Sample records for clinical rating scale

  1. Scale for the assessment and rating of ataxia: development of a new clinical scale.

    NARCIS (Netherlands)

    Schmitz-Hubsch, T.; Montcel, S.T. du; Baliko, L.; Berciano, J.; Boesch, S.; Depondt, C.; Giunti, P.; Globas, C.; Infante, J.; Kang, J.S.; Kremer, H.P.H.; Mariotti, C.; Melegh, B.; Pandolfo, M.; Rakowicz, M.; Ribai, P.; Rola, R.; Schols, L.; Szymanski, S.; Warrenburg, B.P.C. van de; Durr, A.; Klockgether, T.; Fancellu, R.


    OBJECTIVE: To develop a reliable and valid clinical scale measuring the severity of ataxia. METHODS: The authors devised the Scale for the Assessment and Rating of Ataxia (SARA) and tested it in two trials of 167 and 119 patients with spinocerebellar ataxia. RESULTS: The mean time to administer SARA

  2. Standardized clinical outcome rating scale for depression for use in clinical practice. (United States)

    Zimmerman, Mark; Posternak, Michael A; Chelminski, Iwona; Friedman, Michael


    The integration of research into clinical practice to conduct effectiveness studies faces multiple obstacles. One obstacle is the burden of completing research measures of outcome. A simple, reliable, and valid measure that could be rated at every visit, incorporated into a clinician's progress note, and reflect the DSM-IV definition of a major depressive episode (including partial and full remission from the episode) would enhance the ability to conduct effectiveness research. The goal of the present study was to examine the reliability and validity of such a measure. Three hundred and three psychiatric outpatients who were being treated for a DSM-IV major depressive episode were rated on the Standardized Clinical Outcome Rating for Depression (SCOR-D), 17-item Hamilton Rating Scale for Depression, Montgomery-Asberg Depression Rating Scale, and the Global Assessment of Functioning. We examined the correlation between the SCOR-D and the other measures, and conducted an analyses of variance to compare mean values on these measures for each rating point on the SCOR-D. The inter-rater reliability of the SCOR-D dimensional ratings and categorical determination of remission were high. The SCOR-D was highly correlated with the other scales, and there were significant differences on the other measures of depression severity between each adjacent rating level of the SCOR-D. The SCOR-D is a brief standardized outcome measure linked to the DSM-IV approach toward defining remission that can be incorporated into routine clinical practice without adding undue burden to the treating clinician with some evidence of reliability and validity. This measure could make it more feasible to conduct effectiveness studies in clinical practice.

  3. Outcome Rating Scale and Session Rating Scale in Psychological Practice: Clinical Utility of Ultra-Brief Measures (United States)

    Campbell, Alistair; Hemsley, Samantha


    The validity and reliability of the Outcome Rating Scale (ORS) and the Session Rating Scale (SRS) were evaluated against existing longer measures, including the Outcome Questionnaire-45, Working Alliance Inventory, Depression Anxiety Stress Scale-21, Quality of Life Scale, Rosenberg Self-Esteem Scale and General Self-efficacy Scale. The measures…

  4. Raters & Rating Scales. (United States)

    Lopez, Winifred A.; Stone, Mark H.


    The first article in this section, "Rating Scales and Shared Meaning," by Winifred A. Lopez, discusses the analysis of rating scale data. The second article, "Rating Scale Categories: Dichotomy, Double Dichotomy, and the Number Two," by Mark H. Stone, argues that dichotomies in rating scales are more useful than multiple ratings. (SLD)

  5. [The ICD-10 Symptom Rating (ISR): validation of the depression scale in a clinical sample]. (United States)

    Brandt, Wolfram Alexis; Loew, Thomas; von Heymann, Friedrich; Stadtmüller, Godehard; Georgi, Alexander; Tischinger, Michael; Strom, Frederik; Mutschler, Friederike; Tritt, Karin


    The ICD-10 Symptom Rating (ISR) 1 measures the severity of psychiatric disorders with 29 items on 5 subscales as comprehensively as possible. The following syndromes are measured: Depressive syndrome, anxiety syndrome, obsessive-compulsive syndrome, Somatoform syndrome, eating disorder syndrome as well as additional items that cover various mental syndromes, and an overall score. The study reports findings on the validity and sensitivity to change of the depression subscale (ISR-D). In a clinical sample of N=949 inpatients with depression spectrum disorders the convergent validity was determined by correlation with the Beck Depression Inventory (BDI) 3 and the subscale "depression" of the Symptom-Checklist-90-R (SCL-90-R) 4. The high correlation between the different instruments confirms the validity of the ISR-Depression Scale. The sensitivity to change of the ISR seems higher than that of the BDI and the SCL-90. Because of its economy and the good psychometric properties the ISR is recommended for use in clinical samples.

  6. Ataxia rating scales--psychometric profiles, natural history and their application in clinical trials. (United States)

    Saute, Jonas Alex Morales; Donis, Karina Carvalho; Serrano-Munuera, Carmen; Genis, David; Ramirez, Luís Torres; Mazzetti, Pilar; Pérez, Luis Velázquez; Latorre, Pilar; Sequeiros, Jorge; Matilla-Dueñas, Antoni; Jardim, Laura Bannach


    We aimed to perform a comprehensive systematic review of the existing ataxia scales. We described the disorders for which the instruments have been validated and used, the time spent in its application, its validated psychometric properties, and their use in studies of natural history and clinical trials. A search from 1997 onwards was performed in the MEDLINE, LILACS, and Cochrane databases. The web sites and were also used to identify the endpoints used in ongoing randomized clinical trials. We identified and described the semiquantitative ataxia scales (ICARS, SARA, MICARS, BARS); semiquantitative ataxia and non-ataxia scales (UMSARS, FARS, NESSCA); a semiquantitative non-ataxia scale (INAS); quantitative ataxia scales (CATSYS 2000, AFCS, CCFS and CCFSw, and SCAFI); and the self-performed ataxia scale (FAIS). SARA and ICARS were the best studied and validated so far, and their reliability sustain their use. Ataxia and non-ataxia scores will probably provide a better view of the overall disability in long-term trials and studies of natural history. Up to now, no clear advantage has been disclosed for any of them; however, we recommend the use of specific measurements of gait since gait ataxia is the first significant manifestation in the majority of ataxia disorders and comment on the best scales to be used in specific ataxia forms. Quantitative ataxia scales will be needed to speed up evidence from phase II clinical trials, from trials focused on the early phase of diseases, and for secondary endpoints in phase III trials. Finally, it is worth remembering that estimation of the actual minimal clinically relevant difference is still lacking; this, together with changes in quality of life, will probably be the main endpoints to measure in future therapeutic studies.

  7. Evidence Based Clinical Assessment of Child and Adolescent Social Phobia: A Critical Review of Rating Scales (United States)

    Tulbure, Bogdan T.; Szentagotai, Aurora; Dobrean, Anca; David, Daniel


    Investigating the empirical support of various assessment instruments, the evidence based assessment approach expands the scientific basis of psychotherapy. Starting from Hunsley and Mash's evaluative framework, we critically reviewed the rating scales designed to measure social anxiety or phobia in youth. Thirteen of the most researched social…

  8. The development, reliability, and validity of a clinical rating scale for codependency. (United States)

    Harkness, D; Swenson, M; Madsen-Hampton, K; Hale, R


    This investigation examined the reliability and validity of a rating scale for codependency in substance abuse treatment. The investigators developed an example-anchored rating scale to operationalize codependency as substance abuse counselors construe it in practice, and recruited 27 counselors for a counterbalanced multiple-treatment experiment. Counselors were randomly assigned to one of four continuing education workshops for rating-scale training, and asked to evaluate codependency in five videotaped cases. Semistructured case interviews were videotaped with a male and a female from five adult populations to vary the gender and codependency of cases: (1) outpatients in treatment for addiction, (2) outpatient spouses, (3) members of Codependents Anonymous, (4) United States Bureau of Land Management smoke jumpers, and (5) college students majoring in business or economics. To control for gender effects, one workshop presented male cases, one workshop presented female cases, and two workshops presented cases of both genders. To control for order effects, the assignment of videotapes to workshops was randomized to counterbalance the order in which counselors viewed them. The findings suggest that the rating scale yields reliable and valid evaluations of codependency without appreciable gender bias.

  9. Assessing Communication Skills of Medical Students in Objective Structured Clinical Examinations (OSCE--A Systematic Review of Rating Scales.

    Directory of Open Access Journals (Sweden)

    Musa Cömert

    Full Text Available Teaching and assessment of communication skills have become essential in medical education. The Objective Structured Clinical Examination (OSCE has been found as an appropriate means to assess communication skills within medical education. Studies have demonstrated the importance of a valid assessment of medical students' communication skills. Yet, the validity of the performance scores depends fundamentally on the quality of the rating scales used in an OSCE. Thus, this systematic review aimed at providing an overview of existing rating scales, describing their underlying definition of communication skills, determining the methodological quality of psychometric studies and the quality of psychometric properties of the identified rating scales.We conducted a systematic review to identify psychometrically tested rating scales, which have been applied in OSCE settings to assess communication skills of medical students. Our search strategy comprised three databases (EMBASE, PsycINFO, and PubMed, reference tracking and consultation of experts. We included studies that reported psychometric properties of communication skills assessment rating scales used in OSCEs by examiners only. The methodological quality of included studies was assessed using the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN checklist. The quality of psychometric properties was evaluated using the quality criteria of Terwee and colleagues.Data of twelve studies reporting on eight rating scales on communication skills assessment in OSCEs were included. Five of eight rating scales were explicitly developed based on a specific definition of communication skills. The methodological quality of studies was mainly poor. The psychometric quality of the eight rating scales was mainly intermediate.Our results reveal that future psychometric evaluation studies focusing on improving the methodological quality are needed in order to yield

  10. Assessing Communication Skills of Medical Students in Objective Structured Clinical Examinations (OSCE) - A Systematic Review of Rating Scales (United States)

    Cömert, Musa; Zill, Jördis Maria; Christalle, Eva; Dirmaier, Jörg; Härter, Martin; Scholl, Isabelle


    Background Teaching and assessment of communication skills have become essential in medical education. The Objective Structured Clinical Examination (OSCE) has been found as an appropriate means to assess communication skills within medical education. Studies have demonstrated the importance of a valid assessment of medical students’ communication skills. Yet, the validity of the performance scores depends fundamentally on the quality of the rating scales used in an OSCE. Thus, this systematic review aimed at providing an overview of existing rating scales, describing their underlying definition of communication skills, determining the methodological quality of psychometric studies and the quality of psychometric properties of the identified rating scales. Methods We conducted a systematic review to identify psychometrically tested rating scales, which have been applied in OSCE settings to assess communication skills of medical students. Our search strategy comprised three databases (EMBASE, PsycINFO, and PubMed), reference tracking and consultation of experts. We included studies that reported psychometric properties of communication skills assessment rating scales used in OSCEs by examiners only. The methodological quality of included studies was assessed using the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. The quality of psychometric properties was evaluated using the quality criteria of Terwee and colleagues. Results Data of twelve studies reporting on eight rating scales on communication skills assessment in OSCEs were included. Five of eight rating scales were explicitly developed based on a specific definition of communication skills. The methodological quality of studies was mainly poor. The psychometric quality of the eight rating scales was mainly intermediate. Discussion Our results reveal that future psychometric evaluation studies focusing on improving the methodological quality are needed

  11. Multidimensional assessment of neuro-psychiatric symptoms in patients with low-grade hepatic encephalopathy: A clinical rating scale

    Institute of Scientific and Technical Information of China (English)

    Sergei Mechtcheriakov; Ivo W Graziadei; André Kugener; Julia Wiedemann; Chantal Galbavy; Hartmann Hinterhuber; Josef Marksteiner; Wolfgang Vogel


    AIM: To evaluate the feasibility of a new clinical rating scale for a standardized assessment of cirrhosis-associated neuro-psychiatric symptoms.METHODS: Forty patients with liver cirrhosis (LC, with or without low-grade hepatic encephalopathy) were invest-igated using a clinical neuro-psychiatric rating scale based on a comprehensive list of neurological, psychomotor,cognitive, affective, behavioral symptoms, and symptoms of disturbed bioregulation.RESULTS: The analysis revealed that the majority of cirrhotic patients showed, besides characteristic neurological symptoms of hepatic encephalopathy, various psychomotor,affective and bioregulatory symptoms (disturbed sleep and sexual dysfunction). Patients were impaired in the following subscales: sleep and biorhythm disorder (75.0% of patients), Parkinsonoid symptoms (25.0%), affective symptoms (17.5%), and psychomotor retardation (12.5%).The increase of total neuro-psychiatric clinical score was significantly associated with the degree of hepatic enceph-alopathy.CONCLUSION: This study suggests that a substantial number of patients with LC and low-grade hepatic encephalopathy manifest various clinical neuro-psychiatric symptoms. The use of a rating scale, which explores clinical dimensions of hepatic encephalopathy, would improve the management of patients with LC.

  12. A new clinical rating scale for work absence and productivity: validation in patients with major depressive disorder

    Directory of Open Access Journals (Sweden)

    Yatham Lakshmi N


    Full Text Available Abstract Background The prevalence of major depressive disorder (MDD is highest in working age people and depression causes significant impairment in occupational functioning. Work productivity and work absence should be incorporated into clinical assessments but currently available scales may not be optimized for clinical use. This study seeks to validate the Lam Employment Absence and Productivity Scale (LEAPS, a 10-item self-report questionnaire that takes 3-5 minutes to complete. Methods The study sample consisted of consecutive patients attending a Mood Disorders outpatient clinic who were in full- or part-time paid work. All patients met DSM-IV criteria for MDD and completed during their intake assessment the LEAPS, the self-rated version of the Quick Inventory for Depressive Symptomatology (QIDS-SR, the Sheehan Disability Scale (SDS and the Health and Work Performance Questionnaire (HPQ. Standard psychometric analyses for validation were conducted. Results A total of 234 patients with MDD completed the assessments. The LEAPS displayed excellent internal consistency as assessed by Cronbach's alpha of 0.89. External validity was assessed by comparing the LEAPS to the other clinical and work functioning scales. The LEAPS total score was significantly correlated with the SDS work disability score (r = 0.63, p Conclusion The LEAPS displays good internal and external validity in a population of patients with MDD attending an outpatient clinic, which suggests that it may be a clinically useful tool to assess and monitor work functioning and productivity in depressed patients.

  13. The impact of MRI combined with visual rating scales on the clinical diagnosis of dementia: a prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Verhagen, Martijn V.; Guit, Gerard L. [Spaarne Gasthuis, Department of Radiology, Haarlem (Netherlands); Hafkamp, Gerrit Jan; Kalisvaart, Kees [Spaarne Gasthuis, Department of Geriatrics, Haarlem (Netherlands)


    Dementia is foremost a clinical diagnosis. However, in diagnosing dementia, it is advocated to perform at least one neuroimaging study. This has two purposes: to rule out potential reversible dementia (PRD), and to help determine the dementia subtype. Our first goal was to establish if MRI combined with visual rating scales changes the clinical diagnosis. The second goal was to demonstrate if MRI contributes to a geriatrician's confidence in the diagnosis. The dementia subtype was determined prior to and after MRI. Scoring scales used were: global cortical atrophy (GCA), medial temporal atrophy (MTA), and white matter hyperintensity measured according to the Fazekas scale. The confidence level of the geriatrician was determined using a visual analogue scale. One hundred and thirty-five patients were included. After MRI, the diagnosis changed in 23.7 % (CI 17.0 %-31.1 %) of patients. Change was due to vascular aetiology in 13.3 % of patients. PRD was found in 2.2 % of all patients. The confidence level in the diagnosis increased significantly after MRI (p = 0.001). MRI, combined with visual rating scales, has a significant impact on dementia subtype diagnosis and on a geriatrician's confidence in the final diagnosis. (orig.)

  14. Assessment of formal thought disorder: The relation between the Kiddie Formal Thought Disorder Rating Scale and clinical judgment. (United States)

    de Bruin, Esther I; Verheij, Fop; Wiegman, Tamar; Ferdinand, Robert F


    The presence of formal thought disorder (FTD) in childhood is sometimes viewed as a possible precursor of psychotic symptoms or adult schizophrenia. It is possible to assess FTD in childhood in a valid and reliable manner, by using the Kiddie Formal Thought Disorder Rating Scale (K-FTDS). However, training and rating procedures are very time consuming, and may be particularly difficult during clinical assessment. The aim of this study was therefore to compare the clinician's rapid judgment of FTD to the detailed ratings of the K-FTDS. The K-FTDS was administered to 172 consecutively referred children, aged 6 to 12 years and subsequently rated by two blind raters. The same criteria, as used in the K-FTDS (illogical thinking, loose associations, incoherence, and poverty of content of speech), were rated by nine clinicians. The overall agreement between K-FTDS scores and FTD scores as rated by the clinician was low. The clinician's judgment of FTD did not correspond very highly with ratings on the K-FTDS. Thus, although detecting FTD has important clinical value, the assessment of its presence or absence seemed to depend highly on which measure was used.

  15. Validity and clinical feasibility of the ADHD rating scale (ADHD-RS) A Danish Nationwide Multicenter Study

    DEFF Research Database (Denmark)

    Szomlaiski, N; Dyrborg, J; Rasmussen, H


    Aim: To establish the validity of a Danish version of the Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS), secondly to present national norm scores compared to that of United States and other European data and thirdly to evaluate ADHD-RS when used for monitoring treatment...... effectiveness. Methods: A Danish translation of the ADHD-RS was used on a normative sample of 837 children. Two clinical samples, 138 hyperkinetic disorder (HKD) cases and 110 clinical controls were recruited from eleven Danish Child and Adolescent Mental Health (CAMH) centres and assessed according to usual......, quality improvement and service planning as well as in effectiveness studies of different interventions for patients with HKD and related disorders in routine clinical settings....

  16. Fertility Clinic Success Rates (United States)

    ... and Autism 2013 Assisted Reproductive Technology Fertility Clinic Success Rates Report Recommend on Facebook Tweet Share Compartir 2013 ART Fertility Clinic Success Rates Report [PDF - 1MB] Bookmarks and thumbnails are ...

  17. Dimensional approach to symptom factors of major depressive disorder in Koreans, using the Brief Psychiatric Rating Scale: the Clinical Research Center for Depression of South Korea study. (United States)

    Park, Seon-Cheol; Jang, Eun Young; Kim, Daeho; Jun, Tae-Youn; Lee, Min-Soo; Kim, Jae-Min; Kim, Jung-Bum; Jo, Sun-Jin; Park, Yong Chon


    Although major depressive disorder (MDD) has a variety of symptoms beyond the affective dimensions, the factor structure and contents of comprehensive psychiatric symptoms of this disorder have rarely been explored using the 18-item Brief Psychiatric Rating Scale (BPRS). We aimed to identify the factor structure of the 18-item BPRS in Korean MDD patients. A total of 258 MDD patients were recruited from a multicenter sample of the Clinical Research Center for Depression of South Korea study. Psychometric scales were used to assess overall psychiatric symptoms (BPRS), depression (Hamilton Depression Rating Scale), anxiety (Hamilton Anxiety Rating Scale), global severity (Clinical Global Impression of Severity Scale), suicidal ideation (Scale for Suicide Ideation), functioning (Social and Occupational Functioning Assessment Scale), and quality of life (World Health Organization Quality of Life Assessment-abbreviated version). Common factor analysis with oblique rotation was used to yield factor structure. A four-factor structure was designed and interpreted by the symptom dimensions to reflect mood disturbance, positive symptoms/apathy, bipolarity, and thought distortion/mannerism. These individual factors were also significantly correlated with clinical variables. The findings of this study support the view that the BPRS may be a promising measuring tool for the initial assessment of MDD patients. In addition, the four-factor structure of the BPRS may be useful in understanding the mood and psychotic characteristics of these patients.

  18. Assessment of formal thought disorder : The relation between the Kiddie Formal Thought Disorder Rating Scale and clinical judgment

    NARCIS (Netherlands)

    de Bruin, Esther I.; Verheij, Fop; Wiegman, Tamar; Ferdinand, Robert F.


    The presence of formal thought disorder (FTD) in childhood is sometimes viewed as a possible precursor of psychotic symptoms or adult schizophrenia. It is possible to assess FTD in childhood in a valid and reliable manner, by using the Kiddie Formal Thought Disorder Rating Scale (K-FTDS). However, t

  19. Clinical use of the Hamilton Depression Rating Scale: Is increased efficiency possible? A post hoc comparison of HDRS, Maier and Bech sub-scales, CGI and SCL-90 scores

    NARCIS (Netherlands)

    Ruhe, H.G.; Dekker, J.J.M.; Peen, J.; Jonghe, de F.


    Background The 17-item Hamilton Depression Rating Scale (HDRS) is used as a semi–gold standard in research. In treatment guidelines, the HDRS measurements serve to determine response and remission and guide clinical decision making for nonresponders. However, its use in clinical practice is limited,

  20. The Validity of the Different Versions of the Hamilton Depression Scale in Separating Remission Rates of Placebo and Antidepressants in Clinical Trials of Major Depression

    DEFF Research Database (Denmark)

    Kyle, Phillip Raphael; Lemming, Ole; Timmerby, Nina


    Abstract: Our objectivewas to validate the different versions of the Hamilton Depression Scale (HAM-D) both psychometrically (scalability) and clinically in discriminating antidepressants from placebo in terms of remission rates in an 8-week clinical trial in the acute treatment of major depression...... in the longer HAM-D versions indicated smaller discriminating validity over placebo. The HAM-D6 indicated a dose effect on remission for vortioxetine in both moderate and severe major depression. The brief HAM-D6 was thus found superior to HAM-D17, HAM-D21, and HAM-D24 both in terms of scalability...

  1. Clinical characteristics related to worsening of motor function assessed by the Unified Parkinson's Disease Rating Scale in the elderly population. (United States)

    Liepelt-Scarfone, Inga; Lerche, Stefanie; Behnke, Stefanie; Godau, Jana; Gaenslen, Alexandra; Pausch, Christoph; Fassbender, Klaus; Brockmann, Kathrin; Srulijes, Karin; Huber, Heiko; Wurster, Isabel; Berg, Daniela


    There is evidence that nigrostriatal pathology may at least partly underlie mild Parkinsonian signs. We evaluated whether an increase in the Unified Parkinson's Disease Rating Scale part III (UPDRS-III) could be predicted by the presence of risk and prodromal markers for neurodegenerative diseases in elderly individuals without those diseases. Therefore, we analyzed the UPDRS-III score and various risk and prodromal markers known to antecede neurodegenerative diseases in a population-based cohort comprising 807 individuals free of neurodegenerative diseases at baseline. After 5 years, eight persons (1.0 %) were diagnosed with Parkinson's Disease (PD). Of those, seven (87.5 %) had motor worsening ≥3 points on the UPDRS-III from baseline to follow-up, one had two points increase. Of the 788 people without PD, 568 (72.1 %) showed no increase in the UPDRS-III scale, 220 (27.9 %) had ≥1 point increase and out of these 104 (13.2 %) had an increase of ≥3 points in the UPDRS-III score after 5 years. We identified an age >60 years (relative risk, RR = 1.7; confidence interval, CI 1.3-2.1) and the occurrence of ≥2 risk factors (RR = 1.5; CI 1.2-1.9) as possible predictors of motor progression. After 5 years, individuals with an increase in the UPDRS-III score had more often a one-sided reduced arm swing (p UPDRS-III parallels the development of prodromal markers for neurodegenerative diseases in the elderly population.

  2. Rating scales measuring the severity of psychotic depression

    DEFF Research Database (Denmark)

    Østergaard, S D; Rothschild, A J; Flint, A J


    OBJECTIVE: Unipolar psychotic depression (PD) is a severe and debilitating syndrome, which requires intensive monitoring. The objective of this study was to provide an overview of the rating scales used to assess illness severity in PD. METHOD: Selective review of publications reporting results...... on non-self-rated, symptom-based rating scales utilized to measure symptom severity in PD. The clinical and psychometric validity of the identified rating scales was reviewed. RESULTS: A total of 14 rating scales meeting the predefined criteria were included in the review. These scales grouped...... into the following categories: (i) rating scales predominantly covering depressive symptoms, (ii) rating scales predominantly covering psychotic symptoms, (iii) rating scales covering delusions, and (iv) rating scales covering PD. For the vast majority of the scales, the clinical and psychometric validity had...

  3. Young Mania Rating Scale: how to interpret the numbers? Determination of a severity threshold and of the minimal clinically significant difference in the EMBLEM cohort. (United States)

    Lukasiewicz, Michael; Gerard, Stephanie; Besnard, Adeline; Falissard, Bruno; Perrin, Elena; Sapin, Helene; Tohen, Mauricio; Reed, Catherine; Azorin, Jean-Michel


    The aim of this analysis was to identify Young Mania Rating Scale (YMRS) meaningful benchmarks for clinicians (severity threshold, minimal clinically significant difference [MCSD]) using the Clinical Global Impressions Bipolar (CGI-BP) mania scale, to provide a clinical perspective to randomized clinical trials (RCTs) results. We used the cohort of patients with acute manic/mixed state of bipolar disorders (N = 3459) included in the European Mania in Bipolar Longitudinal Evaluation of Medication (EMBLEM) study. A receiver-operating characteristic analysis was performed on randomly selected patients to determine the YMRS optimal severity threshold with CGI-BP mania score ≥ "Markedly ill" defining severity. The MCSD (clinically meaningful change in score relative to one point difference in CGI-BP mania for outcome measures) of YMRS, was assessed with a linear regression on baseline data. At baseline, YMRS mean score was 26.4 (±9.9), CGI-BP mania mean score was 4.8 (±1.0) and 61.7% of patients had a score ≥ 5. The optimal YMRS severity threshold of 25 (positive predictive value [PPV] = 83.0%; negative predictive value [NPV] = 66.0%) was determined. In this cohort, a YMRS score of 20 (typical cutoff for RCTs inclusion criteria) corresponds to a PPV of 74.6% and to a NPV of 77.6%, meaning that the majority of patients included would be classified as severely ill. The YMRS minimal clinically significant difference was 6.6 points.

  4. The Relationship between the "Childhood Autism Rating Scale: Second Edition" and Clinical Diagnosis Utilizing the DSM-IV-TR and the DSM-5 (United States)

    Dawkins, Tamara; Meyer, Allison T.; Van Bourgondien, Mary E.


    "The Childhood Autism Rating Scale, Second Edition" (CARS2; 2010) includes two rating scales; the CARS2-Standard Version (CARS2-ST) and the newly developed CARS2-High Functioning Version (CARS2-HF). To assess the diagnostic agreement between the CARS2 and DSM-IV-TR versus DSM-5 criteria for Autism Spectrum Disorder (ASD), clinicians at…

  5. Clinical note: Validation of the Swedish version of the Parents’ Evaluation of Aural/Oral Performance of Children (PEACH) Rating Scale for normal hearing infants and children

    DEFF Research Database (Denmark)

    Brännström, K. Jonas; Ludvigsson, Josefine; Morris, David Jackson;


    Objective: The aims of the present pilot study were to translate the PEACH Rating Scale into Swedish, examine the preliminary psychometric properties of this translation, and explore the association between age and the reported outcome. Study design: Responses on the PEACH Rating Scale were...... suggest that each item contributes logically to the scale. The total scores increase rapidly with increasing age until about 20 months after which the score increase tails off and is asymptotic beyond 50 months of age. Conclusions: Parental responses from the Swedish translation show psychometric...... characteristics similar to those previously reported and this version shows a similar relationship between total score on the scale and age, as found in previous studies....

  6. The Relationship Between the Childhood Autism Rating Scale: Second Edition and Clinical Diagnosis Utilizing the DSM-IV-TR and the DSM-5. (United States)

    Dawkins, Tamara; Meyer, Allison T; Van Bourgondien, Mary E


    The Childhood Autism Rating Scale, Second Edition (CARS2; 2010) includes two rating scales; the CARS2-Standard Version (CARS2-ST) and the newly developed CARS2-High Functioning Version (CARS2-HF). To assess the diagnostic agreement between the CARS2 and DSM-IV-TR versus DSM-5 criteria for Autism Spectrum Disorder (ASD), clinicians at community based centers of the University of North Carolina TEACCH Autism Program rated participants seen for a diagnostic evaluation on symptoms of autism using both the DSM-IV-TR and DSM-5 criteria and either the CARS2-HF or the CARS2-ST. Findings suggest that overall, the diagnostic agreement of the CARS2 remains high across DSM-IV and DSM-5 criteria for autism.

  7. Rating on life valuation scale

    Directory of Open Access Journals (Sweden)

    Lapčević Mirjana


    Full Text Available Introduction: World Health Organization (WHO Articles of Association defines health as the state of complete physical, mental and social well-being and not merely the absence of disease. According to this definition, the concept of health is enlarged and consists of public and personal needs, motives and psychological nature of a person, education, culture, tradition, religion, etc. All these needs do not have the same rank on life valuation scale. Objective: The objective of our study was ranking 6 most important values of life out of 12 suggested. Method: Questionnaire about Life Valuation Scale was used as method in our study. This questionnaire was created by the Serbian Medical Association and Department of General Medicine, School of Medicine, University of Belgrade. It analyzed 10% of all citizens in 18 places in Serbia, aged from 25 to 64 years, including Belgrade commune Vozdovac. Survey was performed in health institutions and in citizens’ residencies in 1995/96 by doctors, nurses and field nurses. Results: A total of 14,801 citizens was questioned in Serbia (42.57% of men, 57.25% of women, and 852 citizens in Vozdovac commune (34.62% of men, 65.38% of women. People differently value things in their lives. On the basis of life values scoring, the most important thing in people’s life was health. In Serbia, public rank of health was 4.79%, and 4.4% in Vozdovac commune. Relations in family were on the second place, and engagement in politics was on the last place. Conclusion: The results of our study in the whole Serbia and in Vozdovac commune do not differ significantly from each other, and all of them demonstrated that people attached the greatest importance to health on the scale of proposed values. Relationships in family were on the second place, and political activity was on the last place. High ranking of health and relationships in family generally shows that general practitioners in Serbia take important part in primary

  8. The rapid disability rating scale-2. (United States)

    Linn, M W; Linn, B S


    A revised version of the Rapid Disability Rating Scale (RDRS-2) is presented. Item definitions have been sharpened and directions expanded to indicate that ratings are based upon the patient's performance in regard to behavior, and that prosthesis normally used by the patient should be included in the assessment. Three items have been added to increase the breadth of the scale. Response items have been changed from three-point to four-point ratings in order to increase group discrimination amd make the scale more sensitive to changes in treatment. The new appraisals of reliability, factor structure, and validity are reported, along with the potential uses of the scale.

  9. Enhancing the Construct and Content Validity of Rating Scales for Clinical Research: Using Qualitative Methods to Develop a Rating Scale to Assess Parental Perceptions of Their Role in Promoting Infant Exercise. (United States)

    Olshansky, Ellen; Lakes, Kimberley D; Vaughan, Jessica; Gravem, Dana; Rich, Julia K; David, Marissa; Nguyen, Heather; Cooper, Dan


    With a focus on the early stages of developing new assessment tools, we present an example of how researchers can apply qualitative data to the development of conceptual domains and specific items representing those domains for quantitative instruments. Specifically, our previous research examining mothers' perceptions and experiences of engaging in assisted exercise with their infants provided the foundation for the development of the Perceptions of Pediatric Activity Scale (PPAS). We describe the process we used to develop the PPAS as an exemplar for the process of incorporating qualitative data in instrument development. In addition, we address instrument development for diverse populations, and we provide examples illustrating how we extracted concepts using a concept-indicator model to construct the items in the PPAS. We conclude by noting that we are currently in the process of pilot-testing the PPAS to evaluate its utility and reliability.

  10. Modelling of rate effects at multiple scales

    DEFF Research Database (Denmark)

    Pedersen, R.R.; Simone, A.; Sluys, L. J.


    At the macro- and meso-scales a rate dependent constitutive model is used in which visco-elasticity is coupled to visco-plasticity and damage. A viscous length scale effect is introduced to control the size of the fracture process zone. By comparison of the widths of the fracture process zone......, the length scale in the meso-model and the macro-model can be coupled. In this fashion, a bridging of length scales can be established. A computational analysis of  a Split Hopkinson bar test at medium and high impact load is carried out at macro-scale and meso-scale including information from  the micro-scale....

  11. Evaluation of the ADHD Rating Scale in Youth with Autism (United States)

    Yerys, Benjamin E.; Nissley-Tsiopinis, Jenelle; de Marchena, Ashley; Watkins, Marley W.; Antezana, Ligia; Power, Thomas J.; Schultz, Robert T.


    Scientists and clinicians regularly use clinical screening tools for attention deficit/hyperactivity disorder (ADHD) to assess comorbidity without empirical evidence that these measures are valid in youth with autism spectrum disorder (ASD). We examined the prevalence of youth meeting ADHD criteria on the ADHD rating scale fourth edition…

  12. UFMG Sydenham's chorea rating scale (USCRS): reliability and consistency. (United States)

    Teixeira, Antônio Lúcio; Maia, Débora P; Cardoso, Francisco


    Despite the renewed interest in Sydenham's chorea (SC) in recent years, there were no valid and reliable scales to rate the several signs and symptoms of patients with SC and related disorders. The Universidade Federal de Minas Gerais (UFMG) Sydenham's Chorea Rating Scale (USCRS) was designed to provide a detailed quantitative description of the performance of activities of daily living, behavioral abnormalities, and motor function of subjects with SC. The scale comprises 27 items and each one is scored from 0 (no symptom or sign) to 4 (severe disability or finding). Data from 84 subjects, aged 4.9 to 33.6 years, support the interrater reliability and internal consistency of the scale. The USCRS is a promising instrument for rating the clinical features of SC as well as their functional impact in children and adults.

  13. Scale Invariant Properties in Heart Rate Signals (United States)

    Makowiec, D.; Dudkowska, A.; Zwierz, M.; Galaska, R.; Rynkiewicz, A.


    The rate of heart beat is controlled by autonomic nervous system: accelerated by the sympathetic system and slowed by the parasympathetic system. Scaling properties in heart rate are usually related to the intrinsic dynamics of this physiological regulatory system. The two packages calculating local exponent spectra: Wavelet Transform Modulus Maxima and Multifractal Detrended Fluctuation Analysis (accessible from Physionet home page are tested, and then used to investigate the spectrum of singularity exponents in series of heart rates obtained from patients suffering from reduced left ventricle systolic function. It occurs that this state of a heart could be connected to some perturbation in the regulatory system, because the heart rate appears to be less controlled than in a healthy human heart. The multifractality in the heart rate signal is weakened: the spectrum is narrower and moved to higher values what indicate the higher activity of the sympatethic nervous system.

  14. Rating scales in general practice depression

    DEFF Research Database (Denmark)

    Bech, Per; Paykel, Eugene; Sireling, Lester


    within major depressive disorder. The CID was compared to the Hamilton Depression Rating Scale (HAM-D17). METHODS: 146 patients from a previous study in general practice with the CID were investigated. The item response theory model established by Rasch was used to investigate the scalability (a scale......׳s psychometric adequacy) of the subscales, and principal component analysis was used to identify subsyndromes with the symptoms of major depression according to DSM-5 or ICD-10. RESULTS: Whereas the HAM-D17 was found not to have an acceptable scalability, the three brief CID subscales for depression (six items......), anxiety (five items), and apathy (five items) all had an acceptable scalability. Within the major depressive symptoms, principal component analysis identified the CID items of hypersomnia, increased appetite or weight gain as defining the subsyndrome of atypical depression. In total 29 patients...

  15. The Unified Parkinson's Disease Rating Scale (UPDRS): status and recommendations. (United States)


    The Movement Disorder Society Task Force for Rating Scales for Parkinson's Disease prepared a critique of the Unified Parkinson's Disease Rating Scale (UPDRS). Strengths of the UPDRS include its wide utilization, its application across the clinical spectrum of PD, its nearly comprehensive coverage of motor symptoms, and its clinimetric properties, including reliability and validity. Weaknesses include several ambiguities in the written text, inadequate instructions for raters, some metric flaws, and the absence of screening questions on several important non-motor aspects of PD. The Task Force recommends that the MDS sponsor the development of a new version of the UPDRS and encourage efforts to establish its clinimetric properties, especially addressing the need to define a Minimal Clinically Relevant Difference and a Minimal Clinically Relevant Incremental Difference, as well as testing its correlation with the current UPDRS. If developed, the new scale should be culturally unbiased and be tested in different racial, gender, and age-groups. Future goals should include the definition of UPDRS scores with confidence intervals that correlate with clinically pertinent designations, "minimal," "mild," "moderate," and "severe" PD. Whereas the presence of non-motor components of PD can be identified with screening questions, a new version of the UPDRS should include an official appendix that includes other, more detailed, and optionally used scales to determine severity of these impairments.

  16. Clinical interpretation and use of stroke scales. (United States)

    Kasner, Scott E


    No single outcome measure can describe or predict all dimensions of recovery and disability after acute stroke. Several scales have proven reliability and validity in stroke trials, including the National Institutes of Health stroke scale (NIHSS), the modified Rankin scale (mRS), the Barthel index (BI), the Glasgow outcome scale (GOS), and the stroke impact scale (SIS). Several scales have been combined in stroke trials to derive a global statistic to better define the effect of acute interventions, although this composite statistic is not clinically tenable. In practice, the NIHSS is useful for early prognostication and serial assessment, whereas the BI is useful for planning rehabilitative strategies. The mRS and GOS provide summary measures of outcome and might be most relevant to clinicians and patients considering early intervention. The SIS was designed to measure the patient's perspective on the effect of stroke. Familiarity with these scales could improve clinicians' interpretation of stroke research and their clinical decision-making.

  17. Columbia-Suicide Severity Rating Scale (United States)

    Gipson, Polly Y.; Agarwala, Prachi; Opperman, Kiel J.; Horwitz, Adam; King, Cheryl A.


    Objective Despite the high prevalence of psychiatric emergency (PE) visits for attempted suicide and nonsuicidal self-injury (NSSI) among adolescents, we have limited information about assessment tools that are helpful in predicting subsequent risk for suicide attempts among adolescents in PE settings. This study examined the predictive validity of a highly promising instrument, the Columbia-Suicide Severity Rating Scale (C-SSRS). Method Participants were 178 adolescents (44.4% male; ages 13–17 years) seeking PE services. The C-SSRS interview and selected medical chart data were collected for the index visit and subsequent visits during a 1-year follow-up. Results A suicide risk concern was the most common chief complaint (50.6%) in this sample, and nearly one third of the adolescents (30.4%) reported a lifetime history of suicide attempt at index visit. Sixty-two adolescents (34.8%) had at least one return PE visit during follow-up. Lifetime history of NSSI predicted both return PE visits and a suicide attempt at return visit. The C-SSRS intensity scale score was a significant predictor of a suicide attempt at return visit for both the full sample of adolescents and the subsample who reported suicidal ideation at their index visit. In this subsample, one specific item on the intensity scale, duration, was also a significant predictor of both a return PE visit and a suicide attempt at return visit. Conclusions The C-SSRS intensity scale and NSSI had predictive validity for suicide attempts at return visit. Results also suggest that duration of adolescents’ suicidal thoughts may be particularly important to risk for suicidal behavior, warranting further study. PMID:25285389

  18. Item screening technique on clinical outcome rating scale which based on patient-reported outcomes%基于患者报告的临床结局评价量表的条目筛选方法

    Institute of Scientific and Technical Information of China (English)

    何庆勇; 王阶; 张允岭; 王师菡; 杨戈


    Development of clinical outcome rating scale based on patient-reported outcomes in traditional Chinese medicine has become the current the most active research areas in effect evaluation.But a key step of development of clinical outcome rating scale based on patient-reported outcomes is the item screening.Expert score method, distribution of entry method,discrete Trend method, factor analysis, cluster analysis, cronbach's a coefficient, stepwise regression, stepwise discriminant method, correlation coefficient, t-test, resolution coefficient method are systematic described in this paper.In order to screen items more comprehensively and objectively.%研制患者报告的临床结局评价量表已成为当前中医药疗效评价研究的最活跃领域之一.而研制患者报告的临床结局评价量表的关键一步是条目的筛选.本文较系统的叙述了专家重要评分法、条目分布考察法、离散趋势法、因子分析法、聚类分析法、Conbach's a系数法、逐步回归法、逐步判别法、相关系数法、t检验法、分辨力系数法等11种方法在患者报告的临床结局评价量表条目筛选中的应用方法,以求更好的全面而客观的筛选患者报告的临床结局评价量表的条目.

  19. International versions of the Menopause Rating Scale (MRS

    Directory of Open Access Journals (Sweden)

    Schneider Hermann PG


    Full Text Available Abstract Background Symptom scales for aging women have clinically been used for years and the interest in measuring health-related quality of life (HRQoL has increased in recent years. The Menopause Rating Scale (MRS is a formally validated scale according to the requirements for quality of life instruments. The aim of this paper is to review the current state of the instrument particularly concerning versions of the scale in different languages. MRS versions available The translations were performed following international methodological recommendations for the linguistic & cultural adaptation of HRQoL instruments. The first translation was done from the German original scale into English (UK & USA. The English version was used as the source language for the translations into French, Spanish, Swedish, Mexican/Argentine, Brazilian, Turkish, and Indonesian languages (attached as additional PDF files. Conclusion The MRS scale is obviously a valuable tool for assessing health related quality of life of women in the menopausal transition and is used worldwide. The currently available 9 language versions have been translated following international standards for the linguistic and cultural translation of quality of life scales. Assistance is offered to help interested parties in the translation process.

  20. Assessment of pruritus intensity: prospective study on validity and reliability of the visual analogue scale, numerical rating scale and verbal rating scale in 471 patients with chronic pruritus. (United States)

    Phan, Ngoc Quan; Blome, Christine; Fritz, Fleur; Gerss, Joachim; Reich, Adam; Ebata, Toshiya; Augustin, Matthias; Szepietowski, Jacek C; Ständer, Sonja


    The most commonly used tool for self-report of pruritus intensity is the visual analogue scale (VAS). Similar tools are the numerical rating scale (NRS) and verbal rating scale (VRS). In the present study, initiated by the International Forum for the Study of Itch assessing reliability of these tools, 471 randomly selected patients with chronic itch (200 males, 271 females, mean age 58.44 years) recorded their pruritus intensity on VAS (100-mm line), NRS (0-10) and VRS (four-point) scales. Re-test reliability was analysed in a subgroup of 250 patients after one hour. Statistical analysis showed a high reliability and concurrent validity (r>0.8; pscales showed a high correlation. In conclusion, high reliability and concurrent validity was found for VAS, NRS and VRS. On re-test, higher correlation and less missing values were observed. A training session before starting a clinical trial is recommended.

  1. Development of the Crisis Call Outcome Rating Scale. (United States)

    Bonneson, Mary E.; Hartsough, Don M.


    Constructed and tested Crisis Call Outcome Rating Scale, rating scale of caller behavior, as an outcome measure at telephone hotline facility. Psychology students rated caller behavior on role-played audiotapes. Items having respectable item-total correlations comprise final version of scale which detected meaningful differences among audiotapes.…

  2. Reliability of Multi-Category Rating Scales (United States)

    Parker, Richard I.; Vannest, Kimberly J.; Davis, John L.


    The use of multi-category scales is increasing for the monitoring of IEP goals, classroom and school rules, and Behavior Improvement Plans (BIPs). Although they require greater inference than traditional data counting, little is known about the inter-rater reliability of these scales. This simulation study examined the performance of nine…

  3. Clinical and psychometric validation of the psychotic depression assessment scale

    DEFF Research Database (Denmark)

    Østergaard, Søren Dinesen; Pedersen, Christina H; Uggerby, Peter


    recordings of these interviews were assessed by two experienced psychiatrists (global severity rating of psychotic depression, depressive symptoms and psychotic symptoms) and by two young physicians (rating on 27 symptom items, including the 11 PDAS items). The clinical validity and responsiveness......BACKGROUND: Recent studies have indicated that the 11-item Psychotic Depression Assessment Scale (PDAS), consisting of the 6-item melancholia subscale (HAM-D6) of the Hamilton Depression Rating Scale and 5 psychosis items from the Brief Psychiatric Rating Scale (BPRS), is a valid measure...... for the severity of psychotic depression. The aim of this study was to subject the PDAS, and its depression (HAM-D6) and psychosis (BPRS5) subscales to further validation. METHODS: Patients diagnosed with psychotic depression at Danish psychiatric hospitals participated in semi-structured interviews. Video...

  4. Disability rating scale for severe head trauma: coma to community. (United States)

    Rappaport, M; Hall, K M; Hopkins, K; Belleza, T; Cope, D N


    The objective of this study was to develop one instrument for assessing quantitatively the disability of severe head trauma patients so their rehabilitative progress could be followed from coma through different levels of awareness and functioning to their return to the community. This disability rating (DR) instrument was designed to be easily learned, quickly completed, valid, predictive of outcome and to have a high inter-rater reliability. The DR Scale consists of 8 items divided into 4 categories; 1. Arousal and awareness; 2. Cognitive ability to handle self-care functions; 3. Physical dependence upon others; 4. Psychosocial adaptability for work, housework, or school. Completed independently by several raters for more than 88 serious head injury patients, inter-rater correlations were highly significant. The admission DR was significantly related to clinical outcome at 1 year after injury and was significantly related to electrophysiologic measures of brain dysfunction as reflected in degree of abnormality of evoked brain potential patterns. The DR Scale is more sensitive than the Glasgow Outcome Scale in detecting and measuring clinical changes in individuals who have sustained severe head trauma. Also it can be used to help identify patients most likely to benefit from intensive rehabilitation care within a hospital setting. It provides a shorthand global description of a head injury patient's condition that facilitates understanding and communication.

  5. Reliability and validity of the Wolfram Unified Rating Scale (WURS

    Directory of Open Access Journals (Sweden)

    Nguyen Chau


    Full Text Available Abstract Background Wolfram syndrome (WFS is a rare, neurodegenerative disease that typically presents with childhood onset insulin dependent diabetes mellitus, followed by optic atrophy, diabetes insipidus, deafness, and neurological and psychiatric dysfunction. There is no cure for the disease, but recent advances in research have improved understanding of the disease course. Measuring disease severity and progression with reliable and validated tools is a prerequisite for clinical trials of any new intervention for neurodegenerative conditions. To this end, we developed the Wolfram Unified Rating Scale (WURS to measure the severity and individual variability of WFS symptoms. The aim of this study is to develop and test the reliability and validity of the Wolfram Unified Rating Scale (WURS. Methods A rating scale of disease severity in WFS was developed by modifying a standardized assessment for another neurodegenerative condition (Batten disease. WFS experts scored the representativeness of WURS items for the disease. The WURS was administered to 13 individuals with WFS (6-25 years of age. Motor, balance, mood and quality of life were also evaluated with standard instruments. Inter-rater reliability, internal consistency reliability, concurrent, predictive and content validity of the WURS were calculated. Results The WURS had high inter-rater reliability (ICCs>.93, moderate to high internal consistency reliability (Cronbach’s α = 0.78-0.91 and demonstrated good concurrent and predictive validity. There were significant correlations between the WURS Physical Assessment and motor and balance tests (rs>.67, ps>.76, ps=-.86, p=.001. The WURS demonstrated acceptable content validity (Scale-Content Validity Index=0.83. Conclusions These preliminary findings demonstrate that the WURS has acceptable reliability and validity and captures individual differences in disease severity in children and young adults with WFS.

  6. Sensitivity of School-Performance Ratings to Scaling Decisions


    Ng, Hui L.; Koretz, Daniel


    Policymakers usually leave decisions about scaling the scores used for accountability to their appointed technical advisory committees and the testing contractors. However, scaling decisions can have an appreciable impact on school ratings (Briggs & Weeks, 2009). Using middle-school data from New York State, we examined the consistency of school ratings based on two scaling approaches that differed in scaling decisions that are important in high-stakes testing contexts. We found that, dependi...

  7. Measuring feedback from clients. The psychometric properties of the Dutch Outcome Rating Scale and Session rating Scale

    NARCIS (Netherlands)

    Janse, P.D.; Boezen-Hilberdink, L.; Dijk, M.K. van; Verbraak, M.J.P.M.; Hutschemaekers, G.J.M.


    Treatment results can be improved by obtaining feedback from clients concerning their progress during therapy and the quality of the therapeutic relationship. This feedback can be rated using short instruments such as the Outcome Rating Scale (ORS) and the Session Rating Scale (SRS), which are being

  8. The clinical information system implementation evaluation scale. (United States)

    Gugerty, Brian; Maranda, Michael; Rook, Dona


    Measurement instruments to assess user satisfaction with Clinical Information Systems (CIS) and with the implementation of CIS are needed as part of multi-faceted evaluation of CIS. Seven years of experience in developing measurement instruments to assess staff satisfaction with CIS preceded the development effort that created the Clinical Information System Evaluation Scale (CISIES). The scale was developed using precursors of the CISIES and it was guided by an expert panel. Following its construction the 37-item measurement instrument was piloted as part of the assessment of a Critical Care Clinical Information System implementation at a medical center in Florida, USA. Results indicated satisfaction with the implementation, although not strong, at the time of administration. The results of the CISIES administration were used by informaticians at the research site to plan and execute an intervention to improve satisfaction with the implementation. Re-administration of the CISIES at the site to evaluate the success of this intervention is planned. The CISIES was found to be a useful instrument, easy to administer, acceptable to respondents, easy to score and understandable by non-researcher at the study site. Early indications are that it will be useful in the formative and summative evaluation of CIS implementations.

  9. Using dementia rating scales in the diagnosis of Alzheimer's disease

    Institute of Scientific and Technical Information of China (English)


    Objective: To study the significance of dementia rating scales in the diagnosis of Alzheimer' s disease (AD).Methods: Probable AD patients(118 cases) diagnosed according to NINCDS-ADRDA criteria and the normal controls(100 cases) were examined with a battery of neuropsychological tests and the dementia severity of AD patients was determined with clinical dementia rating(CDR). Changed neuropsychological characteristics of different AD dementia severities were analyzed. The discriminant analysis and ROC curve analysis were performed to analyze the specificity, the sensitivity, and the general accuracy of various dementia rating scales in the diagnosis of AD, and the area under the ROC curve. Results: The total cognition function in mild (CDR = 1), moderate(CDR = 2) and severe stages(CDR=3) of AD had an obvious trend of continuous decline, with the MMSE values 17.44 ± 2.64, 13.90 ± 4.32, and5.50± 3.90 respectively. The trend of decline of the verbal fluency function in AD was same as that of total cognition function. The visuospatial function was reduced in early stage of AD (CDR = 1 ) and completely lost in moderate and severe AD. Delay memory function began to show decline in the early stage of AD, and the decline turned apparent in moderate and severe AD. Immediate memory function showed unchanged in early stage of AD, while showed decline in moderate AD, and the decline became very quick in severe AD. The impairment of daily living ability and social activity function developed with the severity degree of AD. But the decline of social activity function was very quick in moderate stage of AD. In general, the leading scale to diagnose AD was FOM, followed by RVR, POD, MMSE, BD,ADL and DS. When MMSE was combined with one or more of FOM, RVR, BD, DS, the general accuracy in distinguishing AD from the normal controls was improved. Conclusion: Neuropsychological test is useful in the diagnosis of AD, especially in the early stage. The validity is improved when

  10. Sensitivity of School-Performance Ratings to Scaling Decisions (United States)

    Ng, Hui Leng; Koretz, Daniel


    Policymakers usually leave decisions about scaling the scores used for accountability to their appointed technical advisory committees and the testing contractors. However, scaling decisions can have an appreciable impact on school ratings. Using middle-school data from New York State, we examined the consistency of school ratings based on two…

  11. Ataxia rating scales are age-dependent in healthy children

    NARCIS (Netherlands)

    Brandsma, Rick; Spits, Anne H.; Kuiper, Marieke J.; Lunsing, Roelinka J.; Burger, Huibert; Kremer, Hubertus P.; Sival, Deborah A.


    AIM: To investigate ataxia rating scales in children for reliability and the effect of age and sex. METHOD: Three independent neuropaediatric observers cross-sectionally scored a set of paediatric ataxia rating scales in a group of 52 healthy children (26 males, 26 females) aged 4 to 16 years (mean

  12. Measuring cognitive load with subjective rating scales during problem solving : differences between immediate and delayed ratings

    NARCIS (Netherlands)

    Schmeck, Annett; Opfermann, Maria; van Gog, Tamara; Paas, Fred; Leutner, Detlev


    Subjective cognitive load (CL) rating scales are widely used in educational research. However, there are still some open questions regarding the point of time at which such scales should be applied. Whereas some studies apply rating scales directly after each step or task and use an average of these

  13. Confirmatory Factor Analysis of the Behavioral and Emotional Rating Scale-2 (BERS-2) Parent and Youth Rating Scales (United States)

    Buckley, Jacquelyn A.; Ryser, Gail; Reid, Robert; Epstein, Michael H.


    We confirmed the factor structure of the Behavioral and Emotional Rating Scale-2nd Edition (BERS-2) with a normative parent and youth sample. The BERS-2, based on the Behavioral and Emotional Rating Scale (BERS), is a standardized instrument that assesses children's emotional and behavioral strengths. The original BERS was renormed to create a…

  14. Evaluating the quality of analytic ratings with Mokken scaling

    Directory of Open Access Journals (Sweden)

    Stefanie A. Wind


    Full Text Available Greatly influenced by the work of Rasch (1960/1980, Mokken (1971 presented a nonparametric scaling procedure that is based on the theory of invariant measurement, but draws upon less strict requirements related to the scale of measurement. Because they are theoretically and empirically related to Rasch models, Mokken’s nonparametric models have been recognized as a useful exploratory tool for examining data in terms of the basic requirements for invariant measurement before the application of a parametric model. In particular, recent research has explored the use of polytomous versions of Mokken’s (1971 nonparametric scaling models as a technique for evaluating the quality of holistic ratings (Wind & Engelhard, in press and rating scales (Wind, 2014 for performance assessments in terms of the requirements for invariant measurement. The current study continues the extension of Mokken scaling to performance assessments by exploring the degree to which Mokken-based rating quality indices can be used to explore the quality of ratings assigned within domains on an analytic rubric. Using an illustrative analysis, this study demonstrates the use of a generalized rating design to explore the quality of analytic ratings within the framework of Mokken scaling. Findings from the illustrative analysis suggest that a generalized rating design can be used to examine the quality of analytic ratings in terms of the requirements for invariant measurement.

  15. Psychometric Properties of the Parent and Teacher ADHD Rating Scale (ADHD-RS)

    DEFF Research Database (Denmark)

    Makransky, Guido; Bilenberg, Niels


    Attention deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in childhood and adolescence. Rating the severity of psychopathology and symptom load is essential in daily clinical practice and in research. The parent and teacher ADHD-Rating Scale (ADHD-RS) includes...

  16. A parametric investigation of ride quality rating scales (United States)

    Dempsey, T. K.; Coates, G. D.; Leatherwood, J. D.


    The relative merits of various category scales for the prediction of human discomfort response to vibration and the mathematical relationships that allow for transformations of subjective data from one scale to another scale were determined. A total of 16 category scales were studied and these represented various parametric combinations of polarity, scale type, and number of scalar points. Sixteen subject groups were used and each subject group evaluated its comfort/discomfort to vertical sinusoidal vibration using one of the rating scales. The passenger ride quality apparatus which can expose six subjects simultaneously to predetermined vibrations was utilized. The vibration stimuli were composed of repeats of selected sinusoidal frequencies applied at each of nine peak floor acceleration levels. A higher degree of reliability and discriminability was generally obtained from unipolar continuous type scales containing either seven or nine scalar points as opposed to the other scales investigated.

  17. Scaling of Growth Rate Volatility for Six Macroeconomic Variables

    Directory of Open Access Journals (Sweden)

    Boris Podobnik


    Full Text Available We study the annual growth rates of six macroeconomic variables: public debt, public health expenditures, exports of goods, government consumption expenditures, total exports of goods and services, and total imports of goods and services. For each variable, we find (i that the distribution of the growth rate residuals approximately follows a double exponential (Laplace distribution and (ii that the standard deviation of growth rate residuals scales according to the size of the variable as a power law, with a scaling exponent similar to the scaling exponent found for GDP [Economics Letters 60, 335 (1998]. We hypothesise that the volatility scaling we find for these GDP constituents causes the volatility scaling found in GDP data.

  18. Reliability and validity of a Portuguese version of the Young Mania Rating Scale

    Directory of Open Access Journals (Sweden)

    J.A.A. Vilela


    Full Text Available The reliability and validity of a Portuguese version of the Young Mania Rating Scale were evaluated. The original scale was translated into and adapted to Portuguese by the authors. Definitions of clinical manifestations, a semi-structured anchored interview and more explicit rating criteria were added to the scale. Fifty-five adult subjects, aged 18 to 60 years, with a diagnosis of Current Manic Episode according to DSM-III-R criteria were assessed using the Young Mania Rating Scale as well as the Brief Psychiatric Rating Scale in two sessions held at intervals from 7 to 10 days. Good reliability ratings were obtained, with intra-class correlation coefficient of 0.97 for total scores, and levels of agreement above 0.80 (P < 0.001 for all individual items. Internal consistency analysis resulted in an alpha = 0.67 for the scale as a whole, and an alpha = 0.72 for each standardized item (P < 0.001. For the concurrent validity, a correlation of 0.78 was obtained by the Pearson coefficient between the total scores of the Young Mania Rating Scale and Brief Psychiatric Rating Scale. The results are similar to those reported for the English version, indicating that the Portuguese version of the scale constitutes a reliable and valid instrument for the assessment of manic patients.

  19. Future increases in extreme precipitation exceed observed scaling rates (United States)

    Bao, Jiawei; Sherwood, Steven C.; Alexander, Lisa V.; Evans, Jason P.


    Models and physical reasoning predict that extreme precipitation will increase in a warmer climate due to increased atmospheric humidity. Observational tests using regression analysis have reported a puzzling variety of apparent scaling rates including strong rates in midlatitude locations but weak or negative rates in the tropics. Here we analyse daily extreme precipitation events in several Australian cities to show that temporary local cooling associated with extreme events and associated synoptic conditions reduces these apparent scaling rates, especially in warmer climatic conditions. A regional climate projection ensemble for Australia, which implicitly includes these effects, accurately and robustly reproduces the observed apparent scaling throughout the continent for daily precipitation extremes. Projections from the same model show future daily extremes increasing at rates faster than those inferred from observed scaling. The strongest extremes (99.9th percentile events) scale significantly faster than near-surface water vapour, between 5.7-15% °C-1 depending on model details. This scaling rate is highly correlated with the change in water vapour, implying a trade-off between a more arid future climate or one with strong increases in extreme precipitation. These conclusions are likely to generalize to other regions.

  20. Validation of the Italian version of the SBMA Functional Rating Scale as outcome measure. (United States)

    Querin, Giorgia; DaRe, Elisa; Martinelli, Ilaria; Bello, Luca; Bertolin, Cinzia; Pareyson, Davide; Mariotti, Caterina; Pegoraro, Elena; Sorarù, Gianni


    The Spinal and Bulbar Muscular Atrophy Functional Rating Scale (SBMAFRS) is an established rating instrument used to assess the functional status of patients with Spinal and Bulbar Muscular Atrophy (SBMA). Our aim was to validate an Italian version of the scale. We administered the SBMAFRS to sixty SBMA patients during routine follow-up of clinical evaluations. To estimate the test stability, the scale was re-administered to a subset of 39 randomly selected patients after 8 weeks. The patients underwent clinical evaluation including 6-min walk. Psychometric analysis included reliability assessment and factorial analysis. To evaluate convergent validity, correlations between SBMAFRS items and muscular force assessed by manual testing, ALSFRS total score and subscales scores, and forced vital capacity, were performed. Internal consistency as measured by Cronbach's alpha (total scale 0.85) was high. Test-retest reliability assessed by Spearman's rho was also high. Principal component analysis with varimax rotation yielded a four-factor solution accounting for approximately 79 % of the variance. The scale total score and subscales score were strongly correlated with respective items and subscores of the ALSFRS, with respiratory function and with the 6-min walk test. In conclusion, we performed an Italian validation of the only existing disease-specific Functional Rating Scale for SBMA patients. This scale will be a useful tool not only in the clinical practice but also as an outcome measure in upcoming clinical trials.

  1. 1/f scaling in heart rate requires antagonistic autonomic control (United States)

    Struzik, Zbigniew R.; Hayano, Junichiro; Sakata, Seiichiro; Kwak, Shin; Yamamoto, Yoshiharu


    We present systematic evidence for the origins of 1/f -type temporal scaling in human heart rate. The heart rate is regulated by the activity of two branches of the autonomic nervous system: the parasympathetic (PNS) and the sympathetic (SNS) nervous systems. We examine alterations in the scaling property when the balance between PNS and SNS activity is modified, and find that the relative PNS suppression by congestive heart failure results in a substantial increase in the Hurst exponent H towards random-walk scaling 1/f2 and a similar breakdown is observed with relative SNS suppression by primary autonomic failure. These results suggest that 1/f scaling in heart rate requires the intricate balance between the antagonistic activity of PNS and SNS.

  2. Components of Clinical Competence Ratings of Physicians: An Empirical Approach. (United States)

    Hojat, Mohammadreza; And Others


    The underlying structure of ratings of clinical competence was investigated. The instrument consisted of 33 statements on clinical behavior filled out by directors of medical education programs at postgraduate training institutions. It was concluded that ratings of clinical competence represent a multidimensional construct involving at least three…

  3. Prediction of the Scale Removal Rate in Heat Exchanger Piping

    Directory of Open Access Journals (Sweden)

    Najwa S. Majeed


    Full Text Available The possibility of predicting the mass transfer controlled CaCO3 scale removal rate has been investigated.Experiments were carried out using chelating agents as a cleaning solution at different time and Reynolds’s number. The results of CaCO3 scale removal or (mass transfer rate (as it is the controlling process are compared with proposed model of prandtl’s and Taylor particularly based on the concept of analogy among momentum and mass transfer.Correlation for the variation of Sherwood number ( or mass transfer rate with Reynolds’s number have been obtained .

  4. Time scale bias in erosion rates of glaciated landscapes. (United States)

    Ganti, Vamsi; von Hagke, Christoph; Scherler, Dirk; Lamb, Michael P; Fischer, Woodward W; Avouac, Jean-Philippe


    Deciphering erosion rates over geologic time is fundamental for understanding the interplay between climate, tectonic, and erosional processes. Existing techniques integrate erosion over different time scales, and direct comparison of such rates is routinely done in earth science. On the basis of a global compilation, we show that erosion rate estimates in glaciated landscapes may be affected by a systematic averaging bias that produces higher estimated erosion rates toward the present, which do not reflect straightforward changes in erosion rates through time. This trend can result from a heavy-tailed distribution of erosional hiatuses (that is, time periods where no or relatively slow erosion occurs). We argue that such a distribution can result from the intermittency of erosional processes in glaciated landscapes that are tightly coupled to climate variability from decadal to millennial time scales. In contrast, we find no evidence for a time scale bias in spatially averaged erosion rates of landscapes dominated by river incision. We discuss the implications of our findings in the context of the proposed coupling between climate and tectonics, and interpreting erosion rate estimates with different averaging time scales through geologic time.

  5. Reoperation versus clinical recurrence rate after ventral hernia repair

    DEFF Research Database (Denmark)

    Helgstrand, Frederik; Rosenberg, Jacob; Kehlet, Henrik


    OBJECTIVE:: To compare the clinical recurrence rate with reoperation rate for recurrence after ventral hernia repair. BACKGROUND:: Reoperation is often used as an outcome measure after ventral hernia repair, but it is unknown whether reoperation rate reflects the overall clinical risk for recurre...


    Energy Technology Data Exchange (ETDEWEB)

    Vasquez, Bernard J., E-mail: [Physics Department and Space Science Center, University of New Hampshire, Durham, NH 03824 (United States)


    Three-dimensional numerical hybrid simulations with particle protons and quasi-neutralizing, fluid electrons are conducted for a freely decaying turbulence. The main results are obtained from a series of runs as a function of the initial total rms fluctuation amplitude. In the turbulent phase and at a corresponding nonlinear time dependent on the amplitude, the scaling of the proton perpendicular heating rate is examined as a function of the spectral value of the electron bulk perpendicular speed integrated in wavenumbers about the inverse thermal proton gyroradius. The perpendicular direction is relative to the background magnetic field. The obtained spectral value is normalized to the proton thermal speed and ranges from 0.06 to 0.16. The scaling of the perpendicular heating rate with this spectral value is fitted with a power law, which has an index of −3.3 ± 0.2. The fit is consistent with the scaling of the total heating rate as a function of total rms amplitude, which has an index of −3.06 ± 0.12. The power-law index is near the turbulent hydrodynamic-like prediction for the energy cascade rate as a function of amplitude. The heating rate, then, obeys a power law with amplitude or spectral value regardless of whether that quantity is evaluated at large scales or at the proton gyroradius scales.

  7. Relationship between manual dexterity and the unified parkinson's disease rating scale-motor exam. (United States)

    Hwang, Sujin; Song, Chiang-Soon


    [Purpose] The purpose of this study was to examine the relationships between manual dexterity and the Unified Parkinson's Disease Rating Scale-Motor Exam as a clinical tool for quantifying upper extremity function in persons with Parkinson's disease. [Subjects and Methods] Thirty-two persons with idiopathic Parkinson's disease participated in this study. This study measured two clinical outcomes, the box-and-block test and the Unified Parkinson's Disease Rating Scale-Motor Exam, to investigate the relationships between manual dexterity and the Unified Parkinson's Disease Rating Scale-Motor Exam. [Results] The box-and-block test on the more affected side was positive relationship with the box-and-block test on the less affected side. The Unified Parkinson's Disease Rating Scale-motor exam score had a negative correlation with the box-and-block test results for both sides. [Conclusion] A positive association was noted between manual dexterity and motor function in patients with idiopathic Parkinson disease. The results of this study suggest that the box-and-block test and the Unified Parkinson's Disease Rating Scale-Motor Exam are good clinical measures that quantify upper extremity function and are necessary for the accurate evaluation of patients and to plan intervention strategies.

  8. Reliability and discriminant validity of ataxia rating scales in early onset ataxia

    NARCIS (Netherlands)

    Brandsma, Rick; Lawerman, Tjitske F; Kuiper, Marieke J; Lunsing, Roelineke J; Burger, Huibert; Sival, Deborah A


    AIM: To determine whether ataxia rating scales are reliable disease biomarkers for early onset ataxia (EOA). METHOD: In 40 patients clinically identified with EOA (28 males, 12 females; mean age 15y 3mo [range 5-34y]), we determined interobserver and intraobserver agreement (interclass correlation c

  9. Validity Evidence for the Interpretation and Use of Essential Elements of Communication Global Rating Scale Scores (United States)

    Schneider, Nancy Rhoda


    Purpose. Clinical communication influences health outcomes, so medical schools are charged to prepare future physicians with the skills they need to interact effectively with patients. Communication leaders at The University of New Mexico School of Medicine (UNMSOM) developed The Essential Elements of Communication-Global Rating Scale (EEC-GRS) to…

  10. Absolute and Relative Reliability of Percentage of Syllables Stuttered and Severity Rating Scales (United States)

    Karimi, Hamid; O'Brian, Sue; Onslow, Mark; Jones, Mark


    Purpose: Percentage of syllables stuttered (%SS) and severity rating (SR) scales are measures in common use to quantify stuttering severity and its changes during basic and clinical research conditions. However, their reliability has not been assessed with indices measuring both relative and absolute reliability. This study was designed to provide…

  11. Evaluating machine learning algorithms estimating tremor severity ratings on the Bain-Findley scale (United States)

    Yohanandan, Shivanthan A. C.; Jones, Mary; Peppard, Richard; Tan, Joy L.; McDermott, Hugh J.; Perera, Thushara


    Tremor is a debilitating symptom of some movement disorders. Effective treatment, such as deep brain stimulation (DBS), is contingent upon frequent clinical assessments using instruments such as the Bain-Findley tremor rating scale (BTRS). Many patients, however, do not have access to frequent clinical assessments. Wearable devices have been developed to provide patients with access to frequent objective assessments outside the clinic via telemedicine. Nevertheless, the information they report is not in the form of BTRS ratings. One way to transform this information into BTRS ratings is through linear regression models (LRMs). Another, potentially more accurate method is through machine learning classifiers (MLCs). This study aims to compare MLCs and LRMs, and identify the most accurate model that can transform objective tremor information into tremor severity ratings on the BTRS. Nine participants with upper limb tremor had their DBS stimulation amplitude varied while they performed clinical upper-extremity exercises. Tremor features were acquired using the tremor biomechanics analysis laboratory (TREMBAL). Movement disorder specialists rated tremor severity on the BTRS from video recordings. Seven MLCs and 6 LRMs transformed TREMBAL features into tremor severity ratings on the BTRS using the specialists’ ratings as training data. The weighted Cohen’s kappa ({κ\\text{w}} ) defined the models’ rating accuracy. This study shows that the Random Forest MLC was the most accurate model ({κ\\text{w}}   =  0.81) at transforming tremor information into BTRS ratings, thereby improving the clinical interpretation of tremor information obtained from wearable devices.

  12. Validation of the Global Rating Scale for endoscopy. (United States)

    Williams, T; Ross, A; Stirling, C; Palmer, K; Phull, P S


    The Global Rating Scale for endoscopy is a web-based tool that can be used to assess and improve the quality of an endoscopy service. It was developed by asking endoscopy health professionals what they would want from the service for themselves or their relatives if they were undergoing an endoscopic procedure. To date, the Global Rating Scale has not been validated by patients themselves. We used focus groups in order to access the views and opinions of patients who had recently had experience of endoscopy services. Six focus groups were undertaken in five different Health Board areas across Scotland; in total 26 people participated. The results indicated that from the patients' perspective the 12 items of the GRS covered all areas of the endoscopy experience. There were no specific concerns identified that were not already covered within the Global Rating Scale. We conclude that the Global Rating Scale does address quality issues that matter to patients undergoing endoscopy, and validates the use of the GRS as a quality assessment tool for endoscopy services.

  13. Construct Validity and Reliability of the Ethical Behavior Rating Scale. (United States)

    Hill, Gloria; Swanson, H. Lee


    Results of factor and correlational analyses of the Ethical Behavior Rating Scale (EBRS) are reported. The test-retest method and internal consistency estimates yielded reliability coefficients. Construct validity was determined by correlating the EBRS with items from the Ethical Reasoning Inventory. The EBRS reflects the behavioral aspects of…

  14. Scaling Behaviour and Memory in Heart Rate of Healthy Human

    Institute of Scientific and Technical Information of China (English)

    CAI Shi-Min; PENG Hu; YANG Hui-Jie; ZHOU Tao; ZHOU Pei-Ling; WANG Bing-Hong


    We investigate a set of complex heart rate time series from healthy human in different behaviour states with the detrended fluctuation analysis and diffusion entropy (DE) method. It is proposed that the scaling properties are influenced by behaviour states. The memory detected by DE exhibits an approximately same pattern after a detrending procedure. Both of them demonstrate the long-range strong correlations in heart rate. These findings may be helpful to understand the underlying dynamical evolution process in the heart rate control system, as well as to model the cardiac dynamic process.

  15. Development and validation of the Cancer Dyspnoea Scale: a multidimensional, brief, self-rating scale


    K. Tanaka; Akechi, T.; T. Okuyama; Nishiwaki,Y; Uchitomi, Y


    Dyspnoea is one of the most frequent and refractory symptoms in cancer patients. Lack of an appropriate assessment tool for dyspnoea seems to disturb establishment of management strategy. The purpose of this study was to develop and validate a brief self-rating scale to assess the multidimensional nature of dyspnoea in cancer patients. We developed a 12-item scale, the Cancer Dyspnoea Scale (CDS), composed of three factors (sense of effort/sense of anxiety/sense of discomfort), by using facto...

  16. Scaling laws in the dynamics of crime growth rate (United States)

    Alves, Luiz G. A.; Ribeiro, Haroldo V.; Mendes, Renio S.


    The increasing number of crimes in areas with large concentrations of people have made cities one of the main sources of violence. Understanding characteristics of how crime rate expands and its relations with the cities size goes beyond an academic question, being a central issue for contemporary society. Here, we characterize and analyze quantitative aspects of murders in the period from 1980 to 2009 in Brazilian cities. We find that the distribution of the annual, biannual and triannual logarithmic homicide growth rates exhibit the same functional form for distinct scales, that is, a scale invariant behavior. We also identify asymptotic power-law decay relations between the standard deviations of these three growth rates and the initial size. Further, we discuss similarities with complex organizations.

  17. Scaling laws in the dynamics of crime growth rate

    CERN Document Server

    Alves, Luiz Gustavo de Andrade; Mendes, Renio dos Santos


    The increasing number of crimes in areas with large concentrations of people have made cities one of the main source of violence. Understanding characteristics of how crime rate expands and its relations with the cities size goes beyond an academic question, being a central issue for the contemporary society. Here, we characterize and analyze quantitative aspects of murders in the period from 1980 to 2009 in Brazilian cities. We find that the distribution of the annual, biannual and triannual logarithmic homicide growth rates exhibit the same functional form for distinct scales, that is, a scale invariant behaviour. We also identify asymptotic power-law decay relations between the standard deviations of these three growth rates and the initial size. Further, we discuss similarities with complex organizations.

  18. Cross Informant Agreement of the Behavioral and Emotional Rating Scale - 2nd Edition (BERS-2) Parent and Youth Rating Scales (United States)

    Synhorst, Lori L.; Buckley, Jacquelyn A.; Reid, Robert; Epstein, Michael E.; Ryser, Gail


    Behavior rating scales are important tools in the process of assessing students' emotional and behavioral needs. Best practices in behavioral assessment dictate that the perspectives of multiple informants (e.g., teacher, parent, youth) should be considered. Overall, agreement between multiple informants is modest at best and is especially low…

  19. Cross Informant Agreement of the Behavioral and Emotional Rating Scale--2nd Edition (BERS-2) Parent and Youth Rating Scales (United States)

    Synhorst, Lori L.; Buckley, Jacquelyn A.; Reid, Robert; Epstein, Michael E.; Ryser, Gail


    Behavior rating scales are important tools in the process of assessing students' emotional and behavioral needs. Best practices in behavioral assessment dictate that the perspectives of multiple informants (e.g., teacher, parent, youth) should be considered. Overall, agreement between multiple informants is modest at best and is especially low…

  20. A Comparison of Two Task Rating Scales of Physical Demand. (United States)


    Research Report 3/86 0 r=CG RISON OF TwO TASK RATING SCALES CF PHYSICAL CEMAND by Major Robert S. Collyer Commonwealth of Autralia ! August 19g86 This...analysis system . because the wording of the anchor points for the PSE scale made reference to specific weights and heights, it was judged to be an...Air Force Occupational ’,easurement Center. Lindquist, E. F. (1953). Design and analysis of experiments in psychology and education . Boston, l,1A

  1. On the Rate of Structural Change in Scale Spaces

    DEFF Research Database (Denmark)

    Gustafsson, David Karl John; Pedersen, Kim Steenstrup; Lauze, Francois Bernard;


    We analyze the rate in which image details are suppressed as a function of the regularization parameter, using first order Tikhonov regularization, Linear Gaussian Scale Space and Total Variation image decomposition. The squared L2-norm of the regularized solution and the residual are studied...... as a function of the regularization parameter. For first order Tikhonov regularization it is shown that the norm of the regularized solution is a convex function, while the norm of the residual is not a concave function. The same result holds for Gaussian Scale Space when the parameter is the variance...

  2. Cross-cultural adaptation of the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS to Brazilian Portuguese

    Directory of Open Access Journals (Sweden)

    F A Sekeff-Sallem


    Full Text Available Cervical dystonia (CD is a prevalent and incapacitating movement disorder which needs a thorough clinical evaluation of every patient to better tailor treatment strategies. In Brazil, there are no validated CD scales that measure the burden of dystonia. The aim of our study was to translate and adapt the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS to Brazilian Portuguese. After translation and back-translation according to international methods, a pre-test was carried out with 30 patients. Patients under 8 years of formal schooling had severe difficulty in understanding the whole scale. The scale went through a remodeling process, without loss of its conceptual and semantic properties. The new scale was tested in 15 patients, with good understanding scores. We are now in the process of validation of the adapted scale.

  3. Characteristics of depression in Parkinson's disease: evaluating with Zung's Self-Rating Depression Scale. (United States)

    Kanda, Fumio; Oishi, Kenichi; Sekiguchi, Kenji; Kuga, Atsushi; Kobessho, Hiroshi; Shirafuji, Toshihiko; Higuchi, Masatsugu; Ishihara, Hiroyuki


    The purpose of the study was to elucidate characteristics of depression in Parkinson's disease (PD). Fifty-eight PD patients were evaluated with Zung's Self-Rating Depression Scale (SDS) and the Unified Parkinson's Disease Rating Scale (UPDRS). Scores for "suicidal ideation" on the SDS correlated with posture and gait disturbances on the UPDRS. Twenty-six patients with spinocerebellar degeneration (SCD) were also evaluated with the SDS. SDS scores for "indecisiveness" and "constipation" were significantly higher in PD patients than SCD patients. Our results suggest that depression is common in disabled persons but PD patients might have a characteristic clinical presentation.

  4. Characterizing heart rate variability by scale-dependent Lyapunov exponent (United States)

    Hu, Jing; Gao, Jianbo; Tung, Wen-wen


    Previous studies on heart rate variability (HRV) using chaos theory, fractal scaling analysis, and many other methods, while fruitful in many aspects, have produced much confusion in the literature. Especially the issue of whether normal HRV is chaotic or stochastic remains highly controversial. Here, we employ a new multiscale complexity measure, the scale-dependent Lyapunov exponent (SDLE), to characterize HRV. SDLE has been shown to readily characterize major models of complex time series including deterministic chaos, noisy chaos, stochastic oscillations, random 1/f processes, random Levy processes, and complex time series with multiple scaling behaviors. Here we use SDLE to characterize the relative importance of nonlinear, chaotic, and stochastic dynamics in HRV of healthy, congestive heart failure, and atrial fibrillation subjects. We show that while HRV data of all these three types are mostly stochastic, the stochasticity is different among the three groups.

  5. Rating scales for cervical dystonia: a critical evaluation of tools for outcome assessment of botulinum toxin therapy. (United States)

    Jost, Wolfgang H; Hefter, Harald; Stenner, Andrea; Reichel, Gerhard


    Botulinum neurotoxin is the therapy of choice for all forms of cervical dystonia (CD), but treatment regimens still vary considerably. The interpretation of treatment outcome is mainly based on the clinical experience and on the scientific value of the rating scales applied. The aim of this review is to describe the historical development of rating scales for the assessment of CD and to provide an appraisal of their advantages and drawbacks. The Tsui score and the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) have been widely employed in numerous clinical studies as specific instruments for CD. The obvious advantage of the Tsui score is its simplicity so that it can be easily implemented in clinical routine. The TWSTRS allows a more sophisticated assessment of functional features of CD, but only the Tsui score includes a rating for tremor. Other benefits of the TWSTRS are the disability and pain subscales, but despite its value in clinical trials, it might be too complex for routine clinical practice. None of the rating scales used at present has been rigorously tested for responsiveness to detect significant changes in clinical status after therapeutic interventions. Moreover, clinical data support a new classification of CD leading to a differentiation between head and neck subtypes. As the current rating scales are not able to cover all these aspects of the disorder, further research is needed to develop a valid and reliable instrument which considers the most current classification of CD.

  6. A large-scale validation study of the Medication Adherence Rating Scale (MARS). (United States)

    Fialko, Laura; Garety, Philippa A; Kuipers, Elizabeth; Dunn, Graham; Bebbington, Paul E; Fowler, David; Freeman, Daniel


    Adherence to medication is an important predictor of illness course and outcome in psychosis. The Medication Adherence Rating Scale (MARS) is a ten-item self-report measure of medication adherence in psychosis [Thompson, K., Kulkarni, J., Sergejew, A.A., 2000. Reliability and validity of a new Medication Adherence Rating Scale (MARS) for the psychoses. Schizophrenia Research. 42. 241-247]. Although initial results suggested that the scale has good reliability and validity, the development sample was small. The current study aimed to establish the psychometric properties of the MARS in a sample over four times larger. The scale was administered to 277 individuals with psychosis, along with measures of insight and psychopathology. Medication adherence was independently rated by each individual's keyworker. Results showed the internal consistency of the MARS to be lower than in the original sample, though adequate. MARS total score correlated weakly with keyworker-rated adherence, hence concurrent validity of the scale appeared only moderate to weak. The three factor structure of the MARS was replicated. Examination of the factor scores suggested that the factor 1 total score, which corresponds to the Medication Adherence Questionnaire [Morisky,D.E., Green,L.W. and Levine,D.M., 1986. Concurrent and predictive validity of a self-reported measure of medication adherence. Medical Care. 24, 67-74] may be a preferable measure of medication adherence behaviour to the total scale score.

  7. Pharyngeal Residue Severity Rating Scales Based on Fiberoptic Endoscopic Evaluation of Swallowing: A Systematic Review. (United States)

    Neubauer, Paul D; Hersey, Denise P; Leder, Steven B


    Identification of pharyngeal residue severity located in the valleculae and pyriform sinuses has always been a primary goal during fiberoptic endoscopic evaluation of swallowing (FEES). Pharyngeal residue is a clinical sign of potential prandial aspiration making an accurate description of its severity an important but difficult challenge. A reliable, validated, and generalizable pharyngeal residue severity rating scale for FEES would be beneficial. A systematic review of the published English language literature since 1995 was conducted to determine the quality of existing pharyngeal residue severity rating scales based on FEES. Databases were searched using controlled vocabulary words and synonymous free text words for topics of interest (deglutition disorders, pharyngeal residue, endoscopy, videofluoroscopy, fiberoptic technology, aspiration, etc.) and outcomes of interest (scores, scales, grades, tests, FEES, etc.). Search strategies were adjusted for syntax appropriate for each database/platform. Data sources included MEDLINE (OvidSP 1946-April Week 3 2015), Embase (OvidSP 1974-2015 April 20), Scopus (Elsevier), and the unindexed material in PubMed (NLM/NIH) were searched for relevant articles. Supplementary efforts to identify studies included checking reference lists of articles retrieved. Scales were compared using qualitative properties (sample size, severity definitions, number of raters, and raters' experience and training) and psychometric analyses (randomization, intra- and inter-rater reliability, and construct validity). Seven articles describing pharyngeal residue severity rating scales met inclusion criteria. Six of seven scales had insufficient data to support their use as evidenced by methodological weaknesses with both qualitative properties and psychometric analyses. There is a need for qualitative and psychometrically reliable, validated, and generalizable pharyngeal residue severity rating scales that are anatomically specific, image

  8. Ratings of Residents' Clinical Competence and Performance on Certification Examination. (United States)

    Norcinin, John J.; And Others


    A study of the correlation between certification test results and ratings of clinical competence for graduate medical students in internal medicine during a six-year period found strong correlations on both individual and general indicators of competence. (MSE)

  9. Comparison of visual analogue scale and faces rating scale in measuring acute postoperative pain. (United States)

    Fadaizadeh, Lida; Emami, Habib; Samii, Kamran


    Several pain assessment tools have been proposed for use in different settings, but neither have been validated for all patients, especially Iranians. We conducted this study to compare the accuracy of two most commonly used tools for evaluation of pain intensity in a group of postoperative Iranian patients. All postoperative patients admitted to the surgical wards of Masih Daneshvari and Rasoul Akram Hospitals, Tehran, Iran were studied. During a two-month period, patients were evaluated for pain intensity within 24 hours of operation. Visual analogue scale and faces rating scale were used for this purpose. Eighty-two patients were enrolled into the study. Forty-eight patients underwent obstetrics and 34 had general surgeries. Using Spearman analysis, we found a linear correlation between the results of the two methods (P=0.952). Using multivariate analysis, we found that none of the variables such as age, gender, and education level had significant effects on correlation between visual analogue scale and faces rating scale. Visual analogue scale and faces rating scale are two pain assessment tools that can be used interchangeably for evaluation of acute postoperative pain.

  10. Scale dependence of rock friction at high work rate. (United States)

    Yamashita, Futoshi; Fukuyama, Eiichi; Mizoguchi, Kazuo; Takizawa, Shigeru; Xu, Shiqing; Kawakata, Hironori


    Determination of the frictional properties of rocks is crucial for an understanding of earthquake mechanics, because most earthquakes are caused by frictional sliding along faults. Prior studies using rotary shear apparatus revealed a marked decrease in frictional strength, which can cause a large stress drop and strong shaking, with increasing slip rate and increasing work rate. (The mechanical work rate per unit area equals the product of the shear stress and the slip rate.) However, those important findings were obtained in experiments using rock specimens with dimensions of only several centimetres, which are much smaller than the dimensions of a natural fault (of the order of 1,000 metres). Here we use a large-scale biaxial friction apparatus with metre-sized rock specimens to investigate scale-dependent rock friction. The experiments show that rock friction in metre-sized rock specimens starts to decrease at a work rate that is one order of magnitude smaller than that in centimetre-sized rock specimens. Mechanical, visual and material observations suggest that slip-evolved stress heterogeneity on the fault accounts for the difference. On the basis of these observations, we propose that stress-concentrated areas exist in which frictional slip produces more wear materials (gouge) than in areas outside, resulting in further stress concentrations at these areas. Shear stress on the fault is primarily sustained by stress-concentrated areas that undergo a high work rate, so those areas should weaken rapidly and cause the macroscopic frictional strength to decrease abruptly. To verify this idea, we conducted numerical simulations assuming that local friction follows the frictional properties observed on centimetre-sized rock specimens. The simulations reproduced the macroscopic frictional properties observed on the metre-sized rock specimens. Given that localized stress concentrations commonly occur naturally, our results suggest that a natural fault may lose its

  11. Scale Specific and Scale Independent Measures of Heart Rate Variability as Risk Indicators

    CERN Document Server

    Ashkenazy, Yu; Levitan, J; Havlin, S; Saermark, K; Moelgaard, H; Thomsen, P E B; Möller, M; Hintze, U; Huikuri, H


    We study the Heart Rate Variability (HRV) using scale specific variance and scaling exponents as measures of healthy and cardiac impaired individuals. Our results show that the variance and the scaling exponent are highly uncorrelated. We find that the variance measure at certain scales are well suited to separate healthy subjects from heart patients. However, for cumulative survival probability the scaling exponents outperform the variance measure. Our risk study is based on a database containing recordings from 428 MI individuals (after myocardial infarct) and on database containing 105 healthy subjects and 11 heart patients. The results have been obtained by applying three recently developed methods (DFA - Detrended Fluctuation Analysis, WAV - Multiresolution Wavelet Analysis, and DTS - Detrended Time Series analysis) which are found to be highly correlated.

  12. Success rate of microimplants in a university orthodontic clinic. (United States)

    Sharma, P; Valiathan, A; Sivakumar, A


    Introduction. The purpose of this study was to examine the success rate and find factors affecting the clinical success of microimplants used as orthodontic anchorage. Methods. Seventy-three consecutive patients (25 male, 48 female; mean age, 22.45 years) with a total of 139 screw implants of 2 types were examined. Success rate was determined according to 18 clinical variables. Results. The overall success rate was 87.8%. The clinical variables of microimplant factors (type), patient factors (sex, skeletal and dental relationships, overbite, jaw involved, side involved and site involved), and treatment factors (type of insertion, time of loading, purpose of microimplant insertion, mode of loading, type of anchorage used, direction of forces applied) did not show any statistical difference in success rates. Mandibular angle, vertical position of implant placement, oral hygiene status, and inflammation showed significant difference in success rates. Conclusions. Proper case selection and following the recommended protocol are extremely essential to minimise failures.

  13. How Do Observational Scales Correlate the Ratings of Children’s Behavior during Pediatric Procedural Sedation?

    Directory of Open Access Journals (Sweden)

    Larissa da Silva Moura


    Full Text Available Background. There is little information regarding the ability of observational scales to properly assess children’s behavior during procedural sedation. Aim. To evaluate the characteristics of the Houpt scales, the Ohio State University Behavioral Rating Scale (OSUBRS and the Venham Behavior Rating Scale when applied to preschool children undergoing conscious dental sedation. Design. This study included 27 children, 4–6 years old with early childhood caries that participated in a clinical trial (NCT02284204 that investigated two sedative regimes using oral midazolam/ketamine. Dental appointments were video-recorded; five calibrated observers assessed 1,209 minutes of video recording to score the children’s behavior, following the instructions of the investigated scales. Data were analyzed by descriptive analysis and Spearman correlation tests (P<0.05. Results. The Houpt overall behavior and the Venham scale were highly correlated (rho = −0.87; P<0.001. OSUBRS scores were better correlated with Houpt overall behavior and Venham ratings, when compared to Houpt scores in the categories for movement and crying. Conclusions. The Houpt overall behavior and the Venham scores are global scales that properly measure children’s behavior during dental sedation. Continuous assessment with OSUBRS through videos has a chance to give more precise data, while the Houpt categories can easily demonstrate children’s behavior during procedures.

  14. How Do Observational Scales Correlate the Ratings of Children's Behavior during Pediatric Procedural Sedation? (United States)

    Moura, Larissa da Silva


    Background. There is little information regarding the ability of observational scales to properly assess children's behavior during procedural sedation. Aim. To evaluate the characteristics of the Houpt scales, the Ohio State University Behavioral Rating Scale (OSUBRS) and the Venham Behavior Rating Scale when applied to preschool children undergoing conscious dental sedation. Design. This study included 27 children, 4–6 years old with early childhood caries that participated in a clinical trial (NCT02284204) that investigated two sedative regimes using oral midazolam/ketamine. Dental appointments were video-recorded; five calibrated observers assessed 1,209 minutes of video recording to score the children's behavior, following the instructions of the investigated scales. Data were analyzed by descriptive analysis and Spearman correlation tests (P < 0.05). Results. The Houpt overall behavior and the Venham scale were highly correlated (rho = −0.87; P < 0.001). OSUBRS scores were better correlated with Houpt overall behavior and Venham ratings, when compared to Houpt scores in the categories for movement and crying. Conclusions. The Houpt overall behavior and the Venham scores are global scales that properly measure children's behavior during dental sedation. Continuous assessment with OSUBRS through videos has a chance to give more precise data, while the Houpt categories can easily demonstrate children's behavior during procedures. PMID:28116299

  15. Psychometric properties of the self-rating organization scale with adult samples

    Directory of Open Access Journals (Sweden)

    Takeda T


    Full Text Available Toshinobu Takeda,1 Yui Tsuji,2 Mizuho Ando3 1Department of Clinical Psychology, Ryukoku University, Kyoto, 2School of Psychological Science, Health Sciences University of Hokkaido, Sapporo, 3Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan Abstract: Organization skills are defined broadly to include both materials and temporal features. Given its symptoms and neurobiological features, attention-deficit hyperactivity disorder (ADHD should be susceptible to impairment in organization. A valid organization scale is imperative to assess and intervene individuals with ADHD. However, there is no validated organization scale in Japan. Referring to existing scales and clinical experience, the self-rating organization scale (SOS was developed and tested in terms of its psychometric properties with 1,017 adults and students including 47 adults with ADHD. Additionally, cutoffs for disorganization were set for clinical utility. Three factors (materials disorganization, temporal disorganization, and mess were extracted by factor analyses. The index for reliability and validity of the SOS was acceptable. The factor “mess” could reflect the unique aspect of the Japanese environment. Further study is needed to enhance the clinical utility of the SOS. Keywords: adult, attention-deficit hyperactivity disorder, organization, scale

  16. Comparison of a timed motor test battery to the Unified Parkinson's Disease Rating Scale-III in Parkinson's disease.

    NARCIS (Netherlands)

    Haaxma, C.A.; Bloem, B.R.; Borm, G.F.; Horstink, M.W.I.M.


    The most widely used scale currently available for the clinical evaluation of motor dysfunction in Parkinson's disease (PD)-the Unified Parkinson's Disease Rating Scale-III (UPDRS-III) -is time-consuming, subjective, and has suboptimal sensitivity. A brief timed motor test (TMT) battery could possib

  17. MMPI-2 Clinical Scale 6 (Paranoia and Restructured Clinical Scale 6 (Ideas of Persecution in Child Custody Litigants

    Directory of Open Access Journals (Sweden)

    Robert Semel


    Full Text Available The MMPI-2 is the most frequently used psychological test with parents undergoing child custody evaluations (CCE's. Studies of parents who completed the MMPI-2 in the CCE context have consistently found that, on average, parents portray a very favorable image of themselves as both virtuous and psychologically well-adjusted. Also, on average, Clinical Scale 6 (Paranoia and its counterpart on the Restructured Clinical Scales, RC6, have been the most frequently elevated of the clinical scales on the MMPI-2 in samples of child custody litigants, albeit, the reported scores on these scales are well within the norm. This paper examines the significance of clinically elevated scores on Scale 6 (and RC6 in parents undergoing CCE's, with consideration of both contextual and psychometric features. Based on these considerations, this writer suggests that custody evaluators may encounter the paradox that some parents whose clinical profile suggests mistrust and suspiciousness in interpersonal relations may actually trust enough to report their perceptions in a candid and forthcoming manner. At least some of these parents are not mistrustful in general and are not inclined to model or influence their children toward the development of mistrust. In contrast, other parents may respond to the test in a more defensive and deceptive manner resulting in a "normal" clinical profile, which may be specific to the evaluation context, but may also reflect moral righteousness and a more insidious tactic. The custody evaluator is advised to use caution when interpreting clinically elevated scores on the MMPI-2.

  18. Observer bias in randomized clinical trials with measurement scale outcomes

    DEFF Research Database (Denmark)

    Hróbjartsson, Asbjørn; Thomsen, Ann Sofia Skou; Emanuelsson, Frida;


    BACKGROUND:Clinical trials are commonly done without blinded outcome assessors despite the risk of bias. We wanted to evaluate the effect of nonblinded outcome assessment on estimated effects in randomized clinical trials with outcomes that involved subjective measurement scales. METHODS......:We conducted a systematic review of randomized clinical trials with both blinded and nonblinded assessment of the same measurement scale outcome. We searched PubMed, EMBASE, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials, HighWire Press and Google Scholar for relevant studies. Two......%). Heterogeneity was moderate (I(2) = 46%, p = 0.02) and unexplained by metaregression. INTERPRETATION:We provide empirical evidence for observer bias in randomized clinical trials with subjective measurement scale outcomes. A failure to blind assessors of outcomes in such trials results in a high risk...

  19. Scaling Relations of Galactic Winds with Star Formation Rate (United States)

    Tanner, Ryan; Cecil, Gerald; Heitsch, Fabian


    The galactic scale outflows generated by nuclear starbursts consist of a multiphase medium where each phase has a distinct velocity depending on the characteristics of the starburst. Using synthetic absorption lines generated from 3D hydrodynamical simulations we probe the outflow velocity of the hot, warm, and neutral gas entrained in a galactic wind. By varying the star formation rate (SFR) in our simulations, we find no correlation between the outflow velocity of the hot gas with the SFR, but we do find a correlation between the outflow velocity of both warm and neutral gas with the SFR. The scaling relation between outflow velocity and SFR only holds for low SFR until the scaling relation abruptly flattens at a SFR determined by the mass loading of the starburst. The outflow velocity of the hot gas only depends on the mass loading of the starburst and not the SFR. For low SFRs the difference between the velocity of cold gas, as measured by absorption lines of neutral or low ionized gas, may be 5-7 times lower than the velocity of the hot, highly ionized gas. The difference in velocity between the cold and hot gas for higher SFRs depends on the mass loading factor of the starburst. Thus the measured velocities of neutral or low ionized gas cannot be used to estimate the outflow velocity of the hot gas without determining the mass loading of the starburst.

  20. Quantitative regional validation of the visual rating scale for posterior cortical atrophy

    Energy Technology Data Exchange (ETDEWEB)

    Moeller, Christiane; Benedictus, Marije R.; Koedam, Esther L.G.M.; Scheltens, Philip [VU University Medical Center, Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, P.O. Box 7057, Amsterdam (Netherlands); Flier, Wiesje M. van der [VU University Medical Center, Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, P.O. Box 7057, Amsterdam (Netherlands); VU University Medical Center, Department of Epidemiology and Biostatistics, Neuroscience Campus Amsterdam, P.O. Box 7057, Amsterdam (Netherlands); Versteeg, Adriaan; Wattjes, Mike P.; Barkhof, Frederik [VU University Medical Center, Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, P.O. Box 7057, Amsterdam (Netherlands); Vrenken, Hugo [VU University Medical Center, Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, P.O. Box 7057, Amsterdam (Netherlands); VU University Medical Center, Department of Physics and Medical Technology, Neuroscience Campus Amsterdam, P.O. Box 7057, Amsterdam (Netherlands)


    Validate the four-point visual rating scale for posterior cortical atrophy (PCA) on magnetic resonance images (MRI) through quantitative grey matter (GM) volumetry and voxel-based morphometry (VBM) to justify its use in clinical practice. Two hundred twenty-nine patients with probable Alzheimer's disease and 128 with subjective memory complaints underwent 3T MRI. PCA was rated according to the visual rating scale. GM volumes of six posterior structures and the total posterior region were extracted using IBASPM and compared among PCA groups. To determine which anatomical regions contributed most to the visual scores, we used binary logistic regression. VBM compared local GM density among groups. Patients were categorised according to their PCA scores: PCA-0 (n = 122), PCA-1 (n = 143), PCA-2 (n = 79), and PCA-3 (n = 13). All structures except the posterior cingulate differed significantly among groups. The inferior parietal gyrus volume discriminated the most between rating scale levels. VBM showed that PCA-1 had a lower GM volume than PCA-0 in the parietal region and other brain regions, whereas between PCA-1 and PCA-2/3 GM atrophy was mostly restricted to posterior regions. The visual PCA rating scale is quantitatively validated and reliably reflects GM atrophy in parietal regions, making it a valuable tool for the daily radiological assessment of dementia. (orig.)

  1. The neurobehavioural rating scale: assessment of the behavioural sequelae of head injury by the clinician. (United States)

    Levin, H S; High, W M; Goethe, K E; Sisson, R A; Overall, J E; Rhoades, H M; Eisenberg, H M; Kalisky, Z; Gary, H E


    To investigate the inter-rater reliability and validity of the Neurobehavioural Rating Scale at various stages of recovery after hospitalisation for closed head injury, we studied 101 head trauma patients who had no antecedent neuropsychiatric disorder. The results demonstrated satisfactory inter-rater reliability and showed that the Neurobehavioural Rating Scale reflects both the severity and chronicity of closed head injury. A principal components analysis revealed four factors which were differentially related to severity of head injury and the presence of a frontal lobe mass lesion. Although our findings provide support for utilising clinical ratings of behaviour to investigate sequelae of head injury, extension of this technique to other settings is necessary to evaluate the distinctiveness of the neurobehavioural profile of closed head injury as compared with other aetiologies of brain damage. PMID:3572433

  2. Psychometric properties of the adjective rating scale for withdrawal across treatment groups, gender, and over time. (United States)

    Barbosa-Leiker, Celestina; McPherson, Sterling; Mamey, Mary Rose; Burns, G Leonard; Roll, John


    The adjective rating scale for withdrawal (ARSW) is commonly used to assess opiate withdrawal in clinical practice and research. The aims of this study were to examine the factor structure of the ARSW, test measurement invariance across gender and treatment groups, and assess longitudinal measurement invariance across the clinical trial. Secondary data analysis of the National Drug Abuse Treatment Clinical Trials Network 000-3, a randomized clinical trial comparing two tapering strategies, was performed. The ARSW was analyzed at baseline, end of taper and 1-month follow-up (N=515 opioid-dependent individuals). A 1-factor model of the ARSW fit the data and demonstrated acceptable reliability. Measurement invariance was supported across gender and taper groups. Longitudinal measurement invariance was not found across the course of the trial, with baseline assessment contributing to the lack of invariance. If change over time is of interest, change from post-treatment through follow-up may offer the most valid comparison.

  3. Deriving health state utilities for the numerical pain rating scale

    Directory of Open Access Journals (Sweden)

    Retsa Peny


    Full Text Available Abstract Background The use of patient reported outcome measures within cost-effectiveness analysis has become commonplace. However, specific measures are required that produce values, referred to as 'utilities', that are capable of generating quality adjusted life years. One such measure - the EQ-5D - has come under criticism due to the inherent limitations of its three-level response scales. In evaluations of chronic pain, the numerical pain rating scale (NPRS which has eleven levels is routinely used which has a greater measurement range, but which can not be used in cost-effetiveness analyses. This study derived utility values for a series of EQ-5D health states that replace the pain dimensions with the NPRS, thereby allowing a potentially greater range of pain intensities to be captured and included in economic analyses. Methods Interviews were undertaken with 100 member of the general population. Health state valuations were elicited using the time trade-off approach with a ten year time horizon. Additionally, respondents were asked where the EQ-5D response scale descriptors of moderate and extreme pain lay on the 11-point NPRS scale. Results 625 valuations were undertaken across the study sample with the crude mean health state utilities showing a negative non-linear relationship with respect to increasing pain intensity. Relative to a NPRS of zero (NPRS0, the successive pain levels (NPRS1-10 had mean decrements in utility of 0.034, 0.043, 0.061, 0.121, 0.144, 0.252, 0.404, 0.575, 0.771 and 0.793, respectively. When respondents were asked to mark on the NPRS scale the EQ-5D pain descriptors of moderate and extreme pain, the median responses were '4' and '8', respectively. Conclusions These results demonstrate the potential floor effect of the EQ-5D with respect to pain and provide estimates of health reduction associated with pain intensity described by the NPRS. These estimates are in excess of the decrements produced by an application

  4. Inhomogeneous scaling behaviors in Malaysian foreign currency exchange rates (United States)

    Muniandy, S. V.; Lim, S. C.; Murugan, R.


    In this paper, we investigate the fractal scaling behaviors of foreign currency exchange rates with respect to Malaysian currency, Ringgit Malaysia. These time series are examined piecewise before and after the currency control imposed in 1st September 1998 using the monofractal model based on fractional Brownian motion. The global Hurst exponents are determined using the R/ S analysis, the detrended fluctuation analysis and the method of second moment using the correlation coefficients. The limitation of these monofractal analyses is discussed. The usual multifractal analysis reveals that there exists a wide range of Hurst exponents in each of the time series. A new method of modelling the multifractal time series based on multifractional Brownian motion with time-varying Hurst exponents is studied.

  5. The VAGUS insight into psychosis scale--self-report and clinician-rated versions. (United States)

    Gerretsen, Philip; Remington, Gary; Borlido, Carol; Quilty, Lena; Hassan, Sabrina; Polsinelli, Gina; Teo, Celine; Mar, Wanna; Simon, Regina; Menon, Mahesh; Pothier, David D; Nakajima, Shinichiro; Caravaggio, Fernando; Mamo, David C; Rajji, Tarek K; Mulsant, Benoit H; Deluca, Vincenzo; Ganguli, Rohan; Pollock, Bruce G; Graff-Guerrero, Ariel


    The aim of this study was to develop self-report and clinician-rated versions of an insight scale that would be easy to administer, sensitive to small changes, and inclusive of the core dimensions of clinical insight into psychosis. Ten-item self-report (VAGUS-SR) and five-item clinician-rated (VAGUS-CR) scales were designed to measure the dimensions of insight into psychosis and evaluated in 215 and 140 participants, respectively ( Tests of reliability and validity were performed. Both the VAGUS-SR and VAGUS-CR showed good internal consistency and reliability. They demonstrated good convergent and discriminant validity. Both versions were strongly correlated with one another and with the Schedule for the Assessment of Insight and Birchwood Insight Scale. Exploratory factor analyses identified three possible latent components of insight. The VAGUS-CR and VAGUS-SR are valid, reliable and easy to administer. They are build on previous insight scales with separate clinician-rated and self-report versions. The VAGUS-SR exhibited a multidimensional factor structure. Using a 10-point Likert scale for each item, the VAGUS has the capacity to detect small, temporally sensitive changes in insight, which is essential for intervention studies with neurostimulation or rapidly acting medications.

  6. The VAGUS insight into psychosis scale – Self-report & clinician-rated versions (United States)

    Gerretsen, Philip; Remington, Gary; Borlido, Carol; Quilty, Lena; Hassan, Sabrina; Polsinelli, Gina; Teo, Celine; Mar, Wanna; Simon, Regina; Menon, Mahesh; Pothier, David D.; Nakajima, Shinichiro; Caravaggio, Fernando; Mamo, David C.; Rajji, Tarek K.; Mulsant, Benoit H.; Deluca, Vincenzo; Ganguli, Rohan; Pollock, Bruce G.; Graff-Guerrero, Ariel


    The aim of this study was to develop self-report and clinician-rated versions of an insight scale that would be easy to administer, sensitive to small changes, and inclusive of the core dimensions of clinical insight into psychosis. Ten-item self-report (VAGUS-SR) and five-item clinician-rated (VAGUS-CR) scales were designed to measure the dimensions of insight into psychosis and evaluated in 215 and 140 participants, respectively ( Tests of reliability and validity were performed. Both the VAGUS-SR and VAGUS-CR showed good internal consistency and reliability. They demonstrated good convergent and discriminant validity. Both versions were strongly correlated with one another and with the Schedule for the Assessment of Insight and Birchwood Insight Scale. Exploratory factor analyses identified three possible latent components of insight. The VAGUS-CR and VAGUS-SR are valid, reliable and easy to administer. They are build on previous insight scales with separate clinician-rated and self-report versions. The VAGUS-SR exhibited a multidimensional factor structure. Using a 10-point Likert scale for each item, the VAGUS has the capacity to detect small, temporally sensitive changes in insight, which is essential for intervention studies with neurostimulation or rapidly acting medications. PMID:25246410

  7. The Columbia-Suicide Severity Rating Scale (C–SSRS): Has the “Gold Standard” Become a Liability?


    Giddens, Jennifer M.; Sheehan, Kathy Harnett; Sheehan, David V


    Objective: The Columbia– Suicide Severity Rating Scale has become the gold standard for the assessment of suicidal ideation and behavior in clinical trials. Criticism of the instrument has been mounting. We examine whether the instrument meets widely accepted psychometric standards and maps to the United States Food and Drug Administration’s most recent 2012 algorithm for assessment of suicidal phenomena. Our goal is to determine if the Columbia–Suicide Severity Rating Scale should be retaine...

  8. Scaling of standard metabolic rate in estuarine crocodiles Crocodylus porosus. (United States)

    Seymour, Roger S; Gienger, C M; Brien, Matthew L; Tracy, Christopher R; Charlie Manolis, S; Webb, Grahame J W; Christian, Keith A


    Standard metabolic rate (SMR, ml O2 min(-1)) of captive Crocodylus porosus at 30 °C scales with body mass (kg) according to the equation, SMR = 1.01 M(0.829), in animals ranging in body mass of 3.3 orders of magnitude (0.19-389 kg). The exponent is significantly higher than 0.75, so does not conform to quarter-power scaling theory, but rather is likely an emergent property with no single explanation. SMR at 1 kg body mass is similar to the literature for C. porosus and for alligators. The high exponent is not related to feeding, growth, or obesity of captive animals. The log-transformed data appear slightly curved, mainly because SMR is somewhat low in many of the largest animals (291-389 kg). A 3-parameter model is scarcely different from the linear one, but reveals a declining exponent between 0.862 and 0.798. A non-linear model on arithmetic axes overestimates SMR in 70% of the smallest animals and does not satisfactorily represent the data.

  9. The quenching time scale and quenching rate of galaxies

    CERN Document Server

    Lian, Jianhui; Zhang, Kai; Kong, Xu


    The average star formation rate (SFR) in galaxies has been declining since redshift of 2. A fraction of galaxies quench and become quiescent. We constrain two key properties of the quenching process: the quenching time scale and the quenching rate among galaxies. We achieve this by analyzing the galaxy number density profile in NUV-u color space and the distribution in NUV-u v.s. u-i color-color diagram with a simple toy-model framework. We focus on galaxies in three mass bins between 10 to 10 and 10 to 10.6 solar mass. In the NUV-u v.s. u-i color-color diagram, the red u-i galaxies exhibit a different slope from the slope traced by the star-forming galaxies. This angled distribution and the number density profile of galaxies in NUV-u space strongly suggest that the decline of the SFR in galaxies has to accelerate before they turn quiescent. We model this color-color distribution with a two-phase exponential decline star formation history. The models with an e-folding time in the second phase (the quenching p...

  10. Achievable Rates and Scaling Laws for Cognitive Radio Channels

    Directory of Open Access Journals (Sweden)

    Devroye Natasha


    Full Text Available Abstract Cognitive radios have the potential to vastly improve communication over wireless channels. We outline recent information theoretic results on the limits of primary and cognitive user communication in single and multiple cognitive user scenarios. We first examine the achievable rate and capacity regions of single user cognitive channels. Results indicate that at medium SNR (0–20 dB, the use of cognition improves rates significantly compared to the currently suggested spectral gap-filling methods of secondary spectrum access. We then study another information theoretic measure, the multiplexing gain. This measure captures the number of point-to-point Gaussian channels contained in a cognitive channel as the SNR tends to infinity. Next, we consider a cognitive network with a single primary user and multiple cognitive users. We show that with single-hop transmission, the sum capacity of the cognitive users scales linearly with the number of users. We further introduce and analyze the primary exclusive radius, inside of which primary receivers are guaranteed a desired outage performance. These results provide guidelines when designing a network with secondary spectrum users.

  11. Effectiveness of respiratory rates in determining clinical deterioration

    DEFF Research Database (Denmark)

    Mølgaard, Rikke Rishøj; Larsen, Palle; Håkonsen, Sasa Jul


    Review question/objective: The objective of this systematic review is to identify, appraise and synthesize the best available evidence on the effectiveness of manually measuring respiratory rates for 60 s or less in detecting clinical deterioration of inpatients. More specifically, the review...

  12. Preliminary compilation and reliability and validity test of clinical nurse’s job self rating scale fall prevention of inpatients%住院病人跌倒预防之临床护士工作自评量表的编制及信效度检验

    Institute of Scientific and Technical Information of China (English)

    呼亚丽; 康凤英; 薛宁宁; 张亚茹; 毛怡君


    Objective:To compile the clinical nurse’s job self rating scale fall prevention of inpatients and to test the reliability and validity of it.Methods:The initial scale was formed by literature review,group discussion and two rounds of expert consultation,the pre investigation and formal investigation were conducted to test the reliability and validity and the formal scale was formed.Results:The scale was consisted of 1 2 dimensions and 50 items in 5 domains.Exploratory factor analysis extracted 12 common factors,cumulative variance contri-bution rate was 70.15%,scale content validity was 0.979,content validity of each item was 0.813~1.000;con-firmatory factor analysis showed that the fitting degree of each indicator was better.The total Cronbach’s alpha coefficient of the scale was 0.950;split half reliability was 0.811;retest reliability was 0.922.Conclusion:The clinical nurse’s job self rating scale fall prevention of inpatients had good reliability and validity,and could be used as a quantitative evaluation tool for clinical nurses’fall prevention work.%[目的]编制住院病人跌倒预防之临床护士工作自评量表,并对其进行信效度检验。[方法]通过文献回顾、课题小组讨论和两轮专家咨询后形成初始量表,进行预调查和正式调查检验其信效度,形成正式量表。[结果]量表由5个领域、12个维度、50个条目组成。探索性因子分析提取12个公因子,其累计方差贡献率为70.15%。量表内容效度为0.979,各条目内容效度为0.813~1.000;验证性因子分析显示各指标拟合程度较好。量表总的 Cronbach’sα系数为0.950,分半信度为0.811,重测信度为0.922。[结论]住院病人跌倒预防之临床护士自评量表具有较好的信度和效度,可以作为临床护士跌倒预防工作实施情况的量化评价工具。

  13. Clinical pearls: factors affecting reported contraceptive efficacy rates in clinical studies. (United States)

    Burkman, Ronald T


    Current combination oral contraceptives (OCs) are among the most popular, safe, and effective methods of reversible contraception. There are, however, many factors that can affect contraceptive failure rates as reported in clinical trials, including subject characteristics, factors related to study methodology and data analysis, and publication biases. The variability of these factors among clinical trials makes meaningful comparisons of contraceptive efficacy data across studies difficult, if not misleading or erroneous. It is even more difficult to reconcile the differences between clinical trial efficacy rates and everyday use rates; for instance, the National Survey of Family Growth reported that the rate of OC failure is close to 8% in the United States, which is higher than rates reported in clinical trials. Thus, it is important for the clinician to consider the many factors that can influence reporting of contraceptive failure rates in clinical trials and be aware of the limitations in differentiating OCs on the basis of contraceptive efficacy derived from clinical trial data. Furthermore, clinical trial data may not accurately predict contraceptive efficacy in everyday use.

  14. Parkinson's disease-cognitive rating scale: psychometrics for mild cognitive impairment. (United States)

    Fernández de Bobadilla, Ramón; Pagonabarraga, Javier; Martínez-Horta, Saül; Pascual-Sedano, Berta; Campolongo, Antonia; Kulisevsky, Jaime


    Lack of validated data on cutoff scores for mild cognitive impairment (MCI) and sensitivity to change in predementia stages of Parkinson's disease (PD) limit the utility of instruments measuring global cognition as screening and outcome measures in therapeutic trials. Investigators who were blinded to PD-Cognitive Rating Scale (PD-CRS) scores classified a cohort of prospectively recruited, nondemented patients into a PD with normal cognition (PD-NC) group and a PD with MCI (PD-MCI) group using Clinical Dementia Rating (CDR) and the Mattis Dementia Rating Scale-2 (MDRS-2). The discriminative power of the PD-CRS for PD-MCI was examined in a representative sample of 234 patients (145 in the PD-NC group; 89 in the PD-MCI group) and in a control group of 98 healthy individuals. Sensitivity to change in the PD-CRS score (the minimal clinically important difference was examined with the Clinical Global Impression of Change scale and was calculated with a combination of distribution-based and anchor-based approaches) was explored in a 6-month observational multicenter trial involving a subset of 120 patients (PD-NC, 63; PD-MCI, 57). Regression analysis demonstrated that PD-CRS total scores (P < 0.001) and age (P = 0.01) independently differentiated PD-NC from PD-MCI. Area under the receiver operating characteristic curve (AUC) analysis (AUC, 0.85; 95% confidence interval, 0.80-0.90) indicated that a score ≤ 81 of 134 was the optimal cutoff point on the total score for the PD-CRS (sensitivity, 79%; specificity, 80%; positive predictive value, 59%; negative predictive value, 91%). A range of change from 10 to 13 points on the PD-CRS total score was indicative of clinically significant change. These findings suggest that the PD-CRS is a useful tool to identify PD-MCI and to track cognitive changes in nondemented patients with PD.

  15. Gait in children with cerebral palsy - Observer reliability of Physician Rating Scale and Edinburgh Visual Gait Analysis Interval Testing Scale

    NARCIS (Netherlands)

    Maathuis, KGB; van der Schans, CP; van Iperen, A; Rietman, HS; Geertzen, JHB


    The aim of this study was to test the inter- and intra-observer reliability of the Physician Rating Scale (PRS) and the Edinburgh Visual Gait Analysis Interval Testing (GAIT) scale for use in children with cerebral palsy (CP). Both assessment scales are quantitative observational scales, evaluating

  16. Gait in children with cerebral palsy : observer reliability of Physician Rating Scale and Edinburgh Visual Gait Analysis Interval Testing scale

    NARCIS (Netherlands)

    Maathuis, KGB; van der Schans, CP; van Iperen, A; Rietman, HS; Geertzen, JHB


    The aim of this study was to test the inter- and intra-observer reliability of the Physician Rating Scale (PRS) and the Edinburgh Visual Gait Analysis Interval Testing (GAIT) scale for use in children with cerebral palsy (CP). Both assessment scales are quantitative observational scales, evaluating

  17. Improving cervical cancer screening rates in an urban HIV clinic. (United States)

    Cross, Sara L; Suharwardy, Sanaa H; Bodavula, Phani; Schechtman, Kenneth; Overton, E Turner; Onen, Nur F; Lane, Michael A


    Human immunodeficiency virus (HIV)-infected women are at increased risk of invasive cervical cancer; however, screening rates remain low. The objectives of this study were to analyze a quality improvement intervention to increase cervical cancer screening rates in an urban academic HIV clinic and to identify factors associated with inadequate screening. Barriers to screening were identified by a multidisciplinary quality improvement committee at the Washington University Infectious Diseases clinic. Several strategies were developed to address these barriers. The years pre- and post-implementation were analyzed to examine the clinical impact of the intervention. A total of 422 women were seen in both the pre-implementation and post-implementation periods. In the pre-implementation period, 222 women (53%) underwent cervical cancer screening in the form of Papanicolaou (Pap) testing. In the post-implementation period, 318 women (75.3%) underwent cervical cancer screening (p screening included fewer visits attended (pre: 4.2 ± 1.5; post: 3.4 ± 1.4; p screening rates in an urban academic HIV clinic.

  18. [The initial testing and the discrimination property of the UFMG Sydenham's Chorea Rating Scale (USCRS)]. (United States)

    Teixeira, Antônio Lúcio; Maia, Débora Palma; Cardoso, Francisco


    Recently we developed and validated the Universidade Federal de Minas Gerais (UFMG) Sydenham's chorea Rating Scale (USCRS) to systematically assess SC patients. In this study, we assessed 97 children and adults with SC (mean age +/- SD, 15.5 +/- 5.9; male/female, 31/66) seen at the Movement Disorders Clinic at UFMG employing the USCRS. The patients were divided into 4 groups according to their clinical status: acute (n=19), recurrent (n=17), persistent (n=19) and remission (n=42). The mean +/- SEM USCRS scores for each group were: 47.7 +/- 4.7 for acute group, 29.5 +/- 2.6 for recurrent group, 17.6 +/- 3.1 for persistent group and 1.1 +/- 0.2 for remission group. All pair comparisons were statistically significant (p<0.05). Our results indicate that the USRSC can reasonably discriminate groups of SC patients in different clinical stages of the disease.

  19. Do pressure ulcer risk assessment scales improve clinical practice?

    Directory of Open Access Journals (Sweden)

    Jan Kottner


    Full Text Available Jan Kottner1, Katrin Balzer21Department of Nursing Science, Charité-Universitätsmedizin Berlin, Germany; 2Nursing Research Group, Institute for Social Medicine, Universitätsklinikum Schleswig-Holstein, Lübeck, GermanyAbstract: Standardized assessment instruments are deemed important for estimating pressure ulcer risk. Today, more than 40 so-called pressure ulcer risk assessment scales are available but still there is an ongoing debate about their usefulness. From a measurement point of view pressure ulcer (PU risk assessment scales have serious limitations. Empirical evidence supporting the validity of PU risk assessment scale scores is weak and obtained scores contain varying amounts of measurement error. The concept of pressure ulcer risk is strongly related to the general health status and severity of illness. A clinical impact due do the application of these scales could also not be demonstrated. It is questionable whether completion of standardized pressure ulcer risk scales in clinical practice is really needed.Keywords: Braden pressure ulcer, prevention, risk assessment, nursing assessment, predictive value, clinical effectiveness, review

  20. Cut points on 0-10 numeric rating scales for symptoms included in the edmonton symptom assessment scale in cancer patients: A systematic review

    NARCIS (Netherlands)

    W.H. Oldenmenger (Wendy); P.J. de Raaf (Pleun); C. de Klerk (Cora); C.C.D. van der Rijt (Carin)


    textabstractContext: To improve the management of cancer-related symptoms, systematic screening is necessary, often performed by using 0-10 numeric rating scales. Cut points are used to determine if scores represent clinically relevant burden. Objectives: The aim of this systematic review was to exp

  1. Monitoring progression in Friedreich ataxia (FRDA): the use of clinical scales. (United States)

    Bürk, Katrin; Schulz, Stefanie R; Schulz, Jörg B


    Friedreich ataxia (FRDA) is a progressive neurodegenerative disorder associated with ataxia, dysarthria, pyramidal tract signs, sensory loss, cardiomyopathy and diabetes. There is no cure for FRDA so far. Studies of the natural history of the disease and future therapeutic trials require development of appropriate outcome markers. Since any therapeutic benefit is expected to modulate deterioration over time rather than to reverse disability, potential outcome measures must be sensitive instruments carefully analysed for their significance. Clinical scales may represent an appropriate measuring tool. Over the last few years the construction, evaluation and validation of sensitive clinical scales for the assessment of disease severity and progression in ataxia have had considerable impact on our understanding of the disease. Currently, there are three different scales that are most frequently applied: The International Cooperative Ataxia Rating Scale (ICARS), the Friedreich Ataxia Rating Scale (FARS) and the Scale for the Assessment and Rating of Ataxia (SARA). All scales have been validated and compared with regard to their testing properties.

  2. Adaptation of abbreviated mathematics anxiety rating scale for engineering students (United States)

    Nordin, Sayed Kushairi Sayed; Samat, Khairul Fadzli; Sultan, Al Amin Mohamed; Halim, Bushra Abdul; Ismail, Siti Fatimah; Mafazi, Nurul Wirdah


    Mathematics is an essential and fundamental tool used by engineers to analyse and solve problems in their field. Due to this, most engineering education programs involve a concentration of study in mathematics courses whereby engineering students have to take mathematics courses such as numerical methods, differential equations and calculus in the first two years and continue to do so until the completion of the sequence. However, the students struggled and had difficulties in learning courses that require mathematical abilities. Hence, this study presents the factors that caused mathematics anxiety among engineering students using Abbreviated Mathematics Anxiety Rating Scale (AMARS) through 95 students of Universiti Teknikal Malaysia Melaka (UTeM). From 25 items in AMARS, principal component analysis (PCA) suggested that there are four mathematics anxiety factors, namely experiences of learning mathematics, cognitive skills, mathematics evaluation anxiety and students' perception on mathematics. Minitab 16 software was used to analyse the nonparametric statistics. Kruskal-Wallis Test indicated that there is a significant difference in the experience of learning mathematics and mathematics evaluation anxiety among races. The Chi-Square Test of Independence revealed that the experience of learning mathematics, cognitive skills and mathematics evaluation anxiety depend on the results of their SPM additional mathematics. Based on this study, it is recommended to address the anxiety problems among engineering students at the early stage of studying in the university. Thus, lecturers should play their part by ensuring a positive classroom environment which encourages students to study mathematics without fear.

  3. Low heart rate variability in patients with clinical burnout. (United States)

    Lennartsson, Anna-Karin; Jonsdottir, Ingibjörg; Sjörs, Anna


    Several studies have shown that acute psychosocial stress and chronic psychosocial stress reduce heart rate variability (HRV). It is likely that individuals suffering from burnout have reduced HRV, as a consequence of the long-term stress exposure. This study investigated HRV in 54 patients with clinical burnout (40 women and 14 men) and in 55 individuals reporting low burnout scores (healthy; 24 women and 31 men) and 52 individuals reporting high burnout scores (non-clinical burnout; 33 women and 19 men). The participants underwent a 300s ECG recording in the supine position. Standard deviation of normal R-R intervals (SDNN) and the root mean square of successive normal interval differences (RMSSD) were derived from time domain HRV analysis. Frequency domain HRV measures; total power (TP), low frequency power (LF), high frequency power (HF), and LF/HF ratio were calculated. All HRV measures, except LF/HF ratio, were lower in the clinical burnout patients compared to both the non-clinical burnout group and the healthy group. The difference was larger between the patients and the healthy group than between the patients and the non-clinical burnout group. HRV did not differ significantly between the non-clinical burnout group and the healthy group. Low HRV in burnout patients may constitute one of the links to associated adverse health, since low HRV reflects low parasympathetic activity - and accordingly low anabolic/regenerative activity.

  4. Clinical impact of evaluation of cardiovascular control by novel methods of heart rate dynamics. (United States)

    Huikuri, Heikki V; Perkiömäki, Juha S; Maestri, Roberto; Pinna, Gian Domenico


    Heart rate variability (HRV) has been conventionally analysed with time- and frequency-domain methods, which measure the overall magnitude of RR interval fluctuations around its mean value or the magnitude of fluctuations in some predetermined frequencies. Analysis of heart rate dynamics by novel methods, such as heart rate turbulence after ventricular premature beats, deceleration capacity of heart rate and methods based on chaos theory and nonlinear system theory, have gained recent interest. Recent observational studies have suggested that some indices describing nonlinear heart rate dynamics, such as fractal scaling exponents, heart rate turbulence and deceleration capacity, may provide useful prognostic information in various clinical settings and their reproducibility may be better than that of traditional indices. For example, the short-term fractal scaling exponent measured by the detrended fluctuation analysis method has been shown to predict fatal cardiovascular events in various populations. Similarly, heart rate turbulence and deceleration capacity have performed better than traditional HRV measures in predicting mortality in post-infarction patients. Approximate entropy, a nonlinear index of heart rate dynamics, which describes the complexity of RR interval behaviour, has provided information on the vulnerability to atrial fibrillation. There are many other nonlinear indices which also give information on the characteristics of heart rate dynamics, but their clinical usefulness is not as well established. Although the concepts of nonlinear dynamics, fractal mathematics and complexity measures of heart rate behaviour, heart rate turbulence, deceleration capacity in relation to cardiovascular physiology or various cardiovascular events are still far away from clinical medicine, they are a fruitful area for research to expand our knowledge concerning the behaviour of cardiovascular oscillations in normal healthy conditions as well as in disease states.

  5. Linear and Nonlinear Heart Rate Variability Indexes in Clinical Practice

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    Buccelletti Francesco


    Full Text Available Biological organisms have intrinsic control systems that act in response to internal and external stimuli maintaining homeostasis. Human heart rate is not regular and varies in time and such variability, also known as heart rate variability (HRV, is not random. HRV depends upon organism's physiologic and/or pathologic state. Physicians are always interested in predicting patient's risk of developing major and life-threatening complications. Understanding biological signals behavior helps to characterize patient's state and might represent a step toward a better care. The main advantage of signals such as HRV indexes is that it can be calculated in real time in noninvasive manner, while all current biomarkers used in clinical practice are discrete and imply blood sample analysis. In this paper HRV linear and nonlinear indexes are reviewed and data from real patients are provided to show how these indexes might be used in clinical practice.

  6. Assessment scales in stroke: clinimetric and clinical considerations

    Directory of Open Access Journals (Sweden)

    Harrison JK


    Full Text Available Jennifer K Harrison,1 Katherine S McArthur,2 Terence J Quinn21Department of Cardiovascular Sciences, University of Leicester, Leicester, UK; 2Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UKAbstract: As stroke care has developed, there has been a need to robustly assess the efficacy of interventions both at the level of the individual stroke survivor and in the context of clinical trials. To describe stroke-survivor recovery meaningfully, more sophisticated measures are required than simple dichotomous end points, such as mortality or stroke recurrence. As stroke is an exemplar disabling long-term condition, measures of function are well suited as outcome assessment. In this review, we will describe functional assessment scales in stroke, concentrating on three of the more commonly used tools: the National Institutes of Health Stroke Scale, the modified Rankin Scale, and the Barthel Index. We will discuss the strengths, limitations, and application of these scales and use the scales to highlight important properties that are relevant to all assessment tools. We will frame much of this discussion in the context of "clinimetric" analysis. As they are increasingly used to inform stroke-survivor assessments, we will also discuss some of the commonly used quality-of-life measures. A recurring theme when considering functional assessment is that no tool suits all situations. Clinicians and researchers should chose their assessment tool based on the question of interest and the evidence base around clinimetric properties.Keywords: Barthel Index, clinimetrics, clinical trial, disability, methodology, modified Rankin Scale, National Institutes Health Stroke Scale, scales, stroke, outcomes

  7. Item Response Theory Analyses of the Parent and Teacher Ratings of the DSM-IV ADHD Rating Scale (United States)

    Gomez, Rapson


    The graded response model (GRM), which is based on item response theory (IRT), was used to evaluate the psychometric properties of the inattention and hyperactivity/impulsivity symptoms in an ADHD rating scale. To accomplish this, parents and teachers completed the DSM-IV ADHD Rating Scale (DARS; Gomez et al., "Journal of Child Psychology and…

  8. The improved Clinical Global Impression Scale (iCGI: development and validation in depression

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    Kadouri Alane


    Full Text Available Abstract Background The Clinical Global Impression scale (CGI is frequently used in medical care and clinical research because of its face validity and practicability. This study proposes to improve the reliability of the Clinical Global Impression (CGI scale in depressive disorders by the use of a semi-standardized interview, a new response format, and a Delphi procedure. Methods Thirty patients hospitalised for a major depressive episode were filmed at T1 (first week in hospital and at T2 (2 weeks later during a 5' specific interview. The Hamilton Depressive Rating Scale and the Symptom Check List were also rated. Eleven psychiatrists rated these videos using either the usual CGI response format or an improved response format, with or without a Delphi procedure. Results The new response format slightly improved (but not significantly the interrater agreement, the Delphi procedure did not. The best results were obtained when ratings by 4 independent raters were averaged. In this situation, intraclass correlation coefficients were about 0.9. Conclusion The Clinical Global Impression is a useful approach in psychiatry since it apprehends patients in their entirety. This study shows that it is possible to quantify such impressions with a high level of interrater agreement.

  9. On the Validity of the Psychosocial Maturity Scales: Relationship to Teacher Ratings. Report No. 171. (United States)

    Josselson, Ruthellen; And Others

    This study attempts to provide evidence for the criterion validity of the Psychosocial Maturity (PSM) scales. Students' scores on the nine PSM scales were related to teachers' ratings of student PSM-related behavior. All scales except Trust significantly differentiated students rated high on PSM-related traits from students not rated high. Only…

  10. The Effect of Rubric Rating Scale on the Evaluation of Engineering Design Projects

    DEFF Research Database (Denmark)

    Thompson, Mary Kathryn; Clemmensen, Line Katrine Harder; Ahn, Beung-uk


    This paper explores the impact of the rubric rating scale on the evaluation of projects from a first year engineering design course.Asmall experiment was conducted in which twenty-one experienced graders scored five technical posters using one of four rating scales. All rating scales tested...

  11. A succinct rating scale for radiology report quality

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    Chengwu Yang


    Full Text Available Context: Poorly written radiology reports are common among residents and are a significant challenge for radiology education. While training may improve report quality, a professionally developed reliable and valid scale to measure report quality does not exist. Objectives: To develop a measurement tool for report quality, the quality of report scale, with rigorous validation through empirical data. Methods: A research team of an experienced psychometrician and six senior radiologists conducted qualitative and quantitative studies. Five items were identified for the quality of report scale, each measuring a distinct aspect of report quality. Two dedicated training sessions were designed and implemented to help residents generate high-quality reports. In a blinded fashion, the quality of report scale was applied to 804 randomly selected reports issued before (n = 403 and after (n = 401 training. Full-scale psychometrical assessments were implemented onto the quality of report scale’s item- and scale-scores from the reports. The quality of report scale scores were correlated with report professionalism and attendings’ preference and were compared pre-/post-training. Results: The quality of report scale showed sound psychometrical properties, with high validity and reliability. Reports with higher quality of report scale score were more professional and preferable by attendings. Training improved the quality of report scale score, empirically validating the quality of report scale further. Conclusion: While succinct and practitioner friendly, the quality of report scale is a reliable and valid measure of radiology report quality and has the potential to be easily adapted to other fields such as pathology, where similar training would be beneficial.

  12. Concurrent Validity of the Millon Clinical Multiaxial Inventory Depression Scales. (United States)

    Goldberg, Joel O.; And Others


    Compared two new measures of depression (Millon Multiaxial Inventory Dysthymia and Major Depression subscales) with two established instruments: Beck Depression Inventory, a self-report measure which emphasizes the cognitive-affective aspects of depression, and Hamilton Rating Scale for Depression, an interview measure that emphasizes somatic…

  13. A succinct rating scale for radiology report quality


    Chengwu Yang; Kasales, Claudia J; Tao Ouyang; Peterson, Christine M; Nabeel I Sarwani; Rafel Tappouni; Michael Bruno


    Context: Poorly written radiology reports are common among residents and are a significant challenge for radiology education. While training may improve report quality, a professionally developed reliable and valid scale to measure report quality does not exist. Objectives: To develop a measurement tool for report quality, the quality of report scale, with rigorous validation through empirical data. Methods: A research team of an experienced psychometrician and six senior radiologists conduct...

  14. The importance of rating scales in measuring patient-reported outcomes

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    Khadka Jyoti


    Full Text Available Abstract Background A critical component that influences the measurement properties of a patient-reported outcome (PRO instrument is the rating scale. Yet, there is a lack of general consensus regarding optimal rating scale format, including aspects of question structure, the number and the labels of response categories. This study aims to explore the characteristics of rating scales that function well and those that do not, and thereby develop guidelines for formulating rating scales. Methods Seventeen existing PROs designed to measure vision-related quality of life dimensions were mailed for self-administration, in sets of 10, to patients who were on a waiting list for cataract extraction. These PROs included questions with ratings of difficulty, frequency, severity, and global ratings. Using Rasch analysis, performance of rating scales were assessed by examining hierarchical ordering (indicating categories are distinct from each other and follow a logical transition from lower to higher value, evenness (indicating relative utilization of categories, and range (indicating coverage of the attribute by the rating scale. Results The rating scales with complicated question format, a large number of response categories, or unlabelled categories, tended to be dysfunctional. Rating scales with five or fewer response categories tended to be functional. Most of the rating scales measuring difficulty performed well. The rating scales measuring frequency and severity demonstrated hierarchical ordering but the categories lacked even utilization. Conclusion Developers of PRO instruments should use a simple question format, fewer (four to five and labelled response categories.

  15. Visual assessment of posterior atrophy development of a MRI rating scale

    Energy Technology Data Exchange (ETDEWEB)

    Koedam, Esther L.G.E.; Scheltens, Philip; Pijnenburg, Yolande A.L. [VU University Medical Centre, Department of Neurology and Alzheimer Centre, PO Box 7057, MB, Amsterdam (Netherlands); Lehmann, Manja; Fox, Nick [UCL Institute of Neurology, Dementia Research Centre, London (United Kingdom); Flier, Wiesje M. van der [VU University Medical Centre, Department of Neurology and Alzheimer Centre, PO Box 7057, MB, Amsterdam (Netherlands); VU University Medical Centre, Department Epidemiology and Biostatistics, PO Box 7057, MB, Amsterdam (Netherlands); Barkhof, Frederik; Wattjes, Mike P. [VU University Medical Centre, Department of Radiology, PO Box 7057, MB, Amsterdam (Netherlands)


    To develop a visual rating scale for posterior atrophy (PA) assessment and to analyse whether this scale aids in the discrimination between Alzheimer's disease (AD) and other dementias. Magnetic resonance imaging of 118 memory clinic patients were analysed for PA (range 0-3), medial temporal lobe atrophy (MTA) (range 0-4) and global cortical atrophy (range 0-3) by different raters. Weighted-kappas were calculated for inter- and intra-rater agreement. Relationships between PA and MTA with the MMSE and age were estimated with linear-regression analysis. Intra-rater agreement ranged between 0.93 and 0.95 and inter-rater agreement between 0.65 and 0.84. Mean PA scores were higher in AD compared to controls (1.6 {+-} 0.9 and 0.6 {+-} 0.7, p < 0.01), and other dementias (0.8 {+-} 0.8, p < 0.01). PA was not associated with age compared to MTA (B = 1.1 (0.8) versus B = 3.1 (0.7), p < 0.01). PA and MTA were independently negatively associated with the MMSE (B = -1.6 (0.5), p < 0.01 versus B = -1.4 (0.5), p < 0.01). This robust and reproducible scale for PA assessment conveys independent information in a clinical setting and may be useful in the discrimination of AD from other dementias. (orig.)

  16. The dutch social interaction anxiety scale and the social phobia scale: reliability, validity, and clinical utility. (United States)

    de Beurs, Edwin; Tielen, Deirdre; Wollmann, Lisa


    The social interaction anxiety scale (SIAS) and the social phobia scale (SPS) assess anxiety in social interactions and fear of scrutiny by others. This study examines the psychometric properties of the Dutch versions of the SIAS and SPS using data from a large group of patients with social phobia and a community-based sample. Confirmatory factor analysis revealed that the SIAS is unidimensional, whereas the SPS is comprised of three subscales. The internal consistency of the scales and subscales was good. The concurrent and discriminant validity was supported and the scales were well able to discriminate between patients and community-based respondents. Cut-off values with excellent sensitivity and specificity are presented. Of all self-report measures included, the SPS was the most sensitive for treatment effects. Normative data are provided which can be used to assess whether clinically significant change has occurred in individual patients.

  17. Validation of a Spanish Version of the Lille Apathy Rating Scale for Parkinson’s Disease

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    Rocio García-Ramos


    Full Text Available Introduction. To date, no rating scales for detecting apathy in Parkinson’s disease (PD patients have been validated in Spanish. For this reason, the aim of this study was to validate a Spanish version of Lille apathy rating scale (LARS in a cohort of PD patients from Spain. Participants and Methods. 130 PD patients and 70 healthy controls were recruited to participate in the study. Apathy was measured using the Spanish version of LARS and the neuropsychiatric inventory (NPI. Reliability (internal consistency, test-retest, and interrater reliability and validity (construct, content, and criterion validity were measured. Results. Interrater reliability was 0.93. Cronbach’s α for LARS was 0.81. The test-retest correlation coefficient was 0.97. The correlation between LARS and NPI scores was 0.61. The optimal cutoff point under the ROC curve was -14, whereas the value derived from healthy controls was -11. The prevalence of apathy in our population tested by LARS was 42%. Conclusions. The Spanish version of LARS is a reliable and useful tool for diagnosing apathy in PD patients. Total LARS score is influenced by the presence of depression and cognitive impairment. However, both disorders are independent identities with respect to apathy. The satisfactory reliability and validity of the scale make it an appropriate instrument for screening and diagnosing apathy in clinical practice or for research purposes.

  18. Pain relief scale is more highly correlated with numerical rating scale than with visual analogue scale in chronic pain patients. (United States)

    Lee, Jae Jin; Lee, Mi Kyoung; Kim, Jung Eun; Kim, Hee Zoo; Park, Sang Hoon; Tae, Jong Hyun; Choi, Sang Sik


    The pain relief scale (PRS) is a method that measures the magnitude of change in pain intensity after treatment. The present study aimed to evaluate the correlation between PRS and changes in pain determined by the visual analogue scale (VAS) and numerical rating scale (NRS), to confirm the evidence supporting the use of PRS. Sixty patients with chronic spinal pain that had a VAS and NRS recorded during an initial examination were enrolled in the study. One week later, the patients received an epidural nerve block, then VAS, NRS, and PRS assessments were performed. Differences between VAS and NRS were compared to the PRS and scatter plots and correlation coefficient were generated. The differences and magnitude of decrease in the VAS and NRS raw data were converted to percentile values, and compared to the PRS. Both VAS and NRS values exhibited strong correlations (> 0.8) with PRS. Further, the differences between the VAS-PRS R (0.859) and NRS-PRS R (0.915) were statistically significant, (P = 0.0259). Compared to PRS, the VAS and NRS percentile scores exhibited higher correlation coefficients than scores based on the raw data differences. Furthermore, even when converted to a percentile, the NRS%-PRS R (0.968) was higher than the VAS%-PRS R (0.904), P = 0.0001. The results indicated that using the PRS together with NRS in pain assessment increased the objectivity of the assessment compared to using only VAS or NRS, and may have offset the limitations of VAS or NRS alone.

  19. Botulinum neurotoxins for the treatment of focal dystonias: Review of rating tools used in clinical trials. (United States)

    Del Sorbo, Francesca; Albanese, Alberto


    Botulinum neurotoxins (BoNTs) are used to achieve therapeutic benefit in focal dystonia. An expert panel recently reviewed published evidence on the efficacy of BoNTs for the treatment of focal dystonias and produced recommendations for clinical practice. Another panel reviewed the clinimetric properties of rating scales for dystonia and produced recommendations for current usage and future directions. Considering that the strength of evidence derives not only from the quality of the study design, but also from usage of validated outcome measures, we combined the information provided by these two recent reviews and assessed the appropriateness of the rating instruments used in clinical trials on BoNT treatment in focal dystonia. Data sources included all the publications on BoNT treatment for focal dystonias reviewed by the recent evidence-based analysis. We reviewed all rating instruments used to assess primary and secondary outcome following BoNT treatment. The publications were allocated into five topics according to the focal dystonia type reviewed in the meta-analysis: blepharospasm, oromandibular dystonia, cervical dystonia, upper limb dystonia, and laryngeal dystonia. For each topic, papers were divided, according to the terminology used in the meta-analysis, into placebo-controlled, active comparator and methodological or uncontrolled. For each topic we identified the rating tools used in each study class and annotated which were the mostly used in each focal dystonia type. Outcome measures included tools related to motor and non-motor features, such as pain and depression, and functional as well as health-related quality of life features. Patient- and investigator-reported outcomes were also included. Rating instruments were classified as recommended, suggested, listed or not included, based on recommendations produced by the rating scale task force. Both primary and secondary outcome measures were assessed. As a final step we compared current practice, as

  20. Extract Multiple Scaling in Long-Term Heart Rate Variability (United States)


    interval record (r(s) (sec) vs. s (x10 3 beat)), (b) the power spectral density function of r(s) (in log-log scale). (c) histogram of Ar(t), t = 4 ( methods, such as the power spectral density function or DFA, may be obtained. It should be noted that the current methodology is not able to extract

  1. Maximizing measurement efficiency of behavior rating scales using Item Response Theory: An example with the Social Skills Improvement System - Teacher Rating Scale. (United States)

    Anthony, Christopher J; DiPerna, James C; Lei, Pui-Wa


    Measurement efficiency is an important consideration when developing behavior rating scales for use in research and practice. Although most published scales have been developed within a Classical Test Theory (CTT) framework, Item Response Theory (IRT) offers several advantages for developing scales that maximize measurement efficiency. The current study provides an example of using IRT to maximize rating scale efficiency with the Social Skills Improvement System - Teacher Rating Scale (SSIS - TRS), a measure of student social skills frequently used in practice and research. Based on IRT analyses, 27 items from the Social Skills subscales and 14 items from the Problem Behavior subscales of the SSIS - TRS were identified as maximally efficient. In addition to maintaining similar content coverage to the published version, these sets of maximally efficient items demonstrated similar psychometric properties to the published SSIS - TRS.

  2. Reliability and concurrent validity of visual analogue scale and modified verbal rating scale of pain assessment in adult patients with knee osteoathritis in Nigeria

    Directory of Open Access Journals (Sweden)

    M. O.B Olaogun


    Full Text Available The objective of this study was to determine the reliability and concurrent validity of two pain rating scales - Visual Analogue Scale (VAS and Verbal Rating Scale (VRS. The verbal rating scale was modified by translating the English description of subjective pain experience into vernacular (Yoruba equivalents and rating the knee pain when the patient was  standing with the knee  flexed . Twenty seven patients who were clinically and radiologically diagnosed with osteoarthritis (OA and with knee pain were purposively selected for the study. Two testers (physiotherapists independently rated the pain experienced by patients, when bearing full weight while standing on the affected leg with slight knee flexion, over a period of several days. For each patient pain was rated with the VAS and the modified VRS (MVRS. There were significant correlations between VAS and MVRS by the same tester (tester 1 and tester2 (r=0.92, p<0.01; r = 0.89,            p<0.01respectively, and between VAS and MVRS between tester 1 and tester 2 (r=0.91,p<0.01. There were no significant differences between VAS for tester 1 and VAS for tester 2, and between MVRS for tester 1and MVRS for tester 2 (p> 0.01.  According to this study, the two pain rating scales for knee OA are reliable. Our use of VAS and MVRS togetherwith the procedure involving the flexed knee posture is, therefore, recommended for wider clinical trials.

  3. The scale for the assessment and rating of ataxia correlates with dysarthria assessment in Friedreich's ataxia. (United States)

    Eigentler, Andreas; Rhomberg, Johanna; Nachbauer, Wolfgang; Ritzer, Irmgard; Poewe, Werner; Boesch, Sylvia


    Dysarthria is an acquired neurogenic sensorimotor speech symptom and an integral part within the clinical spectrum of ataxia syndromes. Ataxia measurements and disability scores generally focus on the assessment of motor functions. Since comprehensive investigations of dysarthria in ataxias are sparse, we assessed dysarthria in ataxia patients using the Frenchay Dysarthria Assessment. The Frenchay Dysarthria Assessment is a ten-item validated test in which eight items focus on the observation of oral structures and speech functions. Fifteen Friedreich's ataxia patients and 15 healthy control individuals were analyzed using clinical and logopedic methodology. All patients underwent neurological assessment applying the Scale for the Assessment and Rating of Ataxia. In Friedreich's ataxia patients, the Frenchay sub-item voice showed to be most affected compared to healthy individuals followed by items such as reflexes, palate, tongue, and intelligibility. Scoring of lips, jaw, and respiration appeared to be mildly affected. Ataxia severity in Friedreich's ataxia patients revealed a significant correlation with the Frenchay dysarthria sum score. The introduction of a binary Adapted Dysarthria Score additionally allowed allocation to distinct dysarthria pattern in ataxias. The Frenchay Dysarthria Assessment proved to be a valid dysarthria measure in Friedreich's ataxia. Its availability in several languages provides a major advantage regarding the applicability in international clinical studies. Shortcomings of the Frenchay test are the multiplicity of items tested and its alphabetic coding. Numerical scoring and condensation of assessments in a modified version may, however, provide an excellent clinical tool for the measurement and scoring of dysarthria in ataxic speech disorders.

  4. Excellent reliability of the Hamilton Depression Rating Scale (HDRS-21) in Indonesia after training

    NARCIS (Netherlands)

    Istriana, E.; Kurnia, A.; Weijers, A.; Hidayat, T.; Pinxten, W.J.L.; Jong, C.A.J. de; Schellekens, A.F.A.


    Introduction: The Hamilton Depression Rating Scale (HDRS) is the most widely used depression rating scale worldwide. Reliability of HDRS has been reported mainly from Western countries. The current study tested the reliability of HDRS ratings among psychiatric residents in Indonesia, before and afte

  5. The use of global rating scales for OSCEs in veterinary medicine. (United States)

    Read, Emma K; Bell, Catriona; Rhind, Susan; Hecker, Kent G


    OSCEs (Objective Structured Clinical Examinations) are widely used in health professions to assess clinical skills competence. Raters use standardized binary checklists (CL) or multi-dimensional global rating scales (GRS) to score candidates performing specific tasks. This study assessed the reliability of CL and GRS scores in the assessment of veterinary students, and is the first study to demonstrate the reliability of GRS within veterinary medical education. Twelve raters from two different schools (6 from University of Calgary [UCVM] and 6 from Royal (Dick) School of Veterinary Studies [R(D)SVS] were asked to score 12 students (6 from each school). All raters assessed all students (video recordings) during 4 OSCE stations (bovine haltering, gowning and gloving, equine bandaging and skin suturing). Raters scored students using a CL, followed by the GRS. Novice raters (6 R(D)SVS) were assessed independently of expert raters (6 UCVM). Generalizability theory (G theory), analysis of variance (ANOVA) and t-tests were used to determine the reliability of rater scores, assess any between school differences (by student, by rater), and determine if there were differences between CL and GRS scores. There was no significant difference in rater performance with use of the CL or the GRS. Scores from the CL were significantly higher than scores from the GRS. The reliability of checklist scores were .42 and .76 for novice and expert raters respectively. The reliability of the global rating scale scores were .7 and .86 for novice and expert raters respectively. A decision study (D-study) showed that once trained using CL, GRS could be utilized to reliably score clinical skills in veterinary medicine with both novice and experienced raters.

  6. The use of global rating scales for OSCEs in veterinary medicine.

    Directory of Open Access Journals (Sweden)

    Emma K Read

    Full Text Available OSCEs (Objective Structured Clinical Examinations are widely used in health professions to assess clinical skills competence. Raters use standardized binary checklists (CL or multi-dimensional global rating scales (GRS to score candidates performing specific tasks. This study assessed the reliability of CL and GRS scores in the assessment of veterinary students, and is the first study to demonstrate the reliability of GRS within veterinary medical education. Twelve raters from two different schools (6 from University of Calgary [UCVM] and 6 from Royal (Dick School of Veterinary Studies [R(DSVS] were asked to score 12 students (6 from each school. All raters assessed all students (video recordings during 4 OSCE stations (bovine haltering, gowning and gloving, equine bandaging and skin suturing. Raters scored students using a CL, followed by the GRS. Novice raters (6 R(DSVS were assessed independently of expert raters (6 UCVM. Generalizability theory (G theory, analysis of variance (ANOVA and t-tests were used to determine the reliability of rater scores, assess any between school differences (by student, by rater, and determine if there were differences between CL and GRS scores. There was no significant difference in rater performance with use of the CL or the GRS. Scores from the CL were significantly higher than scores from the GRS. The reliability of checklist scores were .42 and .76 for novice and expert raters respectively. The reliability of the global rating scale scores were .7 and .86 for novice and expert raters respectively. A decision study (D-study showed that once trained using CL, GRS could be utilized to reliably score clinical skills in veterinary medicine with both novice and experienced raters.

  7. Revised Hammersmith Scale for spinal muscular atrophy: A SMA specific clinical outcome assessment tool (United States)

    Scoto, Mariacristina; Mayhew, Anna; Main, Marion; Mazzone, Elena S.; Montes, Jacqueline; de Sanctis, Roberto; Dunaway Young, Sally; Salazar, Rachel; Glanzman, Allan M.; Pasternak, Amy; Quigley, Janet; Mirek, Elizabeth; Duong, Tina; Gee, Richard; Civitello, Matthew; Tennekoon, Gihan; Pane, Marika; Pera, Maria Carmela; Bushby, Kate; Day, John; Darras, Basil T.; De Vivo, Darryl; Finkel, Richard; Mercuri, Eugenio; Muntoni, Francesco


    Recent translational research developments in Spinal Muscular Atrophy (SMA), outcome measure design and demands from regulatory authorities require that clinical outcome assessments are ‘fit for purpose’. An international collaboration (SMA REACH UK, Italian SMA Network and PNCRN USA) undertook an iterative process to address discontinuity in the recorded performance of the Hammersmith Functional Motor Scale Expanded and developed a revised functional scale using Rasch analysis, traditional psychometric techniques and the application of clinical sensibility via expert panels. Specifically, we intended to develop a psychometrically and clinically robust functional clinician rated outcome measure to assess physical abilities in weak SMA type 2 through to strong ambulant SMA type 3 patients. The final scale, the Revised Hammersmith Scale (RHS) for SMA, consisting of 36 items and two timed tests, was piloted in 138 patients with type 2 and 3 SMA in an observational cross-sectional multi-centre study across the three national networks. Rasch analysis demonstrated very good fit of all 36 items to the construct of motor performance, good reliability with a high Person Separation Index PSI 0.98, logical and hierarchical scoring in 27/36 items and excellent targeting with minimal ceiling. The RHS differentiated between clinically different groups: SMA type, World Health Organisation (WHO) categories, ambulatory status, and SMA type combined with ambulatory status (all p < 0.001). Construct and concurrent validity was also confirmed with a strong significant positive correlation with the WHO motor milestones rs = 0.860, p < 0.001. We conclude that the RHS is a psychometrically sound and versatile clinical outcome assessment to test the broad range of physical abilities of patients with type 2 and 3 SMA. Further longitudinal testing of the scale with regards change in scores over 6 and 12 months are required prior to its adoption in clinical trials. PMID:28222119

  8. The Construction and Norm-Finding of a Rating Scale for Diagnosing Attention Deficit Hyperactivity Disorder in Children

    Directory of Open Access Journals (Sweden)

    Zahra Hooshyari


    Full Text Available Objective: Evaluation and diagnosis are determinants of treatment outcome; therefore, diagnostic tools should be accurate. The purpose of the present research is construction and norm-finding of a rating scale for the diagnosis of attention deficit hyperactivity disorder (ADHD. Method: A checklist based on behavioral symptoms of ADHD from clinical sources was constructed, based on interview with patients and the medical records. After being studied by specialists, this checklist was reduced to items and arranged in a rating scale format. The study population included Tehran's elementary school students (boys and girls from which a sample of 800 children was chosen in a random-cluster manner. Then teachers were asked to rate the students according to the scale characteristics. After two weeks, the subjects were tested and interviewed using a corrected form of the scale, the rating scale of Swanson, Nolan and Pelham (SNAP-IV and Diagnostic and Statistical Manual of Mental Disorders (DSM-IV. After data analysis the scale was reduced to 23 items. Results: According to the results of the analysis, the scale had two factors: The first factor was hyperactivity that explained 37.41%, and the second factor was attention deficit that explained 33.78% of the total variance . Cronbach's alpha was 0.96 and the alpha of the two subscales, hyperactivity and attention deficit, was 0.94 and 0.96, respectively. Spearman-Brown Coefficient was 0.78 and scale coefficient correlation with a similar from (SNAP-IV was 0.82. Criterion validity coefficient of the scale was 0.76 and the content validity of the scale was confirmed by the experts. According to sensitivity analysis of the trait, the cutoff point of the scale was 35. Considering the above findings, we can safely use the above scale in clinical studies. Conclusion: Considering the obtained values in the psychometric indexes and the consensus among specialists on the basis of test content validity and

  9. Scaling laws for the upper ocean temperature dissipation rate

    NARCIS (Netherlands)

    Bogucki, D.J.; Huguenard, K.; Haus, B.K.; Özgökmen, T.M.; Reniers, A.J.H.M.; Laxague, N.J.M.


    Our understanding of temperature dissipation rate χ within the upper ocean boundary layer, which is critical for climate forecasts, is very limited. Near-surface turbulence also affects dispersion of contaminants and biogeochemical tracers. Using high-resolution optical turbulence measurements, scal

  10. Effect of Heating Rates on the Formable Oxide Scale on a C-Steel Surface

    Institute of Scientific and Technical Information of China (English)



    Oxide scale formation on a C-steel surface has been investigated using linear heating rates ranging from 0.1℃/min to 10℃/min at high temperatures. The studies on the oxide scale formation at high temperature (650℃) at slower heating rate (0.1℃/min) shows that the kinetic regime is linear. X-ray diffraction measurements revealed that the scale constituents are significantly influenced by the heating rate. The adherence of the scale was improved by using slower heating rate (0.1℃/min-≤650℃),while above such degree the scale was susceptible to cracking and flaking out of the alloy surface. In fact, the development of oxide growth stresses can cause considerable scale cracking. As well, variation of the crystallite sizes under the aforementioned conditions might affect the scale stacking to the alloy surface. The secondary electron detector images of the oxide scale shows that the scale was imperfectly smooth and there were a number of voids and defects in the scale skin, especially at fast heating rate. This observation could be attributed to defects of the as-received alloy. In general, slower heating rate reduced the defects of the scale and improved its adherence.

  11. [Standardization of the Greek version of Zung's Self-rating Anxiety Scale (SAS)]. (United States)

    Samakouri, M; Bouhos, G; Kadoglou, M; Giantzelidou, A; Tsolaki, K; Livaditis, M


    Self-rating Anxiety Scale (SAS), introduced by Zung, has been widely used in research and in clinical practice for the detection of anxiety. The present study aims at standardizing the Greek version of SAS. SAS consists of 20 items rated on a 1-4 likert type scale. The total SAS score may vary from 20 (no anxiety at all) to 80 (severe anxiety). Two hundred and fifty four participants (114 male and 140 female), psychiatric patients, physically ill and general population individuals, aged 45.40±11.35 years, completed the following: (a) a demographic characteristics' questionnaire, (b) the SAS Greek version, (c) the Spielberg's Modified Greek State-Trait Anxiety Scale (STAI-Gr.-X) and (d) the Zung Depression Rating Scale (ZDRS). Seventy six participants answered the SAS twice within a 12th-day median period of time. The following parameters were calculated: (a) internal consistency of the SAS in terms of Cronbach's α co-efficient, (b) its test-retest reliability in terms of the Intraclass Correlation Coefficient (ICC) and (c) its concurrent and convergent validities through its score's Spearman's rho correlations with both the state and trait subscales of STAI-Gr X and the ZDRS. In addition, in order to evaluate SAS' discriminant validity, the scale's scores of the three groups of participants (psychiatric patients, physically ill and general population individuals) were compared among each other, in terms of Kruskall Wallis and Mann Whitney U tests. SAS Cronbach's alpha equals 0.897 while ICC regarding its test-retest reliability equals 0.913. Spearman's rho concerning validity: (a) when SAS is compared to STAI-Gr.-X (state), equals it 0.767, (b) when SAS is compared to STAI-Gr. X (trait), it equals 0.802 and (c) when SAS is compared to ZDRS, it equals 0.835. The mentally ill scored significantly higher in SAS compared to both the healthy and the general population. In conclusion, the SAS Greek version presents very satisfactory psychometric properties regarding

  12. Development and Validation of a Rating Scale for Wind Jazz Improvisation Performance (United States)

    Smith, Derek T.


    The purpose of this study was to construct and validate a rating scale for collegiate wind jazz improvisation performance. The 14-item Wind Jazz Improvisation Evaluation Scale (WJIES) was constructed and refined through a facet-rational approach to scale development. Five wind jazz students and one professional jazz educator were asked to record…

  13. Intervention Validity of Social Behavior Rating Scales: Features of Assessments that Link Results to Treatment Plans (United States)

    Elliott, Stephen N.; Gresham, Frank M.; Frank, Jennifer L.; Beddow, Peter A., III


    The term "intervention validity" refers to the extent to which assessment results can be used to guide the selection of interventions and evaluation of outcomes. In this article, the authors review the defining attributes of rating scales that distinguish them from other assessment tools, assumptions regarding the use of rating scales to measure…

  14. Emotional Indicators on the Bender-Gestalt and the Devereux Child Behavior Rating Scale (United States)

    Gregory Mary K.


    A heterogeneous group of elementary school children referred for psycho-educational diagnosis were rated on the Devereux Child Behavior Rating Scale and the Bender Visual-Motor Gestalt Test, scoring for Koppitz Emotional Indicators. Findings suggests that certain DCB factors may be more predictive of emotional problems than others in the scale.…

  15. Programs for the Construction and Analysis of Custom Questionnaires and Rating Scales (United States)

    Doyle, Kenneth O., Jr.; Wattawa, Scott


    Programs are described for the construction and analysis of student evaluation questionnaires and rating scales that are custom-designed for individual course instructors. Minor modifications would permit the use of these programs for other kinds of questionnaires and rating scales as well as for achievement tests. (Author)

  16. Quantum Quenches in Free Field Theory: Universal Scaling at Any Rate

    CERN Document Server

    Das, Sumit R; Myers, Robert C


    Quantum quenches display universal scaling in several regimes. For quenches which start from a gapped phase and cross a critical point, with a rate slow compared to the initial gap, many systems obey Kibble-Zurek scaling. More recently, a different scaling behaviour has been shown to occur when the quench rate is fast compared to all other physical scales, but still slow compared to the UV cutoff. We investigate the passage from fast to slow quenches in scalar and fermionic free field theories with time dependent masses for which the dynamics can be solved exactly for all quench rates. We find that renormalized one point functions smoothly cross over between the regimes.

  17. Construct and concurrent validation of OMNI-Kayak rating of Perceived Exertion Scale. (United States)

    Nakamura, Fábio Y; Perandini, Luiz A; Okuno, Nilo M; Borges, Thiago O; Bertuzzi, Rômulo C M; Robertson, Robert J


    This study tested the concurrent and construct validity of a newly developed OMNI-Kayak Scale, testing 8 male kayakers who performed a flatwater load-incremented "shuttle" test over a 500-m course and 3 estimation-production trials over a 1,000-m course. Velocity, blood lactate concentration, heart rate, and rating of perceived exertion (RPE), using the OMNI-Kayak RPE Scale and the Borg 6-20 Scale were recorded. OMNI-Kayak Scale RPE was highly correlated with velocity, the Borg 6-20 Scale RPE, blood lactate, and heart rate for both load-incremented test (rs = .87-.96), and estimation trials (rs = .75-.90). There were no significant differences among velocities, heart rate and blood lactate concentration between estimation and production trials. The OMNI-Kayak RPE Scale showed concurrent and construct validity in assessing perception of effort in flatwater kayaking and is a valid tool for self-regulation of exercise intensity.

  18. The Yale Pharyngeal Residue Severity Rating Scale: An Anatomically Defined and Image-Based Tool. (United States)

    Neubauer, Paul D; Rademaker, Alfred W; Leder, Steven B


    The Yale Pharyngeal Residue Severity Rating Scale was developed, standardized, and validated to provide reliable, anatomically defined, and image-based assessment of post-swallow pharyngeal residue severity as observed during fiberoptic endoscopic evaluation of swallowing (FEES). It is a five-point ordinal rating scale based on residue location (vallecula and pyriform sinus) and amount (none, trace, mild, moderate, and severe). Two expert judges reviewed a total of 261 FEES evaluations and selected a no residue exemplar and three exemplars each of trace, mild, moderate, and severe vallecula and pyriform sinus residue. Hard-copy color images of the no residue, 12 vallecula, and 12 pyriform sinus exemplars were randomized by residue location for hierarchical categorization by 20 raters with a mean of 8.3 years of experience (range 2-27 years) performing and interpreting FEES. Severity ratings for all images were performed by the same 20 raters, 2 weeks apart, and with the order of image presentations randomized. Intra-rater test-retest reliability, inter-rater reliability, and construct validity were determined by pooled multi-category multi-rater kappa statistics. Residue ratings were excellent for intra-rater reliability for vallecula (kappa = 0.957 ± 0.014) and pyriform sinus (kappa = 0.854 ± 0.021); very good to excellent for inter-rater reliability for vallecula (kappa = 0.868 ± 0.011) and pyriform sinus (kappa = 0.751 ± 0.011); and excellent for validity for vallecula (kappa = 0.951 ± 0.014) and pyriform sinus (kappa = 0.908 ± 0.017). Clinical uses include accurate classification of vallecula and pyriform sinus residue severity patterns as none, trace, mild, moderate, or severe for diagnostic purposes, determination of functional therapeutic change, and precise dissemination of shared information. Scientific uses include tracking outcome measures, demonstrating efficacy of interventions to reduce pharyngeal residue, investigating morbidity and mortality

  19. Optimizing the compatibility between rating scales and measures of productive second language competence. (United States)

    Weaver, Christopher


    This study presents a systematic investigation concerning the performance of different rating scales used in the English section of a university entrance examination to assess 1,287 Japanese test takers' ability to write a third-person introduction speech. Although the rating scales did not conform to all of the expectations of the Rasch model, they successfully defined a meaningful continuum of English communicative competence. In some cases, the expectations of the Rasch model needed to be weighed against the specific assessment needs of the university entrance examination. This investigation also found that the degree of compatibility between the number of points allotted to the different rating scales and the various requirements of an introduction speech played a considerable role in determining the extent to which the different rating scales conformed to the expectations of the Rasch model. Compatibility thus becomes an important factor to consider for optimal rating scale performance.


    Institute of Scientific and Technical Information of China (English)

    Yilong Bai; Mengfen Xia; Haiying Wang; Fujiu Ke


    Multi-scale modeling of materials properties and chemical processes has drawn great attention from science and engineering. For these multi-scale and rate-dependent processes, how to characterize their trans-scale formulation is a key point. Three questions should be addressed:● How do multi-sizes affect the problems?● How are length scales coupled with time scales?● How to identify emergence of new structure in process and its effect?For this sake, the macroscopic equations of mechanics and the kinetic equations of the microstructural transformations should form a unified set that be solved simultaneously.As a case study of coupling length and time scales, the trans-scale formulation of wave-induced damage evolution due to mesoscopic nucleation and growth is discussed. In this problem, the trans-scaling could be reduced to two independent dimensionless numbers: the imposed Deborah number De*=(ac*)/(LV*) and the intrinsic Deborah number D* = (nN*c*5)/V* , where a, L, c*, V* and nN* are wave speed, sample size, microcrack size, the rate of microcrack growth and the rate of microcrack nucleation density, respectively. Clearly, the dimensionless number De*=(ac*)/(LV*) includes length and time scales on both meso- and macro- levels and governs the progressive process.Whereas, the intrinsic Deborah number D* indicates the characteristic transition of microdamage to macroscopic rupture since D* is related to the criterion of damage localization, which is a precursor of macroscopic rupture. This case study may highlight the scaling in multi-scale and rate-dependent problems.Then, more generally, we compare some historical examples to see how trans-scale formulations were achieved and what are still open now. The comparison of various mechanisms governing the enhancement of meso-size effects reminds us of the importance of analyzing multi-scale and rate-dependent processes case by case.For multi-scale and rate-dependent processes with chemical reactions and

  1. Perspectives on clinical informatics: integrating large-scale clinical, genomic, and health information for clinical care. (United States)

    Choi, In Young; Kim, Tae-Min; Kim, Myung Shin; Mun, Seong K; Chung, Yeun-Jun


    The advances in electronic medical records (EMRs) and bioinformatics (BI) represent two significant trends in healthcare. The widespread adoption of EMR systems and the completion of the Human Genome Project developed the technologies for data acquisition, analysis, and visualization in two different domains. The massive amount of data from both clinical and biology domains is expected to provide personalized, preventive, and predictive healthcare services in the near future. The integrated use of EMR and BI data needs to consider four key informatics areas: data modeling, analytics, standardization, and privacy. Bioclinical data warehouses integrating heterogeneous patient-related clinical or omics data should be considered. The representative standardization effort by the Clinical Bioinformatics Ontology (CBO) aims to provide uniquely identified concepts to include molecular pathology terminologies. Since individual genome data are easily used to predict current and future health status, different safeguards to ensure confidentiality should be considered. In this paper, we focused on the informatics aspects of integrating the EMR community and BI community by identifying opportunities, challenges, and approaches to provide the best possible care service for our patients and the population.

  2. Measurement-based Treatment of Residual Symptoms Using Clinically Useful Depression Outcome Scale: Korean Validation Study (United States)

    Jeon, Sang Won; Han, Changsu; Ko, Young-Hoon; Yoon, Seo Young; Pae, Chi-Un; Choi, Joonho; Park, Yong Chon; Kim, Jong-Woo; Yoon, Ho-Kyoung; Ko, Seung-Duk; Patkar, Ashwin A.; Zimmerman, Mark


    Objective This study was aimed at evaluating the diagnostic validity of the Korean version of the Clinically Useful Depression Outcome Scale (CUDOS) with varying follow-up in a typical clinical setting in multiple centers. Methods In total, 891 psychiatric outpatients were enrolled at the time of their intake appointment. Current diagnostic characteristics were examined using the Structured Clinical Interview for DSM-IV (41% major depressive disorder). The CUDOS was measured and compared with three clinician rating scales and four self-report scales. Results The CUDOS showed excellent results for internal consistency (Cronbach’s α, 0.91), test-retest reliability (patients at intake, r=0.81; depressed patients in ongoing treatment, r=0.89), and convergent and discriminant validity (measures of depression, r=0.80; measures of anxiety and somatization, r=0.42). The CUDOS had a high ability to discriminate between different levels of depression severity based on the rating of Clinical Global Impression for depression severity and the diagnostic classification of major depression, minor depression, and non-depression. The ability of the CUDOS to identify patients with major depression was high (area under the receiver operating characteristic curve=0.867). A score of 20 as the optimal cutoff point was suggested when screening for major depression using the CUDOS (sensitivity=89.9%, specificity=69.5%). The CUDOS was sensitive to change after antidepressant treatment: patients with greater improvement showed a greater decrease in CUDOS scores (pKorean version of the CUDOS is a very useful measurement for research and for clinical practice. PMID:28138107

  3. Convergent Validity with the BERS-2 Teacher Rating Scale and the Achenbach Teacher's Report Form: A Replication and Extension (United States)

    Benner, Gregory J.; Beaudoin, Kathleen; Mooney, Paul; Uhing, Brad M.; Pierce, Corey D.


    In the present study, we sought to extend instrument validation research for a strength-based emotional and behavior rating scale, the "Teacher Rating Scale of the Behavior and Emotional Rating Scale-Second Edition" (BERS-2; Epstein, M. H. (2004). "Behavioral and emotional rating scale" (2nd ed.). Austin, TX: PRO-ED) through…

  4. Translation and validation into Brazilian Portuguese of the Spastic Paraplegia Rating Scale (SPRS

    Directory of Open Access Journals (Sweden)

    Katiane R. Servelhere


    Full Text Available ABSTRACT Hereditary spastic paraplegias (HSP are characterized by progressive lower limb weakness and spasticity. There are no validated instruments to quantify disease severity in Portuguese. Objective To translate and validate the Spastic Paraplegia Rating Scale (SPRS into Brazilian-Portuguese. Method Two experienced and English-fluent neurologists translated SPRS into Portuguese, creating SPRS-BR. We then assessed inter and intra-rater reliability of this version using coefficients of correlation and variability in a cohort of 30 patients. Results Mean age of patients and disease duration were 47.7 ± 10.5 and 17.0 ± 10.6 years, respectively. Twenty-one had pure HSP and SPG4 was the most frequent genotype. Mean Rankin and SPRS-BR scores were 2.2 ± 0.9 and 19.9 ± 9.9, respectively. Mean intra and inter-rater correlation coefficients of SPRS-BR scores were 0.951 and 0.934, whereas coefficients of variation were 11.5% (inter-rater and 9.9% (intra-rater. Cronbach’s alpha for the whole SPRS-BR scale was 0.873. Conclusion SPRS-BR is a useful, reliable and valid clinical instrument.

  5. The un-making of a method: From rating scales to the study of psychological processes

    DEFF Research Database (Denmark)

    Rosenbaum, Philip J.; Valsiner, Jaan


    Rating scales are standard instruments in psychology. They force the research participant to provide a numerical estimate of an assumed “degree” of some characteristic along a linear scale. We prove that such numerical estimates are artifacts based on unknown psychological processes that are used...... in the making of a rating. Psychology’s current use of rating scales entails reliance upon unexplored and abbreviated introspection. It superimposes upon the rater the use of real numbers for the subjective construction of the ratings. The axiomatic superimposition of the notion of “degree” of subjective...... estimates by the rating task overlooks the qualitative (structural) relation between the implied opposites. We propose the reconstruction of the rating tasks into a method that accesses the process of meaning construction by the rater. When the rater faces a rating task, a field of meanings is constructed...

  6. Calibration of unified Parkinson's disease rating scale scores to Movement Disorder Society-unified Parkinson's disease rating scale scores. (United States)

    Goetz, Christopher G; Stebbins, Glenn T; Tilley, Barbara C


    The aim of this study was to develop formulas to convert the UPDRS to Movement Disorder Society (MDS)-UPDRS scores. The MDS-UPDRS is a revision of the UPDRS with sound clinimetric properties. Reliable formulas to recalculate UPDRS scores into MDS-UPDRS equivalents are pivotal to the practical transition and definitive adoption of the MDS-UPDRS. UPDRS and MDS-UPDRS scores were collected on 875 PD patients. A developmental sample was used to regress UPDRS scores on corresponding MDS-UPDRS scores based on three H & Y groupings (I/II, III, and IV/V). Regression weighting factors and intercept terms provided formulas for UPDRS conversions to be tested in a validation sample. Concordance between the true MDS-UPDRS Part scores and those derived from the formulas was compared using Bland-Altman's plots and Lin's concordance coefficient (LCC). Significant concordance between UPDRS-estimated MDS-UPDRS scores was achieved for Parts II (Motor Experiences of Daily Living) (LCC = 0.93) and III (Motor Examination) (LCC = 0.97). The formulas resulted in mean differences between the true MDS-UPDRS and estimated MDS-UPDRS scores of less than 1 point for both Parts II and III. Concordance was not achieved for Parts I and IV (Non-motor Experiences of Daily Living and Complications of Therapy). Formulas allow archival UPDRS Parts II and III individual patient data to be accurately transferred to MDS-UPDRS scores. Because Part I collects data on much more extensive information than the UPDRS, and because Part IV is structured differently in the two versions, old ratings for these parts cannot be converted. © 2012 Movement Disorder Society.

  7. The influence of different rating scales on impression management in high stakes assessment

    Directory of Open Access Journals (Sweden)

    Lale Khorramdel


    Full Text Available The impact of different rating scales on intentional response distortion in personality questionnaires in high stakes assessment was investigated by administering the Personality Research Form (PRF; Stumpf, Angleitner, Wieck, Jackson, & Beloch-Till, 1984 to 268 applicants in real selection situations. The applicants responded with either a 6-point rating scale (n = 184 or a 2-point rating scale (n = 84. It was hypothesised that a 6-point rating scale leads to less intentional response distortion than a 2-point rating scale, as it might be more difficult to adjust responses to a faking good schema. Both applicant groups were additionally compared to a volunteer sample (n = 184 randomly selected from the PRF norm sample. Results provide evidence of faking tendencies in the applicant samples and show an advantage of the 6-point rating scale (less faking tendencies. Moreover, it is assumed that the type of response format might interact with item content and wording. Nevertheless, even the applicant group with the 6-point rating scale seems to have faked responses compared to a volunteer sample.

  8. A Comparison of Pain Assessment Measures in Pediatric Sickle Cell Disease: Visual Analog Scale Versus Numeric Rating Scale. (United States)

    Myrvik, Matthew P; Drendel, Amy L; Brandow, Amanda M; Yan, Ke; Hoffmann, Raymond G; Panepinto, Julie A


    Given the availability of various pain severity scales, greater understanding of the agreement between pain scales is warranted. We compared Visual Analog Scale (VAS) and Numeric Rating Scale (NRS) pain severity ratings in children with sickle cell disease (SCD) to identify the relationship and agreement between pain scale ratings. Twenty-eight patients (mean ± SD age, 14.65 ± 3.12 y, 50% female) receiving pain interventions within the emergency department completed serial VAS and NRS pain severity ratings every 30 minutes. Data were used to calculate the relationship (Spearman correlation) and agreement (Bland-Altman approach) between the VAS and NRS. One hundred twenty-eight paired VAS-NRS measurements were obtained. VAS and NRS ratings were significantly correlated for the initial assessment (rs = 0.88, P < 0.001) and all assessments (rs = 0.87, P < 0.001). Differences between VAS and NRS means were -0.52 (P = 0.006) for the initial assessment and -0.86 (P < 0.001) across all assessments. The difference between VAS and NRS ratings decreased as pain severity increased across all assessments (P = 0.027), but not the initial assessment. Within pediatric patients with SCD, VAS and NRS ratings were found to trend together; however, VAS scores were found to be significantly lower than NRS scores across assessments. The agreement between the 2 measures improved at increasing levels of pain severity. These findings demonstrate that the VAS and NRS are similar, but cannot be used interchangeably when assessing self-reported pain in SCD.

  9. The Columbia-Suicide Severity Rating Scale (C–SSRS): Has the “Gold Standard” Become a Liability? (United States)

    Giddens, Jennifer M.; Sheehan, David V.


    Objective: The Columbia– Suicide Severity Rating Scale has become the gold standard for the assessment of suicidal ideation and behavior in clinical trials. Criticism of the instrument has been mounting. We examine whether the instrument meets widely accepted psychometric standards and maps to the United States Food and Drug Administration’s most recent 2012 algorithm for assessment of suicidal phenomena. Our goal is to determine if the Columbia–Suicide Severity Rating Scale should be retained as the preferred instrument for assessment of suicidal ideation and behavior. Method: Standard psychometric criteria dictate that categorizations to avoid type I and type II errors should be comprehensive and address the full spectrum (i.e., all dimensions) of a phenomenon. The criteria should also be well defined and consistent, and the wording throughout should be unambiguous. We examine the Columbia–Suicide Severity Rating Scale in terms of these criteria. Results: The Columbia–Suicide Severity Rating Scale does not address the full spectrum of suicidal ideation or behavior. As a result, it has the potential to miss many combinations of suicidal ideation and behavior that present to clinicians in practice (type II error). Potential misclassifications (type I and II errors) are compounded by flawed navigation instructions; mismatches in category titles, definitions, and probes; and wording that is susceptible to multiple interpretations. Further, the Columbia–Suicide Severity Rating Scale in its current form does not map to the 2012 Food and Drug Administration’s draft classification algorithm for suicidal ideation and behavior. Conclusion: The evidence suggests that the Columbia–Suicide Severity Rating Scale is conceptually and psychometrically flawed and does not map to the Food and Drug Administration’s new standards. A new gold standard for assessment of suicidality may be warranted. PMID:25520890

  10. A novel clinical grading scale to guide the management of crusted scabies.

    Directory of Open Access Journals (Sweden)

    Joshua S Davis

    Full Text Available BACKGROUND: Crusted scabies, or hyperinfestation with Sarcoptes scabiei, occurs in people with an inadequate immune response to the mite. In recent decades, data have emerged suggesting that treatment of crusted scabies with oral ivermectin combined with topical agents leads to lower mortality, but there are no generally accepted tools for describing disease severity. Here, we describe a clinical grading scale for crusted scabies and its utility in real world practice. METHODOLOGY/PRINCIPAL FINDINGS: In 2002, Royal Darwin Hospital (RDH, a hospital in tropical Australia developed and began using a clinical grading scale to guide the treatment of crusted scabies. We conducted a retrospective observational study including all episodes of admission to RDH for crusted scabies during the period October 2002-December 2010 inclusive. Patients who were managed according to the grading scale were compared with those in whom the scale was not used at the time of admission but was calculated retrospectively. There were 49 admissions in 30 patients during the study period, of which 49 (100% were in Indigenous Australians, 29 (59% were male and the median age was 44.1 years. According to the grading scale, 8 (16% episodes were mild, 24 (49% were moderate, and 17 (35% were severe. Readmission within the study period was significantly more likely with increasing disease severity, with an odds ratio (95% CI of 12.8 (1.3-130 for severe disease compared with mild. The patients managed according to the grading scale (29 episodes did not differ from those who were not (20 episodes, but they received fewer doses of ivermectin and had a shorter length of stay (11 vs. 16 days, p = 0.02. Despite this the outcomes were no different, with no deaths in either group and a similar readmission rate. CONCLUSIONS/SIGNIFICANCE: Our grading scale is a useful tool for the assessment and management of crusted scabies.

  11. Concurrent Criterion Validity of the Ausburg Multidimensional Personality Instrument (AMPI) Clinical Scales among College Students (United States)

    Kelly, William E.; Lutz, Daniel


    The concurrent criterion validity of the Ausburg Multidimensional Personality Instrument (AMPI) clinical scales was examined. The AMPI and several scales purportedly measuring the same or similar constructs as those of the AMPI clinical scales were administered to two samples of college students (N = 134 and N = 118). The correlations between the…

  12. Description, evaluation and clinical decision making according to various fetal heart rate patterns. Inter-observer and regional variability

    DEFF Research Database (Denmark)


    At 10 Danish obstetrical departments, 116 residents (42 senior and 74 junior) participated in a study to assess inter-observer and regional variability in the description and evaluation of and clinical decision regarding 11 fetal heart rate patterns. The 11 traces included normal as well...... and the presence of silent or sinusoidal pattern (87-94% on an arbitrary 0-100% scale), and low regarding the assessment of variability and type of deceleration (50-72%). The degree of agreement in interpreting heart rate patterns was 59% (on an arbitrary 0-100% scale). Senior residents generally interpreted...

  13. Translation, cross-cultural adaptation and applicability of the Brazilian version of the Frontotemporal Dementia Rating Scale (FTD-FRS

    Directory of Open Access Journals (Sweden)

    Thais Bento Lima-Silva

    Full Text Available ABSTRACT Background: Staging scales for dementia have been devised for grading Alzheimer's disease (AD but do not include the specific symptoms of frontotemporal lobar degeneration (FTLD. Objective: To translate and adapt the Frontotemporal Dementia Rating Scale (FTD-FRS to Brazilian Portuguese. Methods: The cross-cultural adaptation process consisted of the following steps: translation, back-translation (prepared by independent translators, discussion with specialists, and development of a final version after minor adjustments. A pilot application was carried out with 12 patients diagnosed with bvFTD and 11 with AD, matched for disease severity (CDR=1.0. The evaluation protocol included: Addenbrooke's Cognitive Examination-Revised (ACE-R, Mini-Mental State Examination (MMSE, Executive Interview (EXIT-25, Neuropsychiatric Inventory (NPI, Frontotemporal Dementia Rating Scale (FTD-FRS and Clinical Dementia Rating scale (CDR. Results: The Brazilian version of the FTD-FRS seemed appropriate for use in this country. Preliminary results revealed greater levels of disability in bvFTD than in AD patients (bvFTD: 25% mild, 50% moderate and 25% severe; AD: 36.36% mild, 63.64% moderate. It appears that the CDR underrates disease severity in bvFTD since a relevant proportion of patients rated as having mild dementia (CDR=1.0 in fact had moderate or severe levels of disability according to the FTD-FRS. Conclusion: The Brazilian version of the FTD-FRS seems suitable to aid staging and determining disease progression.

  14. Response rate of catatonia to electroconvulsive therapy and its clinical correlates. (United States)

    Raveendranathan, Dhanya; Narayanaswamy, Janardhanan C; Reddi, Senthil V


    Electroconvulsive therapy (ECT) is an important treatment for catatonia. We aimed to study the response rate of catatonia treated with ECT and its clinical correlates in a large sample of inpatients. The ECT parameters of all patients (n = 63) admitted with catatonia between the months of January and December 2007 were examined. The number of ECTs administered, seizure threshold, failure to achieve adequate seizures and clinical signs pertaining to catatonia were analyzed. Response was considered as complete resolution of catatonic symptoms with Bush Francis Catatonia Rating Scale (BFCRS) score becoming zero. ECT was mostly started after failed lorazepam treatment except in 6 patients where ECT was the first choice. Patients who responded in 4 ECT sessions were considered fast responders (mean session number for response is 4 sessions) and response with 5 or more ECTs was considered slow response. Fast responders had significantly lower duration of catatonia (19.67 ± 21.66 days, P = 0.02) and higher BFCRS score at presentation (17.25 ± 6.21, P = 0.03). Presence of waxy flexibility and gegenhalten (22.60% vs. 0%, P = 0.01) predicted faster response, whereas presence of echophenomena (3.2% vs. 24.0%) predicted slow response. The response rate to catatonia appears to be associated with the severity and duration of catatonia, and the presence of certain catatonic signs.

  15. Verification of energy dissipation rate scalability in pilot and production scale bioreactors using computational fluid dynamics. (United States)

    Johnson, Chris; Natarajan, Venkatesh; Antoniou, Chris


    Suspension mammalian cell cultures in aerated stirred tank bioreactors are widely used in the production of monoclonal antibodies. Given that production scale cell culture operations are typically performed in very large bioreactors (≥ 10,000 L), bioreactor scale-down and scale-up become crucial in the development of robust cell-culture processes. For successful scale-up and scale-down of cell culture operations, it is important to understand the scale-dependence of the distribution of the energy dissipation rates in a bioreactor. Computational fluid dynamics (CFD) simulations can provide an additional layer of depth to bioreactor scalability analysis. In this communication, we use CFD analyses of five bioreactor configurations to evaluate energy dissipation rates and Kolmogorov length scale distributions at various scales. The results show that hydrodynamic scalability is achievable as long as major design features (# of baffles, impellers) remain consistent across the scales. Finally, in all configurations, the mean Kolmogorov length scale is substantially higher than the average cell size, indicating that catastrophic cell damage due to mechanical agitation is highly unlikely at all scales.

  16. The Development of a Behavior Patterns Rating Scale for Preservice Teachers (United States)

    Caliskan, Nihat; Kuzu, Okan; Kuzu, Yasemin


    The purpose of this study was to develop a rating scale that can be used to evaluate behavior patterns of the organization people pattern of preservice teachers (PSTs). By reviewing the related literature on people patterns, a preliminary scale of 38 items with a five-points Likert type was prepared. The number of items was reduced to 29 after…

  17. Discrete Scale Invariance in the Cascade Heart Rate Variability Of Healthy Humans

    CERN Document Server

    Lin, D C


    Evidence of discrete scale invariance (DSI) in daytime healthy heart rate variability (HRV) is presented based on the log-periodic power law scaling of the heart beat interval increment. Our analysis suggests multiple DSI groups and a dynamic cascading process. A cascade model is presented to simulate such a property.

  18. RBANS embedded measures of suboptimal effort in dementia: effort scale has a lower failure rate than the effort index. (United States)

    Burton, Rachel L; Enright, Joe; O'Connell, Megan E; Lanting, Shawnda; Morgan, Debra


    The importance of evaluating effort in neuropsychological assessments has been widely acknowledged, but measuring effort in the context of dementia remains challenging due to the impact of dementia severity on effort measure scores. Two embedded measures have been developed for the repeatable battery for the assessment of neuropsychological status (RBANS; Randolph, C., Tierney, M. C., Mohr, E., & Chase, T. N. (1998). The repeatable battery for the assessment of neuropsychological status (RBANS): Preliminary clinical validity. Journal of Clinical and Experimental Neuropsychology, 20 (3), 310-319): the Effort Index (EI; Silverberg, N. D., Wertheimer, J. C., & Fichtenberg, N. L. (2007). An effort index for the repeatable battery for the assessment of neuropsychological status (RBANS). Clinical Neuropsychologist, 21 (5), 841-854) and the Effort Scale (ES; Novitski, J., Steele, S., Karantzoulis, S., & Randolph, C. (2012). The repeatable battery for the assessment of neuropsychological status effort scale. Archives of Clinical Neuropsychology, 27 (2), 190-195). We explored failure rates on these effort measures in a non-litigating mixed dementia sample (N = 145). Failure rate on the EI was high (48%) and associated with dementia severity. In contrast, failure on the ES was 14% but differed based on type of dementia. ES failure was low (4%) when dementia was due to Alzheimer disease (AD), but high (31%) for non-AD dementias. These data raise concerns about use of the RBANS embedded effort measures in dementia evaluations.

  19. Validity, reliability, and feasibility of clinical staging scales in dementia: a systematic review

    DEFF Research Database (Denmark)

    Rikkert, Marcel G M Olde; Tona, Klodiana Daphne; Janssen, Lieneke;


    New staging systems of dementia require adaptation of disease management programs and adequate staging instruments. Therefore, we systematically reviewed the literature on validity and reliability of clinically applicable, multidomain, and dementia staging instruments. A total of 23 articles desc......, and is available in 14 languages. Taking into account the increasing differentiation of Alzheimer's disease in preclinical and predementia stages, there is an urgent need for global rating scales to be refined as well.......New staging systems of dementia require adaptation of disease management programs and adequate staging instruments. Therefore, we systematically reviewed the literature on validity and reliability of clinically applicable, multidomain, and dementia staging instruments. A total of 23 articles...... describing 12 staging instruments were identified (N = 6109 participants, age 65-87). Reliability was studied in most (91%) of the articles and was judged moderate to good. Approximately 78% of the articles evaluated concurrent validity, which was good to very good, while discriminant validity was assessed...

  20. Translation of the Manchester Clinical Supervision Scale (MCSS) into Danish and a preliminary psychometric validation

    DEFF Research Database (Denmark)

    Buus, Niels; Gonge, Henrik


    A central challenge for empirical research of clinical supervision is how to measure the effectiveness of clinical supervision. The Manchester Clinical Supervision Scale (MCSS) measures supervisees' perception of the effectiveness of clinical supervision. The aims of this paper were to account fo...

  1. Psychometric Properties of the Working Memory Rating Scale for Spanish-Speaking English Language Learners (United States)

    Guzman-Orth, Danielle; Grimm, Ryan; Gerber, Michael; Orosco, Michael; Swanson, H. Lee; Lussier, Cathy


    The Working Memory Rating Scale (WMRS) was designed as a behavioral rating tool to assist teachers in identifying students at risk of working memory difficulties. The instrument was originally normed on 417 monolingual English-speaking children from the United Kingdom. The purpose of this study was to test the reliability and validity of the WMRS…

  2. Evaluation of the Bess TRS-CA Using the Rasch Rating Scale Model (United States)

    DiStefano, Christine; Morgan, Grant B.


    This study examined the Behavioral and Emotional Screening System Teacher Rating System for Children and Adolescents (BESS TRS-CA; Kamphaus & Reynolds, 2007) screener using Rasch Rating Scale model (RSM) methodology to provide additional information about psychometric properties of items. Data from the Behavioral Assessment System for Children…

  3. The Treatment Engagement Rating scale (TER) for forensic outpatient treatment : Description, psychometric properties, and norms

    NARCIS (Netherlands)

    Drieschner, Klaus Heinrich; Boomsma, Anne


    The Treatment Engagement Rating scale (TER) is a Dutch therapist rating instrument for treatment engagement (TE) of forensic outpatients. It yields scores for nine components of TE, which are aggregated in a total score. Following an analysis of the concept of TE, the TER is described, and various p

  4. The Scaling of Maximum and Basal Metabolic Rates of Mammals and Birds

    CERN Document Server

    Barbosa, L A; Silva, J K L; Barbosa, Lauro A.; Garcia, Guilherme J. M.; Silva, Jafferson K. L. da


    Allometric scaling is one of the most pervasive laws in biology. Its origin, however, is still a matter of dispute. Recent studies have established that maximum metabolic rate scales with an exponent larger than that found for basal metabolism. This unpredicted result sets a challenge that can decide which of the concurrent hypotheses is the correct theory. Here we show that both scaling laws can be deduced from a single network model. Besides the 3/4-law for basal metabolism, the model predicts that maximum metabolic rate scales as $M^{6/7}$, maximum heart rate as $M^{-1/7}$, and muscular capillary density as $M^{-1/7}$, in agreement with data.

  5. Large-scale dynamo growth rates from numerical simulations and implications for mean-field theories. (United States)

    Park, Kiwan; Blackman, Eric G; Subramanian, Kandaswamy


    Understanding large-scale magnetic field growth in turbulent plasmas in the magnetohydrodynamic limit is a goal of magnetic dynamo theory. In particular, assessing how well large-scale helical field growth and saturation in simulations match those predicted by existing theories is important for progress. Using numerical simulations of isotropically forced turbulence without large-scale shear with its implications, we focus on several additional aspects of this comparison: (1) Leading mean-field dynamo theories which break the field into large and small scales predict that large-scale helical field growth rates are determined by the difference between kinetic helicity and current helicity with no dependence on the nonhelical energy in small-scale magnetic fields. Our simulations show that the growth rate of the large-scale field from fully helical forcing is indeed unaffected by the presence or absence of small-scale magnetic fields amplified in a precursor nonhelical dynamo. However, because the precursor nonhelical dynamo in our simulations produced fields that were strongly subequipartition with respect to the kinetic energy, we cannot yet rule out the potential influence of stronger nonhelical small-scale fields. (2) We have identified two features in our simulations which cannot be explained by the most minimalist versions of two-scale mean-field theory: (i) fully helical small-scale forcing produces significant nonhelical large-scale magnetic energy and (ii) the saturation of the large-scale field growth is time delayed with respect to what minimalist theory predicts. We comment on desirable generalizations to the theory in this context and future desired work.

  6. Landscape scale measures of steelhead (Oncorhynchus mykiss) bioenergetic growth rate potential in Lake Michigan and comparison with angler catch rates (United States)

    Hook, T.O.; Rutherford, E.S.; Brines, Shannon J.; Geddes, C.A.; Mason, D.M.; Schwab, D.J.; Fleischer, G.W.


    The relative quality of a habitat can influence fish consumption, growth, mortality, and production. In order to quantify habitat quality, several authors have combined bioenergetic and foraging models to generate spatially explicit estimates of fish growth rate potential (GRP). However, the capacity of GRP to reflect the spatial distributions of fishes over large areas has not been fully evaluated. We generated landscape scale estimates of steelhead (Oncorhynchus mykiss) GRP throughout Lake Michigan for 1994-1996, and used these estimates to test the hypotheses that GRP is a good predictor of spatial patterns of steelhead catch rates. We used surface temperatures (measured with AVHRR satellite imagery) and acoustically measured steelhead prey densities (alewife, Alosa pseudoharengus) as inputs for the GRP model. Our analyses demonstrate that potential steelhead growth rates in Lake Michigan are highly variable in both space and time. Steelhead GRP tended to increase with latitude, and mean GRP was much higher during September 1995, compared to 1994 and 1996. In addition, our study suggests that landscape scale measures of GRP are not good predictors of steelhead catch rates throughout Lake Michigan, but may provide an index of interannual variation in system-wide habitat quality.

  7. A new respiratory rate monitor: development and initial clinical experience

    DEFF Research Database (Denmark)

    Hök, B; Wiklund, L; Henneberg, S


    different kinds of interference, including motion artefacts. The sensor is nonexpensive, rugged, simple to apply and inherently safe. An instrument with continuous display of respiratory rate, and an audiovisual apnea alarm has been designed and built. The complete system has been tested on patients during......The need for continuous, noninvasive, and reliable respiratory rate monitoring during recovery from general anesthesia has long been recognized. Alternative principles can be grouped into those detecting the respiratory effort, and those detecting the actual result, i.e. the respiratory gas flow...... recovery after general anesthesia. In 16 patients, the respiratory rate displayed by the instrument has been correlated against that visually observed. A good correlation was obtained. Minor discrepancies can be explained from the fact that visual observation corresponds to the respiratory effort, whereas...

  8. Symbolic dynamics marker of heart rate variability combined with clinical variables enhance obstructive sleep apnea screening (United States)

    Ravelo-García, A. G.; Saavedra-Santana, P.; Juliá-Serdá, G.; Navarro-Mesa, J. L.; Navarro-Esteva, J.; Álvarez-López, X.; Gapelyuk, A.; Penzel, T.; Wessel, N.


    Many sleep centres try to perform a reduced portable test in order to decrease the number of overnight polysomnographies that are expensive, time-consuming, and disturbing. With some limitations, heart rate variability (HRV) has been useful in this task. The aim of this investigation was to evaluate if inclusion of symbolic dynamics variables to a logistic regression model integrating clinical and physical variables, can improve the detection of subjects for further polysomnographies. To our knowledge, this is the first contribution that innovates in that strategy. A group of 133 patients has been referred to the sleep center for suspected sleep apnea. Clinical assessment of the patients consisted of a sleep related questionnaire and a physical examination. The clinical variables related to apnea and selected in the statistical model were age (p neck circumference (p < 10-3), score on a questionnaire scale intended to quantify daytime sleepiness (p < 10-3), and intensity of snoring (p < 10-3). The validation of this model demonstrated an increase in classification performance when a variable based on non-linear dynamics of HRV (p < 0.01) was used additionally to the other variables. For diagnostic rule based only on clinical and physical variables, the corresponding area under the receiver operating characteristic (ROC) curve was 0.907 (95% confidence interval (CI) = 0.848, 0.967), (sensitivity 87.10% and specificity 80%). For the model including the average of a symbolic dynamic variable, the area under the ROC curve was increased to 0.941 (95% = 0.897, 0.985), (sensitivity 88.71% and specificity 82.86%). In conclusion, symbolic dynamics, coupled with significant clinical and physical variables can help to prioritize polysomnographies in patients with a high probability of apnea. In addition, the processing of the HRV is a well established low cost and robust technique.

  9. Unidimensional pain rating scales: a multidimensional affect and pain survey (MAPS) analysis of what they really measure. (United States)

    Clark, W Crawford; Yang, Joseph C; Tsui, Siu Lun; Ng, Kwok-Fu; Bennett Clark, Susanne


    Pain is now regarded as 'the fifth vital sign' and patients are frequently asked to score the intensity of their pain on a numerical pain rating scale (NPRS). However, the use of a unidimensional scale is questionable in view of the belief, overwhelmingly supported by clinical experience as well as by empirical evidence from multidimensional scaling and other sources, that pain has at least two dimensions: somatosensory qualities and affect. We used a Chinese translation of the 101 descriptor multidimensional affect and pain survey (MAPS) questionnaire to determine the relative contributions of various dimensions of postoperative pain to a patient's score on a unidimensional NPRS. MAPS and NPRS were administered postoperatively to 69 patients with descending colon carcinoma who were recovering from left hemi-colectomy. Multiple linear regression revealed that the emotional pain qualities supercluster (P=0.0005) and four of its eight subclusters, anxiety, depressed mood, fear and anger, significantly (P=0.001-0.007) predicted a patient's score on the unidimensional NPRS. Notably, none of the 17 subclusters in the somatosensory pain qualities supercluster predicted NPRS scores. It may be concluded that patient scores on unidimensional pain intensity scales reflect the emotional qualities of pain much more than its sensory intensity or other qualities. Accordingly such scales are poor indicators of analgesic requirement. The results also suggest that patients' postoperative anxiety and depression are inadequately treated. Based on our findings we present six unidimensional scales that should yield a more accurate assessment of the sources of a patient's pain.

  10. Evaluating students' perception of their clinical placements - testing the clinical learning environment and supervision and nurse teacher scale (CLES + T scale) in Germany. (United States)

    Bergjan, Manuela; Hertel, Frank


    Clinical nursing education in Germany has not received attention in nursing science and practice for a long time, as it often seems to be a more or less "formalized appendix" of nursing education. Several development projects of clinical education taking place are mainly focused on the qualification of clinical preceptors. However, the clinical context and its influence on learning processes have still not been sufficiently investigated. The aim of this study was the testing of a German version of the clinical learning environment and supervision and nurse teacher scale (CLES + T scale). The sample of the pilot study consists of first-, second- and third-year student nurses (n=240) of a university nursing school from January to March 2011. Psychometric testing of the instrument is carried out by selected methods of classical testing theories using SPPS 19. The results show transferability of all subcategories of the CLES + T scale in the non-academic nursing education system of a university hospital in Germany, without the teacher scale. The strongest factor is "supervisory relationship". The German version of the CLES + T scale may help to evaluate and compare traditional and new models in clinical nursing education.

  11. Genome-wide fine-scale recombination rate variation in Drosophila melanogaster.

    Directory of Open Access Journals (Sweden)

    Andrew H Chan

    Full Text Available Estimating fine-scale recombination maps of Drosophila from population genomic data is a challenging problem, in particular because of the high background recombination rate. In this paper, a new computational method is developed to address this challenge. Through an extensive simulation study, it is demonstrated that the method allows more accurate inference, and exhibits greater robustness to the effects of natural selection and noise, compared to a well-used previous method developed for studying fine-scale recombination rate variation in the human genome. As an application, a genome-wide analysis of genetic variation data is performed for two Drosophila melanogaster populations, one from North America (Raleigh, USA and the other from Africa (Gikongoro, Rwanda. It is shown that fine-scale recombination rate variation is widespread throughout the D. melanogaster genome, across all chromosomes and in both populations. At the fine-scale, a conservative, systematic search for evidence of recombination hotspots suggests the existence of a handful of putative hotspots each with at least a tenfold increase in intensity over the background rate. A wavelet analysis is carried out to compare the estimated recombination maps in the two populations and to quantify the extent to which recombination rates are conserved. In general, similarity is observed at very broad scales, but substantial differences are seen at fine scales. The average recombination rate of the X chromosome appears to be higher than that of the autosomes in both populations, and this pattern is much more pronounced in the African population than the North American population. The correlation between various genomic features-including recombination rates, diversity, divergence, GC content, gene content, and sequence quality-is examined using the wavelet analysis, and it is shown that the most notable difference between D. melanogaster and humans is in the correlation between

  12. Effects of Post-Fire Salvage Logging on Erosion Rates at Multiple Scales (United States)

    Wagenbrenner, J. W.; Robichaud, P. R.; MacDonald, L. H.; Brown, R. E.


    Forest managers sometimes harvest burned trees after wildfires to realize economic value, reduce fuel loads, or achieve other operational goals. This logging can be controversial because some ecosystem effects are negative, yet the potential impacts on erosion rates have not been clearly identified. Our objectives were to quantify hillslope-scale erosion rates and compare the hillslope erosion rates to rates from larger (swale) and smaller (rill) scales. Soil characteristics, vegetative regrowth, and erosion rates were measured in logged areas and unlogged controls at seven severely burned sites in the western US. One site had replicated measurements at all three scales, five sites had only hillslope or swale scale measurements, and one site had only rill measurements. Erosion rates from hillslopes (70-170 m2) and swales (0.1-2.6 ha) were measured with sediment fences. Rill erosion rates were measured with rill experiments, where water was applied to a hillslope at five flow rates for 12 min each; water samples were collected at a point 9 m downslope. At the hillslope scale the passage of heavy logging equipment reduced soil water repellency, compacted the soil, reduced vegetative regrowth rates, and generally increased erosion rates by one or two orders of magnitude relative to the controls. The rill experiments also showed greater rates of rill incision and erosion from the areas disturbed by heavy logging equipment relative to the controls. At the swale scale erosion rates were higher in the logged areas than the controls when measurements were replicated and simultaneous but there was no detectable change in the other study areas. Overall, the absolute erosion rates from both logged and unlogged areas tended to decline over time while the relative difference in erosion tended to increase due to the slower vegetative recovery in the more heavily disturbed areas. The potential adverse effects of salvage logging can be minimized by reducing compaction and

  13. Laboratory-Scale Melter for Determination of Melting Rate of Waste Glass Feeds

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong-Sang; Schweiger, Michael J.; Buchmiller, William C.; Matyas, Josef


    The purpose of this study was to develop the laboratory-scale melter (LSM) as a quick and inexpensive method to determine the processing rate of various waste glass slurry feeds. The LSM uses a 3 or 4 in. diameter-fused quartz crucible with feed and off-gas ports on top. This LSM setup allows cold-cap formation above the molten glass to be directly monitored to obtain a steady-state melting rate of the waste glass feeds. The melting rate data from extensive scaled-melter tests with Hanford Site high-level wastes performed for the Hanford Tank Waste Treatment and Immobilization Plant have been compiled. Preliminary empirical model that expresses the melting rate as a function of bubbling rate and glass yield were developed from the compiled database. The two waste glass feeds with most melter run data were selected for detailed evaluation and model development and for the LSM tests so the melting rates obtained from LSM tests can be compared with those from scaled-melter tests. The present LSM results suggest the LSM setup can be used to determine the glass production rates for the development of new glass compositions or feed makeups that are designed to increase the processing rate of the slurry feeds.

  14. A new respiratory rate monitor: development and initial clinical experience

    DEFF Research Database (Denmark)

    Hök, B; Wiklund, L; Henneberg, S


    different kinds of interference, including motion artefacts. The sensor is nonexpensive, rugged, simple to apply and inherently safe. An instrument with continuous display of respiratory rate, and an audiovisual apnea alarm has been designed and built. The complete system has been tested on patients during...... and apnea. Such events may in some patients be as frequent as one incident per hour. One case of 'Ondine's curse' provided clear evidence that pulse oximetry has a low sensitivity to respiratory disorders....

  15. The UPDRS-8: a brief clinical assessment scale for Parkinson's disease. (United States)

    Hauser, Robert A; Lyons, Kelly E; Pahwa, Rajesh


    We evaluated a brief, 8-item version of the Unified Parkinson's Disease Rating Scale (UPDRS) using two existing patient databases. One database included 1,445 PD patients. Spearman correlation between UPDRS-8 motor scores and full UPDRS motor scores was .765 (p UPDRS-8 scores and full UPDRS total scores (parts I-III) was .798 (p UPDRS-8 scores and total 39-item PD questionnaire (PDQ-39) scores was .629 (p UPDRS-8 motor scores were similarly significantly sensitive to change as full UPDRS motor scores in assessing change from the medication OFF state to the medication ON state at baseline and from the medication OFF state at baseline to the medication OFF/stimulation ON state 1 year post-DBS. The UPDRS-8 focuses on items that are most relevant for clinical decision making. In this study, the UPDRS-8 exhibited good correlation with the full UPDRS and the PDQ-39. We therefore believe that it can provide a useful, rapid assessment of PD patients in clinical practice. Whether it might be useful in clinical trials depends on demonstrating that it is also sensitive to relatively small changes in clinical status.

  16. Dichoptic viewing methods for binocular rivalry research: prospects for large-scale clinical and genetic studies. (United States)

    Law, Phillip C F; Paton, Bryan K; Thomson, Richard H; Liu, Guang B; Miller, Steven M; Ngo, Trung T


    Binocular rivalry (BR) is an intriguing phenomenon that occurs when two different images are presented, one to each eye, resulting in alternation or rivalry between the percepts. The phenomenon has been studied for nearly 200 years, with renewed and intensive investigation over recent decades. The rate of perceptual switching has long been known to vary widely between individuals but to be relatively stable within individuals. A recent twin study demonstrated that individual variation in BR rate is under substantial genetic control, a finding that also represented the first report, using a large study, of genetic contribution for any post-retinal visual processing phenomenon. The twin study had been prompted by earlier work showing BR rate was slow in the heritable psychiatric condition, bipolar disorder (BD). Together, these studies suggested that slow BR may represent an endophenotype for BD, and heralded the advent of modern clinical and genetic studies of rivalry. This new focus has coincided with rapid advances in 3D display technology, but despite such progress, specific development of technology for rivalry research has been lacking. This review therefore compares different display methods for BR research across several factors, including viewing parameters, image quality, equipment cost, compatibility with other investigative methods, subject group, and sample size, with a focus on requirements specific to large-scale clinical and genetic studies. It is intended to be a resource for investigators new to BR research, such as clinicians and geneticists, and to stimulate the development of 3D display technology for advancing interdisciplinary studies of rivalry.

  17. Creation of the physical appearance and the body image rating scale for the Czech context

    Directory of Open Access Journals (Sweden)

    Lenka Šrámková


    Full Text Available Problem and methods: Physical appearance is one of the key components of selfperception from early childhood. An individual’s perceived physical attractiveness is largely conditioned by geographical, cultural and historical factors. Every culture develops its own criteria of attractiveness and any deviations to those are often a cause of ostracism, for example through exclusion or rejection. Still, there are certain universal principles of attractiveness (e.g. a higher waist-hip ratio, facial symmetry, sexually dimorphic features, which exist across cultures and time periods with little variation. To measure a person’s level of satisfaction with his/her physical appearance, psychologists regularly employ figure rating scales. The primary goal of our work was to develop and verify an updated visual body rating scale called the Basic Olomouc Body Rating (BOBR, making sure that it is widely usable, valid and reliable. The scale was created using the method of document analysis of academic papers according body-rating scales and a method of interview with potential probands. In the pilot data gathering phase, a group of respondents was presented with the 3 scales commonly used in the European context, i.e. FDS (Stunkard, Sorensen & Schulsinger, 1983, CDRS (Thompson & Gray, 1995 and BIAS-BD (Gardner, Jappe & Gardner, 2009. The purpose of this was to get feedback on these scales and find out if people are able to use these scales to rate themselves. New schematic figure rating scale for both men and women which would do away with the limitations of the scales used so far was developed. Results: The result is creation of a body-rating scale widely usable in further research and practical consulting. The paper briefly summarizes results of an additional study – the goal definition phase was followed by online research on the subject of body image and the self-perceived sexual attractiveness. Altogether, 5,616 respondents from the Czech Republic

  18. Differences in methylphenidate abuse rates among methadone maintenance treatment patients in two clinics. (United States)

    Peles, Einat; Schreiber, Shaul; Linzy, Shirley; Domani, Yoav; Adelson, Miriam


    Methylphenidate, an amphetamine-like prescription medication for attention deficit hyperactivity disorder (ADHD) was suspected as being abused among methadone maintenance treatment (MMT) patients. We tested its presence in the routine urine monitoring of all patients in both Tel Aviv and Las Vegas MMT clinics. Data on demographic and addiction history, ADHD (Wender Utah Rating Scale), cognitive impairment (Mini Mental State Exam), and lifetime DSM-IV-TR psychiatric diagnosis from admission were retrieved, and retention following 6 months. None of the 190 patients in Las Vegas tested positive for methylphenidate, while 14.7% (45/306) did in Tel Aviv. Abusers were less educated (p = 0.01), had higher ADHD scores (p = 0.02), lower cognitive scores (p = 0.05), and a higher benzodiazepine (BDZ) abuse rate (p abuse and infectious disease. Of the methylphenidate abuse 42.2% have take-home methadone dose privileges. Not like opiate use, being methylphenidate positive did not relate to 6-months retention. Compared to Tel Aviv, Las Vegas patients were more educated, with lower BDZ, and cocaine abuse. The greater abuse of methylphenidate among ADHD subjects might indicate their using it as self-medication, raising a possible indication for its prescription for that subgroup of MMT patients. The high rate of methylphenidate abuse in Israel needs future study.

  19. Combining Dual Scaling with Semi-Structured Interviews to Interpret Rating Differences

    Directory of Open Access Journals (Sweden)

    Ruth A. Childs


    Full Text Available Dual scaling, a variation of multidimensional scaling, can reveal the dimensions underlying scores, such as raters' judgments. This study illustrates the use of a dual scaling analysis with semi-structured interviews of raters to investigate the differences among the raters as captured by the dimensions. Thirty applications to a one-year post-Bachelor's degree teacher education program were rated by nine teacher educators. Eight of the raters were subsequently interviewed about how they rated the responses. A three-dimensional model was found to explain most of the variance in the ratings for two of the questions and a two-dimensional model was most interpretable for the third question. The interviews suggested that the dimensions reflected, in addition to differences in raters' stringency, differences in their beliefs about their roles as raters and about the types of insights that were required of applicants.

  20. An Exploration of the Base Rate Scores of the Millon Clinical Multiaxial Inventory-III (United States)

    Grove, William M.; Vrieze, Scott I.


    The Millon Clinical Multiaxial Inventory (3rd ed.; MCMI-III) is a widely used psychological assessment of clinical and personality disorders. Unlike typical tests, the MCMI-III uses a base-rate score transformation to incorporate prior probabilities of disorder (i.e., base rates) in test output and diagnostic thresholds. The authors describe the…

  1. Event Rates in Randomized Clinical Trials Evaluating Cardiovascular Interventions and Devices

    NARCIS (Netherlands)

    Mahmoud, Karim D.; Lennon, Ryan J.; Holmes, David R.


    Randomized clinical trials (RCTs) are considered the gold standard for evidence-based medicine. However, an accurate estimation of the event rate is crucial for their ability to test clinical hypotheses. Overestimation of event rates reduces the required sample size but can compromise the statistica

  2. Validation of the German version of the extended ALS functional rating scale as a patient-reported outcome measure. (United States)

    Abdulla, Susanne; Vielhaber, Stefan; Körner, Sonja; Machts, Judith; Heinze, Hans-Jochen; Dengler, Reinhard; Petri, Susanne


    The revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) is a well-established rating instrument to assess the functional status of ALS patients. A recent innovation was the addition of three further items designed to improve its sensitivity at lower levels of physical function (ALSFRS-Extension, ALSFRS-EX). Neither the ALSFRS-R nor the ALSFRS-EX has been validated in German yet. The aim of the present study was the validation of the German version of a self-administered form of the ALSFRS-EX. Seventy-six patients participated in the study. Psychometric analysis included reliability assessment and factorial analysis. To evaluate convergent validity, correlations between ALSFRS-EX items and the MRC score, spasticity, tongue movement, pulmonary function, ALSAQ-40 and Borg dyspnoea scales (upright and supine) were performed. Internal consistency as measured by Cronbach's alpha (total scale 0.868, subscales 0.690-0.938) and corrected item to total correlations (all above 0.50) was high. Test-retest reliability assessed by Spearman's rho (0.882-0.972) and Cohen's Kappa (0.63-0.92) was also high. Principal component analysis with varimax rotation yielded a four-factor solution accounting for approximately 79% of the variance. Clinical parameters were strongly correlated with respective items and subscores of the ALSFRS-EX (muscle strength 0.568-0.833 p scale including high internal consistency and test-retest reliability as well as excellent convergent validity.

  3. Measuring cognitive errors using the Cognitive Distortions Scale (CDS: psychometric properties in clinical and non-clinical samples.

    Directory of Open Access Journals (Sweden)

    Kadir Özdel

    Full Text Available The Cognitive Distortions Scale was developed to assess thinking errors using case examples in two domains: interpersonal and personal achievement. Although its validity and reliability has been previously demonstrated in non-clinical samples, its psychometric properties and scoring has not yet been evaluated. The aim of the current study was to evaluate the psychometric properties of the Cognitive Distortions Scale in two Turkish samples and to examine the usefulness of the categorical scoring system. A total of 325 individuals (Sample 1 and Sample 2 were enrolled in this study to assess those psychometric properties. Our Sample 1 consisted of 225 individuals working as interns at the Diskapi Yildirim Beyazit Teaching and Research Hospital and Sample 2 consisted of 100 patients diagnosed with depression presenting to the outpatient unit of the same Hospital. Construct validity was assessed using the Beck Depression Inventory, the State Trait Anxiety Inventory, the Dysfunctional Attitude Scale, and the Automatic Thought Questionnaire. Factor analyses supported a one-factor model in these clinical and non-clinical samples. Cronbach's α values were excellent in both the non-clinical and clinical samples (0.933 and 0.918 respectively. Cognitive Distortions Scale scores showed significant correlation with relevant clinical measures. Study Cognitive Distortions Scale scores were stable over a time span of two weeks. This study showed that the Cognitive Distortions Scale is a valid and reliable measure in clinical and non-clinical populations. In addition, it shows that the categorical exists/does not exist scoring system is relevant and could be used in clinical settings.

  4. Correlation and characteristics of self-rating and clinical rating of depression among alcoholics in the course of early abstinence

    Directory of Open Access Journals (Sweden)

    Mandić-Gajić Gordana


    Full Text Available Background/Aim. Depression is an alcoholism relapse risk factor, but frequently stays underdiagnosed among treated alcoholics. The correlation and characteristics of self-reported and clinically assessed depression in the course of early alcohol abstinence were explored. Methods. A total of 100 inpatient, primary male alcoholics (20-60 years diagnosed according to Classificaton of Mental and Behavioural Disorders (ICD-10 and Diagnostic and Statistical Manual of Mental Disorders (DSM-IV were recruited consecutively. The Hamilton Depression Rating Scale (HDRS and Beck Depression Inventory (BDI were scored on admission (T1, after 4 weeks (T2 and after 8 weeks (T3. Student's t-test, repeated measures ANOVA and Pearson's correlation between the scores were done (p < 0.05. Factor analyses of symptoms were performed. Results: On HDRS T1, T2, T3 90,7%, 39.5%, 17.4% alcoholics were depressive, respectively. The mean HDRS vs BDI scores on T1, T2 and T3 were 15.16 ± 6.34, 7.35 ± 4.18, 4.23 ± 2.93 vs 14.20 ± 9.56, 8.14 ± 7.35, 5.30 ± 4.94, respectively. Depression severity significantly lowered in the course of abstinence (ANOVA. The HRDS and BDI correlations on T1, T2 and T3 were significant (r1 = 0.763, r2 = 0.684, r3 = 0.613 respectively. Dysphoric mood, anxious, vegetative and cognitive HDRS subscales on T1, T2 and T3 were detected, but not BDI factors, thus BDI symptoms were analysed. Conclusions. The majority of alcoholics had depression on admission. A predominant mild-degree with a significant lowering of depression severity and positive significant correlations between HRDS and BDI scores in the course of abstinence were detected. The dysphoric mood on the HDRS sub-scale, and self-blame, anhedonia and guilt BDI symptoms were most prominent and persisted. The BDI could be a useful tool not only for routine screening and reassessment of depression, but also for exploring emotional content during early abstinence and planning tailored

  5. Measuring hunger and satiety in primary school children. Validation of a new picture rating scale. (United States)

    Bennett, Carmel; Blissett, Jackie


    Measuring hunger and satiety in children is essential to many studies of childhood eating behaviour. Few validated measures currently exist that allow children to make accurate and reliable ratings of hunger/satiety. Three studies aimed to validate the use of a new categorical rating scale in the context of estimated and real eating episodes. Forty-seven 6- to 8-year-olds participated in Study 1, which used a between-participant design. Results indicated that the majority of children were able to make estimated hunger/satiety ratings for a story character using the scale. No significant differences in the ratings of hunger/satiety of children measured before and after lunch were observed and likely causes are discussed. To account for inter-individual differences in hunger/satiety perceptions Study 2 employed a within-participant design. Fifty-four 5- to 7-year-olds participated and made estimated hunger/satiety ratings for a story character and real hunger/satiety ratings before and after lunch. The results indicated that the majority of children were able to use the scale to make estimated and real hunger and satiety ratings. Children were found to be significantly hungrier before compared to after lunch. As it was not possible to establish the types and quantities of food children ate for lunch a third study was carried out in a controlled laboratory environment. Thirty-six 6- to 9-year-olds participated in Study 3 and made hunger/satiety ratings before and after ingesting an ad libitum snack of known composition and quantity. Results indicated that children felt hungrier before than after the snack and that pre-snack hunger/satiety, and changes in hunger/satiety, were associated with snack intake. Overall, the studies indicate that the scale has potential for use with primary school children. Implications of the findings are discussed.

  6. Scale dependence of the alignment between strain rate and rotation in turbulent shear flow

    KAUST Repository

    Fiscaletti, D.


    The scale dependence of the statistical alignment tendencies of the eigenvectors of the strain-rate tensor e(i), with the vorticity vector omega, is examined in the self-preserving region of a planar turbulent mixing layer. Data from a direct numerical simulation are filtered at various length scales and the probability density functions of the magnitude of the alignment cosines between the two unit vectors vertical bar e(i) . (omega) over cap vertical bar are examined. It is observed that the alignment tendencies are insensitive to the concurrent large-scale velocity fluctuations, but are quantitatively affected by the nature of the concurrent large-scale velocity-gradient fluctuations. It is confirmed that the small-scale (local) vorticity vector is preferentially aligned in parallel with the large-scale (background) extensive strain-rate eigenvector e(1), in contrast to the global tendency for omega to be aligned in parallelwith the intermediate strain-rate eigenvector [Hamlington et al., Phys. Fluids 20, 111703 (2008)]. When only data from regions of the flow that exhibit strong swirling are included, the so-called high-enstrophy worms, the alignment tendencies are exaggerated with respect to the global picture. These findings support the notion that the production of enstrophy, responsible for a net cascade of turbulent kinetic energy from large scales to small scales, is driven by vorticity stretching due to the preferential parallel alignment between omega and nonlocal e(1) and that the strongly swirling worms are kinematically significant to this process.

  7. Non-linear and scale-invariant analysis of the Heart Rate Variability

    CERN Document Server

    Kalda, J; Vainu, M; Laan, M


    Human heart rate fluctuates in a complex and non-stationary manner. Elaborating efficient and adequate tools for the analysis of such signals has been a great challenge for the researchers during last decades. Here, an overview of the main research results in this field is given. The following question are addressed: (a) what are the intrinsic features of the heart rate variability signal; (b) what are the most promising non-linear measures, bearing in mind clinical diagnostic and prognostic applications.

  8. Further validation of the visual analogue scale for irritable bowel syndrome after use in clinical practice. (United States)

    Bengtsson, Mariette; Persson, Jesper; Sjölund, Kristina; Ohlsson, Bodil


    The Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS), a self-rating questionnaire, was designed to measure symptoms and the effect of treatment in patients suffering from irritable bowel syndrome. The aim of this descriptive correlational study was to conduct further psychometric validation after the VAS-IBS had been used in clinical practice, translate it into English, and compare the results with controls. Forty-nine patients with irritable bowel syndrome (median age = 38 years old [range, 18-69 years]) were compared with 90 healthy persons (median age = 44 years old [range, 21-77 years]) who served as controls. The patients with irritable bowel syndrome completed 3 questionnaires: the VAS-IBS, the Gastrointestinal Symptom Rating Scale, and the Perception of Change of Symptoms. Controls completed only the VAS-IBS. Results showed that the VAS-IBS is a valid questionnaire that measures the degree of change of symptoms and discriminates between patients who have irritable bowel syndrome from those who do not. It is important to compare the VAS-IBS among different cultural populations so we suggest that the English version of the VAS-IBS should now be used in English-speaking countries and be further tested for validity and reliability with English-speaking patients.


    Institute of Scientific and Technical Information of China (English)

    姜楠; 王玉春; 舒玮; 王振东


    Experimental investigations have been devoted to the study of scaling law of coarse-grained dissipation rate structure function for velocity and temperature fluctuation of non-isotropic and inhomogeneous turbulent flows at moderate Reynolds number. Much attention has been paid to the case of turbulent boundary layer, which is typically the nonistropic and inhomogeneous trubulence because of the dynamically important existence of organized coherent structure burst process in the near wall region. Longitudinal velocity and temperature have been measured at different vertical positions in turbulent boundary layer over a heated and unheated flat plate in a wind tunnel using hot wire anemometer. The influence of non-isotropy and inhomogeneity and heating the wall on the scaling law of the dissipation rate structure function is studied because of the existence of organized coherent structure burst process in the near wall region. The scaling law of coarse-grained dissipation rate structure function is found to be independent of the mean velocity shear strain and the heating wall boundary condition. The scaling law of the dissipation rate structure function is verified to be in agreement with the hierarchical structure model that has been verified valid for isotropic and homogeneous turbulence.


    NARCIS (Netherlands)



    This article reports on some psychometric features of the Therapist Client Rating Scale (TCRS), an instrument that claims to measure the therapeutic relationship in behaviour therapy sessions. A study is described in which the TCRS was completed after each therapy session by 28 obsessive-compulsive

  11. Reliability and discriminant validity of ataxia rating scales in early onset ataxia

    NARCIS (Netherlands)

    Brandsma, R.; Lawerman, T. F.; Kuiper, M. J.; Geffen, van Joke; Lunsing, I. J.; Burger, H.; de Koning, T. J.; de Vries, J. J.; de Koning-Tijssen, M. A. J.; Sival, D. A.


    Objective: To determine observer-agreement and discriminantvalidity of ataxia rating scales.Background: In children and young adults, Early Onset Ataxia(EOA) is frequently concurrent with other Movement Disorders,resulting in moderate inter-observer agreement among MovementDisorder professionals. To

  12. An Exploratory Study of the Application of Early Childhood Environment Rating Scale Criteria (United States)

    Warash, Barbara G.; Ward, Corina; Rotilie, Sally


    This study examined whether attending a one day training on the Early Childhood Environment Rating Scale-Revised (ECERS-R) corresponded to pre-k classroom changes. Teachers attended an ECERS-R module training and six months later completed a questionnaire to report any classroom changes. The questionnaire consisted of listing the subscales and…

  13. Parent-child parallel nutritional status assessment using silhouette rating scales

    Directory of Open Access Journals (Sweden)

    Jorga Jagoda B.


    Full Text Available Introduction The aim of this study was to determine the validity of silhouettes in assessing genetic factors of obesity in school children aged 12-14. Material and methods 290 primary school students aged 12-14 from Belgrade had undergone body height and weight measurements as well as answering questionnaires. Silhouette rating scales were used to assess the nutritional status of students (6-silhouette scale and their parents (9-silhouette scale. Results Significant differences in body mass index (BMI were found among children whose parents had been rated "normal" and those rated “problematic”. BMI status and gender significantly affected assessment of the nutritional status. An interaction between factors was found (F (1.230 =7.017, p<0.01. The majority of children from the normal BMI category (64.5% selected silhouettes 3 and 4 to describe their current appearance. On the other hand, 70% of children with problematic BMI selected silhouettes 5 and 6. Girls generally selected significantly smaller silhouettes than boys. Girls within the problematic BMI category selected significantly bigger silhouettes for their mother's than the other children. Boys within the normal BMI category, selected significantly bigger silhouettes representing their father’s body size. Discussion According to the results, silhouette rating scales appear to be reliable in parallel assessment of the nutritional status of children and their parents. This subject can be further developed by acquiring data on parents` height and body mass.

  14. Factorial Validity and Reliability of the Devereux Elementary School Behavior Rating Scale. (United States)

    Reynolds, William M.; Bernstein, Sydna M.


    The factorial validity and internal consistency reliability of the Devereux Elementary School Behavior Rating Scale were examined with a random sample of elementary school children. Given the problem of multicollinearity that was shown to exist among subscales, the authors suggest caution in the interpretation of Devereux subscales as discrete…

  15. Factor Structure of the Rorschach Prognostic Rating Scale and Its Relation to Therapeutic Outcome (United States)

    Auerbach, Stephen M.; Edinger, Jack D.


    This study evaluated the factor structure of the Rorschach Prognostic Rating Scale (RPRS) in order to: (a) test the assumption that the RPRS represents a unitary response system and (b) determine the efficacy of employing population specific factor scores as predictors of therapy outcome. (Author/NG)

  16. The Validity of the Rorschach Prognostic Rating Scale with Incarcerated Offenders (United States)

    Edinger, Jack D.; Bogan, Joseph B.


    Previous research has shown that the Rorschach Prognostic Rating Scale reliably predicts the adjustment capacity of various S types to a variety of situations. The present study investigated the efficacy of the RPRS to suggest the adjustment capacity of prisoners to various aspects of their institutional environment. (Editor)

  17. Psychometric Properties of the Teacher-Reported Motor Skills Rating Scale (United States)

    Kim, Helyn; Murrah, William M.; Cameron, Claire E.; Brock, Laura L.; Cottone, Elizabeth A.; Grissmer, David


    Children's early motor competence is associated with social development and academic achievement. However, few studies have examined teacher reports of children's motor skills. This study evaluated the psychometric properties of the Motor Skills Rating Scale (MSRS), a 19-item measure of children's teacher-reported motor skills in the classroom.…

  18. Identifying Gifted Students in Puerto Rico: Validation of a Spanish Translation of the Gifted Rating Scales (United States)

    Rosado, Javier I.; Pfeiffer, Steven; Petscher, Yaacov


    The challenge of correctly identifying gifted students is a critical issue. Gifted education in Puerto Rico is marked by insufficient support and a lack of appropriate identification methods. This study examined the reliability and validity of a Spanish translation of the "Gifted Rating Scales-School Form" (GRS) with a sample of 618…

  19. Development of a student rating scale to evaluate teachers' competencies for facilitating reflective learning

    NARCIS (Netherlands)

    Schaub-de Jong, Mirabelle A.; Schonrock-Adema, Johanna; Dekker, Hanke; Verkerk, Marian; Cohen-Schotanus, Janke


    Context Teaching students in reflection calls for specific teacher competencies. We developed and validated a rating scale focusing on Student perceptions of their Teachers' competencies to Encourage Reflective Learning in small Groups (STERLinG). Methods We applied an iterative procedure to reduce

  20. Problematizing Rating Scales in EFL Academic Writing Assessment: Voices from Iranian Context (United States)

    Ghanbar, Batoul; Barati, Hossein; Moinzadeh, Ahmad


    Along with a more humanitarian movement in language testing, accountability to contextual variables in the design and development of any assessment enterprise is emphasized. However, when it comes to writing assessment, it is found that multiplicity of rating scales developed to fit diverse contexts is mainly headed by well-known native testing…

  1. Technical Analysis of the Disruptive Behavior Rating Scale--Second Edition--Teacher Version (United States)

    Erford, Bradley T.; Clark, Kelly


    The reliability and validity of scores on the Disruptive Behavior Rating Scale-second edition-teacher version (DBRS-II-T) was analyzed. The DBRS-II-T was designed to assess teacher observations of students referred for behavioral difficulties. The five-factor model fit the data poorly, but convergent and diagnostic validities were excellent.…

  2. Technical Adequacy of the Disruptive Behavior Rating Scale-2nd Edition--Self-Report (United States)

    Erford, Bradley T.; Miller, Emily M.; Isbister, Katherine


    This study provides preliminary analysis of the Disruptive Behavior Rating Scale-2nd Edition--Self-Report, which was designed to screen individuals aged 10 years and older for anxiety and behavior symptoms. Score reliability and internal and external facets of validity were good for a screening-level test.

  3. Family Child Care Environment Rating Scale Revised Edition (FCCERS-R) (United States)

    Harms, Thelma; Cryer, Debby; Clifford, Richard M.


    Featuring a new spiral binding, the FCCERS-R is a thorough revision of the widely used program quality assessment instrument, "The Family Day Care Rating Scale." Designed for use in family child care programs, it is suitable for programs serving children from infancy through school-age. Following extensive input from users of the…

  4. Determination and Interpretation of the Norm Values of Preschool Social Skills Rating Scale Teacher Form (United States)

    Omeroglu, Esra; Buyukozturk, Sener; Aydogan, Yasemin; Cakan, Mehtap; Cakmak, Ebru Kilic; Ozyurek, Arzu; Akduman, Gulumser Gultekin; Gunindi, Yunus; Kutlu, Omer; Coban, Aysel; Yurt, Ozlem; Kogar, Hakan; Karayol, Seda


    This study aimed to determine and interpret norms of the Preschool Social Skills Rating Scale (PSSRS) teacher form. The sample included 224 independent preschools and 169 primary schools. The schools are distributed among 48 provinces and 3324 children were included. Data were obtained from the PSSRS teacher form. The validity and reliability…

  5. Diagnostic Group Differences in Parent and Teacher Ratings on the BRIEF and Conners' Scales (United States)

    Sullivan, Jeremy R.; Riccio, Cynthia A.


    Objective: Behavioral rating scales are common instruments used in evaluations of ADHD and executive function. It is important to explore how different diagnostic groups perform on these measures, as this information can be used to provide criterion-related validity evidence for the measures. Method: Data from 92 children and adolescents were used…

  6. Validity of the Children's Orientation to Book Reading Rating Scale (United States)

    Kaderavek, Joan N.; Guo, Ying; Justice, Laura M.


    The present study investigates the validity of a 4-point rating scale used to measure the level of preschool children's orientation to literacy during shared book reading. Validity was explored by (a) comparing the children's level of literacy orientation as measured with the "Children's Orientation to Book Reading Rating…

  7. Quality of Child Care Using the Environment Rating Scales: A Meta-Analysis of International Studies (United States)

    Vermeer, Harriet J.; van IJzendoorn, Marinus H.; Cárcamo, Rodrigo A.; Harrison, Linda J.


    The current study provides a systematic examination of child care quality around the globe, using the Environment Rating Scales (ERS). Additional goals of this study are to examine associations between ERS process quality and structural features (group size, caregiver-child ratio) that underpin quality and between ERS and more proximal aspects of…

  8. Adaptation of the Rating Scale Mental Effort (RSME) for use in Indonesia

    NARCIS (Netherlands)

    Widyanti, Ari; Johnson, Addie; de Waard, Dick


    The Rating Scale Mental Effort (RSME) is a unidimensional instrument used to measure subjective mental workload. The RSME consists of a line with a length of 150 mm marked with nine anchor points, each accompanied by a descriptive label indicating a degree of effort. The RSME has been widely used in

  9. Erosive Augmentation of Solid Propellant Burning Rate: Motor Size Scaling Effect (United States)

    Strand, L. D.; Cohen, Norman S.


    Two different independent variable forms, a difference form and a ratio form, were investigated for correlating the normalized magnitude of the measured erosive burning rate augmentation above the threshold in terms of the amount that the driving parameter (mass flux or Reynolds number) exceeds the threshold value for erosive augmentation at the test condition. The latter was calculated from the previously determined threshold correlation. Either variable form provided a correlation for each of the two motor size data bases individually. However, the data showed a motor size effect, supporting the general observation that the magnitude of erosive burning rate augmentation is reduced for larger rocket motors. For both independent variable forms, the required motor size scaling was attained by including the motor port radius raised to a power in the independent parameter. A boundary layer theory analysis confirmed the experimental finding, but showed that the magnitude of the scale effect is itself dependent upon scale, tending to diminish with increasing motor size.

  10. Validity study of the Beck Anxiety Inventory (Portuguese version by the Rasch Rating Scale model

    Directory of Open Access Journals (Sweden)

    Sónia Quintão


    Full Text Available Our objective was to conduct a validation study of the Portuguese version of the Beck Anxiety Inventory (BAI by means of the Rasch Rating Scale Model, and then compare it with the most used scales of anxiety in Portugal. The sample consisted of 1,160 adults (427 men and 733 women, aged 18-82 years old (M=33.39; SD=11.85. Instruments were Beck Anxiety Inventory, State-Trait Anxiety Inventory and Zung Self-Rating Anxiety Scale. It was found that Beck Anxiety Inventory's system of four categories, the data-model fit, and people reliability were adequate. The measure can be considered as unidimensional. Gender and age-related differences were not a threat to the validity. BAI correlated significantly with other anxiety measures. In conclusion, BAI shows good psychometric quality.

  11. Solute transport predicts scaling of surface reaction rates in porous media: Applications to silicate weathering

    CERN Document Server

    Hunt, Allen G; Ghanbarian, Behzad


    We apply our theory of conservative solute transport, based on concepts from percolation theory, directly and without modification to reactive solute transport. This theory has previously been shown to predict the observed range of dispersivity values for conservative solute transport over ten orders of magnitude of length scale. We now show that the temporal dependence derived for the solute velocity accurately predicts the time-dependence for the weathering of silicate minerals over nine orders of magnitude of time scale, while its predicted length dependence agrees with data obtained for reaction rates over five orders of magnitude of length scale. In both cases, it is possible to unify lab and field results. Thus, net reaction rates appear to be limited by solute transport velocities. We suggest the possible relevance of our results to landscape evolution of the earth's terrestrial surface.

  12. Scale Factor Determination of Micro-Machined Angular Rate Sensors Without a Turntable

    Institute of Scientific and Technical Information of China (English)

    Gaisser Alexander; GAO Zhongyu; ZHOU Bin; ZHANG Rong; CHEN Zhiyong


    This paper presents a digital readout system to detect small capacitive signals of a micro-machined angular rate sensor. The flexible parameter adjustment ability and the computation speed of the digital signal processor were used to develop a new calibration procedure to determine the scale factor of a gyroscope without a turntable. The force of gravity was used to deflect the movable masses in the sensor, which resulted in a corresponding angular rate input. The gyroscope scale factor was then measured without a turntable. Test results show a maximum deviation of about 1.2% with respect to the scale factor determined on a turntable with the accuracy independent of the manufacturing process and property variations. The calibration method in combination with the improved readout electronics can minimize the calibration procedure and, thus, reduce the manufacturing costs.

  13. The DSM-5 Dimensional Anxiety Scales in a Dutch non-clinical sample: psychometric properties including the adult separation anxiety disorder scale. (United States)

    Möller, Eline L; Bögels, Susan M


    With DSM-5, the American Psychiatric Association encourages complementing categorical diagnoses with dimensional severity ratings. We therefore examined the psychometric properties of the DSM-5 Dimensional Anxiety Scales, a set of brief dimensional scales that are consistent in content and structure and assess DSM-5-based core features of anxiety disorders. Participants (285 males, 255 females) completed the DSM-5 Dimensional Anxiety Scales for social anxiety disorder, generalized anxiety disorder, specific phobia, agoraphobia, and panic disorder that were included in previous studies on the scales, and also for separation anxiety disorder, which is included in the DSM-5 chapter on anxiety disorders. Moreover, they completed the Screen for Child Anxiety Related Emotional Disorders Adult version (SCARED-A). The DSM-5 Dimensional Anxiety Scales demonstrated high internal consistency, and the scales correlated significantly and substantially with corresponding SCARED-A subscales, supporting convergent validity. Separation anxiety appeared present among adults, supporting the DSM-5 recognition of separation anxiety as an anxiety disorder across the life span. To conclude, the DSM-5 Dimensional Anxiety Scales are a valuable tool to screen for specific adult anxiety disorders, including separation anxiety. Research in more diverse and clinical samples with anxiety disorders is needed. © 2016 The Authors International Journal of Methods in Psychiatric Research Published by John Wiley & Sons Ltd.

  14. Generalizability of Standardized Patients' Satisfaction Ratings of Their Clinical Encounter with Fourth-Year Medical Students. (United States)

    Vu, Nu Viet; And Others


    At the end of their clinical clerkship rotations, all students in one medical school's classes of 1988 (N=69), 1989 (N=63), 1990 (N=66) took the Post-Clerkship Examination. This study examined the nature of the patients' satisfaction ratings; reliability of patient satisfaction ratings and number of patients needed to derive reliable ratings; etc.…

  15. The scaling of contact rates with population density for the infectious disease models. (United States)

    Hu, Hao; Nigmatulina, Karima; Eckhoff, Philip


    Contact rates and patterns among individuals in a geographic area drive transmission of directly-transmitted pathogens, making it essential to understand and estimate contacts for simulation of disease dynamics. Under the uniform mixing assumption, one of two mechanisms is typically used to describe the relation between contact rate and population density: density-dependent or frequency-dependent. Based on existing evidence of population threshold and human mobility patterns, we formulated a spatial contact model to describe the appropriate form of transmission with initial growth at low density and saturation at higher density. We show that the two mechanisms are extreme cases that do not capture real population movement across all scales. Empirical data of human and wildlife diseases indicate that a nonlinear function may work better when looking at the full spectrum of densities. This estimation can be applied to large areas with population mixing in general activities. For crowds with unusually large densities (e.g., transportation terminals, stadiums, or mass gatherings), the lack of organized social contact structure deviates the physical contacts towards a special case of the spatial contact model - the dynamics of kinetic gas molecule collision. In this case, an ideal gas model with van der Waals correction fits well; existing movement observation data and the contact rate between individuals is estimated using kinetic theory. A complete picture of contact rate scaling with population density may help clarify the definition of transmission rates in heterogeneous, large-scale spatial systems.

  16. Scaling in Rate-Changeable Birth and Death Processes with Random Removals

    Institute of Scientific and Technical Information of China (English)

    KE Jian-Hong; LIN Zhen-Quan; CHEN Xiao-Shuang


    We propose a monomer birth-death model with random removals, in which an aggregate of size k can produce a new monomer at a time-dependent rate I(t)k or lose one monomer at a rate J(t)k, and with a probability P(t) an aggregate of any size is randomly removed. We then analytically investigate the kinetic evolution of the model by means of the rate equation. The results show that the scaling behavior of the aggregate size distribution is dependent crucially on the net birth rate I(t)-J(t) as well as the birth rate I(t). The aggregate size distribution can approach a standard or modified scaling form in some cases, but it may take a scale-free form in other cases. Moreover, the species can survive finally only if either I(t) - J(t) ≥ P(t) or [J(t) + P(t) - I(t)]t (≌) 0 at t > 1; otherwise, it will become extinct.

  17. The Reliability of Methodological Ratings for speechBITE Using the PEDro-P Scale (United States)

    Murray, Elizabeth; Power, Emma; Togher, Leanne; McCabe, Patricia; Munro, Natalie; Smith, Katherine


    Background: speechBITE ( is an online database established in order to help speech and language therapists gain faster access to relevant research that can used in clinical decision-making. In addition to containing more than 3000 journal references, the database also provides methodological ratings on the PEDro-P (an…

  18. Usefulness of a Clinician Rating Scale in Identifying Preschool Children with ADHD (United States)

    Gopin, Chaya; Healey, Dione; Castelli, Katia; Marks, David; Halperin, Jeffrey M.


    Objective: To ascertain the psychometric properties and clinical utility of the Behavioral Rating Inventory for Children (BRIC), a novel clinician inventory for preschoolers. Method: Completion of the BRIC for 214 preschoolers follows 2 evaluation sessions, generally separated by less than 2 weeks. Items are submitted to a Principal Components…

  19. Pore-scale network modeling of microbially induced calcium carbonate precipitation: Insight into scale dependence of biogeochemical reaction rates (United States)

    Qin, Chao-Zhong; Hassanizadeh, S. Majid; Ebigbo, Anozie


    The engineering of microbially induced calcium carbonate precipitation (MICP) has attracted much attention in a number of applications, such as sealing of CO2 leakage pathways, soil stabilization, and subsurface remediation of radionuclides and toxic metals. The goal of this work is to gain insight into pore-scale processes of MICP and scale dependence of biogeochemical reaction rates. This will help us develop efficient field-scale MICP models. In this work, we have developed a comprehensive pore-network model for MICP, with geochemical speciation calculated by the open-source PHREEQC module. A numerical pseudo-3-D micromodel as the computational domain was generated by a novel pore-network generation method. We modeled a three-stage process in the engineering of MICP including the growth of biofilm, the injection of calcium-rich medium, and the precipitation of calcium carbonate. A number of test cases were conducted to illustrate how calcite precipitation was influenced by different operating conditions. In addition, we studied the possibility of reducing the computational effort by simplifying geochemical calculations. Finally, the effect of mass transfer limitation of possible carbonate ions in a pore element on calcite precipitation was explored.

  20. Hot Melt Extrusion: Development of an Amorphous Solid Dispersion for an Insoluble Drug from Mini-scale to Clinical Scale. (United States)

    Agrawal, Anjali M; Dudhedia, Mayur S; Zimny, Ewa


    The objective of the study was to develop an amorphous solid dispersion (ASD) for an insoluble compound X by hot melt extrusion (HME) process. The focus was to identify material-sparing approaches to develop bioavailable and stable ASD including scale up of HME process using minimal drug. Mixtures of compound X and polymers with and without surfactants or pH modifiers were evaluated by hot stage microscopy (HSM), polarized light microscopy (PLM), and modulated differential scanning calorimetry (mDSC), which enabled systematic selection of ASD components. Formulation blends of compound X with PVP K12 and PVP VA64 polymers were extruded through a 9-mm twin screw mini-extruder. Physical characterization of extrudates by PLM, XRPD, and mDSC indicated formation of single-phase ASD's. Accelerated stability testing was performed that allowed rapid selection of stable ASD's and suitable packaging configurations. Dissolution testing by a discriminating two-step non-sink dissolution method showed 70-80% drug release from prototype ASD's, which was around twofold higher compared to crystalline tablet formulations. The in vivo pharmacokinetic study in dogs showed that bioavailability from ASD of compound X with PVP VA64 was four times higher compared to crystalline tablet formulations. The HME process was scaled up from lab scale to clinical scale using volumetric scale up approach and scale-independent-specific energy parameter. The present study demonstrated systematic development of ASD dosage form and scale up of HME process to clinical scale using minimal drug (∼500 g), which allowed successful clinical batch manufacture of enabled formulation within 7 months.

  1. A clinical and SEM evaluation of the efficiency of sofscale gel and hand scaling and hand scaling alone. (United States)

    Thomas, K; Vandana, K L; Reddy, V Ramesh


    The purpose of this study is to compose between hand scaling with abd without the calculus solvent gel (sofscale) and ultrasonic instrumentation at clinical and SEM level. 30 patients belonging to the age group of 17-50 year were selected. Patients selected were subjected to three different scaling modalities namely hand scaling (control), hand scaling using sofscale (Experimental quadrant A) and ultrasonic scaling (Experimental quadrant B), in three different quadrants. Case report forms were used to document the tooth sensitivity, soft tissue pain after scaling, patient preference of instrumentation, ease of calculus removal, patient comfort, soft tissue irritation, time taken for scaling, Bleeding while scaling, pre and post operative sulcus bleeding index. In addition to the clinical criteria, the teeth treated were extracted and evaluated using the scanning electron microscope to show potential effects on cemntal surfaces. No difference in tooth sensitivity was appreciated between control and experimental quadrant A. There was a higher degree of tooth sensitivity when treated with ultrasonic. Patients in control group appreciated a higher degree of soft tissue pain. Hand scaling using softscale produced a lesser amount of pain and treatment with ultrasoincs was the least painful. Most of the patients preferred ultrasonic scaling (70%) Calculus removal was easier. Hand scaling using sofscale gel results in more patient comfort when compared to hand scaling alone. There was no significant difference in patient comfort between handscaling using sofscale and ultrasonic scaling. The percentage of reduction of sulcus bleeding index showed no difference between the 3 scaling modalities SEM evaluation revealed that there was no significant difference the 3 scaling modalities in relation to residual calculus, cleaning efficiency and damage to the root surface. This study concluded that treatment with sofscale gel appears to be safe and effective method for removal

  2. Comparison and application of three visual rating scales for white matter lesions in Alzheimer’s disease and mild cognitive impairment

    Institute of Scientific and Technical Information of China (English)



    Objective To compare the clinical value of three visual rating scales (VRS) for white matter lesions (WML) in Alzheimer’s disease (AD) and mild cognitive impairment (MCI) .Methods Totally 184 subjects,including 107 AD patients,47 MCI patients and 30 normal controls,were recruited.All subjects underwent comprehensive neuropsychological tests and were examined with a standard protocol of MR imaging.WML burden was rated with the Age-Related White Matter Changes (AR-

  3. Do pressure ulcer risk assessment scales improve clinical practice?


    Jan Kottner; Katrin Balzer


    Jan Kottner1, Katrin Balzer21Department of Nursing Science, Charité-Universitätsmedizin Berlin, Germany; 2Nursing Research Group, Institute for Social Medicine, Universitätsklinikum Schleswig-Holstein, Lübeck, GermanyAbstract: Standardized assessment instruments are deemed important for estimating pressure ulcer risk. Today, more than 40 so-called pressure ulcer risk assessment scales are available but still there is an ongoing debate about their usefulne...

  4. Scaling up syphilis testing in China: implementation beyond the clinic (United States)

    Hawkes, Sarah J; Yin, Yue-Pin; Peeling, Rosanna W; Cohen, Myron S; Chen, Xiang-Sheng


    Abstract China is experiencing a syphilis epidemic of enormous proportions. The regions most heavily affected by syphilis correspond to regions where sexually transmitted HIV infection is also a major public health threat. Many high-risk patients in China fail to receive routine syphilis screening. This missed public health opportunity stems from both a failure of many high-risk individuals to seek clinical care and a disconnect between policy and practice. New point-of-care syphilis testing enables screening in non-traditional settings such as community organizations or sex venues. This paper describes the current Chinese syphilis policies, suggests a spatiotemporal framework (based on targeting high-risk times and places) to improve screening and care practices, and emphasizes a syphilis control policy extending beyond the clinical setting. PMID:20539859

  5. Leverage hadoop framework for large scale clinical informatics applications. (United States)

    Dong, Xiao; Bahroos, Neil; Sadhu, Eugene; Jackson, Tommie; Chukhman, Morris; Johnson, Robert; Boyd, Andrew; Hynes, Denise


    In this manuscript, we present our experiences using the Apache Hadoop framework for high data volume and computationally intensive applications, and discuss some best practice guidelines in a clinical informatics setting. There are three main aspects in our approach: (a) process and integrate diverse, heterogeneous data sources using standard Hadoop programming tools and customized MapReduce programs; (b) after fine-grained aggregate results are obtained, perform data analysis using the Mahout data mining library; (c) leverage the column oriented features in HBase for patient centric modeling and complex temporal reasoning. This framework provides a scalable solution to meet the rapidly increasing, imperative "Big Data" needs of clinical and translational research. The intrinsic advantage of fault tolerance, high availability and scalability of Hadoop platform makes these applications readily deployable at the enterprise level cluster environment.

  6. Not Worth the Extra Cost? Diluting the Differentiation Ability of Highly Rated Products by Altering the Meaning of Rating Scale Levels

    DEFF Research Database (Denmark)

    Meissner, Martin; Heinzle, Stefanie Lena; Decker, Reinhold


    Over the last decade, the use of rating scales has grown in popularity in various fields, including customer online reviews and energy labels. Rating scales convey important information on attributes of products or services that consumers evaluate in their purchase decisions. By applying multidim...

  7. Using Rating Scales for the Assessment of Physical Self-Concept: Why the Number of Response Categories Matters (United States)

    Freund, Philipp Alexander; Tietjens, Maike; Strauss, Bernd


    The current study employs Mixture Distribution Rasch models to compare the psychometric properties of two rating scale variants (original rating scale with six response categories, "N"?=?806 school students; a variant with four response categories, "N"?=?905 school students) for five specific scales of the Physical…

  8. A Chinese version of the Psychotic Symptom Rating Scales: psychometric properties in recent-onset and chronic psychosis (United States)

    Chien, Wai-Tong; Lee, Isabella Yuet-Ming; Wang, Li-Qun


    The purpose of this study was to test the reliability, validity, and factor structure of a Chinese version of the Psychotic Symptom Rating Scale (PSYRATS) in 198 and 202 adult patients with recent-onset and chronic psychosis, respectively. The PSYRATS has been translated into different language versions and has been validated for clinical and research use mainly in chronic psychotic patients but not in recent-onset psychosis patients or in Chinese populations. The psychometric analysis of the translated Chinese version included assessment of its content validity, semantic equivalence, interrater and test–retest reliability, reproducibility, sensitivity to changes in psychotic symptoms, internal consistency, concurrent validity (compared to a valid psychotic symptom scale), and factor structure. The Chinese version demonstrated very satisfactory content validity as rated by an expert panel, good semantic equivalence with the original version, and high interrater and test–retest (at 2-week interval) reliability. It also indicated very good reproducibility of and sensitivity to changes in psychotic symptoms in line with the symptom severity measured with the Positive and Negative Syndrome Scale (PANSS). The scale consisted of four factors for the hallucination subscale and two factors for the delusion subscale, explaining about 80% of the total variance of the construct, indicating satisfactory correlations between the hallucination and delusion factors themselves, between items, factors, subscales, and overall scale, and between factors and relevant item and subscale scores of the PANSS. The Chinese version of the PSYRATS is a reliable and valid instrument to measure symptom severity in Chinese psychotic patients complementary to other existing measures mainly in English language.

  9. Association Between Medicare Summary Star Ratings for Patient Experience and Clinical Outcomes in US Hospitals

    Directory of Open Access Journals (Sweden)

    Stephen Trzeciak MD, MPH


    Full Text Available Objective: In 2015, the Centers for Medicare and Medicaid Services (CMS released new summary star ratings for US hospitals based on patient experience. We aimed to test the association between CMS patient experience star ratings and clinical outcomes. Methods: We analyzed risk-adjusted data for more than 3000 US hospitals from CMS Hospital Compare using linear regression. Results: We found that better patient experience was associated with favorable clinical outcomes. Specifically, a higher number of stars for patient experience had a statistically significant association with lower rates of many in-hospital complications. A higher patient experience star rating also had a statistically significant association with lower rates of unplanned readmissions to the hospital within 30 days. Conclusion: Better patient experience according to the CMS star ratings is associated with favorable clinical outcomes. These results support the inclusion of patient experience data in the framework of how hospitals are paid for services.

  10. Discriminant of validity the Wender Utah rating scale in Iranian adults.

    Directory of Open Access Journals (Sweden)

    Farideh Farokhzadi


    Full Text Available The aim of this study is the normalization of the Wender Utah rating scale which is used to detect adults with Attention-Deficit and Hyperactivity Disorder (ADHD. Available sampling method was used to choose 400 parents of children (200 parents of children with ADHD as compared to 200 parents of normal children. Wender Utah rating scale, which has been designed to diagnose ADHD in adults, is filled out by each of the parents to most accurately diagnose of ADHD in parents. Wender Utah rating scale was divided into 6 sub scales which consist of dysthymia, oppositional defiant disorder; school work problems, conduct disorder, anxiety, and ADHD were analyzed with exploratory factor analysis method. The value of (Kaiser-Meyer-Olkin KMO was 86.5% for dysthymia, 86.9% for oppositional defiant disorder, 77.5% for school related problems, 90.9% for conduct disorder, 79.6% for anxiety and 93.5% for Attention deficit/hyperactivity disorder, also the chi square value based on Bartlett's Test was 2242.947 for dysthymia, 2239.112 for oppositional defiant disorder, 1221.917 for school work problems, 5031.511 for conduct, 1421.1 for anxiety, and 7644.122 for ADHD. Since mentioned values were larger than the chi square critical values (P<0.05, it found that the factor correlation matrix is appropriate for factor analysis. Based on the findings, we can conclude that Wender Utah rating scale can be appropriately used for predicting dysthymia, oppositional defiant disorder, school work problems, conduct disorder, anxiety, in adults with ADHD.

  11. Correlation between the Movement Disorders Society Unified Parkinson's Disease rating scale (MDS-UPDRS) and the Unified Parkinson's Disease rating scale (UPDRS) during L-dopa acute challenge. (United States)

    Merello, Marcelo; Gerschcovich, Eliana Roldan; Ballesteros, Diego; Cerquetti, Daniel


    While Movement Disorders Society Unified Parkinson's Disease rating scale (MDS-UPDRS) validation has been exhaustive; performance evaluation to detect acute changes arising after administration of a single dose of L-dopa has yet to be explored. To determine the correlation between UPDRS and MDS-UPDRS during the acute challenge with Ldopa and the MDS-UPDRS equivalent to 30% cutoff score of UPDRS for defining responsiveness, 64 patients were assessed. Consecutive assessments were performed immediately before and after administration of a single dose of L-dopa/carbidopa 250/25 mg using the motor section of the UPDRS and the MDS-UPDRS. Good diagnostic accuracy, consistent with published findings of high correlation between scales was observed. Area under the curve (AUC) was 0.99 (CI = 0.97-1.00, P UPDRS and MDS-UPDRS and that the 30% of variation in UPDRS score used for predicting sustained long term L-dopa response was equivalent to 24% in MDS-UPDRS.

  12. The Structure of the Narcissistic Personality Inventory With Binary and Rating Scale Items. (United States)

    Boldero, Jennifer M; Bell, Richard C; Davies, Richard C


    Narcissistic Personality Inventory (NPI) items typically have a forced-choice format, comprising a narcissistic and a nonnarcissistic statement. Recently, some have presented the narcissistic statements and asked individuals to either indicate whether they agree or disagree that the statements are self-descriptive (i.e., a binary response format) or to rate the extent to which they agree or disagree that these statements are self-descriptive on a Likert scale (i.e., a rating response format). The current research demonstrates that when NPI items have a binary or a rating response format, the scale has a bifactor structure (i.e., the items load on a general factor and on 6 specific group factors). Indexes of factor strength suggest that the data are unidimensional enough for the NPI's general factor to be considered a measure of a narcissism latent trait. However, the rating item general factor assessed more narcissism components than the binary item one. The positive correlations of the NPI's general factor, assessed when items have a rating response format, were moderate with self-esteem, strong with a measure of narcissistic grandiosity, and weak with 2 measures of narcissistic vulnerability. Together, the results suggest that using a rating format for items enhances the information provided by the NPI.

  13. A pilot rating scale for evaluating failure transients in electronic flight control systems (United States)

    Hindson, William S.; Schroeder, Jeffery A.; Eshow, Michelle M.


    A pilot rating scale was developed to describe the effects of transients in helicopter flight-control systems on safety-of-flight and on pilot recovery action. The scale was applied to the evaluation of hardovers that could potentially occur in the digital flight-control system being designed for a variable-stability UH-60A research helicopter. Tests were conducted in a large moving-base simulator and in flight. The results of the investigation were combined with existing airworthiness criteria to determine quantitative reliability design goals for the control system.

  14. Feature analysis of the scale factor variation on a constant rate biased ring laser gyro

    Institute of Scientific and Technical Information of China (English)

    Shiqiao Qin; Zongsheng Huang; Xingshu Wang


    Scale factor of a constant rate biased ring laser gyro (RLG) is studied both theoretically and experimentally.By analyzing experimental data, we find that there are three main terms contributing to the scale factor deviation. One of them is independent of time, the second varies linearly with time and the third varies exponentially with time. Theoretical analyses show that the first term is caused by experimental setup,the second and the third are caused by un-uniform thermal expension and cavity loss variation of the RLG.

  15. High mutational rates of large-scale duplication and deletion in Daphnia pulex (United States)

    Keith, Nathan; Tucker, Abraham E.; Jackson, Craig E.; Sung, Way; Lucas Lledó, José Ignacio; Schrider, Daniel R.; Schaack, Sarah; Dudycha, Jeffry L.; Ackerman, Matthew; Younge, Andrew J.; Shaw, Joseph R.; Lynch, Michael


    Knowledge of the genome-wide rate and spectrum of mutations is necessary to understand the origin of disease and the genetic variation driving all evolutionary processes. Here, we provide a genome-wide analysis of the rate and spectrum of mutations obtained in two Daphnia pulex genotypes via separate mutation-accumulation (MA) experiments. Unlike most MA studies that utilize haploid, homozygous, or self-fertilizing lines, D. pulex can be propagated ameiotically while maintaining a naturally heterozygous, diploid genome, allowing the capture of the full spectrum of genomic changes that arise in a heterozygous state. While base-substitution mutation rates are similar to those in other multicellular eukaryotes (about 4 × 10−9 per site per generation), we find that the rates of large-scale (>100 kb) de novo copy-number variants (CNVs) are significantly elevated relative to those seen in previous MA studies. The heterozygosity maintained in this experiment allowed for estimates of gene-conversion processes. While most of the conversion tract lengths we report are similar to those generated by meiotic processes, we also find larger tract lengths that are indicative of mitotic processes. Comparison of MA lines to natural isolates reveals that a majority of large-scale CNVs in natural populations are removed by purifying selection. The mutations observed here share similarities with disease-causing, complex, large-scale CNVs, thereby demonstrating that MA studies in D. pulex serve as a system for studying the processes leading to such alterations. PMID:26518480

  16. The therapeutic effect of clinical trials: understanding placebo response rates in clinical trials – A secondary analysis

    Directory of Open Access Journals (Sweden)

    Walach Harald


    Full Text Available Abstract Background and purpose Placebo response rates in clinical trials vary considerably and are observed frequently. For new drugs it can be difficult to prove effectiveness superior to placebo. It is unclear what contributes to improvement in the placebo groups. We wanted to clarify, what elements of clinical trials determine placebo variability. Methods We analysed a representative sample of 141 published long-term trials (randomized, double-blind, placebo-controlled; duration > 12 weeks to find out what study characteristics predict placebo response rates in various diseases. Correlational and regression analyses with study characteristics and placebo response rates were carried out. Results We found a high and significant correlation between placebo and treatment response rate across diseases (r = .78; p Conclusion Medication response rates and placebo response rates in clinical trials are highly correlated. Trial characteristics can explain some portion of the variance in placebo healing rates in RCTs. Placebo response in trials is only partially due to methodological artefacts and only partially dependent on the diagnoses treated.

  17. Time Scale Analysis of Interest Rate Spreads and Output Using Wavelets

    Directory of Open Access Journals (Sweden)

    Marco Gallegati


    Full Text Available This paper adds to the literature on the information content of different spreads for real activity by explicitly taking into account the time scale relationship between a variety of monetary and financial indicators (real interest rate, term and credit spreads and output growth. By means of wavelet-based exploratory data analysis we obtain richer results relative to the aggregate analysis by identifying the dominant scales of variation in the data and the scales and location at which structural breaks have occurred. Moreover, using the “double residuals” regression analysis on a scale-by-scale basis, we find that changes in the spread in several markets have different information content for output at different time frames. This is consistent with the idea that allowing for different time scales of variation in the data can provide a fruitful understanding of the complex dynamics of economic relationships between variables with non-stationary or transient components, certainly richer than those obtained using standard time domain methods.

  18. How One Clinic Got a Big Boost in HPV Vaccination Rates (United States)

    ... One Clinic Got a Big Boost in HPV Vaccination Rates The cervical cancer vaccine was treated as ... the United States, lagging far behind other recommended vaccinations in this age group. But, by lumping HPV ...

  19. Measuring clinical management by physicians and nurses in European hospitals: development and validation of two scales



    Objective Clinical management is hypothesized to be critical for hospital management and hospital performance. The aims of this study were to develop and validate professional involvement scales for measuring the level of clinical management by physicians and nurses in European hospitals. Design Testing of validity and reliability of scales derived from a questionnaire of 21 items was developed on the basis of a previous study and expert opinion and administered in a cross-sectional seven-cou...

  20. Reliability and Validity of the Clinical Dementia Rating for Community-Living Elderly Subjects without an Informant

    Directory of Open Access Journals (Sweden)

    Ma Shwe Zin Nyunt


    Full Text Available Background: The Clinical Dementia Rating (CDR scale is widely used to assess cognitive impairment in Alzheimer's disease. It requires collateral information from a reliable informant who is not available in many instances. We adapted the original CDR scale for use with elderly subjects without an informant (CDR-NI and evaluated its reliability and validity for assessing mild cognitive impairment (MCI and dementia among community-dwelling elderly subjects. Method: At two consecutive visits 1 week apart, nurses trained in CDR assessment interviewed, observed and rated cognitive and functional performance according to a protocol in 90 elderly subjects with suboptimal cognitive performance [Mini-Mental State Examination (MMSE Results: The CDR-NI scores (0, 0.5, 1 showed good internal consistency (Crohnbach's a 0.83-0.84, inter-rater reliability (κ 0.77-1.00 for six domains and 0.95 for global rating and test-retest reliability (κ 0.75-1.00 for six domains and 0.80 for global rating, good agreement (κ 0.79 with the clinical assessment status of MCI (n = 37 and dementia (n = 4 and significant differences in the mean scores for MMSE, MOCA and Instrumental Activities of Daily Living (ANOVA global p Conclusion: Owing to the protocol of the interviews, assessments and structured observations gathered during the two visits, CDR-NI provides valid and reliable assessment of MCI and dementia in community-living elderly subjects without an informant.

  1. The association between GP and patient ratings of quality of care at outpatient clinics (United States)

    Garratt, Andrew; Iversen, Hilde; Ruud, Torleif


    Background. GPs and patients are frequently asked to evaluate mental health care, but studies including evaluations from both groups are rare. Objective. To assess the association between GPs' and patients' assessment of mental health outpatient clinic in Norway and identify important health care predictors for patient and GP satisfaction with the clinics. Methods. Two cross-sectional national surveys were carried out: survey of GPs in 2006 and patients in 2007 evaluating outpatient clinics at 69 community mental health centres in Norway. A total of 2009 GPs and 9001 outpatients assessed the clinics by means of a postal questionnaire. Main outcome measures were correlations between GP and patient ratings of the outpatient clinics at the clinic level and health care predictors for patient satisfaction and GP satisfaction with the clinics. Results. Clinic scores for GPs' and patients' assessment of waiting time were moderate to highly correlated (0.65), while clinic scores for GP and patient satisfaction had a lower but significant positive association (0.37). Significant positive correlations between clinic scores for GP and patients ratings were found for 38 of the 48 associations tested. The most important predictors for patient satisfaction with the clinics were interaction with the clinician (beta: 0.23) and being met with politeness and respect at the clinic (beta: 0.19), while the most important predictors for GP satisfaction with the clinics were perceived competence (beta: 0.25), rejection of referrals (beta: −0.17) and waiting time for patients (beta: −0.16). Conclusions. A consistent positive association between GP and patient ratings at the clinic level was identified. Mental health services aiming at improving GP and patient satisfaction should be sensitive to the fact that the two groups prioritize different health care factors. PMID:19584122


    Directory of Open Access Journals (Sweden)



    Full Text Available BACKGROUND: Incorporating herbal extracts in the formulation of toothpastes is becoming an accepted mode of chemical plaque control. Parodontax® is a herbal toothpaste designed to reduce bleeding gums and prevent gingivitis and periodontitis. The aim of the present study is to compare the clinical efficacy of commercially available dentifrice viz Parodontax®, Parodontax® with scaling and scaling alone. MATERIAL AND METHODS: Ninety patients with gingivitis had been referred to the Department of Dentistry, Adhichunchanagiri Institute of Medical Sciences. The subjects were randomly allocated into 3 groups. Group I- Parodontax® tooth paste only (n=30, Group II-Parodontax® with scaling (n=30, Group III–scaling only (n=30. Clinical parameters were assessed using Gingival Index, Plaque Index and Bleeding Index at baseline, 4 and 6 weeks. OBSERVATIONS: The results of the present study therefore have confirmed the effectiveness of initial therapy, in the form of repeated oral hygiene instruction and thorough scaling and root planning in conjunction with Parodontax, in significantly reducing the clinical parameters of gingivitis and periodontal disease. CONCLUSION: The present study revealed that when Parodontax used in conjunction with scaling and root planning has shown to be effective anti-plaque agent. Further, the combined use of parodontax with scaling and root planning has been shown to reduce gingival inflammation and sulcular bleeding significantly over 6months period. However, it is important for therapeutic products to be tested within the context of their possible use. Therefore Parodontax used as an adjunct to convention universal therapy in the treatments of patients with varying degrees of gingival and periodontal diseases, it is important for these products to be tested accordingly.

  3. The base-scale entropy analysis of short-term heart rate variability signal

    Institute of Scientific and Technical Information of China (English)

    LI Jin; NING Xinbao


    The complexity of heart rate variability (HRV) signal can reflect physiological functions and healthy status of heart system. Detecting complexity of the short-term HRV signal has an important practical meaning. We introduce the base-scale entropy method to analyze the complexity of time series. The advantages of our method are its simplicity, extremely fast calculation for very short data and anti-noise characteristic. For the well-known chaotic dynamical system―logistic map, it is shown that our complexity behaves similarly to Lyapunov exponents, and is especially effective in the presence of random Gaussian noise. This paper addresses the use of base-scale entropy method to 3 low-dimensional nonlinear deterministic systems. At last, we apply this idea to short-term HRV signal, and the result shows the method could robustly identify patterns generated from healthy and pathologic states, as well as aging. The base-scale entropy can provide convenience in practically applications.

  4. Korean Version of the Scale for the Assessment and Rating of Ataxia in Ataxic Stroke Patients


    Kim, Bo-Ram; Lee, Jin-Youn; Kim, Min Jeong; Jung, Heeyoune; Lee, Jongmin


    Objective To investigate the intra-rater and inter-rater reliability and usefulness of the Korean version of the Scale for the Assessment and Rating of Ataxia (K-SARA) in ataxic stroke patients. Methods The original SARA was translated into Korean, back translated to English, and compared to the original version. Stroke patients (n=60) with ataxia were evaluated using the K-SARA by one physiatrist and one occupational therapist. All subjects were rated twice. We divided the subjects into 5 gr...

  5. The validity of self-rating depression scales in patients with chronic widespread pain

    DEFF Research Database (Denmark)

    Amris, Kirstine; Omerovic, Emina; Danneskiold-Samsøe, Bente


    BACKGROUND: Assessment of depression in chronic pain patients by self-rating questionnaires developed and validated for use in normal and/or psychiatric populations is common. The aim of this study was to evaluate the psychometric properties of the Major Depression Inventory (MDI) in a sample...... of females with chronic widespread pain (CWP). METHOD: A total of 263 females diagnosed with CWP and referred for rehabilitation completed the MDI as part of the baseline evaluation. Rasch analysis was applied to this dataset. Rasch measurement models allow detailed analyses of an instrument's rating scale...

  6. Scale-up, retention and HIV/STI prevalence trends among female sex workers attending VICITS clinics in Guatemala.

    Directory of Open Access Journals (Sweden)

    Sonia Morales-Miranda

    Full Text Available BACKGROUND: Since 2007, Guatemala integrated STI clinical service with an HIV prevention model into four existing public health clinics to prevent HIV infection, known as the VICITS strategy. We present the first assessment of VICITS scale-up, retention, HIV and STI prevalence trends, and risk factors associated with HIV infection among Female Sex Workers (FSW attending VICITS clinics in Guatemala. METHODS: Demographic, behavioral and clinical data were collected using a standardized form. Data was analyzed by year and health center. HIV and STI prevalence were estimated from routine visits. Retention was estimated as the percent of new users attending VICITS clinics who returned for at least one follow-up visit to any VICITS clinic within 12 months. Separate multivariate logistic regression models were conducted to investigate factors associated with HIV infection and program retention. RESULTS: During 2007-2011 5,682 FSW visited a VICITS clinic for the first-time. HIV prevalence varied from 0.4% to 5.8%, and chlamydia prevalence from 0% to 14.3%, across sites. Attending the Puerto Barrios clinic, having a current syphilis infection, working primarily on the street, and using the telephone or internet to contact clients were associated with HIV infection. The number of FSW accessing VICITS annually increased from 556 to 2,557 (361% during the period. In 2011 retention varied across locations from 7.7% to 42.7%. Factors negatively impacting retention included current HIV diagnosis, having practiced sex work in another country, being born in Honduras, and attending Marco Antonio Foundation or Quetzaltenango clinic sites. Systematic time trends did not emerge, however 2008 and 2010 were characterized by reduced retention. CONCLUSIONS: Our data show local differences in HIV prevalence and clinic attendance that can be used to prioritize prevention activities targeting FSW in Guatemala. VICITS achieved rapid scale-up; however, a better understanding

  7. Regional processes in mangrove ecosystems: Spatial scaling relationships, biomass, and turnover rates following catastrophic disturbance (United States)

    Ward, G.A.; Smith, T. J.; Whelan, K.R.T.; Doyle, T.W.


    Physiological processes and local-scale structural dynamics of mangroves are relatively well studied. Regional-scale processes, however, are not as well understood. Here we provide long-term data on trends in structure and forest turnover at a large scale, following hurricane damage in mangrove ecosystems of South Florida, U.S.A. Twelve mangrove vegetation plots were monitored at periodic intervals, between October 1992 and March 2005. Mangrove forests of this region are defined by a -1.5 scaling relationship between mean stem diameter and stem density, mirroring self-thinning theory for mono-specific stands. This relationship is reflected in tree size frequency scaling exponents which, through time, have exhibited trends toward a community average that is indicative of full spatial resource utilization. These trends, together with an asymptotic standing biomass accumulation, indicate that coastal mangrove ecosystems do adhere to size-structured organizing principles as described for upland tree communities. Regenerative dynamics are different between areas inside and outside of the primary wind-path of Hurricane Andrew which occurred in 1992. Forest dynamic turnover rates, however, are steady through time. This suggests that ecological, more-so than structural factors, control forest productivity. In agreement, the relative mean rate of biomass growth exhibits an inverse relationship with the seasonal range of porewater salinities. The ecosystem average in forest scaling relationships may provide a useful investigative tool of mangrove community biomass relationships, as well as offer a robust indicator of general ecosystem health for use in mangrove forest ecosystem management and restoration. ?? Springer 2006.

  8. Evaluating clinical teachers with the Maastricht clinical teaching questionnaire : How much 'teacher' is in student ratings?

    NARCIS (Netherlands)

    Boerboom, Tobias B. B.; Mainhard, Tim; Dolmans, Diana H. J. M.; Scherpbier, Albert J. J. A.; Van Beukelen, Peter; Jaarsma, A. D. (Debbie) C.


    Background: Students are a popular source of data to evaluate the performance of clinical teachers. Instruments to obtain student evaluations must have proven validity. One aspect of validity that often remains underexposed is the possibility of effects of between-student differences and teacher and

  9. Effect of meditation on scaling behavior and complexity of human heart rate variability


    Sarkar, A.; Barat, P.


    The heart beat data recorded from samples before and during meditation are analyzed using two different scaling analysis methods. These analyses revealed that mediation severely affects the long range correlation of heart beat of a normal heart. Moreover, it is found that meditation induces periodic behavior in the heart beat. The complexity of the heart rate variability is quantified using multiscale entropy analysis and recurrence analysis. The complexity of the heart beat during mediation ...

  10. Large-scale calculations of the beta-decay rates and r-process nucleosynthesis

    Energy Technology Data Exchange (ETDEWEB)

    Borzov, I.N.; Goriely, S. [Inst. d`Astronomie et d`Astrophysique, Univ. Libre de Bruxelles, Campus Plaine, Bruxelles (Belgium); Pearson, J.M. [Inst. d`Astronomie et d`Astrophysique, Univ. Libre de Bruxelles, Campus Plaine, Bruxelles (Belgium)]|[Lab. de Physique Nucleaire, Univ. de Montreal, Montreal (Canada)


    An approximation to a self-consistent model of the ground state and {beta}-decay properties of neutron-rich nuclei is outlined. The structure of the {beta}-strength functions in stable and short-lived nuclei is discussed. The results of large-scale calculations of the {beta}-decay rates for spherical and slightly deformed nuclides of relevance to the r-process are analysed and compared with the results of existing global calculations and recent experimental data. (orig.)

  11. The endoscopy Global Rating Scale – Canada: Development and implementation of a quality improvement tool


    Donald MacIntosh; Catherine Dubé; Roger Hollingworth; Sander Veldhuyzen van Zanten; Sandra Daniels; George Ghattas


    BACKGROUND: Increasing use of gastrointestinal endoscopy, particularly for colorectal cancer screening, and increasing emphasis on health care quality highlight the need for endoscopy facilities to review the quality of the service they offer.OBJECTIVE: To adapt the United Kingdom Global Rating Scale (UK-GRS) to develop a web-based and patient-centred tool to assess and improve the quality of endoscopy services provided.METHODS: Based on feedback from 22 sites across Canada that completed the...

  12. Effect of meditation on scaling behavior and complexity of human heart rate variability

    CERN Document Server

    Sarkar, A


    The heart beat data recorded from samples before and during meditation are analyzed using two different scaling analysis methods. These analyses revealed that mediation severely affects the long range correlation of heart beat of a normal heart. Moreover, it is found that meditation induces periodic behavior in the heart beat. The complexity of the heart rate variability is quantified using multiscale entropy analysis and recurrence analysis. The complexity of the heart beat during mediation is found to be more.

  13. The reliability of a severity rating scale to measure stuttering in an unfamiliar language. (United States)

    Hoffman, Laura; Wilson, Linda; Copley, Anna; Hewat, Sally; Lim, Valerie


    With increasing multiculturalism, speech-language pathologists (SLPs) are likely to work with stuttering clients from linguistic backgrounds that differ from their own. No research to date has estimated SLPs' reliability when measuring severity of stuttering in an unfamiliar language. Therefore, this study was undertaken to estimate the reliability of SLPs' use of a 9-point severity rating (SR) scale, to measure severity of stuttering in a language that was different from their own. Twenty-six Australian SLPs rated 20 speech samples (10 Australian English [AE] and 10 Mandarin) of adults who stutter using a 9-point SR scale on two separate occasions. Judges showed poor agreement when using the scale to measure stuttering in Mandarin samples. Results also indicated that 50% of individual judges were unable to reliably measure the severity of stuttering in AE. The results highlight the need for (a) SLPs to develop intra- and inter-judge agreement when using the 9-point SR scale to measure severity of stuttering in their native language (in this case AE) and in unfamiliar languages; and (b) research into the development and evaluation of practice and/or training packages to assist SLPs to do so.

  14. Uplink Downlink Rate Balancing and Throughput Scaling in FDD Massive MIMO Systems (United States)

    Bergel, Itsik; Perets, Yona; Shamai, Shlomo


    In this work we extend the concept of uplink-downlink rate balancing to frequency division duplex (FDD) massive MIMO systems. We consider a base station with large number antennas serving many single antenna users. We first show that any unused capacity in the uplink can be traded off for higher throughput in the downlink in a system that uses either dirty paper (DP) coding or linear zero-forcing (ZF) precoding. We then also study the scaling of the system throughput with the number of antennas in cases of linear Beamforming (BF) Precoding, ZF Precoding, and DP coding. We show that the downlink throughput is proportional to the logarithm of the number of antennas. While, this logarithmic scaling is lower than the linear scaling of the rate in the uplink, it can still bring significant throughput gains. For example, we demonstrate through analysis and simulation that increasing the number of antennas from 4 to 128 will increase the throughput by more than a factor of 5. We also show that a logarithmic scaling of downlink throughput as a function of the number of receive antennas can be achieved even when the number of transmit antennas only increases logarithmically with the number of receive antennas.

  15. Measuring clinical management by physicians and nurses in European hospitals: development and validation of two scales.

    NARCIS (Netherlands)

    Plochg, T.; Arah, O.A.; Botje, D.; Thompson, C.A.; Klazinga, N.S.; Wagner, C.; Mannion, R.; Lombarts, K.


    Objective: Clinical management is hypothesized to be critical for hospital management and hospital performance. The aims of this study were to develop and validate professional involvement scales for measuring the level of clinical management by physicians and nurses in European hospitals. Design: T

  16. The Unified Parkinson's Disease Rating Scale as a predictor of peak aerobic capacity and ambulatory function. (United States)

    Ivey, Frederick M; Katzel, Leslie I; Sorkin, John D; Macko, Richard F; Shulman, Lisa M


    The Unified Parkinson's Disease Rating Scale (UPDRS) is a widely applied index of disease severity. Our objective was to assess the utility of UPDRS for predicting peak aerobic capacity (VO2 peak) and ambulatory function. Participants (n = 70) underwent evaluation for UPDRS (Total and Motor ratings), VO2 peak, 6-minute walk distance (6MW), and 30-foot self-selected walking speed (SSWS). Using regression, we determined the extent to which the Total and Motor UPDRS scores predicted each functional capacity measure after adjusting for age and sex. We also tested whether adding the Hoehn and Yahr scale (H-Y) to the model changed predictive power of the UPDRS. Adjusted for age and sex, both the Total UPDRS and Motor UPDRS subscale failed to predict VO2 peak. The Total UPDRS did weakly predict 6MW and SSWS (both p UPDRS subscale did not predict these ambulatory function tests. After adding H-Y to the model, Total UPDRS was no longer an independent predictor of 6MW but remained a predictor of SSWS. We conclude that Total and Motor UPDRS rating scales do not predict VO2 peak, but that a weak relationship exists between Total UPDRS and measures of ambulatory function.

  17. Development of the self-report version of the Zanarini Rating Scale for Borderline Personality Disorder. (United States)

    Zanarini, Mary C; Weingeroff, Jolie L; Frankenburg, Frances R; Fitzmaurice, Garrett M


    The purpose of this study was to assess the psychometric properties of the self-report version of the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD). The measure covers a 1-week time frame, and each of the nine criteria for BPD is rated on a five-point anchored rating scale of 0-4. Seventy-five subjects meeting DSM-IV criteria for BPD were recruited from the community. The convergent validity of the interview and self-report versions of the ZAN-BPD was found to be high (with a median value of 0.70). In terms of reliability, the internal consistency of the nine criteria scores of the ZAN-BPD was found to be good (Cronbach's alpha = 0.84). In addition, 13 of 14 intraclass correlations for same-day test-retest reliability were in the excellent range (> 0.75). Finally, the sensitivity of both versions of the ZAN-BPD to change was assessed 7-10 days after they were first administered and found to be adequate (e.g. r = 0.66 for total score of ZAN-BPD). Taken together, the results of this study suggest that the self-report ZAN-BPD is a promising self-report scale for the assessment of change in the severity of borderline psychopathology over time.

  18. Refined-scale panel data crash rate analysis using random-effects tobit model. (United States)

    Chen, Feng; Ma, XiaoXiang; Chen, Suren


    Random effects tobit models are developed in predicting hourly crash rates with refined-scale panel data structure in both temporal and spatial domains. The proposed models address left-censoring effects of crash rates data while accounting for unobserved heterogeneity across groups and serial correlations within group in the meantime. The utilization of panel data in both refined temporal and spatial scales (hourly record and 1-mile roadway segments on average) exhibits strong potential on capturing the nature of time-varying and spatially varying contributing variables that is usually ignored in traditional aggregated traffic accident modeling. 1-year accident data and detailed traffic, environment, road geometry and surface condition data from a segment of I-25 in Colorado are adopted to demonstrate the proposed methodology. To better understand significantly different characteristics of crashes, two separate models, one for daytime and another for nighttime, have been developed. The results show major difference in contributing factors towards crash rate between daytime and nighttime models, implying considerable needs to investigate daytime and nighttime crashes separately using refined-scale data. After the models are developed, a comprehensive review of various contributing factors is made, followed by discussions on some interesting findings.

  19. Fine-Scale Crossover Rate Variation on the Caenorhabditis elegans X Chromosome (United States)

    Bernstein, Max R.; Rockman, Matthew V.


    Meiotic recombination creates genotypic diversity within species. Recombination rates vary substantially across taxa, and the distribution of crossovers can differ significantly among populations and between sexes. Crossover locations within species have been found to vary by chromosome and by position within chromosomes, where most crossover events occur in small regions known as recombination hotspots. However, several species appear to lack hotspots despite significant crossover heterogeneity. The nematode Caenorhabditis elegans was previously found to have the least fine-scale variation in crossover distribution among organisms studied to date. It is unclear whether this pattern extends to the X chromosome given its unique compaction through the pachytene stage of meiotic prophase in hermaphrodites. We generated 798 recombinant nested near-isogenic lines (NILs) with crossovers in a 1.41 Mb region on the left arm of the X chromosome to determine if its recombination landscape is similar to that of the autosomes. We find that the fine-scale variation in crossover rate is lower than that of other model species, and is inconsistent with hotspots. The relationship of genomic features to crossover rate is dependent on scale, with GC content, histone modifications, and nucleosome occupancy being negatively associated with crossovers. We also find that the abundances of 4- to 6-bp DNA motifs significantly explain crossover density. These results are consistent with recombination occurring at unevenly distributed sites of open chromatin. PMID:27172189

  20. Experimental investigation of fuel regression rate in a HTPB based lab-scale hybrid rocket motor (United States)

    Li, Xintian; Tian, Hui; Yu, Nanjia; Cai, Guobiao


    The fuel regression rate is an important parameter in the design process of the hybrid rocket motor. Additives in the solid fuel may have influences on the fuel regression rate, which will affect the internal ballistics of the motor. A series of firing experiments have been conducted on lab-scale hybrid rocket motors with 98% hydrogen peroxide (H2O2) oxidizer and hydroxyl terminated polybutadiene (HTPB) based fuels in this paper. An innovative fuel regression rate analysis method is established to diminish the errors caused by start and tailing stages in a short time firing test. The effects of the metal Mg, Al, aromatic hydrocarbon anthracene (C14H10), and carbon black (C) on the fuel regression rate are investigated. The fuel regression rate formulas of different fuel components are fitted according to the experiment data. The results indicate that the influence of C14H10 on the fuel regression rate of HTPB is not evident. However, the metal additives in the HTPB fuel can increase the fuel regression rate significantly.

  1. Survey Response Rates and Survey Administration in Counseling and Clinical Psychology: A Meta-Analysis (United States)

    Van Horn, Pamela S.; Green, Kathy E.; Martinussen, Monica


    This article reports results of a meta-analysis of survey response rates in published research in counseling and clinical psychology over a 20-year span and describes reported survey administration procedures in those fields. Results of 308 survey administrations showed a weighted average response rate of 49.6%. Among possible moderators, response…

  2. Evaluation of the Short Parkinson's Evaluation Scale: a new friendly scale for the evaluation of Parkinson's disease in clinical drug trials. (United States)

    Rabey, J M; Bass, H; Bonuccelli, U; Brooks, D; Klotz, P; Korczyn, A D; Kraus, P; Martinez-Martin, P; Morrish, P; Van Sauten, W; Van Hilten, B


    The extensive use of the Unified Parkinson's Disease Rating Scale (UPDRS) has revealed low interrater reliability in some items and redundancy in others. In view of these shortcomings, we have structured a new scale that includes a zero-to three-point scale for each item in the evaluation of PD. The mental axis includes memory, thought disorders, and depression. Activities of daily living (ADL) includes eight items: speech, eating, feeding, dressing, hygiene, handwriting, walking, and turning in bed. The motor examination includes eight items: speech, tremor, rest and posture, rigidity, finger tapping, arising from chair, gait, and postural stability. Complications of therapy were also included: dyskinesias, dystonia, motor fluctuations, and freezing episodes, collected by history. In addition, a global scoring for motor fluctuations that should complement the Hoehn and Yahr Scale was incorporated. In this report, we present a statistical analysis of the ADL, motor evaluation, and complications of therapy sections. Concerning the interrater reliability mean, Kendall's W values were >0.9 for most of the items in the Short Parkinson's Evaluation Scale (SPES). Kendall's W <0.8 (motor evaluation) was found for two items of the SPES and nine items of the UPDRS. The mean interrater reliability for both scales across all seven centers (seven Kendall's W for seven centers) (Mann-Whitney test) showed no statistical differences between the scales. Spearman's correlations between items of both scales were significant. Factor analysis of the SPES and UPDRS data revealed a four-factor solution that explained approximately 60% of the data. All participating centers found the SPES easier to apply and quicker to complete, when compared with the UPDRS. The results obtained strongly favor the introduction of SPES for clinical practice.

  3. Phenomenological features of dreams: Results from dream log studies using the Subjective Experiences Rating Scale (SERS). (United States)

    Kahan, Tracey L; Claudatos, Stephanie


    Self-ratings of dream experiences were obtained from 144 college women for 788 dreams, using the Subjective Experiences Rating Scale (SERS). Consistent with past studies, dreams were characterized by a greater prevalence of vision, audition, and movement than smell, touch, or taste, by both positive and negative emotion, and by a range of cognitive processes. A Principal Components Analysis of SERS ratings revealed ten subscales: four sensory, three affective, one cognitive, and two structural (events/actions, locations). Correlations (Pearson r) among subscale means showed a stronger relationship among the process-oriented features (sensory, cognitive, affective) than between the process-oriented and content-centered (structural) features--a pattern predicted from past research (e.g., Bulkeley & Kahan, 2008). Notably, cognition and positive emotion were associated with a greater number of other phenomenal features than was negative emotion; these findings are consistent with studies of the qualitative features of waking autobiographical memory (e.g., Fredrickson, 2001).

  4. 99Tc(VII) Retardation, Reduction, and Redox Rate Scaling in Naturally Reduced Sediments

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Yuanyuan; Liu, Chongxuan; Kukkadapu, Ravi K.; McKinley, James P.; Zachara, John M.; Plymale, Andrew E.; Miller, Micah D.; Varga, Tamas; Resch, Charles T.


    Abstract: An experimental and modeling study was conducted to investigate pertechnetate (Tc(VII)) retardation, reduction, and rate scaling in three sediments from Ringold formation at U.S. Department of Energy’s Hanford site, where 99Tc is a major contaminant in groundwater. Tc(VII) was reduced in all the sediments in both batch reactors and diffusion columns, with a faster rate in a sediment containing a higher concentration of HCl-extractable Fe(II). Tc(VII) migration in the diffusion columns was reductively retarded with retardation degrees correlated with Tc(VII) reduction rates. The reduction rates were faster in the diffusion columns than those in the batch reactors, apparently influenced by the spatial distribution of redox-reactive minerals along transport paths that supplied Tc(VII). X-ray computed tomography and autoradiography were performed to identify the spatial locations of Tc(VII) reduction and transport paths in the sediments, and results generally confirmed the newly found behavior of reaction rate changes from batch to column. The results from this study implied that Tc(VII) migration can be reductively retarded at Hanford site with a retardation degree dependent on reactive Fe(II) content and its distribution in sediments. This study also demonstrated that an effective reaction rate may be faster in transport systems than that in well-mixed reactors.

  5. Clinical Utility of Vanderbilt Adhd Parent Rating Scale for Comorbidity in Children with Tic Disorder%V anderbilt 父母评定量表在儿童抽动障碍共患病诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    肖智辉; 周克英; 陈言钊


    [Objective] To evaluate the diagnostic value of Vanderbilt parent ADHD rating scale (VAD‐PRS) for comorbidities in children with tic disorder (TD) .[Methods] VADPRS was used for screening co‐morbidities in 136 children during a second visit in 2 weeks .And TD was diagnosed during the first visit .The DSM‐Ⅳ standard was used for confirming the diagnosis and the diagnostic differences of comorbidities between two visits were compared .[Results]VADPRS in 136 children with TD showed that there were 71(52 .21% ) children with co‐morbid ADHD ,43(31 .62% )oppositional defiant disorder (ODD) and 29(21 .32% )emotional disorders (ED) .And the differences were significant compared with comorbidities diagnosed during the first visit (χ2 =16 .672 ,P 0 .05) .The VADPRS performance part showed that significant difference existed in to‐tal impairment score .[Conclusion] VADPRS is helpful for the diagnosis of comorbidities in TD children .%【目的】探讨儿童抽动障碍(T D )共患病的诊断方法。【方法】对136例初诊为T D于2周内复诊的患儿,先采用Vanderbilt父母评定量表(Vanderbilt ADHD Parent Rating Scale ,VADPRS)进行共患病筛查,然后用DSM‐Ⅳ标准确定诊断,观察其共患病漏诊情况。【结果】136例TD患儿VADPRS筛查显示:共患注意缺陷多动障碍(attention deficit hyperactivity disorders ,ADHD)占52.21%(71/136)、对立违抗性障碍(opposi‐tional defiant disorder ,ODD)占31.62%(43/136)、情绪障碍(emotional disorders ,ED)占21.32%(29/136),与初次诊断结果差异有显著性(χ2=16.672,P <0.05;χ2=8.002,P <0.05;χ2=10.806,P <0.05)。共患品行障碍(conduct disorder ,CD)占17.65%(24/136),与初次诊断结果差异无显著性(χ2=2.425,P >0.05)。量表筛查结果与按DSM‐Ⅳ标准确定诊断差异无显著性。量表表现部分结果显示:有共

  6. The symptoms and functioning severity scale (SFSS): psychometric evaluation and discrepancies among youth, caregiver, and clinician ratings over time. (United States)

    Athay, M Michele; Riemer, Manuel; Bickman, Leonard


    This paper describes the development and psychometric evaluation of the symptoms and functioning severity scale (SFSS), which includes three parallel forms to systematically capture clinician, youth, and caregiver perspectives of youth symptoms on a frequent basis. While there is widespread consensus that different raters of youth psychopathology vary significantly in their assessment, this is the first paper that specifically investigated the discrepancies among clinician, youth, and caregiver ratings throughout the treatment process within a community mental health setting. Results for all three respondent versions indicated the SFSS is a psychometrically sound instrument for use in this population. Significant discrepancies in scores existed at baseline among the three respondents. Longitudinal analyses reveal the youth-clinician and caregiver-clinician score discrepancies decreased significantly over time. Differences by youth gender existed for caregiver-clinician discrepancies. The average youth-caregiver score discrepancy remained consistent throughout treatment. Implications for future research and clinical practice are discussed.

  7. Does a web-based feedback training program result in improved reliability in clinicians' ratings of the Global Assessment of Functioning (GAF) Scale? (United States)

    Støre-Valen, Jakob; Ryum, Truls; Pedersen, Geir A F; Pripp, Are H; Jose, Paul E; Karterud, Sigmund


    The Global Assessment of Functioning (GAF) Scale is used in routine clinical practice and research to estimate symptom and functional severity and longitudinal change. Concerns about poor interrater reliability have been raised, and the present study evaluated the effect of a Web-based GAF training program designed to improve interrater reliability in routine clinical practice. Clinicians rated up to 20 vignettes online, and received deviation scores as immediate feedback (i.e., own scores compared with expert raters) after each rating. Growth curves of absolute SD scores across the vignettes were modeled. A linear mixed effects model, using the clinician's deviation scores from expert raters as the dependent variable, indicated an improvement in reliability during training. Moderation by content of scale (symptoms; functioning), scale range (average; extreme), previous experience with GAF rating, profession, and postgraduate training were assessed. Training reduced deviation scores for inexperienced GAF raters, for individuals in clinical professions other than nursing and medicine, and for individuals with no postgraduate specialization. In addition, training was most beneficial for cases with average severity of symptoms compared with cases with extreme severity. The results support the use of Web-based training with feedback routines as a means to improve the reliability of GAF ratings performed by clinicians in mental health practice. These results especially pertain to clinicians in mental health practice who do not have a masters or doctoral degree.

  8. The multiple sclerosis rating scale, revised (MSRS-R: Development, refinement, and psychometric validation using an online community

    Directory of Open Access Journals (Sweden)

    Wicks Paul


    Full Text Available Abstract Background In developing the PatientsLikeMe online platform for patients with Multiple Sclerosis (MS, we required a patient-reported assessment of functional status that was easy to complete and identified disability in domains other than walking. Existing measures of functional status were inadequate, clinician-reported, focused on walking, and burdensome to complete. In response, we developed the Multiple Sclerosis Rating Scale (MSRS. Methods We adapted a clinician-rated measure, the Guy’s Neurological Disability Scale, to a self-report scale and deployed it to an online community. As part of our validation process we reviewed discussions between patients, conducted patient cognitive debriefing, and made minor improvements to form a revised scale (MSRS-R before deploying a cross-sectional survey to patients with relapsing-remitting MS (RRMS on the PatientsLikeMe platform. The survey included MSRS-R and comparator measures: MSIS-29, PDDS, NARCOMS Performance Scales, PRIMUS, and MSWS-12. Results In total, 816 RRMS patients responded (19% response rate. The MSRS-R exhibited high internal consistency (Cronbach’s alpha = .86. The MSRS-R walking item was highly correlated with alternative walking measures (PDDS, ρ = .84; MSWS-12, ρ = .83; NARCOMS mobility question, ρ = .86. MSRS-R correlated well with comparison instruments and differentiated between known groups by PDDS disease stage and relapse burden in the past two years. Factor analysis suggested a single factor accounting for 51.5% of variance. Conclusions The MSRS-R is a concise measure of MS-related functional disability, and may have advantages for disease measurement over longer and more burdensome instruments that are restricted to a smaller number of domains or measure quality of life. Studies are underway describing the use of the instrument in contexts outside our online platform such as clinical practice or trials. The MSRS-R is released for use under

  9. Population-Scale Sequencing Data Enable Precise Estimates of Y-STR Mutation Rates. (United States)

    Willems, Thomas; Gymrek, Melissa; Poznik, G David; Tyler-Smith, Chris; Erlich, Yaniv


    Short tandem repeats (STRs) are mutation-prone loci that span nearly 1% of the human genome. Previous studies have estimated the mutation rates of highly polymorphic STRs by using capillary electrophoresis and pedigree-based designs. Although this work has provided insights into the mutational dynamics of highly mutable STRs, the mutation rates of most others remain unknown. Here, we harnessed whole-genome sequencing data to estimate the mutation rates of Y chromosome STRs (Y-STRs) with 2-6 bp repeat units that are accessible to Illumina sequencing. We genotyped 4,500 Y-STRs by using data from the 1000 Genomes Project and the Simons Genome Diversity Project. Next, we developed MUTEA, an algorithm that infers STR mutation rates from population-scale data by using a high-resolution SNP-based phylogeny. After extensive intrinsic and extrinsic validations, we harnessed MUTEA to derive mutation-rate estimates for 702 polymorphic STRs by tracing each locus over 222,000 meioses, resulting in the largest collection of Y-STR mutation rates to date. Using our estimates, we identified determinants of STR mutation rates and built a model to predict rates for STRs across the genome. These predictions indicate that the load of de novo STR mutations is at least 75 mutations per generation, rivaling the load of all other known variant types. Finally, we identified Y-STRs with potential applications in forensics and genetic genealogy, assessed the ability to differentiate between the Y chromosomes of father-son pairs, and imputed Y-STR genotypes.

  10. Usefulness of medial temporal lobe atrophy visual rating scale in detecting Alzheimer′s disease: Preliminary study

    Directory of Open Access Journals (Sweden)

    Jae-Hyeok Heo


    Full Text Available Background: The Korean version of Mini-Mental Status Examination (K-MMSE and the Korean version of Addenbrooke Cognitive Examination (K-ACE have been validated as quick neuropsychological tests for screening dementia in various clinical settings. Medial temporal atrophy (MTA is an early pathological characteristic of Alzheimer′s disease (AD. We aimed to assess the diagnostic validity of the fusion of the neuropsychological test and visual rating scale (VRS of MTA in AD. Materials and Methods: A total of fifty subjects (25 AD, 25 controls were included. The neuropsychological tests used were the K-MMSE and the K-ACE. T1 axial imaging visual rating scale (VRS was applied for assessing the grade of MTA. We calculated the fusion score with the difference of neuropsychological test and VRS of MTA. The receiver operating characteristics (ROC curve was used to determine optimal cut-off score, sensitivity and specificity of the fusion scores in screening AD. Results: No significant differences in age, gender and education were found between AD and control group. The values of K-MMSE, K-ACE, CDR, VRS and cognitive function test minus VRS were significantly lower in the AD group than control group. The AUC (Area under the curve, sensitivity and specificity for K-MMSE minus VRS were 0.857, 84% and 80% and for K-ACE minus VRS were 0.884, 80% and 88%, respectively. Those for K-MMSE only were 0.842, 76% and 72% and for K-ACE only were 0.868, 80% and 88%, respectively. Conclusions: The fusion of the neuropsychological test and VRS suggested clinical usefulness in their easy and superiority over neuropsychological test only. However, this study failed to find any difference. This may be because of small numbers in the study or because there is no true difference.

  11. The Medical Research Council prion disease rating scale: a new outcome measure for prion disease therapeutic trials developed and validated using systematic observational studies. (United States)

    Thompson, Andrew G B; Lowe, Jessica; Fox, Zoe; Lukic, Ana; Porter, Marie-Claire; Ford, Liz; Gorham, Michele; Gopalakrishnan, Gosala S; Rudge, Peter; Walker, A Sarah; Collinge, John; Mead, Simon


    Progress in therapeutics for rare disorders like prion disease is impeded by the lack of validated outcome measures and a paucity of natural history data derived from prospective observational studies. The first analysis of the U.K. National Prion Monitoring Cohort involved 1337 scheduled clinical assessments and 479 telephone assessments in 437 participants over 373 patient-years of follow-up. Scale development has included semi-quantitative and qualitative carer interviews, item response modelling (Rasch analysis), inter-rater reliability testing, construct analysis and correlation with several existing scales. The proposed 20-point Medical Research Council prion disease rating scale assesses domains of cognitive function, speech, mobility, personal care/feeding and continence, according to their relative importance documented by carer interviews. It is quick and simple to administer, and has been validated for use by doctors and nurses and for use over the telephone, allowing for frequent assessments that capture the rapid change typical of these diseases. The Medical Research Council Scale correlates highly with widely used cognitive and single item scales, but has substantial advantages over these including minimal floor effects. Three clear patterns of decline were observed using the scale: fast linear decline, slow linear decline (usually inherited prion disease) and in some patients, decline followed by a prolonged preterminal plateau at very low functional levels. Rates of decline and progress through milestones measured using the scale vary between sporadic, acquired and inherited prion diseases following clinical expectations. We have developed and validated a new functionally-oriented outcome measure and propose that future clinical trials in prion disease should collect data compatible with this scale, to allow for combined and comparative analyses. Such approaches may be advantageous in orphan conditions, where single studies of feasible duration will

  12. Disagreements in meta-analyses using outcomes measured on continuous or rating scales: observer agreement study

    DEFF Research Database (Denmark)

    Tendal, Britta; Higgins, Julian P T; Jüni, Peter;


    OBJECTIVE: To study the inter-observer variation related to extraction of continuous and numerical rating scale data from trial reports for use in meta-analyses. DESIGN: Observer agreement study. DATA SOURCES: A random sample of 10 Cochrane reviews that presented a result as a standardised mean...... to the reviews but to the protocols, where the relevant outcome was highlighted. The agreement was analysed at both trial and meta-analysis level, pairing the observers in all possible ways (45 pairs, yielding 2025 pairs of trials and 450 pairs of meta-analyses). Agreement was defined as SMDs that differed less......% v 46%), but not at meta-analysis level. Important reasons for disagreement were differences in selection of time points, scales, control groups, and type of calculations; whether to include a trial in the meta-analysis; and data extraction errors made by the observers. In 14 out of the 100 SMDs...

  13. Very Small Scale Clustering and Merger Rate of Luminous Red Galaxies (United States)

    Masjedi, Morad; Hogg, David W.; Cool, Richard J.; Eisenstein, Daniel J.; Blanton, Michael R.; Zehavi, Idit; Berlind, Andreas A.; Bell, Eric F.; Schneider, Donald P.; Warren, Michael S.; Brinkmann, Jon


    We present the small-scale (0.01 Mpcaccount for the collisions, extensively tested against mock catalogs. We correct for photometric biases in the SDSS imaging of close galaxy pairs. We find that the correlation function ξ(r) is surprisingly close to a r-2 power law over more than 4 orders of magnitude in separation r. This result is too steep at small scales to be explained in current versions of the halo model for galaxy clustering. We infer an LRG-LRG merger rate of <~0.6×104 Gyr-1 Gpc-3 for this sample. This result suggests that the LRG-LRG mergers are not the main mode of mass growth for LRGs at z<0.36.

  14. Development of an observer rating scale for caregiver communication in persons with Alzheimer's disease. (United States)

    Williams, Christine L; Parker, Carlo


    There have been few reported studies of communication between spouses with Alzheimer's disease (AD) and related dementia. An observer rating scale for verbal and nonverbal behavior, Verbal-Nonverbal Interaction Scale for Caregivers (VNVIS-CG), was developed to study caregiver communication in couples affected by AD. Preliminary psychometric testing showed that the VNVIS-CG evidenced good reliability and validity. Researchers observed both common caregiver communication strategies and novel strategies that have not been reported in the literature. In future studies, researchers can examine the relationship between caregiver communication and indicators of mental health. Everyday conversations provide fertile ground for nurses to influence family relationships. Nurses can teach caregivers to use strategies that promote engagement and avoid those that discourage participation.

  15. Cooling rate dependence of solidification for liquid aluminium: a large-scale molecular dynamics simulation study. (United States)

    Hou, Z Y; Dong, K J; Tian, Z A; Liu, R S; Wang, Z; Wang, J G


    The effect of the cooling rate on the solidification process of liquid aluminium is studied using a large-scale molecular dynamics method. It is found that there are various types of short-range order (SRO) structures in the liquid, among which the icosahedral (ICO)-like structures are dominant. These SRO structures are in dynamic fluctuation and transform each other. The effect of the cooling rate on the microstructure is very weak at high temperatures and in supercooled liquids, and it appears only below the liquid-solid transition temperature. Fast cooling rates favour the formation of amorphous structures with ICO-like features, while slow cooling rates favour the formation of FCC crystalline structures. Furthermore, FCC and HCP structures can coexist in crystalline structures. It is also found that nanocrystalline aluminium can be achieved at appropriate cooling rates, and its formation mechanism is thoroughly investigated by tracing the evolution of nanoclusters. The arrangement of FCC and HCP atoms in the nanograins displays various twinned structures as observed using visualization analysis, which is different from the layering or phase separation structures observed in the solidification of Lennard-Jones fluids and some metal liquids.

  16. A Globally Stable Lyapunov Pointing and Rate Controller for the Magnetospheric MultiScale Mission (MMS) (United States)

    Shah, Neerav


    The Magnetospheric MultiScale Mission (MMS) is scheduled to launch in late 2014. Its primary goal is to discover the fundamental plasma physics processes of reconnection in the Earth's magnetosphere. Each of the four MMS spacecraft is spin-stabilized at a nominal rate of 3 RPM. Traditional spin-stabilized spacecraft have used a number of separate modes to control nutation, spin rate, and precession. To reduce the number of modes and simplify operations, the Delta-H control mode is designed to accomplish nutation control, spin rate control, and precession control simultaneously. A nonlinear design technique, Lyapunov's method, is used to design the Delta-H control mode. A global spin rate controller selected as the baseline controller for MMS, proved to be insufficient due to an ambiguity in the attitude. Lyapunov's design method was used to solve this ambiguity, resulting in a controller that meets the design goals. Simulation results show the advantage of the pointing and rate controller for maneuvers larger than 90 deg and provide insight into the performance of this controller.

  17. Detecting Parental Deception Using a Behavior Rating Scale during Assessment of Attention-Deficit/Hyperactivity Disorder: An Experimental Study (United States)

    Norfolk, Philip A.; Floyd, Randy G.


    It is often assumed that parents completing behavior rating scales during the assessment of attention-deficit/hyperactivity disorder (ADHD) can deliberately manipulate the outcomes of the assessment. To detect these actions, items designed to detect over-reporting or under-reporting of results are sometimes embedded in such rating scales. This…

  18. How Many Fidgets in a Pretty Much: A Critique of Behavior Rating Scales for Identifying Students with ADHD. (United States)

    Reid, Robert; Maag, John W.


    Article describes behavior rating scales and the difficulties in the use of cutoff scores to identify students as Attention-Deficit Hyperactivity Disorder. Also described are how problems with interobserver agreement hamper the validity of rating scales and the subsequent conclusions that can be drawn about students' behavior. (RJM)

  19. Generalizability and Dependability of a Multi-Item Direct Behavior Rating Scale in a Kindergarten Classroom Setting (United States)

    Wickerd, Garry; Hulac, David


    Accurate and rapid identification of students displaying behavioral problems requires instrumentation that is user friendly and reliable. The purpose of the study was to evaluate a multi-item direct behavior rating scale called the Direct Behavior Rating-Multiple Item Scale (DBR-MIS) for disruptive behavior to determine the number of…

  20. Test Review: Michael H. Epstein and Lori Synhorst "Preschool Behavioral and Emotional Rating Scale" Austin, TX--PRO-ED, 2009 (United States)

    Drevon, Daniel D.


    This article presents a review of the "Preschool Behavioral and Emotional Rating Scale" (PreBERS), a 42-item family member--or school personnel--completed rating scale designed to measure the behavioral and emotional strengths of preschool children ages 3-0 to 5-11. According to the manual, results can be used to identify preschoolers with limited…

  1. Multi-scale Modeling in Clinical Oncology: Opportunities and Barriers to Success. (United States)

    Yankeelov, Thomas E; An, Gary; Saut, Oliver; Luebeck, E Georg; Popel, Aleksander S; Ribba, Benjamin; Vicini, Paolo; Zhou, Xiaobo; Weis, Jared A; Ye, Kaiming; Genin, Guy M


    Hierarchical processes spanning several orders of magnitude of both space and time underlie nearly all cancers. Multi-scale statistical, mathematical, and computational modeling methods are central to designing, implementing and assessing treatment strategies that account for these hierarchies. The basic science underlying these modeling efforts is maturing into a new discipline that is close to influencing and facilitating clinical successes. The purpose of this review is to capture the state-of-the-art as well as the key barriers to success for multi-scale modeling in clinical oncology. We begin with a summary of the long-envisioned promise of multi-scale modeling in clinical oncology, including the synthesis of disparate data types into models that reveal underlying mechanisms and allow for experimental testing of hypotheses. We then evaluate the mathematical techniques employed most widely and present several examples illustrating their application as well as the current gap between pre-clinical and clinical applications. We conclude with a discussion of what we view to be the key challenges and opportunities for multi-scale modeling in clinical oncology.

  2. Evaluation of Mackey Childbirth Satisfaction Rating Scale in Iran: What Are the Psychometric Properties?

    Directory of Open Access Journals (Sweden)



    Full Text Available Background With the integration of the evaluation of patient satisfaction in the overall assessment of healthcare services, authorities can be assured about the alignment of these services with patient needs and the suitability of care provided at the local level. Objectives This study was conducted in 2013 in Zahedan, Iran, in order to assess the psychometric properties of the Iranian version of the mackey childbirth satisfaction rating scale (MCSRS. Patients and Methods For this study, a methodological design was used. After translating the MCSRS and confirming its initial validity, the questionnaires were distributed among women with uncomplicated pregnancies and no prior history of cesarean section. The participants had given birth to healthy, full-term, singletons (with cephalic presentation via normal vaginal delivery at hospitals within the past six months. Cronbach’s alpha and test-retest (via the intraclass correlation coefficient were applied to analyze the internal consistency and reliability of the scale. Moreover, the validity of the scale was tested via exploratory factor analysis, confirmatory factor analysis, and convergent validity. Results The MCSRS consists of six subscales. Through the process of validation, two partner-related items (“partner” subscale of the scale were excluded due to cultural barriers and hospital policies. Cronbach’s alpha for the total scale was 0.78. It ranged between 0.70 and 0.86 for five subscales, and was 0.31 for the “baby” subscale. Factor analysis confirmed the subscales of “nurse,” “physician,” and “baby,” which were identified in the original scale. However, in the translated version, the “self” subscale was divided into two separate dimensions. The six subscales explained 70.37% of the variance. Confirmatory factor analysis indicated a good fitness for the new model. Convergent validity showed a significant correlation between the MCSRS and the SERVQUAL scale (r = 0

  3. Validation of the Brazilian version of the Clinical Gait and Balance Scale and comparison with the Berg Balance Scale

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    Jussara Almeida Oliveira Baggio


    Full Text Available Objective To validate the Clinical Gait and Balance Scale (GABS for a Brazilian population of patients with Parkinson's disease (PD and to compare it to the Berg Balance Scale (BBS. Methods One hundred and seven PD patients were evaluated by shortened UPDRS motor scale (sUPDRSm, Hoehn and Yahr (HY, Schwab and England scale (SE, Falls Efficacy Scale International (FES-I, Freezing of Gait Questionnaire (FOG-Q, BBS and GABS. Results The internal consistency of the GABS was 0.94, the intra-rater and inter-rater reliability were 0.94 and 0.98 respectively. The area under the receiver operating characteristic (ROC curve was 0.72, with a sensitivity of 0.75 and specificity of 0.6, to discriminate patients with a history of falls in the last twelve months, for a cut-off score of 13 points. Conclusions Our study shows that the Brazilian version of the GABS is a reliable and valid instrument to assess gait and balance in PD.

  4. Rasch analysis in the development of a rating scale for assessment of mobility after stroke

    DEFF Research Database (Denmark)

    Engberg, A; Garde, B; Kreiner, S


    The study describes the development of a rating scale for assessment of mobility after stroke. It was based on 74 first-stroke patients, 40 men and 34 women, each assessed three times during rehabilitation. Their median age was 69 years, and they represented all degrees of severity of paresis. Co...... in the 10-item subscores; 3) the score sum is independent of age, side of hemiparesis, and gender of the patient. Latent trait analysis (Rasch) was found to be an ideal model for statistical investigation of these properties....

  5. The Verbal Rating Scale Is Reliable for Assessment of Postoperative Pain in Hip Fracture Patients

    DEFF Research Database (Denmark)

    Bech, R. D.; Lauritsen, J.; Ovesen, O.


    Background. Hip fracture patients represent a challenge to pain rating due to the high prevalence of cognitive impairment. Methods. Patients prospectively rated pain on the VRS. Furthermore, patients described the changes in pain after raising their leg, with one of five descriptors. Agreement...... of assessing possible change in pain from the selected descriptors. Cognitive status was quantified by the short Orientation-Memory-Concentration Test. Results. 110 patients were included. Paired scores with maximum disagreement of one scale point reached 97% at rest and 95% at straight leg raise. Linear....... The VRS is reliable for assessment of pain after hip fracture. The validity of intermittent questioning about possible change in pain intensity is poor....

  6. Synoptic-scale variability of satellite-derived sea-ice deformation rates in the Arctic (United States)

    Herman, A.; Głowacki, O.


    Observational data show that deformation of the compact sea ice covering the central Arctic takes place within elongated, narrow zones separating semi-rigid floes. Localization of deformation, and a related intermittent character of internal stress in the ice, cannot be satisfactorily reproduced with present state-of-the-art numerical models, especially those based on various versions of viscous-plastic rheology. Similarly, sea-ice models do not reproduce properly the observed power-law tails of deformation-rate probability distributions (pdfs), with a slope depending on the scale of the observation. In order to be able to improve the models, one needs: (i) relevant quantitative measures of ice deformation rates that the models should aim to reproduce; (ii) a better understanding of the time variability of those measures (existing studies are usually limited to the analysis of single events) and their dependence on changes of the external forcing and of the properties of the ice itself. In this study, we use gridded sea-ice total deformation rates from the RGPS data provided by the RADARSAT-1 satellite, available for 11 winter seasons with a time resolution of 3 days and a spatial resolution of 12.55 km. The analysis is based on deformation-rate pdfs obtained by means of a rank-order analysis of the data for each snapshot in the dataset. We analyze the time variability of: (i) the slope of the power-law tails of the pdfs, estimated with a maximum-likelihood method; and (ii) the moments of the pdfs for a range of exponents q and spatial scales L from the original mesh size to approximately 1000 km. In all analyzed cases, the slope of the moments as a function of the length scale L increases (faster than linearly) with increasing power q. However, the tempo of this increase can be very different. Generally, there are two distinct, dominating patterns of variability, with the first pattern describing the overall level of deformation, and the second one being generally

  7. Rating of Everyday Arm-Use in the Community and Home (REACH scale for capturing affected arm-use after stroke: development, reliability, and validity.

    Directory of Open Access Journals (Sweden)

    Lisa A Simpson

    Full Text Available OBJECTIVE: To develop a brief, valid and reliable tool [the Rating of Everyday Arm-use in the Community and Home (REACH scale] to classify affected upper limb use after stroke outside the clinical setting. METHODS: Focus groups with clinicians, patients and caregivers (n = 33 and a literature review were employed to develop the REACH scale. A sample of community-dwelling individuals with stroke was used to assess the validity (n = 96 and inter-rater reliability (n = 73 of the new scale. RESULTS: The REACH consists of separate scales for dominant and non-dominant affected upper limbs, and takes five minutes to administer. Each scale consists of six categories that capture 'no use' to 'full use'. The intraclass correlation coefficient and weighted kappa for inter-rater reliability were 0.97 (95% confidence interval: 0.95-0.98 and 0.91 (0.89-0.93 respectively. REACH scores correlated with external measures of upper extremity use, function and impairment (rho = 0.64-0.94. CONCLUSIONS: The REACH scale is a reliable, quick-to-administer tool that has strong relationships to other measures of upper limb use, function and impairment. By providing a rich description of how the affected upper limb is used outside of the clinical setting, the REACH scale fills an important gap among current measures of upper limb use and is useful for understanding the long term effects of stroke rehabilitation.

  8. Birth Rates Among Hispanics and Non-Hispanics and their Representation in Contemporary Obstetric Clinical Trials. (United States)

    Kahr, Maike K; De La Torre, Rosa; Racusin, Diana A; Suter, Melissa A; Mastrobattista, Joan M; Ramin, Susan M; Clark, Steven L; Dildy, Gary A; Belfort, Michael A; Aagaard, Kjersti M


    Objective Our study aims were to establish whether subjects enrolled in current obstetric clinical trials proportionately reflects the contemporary representation of Hispanic ethnicities and their birth rates in the United States. Methods Using comprehensive source data over a defined interval (January 2011-September 2015) on birth rates by ethnicity from the Centers for Disease Control and Prevention (CDC), we evaluated the proportional rate by ethnicity, then analyzed the observed to expected relative ratio of enrolled subjects. Results Hispanic women comprise a significant contribution to births in the United States (23% of all births). Systematic analysis of 90 published obstetric clinical trials showed a correlation between inclusion of Hispanic gravidae and the corresponding state's birth rates (r = 0.501, p < 0.001). While the mean was strongly correlated, individual clinical trials may have relatively over-enrolled (n = 31, or 34%) or under-enrolled (n = 33, or 37%) relative to their regional population. In 48% of obstetric clinical trials the Hispanic proportion of the study population was not reported. Conclusion Hispanic gravidae represent a significant number of contemporary U.S. births, and are generally adequately represented as obstetric subjects in clinical trials. However, this is trial-dependent, with significant trial-specific under- and over-enrollment of Hispanic subjects relative to the regional birth population.

  9. High frame rate photoacoustic imaging at 7000 frames per second using clinical ultrasound system. (United States)

    Sivasubramanian, Kathyayini; Pramanik, Manojit


    Photoacoustic tomography, a hybrid imaging modality combining optical and ultrasound imaging, is gaining attention in the field of medical imaging. Typically, a Q-switched Nd:YAG laser is used to excite the tissue and generate photoacoustic signals. But, such photoacoustic imaging systems are difficult to translate into clinical applications owing to their high cost, bulky size often requiring an optical table to house such lasers. Moreover, the low pulse repetition rate of few tens of hertz prevents them from being used in high frame rate photoacoustic imaging. In this work, we have demonstrated up to 7000 Hz photoacoustic imaging (B-mode) and measured the flow rate of a fast moving object. We used a ~140 nanosecond pulsed laser diode as an excitation source and a clinical ultrasound imaging system to capture and display the photoacoustic images. The excitation laser is ~803 nm in wavelength with ~1.4 mJ energy per pulse. So far, the reported 2-dimensional photoacoustic B-scan imaging is only a few tens of frames per second using a clinical ultrasound system. Therefore, this is the first report on 2-dimensional photoacoustic B-scan imaging with 7000 frames per second. We have demonstrated phantom imaging to view and measure the flow rate of ink solution inside a tube. This fast photoacoustic imaging can be useful for various clinical applications including cardiac related problems, where the blood flow rate is quite high, or other dynamic studies.

  10. Scaling of heat production by thermogenic flowers: limits to floral size and maximum rate of respiration. (United States)

    Seymour, Roger S


    Effect of size of inflorescences, flowers and cones on maximum rate of heat production is analysed allometrically in 23 species of thermogenic plants having diverse structures and ranging between 1.8 and 600 g. Total respiration rate (, micromol s(-1)) varies with spadix mass (M, g) according to in 15 species of Araceae. Thermal conductance (C, mW degrees C(-1)) for spadices scales according to C = 18.5M(0.73). Mass does not significantly affect the difference between floral and air temperature. Aroids with exposed appendices with high surface area have high thermal conductance, consistent with the need to vaporize attractive scents. True flowers have significantly lower heat production and thermal conductance, because closed petals retain heat that benefits resident insects. The florets on aroid spadices, either within a floral chamber or spathe, have intermediate thermal conductance, consistent with mixed roles. Mass-specific rates of respiration are variable between species, but reach 900 nmol s(-1) g(-1) in aroid male florets, exceeding rates of all other plants and even most animals. Maximum mass-specific respiration appears to be limited by oxygen delivery through individual cells. Reducing mass-specific respiration may be one selective influence on the evolution of large size of thermogenic flowers.

  11. The assessment of dyspnea during the vigorous intensity exercise by three Dyspnea Rating Scales in inactive medical personnel. (United States)

    Intarakamhang, Patrawut; Wangjongmeechaikul, Piyathida


    It is well recognized that exercise is good for health especially as it's known to prevent metabolic syndromes such as diabetes, hypertension and heart disease. To reap the benefits from exercise the most appropriate level of intensity must be determined, the level of intensity ranging from low, low to moderate to hard (vigorous). This study is aimed to 1. To investigate and evaluate 3 subjective rating scales. The Borg scale, the Combined Numerical Rating Scale (NRS) + FACES Dyspnea Rating Scale (FACES) and the Likert scale, during hard (vigorous) exercise. 2. To compare the effectiveness of the Borg scale and Combined Numerical Rating Scale (NRS) + FACES Dyspnea Rating Scale during the hard (vigorous) intensity exercise. This study uses a descriptive methodology. The sample group was 73 medical personnel that were leading an inactive life style, volunteers from Phramongkutklao Hospital. Participants were randomly divided into 3 groups. Group 1, those to report using the Borg Scale, group 2 using NRS + FACES, and group 3 to subjectively assess the intensity of the exercise using the Likert scale during a treadmill Exercise Stress Test (EST) using the Bruce protocol. The upper limit of the intensity in the study was equal to 85% of the maximal heart rate of all participants. The subjective reporting of the experienced level of dyspnea was undertaken immediately after the completion of exercise. The average age of participants was 23.37 years old. The 26 participants reporting using the Borg scale had mean Borg scale score of 13.46+1.77, a mode score of 15. The 24 participants reporting intensity levels through NRS +FACES had a mean NRS + FACES score of 6.83+1.09 and mode on the NRS + FACES scale equal to 7. The Likert scale group evaluated 23 participants with a mean Likert scale score of 2.74. That is those choosing Levels 2 and 3 were 6 (26.9%) and 17 participants (73.95%), respectively. Comparing the two groups with the Borg scale at equal to or greater than 15

  12. Additive scales in degenerative disease - calculation of effect sizes and clinical judgment

    Directory of Open Access Journals (Sweden)

    Riepe Matthias W


    Full Text Available Abstract Background The therapeutic efficacy of an intervention is often assessed in clinical trials by scales measuring multiple diverse activities that are added to produce a cumulative global score. Medical communities and health care systems subsequently use these data to calculate pooled effect sizes to compare treatments. This is done because major doubt has been cast over the clinical relevance of statistically significant findings relying on p values with the potential to report chance findings. Hence in an aim to overcome this pooling the results of clinical studies into a meta-analyses with a statistical calculus has been assumed to be a more definitive way of deciding of efficacy. Methods We simulate the therapeutic effects as measured with additive scales in patient cohorts with different disease severity and assess the limitations of an effect size calculation of additive scales which are proven mathematically. Results We demonstrate that the major problem, which cannot be overcome by current numerical methods, is the complex nature and neurobiological foundation of clinical psychiatric endpoints in particular and additive scales in general. This is particularly relevant for endpoints used in dementia research. 'Cognition' is composed of functions such as memory, attention, orientation and many more. These individual functions decline in varied and non-linear ways. Here we demonstrate that with progressive diseases cumulative values from multidimensional scales are subject to distortion by the limitations of the additive scale. The non-linearity of the decline of function impedes the calculation of effect sizes based on cumulative values from these multidimensional scales. Conclusions Statistical analysis needs to be guided by boundaries of the biological condition. Alternatively, we suggest a different approach avoiding the error imposed by over-analysis of cumulative global scores from additive scales.

  13. Clinical assessments of the erbium:YAG laser for soft tissue surgery and scaling. (United States)

    Watanabe, H; Ishikawa, I; Suzuki, M; Hasegawa, K


    We evaluated the clinical usefulness of an erbium:YAG laser for soft tissue surgery, and scaling. Thirty-one patients with soft tissue lesions (13 males and 18 females from 24 to 71 years old), and 60 patients with calculus deposits (21 males and 39 females from 19 to 72 years old) were treated with the laser. The clinical parameters evaluated were pain, redness, swelling of the gingiva, and the subjective patient comfort parameters including uneasiness with the sound and vibration associated with laser treatment. Additionally, hemorrhage and wound healing during and after the surgery, the roughness of the root surface after scaling, and the effectiveness of scaling using the laser were examined. Laser surgery caused less hemorrhage and resulted in better wound healing when compared with conventional methods. It was easy to remove calculi from the root surface with the laser in 95% of the cases. Although the scaled site showed some irregularity, it was not clinically significant in 98% of the cases. Only a few patients complained about the unpleasant sound and vibration. There were no complications or side effects during this clinical trial. Thus, this study suggests that an Er:YAG laser is useful for soft tissue surgery and scaling.

  14. Development and validation of the Bush-Francis Catatonia Rating Scale – Brazilian version

    Directory of Open Access Journals (Sweden)

    Ana Letícia Santos Nunes

    Full Text Available ABSTRACT Objective: This article aims to describe the adaptation and translation process of the Bush-Francis Catatonia Rating Scale (BFCRS and its reduced version, the Bush-Francis Catatonia Screening Instrument (BFCSI for Brazilian Portuguese, as well as its validation. Methods: Semantic equivalence processes included four steps: translation, back translation, evaluation of semantic equivalence and a pilot-study. Validation consisted of simultaneous applications of the instrument in Portuguese by two examiners in 30 catatonic and 30 non-catatonic patients. Results: Total scores averaged 20.07 for the complete scale and 7.80 for its reduced version among catatonic patients, compared with 0.47 and 0.20 among non-catatonic patients, respectively. Overall values of inter-rater reliability of the instruments were 0.97 for the BFCSI and 0.96 for the BFCRS. Conclusion: The scale's version in Portuguese proved to be valid and was able to distinguish between catatonic and non-catatonic patients. It was also reliable, with inter-evaluator reliability indexes as high as those of the original instrument.

  15. Factor structure of Bech's version of the Brief Psychiatric Rating Scale in Brazilian patients

    Directory of Open Access Journals (Sweden)

    J.A.S. Crippa


    Full Text Available The objective of the present study was to evaluate the factor structure of Bech's version of the Brief Psychiatric Rating Scale (BPRS, translated into Portuguese. The BPRS was administered to a heterogeneous group of psychiatric inpatients (N = 98 and outpatients (N = 62 in a University Hospital. Each patient was evaluated from one to eight times. The interval between consecutive interviews was one week for the inpatients and one month for the outpatients. The results were submitted to factorial analysis. The internal consistency of the total scale and of each factor was also estimated. Factorial analysis followed by normalized orthogonal rotation (Varimax yielded four factors: Withdrawal-Retardation, Thinking Disorder, Anxious-Depression and Activation. Internal consistency measured by Cronbach's alpha coefficient ranged from 0.766 to 0.879. The data show that the factor structure of the present instrument is similar to that of the American version of the BPRS which contains 18 items, except for the absence of the fifth factor of the latter scale, Hostile-Suspiciousness.

  16. Reliability and validity of the Chinese version of the Scale for Assessment and Rating of Ataxia

    Institute of Scientific and Technical Information of China (English)

    TAN Song; NIU Hui-xia; ZHAO Lu; GAO Yuan; LU Jia-meng; SHI Chang-he; Chandra Avinash


    Background The Scale for the Assessment and Rating of Ataxia (SARA) was shown to be a reliable and valid measurement for patients with spinocerebellar ataxia (SCA).The Brazilian version and the Japanese version of SARAwere favorable for good reliability and validity.This study aimed to translate SARA into Chinese and test its reliability and validity in measurement of cerebellar ataxia.Methods SARA was translated into Chinese.A total 39 patients with degeneration cerebellar ataxia were evaluated independently by two neurologists with the Chinese version of SARA.Then the patients were evaluated by one of above neurologists with International Cooperative Ataxia Rating Scale (ICARS).The statistical analyses were performed using SPSS 17.0 for Windows.Results The Cronbach's alpha coefficient of the Chinese version of SARA was 0.78,which represents a good internal consistence.The correlation coefficient of the Chinese version of SARA scores between the two evaluators was 0.86,illustrating that the inter-rater reliability of Chinese version of SARA was good.The correlation coefficient between the Chinese version of SARA and ICARS was 0.91,illustrating that the criterion validity of Chinese version of SARA was not bad.Conclusions The Chinese version of SARA is reliable and effective for the assessment of degeneration cerebellar ataxia.Compared with ICARS,the evaluation of Chinese version of SARA is more objective,the assessment time is shortened,and the maneuverability is better.

  17. Evaporation of Liquid Droplet in Nano and Micro Scales from Statistical Rate Theory. (United States)

    Duan, Fei; He, Bin; Wei, Tao


    The statistical rate theory (SRT) is applied to predict the average evaporation flux of liquid droplet after the approach is validated in the sessile droplet experiments of the water and heavy water. The steady-state experiments show a temperature discontinuity at the evaporating interface. The average evaporation flux is evaluated by individually changing the measurement at a liquid-vapor interface, including the interfacial liquid temperature, the interfacial vapor temperature, the vapor-phase pressure, and the droplet size. The parameter study shows that a higher temperature jump would reduce the average evaporation flux. The average evaporation flux can significantly be influenced by the interfacial liquid temperature and the vapor-phase pressure. The variation can switch the evaporation into condensation. The evaporation flux is found to remain relative constant if the droplet is larger than a micro scale, while the smaller diameters in nano scale can produce a much higher evaporation flux. In addition, a smaller diameter of droplets with the same liquid volume has a larger surface area. It is suggested that the evaporation rate increases dramatically as the droplet shrinks into nano size.

  18. Physical origin of the large-scale conformity in the specific star formation rates of galaxies

    CERN Document Server

    Kauffmann, Guinevere


    Two explanations have been put forward to explain the observed conformity between the colours and specific star formation rates (SFR/$M_*$) of galaxies on large scales: 1) the formation times of their surrounding dark matter halos are correlated (commonly referred to as "assembly bias"), 2) gas is heated over large scales at early times, leading to coherent modulation of cooling and star formation between well-separated galaxies (commonly referred to as "pre-heating") . To distinguish between the pre-heating and assembly bias scenarios, we search for relics of energetic feedback events in the neighbourhood of central galaxies with different specific star formation rates. We find a significant excess of very high mass ($\\log M_* > 11.3$) galaxies out to a distance of 2.5 Mpc around low SFR/$M_*$ central galaxies compared to control samples of higher SFR/$M_*$ central galaxies with the same stellar mass and redshift. We also find that very massive galaxies in the neighbourhood of low SFR/$M_*$ galaxies have muc...

  19. Periodontal treatment during pregnancy decreases the rate of adverse pregnancy outcome: a controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Adriana Campos Passanezi Sant'Ana


    Full Text Available OBJECTIVES: The aim of this study was to evaluate the effects of non-surgical treatment of periodontal disease during the second trimester of gestation on adverse pregnancy outcomes. MATERIAL AND METHODS: Pregnant patients during the 1st and 2nd trimesters at antenatal care in a Public Health Center were divided into 2 groups: NIG - "no intervention" (n=17 or IG- "intervention" (n=16. IG patients were submitted to a non-surgical periodontal treatment performed by a single periodontist consisting of scaling and root planning (SRP, professional prophylaxis (PROPH and oral hygiene instruction (OHI. NIG received PROPH and OHI during pregnancy and were referred for treatment after delivery. Periodontal evaluation was performed by a single trained examiner, blinded to periodontal treatment, according to probing depth (PD, clinical attachment level (CAL, plaque index (PI and sulcular bleeding index (SBI at baseline and 35 gestational weeks-28 days post-partum. Primary adverse pregnancy outcomes were preterm birth (0.05 at IG and worsening of all periodontal parameters at NIG (p<0.0001, except for PI. Signifcant differences in periodontal conditions of IG and NIG were observed at 2nd examination (p<0.001. The rate of adverse pregnancy outcomes was 47.05% in NIG and 6.25% in IG. Periodontal treatment during pregnancy was associated to a decreased risk of developing adverse pregnancy outcomes [OR=13.50; CI: 1.47-123.45; p=0.02]. CONCLUSIONS: Periodontal treatment during the second trimester of gestation contributes to decrease adverse pregnancy outcomes.

  20. Validity and test–retest reliability of the Persian version of the Montgomery–Asberg Depression Rating Scale

    Directory of Open Access Journals (Sweden)

    Ahmadpanah M


    Full Text Available Mohammad Ahmadpanah,1 Meisam Sheikhbabaei,1 Mohammad Haghighi,1 Fatemeh Roham,1 Leila Jahangard,1 Amineh Akhondi,2 Dena Sadeghi Bahmani,3 Hafez Bajoghli,4 Edith Holsboer-Trachsler,3 Serge Brand3,5 1Behavioral Disorders and Substances Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran; 2Hamadan Educational Organization, Ministry of Education, Hamadan, Iran; 3Center for Affective, Stress, and Sleep Disorders, Psychiatric Clinics of the University of Basel, Basel, Switzerland; 4Iranian National Center for Addiction Studies (INCAS, Tehran University of Medical Sciences, Tehran, Iran; 5Department of Sport, Exercise and Health Science, Sport Science Section, University of Basel, Basel, Switzerland Background and aims: The Montgomery–Asberg Depression Rating Scale (MADRS is an expert’s rating tool to assess the severity and symptoms of depression. The aim of the present two studies was to validate the Persian version of the MADRS and determine its test–retest reliability in patients diagnosed with major depressive disorders (MDD. Methods: In study 1, the translated MADRS and the Hamilton Depression Rating Scale (HDRS were applied to 210 patients diagnosed with MDD and 100 healthy adults. In study 2,200 patients diagnosed with MDD were assessed with the MADRS in face-to-face interviews. Thereafter, 100 patients were assessed 3–14 days later, again via face-to-face-interviews, while the other 100 patients were assessed 3–14 days later via a telephone interview. Results: Study 1: The MADRS and HDRS scores between patients with MDD and healthy controls differed significantly. Agreement between scoring of the MADRS and HDRS was high (r=0.95. Study 2: The intraclass correlation coefficient (test–retest reliability was r=0.944 for the face-to-face interviews, and r=0.959 for the telephone interviews. Conclusion: The present data suggest that the Persian MADRS has high validity and excellent test–retest reliability over

  1. Scaling Out and Evaluation of OBSecAn, an Automated Section Annotator for Semi-Structured Clinical Documents, on a Large VA Clinical Corpus. (United States)

    Tran, Le-Thuy T; Divita, Guy; Redd, Andrew; Carter, Marjorie E; Samore, Matthew; Gundlapalli, Adi V


    "Identifying and labeling" (annotating) sections improves the effectiveness of extracting information stored in the free text of clinical documents. OBSecAn, an automated ontology-based section annotator, was developed to identify and label sections of semi-structured clinical documents from the Department of Veterans Affairs (VA). In the first step, the algorithm reads and parses the document to obtain and store information regarding sections into a structure that supports the hierarchy of sections. The second stage detects and makes correction to errors in the parsed structure. The third stage produces the section annotation output using the final parsed tree. In this study, we present the OBSecAn method and its scale to a million document corpus and evaluate its performance in identifying family history sections. We identify high yield sections for this use case from note titles such as primary care and demonstrate a median rate of 99% in correctly identifying a family history section.

  2. Self-esteem, stress and self-rated health in family planning clinic patients

    Directory of Open Access Journals (Sweden)

    Young Rodney


    Full Text Available Abstract Background The independent effects of stress on the health of primary care patients might be different for different types of clinic populations. This study examines these relationships in a low-income female population of patients attending a family planning clinic. Methods This study investigated the relevance of different sources of personal stress and social support to self-rated health, adjusting for mental health, health behavior and demographic characteristics of subjects. Five hundred women who attended family planning clinics were surveyed and 345 completed the form for a response rate of 72 percent. Results Multiple logistic regression analysis revealed that liking oneself was related to good self-rated health (Odds ratio = 7.11, but stress or support from children, parents, friends, churches or spouses were not significant. White non-Hispanic and non-white non-Hispanic respondents had lower odds of reporting good self-rated health than Hispanic respondents (odds ratios were 2.87 and 2.81, respectively. Exercising five or more days per week also was related to good self-rated health. Smoking 20 or more cigarettes per day, and obese III were negatively related to good self-rated health (odds ratios were .19 and .22, respectively with corresponding p-values equal to .0043 and .0332. Conclusions Among younger low-income women, addressing low self-esteem might improve health status.

  3. Psychometric evaluation of the altered states of consciousness rating scale (OAV.

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    Erich Studerus

    Full Text Available BACKGROUND: The OAV questionnaire has been developed to integrate research on altered states of consciousness (ASC. It measures three primary and one secondary dimensions of ASC that are hypothesized to be invariant across ASC induction methods. The OAV rating scale has been in use for more than 20 years and applied internationally in a broad range of research fields, yet its factorial structure has never been tested by structural equation modeling techniques and its psychometric properties have never been examined in large samples of experimentally induced ASC. METHODOLOGY/PRINCIPAL FINDINGS: The present study conducted a psychometric evaluation of the OAV in a sample of psilocybin (n = 327, ketamine (n = 162, and MDMA (n = 102 induced ASC that was obtained by pooling data from 43 experimental studies. The factorial structure was examined by confirmatory factor analysis, exploratory structural equation modeling, hierarchical item clustering (ICLUST, and multiple indicators multiple causes (MIMIC modeling. The originally proposed model did not fit the data well even if zero-constraints on non-target factor loadings and residual correlations were relaxed. Furthermore, ICLUST suggested that the "oceanic boundlessness" and "visionary restructuralization" factors could be combined on a high level of the construct hierarchy. However, because these factors were multidimensional, we extracted and examined 11 new lower order factors. MIMIC modeling indicated that these factors were highly measurement invariant across drugs, settings, questionnaire versions, and sexes. The new factors were also demonstrated to have improved homogeneities, satisfactory reliabilities, discriminant and convergent validities, and to differentiate well among the three drug groups. CONCLUSIONS/SIGNIFICANCE: The original scales of the OAV were shown to be multidimensional constructs. Eleven new lower order scales were constructed and demonstrated to have desirable psychometric

  4. Effects of risperidone on core symptoms of autistic disorder based on childhood autism rating scale: An open label study

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    Padideh Ghaeli


    Full Text Available Background: The aim of the present study was to evaluate the effect of risperidone in patients afflicted by autistic disorder especially with regards to its three core symptoms, including "relating to others", "communication skills", and "stereotyped behaviors" based on Childhood Autism Rating Scale (CARS. Materials and Methods: An 8-week open-label study of risperidone for treatment of autistic disorder in children 4-17 years old was designed. Risperidone dose titration was as follow: 0.02 mg/kg/day at the first week, 0.04 mg/kg/day at the second week, and 0.06 mg/kg/day at the third week and thereafter. The outcome measures were scores obtained by CARS, Aberrant Behavior Checklist (ABC, and Clinical Global Impression-Improvement (CGI-I scale. Results: Fifteen patients completed this study. After 8 weeks, CARS total score decreased significantly, (P=0.001. At the end of the study, social interactions and verbal communication skills of the patients were significantly improved (P<0.001, P=0.03, respectively. However, stereotypic behaviors did not show any significant change in this study. Increase in appetite and somnolence were the most reported side effects. Conclusion: This study suggests that risperidone may be an effective treatment for the management of core symptoms of autistic disorder.

  5. The Worst Itch Numeric Rating Scale for patients with moderate to severe plaque psoriasis or psoriatic arthritis. (United States)

    Naegeli, April N; Flood, Emuella; Tucker, Jennifer; Devlen, Jennifer; Edson-Heredia, Emily


    Plaque psoriasis (PP) and psoriatic arthritis (PsA) are autoinflammatory chronic conditions associated with skin involvement. Pruritus, or itching, is a prevalent and bothersome symptom in patients with PP and is associated with reduced health-related quality of life. The Worst Itch Numeric Rating Scale (WI-NRS) has been developed as a simple, single item with which to assess the patient-reported severity of this symptom at its most intense during the previous 24-hour period. Qualitative research was undertaken to assess the content validity of the WI-NRS. Patients with moderate to severe PP and patients with PsA were recruited from clinical sites in the USA. The qualitative research entailed two-part interviews, which began with concept elicitation to gain understanding of patients' experiences of itching, followed by cognitive debriefing of the WI-NRS to assess the instrument's understandability, clarity, and degree of appropriateness from the patient's perspective. Twelve patients with PP and 22 with PsA participated in the study. Patients reported that itching was an important and relevant symptom of their psoriatic disease. The WI-NRS was reported to be complete and easy to understand; the recall period was considered appropriate, the response scale was familiar, and, overall, the instrument was found to be appropriate for assessing itching severity. Patient responses support the content validity of the WI-NRS. The psychometric properties of the tool will be evaluated in future studies.

  6. Translation, adaptation, and validation of the Stanford Hypnotic Clinical Scale in Puerto Rico. (United States)

    Deynes-Exclusa, Yazmin; Sayers-Montalvo, Sean K; Martinez-Taboas, Alfonso


    The only hypnotizability scale that has been translated and validated for the Puerto Rican population is the Barber Suggestibility Scale (BSS). In this article, the Stanford Hypnotic Clinical Scale (SHCS) was translated and validated for this population. The translated SHCS ("Escala Stanford de Hipnosis Clinica" [ESHC]) was administered individually to 100 Puerto Rican college students. There were no significant differences found between the norms of the original SHCS samples and the Spanish version of the SHCS. Both samples showed similar distributions. The Spanish version's internal reliability as well as the item discrimination index were adequate. The authors conclude that the ESHC is an adequate instrument to measure hypnotizability in the Puerto Rican population.

  7. Cross-Cultural Aspect of Behavior Assessment System for Children-2, Parent Rating Scale-Child: Standardization in Korean Children (United States)

    Song, Jungeun; Leventhal, Bennett L.; Koh, Yun-Joo; Cheon, Keun-Ah; Hong, Hyun Ju; Kim, Young-Key; Cho, Kyungjin; Lim, Eun-Chung; Park, Jee In


    Purpose Our study aimed to examine psychometric properties and cross-cultural utility of the Behavior Assessment System for Children-2, Parent Rating Scale-Child (BASC-2 PRS-C) in Korean children. Materials and Methods Two study populations were recruited: a general population sample (n=2115) of 1st to 6th graders from 16 elementary schools and a clinical population (n=219) of 6–12 years old from 5 child psychiatric clinics and an epidemiological sample of autism spectrum disorder. We assessed the validity and reliability of the Korean version of BASC-2 PRS-C (K-BASC-2 PRS-C) and compared subscales with those used for US populations. Results Our results indicate that the K-BASC-2 PRS-C is a valuable instrument with reliability and validity for measuring developmental psychopathology that is comparable to those in Western population. However, there were some differences noted in the mean scores of BASC-2 PRS-C between Korean and US populations. Conclusion K-BASC-2 PRS-C is an effective and useful instrument with psychometric properties that permits measurement of general developmental psychopathology. Observed Korean-US differences in patterns of parental reports of children's behaviors indicate the importance of the validation, standardization and cultural adaptation for tools assessing psychopathology especially when used in populations different from those for which the instrument was originally created. PMID:28120577

  8. Assessing relational schemas in parents of children with externalizing behavior disorders: reliability and validity of the Family Affective Attitude Rating Scale. (United States)

    Pasalich, Dave S; Dadds, Mark R; Hawes, David J; Brennan, John


    Direct observational assessment of parent-child interaction is important in clinical intervention with conduct-problem children, but is costly and resource-intensive. We examined the reliability and validity of a brief measure of parents' relational schemas (RSs) regarding their child. Children (aged 4 to 11years) and their families receiving treatment at a clinic for externalizing behavior problems (n=150) or mood/developmental disorders (n=28) were assessed using a multi-method, multi-informant procedure. RSs were coded from Five-Minute Speech Samples (FMSS) using the Family Affective Attitude Rating Scale (FAARS), and were compared with directly observed parent-child interaction and questionnaire measures of family and parental dysfunction and conduct problems. Mothers' and fathers' RS scales were internally consistent and could be reliably coded in under 10min. Less positive RSs and more negative RSs were associated with higher rates of child conduct problems, and were more characteristic of the speech samples of parents of children with externalizing disorders, compared with clinic control parents. RSs demonstrated some associations with parenting behavior and measures of family functioning and symptoms of parental psychopathology, and predicted conduct problems independently of observed parental criticism. The results demonstrate the reliability and validity of the FAARS assessment of parental RSs in clinic-referred families. This brief measure of parent-child dynamics appears well-suited to 'real-world' (i.e., community) clinical settings in which intensive methods of observation are often not feasible.

  9. Combined Student Ratings and Self-Assessment Provide Useful Feedback for Clinical Teachers (United States)

    Stalmeijer, Renee E.; Dolmans, Diana H. J. M.; Wolfhagen, Ineke H. A. P.; Peters, Wim G.; van Coppenolle, Lieve; Scherpbier, Albert J. J. A.


    Many evaluation instruments have been developed to provide feedback to physicians on their clinical teaching but written feedback alone is not always effective. We explored whether feedback effectiveness improved when teachers' self-assessment was added to written feedback based on student ratings. 37 physicians (10 residents, 27 attending…

  10. Development and Validity of the Rating Scales of Academic Skills for Reading Comprehension. (United States)

    Shapiro, Edward S; Gebhardt, Sarah; Flatley, Katie; Guard, Kirra B; Fu, Qiong; Leichman, Erin S; Calhoon, Mary Beth; Hojnoski, Robin


    The development and psychometric qualities of a measure using teacher judgment to rate performance in reading comprehension for narrative text is described-the Rating Scales for Academic Skills-Reading Comprehension Narrative (RSAS-RCN). Sixty-five teachers from the third, fourth, and fifth grades of 8 elementary schools completed the measure on 177 students. Each teacher rated students who had been identified through school-based universal screening to be below the 25th percentile, between the 25th and 74th percentile, and at or above the 75th percentile on national normative standards. Results indicated the RSAS-RCN has strong to moderate evidence of (a) 1-week test-retest reliability, (b) concurrent validity with the Group Reading Assessment and Diagnostic Evaluation (GRADE) and end of year state assessment in reading, and (c) significant classification accuracy across student ability levels. Principal component analysis and item response theory (Rasch modeling) indicate the RSAS-RCN is comprised of a single general dimension. Overall, this examination of the RSAS-RCN suggests teacher judgment may be a potentially valuable tool in assessing reading comprehension among upper elementary school students. (PsycINFO Database Record

  11. Polymethylmethacrylate-assisted ventral discectomy: Rate of pseudarthrosis and clinical outcome with a minimum follow-up of 5 years

    Directory of Open Access Journals (Sweden)

    Maier-Hauff Klaus


    Full Text Available Abstract Background Polymethylmethacrylate (PMMA assisted ventral discectomy has been criticized for high rates of graft migration and pseudarthrosis when compared with various other fusion procedures for the treatment of cervical degenerative disc disease (DDD, therefore rendering it not the preferred choice of treatment today. Recently however spine surgery has been developing towards preservation rather than restriction of motion, indicating that fusion might not be necessary for clinical success. This study presents a long term comparison of clinical and radiological data from patients with pseudarthrosis and solid arthrodesis after PMMA assisted ventral discectomy was performed. Methods From 1986 to 2004 416 patients underwent ventral discectomy and PMMA interposition for DDD. The clinical and radiological outcome was assessed for 50 of 127 eligible patients after a mean of 8.1 years. Based on postoperative radiographs the patients were dichotomized in those with a pseudarthrosis (group A and those with solid arthrodesis (group B. Results Pseudarthrosis with movement of more than 2 of the operated segment was noted in 17 cases (group A. In 33 cases no movement of the vertebral segment could be detected (group B. The analysis of the clinical data assessed through the neck disability index (NDI, the visual analogue scale (VAS of neck and arm pain and Odom's criteria did not show any significant differences between the groups. Patients from group B showed a trend to higher adjacent segment degeneration (ASD than group A (p = 0.06. This correlated with the age of the patients. Conclusions PMMA assisted discectomy shows a high rate of pseudarthrosis. But the clinical long-term success does not seem to be negatively affected by this.

  12. Validation of the Novaco Anger Scale-Provocation Inventory (Danish) With Nonclinical, Clinical, and Offender Samples

    DEFF Research Database (Denmark)

    Moeller, Stine Bjerrum; Novaco, Raymond; Heinola-Nielsen, Vivian;


    Anger has high prevalence in clinical and forensic settings, and it is associated with aggressive behavior and ward atmosphere on psychiatric units. Dysregulated anger is a clinical problem in Danish mental health care systems, but no anger assessment instruments have been validated in Danish....... Because the Novaco Anger Scale and Provocation Inventory (NAS-PI) has been extensively validated with different clinical populations and lends itself to clinical case formulation, it was selected for translation and evaluation in the present multistudy project. Psychometric properties of the NAS-PI were...... investigated with samples of 477 nonclinical, 250 clinical, 167 male prisoner, and 64 male forensic participants. Anger prevalence and its relationship with other anger measures, anxiety/depression, and aggression were examined. NAS-PI was found to have high reliability, concurrent validity, and discriminant...

  13. Do Case Rates Affect Physicians' Clinical Practice in Radiation Oncology?: An Observational Study. (United States)

    Loy, Bryan A; Shkedy, Clive I; Powell, Adam C; Happe, Laura E; Royalty, Julie A; Miao, Michael T; Smith, Gary L; Long, James W; Gupta, Amit K


    Case rate payments combined with utilization monitoring may have the potential to improve the quality of care by reducing over and under-treatment. Thus, a national managed care organization introduced case rate payments at one multi-site radiation oncology provider while maintaining only fee-for-service payments at others. This study examined whether the introduction of the payment method had an effect on radiation fractions administered when compared to clinical guidelines. The number of fractions of radiation therapy delivered to patients with bone metastases, breast, lung, prostate, and skin cancer was assessed for concordance with clinical guidelines. The proportion of guideline-based care ascertained from the payer's claims database was compared before (2011) and after (2013) the payment method introduction using relative risks (RR). After the introduction of case rates, there were no significant changes in guideline-based care in breast, lung, and skin cancer; however, patients with bone metastases and prostate cancer were significantly more likely to have received guideline-based care (RR = 2.0 and 1.1, respectively, pcase rate payments, while the over-treatment rate remained steady at 9%, with no significant change (p = 0.20). These findings suggest that the introduction of case rate payments did not adversely affect the rate of guideline-based care at the provider examined. Additional research is needed to isolate the effect of the payment model and assess implications in other populations.

  14. Psychometric properties and clinical relevance of the Adolescent Sleep Hygiene Scale in Dutch adolescents

    NARCIS (Netherlands)

    de Bruin, E.J.; van Kampen, R.K.A.; van Kooten, T.; Meijer, A.M.


    Objective: This study investigated reliability, validity, and clinical relevance of the Adolescent Sleep Hygiene Scale (ASHS) in Dutch adolescents. Methods: The Dutch translation of the ASHS was administered to 186 normal-sleeping adolescents and 112 adolescents with insomnia. Their sleep variables

  15. A review of the clinical experience in pulsed dose rate brachytherapy. (United States)

    Balgobind, Brian V; Koedooder, Kees; Ordoñez Zúñiga, Diego; Dávila Fajardo, Raquel; Rasch, Coen R N; Pieters, Bradley R


    Pulsed dose rate (PDR) brachytherapy is a treatment modality that combines physical advantages of high dose rate (HDR) brachytherapy with the radiobiological advantages of low dose rate brachytherapy. The aim of this review was to describe the effective clinical use of PDR brachytherapy worldwide in different tumour locations. We found 66 articles reporting on clinical PDR brachytherapy including the treatment procedure and outcome. Moreover, PDR brachytherapy has been applied in almost all tumour sites for which brachytherapy is indicated and with good local control and low toxicity. The main advantage of PDR is, because of the small pulse sizes used, the ability to spare normal tissue. In certain cases, HDR resembles PDR brachytherapy by the use of multifractionated low-fraction dose.

  16. Relationship between the length of the uterine cavity and clinical pregnancy rates after in vitro fertilization or intracytoplasmic sperm injection. (United States)

    Chun, Sang Sik; Chung, Min Ji; Chong, Gun Oh; Park, Kee Sang; Lee, Taek Hoo


    In this prospective clinical study involving 354 IVF-intracytoplasmic sperm injection cycles, we determined the influence of the length of the uterine cavity on clinical pregnancy rates. Our data showed that clinical pregnancy and implantation rates are associated positively with an increased length of the uterine cavity.

  17. ESMO - Magnitude of Clinical Benefit Scale V.1.0 questions and answers (United States)

    Cherny, N I; Sullivan, R; Dafni, U; Kerst, J M; Sobrero, A; Zielinski, C; Piccart, M J; Bogaerts, J; Tabernero, J; Latino, N J; de Vries, E G E


    The ESMO Magnitude of Clinical Benefit Scale (ESMO-MCBS) is a standardised, generic, validated tool to stratify the magnitude of clinical benefit that can be anticipated from anticancer therapies. The ESMO-MCBS is intended to both assist oncologists in explaining the likely benefits of a particular treatment to their patients as well as to aid public health decision makers' prioritise therapies for reimbursement. From its inception the ESMO-MCBS Working Group has invited questions and critiques to promote understanding and to address misunderstandings regarding the nuanced use of the scale, and to identify shortcomings in the scale to be addressed in future planned revisions and updates. The ESMO-MCBS V.1.0 has attracted many questions regarding its development, structure and potential applications. These questions, together with responses from the ESMO-MCBS Working Group, have been edited and collated, and are herein presented as a supplementary resource. PMID:27900206

  18. Validation of cosmogenic nuclide production rate scaling factors through direct measurement

    CERN Document Server

    Graham, I J; Ditchburn, R G; Whitehead, N E


    sup 7 Be produced in water targets by nuclear interactions of cosmic rays has been measured to determine cosmogenic nuclide production rates as a function of altitude (sea level to 2 km) and geomagnetic latitude (20-79 deg. S). Relative intensities of low energy cosmic ray neutrons have at the same time been measured using neutron monitors based on IGY/NM-64 designed to efficiently thermalise ca. 2-30 MeV neutrons. The research is on-going and we present here preliminary data from the past two years. Water target and neutron flux results are in general agreement, and are consistent with the altitude-dependent scaling factors of Lal [Earth Planet. Sci. Lett. 104 (1991) 4241]. Significant differences between the sea level, latitude-dependent neutron flux data and Lal's predictions are possibly related to the response function of the detector.

  19. Equipartition magnetic fields and star formation rates in normal galaxies at sub-kpc scales

    CERN Document Server

    Basu, Aritra


    We studied the total magnetic field strength in normal star-forming galaxies estimated using energy equipartition assumption. Using the well known radio--far infrared correlation we demonstrate that the equipartition assumption is valid in galaxies at sub-kpc scales. We find that the magnetic field strength is strongly correlated with the surface star formation rate in the galaxies NGC 6946 and NGC 5236. Further, we compare the magnetic field energy density to the total (thermal + turbulent) energy densities of gas (neutral + ionized) to identify regions of efficient field amplification in the galaxy NGC 6946. We find that in regions of efficient star formation, the magnetic field energy density is comparable to that of the total energy density of various interstellar medium components and systematically dominates in regions of low star formation efficiency.

  20. Developing the Diagnostic Adherence to Medication Scale (the DAMS for use in clinical practice

    Directory of Open Access Journals (Sweden)

    Garfield Sara


    Full Text Available Abstract Background There is a need for an adherence measure, to monitor adherence services in clinical practice, which can distinguish between different types of non-adherence and measure changes over time. In order to be inclusive of all patients it needs to be able to be administered to both patients and carers and to be suitable for patients taking multiple medications for a range of clinical conditions. A systematic review found that no adherence measure met all these criteria. We therefore wished to develop a theory based adherence scale (the DAMS and establish its content, face and preliminary construct validity in a primary care population. Methods The DAMS (consisting of 6 questions was developed from theory by a multidisciplinary team and the questions were initially tested in small patient populations. Further to this, patients were recruited when attending a General Practice and interviewed using the DAMS and two other validated self-reported adherence measures, theMorisky-8 and Lu questionnaires. A semi-structured interview was used to explore acceptability and reasons for differences in responses between the DAMS and the other measures. Descriptive data were generated and Spearman rank correlation tests were used to identify associations between the DAMS and the other adherence measures. Results One hundred patients completed the DAMS in an average of 1 minute 28 seconds and reported finding it straightforward to complete. An adherence score could not be calculated for the 4(4% patients only taking ‘when required’ medication. Thirty six(37.5% of the remaining patients reported some non-adherence. Adherence ratings of the DAMS were significantly associated with levels of self reported adherence on all other measures Spearman Rho 0.348-0.719, (p  Conclusion The DAMS has been developed for routine monitoring of adherence in clinical practice. It was acceptable to patients taking single or multiple medication and valid when

  1. Predictive capacity of risk assessment scales and clinical judgment for pressure ulcers: a meta-analysis. (United States)

    García-Fernández, Francisco Pedro; Pancorbo-Hidalgo, Pedro L; Agreda, J Javier Soldevilla


    A systematic review with meta-analysis was completed to determine the capacity of risk assessment scales and nurses' clinical judgment to predict pressure ulcer (PU) development. Electronic databases were searched for prospective studies on the validity and predictive capacity of PUs risk assessment scales published between 1962 and 2010 in English, Spanish, Portuguese, Korean, German, and Greek. We excluded gray literature sources, integrative review articles, and retrospective or cross-sectional studies. The methodological quality of the studies was assessed according to the guidelines of the Critical Appraisal Skills Program. Predictive capacity was measured as relative risk (RR) with 95% confidence intervals. When 2 or more valid original studies were found, a meta-analysis was conducted using a random-effect model and sensitivity analysis. We identified 57 studies, including 31 that included a validation study. We also retrieved 4 studies that tested clinical judgment as a risk prediction factor. Meta-analysis produced the following pooled predictive capacity indicators: Braden (RR = 4.26); Norton (RR = 3.69); Waterlow (RR = 2.66); Cubbin-Jackson (RR = 8.63); EMINA (RR = 6.17); Pressure Sore Predictor Scale (RR = 21.4); and clinical judgment (RR = 1.89). Pooled analysis of 11 studies found adequate risk prediction capacity in various clinical settings; the Braden, Norton, EMINA (mEntal state, Mobility, Incontinence, Nutrition, Activity), Waterlow, and Cubbin-Jackson scales showed the highest predictive capacity. The clinical judgment of nurses was found to achieve inadequate predictive capacity when used alone, and should be used in combination with a validated scale.

  2. Monitoring granulation rate processes using three PAT tools in a pilot-scale fluidized bed. (United States)

    Tok, Ai Tee; Goh, Xueping; Ng, Wai Kiong; Tan, Reginald B H


    The purpose of this research was to analyze and compare the responses of three Process Analytical Technology (PAT) techniques applied simultaneously to monitor a pilot-scale fluidized bed granulation process. Real-time measurements using focused beam reflectance measurement (Lasentec FBRM) and near-infra red spectroscopy (Bruker NIR) were taken by inserting in-line probes into the fluidized bed. Non-intrusive acoustic emission measurements (Physical Acoustic AE) were performed by attaching piezoelectric sensors on the external wall of the fluidized bed. Powder samples were collected at regular intervals during the granulation process and characterized offline using laser diffraction, scanning electron microscopy, stereo-optical microscopy and loss on drying method. PAT data comprising chord length distribution and chord count (from FBRM), absorption spectra (from NIR) and average signal levels and counts (from AE) were compared with the particle properties measured using offline samples. All three PAT techniques were able to detect the three granulation regimes or rate processes (wetting and nucleation, consolidation and growth, breakage) to varying degrees of sensitivity. Being dependent on optical signals, the sensitivities of the FBRM and NIR techniques were susceptible to fouling on probe windows. The AE technique was sensitive to background fluidizing air flows and external interferences. The sensitivity, strengths and weaknesses of the PAT techniques examined may facilitate the selection of suitable PAT tools for process development and scale-up studies.

  3. Changes in Heart Rate Variability after Coronary Artery Bypass Grafting and Clinical Importance of These Findings. (United States)

    Lakusic, Nenad; Mahovic, Darija; Kruzliak, Peter; Cerkez Habek, Jasna; Novak, Miroslav; Cerovec, Dusko


    Heart rate variability is a physiological feature indicating the influence of the autonomic nervous system on the heart rate. Association of the reduced heart rate variability due to myocardial infarction and the increased postinfarction mortality was first described more than thirty years ago. Many studies have unequivocally demonstrated that coronary artery bypass grafting surgery generally leads to significant reduction in heart rate variability, which is even more pronounced than after myocardial infarction. Pathophysiologically, however, the mechanisms of heart rate variability reduction associated with acute myocardial infarction and coronary artery bypass grafting are different. Generally, heart rate variability gradually recovers to the preoperative values within six months of the procedure. Unlike the reduced heart rate variability in patients having sustained myocardial infarction, a finding of reduced heart rate variability after coronary artery bypass surgery is not considered relevant in predicting mortality. Current knowledge about changes in heart rate variability in coronary patients and clinical relevance of such a finding in patients undergoing coronary artery bypass grafting are presented.

  4. Impact of dose rate on clinical course in uveal melanoma after brachytherapy with ruthenium-106

    Energy Technology Data Exchange (ETDEWEB)

    Mossboeck, G.; Rauscher, T.; Langmann, G. [Medical Univ. of Graz (Austria). Dept. of Opthalmology; Winkler, P.; Kapp, K.S. [Medical Univ. of Graz (Austria). Dept. of Therapeutic Radiology and Oncology


    Background and Purpose: It has been suggested that the actual dose rate of an irradiating source may be a distinct influencing factor for the biological effect after brachytherapy with ruthenium-106 for uveal melanoma. The purpose of this study was to investigate a hypothesized impact of the dose rate on the clinical and echographic course after brachytherapy. Patients and Methods: In total, 45 patients were included in this retrospective study. According to the actual dose rate, two groups were defined: group 1 with a dose rate < 4 Gy/h and group 2 with a dose rate {>=} 4 Gy/h. Regarding age, tumor height, basal diameter, scleral and apical dose, differences between the groups were not significant. Clinical parameters, including early and late side effects, and echographic courses were compared. Results: A significantly lower metastatic rate was found in group 2. Using univariate Cox proportional hazards regression, only dose rate predicted metastatic spread significantly (p < 0.05), while in a multivariate analysis, using age at the time of treatment, greatest tumor height and greatest basal diameter as covariates, the variable dose rate was of borderline significance (p = 0.077). Patients in group 2 had more early side effects and more pronounced visual decline, but these differences were of borderline significance with p-values of 0.072 and 0.064, respectively. Conclusion: These data suggest that a higher dose rate may confer a lower risk for metastatic spread, but may be associated with more side effects and more pronounced visual decline. (orig.)

  5. The South African triage scale (adult version) provides valid acuity ratings when used by doctors and enrolled nursing assistants


    Michèle Twomey; Lee A. Wallis; Mary Lou Thompson; Myers, Jonathan E


    Objective: To estimate the validity of triage ratings by South African nurses and doctors with training and practical experience using the South African Triage Scale. Methods: Five emergency physicians and 10 enrolled nursing assistants, who had been trained in the use of the South African Triage Scale, were selected via convenience sampling to retrospectively triage adult emergency centre vignettes. Participants independently assigned triage ratings to 100 written vignettes unaware of the...

  6. Per-beam, planar IMRT QA passing rates do not predict clinically relevant patient dose errors

    Energy Technology Data Exchange (ETDEWEB)

    Nelms, Benjamin E.; Zhen Heming; Tome, Wolfgang A. [Canis Lupus LLC and Department of Human Oncology, University of Wisconsin, Merrimac, Wisconsin 53561 (United States); Department of Medical Physics, University of Wisconsin, Madison, Wisconsin 53705 (United States); Departments of Human Oncology, Medical Physics, and Biomedical Engineering, University of Wisconsin, Madison, Wisconsin 53792 (United States)


    Purpose: The purpose of this work is to determine the statistical correlation between per-beam, planar IMRT QA passing rates and several clinically relevant, anatomy-based dose errors for per-patient IMRT QA. The intent is to assess the predictive power of a common conventional IMRT QA performance metric, the Gamma passing rate per beam. Methods: Ninety-six unique data sets were created by inducing four types of dose errors in 24 clinical head and neck IMRT plans, each planned with 6 MV Varian 120-leaf MLC linear accelerators using a commercial treatment planning system and step-and-shoot delivery. The error-free beams/plans were used as ''simulated measurements'' (for generating the IMRT QA dose planes and the anatomy dose metrics) to compare to the corresponding data calculated by the error-induced plans. The degree of the induced errors was tuned to mimic IMRT QA passing rates that are commonly achieved using conventional methods. Results: Analysis of clinical metrics (parotid mean doses, spinal cord max and D1cc, CTV D95, and larynx mean) vs IMRT QA Gamma analysis (3%/3 mm, 2/2, 1/1) showed that in all cases, there were only weak to moderate correlations (range of Pearson's r-values: -0.295 to 0.653). Moreover, the moderate correlations actually had positive Pearson's r-values (i.e., clinically relevant metric differences increased with increasing IMRT QA passing rate), indicating that some of the largest anatomy-based dose differences occurred in the cases of high IMRT QA passing rates, which may be called ''false negatives.'' The results also show numerous instances of false positives or cases where low IMRT QA passing rates do not imply large errors in anatomy dose metrics. In none of the cases was there correlation consistent with high predictive power of planar IMRT passing rates, i.e., in none of the cases did high IMRT QA Gamma passing rates predict low errors in anatomy dose metrics or vice versa

  7. Using COSI-CORR to Quantify Earthflow Movement Rates Over Decadal Time Scales (United States)

    Cerovski-Darriau, C.; Roering, J. J.


    Large, complex earthflow systems can evolve over diverse (seasonal to millennial) timescales and thus require a range of tools to document their kinematics. In many areas, extensive archives of historical aerial photographs offer potential for quantifying decadal fluctuations, but tracking individual features has been impractical over significant temporal and spatial scales. Here, we explore recent software that automates landslide mapping and improves feasibility of tracking deformation at these scales. The Co-registration of Optically Sensed Images and Correlation (COSI-Corr) software allows for correlation between air photographs and LiDAR imagery, and tracks surface deformation over a sequence of aerial surveys. To analyze the efficacy for landslides, we focused on a 1km2 area riddled with active earthflows, shallow landslides, and gullying in the Waipaoa River catchment on the North Island of New Zealand. This area is dominated by Late Cretaceous-Early Tertiary clay-rich mudstones and calcite-rich sandstones with highly sheared and more massive units that fail in diverse fashion. Starting in the 1900s, the area was burned and converted to pastureland, and is now heavily grazed by sheep and cattle. Slope deformation in the study area has accelerated due to this history of land use changes. We used aerial photographs from 1956, 1960, 1979, and 1982 to track slide movement. The photos were scanned at 1200 dpi (21 micron), giving a ground resolution between approximately 0.2-1m/pixel (scale of 1:16000 to 1:47000). We rectified the photos with 2010 orthophotos and a corresponding 1m LiDAR DEM and hillshade map using the COSI-Corr interface in ENVI 4.5. They were then sequentially correlated, which automatically identifies surface changes with sub-pixel resolution. Next we generated a vector field displacement map for each time step with 8m grid nodes. The resulting vector maps show velocities ranging from about 1-5m/yr. This corresponds well with previously

  8. Ocean-scale patterns in community respiration rates along continuous transects across the Pacific Ocean. (United States)

    Wilson, Jesse M; Severson, Rodney; Beman, J Michael


    Community respiration (CR) of organic material to carbon dioxide plays a fundamental role in ecosystems and ocean biogeochemical cycles, as it dictates the amount of production available to higher trophic levels and for export to the deep ocean. Yet how CR varies across large oceanographic gradients is not well-known: CR is measured infrequently and cannot be easily sensed from space. We used continuous oxygen measurements collected by autonomous gliders to quantify surface CR rates across the Pacific Ocean. CR rates were calculated from changes in apparent oxygen utilization and six different estimates of oxygen flux based on wind speed. CR showed substantial spatial variation: rates were lowest in ocean gyres (mean of 6.93 mmol m(-3) d(-1)±8.0 mmol m(-3) d(-1) standard deviation in the North Pacific Subtropical Gyre) and were more rapid and more variable near the equator (8.69 mmol m(-3) d(-1)±7.32 mmol m(-3) d(-1) between 10°N and 10°S) and near shore (e.g., 5.62 mmol m(-3) d(-1)±45.6 mmol m(-3) d(-1) between the coast of California and 124°W, and 17.0 mmol m(-3) d(-1)±13.9 mmol m(-3) d(-1) between 156°E and the Australian coast). We examined how CR varied with coincident measurements of temperature, turbidity, and chlorophyll concentrations (a proxy for phytoplankton biomass), and found that CR was weakly related to different explanatory variables across the Pacific, but more strongly related to particular variables in different biogeographical areas. Our results indicate that CR is not a simple linear function of chlorophyll or temperature, and that at the scale of the Pacific, the coupling between primary production, ocean warming, and CR is complex and variable. We suggest that this stems from substantial spatial variation in CR captured by high-resolution autonomous measurements.

  9. Test-retest reliability of the Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) scale. (United States)

    Gustafsson, Margareta; Blomberg, Karin; Holmefur, Marie


    The Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) scale evaluates the student nurses' perception of the learning environment and supervision within the clinical placement. It has never been tested in a replication study. The aim of the present study was to evaluate the test-retest reliability of the CLES + T scale. The CLES + T scale was administered twice to a group of 42 student nurses, with a one-week interval. Test-retest reliability was determined by calculations of Intraclass Correlation Coefficients (ICCs) and weighted Kappa coefficients. Standard Error of Measurements (SEM) and Smallest Detectable Difference (SDD) determined the precision of individual scores. Bland-Altman plots were created for analyses of systematic differences between the test occasions. The results of the study showed that the stability over time was good to excellent (ICC 0.88-0.96) in the sub-dimensions "Supervisory relationship", "Pedagogical atmosphere on the ward" and "Role of the nurse teacher". Measurements of "Premises of nursing on the ward" and "Leadership style of the manager" had lower but still acceptable stability (ICC 0.70-0.75). No systematic differences occurred between the test occasions. This study supports the usefulness of the CLES + T scale as a reliable measure of the student nurses' perception of the learning environment within the clinical placement at a hospital.

  10. EFRT M-12 Issue Resolution: Caustic Leach Rate Constants from PEP and Laboratory-Scale Tests

    Energy Technology Data Exchange (ETDEWEB)

    Mahoney, Lenna A.; Rassat, Scot D.; Eslinger, Paul W.; Aaberg, Rosanne L.; Aker, Pamela M.; Golovich, Elizabeth C.; Hanson, Brady D.; Hausmann, Tom S.; Huckaby, James L.; Kurath, Dean E.; Minette, Michael J.; Sundaram, S. K.; Yokuda, Satoru T.


    concentrated to nominally 20 wt% solids using cross-flow ultrafiltration before adding caustic. The work described in this report addresses the kinetics of caustic leach under WTP conditions, based on tests performed with a Hanford waste simulant. The tests were completed at the lab-scale and in the PEP, which is a 1/4.5-scale mock-up of key PTF process equipment. The purpose of this report is to summarize the results from both scales that are related to caustic leach chemistry to support a scale-up factor for the submodels to be used in the G2 model, which predicts WTP operating performance. The scale-up factor will take the form of an adjustment factor for the rate constant in the boehmite leach kinetic equation in the G2 model.

  11. Examining the factor structure of the Clinical Opiate Withdrawal Scale: A secondary data analysis from the National Drug Abuse Treatment Clinical Trials Network (CTN) 0003 (United States)

    Barbosa-Leiker, Celestina; McPherson, Sterling; Mamey, Mary Rose; Burns, G. Leonard; Layton, Matthew E.; Roll, John; Ling, Walter


    Background The Clinical Opiate Withdrawal Scale (COWS) is used to assess withdrawal in clinical trials and practice. The aims of this study were to examine the inter-item correlations and factor structure of the COWS in opioid-dependent men and women. Methods This is a secondary data analysis of the National Drug Abuse Treatment Clinical Trials Network 0003, a randomized clinical trial that compared buprenorphine/naloxone tapering strategies. The trial included 11 sites in 10 US cities. Participants were opioid-dependent individuals (n=516) that had data on the COWS. The COWS at study baseline was analyzed in this study. Results Inter-item correlations showed weak to moderate relationships among the items. A 1-factor model did not fit the data for men (comparative fit index (CFI)=.801, root mean square error of approximation (RMSEA)=.073, weighted root mean square residual (WRMR)=1.132) or women (CFI=.694, RMSEA=.071, WRMR=.933), where resting pulse rate was not related to withdrawal for men, and yawning and gooseflesh skin was not related to withdrawal for women. A reduced model comprised of only the 8 items that were significantly related to the construct of withdrawal in both men and women, and an exploratory 2-factor model, were also assessed but not retained due to inconsistencies across gender. Conclusions When traditional psychometric models are applied to the COWS, it appears that the scale may not relate to a single underlying construct of withdrawal. Further research testing the hypothesized factor structure in other opioid-dependent samples is needed. PMID:25908321

  12. Do Case Rates Affect Physicians' Clinical Practice in Radiation Oncology?: An Observational Study.

    Directory of Open Access Journals (Sweden)

    Bryan A Loy

    Full Text Available Case rate payments combined with utilization monitoring may have the potential to improve the quality of care by reducing over and under-treatment. Thus, a national managed care organization introduced case rate payments at one multi-site radiation oncology provider while maintaining only fee-for-service payments at others. This study examined whether the introduction of the payment method had an effect on radiation fractions administered when compared to clinical guidelines. The number of fractions of radiation therapy delivered to patients with bone metastases, breast, lung, prostate, and skin cancer was assessed for concordance with clinical guidelines. The proportion of guideline-based care ascertained from the payer's claims database was compared before (2011 and after (2013 the payment method introduction using relative risks (RR. After the introduction of case rates, there were no significant changes in guideline-based care in breast, lung, and skin cancer; however, patients with bone metastases and prostate cancer were significantly more likely to have received guideline-based care (RR = 2.0 and 1.1, respectively, p<0.05. For the aggregate of all cancers, the under-treatment rate significantly declined (p = 0.008 from 4% to 0% after the introduction of case rate payments, while the over-treatment rate remained steady at 9%, with no significant change (p = 0.20. These findings suggest that the introduction of case rate payments did not adversely affect the rate of guideline-based care at the provider examined. Additional research is needed to isolate the effect of the payment model and assess implications in other populations.

  13. Clinical utility of the Snaith-Hamilton-Pleasure scale in the Chinese settings

    Directory of Open Access Journals (Sweden)

    Liu Wen-hua


    Full Text Available Abstract Background The Snaith-Hamilton-Pleasure-Scale (SHAPS is a self-reported scale evaluating anhedonia for neuropsychiatric disorders. It has demonstrated with impressive psychometric properties and advantages in its applicability over other similar instruments. However, very few studies have been conducted to examine the clinical utility of the SHAPS in the context of Chinese settings. The current study aimed to examine the clinical utility of the translated version of the SHAPS in the Chinese clinical settings. Methods A Chinese version of SHAPS was administered to 336 college students to examine the internal consistency and test-retest reliability at a 4-week interval. Moreover, the translated SHAPS was also administered to 141 patients with major depression, 72 patients with schizophrenia, and 72 healthy controls to examine its clinical discrimination. Results The internal consistency of the SHAPS for the non-clinical sample and test-retest reliability at a 4- week interval were 0.85 and 0.64, respectively. Moreover, the SHAPS also showed an excellent internal consistency (alpha was 0.93 and a one-factor solution with the first factor accounted for 51.53% of the variance in the clinical psychiatric samples. ANOVA of the SHAPS total score indicated that the patients with depression scored significantly more anhedonia than the patients with schizophrenia and healthy controls (p Conclusions These findings suggest that the Chinese version of the SHAPS is a useful and promising instrument in assessing anhedonia for clinical patients and non-clinical individuals in the Chinese settings.

  14. Telephone reminders reduced the non-attendance rate in a gastroenterology outpatient clinic

    DEFF Research Database (Denmark)

    Jeppesen, Maja Haunstrup; Ainsworth, Mark Andrew


    in a gastroenterology outpatient clinic like ours. METHODS: This was a comparative intervention study with a historical control group in a gastroenterology outpatient clinic. The study lasted six months. Patients with a scheduled appointment in the first three-month period received no reminder (control group, n = 2......,705). Patients in the following three-month period were reminded by telephone one weekday in advance of their appointment, when possible (intervention group, n = 2,479). Non-attending patients in the intervention group received a questionnaire. Based on the results, a financial cost-benefit analysis was made......-attendees. The most common explanation for non-attendance in the intervention group was forgetfulness (39%). The reminder telephone call was cost-effective. CONCLUSION: In this outpatient clinic, telephone reminders were cost-effective and significantly reduced the non-attendance rate by 43%....

  15. Frequency, Clinical Correlates, and Ratings of Behavioral Changes in Primary Brain Tumor Patients: A Preliminary Investigation


    Simpson, Grahame K.; Eng-Siew eKoh; Diane eWhiting; Wright, Kylie M.; Teresa eSimpson; Rochelle eFirth; Lauren eGillett; Kathryn eYounan


    Purpose Few studies have addressed the specific behavioral changes associated with primary brain tumor (PBT). This paper will report on the frequency and demographic/clinical correlates of such behaviors, and the reliability of rating such behaviors among people with PBT, family informants, and clinicians. The association of behavioral changes and patient functional status will also be discussed. Methods A total of 57 patients with 37 family informants were recruited from two large...

  16. Validity and reliability of menopause rating scale in colombian indigenous population

    Directory of Open Access Journals (Sweden)

    Álvaro Monterrosa-Castro


    Full Text Available The Menopause Rating Scale (MRS measures quality of life in menopausal women. It compounds of three dimensions that assess somatic, psychological and urogenital menopausal-related symptoms. However, the validity of the scales may vary according to population characteristics, and there are no validations to date of MRS in American indigenous population. To assess the validity of MRS in Indigenous Colombian women during menopause. A research was done a sample of 914 indigenous women, 507 postmenopausal women and 407 premenopausal. They were between 40-49 years-old, with a mean age of 59.3 ± 5.9years. MRS was applied to all enrolled women. Cronbach's alpha was applied for the original proposed dimensions, and the dimensions from the results of factor analysis and maximum likelihood methods. A Promax rotation was applied to analysis. MRS showed a Cronbach's alpha: 0.86. The somatic dimension: 0.63, the psychological dimension: 0.75, and urogenital: 0.84. Score was greater in postmenopausal compared to premenopausal, 14.4 (±SD, 6.4 versus 8.4 (±SD, 5.9 (P<0.001. The factor analysis showed two dimensions. The first dimension included items 1,7,8,9,10,11; and accounted for 39.9% of variance. The second dimension included items 2,3,4,5,6; explaining 14.2% of variance. Cronbach's alpha was 0.86 for the first dimension and 0.81 for the second dimension. MRS showed high internal consistency and adequate nomological validity. The factor analysis resulted in two dimensions. These results evidence the need to better assess the validity of the instruments in different populations.

  17. Dumping syndrome following gastric bypass: validation of the dumping symptom rating scale. (United States)

    Laurenius, Anna; Olbers, Torsten; Näslund, Ingmar; Karlsson, Jan


    There is a lack of prevalent data for dumping syndrome (DS) and methods discriminating between different symptoms of the DS. A self-assessment questionnaire, the Dumping Symptom Rating Scale (DSRS), was developed. The aim was to measure the severity and frequency of nine dumping symptoms and to evaluate the construct validity of the DSRS. Pre- and 1 and 2 years after Roux-en-Y gastric bypass surgery, 47 adults and 82 adolescents completed the DSRS. Cognitive interview was performed. Reliability and construct validity were tested. Effect sizes (ES) of changes were calculated. Patients found the questionnaire relevant. A high proportion of the respondents reported no symptoms affecting them negatively at all (floor effects). However, 12 % stated, quite severe, severe, or very severe problems regarding fatigue after meal and half of them were so tired that they needed to lie down. Nearly 7 % reported quite severe, severe, or very severe problems dominated by nausea and 6 % dominated by fainting esteem. The internal consistency reliability was adequate for both severity (0.81-0.86) and frequency (0.76-0.84) scales. ES were small, since some subjects experienced symptoms already preoperatively. Although most patients reported no or mild dumping symptoms 1 and 2 years after gastric bypass surgery, around 12 % had persistent symptoms, in particular, postprandial fatigue, and needed to lie down. Another 7 % had problems with nausea and 6 % had problems with fainting esteem. The DSRS is a reliable screening tool to identify these patients.

  18. Grain-Size Based Additivity Models for Scaling Multi-rate Uranyl Surface Complexation in Subsurface Sediments

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Xiaoying; Liu, Chongxuan; Hu, Bill X.; Hu, Qinhong


    The additivity model assumed that field-scale reaction properties in a sediment including surface area, reactive site concentration, and reaction rate can be predicted from field-scale grain-size distribution by linearly adding reaction properties estimated in laboratory for individual grain-size fractions. This study evaluated the additivity model in scaling mass transfer-limited, multi-rate uranyl (U(VI)) surface complexation reactions in a contaminated sediment. Experimental data of rate-limited U(VI) desorption in a stirred flow-cell reactor were used to estimate the statistical properties of the rate constants for individual grain-size fractions, which were then used to predict rate-limited U(VI) desorption in the composite sediment. The result indicated that the additivity model with respect to the rate of U(VI) desorption provided a good prediction of U(VI) desorption in the composite sediment. However, the rate constants were not directly scalable using the additivity model. An approximate additivity model for directly scaling rate constants was subsequently proposed and evaluated. The result found that the approximate model provided a good prediction of the experimental results within statistical uncertainty. This study also found that a gravel-size fraction (2 to 8 mm), which is often ignored in modeling U(VI) sorption and desorption, is statistically significant to the U(VI) desorption in the sediment.

  19. Criterion Noise in Ratings-Based Recognition: Evidence from the Effects of Response Scale Length on Recognition Accuracy (United States)

    Benjamin, Aaron S.; Tullis, Jonathan G.; Lee, Ji Hae


    Rating scales are a standard measurement tool in psychological research. However, research has suggested that the cognitive burden involved in maintaining the criteria used to parcel subjective evidence into ratings introduces "decision noise" and affects estimates of performance in the underlying task. There has been debate over whether…

  20. [Attention deficit hyperactivity disorder in adults. Benchmarking diagnosis using the Wender-Reimherr adult rating scale]. (United States)

    Rösler, M; Retz, W; Retz-Junginger, P; Stieglitz, R D; Kessler, H; Reimherr, F; Wender, P H


    We report on a study comparing different systems for the diagnosis of attention deficit hyperactivity disorder (ADHD) in adulthood. Recruited for evaluation were 168 patients referred to our ADHD outpatient unit. We used the Diagnostic and Statistical Manual of Mental Disorders 4th edn. (DSM-IV), International Classification of Diseases 10th edn. (ICD-10), and Utah criteria for diagnostic assessment and the Wender Utah rating scale, ADHD Self Report (ADHD-SR), and Wender Reimherr Adult Attention Deficit Disorder Rating Scale as psychopathological assessment tools. We present basic psychometric data of the Wender-Reimherr Interview (WRI). Internal consistency was determined as 0.82 (alpha). The inter-rater reliability was 1.0 (kappa coefficient) regarding ADHD diagnoses, and the ICC was 0.98 referring to the WRI total scores. The convergent validity with the ADHD-SR was 0.65 (Spearman coefficient). In 126 of 168 patients an ADHD diagnosis was made according to at least one of the three systems. The DSM-IV diagnostic set led to 119 ADHD diagnoses. As compared with the two other systems, this is about the minimum level for an ADHD diagnosis. All of the 87 ADHD diagnoses according to ICD-10 were covered by DSM-IV. The ICD-10 had no independent psychopathological items and therefore offered no additional points for the diagnostic procedure than the DSM-IV. The situation regarding Utah criteria is different. These criteria contain seven psychopathological domains: inattention, hyperactivity, disorganisation, impulsivity, affective lability, overreactivity, and hot temper. They can be assessed by use of the WRI. Ninety-three of 168 patients were diagnosed as having ADHD according to the Utah concept, which is much lower than with the DSM-IV. The particular definition of the disorder by the Utah criteria resulted in seven patients having only a Utah diagnosis but no DSM-IV diagnosis. Thus we are in a position to say that the Utah criteria have a relatively high level for

  1. Change of International Restless Legs Syndrome Study Group Rating Scale subscales with treatment and placebo: a pilot study

    Directory of Open Access Journals (Sweden)

    Mitchell UH


    Full Text Available Ulrike H Mitchell,1 Sterling C Hilton2 1Brigham Young University, Department of Exercise Sciences, 2Department of Educational Leadership and Foundations, Provo, UT, USA Background: In 2003, the 10-question International Restless Legs Syndrome Study Group Rating Scale (IRLS was developed as a means of assessing the severity of restless legs syndrome. Two subscales were identified: symptom severity (SS 1 and symptom impact (SS 2. Only one study has investigated the subscales' responsiveness to a 12-week treatment with ropinirole. This current study was undertaken to assess the impact of a 4-week, non-pharmaceutical treatment on the two subscales and to explore whether or not both subscales were impacted by the observed placebo effect. Methods: The pooled data from questionnaires of 58 patients (41 from both treatment groups and 17 from the sham treatment control group, who participated in two clinical studies, were reviewed. Their change in score over a 4-week trial was computed. The average change in both subscales in both groups was computed and t-tests were performed. Results: In the treatment group, the average scores of both subscales changed significantly from baseline to week 4 (P<0.005 for both. Compared to the control, SS 1 changed (P<0.001, but not SS 2 (P=0.18. In the sham treatment group, the scores for SS 1 changed significantly (P=0.002, but not for SS 2 (P=0.2. Conclusion: This study corroborated findings from an earlier study in which both subscales changed with a 12-week drug treatment. It also showed that the observed placebo effect is attributed to a small but significant change in symptom severity, but not symptom impact. Keywords: restless legs syndrome, RLS severity scale, IRLS subscales, symptom impact, symptom severity

  2. Parent-Youth Rating Concordance for Hair Pulling Variables, Functional Impairment, and Anxiety Scale Scores in Trichotillomania (United States)

    Keuthen, Nancy J.; Flessner, Christopher A.; Woods, Douglas W.; Franklin, Martin E.; Piacentini, John A.; Khanna, Muniya; Moore, Phoebe; Cashin, Susan


    Knowledge of cross-informant rating concordance is critical for the assessment of child and adolescent problems in clinical and research settings. We explored parent-youth rating concordance for hair pulling variables, functional impairment, and anxiety symptoms in a sample of child and adolescent hair pullers (n = 133) satisfying conservative…

  3. Multi-scale modeling of the impact response of a strain-rate sensitive high-manganese austenitic steel


    Canadinç, Demircan; Önal, Orkun; Özmenci, Cemre


    A multi-scale modeling approach was applied to predict the impact response of a strain rate sensitive high-manganese austenitic steel. The roles of texture, geometry, and strain rate sensitivity were successfully taken into account all at once by coupling crystal plasticity and finite element (FE) analysis. Specifically, crystal plasticity was utilized to obtain the multi-axial flow rule at different strain rates based on the experimental deformation response under uniaxial ten...

  4. The visual aura rating scale as an outcome predictor for persistent visual aura without infarction. (United States)

    Wang, Y-F; Fuh, J-L; Chen, W-T; Wang, S-J


    Persistent visual aura without infarction is rare. Its pathogenic mechanism is unknown, and the response to migraine prophylactic agents varies. A systematic analysis of 29 patients (23 from the literature and six in the present report; 6M/23F, mean age 37.6 years) was carried out in terms of demographics, headache and visual symptom profiles, treatment regimens and outcomes. Patterns of visual disturbances (VDs) were re-assessed with the Visual Aura Rating Scale (VARS, score 0-10). Even though the majority of patients had headache improvement, only eight (27.6%) had complete resolution of persistent VD, without definite relevance to any specific agent. Patients with complete resolution of VD tended to have scotoma (50.0% vs. 0%; P = 0.003), unilateral/homonymous involvement (62.5% vs. 9.5%; P = 0.008), higher VARS scores (1.88 +/- 1.73 vs. 0.10 +/- 0.30; P outcome. For those with a potential for complete resolution, improvement would occur early in the course.

  5. Relationship between Fractal Dimension and Spectral Scaling Decay Rate in Computer-Generated Fractals

    Directory of Open Access Journals (Sweden)

    Alexander J. Bies


    Full Text Available Two measures are commonly used to describe scale-invariant complexity in images: fractal dimension (D and power spectrum decay rate (β. Although a relationship between these measures has been derived mathematically, empirical validation across measurements is lacking. Here, we determine the relationship between D and β for 1- and 2-dimensional fractals. We find that for 1-dimensional fractals, measurements of D and β obey the derived relationship. Similarly, in 2-dimensional fractals, measurements along any straight-line path across the fractal’s surface obey the mathematically derived relationship. However, the standard approach of vision researchers is to measure β of the surface after 2-dimensional Fourier decomposition rather than along a straight-line path. This surface technique provides measurements of β that do not obey the mathematically derived relationship with D. Instead, this method produces values of β that imply that the fractal’s surface is much smoother than the measurements along the straight lines indicate. To facilitate communication across disciplines, we provide empirically derived equations for relating each measure of β to D. Finally, we discuss implications for future research on topics including stress reduction and the perception of motion in the context of a generalized equation relating β to D.

  6. Large-scale variation in boreal and temperate forest carbon turnover rate related to climate (United States)

    Thurner, Martin; Beer, Christian; Carvalhais, Nuno; Forkel, Matthias; Santoro, Maurizio; Tum, Markus; Schmullius, Christiane


    Vegetation carbon turnover processes in forest ecosystems and their dominant drivers are far from being understood at a broader scale. Many of these turnover processes act on long timescales and include a lateral dimension and thus can hardly be investigated by plot-level studies alone. Making use of remote sensing-based products of net primary production (NPP) and biomass, here we show that spatial gradients of carbon turnover rate (k) in Northern Hemisphere boreal and temperate forests are explained by different climate-related processes depending on the ecosystem. k is related to frost damage effects and the trade-off between growth and frost adaptation in boreal forests, while drought stress and climate effects on insects and pathogens can explain an elevated k in temperate forests. By identifying relevant processes underlying broadscale patterns in k, we provide the basis for a detailed exploration of these mechanisms in field studies, and ultimately the improvement of their representations in global vegetation models (GVMs).

  7. Validation of the Italian version of the Movement Disorder Society--Unified Parkinson's Disease Rating Scale. (United States)

    Antonini, Angelo; Abbruzzese, Giovanni; Ferini-Strambi, Luigi; Tilley, Barbara; Huang, Jing; Stebbins, Glenn T; Goetz, Christopher G; Barone, Paolo; Bandettini di Poggio, Monica; Fabbrini, Giovanni; Di Stasio, Flavio; Tinazzi, Michele; Bovi, Tommaso; Ramat, Silvia; Meoni, Sara; Pezzoli, Gianni; Canesi, Margherita; Martinelli, Paolo; Maria Scaglione, Cesa Lorella; Rossi, Aroldo; Tambasco, Nicola; Santangelo, Gabriella; Picillo, Marina; Morgante, Letterio; Morgante, Francesca; Quatrale, Rocco; Sensi, MariaChiara; Pilleri, Manuela; Biundo, Roberta; Nordera, Giampietro; Caria, Antonella; Pacchetti, Claudio; Zangaglia, Roberta; Lopiano, Leonardo; Zibetti, Maurizio; Zappia, Mario; Nicoletti, Alessandra; Quattrone, Aldo; Salsone, Maria; Cossu, Gianni; Murgia, Daniela; Albanese, Alberto; Del Sorbo, Francesca


    The Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) has been available in English since 2008. As part of this process, the MDS-UPDRS organizing team developed guidelines for development of official non-English translations. We present here the formal process for completing officially approved non-English versions of the MDS-UPDRS and specifically focus on the first of these versions in Italian. The MDS-UPDRS was translated into Italian and tested in 377 native-Italian speaking PD patients. Confirmatory and exploratory factor analyses determined whether the factor structure for the English-language MDS-UPDRS could be confirmed in data collected using the Italian translation. To be designated an 'Official MDS translation,' the Comparative Fit Index (CFI) had to be ≥0.90 relative to the English-language version. For all four parts of the Italian MDS-UPDRS, the CFI, in comparison with the English-language data, was ≥0.94. Exploratory factor analyses revealed some differences between the two datasets, however these differences were considered to be within an acceptable range. The Italian version of the MDS-UPDRS reaches the criterion to be designated as an Official Translation and is now available for use. This protocol will serve as outline for further validation of this in multiple languages.

  8. Capturing Age-group Differences and Developmental Change with the BASC Parent Rating Scales. (United States)

    Barbot, Baptiste; Hein, Sascha; Luthar, Suniya S; Grigorenko, Elena L


    Estimation of age-group differences and intra-individual change across distinct developmental periods is often challenged by the use of age-appropriate (but non-parallel) measures. We present a short version of the Behavior Assessment System (Reynolds & Kamphaus, 1998), Parent Rating Scales for Children (PRS-C) and Adolescents (PRS-A), which uses only their common-items to derive estimates of the initial constructs optimized for developmental studies. Measurement invariance of a three-factor model (Externalizing, Internalizing, Adaptive Skills) was tested across age-groups (161 mothers using PRS-C; 200 mothers using PRS-A) and over time (115 mothers using PRS-C at baseline and PRS-A five years later) with the original versus short PRS. Results indicated that the short PRS holds a sufficient level of invariance for a robust estimation of age-group differences and intra-individual change, as compared to the original PRS, which held only weak invariance leading to flawed developmental inferences. Importance of test-content parallelism for developmental studies is discussed.

  9. The role of reactant unmixedness, strain rate, and length scale on premixed combustor performance

    Energy Technology Data Exchange (ETDEWEB)

    Samuelsen, S.; LaRue, J.; Vilayanur, S. [Univ. of California, Irvine, CA (United States)] [and others


    Lean premixed combustion provides a means to reduce pollutant formation and increase combustion efficiency. However, fuel-air mixing is rarely uniform in space and time. This nonuniformity in concentration will lead to relative increases in pollutant formation and decreases in combustion efficiency. The nonuniformity of the concentration at the exit of the premixer has been defined by Lyons (1981) as the {open_quotes}unmixedness.{close_quotes} Although turbulence properties such as length scales and strain rate are known to effect unmixedness, the exact relationship is unknown. Evaluating this relationship and the effect of unmixedness in premixed combustion on pollutant formation and combustion efficiency are an important part of the overall goal of US Department of Energy`s Advanced Turbine Systems (ATS) program and are among the goals of the program described herein. The information obtained from ATS is intended to help to develop and commercialize gas turbines which have (1) a wide range of operation/stability, (2) a minimal amount of pollutant formation, and (3) high combustion efficiency. Specifically, with regard to pollutants, the goals are to reduce the NO{sub x} emissions by at least 10%, obtain less than 20 PPM of both CO and UHC, and increase the combustion efficiency by 5%.

  10. Modeling responses and response times in personality tests with rating scales

    Directory of Open Access Journals (Sweden)

    Jochen Ranger


    Full Text Available In this article several latent trait models for the joint distribution of the responses and response times in rating scales are compared. Among these models are two generalizations of established models for binary items, namely a generalization of the approach of Ferrando and Lorenzo-Seva (2007a and a generalization of the approach of Ranger and Ortner (2011. Two new models and a variant of the hierarchical model of van der Linden (2007 are also considered. All these models combine the graded response model with a response time model based on the log-normal distribu-tion. The models differ in the assumed relationship between the expected log response time and the underlying latent traits. Although the proposed models have different interpretations and implications they can all be calibrated within the same general framework using marginal maximum likelihood estimation and an application of the ECM-algorithm. The models are used for the analysis of an empirical data set. According to the AIC index, the generalization of the model of Ranger and Ortner (2011 can represent the data best.

  11. Is the Mattis Dementia Rating Scale appropriate to detect Mild Cognitive Impairment?

    Directory of Open Access Journals (Sweden)

    Anabel Belaus


    Full Text Available Some studies have tried to assess the Mattis Dementia Rating Scale (MDRS capability to detect incipient dementia or Mild Cognitive Impairment (MCI, but the results are not clear. The aim of this research was to evaluate the sensitivity and specificity of the MDRS, and to localize the optimal cutoff score for MCI. Methodology. A neuropsychological battery that included the MDRS was administered to 60 older adults of both genders (Mean age=68.38, SD=6.80 in Cór- doba, Argentina, who were then classified as “Control” (34 cases or “MCI” (26 cases according to performance in the neuropsychological evaluation, excluding the MDRS. The criteria used were those stated by the Sociedad Española de Neurología. We performed mean comparisons in order to evaluate if the MDRS was able to detect the group differences. Then, a logistic regression with the MDRS total score as the predictor variable and the group as the criterion variable was performed to determine the cutoff score. Results. Even though the mean comparisons showed a significant difference in the MDRS (p=.004, the diagnostic accuracy was only 63% with a 133 points cutoff score. The sensitivity was 42% and the specificity was 79%. Conclusions. The MDRS does not seem to be a useful tool to detect MCI since it generates numerous misclassified cases. The development of more accurate tools becomes fundamental in order to detect MCI.

  12. Cumulative clinical pregnancy rates after COH and IUI in subfertile couples. (United States)

    Farhi, Jacob; Orvieto, Raoul


    To evaluate the influence of female age and cause of infertility on the outcome of controlled ovarian hyperstimulation (COH) and intrauterine insemination (IUI), we studied 2717 COH cycles in 1035 subfertile couples. The cumulative clinical pregnancy rates were 39% and 58% after three and six COH cycles, respectively. The cumulative pregnancy rate significantly decreased with maternal age and differed by cause of infertility. The cumulative pregnancy rate continued to increase with an increase in COH cycle number up to the third, or forth cycle, in patients with mechanical and combined infertility, respectively, and in up to the second cycle in patients aged 40 years or more. These findings provide treatment guidelines for clinicians in determining the likelihood of treatment success and the point at which to proceed to the next treatment strategy.

  13. Respiratory rates measured by a standardised clinical approach, ward staff, and a wireless device

    DEFF Research Database (Denmark)

    Granholm, A; Pedersen, N E; Lippert, A.


    BACKGROUND: Respiratory rate is among the first vital signs to change in deteriorating patients. The aim was to investigate the agreement between respiratory rate measurements by three different methods. METHODS: This prospective observational study included acutely admitted adult patients...... in a medical ward. Respiratory rate was measured by three methods: a standardised approach over 60 s while patients lay still and refrained from talking, by ward staff and by a wireless electronic patch (SensiumVitals). The Bland-Altman method was used to compare measurements and three breaths per minute (BPM...... of agreement were -13.3 (95% CI: -17.2 to -9.5) BPM and 16.8 (95% CI: 13.0 to 20.6) BPM. CONCLUSION: A concerning lack of agreement was found between a wireless monitoring system and a standardised clinical approach. Ward staff's measurements also seemed to be inaccurate....

  14. Modulation of Leaf Economic Traits and Rates by Soil Properties, at Global Scale (United States)

    Maire, V.; Wright, I. J.; Reich, P. B.; Batjes, N. H., Jr.; van Bodegom, P. M.; Bhaskar, R.; Santiago, L. S.; Ellsworth, D.; Niinemets, U.; Cornwell, W.


    now be taken into account in broad-scale analyses, and that effects uniquely attributable to soil properties are important determinants of leaf photosynthetic traits and rates. Understanding what soils tell us (that climate does not) is an important step to progress towards more reliable modelling of global vegetation function.

  15. Ocean-scale patterns in community respiration rates along continuous transects across the Pacific Ocean.

    Directory of Open Access Journals (Sweden)

    Jesse M Wilson

    Full Text Available Community respiration (CR of organic material to carbon dioxide plays a fundamental role in ecosystems and ocean biogeochemical cycles, as it dictates the amount of production available to higher trophic levels and for export to the deep ocean. Yet how CR varies across large oceanographic gradients is not well-known: CR is measured infrequently and cannot be easily sensed from space. We used continuous oxygen measurements collected by autonomous gliders to quantify surface CR rates across the Pacific Ocean. CR rates were calculated from changes in apparent oxygen utilization and six different estimates of oxygen flux based on wind speed. CR showed substantial spatial variation: rates were lowest in ocean gyres (mean of 6.93 mmol m(-3 d(-1±8.0 mmol m(-3 d(-1 standard deviation in the North Pacific Subtropical Gyre and were more rapid and more variable near the equator (8.69 mmol m(-3 d(-1±7.32 mmol m(-3 d(-1 between 10°N and 10°S and near shore (e.g., 5.62 mmol m(-3 d(-1±45.6 mmol m(-3 d(-1 between the coast of California and 124°W, and 17.0 mmol m(-3 d(-1±13.9 mmol m(-3 d(-1 between 156°E and the Australian coast. We examined how CR varied with coincident measurements of temperature, turbidity, and chlorophyll concentrations (a proxy for phytoplankton biomass, and found that CR was weakly related to different explanatory variables across the Pacific, but more strongly related to particular variables in different biogeographical areas. Our results indicate that CR is not a simple linear function of chlorophyll or temperature, and that at the scale of the Pacific, the coupling between primary production, ocean warming, and CR is complex and variable. We suggest that this stems from substantial spatial variation in CR captured by high-resolution autonomous measurements.

  16. A quick and easy-to-use clinical scale to assess balance in Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Lieberman A


    Full Text Available Abraham Lieberman,1 Sara Dhanani,1 Rohit Dhall,1 Di Pan21Muhammad Ali Parkinson Center (MAPC of Barrow Neurological Institute, St Joseph's Hospital and Medical Center, Phoenix, AZ, USA; 2Center for Health Information and Research, Arizona State University, Tempe, AZ, USABackground: Balance difficulty is a major contributor to falls in Parkinson's disease (PD. However, the new Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS motor examination contains only one subtest – postural instability – and it is only 3% of the total that assesses balance. There are several balance scales, but they were not developed for PD and they do not complement the MDS-UPDRS. There is a need for a quick and easy-to-use balance scale in PD and one that complements the MDS-UPDRS.Methods: The Barrow Neurological Institute (BNI balance scale was developed as a complement to the MDS-UPDRS and was used to evaluate the risk of falling in 53 PD patients. There were nine patients who fell three times per month ("fallers". The BNI scale was compared with the widely used Tinetti scale. The Tinetti scale has 16 subtests; the BNI scale has five.Results: The nine fallers had a significantly longer PD duration, a higher MDS-UPDRS score, a higher (worse BNI balance score, and a lower (worse Tinetti score compared to 44 nonfallers. Fallers were significantly more impaired on the MDS-UPDRS subtest of postural stability and on the BNI scale. A BNI scale score ≥ 13 had a sensitivity of 100% and a specificity of 88.6% in identifying fallers, whereas a Tinetti scale score ≤ 18 had a sensitivity of 55.6% and a specificity of 95.5% in identifying fallers. The BNI scale with five subtests is easier to perform than the Tinetti with 16 subtests.Conclusion: The BNI balance scale is more sensitive and specific in predicting falls than the Tinetti. It is a useful adjunct to the MDS-UPDRS.Keywords: balance, falls, Parkinson’s disease, Tinetti scale

  17. Clinical and Laboratory Presentation of Hairy Cell Leukemia (Hcl and Rate of Response to Cladribine

    Directory of Open Access Journals (Sweden)

    M Forat Yazdi


    Full Text Available Introduction: HCL is a rare malignant condition that is curable if diagnosed early. HCL can present with reduced blood cells and splenomegaly which maybe misdiagnosed with other conditions. The aim of the present study was to determine the frequency of early clinical and laboratory findings as well as the response rate of patients to the standard treatment regimen of Cladribine. Methods: The study was an uncontrolled clinical trial including 25 HCL patients referring to Oncology Clinics of Shahid Sadoughi (Yazd - Iran and Shahid Beheshti (Tehran - Iran between 1999 and 2005. Data was gathered by a pre–designed questionnaire. 21 out of 25 patients were treated with Cladribine and the clinical and laboratory response was assessed. Results: Of the 25 patients studied, 20 patients (80% were male and 5 patients (20% were female. Most of the patients at diagnosis were 55–67 years old and the most common presenting symptom was fatigue and lassitude secondary to anemia. Two patients were asymptomatic and were diagnosed incidentally. Splenomegaly was the main clinical finding which was present in about 80% of the males and all of the females. Accordingly, hairy cells in the peripheral blood smear, leukopenia and anemia were the most common laboratory findings. In contrast to previous results, pancytopenia was found in only 60% of the patients. Response rate was 90% (19 out of 21 of which 61.9% (13 patients and 28.5% (6 patients had complete remission (CR and partial remission (PR, respectively. Conclusion: According to the results, it can be concluded that HCL should be considered as a possible diagnosis in the context of fatigue, splenomegaly and reduced blood cell count. The results of the present study were similar to other similar international studies.

  18. Optimization and scale-up of Wharton's jelly-derived mesenchymal stem cells for clinical applications. (United States)

    Nekanti, Usha; Mohanty, Lipsa; Venugopal, Parvathy; Balasubramanian, Sudha; Totey, Satish; Ta, Malancha


    MSCs are promising candidates for stem cell therapy and regenerative medicine. Umbilical cord is the easiest obtainable biological source of MSCs and the Wharton's jelly of the umbilical cord is a rich source of fetus-derived stem cells. However, the use of MSCs for therapeutic application is based on their subsequent large-scale in vitro expansion. A fast and efficient protocol for generation of large quantities of MSCs is required to meet the clinical demand and biomedical research needs. Here we have optimized conditions for scaling up of WJ-MSCs. Low seeding density along with basic fibroblast growth factor (bFGF) supplementation in the growth medium, which is DMEM-KO, resulted in propagation of more than 1 x 10(8) cells within a time period of 15 days from a single umbilical cord. The upscaled WJ-MSCs retained their differentiation potential and immunosuppressive capacity. They expressed the typical hMSC surface antigens and the addition of bFGF in the culture medium did not affect the expression levels of HLA-DR and CD 44. A normal karyotype was confirmed in the large-scale expanded WJ-MSCs. Hence, in this study we attempted rapid clinical-scale expansion of WJ-MSCs which would allow these fetus-derived stem cells to be used for various allogeneic cell-based transplantations and tissue engineering.

  19. Validation of cross-cultural child mental health and psychosocial research instruments: adapting the Depression Self-Rating Scale and Child PTSD Symptom Scale in Nepal

    Directory of Open Access Journals (Sweden)

    Tol Wietse A


    Full Text Available Abstract Background The lack of culturally adapted and validated instruments for child mental health and psychosocial support in low and middle-income countries is a barrier to assessing prevalence of mental health problems, evaluating interventions, and determining program cost-effectiveness. Alternative procedures are needed to validate instruments in these settings. Methods Six criteria are proposed to evaluate cross-cultural validity of child mental health instruments: (i purpose of instrument, (ii construct measured, (iii contents of construct, (iv local idioms employed, (v structure of response sets, and (vi comparison with other measurable phenomena. These criteria are applied to transcultural translation and alternative validation for the Depression Self-Rating Scale (DSRS and Child PTSD Symptom Scale (CPSS in Nepal, which recently suffered a decade of war including conscription of child soldiers and widespread displacement of youth. Transcultural translation was conducted with Nepali mental health professionals and six focus groups with children (n = 64 aged 11-15 years old. Because of the lack of child mental health professionals in Nepal, a psychosocial counselor performed an alternative validation procedure using psychosocial functioning as a criterion for intervention. The validation sample was 162 children (11-14 years old. The Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS and Global Assessment of Psychosocial Disability (GAPD were used to derive indication for treatment as the external criterion. Results The instruments displayed moderate to good psychometric properties: DSRS (area under the curve (AUC = 0.82, sensitivity = 0.71, specificity = 0.81, cutoff score ≥ 14; CPSS (AUC = 0.77, sensitivity = 0.68, specificity = 0.73, cutoff score ≥ 20. The DSRS items with significant discriminant validity were "having energy to complete daily activities" (DSRS.7, "feeling that life is not worth living" (DSRS.10, and

  20. Effect of Rating Scales and Test Parts of Body on the Evaluation Results of Fabric-evoked Prickle

    Institute of Scientific and Technical Information of China (English)

    WANG Ge-hui; RON Postle; ZHANG Wei-yuan


    The effect of rating scales and test parts of body on the fabric-evoked prickle evaluation results are studied by carrying out subjective evaluation tests under controlled environment conditions (24±1)℃, (65±5) %RH. Ten college female students aged about 20 were chosen as the subjects, who have participated a preliminary training on subjective prickle evaluation. The prickle of a range of 9 light-weight worsted woven wool and wool blend fabrics and a cotton fabric were tested by using a 1 - 5 rating scale and using a 0 - 10 rating scale respectively at different test parts of body respectively such as forearm, upper arm ball and neck back. The test results were statistically analyzed. It is found that there is a significant correlation coefficient between the evaluation results of using the 1 - 5 rating scale and of using the 0 - 10 rating scale. It is also found that there are highly significant correlation coefficients between the evaluation results of using the forearm prickle test and the neck back prickle test, between the evaluation results of using the neck back prickle test and the upper arm ball prickle test, and between the evaluation results of using the forearm prickle test and the upper arm ball prickle test. It is suggested that the forearm prickle test is preferable in evaluating fabric-evoked prickle for its convenience and sensitivity.

  1. High heart rate: more than a risk factor. Lessons from a clinical practice survey. (United States)

    Barrios, Vivencio; Escobar, Carlos; Bertomeu, Vicente; Murga, Nekane; de Pablo, Carmen; Asín, Enrique


    Several epidemiological studies have reported that an elevated heart rate (HR) is associated with coronary atherosclerosis independently of other risk factors. Nevertheless, it is still unclear whether HR is itself the cause or there is merely an association between HR and mortality in this population. A total of 1686 patients with hypertension and chronic ischemic heart disease were included in this study. According to the resting HR, the patients were distributed in 3 groups (group 1: HR82 bpm). 580 patients (34.4%) belonged to group 1; 936 (55.5%) to group 2 and 170 (10.1%) to group 3. Patients with high HR exhibited a poorer prognosis not only due to a worse clinical profile (more concomitant cardiovascular risk factors and organ damage), but suggestively because despite the use of a similar number of drugs, patients with higher HR were associated with lesser risk control rates in daily clinical practice. Despite current guidelines that do not still recognize HR as a cardiovascular risk factor, it appears that physicians should pay more attention to it in clinical practice since high HR is warning about an increased risk.

  2. Depression and anxiety in patients with rheumatoid arthritis: prevalence rates based on a comparison of the Depression, Anxiety and Stress Scale (DASS and the hospital, Anxiety and Depression Scale (HADS

    Directory of Open Access Journals (Sweden)

    Covic Tanya


    Full Text Available Abstract Background While it is recognised that depression is prevalent in Rheumatoid Arthritis (RA, recent studies have also highlighted significant levels of anxiety in RA patients. This study compared two commonly used scales, the Depression Anxiety and Stress Scale (DASS and the Hospital Anxiety and Depression Scale (HADS, in relation to their measurement range and cut points to consider the relative prevalence of both constructs, and if prevalence rates may be due to scale-specific case definition. Methods Patients meeting the criteria for RA were recruited in Leeds, UK and Sydney, Australia and asked to complete a survey that included both scales. The data was analysed using the Rasch measurement model. Results A total of 169 RA patients were assessed, with a repeat subsample, resulting in 323 cases for analysis. Both scales met Rasch model expectations. Using the 'possible+probable' cut point from the HADS, 58.3% had neither anxiety nor depression; 13.5% had anxiety only; 6.4% depression only and 21.8% had both 'possible+probable' anxiety and depression. Cut points for depression were comparable across the two scales while a lower cut point for anxiety in the DASS was required to equate prevalence. Conclusions This study provides further support for high prevalence of depression and anxiety in RA. It also shows that while these two scales provide a good indication of possible depression and anxiety, the estimates of prevalence so derived could vary, particularly for anxiety. These findings are discussed in terms of comparisons across studies and selection of scales for clinical use.

  3. Serum α-klotho concentrations during preimplantation can predict aging or quality of human oocytes and clinical pregnancy rates


    Takemura, Takashi; Okabe, Midori


    Background To discover simple biomarkers to evaluate the aging or quality of human oocytes and clinical pregnancy rates is needed. However, the association among serum α-klotho concentrations during preimplantation, the aging or quality of human oocytes and clinical pregnancy rates has not been investigated. Findings The serum α-klotho concentrations during preimplantation decreased due to aging (p 

  4. The effect of reminder calls in reducing non-attendance rates at care of the elderly clinics



    BACKGROUND—DNA ("did not attend") at outpatient clinics is an important problem costing the NHS an estimated £266 million annually. The national DNA rate for 1996-1997 for all clinics was 12%. The DNA rate at Hammersmith Hospital for the same year in the care of the elderly specialty was 21%. The aim of this study was to establish why this was so, and to test the efficacy of a reminder call in increasing attendance rates at care of the elderly clinics.
METHODS—23 DNAs from seven clinics were ...

  5. Improving Treatment Trial Outcomes for Rett Syndrome: The Development of Rett-specific Anchors for the Clinical Global Impression Scale. (United States)

    Neul, Jeffrey L; Glaze, Daniel G; Percy, Alan K; Feyma, Tim; Beisang, Arthur; Dinh, Thuy; Suter, Bernhard; Anagnostou, Evdokia; Snape, Mike; Horrigan, Joseph; Jones, Nancy E


    Rett syndrome is a genetically based neurodevelopmental disorder. Although the clinical consequences of Rett syndrome are profound and lifelong, currently no approved drug treatments are available specifically targeted to Rett symptoms. High quality outcome measures, specific to the core symptoms of a disorder are a critical component of well-designed clinical trials for individuals with neurodevelopmental disorders. The Clinical Global Impression Scale is a measure of global clinical change with strong face validity that has been widely used as an outcome measure in clinical trials of central nervous system disorders. Despite its favorable assay sensitivity in clinical trials, as a global measure, the Clinical Global Impression Scale is not specific to the signs and symptoms of the disorder under study. Development of key anchors for the scale, specific to the disorder being assessed, holds promise for enhancing the validity and reliability of the measure for disorders such as Rett syndrome.

  6. A group-theoretical notation for disease states: an example using the psychiatric rating scale

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    Sawamura Jitsuki


    Full Text Available Abstract Background While many branches of natural science have embraced group theory reaping enormous advantages for their respective fields, clinical medicine lacks to date such applications. Here we intend to explain a prototypal model based on the postulates of groups that could have potential in categorizing clinical states. Method As an example, we begin by modifying the original ‘Brief Psychiatric Rating Scale’ (BPRS, the most frequently used standards for evaluating the psychopathology of patients with schizophrenia. We consider a presumptively idealized (virtually standardized BPRS (denoted BPRS-I with assessments ranging from ‘0’ to ‘6’ to simplify our discussion. Next, we introduce the modulo group Z7 containing elements {0,1,2,…,6} defined by composition rule, ‘modulo 7 addition’, denoted by *. Each element corresponds to a score resulting from grading a symptom under the BPRS-I assessment. By grading all symptoms associated with the illness, a Cartesian product, denoted Aj, constitutes a summary of a patient assessment. By considering operations denoted A(j→k that change state Aj into state Ak, a group M (that itself contains Aj and Ak as elements is also considered. Furthermore, composition of these operations obey modulo 7 arithmetic (i.e., addition, multiplication, and division. We demonstrate the application with a simple example in the form of a series of states (A4 = A1*A(1→2*A(2→3*A(3→4 to illustrate this result. Results The psychiatric disease states are defined as 18-fold Cartesian products of Z7, i.e., Z7×18 = Z7×…×Z7 (18 times. We can construct set G ≡ {a(mi| m = 1,2,3,…(the patient’s history of the i-th symptom} and M ≡ {Am | Am ∈ Z7×18 (the set of all possible assessments of a patient} simplistically, at least, in terms of modulo 7 addition that satisfies the group postulates. Conclusions Despite the large limitations of our methodology, there are grounds not

  7. Clinical trial success rates of anti-obesity agents: the importance of combination therapies. (United States)

    Hussain, H T; Parker, J L; Sharma, A M


    The objective of this study was to construct a clinical trial profile assessing the risk of drug failure among anti-obesity agents. Research was conducted by looking at anti-obesity therapies currently on the market or in clinical trials (phases I to III) conducted from 1998 to September 2014, with the exclusion of any drugs whose phase I trial was conducted prior to January 1998. This was completed primarily through a search on where a total of 51 drugs met the search criteria. The transition probabilities were then calculated based on various classifications and compared against industry standards. The transition probability of anti-obesity agents was 8.50% whereas the transition probability of industry standards was 10.40%. Combination therapies had four times the transition probability than monotherapies, 40% and 4.75%, respectively. Therefore, it was determined that 92% of drugs fail during clinical trial testing for this indication and combination therapy appears to improve clinical trial success rates to 10-fold.

  8. Development of the A-DIVA Scale: A Clinical Predictive Scale to Identify Difficult Intravenous Access in Adult Patients Based on Clinical Observations. (United States)

    van Loon, Fredericus H J; Puijn, Lisette A P M; Houterman, Saskia; Bouwman, Arthur R A


    Placement of a peripheral intravenous catheter is a routine procedure in clinical practice, but failure of intravenous cannulation regularly occurs. An accurate and reliable predictive scale for difficult venous access creates the possibility to use other techniques in an earlier time frame. We aimed to develop a predictive scale to identify adult patients with a difficult intravenous access prospectively: the A-DIVA scale. This prospective, observational, cross-sectional cohort study was conducted between January 2014 and January 2015, and performed at the department of anesthesiology of the Catharina Hospital (Eindhoven, The Netherlands). Patients 18 years or older were eligible if scheduled for any surgical procedure, regardless ASA classification, demographics, and medical history. Experienced and certified anesthesiologists and nurse anesthetists routinely obtained peripheral intravenous access. Cannulation was performed regarding standards for care. A failed peripheral intravenous cannulation on the first attempt was the outcome of interest. A population-based sample of 1063 patients was included. Failure of intravenous cannulation was observed in 182/1063 patients (17%). Five variables were associated with a failed first attempt of peripheral intravenous cannulation: palpability of the target vein (OR = 4.94, 95% CI [2.85-8.56]; P < 0.001), visibility of the target vein (OR = 3.63, 95% CI [2.09-6.32]; P < 0.001), a history of difficult peripheral intravenous cannulation (OR = 3.86, 95% CI [2.39-6.25]; P < 0.001), an unplanned indication for surgery (OR = 4.86, 95% CI [2.92-8.07]; P < 0.001), and the vein diameter of at most 2 millimeters (OR = 3.37, 95% CI [2.12-5.36]; P < 0.001). The scoring system was applied in 3 risk groups: 36/788 patients (5%) suffered from a failed first attempt in the low-risk group (A-DIVA score 0 or 1), whereas the medium (A-DIVA score 2 or 3) and high-risk group (A-DIVA score 4 plus

  9. Association between Number of Formed Embryos, Embryo Morphology and Clinical Pregnancy Rate after Intracytoplasmic Sperm Injection. (United States)

    Luz, Caroline Mantovani da; Giorgi, Vanessa Silvestre Innocenti; Coelho Neto, Marcela Alencar; Martins, Wellington de Paula; Ferriani, Rui Alberto; Navarro, Paula Andrea


    Introduction Infertility has a high prevalence in the general population, affecting ∼ 5 to 15% of couples in reproductive age. The assisted reproduction techniques (ART) include in vitro manipulation of gametes and embryos and are an important treatment indicated to these couples. It is well accepted that the implantation rate is positively influenced by the morphology of transferred embryos. However, we question if, apart from the assessment of embryo morphology, the number of produced embryos per cycle is also related to pregnancy rates in the first fresh transfer cycle. Purpose To evaluate the clinical pregnancy rate according to the number of formed embryos and the transfer of top quality embryos (TQEs). Methods In a retrospective cohort study, between January 2011 and December 2012, we evaluated women who underwent intracytoplasmic sperm injection (ICSI), aged < 40 years, and with at least 1 formed embryo fresh transferred in cleavage stage. These women were stratified into 3 groups according to the number of formed embryos (1 embryo, 2-3 and ≥ 4 embryos). Each group was divided into 2 subgroups according to the presence or not of at least 1 transferred TQE (1 with TQE; 1 without TQE; 2-3 with TQE, 2-3 without TQE; ≥ 4 with TQE; ≥ 4 without TQE). The clinical pregnancy rates were compared in each subgroup based on the presence or absence of at least one transferred TQE. Results During the study period, 636 women had at least one embryo to be transferred in the first fresh cycle (17.8% had 1 formed embryo [32.7% with TQE versus 67.3% without TQE], 42.1% of women had 2-3 formed embryos [55.6% with TQE versus 44.4% without TQE], and 40.1% of patients had ≥ 4 formed embryos [73.7% with TQE versus 26.3% without TQE]). The clinical pregnancy rate was significantly higher in the subgroup with ≥ 4 formed embryos with at least 1 transfered TQE (45.2%) compared with the subgroup without TQE (28.4%). Conclusions Having at

  10. Gender differences in notification rates, clinical forms and treatment outcome of tuberculosis patients under the RNTCP

    Directory of Open Access Journals (Sweden)

    Abhijit Mukherjee


    Full Text Available Introduction: An increased notification rate of tuberculosis (TB in men is seen in the SAARC region. In India, the Revised National Tuberculosis Control Programme (RNTCP detects nearly three times more male than female TB patients. Gender differences have also been reported in the clinical forms of tuberculous disease and in treatment adherence and cure rates in patients undergoing treatment for tuberculosis. The present study was undertaken to find out the sex differences in the notification rates and treatment outcomes of TB patients registered under the RNTCP in a rural tuberculosis unit (TU in West Bengal. Materials and Methods: A retrospective record-based study was carried out among a total of 3605 cases registered under the RNTCP between January 1999 and June 2005. Notification rates of TB, clinical forms of TB and disease treatment outcomes recorded in the registers were analyzed based on genders. Outcomes were defined in accordance with the standard RNTCP definitions. The Z-test for proportion (for comparing differences in proportions, Student t-test (for comparing mean, and χ2 test (to see association were performed for statistical analysis. Results: Among the total of 3605 patients, 2498 (69.3% were male and 1107 (30.7% were female with a male female ratio of 2.25:1. In patients less than 20 years of age, the notification rates among males and females were similar. In the other age groups, males were more likely to be notified compared to females and the difference was statistically significant. While new smear positive and retreatment cases were significantly more than in males, among females, new smear negative and new extrapulmonary cases were significantly higher. Among the new smear positive patients 89.4% of females were cured compared to 85.8% of males which was again significant statistically (Z=1.70, P0.05. Conclusion: The present study demonstrates a gender difference in the notification rates, clinical presentations and

  11. Differential Item Functioning of the Psychological Domain of the Menopause Rating Scale. (United States)

    Monterrosa-Castro, Alvaro; Portela-Buelvas, Katherin; Oviedo, Heidi C; Herazo, Edwin; Campo-Arias, Adalberto


    Introduction. Quality of life could be quantified with the Menopause Rating Scale (MRS), which evaluates the severity of somatic, psychological, and urogenital symptoms in menopause. However, differential item functioning (DIF) analysis has not been applied previously. Objective. To establish the DIF of the psychological domain of the MRS in Colombian women. Methods. 4,009 women aged between 40 and 59 years, who participated in the CAVIMEC (Calidad de Vida en la Menopausia y Etnias Colombianas) project, were included. Average age was 49.0 ± 5.9 years. Women were classified in mestizo, Afro-Colombian, and indigenous. The results were presented as averages and standard deviation (X ± SD). A p value <0.001 was considered statistically significant. Results. In mestizo women, the highest X ± SD were obtained in physical and mental exhaustion (PME) (0.86 ± 0.93) and the lowest ones in anxiety (0.44 ± 0.79). In Afro-Colombian women, an average score of 0.99 ± 1.07 for PME and 0.63 ± 0.88 for anxiety was gotten. Indigenous women obtained an increased average score for PME (1.33 ± 0.93). The lowest score was evidenced in depressive mood (0.50 ± 0.81), which is different from other Colombian women (p < 0.001). Conclusions. The psychological items of the MRS show differential functioning according to the ethnic group, which may induce systematic error in the measurement of the construct.

  12. Differential Item Functioning of the Psychological Domain of the Menopause Rating Scale (United States)

    Portela-Buelvas, Katherin; Oviedo, Heidi C.; Herazo, Edwin; Campo-Arias, Adalberto


    Introduction. Quality of life could be quantified with the Menopause Rating Scale (MRS), which evaluates the severity of somatic, psychological, and urogenital symptoms in menopause. However, differential item functioning (DIF) analysis has not been applied previously. Objective. To establish the DIF of the psychological domain of the MRS in Colombian women. Methods. 4,009 women aged between 40 and 59 years, who participated in the CAVIMEC (Calidad de Vida en la Menopausia y Etnias Colombianas) project, were included. Average age was 49.0 ± 5.9 years. Women were classified in mestizo, Afro-Colombian, and indigenous. The results were presented as averages and standard deviation (X ± SD). A p value <0.001 was considered statistically significant. Results. In mestizo women, the highest X ± SD were obtained in physical and mental exhaustion (PME) (0.86 ± 0.93) and the lowest ones in anxiety (0.44 ± 0.79). In Afro-Colombian women, an average score of 0.99 ± 1.07 for PME and 0.63 ± 0.88 for anxiety was gotten. Indigenous women obtained an increased average score for PME (1.33 ± 0.93). The lowest score was evidenced in depressive mood (0.50 ± 0.81), which is different from other Colombian women (p < 0.001). Conclusions. The psychological items of the MRS show differential functioning according to the ethnic group, which may induce systematic error in the measurement of the construct. PMID:27847825

  13. Validation of the traditional Chinese version of the Menopausal Rating Scale with WHOQOL-BREF. (United States)

    Wu, H-c; Wen, S-h; Hwang, J-s; Huang, S-c


    Objective To assess the criterion validity, construct validity and test-retest reliability of the traditional Chinese language version of the Menopause Rating Scale (MRS-TC version). Methods This was an observational, cross-sectional study covering hospital and community samples of 317 women aged 39-62 years. Two questionnaires were administered, namely, the MRS-TC version, made up of 11 items in three dimensions, and the World Health Organization Quality of Life-BREF (WHOQOL-BREF). The intraclass correlation coefficient was used to examine the test-retest reliability of the questionnaire on two separate occasions, 2 weeks apart. The internal consistency was assessed with Cronbach's α. To evaluate criterion validity, the relationship between the individual items and dimension scores of both instruments was estimated. Pearson's correlation was used to assess convergent and discriminant validity; construct validity was evaluated by comparing the mean scores of menopausal and non-menopausal women for each of the MRS dimensions. Results The final questionnaire comprised 11 items in three dimensions. The intra-class correlation (ICC) for the test-retest reliability ranged from 0.83 to 0.93; values of Cronbach's α for psychological, somatic, and urogenital symptom domains were 0.88, 0.68, and 0.59, respectively. For the convergent and discriminant validity, the correlations between the individual questionnaire and the WHOQOL-BREF were significant; those with the MRS dimensions were significantly negatively associated for the physical, psychological, social and environmental domains. Conclusion The MRS-TC version using the traditional Chinese language is a reliable and valid questionnaire for assessing menopausal symptoms and global quality of life in climacteric women.

  14. Brief, unidimensional melancholia rating scales are highly sensitive to the effect of citalopram and may have biological validity

    DEFF Research Database (Denmark)

    Østergaard, Søren Dinesen; Bech, Per; Trivedi, Madhukar H


    BACKGROUND: Most depression rating scales are multidimensional and the resulting heterogeneity may impede identification of coherent biomarkers. The aim of this study was to compare the psychometric performance of the multidimensional 17-item Hamilton Depression Rating Scale (HAM-D17) and the 30......-item Inventory of Depressive Symptomatology (IDS-C30) to that of their unidimensional six-item melancholia subscales (HAM-D6 and IDS-C6). METHODS: A total of 2242 subjects from level 1 (citalopram) of the Sequenced Treatment Alternatives to Relieve Depression (STAR* study were included in the analysis....... Symptom change, response and remission rates were compared for HAM-D6 versus HAM-D17 and for IDS-C6 versus IDS-C30. The changes in total scores on these scales were compared to the change in Quality of Life Enjoyment and Satisfaction Questionnaire (QLES-Q) score using correlation analysis. RESULTS...

  15. An investigation of the effect of pore scale flow on average geochemical reaction rates using direct numerical simulation

    Energy Technology Data Exchange (ETDEWEB)

    Molins, Sergi [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Earth Sciences Division; Trebotich, David [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Computational Research Division; Steefel, Carl I. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Earth Sciences Division; Shen, Chaopeng [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Computational Research Division


    The scale-dependence of geochemical reaction rates hinders their use in continuum scale models intended for the interpretation and prediction of chemical fate and transport in subsurface environments such as those considered for geologic sequestration of CO2. Processes that take place at the pore scale, especially those involving mass transport limitations to reactive surfaces, may contribute to the discrepancy commonly observed between laboratory-determined and continuum-scale or field rates. In this study we investigate the dependence of mineral dissolution rates on the pore structure of the porous media by means of pore scale modeling of flow and multicomponent reactive transport. The pore scale model is composed of high-performance simulation tools and algorithms for incompressible flow and conservative transport combined with a general-purpose multicomponent geochemical reaction code. The model performs direct numerical simulation of reactive transport based on an operator-splitting approach to coupling transport and reactions. The approach is validated with a Poiseuille flow single-pore experiment and verified with an equivalent 1-D continuum-scale model of a capillary tube packed with calcite spheres. Using the case of calcite dissolution as an example, the high-resolution model is used to demonstrate that nonuniformity in the flow field at the pore scale has the effect of decreasing the overall reactivity of the system, even when systems with identical reactive surface area are considered. In conclusion, the effect becomes more pronounced as the heterogeneity of the reactive grain packing increases, particularly where the flow slows sufficiently such that the solution approaches equilibrium locally and the average rate becomes transport-limited.

  16. Translating and validating the Finnish version of the Manchester Clinical Supervision Scale. (United States)

    Hyrkäs, Kristiina; Appelqvist-Schmidlechner, Kaija; Paunonen-Ilmonen, Marita


    Evaluation research provides new perspectives for clinical supervision (CS), and international collaboration offers advantages to develop valid instruments for this purpose. Besides translation, an instrument developed and tested in another culture requires systematic validation. The study focuses on the translation process of the Manchester Clinical Supervision Scale for testing in Finland carried out collaboratively between the Universities of Tampere and Manchester. The instrument is a 45-item questionnaire with a Likert-type (1-5) scale comprising seven sub-scales: trust and rapport, supervisor advice and support, improved care and skills, importance and value of CS, finding time, personal issues and reflection and total score. At first, a licensed translator translated the instrument into Finnish. A native British language teacher at the University language centre performed the blind back-translation into English. The translations were compared by both collaborative parties and by three experienced Finnish supervisors. A pilot sample (n = 182) was collected to test the translated instrument. In this sample Cronbach's alpha value for the total score was 0.9227 and in the sub-scales 0.6393-0.8838. The mean values in the sub-scales were 14.2-29.3, SDs 3.02-3.88 and modes 14.0-30.0. The British test sample had almost similar values. Translating an instrument into another language not only requires expertise in language, but also in practice. The cultural validation is the most important phase in the process that can be accomplished with pilot testing and statistical methods. However, further expert evaluation is required for the validity of the instrument.

  17. Development and applications of the SWAN rating scale for assessment of attention deficit hyperactivity disorder: a literature review. (United States)

    Brites, C; Salgado-Azoni, C A; Ferreira, T L; Lima, R F; Ciasca, S M


    This study reviewed the use of the Strengths and Weaknesses of Attention-Deficit/Hyperactivity-symptoms and Normal-behaviors (SWAN) rating scale in diagnostic and evolutive approaches to attention deficit hyperactivity disorder (ADHD) and in correlational studies of the disorder. A review of articles published in indexed journals from electronic databases was conducted and 61 articles on the SWAN scale were analyzed. From these, 27 were selected to a) examine use of SWAN in research on attention disorders and b) verify evidence of its usefulness in the areas of genetics, neuropsychology, diagnostics, psychiatric comorbidities, neuroimaging, pharmacotherapy, and to examine its statistical reliability and validity in studies of diverse populations. This review of articles indicated a growing use of the SWAN scale for diagnostic purposes, for therapy, and in research on areas other than ADHD, especially when compared with other reliable scales. Use of the scale in ADHD diagnosis requires further statistical testing to define its psychometric properties.

  18. Development and applications of the SWAN rating scale for assessment of attention deficit hyperactivity disorder: a literature review

    Directory of Open Access Journals (Sweden)

    C. Brites


    Full Text Available This study reviewed the use of the Strengths and Weaknesses of Attention-Deficit/Hyperactivity-symptoms and Normal-behaviors (SWAN rating scale in diagnostic and evolutive approaches to attention deficit hyperactivity disorder (ADHD and in correlational studies of the disorder. A review of articles published in indexed journals from electronic databases was conducted and 61 articles on the SWAN scale were analyzed. From these, 27 were selected to a examine use of SWAN in research on attention disorders and b verify evidence of its usefulness in the areas of genetics, neuropsychology, diagnostics, psychiatric comorbidities, neuroimaging, pharmacotherapy, and to examine its statistical reliability and validity in studies of diverse populations. This review of articles indicated a growing use of the SWAN scale for diagnostic purposes, for therapy, and in research on areas other than ADHD, especially when compared with other reliable scales. Use of the scale in ADHD diagnosis requires further statistical testing to define its psychometric properties.

  19. The Beliefs about Paranoia Scale: Confirmatory factor analysis and tests of a metacognitive model of paranoia in a clinical sample. (United States)

    Murphy, Elizabeth K; Tully, Sarah; Pyle, Melissa; Gumley, Andrew I; Kingdon, David; Schwannauer, Matthias; Turkington, Douglas; Morrison, Anthony P


    This study aimed to confirm the factor structure of the Beliefs about Paranoia Scale (BaPS), a self-report measure to assess metacognitive beliefs about paranoia, and to test hypotheses of a metacognitive model. We hypothesised that positive and negative beliefs about paranoia would be associated with severity of suspiciousness, and that the co-occurrence of positive and negative beliefs would be associated with increased suspiciousness. A total of 335 patients meeting criteria for a schizophrenia spectrum disorder completed the BaPS, the Positive and Negative Syndromes Scale (PANSS), and the Psychotic Symptom Rating Scales (PSYRATS). Confirmatory factor analysis verified that the three BaPS subscales (negative beliefs about paranoia, paranoia as a survival strategy, and normalizing beliefs) were an adequate fit of the data. Ordinal regression showed that positive beliefs about paranoia as a survival strategy and negative beliefs were both associated with severity of suspiciousness. This was the first study to show that the co-occurrence of positive and negative beliefs was associated with increased suspiciousness. All hypotheses were confirmed, suggesting that a metacognitive approach has utility for the conceptualization of paranoia. Clinical implications suggest a role for metacognitive therapy, including strategies such as detached mindfulness and worry postponement.

  20. Federated queries of clinical data repositories: Scaling to a national network. (United States)

    Weber, Griffin M


    Federated networks of clinical research data repositories are rapidly growing in size from a handful of sites to true national networks with more than 100 hospitals. This study creates a conceptual framework for predicting how various properties of these systems will scale as they continue to expand. Starting with actual data from Harvard's four-site Shared Health Research Information Network (SHRINE), the framework is used to imagine a future 4000 site network, representing the majority of hospitals in the United States. From this it becomes clear that several common assumptions of small networks fail to scale to a national level, such as all sites being online at all times or containing data from the same date range. On the other hand, a large network enables researchers to select subsets of sites that are most appropriate for particular research questions. Developers of federated clinical data networks should be aware of how the properties of these networks change at different scales and design their software accordingly.

  1. Detection of anomalous diffusion using confidence intervals of the scaling exponent with application to preterm neonatal heart rate variability (United States)

    Bickel, David R.; Verklan, M. Terese; Moon, Jon


    The scaling exponent of the root mean square (rms) displacement quantifies the roughness of fractal or multifractal time series; it is equivalent to other second-order measures of scaling, such as the power-law exponents of the spectral density and autocorrelation function. For self-similar time series, the rms scaling exponent equals the Hurst parameter, which is related to the fractal dimension. A scaling exponent of 0.5 implies that the process is normal diffusion, which is equivalent to an uncorrelated random walk; otherwise, the process can be modeled as anomalous diffusion. Higher exponents indicate that the increments of the signal have positive correlations, while exponents below 0.5 imply that they have negative correlations. Scaling exponent estimates of successive segments of the increments of a signal are used to test the null hypothesis that the signal is normal diffusion, with the alternate hypothesis that the diffusion is anomalous. Dispersional analysis, a simple technique which does not require long signals, is used to estimate the scaling exponent from the slope of the linear regression of the logarithm of the standard deviation of binned data points on the logarithm of the number of points per bin. Computing the standard error of the scaling exponent using successive segments of the signal is superior to previous methods of obtaining the standard error, such as that based on the sum of squared errors used in the regression; the regression error is more of a measure of the deviation from power-law scaling than of the uncertainty of the scaling exponent estimate. Applying this test to preterm neonate heart rate data, it is found that time intervals between heart beats can be modeled as anomalous diffusion with negatively correlated increments. This corresponds to power spectra between 1/f2 and 1/f, whereas healthy adults are usually reported to have 1/f spectra, suggesting that the immaturity of the neonatal nervous system affects the scaling

  2. The Aberrant Behavior Checklist: A Behavior Rating Scale for the Assessment of Treatment Effects. (United States)

    Aman, Michael G.; And Others


    The development of a scale to assess drug and other treatment effects on severely mentally retarded individuals is described. Separate factor analyses of the data from two samples resulted in a five-factor scale: (1) Irritability, Agitation, Crying; (2) Lethargy, Social Withdrawal; (3) Stereotypic Behavior; (4) Hyperactivity, Noncompliance; and…

  3. Teaching program for the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale: (MDS-UPDRS). (United States)

    Goetz, Christopher G; Stebbins, Glenn T; Chmura, Teresa A; Fahn, Stanley; Poewe, Werner; Tanner, Caroline M


    To accompany the newly developed Movement Disorder Society revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS), we developed a teaching program. The DVD-based program covers the four parts of the scale with visual and verbal instructions for uniform application. For the motor section (Part III), all items except rigidity are shown with an example of each rating option (0-4) as agreed upon by a panel of experts. The rate of agreement for the selected samples was always significant, with Kendall's coefficient of concordance W ranging between 0.99 and 0.72. The teaching program also provides a full patient examination with rating answers provided and four full MDS-UPDRS cases for a Certificate Program exercise of Part III. This training program is in English, but as non-English official translations of the MDS-UPDRS are developed, the program can be potentially modified into different languages.

  4. Pilot-scale gasification of municipal solid wastes by high-rate and two-phase anaerobic digestion (TPAD). (United States)

    Ghosh, S; Henry, M P; Sajjad, A; Mensinger, M C; Arora, J L


    Bioconversion of municipal solid waste-sludge blend by conventional high-rate and two-phase anaerobic digestion was studied. RDF (refused-derived fuel)-quality feed produced in a Madison, Wisconsin, USA, MRF (materials-recovery facility) was used. High-rate digestion experiments were conducted with bench-scale digesters under target operating conditions developed from an economic feasibility study. The effects of digestion temperature, RDF content of digester feed, HRT, loading rate, RDF particle size, and RDF pretreatment with cellulase or dilute solutions of NaOH or lime on digester performance were studied. A pilot-scale two-phase digestion plant was operated with 80:20 (weight ratio) RDF-sludge blends to show that this process exhibited a higher methane yield, and produced a higher methane-content digester gas than those obtained by single-stage, high-rate anaerobic digestion.

  5. The Eating Disorder Diagnostic Scale: psychometric features within a clinical population and a cut-off point to differentiate clinical patients from healthy controls

    NARCIS (Netherlands)

    Krabbenborg, M.A.M.; Danner, U.N.; Larsen, J.K.; Veer, N. van der; Elburg, A.A. van; Ridder, D.T. de; Evers, C.; Stice, E.; Engels, R.C.E.M.


    The Eating Disorder Diagnostic Scale (EDDS) is a brief self-report measure for diagnosing anorexia nervosa, bulimia nervosa and binge eating disorder. Research has provided evidence of the reliability and validity of this scale in non-clinical populations. Our study is the first to examine the psych

  6. The Unified Parkinson’s Disease Rating Scale as a predictor of peak aerobic capacity and ambulatory function


    Frederick M. Ivey, PhD; Leslie I. Katzel, MD, PhD; John D. Sorkin, MD, PhD; Richard F. Macko, MD; Lisa M. Shulman, MD


    The Unified Parkinson’s Disease Rating Scale (UPDRS) is a widely applied index of disease severity. Our objective was to assess the utility of UPDRS for predicting peak aerobic capacity (VO2 peak) and ambulatory function. Participants (n = 70) underwent evaluation for UPDRS (Total and Motor ratings), VO2 peak, 6-minute walk distance (6MW), and 30-foot self-selected walking speed (SSWS). Using regression, we determined the extent to which the Total and Motor UPDRS scores predicted each functio...

  7. The multiple sclerosis rating scale, revised (MSRS-R): Development, refinement, and psychometric validation using an online community



    Abstract Background In developing the PatientsLikeMe online platform for patients with Multiple Sclerosis (MS), we required a patient-reported assessment of functional status that was easy to complete and identified disability in domains other than walking. Existing measures of functional status were inadequate, clinician-reported, focused on walking, and burdensome to complete. In response, we developed the Multiple Sclerosis Rating Scale (MSRS). Methods We adapted a clinician-rated measure,...

  8. In-Flight Validation of a Pilot Rating Scale for Evaluating Failure Transients in Electronic Flight Control Systems (United States)

    Kalinowski, Kevin F.; Tucker, George E.; Moralez, Ernesto, III


    Engineering development and qualification of a Research Flight Control System (RFCS) for the Rotorcraft Aircrew Systems Concepts Airborne Laboratory (RASCAL) JUH-60A has motivated the development of a pilot rating scale for evaluating failure transients in fly-by-wire flight control systems. The RASCAL RFCS includes a highly-reliable, dual-channel Servo Control Unit (SCU) to command and monitor the performance of the fly-by-wire actuators and protect against the effects of erroneous commands from the flexible, but single-thread Flight Control Computer. During the design phase of the RFCS, two piloted simulations were conducted on the Ames Research Center Vertical Motion Simulator (VMS) to help define the required performance characteristics of the safety monitoring algorithms in the SCU. Simulated failures, including hard-over and slow-over commands, were injected into the command path, and the aircraft response and safety monitor performance were evaluated. A subjective Failure/Recovery Rating (F/RR) scale was developed as a means of quantifying the effects of the injected failures on the aircraft state and the degree of pilot effort required to safely recover the aircraft. A brief evaluation of the rating scale was also conducted on the Army/NASA CH-47B variable stability helicopter to confirm that the rating scale was likely to be equally applicable to in-flight evaluations. Following the initial research flight qualification of the RFCS in 2002, a flight test effort was begun to validate the performance of the safety monitors and to validate their design for the safe conduct of research flight testing. Simulated failures were injected into the SCU, and the F/RR scale was applied to assess the results. The results validate the performance of the monitors, and indicate that the Failure/Recovery Rating scale is a very useful tool for evaluating failure transients in fly-by-wire flight control systems.

  9. Effects of Rating Training on Inter-Rater Consistency for Developing a Dental Hygiene Clinical Rater Qualification System

    Directory of Open Access Journals (Sweden)

    Jeong Ran Park


    Full Text Available We tried to develop itemized evaluation criteria and a clinical rater qualification system through rating training of inter-rater consistency for experienced clinical dental hygienists and dental hygiene clinical educators. A total of 15 clinical dental hygienists with 1-year careers participated as clinical examination candidates, while 5 dental hygienists with 3-year educations and clinical careers or longer participated as clinical raters. They all took the clinical examination as examinees. The results were compared, and the consistency of competence was measured. The comparison of clinical competence between candidates and clinical raters showed that the candidate group?占퐏 mean clinical competence ranged from 2.96 to 3.55 on a 5-point system in a total of 3 instruments (Probe, Explorer, Curet, while the clinical rater group?占퐏 mean clinical competence ranged from 4.05 to 4.29. There was a higher inter-rater consistency after education of raters in the following 4 items: Probe, Explorer, Curet, and insertion on distal surface. The mean score distribution of clinical raters ranged from 75% to 100%, which was more uniform in the competence to detect an artificial calculus than that of candidates (25% to 100%. According to the above results, there was a necessity in the operating clinical rater qualification system for comprehensive dental hygiene clinicians. Furthermore, in order to execute the clinical rater qualification system, it will be necessary to keep conducting a series of studies on educational content, time, frequency, and educator level.

  10. Grain-Size Based Additivity Models for Scaling Multi-rate Uranyl Surface Complexation in Subsurface Sediments

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Xiaoying; Liu, Chongxuan; Hu, Bill X.; Hu, Qinhong


    This study statistically analyzed a grain-size based additivity model that has been proposed to scale reaction rates and parameters from laboratory to field. The additivity model assumed that reaction properties in a sediment including surface area, reactive site concentration, reaction rate, and extent can be predicted from field-scale grain size distribution by linearly adding reaction properties for individual grain size fractions. This study focused on the statistical analysis of the additivity model with respect to reaction rate constants using multi-rate uranyl (U(VI)) surface complexation reactions in a contaminated sediment as an example. Experimental data of rate-limited U(VI) desorption in a stirred flow-cell reactor were used to estimate the statistical properties of multi-rate parameters for individual grain size fractions. The statistical properties of the rate constants for the individual grain size fractions were then used to analyze the statistical properties of the additivity model to predict rate-limited U(VI) desorption in the composite sediment, and to evaluate the relative importance of individual grain size fractions to the overall U(VI) desorption. The result indicated that the additivity model provided a good prediction of the U(VI) desorption in the composite sediment. However, the rate constants were not directly scalable using the additivity model, and U(VI) desorption in individual grain size fractions have to be simulated in order to apply the additivity model. An approximate additivity model for directly scaling rate constants was subsequently proposed and evaluated. The result found that the approximate model provided a good prediction of the experimental results within statistical uncertainty. This study also found that a gravel size fraction (2-8mm), which is often ignored in modeling U(VI) sorption and desorption, is statistically significant to the U(VI) desorption in the sediment.

  11. Clinical outcome of high-dose-rate interstitial brachytherapy in patients with oral cavity cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sung Uk; Cho, Kwan Ho; Moon, Sung Ho; Choi, Sung Weon; Park, Joo Yong; Yun, Tak; Lee, Sang Hyun; Lim, Young Kyung; Jeong, Chi Young [National Cancer Center, Goyang (Korea, Republic of)


    To evaluate the clinical outcome of high-dose-rate (HDR) interstitial brachytherapy (IBT) in patients with oral cavity cancer. Sixteen patients with oral cavity cancer treated with HDR remote-control afterloading brachytherapy using 192Ir between 2001 and 2013 were analyzed retrospectively. Brachytherapy was administered in 11 patients as the primary treatment and in five patients as salvage treatment for recurrence after the initial surgery. In 12 patients, external beam radiotherapy (50-55 Gy/25 fractions) was combined with IBT of 21 Gy/7 fractions. In addition, IBT was administered as the sole treatment in three patients with a total dose of 50 Gy/10 fractions and as postoperative adjuvant treatment in one patient with a total of 35 Gy/7 fractions. The 5-year overall survival of the entire group was 70%. The actuarial local control rate after 3 years was 84%. All five recurrent cases after initial surgery were successfully salvaged using IBT +/- external beam radiotherapy. Two patients developed local recurrence at 3 and 5 months, respectively, after IBT. The acute complications were acceptable (< or =grade 2). Three patients developed major late complications, such as radio-osteonecrosis, in which one patient was treated by conservative therapy and two required surgical intervention. HDR IBT for oral cavity cancer was effective and acceptable in diverse clinical settings, such as in the cases of primary or salvage treatment.

  12. Improving Clinical Remission Rates in Pediatric Inflammatory Bowel Disease with Previsit Planning (United States)

    Savarino, Jeffrey R.; Kaplan, Jess L.; Winter, Harland S.; Moran, Christopher J.; Israel, Esther J.


    Inflammatory Bowel Disease (IBD) is a chronic autoimmune inflammatory disease of the intestine which can lead to malnutrition, poor quality of life, and colon cancer.1–4 Although there is no cure for the disease, clinical remission is the primary goal.5 The Center for Inflammatory Bowel Disease at MassGeneral Hospital for Children (MGHfC) adopted a Previsit Planning (PVP) model to identify and discuss symptomatic patients prior to their appointments to identify specific issues that impact disease management.6–8 The Registry from ImproveCareNow (ICN), the international Quality Improvement Collaborative for the management of Crohn's Disease and Ulcerative Colitis in pediatric and adolescent patients, was used to capture information from each ambulatory visit and hospitalization. Using the Model for Improvement framework, the team began a weekly review and made care recommendations of patients with active disease who were cared for by one physician. Interventions were modified over multiple Plan-Do-Study-Act (PDSA) improvement cycles to increase the number of providers and to include patients with mild or moderate disease activity.9 Feedback from the providers regarding this process was elicited via a REDCap survey and the clinical remission rate was tracked using the ICN Registry. The clinical remission rate for the Center's patients increased from 77% (n=597) in September 2014 to 83% (n=585) in August 2015 and has been maintained. 78% of responding providers indicated that they found the PVP recommendations helpful “all of the time”. One hundred percent who responded to the survey said that they have used at least one recommendation provided to them. PVP for management of a chronic disease in pediatrics is feasible, even in a high volume practice. This process at MGHfC has resulted in the improvement of clinical remission rate. PDSA cycles were used to document successes and failures to help guide the work. Ongoing expansion of this PVP practice to all

  13. Tuberculosis in ageing: high rates, complex diagnosis and poor clinical outcomes (United States)

    Cruz-Hervert, Luis Pablo; García-García, Lourdes; Ferreyra-Reyes, Leticia; Bobadilla-del-Valle, Miriam; Cano-Arellano, Bulmaro; Canizales-Quintero, Sergio; Ferreira-Guerrero, Elizabeth; Báez-Saldaña, Renata; Téllez-Vázquez, Norma; Nava-Mercado, Ariadna; Juárez-Sandino, Luis; Delgado-Sánchez, Guadalupe; Fuentes-Leyra, César Alejandro; Montero-Campos, Rogelio; Martínez-Gamboa, Rosa Areli; Small, Peter M.; Sifuentes-Osornio, José; Ponce-de-León, Alfredo


    Background: worldwide, the frequency of tuberculosis among older people almost triples that observed among young adults. Objective: to describe clinical and epidemiological consequences of pulmonary tuberculosis among older people. Methods: we screened persons with a cough lasting more than 2 weeks in Southern Mexico from March 1995 to February 2007. We collected clinical and mycobacteriological information (isolation, identification, drug-susceptibility testing and IS6110-based genotyping and spoligotyping) from individuals with bacteriologically confirmed pulmonary tuberculosis. Patients were treated in accordance with official norms and followed to ascertain treatment outcomes, retreatment, and vital status. Results: eight hundred ninety-three tuberculosis patients were older than 15 years of age; of these, 147 (16.5%) were 65 years of age or older. Individuals ≥65 years had significantly higher rates of recently transmitted and reactivated tuberculosis. Older age was associated with treatment failure (OR = 5.37; 95% CI: 1.06–27.23; P = 0.042), and death due to tuberculosis (HR = 3.52; 95% CI: 1.78–6.96; P < 0.001) adjusting for sociodemographic and clinical variables. Conclusions: community-dwelling older individuals participate in chains of transmission indicating that tuberculosis is not solely due to the reactivation of latent disease. Untimely and difficult diagnosis and a higher risk of poor outcomes even after treatment completion emphasise the need for specific strategies for this vulnerable group. PMID:22431155

  14. Enhancing biomass energy yield from pilot-scale high rate algal ponds with recycling. (United States)

    Park, J B K; Craggs, R J; Shilton, A N


    This paper investigates the effect of recycling on biomass energy yield in High Rate Algal Ponds (HRAPs). Two 8 m(3) pilot-scale HRAPs treating primary settled sewage were operated in parallel and monitored over a 2-year period. Volatile suspended solids were measured from both HRAPs and their gravity settlers to determine biomass productivity and harvest efficiency. The energy content of the biomass was also measured. Multiplying biomass productivity and harvest efficiency gives the 'harvestable biomass productivity' and multiplying this by the energy content defines the actual 'biomass energy yield'. In Year 1, algal recycling was implemented in one of the ponds (HRAPr) and improved harvestable biomass productivity by 58% compared with the control (HRAPc) without recycling (HRAPr: 9.2 g/m(2)/d; HRAPc: 5.8 g/m(2)/d). The energy content of the biomass grown in HRAPr, which was dominated by Pediastrun boryanum, was 25% higher than the control HRAPc which contained a mixed culture of 4-5 different algae (HRAPr: 21.5 kJ/g; HRAPc: 18.6 kJ/g). In Year 2, HRAPc was then seeded with the biomass harvested from the P. boryanum dominated HRAPr. This had the effect of shifting algal dominance from 89% Dictyosphaerium sp. (which is poorly-settleable) to over 90% P. boryanum in 5 months. Operation of this pond was then switched to recycling its own harvested biomass, which maintained P. boryanum dominance for the rest of Year 2. This result confirms, for the first time in the literature, that species control is possible for similarly sized co-occurring algal colonies in outdoor HRAP by algal recycling. With regard to the overall improvement in biomass energy yield, which is a critical parameter in the context of algal cultivation for biofuels, the combined improvements that recycling triggered in biomass productivity, harvest efficiency and energy content enhanced the harvested biomass energy yield by 66% (HRAPr: 195 kJ/m(2)/day; HRAPc: 118 kJ/m(2)/day).

  15. The DSM‐5 Dimensional Anxiety Scales in a Dutch non‐clinical sample: psychometric properties including the adult separation anxiety disorder scale


    Möller, Eline L.; Bögels, Susan M.


    Abstract With DSM‐5, the American Psychiatric Association encourages complementing categorical diagnoses with dimensional severity ratings. We therefore examined the psychometric properties of the DSM‐5 Dimensional Anxiety Scales, a set of brief dimensional scales that are consistent in content and structure and assess DSM‐5‐based core features of anxiety disorders. Participants (285 males, 255 females) completed the DSM‐5 Dimensional Anxiety Scales for social anxiety disorder, generalized an...


    Woods-Groves, Suzanne


    Currently there is a call for brief concise measurements to appraise relevant 21st century college readiness skills in K-12 learners. This study employed K-12 teachers' ratings for over 3,000 students for an existing 91-item rating scale, the Human Behavior Rating Scale, that measured the 21st century skills of persistence, curiosity, externalizing affect, internalizing affect, and cognition. Teachers' ratings for K-12 learners were used to develop a brief, concise, and manageable 30-item tool, the Human Behavior Rating Scale-Brief. Results yielded high internal consistency coefficients and inter-item correlations. The items were not biased with regard to student sex or race, and were supported through confirmatory factor analyses. In addition, when teachers' ratings were compared with students' academic and behavioral performance data, moderate to strong relationships were revealed. This study provided an essential first step in the development of a psychometrically sound, manageable, and brief tool to appraise 21st century skills in K-12 learners.

  17. Halo, Central Tendency, and Leniency in performance appraisel: A comparison between a graphic rating scale and a behaviourally based measure

    Directory of Open Access Journals (Sweden)

    X. C. Birkenbach


    Full Text Available The process of performance appraisal can serve important employee development as well as organizational administrative functions. However, the reliable and accurate assessment of performance could be hampered by rating errors such as halo, leniency, and central tendency. Because the traditional approach to appraisal by means of graphic rating scales is considered to be susceptible to these errors, behaviourally based measures have been developed which have the claimed advantage of being relatively resistant to rating errors. This study compared the ratings given to a group of employees on a graphic rating scale and a behavioural observation scale. The results did not support the superiority of the BOS in resisting rating errors. OpsommingDie proses van prestasiebeoordeling speel 'n belangrike rol in die ontwikkeling van werknemers asook om administratiewe besluite te maak oor personeel. Die betroubare en akkurate evaluering van werkprestasie kan egter belemmer word deur beoordelingsfoute soos die stralekranseffek, toegeeflikheid, en sentrale neiging. Omrede die alombekende grafiese beoordelingskaal veronderstel is om baie vatbaar te wees vir beoordelingsfoute is daar die afgelope paar jaar aandag geskenk aan die ontwikkeling van gedragsgeoriënteerde beoordelingsmetodes. Dit word aangevoer dat laasgenoemde minder onderworpe is aan beoordelingsfoute. Hierdie studie het die beoordelings van 'n groep werkers op 'n grafiese beoordelingskaal en 'n gedragswaarnemingskaal met mekaar vergelyk. Die resultate kon nie ondersteuning verleen aan die standpunt dat grafiese skale meer vatbaar is vir beoordelingsfoute nie.

  18. Direct-to-consumer advertising of success rates for medically assisted reproduction: a review of national clinic websites (United States)

    Vail, Andy; Roberts, Stephen A


    Objectives To establish how medically assisted reproduction (MAR) clinics report success rates on their websites. Setting Websites of private and NHS clinics offering in vitro fertilisation (IVF) in the UK. Participants We identified clinics offering IVF using the Choose a Fertility Clinic facility on the website of the Human Fertilisation and Embryology Authority (HFEA). Of 81 clinics identified, a website could not be found for 2, leaving 79 for inclusion in the analysis. Primary and secondary outcome measures Outcome measures reported by clinic websites. The numerator and denominator included in the outcome measure were of interest. Results 53 (67%) websites reported their performance using 51 different outcome measures. It was most common to report pregnancy (83% of these clinics) or live birth rates (51%). 31 different ways of reporting pregnancy and 9 different ways of reporting live birth were identified. 11 (21%) reported multiple birth or pregnancy rates. 1 clinic provided information on adverse events. It was usual for clinics to present results without relevant contextual information such as sample size, reporting period, the characteristics of patients and particular details of treatments. Conclusions Many combinations of numerator and denominator are available for the purpose of reporting success rates for MAR. The range of reporting options available to clinics is further increased by the possibility of presenting results for subgroups of patients and for different time periods. Given the status of these websites as advertisements to patients, the risk of selective reporting is considerable. Binding guidance is required to ensure consistent, informative reporting. PMID:28082363

  19. High rate of smoking in female patients with Mondor's disease in an outpatient clinic in Japan

    Directory of Open Access Journals (Sweden)

    Okumura T


    Full Text Available Toshikatsu Okumura,1 Masumi Ohhira,1 Tsukasa Nozu21Department of General Medicine, 2Department of Regional Medicine and Education, Asahikawa Medical University, Asahikawa, Hokkaido, JapanPurpose: Little is known about the epidemiology of Mondor's disease. The aim of this study was to analyze the clinical features of Mondor's disease in an outpatient clinic where primary care physicians are working in Japan, to better understand the epidemiological characteristics of the disease.Patients and methods: The data for consecutive outpatients who were new visitors to the Department of General Medicine in the teaching hospital (Asahikawa Medical University Hospital at Asahikawa Medical University, Asahikawa, Hokkaido, Japan, between April 2004 and March 2012 were analyzed. Parameters such as age, sex, diagnosis, and clinical presentation were investigated.Results: During the 8-year period covered in this study, six (0.07% out of 8767 patients were diagnosed as having Mondor's disease. All of these patients with Mondor's disease were female, and the mean age was 41 plus or minus 12 years; the overall rate of Mondor's disease in all female patients involved in this study was 0.12%. The patients complained of pain and a cord-like structure in the anterolateral thoracoabdominal wall. The painful mass had persisted for 1–4 weeks before presenting at the Department of General Medicine and it disappeared within a couple of weeks. Current smoking was significantly higher in the patients with Mondor's disease than in the age-matched female patients without Mondor's disease who were also evaluated in this study.Conclusion: These results suggest that a high rate of smoking in middle-aged females may be a characteristic feature of Mondor's disease. These epidemiological data may be useful in detection of the disease in the primary care setting in Japan.Keywords: primary care, epidemiology, current smoking, women

  20. Clinical utility of the Wechsler Adult Intelligence Scale-Fourth Edition after traumatic brain injury. (United States)

    Donders, Jacobus; Strong, Carrie-Ann H


    The performance of 100 patients with traumatic brain injury (TBI) on the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) was compared with that of 100 demographically matched neurologically healthy controls. Processing Speed was the only WAIS-IV factor index that was able to discriminate between persons with moderate-severe TBI on the one hand and persons with either less severe TBI or neurologically healthy controls on the other hand. The Processing Speed index also had acceptable sensitivity and specificity when differentiating between patients with TBI who either did or did not have scores in the clinically significant range on the Trail Making Test. It is concluded that WAIS-IV Processing Speed has acceptable clinical utility in the evaluation of patients with moderate-severe TBI but that it should be supplemented with other measures to assure sufficient accuracy in the diagnostic process.

  1. Association of biodiversity with the rates of micropollutant biotransformations among full-scale wastewater treatment plant communities. (United States)

    Johnson, David R; Helbling, Damian E; Lee, Tae Kwon; Park, Joonhong; Fenner, Kathrin; Kohler, Hans-Peter E; Ackermann, Martin


    Biodiversities can differ substantially among different wastewater treatment plant (WWTP) communities. Whether differences in biodiversity translate into differences in the provision of particular ecosystem services, however, is under active debate. Theoretical considerations predict that WWTP communities with more biodiversity are more likely to contain strains that have positive effects on the rates of particular ecosystem functions, thus resulting in positive associations between those two variables. However, if WWTP communities were sufficiently biodiverse to nearly saturate the set of possible positive effects, then positive associations would not occur between biodiversity and the rates of particular ecosystem functions. To test these expectations, we measured the taxonomic biodiversity, functional biodiversity, and rates of 10 different micropollutant biotransformations for 10 full-scale WWTP communities. We have demonstrated that biodiversity is positively associated with the rates of specific, but not all, micropollutant biotransformations. Thus, one cannot assume whether or how biodiversity will associate with the rate of any particular micropollutant biotransformation. We have further demonstrated that the strongest positive association is between biodiversity and the collective rate of multiple micropollutant biotransformations. Thus, more biodiversity is likely required to maximize the collective rates of multiple micropollutant biotransformations than is required to maximize the rate of any individual micropollutant biotransformation. We finally provide evidence that the positive associations are stronger for rare micropollutant biotransformations than for common micropollutant biotransformations. Together, our results are consistent with the hypothesis that differences in biodiversity can indeed translate into differences in the provision of particular ecosystem services by full-scale WWTP communities.

  2. Maintaining continuity of clinical operations while implementing large-scale filmless operations. (United States)

    Honea, R; Mensch, B


    Texas Children's Hospital is a pediatric tertiary care facility in the Texas Medical Center with a large-scale, Digital Imaging and Communications in Medicine (DICOM)-compliant picture archival and communications system (PACS) installation. As our PACS has grown from an ultrasound niche PACS into a full-scale, multimodality operation, assuring continuity of clinical operations has become the number one task of the PACS staff. As new equipment is acquired and incorporated into the PACS, workflow processes, responsibilities, and job descriptions must be revised to accommodate filmless operations. Round-the-clock clinical operations must be supported with round-the-clock service, including three shifts, weekends, and holidays. To avoid unnecessary interruptions in clinical service, this requirement includes properly trained operators and users, as well as service personnel. Redundancy is a cornerstone in assuring continuity of clinical operations. This includes all PACS components such as acquisition, network interfaces, gateways, archive, and display. Where redundancy is not feasible, spare parts must be readily available. The need for redundancy also includes trained personnel. Procedures for contingency operations in the event of equipment failures must be devised, documented, and rehearsed. Contingency operations might be required in the event of scheduled as well as unscheduled service events, power outages, network outages, or interruption of the radiology information system (RIS) interface. Methods must be developed and implemented for reporting and documenting problems. We have a Trouble Call service that records a voice message and automatically pages the PACS Console Operator on duty. We also have developed a Maintenance Module on our RIS system where service calls are recorded by technologists and service actions are recorded and monitored by PACS support personnel. In a filmless environment, responsibility for the delivery of images to the radiologist and

  3. Islet Oxygen Consumption Rate (OCR Dose Predicts Insulin Independence in Clinical Islet Autotransplantation.

    Directory of Open Access Journals (Sweden)

    Klearchos K Papas

    Full Text Available Reliable in vitro islet quality assessment assays that can be performed routinely, prospectively, and are able to predict clinical transplant outcomes are needed. In this paper we present data on the utility of an assay based on cellular oxygen consumption rate (OCR in predicting clinical islet autotransplant (IAT insulin independence (II. IAT is an attractive model for evaluating characterization assays regarding their utility in predicting II due to an absence of confounding factors such as immune rejection and immunosuppressant toxicity.Membrane integrity staining (FDA/PI, OCR normalized to DNA (OCR/DNA, islet equivalent (IE and OCR (viable IE normalized to recipient body weight (IE dose and OCR dose, and OCR/DNA normalized to islet size index (ISI were used to characterize autoislet preparations (n = 35. Correlation between pre-IAT islet product characteristics and II was determined using receiver operating characteristic analysis.Preparations that resulted in II had significantly higher OCR dose and IE dose (p<0.001. These islet characterization methods were highly correlated with II at 6-12 months post-IAT (area-under-the-curve (AUC = 0.94 for IE dose and 0.96 for OCR dose. FDA/PI (AUC = 0.49 and OCR/DNA (AUC = 0.58 did not correlate with II. OCR/DNA/ISI may have some utility in predicting outcome (AUC = 0.72.Commonly used assays to determine whether a clinical islet preparation is of high quality prior to transplantation are greatly lacking in sensitivity and specificity. While IE dose is highly predictive, it does not take into account islet cell quality. OCR dose, which takes into consideration both islet cell quality and quantity, may enable a more accurate and prospective evaluation of clinical islet preparations.

  4. The Interrater Reliability of the Modified Gait Abnormality Rating Scale for Use with People with Intellectual Disability (United States)

    Hale, Leigh; McIlraith, Lucy; Miller, Clare; Stanley-Clarke, Terri; George, Rebecca


    Background: Researching falls in persons with ID is limited by difficulties in applying standardised balance outcome measures. The modified Gait Abnormality Rating Scale (GARS-M), developed to identify falls risk in older adults, requires only that the participant walks and thus may be a feasible falls research tool to use with people with ID. In…


    Energy Technology Data Exchange (ETDEWEB)

    Peters, Catherine A [Princeton University


    This project addressed the scaling of geochemical reactions to core and field scales, and the interrelationship between reaction rates and flow in porous media. We targeted reactive transport problems relevant to the Hanford site specifically the reaction of highly caustic, radioactive waste solutions with subsurface sediments, and the immobilization of 90Sr and 129I through mineral incorporation and passive flow blockage, respectively. We addressed the correlation of results for pore-scale fluid-soil interaction with field-scale fluid flow, with the specific goals of (i) predicting attenuation of radionuclide concentration; (ii) estimating changes in flow rates through changes of soil permeabilities; and (iii) estimating effective reaction rates. In supplemental work, we also simulated reactive transport systems relevant to geologic carbon sequestration. As a whole, this research generated a better understanding of reactive transport in porous media, and resulted in more accurate methods for reaction rate upscaling and improved prediction of permeability evolution. These scientific advancements will ultimately lead to better tools for management and remediation of DOE legacy waste problems.

  6. Use of the Childhood Autism Rating Scale (CARS) for Children with High Functioning Autism or Asperger Syndrome (United States)

    Mayes, Susan Dickerson; Calhoun, Susan L.; Murray, Michael J.; Morrow, Jill D.; Yurich, Kirsten K. L.; Cothren, Shiyoko; Purichia, Heather; Mahr, Fauzia; Bouder, James N.; Petersen, Christopher


    The authors of the "Childhood Autism Rating Scale" (CARS) state in the manual that the best cutoff score for distinguishing low functioning autism (LFA) from intellectual disability is 30 for children and 28 for adolescents and adults. This study determined that a cutoff score of 25.5 was most accurate in differentiating between high functioning…

  7. A Brief "DSM-IV"-Referenced Teacher Rating Scale for Monitoring Behavioral Improvement in ADHD and Co-Occurring Symptoms (United States)

    Sprafkin, Joyce; Mattison, Richard E.; Gadow, Kenneth D.; Schneider, Jayne; Lavigne, John V.


    Objective: To examine the psychometric properties of the 30-item teacher's version of the Child and Adolescent Symptom Inventory Progress Monitor (CASI-PM-T), a "DSM-IV"-referenced rating scale for monitoring change in ADHD and co-occurring symptoms in youths receiving behavioral or pharmacological interventions. Method: Three separate studies…

  8. A Facet-Factorial Approach towards the Development and Validation of a Jazz Rhythm Section Performance Rating Scale (United States)

    Wesolowski, Brian C.


    The purpose of this study was to develop a valid and reliable rating scale to assess jazz rhythm sections in the context of jazz big band performance. The research questions that guided this study included: (a) what central factors contribute to the assessment of a jazz rhythm section? (b) what items should be used to describe and assess a jazz…

  9. Delirium subtype identification and the validation of the Delirium Rating Scale - Revised-98 (Dutch version) in hospitalized elderly patients

    NARCIS (Netherlands)

    S.E. de Rooij; B.C. Munster; J.C. Korevaar; G. Casteelen; M.J. Schuurmans; R.C. van der Mast; M. Levi


    Background Delirium is the most common acute neuropsychiatric disorder in hospitalized elderly. The Dutch version of the Delirium Rating Scale-Revised-98 (DRS-R-98) appears to be a reliable method to classify delirium. The aim of this study was to determine the validity and reliability of the DRS-R-

  10. Defining Treatment Response and Remission in Child Anxiety: Signal Detection Analysis Using the Pediatric Anxiety Rating Scale (United States)

    Caporino, Nicole E.; Brodman, Douglas M.; Kendall, Philip C.; Albano, Anne Marie; Sherrill, Joel; Piacentini, John; Sakolsky, Dara; Birmaher, Boris; Compton, Scott N.; Ginsburg, Golda; Rynn, Moira; McCracken, James; Gosch, Elizabeth; Keeton, Courtney; March, John; Walkup, John T.


    Objective: To determine optimal Pediatric Anxiety Rating Scale (PARS) percent reduction and raw score cut-offs for predicting treatment response and remission among children and adolescents with anxiety disorders. Method: Data were from a subset of youth (N = 438; 7-17 years of age) who participated in the Child/Adolescent Anxiety Multimodal Study…

  11. Standard gamble, time trade-off and rating scale: Experimental results on the ranking properties of QALYs

    NARCIS (Netherlands)

    H. Bleichrodt (Han); M. Johannesson (Magnus)


    textabstractThis paper compares the relative performance of quality adjusted life years (QALYs) based on quality weights elicited by rating scale (RS), time trade-off (TTO) and standard gamble (SG). The standard against which relative performance is assessed is individual preference elicited by dire

  12. The Ethical Issues Rating Scale: An Instrument for Measuring Ethical Orientation of College Students toward Various Business Practices. (United States)

    Daniel, Larry G.; And Others


    Factor analysis of data from 213 college business students supported the existence of 5 constructs for the Ethical Issues Rating Scale, an instrument measuring respondents' assessment of the importance of various ethical issues. Suggestions about refining the instrument and using it are discussed. (SLD)

  13. Measuring Depression Over Time . . . or not? : Lack of Unidimensionality and Longitudinal Measurement Invariance in Four Common Rating Scales of Depression

    NARCIS (Netherlands)

    Fried, Eiko I.; van Borkulo, Claudia D.; Epskamp, Sacha; Schoevers, Robert A.; Tuerlinckx, Francis; Borsboom, Denny


    In depression research, symptoms are routinely assessed via rating scales and added to construct sum-scores. These scores are used as a proxy for depression severity in cross-sectional research, and differences in sum-scores over time are taken to reflect changes in an underlying depression construc

  14. Measuring depression over time . . . Or not? : Lack of unidimensionality and longitudinal measurement invariance in four common rating scales of depression

    NARCIS (Netherlands)

    Fried, E.I.; van Borkulo, C.D.; Epskamp, S.; Schoevers, R.A.; Tuerlinckx, F.; Borsboom, D.


    In depression research, symptoms are routinely assessed via rating scales and added to construct sum-scores. These scores are used as a proxy for depression severity in cross-sectional research, and differences in sum-scores over time are taken to reflect changes in an underlying depression construc

  15. Measuring Depression Over Time ... or not? Lack of Unidimensionality and Longitudinal Measurement Invariance in Four Common Rating Scales of Depression

    NARCIS (Netherlands)

    Fried, Eiko I.; van Borkulo, Claudia D.; Epskamp, Sacha; Schoevers, Robert A.; Tuerlinckx, Francis; Borsboom, Denny


    In depression research, symptoms are routinely assessed via rating scales and added to construct sum-scores. These scores are used as a proxy for depression severity in cross-sectional research, and differences in sum-scores over time are taken to reflect changes in an underlying depression construc

  16. Application of the Rasch Rating Scale Model to the Assessment of Quality of Life of Persons with Intellectual Disability (United States)

    Gomez, Laura E.; Arias, Benito; Verdugo, Miguel Angel; Navas, Patricia


    Background: Most instruments that assess quality of life have been validated by means of the classical test theory (CTT). However, CTT limitations have resulted in the development of alternative models, such as the Rasch rating scale model (RSM). The main goal of this paper is testing and improving the psychometric properties of the INTEGRAL…

  17. Confirmatory Factor Analysis of the "Preschool Behavioral and Emotional Rating Scale" (PreBERS) with Preschool Children with Disabilities (United States)

    Cress, Cynthia J.; Synhorst, Lori; Epstein, Michael H.; Allen, Elizabeth


    The "Preschool Behavioral and Emotional Rating Scale" (PreBERS) is a standardized, norm-referenced instrument that assesses emotional and behavioral strengths of preschool children. This study investigated whether the PreBERS four-factor structure (i.e., emotional regulation, school readiness, social confidence, and family involvement)…

  18. Membrane-aerated biofilms for high rate biotreatment: performance appraisal, engineering principles, scale-up, and development requirements. (United States)

    Syron, Eoin; Casey, Eoin


    Diffusion of the electron acceptor is the rate controlling step in virtually all biofilm reactors employed for aerobic wastewater treatment. The membrane-aerated biofilm reactor (MABR) is a technology that can deliver oxygen at high rates and transfer efficiencies, thereby enhancing the biofilm activity. This paper provides a comparative performance rate analysis of the MABR in terms of its application for carbonaceous pollutant removal, nitrification/denitrification and xenobiotic biotreatment. We also describe the mechanisms influencing process performance in the MABR and the inter-relationships between these factors. The challenges involved in scaling-up the process are discussed with recommendations for prioritization of research needs.

  19. Measurement of glomerular filtration rate by impulse synthesis: Clinical validation and optimization

    Energy Technology Data Exchange (ETDEWEB)

    Palagi, B.; Verga, P.; Broggi, A.; Picozzi, R.; Villa, F.; Guzzini, F.; Cozzi, C.; Tomasi, A.


    Impulse synthesis is a technique which relies upon the logic of continuous infusion but extracts the clearance value from single-injection data by shifting and adding them until an asymptotic value is attained. This study has been aimed at validating and optimizing clinically the measurement of glomerular filtration rate by impulse synthesis. A single intravenous injection of /sup 51/Cr-EDTA has been made in 32 patients and plasma activity monitored over the next 6 h. Glomerular filtration rate computed by a single-exponential fit method (GFR-SEF) has been shown to be significantly (p<0.001) overestimated when compared with the glomerular filtration rate obtained by the impulse synthesis technique (GFR-IS) in spite of an excellent (r=0.989) linear correlation between the two sets of data. On the other hand, the comparison between GFR-IS and 24-h creatinine clearance has not shown any significant difference. Moreover, we have found that in patients with severe renal failure GFR-IS is overestimated when the sampling time span is shortened to 3 h. On the other hand, GFR-IS is slightly underestimated in patients with severe renal failure when the convolution time interval is increased over a few minutes.

  20. The Changing Patterns in Referral Rates of Geriatric Cats and Dogs to an University Clinic

    Directory of Open Access Journals (Sweden)

    Sinem ÜLGEN


    Full Text Available Improving quality of care and nutrition of pet animals and advanced diagnosis and treatment by developing technologies, lead to an increase in survival rate. As the present authors were unaware of finding documented reports for several diseases, it was aimed to investigate the number and health status of geriatric cats and dogs which were brought to Internal Medicine clinics of our faculty’s training and research hospital within six years. Twenty-four cats and 10 dogs enrolled in the study were found to be healthy, whereas multiple health concerns were diagnosed in totally 1354 animals (n=403 for cats, n=951 for dogs. Increase in survival rate within 6 years was determined as 27.7% increase for cats and as 5.3% increase for dogs. The urinary system diseases for cats and cardiovascular system diseases for dogs were found to be the most frequent diagnosis. Geriatric animal rates varied between 4.2 and 12.3% for cats and 6.2 and 15.7% for dogs within years which were not expected as higher.

  1. Effects of acupressure on progress of labor and cesarean section rate: randomized clinical trial. (United States)

    Mafetoni, Reginaldo Roque; Shimo, Antonieta Keiko Kakuda


    OBJECTIVE To analyze the effects of acupressure at the SP6 point on labor duration and cesarean section rates in parturients served in a public maternity hospital. METHODS This controlled, randomized, double-blind, pragmatic clinical trial involved 156 participants with gestational age ≥ 37 weeks, cervical dilation ≥ 4 cm, and ≥ 2 contractions in 10 min. The women were randomly divided into an acupressure, placebo, or control group at a university hospital in an inland city in the state of Sao Paulo, Brazil, in 2013. Acupressure was applied to the SP6 point during contractions for 20 min. RESULTS The average labor duration was significantly different between the SP6 acupressure group [221.5 min (SD = 162.4)] versus placebo [397.9 min (SD = 265.6)] and versus control [381.9 min (SD = 358.3)] (p = 0.0047); however, the groups were similar regarding the cesarean section rates (p = 0.2526) and Apgar scores in the first minute (p = 0.9542) and the fifth minute (p = 0.7218) of life of the neonate. CONCLUSIONS The SP6 acupressure point proved to be a complementary measure to induce labor and may shorten the labor duration without causing adverse effects to the mother or the newborn. However, it did not affect the cesarean section rate.

  2. How to compare scores from different depression scales: equating the Patient Health Questionnaire (PHQ) and the ICD-10-Symptom Rating (ISR) using Item Response Theory. (United States)

    Fischer, H Felix; Tritt, Karin; Klapp, Burghard F; Fliege, Herbert


    A wide range of questionnaires for measuring depression are available. Item Response Theory models can help to evaluate the questionnaires exceeding the boundaries of Classical Test Theory and provide an opportunity to equate the questionnaires. In this study after checking for unidimensionality, a General Partial Credit Model was applied to data from two different depression scales [Patient Health Questionnaire (PHQ-9) and ICD-10-Symptom Rating (ISR)] obtained in clinical settings from a consecutive sample, including 4517 observations from a total of 2999 inpatients and outpatients of a psychosomatic clinic. The precision of each questionnaire was compared and the model was used to transform scores based on the assumed underlying latent trait. Both instruments were constructed to measure the same construct and their estimates of depression severity are highly correlated. Our analysis showed that the predicted scores provided by the conversion tables are similar to the observed scores in a validation sample. The PHQ-9 and ISR depression scales measure depression severity across a broad range with similar precision. While the PHQ-9 shows advantages in measuring low or high depression severity, the ISR is more parsimonious and also suitable for clinical purposes. Furthermore, the equation tables derived in this study enhance the comparability of studies using either one of the instruments, but due to substantial statistical spread the comparison of individual scores is imprecise.

  3. Mobile App Rating Scale: A New Tool for Assessing the Quality of Health Mobile Apps


    Stoyanov, Stoyan R.; Hides, Leanne; Kavanagh, David John; Zelenko, Oksana; Tjondronegoro, Dian; Mani, Madhavan


    Background The use of mobile apps for health and well being promotion has grown exponentially in recent years. Yet, there is currently no app-quality assessment tool beyond “star”-ratings. Objective The objective of this study was to develop a reliable, multidimensional measure for trialling, classifying, and rating the quality of mobile health apps. Methods A literature search was conducted to identify articles containing explicit Web or app quality rating criteria published between January ...

  4. Translating dosages from animal models to human clinical trials--revisiting body surface area scaling. (United States)

    Blanchard, Otis L; Smoliga, James M


    Body surface area (BSA) scaling has been used for prescribing individualized dosages of various drugs and has also been recommended by the U.S. Food and Drug Administration as one method for using data from animal model species to establish safe starting dosages for first-in-human clinical trials. Although BSA conversion equations have been used in certain clinical applications for decades, recent recommendations to use BSA to derive interspecies equivalents for therapeutic dosages of drug and natural products are inappropriate. A thorough review of the literature reveals that BSA conversions are based on antiquated science and have little justification in current translational medicine compared to more advanced allometric and physiologically based pharmacokinetic modeling. Misunderstood and misinterpreted use of BSA conversions may have disastrous consequences, including underdosing leading to abandonment of potentially efficacious investigational drugs, and unexpected deadly adverse events. We aim to demonstrate that recent recommendations for BSA are not appropriate for animal-to-human dosage conversions and use pharmacokinetic data from resveratrol studies to demonstrate how confusion between the "human equivalent dose" and "pharmacologically active dose" can lead to inappropriate dose recommendations. To optimize drug development, future recommendations for interspecies scaling must be scientifically justified using physiologic, pharmacokinetic, and toxicology data rather than simple BSA conversion.

  5. Diagnostic accuracy comparison between clinical signs and hemoglobin color scale as screening methods in the diagnosis of anemia in children


    Leal,Luciana Pedrosa; Mônica M. Osório


    OBJECTIVES: to compare the validity and reproducibility of clinical signs with the World Health Organization hemoglobin color scale. METHODS: Two hundred six children in the age range of 6-23 months, at the Instituto Materno Infantil Prof. Fernando Figueira, IMIP, were assessed. Two examiners evaluated the clinical signs and the hemoglobin color scale of each child at the different times. The hemoglobin value was used as a standard for validation. RESULTS: in more than 90% of cases the agreem...

  6. Adherence to clinical practice guidelines on community acquired pneumonia and its relation to mortality rates.

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    María Caridad Fragoso Marchante


    Full Text Available Background: Community acquired pneumonia is a common disease that is associated with significant morbidity and mortality rates. In the General University Hospital ´´Dr. Gustavo Aldereguía Lima¨ in Cienfuegos, there are guidelines for the management of patients with community-acquired pneumonia, but no studies have been conducted as to the relation between their compliance and the mortality rate. Objective: To assess the adherence to guidelines for diagnosis and treatment of community-acquired pneumonia and its relation to mortality in hospitalized patients. Methods: A descriptive, observational and prospective case series study was conducted in all patients with a diagnosis of pneumonia or bronchopneumonia at the moment of admission and discharge from June 2006 to May 31, 2007. The relation between the different variables and the mortality rate was analyzed as to the different types of risks and the overall compliance with the guidelines for each risk with mortality. A multivariate analysis (logistic regression was performed, with a 95% confidence interval. Results: The results are presented in tables of numbers and percent. Variables independently associated with mortality were: age (over 65 years old people, radiological lesions in more than one lobe or bilateral, atypical pneumonia debut, negative assessments as to the adherence to guidelines and inadequate treatments. Conclusion: The variables included in the study were enough to explain the final outcome of the patients, so it could be determined, for the first time in Cienfuegos, that the non-compliance with the guidelines of good clinical practice is related to mortality rates.

  7. The DSM-5 social anxiety disorder severity scale: Evidence of validity and reliability in a clinical sample. (United States)

    LeBeau, Richard T; Mesri, Bita; Craske, Michelle G


    With DSM-5, the APA began providing guidelines for anxiety disorder severity assessment that incorporates newly developed self-report scales. The scales share a common template, are brief, and are free of copyright restrictions. Initial validation studies have been promising, but the English-language versions of the scales have not been formally validated in clinical samples. Forty-seven individuals with a principal diagnosis of Social Anxiety Disorder (SAD) completed a diagnostic assessment, as well as the DSM-5 SAD severity scale and several previously validated measures. The scale demonstrated internal consistency, convergent validity, and discriminant validity. The next steps in the validation process are outlined.

  8. Dependence of alanine gel dosimeter response as a function of photon clinical beams dose rate

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    Silva, Cleber Feijo, E-mail: [Faculdade Metodo de Sao Paulo (FAMESP), SP (Brazil); Campos, Leticia Lucente, E-mail: [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)


    Gel dosimetry is a new area developed by Gore, it is ery useful for application in radiotherapy because using NMR imaging as evaluation technique is possible to evaluate three dimensional absorbed dose distribution. The measure technique is based on difference of ferrous (Fe{sup 2+}) and ferric (Fe{sup 3+}) ) ions concentration that can be measured also by spectrophotometry technique. The Alanine gel dosimeter was developed at IPEN. The alanine is an amino acid and tissue equivalent material that presents significant improvement on previous alanine dosimetry systems. The addition of Alanine increases the production of ferric ions in the solution. This work aims to study the dose rate dependence of photon clinical beams radiation on the alanine gel dosimeter optical response, as well as the response repeatability and gel production reproducibility, since this property is very important for characterization and standardization of any dosimeter. (author)

  9. Complication rate of molar crowns: a practice-based clinical evaluation. (United States)

    Rinke, S; Schäfer, S; Roediger, M


    This practice-based study evaluates the initial clinical performance of conventionally luted metal-ceramic and zirconia molar crowns fabricated with a prolonged cooling period of the veneering porcelain. Forty-nine patients were treated (group A: high precious alloy + low fusing porcelain; group B: zirconia crowns). All zirconia crowns were veneered with a modified porcelain firing cycle including a 6-minute cooling period. Ninety-two restorations (74 vital abutments/18 nonvital abutments) were evaluated after a mean observation period of 18.2 +/- 4.6 months. No complete failures or loss of vitality were recorded in either group. Two events were recorded in group A (1 loss of retention/1 minor ceramic chipping zirconia crowns fabricated with a modified porcelain firing. The modified firing of the zirconia porcelain seems to decrease the risk for early ceramic chipping in the molar area, leading to a technical complication rate comparable to that of metal-ceramic crowns.

  10. Clinical and biochemical characteristics of Cushing’s disease with different suppression rates by high-dose dexamethasone

    Institute of Scientific and Technical Information of China (English)



    Objective To analyze the clinical and biochemical characteristics of Cushing’s disease with different suppression rates by high-dose dexamethasone.Methods Two hundred and two consecutive patients with

  11. The Anti-Clot Treatment Scale (ACTS in clinical trials: cross-cultural validation in venous thromboembolism patients

    Directory of Open Access Journals (Sweden)

    Cano Stefan J


    Full Text Available Abstract Background The Anti-Clot Treatment Scale (ACTS is a 15-item patient-reported instrument of satisfaction with anticoagulant treatment. It includes a 12-item ACTS Burdens scale and a 3-item ACTS Benefits scale. Its role in clinical trials and other settings should be supported by evidence that it is both clinically meaningful and scientifically sound. The aim of the study was to evaluate the measurement performance of the ACTS (Dutch, Italian, French, German and English language versions in patients with venous thromboembolism based on traditional psychometric methods. Methods ACTS Burdens and Benefits scale data from a large clinical trial (EINSTEIN DVT involving 1336 people with venous thromboembolism were analysed at both the scale and item level. Five key psychometric properties were examined using traditional psychometric methods: acceptability, scaling assumptions, reliability (including internal consistency reliability, test-retest reproducibility; validity (including known groups and discriminant validity; and responsiveness. These methods of examination underpin the US Food and Drug Administration recommendations for patient-reported outcome instrument evaluation. Results Overall, the 12-item ACTS Burdens scale and 3-item ACTS Benefits scale met the psychometric criteria evaluated at both item and scale levels, with the exception of some relatively minor issues in the Dutch language version, which were just below reliability criteria (i.e. alpha = 0.72, test-retest intraclass correlation = 0.79. A consistent finding from item-level evaluations of aggregate endorsement frequencies and skewness suggested that response scales may be improved by reducing the number of response options from five to four. Conclusions Both the ACTS Burdens and ACTS Benefits scales consistently satisfied traditional reliability and validity criteria across multiple language datasets, supporting it as a clinically useful patient

  12. A scale-space method for detecting recurrent DNA copy number changes with analytical false discovery rate control. (United States)

    van Dyk, Ewald; Reinders, Marcel J T; Wessels, Lodewyk F A


    Tumor formation is partially driven by DNA copy number changes, which are typically measured using array comparative genomic hybridization, SNP arrays and DNA sequencing platforms. Many techniques are available for detecting recurring aberrations across multiple tumor samples, including CMAR, STAC, GISTIC and KC-SMART. GISTIC is widely used and detects both broad and focal (potentially overlapping) recurring events. However, GISTIC performs false discovery rate control on probes instead of events. Here we propose Analytical Multi-scale Identification of Recurrent Events, a multi-scale Gaussian smoothing approach, for the detection of both broad and focal (potentially overlapping) recurring copy number alterations. Importantly, false discovery rate control is performed analytically (no need for permutations) on events rather than probes. The method does not require segmentation or calling on the input dataset and therefore reduces the potential loss of information due to discretization. An important characteristic of the approach is that the error rate is controlled across all scales and that the algorithm outputs a single profile of significant events selected from the appropriate scales. We perform extensive simulations and showcase its utility on a glioblastoma SNP array dataset. Importantly, ADMIRE detects focal events that are missed by GISTIC, including two events involving known glioma tumor-suppressor genes: CDKN2C and NF1.

  13. Detection Rate and Clinical Impact of Respiratory Viruses in Children with Kawasaki Disease

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    Ja Hye Kim


    Full Text Available &lt;B&gt;Purpose:&lt;/B&gt; The purpose of this prospective case-control study was to survey the detection rate of respiratory viruses in children with Kawasaki disease (KD by using multiplex reverse transcriptasepolymerase chain reaction (RT-PCR, and to investigate the clinical implications of the prevalence of respiratory viruses during the acute phase of KD. &lt;B&gt;Methods:&lt;/B&gt; RT-PCR assays were carried out to screen for the presence of respiratory syncytial virus A and B, adenovirus, rhinovirus, parainfluenza viruses 1 to 4, influenza virus A and B, metapneumovirus, bocavirus, coronavirus OC43/229E and NL63, and enterovirus in nasopharyngeal secretions of 55 KD patients and 78 control subjects. &lt;B&gt;Results:&lt;/B&gt; Virus detection rates in KD patients and control subjects were 32.7% and 30.8%, respectively (P=0.811. However, there was no significant association between the presence of any of the 15 viruses and the incidence of KD. Comparisons between the 18 patients with positive RT-PCR results and the other 37 KD patients revealed no significant differences in terms of clinical findings (including the prevalence of incomplete presentation of the disease and coronary artery diameter. &lt;B&gt;Conclusion:&lt;/B&gt; A positive RT-PCR for currently epidemic respiratory viruses should not be used as an evidence against the diagnosis of KD. These viruses were not associated with the incomplete presentation of KD and coronary artery dilatation.

  14. Heart rate control with adrenergic blockade: Clinical outcomes in cardiovascular medicine

    Directory of Open Access Journals (Sweden)

    David Feldman


    Full Text Available David Feldman1, Terry S Elton2, Doron M Menachemi3, Randy K Wexler41Heart Failure/Transplant and VAD Programs, Minneapolis Heart Institute, Minneapolis, Minnesota, USA; 2Division of Pharmacology, College of Pharmacology, The Ohio State University, Columbus, Ohio, USA; 3Heart Failure Services, Edith Wolfson Medical Center, The Heart Institute, Sakler School of Medicine, Tel-Aviv University, Holon, Israel; 4Department of Clinical Family Medicine, The Ohio State University, Columbus, Ohio, USAAbstract: The sympathetic nervous system is involved in regulating various cardiovascular parameters including heart rate (HR and HR variability. Aberrant sympathetic nervous system expression may result in elevated HR or decreased HR variability, and both are independent risk factors for development of cardiovascular disease, including heart failure, myocardial infarction, and hypertension. Epidemiologic studies have established that impaired HR control is linked to increased cardiovascular morbidity and mortality. One successful way of decreasing HR and cardiovascular mortality has been by utilizing β-blockers, because their ability to alter cell signaling at the receptor level has been shown to mitigate the pathogenic effects of sympathetic nervous system hyperactivation. Numerous clinical studies have demonstrated that β-blocker-mediated HR control improvements are associated with decreased mortality in postinfarct and heart failure patients. Although improved HR control benefits have yet to be established in hypertension, both traditional and vasodilating β-blockers exert positive HR control effects in this patient population. However, differences exist between traditional and vasodilating β-blockers; the latter reduce peripheral vascular resistance and exert neutral or positive effects on important metabolic parameters. Clinical evidence suggests that attainment of HR control is an important treatment objective for patients with cardiovascular

  15. Clinical utility of the Wechsler Memory Scale - Fourth Edition (WMS-IV) in patients with intractable temporal lobe epilepsy

    NARCIS (Netherlands)

    Bouman, Z.; Elhorst, D.; Hendriks, M.P.H.; Kessels, R.P.C.; Aldenkamp, A.P.


    Introduction: The Wechsler Memory Scale (WMS) is one of the most widely used test batteries to assess memory functions in patients with brain dysfunctions of different etiologies. This study examined the clinical validation of the Dutch Wechsler Memory Scale-Fourth Edition (WMS-IV-NL) in patients wi

  16. Large scale atmospheric forcing and topographic modification of precipitation rates over High Asia – a neural network based approach

    Directory of Open Access Journals (Sweden)

    L. Gerlitz


    Full Text Available The heterogeneity of precipitation rates in high mountain regions is not sufficiently captured by state of the art climate reanalysis products due to their limited spatial resolution. Thus there exists a large gap between the available data sets and the demands of climate impact studies. The presented approach aims to generate spatially high resolution precipitation fields for a target area in Central Asia, covering the Tibetan Plateau, the adjacent mountain ranges and lowlands. Based on the assumption, that observed local scale precipitation amounts are triggered by varying large scale atmospheric situations and modified by local scale topographic characteristics, the statistical downscaling approach estimates local scale precipitation rates as a function of large scale atmospheric conditions, derived from the ERA-Interim reanalysis, and high resolution terrain parameters. Since the relationships of the predictor variables with local scale observations are rather unknown and highly non-linear, an Artificial Neural Network (ANN was utilized for the development of adequate transfer functions. Different ANN-architectures were evaluated with regard to their predictive performance. The final downscaling model was used for the cellwise estimation of monthly precipitation sums, the number of rainy days and the maximum daily precipitation amount with a spatial resolution of 1 km2. The model was found to sufficiently capture the temporal and spatial variations of precipitation rates in the highly structured target area and allows a detailed analysis of the precipitation distribution. A concluding sensitivity analysis of the ANN model reveals the effect of the atmospheric and topographic predictor variables on the precipitation estimations in the climatically diverse subregions.

  17. X-Chromosome Control of Genome-Scale Recombination Rates in House Mice. (United States)

    Dumont, Beth L


    Sex differences in recombination are widespread in mammals, but the causes of this pattern are poorly understood. Previously, males from two interfertile subspecies of house mice, Mus musculus musculus and M. m. castaneus, were shown to exhibit a ~30% difference in their global crossover frequencies. Much of this crossover rate divergence is explained by six autosomal loci and a large-effect locus on the X chromosome. Intriguingly, the allelic effects at this X-linked locus are transgressive, with the allele conferring increased crossover rate transmitted by the low crossover rate M. m. castaneus parent. Despite the pronounced divergence between males, females from these subspecies exhibit similar crossover rates, raising the question of how recombination is genetically controlled in this sex. Here, I analyze publicly available genotype data from early generations of the Collaborative Cross, an 8-way panel of recombinant inbred strains, to estimate crossover frequencies in female mice with sex chromosome genotypes of diverse sub-specific origins. Consistent with the transgressive influence of the X chromosome in males, I show that females inheriting a M. m. castaneus X possess higher average crossover rates than females lacking the M. m. castaneus X chromosome. The differential inheritance of the X chromosome in males and females provides a simple genetic explanation for sex-limited evolution of this trait. Further, the presence of X-linked and autosomal crossover rate modifiers with antagonistic effects hints at an underlying genetic conflict fueled by selection for distinct crossover rate optima in males and females.

  18. Subthalamic nucleus and internal globus pallidus scale with the rate of change of force production in humans. (United States)

    Vaillancourt, David E; Mayka, Mary A; Thulborn, Keith R; Corcos, Daniel M


    The basal ganglia, motor cortex, and cerebellum have been implicated as a circuit that codes for movement velocity. Since movement velocity covaries with the magnitude of force exerted and previous studies have shown that similar regions scale in activation for velocity and force, the scaling of neuronal activity with movement velocity could be due to the force exerted. The present study implemented a parametric functional magnetic resonance imaging (fMRI) design to determine which brain regions directly scale with the rate of change of force production, independent of the magnitude of force exerted. Nine healthy adults produced force with their right middle finger and thumb at 25% of their maximal voluntary contraction across four conditions: (1) fast pulse, (2) fast hold, (3) medium hold, and (4) slow hold. There were three primary findings: (i) the activation volume in multiple regions increased with the duration of the force contraction, (ii) only the activation volume in the bilateral internal globus pallidus and left subthalamic nucleus parametrically scaled with the rate of change of force production, and (iii) there was an inverse relation between the activation volume in the subthalamic nucleus and internal globus pallidus with the rate of change of force production. The current findings are the first to have used neuroimaging techniques in humans to segregate the functional anatomy of the internal globus pallidus from external globus pallidus, distinguish functional activation in the globus pallidus from the putamen, and demonstrate task-dependent scaling in the subthalamic nucleus and internal globus pallidus. We conclude that fast, ballistic force production is preprogrammed, requiring a small metabolic demand from the basal ganglia. In contrast, movements that require the internal regulation of the rate of change of force are associated with increased metabolic demand from the subthalamic nucleus and internal segment of the globus pallidus.

  19. Very Small-Scale Clustering and Merger Rate of Luminous Red Galaxies

    CERN Document Server

    Masjedi, M; Berlind, A A; Blanton, M R; Brinkmann, J; Cool, R J; Eisenstein, D J; Hogg, D W; Schneider, D P; Warren, M S; Zehavi, I; Bell, Eric F.; Berlind, Andreas A.; Blanton, Michael R.; Brinkmann, Jon; Cool, Richard J.; Eisenstein, Daniel J.; Hogg, David W.; Masjedi, Morad; Schneider, Donald P.; Warren, Michael S.; Zehavi, Idit


    We present the small-scale (0.01scales smaller than 55 arcseconds prevents measurements of the correlation function for LRGs on scales smaller than ~0.3 Mpc by the usual methods. In this work, we cross-correlate the spectroscopic sample with the imaging sample, with a weighting scheme to account for the collisions, extensively tested against mock catalogs. We correct for photometric biases in the SDSS imaging of close galaxy pairs. We find that the correlation function xi(r) is surprisingly close to a r^{-2} power law over more than 4 orders of magnitude in separation r. This result is too steep at small scales to be explained in current versions of the halo model for galaxy clustering. We infer an LRG-LRG merger...

  20. Measuring awareness in people with mild to moderate Alzheimer's disease: development of the Memory Awareness Rating Scale--adjusted. (United States)

    Hardy, Rachel M; Oyebode, Jan R; Clare, Linda


    Variations in level of awareness among people with Alzheimer's disease (AD) may impact on well-being for the person with dementia and their carer, and may influence outcomes of cognitive rehabilitation interventions. Awareness has often been assessed using discrepancies between self and proxy rating or between self-rating and objective task performance, with the latter considered to be preferable. Measures are available that are suitable for people with mild AD, for example the Memory Awareness Rating Scale (MARS). However, these may be less appropriate for people whose impairments are more advanced and who consequently have more difficulty with the objective task component. In order to provide a measure suitable for people with moderate AD, an adjusted Memory Awareness Rating Scale (MARSA) was developed by altering the objective task component of the MARS. The MARSA was piloted with 41 participants with mild to moderate AD. It was found to be suitable for use with a broader group of participants than the MARS. The component ratings were found to have good internal consistency. The component ratings and the two indices of awareness had high test-retest reliability. The extension of the original measure offers the opportunity to consider awareness throughout the course of the disease and provides a basis for longitudinal investigations of awareness.

  1. Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results. (United States)

    Goetz, Christopher G; Tilley, Barbara C; Shaftman, Stephanie R; Stebbins, Glenn T; Fahn, Stanley; Martinez-Martin, Pablo; Poewe, Werner; Sampaio, Cristina; Stern, Matthew B; Dodel, Richard; Dubois, Bruno; Holloway, Robert; Jankovic, Joseph; Kulisevsky, Jaime; Lang, Anthony E; Lees, Andrew; Leurgans, Sue; LeWitt, Peter A; Nyenhuis, David; Olanow, C Warren; Rascol, Olivier; Schrag, Anette; Teresi, Jeanne A; van Hilten, Jacobus J; LaPelle, Nancy


    We present a clinimetric assessment of the Movement Disorder Society (MDS)-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS). The MDS-UDPRS Task Force revised and expanded the UPDRS using recommendations from a published critique. The MDS-UPDRS has four parts, namely, I: Non-motor Experiences of Daily Living; II: Motor Experiences of Daily Living; III: Motor Examination; IV: Motor Complications. Twenty questions are completed by the patient/caregiver. Item-specific instructions and an appendix of complementary additional scales are provided. Movement disorder specialists and study coordinators administered the UPDRS (55 items) and MDS-UPDRS (65 items) to 877 English speaking (78% non-Latino Caucasian) patients with Parkinson's disease from 39 sites. We compared the two scales using correlative techniques and factor analysis. The MDS-UPDRS showed high internal consistency (Cronbach's alpha = 0.79-0.93 across parts) and correlated with the original UPDRS (rho = 0.96). MDS-UPDRS across-part correlations ranged from 0.22 to 0.66. Reliable factor structures for each part were obtained (comparative fit index > 0.90 for each part), which support the use of sum scores for each part in preference to a total score of all parts. The combined clinimetric results of this study support the validity of the MDS-UPDRS for rating PD.

  2. Comparison of 5 health care professionals’ratings of the clinical significance of drug related problems

    DEFF Research Database (Denmark)

    Villesen, Christine; Hojsted, Jette; Kjeldsen, Lene Juel


    Background Patients have medicines reviews conducted by different health care professionals in different settings. Introducing a clinical panel to drug related problems (DRPs) to evaluate their clinical significance is common practice. The clinical panel discuss the potential consequences and com...

  3. Type I Error Rates and Power Estimates of Selected Parametric and Nonparametric Tests of Scale. (United States)

    Olejnik, Stephen F.; Algina, James


    Estimated Type I Error rates and power are reported for the Brown-Forsythe, O'Brien, Klotz, and Siegal-Tukey procedures. The effect of aligning the data using deviations from group means or group medians is investigated. (RB)

  4. Human platelet lysate permits scale-up of dental pulp stromal cells for clinical applications. (United States)

    Govindasamy, Vijayendran; Ronald, Veronica Sainik; Abdullah, Aimi Naim Binti; Ganesan Nathan, Kavitha R; Aziz, Zeti Adura Che Abdul; Abdullah, Mariam; Zain, Rosnah Binti; Kasim, Noor Hayaty Abu; Musa, Sabri; Bhonde, Ramesh R


    BACKGROUND AIMS. Dental pulp stromal cells (DPSC) are considered to be a promising source of stem cells in the field of regenerative therapy. However, the usage of DPSC in transplantation requires large-scale expansion to cater for the need for clinical quantity without compromising current good manufacturing practice (cGMP). Existing protocols for cell culturing make use of fetal bovine serum (FBS) as a nutritional supplement. Unfortunately, FBS is an undesirable additive to cells because it carries the risk of transmitting viral and prion diseases. Therefore, the present study was undertaken to examine the efficacy of human platelet lysate (HPL) as a substitute for FBS in a large-scale set-up. METHODS. We expanded the DPSC in Dulbecco's modified Eagle's medium-knock-out (DMEM-KO) with either 10% FBS or 10% HPL, and studied the characteristics of DPSC at pre- (T25 culture flask) and post- (5-STACK chamber) large-scale expansion in terms of their identity, quality, functionality, molecular signatures and cytogenetic stability. RESULTS. In both pre- and post-large-scale expansion, DPSC expanded in HPL showed extensive proliferation of cells (c. 2-fold) compared with FBS; the purity, immune phenotype, colony-forming unit potential and differentiation were comparable. Furthermore, to understand the gene expression profiling, the transcriptomes and cytogenetics of DPSC expanded under HPL and FBS were compared, revealing similar expression profiles. CONCLUSIONS. We present a highly economized expansion of DPSC in HPL, yielding double the amount of cells while retaining their basic characteristics during a shorter time period under cGMP conditions, making it suitable for therapeutic applications.


    Bonacci, Robert A.; Cruz-Hervert, Luis Pablo; García-García, Lourdes; Reynales-Shigematsu, Luz Myriam; Ferreyra-Reyes, Leticia; Bobadilla-del-Valle, Miriam; Canizales-Quintero, Sergio; Ferreira-Guerrero, Elizabeth; Báez-Saldaña, Renata; Téllez-Vázquez, Norma; Mongua-Rodríguez, Norma; Montero-Campos, Rogelio; Delgado-Sánchez, Guadalupe; Martínez-Gamboa, Rosa Areli; Cano-Arellano, Bulmaro; Sifuentes-Osornio, José; de León, Alfredo Ponce


    Objectives To examine the relationship between cigarette smoking and incidence and mortality rates of pulmonary tuberculosis (TB) and treatment outcomes. Materials From 1995-2010, we analyzed data from 1062 patients with TB and from 2001-2004, 2951 contacts in Southern Mexico. Patients with acid-fast bacilli or Mycobacterium tuberculosis in sputum samples underwent epidemiological, clinical and mycobacteriological evaluation and received treatment by the local DOTS program. Results Consumers of 1-10 (LS) or 11 or more (HS) cigarettes per day incidence (1.75 and 11.79) and mortality (HS,17.74) smoker-nonsmoker rate ratios were significantly higher for smokers. Smoker population was more likely to experience unfavorable treatment outcomes (HS, adjusted OR 2.36) and retreatment (LS and HS, adjusted hazard ratio (HR) 2.14 and 2.37). Contacts that smoked had a higher probability of developing active TB (HR 2.38) during follow up. Conclusions Results indicate the need of incorporating smoking prevention and cessation, especially among men, into international TB control strategies. PMID:22982014

  6. High mutational rates of large-scale duplication and deletion in Daphnia pulex


    Keith, Nathan; Tucker, Abraham E.; Jackson, Craig E.; Sung, Way; Lucas Lledó, José Ignacio; Schrider, Daniel R.; Schaack, Sarah; DUDYCHA, JEFFRY L.; Ackerman, Matthew; Andrew J. Younge; Shaw, Joseph R.; Lynch, Michael


    Knowledge of the genome-wide rate and spectrum of mutations is necessary to understand the origin of disease and the genetic variation driving all evolutionary processes. Here, we provide a genome-wide analysis of the rate and spectrum of mutations obtained in two Daphnia pulex genotypes via separate mutation-accumulation (MA) experiments. Unlike most MA studies that utilize haploid, homozygous, or self-fertilizing lines, D. pulex can be propagated ameiotically while maintaining a naturally h...

  7. A comparison of a patient-rated visual analogue scale with the Liebowitz Social Anxiety Scale for social anxiety disorder: A cross-sectional study


    興津, 裕美


    博士(医学) 乙第2814号, 著者名:Hiromi Okitsu・Jitsuki Sawamura・Katsuji Nishimura・Yasuto Sato・Jun Ishigooka,タイトル:A comparison of a patient-rated visual analogue scale with the Liebowitz Social Anxiety Scale for social anxiety disorder: A cross-sectional study,掲載誌:Open Journal of Psychiatry (2161-7325),巻・頁・年:4巻1号 p.68~74 (2014),著作権関連情報:Copyright © 2014 by authors and Scientific Research Publishing Inc.,DOI:10.4236/ojpsych.2014.41010...

  8. Impact of Scaling on CMOS Chip Failure Rate, and Design Rules for Hot Carrier Reliability



    Silicon-hydrogen bonds passivate the interface defects at the silicon-silicon dioxide interface of CMOS transistors. The activation of these bonds and subsequent creation of interface traps is an important source of transistor degradation at current operating conditions. There is now evidence for a distribution in the activation energies of these bonds instead of a single threshold value. We show that conventional CMOS scaling rules are substantially affected by this energy dis...

  9. Outdoor pilot-scale production of Nannochloropsis gaditana: influence of culture parameters and lipid production rates in tubular photobioreactors. (United States)

    San Pedro, A; González-López, C V; Acién, F G; Molina-Grima, E


    This work studied outdoor pilot scale production of Nannochloropsis gaditana in tubular photobioreactors. The growth and biomass composition of the strain were studied under different culture strategies: continuous-mode (varying nutrient supply and dilution rate) and two-stage cultures aiming lipid enhancement. Besides, parameters such as irradiance, specific nitrate input and dilution rate were used to obtain models predicting growth, lipid and fatty acids production rates. The range of optimum dilution rate was 0.31-0.351/day with maximum biomass, lipid and fatty acids productivities of 590, 110 and 66.8 mg/l day, respectively. Nitrate limitation led to an increase in lipid and fatty acids contents (from 20.5% to 38.0% and from 16.9% to 23.5%, respectively). Two-stage culture strategy provided similar fatty acids productivities (56.4 mg/l day) but the neutral lipids content was doubled.

  10. High rates of relapse in adolescents crack users after inpatient clinic discharge

    Directory of Open Access Journals (Sweden)

    Rosemeri Siqueira Pedroso

    Full Text Available ABSTRACT Objective The objective of the present study was to evaluate 88 adolescent crack users referred to hospitalization and to follow them up after discharge to investigate relapse and factors associated with treatment. Methods Cohort (30 and 90 days after discharge from a psychiatric hospital and a rehab clinic for treatment for chemical dependency in Porto Alegre between 2011 and 2012. Instruments: Semi-structured interview, conducted to evaluate the sociodemographic profile of the sample and describe the pattern of psychoactive substance use; Crack Use Relapse Scale/CURS; Questionnaire Tracking Users to Crack/QTUC; K-SADS-PL. Results In the first follow-up period (30 days after discharge, 65.9% of participants had relapsed. In the second follow-up period (90 days after discharge, 86.4% of participants had relapsed. Conclusion This is one of the first studies that show the extremely high prevalence of early relapse in adolescent crack users after discharge, questioning the cost/benefit of inpatient treatment for this population. Moreover, these results corroborate studies which suggested, young psychostimulants users might need tailored intensive outpatient treatment with contingency management and other behavioral strategies, in order to increase compliance and reduce drug or crime relapse, but this specific therapeutic modality is still scarce and must be developed in Brazil.

  11. Entropy Rate Estimates for Natural Language—A New Extrapolation of Compressed Large-Scale Corpora

    Directory of Open Access Journals (Sweden)

    Ryosuke Takahira


    Full Text Available One of the fundamental questions about human language is whether its entropy rate is positive. The entropy rate measures the average amount of information communicated per unit time. The question about the entropy of language dates back to experiments by Shannon in 1951, but in 1990 Hilberg raised doubt regarding a correct interpretation of these experiments. This article provides an in-depth empirical analysis, using 20 corpora of up to 7.8 gigabytes across six languages (English, French, Russian, Korean, Chinese, and Japanese, to conclude that the entropy rate is positive. To obtain the estimates for data length tending to infinity, we use an extrapolation function given by an ansatz. Whereas some ansatzes were proposed previously, here we use a new stretched exponential extrapolation function that has a smaller error of fit. Thus, we conclude that the entropy rates of human languages are positive but approximately 20% smaller than without extrapolation. Although the entropy rate estimates depend on the script kind, the exponent of the ansatz function turns out to be constant across different languages and governs the complexity of natural language in general. In other words, in spite of typological differences, all languages seem equally hard to learn, which partly confirms Hilberg’s hypothesis.

  12. Scaling of viscosity with rate, pressure, and temperature: Linking simulations to experiments (United States)

    Jadhao, Vikram; Robbins, Mark

    Elastohydrodynamic lubrication (EHL) is important in many practical devices and produces extreme pressures (> 1 GPa) and shear rates (105 -107 s-1). This makes EHL fluids ideal candidates for bridging the gap between experimental and simulation studies of viscosity. There is an ongoing debate about whether the high-rate response of simple molecules like squalane follows a power-law Carreau model or a thermal activation based Eyring model. We use molecular dynamics simulations to investigate the rheological response of squalane for a wide range of rates (105 -1010 s-1), pressures (0.1 MPa to 3 GPa), and temperatures (100 - 313 K). We find that experimental and theoretical results can be collapsed onto a master curve consistent with Eyring theory over more than 20 orders of magnitude in rate. Extrapolating Eyring fits to simulations at 107 s-1 and above yields Newtonian viscosities η0 that are consistent with available low-rate experiments, and allows predictions to much higher pressures and lower temperatures. There is no indication of a diverging viscosity at finite stress, since log η0 rises sublinearly with pressure up to 6 GPa and η0 >1012 Pa-s. Correlations between chain conformations and Eyring parameters are also presented. This research was performed within the Center for Materials in Extreme Dynamic Environments (CMEDE) under the Hopkins Extreme Materials Institute at Johns Hopkins University. Financial support was provided by Grant W911NF-12-2-0022.

  13. Neurological outcome scale for traumatic brain injury: III. Criterion-related validity and sensitivity to change in the NABIS hypothermia-II clinical trial. (United States)

    McCauley, Stephen R; Wilde, Elisabeth A; Moretti, Paolo; Macleod, Marianne C; Pedroza, Claudia; Drever, Pamala; Fourwinds, Sierra; Frisby, Melisa L; Beers, Sue R; Scott, James N; Hunter, Jill V; Traipe, Elfrides; Valadka, Alex B; Okonkwo, David O; Zygun, David A; Puccio, Ava M; Clifton, Guy L


    The neurological outcome scale for traumatic brain injury (NOS-TBI) is a measure assessing neurological functioning in patients with TBI. We hypothesized that the NOS-TBI would exhibit adequate concurrent and predictive validity and demonstrate more sensitivity to change, compared with other well-established outcome measures. We analyzed data from the National Acute Brain Injury Study: Hypothermia-II clinical trial. Participants were 16-45 years of age with severe TBI assessed at 1, 3, 6, and 12 months postinjury. For analysis of criterion-related validity (concurrent and predictive), Spearman's rank-order correlations were calculated between the NOS-TBI and the glasgow outcome scale (GOS), GOS-extended (GOS-E), disability rating scale (DRS), and neurobehavioral rating scale-revised (NRS-R). Concurrent validity was demonstrated through significant correlations between the NOS-TBI and GOS, GOS-E, DRS, and NRS-R measured contemporaneously at 3, 6, and 12 months postinjury (all prate was outcome in the GOS, GOS-E, and DRS at 3 and 6 months postinjury (all poutcomes at 6 and 12 months postinjury (all poutcome measures. The NOS-TBI may enhance prediction of outcome in clinical practice and measurement of outcome in TBI research.

  14. Impact of a Metabolic Screening Bundle on Rates of Screening for Metabolic Syndrome in a Psychiatry Resident Outpatient Clinic (United States)

    Wiechers, Ilse R.; Viron, Mark; Stoklosa, Joseph; Freudenreich, Oliver; Henderson, David C.; Weiss, Anthony


    Objective: Although it is widely acknowledged that second-generation antipsychotics are associated with cardiometabolic side effects, rates of metabolic screening have remained low. The authors created a quality-improvement (QI) intervention in an academic medical center outpatient psychiatry resident clinic with the aim of improving rates of…

  15. Multi-scale detection of rate changes in spike trains with weak dependencies


    Messer, Michael; Costa, Kauê M.; Roeper, Jochen; Schneider, Gaby


    The statistical analysis of neuronal spike trains by models of point processes often relies on the assumption of constant process parameters. However, it is a well-known problem that the parameters of empirical spike trains can be highly variable, such as for example the firing rate. In order to test the null hypothesis of a constant rate and to estimate the change points, a Multiple Filter Test (MFT) and a corresponding algorithm (MFA) have been proposed that can be applied under the assumpt...

  16. Exploring nonlinear relations: models of clinical decision making by regression with optimal scaling. (United States)

    Hartmann, Armin; Van Der Kooij, Anita J; Zeeck, Almut


    In explorative regression studies, linear models are often applied without questioning the linearity of the relations between the predictor variables and the dependent variable, or linear relations are taken as an approximation. In this study, the method of regression with optimal scaling transformations is demonstrated. This method does not require predefined nonlinear functions and results in easy-to-interpret transformations that will show the form of the relations. The method is illustrated using data from a German multicenter project on the indication criteria for inpatient or day clinic psychotherapy treatment. The indication criteria to include in the regression model were selected with the Lasso, which is a tool for predictor selection that overcomes the disadvantages of stepwise regression methods. The resulting prediction model indicates that treatment status is (approximately) linearly related to some criteria and nonlinearly related to others.

  17. Tau energy scale and $\\mu \\rightarrow \\tau$ misidentification rate estimated with early 2016 data using Z events.

    CERN Document Server

    CMS Collaboration


    This note presents results of the tau energy scale ($\\tau$~ES) measured using $\\mathrm{Z\\rightarrow \\tau_{\\mu} \\tau_{h}}$, and $\\mu \\rightarrow \\tau$ misidentification rate measured using $\\mathrm{Z\\rightarrow \\mu \\mu}$. Both measurements were made with 6.3 fb$^{-1}$ of pp data at $\\mathrm{\\sqrt{s}} = 13$~TeV collected by the CMS detector in first half of 2016.

  18. Perbandingan Kombinasi Tramadol Parasetamol Intravena dengan Tramadol Ketorolak Intravena terhadap Nilai Numeric Rating Scale dan Kebutuhan Opioid Pascahisterektomi


    Dendi Karmena; Ezra Oktaliansah; Eri Surahman


    Postoperative pain is an important problem in surgery. This study aimed to compare the combination of intravenous tramadol paracetamol and tramadol ketorolac to numeric rating scale (NRS) to postoperative opioid requirements in abdominal hysterectomy. Double blind randomized controlled trial was conducted on 42 women (18–60 years) with ASA physical status I–II who underwent abdominal hysterectomy surgery under general anesthesia in Dr. Hasan Sadikin General Hospital Bandung within the period ...

  19. Scaling and wavelet-based analyses of the long-term heart rate variability of the Eastern Oyster

    CERN Document Server

    Ritto, P A; Alvarado-Gil, J J


    Characterisations of the long--term behaviour of heart rate variability in humans have emerged in the last few years as promising candidates to became clinically significant tools. We present two different statistical analyses of long time recordings of the heart rate variation in the Eastern Oyster. The circulatory system of this marine mollusk has important anatomical and physiological dissimilitudes in comparison to that of humans and it is exposed to dramatically different environmental influences. Our results resemble those previously obtained in humans. This suggests that in spite of the discrepancies, the mechanisms of long--term cardiac control on both systems share a common underlying dynamic.

  20. Scaling Relations and Optimization of Excitonic Energy Transfer Rates between One-Dimensional Molecular Aggregates

    NARCIS (Netherlands)

    Chuang, Chern; Knoester, Jasper; Cao, Jianshu


    We theoretically study the distance, chain length, and temperature dependence of the electronic couplings as well as the excitonic energy transfer rates between one-dimensional (1D) chromophore aggregates. In addition to the well-known geometry dependent factor that leads to the deviation from Forst

  1. A Self Rating Scale as a Pre and Post Assessment Tool for Use with Instructional Modules. (United States)

    Gotts, Sandra Harris

    This article describes a self rating pre- and post-assessment instrument that has been developed at the Central Michigan University (CMU). Nine instructional modules have been developed and are being used in science methods courses at CMU. Each module focuses on an identified area of competency for elementary science teachers and contains a…

  2. Variance in population firing rate as a measure of slow time-scale correlation

    Directory of Open Access Journals (Sweden)

    Adam C. Snyder


    Full Text Available Correlated variability in the spiking responses of pairs of neurons, also known as spike count correlation, is a key indicator of functional connectivity and a critical factor in population coding. Underscoring the importance of correlation as a measure for cognitive neuroscience research is the observation that spike count correlations are not fixed, but are rather modulated by perceptual and cognitive context. Yet while this context fluctuates from moment to moment, correlation must be calculated over multiple trials. This property undermines its utility as a dependent measure for investigations of cognitive processes which fluctuate on a trial-to-trial basis, such as selective attention. A measure of functional connectivity that can be assayed on a moment-to-moment basis is needed to investigate the single-trial dynamics of populations of spiking neurons. Here, we introduce the measure of population variance in normalized firing rate for this goal. We show using mathematical analysis, computer simulations and in vivo data how population variance in normalized firing rate is inversely related to the latent correlation in the population, and how this measure can be used to reliably classify trials from different typical correlation conditions, even when firing rate is held constant. We discuss the potential advantages for using population variance in normalized firing rate as a dependent measure for both basic and applied neuroscience research.

  3. Extrapolating soil redistribution rates estimated from 137Cs to catchment scale in a complex agroforestry landscape using GIS (United States)

    Gaspar, Leticia; López-Vicente, Manuel; Palazón, Leticia; Quijano, Laura; Navas, Ana


    The use of fallout radionuclides, particularly 137Cs, in soil erosion investigations has been successfully used over a range of different landscapes. This technique provides mean annual values of spatially distributed soil erosion and deposition rates for the last 40-50 years. However, upscaling the data provided by fallout radionuclides to catchment level is required to understand soil redistribution processes, to support catchment management strategies, and to assess the main soil erosion factors like vegetation cover or topography. In recent years, extrapolating field scale soil erosion rates estimated from 137Cs data to catchment scale has been addressed using geostatistical interpolation and Geographical Information Systems (GIS). This study aims to assess soil redistribution in an agroforestry catchment characterized by abrupt topography and an intricate mosaic of land uses using 137Cs data and GIS. A new methodological approach using GIS is presented as an alternative of interpolation tools to extrapolating soil redistribution rates in complex landscapes. This approach divides the catchment into Homogeneous Physiographic Units (HPUs) based on unique land use, hydrological network and slope value. A total of 54 HPUs presenting specific land use, strahler order and slope combinations, were identified within the study area (2.5 km2) located in the north of Spain. Using 58 soil erosion and deposition rates estimated from 137Cs data, we were able to characterize the predominant redistribution processes in 16 HPUs, which represent the 78% of the study area surface. Erosion processes predominated in 6 HPUs (23%) which correspond with cultivated units in which slope and strahler order is moderate or high, and with scrubland units with high slope. Deposition was predominant in 3 HPUs (6%), mainly in riparian areas, and to a lesser extent in forest and scrubland units with low slope and low and moderate strahler order. Redistribution processes, both erosion and

  4. Health-Related Quality of Life in Parkinson disease: Correlation between Health Utilities Index III and Unified Parkinson's Disease Rating Scale (UPDRS in U.S. male veterans

    Directory of Open Access Journals (Sweden)

    Kleiner-Fisman Galit


    Full Text Available Abstract Objective To apply a scaled, preference-based measure to the evaluation of health-related quality of life (HRQoL in Parkinson's disease (PD; to evaluate the relationship between disease-specific rating scales and estimated HRQoL; and to identify predictors of diminished HRQoL. Background Scaled, preference-based measures of HRQoL ("utilities" serve as indices of impact of disease, and can be used to generate quality-adjusted estimates of survival for health-economic evaluations. Evaluation of utilities for PD and their correlation with standard rating scales have been limited. Methods Utilities were generated using the Health Utilities Index Mark III (HUI-III on consecutive patients attending a PD Clinic between October 2003 and June 2006. Disease severity, medical, surgical (subthalamic nucleus deep brain stimulation (STN-DBS, and demographic information were used as model covariates. Predictors of HUI-III utility scores were evaluated using the Wilxocon rank-sum test and linear regression models. Results 68 men with a diagnosis of PD and a mean age of 74.0 (SD 7.4 were included in the data analysis. Mean HUI-III utility at first visit was 0.45 (SD 0.33. In multivariable models, UPDRS-II score (r2 = 0.56, P Conclusions Poor self-care in PD reflected by worsening UPDRS-II scores is strongly correlated with low generic HRQoL. HUI-III-based health utilities display convergent validity with the UPDRS-II. These findings highlight the importance of measures of independence as determinants of HRQoL in PD, and will facilitate the utilization of existing UPDRS data into economic analyses of PD therapies.

  5. Skin conductance as pain indicator in newborns: a comparison study with heart rate, oxygen saturation and pain behavioral scales

    Directory of Open Access Journals (Sweden)

    Jose Alfredo Lacerda de Jesus


    Full Text Available Introduction Heart rate (HR, oxygen saturation (OS and skin conductance activity (SCA are physiological markers of acute pain. Neonatal Facial Coding System (NFCS, Neonatal Infant Pain Scale (NIPS and modified COMFORT are validated pain behavioral scales. Objective It was to compare whether the scores of these measures fit the psychophysical parameters for a pain marker (intensity, reactivity, direction, regulation and slope. Method Observational prospective study including 41 newborns, in which it were compared the maximum HR, the minimum OS, the SCA variables number of waves per second (NWps and relative area under the curve of waves (AUC, and the scores of behavioral pain scales in the periods before, during and after heel prick. Results The parameters intensity and regulation were significant for the NWps (p0.05. The slope was significant for the minimum OS and NIPS and modified COMFORT scales (p<0.05. Conclusion The responses of SCA, HR, OS and behavioral pain scales are similarly in acute painful events. They fit the psychophysical parameters of a pain marker and serve as measures for pain diagnostic.

  6. Moment rate scaling for earthquakes 3.3 ≤ M ≤ 5.3 with implications for stress drop (United States)

    Archuleta, Ralph J.; Ji, Chen


    We have determined a scalable apparent moment rate function (aMRF) that correctly predicts the peak ground acceleration (PGA), peak ground velocity (PGV), local magnitude, and the ratio of PGA/PGV for earthquakes 3.3 ≤ M ≤ 5.3. Using the NGA-West2 database for 3.0 ≤ M ≤ 7.7, we find a break in scaling of LogPGA and LogPGV versus M around M 5.3 with nearly linear scaling for LogPGA and LogPGV for 3.3 ≤ M ≤ 5.3. Temporal parameters tp and td—related to rise time and total duration—control the aMRF. Both scale with seismic moment. The Fourier amplitude spectrum of the aMRF has two corners between which the spectrum decays f- 1. Significant attenuation along the raypath results in a Brune-like spectrum with one corner fC. Assuming that fC ≅ 1/td, the aMRF predicts non-self-similar scaling M0∝fC3.3 and weak stress drop scaling Δσ∝M00.091. This aMRF can explain why stress drop is different from the stress parameter used to predict high-frequency ground motion.

  7. The clinical significance of detection to heart rate deceleration capacity and heart rate variability in patients with chronic heart failure

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    Jiang-rong Zhou


    Full Text Available Objective: To study the change of heart rate deceleration capacity ( DC and heart rate variability in patients with chronic heart failure (CHF and its relationship with left ventricular ejection fraction (LVEF. Methods: DC, LVEF, time and frequency domain parameters of HRV were measured in 66 patients with CHF and 34 healthy adults (control group by using 24h Holter recordings and Echocardiography. The standard deviation of normal R-R intervals( SDNN, squares of differences between adjacent NN intervals ( RMSSD,low frequency power( LFn and high frequency power( HFn and the changes of LVEF were compared between  the two groups,the relationship between DC,LVEF and HRV were studied in patients with CHF. Results: The median value of DC in the patients with CHF was significantly lower than that in control group( 3.1 ± 2.4 ms vs 7.2 ± 1.3 ms,P <0.01.Incidence of abnormal DC in the CHF group was 57.5%,which was significantly higher than that in the control group (P <0.01.The HRV index, including SDNN、RMSSD、LFn、HFn, in the CHF group was significantly lower than that in normal control group (P < 0.01. Significant positive correlation between HRV index and LVEF were confirmed (P < 0.01. Conclusions: DC and HRV index are lower in patients with CHF and have a good correlation with the left ventricular ejection fraction.

  8. High dose rate versus low dose rate brachytherapy for oral cancer--a meta-analysis of clinical trials.

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    Zhenxing Liu

    Full Text Available OBJECTIVE: To compare the efficacy and safety of high dose rate (HDR and low dose rate (LDR brachytherapy in treating early-stage oral cancer. DATA SOURCES: A systematic search of MEDLINE, EMBASE and Cochrane Library databases, restricted to English language up to June 1, 2012, was performed to identify potentially relevant studies. STUDY SELECTION: Only randomized controlled trials (RCT and controlled trials that compared HDR to LDR brachytherapy in treatment of early-stage oral cancer (stages I, II and III were of interest. DATA EXTRACTION AND SYNTHESIS: Two investigators independently extracted data from retrieved studies and controversies were solved by discussion. Meta-analysis was performed using RevMan 5.1. One RCT and five controlled trials (607 patients: 447 for LDR and 160 for HDR met the inclusion criteria. The odds ratio showed no statistically significant difference between LDR group and HDR group in terms of local recurrence (OR = 1.12, CI 95% 0.62-2.01, overall mortality (OR = 1.01, CI 95% 0.61-1.66 and Grade 3/4 complications (OR = 0.86, CI 95% 0.52-1.42. CONCLUSIONS: This meta-analysis indicated that HDR brachytherapy was a comparable alternative to LDR brachytherapy in treatment of oral cancer. HDR brachytherapy might become a routine choice for early-stage oral cancer in the future.

  9. Micro-scale experimental investigation of the effect of flow rate on trapping in sandstone and carbonate rock samples (United States)

    Khishvand, Mahdi; Akbarabadi, Morteza; Piri, Mohammad


    We present the results of a pore-scale experimental study of residual trapping in consolidated sandstone and carbonate rock samples under confining stress. We investigate how the changes in wetting phase flow rate impacts pore-scale distribution of fluids during imbibition in natural, water-wet porous media. We systematically study pore-scale trapping of the nonwetting phase as well as size and distribution of its disconnected globules. Seven sets of drainage-imbibition experiments were performed with brine and oil as the wetting and nonwetting phases, respectively. We utilized a two-phase miniature core-flooding apparatus integrated with an X-ray microtomography system to examine pore-scale fluid distributions in small Bentheimer sandstone (D = 4.9 mm and L = 13 mm) and Gambier limestone (D = 4.4 mm and L = 75 mm) core samples. The results show that with increase in capillary number, the residual oil saturation at the end of the imbibition reduces from 0.46 to 0.20 in Bemtheimer sandstone and from 0.46 to 0.28 in Gambier limestone. We use pore-scale displacement mechanisms, in-situ wettability characteristics, and pore size distribution information to explain the observed capillary desaturation trends. The reduction was believed to be caused by alteration of the order in which pore-scale displacements took place during imbibition. Furthermore, increase in capillary number produced significantly different pore-scale fluid distributions during imbibition. We explored the pore fluid occupancies and studied size and distribution of the trapped oil clusters during different imbibition experiments. The results clearly show that as the capillary number increases, imbibition produces smaller trapped oil globules. In other words, the volume of individual trapped oil globules decreased at higher brine flow rates. Finally, we observed that the pore space in the limestone sample was considerably altered through matrix dissolution at extremely high brine flow rates. This

  10. The transit dose component of high dose rate brachytherapy: Direct measurements and clinical implications

    Energy Technology Data Exchange (ETDEWEB)

    Bastin, K.T.; Podgorsak, M.B.; Thomadsen, B.R. (Univ. of Wisconsin Hospitals and Clinics, Madison, WI (United States))


    The purpose was to measure the transit dose produced by a moving high dose rate brachytherapy source and assess its clinical significance. The doses produced from source movement during Ir-192 HDR afterloading were measured using calibrated thermoluminescent dosimeter rods. Transit doses at distances of 0.5-4.0 cm from an endobronchial applicator were measured using a Lucite phantom accommodating 1 x 1 x 6 mm thermoluminescent rods. Surface transit dose measurements were made using esophageal and endobronchial catheters, a gynecologic tandem, and an interstitial needle. No difference was detected in thermoluminescent dosimeter rod responses to 4 MV and Ir-192 spectra (427 nC/Gy) in a range of dose between 2 and 300 cGy. The transit dose at 0.5 cm from an endobronchial catheter was 0.31 cGy/(Curie-fraction) and followed an inverse square fall-off with increasing distance. Surface transit doses ranged from 0.38 cGy/(Curie-fraction) for an esophageal catheter to 1.03 cGy/(Curie-fraction) for an endobronchial catheter. Source velocity is dependent on the interdwell distance and varies between 220-452 mm/sec. A numeric algorithm was developed to calculate total transit dose, and was based on a dynamic point approximation for the moving high dose rate source. This algorithm reliably predicted the empirical transit doses and demonstrated that total transit dose is dependent on source velocity, number of fractions, and source activity. Surface transit doses are dependent on applicator diameter and wall material and thickness. Total transit doses within or outside the desired treatment volume are typically <100 cGy, but may exceed 200 cGy when using a large number of fractions with a high activity source. 9 refs., 8 figs., 1 tab.

  11. Bayesian estimation of false-negative rate in a clinical trial of sentinel node biopsy. (United States)

    Newcombe, Robert G


    Estimating the false-negative rate is a major issue in evaluating sentinel node biopsy (SNB) for staging cancer. In a large multicentre trial of SNB for intra-operative staging of clinically node-negative breast cancer, two sources of information on the false-negative rate are available.Direct information is available from a preliminary validation phase: all patients underwent SNB followed by axillary nodal clearance or sampling. Of 803 patients with successful sentinel node localization, 19 (2.4 per cent) were classed as false negatives. Indirect information is also available from the randomized phase. Ninety-seven (25.4 per cent) of 382 control patients undergoing axillary clearance had positive axillae. In the experimental group, 94/366 (25.7 per cent) were apparently node positive. Taking a simple difference of these proportions gives a point estimate of -0.3 per cent for the proportion of patients who had positive axillae but were missed by SNB. This estimate is clearly inadmissible. In this situation, a Bayesian analysis yields interpretable point and interval estimates. We consider the single proportion estimate from the validation phase; the difference between independent proportions from the randomized phase, both unconstrained and constrained to non-negativity; and combined information from the two parts of the study. As well as tail-based and highest posterior density interval estimates, we examine three obvious point estimates, the posterior mean, median and mode. Posterior means and medians are similar for the validation and randomized phases separately and combined, all between 2 and 3 per cent, indicating similarity rather than conflict between the two data sources.

  12. Clinical Implications of Human Population Differences in Genome-wide Rates of Functional Genotypes

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    Ali eTorkamani


    Full Text Available There have been a number of recent successes in the use of whole genome sequencing and sophisticated bioinformatics techniques to identify pathogenic DNA sequence variants responsible for individual idiopathic congenital conditions. However, the success of this identification process is heavily influenced by the ancestry or genetic background of a patient with an idiopathic condition. This is so because potential pathogenic variants in a patient’s genome must be contrasted with variants in a reference set of genomes made up of other individuals’ genomes of the same ancestry as the patient. We explored the effect of ignoring the ancestries of both an individual patient and the individuals used to construct reference genomes. We pursued this exploration in two major steps. We first considered variation in the per-genome number and rates likely functional derived (i.e., non-ancestral, based on the chimp genome single nucleotide variants and small indels in 52 individual whole human genomes sampled from 10 different global populations. We took advantage of a suite of computational and bioinformatics techniques to predict the functional effect of over 24 million genomic variants, both coding and non-coding, across these genomes. We found that the typical human genome harbors ~5.5-6.1 million total derived variants, of which ~12,000 are likely to have a functional effect (~5000 coding and ~7000 non-coding. We also found that the rates of functional genotypes per the total number of genotypes in individual whole genomes differ dramatically between human populations. We then created tables showing how the use of comparator or reference genome panels comprised of genomes from individuals that do not have the same ancestral background as a patient can negatively impact pathogenic variant identification. Our results have important implications for clinical sequencing initiatives.

  13. Large-scale clinical-grade retroviral vector production in a fixed-bed bioreactor. (United States)

    Wang, Xiuyan; Olszewska, Malgorzata; Qu, Jinrong; Wasielewska, Teresa; Bartido, Shirley; Hermetet, Gregory; Sadelain, Michel; Rivière, Isabelle


    The successful genetic engineering of patient T cells with γ-retroviral vectors expressing chimeric antigen receptors or T-cell receptors for phase II clinical trials and beyond requires the large-scale manufacture of high-titer vector stocks. The production of retroviral vectors from stable packaging cell lines using roller bottles or 10- to 40-layer cell factories is limited by a narrow harvest window, labor intensity, open-system operations, and the requirement for significant incubator space. To circumvent these shortcomings, we optimized the production of vector stocks in a disposable fixed-bed bioreactor using good manufacturing practice-grade packaging cell lines. High-titer vector stocks were harvested over 10 days, representing a much broader harvest window than the 3-day harvest afforded by cell factories. For PG13 and 293Vec packaging cells, the average vector titer and the vector stocks' yield in the bioreactor were higher by 3.2- to 7.3-fold, and 5.6- to 13.1-fold, respectively, than those obtained in cell factories. The vector production was 10.4 and 18.6 times more efficient than in cell factories for PG13 and 293Vec cells, respectively. Furthermore, the vectors produced from the fixed-bed bioreactors passed the release test assays for clinical applications. Therefore, a single vector lot derived from 293Vec is suitable to transduce up to 500 patients cell doses in the context of large clinical trials using chimeric antigen receptors or T-cell receptors. These findings demonstrate for the first time that a robust fixed-bed bioreactor process can be used to produce γ-retroviral vector stocks scalable up to the commercialization phase.

  14. Optimization and Scale-up Isolation and Culture of Neonatal Porcine Islets: Potential for Clinical Application. (United States)

    Ellis, Cara; Lyon, James G; Korbutt, Gregory S


    One challenge that must be overcome to allow transplantation of neonatal porcine islets (NPIs) to become a clinical reality is defining a reproducible and scalable protocol for the efficient preparation of therapeutic quantities of clinical grade NPIs. In our standard protocol, we routinely isolate NPIs from a maximum of four pancreases, requiring tissue culture in 16 Petri dishes (four per pancreas) in Ham's F10 and bovine serum albumin (BSA). We have now developed a scalable and technically simpler protocol that allows us to isolate NPIs from a minimum of 12 pancreases at a time by employing automated tissue chopping, collagenase digestion in a single vessel, and tissue culture/media changes in 75% fewer Petri dishes. For culture, BSA is replaced with human serum albumin and supplemented with Z-VAD-FMK general caspase inhibitor and a protease inhibitor cocktail. The caspase inhibitor was added to the media for only the first 90 min of culture. NPIs isolated using the scalable protocol had significantly more cellular insulin recovered (56.9 ± 1.4 µg) when compared to the standard protocol (15.0 ± 0.5 µg; p protocol, recovery of β-cells (6.0 × 10(6) ± 0.2 vs. 10.0 × 10(6) ± 0.4; p protocol. During a static glucose stimulation assay, the SI of islets isolated by the standard protocol were significantly lower than the scale-up protocol (4.3 ± 0.2 vs. 5.5 ± 0.1; p protocol had significantly lower blood glucose levels than the mice that receiving NPIs from the standard protocol (p protocol is a significantly more efficient means for preparing therapeutic quantities of clinical grade NPIs.

  15. Content Validity of the ADHD Rating Scale (ADHD RS-IV and Adult ADHD Self-Report Scale (ASRS in Phenylketonuria

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    Kathleen W. Wyrwich PhD


    Full Text Available The ADHD Rating Scale (ADHD RS-IV; parent report and Adult ADHD Self-Rating Scale (ASRS; self-report are validated instruments for measuring symptoms of attention-deficit/hyperactivity disorder (ADHD. The objectives of this study were to elicit descriptions of phenylketonuria (PKU symptoms and assess content validity of these instruments in PKU. Parents (N = 15 of children with PKU (≥8 years old and adults with PKU (N=13 described PKU-related symptoms and commented on the scale’s clarity, comprehensiveness, and relevance to their experience with PKU. Most of the adults (84.6% and all of the children were on a phenylalanine-restricted diet, according to respondent report. The inattentiveness symptoms reported by participants mapped to the inattentive items of the questionnaires. Most participants felt the inattentive items were clear and relevant to their experience. Despite study design limitations, these results demonstrate the relevance of assessing inattentiveness in PKU, and both instruments achieved content validity for inattentive subscale items.

  16. Objectifying Acupuncture Effects by Lung Function and Numeric Rating Scale in Patients Undergoing Heart Surgery

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    Anna Maimer


    Full Text Available Rationale. Poststernotomy pain and impaired breathing are common clinical problems in early postoperative care following heart surgery. Insufficiently treated pain increases the risk of pulmonary complications. High-dose opioids are used for pain management, but they may cause side effects such as respiratory depression. Study Design. We performed a prospective, randomized, controlled, observer-blinded, three-armed clinical trial with 100 patients. Group 1 (n=33 and Group 2 (n=34 received one 20 min session of standardized acupuncture treatment with two different sets of acupoints. Group 3 (n=33 served as standard analgesia control without additional intervention. Results. Primary endpoint analysis revealed a statistically significant analgesic effect for both acupuncture treatments. Group 1 showed a mean percentile pain reduction (PPR of 18% (SD 19, P<0.001. Group 2 yielded a mean PPR of 71% (SD 13, P<0.001. In Group 1, acupuncture resulted in a mean forced vital capacity (FVC increase of 30 cm3 (SD 73 without statistical significance (P=0.303. In Group 2, posttreatment FVC showed a significant increase of 306 cm3 (SD 215, P<0.001. Conclusion. Acupuncture revealed specific analgesic effects after sternotomy. Objective measurement of poststernotomy pain via lung function test was possible.

  17. Growth rate of matter perturbations as a probe of large-scale magnetism

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    Giovannini, Massimo


    The growth rate of matter perturbations is computed in a magnetized environment for the LambdaCDM and wCDM paradigms. It is argued that the baryons do not necessarily follow into the dark matter potential wells after they are released from the drag of the photons. The baryonic evolution equations inherit a forcing term whose explicit form depends on the plasma description and can be deduced, for instance, in the resistive magnetohydrodynamical approximation. After deriving an analytical expression for the growth rate applicable when dark energy does not cluster, the effects of relativistic corrections and of the inhomogeneities associated with the other species of the plasma are taken into account numerically. The spectral amplitudes and slopes of the stochastic magnetic background are selected to avoid appreciable distortions in the measured temperature and polarization anisotropies of the Cosmic Microwave Background. The growth of structures in the current paradigms of structure formation represents a compl...

  18. Strain rate and shear stress at the grain scale generated during near equilibrium antigorite dehydration (United States)

    Padrón-Navarta, José Alberto; Tommasi, Andréa; Garrido, Carlos J.; Mainprice, David; Clément, Maxime


    Dehydration reactions are an outstanding case of mineral replacement reactions because they produce a significant transient fluid-filled porosity. Because fluids are present, these reactions occur by interface-coupled dissolution-precipitation. Under poorly drained conditions corresponding to foliated metamorphic rocks, they generate fluid pressure gradients that evolve in time and space eventually controlling fluid migration [1]. Despite the general agreement on this fact, we still lack of a precise knowledge of the complex coupling between the stresses generated during the reaction and the timescales for mineral growth and how they ultimate control the rate of fluid migration. Constraining these rates is challenge because the timescales of the feedback between fluid flow and mineral growth rates at near equilibrium are beyond the current experimental capabilities. For instance, numerical simulations suggest that the draining times of a dehydration front by compaction are in the order of 10-100 ky [1] difficult to translate into experimental strain rates. On the other hand, the natural record of dehydration reaction might potentially provide unique constrains on this feedback, but we need to identify microstructures related to compaction and quantify them. Features interpreted as due to compaction have been identified in a microstructural study [2] of the first stages of the antigorite dehydration at high-pressure conditions in Cerro del Almirez, Spain (ca. 1.6-1.9 GPa and 630-710 ° C). Compaction features can be mostly observed in the metamorphic enstatite in the form of (1) gradual crystallographic misorientation (up to 16°) of prismatic crystals due to buckling, (3) localized orthoenstatite(Pbca)/low clinoenstatite (P21/c) inversion (confirmed optically and by means of Electron Backscattered Diffraction) and (4) brittle fracturing of prismatic enstatite wrapped by plastically deformed chlorite. The coexistence of enstatite buckling and clinoenstatite lamellae

  19. Multi-scale Modeling of the Impact Response of a Strain Rate Sensitive High-Manganese Austenitic Steel

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    Orkun eÖnal


    Full Text Available A multi-scale modeling approach was applied to predict the impact response of a strain rate sensitive high-manganese austenitic steel. The roles of texture, geometry and strain rate sensitivity were successfully taken into account all at once by coupling crystal plasticity and finite element (FE analysis. Specifically, crystal plasticity was utilized to obtain the multi-axial flow rule at different strain rates based on the experimental deformation response under uniaxial tensile loading. The equivalent stress – equivalent strain response was then incorporated into the FE model for the sake of a more representative hardening rule under impact loading. The current results demonstrate that reliable predictions can be obtained by proper coupling of crystal plasticity and FE analysis even if the experimental flow rule of the material is acquired under uniaxial loading and at moderate strain rates that are significantly slower than those attained during impact loading. Furthermore, the current findings also demonstrate the need for an experiment-based multi-scale modeling approach for the sake of reliable predictions of the impact response.

  20. A review on the use of NEO-PI-R validity scales in normative, job selection, and clinical samples

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    Angel Blanch


    Full Text Available Background and Objectives: In this study we review the use of the Positive Presentation Management (PPM and Negative Presentation Management (NPM scales, two NEO-PI-R derived measures originally devised to control for biased and distorted responses. These scales have been used with normative, job selection and clinical samples, in cross-sectional and experimental studies. Methods: Web-based and manual searches in personality and psychological assessment journals were conducted, and information on the PPM and NPM scales was systematically recorded. Means, standard deviations and reliability coefficients were summarized and compared between three types of samples: normative, job selection and clinical. Results: Five studies were performed with normative samples (33%, 3 with employment samples (20% and 7 with clinical samples (47%. Cross-sectional designs were most common (60%, although there were also experimental studies (40%. Reported reliability coefficients were lower than usually accepted. There were differences in mean PPM and NPM scores in regard to the study sample background. Conclusions: There were some discrepancies when reporting PPM and NPM results across the reviewed studies. Normative and employment samples scored higher in PPM than clinical samples. Clinical samples scored higher in NPM than normative and employment samples The PPM and NPM scales could be useful in applied situations, although parallel sources of information should be taken into account to detect distorted responses to the questionnaire. However, the results on these scales should be systematically reported in future studies.