WorldWideScience

Sample records for account outcome measurements

  1. Network meta-analysis of multiple outcome measures accounting for borrowing of information across outcomes.

    Science.gov (United States)

    Achana, Felix A; Cooper, Nicola J; Bujkiewicz, Sylwia; Hubbard, Stephanie J; Kendrick, Denise; Jones, David R; Sutton, Alex J

    2014-07-21

    Network meta-analysis (NMA) enables simultaneous comparison of multiple treatments while preserving randomisation. When summarising evidence to inform an economic evaluation, it is important that the analysis accurately reflects the dependency structure within the data, as correlations between outcomes may have implication for estimating the net benefit associated with treatment. A multivariate NMA offers a framework for evaluating multiple treatments across multiple outcome measures while accounting for the correlation structure between outcomes. The standard NMA model is extended to multiple outcome settings in two stages. In the first stage, information is borrowed across outcomes as well across studies through modelling the within-study and between-study correlation structure. In the second stage, we make use of the additional assumption that intervention effects are exchangeable between outcomes to predict effect estimates for all outcomes, including effect estimates on outcomes where evidence is either sparse or the treatment had not been considered by any one of the studies included in the analysis. We apply the methods to binary outcome data from a systematic review evaluating the effectiveness of nine home safety interventions on uptake of three poisoning prevention practices (safe storage of medicines, safe storage of other household products, and possession of poison centre control telephone number) in households with children. Analyses are conducted in WinBUGS using Markov Chain Monte Carlo (MCMC) simulations. Univariate and the first stage multivariate models produced broadly similar point estimates of intervention effects but the uncertainty around the multivariate estimates varied depending on the prior distribution specified for the between-study covariance structure. The second stage multivariate analyses produced more precise effect estimates while enabling intervention effects to be predicted for all outcomes, including intervention effects on

  2. Spatial cluster detection for repeatedly measured outcomes while accounting for residential history.

    Science.gov (United States)

    Cook, Andrea J; Gold, Diane R; Li, Yi

    2009-10-01

    Spatial cluster detection has become an important methodology in quantifying the effect of hazardous exposures. Previous methods have focused on cross-sectional outcomes that are binary or continuous. There are virtually no spatial cluster detection methods proposed for longitudinal outcomes. This paper proposes a new spatial cluster detection method for repeated outcomes using cumulative geographic residuals. A major advantage of this method is its ability to readily incorporate information on study participants relocation, which most cluster detection statistics cannot. Application of these methods will be illustrated by the Home Allergens and Asthma prospective cohort study analyzing the relationship between environmental exposures and repeated measured outcome, occurrence of wheeze in the last 6 months, while taking into account mobile locations.

  3. Distance Education in a Cost Accounting Course: Instruction, Interaction, and Multiple Measures of Learning Outcomes

    Science.gov (United States)

    Chen, Clement C.; Jones, Keith T.; Moreland, Keith

    2010-01-01

    Students in online and traditional classroom sections of an intermediate-level cost accounting course responded to a survey about their experiences in the course. Specifically, several items related to the instruction and learning outcomes were addressed. Additionally, student examination performance in the two types of sections was compared. The…

  4. Spatial Cluster Detection for Repeatedly Measured Outcomes while Accounting for Residential History

    OpenAIRE

    Cook, Andrea J.; Gold, Diane R.; Li, Yi

    2009-01-01

    Spatial cluster detection has become an important methodology in quantifying the effect of hazardous exposures. Previous methods have focused on cross-sectional outcomes that are binary or continuous. There are virtually no spatial cluster detection methods proposed for longitudinal outcomes. This paper proposes a new spatial cluster detection method for repeated outcomes using cumulative geographic residuals. A major advantage of this method is its ability to readily incorporate information ...

  5. Evaluation of accountability measurements

    International Nuclear Information System (INIS)

    Cacic, C.G.

    1988-01-01

    The New Brunswick Laboratory (NBL) is programmatically responsible to the U.S. Department of Energy (DOE) Office of Safeguards and Security (OSS) for providing independent review and evaluation of accountability measurement technology in DOE nuclear facilities. This function is addressed in part through the NBL Safegaurds Measurement Evaluation (SME) Program. The SME Program utilizes both on-site review of measurement methods along with material-specific measurement evaluation studies to provide information concerning the adequacy of subject accountability measurements. This paper reviews SME Program activities for the 1986-87 time period, with emphasis on noted improvements in measurement capabilities. Continued evolution of the SME Program to respond to changing safeguards concerns is discussed

  6. FINANCIAL OUTCOME BETWEEN ACCOUNTING AND FISCALITY

    Directory of Open Access Journals (Sweden)

    Florentina Moisescu

    2015-05-01

    Full Text Available The tax result does not reflect the real financial performance of a company but rather shows a result of taxation which is to determine the size of tax for a company. Therefore, in Romanian accounting there are a lot of different ways which are used to obtain an `embellished` accounting result due to a large variety of accounting policies and methods which allows the company to choose the desired outcome. In our county, the main goal of an enterprise seems to be either the decrease of the financial result in order to avoid payment of a bigger tax to the state tax authority or the postponement of it, while companies from other countries want a financial result as big as possible so that they can attract investors.

  7. Education Funding and Student Outcomes: A Conceptual Framework for Measurement of the Alignment of State Education Finance and Academic Accountability Policies

    Science.gov (United States)

    Knoeppel, Robert C.; Della Sala, Matthew R.

    2015-01-01

    The conceptualization and measurement of education finance equity and adequacy has engaged researchers for more than three decades. At the same time, calls for increased academic accountability and higher student achievement in K-12 public education have reached new levels at both the national and state levels. Aligning these represents an…

  8. Risks factoring business: accounting measurement

    Directory of Open Access Journals (Sweden)

    Z.V. Gutsaylyuk

    2015-06-01

    Full Text Available The paper carried out the identification of risk factors for the development of possible accounting software management. Studied theoretical and methodological aspects of the risk classification of factoring operations in the part of the risk assessment factors. It is proposed to consider the risks factors as the risk that is acceptable controlled by accounting instruments and the risks that can not be taken into account in the accounting records. To minimize the risk factor, accounting-driven tools, a method of self-insurance, which is a factor in the creation of provision for factoring transactions designed to cover unexpected expenses and losses. Provision for factoring factor will establish more stable conditions of financial activity and avoid the fluctuations of profit factor in relation to the writing off of losses on factoring operatsіyam.Developed proposals allow for further research to improve the organizational and methodological basis of accounting and analysis of information as a basis for providing risk management factor, particularly in terms of improving the evaluation questions such risks and their qualitative and quantitative analysis.

  9. Measurement of Accountability Management of Village Funds

    OpenAIRE

    Yunita, Anggraeni; Christianingrum

    2018-01-01

    The purpose of this study is to measure the accountability of village funds management in Kabupaten Bangka. In relation to the Village Funds program which is a government program, the measurement of accountability of Village Funds management uses accountability principles consisting of Transparency, Liability, Controlling, Responsibility and Responsiveness which are the principles of accountability developed by the United Nations Development Program in measuring bureaucratic accountability. T...

  10. FINANCIAL ACCOUNTING MEASUREMENT: INSTRUMENTATION AND CALIBRATION

    OpenAIRE

    stanley c. w. salvary

    2005-01-01

    In its Conceptual Framework (CF), the Financial Accounting Standards Board (FASB) has not identified the observable phenomena and was not able to identify a single measurement property in financial accounting. While identifying aspects of the observable phenomena in financial accounting, the FASB has indicated that there are five measurement attributes which are used in financial accounting and the result is a mixed-attributes model. Lacking a critical underlying theory, the FASB’s Conceptual...

  11. Measurements in Accounting: Issues and Choices Determinants ...

    African Journals Online (AJOL)

    This paper examines the common measurements in accounting, addressing the issues in general terms, including the circumstances and situations that determine each accounting measurement choice .To drive these issues, references were made to extant literature on common measurement bases and while each ...

  12. 50 CFR 648.323 - Accountability measures.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Accountability measures. 648.323 Section 648.323 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC... Skate Complex Fisheries § 648.323 Accountability measures. (a) TAL overages. If the skate wing fishery...

  13. 50 CFR 622.49 - Accountability measures.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Accountability measures. 622.49 Section 622.49 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC... § 622.49 Accountability measures. (a) Gulf reef fish—(1) Greater amberjack—(i) Commercial fishery. If...

  14. Measuring Learning Outcomes in Auditing Education

    DEFF Research Database (Denmark)

    Holm, Claus; Steenholdt, Niels

    The ability to provide sensible measures for learning outcomes in accounting education is under increased scrutiny. In this paper we use a learner perspective in auditing education, which reflects that some students taking accounting classes also are provided with on-the-job training in accountin...

  15. Educational Testing as an Accountability Measure

    DEFF Research Database (Denmark)

    Ydesen, Christian

    2013-01-01

    analysis of the origins and impacts of test-based accountability measures applying both top-down and bottom-up perspectives. These historical perspectives offer the opportunity to gain a fuller understanding of this contemporary accountability concept and its potential, appeal, and implications...... for continued use in contemporary educational settings. Accountability measures and practices serve as a way to govern schools; by analysing the history of accountability as the concept has been practised in the education sphere, the article will discuss both pros and cons of such a methodology, particularly......This article reveals perspectives based on experiences from twentieth-century Danish educational history by outlining contemporary, test-based accountability regime characteristics and their implications for education policy. The article introduces one such characteristic, followed by an empirical...

  16. Measuring Population Health Outcomes

    OpenAIRE

    Parrish, R. Gibson

    2010-01-01

    An ideal population health outcome metric should reflect a population's dynamic state of physical, mental, and social well-being. Positive health outcomes include being alive; functioning well mentally, physically, and socially; and having a sense of well-being. Negative outcomes include death, loss of function, and lack of well-being. In contrast to these health outcomes, diseases and injuries are intermediate factors that influence the likelihood of achieving a state of health. On the basis...

  17. Measurement control program for nuclear material accounting

    International Nuclear Information System (INIS)

    Brouns, R.J.; Roberts, F.P.; Merrill, J.A.; Brown, W.B.

    1980-06-01

    A measurement control program for nuclear material accounting monitors and controls the quality of the measurments of special nuclear material that are involved in material balances. The quality is monitored by collecting data from which the current precision and accuracy of measurements can be evaluated. The quality is controlled by evaluations, reviews, and other administrative measures for control of selection or design of facilities, equipment and measurement methods and the training and qualification of personnel who perform SNM measurements. This report describes the most important elements of a program by which management can monitor and control measurement quality

  18. Accountability Quality Shuffler Measurements on Pits

    International Nuclear Information System (INIS)

    Rinard, P.M.

    2000-01-01

    Pits have generally been treated as accountable units that are intact if merely present and they are excluded from the more demanding nondestructive assay requirements. As pits begin to flow into disposition streams, there may be more incentive to measure the masses of their fissile components for accountability purposes. This Department of Energy Office of Safeguards and Security (OSS) Lifecycle Project has explored some ways in which such measurements may be done successfully. The active neutron instrument called a shuffler has been used to measure a variety of actual pits, and a calculational technique has been developed to accurately predict such count rates. Passive multiplicity counting has previously been applied to pits for determining their plutonium contents. This combination of measurement and calculational techniques provide powerful and accurate tools for determining the fissile contents of pits with the quality needed for accountability purposes

  19. Could Learning Outcomes of the First Course in Accounting Predict Overall Academic Performance?

    Science.gov (United States)

    Alanzi, Khalid A.; Alfraih, Mishari M.

    2017-01-01

    Purpose: This study aims to question whether learning outcomes of the first course in accounting could predict the overall academic performance of accounting students as measured by their graduating grade point average (GPA). Design/methodology/approach The sample of the present study was drawn from accounting students who were graduated during…

  20. Measuring Learning Outcomes in Auditing Education

    DEFF Research Database (Denmark)

    Holm, Claus; Steenholdt, Niels

    2003-01-01

    The ability to provide sensible measures for learning outcomes in accounting education is under increased scrutiny. In this paper we use a learner perspective in auditing education, which reflects that some students taking accounting classes also are provided with on-the-job training in accounting...... firms. Hence knowledge about learning outcomes for different groups of students is essential information for educators as well as the accounting profession. This paper extends prior research on the role of declarative and procedural knowledge in performing auditing tasks. Measuring learning outcomes......). The study provides evidence, which confirms an interrelationship between declarative and procedural knowledge in auditing, and the findings also suggest that students with auditing experience perform better than students without experience on procedural questions....

  1. Conceptual basis of outcome measures.

    Science.gov (United States)

    Keith, R A

    1995-01-01

    Because of its treatment configuration and the assumption of long-term benefit, rehabilitation has had a continuing interest in the measurement of outcomes. The utility of outcome indicators rests on their conceptual foundations, the technical development of measures and validation research. Some measures, particularly of functional status, have become increasingly sophisticated with the application of psychometric and statistical analysis techniques. Less effort has been devoted to an elaboration of their theoretical basis. A first step is an examination of the assumptions underlying outcome measures, the purpose of this article. Central to an understanding is clarification of definitions of key terms such as outcomes, independence, impairment, disability and handicap. All outcome measures must be seen as part of a social context of norms and expectations. However, most norms in rehabilitation are implied rather than explicit. The assumptions behind several common outcomes are examined with suggestions for ways to increase their utility. The ability of rehabilitation to compete in the current climate, stressing cost-effectiveness, will depend heavily on the robustness of outcome measures.

  2. MEASUREMENT: ACCOUNTING FOR RELIABILITY IN PERFORMANCE ESTIMATES.

    Science.gov (United States)

    Waterman, Brian; Sutter, Robert; Burroughs, Thomas; Dunagan, W Claiborne

    2014-01-01

    When evaluating physician performance measures, physician leaders are faced with the quandary of determining whether departures from expected physician performance measurements represent a true signal or random error. This uncertainty impedes the physician leader's ability and confidence to take appropriate performance improvement actions based on physician performance measurements. Incorporating reliability adjustment into physician performance measurement is a valuable way of reducing the impact of random error in the measurements, such as those caused by small sample sizes. Consequently, the physician executive has more confidence that the results represent true performance and is positioned to make better physician performance improvement decisions. Applying reliability adjustment to physician-level performance data is relatively new. As others have noted previously, it's important to keep in mind that reliability adjustment adds significant complexity to the production, interpretation and utilization of results. Furthermore, the methods explored in this case study only scratch the surface of the range of available Bayesian methods that can be used for reliability adjustment; further study is needed to test and compare these methods in practice and to examine important extensions for handling specialty-specific concerns (e.g., average case volumes, which have been shown to be important in cardiac surgery outcomes). Moreover, it's important to note that the provider group average as a basis for shrinkage is one of several possible choices that could be employed in practice and deserves further exploration in future research. With these caveats, our results demonstrate that incorporating reliability adjustment into physician performance measurements is feasible and can notably reduce the incidence of "real" signals relative to what one would expect to see using more traditional approaches. A physician leader who is interested in catalyzing performance improvement

  3. Outcome measures in inflammatory rheumatic diseases.

    NARCIS (Netherlands)

    Fransen, J.; Riel, P.L.C.M. van

    2009-01-01

    Inflammatory rheumatic diseases are generally multifaceted disorders and, therefore, measurement of multiple outcomes is relevant to most of these diseases. Developments in outcome measures in the rheumatic diseases are promoted by the development of successful treatments. Outcome measurement will

  4. Neighborhood Deprivation and Childhood Asthma Outcomes, Accounting for Insurance Coverage.

    Science.gov (United States)

    Nkoy, Flory L; Stone, Bryan L; Knighton, Andrew J; Fassl, Bernhard A; Johnson, Joseph M; Maloney, Christopher G; Savitz, Lucy A

    2018-01-09

    Collecting social determinants data is challenging. We assigned patients a neighborhood-level social determinant measure, the area of deprivation index (ADI), by using census data. We then assessed the association between neighborhood deprivation and asthma hospitalization outcomes and tested the influence of insurance coverage. A retrospective cohort study of children 2 to 17 years old admitted for asthma at 8 hospitals. An administrative database was used to collect patient data, including hospitalization outcomes and neighborhood deprivation status (ADI scores), which were grouped into quintiles (ADI 1, the least deprived neighborhoods; ADI 5, the most deprived neighborhoods). We used multivariable models, adjusting for covariates, to assess the associations and added a neighborhood deprivation status and insurance coverage interaction term. A total of 2270 children (median age 5 years; 40.6% girls) were admitted for asthma. We noted that higher ADI quintiles were associated with greater length of stay, higher cost, and more asthma readmissions ( P < .05 for most quintiles). Having public insurance was independently associated with greater length of stay (β: 1.171; 95% confidence interval [CI]: 1.117-1.228; P < .001), higher cost (β: 1.147; 95% CI: 1.093-1.203; P < .001), and higher readmission odds (odds ratio: 1.81; 95% CI: 1.46-2.24; P < .001). There was a significant deprivation-insurance effect modification, with public insurance associated with worse outcomes and private insurance with better outcomes across ADI quintiles ( P < .05 for most combinations). Neighborhood-level ADI measure is associated with asthma hospitalization outcomes. However, insurance coverage modifies this relationship and needs to be considered when using the ADI to identify and address health care disparities. Copyright © 2018 by the American Academy of Pediatrics.

  5. Patient reported outcome measures (PROMs)

    DEFF Research Database (Denmark)

    Bech, Per; Austin, Stephen Fitzgerald; Lau, Marianne Engelbrecht

    2018-01-01

    INTRODUCTION: Patient-reported outcome measures (PROMs) for anxiety and depressive disorders are an important aspect of measurement-based care. AIM: The aim of the study was to perform a clinimetric analysis of two PROMs scales in patents with depression and anxiety. METHODS: Patients completed...... recruited from two Danish mental health centers with anxiety or depression. The standardization of the SCL-10 and WHO-5 by T-scores indicated that a T-score of 65 corresponding to being moderately in need of treatment and a T-score of 75 to be severely in need of treatment. The coefficient of alpha...... with anxiety or depression undergoing psychotherapy treatment....

  6. Improving Oncology Quality Measurement in Accountable Care: Filling Gaps with Cross-Cutting Measures.

    Science.gov (United States)

    Valuck, Tom; Blaisdell, David; Dugan, Donna P; Westrich, Kimberly; Dubois, Robert W; Miller, Robert S; McClellan, Mark

    2017-02-01

    Payment for health care services, including oncology services, is shifting from volume-based fee-for-service to value-based accountable care. The objective of accountable care is to support providers with flexibility and resources to reform care delivery, accompanied by accountability for maintaining or improving outcomes while lowering costs. These changes depend on health care payers, systems, physicians, and patients having meaningful measures to assess care delivery and outcomes and to balance financial incentives for lowering costs while providing greater value. Gaps in accountable care measure sets may cause missed signals of problems in care and missed opportunities for improvement. Measures to balance financial incentives may be particularly important for oncology, where high cost and increasingly targeted diagnostics and therapeutics intersect with the highly complex and heterogeneous needs and preferences of cancer patients. Moreover, the concept of value in cancer care, defined as the measure of outcomes achieved per costs incurred, is rarely incorporated into performance measurement. This article analyzes gaps in oncology measures in accountable care, discusses challenging measurement issues, and offers strategies for improving oncology measurement. Discern Health analyzed gaps in accountable care measure sets for 10 cancer conditions that were selected based on incidence and prevalence; impact on cost and mortality; a diverse range of high-cost diagnostic procedures and treatment modalities (e.g., genomic tumor testing, molecularly targeted therapies, and stereotactic radiotherapy); and disparities or performance gaps in patient care. We identified gaps by comparing accountable care set measures with high-priority measurement opportunities derived from practice guidelines developed by the National Comprehensive Cancer Network and other oncology specialty societies. We found significant gaps in accountable care measure sets across all 10 conditions. For

  7. Measuring the safeguards value of material accountability

    International Nuclear Information System (INIS)

    Sicherman, A.

    1988-01-01

    Material accountability (MA) activities focus on providing after-the-fact indication of diversion or theft of special nuclear material (SNM). MA activities include maintaining records for tracking nuclear material and conducting periodic inventories and audits to ensure that loss has not occurred. This paper presents a value model concept for assessing the safeguards benefits of MA activities and for comparing these benefits to those provided by physical protection (PP) and material control (MC) components. The model considers various benefits of MA, which include: 1) providing information to assist in recovery of missing material, 2) providing assurance that physical protection and material control systems have been working, 3) defeating protracted theft attempts, and 4) properly resolving causes of and responding appropriately to anomalies of missing material and external alarms (e.g., hoax). Such a value model can aid decision-makers in allocating safeguards resources among PP, MC, and MA systems

  8. Material Control and Accountability Measurements for FB-Line Processes

    International Nuclear Information System (INIS)

    Casella, V.R.

    2002-01-01

    This report provides an overview of FB-Line processes and nuclear material accountability measurements. Flow diagrams for the product, waste, and packaging and stabilization processes are given along with the accountability measurements done before and after each of these processes. Brief descriptions of these measurements are provided. This information provides a better understanding of the general FB-Line processes and how MC and A measurements are used to keep track of the accountable material inventory

  9. HUMAN HEALTH OUTCOMES AND ACCOUNTABILITY - RISK POLICY REPORT

    Science.gov (United States)

    EPA is identifying human health "outcomes" as part of a significant shift in how the Agency frames questions and assesses its impact on environmental quality. These outcomes, while complementing traditional process indicators such as decreases in emissions, discharges and pollut...

  10. The International Dermatology Outcome Measures Group

    DEFF Research Database (Denmark)

    Gottlieb, Alice B; Levin, Adriane A; Armstrong, April W

    2015-01-01

    As quality standards are increasingly in demand throughout medicine, dermatology needs to establish outcome measures to quantify the effectiveness of treatments and providers. The International Dermatology Outcome Measures Group was established to address this need. Beginning with psoriasis...

  11. Redesigning Systems of School Accountability: A Multiple Measures Approach to Accountability and Support

    Science.gov (United States)

    Bae, Soung

    2018-01-01

    The challenges facing our children in the 21st century are rapidly changing. As a result, schools bear a greater responsibility to prepare students for college, career, and life and must be held accountable for more than just testing and reporting on a narrow set of outcomes aimed at minimum levels of competency. Thus, scholars, educators, and…

  12. [Patient evaluation and outcome measures].

    Science.gov (United States)

    Nieto Pol, Enrique

    2014-01-01

    Both the initial evaluation and follow-up of patients with osteoarthritis require systematic evaluation of the indicators that provide information on the degree of involvement of the disease and allow its quantification. Reliable measures of disease progression help decision-making by clinicians and provide valid information on treatment response and the effectiveness of the distinct therapeutic interventions. The instruments recommended in research, as outcome measures in osteoarthritis, are pain evaluation, assessment of physical function, and self-reported global evaluation. In studies lasting more than 1 year, structural changes are evaluated through simple X-ray. Self-reported quality of life assessment and physician global assessment are also recommended as options. These indicators should be incorporated into routine clinical practice for adequate evaluation and correct follow-up of patients with osteoarthritis. The recommended pain evaluation method for use in clinical practice is the visual analog scale (VAS). The best instrument to evaluate physical function in patients with hip or knee osteoarthritis is the WOMAC scale (Western Ontario and McMaster Universities Osteoarthritis Index). For patient-reported global assessment in routine practice, the recommended scales are VAS or the SF-12 (12-item short-form health survey). Copyright © 2014 Elsevier España, S.L. All rights reserved.

  13. BUSINESS FLUCTUATIONS AND FINANCIAL ACCOUNTING MEASUREMENT: HISTORICAL COMMENTS

    OpenAIRE

    stanley c. w. salvary

    2005-01-01

    This paper addresses a theme in an historical setting that financial accounting measurement contributes to: (1) retardation of national economic growth by the failure of financial accounting to provide for the replacement of capital goods in its measurement process; and (2) the business cycle owing to the illusory profits reported in financial statements. The author explores the issues and concludes that the arguments against accounting are based upon misunderstandings.

  14. Measuring Learning Outcomes. A Learner Perspective in Auditing Education

    DEFF Research Database (Denmark)

    Holm, Claus; Steenholdt, Niels

    2000-01-01

    The ability to provide sensible measures for learning outcomes in accounting education is under increased scrutiny. In this paper we use a learner perspective in auditing education which reflects that some students taking accounting classes also are provided with on-the-job training in accounting...... for students taking a graduate auditing course reflect prior accounting work experience for some students and undergraduate accounting coursework experience for all students. This paper extends prior research on the role of declarative and procedural knowledge in performing auditing tasks. Measuring learning...... suggested by Robert M. Gagné. An instrument was developed to measure differences regarding learning outcomes in the context of an auditing course by posing a broad set of questions testing declarative knowledge and the full range of intellectual skills from discrimination to the use of higher...

  15. HB-Line Material Control and Accountability Measurements at SRS

    International Nuclear Information System (INIS)

    Casella, V.R.

    2003-01-01

    Presently, HB-Line work at the Savannah River Site consists primarily of the stabilization and packaging of nuclear materials for storage and the characterization of materials for disposition in H-Area. In order to ensure compliance with Material Control and Accountability (MC and A) Regulations, accountability measurements are performed throughout the HB-Line processes. Accountability measurements are used to keep track of the nuclear material inventory by constantly updating the amount of material in the MBAs (Material Balance Area) and sub-MBAs. This is done by subtracting the amount of accountable material that is added to a process and by adding the amount of accountable material that is put back in storage. A Physical Inventory is taken and compared to the ''Book Value'' listed in the Nuclear Material Accounting System. The difference (BPID) in the Book Inventory minus the Physical Inventory of a sub-account for bulk material must agree within the measurement errors combined in quadrature to provide assurance that nuclear material is accounted for. This work provides an overview of HB-Line processes and accountability measurements. The Scrap Recovery Line and Neptunium-237/Plutonium-239 Oxide Line are described and sampling and analyses for Phase II are provided. Recommendations for improvements are provided to improve efficiency and cost effectiveness

  16. Hospital Quality Initiative - Outcome Measures

    Data.gov (United States)

    U.S. Department of Health & Human Services — In the interest of promoting high-quality, patient-centered care and accountability, the Centers for Medicare and Medicaid Services (CMS) and Hospital Quality...

  17. Multiple Measures Accountability Systems: A Perspective from Vermont

    Science.gov (United States)

    Fowler, Amy

    2018-01-01

    In response to Bae's (2018) "Redesigning systems of school accountability: A multiple measures approach to accountability and support," this commentary expands on some key considerations for states and school districts as they seek different ways to support school improvement while also addressing the competing demands of educators,…

  18. Measuring Learning Outcomes. A Learner Perspective in Auditing Education

    DEFF Research Database (Denmark)

    Holm, Claus; Steenholdt, Niels

    The ability to provide sensible measures for learning outcomes in accounting education is under increased scrutiny. In this paper we use a learner perspective in auditing education which reflects that some students taking accounting classes also are provided with on-the-job training in accounting...... is part of every day life within most accounting firms. Developing a sound on-the-job training environment is pivotal in the recruitment and design of supervision, and in the end for the expected "successrate" in retaining (valuable) employees. Prior research suggests that scripts or schemas provide...

  19. Accounting in Agriculture: Measurement practices of listed firms

    OpenAIRE

    Rute Gonçalves; Patrícia Lopes

    2015-01-01

    Based on the International Accounting Standard (IAS) 41 – Agriculture, this paper examines measurement practices of biological assets and their drivers, under accounting choice theory, given data from 2012. Taking into consideration 324 listed firms worldwide that have adopted International Financial Reporting Standards (IFRS) until 2011, the empirical evidence supports that while a large number of firms measures biological assets at fair value, there are others that refute the presumption of...

  20. Historical Costs versus Fair Value Measurement in Financial Accounting

    OpenAIRE

    Dvořáková, Dana

    2009-01-01

    There are two important points in which in which we need assets and liabilities measured in financial accounting: on initial recognition and at a balance sheet day. Many International Financial Reporting Standards (IFRS) used the fair value measurement concept. But most of these standards use the fair value measurement method only at a balance sheet day. On initial recognition assets and liabilities are measured usually at costs. The IASB presented the discussion paper “Measurement Bases for ...

  1. Prevention validation and accounting platform: a framework for establishing accountability and performance measures of substance abuse prevention programs.

    Science.gov (United States)

    Kim, S; McLeod, J H; Williams, C; Hepler, N

    2000-01-01

    The field of substance abuse prevention has neither an overarching conceptual framework nor a set of shared terminologies for establishing the accountability and performance outcome measures of substance abuse prevention services rendered. Hence, there is a wide gap between what we currently have as data on one hand and information that are required to meet the performance goals and accountability measures set by the Government Performance and Results Act of 1993 on the other. The task before us is: How can we establish the accountability and performance measures of substance abuse prevention programs and transform the field of prevention into prevention science? The intent of this volume is to serve that purpose and accelerate the processes of this transformation by identifying the requisite components of the transformation (i.e., theory, methodology, convention on terms, and data) and by introducing an open forum called, Prevention Validation and Accounting (PREVA) Platform. The entire PREVA Platform (for short, the Platform) is designed as an analytic framework, which is formulated by a collectivity of common concepts, terminologies, accounting units, protocols for counting the units, data elements, and operationalizations of various constructs, and other summary measures intended to bring about an efficient and effective measurement of process input, program capacity, process output, performance outcome, and societal impact of substance abuse prevention programs. The measurement units and summary data elements are designed to be measured across time and across jurisdictions, i.e., from local to regional to state to national levels. In the Platform, the process input is captured by two dimensions of time and capital. Time is conceptualized in terms of service delivery time and time spent for research and development. Capital is measured by the monies expended for the delivery of program activities during a fiscal or reporting period. Program capacity is captured

  2. Considerations for sampling nuclear materials for SNM accounting measurements. Special nuclear material accountability report

    International Nuclear Information System (INIS)

    Brouns, R.J.; Roberts, F.P.; Upson, U.L.

    1978-05-01

    This report presents principles and guidelines for sampling nuclear materials to measure chemical and isotopic content of the material. Development of sampling plans and procedures that maintain the random and systematic errors of sampling within acceptable limits for SNM(Special Nuclear Materials) accounting purposes are emphasized

  3. Contracts, Performance Measurement and Accountability in the Public Sector

    DEFF Research Database (Denmark)

    Drewry, Gavin; Greve, Carsten; Tanquerel, Thierry

    This book addresses issues to do with public accountability, audit and performance measurement that are both highly topical and of crucial importance to the theory and practice of public administration in an era of contractualized public management. The literature on public sector contracting...... of audit and accountability in a variety of countries and contexts; the third part offers some wider, cross-cutting perspectives. Based on the work of the EGPA permanent study group on the history of contractualization, Contracts, Performance Measurement and Accountability in the Public Sector draws upon...... - covering both 'hard' agreements (ones that are legally enforceable) and 'soft' agreements (enforced by negotiation and mutual trust) - has been growing for some time and the present book adds a primarily European perspective on contracting, performance-based management and accountability. One important...

  4. Circles of Support and Accountability for Sex Offenders: A Systematic Review of Outcomes.

    Science.gov (United States)

    Clarke, Martin; Brown, Susan; Völlm, Birgit

    2017-08-01

    We conducted a systematic review of studies reporting on the effectiveness of Circles of Support and Accountability (Circles). Circles use volunteers to provide support for sex offenders living in the community. We searched 10 databases up to the end of 2013 and identified 3 relevant outcome studies. An additional 12 papers or reports were identified by searching reference lists, Google, and contacting key authors and Circles providers to obtain unpublished data. These 15 studies comprised one randomized controlled trial, three retrospective cohorts with matched controls, and 11 case series. The majority reported measures of recidivism, particularly reconviction. The 4 studies with controls generally reported that participation in Circles was associated with lower recidivism although there were few statistically significant differences. Few studies examined changes in risk or psychosocial outcomes. A number of methodological issues are discussed. Longer term, prospective follow-up studies with control groups are required to address these issues.

  5. Measuring Student Learning Outcomes Using the SALG Instrument

    Science.gov (United States)

    Scholl, Kathleen; Olsen, Heather M.

    2014-01-01

    U.S. higher education institutions are being called to question their central nature, priorities, and functions, with prominent and unprecedented attention being given to accountability and the measurement of student learning outcomes. As higher education evolves in how it assesses student learning and leisure studies and recreation departments…

  6. Preliminary concepts for materials measurement and accounting in critical facilities

    International Nuclear Information System (INIS)

    Cobb, D.D.; Sapir, J.L.

    1978-01-01

    Preliminary concepts are presented for improved materials measurement and accounting in large critical facilities. These concepts will be developed as part of a study that will emphasize international safeguarding of critical facilities. The major safeguards problem is the timely verification of in-reactor inventory during periods of reactor operation. This will require a combination of measurement, statistical sampling, and data analysis techniques. Promising techniques include integral measurements of reactivity and other reactor parameters that are sensitive to the total fissile inventory, and nondestructive assay measurements of the fissile material in reactor fuel drawers and vault storage canisters coupled with statistical sampling plans tailored for the specific application. The effectiveness of proposed measurement and accounting strategies will be evaluated during the study

  7. Un-"Chartered" Waters: Balancing Montessori Curriculum and Accountability Measures in a Charter School

    Science.gov (United States)

    Scott, Catherine M.

    2017-01-01

    More than 6,000 charter schools exist in the United States, and of these 120 are Montessori charter schools. When studying charter school practices, researchers often examine issues such as performance accountability measures and effectiveness of charter school curricula. In doing so, the outcomes often overlook the challenges for teachers as they…

  8. Responsiveness of Clinical Outcome Measures

    DEFF Research Database (Denmark)

    Lauridsen, Henrik Hein

    Background The Oswestry Disability Index (ODI) is one of two standardised functional health measurement scales (HMS) recommended. Despite extensive psychometric testing, little is known about HMS behaviour and the minimal clinically important difference (MCID) in subgroups of LBP patients. Moreover...... obtainable by a certain treatment. Chronic LBP patients seem to have a reasonable idea of an acceptable change in pain but overestimate change in functional and psychological /affective domains....

  9. Measurement and the Professions: Lessons from Accounting, Law, and Medicine.

    Science.gov (United States)

    Nowakowski, Jeri; And Others

    1983-01-01

    This detailed analysis of the role of measurement across the three professions of law, medicine, and accounting offers insights into entry-level and performance barriers in occupations that rely on certification, licensing, and regulation to influence performance, ethics, and training. (Author/PN)

  10. Financial accounting effects of tax aggressiveness: Contracting and measurement

    NARCIS (Netherlands)

    DeWaegenaere, A.M.B.; Sansing, R.C.; Wielhouwer, J.L.

    2015-01-01

    This study examines a setting in which a tax-reporting decision is delegated to a firm's tax manager. Using financial accounting measures of tax expense to evaluate the tax manager allows the firm to efficiently attain the level of tax avoidance it prefers, despite the fact that the consequences of

  11. Financial accounting effects of tax aggressiveness : Contracting and measurement

    NARCIS (Netherlands)

    De Waegenaere, A.M.B.; Sansing, R.; Wielhouwer, J.L.

    This study examines a setting in which a tax-reporting decision is delegated to a firm's tax manager. Using financial accounting measures of tax expense to evaluate the tax manager allows the firm to efficiently attain the level of tax avoidance it prefers, despite the fact that the consequences of

  12. Considerations for sampling nuclear materials for SNM accounting measurements

    International Nuclear Information System (INIS)

    Brouns, R.J.; Roberts, F.P.; Upson, U.L.

    1978-01-01

    This report presents principles and guidelines for sampling nuclear materials to measure chemical and isotopic content of the material. Development of sampling plans and procedures that maintain the random and systematic errors of sampling within acceptable limits for SNM accounting purposes are emphasized

  13. Adapting Accountability Systems to the Limitations of Educational Measurement

    Science.gov (United States)

    Kane, Michael

    2015-01-01

    Michael Kane writes in this article that he is in more or less complete agreement with Professor Koretz's characterization of the problem outlined in the paper published in this issue of "Measurement." Kane agrees that current testing practices are not adequate for test-based accountability (TBA) systems, but he writes that he is far…

  14. Measuring Inclusive Education Outcomes in Alberta, Canada

    Science.gov (United States)

    Loreman, Tim

    2014-01-01

    This study details the results of a review of the academic and public sector literature on measuring inclusive education in large systems. It highlights some outcomes drawn from the international literature on inclusion that might be indicative of the presence and quality of inclusive education in an effort to develop a set of outcomes for…

  15. Accounting for measurement error: a critical but often overlooked process.

    Science.gov (United States)

    Harris, Edward F; Smith, Richard N

    2009-12-01

    Due to instrument imprecision and human inconsistencies, measurements are not free of error. Technical error of measurement (TEM) is the variability encountered between dimensions when the same specimens are measured at multiple sessions. A goal of a data collection regimen is to minimise TEM. The few studies that actually quantify TEM, regardless of discipline, report that it is substantial and can affect results and inferences. This paper reviews some statistical approaches for identifying and controlling TEM. Statistically, TEM is part of the residual ('unexplained') variance in a statistical test, so accounting for TEM, which requires repeated measurements, enhances the chances of finding a statistically significant difference if one exists. The aim of this paper was to review and discuss common statistical designs relating to types of error and statistical approaches to error accountability. This paper addresses issues of landmark location, validity, technical and systematic error, analysis of variance, scaled measures and correlation coefficients in order to guide the reader towards correct identification of true experimental differences. Researchers commonly infer characteristics about populations from comparatively restricted study samples. Most inferences are statistical and, aside from concerns about adequate accounting for known sources of variation with the research design, an important source of variability is measurement error. Variability in locating landmarks that define variables is obvious in odontometrics, cephalometrics and anthropometry, but the same concerns about measurement accuracy and precision extend to all disciplines. With increasing accessibility to computer-assisted methods of data collection, the ease of incorporating repeated measures into statistical designs has improved. Accounting for this technical source of variation increases the chance of finding biologically true differences when they exist.

  16. Korean Clinic Based Outcome Measure Studies

    OpenAIRE

    Jongbae Park

    2003-01-01

    Background: Evidence based medicine has become main tools for medical practice. However, conducting a highly ranked in the evidence hierarchy pyramid is not easy or feasible at all times and places. There remains a room for descriptive clinical outcome measure studies with admitting the limit of the intepretation. Aims: Presents three Korean clinic based outcome measure studies with a view to encouraging Korean clinicians to conduct similar studies. Methods: Three studies are presented...

  17. Volume measurement study for large scale input accountancy tank

    International Nuclear Information System (INIS)

    Uchikoshi, Seiji; Watanabe, Yuichi; Tsujino, Takeshi

    1999-01-01

    Large Scale Tank Calibration (LASTAC) facility, including an experimental tank which has the same volume and structure as the input accountancy tank of Rokkasho Reprocessing Plant (RRP) was constructed in Nuclear Material Control Center of Japan. Demonstration experiments have been carried out to evaluate a precision of solution volume measurement and to establish the procedure of highly accurate pressure measurement for a large scale tank with dip-tube bubbler probe system to be applied to the input accountancy tank of RRP. Solution volume in a tank is determined from substitution the solution level for the calibration function obtained in advance, which express a relation between the solution level and its volume in the tank. Therefore, precise solution volume measurement needs a precise calibration function that is determined carefully. The LASTAC calibration experiments using pure water showed good result in reproducibility. (J.P.N.)

  18. Accounting for components interactions in the differential importance measure

    International Nuclear Information System (INIS)

    Zio, Enrico; Podofillini, Luca

    2006-01-01

    A limitation of the importance measures (IMs) currently used in reliability and risk analyses is that they rank only individual components or basic events whereas they are not directly applicable to combinations or groups of components or basic events. To partially overcome this limitation, recently, the differential importance measure (DIM), has been introduced for use in risk-informed decision making. The DIM is a first-order sensitivity measure that ranks the parameters of the risk model according to the fraction of total change in the risk that is due to a small change in the parameters' values, taken one at a time. However, it does not account for the effects of interactions among components. In this paper, a second-order extension of the DIM, named DIM II , is proposed for accounting of the interactions of pairs of components when evaluating the change in system performance due to changes of the reliability parameters of the components. A numerical application is presented in which the informative contents of DIM and DIM II are compared. The results confirm that in certain cases when second-order interactions among components are accounted for, the importance ranking of the components may differ from that produced by a first-order sensitivity measure

  19. Outcome-Based Education and Student Learning in Managerial Accounting in Hong Kong

    Science.gov (United States)

    Lui, Gladie; Shum, Connie

    2012-01-01

    Although Outcome-based Education has not been successful in public education in several countries, it has been successful in the medical fields in higher education in the U.S. The author implemented OBE in her Managerial Accounting course in H.K. Intended learning outcomes were mapped again Bloom's Cognitive Domain. Teaching and learning…

  20. Volunteers in Circles of Support and Accountability Job Demands, Job Resources, and Outcome.

    Science.gov (United States)

    Höing, Mechtild; Bogaerts, Stefan; Vogelvang, Bas

    2017-09-01

    In Circles of Support and Accountability (CoSA), volunteers support a medium- to high-risk sex offender in his process toward desistance by developing a long-term empathic relationship. More knowledge is needed about the impact of this work on volunteers themselves. In a sample of 40 Dutch CoSA volunteers-at the time constituting 37% of the national population of 108 then active CoSA volunteers-we measured outcome in terms of volunteer satisfaction, determination to continue, compassion satisfaction, burnout and secondary stress, vicarious growth, civic capacities, and professional skills. We explored theoretically derived predictors of positive and negative outcome, and conceptualized them within the Job Demands-Resources model (JD-R). Volunteers reported mainly positive effects, especially high levels of volunteer satisfaction, compassion satisfaction, and determination to continue. Results indicated that job demands and most of the internal job resources were of minor importance. External job resources, especially social support and connectedness, were associated with positive outcome. Connectedness mediated the effect of social support on compassion satisfaction.

  1. Fair Value Accounting and Measurement through FASB’s Developments

    OpenAIRE

    Bonaci, Carmen Giorgiana; Strouhal, Jiří; Matis, Dumitru

    2009-01-01

    Our research follows the path of fair value as a term and concept, as well as its disclosure, measurement and recognition back from 1953 until our days, and analyzes the regulations issued by United States Accounting Standard setters, through the point of view of the historical events, which led to their appearance. Our study brings its’ contribution to complementing growing literature on the value relevance of fair value, but focuses on the assessment of fair value as a financial reporting s...

  2. Role of measurements in material control and accountability (abstract)

    International Nuclear Information System (INIS)

    Mahmud, T.

    2011-01-01

    Analytical techniques are widely used for verification and accountancy of nuclear materials. Nuclear Material (NM) inventories are based on sampling followed by Destructive Analysis. Destructive Analyses range from traditional chemical techniques to recent implementations of radiometric methods. These techniques are performed to quantify the amount of nuclear material (elemental assay and isotopic composition) present in a specific item, container, or in some cases facility and resolving shipper-receiver differences. Analytical techniques used for the MC and A of nuclear material normally require more attention than that for process control because the largest contribution to Material Unaccounted For is in measurement uncertainty. Therefore analytical techniques selected for material control and accountability are highly precise and they comply with accepted 'International Target Values 2010'. (author)

  3. Water Accounting Plus (WA+) - a water accounting procedure for complex river basins based on satellite measurements

    Science.gov (United States)

    Karimi, P.; Bastiaanssen, W. G. M.; Molden, D.

    2012-11-01

    Coping with the issue of water scarcity and growing competition for water among different sectors requires proper water management strategies and decision processes. A pre-requisite is a clear understanding of the basin hydrological processes, manageable and unmanageable water flows, the interaction with land use and opportunities to mitigate the negative effects and increase the benefits of water depletion on society. Currently, water professionals do not have a common framework that links hydrological flows to user groups of water and their benefits. The absence of a standard hydrological and water management summary is causing confusion and wrong decisions. The non-availability of water flow data is one of the underpinning reasons for not having operational water accounting systems for river basins in place. In this paper we introduce Water Accounting Plus (WA+), which is a new framework designed to provide explicit spatial information on water depletion and net withdrawal processes in complex river basins. The influence of land use on the water cycle is described explicitly by defining land use groups with common characteristics. Analogous to financial accounting, WA+ presents four sheets including (i) a resource base sheet, (ii) a consumption sheet, (iii) a productivity sheet, and (iv) a withdrawal sheet. Every sheet encompasses a set of indicators that summarize the overall water resources situation. The impact of external (e.g. climate change) and internal influences (e.g. infrastructure building) can be estimated by studying the changes in these WA+ indicators. Satellite measurements can be used for 3 out of the 4 sheets, but is not a precondition for implementing WA+ framework. Data from hydrological models and water allocation models can also be used as inputs to WA+.

  4. Measuring Quality and Outcomes in Sports Medicine.

    Science.gov (United States)

    Ruzbarsky, Joseph J; Marom, Niv; Marx, Robert G

    2018-07-01

    Patient-reported outcome measures (PROMs) are objective metrics critical to evaluating outcomes throughout orthopedic surgery. New instruments continue to emerge, increasing the breadth of information required for those intending to use these measures for research or clinical care. Although earlier metrics were developed using the principles of classic test theory, newer instruments constructed using item response theory are amenable to computer-adaptive testing and may change the way these instruments are administered. This article aims to define the psychometric properties that are important to understand when using all PROMs and to review the most widely used instruments in sports medicine. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. International Accounting Convergence in the Field of Fair Value Measurement

    Directory of Open Access Journals (Sweden)

    Diana Cozma Ighian

    2015-09-01

    Full Text Available The investors’ desire for high-quality, internationally comparable financial information that is useful for decision-making in increasingly global capital markets imposed an international convergence, the ultimate goal of which is a single set of international accounting standards that companies worldwide would use for both domestic and cross-border financial reporting. The guidance, set out in IFRS 13 Fair Value Measurement and the update to Topic 820 (formerly referred to as SFAS 157, completes a major project of the boards’ joint work to improve IFRSs and US GAAP and to bring about their convergence. This article describes the controversial history of fair value measurement and the main novelties in the field of fair value measurement, arising from the international convergence process.

  6. Measurement properties of outcome measures for vitiligo. A systematic review.

    Science.gov (United States)

    Vrijman, Charlotte; Linthorst Homan, May W; Limpens, Jacqueline; van der Veen, Wietze; Wolkerstorfer, Albert; Terwee, Caroline B; Spuls, Phyllis I

    2012-11-01

    OBJECTIVE To summarize and critically appraise the evidence on the measurement properties of clinician-, patient-, and observer-reported outcomes, measuring any construct of interest in patients with all types of vitiligo. DATA SOURCES Electronic databases including PubMed (1948 to July 2011), OVID EMBASE (1980 to July 2011), and CINAHL (EBSCOhost) (1982 to July 2011) were searched. STUDY SELECTION Two authors independently screened all records for eligibility. For inclusion, the study population had to include patients with vitiligo, for which outcome measures were developed or evaluated on their measurement properties. The initial search retrieved 1249 records, of which 14 articles met the inclusion criteria. DATA EXTRACTION Characteristics of the included instruments, study population, and results of the measurement properties were extracted. The Consensus-Based Standards for the Selection of Health Status Measurement Instruments (COSMIN) 4-point checklist, combined with quality criteria for measurement properties, was used to calculate the overall level of evidence per measurement property of each instrument. Independent extraction and assessment was performed by 2 authors. DATA SYNTHESIS Eleven different measurement instruments were identified. Strong evidence was found for a positive internal consistency of the Dermatology Life Quality Index. For other instruments, the evidence of measurement properties was limited or unknown. CONCLUSIONS Recommendations on the use of specific outcome measures for vitiligo should be formulated with caution because current evidence is insufficient owing to a low number of studies with poor methodological quality and unclear clinical relevance. To recommend outcome measures for vitiligo, further research on measurement properties of clinical relevant outcome measures for vitiligo according to COSMIN quality criteria is needed.

  7. Accountability

    Science.gov (United States)

    Fielding, Michael; Inglis, Fred

    2017-01-01

    This contribution republishes extracts from two important articles published around 2000 concerning the punitive accountability system suffered by English primary and secondary schools. The first concerns the inspection agency Ofsted, and the second managerialism. Though they do not directly address assessment, they are highly relevant to this…

  8. 77 FR 32914 - Snapper-Grouper Fishery of the South Atlantic; 2012 Recreational Accountability Measure and...

    Science.gov (United States)

    2012-06-04

    ... Accountability Measure and Closure for South Atlantic Golden Tilefish AGENCY: National Marine Fisheries Service...; closure. SUMMARY: NMFS implements accountability measures (AMs) for the recreational sector of golden...

  9. 78 FR 30779 - Snapper-Grouper Fishery of the South Atlantic; 2013 Recreational Accountability Measure and...

    Science.gov (United States)

    2013-05-23

    ... Accountability Measure and Closure for South Atlantic Snowy Grouper AGENCY: National Marine Fisheries Service...; closure. SUMMARY: NMFS implements accountability measures (AMs) for the recreational sector of snowy...

  10. 78 FR 32995 - Snapper-Grouper Fishery of the South Atlantic; 2013 Recreational Accountability Measure and...

    Science.gov (United States)

    2013-06-03

    ... Accountability Measure and Closure for South Atlantic Golden Tilefish AGENCY: National Marine Fisheries Service...; closure. SUMMARY: NMFS implements accountability measures (AMs) for the recreational sector of golden...

  11. Measurement Properties of Outcome Measures for Vitiligo A Systematic Review

    NARCIS (Netherlands)

    Vrijman, C.; Homan, M.W.L.; Limpens, J.; Veen, W.; Wolkerstorfer, A.; Terwee, C.B.; Spuls, P.I.

    2012-01-01

    Objective: To summarize and critically appraise the evidence on the measurement properties of clinician-, patient-, and observer-reported outcomes, measuring any construct of interest in patients with all types of vitiligo. Data Sources: Electronic databases including PubMed (1948 to July 2011),

  12. Measurement properties of outcome measures for vitiligo. A systematic review

    NARCIS (Netherlands)

    Vrijman, Charlotte; Linthorst Homan, May W.; Limpens, Jacqueline; van der Veen, Wietze; Wolkerstorfer, Albert; Terwee, Caroline B.; Spuls, Phyllis I.

    2012-01-01

    OBJECTIVE To summarize and critically appraise the evidence on the measurement properties of clinician-, patient-, and observer-reported outcomes, measuring any construct of interest in patients with all types of vitiligo. DATA SOURCES Electronic databases including PubMed (1948 to July 2011), OVID

  13. Technology development for nuclear material measurement and accountability

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Jong Sook; Lee, Byung Doo; Cha, Hong Ryul; Lee, Yong Duk; Choi, Hyung Nae; Nah, Won Woo; Park, Hoh Joon; Lee, Yung Kil [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1994-12-01

    The measurement techniques for Pu samples and spent fuel assembly were developed in support of the implementation of national inspection responsibility under the Atomic Energy Act promulgated in 1994 and a computer program was also developed to assess the total nuclear material balance by facility declared records. The results of plutonium isotopic determination by gamma-ray spectrometry with high resolution germanium detector with peak analysis codes (FRAM and MGA codes) were approached to within 1% {approx} 2% of error from chemical analysis values by mass spectrometry. A gamma-ray measurement system for underwater spent nuclear fuels was developed and tested successfully. The falsification of facility and state records can be traced with the help of the developed computer code against declared reports submitted by the concerned state. This activity eventually resulted in finding the discrepancy of accountability records. 18 figs, 20 tabs, 27 refs. (Author).

  14. Radiation protection in the age of accountability - measuring our effectiveness

    International Nuclear Information System (INIS)

    Hutchinson, D.E.

    1993-01-01

    Effectiveness and accountability were catch-words of the 1980s for public and private enterprises. This mood has persisted into the current decade and radiation protection authorities have not escaped the organisational microscope. But whereas simple models and measures of effectiveness can be applied to most private companies and government agencies, organisations in the regulatory and preventative health areas cannot be assessed by the same criteria. These organisations are fundamentally different because their primary objective is one of minimisation. This paper looks at options for measuring and reporting the effectiveness of radiation protection organisations. Some performance indicators are proposed and evaluated. The intention is not, however, to present a 'solution' to this apparently vexing problem. Indeed, the answer may be that there is none. 11 refs., 4 figs

  15. Technology development for nuclear material measurement and accountability

    International Nuclear Information System (INIS)

    Hong, Jong Sook; Lee, Byung Doo; Cha, Hong Ryul; Lee, Yong Duk; Choi, Hyung Nae; Nah, Won Woo; Park, Hoh Joon; Lee, Yung Kil

    1994-12-01

    The measurement techniques for Pu samples and spent fuel assembly were developed in support of the implementation of national inspection responsibility under the Atomic Energy Act promulgated in 1994 and a computer program was also developed to assess the total nuclear material balance by facility declared records. The results of plutonium isotopic determination by gamma-ray spectrometry with high resolution germanium detector with peak analysis codes (FRAM and MGA codes) were approached to within 1% ∼ 2% of error from chemical analysis values by mass spectrometry. A gamma-ray measurement system for underwater spent nuclear fuels was developed and tested successfully. The falsification of facility and state records can be traced with the help of the developed computer code against declared reports submitted by the concerned state. This activity eventually resulted in finding the discrepancy of accountability records. 18 figs, 20 tabs, 27 refs. (Author)

  16. ACCOUNTABILITY INFLUENCE, TECHNICAL DIFFICULTY AND MEASUREMENT DIFFICULTY TOWARDS THE IMPLEMENTATION OF INDONESIAN STANDARD STATEMENT OF FINANCIAL ACCOUNTING (PSAK) NO. 27 (REVISED 1998) ABOUT COOPERATIVES ACCOUNTING IN EAST JAVA

    OpenAIRE

    ., Sutarto; ., Isnalita; ., Habiburrochman

    2008-01-01

    Financial report is a tool for business entity to deliver information to stakeholders. Thedifference of user’s interests causes that the financial report needs to be audited by theindependent auditor, to make sure fairness and conform with accounting standard. Thecooperatives managers must conduct the rule stated in accounting standard. Thus, thatthe Accountability, Technical Difficulty, Measurement Difficulty are the basic to realizethe implementation of cooperative accounting standard. The ...

  17. Accountability Influence, Technical Difficulty and Measurement Difficulty Towards the Implementation of Indonesian Standard Statement of Financial Accounting (PSAK) No. 27 (Revised 1998) About Cooperatives Accounting in East Java

    OpenAIRE

    Habiburrahman, Sutarto Isnalita

    2008-01-01

    Financial report is a tool for business entity to deliver information to stakeholders. Thedifference of user's interests causes that the financial report needs to be audited by theindependent auditor, to make sure fairness and conform with accounting standard. Thecooperatives managers must conduct the rule stated in accounting standard. Thus, thatthe Accountability, Technical Difficulty, Measurement Difficulty are the basic to realizethe implementation of cooperative accounting standard. The...

  18. Performance Measurement and Management Promotion through Non-Financial Measures: A Management Accounting Perspective

    OpenAIRE

    Eisenberg, Paul

    2016-01-01

    The purpose of this paper is the discussion of non-financial performance measures that can be adopted in the management accounting function of business organisations. The study is important because it shows how organisational focus on non-financial measures can substantially enhance profitability, albeit being subject to cost constraints. To begin with, the evolution of management accounting research over the last three decades is resented. The development in the academia is then contra...

  19. Theoretical conditions for validity in accounting performance measurement

    DEFF Research Database (Denmark)

    Nørreklit, Hanne; Nørreklit, Lennart; Mitchell, Falconer

    2007-01-01

    The concept of truth is a foundation upon which the accounting profession has built its reputation. The need for truth in accounting is enshrined in ethical codes, accounting regulations, authoritative texts and, of course, the auditor's assignation of a "true and fair view"....

  20. Korean Clinic Based Outcome Measure Studies

    Directory of Open Access Journals (Sweden)

    Jongbae Park

    2003-02-01

    Full Text Available Background: Evidence based medicine has become main tools for medical practice. However, conducting a highly ranked in the evidence hierarchy pyramid is not easy or feasible at all times and places. There remains a room for descriptive clinical outcome measure studies with admitting the limit of the intepretation. Aims: Presents three Korean clinic based outcome measure studies with a view to encouraging Korean clinicians to conduct similar studies. Methods: Three studies are presented briefly here including 1 Quality of Life of liver cancer patients after 8 Constitutional acupuncture; 2 Developing a Korean version of Measuring yourself Medical Outcome profile (MYMOP; and 3 Survey on 5 Shu points: a pilot In the first study, we have included 4 primary or secondary liver cancer patients collecting their diagnostic X-ray film and clinical data f개m their hospital, and asked them to fill in the European Organization Research and Treatment of Cancer, Quality of Life Questionnaire before the commencement of the treatment. The acupuncture treatment is set up format but not disclosed yet. The translation and developing a Korean version of outcome measures that is Korean clinician friendly has been sought for MYMOP is one of the most appropriate one. The permission was granted, the translation into Korean was done, then back translated into English only based on the Korean translation by the researcher who is bilingual in both languages. The back translation was compared by the original developer of MYMOP and confirmed usable. In order to test the existence of acupoints and meridians through popular forms of Korean acupuncture regimes, we aim at collecting opinions from 101 Korean clinicians that have used those forms. The questions asked include most effective symptoms, 5 Shu points, points those are least likely to use due to either adverse events or the lack of effectiveness, theoretical reasons for the above proposals, proposing outcome measures

  1. Questionnaires for Measuring Refractive Surgery Outcomes.

    Science.gov (United States)

    Kandel, Himal; Khadka, Jyoti; Lundström, Mats; Goggin, Michael; Pesudovs, Konrad

    2017-06-01

    To identify the questionnaires used to assess refractive surgery outcomes, assess the available questionnaires in regard to their psychometric properties, validity, and reliability, and evaluate the performance of the available questionnaires in measuring refractive surgery outcomes. An extensive literature search was done on PubMed, MEDLINE, Scopus, CINAHL, Cochrane, and Web of Science databases to identify articles that described or used at least one questionnaire to assess refractive surgery outcomes. The information on content quality, validity, reliability, responsiveness, and psychometric properties was extracted and analyzed based on an extensive set of quality criteria. Eighty-one articles describing 27 questionnaires (12 refractive error-specific, including 4 refractive surgery-specific, 7 vision-but-non-refractive, and 8 generic) were included in the review. Most articles (56, 69.1%) described refractive error-specific questionnaires. The Quality of Life Impact of Refractive Correction (QIRC), the Quality of Vision (QoV), and the Near Activity Visual Questionnaire (NAVQ) were originally constructed using Rasch analysis; others were developed using the Classical Test Theory. The National Eye Institute Refractive Quality of Life questionnaire was the most frequently used questionnaire, but it does not provide a valid measurement. The QoV, QIRC, and NAVQ are the three best existing questionnaires to assess visual symptoms, quality of life, and activity limitations, respectively. This review identified three superior quality questionnaires for measuring different aspects of quality of life in refractive surgery. Clinicians and researchers should choose a questionnaire based on the concept being measured with superior psychometric properties. [J Refract Surg. 2017;33(6):416-424.]. Copyright 2017, SLACK Incorporated.

  2. Measuring outcomes in psychiatry: an inpatient model.

    Science.gov (United States)

    Davis, D E; Fong, M L

    1996-02-01

    This article describes a system for measuring outcomes recently implemented in the department of psychiatry of Baptist Memorial Hospital, a 78-bed inpatient and day treatment unit that represents one service line of a large, urban teaching hospital in Memphis. In June 1993 Baptist Hospital began a 15-month pilot test of PsychSentinel, a measurement tool developed by researchers in the Department of Community Medicine at the University of Connecticut. The hospital identified the following four primary goals for this pilot project: provide data for internal hospital program evaluation, provide data for external marketing in a managed care environment, satisfy requirements of the Joint Commission on Accreditation of Health Care Organizations, and generate studies that add to the literature in psychiatry and psychology. PsychSentinel is based on the standardized diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). The outcome measure assesses the change in the number of symptoms of psychopathology that occurs between admission and discharge from the hospital. Included in the nonproprietary system are risk adjustment factors, as well as access to a national reference database for comparative analysis purposes. Data collection can be done by trained ancillary staff members, with as much or as little direct physician involvement as desired. The system has proven to be both time effective and cost effective, and it provides important outcome information both at the program level and at the clinician level. After the pilot test, the staff at Baptist Memorial Hospital determined that the system met all initial objectives identified and recently adopted the system as an ongoing measure of quality patient care in the department of psychiatry.

  3. Online versus Face-to-Face Accounting Education: A Comparison of CPA Exam Outcomes across Matched Institutions

    Science.gov (United States)

    Morgan, John Daniel

    2015-01-01

    Programmatic-level comparisons are made between the certified public accountant (CPA) exam outcomes of two types of accounting programs: online or distance accounting programs and face-to-face or classroom accounting programs. After matching programs from each group on student selectivity at admission, the two types of programs are compared on CPA…

  4. 42 CFR 486.318 - Condition: Outcome measures.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Outcome measures. 486.318 Section 486... Organizations Organ Procurement Organization Outcome Requirements § 486.318 Condition: Outcome measures. (a..., territories, or possessions, an OPO must meet all 3 of the following outcome measures: (1) The OPO's donation...

  5. Verification of the Indicating Measuring Instruments Taking into Account their Instrumental Measurement Uncertainty

    Directory of Open Access Journals (Sweden)

    Zakharov Igor

    2017-12-01

    Full Text Available The specific features of the measuring instruments verification based on the results of their calibration are considered. It is noted that, in contrast to the verification procedure used in the legal metrology, the verification procedure for calibrated measuring instruments has to take into account the uncertainty of measurements into account. In this regard, a large number of measuring instruments, considered as those that are in compliance after verification in the legal metrology, turns out to be not in compliance after calibration. In this case, it is necessary to evaluate the probability of compliance of indicating measuring instruments. The procedure of compliance probability determination on the basis of the Monte Carlo method is considered. An example of calibration of a Vernier caliper is given.

  6. A general approach to welfare measurement through national income accounting

    OpenAIRE

    Asheim, Geir B.; Buchholz, Wolfgang

    2002-01-01

    We develop a framework for analyzing national income accounting using a revealed welfare approach that is sufficiently general to cover, e.g., both the standard discounted utilitarian and maximin criteria as special cases. We show that the basic welfare properties of comprehensive national income accounting, which were previously ascribed only to the discounted utilitarian case, in fact extend to this more general framework. In particular, it holds under a wide range of circumstances that rea...

  7. Implications Of The Crisis Of Objectivity In Accounting Measurement On The Development Of Finance Theory

    OpenAIRE

    Saratiel Wedzerai Musvoto

    2011-01-01

    Studies in accounting measurement indicate the absence of empirical relational structures that should form the basis for accounting measurement. This suggests the lack of objectivity of accounting information. Landmarks in the development of finance theory indicate the use of accounting measurement information as a basis for their development. This indicates that subjective accounting information is incorporated in finance theory. Consequently, this questions the status of finance as a univer...

  8. The International Dermatology Outcome Measures Group: formation of patient-centered outcome measures in dermatology.

    Science.gov (United States)

    Gottlieb, Alice B; Levin, Adriane A; Armstrong, April W; Abernethy, April; Duffin, Kristina Callis; Bhushan, Reva; Garg, Amit; Merola, Joseph F; Maccarone, Mara; Christensen, Robin

    2015-02-01

    As quality standards are increasingly in demand throughout medicine, dermatology needs to establish outcome measures to quantify the effectiveness of treatments and providers. The International Dermatology Outcome Measures Group was established to address this need. Beginning with psoriasis, the group aims to create a tool considerate of patients and providers using the input of all relevant stakeholders in assessment of disease severity and response to treatment. Herein, we delineate the procedures through which consensus is being reached and the future directions of the project. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  9. Culturally Sensitive and Environment-Friendly Outcome Measures in

    African Journals Online (AJOL)

    Dr Olaleye

    A systematic review of evidence on culturally sensitive and environment-friendly outcome measures in ..... which included manual grass cutting/hoeing, assuming the Islamic ... who opined that the starting point for any outcome measure is to ...

  10. 42 CFR 410.146 - Diabetes outcome measurements.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Diabetes outcome measurements. 410.146 Section 410.146 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Training and Diabetes Outcome Measurements § 410.146 Diabetes outcome measurements. (a) Information...

  11. Performance-Based Measurement: Action for Organizations and HPT Accountability

    Science.gov (United States)

    Larbi-Apau, Josephine A.; Moseley, James L.

    2010-01-01

    Basic measurements and applications of six selected general but critical operational performance-based indicators--effectiveness, efficiency, productivity, profitability, return on investment, and benefit-cost ratio--are presented. With each measurement, goals and potential impact are explored. Errors, risks, limitations to measurements, and a…

  12. Debate Regarding Measuring Accounting Value: Historical Cost against Fair Value

    OpenAIRE

    Victor Munteanu; Marilena Zuca

    2015-01-01

    The transition from historical cost to fair value represents an option with major implications in accounting, because it is a complex process that requires tuning to today’s trends of national and global economy. We can state that with all the advantages of using historical cost it has its limitations and it is” getting old”. That doesn’t mean that will be abandoned but substituted when it is needed with another value. At present, the lack of historical value is inconceivable; many practit...

  13. Debate Regarding Measuring Accounting Value: Historical Cost against Fair Value

    Directory of Open Access Journals (Sweden)

    Victor Munteanu

    2015-12-01

    Full Text Available The transition from historical cost to fair value represents an option with major implications in accounting, because it is a complex process that requires tuning to today’s trends of national and global economy. We can state that with all the advantages of using historical cost it has its limitations and it is” getting old”. That doesn’t mean that will be abandoned but substituted when it is needed with another value. At present, the lack of historical value is inconceivable; many practitioners consider it to be the best method to evaluate assets.

  14. Factors influencing the use of outcome measures in physical therapy practice.

    Science.gov (United States)

    Wedge, Frances M; Braswell-Christy, Jennifer; Brown, Cynthia J; Foley, Kathleen T; Graham, Cecilia; Shaw, Sharon

    2012-02-01

    Use of outcome measures in physical therapy practice is central to evaluating the effectiveness of treatment interventions, providing accountability and addressing quality of physical therapy programs. There is limited discussion on barriers and facilitators to using outcome measures in physical therapy practice. The purpose of this study was to identify factors that influence a physical therapist when deciding to use outcome measures in clinical practice. Participants were 21 physical therapists, seven each from skilled nursing facilities, outpatient clinics, and inpatient rehabilitation facilities. A grounded theory approach was used for interview and data collection. Common themes were determined from the data and a theory developed to explain the rationale behind physical therapists' decisions to use or not use outcome measures in clinical practice. Three overlapping themes related to (1) concepts of time, (2) knowledge, and (3) facility culture were indentified as factors influencing the use of outcome measures. A fourth encompassing theme, professionalism, identified the value placed on the use of outcome measures in practice. Data revealed that therapists require more information on the outcome measures available, and this information needs to be easily accessible within the workplace. Therapists value information generated by using outcome measures in the clinical setting, but need information on what measures are available and psychometric properties. Information must be easily accessible and measures easy to use. Newer graduates and recent learners have a foundation in the use of outcome measures, but more needs to be done in the clinic and through continuing education to promote increased use and understanding.

  15. Food away from home and body mass outcomes: taking heterogeneity into account enhances quality of results.

    Science.gov (United States)

    Kim, Tae Hyun; Lee, Eui-Kyung; Han, Euna

    2014-09-01

    The aim of this study was to explore the heterogeneous association of consumption of food away from home (FAFH) with individual body mass outcomes including body mass index and waist circumference over the entire conditional distribution of each outcome. Information on 16,403 adults obtained from nationally representative data on nutrition and behavior in Korea was used. A quantile regression model captured the variability of the association of FAFH with body mass outcomes across the entire conditional distribution of each outcome measure. Heavy FAFH consumption was defined as obtaining ≥1400 kcal from FAFH on a single day. Heavy FAFH consumption, specifically at full-service restaurants, was significantly associated with higher body mass index (+0.46 kg/m2 at the 50th quantile, 0.55 at the 75th, 0.66 at the 90th, and 0.44 at the 95th) and waist circumference (+0.96 cm at the 25th quantile, 1.06 cm at the 50th, 1.35 cm at the 75th, and 0.96 cm at the 90th quantiles) with overall larger associations at higher quantiles. Findings of the study indicate that conventional regression methods may mask important heterogeneity in the association between heavy FAFH consumption and body mass outcomes. Further public health efforts are needed to improve the nutritional quality of affordable FAFH choices and nutrition education and to establish a healthy food consumption environment. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. A measurement evaluation program to support nuclear material control and accountability measurements in Brazilian laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Dias, Fabio C., E-mail: fabio@ird.gov.br [Comissao Nacional de Energia Nuclear (CNEN-RJ), Rio de Janeiro, RJ (Brazil); Mason, Peter, E-mail: peter.mason@ch.doe.gov [New Brunswick Laboratory (DOE/NBL), Argonne, IL (United States)

    2013-07-01

    A measurement evaluation program (MEP) is one of a number of valuable tools that analytical chemists can use to ensure that the data produced in the laboratory are fit for their intended purpose and consistent with expected performance values at a given time. As such, participation in a MEP is an important indicator of the quality of analytical data, and is recognized as such by independent regulatory and/or accreditation bodies. With the intent to implement such a program in Brazil, in November 2012 the Nuclear Energy Commission of Brazil (CNEN), with support from the Department of Energy of the United States' (US-DOE International Safeguards and Engagement Program), decided to initiate a technical cooperation project aiming at organizing a Safeguards Measurement Evaluation Program (SMEP) for Brazilian facilities. The project, entitled Action Sheet 23, was formalized under the terms of the Agreement between the US-DOE and the CNEN concerning research and development in nuclear material control, accountancy, verification, physical protection, and advanced containment and surveillance technologies for International Safeguards Applications. The work, jointly performed by the CNEN's Safeguards Laboratory (LASAL) and the New Brunswick Laboratory (NBL), has the objective to strengthen the traceability of accountability measurements and ensure adequate quality of safeguards measurements for facilities within Brazil, utilizing test samples characterized and provided by NBL. Recommendations to participants included measurement frequency, number of results per sample and format for reporting results using ISO methods for calculating and expressing measurement uncertainties. In this paper, we discuss the main steps taken by CNEN and NBL aiming at implementing such a program and the expected results, in particular the impact of uncertainty estimation on the evaluation of performance of each participant laboratory. The program is considered by Brazilian safeguards

  17. A measurement evaluation program to support nuclear material control and accountability measurements in Brazilian laboratories

    International Nuclear Information System (INIS)

    Dias, Fabio C.; Mason, Peter

    2013-01-01

    A measurement evaluation program (MEP) is one of a number of valuable tools that analytical chemists can use to ensure that the data produced in the laboratory are fit for their intended purpose and consistent with expected performance values at a given time. As such, participation in a MEP is an important indicator of the quality of analytical data, and is recognized as such by independent regulatory and/or accreditation bodies. With the intent to implement such a program in Brazil, in November 2012 the Nuclear Energy Commission of Brazil (CNEN), with support from the Department of Energy of the United States' (US-DOE International Safeguards and Engagement Program), decided to initiate a technical cooperation project aiming at organizing a Safeguards Measurement Evaluation Program (SMEP) for Brazilian facilities. The project, entitled Action Sheet 23, was formalized under the terms of the Agreement between the US-DOE and the CNEN concerning research and development in nuclear material control, accountancy, verification, physical protection, and advanced containment and surveillance technologies for International Safeguards Applications. The work, jointly performed by the CNEN's Safeguards Laboratory (LASAL) and the New Brunswick Laboratory (NBL), has the objective to strengthen the traceability of accountability measurements and ensure adequate quality of safeguards measurements for facilities within Brazil, utilizing test samples characterized and provided by NBL. Recommendations to participants included measurement frequency, number of results per sample and format for reporting results using ISO methods for calculating and expressing measurement uncertainties. In this paper, we discuss the main steps taken by CNEN and NBL aiming at implementing such a program and the expected results, in particular the impact of uncertainty estimation on the evaluation of performance of each participant laboratory. The program is considered by Brazilian safeguards authorities

  18. Distinctive research patterns on public sector performance measurement of public administration and accounting disciplines

    NARCIS (Netherlands)

    van Helden, G. Jan; Johnsen, Age; Vakkuri, Jarmo

    2008-01-01

    This article explores distinctive research patterns of public administration and accounting disciplines concerning public sector performance measurement (PSPM). Our review shows that accounting researchers from Europe investigate reasons for limited PM use and factors explaining a rational or

  19. Perspectives on differing health outcomes by city: accounting for Glasgow's excess mortality.

    Science.gov (United States)

    Fraser, Simon Ds; George, Steve

    2015-01-01

    Several health outcomes (including mortality) and health-related behaviors are known to be worse in Scotland than in comparable areas of Europe and the United Kingdom. Within Scotland, Greater Glasgow (in West Central Scotland) experiences disproportionately poorer outcomes independent of measurable variation in socioeconomic status and other important determinants. Many reasons for this have been proposed, particularly related to deprivation, inequalities, and variation in health behaviors. The use of models (such as the application of Bradford Hill's viewpoints on causality to the different hypotheses) has provided useful insights on potentially causal mechanisms, with health behaviors and inequalities likely to represent the strongest individual candidates. This review describes the evolution of our understanding of Glasgow's excess mortality, summarizes some of the key work in this area, and provides some suggestions for future areas of exploration. In the context of demographic change, the experience in Glasgow is an important example of the complexity that frequently lies behind observed variations in health outcomes within and between populations. A comprehensive explanation of Glasgow's excess mortality may continue to remain elusive, but is likely to lie in a complex and difficult-to-measure interplay of health determinants acting at different levels in society throughout the life course. Lessons learned from the detailed examination of different potentially causative determinants in Scotland may provide useful methodological insights that may be applied in other settings. Ongoing efforts to unravel the causal mechanisms are needed to inform public health efforts to reduce health inequalities and improve outcomes in Scotland.

  20. Nuclear materials control and accountability criteria for upgrades measures

    Energy Technology Data Exchange (ETDEWEB)

    Erkkila, B.H.; Hatcher, C.R.

    1998-11-01

    As a result of major political and societal changes in the past several years, methods of nuclear material control may no longer be as effective as in the past in Russia, the Newly Independent States (NIS), and the Baltic States (BS). The objective of the Department of Energy (DOE) Material Protection, Control, and Accounting Program (MPC and A) is to reduce the threat of nuclear proliferation by collaborating with Russia, NIS, and BS governments to promote western-style MPC and A. This cooperation will improve the MPC and A on all weapons useable nuclear materials and will establish a sustainable infrastructure to provide future support and maintenance for these technology-based improvements. Nuclear materials of proliferation concern include materials of the types and quantities that can be most easily and directly used in a nuclear weapon. Sabotage of nuclear material is an event of great concern and potentially disastrous consequences to both the US and the host country. However, sabotage is currently beyond the scope of program direction and cannot be used to justify US-funded MPC and A upgrades. Judicious MPC and A upgrades designed to protect against insider and outsider theft scenarios would also provide addition, although not comprehensive, protection against saboteurs. This paper provides some suggestions to establish consistency in prioritizing system-enhancement efforts at nuclear material facilities. The suggestions in this paper are consistent with DOE policy and directions and should be used as a supplement to any policy directives issued by NN-40, DOE Russia/NIS Task Force.

  1. Nuclear materials control and accountability criteria for upgrades measures

    International Nuclear Information System (INIS)

    Erkkila, B.H.; Hatcher, C.R.

    1998-01-01

    As a result of major political and societal changes in the past several years, methods of nuclear material control may no longer be as effective as in the past in Russia, the Newly Independent States (NIS), and the Baltic States (BS). The objective of the Department of Energy (DOE) Material Protection, Control, and Accounting Program (MPC and A) is to reduce the threat of nuclear proliferation by collaborating with Russia, NIS, and BS governments to promote western-style MPC and A. This cooperation will improve the MPC and A on all weapons useable nuclear materials and will establish a sustainable infrastructure to provide future support and maintenance for these technology-based improvements. Nuclear materials of proliferation concern include materials of the types and quantities that can be most easily and directly used in a nuclear weapon. Sabotage of nuclear material is an event of great concern and potentially disastrous consequences to both the US and the host country. However, sabotage is currently beyond the scope of program direction and cannot be used to justify US-funded MPC and A upgrades. Judicious MPC and A upgrades designed to protect against insider and outsider theft scenarios would also provide addition, although not comprehensive, protection against saboteurs. This paper provides some suggestions to establish consistency in prioritizing system-enhancement efforts at nuclear material facilities. The suggestions in this paper are consistent with DOE policy and directions and should be used as a supplement to any policy directives issued by NN-40, DOE Russia/NIS Task Force

  2. Women in Jordanian banks and performance: Financial accounting measurement

    OpenAIRE

    Muhannad Akram Ahmad; Seif Obeid Alshbiel

    2016-01-01

    This study highlights the gender diversity issues in the banking sector taking into consideration their impact on the performance measured by profitability (ROA). As the banking sector has widely been ignored from the previous studies due to their strict system, this study empirically examined the impact of the CEO gender and board with a female director on the performance of the Jordanian commercial banks in a period from 2004 to 2013. The multiple regression analysis shows that the banks wi...

  3. Accounting for heterogeneity in the measurement of hospital performance

    OpenAIRE

    Philippe K. Widmer; Peter Zweifel; Mehdi Farsi

    2011-01-01

    With prospective payment of hospitals becoming more common, measuring their performance is gaining in importance. However, the standard cost frontier model yields biased efficiency scores because it ignores technological heterogeneity between hospitals. In this paper, efficiency scores are derived from a random intercept and an extended random parameter frontier model, designed to overcome the problem of unobserved heterogeneity in stochastic frontier analysis. Using a sample of 100 Swiss ...

  4. THE PERFORMANCE OF THE ECONOMIC ENTITY MEASURED THROUGH ACCOUNTING INFORMATION

    Directory of Open Access Journals (Sweden)

    Marius Cristian Milos

    2012-01-01

    Full Text Available The users of financial statements need information regarding the resources of an economic entity and also data regarding the way in which the entity’s management is using resources. This information helps users to quantify efficiency and performance within an entity. There are many stakeholders who do show interest in an entity’s financial reports, including existing and potential investors, employees, lenders, suppliers, customers, regulators and other government agencies and not the least the common citizens. The main purpose of this paper is to highlight the importance of the performance measurement and to discuss possible reporting methods. Performance is a concept that raises many questions regarding the most accurate way or the best method for quantifying and reporting performance at the company level .So if financial performance indicators are considered to offer an accurate image of the situation of a company, the modern approach which focuses also on non-financial indicators offers new perspectives upon performance measurement, which may be really expressive and also based on simplicity.

  5. Error evaluation method for material accountancy measurement. Evaluation of random and systematic errors based on material accountancy data

    International Nuclear Information System (INIS)

    Nidaira, Kazuo

    2008-01-01

    International Target Values (ITV) shows random and systematic measurement uncertainty components as a reference for routinely achievable measurement quality in the accountancy measurement. The measurement uncertainty, called error henceforth, needs to be periodically evaluated and checked against ITV for consistency as the error varies according to measurement methods, instruments, operators, certified reference samples, frequency of calibration, and so on. In the paper an error evaluation method was developed with focuses on (1) Specifying clearly error calculation model, (2) Getting always positive random and systematic error variances, (3) Obtaining probability density distribution of an error variance and (4) Confirming the evaluation method by simulation. In addition the method was demonstrated by applying real data. (author)

  6. Hepatology may have problems with putative surrogate outcome measures

    DEFF Research Database (Denmark)

    Gluud, Christian; Brok, Jesper; Gong, Yan

    2007-01-01

    A surrogate outcome measure is a laboratory measurement, a physical sign, or another intermediate substitute that is able to predict an intervention's effect on a clinically meaningful outcome. A clinical outcome detects how a patient feels, functions, or survives. Surrogate outcome measures occur...... faster or more often, are cheaper, and/or are less invasively achieved than the clinical outcome. In practice, validation is surprisingly often overlooked, especially if a biologic plausible rationale is proposed. Surrogate outcomes must be validated before use. The first step in validation...... predicts the intervention's effect on the clinical outcome. In hepatology a number of putative surrogate outcomes are used both in clinical research and in clinical practice without having been properly validated. Sustained virological response to interferons and ribavirin in patients with chronic...

  7. Women in Jordanian banks and performance: Financial accounting measurement

    Directory of Open Access Journals (Sweden)

    Muhannad Akram Ahmad

    2016-08-01

    Full Text Available This study highlights the gender diversity issues in the banking sector taking into consideration their impact on the performance measured by profitability (ROA. As the banking sector has widely been ignored from the previous studies due to their strict system, this study empirically examined the impact of the CEO gender and board with a female director on the performance of the Jordanian commercial banks in a period from 2004 to 2013. The multiple regression analysis shows that the banks with female CEOs underperform their counterparts run by male CEOs. The reason could be due to their harmonious relationships orientation; that is, women do not tend to invest in risky investments. However, female director plays insignificant roles on the performance which supports the evidence of tokenism as argued by the psychological social theory

  8. Measuring outcomes in children's rehabilitation: a decision protocol.

    Science.gov (United States)

    Law, M; King, G; Russell, D; MacKinnon, E; Hurley, P; Murphy, C

    1999-06-01

    To develop and test the feasibility and clinical utility of a computerized self-directed software program designed to enable service providers in children's rehabilitation to make decisions about the most appropriate outcome measures to use in client and program evaluation. A before-and-after design was used to test the feasibility and initial impact of the decision-making outcome software in improving knowledge and use of clinical outcome measures. A children's rehabilitation center in a city of 50,000. All service providers in the children's rehabilitation center. Disciplines represented included early childhood education, occupational therapy, physical therapy, speech and language pathology, audiology, social work, and psychology. Using a conceptual framework based on the International Classification of Impairment, Disability, and Handicap (ICIDH), an outcome measurement decision-making protocol was developed. The decision-making protocol was computerized in an educational software program with an attached database of critically appraised measures. Participants learned about outcome measures through the program and selected outcome measures that met their specifications. The computer software was tested for feasibility in the children's rehabilitation center for 6 months. Knowledge and use of clinical outcome measures were determined before and after the feasibility testing using a survey of all service providers currently at the centre and audits of 30 randomly selected rehabilitation records (at pretest, posttest, and follow-up). Service providers indicated that the outcomes software was easy to follow and believed that the use of the ICIDH framework helped them in making decisions about selecting outcome measures. Results of the survey indicated that there were significant changes in the service providers' level of comfort with selecting measures and knowing what measures were available. Use of outcome measures as identified through the audit did not change

  9. Health outcome after major trauma: what are we measuring?

    Science.gov (United States)

    Hoffman, Karen; Cole, Elaine; Playford, E Diane; Grill, Eva; Soberg, Helene L; Brohi, Karim

    2014-01-01

    Trauma is a global disease and is among the leading causes of disability in the world. The importance of outcome beyond trauma survival has been recognised over the last decade. Despite this there is no internationally agreed approach for assessment of health outcome and rehabilitation of trauma patients. To systematically examine to what extent outcomes measures evaluate health outcomes in patients with major trauma. MEDLINE, EMBASE, and CINAHL (from 2006-2012) were searched for studies evaluating health outcome after traumatic injuries. Studies of adult patients with injuries involving at least two body areas or organ systems were included. Information on study design, outcome measures used, sample size and outcomes were extracted. The World Health Organisation International Classification of Function, Disability and Health (ICF) were used to evaluate to what extent outcome measures captured health impacts. 34 studies from 755 studies were included in the review. 38 outcome measures were identified. 21 outcome measures were used only once and only five were used in three or more studies. Only 6% of all possible health impacts were captured. Concepts related to activity and participation were the most represented but still only captured 12% of all possible concepts in this domain. Measures performed very poorly in capturing concepts related to body function (5%), functional activities (11%) and environmental factors (2%). Outcome measures used in major trauma capture only a small proportion of health impacts. There is no inclusive classification for measuring disability or health outcome following trauma. The ICF may provide a useful framework for the development of a comprehensive health outcome measure for trauma care.

  10. Health outcome after major trauma: what are we measuring?

    Directory of Open Access Journals (Sweden)

    Karen Hoffman

    Full Text Available Trauma is a global disease and is among the leading causes of disability in the world. The importance of outcome beyond trauma survival has been recognised over the last decade. Despite this there is no internationally agreed approach for assessment of health outcome and rehabilitation of trauma patients.To systematically examine to what extent outcomes measures evaluate health outcomes in patients with major trauma.MEDLINE, EMBASE, and CINAHL (from 2006-2012 were searched for studies evaluating health outcome after traumatic injuries.Studies of adult patients with injuries involving at least two body areas or organ systems were included. Information on study design, outcome measures used, sample size and outcomes were extracted. The World Health Organisation International Classification of Function, Disability and Health (ICF were used to evaluate to what extent outcome measures captured health impacts.34 studies from 755 studies were included in the review. 38 outcome measures were identified. 21 outcome measures were used only once and only five were used in three or more studies. Only 6% of all possible health impacts were captured. Concepts related to activity and participation were the most represented but still only captured 12% of all possible concepts in this domain. Measures performed very poorly in capturing concepts related to body function (5%, functional activities (11% and environmental factors (2%.Outcome measures used in major trauma capture only a small proportion of health impacts. There is no inclusive classification for measuring disability or health outcome following trauma. The ICF may provide a useful framework for the development of a comprehensive health outcome measure for trauma care.

  11. Rethinking The Going Concern Assumption As A Pre-Condition For Accounting Measurement

    OpenAIRE

    Saratiel Wedzerai Musvoto; Daan G Gouws

    2011-01-01

    This study compares the principles of the going concern concept against the principles of representational measurement to determine if it is possible to establish foundations of accounting measurement with the going concern concept as a precondition. Representational measurement theory is a theory that establishes measurement in social scientific disciplines such as accounting. The going concern assumption is prescribed as one of the preconditions for measuring the attributes of the elements ...

  12. Measuring Learning Outcomes in Library Instruction

    OpenAIRE

    Connor, Elizabeth

    2010-01-01

    The author uses clicker technology to incorporate polling and multiple choice question techniques into library instruction classes. Clickers can be used to give a keener understanding of how many students grasp the concepts presented in a specific class session. Typically, a student that aces a definition-type question will fail to answer an application-type question correctly. Immediate, electronic feedback helps to calibrate teaching approaches and gather data about learning outcomes. Th...

  13. Toward defining and measuring social accountability in graduate medical education: a stakeholder study.

    Science.gov (United States)

    Reddy, Anjani T; Lazreg, Sonia A; Phillips, Robert L; Bazemore, Andrew W; Lucan, Sean C

    2013-09-01

    Since 1965, Medicare has publically financed graduate medical education (GME) in the United States. Given public financing, various advisory groups have argued that GME should be more socially accountable. Several efforts are underway to develop accountability measures for GME that could be tied to Medicare payments, but it is not clear how to measure or even define social accountability. We explored how GME stakeholders perceive, define, and measure social accountability. Through purposive and snowball sampling, we completed semistructured interviews with 18 GME stakeholders from GME training sites, government agencies, and health care organizations. We analyzed interview field notes and audiorecordings using a flexible, iterative, qualitative group process to identify themes. THREE THEMES EMERGED IN REGARDS TO DEFINING SOCIAL ACCOUNTABILITY: (1) creating a diverse physician workforce to address regional needs and primary care and specialty shortages; (2) ensuring quality in training and care to best serve patients; and (3) providing service to surrounding communities and the general public. All but 1 stakeholder believed GME institutions have a responsibility to be socially accountable. Reported barriers to achieving social accountability included training time constraints, financial limitations, and institutional resistance. Suggestions for measuring social accountability included reviewing graduates' specialties and practice locations, evaluating curricular content, and reviewing program services to surrounding communities. Most stakeholders endorsed the concept of social accountability in GME, suggesting definitions and possible measures that could inform policy makers calls for increased accountability despite recognized barriers.

  14. Staff perceptions of using outcome measures in stroke rehabilitation.

    Science.gov (United States)

    Burton, Louisa-Jane; Tyson, Sarah; McGovern, Alison

    2013-05-01

    The use of standardised outcome measures is an integral part of stroke rehabilitation and is widely recommended as good practice. However, little is known about how measures are actually used or their impact. This study aimed to identify current clinical practice; how healthcare professionals working in stroke rehabilitation use outcome measures and their perceptions of the benefits and barriers to use. Eighty-four Health Care Professionals and 12 service managers and commissioners working in stroke services across a large UK county were surveyed by postal questionnaire. Ninety-six percent of clinical respondents used at least one measure, however, less than half used measures regularly during a patient's stay. The mean number of tools used was 3.2 (SD = 1.9). Eighty-one different tools were identified; 16 of which were unpublished and unvalidated. Perceived barriers in using outcome measures in day-to-day clinical practice included lack of resources (time and training) and lack of knowledge of appropriate measures. Benefits identified were to demonstrate the effectiveness of rehabilitation interventions and monitor patients' progress. Although the use of outcome measures is prevalent in clinical practice, there is little consistency in the tools utilised. The term "outcome measures" is used, but staff rarely used the measures at appropriate time points to formally assess and evaluate outcome. The term "measurement tool" more accurately reflects the purposes to which they were put and potential benefits. Further research to overcome the barriers in using standardised measurement tools and evaluate the impact of implementation on clinical practice is needed. • Health professionals working in stroke rehabilitation should work together to agree when and how outcome measures can be most effectively used in their service. • Efforts should be made to ensure that standardised tools are used to measure outcome at set time-points during rehabilitation, in order to

  15. 77 FR 74119 - Snapper-Grouper Fishery of the South Atlantic; 2012 Commercial Accountability Measure and Closure...

    Science.gov (United States)

    2012-12-13

    ... Accountability Measure and Closure for South Atlantic Snowy Grouper AGENCY: National Marine Fisheries Service...; closure. SUMMARY: NMFS implements accountability measures (AMs) for the commercial sector for snowy...

  16. 76 FR 61284 - Accountability Measures and Reduced Season for the South Atlantic Recreational Sector of Golden...

    Science.gov (United States)

    2011-10-04

    ... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration 50 CFR Part 622 [Docket No. 0907271173-0629-03] RIN 0648-XA701 Accountability Measures and Reduced Season for the South Atlantic.... SUMMARY: NMFS implements accountability measures (AMs) for the recreational sector of golden tilefish in...

  17. 48 CFR 9904.412 - Cost accounting standard for composition and measurement of pension cost.

    Science.gov (United States)

    2010-10-01

    ... accounting standard for composition and measurement of pension cost. ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Cost accounting standard for composition and measurement of pension cost. 9904.412 Section 9904.412 Federal Acquisition...

  18. Outcome measurements in major trauma--results of a consensus meeting.

    Science.gov (United States)

    Ardolino, A; Sleat, G; Willett, K

    2012-10-01

    The NHS Outcomes Framework for England has identified recovery from major injury as an important clinical area. At present, there are no established outcome indicators. As more patients survive major trauma, outcomes will need to be measured in terms of morbidity and not mortality alone. To make recommendations for a selection of outcome measures that could be integrated into National Clinical Audit data collection and form part of clinical governance requirements for Regional Trauma Networks (RTNs) and measures by which RTNs are held to account by government. Specific focus was given to acute care and rehabilitation for both adults and children. A Multiprofessional, multidisciplinary expert group reviewed the current evidence on outcome measures for major trauma in the adult and children's populations, informed by a systematic review carried out jointly by the Trauma Audit and Research Network (TARN) and the Cochrane Injuries Group. A structured discussion covered functional and quality of life outcome measures as well as patient experience and indicators such as return to work, education and social dependency. For the adult population the group agreed with the in-hospital performance and hospital discharge measures recommended in the TARN and Cochrane systematic review. Concerning longer-term outcome indicators, the group suggested the use of the Glasgow Outcome Scale - Extended (GOS-E) and European Quality of Life 5D (EQ-5D) with consideration to be given to the World Health Organisation Quality of Life survey (WHO-QoL). For patients who had ongoing inpatient rehabilitation needs the group thought the measurement of the Rehabilitation Complexity Scale (RCS) and Functional Independence Measure (FIM) were important in total brain injury and, the American Spinal Injury Association Impairment Scale (ASIA) and Spinal Cord Independence Measure (SCIM) in spinal cord injury. For children the group recommended the use of the King's Outcome Scale for Childhood Head Injury

  19. Inter-provider comparison of patient-reported outcomes: developing an adjustment to account for differences in patient case mix.

    Science.gov (United States)

    Nuttall, David; Parkin, David; Devlin, Nancy

    2015-01-01

    This paper describes the development of a methodology for the case-mix adjustment of patient-reported outcome measures (PROMs) data permitting the comparison of outcomes between providers on a like-for-like basis. Statistical models that take account of provider-specific effects form the basis of the proposed case-mix adjustment methodology. Indirect standardisation provides a transparent means of case mix adjusting the PROMs data, which are updated on a monthly basis. Recently published PROMs data for patients undergoing unilateral knee replacement are used to estimate empirical models and to demonstrate the application of the proposed case-mix adjustment methodology in practice. The results are illustrative and are used to highlight a number of theoretical and empirical issues that warrant further exploration. For example, because of differences between PROMs instruments, case-mix adjustment methodologies may require instrument-specific approaches. A number of key assumptions are made in estimating the empirical models, which could be open to challenge. The covariates of post-operative health status could be expanded, and alternative econometric methods could be employed. © 2013 Crown copyright.

  20. Alternate financial incentives in multi-tiered formulary systems to improve accountability for outcomes.

    Science.gov (United States)

    Chung, Richard S; Taira, Deborah A; Noh, Charles

    2003-01-01

    Drug manufacturer rebates paid to health plans and pharmacy benefit management companies have come under increased public scrutiny. Over the past several years, numerous articles have appeared in the literature encouraging a shift to a more quality-based decision-making process for health plan drug formularies. To propose a new basis for formulary placement decisions that would include consideration of health-plan-specific measures (clinical outcomes, total cost, adherence, and appropriateness of care) and align incentives for health plans, physicians, pharmacists, and pharmaceutical companies to promote high-quality care. The proposed approach builds on key components of the Pharmacy's Framework for Drug Therapy Management in the 21st Century and the Academy of Managed Care Pharmacy's Format for Formulary Submission, including a focus on patient outcomes and evidence-based decision making. The proposed approach would lessen the influence of drug manufacturer rebates on formulary placement by shifting the focus to appropriateness of care, clinical outcomes, patient adherence, and total cost of care. Pharmaceutical manufacturers would benefit from the focus on adherence to drug therapy and total cost of care. Health plans and pharmacy benefit management companies would gain in that they may be able to reduce efforts in drug utilization review as pharmaceutical manufacturers are given incentives to market their drugs more appropriately. Physicians and pharmacists would benefit because the rebate money would be used to provide quality-based financial incentives related to adherence and appropriate use of drugs. The implementation of this approach would be difficult and require cooperation from employers, pharmacists, pharmaceutical manufacturers, health plans, and pharmacy benefit management companies. Aspects of this approach could be incorporated into existing pharmacy benefit management processes to encourage the delivery of high-quality health care.

  1. Improving Outcome Measures Other Than Achievement

    Directory of Open Access Journals (Sweden)

    Kristin Anderson Moore

    2015-05-01

    Full Text Available Research indicates that educational, economic, and life success reflect children’s nonacademic as well as academic competencies. Therefore, longitudinal surveys that assess educational progress and success need to incorporate nonacademic measures to avoid omitted variable bias, inform development of new intervention strategies, and support mediating and moderating analyses. Based on a life course model and a whole child perspective, this article suggests constructs in the domains of child health, emotional/psychological development, educational achievement/attainment, social behavior, and social relationships. Four critical constructs are highlighted: self-regulation, agency/motivation, persistence/diligence, and executive functioning. Other constructs that are currently measured need to be retained, including social skills, positive relationships, activities, positive behaviors, academic self-efficacy, educational engagement, and internalizing/emotional well-being. Examples of measures that are substantively and psychometrically robust are provided.

  2. Accounting for measurement reliability to improve the quality of inference in dental microhardness research: a worked example.

    Science.gov (United States)

    Sever, Ivan; Klaric, Eva; Tarle, Zrinka

    2016-07-01

    Dental microhardness experiments are influenced by unobserved factors related to the varying tooth characteristics that affect measurement reproducibility. This paper explores the appropriate analytical tools for modeling different sources of unobserved variability to reduce the biases encountered and increase the validity of microhardness studies. The enamel microhardness of human third molars was measured by Vickers diamond. The effects of five bleaching agents-10, 16, and 30 % carbamide peroxide, and 25 and 38 % hydrogen peroxide-were examined, as well as the effect of artificial saliva and amorphous calcium phosphate. To account for both between- and within-tooth heterogeneity in evaluating treatment effects, the statistical analysis was performed in the mixed-effects framework, which also included the appropriate weighting procedure to adjust for confounding. The results were compared to those of the standard ANOVA model usually applied. The weighted mixed-effects model produced the parameter estimates of different magnitude and significance than the standard ANOVA model. The results of the former model were more intuitive, with more precise estimates and better fit. Confounding could seriously bias the study outcomes, highlighting the need for more robust statistical procedures in dental research that account for the measurement reliability. The presented framework is more flexible and informative than existing analytical techniques and may improve the quality of inference in dental research. Reported results could be misleading if underlying heterogeneity of microhardness measurements is not taken into account. The confidence in treatment outcomes could be increased by applying the framework presented.

  3. Performance of an accountability measurement system at an operating fuel reprocessing facility

    International Nuclear Information System (INIS)

    Wade, M.A.; Spraktes, F.W.; Hand, R.L.; Baldwin, J.M.; Filby, E.E.; Lewis, L.C.

    1978-01-01

    The ICPP has been engaged for 25 years in the recovery of uranium from spent reactor fuels. In concert with the reprocessing activity, an accountability measurements system has been operated throughout the history of the ICPP. The structure and functions of the accountability measurements system are presented. Its performance is evaluated in order to illustrate the relation of analytical methodology to the overall measurements system. 6 figures, 5 tables

  4. Measurement Bases for Acquisitions and Mergers in Financial Accounting and in Commercial Law

    OpenAIRE

    Vomáčková, Hana

    2011-01-01

    In association with transactions involving businesses, acquisitions and mergers, etc., commercial law stipulates the new measurement of business assets and thus also net business assets. Similarly, financial accounting stipulates the new measurement of assets, liabilities and net assets with an impact on the amount and structure of equity. It is a principal question as to whether the new measurement bases required by both commercial law and financial accounting are in principal identical. Pra...

  5. Does public reporting measure up? Federalism, accountability and child-care policy in Canada.

    Science.gov (United States)

    Anderson, Lynell; Findlay, Tammy

    2010-01-01

    Governments in Canada have recently been exploring new accountability measures within intergovernmental relations. Public reporting has become the preferred mechanism in a range of policy areas, including early learning and child-care, and the authors assess its effectiveness as an accountability measure. The article is based on their experience with a community capacity-building project that considers the relationship between the public policy, funding and accountability mechanisms under the federal/provincial/territorial agreements related to child-care. The authors argue that in its current form, public reporting has not lived up to its promise of accountability to citizens. This evaluation is based on the standards that governments have set for themselves under the federal/provincial/territorial agreements, as well as guidelines set by the Public Sector Accounting Board, an independent body that develops accounting standards over time through consultation with governments.

  6. Systematic Review of Treatment Outcome Measures for Vulvodynia.

    Science.gov (United States)

    Sadownik, Leslie A; Yong, Paul J; Smith, Kelly B

    2018-07-01

    To systematically evaluate the literature regarding vulvodynia treatment outcome measures. A systematic literature search on OVID, PubMed, and PsycINFO databases was conducted from inception until May 2016. Studies were included/excluded based on prespecified criteria. Reported outcome measures were organized into 6 core outcome domains recommended by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT): pain; physical functioning, emotional functioning, participant ratings of global improvement and satisfaction with treatment, symptoms and adverse events, and participant disposition. Of the 206 articles identified for full-text screening, 33 met our criteria. One study adhered to all IMMPACT recommendations. The number of outcomes measured per study ranged from 1 to greater than 20. Patient-reported pain outcomes were found in the majority (27/33; 82%) of studies. Pain severity with intercourse was reported by 24 (73%) of 33 studies-9 different scales were used to measure this outcome. Clinician-reported outcomes were present in 14 (42%) of 33 studies. Methods of measuring vestibular sensitivity by "cotton swab" test were different in 8 of 10 studies. Other domains reported included; physical function (8/33 studies; 24%), sexual function (23/33 studies; 70%), and emotional function (13/33 studies; 39%). Symptoms and adverse events were reported by 15 (45%) of 33 studies. One study formally reported participant disposition using all the information recommended by CONSORT. Comparison of clinical trial results in vulvodynia is not possible because of a lack of standard treatment outcome measures. Vulvodynia researchers should apply the IMMPACT criteria to guide the development of a minimum core set of standard outcome measures that measure holistic health.

  7. Knee Injury and Osteoarthritis Outcome Score (KOOS)--development of a self-administered outcome measure

    DEFF Research Database (Denmark)

    Roos, Ewa M.; Roos, H P; Lohmander, L S

    1998-01-01

    There is broad consensus that good outcome measures are needed to distinguish interventions that are effective from those that are not. This task requires standardized, patient-centered measures that can be administered at a low cost. We developed a questionnaire to assess short- and long......-term patient-relevant outcomes following knee injury, based on the WOMAC Osteoarthritis Index, a literature review, an expert panel, and a pilot study. The Knee injury and Osteoarthritis Outcome Score (KOOS) is self-administered and assesses five outcomes: pain, symptoms, activities of daily living, sport...

  8. Measuring the Alignment between States' Finance and Accountability Policies: The Opportunity Gap

    Science.gov (United States)

    Della Sala, Matthew R.; Knoeppel, Robert C.

    2015-01-01

    The research described in this paper expands on attempts to conceptualize, measure, and evaluate the degree to which states have aligned their finance systems with their respective accountability policies. State education finance and accountability policies serve as levers to provide equal educational opportunities for all students--scholars have…

  9. A Binomial Test of Group Differences with Correlated Outcome Measures

    Science.gov (United States)

    Onwuegbuzie, Anthony J.; Levin, Joel R.; Ferron, John M.

    2011-01-01

    Building on previous arguments for why educational researchers should not provide effect-size estimates in the face of statistically nonsignificant outcomes (Robinson & Levin, 1997), Onwuegbuzie and Levin (2005) proposed a 3-step statistical approach for assessing group differences when multiple outcome measures are individually analyzed…

  10. Culturally Sensitive and Environment-Friendly Outcome Measures in

    African Journals Online (AJOL)

    Dr Olaleye

    to review research studies on outcome measures that were developed for ... A systematic review of evidence on culturally sensitive and environment- ... Various databases including Google Scholar, PEDro and PubMed were accessed to search for relevant empirical ... utilization of disease-specific, patient-centered outcome.

  11. Measuring Outcomes for Children Late Placed for Adoption.

    Science.gov (United States)

    Rushton, Alan

    1998-01-01

    Describes the selection of outcome measures used by the Maudsley Family Research team to assess outcomes--across a broad range of developmental dimensions--of permanent placement for children and adolescents. Developed a package of instruments to examine child emotional, cognitive, social, and academic development; attachment; and self-esteem, for…

  12. Applications of bulk measurement techniques for the near-real-time accounting system at the BNFP

    International Nuclear Information System (INIS)

    Ellis, J.H.

    1981-11-01

    Nuclear materials accountancy at the Barnwell Nuclear Fuel Plant (BNFP) is based primarily on bulk measurement of aqueous solutions containing uranium, plutonium, and fission products. Since 1973, Allied-General Nuclear Services (AGNS) has been adapting volume measurement and measurement control techniques at the various key measurement points within the plant. Starting in 1977, AGNS has been incorporating these measurement activities into a computerized nuclear materials control and accounting system (CNMCAS). This paper presents the major features of the measurement systems and describes the results of plant-scale testing of the system using unirradiated natural uranium. The results of these tests indicate that total uncertainties of about 0.2% of throughput (2 sigma level) can be achieved for conventional accounting and about 2.0% of hold-up can be achieved for in-process inventory estimates. These results are based on measurement of almost 500 MTU of throughput over 130 operating days

  13. The Development of NOAA Education Common Outcome Performance Measures (Invited)

    Science.gov (United States)

    Baek, J.

    2013-12-01

    The National Oceanic and Atmospheric Administration (NOAA) Education Council has embarked on an ambitious Monitoring and Evaluation (M&E) project that will allow it to assess education program outcomes and impacts across the agency, line offices, and programs. The purpose of this internal effort is to link outcome measures to program efforts and to evaluate the success of the agency's education programs in meeting the strategic goals. Using an outcome-based evaluation approach, the NOAA Education Council is developing two sets of common outcome performance measures, environmental stewardship and professional development. This presentation will examine the benefits and tradeoffs of common outcome performance measures that collect program results across a portfolio of education programs focused on common outcomes. Common outcome performance measures have a few benefits to our agency and to the climate education field at large. The primary benefit is shared understanding, which comes from our process for writing common outcome performance measures. Without a shared and agreed upon set of definitions for the measure of an outcome, the reported results may not be measuring the same things and would incorrectly indicate levels of performance. Therefore, our writing process relies on a commitment to developing a shared set of definitions based on consensus. We hope that by taking the time to debate and coming to agreement across a diverse set of programs, the strength of our common measures can indicate real progress towards outcomes we care about. An additional benefit is that these common measures can be adopted and adapted by other agencies and organizations that share similar theories of change. The measures are not without their drawbacks, and we do make tradeoffs as part of our process in order to continue making progress. We know that any measure is necessarily a narrow slice of performance. A slice that may not best represent the unique and remarkable contribution

  14. Understanding paediatric rehabilitation therapists' lack of use of outcome measures.

    Science.gov (United States)

    King, Gillian; Wright, Virginia; Russell, Dianne J

    2011-01-01

    Despite widespread educational and promotional efforts, paediatric rehabilitation therapists still do not systematically or routinely use outcome measures. A review of contextual and psychosocial factors affecting therapists' use of outcome measures was performed, incorporating information from past studies of barriers to therapists' use of measures and more recent information about measure use, knowledge brokering and expert practice. This cumulative and contextual overview provided insights into how many therapists may approach practice. Therapists' beliefs in the importance of establishing effective relationships may lead them to place less value on formal measurement, to adopt a less rigorous and more pragmatic approach to ascertaining whether outcomes are achieved, and to avoid measures that may show little improvement. A relational goal-oriented approach to practice is proposed in which therapists adopt a broader facilitative and educational role with families about the importance of the measurement process.

  15. Unemployment, labour slack and labour market accounting. Theory, measurement and policy

    NARCIS (Netherlands)

    Neubourg, Christiaan Rita Jan de

    1987-01-01

    This study investigates how our understanding of unemployment and the utilisation of labour resources can be refined by the application of a system of labour market accounts and a new measure of labour slack. ... Zie: Summary

  16. Transportation Satellite Accounts : A New Way of Measuring Transportation Services in America

    Science.gov (United States)

    2011-01-01

    Transportation Satellite Accounts (TSA), produced by the Bureau of Economic Analysis and the Bureau of Transportation Statistics, provides measures of national transportation output. TSA includes both in-house and for-hire transportation services. Fo...

  17. Outcome Measurement in Nursing: Imperatives, Ideals, History, and Challenges

    Science.gov (United States)

    Jones, Terry L

    2016-05-31

    Nurses have a social responsibility to evaluate the effect of nursing practice on patient outcomes in the areas of health promotion; injury and illness prevention; and alleviation of suffering. Quality assessment initiatives are hindered by the paucity of available data related to nursing processes and patient outcomes across these three domains of practice. Direct care nurses are integral to self-regulation for the discipline as they are the best source of information about nursing practice and patient outcomes. Evidence supports the assumption that nurses do contribute to prevention of adverse events but there is insufficient evidence to explain how nurses contribute to these and/or other patient outcomes. The purposes of this article are to examine the imperatives, ideal conditions, history, and challenges related to effective outcome measurement in nursing. The article concludes with recommendations for action to move quality assessment forward, such as substantial investment to support adequate documentation of nursing practice and patient outcomes.

  18. The Impact of Merit Pay on Teaching and Research Outcomes of Accounting Programs

    Science.gov (United States)

    Lindsay, David H.; Campbell, Annhenrie; Tan, Kim B.

    2012-01-01

    Basing the compensation of accounting professors on merit pay in order to encourage better teaching, research and service is controversial. This study uses data from a survey of the 852 accounting programs in the United States to empirically examine the influence of merit-based salary plans. Findings indicate a strong positive association between…

  19. Water Accounting Plus (WA+ – a water accounting procedure for complex river basins based on satellite measurements

    Directory of Open Access Journals (Sweden)

    P. Karimi

    2013-07-01

    Full Text Available Coping with water scarcity and growing competition for water among different sectors requires proper water management strategies and decision processes. A pre-requisite is a clear understanding of the basin hydrological processes, manageable and unmanageable water flows, the interaction with land use and opportunities to mitigate the negative effects and increase the benefits of water depletion on society. Currently, water professionals do not have a common framework that links depletion to user groups of water and their benefits. The absence of a standard hydrological and water management summary is causing confusion and wrong decisions. The non-availability of water flow data is one of the underpinning reasons for not having operational water accounting systems for river basins in place. In this paper, we introduce Water Accounting Plus (WA+, which is a new framework designed to provide explicit spatial information on water depletion and net withdrawal processes in complex river basins. The influence of land use and landscape evapotranspiration on the water cycle is described explicitly by defining land use groups with common characteristics. WA+ presents four sheets including (i a resource base sheet, (ii an evapotranspiration sheet, (iii a productivity sheet, and (iv a withdrawal sheet. Every sheet encompasses a set of indicators that summarise the overall water resources situation. The impact of external (e.g., climate change and internal influences (e.g., infrastructure building can be estimated by studying the changes in these WA+ indicators. Satellite measurements can be used to acquire a vast amount of required data but is not a precondition for implementing WA+ framework. Data from hydrological models and water allocation models can also be used as inputs to WA+.

  20. 78 FR 13284 - Fisheries of the Caribbean, Gulf of Mexico, and South Atlantic; 2013 Accountability Measures for...

    Science.gov (United States)

    2013-02-27

    ... Accountability Measures for Gulf of Mexico Commercial Greater Amberjack AGENCY: National Marine Fisheries Service...; accountability measures. SUMMARY: NMFS implements accountability measures (AMs) for commercial greater amberjack... accountability. On November 13, 2012, NMFS published a final rule for Amendment 35 (77 FR 67574). That final rule...

  1. The Popularity of Outcome Measures for Hip and Knee Arthroplasties.

    Science.gov (United States)

    Lovelock, Thomas M; Broughton, Nigel S; Williams, Cylie M

    2018-01-01

    The optimal methods of determining outcomes following hip and knee arthroplasty remain controversial. The objectives of this study were to determine the most frequently used outcome measures in randomized controlled trials (RCT) and study protocols registered with clinical trials registries (CTR) on hip and knee arthroplasty. A systematic search strategy was undertaken to identify the outcome measures used in RCT and CTR following joint arthroplasty. Databases searched included Embase, Ovid MEDLINE (including In-Process), Cochrane Central Register of Controlled Trials, CINAHL Plus, clinicaltrials.gov, ISRCTN registry, and ANZCTR. Differences in the use of outcome measures between RCT and CTR were assessed using logistic regression. There were 291 RCT and 113 CTR on hip arthroplasty and 452 RCT and 184 CTR on knee arthroplasty that met the inclusion criteria. The most popular outcome measures were the Harris Hip Score and the Knee Society Score. Multiple outcome measures were used in greater than 50% of the included studies. The Oxford Hip Score, Oxford Knee Score, EuroQol-5D, and Knee Injury and Osteoarthritis Outcome Score (all P < .001) were used in significantly more CTR than RCT. There is a clear preference for the use of the Harris Hip Score and Knee Society Score, contrary to existing international guidelines and reviews on the topic. Both measures require clinician input, which potentially influences their validity and increases their overall administration cost. Some patient-reported outcome measures, such as the Oxford Hip and Knee Scores, EuroQol-5D, and KOOS, appear to be increasing in popularity. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. The impact of retirement account distributions on measures of family income.

    Science.gov (United States)

    Iams, Howard M; Purcell, Patrick J

    2013-01-01

    In recent decades, employers have increasingly replaced defined benefit (DB) pensions with defined contribution (DC) retirement accounts for their employees. DB plans provide annuities, or lifetime benefits paid at regular intervals. The timing and amounts of DC distributions, however, may vary widely. Most surveys that provide data on the family income of the aged either collect no data on nonannuity retirement account distributions, or exclude such distributions from their summary measures of family income. We use Survey of Income and Program Participation (SIPP) data for 2009 to estimate the impact of including retirement account distributions on total family income calculations. We find that about one-fifth of aged families received distributions from retirement accounts in 2009. Measured mean income for those families would be about 15 percent higher and median income would be 18 percent higher if those distributions were included in the SIPP summary measure of family income.

  3. Outcomes assessment in rotator cuff pathology: what are we measuring?

    Science.gov (United States)

    Makhni, Eric C; Steinhaus, Michael E; Morrow, Zachary S; Jobin, Charles M; Verma, Nikhil N; Cole, Brian J; Bach, Bernard R

    2015-12-01

    Assessments used to measure outcomes associated with rotator cuff pathology and after repair are varied. This lack of standardization leads to difficulty drawing comparisons across studies. We hypothesize that this variability in patient-reported outcome measures and objective metrics used in rotator cuff studies persists even in high-impact, peer reviewed journals. All studies assessing rotator cuff tear and repair outcomes in 6 orthopedic journals with a high impact factor from January 2010 to December 2014 were reviewed. Cadaveric and animal studies and those without outcomes were excluded. Outcome measures included range of motion (forward elevation, abduction, external rotation, and internal rotation), strength (in the same 4 planes), tendon integrity imaging, patient satisfaction, and functional assessment scores. Of the 156 included studies, 63% documented range of motion measurements, with 18% reporting range of motion in all 4 planes. Only 38% of studies reported quantitative strength measurements. In 65% of studies, tendon integrity was documented with imaging (38% magnetic resonance imaging/magnetic resonance anrhrogram, 31% ultrasound, and 8% computed tomography arthrogram). Finally, functional score reporting varied significantly, with the 5 most frequently reported scores ranging from 16% to 61% in studies, and 15 of the least reported outcomes were each reported in ≤6% of studies. Significant variability exists in outcomes reporting after rotator cuff tear and repair, making comparisons between clinical studies difficult. Creating a uniformly accepted, validated outcomes tool that assesses pain, function, patient satisfaction, and anatomic integrity would enable consistent outcomes assessment after operative and nonoperative management and allow comparisons across the literature. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  4. The need for global application of the accountability for reasonableness approach to support sustainable outcomes

    DEFF Research Database (Denmark)

    Byskov, Jens; Maluka, Stephen Oswald; Marchal, Bruno

    2017-01-01

    The accountability for reasonableness (AFR) concept has been developed and discussed for over two decades. Its interpretation has been studied in several ways partly guided by the specific settings and the researchers involved. This has again influenced the development of the concept, but not led...... lead to optimally accountable, fair and sustainable solutions. Technical experts, politicians, managers, service providers, community members, and beneficiaries each have their own values, expertise and preferences, to be considered for necessary buy in and sustainability. Legitimacy, accountability...... should be widely adopted in projects and services under close monitoring and frequent reviews....

  5. Measuring and communicating meaningful outcomes in neonatology: A family perspective.

    Science.gov (United States)

    Janvier, Annie; Farlow, Barbara; Baardsnes, Jason; Pearce, Rebecca; Barrington, Keith J

    2016-12-01

    Medium- and long-term outcomes have been collected and described among survivors of neonatal intensive care units for decades, for a number of purposes: (1) quality control within units, (2) comparisons of outcomes between NICUs, (3) clinical trials (whether an intervention improves outcomes), (4) end-of-life decision-making, (5) to better understand the effects of neonatal conditions and/or interventions on organs and/or long-term health, and finally (6) to better prepare parents for the future. However, the outcomes evaluated have been selected by investigators, based on feasibility, availability, cost, stability, and on what investigators consider to be important. Many of the routinely measured outcomes have major limitations: they may not correlate well with long-term difficulties, they may artificially divide continuous outcomes into dichotomous ones, and may have no clear relationship with quality of life and functioning of children and their families. Several investigations, such as routine term cerebral resonance imaging for preterm infants, have also not yet been shown to improve the outcome of children nor their families. In this article, the most common variables used in neonatology as well as some variables which are rarely measured but may be of equal importance for families are presented. The manner in which these outcomes are communicated to families will be examined, as well as recommendations to optimize communication with parents. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Do Activity Level Outcome Measures Commonly Used in Neurological Practice Assess Upper-Limb Movement Quality?

    Science.gov (United States)

    Demers, Marika; Levin, Mindy F

    2017-07-01

    Movement is described in terms of task-related end point characteristics in external space and movement quality (joint rotations in body space). Assessment of upper-limb (UL) movement quality can assist therapists in designing effective treatment approaches for retraining lost motor elements and provide more detailed measurements of UL motor improvements over time. To determine the extent to which current activity level outcome measures used in neurological practice assess UL movement quality. Outcome measures assessing arm/hand function at the International Classification of Function activity level recommended by neurological clinical practice guidelines were reviewed. Measures assessing the UL as part of a general mobility assessment, those strictly evaluating body function/structure or participation, and paediatric measures were excluded. In all, 15 activity level outcome measures were identified; 9 measures assess how movement is performed by measuring either end point characteristics or movement quality. However, except for the Reaching Performance Scale for Stroke and the Motor Evaluation Scale for Upper Extremity in Stroke Patients, these measures only account for deficits indirectly by giving a partial score if movements are slower or if the person experiences difficulties. Six outcome measures neither assess any parameters related to movement quality, nor distinguish between improvements resulting from motor compensation or recovery of desired movement strategies. Current activity measures may not distinguish recovery from compensation and adequately track changes in movement quality over time. Movement quality may be incorporated into clinical assessment using observational kinematics with or without low-cost motion tracking technology.

  7. Models and error analyses of measuring instruments in accountability systems in safeguards control

    International Nuclear Information System (INIS)

    Dattatreya, E.S.

    1977-05-01

    Essentially three types of measuring instruments are used in plutonium accountability systems: (1) the bubblers, for measuring the total volume of liquid in the holding tanks, (2) coulometers, titration apparatus and calorimeters, for measuring the concentration of plutonium; and (3) spectrometers, for measuring isotopic composition. These three classes of instruments are modeled and analyzed. Finally, the uncertainty in the estimation of total plutonium in the holding tank is determined

  8. Toward a Measure of Accountability in Nursing: A Three-Stage Validation Study.

    Science.gov (United States)

    Drach-Zahavy, Anat; Leonenko, Marina; Srulovici, Einav

    2018-06-04

    To develop and psychometrically evaluate a three-dimensional questionnaire suitable for evaluating personal and organizational accountability in nurses. Accountability is defined as a three-dimensional value, directing professionals to take responsibility for their decisions and actions, to be willing to explain them (transparency) and to be judged according to society's accepted values (answerability). Despite the relatively clear definition, measurement of accountability lags well behind. Existing self-report questionnaires do not fully capture the complexity of the concept; nor do they capture the different sources of accountability (e.g., personal accountability, organizational accountability). A three-stage measure development. Data were collected during 2015-2016. In Phase 1, an initial database of items (N = 74) was developed, based on literature review and qualitative study, establishing face and content validity. In Phase 2, the face, content, construct and criterion-related validity of the initial questionnaires (19 items for personal and organizational accountability questionnaire) was established with a sample of 229 nurses. In Phase 3, the final questionnaires (19 items each) were validated with a new sample of 329 nurses and established construct validity. The final version of the instruments comprised 19 items, suitable for assessing personal and organizational accountability. The questionnaire referred to the dimensions of responsibility, transparency and answerability. The findings established the instrument's content, construct and criterion-related validity, as well as good internal reliability. The questionnaire portrays accountability in nursing, by capturing nurses' subjective perceptions of accountability dimensions (responsibility, transparency, answerability), as demonstrated by personal and organizational values. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  9. Using Patient Reported Outcomes Measures to Promote Integrated Care

    Directory of Open Access Journals (Sweden)

    Marcel G. M. Olde Rikkert

    2018-04-01

    Full Text Available Introduction: Patient reported outcome measures (PROMs have been introduced as standardised outcomes, but have not been implemented widely for disease targeted pathways of care, nor for geriatric patients who prefer functional performance and quality of life. Discussion: We describe innovative multipurpose implementation of PROMs as evidenced by two best practices of PROMs application in geriatric and physiotherapy practice. We show that PROMs can show meaningful outcomes in older subjects’ patient journeys, which can at the same time serve individuals and groups of both patients and professionals. Key lesson: PROMs can deliver generic outcomes relevant for older patients, may improve patient-physician relationship, quality of care and prediction of future outcomes in geriatric care, if they are valid, reliable and responsive, but still short and simple. A precondition to make the hard tip from research to practice is that PROMs are carefully positioned in the clinical encounters and in electronic health records.

  10. Disability outcome measures in multiple sclerosis clinical trials

    DEFF Research Database (Denmark)

    Cohen, Jeffrey A; Reingold, Stephen C; Polman, Chris H

    2012-01-01

    Many of the available disability outcome measures used in clinical trials of multiple sclerosis are insensitive to change over time, inadequately validated, or insensitive to patient-perceived health status or quality of life. Increasing focus on therapies that slow or reverse disability...... recommend practical refinements. Conversely, although substantial data support the multiple sclerosis functional composite as an alternative measure, changes to its component tests and scoring method are needed. Novel approaches, including the use of composite endpoints, patient-reported outcomes...... progression makes it essential to refine existing measures or to develop new tools. Major changes to the expanded disability status scale should be avoided to prevent the loss of acceptance by regulators as a measure for primary outcomes in trials that provide substantial evidence of effectiveness. Rather, we...

  11. Measuring Patient-Reported Outcomes: Key Metrics in Reconstructive Surgery.

    Science.gov (United States)

    Voineskos, Sophocles H; Nelson, Jonas A; Klassen, Anne F; Pusic, Andrea L

    2018-01-29

    Satisfaction and improved quality of life are among the most important outcomes for patients undergoing plastic and reconstructive surgery for a variety of diseases and conditions. Patient-reported outcome measures (PROMs) are essential tools for evaluating the benefits of newly developed surgical techniques. Modern PROMs are being developed with new psychometric approaches, such as Rasch Measurement Theory, and their measurement properties (validity, reliability, responsiveness) are rigorously tested. These advances have resulted in the availability of PROMs that provide clinically meaningful data and effectively measure functional as well as psychosocial outcomes. This article guides the reader through the steps of creating a PROM and highlights the potential research and clinical uses of such instruments. Limitations of PROMs and anticipated future directions in this field are discussed.

  12. Failing Tests: Commentary on "Adapting Educational Measurement to the Demands of Test-Based Accountability"

    Science.gov (United States)

    Thissen, David

    2015-01-01

    In "Adapting Educational Measurement to the Demands of Test-Based Accountability" Koretz takes the time-honored engineering approach to educational measurement, identifying specific problems with current practice and proposing minimal modifications of the system to alleviate those problems. In response to that article, David Thissen…

  13. Accounting for health and health care: approaches to measuring the sources and costs of their improvement

    National Research Council Canada - National Science Library

    Panel to Advance a Research Program on the Design of National Health Accounts

    .... Accounting for Health and Health Care addresses both these issues. The government agencies responsible for measuring unit prices for medical services have taken steps in recent years that have greatly improved the accuracy of those measures. Nonetheless, this book has several recommendations aimed at further improving the price indices.

  14. Accounting for covariate measurement error in a Cox model analysis of recurrence of depression.

    Science.gov (United States)

    Liu, K; Mazumdar, S; Stone, R A; Dew, M A; Houck, P R; Reynolds, C F

    2001-01-01

    When a covariate measured with error is used as a predictor in a survival analysis using the Cox model, the parameter estimate is usually biased. In clinical research, covariates measured without error such as treatment procedure or sex are often used in conjunction with a covariate measured with error. In a randomized clinical trial of two types of treatments, we account for the measurement error in the covariate, log-transformed total rapid eye movement (REM) activity counts, in a Cox model analysis of the time to recurrence of major depression in an elderly population. Regression calibration and two variants of a likelihood-based approach are used to account for measurement error. The likelihood-based approach is extended to account for the correlation between replicate measures of the covariate. Using the replicate data decreases the standard error of the parameter estimate for log(total REM) counts while maintaining the bias reduction of the estimate. We conclude that covariate measurement error and the correlation between replicates can affect results in a Cox model analysis and should be accounted for. In the depression data, these methods render comparable results that have less bias than the results when measurement error is ignored.

  15. Topical understandings of nuclear material measurement · accountancy and quality assurance

    International Nuclear Information System (INIS)

    Kikuchi, Masahiro; Muraoka, Susumu; Osabe, Takeshi; Terada, Hiromi; Shimizu, Kenichi; Ohtani, Tetsuo; Fujimaki, Kazunori; Ishikawa, Tadatsugu; Shinohara, Yoshinori

    2002-01-01

    Nuclear material measurement is an important measure to determine the amount of nuclear material of each stage such as receipt, shipment, inventory and hold-up. The material accountancy based on the material balance among the measurements is a measure to control of nuclear material. The material accountancy, from the technical aspect, can be used as promising measures for purposes from operator's level to state's level such as the nuclear safety, property control and environmental preservation other than safeguards measures only to conclude no diversion of nuclear material. This paper discusses various purposes of nuclear material measurements and clarifies the certain function such as quality assurance to be expected at each purpose. Based on the discussion, critical points for the quality assurance of each stage are studied. (author)

  16. Comparative study of outcome measures and analysis methods for traumatic brain injury trials.

    Science.gov (United States)

    Alali, Aziz S; Vavrek, Darcy; Barber, Jason; Dikmen, Sureyya; Nathens, Avery B; Temkin, Nancy R

    2015-04-15

    Batteries of functional and cognitive measures have been proposed as alternatives to the Extended Glasgow Outcome Scale (GOSE) as the primary outcome for traumatic brain injury (TBI) trials. We evaluated several approaches to analyzing GOSE and a battery of four functional and cognitive measures. Using data from a randomized trial, we created a "super" dataset of 16,550 subjects from patients with complete data (n=331) and then simulated multiple treatment effects across multiple outcome measures. Patients were sampled with replacement (bootstrapping) to generate 10,000 samples for each treatment effect (n=400 patients/group). The percentage of samples where the null hypothesis was rejected estimates the power. All analytic techniques had appropriate rates of type I error (≤5%). Accounting for baseline prognosis either by using sliding dichotomy for GOSE or using regression-based methods substantially increased the power over the corresponding analysis without accounting for prognosis. Analyzing GOSE using multivariate proportional odds regression or analyzing the four-outcome battery with regression-based adjustments had the highest power, assuming equal treatment effect across all components. Analyzing GOSE using a fixed dichotomy provided the lowest power for both unadjusted and regression-adjusted analyses. We assumed an equal treatment effect for all measures. This may not be true in an actual clinical trial. Accounting for baseline prognosis is critical to attaining high power in Phase III TBI trials. The choice of primary outcome for future trials should be guided by power, the domain of brain function that an intervention is likely to impact, and the feasibility of collecting outcome data.

  17. Accounting for External Turbulence of Logistics Organizations via Performance Measurement Systems

    DEFF Research Database (Denmark)

    Bühler, Andreas; Wallenburg, Carl Marcus; Wieland, Andreas

    2016-01-01

    Purpose: This paper aims to investigate the role of upper management in designing performance measurement systems (PMS) that account for external turbulence of the organization and to show how this PMS design for turbulence impacts organizational resilience and distribution service performance....... Design/methodology/approach: Hypotheses are developed by integrating management accounting and strategic management perspectives into supply chain management and subsequently tested based on data from 431 logistics organizations (i.e. both logistics companies and internal logistics departments...

  18. KMS fusion system resource accounting and performance measurement system for RSX11M V3. 2

    Energy Technology Data Exchange (ETDEWEB)

    Downward, J. G.

    1980-01-01

    Version 3.2 of the KMS FUSION accounting system is aimed at providing the user of RSX11M V3.2 with a versatile tool for measuring the performance of the operating system, tuning the system, and providing sufficient usage statistics so that the system manager can implement chargeback accounting if it is required by the installation. Sufficient hooks are provided so that the intrepid user can expand the system substantially beyond what is currently provided.

  19. Wealth and the Accounting Period in the Measurement of Means. The Measure of Poverty, Technical Paper VI.

    Science.gov (United States)

    Steuerle, Eugene; McClung, Nelson

    This technical study is concerned with both the statistical and policy effects of alternative definitions of poverty which result when the definition of means is altered by varying the time period (accounting period) over which income is measured or by including in the measure of means not only realized income, but also unrealized income and…

  20. A statistical examination of the practical problems of measurement in accountancy tanks

    International Nuclear Information System (INIS)

    Davies, W.; Good, P.T.; Hamlin, A.G.

    1979-01-01

    In the first part of the paper the general problems of measurement in large accountancy tanks are considered. The generalized tank is assumed to have an extended geometry for the avoidance of criticality, to be fitted with pneumatic level indicating devices and with temperature sensors, and to contain liquid to be accounted, such as that derived from irradiated fuel elements, which is sufficiently active to generate appreciable heat and also radiolytic gases. Possible uncertainties contributed to the final measurement of fissile material contained in or discharged from the tank by the effects of hydrostatic heads, temperature, radiolysis, surface tension, and drainage are considered in detail. The magnitude of these is established from practical data and the errors combined in order to estimate the best possible performance, which, under the specified conditions, appears to be about +-0.3% (1 sigma). The implications for the design of large accountancy tanks are considered, with particular reference to the design of accountancy tanks for future plants where the above precision may not be adequate. The second part of the paper considers practical approaches to the problem of ensuring that actual performance of the measuring system approaches the best possible as closely as possible. In particular, a system of operation in which the accountancy tank is utilized essentially as a fixed volume, with the measuring systems restricted to determining small variations from this nominal volume, offers considerable promise

  1. Account for uncertainties of control measurements in the assessment of design margin factors

    International Nuclear Information System (INIS)

    Dementiev, V. G.; Sidorenko, V. D.; Shishkov, L. K.

    2011-01-01

    The paper discusses the feasibility of accounting for uncertainties of control measurements in estimation of design margin factors. The feasibility is also taken into consideration proceeding from the fact how much the processed measured data were corrected by a priori calculated data of measurable parameters. The possibility and feasibility of such data correction is demonstrated by the authors with the help of Bayes theorem famous in mathematical statistics. (Authors)

  2. Towards New Empirical Versions of Financial and Accounting Models Corrected for Measurement Errors

    OpenAIRE

    Francois-Éric Racicot; Raymond Théoret; Alain Coen

    2006-01-01

    In this paper, we propose a new empirical version of the Fama and French Model based on the Hausman (1978) specification test and aimed at discarding measurement errors in the variables. The proposed empirical framework is general enough to be used for correcting other financial and accounting models of measurement errors. Removing measurement errors is important at many levels as information disclosure, corporate governance and protection of investors.

  3. Measuring Learning Outcomes. Evolution of Cognitive Skills among Graduate Students in Auditing

    DEFF Research Database (Denmark)

    Holm, Claus; Steenholdt, Niels

    with the knowledge provided in a graduate course the student learns from his prior experiences and stores the important aspects of each experience in memory in accordance with such schemas. The schemas available for students taking a graduate auditing course reflects prior accounting work experience for some...... students and undergraduate accounting coursework experience for all students. This paper extends prior research on the role of declarative and procedural knowledge in performing auditing tasks. Measuring learning outcomes is a complex matter requiring sensible measures for both declarative knowledge...... outcomes in the context of an auditing course by posing a broad set of questions testing declarative knowledge and the full range of intellectual skills from discrimination to the use of higher-order-rules . The paper presents data collected in September 1999 including 34 graduate students representing...

  4. Instrumentalities for the Effectiveness of Measures of Public Accountability in Africa

    Directory of Open Access Journals (Sweden)

    Agu Sylvia U

    2016-04-01

    Full Text Available The effectiveness of the various measures put in place by government for the promotion of public accountability in Africa using Nigeria as a case study was examined using a 12-item questionnaire. The aim was to find the importance of these measures in the promotion of public accountability in Nigeria. A total of 240 respondents, comprising 140 males (65.6% and 100 females (34.4%, answered the questionnaire. The mean age of the respondents was 24.89 years. The result disclosed that these measures were partially implemented in the discharge of duties and this led to the achievement of very limited successes. The chi-square was also used to test the relationship between implementation of these measures and effectiveness of public accountability. The result revealed a significant relationship. Suggestions were therefore made on how to improve the use of these measures which included recognition of the importance of these measures, adequate monitoring, removal of the immunity clause, strict adherence to sanctions irrespective of whoever is involved, and compulsory accountability by leaders.

  5. The Impact of Corporate Governance on Financial Performance: (Measured using Accounting and Value-Added based Measures): Evidence from Malaysia

    OpenAIRE

    Abdul Aziz, Khairul Annuar

    2005-01-01

    This paper aims to test empirically which measure, an accounting based financial performance measure such as Return on Equity, Price to Earnings Ratio, Earnings Per Share and Return on Capital Employed; or value-added based financial performance measures such as Economic Value Added and Market Value Added; is more closely related with Corporate Governance Compliance. This paper also aims to study the level of Corporate Governance Compliance of the Smaller Companies listed on the KLSE, the mea...

  6. 78 FR 59626 - Main Hawaiian Islands Deep 7 Bottomfish Annual Catch Limits and Accountability Measures for 2013-14

    Science.gov (United States)

    2013-09-27

    ... Accountability Measures for 2013-14 AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and... associated accountability measure (AM) close the non-commercial and commercial fisheries for Deep 7...

  7. 77 FR 56791 - Main Hawaiian Islands Deep 7 Bottomfish Annual Catch Limits and Accountability Measures for 2012-13

    Science.gov (United States)

    2012-09-14

    ... Accountability Measures for 2012-13 AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and... accountability measure will help prevent overfishing and ensure sustainable, long-term catches for fishermen...

  8. Wind power deployment outcomes: How can we account for the differences?

    NARCIS (Netherlands)

    Toke, D.; Breukers, S.; Wolsink, M.

    2008-01-01

    This paper aims to understand different outcomes of implementation of wind power deployment programmes. Geographical variables such as quantity of wind resources are in themselves insufficient to explain patterns of implementation of wind power. To enhance the review of the factors affecting wind

  9. Measuring patient knowledge of asthma: a systematic review of outcome measures.

    NARCIS (Netherlands)

    Pink, J.; Pink, K.; Elwyn, G.

    2009-01-01

    BACKGROUND: Asthma self-management education is a key component of international guidelines. No gold standard patient centred outcome measure exists for asthma knowledge. Our aim was to identify high-quality, validated, and reliable outcome measures suitable for use in either the research or

  10. Accounting for posttraumatic stress disorder symptom severity with pre- and posttrauma measures

    DEFF Research Database (Denmark)

    Ogle, Christin M.; Rubin, David C.; Siegler, Ilene C.

    2016-01-01

    Using data from a longitudinal study of community-dwelling older adults, we analyzed the most extensive set of known correlates of posttraumatic stress disorder (PTSD) symptoms obtained from a single sample to examine the measures’ independent and combined utility in accounting for PTSD symptom...... attachment and factors related to the current trauma memory, such as self-rated severity, event centrality, frequency of involuntary recall, and physical reactions to the memory, accounted for symptom severity better than did measures of pretrauma factors. In an analysis restricted to prospective measures...... severity. Fifteen measures identified as PTSD risk factors in published meta-analyses as well as 12 theoretically and empirically supported individual difference and health-related measures were included in our analysis. Individual difference measures assessed after the trauma, including insecure...

  11. Accounting- versus economic-based rates of return: implications for profitability measures in the pharmaceutical industry.

    Science.gov (United States)

    Skrepnek, Grant H

    2004-01-01

    Accounting-based profits have indicated that pharmaceutical firms have achieved greater returns relative to other sectors. However, partially due to the theoretically inappropriate reporting of research and development (R&D) expenditures according to generally accepted accounting principles, evidence suggests that a substantial and upward bias is present in accounting-based rates of return for corporations with high levels of intangible assets. Given the intensity of R&D in pharmaceutical firms, accounting-based profit metrics in the drug sector may be affected to a greater extent than other industries. The aim of this work was to address measurement issues associated with corporate performance and factors that contribute to the bias within accounting-based rates of return. Seminal and broadly cited works on the subject of accounting- versus economic-based rates of return were reviewed from the economic and finance literature, with an emphasis placed on issues and scientific evidence directly related to the drug development process and pharmaceutical industry. With international convergence and harmonization of accounting standards being imminent, stricter adherence to theoretically sound economic principles is advocated, particularly those based on discounted cash-flow methods. Researchers, financial analysts, and policy makers must be cognizant of the biases and limitations present within numerous corporate performance measures. Furthermore, the development of more robust and valid economic models of the pharmaceutical industry is required to capture the unique dimensions of risk and return of the drug development process. Empiric work has illustrated that estimates of economic-based rates of return range from approximately 2 to approximately 11 percentage points below various accounting-based rates of return for drug companies. Because differences in the nature of risk and uncertainty borne by drug manufacturers versus other sectors make comparative assessments

  12. Populations and outcome measures used in ongoing research in sarcopenia.

    Science.gov (United States)

    Peña Ordóñez, Gloria Gabriela; Bustamante Montes, Lilia Patricia; Ramírez Duran, Ninfa; Sánchez Castellano, Carmen; Cruz-Jentoft, Alfonso J

    2017-08-01

    Sarcopenia research may be hampered by the heterogeneity of populations and outcome measures used in clinical studies. The aim of this study was to describe the inclusion/exclusion criteria and outcome measures used in ongoing research in sarcopenia. All active intervention studies registered in the World Health Organization with the keyword sarcopenia were included. Study design, type of intervention, inclusion/exclusion criteria and outcome measures were registered and classified. In April 2014, 151 studies on sarcopenia were registered in the WHO database. One hundred twenty-three were intervention studies. Most trials (94.3 %) were single centre and randomized (93.5 %), 51.2 % were double blind. Nutritional interventions (36.6 %), physical exercise (12.2 %) or both (19.5 %) were the most common interventions tested. Only 54.4 % included subjects of both genders, and 46.3 % had an upper age limit. Definition of the target populations was heterogeneous, with 57.7 % including healthy subjects and none using recent definitions of sarcopenia. Lifestyle and the degree of physical activity of subjects were not described or considered in most cases (79.7 %). Subjects with cardiovascular, neuropsychiatric or metabolic disorders and those with physical disability were usually excluded. Muscle mass and muscle strength were the primary outcome variables in 28.5 and 29.5 % of studies and physical performance in 19.5 %, but only 4.1 % used the three variables used the three of them. An additional 26.8 % used biological outcome variables. Little information and agreement existed in the way muscle and physical performance parameters were measured. We found a large heterogeneity in trial design, definition of populations and outcome measures in present research.

  13. Optimal measurement uncertainties for materials accounting in a fast breeder reactor spent-fuel reprocessing plant

    International Nuclear Information System (INIS)

    Dayem, H.A.; Kern, E.A.; Markin, J.T.

    1982-01-01

    Optimization techniques are used to calculate measurement uncertainties for materials accountability instruments in a fast breeder reactor spent-fuel reprocessing plant. Optimal measurement uncertainties are calculated so that performance goals for detecting materials loss are achieved while minimizing the total instrument development cost. Improved materials accounting in the chemical separations process (111 kg Pu/day) to meet 8-kg plutonium abrupt (1 day) and 40-kg plutonium protracted (6 months) loss-detection goals requires: process tank volume and concentration measurements having precisions less than or equal to 1%; accountability and plutonium sample tank volume measurements having precisions less than or equal to 0.3%, short-term correlated errors less than or equal to 0.04%, and long-term correlated errors less than or equal to 0.04%; and accountability and plutonium sample tank concentration measurements having precisions less than or equal to 0.4%, short-term correlated errors less than or equal to 0.1%, and long-term correlated errors less than or equal to 0.05%

  14. Accounting for health-care outcomes: implications for intensive care unit practice and performance.

    Science.gov (United States)

    Sorensen, Roslyn; Iedema, Rick

    2010-08-01

    The aim of this study was to understand the environment of health care, and how clinicians and managers respond in terms of performance accountability. A qualitative method was used in a tertiary metropolitan teaching intensive care unit (ICU) in Sydney, Australia, including interviews with 15 clinical managers and focus groups with 29 nurses of differing experience. The study found that a managerial focus on abstract goals, such as budgets detracted from managing the core business of clinical work. Fractures were evident within clinical units, between clinical units and between clinical and managerial domains. These fractures reinforced the status quo where seemingly unconnected patient care activities were undertaken by loosely connected individual clinicians with personalized concepts of accountability. Managers must conceptualize health services as an interconnected entity within which self-directed teams negotiate and agree objectives, collect and review performance data and define collective practice. Organically developing regimens of care within and across specialist clinical units, such as in ICUs, directly impact upon health service performance and accountability.

  15. 78 FR 52125 - Main Hawaiian Islands Deep 7 Bottomfish Annual Catch Limits and Accountability Measures for 2013-14

    Science.gov (United States)

    2013-08-22

    ... Accountability Measures for 2013-14 AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and... projected to be reached, NMFS, as an accountability measure, would close the commercial and non-commercial... and accountability measure, and anticipates announcing the final specifications prior to the scheduled...

  16. Outcome Measures for Clinical Trials in Down Syndrome.

    Science.gov (United States)

    Esbensen, Anna J; Hooper, Stephen R; Fidler, Deborah; Hartley, Sigan L; Edgin, Jamie; d'Ardhuy, Xavier Liogier; Capone, George; Conners, Frances A; Mervis, Carolyn B; Abbeduto, Leonard; Rafii, Michael; Krinsky-McHale, Sharon J; Urv, Tiina

    2017-05-01

    Increasingly individuals with intellectual and developmental disabilities, including Down syndrome, are being targeted for clinical trials. However, a challenge exists in effectively evaluating the outcomes of these new pharmacological interventions. Few empirically evaluated, psychometrically sound outcome measures appropriate for use in clinical trials with individuals with Down syndrome have been identified. To address this challenge, the National Institutes of Health (NIH) assembled leading clinicians and scientists to review existing measures and identify those that currently are appropriate for trials; those that may be appropriate after expansion of age range addition of easier items, and/or downward extension of psychometric norms; and areas where new measures need to be developed. This article focuses on measures in the areas of cognition and behavior.

  17. Measuring public health practice and outcomes in chronic disease: a call for coordination.

    Science.gov (United States)

    Porterfield, Deborah S; Rogers, Todd; Glasgow, LaShawn M; Beitsch, Leslie M

    2015-04-01

    A strategic opportunity exists to coordinate public health systems and services researchers' efforts to develop local health department service delivery measures and the efforts of divisions within the Centers for Disease Control and Prevention's National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) to establish outcome indicators for public health practice in chronic disease. Several sets of outcome indicators developed by divisions within NCCDPHP and intended for use by state programs can be tailored to assess outcomes of interventions within smaller geographic areas or intervention settings. Coordination of measurement efforts could potentially allow information to flow from the local to the state to the federal level, enhancing program planning, accountability, and even subsequent funding for public health practice.

  18. Accounting for the speed shear in wind turbine power performance measurement

    DEFF Research Database (Denmark)

    Wagner, Rozenn

    the vertical wind shear and the turbulence intensity. The work presented in this thesis consists of the description and the investigation of a simple method to account for the wind speed shear in the power performance measurement. Ignoring this effect was shown to result in a power curve dependant on the shear...... for turbulence intensity suggested by Albers. The second method was found to be more suitable for normalising the power curve for the turbulence intensity. Using the equivalent wind speed accounting for the wind shear in the power performance measurement was shown to result in a more repeatable power curve than......The power curve of a wind turbine is the primary characteristic of the machine as it is the basis of the warranty for it power production. The current IEC standard for power performance measurement only requires the measurement of the wind speed at hub height and the air density to characterise...

  19. Measuring the Academic Self-Efficacy of First-Year Accounting Students

    Science.gov (United States)

    Byrne, Marann; Flood, Barbara; Griffin, Julie

    2014-01-01

    This study measured the levels of academic self-efficacy of first-year accounting students. It also investigated whether there were any gender differences and the extent to which efficacy levels explained variation in academic performance. Overall the analysis revealed that many students lacked the confidence to participate fully in the academic…

  20. Multiple imputation to account for measurement error in marginal structural models

    Science.gov (United States)

    Edwards, Jessie K.; Cole, Stephen R.; Westreich, Daniel; Crane, Heidi; Eron, Joseph J.; Mathews, W. Christopher; Moore, Richard; Boswell, Stephen L.; Lesko, Catherine R.; Mugavero, Michael J.

    2015-01-01

    Background Marginal structural models are an important tool for observational studies. These models typically assume that variables are measured without error. We describe a method to account for differential and non-differential measurement error in a marginal structural model. Methods We illustrate the method estimating the joint effects of antiretroviral therapy initiation and current smoking on all-cause mortality in a United States cohort of 12,290 patients with HIV followed for up to 5 years between 1998 and 2011. Smoking status was likely measured with error, but a subset of 3686 patients who reported smoking status on separate questionnaires composed an internal validation subgroup. We compared a standard joint marginal structural model fit using inverse probability weights to a model that also accounted for misclassification of smoking status using multiple imputation. Results In the standard analysis, current smoking was not associated with increased risk of mortality. After accounting for misclassification, current smoking without therapy was associated with increased mortality [hazard ratio (HR): 1.2 (95% CI: 0.6, 2.3)]. The HR for current smoking and therapy (0.4 (95% CI: 0.2, 0.7)) was similar to the HR for no smoking and therapy (0.4; 95% CI: 0.2, 0.6). Conclusions Multiple imputation can be used to account for measurement error in concert with methods for causal inference to strengthen results from observational studies. PMID:26214338

  1. Evaluating Performance Measurement Systems in Nonprofit Agencies: The Program Accountability Quality Scale (PAQS).

    Science.gov (United States)

    Poole, Dennis L.; Nelson, Joan; Carnahan, Sharon; Chepenik, Nancy G.; Tubiak, Christine

    2000-01-01

    Developed and field tested the Performance Accountability Quality Scale (PAQS) on 191 program performance measurement systems developed by nonprofit agencies in central Florida. Preliminary findings indicate that the PAQS provides a structure for obtaining expert opinions based on a theory-driven model about the quality of proposed measurement…

  2. Multiple Imputation to Account for Measurement Error in Marginal Structural Models.

    Science.gov (United States)

    Edwards, Jessie K; Cole, Stephen R; Westreich, Daniel; Crane, Heidi; Eron, Joseph J; Mathews, W Christopher; Moore, Richard; Boswell, Stephen L; Lesko, Catherine R; Mugavero, Michael J

    2015-09-01

    Marginal structural models are an important tool for observational studies. These models typically assume that variables are measured without error. We describe a method to account for differential and nondifferential measurement error in a marginal structural model. We illustrate the method estimating the joint effects of antiretroviral therapy initiation and current smoking on all-cause mortality in a United States cohort of 12,290 patients with HIV followed for up to 5 years between 1998 and 2011. Smoking status was likely measured with error, but a subset of 3,686 patients who reported smoking status on separate questionnaires composed an internal validation subgroup. We compared a standard joint marginal structural model fit using inverse probability weights to a model that also accounted for misclassification of smoking status using multiple imputation. In the standard analysis, current smoking was not associated with increased risk of mortality. After accounting for misclassification, current smoking without therapy was associated with increased mortality (hazard ratio [HR]: 1.2 [95% confidence interval [CI] = 0.6, 2.3]). The HR for current smoking and therapy [0.4 (95% CI = 0.2, 0.7)] was similar to the HR for no smoking and therapy (0.4; 95% CI = 0.2, 0.6). Multiple imputation can be used to account for measurement error in concert with methods for causal inference to strengthen results from observational studies.

  3. a locally adapted functional outcome measurement score for total

    African Journals Online (AJOL)

    Results and success of total hip arthroplasty are often measured using a functional outcome scoring system. Most current scores were developed in Europe and. North America (1-3). During the evaluation of a Total. Hip Replacement (THR) project in Ouagadougou,. Burkina Faso (4) it was felt that these scores were not.

  4. Translation of the Ibadan Knee/Hip Osteoarthritis Outcome Measure

    African Journals Online (AJOL)

    Dr Olaleye

    rated by the clinician on five and six (0-5) point ordinal scales. IKHOAM has been ... Igbo translation of Ibadan osteoarthritis outcome measure. 176 .... encourage the use of scales and questionnaires in an .... Validation of a Yoruba translation of the World Health ... Scales: A practical guide to their development and use (1st.

  5. Estimation and empirical properties of a firm-year measure of accounting conservatism

    OpenAIRE

    Khan, Mozaffar Nayim; Watts, Ross Leslie

    2009-01-01

    We estimate a firm-year measure of accounting conservatism, examine its empirical properties as a metric, and illustrate applications by testing new hypotheses that shed further light on the nature and effects of conservatism. The results are consistent with the measure, C_Score, capturing variation in conservatism and also predicting asymmetric earnings timeliness at horizons of up to three years ahead. Cross-sectional hypothesis tests suggest firms with longer investment cycles, higher idio...

  6. No Pipe Dream: Achieving Care That Is Accountable for Cost, Quality, and Outcomes.

    Science.gov (United States)

    Terrell, Grace E

    2016-01-01

    The April 2015 passage of the Medicare Access and Children's Health Insurance Program Reauthorization Act is accelerating the move of the US health care industry from traditional fee-for-service provider payments to alternative payment methods that are focused on value rather than volume of services. Medicaid, private employers, and consumer groups are also developing similar payment models. Learning from the experience of the 27 early accountable care organizations in North Carolina, such as Cornerstone Health Care, will help to accelerate the transformation that will be necessary across the health care delivery ecosystem in our state. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

  7. A systematic review of measurement properties of patient reported outcome measures in psoriatic arthritis

    DEFF Research Database (Denmark)

    Højgaard, Pil; Klokker, Louise; Orbai, Ana Maria

    2018-01-01

    Background: An updated psoriatic arthritis (PsA) core outcome set (COS) for randomized controlled trials (RCTs) was endorsed at the Outcome Measures in Rheumatology (OMERACT) meeting in 2016. Objectives: To synthesize the evidence on measurement properties of patient reported outcome measures...... (PROMs) for PsA and thereby contribute to development of a PsA core outcome measurement set (COMS) as described by the OMERACT Filter 2.0. Methods: A systematic literature search was performed in EMBASE, MEDLINE and PsycINFO on Jan 1, 2017 to identify full-text articles with an aim of assessing...... the measurement properties of PROMs in PsA. Two independent reviewers rated the quality of studies using the COnsensus based standards for the Selection of health Measurement INstruments (COSMIN) checklist, and performed a qualitative evidence synthesis. Results: Fifty-five studies were included in the systematic...

  8. Accounting for the risk of extreme outcomes in an integrated assessment of climate change

    International Nuclear Information System (INIS)

    Gerst, Michael D.; Howarth, Richard B.; Borsuk, Mark E.

    2010-01-01

    The potential for climate catastrophes, represented by 'fat-tailed' distributions on consequences, has attracted much attention recently. To date, however, most integrated assessment models have either been largely deterministic or deterministic with ex-post sensitivity analysis. The conclusions of such analyses are likely to differ from those employing models that accurately characterize society's joint preferences concerning time and risk, especially when distributions are fat-tailed. Using a dynamic stochastic general equilibrium model adapted from Nordhaus's DICE model, we show that failing to accurately account for risk can lead to substantial underestimation of the net benefits of greenhouse gas abatement. A robust finding of our analysis is that a lenient 'policy ramp' emissions reduction strategy is preferable over a more aggressive strategy-such as that advocated by the Stern Review-only if the model does not account for uncertainty about the climate system, the carbon cycle and economic damages, and specifies a consumption discount rate that is counterfactually higher than the historical global weighted average cost of capital of 4.0%. In the debate over uncertainty and time discounting, our results imply that what matters most in climate change assessment is the inclusion and particular specification of uncertainty rather than the precise choice of discount rate.

  9. How do aggregated patient-reported outcome measures data stimulate health care improvement? A realist synthesis

    Science.gov (United States)

    Dalkin, Sonia; Gibbons, Elizabeth; Wright, Judy; Valderas, Jose Maria; Meads, David; Black, Nick

    2017-01-01

    Objectives Internationally, there has been considerable debate about the role of data in supporting quality improvement in health care. Our objective was to understand how, why and in what circumstances the feedback of aggregated patient-reported outcome measures data improved patient care. Methods We conducted a realist synthesis. We identified three main programme theories underlying the use of patient-reported outcome measures as a quality improvement strategy and expressed them as nine ‘if then’ propositions. We identified international evidence to test these propositions through searches of electronic databases and citation tracking, and supplemented our synthesis with evidence from similar forms of performance data. We synthesized this evidence through comparing the mechanisms and impact of patient-reported outcome measures and other performance data on quality improvement in different contexts. Results Three programme theories were identified: supporting patient choice, improving accountability and enabling providers to compare their performance with others. Relevant contextual factors were extent of public disclosure, use of financial incentives, perceived credibility of the data and the practicality of the results. Available evidence suggests that patients or their agents rarely use any published performance data when selecting a provider. The perceived motivation behind public reporting is an important determinant of how providers respond. When clinicians perceived that performance indicators were not credible but were incentivized to collect them, gaming or manipulation of data occurred. Outcome data do not provide information on the cause of poor care: providers needed to integrate and interpret patient-reported outcome measures and other outcome data in the context of other data. Lack of timeliness of performance data constrains their impact. Conclusions Although there is only limited research evidence to support some widely held theories of how

  10. Accounting for misclassification bias of binary outcomes due to underscreening: a sensitivity analysis

    Directory of Open Access Journals (Sweden)

    Nanhua Zhang

    2017-12-01

    Full Text Available Abstract Background Diagnostic tests are performed in a subset of the population who are at higher risk, resulting in undiagnosed cases among those who do not receive the test. This poses a challenge for estimating the prevalence of the disease in the study population, and also for studying the risk factors for the disease. Methods We formulate this problem as a missing data problem because the disease status is unknown for those who do not receive the test. We propose a Bayesian selection model which models the joint distribution of the disease outcome and whether testing was received. The sensitivity analysis allows us to assess how the association of the risk factors with the disease outcome as well as the disease prevalence change with the sensitivity parameter. Results We illustrated our model using a retrospective cohort study of children with asthma exacerbation that were evaluated for pneumonia in the emergency department. Our model found that female gender, having fever during ED or at triage, and having severe hypoxia are significantly associated with having radiographic pneumonia. In addition, simulation studies demonstrate that the Bayesian selection model works well even under circumstances when both the disease prevalence and the screening proportion is low. Conclusion The Bayesian selection model is a viable tool to consider for estimating the disease prevalence and in studying risk factors of the disease, when only a subset of the target population receive the test.

  11. Accountability Policy Outcomes Related to No Child Left Behind and Educational Equity for Big5 City Schools in New York State

    Science.gov (United States)

    Shin, Hyejin

    2016-01-01

    The purpose of this study was to explore the association of NCLB/accountability with educational output and input for New York State, collectively. Focusing on ELA and Math achievement in 4th and 8th grades, this study demonstrated the association of accountability outcomes in three ways: "accountability design, school proficiency level, and…

  12. Accounting for measurement error in human life history trade-offs using structural equation modeling.

    Science.gov (United States)

    Helle, Samuli

    2018-03-01

    Revealing causal effects from correlative data is very challenging and a contemporary problem in human life history research owing to the lack of experimental approach. Problems with causal inference arising from measurement error in independent variables, whether related either to inaccurate measurement technique or validity of measurements, seem not well-known in this field. The aim of this study is to show how structural equation modeling (SEM) with latent variables can be applied to account for measurement error in independent variables when the researcher has recorded several indicators of a hypothesized latent construct. As a simple example of this approach, measurement error in lifetime allocation of resources to reproduction in Finnish preindustrial women is modelled in the context of the survival cost of reproduction. In humans, lifetime energetic resources allocated in reproduction are almost impossible to quantify with precision and, thus, typically used measures of lifetime reproductive effort (e.g., lifetime reproductive success and parity) are likely to be plagued by measurement error. These results are contrasted with those obtained from a traditional regression approach where the single best proxy of lifetime reproductive effort available in the data is used for inference. As expected, the inability to account for measurement error in women's lifetime reproductive effort resulted in the underestimation of its underlying effect size on post-reproductive survival. This article emphasizes the advantages that the SEM framework can provide in handling measurement error via multiple-indicator latent variables in human life history studies. © 2017 Wiley Periodicals, Inc.

  13. Accounting for response misclassification and covariate measurement error improves power and reduces bias in epidemiologic studies.

    Science.gov (United States)

    Cheng, Dunlei; Branscum, Adam J; Stamey, James D

    2010-07-01

    To quantify the impact of ignoring misclassification of a response variable and measurement error in a covariate on statistical power, and to develop software for sample size and power analysis that accounts for these flaws in epidemiologic data. A Monte Carlo simulation-based procedure is developed to illustrate the differences in design requirements and inferences between analytic methods that properly account for misclassification and measurement error to those that do not in regression models for cross-sectional and cohort data. We found that failure to account for these flaws in epidemiologic data can lead to a substantial reduction in statistical power, over 25% in some cases. The proposed method substantially reduced bias by up to a ten-fold margin compared to naive estimates obtained by ignoring misclassification and mismeasurement. We recommend as routine practice that researchers account for errors in measurement of both response and covariate data when determining sample size, performing power calculations, or analyzing data from epidemiological studies. 2010 Elsevier Inc. All rights reserved.

  14. The International Dermatology Outcome Measures initiative as applied to psoriatic disease outcomes

    DEFF Research Database (Denmark)

    Gottlieb, Alice B; Armstrong, April W; Christensen, Robin

    2014-01-01

    In the United States, access to care is the number one issue facing our patients with dermatological conditions. In part, this is because we do not have outcome measures that are useful in clinical practice and available in databases where payers and governmental agencies can compare the performa...

  15. Outcome measures for adult critical care: a systematic review.

    Science.gov (United States)

    Hayes, J A; Black, N A; Jenkinson, C; Young, J D; Rowan, K M; Daly, K; Ridley, S

    2000-01-01

    1. To identify generic and disease specific measures of impairment, functional status and health-related quality of life that have been used in adult critical care (intensive and high-dependency care) survivors. 2. To review the validity, reliability and responsiveness of the measures in adult critical care survivors. 3. To consider the implications for future policy and to make recommendations for further methodological research. 4. To review what is currently known of the outcome of adult critical care. Searches of electronic databases (MEDLINE, EMBASE, CINAHL, PsycLIT, The Cochrane Library and SIGLE) from 1970 to August 1998. Manual searches of five journals (1985-98) not indexed in electronic databases and relevant conference proceedings (1993-98). Reference lists of six existing reviews, plus snowballing from reference lists of all relevant articles identified. Randomised trials, non-randomised trials (cohort studies) and case series that included data on outcomes after discharge from adult (16 years and over) critical care. If reported, the following data were extracted from each paper: patient characteristics (age, gender, severity of illness, diagnostic category) number of patients eligible for study, follow-up period, number of deaths before follow-up, number and proportion of survivors included in follow-up method of presentation of outcome data - proportion normal as defined by reference values, or aggregate value (e.g. mean or median), or aggregate values plus an indication of variance (e.g. standard deviation or inter-quartile range). Evidence for three measurement properties was sought for each outcome measure that had been used in at least two studies - their validity, reliability and responsiveness in adult critical care. If the authors did not report these aspects explicitly, an attempt was made to use the data provided to provide these measurement properties. For measures that were used in at least ten studies, information on actual reported

  16. Measuring treatment outcomes in gambling disorders: a systematic review.

    Science.gov (United States)

    Pickering, Dylan; Keen, Brittany; Entwistle, Gavin; Blaszczynski, Alex

    2018-03-01

    Considerable variation of outcome variables used to measure recovery in the gambling treatment literature has precluded effective cross-study evaluations and hindered the development of best-practice treatment methodologies. The aim of this systematic review was to describe current diffuse concepts of recovery in the gambling field by mapping the range of outcomes and measurement strategies used to evaluate treatments, and to identify more commonly accepted indices of recovery. A systematic search of six academic databases for studies evaluating treatments (psychological and pharmacological) for gambling disorders with a minimum 6-month follow-up. Data from eligible studies were tabulated and analysis conducted using a narrative approach. Guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were adhered to. Thirty-four studies were reviewed systematically (RCTs = 17, comparative designs = 17). Sixty-three different outcome measures were identified: 25 (39.7%) assessed gambling-specific constructs, 36 (57.1%) assessed non-gambling specific constructs, and two instruments were used across both categories (3.2%). Self-report instruments ranged from psychometrically validated to ad-hoc author-designed questionnaires. Units of measurement were inconsistent, particularly in the assessment of gambling behaviour. All studies assessed indices of gambling behaviour and/or symptoms of gambling disorder. Almost all studies (n = 30; 88.2%) included secondary measures relating to psychiatric comorbidities, psychological processes linked to treatment approach, or global functioning and wellbeing. In research on gambling disorders, the incorporation of broader outcome domains that extend beyond disorder-specific symptoms and behaviours suggests a multi-dimensional conceptualization of recovery. Development of a single comprehensive scale to measure all aspects of gambling recovery could help to facilitate uniform reporting practices

  17. Patient-reported outcome measures in arthroplasty registries

    DEFF Research Database (Denmark)

    Rolfson, Ola; Eresian Chenok, Kate; Bohm, Eric

    2016-01-01

    survey (SF-12) or the similar Veterans RAND 12-item health survey (VR-12). The most common specific PROMs were the Hip disability and Osteoarthritis Outcome Score (HOOS), the Knee injury and Osteoarthritis Outcome Score (KOOS), the Oxford Hip Score (OHS), the Oxford Knee Score (OKS), the Western Ontario...... of PROMs for hip and knee arthroplasty in registries worldwide. The 2 main types of PROMs include generic (general health) PROMs, which provide a measure of general health for any health state, and specific PROMs, which focus on specific symptoms, diseases, organs, body regions, or body functions...... all elective hip or knee arthroplasty patients and 6 registries collected PROMs for sample populations; 1 other registry had planned but had not started collection of PROMs. The most common generic instruments used were the EuroQol 5 dimension health outcome survey (EQ-5D) and the Short Form 12 health...

  18. Comparison of Physician-Predicted to Measured Low Vision Outcomes

    Science.gov (United States)

    Chan, Tiffany L.; Goldstein, Judith E.; Massof, Robert W.

    2013-01-01

    Purpose To compare low vision rehabilitation (LVR) physicians’ predictions of the probability of success of LVR to patients’ self-reported outcomes after provision of usual outpatient LVR services; and to determine if patients’ traits influence physician ratings. Methods The Activity Inventory (AI), a self-report visual function questionnaire, was administered pre and post-LVR to 316 low vision patients served by 28 LVR centers that participated in a collaborative observational study. The physical component of the Short Form-36, Geriatric Depression Scale, and Telephone Interview for Cognitive Status were also administered pre-LVR to measure physical capability, depression and cognitive status. Following patient evaluation, 38 LVR physicians estimated the probability of outcome success (POS), using their own criteria. The POS ratings and change in functional ability were used to assess the effects of patients’ baseline traits on predicted outcomes. Results A regression analysis with a hierarchical random effects model showed no relationship between LVR physician POS estimates and AI-based outcomes. In another analysis, Kappa statistics were calculated to determine the probability of agreement between POS and AI-based outcomes for different outcome criteria. Across all comparisons, none of the kappa values were significantly different from 0, which indicates the rate of agreement is equivalent to chance. In an exploratory analysis, hierarchical mixed effects regression models show that POS ratings are associated with information about the patient’s cognitive functioning and the combination of visual acuity and functional ability, as opposed to visual acuity or functional ability alone. Conclusions Physicians’ predictions of LVR outcomes appear to be influenced by knowledge of patients’ cognitive functioning and the combination of visual acuity and functional ability - information physicians acquire from the patient’s history and examination. However

  19. Redefining Outcome Measurement: A Model for Brief Psychotherapy.

    Science.gov (United States)

    McGuinty, Everett; Nelson, John; Carlson, Alain; Crowther, Eric; Bednar, Dina; Foroughe, Mirisse

    2016-05-01

    The zeitgeist for short-term psychotherapy efficacy has fundamentally shifted away from evidence-based practices to include evidence-informed practices, resulting in an equally important paradigm shift in outcome measurement designed to reflect change in this short-term modality. The present article delineates a short-term psychotherapy structure which defines four fundamental stages that all brief therapies may have in common, and are represented through Cognitive Behavioral Therapy, Solution-Focused Brief Therapy, Narrative Therapy, and Emotion-Focused Therapy. These four theoretical approaches were analyzed via a selected literature review through comparing and contrasting specific and common tasks as they relate to the process of psychotherapy and change. Once commonalities were identified within session, they were categorized or grouped into themes or general stages of change within the parameters of a four to six session model of short-term therapy. Commonalities in therapeutic stages of change may more accurately and uniformly measure outcome in short-term work, unlike the symptom-specific psychometric instruments of longer-term psychotherapy. A systematic framework for evaluating the client and clinician adherence to 20 specific tasks for these four short-term therapies is presented through the newly proposed, Brief Task Acquisition Scale (BTAS). It is further proposed that the client-clinicians' adherence to these tasks will track and ultimately increase treatment integrity. Thus, when the client-clinician relationship tracks and evaluates the three pillars of (1) stage/process change, (2) task acquisition, and (3) treatment integrity, the culmination of these efforts presents a new way of more sensitively measuring outcome in short-term psychotherapy. Data collection is suggested as a first step to empirically evaluate the testable hypotheses suggested within this current model. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message The

  20. Dignity Impact as a Primary Outcome Measure for Dignity Therapy.

    Science.gov (United States)

    Scarton, Lisa; Oh, Sungho; Sylvera, Ashley; Lamonge, Ralph; Yao, Yingwei; Chochinov, Harvey; Fitchett, George; Handzo, George; Emanuel, Linda; Wilkie, Diana

    2018-01-01

    Feasibility of dignity therapy (DT) is well established in palliative care. Evidence of its efficacy, however, has been inconsistent and may stem from DT's primary effects differing from the outcomes measured in previous studies. We proposed that DT effects were in the spiritual domain and created a new outcome measure, Dignity Impact Scale (DIS), from items previously used in a large randomized controlled trial (RCT). The purpose of this secondary analysis study was to examine properties of a new measure of dignity impact. Using the DIS, we conducted reanalysis of posttest data from a large 3-arm, multi-site RCT study. Participants were receiving hospice/palliative care (n = 326, 50.6% female, mean age = 65.1 years, 89.3% white, all with a terminal illness with 6 months or less life expectancy). They had been randomized to standard palliative care (n = 111), client-centered care (n = 107), or DT (n = 108). The 7-item DIS was derived from selected items in a posttest DT Patient Feedback Questionnaire. The DIS had strong internal consistency (α = 0.85). The DT group mean DIS score (21.4 ± 5.0) was significantly higher than the usual care group mean score (17.7 ± 5.5; t = 5.2, df = 216, P death, and life completion tasks. We propose that the DIS be used as the primary outcome measure in evaluating the effects of DT.

  1. Retail price as an outcome measure for the effectiveness of drug law enforcement.

    Science.gov (United States)

    Bright, David A; Ritter, Alison

    2010-09-01

    One outcome measure of law enforcement effectiveness is the reduction in drug consumption which occurs as a result of law enforcement interventions. A theoretical relationship between drug consumption and retail price has promoted the use of retail price as a surrogate measure for consumption. In the current article, retail price is examined as a potential outcome measure for the effectiveness of law enforcement. The predictions regarding the relationship between law enforcement intensity and price are only partially supported by research. Explanations for the disconnect between the drug law enforcement activity and retail price include: rapid adaptation by market players, enforcement swamping, assumptions of rational actors, short-run versus long-run effects, structure of the illicit market, simultaneous changes that affect price in perverse ways, the role of violence in markets, and data limitations. Researchers who use retail price as an outcome measure need to take into account the complex relationship between drug law enforcement interventions and the retail price of illicit drugs. Viable outcome measures which can be used as complements to retail price are worth investigation. Copyright 2009 Elsevier B.V. All rights reserved.

  2. Measuring and accounting for the intensity of nursing care: is it worthwhile?

    Science.gov (United States)

    Finkler, Steven A

    2008-05-01

    In June 2007, the Robert Wood Johnson Foundation sponsored a conference titled "The Economics of Nursing: Paying for Quality Nursing Care." The second topic at the conference was "the appropriateness and feasibility of measuring and accounting for the intensity of nursing care." Drs. Welton and Sermeus presented papers on that topic. This response to those papers focuses on why the hospital industry has not always accounted for and measured nursing intensity. Then it asks, "Why do we want more accurate information about nursing resources used by different patients?" It is not sufficient to say the data regarding nursing costs are not accurate. Nor is it sufficient to say that we now can improve the accuracy of the data. To move forward in this area, we need to develop compelling evidence and arguments that indicate that nursing-cost data of greater accuracy have a benefit that will exceed the costs of that data collection.

  3. Overview report of the international workshop on the near-real-time accountancy measure

    International Nuclear Information System (INIS)

    Gupta, D.

    1983-07-01

    After establishing the process and accountancy data-base for a 1000 t HM/a reference reprocessing facility, the workshop developed simulation models for the sequential generation of data for throughput and inventory of plutonium in the process material balance area (MBA). A well defined set of boundary conditions and parameter values for measurement uncertainties and loss patterns was established, on the basis of which a number of sequential statistical test procedures was evaluated. One important condition for the application of the NRTA measure was the stipulation that routinely measured Pu inventories in process tanks only, would be used, since more than 95% of Pu inventories in the process MBA are in these tanks. About 12 kg of Pu, expected to be the normal inventory in six pulse columns, was assumed to be constant. In spite of the simplifications made and the fact that mainly simulated data were used, these investigations permit the conclusion that the NRTA measure provides a greater sensitivity in terms of the amounts which can be detected and the timeliness of detection, than the conventional material accountancy. Since measurements are restricted to process tanks only, routinely available measurement techniques can be used. (orig.) [de

  4. REVIEW OF EQUIPMENT USED IN RUSSIAN PRACTICE FOR ACCOUNTING MEASUREMENTS OF NUCLEAR MATERIALS

    International Nuclear Information System (INIS)

    NEYMOTIN, L.

    1999-01-01

    The objective of this work was to analyze instrumentation and methodologies used at Russian nuclear facilities for measurement of item nuclear materials, materials in bulk form, and waste streams; specify possibilities for the application of accounting measurements; and develop recommendations for improvement. The major steps and results: Representative conversion, enrichment (gas centrifuge), fuel fabrication, spent fuel reprocessing, and chemical-metallurgical production facilities in Russia were selected; Full lists of nuclear materials were prepared; Information about measurement methods and instrumentation for each type of nuclear material were gathered; and Recommendations on methodological and instrumentation support of accounting measurements for all types of materials were formulated. The analysis showed that the existing measurement methods and instrumentation serve mostly to support the technological process control and nuclear and radiation safety control. Requirements for these applications are lower than requirements for MC and A applications. To improve the state of MC and A at Russian nuclear facilities, significant changes in instrumentation support will be required, specifically in weighing equipment, volume measurements, and destructive and non-destructive analysis equipment, along with certified reference materials

  5. Measuring Outcome in the Treatment of Cocaine Dependence

    Science.gov (United States)

    Crits-Christoph, Paul; Gallop, Robert; Gibbons, Mary Beth Connolly; Sadicario, Jaclyn S.; Woody, George

    2015-01-01

    Background Little in known about the extent to which outcome measures used in studies of the treatment of cocaine dependence are associated with longer-term use and with broader measures of clinical improvement. The current study examined reductions in use, and abstinence-oriented measures, in relation to functioning and longer-term clinical benefits in the treatment of cocaine dependence. Methods Overall drug use, cocaine use, and functioning in a number of addiction-related domains for 487 patients diagnosed with DSM-IV cocaine dependence and treated with one of four psychosocial interventions in the NIDA Cocaine Collaborative Treatment Study were assessed monthly during 6 months of treatment and at 9, 12, 15, and 18 month follow-up. Results Measures of during-treatment reduction in use were moderately correlated with drug and cocaine use measures 12 months, but showed non-significant or small correlations with measures of functioning at 12 months. Highest correlations were evident for abstinence measures (maximum consecutive days abstinence and completely abstinent) during treatment in relation to sustained (3 month) abstinence at 12 months. Latent class analysis of patterns of change over time revealed that most patients initially (months 1 to 4 of treatment) either became abstinent immediately or continued to use every month. Over the couse of follow-up, patients either maintained abstinence or used regularly – intermittent use was less common. Conclusions There were generally small associations between various measures of cocaine use and longer-term clinical benefits, other than abstinence was associated with continued abstinence. No one method of measuring outcome of treatment of cocaine dependence appears superior to others. PMID:26366427

  6. Accounting for the measurement error of spectroscopically inferred soil carbon data for improved precision of spatial predictions.

    Science.gov (United States)

    Somarathna, P D S N; Minasny, Budiman; Malone, Brendan P; Stockmann, Uta; McBratney, Alex B

    2018-08-01

    Spatial modelling of environmental data commonly only considers spatial variability as the single source of uncertainty. In reality however, the measurement errors should also be accounted for. In recent years, infrared spectroscopy has been shown to offer low cost, yet invaluable information needed for digital soil mapping at meaningful spatial scales for land management. However, spectrally inferred soil carbon data are known to be less accurate compared to laboratory analysed measurements. This study establishes a methodology to filter out the measurement error variability by incorporating the measurement error variance in the spatial covariance structure of the model. The study was carried out in the Lower Hunter Valley, New South Wales, Australia where a combination of laboratory measured, and vis-NIR and MIR inferred topsoil and subsoil soil carbon data are available. We investigated the applicability of residual maximum likelihood (REML) and Markov Chain Monte Carlo (MCMC) simulation methods to generate parameters of the Matérn covariance function directly from the data in the presence of measurement error. The results revealed that the measurement error can be effectively filtered-out through the proposed technique. When the measurement error was filtered from the data, the prediction variance almost halved, which ultimately yielded a greater certainty in spatial predictions of soil carbon. Further, the MCMC technique was successfully used to define the posterior distribution of measurement error. This is an important outcome, as the MCMC technique can be used to estimate the measurement error if it is not explicitly quantified. Although this study dealt with soil carbon data, this method is amenable for filtering the measurement error of any kind of continuous spatial environmental data. Copyright © 2018 Elsevier B.V. All rights reserved.

  7. Development of a simulation program to study error propagation in the reprocessing input accountancy measurements

    International Nuclear Information System (INIS)

    Sanfilippo, L.

    1987-01-01

    A physical model and a computer program have been developed to simulate all the measurement operations involved with the Isotopic Dilution Analysis technique currently applied in the Volume - Concentration method for the Reprocessing Input Accountancy, together with their errors or uncertainties. The simulator is apt to easily solve a number of problems related to the measurement sctivities of the plant operator and the inspector. The program, written in Fortran 77, is based on a particular Montecarlo technique named ''Random Sampling''; a full description of the code is reported

  8. Indicators as an Instrument of Measurement in Management Accounting in Logistics Enterprises in Poland

    Directory of Open Access Journals (Sweden)

    Justyna Dobroszek

    2015-12-01

    Full Text Available Purpose: The purpose of this study was to present the extent to which indicators applied by logistics providers in Poland measure logistics-related processes and performance in the context of implementing the concept of management accounting in the enterprises that were researched. Methodology: The research methods used by the authors included a literature review of mainly German and Polish publications and survey research conducted in 2011–2013 among logistics enterprises in Poland. This study served as the basis for verifying four hypotheses and formulating conclusions. Findings: The main results of this study showed that management accounting systems are implemented in about half of then logistics providers in Poland covered by the survey. 75% of all enterprises conducted indicator analysis to evaluate logistics processes, costs and performance, and 90% of the indicators used by these enterprises were of a financial nature. Research limitations: The main limitation of the research was associated with conducting the survey. The low return rate of completed questionnaires did not allow for a detailed analysis of the undertaken subject to be conducted. Moreover, the research results cannot be generalized to all logistics companies in Poland. Originality: The study was the first review of the application of indicators in logistics companies in Poland in relation to the implementation of the management accounting concept. The study provides knowledge about how Polish logistics enterprises use indicators as an important management accounting instrument.

  9. Measuring the attitudes of dental students towards social accountability following dental education - Qualitative findings.

    Science.gov (United States)

    Chen, Vivian; Foster Page, Lyndie; McMillan, John; Lyons, Karl; Gibson, Barry

    2016-06-01

    The term social accountability has gained increased interest in medical education, but is relatively unexplored in dentistry. The aim of this study is to explore dental students' attitudes towards social accountability. A qualitative study utilizing focus groups with University of Otago final year (5th year) Bachelor of Dental Surgery (BDS) students was carried out. A questionnaire designed to measure medical students' attitudes towards social responsibility was used as a guide. Following data collection, framework analysis was used to analyze each of the three focus groups, and repeating themes were noted. Analysis of the focus groups discovered recurring themes, such that participants believed that dentists should be accountable to society in a professional context and that they are responsible for patients who present at their clinic but that there is no professional obligation to help reduce oral health inequalities by working with populations facing inequalities. There was strong agreement that there needs to be change to the dental health care system from a structural and political level to address oral health inequalities, rather than individual dentists assuming greater responsibility. Our findings show that dental education may not be accountable to society in the sense that it is not producing graduates who believe that they have an obligation to address the priority oral health concerns of society.

  10. Accounting for the speed shear in wind turbine power performance measurement

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, R.

    2010-04-15

    The power curve of a wind turbine is the primary characteristic of the machine as it is the basis of the warranty for it power production. The current IEC standard for power performance measurement only requires the measurement of the wind speed at hub height and the air density to characterise the wind field in front of the turbine. However, with the growing size of the turbine rotors during the last years, the effect of the variations of the wind speed within the swept rotor area, and therefore of the power output, cannot be ignored any longer. Primary effects on the power performance are from the vertical wind shear and the turbulence intensity. The work presented in this thesis consists of the description and the investigation of a simple method to account for the wind speed shear in the power performance measurement. Ignoring this effect was shown to result in a power curve dependant on the shear condition, therefore on the season and the site. It was then proposed to use an equivalent wind speed accounting for the whole speed profile in front of the turbine. The method was first tested with aerodynamic simulations of a multi-megawatt wind turbine which demonstrated the decrease of the scatter in the power curve. A power curve defined in terms of this equivalent wind speed would be less dependant on the shear than the standard power curve. The equivalent wind speed method was then experimentally validated with lidar measurements. Two equivalent wind speed definitions were considered both resulting in the reduction of the scatter in the power curve. As a lidar wind profiler can measure the wind speed at several heights within the rotor span, the wind speed profile is described with more accuracy than with the power law model. The equivalent wind speed derived from measurements, including at least one measurement above hub height, resulted in a smaller scatter in the power curve than the equivalent wind speed derived from profiles extrapolated from measurements

  11. Goal setting as an outcome measure: A systematic review.

    Science.gov (United States)

    Hurn, Jane; Kneebone, Ian; Cropley, Mark

    2006-09-01

    Goal achievement has been considered to be an important measure of outcome by clinicians working with patients in physical and neurological rehabilitation settings. This systematic review was undertaken to examine the reliability, validity and sensitivity of goal setting and goal attainment scaling approaches when used with working age and older people. To review the reliability, validity and sensitivity of both goal setting and goal attainment scaling when employed as an outcome measure within a physical and neurological working age and older person rehabilitation environment, by examining the research literature covering the 36 years since goal-setting theory was proposed. Data sources included a computer-aided literature search of published studies examining the reliability, validity and sensitivity of goal setting/goal attainment scaling, with further references sourced from articles obtained through this process. There is strong evidence for the reliability, validity and sensitivity of goal attainment scaling. Empirical support was found for the validity of goal setting but research demonstrating its reliability and sensitivity is limited. Goal attainment scaling appears to be a sound measure for use in physical rehabilitation settings with working age and older people. Further work needs to be carried out with goal setting to establish its reliability and sensitivity as a measurement tool.

  12. Measurement properties of patient-reported outcome measures (PROMS) in Patellofemoral Pain Syndrome: a systematic review.

    Science.gov (United States)

    Green, Andrew; Liles, Clive; Rushton, Alison; Kyte, Derek G

    2014-12-01

    This systematic review investigated the measurement properties of disease-specific patient-reported outcome measures used in Patellofemoral Pain Syndrome. Two independent reviewers conducted a systematic search of key databases (MEDLINE, EMBASE, AMED, CINHAL+ and the Cochrane Library from inception to August 2013) to identify relevant studies. A third reviewer mediated in the event of disagreement. Methodological quality was evaluated using the validated COSMIN (Consensus-based Standards for the Selection of Health Measurement Instruments) tool. Data synthesis across studies determined the level of evidence for each patient-reported outcome measure. The search strategy returned 2177 citations. Following the eligibility review phase, seven studies, evaluating twelve different patient-reported outcome measures, met inclusion criteria. A 'moderate' level of evidence supported the structural validity of several measures: the Flandry Questionnaire, Anterior Knee Pain Scale, Functional Index Questionnaire, Eng and Pierrynowski Questionnaire and Visual Analogue Scales for 'usual' and 'worst' pain. In addition, there was a 'Limited' level of evidence supporting the test-retest reliability and validity (cross-cultural, hypothesis testing) of the Persian version of the Anterior Knee Pain Scale. Other measurement properties were evaluated with poor methodological quality, and many properties were not evaluated in any of the included papers. Current disease-specific outcome measures for Patellofemoral Pain Syndrome require further investigation. Future studies should evaluate all important measurement properties, utilising an appropriate framework such as COSMIN to guide study design, to facilitate optimal methodological quality. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Vision and vision-related outcome measures in multiple sclerosis

    DEFF Research Database (Denmark)

    Balcer, Laura J; Miller, David H; Reingold, Stephen C

    2015-01-01

    Visual impairment is a key manifestation of multiple sclerosis. Acute optic neuritis is a common, often presenting manifestation, but visual deficits and structural loss of retinal axonal and neuronal integrity can occur even without a history of optic neuritis. Interest in vision in multiple...... sclerosis is growing, partially in response to the development of sensitive visual function tests, structural markers such as optical coherence tomography and magnetic resonance imaging, and quality of life measures that give clinical meaning to the structure-function correlations that are unique...... of investigators involved in the development and study of visual outcomes in multiple sclerosis, which had, as its overriding goals, to review the state of the field and identify areas for future research. We review data and principles to help us understand the importance of vision as a model for outcomes...

  14. Measuring outcomes of communication partner training of health care professionals:

    DEFF Research Database (Denmark)

    Isaksen, Jytte; Jensen, Lise Randrup

    health care, and other communicative exchanges associated with appropriate health care [3]. As a consequence of these challenges in patient-provider communication, implementation of evidence- based methods of communication partner training is becoming increasingly frequent in different health care...... with large groups of trainees, e.g. all staff from a ward. Self-rating questionnaires, however, present another set of issues when used as outcome measures, including the need to examine their content validity, reliability and sensitivity to change [9]. This work appears to be lacking for most...... of the available questionnaires. However, it is important in order to lay the groundwork for future studies, which compare the efficacy and outcome of different methods of implementing conversation partner training in clinical practice. Aims: The overall purpose of this round table is to: 1. provide an overview...

  15. Accounting for External Turbulence of Logistics Organizations via Performance Measurement Systems

    DEFF Research Database (Denmark)

    Bühler, Andreas; Wallenburg, Carl Marcus; Wieland, Andreas

    2016-01-01

    Purpose: This paper aims to investigate the role of upper management in designing performance measurement systems (PMS) that account for external turbulence of the organization and to show how this PMS design for turbulence impacts organizational resilience and distribution service performance....... Design/methodology/approach: Hypotheses are developed by integrating management accounting and strategic management perspectives into supply chain management and subsequently tested based on data from 431 logistics organizations (i.e. both logistics companies and internal logistics departments...... distribution service performance. Originality/value: This paper is the first to introduce the concept of PMS design for turbulence to the literature and to show that it is relevant for supply chain risk management by fostering the capabilities and the performance of logistics organizations. Further...

  16. Use of outcome measures in pulmonary hypertension clinical trials.

    Science.gov (United States)

    Parikh, Kishan S; Rajagopal, Sudarshan; Arges, Kristine; Ahmad, Tariq; Sivak, Joseph; Kaul, Prashant; Shah, Svati H; Tapson, Victor; Velazquez, Eric J; Douglas, Pamela S; Samad, Zainab

    2015-09-01

    To evaluate the use of surrogate measures in pulmonary hypertension (PH) clinical trials and how it relates to clinical practice. Studies of pulmonary arterial hypertension (PAH) employ a variety of surrogate measures in addition to clinical events because of a small patient population, participant burden, and costs. The use of these measures in PH drug trials is poorly defined. We searched PubMed/MEDLINE/Embase for randomized or prospective cohort PAH clinical treatment trials from 1985 to 2013. Extracted data included intervention, trial duration, study design, patient characteristics, and primary and secondary outcome measures. To compare with clinical practice, we assessed the use of surrogate measures in a clinical sample of patients on PH medications at Duke University Medical Center between 2003 and 2014. Between 1985 and 2013, 126 PAH trials were identified and analyzed. Surrogate measures served as primary endpoints in 119 trials (94.0%). Inclusion of invasive hemodynamics decreased over time (78.6%, 75.0%, 52.2%; P for trend = .02), while functional testing (7.1%, 60.0%, 81.5%; P for trend clinical assessments regularly incorporated serial echocardiography and 6-minute walk distance tests (92% and 95% of patients, respectively) and repeat measurement of invasive hemodynamics (46% of patients). The majority of PAH trials have utilized surrogate measures as primary endpoints. The use of these surrogate endpoints has evolved significantly over time with increasing use of patient-centered endpoints and decreasing or stable use of imaging and invasive measures. In contrast, imaging and invasive measures are commonly used in contemporary clinical practice. Further research is needed to validate and standardize currently used measures. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. How does accounting for worker productivity affect the measured cost-effectiveness of lumbar discectomy?

    Science.gov (United States)

    Koenig, Lane; Dall, Timothy M; Gu, Qian; Saavoss, Josh; Schafer, Michael F

    2014-04-01

    Back pain attributable to lumbar disc herniation is a substantial cause of reduced workplace productivity. Disc herniation surgery is effective in reducing pain and improving function. However, few studies have examined the effects of surgery on worker productivity. We wished to determine the effect of disc herniation surgery on workers' earnings and missed workdays and how accounting for this effect influences the cost-effectiveness of surgery? Regression models were estimated using data from the National Health Interview Survey to assess the effects of lower back pain caused by disc herniation on earnings and missed workdays. The results were incorporated into Markov models to compare societal costs associated with surgical and nonsurgical treatments for privately insured, working patients. Clinical outcomes and utilities were based on results from the Spine Patient Outcomes Research Trial and additional clinical literature. We estimate average annual earnings of $47,619 with surgery and $45,694 with nonsurgical treatment. The increased earnings for patients receiving surgery as compared with nonsurgical treatment is equal to $1925 (95% CI, $1121-$2728). After surgery, we also estimate that workers receiving surgery miss, on average, 3 fewer days per year than if workers had received nonsurgical treatment (95% CI, 2.4-3.7 days). However, these fewer missed work days only partially offset the assumed 20 workdays missed to recover from surgery. More fully accounting for the effects of disc herniation surgery on productivity reduced the cost of surgery per quality-adjusted life year (QALY) from $52,416 to $35,146 using a 4-year time horizon and from $27,359 to $4186 using an 8-year time horizon. According to a sensitivity analysis, the 4-year cost per QALY varies between $27,921 and $49,787 depending on model assumptions. Increased worker earnings resulting from disc herniation surgery may offset the increased direct medical costs associated with surgery. After

  18. Engaging the hearts and minds of clinicians in outcome measurement - the UK Rehabilitation Outcomes Collaborative approach.

    Science.gov (United States)

    Turner-Stokes, Lynne; Williams, Heather; Sephton, Keith; Rose, Hilary; Harris, Sarah; Thu, Aung

    2012-01-01

    This article explores the rationale for choosing the instruments included within the UK Rehabilitation Outcomes Collaborative (UKROC) data set. Using one specialist neuro-rehabilitation unit as an exemplar service, it describes an approach to engaging the hearts and minds of clinicians in recording the data. Measures included within a national data set for rehabilitation should be psychometrically robust and feasible to use in routine clinical practice; they should also support clinical decision-making so that clinicians actually want to use them. Learning from other international casemix models and benchmarking data sets, the UKROC team has developed a cluster of measures to inform the development of effective and cost-efficient rehabilitation services. These include measures of (1) "needs" for rehabilitation (complexity), (2) inputs provided to meet those needs (nursing and therapy intervention), and (3) outcome, including the attainment of personal goals as well as gains in functional independence. By integrating the use of the data set measures in everyday clinical practice, we have achieved a very high rate of compliance with data collection. However, staff training and ongoing commitment from senior staff and managers are critical to the maintenance of effort required to provide assurance of data quality in the longer term.

  19. CT Measured Psoas Density Predicts Outcomes After Enterocutaneous Fistula Repair

    Science.gov (United States)

    Lo, Wilson D.; Evans, David C.; Yoo, Taehwan

    2018-01-01

    Background Low muscle mass and quality are associated with poor surgical outcomes. We evaluated CT measured psoas muscle density as a marker of muscle quality and physiologic reserve, and hypothesized that it would predict outcomes after enterocutaneous fistula repair (ECF). Methods We conducted a retrospective cohort study of patients 18 – 90 years old with ECF failing non-operative management requiring elective operative repair at Ohio State University from 2005 – 2016 that received a pre-operative abdomen/pelvis CT with intravenous contrast within 3 months of their operation. Psoas Hounsfield Unit average calculation (HUAC) were measured at the L3 level. 1 year leak rate, 90 day, 1 year, and 3 year mortality, complication risk, length of stay, dependent discharge, and 30 day readmission were compared to HUAC. Results 100 patients met inclusion criteria. Patients were stratified into interquartile (IQR) ranges based on HUAC. The lowest HUAC IQR was our low muscle quality (LMQ) cutoff, and was associated with 1 year leak (OR 3.50, p < 0.01), 1 year (OR 2.95, p < 0.04) and 3 year mortality (OR 3.76, p < 0.01), complication risk (OR 14.61, p < 0.01), and dependent discharge (OR 4.07, p < 0.01) compared to non-LMQ patients. Conclusions Psoas muscle density is a significant predictor of poor outcomes in ECF repair. This readily available measure of physiologic reserve can identify patients with ECF on pre-operative evaluation that have significantly increased risk that may benefit from additional interventions and recovery time to mitigate risk before operative repair. PMID:29505144

  20. Accounting for the effect of horizontal gradients in limb measurements of scattered sunlight

    Directory of Open Access Journals (Sweden)

    J. Puķīte

    2008-06-01

    Full Text Available Limb measurements provided by the SCanning Imaging Absorption spectrometer for Atmospheric CHartographY (SCIAMACHY on the ENVISAT satellite allow retrieving stratospheric profiles of various trace gases on a global scale, among them BrO for the first time. For limb observations in the UV/VIS spectral region the instrument measures scattered light with a complex distribution of light paths: the light is measured at different tangent heights and can be scattered or absorbed in the atmosphere or reflected by the ground. By means of spectroscopy and radiative transfer modelling these measurements can be inverted to retrieve the vertical distribution of stratospheric trace gases.

    The fully spherical 3-D Monte Carlo radiative transfer model "Tracy-II" is applied in this study. The Monte Carlo method benefits from conceptual simplicity and allows realizing the concept of full spherical geometry of the atmosphere and also its 3-D properties, which is important for a realistic description of the limb geometry. Furthermore it allows accounting for horizontal gradients in the distribution of trace gases.

    In this study the effect of horizontally inhomogeneous distributions of trace gases along flight/viewing direction on the retrieval of profiles is investigated. We introduce a tomographic method to correct for this effect by combining consecutive limb scanning sequences and utilizing the overlap in their measurement sensitivity regions. It is found that if horizontal inhomogenity is not properly accounted for, typical errors of 20% for NO2 and up to 50% for OClO around the altitude of the profile peak can arise for measurements close to the Arctic polar vortex boundary in boreal winter.

  1. Transactional stress and coping theory in accounting for psychological states measures

    Directory of Open Access Journals (Sweden)

    V. Buško

    2007-08-01

    Full Text Available The paper examines a relative predictive value of some stable individual attributes and the processes of cognitive appraisals and coping with stress in accounting for specific components of anxiety state measures. Self-report instruments for the measurement of selected psychological constructs, i.e. perceived incompetence, externality, stress intensity and duration, situation-specific coping strategies, and the two anxiety state components, were taken in a sample of 449 male military basics trainees, ranging in age from 18-27. Hierarchical multiple regression analyses showed that the set of predictors employed could account for statistically, as well as theoretically and practically a significant part of variance in cognitive anxiety component (45,5%, and in visceral-emotional component (32,2% of the anxiety state. The extent of anxiety reactions assessed by both scales could primarily be explained by general perception of personal incompetence, as a relatively stable dimension of general self-concept. Of the ways of coping examined, reinterpretation of stressful events was the only strategy contributing to low level, whereas passivization, wishful thinking, and seeking social support contributed to higher levels of anxiety measured by both scales. The results give partial support to the basic hypotheses on the mediating role of coping in the relationships among particular components of the stress and coping models.

  2. How to simplify the analytics for input-output accountability measurements in a reprocessing plant

    International Nuclear Information System (INIS)

    Ottmar, H.; Eberle, H.; Matussek, P.; Michel-Piper, I.

    1986-02-01

    An analytical approach to high-performance uranium and plutonium accountancy measurements in reprocessing input and output solutions is presented, which provides larger operational simplicity than the conventionally applied chemical methods. The proposed alternative is based on energy-dispersive absorption edge and fluorescence X-ray spectrometry, using the proven and reliable K-edge densitometry technique as reference method. Two X-ray densitometers developed for accurate and reliable uranium and plutonium analysis in both the feed and product solutions are described. Practical experiences and results from their performance evaluation on actual process solutions from a reprocessing plant are presented and discussed. (orig.) [de

  3. Directly measured secondhand smoke exposure and COPD health outcomes

    Directory of Open Access Journals (Sweden)

    Balmes John

    2006-06-01

    Full Text Available Abstract Background Although personal cigarette smoking is the most important cause and modulator of chronic obstructive pulmonary disease (COPD, secondhand smoke (SHS exposure could influence the course of the disease. Despite the importance of this question, the impact of SHS exposure on COPD health outcomes remains unknown. Methods We used data from two waves of a population-based multiwave U.S. cohort study of adults with COPD. 77 non-smoking respondents with a diagnosis of COPD completed direct SHS monitoring based on urine cotinine and a personal badge that measures nicotine. We evaluated the longitudinal impact of SHS exposure on validated measures of COPD severity, physical health status, quality of life (QOL, and dyspnea measured at one year follow-up. Results The highest level of SHS exposure, as measured by urine cotinine, was cross-sectionally associated with poorer COPD severity (mean score increment 4.7 pts; 95% CI 0.6 to 8.9 and dyspnea (1.0 pts; 95% CI 0.4 to 1.7 after controlling for covariates. In longitudinal analysis, the highest level of baseline cotinine was associated with worse COPD severity (4.7 points; 95% CI -0.1 to 9.4; p = 0.054, disease-specific QOL (2.9 pts; -0.16 to 5.9; p = 0.063, and dyspnea (0.9 pts; 95% CI 0.2 to 1.6 pts; p Conclusion Directly measured SHS exposure appears to adversely influence health outcomes in COPD, independent of personal smoking. Because SHS is a modifiable risk factor, clinicians should assess SHS exposure in their patients and counsel its avoidance. In public health terms, the effects of SHS exposure on this vulnerable subpopulation provide a further rationale for laws prohibiting public smoking.

  4. Measuring social accountability in health professional education: development and international pilot testing of an evaluation framework.

    Science.gov (United States)

    Larkins, Sarah L; Preston, Robyn; Matte, Marie C; Lindemann, Iris C; Samson, Rex; Tandinco, Filedito D; Buso, David; Ross, Simone J; Pálsdóttir, Björg; Neusy, André-Jacques

    2013-01-01

    Health professional schools are responsible for producing graduates with competencies and attitudes to address health inequities and respond to priority health needs. Health professional schools striving towards social accountability founded the Training for Health Equity Network (THEnet). This article describes the development of THEnet evaluation framework for socially accountable health professional education, presents the framework to be used as a tool by other schools and discusses the findings of pilot implementation at five schools. The framework was designed collaboratively and built on Boelen and Woollard's conceptualization, production and usability model. It includes key components, linked to aspirational statements, indicators and suggested measurement tools. Five schools completed pilot implementation, involving workshops, document/data review and focus group discussions with faculty, students and community members. Three sections of the framework consider: How does our school work?; What do we do? and What difference do we make? Pilot testing proved that the evaluation framework was acceptable and feasible across contexts and produced findings useful at school level and to compare schools. The framework is designed as a formative exercise to help schools take a critical look at their performance and progress towards social accountability. Initiatives to implement the framework more widely are underway. The framework effectively aids in identifying strengths, weaknesses and gaps, with a view to schools striving for continuous self-improvement. THEnet evaluation framework is applicable and useful across contexts. It is possible and desirable to assess progress towards social accountability in health professional schools and this is an important step in producing health professionals with knowledge, attitudes, and skills to meet the challenges of priority health needs of underserved populations.

  5. Patient-reported outcome measures in arthroplasty registries

    DEFF Research Database (Denmark)

    Rolfson, Ola; Bohm, Eric; Franklin, Patricia

    2016-01-01

    The International Society of Arthroplasty Registries (ISAR) Patient-Reported Outcome Measures (PROMs) Working Group have evaluated and recommended best practices in the selection, administration, and interpretation of PROMs for hip and knee arthroplasty registries. The 2 generic PROMs in common use...... are the Short Form health surveys (SF-36 or SF-12) and EuroQol 5-dimension (EQ-5D). The Working Group recommends that registries should choose specific PROMs that have been appropriately developed with good measurement properties for arthroplasty patients. The Working Group recommend the use of a 1-item pain...... should consider the absolute level of pain, function, and general health status as well as improvement, missing data, approaches to analysis and case-mix adjustment, minimal clinically important difference, and minimal detectable change. The Working Group recommends data collection immediately before...

  6. Single-case synthesis tools II: Comparing quantitative outcome measures.

    Science.gov (United States)

    Zimmerman, Kathleen N; Pustejovsky, James E; Ledford, Jennifer R; Barton, Erin E; Severini, Katherine E; Lloyd, Blair P

    2018-03-07

    Varying methods for evaluating the outcomes of single case research designs (SCD) are currently used in reviews and meta-analyses of interventions. Quantitative effect size measures are often presented alongside visual analysis conclusions. Six measures across two classes-overlap measures (percentage non-overlapping data, improvement rate difference, and Tau) and parametric within-case effect sizes (standardized mean difference and log response ratio [increasing and decreasing])-were compared to determine if choice of synthesis method within and across classes impacts conclusions regarding effectiveness. The effectiveness of sensory-based interventions (SBI), a commonly used class of treatments for young children, was evaluated. Separately from evaluations of rigor and quality, authors evaluated behavior change between baseline and SBI conditions. SBI were unlikely to result in positive behavior change across all measures except IRD. However, subgroup analyses resulted in variable conclusions, indicating that the choice of measures for SCD meta-analyses can impact conclusions. Suggestions for using the log response ratio in SCD meta-analyses and considerations for understanding variability in SCD meta-analysis conclusions are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

  7. Refining estimates of public health spending as measured in national health expenditure accounts: the Canadian experience.

    Science.gov (United States)

    Ballinger, Geoff

    2007-01-01

    The recent focus on public health stemming from, among other things, severe acute respiratory syndrome and avian flu has created an imperative to refine health-spending estimates in the Canadian Health Accounts. This article presents the Canadian experience in attempting to address the challenges associated with developing the needed taxonomies for systematically capturing, measuring, and analyzing the national investment in the Canadian public health system. The first phase of this process was completed in 2005, which was a 2-year project to estimate public health spending based on a more classic definition by removing the administration component of the previously combined public health and administration category. Comparing the refined public health estimate with recent data from the Organization for Economic Cooperation and Development still positions Canada with the highest share of total health expenditure devoted to public health than any other country reporting. The article also provides an analysis of the comparability of public health estimates across jurisdictions within Canada as well as a discussion of the recommendations for ongoing improvement of public health spending estimates. The Canadian Institute for Health Information is an independent, not-for-profit organization that provides Canadians with essential statistics and analysis on the performance of the Canadian health system, the delivery of healthcare, and the health status of Canadians. The Canadian Institute for Health Information administers more than 20 databases and registries, including Canada's Health Accounts, which tracks historically 40 categories of health spending by 5 sources of finance for 13 provincial and territorial jurisdictions. Until 2005, expenditure on public health services in the Canadian Health Accounts included measures to prevent the spread of communicable disease, food and drug safety, health inspections, health promotion, community mental health programs, public

  8. 77 FR 32913 - Accountability Measures for the Recreational Sector of Gray Triggerfish in the Gulf of Mexico for...

    Science.gov (United States)

    2012-06-04

    ... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration 50 CFR Part 622 [Docket No. 120417412-2412-01] RIN 0648-XCO36 Accountability Measures for the Recreational Sector of Gray Triggerfish in...: NMFS implements accountability measures (AMs) for the recreational sector of gray triggerfish in the...

  9. 77 FR 60945 - 2012-2013 Accountability Measure and Closure for Commercial Black Sea Bass in the South Atlantic

    Science.gov (United States)

    2012-10-05

    ... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration 50 CFR Part 622 [Docket No. 0907271173-0629-03] RIN 0648-XC152 2012-2013 Accountability Measure and Closure for Commercial Black Sea Bass... accountability measure (AM) for the commercial sector of black sea bass in the exclusive economic zone (EEZ) of...

  10. The Relationship between Market and Accounting Determined Risk Measures: Reviewing and Updating the Beaver, Kettler, Scholes (1970) Study

    Science.gov (United States)

    Jarvela, Michael; Kozyra, James; Potter, Carla

    2009-01-01

    The association between market-determined risk measures and accounting-determined risk measures was originally explored in the 1970s by Beaver, Kettler, and Scholes (BKS). The results of the BKS (1970) study suggest that accounting information is usefulness in assessing firm specific risk. Since BKS, there have been few studies conducted to…

  11. Improvement of sample preparation for input plutonium accountability measurement by isotope dilution gammy-ray spectroscopy

    International Nuclear Information System (INIS)

    Nishida, K.; Kuno, Y.; Sato, S.; Masui, J.; Li, T.K.; Parker, J.L.; Hakkila, E.A.

    1992-01-01

    The sample preparation method for the isotope dilution gamma-ray spectrometry (IDGS) technique has been further improved for simultaneously determining the plutonium concentration and isotopic composition of highly irradiated spent-fuel dissolver solutions. The improvement includes using ion-exchange filter papers (instead of resin beads, as in two previous experiments) for better separation and recovery of plutonium from fission products. The results of IDGS measurements for five dissolver solutions are in good agreement with those by mass spectrometry with ∼0.4% for plutonium concentration and ∼0.1% for 239 Pu isotopic composition. The precision of the plutonium concentration is ∼1% with a 1-h count time. The technique could be implemented as an alternative method for input accountability and verification measurements in reprocessing plants

  12. Accounting for measurement error in log regression models with applications to accelerated testing.

    Directory of Open Access Journals (Sweden)

    Robert Richardson

    Full Text Available In regression settings, parameter estimates will be biased when the explanatory variables are measured with error. This bias can significantly affect modeling goals. In particular, accelerated lifetime testing involves an extrapolation of the fitted model, and a small amount of bias in parameter estimates may result in a significant increase in the bias of the extrapolated predictions. Additionally, bias may arise when the stochastic component of a log regression model is assumed to be multiplicative when the actual underlying stochastic component is additive. To account for these possible sources of bias, a log regression model with measurement error and additive error is approximated by a weighted regression model which can be estimated using Iteratively Re-weighted Least Squares. Using the reduced Eyring equation in an accelerated testing setting, the model is compared to previously accepted approaches to modeling accelerated testing data with both simulations and real data.

  13. Accounting for measurement error in log regression models with applications to accelerated testing.

    Science.gov (United States)

    Richardson, Robert; Tolley, H Dennis; Evenson, William E; Lunt, Barry M

    2018-01-01

    In regression settings, parameter estimates will be biased when the explanatory variables are measured with error. This bias can significantly affect modeling goals. In particular, accelerated lifetime testing involves an extrapolation of the fitted model, and a small amount of bias in parameter estimates may result in a significant increase in the bias of the extrapolated predictions. Additionally, bias may arise when the stochastic component of a log regression model is assumed to be multiplicative when the actual underlying stochastic component is additive. To account for these possible sources of bias, a log regression model with measurement error and additive error is approximated by a weighted regression model which can be estimated using Iteratively Re-weighted Least Squares. Using the reduced Eyring equation in an accelerated testing setting, the model is compared to previously accepted approaches to modeling accelerated testing data with both simulations and real data.

  14. Isotope correlation techniques for verifying input accountability measurements at a reprocessing plant

    International Nuclear Information System (INIS)

    Umezawa, H.; Nakahara, Y.

    1983-01-01

    Isotope correlation techniques were studied to verify input accountability measurements at a reprocessing plant. On the basis of a historical data bank, correlation between plutonium-to-uranium ratio and isotopic variables was derived as a function of burnup. The burnup was determined from the isotopic ratios of uranium and plutonium, too. Data treatment was therefore made in an iterative manner. The isotopic variables were defined to cover a wide spectrum of isotopes of uranium and plutonium. The isotope correlation techniques evaluated important parameters such as the fuel burnup, the most probable ratio of plutonium to uranium, and the amounts of uranium and plutonium in reprocessing batches in connection with fresh fuel fabrication data. In addition, the most probable values of isotope abundance of plutonium and uranium could be estimated from the plutonium-to-uranium ratio determined, being compared with the reported data for verification. A pocket-computer-based system was developed to enable inspectors to collect and evaluate data in a timely fashion at the input accountability measurement point by the isotope correlation techniques. The device is supported by battery power and completely independent of the operator's system. The software of the system was written in BASIC. The data input can be stored in a cassette tape and transferred into a higher level computer. The correlations used for the analysis were given as a form of analytical function. Coefficients for the function were provided relevant to the type of reactor and the initial enrichment of fuel. (author)

  15. Material accountancy measurement techniques in dry-powdered processing of nuclear spent fuels

    International Nuclear Information System (INIS)

    Wolf, S. F.

    1999-01-01

    The paper addresses the development of inductively coupled plasma-mass spectrometry (ICPMS), thermal ionization-mass spectrometry (TIMS), alpha-spectrometry, and gamma spectrometry techniques for in-line analysis of highly irradiated (18 to 64 GWD/T) PWR spent fuels in a dry-powdered processing cycle. The dry-powdered technique for direct elemental and isotopic accountancy assay measurements was implemented without the need for separation of the plutonium, uranium and fission product elements in the bulk powdered process. The analyses allow the determination of fuel burn-up based on the isotopic composition of neodymium and/or cesium. An objective of the program is to develop the ICPMS method for direct fissile nuclear materials accountancy in the dry-powdered processing of spent fuel. The ICPMS measurement system may be applied to the KAERI DUPIC (direct use of spent PWR fuel in CANDU reactors) experiment, and in a near-real-time mode for international safeguards verification and non-proliferation policy concerns

  16. Use of continuous glucose monitoring as an outcome measure in clinical trials.

    Science.gov (United States)

    Beck, Roy W; Calhoun, Peter; Kollman, Craig

    2012-10-01

    Although developed to be a management tool for individuals with diabetes, continuous glucose monitoring (CGM) also has potential value for the assessment of outcomes in clinical studies. We evaluated using CGM as such an outcome measure. Data were analyzed from six previously completed inpatient studies in which both CGM (Freestyle Navigator™ [Abbott Diabetes Care, Alameda, CA] or Guardian(®) [Medtronic, Northridge, CA]) and reference glucose measurements were available. The analyses included 97 days of data from 93 participants with type 1 diabetes (age range, 5-57 years; mean, 18 ± 12 years). Mean glucose levels per day were similar for the CGM and reference measurements (median, 148 mg/dL vs. 143 mg/dL, respectively; P = 0.92), and the correlation of the two was high (r = 0.89). Similarly, most glycemia metrics showed no significant differences comparing CGM and reference values, except that the nadir glucose tended to be slightly lower and peak glucose slightly higher with reference measurements than CGM measurements (respective median, 59 mg/dL vs. 66 mg/dL [P = 0.05] and 262 mg/dL vs. 257 mg/dL [P = 0.003]) and glucose variability as measured with the coefficient of variation was slightly lower with CGM than reference measurements (respective median, 31% vs. 35%; Pblood glucose measurements. CGM inaccuracy and underestimation of the extremes of hyperglycemia and hypoglycemia can be accounted for in a clinical trial's study design. Thus, in appropriate settings, CGM can be a very meaningful and feasible outcome measure for clinical trials.

  17. Proceedings of Patient Reported Outcome Measure?s (PROMs) Conference Sheffield 2016: advances in patient reported outcomes research

    OpenAIRE

    Croudace, Tim; Brazier, John; Gutacker, Nils; Street, Andrew; Robotham, Dan; Waterman, Samantha; Rose, Diana; Satkunanathan, Safarina; Wykes, Til; Nasr, Nasrin; Enderby, Pamela; Carlton, Jill; Rowen, Donna; Elliott, Jackie; Brazier, John

    2016-01-01

    Table of contents S1 Using computerized adaptive testing Tim Croudace S2 Well-being: what is it, how does it compare to health and what are the implications of using it to inform health policy John Brazier O1 “Am I going to get better?”—Using PROMs to inform patients about the likely benefit of surgery Nils Gutacker, Andrew Street O2 Identifying Patient Reported Outcome Measures for an electronic Personal Health Record Dan Robotham, Samantha Waterman, Diana Rose, Safarina Satkunanathan, Til W...

  18. International target values 2010 for achievable measurement uncertainties in nuclear material accountancy

    International Nuclear Information System (INIS)

    Dias, Fabio C.; Almeida, Silvio G. de; Renha Junior, Geraldo

    2011-01-01

    The International Target Values (ITVs) are reasonable uncertainty estimates that can be used in judging the reliability of measurement techniques applied to industrial nuclear and fissile materials subject to accountancy and/or safeguards verification. In the absence of relevant experimental estimates, ITVs can also be used to select measurement techniques and calculate sample population during the planning phase of verification activities. It is important to note that ITVs represent estimates of the 'state-of-the-practice', which should be achievable under routine measurement conditions affecting both facility operators and safeguards inspectors, not only in the field, but also in laboratory. Tabulated values cover measurement methods used for the determination of volume or mass of the nuclear material, for its elemental and isotopic assays, and for its sampling. The 2010 edition represents the sixth revision of the International Target Values (ITVs), issued by the International Atomic Energy Agency (IAEA) as a Safeguards Technical Report (STR-368). The first version was released as 'Target Values' in 1979 by the Working Group on Techniques and Standards for Destructive Analysis (WGDA) of the European Safeguards Research and Development Association (ESARDA) and focused on destructive analytical methods. In the latest 2010 revision, international standards in estimating and expressing uncertainties have been considered while maintaining a format that allows comparison with the previous editions of the ITVs. Those standards have been usually applied in QC/QA programmes, as well as qualification of methods, techniques and instruments. Representatives of the Brazilian Nuclear Energy Commission (CNEN) and the Brazilian-Argentine Agency for Accounting and Control of Nuclear Materials (ABACC) participated in previous Consultants Group Meetings since the one convened to establish the first list of ITVs released in 1993 and in subsequent revisions, including the latest one

  19. Accountability, Inequality, and Achievement: The Effects of the No Child Left Behind Act on Multiple Measures of Student Learning

    Directory of Open Access Journals (Sweden)

    Jennifer L. Jennings

    2016-09-01

    Full Text Available Scholars continue to debate whether gains on the state tests used for accountability generalize to other measures of student achievement. Using panel data on students from a large urban school district, we estimate the impact of accountability pressure related to the No Child Left Behind Act on two measures of academic achievement: the state test and an “audit” test that is not tied to the accountability system. Overall, we find that accountability pressure is associated with increased state test scores in math and lower audit math and reading test scores. However, the sources of state and audit test score divergence varied by students’ race. Black students in schools facing the most accountability pressure made no gains on state tests, and their losses on audit math tests were twice as large as those of Hispanic students. These findings highlight the importance of better understanding the mechanisms that produce heterogeneous effects of accountability pressure across achievement measures and subgroups.

  20. Demonstration of an automated electromanometer for measurement of solution volume in accountability vessels

    International Nuclear Information System (INIS)

    Suda, S.; Keisch, B.; Hayashi, M.; Onuma, T.; Fukuari, Y.

    1981-09-01

    A system for measuring the liquid volume in input and plutonium product accountability vessels, based upon a desktop-computer-controlled electromanometer, was installed at the Tokai-Mura reprocessing plant. In-tank temperatures, pressure measurements relating to volume and density, and load-cell weights are measured cyclically and recorded. The system feasibility was demonstrated through a series of tests including vessel calibration and the effects of thermal expansion, and through use during thirteen months of on-line plant operation. The value to the operator of the recording, display, replay, data handling, and report generation features of the system was demonstrated as was the enhanced precision of the electromanometer as compared to the conventional water-filled manometer system. The automated electromanometer system consists of a pneumatic scanner, a precision electromanometer, electronic scanner, a digital voltmeter, and a desktop computer with disc and tape mass storage, cathode-ray tube (CRT) graphics display, and printer output. The desktop computer is used to control the pneumatic and electronic scanners and the digital voltmeter and to log in the measurement data

  1. Estimation of the thermal diffusion coefficient in fusion plasmas taking frequency measurement uncertainties into account

    International Nuclear Information System (INIS)

    Van Berkel, M; Hogeweij, G M D; Van den Brand, H; De Baar, M R; Zwart, H J; Vandersteen, G

    2014-01-01

    In this paper, the estimation of the thermal diffusivity from perturbative experiments in fusion plasmas is discussed. The measurements used to estimate the thermal diffusivity suffer from stochastic noise. Accurate estimation of the thermal diffusivity should take this into account. It will be shown that formulas found in the literature often result in a thermal diffusivity that has a bias (a difference between the estimated value and the actual value that remains even if more measurements are added) or have an unnecessarily large uncertainty. This will be shown by modeling a plasma using only diffusion as heat transport mechanism and measurement noise based on ASDEX Upgrade measurements. The Fourier coefficients of a temperature perturbation will exhibit noise from the circular complex normal distribution (CCND). Based on Fourier coefficients distributed according to a CCND, it is shown that the resulting probability density function of the thermal diffusivity is an inverse non-central chi-squared distribution. The thermal diffusivity that is found by sampling this distribution will always be biased, and averaging of multiple estimated diffusivities will not necessarily improve the estimation. Confidence bounds are constructed to illustrate the uncertainty in the diffusivity using several formulas that are equivalent in the noiseless case. Finally, a different method of averaging, that reduces the uncertainty significantly, is suggested. The methodology is also extended to the case where damping is included, and it is explained how to include the cylindrical geometry. (paper)

  2. Measuring persistence to hormonal therapy in patients with breast cancer: accounting for temporary treatment discontinuation.

    Science.gov (United States)

    Huiart, Laetitia; Ferdynus, Cyril; Dell'Aniello, Sophie; Bakiri, Naciba; Giorgi, Roch; Suissa, Samy

    2014-08-01

    Several studies have been conducted to estimate persistence to hormonal therapy among women with breast cancer (BC). Most studies focus on first treatment discontinuation. Patients, however, can have numerous periods of treatment discontinuation or treatment exposure. Our objective is to estimate persistence to tamoxifen in patients with BC while accounting for temporary treatment discontinuations and this by using multi-state (MS) models. A cohort of 10,806 women with BC having received at least one prescription of tamoxifen between 1998 and 2008 was constituted from the UK General Practice Research Database. We fitted a semi-Markov model with three states to estimate the probability of being off treatment over a 5-year period while accounting for temporary treatment discontinuations (transition between on treatment and off treatment) and competing risks (recurrence of BC or death). Non-persistence, as estimated from the MS model, ranged from 12.1% (95% confidence interval [95%CI]: 9.2-15.1) at 1 year to 14.9% (95%CI: 11.7-18.1) at 5 years. Estimations of non-persistence based on the Kaplan-Meier model were higher, i.e., 29.3% (95%CI: 28.1-30.6) at 5 years, as well as those obtained from a competing risk model, i.e., 24.0% (95%CI: 22.9-25.1). Most temporary discontinuations (94.7%) lasted less than 6 months. Temporary treatment discontinuations are frequent and should be accounted for when measuring adherence to treatment. MS models can provide a useful framework for this sort of analysis insofar as they help describe patients' complex behavior. This may help tailor interventions that improve persistence to hormonal therapy among women with BC. Copyright © 2014 John Wiley & Sons, Ltd.

  3. Patient reported outcome measures in male incontinence surgery.

    Science.gov (United States)

    Tran, M G B; Yip, J; Uveili, K; Biers, S M; Thiruchelvam, N

    2014-10-01

    Patient reported outcome measures (PROMs) were used to evaluate outcomes of the artificial urinary sphincter (AUS) and the AdVance™ (American Medical Systems, Minnetonka, MN, US) male sling system (AVMS) for the symptomatic management of male stress urinary incontinence. All male patients with stress urinary incontinence referred to our specialist clinic over a two-year period completed the ICIQ-UI SF (International Consultation on Incontinence Questionnaire on Urinary Incontinence Short Form) and the ICIQ-MLUTS LF (International Consultation on Incontinence Questionnaire on Male Lower Urinary Tract Symptoms Long Form) at consultation as well as at subsequent follow-up appointments. The Wilcoxon signed-rank test for non-parametric paired data was used for pre and postoperative comparisons. The chi-squared test was used for categorical variables. Thirty-seven patients (forty surgical cases) completed a preoperative and at least one follow-up questionnaire. There was a statistically significant improvement in PROMs postoperatively, regardless of mode of surgery (p25) had greater improvement with an AUS than with the AVMS (p<0.01). This prospective study shows that completion and collection of PROMs as part of routine clinical practice is achievable and useful in the assessment of male stress incontinence surgery. PROMs are important instruments to assess effectiveness of healthcare intervention and they are useful adjuncts in surgical studies.

  4. Vision and vision-related outcome measures in multiple sclerosis

    Science.gov (United States)

    Balcer, Laura J.; Miller, David H.; Reingold, Stephen C.

    2015-01-01

    Visual impairment is a key manifestation of multiple sclerosis. Acute optic neuritis is a common, often presenting manifestation, but visual deficits and structural loss of retinal axonal and neuronal integrity can occur even without a history of optic neuritis. Interest in vision in multiple sclerosis is growing, partially in response to the development of sensitive visual function tests, structural markers such as optical coherence tomography and magnetic resonance imaging, and quality of life measures that give clinical meaning to the structure-function correlations that are unique to the afferent visual pathway. Abnormal eye movements also are common in multiple sclerosis, but quantitative assessment methods that can be applied in practice and clinical trials are not readily available. We summarize here a comprehensive literature search and the discussion at a recent international meeting of investigators involved in the development and study of visual outcomes in multiple sclerosis, which had, as its overriding goals, to review the state of the field and identify areas for future research. We review data and principles to help us understand the importance of vision as a model for outcomes assessment in clinical practice and therapeutic trials in multiple sclerosis. PMID:25433914

  5. Nonadherence in dialysis patients: prevalence, measurement, outcome, and psychological determinants.

    Science.gov (United States)

    Clark, Sarah; Farrington, Ken; Chilcot, Joseph

    2014-01-01

    Nonadherence to aspects of the management of End-Stage Kidney Disease (ESKD) is common. Estimates of nonadherence vary with assessment method. Whilst readily available and free from report bias, physiological proxies-frequently used as measures of adherence-are often confounded by clinical factors including residual kidney function and dialysis adequacy. Despite variation in estimates of its prevalence, it is clear that suboptimal adherence to dialysis prescriptions, medication and diet can lead to adverse clinical outcomes. Several factors can help explain nonadherence in ESKD including mood, self-efficacy, social support, illness, and treatment perceptions. Psychological interventions have been shown to improve ESKD adherence, yet achieving long-term behavior change remains challenging. Identifying individuals who struggle to adhere to aspects of the dialysis regime, and tailoring theory-led interventions to improve and support adherence is a clear clinical need requiring further empirical enquiry. © 2013 Wiley Periodicals, Inc.

  6. Muscle MRI and functional outcome measures in Becker muscular dystrophy.

    Science.gov (United States)

    Barp, Andrea; Bello, Luca; Caumo, Luca; Campadello, Paola; Semplicini, Claudio; Lazzarotto, Annalisa; Sorarù, Gianni; Calore, Chiara; Rampado, Alessandro; Motta, Raffaella; Stramare, Roberto; Pegoraro, Elena

    2017-11-22

    Becker muscular dystrophy (BMD) is a neuromuscular disorder allelic to Duchenne muscular dystrophy (DMD), caused by in-frame mutations in the dystrophin gene, and characterized by a clinical progression that is both milder and more heterogeneous than DMD. Muscle magnetic resonance imaging (MRI) has been proposed as biomarker of disease progression in dystrophinopathies. Correlation with clinically meaningful outcome measures such as North Star Ambulatory Assessment (NSAA) and 6 minute walk test (6MWT) is paramount for biomarker qualification. In this study, 51 molecularly confirmed BMD patients (aged 7-69 years) underwent muscle MRI and were evaluated with functional measures (NSAA and 6MWT) at the time of the MRI, and subsequently after one year. We confirmed a pattern of fatty substitution involving mainly the hip extensors and most thigh muscles. Severity of muscle fatty substitution was significantly correlated with specific DMD mutations: in particular, patients with an isolated deletion of exon 48, or deletions bordering exon 51, showed milder involvement. Fat infiltration scores correlated with baseline functional measures, and predicted changes after 1 year. We conclude that in BMD, skeletal muscle MRI not only strongly correlates with motor function, but also helps in predicting functional deterioration within a 12-month time frame.

  7. Objective versus subjective outcome measures of biofeedback: what really matters?

    Science.gov (United States)

    Berry, Amanda; Rudick, Kristen; Richter, Meg; Zderic, Stephen

    2014-08-01

    Clinical epidemiologic studies suggest that once established, voiding dysfunction can become a lifelong condition if not treated correctly early on in life. Biofeedback is one component of a voiding retraining program to help children with voiding dysfunction. Our goal was to compare objective non-invasive urodynamic data obtained during office biofeedback sessions with patient reported voiding symptom scores. Charts of 55 children referred in 2010 for pelvic floor muscle biofeedback therapy for urinary incontinence were retrospectively reviewed. Patients with any anatomic diagnoses were excluded. Forty-seven (86%) females and eight males (14%) with a mean age of 8.2 years made up the cohort. Uroflow curves, voided volumes, and post-void residuals were recorded at each visit and served as objective data. Volumes were normalized as a percentage of expected bladder capacity according to age. The patient reported symptom score and patient reported outcome (improved, no change or worse) served as subjective measures of intervention. The primary referral diagnoses were day and night wetting in 37 (67%) and daytime incontinence in 18 (33%) children. A history of urinary tract infection (UTI) was noted in 32 (64%) patients, and 25% were maintained on antibiotic prophylaxis during the study period. Twenty-nine percent were maintained on anticholinergic medication. Patients attended an average of 2.5 biofeedback sessions. Voided volumes and post void residual volumes were unchanged, 50% of the abnormal uroflow curves normalized over the course of treatment (p biofeedback were rated an improved in 26 (47%), no change in 15 (27%), worse in three (5%) patients, and not rated in 11 patients (21%). Pelvic floor muscle biofeedback is associated with patient-reported improvement in symptoms, reduction in voiding symptom score, and normalization of uroflow curves, but these improvements are not correlated with objective parameters of voided volumes and post-void residual urine

  8. Accounting for baseline differences and measurement error in the analysis of change over time.

    Science.gov (United States)

    Braun, Julia; Held, Leonhard; Ledergerber, Bruno

    2014-01-15

    If change over time is compared in several groups, it is important to take into account baseline values so that the comparison is carried out under the same preconditions. As the observed baseline measurements are distorted by measurement error, it may not be sufficient to include them as covariate. By fitting a longitudinal mixed-effects model to all data including the baseline observations and subsequently calculating the expected change conditional on the underlying baseline value, a solution to this problem has been provided recently so that groups with the same baseline characteristics can be compared. In this article, we present an extended approach where a broader set of models can be used. Specifically, it is possible to include any desired set of interactions between the time variable and the other covariates, and also, time-dependent covariates can be included. Additionally, we extend the method to adjust for baseline measurement error of other time-varying covariates. We apply the methodology to data from the Swiss HIV Cohort Study to address the question if a joint infection with HIV-1 and hepatitis C virus leads to a slower increase of CD4 lymphocyte counts over time after the start of antiretroviral therapy. Copyright © 2013 John Wiley & Sons, Ltd.

  9. Estimating the acute health effects of coarse particulate matter accounting for exposure measurement error.

    Science.gov (United States)

    Chang, Howard H; Peng, Roger D; Dominici, Francesca

    2011-10-01

    In air pollution epidemiology, there is a growing interest in estimating the health effects of coarse particulate matter (PM) with aerodynamic diameter between 2.5 and 10 μm. Coarse PM concentrations can exhibit considerable spatial heterogeneity because the particles travel shorter distances and do not remain suspended in the atmosphere for an extended period of time. In this paper, we develop a modeling approach for estimating the short-term effects of air pollution in time series analysis when the ambient concentrations vary spatially within the study region. Specifically, our approach quantifies the error in the exposure variable by characterizing, on any given day, the disagreement in ambient concentrations measured across monitoring stations. This is accomplished by viewing monitor-level measurements as error-prone repeated measurements of the unobserved population average exposure. Inference is carried out in a Bayesian framework to fully account for uncertainty in the estimation of model parameters. Finally, by using different exposure indicators, we investigate the sensitivity of the association between coarse PM and daily hospital admissions based on a recent national multisite time series analysis. Among Medicare enrollees from 59 US counties between the period 1999 and 2005, we find a consistent positive association between coarse PM and same-day admission for cardiovascular diseases.

  10. The measures for training professional skills of accounting major in secondary vocational school

    Institute of Scientific and Technical Information of China (English)

    DAJENAH MANNAA QAIDABDO

    2017-01-01

    With the development of economy, the importance of accounting is becoming more and more prominent, and the requirements of relevant industries for accountting have been gradually raised. so more and more people learn accounting, but the the effect of practical teaching in college is not ideal. Taking secondary vocational school as an example, although the accounting is one of the major with long history since secondary vocational colleges started to run, but due to various factors, accounting teaching in secondary vocational colleges is not up to the requirement of the society. Moreover, the teaching quality and teaching efficiency are relatively low, so the status of secondary vocational school is also low in the whole education circle. In order to improve the quality of cultivating professional skills for accounting in secondary vocational schools, and promote the development of accounting teaching in secondary vocational schools, this paper analyzes the current professional skills training for accounting in secondary vocational colleges.

  11. International target values 2010 for achievable measurement uncertainties in nuclear material accountancy

    Energy Technology Data Exchange (ETDEWEB)

    Dias, Fabio C., E-mail: fabio@ird.gov.b [Comissao Nacional de Energia Nuclear (CNEN), Rio de Janeiro, RJ (Brazil); Almeida, Silvio G. de; Renha Junior, Geraldo, E-mail: silvio@abacc.org.b, E-mail: grenha@abacc.org.b [Agencia Brasileiro-Argentina de Contabilidade e Controle de Materiais Nucleares (ABACC), Rio de Janeiro, RJ (Brazil)

    2011-07-01

    The International Target Values (ITVs) are reasonable uncertainty estimates that can be used in judging the reliability of measurement techniques applied to industrial nuclear and fissile materials subject to accountancy and/or safeguards verification. In the absence of relevant experimental estimates, ITVs can also be used to select measurement techniques and calculate sample population during the planning phase of verification activities. It is important to note that ITVs represent estimates of the 'state-of-the-practice', which should be achievable under routine measurement conditions affecting both facility operators and safeguards inspectors, not only in the field, but also in laboratory. Tabulated values cover measurement methods used for the determination of volume or mass of the nuclear material, for its elemental and isotopic assays, and for its sampling. The 2010 edition represents the sixth revision of the International Target Values (ITVs), issued by the International Atomic Energy Agency (IAEA) as a Safeguards Technical Report (STR-368). The first version was released as 'Target Values' in 1979 by the Working Group on Techniques and Standards for Destructive Analysis (WGDA) of the European Safeguards Research and Development Association (ESARDA) and focused on destructive analytical methods. In the latest 2010 revision, international standards in estimating and expressing uncertainties have been considered while maintaining a format that allows comparison with the previous editions of the ITVs. Those standards have been usually applied in QC/QA programmes, as well as qualification of methods, techniques and instruments. Representatives of the Brazilian Nuclear Energy Commission (CNEN) and the Brazilian-Argentine Agency for Accounting and Control of Nuclear Materials (ABACC) participated in previous Consultants Group Meetings since the one convened to establish the first list of ITVs released in 1993 and in subsequent revisions

  12. Validation of the Focus on the Outcomes of Communication under Six outcome measure

    Science.gov (United States)

    Thomas-Stonell, Nancy; Oddson, Bruce; Robertson, Bernadette; Rosenbaum, Peter

    2013-01-01

    Aim The aim of this study was to establish the construct validity of the Focus on the Outcomes of Communication Under Six (FOCUS©),a tool designed to measure changes in communication skills in preschool children. Method Participating families' children (n=97; 68 males, 29 females; mean age 2y 8mo; SD 1.04y, range 10mo–4y 11mo) were recruited through eight Canadian organizations. The children were on a waiting list for speech and language intervention. Parents completed the Ages and Stages Questionnaire – Social/Emotional (ASQ-SE) and the FOCUS three times: at assessment and at the start and end of treatment. A second sample (n=28; 16 males 12 females) was recruited from another organization to correlate the FOCUS scores with speech, intelligibility and language measures. Second sample participants ranged in age from 3 years 1 month to 4 years 9 months (mean 3y 11mo; SD 0.41y). At the start and end of treatment, children were videotaped to obtain speech and language samples. Parents and speech–language pathologists (SLPs) independently completed the FOCUS tool. SLPs who were blind to the pre/post order of the videotapes analysed the samples. Results The FOCUS measured significantly more change (p<0.01) during treatment than during the waiting list period. It demonstrated both convergent and discriminant validity against the ASQ-SE. The FOCUS change corresponded to change measured by a combination of clinical speech and language measures (κ=0.31, p<0.05). Conclusion The FOCUS shows strong construct validity as a change-detecting instrument. PMID:23461266

  13. 77 FR 37330 - Reef Fish Fishery of the Gulf of Mexico; 2012 Commercial Accountability Measure and Closure for...

    Science.gov (United States)

    2012-06-21

    ... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration 50 CFR Part 622 [Docket No. 120417412-2412-01] RIN 0648-XCO76 Reef Fish Fishery of the Gulf of Mexico; 2012 Commercial Accountability...: NMFS implements accountability measures (AMs) for the commercial sector of gray triggerfish in the Gulf...

  14. Selection effects may account for better outcomes of the German Disease Management Program for type 2 diabetes.

    Science.gov (United States)

    Schäfer, Ingmar; Küver, Claudia; Gedrose, Benjamin; von Leitner, Eike-Christin; Treszl, András; Wegscheider, Karl; van den Bussche, Hendrik; Kaduszkiewicz, Hanna

    2010-12-31

    The nationwide German disease management program (DMP) for type 2 diabetes was introduced in 2003. Meanwhile, results from evaluation studies were published, but possible baseline differences between DMP and usual-care patients have not been examined. The objective of our study was therefore to find out if patient characteristics as socio-demographic variables, cardiovascular risk profile or motivation for life style changes influence the chance of being enrolled in the German DMP for type 2 diabetes and may therefore account for outcome differences between DMP and usual-care patients. Case control study comparing DMP patients with usual-care patients at baseline and follow up; mean follow-up period of 36 ± 14 months. We used chart review data from 51 GP surgeries. Participants were 586 DMP and 250 usual-care patients with type 2 diabetes randomly selected by chart registry. Data were analysed by multivariate logistic and linear regression analyses. Significance levels were p ≤ 0.05. There was a better chance for enrolment if patients a) had a lower risk status for diabetes complications, i.e. non-smoking (odds ratio of 1.97, 95% confidence interval of 1.11 to 3.48) and lower systolic blood pressure (1.79 for 120 mmHg vs. 160 mmHg, 1.15 to 2.81); b) had higher activity rates, i.e. were practicing blood glucose self-monitoring (1.67, 1.03 to 2.76) and had been prescribed a diabetes patient education before enrolment (2.32, 1.29 to 4.19) c) were treated with oral medication (2.17, 1.35 to 3.49) and d) had a higher GP-rated motivation for diabetes education (4.55 for high motivation vs. low motivation, 2.21 to 9.36). At baseline, future DMP patients had a lower risk for diabetes complications, were treated more intensively and were more active and motivated in managing their disease than usual-care patients. This finding a) points to the problem that the German DMP may not reach the higher risk patients and b) selection bias may impair the assessment of differences

  15. Ecologically relevant outcome measure for post-inpatient rehabilitation.

    Science.gov (United States)

    Marquez de la Plata, Carlos; Qualls, Devin; Plenger, Patrick; Malec, James F; Hayden, Mary Ellen

    2017-01-01

    Transfer of skills learned within the clinic environment to patients' home or community is important in post-inpatient brain injury rehabilitation (PBIR). Outcome measures used in PBIR assess level of independence during functional tasks; however, available functional instruments do not quantitate the environment in which the behaviors occur. To examine the reliability and validity of an instrument used to assess patients' functional abilities while quantifying the amount of structure and distractions in the environment. 2501 patients who sustained a traumatic brain injury (TBI) or cerebrovascular accident (CVA) and participated in a multidisciplinary PBIR program between 2006 and 2014 were identified retrospectively for this study. The PERPOS and MPAI-4 were used to assess functional abilities at admission and at discharge. Construct validity was assessed using a bivariate Spearman rho analysis A subsample of 56 consecutive admissions during 2014 were examined to determine inter-rater reliability. Intra-class correlation coefficient (ICC) and Kappa coefficients assessed inter-rater agreement of the total PERPOS and PERPOS subscales respectively. The PERPOS and MPAI-4 demonstrated a strong negative association among both TBI and CVA patients. Kappa scores for the three PERPOS scales each demonstrated good to excellent inter-rater agreement. The ICC for overall PERPOS scores fell in the good agreement range. The PERPOS can be used reliably in PBIR to quantify patients' functional abilities within the context of environmental demands.

  16. Development of the FOCUS (Focus on the Outcomes of Communication under Six), a Communication Outcome Measure for Preschool Children

    Science.gov (United States)

    Thomas-Stonell, Nancy L.; Oddson, Bruce; Robertson, Bernadette; Rosenbaum, Peter L.

    2010-01-01

    Aim: Our aim was to develop an outcome measure, called Focus on the Outcomes of Communication Under Six (FOCUS), that captures real-world changes in preschool children's communication. Conceptually grounded in the World Health Organization International Classification of Functioning, Disability and Health framework, the FOCUS items were derived…

  17. Accounting for multimorbidity in pay for performance: a modelling study using UK Quality and Outcomes Framework data.

    Science.gov (United States)

    Ruscitto, Andrea; Mercer, Stewart W; Morales, Daniel; Guthrie, Bruce

    2016-08-01

    The UK Quality and Outcomes Framework (QOF) offers financial incentives to deliver high-quality care for individual diseases, but the single-disease focus takes no account of multimorbidity. To examine variation in QOF payments for two indicators incentivised in ≥1 disease domain. Modelling study using cross-sectional data from 314 general practices in Scotland. Maximum payments that practices could receive under existing financial incentives were calculated for blood pressure (BP) control and influenza immunisation according to the number of coexisting clinical conditions. Payments were recalculated assuming a single new indicator. Payment varied by condition (£4.71-£11.08 for one BP control and £2.09-£5.78 for one influenza immunisation). Practices earned more for delivering the same action in patients with multimorbidity: in patients with 2, 3, and ≥4 conditions mean payments were £13.95, £21.92, and £29.72 for BP control, and £7.48, £11.21, and £15.14 for influenza immunisation, respectively. Practices in deprived areas had more multiple incentivised patients. When recalculated so that each incentivised action was only paid for once, all practices received less for BP control: affluent practices received more and deprived practices received less for influenza immunisation. For patients with single conditions, existing QOF payment methods have more than twofold variation in payment for delivering the same process. Multiple payments were common in patients with multimorbidity. A payment method is required that ensures fairness of rewards while maintaining adequate funding for practices based on actual workload. © British Journal of General Practice 2016.

  18. Material control in nuclear fuel fabrication facilities. Part II. Accountability, instrumentation and measurement techniques in fuel fabrication facilities

    International Nuclear Information System (INIS)

    Borgonovi, G.M.; McCartin, T.J.; McDaniel, T.; Miller, C.L.; Nguyen, T.

    1978-01-01

    This report describes the measurement techniques, the instrumentation, and the procedures used in accountability and control of nuclear materials, as they apply to fuel fabrication facilities. A general discussion is given of instrumentation and measurement techniques which are presently used being considered for fuel fabrication facilities. Those aspects which are most significant from the point of view of satisfying regulatory constraints have been emphasized. Sensors and measurement devices have been discussed, together with their interfacing into a computerized system designed to permit real-time data collection and analysis. Estimates of accuracy and precision of measurement techniques have been given, and, where applicable, estimates of associated costs have been presented. A general description of material control and accounting is also included. In this section, the general principles of nuclear material accounting have been reviewed first (closure of material balance). After a discussion of the most current techniques used to calculate the limit of error on inventory difference, a number of advanced statistical techniques are reviewed. The rest of the section deals with some regulatory aspects of data collection and analysis, for accountability purposes, and with the overall effectiveness of accountability in detecting diversion attempts in fuel fabrication facilities. A specific example of application of the accountability methods to a model fuel fabrication facility is given. The effect of random and systematic errors on the total material uncertainty has been discussed, together with the effect on uncertainty of the length of the accounting period

  19. Material control in nuclear fuel fabrication facilities. Part II. Accountability, instrumentation and measurement techniques in fuel fabrication facilities

    Energy Technology Data Exchange (ETDEWEB)

    Borgonovi, G.M.; McCartin, T.J.; McDaniel, T.; Miller, C.L.; Nguyen, T.

    1978-01-01

    This report describes the measurement techniques, the instrumentation, and the procedures used in accountability and control of nuclear materials, as they apply to fuel fabrication facilities. A general discussion is given of instrumentation and measurement techniques which are presently used being considered for fuel fabrication facilities. Those aspects which are most significant from the point of view of satisfying regulatory constraints have been emphasized. Sensors and measurement devices have been discussed, together with their interfacing into a computerized system designed to permit real-time data collection and analysis. Estimates of accuracy and precision of measurement techniques have been given, and, where applicable, estimates of associated costs have been presented. A general description of material control and accounting is also included. In this section, the general principles of nuclear material accounting have been reviewed first (closure of material balance). After a discussion of the most current techniques used to calculate the limit of error on inventory difference, a number of advanced statistical techniques are reviewed. The rest of the section deals with some regulatory aspects of data collection and analysis, for accountability purposes, and with the overall effectiveness of accountability in detecting diversion attempts in fuel fabrication facilities. A specific example of application of the accountability methods to a model fuel fabrication facility is given. The effect of random and systematic errors on the total material uncertainty has been discussed, together with the effect on uncertainty of the length of the accounting period.

  20. Integration of technology-based outcome measures in clinical trials of Parkinson and other neurodegenerative diseases.

    Science.gov (United States)

    Artusi, Carlo Alberto; Mishra, Murli; Latimer, Patricia; Vizcarra, Joaquin A; Lopiano, Leonardo; Maetzler, Walter; Merola, Aristide; Espay, Alberto J

    2018-01-01

    We sought to review the landscape of past, present, and future use of technology-based outcome measures (TOMs) in clinical trials of neurodegenerative disorders. We systematically reviewed PubMed and ClinicalTrials.gov for published and ongoing clinical trials in neurodegenerative disorders employing TOMs. In addition, medical directors of selected pharmaceutical companies were surveyed on their companies' ongoing efforts and future plans to integrate TOMs in clinical trials as primary, secondary, or exploratory endpoints. We identified 164 published clinical trials indexed in PubMed that used TOMs as outcome measures in Parkinson disease (n = 132) or other neurodegenerative disorders (n = 32). The ClinicalTrials.gov search yielded 42 clinical trials using TOMs, representing 2.7% of ongoing trials. Sensor-based technology accounted for over 75% of TOMs applied. Gait and physical activity were the most common targeted domains. Within the next 5 years, 83% of surveyed pharmaceutical companies engaged in neurodegenerative disorders plan to deploy TOMs in clinical trials. Although promising, TOMs are underutilized in clinical trials of neurodegenerative disorders. Validating relevant endpoints, standardizing measures and procedures, establishing a single platform for integration of data and algorithms from different devices, and facilitating regulatory approvals should advance TOMs integration into clinical trials. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. What You Measure Is What You Get. The Effects of Accounting Standards Effects Studies

    NARCIS (Netherlands)

    Koenigsgruber, R.; Gross, C.

    2012-01-01

    The UK's Accounting Standards Board and the European Financial Reporting Advisory Group have published a discussion paper entitled 'Considering the Effects of Accounting Standards'. While the effort to think through potential consequences of proposed regulatory acts in advance is welcome, we argue

  2. 78 FR 48075 - Western Pacific Fisheries; 2013 Annual Catch Limits and Accountability Measures; Correcting...

    Science.gov (United States)

    2013-08-07

    ... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration 50 CFR Part 665 [Docket No. 121107617-3628-03] RIN 0648-XC351 Western Pacific Fisheries; 2013 Annual Catch Limits and Accountability...-Deep 7 bottomfish fishery is not subject to in-season closure or other in- season accountability...

  3. Measuring Networking as an Outcome Variable in Undergraduate Research Experiences.

    Science.gov (United States)

    Hanauer, David I; Hatfull, Graham

    2015-01-01

    The aim of this paper is to propose, present, and validate a simple survey instrument to measure student conversational networking. The tool consists of five items that cover personal and professional social networks, and its basic principle is the self-reporting of degrees of conversation, with a range of specific discussion partners. The networking instrument was validated in three studies. The basic psychometric characteristics of the scales were established by conducting a factor analysis and evaluating internal consistency using Cronbach's alpha. The second study used a known-groups comparison and involved comparing outcomes for networking scales between two different undergraduate laboratory courses (one involving a specific effort to enhance networking). The final study looked at potential relationships between specific networking items and the established psychosocial variable of project ownership through a series of binary logistic regressions. Overall, the data from the three studies indicate that the networking scales have high internal consistency (α = 0.88), consist of a unitary dimension, can significantly differentiate between research experiences with low and high networking designs, and are related to project ownership scales. The ramifications of the networking instrument for student retention, the enhancement of public scientific literacy, and the differentiation of laboratory courses are discussed. © 2015 D. I. Hanauer and G. Hatfull. CBE—Life Sciences Education © 2015 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  4. Towards global consensus on outcome measures for atopic eczema research: results of the HOME II meeting

    NARCIS (Netherlands)

    Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F.; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

    2012-01-01

    The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes

  5. Towards global consensus on outcome measures for atopic eczema research : Results of the HOME II meeting

    NARCIS (Netherlands)

    Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

    The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes

  6. Using Cross-Cultural Dimensions Exercises to Improve and Measure Learning Outcomes in International Business Courses

    Science.gov (United States)

    Zainuba, Mohamed; Rahal, Ahmad

    2012-01-01

    This article proposes an approach for using cross-cultural dimensions exercises to improve and measure learning outcomes in international business courses. The following key issues are highlighted: (a) what are the targeted learning outcomes to be assessed, (b) how to measure the accomplishment of these learning outcomes, (c) the input measures…

  7. Ultrasound as an Outcome Measure in Gout. A Validation Process by the OMERACT Ultrasound Working Group

    DEFF Research Database (Denmark)

    Terslev, Lene; Gutierrez, Marwin; Schmidt, Wolfgang A

    2015-01-01

    OBJECTIVE: To summarize the work performed by the Outcome Measures in Rheumatology (OMERACT) Ultrasound (US) Working Group on the validation of US as a potential outcome measure in gout. METHODS: Based on the lack of definitions, highlighted in a recent literature review on US as an outcome tool...

  8. Effects of a social accountability approach, CARE's Community Score Card, on reproductive health-related outcomes in Malawi: A cluster-randomized controlled evaluation.

    Science.gov (United States)

    Gullo, Sara; Galavotti, Christine; Sebert Kuhlmann, Anne; Msiska, Thumbiko; Hastings, Phil; Marti, C Nathan

    2017-01-01

    Social accountability approaches, which emphasize mutual responsibility and accountability by community members, health care workers, and local health officials for improving health outcomes in the community, are increasingly being employed in low-resource settings. We evaluated the effects of a social accountability approach, CARE's Community Score Card (CSC), on reproductive health outcomes in Ntcheu district, Malawi using a cluster-randomized control design. We matched 10 pairs of communities, randomly assigning one from each pair to intervention and control arms. We conducted two independent cross-sectional surveys of women who had given birth in the last 12 months, at baseline and at two years post-baseline. Using difference-in-difference (DiD) and local average treatment effect (LATE) estimates, we evaluated the effects on outcomes including modern contraceptive use, antenatal and postnatal care service utilization, and service satisfaction. We also evaluated changes in indicators developed by community members and service providers in the intervention areas. DiD analyses showed significantly greater improvements in the proportion of women receiving a home visit during pregnancy (B = 0.20, P reproductive health-related outcomes. Further, the CSC builds mutual accountability, and ensures that solutions to problems are locally-relevant, locally-supported and feasible to implement.

  9. Quality of life measurement and outcome in aphasia

    Directory of Open Access Journals (Sweden)

    Spaccavento S

    2013-12-01

    : The QLQA is a valid measure of QL in PWA, contributing to a better distinction between severe and mild aphasia, and it is sensitive also to the variations in QL depending on the time interval from stroke. Keywords: aphasia, quality of life, outcome, rehabilitation

  10. Measuring the attractiveness of rural communities in accounting for differences of rural primary care workforce supply.

    Science.gov (United States)

    McGrail, Matthew R; Wingrove, Peter M; Petterson, Stephen M; Humphreys, John S; Russell, Deborah J; Bazemore, Andrew W

    2017-01-01

    Many rural communities continue to experience an undersupply of primary care doctor services. While key professional factors relating to difficulties of recruitment and retention of rural primary care doctors are widely identified, less attention has been given to the role of community and place aspects on supply. Place-related attributes contribute to a community's overall amenity or attractiveness, which arguably influence both rural recruitment and retention relocation decisions of doctors. This bi-national study of Australia and the USA, two developed nations with similar geographic and rural access profiles, investigates the extent to which variations in community amenity indicators are associated with spatial variations in the supply of rural primary care doctors. Measures from two dimensions of community amenity: geographic location, specifically isolation/proximity; and economics and sociodemographics were included in this study, along with a proxy measure (jurisdiction) of a third dimension, environmental amenity. Data were chiefly collated from the American Community Survey and the Australian Census of Population and Housing, with additional calculated proximity measures. Rural primary care supply was measured using provider-to-population ratios in 1949 US rural counties and in 370 Australian rural local government areas. Additionally, the more sophisticated two-step floating catchment area method was used to measure Australian rural primary care supply in 1116 rural towns, with population sizes ranging from 500 to 50 000. Associations between supply and community amenity indicators were examined using Pearson's correlation coefficients and ordinary least squares multiple linear regression models. It was found that increased population size, having a hospital in the county, increased house prices and affluence, and a more educated and older population were all significantly associated with increased workforce supply across rural areas of both countries

  11. Evaluating complementary and alternative medicine interventions: in search of appropriate patient-centered outcome measures

    Directory of Open Access Journals (Sweden)

    Mallory Devon

    2006-11-01

    Full Text Available Abstract Background Central to the development of a sound evidence base for Complementary and Alternative Medicine (CAM interventions is the need for valid, reliable and relevant outcome measures to assess whether the interventions work. We assessed the specific needs for a database that would cover a wide range of outcomes measures for CAM research and considered a framework for such a database. Methods The study was a survey of CAM researchers, practitioners and students. An online questionnaire was emailed to the members of the Canadian Interdisciplinary Network for CAM Research (IN-CAM and the CAM Education and Research Network of Alberta (CAMera. The majority of survey questions were open-ended and asked about outcome measures currently used, outcome measures' assessment criteria, sources of information, perceived barriers to finding outcome measures and outcome domains of importance. Descriptive quantitative analysis and qualitative content analysis were used. Results One hundred and sixty-four completed surveys were received. Of these, 62 respondents reported using outcome measures in their CAM research and identified 92 different specific outcomes. The most important barriers were the fact that, for many health concepts, outcome measures do not yet exist, as well as issues related to accessibility of instruments. Important outcome domains identified included physical, psychological, social, spiritual, quality of life and holistic measures. Participants also mentioned the importance of individualized measures that assess unique patient-centered outcomes for each research participant, and measures to assess the context of healing and the process of healing. Conclusion We have developed a preliminary framework that includes all components of health-related outcomes. The framework provides a foundation for a larger, comprehensive collection of CAM outcomes. It fits very well in a whole systems perspective, which requires an expanded set of

  12. Are current psychometric tools suitable for measuring outcomes of diabetes education?

    DEFF Research Database (Denmark)

    Eigenmann, C. A.; Colagiuri, R.; Skinner, T. C.

    2009-01-01

    Aims To critically appraise the suitability, validity, reliability, feasibility and sensitivity to change of available psychometric tools for measuring the education outcomes identified in the (Australian) National Consensus on Outcomes and Indicators for Diabetes Patient Education. Methods Poten...

  13. The impact of stroke unit care on outcome in a Scottish stroke population, taking into account case mix and selection bias.

    Science.gov (United States)

    Turner, Melanie; Barber, Mark; Dodds, Hazel; Dennis, Martin; Langhorne, Peter; Macleod, Mary Joan

    2015-03-01

    Randomised trials indicate that stroke unit care reduces morbidity and mortality after stroke. Similar results have been seen in observational studies but many have not corrected for selection bias or independent predictors of outcome. We evaluated the effect of stroke unit compared with general ward care on outcomes after stroke in Scotland, adjusting for case mix by incorporating the six simple variables (SSV) model, also taking into account selection bias and stroke subtype. We used routine data from National Scottish datasets for acute stroke patients admitted between 2005 and 2011. Patients who died within 3 days of admission were excluded from analysis. The main outcome measures were survival and discharge home. Multivariable logistic regression was used to estimate the OR for survival, and adjustment was made for the effect of the SSV model and for early mortality. Cox proportional hazards model was used to estimate the hazard of death within 365 days. There were 41 692 index stroke events; 79% were admitted to a stroke unit at some point during their hospital stay and 21% were cared for in a general ward. Using the SSV model, we obtained a receiver operated curve of 0.82 (SE 0.002) for mortality at 6 months. The adjusted OR for survival at 7 days was 3.11 (95% CI 2.71 to 3.56) and at 1 year 1.43 (95% CI 1.34 to 1.54) while the adjusted OR for being discharged home was 1.19 (95% CI 1.11 to 1.28) for stroke unit care. In routine practice, stroke unit admission is associated with a greater likelihood of discharge home and with lower mortality up to 1 year, after correcting for known independent predictors of outcome, and excluding early non-modifiable mortality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. KMS fusion system resource accounting and performance measurement system for RSX11M V3.2

    International Nuclear Information System (INIS)

    Downward, J.G.

    1980-01-01

    Version 3.2 of the KMS FUSION accounting system is aimed at providing the user of RSX11M V3.2 with a versatile tool for measuring the performance of the operating system, tuning the system, and providing sufficient usage statistics so that the system manager can implement chargeback accounting if it is required by the installation. Sufficient hooks are provided so that the intrepid user can expand the system substantially beyond what is currently provided

  15. Measure for measure. Outcome assessment of arthritis treatment in clinical practice

    OpenAIRE

    Gülfe, Anders

    2009-01-01

    Objective: To investigate (i) the performance and agreement between various activity indices and response criteria in TNF-blockade of RA; (ii) the predictive ability of different response criteria and disease activity states regarding continuation of anti-TNF treatment of RA; (iii) Euro-QoL-5-dimensions utility development during TNF blockade of RA, PsA and SpA. Also, (iv) to develop a simple, utility-based outcome measure, the number needed to treat per quality adjusted life year gained (NN...

  16. Accounting for Posttraumatic Stress Disorder Symptom Severity With Pre- and Posttrauma Measures: A Longitudinal Study of Older Adults.

    Science.gov (United States)

    Ogle, Christin M; Rubin, David C; Siegler, Ilene C

    2016-03-01

    Using data from a longitudinal study of community-dwelling older adults, we analyzed the most extensive set of known correlates of PTSD symptoms obtained from a single sample to examine the measures' independent and combined utility in accounting for PTSD symptom severity. Fifteen measures identified as PTSD risk factors in published meta-analyses and 12 theoretically and empirically supported individual difference and health-related measures were included. Individual difference measures assessed after the trauma, including insecure attachment and factors related to the current trauma memory, such as self-rated severity, event centrality, frequency of involuntary recall, and physical reactions to the memory, accounted for symptom severity better than measures of pre-trauma factors. In an analysis restricted to prospective measures assessed before the trauma, the total variance explained decreased from 56% to 16%. Results support a model of PTSD in which characteristics of the current trauma memory promote the development and maintenance of PTSD symptoms.

  17. Measuring Performance for Accountability of a Small Social Economy Organization: The Case of an Independent School

    Directory of Open Access Journals (Sweden)

    Steven M. Smith

    2011-01-01

    Full Text Available This article is a result of a joint project in social economy research between a community partner-an independent school-and academic partners. The school is a democratic organization, run by teachers and parents. The goal of the project was to find ways to improve communication and reporting about general performance of the school as part of the school's accountability to its members. Starting from lessons of the balanced scorecard approach for non-profits, we describe the process of development of survey-based measures for the particular organization. The direction of the tool development and subsequent organizational changes were carried out in a participatory process between the school's staff, the parents, and the board. We identify the limitations and challenges of this process, and outline its successes to draw lessons for other similar democratic organizations. / Cet article est le produit d'un projet conjoint de recherche sur l'économie sociale entre un partenaire communautaire-une école privée-et des partenaires académiques. L'école est une organisation démocratique dirigée par des enseignants et des parents. Le but de ce projet était de trouver des façons d'améliorer la communication et la reddition de compte en ce qui a trait au rendement général de l'école comme faisant partie de la responsabilité de l'école envers ses membres. En commençant par des leçons sur l'approche de tableau de bord équilibré pour les organismes sans but lucratif, nous abordons le processus de l'élaboration de mesures fondées sur des enquêtes pour l'organisation particulière. L'orientation du développement d'outils et des changements organisationnels subséquents ont été déterminés lors d'un processus participatif entre le personnel de l'école, les parents et la direction. Nous établissons les limites et les défis de cette façon de procéder et en soulignons les réussites pour tirer des leçons qui serviront à d

  18. Fair value or cost-based measurement for PPE and IP: evidence from accounting practice under IFRS

    OpenAIRE

    Fonseca, Maria

    2007-01-01

    Some standards permit a choice between different measurement bases. IAS 16 and IAS 40 allow entities to choose between fair value and cost-based measurement for property, plant and equipment (PPE) and investment property (IP), respectively. This study analyzes the accounting practice concerning measurement of PPE and IP after recognition, under IFRS. The sample was extracted from stock exchange listed European companies included in the S&P Europe 350 Index. Data was hand collec...

  19. Patient-Oriented Eczema Measure (POEM), a core instrument to measure symptoms in clinical trials: a Harmonising Outcome Measures for Eczema (HOME) statement

    NARCIS (Netherlands)

    Spuls, P. I.; Gerbens, L. A. A.; Simpson, E.; Apfelbacher, C. J.; Chalmers, J. R.; Thomas, K. S.; Prinsen, C. A. C.; von Kobyletzki, L. B.; Singh, J. A.; Williams, H. C.; Schmitt, J.

    2017-01-01

    The Harmonising Outcome Measures for Eczema (HOME) initiative has defined four core outcome domains for a core outcome set (COS) to be measured in all atopic eczema (AE) trials to ensure cross-trial comparison: clinical signs, symptoms, quality of life and long-term control. The aim of this paper is

  20. Quality of life as an outcome measure in surgical oncology

    NARCIS (Netherlands)

    Langenhoff, B S; Krabbe, P F; Wobbes, T; Ruers, T J

    BACKGROUND: There is a growing interest in assessing the impact of a disease and the effect of a treatment on a patient's life, expressed as health-related quality of life (HRQoL). HRQoL assessment can provide essential outcome information for cancer surgery. METHODS: The core of this review is

  1. Outcomes assessment in cancer: measures, methods, and applications

    National Research Council Canada - National Science Library

    Lipscomb, Joseph; Snyder, Claire; Gotay, Carolyn C

    2005-01-01

    ... on individuals and populations. The findings and recommendations of the working group's 35 internationally recognized members are reported in Outcomes Assessment in Cancer, lucidly written and accessible to both researchers and policy makers in academia, government, and industry. This volume provides the most penetrating yet practical discussion to date of alte...

  2. The Aphasia Communication Outcome Measure (ACOM): Dimensionality, Item Bank Calibration, and Initial Validation

    Science.gov (United States)

    Hula, William D.; Doyle, Patrick J.; Stone, Clement A.; Hula, Shannon N. Austermann; Kellough, Stacey; Wambaugh, Julie L.; Ross, Katherine B.; Schumacher, James G.; St. Jacque, Ann

    2015-01-01

    Purpose: The purpose of this study is to investigate the structure and measurement properties of the Aphasia Communication Outcome Measure (ACOM), a patient-reported outcome measure of communicative functioning for persons with aphasia. Method: Three hundred twenty-nine participants with aphasia responded to 177 items asking about communicative…

  3. Developing a General Outcome Measure Off Growth in Social Skills for Infants and Toddlers

    Science.gov (United States)

    Carta, Judith; Greenwood, Charles; Luze, Gayle; Cline, Gabriel; Kuntz, Susan

    2004-01-01

    Proficiency in social interaction with adults and peers is an important outcome in early childhood. The development of an experimental measure for assessing growth in social skills in children birth to 3 years is described. Based on the general outcome measurement (GOM) approach (e.g., Deno, 1997), the measure is intended for use by early…

  4. Developing a General Outcome Measure of Growth in Social Skills for Infants and Toddlers

    Science.gov (United States)

    Carta, Judith; Greenwood, Charles; Luze, Gayle; Cline, Gabriel; Kuntz, Susan

    2004-01-01

    Proficiency in social interaction with adults and peers is an important outcome in early childhood. The development of an experimental measure for assessing growth in social skills in children birth to 3 years is described. Based on the general outcome measurement (GOM) approach (e.g., Deno, 1997), the measure is intended for use by early…

  5. Parents' Experiences as Predictors of State Accountability Measures of Schools' Facilitation of Parent Involvement

    Science.gov (United States)

    Elbaum, Batya; Blatz, Erin T.; Rodriguez, Raymond J.

    2016-01-01

    The aim of this study was to ascertain which dimensions of parents' experiences with schools are most strongly associated with parents' perceptions that schools are or are not facilitating parent involvement as mandated by the federal accountability system under the Individuals With Disabilities Education Act (IDEA). Participants were 92 parents…

  6. Isotope dilution mass spectrometry for nuclear material accountability measurements: dreams and reality

    International Nuclear Information System (INIS)

    Deron, S.; )

    1996-01-01

    Gravimetry, titration, coulometry and isotope dilution mass spectrometry are alternative techniques which can be used to obtain elemental assays of the desirable accuracy. The communication briefly describes the characteristics of the procedure and summarizes a wealth of experience accumulated during actual accountability verification activities

  7. Study Concerning the Measure of Using Accounting, Economical and Administrative Evaluation in Practice

    Directory of Open Access Journals (Sweden)

    Dreghiciu Andreea Elena

    2017-01-01

    Starting from the purpose for which the evaluation is requested, this can be accountingevaluation, administrative evaluation and respectively economical – financial evaluation. Thepurpose of accounting evaluation is to elaborate financial reports, and administrative, economicaland financial evaluations have the purpose of determining the market value for different reasons.

  8. Issues in the definition and measurement of drinking outcomes in alcoholism treatment research.

    Science.gov (United States)

    Babor, T F; Longabaugh, R; Zweben, A; Fuller, R K; Stout, R L; Anton, R F; Randall, C L

    1994-12-01

    This article reviews methodological and conceptual issues regarding the choice of drinking outcome measures in alcoholism treatment research. The following issues are discussed: Should drinking outcomes be conceptualized in terms of an underlying unitary disorder, or should provision be made for independent outcomes that cover a wide variety of dimensions? Which drinking outcomes are typically measured in treatment evaluation studies and how are they operationalized? What are the empirical associations among drinking outcome measures? If multiple outcomes are measured, which should be given primary importance? Over what period of time should treatment outcome be evaluated? What procedures can be used to detect, correct or prevent the response bias associated with verbal report methods? Because outcome measures need to fit the hypotheses and practical needs of a particular study, it is unlikely that complete standardization can be achieved across all studies. Nevertheless, given the importance of drinking outcomes and the need for economy, two primary dependent measures are recommended: (1) proportion of available drinking days abstinent; and (2) intensity of drinking, as defined by the total amount consumed (in ounces absolute alcohol) during the follow-up period divided by the number of actual drinking days. This article also proposes a strategy that may help to guide the selection of outcome measures in future research.

  9. THE RELATIONSHIP BETWEEN THE USE OF A PERFORMANCE MEASUREMENT SYSTEM, ORGANIZATIONAL FACTORS, ACCOUNTABILITY, AND THE PERFORMANCE OF PUBLIC SECTOR ORGANIZATIONS

    Directory of Open Access Journals (Sweden)

    Muhammad Ahyaruddin

    2016-01-01

    Full Text Available This research studies the accountability and performance of public sector organizations. It provides empirical evidence about the relationship between the use of a performance measurement system and the organizational factors of accountability and organizational performance. We investigate the three roles of a performance measurement system (its operational use, incentive use, and exploratory use, and three organizational factors (contractibility, the legislative mandate, and management commitment. A mixed method approach with sequential explanatory design was used to answer the research question. The hypotheses testing used Structural Equation Modelling-Partial Least Square (SEM-PLS. Our findings were based on survey data from 137 SKPD officers in the local government of Yogyakarta Province, and showed that management commitment had a positive association with accountability and organizational performance. We also found a positive association between the legislative mandate and accountability. However, this research did not find any significant association among the three roles of the performance measurement system with accountability and organizational performance. Based on the institutional theory, our findings show substantial contributions by the institutional isomorphism, which was used in an appropriate manner to explain the context of public sector organizations, especially in the local government of Yogyakarta Province.

  10. Outcome Measures in Myasthenia Gravis: Incorporation Into Clinical Practice.

    Science.gov (United States)

    Muppidi, Srikanth

    2017-03-01

    The development of validated assessment tools for evaluating disease status and response to interventions in patients with myasthenia gravis (MG) has been driven by clinical studies of emerging MG therapies. However, only a small proportion of MG-focused neurology practices have adopted these assessment tools for routine clinical use. This article reviews the suitability of 5 assessment instruments for incorporation into clinical practice, which should be driven by their ability to contribute to improved patient outcomes, and to be implemented within practice personnel and resource constraints. It is recommended that assessments based on both physician-evaluated and patient-reported outcomes be selected, to adequately evaluate both point-in-time symptom load and functional impact of MG symptoms over time. Provider resource allocation and reimbursement issues may be the most significant roadblocks to successful ongoing use of these tools; to that end, the addition of regular assessments to MG standards of care is recommended.

  11. Transportation performance measures for outcome based system management and monitoring.

    Science.gov (United States)

    2014-09-01

    The Oregon Department of Transportation (ODOT) is mature in its development and use of : performance measures, however there was not a standard approach for selecting measures nor : evaluating if existing ones were used to inform decision-making. Thi...

  12. Measuring management success for protected species: Looking beyond biological outcomes

    Directory of Open Access Journals (Sweden)

    Kathryn D Bisack

    2016-05-01

    Full Text Available The complexity of the ocean ecosystem, including the human component, is such that a single fishery may require multiple policy instruments to support recovery and conservation of protected species, in addition to those for fisheries management. As regulations multiply, the need for retrospective analysis and evaluation grows in order to inform future policy. To accurately evaluate policy instruments, clear objectives and their link to outcomes are necessary, as well as identifying criteria to evaluate outcomes. The Northeast United States sink gillnet groundfish fishery provides a case study of the complexity of regulations and policy instruments implemented under the Marine Mammal Protection Act and the Endangered Species Act to address bycatch of marine mammals. The case study illustrates a range of possible objectives for the policy instruments including biological, economic, social-normative and longevity factors. We highlight links between possible objectives, outcomes and criteria for the four factors, as well as areas for consideration when undertaking ex-post analyses. To support learning from past actions, we call for a coordinated effort involving multiple disciplines and jurisdictions to undertake retrospective analyses and evaluations of key groups of policy instruments used for protected species.

  13. A probabilistic Poisson-based model accounts for an extensive set of absolute auditory threshold measurements.

    Science.gov (United States)

    Heil, Peter; Matysiak, Artur; Neubauer, Heinrich

    2017-09-01

    Thresholds for detecting sounds in quiet decrease with increasing sound duration in every species studied. The neural mechanisms underlying this trade-off, often referred to as temporal integration, are not fully understood. Here, we probe the human auditory system with a large set of tone stimuli differing in duration, shape of the temporal amplitude envelope, duration of silent gaps between bursts, and frequency. Duration was varied by varying the plateau duration of plateau-burst (PB) stimuli, the duration of the onsets and offsets of onset-offset (OO) stimuli, and the number of identical bursts of multiple-burst (MB) stimuli. Absolute thresholds for a large number of ears (>230) were measured using a 3-interval-3-alternative forced choice (3I-3AFC) procedure. Thresholds decreased with increasing sound duration in a manner that depended on the temporal envelope. Most commonly, thresholds for MB stimuli were highest followed by thresholds for OO and PB stimuli of corresponding durations. Differences in the thresholds for MB and OO stimuli and in the thresholds for MB and PB stimuli, however, varied widely across ears, were negative in some ears, and were tightly correlated. We show that the variation and correlation of MB-OO and MB-PB threshold differences are linked to threshold microstructure, which affects the relative detectability of the sidebands of the MB stimuli and affects estimates of the bandwidth of auditory filters. We also found that thresholds for MB stimuli increased with increasing duration of the silent gaps between bursts. We propose a new model and show that it accurately accounts for our results and does so considerably better than a leaky-integrator-of-intensity model and a probabilistic model proposed by others. Our model is based on the assumption that sensory events are generated by a Poisson point process with a low rate in the absence of stimulation and higher, time-varying rates in the presence of stimulation. A subject in a 3I-3AFC

  14. Measurement errors in network load measurement: Effects on lead management and accounting. Messfehler bei der Netzlasterfassung: Einfluss auf Lastregelung und Leistungsverrechnung

    Energy Technology Data Exchange (ETDEWEB)

    Bunten, B. (Teilbereich Lastfuehrung, ABB Netzleittechnik GmbH, Ladenburg (Germany)); Dib, R.N. (Fachhochschule Giessen-Friedberg, Bereich Elektrische Energietechnik, Friedberg (Germany))

    1994-05-16

    In electric power supply systems continuous power measurement in the delivery points is necessary both for the purpose of load-management and for energy and power accounting. Electricity meters with pulse output points are commonly used for both applications today. The authors quantify the resulting errors in peak load measurement and load management as a function of the main influencing factors. (orig.)

  15. MEASURING THE EFFECTS OF IFRS ADOPTION IN ROMANIA ON THEVALUE RELEVANCE OF ACCOUNTING DATA

    OpenAIRE

    Irina-Doina Pascan

    2014-01-01

    In Romania, the entities listed on a regulated market must prepare their individualfinancial statements in accordance with the International Financial Reporting Standards (IFRS)starting with the financial year 2012. Since the IFRSs are considered high-quality accountingstandards, IFRS adoption should lead to improvement of the quality of financial reporting. In thispaper, we analyze the effect of mandatory IFRS introduction in Romania on accounting quality.Our main objective is to empirically...

  16. Measuring Performance for Accountability of a Small Social Economy Organization: The Case of an Independent School

    OpenAIRE

    Steven M. Smith; Sonja Novkovic; John Maddocks

    2011-01-01

    This article is a result of a joint project in social economy research between a community partner-an independent school-and academic partners. The school is a democratic organization, run by teachers and parents. The goal of the project was to find ways to improve communication and reporting about general performance of the school as part of the school's accountability to its members. Starting from lessons of the balanced scorecard approach for non-profits, we describe the process of develop...

  17. 77 FR 46014 - Main Hawaiian Islands Deep 7 Bottomfish Annual Catch Limits and Accountability Measures for 2012-13

    Science.gov (United States)

    2012-08-02

    ... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration 50 CFR Part 665 [Docket No. 120628195-2276-01] RIN 0648-XC089 Main Hawaiian Islands Deep 7 Bottomfish Annual Catch Limits and Accountability Measures for 2012-13 AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and...

  18. Taking account of sample finite dimensions in processing measurements of double differential cross sections of slow neutron scattering

    International Nuclear Information System (INIS)

    Lisichkin, Yu.V.; Dovbenko, A.G.; Efimenko, B.A.; Novikov, A.G.; Smirenkina, L.D.; Tikhonova, S.I.

    1979-01-01

    Described is a method of taking account of finite sample dimensions in processing measurement results of double differential cross sections (DDCS) of slow neutron scattering. A necessity of corrective approach to the account taken of the effect of sample finite dimensions is shown, and, in particular, the necessity to conduct preliminary processing of DDCS, the account being taken of attenuation coefficients of single scattered neutrons (SSN) for measurements on the sample with a container, and on the container. Correction for multiple scattering (MS) calculated on the base of the dynamic model should be obtained, the account being taken of resolution effects. To minimize the effect of the dynamic model used in calculations it is preferred to make absolute measurements of DDCS and to use the subraction method. The above method was realized in the set of programs for the BESM-5 computer. The FISC program computes the coefficients of SSN attenuation and correction for MS. The DDS program serves to compute a model DDCS averaged as per the resolution function of an instrument. The SCATL program is intended to prepare initial information necessary for the FISC program, and permits to compute the scattering law for all materials. Presented are the results of using the above method while processing experimental data on measuring DDCS of water by the DIN-1M spectrometer

  19. Linking Teacher Education to Redesigned Systems of Accountability: A Call for Multiple Measures in Pre-Service Teacher Effectiveness

    Science.gov (United States)

    Farley, Amy N.; Clayton, Grant; Kaka, Sarah J.

    2018-01-01

    In this written commentary for the special issue of "Education Policy Analysis Archives" focused on "Redesigning Assessment and Accountability," we call for teacher preparation to embrace a multiple measures philosophy by providing teacher candidates with rich opportunities to engage with data from a variety of sources, beyond…

  20. Materials measurement and accounting in an operating plutonium conversion and purification process. Phase I. Process modeling and simulation

    International Nuclear Information System (INIS)

    Thomas, C.C. Jr.; Ostenak, C.A.; Gutmacher, R.G.; Dayem, H.A.; Kern, E.A.

    1981-04-01

    A model of an operating conversion and purification process for the production of reactor-grade plutonium dioxide was developed as the first component in the design and evaluation of a nuclear materials measurement and accountability system. The model accurately simulates process operation and can be used to identify process problems and to predict the effect of process modifications

  1. Measurement properties of patient reported outcome measures for spondyloarthritis: A systematic review.

    Science.gov (United States)

    Png, Kelly; Kwan, Yu Heng; Leung, Ying Ying; Phang, Jie Kie; Lau, Jia Qi; Lim, Ka Keat; Chew, Eng Hui; Low, Lian Leng; Tan, Chuen Seng; Thumboo, Julian; Fong, Warren; Østbye, Truls

    2018-03-21

    This systematic review aimed to identify studies investigating measurement properties of patient reported outcome measures (PROMs) for spondyloarthritis (SpA), and to evaluate their methodological quality and level of evidence relating to the measurement properties of PROMs. This systematic review was guided by the preferred reporting items for systematic review and meta-analysis (PRISMA). Articles published before 30 June 2017 were retrieved from PubMed ® , Embase ® , and PsychINFO ® (Ovid). Methodological quality and level of evidence were evaluated according to recommendations from the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). We identified 60 unique PROMs from 125 studies in 39 countries. Twenty-one PROMs were validated for two or more SpA subtypes. The literature examined hypothesis testing (82.4%) most frequently followed by reliability (60.0%). A percentage of 77.7% and 42.7% of studies that assessed PROMs for hypothesis testing and reliability, respectively had "fair" or better methodological quality. Among the PROMs identified, 41.7% were studied in ankylosing spondylitis (AS) only and 23.3% were studied in psoriatic arthritis (PsA) only. The more extensively assessed PROMs included the ankylosing spondylitis quality of life (ASQoL) and bath ankylosing spondylitis functional index (BASFI) for ankylosing spondylitis, and the psoriatic arthritis quality of life questionnaire (VITACORA-19) for psoriatic arthritis. This study identified 60 unique PROMs through a systematic review and synthesized evidence of the measurement properties of the PROMs. There is a lack of validation of PROMs for use across SpA subtypes. Future studies may consider validating PROMs for use across different SpA subtypes. Copyright © 2018 Elsevier Inc. All rights reserved.

  2. Accounting for response behavior heterogeneity in the measurement of attitudes: an application to demand for electric vehicles

    OpenAIRE

    Glerum, Aurélie; Bierlaire, Michel

    2012-01-01

    Hybrid choice models have proved to be a powerful framework that integrates attitudinal and perceptional data into discrete choice models. However the measurement component of such a framework often fails to exploit individual-specific information that might affect the way subjects answer to indicators of opinion. In this paper we propose an HCM with a measurement model that takes into account heterogeneity in the response behavior. Precisely, we capture effects of exaggeration in answers to ...

  3. Towards global consensus on outcome measures for atopic eczema research: results of the HOME II meeting.

    Science.gov (United States)

    Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

    2012-09-01

    The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes research. In June 2011, the HOME initiative conducted a consensus study involving 43 individuals from 10 countries, representing different stakeholders (patients, clinicians, methodologists, pharmaceutical industry) to determine core outcome domains for atopic eczema trials, to define quality criteria for atopic eczema outcome measures and to prioritize topics for atopic eczema outcomes research. Delegates were given evidence-based information, followed by structured group discussion and anonymous consensus voting. Consensus was achieved to include clinical signs, symptoms, long-term control of flares and quality of life into the core set of outcome domains for atopic eczema trials. The HOME initiative strongly recommends including and reporting these core outcome domains as primary or secondary endpoints in all future atopic eczema trials. Measures of these core outcome domains need to be valid, sensitive to change and feasible. Prioritized topics of the HOME initiative are the identification/development of the most appropriate instruments for the four core outcome domains. HOME is open to anyone with an interest in atopic eczema outcomes research. © 2012 John Wiley & Sons A/S.

  4. Access management performance measures for Virginia : a practical approach for public accountability.

    Science.gov (United States)

    2010-04-01

    In order to develop performance measures to communicate the effect of Virginias access management program, five : tasks were performed: (1) the appropriate literature was reviewed, (2) a catalog of potential performance measures was : developed, (...

  5. Demonstration of an instrumental technique in the measurement of solution weight in the accountability vessels of a fuel reprocessing plant

    International Nuclear Information System (INIS)

    Nakajima, K.

    1977-04-01

    Load cells were installed on the input accountability vessel of a commercial reactor fuel reprocessing facility to determine if this proven principle of mass measurement is in fact applicable in such a severe radiation environment over a long period of time. Two other locations selected were the plutonium product nitrate solution accountability vessel and the plutonium product nitrate solution storage vessel. The latter two environments, while not severely radio-active, require a high degree of contamination control. All three vessels are of different geometrical configuration and capacity. Each vessel was carefully calibrated for volume measurements by adding controlled pre-measured increments of water. Measurements were made using the conventional dip-tube manometer system and the load cell - digital voltmeter. Standard deviation of the measurements on the input vessel and the plutonium storage vessel were in both cases 0.3%; for the plutonium accountability vessel 1.9%. Measurements taken of the input vessel during the ''cold run'' over a six-month period using solutions of unirradiated uranium showed a standard deviation of 0.4% and a bias of 0.8% in the summer months and 0.7% and 0.6% respectively in the winter months FINAL STOP CODE

  6. Healing models for organizations: description, measurement, and outcomes.

    Science.gov (United States)

    Malloch, K

    2000-01-01

    Healthcare leaders are continually searching for ways to improve their ability to provide optimal healthcare services, be financially viable, and retain quality caregivers, often feeling like such goals are impossible to achieve in today's intensely competitive environment. Many healthcare leaders intuitively recognize the need for more humanistic models and the probable connection with positive patient outcomes and financial success but are hesitant to make significant changes in their organizations because of the lack of model descriptions or documented recognition of the clinical and financial advantages of humanistic models. This article describes a study that was developed in response to the increasing work in humanistic or healing environment models and the need for validation of the advantages of such models. The healthy organization model, a framework for healthcare organizations that incorporates humanistic healing values within the traditional structure, is presented as a result of the study. This model addresses the importance of optimal clinical services, financial performance, and staff satisfaction. The five research-based organizational components that form the framework are described, and key indicators of organizational effectiveness over a five-year period are presented. The resulting empirical data are strongly supportive of the healing model and reflect positive outcomes for the organization.

  7. Prospective evaluation of outcome measures in free-flap surgery.

    LENUS (Irish Health Repository)

    Kelly, John L

    2004-08-01

    Free-flap failure is usually caused by venous or arterial thrombosis. In many cases, lack of experience and surgical delay also contribute to flap loss. The authors prospectively analyzed the outcome of 57 free flaps over a 28-month period (January, 1999 to April, 2001). The setting was a university hospital tertiary referral center. Anastomotic technique, ischemia time, choice of anticoagulant, and the grade of surgeon were recorded. The type of flap, medications, and co-morbidities, including preoperative radiotherapy, were also documented. Ten flaps were re-explored (17 percent). There were four cases of complete flap failure (6.7 percent) and five cases of partial failure (8.5 percent). In patients who received perioperative systemic heparin or dextran, there was no evidence of flap failure (p = .08). The mean ischemia time was similar in flaps that failed (95 +\\/- 29 min) and in those that survived (92 +\\/- 34 min). Also, the number of anastomoses performed by trainees in flaps that failed (22 percent), was similar to the number in flaps that survived (28 percent). Nine patients received preoperative radiotherapy, and there was complete flap survival in each case. This study reveals that closely supervised anastomoses performed by trainees may have a similar outcome to those performed by more senior surgeons. There was no adverse effect from radiotherapy or increased ischemia time on flap survival.

  8. Proposed outcome measures for prospective clinical trials in juvenile idiopathic arthritis-associated uveitis

    DEFF Research Database (Denmark)

    Heiligenhaus, Arnd; Foeldvari, Ivan; Edelsten, Clive

    2012-01-01

    To develop a set of core outcome measures for use in randomized controlled trials (RCTs) and longitudinal observational studies in juvenile idiopathic arthritis (JIA)-associated uveitis.......To develop a set of core outcome measures for use in randomized controlled trials (RCTs) and longitudinal observational studies in juvenile idiopathic arthritis (JIA)-associated uveitis....

  9. A systematic review of patient-reported outcome measures in paediatric otolaryngology.

    Science.gov (United States)

    Powell, J; Powell, S; Robson, A

    2018-01-01

    Recently, there has been increased emphasis on the development and application of patient-reported outcome measures. This drive to assess the impact of illness or interventions, from the patient's perspective, has resulted in a greater number of available questionnaires. The importance of selecting an appropriate patient-reported outcome measure is specifically emphasised in the paediatric population. The literature on patient-reported outcome measures used in paediatric otolaryngology was reviewed. A comprehensive literature search was conducted using the databases Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, and PsycInfo, using the terms: 'health assessment questionnaire', 'structured questionnaire', 'questionnaire', 'patient reported outcome measures', 'PROM', 'quality of life' or 'survey', and 'children' or 'otolaryngology'. The search was limited to English-language articles published between 1996 and 2016. The search yielded 656 articles, of which 63 were considered relevant. This included general paediatric patient-reported outcome measures applied to otolaryngology, and paediatric otolaryngology disease-specific patient-reported outcome measures. A large collection of patient-reported outcome measures are described in the paediatric otolaryngology literature. Greater standardisation of the patient-reported outcome measures used in paediatric otolaryngology would assist in pooling of data and increase the validation of tools used.

  10. Accounting for center in the Early External Cephalic Version trials: an empirical comparison of statistical methods to adjust for center in a multicenter trial with binary outcomes.

    Science.gov (United States)

    Reitsma, Angela; Chu, Rong; Thorpe, Julia; McDonald, Sarah; Thabane, Lehana; Hutton, Eileen

    2014-09-26

    Clustering of outcomes at centers involved in multicenter trials is a type of center effect. The Consolidated Standards of Reporting Trials Statement recommends that multicenter randomized controlled trials (RCTs) should account for center effects in their analysis, however most do not. The Early External Cephalic Version (EECV) trials published in 2003 and 2011 stratified by center at randomization, but did not account for center in the analyses, and due to the nature of the intervention and number of centers, may have been prone to center effects. Using data from the EECV trials, we undertook an empirical study to compare various statistical approaches to account for center effect while estimating the impact of external cephalic version timing (early or delayed) on the outcomes of cesarean section, preterm birth, and non-cephalic presentation at the time of birth. The data from the EECV pilot trial and the EECV2 trial were merged into one dataset. Fisher's exact method was used to test the overall effect of external cephalic version timing unadjusted for center effects. Seven statistical models that accounted for center effects were applied to the data. The models included: i) the Mantel-Haenszel test, ii) logistic regression with fixed center effect and fixed treatment effect, iii) center-size weighted and iv) un-weighted logistic regression with fixed center effect and fixed treatment-by-center interaction, iv) logistic regression with random center effect and fixed treatment effect, v) logistic regression with random center effect and random treatment-by-center interaction, and vi) generalized estimating equations. For each of the three outcomes of interest approaches to account for center effect did not alter the overall findings of the trial. The results were similar for the majority of the methods used to adjust for center, illustrating the robustness of the findings. Despite literature that suggests center effect can change the estimate of effect in

  11. Synthesis and review: delivering on conservation promises: the challenges of managing and measuring conservation outcomes

    International Nuclear Information System (INIS)

    Adams, Vanessa M; Game, Edward T; Bode, Michael

    2014-01-01

    Growing threats and limited resources have always been the financial realities of biodiversity conservation. As the conservation sector has matured, however, the accountability of conservation investments has become an increasingly debated topic, with two key topics being driven to the forefront of the discourse: understanding how to manage the risks associated with our conservation investments and demonstrating that our investments are making a difference through evidence-based analyses. A better understanding of the uncertainties associated with conservation decisions is a central component of managing risks to investments that is often neglected. This focus issue presents both theoretical and applied approaches to quantifying and managing risks. Furthermore, transparent and replicable approaches to measuring impacts of conservation investments are noticeably absent in many conservation programs globally. This focus issue contains state of the art conservation program impact evaluations that both demonstrate how these methods can be used to measure outcomes as well as directing future investments. This focus issue thus brings together current thinking and case studies that can provide a valuable resource for directing future conservation investments. (paper)

  12. Synthesis and review: delivering on conservation promises: the challenges of managing and measuring conservation outcomes

    Science.gov (United States)

    Adams, Vanessa M.; Game, Edward T.; Bode, Michael

    2014-08-01

    Growing threats and limited resources have always been the financial realities of biodiversity conservation. As the conservation sector has matured, however, the accountability of conservation investments has become an increasingly debated topic, with two key topics being driven to the forefront of the discourse: understanding how to manage the risks associated with our conservation investments and demonstrating that our investments are making a difference through evidence-based analyses. A better understanding of the uncertainties associated with conservation decisions is a central component of managing risks to investments that is often neglected. This focus issue presents both theoretical and applied approaches to quantifying and managing risks. Furthermore, transparent and replicable approaches to measuring impacts of conservation investments are noticeably absent in many conservation programs globally. This focus issue contains state of the art conservation program impact evaluations that both demonstrate how these methods can be used to measure outcomes as well as directing future investments. This focus issue thus brings together current thinking and case studies that can provide a valuable resource for directing future conservation investments.

  13. Grades and Incentives: Assessing Competing Grade Point Average Measures and Postgraduate Outcomes

    Science.gov (United States)

    Bailey, Michael A.; Rosenthal, Jeffrey S.; Yoon, Albert H.

    2016-01-01

    In many educational settings, students may have an incentive to take courses where high grades are easier to achieve, potentially corroding student learning, evaluation of student achievement, and the fairness and efficiency of post-graduation labor outcomes. A grading system that takes into account heterogeneity of teacher standards and student…

  14. Determination of corrective factors for an ultrasonic flow measuring method in pipes accounting for perturbations

    International Nuclear Information System (INIS)

    Etter, S.

    1982-01-01

    By current ultrasonic flow measuring equipment (UFME) the mean velocity is measured for one or two measuring paths. This mean velocity is not equal to the velocity averaged over the flow cross-section, by means of which the flow rate is calculated. This difference will be found already for axially symmetrical, fully developed velocity profiles and, to a larger extent, for disturbed profiles varying in flow direction and for nonsteady flow. Corrective factors are defined for steady and nonsteady flows. These factors can be derived from the flow profiles within the UFME. By mathematical simulation of the entrainment effect the influence of cross and swirl flows on various ultrasonic measuring methods is studied. The applied UFME with crossed measuring paths is shown to be largely independent of cross and swirl flows. For evaluation in a computer of velocity network measurements in circular cross-sections the equations for interpolation and integration are derived. Results of the mathematical method are the isotach profile, the flow rate and, for fully developed flow, directly the corrective factor. In the experimental part corrective factors are determined in nonsteady flow in a measuring plane before and in form measuring planes behind a perturbation. (orig./RW) [de

  15. Translating patient reported outcome measures: methodological issues explored using cognitive interviewing with three rheumatoid arthritis measures in six European languages

    NARCIS (Netherlands)

    Hewlett, Sarah E.; Nicklin, Joanna; Bode, Christina; Carmona, Loretto; Dures, Emma; Engelbrecht, Matthias; Hagel, Sofia; Kirwan, John R.; Molto, Anna; Redondo, Marta; Gossec, Laure

    2016-01-01

    Objective. Cross-cultural translation of patient-reported outcome measures (PROMs) is a lengthy process, often performed professionally. Cognitive interviewing assesses patient comprehension of PROMs. The objective was to evaluate the usefulness of cognitive interviewing to assess translations and

  16. Accounting for quality in the measurement of hospital performance: evidence from Costa Rica.

    Science.gov (United States)

    Arocena, Pablo; García-Prado, Ariadna

    2007-07-01

    This paper provides insights into how Costa Rican public hospitals responded to the pressure for increased efficiency and quality introduced by the reforms carried out over the period 1997-2001. To that purpose we compute a generalized output distance function by means of non-parametric mathematical programming to construct a productivity index, which accounts for productivity changes while controlling for quality of care. Our results show an improvement in hospital performance mainly driven by quality increases. The adoption of management contracts seems to have contributed to such enhancement, more notably for small hospitals. Further, productivity growth is primarily due to technical and scale efficiency change rather than technological change. A number of policy implications are drawn from these results. Copyright (c) 2006 John Wiley & Sons, Ltd.

  17. Infant-parent attachment: Definition, types, antecedents, measurement and outcome.

    Science.gov (United States)

    Benoit, Diane

    2004-10-01

    Attachment theory is one of the most popular and empirically grounded theories relating to parenting. The purpose of the present article is to review some pertinent aspects of attachment theory and findings from attachment research. Attachment is one specific aspect of the relationship between a child and a parent with its purpose being to make a child safe, secure and protected. Attachment is distinguished from other aspects of parenting, such as disciplining, entertaining and teaching. Common misconceptions about what attachment is and what it is not are discussed. The distinction between attachment and bonding is provided. The recognized method to assess infant-parent attachment, the Strange Situation procedure, is described. In addition, a description is provided for the four major types of infant-parent attachment, ie, secure, insecure-avoidant, insecure-resistant and insecure-disorganized. The antecedents and consequences of each of the four types of infant-parent attachment are discussed. A special emphasis is placed on the description of disorganized attachment because of its association with significant emotional and behavioural problems, and poor social and emotional outcomes in high-risk groups and in the majority of children who have disorganized attachment with their primary caregiver. Practical applications of attachment theory and research are presented.

  18. An automated electromanometer for measurement of the solution content in accountability vessels (JASPAS project 81-3)

    International Nuclear Information System (INIS)

    Yamanouchi, Tanehiko; Suyama, Naohiro; Hayashi, Makoto; Komatsu, Hisato; Fukuari, Yoshihiro

    1982-01-01

    The automated electromanometer system was introduced to the Tokai Reprocessing Plant, PNC (Power Reactor and Nuclear Fuel Development Corp.), through the Brookhaven National Laboratory after the demonstration and acceptance testing conducted at the Barnwell Nuclear Fuels Plant. It was installed at the input accountability vessel and the plutonium product accountability vessel in the Process Material Balance Area of the plant in 1979. In this paper, the results of measurement which were obtained by the field operation test in 1981 and the data analysis are described. The system consists of a pneumatic scanner, an electromanometer, a digital voltmeter and a desktop computer, and it is so designed as to receive automatically the pneumatic signals on liquid level and density along with liquid temperature, leading to the instantaneous and accurate calculation of liquid volume. The field test results were compared with those of a water manometer. The data showed negative deviation from those of the water manometer in the first test. This difference became smaller in the second test. The demonstration for one year in 1981 showed that the system was very useful for the volume measurement of the input accountability vessel and the plutonium product accountability vessel. (Wakatsuki, Y.)

  19. Accounting for the speed shear in wind turbine power performance measurement

    DEFF Research Database (Denmark)

    Wagner, Rozenn; Courtney, Michael; Gottschall, Julia

    2011-01-01

    The current IEC standard for wind turbine power performance measurement only requires measurement of the wind speed at hub height assuming this wind speed to be representative for the whole rotor swept area. However, the power output of a wind turbine depends on the kinetic energy flux, which...... itself depends on the wind speed profile, especially for large turbines. Therefore, it is important to characterize the wind profile in front of the turbine, and this should be preferably achieved by measuring the wind speed over the vertical range between lower and higher rotor tips. In this paper, we...... describe an experiment in which wind speed profiles were measured in front of a multimegawatt turbine using a ground–based pulsed lidar. Ignoring the vertical shear was shown to overestimate the kinetic energy flux of these profiles, in particular for those deviating significantly from a power law profile...

  20. Prompt neutron decay constants and subcritical measurements for material control and accountability in SHEBA

    International Nuclear Information System (INIS)

    Sanchez, R.; Jaegers, P.

    1998-01-01

    Rossi-Alpha measurements were performed on the SHEBA assembly to determine the prompt neutron decay constants. These prompt neutron decay constants represent an eigenvalue characteristic of this particular assembly, which can be used to infer the amount of fissile material in the assembly. In addition, subcritical measurements using Rossi-Alpha and the source-jerk techniques were also performed on the SHEBA assembly. These measurements were compared against TWODANT calculations and agreed quite well. The subcritical measurements were also used to obtain a unique signature that represented the amount of material associated with the degree of subcriticality of the SHEBA assembly. Finally, the Feynman variance-to-mean technique in conjunction with TWODANT, were used to determine the effective delayed neutron fraction for the SHEBA assembly

  1. Changes in the measurement of fair value : implications for accounting earnings.

    OpenAIRE

    Fargher, N.; Zhang, J.

    2014-01-01

    With the FASB's issue of staff position papers in 2009 and the relaxation of how fair value standards are applied, there has been a change in the practice of how fair value is measured. Since the FASB staff position papers in 2009, fair value measurement by financial institutions has increasingly relied on managerial assumptions. This study examines the impact of this change on the quality of earnings. Consistent with attribute substitution theory that emphasises reliability over relevance, w...

  2. Motor outcome measures in Huntington disease clinical trials.

    Science.gov (United States)

    Reilmann, Ralf; Schubert, Robin

    2017-01-01

    Deficits in motor function are a hallmark of Huntington disease (HD). The Unified Huntington's Disease Rating Scale Total Motor Score (UHDRS-TMS) is a categoric clinical rating scale assessing multiple domains of motor disability in HD. The UHDRS-TMS or subsets of its items have served as primary or secondary endpoints in numerous clinical trials. In spite of a well-established video-based annual online certification system, intra- and interrater variability, subjective error, and rater-induced placebo effects remain a concern. In addition, the UHDRS-TMS was designed to primarily assess motor symptoms in manifest HD. Recently, advancement of technology resulted in the introduction of the objective Q-Motor (i.e., Quantitative-Motor) assessments in biomarker studies and clinical trials in HD. Q-Motor measures detected motor signs in blinded cross-sectional and longitudinal analyses of manifest, prodromal, and premanifest HD cohorts up to two decades before clinical diagnosis. In a multicenter clinical trial in HD, Q-Motor measures were more sensitive than the UHDRS-TMS and exhibited no placebo effects. Thus, Q-Motor measures are currently explored in several multicenter trials targeting both symptomatic and disease-modifying mechanisms. They may supplement the UHDRS-TMS, increase the sensitivity and reliability in proof-of-concept studies, and open the door for phenotype assessments in clinical trials in prodromal and premanifest HD. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Patient-reported outcome measures versus inertial performance-based outcome measures: A prospective study in patients undergoing primary total knee arthroplasty.

    Science.gov (United States)

    Bolink, S A A N; Grimm, B; Heyligers, I C

    2015-12-01

    Outcome assessment of total knee arthroplasty (TKA) by subjective patient reported outcome measures (PROMs) may not fully capture the functional (dis-)abilities of relevance. Objective performance-based outcome measures could provide distinct information. An ambulant inertial measurement unit (IMU) allows kinematic assessment of physical performance and could potentially be used for routine follow-up. To investigate the responsiveness of IMU measures in patients following TKA and compare outcomes with conventional PROMs. Patients with end stage knee OA (n=20, m/f=7/13; age=67.4 standard deviation 7.7 years) were measured preoperatively and one year postoperatively. IMU measures were derived during gait, sit-stand transfers and block step-up transfers. PROMs were assessed by using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee Society Score (KSS). Responsiveness was calculated by the effect size, correlations were calculated with Spearman's rho correlation coefficient. One year after TKA, patients performed significantly better at gait, sit-to-stand transfers and block step-up transfers. Measures of time and kinematic IMU measures demonstrated significant improvements postoperatively for each performance-based test. The largest improvement was found in block step-up transfers (effect size=0.56-1.20). WOMAC function score and KSS function score demonstrated moderate correlations (Spearman's rho=0.45-0.74) with some of the physical performance-based measures pre- and postoperatively. To characterize the changes in physical function after TKA, PROMs could be supplemented by performance-based measures, assessing function during different activities and allowing kinematic characterization with an ambulant IMU. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. Accounting for randomness in measurement and sampling in studying cancer cell population dynamics.

    Science.gov (United States)

    Ghavami, Siavash; Wolkenhauer, Olaf; Lahouti, Farshad; Ullah, Mukhtar; Linnebacher, Michael

    2014-10-01

    Knowing the expected temporal evolution of the proportion of different cell types in sample tissues gives an indication about the progression of the disease and its possible response to drugs. Such systems have been modelled using Markov processes. We here consider an experimentally realistic scenario in which transition probabilities are estimated from noisy cell population size measurements. Using aggregated data of FACS measurements, we develop MMSE and ML estimators and formulate two problems to find the minimum number of required samples and measurements to guarantee the accuracy of predicted population sizes. Our numerical results show that the convergence mechanism of transition probabilities and steady states differ widely from the real values if one uses the standard deterministic approach for noisy measurements. This provides support for our argument that for the analysis of FACS data one should consider the observed state as a random variable. The second problem we address is about the consequences of estimating the probability of a cell being in a particular state from measurements of small population of cells. We show how the uncertainty arising from small sample sizes can be captured by a distribution for the state probability.

  5. An evaluation of accounting-based finding costs as efficiency measures for oil and gas exploration

    International Nuclear Information System (INIS)

    Boynton, C.E. IV; Boone, J.P.

    1994-08-01

    The authors have operationalized firm-specific exploration efficiency as the difference between a firm-specific intercept estimated in a fixed-effects panel data Cobb-Douglas production frontier model and the maximum firm-specific intercept estimated in that model. The production model was estimated during two different time periods, 1982--1985 and 1989--1992, allowing efficiency to vary intertemporally. This efficiency estimate served as a benchmark against which they compared various measures of inverse finding costs. They assumed that the degree of association with an efficiency benchmark is an important attribute of any finding cost measure and that, further, the degree of association may be used as a metric for choosing between alternative finding cost measures. Accordingly, they evaluated the cross-sectional statistical association between estimated efficiency and alternative inverse finding cost measures. They discovered that the inverse finding cost measure that exhibited the strongest association with efficiency during the two time periods was a three-year moving-average finding cost which included exploration plus development expenditures as costs and reserve extensions and additions plus revisions as the units added

  6. An evaluation of accounting-based finding costs as efficiency measures for oil and gas exploration

    Energy Technology Data Exchange (ETDEWEB)

    Boynton, C.E. IV; Boone, J.P.

    1994-08-01

    The authors have operationalized firm-specific exploration efficiency as the difference between a firm-specific intercept estimated in a fixed-effects panel data Cobb-Douglas production frontier model and the maximum firm-specific intercept estimated in that model. The production model was estimated during two different time periods, 1982--1985 and 1989--1992, allowing efficiency to vary intertemporally. This efficiency estimate served as a benchmark against which they compared various measures of inverse finding costs. They assumed that the degree of association with an efficiency benchmark is an important attribute of any finding cost measure and that, further, the degree of association may be used as a metric for choosing between alternative finding cost measures. Accordingly, they evaluated the cross-sectional statistical association between estimated efficiency and alternative inverse finding cost measures. They discovered that the inverse finding cost measure that exhibited the strongest association with efficiency during the two time periods was a three-year moving-average finding cost which included exploration plus development expenditures as costs and reserve extensions and additions plus revisions as the units added.

  7. Beyond Measurement and Reward: Methods of Motivating Quality Improvement and Accountability.

    Science.gov (United States)

    Berenson, Robert A; Rice, Thomas

    2015-12-01

    The article examines public policies designed to improve quality and accountability that do not rely on financial incentives and public reporting of provider performance. Payment policy should help temper the current "more is better" attitude of physicians and provider organizations. Incentive neutrality would better support health professionals' intrinsic motivation to act in their patients' best interests to improve overall quality than would pay-for-performance plans targeted to specific areas of clinical care. Public policy can support clinicians' intrinsic motivation through approaches that support systematic feedback to clinicians and provide concrete opportunities to collaborate to improve care. Some programs administered by the Centers for Medicare & Medicaid Services, including Partnership for Patients and Conditions of Participation, deserve more attention; they represent available, but largely ignored, approaches to support providers to improve quality and protect beneficiaries against substandard care. Public policies related to quality improvement should focus more on methods of enhancing professional intrinsic motivation, while recognizing the potential role of organizations to actively promote and facilitate that motivation. Actually achieving improvement, however, will require a reexamination of the role played by financial incentives embedded in payments and the unrealistic expectations placed on marginal incentives in pay-for-performance schemes. © Health Research and Educational Trust.

  8. Relationship outcomes as measurement criteria to assist communication strategists to manage organisational relationships

    Directory of Open Access Journals (Sweden)

    E. Botha

    2011-06-01

    Full Text Available Nonfinancial assets like relationships are increasingly important to managers. Communication managers in particular are focusing on measuring and managing organisational relationships as a means to quantify the return on investment (ROI of public relations and communication strategies. Measuring relationships offers communication managers a way to evaluate its contribution to the organisation. A commonly agreed upon definition of these relationships, however, does not exist. If we consider communication management is a managerial function, it must first refine its instruments of measurement. This study looks at the three-stage model of organisational relationships (relationship antecedents, maintenance strategies and relationship outcomes proposed by Grunig & Huang (2000 to firstly review the development of the model. Secondly, the study takes an in-depth look at each relationship outcomes of trust, commitment, satisfaction and control mutuality. Lastly, we assess the reliability and validity of the use of current relationship outcome measures through a survey of 154 organisational relationships. Previous studies that have utilized these outcomes in the measurement of organisational relationships do not discuss the possible interaction (or relationship among these outcomes. This study contributes to current literature by both providing an improved framework for the measurement of relationship outcomes and hypothesizing about how these outcomes interact with one another. It also discusses the managerial implications of managing relationships through the constant measurement of trust, commitment, satisfaction and control mutuality

  9. Ideas on a practical method to make more uniform the measure and the account of doses

    International Nuclear Information System (INIS)

    Boussard, P.; Dollo, R.; De Kerviller, M.; Penneroux, M.

    1992-01-01

    The ICRP 60 publication and its consequences on the revision of CEC regulations and basic norms, discussions on dosimetry of outside workers and more generally on the development of exchanges of information between users have led EDF to question its practices for measuring counting doses. Faced with this wide range of french practices and in a desire for harmonisation, an EDF and CEA work team has established a summary of present methods, an evaluation of the consequences of these different strategies and have then suggested a harmonisation of dosimetric measures based on systematic methodology. (author)

  10. Measuring outcomes in adult spinal deformity surgery: a systematic review to identify current strengths, weaknesses and gaps in patient-reported outcome measures.

    Science.gov (United States)

    Faraj, Sayf S A; van Hooff, Miranda L; Holewijn, Roderick M; Polly, David W; Haanstra, Tsjitske M; de Kleuver, Marinus

    2017-08-01

    Adult spinal deformity (ASD) causes severe disability, reduces overall quality of life, and results in a substantial societal burden of disease. As healthcare is becoming more value based, and to facilitate global benchmarking, it is critical to identify and standardize patient-reported outcome measures (PROMs). This study aims to identify the current strengths, weaknesses, and gaps in PROMs used for ASD. Studies were included following a systematic search in multiple bibliographic databases between 2000 and 2015. PROMs were extracted and linked to the outcome domains of WHO's International Classification of Functioning and Health (ICF) framework. Subsequently, the clinimetric quality of identified PROMs was evaluated. The literature search identified 144 papers that met the inclusion criteria, and nine frequently used PROMs were identified. These covered 29 ICF outcome domains, which could be grouped into three of the four main ICF chapters: body function (n = 7), activity and participation (n = 19), environmental factors (n = 3), and body structure (n = 0). A low quantity (n = 3) of papers was identified that studied the clinimetric quality of PROMs. The Scoliosis Research Society (SRS)-22 has the highest level of clinimetric quality for ASD. Outcome domains related to mobility and pain were well represented. We identified a gap in current outcome measures regarding neurological and pulmonary function. In addition, no outcome domains were measured in the ICF chapter body structure. These results will serve as a foundation for the process of seeking international consensus on a standard set of outcome domains, accompanied PROMs and contributing factors to be used in future clinical trials and spine registries.

  11. Identifying an outcome measure to assess the impact of Mobility Dogs.

    Science.gov (United States)

    Mudge, Suzie; Rewi, Dallas; Channon, Alexis

    2017-01-01

    Mobility Dogs® trains dogs to work with people with physical disabilities to increase independence, confidence, self-esteem and participation. Mobility Dogs® seeks to critically evaluate and improve its services as it grows. This study aimed to identify and implement a standardised outcome measure into practice at Mobility Dogs®. Based on the Consolidated Framework for Implementation Research and guided by a steering group of key stakeholders, a three-phase approach was developed to identify and assess an outcome measure. The steering group highlighted the organisation's specific needs, selected participation as the assessment domain and identified core utility requirements of the measure. A comprehensive review of evidence was undertaken to identify and rank potential measures according to the specified needs. Of the seven participation outcome measures that met inclusion criteria, the three highest ranked measures were critically evaluated by the steering group to determine suitability against the organisation's needs. The Impact on Participation and Autonomy (IPA) was selected for implementation into practice at Mobility Dogs®. Use of the IPA is an important first step for Mobility Dogs® to test the benefits of trained service dogs. This process could be replicated by other service dog organisations to identify outcome measures to assess their own services. Implications for Rehabilitation Service dogs (such as Mobility Dogs® in New Zealand) assist people living with physical impairments by performing tasks, however there is limited evidence on outcomes. The process for selecting an appropriate outcome measure for Mobility Dogs® involving partnership between Mobility Dogs® personnel and academics was an effective way to steer the project by determining important properties of the measure, before a search of the literature was undertaken. While the IPA was selected as the most appropriate outcome measure for use at Mobility Dogs®, it was the process that

  12. Measures of Maternal Socioeconomic Status in Yemen and Association with Maternal and Child Health Outcomes.

    Science.gov (United States)

    Alosaimi, Abdullah N; Luoto, Riitta; Al Serouri, Abdul Wahed; Nwaru, Bright I; Mouniri, Halima

    2016-02-01

    Reliable measurement of socioeconomic status (SES) in health research requires extensive resources and can be challenging in low-income countries. We aimed to develop a set of maternal SES indices and investigate their associations with maternal and child health outcomes in rural Yemen. We applied factor analysis based on principal component analysis extraction to construct the SES indices by capturing household attributes for 7295 women of reproductive age. Data were collected from a sub-national household survey conducted in six rural districts in four Yemeni provinces in 2008-2009. Logistic regression models were fitted to estimate the associations between the SES indices and maternal mortality, spontaneous abortion, stillbirth, neonatal and infant mortality. Three SES indices (wealth, educational and housing quality) were extracted, which together explained 54 % of the total variation in SES. Factor scores were derived and categorized into tertiles. After adjusting for potential confounding factors, higher tertiles of all the indices were inversely associated with spontaneous abortion. Higher tertiles of wealth and educational indices were inversely associated with stillbirth, neonatal and infant mortality. None of the SES indices was strongly associated with maternal mortality. By subjecting a number of household attributes to factor analysis, we derived three SES indices (wealth, educational, and housing quality) that are useful for maternal and child health research in rural Yemen. The indices were worthwhile in predicting a number of maternal and child health outcomes. In low-income settings, failure to account for the multidimensionality of SES may underestimate the influence of SES on maternal and child health.

  13. Methods for measuring, enhancing, and accounting for medication adherence in clinical trials.

    Science.gov (United States)

    Vrijens, B; Urquhart, J

    2014-06-01

    Adherence to rationally prescribed medications is essential for effective pharmacotherapy. However, widely variable adherence to protocol-specified dosing regimens is prevalent among participants in ambulatory drug trials, mostly manifested in the form of underdosing. Drug actions are inherently dose and time dependent, and as a result, variable underdosing diminishes the actions of trial medications by various degrees. The ensuing combination of increased variability and decreased magnitude of trial drug actions reduces statistical power to discern between-group differences in drug actions. Variable underdosing has many adverse consequences, some of which can be mitigated by the combination of reliable measurements of ambulatory patients' adherence to trial and nontrial medications, measurement-guided management of adherence, statistically and pharmacometrically sound analyses, and modifications in trial design. Although nonadherence is prevalent across all therapeutic areas in which the patients are responsible for treatment administration, the significance of the adverse consequences depends on the characteristics of both the disease and the medications.

  14. Accounting for sensor calibration, data validation, measurement and sampling uncertainties in monitoring urban drainage systems.

    Science.gov (United States)

    Bertrand-Krajewski, J L; Bardin, J P; Mourad, M; Béranger, Y

    2003-01-01

    Assessing the functioning and the performance of urban drainage systems on both rainfall event and yearly time scales is usually based on online measurements of flow rates and on samples of influent effluent for some rainfall events per year. In order to draw pertinent scientific and operational conclusions from the measurement results, it is absolutely necessary to use appropriate methods and techniques in order to i) calibrate sensors and analytical methods, ii) validate raw data, iii) evaluate measurement uncertainties, iv) evaluate the number of rainfall events to sample per year in order to determine performance indicator with a given uncertainty. Based an previous work, the paper gives a synthetic review of required and techniques, and illustrates their application to storage and settling tanks. Experiments show that, controlled and careful experimental conditions, relative uncertainties are about 20% for flow rates in sewer pipes, 6-10% for volumes, 25-35% for TSS concentrations and loads, and 18-276% for TSS removal rates. In order to evaluate the annual pollutant interception efficiency of storage and settling tanks with a given uncertainty, efforts should first be devoted to decrease the sampling uncertainty by increasing the number of sampled events.

  15. Outcome Measurement in the Treatment of Spasmodic Dysphonia: A Systematic Review of the Literature.

    Science.gov (United States)

    Rumbach, Anna; Aiken, Patrick; Novakovic, Daniel

    2018-04-11

    The aim of this review was to systematically identify all available studies reporting outcomes measures to assess treatment outcomes for people with spasmodic dysphonia (SD). Full-text journal articles were identified through searches of PubMed, Embase, CINAHL, and Cochrane databases and hand searching of journals. A total of 4,714 articles were retrieved from searching databases; 1,165 were duplicates. Titles and abstracts of 3,549 were screened, with 171 being selected for full-text review. During full-text review, 101 articles were deemed suitable for inclusion. An additional 24 articles were identified as suitable for inclusion through a hand search of reference lists. Data were extracted from 125 studies. A total of 220 outcome measures were identified. Considered in reference to the World Health Organization International Classification of Functioning, Disability and Health (ICF), the majority of outcomes were measured at a Body Function level (n = 212, 96%). Outcomes that explored communication and participation in everyday life and attitudes toward communication (ie, activity and participation domains) were infrequent (n = 8; 4%). Quality of life, a construct not measured within the ICF, was also captured by four outcome measures. No instruments evaluating communication partners' perspectives or burden/disability were identified. The outcome measures used in SD treatment studies are many and varied. The outcome measures identified predominately measure constructs within the Body Functions component of the ICF. In order to facilitate data synthesis across trials, the development of a core outcome set is recommended. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

  16. Who Benefits from Gender Responsive Treatment? Accounting for Abuse History on Longitudinal Outcomes for Women in Prison.

    Science.gov (United States)

    Saxena, Preeta; Messina, Nena; Grella, Christine E

    2014-04-01

    This study explores outcome variation among women offenders who participated in gender-responsive substance abuse treatment (GRT). In order to identify subgroups of participants that may differentially benefit from this treatment, secondary analyses examined the interaction between randomization into GRT and a history of abuse (physical/sexual) on depression and number of substances used post- treatment. The sample consisted of 115 incarcerated women assessed at baseline and 6- and 12-months post parole. Longitudinal regression showed that women reporting abuse randomized into GRT had significantly reduced odds of depression ( OR = .29, p < .05, 95% CI = .10 - .86) and lowered rates of number of substances used ( IRR = .52, p < .05, 95% CI = 0.28-0.98), in comparison to those who reported abuse and were randomized to the non-GRT group. GRT for women offenders who have experienced prior abuse would maximize the benefits of the trauma-informed, gender-sensitive intervention.

  17. Absolute and proportional measures of potential markers of rehearsal, and their implications for accounts of its development

    Science.gov (United States)

    Jarrold, Christopher; Danielsson, Henrik; Wang, Xiaoli

    2015-01-01

    Previous studies of the development of phonological similarity and word length effects in children have shown that these effects are small or absent in young children, particularly when measured using visual presentation of the memoranda. This has often been taken as support for the view that young children do not rehearse. The current paper builds on recent evidence that instead suggests that absent phonological similarity and word length effects in young children reflects the same proportional cost of these effects in children of all ages. Our aims are to explore the conditions under which this proportional scaling account can reproduce existing developmental data, and in turn suggest ways that future studies might measure and model phonological similarity and word length effects in children. To that end, we first fit a single mathematical function through previously reported data that simultaneously captures absent and negative proportional effects of phonological similarity in young children plus constant proportional similarity effects in older children. This developmental function therefore provides the benchmark that we seek to re-produce in a series of subsequent simulations that test the proportional scaling account. These simulations reproduce the developmental function well, provided that they take into account the influence of floor effects and of measurement error. Our simulations suggest that future empirical studies examining these effects in the context of the development of rehearsal need to take into account proportional scaling. They also provide a demonstration of how proportional costs can be explored, and of the possible developmental functions associated with such an analysis. PMID:25852615

  18. Outcome-driven thresholds for home blood pressure measurement: international database of home blood pressure in relation to cardiovascular outcome.

    Science.gov (United States)

    Niiranen, Teemu J; Asayama, Kei; Thijs, Lutgarde; Johansson, Jouni K; Ohkubo, Takayoshi; Kikuya, Masahiro; Boggia, José; Hozawa, Atsushi; Sandoya, Edgardo; Stergiou, George S; Tsuji, Ichiro; Jula, Antti M; Imai, Yutaka; Staessen, Jan A

    2013-01-01

    The lack of outcome-driven operational thresholds limits the clinical application of home blood pressure (BP) measurement. Our objective was to determine an outcome-driven reference frame for home BP measurement. We measured home and clinic BP in 6470 participants (mean age, 59.3 years; 56.9% women; 22.4% on antihypertensive treatment) recruited in Ohasama, Japan (n=2520); Montevideo, Uruguay (n=399); Tsurugaya, Japan (n=811); Didima, Greece (n=665); and nationwide in Finland (n=2075). In multivariable-adjusted analyses of individual subject data, we determined home BP thresholds, which yielded 10-year cardiovascular risks similar to those associated with stages 1 (120/80 mm Hg) and 2 (130/85 mm Hg) prehypertension, and stages 1 (140/90 mm Hg) and 2 (160/100 mm Hg) hypertension on clinic measurement. During 8.3 years of follow-up (median), 716 cardiovascular end points, 294 cardiovascular deaths, 393 strokes, and 336 cardiac events occurred in the whole cohort; in untreated participants these numbers were 414, 158, 225, and 194, respectively. In the whole cohort, outcome-driven systolic/diastolic thresholds for the home BP corresponding with stages 1 and 2 prehypertension and stages 1 and 2 hypertension were 121.4/77.7, 127.4/79.9, 133.4/82.2, and 145.4/86.8 mm Hg; in 5018 untreated participants, these thresholds were 118.5/76.9, 125.2/79.7, 131.9/82.4, and 145.3/87.9 mm Hg, respectively. Rounded thresholds for stages 1 and 2 prehypertension and stages 1 and 2 hypertension amounted to 120/75, 125/80, 130/85, and 145/90 mm Hg, respectively. Population-based outcome-driven thresholds for home BP are slightly lower than those currently proposed in hypertension guidelines. Our current findings could inform guidelines and help clinicians in diagnosing and managing patients.

  19. Is it worth it to consider videogames in accounting education? A comparison of a simulation and a videogame in attributes, motivation and learning outcomes

    Directory of Open Access Journals (Sweden)

    Jordi Carenys

    2017-07-01

    Full Text Available The objective of this study is to assess the effectiveness of videogames in comparison to simulations in a higher education environment and with regard to their attributes, motivation, and learning outcomes, as three of the main dimensions that play a role in the effectiveness of digital game-based learning. Results demonstrate significant differences between the attributes and motivation dimensions, while no significant differences were found for the learning outcomes. This would imply that although both instructional tools lead students to the desired level of knowledge acquisition, the motivation generated, together with the set of features provided by the games complement each other, leading to a superior learning experience. These results support the inclusion of videogames as a complement to simulations in higher education accounting and business environments and allow us to propose a blended approach that provides the learner with the ‘best of both worlds’.

  20. Multiple Measures of Outcome in Assessing a Prison-Based Drug Treatment Program

    Science.gov (United States)

    Prendergast, Michael L.; Hall, Elizabeth A.; Wexler, Harry K.

    2003-01-01

    Evaluations of prison-based drug treatment programs typically focus on one or two dichotomous outcome variables related to recidivism. In contrast, this paper uses multiple measures of outcomes related to crime and drug use to examine the impact of prison treatment. Crime variables included self-report data of time to first illegal activity,…

  1. Systematic review of tools to measure outcomes for young children with autism spectrum disorder

    NARCIS (Netherlands)

    McConachie, H.; Parr, J.R.; Glod, M.; Hanratty, J.; Livingstone, N.; Oono, I.P.; Robalino, S.; Baird, G.; Beresford, B.; Charman, T.; Garland, D.; Green, J.; Gringras, P.; Jones, G.; Law, J.; Le Couteur, A.S.; Macdonald, G.; McColl, E.M.; Morris, C.; Rodgers, J.; Simonoff, E.; Terwee, C.B.; Williams, K.

    2015-01-01

    Background: The needs of children with autism spectrum disorder (ASD) are complex and this is reflected in the number and diversity of outcomes assessed and measurement tools used to collect evidence about children�s progress. Relevant outcomes include improvement in core ASD impairments, such as

  2. [Improving care for cleft lip and palate patients: uniform and patient-orientated outcome measures].

    Science.gov (United States)

    Haj, M; de Gier, H H W; van Veen-van der Hoek, M; Versnel, S L; van Adrichem, L N; Wolvius, E B; Hazelzet, J A; Koudstaal, M J

    2018-02-01

    The quality of care for patients with cleft lip and palate is extremely variable across the world. Treatment protocols differ and methods of data registration are not uniform. Improving this care by means of comparative research is challenging. The best treatment programmes can be identified by uniformly registering patient-orientated outcomes and comparing the outcomes with those of other treatment centres. That knowledge can be used to improve one's own care. An international team consisting of specialists and cleft lip and palate patients has developed a set of outcome measures that are considered by patients to be most important. This team is coordinated by the International Consortium of Health Outcomes Measurement (ICHOM). The cleft lip and palate outcome set can be used by all centres worldwide in following up on cleft lip and palate patients. In the Erasmus Medical Centre in Rotterdam, the 'Zorgmonitor Schisis' (Care Monitor Cleft Lip and Palate) has been built, an application in which these outcome measures are collected at fixed times. Implementing this set of outcome measures in other cleft lip and palate treatment centres and using the outcomes as (inter)national benchmarks will result in transparency and the improvement of the treatment of cleft lip and palate worldwide.

  3. Treatment of patients with hand osteoarthritis : outcome measures, patient satisfaction, and economic evaluation

    NARCIS (Netherlands)

    Marks, Miriam

    2014-01-01

    The aim of this thesis was to investigate the limitations in daily life, outcome measures, clinical outcomes with the emphasis on patient satisfaction, and economic aspects of the treatment of hand osteoarthritis (OA). Patients with hand OA report severe restrictions in daily life, in particular in

  4. Cost-effectiveness analysis in severe mental illness : Outcome measures selection

    NARCIS (Netherlands)

    Stant, A. Dennis; Buskens, Erik; Jenner, Jack A.; Wiersma, Durk; TenVergert, Elisabeth M.

    Background: Most economic evaluations conducted in mental healthcare did not include widely recommended preference-based health outcomes like the QALY (Quality-Adjusted Life Years). Instead, studies have mainly been designed as cost-effectiveness analyses that include single outcome measures aimed

  5. Clinical Outcomes Measures for Assessment of Longevity in the Dental Implant Literature : ORONet Approach

    NARCIS (Netherlands)

    Bassi, Francesco; Carr, Alan B.; Chang, Ting-Ling; Estafanous, Emad; Garrett, Neal R.; Happonen, Risto-Pekka; Koka, Sreenivas; Laine, Juhani; Osswald, Martin; Reintsema, Harry; Rieger, Jana; Roumanas, Eleni; Salinas, Thomas J.; Stanford, Clark M.; Wolfaardt, Johan

    2013-01-01

    The Oral Rehabilitation Outcomes Network (ORONet) Longevity Working Group undertook a search of the literature from 1995 to 2009 on randomized controlled trials related to longevity of osseointegrated implants. Outcomes measures used in these studies were identified and subjected to the OMERACT

  6. The National Outcomes Measurement System for Pediatric Speech-Language Pathology

    Science.gov (United States)

    Mullen, Robert; Schooling, Tracy

    2010-01-01

    Purpose: The American Speech-Language-Hearing Association's (ASHA's) National Outcomes Measurement System (NOMS) was developed in the late 1990s. The primary purpose was to serve as a source of data for speech-language pathologists (SLPs) who found themselves called on to provide empirical evidence of the functional outcomes associated with their…

  7. Outcomes of bone density measurements in coeliac disease.

    Science.gov (United States)

    Bolland, Mark J; Grey, Andrew; Rowbotham, David S

    2016-01-29

    Some guidelines recommend that patients with newly diagnosed coeliac disease undergo bone density scanning. We assessed the bone density results in a cohort of patients with coeliac disease. We searched bone density reports over two 5-year periods in all patients from Auckland District Health Board (2008-12) and in patients under 65 years from Counties Manukau District Health Board (2009-13) for the term 'coeliac.' Reports for 137 adults listed coeliac disease as an indication for bone densitometry. The average age was 47 years, body mass index (BMI) 25 kg/m(2), and 77% were female. The median time between coeliac disease diagnosis and bone densitometry was 261 days. The average bone density Z-score was slightly lower than expected (Z-score -0.3 to 0.4) at the lumbar spine, total hip and femoral neck, but 88-93% of Z-scores at each site lay within the normal range. Low bone density was strongly related to BMI: the proportions with Z-score 30 kg/m(2) were 28%, 15%, 6% and 0% respectively. Average bone density was normal, suggesting that bone density measurement is not indicated routinely in coeliac disease, but could be considered on a case-by-case basis for individuals with strong risk factors for fracture.

  8. Optimized Clustering Estimators for BAO Measurements Accounting for Significant Redshift Uncertainty

    Energy Technology Data Exchange (ETDEWEB)

    Ross, Ashley J. [Portsmouth U., ICG; Banik, Nilanjan [Fermilab; Avila, Santiago [Madrid, IFT; Percival, Will J. [Portsmouth U., ICG; Dodelson, Scott [Fermilab; Garcia-Bellido, Juan [Madrid, IFT; Crocce, Martin [ICE, Bellaterra; Elvin-Poole, Jack [Jodrell Bank; Giannantonio, Tommaso [Cambridge U., KICC; Manera, Marc [Cambridge U., DAMTP; Sevilla-Noarbe, Ignacio [Madrid, CIEMAT

    2017-05-15

    We determine an optimized clustering statistic to be used for galaxy samples with significant redshift uncertainty, such as those that rely on photometric redshifts. To do so, we study the BAO information content as a function of the orientation of galaxy clustering modes with respect to their angle to the line-of-sight (LOS). The clustering along the LOS, as observed in a redshift-space with significant redshift uncertainty, has contributions from clustering modes with a range of orientations with respect to the true LOS. For redshift uncertainty $\\sigma_z \\geq 0.02(1+z)$ we find that while the BAO information is confined to transverse clustering modes in the true space, it is spread nearly evenly in the observed space. Thus, measuring clustering in terms of the projected separation (regardless of the LOS) is an efficient and nearly lossless compression of the signal for $\\sigma_z \\geq 0.02(1+z)$. For reduced redshift uncertainty, a more careful consideration is required. We then use more than 1700 realizations of galaxy simulations mimicking the Dark Energy Survey Year 1 sample to validate our analytic results and optimized analysis procedure. We find that using the correlation function binned in projected separation, we can achieve uncertainties that are within 10 per cent of of those predicted by Fisher matrix forecasts. We predict that DES Y1 should achieve a 5 per cent distance measurement using our optimized methods. We expect the results presented here to be important for any future BAO measurements made using photometric redshift data.

  9. Measurement and control of bias in patient reported outcomes using multidimensional item response theory.

    Science.gov (United States)

    Dowling, N Maritza; Bolt, Daniel M; Deng, Sien; Li, Chenxi

    2016-05-26

    Patient-reported outcome (PRO) measures play a key role in the advancement of patient-centered care research. The accuracy of inferences, relevance of predictions, and the true nature of the associations made with PRO data depend on the validity of these measures. Errors inherent to self-report measures can seriously bias the estimation of constructs assessed by the scale. A well-documented disadvantage of self-report measures is their sensitivity to response style (RS) effects such as the respondent's tendency to select the extremes of a rating scale. Although the biasing effect of extreme responding on constructs measured by self-reported tools has been widely acknowledged and studied across disciplines, little attention has been given to the development and systematic application of methodologies to assess and control for this effect in PRO measures. We review the methodological approaches that have been proposed to study extreme RS effects (ERS). We applied a multidimensional item response theory model to simultaneously estimate and correct for the impact of ERS on trait estimation in a PRO instrument. Model estimates were used to study the biasing effects of ERS on sum scores for individuals with the same amount of the targeted trait but different levels of ERS. We evaluated the effect of joint estimation of multiple scales and ERS on trait estimates and demonstrated the biasing effects of ERS on these trait estimates when used as explanatory variables. A four-dimensional model accounting for ERS bias provided a better fit to the response data. Increasing levels of ERS showed bias in total scores as a function of trait estimates. The effect of ERS was greater when the pattern of extreme responding was the same across multiple scales modeled jointly. The estimated item category intercepts provided evidence of content independent category selection. Uncorrected trait estimates used as explanatory variables in prediction models showed downward bias. A

  10. Analyzing repeated measures data on individuals nested within groups: accounting for dynamic group effects.

    Science.gov (United States)

    Bauer, Daniel J; Gottfredson, Nisha C; Dean, Danielle; Zucker, Robert A

    2013-03-01

    Researchers commonly collect repeated measures on individuals nested within groups such as students within schools, patients within treatment groups, or siblings within families. Often, it is most appropriate to conceptualize such groups as dynamic entities, potentially undergoing stochastic structural and/or functional changes over time. For instance, as a student progresses through school, more senior students matriculate while more junior students enroll, administrators and teachers may turn over, and curricular changes may be introduced. What it means to be a student within that school may thus differ from 1 year to the next. This article demonstrates how to use multilevel linear models to recover time-varying group effects when analyzing repeated measures data on individuals nested within groups that evolve over time. Two examples are provided. The 1st example examines school effects on the science achievement trajectories of students, allowing for changes in school effects over time. The 2nd example concerns dynamic family effects on individual trajectories of externalizing behavior and depression. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  11. Demonstration of an automated electromanometer for measurement of solution in accountability vessels in the Tokai Reprocessing Plant (part II)

    International Nuclear Information System (INIS)

    Yamonouchi, T.; Fukuari, Y.; Hayashi, M.; Komatsu, M.; Suyama, N.; Uchida, T.

    1982-01-01

    This report describes the results of an operational field test of the automated electromanometer system installed at the input accountability vessel (251V10) and the plutonium product accountability vessel (266V23) in the Tokai Reprocessing Plant. This system has been in use since September 1979 when it was installed in the PNC plant by BNL as part of Task-E, one of the thirteen tasks, in the Tokai Advanced Safeguards Technology Exercise (TASTEX) program. The first report on the progress of this task was published by S. Suda, et al., in the Proceedings of the INMM 22nd Annual Meeting. In this paper, further results of measurement and data analysis are shown. Also, the reliability and applicability of this instrument for accountability, safeguards, and process control purposes are investigated using the data of 106 batches for 251V10 and 40 batches for 266V23 obtained during two campaigns in 1981. There were small but significant differences relative to the plant's measurements for both vessels of 251V10 and 266V23; however, the difference for 251V10 was slightly decreased in the latest vessel calibration. Initially, there were many spurious signals originating with the raw data caused by a software error in the system. However, almost normal conditions were obtained after corrections of the program were made

  12. Semi-Competing Risks Data Analysis: Accounting for Death as a Competing Risk When the Outcome of Interest Is Nonterminal.

    Science.gov (United States)

    Haneuse, Sebastien; Lee, Kyu Ha

    2016-05-01

    Hospital readmission is a key marker of quality of health care. Notwithstanding its widespread use, however, it remains controversial in part because statistical methods used to analyze readmission, primarily logistic regression and related models, may not appropriately account for patients who die before experiencing a readmission event within the time frame of interest. Toward resolving this, we describe and illustrate the semi-competing risks framework, which refers to the general setting where scientific interest lies with some nonterminal event (eg, readmission), the occurrence of which is subject to a terminal event (eg, death). Although several statistical analysis methods have been proposed for semi-competing risks data, we describe in detail the use of illness-death models primarily because of their relation to well-known methods for survival analysis and the availability of software. We also describe and consider in detail several existing approaches that could, in principle, be used to analyze semi-competing risks data, including composite end point and competing risks analyses. Throughout we illustrate the ideas and methods using data on N=49 763 Medicare beneficiaries hospitalized between 2011 and 2013 with a principle discharge diagnosis of heart failure. © 2016 American Heart Association, Inc.

  13. A hierarchy of patient-reported outcome measures for meta-analysis of knee osteoarthritis trials

    DEFF Research Database (Denmark)

    Juhl, Carsten Bogh; Lund, Hans; Guyatt, GH

    2010-01-01

    Title A hierarchy of patient-reported outcome measures for meta-analysis of knee osteoarthritis trials: empirical evidence from a survey of high impact journals Objective To develop a prioritized list for extracting patient-reported outcomes (PROs) measuring pain and disability for meta-analyses ......Title A hierarchy of patient-reported outcome measures for meta-analysis of knee osteoarthritis trials: empirical evidence from a survey of high impact journals Objective To develop a prioritized list for extracting patient-reported outcomes (PROs) measuring pain and disability for meta...... composite disability scores. Conclusions As choosing the most favorable PROs from individual trials can overestimate the effect compared to a systematic approach, using a prioritized list as presented in this study is recommended to reduce reviewer's likelihood of biased selection of PROs in meta-analyses....

  14. Measuring energy rebound effect in the Chinese economy: An economic accounting approach

    International Nuclear Information System (INIS)

    Lin, Boqiang; Du, Kerui

    2015-01-01

    Estimating the magnitude of China's economy-wide rebound effect has attracted much attention in recent years. Most existing studies measure the rebound effect through the additional energy consumption from technological progress. However, in general technological progress is not equivalent to energy efficiency improvement. Consequently, their estimation may be misleading. To overcome the limitation, this paper develops an alternative approach for estimating energy rebound effect. Based on the proposed approach, China's economy-wide energy rebound effect is revisited. The empirical result shows that during the period 1981–2011 the rebound effects in China are between 30% and 40%, with an average value of 34.3%. - Highlights: • This paper develops an alternative approach for estimating energy rebound effect. • The proposed approach is based on the multilevel–hierarchical (M–H) IDA model. • The energy rebound effects in China are estimated between 30% and 40%

  15. Total neutron-counting plutonium inventory measurement systems (PIMS) and their potential application to near real time materials accountancy (NRTMA)

    International Nuclear Information System (INIS)

    Driscall, I.; Fox, G.H.; Orr, C.H.; Whitehouse, K.R.

    1988-01-01

    A radiometric method of determining the inventory of an operating plutonium plant is described. An array of total neutron counters distributed across the plant is used to estimate hold-up at each plant item. Corrections for the sensitivity of detectors to plutonium in adjacent plant items are achieved through a matrix approach. This paper describes our experience in design, calibration and operation of a Plutonium Inventory Measurement System (PIMS) on an oxalate precipitation plutonium finishing line. Data from a recent trial of Near-Real-Time Materials Accounting (NRTMA) using the PIMS are presented and used to illustrate its present performance and problem areas. The reader is asked to consider what role PIMS might have in future accountancy systems

  16. Developing a General Outcome Measure of Growth in Movement for Infants and Toddlers.

    Science.gov (United States)

    Greenwood, Charles R.; Luze, Gayle J.; Cline, Gabriel; Kuntz, Susan; Leitschuh, Carol

    2002-01-01

    The development of an experimental measure for assessing growth in movement in children (ages birth-3) is described. Results from the use of the Movement General Outcome Measurement with 29 infants and toddlers demonstrated the feasibility of the measure. The 6-minute assessment was found reliable in terms of inter-observer agreement. (Contains…

  17. Use of the measure your medical outcome profile (MYMOP2 and W-BQ12 (Well-Being outcomes measures to evaluate chiropractic treatment: an observational study

    Directory of Open Access Journals (Sweden)

    Polus Barbara I

    2011-03-01

    Full Text Available Abstract Background The objective was to assess the use of the Measure Yourself Medical Outcome Profile (MYMOP2 and W-BQ12 well-being questionnaire for measuring clinical change associated with a course of chiropractic treatment. Methods Chiropractic care of the patients involved spinal manipulative therapy (SMT, mechanically assisted techniques, soft tissue therapy, and physiological therapeutic devices. Outcome measures used were MYMOP2 and the Well-Being Questionnaire 12 (W-BQ12. Results Statistical and clinical significant changes were demonstrated with W-BQ12 and MYMOP2. Conclusions The study demonstrated that MYMOP2 was responsive to change and may be a useful instrument for assessing clinical changes among chiropractic patients who present with a variety of symptoms and clinical conditions.

  18. Functional outcome measures in a surgical model of hip osteoarthritis in dogs

    OpenAIRE

    Little, Dianne; Johnson, Stephen; Hash, Jonathan; Olson, Steven A.; Estes, Bradley T.; Moutos, Franklin T.; Lascelles, B. Duncan X.; Guilak, Farshid

    2016-01-01

    Background The hip is one of the most common sites of osteoarthritis in the body, second only to the knee in prevalence. However, current animal models of hip osteoarthritis have not been assessed using many of the functional outcome measures used in orthopaedics, a characteristic that could increase their utility in the evaluation of therapeutic interventions. The canine hip shares similarities with the human hip, and functional outcome measures are well documented in veterinary medicine, pr...

  19. Psychometric evaluation of self-report outcome measures for prosthetic applications

    OpenAIRE

    Hafner, Brian J.; Morgan, Sara J.; Askew, Robert L.; Salem, Rana

    2016-01-01

    Documentation of clinical outcomes is increasingly expected in delivery of prosthetic services and devices. However, many outcome measures suitable for use in clinical care and research have not been psychometrically tested with prosthesis users. The aim of this study was to determine test-retest reliability, mode-of-administration (MoA) equivalence, standard error of measurement (SEM), and minimal detectable change (MDC) of standardized, self-report instruments that assess constructs of impo...

  20. Development and evaluation of an Individualized Outcome Measure (IOM) for randomized controlled trials in mental health.

    Science.gov (United States)

    Pesola, Francesca; Williams, Julie; Bird, Victoria; Freidl, Marion; Le Boutillier, Clair; Leamy, Mary; Macpherson, Rob; Slade, Mike

    2015-12-01

    Pre-defined, researcher-selected outcomes are routinely used as the clinical end-point in randomized controlled trials (RCTs); however, individualized approaches may be an effective way to assess outcome in mental health research. The present study describes the development and evaluation of the Individualized Outcome Measure (IOM), which is a patient-specific outcome measure to be used for RCTs of complex interventions. IOM was developed using a narrative review, expert consultation and piloting with mental health service users (n = 20). The final version of IOM comprises two components: Goal Attainment (GA) and Personalized Primary Outcome (PPO). For GA, patients identify one relevant goal at baseline and rate its attainment at follow-up. For PPO, patients choose an outcome domain related to their goal from a pre-defined list at baseline, and complete a standardized questionnaire assessing the chosen outcome domain at baseline and follow-up. A feasibility study indicated that IOM had adequate completion (89%) and acceptability (96%) rates in a clinical sample (n = 84). IOM was then evaluated in a RCT (ISRCTN02507940). GA and PPO components were associated with each other and with the trial primary outcome. The use of the PPO component of IOM as the primary outcome could be considered in future RCTs. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  1. Conservation covenants on private land: issues with measuring and achieving biodiversity outcomes in Australia.

    Science.gov (United States)

    Fitzsimons, James A; Carr, C Ben

    2014-09-01

    Conservation covenants and easements have become essential tools to secure biodiversity outcomes on private land, and to assist in meeting international protection targets. In Australia, the number and spatial area of conservation covenants has grown significantly in the past decade. Yet there has been little research or detailed policy analysis of conservation covenanting in Australia. We sought to determine how conservation covenanting agencies were measuring the biodiversity conservation outcomes achieved on covenanted properties, and factors inhibiting or contributing to measuring these outcomes. In addition, we also investigated the drivers and constraints associated with actually delivering the biodiversity outcomes, drawing on detailed input from covenanting programs. Although all conservation covenanting programs had the broad aim of maintaining or improving biodiversity in their covenants in the long term, the specific stated objectives of conservation covenanting programs varied. Programs undertook monitoring and evaluation in different ways and at different spatial and temporal scales. Thus, it was difficult to determine the extent Australian conservation covenanting agencies were measuring the biodiversity conservation outcomes achieved on covenanted properties on a national scale. Lack of time available to covenantors to undertake management was one of the biggest impediments to achieving biodiversity conservation outcomes. A lack of financial resources and human capital to monitor, knowing what to monitor, inconsistent monitoring methodologies, a lack of benchmark data, and length of time to achieve outcomes were all considered potential barriers to monitoring the biodiversity conservation outcomes of conservation covenants.

  2. Tritium accountancy

    International Nuclear Information System (INIS)

    Avenhaus, R.; Spannagel, G.

    1995-01-01

    Conventional accountancy means that for a given material balance area and a given interval of time the tritium balance is established so that at the end of that interval of time the book inventory is compared with the measured inventory. In this way, an optimal effectiveness of accountancy is achieved. However, there are still further objectives of accountancy, namely the timely detection of anomalies as well as the localization of anomalies in a major system. It can be shown that each of these objectives can be optimized only at the expense of the others. Recently, Near-Real-Time Accountancy procedures have been studied; their methodological background as well as their merits will be discussed. (orig.)

  3. Psychometric properties of the Spanish version of the Clinical Outcomes in Routine Evaluation – Outcome Measure

    Directory of Open Access Journals (Sweden)

    Trujillo A

    2016-06-01

    Full Text Available Adriana Trujillo,1,2 Guillem Feixas,1,2 Arturo Bados,1 Eugeni García-Grau,1 Marta Salla,1 Joan Carles Medina,1 Adrián Montesano,1,2 José Soriano,3 Leticia Medeiros-Ferreira,4 Josep Cañete,5 Sergi Corbella,6 Antoni Grau,7 Fernando Lana,8 Chris Evans9 1Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology, 2Institute for Brain, Cognition and Behaviour, University of Barcelona, 3Hospital of the Holy Cross and Saint Paul, 4Nou Barris Mental Health Center, Barcelona, 5Hospital of Mataró, Sanitary Consortium of Maresme, Mataró, 6FPCEE, Blanquerna, Universitat Ramon Llull, 7Institute of Eating Disorders, Barcelona, 8MAR Health Park, CAEMIL, Santa Coloma de Gramenet, Spain; 9East London NHS Foundation Trust, NPDDNet, London, UK Objective: The objective of this paper is to assess the reliability and validity of the Spanish translation of the Clinical Outcomes in Routine Evaluation – Outcome Measure, a 34-item self-report questionnaire that measures the client’s status in the domains of Subjective well-being, Problems/Symptoms, Life functioning, and Risk.Method: Six hundred and forty-four adult participants were included in two samples: the clinical sample (n=192 from different mental health and primary care centers; and the nonclinical sample (n=452, which included a student and a community sample.Results: The questionnaire showed good acceptability and internal consistency, appropriate test–retest reliability, and acceptable convergent validity. Strong differentiation between clinical and nonclinical samples was found. As expected, the Risk domain had different characteristics than other domains, but all findings were comparable with the UK referential data. Cutoff scores were calculated for clinical significant change assessment.Conclusion: The Spanish version of the Clinical Outcomes in Routine Evaluation – Outcome Measure showed acceptable psychometric properties, providing support for using the

  4. Engaging the hearts and minds of clinicians in outcome measurement – the UK rehabilitation outcomes collaborative approach

    Science.gov (United States)

    2012-01-01

    Purpose This article explores the rationale for choosing the instruments included within the UK Rehabilitation Outcomes Collaborative (UKROC) data set. Using one specialist neuro-rehabilitation unit as an exemplar service, it describes an approach to engaging the hearts and minds of clinicians in recording the data. Key messages and implications Measures included within a national data set for rehabilitation should be psychometrically robust and feasible to use in routine clinical practice; they should also support clinical decision-making so that clinicians actually want to use them. Learning from other international casemix models and benchmarking data sets, the UKROC team has developed a cluster of measures to inform the development of effective and cost-efficient rehabilitation services. These include measures of (1) “needs” for rehabilitation (complexity), (2) inputs provided to meet those needs (nursing and therapy intervention), and (3) outcome, including the attainment of personal goals as well as gains in functional independence. Conclusions By integrating the use of the data set measures in everyday clinical practice, we have achieved a very high rate of compliance with data collection. However, staff training and ongoing commitment from senior staff and managers are critical to the maintenance of effort required to provide assurance of data quality in the longer term. PMID:22506959

  5. Physical outcome measures for conductive and mixed hearing loss treatment: A systematic review.

    Science.gov (United States)

    Johansson, M L; Tysome, J R; Hill-Feltham, P; Hodgetts, W E; Ostevik, A; McKinnon, B J; Monksfield, P; Sockalingam, R; Wright, T

    2018-05-07

    The number of potential options for rehabilitation of patients with conductive or mixed hearing loss is continually expanding. To be able to inform patients and other stakeholders there is a need to identify and develop patient-centred outcomes for treatment of hearing loss. To identify outcome measures in the physical core area used when reporting the outcome after treatment of conductive and mixed hearing loss in adult patients. Systematic review. Systematic review of literature related to reported physical outcome measures after treatment of mixed or conductive hearing loss without restrictions regarding type of intervention, treatment or device. Any measure reporting the physical outcome after treatment or intervention of mixed or conductive hearing loss was sought and categorised. The physical outcomes measures that had been extracted were then grouped into domains. The literature search resulted in the identification of 1,434 studies, of which 153 were selected for inclusion in the review. The majority (57%) of papers reported results from middle ear surgery, with the remainder reporting results from either bone conduction hearing devices or middle ear implants. Outcomes related to complications were categorised into 17 domains, whereas outcomes related to treatment success was categorised in 22 domains. The importance of these domains to patients and other stakeholders needs to be further explored in order to establish which of these domains are most relevant to interventions for conductive or mixed hearing loss. This will allow us to then assess which outcomes measures are most suitable for inclusion in the core set This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  6. The uses of outcome measures within multidisciplinary early childhood intervention services: a systematic review.

    Science.gov (United States)

    Calder, Samuel; Ward, Roslyn; Jones, Megan; Johnston, Jenelle; Claessen, Mary

    2017-07-18

    Purpose of the article: To review the use of outcome measures, across the domains of activity, participation, and environment, within multidisciplinary early childhood intervention services. A systematic literature search was undertaken that included four electronic databases: Medline, CINAHL, EMBASE, and the Cochrane Library and Cochrane Database of Systematic Review. Inclusion criteria were age 0-24 months, having or at risk of a developmental disability, in receipt of multidisciplinary early childhood intervention services, and included outcome measures across all domains of the International Classification of Functioning-Child & Youth (ICF-CY). Only peer-reviewed journal articles were considered. Eligible studies were coded using the Oxford Levels of Evidence. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) Scale for randomised controlled trials and the QualSyst for non-randomised control trials. Of the total of 5764 records identified, 10 were considered to meet inclusion criteria. Fourteen outcome measures were identified, addressing the domains of activity, participation, and environment. Of these, eight have been recommended in the early intervention literature. While the methodological quality of the 10 studies varied, these papers make a contribution to the body of research that acknowledges the role of routine and enriched environments. Implications for Rehabilitation Core practice elements of multidisciplinary early childhood intervention services indicate it is necessary to select outcome measures framed within the International Classification of Functioning-Child & Youth to inform clinical decision-making for measuring intervention effectiveness across the domains of activity, participation and environment. Of the identified measures, three (Canadian Occupational Performance Measure, Pediatric Evaluation of Disability Inventory, and Goal Attainment Scaling) are well-established and identified in the literature as

  7. Positive psychology outcome measures for family caregivers of people living with dementia: a systematic review.

    Science.gov (United States)

    Stansfeld, Jacki; Stoner, Charlotte R; Wenborn, Jennifer; Vernooij-Dassen, Myrra; Moniz-Cook, Esme; Orrell, Martin

    2017-08-01

    Family caregivers of people living with dementia can have both positive and negative experiences of caregiving. Despite this, existing outcome measures predominately focus on negative aspects of caregiving such as burden and depression. This review aimed to evaluate the development and psychometric properties of existing positive psychology measures for family caregivers of people living with dementia to determine their potential utility in research and practice. A systematic review of positive psychology outcome measures for family caregivers of people with dementia was conducted. The databases searched were as follows: PsychINFO, CINAHL, MEDLINE, EMBASE, and PubMed. Scale development papers were subject to a quality assessment to appraise psychometric properties. Twelve positive outcome measures and six validation papers of these scales were identified. The emerging constructs of self-efficacy, spirituality, resilience, rewards, gain, and meaning are in line with positive psychology theory. There are some robust positive measures in existence for family caregivers of people living with dementia. However, lack of reporting of the psychometric properties hindered the quality assessment of some outcome measures identified in this review. Future research should aim to include positive outcome measures in interventional research to facilitate a greater understanding of the positive aspects of caregiving and how these contribute to well-being.

  8. Associations between nine family dinner frequency measures and child weight, dietary and psychosocial outcomes

    Science.gov (United States)

    Fulkerson, Jayne A.; Friend, Sarah E.; Neumark-Sztainer, Dianne

    2015-01-01

    Background Family meal frequency has been consistently and significantly associated with positive youth dietary and psychosocial outcomes but less consistently associated with weight outcomes. Family meal frequency measurement has varied widely and it is unclear how this variation may impact relationships with youth weight, dietary, and psychosocial outcomes. Objective This study assesses how five parent/caregiver-reported and four child-reported family dinner frequency measures correlate with each other and are associated with health-related outcomes. Design/Participants This secondary, cross-sectional analysis uses baseline, parent/caregiver (n=160) and 8–12 year old child (n=160) data from the Healthy Home Offerings via the Mealtime Environment (HOME) Plus trial (collected 2011–2012). Data were obtained from objective measurements, dietary recall interviews, and psychosocial surveys. Outcome measures Outcomes included child body mass index z-scores (BMIz), fruit, vegetable and sugar-sweetened beverage intake, dietary quality (Healthy Eating Index-2010 [HEI-2010]), family connectedness, and meal conversations. Statistical analyses performed Pearson correlations and general linear models were used to assess associations between family dinner frequency measures and outcomes. Results All family dinner frequency measures had comparable means and were correlated within and across parent/caregiver- and child-reporters (r=0.17–0.94, pdinner frequency measures were significantly associated with BMIz scores and 100% were significantly associated with fruit/vegetable intake and HEI-2010. In adjusted models, most significant associations with dietary and psychosocial outcomes remained but associations with child BMIz remained significant only for parent/caregiver- (β±SE= −0.07±0.03; pdinner frequency measures asking about ‘sitting and eating’ dinner. Conclusions In spite of phrasing variations in family dinner frequency measures (e.g., which family members

  9. Development and validation of MyLifeTracker: a routine outcome measure for youth mental health

    Directory of Open Access Journals (Sweden)

    Kwan B

    2018-04-01

    Full Text Available Benjamin Kwan,1 Debra J Rickwood,1,2 Nic R Telford2 1Faculty of Health, University of Canberra, Bruce, ACT, 2headspace National Youth Mental Health Foundation, Melbourne, VIC, Australia Purpose: Routine outcome measures are now being designed for session-by-session use, with emphasis on clinically meaningful items and sensitivity to change. Despite an increasing mental health service focus for young people aged 12–25 years, there is a lack of outcome measures that are designed to be used across this age group. Consequently, MyLifeTracker (MLT was developed as a brief mental health outcome measure designed for young people for routine use. It consists of the following five items targeting areas of importance to young people: general well-being, day-to-day activities, relationships with friends, relationships with family, and general coping. Participants and methods: The measure was tested with 75,893 young people aged 12–25 years attending headspace centers across Australia for mental health-related issues. Results: MLT showed a robust unidimensional factor structure and appropriate reliability. It exhibited good concurrent validity against well-validated measures of psychological distress, well-being, functioning, and life satisfaction. The measure was further demonstrated to be sensitive to change. Conclusion: MLT provides a psychometrically sound mental health outcome measure for young people. The measure taps into items that are meaningful to young people and provides an additional clinical support tool for clinicians and clients during therapy. The measure is brief and easy to use and has been incorporated into an electronic system that routinely tracks session-by-session change and produces time-series charts for the ease of use and interpretation. Keywords: MyLifeTracker, youth mental health, routine outcome measure, routine outcome monitoring, adolescent and young adult

  10. Determinants of 25(OH)D sufficiency in obese minority children: selecting outcome measures and analytic approaches.

    Science.gov (United States)

    Zhou, Ping; Schechter, Clyde; Cai, Ziyong; Markowitz, Morri

    2011-06-01

    To highlight complexities in defining vitamin D sufficiency in children. Serum 25-(OH) vitamin D [25(OH)D] levels from 140 healthy obese children age 6 to 21 years living in the inner city were compared with multiple health outcome measures, including bone biomarkers and cardiovascular risk factors. Several statistical analytic approaches were used, including Pearson correlation, analysis of covariance (ANCOVA), and "hockey stick" regression modeling. Potential threshold levels for vitamin D sufficiency varied by outcome variable and analytic approach. Only systolic blood pressure (SBP) was significantly correlated with 25(OH)D (r = -0.261; P = .038). ANCOVA revealed that SBP and triglyceride levels were statistically significant in the test groups [25(OH)D 25 ng/mL]. ANCOVA also showed that only children with severe vitamin D deficiency [25(OH)D model regression analyses found evidence of a threshold level in SBP, with a 25(OH)D breakpoint of 27 ng/mL, along with a 25(OH)D breakpoint of 18 ng/mL for triglycerides, but no relationship between 25(OH)D and parathyroid hormone. Defining vitamin D sufficiency should take into account different vitamin D-related health outcome measures and analytic methodologies. Copyright © 2011 Mosby, Inc. All rights reserved.

  11. Improving the Accuracy of Satellite Sea Surface Temperature Measurements by Explicitly Accounting for the Bulk-Skin Temperature Difference

    Science.gov (United States)

    Castro, Sandra L.; Emery, William J.

    2002-01-01

    The focus of this research was to determine whether the accuracy of satellite measurements of sea surface temperature (SST) could be improved by explicitly accounting for the complex temperature gradients at the surface of the ocean associated with the cool skin and diurnal warm layers. To achieve this goal, work centered on the development and deployment of low-cost infrared radiometers to enable the direct validation of satellite measurements of skin temperature. During this one year grant, design and construction of an improved infrared radiometer was completed and testing was initiated. In addition, development of an improved parametric model for the bulk-skin temperature difference was completed using data from the previous version of the radiometer. This model will comprise a key component of an improved procedure for estimating the bulk SST from satellites. The results comprised a significant portion of the Ph.D. thesis completed by one graduate student and they are currently being converted into a journal publication.

  12. Fatigue is a reliable, sensitive and unique outcome measure in rheumatoid arthritis.

    LENUS (Irish Health Repository)

    Minnock, Patricia

    2009-12-01

    Fatigue is an important symptom in patients with RA. Measurement of fatigue in clinical trials and in clinical practice requires scales that are reproducible, sensitive to change and practical. This study examined the reliability and sensitivity to change of fatigue and its relative independence as an outcome measure in RA.

  13. Outcomes Measurement in Voice Disorders: Application of an Acoustic Index of Dysphonia Severity

    Science.gov (United States)

    Awan, Shaheen N.; Roy, Nelson

    2009-01-01

    Purpose: The purpose of this experiment was to assess the ability of an acoustic model composed of both time-based and spectral-based measures to track change following voice disorder treatment and to serve as a possible treatment outcomes measure. Method: A weighted, four-factor acoustic algorithm consisting of shimmer, pitch sigma, the ratio of…

  14. The Benchmarking Capacity of a General Outcome Measure of Academic Language in Science and Social Studies

    Science.gov (United States)

    Mooney, Paul; Lastrapes, Renée E.

    2016-01-01

    The amount of research evaluating the technical merits of general outcome measures of science and social studies achievement is growing. This study targeted criterion validity for critical content monitoring. Questions addressed the concurrent criterion validity of alternate presentation formats of critical content monitoring and the measure's…

  15. Test-Retest Reliability of Dual-Task Outcome Measures in People With Parkinson Disease

    NARCIS (Netherlands)

    Strouwen, C.; Molenaar, E.A.; Keus, S.H.; Munks, L.; Bloem, B.R.; Nieuwboer, A.

    2016-01-01

    BACKGROUND: Dual-task (DT) training is gaining ground as a physical therapy intervention in people with Parkinson disease (PD). Future studies evaluating the effect of such interventions need reliable outcome measures. To date, the test-retest reliability of DT measures in patients with PD remains

  16. Joint ANSI-INMM 8.1: Nuclear Regulatory Commission study of uranium hexafluoride cylinder material accountability bulk measurements

    International Nuclear Information System (INIS)

    Pontius, P.E.; Doher, L.W.

    1977-01-01

    This paper reports the progress to date in a demonstration of the procedures in ANSI N15.18-1975, ''Mass Calibration Techniques for Nuclear Material Control,'' sponsored and funded by the Nuclear Regulatory Commission (NRC). The philosophy of mass measurement as a production process, as promulgated in ANSI N15.18-1975, is reviewed. Special emphasis is placed on the use of artifact Reference Mass Standards (RMS) as references for uranium hexafluoride (UF 6 ) calibration and bulk measurement processes. The history of the creation of the artifact concept and its adoption by ANSI N15.18-1975 and the Nuclear Regulatory Commission is narrated. The program now under way is specifically described; including descriptions of the RMS, their calibration, and the assignment of uncertainties to them by the National Bureau of Standards (NBS). Instrument tests, in-house standards (IHS), and assignment of values relative to the RMS-NBS values at nuclear facilities which measure UF 6 cylinders are described. Comparisons and the data base are detailed to provide realistic measurement process parameters associated with accountable transfer of UF 6 . The as yet uncompleted part of the demonstration is described, that is, to further close the measurement loop by verification both between and within facilities

  17. Patient-Oriented Eczema Measure (POEM), a core instrument to measure symptoms in clinical trials: a Harmonising Outcome Measures for Eczema (HOME) statement

    OpenAIRE

    Spuls, Ph.I.; Gerbens, L.A.A.; Simpson, E.; Apfelbacher, C.J.; Chalmers, J.R.; Thomas, K.S.; Prinsen, C.A.C.; Kobyletzki, L.B. von; Singh, J.A.; Williams, Hywel C.; Schmitt, J.

    2017-01-01

    Background: The Harmonising Outcome Measures for Eczema (HOME) initiative has defined four core outcome domains for a core outcome set (COS) to be measured in all atopic eczema (AE) trials to ensure cross-trial comparison: clinical signs, symptoms, quality of life and longterm control.\\ud Objectives: The aim of this paper is to report on the consensus process that was used to select the core instrument to consistently assess symptoms in all future AE trials.\\ud Methods: Following the HOME roa...

  18. Measuring the Effects of Self-Awareness: Construction of the Self-Awareness Outcomes Questionnaire

    Directory of Open Access Journals (Sweden)

    Anna Sutton

    2016-11-01

    Full Text Available Dispositional self-awareness is conceptualized in several different ways, including insight, reflection, rumination and mindfulness, with the latter in particular attracting extensive attention in recent research. While self-awareness is generally associated with positive psychological well-being, these different conceptualizations are also each associated with a range of unique outcomes. This two part, mixed methods study aimed to advance understanding of dispositional self-awareness by developing a questionnaire to measure its outcomes. In Study 1, expert focus groups categorized and extended an initial pool of potential items from previous research. In Study 2, these items were reduced to a 38 item self-report questionnaire with four factors representing three beneficial outcomes (reflective self-development, acceptance and proactivity and one negative outcome (costs. Regression of these outcomes against self-awareness measures revealed that self-reflection and insight predicted beneficial outcomes, rumination predicted reduced benefits and increased costs, and mindfulness predicted both increased proactivity and costs. These studies help to refine the self-awareness concept by identifying the unique outcomes associated with the concepts of self-reflection, insight, reflection, rumination and mindfulness. It can be used in future studies to evaluate and develop awareness-raising techniques to maximize self-awareness benefits while minimizing related costs.

  19. Surrogacy assessment using principal stratification when surrogate and outcome measures are multivariate normal.

    Science.gov (United States)

    Conlon, Anna S C; Taylor, Jeremy M G; Elliott, Michael R

    2014-04-01

    In clinical trials, a surrogate outcome variable (S) can be measured before the outcome of interest (T) and may provide early information regarding the treatment (Z) effect on T. Using the principal surrogacy framework introduced by Frangakis and Rubin (2002. Principal stratification in causal inference. Biometrics 58, 21-29), we consider an approach that has a causal interpretation and develop a Bayesian estimation strategy for surrogate validation when the joint distribution of potential surrogate and outcome measures is multivariate normal. From the joint conditional distribution of the potential outcomes of T, given the potential outcomes of S, we propose surrogacy validation measures from this model. As the model is not fully identifiable from the data, we propose some reasonable prior distributions and assumptions that can be placed on weakly identified parameters to aid in estimation. We explore the relationship between our surrogacy measures and the surrogacy measures proposed by Prentice (1989. Surrogate endpoints in clinical trials: definition and operational criteria. Statistics in Medicine 8, 431-440). The method is applied to data from a macular degeneration study and an ovarian cancer study.

  20. Heterogeneity of wound outcome measures in RCTs of treatments for VLUs: a systematic review.

    Science.gov (United States)

    Gethin, G; Killeen, F; Devane, D

    2015-05-01

    Venous leg ulcers (VLUs) affect up to 4% of the population aged over 65 years. Outcomes of randomised controlled trials (RCTs) in VLUs are important to guide clinical and resource decision making. Our objective was to identify what endpoints and wound bed outcomes were assessed in RCTs in VLUs; how these were assessed and what reference was made to validity and reliability of methods used. A systematic review of all full text RCTs, published in English, from 1998-2013. Our criteria were met by 102 studies. There were 78 different endpoints recorded, the majority (n=34) related to healing and were evaluated at 12 different times points. Size was the most frequently reported outcome measure (n=99), with photographs, tissue type, exudate, odour and pain also recorded. There was poor reporting of methods used to assess outcomes. Visual analogue scales predominated as a method of assessment, but 95% of studies made no reference to the validity or reliability of assessment methods. Future research in VLUs requires standards for measuring outcomes with acceptable inter-rater reliability and validated measures of patient-reported outcomes.

  1. Accountability in public health units: using a modified nominal group technique to develop a balanced scorecard for performance measurement.

    Science.gov (United States)

    Robinson, Victoria A; Hunter, Duncan; Shortt, Samuel E D

    2003-01-01

    Little attention has been paid to the need for accountability instruments applicable across all health units in the public health system. One tool, the balanced scorecard was created for industry and has been successfully adapted for use in Ontario hospitals. It consists of 4 quadrants: financial performance, outcomes, customer satisfaction and organizational development. The aim of the present study was to determine if a modified nominal group technique could be used to reach consensus among public health unit staff and public health specialists in Ontario about the components of a balanced scorecard for public health units. A modified nominal group technique consensus method was used with the public health unit staff in 6 Eastern Ontario health units (n=65) and public health specialists (n=18). 73.8% of the public health unit personnel from all six health units in the eastern Ontario region participated in the survey of potential indicators. A total of 74 indicators were identified in each of the 4 quadrants: program performance (n=44); financial performance (n=11); public perceptions (n=11); and organizational performance (n=8). The modified nominal group technique was a successful method of incorporating the views of public health personnel and specialists in the development of a balanced scorecard for public health.

  2. A systematic review of measurement properties of patient reported outcome measures in psoriatic arthritis: A GRAPPA-OMERACT initiative.

    Science.gov (United States)

    Højgaard, Pil; Klokker, Louise; Orbai, Ana-Maria; Holmsted, Kim; Bartels, Else M; Leung, Ying Ying; Goel, Niti; de Wit, Maarten; Gladman, Dafna D; Mease, Philip; Dreyer, Lene; Kristensen, Lars E; FitzGerald, Oliver; Tillett, William; Gossec, Laure; Helliwell, Philip; Strand, Vibeke; Ogdie, Alexis; Terwee, Caroline B; Christensen, Robin

    2018-04-01

    An updated psoriatic arthritis (PsA) core outcome set (COS) for randomized controlled trials (RCTs) was endorsed at the Outcome Measures in Rheumatology (OMERACT) meeting in 2016. To synthesize the evidence on measurement properties of patient reported outcome measures (PROMs) for PsA and thereby contribute to development of a PsA core outcome measurement set (COMS) as described by the OMERACT Filter 2.0. A systematic literature search was performed in EMBASE, MEDLINE and PsycINFO on Jan 1, 2017 to identify full-text articles with an aim of assessing the measurement properties of PROMs in PsA. Two independent reviewers rated the quality of studies using the COnsensus based standards for the Selection of health Measurement INstruments (COSMIN) checklist, and performed a qualitative evidence synthesis. Fifty-five studies were included in the systematic review. Forty-four instruments and a total of 89 scales were analyzed. PROMs measuring COS domains with at least fair quality evidence for good validity and reliability (and no evidence for poor properties) included the Stockerau Activity Score for PsA (German), Psoriasis Symptom Inventory, visual analogue scale for Patient Global, 36 Item Short Form Health Survey Physical Function subscale, Health Assessment Questionnaire Disability Index, Bath Ankylosing Spondylitis Functional Index, PsA Impact of Disease questionnaire, PsA Quality of Life questionnaire, VITACORA-19, Functional Assessment of Chronic Illness Therapy Fatigue scale and Social Role Participation Questionnaire. At least one PROM with some evidence for aspects of validity and reliability was available for six of the eight mandatory domains of the PsA COS. Copyright © 2018 Elsevier Inc. All rights reserved.

  3. Systematic review of tools to measure outcomes for young children with autism spectrum disorder.

    Science.gov (United States)

    McConachie, Helen; Parr, Jeremy R; Glod, Magdalena; Hanratty, Jennifer; Livingstone, Nuala; Oono, Inalegwu P; Robalino, Shannon; Baird, Gillian; Beresford, Bryony; Charman, Tony; Garland, Deborah; Green, Jonathan; Gringras, Paul; Jones, Glenys; Law, James; Le Couteur, Ann S; Macdonald, Geraldine; McColl, Elaine M; Morris, Christopher; Rodgers, Jacqueline; Simonoff, Emily; Terwee, Caroline B; Williams, Katrina

    2015-06-01

    The needs of children with autism spectrum disorder (ASD) are complex and this is reflected in the number and diversity of outcomes assessed and measurement tools used to collect evidence about children's progress. Relevant outcomes include improvement in core ASD impairments, such as communication, social awareness, sensory sensitivities and repetitiveness; skills such as social functioning and play; participation outcomes such as social inclusion; and parent and family impact. To examine the measurement properties of tools used to measure progress and outcomes in children with ASD up to the age of 6 years. To identify outcome areas regarded as important by people with ASD and parents. The MeASURe (Measurement in Autism Spectrum disorder Under Review) research collaboration included ASD experts and review methodologists. We undertook systematic review of tools used in ASD early intervention and observational studies from 1992 to 2013; systematic review, using the COSMIN checklist (Consensus-based Standards for the selection of health Measurement Instruments) of papers addressing the measurement properties of identified tools in children with ASD; and synthesis of evidence and gaps. The review design and process was informed throughout by consultation with stakeholders including parents, young people with ASD, clinicians and researchers. The conceptual framework developed for the review was drawn from the International Classification of Functioning, Disability and Health, including the domains 'Impairments', 'Activity Level Indicators', 'Participation', and 'Family Measures'. In review 1, 10,154 papers were sifted - 3091 by full text - and data extracted from 184; in total, 131 tools were identified, excluding observational coding, study-specific measures and those not in English. In review 2, 2665 papers were sifted and data concerning measurement properties of 57 (43%) tools were extracted from 128 papers. Evidence for the measurement properties of the reviewed

  4. Use of standardized outcome measures in physical therapist practice: perceptions and applications.

    Science.gov (United States)

    Jette, Diane U; Halbert, James; Iverson, Courtney; Miceli, Erin; Shah, Palak

    2009-02-01

    Standardized instruments for measuring patients' activity limitations and participation restrictions have been advocated for use by rehabilitation professionals for many years. The available literature provides few recent reports of the use of these measures by physical therapists in the United States. The primary purpose of this study was to determine: (1) the extent of the use of standardized outcome measures and (2) perceptions regarding their benefits and barriers to their use. A secondary purpose was to examine factors associated with their use among physical therapists in clinical practice. The study used an observational design. A survey questionnaire comprising items regarding the use and perceived benefits and barriers of standardized outcome measures was sent to 1,000 randomly selected members of the American Physical Therapy Association (APTA). Forty-eight percent of participants used standardized outcome measures. The majority of participants (>90%) who used such measures believed that they enhanced communication with patients and helped direct the plan of care. The most frequently reported reasons for not using such measures included length of time for patients to complete them, length of time for clinicians to analyze the data, and difficulty for patients in completing them independently. Use of standardized outcome measures was related to specialty certification status, practice setting, and the age of the majority of patients treated. The limitations included an unvalidated survey for data collection and a sample limited to APTA members. Despite more than a decade of development and testing of standardized outcome measures appropriate for various conditions and practice settings, physical therapists have some distance to go in implementing their use routinely in most clinical settings. Based on the perceived barriers, alterations in practice management strategies and the instruments themselves may be necessary to increase their use.

  5. The art and science of using routine outcome measurement in mental health benchmarking.

    Science.gov (United States)

    McKay, Roderick; Coombs, Tim; Duerden, David

    2014-02-01

    To report and critique the application of routine outcome measurement data when benchmarking Australian mental health services. The experience of the authors as participants and facilitators of benchmarking activities is augmented by a review of the literature regarding mental health benchmarking in Australia. Although the published literature is limited, in practice, routine outcome measures, in particular the Health of the National Outcomes Scales (HoNOS) family of measures, are used in a variety of benchmarking activities. Use in exploring similarities and differences in consumers between services and the outcomes of care are illustrated. This requires the rigour of science in data management and interpretation, supplemented by the art that comes from clinical experience, a desire to reflect on clinical practice and the flexibility to use incomplete data to explore clinical practice. Routine outcome measurement data can be used in a variety of ways to support mental health benchmarking. With the increasing sophistication of information development in mental health, the opportunity to become involved in benchmarking will continue to increase. The techniques used during benchmarking and the insights gathered may prove useful to support reflection on practice by psychiatrists and other senior mental health clinicians.

  6. Automated on-line L-edge measurement of SNM concentration for near-real-time accounting

    International Nuclear Information System (INIS)

    Russo, P.A.; Marks, T. Jr.; Stephens, M.M.; Hsue, S.T.; Baker, A.L.; Cobb, D.D.

    1982-01-01

    The L-edge densitometer developed at Los Alamos National Laboratory has been modified, tested, and demonstrated for on-line assay of special nuclear material concentration in flowing solution streams. The demonstration was part of a larger demonstration of near-real-time nuclear materials accounting during a continuous, week-long, cold operation of the Allied General Nuclear Services facility in Barnwell, South Carolina. The L-edge data were automatically analyzed and the results were transmitted to the materials accounting computer once every 5.5 min for the duration of the cold run. This report compares the results of the L-edge analyses with the delayed results obtained from destructive analysis of samples withdrawn from the same process line. Comparisons are also made with the results obtained in near real time from an automated process control instrument installed in series with the L-edge densitometer. The performance of the L-edge instrument was reliable throughout the continous operation. The assay precision was consistent with that predicted by the counting statistics of the measurement. The results of the L-edge assays show good agreement with those of the destructive assays. A gradually varying discrepancy (of a few percent) between the L-edge and the process control results remains unexplained. 9 figures

  7. Automated on-line L-edge measurement of SNM concentration for near-real-time accounting

    International Nuclear Information System (INIS)

    Russo, P.A.; Marks, T. Jr.; Stephens, M.M.; Baker, A.L.; Cobb, D.D.

    1982-09-01

    An L-edge densitometer has been modified, tested, and demonstrated for on-line assay of special nuclear material concentration in flowing solution streams. The demonstration was part of a larger demonstration of near-real-time nuclear materials accounting during a continuous, week-long, cold operation of the Barnwell facility. The L-edge data were automatically analyzed and the results were transmitted to the materials accounting computer once every 5.5 min for the duration of the cold run. This report compares the results of the L-edge analyses with the delayed results obtained from destructive analysis of samples withdrawn from the same process line. Comparisons are also made with the results obtained in near real time from an automated process control instrument installed in series with the L-edge densitometer. The performance of the L-edge instrument was reliable throughout the continuous operation. The assay precision was consistent with that predicted by the counting statistics of the measurement. The results of the L-edge assays show good agreement with those of the destructive assays. A gradually varying discrepancy (of a few percent) between the L-edge and the process control results remains unexplained

  8. Comparison of reliability and responsiveness of patient-reported clinical outcome measures in knee osteoarthritis rehabilitation.

    Science.gov (United States)

    Williams, Valerie J; Piva, Sara R; Irrgang, James J; Crossley, Chad; Fitzgerald, G Kelley

    2012-08-01

    Secondary analysis, pretreatment-posttreatment observational study. To compare the reliability and responsiveness of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Knee Outcome Survey activities of daily living subscale (KOS-ADL), and the Lower Extremity Functional Scale (LEFS) in individuals with knee osteoarthritis (OA). The WOMAC is the current standard in patient-reported measures of function in patients with knee OA. The KOS-ADL and LEFS were designed for potential use in patients with knee OA. If the KOS-ADL and LEFS are to be considered viable alternatives to the WOMAC for measuring patient-reported function in individuals with knee OA, they should have measurement properties comparable to the WOMAC. It would also be important to determine whether either of these instruments may be superior to the WOMAC in terms of reliability or responsiveness in this population. Data from 168 subjects with knee OA, who participated in a rehabilitation program, were used in the analyses. Reliability and responsiveness of each outcome measure were estimated at follow-ups of 2, 6, and 12 months. Reliability was estimated by calculating the intraclass correlation coefficient (ICC2,1) for subjects who were unchanged in status from baseline at each follow-up time, based on a global rating of change score. To examine responsiveness, the standard error of the measurement, minimal detectable change, minimal clinically important difference, and the Guyatt responsiveness index were calculated for each outcome measure at each follow-up time. All 3 outcome measures demonstrated reasonable reliability and responsiveness to change. Reliability and responsiveness tended to decrease somewhat with increasing follow-up time. There were no substantial differences between outcome measures for reliability or any of the 3 measures of responsiveness at any follow-up time. The results do not indicate that one outcome measure is more reliable or responsive than

  9. Relationships between Student, Staff, and Administrative Measures of School Climate and Student Health and Academic Outcomes

    Science.gov (United States)

    Gase, Lauren Nichol; Gomez, Louis M.; Kuo, Tony; Glenn, Beth A.; Inkelas, Moira; Ponce, Ninez A.

    2018-01-01

    BACKGROUND School climate is an integral part of a comprehensive approach to improving the wellbeing of students; however, little is known about the relationships between its different domains and measures. This study examined the relationships between student, staff, and administrative measures of school climate in order to understand the extent to which they were related to each other and student outcomes. METHODS The sample included 33,572 secondary school students from 121 schools in Los Angeles County during the 2014–2015 academic year. A multilevel regression model was constructed to examine the association between the domains and measures of school climate and five outcomes of student wellbeing: depressive symptoms or suicidal ideation, tobacco use, alcohol use, marijuana use, and grades. RESULTS Student, staff, and administrative measures of school climate were weakly correlated. Strong associations were found between student outcomes and student reports of engagement and safety, while school staff reports and administrative measures of school climate showed limited associations with student outcomes. CONCLUSIONS As schools seek to measure and implement interventions aimed at improving school climate, consideration should be given to grounding these efforts in a multi-dimensional conceptualization of climate that values student perspectives and includes elements of both engagement and safety. PMID:28382671

  10. Relationships Among Student, Staff, and Administrative Measures of School Climate and Student Health and Academic Outcomes.

    Science.gov (United States)

    Gase, Lauren N; Gomez, Louis M; Kuo, Tony; Glenn, Beth A; Inkelas, Moira; Ponce, Ninez A

    2017-05-01

    School climate is an integral part of a comprehensive approach to improving the well-being of students; however, little is known about the relationships between its different domains and measures. We examined the relationships between student, staff, and administrative measures of school climate to understand the extent to which they were related to each other and student outcomes. The sample included 33,572 secondary school students from 121 schools in Los Angeles County during the 2014-2015 academic year. A multilevel regression model was constructed to examine the association between the domains and measures of school climate and 5 outcomes of student well-being: depressive symptoms or suicidal ideation, tobacco use, alcohol use, marijuana use, and grades. Student, staff, and administrative measures of school climate were weakly correlated. Strong associations were found between student outcomes and student reports of engagement and safety, while school staff reports and administrative measures of school climate showed limited associations with student outcomes. As schools seek to measure and implement interventions aimed at improving school climate, consideration should be given to grounding these efforts in a multidimensional conceptualization of climate that values student perspectives and includes elements of both engagement and safety. © 2017, American School Health Association.

  11. Functional outcome measures in a surgical model of hip osteoarthritis in dogs.

    Science.gov (United States)

    Little, Dianne; Johnson, Stephen; Hash, Jonathan; Olson, Steven A; Estes, Bradley T; Moutos, Franklin T; Lascelles, B Duncan X; Guilak, Farshid

    2016-12-01

    The hip is one of the most common sites of osteoarthritis in the body, second only to the knee in prevalence. However, current animal models of hip osteoarthritis have not been assessed using many of the functional outcome measures used in orthopaedics, a characteristic that could increase their utility in the evaluation of therapeutic interventions. The canine hip shares similarities with the human hip, and functional outcome measures are well documented in veterinary medicine, providing a baseline for pre-clinical evaluation of therapeutic strategies for the treatment of hip osteoarthritis. The purpose of this study was to evaluate a surgical model of hip osteoarthritis in a large laboratory animal model and to evaluate functional and end-point outcome measures. Seven dogs were subjected to partial surgical debridement of cartilage from one femoral head. Pre- and postoperative pain and functional scores, gait analysis, radiographs, accelerometry, goniometry and limb circumference were evaluated through a 20-week recovery period, followed by histological evaluation of cartilage and synovium. Animals developed histological and radiographic evidence of osteoarthritis, which was correlated with measurable functional impairment. For example, Mankin scores in operated limbs were positively correlated to radiographic scores but negatively correlated to range of motion, limb circumference and 20-week peak vertical force. This study demonstrates that multiple relevant functional outcome measures can be used successfully in a large laboratory animal model of hip osteoarthritis. These measures could be used to evaluate relative efficacy of therapeutic interventions relevant to human clinical care.

  12. Measure of functional independence dominates discharge outcome prediction after inpatient rehabilitation for stroke.

    Science.gov (United States)

    Brown, Allen W; Therneau, Terry M; Schultz, Billie A; Niewczyk, Paulette M; Granger, Carl V

    2015-04-01

    Identifying clinical data acquired at inpatient rehabilitation admission for stroke that accurately predict key outcomes at discharge could inform the development of customized plans of care to achieve favorable outcomes. The purpose of this analysis was to use a large comprehensive national data set to consider a wide range of clinical elements known at admission to identify those that predict key outcomes at rehabilitation discharge. Sample data were obtained from the Uniform Data System for Medical Rehabilitation data set with the diagnosis of stroke for the years 2005 through 2007. This data set includes demographic, administrative, and medical variables collected at admission and discharge and uses the FIM (functional independence measure) instrument to assess functional independence. Primary outcomes of interest were functional independence measure gain, length of stay, and discharge to home. The sample included 148,367 people (75% white; mean age, 70.6±13.1 years; 97% with ischemic stroke) admitted to inpatient rehabilitation a mean of 8.2±12 days after symptom onset. The total functional independence measure score, the functional independence measure motor subscore, and the case-mix group were equally the strongest predictors for any of the primary outcomes. The most clinically relevant 3-variable model used the functional independence measure motor subscore, age, and walking distance at admission (r(2)=0.107). No important additional effect for any other variable was detected when added to this model. This analysis shows that a measure of functional independence in motor performance and age at rehabilitation hospital admission for stroke are predominant predictors of outcome at discharge in a uniquely large US national data set. © 2015 American Heart Association, Inc.

  13. The Autism Impact Measure (AIM): Initial Development of a New Tool for Treatment Outcome Measurement

    Science.gov (United States)

    Kanne, Stephen M.; Mazurek, Micah O.; Sikora, Darryn; Bellando, Jayne; Branum-Martin, Lee; Handen, Benjamin; Katz, Terry; Freedman, Brian; Powell, Mary Paige; Warren, Zachary

    2014-01-01

    The current study describes the development and psychometric properties of a new measure targeting sensitivity to change of core autism spectrum disorder (ASD) symptoms, the Autism Impact Measure (AIM). The AIM uses a 2-week recall period with items rated on two corresponding 5-point scales (frequency and impact). Psychometric properties were…

  14. Discrepancies between patient-reported outcome measures when assessing urinary incontinence or pelvic-prolapse surgery

    DEFF Research Database (Denmark)

    Larsen, Michael Due; Lose, Gunnar; Guldberg, Rikke

    2016-01-01

    INTRODUCTION AND HYPOTHESIS: In order to assess the outcome following surgery for urinary incontinence (UI) and pelvic organ prolapse (POP) the importance of patient-reported outcome measures, in addition to the clinical objective measures, has been recognised. The International Consultation...... on Incontinence has initiated the development and evaluation of disease-specific questionnaires (ICIQ) to compare the patient's degree of improvement. Alternatively, the Patient's Global Impression of Improvement (PGI-I score) with an inherent before-after assessment has been widely accepted in recent studies...

  15. Health economics research into supporting carers of people with dementia: A systematic review of outcome measures

    Science.gov (United States)

    2012-01-01

    Advisory bodies, such as the National Institute for Health and Clinical Excellence (NICE) in the UK, advocate using preference based instruments to measure the quality of life (QoL) component of the quality-adjusted life year (QALY). Cost per QALY is used to determine cost-effectiveness, and hence funding, of interventions. QALYs allow policy makers to compare the effects of different interventions across different patient groups. Generic measures may not be sensitive enough to fully capture the QoL effects for certain populations, such as carers, so there is a need to consider additional outcome measures, which are preference based where possible to enable cost-effectiveness analysis to be undertaken. This paper reviews outcome measures commonly used in health services research and health economics research involving carers of people with dementia. An electronic database search was conducted in PubMed, Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, the National Health Service Economic Evaluation Database (NHS EED), Database of Abstracts of Reviews of Effects (DARE) and Health Technology Assessment database. Studies were eligible for inclusion if they included an outcome measure for carers of people with dementia. 2262 articles were identified. 455 articles describing 361 studies remained after exclusion criteria were applied. 228 outcome measures were extracted from the studies. Measures were categorised into 44 burden measures, 43 mastery measures, 61 mood measures, 32 QoL measures, 27 social support and relationships measures and 21 staff competency and morale measures. The choice of instrument has implications on funding decisions; therefore, researchers need to choose appropriate instruments for the population being measured and the type of intervention undertaken. If an instrument is not sensitive enough to detect changes in certain populations, the effect of an intervention may be underestimated, and hence

  16. Can We Measure the Transition to Reading? General Outcome Measures and Early Literacy Development From Preschool to Early Elementary Grades

    Directory of Open Access Journals (Sweden)

    Scott McConnell

    2015-06-01

    Full Text Available This study evaluated the extent to which existing measures met standards for a continuous suite of general outcome measures (GOMs assessing children’s early literacy from preschool through early elementary school. The study assessed 316 children from age 3 years (2 years prekindergarten through Grade 2, with 8 to 10 measures of language, alphabetic principle, phonological awareness, and beginning reading. We evaluated measures at each grade group against six standards for GOMs extracted from earlier work. We found that one measure of oral language met five or six standards at all grade levels, and several measures of phonological awareness and alphabetic principle showed promise across all five grade levels. Results are discussed in relation to ongoing research and development of a flexible and seamless system to assess children’s academic progress across time for effective prevention and remediation, as well as theoretical and empirical analyses in early literacy, early reading, and GOMs.

  17. Accounting for graduate medical education production of primary care physicians and general surgeons: timing of measurement matters.

    Science.gov (United States)

    Petterson, Stephen; Burke, Matthew; Phillips, Robert; Teevan, Bridget

    2011-05-01

    Legislation proposed in 2009 to expand GME set institutional primary care and general surgery production eligibility thresholds at 25% at entry into training. The authors measured institutions' production of primary care physicians and general surgeons on completion of first residency versus two to four years after graduation to inform debate and explore residency expansion and physician workforce implications. Production of primary care physicians and general surgeons was assessed by retrospective analysis of the 2009 American Medical Association Masterfile, which includes physicians' training institution, residency specialty, and year of completion for up to six training experiences. The authors measured production rates for each institution based on physicians completing their first residency during 2005-2007 in family or internal medicine, pediatrics, or general surgery. They then reassessed rates to account for those who completed additional training. They compared these rates with proposed expansion eligibility thresholds and current workforce needs. Of 116,004 physicians completing their first residency, 54,245 (46.8%) were in primary care and general surgery. Of 683 training institutions, 586 met the 25% threshold for expansion eligibility. At two to four years out, only 29,963 physicians (25.8%) remained in primary care or general surgery, and 135 institutions lost eligibility. A 35% threshold eliminated 314 institutions collectively training 93,774 residents (80.8%). Residency expansion thresholds that do not account for production at least two to four years after completion of first residency overestimate eligibility. The overall primary care production rate from GME will not sustain the current physician workforce composition. Copyright © by the Association of American medical Colleges.

  18. Ancillary outcome measures for assessment of individuals with cervical spondylotic myelopathy.

    Science.gov (United States)

    Kalsi-Ryan, Sukhvinder; Singh, Anoushka; Massicotte, Eric M; Arnold, Paul M; Brodke, Darrel S; Norvell, Daniel C; Hermsmeyer, Jeffrey T; Fehlings, Michael G

    2013-10-15

    Narrative review. To identify suitable outcome measures that can be used to quantify neurological and functional impairment in the management of cervical spondylotic myelopathy (CSM). CSM is the leading cause of acquired spinal cord disability, causing varying degrees of neurological impairment which impact on independence and quality of life. Because this impairment can have a heterogeneous presentation, a single outcome measure cannot define the broad range of deficits seen in this population. Therefore, it is necessary to define outcome measures that characterize the deficits with greater validity and sensitivity. This review was conducted in 3 stages. Stage I: To evaluate the current use of outcome measures in CSM, PubMed was searched using the name of the outcome measure and the common abbreviation combined with "CSM" or "myelopathy." Stage II: Having identified a lack of appropriate outcome measures, we constructed criteria by which measures appropriate for assessing the various aspects of CSM could be identified. Stage III: A second literature search was then conducted looking at specified outcomes that met these criteria. All literature was reviewed to determine specificity and psychometric properties of outcomes for CSM. Nurick grade, modified Japanese Orthopaedic Association Scale, visual analogue scale (VAS) for pain, Short Form (36) Health Survey (SF-36), and Neck Disability Index were the most commonly cited measures. The Short-Form 36 Health Survey and Myelopathy Disability Index have been validated in the CSM population with multiple studies, whereas the modified Japanese Orthopaedic Association Scale score, Nurick grade, and European Myelopathy Scale each had only one study assessing psychometric characteristics. No validity, reliability, or responsiveness studies were found for the VAS or Neck Disability Index in the CSM population. We recommend that the modified Japanese Orthopaedic Association Scale, Nurick grade, Myelopathy Disability Index

  19. Treatment of Phonological Disorder: A Feasibility Study With Focus on Outcome Measures.

    Science.gov (United States)

    Smit, Ann Bosma; Brumbaugh, Klaire Mann; Weltsch, Barbara; Hilgers, Melanie

    2018-02-20

    In a feasibility study for a randomized controlled trial of treatments for phonological disorders conducted over a period of 8 months, we examined 6 clinically relevant outcome measures. We took steps to reduce error variance and to maximize systematic variance. Six children received traditional treatment (Van Riper, 1939), and 7 received expansion points (Smit, 2000), a treatment program with both phonological and traditional elements. Outcome measures, which were applied to both word list and conversational samples, included percentage of consonants correct (PCC; Shriberg & Kwiatkowski, 1982), PCC for late and/or difficult (L/D) consonants and number of L/D consonants acquired. In repeated-measures analyses of variance, all measures showed significant differences from pretreatment to posttreatment, and the word list measures were associated with very high power values. In analyses of covariance for between-groups contrasts, the adjusted expansion points mean exceeded the adjusted traditional treatment mean for every measure; however, no differences reached significance. For the L/D PCC (conversation) measure, the contrast between groups was associated with a large effect size. We recommend that practitioners use outcome measures related to a word list. We recommend that researchers consider using L/D PCC on the basis of conversational samples to detect differences among treatment groups. https://doi.org/10.23641/asha.5872677.

  20. Framework of outcome measures recommended for use in the evaluation of childhood obesity treatment interventions: the CoOR framework.

    Science.gov (United States)

    Bryant, M; Ashton, L; Nixon, J; Jebb, S; Wright, J; Roberts, K; Brown, J

    2014-12-01

    Consensus is lacking in determining appropriate outcome measures for assessment of childhood obesity treatments. Inconsistency in the use and reporting of such measures impedes comparisons between treatments and limits consideration of effectiveness. This study aimed to produce a framework of recommended outcome measures: the Childhood obesity treatment evaluation Outcomes Review (CoOR) framework. A systematic review including two searches was conducted to identify (1) existing trial outcome measures and (2) manuscripts describing development/evaluation of outcome measures. Outcomes included anthropometry, diet, eating behaviours, physical activity, sedentary time/behaviour, fitness, physiology, environment, psychological well-being and health-related quality of life. Eligible measures were appraised by the internal team using a system developed from international guidelines, followed by appraisal from national external expert collaborators. A total of 25,486 papers were identified through both searches. Eligible search 1 trial papers cited 417 additional papers linked to outcome measures, of which 56 were eligible. A further 297 outcome development/evaluation papers met eligibility criteria from search 2. Combined, these described 191 outcome measures. After internal and external appraisal, 52 measures across 10 outcomes were recommended for inclusion in the CoOR framework. Application of the CoOR framework will ensure greater consistency in choosing robust outcome measures that are appropriate to population characteristics. © 2014 The Authors. Pediatric Obesity © 2014 International Association for the Study of Obesity.

  1. Implementation of learning outcome attainment measurement system in aviation engineering higher education

    Science.gov (United States)

    Salleh, I. Mohd; Mat Rani, M.

    2017-12-01

    This paper aims to discuss the effectiveness of the Learning Outcome Attainment Measurement System in assisting Outcome Based Education (OBE) for Aviation Engineering Higher Education in Malaysia. Direct assessments are discussed to show the implementation processes that become a key role in the successful outcome measurement system. A case study presented in this paper involves investigation on the implementation of the system in Aircraft Structure course for Bachelor in Aircraft Engineering Technology program in UniKL-MIAT. The data has been collected for five semesters, starting from July 2014 until July 2016. The study instruments used include the report generated in Learning Outcomes Measurements System (LOAMS) that contains information on the course learning outcomes (CLO) individual and course average performance reports. The report derived from LOAMS is analyzed and the data analysis has revealed that there is a positive significant correlation between the individual performance and the average performance reports. The results for analysis of variance has further revealed that there is a significant difference in OBE grade score among the report. Independent samples F-test results, on the other hand, indicate that the variances of the two populations are unequal.

  2. Goal specificity: a proxy measure for improvements in environmental outcomes in collaborative governance.

    Science.gov (United States)

    Biddle, Jennifer C; Koontz, Tomas M

    2014-12-01

    Collaborative governance critics continually call for evidence to support its prevalent use. As is often the case in environmental policy, environmental outcomes occur at a rate incompatible with political agendas. In addition, a multitude of possibly confounding variables makes it difficult to correlate collaborative governance processes with environmental outcomes. The findings of this study offer empirical evidence that collaborative processes have a measurable, beneficial effect on environmental outcomes. Through the use of a unique paired-waterbody design, our dataset reduced the potential for confounding variables to impact our environmental outcome measurements. The results of a path analysis indicate that the output of setting specific pollutant reduction goals is significantly related to watershed partnerships' level of attainment of their environmental improvement goals. The action of setting specific goals (e.g. percentage of load reductions in pollutant levels) is fostered by sustained participation from partnership members throughout the lifecycle of the collaborative. In addition, this study demonstrates the utility of logic modeling for environmental planning and management, and suggests that the process of setting specific pollutant reduction goals is a useful proxy measure for reporting progress towards improvements in environmental outcomes when long-term environmental data are not available. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. 77 FR 43542 - Cost Accounting Standards: Cost Accounting Standards 412 and 413-Cost Accounting Standards...

    Science.gov (United States)

    2012-07-25

    ... rule that revised Cost Accounting Standard (CAS) 412, ``Composition and Measurement of Pension Cost... Accounting Standards: Cost Accounting Standards 412 and 413--Cost Accounting Standards Pension Harmonization Rule AGENCY: Cost Accounting Standards Board, Office of Federal Procurement Policy, Office of...

  4. Outcome measures for oral health based on clinical assessments and claims data: feasibility evaluation in practice.

    Science.gov (United States)

    Hummel, Riët; Bruers, Josef; van der Galiën, Onno; van der Sanden, Wil; van der Heijden, Geert

    2017-10-05

    It is well known that treatment variation exists in oral healthcare, but the consequences for oral health are unknown as the development of outcome measures is still in its infancy. The aim of this study was to identify and develop outcome measures for oral health and explore their performance using health insurance claims records and clinical data from general dental practices. The Dutch healthcare insurance company Achmea collaborated with researchers, oral health experts, and general dental practitioners (GDPs) in a proof of practice study to test the feasibility of measures in general dental practices. A literature search identified previously described outcome measures for oral healthcare. Using a structured approach, identified measures were (i) prioritized, adjusted and added to after discussion and then (ii) tested for feasibility of data collection, their face validity and discriminative validity. Data sources were claims records from Achmea, clinical records from dental practices, and prospective, pre-determined clinical assessment data obtained during routine consultations. In total eight measures (four on dental caries, one on tooth wear, two on periodontal health, one on retreatment) were identified, prioritized and tested. The retreatment measure and three measures for dental caries were found promising as data collection was feasible, they had face validity and discriminative validity. Deployment of these measures demonstrated variation in clinical practices of GDPs. Feedback of this data to GDPs led to vivid discussions on best practices and quality of care. The measure 'tooth wear' was not considered sufficiently responsive; 'changes in periodontal health score' was considered a controversial measure. The available data for the measures 'percentage of 18-year-olds with no tooth decay' and 'improvement in gingival bleeding index at reassessment' was too limited to provide accurate estimates per dental practice. The evaluated measures 'time to first

  5. Measuring Outcomes in Adult Weight Loss Studies That Include Diet and Physical Activity: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Rachel A. Millstein

    2014-01-01

    Full Text Available Background. Measuring success of obesity interventions is critical. Several methods measure weight loss outcomes but there is no consensus on best practices. This systematic review evaluates relevant outcomes (weight loss, BMI, % body fat, and fat mass to determine which might be the best indicator(s of success. Methods. Eligible articles described adult weight loss interventions that included diet and physical activity and a measure of weight or BMI change and body composition change. Results. 28 full-text articles met inclusion criteria. Subjects, settings, intervention lengths, and intensities varied. All studies measured body weight (−2.9 to −17.3 kg, 9 studies measured BMI (−1.1 to −5.1 kg/m2, 20 studies measured % body fat (−0.7 to −10.2%, and 22 studies measured fat mass (−0.9 to −14.9 kg. All studies found agreement between weight or BMI and body fat mass or body fat % decreases, though there were discrepancies in degree of significance between measures. Conclusions. Nearly all weight or BMI and body composition measures agreed. Since body fat is the most metabolically harmful tissue type, it may be a more meaningful measure of health change. Future studies should consider primarily measuring % body fat, rather than or in addition to weight or BMI.

  6. Psychometric properties of carer-reported outcome measures in palliative care: A systematic review

    Science.gov (United States)

    Michels, Charlotte TJ; Boulton, Mary; Adams, Astrid; Wee, Bee; Peters, Michele

    2016-01-01

    Background: Informal carers face many challenges in caring for patients with palliative care needs. Selecting suitable valid and reliable outcome measures to determine the impact of caring and carers’ outcomes is a common problem. Aim: To identify outcome measures used for informal carers looking after patients with palliative care needs, and to evaluate the measures’ psychometric properties. Design: A systematic review was conducted. The studies identified were evaluated by independent reviewers (C.T.J.M., M.B., M.P.). Data regarding study characteristics and psychometric properties of the measures were extracted and evaluated. Good psychometric properties indicate a high-quality measure. Data sources: The search was conducted, unrestricted to publication year, in the following electronic databases: Applied Social Sciences Index and Abstracts, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, EMBASE, PubMed, PsycINFO, Social Sciences Citation Index and Sociological Abstracts. Results: Our systematic search revealed 4505 potential relevant studies, of which 112 studies met the inclusion criteria using 38 carer measures for informal carers of patients with palliative care needs. Psychometric properties were reported in only 46% (n = 52) of the studies, in relation to 24 measures. Where psychometric data were reported, the focus was mainly on internal consistency (n = 45, 87%), construct validity (n = 27, 52%) and/or reliability (n = 14, 27%). Of these, 24 measures, only four (17%) had been formally validated in informal carers in palliative care. Conclusion: A broad range of outcome measures have been used for informal carers of patients with palliative care needs. Little formal psychometric testing has been undertaken. Furthermore, development and refinement of measures in this field is required. PMID:26407683

  7. Measuring quality of life in cleft lip and palate patients: currently available patient-reported outcomes measures.

    Science.gov (United States)

    Eckstein, Donna A; Wu, Rebecca L; Akinbiyi, Takintope; Silver, Lester; Taub, Peter J

    2011-11-01

    Patient-reported outcomes in cleft lip and palate treatment are critical for patient care. Traditional surgical outcomes focused on objective measures, such as photographs, anatomic measurements, morbidity, and mortality. Although these remain important, they leave many questions unanswered. Surveys that include aesthetics, speech, functionality, self-image, and quality of life provide more thorough outcomes assessment. It is vital that reliable, valid, and comprehensive questionnaires are available to craniofacial surgeons. The authors performed a literature review to identify questionnaires validated in cleft lip and palate patients. Qualifying instruments were assessed for adherence to guidelines for development and validation by the scientific advisory committee and for content. The authors identified 44 measures used in cleft lip and palate studies. After 15 ad hoc questionnaires, eight generic instruments, 11 psychiatric instruments, and one non-English language questionnaire were excluded, nine measures remained. Of these, four were never validated in the cleft population. Analysis revealed one craniofacial-specific measure (Youth Quality of Life-Facial Differences), two voice-related measures (Patient Voice-Related Quality of Life and Cleft Audit Protocol for Speech-Augmented), and two oral health-related measures (Child Oral Health Impact Profile and Child Oral Health Quality of Life). The Youth Quality of Life-Facial Differences, Child Oral Health Impact Profile, and Child Oral Health Quality of Life questionnaires were sufficiently validated. None was created specifically for clefts, resulting in content limitations. There is a lack of comprehensive, valid, and reliable questionnaires for cleft lip and palate surgery. For thorough assessment of satisfaction, further research to develop and validate cleft lip and palate surgery-specific instruments is needed.

  8. Process Accounting

    OpenAIRE

    Gilbertson, Keith

    2002-01-01

    Standard utilities can help you collect and interpret your Linux system's process accounting data. Describes the uses of process accounting, standard process accounting commands, and example code that makes use of process accounting utilities.

  9. Measuring social inclusion--a key outcome in global mental health.

    Science.gov (United States)

    Baumgartner, Joy Noel; Burns, Jonathan K

    2014-04-01

    Social inclusion is increasingly recognized as a key outcome for evaluating global mental health programmes and interventions. Whereas social inclusion as an outcome is not a new concept in the field of mental health, its measurement has been hampered by varying definitions, concepts and instruments. To move the field forward, this paper reviews the currently available instruments which measure social inclusion and are reported in the literature, realizing that no single measure will be appropriate for all studies or contexts. A systematic literature search of English language peer-reviewed articles published through February 2013 was undertaken to identify scales specifically developed to measure social inclusion or social/community integration among populations with mental disorders. Five instruments were identified through the search criteria. The scales are discussed in terms of their theoretical underpinnings, domains and/or key items and their potential for use in global settings. Whereas numerous reviewed abstracts discussed mental health and social inclusion or social integration, very few were concerned with direct measurement of the construct. All identified scales were developed in high-income countries with limited attention paid to how the scale could be adapted for cross-cultural use. Social inclusion is increasingly highlighted as a key outcome for global mental health policies and programmes, yet its measurement is underdeveloped. There is need for a global cross-cultural measure that has been developed and tested in diverse settings. However, until that need is met, some of the scales presented here may be amenable to adaptation.

  10. Outcome measures and definition of cure in female stress urinary incontinence surgery: a survey of recent publications.

    Science.gov (United States)

    Castillo, Peter A; Espaillat-Rijo, Luis M; Davila, G Willy

    2010-03-01

    Much variability exists in outcome measures used to report success of SUI surgery. We set out to evaluate outcome measures and definitions of cure in SUI surgery studies. Outcome measures, success rates, and definition of cure were analyzed from published series and compared to recommendations by leading authorities. Ninety-one publications were analyzed. Thirty (33%) utilized solely subjective measures, four (4%) utilized only objective measures, and 57 (63%) included both. Sixty-one (67%) used symptom questionnaires, 56 (60%) QOL questionnaires, and six (7%) visual analog scale. Twelve (13%) used voiding diaries and 52 (56%) used self-reporting as an outcome measure. Objective measures: 52 (57%) cough stress test, 37 (41%) urodynamic evaluation, 28 (31%) pad testing and a combination in 33 (36%). Few studies adhered to one set of outcome recommendations. Outcome measures used to evaluate success of anti-incontinence procedures lack consensus and comparability.

  11. Theoretical framework and methodological development of common subjective health outcome measures in osteoarthritis: a critical review

    Directory of Open Access Journals (Sweden)

    Johnston Marie

    2007-03-01

    Full Text Available Abstract Subjective measures involving clinician ratings or patient self-assessments have become recognised as an important tool for the assessment of health outcome. The value of a health outcome measure is usually assessed by a psychometric evaluation of its reliability, validity and responsiveness. However, psychometric testing involves an accumulation of evidence and has recognised limitations. It has been suggested that an evaluation of how well a measure has been developed would be a useful additional criteria in assessing the value of a measure. This paper explored the theoretical background and methodological development of subjective health status measures commonly used in osteoarthritis research. Fourteen subjective health outcome measures commonly used in osteoarthritis research were examined. Each measure was explored on the basis of their i theoretical framework (was there a definition of what was being assessed and was it part of a theoretical model? and ii methodological development (what was the scaling strategy, how were the items generated and reduced, what was the response format and what was the scoring method?. Only the AIMS, SF-36 and WHOQOL defined what they were assessing (i.e. the construct of interest and no measure assessed was part of a theoretical model. None of the clinician report measures appeared to have implemented a scaling procedure or described the rationale for the items selected or scoring system. Of the patient self-report measures, the AIMS, MPQ, OXFORD, SF-36, WHOQOL and WOMAC appeared to follow a standard psychometric scaling method. The DRP and EuroQol used alternative scaling methods. The review highlighted the general lack of theoretical framework for both clinician report and patient self-report measures. This review also drew attention to the wide variation in the methodological development of commonly used measures in OA. While, in general the patient self-report measures had good methodological

  12. Local Control in Action: Learning from the CORE Districts' Focus on Measurement, Capacity Building, and Shared Accountability. Policy Brief 16-4

    Science.gov (United States)

    Marsh, Julie; Bush-Mecenas, Susan; Hough, Heather

    2016-01-01

    California and the nation are at the crossroads of a major shift in school accountability policy. At the state level, California's Local Control and Accountability Plan (LCAP) encourages the use of multiple measures of school performance used locally to support continuous improvement and strategic resource allocation. Similarly, the federal Every…

  13. The patient-specific functional scale: psychometrics, clinimetrics, and application as a clinical outcome measure.

    Science.gov (United States)

    Horn, Katyana Kowalchuk; Jennings, Sophie; Richardson, Gillian; Vliet, Ditte Van; Hefford, Cheryl; Abbott, J Haxby

    2012-01-01

    Systematic review of the literature. To summarize peer-reviewed literature on the reliability, validity, and responsiveness of the Patient-Specific Functional Scale (PSFS), and to identify its use as an outcome measure. Searches were performed of several electronic databases from 1995 to May 2010. Studies included were published articles containing (1) primary research investigating the psychometric and clinimetrics of the PSFS or (2) the implementation of the PSFS as an outcome measure. We assessed the methodological quality of studies included in the first category. Two hundred forty-two articles published from 1994 to May 2010 were identified. Of these, 66 met the inclusion criteria for this review, with 13 reporting the measurement properties of the PSFS, 55 implementing the PSFS as an outcome measure, and 2 doing both of the above. The PSFS was reported to be valid, reliable, and responsive in populations with knee dysfunction, cervical radiculopathy, acute low back pain, mechanical low back pain, and neck dysfunction. The PSFS was found to be reliable and responsive in populations with chronic low back pain. The PSFS was also reported to be valid, reliable, or responsive in individuals with a limited number of acute, subacute, and chronic conditions. This review found that the PSFS is also being used as an outcome measure in many other conditions, despite a lack of published evidence supporting its validity in these conditions. Although the use of the PSFS as an outcome measure is increasing in physiotherapy practice, there are gaps in the research literature regarding its validity, reliability, and responsiveness in many health conditions.

  14. Rethinking exploitation: a process-centered account.

    Science.gov (United States)

    Jansen, Lynn A; Wall, Steven

    2013-12-01

    Exploitation has become an important topic in recent discussions of biomedical and research ethics. This is due in no small measure to the influence of Alan Wertheimer's path-breaking work on the subject. This paper presents some objections to Wertheimer's account of the concept. The objections attempt to show that his account places too much emphasis on outcome-based considerations and too little on process-based considerations. Building on these objections, the paper develops an alternative process-centered account of the concept. This alternative account of exploitation takes as its point of departure the broadly Kantian notion that it is wrong to use another as an instrument for the advancement of one's own ends. It sharpens this slippery notion and adds a number of refinements to it. The paper concludes by arguing that process-centered accounts of exploitation better illuminate the ethical challenges posed by research on human subjects than outcome-centered accounts.

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

    Science.gov (United States)

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

    2017-10-01

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

  16. An International Standard Set of Patient-Centered Outcome Measures After Stroke

    NARCIS (Netherlands)

    Salinas, J. (Joel); Sprinkhuizen, S.M. (Sara M.); Ackerson, T. (Teri); Bernhardt, J. (Julie); Davie, C. (Charlie); George, M.G. (Mary G.); Gething, S. (Stephanie); Kelly, A.G. (Adam G.); Lindsay, P. (Patrice); Liu, L. (Liping); Martins, S.C.O. (Sheila C.O.); Morgan, L. (Louise); B. Norrving (Bo); Ribbers, G.M. (Gerard M.); Silver, F.L. (Frank L.); Smith, E.E. (Eric E.); Williams, L.S. (Linda S.); Schwamm, L.H. (Lee H.)

    2015-01-01

    markdownabstract__BACKGROUND AND PURPOSE:__ Value-based health care aims to bring together patients and health systems to maximize the ratio of quality over cost. To enable assessment of healthcare value in stroke management, an international standard set of patient-centered stroke outcome measures

  17. Measuring Longitudinal Student Performance on Student Learning Outcomes in Sustainability Education

    Science.gov (United States)

    Jarchow, Meghann E.; Formisano, Paul; Nordyke, Shane; Sayre, Matthew

    2018-01-01

    Purpose: The purpose of this paper is to describe the student learning outcomes (SLOs) for a sustainability major, evaluate faculty incorporation of the SLOs into the courses in the sustainability major curriculum and measure student performance on the SLOs from entry into the major to the senior capstone course. Design/methodology/approach:…

  18. Anastomotic leakage as an outcome measure for quality of colorectal cancer surgery

    NARCIS (Netherlands)

    Snijders, H. S.; Henneman, D.; van Leersum, N. L.; ten Berge, M.; Fiocco, M.; Karsten, T. M.; Havenga, K.; Wiggers, T.; Dekker, J. W.; Tollenaar, R. A. E. M.; Wouters, M. W. J. M.

    Introduction When comparing mortality rates between hospitals to explore hospital performance, there is an important role for adjustment for differences in case-mix. Identifying outcome measures that are less influenced by differences in case-mix may be valuable. The main goal of this study was to

  19. Relationship of patient-reported outcomes with MRI measures in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Baker, Joshua F; Conaghan, Philip G.; Emery, Paul

    2017-01-01

    PURPOSE: We assessed whether MRI measures of synovitis, osteitis and bone erosion were associated with patient-reported outcomes (PROs) in a longitudinal clinical trial setting among patients with rheumatoid arthritis (RA). METHODS: This longitudinal cohort of 291 patients with RA was derived from...

  20. Student Identification with Business Education Models: Measurement and Relationship to Educational Outcomes

    Science.gov (United States)

    Halbesleben, Jonathon R. B.; Wheeler, Anthony R.

    2009-01-01

    Although management scholars have provided a variety of metaphors to describe the role of students in management courses, researchers have yet to explore students' identification with the models and how they are linked to educational outcomes. This article develops a measurement tool for students' identification with business education models and…

  1. An introduction to patient-reported outcome measures (PROMs) in physiotherapy

    NARCIS (Netherlands)

    Kyte, D.G.; Calvert, M.; Wees, P.J. van der; Hove, R. Ten; Tolan, S.; Hill, J.C.

    2015-01-01

    The use of patient-reported outcome measures (PROMs) is set to rise in physiotherapy. PROMs provide additional 'patient-centred' data which is unique in capturing the patient's own opinion on the impact of their disease or disorder, and its treatment, on their life. Thus, PROMs are increasingly used

  2. Questioning the Use of Outcome Measures to Evaluate Principal Preparation Programs

    Science.gov (United States)

    Fuller, Ed; Hollingworth, Liz

    2018-01-01

    Policymakers are proposing the use of outcome measures as indicators of effective principal preparation programs. The three most common metrics recommended are: (1) graduates' effectiveness in improving student achievement test scores, (2) graduate job placement rates, and (3) principal job retention once employed. This article explores the use of…

  3. A Comparison of Several Outcome Measures Used to Evaluate a Psychiatric Clerkship.

    Science.gov (United States)

    Cuerdon, Timothy; And Others

    The teaching of interviewing skills is increasingly incorporated into clinical medicine courses in American medical schools, yet the attempts to evaluate the effectiveness of these efforts have been woefully inadequate. Typical outcome measures have included paper and pencil tests of knowledge, preceptor evaluations of clinical performance, and…

  4. Reporting outcome measures of functional constipation in children from 0 to 4 years of age

    NARCIS (Netherlands)

    Kuizenga-Wessel, Sophie; Benninga, Marc A.; Tabbers, Merit M.

    2015-01-01

    Functional constipation (FC) often begins in the first year of life. Although standard definitions and criteria have been formulated to describe FC, these are rarely used in research and clinical practice. The aim of the study is to systematically assess how definitions and outcome measures are

  5. Faustmann and the forestry tradition of outcome-based performance measures

    Science.gov (United States)

    Peter J. Ince

    1999-01-01

    The concept of land expectation value developed by Martin Faustmann may serve as a paradigm for outcome-based performance measures in public forest management if the concept of forest equity value is broadened to include social and environmental benefits and costs, and sustainability. However, anticipation and accurate evaluation of all benefits and costs appears to...

  6. Side Effects of Minocycline Treatment in Patients with Fragile X Syndrome and Exploration of Outcome Measures

    Science.gov (United States)

    Utari, Agustini; Chonchaiya, Weerasak; Rivera, Susan M.; Schneider, Andrea; Hagerman, Randi J.; Faradz, Sultana M. H.; Ethell, Iryna M.; Nguyen, Danh V.

    2010-01-01

    Minocycline can rescue the dendritic spine and synaptic structural abnormalities in the fragile X knock-out mouse. This is a review and preliminary survey to document side effects and potential outcome measures for minocycline use in the treatment of individuals with fragile X syndrome. We surveyed 50 patients with fragile X syndrome who received…

  7. Variations in Definitions and Outcome Measures in Gastroesophageal Reflux Disease: A Systematic Review

    NARCIS (Netherlands)

    Singendonk, Maartje M. J.; Brink, Anna J.; Steutel, Nina F.; van Etten-Jamaludin, Faridi S.; van Wijk, Michiel P.; Benninga, Marc A.; Tabbers, Merit M.

    2017-01-01

    CONTEXT: Gastroesophageal reflux (GER) is defined as GER disease (GERD) when it leads to troublesome symptoms and/or complications. We hypothesized that definitions and outcome measures in randomized controlled trials (RCTs) on pediatric GERD would be heterogeneous. OBJECTIVES: Systematically assess

  8. Creating guidance for the use of patient reported outcome measures (PROMS) in clinical palliatieve care.

    NARCIS (Netherlands)

    Vliet, L.M. van; Harding, R.; Bausewein, C.; Payne, S.; Higginson, I.J.

    2014-01-01

    Introduction: Routine use of Patient Reported Outcome Measures (PROMs) in clinical practice can influence care but is not always achieved. One reason for this seems to be a lack of guidance on how to use PROMs in palliative care practice. This project aimed to provide such guidance. Aim(s) and

  9. Training clinicians in how to use patient-reported outcome measures in routine clinical practice

    NARCIS (Netherlands)

    Santana, Maria J.; Haverman, Lotte; Absolom, Kate; Takeuchi, Elena; Feeny, David; Grootenhuis, Martha; Velikova, Galina

    2015-01-01

    Patient-reported outcome measures (PROs) were originally developed for comparing groups of people in clinical trials and population studies, and the results were used to support treatment recommendations or inform health policy, but there was not direct benefit for the participants providing PROs

  10. Combining Clinical Information and Patient Reported Outcome Measures in Orthopaedic Surgery and Sports Medicine

    NARCIS (Netherlands)

    Kampen, D.A. van

    2013-01-01

    In this thesis we investigated the use of clinical information and Patient Reported Outcome Measures (PROMs) for patient evaluation in orthopaedic surgery and sports medicine. In the first part, we showed that the Dutch version of the Simple Shoulder Test (SST) is a valid and reliable

  11. Analysis of Traditional versus Three-Dimensional Augmented Curriculum on Anatomical Learning Outcome Measures

    Science.gov (United States)

    Peterson, Diana Coomes; Mlynarczyk, Gregory S.A.

    2016-01-01

    This study examined whether student learning outcome measures are influenced by the addition of three-dimensional and digital teaching tools to a traditional dissection and lecture learning format curricula. The study was performed in a semester long graduate level course that incorporated both gross anatomy and neuroanatomy curricula. Methods…

  12. Outcome measures based on classification performance fail to predict the intelligibility of binary-masked speech

    DEFF Research Database (Denmark)

    Kressner, Abigail Anne; May, Tobias; Rozell, Christopher J.

    2016-01-01

    To date, the most commonly used outcome measure for assessing ideal binary mask estimation algorithms is based on the difference between the hit rate and the false alarm rate (H-FA). Recently, the error distribution has been shown to substantially affect intelligibility. However, H-FA treats each...... evaluations should not be made solely on the basis of these metrics....

  13. Positive psychology outcome measures for family caregivers of people living with dementia: a systematic review

    NARCIS (Netherlands)

    Stansfeld, J.; Stoner, C.R.; Wenborn, J.; Vernooij-Dassen, M.J.F.J.; Moniz-Cook, E.; Orrell, M.

    2017-01-01

    BACKGROUND: Family caregivers of people living with dementia can have both positive and negative experiences of caregiving. Despite this, existing outcome measures predominately focus on negative aspects of caregiving such as burden and depression. This review aimed to evaluate the development and

  14. Method and timing of tumor volume measurement for outcome prediction in cervical cancer using magnetic resonance imaging

    International Nuclear Information System (INIS)

    Mayr, Nina A.; Taoka, Toshiaki; Yuh, William T.C.; Denning, Leah M.; Zhen, Weining K.; Paulino, Arnold C.; Gaston, Robert C.; Sorosky, Joel I.; Meeks, Sanford L.; Walker, Joan L.; Mannel, Robert S.; Buatti, John M.

    2002-01-01

    -99 cm 3 ) tumors, which accounted for the majority of patients (55%). Tumor regression rate (fast vs. slow) obtained during mid-RT (45-50 Gy), which could only be appreciated by 3D ROI volumetry, had the best outcome prediction rate for local control (84% vs. 22%, p<0.0001) and disease-free survival (63% vs. 20%, p=0.0005). Within the difficult to classify intermediate pre-RT size group, slow ROI-based regression rate predicted all treatment failures (local control rate: 0% vs. 91%, p<0.0001; disease-free survival: 0% vs. 73%, p<0.0001). Mid-RT regression rate based on simple diameter measurement did not predict outcome. The early-RT and post-RT measurements were least useful with either measuring method. Conclusion: Our preliminary data suggest that for the prediction of treatment outcome in cervical cancer, initial tumor volume can be estimated by simple diameter-based measurement obtained from film hard copies. When initial tumor volume is in the intermediate size range, ROI volumetry and an additional MRI during RT are needed to quantitatively analyze tumor regression rate for the prediction of treatment outcome

  15. The Relationship Between Implementation of School-Wide Positive Behavior Intervention and Supports and Performance on State Accountability Measures

    Directory of Open Access Journals (Sweden)

    Adriana M. Marin

    2013-10-01

    Full Text Available This study examined data from 96 schools in a Southeastern U.S. state participating in training and/or coaching on School-Wide Positive Behavioral Interventions and Supports (SWPBIS provided by the State Personnel Development Grant (SPDG in their state. Schools studied either received training only (“non-intensive” sites or training and on-site coaching (“intensive” sites. Fidelity of implementation was self-evaluated by both types of schools using the Benchmarks of Quality (BOQ. Some schools were also externally evaluated using the School-Wide Evaluation Tool (SET, with those scoring 80% or higher determined “model sites.” Using an independent sample t-test, analyses revealed statistically significant differences between intensive and nonintensive schools’ Quality of Distribution Index (QDI scores and between model sites and nonmodel sites on QDI scores. Correlations were performed to determine whether the fidelity of implementation of SWPBIS as measured by the BOQ was related to any of the state’s accountability measures: performance classification, QDI, or growth.

  16. Accounting for measurement error in biomarker data and misclassification of subtypes in the analysis of tumor data.

    Science.gov (United States)

    Nevo, Daniel; Zucker, David M; Tamimi, Rulla M; Wang, Molin

    2016-12-30

    A common paradigm in dealing with heterogeneity across tumors in cancer analysis is to cluster the tumors into subtypes using marker data on the tumor, and then to analyze each of the clusters separately. A more specific target is to investigate the association between risk factors and specific subtypes and to use the results for personalized preventive treatment. This task is usually carried out in two steps-clustering and risk factor assessment. However, two sources of measurement error arise in these problems. The first is the measurement error in the biomarker values. The second is the misclassification error when assigning observations to clusters. We consider the case with a specified set of relevant markers and propose a unified single-likelihood approach for normally distributed biomarkers. As an alternative, we consider a two-step procedure with the tumor type misclassification error taken into account in the second-step risk factor analysis. We describe our method for binary data and also for survival analysis data using a modified version of the Cox model. We present asymptotic theory for the proposed estimators. Simulation results indicate that our methods significantly lower the bias with a small price being paid in terms of variance. We present an analysis of breast cancer data from the Nurses' Health Study to demonstrate the utility of our method. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  17. Critical thinking as an educational outcome: an evaluation of current tools of measurement.

    Science.gov (United States)

    Adams, M H; Whitlow, J F; Stover, L M; Johnson, K W

    1996-01-01

    Critical thinking, an outcome criterion of the National League for Nursing and the Council of Baccalaureate and Higher Degree Programs, is an abstract skill difficult to measure. The authors provide a comprehensive review of four instruments designed to measure critical thinking and summarize research in which the tools were used. Analysis of this information will empower nursing faculty members to select a critical-thinking instrument that is individualized to the needs of their respective nursing programs.

  18. Challenges and Opportunities in Using Patient-Reported Outcomes in Quality Measurement in Rheumatology

    OpenAIRE

    Wahl, Elizabeth; Yazdany, Jinoos

    2016-01-01

    Use of Patient-reported outcome measures (PROs) in rheumatology research is widespread, but use of PRO data to evaluate the quality of rheumatologic care delivered is less well established. This article reviews the use of PROs in assessing healthcare quality, and highlights challenges and opportunities specific to their use in rheumatology quality measurement. We first explore other countries’ experiences collecting and evaluating national PRO data to assess quality of care. We describe the c...

  19. Outcome measures and scar aesthetics in minimally invasive video-assisted parathyroidectomy.

    LENUS (Irish Health Repository)

    Casserly, Paula

    2012-02-01

    OBJECTIVES: To compare the scar outcome of video-assisted parathyroidectomy (VAP) with traditional bilateral cervical exploration (BCE) using previously validated scar assessment scales, and to examine the feasibility of introducing VAP into a general otolaryngology-head and neck practice. DESIGN: A retrospective review of medical records from a prospectively obtained database of patients and long-term follow-up of scar analysis. PATIENTS: The records of 60 patients undergoing parathyroidectomy were reviewed: 29 patients underwent VAP and 31 patients underwent an open procedure with BCE. The groups were matched for age and sex. A total of 46 patients were followed up to assess scar outcome. MAIN OUTCOME MEASURES: The primary outcome was a comparison of patient and observer scar satisfaction between VAP and traditional BCE using validated scar assessment tools: the Patient Scar Assessment Scale and the Manchester Scar Scale. The secondary outcomes were to retrospectively evaluate our results with VAP and to assess the suitability of introducing this technique into a general otolaryngology-head and neck practice. RESULTS: The average scar length in the VAP group was 1.7 cm, and the average scar length in the BCE group was 4.3 cm. The patients in the BCE group scored higher than the patients in the VAP group on the Manchester Scar Scale (P < .01) and on the Patient and Observer Scar Scales (P = .02), indicating a worse scar outcome. The mean operative time in the VAP group was 41 minutes compared with 115 minutes in the open procedure BCE group. There was no difference between the 2 groups in terms of postoperative complications. CONCLUSIONS: Video-assisted parathyroidectomy is a safe and feasible procedure in the setting of a general otolaryngology-head and neck practice, with outcomes and complication rates that are comparable to those of traditional bilateral neck exploration. Both patient and observer analysis demonstrated that VAP was associated with a more

  20. Kinematic measures for upper limb robot-assisted therapy following stroke and correlations with clinical outcome measures: A review.

    Science.gov (United States)

    Tran, Vi Do; Dario, Paolo; Mazzoleni, Stefano

    2018-03-01

    This review classifies the kinematic measures used to evaluate post-stroke motor impairment following upper limb robot-assisted rehabilitation and investigates their correlations with clinical outcome measures. An online literature search was carried out in PubMed, MEDLINE, Scopus and IEEE-Xplore databases. Kinematic parameters mentioned in the studies included were categorized into the International Classification of Functioning, Disability and Health (ICF) domains. The correlations between these parameters and the clinical scales were summarized. Forty-nine kinematic parameters were identified from 67 articles involving 1750 patients. The most frequently used parameters were: movement speed, movement accuracy, peak speed, number of speed peaks, and movement distance and duration. According to the ICF domains, 44 kinematic parameters were categorized into Body Functions and Structure, 5 into Activities and no parameters were categorized into Participation and Personal and Environmental Factors. Thirteen articles investigated the correlations between kinematic parameters and clinical outcome measures. Some kinematic measures showed a significant correlation coefficient with clinical scores, but most were weak or moderate. The proposed classification of kinematic measures into ICF domains and their correlations with clinical scales could contribute to identifying the most relevant ones for an integrated assessment of upper limb robot-assisted rehabilitation treatments following stroke. Increasing the assessment frequency by means of kinematic parameters could optimize clinical assessment procedures and enhance the effectiveness of rehabilitation treatments. Copyright © 2018 IPEM. Published by Elsevier Ltd. All rights reserved.

  1. A tool for evaluating the potential for cost-effective outcomes measurement

    Directory of Open Access Journals (Sweden)

    Somasekhar MM

    2012-04-01

    Full Text Available Melinda M Somasekhar1, Alfred Bove2, Chris Rausch1, James Degnan3, Cathy T King1, Arnold Meyer11The Albert J Finestone, MD, Office for Continuing Medical Education, 2Section of Cardiology, Temple University School of Medicine, Philadelphia, PA, USA; 3Measurement and Research Center, Temple University, Philadelphia, PA, USAAbstract: Cost related to higher-level outcomes measurement is often very high. However, the cost burden is felt even more by smaller, less well-funded continuing medical education (CME programs. It is possible to overcome financial and participant-related barriers to measuring Level 6 outcomes, which are patient health outcomes. The Temple University School of Medicine’s Office for Continuing Medical Education developed a sequential tool for attaining cost-effective outcomes measurement for determining the likelihood of a CME intervention to produce significant changes in physician performance. The appropriate selection of the CME topic and specific practice change indictors drive this tool. This tool walks providers through a simple YES or NO decision-making list that guides them toward an accurate prediction of potential programmatic outcomes. Factors considered during the decision-making process include whether: (a the intended change(s will have a substantial impact on current practice; (b the intended practice change(s are well supported by clinical data, specialty organization/government recommendations, expert opinion, etc; (c the potential change(s affects a large population; (d external factors, such as system pressures, media pressures, financial pressures, patient pressures, safety pressures, etc, are driving this intended change in performance; (e there is a strong motivation on the part of physicians to implement the intended change(s; and (f the intended change(s is relatively easy to implement within any system of practice. If each of these questions can be responded to positively, there is a higher likelihood

  2. Patient-reported outcome measures in burning mouth syndrome - a review of the literature.

    Science.gov (United States)

    Ni Riordain, R; McCreary, C

    2013-04-01

    Oral Diseases (2013) 19, 230-235 This review aims to investigate the patient-reported outcomes currently used in the burning mouth syndrome literature and to explore whether any standardisation of such measures has taken place. Electronic databases were searched for all types of burning mouth syndrome studies using patient-reported outcome measures. Studies were selected by predefined inclusion criteria. Copies of the papers obtained were thoroughly reviewed. A study-specific data extraction form was used, allowing papers to be reviewed in a standardised manner. The initial literature search yielded a total of 173 citations, 43 of which were deemed suitable for inclusion in this study. Symptom severity and symptomatic relief were reported as a patient-reported outcome measure in 40 of the studies and quantified most commonly using a visual analogue scale. Quality of life was reported in 13 studies included in this review. Depression and/or anxiety was reported in 14 of the studies. As is evident from the variety of questionnaires and instruments used in the evaluation of the impact of burning mouth syndrome on patients' lives, no standardisation of patient outcomes has yet been achieved. © 2012 John Wiley & Sons A/S.

  3. Psychometric evaluation of self-report outcome measures for prosthetic applications.

    Science.gov (United States)

    Hafner, Brian J; Morgan, Sara J; Askew, Robert L; Salem, Rana

    2016-01-01

    Documentation of clinical outcomes is increasingly expected in delivery of prosthetic services and devices. However, many outcome measures suitable for use in clinical care and research have not been psychometrically tested with prosthesis users. The aim of this study was to determine test-retest reliability, mode-of-administration (MoA) equivalence, standard error of measurement (SEM), and minimal detectable change (MDC) of standardized, self-report instruments that assess constructs of importance to people with lower limb loss. Prosthesis users (n = 201) were randomly assigned to groups based on MoA (i.e., paper, electronic, or mixed-mode). Participants completed two surveys 2 to 3 d apart. Instruments included the Prosthetic Limb Users Survey of Mobility, Prosthesis Evaluation Questionnaire-Mobility Subscale, Activities-Specific Balance Confidence Scale, Quality of Life in Neurological Conditions-Applied Cognition/General Concerns, Patient-Reported Outcomes Measurement Information System Profile, and Socket Comfort Score. Intraclass correlation coefficients indicated all instruments are appropriate for group-level comparisons and select instruments are suitable for individual-level applications. Several instruments showed evidence of possible floor and ceiling effects. All were equivalent across MoAs. SEM and MDC were quantified to facilitate interpretation of outcomes and change scores. These results can enhance clinicians' and researchers' ability to select, apply, and interpret scores from instruments administered to prosthesis users.

  4. Creating a Novel Video Vignette Stroke Preparedness Outcome Measure Using a Community-Based Participatory Approach.

    Science.gov (United States)

    Skolarus, Lesli E; Murphy, Jillian B; Dome, Mackenzie; Zimmerman, Marc A; Bailey, Sarah; Fowlkes, Sophronia; Morgenstern, Lewis B

    2015-07-01

    Evaluating the efficacy of behavioral interventions for rare outcomes is a challenge. One such topic is stroke preparedness, defined as inteventions to increase stroke symptom recognition and behavioral intent to call 911. Current stroke preparedness intermediate outcome measures are centered on written vignettes or open-ended questions and have been shown to poorly reflect actual behavior. Given that stroke identification and action requires aural and visual processing, video vignettes may improve on current measures. This article discusses an approach for creating a novel stroke preparedness video vignette intermediate outcome measure within a community-based participatory research partnership. A total of 20 video vignettes were filmed of which 13 were unambiguous (stroke or not stroke) as determined by stroke experts and had test discrimination among community participants. Acceptable reliability, high satisfaction, and cultural relevance were found among the 14 community respondents. A community-based participatory approach was effective in creating a video vignette intermediate outcome. Future projects should consider obtaining expert and community feedback prior to filming all the video vignettes to improve the proportion of vignettes that are usable. While content validity and preliminary reliability were established, future studies are needed to confirm the reliability and establish construct validity. © 2014 Society for Public Health Education.

  5. Assessing participation in the ACL injured population: Selecting a patient reported outcome measure on the basis of measurement properties.

    Science.gov (United States)

    Letchford, Robert; Sparkes, Valerie; van Deursen, Robert W M

    2015-06-01

    A return to pre injury activity participation remains a common but often elusive goal following ACL injury. Investigations to improve our understanding of participation restrictions are limited by inconsistent use of insufficiently investigated measurement tools. The aim of this study was to follow the consensus based standards for the selection of health measurement instruments (COSMIN) guideline to provide a comparative evaluation of four patient reported outcomes (PROMs) on the basis of measurement properties. This will inform recommendations for measuring participation of ACL injured subjects, particularly in the United Kingdom (UK) National Health Service (NHS). Thirteen criteria were compiled from the COSMIN guideline. These included reliability, measurement error, content validity, construct validity, responsiveness and interpretability. Data from 51 subjects collected as part of a longitudinal observational study of recovery over the first year following ACLR was used in the analysis. Of the thirteen criteria, the required standard was met in 11 for Tegner, 11 for International Knee Documentation Committee (IKDC), 6 for Cincinnati Sports Activity Scale (CSAS) and 6 for Marx. The two weaknesses identified for the Tegner are more easily compensated for during interpretation than those in the IKDC; for this reason the Tegner is the recommended PROM. The Tegner activity rating scale performed consistently well in respect of all measurement properties in this sample, with clear benefits over the other PROMs. The measurement properties presented should be used to inform implementation and interpretation of this outcome measure in clinical practice and research. Level II prospective study. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Health behavior in persons with spinal cord injury: development and initial validation of an outcome measure.

    Science.gov (United States)

    Pruitt, S D; Wahlgren, D R; Epping-Jordan, J E; Rossi, A L

    1998-10-01

    To describe the development and initial psychometric properties of a new outcome measure for health behaviors that delay or prevent secondary impairments associated with spinal cord injury (SCI). Persons with SCI were surveyed during routine annual physical evaluations. Veterans Affairs Medical Center Spinal Cord Injury Unit, which specializes in primary care for persons with SCI. Forty-nine persons with SCI, aged 19-73 years, 1-50 years post-SCI. The newly developed Spinal Cord Injury Lifestyle Scale (SCILS). Internal consistency is high (alpha = 0.81). Correlations between clinicians' ratings of participants' health behavior and the new SCILS provide preliminary support for construct validity. The SCILS is a brief, self-report measure of health-related behavior in persons with SCI. It is a promising new outcome measure to evaluate the effectiveness of clinical and educational efforts for health maintenance and prevention of secondary impairments associated with SCI.

  7. The quality of systematic reviews of health-related outcome measurement instruments.

    Science.gov (United States)

    Terwee, C B; Prinsen, C A C; Ricci Garotti, M G; Suman, A; de Vet, H C W; Mokkink, L B

    2016-04-01

    Systematic reviews of outcome measurement instruments are important tools for the selection of instruments for research and clinical practice. Our aim was to assess the quality of systematic reviews of health-related outcome measurement instruments and to determine whether the quality has improved since our previous study in 2007. A systematic literature search was performed in MEDLINE and EMBASE between July 1, 2013, and June 19, 2014. The quality of the reviews was rated using a study-specific checklist. A total of 102 reviews were included. In many reviews the search strategy was considered not comprehensive; in only 59 % of the reviews a search was performed in EMBASE and in about half of the reviews there was doubt about the comprehensiveness of the search terms used for type of measurement instruments and measurement properties. In 41 % of the reviews, compared to 30 % in our previous study, the methodological quality of the included studies was assessed. In 58 %, compared to 55 %, the quality of the included instruments was assessed. In 42 %, compared to 7 %, a data synthesis was performed in which the results from multiple studies on the same instrument were somehow combined. Despite a clear improvement in the quality of systematic reviews of outcome measurement instruments in comparison with our previous study in 2007, there is still room for improvement with regard to the search strategy, and especially the quality assessment of the included studies and the included instruments, and the data synthesis.

  8. A tool for evaluating the potential for cost-effective outcomes measurement.

    Science.gov (United States)

    Somasekhar, Melinda M; Bove, Alfred; Rausch, Chris; Degnan, James; King, Cathy T; Meyer, Arnold

    2012-01-01

    Cost related to higher-level outcomes measurement is often very high. However, the cost burden is felt even more by smaller, less well-funded continuing medical education (CME) programs. It is possible to overcome financial and participant-related barriers to measuring Level 6 outcomes, which are patient health outcomes. The Temple University School of Medicine's Office for Continuing Medical Education developed a sequential tool for attaining cost-effective outcomes measurement for determining the likelihood of a CME intervention to produce significant changes in physician performance. The appropriate selection of the CME topic and specific practice change indictors drive this tool. This tool walks providers through a simple YES or NO decision-making list that guides them toward an accurate prediction of potential programmatic outcomes. Factors considered during the decision-making process include whether: (a) the intended change(s) will have a substantial impact on current practice; (b) the intended practice change(s) are well supported by clinical data, specialty organization/government recommendations, expert opinion, etc; (c) the potential change(s) affects a large population; (d) external factors, such as system pressures, media pressures, financial pressures, patient pressures, safety pressures, etc, are driving this intended change in performance; (e) there is a strong motivation on the part of physicians to implement the intended change(s); and (f) the intended change(s) is relatively easy to implement within any system of practice. If each of these questions can be responded to positively, there is a higher likelihood that the intended practice-related change(s) will occur. Such change can be measured using a simpler and less costly methodology.

  9. A systematic literature search to identify performance measure outcomes used in clinical studies of racehorses.

    Science.gov (United States)

    Wylie, C E; Newton, J R

    2018-05-01

    Racing performance is often used as a measurable outcome variable in research studies investigating clinical diagnoses or interventions. However, the use of many different performance measures largely precludes conduct of meaningful comparative studies and, to date, those being used have not been collated. To systematically review the veterinary scientific literature for the use of racing performance as a measurable outcome variable in clinical studies of racehorses, collate and identify those most popular, and identify their advantages and disadvantages. Systematic literature search. The search criteria "((racing AND performance) AND (horses OR equidae))" were adapted for both MEDLINE and CAB Abstracts databases. Data were collected in standardised recording forms for binary, categorical and quantitative measures, and the use of performance indices. In total, 217 studies that described racing performance were identified, contributing 117 different performance measures. No one performance measure was used in all studies, despite 90.3% using more than one variable. Data regarding race starts and earnings were used most commonly, with 88.0% and 54.4% of studies including at least one measure of starts and earnings, respectively. Seventeen variables were used 10 times or more, with the top five comprising: 'return to racing', 'number of starts', 'days to first start', 'earnings per period of time' and 'earnings per start'. The search strategies may not have identified all relevant papers, introducing bias to the review. Performance indices have been developed to improve assessment of interventions; however, they are not widely adopted in the scientific literature. Use of the two most commonly identified measures, whether the horse returned to racing and number of starts over a defined period of time, would best facilitate future systematic reviews and meta-analyses in advance of the development of a gold-standard measure of race performance outcome. © 2017 EVJ Ltd.

  10. The Premature Ejaculation Profile: validation of self-reported outcome measures for research and practice.

    Science.gov (United States)

    Patrick, Donald L; Giuliano, François; Ho, Kai Fai; Gagnon, Dennis D; McNulty, Pauline; Rothman, Margaret

    2009-02-01

    To evaluate the reliability and validity of the Premature Ejaculation Profile (PEP), a self-reported outcome instrument for evaluating domains of PE and its treatment, comprised of four single-item measures, a profile, and an index score. Data were from men participating in observational studies in the USA (PE, 207 men; non-PE, 1380) and Europe (PE, 201; non-PE, 914) and from men with PE (1238) participating in a phase III randomized, placebo-controlled clinical trial of dapoxetine. The PEP contains four measures: perceived control over ejaculation, personal distress related to ejaculation, satisfaction with sexual intercourse, and interpersonal difficulty related to ejaculation, each assessed on five-point response scales. Test-retest reliability, known-groups validity, and ability to detect a patient-reported global impression of change (PGI) in condition were evaluated for the individual PEP measures and a PEP index score (the mean of all four measures). Profile analysis was conducted using multivariate analysis of variance. All PEP measures showed acceptable reliability (intraclass correlation coefficients ranged from 0.66 to 0.83) and mean scores for all measures differed significantly between PE and non-PE groups (P measures. The PEP profiles of men with and without PE differed significantly (P measure for use in monitoring outcomes of men with PE.

  11. Quantitative outcome measures for systemic sclerosis-related Microangiopathy - Reliability of image acquisition in Nailfold Capillaroscopy.

    Science.gov (United States)

    Dinsdale, Graham; Moore, Tonia; O'Leary, Neil; Berks, Michael; Roberts, Christopher; Manning, Joanne; Allen, John; Anderson, Marina; Cutolo, Maurizio; Hesselstrand, Roger; Howell, Kevin; Pizzorni, Carmen; Smith, Vanessa; Sulli, Alberto; Wildt, Marie; Taylor, Christopher; Murray, Andrea; Herrick, Ariane L

    2017-09-01

    Nailfold capillaroscopic parameters hold increasing promise as outcome measures for clinical trials in systemic sclerosis (SSc). Their inclusion as outcomes would often naturally require capillaroscopy images to be captured at several time points during any one study. Our objective was to assess repeatability of image acquisition (which has been little studied), as well as of measurement. 41 patients (26 with SSc, 15 with primary Raynaud's phenomenon) and 10 healthy controls returned for repeat high-magnification (300×) videocapillaroscopy mosaic imaging of 10 digits one week after initial imaging (as part of a larger study of reliability). Images were assessed in a random order by an expert blinded observer and 4 outcome measures extracted: (1) overall image grade and then (where possible) distal vessel locations were marked, allowing (2) vessel density (across the whole nailfold) to be calculated (3) apex width measurement and (4) giant vessel count. Intra-rater, intra-visit and intra-rater inter-visit (baseline vs. 1week) reliability were examined in 475 and 392 images respectively. A linear, mixed-effects model was used to estimate variance components, from which intra-class correlation coefficients (ICCs) were determined. Intra-visit and inter-visit reliability estimates (ICCs) were (respectively): overall image grade, 0.97 and 0.90; vessel density, 0.92 and 0.65; mean vessel width, 0.91 and 0.79; presence of giant capillary, 0.68 and 0.56. These estimates were conditional on each parameter being measurable. Within-operator image analysis and acquisition are reproducible. Quantitative nailfold capillaroscopy, at least with a single observer, provides reliable outcome measures for clinical studies including randomised controlled trials. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. The national trajectory project of individuals found not criminally responsible on account of mental disorder in Canada. Part 3: trajectories and outcomes through the forensic system.

    Science.gov (United States)

    Crocker, Anne G; Charette, Yanick; Seto, Michael C; Nicholls, Tonia L; Côté, Gilles; Caulet, Malijai

    2015-03-01

    To examine the processing and Review Board (RB) disposition outcomes of people found not criminally responsible on account of mental disorder (NCRMD) across the 3 most populous provinces in Canada. Although the Criminal Code is federally legislated, criminal justice is administered by provinces and territories. It follows that a person with mental illness who comes into conflict with the law and subsequently comes under the management of a legally mandated RB may experience different trajectories across jurisdictions. The National Trajectory Project examined 1800 men and women found NCRMD in British Columbia (n = 222), Quebec (n = 1094), and Ontario (n = 484) between May 2000 and April 2005, followed until December 2008. We found significant interprovincial differences in the trajectories of people found NCRMD, including time detained in hospital and time under the supervision of an RB. The odds of being conditionally or absolutely discharged by the RB varied across provinces, even after number of past offences, diagnosis at verdict, and most severe index offence (all covariates decreased likelihood of discharge) were considered. Considerable discrepancies in the application of NCRMD legislation and the processing of NCRMD cases through the forensic system across the provinces suggests that fair and equitable treatment under the law could be enhanced by increased national integration and collaboration.

  13. Statistical approaches to assessing single and multiple outcome measures in dry eye therapy and diagnosis.

    Science.gov (United States)

    Tomlinson, Alan; Hair, Mario; McFadyen, Angus

    2013-10-01

    Dry eye is a multifactorial disease which would require a broad spectrum of test measures in the monitoring of its treatment and diagnosis. However, studies have typically reported improvements in individual measures with treatment. Alternative approaches involve multiple, combined outcomes being assessed by different statistical analyses. In order to assess the effect of various statistical approaches to the use of single and combined test measures in dry eye, this review reanalyzed measures from two previous studies (osmolarity, evaporation, tear turnover rate, and lipid film quality). These analyses assessed the measures as single variables within groups, pre- and post-intervention with a lubricant supplement, by creating combinations of these variables and by validating these combinations with the combined sample of data from all groups of dry eye subjects. The effectiveness of single measures and combinations in diagnosis of dry eye was also considered. Copyright © 2013. Published by Elsevier Inc.

  14. Measurement of cardiorespiratory fitness in children from two commonly used field tests after accounting for body fatness and maturity.

    Science.gov (United States)

    Hamlin, Michael J; Fraser, Meegan; Lizamore, Catherine A; Draper, Nick; Shearman, Jeremy P; Kimber, Nicholas E

    2014-03-27

    Body fat and maturation both influence cardiorespiratory fitness, however few studies have taken these variables into account when using field tests to predict children's fitness levels. The purpose of this study was to determine the relationship between two field tests of cardiorespiratory fitness (20 m Maximal Multistage Shuttle Run [20-MST], 550 m distance run [550-m]) and direct measurement of VO2max after adjustment for body fatness and maturity levels. Fifty-three participants (25 boys, 28 girls, age 10.6 ± 1.2 y, mean ± SD) had their body fat levels estimated using bioelectrical impedance (16.6% ± 6.0% and 20.0% ± 5.8% for boys and girls, respectively). Participants performed in random order, the 20-MST and 550-m run followed by a progressive treadmill test to exhaustion during which gas exchange measures were taken. Pearson correlation coefficient analysis revealed that the participants' performance in the 20-MST and 550-m run were highly correlated to VO2max obtained during the treadmill test to exhaustion (r = 0.70 and 0.59 for 20-MST and 550-m run, respectively). Adjusting for body fatness and maturity levels in a multivariate regression analysis increased the associations between the field tests and VO2max (r = 0.73 for 20-MST and 0.65 for 550-m). We may conclude that both the 20-MST and the 550-m distance run are valid field tests of cardiorespiratory fitness in New Zealand 8-13 year old children and incorporating body fatness and maturity levels explains an additional 5-7% of the variance.

  15. Improving the Accuracy of Satellite Sea Surface Temperature Measurements by Explicitly Accounting for the Bulk-Skin Temperature Difference

    Science.gov (United States)

    Wick, Gary A.; Emery, William J.; Castro, Sandra L.; Lindstrom, Eric (Technical Monitor)

    2002-01-01

    The focus of this research was to determine whether the accuracy of satellite measurements of sea surface temperature (SST) could be improved by explicitly accounting for the complex temperature gradients at the surface of the ocean associated with the cool skin and diurnal warm layers. To achieve this goal, work was performed in two different major areas. The first centered on the development and deployment of low-cost infrared radiometers to enable the direct validation of satellite measurements of skin temperature. The second involved a modeling and data analysis effort whereby modeled near-surface temperature profiles were integrated into the retrieval of bulk SST estimates from existing satellite data. Under the first work area, two different seagoing infrared radiometers were designed and fabricated and the first of these was deployed on research ships during two major experiments. Analyses of these data contributed significantly to the Ph.D. thesis of one graduate student and these results are currently being converted into a journal publication. The results of the second portion of work demonstrated that, with presently available models and heat flux estimates, accuracy improvements in SST retrievals associated with better physical treatment of the near-surface layer were partially balanced by uncertainties in the models and extra required input data. While no significant accuracy improvement was observed in this experiment, the results are very encouraging for future applications where improved models and coincident environmental data will be available. These results are included in a manuscript undergoing final review with the Journal of Atmospheric and Oceanic Technology.

  16. Improved accountability method for measuring enriched uranium in H-Canyon dissolver solution at the Savannah River Site

    International Nuclear Information System (INIS)

    Maxwell, S.L. III; Satkowski, J.; Mahannah, R.N.

    1992-01-01

    At the Savannah River Site (SRS), accountability measurement of enriched uranium dissolved in H-Canyon is performed using isotope dilution mass spectrometry (IDMS). In the IDMS analytical method, a known quantity of uranium 233 is added to the sample solution containing enriched uranium and fission products. The resulting uranium mixture must first be purified using a separation technique in the shielded analytical(''hot'') cells to lower radioactivity levels by removing fission products. Following this purification, the sample is analyzed by mass spectrometry to determine the total uranium content and isotopic abundance. The magnitude of the response of each uranium isotope in the sample solution and the response of the U 233 spike is measured. By ratioing these responses, relative to the known quantity of the U 233 spike, the uranium content can be determined. A hexane solvent extraction technique, used for years at SRS to remove fission products prior to the mass spectrometry analysis of uranium, has several problems. The hexone method is tedious, requires additional sample clean-up after the purified sample is removed from the shielded cells and requires the use of Resource Conservation and Recovery Act (RCRA)-listed hazardous materials (hexone and chromium compounds). A new high speed separation method that enables a rapid removal of fission products in a shielded cells environment has been developed by the SRS Central Laboratory to replace the hexone method. The new high speed column extraction chromatography technique employs applied vacuum and columns containing tri (2-ethyl-hexyl) phosphate (TEHP) solvent coated on a small particle inert support (SM-7 Bio Beads). The new separation is rapid, user friendly, eliminates the use of the RCA-listed hazardous chemicals and reduces the amount of solid waste generated by the separation method. 2 tabs. 4 figs

  17. Should English healthcare providers be penalised for failing to collect patient-reported outcome measures? A retrospective analysis.

    Science.gov (United States)

    Gutacker, Nils; Street, Andrew; Gomes, Manuel; Bojke, Chris

    2015-08-01

    The best practice tariff for hip and knee replacement in the English National Health Service (NHS) rewards providers based on improvements in patient-reported outcome measures (PROMs) collected before and after surgery. Providers only receive a bonus if at least 50% of their patients complete the preoperative questionnaire. We determined how many providers failed to meet this threshold prior to the policy introduction and assessed longitudinal stability of participation rates. Retrospective observational study using data from Hospital Episode Statistics and the national PROM programme from April 2009 to March 2012. We calculated participation rates based on either (a) all PROM records or (b) only those that could be linked to inpatient records; constructed confidence intervals around rates to account for sampling variation; applied precision weighting to allow for volume; and applied risk adjustment. NHS hospitals and private providers in England. NHS patients undergoing elective unilateral hip and knee replacement surgery. Number of providers with participation rates statistically significantly below 50%. Crude rates identified many providers that failed to achieve the 50% threshold but there were substantially fewer after adjusting for uncertainty and precision. While important, risk adjustment required restricting the analysis to linked data. Year-on-year correlation between provider participation rates was moderate. Participation rates have improved over time and only a small number of providers now fall below the threshold, but administering preoperative questionnaires remains problematic in some providers. We recommend that participation rates are based on linked data and take into account sampling variation. © The Royal Society of Medicine.

  18. Initial constructs for patient-centered outcome measures to evaluate brain-computer interfaces.

    Science.gov (United States)

    Andresen, Elena M; Fried-Oken, Melanie; Peters, Betts; Patrick, Donald L

    2016-10-01

    The authors describe preliminary work toward the creation of patient-centered outcome (PCO) measures to evaluate brain-computer interface (BCI) as an assistive technology (AT) for individuals with severe speech and physical impairments (SSPI). In Phase 1, 591 items from 15 existing measures were mapped to the International Classification of Functioning, Disability and Health (ICF). In Phase 2, qualitative interviews were conducted with eight people with SSPI and seven caregivers. Resulting text data were coded in an iterative analysis. Most items (79%) were mapped to the ICF environmental domain; over half (53%) were mapped to more than one domain. The ICF framework was well suited for mapping items related to body functions and structures, but less so for items in other areas, including personal factors. Two constructs emerged from qualitative data: quality of life (QOL) and AT. Component domains and themes were identified for each. Preliminary constructs, domains and themes were generated for future PCO measures relevant to BCI. Existing instruments are sufficient for initial items but do not adequately match the values of people with SSPI and their caregivers. Field methods for interviewing people with SSPI were successful, and support the inclusion of these individuals in PCO research. Implications for Rehabilitation Adapted interview methods allow people with severe speech and physical impairments to participate in patient-centered outcomes research. Patient-centered outcome measures are needed to evaluate the clinical implementation of brain-computer interface as an assistive technology.

  19. Exploring Outcome Measures for Exercise Intervention in People with Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    L. A. King

    2013-01-01

    Full Text Available Background. It is widely believed that exercise improves mobility in people with Parkinson’s disease (PD. However, it is difficult to determine whether a specific type of exercise is the most effective. The purpose of this study was to determine which outcome measures were sensitive to exercise intervention and to explore the effects of two different exercise programs for improving mobility in patients with PD. Methods. Participants were randomized into either the Agility Boot Camp (ABC or treadmill training; 4x/week for 4 weeks. Outcome measures were grouped by the International Classification of Function/Disability (ICF. To determine the responsiveness to exercise, we calculated the standardized response means. t-tests were used to compare the relative benefits of each exercise program. Results. Four of five variables at the structure/function level changed after exercise: turn duration (P=0.03, stride velocity (P=0.001, peak arm speed (P=0.001, and horizontal trunk ROM during gait (P=0.02. Most measures improved similarly for both interventions. The only variable that detected a difference between groups was postural sway in ABC group (F=4.95; P=0.03. Conclusion. Outcome measures at ICF body structure/function level were most effective at detecting change after exercise and revealing differences in improvement between interventions.

  20. Capsular Outcomes After Pediatric Cataract Surgery Without Intraocular Lens Implantation: Qualitative Classification and Quantitative Measurement.

    Science.gov (United States)

    Tan, Xuhua; Lin, Haotian; Lin, Zhuoling; Chen, Jingjing; Tang, Xiangchen; Luo, Lixia; Chen, Weirong; Liu, Yizhi

    2016-03-01

    The objective of this study was to investigate capsular outcomes 12 months after pediatric cataract surgery without intraocular lens implantation via qualitative classification and quantitative measurement.This study is a cross-sectional study that was approved by the institutional review board of Zhongshan Ophthalmic Center of Sun Yat-sen University in Guangzhou, China.Digital coaxial retro-illumination photographs of 329 aphakic pediatric eyes were obtained 12 months after pediatric cataract surgery without intraocular lens implantation. Capsule digital coaxial retro-illumination photographs were divided as follows: anterior capsule opening area (ACOA), posterior capsule opening area (PCOA), and posterior capsule opening opacity (PCOO). Capsular outcomes were qualitatively classified into 3 types based on the PCOO: Type I-capsule with mild opacification but no invasion into the capsule opening; Type II-capsule with moderate opacification accompanied by contraction of the ACOA and invasion to the occluding part of the PCOA; and Type III-capsule with severe opacification accompanied by total occlusion of the PCOA. Software was developed to quantitatively measure the ACOA, PCOA, and PCOO using standardized DCRPs. The relationships between the accurate intraoperative anterior and posterior capsulorhexis sizes and the qualitative capsular types were statistically analyzed.The DCRPs of 315 aphakic eyes (95.8%) of 191 children were included. Capsular outcomes were classified into 3 types: Type I-120 eyes (38.1%); Type II-157 eyes (49.8%); Type III-38 eyes (12.1%). The scores of the capsular outcomes were negatively correlated with intraoperative anterior capsulorhexis size (R = -0.572, P PCOA increased in size from Type I to Type II, and the PCOO increased from Type II to Type III (all P < 0.05).Capsular outcomes after pediatric cataract surgery can be qualitatively classified and quantitatively measured by acquisition, division, definition, and user

  1. Reporting outcome measures of functional constipation in children from 0 to 4 years of age.

    Science.gov (United States)

    Kuizenga-Wessel, Sophie; Benninga, Marc A; Tabbers, Merit M

    2015-04-01

    Functional constipation (FC) often begins in the first year of life. Although standard definitions and criteria have been formulated to describe FC, these are rarely used in research and clinical practice. The aim of the study is to systematically assess how definitions and outcome measures are defined in therapeutic randomized controlled trials (RCTs) of infants with FC. PubMed, EMBASE, and Cochrane databases were searched. Studies were included if it was a (systematic review of) therapeutic RCT, children ≤4 years old, they had FC, a clear definition of constipation was provided, and were written in English. Quality was assessed using the Delphi list. A total of 1115 articles were found; only 5 studies fulfilled the inclusion criteria. Four different definitions were used, of which only 2 used the internationally accepted Rome III criteria. Defecation frequency was used as primary outcome in all included trials and stool consistency in 3 trials. Two trials involving infants investigated new infant formulas, whereas the third RCT evaluated the efficacy of a probiotic strain. The 2 trials including infants up to 4 years of age compared polyethylene glycol without electrolytes (PEG4000) with lactulose and milk of magnesia. All of the trials used nonvalidated parental diaries. Different definitions and outcome measures for FC in infants are used in RCTs. Disappointingly, there is a lack of well-designed therapeutic trials in infants with constipation. To make comparison between future trials possible, standard definitions, core outcomes, and validated instruments are needed.

  2. ACCRUAL ACCOUNTING BETWEEN DYNAMISM AND PRUDENCE

    Directory of Open Access Journals (Sweden)

    Mihaela TULVINSCHI

    2016-08-01

    Full Text Available Economic environment and the behavior of the economic entity is in continuous transformation. A determined value today may be outdated tomorrow. Consequently, maintaining a balance in the activity of the economic entity requires corrective actions. The purpose of this article is to highlight the connection between the accrual accounting, the dynamic accounting theory and the accounting prudence. Establishing the optimal timing for recognition of expenses, revenues and outcome, dynamic accounting theory gives managers quality information in order to make the best decisions. Adopting a prudent behavior is necessary in a reasonable measure in order to avoid serious repercussions caused by an exaggerated optimism.

  3. Prosthetists' perceptions and use of outcome measures in clinical practice: Long-term effects of focused continuing education.

    Science.gov (United States)

    Hafner, Brian J; Spaulding, Susan E; Salem, Rana; Morgan, Sara J; Gaunaurd, Ignacio; Gailey, Robert

    2017-06-01

    Continuing education is intended to facilitate clinicians' skills and knowledge in areas of practice, such as administration and interpretation of outcome measures. To evaluate the long-term effect of continuing education on prosthetists' confidence in administering outcome measures and their perceptions of outcomes measurement in clinical practice. Pretest-posttest survey methods. A total of 66 prosthetists were surveyed before, immediately after, and 2 years after outcomes measurement education and training. Prosthetists were grouped as routine or non-routine outcome measures users, based on experience reported prior to training. On average, prosthetists were just as confident administering measures 1-2 years after continuing education as they were immediately after continuing education. In all, 20% of prosthetists, initially classified as non-routine users, were subsequently classified as routine users at follow-up. Routine and non-routine users' opinions differed on whether outcome measures contributed to efficient patient evaluations (79.3% and 32.4%, respectively). Both routine and non-routine users reported challenges integrating outcome measures into normal clinical routines (20.7% and 45.9%, respectively). Continuing education had a long-term impact on prosthetists' confidence in administering outcome measures and may influence their clinical practices. However, remaining barriers to using standardized measures need to be addressed to keep practitioners current with evolving practice expectations. Clinical relevance Continuing education (CE) had a significant long-term impact on prosthetists' confidence in administering outcome measures and influenced their clinical practices. In all, approximately 20% of prosthetists, who previously were non-routine outcome measure users, became routine users after CE. There remains a need to develop strategies to integrate outcome measurement into routine clinical practice.

  4. The PU-PROM: A patient-reported outcome measure for peptic ulcer disease.

    Science.gov (United States)

    Liu, Na; Lv, Jing; Liu, Jinchun; Zhang, Yanbo

    2017-12-01

    Patient-reported outcome measure (PROM) conceived to enable description of treatment-related effects, from the patient perspective, bring the potential to improve in clinical research, and to provide patients with accurate information. Therefore, the aim of this study was to develop a patient-centred peptic ulcer patient-reported outcome measure (PU-PROM) and evaluate its reliability, validity, differential item functioning (DIF) and feasibility. To develop a conceptual framework and item pool for the PU-PROM, we performed a literature review and consulted other measures created in China and other countries. Beyond that, we interviewed 10 patients with peptic ulcers, and consulted six key experts to ensure that all germane parameters were included. In the first item selection phase, classical test theory and item response theory were used to select and adjust items to shape the preliminary measure completed by 130 patients and 50 controls. In the next phase, the measure was evaluated used the same methods with 492 patients and 124 controls. Finally, we used the same population in the second item reselection to assess the reliability, validity, DIF and feasibility of the final measure. The final peptic ulcer PRO measure comprised four domains (physiology, psychology, society and treatment), with 11 subdomains, and 54 items. The Cronbach's α coefficient of each subdomain for the measure was >0.800. Confirmatory factory analysis indicated that the construct validity fulfilled expectations. Model fit indices, such as RMR, RMSEA, NFI, NNFI, CFI and IFI, showed acceptable fit. The measure showed a good response rate. The peptic ulcer PRO measure had good reliability, validity, DIF and feasibility, and can be used as a clinical research evaluation instrument with patients with peptic ulcers to assess their condition focus on treatment. This measure may also be applied in other health areas, especially in clinical trials of new drugs, and may be helpful in clinical

  5. Perspectives of patients and professionals on the use of patient reported outcome measures in primary care

    DEFF Research Database (Denmark)

    Porter, Ian; Gangannagaripalli, Jaheeda; Davey, Antoinette

    2017-01-01

    /or healthcare professional’s perspectives on the clinical utility of using PROMs in clinical practice. Results: 19 studies met the inclusion criteria (4 after 2012), 11 of which were conducted in the UK, reporting on the views of professionals (8), patients (5), and both (7). The majority of studies (12...... communication it was also noted that they undermined the human element of consultations, along with professional intuition and judgement. Burden on GP time was also noted. Conclusions: Patients and professionals highlighted a number of benefits of using PROMs in clinical practice, particularly in terms......A71 Perspectives of patients and professionals on the use of patient-reported outcome measures in primary care: a systematic review of qualitative studies Background: Although the use of patient-reported outcome measures (PROMs) in healthcare settings has increased substantially over recent years...

  6. Development and validation of a preference weight multiattribute health outcome measure for rheumatoid arthritis.

    Science.gov (United States)

    Chiou, Chiun-Fang; Suarez-Almazor, Maria E; Sherbourne, Cathy D; Chang, Chih-Hung; Reyes, Carolina; Dylan, Michelle; Ofman, Joshua; Wallace, Daniel J; Mizutani, Wesley; Weisman, Michael

    2006-12-01

    To develop and validate multiattribute measures for patients with rheumatoid arthritis (RA) to report health states and estimate preference weights. Survey materials were mailed to 748 patients. Factor analysis, an item response theory-based model, and an internal consistency test were used to identify attributes and evaluate items. Two multiattribute preference weight functions (MAPWF) were constructed. Construct validity of the new measures was then tested. Four hundred eighty-seven patients returned the survey; 24 items on 6 health attributes were selected to form the new outcomes measure. Two MAPWF were derived with preference weights measured with time tradeoff and visual analog scales as dependent variables. All validity test results were statistically significant. Our results reveal that the new measures are reliable and valid in assessing health states and associated preference weights of patients with RA.

  7. Academic Outcome Measures of a Dedicated Education Unit Over Time: Help or Hinder?

    Science.gov (United States)

    Smyer, Tish; Gatlin, Tricia; Tan, Rhigel; Tejada, Marianne; Feng, Du

    2015-01-01

    Critical thinking, nursing process, quality and safety measures, and standardized RN exit examination scores were compared between students (n = 144) placed in a dedicated education unit (DEU) and those in a traditional clinical model. Standardized test scores showed that differences between the clinical groups were not statistically significant. This study shows that the DEU model is 1 approach to clinical education that can enhance students' academic outcomes.

  8. Capturing the True Value of Assistive Technologies to Consumers in Routine Outcome Measurement

    Directory of Open Access Journals (Sweden)

    Desleigh de Jonge

    2016-10-01

    Full Text Available (1 Background: Recent reforms in Australia, providing people with disability and older people with choice and control over allocated funding, have altered consumer expectations and transformed the landscape of assistive technology (AT service provision. The purpose of this study is to report on the routine AT outcomes of people who accessed an AT consultation service and examine how well these capture the impact of AT on their lives; (2 Methods: This study, which uses mixed methods for concurrent triangulation of the data, reports on the outcomes for 127 people who acquired a range of assistive technology in 2015 and examines the adequacy of an existing service outcome framework in capturing the true value of these technologies to AT users. Outcome data was routinely collected by a community service 2–4 months following an AT consultation. A telephone or face-to-face interview gathered demographic information as well as AT outcomes, using two standardized tools, the Individualized Prioritised Problem Assessment (IPPA and the EATS 6D. Qualitative comments relating to the impact of the AT on the person’s life were also documented; (3 Results: The acquired AT generally met or exceeded expectations of the person using the AT and the attending health professional. Overall, people experienced decreased difficulty and increased feelings of autonomy, with most of the reported improvements identified in mobility and usual activities; (4 Conclusion: Routine outcome data provide some evidence of the value of AT in addressing concerns as identified by clients. Qualitative data, which captured the impact of AT on people’s lives, suggest that the empowering and transformative aspects of AT are not currently being captured by existing measures.

  9. Strategic B2B customer experience management: the importance of outcomes-based measures

    OpenAIRE

    Zolkiewski, Judy; Story, Victoria; Burton, Jamie; Chan, Paul; Gomes, Andre; Hunter-Jones, Philippa; O’Malley, Lisa; Peters, Linda D.; Raddats, Chris; Robinson, William

    2017-01-01

    Purpose\\ud \\ud The purpose of this paper is to critique the adequacy of efforts to capture the complexities of customer experience in a business-to-business (B2B) context using input–output measures. The paper introduces a strategic customer experience management framework to capture the complexity of B2B service interactions and discusses the value of outcomes-based measurement.\\ud Design/methodology/approach\\ud \\ud This is a theoretical paper that reviews extant literature related to B2B cu...

  10. Measuring intangibles: Managing intangibles for tangible outcomes in research and innovation

    International Nuclear Information System (INIS)

    Carayannis, E.G.

    2004-01-01

    Knowledge sharing is critical to the success and survival of companies in knowledge intensive industries. It is essential to effectively measure knowledge creation and sharing to facilitate good investment decision making in knowledge management initiatives. This paper will focus on the identification of intangible benefits, the cause and effect relationships, and the applicability of existing metrics to these intangibles. The premise is that existing measurements may not apply. The development of new metrics for managing intangible assets to obtain tangible outcomes is a necessity. (author)

  11. Psychometric validation of patient-reported outcome measures assessing chronic constipation

    Directory of Open Access Journals (Sweden)

    Nelson LM

    2014-09-01

    Full Text Available Lauren M Nelson,1 Valerie SL Williams,1 Sheri E Fehnel,1 Robyn T Carson,2 James MacDougall,3 Mollie J Baird,3 Stavros Tourkodimitris,2 Caroline B Kurtz,3 Jeffrey M Johnston31RTI Health Solutions, Durham, NC, USA; 2Forest Research Institute, Jersey City, NJ, USA; 3Ironwood Pharmaceuticals, Cambridge, MA, USABackground: Measures assessing treatment outcomes in previous CC clinical trials have not met the requirements described in the US Food and Drug Administration's guidance on patient-reported outcomes.Aim: Psychometric analyses using data from one Phase IIb study and two Phase III trials of linaclotide for the treatment of chronic constipation (CC were conducted to document the measurement properties of patient-reported CC Symptom Severity Measures.Study methods: Each study had a multicenter, randomized, double-blind, placebo-controlled, parallel-group design, comparing placebo to four doses of oral linaclotide taken once daily for 4 weeks in the Phase IIb dose-ranging study (n=307 and to two doses of linaclotide taken once daily for 12 weeks in the Phase III trials (n=1,272. The CC Symptom Severity Measures addressing bowel function (Bowel Movement Frequency, Stool Consistency, Straining and abdominal symptoms (Bloating, Abdominal Discomfort, Abdominal Pain were administered daily using interactive voice-response system technology. Intraclass correlations, Pearson correlations, factor analyses, F-tests, and effect sizes were computed.Results: The CC Symptom Severity Measures demonstrated satisfactory test–retest reliability and construct validity. Factor analyses indicated one factor for abdominal symptoms and another for bowel symptoms. Known-groups F-tests substantiated the discriminating ability of the CC Symptom Severity Measures. Responsiveness statistics were moderate to strong, indicating that these measures are capable of detecting change.Conclusion: In large studies of CC patients, linaclotide significantly improved abdominal and

  12. Material control in nuclear fuel fabrication facilities. Part II. Accountability, instrumntation, and measurement techniques in fuel fabrication facilities, P.O.1236909. Final report

    International Nuclear Information System (INIS)

    Borgonovi, G.M.; McCartin, T.J.; McDaniel, T.; Miller, C.L.; Nguyen, T.

    1978-12-01

    This report describes the measurement techniques, the instrumentation, and the procedures used in accountability and control of nuclear materials, as they apply to fuel fabrication facilities. Some of the material included has appeared elswhere and it has been summarized. An extensive bibliography is included. A spcific example of application of the accountability methods to a model fuel fabrication facility which is based on the Westinghouse Anderson design

  13. Material control in nuclear fuel fabrication facilities. Part II. Accountability, instrumntation, and measurement techniques in fuel fabrication facilities, P. O. 1236909. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Borgonovi, G.M.; McCartin, T.J.; McDaniel, T.; Miller, C.L.; Nguyen, T.

    1978-12-01

    This report describes the measurement techniques, the instrumentation, and the procedures used in accountability and control of nuclear materials, as they apply to fuel fabrication facilities. Some of the material included has appeared elswhere and it has been summarized. An extensive bibliography is included. A spcific example of application of the accountability methods to a model fuel fabrication facility which is based on the Westinghouse Anderson design.

  14. A Systematic Review of Measurement Properties of Patient-Reported Outcome Measures Used in Patients Undergoing Total Knee Arthroplasty.

    Science.gov (United States)

    Gagnier, Joel J; Mullins, Megan; Huang, Hsiaomin; Marinac-Dabic, Danica; Ghambaryan, Anna; Eloff, Benjamin; Mirza, Faisal; Bayona, Manuel

    2017-05-01

    While clinical research on total knee arthroplasty (TKA) outcomes is prevalent in the literature, studies often have poor methodological and reporting quality. A high-quality patient-reported outcome instrument is reliable, valid, and responsive. Many studies evaluate these properties, but none have done so with a systematic and accepted method. The objectives of this study were to identify patient-reported outcome measures (PROMs) for TKA, and to critically appraise, compare, and summarize their psychometric properties using accepted methods. MEDLINE, EMBASE, SCOPUS, Web of Science, PsycINFO, and SPORTDiscus were systematically searched for articles with the following inclusion criteria: publication before December 2014, English language, non-generic PRO, and evaluation in the TKA population. Methodological quality and evidence of psychometric properties were assessed with the COnsensus-based standards for the selection of health Status Measurement INstruments (COSMIN) checklist and criteria for psychometric evidence proposed by the COSMIN group and Terwee et al. One-hundred fifteen studies on 32 PROMs were included in this review. Only the Work, Osteoarthritis or joint-Replacement Questionnaire, the Oxford Knee Score, and the Western Ontario and McMaster Universities Arthritis Index had 4 or more properties with positive evidence. Most TKA PROMs have limited evidence for their psychometric properties. Although not all the properties were studied, the Work, Osteoarthritis or joint-Replacement Questionnaire, with the highest overall ratings, could be a useful PROM for evaluating patients undergoing TKA. The methods and reporting of this literature can improve by following accepted guidelines. Published by Elsevier Inc.

  15. Internet accounting

    NARCIS (Netherlands)

    Pras, Aiko; van Beijnum, Bernhard J.F.; Sprenkels, Ron; Parhonyi, R.

    2001-01-01

    This article provides an introduction to Internet accounting and discusses the status of related work within the IETF and IRTF, as well as certain research projects. Internet accounting is different from accounting in POTS. To understand Internet accounting, it is important to answer questions like

  16. Term-equivalent functional brain maturational measures predict neurodevelopmental outcomes in premature infants.

    Science.gov (United States)

    El Ters, Nathalie M; Vesoulis, Zachary A; Liao, Steve M; Smyser, Christopher D; Mathur, Amit M

    2018-04-01

    Term equivalent age (TEA) brain MRI identifies preterm infants at risk for adverse neurodevelopmental outcomes. But some infants may experience neurodevelopmental impairments even in the absence of neuroimaging abnormalities. Evaluate the association of TEA amplitude-integrated EEG (aEEG) measures with neurodevelopmental outcomes at 24-36 months corrected age. We performed aEEG recordings and brain MRI at TEA (mean post-menstrual age of 39 (±2) weeks in a cohort of 60 preterm infants born at a mean gestational age of 26 (±2) weeks. Forty-four infants underwent Bayley Scales of Infant Development, 3rd Edition (BSID-III) testing at 24-36 months corrected age. Developmental delay was defined by a score greater than one standard deviation below the mean (neurodevelopmental outcomes was assessed using odds ratio, then adjusted for confounding variables using logistic regression. Infants with developmental delay in any domain had significantly lower values of SEF 90 . Absent cyclicity was more prevalent in infants with cognitive and motor delay. Both left and right SEF 90  neurodevelopmental outcomes. Therefore, a larger study is needed to validate these results in premature infants at low and high risk of brain injury. Copyright © 2018. Published by Elsevier B.V.

  17. Sensitivity of adaptive enrichment trial designs to accrual rates, time to outcome measurement, and prognostic variables

    Directory of Open Access Journals (Sweden)

    Tianchen Qian

    2017-12-01

    Full Text Available Adaptive enrichment designs involve rules for restricting enrollment to a subset of the population during the course of an ongoing trial. This can be used to target those who benefit from the experimental treatment. Trial characteristics such as the accrual rate and the prognostic value of baseline variables are typically unknown when a trial is being planned; these values are typically assumed based on information available before the trial starts. Because of the added complexity in adaptive enrichment designs compared to standard designs, it may be of special concern how sensitive the trial performance is to deviations from assumptions. Through simulation studies, we evaluate the sensitivity of Type I error, power, expected sample size, and trial duration to different design characteristics. Our simulation distributions mimic features of data from the Alzheimer's Disease Neuroimaging Initiative cohort study, and involve two subpopulations based on a genetic marker. We investigate the impact of the following design characteristics: the accrual rate, the time from enrollment to measurement of a short-term outcome and the primary outcome, and the prognostic value of baseline variables and short-term outcomes. To leverage prognostic information in baseline variables and short-term outcomes, we use a semiparametric, locally efficient estimator, and investigate its strengths and limitations compared to standard estimators. We apply information-based monitoring, and evaluate how accurately information can be estimated in an ongoing trial.

  18. Intercentre variance in patient reported outcomes is lower than objective rheumatoid arthritis activity measures

    DEFF Research Database (Denmark)

    Khan, Nasim Ahmed; Spencer, Horace Jack; Nikiphorou, Elena

    2017-01-01

    Objective: To assess intercentre variability in the ACR core set measures, DAS28 based on three variables (DAS28v3) and Routine Assessment of Patient Index Data 3 in a multinational study. Methods: Seven thousand and twenty-three patients were recruited (84 centres; 30 countries) using a standard...... built to adjust for the remaining ACR core set measure (for each ACR core set measure or each composite index), socio-demographics and medical characteristics. ANOVA and analysis of covariance models yielded similar results, and ANOVA tables were used to present variance attributable to recruiting...... centre. Results: The proportion of variances attributable to recruiting centre was lower for patient reported outcomes (PROs: pain, HAQ, patient global) compared with objective measures (joint counts, ESR, physician global) in all models. In the full model, variance in PROs attributable to recruiting...

  19. Goals and Psychological Accounting

    DEFF Research Database (Denmark)

    Koch, Alexander Karl; Nafziger, Julia

    We model how people formulate and evaluate goals to overcome self-control problems. People often attempt to regulate their behavior by evaluating goal-related outcomes separately (in narrow psychological accounts) rather than jointly (in a broad account). To explain this evidence, our theory...... of endogenous narrow or broad psychological accounts combines insights from the literatures on goals and mental accounting with models of expectations-based reference-dependent preferences. By formulating goals the individual creates expectations that induce reference points for task outcomes. These goal......-induced reference points make substandard performance psychologically painful and motivate the individual to stick to his goals. How strong the commitment to goals is depends on the type of psychological account. We provide conditions when it is optimal to evaluate goals in narrow accounts. The key intuition...

  20. Comparing the responsiveness of functional outcome assessment measures for trauma registries.

    Science.gov (United States)

    Williamson, Owen D; Gabbe, Belinda J; Sutherland, Ann M; Wolfe, Rory; Forbes, Andrew B; Cameron, Peter A

    2011-07-01

    Measuring long-term disability and functional outcomes after major trauma is not standardized across trauma registries. An ideal measure would be responsive to change but not have significant ceiling effects. The aim of this study was to compare the responsiveness of the Glasgow Outcome Scale (GOS), GOS-Extended (GOSE), Functional Independence Measure (FIM), and modified FIM in major trauma patients, with and without significant head injuries. Patients admitted to two adult Level I trauma centers in Victoria, Australia, who survived to discharge from hospital, were aged 15 years to 80 years with a blunt mechanism of injury, and had an estimated Injury Severity Score >15 on admission, were recruited for this prospective study. The instruments were administered at baseline (hospital discharge) and by telephone interview 6 months after injury. Measures of responsiveness, including effect sizes, were calculated. Bootstrapping techniques, and floor and ceiling effects, were used to compare the measures. Two hundred forty-three patients participated, of which 234 patients (96%) completed the study. The GOSE and GOS were the most responsive instruments in this major trauma population with effect sizes of 5.3 and 4.4, respectively. The GOSE had the lowest ceiling effect (17%). The GOSE was the instrument with greatest responsiveness and the lowest ceiling effect in a major trauma population with and without significant head injuries and is recommended for use by trauma registries for monitoring functional outcomes and benchmarking care. The results of this study do not support the use of the modified FIM for this purpose.

  1. Cerebral atrophy as outcome measure in short-term phase 2 clinical trials in multiple sclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Elskamp, I.J. van den; Boden, B.; Barkhof, F. [VU University Medical Center, Department of Radiology, MS Center Amsterdam, Amsterdam (Netherlands); Dattola, V. [VU University Medical Center, Department of Radiology, MS Center Amsterdam, Amsterdam (Netherlands); University of Messina, Department of Neurosciences, Psychiatric and Anaesthesiological Sciences, Messina (Italy); Knol, D.L. [VU University Medical Center, Department of Epidemiology and Biostatistics, Amsterdam (Netherlands); Filippi, M. [Scientific Institute and University Ospedale San Raffaele, Neuroimaging Research Unit, Milan (Italy); Kappos, L. [University Hospital, University of Basel, Department of Neurology, Basel (Switzerland); Fazekas, F. [Medical University of Graz, Department of Neurology, Graz (Austria); Wagner, K. [Bayer-Schering Pharma, Berlin (Germany); Pohl, C. [Bayer-Schering Pharma, Berlin (Germany); University Hospital Bonn, Department of Neurology, Bonn (Germany); Sandbrink, R. [Bayer-Schering Pharma, Berlin (Germany); Heinrich-Heine-University Dusseldorf, Department of Neurology, Dusseldorf (Germany); Polman, C.H. [VU University Medical Center, Department of Neurology, MS Center Amsterdam, Amsterdam (Netherlands); Uitdehaag, B.M.J. [VU University Medical Center, Department of Epidemiology and Biostatistics, Amsterdam (Netherlands); VU University Medical Center, Department of Neurology, MS Center Amsterdam, Amsterdam (Netherlands)

    2010-10-15

    Cerebral atrophy is a compound measure of the neurodegenerative component of multiple sclerosis (MS) and a conceivable outcome measure for clinical trials monitoring the effect of neuroprotective agents. In this study, we evaluate the rate of cerebral atrophy in a 6-month period, investigate the predictive and explanatory value of other magnetic resonance imaging (MRI) measures in relation to cerebral atrophy, and determine sample sizes for future short-term clinical trials using cerebral atrophy as primary outcome measure. One hundred thirty-five relapsing-remitting multiple sclerosis patients underwent six monthly MRI scans from which the percentage brain volume change (PBVC) and the number and volume of gadolinium (Gd)-enhancing lesions, T2 lesions, and persistent black holes (PBH) were determined. By means of multiple linear regression analysis, the relationship between focal MRI variables and PBVC was assessed. Sample size calculations were performed for all patients and subgroups selected for enhancement or a high T2 lesion load at baseline. A significant atrophy occurred over 6 months (PBVC = -0.33%, SE = 0.061, p < 0.0001). The number of baseline T2 lesions (p = 0.024), the on-study Gd-enhancing lesion volume (p = 0.044), and the number of on-study PBHs (p = 0.003) were associated with an increased rate of atrophy. For a 50% decrease in rate of atrophy, the sample size calculations showed that approximately 283 patients per arm are required in an unselected sampled population and 185 patients per arm are required in a selected population. Within a 6-month period, significant atrophy can be detected and on-study associations of PBVC and PBHs emphasizes axonal loss to be a driving mechanism. Application as primary outcome measure in short-term clinical trials with feasible sample size requires a potent drug to obtain sufficient power. (orig.)

  2. Measures of outcome for stimulant trials: ACTTION recommendations and research agenda.

    Science.gov (United States)

    Kiluk, Brian D; Carroll, Kathleen M; Duhig, Amy; Falk, Daniel E; Kampman, Kyle; Lai, Shengan; Litten, Raye Z; McCann, David J; Montoya, Ivan D; Preston, Kenzie L; Skolnick, Phil; Weisner, Constance; Woody, George; Chandler, Redonna; Detke, Michael J; Dunn, Kelly; Dworkin, Robert H; Fertig, Joanne; Gewandter, Jennifer; Moeller, F Gerard; Ramey, Tatiana; Ryan, Megan; Silverman, Kenneth; Strain, Eric C

    2016-01-01

    The development and approval of an efficacious pharmacotherapy for stimulant use disorders has been limited by the lack of a meaningful indicator of treatment success, other than sustained abstinence. In March, 2015, a meeting sponsored by Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) was convened to discuss the current state of the evidence regarding meaningful outcome measures in clinical trials for stimulant use disorders. Attendees included members of academia, funding and regulatory agencies, pharmaceutical companies, and healthcare organizations. The goal was to establish a research agenda for the development of a meaningful outcome measure that may be used as an endpoint in clinical trials for stimulant use disorders. Based on guidelines for the selection of clinical trial endpoints, the lessons learned from prior addiction clinical trials, and the process that led to identification of a meaningful indicator of treatment success for alcohol use disorders, several recommendations for future research were generated. These include a focus on the validation of patient reported outcome measures of functioning, the exploration of patterns of stimulant abstinence that may be associated with physical and/or psychosocial benefits, the role of urine testing for validating self-reported measures of stimulant abstinence, and the operational definitions for reduction-based measures in terms of frequency rather than quantity of stimulant use. These recommendations may be useful for secondary analyses of clinical trial data, and in the design of future clinical trials that may help establish a meaningful indicator of treatment success. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Clinical assessment and patient-reported outcome measures in low-back pain - a survey among primary health care physiotherapists.

    Science.gov (United States)

    Östhols, Sara; Boström, Carina; Rasmussen-Barr, Eva

    2018-05-09

    We aimed to map the physiotherapy practice in Sweden of clinical tests and patient-reported outcome measures in low-back pain (LBP), and to study advantages and barriers in using patient-reported outcome measures. An online survey was mailed to 4934 physiotherapists in primary health care in Sweden. Multiple choice questions investigated the use of clinical tests and patient-reported outcome measures in assessing patients with LBP. Open questions investigating the advantages and barriers to the use of patient-reported outcome measures were analyzed with content analysis. The response rate was 25% (n = 1217). Clinical tests were used "always/often" by >60% of the participants, while most patient-reported outcome measures were used by measures were: the clinical reasoning process, to increase the quality of assessment, to get the patient's voice, education and motivation of patients, and communication with health professionals. Barriers were lack of time and knowledge, administrative aspects, the interaction between physiotherapist and patient and, the applicability and validity of the patient-reported outcome measures. Our findings show that physiotherapists working in primary health care use clinical testing in LBP to a great extent, while various patient-reported outcome measures are used to a low-to-very-low extent. Several barriers to the use of patient-reported outcome measures were reported such as time, knowledge, and administrative issues, while important findings on advantages were to enhance the clinical reasoning process and to educate and motivate the patient. Barriers might be changed through education or organizational change-work. To enhance the use of patient-reported outcome measures and thus person-centered care in low-back pain, recommendation, and education on various patient-reported outcome measures need to be advocated. Implications for rehabilitation To increase the effects of rehabilitation in low-back pain, yellow flags, and other

  4. Outcome measures in studies on the use of oxytocin for the treatment of delay in labour: A systematic review.

    LENUS (Irish Health Repository)

    Begley, Cecily M

    2014-07-01

    to identify primary and secondary outcome measures in randomised trials, and systematic reviews of randomised trials, measuring effectiveness of oxytocin for treatment of delay in the first and second stages of labour, and to identify any positive health-focussed outcomes used.

  5. Correlating nerve conduction studies and clinical outcome measures on carpal tunnel syndrome: lessons from a randomized controlled trial

    NARCIS (Netherlands)

    Schrijver, H.M.; Gerritsen, A.A.M.; Strijers, R.L.; Uitdehaag, B.M.J.; Scholten, R.J.P.M.; Vet, de H.C.W.; Bouter, L.M.

    2005-01-01

    0.4) were found between the neurophysiologic and clinical outcome measures after 12 months, and between the changes in these different categories of outcome measures. This study confirms that the parameters of NCS improve significantly after treatment for CTS, but the modest correlations between

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

    Science.gov (United States)

    Bopp, Melissa; Bopp, Christopher; Schuchert, Megan

    2015-03-01

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

  7. The Role of Patient-Reported Outcome Measures in Value-Based Payment Reform.

    Science.gov (United States)

    Squitieri, Lee; Bozic, Kevin J; Pusic, Andrea L

    2017-06-01

    The U.S. health care system is currently experiencing profound change. Pressure to improve the quality of patient care and control costs have caused a rapid shift from traditional volume-driven fee-for-service reimbursement to value-based payment models. Under the 2015 Medicare Access and Children's Health Insurance Program Reauthorization Act, providers will be evaluated on the basis of quality and cost efficiency and ultimately receive adjusted reimbursement as per their performance. Although current performance metrics do not incorporate patient-reported outcome measures (PROMs), many wonder whether and how PROMs will eventually fit into value-based payment reform. On November 17, 2016, the second annual Patient-Reported Outcomes in Healthcare Conference brought together international stakeholders across all health care disciplines to discuss the potential role of PROs in value-based health care reform. The purpose of this article was to summarize the findings from this conference in the context of recent literature and guidelines to inform implementation of PROs in value-based payment models. Recommendations for evaluating key perspectives and measurement goals are made to facilitate appropriate use of PROMs to best benefit and amplify the voice of our patients. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  8. Evaluation of outcome measures for use in clinical practice for adults with musculoskeletal conditions of the knee: a systematic review.

    Science.gov (United States)

    Howe, Tracey E; Dawson, Lesley J; Syme, Grant; Duncan, Louise; Reid, Judith

    2012-04-01

    This systematic review reported on the clinimetric properties of outcome measures for use in clinical practice for adults with musculoskeletal conditions of the knee. A systematic search was performed in Medline, EMBASE, Cinahl and AMED to identify studies examining the clinimetric properties of outcome measures for adults undergoing conservative treatment of ligament injuries, meniscal lesions, patellofemoral pain and osteoarthritis of the knee. Outcomes measures taking less than 20 min to administer and requiring minimal equipment and space were included. Pairs of authors used a checklist to record the characteristics of the outcome measures, their reported clinimetric properties and the demographics of the study populations. The OMERACT filters of 'truth' and 'discrimination' were applied to the data for each outcome measure by an expert panel. Forty-seven studies were included evaluating 37 outcome measures. Ten outcome measures had adequate supporting evidence for 'truth' and 'discrimination': AAOS, AKPS, goniometer measurement, IKDC, KOOS, LEFS, Lysholm, Tegner, WOMAC and WOMET. However none of the outcome measures had been comprehensively tested across all clinimetric properties. Despite the widespread use of some outcome measures in clinical practice and primary research, data on the clinimetric properties were available for only 37 and of these only 10 had adequate supporting evidence for use in this population. However, before a core set of outcome measures can be recommended use in clinical practice, for adults with musculoskeletal conditions of the knee, consensus should be obtained on 'feasibility' in terms of burden on the clinician and the participant. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. No common denominator: a review of outcome measures in IVF RCTs.

    Science.gov (United States)

    Wilkinson, Jack; Roberts, Stephen A; Showell, Marian; Brison, Daniel R; Vail, Andy

    2016-12-01

    Which outcome measures are reported in RCTs for IVF? Many combinations of numerator and denominator are in use, and are often employed in a manner that compromises the validity of the study. The choice of numerator and denominator governs the meaning, relevance and statistical integrity of a study's results. RCTs only provide reliable evidence when outcomes are assessed in the cohort of randomised participants, rather than in the subgroup of patients who completed treatment. Review of outcome measures reported in 142 IVF RCTs published in 2013 or 2014. Trials were identified by searching the Cochrane Gynaecology and Fertility Specialised Register. English-language publications of RCTs reporting clinical or preclinical outcomes in peer-reviewed journals in the period 1 January 2013 to 31 December 2014 were eligible. Reported numerators and denominators were extracted. Where they were reported, we checked to see if live birth rates were calculated correctly using the entire randomised cohort or a later denominator. Over 800 combinations of numerator and denominator were identified (613 in no more than one study). No single outcome measure appeared in the majority of trials. Only 22 (43%) studies reporting live birth presented a calculation including all randomised participants or only excluding protocol violators. A variety of definitions were used for key clinical numerators: for example, a consensus regarding what should constitute an ongoing pregnancy does not appear to exist at present. Several of the included articles may have been secondary publications. Our categorisation scheme was essentially arbitrary, so the frequencies we present should be interpreted with this in mind. The analysis of live birth denominators was post hoc. There is massive diversity in numerator and denominator selection in IVF trials due to its multistage nature, and this causes methodological frailty in the evidence base. The twin spectres of outcome reporting bias and analysis of non

  10. Historical perspective: The pros and cons of conventional outcome measures in Parkinson's disease.

    Science.gov (United States)

    Lim, Shen-Yang; Tan, Ai Huey

    2018-01-01

    Conventional outcome measures (COMs) in Parkinson's disease (PD) refer to rating scales, questionnaires, patient diaries and clinically-based tests that do not require specialized equipment. It is timely at this juncture - as clinicians and researchers begin to grapple with the "invasion" of digital technologies - to review the strengths and weaknesses of these outcome measures. This paper discusses advances (including an enhanced understanding of PD itself, and the development of clinimetrics as a field) that have led to improvements in the COMs used in PD; their strengths and limitations; and factors to consider when selecting and using a measuring instrument. It is envisaged that in the future, a combination of COMs and technology-based objective measures will be utilized, with different methods having their own strengths and weaknesses. Judgement is required on the part of the clinician and researcher in terms of which instrument(s) are appropriate to use, depending on the particular clinical or research setting or question. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Alzheimer Disease Biomarkers as Outcome Measures for Clinical Trials in MCI.

    Science.gov (United States)

    Caroli, Anna; Prestia, Annapaola; Wade, Sara; Chen, Kewei; Ayutyanont, Napatkamon; Landau, Susan M; Madison, Cindee M; Haense, Cathleen; Herholz, Karl; Reiman, Eric M; Jagust, William J; Frisoni, Giovanni B

    2015-01-01

    The aim of this study was to compare the performance and power of the best-established diagnostic biological markers as outcome measures for clinical trials in patients with mild cognitive impairment (MCI). Magnetic resonance imaging, F-18 fluorodeoxyglucose positron emission tomography markers, and Alzheimer's Disease Assessment Scale-cognitive subscale were compared in terms of effect size and statistical power over different follow-up periods in 2 MCI groups, selected from Alzheimer's Disease Neuroimaging Initiative data set based on cerebrospinal fluid (abnormal cerebrospinal fluid Aβ1-42 concentration-ABETA+) or magnetic resonance imaging evidence of Alzheimer disease (positivity to hippocampal atrophy-HIPPO+). Biomarkers progression was modeled through mixed effect models. Scaled slope was chosen as measure of effect size. Biomarkers power was estimated using simulation algorithms. Seventy-four ABETA+ and 51 HIPPO+ MCI patients were included in the study. Imaging biomarkers of neurodegeneration, especially MR measurements, showed highest performance. For all biomarkers and both MCI groups, power increased with increasing follow-up time, irrespective of biomarker assessment frequency. These findings provide information about biomarker enrichment and outcome measurements that could be employed to reduce MCI patient samples and treatment duration in future clinical trials.

  12. Evaluating the use of gas discharge visualization to measure massage therapy outcomes

    Science.gov (United States)

    Haun, Jolie; Patel, Nitin; Schwartz, Gary; Ritenbaugh, Cheryl

    2017-01-01

    Background The purpose of this study was to evaluate the short-term effects of massage therapy using gas discharge visualization (GDV), a computerized biophysical electrophoton capture (EPC), in tandem with traditional self-report measures to evaluate the use of GDV measurement to assess the bioenergetic whole-person effects of massage therapy. Methods This study used a single treatment group, pre–post-repeated measures design with a sample of 23 healthy adults. This study utilized a single 50-min full-body relaxation massage with participants. GDV measurement method, an EPC, and traditional paper-based measures evaluating pain, stress, muscle tension, and well-being were used to assess intervention outcomes. Results Significant differences were found between pre- and post-measures of well-being, pain, stress, muscle tension, and GDV parameters. Pearson correlations indicate the GDV measure is correlated with pain and stress, variables that impact the whole person. Conclusions This study demonstrates that GDV parameters may be used to indicate significant bioenergetic change from pre- to post-massage. Findings warrant further investigation with a larger diverse sample size and control group to further explore GDV as a measure of whole-person bioenergetic effects associated with massage. PMID:26087069

  13. Core outcome measurement instruments for clinical trials in nonspecific low back pain

    Science.gov (United States)

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

    2018-01-01

    Abstract To standardize outcome reporting in clinical trials of patients with nonspecific low back pain, an international multidisciplinary panel recommended physical functioning, pain intensity, and health-related quality of life (HRQoL) as core outcome domains. Given the lack of a consensus on measurement instruments for these 3 domains in patients with low back pain, this study aimed to generate such consensus. The measurement properties of 17 patient-reported outcome measures for physical functioning, 3 for pain intensity, and 5 for HRQoL were appraised in 3 systematic reviews following the COSMIN methodology. Researchers, clinicians, and patients (n = 207) were invited in a 2-round Delphi survey to generate consensus (≥67% agreement among participants) on which instruments to endorse. Response rates were 44% and 41%, respectively. In round 1, consensus was achieved on the Oswestry Disability Index version 2.1a for physical functioning (78% agreement) and the Numeric Rating Scale (NRS) for pain intensity (75% agreement). No consensus was achieved on any HRQoL instrument, although the Short Form 12 (SF12) approached the consensus threshold (64% agreement). In round 2, a consensus was reached on an NRS version with a 1-week recall period (96% agreement). Various participants requested 1 free-to-use instrument per domain. Considering all issues together, recommendations on core instruments were formulated: Oswestry Disability Index version 2.1a or 24-item Roland-Morris Disability Questionnaire for physical functioning, NRS for pain intensity, and SF12 or 10-item PROMIS Global Health form for HRQoL. Further studies need to fill the evidence gaps on the measurement properties of these and other instruments. PMID:29194127

  14. A critical appraisal of instruments to measure outcomes of interprofessional education.

    Science.gov (United States)

    Oates, Matthew; Davidson, Megan

    2015-04-01

    Interprofessional education (IPE) is believed to prepare health professional graduates for successful collaborative practice. A range of instruments have been developed to measure the outcomes of IPE. An understanding of the psychometric properties of these instruments is important if they are to be used to measure the effectiveness of IPE. This review set out to identify instruments available to measure outcomes of IPE and collaborative practice in pre-qualification health professional students and to critically appraise the psychometric properties of validity, responsiveness and reliability against contemporary standards for instrument design. Instruments were selected from a pool of extant instruments and subjected to critical appraisal to determine whether they satisfied inclusion criteria. The qualitative and psychometric attributes of the included instruments were appraised using a checklist developed for this review. Nine instruments were critically appraised, including the widely adopted Readiness for Interprofessional Learning Scale (RIPLS) and the Interdisciplinary Education Perception Scale (IEPS). Validity evidence for instruments was predominantly based on test content and internal structure. Ceiling effects and lack of scale width contribute to the inability of some instruments to detect change in variables of interest. Limited reliability data were reported for two instruments. Scale development and scoring protocols were generally reported by instrument developers, but the inconsistent application of scoring protocols for some instruments was apparent. A number of instruments have been developed to measure outcomes of IPE in pre-qualification health professional students. Based on reported validity evidence and reliability data, the psychometric integrity of these instruments is limited. The theoretical test construction paradigm on which instruments have been developed may be contributing to the failure of some instruments to detect change in

  15. Varying the item format improved the range of measurement in patient-reported outcome measures assessing physical function.

    Science.gov (United States)

    Liegl, Gregor; Gandek, Barbara; Fischer, H Felix; Bjorner, Jakob B; Ware, John E; Rose, Matthias; Fries, James F; Nolte, Sandra

    2017-03-21

    Physical function (PF) is a core patient-reported outcome domain in clinical trials in rheumatic diseases. Frequently used PF measures have ceiling effects, leading to large sample size requirements and low sensitivity to change. In most of these instruments, the response category that indicates the highest PF level is the statement that one is able to perform a given physical activity without any limitations or difficulty. This study investigates whether using an item format with an extended response scale, allowing respondents to state that the performance of an activity is easy or very easy, increases the range of precise measurement of self-reported PF. Three five-item PF short forms were constructed from the Patient-Reported Outcomes Measurement Information System (PROMIS®) wave 1 data. All forms included the same physical activities but varied in item stem and response scale: format A ("Are you able to …"; "without any difficulty"/"unable to do"); format B ("Does your health now limit you …"; "not at all"/"cannot do"); format C ("How difficult is it for you to …"; "very easy"/"impossible"). Each short-form item was answered by 2217-2835 subjects. We evaluated unidimensionality and estimated a graded response model for the 15 short-form items and remaining 119 items of the PROMIS PF bank to compare item and test information for the short forms along the PF continuum. We then used simulated data for five groups with different PF levels to illustrate differences in scoring precision between the short forms using different item formats. Sufficient unidimensionality of all short-form items and the original PF item bank was supported. Compared to formats A and B, format C increased the range of reliable measurement by about 0.5 standard deviations on the positive side of the PF continuum of the sample, provided more item information, and was more useful in distinguishing known groups with above-average functioning. Using an item format with an extended

  16. Objectively measured walkability and active transport and weight-related outcomes in adults: a systematic review.

    Science.gov (United States)

    Grasser, Gerlinde; Van Dyck, Delfien; Titze, Sylvia; Stronegger, Willibald

    2013-08-01

    The aim of this study was to investigate which GIS-based measures of walkability (density, land-use mix, connectivity and walkability indexes) in urban and suburban neighbourhoods are used in research and which of them are consistently associated with walking and cycling for transport, overall active transportation and weight-related measures in adults. A systematic review of English publications using PubMed, Science Direct, Active Living Research Literature Database, the Transportation Research Information Service and reference lists was conducted. The search terms utilised were synonyms for GIS in combination with synonyms for the outcomes. Thirty-four publications based on 19 different studies were eligible. Walkability measures such as gross population density, intersection density and walkability indexes most consistently correlated with measures of physical activity for transport. Results on weight-related measures were inconsistent. More research is needed to determine whether walkability is an appropriate measure for predicting weight-related measures and overall active transportation. As most of the consistent correlates, gross population density, intersection density and the walkability indexes have the potential to be used in planning and monitoring.

  17. Advancing Accounting Research of Teaching Efficacy: Developing a Scale to Measure Student Attitudes toward Active Learning Experiences

    Science.gov (United States)

    Burney, Laurie; Zascavage, Victoria; Matherly, Michele

    2017-01-01

    Literature consistently documents a positive, direct effect of students' attitudes on learning (Lizzio, Wilson, & Simons, 2002). Hence, accounting studies describing active learning activities often report student attitudes as evidence of efficacy (e.g., Matherly & Burney, 2013), but rely on single-item instead of multi-item scales. This…

  18. Toward Ensuring Health Equity: Readability and Cultural Equivalence of OMERACT Patient-reported Outcome Measures.

    Science.gov (United States)

    Petkovic, Jennifer; Epstein, Jonathan; Buchbinder, Rachelle; Welch, Vivian; Rader, Tamara; Lyddiatt, Anne; Clerehan, Rosemary; Christensen, Robin; Boonen, Annelies; Goel, Niti; Maxwell, Lara J; Toupin-April, Karine; De Wit, Maarten; Barton, Jennifer; Flurey, Caroline; Jull, Janet; Barnabe, Cheryl; Sreih, Antoine G; Campbell, Willemina; Pohl, Christoph; Duruöz, Mehmet Tuncay; Singh, Jasvinder A; Tugwell, Peter S; Guillemin, Francis

    2015-12-01

    The goal of the Outcome Measures in Rheumatology (OMERACT) 12 (2014) equity working group was to determine whether and how comprehensibility of patient-reported outcome measures (PROM) should be assessed, to ensure suitability for people with low literacy and differing cultures. The English, Dutch, French, and Turkish Health Assessment Questionnaires and English and French Osteoarthritis Knee and Hip Quality of Life questionnaires were evaluated by applying 3 readability formulas: Flesch Reading Ease, Flesch-Kincaid grade level, and Simple Measure of Gobbledygook; and a new tool, the Evaluative Linguistic Framework for Questionnaires, developed to assess text quality of questionnaires. We also considered a study assessing cross-cultural adaptation with/without back-translation and/or expert committee. The results of this preconference work were presented to the equity working group participants to gain their perspectives on the importance of comprehensibility and cross-cultural adaptation for PROM. Thirty-one OMERACT delegates attended the equity session. Twenty-six participants agreed that PROM should be assessed for comprehensibility and for use of suitable methods (4 abstained, 1 no). Twenty-two participants agreed that cultural equivalency of PROM should be assessed and suitable methods used (7 abstained, 2 no). Special interest group participants identified challenges with cross-cultural adaptation including resources required, and suggested patient involvement for improving translation and adaptation. Future work will include consensus exercises on what methods are required to ensure PROM are appropriate for people with low literacy and different cultures.

  19. Patient Reported Outcome Measure of Spiritual Care as Delivered by Chaplains.

    Science.gov (United States)

    Snowden, Austyn; Telfer, Iain

    2017-01-01

    Chaplains are employed by health organizations around the world to support patients in recognizing and addressing their spiritual needs. There is currently no generalizable measure of the impact of these interventions and so the clinical and strategic worth of chaplaincy is difficult to articulate. This article introduces the Scottish PROM, an original five-item patient reported outcome measure constructed specifically to address this gap. It describes the validation process from its conceptual grounding in the spiritual care literature through face and content validity cycles. It shows that the Scottish PROM is internally consistent and unidimensional. Responses to the Scottish PROM show strong convergent validity with responses to the Warwick and Edinburgh Mental Well-Being Scale, a generic well-being scale often used as a proxy for spiritual well-being. In summary, the Scottish PROM is fit for purpose. It measures the outcomes of spiritual care as delivered by chaplains in this study. This novel project introduces an essential and original breakthrough; the possibility of generalizable international chaplaincy research.

  20. Validity of the Symbol Digit Modalities Test as a cognition performance outcome measure for multiple sclerosis.

    Science.gov (United States)

    Benedict, Ralph Hb; DeLuca, John; Phillips, Glenn; LaRocca, Nicholas; Hudson, Lynn D; Rudick, Richard

    2017-04-01

    Cognitive and motor performance measures are commonly employed in multiple sclerosis (MS) research, particularly when the purpose is to determine the efficacy of treatment. The increasing focus of new therapies on slowing progression or reversing neurological disability makes the utilization of sensitive, reproducible, and valid measures essential. Processing speed is a basic elemental cognitive function that likely influences downstream processes such as memory. The Multiple Sclerosis Outcome Assessments Consortium (MSOAC) includes representatives from advocacy organizations, Food and Drug Administration (FDA), European Medicines Agency (EMA), National Institute of Neurological Disorders and Stroke (NINDS), academic institutions, and industry partners along with persons living with MS. Among the MSOAC goals is acceptance and qualification by regulators of performance outcomes that are highly reliable and valid, practical, cost-effective, and meaningful to persons with MS. A critical step for these neuroperformance metrics is elucidation of clinically relevant benchmarks, well-defined degrees of disability, and gradients of change that are deemed clinically meaningful. This topical review provides an overview of research on one particular cognitive measure, the Symbol Digit Modalities Test (SDMT), recognized as being particularly sensitive to slowed processing of information that is commonly seen in MS. The research in MS clearly supports the reliability and validity of this test and recently has supported a responder definition of SDMT change approximating 4 points or 10% in magnitude.