar patterns in individual countries. The revised BRAF-NRS V2 Coping item had stronger validity than the original in all analyses. The revised Spanish RAID coping item performed as well as the original. Conclusion Across six European countries, the BRAF-MDQ identifies the same four aspects of fatigue, and along with the RAID, shows strong factor structure and internal consistency and moderate–good construct validity. The revised BRAF-NRS V2 shows improved construct validity and replaces the original. PMID:29087507

The revised Bristol Rheumatoid Arthritis Fatigue measures and the Rheumatoid Arthritis Impact of Disease scale: validation in six countries.

PubMed

Hewlett, Sarah; Kirwan, John; Bode, Christina; Cramp, Fiona; Carmona, Loreto; Dures, Emma; Englbrecht, Matthias; Fransen, Jaap; Greenwood, Rosemary; Hagel, Sofia; van de Laar, Maart; Molto, Anna; Nicklin, Joanna; Petersson, Ingemar F; Redondo, Marta; Schett, Georg; Gossec, Laure

2018-02-01

To evaluate the Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire (BRAF-MDQ), the revised Bristol Rheumatoid Arthritis Numerical Rating Scales (BRAF-NRS V2) and the Rheumatoid Arthritis Impact of Disease (RAID) scale in six countries. We surveyed RA patients in France, Germany, The Netherlands, Spain, Sweden and the UK, including the HAQ, 36-item Short Form Health Survey (SF-36) and potential revisions of the BRAF-NRS coping and Spanish RAID coping items. Factor structure and internal consistency were examined by factor analysis and Cronbach's α and construct validity by Spearman's correlation. A total of 1276 patients participated (76% female, 25% with a disease duration <5 years, median HAQ 1.0). The original BRAF-MDQ four-factor structure and RAID single-factor structure were confirmed in every country with ⩾66% of variation in items explained by each factor and all item factor loadings of 0.71-0.98. Internal consistency for the BRAF-MDQ total and subscales was a Cronbach's α of 0.75-0.96 and for RAID, 0.93-0.96. Fatigue construct validity was shown for the BRAF-MDQ and BRAF-NRS severity and effect scales, correlated internally with SF-36 vitality and with RAID fatigue (r = 0.63-0.93). Broader construct validity for the BRAFs and RAID was shown by correlation with each other, HAQ and SF-36 domains (r = 0.46-0.82), with similar patterns in individual countries. The revised BRAF-NRS V2 Coping item had stronger validity than the original in all analyses. The revised Spanish RAID coping item performed as well as the original. Across six European countries, the BRAF-MDQ identifies the same four aspects of fatigue, and along with the RAID, shows strong factor structure and internal consistency and moderate-good construct validity. The revised BRAF-NRS V2 shows improved construct validity and replaces the original. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology.

A Comparison of Reliability and Construct Validity between the Original and Revised Versions of the Rosenberg Self-Esteem Scale

PubMed Central

Nahathai, Wongpakaran

2012-01-01

Objective The Rosenberg Self-Esteem Scale (RSES) is a widely used instrument that has been tested for reliability and validity in many settings; however, some negative-worded items appear to have caused it to reveal low reliability in a number of studies. In this study, we revised one negative item that had previously (from the previous studies) produced the worst outcome in terms of the structure of the scale, then re-analyzed the new version for its reliability and construct validity, comparing it to the original version with respect to fit indices. Methods In total, 851 students from Chiang Mai University (mean age: 19.51±1.7, 57% of whom were female), participated in this study. Of these, 664 students completed the Thai version of the original RSES - containing five positively worded and five negatively worded items, while 187 students used the revised version containing six positively worded and four negatively worded items. Confirmatory factor analysis was applied, using a uni-dimensional model with method effects and a correlated uniqueness approach. Results The revised version showed the same level of reliability (good) as the original, but yielded a better model fit. The revised RSES demonstrated excellent fit statistics, with χ2=29.19 (df=19, n=187, p=0.063), GFI=0.970, TFI=0.969, NFI=0.964, CFI=0.987, SRMR=0.040 and RMSEA=0.054. Conclusion The revised version of the Thai RSES demonstrated an equivalent level of reliability but a better construct validity when compared to the original. PMID:22396685

A comparison of reliability and construct validity between the original and revised versions of the Rosenberg Self-Esteem Scale.

PubMed

Wongpakaran, Tinakon; Tinakon, Wongpakaran; Wongpakaran, Nahathai; Nahathai, Wongpakaran

2012-03-01

The Rosenberg Self-Esteem Scale (RSES) is a widely used instrument that has been tested for reliability and validity in many settings; however, some negative-worded items appear to have caused it to reveal low reliability in a number of studies. In this study, we revised one negative item that had previously (from the previous studies) produced the worst outcome in terms of the structure of the scale, then re-analyzed the new version for its reliability and construct validity, comparing it to the original version with respect to fit indices. In total, 851 students from Chiang Mai University (mean age: 19.51±1.7, 57% of whom were female), participated in this study. Of these, 664 students completed the Thai version of the original RSES - containing five positively worded and five negatively worded items, while 187 students used the revised version containing six positively worded and four negatively worded items. Confirmatory factor analysis was applied, using a uni-dimensional model with method effects and a correlated uniqueness approach. The revised version showed the same level of reliability (good) as the original, but yielded a better model fit. The revised RSES demonstrated excellent fit statistics, with χ²=29.19 (df=19, n=187, p=0.063), GFI=0.970, TFI=0.969, NFI=0.964, CFI=0.987, SRMR=0.040 and RMSEA=0.054. The revised version of the Thai RSES demonstrated an equivalent level of reliability but a better construct validity when compared to the original.

Problem Gambling in Chinese American Adolescents: Characteristics and Risk Factors

ERIC Educational Resources Information Center

Chiu, Eddie Yu-Wai; Woo, Kent

2012-01-01

This preliminary study examined the characteristics and risk factors of problem gambling among Chinese American adolescents. A total of 192 Chinese American students (aged 13-19) from 9th to 12th grades were recruited from three high schools in San Francisco, California. Students were administered the South Oaks Gambling Screen Revised for…

The Case for the Perceived Social Competence Scale II

ERIC Educational Resources Information Center

Anderson-Butcher, Dawn; Amorose, Anthony J.; Lower, Leeann M.; Riley, Allison; Gibson, Allison; Ruch, Donna

2016-01-01

Objective: This study examines the psychometric properties of the revised Perceived Social Competence Scale (PSCS), a brief, user-friendly tool used to assess social competence among youth. Method: Confirmatory factor analyses (CFAs) examined the factor structure and invariance of an enhanced scale (PSCS-II), among a sample of 420 youth.…

Factors Associated with Staff Perceptions towards Inclusive Education in Singapore

ERIC Educational Resources Information Center

Poon, Kenneth K.; Ng, Zijia; Wong, Meng Ee; Kaur, Sarinajit

2016-01-01

In this study, we sought to examine the perceptions of teachers and other school professionals towards the inclusion of secondary school students with special educational needs (SEN), and the associated factors. The Sentiments, Attitudes and Concerns about Inclusive Education Revised scale (SACIE-R) was completed by 131 teachers and school…

The Revised Child Anxiety and Depression Scale 25-Parent Version: Scale Development and Validation in a School-Based and Clinical Sample.

PubMed

Ebesutani, Chad; Korathu-Larson, Priya; Nakamura, Brad J; Higa-McMillan, Charmaine; Chorpita, Bruce

2017-09-01

To help facilitate the dissemination and implementation of evidence-based assessment practices, we examined the psychometric properties of the shortened 25-item version of the Revised Child Anxiety and Depression Scale-parent report (RCADS-25-P), which was based on the same items as the previously published shortened 25-item child version. We used two independent samples of youth-a school sample ( N = 967, Grades 3-12) and clinical sample ( N = 433; 6-18 years)-to examine the factor structure, reliability, and validity of the RCADS-25-P scale scores. Results revealed that the two-factor structure (i.e., depression and broad anxiety factor) fit the data well in both the school and clinical sample. All reliability estimates, including test-retest indices, exceeded benchmark for good reliability. In the school sample, the RCADS-25-P scale scores converged significantly with related criterion measures and diverged with nonrelated criterion measures. In the clinical sample, the RCADS-25-P scale scores successfully discriminated between those with and without target problem diagnoses. In both samples, child-parent agreement indices were in the expected ranges. Normative data were also reported. The RCADS-25-P thus demonstrated robust psychometric properties across both a school and clinical sample as an effective brief screening instrument to assess for depression and anxiety in children and adolescents.

Quality measurement in the shunt treatment of hydrocephalus: analysis and risk adjustment of the Revision Quotient.

PubMed

Piatt, Joseph H; Freibott, Christina E

2014-07-01

OBJECT.: The Revision Quotient (RQ) has been defined as the ratio of the number of CSF shunt revisions to the number of new shunt insertions for a particular neurosurgical practice in a unit of time. The RQ has been proposed as a quality measure in the treatment of childhood hydrocephalus. The authors examined the construct validity of the RQ and explored the feasibility of risk stratification under this metric. The Kids' Inpatient Database for 1997, 2000, 2003, 2006, and 2009 was queried for admissions with diagnostic codes for hydrocephalus and procedural codes for CSF shunt insertion or revision. Revision quotients were calculated for hospitals that performed 12 or more shunt insertions annually. The univariate associations of hospital RQs with a variety of institutional descriptors were analyzed, and a generalized linear model of the RQ was constructed. There were 12,244 admissions (34%) during which new shunts were inserted, and there were 23,349 admissions (66%) for shunt revision. Three hundred thirty-four annual RQs were calculated for 152 different hospitals. Analysis of variance in hospital RQs over the 5 years of study data supports the construct validity of the metric. The following factors were incorporated into a generalized linear model that accounted for 41% of the variance of the measured RQs: degree of pediatric specialization, proportion of initial case mix in the infant age group, and proportion with neoplastic hydrocephalus. The RQ has construct validity. Risk adjustment is feasible, but the risk factors that were identified relate predominantly to patterns of patient flow through the health care system. Possible advantages of an alternative metric, the Surgical Activity Ratio, are discussed.

[Post-traumatic stress reaction in a sample of bank employees victims of robbery in the workplace: the role of pre-trauma and peri-trauma factors].

PubMed

Converso, Daniela; Viotti, Sara

2014-07-24

Robberies are traumatizing events for workers. Consequently, a number of health problems can arise. In the short term, a common reaction is post-traumatic stress (including intrusion, avoidance, and hyperarousal symptoms). The aim of the present study was to identify, among pre-trauma factors (personal characteristics: gender, age, educational level, and prior exposure to robberies) and peri-trauma factors (kind of weapon, duration of the event, number of robbers, and numbers of colleagues and clients involved), those that were most likely to cause post-traumatic symptoms in a sample of bank employees who were victims of a robbery. One-hundred-seventy-two employees at two banks in northwest Italy were involved in the research. A month after a robbery, the employees completed a self-report questionnaire including the Impact of Event Scale-Revised (IES-R) by Weiss and Marmar (39). Analyses found one pre-trauma factor (prior exposure to robbery/ies, and one peri-trauma factor, number of robbers) as significant predictors of intrusion. Two peri-trauma factors (number of robbers and duration of robbery) were identified as predictors of avoidance. Finally, one pre-trauma factor (prior exposure to robbery/ies) and two peri-trauma factors (number of robbers and number of colleagues involved in the robbery) were found to be predictors of hyperarousal. The results showed that several peri-trauma factors can increase the risk of workers developing post-traumatic stress reaction and suggest that these factors should be kept in mind when planning intervention programmes aimed at preventing and contrasting psychological consequences of robbery.

Family Engagement in Literacy Activities: Revised Factor Structure for the Familia--An Instrument Examining Family Support for Early Literacy Development

ERIC Educational Resources Information Center

Buhs, Eric S.; Welch, Greg; Burt, Jennifer; Knoche, Lisa

2011-01-01

This study evaluated a data-set drawn using "The Familia"--a measure originally developed to evaluate shared-reading activities. A newly developed set of conceptual supports and a confirmatory factor analysis (CFA) were applied to a new factor structure/model. Data were drawn from 219 young children and their families (mean age = 43…

Neutron dose per fluence and weighting factors for use at high energy accelerators

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

Cossairt, J.Donald; Vaziri, Kamran; /Fermilab

2008-07-01

In June 2007, the United States Department of Energy incorporated revised values of neutron weighting factors into its occupational radiation protection Regulation 10 CFR Part 835 as part of updating its radiation dosimetry system. This has led to a reassessment of neutron radiation fields at high energy proton accelerators such as those at the Fermi National Accelerator Laboratory (Fermilab). Values of dose per fluence factors appropriate for accelerator radiation fields calculated elsewhere are collated and radiation weighting factors compared. The results of this revision to the dosimetric system are applied to americium-beryllium neutron energy spectra commonly used for instrument calibrations.more » A set of typical accelerator neutron energy spectra previously measured at Fermilab are reassessed in light of the new dosimetry system. The implications of this revision are found to be of moderate significance.« less

The SAAS-R: A New Instrument to Assess the School Attitudes of Students with High and Low Academic Achievement in Spain

ERIC Educational Resources Information Center

Miñano Pérez, Pablo; Costa, Juan Luis Castejón; Corbi, Raquel Gilar; Iniesta, Alejandro Veas

2017-01-01

We examined the psychometric properties of the School Attitude Assessment Survey-Revised in a Spanish population (n = 1,398). Confirmatory factor analysis procedures supported the instrument's five-factor structure. The results of discriminant analysis demonstrated the predictive power of the School Attitude Assessment Survey-Revised scales as…

Type I and Type II Error Rates and Overall Accuracy of the Revised Parallel Analysis Method for Determining the Number of Factors

ERIC Educational Resources Information Center

Green, Samuel B.; Thompson, Marilyn S.; Levy, Roy; Lo, Wen-Juo

2015-01-01

Traditional parallel analysis (T-PA) estimates the number of factors by sequentially comparing sample eigenvalues with eigenvalues for randomly generated data. Revised parallel analysis (R-PA) sequentially compares the "k"th eigenvalue for sample data to the "k"th eigenvalue for generated data sets, conditioned on"k"-…

Confirmatory Factor Analysis of a Family Quality of Life Scale for Taiwanese Families of Children With Intellectual Disability/Developmental Delay.

PubMed

Chiu, Chun-Yu; Seo, Hyojeong; Turnbull, Ann P; Summers, Jean Ann

2017-04-01

The Beach Center Family Quality of Life Scale is an internationally validated instrument for measuring family outcomes. To revise the scale for better alignment with the Family Quality of Life theory, the authors excluded non-outcome items in this revision. In this study, we examined reliability and validity of the revised scale (i.e., the FQoL Scale-21) and its scores for Taiwanese families of children and youth with intellectual disability and developmental delay (age 0-18). Results from 400 Taiwanese respondents suggested that the FQoL Scale-21 has the potential to be used as an indicator of positive outcomes in intervention evaluation, policy making, and service delivery.

Traumatic graft rupture after primary and revision anterior cruciate ligament reconstruction: retrospective analysis of incidence and risk factors in 2915 cases.

PubMed

Schlumberger, Michael; Schuster, Philipp; Schulz, Martin; Immendörfer, Micha; Mayer, Philipp; Bartholomä, Jochen; Richter, Jörg

2017-05-01

To determine incidence and risk factors for traumatic graft rupture following primary and revision anterior cruciate ligament (ACL) reconstruction. All cases of isolated ACL reconstructions (primary or revision) performed at our institution between January 2007 and December 2010 were included. From this group of 2467 primary reconstructions (32.4 ± 12.2 years) and 448 revision reconstructions (33.0 ± 10.4 years), we identified all patients who underwent revision ACL reconstruction following traumatic graft rupture in further course and all patients who underwent contralateral primary ACL reconstruction until January 2014. Age, gender, time from index procedure and graft diameter (for hamstring autografts) were analysed in terms of being a potential risk factor for graft rupture. Within a follow-up period of 5.0 ± 1.1 years (3.0-7.0), a total of 82 traumatic graft ruptures were identified, resulting in an incidence of 2.8 %. Seventy-three cases were seen following primary reconstructions (3.0 %), and nine cases following revision reconstructions (2.0 %), respectively (n.s.). Age younger than 25 years was identified as a risk factor for both groups (p = 0.001 and p = 0.008; odds ratio 6.0 and 6.4, respectively). In primary reconstruction, male patients had a higher risk of graft rupture compared with females (3.7 vs. 1.6 %; p = 0.005), and the first year after index procedure was associated with a higher risk of graft rupture compared with the following (p < 0.001). Graft diameter did not influence the risk of graft rupture. Incidence of contralateral ACL rupture was 3.1 %, which was not different to the incidence of graft rupture ipsilaterally (n.s.). No statistically significant differences were seen between graft rupture incidence of primary and revision ACL reconstructions. Young age (<25 years) and short time to the index procedure (especially within the first year) were confirmed as risk factors for graft rupture in both groups. Male gender was a risk factor for primary reconstructions. Graft diameter had no influence on graft rupture rates. No difference in incidence of graft rupture compared to ACL rupture on the contralateral side was apparent. Retrospective case series, Level IV.

Endoscopic bilio-duodenal bypass: outcomes of primary and revision efficacy of combined metallic stents in malignant duodenal and biliary obstructions.

PubMed

Canena, Jorge; Coimbra, João; Carvalho, Diana; Rodrigues, Catarina; Silva, Mário; Costa, Mariana; Horta, David; Mateus Dias, António; Seves, Isabel; Ramos, Gonçalo; Ricardo, Leonel; Coutinho, António Pereira; Romão, Carlos; Veiga, Pedro Mota

2014-11-01

Self-expandable metal stents (SEMSs) can be used for palliation of combined malignant biliary and duodenal obstructions. However, the results of the concomitant stent placement for the duration of the patients' lives, as well as the need for and efficacy of endoscopic revision, are unclear. This study evaluated the clinical effectiveness of SEMS placement for combined biliary and duodenal obstructions throughout the patients' lives and the need for endoscopic revision. This study is a retrospective multicenter study of 50 consecutive patients who underwent simultaneous or sequential SEMS placement for malignant biliary and duodenal obstructions. The data were collected to analyze the sustained relief of obstructive symptoms until the patients' death and the efficacy of endoscopic revision, as well as stent patency, adverse events, survival and prognostic factors for stent patency. Technical and immediate clinical success was achieved in all of the patients. Duodenal stricture occurred before the papilla in 35 patients (70 %), involved the papilla in 11 patients (22 %) and was observed distal to the papilla in four patients (8 %). Initial biliary stenting was performed endoscopically in 42 patients (84 %) and percutaneously in eight patients. After combined stenting, 30 patients (60 %) required no additional intervention until the time of their death. The remaining 20 patients were successfully treated using endoscopic stent reinsertion: nine patients needed biliary revision, three patients needed duodenal restenting and eight patients needed both biliary and duodenal reinsertion. The median duodenal stent patency and median biliary stent patency were 34 and 27 weeks, respectively. The median survival after combined stent placement was 18 weeks. A Cox multivariate analysis showed that duodenal stent obstruction after combined stenting was a risk factor for biliary stent obstruction (hazard ratio 6.85; 95 % confidence interval 1.43-198.98; P = 0.025). Endoscopic bilio-duodenal bypass is clinically effective, and the majority of the patients need no additional intervention until their death. Endoscopic revision is feasible and has a high success rate.

Impact of centralized diagnostic review on quality of initial staging in Hodgkin lymphoma: experience of the German Hodgkin Study Group.

PubMed

Bröckelmann, Paul J; Goergen, Helen; Fuchs, Michael; Kriz, Jan; Semrau, Robert; Baues, Christian; Kobe, Carsten; Behringer, Karolin; Eichenauer, Dennis A; von Tresckow, Bastian; Klimm, Beate; Halbsguth, Teresa; Wongso, Diana; Plütschow, Annette; Haverkamp, Heinz; Dietlein, Markus; Eich, Hans T; Stein, Harald; Diehl, Volker; Borchmann, Peter; Engert, Andreas

2015-11-01

Accurate clinical staging is crucial for adequate risk-adapted treatment in Hodgkin lymphoma (HL) to prevent patients from under- or over-treatment. Within the latest German Hodgkin Study Group trial generation, diagnostic findings such as histopathology, computerized tomography imaging and clinical risk factors were re-evaluated by expert panels. Here, we retrospectively analysed 5965 patients and identified 399 in who major discordant findings changed their first-line treatment allocation. Histopathology review did not confirm the initial diagnosis of HL in 87 patients. Treatment allocation was revised in 312 of the remaining 5878 patients: 176 were assigned to a higher and 128 to a lower risk group, respectively; the correct treatment group remained unclear in 8 patients. Cases of revised treatment allocation accounted for 9·8%, 6·0%, 0·8%, and 14·8% of patients initially assigned to the HD13, HD14, HD15 trials and stage IA lymphocyte-predominant HL project, respectively. Most revisions were due to wrong application of clinical stage (20·5% of 312 patients with revised treatment group), histological subtype (9·0%) or the risk factors ≥3 involved areas (46·8%) or large mediastinal mass (9·3%). In conclusion, centralized review by experienced experts changed risk-adapted first-line treatment in a relevant proportion of HL patients. Quality control measures clearly improve the accuracy of treatment and should be implemented in clinical practice. © 2015 John Wiley & Sons Ltd.

Use of Compressive Osseointegration Endoprostheses for Massive Bone Loss From Tumor and Failed Arthroplasty: A Viable Option in the Upper Extremity.

PubMed

Goulding, Krista A; Schwartz, Adam; Hattrup, Steven J; Randall, R Lor; Lee, Donald; Rispoli, Damian M; Lerman, Daniel M; Beauchamp, Christopher

2017-06-01

Endoprostheses using principles of compressive osseointegration have shown good survivorship in several studies involving the lower extremity; however, no series to our knowledge have documented the use of this technology in the management of massive bone loss in the upper limb. (1) What proportion of upper extremity implants using compressive osseointegration fixation principles achieved durable short-term fixation, and what were the modes of failure? (2) What surgical complications resulted from reconstruction using this technique? A multiinstitutional retrospective review identified nine patients (five women; four men) who underwent 13 endoprosthetic replacements between 2003 and 2014 using compressive osseointegration (Compliant ® Pre-stress Device [CPS]; Biomet Inc, Warsaw, IN, USA) in the upper extremity, including two proximal humeri, two humeral diaphyses, seven distal humeri, and two proximal ulna. During the early part of that period, the indication for use of a compressive prosthesis in our centers was revision of a previous tumor reconstruction (allograft-prosthetic composite or stemmed endoprosthetic reconstruction) (three patients; five implants), or revision arthroplasty with massive bone loss (three patients, four implants); more recently, indications became somewhat more permissive and included posttraumatic bone loss (one patient, one implant), primary bone sarcoma, and resections with very short remaining end segments after diaphyseal resections (two patients, three implants). Minimum followup was 24 months; one patient (one implant) was lost to followup before that time with the implant intact at 14 months and no patients have died. The mean age of the patients was 45 years (range, 21-62 years). Mean followup was 68 months (range, 24-141 months). Implant revision for any cause and for failure of the CPS mechanism was recorded. Modes of failure were categorized as soft tissue, aseptic loosening, structural, infection, and tumor progression; CPS modes of failure were defined as lack of fixation, with or without bone or implant fracture. Of the 12 implants accounted for beyond 2 years, six had undergone revision of any kind. Only two revisions in two patients were attributable to lack of CPS fixation at the bone-implant interface; one of the patients also had periprosthetic and implant fracture develop through the traction bar. Other modes of failure were aseptic loosening of the standard ulnar component (two patients, two implants), bushing wear (one patient; one implant) and infection resulting in two-stage exchange and free soft tissue transfer with retention of the CPS spindle (one patient, one implant). Complications for all nine patients included one transient radial nerve palsy, one ulnar nerve sensory neurapraxia, one superficial infection, and two glenohumeral subluxations, one underwent revision surgery with implantation of a constrained liner. A compressive osseointegration endoprosthesis is an option for very difficult revisions or sarcoma resection in the upper extremity in which the remaining segment of host bone is too short for a conventional prosthesis. However, surgeons must inform patients that these are salvage operations, and revision surgery is common. Long-term followup of more patients is necessary to further document the survivorship of these implants in the upper extremity. Level IV, therapeutic study.

Psychometric validation of the revised clinical cultural competency questionnaire.

PubMed

Mareno, Nicole; Hart, Patricia L; VanBrackle, Lewis

2013-01-01

Growing diversity in health care requires culturally competent care. Assessing nurses' cultural competence is the first step in designing cultural competency education. The Clinical Cultural Competency Questionnaire (CCCQ) is one instrument to assess nurses' cultural competence. The psychometric properties and factor structure of the revised CCCQ-PRE (CCCQ-PRE-R) for nurses was examined. A 1-factor solution was noted for the knowledge and skills subscales. A 2-factor solution was discovered for the comfort and awareness subscales: differentiating between comfort in dealing with positive and negative cross-cultural encounters/situations, and differentiating between importance awareness and self-awareness. Cronbach's alpha coefficients were high for all subscales. The findings support the use of the revised CCCQ-PRE-R with nurses. Further testing in larger, more diverse nursing populations is warranted.

Updated Design Standards and Guidance from the What Works Clearinghouse: Regression Discontinuity Designs and Cluster Designs

ERIC Educational Resources Information Center

Cole, Russell; Deke, John; Seftor, Neil

2016-01-01

The What Works Clearinghouse (WWC) maintains design standards to identify rigorous, internally valid education research. As education researchers advance new methodologies, the WWC must revise its standards to include an assessment of the new designs. Recently, the WWC has revised standards for two emerging study designs: regression discontinuity…

More Learning in Less Time: A Guide to Effective Study for University Students.

ERIC Educational Resources Information Center

Kahn, Norma B.

A revision of "Effective and Efficient Study," a guide to effective study for university students, is presented. Topics include: self-evaluation using a checklist of factors involved in college reading and study problems; self-evaluation regarding test anxiety; organizing work and budgeting time; remembering effectively; improving…

Do the Reasons for Ceramic-on-ceramic Revisions Differ From Other Bearings in Total Hip Arthroplasty?

PubMed

Migaud, Henri; Putman, Sophie; Kern, Grégory; Isida, Ronald; Girard, Julien; Ramdane, Nassima; Delaunay, Christian P; Hamadouche, Moussa

2016-10-01

Despite widespread use of ceramic-on-ceramic (CoC) in total hip arthroplasty (THA) during the past 10 years, little is known about why revisions are performed in hips with this bearing or the time elapsed before revision. The purposes of this study were: (1) Do the reasons for first revision differ between CoC bearings and other bearing couples? (2) Does the time to revision differ between CoC and other bearing couples? (3) Are there unique reasons for revisions of CoC bearings? All members of the Société Française de Chirurgie Orthopédique et Traumatologique (SoFCOT) who performed ≥ 30 revisions per year were invited to participate in this multicenter, prospective, observational study. Our data represent 12% of the revision procedures performed in France. A total of 2107 first revisions of THA (from January 2010 to December 2011) were done in 2107 patients (1201 females [57%] and 906 males [43%]; median age, 73 years; age range, 17-104 years) at the time of surgery after a median of 11 years (range, 0 day-42 years) after the primary THA. There were 238 of 2107 (11%) CoC, 148 of 2107 (7%) metal-on-metal (MoM), and 1721 of 2017 (82%) metal-on-polyethylene (MoP) bearings. The reasons for reoperation differed according to the bearing component: (1) for the MoP reference bearing (odds ratio [OR]; 95% confidence interval), cup loosening occurred in 698 of 1721 hips (41%), periprosthetic fracture in 220 of 1721 hips (13%), and osteolysis in 213 of 1721 hips (12%); (2) for CoC, cup loosening occurred in 41 of 238 hips (17%) (OR, 0.31 [0.22-0.43; p < 0.001), infection in 39 of 238 hips (16%) (OR, 1.63 [1.12-2.37]; p = 0.01), and dislocation in 23 of 238 hips (10%) (OR, 0.9 [0.57-1.42]; p = 0.9); (3) for MoM, cup loosening occurred in 28 of 148 hips (19%) (OR, 0.34 [0.22-0.52]; p < 0.001), adverse reaction to metallic debris in 26 of 148 hips (18%) (OR, 18.12 [9.84-33.4]; p < 0.001), and infection in 16 of 148 hips (11%) (OR, 1 [0.59-1.73]; p = 0.9). In comparison with MoP, osteolysis was rarely the reason for revision in CoC (four of 238 hips [2%]; OR, 0.12 [0.05-0.33]; p < 0.001), but this bearing was frequently revised because of iliopsoas irritation (18 of 238 hips [8%]; OR, 4.9 [2.7-9]; p < 0.001). The time elapsed before revision differed between bearings: median of 3 years (range, 3 days to 28 years) for CoC and 4 years (range, 14 days to 37 years) for MoM versus a median 13 years (range, 0 day to 42 years) for MoP (p < 0.001). Thirty-seven of the 238 revisions (16%) were directly related to ceramic use (ceramic breakage [n = 23], squeaking [n = 6], impingement [n = 7], incorrect ceramic insert insertion [n = 1]). No factors were identified that contributed to breakage of the 12 bulk ceramic components (eight heads, four inserts, four of 12 Delta ceramic). No factors were associated with squeaking, iliopsoas irritation, or impingement, but component orientation was not assessed. The reasons and time to first revision differed between CoC and other bearings. CoC THAs are revised earlier and are sensitive to mechanical problems such as impingement, squeaking, and ceramic rupture that did not disappear with introduction of Delta ceramics and large-diameter (≥ 36 mm) bearings. CoC was rarely revised for osteolysis, but a high rate of iliopsoas irritation requires further investigation. Level III, therapeutic study.

HUNGARIAN EXPERIENCES WITH THE BELIEFS ABOUT ATTRACTIVENESS SCALE.

PubMed

Czeglédi, Edit; Szabo, Kornélia

2016-03-30

Sociocultural influences regarding bodily appearance and their psychological consequences play a considerable role in the development and maintenance of body image disturbance and eating disorders. The purpose of the study was to explore the psychometric properties of the Beliefs About Attractiveness Scale-Revised and its correlates among young adults in Hungary. In our cross-sectional online study, participants were 18-35 years old (N = 820, 40% male). self-reported anthropometric data, Beliefs About Attractiveness Scale-Revised, Eating Disorder Inventory, SCOFF questionnaire, Sociocultural Attitudes Towards Appearance Questionnaire-3, and Rosenberg Self-esteem Scale. The exploratory factor analysis showed that the fit indices of the three-factor solution are acceptable (χ²(₁₇₁)) = 5124.8, p < 0.001, CFI = 0.944, TLI = 0.918, RMSEA = 0.054, SRMR = 0.030). Along the original 'Importance of being thin' and the 'Importance of being fit' factors, a third factor emerged, namely the 'Life fulfilment aspect of attractiveness' factor. Internal consistency and construct validity of the scales were confirmed. Among those who were at risk of developing an eating disorder, all of the measured beliefs were significantly greater than among those who were not at risk (thin: Z = 6.501, p < 0.001, Cohen's d = 0.63, fit: t(₈₁₈) = -4.749, p < 0.001, Cohen's d = 0.41, and life fulfilment: t(₂₃₉) = -5.702, p < 0.001, Cohen's d = 0.53). The Hungarian version of the Beliefs About Attractiveness Scale-Revised is a reliable, valid measure and we suggest its introduction into Hungarian research. Relationships between beliefs about attractiveness and self- esteem, body image and eating disorders suggest intervention opportunities in with regards to prevention and treatment of eating disorders.

Assessing the Five Factors of Personality in Adolescents: The Junior Version of the Spanish NEO-PI-R

ERIC Educational Resources Information Center

Ortet, Generos; Ibanez, Manuel I.; Moya, Jorge; Villa, Helena; Viruela, Ana; Mezquita, Laura

2012-01-01

This article presents the development of a junior version of the Spanish (Castilian) NEO Personality Inventory-Revised (JS NEO) suitable for adolescents aged 12 to 18 years. The psychometric properties of the new JS NEO were investigated using two samples of 2,733 and 983 adolescents in Spain. The results showed that the adult NEO-PI-R factor…

Social Studies: Selected Cultures. Grade 6.

ERIC Educational Resources Information Center

Taylor, Marshall R.

This revised teachers guide attempts to facilitate the study of selected cultures through a conceptual approach and multimedia instruction in a spiral curriculum. There are six units: 1) Cultures and Archaeology --cultural factors, cultural study, artifacts, fossils, archaeological sites and evidence; 2) Food Gathering Complex --life styles,…

Confirmatory factor analysis of the School Refusal Assessment Scale – Revised in an African American community sample

PubMed Central

Lyon, Aaron R.

2010-01-01

The current study used confirmatory factor analysis techniques to investigate the construct validity of the child version of the School Refusal Assessment Scale – Revised (SRAS-R) in a community sample of low socioeconomic status, urban, African American fifth and sixth graders (n = 174). The SRAS-R is the best-researched measure of school refusal behavior in youth and typically yields four functional dimensions. Results of the investigation suggested that a modified version of the four-factor model, in which three items from the tangible reinforcement dimension are removed, may have construct validity in the current sample of youth. In addition, youth endorsement of the dimension measuring avoidance of social and/or evaluative situations was positively associated with unexcused absences. Implications for further psychometric research and early identification and prevention of problematic absenteeism in low-SES, ethnic minority community samples are highlighted. PMID:20567603

Construction and validation of the South African version of the Fear Survey Schedule for Children: an exploratory factor analysis.

PubMed

Burkhardt, Käthe; Loxton, Helene; Kagee, Ashraf; Ollendick, Thomas H

2012-09-01

The Fear Survey Schedule for Children-Revised (Ollendick, 1983) is an 80-item self-report instrument that has been used internationally to asses the number of fears and general level of fearfulness among children. Despite its widespread use, this instrument has not been adapted to the South African context. The present study addressed this gap by means of a 2-phase investigation aimed at developing a South African version of the instrument. In Phase 1, semistructured interviews were conducted with 40 children (7 to 13 years of age). Qualitative data obtained from these interviews were used to construct additional items for inclusion in the South African Fear Survey Schedule for Children-Revised. The modified scale, consisting of 97 items, was then administered to a sample of 646 children between the ages of 7 and 13 years. Further psychometric considerations resulted in the final version of the scale consisting of 74 items with high internal consistency (α=.97). The factor structure was explored by means of principal component analysis with varimax rotation and a 5-factor solution was found to provide the best conceptual fit. The factors identified were as follows: Fear of Death and Danger; Fear of the Unknown; Fear of Small Animals and Minor Threats to Self; Large Animal Fears; and Situational Fears. Differences between the South African version and the original Fear Survey Schedule for Children-Revised are noted and implications for the study of fear in South Africa and other countries are discussed. Copyright © 2012. Published by Elsevier Ltd.

Socket position determines hip resurfacing 10-year survivorship.

PubMed

Amstutz, Harlan C; Le Duff, Michel J; Johnson, Alicia J

2012-11-01

Modern metal-on-metal hip resurfacing arthroplasty designs have been used for over a decade. Risk factors for short-term failure include small component size, large femoral head defects, low body mass index, older age, high level of sporting activity, and component design, and it is established there is a surgeon learning curve. Owing to failures with early surgical techniques, we developed a second-generation technique to address those failures. However, it is unclear whether the techniques affected the long-term risk factors. We (1) determined survivorship for hips implanted with the second-generation cementing technique; (2) identified the risk factors for failure in these patients; and (3) determined the effect of the dominant risk factors on the observed modes of failure. We retrospectively reviewed the first 200 hips (178 patients) implanted using our second-generation surgical technique, which consisted of improvements in cleaning and drying the femoral head before and during cement application. There were 129 men and 49 women. Component orientation and contact patch to rim distance were measured. We recorded the following modes of failure: femoral neck fracture, femoral component loosening, acetabular component loosening, wear, dislocation, and sepsis. The minimum followup was 25 months (mean, 106.5 months; range, 25-138 months). Twelve hips were revised. Kaplan-Meier survivorship was 98.0% at 5 years and 94.3% at 10 years. The only variable associated with revision was acetabular component position. Contact patch to rim distance was lower in hips that dislocated, were revised for wear, or were revised for acetabular loosening. The dominant modes of failure were related to component wear or acetabular component loosening. Acetabular component orientation, a factor within the surgeon's control, determines the long-term success of our current hip resurfacing techniques. Current techniques have changed the modes of failure from aseptic femoral failure to wear or loosening of the acetabular component. Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

Relating Sexual Sadism and Psychopathy to One Another, Non-Sexual Violence, and Sexual Crime Behaviors

PubMed Central

Robertson, Carrie A.; Knight, Raymond A.

2014-01-01

Sexual sadism and psychopathy have been theoretically, clinically, and empirically linked to violence. Although both constructs are linked to predatory violence, few studies have sought to explore the covariation of the two constructs, and even fewer have sought to conceptualize the similarities of violence prediction in each. The current study considered all four Psychopathy Checklist-Revised (PCL-R) facets and employed well-defined, validated measures of sadism to elucidate the relation between sadism and psychopathy, as well as to determine the role of each in the prediction of non-sexual violence and sexual crime behaviors. Study 1 assessed 314 adult, male sex offenders using archival ratings, as well as the self-report Multidimensional Inventory of Development, Sex, and Aggression (the MIDSA). Study 2 used archival ratings to assess 599 adult, male sex offenders. Exploratory and confirmatory factor analyses of crime scene descriptions yielded four sexual crime behavior factors: Violence, Physical Control, Sexual Behavior, and Paraphilic. Sadism and psychopathy covaried, but were not coextensive; sadism correlated with Total PCL-R, Facet 1, and Facet 4 scores. The constructs predicted all non-sexual violence measures, but predicted different sexual crime behavior factors. The PCL-R facets collectively predicted the Violence and Paraphilic factors, whereas sadism only predicted the Violence factor. PMID:24019144

Relating sexual sadism and psychopathy to one another, non-sexual violence, and sexual crime behaviors.

PubMed

Robertson, Carrie A; Knight, Raymond A

2014-01-01

Sexual sadism and psychopathy have been theoretically, clinically, and empirically linked to violence. Although both constructs are linked to predatory violence, few studies have sought to explore the covariation of the two constructs, and even fewer have sought to conceptualize the similarities of violence prediction in each. The current study considered all four Psychopathy Checklist-Revised (PCL-R) facets and employed well-defined, validated measures of sadism to elucidate the relation between sadism and psychopathy, as well as to determine the role of each in the prediction of non-sexual violence and sexual crime behaviors. Study 1 assessed 314 adult, male sex offenders using archival ratings, as well as the self-report Multidimensional Inventory of Development, Sex, and Aggression (the MIDSA). Study 2 used archival ratings to assess 599 adult, male sex offenders. Exploratory and confirmatory factor analyses of crime scene descriptions yielded four sexual crime behavior factors: Violence, Physical Control, Sexual Behavior, and Paraphilic. Sadism and psychopathy covaried, but were not coextensive; sadism correlated with Total PCL-R, Facet 1, and Facet 4 scores. The constructs predicted all non-sexual violence measures, but predicted different sexual crime behavior factors. The PCL-R facets collectively predicted the Violence and Paraphilic factors, whereas sadism only predicted the Violence factor. © 2013 Wiley Periodicals, Inc.

Zuckerman's revised alternative five-factor model: validation of the Zuckerman-Kuhlman-Aluja Personality Questionnaire in four French-speaking countries.

PubMed

Rossier, Jérôme; Hansenne, Michel; Baudin, Nicolas; Morizot, Julien

2012-01-01

The aim of this study was to analyze the replicability of Zuckerman's revised Alternative Five-factor model in a French-speaking context by validating the Zuckerman-Kuhlman-Aluja Personality Questionnaire (ZKA-PQ) simultaneously in 4 French-speaking countries. The total sample was made up of 1,497 subjects from Belgium, Canada, France, and Switzerland. The internal consistencies for all countries were generally similar to those found for the normative U.S. and Spanish samples. A factor analysis confirmed that the normative structure replicated well and was stable within this French-speaking context. Moreover, multigroup confirmatory factor analyses have shown that the ZKA-PQ reaches scalar invariance across these 4 countries. Mean scores were slightly different for women and men, with women scoring higher on Neuroticism but lower on Sensation Seeking. Globally, mean score differences across countries were small. Overall, the ZKA-PQ seems an interesting alternative to assess both lower and higher order personality traits for applied or research purposes.

Revision total knee arthroplasty in the young patient: is there trouble on the horizon?

PubMed

Aggarwal, Vinay K; Goyal, Nitin; Deirmengian, Gregory; Rangavajulla, Ashwin; Parvizi, Javad; Austin, Matthew S

2014-04-02

The volume of total knee arthroplasties, including revisions, in young patients is expected to rise. The objective of this study was to compare the reasons for revision and re-revision total knee arthroplasties between younger and older patients, to determine the survivorship of revision total knee arthroplasties, and to identify risk factors associated with failure of revision in patients fifty years of age or younger. Perioperative data were collected for all total knee arthroplasty revisions performed from August 1999 to December 2009. A cohort of eighty-four patients who were fifty years of age or younger and a cohort of eighty-four patients who were sixty to seventy years of age were matched for the date of surgery, sex, and body mass index (BMI). The etiology of failure of the index total knee arthroplasty and all subsequent revision total knee arthroplasties was determined. Kaplan-Meier survival curves were used to evaluate the timing of the primary failure and the survivorship of revision knee procedures. Finally, multivariate Cox regression was used to calculate risk ratios for the influence of age, sex, BMI, and the reason for the initial revision on survival of the revision total knee arthroplasty. The most common reason for the initial revision was aseptic loosening (27%; 95% confidence interval [CI] = 19% to 38%) in the younger cohort and infection (30%; 95% CI = 21% to 40%) in the older cohort. Of the twenty-five second revisions in younger patients, 32% (95% CI = 17% to 52%) were for infection, whereas 50% (95% CI = 32% to 68%) of the twenty-six second revisions in the older cohort were for infection. Cumulative six-year survival rates were 71.0% (95% CI = 60.7% to 83.0%) and 66.1% (95% CI = 54.5% to 80.2%) for revisions in the younger and older cohorts, respectively. Infection and a BMI of ≥ 40 kg/m(2) posed the greatest risk of failure of revision procedures, with risk ratios of 2.731 (p = 0.006) and 2.934 (p = 0.009), respectively. The survivorship of knee revisions in younger patients is a cause of concern, and the higher rates of aseptic failure in these patients may be related to unique demands that they place on the reconstruction. Improvement in implant fixation and treatment of infection when these patients undergo revision total knee arthroplasty is needed.

Validity of Factors of the Psychopathy Checklist-Revised in Female Prisoners: Discriminant Relations with Antisocial Behavior, Substance Abuse, and Personality

ERIC Educational Resources Information Center

Kennealy, Patrick J.; Hicks, Brian M.; Patrick, Christopher J.

2007-01-01

The validity of the Psychopathy Checklist-Revised (PCL-R) has been examined extensively in men, but its validity for women remains understudied. Specifically, the correlates of the general construct of psychopathy and its components as assessed by PCL-R total, factor, and facet scores have yet to be examined in depth. Based on previous research…

Revision Hip Arthroscopy Indications and Outcomes: A Systematic Review.

PubMed

Sardana, Vandit; Philippon, Marc J; de Sa, Darren; Bedi, Asheesh; Ye, Lily; Simunovic, Nicole; Ayeni, Olufemi R

2015-10-01

To identify the indications and outcomes in patients undergoing revision hip arthroscopy. The electronic databases Embase, Medline, HealthStar, and PubMed were searched from 1946 to July 19, 2014. Two blinded reviewers searched, screened, and evaluated the data quality of the studies using the Methodological Index for Non-Randomized Studies scale. Data were abstracted in duplicate. Agreement and descriptive statistics are presented. Six studies were included (3 prospective case series and 3 retrospective chart reviews), with a total of 448 hips examined. The most common indications for revision hip arthroscopy included residual femoroacetabular impingement (FAI), labral tears, and chondral lesions. The mean interval between revision arthroscopy and the index procedure was 25.6 months. Overall, the modified Harris Hip Score improved by a mean of 33.6% (19.3 points) from the baseline score at 1-year follow-up. In 14.6% of patients, further surgical procedures were required, including re-revision hip arthroscopy (8.0%), total hip replacement (5.6%), and hip resurfacing (1.0%). Female patients more commonly underwent revision hip arthroscopy (59.7%). The current evidence examined in this review supports revision hip arthroscopy as a successful intervention to improve functional outcomes (modified Harris Hip Score) and relieve pain in patients with residual symptoms after primary FAI surgery, although the outcomes are inferior when compared with a matched cohort of patients undergoing primary hip arthroscopy for FAI. The main indication for revision is a candidate who has symptoms due to residual cam- or pincer-type deformity that was either unaddressed or under-resected during the index operation. However, it is important to consider that the studies included in this review are of low-quality evidence. Surgeons should consider incorporating a minimum 2-year follow-up for individuals after index hip-preservation surgery because revisions tended to occur within this time frame. Level IV, systematic review of Level III and IV studies. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Psychometric Testing of an Arabic Translation of the Revised-Illness Perception Questionnaire (IPQ-R) for Chronic Illness Patients.

PubMed

Aberkane, Salah

2017-08-01

Researchers lack a properly validated instrument to measure perceptions of chronic disease in Arabic language contexts. This study aimed to adapt and validate the Revised-Illness Perception Questionnaire (IPQ-R) for Arabic speaking chronic illness patients. A cross-sectional design was conducted to examine the psychometric properties of the adapted English version of the IPQ-R for Arabic speaking chronic illness patients. The study instrument was an Arabic version of the IPQ-R prepared through a translation process. The reliability and validity of the instrument were assessed using exploratory and confirmatory factor analysis and Cronbach's alpha coefficient. Three hundred and sixteen participants (ages 16-79) from the Batna region in Algeria completed the IPQ-R. A total of 316 (100%) patients responded to this study. Regarding internal consistency, Cronbach's alpha a coefficient was consistently higher than 0.45. Several areas of fit were identified and substantial changes to the measurement model were made, such as the deletion of 22 items from the original 38-item IPQ-R and two items from the original 18 causal items this accounted for 64.63% of the total variance, and the respecification of indicators had to be applied to achieve acceptable model fit. The final model consists of two sections: The 16-item Arabic IPQ-R, which had a good fit; (CMIN/Df = 1.30, P < 0.001, CFI = 0.93, RMSEA = 0.08, SRMR = 0.03), and was similar to the Arabic 16 causal items (CMIN/DF = 1.11, P < 0.001, CFI = 0.95, RMSEA = 0.080, SRMR = 0.02). The factor structure concurred with prior finding despite differences to the type of sample and cultural considerations that might explain these findings. Replication of this study in Algerian patients with specific illness, such as silicosis, breast cancer and multiple sclerosis. Further psychometric testing on other large samples is recommended.

Psychometric Testing of an Arabic Translation of the Revised-Illness Perception Questionnaire (IPQ-R) for Chronic Illness Patients

PubMed Central

Aberkane, Salah

2017-01-01

Background Researchers lack a properly validated instrument to measure perceptions of chronic disease in Arabic language contexts. This study aimed to adapt and validate the Revised-Illness Perception Questionnaire (IPQ-R) for Arabic speaking chronic illness patients. Methods A cross-sectional design was conducted to examine the psychometric properties of the adapted English version of the IPQ-R for Arabic speaking chronic illness patients. The study instrument was an Arabic version of the IPQ-R prepared through a translation process. The reliability and validity of the instrument were assessed using exploratory and confirmatory factor analysis and Cronbach’s alpha coefficient. Three hundred and sixteen participants (ages 16–79) from the Batna region in Algeria completed the IPQ-R. Results A total of 316 (100%) patients responded to this study. Regarding internal consistency, Cronbach’s alpha a coefficient was consistently higher than 0.45. Several areas of fit were identified and substantial changes to the measurement model were made, such as the deletion of 22 items from the original 38-item IPQ-R and two items from the original 18 causal items this accounted for 64.63% of the total variance, and the respecification of indicators had to be applied to achieve acceptable model fit. The final model consists of two sections: The 16–item Arabic IPQ-R, which had a good fit; (CMIN/Df = 1.30, P < 0.001, CFI = 0.93, RMSEA = 0.08, SRMR = 0.03), and was similar to the Arabic 16 causal items (CMIN/DF = 1.11, P < 0.001, CFI = 0.95, RMSEA = 0.080, SRMR = 0.02). Conclusion The factor structure concurred with prior finding despite differences to the type of sample and cultural considerations that might explain these findings. Replication of this study in Algerian patients with specific illness, such as silicosis, breast cancer and multiple sclerosis. Further psychometric testing on other large samples is recommended. PMID:28951692

Human Factors in the Design of a Computer-Assisted Instruction System. Technical Progress Report.

ERIC Educational Resources Information Center

Mudge, J. C.

A research project built an author-controlled computer-assisted instruction (CAI) system to study ease-of-use factors in student-system, author-system, and programer-system interfaces. Interfaces were designed and observed in use and systematically revised. Development of course material by authors, use by students, and administrative tasks were…

Cultural Orientation as a Protective Factor against Tobacco and Marijuana Smoking for African American Young Women

ERIC Educational Resources Information Center

Nasim, Aashir; Corona, Rosalie; Belgrave, Faye; Utsey, Shawn O.; Fallah, Niloofar

2007-01-01

The present study examined cultural orientation as a protective factor against tobacco and marijuana smoking for African American young women (ages 18 to 25). African American college students (N = 145) from a predominantly White university were administered subscales from the African American Acculturation Scale-Revised (AAAS-R); the shortened…

Modifying Pro-Drug Risk Factors in Adolescents: Results from Project ALERT

ERIC Educational Resources Information Center

Ghosh-Dastidar, Bonnie; Longshore, Douglas L.; Ellickson, Phyllis L.; McCaffrey, Daniel F.

2004-01-01

The objective of this study was to evaluate the impact of a revised state-of-the-art drug prevention program, Project ALERT, on risk factors for drug use in mostly rural midwestern schools and communities. Fifty-five middle schools from South Dakota were randomly assigned to treatment or control conditions. Treatment-group students received 11…

Relationship between Revised Graduated Index (R-GINDEX) of prenatal care utilization & preterm labor and low birth weight.

PubMed

Tayebi, Tahereh; Hamzehgardeshi, Zeinab; Ahmad Shirvani, Marjan; Dayhimi, Marjaneh; Danesh, Mahmonir

2014-02-28

Prenatal care refers to accurate and consistent performance of the principles important to maintain healthy pregnancy outcomes and also for mother and child health. One of the new indices to assess the adequacy of care is Revised Graduated Index of Prenatal Care Utilization (R-GINDEX).The study aims to assess the relationship between quantitative prenatal care factors and preterm labor and low birth weight using R-GINDEX. This historical cohort study has been conducted on 420 mothers during the first two years after delivery in 2010. The adequacy of care was calculated by R-GINDEX. Based on this index, participants have been divided into three care groups including inadequate, adequate and intensive care groups. A significant relationship has been found between R-GINDEX and preterm birth and low birth weight (P<0.05). Thus the probability of premature labor in inadequate care group (RR=3.93) and low birth weight (RR= 2.53) was higher than that of the adequate and intensive care group. The results showed that the quantity of prenatal care is effective in reducing preterm birth and low birth weight.

Positive Culture Rate in Revision Shoulder Arthroplasty

PubMed Central

Hobgood, E. Rhett

2009-01-01

We recognized a trend of positive cultures taken from presumably uninfected shoulders during revision arthroplasty. Owing to the indolent nature of common shoulder pathogens such as Propionibacterium acnes, these cultures often become positive several days, even weeks, after surgery. Having concern regarding the potential importance of these positive cultures, we reviewed our revision arthroplasty population to determine the rate of positive intraoperative cultures in patients presumed to be aseptic, to characterize the isolated organisms, and to determine the subsequent development of infection. We retrospectively reviewed 27 patients (28 revisions) presumed to be uninfected between April 2005 and October 2007. Intraoperative cultures were positive in eight (29%) of the 28 revisions. Propionibacterium acnes was isolated in six. Methicillin-resistant Staphylococcus aureus was isolated in one patient and coagulase-negative Staphylococcus aureus was isolated in one patient. One-year followup was available on 24 of the 28 revisions. Two of the eight culture-positive revisions had a subsequent infection develop. Cultures taken at revision surgery for failed shoulder arthroplasty are often positive, and our findings document the importance of these positive cultures. Our data confirm previous reports isolating Propionibacterium acnes as a primary pathogen in revision shoulder arthroplasty. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:19434469

A Developmental Examination of the Psychometric Properties and Predictive Utility of a Revised Psychological Self-Concept Measure for Preschool-Aged Children

PubMed Central

Jia, Rongfang; Lang, Sarah N.; Schoppe-Sullivan, Sarah J.

2015-01-01

Accurate assessment of psychological self-concept in early childhood relies on the development of psychometrically sound instruments. From a developmental perspective, the current study revised an existing measure of young children's psychological self-concepts, the Child Self-View Questionnaire (CSVQ, Eder, 1990), and examined its psychometric properties using a sample of preschool-aged children assessed at approximately 4 years old with a follow-up at age 5 (N = 111). The item compositions of lower-order dimensions were revised, leading to improved internal consistency. Factor Analysis revealed three latent psychological self-concept factors (i.e., Sociability, Control, and Assurance) from the lower-order dimensions. Measurement invariance by gender was supported for Sociability and Assurance, not for Control. Test-retest reliability was supported by stability of the psychological self-concept measurement model during the preschool years, although some evidence of increasing differentiation was obtained. Validity of children's scores on the three latent psychological self-concept factors was tested by investigating their concurrent associations with teacher-reported behavioral adjustment on the Social Competence and Behavior Evaluation Scale – Short Form (SCBE-SF, LaFreniere & Dumas, 1996). Children who perceived themselves as higher in Sociability at 5 years old displayed less internalizing behavior and more social competence; boys who perceived themselves as higher in Control at age 4 exhibited lower externalizing behavior; children higher in Assurance had greater social competence at age 4, but displayed more externalizing behavior at age 5. Implications relevant to the utility of the revised psychological self-concept measure are discussed. PMID:26098231

The "Reading the Mind in the Voice" Test-Revised: A Study of Complex Emotion Recognition in Adults with and Without Autism Spectrum Conditions

ERIC Educational Resources Information Center

Golan, Ofer; Baron-Cohen, Simon; Hill, Jacqueline J.; Rutherford, M. D.

2007-01-01

This study reports a revised version of the "Reading the Mind in the Voice" (RMV) task. The original task (Rutherford et al., (2002), "Journal of Autism and Developmental Disorders, 32," 189-194) suffered from ceiling effects and limited sensitivity. To improve that, the task was shortened and two more foils were added to each of the remaining…

Comparative Analysis of Direct Hospital Care Costs between Aseptic and Two-Stage Septic Knee Revision

PubMed Central

Kasch, Richard; Merk, Sebastian; Assmann, Grit; Lahm, Andreas; Napp, Matthias; Merk, Harry; Flessa, Steffen

2017-01-01

Background The most common intermediate and long-term complications of total knee arthroplasty (TKA) include aseptic and septic failure of prosthetic joints. These complications cause suffering, and their management is expensive. In the future the number of revision TKA will increase, which involves a greater financial burden. Little concrete data about direct costs for aseptic and two-stage septic knee revisions with an in depth-analysis of septic explantation and implantation is available. Questions/Purposes A retrospective consecutive analysis of the major partial costs involved in revision TKA for aseptic and septic failure was undertaken to compare 1) demographic and clinical characteristics, and 2) variable direct costs (from a hospital department’s perspective) between patients who underwent single-stage aseptic and two-stage septic revision of TKA in a hospital providing maximum care. We separately analyze the explantation and implantation procedures in septic revision cases and identify the major cost drivers of knee revision operations. Methods A total of 106 consecutive patients (71 aseptic and 35 septic) was included. All direct costs of diagnosis, surgery, and treatment from the hospital department’s perspective were calculated as real purchase prices. Personnel involvement was calculated in units of minutes. Results Aseptic versus septic revisions differed significantly in terms of length of hospital stay (15.2 vs. 39.9 days), number of reported secondary diagnoses (6.3 vs. 9.8) and incision-suture time (108.3 min vs. 193.2 min). The management of septic revision TKA was significantly more expensive than that of aseptic failure ($12,223.79 vs. $6,749.43) (p <.001). On the level of the separate hospitalizations the mean direct costs of explantation stage ($4,540.46) were lower than aseptic revision TKA ($6,749.43) which were again lower than those of the septic implantation stage ($7,683.33). All mean costs of stays were not comparable as they differ significantly (p <.001). Major cost drivers were the cost of the implant and general staff. The septic implantation part was on average $3,142.87 more expensive than septic explantations (p <.001). Conclusions Our study for the first time provides a detailed analysis of the major direct case costs of aseptic and septic revision TKA from the hospital-department’s perspective which is the basis for long-term orientated decision making. In the future, our cost analysis has to be interpreted in relation to reimbursement estimates. This is important to check whether revision TKA lead to a financial loss for the operating department. PMID:28107366

Assessing a five factor model of PTSD: is dysphoric arousal a unique PTSD construct showing differential relationships with anxiety and depression?

PubMed

Armour, Cherie; Elhai, Jon D; Richardson, Don; Ractliffe, Kendra; Wang, Li; Elklit, Ask

2012-03-01

Posttraumatic stress disorder's (PTSD) latent structure has been widely debated. To date, two four-factor models (Numbing and Dysphoria) have received the majority of factor analytic support. Recently, Elhai et al. (2011) proposed and supported a revised (five-factor) Dysphoric Arousal model. Data were gathered from two separate samples; War veterans and Primary Care medical patients. The three models were compared and the resultant factors of the Dysphoric Arousal model were validated against external constructs of depression and anxiety. The Dysphoric Arousal model provided significantly better fit than the Numbing and Dysphoria models across both samples. When differentiating between factors, the current results support the idea that Dysphoric Arousal can be differentiated from Anxious Arousal but not from Emotional Numbing when correlated with depression. In conclusion, the Dysphoria model may be a more parsimonious representation of PTSD's latent structure in these trauma populations despite superior fit of the Dysphoric Arousal model. Copyright © 2011 Elsevier Ltd. All rights reserved.

Determination of quality factors by microdosimetry

NASA Astrophysics Data System (ADS)

Al-Affan, I. A. M.; Watt, D. E.

1987-03-01

The application of microdose parameters for the specification of a revised scale of quality factors which would be applicable at low doses and dose rates is examined in terms of an original proposal by Rossi. Two important modifications are suggested to enable an absolute scale of quality factors to be constructed. Allowance should be made to allow for the dependence of the saturation threshold of lineal energy on the type of heavy charged particle. Also, an artificial saturation threshold should be introduced for electron tracks as a mean of modifying the measurements made in the microdosimeter to the more realistic site sizes of nanometer dimensions. The proposed absolute scale of quality factors nicely encompasses the high RBEs of around 3 observed at low doses for tritium β rays and is consistent with the recent recommendation of the ICRP that the quality factor for fast neutrons be increased by a factor of two, assuming that there is no biological repair for the reference radiation.

Infertility in Mazandaran province - north of Iran: an etiological study

PubMed Central

Karimpour Malekshah, Abbasali; Esmailnejad Moghaddam, Amir; Moslemizadeh, Narges; Peivandi, Sepideh; Barzegarnejad, Ayyub; Musanejad, Nadali; Jursarayee, Gholamali

2011-01-01

Background: The prevalence and etiology of infertility are not similar in different parts of the world. There are only few reports of this topic in Iran. Objective: This study was conducted to determine the clinical patterns and major causes of infertility in Mazandaran province in north of Iran. Materials and Methods: The medical records of 3734 consecutive couples attending two infertility clinics in Mazandaran province, from 2003 to 2008, were reviewed. The couples had not had a viable birth after at least 1 year of unprotected intercourse and were fully investigated. Results: Of the entire samples, 78.7% had primary infertility and 21.3% had secondary infertility. The mean duration of infertility in couples was 5.7±4 years. The etiology of infertility in couples revealed; male factor in 38.9%, female factor in 34.7%, combined factors in 14.6% and undetermined cause in 11.8%. Conclusion: In this study, delayed attendance of infertile couples to the infertility clinic was found. Therefore, there is a need to revise public health program on infertility to focus on the education and prevention of infertility and its risk factors. PMID:25356077

Moral Distress in PICU and Neonatal ICU Practitioners: A Cross-Sectional Evaluation.

PubMed

Larson, Charles Philip; Dryden-Palmer, Karen D; Gibbons, Cathy; Parshuram, Christopher S

2017-08-01

To measure the level of moral distress in PICU and neonatal ICU health practitioners, and to describe the relationship of moral distress with demographic factors, burnout, and uncertainty. Cross-sectional survey. A large pediatric tertiary care center. Neonatal ICU and PICU health practitioners with at least 3 months of ICU experience. A 41-item questionnaire examining moral distress, burnout, and uncertainty. The main outcome was moral distress measured with the Revised Moral Distress Scale. Secondary outcomes were frequency and intensity Revised Moral Distress Scale subscores, burnout measured with the Maslach Burnout Inventory depersonalization subscale, and uncertainty measured with questions adapted from Mishel's Parent Perception of Uncertainty Scale. Linear regression models were used to examine associations between participant characteristics and the measures of moral distress, burnout, and uncertainty. Two-hundred six analyzable surveys were returned. The median Revised Moral Distress Scale score was 96.5 (interquartile range, 69-133), and 58% of respondents reported significant work-related moral distress. Revised Moral Distress Scale items involving end-of-life care and communication scored highest. Moral distress was positively associated with burnout (r = 0.27; p < 0.001) and uncertainty (r = 0.04; p = 0.008) and inversely associated with perceived hospital supportiveness (r = 0.18; p < 0.001). Nurses reported higher moral distress intensity than physicians (Revised Moral Distress Scale intensity subscores: 57.3 vs 44.7; p = 0.002). In nurses only, moral distress was positively associated with increasing years of ICU experience (p = 0.02) and uncertainty about whether their care was of benefit (r = 0.11; p < 0.001) and inversely associated with uncertainty about a child's prognosis (r = 0.03; p = 0.03). In this single-center, cross-sectional study, we found that moral distress is present in PICU and neonatal ICU health practitioners and is correlated with burnout, uncertainty, and feeling unsupported.

Single-stage Acetabular Revision During Two-stage THA Revision for Infection is Effective in Selected Patients.

PubMed

Fink, Bernd; Schlumberger, Michael; Oremek, Damian

2017-08-01

The treatment of periprosthetic infections of hip arthroplasties typically involves use of either a single- or two-stage (with implantation of a temporary spacer) revision surgery. In patients with severe acetabular bone deficiencies, either already present or after component removal, spacers cannot be safely implanted. In such hips where it is impossible to use spacers and yet a two-stage revision of the prosthetic stem is recommended, we have combined a two-stage revision of the stem with a single revision of the cup. To our knowledge, this approach has not been reported before. (1) What proportion of patients treated with single-stage acetabular reconstruction as part of a two-stage revision for an infected THA remain free from infection at 2 or more years? (2) What are the Harris hip scores after the first stage and at 2 years or more after the definitive reimplantation? Between June 2009 and June 2014, we treated all patients undergoing surgical treatment for an infected THA using a single-stage acetabular revision as part of a two-stage THA exchange if the acetabular defect classification was Paprosky Types 2B, 2C, 3A, 3B, or pelvic discontinuity and a two-stage procedure was preferred for the femur. The procedure included removal of all components, joint débridement, definitive acetabular reconstruction (with a cage to bridge the defect, and a cemented socket), and a temporary cemented femoral component at the first stage; the second stage consisted of repeat joint and femoral débridement and exchange of the femoral component to a cementless device. During the period noted, 35 patients met those definitions and were treated with this approach. No patients were lost to followup before 2 years; mean followup was 42 months (range, 24-84 months). The clinical evaluation was performed with the Harris hip scores and resolution of infection was assessed by the absence of clinical signs of infection and a C-reactive protein level less than 10 mg/L. All patients were assessed before surgery, between stages, every 3 months during the first year after surgery, every 6 months during the second year postoperative, and at latest followup, and were retrospectively drawn from a longitudinally maintained institutional database. Thirty-four of 35 patients (97.2%; 95% CI, 85.4%-99.5%) appeared free of infection by criteria of Masri et al. and Zimmerli et al. at latest followup. The Harris hip score was 61 ± 13 points after the first operation and 82 ± 16 points 2 years after the second operation. This technique is a promising treatment option for periprosthetic infections of the hip in which substantial acetabular defects exclude implantation of a normal spacer and a two-stage revision of the femoral component is favored. Level IV, therapeutic study.

Revising and assessing explanatory models in a high school genetics class: A comparison of unsuccessful and successful performance

NASA Astrophysics Data System (ADS)

Johnson, Susan K.; Stewart, Jim

2002-07-01

In this paper we describe the model-revising problem-solving strategies of two groups of students (one successful, one unsuccessful) as they worked (in a genetics course we developed) to revise Mendel's simple dominance model to explain the inheritance of a trait expressed in any of four variations. The two groups described in this paper were chosen with the intent that the strategies that they employed be used to inform the design of model-based instruction. Differences were found in the groups' abilities to recognize anomalous data, use existing models as templates for revisions, and assess revised models.

The Play Experience Scale: development and validation of a measure of play.

PubMed

Pavlas, Davin; Jentsch, Florian; Salas, Eduardo; Fiore, Stephen M; Sims, Valerie

2012-04-01

A measure of play experience in video games was developed through literature review and two empirical validation studies. Despite the considerable attention given to games in the behavioral sciences, play experience remains empirically underexamined. One reason for this gap is the absence of a scale that measures play experience. In Study 1, the initial Play Experience Scale (PES) was tested through an online validation that featured three different games (N = 203). In Study 2, a revised PES was assessed with a serious game in the laboratory (N = 77). Through principal component analysis of the Study 1 data, the initial 20-item PES was revised, resulting in the 16-item PES-16. Study 2 showed the PES-16 to be a robust instrument with the same patterns of correlations as in Study 1 via (a) internal consistency estimates, (b) correlations with established scales of motivation, (c) distributions of PES-16 scores in different game conditions, and (d) examination of the average variance extracted of the PES and the Intrinsic Motivation Scale. We suggest that the PES is appropriate for use in further validation studies. Additional examinations of the scale are required to determine its applicability to other contexts and its relationship with other constructs. The PES is potentially relevant to human factors undertakings involving video games, including basic research into play, games, and learning; prototype testing; and exploratory learning studies.

Psychometric Testing of the Persian Version of the Perceived Perioperative Competence Scale-Revised.

PubMed

Ajorpaz, Neda Mirbagher; Tafreshi, Mansoureh Zagheri; Mohtashami, Jamileh; Zayeri, Farid; Rahemi, Zahra

2017-12-01

The clinical competence of nursing students in operating room (OR) is an important issue in nursing education. The purpose of this study was to evaluate the psychometric properties of the Persian Perceived Perioperative Competence Scale-Revised (PPCS-R) instrument. This cross-sectional study was conducted across 12 universities in Iran. The psychometric properties and factor structure of the PPCS-R for OR students was examined. Based on the results of factor analysis, seven items were removed from the original version of the scale. The fitness indices of the Persian scale include comparative fit index (CFI) = .90, goodness-of-fit-index (GFI) = .86, adjusted goodness-of-fit index (AGFI) = .90, normed fit index (NFI) = .84, and root mean square error of approximation (RMSEA) = .04. High validity and reliability indicated the scale's value for measuring perceived perioperative competence of Iranian OR students.

Pollybeak Deformity in Middle Eastern Rhinoplasty: Prevention and Treatment.

PubMed

Hussein, Wael K A; Foda, Hossam M T

2016-08-01

The pollybeak deformity is one of the commonest causes of revision rhinoplasty. The Middle Eastern nose has certain criteria that predispose to the development of pollybeak deformity. The aim of this study is to detect the factors contributing to the development of pollybeak deformity in the Middle Eastern nose and methods used to prevent as well as to treat such deformity. Out of the 1,160 revision patients included in this study, 720 (62%) patients had a pollybeak deformity. The commonest contributing factors included underprojected tip with poor support in 490 (68%) patients, excessive supratip scarring in 259 (36%) patients, overresected bony dorsum in 202 (28%) patients, and high anterior septal angle in 173 (24%) patients. The methods used by the authors to treat the pollybeak deformity are described, along with the local steroid injection protocol used to guard against the recurrence of pollybeak deformity. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Youth at ultra high risk for psychosis: using the Revised Network Episode Model to examine pathways to mental health care.

PubMed

Boydell, Katherine M; Volpe, Tiziana; Gladstone, Brenda M; Stasiulis, Elaine; Addington, Jean

2013-05-01

This paper aims to identify the ways in which youth at ultra high risk for psychosis access mental health services and the factors that advance or delay help seeking, using the Revised Network Episode Model (REV NEM) of mental health care. A case study approach documents help-seeking pathways, encompassing two qualitative interviews with 10 young people and 29 significant others. Theoretical propositions derived from the REV NEM are explored, consisting of the content, structure and function of the: (i) family; (ii) community and school; and (iii) treatment system. Although the aspects of the REV NEM are supported and shape pathways to care, we consider rethinking the model for help seeking with youth at ultra high risk for psychosis. The pathway concept is important to our understanding of how services and supports are received and experienced over time. Understanding this process and the strategies that support positive early intervention on the part of youth and significant others is critical. © 2012 Wiley Publishing Asia Pty Ltd.

Aseptic loosening of cobalt chromium monoblock sockets after hip resurfacing.

PubMed

Amstutz, Harlan C; Le Duff, Michel J

2015-01-01

Acetabular component loosening is a leading cause for revision after metal-on-metal hip resurfacing arthroplasty (MMHRA). We aimed to identify potential risk factors and determine radiographic signs associated with this mode of failure. From a series of 1375 hips treated with MMHRA, 21 (20 patients) underwent revision surgery secondary to aseptic loosening of the acetabular component and 6 patients had a radiographically loose acetabular component. A control group of 27 hips (26 patients) was selected among the patients that did not have a revision, and was matched for age, gender, component size and diagnosis. Mean time to revision in the loosening group was 103.0 months and the mean time of follow-up in the control group was 161.4 months. We found greater activity levels, range of motion scores, and cup abduction angles in the loosening group. The centre-edge (CE) angle of Wiberg was 10° lower in the loosening group compared with the control group. In addition, 11 of the hips from the study group presented a sclerotic halo superior to the cup on the last radiograph vs. none in the control group. There was no difference in the prevalence of postoperative reaming gaps or radiographic signs of neck-cup impingement between the 2 groups. Risk factors for acetabular loosening included hip dysplasia with low CE angle, and a large cup abduction angle. The patient's level of activity influences the appearance of symptoms and the time to revision. We recommend selecting patients with a sufficient CE angle and properly orienting the cup.

Metabolically Derived Human Ventilation Rates: A Revised ...

EPA Pesticide Factsheets

EPA announced the availability of the final report, Metabolically Derived Human Ventilation Rates: A Revised Approach Based Upon Oxygen Consumption Rates. This report provides a revised approach for calculating an individual's ventilation rate directly from their oxygen consumption rate. This approach will be used to update the ventilation rate information in the Exposure Factors Handbook, which serve as a resources for exposure assessors for calculating inhalation and other exposures. In this report, EPA presents a revised approach in which ventilation rate is calculated directly from an individual's oxygen consumption rate.

Revised methane emissions factors and spatially distributed annual carbon fluxes for global livestock.

PubMed

Wolf, Julie; Asrar, Ghassem R; West, Tristram O

2017-09-29

Livestock play an important role in carbon cycling through consumption of biomass and emissions of methane. Recent research suggests that existing bottom-up inventories of livestock methane emissions in the US, such as those made using 2006 IPCC Tier 1 livestock emissions factors, are too low. This may be due to outdated information used to develop these emissions factors. In this study, we update information for cattle and swine by region, based on reported recent changes in animal body mass, feed quality and quantity, milk productivity, and management of animals and manure. We then use this updated information to calculate new livestock methane emissions factors for enteric fermentation in cattle, and for manure management in cattle and swine. Using the new emissions factors, we estimate global livestock emissions of 119.1 ± 18.2 Tg methane in 2011; this quantity is 11% greater than that obtained using the IPCC 2006 emissions factors, encompassing an 8.4% increase in enteric fermentation methane, a 36.7% increase in manure management methane, and notable variability among regions and sources. For example, revised manure management methane emissions for 2011 in the US increased by 71.8%. For years through 2013, we present (a) annual livestock methane emissions, (b) complete annual livestock carbon budgets, including carbon dioxide emissions, and (c) spatial distributions of livestock methane and other carbon fluxes, downscaled to 0.05 × 0.05 degree resolution. Our revised bottom-up estimates of global livestock methane emissions are comparable to recently reported top-down global estimates for recent years, and account for a significant part of the increase in annual methane emissions since 2007. Our results suggest that livestock methane emissions, while not the dominant overall source of global methane emissions, may be a major contributor to the observed annual emissions increases over the 2000s to 2010s. Differences at regional and local scales may help distinguish livestock methane emissions from those of other sectors in future top-down studies. The revised estimates allow improved reconciliation of top-down and bottom-up estimates of methane emissions, will facilitate the development and evaluation of Earth system models, and provide consistent regional and global Tier 1 estimates for environmental assessments.

Radiographic methods of wear analysis in total hip arthroplasty.

PubMed

Rahman, Luthfur; Cobb, Justin; Muirhead-Allwood, Sarah

2012-12-01

Polyethylene wear is an important factor in failure of total hip arthroplasty (THA). With increasing numbers of THAs being performed worldwide, particularly in younger patients, the burden of failure and revision arthroplasty is increasing, as well, along with associated costs and workload. Various radiographic methods of measuring polyethylene wear have been developed to assist in deciding when to monitor patients more closely and when to consider revision surgery. Radiographic methods that have been developed to measure polyethylene wear include manual and computer-assisted plain radiography, two- and three-dimensional techniques, and radiostereometric analysis. Some of these methods are important in both clinical and research settings. CT has the potential to provide additional information on component orientation and enables assessment of periprosthetic osteolysis, which is an important consequence of polyethylene wear.

Cross-Cultural Adaptation and Validation of the MPAM-R to Brazilian Portuguese and Proposal of a New Method to Calculate Factor Scores

PubMed Central

Albuquerque, Maicon R.; Lopes, Mariana C.; de Paula, Jonas J.; Faria, Larissa O.; Pereira, Eveline T.; da Costa, Varley T.

2017-01-01

In order to understand the reasons that lead individuals to practice physical activity, researchers developed the Motives for Physical Activity Measure-Revised (MPAM-R) scale. In 2010, a translation of MPAM-R to Portuguese and its validation was performed. However, psychometric measures were not acceptable. In addition, factor scores in some sports psychology scales are calculated by the mean of scores by items of the factor. Nevertheless, it seems appropriate that items with higher factor loadings, extracted by Factor Analysis, have greater weight in the factor score, as items with lower factor loadings have less weight in the factor score. The aims of the present study are to translate, validate the MPAM-R for Portuguese versions, and investigate agreement between two methods used to calculate factor scores. Three hundred volunteers who were involved in physical activity programs for at least 6 months were collected. Confirmatory Factor Analysis of the 30 items indicated that the version did not fit the model. After excluding four items, the final model with 26 items showed acceptable model fit measures by Exploratory Factor Analysis, as well as it conceptually supports the five factors as the original proposal. When two methods are compared to calculate factors scores, our results showed that only “Enjoyment” and “Appearance” factors showed agreement between methods to calculate factor scores. So, the Portuguese version of the MPAM-R can be used in a Brazilian context, and a new proposal for the calculation of the factor score seems to be promising. PMID:28293203

49 CFR Appendix C to Part 227 - Audiometric Baseline Revision

Code of Federal Regulations, 2011 CFR

2011-10-01

... FRA STS. The two ears are examined separately and independently for improvement and for worsening. If one ear meets the criteria for revision of baseline, then the baseline is revised for that ear only. Therefore, if the two ears show different hearing trends, the baseline for the left ear may be from one test...

49 CFR Appendix C to Part 227 - Audiometric Baseline Revision

Code of Federal Regulations, 2012 CFR

2012-10-01

... FRA STS. The two ears are examined separately and independently for improvement and for worsening. If one ear meets the criteria for revision of baseline, then the baseline is revised for that ear only. Therefore, if the two ears show different hearing trends, the baseline for the left ear may be from one test...

Prognostic factors for bacterial cultures positive for Propionibacterium acnes and other organisms in a large series of revision shoulder arthroplasties performed for stiffness, pain, or loosening.

PubMed

Pottinger, Paul; Butler-Wu, Susan; Neradilek, Moni Blazej; Merritt, Andrew; Bertelsen, Alexander; Jette, Jocelyn L; Warme, Winston J; Matsen, Frederick A

2012-11-21

Propionibacterium acnes has been grown on culture in half of the reported cases of chronic infection associated with shoulder arthroplasty. The presence of this organism can be overlooked because its subtle presentation may not suggest the need for culture or because, in contrast to many orthopaedic infections, multiple tissue samples and weeks of culture incubation are often necessary to recover this organism. Surgical decisions regarding implant revision and antibiotic therapy must be made before the results of intraoperative cultures are known. In the present study, we sought clinically relevant prognostic evidence that could help to guide treatment decisions. We statistically correlated preoperative and intraoperative observations on 193 shoulder arthroplasty revisions that were performed because of pain, loosening, or stiffness with the results of a Propionibacterium acnes-specific culture protocol. Regression models were used to identify factors predictive of a positive culture for Propionibacterium acnes. One hundred and eight of the 193 revision arthroplasties were associated with positive cultures; 70% of the positive cultures demonstrated growth of Propionibacterium acnes. The rate of positive cultures per shoulder increased with the number of culture specimens obtained from each shoulder. Fifty-five percent of the positive cultures required observation for more than one week. Male sex, humeral osteolysis, and cloudy fluid were each associated with significant increases of ≥ 600% in the likelihood of obtaining a positive Propionibacterium acnes culture. Humeral loosening, glenoid wear, and membrane formation were associated with significant increases of >300% in the likelihood of obtaining a positive Propionibacterium acnes culture. Preoperative and intraoperative factors can be used to help to predict the risk of a positive culture for Propionibacterium acnes. This evidence is clinically relevant to decisions regarding prosthesis removal or retention and the need for immediate antibiotic therapy at the time of revision shoulder arthroplasty before the culture results become available. Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Poor short term outcome with a metal-on-metal total hip arthroplasty.

PubMed

Levy, Yadin D; Ezzet, Kace A

2013-08-01

Metal-on-metal (MoM) bearings for total hip arthroplasty (THA) have come under scrutiny with reports of high failure rates. Clinical outcome studies with several commercially available MoM THA bearings remain unreported. We evaluated 78 consecutive MoM THAs from a single manufacturer in 68 patients. Sixty-six received cobalt-chrome (CoCr) monoblock and 12 received modular titanium acetabular cups with internal CoCr liners. Femoral components were titanium with modular necks. At average 2.1 years postoperatively, 12 THAs (15.4%) demonstrated aseptic failure (10 revisions, 2 revision recommended). All revised hips demonstrated capsular necrosis with positive histology reaction for aseptic lymphocytic vasculitis-associated lesions/adverse local tissue reactions. Prosthetic instability following revision surgery was relatively common. Female gender was a strong risk factor for failure, though smaller cups were not. Both monoblock and modular components fared poorly. Corrosion was frequently observed around the proximal and distal end of the modular femoral necks. Copyright © 2013 Elsevier Inc. All rights reserved.

Expression of the Eukaryotic Translation Initiation Factors 4E and 2α in Non-Hodgkin’s Lymphomas

PubMed Central

Wang, Songtao; Rosenwald, Igor B.; Hutzler, Michael J.; Pihan, German A.; Savas, Lou; Chen, Jane-Jane; Woda, Bruce A.

1999-01-01

Transition of cells from quiescence to proliferation requires an increase in the rate of protein synthesis, which is regulated in part by two key translation initiation factors, 4E and 2α. The expression and activity of both factors are increased transiently when normal resting cells are stimulated to proliferate. They are constitutively elevated in oncogene transformed cultured cells, and overexpression of either initiation factor in rodent cells makes them tumorigenic. In this study we investigate an association between the expression of translation initiation factors and lymphomagenesis. We have analyzed the expression of the protein synthesis initiation factors 4E and 2α by immunohistochemistry in reactive lymph nodes and several types of non-Hodgkin’s lymphoma representing a wide range of clinical behaviors based on the Revised European-American Lymphoma behavioral classification. The study included 7 benign lymph nodes with follicular hyperplasia, 26 indolent lymphomas (6 marginal zone lymphomas, 7 small lymphocytic lymphomas, and 13 follicular lymphomas, grades 1 and 2), 16 moderately aggressive lymphomas (8 mantle cell lymphomas and 8 follicular lymphomas, grade 3), 24 aggressive lymphomas (14 large-B-cell lymphomas and 10 anaplastic large-cell lymphomas), and 15 highly aggressive lymphomas (7 lymphoblastic lymphomas and 8 Burkitt’s lymphomas). Strong expression of initiation factors 4E and 2α was demonstrated in the germinal centers of reactive follicles. Minimal or no expression was seen in the mantle zones and surrounding paracortices, indicating that high expression of initiation factors 4E and 2α is associated with the active proliferation of lymphocytes. Most cases of aggressive and highly aggressive lymphomas showed strong expression of initiation factors 4E and 2α, in contrast to the cases of indolent and moderately aggressive lymphoma, in which their expression was intermediate between the germinal centers and the mantles of reactive follicles. A positive correlation was found between the expression of both initiation factors 4E and 2α and the Revised European-American Lymphoma behavior classification (P < 0.05). Thus, constitutively increased expression of initiation factors 4E and 2α may play an important role in the development of lymphomas and is correlated with their biological aggressiveness. PMID:10393856

Revision hip arthroplasty with an extensively 
porous-coated stem - excellent long-term 
results also in severe femoral bone stock loss.

PubMed

Thomsen, Per B; Jensen, Niels J F; Kampmann, Jens; Bæk Hansen, Torben

2013-01-01

During the last 25 years uncemented hip stem revision relying on diaphyseal fixation has shown improving clinical results and stem survival. The purpose of this study was to present the long-term results of hip revision with the SOLUTION stem (DePuy, Warsaw Indiana).
Ninety-three consecutive SOLUTION hip stem revisions in 84 patients with a mean age of 69 years (range 33-86 years) were reviewed. Of these, clinical and radiographic follow-up examination by an independent observer was possible in 36 hips/29 patients after mean 14 years (range 10-18 years). Stem re-revision was documented by our own files and by the Danish Hip Arthroplasty Registry. 
Stem re-revision had been performed in two hips for aseptic loosening, one due to deep infection and in one patient due to stem fracture. The 18 years cumulative survival, free of re-revision for any reason was calculated as 94.4% (88.9-99.8)% and for aseptic loosening to 97.6% (94.3-100%). Intraoperative complications were frequent with incidence of shaft fractures (14/93) and perforations (9/93) showing a significant learning curve. Mean Harris Hip Score was 85 (range 53-99). Osseointegration was seen in 34/36 stems with two stems fibrous fixated. Stress shielding was significant associated with stem diameters ≥15 mm. Severe preoperative bone deficiency had no negative bearing on stem survival and no significant influence on osseointegration of the stem or on Harris Hip Score. 
 Femoral stem revision with an extensively porous-coated monoblock chrome-cobalt stem seems to be a reliable and reproducible technique resulting in excellent long-term survivorship and clinical outcome. It can be used in femurs with deficient bone stock.

Long-term survivorship of the Corail™ standard stem.

PubMed

Louboutin, L; Viste, A; Desmarchelier, R; Fessy, M-H

2017-11-01

The Corail™ stem, which was first introduced in 1986, has since been modified twice: first to make the neck thinner and then to change the location of the laser markings. The survival and complications of the first-generation straight, titanium, hydroxyapatite-coated stem are known; however, there is little specific information about the latest-generation stem. This led us to conduct a retrospective study to determine the: (1) long-term survival; (2) clinical and radiographic outcomes; (3) complications; and (4) risk factors for revision of the newest Corail™ stem. The newest Corail™ AMT (Articul/EZE™ Mini Taper) standard stem has comparable survival to prior models. This single-center, retrospective study included 133 patients (140 hips), who underwent primary total hip arthroplasty (THA), between January and December 2004, in which a Corail™ Standard stem was implanted using a posterolateral approach. Patients who underwent revision THA, THA due to femoral neck fracture or who received lateralized (offset) stems were excluded. The mean age at the time of THA was 69±13 years [35-92] in 85 men (61%) and 55 women (39%) who had a mean BMI of 27kg/m 2 ±11 [16-39]. At the latest follow-up, 32 patients (32 hips) had died and 8 patients (8 hips) had less than 3 years' follow-up, thus were not included in the clinical evaluation. The Merle d'Aubigné (PMA) score was collected. The stem's survivorship was calculated using the Kaplan-Meier method with revision for aseptic loosening and revision or implant removal for any reason as the end-points. The Cox model was used to analyze risk factors for revision. The mean follow-up was 10±3 years [3-12]. The PMA score was 12±2.6 [5-17] preoperatively and 16±2.7 [7-18] at the last follow-up (P<0.00001). Eighteen complications (12.8%) were recorded at the last follow-up. There were 15 early complications: 6 dislocations, 5 calcar fractures (4 treated by wire cerclage and 1 by stem change plus wire cerclage), 2 greater trochanter fractures (treated non-surgically) and 2 cases of sciatic nerve palsy. There were 3 late complications: 2 cases of iliopsoas irritation and 1 ceramic insert fracture. Stem survival for surgical revision due to aseptic loosening was 98% (95% CI: [0.96-1]). At 12 years, 95% of stems had not been revised or removed (95% CI: [0.92-0.99]). Being less than 58 years of age at the time of surgery was the only risk factor significantly associated with stem revision for any reason (P=0.04). Survival of the Corail™ Standard stem is similar to that of previous generation stems. The changes made in this stem solved the neck failure problem and did not induce new complications. Level IV (retrospective study). Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Revised Baseline Budget Projections for Fiscal Years 1999-2008

DTIC Science & Technology

1998-03-03

or for the conclusions that CBO reached. CONTENTS SUMMARY AND INTRODUCTION 1 MODELING THE ECONOMY 3 Production 6 Private Capital and Labor 7... modeling the economy and the federal budget in the long run and to estimating the effects of uncertainty about future population and productivity . MODELING ...conventions of the official national income and product accounts (NIPAs). Given the equations, the model needs two other factors to make a simulation

Revision, Criterion Validity, and Multi-group Assessment of the Reactions to Homosexuality Scale

PubMed Central

Smolenski, Derek J.; Diamond, Pamela M.; Ross, Michael W.; Simon Rosser, B. R.

2010-01-01

Internalized homonegativity encompasses negative attitudes toward one’s own sexual orientation, and is associated with negative mental and physical health outcomes. The Reactions to Homosexuality scale (Ross & Rosser, 1996), an instrument used to measure internalized homonegativity, has been criticized for including content irrelevant to the construct of internalized homonegativity. We revised the scale using exploratory and confirmatory factor analyses, and identified a seven-item, three-factor reduced version that demonstrated measurement invariance across racial/ethnic categorizations and between English and Spanish versions. We also investigated criterion validity by estimating correlations with hypothesized outcomes associated with outness, relationship status, sexual orientation, and gay community affiliation. The evidence of measurement invariance suggests that this scale is appropriate for pluralistic treatment or study groups. PMID:20954058

The Factor Structure and Psychometric Properties of the Persian Version of the Revised Prenatal Coping Inventory (Nu-PCI).

PubMed

Faramarzi, Mahbobeh; Pasha, Hajar; Khafri, Sorayya; Heidary, Shima

2017-03-01

Familiarity with coping strategies is essential for stress management during pregnancy. The Revised Prenatal Coping Inventory (Nu-PCI) was developed to assess coping strategies during pregnancy. This study aimed to assess the factor structure and psychometric properties of the Persian version of the Nu-PCI. After forward-backward translation, the Nu-PCI was administered to 210 pregnant women who were enrolled in two teaching referral clinics in the North of the Islamic Republic of Iran (Babol). The participants completed the Persian Nu-PCI and Ways of Coping Questionnaire (WCQ), which was used to determine the validity of the Persian Nu-PCI. To test construct validity of the Persian Nu-PCI, a principal components factor analysis was performed. Principal components analysis with varimax rotation showed a best fitting 3-factor structure similar to the original with three coping subscales: planning-preparation, avoidance, and spiritual-positive coping. The Persian Nu-PCI was internally consistent and within the acceptable range (α=0.89-0.97). The alpha coefficients for the Nu-PCI and the subscales of planning-preparation, avoidance, and spiritual-positive coping were high. Test-retest coefficients for the Nu-PCI and subscales were 0.98-0.99. The Nu-PCI and its subscales correlated with the WCQ in the entire sample and within each trimester. The Persian version of the Nu-PCI and the subscales of planning-preparation, avoidance, and spiritual-positive coping represent the first reliable standardized tool for measuring coping strategies during pregnancy in the Islamic Republic of Iran. Therefore, it can be applied as a quick and accurate preliminary screening tool for evaluating coping strategies throughout pregnancy in clinics and other medical and research settings.

Predicting ventriculoperitoneal shunt infection in children with hydrocephalus using artificial neural network.

PubMed

Habibi, Zohreh; Ertiaei, Abolhasan; Nikdad, Mohammad Sadegh; Mirmohseni, Atefeh Sadat; Afarideh, Mohsen; Heidari, Vahid; Saberi, Hooshang; Rezaei, Abdolreza Sheikh; Nejat, Farideh

2016-11-01

The relationships between shunt infection and predictive factors have not been previously investigated using Artificial Neural Network (ANN) model. The aim of this study was to develop an ANN model to predict shunt infection in a group of children with shunted hydrocephalus. Among more than 800 ventriculoperitoneal shunt procedures which had been performed between April 2000 and April 2011, 68 patients with shunt infection and 80 controls that fulfilled a set of meticulous inclusion/exclusion criteria were consecutively enrolled. Univariate analysis was performed for a long list of risk factors, and those with p value < 0.2 were used to create ANN and logistic regression (LR) models. Five variables including birth weight, age at the first shunting, shunt revision, prematurity, and myelomeningocele were significantly associated with shunt infection via univariate analysis, and two other variables (intraventricular hemorrhage and coincided infections) had a p value of less than 0.2. Using these seven input variables, ANN and LR models predicted shunt infection with an accuracy of 83.1 % (AUC; 91.98 %, 95 % CI) and 55.7 % (AUC; 76.5, 95 % CI), respectively. The contribution of the factors in the predictive performance of ANN in descending order was history of shunt revision, low birth weight (under 2000 g), history of prematurity, the age at the first shunt procedure, history of intraventricular hemorrhage, history of myelomeningocele, and coinfection. The findings show that artificial neural networks can predict shunt infection with a high level of accuracy in children with shunted hydrocephalus. Also, the contribution of different risk factors in the prediction of shunt infection can be determined using the trained network.

Predictions of space radiation fatality risk for exploration missions

NASA Astrophysics Data System (ADS)

Cucinotta, Francis A.; To, Khiet; Cacao, Eliedonna

2017-05-01

In this paper we describe revisions to the NASA Space Cancer Risk (NSCR) model focusing on updates to probability distribution functions (PDF) representing the uncertainties in the radiation quality factor (QF) model parameters and the dose and dose-rate reduction effectiveness factor (DDREF). We integrate recent heavy ion data on liver, colorectal, intestinal, lung, and Harderian gland tumors with other data from fission neutron experiments into the model analysis. In an earlier work we introduced distinct QFs for leukemia and solid cancer risk predictions, and here we consider liver cancer risks separately because of the higher RBE's reported in mouse experiments compared to other tumors types, and distinct risk factors for liver cancer for astronauts compared to the U.S. population. The revised model is used to make predictions of fatal cancer and circulatory disease risks for 1-year deep space and International Space Station (ISS) missions, and a 940 day Mars mission. We analyzed the contribution of the various model parameter uncertainties to the overall uncertainty, which shows that the uncertainties in relative biological effectiveness (RBE) factors at high LET due to statistical uncertainties and differences across tissue types and mouse strains are the dominant uncertainty. NASA's exposure limits are approached or exceeded for each mission scenario considered. Two main conclusions are made: 1) Reducing the current estimate of about a 3-fold uncertainty to a 2-fold or lower uncertainty will require much more expansive animal carcinogenesis studies in order to reduce statistical uncertainties and understand tissue, sex and genetic variations. 2) Alternative model assumptions such as non-targeted effects, increased tumor lethality and decreased latency at high LET, and non-cancer mortality risks from circulatory diseases could significantly increase risk estimates to several times higher than the NASA limits.

An evaluation of ICD-11 posttraumatic stress disorder criteria in two samples of adolescents and young adults exposed to mass shootings: factor analysis and comparisons to ICD-10 and DSM-IV.

PubMed

Haravuori, Henna; Kiviruusu, Olli; Suomalainen, Laura; Marttunen, Mauri

2016-05-12

The proposed posttraumatic stress disorder (PTSD) criteria for the International Classification of Diseases (ICD) 11th revision are simpler than the criteria in ICD-10, DSM-IV or DSM-5. The aim of this study was to evaluate the ICD-11 PTSD factor structure in samples of young people, and to compare PTSD prevalence rates and diagnostic agreement between the different diagnostic systems. Possible differences in clinical characteristics of the PTSD cases identified by ICD-11, ICD-10 and DSM-IV are explored. Two samples of adolescents and young adults were followed after exposure to similar mass shooting incidents in their schools. Semi-structured diagnostic interviews were performed to assess psychiatric diagnoses and PTSD symptom scores (N = 228, mean age 17.6 years). PTSD symptom item scores were used to compose diagnoses according to the different classification systems. Confirmatory factor analyses indicated that the proposed ICD-11 PTSD symptoms represented two rather than three factors; re-experiencing and avoidance symptoms comprised one factor and hyperarousal symptoms the other factor. In the studied samples, the three-factor ICD-11 criteria identified 51 (22.4%) PTSD cases, the two-factor ICD-11 identified 56 (24.6%) cases and the DSM-IV identified 43 (18.9%) cases, while the number of cases identified by ICD-10 was larger, being 85 (37.3%) cases. Diagnostic agreement of the ICD-11 PTSD criteria with ICD-10 and DSM-IV was moderate, yet the diagnostic agreement turned to be good when an impairment criterion was imposed on ICD-10. Compared to ICD-11, ICD-10 identified cases with less severe trauma exposure and posttraumatic symptoms and DSM-IV identified cases with less severe trauma exposure. The findings suggest that the two-factor model of ICD-11 PTSD is preferable to the three-factor model. The proposed ICD-11 criteria are more restrictive compared to the ICD-10 criteria. There were some differences in the clinical characteristics of the PTSD cases identified by ICD-11, when compared to ICD-10 and DSM-IV.

The Movement Imagery Questionnaire-Revised, Second Edition (MIQ-RS) Is a Reliable and Valid Tool for Evaluating Motor Imagery in Stroke Populations

PubMed Central

Butler, Andrew J.; Cazeaux, Jennifer; Fidler, Anna; Jansen, Jessica; Lefkove, Nehama; Gregg, Melanie; Hall, Craig; Easley, Kirk A.; Shenvi, Neeta; Wolf, Steven L.

2012-01-01

Mental imagery can improve motor performance in stroke populations when combined with physical therapy. Valid and reliable instruments to evaluate the imagery ability of stroke survivors are needed to maximize the benefits of mental imagery therapy. The purposes of this study were to: examine and compare the test-retest intra-rate reliability of the Movement Imagery Questionnaire-Revised, Second Edition (MIQ-RS) in stroke survivors and able-bodied controls, examine internal consistency of the visual and kinesthetic items of the MIQ-RS, determine if the MIQ-RS includes both the visual and kinesthetic dimensions of mental imagery, correlate impairment and motor imagery scores, and investigate the criterion validity of the MIQ-RS in stroke survivors by comparing the results to the KVIQ-10. Test-retest analysis indicated good levels of reliability (ICC range: .83–.99) and internal consistency (Cronbach α: .95–.98) of the visual and kinesthetic subscales in both groups. The two-factor structure of the MIQ-RS was supported by factor analysis, with the visual and kinesthetic components accounting for 88.6% and 83.4% of the total variance in the able-bodied and stroke groups, respectively. The MIQ-RS is a valid and reliable instrument in the stroke population examined and able-bodied populations and therefore useful as an outcome measure for motor imagery ability. PMID:22474504

Predictors of Broad Dimensions of Psychopathology among Patients with Panic Disorder after Cognitive-Behavioral Therapy

PubMed Central

Kondo, Masaki; Ino, Keiko; Imai, Risa; Ii, Toshitaka; Furukawa, Toshi A.; Akechi, Tatsuo

2018-01-01

Background Many patients with panic disorder meet criteria for at least one other diagnosis, most commonly other anxiety or mood disorders. Cognitive-behavioral therapy is the best empirically supported psychotherapy for panic disorder. There is now evidence indicating that cognitive-behavioral therapy for panic disorder yields positive benefits upon comorbid disorders. Objectives The present study aimed to examine the predictors of broad dimensions of psychopathology in panic disorder after cognitive-behavioral therapy. Methods Two hundred patients affected by panic disorder were treated with manualized group cognitive-behavioral therapy. We examined if the baseline personality dimensions of NEO Five Factor Index predicted the subscales of Symptom Checklist-90 Revised at endpoint using multiple regression analysis based on the intention-to-treat principle. Results Conscientiousness score of NEO Five Factor Index at baseline was a predictor of four Symptom Checklist-90 Revised subscales including obsessive-compulsive (β = −0.15, P < 0.01), depression (β = −0.13, P < 0.05), phobic anxiety (β = −0.15, P < 0.05), and Global Severity Index (β = −0.13, P < 0.05). Conclusion Conscientiousness at baseline may predict several dimensions of psychopathology in patients with panic disorder after cognitive-behavioral therapy. For the purpose of improving a wide range of psychiatric symptoms with patients affected by panic disorder, it may be useful to pay more attention to this personal trait at baseline. PMID:29721499

Predictors of Broad Dimensions of Psychopathology among Patients with Panic Disorder after Cognitive-Behavioral Therapy.

PubMed

Ogawa, Sei; Kondo, Masaki; Ino, Keiko; Imai, Risa; Ii, Toshitaka; Furukawa, Toshi A; Akechi, Tatsuo

2018-01-01

Many patients with panic disorder meet criteria for at least one other diagnosis, most commonly other anxiety or mood disorders. Cognitive-behavioral therapy is the best empirically supported psychotherapy for panic disorder. There is now evidence indicating that cognitive-behavioral therapy for panic disorder yields positive benefits upon comorbid disorders. The present study aimed to examine the predictors of broad dimensions of psychopathology in panic disorder after cognitive-behavioral therapy. Two hundred patients affected by panic disorder were treated with manualized group cognitive-behavioral therapy. We examined if the baseline personality dimensions of NEO Five Factor Index predicted the subscales of Symptom Checklist-90 Revised at endpoint using multiple regression analysis based on the intention-to-treat principle. Conscientiousness score of NEO Five Factor Index at baseline was a predictor of four Symptom Checklist-90 Revised subscales including obsessive-compulsive ( β = -0.15, P < 0.01), depression ( β = -0.13, P < 0.05), phobic anxiety ( β = -0.15, P < 0.05), and Global Severity Index ( β = -0.13, P < 0.05). Conscientiousness at baseline may predict several dimensions of psychopathology in patients with panic disorder after cognitive-behavioral therapy. For the purpose of improving a wide range of psychiatric symptoms with patients affected by panic disorder, it may be useful to pay more attention to this personal trait at baseline.

Striving for Normalcy after Lower Extremity Reconstruction with Free Tissue: The Role of Secondary Esthetic Refinements.

PubMed

Nelson, Jonas A; Fischer, John P; Haddock, Nicholas T; Mackay, Duncan; Wink, Jason D; Newman, Andrew S; Levin, L Scott; Kovach, Stephen J

2016-02-01

Many patients with successful lower extremity salvage have postoperative functional and esthetic concerns. Such concerns range from contour irregularity preventing proper shoe-fitting to esthetic concerns involving color, contour, and texture match. The purpose of this study is to determine the overall incidence as well as factors associated with an increased likelihood of undergoing secondary, esthetic refinements of lower extremity free flaps and to review current revision techniques. All patients undergoing lower extremity soft tissue coverage for limb salvage procedures between January 2007 and June 2013 at a single institution were included in the analysis. Patients who underwent secondary refinements for lower extremity free flaps were compared with patients not undergoing secondary procedures. During the study period, 152 patients underwent reconstruction and were eligible for inclusion. Of these, 32 (21.1%) patients underwent secondary, esthetic revisions. Few differences in patient or case characteristics were noted, although revision patients trended toward being younger, having lower body mass index, with defects secondary to acute trauma located below the ankle. The most common revision was complex soft tissue rearrangement or surgical flap debulking/direct excision (87.5% of patients), followed by scar revision (12.5%), suction-assisted lipectomy (3.1%), laser scar revision (3.1%), and tissue expansion with local tissue rearrangement (3.1%). A significant portion of patients desire secondary revisions following the initial procedure. This is especially true of younger patients with below ankle reconstruction. In many patients, an esthetic consideration should not be of secondary concern, but should be part of the ultimate reconstructive algorithm for lower extremity limb salvage. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Long-term follow-up after surgery in localized laryngeal amyloidosis.

PubMed

Hazenberg, Aldert J C; Hazenberg, Bouke P C; Dikkers, Frederik G

2016-09-01

To study effectiveness of surgery and watchful waiting in localized laryngeal amyloidosis, retrospective case series. This retrospective study comprises all consecutive patients with localized laryngeal amyloidosis surgically treated in a tertiary hospital between 1994 and February 2016. Recurrence rate, revision surgery, progression to systemic amyloidosis, and changes in voice were monitored yearly. Eighteen patients were included. Seven women and eleven men had a median age 50 years (range 21-77 years) and median follow-up 6.4 years (2.4-17 years). Amyloid was located in subglottis (5), glottis (8), false vocal folds (8) and other supraglottic areas (5), in more than one laryngeal region (13) and bilaterally (12). Cold steel excision was used at the glottis; CO2 laser excision, sometimes assisted by microdebrider, at other laryngeal areas. Eleven patients needed revision surgery, ten within the first 4 years after surgical treatment. One patient needed his first revision surgery after 11 years. Five patients needed a second revision within 6 years after initial diagnosis. Two patients needed a third revision. Indications for first revision surgery were progression (8) with dysphonia (7), dyspnea (2), dysphagia (1), exclusion of malignancy (1), and aphonia (1). No patient developed systemic amyloidosis during follow-up. Although local progression of amyloid necessitates revision surgery once or twice in the first 4-6 years, progression slows down thereafter. Late progression, however, remains possible.

Early Marriage, Rape, Child Prostitution, and Related Factors Determining the Psychosocial Effects Severity of Child Sexual Abuse in Ethiopia

ERIC Educational Resources Information Center

Wondie, Yemataw; Zemene, Workie; Reschke, Konrad; Schroder, Harry

2011-01-01

This study was aimed at identifying factors that determine the psychosocial effects severity of child sexual abuse. Data were collected from 318 female children in Ethiopia using the Children's Impact of Traumatic Events Scale-Revised and the Rosenberg Self-Esteem Scale. The results revealed that respondents who survived rape and child…

Brief Report: Repetitive Behaviours in Greek Individuals with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Georgiades, Stelios; Papageorgiou, Vaya; Anagnostou, Evdokia

2010-01-01

The main objective of this study was to examine the factor structure of restricted repetitive behaviours (RRBs) in a sample of 205 Greek individuals with Autism Spectrum Disorder (ASD), using the Repetitive Behavior Scale-Revised (RBS-R). Results show that the structure of RRBs in this Greek sample can be described using a 2-factor solution. The…

Factor Structure of the Hare Psychopathy Checklist: Youth Version in German Female and Male Detainees and Community Adolescents

ERIC Educational Resources Information Center

Sevecke, Kathrin; Pukrop, Ralf; Kosson, David S.; Krischer, Maya K.

2009-01-01

Substantial evidence exists for 3- and 4-factor models of psychopathy underlying patterns of covariation among the items of the Psychopathy Checklist-Revised (PCL-R) in diverse adult samples. Although initial studies conducted with the Psychopathy Checklist: Youth Version (PCL:YV) indicated reasonable fit for these models in incarcerated male…

Factors Affecting Responses of Children with Autism Spectrum Disorder to "Yes/No" Questions

ERIC Educational Resources Information Center

Funazaki, Yasuhiro; Oi, Manabu

2013-01-01

This study aimed to clarify factors related to difficulties in responding to "yes/no" questions (Y/N-Qs) among 52 children with autism spectrum disorder (ASD), 41 boys and 11 girls aged between 3:5-16:0 years. Participants completed the Tanaka-Binet Intelligence Scale V, the Picture Vocabulary Test: Revised (PVT-R), and the Pervasive…

Change in Level of Service Inventory-Ontario Revised (LSI-OR) Risk Scores Over Time: An Examination of Overall Growth Curves and Subscale-Dependent Growth Curves.

PubMed

Day, David M; Wilson, Holly A; Bodwin, Kelly; Monson, Candice M

2017-10-01

The dynamic nature of risk to re-offend is an important issue in the management of offenders and has stimulated extensive research into dynamic risk factors that can alter an individual's overall risk to re-offend if addressed. However, few studies have examined the relative importance of these dynamic risk factors, complicating the task of developing case management and treatment plans that will effect the most change. Using a large, high-risk sample and multi-wave data of a common risk assessment tool, the Level of Service Inventory-Ontario Revised (LSI-OR), the current study investigated the relationship among criminogenic risk factors and their role in influencing the overall risk score. Results indicated a diverse pattern of effects on the eight subscale scores, specifically suggesting that changes on Procriminal Attitude/Orientation, Criminal History, and Leisure/Recreation subscales resulted in a quicker rate of change to the overall risk score over time. These results suggest that some factors may be driving the change in overall risk and could potentially effect the most change if prioritized for intervention. Practical implications and implications for further research are discussed.

Treatment-Limiting Complications of Percutaneous Spinal Cord Stimulator Implants: A Review of Eight Years of Experience From an Academic Center Database.

PubMed

Hayek, Salim M; Veizi, Elias; Hanes, Michael

2015-10-01

The study aims to evaluate the long-term implant survival and complications of spinal cord stimulation (SCS) leading to surgical revision or explant in patients treated for chronic noncancer pain. This is a retrospective study of all patients who underwent a percutaneous spinal cord stimulation trial followed by implant in an academic Pain Medicine division by four practitioners from 2007 to 2013, with follow-up data through April 2014. A total of 345 patients were considered candidates for dorsal column stimulation and underwent a trial. Two hundred thirty-four patients were implanted with an implant-to-trial ratio of 67-86% across various chronic pain entities (postlaminectomy syndrome, complex regional pain syndrome, small-fiber peripheral neuropathy, abdominal/pelvic pain, nonsurgical candidates with lumbosacral neuropathy, and neuropathic pain not otherwise specified), with the exception of nonsurgical candidates with lumbosacral neuropathy who had an implant ratio of 43%. The complication rate was 34.6%, with the hardware related being the most common reason, comprising 74.1% of all complications. The revision and explant rates were 23.9% each. The most common reason for explant was loss of therapeutic effect (41.1%). SCS is an effective treatment for chronic noncancer pain. It is a minimally invasive procedure, safe, and with good long-term outcomes. However, the surgical revision and explant rates are relatively high. As the use of SCS continues to grow, research into the causes of and risk factors for SCS-related complications is paramount to decrease complication rates in the future. © 2015 International Neuromodulation Society.

Preoperative anaemia is associated with increased allogeneic pack red cell transfusion in revision hip and knee joint arthroplasty: a retrospective analysis of 5387 patients over a 10-year period at a single high volume centre.

PubMed

Kasivisvanathan, R; Ramesh, V; Rao Baikady, R; Nadaraja, S

2016-08-01

To estimate the prevalence of preoperative World Health Organization (WHO) defined anaemia in patients presenting for revision hip and knee arthroplasty and its association with transfusion of allogeneic packed red blood cells (PRBC). Studies have mainly investigated the prevalence of preoperative anaemia in primary and not revision hip and knee joint arthroplasty. An analysis of a prospectively collected patient data for 5387 patients having revision hip or knee arthroplasty over a 10-year period at a single high volume centre was conducted. Logistic regression was used to assess whether the presence of WHO defined preoperative anaemia as well as other risk factors were associated with inpatient allogeneic PRBC transfusion. There were 5387 patients assessed of which 3021 (56·01%) patients had revision total hip replacements and 2366 (43·09%) had revision total knee arthroplasty. Of these patients 1956 (36·03%) had preoperative WHO defined anaemia. A total of 2034 (37·08%) patients received at least one unit of allogeneic PRBC during their primary hospital admission. In the final model preoperative WHO defined anaemia was independently associated with allogeneic PRBC transfusion in hip and knee revision surgery OR 4·042 (4·012-4·072 95% CI) CONCLUSIONS: Preoperative anaemia is common in patients presenting for revision hip and knee arthroplasty and independently associated with transfusion of allogeneic PRBC. © 2016 British Blood Transfusion Society.

Kaplan-Meier Survival Analysis Overestimates the Risk of Revision Arthroplasty: A Meta-analysis.

PubMed

Lacny, Sarah; Wilson, Todd; Clement, Fiona; Roberts, Derek J; Faris, Peter D; Ghali, William A; Marshall, Deborah A

2015-11-01

Although Kaplan-Meier survival analysis is commonly used to estimate the cumulative incidence of revision after joint arthroplasty, it theoretically overestimates the risk of revision in the presence of competing risks (such as death). Because the magnitude of overestimation is not well documented, the potential associated impact on clinical and policy decision-making remains unknown. We performed a meta-analysis to answer the following questions: (1) To what extent does the Kaplan-Meier method overestimate the cumulative incidence of revision after joint replacement compared with alternative competing-risks methods? (2) Is the extent of overestimation influenced by followup time or rate of competing risks? We searched Ovid MEDLINE, EMBASE, BIOSIS Previews, and Web of Science (1946, 1980, 1980, and 1899, respectively, to October 26, 2013) and included article bibliographies for studies comparing estimated cumulative incidence of revision after hip or knee arthroplasty obtained using both Kaplan-Meier and competing-risks methods. We excluded conference abstracts, unpublished studies, or studies using simulated data sets. Two reviewers independently extracted data and evaluated the quality of reporting of the included studies. Among 1160 abstracts identified, six studies were included in our meta-analysis. The principal reason for the steep attrition (1160 to six) was that the initial search was for studies in any clinical area that compared the cumulative incidence estimated using the Kaplan-Meier versus competing-risks methods for any event (not just the cumulative incidence of hip or knee revision); we did this to minimize the likelihood of missing any relevant studies. We calculated risk ratios (RRs) comparing the cumulative incidence estimated using the Kaplan-Meier method with the competing-risks method for each study and used DerSimonian and Laird random effects models to pool these RRs. Heterogeneity was explored using stratified meta-analyses and metaregression. The pooled cumulative incidence of revision after hip or knee arthroplasty obtained using the Kaplan-Meier method was 1.55 times higher (95% confidence interval, 1.43-1.68; p < 0.001) than that obtained using the competing-risks method. Longer followup times and higher proportions of competing risks were not associated with increases in the amount of overestimation of revision risk by the Kaplan-Meier method (all p > 0.10). This may be due to the small number of studies that met the inclusion criteria and conservative variance approximation. The Kaplan-Meier method overestimates risk of revision after hip or knee arthroplasty in populations where competing risks (such as death) might preclude the occurrence of the event of interest (revision). Competing-risks methods should be used to more accurately estimate the cumulative incidence of revision when the goal is to plan healthcare services and resource allocation for revisions.

Comparison of the Reading Subtests of the Wechsler Individual Achievement Test-Third Edition and the Peabody Individual Achievement Test-Revised/Normative Update

ERIC Educational Resources Information Center

Ott, Lauren M.

2010-01-01

This study compared the reading subtests of the Wechsler Individual Achievement Test-Third Edition and the Peabody Individual Achievement Test-Revised/Normative Update. Scores were compared on these two tests in a group of 28 students ages 7 through 12 who were referred or reevaluated for suspected learning problems. The data were collected…

78 FR 59429 - Endangered and Threatened Wildlife and Plants; Revised Designation of Critical Habitat for the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-26

...We, the U.S. Fish and Wildlife Service, propose to designate revised critical habitat for the contiguous U.S. distinct population segment (DPS) of the Canada lynx under the Endangered Species Act of 1973, as amended, and to revise the boundary of the Canada lynx DPS. These proposed revisions fulfill our obligations under two settlement agreements. The revised critical habitat proposed rule also addresses issues raised by two courts in 2010. If we finalize this rule as proposed, it would extend the Endangered Species Act's protections to the Canada lynx wherever it occurs in the contiguous United States, including New Mexico, and it would revise this species' critical habitat. The effect of this regulation is to conserve the Canada lynx and its habitats in the contiguous United States under the Endangered Species Act.

TED analysis of the Si(113) surface structure

NASA Astrophysics Data System (ADS)

Suzuki, T.; Minoda, H.; Tanishiro, Y.; Yagi, K.

1999-09-01

We carried out a TED (transmission electron diffraction) analysis of the Si(113) surface structure. The TED patterns taken at room temperature showed reflections due to the 3×2 reconstructed structure. The TED pattern indicated that a glide plane parallel to the <332> direction suggested in some models is excluded. We calculated the R-factors (reliability factors) for six surface structure models proposed previously. All structure models with energy-optimized atomic positions have large R-factors. After revision of the atomic positions, the R-factors of all the structure models decreased below 0.3, and the revised version of Dabrowski's 3×2 model has the smallest R-factor of 0.17.

Response of ecosystem services to land use change in Xiamen Island

NASA Astrophysics Data System (ADS)

Gao, L.

2009-12-01

: Land use change was a major factor affecting ecosystem services. Taken Xiamen Island as an example, by integrating remote sensing data to examine land use patterns from 1950 to 2007, the regional ecosystem services of Xiamen Island were evaluated based on two revised methods aiming to identify the stress effects and mechanisms of land use change on ecosystem services. The results showed that during 1950~2007, in general, Xiamen Island’s land use intensity had been annually rising. The trends of Xiamen Island’s ecosystem services value acquired by two methods were both consistent with decreasing along with the growth of land use intensity. Before 1987, the ecosystem service value of Xiamen Island had increased by 1.07 million yuan, due to the expanding of 12.87 km2 water and wetland. After the establishment of Xiamen special economic zone in 1984, the rapid urbanization has resulted a sharp decline in ecosystem service value, the average annual loss reached by 619,773 yuan after 1987. As the utilization of land reaching saturation and the launching of ecological projects, such as the Xiamen Eastern Sea Comprehensive Improvement Project, it could be predicted that the decreasing trend of ecosystem services value was going to be slowed down in the near future. The first revised method referencing four eco-system services solved the problem of overestimated value caused by the second revised method based on provisioning service alone. By applying the ESV total correction method, the problem of over counting service value by correction made from a single aspect could be solved.Equivalent value per unit area of ecosystem services in China 2007 and revised value by second method Note: The modified coefficient of crop, orchard & forest, wetland and inland water provisioning ESV revised by the second method is 2.858, 2.405, 1.523, 1.843 respectively; for regulating, ultural and supporting ESV, the coefficient is 2.339, 15.339, 2.339 respectively.

The psychometric characteristics of the revised depression attitude questionnaire (R-DAQ) in Pakistani medical practitioners: a cross-sectional study of doctors in Lahore.

PubMed

Haddad, Mark; Waqas, Ahmed; Sukhera, Ahmed Bashir; Tarar, Asad Zaman

2017-07-27

Depression is common mental health problem and leading contributor to the global burden of disease. The attitudes and beliefs of the public and of health professionals influence social acceptance and affect the esteem and help-seeking of people experiencing mental health problems. The attitudes of clinicians are particularly relevant to their role in accurately recognising and providing appropriate support and management of depression. This study examines the characteristics of the revised depression attitude questionnaire (R-DAQ) with doctors working in healthcare settings in Lahore, Pakistan. A cross-sectional survey was conducted in 2015 using the revised depression attitude questionnaire (R-DAQ). A convenience sample of 700 medical practitioners based in six hospitals in Lahore was approached to participate in the survey. The R-DAQ structure was examined using Parallel Analysis from polychoric correlations. Unweighted least squares analysis (ULSA) was used for factor extraction. Model fit was estimated using goodness-of-fit indices and the root mean square of standardized residuals (RMSR), and internal consistency reliability for the overall scale and subscales was assessed using reliability estimates based on Mislevy and Bock (BILOG 3 Item analysis and test scoring with binary logistic models. Mooresville: Scientific Software, 55) and the McDonald's Omega statistic. Findings using this approach were compared with principal axis factor analysis based on Pearson correlation matrix. 601 (86%) of the doctors approached consented to participate in the study. Exploratory factor analysis of R-DAQ scale responses demonstrated the same 3-factor structure as in the UK development study, though analyses indicated removal of 7 of the 22 items because of weak loading or poor model fit. The 3 factor solution accounted for 49.8% of the common variance. Scale reliability and internal consistency were adequate: total scale standardised alpha was 0.694; subscale reliability for professional confidence was 0.732, therapeutic optimism/pessimism was 0.638, and generalist perspective was 0.769. The R-DAQ was developed with a predominantly UK-based sample of health professionals. This study indicates that this scale functions adequately and provides a valid measure of depression attitudes for medical practitioners in Pakistan, with the same factor structure as in the scale development sample. However, optimal scale function necessitated removal of several items, with a 15-item scale enabling the most parsimonious factor solution for this population.

Maladaptive Personality Trait Models: Validating the Five-Factor Model Maladaptive Trait Measures With the Personality Inventory for DSM-5 and NEO Personality Inventory.

PubMed

Helle, Ashley C; Mullins-Sweatt, Stephanie N

2017-05-01

Eight measures have been developed to assess maladaptive variants of the five-factor model (FFM) facets specific to personality disorders (e.g., Five-Factor Borderline Inventory [FFBI]). These measures can be used in their entirety or as facet-based scales (e.g., FFBI Affective Dysregulation) to improve the comprehensiveness of assessment of pathological personality. There are a limited number of studies examining these scales with other measures of similar traits (e.g., DSM-5 alternative model). The current study examined the FFM maladaptive scales in relation to the respective general personality traits of the NEO Personality Inventory-Revised and the pathological personality traits of the DSM-5 alternative model using the Personality Inventory for DSM-5. The results indicated the FFM maladaptive trait scales predominantly converged with corresponding NEO Personality Inventory-Revised, and Personality Inventory for DSM-5 traits, providing further validity for these measures as extensions of general personality traits and evidence for their relation to the pathological trait model. Benefits and applications of the FFM maladaptive scales in clinical and research settings are discussed.

Inferential revision in narrative texts: An ERP study.

PubMed

Pérez, Ana; Cain, Kate; Castellanos, María C; Bajo, Teresa

2015-11-01

We evaluated the process of inferential revision during text comprehension in adults. Participants with high or low working memory read short texts, in which the introduction supported two plausible concepts (e.g., 'guitar/violin'), although one was more probable ('guitar'). There were three possible continuations: a neutral sentence, which did not refer back to either concept; a no-revise sentence, which referred to a general property consistent with either concept (e.g., '…beautiful curved body'); and a revise sentence, which referred to a property that was consistent with only the less likely concept (e.g., '…matching bow'). Readers took longer to read the sentence in the revise condition, indicating that they were able to evaluate their comprehension and detect a mismatch. In a final sentence, a target noun referred to the alternative concept supported in the revise condition (e.g., 'violin'). ERPs indicated that both working memory groups were able to evaluate their comprehension of the text (P3a), but only high working memory readers were able to revise their initial incorrect interpretation (P3b) and integrate the new information (N400) when reading the revise sentence. Low working memory readers had difficulties inhibiting the no-longer-relevant interpretation and thus failed to revise their situation model, and they experienced problems integrating semantically related information into an accurate memory representation.

Assessing the effects of urbanization and climate change on groundwater management in China

NASA Astrophysics Data System (ADS)

Hua, S.; Zheng, C.

2017-12-01

Groundwater is expected to be more vulnerable in the future due to climate change coupled with rapid urbanization. Thus, protecting future groundwater resources under the impact of urbanization and climate change is necessary towards more sustainable groundwater resource development. This study is intended to shed lights on how water managers may plan for the adverse effects of urbanization and climate change on groundwater quality. A new approach is presented in which the groundwater vulnerability under future climate change scenarios is employed as a constraint to urban expansion. An original form of the Land Transformation Model (LTM) and a revised LTM simulation are applied to model the urbanization. The results indicated that there would be a notable and uneven urban growth between 2010 and 2050. Future groundwater vulnerability is expected to shift significantly under future climate change scenarios. The results of the revised LTM project more urban expansion in the central regions of China, while those of the original LTM project urban expansion in throughout China, although the two projections have the same areas of expansion. The urban expansion simulated by the original LTM follows the historical trend under the drivers of socioeconomic, political and geographic factors. However, the revised LTM drives the urban expansion to the regions with relatively lower groundwater vulnerability, in contrast to the historical trend. This study demonstrates that the integration of LTM and future groundwater vulnerability in the urban planning can better protect the groundwater resource and promote more sustainable socioeconomic development. The methodology developed in this study provides water managers and city planners a useful groundwater management tool for mitigating the risks associated with rapid urbanization and climate change.

Using a Revised Theory of Student Departure to Understand Student Athlete Persistence

ERIC Educational Resources Information Center

Reisinger, Scot Hugh

2016-01-01

This study examined the relationship between intercollegiate participation and persistence in college. In addition, it explored the different factors that influenced student athletes' persistence patterns as compared to non-student athletes at residential liberal arts schools. Using data from the Wabash National Study of Liberal Arts Education…

Low Openness on the Revised NEO Personality Inventory as a Risk Factor for Treatment-Resistant Depression

PubMed Central

Takahashi, Michio; Shirayama, Yukihiko; Muneoka, Katsumasa; Suzuki, Masatoshi; Sato, Koichi; Hashimoto, Kenji

2013-01-01

Background Recently, we reported that low reward dependence, and to a lesser extent, low cooperativeness in the Temperature and Character Inventory (TCI) may be risk factors for treatment-resistant depression. Here, we analyzed additional psychological traits in these patients. Methods We administered Costa and McCrae's five-factor model personality inventory, NEO Personality Inventory-Revised (NEO-PI-R), to antidepressant-treatment resistant depressed patients (n = 35), remitted depressed patients (n = 27), and healthy controls (n = 66). We also evaluated the relationships between scores on NEO and TCI, using the same cohort of patients with treatment-resistant depression, as our previous study. Results Patients with treatment-resistant depression showed high scores for neuroticism, low scores for extraversion, openness and conscientiousness, without changes in agreeableness, on the NEO. However, patients in remitted depression showed no significant scores on NEO. Patients with treatment-resistant depression and low openness on NEO showed positive relationships with reward dependence and cooperativeness on the TCI. Conclusions Many studies have reported that depressed patients show high neuroticism, low extraversion and low conscientiousness on the NEO. Our study highlights low openness on the NEO, as a risk mediator in treatment-resistant depression. This newly identified trait should be included as a risk factor in treatment-resistant depression. PMID:24019864

Low openness on the revised NEO personality inventory as a risk factor for treatment-resistant depression.

PubMed

Takahashi, Michio; Shirayama, Yukihiko; Muneoka, Katsumasa; Suzuki, Masatoshi; Sato, Koichi; Hashimoto, Kenji

2013-01-01

Recently, we reported that low reward dependence, and to a lesser extent, low cooperativeness in the Temperature and Character Inventory (TCI) may be risk factors for treatment-resistant depression. Here, we analyzed additional psychological traits in these patients. We administered Costa and McCrae's five-factor model personality inventory, NEO Personality Inventory-Revised (NEO-PI-R), to antidepressant-treatment resistant depressed patients (n=35), remitted depressed patients (n=27), and healthy controls (n=66). We also evaluated the relationships between scores on NEO and TCI, using the same cohort of patients with treatment-resistant depression, as our previous study. Patients with treatment-resistant depression showed high scores for neuroticism, low scores for extraversion, openness and conscientiousness, without changes in agreeableness, on the NEO. However, patients in remitted depression showed no significant scores on NEO. Patients with treatment-resistant depression and low openness on NEO showed positive relationships with reward dependence and cooperativeness on the TCI. Many studies have reported that depressed patients show high neuroticism, low extraversion and low conscientiousness on the NEO. Our study highlights low openness on the NEO, as a risk mediator in treatment-resistant depression. This newly identified trait should be included as a risk factor in treatment-resistant depression.

78 FR 4804 - Revision to the Washington State Implementation Plan; Tacoma-Pierce County Nonattainment Area

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-23

... Plan (SIP) revision submitted by the Washington Department of Ecology (Ecology) dated November 28, 2012... Air Quality Standard (NAAQS). Second, EPA is proposing to approve updated rules submitted by Ecology... emissions. II. Summary of SIP Revision Ecology's November 28, 2012 SIP revision contains two elements for...

Initial development of the recovery-oriented services assessment: A collaboration with peer-provider consultants.

PubMed

Lodge, Amy C; Kuhn, Wendy; Earley, Juli; Stevens Manser, Stacey

2018-06-01

The Recovery Self-Assessment (RSA) is a reliable and valid tool used to measure recovery-oriented services. Recent studies, however, suggest that the length and reading level of the RSA makes its routine use in service settings difficult. Recognizing the importance of including people with lived experience of a mental health challenge in research processes and the need to enhance the utility of tools that measure recovery-oriented services, this paper describes an innovative researcher-peer provider consultant multistep process used to revise the provider version of the RSA to create a new instrument-the Recovery-Oriented Services Assessment (ROSA). The authors conducted an exploratory factor analysis (EFA) with principal axis factoring extraction and direct oblimin rotation to evaluate the underlying structure of the provider RSA using data from mental health employees (n = 323). To triangulate the findings of the EFA, quantitative and qualitative data were collected from peer provider consultants (n = 9) on the importance of and language of RSA items. EFA results indicated that a 1-factor solution provided the best fit and explained 48% of the total variance. Consultants triangulated EFA results and recommended the addition of 2 items and language revisions. These results were used to develop the ROSA-a 15-item instrument measuring recovery-oriented services with accessible language. Two versions of the ROSA were developed: a staff version and a people-in-services version. The ROSA may provide organizations with a more accessible way to measure the extent to which their services are recovery oriented. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Psychometric properties of the brief version of the Fear of Negative Evaluation Scale in a Turkish sample.

PubMed

Koydemir, Selda; Demir, Ayhan

2007-06-01

The purpose of the study was to report initial data on the psychometric properties of the Brief Fear of Negative Evaluation Scale. The scale was applied to a nonclinical sample of 250 (137 women, 113 men) Turkish undergraduate students selected randomly from Middle East Technical University. Their mean age was 20.4 yr. (SD= 1.9). The factor structure of the Turkish version, its criterion validity, and internal reliability coefficients were assessed. Although maximum likelihood factor analysis initially indicated that the scale had only one factor, a forced two-factor solution accounted for more variance (61%) in scale scores than a single factor. The straightforward items loaded on the first factor, and the reverse-coded items loaded on the second factor. The total score was significantly positively correlated with scores on the Revised Cheek and Buss Shyness Scale and significantly negatively correlated with scores on the Rosenberg Self-Esteem Scale. Factor 1 (straightforward items) correlated more highly with both Shyness and Self-esteem than Factor 2 (reverse-coded items). Internal consistency estimate was .94 for the Total scores, .91 for the Factor 1 (straightforward items), and .87 for the Factor 2 (reverse-coded items). No sex differences were evident for Fear of Negative Evaluation.

Two-Stage Revision for Infected Total Knee Arthroplasty: Based on Autoclaving the Recycled Femoral Component and Intraoperative Molding Using Antibiotic-Impregnated Cement on the Tibial Side.

PubMed

Lee, Byoung-Joo; Kyung, Hee-Soo; Yoon, Seong-Dae

2015-09-01

The purpose of this study was to determine the degree of infection control and postoperative function for new articulating metal-on-cement spacer. A retrospective study of 19 patients (20 cases), who underwent a two-stage revision arthroplasty using mobile cement prosthesis, were followed for a minimum of 2 years. This series consisted of 16 women and 3 men, having an overall mean age of 71 years. During the first stage of revision, the femoral implant and all the adherent cement was removed, after which it was autoclaved before replacement. The tibial component was removed and a doughy state, antibiotic-impregnated cement was inserted on the tibial side. To achieve joint congruency, intraoperative molding was performed by flexing and extending the knee joint. Each patient was evaluated clinically and radiologically. The clinical assessments included range of motion, and the patients were scored as per the Hospital for Special Surgery (HSS) and Knee Society (KS) criteria. The mean range of knee joint motion was 70° prior to the first stage operation and 72° prior to the second stage revision arthroplasty; following revision arthroplasty, it was 113° at the final follow-up. The mean HSS score and KS knee and function scores were 86, 82, and 54, respectively, at the final follow-up. The success rate in terms of infection eradication was 95% (19/20 knees). No patient experienced soft tissue contracture requiring a quadriceps snip. This novel technique provides excellent radiological and clinical outcomes. It offers a high surface area of antibiotic-impregnated cement, a good range of motion between first and second stage revision surgery for the treatment of chronic infection after total knee arthroplasty, and is of a reasonable cost.

Revision to Reverse Total Shoulder Arthroplasty Restores Stability for Patients With Unstable Shoulder Prostheses.

PubMed

Hernandez, Nicholas M; Chalmers, Brian P; Wagner, Eric R; Sperling, John W; Cofield, Robert H; Sanchez-Sotelo, Joaquin

2017-11-01

Instability after shoulder arthroplasty remains a complication with limited salvage options. Reoperation for instability with anatomic designs has led to high rates of persistent instability, therefore we aimed to evaluate the use of RSA for treatment of prosthetic instability. (1) After revision shoulder arthroplasty to a reverse prosthesis (RSA), what is the survivorship free from dislocations at 2 and 5 years? (2) What factors are associated with dislocations? (3) What is the survivorship free from revision after revision to RSA? (4) From preoperation to postrevision to RSA, what are the clinical outcomes-the proportion of patients with moderate to severe pain, shoulder elevation and external rotation ROM, American Shoulder and Elbow Surgeons scores, and Simple Shoulder Test scores? All shoulder arthroplasties revised for prosthetic instability using RSA components between January 2004 and July 2014 were retrospectively studied. During the period in question, we performed 82 revisions for instability of an anatomic total shoulder arthroplasty (TSA) (n = 62), hemiarthroplasty (n = 13), or reverse TSA (n = 7). We typically used a reverse TSA to treat this problem, but we identified 12 treated in other ways, including revision of a TSA to hemiarthroplasty (n = 3), revision of a reverse TSA to hemiarthroplasty (n = 2), revision of hemiarthroplasty to a hemiarthroplasty (n = 1), and revision of an anatomic TSA to another anatomic TSA (n = 6). This left 70 patients for evaluation; of those, 65 (93%) were available for analysis at a mean of 3 years (range, 2-10 years). A total of seven patients died. Eight of the 65 shoulders were not evaluated during the last 5 years, including three in patients who died earlier. The mean age of the patients at the time of revision RSA was 65 years (range, 40-89 years). Data were obtained from a longitudinally maintained institutional joint registry. Instability was defined as severe subluxation confirmed on clinical and radiographic examinations. We evaluated pain and ROM, and Kaplan-Meier curves were used to estimate survivorship. The survivorship free from dislocation at 2 and 5 years was 87% (95% CI, 80%-94%) and 79% (95% CI, 67%-91%) respectively, with 10 of 65 (15%) patients having an episode of dislocation after revision surgery. Persistent instability was more common in those with a BMI greater than 35 kg/m 2 (hazard ratio [HR], 5; 95% CI, 2-16; p = 0.008) and prior hemiarthroplasty (HR, 5; 95% CI, 2-16; p = 0.005), whereas patients who had undergone a previous TSA were less likely to have persistent instability (HR, 0.08; 95% CI, 0.0-0.30; p < 0.001) The survival free from rerevision for any indication at 2 and 5 years was 85% (95% CI, 76%-94%) and 78% (95% CI, 66%-90%) respectively; with the numbers available, we were not able to find associated factors. Fewer patients had moderate or severe pain after revision to RSA (preoperative: 48 of 65 [74%]; postoperative: nine of 65 [14%]; p < 0.001). After surgery, patients showed improvement in shoulder elevation (preoperative: 42° [± 30°], postoperative: 112° [42°]; mean difference, 70° [95% CI, - 83 o to 57°]; p < 0.001) and external rotation (preoperative: 20° [± 22°], postoperative: 42° [± 23°]; mean difference, 22° [95% CI, - 30° to - 14°]; p < 0.001). American Shoulder and Elbow Surgeons scores improved (preoperative: 21 [± 10], postoperative: 68 [± 14], mean difference, 46 [95% CI, - 58 to - 35]; p < 0.001); where a higher score is better. Simple Shoulder Test scores also improved (preoperative: 2/12 [± 2], postoperative: 7/12 [± 3]; mean difference, 5 [95% CI, - 7 to - 2.17]; p < 0.001); where a higher score is better. Revision RSA for prosthetic instability after shoulder arthroplasty is associated with reasonable implant survival and few complications. Approximately one in seven patients will have a recurrent dislocation. In patients with persistent instability or with risk factors for instability, consideration should be given for use of larger glenospheres and increasing the lateral offset at the time of RSA. Level IV, therapeutic study.

Measurement invariance of the strength of motivation for medical school: a multi-group confirmatory factor analysis.

PubMed

An, M; Kusurkar, R A; Li, L; Xiao, Y; Zheng, C; Hu, J; Chen, M

2017-07-11

The Strength of Motivation for Medical School-Revised (SMMS-R) questionnaire measures students' motivation for studying medicine. It includes three subscales: 'willingness to sacrifice', 'readiness to start', and 'persistence'. Measurement invariance is a prerequisite for group comparisons. The objectives of this study were to verify the factorial structure of the SMMS-R questionnaire and to investigate it's measurement invariance. A total of 989 medical students were approached, 930 cases were kept for data analysis. Factorial structure of and measurement invariance of the SMMS-R were tested using single and multiple group confirmatory factor analyses with Mplus. Trational Cronbach's α along with McDonald's ω and glb were used to measure internal consistency for each subscale. Internal consistency for subscales and the full instrument were within the acceptable range. A 3-factor structure of the Chinese version of the SMMS-R was supported. Full configural, metric and partial scalar invariance were obtained. The SMMS-R showed measurement invariance across gender and two independent samples. So it can be used for group and cross-cultural comparisons.

Confirmatory Factor and Rasch Analyses Support a Revised 14-Item Version of the Organizational, Policies, and Practices (OPP) Scale.

PubMed

Shi, Qiyun; MacDermid, Joy C; Tang, Kenneth; Sinden, Kathryn E; Walton, Dave; Grewal, Ruby

2017-06-01

Background The long version of the organizational, policies and practices (OPP) had a high burden and short versions were developed to solve this drawback. The 11-item version showed promise, but the ergonomic subscale was deficient. The OPP-14 was developed by adding three additional items to the ergonomics subscale. The aim of this study is to evaluate the factor structure using confirmatory factor and Rasch analyses in healthy firefighters. Methods A sample of 261 firefighters (Mean age 42 years, 95 % male) were sampled. A confirmatory factor and Rasch analyses were used to assess the internal consistency, factor structure and other psychometric characteristics of revised OPP-14. Results The OPP-14 demonstrates sound factor structure and internal consistency in firefighters. Confirmatory factor analysis confirmed the consistency of the original 4-domain structure (CFI = 0.97, TLI = 0.96, and RMSEA = 0.053). The 5 items showing misfit initially with disordered thresholds were rescored. The four subscales satisfied Rasch expectations with well target and acceptable reliability. Conclusions The OPP-14 scale shows a promising factor structure in this sample and remediated deficits found in OPP-11. This version may be preferable for musculoskeletal concerns or work applications where ergonomic indicators are relevant.

Differences in the causes of death of HIV-positive patients in a cohort study by data sources and coding algorithms.

PubMed

Hernando, Victoria; Sobrino-Vegas, Paz; Burriel, M Carmen; Berenguer, Juan; Navarro, Gemma; Santos, Ignacio; Reparaz, Jesús; Martínez, M Angeles; Antela, Antonio; Gutiérrez, Félix; del Amo, Julia

2012-09-10

To compare causes of death (CoDs) from two independent sources: National Basic Death File (NBDF) and deaths reported to the Spanish HIV Research cohort [Cohort de adultos con infección por VIH de la Red de Investigación en SIDA CoRIS)] and compare the two coding algorithms: International Classification of Diseases, 10th revision (ICD-10) and revised version of Coding Causes of Death in HIV (revised CoDe). Between 2004 and 2008, CoDs were obtained from the cohort records (free text, multiple causes) and also from NBDF (ICD-10). CoDs from CoRIS were coded according to ICD-10 and revised CoDe by a panel. Deaths were compared by 13 disease groups: HIV/AIDS, liver diseases, malignancies, infections, cardiovascular, blood disorders, pulmonary, central nervous system, drug use, external, suicide, other causes and ill defined. There were 160 deaths. Concordance for the 13 groups was observed in 111 (69%) cases for the two sources and in 115 (72%) cases for the two coding algorithms. According to revised CoDe, the commonest CoDs were HIV/AIDS (53%), non-AIDS malignancies (11%) and liver related (9%), these percentages were similar, 57, 10 and 8%, respectively, for NBDF (coded as ICD-10). When using ICD-10 to code deaths in CoRIS, wherein HIV infection was known in everyone, the proportion of non-AIDS malignancies was 13%, liver-related accounted for 3%, while HIV/AIDS reached 70% due to liver-related, infections and ill-defined causes being coded as HIV/AIDS. There is substantial variation in CoDs in HIV-infected persons according to sources and algorithms. ICD-10 in patients known to be HIV-positive overestimates HIV/AIDS-related deaths at the expense of underestimating liver-related diseases, infections and ill defined causes. CoDe seems as the best option for cohort studies.

Comparison of familial and psychological factors in groups of encopresis patients with constipation and without constipation.

PubMed

Çengel-Kültür, S Ebru; Akdemir, Devrim; Saltık-Temizel, İnci N

2014-01-01

The study aimed to evaluate the differences between groups of encopresis patients with constipation and without constipation. The Symptom Checklist- 90-Revised, the COPE Questionnaire, the Relationship Scales Questionnaire, the McMaster Family Assessment Device and the Parenting Style Scale were used to evaluate, respectively, maternal psychiatric symptoms, coping abilities, attachment style, family functioning and children's perceptions of parenting behaviors. Psychiatric diagnoses were evaluated using the K-SADS. A higher level of maternal psychiatric symptoms, impaired role and affective involvement functioning of the family and less psychological autonomy were observed in the group of encopresis patients with constipation than in the group of encopresis patients without constipation. No significant differences were found between the groups in psychiatric comorbidities, maternal coping abilities and attachment style. The two groups had a similar pattern of comorbid psychiatric disorders and maternal psychological factors, although some familial factors-related mainly to parental authority-were differentiated in the encopresis with constipation group.

Revision lumbar surgery in elderly patients with symptomatic pseudarthrosis, adjacent-segment disease, or same-level recurrent stenosis. Part 2. A cost-effectiveness analysis: clinical article.

PubMed

Adogwa, Owoicho; Owens, Ryan; Karikari, Isaac; Agarwal, Vijay; Gottfried, Oren N; Bagley, Carlos A; Isaacs, Robert E; Cheng, Joseph S

2013-02-01

Despite advances in technology and understanding in spinal physiology, reoperation for symptomatic adjacent-segment disease (ASD), same-level recurrent stenosis, and pseudarthrosis in elderly patients continues to occur. While revision lumbar surgery is effective, attention has turned to questions on the utility and value of the revision decompression and fusion procedure. To date, an analysis of the cost and health state gain associated with revision lumbar surgery in elderly patients with symptomatic pseudarthrosis, ASD, or same-level recurrent lumbar stenosis has yet to be performed. The aim of this study was to assess the long-term outcomes and cost-effectiveness of revision surgery in elderly patients with recurrent or persistent back and leg pain. After reviewing their institutional database, the authors found 69 patients 65 years of age and older who had undergone revision decompression and instrumented fusion for back and leg pain associated with pseudarthrosis (17 patients), same-level recurrent stenosis (24 patients), or ASD (28 patients) and included them in this study. Total 2-year back-related medical resource utilization and health state values (quality-adjusted life years [QALYs], calculated from the EQ-5D, the EuroQol-5D health survey, with US valuation) were assessed. Two-year resource use was multiplied by unit costs based on Medicare national allowable payment amounts. The mean total 2-year cost per QALY gained after revision surgery was assessed. The mean (± standard deviation) time between the index surgery and revision surgery was 3.51 ± 3.63 years. A mean cumulative 2-year gain of 0.35 QALY was observed after revision surgery. The mean total 2-year cost of revision surgery was $28,256 ± $3000 (ASD: $28,829 ± $3812, pseudarthrosis: $28,069 ± $2508, same-level recurrent stenosis: $27,871 ± $2375). Revision decompression and extension of fusion was associated with a mean 2-year cost of $80,594 per QALY gained. Revision decompression and fusion provided a significant gain in health state utility for elderly patients with symptomatic pseudarthrosis, same-level recurrent stenosis, or ASD, with a mean 2-year cost of $80,594 per QALY gained. When indicated, revision surgery for symptomatic ASD, same-level recurrent stenosis, and pseudarthrosis is a valuable treatment option for elderly patients experiencing persistent back and leg pain. Findings in this study provided a value measure of surgery that can be compared with future cost-per-QALY-gained studies of medical management or alternative surgical approaches.

An analysis of teacher’s preparation in implementing 2013 revision edition curriculum on mathematics specialization learning

NASA Astrophysics Data System (ADS)

Susilo, T.; Suryawan, A.

2018-05-01

This study aimed to determine the pedagogical competence of teachers, the readiness of planning and implementation of learning related to the implementation 2013 revised edition curriculum on mathematics specialization learning for senior high schools Wonogiri. Informants in this study there are 6 high school mathematics teachers X and XI class who teach in the school district Wonogiri. Data were collected using questionnaire method, interview, observation and documentation. Qualitative data analysis is done interactively through 4 paths: data collection, data reduction, data display, drawing conclusion. The results showed that high school mathematics teacher class X and XI in school district of Wonogiri City. The results show that most high school mathematics teachers in grade X and XI are ready to implement the 2013 revised edition curriculum and a few have not been able to implement due to internal or external factors. High school math teachers at Wonogiri district who are ready to face the 2013 revised edition curriculum have applied 10 teacher pedagogic competency indicators according to Regulation of the national education ministry Number 16 Year 2007 in learning. The readiness and implementation of mathematics learning is in line with the demands of the 2013 revised edition curriculum. Based on the teachers who are not ready, data on issues that arise in the implementation of the 2013 revised edition curriculum. Especially the problems in learning, namely mismatch of Core Competence (KI) and Basic Competence (KD) in teacher manual, material disregard in student handbook and lack of examples of problems that exist in teacher manual.

Economic Analysis of 4221 Revisions Due to Periprosthetic Joint Infection in Poland.

PubMed

Babiak, Ireneusz; Pędzisz, Piotr; Janowicz, Jakub; Kulig, Mateusz; Małdyk, Paweł

2017-01-26

Periprosthetic joint infection (PJI) is one of the most severe complications of total hip (THA) and total knee (TKA) arthroplasty. The aim of the study is to determine the number and type of hip and knee prosthesis revisions in Poland performed due to infection and reimbursement of the cost of septic revisions and to compare the costs of septic and aseptic revisions in Poland and other countries. The data published for the period 2009-2013 by the National Health Fund (NHF) were analysed and the average cost of septic and aseptic revisions was calculated. In the years 2009-2013, a total of 260,030 hip and knee arthroplasties including 23,027 revisions (incl. 4,221 septic) were performed in Poland. In 2013, septic revisions accounted for 1.38% of all hip replacement procedures, 2.56% of all knee replacement procedures and 14.67% of all hip revisions and 30.23% of all knee revisions. In 2013, the difference between the average cost incurred by the hospital and the NHF refund for septic revision due to PJI was at least €238 and the cost-refund gap for the entire year was €219198. 1. The system of reporting periprostheticjoint infections currently in use in Poland does not adequately reflect the current classification of PJI and reimbursement for septic revision of joint prosthesis does not match the actual costs. 2. The Polish DRG system does not distinguish between early and late PJI and fails to acknowledge basic guidelines for infection treatment currently followed in Poland and worldwide. 3. According to the DRG system, patients requiring different treatment are placed in one category. 4. Until the year 2013, the less expensive treatment of early infections had been reimbursed on the same basis as the more costly two-stage revision procedures.

Improving the Cooperation Rate of Older Adults and Their Caregivers in Research Surveys.

PubMed

Green, Ohad; Ayalon, Liat

2015-01-01

Recruiting older adults, their family members and their home care workers as participants in research studies is particularly complicated. This might be due to medical or cognitive problems of the older adult as well as the high workload and shortage of time experienced by caregivers. The present study compared the contribution of two different versions of an advanced letter followed by two different versions of a recruitment phone call to the cooperation rate of older adults, family caregivers and home care workers in a face-to-face survey. A quasi-experimental design was used to compare the contribution of the different types of appeal. A total of 2,014 caregiving units (composed of an older adult, a family member and a home care worker) were randomly sampled from a list of Israeli long-term care insurance beneficiaries. 74.32% of the sampled caregiving units were eligible to participate in the study. The first group of participants received formal and succinctly phrased written and oral appeals - an advanced letter followed by a recruitment phone call. The second group of participants received the original formal and succinctly phrased advanced letter, but a revised recruitment phone call that included a more personal approach, the provision of broader information about the study and the avoidance of words with a possible negative connotation. The third group of participants received both a revised advanced letter and a revised recruitment phone call. Using the succinctly phrased written and oral appeals, we had a cooperation rate of about 50% for the entire caregiving unit. Using a revised advanced letter and a revised recruitment phone call yielded an increase of 20-25% in the cooperation rate for the entire caregiving unit. Using the revised recruitment phone call and the original advanced letter yielded an increase in the cooperation rate only among migrant home care workers. This study showed that by changing the format of appeal we can increase the cooperation rate of older adults and their caregivers in a research survey. This study also pointed out the importance of the advanced letter. © 2014 S. Karger AG, Basel.

A Confirmatory Factor Analysis of the Student Evidence-Based Practice Questionnaire (S-EBPQ) in an Australian sample.

PubMed

Beccaria, Lisa; Beccaria, Gavin; McCosker, Catherine

2018-03-01

It is crucial that nursing students develop skills and confidence in using Evidence-Based Practice principles early in their education. This should be assessed with valid tools however, to date, few measures have been developed and applied to the student population. To examine the structural validity of the Student Evidence-Based Practice Questionnaire (S-EBPQ), with an Australian online nursing student cohort. A cross-sectional study for constructing validity. Three hundred and forty-five undergraduate nursing students from an Australian regional university were recruited across two semesters. Confirmatory Factor Analysis was used to examine the structural validity. Confirmatory Factor Analysis was applied which resulted in a good fitting model, based on a revised 20-item tool. The S-EBPQ tool remains a psychometrically robust measure of evidence-based practice use, attitudes, and knowledge and skills and can be applied in an online Australian student context. The findings of this study provided further evidence of the reliability and four factor structure of the S-EBPQ. Opportunities for further refinement of the tool may result in improvements in structural validity. Copyright © 2018 Elsevier Ltd. All rights reserved.

Arthrodesis following failed total knee arthroplasty: comprehensive review and meta-analysis of recent literature.

PubMed

Damron, T A; McBeath, A A

1995-04-01

With the increasing duration of follow up on total knee arthroplasties, more revision arthroplasties are being performed. When revision is not advisable, a salvage procedure such as arthrodesis or resection arthroplasty is indicated. This article provides a comprehensive review of the literature regarding arthrodesis following failed total knee arthroplasty. In addition, a statistical meta-analysis of five studies using modern arthrodesis techniques is presented. A statistically significant greater fusion rate with intramedullary nail arthrodesis compared to external fixation is documented. Gram negative and mixed infections are found to be significant risk factors for failure of arthrodesis.

Hepatitis B vaccination coverage and risk factors associated with incomplete vaccination of children born to hepatitis B surface antigen-positive mothers, Denmark, 2006 to 2010.

PubMed

Kunoee, Asja; Nielsen, Jens; Cowan, Susan

2016-01-01

In Denmark, universal screening of pregnant women for hepatitis B has been in place since November 2005, with the first two years as a trial period with enhanced surveillance. It is unknown what the change to universal screening without enhanced surveillance has meant for vaccination coverage among children born to hepatitis B surface antigen (HBsAg)-positive mothers and what risk factors exist for incomplete vaccination. This retrospective cohort study included 699 children of mothers positive for HBsAg. Information on vaccination and risk factors was collected from central registers. In total, 93% (651/699) of the children were vaccinated within 48 hours of birth, with considerable variation between birthplaces. Only 64% (306/475) of the children had received all four vaccinations through their general practitioner (GP) at the age of two years, and 10% (47/475) of the children had received no hepatitis B vaccinations at all. Enhanced surveillance was correlated positively with coverage of birth vaccination but not with coverage at the GP. No or few prenatal examinations were a risk factor for incomplete vaccination at the GP. Maternity wards and GPs are encouraged to revise their vaccination procedures and routines for pregnant women, mothers with chronic HBV infection and their children.

Geochemical Constraints on Core Formation in the Earth

NASA Technical Reports Server (NTRS)

Jones, John H.; Drake, Michael J.

1986-01-01

New experimental data on the partitioning of siderophile and chalcophile elements among metallic and silicate phases may be used to constrain hypotheses of core formation in the Earth. Three current hypotheses can explain gross features of mantle geochemistry, but none predicts siderophile and chalcophile element abundances to within a factor of two of observed values. Either our understanding of metal-silicate interactions and/or our understanding of the early Earth requires revision.

Psychological Assessment via the Internet: A Reliability and Validity Study of Online (vs Paper-and-Pencil) Versions of the General Health Questionnaire-28 (GHQ-28) and the Symptoms Check-List-90-Revised (SCL-90-R)

PubMed Central

Jordán, Carlos M; Díaz, Marta I; Comeche, María I; Ortega, José

2007-01-01

Background Internet psychology services are rapidly increasing and that implies online assessment. To guarantee the results of these new online evaluation procedures, it is necessary to have reliable and valid assessment tools. Objective In this work we analyzed the online versions of two popular psychopathology screening questionnaires: the General Health Questionnaire-28 (GHQ-28) and the Symptoms Check-List-90-Revised (SCL-90-R). Methods A total of 185 psychology students were recruited from two universities in Madrid, Spain. All of them had Internet access at home. A test-retest situation and factorial analysis were used to generate reliability and validity data. Both paper-and-pencil questionnaires (test) and their online versions (retest) were completed by 100 participants (median gap = 17 days). Results Results suggest that both online questionnaires were fairly equivalent to their paper-and-pencil versions, with higher reliability values for the SCL-90-R. Factorial analysis tended to reproduce the structure shown in former investigations of both questionnaires, replicating the four-factor structure of the GHQ-28 but failing to do so with the nine-factor structure of the SCL-90-R. Instead, a large unrotated factor appeared. Conclusions Further research should be carried out to confirm these data, but our work supports the online use of both assessment tools. The psychometric properties of the online version of GHQ-28 is similar to the paper-and-pencil and we can recommend its utilization in a Web environment. In contrast, SCL-90-R can only be recommended as a global index for psychological distress, using the Global Severity Index (GSI), not necessarily its subscales; and it should be considered that the online scores were lower than the ones with the paper-and-pencil version. PMID:17478411

Psychological assessment via the internet: a reliability and validity study of online (vs paper-and-pencil) versions of the General Health Questionnaire-28 (GHQ-28) and the Symptoms Check-List-90-Revised (SCL-90-R).

PubMed

Vallejo, Miguel A; Jordán, Carlos M; Díaz, Marta I; Comeche, María I; Ortega, José

2007-01-31

Internet psychology services are rapidly increasing and that implies online assessment. To guarantee the results of these new online evaluation procedures, it is necessary to have reliable and valid assessment tools. In this work we analyzed the online versions of two popular psychopathology screening questionnaires: the General Health Questionnaire-28 (GHQ-28) and the Symptoms Check-List-90-Revised (SCL-90-R). A total of 185 psychology students were recruited from two universities in Madrid, Spain. All of them had Internet access at home. A test-retest situation and factorial analysis were used to generate reliability and validity data. Both paper-and-pencil questionnaires (test) and their online versions (retest) were completed by 100 participants (median gap = 17 days). Results suggest that both online questionnaires were fairly equivalent to their paper-and-pencil versions, with higher reliability values for the SCL-90-R. Factorial analysis tended to reproduce the structure shown in former investigations of both questionnaires, replicating the four-factor structure of the GHQ-28 but failing to do so with the nine-factor structure of the SCL-90-R. Instead, a large unrotated factor appeared. Further research should be carried out to confirm these data, but our work supports the online use of both assessment tools. The psychometric properties of the online version of GHQ-28 is similar to the paper-and-pencil and we can recommend its utilization in a Web environment. In contrast, SCL-90-R can only be recommended as a global index for psychological distress, using the Global Severity Index (GSI), not necessarily its subscales; and it should be considered that the online scores were lower than the ones with the paper-and-pencil version.

The Survival of Total Knee Arthroplasty: Current Data from Registries on Tribology: Review Article.

PubMed

Civinini, Roberto; Carulli, Christian; Matassi, Fabrizio; Lepri, Andrea Cozzi; Sirleo, Luigi; Innocenti, Massimo

2017-02-01

Polyethylene (PE) wear is a major contributor to implant loosening following total knee arthroplasty (TKA), and advanced bearings in TKA are being investigated with hopes of reducing or eliminate wear-related loosening. Currently, information on knee tribology is available from national joint registries and may be the best tools to evaluate the efficacy and safety of design innovations in joint arthroplasty. We performed a review of national joint registries trying to answer the following questions: "Which is the main factor directly related to revisions rate in TKA?" and "Are there new bearing options better than conventional ones?" A review was performed of all published annual reports of National Joint Registers, as well as of the literature. The search was carried out using and comparing the National Joint Registers. Current data from registries for total knee arthroplasty indicates that age is the major factor affecting the outcome of primary total knee replacement. The 10-year cumulative revision rate for non-cross-linked PE was 5.8% and for XLPE it was 3.5%. The effect of cross-linked polyethylene was more evident in the younger patients. The survival of the oxidized zirconium (OxZr) femoral component appears better when compared to a similar age group of patients with conventional group of prostheses. Our review suggests that the revision rates are half for the OxZr components compared to conventional CoCr femoral components. Age is the most relevant single factor related to revision rate. Cross-linked PE has a statistical lower revision rate at 10 years compared to conventional PE and, in the OxZr group, the revision rate is 2 times lower than Co-Cr in the same group of age.

Acute Infection in Total Knee Arthroplasty: Diagnosis and Treatment

PubMed Central

Martínez-Pastor, Juan Carlos; Maculé-Beneyto, Francisco; Suso-Vergara, Santiago

2013-01-01

Infection is one of the most serious complications after total knee arthroplasty (TKA). The current incidence of prosthetic knee infection is 1-3%, depending on the series. For treatment and control to be more cost effective, multidisciplinary groups made up of professionals from different specialities who can work together to eradicate these kinds of infections need to be assembled. About the microbiology, Staphylococcus aureus and coagulase-negative staphylococcus were among the most frequent microorganisms involved (74%). Anamnesis and clinical examination are of primary importance in order to determine whether the problem may point to a possible acute septic complication. The first diagnosis may then be supported by increased CRP and ESR levels. The surgical treatment for a chronic prosthetic knee infection has been perfectly defined and standardized, and consists in a two-stage implant revision process. In contrast, the treatment for acute prosthetic knee infection is currently under debate. Considering the different surgical techniques that already exist, surgical debridement with conservation of the prosthesis and polythene revision appears to be an attractive option for both surgeon and patient, as it is less aggressive than the two-stage revision process and has lower initial costs. The different results obtained from this technique, along with prognosis factors and conclusions to keep in mind when it is indicated for an acute prosthetic infection, whether post-operative or haematogenous, will be analysed by the authors. PMID:23919094

Pedicle screw loosening is correlated to chronic subclinical deep implant infection: a retrospective database analysis.

PubMed

Leitner, Lukas; Malaj, Isabella; Sadoghi, Patrick; Amerstorfer, Florian; Glehr, Mathias; Vander, Klaus; Leithner, Andreas; Radl, Roman

2018-04-13

Spinal fusion is used for treatment of spinal deformities, degeneration, infection, malignancy, and trauma. Reduction of motion enables osseous fusion and permanent stabilization of segments, compromised by loosening of the pedicle screws (PS). Deep implant infection, biomechanical, and chemical mechanisms are suspected reasons for loosening of PS. Study objective was to investigate the frequency and impact of deep implant infection on PS loosening. Intraoperative infection screening from wound and explanted material sonication was performed during revision surgeries following dorsal stabilization. Case history events and factors, which might promote implant infections, were included in this retrospective survey. 110 cases of spinal metal explantation were included. In 29.1% of revision cases, infection screening identified a germ, most commonly Staphylococcus (53.1%) and Propionibacterium (40.6%) genus. Patients screened positive had a significant higher number of previous spinal operations and radiologic loosening of screws. Patients revised for adjacent segment failure had a significantly lower rate of positive infection screening than patients revised for directly implant associated reasons. Removal of implants that revealed positive screening effected significant pain relief. Chronic implant infection seems to play a role in PS loosening and ongoing pain, causing revision surgery after spinal fusion. Screw loosening and multiple prior spinal operations should be suspicious for implant infection after spinal fusion when it comes to revision surgery. These slides can be retrieved under Electronic Supplementary Material.

[Arthrodesis following revision of a knee endoprosthesis. Literature review 1984-1994].

PubMed

Kohn, D; Schmolke, S

1996-04-01

Two percent of primary and 8% of revision total knee replacements are followed by arthrodesis. Today knee arthrodesis is the most important salvage procedure after failed total knee arthroplasty, resection arthroplasty and above-the-knee amputation being the only alternatives. Analysis of the literature between 1984 and 1994 revealed 533 cases treated with arthrodesis of the knee; 403 were done after failed total knee arthroplasty. The fusion rate was 74%. External fixation, intramedullary nail, plates and combinations of these are currently used for fixation. The literature and an analysis of our own patients from 1988 to 1994 showed that arthrodesis after failed arthroplasty is a difficult procedure, and complications often occur. Bone loss of the distal femur and proximal tibia is the one most important prognostic factor. A new classification system for bone loss is presented.

Design, Analysis, and Interpretation of Screening Studies for Human Factors Engineering Research. Revision.

DTIC Science & Technology

1978-06-01

FNO GlX GJP GMO HIP HJ( 11MN ILO JLN KLb: B ABCD AC? ADO AE1 AHL A J t’ Ar*N AD? CDL CEM CON CiJ ChP CN 0 DEN DFH D1K DJ? DMO EFJ ECK EHI’ EiD FUL FIN...Westlake Village, CA 91361 II.- CoN TIro I ING OFF 1C- NAME., AN C) AP"tOFF 12 R.. POFRT o AT " Air Force Office of Scientific Research September 1977...explains the techniques devel- oped by Box and Hunter (1961) and Daniel (1962) for con - structing Resolution IV screening designs from two Resolution

An in-vitro biomechanical study of different fixation techniques for the extended trochanteric osteotomy in revision THA.

PubMed

Zhu, Zhonglin; Ding, Hui; Shao, Hongyi; Zhou, Yixin; Wang, Guangzhi

2013-04-09

The wire fixation and the cable grip fixation have been developed for the extended trochanteric osteotomy (ETO) in the revision of total hip arthroplasty (THA). Many studies reported the postoperative performance of the patients, but with little quantitative biomechanical comparison of the two fixation systems. An in-vitro testing approach was designed to record the loosening between the femoral bed and the greater trochanter after fixations. Ten cadaveric femurs were chosen in this study. Each femur underwent the THA, revision by ETO and fixations. The tension to the greater trochanter was from 0 to 500N in vertical and lateral direction, respectively. The translation and rotation of the greater trochanter with respect to the bony bed were captured by an optical tracking system. In the vertical tension tests, the overall translation of the greater trochanter was observed 0.4 mm in the cable fixations and 7.0 mm in the wire fixations. In the lateral tension tests, the overall motion of the greater trochanter was 2.0 mm and 1.2° in the cable fixations, while it was 6.2 mm and 5.3° in the wire fixations. The result was significantly different between the two fixation systems. The stability of the proximal femur after ETO using different fixations in the revision THA was investigated. The cable grip fixation was significantly more stable than the wire fixation.

Analysis of difficulties in mathematics problem solving based on revised Bloom’s Taxonomy viewed from high self-efficacy

NASA Astrophysics Data System (ADS)

Prismana, R. D. E.; Kusmayadi, T. A.; Pramudya, I.

2018-04-01

The ability of solving problem is a part of the mathematic curriculum that is very important. Problem solving prefers the process and strategy that is done by students in solving a problem rather than the result. This learning concept in accordance with the stages on the revised bloom’s taxonomy. The revised Bloom’s Taxonomy has two dimensions, namely the dimension of cognitive process and the dimension of knowledge. Dimension of knowledge has four categories, but this study only restricted on two knowledge, conceptual knowledge and procedural knowledge. Dimensions of cognitive processes are categorized into six kinds, namely remembering, understanding, applying, analyzing, evaluating, and creating. Implementation of learning more emphasis on the role of students. Students must have their own belief in completing tasks called self-efficacy. This research is a qualitative research. This research aims to know the site of the students’ difficulty based on revised Bloom’s Taxonomy viewed from high self-efficacy. The results of the study stated the students with high self efficacy have difficulties site. They are evaluating conceptual knowledge, evaluating procedural knowledge, creating conceptual knowledge, and creating procedural knowledge. It could be the consideration of teachers in the teaching, so as to reduce the difficulties of learning in students.

Coma Recovery Scale-Revised: evidentiary support for hierarchical grading of level of consciousness.

PubMed

Gerrard, Paul; Zafonte, Ross; Giacino, Joseph T

2014-12-01

To investigate the neurobehavioral pattern of recovery of consciousness as reflected by performance on the subscales of the Coma Recovery Scale-Revised (CRS-R). Retrospective item response theory (IRT) and factor analysis. Inpatient rehabilitation facilities. Rehabilitation inpatients (N=180) with posttraumatic disturbance in consciousness who participated in a double-blinded, randomized, controlled drug trial. Not applicable. Scores on CRS-R subscales. The CRS-R was found to fit factor analytic models adhering to the assumptions of unidimensionality and monotonicity. In addition, subscales were mutually independent based on residual correlations. Nonparametric IRT reaffirmed the finding of monotonicity. A highly constrained confirmatory factor analysis model, which imposed equal factor loadings on all items, was found to fit the data well and was used to estimate a 1-parameter IRT model. This study provides evidence of the unidimensionality of the CRS-R and supports the hierarchical structure of the CRS-R subscales, suggesting that it is an effective tool for establishing diagnosis and monitoring recovery of consciousness after severe traumatic brain injury. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Postoperative Urinary Retention and Urinary Tract Infections Predict Midurethral Sling Mesh Complications.

PubMed

Punjani, Nahid; Winick-Ng, Jennifer; Welk, Blayne

2017-01-01

To determine if postoperative urinary retention and urinary tract infections (UTIs) were predictors of future mesh complications requiring surgical intervention after midurethral sling (MUS). Administrative data in Ontario, Canada, between 2002 and 2013 were used to identify all women who underwent a mesh-based MUS. The primary outcome was revision of the transvaginal mesh sling (including mesh removal/erosion/fistula, or urethrolysis). Two potential risk factors were analyzed: postoperative retention (within 30 days of procedure) and number of postoperative emergency room visits or hospital admissions for UTI symptoms. A total of 59,556 women had a MUS, of which 1598 (2.7%) required revision surgery. Of the 2025 women who presented to the emergency room or were admitted to hospital for postoperative retention, 212 (10.5%) required operative mesh revision. Of the 11,747 patients who had at least one postoperative UTI, 366 (3.1%) patients required operative mesh revision. In adjusted analysis, postoperative retention was significantly predictive of future reoperation (hazard ratio [HR] 3.46, 95% confidence interval [CI] 2.97-4.02), and this difference persisted when urethrolysis was excluded as a reason for sling revision (HR 3.08, 95% CI 2.62-3.63). Similarly, in adjusted analysis, each additional postoperative hospital visit for UTI symptoms increased the risk for surgical intervention for mesh complications (HR 1.74, 95% CI 1.61-1.87). Postoperative urinary retention and hospital presentation for UTI symptoms are associated with an increased risk of reoperation for MUS complications. These patients should be followed and investigated for mesh complications when appropriate. Copyright © 2016 Elsevier Inc. All rights reserved.

Risk of Revision Was Not Reduced by a Double-bundle ACL Reconstruction Technique: Results From the Scandinavian Registers.

PubMed

Aga, Cathrine; Kartus, Jüri-Tomas; Lind, Martin; Lygre, Stein Håkon Låstad; Granan, Lars-Petter; Engebretsen, Lars

2017-10-01

Double-bundle anterior cruciate ligament (ACL) reconstruction has demonstrated improved biomechanical properties and moderately better objective outcomes compared with single-bundle reconstructions. This could make an impact on the rerupture rate and reduce the risk of revisions in patients undergoing double-bundle ACL reconstruction compared with patients reconstructed with a traditional single-bundle technique. The National Knee Ligament Registers in Scandinavia provide information that can be used to evaluate the revision outcome after ACL reconstructions. The purposes of the study were (1) to compare the risk of revision between double-bundle and single-bundle reconstructions, reconstructed with autologous hamstring tendon grafts; (2) to compare the risk of revision between double-bundle hamstring tendon and single-bundle bone-patellar tendon-bone autografts; and (3) to compare the hazard ratios for the same two research questions after Cox regression analysis was performed. Data collection of primary ACL reconstructions from the National Knee Ligament Registers in Denmark, Norway, and Sweden from July 1, 2005, to December 31, 2014, was retrospectively analyzed. A total of 60,775 patients were included in the study; 994 patients were reconstructed with double-bundle hamstring tendon grafts, 51,991 with single-bundle hamstring tendon grafts, and 7790 with single-bundle bone-patellar tendon-bone grafts. The double-bundle ACL-reconstructed patients were compared with the two other groups. The risk of revision for each research question was detected by the risk ratio, hazard ratio, and the corresponding 95% confidence intervals. Kaplan-Meier analysis was used to estimate survival at 1, 2, and 5 years for the three different groups. Furthermore, a Cox proportional hazard regression model was applied and the hazard ratios were adjusted for country, age, sex, meniscal or chondral injury, and utilized fixation devices on the femoral and tibial sides. There were no differences in the crude risk of revision between the patients undergoing the double-bundle technique and the two other groups. A total of 3.7% patients were revised in the double-bundle group (37 of 994 patients) versus 3.8% in the single-bundle hamstring tendon group (1952 of 51,991; risk ratio, 1.01; 95% confidence interval (CI), 0.73-1.39; p = 0.96), and 2.8% of the patients were revised in the bone-patellar tendon-bone group (219 of the 7790 bone-patellar tendon-bone patients; risk ratio, 0.76; 95% CI, 0.54-1.06; p = 0.11). Cox regression analysis with adjustment for country, age, sex, menisci or cartilage injury, and utilized fixation device on the femoral and tibial sides, did not reveal any further difference in the risk of revision between the single-bundle hamstring tendon and double-bundle hamstring tendon groups (hazard ratio, 1.18; 95% CI, 0.85-1.62; p = 0.33), but the adjusted hazard ratio showed a lower risk of revision in the single-bundle bone-patellar tendon-bone group compared with the double-bundle group (hazard ratio, 0.62; 95% CI, 0.43-0.90; p = 0.01). Comparisons of the graft revision rates reported separately for each country revealed that double-bundle hamstring tendon reconstructions in Sweden had a lower hazard ratio compared with the single-bundle hamstring tendon reconstructions (hazard ratio, 1.00 versus 1.89; 95% CI, 1.09-3.29; p = 0.02). Survival at 5 years after index surgery was 96.0% for the double-bundle group, 95.4% for the single-bundle hamstring tendon group, and 97.0% for the single-bundle bone-patellar tendon-bone group. Based on the data from all three national registers, the risk of revision was not influenced by the reconstruction technique in terms of using single- or double-bundle hamstring tendons, although national differences in survival existed. Using bone-patellar tendon-bone grafts lowered the risk of revision compared with double-bundle hamstring tendon grafts. These findings should be considered when deciding what reconstruction technique to use in ACL-deficient knees. Future studies identifying the reasons for graft rerupture in single- and double-bundle reconstructions would be of interest to understand the findings of the present study. Level III, therapeutic study.

50 CFR 424.18 - Final rules-general.

Code of Federal Regulations, 2010 CFR

2010-10-01

... OF COMMERCE); ENDANGERED SPECIES COMMITTEE REGULATIONS SUBCHAPTER A LISTING ENDANGERED AND THREATENED SPECIES AND DESIGNATING CRITICAL HABITAT Revision of the Lists § 424.18 Final rules—general. (a) Contents... reclassify a species or designate or revise critical habitat shall also provide a summary of factors...

Psychometric Characteristics of a Vocational Preference Inventory Short Form.

ERIC Educational Resources Information Center

Lowman, Rodney L.; Schurman, Susan J.

1982-01-01

The psychometric properties of a revised version of Holland's Vocational Preference Inventory were assessed using federal government employees. Factor analyses, interscale correlations, measures of internal consistency, and criterion group profiles are presented. Evidence was supportive of the validity of the revised form. (Author/BW)

The incidence and risk factors for retained placenta after vaginal delivery - a single center experience.

PubMed

Ashwal, Eran; Melamed, Nir; Hiersch, Liran; Wiznitzer, Arnon; Yogev, Yariv; Peled, Yoav

2014-12-01

We aimed to determine the incidence and risk factors for retained placenta immediately after vaginal delivery in a single, university-affiliated tertiary center. A case-control study. Women who delivered vaginally and diagnosed with suspected retained placenta were compared to control group of women with spontaneous vaginal delivery with spontaneous non-complicated placental separation between the years 2007 and 2012. Eligibility was limited to singleton fetuses in vertex presentation with no history of more than one cesarean section, stillbirth or major fetal anomaly. Overall, 33,925 women delivered vaginally, of them, 491 (1.4%) underwent revision of uterine cavity due to suspected retained placenta. Women with retained placenta were characterized by a higher rate of previous cesarean section (OR 1.71, 95% CI 1.23-2.36), previous abortions, lower parity (OR 0.79, 95% CI 0.68-0.91), lower gestational age at delivery. Hypertensive disorders, oligohydramnios and labor and delivery interventions as induction of labor (OR 1.84, 95% CI 1.30-2.59), neuro-axial analgesia (OR 1.60, 95% CI 1.27-2.00) and vacuum delivery (OR 1.89, 95% CI 1.48-2.41) were independently associated with uterine revision for retained placenta. Risk factors for manual revision due to retained placenta can be recognized. This data should be taken into consideration in the assessment of women immediately after delivery.

Inter-rater reliability of PATH observations for assessment of ergonomic risk factors in hospital work.

PubMed

Park, Jung-Keun; Boyer, Jon; Tessler, Jamie; Casey, Jeffrey; Schemm, Linda; Gore, Rebecca; Punnett, Laura

2009-07-01

This study examined the inter-rater reliability of expert observations of ergonomic risk factors by four analysts. Ten jobs were observed at a hospital using a newly expanded version of the PATH method (Buchholz et al. 1996), to which selected upper extremity exposures had been added. Two of the four raters simultaneously observed each worker onsite for a total of 443 observation pairs containing 18 categorical exposure items each. For most exposure items, kappa coefficients were 0.4 or higher. For some items, agreement was higher both for the jobs with less rapid hand activity and for the analysts with a higher level of ergonomic job analysis experience. These upper extremity exposures could be characterised reliably with real-time observation, given adequate experience and training of the observers. The revised version of PATH is applicable to the analysis of jobs where upper extremity musculoskeletal strain is of concern.

Learner-Centered Inquiry in Undergraduate Biology: Positive Relationships with Long-Term Student Achievement

PubMed Central

Ebert-May, Diane

2010-01-01

We determined short- and long-term correlates of a revised introductory biology curriculum on understanding of biology as a process of inquiry and learning of content. In the original curriculum students completed two traditional lecture-based introductory courses. In the revised curriculum students completed two new learner-centered, inquiry-based courses. The new courses differed significantly from those of the original curriculum through emphases on critical thinking, collaborative work, and/or inquiry-based activities. Assessments were administered to compare student understanding of the process of biological science and content knowledge in the two curricula. More seniors who completed the revised curriculum had high-level profiles on the Views About Science Survey for Biology compared with seniors who completed the original curriculum. Also as seniors, students who completed the revised curriculum scored higher on the standardized Biology Field Test. Our results showed that an intense inquiry-based learner-centered learning experience early in the biology curriculum was associated with long-term improvements in learning. We propose that students learned to learn science in the new courses which, in turn, influenced their learning in subsequent courses. Studies that determine causal effects of learner-centered inquiry-based approaches, rather than correlative relationships, are needed to test our proposed explanation. PMID:21123693

Does adding antibiotics to cement reduce the need for early revision in total knee arthroplasty?

PubMed

Bohm, Eric; Zhu, Naisu; Gu, Jing; de Guia, Nicole; Linton, Cassandra; Anderson, Tammy; Paton, David; Dunbar, Michael

2014-01-01

There is considerable debate about whether antibiotic-loaded bone cement should be used for fixation of TKAs. While antibiotics offer the theoretical benefit of lowering early revision due to infection, they may weaken the cement and thus increase the likelihood of aseptic loosening, perhaps resulting in a higher revision rate. We (1) compared the frequency of early knee revision arthroplasty in patients treated with antibiotic-loaded or non-antibiotic-loaded cement for initial fixation, (2) determined effects of age, sex, comorbidities, and surgeons' antibiotic-loaded cement usage patterns on revision rate, and (3) compared causes of revision (aseptic or septic) between groups. Our study sample was taken from the Canadian Joint Replacement Registry and Canada's Hospital Morbidity Database and included cemented TKAs performed between April 1, 2003, and March 31, 2008, including 20,016 TKAs inserted with non-antibiotic-loaded cement and 16,665 inserted with antibiotic-loaded cement. Chi-square test was used to compare the frequency of early revisions between groups. Cox regression modeling was used to determine whether revision rate would change by age, sex, comorbidities, or use of antibiotic-loaded cement. Similar Cox regression modeling was used to compare cause of revision between groups. Two-year revision rates were similar between the groups treated with non-antibiotic-loaded cement and antibiotic-loaded cement (1.40% versus 1.51%, p = 0.41). When controlling for age, sex, comorbidities, diabetes, and surgeons' antibiotic-loaded cement usage patterns, the revision risk likewise was similar between groups. Revision rates for infection were similar between groups; however, there were more revisions for aseptic loosening in the group treated with non-antibiotic-loaded cement (p = 0.02). The use of antibiotic-loaded cement in TKAs performed for osteoarthritis has no clinically significant effect on reducing revision within 2 years in patients who received perioperative antibiotics. Longer followup and confirmation of these findings with other national registries are warranted.

Effect of Replacing Race with Apolipoprotein L1 Genotype in Calculation of Kidney Donor Risk Index

PubMed Central

Julian, B. A.; Gaston, R. S.; Brown, W. M.; Reeves-Daniel, A. M.; Israni, A. K.; Schladt, D. P.; Pastan, S. O.; Mohan, S.; Freedman, B. I.; Divers, J.

2016-01-01

Renal allografts from deceased African Americans with two apolipoprotein L1 gene (APOL1) renal-risk variants fail sooner than kidneys from donors with fewer variants. Kidney Donor Risk Index (KDRI) was developed to evaluate organ offers by predicting allograft longevity and includes African American race as a risk factor. Substituting APOL1 genotype for race may refine the KDRI. For 622 deceased African American kidney donors, we applied 10-fold cross-validation approach to estimate contribution of APOL1 variants to a revised KDRI. Cross-validation was repeated 10,000 times to generate distribution of effect size associated with APOL1 genotype. Average effect size was used to derive the revised KDRI weighting. Mean current-KDRI score for all donors was 1.4930 versus mean revised-KDRI score 1.2518 for 529 donors with 0/1 variant and 1.8527 for 93 donors with 2 variants. Original and revised KDRIs had comparable survival prediction errors after transplantation, but the spread in Kidney Donor Profile Index based on presence/absence of 2 APOL1 variants was 37 percentage points. Replacing donor race with APOL1 genotype in KDRI better defines risk associated with kidneys transplanted from deceased African American donors, substantially improves KDRI score for 85-90% of kidneys offered, and enhances the link between donor quality and recipient need. PMID:27862962

Cross-validating a bidimensional mathematics anxiety scale.

PubMed

Haiyan Bai

2011-03-01

The psychometric properties of a 14-item bidimensional Mathematics Anxiety Scale-Revised (MAS-R) were empirically cross-validated with two independent samples consisting of 647 secondary school students. An exploratory factor analysis on the scale yielded strong construct validity with a clear two-factor structure. The results from a confirmatory factor analysis indicated an excellent model-fit (χ(2) = 98.32, df = 62; normed fit index = .92, comparative fit index = .97; root mean square error of approximation = .04). The internal consistency (.85), test-retest reliability (.71), interfactor correlation (.26, p < .001), and positive discrimination power indicated that MAS-R is a psychometrically reliable and valid instrument for measuring mathematics anxiety. Math anxiety, as measured by MAS-R, correlated negatively with student achievement scores (r = -.38), suggesting that MAS-R may be a useful tool for classroom teachers and other educational personnel tasked with identifying students at risk of reduced math achievement because of anxiety.

Part 2: pressure ulcer assessment: implementation and revision of CALCULATE.

PubMed

Richardson, Annette; Straughan, Christine

2015-11-01

Critically ill patients are a vulnerable group at very high risk of developing pressure ulcers, and the incidence varies within critical care. A number of strategies were used to implement the pressure ulcer assessment tool CALCULATE across four adult critical care units. Strategies included, nursing leadership, the provision of definitions for each risk factor, information laid out on posters at each patient's bedside, changes to pre-printed nursing documentation and a 30-min focused training package. Two local audits were conducted to measure the number and types of risk factors occurring in patients with pressure ulcers, and to assess the frequency of assessments and gain feedback on the usability of the tool in practice. Critical care acquired pressure ulcer incidence was 3.4%. The two most commonly occurring risk factors were impaired circulation (82%) and mechanical ventilation (75%). Patients had a mean score of 4, and 65% had 4 or more reported risk factors. Feedback on the usability of the tool was mainly positive. The tool CALCULATE was relatively straightforward to implement and was likely to be due to the design and the various change strategies used to implement the new approach. The seven point tool was revised to an eight point score based on nurses' clinical feedback. Research is required to further enhance and develop pressure ulcer assessment. Meanwhile CALCULATE offers an easy to use and appropriate tool to assist in the identification of patients at an elevated risk of pressure ulcer damage. Careful choice of change management strategies are needed when implementing a new assessment tool. CALCULATE should be considered for use in critical care for pressure ulcer assessment, but used alongside nurses' clinical judgement and observations of skin. © 2015 British Association of Critical Care Nurses.

Digital subtraction angiography during transjugular intrahepatic portosystemic shunt creation or revision: data on radiation exposure and image quality obtained using a standard and a low-dose acquisition protocol in a flat-panel detector-based system.

PubMed

Miraglia, Roberto; Maruzzelli, Luigi; Cortis, Kelvin; Tafaro, Corrado; Gerasia, Roberta; Parisi, Carmelo; Luca, Angelo

2015-08-01

To determine whether the use of a low-dose acquisition protocol (LDP) in digital subtraction angiography during transjugular intrahepatic portosystemic shunt (TIPS) creation/revision results in significant reduction of patient radiation exposure and adequate image quality, as compared to a default reference standard-dose acquisition protocol (SDP). Two angiographic runs were performed during TIPS creation/revision: the first following catheterization of the portal venous system and the second after stent deployment/angioplasty. Constant field of view, object to image-detector distance, and source to image-receptor distance were maintained in each patient during the two angiographic runs. 17 consecutive adult patients who underwent TIPS creation (n = 11) or TIPS revision (n = 6) from December 2013 to March 2014 were considered eligible for this single centre prospective study. In each patient, the LDP and the SDP were used in a random order for the two runs, with each patient serving as his/her own control. The dose-area product (DAP) was calculated for each image and compared. Image quality was graded by two interventional radiologists other than the operator. In all runs acquired with the LDP, image quality was considered adequate for a successful procedural outcome. The DAP per image of the LDP was numerically inferior as compared to the DAP per image of the SDP in all patients. The mean reduction in DAP per image was 75.24% ± 5.7% (p < 0. 001). Radiation exposure during TIPS creation/revision was significantly reduced by selecting a LDP in our flat-panel detector-based system, while maintaining adequate image quality.

Validation of a global scale to assess the quality of interprofessional teamwork in mental health settings.

PubMed

Tomizawa, Ryoko; Yamano, Mayumi; Osako, Mitue; Hirabayashi, Naotugu; Oshima, Nobuo; Sigeta, Masahiro; Reeves, Scott

2017-12-01

Few scales currently exist to assess the quality of interprofessional teamwork through team members' perceptions of working together in mental health settings. The purpose of this study was to revise and validate an interprofessional scale to assess the quality of teamwork in inpatient psychiatric units and to use it multi-nationally. A literature review was undertaken to identify evaluative teamwork tools and develop an additional 12 items to ensure a broad global focus. Focus group discussions considered adaptation to different care systems using subjective judgements from 11 participants in a pre-test of items. Data quality, construct validity, reproducibility, and internal consistency were investigated in the survey using an international comparative design. Exploratory factor analysis yielded five factors with 21 items: 'patient/community centred care', 'collaborative communication', 'interprofessional conflict', 'role clarification', and 'environment'. High overall internal consistency, reproducibility, adequate face validity, and reasonable construct validity were shown in the USA and Japan. The revised Collaborative Practice Assessment Tool (CPAT) is a valid measure to assess the quality of interprofessional teamwork in psychiatry and identifies the best strategies to improve team performance. Furthermore, the revised scale will generate more rigorous evidence for collaborative practice in psychiatry internationally.

Epistemic beliefs of non-STEM majors regarding the nature of science: Where they are and what we can do

NASA Astrophysics Data System (ADS)

Willoughby, Shannon D.; Johnson, Keith

2017-06-01

Students enrolled in introductory astronomy at a mid-sized land grant institution were surveyed at the start and end of each semester for three years regarding their epistemic beliefs about the physical sciences. After collecting data for two years in the control (baseline) course, the course was revised to include regular discussions of the nature of science, practice identifying pseudoscientific claims, and practice with metacognition. Survey data on epistemic beliefs were collected for one more academic year after the course was revised. This work details how the course was structured during the baseline and revised portions of the study. Data from both portions of the study are analyzed as a whole as well as broken down by gender. Negative trends seen in the baseline data are mostly eradicated in the revised portion of the course. The data analysis motivates a discussion of why including content regarding the nature of science should be integrated in classes geared toward non-science majors.

Factor structure of the Bulimia Test--Revised in college women from four ethnic groups.

PubMed

Fernandez, Senaida; Malcarne, Vanessa L; Malacrne, Vanessa L; Wilfley, Denise E; McQuaid, John

2006-07-01

The factor structure of the Bulimia Test--Revised (BULIT-R) was investigated using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). The sample consisted of 2,671 female college students (African American, Asian American, Caucasian American, and Latino American). Reliability coefficients were excellent across groups. African Americans scored significantly lower on the BULIT-R than Caucasian Americans. Across groups, CFA and EFA results suggest a six-factor solution is most appropriate. Consistent across groups were factors representing bingeing, body image, purging, and extreme weight loss behaviors, while few differences were observed across groups. These findings suggest that the measure is reliable and valid for use with diverse ethnic groups. Future research should focus on culturally salient psychological correlates of disordered eating in diverse ethnic groups.

Analysis of intraoperative difficulties and management of operative complications in revision anterior exposure of the lumbar spine: a report of 25 consecutive cases.

PubMed

Flouzat-Lachaniette, Charles-Henri; Delblond, William; Poignard, Alexandre; Allain, Jérôme

2013-04-01

After a first anterior approach to the lumbar spine, formation of adhesions of soft tissues to the spine increases the surgical difficulties and potential for iatrogenic injury during the revision exposure. The objective of this study was to identify the intraoperative difficulties and postoperative complications associated with revision anterior lumbar spine procedures in a single institution. This is a retrospective review of 25 consecutive anterior revision lumbar surgeries in 22 patients (7 men and 15 women) operated on between 1998 and 2011. Patients with trauma or malignancies were excluded. The mean age of the patients at the time of revision surgery was 56 years (range 20-80 years). The complications were analyzed depending on the operative level and the time between the index surgery and the revision. Six major complications (five intraoperatively and one postoperatively) occurred in five patients (20 %): three vein lacerations (12 %) and two ureteral injuries (8 %), despite the presence of a double-J ureteral stent. The three vein damages were repaired or ligated by a vascular surgeon. One of the two ureteral injuries led to a secondary nephrectomy after end-to-end anastomosis failure; the other necessitated secondary laparotomy for small bowel obstruction. Anterior revision of the lumbar spine is technically challenging and is associated with a high rate of vascular or urologic complications. Therefore, the potential complications of the procedure must be weighted against its benefits. When iterative anterior lumbar approach is mandatory, exposure should be performed by an access surgeon in specialized centers that have ready access to vascular and urologic surgeons.

Profile of Students At Risk.

ERIC Educational Resources Information Center

Gastright, Joseph F.

This document analyzes the results of a follow-up study about specific factors that distinguish between students likely to drop out and those who stay in school and graduate. The dropout interview form, which was administered to dropouts in the original study, was revised and administered by counselors to 180 seniors who were in the lower four…

A Framework for Studying Minority Youths' Transitions to Fatherhood: The Case of Puerto Rican Adolescents

ERIC Educational Resources Information Center

Erkut, Sumru; Szalacha, Laura A.; Coll, Cynthia Garcia

2005-01-01

A theoretical framework is proposed for studying minority young men's involvement with their babies that combines the integrative model of minority youth development and a life course developmental perspective with Lamb's revised four-factor model of father involvement. This framework posits a relationship between demographic and family background…

TREATMENT OF INFECTION AFTER TOTAL KNEE ARTHROPLASTY.

PubMed

Cury, Ricardo de Paula Leite; Cinagawa, Eduardo Hitoshi Tsuge; Camargo, Osmar Pedro Arbix; Honda, Emerson Kiyoshi; Klautau, Giselle Burlamaqui; Salles, Mauro José Costa

2015-01-01

To identify and compare the rate of success of therapeutic modalities applied in surgeries for the treatment of infections associated with total knee arthroplasty (TKA), and to evaluate the functional outcome and pain in different therapeutic modalities by means of quality of life scores. We evaluated all patients who developed periprosthetic infection after TKA for primary or secondary osteoarthritis, in the period from January 1(st), 2008 to December 31(st), 2010. In the study period, 29 patients with TKA had infection, and 12 of these underwent debridement and retention of the prosthesis (D+R), seven received two-stage and six one-stage exchange arthroplasties, and four patients were treated with suppressive antibiotic therapy because they could not undergo another surgical procedure. The D+R, one-stage revision and two-stage revision success rates were 75%, 83.3%, and 100%, respectively. The best results of quality of life (QoL) and function occur in patients undergoing D+R. In contrast, the worst QoL and functional results were obtained in patients treated with two-stage revision arthroplasty. Level of Evidence II, Prognostic Studies - Investigating the Effect of a Patient Characteristic on the Outcome of Disease.

Revision of Fontes & Garnier's model for the initial 14C content of dissolved inorganic carbon used in groundwater dating

USGS Publications Warehouse

Han, Liang-Feng; Plummer, Niel

2013-01-01

The widely applied model for groundwater dating using 14C proposed by Fontes and Garnier (F&G) (Fontes and Garnier, 1979) estimates the initial 14C content in waters from carbonate-rock aquifers affected by isotopic exchange. Usually, the model of F&G is applied in one of two ways: (1) using a single 13C fractionation factor of gaseous CO2 with respect to a solid carbonate mineral, εg/s, regardless of whether the carbon isotopic exchange is controlled by soil CO2 in the unsaturated zone, or by solid carbonate mineral in the saturated zone; or (2) using different fractionation factors if the exchange process is dominated by soil CO2 gas as opposed to solid carbonate mineral (typically calcite). An analysis of the F&G model shows an inadequate conceptualization, resulting in underestimation of the initial 14C values (14C0) for groundwater systems that have undergone isotopic exchange. The degree to which the 14C0 is underestimated increases with the extent of isotopic exchange. Examples show that in extreme cases, the error in calculated adjusted initial 14C values can be more than 20% modern carbon (pmc). A model is derived that revises the mass balance method of F&G by using a modified model conceptualization. The derivation yields a “global” model both for carbon isotopic exchange dominated by gaseous CO2 in the unsaturated zone, and for carbon isotopic exchange dominated by solid carbonate mineral in the saturated zone. However, the revised model requires different parameters for exchange dominated by gaseous CO2 as opposed to exchange dominated by solid carbonate minerals. The revised model for exchange dominated by gaseous CO2 is shown to be identical to the model of Mook (Mook, 1976). For groundwater systems where exchange occurs both in the unsaturated zone and saturated zone, the revised model can still be used; however, 14C0 will be slightly underestimated. Finally, in carbonate systems undergoing complex geochemical reactions, such as oxidation of organic carbon, radiocarbon ages are best estimated by inverse geochemical modeling techniques.

Dynamics of Soil Erosion as Influenced by Watershed Management Practices: A Case Study of the Agula Watershed in the Semi-Arid Highlands of Northern Ethiopia.

PubMed

Fenta, Ayele Almaw; Yasuda, Hiroshi; Shimizu, Katsuyuki; Haregeweyn, Nigussie; Negussie, Aklilu

2016-11-01

Since the past two decades, watershed management practices such as construction of stone bunds and establishment of exclosures have been widely implemented in the semi-arid highlands of northern Ethiopia to curb land degradation by soil erosion. This study assessed changes in soil erosion for the years 1990, 2000 and 2012 as a result of such watershed management practices in Agula watershed using the Revised Universal Soil Loss Equation. The Revised Universal Soil Loss Equation factors were computed in a geographic information system for 30 × 30 m raster layers using spatial data obtained from different sources. The results revealed significant reduction in soil loss rates by about 55 % from about 28 to 12 t ha -1 per year in 1990-2000 and an overall 64 % reduction from 28 to 10 t ha -1 per year in 1990-2012. This change in soil loss is attributed to improvement in surface cover and stone bund practices, which resulted in the decrease in mean C and P-factors, respectively, by about 19 % and 34 % in 1990-2000 and an overall decrease in C-factor by 29 % in 1990-2012. Considerable reductions in soil loss were observed from bare land (89 %), followed by cultivated land (56 %) and shrub land (49 %). Furthermore, the reduction in soil loss was more pronounced in steeper slopes where very steep slope and steep slope classes experienced over 70 % reduction. Validation of soil erosion estimations using field observed points showed an overall accuracy of 69 %, which is fairly satisfactory. This study demonstrated the potential of watershed management efforts to bring remarkable restoration of degraded semi-arid lands that could serve as a basis for sustainable planning of future developments of areas experiencing severe land degradation due to water erosion.

The Impact of a Revised Curriculum on Academic Motivation, Burnout, and Quality of Life Among Medical Students.

PubMed

Lyndon, Mataroria P; Henning, Marcus A; Alyami, Hussain; Krishna, Sanjeev; Yu, Tzu-Chieh; Hill, Andrew G

2017-01-01

The purpose of this study was to determine the impact of a revised curriculum on medical student academic motivation, burnout, and quality of life. This cross-sectional comparative study involved 2 medical school cohorts of second year and fourth year medical students at The University of Auckland: a cohort under a traditional curriculum (n = 437) and a cohort under a revised curriculum (n = 446). Participants completed self-reported questionnaires measuring academic motivation, burnout, and quality of life. Two multivariate analyses of covariance (MANCOVAs) were conducted. The response rate was 48%. No statistically significant differences were found between curriculum cohorts for mean scores of academic motivation, personal burnout, and quality of life. However, differences were found when comparing preclinical medical students and students in their clinical years of training. In comparison with Year 2 medical students, the MANCOVA for Year 4 students showed a significant main effect for the revised curriculum with respect to both physical and environmental quality of life. A revised medical curriculum had a differential effect on quality of life for Year 4 students in the latter years of medical school who are based in a clinical learning environment.

Do Changes in the Production Process Affect the Outcome of Ceramic Liners: A 3-Year Follow-Up Study.

PubMed

Schmidt-Braekling, Tom; Renner, Lisa; Mintz, Douglas N; Waldstein, Wenzel; Endo, Yoshimi; Boettner, Friedrich

2017-04-01

In 2011, the current liner was withdrawn from the market because of the potential risk for liner fracture secondary to increased pressures used to assemble the metal locking ring. The present study provides a short-term follow-up of patients with this implant. We retrospectively evaluated 63 consecutive hips in 53 patients operated by a single surgeon using a recalled ceramic-on-ceramic bearing. There were 30 women and 23 men with an average age of 50.6 years (range 20.3-63.5 years). The mean follow-up was 36.8 months. Six hips in 6 patients were revised (9.5%) because of a liner-fracture during the follow-up period. All liner fractures were identified on computer tomography imaging. Nine patients had self-reported episodes of squeaking (14.3%). All 6 patients that underwent revision surgery for liner fracture described squeaking before revision. There were no revisions for other causes. Two of the revised patients had a subsequent dislocation (33%). The recalled ceramic liner lots have an increased liner fracture rate. Patients with mechanical symptoms or squeaking should undergo computer tomography to rule out liner facture. Copyright © 2016 Elsevier Inc. All rights reserved.

Non-Adherence in Patients on Peritoneal Dialysis: A Systematic Review

PubMed Central

Griva, Konstadina; Lai, Alden Yuanhong; Lim, Haikel Asyraf; Yu, Zhenli; Foo, Marjorie Wai Yin; Newman, Stanton P.

2014-01-01

Background It has been increasingly recognized that non-adherence is an important factor that determines the outcome of peritoneal dialysis (PD) therapy. There is therefore a need to establish the levels of non-adherence to different aspects of the PD regimen (dialysis procedures, medications, and dietary/fluid restrictions). Methods A systematic review of peer-reviewed literature was performed in PubMed, PsycINFO and CINAHL databases using PRISMA guidelines in May 2013. Publications on non-adherence in PD were selected by two reviewers independently according to predefined inclusion and exclusion criteria. Relevant data on patient characteristics, measures, rates and factors associated with non-adherence were extracted. The quality of studies was also evaluated independently by two reviewers according to a revised version of the Effective Public Health Practice Project assessment tool. Results The search retrieved 204 studies, of which a total of 25 studies met inclusion criteria. Reported rates of non-adherence varied across studies: 2.6–53% for dialysis exchanges, 3.9–85% for medication, and 14.4–67% for diet/fluid restrictions. Methodological differences in measurement and definition of non-adherence underlie the observed variation. Factors associated with non-adherence that showed a degree of consistency were mostly socio-demographical, such as age, employment status, ethnicity, sex, and time period on PD treatment. Conclusion Non-adherence to different dimensions of the dialysis regimen appears to be prevalent in PD patients. There is a need for further, high-quality research to explore these factors in more detail, with the aim of informing intervention designs to facilitate adherence in this patient population. PMID:24586478

Non-adherence in patients on peritoneal dialysis: a systematic review.

PubMed

Griva, Konstadina; Lai, Alden Yuanhong; Lim, Haikel Asyraf; Yu, Zhenli; Foo, Marjorie Wai Yin; Newman, Stanton P

2014-01-01

It has been increasingly recognized that non-adherence is an important factor that determines the outcome of peritoneal dialysis (PD) therapy. There is therefore a need to establish the levels of non-adherence to different aspects of the PD regimen (dialysis procedures, medications, and dietary/fluid restrictions). A systematic review of peer-reviewed literature was performed in PubMed, PsycINFO and CINAHL databases using PRISMA guidelines in May 2013. Publications on non-adherence in PD were selected by two reviewers independently according to predefined inclusion and exclusion criteria. Relevant data on patient characteristics, measures, rates and factors associated with non-adherence were extracted. The quality of studies was also evaluated independently by two reviewers according to a revised version of the Effective Public Health Practice Project assessment tool. The search retrieved 204 studies, of which a total of 25 studies met inclusion criteria. Reported rates of non-adherence varied across studies: 2.6-53% for dialysis exchanges, 3.9-85% for medication, and 14.4-67% for diet/fluid restrictions. Methodological differences in measurement and definition of non-adherence underlie the observed variation. Factors associated with non-adherence that showed a degree of consistency were mostly socio-demographical, such as age, employment status, ethnicity, sex, and time period on PD treatment. Non-adherence to different dimensions of the dialysis regimen appears to be prevalent in PD patients. There is a need for further, high-quality research to explore these factors in more detail, with the aim of informing intervention designs to facilitate adherence in this patient population.

Independent predictors of failure up to 7.5 years after 35 386 single-brand cementless total hip replacements: a retrospective cohort study using National Joint Registry data.

PubMed

Jameson, S S; Baker, P N; Mason, J; Rymaszewska, M; Gregg, P J; Deehan, D J; Reed, M R

2013-06-01

The popularity of cementless total hip replacement (THR) has surpassed cemented THR in England and Wales. This retrospective cohort study records survival time to revision following primary cementless THR with the most common combination (accounting for almost a third of all cementless THRs), and explores risk factors independently associated with failure, using data from the National Joint Registry for England and Wales. Patients with osteoarthritis who had a DePuy Corail/Pinnacle THR implanted between the establishment of the registry in 2003 and 31 December 2010 were included within analyses. There were 35 386 procedures. Cox proportional hazard models were used to analyse the extent to which the risk of revision was related to patient, surgeon and implant covariates. The overall rate of revision at five years was 2.4% (99% confidence interval 2.02 to 2.79). In the final adjusted model, we found that the risk of revision was significantly higher in patients receiving metal-on-metal (MoM: hazard ratio (HR) 1.93, p < 0.001) and ceramic-on-ceramic bearings (CoC: HR 1.55, p = 0.003) compared with the best performing bearing (metal-on-polyethylene). The risk of revision was also greater for smaller femoral stems (sizes 8 to 10: HR 1.82, p < 0.001) compared with mid-range sizes. In a secondary analysis of only patients where body mass index (BMI) data were available (n = 17 166), BMI ≥ 30 kg/m(2) significantly increased the risk of revision (HR 1.55, p = 0.002). The influence of the bearing on the risk of revision remained significant (MoM: HR 2.19, p < 0.001; CoC: HR 2.09, p = 0.001). The risk of revision was independent of age, gender, head size and offset, shell, liner and stem type, and surgeon characteristics. We found significant differences in failure between bearing surfaces and femoral stem size after adjustment for a range of covariates in a large cohort of single-brand cementless THRs. In this study of procedures performed since 2003, hard bearings had significantly higher rates of revision, but we found no evidence that head size had an effect. Patient characteristics, such as BMI and American Society of Anesthesiologists grade, also influence the survival of cementless components.

The Wechsler Memory Scale: A Review of Research.

ERIC Educational Resources Information Center

Ivison, David

1990-01-01

Research on the standardization, reliability, validity, factor structure, and subtests of the Wechsler Memory Scale (WMS) (1945) and its revised version (1987) is reviewed. Much research relating to the WMS appears to be relevant to the revised version. Use of the instrument in Australia is discussed. (SLD)

Young adult e-cigarette use outcome expectancies: Validity of a revised scale and a short scale.

PubMed

Pokhrel, Pallav; Lam, Tony H; Pagano, Ian; Kawamoto, Crissy T; Herzog, Thaddeus A

2018-03-01

The revised youth e-cigarette outcome expectancies measure adds new items informed by recent qualitative research with young adult e-cigarette users, especially in the domain of positive "smoking" experience. Positive "smoking" experience represents beliefs that use of e-cigarettes provides outcomes associated with a better "smoking" alternative: for example, an alternative that is more socially approved, more suitable for indoor use, and that provides a safer means of enjoying nicotine. In addition, we tested a short, 8-item version of the measure which may be more easily incorporated into surveys. We tested the validity of the revised measure, both long and short versions, in terms of factor structure and associations of the expectancy factors with current e-cigarette use, e-cigarette use susceptibility, and e-cigarette use dependence. Participants were young adults (N=470; 65% women; mean age=20.9, SD=2.1). Results replicated the findings of the previous study as well as highlighted the importance of the added domain of positive "smoking" experience and the validity of the short scale. Furthermore, results showed that positive outcome expectancies are strongly associated with e-cigarette use dependence. The long and short versions of the revised youth e-cigarette outcome expectancies scale appear to be valid and useful for application not only among cigarette smokers and e-cigarette users but also among never smokers and never e-cigarette users. Copyright © 2017 Elsevier Ltd. All rights reserved.

Revision of the APGEMS Dose Conversion Factor File Using Revised Factors from Federal Guidance Report 12 and 13.

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

Hay, Tristan R.; Rishel, Jeremy P.

2013-09-30

The Air Pollutant Graphical Environmental Monitoring System (APGEMS) is used by the Hanford Emergency Operation Center (EOC) to provide refined plume modeling of releases involving radionuclides. The dose conversion factors (DCFs) used by APGEMS to convert air concentration to dose are stored in a file called HUDUFACT.dat; the DCFs are based primarily on ICRP 30 compiled in the late 1980’s. This report updates the DCFs using more recent values reported in the Environmental Protection Agencies (EPAs) Federal Guidance Report (FGR) 12 and 13. FGR 12 provides external exposure (air submersion) DCFs for radionuclides in air; FGR 13 provides DCFs formore » radionuclides from inhalation. DCFs were updated for only those radionuclides listed in the original HUDUFACT.dat file. Since FGR 13 provides inhalation dose conversion factors as a function of age, revised DCF files were created for APGEMS for each age group. The “adult” DCF file is the most relevant to compare to the original DCF file being used in APGEMS; these DCF values are compared in this report.« less

Factors informing fear of reinjury after anterior cruciate ligament reconstruction.

PubMed

Ross, Cheryl A; Clifford, Amanda; Louw, Quinette A

2017-02-01

Fear of reinjury is associated with cessation of sport after anterior cruciate ligament (ACL) reconstruction despite normal postoperative knee function. The objective of this study is to describe factors informing athletes' experience of fear of reinjury post ACL reconstruction, in athletes who cited fear as the sole reason for not returning to their pre-injury level of sport. Mixed-methods study design of qualitative and a preliminary quantitative component. A conveniently selected private hospital. Ten male and two female athletes, aged between 19 and 45 years, were eligible for the interview from 68 male and 32 female potential participants (age range 17-50) who underwent an ACL reconstruction using any graft type, excluding revision or multi-ligament surgery. To explore factors informing fear of reinjury in participants citing fear of reinjury as the sole reason for not returning to sport, albeit normal knee function. From the participant interview, four themes emerged: undergoing the surgery and recovery again, nature of the pre-injury sport imposing risk of reinjury, personality traits, and social priorities. Clinicians should be aware of factors informing fear of reinjury post ACL reconstruction. Modifiable fears including pain, mode and length of rehabilitation and psychological factors should be considered during rehabilitation to potentially improve the return to sport rate.

Prehospital Acute ST-Elevation Myocardial Infarction Identification in San Diego: A Retrospective Analysis of the Effect of a New Software Algorithm.

PubMed

Coffey, Christanne; Serra, John; Goebel, Mat; Espinoza, Sarah; Castillo, Edward; Dunford, James

2018-05-03

A significant increase in false positive ST-elevation myocardial infarction (STEMI) electrocardiogram interpretations was noted after replacement of all of the City of San Diego's 110 monitor-defibrillator units with a new brand. These concerns were brought to the manufacturer and a revised interpretive algorithm was implemented. This study evaluated the effects of a revised interpretation algorithm to identify STEMI when used by San Diego paramedics. Data were reviewed 6 months before and 6 months after the introduction of a revised interpretation algorithm. True-positive and false-positive interpretations were identified. Factors contributing to an incorrect interpretation were assessed and patient demographics were collected. A total of 372 (234 preimplementation, 138 postimplementation) cases met inclusion criteria. There was a significant reduction in false positive STEMI (150 preimplementation, 40 postimplementation; p < 0.001) after implementation. The most common factors resulting in false positive before implementation were right bundle branch block, left bundle branch block, and atrial fibrillation. The new algorithm corrected for these misinterpretations with most postimplementation false positives attributed to benign early repolarization and poor data quality. Subsequent follow-up at 10 months showed maintenance of the observed reduction in false positives. This study shows that introducing a revised 12-lead interpretive algorithm resulted in a significant reduction in the number of false positive STEMI electrocardiogram interpretations in a large urban emergency medical services system. Rigorous testing and standardization of new interpretative software is recommended before introduction into a clinical setting to prevent issues resulting from inappropriate cardiac catheterization laboratory activations. Copyright © 2018 Elsevier Inc. All rights reserved.

Matters of conscience and conscientiousness: the place of ego development in the Five-factor model.

PubMed

Kurtz, John E; Tiegreen, Sara B

2005-12-01

The Five-factor model (FFM; Digman, 1990; Goldberg, 1990) and Loevinger's (1994) theory of ego development are two active research traditions that are often construed as incompatible approaches to the study of personality. For example, each theory proposes a different view of the concept of conscientiousness. Loevinger argued that FFM conscientiousness, which emphasizes attributes such as order, self-discipline, and achievement striving, lacks a moral component and is more similar to the conformist stage in her theory. To investigate these claims, we administered the Revised NEO-Personality Inventory (NEO-PI-R; Costa & McCrae, 1992) and the Washington University Sentence Completion Test (WUSCT; Hy & Loevinger, 1996) to 120 university students on 2 separate occasions. Together, the five traits of the FFM significantly predicted item sum scores from the WUSCT (multiple R = .54). Unique linear relationships of Openness to Experience and Agreeableness with ego level demonstrated that the two theories proposed similar constructs. We argue that these two FFM dimensions have conceptual relevance to the cognitive and interpersonal aspects of the ego development construct. We draw further connections between these FFM dimensions, ego development, and human values.

Retrospective cohort study of the performance of the Pinnacle metal on metal (MoM) total hip replacement: a single-centre investigation in combination with the findings of a national retrieval centre

PubMed Central

Langton, David John; Sidaginamale, Raghavendra Prasad; Avery, Peter; Waller, Sue; Tank, Ghanshyabhai; Lord, James; Joyce, Thomas; Cooke, Nick; Logishetty, Raj; Nargol, Antoni Viraf Francis

2016-01-01

Objectives To determine risk factors for revision in patients implanted with a commonly used metal on metal (MoM) hip replacement. Design Retrospective cohort study in combination with a prospective national retrieval study (Northern Retrieval Registry (NRR)). Setting Combined orthopaedic unit in combination with the NRR. Participants All patients implanted with a DePuy Pinnacle MoM hip prostheses by the 2 senior authors were invited to attend for a review which included clinical examination, blood metal ion measurements, radiographs and targeted imaging. Explanted components underwent wear analysis using validated methodology and these results were compared with those obtained from the NRR. Results 489 MoM Pinnacle hips were implanted into 434 patients (243 females and 191 males). Of these, 352 patients attended the MoM recall clinics. 64 patients had died during the study period. For the purposes of survival analysis, non-attendees were assumed to have well-functioning prostheses. The mean follow-up of the cohort as a whole was 89 months. 71 hips were revised. Prosthetic survival for the whole cohort was 83.6% (79.9–87.3) at 9 years. The majority of explanted devices exhibited signs of taper junction failure. Risk factors for revision were bilateral MoM prostheses, smaller Pinnacle liners, and implantation in 2006 and later years. A significant number of devices were found to be manufactured out of their specifications. This was confirmed with analysis of the wider data set from the NRR. Conclusions This device was found to have an unacceptably high revision rate. Bilateral prostheses, those implanted into female patients and devices implanted in later years were found to be at greater risk. A significant number of explanted components were found to be manufactured with bearing diameters outside of the manufacturer's stated tolerances. Our findings highlight the clinical importance of hitherto unrecognised variations in device production. PMID:27130159

Revised Study Design for Final Phase of the Change Agent Study. Study of Change Agent Programs: A Working Note.

ERIC Educational Resources Information Center

Bass, G.; And Others

The Rand change agent study was designed to determine the factors for successful implementation and continuation of selected federal programs--the Elementary and Secondary Education Act, Title III, Innovation Projects; ESEA Title VII, Bilingual Projects; Vocational Education Part D, Exemplary Programs; and the Right-to-Read program. This report…

Psychometric Properties of a Russian Version of the Cognitive Flexibility Inventory (CFI-R).

PubMed

Kurginyan, Sergey S; Osavolyuk, Ekaterina Y

2018-01-01

The Cognitive Flexibility Inventory (CFI) is a brief self-report measure of the type of cognitive flexibility (CF) necessary to successfully challenge and restructure maladaptive beliefs with more balanced and adaptive thinking; it is particularly popular for use with English speakers. The CFI has recently been translated into five languages (Chinese, Japanese, Iranian, Turkish, and Russian), although estimates of reliability and validity of these translated versions are scarce. This study reports on the factor structure, internal consistency, reliability, and construct validity of the CFI. We adopted the CFI for a Russian-speaking population, using student sample of 445 first and second-year undergraduates ( M = 18.59 years, SD = 1.19) and found that a two-factor model fitted the data well. However, the structure of the CFI was revised because of some modifications, which were made to the original English to match the Russian equivalents of items originally developed to assess the definite aspect of cognitive flexibility. The CFI-R showed good internal consistency and suitable 7-week test-retest reliability. The construct validity of the Russian version of the CFI was studied by computing correlations with other related measures of CF (Attributional Style Questionnaire), depressive symptoms (Beck Depression Inventory), coping (Ways of Coping (Revised), and rigidity (Tomsk Rigidity Questionnaire). Furthermore, to assess whether the construct validity were affected by psychopathology we examined results for non-clinical and clinical samples, using "known-groups" method. The clinical sample reported lower CF than did the non-clinical sample on the CFI-R's total score and its subscales' scores. Findings in the present study suggest that the psychometric properties of the Russian CFI are comparable to the English original, making it appropriate to research assessment of the type of CF in Russian speaking population.

New prognostic factors and scoring system for patients with skeletal metastasis.

PubMed

Katagiri, Hirohisa; Okada, Rieko; Takagi, Tatsuya; Takahashi, Mitsuru; Murata, Hideki; Harada, Hideyuki; Nishimura, Tetsuo; Asakura, Hirofumi; Ogawa, Hirofumi

2014-10-01

The aim of this study was to update a previous scoring system for patients with skeletal metastases, that was proposed by Katagiri et al. in 2005, by introducing a new factor (laboratory data) and analyzing a new patient cohort. Between January 2005 and January 2008, we treated 808 patients with symptomatic skeletal metastases. They were prospectively registered regardless of their treatments, and the last follow-up evaluation was performed in 2012. There were 441 male and 367 female patients with a median age of 64 years. Of these patients, 749 were treated nonsurgically while the remaining 59 underwent surgery for skeletal metastasis. A multivariate analysis was conducted using the Cox proportional hazards model. We identified six significant prognostic factors for survival, namely, the primary lesion, visceral or cerebral metastases, abnormal laboratory data, poor performance status, previous chemotherapy, and multiple skeletal metastases. The first three factors had a larger impact than the remaining three. The prognostic score was calculated by adding together all the scores for individual factors. With a prognostic score of ≥7, the survival rate was 27% at 6 months, and only 6% at 1 year. In contrast, patients with a prognostic score of ≤3 had a survival rate of 91% at 1 year, and 78% at 2 years. Comparing the revised system with the previous one, there was a significantly lower number of wrongly predicted patients using the revised system. This revised scoring system was able to predict the survival rates of patients with skeletal metastases more accurately than the previous system and may be useful for selecting an optimal treatment. © 2014 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Speech disruptions in relation to language growth in children who stutter: an exploratory study.

PubMed

Wagovich, Stacy A; Hall, Nancy E; Clifford, Betsy A

2009-12-01

Young children with typical fluency demonstrate a range of disfluencies, or speech disruptions. One type of disruption, revision, appears to increase in frequency as syntactic skills develop. To date, this phenomenon has not been studied in children who stutter (CWS). Rispoli, Hadley, and Holt (2008) suggest a schema for categorizing speech disruptions in terms of revisions and stalls. The purpose of this exploratory study was to use this schema to evaluate whether CWS show a pattern over time in their production of stuttering, revisions, and stalls. Nine CWS, ages 2;1 to 4;11, participated in the study, producing language samples each month for 10 months. MLU and vocd analyses were performed for samples across three time periods. Active declarative sentences within these samples were examined for the presence of disruptions. Results indicated that the proportion of sentences containing revisions increased over time, but proportions for stalls and stuttering did not. Visual inspection revealed that more stuttering and stalls occurred on longer utterances than on shorter utterances. Upon examination of individual children's language, it appears two-thirds of the children showed a pattern in which, as MLU increased, revisions increased as well. Findings are similar to studies of children with typical fluency, suggesting that, despite the fact that CWS display more (and different) disfluencies relative to typically fluent peers, revisions appear to increase over time and correspond to increases in MLU, just as is the case with peers. The reader will be able to: (1) describe the three types of speech disruptions assessed in this article; (2) compare present findings of disruptions in children who stutter to findings of previous research with children who are typically fluent; and (3) discuss future directions in this area of research, given the findings and implications of this study.

[Two-stage revision of infected total knee arthroplasty using antibiotic-impregnated articulating cement spacer].

PubMed

Cai, Pengde; Hu, Yihe; Xie, Lie; Wang, Long

2012-10-01

To investigate the effectiveness of two-stage revision of infected total knee arthroplasty (TKA) using an antibiotic-impregnated articulating cement spacer. The clinical data were analyzed from 23 patients (23 knees) undergoing two-stage revision for late infection after primary TKA between January 2007 and December 2009. There were 15 males and 8 females, aged from 43 to 75 years (mean, 65.2 years). Infection occurred at 13-52 months (mean, 17.3 months) after TKA. The time interval between infection and admission ranged from 15 days to 7 months (mean, 2.1 months). One-stage operation included surgical debridement and removal of all knee prosthesis and cement, then an antibiotic-impregnated articulating cement spacer was implanted. The re-implantation of prosthesis was performed after 8-10 weeks when infections were controlled. The American Hospital for Special Surgery (HSS) score and Knee Society Score (KSS) were used to compare the function of the knee between pre- and post-revision. The rate of infection control and complication were analyzed. All incisions healed primarily. Re-infection occurred in 2 cases after two-stage revision, and infection was controlled in the other 21 cases, with an infection control rate of 91.3%. The patients were followed up 2-5 years (mean, 3.6 years). The HSS score was increased from 60.6 +/- 9.8 at pre-revision to 82.3 +/- 7.4 at last follow-up, the KSS score was increased from 110.7 +/- 9.6 at pre-revision to 134.0 +/- 10.5 at last follow-up, all showing significant differences (P < 0.01). Radiographs showed that prosthesis had good position with no loosening, fracture, or periprosthetic radiolucent. Two-stage revision using an antibiotic-impregnated articulating cement spacer is an effective method to control infected TKA and to restore the function of affected knee.

Revisions of the Learning Mastery Systems for the Harper and Row Grades One and Two and the Macmillan Bank Street Grade One Reading Series.

ERIC Educational Resources Information Center

Maeder, Jacqueline; And Others

The revisions on the Learning Mastery Systems (LMSs) for the Harper & Row grade-one and grade-two and the Macmillan Bank Street grade-one reading programs are outlined in this document. A rationale for the revisions is presented. An LMS is a set of materials and procedures prepared by the southwest Regional Laboratory (SWRL) as an…

Entrance and exit region friction factor models for annular seal analysis. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Elrod, David Alan

1988-01-01

The Mach number definition and boundary conditions in Nelson's nominally-centered, annular gas seal analysis are revised. A method is described for determining the wall shear stress characteristics of an annular gas seal experimentally. Two friction factor models are developed for annular seal analysis; one model is based on flat-plate flow theory; the other uses empirical entrance and exit region friction factors. The friction factor predictions of the models are compared to experimental results. Each friction model is used in an annular gas seal analysis. The seal characteristics predicted by the two seal analyses are compared to experimental results and to the predictions of Nelson's analysis. The comparisons are for smooth-rotor seals with smooth and honeycomb stators. The comparisons show that the analysis which uses empirical entrance and exit region shear stress models predicts the static and stability characteristics of annular gas seals better than the other analyses. The analyses predict direct stiffness poorly.

Comparing two anesthesia information management system user interfaces: a usability evaluation.

PubMed

Wanderer, Jonathan P; Rao, Anoop V; Rothwell, Sarah H; Ehrenfeld, Jesse M

2012-11-01

Anesthesia information management systems (AIMS) have been developed by multiple vendors and are deployed in thousands of operating rooms around the world, yet not much is known about measuring and improving AIMS usability. We developed a methodology for evaluating AIMS usability in a low-fidelity simulated clinical environment and used it to compare an existing user interface with a revised version. We hypothesized that the revised user interface would be more useable. In a low-fidelity simulated clinical environment, twenty anesthesia providers documented essential anesthetic information for the start of the case using both an existing and a revised user interface. Participants had not used the revised user interface previously and completed a brief training exercise prior to the study task. All participants completed a workload assessment and a satisfaction survey. All sessions were recorded. Multiple usability metrics were measured. The primary outcome was documentation accuracy. Secondary outcomes were perceived workload, number of documentation steps, number of user interactions, and documentation time. The interfaces were compared and design problems were identified by analyzing recorded sessions and survey results. Use of the revised user interface was shown to improve documentation accuracy from 85.1% to 92.4%, a difference of 7.3% (95% confidence interval [CI] for the difference 1.8 to 12.7). The revised user interface decreased the number of user interactions by 6.5 for intravenous documentation (95% CI 2.9 to 10.1) and by 16.1 for airway documentation (95% CI 11.1 to 21.1). The revised user interface required 3.8 fewer documentation steps (95% CI 2.3 to 5.4). Airway documentation time was reduced by 30.5 seconds with the revised workflow (95% CI 8.5 to 52.4). There were no significant time differences noted in intravenous documentation or in total task time. No difference in perceived workload was found between the user interfaces. Two user interface design problems were identified in the revised user interface. The usability of anesthesia information management systems can be evaluated using a low-fidelity simulated clinical environment. User testing of the revised user interface showed improvement in some usability metrics and highlighted areas for further revision. Vendors of AIMS and those who use them should consider adopting methods to evaluate and improve AIMS usability.

Risk Factors for Infection After Shoulder Arthroscopy in a Large Medicare Population.

PubMed

Cancienne, Jourdan M; Brockmeier, Stephen F; Carson, Eric W; Werner, Brian C

2018-03-01

Shoulder arthroscopy is well established as a highly effective and safe procedure for the treatment for several shoulder disorders and is associated with an exceedingly low risk of infectious complications. Few data exist regarding risk factors for infection after shoulder arthroscopy, as previous studies were not adequately powered to evaluate for infection. To determine patient-related risk factors for infection after shoulder arthroscopy by using a large insurance database. Case-control study; Level of evidence, 3. The PearlDiver patient records database was used to query the 100% Medicare Standard Analytic Files from 2005 to 2014 for patients undergoing shoulder arthroscopy. Patients undergoing shoulder arthroscopy for a diagnosis of infection or with a history of prior infection were excluded. Postoperative infection within 90 days postoperatively was then assessed with International Classification of Diseases, Ninth Revision codes for a diagnosis of postoperative infection or septic shoulder arthritis or a procedure for these indications. A multivariate binomial logistic regression analysis was then utilized to evaluate the use of an intraoperative steroid injection, as well as numerous patient-related risk factors for postoperative infection. Adjusted odds ratios (ORs) and 95% CIs were calculated for each risk factor, with P < .05 considered statistically significant. A total of 530,754 patients met all inclusion and exclusion criteria. There were 1409 infections within 90 days postoperatively (0.26%). Revision shoulder arthroscopy was the most significant risk factor for infection (OR, 3.25; 95% CI, 2.7-4.0; P < .0001). Intraoperative steroid injection was also an independent risk factor for postoperative infection (OR, 1.46; 95% CI, 1.2-1.9; P = .002). There were also numerous independent patient-related risk factors for infection, the most significant of which were chronic anemia (OR, 1.58; 95% CI, 1.4-1.8; P < .0001), malnutrition (OR, 1.42; 95% CI, 1.2-1.7; P = .001), male sex (OR, 2.71; 95% CI, 2.4-3.1; P < .0001), morbid obesity (OR, 1.41; 95% CI, 1.2-1.6; P < .0001), and depression (OR, 1.36; 95% CI, 1.2-1.5; P < .0001). Intraoperative steroid injection was a significant independent risk factor for postoperative infection after shoulder arthroscopy. There were also numerous significant patient-related risk factors for postoperative infection, including revision surgery, obesity, male sex, chronic anemia, malnutrition, depression, and alcohol use, among others.