WorldWideScience

Sample records for critical appraisal instruments

  1. A critical appraisal of instruments to measure outcomes of interprofessional education.

    Science.gov (United States)

    Oates, Matthew; Davidson, Megan

    2015-04-01

    Interprofessional education (IPE) is believed to prepare health professional graduates for successful collaborative practice. A range of instruments have been developed to measure the outcomes of IPE. An understanding of the psychometric properties of these instruments is important if they are to be used to measure the effectiveness of IPE. This review set out to identify instruments available to measure outcomes of IPE and collaborative practice in pre-qualification health professional students and to critically appraise the psychometric properties of validity, responsiveness and reliability against contemporary standards for instrument design. Instruments were selected from a pool of extant instruments and subjected to critical appraisal to determine whether they satisfied inclusion criteria. The qualitative and psychometric attributes of the included instruments were appraised using a checklist developed for this review. Nine instruments were critically appraised, including the widely adopted Readiness for Interprofessional Learning Scale (RIPLS) and the Interdisciplinary Education Perception Scale (IEPS). Validity evidence for instruments was predominantly based on test content and internal structure. Ceiling effects and lack of scale width contribute to the inability of some instruments to detect change in variables of interest. Limited reliability data were reported for two instruments. Scale development and scoring protocols were generally reported by instrument developers, but the inconsistent application of scoring protocols for some instruments was apparent. A number of instruments have been developed to measure outcomes of IPE in pre-qualification health professional students. Based on reported validity evidence and reliability data, the psychometric integrity of these instruments is limited. The theoretical test construction paradigm on which instruments have been developed may be contributing to the failure of some instruments to detect change in

  2. Development of a radiology faculty appraisal instrument by using critical incident interviewing.

    Science.gov (United States)

    Collins, J; Albanese, M A; Thakor, S K; Propeck, P A; Scanlan, K A

    1997-12-01

    To develop a valid and reliable radiology faculty appraisal instrument based on scientific methods. Fifteen radiology residents participated in critical incident interviewing. During a 1-hour interview, a resident was asked to describe five incidents each of effective and ineffective faculty behavior. Two investigators independently listened to the tape-recorded interviews, and two different investigators sorted the incidents into broad categories. A faculty appraisal instrument was developed by listing similar incidents under broad categories. A five-point rating scale was applied to each item. Content validity was assessed by resident and faculty critique of the appraisal instrument. A total of 168 incidents of faculty behavior were generated. The frequency with which similar incidents were reported was recorded. The most common behaviors reported were related to staff expertise and teaching. Interjudge reliability was good, as determined by computing K indices of agreement (overall K = 0.59). There was good agreement regarding instrument content validity among residents but not among faculty. Residents supported the use of the new appraisal instrument, but further tests of validity and reliability and faculty acceptance of the instrument will determine its usefulness as a tool for monitoring faculty teaching performance and making decisions regarding faculty promotion.

  3. Clinical practice guidelines for treatment of acne vulgaris: a critical appraisal using the AGREE II instrument.

    Science.gov (United States)

    Sanclemente, Gloria; Acosta, Jorge-Luis; Tamayo, Maria-Eulalia; Bonfill, Xavier; Alonso-Coello, Pablo

    2014-04-01

    A significant number of clinical practice guidelines (CPGs) about the treatment of acne vulgaris in adolescents and adults have been published worldwide. However, little is known about the quality of CPGs in this field. The aim of this study was to appraise the methodological quality of published acne vulgaris CPGs. We performed a systematic review of published CPGs on acne vulgaris therapy from July 2002 to July 2012. Three reviewers independently assessed each CPG using the AGREE II instrument. A standardized score was calculated for each of the six domains. Our search strategy identified 103 citations but just six met our inclusion criteria. Agreement among reviewers was very good: 0.981. The domains that scored better were: "scope and purpose" and "clarity and presentation". Those that scored worse were "stakeholder involvement", "rigor of development", and "applicability". The European and the Malaysian CPGs were the only recommended with no further modifications. In addition, the Mexican, Colombian and the United States guidelines were recommended with provisos, with lower scores regarding stakeholder involvement, rigor of development and applicability. Only two guidelines clearly reported outcome measures for evaluating efficacy or included quality of life outcomes. CPGs varied regarding the consideration of light/laser therapy or consideration of complementary/alternative medicines. None of them included cost considerations of drugs such as systemic isotretinoin. In conclusion, published acne vulgaris CPGs for acne therapy vary in quality with a clear need to improve their methodological rigor. This could be achieved with the adherence to current CPGs development standards.

  4. A critical appraisal of chronic kidney disease mineral and bone disorders clinical practice guidelines using the AGREE II instrument.

    Science.gov (United States)

    Sekercioglu, Nigar; Al-Khalifah, Reem; Ewusie, Joycelyne Efua; Elias, Rosilene M; Thabane, Lehana; Busse, Jason W; Akhtar-Danesh, Noori; Iorio, Alfonso; Isayama, Tetsuya; Martínez, Juan Pablo Díaz; Florez, Ivan D; Guyatt, Gordon H

    2017-02-01

    Patients with chronic kidney disease mineral and bone disorders (CKD-MBD) suffer high rates of morbidity and mortality, in particular related to bone and cardiovascular outcomes. The management of CKD-MBD remains challenging. The objective of this systematic survey is to critically appraise clinical practice guidelines (CPGs) addressing CKD-MBD. Data sources included MEDLINE, EMBASE, the National Guideline Clearinghouse, Guideline International Network and Turning Research into Practice up to May 2016. Teams of two reviewers, independently and in duplicate, screened titles and abstracts and potentially eligible full text reports to determine eligibility and subsequently appraised the guidelines using the Advancing Guideline Development, Reporting and Evaluation in Health Care instrument II (AGREE). Sixteen CPGs published from 2003 to 2015 addressing the diagnosis and management of CKD-MBD in adult patients (11 English, two Spanish, one Italian, one Portuguese and one Slovak) proved eligible. The National Institute for Health and Care Excellence guideline performed best with respect to AGREE II criteria; only three other CPGs warranted high scores on all domains. All other guidelines received scores of under 60% on one or more domains. Major discrepancies in recommendations were not, however, present, and we found no association between quality of CPGs which was not associated with resulting recommendations. Most guidelines assessing CKD-MBD suffer from serious shortcomings using AGREE criteria although limitations with respect to AGREE criteria do not necessarily lead to inappropriate recommendations.

  5. A systematic critical appraisal for non-pharmacological management of osteoarthritis using the appraisal of guidelines research and evaluation II instrument.

    Science.gov (United States)

    Brosseau, Lucie; Rahman, Prinon; Toupin-April, Karine; Poitras, Stéphane; King, Judy; De Angelis, Gino; Loew, Laurianne; Casimiro, Lynn; Paterson, Gail; McEwan, Jessica

    2014-01-01

    Clinical practice CPGs (CPGs) have been developed to summarize evidence related to the management of osteoarthritis (OA). CPGs facilitate uptake of evidence-based knowledge by consumers, health professionals, health administrators and policy makers. The objectives of the present review were: 1) to assess the quality of the CPGs on non-pharmacological management of OA; using a standardized and validated instrument--the Appraisal of Guidelines Research and Evaluation (AGREE II) tool--by three pairs of trained appraisers; and 2) to summarize the recommendations based on only high-quality existing CPGs. Scientific literature databases from 2001 to 2013 were systematically searched for the state of evidence, with 17 CPGs for OA being identified. Most CPGs effectively addressed only a minority of AGREE II domains. Scope and purpose was effectively addressed in 10 CPGs on the management of OA, stakeholder involvement in 12 CPGs, rigour of development in 10 CPGs, clarity/presentation in 17 CPGs, editorial independence in 2 CPGs, and applicability in none of the OA CPGs. The overall quality of the included CPGs, according to the 7-point AGREE II scoring system, is 4.8 ± 0.41 for OA. Therapeutic exercises, patient education, transcutaneous electrical nerve stimulation, acupuncture, orthoses and insoles, heat and cryotherapy, patellar tapping, and weight control are commonly recommended for the non-pharmacological management of OA by the high-quality CPGs. The general clinical management recommendations tended to be similar among high-quality CPGs, although interventions addressed varied. Non-pharmacological management interventions were superficially addressed in more than half of the selected CPGs. For CPGs to be standardized uniform creators should use the AGREE II criteria when developing CPGs. Innovative and effective methods of CPG implementation to users are needed to ultimately enhance the quality of life of arthritic individuals.

  6. Critical appraisal of published literature

    Science.gov (United States)

    Umesh, Goneppanavar; Karippacheril, John George; Magazine, Rahul

    2016-01-01

    With a large output of medical literature coming out every year, it is impossible for readers to read every article. Critical appraisal of scientific literature is an important skill to be mastered not only by academic medical professionals but also by those involved in clinical practice. Before incorporating changes into the management of their patients, a thorough evaluation of the current or published literature is an important step in clinical practice. It is necessary for assessing the published literature for its scientific validity and generalizability to the specific patient community and reader's work environment. Simple steps have been provided by Consolidated Standard for Reporting Trial statements, Scottish Intercollegiate Guidelines Network and several other resources which if implemented may help the reader to avoid reading flawed literature and prevent the incorporation of biased or untrustworthy information into our practice. PMID:27729695

  7. Critical appraisal of published literature

    Directory of Open Access Journals (Sweden)

    Goneppanavar Umesh

    2016-01-01

    Full Text Available With a large output of medical literature coming out every year, it is impossible for readers to read every article. Critical appraisal of scientific literature is an important skill to be mastered not only by academic medical professionals but also by those involved in clinical practice. Before incorporating changes into the management of their patients, a thorough evaluation of the current or published literature is an important step in clinical practice. It is necessary for assessing the published literature for its scientific validity and generalizability to the specific patient community and reader′s work environment. Simple steps have been provided by Consolidated Standard for Reporting Trial statements, Scottish Intercollegiate Guidelines Network and several other resources which if implemented may help the reader to avoid reading flawed literature and prevent the incorporation of biased or untrustworthy information into our practice.

  8. Not so critical appraisal of dapagliflozin

    Directory of Open Access Journals (Sweden)

    Doggrell SA

    2014-08-01

    Full Text Available Sheila A Doggrell School of Biomedical Science, Faculty of Health, Queensland University of Technology, Brisbane, QLD, AustraliaA recent review by Salvo et al published in Patient Preference and Adherence concerned dapagliflozin, and was titled “Patient considerations in the management of type 2 diabetes – critical appraisal of dapagliflozin”.1 Having read the article, I do not consider it to be a critical appraisal of dapagliflozin. Thus, after comparing dapagliflozin with other oral antidiabetic medications, the authors concluded that “Dapagliflozin’s noted blood pressure reduction, weight loss, and low potential to cause hypoglycemia are advantageous, when compared with currently available oral medications”.1 This statement is not supported by the content of the review and/or the literature. Read the original article 

  9. Teaching critical appraisal skills for nursing research.

    Science.gov (United States)

    Jones, Sandra C; Crookes, Patrick A; Johnson, Keryn M

    2011-09-01

    Evidence-based practice is a major focus in nursing, yet the literature continues to document a research-practice gap. Reasons for this gap stem partly from a lack of skills to critique and synthesize the literature, a lack of search skills and difficulty in understanding research articles, and limited knowledge of research by nursing professionals. An innovative and quality driven subject to improve critical appraisal and critical thinking skills was developed for the School of Nursing, Midwifery and Indigenous Health at the University of Wollongong, based on formative research with postgraduate students and supervisors. Through face-to-face and online teaching modules students worked through a structured process of analysing the key aspects of published papers using structured analysis tools for each study design. Pre and post surveys of students found improvements in perceived knowledge of all key skills of critical appraisal. External independent evaluation determined that it was a high quality subject showing many hallmarks of good assessment practice and good practice in use of information and communication technology (ICT) in support of the learning outcomes. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Small Steps Forward Through Critical Appraisal (Editorial

    Directory of Open Access Journals (Sweden)

    Denise Koufogiannakis

    2006-03-01

    Full Text Available As a vocal proponent of evidence based information practice, I have actively encouraged my co‐workers and anyone else who might listen, to take small steps in order to move towards incorporating research evidence into their decision making. I prompt colleagues to search in databases for research articles that may be useful, gather these articles and incorporate research results as part of their decision making process. I am often told of the difficulties faced despite one’s best attempts to make their practice more evidence‐based. A major difficulty is access to the research itself since librarians and information professionals often lack access to databases and journals in our field, particularly those of us working outside of academic libraries. An even more daunting question is how to critically read the existing research to determine whether it is valuable in a specific situation. Not all research is good, and how do we sort out the good from the bad? This inaugural issue of Evidence Based Library and Information Practice brings us one small step closer to addressing some of these concerns by equipping practitioners with information to help in their decision making process. Every issue of Evidence Based Library and Information Practice will incorporate approximately 10 evidence summaries to help readers sort through recently published research and determine if that research was done well. Evidence summaries provide a critical appraisal synthesis for a specific research article, so that practitioners may more readily determine if the evidence in that research study is valid and reliable, and whether they can apply it to their own practice. Evidence summaries are indeed a small step, but an important one. Published in an open‐access forum, these summaries will address three barriers to evidence based practice that we have faced in the past. First of all, they will bring awareness of previously published research to readers who may

  11. A framework for assessing Health Economic Evaluation (HEE) quality appraisal instruments.

    Science.gov (United States)

    Langer, Astrid

    2012-08-16

    Health economic evaluations support the health care decision-making process by providing information on costs and consequences of health interventions. The quality of such studies is assessed by health economic evaluation (HEE) quality appraisal instruments. At present, there is no instrument for measuring and improving the quality of such HEE quality appraisal instruments. Therefore, the objectives of this study are to establish a framework for assessing the quality of HEE quality appraisal instruments to support and improve their quality, and to apply this framework to those HEE quality appraisal instruments which have been subject to more scrutiny than others, in order to test the framework and to demonstrate the shortcomings of existing HEE quality appraisal instruments. To develop the quality assessment framework for HEE quality appraisal instruments, the experiences of using appraisal tools for clinical guidelines are used. Based on a deductive iterative process, clinical guideline appraisal instruments identified through literature search are reviewed, consolidated, and adapted to produce the final quality assessment framework for HEE quality appraisal instruments. The final quality assessment framework for HEE quality appraisal instruments consists of 36 items organized within 7 dimensions, each of which captures a specific domain of quality. Applying the quality assessment framework to four existing HEE quality appraisal instruments, it is found that these four quality appraisal instruments are of variable quality. The framework described in this study should be regarded as a starting point for appraising the quality of HEE quality appraisal instruments. This framework can be used by HEE quality appraisal instrument producers to support and improve the quality and acceptance of existing and future HEE quality appraisal instruments. By applying this framework, users of HEE quality appraisal instruments can become aware of methodological deficiencies

  12. Spent fuel storage options: a critical appraisal

    International Nuclear Information System (INIS)

    Singh, K.P.; Bale, M.G.

    1990-01-01

    The delayed decisions on nuclear fuel reprocessing strategies in the USA and other countries have forced the development of new long-term irradiated fuel storage techniques, to allow a larger volume of fuel to be held on the nuclear station site after removal from the reactor. The nuclear power industry has responded to the challenge by developing several viable options for long-term onsite storage, which can be employed individually or in tandem. They are: densification of storage in the existing spent fuel pool; building another fuel pool facility at the plant site; onsite cask park, and on site vault clusters. Desirable attributes of a storage option are: Safety: minimise the number of fuel handling steps; Economy: minimise total installed, and O and M cost; Security: protection from anti-nuclear protesters; Site adaptability: available site space, earthquake characteristics of the region and so on; Non-intrusiveness: minimise required modifications to existing plant systems; Modularisation: afford the option to adapt a modular approach for staged capital outlays; and Maturity: extent of industry experience with the technology. A critical appraisal is made of each of the four aforementioned storage options in the light of these criteria. (2 figures, 1 table, 4 references) (Author)

  13. A Critical Appraisal of the "Day" Diagram

    Science.gov (United States)

    Roberts, Andrew P.; Tauxe, Lisa; Heslop, David; Zhao, Xiang; Jiang, Zhaoxia

    2018-04-01

    The "Day" diagram (Day et al., 1977, https://doi.org/10.1016/0031-9201(77)90108-X) is used widely to make inferences about the domain state of magnetic mineral assemblages. Based on theoretical and empirical arguments, the Day diagram is demarcated into stable "single domain" (SD), "pseudo single domain" ("PSD"), and "multidomain" (MD) zones. It is straightforward to make the necessary measurements for a sample and to plot results within the "domain state" framework based on the boundaries defined by Day et al. (1977, https://doi.org/10.1016/0031-9201(77)90108-X). We discuss 10 issues that limit Day diagram interpretation, including (1) magnetic mineralogy, (2) the associated magnetocrystalline anisotropy type, (3) mineral stoichiometry, (4) stress state, (5) surface oxidation, (6) magnetostatic interactions, (7) particle shape, (8) thermal relaxation, (9) magnetic particle mixtures, and (10) definitional/measurement issues. In most studies, these variables are unknowns and cannot be controlled for, so that hysteresis parameters for single bulk samples are nonunique and any data point in a Day diagram could result from infinite combinations of relevant variables. From this critical appraisal, we argue that the Day diagram is fundamentally ambiguous for domain state diagnosis. Widespread use of the Day diagram has also contributed significantly to prevalent but questionable views, including underrecognition of the importance of stable SD particles in the geological record and reinforcement of the unhelpful PSD concept and of its geological importance. Adoption of approaches that enable correct domain state diagnosis should be an urgent priority for component-specific understanding of magnetic mineral assemblages and for quantitative rock magnetic interpretation.

  14. Appraisal of seven critical reading strategies employed by teachers ...

    African Journals Online (AJOL)

    Appraisal of seven critical reading strategies employed by teachers in Ogun State senior secondary schools to teach reading comprehension. ... as a result of the teachers' ability to engage the students in skilful and well- framed questions.

  15. A Critical Appraisal of the `Day' Diagram

    Science.gov (United States)

    Roberts, A. P.; Tauxe, L.; Heslop, D.

    2017-12-01

    The `Day' diagram [Day et al., 1977; doi:10.1016/0031-9201(77)90108-X] is used widely to infer the mean domain state of magnetic mineral assemblages. The Day plot coordinates are the ratios of the saturation remanent magnetization to saturation magnetization (Mrs/Ms) and the coercivity of remanence to coercivity (Bcr/Bc), as determined from a major hysteresis loop and a backfield demagnetization curve. Based on theoretical and empirical arguments, Day plots are typically demarcated into stable single domain (SD), `pseudosingle domain' (`PSD'), and multidomain (MD) zones. It is a simple task to determine Mrs/Ms and Bcr/Bc for a sample and to assign a mean domain state based on the boundaries defined by Day et al. [1977]. Many other parameters contribute to variability in a Day diagram, including surface oxidation, mineral stoichiometry, stress state, magnetostatic interactions, and mixtures of magnetic particles with different sizes and shapes. Bulk magnetic measurements usually lack detailed independent evidence to constrain each free parameter, which makes the Day diagram fundamentally ambiguous. This raises questions about its usefulness for diagnosing magnetic particle size variations. The Day diagram is also used to make inferences about binary mixing of magnetic particles, where, for example, mixtures of SD and MD particles give rise to a bulk `PSD' response even though the concentration of `PSD' grains could be zero. In our assessment of thousands of hysteresis measurements of geological samples, binary mixing occurs in a tiny number of cases. Ternary, quaternary, and higher order mixing are usually observed. Also, uniaxial SD and MD end-members are nearly always inappropriate for considering mixing because uniaxial SD particles are virtually non-existent in igneous rocks. Thus, use of mixing lines in Day diagrams routinely provides unsatisfactory representations of particle size variations. We critically appraise the Day diagram and argue that its many

  16. Critical appraisal of nonrandomized studies-A review of recommended and commonly used tools.

    Science.gov (United States)

    Quigley, Joan M; Thompson, Juliette C; Halfpenny, Nicholas J; Scott, David A

    2018-02-27

    When randomized controlled trial data are limited or unavailable, or to supplement randomized controlled trial evidence, health technology assessment (HTA) agencies may rely on systematic reviews of nonrandomized studies (NRSs) for evidence of the effectiveness of health care interventions. NRS designs may introduce considerable bias into systematic reviews, and several methodologies by which to evaluate this risk of bias are available. This study aimed to identify tools commonly used to assess bias in NRS and determine those recommended by HTA bodies. Appraisal tools used in NRS were identified through a targeted search of systematic reviews (January 2013-March 2017; MEDLINE and EMBASE [OVID SP]). Recommendations for the critical appraisal of NRS by expert review groups and HTA bodies were reviewed. From the 686 studies included in the narrative synthesis, 48 critical appraisal tools were identified. Commonly used tools included the Newcastle-Ottawa Scale, the methodological index for NRS, and bespoke appraisal tools. Neither the Cochrane Handbook nor the Centre for Reviews and Dissemination recommends a particular instrument for the assessment of risk of bias in NRS, although Cochrane has recently developed their own NRS critical appraisal tool. Among HTA bodies, only the Canadian Agency for Drugs and Technologies in Health recommends use of a specific critical appraisal tool-SIGN 50 (for cohort or case-control studies). Several criteria including reporting, external validity, confounding, and power were examined. There is no consensus between HTA groups on the preferred appraisal tool. Reviewers should select from a suite of tools on the basis of the design of studies included in their review. © 2018 John Wiley & Sons, Ltd.

  17. Quantum theories of the early universe - a critical appraisal

    International Nuclear Information System (INIS)

    Hu, B.L.

    1988-01-01

    A critical appraisal of certain general problems in the study of quantum processes in curved space as applied to the construction of theories of the early universe is presented. Outstanding issues in different cosmological models and the degree of success of different quantum processes in addressing these issues are summarized. (author)

  18. Financial Literacy: A Critical Adult Education Appraisal

    Science.gov (United States)

    English, Leona M.

    2014-01-01

    This chapter critically examines financial literacy education, asking what its assumptions are and what adult educators need to ask of its curriculum, its bases, and the people being taught to be financially literate.

  19. DMPD: Toll like receptors and autoimmunity: a critical appraisal. [Dynamic Macrophage Pathway CSML Database

    Lifescience Database Archive (English)

    Full Text Available 17959357 Toll like receptors and autoimmunity: a critical appraisal. Papadimitraki ...ml) Show Toll like receptors and autoimmunity: a critical appraisal. PubmedID 17959357 Title Toll like receptors and auto

  20. THE NICHE CONSTRUCTION PERSPECTIVE: A CRITICAL APPRAISAL*

    Science.gov (United States)

    Scott-Phillips, Thomas C; Laland, Kevin N; Shuker, David M; Dickins, Thomas E; West, Stuart A

    2014-01-01

    Niche construction refers to the activities of organisms that bring about changes in their environments, many of which are evolutionarily and ecologically consequential. Advocates of niche construction theory (NCT) believe that standard evolutionary theory fails to recognize the full importance of niche construction, and consequently propose a novel view of evolution, in which niche construction and its legacy over time (ecological inheritance) are described as evolutionary processes, equivalent in importance to natural selection. Here, we subject NCT to critical evaluation, in the form of a collaboration between one prominent advocate of NCT, and a team of skeptics. We discuss whether niche construction is an evolutionary process, whether NCT obscures or clarifies how natural selection leads to organismal adaptation, and whether niche construction and natural selection are of equivalent explanatory importance. We also consider whether the literature that promotes NCT overstates the significance of niche construction, whether it is internally coherent, and whether it accurately portrays standard evolutionary theory. Our disagreements reflect a wider dispute within evolutionary theory over whether the neo-Darwinian synthesis is in need of reformulation, as well as different usages of some key terms (e.g., evolutionary process). PMID:24325256

  1. The niche construction perspective: a critical appraisal.

    Science.gov (United States)

    Scott-Phillips, Thomas C; Laland, Kevin N; Shuker, David M; Dickins, Thomas E; West, Stuart A

    2014-05-01

    Niche construction refers to the activities of organisms that bring about changes in their environments, many of which are evolutionarily and ecologically consequential. Advocates of niche construction theory (NCT) believe that standard evolutionary theory fails to recognize the full importance of niche construction, and consequently propose a novel view of evolution, in which niche construction and its legacy over time (ecological inheritance) are described as evolutionary processes, equivalent in importance to natural selection. Here, we subject NCT to critical evaluation, in the form of a collaboration between one prominent advocate of NCT, and a team of skeptics. We discuss whether niche construction is an evolutionary process, whether NCT obscures or clarifies how natural selection leads to organismal adaptation, and whether niche construction and natural selection are of equivalent explanatory importance. We also consider whether the literature that promotes NCT overstates the significance of niche construction, whether it is internally coherent, and whether it accurately portrays standard evolutionary theory. Our disagreements reflect a wider dispute within evolutionary theory over whether the neo-Darwinian synthesis is in need of reformulation, as well as different usages of some key terms (e.g., evolutionary process). © 2013 The Author(s). Evolution published by Wiley Periodicals, Inc. on behalf of The Society for the Study of Evolution.

  2. Health systems guidance appraisal--a critical interpretive synthesis.

    Science.gov (United States)

    Ako-Arrey, Denis E; Brouwers, Melissa C; Lavis, John N; Giacomini, Mita K

    2016-01-22

    Health systems guidance (HSG) are systematically developed statements that assist with decisions about options for addressing health systems challenges, including related changes in health systems arrangements. However, the development, appraisal, and reporting of HSG poses unique conceptual and methodological challenges related to the varied types of evidence that are relevant, the complexity of health systems, and the pre-eminence of contextual factors. To address this gap, we are conducting a program of research that aims to create a tool to support the appraisal of HSG and further enhance HSG development and reporting. The focus of this paper was to conduct a knowledge synthesis of the published and grey literatures to determine quality criteria (concepts) relevant for this process. We applied a critical interpretive synthesis (CIS) approach to knowledge synthesis that enabled an iterative, flexible, and dynamic analysis of diverse bodies of literature in order to generate a candidate list of concepts that will constitute the foundational components of the HSG tool. Using our review questions as compasses, we were able to guide the search strategy to look for papers based on their potential relevance to HSG appraisal, development, and reporting. The search strategy included various electronic databases and sources, subject-specific journals, conference abstracts, research reports, book chapters, unpublished data, dissertations, and policy documents. Screening the papers and data extraction was completed independently and in duplicate, and a narrative approach to data synthesis was executed. We identified 43 papers that met eligibility criteria. No existing review was found on this topic, and no HSG appraisal tool was identified. Over one third of the authors implicitly or explicitly identified the need for a high-quality tool aimed to systematically evaluate HSG and contribute to its development/reporting. We identified 30 concepts that may be relevant to the

  3. Dental Students' Use of AMSTAR to Critically Appraise Systematic Reviews.

    Science.gov (United States)

    Teich, Sorin T; Heima, Masahiro; Lang, Lisa

    2015-09-01

    The idea of basing clinical procedures upon evidence gathered by observation is less than 200 years old, with the first set of evidence-based position papers dating back only to the early 1970s. The relationship between evidence-based education and health outcomes is difficult to test and may be indirect, but teaching critical appraisal skills may be beneficial in developing knowledge. Systematic reviews have a central role in the process of clinical decision making in practice and therefore should be of high quality, following a rigorous protocol that can be evaluated with validated tools. The aim of this study was to assess how dental students utilized the Assessment of Multiple Systematic Reviews (AMSTAR) appraisal tool to evaluate systematic reviews in the context of a treatment planning course. During the in-class final exam, students were required to appraise the quality of a systematic review and to justify their answers. Of the 74 third-year students who took the exam, 100% answered all questions on the AMSTAR form. The mean number of correct answers was nine (SD=1.047, Min=6, Max=10), with no student providing all 11 correct answers. The fact that nearly 90% of the students provided eight or more correct answers suggests that AMSTAR can be used by students to evaluate the methodological quality of systematic reviews. It also was evident that although the AMSTAR tool requires less than 15 minutes to complete an evaluation, using it requires extensive training and repetition to achieve consistent and reliable results.

  4. Online training course on critical appraisal for nurses: adaptation and assessment.

    Science.gov (United States)

    Reviriego, Eva; Cidoncha, María Angeles; Asua, José; Gagnon, Marie Pierre; Mateos, Maider; Gárate, Lucía; de Lorenzo, Elena; González, Rosa María

    2014-07-05

    Research is an essential activity for improving quality and efficiency in healthcare. The objective of this study was to train nurses from the public Basque Health Service (Osakidetza) in critical appraisal, promoting continuous training and the use of research in clinical practice. This was a prospective pre-post test study. The InfoCritique course on critical appraisal was translated and adapted. A sample of 50 nurses and 3 tutors was recruited. Educational strategies and assessment instruments were established for the course. A course website was created that contained contact details of the teaching team and coordinator, as well as a course handbook and videos introducing the course. Assessment comprised the administration of questionnaires before and after the course, in order to explore the main intervention outcomes: knowledge acquired and self-learning readiness. Satisfaction was also measured at the end of the course. Of the 50 health professionals recruited, 3 did not complete the course for personal or work-related reasons. The mean score on the pre-course knowledge questionnaire was 70.5 out of 100, with a standard deviation of 11.96. In general, participants' performance on the knowledge questionnaire improved after the course, as reflected in the notable increase of the mean score, to 86.6, with a standard deviation of 10.00. Further, analyses confirmed statistically significant differences between pre- and post-course results (p tools for research, promote a research culture, and encourage critical thinking for evidence-based decision making.

  5. Mechanism of West Nile Virus Neuroinvasion: A Critical Appraisal

    Directory of Open Access Journals (Sweden)

    Willy W. Suen

    2014-07-01

    Full Text Available West Nile virus (WNV is an important emerging neurotropic virus, responsible for increasingly severe encephalitis outbreaks in humans and horses worldwide. However, the mechanism by which the virus gains entry to the brain (neuroinvasion remains poorly understood. Hypotheses of hematogenous and transneural entry have been proposed for WNV neuroinvasion, which revolve mainly around the concepts of blood-brain barrier (BBB disruption and retrograde axonal transport, respectively. However, an over‑representation of in vitro studies without adequate in vivo validation continues to obscure our understanding of the mechanism(s. Furthermore, WNV infection in the current rodent models does not generate a similar viremia and character of CNS infection, as seen in the common target hosts, humans and horses. These differences ultimately question the applicability of rodent models for pathogenesis investigations. Finally, the role of several barriers against CNS insults, such as the blood-cerebrospinal fluid (CSF, the CSF-brain and the blood-spinal cord barriers, remain largely unexplored, highlighting the infancy of this field. In this review, a systematic and critical appraisal of the current evidence relevant to the possible mechanism(s of WNV neuroinvasion is conducted.

  6. Critical appraisal skills training for health care professionals: a randomized controlled trial [ISRCTN46272378

    Directory of Open Access Journals (Sweden)

    Ewings Paul E

    2004-12-01

    Full Text Available Abstract Introduction Critical appraisal skills are believed to play a central role in an evidence-based approach to health practice. The aim of this study was to evaluate the effectiveness and costs of a critical appraisal skills educational intervention aimed at health care professionals. Methods This prospective controlled trial randomized 145 self-selected general practitioners, hospital physicians, professions allied to medicine, and healthcare managers/administrators from the South West of England to a half-day critical appraisal skills training workshop (based on the model of problem-based small group learning or waiting list control. The following outcomes were assessed at 6-months follow up: knowledge of the principles necessary for appraising evidence; attitudes towards the use of evidence about healthcare; evidence seeking behaviour; perceived confidence in appraising evidence; and ability to critically appraise a systematic review article. Results At follow up overall knowledge score [mean difference: 2.6 (95% CI: 0.6 to 4.6] and ability to appraise the results of a systematic review [mean difference: 1.2 (95% CI: 0.01 to 2.4] were higher in the critical skills training group compared to control. No statistical significant differences in overall attitude towards evidence, evidence seeking behaviour, perceived confidence, and other areas of critical appraisal skills ability (methodology or generalizability were observed between groups. Taking into account the workshop provision costs and costs of participants time and expenses of participants, the average cost of providing the critical appraisal workshops was approximately £250 per person. Conclusions The findings of this study challenge the policy of funding 'one-off' educational interventions aimed at enhancing the evidence-based practice of health care professionals. Future evaluations of evidence-based practice interventions need to take in account this trial's negative findings

  7. Development and validation of a trustworthy multisource feedback instrument to support nurse appraisals.

    Science.gov (United States)

    Crossley, James G M

    2015-01-01

    Nurse appraisal is well established in the Western world because of its obvious educational advantages. Appraisal works best with many sources of information on performance. Multisource feedback (MSF) is widely used in business and in other clinical disciplines to provide such information. It has also been incorporated into nursing appraisals, but, so far, none of the instruments in use for nurses has been validated. We set out to develop an instrument aligned with the UK Knowledge and Skills Framework (KSF) and to evaluate its reliability and feasibility across a wide hospital-based nursing population. The KSF framework provided a content template. Focus groups developed an instrument based on consensus. The instrument was administered to all the nursing staff in 2 large NHS hospitals forming a single trust in London, England. We used generalizability analysis to estimate reliability, response rates and unstructured interviews to evaluate feasibility, and factor structure and correlation studies to evaluate validity. On a voluntary basis the response rate was moderate (60%). A failure to engage with information technology and employment-related concerns were commonly cited as reasons for not responding. In this population, 11 responses provided a profile with sufficient reliability to inform appraisal (G = 0.7). Performance on the instrument was closely and significantly correlated with performance on a KSF questionnaire. This is the first contemporary psychometric evaluation of an MSF instrument for nurses. MSF appears to be as valid and reliable as an assessment method to inform appraisal in nurses as it is in other health professional groups. © 2015 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

  8. 17 CFR 1.28 - Appraisal of instruments purchased with customer funds.

    Science.gov (United States)

    2010-04-01

    ... purchased with customer funds. 1.28 Section 1.28 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION GENERAL REGULATIONS UNDER THE COMMODITY EXCHANGE ACT Customers' Money, Securities, and Property § 1.28 Appraisal of instruments purchased with customer funds. Futures commission merchants who...

  9. Teacher Support in Learning: Instrumental and Appraisal Support in Relation to Math Achievement

    Science.gov (United States)

    Wong, Tracy K. Y.; Tao, Xi; Konishi, Chiaki

    2018-01-01

    This study explored the extent to which teachers' instrumental (i.e., tangible aid to promote learning) and appraisal support (i.e., teacher feedback) enhanced students' achievement in mathematics. Participants included 13,950 fifteen-year-old Canadian students who participated in the 2012 Programme for International Student Assessment. Based on…

  10. Healthcare librarians and the delivery of critical appraisal training: barriers to involvement.

    Science.gov (United States)

    Maden-Jenkins, Michelle

    2011-03-01

      Many healthcare librarians are undertaking training in critical appraisal but a significant number are not cascading the training to their end-users.   To examine the barriers to healthcare librarian involvement in delivering critical appraisal training.   A questionnaire survey of 57 library services across 48 NHS Trust Library Services in north west England followed up with 21 semi-structured interviews.   Two types of barriers were noted: extrinsic barriers (organisational, environmental, training, role expectations) and intrinsic barriers (knowledge, skills, attitude).   These barriers are not mutually exclusive and by overcoming one of them it does not necessarily follow that healthcare librarians will engage in delivering critical appraisal skills training. The challenge lies in developing strategies to deal effectively with these barriers to encourage and support healthcare librarians in the delivery of critical appraisal training at a level at which they feel confident and able. © 2010 The authors. Health Information and Libraries Journal © 2010 Health Libraries Group.

  11. Experiential learning and andragogy--negotiated learning in nurse education: a critical appraisal.

    Science.gov (United States)

    Burnard, P

    1989-10-01

    Andragogy and experiential learning have frequently been cited as recommended approaches to aspects of nurse education. This paper offers a critical appraisal of the two approaches and offers suggestions as to how a negotiated nursing curriculum may be developed.

  12. Healthcare librarians and the delivery of critical appraisal training: attitudes, level of involvement and support.

    Science.gov (United States)

    Maden-Jenkins, Michelle

    2010-12-01

    Although healthcare librarians are undertaking training in critical appraisal skills, what is not so clear is the impact of the training on the understanding and dissemination of these skills. This study aims to examine the attitudes of healthcare librarians towards delivering critical appraisal training and their level of involvement. A questionnaire survey of 57 library services across 48 NHS Trust Library Services in north-west England followed up with 21 semi-structured interviews. Seventy-three per cent of respondents felt that they ought to be involved in delivering critical appraisal training, however less than a third (29%) are actually involved. Librarians are involved in critical appraisal facilitation at various levels. Debate continues over the extent of librarian involvement in delivering critical appraisal training. As long as healthcare librarians recognise their own capabilities and identify the boundaries within which they feel comfortable then there is no reason why they should not be involved in delivering critical appraisal training. © 2010 The authors. Health Information and Libraries Journal © 2010 Health Libraries Group.

  13. Development of the Quality Improvement Minimum Quality Criteria Set (QI-MQCS): a tool for critical appraisal of quality improvement intervention publications.

    Science.gov (United States)

    Hempel, Susanne; Shekelle, Paul G; Liu, Jodi L; Sherwood Danz, Margie; Foy, Robbie; Lim, Yee-Wei; Motala, Aneesa; Rubenstein, Lisa V

    2015-12-01

    Valid, reliable critical appraisal tools advance quality improvement (QI) intervention impacts by helping stakeholders identify higher quality studies. QI approaches are diverse and differ from clinical interventions. Widely used critical appraisal instruments do not take unique QI features into account and existing QI tools (eg, Standards for QI Reporting Excellence) are intended for publication guidance rather than critical appraisal. This study developed and psychometrically tested a critical appraisal instrument, the QI Minimum Quality Criteria Set (QI-MQCS) for assessing QI-specific features of QI publications. Approaches to developing the tool and ensuring validity included a literature review, in-person and online survey expert panel input, and application to empirical examples. We investigated psychometric properties in a set of diverse QI publications (N=54) by analysing reliability measures and item endorsement rates and explored sources of disagreement between reviewers. The QI-MQCS includes 16 content domains to evaluate QI intervention publications: Organisational Motivation, Intervention Rationale, Intervention Description, Organisational Characteristics, Implementation, Study Design, Comparator Description, Data Sources, Timing, Adherence/Fidelity, Health Outcomes, Organisational Readiness, Penetration/Reach, Sustainability, Spread and Limitations. Median inter-rater agreement for QI-MQCS items was κ 0.57 (83% agreement). Item statistics indicated sufficient ability to differentiate between publications (median quality criteria met 67%). Internal consistency measures indicated coherence without excessive conceptual overlap (absolute mean interitem correlation=0.19). The critical appraisal instrument is accompanied by a user manual detailing What to consider, Where to look and How to rate. We developed a ready-to-use, valid and reliable critical appraisal instrument applicable to healthcare QI intervention publications, but recognise scope for

  14. Validación de un instrumento para la evaluación de la interpretación de los resultados de estudios de investigación en los residentes de un hospital universitario Validation of an instrument to assess research critical appraisal skills in residents in a university hospital

    Directory of Open Access Journals (Sweden)

    Rodolfo Pizarro

    2011-09-01

    Full Text Available Objetivo. Validar por el método de grupos extremos un instrumento para evaluar la interpretación de las pruebas estadísticas más utilizadas en residentes de un hospital universitario. Sujetos y métodos. Respondieron 272 residentes. La media de respuestas correctas fue del 45%. Resultados. No hubo diferencias entre género, especialidad ni años de formación. La fiabilidad fue aceptable (alfa = 0,83 y la diferencia entre grupos extremos fue significativa (0,45 frente a 0,91. Conclusiones. Los residentes mostraron déficits en interpretación crítica de estudios de investigación, hallazgo que es consistente con otros centros internacionales.Aim. To validate an instrument to assess research critical appraisal skills in residents in a university hospital by the extreme groups method. Subjects and methods. 272 residents completed the questionnaire. The mean of correct answers was 45%. Results. No significant differences between gender, specialty or post-graduate year were found. Reliability (alpha = 0.83 was acceptable and difference between extreme groups was significant (0.45 vs. 0.91. Conclusions. Residents showed poor skills to interpret typical results of clinical studies, finding consistent with other countries.

  15. The Halpern Critical Thinking Assessment: Towards a Dutch Appraisal of Critical Thinking

    NARCIS (Netherlands)

    de Bie, Hannie; Wilhelm, P.; van der Meij, Hans

    2015-01-01

    Critical thinking is a vital component of 21st century skills. To assess this skill, a valid and reliable instrument is needed. This study focuses on the psychometric properties of the Dutch version of the Halpern Critical Thinking Assessment (HCTA). The HCTA was administered to university students

  16. Productivity Implications of Employee Performance Appraisal System : A Critical Survey.

    OpenAIRE

    Dr. VSR Subramaniam

    2004-01-01

    The Productivity of any organisation is directly correlated to the Effectiveness of the Employee Performance Appraisal System, subject to the Effectiveness of the Support Systems, depending upon the type of organizational business. INFERENCE : Technology, Systems and Manpower are linked in an inter- related circle focusing towards Productivity =============================================================== DOCTORAL (Ph.D) RESEARCH WORK OF DR.VSR.SUBRAMANIAM IN JAMNALAL BAJAJ INSTITUTE OF MANA...

  17. A Critical Appraisal of Circumferential Resection Margins in Esophageal Carcinoma

    NARCIS (Netherlands)

    Pultrum, Bareld B.; Honing, Judith; Smit, Justin K.; van Dullemen, Hendrik M.; van Dam, Gooitzen M.; Groen, Henk; Hollema, Harry; Plukker, John Th. M.

    In esophageal cancer, circumferential resection margins (CRMs) are considered to be of relevant prognostic value, but a reliable definition of tumor-free CRM is still unclear. The aim of this study was to appraise the clinical prognostic value of microscopic CRM involvement and to determine the

  18. Quality appraisal of generic self-reported instruments measuring health-related productivity changes: a systematic review

    Science.gov (United States)

    2014-01-01

    Background Health impairments can result in disability and changed work productivity imposing considerable costs for the employee, employer and society as a whole. A large number of instruments exist to measure health-related productivity changes; however their methodological quality remains unclear. This systematic review critically appraised the measurement properties in generic self-reported instruments that measure health-related productivity changes to recommend appropriate instruments for use in occupational and economic health practice. Methods PubMed, PsycINFO, Econlit and Embase were systematically searched for studies whereof: (i) instruments measured health-related productivity changes; (ii) the aim was to evaluate instrument measurement properties; (iii) instruments were generic; (iv) ratings were self-reported; (v) full-texts were available. Next, methodological quality appraisal was based on COSMIN elements: (i) internal consistency; (ii) reliability; (iii) measurement error; (iv) content validity; (v) structural validity; (vi) hypotheses testing; (vii) cross-cultural validity; (viii) criterion validity; and (ix) responsiveness. Recommendations are based on evidence syntheses. Results This review included 25 articles assessing the reliability, validity and responsiveness of 15 different generic self-reported instruments measuring health-related productivity changes. Most studies evaluated criterion validity, none evaluated cross-cultural validity and information on measurement error is lacking. The Work Limitation Questionnaire (WLQ) was most frequently evaluated with moderate respectively strong positive evidence for content and structural validity and negative evidence for reliability, hypothesis testing and responsiveness. Less frequently evaluated, the Stanford Presenteeism Scale (SPS) showed strong positive evidence for internal consistency and structural validity, and moderate positive evidence for hypotheses testing and criterion validity. The

  19. Test Review: Watson, G., & Glaser, E. M. (2010), "Watson-Glaser™ II Critical Thinking Appraisal." Washington State University, Pullman, USA

    Science.gov (United States)

    Sternod, Latisha; French, Brian

    2016-01-01

    The Watson-Glaser™ II Critical Thinking Appraisal (Watson-Glaser II; Watson & Glaser, 2010) is a revised version of the "Watson-Glaser Critical Thinking Appraisal®" (Watson & Glaser, 1994). The Watson-Glaser II introduces a simplified model of critical thinking, consisting of three subdimensions: recognize assumptions, evaluate…

  20. Critical appraisal of questionnaires to assess functional impairment in individuals with mild cognitive impairment.

    Science.gov (United States)

    Kaur, Navaldeep; Belchior, Patricia; Gelinas, Isabelle; Bier, Nathalie

    2016-09-01

    Mild deficits in instrumental activities of daily living (IADLs) have consistently been reported in the individuals with mild cognitive impairment (MCI). A variety of functional assessment tools, including self-and informant report questionnaires and performance-based measures, have been employed in MCI. Previously, a limited focus has been directed at appraising the quality of questionnaires. The goal of this study was to identify the questionnaires that have been validated in the MCI population. Additionally, the quality of validation studies and psychometric attributes of these questionnaires were appraised. Relevant articles were systematically searched in PsychINFO, Ovid MEDLINE, and CINAHL against specific eligibility criteria. To evaluate the methodology of the psychometric studies, the COSMIN checklist was employed. Also, the psychometric properties of the assessment tools were evaluated based upon Terwee's criteria. A total of five psychometric studies and questionnaires were critically evaluated. Varying psychometric properties were available for the chosen tools. None of the studies received the best possible rating for their methodological quality. It was found that questionnaires with high discriminative ability to distinguish MCI from other diagnostic groups were: Disability Assessment in Dementia-6 (DAD-6), Functional Activity Questionnaire (FAQ), and Alzheimer's Disease Cooperative Study/Activities of Daily Living scale adapted for MCI patients (ADCS-MCI-ADL-24). Psychometric studies with strong methodological rigor are required in the future. Considering the fact that IADL decline has been associated with dementia, early detection of functional difficulties in MCI needs to be encouraged as it will allow suitable and timely interventions to prolong functional independence of affected individuals.

  1. Dental management of patients using antithrombotic drugs: critical appraisal of existing guidelines

    NARCIS (Netherlands)

    van Diermen, D.E.; Aartman, I.H.A.; Baart, J.A.; Hoogstraten, J.

    2009-01-01

    Objectives The aims were: 1) to identify the guidelines available for management of dental invasive procedures in patients on antithrombotic drugs; 2) to assess their quality with the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument; and 3) to summarize their conclusions and

  2. [Femtosecond laser in cataract surgery. A critical appraisal].

    Science.gov (United States)

    Menapace, R M; Dick, H B

    2014-01-01

    The use of femtosecond lasers (FSL) is increasingly spreading in cataract surgery. Potential advantages over standard manual cataract surgery are the superior precision of corneal incisions and capsular openings as well as the reduction of ultrasound energy for lens nucleus work-up. Exact positioning and dimensioning of the anterior capsular opening should help reduce decentration and tilt of the intraocular lens (IOL) optics and thus achieve better target refraction. Together with the possibility to correct low-grade corneal astigmatism by precise arcuate incision, FSL technology is expected to convert cataract surgery from a purely curative into a refractive procedure. Apart from own experiences this review article critically analyses the pertinent literature published so far as well as congress presentations and personal reports of other FSL surgeons. The advantages and disadvantages are scrutinized with regard to their impact on the surgical and refractive results and compared with those experienced by the authors with manual cataract surgery over several decades. Economic and healthcare political aspects are also addressed. The use of FSL surgery improves the precision and reproducibility of corneal incisions and the capsular opening and reduces the amount of ultrasound energy required for lens nucleus work-up. However, the clinical benefits must be put into perspective due to the subsequent surgical manipulation of the incisions (during lens emulsification, aspiration and IOL injection), the lacking possibility to visualize the crystalline lens equator as the reference for correct capsulotomy centration and the relativity of ultrasound energy consumption on the corneal endothelial trauma. This is of particular relevance against the background of the significantly higher costs. Conversely, tears of the anterior capsule edge which, apart from interfering with correct IOL positioning, may entail serious complications presently occur more frequently with all FSL

  3. Some Notes on Critical Appraisal of Prevalence Studies; Comment on: “The Development of a Critical Appraisal Tool for Use in Systematic Reviews Addressing Questions of Prevalence”

    Directory of Open Access Journals (Sweden)

    Thomas Harder

    2014-10-01

    Full Text Available Decisions in healthcare should be based on information obtained according to the principles of Evidence-Based Medicine (EBM. An increasing number of systematic reviews are published which summarize the results of prevalence studies. Interpretation of the results of these reviews should be accompanied by an appraisal of the methodological quality of the included data and studies. The critical appraisal tool for prevalence studies developed and tested by Munn et al. comprises 10 items and aims at targeting all kinds of prevalence studies. This comment discusses the pros and cons of different designs of quality appraisal tools and highlights their importance for systematic reviews of prevalence studies. Beyond piloting, which has been performed in the study by Munn et al., it is suggested here that the validity of the tool should be tested, including reproducibility and inter-rater reliability. It is concluded that studies as the one by Munn et al. will help to establish a critical understanding of methodological quality and will support the use of systematic reviews of non-intervention studies for health policy making.

  4. Some notes on critical appraisal of prevalence studies: Comment on: "The development of a critical appraisal tool for use in systematic reviews addressing questions of prevalence".

    Science.gov (United States)

    Harder, Thomas

    2014-10-01

    Decisions in healthcare should be based on information obtained according to the principles of Evidence-Based Medicine (EBM). An increasing number of systematic reviews are published which summarize the results of prevalence studies. Interpretation of the results of these reviews should be accompanied by an appraisal of the methodological quality of the included data and studies. The critical appraisal tool for prevalence studies developed and tested by Munn et al. comprises 10 items and aims at targeting all kinds of prevalence studies. This comment discusses the pros and cons of different designs of quality appraisal tools and highlights their importance for systematic reviews of prevalence studies. Beyond piloting, which has been performed in the study by Munn et al., it is suggested here that the validity of the tool should be tested, including reproducibility and inter-rater reliability. It is concluded that studies as the one by Munn et al. will help to establish a critical understanding of methodological quality and will support the use of systematic reviews of non-intervention studies for health policy making.

  5. The Watson-Glaser Critical Thinking Appraisal and the Performance of Business Management Students.

    Science.gov (United States)

    Hicks, R. E.; Southey, G. N.

    1990-01-01

    The 80-item Watson-Glaser Critical Thinking Appraisal-Form A was administered to 415 business management students in Australia as a step toward adapting the test for Australian use. The results correspond reasonably closely to the U.S. data. Analysis of group results and item statistics provided information about necessary modifications. (SLD)

  6. Teaching and Evaluation of Critical Appraisal Skills to Postgraduate ESL Engineering Students

    Science.gov (United States)

    Melles, Gavin

    2009-01-01

    Enrolments in postgraduate engineering in Australia include a significant proportion of Asian ESL (English as a Second Language) students, and there is some debate in the literature about whether they are capable of critical appraisal. Content-based discipline-specific EAP (English for Academic Purposes) courses provide an environment for…

  7. A Critical Appraisal of Exchange Rate Policies and the Value of ...

    African Journals Online (AJOL)

    This paper critically appraised exchange rate policies and its influence on the value of the domestic currency (i.e. Naira) in Nigeria for the period 1970 through 2002 within the framework of tabular approach. Exchange rate theories and the exchange rate policies prior to SAP, during SAP and after SAP were reviewed.

  8. Disease scoring systems for oral lichen planus; a critical appraisal

    NARCIS (Netherlands)

    Wang, J.; van der Waal, I.

    2015-01-01

    The aim of the present study has been to critically review 22 disease scoring systems (DSSs) on oral lichen planus (OLP) that have been reported in the literature during the past decades. Although the presently available DSSs may all have some merit, particularly for research purposes, the diversity

  9. The search for the QGP: A critical appraisal

    International Nuclear Information System (INIS)

    Satz, H.

    2001-01-01

    Over the past 15 years, an extensive program of high energy nuclear collisions at BNL and CERN has been devoted to the experimental search for the quark-gluon plasma predicted by QCD. The start of RHIC this year will increase the highest available collision energy by a factor 10. This seems a good time for a critical assessment: what have we learned so far and what can we hope to learn in the coming years?

  10. Pediatric inguinal hernia repair-a critical appraisal

    DEFF Research Database (Denmark)

    Rosenberg, J.

    2008-01-01

    Inguinal hernia repair in infants and babies is a routine operation, but many issues have not been addressed scientifically. Thus, it is not known, e.g., if all children with a hernia should be operated on, what is the best timing of surgery, or if the operation should be performed with an open a...... approach or laparoscopically. The review is a critical discussion of these and other issues in pediatric herniorrhaphy pointing out the need for further research Udgivelsesdato: 2008/4...

  11. Gould on species, metaphysics and macroevolution: A critical appraisal.

    Science.gov (United States)

    Boucher, Sandy C

    2017-04-01

    Stephen Jay Gould's views on the ontology of species were an important plank of his revisionist program in evolutionary theory. In this paper I cast a critical eye over those views. I focus on three central aspects of Gould's views on species: the relation between the Darwinian and the metaphysical notions of individuality, the relation between the ontology of species and macroevolution, and the issue of contextualism and conventionalism about the metaphysics of species. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Validation of Yoon's Critical Thinking Disposition Instrument.

    Science.gov (United States)

    Shin, Hyunsook; Park, Chang Gi; Kim, Hyojin

    2015-12-01

    The lack of reliable and valid evaluation tools targeting Korean nursing students' critical thinking (CT) abilities has been reported as one of the barriers to instructing and evaluating students in undergraduate programs. Yoon's Critical Thinking Disposition (YCTD) instrument was developed for Korean nursing students, but few studies have assessed its validity. This study aimed to validate the YCTD. Specifically, the YCTD was assessed to identify its cross-sectional and longitudinal measurement invariance. This was a validation study in which a cross-sectional and longitudinal (prenursing and postnursing practicum) survey was used to validate the YCTD using 345 nursing students at three universities in Seoul, Korea. The participants' CT abilities were assessed using the YCTD before and after completing an established pediatric nursing practicum. The validity of the YCTD was estimated and then group invariance test using multigroup confirmatory factor analysis was performed to confirm the measurement compatibility of multigroups. A test of the seven-factor model showed that the YCTD demonstrated good construct validity. Multigroup confirmatory factor analysis findings for the measurement invariance suggested that this model structure demonstrated strong invariance between groups (i.e., configural, factor loading, and intercept combined) but weak invariance within a group (i.e., configural and factor loading combined). In general, traditional methods for assessing instrument validity have been less than thorough. In this study, multigroup confirmatory factor analysis using cross-sectional and longitudinal measurement data allowed validation of the YCTD. This study concluded that the YCTD can be used for evaluating Korean nursing students' CT abilities. Copyright © 2015. Published by Elsevier B.V.

  13. Critical appraisal of scientific articles: part 1 of a series on evaluation of scientific publications.

    Science.gov (United States)

    du Prel, Jean-Baptist; Röhrig, Bernd; Blettner, Maria

    2009-02-01

    In the era of evidence-based medicine, one of the most important skills a physician needs is the ability to analyze scientific literature critically. This is necessary to keep medical knowledge up to date and to ensure optimal patient care. The aim of this paper is to present an accessible introduction into critical appraisal of scientific articles. Using a selection of international literature, the reader is introduced to the principles of critical reading of scientific articles in medicine. For the sake of conciseness, detailed description of statistical methods is omitted. Widely accepted principles for critically appraising scientific articles are outlined. Basic knowledge of study design, structuring of an article, the role of different sections, of statistical presentations as well as sources of error and limitation are presented. The reader does not require extensive methodological knowledge. As far as necessary for critical appraisal of scientific articles, differences in research areas like epidemiology, clinical, and basic research are outlined. Further useful references are presented. Basic methodological knowledge is required to select and interpret scientific articles correctly.

  14. Disease scoring systems for oral lichen planus; a critical appraisal

    Science.gov (United States)

    Wang, Jing

    2015-01-01

    The aim of the present study has been to critically review 22 disease scoring systems (DSSs) on oral lichen planus (OLP) that have been reported in the literature during the past decades. Although the presently available DSSs may all have some merit, particularly for research purposes, the diversity of both the objective and subjective parameters used in these systems and the lack of acceptance of one of these systems for uniform use, there is a need for an international, authorized consensus meeting on this subject. Because of the natural course of OLP characterized by remissions and exacerbations and also due to the varying distribution pattern and the varying clinical types, e.g. reticular and erosive, the relevance of a DSS based on morphologic parameters is somewhat questionable. Instead, one may consider to only look for a quality of life scoring system adapted for use in OLP patients. Key words:Oral lichen planus, disease scoring system, classification. PMID:25681372

  15. Critical appraisal of rigour in interpretive phenomenological nursing research.

    Science.gov (United States)

    de Witt, Lorna; Ploeg, Jenny

    2006-07-01

    This paper reports a critical review of published nursing research for expressions of rigour in interpretive phenomenology, and a new framework of rigour specific to this methodology is proposed. The rigour of interpretive phenomenology is an important nursing research methods issue that has direct implications for the legitimacy of nursing science. The use of a generic set of qualitative criteria of rigour for interpretive phenomenological studies is problematic because it is philosophically inconsistent with the methodology and creates obstacles to full expression of rigour in such studies. A critical review was conducted of the published theoretical interpretive phenomenological nursing literature from 1994 to 2004 and the expressions of rigour in this literature identified. We used three sources to inform the derivation of a proposed framework of expressions of rigour for interpretive phenomenology: the phenomenological scholar van Manen, the theoretical interpretive phenomenological nursing literature, and Madison's criteria of rigour for hermeneutic phenomenology. The nursing literature reveals a broad range of criteria for judging the rigour of interpretive phenomenological research. The proposed framework for evaluating rigour in this kind of research contains the following five expressions: balanced integration, openness, concreteness, resonance, and actualization. Balanced integration refers to the intertwining of philosophical concepts in the study methods and findings and a balance between the voices of study participants and the philosophical explanation. Openness is related to a systematic, explicit process of accounting for the multiple decisions made throughout the study process. Concreteness relates to usefulness for practice of study findings. Resonance encompasses the experiential or felt effect of reading study findings upon the reader. Finally, actualization refers to the future realization of the resonance of study findings. Adoption of this

  16. ESPRIT study design and outcomes--a critical appraisal.

    Science.gov (United States)

    Einhäupl, Karl

    2007-02-01

    Evidence is needed to guide therapeutic decisions on patients who had ischaemic cerebral events. The recently published European/Australasian Stroke Prevention in Reversible Ischaemia Trial (ESPRIT), an open-label randomised controlled study, compared long-term treatment of patients randomised to aspirin 30-325 mg daily with (n = 1363) or without (n = 1376) dipyridamole 200 mg twice daily. The study found the combination to be superior to aspirin alone (13% vs. 16% events in a composite endpoint of vascular death, non-fatal stroke, non-fatal myocardial infarction, or major bleeding; hazard ratio 0.8; 95% confidence interval 0.66-0.98). In the interpretation of the results, criticism has been raised related to the study design (open-label, change during the study), the study conduct (half of the aspirin patients underdosed, 33% drop-out rate in the combination group, missing information on potential confounders such as protective concomitant medication), and the outcomes (lack of differences in the efficacy outcomes between the intent-to-treat and the on-treatment populations, lack of differences in minor bleedings between treatment groups, borderline statistical significance of primary study endpoint). Further studies are needed to determine the place of aspirin/dipyridamole combinations in the secondary prevention of stroke.

  17. Understanding Cultural Relativism: A critical Appraisal of the Theory

    Directory of Open Access Journals (Sweden)

    Yohannes Eshetu

    2017-12-01

    Full Text Available The aim of this review article is to reveal the cons and pros of ethical relativism, especially conventionalism. This article is written with the intention of showing some of the practical upshots of conventionalism without totally denying some of its virtues in a world where diversity of cultures and customs is apparent. The article inquires the question: Is ethical relativism tenable? The review article relies on reviewing secondary sources. What I am arguing in this article is that despite the attraction of ethical relativism as an intellectual weapon to fight against ethnocentrism and cultural intolerance, the view still goes against the idea of intercultural comparison, criticism and moral argumentation, so that it would have serious disastrous implication on practice, especially on the universal character of human rights and shutters all together any sort of moral progress and reform. The article concludes that we can set forth certain objective moral codes, discovered through rational intercultural dialogue and discussion which could be applied regardless of cultural specificities upon which cultural inter-comparison, discussion and moral argumentation is possible.

  18. Situating peace journalism in journalism studies: A critical appraisal

    Directory of Open Access Journals (Sweden)

    Thomas Hanitzsch

    2007-10-01

    Full Text Available Most wars were not brought to our attention if there were no journalists to report on them and no news media to send reporters to conflict spots. At the same time, the media often give priority to conflict and war at the expense of playing a positive role in attempts to bring about peace. The concept of peace journalism is, therefore, seen as an alternative model to traditional ways of war reporting. This article argues, however, that the idea of peace journalism comes as old wine in new bottles. Although carrying a noble goal, it ignores the manifold nuances in the media and tends to highlight the exceptional, spectacular and negative of war coverage. The idea of peace journalism tends to overestimate the influence journalists and the media have on political decisions; and it often understands audiences in terms of a passive mass that needs to be enlightened by virtue of peace reporting. In addition to this, peace journalism is, to a considerable extent, based on an overly individualistic perspective and ignores the many structural constraints that shape and limit the work of journalists: few personnel, time and material resources; editorial procedures and hierarchies; textual constraints; availability of sources; access to the scene and information in general - just to name a few. All this suggests that the conduct of peace journalism is not a matter of individual leeway, and media structures and professional routines cannot be modified from the position of the individual journalist. Modern corporate journalism involves processes of organized news production, thus giving priority to organizational and institutional factors as well as processes of professional socialization. To have any impact on the way the news is made, and its critical scrutiny, the advocates of peace journalism must address the structural constraints of news production. The discussion of peace journalism, and particularly of its practical implications, must be tied to the

  19. Epigenetics of psoriatic disease: A systematic review and critical appraisal.

    Science.gov (United States)

    Pollock, Remy A; Abji, Fatima; Gladman, Dafna D

    2017-03-01

    Psoriasis is an inflammatory disease of the skin that is sometimes accompanied by an auto-inflammatory arthritis called psoriatic arthritis (PsA). Psoriasis and PsA are multifactorial diseases that result from complex interactions of environmental and genetic risk factors. Epigenetic marks, which are labile chemical marks with diverse functions, form a layer of biological information that sits at the interface of genetics and the environment. Aberrant epigenetic regulation has been previously implicated in other rheumatological disorders. The purpose of this review is to summarize and critically evaluate the nascent literature on epigenetics in psoriasis and PsA. A systematic review yielded 52 primary articles after applying inclusion and exclusion criteria. Data were extracted using a standardized template and study quality assessed using a methodological quality checklist. Studies reflect a broad range of epigenetic sub-disciplines, the most common being DNA methylation, followed by the parent of origin effect or genomic imprinting, expression or activity of epigenetic modifying enzymes, and histone modifications. Epidemiological studies demonstrating excessive paternal transmission provided the earliest evidence of epigenetic deregulation in psoriatic disease, however few studies have examined its molecular mechanisms. Methylation studies evolved rapidly from low resolution global to targeted analyses of known psoriatic disease susceptibility loci such as HLA-C*0602. The recent explosion of epigenome-wide association studies has provided us with novel insights into psoriasis pathogenesis, and the mechanism of action of UVB, methotrexate, and anti-TNF therapies, as well as molecular signatures of psoriasis that may have clinical relevance. Finally, recent studies of pharmacological inhibitors of epigenetic modifier enzymes demonstrate their potential applicability as novel treatment modalities for psoriasis. Challenges of epigenetics research in psoriasis and Ps

  20. A critical appraisal of guidelines for the management of knee osteoarthritis using Appraisal of Guidelines Research and Evaluation criteria

    Science.gov (United States)

    Poitras, Stéphane; Avouac, Jérôme; Rossignol, Michel; Avouac, Bernard; Cedraschi, Christine; Nordin, Margareta; Rousseaux, Chantal; Rozenberg, Sylvie; Savarieau, Bernard; Thoumie, Philippe; Valat, Jean-Pierre; Vignon, Éric; Hilliquin, Pascal

    2007-01-01

    Clinical practice guidelines have been elaborated to summarize evidence related to the management of knee osteoarthritis and to facilitate uptake of evidence-based knowledge by clinicians. The objectives of the present review were summarizing the recommendations of existing guidelines on knee osteoarthritis, and assessing the quality of the guidelines using a standardized and validated instrument – the Appraisal of Guidelines Research and Evaluation (AGREE) tool. Internet medical literature databases from 2001 to 2006 were searched for guidelines, with six guidelines being identified. Thirteen clinician researchers participated in the review. Each reviewer was trained in the AGREE instrument. The guidelines were distributed to four groups of three or four reviewers, each group reviewing one guideline with the exception of one group that reviewed two guidelines. One independent evaluator reviewed all guidelines. All guidelines effectively addressed only a minority of AGREE domains. Clarity/presentation was effectively addressed in three out of six guidelines, scope/purpose and rigour of development in two guidelines, editorial independence in one guideline, and stakeholder involvement and applicability in none. The clinical management recommendation tended to be similar among guidelines, although interventions addressed varied. Acetaminophen was recommended for initial pain treatment, combined with exercise and education. Nonsteroidal anti-inflammatory drugs were recommended if acetaminophen failed to control pain, but cautiously because of gastrointestinal risks. Surgery was recommended in the presence of persistent pain and disability. Education and activity management interventions were superficially addressed in most guidelines. Guideline creators should use the AGREE criteria when developing guidelines. Innovative and effective methods of knowledge translation to health professionals are needed. PMID:18062805

  1. Critically appraising qualitative research: a guide for clinicians more familiar with quantitative techniques.

    Science.gov (United States)

    Kisely, Stephen; Kendall, Elizabeth

    2011-08-01

    Papers using qualitative methods are increasingly common in psychiatric journals. This overview is an introduction to critically appraising a qualitative paper for clinicians who are more familiar with quantitative methods. Qualitative research uses data from interviews (semi-structured or unstructured), focus groups, observations or written materials. Data analysis is inductive, allowing meaning to emerge from the data, rather than the more deductive, hypothesis centred approach of quantitative research. This overview compares and contrasts quantitative and qualitative research methods. Quantitative concepts such as reliability, validity, statistical power, bias and generalisability have qualitative equivalents. These include triangulation, trustworthiness, saturation, reflexivity and applicability. Reflexivity also shares features of transference. Qualitative approaches include: ethnography, action-assessment, grounded theory, case studies and mixed methods. Qualitative research can complement quantitative approaches. An understanding of both is useful in critically appraising the psychiatric literature.

  2. Productive criticism, Part 2: A new environment for criticism. Performance appraisals and other real-life situations.

    Science.gov (United States)

    Weisinger, H D

    1996-01-01

    Criticism affects almost all aspects of your job: the quality of work you do, how you feel about it, and your relationships with your boss, coworkers, and subordinates. Used productively, criticism is a powerful tool that helps you improve your work, enhance your working relationships, increase your job satisfaction, and achieve better overall results. Improperly used, it impedes performance, demoralizes you, discourages you from wanting to try again, and creates friction in the workplace. In short, the ability to give and take criticism significantly determines how well you do on the job. In Part 1, we explained how to use productive criticism as an opportunity for the growth and education of subordinates. In Part 2, we will examine how you can productively criticize superiors and peers. We will also offer new performance appraisal technics and examine real-life criticism situations.

  3. Use of a journal club and letter-writing exercise to teach critical appraisal to medical undergraduates.

    Science.gov (United States)

    Edwards, R; White, M; Gray, J; Fischbacher, C

    2001-07-01

    There is growing interest in methods of teaching critical appraisal skills at undergraduate and postgraduate levels. We describe an approach using a journal club and subsequent letter writing to teach critical appraisal and writing skills to medical undergraduates. The exercise occurs during a 3-week public health medicine attachment in the third year of the undergraduate curriculum. Students work in small groups to appraise a recently published research paper, present their findings to their peers in a journal club, and draft a letter to the journal editor. Evaluation took place through: informal and formal feedback from students; number of letters written, submitted and published, and a comparison of marks obtained by students submitting a literature review assignment with and without critical appraisal teaching during the public health attachment. Feedback from students was overwhelmingly positive. In the first 3(1/2) years, 26 letters have been published or accepted for publication, and 58 letters published on the Internet. There were no significant differences in overall marks or marks for the critical appraisal component of the literature review assignments between the two student groups. We believe our approach is an innovative and enjoyable method for teaching critical appraisal and writing skills to medical students. Lack of difference in marks in the literature review between the student groups may reflect its insensitivity as an outcome measure, contamination by other critical appraisal teaching, or true ineffectiveness.

  4. The impact of critical appraisal workshops on residents' evidence based medicine skills and knowledge

    Directory of Open Access Journals (Sweden)

    Nasr JA

    2018-04-01

    Full Text Available Justine A Nasr,1,2 John Falatko,1 Alexandra Halalau1,2 1Internal Medicine Department, Beaumont Hospital, Royal Oak, MI, USA; 2Internal Medicine Department, Oakland University William Beaumont School of Medicine, Rochester, MI, USA Objective: To assess the impact of four evidence based medicine (EBM critical appraisal education workshops in improving residents’ EBM knowledge and skills. Methods: The eligible participants in the workshops were 88 residents-in-training, postgraduate years one through four, rotating through the outpatient internal medicine clinic. Four EBM workshops, consisting of 3 days each (30 minutes daily, were taught by our faculty. Topics covered included critical appraisal of randomized controlled trials, case-control and cohort studies, diagnosis studies, and systematic reviews. Results: As a program evaluation, anonymous pre-workshop and post-workshop tests were administered. Each of the four sets of tests showed improvement in scores: therapy from 58% to 77% (42% response rate, harm from 65% to 73% (38% response rate, diagnosis from 49% to 68% (49% response rate, and systematic review from 57% to 72% (30% response rate. Conclusion: We found that teaching EBM in four short workshops improved EBM knowledge and critical appraisal skills related to the four topics. Keywords: evidence based medicine, medical education, assessment methods, graduate, instructional design, curriculum development, curriculum evaluation

  5. Preferences of Knowledge Users for Two Formats of Summarizing Results from Systematic Reviews: Infographics and Critical Appraisals.

    Directory of Open Access Journals (Sweden)

    Katelynn Crick

    Full Text Available To examine and compare preferences of knowledge users for two different formats of summarizing results from systematic reviews: infographics and critical appraisals.Cross-sectional.Annual members' meeting of a Network of Centres of Excellence in Knowledge Mobilization called TREKK (Translating Emergency Knowledge for Kids. TREKK is a national network of researchers, clinicians, health consumers, and relevant organizations with the goal of mobilizing knowledge to improve emergency care for children.Members of the TREKK Network attending the annual meeting in October 2013.Overall preference for infographic vs. critical appraisal format. Members' rating of each format on a 10-point Likert scale for clarity, comprehensibility, and aesthetic appeal. Members' impressions of the appropriateness of the two formats for their professional role and for other audiences.Among 64 attendees, 58 members provided feedback (91%. Overall, their preferred format was divided with 24/47 (51% preferring the infographic to the critical appraisal. Preference varied by professional role, with 15/22 (68% of physicians preferring the critical appraisal and 8/12 (67% of nurses preferring the infographic. The critical appraisal was rated higher for clarity (mean 7.8 vs. 7.0; p = 0.03, while the infographic was rated higher for aesthetic appeal (mean 7.2 vs. 5.0; p<0.001. There was no difference between formats for comprehensibility (mean 7.6 critical appraisal vs. 7.1 infographic; p = 0.09. Respondents indicated the infographic would be most useful for patients and their caregivers, while the critical appraisal would be most useful for their professional roles.Infographics are considered more aesthetically appealing for summarizing evidence; however, critical appraisal formats are considered clearer and more comprehensible. Our findings show differences in terms of audience-specific preferences for presentation of research results. This study supports other research

  6. CRITICAL ANALYSIS OF THEIR RISK FINANCIAL INSTRUMENTS

    Directory of Open Access Journals (Sweden)

    CARUNTU GENU ALEXANDRU

    2013-12-01

    Full Text Available In the last decade, accounting for financial instruments has experienced a revolution, following the publication of accounting rules on recognition and measurement of these instruments saddle. Need to develop standards for financial instruments appeared on the background of explosion using derivatives and the markets in which they are traded, and as a result of numerous financial scandals that rocked developed countries in the last decade. These were based, among other causes, improper use of derivatives and hiding their disastrous effects of poor management by keeping them off balance and failure to provide related information in the notes of the financial statements.

  7. INSTRUMENTALISM IN SCIENCE: COMMENTS AND CRITICISMS

    African Journals Online (AJOL)

    Admin

    that guide the scientist in making his decisions or a perceived system of procedural rules. ... to science, information and theories than an ... instrumentalists try to provide the foundation of ..... instrumentalism, which are practical rather than.

  8. Development of assessment instruments to measure critical thinking skills

    Science.gov (United States)

    Sumarni, W.; Supardi, K. I.; Widiarti, N.

    2018-04-01

    Assessment instruments that is commonly used in the school generally have not been orientated on critical thinking skills. The purpose of this research is to develop assessment instruments to measure critical thinking skills, to test validity, reliability, and practicality. This type of research is Research and Development. There are two stages on the preface step, which are field study and literacy study. On the development steps, there some parts, which are 1) instrument construction, 2) expert validity, 3) limited scale tryout and 4) narrow scale try-out. The developed assessment instrument are analysis essay and problem solving. Instruments were declared valid, reliable and practical.

  9. A Critical Appraisal of RAFT-Mediated Polymerization-Induced Self-Assembly

    Science.gov (United States)

    2016-01-01

    Recently, polymerization-induced self-assembly (PISA) has become widely recognized as a robust and efficient route to produce block copolymer nanoparticles of controlled size, morphology, and surface chemistry. Several reviews of this field have been published since 2012, but a substantial number of new papers have been published in the last three years. In this Perspective, we provide a critical appraisal of the various advantages offered by this approach, while also pointing out some of its current drawbacks. Promising future research directions as well as remaining technical challenges and unresolved problems are briefly highlighted. PMID:27019522

  10. Preferences of Knowledge Users for Two Formats of Summarizing Results from Systematic Reviews: Infographics and Critical Appraisals.

    Science.gov (United States)

    Crick, Katelynn; Hartling, Lisa

    2015-01-01

    To examine and compare preferences of knowledge users for two different formats of summarizing results from systematic reviews: infographics and critical appraisals. Cross-sectional. Annual members' meeting of a Network of Centres of Excellence in Knowledge Mobilization called TREKK (Translating Emergency Knowledge for Kids). TREKK is a national network of researchers, clinicians, health consumers, and relevant organizations with the goal of mobilizing knowledge to improve emergency care for children. Members of the TREKK Network attending the annual meeting in October 2013. Overall preference for infographic vs. critical appraisal format. Members' rating of each format on a 10-point Likert scale for clarity, comprehensibility, and aesthetic appeal. Members' impressions of the appropriateness of the two formats for their professional role and for other audiences. Among 64 attendees, 58 members provided feedback (91%). Overall, their preferred format was divided with 24/47 (51%) preferring the infographic to the critical appraisal. Preference varied by professional role, with 15/22 (68%) of physicians preferring the critical appraisal and 8/12 (67%) of nurses preferring the infographic. The critical appraisal was rated higher for clarity (mean 7.8 vs. 7.0; p = 0.03), while the infographic was rated higher for aesthetic appeal (mean 7.2 vs. 5.0; pinfographic; p = 0.09). Respondents indicated the infographic would be most useful for patients and their caregivers, while the critical appraisal would be most useful for their professional roles. Infographics are considered more aesthetically appealing for summarizing evidence; however, critical appraisal formats are considered clearer and more comprehensible. Our findings show differences in terms of audience-specific preferences for presentation of research results. This study supports other research indicating that tools for knowledge dissemination and translation need to be targeted to specific end users' preferences

  11. Non-Technical Skills for Surgeons (NOTSS): Critical appraisal of its measurement properties.

    Science.gov (United States)

    Jung, James J; Borkhoff, Cornelia M; Jüni, Peter; Grantcharov, Teodor P

    2018-02-17

    To critically appraise the development and measurement properties, including sensibility, reliability, and validity of the Non-Technical Skills of Surgeons (NOTSS) system. Articles that described development process of the NOTSS system were identified. Relevant primary studies that presented evidence of reliability and validity were identified through a comprehensive literature review. NOTSS was developed through robust item generation and reduction strategies. It was shown to have good content validity, acceptability, and feasibility. Inter-rater reliability increased with greater expertise and number of assessors. Studies demonstrated evidence of cross-sectional construct validity, in that the tool was able to differentiate known groups of varied non-technical skill levels. Evidence of longitudinal construct validity also existed to demonstrate that NOTSS detected changes in non-technical skills before and after targeted training. In populations and settings presented in our critical appraisal, NOTSS provided reliable and valid measurements of intraoperative non-technical skills of surgeons. Copyright © 2018 Elsevier Inc. All rights reserved.

  12. Information retrieval, critical appraisal and knowledge of evidence-based dentistry among Finnish dental students.

    Science.gov (United States)

    Nieminen, P; Virtanen, J I

    2017-11-01

    One of the core skills of competent dentist is the ability to search and analyse high-quality evidence. Problems in understanding the basic aspects of knowledge-based information may impede its implementation into clinical practice. We examined how Finnish dental students acquire scientific information and how familiar they are with methods for evaluating scientific evidence related to clinical questions. All fifth-year dental students (n = 120) at the three universities in Finland received a self-administered questionnaire. The three most commonly used sources of information were colleagues, the commercial Health Gate Portal for dental practitioners and personal lecture notes. Although students rarely read scientific journals, they did find that they possess at least passable or even good skills in literature retrieval. Three questions related to the appraisal of evidence in dentistry revealed that students' knowledge of evidence-based dentistry was inadequate to critically evaluate clinical research findings. Most students seem to lack knowledge of key methodological evidence-based terms. The present curricula in dental schools fail to encourage the students to search and acquire knowledge wider than their patients themselves do. Universities have the responsibility to teach dentists various methods of critical appraisal to cope with scientific information. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Health effects of exposure to carbon nanofibers: Systematic review, critical appraisal, meta analysis and research to practice perspectives

    International Nuclear Information System (INIS)

    Genaidy, Ash; Tolaymat, Thabet; Sequeira, Reynold; Rinder, Magda; Dionysiou, Dion

    2009-01-01

    Background: Literature reviews examining the relationship between exposure to carbon nanofibers (CNFs) and health consequences are qualitative in nature and do not employ an evidence-based assessment. Objective: This research deals with a systematic review, critical appraisal, and meta-analysis designed to examine the potential health effects associated with exposure to CNFs. The utilization of research findings into practice is also explored. Methods: Published articles were obtained from a search of electronic databases and bibliographies of identified articles. A critical appraisal was conducted using an 'Experimental Appraisal Instrument' developed in this study. The meta-analysis was established using statistical techniques with/without the incorporation of overall study quality. The likelihood of utilizing research findings into practice (i.e., from research to practice) was computed using a four-step algorithm based on the criteria of: strength of association, consistency among studies, temporality, biological gradient, type of experimental unit, type of CNF (single- and multi-wall nanotubes), CNF grade (commercial or altered), exposure dose, exposure duration, and support by analogy from the published literature. Results: Twenty-one experimental studies satisfied the inclusion criteria and were performed on human cells, experimental animal models and animal cells as experimental units. The methodological qualities of published studies ranged from 'very poor' to 'excellent', with 'overall study description' scoring 'good' and 'study execution' equal to 'moderate'. The random-effects model was applied in the meta-analysis calculations as heterogeneity was significant at the 10% for all outcomes reported. The mean standardized meta-estimates for the experimental groups were significantly lower than those for the control groups for cell viability and cell death, respectively. Incorporating the effect of overall study quality score widened the gap between the

  14. Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: the AGREE project.

    Science.gov (United States)

    2003-02-01

    International interest in clinical practice guidelines has never been greater but many published guidelines do not meet the basic quality requirements. There have been renewed calls for validated criteria to assess the quality of guidelines. To develop and validate an international instrument for assessing the quality of the process and reporting of clinical practice guideline development. The instrument was developed through a multi-staged process of item generation, selection and scaling, field testing, and refinement procedures. 100 guidelines selected from 11 participating countries were evaluated independently by 194 appraisers with the instrument. Following refinement the instrument was further field tested on three guidelines per country by a new set of 70 appraisers. The final version of the instrument contained 23 items grouped into six quality domains with a 4 point Likert scale to score each item (scope and purpose, stakeholder involvement, rigour of development, clarity and presentation, applicability, editorial independence). 95% of appraisers found the instrument useful for assessing guidelines. Reliability was acceptable for most domains (Cronbach's alpha 0.64-0.88). Guidelines produced as part of an established guideline programme had significantly higher scores on editorial independence and, after the publication of a national policy, had significantly higher quality scores on rigour of development (pinternationally. The instrument is sensitive to differences in important aspects of guidelines and can be used consistently and easily by a wide range of professionals from different backgrounds. The adoption of common standards should improve the consistency and quality of the reporting of guideline development worldwide and provide a framework to encourage international comparison of clinical practice guidelines.

  15. Critical Appraisal of Clinical Practice Guidelines for Age-Related Macular Degeneration

    Directory of Open Access Journals (Sweden)

    Annie M. Wu

    2015-01-01

    Full Text Available Purpose. To evaluate the methodological quality of age-related macular degeneration (AMD clinical practice guidelines (CPGs. Methods. AMD CPGs published by the American Academy of Ophthalmology (AAO and Royal College of Ophthalmologists (RCO were appraised by independent reviewers using the Appraisal of Guidelines for Research and Evaluation (AGREE II instrument, which comprises six domains (Scope and Purpose, Stakeholder Involvement, Rigor of Development, Clarity of Presentation, Applicability, and Editorial Independence, and an Overall Assessment score summarizing methodological quality across all domains. Results. Average domain scores ranged from 35% to 83% for the AAO CPG and from 17% to 83% for the RCO CPG. Intraclass correlation coefficients for the reliability of mean scores for the AAO and RCO CPGs were 0.74 and 0.88, respectively. The strongest domains were Scope and Purpose and Clarity of Presentation. The weakest were Stakeholder Involvement (AAO and Editorial Independence (RCO. Conclusions. Future AMD CPGs can be improved by involving all relevant stakeholders in guideline development, ensuring transparency of guideline development and review methodology, improving guideline applicability with respect to economic considerations, and addressing potential conflict of interests within the development group.

  16. Life support decision making in critical care: Identifying and appraising the qualitative research evidence.

    Science.gov (United States)

    Giacomini, Mita; Cook, Deborah; DeJean, Deirdre

    2009-04-01

    The objective of this study is to identify and appraise qualitative research evidence on the experience of making life-support decisions in critical care. In six databases and supplementary sources, we sought original research published from January 1990 through June 2008 reporting qualitative empirical studies of the experience of life-support decision making in critical care settings. Fifty-three journal articles and monographs were included. Of these, 25 reported prospective studies and 28 reported retrospective studies. We abstracted methodologic characteristics relevant to the basic critical appraisal of qualitative research (prospective data collection, ethics approval, purposive sampling, iterative data collection and analysis, and any method to corroborate findings). Qualitative research traditions represented include grounded theory (n = 15, 28%), ethnography or naturalistic methods (n = 15, 28%), phenomenology (n = 9, 17%), and other or unspecified approaches (n = 14, 26%). All 53 documents describe the research setting; 97% indicate purposive sampling of participants. Studies vary in their capture of multidisciplinary clinician and family perspectives. Thirty-one (58%) report research ethics board review. Only 49% report iterative data collection and analysis, and eight documents (15%) describe an analytically driven stopping point for data collection. Thirty-two documents (60%) indicated a method for corroborating findings. Qualitative evidence often appears outside of clinical journals, with most research from the United States. Prospective, observation-based studies follow life-support decision making directly. These involve a variety of participants and yield important insights into interactions, communication, and dynamics. Retrospective, interview-based studies lack this direct engagement, but focus on the recollections of fewer types of participants (particularly patients and physicians), and typically address specific issues (communication and

  17. Design aspects of safety critical instrumentation of nuclear installations

    Energy Technology Data Exchange (ETDEWEB)

    Swaminathan, P. [Electronics Group, Indira Gandhi Centre for Atomic Research, Kalpakkam 603 102, Tamil Nadu (India)]. E-mail: swamy@igcar.ernet.in

    2005-07-01

    Safety critical instrumentation systems ensure safe shutdown/configuration of the nuclear installation when process status exceeds the safety threshold limits. Design requirements for safety critical instrumentation such as functional and electrical independence, fail-safe design, and architecture to ensure the specified unsafe failure rate and safe failure rate, human machine interface (HMI), etc., are explained with examples. Different fault tolerant architectures like 1/2, 2/2, 2/3 hot stand-by are compared for safety critical instrumentation. For embedded systems, software quality assurance is detailed both during design phase and O and M phase. Different software development models such as waterfall model and spiral model are explained with examples. The error distribution in embedded system is detailed. The usage of formal method is outlined to reduce the specification error. The guidelines for coding of application software are outlined. The interface problems of safety critical instrumentation with sensors, actuators, other computer systems, etc., are detailed with examples. Testability and maintainability shall be taken into account during design phase. Online diagnostics for safety critical instrumentation is detailed with examples. Salient details of design guides from Atomic Energy Regulatory Board, International Atomic Energy Agency and standards from IEEE, BIS are given towards the design of safety critical instrumentation systems. (author)

  18. Design aspects of safety critical instrumentation of nuclear installations

    International Nuclear Information System (INIS)

    Swaminathan, P.

    2005-01-01

    Safety critical instrumentation systems ensure safe shutdown/configuration of the nuclear installation when process status exceeds the safety threshold limits. Design requirements for safety critical instrumentation such as functional and electrical independence, fail-safe design, and architecture to ensure the specified unsafe failure rate and safe failure rate, human machine interface (HMI), etc., are explained with examples. Different fault tolerant architectures like 1/2, 2/2, 2/3 hot stand-by are compared for safety critical instrumentation. For embedded systems, software quality assurance is detailed both during design phase and O and M phase. Different software development models such as waterfall model and spiral model are explained with examples. The error distribution in embedded system is detailed. The usage of formal method is outlined to reduce the specification error. The guidelines for coding of application software are outlined. The interface problems of safety critical instrumentation with sensors, actuators, other computer systems, etc., are detailed with examples. Testability and maintainability shall be taken into account during design phase. Online diagnostics for safety critical instrumentation is detailed with examples. Salient details of design guides from Atomic Energy Regulatory Board, International Atomic Energy Agency and standards from IEEE, BIS are given towards the design of safety critical instrumentation systems. (author)

  19. A critical appraisal of clinical practice guidelines for the treatment of lower-limb osteoarthritis

    Science.gov (United States)

    Pencharz, James N; Grigoriadis, Elizabeth; Jansz, Gwenderlyn F; Bombardier, Claire

    2002-01-01

    Clinical practice guidelines are important tools to assist clinical decision-making. Recently, several guidelines addressing the management of osteoarthritis (OA) have been published. Clinicians treating patients with OA must ensure that these guidelines are developed with consistency and methodological rigour. We undertook a qualitative summary and critical appraisal of six medical treatment guidelines for the management of lower-limb OA published in the medical literature within the past 5 years. A review of these six guidelines revealed that each possesses strengths and weakness. While most described the scope and intended patient populations, the guidelines varied considerably in the rigour of their development, coverage of implementation issues, and disclosure of conflicts of interest. PMID:11879536

  20. Critical appraisal of pemetrexed in the treatment of NSCLC and metastatic pulmonary nodules

    Directory of Open Access Journals (Sweden)

    Li X

    2014-06-01

    Full Text Available Xin Li, Sen Wei, Jun ChenTianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Heping District, Tianjin, People's Republic of ChinaAbstract: Pemetrexed, a new multitarget antifolate antineoplastic agent, has significantly improved the overall survival in nonsquamous non-small-cell lung cancer patients. Presently, pemetrexed is recommended for first line treatment in combination with platinum derivatives, for second line treatment as a single agent and, more recently, as maintenance treatment after first line chemotherapy. In this article we critically appraise the status of pemetrexed including pharmacodynamics, pharmacokinetics, toxicity, and the cost effectiveness of pemetrexed, as well as the predictive biomarkers for pemetrexed based chemotherapy.Keywords: chemotherapy, non-small-cell lung cancer, pemetrexed

  1. Assessing the scholar CanMEDS role in residents using critical appraisal techniques

    Directory of Open Access Journals (Sweden)

    Aliya Kassam

    2013-03-01

    Full Text Available Background: In this brief report, we describe two ways in which we assessed the Scholar CanMEDS role using a method to measure residents’ ability to complete a critical appraisal.  These were incorporated into a modified OSCE format where two stations consisted of 1 critically appraising an article and 2 critiquing an abstract. Method: Residents were invited to participate in the CanMEDS In-Training Exam (CITE through the Office of Postgraduate Medical Education. Mean scores for the two Scholar stations were calculated using the number of correct responses out of 10. The global score represented the examiner’s overall impression of the resident’s knowledge and effort.  Correlations between scores are also presented between the two Scholar stations and a paired sample t-test comparing the global mean scores of the two stations was also performed. Results: Sixty-three of the 64 residents registered to complete the CanMEDS In-Training Exam including the two Scholar stations.  There were no significant differences between the global scores of the Scholar stations showing that the overall knowledge and effort of the residents was similar across both stations (3.8 vs. 3.5, p = 0.13.  The correlation between the total mean scores of both stations (inter-station reliability was also non-significant (r = 0.05, p = 0.67.  No significant differences between senior residents and junior residents were detected or between internal medicine residents and non-internal medicine residents. Conclusion: Further testing of these stations is needed and other novel ways of assessing the Scholar role competencies should also be investigated.

  2. Are consumer surveys valuable as a service improvement tool in health services? A critical appraisal.

    Science.gov (United States)

    Patwardhan, Anjali; Patwardhan, Prakash

    2009-01-01

    In the recent climate of consumerism and consumer focused care, health and social care needs to be more responsive than ever before. Consumer needs and preferences can be elicited with accepted validity and reliability only by strict methodological control, customerisation of the questionnaire and skilled interpretation. To construct, conduct, interpret and implement improved service provision, requires a trained work force and infrastructure. This article aims to appraise various aspects of consumer surveys and to assess their value as effective service improvement tools. The customer is the sole reason organisations exist. Consumer surveys are used worldwide as service and quality of care improvement tools by all types of service providers including health service providers. The article critically appraises the value of consumer surveys as service improvement tools in health services tool and its future applications. No one type of survey is the best or ideal. The key is the selection of the correct survey methodology, unique and customised for the particular type/aspect of care being evaluated. The method used should reflect the importance of the information required. Methodological rigor is essential for the effectiveness of consumer surveys as service improvement tools. Unfortunately so far there is no universal consensus on superiority of one particular methodology over another or any benefit of one specific methodology in a given situation. More training and some dedicated resource allocation is required to develop consumer surveys. More research is needed to develop specific survey methodology and evaluation techniques for improved validity and reliability of the surveys as service improvement tools. Measurement of consumer preferences/priorities, evaluation of services and key performance scores, is not easy. Consumer surveys seem impressive tools as they provide the customer a voice for change or modification. However, from a scientific point

  3. The trigger values in the environmental risk assessment for (veterinary) medicines in the European Union: a critical appraisal

    NARCIS (Netherlands)

    Montforts MHMM; SEC

    2005-01-01

    A critical appraisal of the data used for the establishment of the trigger values for the exposure of the aquatic environment to human medicines and the terrestrial environment to veterinary medicines leads to the recommendation to change these values. The (draft) technical guidance documents in

  4. Critical Science Instrument Alignment of the James Webb Space Telescope (JWST) Integrated Science Instrument Module (ISIM)

    Science.gov (United States)

    Rohrbach, Scott O.; Kubalak, David A.; Gracey, Renee M.; Sabatke, Derek S.; Howard, Joseph M.; Telfer, Randal C.; Zielinski, Thomas P.

    2016-01-01

    This paper describes the critical instrument alignment terms associated with the six-degree of freedom alignment of each the Science Instrument (SI) in the James Webb Space Telescope (JWST), including focus, pupil shear, pupil clocking, and boresight. We present the test methods used during cryogenic-vacuum tests to directly measure the performance of each parameter, the requirements levied on each, and the impact of any violations of these requirements at the instrument and Observatory level.

  5. Appraisal of social concerns: A cognitive assessment instrument for social phobia

    NARCIS (Netherlands)

    Telch, M.J.; Lucas, R.A.; Smits, J.A.J.; Powers, M.B.; Heimberg, R.G.; Hart, T.

    2004-01-01

    The current study describes the validation of a new cognitive assessment measure for social phobia, entitled the Appraisal of Social Concerns (ASC). Item content is relevant to a range of social situations. The ASC can be used to tailor interventions to patients' idiosyncratic concerns. Data are

  6. Greenhouse-gas-induced climatic change: A critical appraisal of simulations and observations

    International Nuclear Information System (INIS)

    Schlesinger, M.E.

    1990-01-01

    This book is the culmination of a Workshop on Greenhouse-Gas-Induced Climatic Change: A Critical Appraisal of Simulations and Observations which was held at the University of Massachusetts, Amherst, during 8--12 May 1989. The objectives of the Workshop were to: (1) present and evaluate the current status of climate model simulations of greenhouse-gas-induced changes of both the equilibrium and nonequilibrium (transient) climates; (2) present and assess the current status of the observations of global and regional climates from the beginning of the industrial revolution to the present, circa 1850 to 1989; (3) present reconstructions of climatic change during the last millennium to determine the ''natural variability'' of climate on the intra-century time scale; (4) critically evaluate whether or not the climate has changes from circa 1850 to 1989; and (5) compare the observations with the model simulations to ascertain whether a greenhouse-gas-induced climatic change has occurred and, if not, to estimate when in the future such a climatic change will likely become detectable against the background of the ''natural variability.''

  7. Nursing students' understanding of critical thinking and appraisal and academic writing: a descriptive, qualitative study.

    Science.gov (United States)

    Borglin, Gunilla; Fagerström, Cecilia

    2012-11-01

    In Sweden, regulations from the National Agency for Higher Education advocate an education that equips students with independence as well as critical, problem-based thinking, i.e. academic literacy skills. However, some research findings indicate that students may leave higher education without mastering these skills effectively. As part of quality-assuring a nursing programme at a university college in south-east Sweden we explored the nursing student's view of crucial academic literacy skills, such as critical thinking and appraisal and academic writing, by conducting a descriptive, qualitative study. Informants were recruited through an advertisement posted on the university's e-learning tool. Eight focused interviews were conducted during autumn 2010. The transcribed interviews were analysed - inspired by content analysis - and two categories became apparent: constantly questioning and formality before substance. The latter revealed a gap between the student's perception of academic writing and that of the educators, thus implying that nursing students might not be equipped with the tools they need to develop within academia. We suggest that students could benefit in their academic endeavours from theoretical educational models that integrate several academic skills simultaneously and which could be incorporated into the development of syllabuses and curriculums. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Effects of School-Based Educational Interventions for Enhancing Adolescents Abilities in Critical Appraisal of Health Claims: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Lena V Nordheim

    Full Text Available Adolescents are frequent media users who access health claims from various sources. The plethora of conflicting, pseudo-scientific, and often misleading health claims in popular media makes critical appraisal of health claims an essential ability. Schools play an important role in educating youth to critically appraise health claims. The objective of this systematic review was to evaluate the effects of school-based educational interventions for enhancing adolescents' abilities in critically appraising health claims.We searched MEDLINE, Embase, PsycINFO, AMED, Cinahl, Teachers Reference Centre, LISTA, ERIC, Sociological Abstracts, Social Services Abstracts, The Cochrane Library, Science Citation Index Expanded, Social Sciences Citation Index, and sources of grey literature. Studies that evaluated school-based educational interventions to improve adolescents' critical appraisal ability for health claims through advancing the students' knowledge about science were included. Eligible study designs were randomised and non-randomised controlled trials, and interrupted time series. Two authors independently selected studies, extracted data, and assessed risk of bias in included studies. Due to heterogeneity in interventions and inadequate reporting of results, we performed a descriptive synthesis of studies. We used GRADE (Grading of Recommendations, Assessment, Development, and Evaluation to assess the certainty of the evidence.Eight studies were included: two compared different teaching modalities, while the others compared educational interventions to instruction as usual. Studies mostly reported positive short-term effects on critical appraisal-related knowledge and skills in favour of the educational interventions. However, the certainty of the evidence for all comparisons and outcomes was very low.Educational interventions in schools may have beneficial short-term effects on knowledge and skills relevant to the critical appraisal of health

  9. Effects of School-Based Educational Interventions for Enhancing Adolescents Abilities in Critical Appraisal of Health Claims: A Systematic Review.

    Science.gov (United States)

    Nordheim, Lena V; Gundersen, Malene W; Espehaug, Birgitte; Guttersrud, Øystein; Flottorp, Signe

    2016-01-01

    Adolescents are frequent media users who access health claims from various sources. The plethora of conflicting, pseudo-scientific, and often misleading health claims in popular media makes critical appraisal of health claims an essential ability. Schools play an important role in educating youth to critically appraise health claims. The objective of this systematic review was to evaluate the effects of school-based educational interventions for enhancing adolescents' abilities in critically appraising health claims. We searched MEDLINE, Embase, PsycINFO, AMED, Cinahl, Teachers Reference Centre, LISTA, ERIC, Sociological Abstracts, Social Services Abstracts, The Cochrane Library, Science Citation Index Expanded, Social Sciences Citation Index, and sources of grey literature. Studies that evaluated school-based educational interventions to improve adolescents' critical appraisal ability for health claims through advancing the students' knowledge about science were included. Eligible study designs were randomised and non-randomised controlled trials, and interrupted time series. Two authors independently selected studies, extracted data, and assessed risk of bias in included studies. Due to heterogeneity in interventions and inadequate reporting of results, we performed a descriptive synthesis of studies. We used GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) to assess the certainty of the evidence. Eight studies were included: two compared different teaching modalities, while the others compared educational interventions to instruction as usual. Studies mostly reported positive short-term effects on critical appraisal-related knowledge and skills in favour of the educational interventions. However, the certainty of the evidence for all comparisons and outcomes was very low. Educational interventions in schools may have beneficial short-term effects on knowledge and skills relevant to the critical appraisal of health claims. The small

  10. Critical Appraisal of International Clinical Practice Guidelines in Kidney Transplantation Using the Appraisal of Guidelines for Research and Education (AGREE) II Tool: A Systematic Review.

    Science.gov (United States)

    OʼDonoghue, Katriona Jane Marie; Reed, Rhiannon D; Knight, Simon R; O'Callaghan, John M; Ayaz-Shah, Anam A; Hassan, Sevda; Weissenbacher, Annemarie; Morris, Peter J; Pengel, Liset H M

    2018-05-22

    Whilst Clinical Practice Guidelines (CPGs) are used for the development of local protocols in kidney transplantation (Ktx), the quality of their methodology is variable. This systematic review aimed to critically appraise international CPGs in all aspects of Ktx using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool. CPGs in Ktx and donation published between 2010 and 2017 were identified from MEDLINE, Embase, National Guideline Clearinghouse, NHS and NICE Evidence Searches, and the websites of transplant societies. Using AGREE II, 3 appraisers assessed the quality of CPGs. Interrater reliability was measured using the intraclass correlation coefficient (ICC). Searches identified 3,168 records and 115 CPGs were included. The highest scoring AGREE II domain was 'Scope and Purpose' (80%; Range 30-100%), followed by 'Clarity of Presentation' (77%; Range 43-98%), 'Editorial independence' (52%; Range 0-94%), 'Rigour of Development' (47%; Range 6-97%) and 'Stakeholder Involvement' (41%; Range 11-85%). The poorest scoring domain was 'Applicability' (31%; Range 3-74%). Most CPGs were recommended for future use either with (63%) or without modifications (18%). A small number were not recommended for future use (14%) or reviewers did not agree on recommending the CPG (5%). The overall mean CPG quality score was 4 out of 7 (Range 2-7). The mean ICC of 0.74 indicated substantial agreement between reviewers. The quality of international CPGs in Ktx was variable, and most CPGs lacked key aspects of methodological robustness and transparency. Improvements in methodology, patient involvement and strategies for implementation are required.

  11. Use of modern software - based instrumentation in safety critical systems

    International Nuclear Information System (INIS)

    Emmett, J.; Smith, B.

    2005-01-01

    Many Nuclear Power Plants are now ageing and in need of various degrees of refurbishment. Installed instrumentation usually uses out of date 'analogue' technology and is often no longer available in the market place. New technology instrumentation is generally un-qualified for nuclear use and specifically the new 'smart' technology contains 'firmware', (effectively 'soup' (Software of Uncertain Pedigree)) which must be assessed in accordance with relevant safety standards before it may be used in a safety application. Particular standards are IEC 61508 [1] and the British Energy (BE) PES (Programmable Electronic Systems) guidelines EPD/GEN/REP/0277/97. [2] This paper outlines a new instrument evaluation system, which has been developed in conjunction with the UK Nuclear Industry. The paper concludes with a discussion about on-line monitoring of Smart instrumentation in safety critical applications. (author)

  12. A Critical Appraisal of Quantitative Studies of Protein Degradation in the Framework of Cellular Proteostasis

    Directory of Open Access Journals (Sweden)

    Beatriz Alvarez-Castelao

    2012-01-01

    Full Text Available Protein homeostasis, proteostasis, is essential to understand cell function. Protein degradation is a crucial component of the proteostatic mechanisms of the cell. Experiments on protein degradation are nowadays present in many investigations in the field of molecular and cell biology. In the present paper, we focus on the different experimental approaches to study protein degradation and present a critical appraisal of the results derived from steady-state and kinetic experiments using detection of unlabelled and labelled protein methodologies with a proteostatic perspective. This perspective allows pinpointing the limitations in interpretation of results and the need of further experiments and/or controls to establish “definitive evidence” for the role of protein degradation in the proteostasis of a given protein or the entire proteome. We also provide a spreadsheet for simple calculations of mRNA and protein decays for mimicking different experimental conditions and a checklist for the analysis of experiments dealing with protein degradation studies that may be useful for researchers interested in the area of protein turnover.

  13. Medication-indication knowledge bases: a systematic review and critical appraisal.

    Science.gov (United States)

    Salmasian, Hojjat; Tran, Tran H; Chase, Herbert S; Friedman, Carol

    2015-11-01

    Medication-indication information is a key part of the information needed for providing decision support for and promoting appropriate use of medications. However, this information is not readily available to end users, and a lot of the resources only contain this information in unstructured form (free text). A number of public knowledge bases (KBs) containing structured medication-indication information have been developed over the years, but a direct comparison of these resources has not yet been conducted. We conducted a systematic review of the literature to identify all medication-indication KBs and critically appraised these resources in terms of their scope as well as their support for complex indication information. We identified 7 KBs containing medication-indication data. They notably differed from each other in terms of their scope, coverage for on- or off-label indications, source of information, and choice of terminologies for representing the knowledge. The majority of KBs had issues with granularity of the indications as well as with representing duration of therapy, primary choice of treatment, and comedications or comorbidities. This is the first study directly comparing public KBs of medication indications. We identified several gaps in the existing resources, which can motivate future research. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. Arboriculture in clinical ethics: using philosophical critical appraisal to clear away underbrush in ethical analysis and argument.

    Science.gov (United States)

    McCullough, Laurence B

    2011-02-01

    This paper introduces the 2011 number of the Journal on Clinical Ethics. Philosophical critical appraisal is essential for the success of philosophical analysis and argument in clinical ethics. To clear away conceptual underbrush, papers in this Clinical Ethics number of the Journal address genetic engineering, conscience-based objections to forms of health care, placebos, and preventing exploitation of patients to be recruited to become research subjects.

  15. The primitives of Santa Clara of Ubeda: stylistic and iconographic study, critical appraisals and vicissitudes of a dispersed heritage

    Directory of Open Access Journals (Sweden)

    Clara Beltrán Catalán

    2016-12-01

    Full Text Available The authors study the stylistic and iconographic aspects of a collection of paintings on wood dating from the 15th and 16th centuries, originally in the Royal Monastery of Santa Clara at Úbeda. This collection was sold in the 1920s with the participation of the antique dealer Celestino Dupont. The research is complemented by an analysis of the critical appraisals given to these works and their history since their introduction into the art market.

  16. Breastfeeding Self-efficacy: A Critical Review of Available Instruments

    Science.gov (United States)

    Tuthill, Emily L.; McGrath, Jacqueline M.; Graber, Melanie; Cusson, Regina M.; Young, Sera L.

    2016-01-01

    Increasing breastfeeding rates in the United States is a national priority. Yet, initiation and duration of breastfeeding remains below national targets. Breastfeeding self-efficacy has been shown to be a strong predictor of both breastfeeding initiation and duration and is therefore an important characteristic to be able to measure. However, there is currently a myriad of instruments for measuring breastfeeding self-efficacy, which makes selection of an appropriate instrument difficult. Thus, our aim was to identify, compare, and critically review available breastfeeding self-efficacy instruments. In a systematic review, 6 breastfeeding self-efficacy instruments were identified. The instruments’ purposes, theoretical framework, final scale development, and application in 5 most recent settings were analyzed. The 6 breastfeeding self-efficacy instruments apply a number of theoretical and conceptual frameworks in their development, with Bandura’s social cognitive theory being most common. Content, construct, and predictive validity were strong for most scales. Some, but not all, have been successfully adapted to novel settings. In sum, there are several measurements of breastfeeding self-efficacy that can and should be employed to better understand reasons for suboptimal breastfeeding rates and the effects of interventions on breastfeeding self-efficacy. Instrument selection should be based on domains of primary interest, time available, peripartum timing, and assessment of previous adaptations. Failure to apply appropriate measures in research may garner results that are inconclusive, inaccurate, or nonrepresentative of true study effects. PMID:26319113

  17. The Prospect for an Australian–Asian Power Grid: A Critical Appraisal

    Directory of Open Access Journals (Sweden)

    Edward Halawa

    2018-01-01

    Full Text Available Australia is an energy net self-sufficient country rich in energy resources, from fossil-based to renewable energy. Australia, a huge continent with low population density, has witnessed impressive reduction in energy consumption in various sectors of activity in recent years. Currently, coal and natural gas are two of Australia’s major export earners, yet its abundant renewable energy resources such as solar, wind, and tidal, are still underutilized. The majority of Asian countries, on the other hand, are in the middle of economic expansion, with increasing energy consumption and lack of energy resources or lack of energy exploration capability becoming a serious challenge. Electricity interconnection linking two or more independent grids within a country or at cross-border or regional levels has found its way into electricity markets worldwide. This concept allows for electricity exchanges that lead to optimized use and sharing of electricity generated from different sources. The interconnection also enables the long distance exploitation of renewable energy which would otherwise be physically impossible. ASEAN (Association of Southeast Asian Nations and other regional groupings in Asia have initiated a number of interconnections to gain economic benefits. Asian’s hunger for energy for its economic development, climate change that has become a global and urgent issue to be solved, and Australia’s abundant renewable energy resources have all prompted increasing interest in a super-grid interconnection linking Australia to Asian grids, the Australian–Asian (Power Grid (AAG. This paper overviews the existing grid interconnections as well as current initiatives at domestic, sub-regional, and regional levels worldwide, with a particular focus on Asia. The paper concludes with a critical appraisal on the benefits, potential, challenges and issues to be encountered by the AAG initiative.

  18. Critical appraisal of dabigatran in the treatment of deep vein thrombosis and pulmonary embolism

    Directory of Open Access Journals (Sweden)

    Ogbonna KC

    2015-06-01

    Full Text Available Kelechi C Ogbonna, Dave L Dixon Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, VA, USA Objective: To compare the safety and efficacy of dabigatran to warfarin for the treatment of deep vein thrombosis and pulmonary embolism. Background: Venous thromboembolism (VTE is a disease comprised of two conditions: deep vein thrombosis and pulmonary embolism. VTE is a major cause of morbidity and mortality worldwide with an annual incidence estimated at 1–3 cases per 1,000 individuals. This incidence increases with age from 0.1 per 1,000 in adolescence to eight per 1,000 in those 80 years of age and older. As the proportion of patients 65 years of age and older expands, the number of patients presenting with VTE will also increase. Anticoagulation remains the cornerstone of VTE treatment. Traditionally, vitamin K antagonists have been used to minimize the risk of thrombus extension and for secondary prevention. Unpredictable pharmacokinetics and pharmacodynamics, routine monitoring, drug–food and drug–drug interactions, and potentially severe adverse events have all been cited as barriers to optimal care. Dabigatran has been proposed as a suitable alternative to warfarin therapy in the treatment of VTE. Therefore, a critical appraisal of dabigatran's safety and efficacy is necessary to determine its role in therapy. Conclusion: Dabigatran remains an alternative to warfarin therapy for the treatment of VTE. However, dabigatran also has distinct disadvantages that warrant consideration. Clinicians must ensure that drug characteristics align with patient characteristics to optimize patient outcomes. Keywords: venous thromboembolism, pulmonary embolisms, venous thrombosis, anticoagulants, warfarin sodium, dabigatran etexilate mesylate

  19. Sub-Symptomatic Aerobic Exercise for Patients with Post-Concussion Syndrome: A Critically Appraised Topic.

    Science.gov (United States)

    Ritter, Katrina G; Hussey, Matthew J; Valovich McLeod, Tamara C

    2017-09-27

    Clinical Scenario: Patients who experience prolonged concussion symptoms can be diagnosed with Post-Concussion Syndrome (PCS) when those symptoms persist past 4 weeks. Aerobic exercise protocols have been shown to be effective in improving physical and mental aspects of health. Emerging research suggests that aerobic exercise maybe useful as a treatment for PCS, where exercise allows patients to feel less isolated and more active during the recovery process. Is aerobic exercise more beneficial in reducing symptoms than current standard care in patients with prolonged symptoms or PCS lasting longer than 4 weeks? Summary of Key Findings: After a thorough literature search, 4 studies were selected relevant to the clinical question. Of the 4 studies, 1 was a randomized control trial and 3 were case series. All 4 studies investigate aerobic exercise protocol as treatment for PCS. 1-4 Three articles demonstrated a greater rate of symptom improvement from baseline assessment to follow-up after a controlled sub-symptomatic aerobic exercise program. 2-4 One study showed a decrease in symptoms in the aerobic exercise group compared to the full body stretching group. 1 Clinical Bottom Line: There is moderate evidence to support sub-symptomatic aerobic exercise as a treatment of PCS, therefore it should be considered as a clinical option for reducing PCS and prolonged concussion symptoms. A previously validated protocol, such as the Buffalo Concussion Treadmill Test, Balke Protocol, or Rating of Perceived Exertion (RPE) as mentioned in this critically appraised topic should be used to measure baseline values and treatment progression. Strength of Recommendation: Level C evidence exists that aerobic exercise protocol is more effective than the current standard of care in treating PCS.

  20. Critical appraisal of the role of ruxolitinib in myeloproliferative neoplasm-associated myelofibrosis

    Directory of Open Access Journals (Sweden)

    Barosi G

    2015-05-01

    because of comparator indirectness (quality of evidence, moderate. In conclusion, using the GRADE technique, we identified factors affecting the quality of evidence that were otherwise unstated. Identifying and evaluating these factors should influence the confidence with which physicians use ruxolitinib in persons with MPN-MF. Keywords: myelofibrosis, myeloproliferative neoplasm-associated myelofibrosis, GRADE, ruxolitinib, JAK inhibitor, critical appraisal

  1. Multicomponent Musculoskeletal Movement Assessment Tools: A Systematic Review and Critical Appraisal of Their Development and Applicability to Professional Practice.

    Science.gov (United States)

    Bennett, Hunter; Davison, Kade; Arnold, John; Slattery, Flynn; Martin, Max; Norton, Kevin

    2017-10-01

    Multicomponent movement assessment tools have become commonplace to measure movement quality, proposing to indicate injury risk and performance capabilities. Despite popular use, there has been no attempt to compare the components of each tool reported in the literature, the processes in which they were developed, or the underpinning rationale for their included content. As such, the objective of this systematic review was to provide a comprehensive summary of current movement assessment tools and appraise the evidence supporting their development. A systematic literature search was performed using PRISMA guidelines to identify multicomponent movement assessment tools. Commonalities between tools and the evidence provided to support the content of each tool was identified. Each tool underwent critical appraisal to identify the rigor in which it was developed, and its applicability to professional practice. Eleven tools were identified, of which 5 provided evidence to support their content as assessments of movement quality. One assessment tool (Soccer Injury Movement Screen [SIMS]) received an overall score of above 65% on critical appraisal, with a further 2 tools (Movement Competency Screen [MCS] and modified 4 movement screen [M4-MS]) scoring above 60%. Only the MCS provided clear justification for its developmental process. The remaining 8 tools scored between 40 and 60%. On appraisal, the MCS, M4-MS, and SIMS seem to provide the most practical value for assessing movement quality as they provide the strongest reports of developmental rigor and an identifiable evidence base. In addition, considering the evidence provided, these tools may have the strongest potential for identifying performance capabilities and guiding exercise prescription in athletic and sport-specific populations.

  2. The critical aspect on using fair value for financial instruments

    Directory of Open Access Journals (Sweden)

    Ionica Holban (Oncioiu

    2009-10-01

    Full Text Available The variety of the book-keeping practices, of the financial auditor, of the fiscal norms and rules, can have a negative impact, not only onthe companies’ ability in furnishing the needed and true financial information to the creditors and investors, but also on the capacity to analyze thefuture investment opportunities regarding the financial instruments, which are vital for the economic increment. Under the Accounting Standard forFinancial Instruments, fair value measurement is required in certain circumstances similar to IFRS or US GAAP. There are also specialists whocriticize the limited use of fair values in IFRS. However, those criticizing fair value accounting do not seem to provide any credible alternatives. Dowe go back to historical cost accounting, wherein the financial assets are stated at outdated values and hence are not relevant or reliable? In thecurrent crisis, a question that is raised is: Should financial instruments be marked down to their current throw away prices? This paper describes howthe fair value is used under the Standard and purposes to decide whether fair value measurement is required or not based on the type of investment.

  3. Re-examining the Evidence in Radiation Dermatitis Management Literature: An Overview and a Critical Appraisal of Systematic Reviews

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Raymond Javan, E-mail: email.rchan@gmail.com [Cancer Care Services, Royal Brisbane and Women' s Hospital (Australia); School of Nursing and Midwifery, University of Queensland, and Research Centre for Clinical and Community Practice Innovation, Griffith University (Australia); Larsen, Emily; Chan, Philip [Cancer Care Services, Royal Brisbane and Women' s Hospital (Australia)

    2012-11-01

    Purpose: To provide an overview and a critical appraisal of systematic reviews (SRs) of published interventions for the prevention/management of radiation dermatitis. Methods and Materials: We searched Medline, CINAHL, Embase, and the Cochrane Library. We also manually searched through individual reference lists of potentially eligible articles and a number of key journals in the topic area. Two authors screened all potential articles and included eligible SRs. Two authors critically appraised and extracted key findings from the included reviews using AMSTAR (the measurement tool for 'assessment of multiple systematic reviews'). Results: Of 1837 potential titles, 6 SRs were included. A number of interventions have been reported to be potentially beneficial for managing radiation dermatitis. Interventions evaluated in these reviews included skin care advice, steroidal/nonsteroidal topical agents, systemic therapies, modes of radiation delivery, and dressings. However, all the included SRs reported that there is insufficient evidence supporting any single effective intervention. The methodological quality of the included studies varied, and methodological shortfalls in these reviews might create biases to the overall results or recommendations for clinical practice. Conclusions: An up-to-date high-quality SR in the prevention/management of radiation dermatitis is needed to guide practice and direction for future research. We recommend that clinicians or guideline developers critically evaluate the information of SRs in their decision making.

  4. Re-examining the Evidence in Radiation Dermatitis Management Literature: An Overview and a Critical Appraisal of Systematic Reviews

    International Nuclear Information System (INIS)

    Chan, Raymond Javan; Larsen, Emily; Chan, Philip

    2012-01-01

    Purpose: To provide an overview and a critical appraisal of systematic reviews (SRs) of published interventions for the prevention/management of radiation dermatitis. Methods and Materials: We searched Medline, CINAHL, Embase, and the Cochrane Library. We also manually searched through individual reference lists of potentially eligible articles and a number of key journals in the topic area. Two authors screened all potential articles and included eligible SRs. Two authors critically appraised and extracted key findings from the included reviews using AMSTAR (the measurement tool for “assessment of multiple systematic reviews”). Results: Of 1837 potential titles, 6 SRs were included. A number of interventions have been reported to be potentially beneficial for managing radiation dermatitis. Interventions evaluated in these reviews included skin care advice, steroidal/nonsteroidal topical agents, systemic therapies, modes of radiation delivery, and dressings. However, all the included SRs reported that there is insufficient evidence supporting any single effective intervention. The methodological quality of the included studies varied, and methodological shortfalls in these reviews might create biases to the overall results or recommendations for clinical practice. Conclusions: An up-to-date high-quality SR in the prevention/management of radiation dermatitis is needed to guide practice and direction for future research. We recommend that clinicians or guideline developers critically evaluate the information of SRs in their decision making.

  5. Increased water intake to reduce headache: learning from a critical appraisal.

    Science.gov (United States)

    Price, Amy; Burls, Amanda

    2015-12-01

    ). 47% in the intervention (water) group self-reported improvement (6 > on a 10-point scale) against 25% in controls. Drinking water did not reduce headache days. The transparency from the author of this critically appraised paper enables others to use this study as a teaching tool and to learn from the shortcomings in the trial. The study was underpowered and contains methodological shortcomings. Participants were partially un-blinded during the trial increasing the risk for bias. Only the subjective measures are statistically significant and attrition was significant. The intervention is low risk and of negligible cost. A methodologically sound RCT is recommended to evaluate if the intervention has beneficial effects. © 2015 John Wiley & Sons, Ltd.

  6. Does a 3-week critical research appraisal course affect how students perceive their appraisal skills and the relevance of research for clinical practice? A repeated cross-sectional survey.

    Science.gov (United States)

    Jelsness-Jørgensen, Lars-Petter

    2015-01-01

    Research utilisation is essential in developing evidence-based practices; although many students may be generally able to adopt such skills, there are reports of barriers related to critical appraisal skills. To explore how students perceive the relevance of research to future clinical practice and patients, and to what extent they read research (including reading pattern). Additionally, the objective was to explore whether a three-week intensive course in critical appraisal of research could affect these variables. A cross-sectional survey design, with a pre- and post-test. One large university college in Southeastern Norway. 196 multidisciplinary healthcare students at baseline and 147 after three weeks. A purposely-designed 21 item questionnaire was used to quantify students' attitudes towards using research and critical thinking. The questionnaire was based on themes emerging from prior focus group interviews with 10 nursing and social educator students as well as from the existing literature. At baseline, 6.1% and 7.1% of respondents perceived the research to be of little or very little importance for their future work and patients, respectively. Furthermore, 83.2% reported that they seldom or very seldom read scientific papers. At baseline, 40 different patterns of reading a scientific paper were identified. Additionally, 7.1% of respondents reported to read the introduction, methods and conclusion in combination. Significantly improved scores were found after completing the three-week course related to a) relevance of research for future work (pskills in critical appraisal (pstudents' practical critical appraisal skills improved their view of the relevance of research for patients, future work as well as their own critical appraisal skills. Prospective studies are warranted to explore the effects of such teaching modules in the long-term. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Computer supported collaborative learning in a clerkship: an exploratory study on the relation of discussion activity and revision of critical appraisal papers

    Directory of Open Access Journals (Sweden)

    Koops Willem JM

    2012-08-01

    Full Text Available Abstract Background Medical students in clerkship are continuously confronted with real and relevant patient problems. To support clinical problem solving skills, students perform a Critical Appraisal of a Topic (CAT task, often resulting in a paper. Because such a paper may contain errors, students could profit from discussion with peers, leading to paper revision. Active peer discussion by a Computer Supported Collaborative Learning (CSCL environment show positive medical students perceptions on subjective knowledge improvement. High students’ activity during discussions in a CSCL environment demonstrated higher task-focussed discussion reflecting higher levels of knowledge construction. However, it remains unclear whether high discussion activity influences students’ decisions revise their CAT paper. The aim of this research is to examine whether students who revise their critical appraisal papers after discussion in a CSCL environment show more task-focussed activity and discuss more intensively on critical appraisal topics than students who do not revise their papers. Methods Forty-seven medical students, stratified in subgroups, participated in a structured asynchronous online discussion of individual written CAT papers on self-selected clinical problems. The discussion was structured by three critical appraisal topics. After the discussion, the students could revise their paper. For analysis purposes, all students’ postings were blinded and analysed by the investigator, unaware of students characteristics and whether or not the paper was revised. Postings were counted and analysed by an independent rater, Postings were assigned into outside activity, non-task-focussed activity or task-focussed activity. Additionally, postings were assigned to one of the three critical appraisal topics. Analysis results were compared by revised and unrevised papers. Results Twenty-four papers (51.6% were revised after the online discussion. The

  8. Computer supported collaborative learning in a clerkship: an exploratory study on the relation of discussion activity and revision of critical appraisal papers.

    Science.gov (United States)

    Koops, Willem J M; van der Vleuten, Cees P M; de Leng, Bas A; Snoeckx, Luc H E H

    2012-08-20

    Medical students in clerkship are continuously confronted with real and relevant patient problems. To support clinical problem solving skills, students perform a Critical Appraisal of a Topic (CAT) task, often resulting in a paper. Because such a paper may contain errors, students could profit from discussion with peers, leading to paper revision. Active peer discussion by a Computer Supported Collaborative Learning (CSCL) environment show positive medical students perceptions on subjective knowledge improvement. High students' activity during discussions in a CSCL environment demonstrated higher task-focussed discussion reflecting higher levels of knowledge construction. However, it remains unclear whether high discussion activity influences students' decisions revise their CAT paper. The aim of this research is to examine whether students who revise their critical appraisal papers after discussion in a CSCL environment show more task-focussed activity and discuss more intensively on critical appraisal topics than students who do not revise their papers. Forty-seven medical students, stratified in subgroups, participated in a structured asynchronous online discussion of individual written CAT papers on self-selected clinical problems. The discussion was structured by three critical appraisal topics. After the discussion, the students could revise their paper. For analysis purposes, all students' postings were blinded and analysed by the investigator, unaware of students characteristics and whether or not the paper was revised. Postings were counted and analysed by an independent rater, Postings were assigned into outside activity, non-task-focussed activity or task-focussed activity. Additionally, postings were assigned to one of the three critical appraisal topics. Analysis results were compared by revised and unrevised papers. Twenty-four papers (51.6%) were revised after the online discussion. The discussions of the revised papers showed significantly higher

  9. Critique of the Watson-Glaser Critical Thinking Appraisal Test: The More You Know, the Lower Your Score

    Directory of Open Access Journals (Sweden)

    Kevin Possin

    2014-12-01

    Full Text Available The Watson-Glaser Critical Thinking Appraisal Test is one of the oldest, most frequently used, multiple-choice critical-thinking tests on the market in business, government, and legal settings for purposes of hiring and promotion. I demonstrate, however, that the test has serious construct-validity issues, stemming primarily from its ambiguous, unclear, misleading, and sometimes mysterious instructions, which have remained unaltered for decades. Erroneously scored items further diminish the test’s validity. As a result, having enhanced knowledge of formal and informal logic could well result in test subjects receiving lower scores on the test. That’s not how things should work for a CT assessment test.

  10. Appraising the quality of sub-Saharan African cancer registration systems that contributed to GLOBOCAN 2008: a review of the literature and critical appraisal.

    Science.gov (United States)

    Crocker-Buque, Tim; Pollock, Allyson M

    2015-02-01

    To critically appraise the quality of sub-Saharan African cancer registration systems that submitted data to GLOBOCAN 2008 with respect to population coverage using publicly available information and to show the use of GLOBOCAN statistics in determining global health priorities. Sources of cancer registration data for twenty-six sub-Saharan African cancer registries were identified from GLOBOCAN 2008 factsheets. Additional information was extracted from International Agency for Research on Cancer publications. A literature search was conducted to identify studies that reported additional information on data collection methods and provided 27 studies. The websites of the 10 largest funders of development assistance for health were searched for GLOBOCAN citations. Twenty-six sub-Saharan African cancer registration systems submitting data to GLOBOCAN 2008 in relation to 21 countries. Information on 15 quality variables were extracted and compared with the international gold standard for cancer registration systems. Population coverage of the cancer registries ranged from from 2.3% of the population in Kenya to 100% in The Gambia, with a heavy urban bias in all countries. However, 20 countries (300 million people) had no cancer registration systems. Nineteen of the 26 registries failed to meet more than five of the 15 quality criteria and only one country met more than 10. Seven of the 10 largest funders of development assistance for health cite GLOBOCAN statistics in support of policy priorities. GLOBOCAN 2008 estimates are based on data drawn from poor quality cancer registration systems, with limited or no population registry coverage. It is essential the GLOBOCAN 2012 estimates should provide information on the quality of the data collection and explain the limitations of the estimates. Development organisations and the World Health Organization need to take a more cautious approach when using these data to determine priorities and allocating resources. © The

  11. Quantitative evaluation of recall and precision of CAT Crawler, a search engine specialized on retrieval of Critically Appraised Topics

    Science.gov (United States)

    Dong, Peng; Wong, Ling Ling; Ng, Sarah; Loh, Marie; Mondry, Adrian

    2004-01-01

    Background Critically Appraised Topics (CATs) are a useful tool that helps physicians to make clinical decisions as the healthcare moves towards the practice of Evidence-Based Medicine (EBM). The fast growing World Wide Web has provided a place for physicians to share their appraised topics online, but an increasing amount of time is needed to find a particular topic within such a rich repository. Methods A web-based application, namely the CAT Crawler, was developed by Singapore's Bioinformatics Institute to allow physicians to adequately access available appraised topics on the Internet. A meta-search engine, as the core component of the application, finds relevant topics following keyword input. The primary objective of the work presented here is to evaluate the quantity and quality of search results obtained from the meta-search engine of the CAT Crawler by comparing them with those obtained from two individual CAT search engines. From the CAT libraries at these two sites, all possible keywords were extracted using a keyword extractor. Of those common to both libraries, ten were randomly chosen for evaluation. All ten were submitted to the two search engines individually, and through the meta-search engine of the CAT Crawler. Search results were evaluated for relevance both by medical amateurs and professionals, and the respective recall and precision were calculated. Results While achieving an identical recall, the meta-search engine showed a precision of 77.26% (±14.45) compared to the individual search engines' 52.65% (±12.0) (p search engine approach. The improved precision due to inherent filters underlines the practical usefulness of this tool for clinicians. PMID:15588311

  12. Quantitative evaluation of recall and precision of CAT Crawler, a search engine specialized on retrieval of Critically Appraised Topics

    Directory of Open Access Journals (Sweden)

    Loh Marie

    2004-12-01

    Full Text Available Abstract Background Critically Appraised Topics (CATs are a useful tool that helps physicians to make clinical decisions as the healthcare moves towards the practice of Evidence-Based Medicine (EBM. The fast growing World Wide Web has provided a place for physicians to share their appraised topics online, but an increasing amount of time is needed to find a particular topic within such a rich repository. Methods A web-based application, namely the CAT Crawler, was developed by Singapore's Bioinformatics Institute to allow physicians to adequately access available appraised topics on the Internet. A meta-search engine, as the core component of the application, finds relevant topics following keyword input. The primary objective of the work presented here is to evaluate the quantity and quality of search results obtained from the meta-search engine of the CAT Crawler by comparing them with those obtained from two individual CAT search engines. From the CAT libraries at these two sites, all possible keywords were extracted using a keyword extractor. Of those common to both libraries, ten were randomly chosen for evaluation. All ten were submitted to the two search engines individually, and through the meta-search engine of the CAT Crawler. Search results were evaluated for relevance both by medical amateurs and professionals, and the respective recall and precision were calculated. Results While achieving an identical recall, the meta-search engine showed a precision of 77.26% (±14.45 compared to the individual search engines' 52.65% (±12.0 (p Conclusion The results demonstrate the validity of the CAT Crawler meta-search engine approach. The improved precision due to inherent filters underlines the practical usefulness of this tool for clinicians.

  13. Results from evaluations of models and cost-effectiveness tools to support introduction decisions for new vaccines need critical appraisal

    Directory of Open Access Journals (Sweden)

    Moorthy Vasee

    2011-05-01

    Full Text Available Abstract The World Health Organization (WHO recommends that the cost-effectiveness (CE of introducing new vaccines be considered before such a programme is implemented. However, in low- and middle-income countries (LMICs, it is often challenging to perform and interpret the results of model-based economic appraisals of vaccines that benefit from locally relevant data. As a result, WHO embarked on a series of consultations to assess economic analytical tools to support vaccine introduction decisions for pneumococcal, rotavirus and human papillomavirus vaccines. The objectives of these assessments are to provide decision makers with a menu of existing CE tools for vaccines and their characteristics rather than to endorse the use of a single tool. The outcome will provide policy makers in LMICs with information about the feasibility of applying these models to inform their own decision making. We argue that if models and CE analyses are used to inform decisions, they ought to be critically appraised beforehand, including a transparent evaluation of their structure, assumptions and data sources (in isolation or in comparison to similar tools, so that decision makers can use them while being fully aware of their robustness and limitations.

  14. Monitoring and Hardware Management for Critical Fusion Plasma Instrumentation

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    Carvalho Paulo F.

    2018-01-01

    Full Text Available Controlled nuclear fusion aims to obtain energy by particles collision confined inside a nuclear reactor (Tokamak. These ionized particles, heavier isotopes of hydrogen, are the main elements inside of plasma that is kept at high temperatures (millions of Celsius degrees. Due to high temperatures and magnetic confinement, plasma is exposed to several sources of instabilities which require a set of procedures by the control and data acquisition systems throughout fusion experiments processes. Control and data acquisition systems often used in nuclear fusion experiments are based on the Advanced Telecommunication Computer Architecture (AdvancedTCA® standard introduced by the Peripheral Component Interconnect Industrial Manufacturers Group (PICMG®, to meet the demands of telecommunications that require large amount of data (TB transportation at high transfer rates (Gb/s, to ensure high availability including features such as reliability, serviceability and redundancy. For efficient plasma control, systems are required to collect large amounts of data, process it, store for later analysis, make critical decisions in real time and provide status reports either from the experience itself or the electronic instrumentation involved. Moreover, systems should also ensure the correct handling of detected anomalies and identified faults, notify the system operator of occurred events, decisions taken to acknowledge and implemented changes. Therefore, for everything to work in compliance with specifications it is required that the instrumentation includes hardware management and monitoring mechanisms for both hardware and software. These mechanisms should check the system status by reading sensors, manage events, update inventory databases with hardware system components in use and maintenance, store collected information, update firmware and installed software modules, configure and handle alarms to detect possible system failures and prevent emergency

  15. Monitoring and Hardware Management for Critical Fusion Plasma Instrumentation

    Science.gov (United States)

    Carvalho, Paulo F.; Santos, Bruno; Correia, Miguel; Combo, Álvaro M.; Rodrigues, AntÓnio P.; Pereira, Rita C.; Fernandes, Ana; Cruz, Nuno; Sousa, Jorge; Carvalho, Bernardo B.; Batista, AntÓnio J. N.; Correia, Carlos M. B. A.; Gonçalves, Bruno

    2018-01-01

    Controlled nuclear fusion aims to obtain energy by particles collision confined inside a nuclear reactor (Tokamak). These ionized particles, heavier isotopes of hydrogen, are the main elements inside of plasma that is kept at high temperatures (millions of Celsius degrees). Due to high temperatures and magnetic confinement, plasma is exposed to several sources of instabilities which require a set of procedures by the control and data acquisition systems throughout fusion experiments processes. Control and data acquisition systems often used in nuclear fusion experiments are based on the Advanced Telecommunication Computer Architecture (AdvancedTCA®) standard introduced by the Peripheral Component Interconnect Industrial Manufacturers Group (PICMG®), to meet the demands of telecommunications that require large amount of data (TB) transportation at high transfer rates (Gb/s), to ensure high availability including features such as reliability, serviceability and redundancy. For efficient plasma control, systems are required to collect large amounts of data, process it, store for later analysis, make critical decisions in real time and provide status reports either from the experience itself or the electronic instrumentation involved. Moreover, systems should also ensure the correct handling of detected anomalies and identified faults, notify the system operator of occurred events, decisions taken to acknowledge and implemented changes. Therefore, for everything to work in compliance with specifications it is required that the instrumentation includes hardware management and monitoring mechanisms for both hardware and software. These mechanisms should check the system status by reading sensors, manage events, update inventory databases with hardware system components in use and maintenance, store collected information, update firmware and installed software modules, configure and handle alarms to detect possible system failures and prevent emergency scenarios

  16. Development and validation of an instrument to assess patients' appraisal, emotions and action tendencies preceding care-seeking in acute myocardial infarction: The PA-AMI questionnaire.

    Science.gov (United States)

    Nymark, C; Saboonchi, F; Mattiasson, A-C; Henriksson, P; Kiessling, A

    2017-03-01

    Reducing patient delay for patients afflicted by an acute myocardial infarction is a task of great complexity, which might be alleviated if more factors that influence this delay could be identified. Although a number of self-reported instruments associated with patient delay exist, none of these taps the content of the appraisal process related to patients' subjective emotions. The aim of this study was to develop and validate a questionnaire aimed at assessing patients' appraisal, emotions and action tendencies when afflicted by an acute myocardial infarction. An item pool was generated based on themes conceptualized in a recent qualitative study of acute myocardial infarction patients' thoughts, feelings and actions preceding the decision to seek medical care. The 'Think-Aloud Protocol' and test-retest analysis at item level were performed. The modified item pool was administered to 96 patients when treated for acute myocardial infarction. Explorative factor analysis and principal component analysis with the non-linear iterative partial least squares algorithm were performed to examine the underlying factor structure of the items. The findings indicated three core dimensions corresponding to three subscales, namely, 'symptom appraisal'; 'perceived inability to act'; 'autonomy preservation'. The results demonstrated acceptable measures of reliability and validity Conclusions: The PA-AMI questionnaire demonstrated satisfactory psychometric properties. Assessment of the included core dimensions may contribute to greater understanding of the appraisal processes for patients afflicted by an acute myocardial infarction.

  17. Equipoise in the enhanced supression of the platelet IIb/IIIa receptor with integrilin trial (ESPRIT): a critical appraisal.

    Science.gov (United States)

    Mann, Howard; London, Alex John; Mann, Jeffrey

    2005-01-01

    Enhanced Supression of the Platelet IIb/IIIa Receptor with Integrilin Trial (ESPRIT) was a multicenter randomized controlled clinical trial in which participants were randomized between eptifibatide and placebo. A "clinical hold" was initially placed on the trial by the US Food and Drug Administration (FDA), which was concerned about the placebo-only control arm. The hold was lifted after additional information concerning the use of platelet glycoprotein IIb/IIIa inhibitors in clinical practice, derived from a survey of interventional cardiologists, was provided. The trial's principal investigator and colleagues have described how these issues were resolved, and advance a claim of equipoise for the trial. In this critical appraisal we examine the information and arguments proffered in support of the trial design and conclude that they evidence a misunderstanding of equipoise. We believe that a placebo-only control arm was not justified by the information provided by the trialists.

  18. A Critical Appraisal of Extracorporeal Photopheresis as a Treatment Modality for Acute and Chronic Graft-Versus-Host Disease

    Directory of Open Access Journals (Sweden)

    Hind Rafei

    2017-10-01

    Full Text Available Although significant advances have been made in the biologic understanding of graft-versus-host disease (GVHD and its treatment options, GVHD remains the single most challenging obstacle to the success of allogeneic hematopoietic cell transplantation (HCT due to high risk of disabling morbidity and mortality. Extracorporeal photopheresis (ECP has promising effects in controlling steroid-refractory GVHD, both acute and chronic, and it has been studied extensively. Its putative immunomodulatory mechanisms, while not immunosuppressive, position ECP as an attractive treatment strategy for GVHD patients who are already receiving global immunosuppression. However, ECP is relatively underutilized due in part to limited access and time commitment. Here, we review the recent findings on the ECP efficacy in both acute and chronic GVHD, primarily for steroid-refractory status, and we critically appraise its benefits. We also explore salient considerations on the optimal use of ECP in the treatment of refractory GVHD.

  19. Needed Research on Child Socialization. A Special Report of the USOE-Sponsored Grant Study: Critical Appraisal of Research in the Personality-Emotions-Motivation Domain.

    Science.gov (United States)

    Gorsuch, Richard L.; And Others

    The task group report presented in this publication is one of a series prepared by eminent psychologists who have served as consultants in the U.S. Office of Education-sponsored grant study to conduct a Critical Appraisal of the Personality-Emotions-Motivation Domain. In order to achieve the goal of identifying important problems and areas for new…

  20. Computer supported collaborative learning in a clerkship: an exploratory study on the relation of discussion activity and revision of critical appraisal papers

    NARCIS (Netherlands)

    Koops, W.J.; Vleuten, C.P.M. van der; de Leng, B.A.; Snoeckx, L.H.

    2012-01-01

    ABSTRACT: BACKGROUND: Medical students in clerkship are continuously confronted with real and relevant patient problems. To support clinical problem solving skills, students perform a Critical Appraisal of a Topic (CAT) task, often resulting in a paper. Because such a paper may contain errors,

  1. A critical appraisal of ibrutinib in the treatment of mantle cell lymphoma and chronic lymphocytic leukemia

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    Tucker DL

    2015-06-01

    Full Text Available David L Tucker, Simon A Rule Department of Haematology, Plymouth Hospitals NHS Trust, Plymouth, UK Abstract: Although chemo-immunotherapy remains at the forefront of first-line treatment for mantle cell lymphoma (MCL and chronic lymphocytic leukemia (CLL, small molecules, such as ibrutinib, are beginning to play a significant role, particularly in patients with multiply relapsed or chemotherapy-refractory disease and where toxicity is an overriding concern. Ibrutinib is a first-in-class, oral inhibitor of Bruton’s tyrosine kinase, which functions by irreversible inhibition of the downstream signaling pathway of the B-cell receptor, which normally promotes cell survival and proliferation. Early clinical trials have demonstrated excellent tolerability and a modest side-effect profile even in elderly and multiply pretreated patient cohorts. Although the majority of disease responses tend to be partial, efficacy data have also been encouraging with more than two-thirds of patients with CLL and MCL demonstrating a durable response, even in the high-risk disease setting. Resistance mechanisms are only partially understood and appear to be multifactorial, including the binding site mutation C481S, and escape through other common cell-signaling pathways. This article appraises the currently available data on safety and efficacy from clinical trials of ibrutinib in the management of MCL and CLL, both as a single agent and in combination with other therapies, and considers how this drug is likely to be used in future clinical practice. Keywords: ibrutinib, mantle cell lymphoma, chronic lymphocytic leukemia, Bruton’s tyrosine kinase, lymphoproliferative disorders

  2. Derivation of Two Critical Appraisal Scores for Trainees to Evaluate Online Educational Resources: A METRIQ Study

    Science.gov (United States)

    Chan, Teresa M.; Thoma, Brent; Krishnan, Keeth; Lin, Michelle; Carpenter, Christopher R.; Astin, Matt; Kulasegaram, Kulamakan

    2016-01-01

    Introduction Online education resources (OERs), like blogs and podcasts, increasingly augment or replace traditional medical education resources such as textbooks and lectures. Trainees’ ability to evaluate these resources is poor, and few quality assessment aids have been developed to assist them. This study aimed to derive a quality evaluation instrument for this purpose. Methods We used a three-phase methodology. In Phase 1, a previously derived list of 151 OER quality indicators was reduced to 13 items using data from published consensus-building studies (of medical educators, expert podcasters, and expert bloggers) and subsequent evaluation by our team. In Phase 2, these 13 items were converted to seven-point Likert scales used by trainee raters (n=40) to evaluate 39 OERs. The reliability and usability of these 13 rating items was determined using responses from trainee raters, and top items were used to create two OER quality evaluation instruments. In Phase 3, these instruments were compared to an external certification process (the ALiEM AIR certification) and the gestalt evaluation of the same 39 blog posts by 20 faculty educators. Results Two quality-evaluation instruments were derived with fair inter-rater reliability: the METRIQ-8 Score (Inter class correlation coefficient [ICC]=0.30, p<0.001) and the METRIQ-5 Score (ICC=0.22, p<0.001). Both scores, when calculated using the derivation data, correlated with educator gestalt (Pearson’s r=0.35, p=0.03 and r=0.41, p<0.01, respectively) and were related to increased odds of receiving an ALiEM AIR certification (odds ratio=1.28, p=0.03; OR=1.5, p=0.004, respectively). Conclusion Two novel scoring instruments with adequate psychometric properties were derived to assist trainees in evaluating OER quality and correlated favourably with gestalt ratings of online educational resources by faculty educators. Further testing is needed to ensure these instruments are accurate when applied by trainees. PMID

  3. Derivation of Two Critical Appraisal Scores for Trainees to Evaluate Online Educational Resources: A METRIQ Study

    Directory of Open Access Journals (Sweden)

    Teresa M. Chan

    2016-09-01

    Full Text Available Introduction: Online education resources (OERs, like blogs and podcasts, increasingly augment or replace traditional medical education resources such as textbooks and lectures. Trainees’ ability to evaluate these resources is poor, and few quality assessment aids have been developed to assist them. This study aimed to derive a quality evaluation instrument for this purpose. Methods: We used a three-phase methodology. In Phase 1, a previously derived list of 151 OER quality indicators was reduced to 13 items using data from published consensus-building studies (of medical educators, expert podcasters, and expert bloggers and subsequent evaluation by our team. In Phase 2, these 13 items were converted to seven-point Likert scales used by trainee raters (n=40 to evaluate 39 OERs. The reliability and usability of these 13 rating items was determined using responses from trainee raters, and top items were used to create two OER quality evaluation instruments. In Phase 3, these instruments were compared to an external certification process (the ALiEM AIR certification and the gestalt evaluation of the same 39 blog posts by 20 faculty educators. Results: Two quality-evaluation instruments were derived with fair inter-rater reliability: the METRIQ-8 Score (Inter class correlation coefficient [ICC]=0.30, p<0.001 and the METRIQ-5 Score (ICC=0.22, p<0.001. Both scores, when calculated using the derivation data, correlated with educator gestalt (Pearson’s r=0.35, p=0.03 and r=0.41, p<0.01, respectively and were related to increased odds of receiving an ALiEM AIR certification (odds ratio=1.28, p=0.03; OR=1.5, p=0.004, respectively. Conclusion: Two novel scoring instruments with adequate psychometric properties were derived to assist trainees in evaluating OER quality and correlated favourably with gestalt ratings of online educational resources by faculty educators. Further testing is needed to ensure these instruments are accurate when applied by

  4. Sediment residence times constrained by uranium-series isotopes: A critical appraisal of the comminution approach

    Science.gov (United States)

    Handley, Heather K.; Turner, Simon; Afonso, Juan C.; Dosseto, Anthony; Cohen, Tim

    2013-02-01

    Quantifying the rates of landscape evolution in response to climate change is inhibited by the difficulty of dating the formation of continental detrital sediments. We present uranium isotope data for Cooper Creek palaeochannel sediments from the Lake Eyre Basin in semi-arid South Australia in order to attempt to determine the formation ages and hence residence times of the sediments. To calculate the amount of recoil loss of 234U, a key input parameter used in the comminution approach, we use two suggested methods (weighted geometric and surface area measurement with an incorporated fractal correction) and typical assumed input parameter values found in the literature. The calculated recoil loss factors and comminution ages are highly dependent on the method of recoil loss factor determination used and the chosen assumptions. To appraise the ramifications of the assumptions inherent in the comminution age approach and determine individual and combined comminution age uncertainties associated to each variable, Monte Carlo simulations were conducted for a synthetic sediment sample. Using a reasonable associated uncertainty for each input factor and including variations in the source rock and measured (234U/238U) ratios, the total combined uncertainty on comminution age in our simulation (for both methods of recoil loss factor estimation) can amount to ±220-280 ka. The modelling shows that small changes in assumed input values translate into large effects on absolute comminution age. To improve the accuracy of the technique and provide meaningful absolute comminution ages, much tighter constraints are required on the assumptions for input factors such as the fraction of α-recoil lost 234Th and the initial (234U/238U) ratio of the source material. In order to be able to directly compare calculated comminution ages produced by different research groups, the standardisation of pre-treatment procedures, recoil loss factor estimation and assumed input parameter values

  5. The economic burden of physical inactivity: a systematic review and critical appraisal.

    Science.gov (United States)

    Ding, Ding; Kolbe-Alexander, Tracy; Nguyen, Binh; Katzmarzyk, Peter T; Pratt, Michael; Lawson, Kenny D

    2017-10-01

    To summarise the literature on the economic burden of physical inactivity in populations, with emphases on appraising the methodologies and providing recommendations for future studies. Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO registration number CRD42016047705). Electronic databases for peer-reviewed and grey literature were systematically searched, followed by reference searching and consultation with experts. Studies that examined the economic consequences of physical inactivity in a population/population-based sample, with clearly stated methodologies and at least an abstract/summary written in English. Of the 40 eligible studies, 27 focused on direct healthcare costs only, 13 also estimated indirect costs and one study additionally estimated household costs. For direct costs, 23 studies used a population attributable fraction (PAF) approach with estimated healthcare costs attributable to physical inactivity ranging from 0.3% to 4.6% of national healthcare expenditure; 17 studies used an econometric approach, which tended to yield higher estimates than those using a PAF approach. For indirect costs, 10 studies used a human capital approach, two used a friction cost approach and one used a value of a statistical life approach. Overall, estimates varied substantially, even within the same country, depending on analytical approaches, time frame and other methodological considerations. Estimating the economic burden of physical inactivity is an area of increasing importance that requires further development. There is a marked lack of consistency in methodological approaches and transparency of reporting. Future studies could benefit from cross-disciplinary collaborations involving economists and physical activity experts, taking a societal perspective and following best practices in conducting and reporting analysis, including accounting for potential confounding, reverse causality and

  6. A critical appraisal of codes as vehicles for realising on-site quality

    NARCIS (Netherlands)

    Van Breugel, K.

    2014-01-01

    The increasing demand for quality, durability and sustainability requires a critical evaluation of currently used building codes. Although there is no doubt that we need codes, standards, certificates etc., the existence of these documents are no guarantee that the prescribed quality is realized on

  7. Reflection-on-Action in Qualitative Research: A Critical Self-Appraisal Rubric for Deconstructing Research

    Science.gov (United States)

    Stynes, Martin; Murphy, Timothy; McNamara, Gerry; O'Hara, Joe

    2018-01-01

    In this paper, four critical friends meet to discuss qualitative research practices. Together they put one of their own case studies under the knife and deconstruct it to investigate the possibilities that knowledge work is complicated not only by the dynamics of socially constructed enterprises and the actors involved therein, but by the…

  8. A critical appraisal of 2007 American College of Occupational and Environmental Medicine (ACOEM) Practice Guidelines for Interventional Pain Management: an independent review utilizing AGREE, AMA, IOM, and other criteria.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Singh, Vijay; Helm, Standiford; Trescot, Andrea M; Hirsch, Joshua A

    2008-01-01

    Today, with the growing interest of the medical community and others in practice guidelines, there is greater emphasis on formal procedures and methods for arriving at a widely scrutinized and endorsed consensus than ever before. Conflicts in terminology and technique are notable for the confusion that guidelines create and for what they reflect about differences in values, experiences, and interests among different parties. While public and private development activities continue to multiply, the means for coordinating these efforts to resolve inconsistencies, fill in gaps, track applications and results, and assess the soundness of particular guidelines continue to be limited. In this era of widespread guideline development by private organizations, the American College of Occupational and Environment Medicine (ACOEM) has developed guidelines that evaluate areas of clinical practice well beyond the scope of occupational medicine and yet fail to properly involve physicians expert in these, especially those in the field of interventional pain management. As the field of guidelines suffers from imperfect and incomplete scientific knowledge as well as imperfect and uneven means of applying that knowledge without a single or correct way to develop guidelines, ACOEM guidelines have been alleged to hinder patient care, reduce access to interventional pain management procedures, and transfer patients into a system of disability, Medicare, and Medicaid. To critically appraise occupational medicine practice guidelines for interventional pain management by an independent review utilizing the Appraisal of Guidelines for Research and Evaluation (AGREE), American Medical Association (AMA), Institute of Medicine (IOM), and other commonly utilized criteria. Revised chapters of ACOEM guidelines, low back pain and chronic pain, developed in 2007 and 2008 are evaluated, utilizing AGREE, AMA, IOM instruments, and Shaneyfelt et al's criteria, were independently reviewed by 4

  9. Critical Taxonomic Appraisal of Some Taxa of Pedicularis from Indian Himalayas Belonging to Section Siphonanthae

    Directory of Open Access Journals (Sweden)

    Arti Garg

    2009-06-01

    Full Text Available The existing confusion on the taxonomic status of five taxa of Pedicularis viz. P. punctata Decne, P. siphonantha D. Don, P. hookeriana Wall. ex Benth., P. megalantha D. Don and P. hoffmeisteri Kl. ex Kl. & Garcke is resolved on the basis of critical morphological study. These taxa belong to section Siphonanthae, subgenus Longirostres. Pennell’s view of segregating these taxa into distinct species is defended and upheld.

  10. A critical appraisal of guidelines for electronic communication between patients and clinicians: the need to modernize current recommendations.

    Science.gov (United States)

    Lee, Joy L; Matthias, Marianne S; Menachemi, Nir; Frankel, Richard M; Weiner, Michael

    2018-04-01

    Patient-provider electronic communication has proliferated in recent years, yet there is a dearth of published research either leading to, or including, recommendations that improve clinical care and prevent unintended negative consequences. We critically appraise published guidelines and suggest an agenda for future work in this area. To understand how existing guidelines align with current practice, evidence, and technology. We performed a narrative review of provider-targeted guidelines for electronic communication between patients and providers, searching Ovid MEDLINE, Embase, and PubMed databases using relevant terms. We limited the search to articles published in English, and manually searched the citations of relevant articles. For each article, we identified and evaluated the suggested practices. Across 11 identified guidelines, the primary focus was on technical and administrative concerns, rather than on relational communication. Some of the security practices recommended by the guidelines are no longer needed because of shifts in technology. It is unclear the extent to which the recommendations that are still relevant are being followed. Moreover, there is no guideline-cited evidence of the effectiveness of the practices that have been proposed. Our analysis revealed major weaknesses in current guidelines for electronic communication between patients and providers: the guidelines appear to be based on minimal evidence and offer little guidance on how best to use electronic tools to communicate effectively. Further work is needed to systematically evaluate and identify effective practices, create a framework to evaluate quality of communication, and assess the relationship between electronic communication and quality of care.

  11. A critical appraisal of the clinical utility of proton therapy in oncology

    Science.gov (United States)

    Wang, Dongxu

    2015-01-01

    Proton therapy is an emerging technology for providing radiation therapy to cancer patients. The depth dose distribution of a proton beam makes it a preferable radiation modality as it reduces radiation to the healthy tissue outside the tumor, compared with conventional photon therapy. While theoretically beneficial, its clinical values are still being demonstrated from the increasing number of patients treated with proton therapy, from several dozen proton therapy centers around the world. High equipment and facility costs are often the major obstacle for its wider adoption. Because of the high cost and lack of definite clinical evidence of its superiority, proton therapy treatment faces criticism on its cost-effectiveness. Technological development is causing a gradual lowering of costs, and research and clinical studies are providing further evidence on its clinical utility. PMID:26604838

  12. Critical appraisal of the role of everolimus in advanced neuroendocrine tumors of pancreatic origin

    Directory of Open Access Journals (Sweden)

    Mulet-Margalef N

    2012-09-01

    Full Text Available Núria Mulet-Margalef, Jaume CapdevilaMedical Oncology Department, Vall d'Hebron University Hospital, Barcelona, SpainAbstract: For many years, the treatment of advanced pancreatic neuroendocrine tumors (pNETs has been limited almost entirely to somatostatin analogs and streptozocin-based chemotherapy, with modest benefit. Increasing knowledge of the biologic features of pNETs has allowed the design of molecular-based clinical trials, which have taken a step forward in the management of these tumors. In this review, we discuss the molecular rationale for the development of everolimus for patients with advanced pNETs, critically review the clinical data obtained by the main studies in this setting, and discuss essential considerations based on recent findings in pNET biology for future drug development involving the phosphatidylinositol 3' kinase-AKT-mTOR pathway.Keywords: pancreatic neuroendocrine tumors, everolimus, targeted therapies

  13. Critical appraisal of paclitaxel balloon angioplasty for femoral–popliteal arterial disease

    Directory of Open Access Journals (Sweden)

    Herten M

    2016-08-01

    Full Text Available Monika Herten,1 Giovanni B Torsello,1,2 Eva Schönefeld,3 Stefan Stahlhoff2 1Department of Vascular and Endovascular Surgery, University Hospital Münster, 2Department of Vascular Surgery, St Franziskus Hospital, Münster, 3Institute for Education and Student Affairs, University Hospital Münster, Münster, Germany Abstract: Peripheral arterial disease, particularly critical limb ischemia, is an area with urgent need for optimized therapies because, to date, vascular interventions often have limited life spans. In spite of initial encouraging technical success after femoropopliteal percutaneous transluminal angioplasty or stenting, postprocedural restenosis remains the major problem. The challenging idea behind the drug-coated balloon (DCB concept is the biological modification of the injury response after balloon dilatation. Antiproliferative drugs administered via DCBs or drug-eluting stents are able to suppress neointimal hyperplasia, the main cause of restenosis. This article reviews the results of DCB treatments of femoropopliteal and infrapopliteal lesions in comparison to standard angioplasty with uncoated balloons. A systematic literature search was performed in 1 medical journals (ie, MEDLINE, 2 international registers for clinical studies (ie, www.clinicaltrials.gov, and 3 abstracts of scientific sessions. Several controlled randomized trials with follow-up periods of up to 5 years demonstrated the efficacy of paclitaxel –DCB technology. However, calcified lesions seem to affect the efficacy of DCB. Combinations of preconditioning methods with DCBs showed promising results. Although the mechanical abrasion of calcium via atherectomy or laser ablation showed favorable periprocedural results, the long-term impact on restenosis and clinical outcome has to be demonstrated. Major advantages of the DCBs are the rapid delivery of drug at uniform concentrations with a single dose, their efficacy in areas wherein stents have been

  14. Construction Of Critical Thinking Skills Test Instrument Related The Concept On Sound Wave

    Science.gov (United States)

    Mabruroh, F.; Suhandi, A.

    2017-02-01

    This study aimed to construct test instrument of critical thinking skills of high school students related the concept on sound wave. This research using a mixed methods with sequential exploratory design, consists of: 1) a preliminary study; 2) design and review of test instruments. The form of test instruments in essay questions, consist of 18 questions that was divided into 5 indicators and 8 sub-indicators of the critical thinking skills expressed by Ennis, with questions that are qualitative and contextual. Phases of preliminary study include: a) policy studies; b) survey to the school; c) and literature studies. Phases of the design and review of test instruments consist of two steps, namely a draft design of test instruments include: a) analysis of the depth of teaching materials; b) the selection of indicators and sub-indicators of critical thinking skills; c) analysis of indicators and sub-indicators of critical thinking skills; d) implementation of indicators and sub-indicators of critical thinking skills; and e) making the descriptions about the test instrument. In the next phase of the review test instruments, consist of: a) writing about the test instrument; b) validity test by experts; and c) revision of test instruments based on the validator.

  15. Human Biomonitoring of Engineered Nanoparticles: An Appraisal of Critical Issues and Potential Biomarkers

    Directory of Open Access Journals (Sweden)

    Enrico Bergamaschi

    2012-01-01

    Full Text Available The present paper deals with the applicability of biological monitoring to the assessment of exposure and possible effects deriving from exposure to engineered nanomaterials (NM. After establishing a conceptual framework in which human biomonitoring should be placed, the paper reviews the critical issues related to the unusual properties of NM affecting the implementation of biomonitoring activities for this new class of chemicals. Relying on the recent advances in the toxicogenomic, it is possible to assess whether specific biological pathways are activated or perturbed by specific NM. However, to evaluate if quantitative changes in these biomarkers can be used as indicators or predictors for toxicity in humans, validation on well characterised groups of exposed people is needed. At present, it appears more pragmatic to evolve NM-associated biomarker identification considering relevant biological responses found in environmental and occupational studies and assessing the early events associated with exposure to these NM. The battery of biochemical markers includes soluble molecules, antioxidant capacity, peroxidated lipids and carbonyl groups in serum proteins as a biomarkers of systemic inflammation and vascular adhesion molecules to assess endothelial activation/damage. Abnormalities in exhaled breath condensate chemistry reflecting intrinsic changes in the airway lining fluid and lung inflammation seem promising tools suitable for BM studies and are broadly discussed.

  16. Economic evaluation, human immunodeficiency virus infection and screening: a review and critical appraisal of economic studies.

    Science.gov (United States)

    Dibosa-Osadolor, Onome; Roberts, Tracy

    2010-07-01

    The aim of this study was to review, systematically and critically, evidence used to derive estimates of cost-effectiveness of human immunodeficiency virus (HIV) screening. A systematic review was conducted. Searched were three main electronic bibliographic databases from 1993 to 2008 using key words including HIV, mass screening, HAART, economic evaluation, cost-effectiveness analysis, modeling. We included studies of sexually transmitted HIV infection in both sexes, including studies comparing diagnostic testing protocols and partner notification. Outcomes included were cases of HIV infection detected, deterioration to the AIDS state, secondary transmission of HIV, the quality-adjusted life-years/survival, costs, and cost-effectiveness of HIV screening. Eighty-four papers were identified; ten of which were formal economic evaluations, one cost study, three effectiveness studies, and three systematic reviews of HIV prevention programs. The predominant assertion was that HIV screening is cost-effective; methodological problems, such as the preponderance of static models which are inappropriate for infectious diseases, varying perspectives from which the studies were analyzed, and arbitrary threshold incremental cost-effectiveness ratio levels, limited the validity of these findings, and their usefulness in informing health policy decisions. The majority of published economic evaluations are based on inappropriate static models. This flaw renders the results of these studies as inconclusive and the purported cost-effectiveness of HIV screening debatable. The results of this review could form a basis for consideration of further research and analysis by health economists into the cost-effectiveness of HIV screening.

  17. Patient considerations in the management of type 2 diabetes – critical appraisal of dapagliflozin

    Directory of Open Access Journals (Sweden)

    Salvo MC

    2014-04-01

    Full Text Available Marissa C Salvo,1 Amie D Brooks,2 Stacey M Thacker3 1Department of Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs, CT, 2Department of Pharmacy Practice, St Louis College of Pharmacy, St Louis, MO, 3Department of Pharmacy Practice, Southern Illinois University Edwardsville, Edwardsville, IL, USA Abstract: Type 2 diabetes affects more than 350 million people worldwide, and its prevalence is increasing. Many patients with diabetes do not achieve and/or maintain glycemic targets, despite therapy implementation and escalation. Multiple therapeutic classes of agents are available for the treatment of type 2 diabetes, and the armamentarium has expanded significantly in the past decade. Selective sodium glucose co-transporter 2 inhibitors, including dapagliflozin, represent the latest development in pharmacologic treatment options for type 2 diabetes. This class has a unique mechanism of action, working by increasing glucose excretion in the urine. The insulin-independent mechanism results in decreased serum glucose, without hypoglycemia or weight gain. Dapagliflozin is a once-daily oral therapy. Expanding therapy options for a complex patient population is critical, and dapagliflozin has a distinct niche that can be a viable option for select patients with diabetes. Keywords: SGLT2 inhibitor, selective sodium glucose co-transporter 2 inhibitors, pharmacological treatment

  18. Next generation diagnostic molecular pathology: critical appraisal of quality assurance in Europe.

    Science.gov (United States)

    Dubbink, Hendrikus J; Deans, Zandra C; Tops, Bastiaan B J; van Kemenade, Folkert J; Koljenović, S; van Krieken, Han J M; Blokx, Willeke A M; Dinjens, Winand N M; Groenen, Patricia J T A

    2014-06-01

    Tumor evaluation in pathology is more and more based on a combination of traditional histopathology and molecular analysis. Due to the rapid development of new cancer treatments that specifically target aberrant proteins present in tumor cells, treatment decisions are increasingly based on the molecular features of the tumor. Not only the number of patients eligible for targeted precision medicine, but also the number of molecular targets per patient and tumor type is rising. Diagnostic molecular pathology, the discipline that determines the molecular aberrations present in tumors for diagnostic, prognostic or predictive purposes, is faced with true challenges. The laboratories have to meet the need of comprehensive molecular testing using only limited amount of tumor tissue, mostly fixed in formalin and embedded in paraffin (FFPE), in short turnaround time. Choices must be made for analytical methods that provide accurate, reliable and cost-effective results. Validation of the test procedures and results is essential. In addition, participation and good performance in internal (IQA) and external quality assurance (EQA) schemes is mandatory. In this review, we critically evaluate the validation procedure for comprehensive molecular tests as well as the organization of quality assurance and assessment of competence of diagnostic molecular pathology laboratories within Europe. Copyright © 2014 Federation of European Biochemical Societies. Published by Elsevier B.V. All rights reserved.

  19. Critical appraisal of ranibizumab in the treatment of diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Stewart MW

    2013-06-01

    Full Text Available Michael W StewartDepartment of Ophthalmology, Mayo School of Medicine, Jacksonville, FL, USAAbstract: Diabetic retinopathy is the leading cause of blindness among individuals of working age in industrialized nations, with most of the vision loss resulting from diabetic macular edema (DME. The formation of DME depends on the action of several growth factors and inflammatory mediators, but vascular endothelial growth factor (VEGF appears to be critical for breaking down the blood-retinal barrier and promoting the accumulation of macular edema. Laser photocoagulation has been the standard-of-care for three decades, and although it stabilizes vision, significant gains in visual acuity after treatment are unusual. Several VEGF inhibitors (pegaptanib, aflibercept, and ranibizumab have been initially developed and tested for the treatment of age-related macular degeneration and subsequently for DME. In Phase I, II, and III trials for DME, ranibizumab has been shown to be superior to macular laser photocoagulation and intraocular triamcinolone acetonide injections for improving visual acuity and drying the macula. As a result, ranibizumab is the only anti-VEGF drug that has been approved by the United States Food and Drug Administration for the treatment of DME. Most experts now consider intravitreal anti-VEGF therapy to be standard-of-care for DME involving the fovea.Keywords: aflibercept, bevacizumab, diabetic macular edema, diabetic retinopathy, ranibizumab, vascular endothelial growth factor

  20. Critical appraisal of paclitaxel balloon angioplasty for femoral-popliteal arterial disease.

    Science.gov (United States)

    Herten, Monika; Torsello, Giovanni B; Schönefeld, Eva; Stahlhoff, Stefan

    2016-01-01

    Peripheral arterial disease, particularly critical limb ischemia, is an area with urgent need for optimized therapies because, to date, vascular interventions often have limited life spans. In spite of initial encouraging technical success after femoropopliteal percutaneous transluminal angioplasty or stenting, postprocedural restenosis remains the major problem. The challenging idea behind the drug-coated balloon (DCB) concept is the biological modification of the injury response after balloon dilatation. Antiproliferative drugs administered via DCBs or drug-eluting stents are able to suppress neointimal hyperplasia, the main cause of restenosis. This article reviews the results of DCB treatments of femoropopliteal and infrapopliteal lesions in comparison to standard angioplasty with uncoated balloons. A systematic literature search was performed in 1) medical journals (ie, MEDLINE), 2) international registers for clinical studies (ie, www.clinicaltrials.gov), and 3) abstracts of scientific sessions. Several controlled randomized trials with follow-up periods of up to 5 years demonstrated the efficacy of paclitaxel -DCB technology. However, calcified lesions seem to affect the efficacy of DCB. Combinations of preconditioning methods with DCBs showed promising results. Although the mechanical abrasion of calcium via atherectomy or laser ablation showed favorable periprocedural results, the long-term impact on restenosis and clinical outcome has to be demonstrated. Major advantages of the DCBs are the rapid delivery of drug at uniform concentrations with a single dose, their efficacy in areas wherein stents have been contraindicated until now (ie, bifurcation, ostial lesions), and in leaving no stent scaffold behind. Reinterventions are easier to perform because DCBs leave no metal behind. Various combinations of DCBs with other treatment modalities may prove to be viable options in future. The follow-up results of clinical studies will evaluate the long-term impact

  1. A Critical Appraisal of the Juvenile Justice System under Cameroon's 2005 Criminal Procedure Code: Emerging Challenges

    Directory of Open Access Journals (Sweden)

    S Tabe

    2012-03-01

    Full Text Available The objective of this article is to examine the changes introduced by the 2005 Cameroonian Criminal Procedure Code on matters of juvenile justice, considering that before this Code, juvenile justice in Cameroon was governed by extra-national laws. In undertaking this analysis, the article highlights the evolution of the administration of juvenile justice 50 years after independence of Cameroon. It also points out the various difficulties and shortcomings in the treatment of juvenile offenders in Cameroon since the enactment of the new Criminal Procedure Code. The article reveals that the 2005 Code is an amalgamation of all hitherto existing laws in the country that pertained to juvenile justice, and that despite the considerable amount of criticism it has received, the Code is clearly an improvement of the system of juvenile justice in Cameroon, since it represents a balance of the due process rights of young people, the protection of society and the special needs of young offenders. This is so because the drafters of the Code took a broad view of the old laws on juvenile justice. Also a wide range of groups were consulted, including criminal justice professionals, children’s service organisations, victims, parents, young offenders, educators, advocacy groups and social-policy analysts. However, to address the challenges that beset the juvenile justice system of Cameroon, the strategy of the government should be focussed on three areas: the prevention of youth crime, the provision of meaningful consequences for the actions of young people, and the rehabilitation and reintegration of young offenders. Cameroonian law should seek educative solutions rather than to impose prison sentences or other repressive measures on young offenders. Special courts to deal with young offenders should be established outside the regular penal system and should be provided with resources that are adequate for and appropriate to fostering their understanding of

  2. Critical appraisal of the potential use of cannabinoids in cancer management

    Directory of Open Access Journals (Sweden)

    Cridge BJ

    2013-08-01

    Full Text Available Belinda J Cridge, Rhonda J Rosengren Department of Pharmacology and Toxicology, University of Otago, Dunedin, New Zealand Abstract: Cannabinoids have been attracting a great deal of interest as potential anticancer agents. Originally derived from the plant Cannabis sativa, there are now a number of endo-, phyto- and synthetic cannabinoids available. This review summarizes the key literature to date around the actions, antitumor activity, and mechanisms of action for this broad range of compounds. Cannabinoids are largely defined by an ability to activate the cannabinoid receptors – CB1 or CB2. The action of the cannabinoids is very dependent on the exact ligand tested, the dose, and the duration of exposure. Some cannabinoids, synthetic or plant-derived, show potential as therapeutic agents, and evidence across a range of cancers and evidence in vitro and in vivo is starting to be accumulated. Studies have now been conducted in a wide range of cell lines, including glioma, breast, prostate, endothelial, liver, and lung. This work is complemented by an increasing body of evidence from in vivo models. However, many of these results remain contradictory, an issue that is not currently able to be resolved through current knowledge of mechanisms of action. While there is a developing understanding of potential mechanisms of action, with the extracellular signal-regulated kinase pathway emerging as a critical signaling juncture in combination with an important role for ceramide and lipid signaling, the relative importance of each pathway is yet to be determined. The interplay between the intracellular pathways of autophagy versus apoptosis is a recent development that is discussed. Overall, there is still a great deal of conflicting evidence around the future utility of the cannabinoids, natural or synthetic, as therapeutic agents. Keywords: cancer, cannabinoid, endocannabinoid, tetrahydrocannabinol, JWH-133, WIN-55,212-2

  3. Critical appraisal of the potential use of cannabinoids in cancer management

    International Nuclear Information System (INIS)

    Cridge, Belinda J; Rosengren, Rhonda J

    2013-01-01

    Cannabinoids have been attracting a great deal of interest as potential anticancer agents. Originally derived from the plant Cannabis sativa, there are now a number of endo-, phyto- and synthetic cannabinoids available. This review summarizes the key literature to date around the actions, antitumor activity, and mechanisms of action for this broad range of compounds. Cannabinoids are largely defined by an ability to activate the cannabinoid receptors – CB 1 or CB 2 . The action of the cannabinoids is very dependent on the exact ligand tested, the dose, and the duration of exposure. Some cannabinoids, synthetic or plant-derived, show potential as therapeutic agents, and evidence across a range of cancers and evidence in vitro and in vivo is starting to be accumulated. Studies have now been conducted in a wide range of cell lines, including glioma, breast, prostate, endothelial, liver, and lung. This work is complemented by an increasing body of evidence from in vivo models. However, many of these results remain contradictory, an issue that is not currently able to be resolved through current knowledge of mechanisms of action. While there is a developing understanding of potential mechanisms of action, with the extracellular signal-regulated kinase pathway emerging as a critical signaling juncture in combination with an important role for ceramide and lipid signaling, the relative importance of each pathway is yet to be determined. The interplay between the intracellular pathways of autophagy versus apoptosis is a recent development that is discussed. Overall, there is still a great deal of conflicting evidence around the future utility of the cannabinoids, natural or synthetic, as therapeutic agents

  4. Critical appraisal of the potential use of cannabinoids in cancer management

    Energy Technology Data Exchange (ETDEWEB)

    Cridge, Belinda J; Rosengren, Rhonda J, E-mail: rhonda.rosengren@otago.ac.nz [Department of Pharmacology and Toxicology, University of Otago, Dunedin (New Zealand)

    2013-08-30

    Cannabinoids have been attracting a great deal of interest as potential anticancer agents. Originally derived from the plant Cannabis sativa, there are now a number of endo-, phyto- and synthetic cannabinoids available. This review summarizes the key literature to date around the actions, antitumor activity, and mechanisms of action for this broad range of compounds. Cannabinoids are largely defined by an ability to activate the cannabinoid receptors – CB{sub 1} or CB{sub 2}. The action of the cannabinoids is very dependent on the exact ligand tested, the dose, and the duration of exposure. Some cannabinoids, synthetic or plant-derived, show potential as therapeutic agents, and evidence across a range of cancers and evidence in vitro and in vivo is starting to be accumulated. Studies have now been conducted in a wide range of cell lines, including glioma, breast, prostate, endothelial, liver, and lung. This work is complemented by an increasing body of evidence from in vivo models. However, many of these results remain contradictory, an issue that is not currently able to be resolved through current knowledge of mechanisms of action. While there is a developing understanding of potential mechanisms of action, with the extracellular signal-regulated kinase pathway emerging as a critical signaling juncture in combination with an important role for ceramide and lipid signaling, the relative importance of each pathway is yet to be determined. The interplay between the intracellular pathways of autophagy versus apoptosis is a recent development that is discussed. Overall, there is still a great deal of conflicting evidence around the future utility of the cannabinoids, natural or synthetic, as therapeutic agents.

  5. Preventing and managing exacerbations in COPD – critical appraisal of the role of tiotropium

    Directory of Open Access Journals (Sweden)

    Donald P Tashkin

    2010-02-01

    Full Text Available Donald P TashkinDepartment of Medicine, Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA,Los Angeles, CA, USAAbstract: The course of COPD is punctuated by acute exacerbations that are associated with an increase in the morbidity and mortality related to this chronic disease and may contribute to its rate of progression. Therefore, preventing and treating exacerbations are major goals of COPD management. The role of tiotropium in the prevention of exacerbations has been investigated in several placebo-controlled randomized clinical trials varying in duration from 3 months to 4 years in patients with moderate to very severe COPD. In all of these trials, tiotropium has uniformly reduced the proportion of patients experiencing at least one exacerbation and delayed the time to the first exacerbation compared with placebo. In the longer trials (≥6 months’ duration tiotropium has also reduced the exposure-adjusted incidence rate of exacerbations. In trials of at least 1 year in duration, tiotropium either significantly reduced the risk of hospitalization for an exacerbation and/or the proportion of patients with an exacerbation-related hospitalization. In a meta-analysis that included 15 trials of tiotropium vs either placebo (n = 13 and/or a longacting beta-agonist (LABA; n = 4, tiotropium significantly reduced the odds of experiencing an exacerbation compared to placebo as well as a LABA. The potential additive benefits of tiotropium to those of a LABA and/or inhaled corticosteroid in reducing exacerbations require further investigation. The mechanism whereby tiotropium reduces exacerbations is not due to an anti-inflammatory effect but more likely relates to its property of causing a sustained increase in airway patency and reduction in hyperinflation, thereby counteracting the tendency for respiratory insults to worsen airflow obstruction and hyperinflation. For the management of acute exacerbations, an

  6. The Effects of Cognitive Appraisal and Emotion on Consumer Behavior: The Critical Role of Recollection in the Luxury Cruise Setting

    OpenAIRE

    Joo, Eunkyung; Shin, Hyejin; Kim, Insin; Choi, Jinsung; Jang, Junhwa; Hyun, Sunghyup

    2016-01-01

    Abstract de la ponencia [EN] The purposes of this study were: (1) to integrate the cognitive appraisal theory and script theory; (2) to examine the bonding character of recollection; and (3) to assess the relationships between consumers ‘appraisals, positive/negative emotions, recollection, storytelling and repurchase intention. A review of previous studies revealed 14 theoretical hypotheses. The proposed hypotheses were tested utilizing data collected from 300 luxury cru...

  7. Development of Assessment Instrument of Critical Thinking in Physics at Senior High School

    Science.gov (United States)

    Sugiarti, T.; Kaniawati, I.; Aviyanti, L.

    2017-02-01

    The result of preliminary study shows that the assessment of physics in school did not train students’ critical thinking skill. The assessment instrument just measured low cognitive aspects. Supposedly, critical thinking skill is trained in the assessment activity. The study aims to determine the characteristics and the quality of critical thinking skill instrument. It employs descriptive-qualitative method with research and development as the research design. The research participants are 35 students involved in the limited trial and 188 students in the wider trial from three public senior high school in Ciamis which in high level school. The data was collected through expert validation, tests and interviews. The results indicate that the characteristics of the assessment instrument of critical thinking skill is open-ended. The instrument fulfills some indicators namely analyzing argument, deduction, induction, and display information in the form of scenario, text, graphic and table. In addition, the data processing through V4 Anates program shows that the instrument reliability achieves 0.67 with high interpretation of 0.67 and the validity is 0.47 with enough interpretation. Thus, the assessment instrument of critical thinking skill in the form of open-ended essay meets the criteria of quality test, so it can use as instrument of assessment critical thinking skill.

  8. Maintenance phase in psoralen-ultraviolet A phototherapy of early-stage mycosis fungoides. A critically appraised topic.

    Science.gov (United States)

    Grandi, V; Delfino, C; Pileri, A; Pimpinelli, N

    2017-08-01

    A 65-year-old patient affected by mycosis fungoides (MF) stage IB achieved complete remission (CR) after a cycle of PUVA phototherapy. The U.S. Cutaneous Lymphoma Consortium (USCLC) guidelines suggest that the patient should be kept in the maintenance phase, defined as a 'period of gradual decrease of frequency of UVL [ultraviolet light] while in clinical remission before discontinuation of phototherapy' by slowly tapering the number of psoralen-ultraviolet A (PUVA) applications over time up to clinical relapse. The USCLC guidelines also suggest a standardized schedule for the maintenance phase. Alternatively, the patient could end PUVA therapy and go straight to follow-up. The aim of this critically appraised topic (CAT) was to determine if a maintenance phase gives a significant benefit in terms of relapse rate (RR) and RFI in patients affected by early-stage MF who had achieved CR under PUVA phototherapy. Embase, PubMed and TRIP databases were searched for 'mycosis fungoides' AND [('photochemotherapy' OR 'puva') OR 'psoralen'] in June 2016. Three articles matched our inclusion criteria and are discussed in this CAT. In this field of research the literature is poor and the reported level of evidence is low. Only one of the studies was conducted prospectively, and none were randomized. No significant difference in terms of reduction in relapse rate or increase in RFI in patients who underwent a PUVA maintenance phase emerged when compared with those who went for simple follow-up. Further randomized clinical trials (RCTs) are required in order to evaluate maintenance phase vs. no treatment before it can be favoured as the standard protocol of treatment in early-stage MF. At the time of writing this paper, we report an ongoing Austrian multicentre RCT (Clinical Trial.gov identifier: NCT01686594) that will hopefully give useful results in this topic. © 2017 British Association of Dermatologists.

  9. A microfluidic sub-critical water extraction instrument

    Science.gov (United States)

    Sherrit, Stewart; Noell, Aaron C.; Fisher, Anita; Lee, Mike C.; Takano, Nobuyuki; Bao, Xiaoqi; Kutzer, Thomas C.; Grunthaner, Frank

    2017-11-01

    This article discusses a microfluidic subcritical water extraction (SCWE) chip for autonomous extraction of amino acids from astrobiologically interesting samples. The microfluidic instrument is composed of three major components. These include a mixing chamber where the soil sample is mixed and agitated with the solvent (water), a subcritical water extraction chamber where the sample is sealed with a freeze valve at the chip inlet after a vapor bubble is injected into the inlet channels to ensure the pressure in the chip is in equilibrium with the vapor pressure and the slurry is then heated to ≤200 °C in the SCWE chamber, and a filter or settling chamber where the slurry is pumped to after extraction. The extraction yield of the microfluidic SCWE chip process ranged from 50% compared to acid hydrolysis and 80%-100% compared to a benchtop microwave SCWE for low biomass samples.

  10. Mobility: A Critical Appraisal

    DEFF Research Database (Denmark)

    McIntosh, James; D. Munk, Martin

    that traditional methods used in the analysis of mobility tables will produce biased and, hence, unreliable estimates of the model's parameters if there are individual attributes that can be observed by the researcher like ability, for example. We also show that the schemata that are used to define social classes...... based on occupational groupings can be tested using classical statistical methods. Using Danish mobility data we found that there were plausible situations where these schemata are rejected by the data. A model of income was developed whose structural parameters could be estimated consistently....... This was then estimated on a Danish longitudinal data base in which respondents were surveyed in 1976 and again in 2000. The main conclusions are that household income depends significantly on parental background variables and in spite of the fact that Denmark has many universal social programmes devoted to improving...

  11. A critical appraisal of 'Shingrix', a novel herpes zoster subunit vaccine (HZ/Su or GSK1437173A) for varicella zoster virus.

    Science.gov (United States)

    Bharucha, Tehmina; Ming, Damien; Breuer, Judith

    2017-08-03

    HZ/Su, branded as 'Shingrix', is one of the newest vaccines to be submitted for multi-national regulatory approval. It is targeted to prevent shingles, a global concern with aging populations. A live attenuated vaccine for shingles has been available for over a decade, however it is contraindicated in specific subgroups of people, and there are added concerns regarding long-term immunogenicity. HZ/Su is the first subunit vaccine developed to protect against shingles. This paper provides a critical appraisal of current evidence regarding HZ/Su.

  12. Contemporary treatment of patients with chronic total occlusion: critical appraisal of different state-of-the-art techniques and devices.

    Science.gov (United States)

    García-García, Héctor M; Kukreja, Neville; Daemen, Joost; Tanimoto, Shuzou; van Mieghem, Carlos; Gonzalo, Nieves; van Weenen, Sander; van der Ent, Martin; Sianos, Georgios; de Feyter, Pim; Serruys, Patrick W

    2007-08-01

    To describe the contemporary approach of chronic total occlusion (CTO) treatment of patients at the Thoraxcenter, Rotterdam, The Netherlands. Additionally, to make a critical appraisal of the performance of state-of-the-art CTO dedicated guidewires and devices in a prospective registry of patients. During 20 months, a total of 160 consecutive patients (165 CTOs) were enrolled. The mean age was 61.5+/-11.1 years and 83.6% were male. In 91.5% of the patients this was the first attempt to open the CTO and 93.8% were de novo. The overall success rate was 60.6%. A median of 1 guiding catheter was used per case (Range: 1 to 9) and a median of 4 guidewires (Range: 1 to 11; 13 different types). 74.5% patients required more than one guidewire/device for the treatment of the CTO. The guidewires that most frequently crossed the CTO were the following: PT Graphix intermediate 33.0%, Miracle 3 g 27.4% and Crosswire NT 25.5%. The only device tested as a first option for the treatment of the CTOs was the CROSSER. Overall, the CROSSER system was used in 23 (13.9%) patients with a success rate of 60.9%. The Point 9(R) X-80 Laser catheter was used in 10 (6.1%) patients with a success rate of 60%. Another 3 patients were treated with the Point 7(R) laser catheter. Both were used either to facilitate the crossing of the balloon, or to treat primarily in-stent restenosis occlusions. The SafeCross(R) System was used in 15 (9.1%) patients and the success rate in these patients was 46.7%. The most common strategy used in this registry was the use of an over-the-wire balloon in 81.5% of the cases. The parallel wire technique was used in 27.3% of the cases and in 12.7% was converted into a "see-saw" technique. When a large false lumen was created, re-entry into the true lumen was attempted in 21.2% of the cases, by means of IVUS guided approach and/or the use of stiffer guidewires, such as a Confianza guidewire. Retrograde recanalisation was attempted in 10 cases (6.1%), in three cases a

  13. Appraisal Report

    DEFF Research Database (Denmark)

    Schleimann, Finn; Enemark, Ulrika; Vagnby, Bo Hellisen

    Appraisal of continued support to Ghana's health sector for a third phase covering 2003 - 2007. Funding recommended with DKK 340 million over five years.......Appraisal of continued support to Ghana's health sector for a third phase covering 2003 - 2007. Funding recommended with DKK 340 million over five years....

  14. Considerations in the construction of an instrument to assess attitudes regarding critical illness gene variation research.

    Science.gov (United States)

    Freeman, Bradley D; Kennedy, Carie R; Bolcic-Jankovic, Dragana; Eastman, Alexander; Iverson, Ellen; Shehane, Erica; Celious, Aaron; Barillas, Jennifer; Clarridge, Brian

    2012-02-01

    Clinical studies conducted in intensive care units are associated with logistical and ethical challenges. Diseases investigated are precipitous and life-threatening, care is highly technological, and patients are often incapacitated and decision-making is provided by surrogates. These investigations increasingly involve collection of genetic data. The manner in which the exigencies of critical illness impact attitudes regarding genetic data collection is unstudied. Given interest in understanding stakeholder preferences as a foundation for the ethical conduct of research, filling this knowledge gap is timely. The conduct of opinion research in the critical care arena is novel. This brief report describes the development of parallel patient/surrogate decision-maker quantitative survey instruments for use in this environment. Future research employing this instrument or a variant of it with diverse populations promises to inform research practices in critical illness gene variation research.

  15. Development of instrument for assessing students’ critical and creative thinking ability

    Science.gov (United States)

    Herpiana, R.; Rosidin, U.

    2018-01-01

    The purpose of this study was to develop instruments to measure critical thinking ability and creative students in the topics of physics simple harmonic motion. The research method used was research development with application of procedures including research and data collection, planning, and initial product development. The participants of the study were thirty-four tenth grade students and five physics teachers of physics who were selected randomly from schools in the province of Lampung. The data collected by using test and analyzed in quantitative descriptive. Initial data showed that students’ critical and creative thinking ability were still low and instruments to assess students’ critical thinking skills and creative students was not yet available. Most of assessment conducted focused on memorization. Thus, the researchers developed a draft of instrument in the form of the test description based on criteria that encouraged students’ activity in understanding the concepts, strategies and decision/solution in dealing with problems. The development of the instrument was conducted considering real-world phenomena in the form of pictures and stories, description of the situation, and verbal presentation.

  16. How to Measure Critical Health Competences: Development and Validation of the Critical Health Competence Test (CHC Test)

    Science.gov (United States)

    Steckelberg, Anke; Hulfenhaus, Christian; Kasper, Jurgen; Rost, Jurgen; Muhlhauser, Ingrid

    2009-01-01

    Consumers' autonomy regarding health increasingly requires competences to critically appraise health information. Critical health literacy refers to the concept of evidence-based medicine. Instruments to measure these competences in curriculum evaluation and surveys are lacking. We aimed to develop and validate an instrument to measure critical…

  17. The critical natural capital, environmental politics' s instrument for the natural resources

    International Nuclear Information System (INIS)

    Lopera C, Sergio Hernando

    2003-01-01

    This work presents the concept of The Critical Natural Capital (CNC), this concept is based on the criterion of strong sustainability and is a fundamental instrument for the design of protection environmental political. In order to advance in the comprehension of this concept we use the capital concept to define the natural capital and then to specify when this can be considered critic. We show some methodologies proposed in the literature for the implementation of a politic of environmental protection based in the CNC; Finally, we thing that this concept is very usefulness for the redesign of the Environment policy in Colombia

  18. A Microsoft-Excel-based tool for running and critically appraising network meta-analyses--an overview and application of NetMetaXL.

    Science.gov (United States)

    Brown, Stephen; Hutton, Brian; Clifford, Tammy; Coyle, Doug; Grima, Daniel; Wells, George; Cameron, Chris

    2014-09-29

    The use of network meta-analysis has increased dramatically in recent years. WinBUGS, a freely available Bayesian software package, has been the most widely used software package to conduct network meta-analyses. However, the learning curve for WinBUGS can be daunting, especially for new users. Furthermore, critical appraisal of network meta-analyses conducted in WinBUGS can be challenging given its limited data manipulation capabilities and the fact that generation of graphical output from network meta-analyses often relies on different software packages than the analyses themselves. We developed a freely available Microsoft-Excel-based tool called NetMetaXL, programmed in Visual Basic for Applications, which provides an interface for conducting a Bayesian network meta-analysis using WinBUGS from within Microsoft Excel. . This tool allows the user to easily prepare and enter data, set model assumptions, and run the network meta-analysis, with results being automatically displayed in an Excel spreadsheet. It also contains macros that use NetMetaXL's interface to generate evidence network diagrams, forest plots, league tables of pairwise comparisons, probability plots (rankograms), and inconsistency plots within Microsoft Excel. All figures generated are publication quality, thereby increasing the efficiency of knowledge transfer and manuscript preparation. We demonstrate the application of NetMetaXL using data from a network meta-analysis published previously which compares combined resynchronization and implantable defibrillator therapy in left ventricular dysfunction. We replicate results from the previous publication while demonstrating result summaries generated by the software. Use of the freely available NetMetaXL successfully demonstrated its ability to make running network meta-analyses more accessible to novice WinBUGS users by allowing analyses to be conducted entirely within Microsoft Excel. NetMetaXL also allows for more efficient and transparent

  19. Ultrasound Shear Wave Elastography for Liver Disease. A Critical Appraisal of the Many Actors on the Stage.

    Science.gov (United States)

    Piscaglia, F; Salvatore, V; Mulazzani, L; Cantisani, V; Schiavone, C

    2016-02-01

    In the last 12 - 18 months nearly all ultrasound manufacturers have arrived to implement ultrasound shear wave elastography modality in their equipment for the assessment of chronic liver disease; the few remaining players are expected to follow in 2016.When all manufacturers rush to a new technology at the same time, it is evident that the clinical demand for this information is of utmost value. Around 1990, there was similar demand for color Doppler ultrasound; high demand for contrast-enhanced ultrasonography was evident at the beginning of this century, and around 2010 demand increased for strain elastography. However, some issues regarding the new shear wave ultrasound technologies must be noted to avoid misuse of the resulting information for clinical decisions. As new articles are expected to appear in 2016 reporting the findings of the new technologies from various companies, we felt that the beginning of this year was the right time to present an appraisal of these issues. We likewise expect that in the meantime EFSUMB will release a new update of the existing guidelines 1 2.The first ultrasound elastography method became available 13 years ago in the form of transient elastography with Fibroscan(®) 3. It was the first technique providing non-invasive quantitive information about the stiffness of the liver and hence regarding the amount of fibrosis in chronic liver disease 3. The innovation was enormous, since a non-invasive modality was finally available to provide findings otherwise achievable only by liver biopsy. In fact, prior to ultrasound elastography, a combination of conventional and Doppler ultrasound parameters were utilized to inform the physician about the presence of cirrhosis and portal hypertension 4. However, skilled operators were required, reproducibility and diagnostic accuracy were suboptimal, and it was not possible to differentiate the pre-cirrhotic stages of fibrosis. All these limitations were substantially improved by

  20. Development of Authentic Assessment instruments for Critical Thinking skills in Global Warming with a Scientific Approach

    Directory of Open Access Journals (Sweden)

    R. Surya Damayanti

    2017-12-01

    Full Text Available This study aims to develop an authentic assessment instrument to measure critical thinking skills in global warming learning and to describe the suitability, easiness, and usefulness of the use instruments which are developed base on the teacher’s opinion.   The development design is carried out by Borg & Gall (2003 development model, which is conducted with seven stages: information gathering stage, planning stage, product development stage, product test stage, product revision stage, field trial stage, and final product. The test subjects are students and teachers in SMA Lampung Tengah by using purposive sampling technique.  Global warming learning using authentic assessment consists of a series of learning activities, including observing, discussing, exploring, associating and communicating.  The results show the authentic assessment techniques global warming to measure and cultivate critical thinking skills consisting of written tests, performance, portfolios, projects, and attitudes.  The developed assessment model meets content and constructs validity, and effectively improves students' critical thinking skills and has a high level of suitability, easiness, and usefulness well-being. The assessment techniques are used in global warming learning are performance assessment techniques, portfolios, projects, products, and attitude that together contribute to the improvement of critical thinking skills on 97,4% of global warming learning.

  1. Lower extremity amputation rates in people with diabetes as an indicator of health systems performance. A critical appraisal of the data collection 2000-2011 by the Organization for Economic Cooperation and Development (OECD)

    NARCIS (Netherlands)

    Carinci, F.; Massi Benedetti, M.; Klazinga, N. S.; Uccioli, L.

    2016-01-01

    Critical appraisal of secondary data made available by the OECD for the time frame 2000-2011. Comparison of trends and variation of amputations in people with diabetes across OECD countries. Generalized estimating equations to test the statistical significance of the annual change adjusting for

  2. Safety critical FPGA-based NPP instrumentation and control systems: assessment, development and implementation

    Energy Technology Data Exchange (ETDEWEB)

    Bakhmach, E. S.; Siora, A. A.; Tokarev, V. I. [Research and Production Corporation Radiy, 29 Geroev Stalingrada Str., Kirovograd 25006 (Ukraine); Kharchenko, V. S.; Sklyar, V. V.; Andrashov, A. A., E-mail: marketing@radiy.co [Center for Safety Infrastructure-Oriented Research and Analysis, 37 Astronomicheskaya Str., Kharkiv 61085 (Ukraine)

    2010-10-15

    The stages of development, production, verification, licensing and implementation methods and technologies of safety critical instrumentation and control systems for nuclear power plants (NPP) based on FPGA (Field Programmable Gates Arrays) technologies are described. A life cycle model and multi-version technologies of dependability and safety assurance of FPGA-based instrumentation and control systems are discussed. An analysis of NPP instrumentation and control systems construction principles developed by Research and Production Corporation Radiy using FPGA-technologies and results of these systems implementation and operation at Ukrainian and Bulgarian NPP are presented. The RADIY{sup TM} platform has been designed and developed by Research and Production Corporation Radiy, Ukraine. The main peculiarity of the RADIY{sup TM} platform is the use of FPGA as programmable components for logic control operation. The FPGA-based RADIY{sup TM} platform used for NPP instrumentation and control systems development ensures sca lability of system functions types, volume and peculiarities (by changing quantity and quality of sensors, actuators, input/output signals and control algorithms); sca lability of dependability (safety integrity) (by changing a number of redundant channel, tiers, diagnostic and reconfiguration procedures); sca lability of diversity (by changing types, depth and method of diversity selection). (Author)

  3. Safety critical FPGA-based NPP instrumentation and control systems: assessment, development and implementation

    International Nuclear Information System (INIS)

    Bakhmach, E. S.; Siora, A. A.; Tokarev, V. I.; Kharchenko, V. S.; Sklyar, V. V.; Andrashov, A. A.

    2010-10-01

    The stages of development, production, verification, licensing and implementation methods and technologies of safety critical instrumentation and control systems for nuclear power plants (NPP) based on FPGA (Field Programmable Gates Arrays) technologies are described. A life cycle model and multi-version technologies of dependability and safety assurance of FPGA-based instrumentation and control systems are discussed. An analysis of NPP instrumentation and control systems construction principles developed by Research and Production Corporation Radiy using FPGA-technologies and results of these systems implementation and operation at Ukrainian and Bulgarian NPP are presented. The RADIY TM platform has been designed and developed by Research and Production Corporation Radiy, Ukraine. The main peculiarity of the RADIY TM platform is the use of FPGA as programmable components for logic control operation. The FPGA-based RADIY TM platform used for NPP instrumentation and control systems development ensures sca lability of system functions types, volume and peculiarities (by changing quantity and quality of sensors, actuators, input/output signals and control algorithms); sca lability of dependability (safety integrity) (by changing a number of redundant channel, tiers, diagnostic and reconfiguration procedures); sca lability of diversity (by changing types, depth and method of diversity selection). (Author)

  4. Utilizing Team Debate to Increase Student Abilities for Mentoring and Critical Appraisal of Global Health Care in Doctor of Nursing Practice Programs.

    Science.gov (United States)

    Elliott, Naomi; Farnum, Karen; Beauchesne, Michelle

    2016-01-01

    Although graduates of doctor of nursing practice (DNP) programs are expected to demonstrate competence in advanced clinical scholarship, mentoring, and leadership, little is published about how team debate on a global health care topic supports DNP student learning and skill development. This article reports on an illuminative evaluation of DNP student learning experiences of team debate in the context of a 2-week international school program in Ireland. A focused illuminative evaluation approach involving a cohort of seven DNP students, who had participated in an international school team debate, was used. Data were collected using a Web-based qualitative questionnaire designed to elicit in-depth reflective accounts of DNP students' learning experiences. Content analysis revealed that team debate on a global health care topic enhanced learning in relation to fostering critical thinking and critical appraisal skills; encouraging teamwork; providing opportunities for mentoring, relationship building, and socialization into profession; and, from the DNP student perspective, increasing knowledge and global understanding of health care. This evaluation provides insights for nurse educators into the benefits of introducing team debate as a group activity to enhancing scholarly inquiry and mentoring skills of DNP students. Further research to evaluate team debate in other nurse education programs is needed. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Critical appraisal of the use of alpha lipoic acid (thioctic acid in the treatment of symptomatic diabetic polyneuropathy

    Directory of Open Access Journals (Sweden)

    McIlduff CE

    2011-09-01

    Full Text Available Courtney E McIlduff, Seward B RutkoveDepartment of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USABackground: The most common of the neuropathies associated with diabetes mellitus, diabetic sensorimotor polyneuropathy (DSPN is a syndrome of diffuse, length-dependent, symmetric nerve dysfunction. The condition is linked with substantial morbidity, frequent healthcare utilization, and compromised quality of life due to related discomfort. Correspondingly, antidepressants, anticonvulsants, and opioids are regularly prescribed with the goal of pain control. However, the agents rarely provide complete pain relief and fail to address progression of the disorder. Whereas strict blood glucose control can slow the onset and worsening of DSPN, near-normoglycemia is not easily attainable. Evidence implicating oxidative processes in the pathogenesis of DSPN offers one potentially important therapeutic avenue. Due to its properties as a potent antioxidant, alpha lipoic acid (ALA could mitigate the development of DSPN and attenuate resultant symptoms and signs. Approved for treatment of DSPN in Germany, the agent is not more widely used due to uncertainty about its efficacy and reported adverse effects. Here we review the effectiveness and tolerability of ALA in the treatment of symptomatic DSPN.Methods: The MEDLINE, EMBASE, and Cochrane Library databases were searched for English-language literature on the topic. Randomized, blinded studies comparing parenteral and oral ALA with placebo in the treatment of peripheral neuropathy in diabetic adults were selected. Analysis included studies with a level of evidence of at least 2b.Results: The current appraisal summarizes data from 1160 participants in the ALADIN, SYDNEY, ORPIL, SYDNEY 2, and ALADIN III trials. In four of the studies, ALA provided significant improvement in manifestations of DSPN.Conclusion: Treatment with ALA 600 mg iv daily for 3 weeks represents a well-tolerated and effective

  6. Instrumentation

    International Nuclear Information System (INIS)

    Prieur, G.; Nadi, M.; Hedjiedj, A.; Weber, S.

    1995-01-01

    This second chapter on instrumentation gives little general consideration on history and classification of instrumentation, and two specific states of the art. The first one concerns NMR (block diagram of instrumentation chain with details on the magnets, gradients, probes, reception unit). The first one concerns precision instrumentation (optical fiber gyro-meter and scanning electron microscope), and its data processing tools (programmability, VXI standard and its history). The chapter ends with future trends on smart sensors and Field Emission Displays. (D.L.). Refs., figs

  7. A Microsoft-Excel-based tool for running and critically appraising network meta-analyses—an overview and application of NetMetaXL

    Science.gov (United States)

    2014-01-01

    Background The use of network meta-analysis has increased dramatically in recent years. WinBUGS, a freely available Bayesian software package, has been the most widely used software package to conduct network meta-analyses. However, the learning curve for WinBUGS can be daunting, especially for new users. Furthermore, critical appraisal of network meta-analyses conducted in WinBUGS can be challenging given its limited data manipulation capabilities and the fact that generation of graphical output from network meta-analyses often relies on different software packages than the analyses themselves. Methods We developed a freely available Microsoft-Excel-based tool called NetMetaXL, programmed in Visual Basic for Applications, which provides an interface for conducting a Bayesian network meta-analysis using WinBUGS from within Microsoft Excel. . This tool allows the user to easily prepare and enter data, set model assumptions, and run the network meta-analysis, with results being automatically displayed in an Excel spreadsheet. It also contains macros that use NetMetaXL’s interface to generate evidence network diagrams, forest plots, league tables of pairwise comparisons, probability plots (rankograms), and inconsistency plots within Microsoft Excel. All figures generated are publication quality, thereby increasing the efficiency of knowledge transfer and manuscript preparation. Results We demonstrate the application of NetMetaXL using data from a network meta-analysis published previously which compares combined resynchronization and implantable defibrillator therapy in left ventricular dysfunction. We replicate results from the previous publication while demonstrating result summaries generated by the software. Conclusions Use of the freely available NetMetaXL successfully demonstrated its ability to make running network meta-analyses more accessible to novice WinBUGS users by allowing analyses to be conducted entirely within Microsoft Excel. NetMetaXL also allows

  8. Instrumentation

    International Nuclear Information System (INIS)

    Decreton, M.

    2000-01-01

    SCK-CEN's research and development programme on instrumentation aims at evaluating the potentials of new instrumentation technologies under the severe constraints of a nuclear application. It focuses on the tolerance of sensors to high radiation doses, including optical fibre sensors, and on the related intelligent data processing needed to cope with the nuclear constraints. Main achievements in these domains in 1999 are summarised

  9. Instrumentation

    Energy Technology Data Exchange (ETDEWEB)

    Decreton, M

    2001-04-01

    SCK-CEN's research and development programme on instrumentation involves the assessment and the development of sensitive measurement systems used within a radiation environment. Particular emphasis is on the assessment of optical fibre components and their adaptability to radiation environments. The evaluation of ageing processes of instrumentation in fission plants, the development of specific data evaluation strategies to compensate for ageing induced degradation of sensors and cable performance form part of these activities. In 2000, particular emphasis was on in-core reactor instrumentation applied to fusion, accelerator driven and water-cooled fission reactors. This involved the development of high performance instrumentation for irradiation experiments in the BR2 reactor in support of new instrumentation needs for MYRRHA, and for diagnostic systems for the ITER reactor.

  10. Instrumentation

    International Nuclear Information System (INIS)

    Decreton, M.

    2001-01-01

    SCK-CEN's research and development programme on instrumentation involves the assessment and the development of sensitive measurement systems used within a radiation environment. Particular emphasis is on the assessment of optical fibre components and their adaptability to radiation environments. The evaluation of ageing processes of instrumentation in fission plants, the development of specific data evaluation strategies to compensate for ageing induced degradation of sensors and cable performance form part of these activities. In 2000, particular emphasis was on in-core reactor instrumentation applied to fusion, accelerator driven and water-cooled fission reactors. This involved the development of high performance instrumentation for irradiation experiments in the BR2 reactor in support of new instrumentation needs for MYRRHA, and for diagnostic systems for the ITER reactor

  11. Do screening-preventative interventions in asymptomatic pregnancies reduce the risk of preterm delivery--a critical appraisal of the literature.

    Science.gov (United States)

    Varma, Rajesh; Gupta, Janesh K; James, David K; Kilby, Mark D

    2006-08-01

    Recent research has suggested that women who experience preterm delivery (PTD) may be identified earlier in pregnancy and before onset of symptoms. Interventions commenced at this earlier asymptomatic stage may offer an opportunity to prevent PTD or lengthen gestation sufficiently to reduce adverse perinatal outcome. Our objective was to examine the evidence that supports or refutes this approach to preventing PTD. We therefore conducted a systematic search and critical appraisal of the identified literature. We found evidence that introducing screening-preventative strategies for asymptomatic pregnancies may reduce the rate of PTD. Evidence for screening and selective treatment exists for: asymptomatic bacteriuria; bacterial vaginosis in low-risk population groups; elective cervical cerclage in high-risk pregnancies; indicated cervical cerclage in women with short cervical length on ultrasound; prophylactic progesterone supplementation in high-risk pregnancies, and smoking cessation. However, for most other strategies, such as increased antenatal attendance, or routine administration of prophylactic micronutrients, the evidence is inconsistent and conflicting. Information on neonatal outcomes apart from PTD (such as serious neonatal morbidity and mortality) was found to be lacking in most studies. It was therefore not possible to establish whether preventing PTD or prolonging gestation would correlate to improved perinatal outcome, and this lessened the potential clinical usefulness of any proposed preventative strategy. No studies were found that evaluated the effectiveness of combining screening-preventative strategies. The review concludes with a suggested an antenatal management plan designed to prevent PTD based on current practice and the evidence presented in this article.

  12. The health economics of ankle and foot sprains and fractures: A systematic review of English-language published papers. Part 1: Overview and critical appraisal.

    Science.gov (United States)

    Bielska, Iwona A; Wang, Xiang; Lee, Raymond; Johnson, Ana P

    2017-07-01

    Ankle and foot sprains and fractures are common injuries affecting many individuals, often requiring considerable and costly medical interventions. The objectives of this systematic review are to collect, assess, and critically appraise the published literature on the health economics of ankle and foot injury (sprain and fracture) treatment. A systematic literature review of Ovid MEDLINE, EMBASE, Cochrane DSR, ACP Journal Club, AMED, Ovid Healthstar, and CINAHL was conducted for English-language studies on the costs of treating ankle and foot sprains and fractures published from January 1980 to December 2014. Two reviewers assessed the articles for study quality and abstracted data. The literature search identified 2047 studies of which 32 were analyzed. A majority of the studies were published in the last decade. A number of the studies did not report full economic information, including the sources of the direct and indirect costs, as suggested in the guidelines. The perspective used in the analysis was missing in numerous studies, as was the follow-up time period of participants. Only five of the studies undertook a sensitivity analysis which is required whenever there are uncertainties regarding cost data. This systematic review found that publications do not consistently report on the components of health economics methodology, which in turn limits the quality of information. Future studies undertaking economic evaluations should ensure that their methods are transparent and understandable so as to yield accurate interpretation for assistance in forthcoming economic evaluations and policy decision-making. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Instrumentation

    International Nuclear Information System (INIS)

    Decreton, M.

    2002-01-01

    SCK-CEN's R and D programme on instrumentation involves the development of advanced instrumentation systems for nuclear applications as well as the assessment of the performance of these instruments in a radiation environment. Particular emphasis is on the use of optical fibres as umbilincal links of a remote handling unit for use during maintanance of a fusion reacor, studies on the radiation hardening of plasma diagnostic systems; investigations on new instrumentation for the future MYRRHA accelerator driven system; space applications related to radiation-hardened lenses; the development of new approaches for dose, temperature and strain measurements; the assessment of radiation-hardened sensors and motors for remote handling tasks and studies of dose measurement systems including the use of optical fibres. Progress and achievements in these areas for 2001 are described

  14. Instrumentation

    Energy Technology Data Exchange (ETDEWEB)

    Decreton, M

    2002-04-01

    SCK-CEN's R and D programme on instrumentation involves the development of advanced instrumentation systems for nuclear applications as well as the assessment of the performance of these instruments in a radiation environment. Particular emphasis is on the use of optical fibres as umbilincal links of a remote handling unit for use during maintanance of a fusion reacor, studies on the radiation hardening of plasma diagnostic systems; investigations on new instrumentation for the future MYRRHA accelerator driven system; space applications related to radiation-hardened lenses; the development of new approaches for dose, temperature and strain measurements; the assessment of radiation-hardened sensors and motors for remote handling tasks and studies of dose measurement systems including the use of optical fibres. Progress and achievements in these areas for 2001 are described.

  15. Instrumentation

    Energy Technology Data Exchange (ETDEWEB)

    Decreton, M

    2000-07-01

    SCK-CEN's research and development programme on instrumentation aims at evaluating the potentials of new instrumentation technologies under the severe constraints of a nuclear application. It focuses on the tolerance of sensors to high radiation doses, including optical fibre sensors, and on the related intelligent data processing needed to cope with the nuclear constraints. Main achievements in these domains in 1999 are summarised.

  16. Introduction: The effectiveness of impact assessment instruments

    OpenAIRE

    Cashmore, M; Bond, A; Sadler, B

    2009-01-01

    The global application of impact assessment instruments to achieve a variety of policy integration goals (e.g. the mainstreaming of environmental, gender or economic efficiency concerns) continues to proliferate. These instruments represent important components of contemporary political governance and hence are an important locus for applied research. This special issue of Impact Assessment and Project Appraisal critically examines 'state-of-the-art' knowledge and understanding of the effecti...

  17. Teorías sobre la globalización: una evaluación crítica (Theories on globalization: a critical appraisal

    Directory of Open Access Journals (Sweden)

    Antonio Martín Cabello

    2014-12-01

    Full Text Available Este artículo trata de revisar la abundante y dispersas literatura científica con el objetivo de identificar las principales explicaciones del proceso de globalización. El objetivo es construir una perspectiva meta-teórica que nos permita desarrollar una teoría de la globalización más analítica para evitar las trampas del debate político. Las diferentes teorías son analizadas utilizando una aproximación histórica y analítica para detectar el mecanismo explicativo propuesto para interpretar la globalización. Se han encontrado cuatro aproximaciones principales: la tesis del comercio, la tesis de la modernización, la tesis tecnológica y la tesis del capitalismo. Después, el artículo trata de hacer una evaluación crítica de las cuatro tesis sobre la globalización. Por último, concluye discutiendo las críticas posmodernas al carácter moderno de la teoría de la globalización. | This paper tries to review the abundant and scattered scientific literature in order to identify the main scientific explanations of the globalization process. The global objective is to build a meta-theoretical perspective that allows us to develop a more analytical globalization theory to avoid the political debate traps. Diverse theories are analysed using a historical and analytical approach to detect the explanatory mechanism proposed to interpret globalization. Four main approaches have been found: the thesis of international trade, the modernization thesis, the technological thesis and the thesis of capitalism. Afterwards, the paper tries to make a critical appraisal of the four globalization thesis. Finally, the article concludes discussing the postmodern criticism to the modern character of the globalization theory.

  18. Instrumentation

    International Nuclear Information System (INIS)

    Umminger, K.

    2008-01-01

    A proper measurement of the relevant single and two-phase flow parameters is the basis for the understanding of many complex thermal-hydraulic processes. Reliable instrumentation is therefore necessary for the interaction between analysis and experiment especially in the field of nuclear safety research where postulated accident scenarios have to be simulated in experimental facilities and predicted by complex computer code systems. The so-called conventional instrumentation for the measurement of e. g. pressures, temperatures, pressure differences and single phase flow velocities is still a solid basis for the investigation and interpretation of many phenomena and especially for the understanding of the overall system behavior. Measurement data from such instrumentation still serves in many cases as a database for thermal-hydraulic system codes. However some special instrumentation such as online concentration measurement for boric acid in the water phase or for non-condensibles in steam atmosphere as well as flow visualization techniques were further developed and successfully applied during the recent years. Concerning the modeling needs for advanced thermal-hydraulic codes, significant advances have been accomplished in the last few years in the local instrumentation technology for two-phase flow by the application of new sensor techniques, optical or beam methods and electronic technology. This paper will give insight into the current state of instrumentation technology for safety-related thermohydraulic experiments. Advantages and limitations of some measurement processes and systems will be indicated as well as trends and possibilities for further development. Aspects of instrumentation in operating reactors will also be mentioned.

  19. Assisted reproductive techniques for cattle breeding in developing countries: a critical appraisal of their value and limitations.

    Science.gov (United States)

    Rodriguez-Martinez, H

    2012-01-01

    Commercialization of animal biotechnologies, including those related to reproduction [also known as assisted reproductive techniques (ARTS)], is an increasing reality in developing countries, following the enormous flow of information around us and the increasing global commercial interests in areas where cattle production has its major assets. The present review discusses the achievements of various biotechnological tools for reproduction in cattle including semen handling for artificial insemination (AI), superovulation and embryo transfer (MOET), in vitro handling of oocytes and production of embryos, reproductive cloning and emerging technologies (sex selection, gene targeting and nuclear transfer for livestock transgenesis, genomics for marker-assisted selection, etc.). The application of these technologies for cattle breeding is critically discussed in relation to their impact in the improvement of the efficiency of dairy and beef production in developed and - particularly - in developing countries, which ultimately rule the possibilities of a competitive and sound production of food for human consumption. Despite the remarkable progress made and the punctual importance of some of the above-mentioned technologies, AI remains the most important assisted reproductive technology (ART) in developing countries. Any attempt to gain widespread of any other ART under the predominant economical conditions in developing countries ought to match the simplicity and the success of AI as a breeding tool. © 2012 Blackwell Verlag GmbH.

  20. Betel quid, chewing habits and difficult intubation: A case report and critical appraisal of evidence for practice.

    Science.gov (United States)

    Narendra, P L; Hegde, Harihar V; Vijaykumar, T K; Nallamilli, Samson

    2015-01-01

    Betel quid is used by 10-20% of world of population. Oral submucus fibrosis (OSF) is a chronic premalignant disease common in South Asian countries where betel quid is chewed. It is characterized by juxtaepithelial fibrosis of oral cavity and limited mouth opening, which can cause difficult intubation. A recent study in Taiwan has revealed long-term betel nut chewing is not predictor of difficult intubation. We describe two cases of OSF and critically analyze this study and its implications for clinical practice. OSF is now seen in Saudi Arabia and western countries with use of commercial betel quid substitutes. Although betel quid without tobacco is used in Taiwan, available evidence suggests rapid and early development of OSF where commercial chewing products like Pan Masala are used in India. Effects of betel quid may vary depending on the composition of quid and chewing habits. Studies where personal habits are involved must be analyzed carefully for external validity. Even though, Taiwan study is controlled, its validity outside Taiwan is highly questionable. Since OSF can cause unanticipated difficult intubation, thus during preanesthetic assessment, history of betel quid chewing, more importantly use of commercial chewing products is more likely to give clues to severity of OSF and possible difficult intubation. Further controlled trails in populations where commercial chewing products are used is necessary to detect association of chewing habits and difficult intubation.

  1. Establishing a library of resources to help people understand key concepts in assessing treatment claims—The “Critical thinking and Appraisal Resource Library” (CARL)

    Science.gov (United States)

    Chalmers, Iain; Atkinson, Patricia; Badenoch, Douglas; Oxman, Andrew D.; Austvoll-Dahlgren, Astrid; Nordheim, Lena; Krause, L. Kendall; Schwartz, Lisa M.; Woloshin, Steven; Burls, Amanda; Mosconi, Paola; Hoffmann, Tammy; Cusack, Leila; Albarqouni, Loai; Glasziou, Paul

    2017-01-01

    Background People are frequently confronted with untrustworthy claims about the effects of treatments. Uncritical acceptance of these claims can lead to poor, and sometimes dangerous, treatment decisions, and wasted time and money. Resources to help people learn to think critically about treatment claims are scarce, and they are widely scattered. Furthermore, very few learning-resources have been assessed to see if they improve knowledge and behavior. Objectives Our objectives were to develop the Critical thinking and Appraisal Resource Library (CARL). This library was to be in the form of a database containing learning resources for those who are responsible for encouraging critical thinking about treatment claims, and was to be made available online. We wished to include resources for groups we identified as ‘intermediaries’ of knowledge, i.e. teachers of schoolchildren, undergraduates and graduates, for example those teaching evidence-based medicine, or those communicating treatment claims to the public. In selecting resources, we wished to draw particular attention to those resources that had been formally evaluated, for example, by the creators of the resource or independent research groups. Methods CARL was populated with learning-resources identified from a variety of sources—two previously developed but unmaintained inventories; systematic reviews of learning-interventions; online and database searches; and recommendations by members of the project group and its advisors. The learning-resources in CARL were organised by ‘Key Concepts’ needed to judge the trustworthiness of treatment claims, and were made available online by the James Lind Initiative in Testing Treatments interactive (TTi) English (www.testingtreatments.org/category/learning-resources).TTi English also incorporated the database of Key Concepts and the Claim Evaluation Tools developed through the Informed Healthcare Choices (IHC) project (informedhealthchoices.org). Results We have

  2. Establishing a library of resources to help people understand key concepts in assessing treatment claims-The "Critical thinking and Appraisal Resource Library" (CARL).

    Science.gov (United States)

    Castle, John C; Chalmers, Iain; Atkinson, Patricia; Badenoch, Douglas; Oxman, Andrew D; Austvoll-Dahlgren, Astrid; Nordheim, Lena; Krause, L Kendall; Schwartz, Lisa M; Woloshin, Steven; Burls, Amanda; Mosconi, Paola; Hoffmann, Tammy; Cusack, Leila; Albarqouni, Loai; Glasziou, Paul

    2017-01-01

    People are frequently confronted with untrustworthy claims about the effects of treatments. Uncritical acceptance of these claims can lead to poor, and sometimes dangerous, treatment decisions, and wasted time and money. Resources to help people learn to think critically about treatment claims are scarce, and they are widely scattered. Furthermore, very few learning-resources have been assessed to see if they improve knowledge and behavior. Our objectives were to develop the Critical thinking and Appraisal Resource Library (CARL). This library was to be in the form of a database containing learning resources for those who are responsible for encouraging critical thinking about treatment claims, and was to be made available online. We wished to include resources for groups we identified as 'intermediaries' of knowledge, i.e. teachers of schoolchildren, undergraduates and graduates, for example those teaching evidence-based medicine, or those communicating treatment claims to the public. In selecting resources, we wished to draw particular attention to those resources that had been formally evaluated, for example, by the creators of the resource or independent research groups. CARL was populated with learning-resources identified from a variety of sources-two previously developed but unmaintained inventories; systematic reviews of learning-interventions; online and database searches; and recommendations by members of the project group and its advisors. The learning-resources in CARL were organised by 'Key Concepts' needed to judge the trustworthiness of treatment claims, and were made available online by the James Lind Initiative in Testing Treatments interactive (TTi) English (www.testingtreatments.org/category/learning-resources).TTi English also incorporated the database of Key Concepts and the Claim Evaluation Tools developed through the Informed Healthcare Choices (IHC) project (informedhealthchoices.org). We have created a database of resources called CARL

  3. Critical appraisal of the role of glucosamine and chondroitin in the management of osteoarthritis of the knee

    Directory of Open Access Journals (Sweden)

    Steven J Narvy

    2010-02-01

    Full Text Available Steven J Narvy1, C Thomas Vangsness Jr21Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; 2Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USAAbstract: Osteoarthritis (OA is the most common musculoskeletal disease in the United States, with rising prevalence. Medical management of OA involves acetaminophen, nonsteroidal anti-inflammatory drugs, and other analgesics, all of which are of variable efficacy and are associated with significant side effects and toxicities. The purpose of this review is to critically evaluate the efficacy of glucosamine and chondroitin, both as single agents and in combination, for the treatment of knee OA. Also evaluated were the level of evidence and funding support of the included articles. Almost every included trial of glucosamine sulfate, glucosamine hydrochloride, and chondroitin sulfate has found the safety of these compounds to be equal to that of placebo, though their therapeutic efficacy in decreasing knee OA pain and improving joint function is variable. Additionally, there are data to support a role of these agents in reducing radiographic progression of knee OA. Industry involvement, however, remains prominent. Further, more comprehensive study by independent researchers free of industry ties is necessary to identify a subset of patients in whom the use of glucosamine and/or chondroitin would be most beneficial. These agents may be safely tried as an initial therapy in select OA patients prior to initiating therapy with nonsteroidal anti-inflammatory drugs, acetaminophen, and other traditional medications.Keywords: glucosamine sulfate, glucosamine hydrochloride, chondroitin sulfate, knee osteoarthritis, nutritional supplement, nutraceutical

  4. Instruments

    International Nuclear Information System (INIS)

    Buehrer, W.

    1996-01-01

    The present paper mediates a basic knowledge of the most commonly used experimental techniques. We discuss the principles and concepts necessary to understand what one is doing if one performs an experiment on a certain instrument. (author) 29 figs., 1 tab., refs

  5. Nuclear incident monitor criticality alarm instrument for the Savannah River Site: Technical manual

    International Nuclear Information System (INIS)

    Jenkins, J.B.

    1996-01-01

    The Savannah River Site is a Department of Energy facility. The facility stores, processes, and works with fissionable material at a number of locations. Technical standards and US Department of Energy orders, require these locations to be monitored by criticality alarm systems under certain circumstances. The Savannah River Site calls such instruments Nuclear Incident Monitors or NIMs. The Sole purpose of the Nuclear Incident Monitor is to provide an immediate evacuation signal in the case of an accidental criticality in order to minimize personnel exposure to radiation. The new unit is the third generation Nuclear Incident Monitor at the Savannah River Site. The second generation unit was developed in 1979. It was designed to eliminate vacuum-tube circuits, and was the first solid state NIM at SRS. The major design objectives of the second generation NIM were to improve reliability and reduce maintenance costs. Ten prototype units have been built and tested. This report describes the design of the new NIM and the testing that took place to verify its acceptability

  6. The Power of Developmental Performance Appraisal

    Directory of Open Access Journals (Sweden)

    Nasser Salim Alghanabousi

    2013-02-01

    Full Text Available Development of employee performance is a must that any organization should take into account to be a successful in achieving its goals. However, the tools of developing that performance are varying based on the type of the organization and the nature of the work performed. Performance appraisal is one of the effective tools that help the organization to measure the accomplishment of its goals, if implemented effectively. In education, it became evident that performance appraisal of educators is an essential element of the development of any educational institution. To make the performance appraisal fruitful, the development element should be dominant in the sense that other elements of the appraisal should serve the broad aim of the appraisal process. Therefore, a well-designed and comprehensive system is needed to cover all the aspects of appraisal process that include of the goals, criteria, instruments, and continuous support.

  7. A critical appraisal of neuroimaging studies of bipolar disorder: toward a new conceptualization of underlying neural circuitry and roadmap for future research

    Science.gov (United States)

    Phillips, Mary L; Swartz, Holly A.

    2014-01-01

    Objective This critical review appraises neuroimaging findings in bipolar disorder in emotion processing, emotion regulation, and reward processing neural circuitry, to synthesize current knowledge of the neural underpinnings of bipolar disorder, and provide a neuroimaging research “roadmap” for future studies. Method We examined findings from all major studies in bipolar disorder that used fMRI, volumetric analyses, diffusion imaging, and resting state techniques, to inform current conceptual models of larger-scale neural circuitry abnormalities in bipolar disorder Results Bipolar disorder can be conceptualized in neural circuitry terms as parallel dysfunction in bilateral prefrontal cortical (especially ventrolateral prefrontal cortical)-hippocampal-amygdala emotion processing and emotion regulation neural circuitries, together with an “overactive” left-sided ventral striatal-ventrolateral and orbitofrontal cortical reward processing circuitry, that result in characteristic behavioral abnormalities associated with bipolar disorder: emotional lability, emotional dysregulation and heightened reward sensitivity. A potential structural basis for these functional abnormalities are gray matter decreases in prefrontal and temporal cortices, amygdala and hippocampus, and fractional anisotropy decreases in white matter tracts connecting prefrontal and subcortical regions. Conclusion Neuroimaging studies of bipolar disorder clearly demonstrate abnormalities in neural circuitries supporting emotion processing, emotion regulation and reward processing, although there are several limitations to these studies. Future neuroimaging research in bipolar disorder should include studies adopting dimensional approaches; larger studies examining neurodevelopmental trajectories in bipolar disorder and at-risk youth; multimodal neuroimaging studies using integrated systems approaches; and studies using pattern recognition approaches to provide clinically useful, individual

  8. Robotic-Assisted Procedures in Pediatric Surgery: A Critical Appraisal of the Current Best Evidence in Comparison to Conventional Minimally Invasive Surgery.

    Science.gov (United States)

    Friedmacher, Florian; Till, Holger

    2015-11-01

    In recent years, the use of robotic-assisted surgery (RAS) has expanded within pediatric surgery. Although increasing numbers of pediatric RAS case-series have been published, the level of evidence remains unclear, with authors mainly focusing on the comparison with open surgery rather than the corresponding laparoscopic approach. The aim of this study was to critically appraise the published literature comparing pediatric RAS with conventional minimally invasive surgery (MIS) in order to evaluate the current best level of evidence. A systematic literature-based search for studies comparing pediatric RAS with corresponding MIS procedures was performed using multiple electronic databases and sources. The level of evidence was determined using the Oxford Centre for Evidence-based Medicine (OCEBM) criteria. A total of 20 studies met defined inclusion criteria, reporting on five different procedures: fundoplication (n=8), pyeloplasty (n=8), nephrectomy (n=2), gastric banding (n=1), and sleeve gastrectomy (n=1). Included publications comprised 5 systematic reviews and 15 cohort/case-control studies (OCEBM Level 3 and 4, respectively). No studies of OCEBM Level 1 or 2 were identified. Limited evidence indicated reduced operative time (pyeloplasty) and shorter hospital stay (fundoplication) for pediatric RAS, whereas disadvantages were longer operative time (fundoplication, nephrectomy, gastric banding, and sleeve gastrectomy) and higher total costs (fundoplication and sleeve gastrectomy). There were no differences reported for complications, success rates, or short-term outcomes between pediatric RAS and conventional MIS in these procedures. Inconsistency was found in study design and follow-up with large clinical heterogeneity. The best available evidence for pediatric RAS is currently OCEBM Level 3, relating only to fundoplication and pyeloplasty. Therefore, higher-quality studies and comparative data for other RAS procedures in pediatric surgery are required.

  9. Instrumentation

    International Nuclear Information System (INIS)

    Muehllehner, G.; Colsher, J.G.

    1982-01-01

    This chapter reviews the parameters which are important to positron-imaging instruments. It summarizes the options which various groups have explored in designing tomographs and the methods which have been developed to overcome some of the limitations inherent in the technique as well as in present instruments. The chapter is not presented as a defense of positron imaging versus single-photon or other imaging modality, neither does it contain a description of various existing instruments, but rather stresses their common properties and problems. Design parameters which are considered are resolution, sampling requirements, sensitivity, methods of eliminating scattered radiation, random coincidences and attenuation. The implementation of these parameters is considered, with special reference to sampling, choice of detector material, detector ring diameter and shielding and variations in point spread function. Quantitation problems discussed are normalization, and attenuation and random corrections. Present developments mentioned are noise reduction through time-of-flight-assisted tomography and signal to noise improvements through high intrinsic resolution. Extensive bibliography. (U.K.)

  10. Sources of Life Strengths Appraisal Scale: A Multidimensional Approach to Assessing Older Adults’ Perceived Sources of Life Strengths

    Directory of Open Access Journals (Sweden)

    Prem S. Fry

    2014-01-01

    Full Text Available Both cognitive and psychosocial theories of adult development stress the fundamental role of older adults’ appraisals of the diverse sources of cognitive and social-emotional strengths. This study reports the development of a new self-appraisal measure that incorporates key theoretical dimensions of internal and external sources of life strengths, as identified in the gerontological literature. Using a pilot study sample and three other independent samples to examine older adults’ appraisals of their sources of life strengths which helped them in their daily functioning and to combat life challenges, adversity, and losses, a psychometric instrument having appropriate reliability and validity properties was developed. A 24-month followup of a randomly selected sample confirmed that the nine-scale appraisal measure (SLSAS is a promising instrument for appraising older adults’ sources of life strengths in dealing with stresses of daily life’s functioning and also a robust measure for predicting outcomes of resilience, autonomy, and well-being for this age group. A unique strength of the appraisal instrument is its critically relevant features of brevity, simplicity of language, and ease of administration to frail older adults.

  11. Performance appraisal of coaches: Acomparative study | Surujlal ...

    African Journals Online (AJOL)

    Within the sport environment, the performance appraisal of coaches continues to be an issue. The performance appraisal of coaches is critical to sport organizations since major decisions like rewarding or terminating coaches is based on it. The purpose of this study was to examine whether any differences exist with regard ...

  12. Measuring the critical resolved shear stresses in Mg alloys by instrumented nanoindentation

    International Nuclear Information System (INIS)

    Sánchez-Martín, R.; Pérez-Prado, M.T.; Segurado, J.; Bohlen, J.; Gutiérrez-Urrutia, I.; Llorca, J.; Molina-Aldareguia, J.M.

    2014-01-01

    One of the main limiting factors in the development of new magnesium (Mg) alloys with enhanced mechanical behavior is the need to use vast experimental campaigns for microstructure and property screening. For example, the influence of new alloying additions on the critical resolved shear stresses (CRSSs) is currently evaluated by a combination of macroscopic single-crystal experiments and crystal plasticity finite-element simulations (CPFEM). This time-consuming process could be considerably simplified by the introduction of high-throughput techniques for efficient property testing. The aim of this paper is to propose a new and fast, methodology for the estimation of the CRSSs of hexagonal close-packed metals which, moreover, requires small amounts of material. The proposed method, which combines instrumented nanoindentation and CPFEM modeling, determines CRSS values by comparison of the variation of hardness (H) for different grain orientations with the outcome of CPFEM. This novel approach has been validated in a rolled and annealed pure Mg sheet, whose H variation with grain orientation has been successfully predicted using a set of CRSSs taken from recent crystal plasticity simulations of single-crystal experiments. Moreover, the proposed methodology has been utilized to infer the effect of the alloying elements of an MN11 (Mg–1% Mn–1% Nd) alloy. The results support the hypothesis that selected rare earth intermetallic precipitates help to bring the CRSS values of basal and non-basal slip systems closer together, thus contributing to the reduced plastic anisotropy observed in these alloys

  13. A modification design and adjusting test for instruments and control system of critical assembly

    International Nuclear Information System (INIS)

    Wu Manrong; Li Guangjian

    1996-12-01

    A more reliable and safe control system and it's instruments for HFETRCA (high flux engineering test reactor critical assembly) have been built. In the system high performance CMOS unit was used, which has high integration, strong anti-interference and high trigger threshold. In the design of control rod driving circuit, the speed negative feedback principle was applied that results in more stable rotating rate of motors of transmission mechanism and more flexibility of adjusting rod speed. In order to improve reactor safety in accident, additional control circuit is equipped, by which not only control rods with electromagnet will rapidly drop but also other control rods will insert at the speed of 2∼6 times faster than the normal inserting speed. The key technique in the adjustment and new method of anti-interference are also introduced. After more than 40 times physical experiments with (4 x 4 - 4) fuel element in HFETRC, it is proved that the design and adjustment of the system is successful and they can be used as a reference to others. (3 figs., 2 tabs.)

  14. Sandia's Geothermal Advanced Drill Rig Instrumentation Assists Critical Oil and Gas Drilling Operation

    International Nuclear Information System (INIS)

    Staller, George E.; Whitlow, Gary

    1999-01-01

    On November 23, 1998, an 18,000-foot-deep wild-cat natural gas well being drilled near Bakersfield, CA blew out and caught fire. All attempts to kill this well failed, and the well continues to flow under limited control, producing large volumes of natural gas, salt water, and some oil. The oil and some of the water is being separated and trucked off site, and the remaining gas and water is being burned at the well head. A relief well is being drilled approximately one-quarter mile away in an attempt to intercept the first well. If the relief well is successful, it will be used to cement in and kill the first well. Epoch Wellsite Services, Inc., the mud-logging company for the initial well and the relief well, requested Sandia's rolling float meter (RFM) for these critical drilling operations. The RFM is being used to measure the mud outflow rate and detect kicks while drilling the relief well, which will undoubtedly encounter reservoir conditions similar to those responsible for the blow out. Based on its prior experience with the RFM, Epoch believes that it is the only instrument capable of providing the level of accuracy and response to mudflow needed to quickly detect kicks and minimize the risk of a blowout on this second critical well. In response to the urgent request from industry, Sandia and Epoch technicians installed the RFM on the relief well return line, and completed its initial calibration. The data from the RFM is displayed in real-time for the driller, the companyman, and the toolpusher via Epochs RIGWATCH Drilling Instmmentation System. The RFM has already detected several small kicks while drilling toward the annulus of the blown out well. A conventional paddle meter is located downstream of the RFM to provide redundancy and the opportunity to compare the two meters in an actual drilling operation, The relief well is nearing 14,000 feet deep, targeting an intercept of the first well near 17,600 feet. The relief well is expected to be completed in

  15. Innovation and organisational performance: A critical review of the instruments used to measure organisational performance

    Directory of Open Access Journals (Sweden)

    Tebogo Sethibe

    2016-10-01

    Full Text Available Background: Innovation is recognised as one of the most important determinant of organisational performance. Yet, the results of studies that investigate the relationship between innovation and organisational performance are inconclusive. The inconsistency has been attributed to a number of factors, which include, among others, the measures used to evaluate organisational performance. Aim: This study was set out to identify, categorise and critically analyse the instruments used to assess organisational performance when investigating the relationship between innovation and organisational performance. Setting: The study focuses on all scientific publications reporting on organisational performance, inclusive of both financial and non-financial indicators of performance, and are not limited to any specific country or industry. Methods: The systematic literature review methodology was used to identify studies which investigated the relationship between innovation and organisational performance. Once identified, articles were analysed on the way organisational performance was measured. Classification was done with reference to financial and non-financial indicators, accounting and market-based, as well as objective and subjective measures. Results: The findings show that profitability, sales growth and return on assets (ROA are the most preferred accounting-based financial measures of organisation performance. In addition, Tobin’s Q was found to be the most favoured market-based financial measure of organisational performance. The study further reveals that market share, customer satisfaction and productivity are the most popular non-financial-based measures of organisational performance. Conclusion: The use of measures of organisational performance is often left to the discussion of the researcher, which is not implicitly wrong, but does little to contribute to the body of knowledge on this important topic. Researchers are firstly urged to

  16. The appraisal of clinical guidelines in dentistry.

    Science.gov (United States)

    Glenny, Anne-Marie; Worthington, Helen V; Clarkson, Jan E; Esposito, Marco

    2009-01-01

    To appraise the reported processes involved in the development of published dental guidelines. Electronic databases were searched to identify guidelines making recommendations for any health professional within dentistry. All included guidelines were appraised using the Appraisal of Guidelines Research and Evaluation (AGREE) instrument. A total of 105 guidelines met the inclusion criteria. The appraised guidelines showed lack of rigour in their development (median score 14.3%; range 0% to 100%). Only 10 (9.5%) were coded as 'strongly recommend' by at least two assessors. If recommendations within clinical guidelines are to be relied upon, the methods used in their development must be explicit and free from bias. When using the AGREE checklist to make decisions on whether or not to implement individual sets of guidelines, the findings of the present assessment reinforce the need for more than two assessors to be included in the appraisal of each set of guidelines.

  17. Impact on mortality of prompt admission to critical care for deteriorating ward patients: an instrumental variable analysis using critical care bed strain.

    Science.gov (United States)

    Harris, Steve; Singer, Mervyn; Sanderson, Colin; Grieve, Richard; Harrison, David; Rowan, Kathryn

    2018-05-07

    To estimate the effect of prompt admission to critical care on mortality for deteriorating ward patients. We performed a prospective cohort study of consecutive ward patients assessed for critical care. Prompt admissions (within 4 h of assessment) were compared to a 'watchful waiting' cohort. We used critical care strain (bed occupancy) as a natural randomisation event that would predict prompt transfer to critical care. Strain was classified as low, medium or high (2+, 1 or 0 empty beds). This instrumental variable (IV) analysis was repeated for the subgroup of referrals with a recommendation for critical care once assessed. Risk-adjusted 90-day survival models were also constructed. A total of 12,380 patients from 48 hospitals were available for analysis. There were 2411 (19%) prompt admissions (median delay 1 h, IQR 1-2) and 9969 (81%) controls; 1990 (20%) controls were admitted later (median delay 11 h, IQR 6-26). Prompt admissions were less frequent (p care. In the risk-adjust survival model, 90-day mortality was similar. After allowing for unobserved prognostic differences between the groups, we find that prompt admission to critical care leads to lower 90-day mortality for patients assessed and recommended to critical care.

  18. Continued Evaluation of the Pulse-Echo Ultrasonic Instrument for Critical Velocity Determination during Hanford Tank Waste Transfer Operations - 12518

    Energy Technology Data Exchange (ETDEWEB)

    Denslow, Kayte M.; Bontha, Jagannadha R.; Adkins, Harold E.; Jenks, Jeromy W.J.; Burns, Carolyn A.; Schonewill, Philip P.; Hopkins, Derek F. [Pacific Northwest National Laboratory, Richland, Washington 99354 (United States); Thien, Michael G.; Wooley, Theodore A. [Washington River Protection Solutions, Richland, Washington 99354 (United States)

    2012-07-01

    The delivery of Hanford double-shell tank waste to the Hanford Tank Waste Treatment and Immobilization Plant (WTP) will be governed by specific Waste Acceptance Criteria that are identified in ICD 19 - Interface Control Document for Waste Feed. Waste must be certified as acceptable before it can be delivered to the WTP. The fluid transfer velocity at which solid particulate deposition occurs in waste slurry transport piping (critical velocity) is a key waste parameter that must be accurately characterized to determine if the waste is acceptable for transfer to the WTP. In 2010 Washington River Protection Solutions and the Pacific Northwest National Laboratory began evaluating the ultrasonic PulseEcho instrument to accurately identify critical velocities in a horizontal slurry transport pipeline for slurries containing particles with a mean particle diameter of >50 micrometers. In 2011 the PulseEcho instrument was further evaluated to identify critical velocities for slurries containing fast-settling, high-density particles with a mean particle diameter of <15 micrometers. This two-year evaluation has demonstrated the ability of the ultrasonic PulseEcho instrument to detect the onset of critical velocity for a broad range of physical and rheological slurry properties that are likely encountered during the waste feed transfer operations between the Hanford tank farms and the WTP. (authors)

  19. Review of Eurotunnel’s Decision-Making Process A critical appraisal of Ex-ante vs. Ex-post studies

    OpenAIRE

    Chevroulet, Tristan; Sevestre, Aymeric; Geambasu, Georgeta; Reynaud, Christian

    2007-01-01

    This document provides a methodical investigation of the main assessment steps that have led to the construction of Eurotunnel and it compares the results of the analyses that were achieved before the key decisions with the results of studies that have been undertaken since Eurotunnel is in operation. The analysis of successful and mismatched appraisals is followed by a series of methodological recommendations aimed at helping decision-makers to gain from positive experience and to avoid the ...

  20. Quality Appraisal of Single-Subject Experimental Designs: An Overview and Comparison of Different Appraisal Tools

    Science.gov (United States)

    Wendt, Oliver; Miller, Bridget

    2012-01-01

    Critical appraisal of the research literature is an essential step in informing and implementing evidence-based practice. Quality appraisal tools that assess the methodological quality of experimental studies provide a means to identify the most rigorous research suitable for evidence-based decision-making. In single-subject experimental research,…

  1. An evidence-based environmental perspective of manufactured silver nanoparticle in syntheses and applications: A systematic review and critical appraisal of peer-reviewed scientific papers

    International Nuclear Information System (INIS)

    Tolaymat, Thabet M.; El Badawy, Amro M.; Genaidy, Ash; Scheckel, Kirk G.; Luxton, Todd P.; Suidan, Makram

    2010-01-01

    research articles. Data and information extraction relied on the type of synthesis methods, that is, synthesized silver nanoparticles in general and specific applications, nanocomposites, and bimetallic techniques. The following items were gathered for: type of silver salt, solvent, reducing agent, stabilizing agent, size, and type of application/nanocomposite/bimetallic, and template (for nanocomposites). The description of evidence was presented in tabular format. The critical appraisal was analyzed in graphical format and discussed. Results: An analysis of the scientific literature suggests that most synthesis processes produce spherical silver nanoparticles with less than 20 nm diameter. Silver nanoparticles are often synthesized via reduction of AgNO 3 , dissolution in water, and utilization of reductants also acting as capping or stabilizing agents for the control of particle size to ensure a relatively stable suspension. Two of the most commonly used reductants and stabilizing agents are NaBH 4 and citrate which yield particles with a negative surface charge over the environmental pH range (3-10). The environmental perspectives of these parameters are discussed. Concluding remarks: It is expected that the antibacterial property of bulk silver is carried over and perhaps enhanced, to silver nanoparticles. Therefore, when one examines the environmental issues associated with the manufacture and use of silver nanoparticle-based products, the antibacterial effects should always be taken into account particularly at the different stages of the product lifecycle. Currently, there are two arguments in the scientific literature about the mechanisms of antimicrobial properties of silver nanoparticles as they relate to colloidal silver particles and inonic silver. Methodologies of risk assessment and control have to account for both arguments.

  2. An evidence-based environmental perspective of manufactured silver nanoparticle in syntheses and applications: A systematic review and critical appraisal of peer-reviewed scientific papers

    Energy Technology Data Exchange (ETDEWEB)

    Tolaymat, Thabet M., E-mail: tolaymat.thabet@epa.gov [USEPA Office of Research and Development, National Risk Management Laboratory, 26 West Martin Luther King Drive, Cincinnati, OH 45224 (United States); El Badawy, Amro M. [Dept. of Civil and Environmental Engineering, University of Cincinnati, Cincinnati, OH (United States); Genaidy, Ash [WorldTek Inc, Cincinnati, OH (United States); Scheckel, Kirk G.; Luxton, Todd P. [USEPA Office of Research and Development, National Risk Management Laboratory, 26 West Martin Luther King Drive, Cincinnati, OH 45224 (United States); Suidan, Makram [Dept. of Civil and Environmental Engineering, University of Cincinnati, Cincinnati, OH (United States)

    2010-02-01

    research articles. Data and information extraction relied on the type of synthesis methods, that is, synthesized silver nanoparticles in general and specific applications, nanocomposites, and bimetallic techniques. The following items were gathered for: type of silver salt, solvent, reducing agent, stabilizing agent, size, and type of application/nanocomposite/bimetallic, and template (for nanocomposites). The description of evidence was presented in tabular format. The critical appraisal was analyzed in graphical format and discussed. Results: An analysis of the scientific literature suggests that most synthesis processes produce spherical silver nanoparticles with less than 20 nm diameter. Silver nanoparticles are often synthesized via reduction of AgNO{sub 3}, dissolution in water, and utilization of reductants also acting as capping or stabilizing agents for the control of particle size to ensure a relatively stable suspension. Two of the most commonly used reductants and stabilizing agents are NaBH{sub 4} and citrate which yield particles with a negative surface charge over the environmental pH range (3-10). The environmental perspectives of these parameters are discussed. Concluding remarks: It is expected that the antibacterial property of bulk silver is carried over and perhaps enhanced, to silver nanoparticles. Therefore, when one examines the environmental issues associated with the manufacture and use of silver nanoparticle-based products, the antibacterial effects should always be taken into account particularly at the different stages of the product lifecycle. Currently, there are two arguments in the scientific literature about the mechanisms of antimicrobial properties of silver nanoparticles as they relate to colloidal silver particles and inonic silver. Methodologies of risk assessment and control have to account for both arguments.

  3. Methodological Aspects for Preclinical Evaluation of Gadolinium Presence in Brain Tissue: Critical Appraisal and Suggestions for Harmonization-A Joint Initiative.

    Science.gov (United States)

    Robert, Philippe; Frenzel, Thomas; Factor, Cécile; Jost, Gregor; Rasschaert, Marlène; Schuetz, Gunnar; Fretellier, Nathalie; Boyken, Janina; Idée, Jean-Marc; Pietsch, Hubertus

    2018-04-13

    Gadolinium (Gd)-based contrast agents (GBCAs) are pharmaceuticals that have been approved for 30 years and used daily in millions of patients worldwide. Their clinical benefits are indisputable. Recently, unexpected long-term presence of Gd in the brain has been reported by numerous retrospective clinical studies and confirmed in preclinical models particularly after linear GBCA (L-GBCA) compared with macrocyclic GBCA (M-GBCA). Even if no clinical consequences of Gd presence in brain tissue has been demonstrated so far, in-depth investigations on potential toxicological consequences and the fate of Gd in the body remain crucial to potentially adapt the clinical use of GBCAs, as done during the nephrogenic systemic fibrosis crisis. Preclinical models are instrumental in the understanding of the mechanism of action as well as the potential safety consequences. However, such models may be associated with risks of biases, often related to the protocol design. Selection of adequate terminology is also crucial. This review of the literature intends to summarize and critically discuss the main methodological aspects for accurate design and translational character of preclinical studies.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

  4. Clinical assessment of spasticity in children with cerebral palsy: a critical review of available instruments

    NARCIS (Netherlands)

    Scholtes, Vanessa A. B.; Becher, Jules G.; Beelen, Anita; Lankhorst, Gustaaf J.

    2006-01-01

    This study reviews the instruments used for the clinical assessment of spasticity in children with cerebral palsy, and evaluates their compliance with the concept of spasticity, defined as a velocity-dependent increase in muscle tone to passive stretch. Searches were performed in Medline, Embase,

  5. Critical Appraisal of the Quality of Evidence Addressing the Diagnosis, Prognosis, and Management of Peripheral Artery Disease in Patients With Diabetic Foot Ulceration.

    Science.gov (United States)

    Ali, Stephen R; Ozdemir, Baris A; Hinchliffe, Robert J

    2018-06-13

    There is a paucity of robust evidence on prevention and management of diabetic foot ulcers (DFUs) to inform treatment. This study appraises the current quality of the evidence addressing diagnosis, prognosis, and management of peripheral artery disease (PAD) in patients with DFUs using a newly devised 21 point scoring (TOPS) disease specific research appraisal tool published by the International Working Group on the Diabetic Foot (IWGDF) and European Wound Management Association. The 2015 IWGDF guidance on diagnosis, prognosis, and management of PAD in patients with DFUs was used to identify studies pertaining to prevention and management. Two reviewers assessed these articles against TOPS, which examines study design, conduct, and outcome reporting. The overall median score was 8 (3-12/21). The median design total score was 2 (0-4/11). The median conduct total score was 2 (1-4/6). The median outcomes total score was 3 (1-4/4). There was improvement with time in overall total (Spearman Rho 0.39, p = .0005), design total (0.35, p = .0023), and outcomes total (0.35, p = .0002), but not conduct total (-0.03, p = .8132) scores. Although this analysis revealed an improvement over time in the overall calibre of studies, the present quality remains poor on which to inform the diagnosis, management, and prognosis of patients with PAD and diabetic foot ulceration. Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.

  6. Instrumented Measurement of Balance and Postural Control in Individuals with Lower Limb Amputation: A Critical Review

    Science.gov (United States)

    Jayakaran, Prasath; Johnson, Gillian M.; Sullivan, S. John; Nitz, Jennifer C.

    2012-01-01

    Measurement of balance and postural performance that underpins activities of daily living is important in the rehabilitation of individuals with a lower limb amputation (LLA), and there are a number of methods and strategies available for this purpose. To provide an evidence-based choice of approach, this review aims to critically review the tasks…

  7. Where Critical Postmodern Theory Meets Practice: Working in the Intersection of Instrumental, Social, and Cultural Education.

    Science.gov (United States)

    Grace, Andre P.

    1997-01-01

    Outlines a critical postmodern adult education practice that is inclusive of peoples and knowledges and inhabits a dynamic space. Key concepts include identity difference; intersection of power relations; community as a social contract; and conflict, voice, and dialog for transformative learning. (SK)

  8. Critical evaluation of the determination of zirconium and hafnium by instrumental and radiochemical neutron activation analysis

    International Nuclear Information System (INIS)

    Burger, Mario; Kraehenbuehl, Urs

    1991-01-01

    Neutron activation analysis (instrument or radiochemical) is suitable for the determination of zirconium and hafnium in samples of geochemical origin only when sufficient attention is paid to inter-fering nuclides. The size of the necessary correction for INAA depends on the composition of the sample; this problem is discussed. The radio-chemical technique which is recommended involves separation of the samples, precipitations and anion-exchange separation. Results are given for various standard reference materials and for meteorites. (author). 12 refs.; 1 fig.; 9 tabs

  9. Learning to Appraise the Quality of Qualitative Research Articles: A Contextualized Learning Object for Constructing Knowledge

    Science.gov (United States)

    Chenail, Ronald J.

    2011-01-01

    Helping beginning qualitative researchers critically appraise qualitative research articles is a common learning objective for introductory methodology courses. To aid students in achieving competency in appraising the quality of qualitative research articles, a multi-part activity incorporating the Critical Appraisal Skills Programme's (CASP)…

  10. Utility of Military Strategy as an Instrument of Foreign Policy | Ebaye ...

    African Journals Online (AJOL)

    This research has taken a critical appraisal of state actors in the international system, and the utility of military power as an instrument of foreign policy. The paper asserts as Osgood did, that one of the main prerequisite of a credible state actor is to develop the military compatibilities and political will, to back its diplomacy by ...

  11. What is the quality of economic evaluations of non-drug therapies? A systematic review and critical appraisal of economic evaluations of radiotherapy for cancer.

    Science.gov (United States)

    Barbieri, M; Weatherly, H L A; Ara, R; Basarir, H; Sculpher, M; Adams, R; Ahmed, H; Coles, C; Guerrero-Urbano, T; Nutting, C; Powell, M

    2014-10-01

    Breast, cervical and colorectal cancers are the three most frequent cancers in women, while lung, prostate and colorectal cancers are the most frequent in men. Much attention has been given to the economic evaluation of pharmaceuticals for treatment of cancer by the National Institute for Health and Care Excellence (NICE) in the UK and similar authorities internationally, while economic analysis developed for other types of anti-cancer interventions, including radiotherapy and surgery, are less common. Our objective was to review methods used in published cost-effectiveness studies evaluating radiotherapy for breast, cervical, colorectal, head and neck and prostate cancer, and to compare the economic evaluation methods applied with those defined in the guidelines used by the NICE technology appraisal programme. A systematic search of seven databases (MEDLINE, EMBASE, CDSR, NHSEED, HTA, DARE, EconLit) as well as research registers, the NICE website and conference proceedings was conducted in July 2012. Only economic evaluations of radiotherapy interventions in individuals diagnosed with cancer that included quality-adjusted life-years (QALYs) or life-years (LYs) were included. Included studies were appraised on the basis of satisfying essential, preferred and UK-specific methods requirements, building on the NICE Reference Case for economic evaluations and on other methods guidelines. A total of 29 studies satisfied the inclusion criteria (breast 14, colorectal 2, prostate 10, cervical 0, head and neck 3). Only two studies were conducted in the UK (13 in the USA). Among essential methods criteria, the main issue was that only three (10%) of the studies used clinical-effectiveness estimates identified through systematic review of the literature. Similarly, only eight (28%) studies sourced health-related quality-of-life data directly from patients with the condition of interest. Other essential criteria (e.g. clear description of comparators, patient group indication

  12. Theoretical foundations of shareholders' right to appraisal

    Directory of Open Access Journals (Sweden)

    Vasiljević Mirko

    2017-01-01

    Full Text Available Shareholders' right to appraisal represents a controversial topic of corporation law, which is why a relatively small number of countries accept it. In this article, the authors analyze the goals that are supposed to be achieved with the introduction of shareholders' appraisal rights. In this respect, traditional and modern explanations for the introduction or maintaining of this right have been presented. In the second part of this article, shareholders' right to appraisal has been critically examined, mostly from corporations' perspective. Afterwards, several potential causes of inefficiency of using this right have been identified. Perceiving pros and cons of shareholders' right to appraisal is of particular importance for Serbia, in order to draw a conclusion about harmonization of our legislative solutions with the theoretical foundations of this right.

  13. (Un)ethical behavior and performance appraisal: the role of affect, support, and organizational justice

    NARCIS (Netherlands)

    Jacobs, G.; Belschak, F.D.; den Hartog, D.N.

    2014-01-01

    Performance appraisals are widely used as an HR instrument. This study among 332 police officers examines the effects of performance appraisals from a behavioral ethics perspective. A mediation model relating justice perceptions of police officers’ last performance appraisal to their work affect,

  14. Models for mature T-cell lymphomas--a critical appraisal of experimental systems and their contribution to current T-cell tumorigenic concepts.

    Science.gov (United States)

    Warner, Kathrin; Crispatzu, Giuliano; Al-Ghaili, Nabil; Weit, Nicole; Florou, Vaia; You, M James; Newrzela, Sebastian; Herling, Marco

    2013-12-01

    Mature T-cell lymphomas/leukemias (MTCL) have been understudied lymphoid neoplasms that currently receive growing attention. Our historically rudimentary molecular understanding and dissatisfactory interventional success in this complex and for the most part poor-prognostic group of tumors is only slightly improving. A major limiting aspect in further progress in these rare neoplasms is the lack of suitable model systems that would substantially facilitate pathogenic studies and pre-clinical drug evaluations. Such representations of MTCL have thus far not been systematically appraised. We therefore provide an overview on existing models and point out their particular advantages and limitations in the context of the specific scientific questions. After addressing issues of species-specific differences and classifications, we summarize data on MTCL cell lines of human as well as murine origin, on murine strain predispositions to MTCL, on available models of genetically engineered mice, and on transplant systems. From an in-silico meta-analysis of available primary data of gene expression profiles on human MTCL we cross-reference genes reported to transform T-cells in mice and reflect on their general vs entity-restricted relevance and on target-promoter influences. Overall, we identify the urgent need for new models of higher fidelity to human MTCL with respect to their increasingly recognized diversity and to predictions of drug response. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. An Appraisal Of The Operation And Management Of Unit Trust ...

    African Journals Online (AJOL)

    An Appraisal Of The Operation And Management Of Unit Trust Schemes In Nigeria. ... Open Access DOWNLOAD FULL TEXT ... instead of being invested in shares or in money market instruments as a result of widespread financial illiteracy.

  16. Limitation of liability for maritime claims: Chronological critical review (international instruments and Croatian solutions

    Directory of Open Access Journals (Sweden)

    Vasilj Aleksandra V.

    2016-01-01

    Full Text Available Limitation of liability of shipowner can based on property or can be personal - shipowner responds to certain part of the property (for example ship or his entire assets to a certain amount. In the first case it is a real, and in the other the personal limitation of liability. On these principles all international instruments in this legal field have been developed. One of the well-known 'universal' principle of civil law says that the injurer must pay for a damage in full, in full extent and amount. However, when we are applying provisions of maritime law (as well as transport law in general on the liability for damages and its compensation, the situation is quite opposite. Though, that the amount of suffered damages is coming closer to said universal principle of civil law has been confirmed by Amendments to the Protocol to the Convention on Limitation of Liability for Maritime Claims 1996 (LLMC 1996. These Amendments increased amount of general (global limitation of liability for maritime claims by 51% compared to the amounts in LLMC. Increased amounts are applicable from 8th June 2015. Regarding these amendments, a number of issues can be placed: justification for introducing the institute of limitation of liability in general; reasons why the injurer is privileged in maritime (and broader in transport, in the context of the amount of the obligation of compensation for damage; and whether the application of the institute undermine the principle that is enshrined in the legal system of every modern country, according to which the injured party has the right to just compensation. On the other hand, justice can be taken as well as an argument just to implement the limitation of liability system.

  17. An improved Peltier effect-based instrument for critical temperature threshold measurement in cold- and heat-induced urticaria.

    Science.gov (United States)

    Magerl, M; Abajian, M; Krause, K; Altrichter, S; Siebenhaar, F; Church, M K

    2015-10-01

    Cold- and heat-induced urticaria are chronic physical urticaria conditions in which wheals, angioedema or both are evoked by skin exposure to cold and heat respectively. The diagnostic work up of both conditions should include skin provocation tests and accurate determination of critical temperature thresholds (CTT) for producing symptoms in order to be able to predict the potential risk that each individual patient faces and how this may be ameliorated by therapy. To develop and validate TempTest(®) 4, a simple and relatively inexpensive instrument for the accurate determination of CTT which may be used in clinical practice. TempTest(®) 4 has a single 2 mm wide 350 mm U-shaped Peltier element generating a temperature gradient from 4 °C to 44 °C along its length. Using a clear plastic guide placed over the skin after provocation, CTT values may be determined with an accuracy of ±1 °C. Here, TempTest(®) 4 was compared with its much more expensive predecessor, TempTest(®) 3, in inducing wheals in 30 cold urticaria patients. Both TempTest(®) 4 and TempTest(®) 3 induced wheals in all 30 patients between 8 ° and 28 °C. There was a highly significant (P < 0.0001) correlation between the instruments in the CTT values in individual patients. The TempTest(®) 4 is a simple, easy to use, licensed, commercially available and affordable instrument for the determination of CTTs in both cold- and heat-induced urticaria. © 2014 European Academy of Dermatology and Venereology.

  18. Implementing the IA stage and developing an instrument to assess the fidelity of critical time interventional: task shifting

    Directory of Open Access Journals (Sweden)

    Tatiana Fernandes Carpinteiro Silva

    2014-10-01

    Full Text Available One strategy that has been used for treat patients with mental health disorder is the implementation of psychosocial interventions. Like the development of a new drug, which requires safety studies before efficacy assessment, the psychosocial interventions should be implemented following defined stages, with the objective of increase the validity and reliability of such interventions. These stages are IA (pre-pilot, IB (pilot study, II (randomized clinical trial and III (additional studies. This study proposes a description of all activities carried out in implementation of the pre-pilot (IA Critical Time Intervention – Task Shifting (CTI-TS, including the development of manuals and the development of an instrument to assess fidelity to the original protocol. As a result, were performed the adaptation of instruments to be used in the pilot study, the adaptation of CTI-TS manual to Brazilian context, the adaptation of the agents CTI-TS training manual, as well the development of the CTI-TS assessment scale fidelity and its instruction manual. This allows multicentric studies conducted in different contexts could be performed avoiding biases. Considering that Brazil is a country that lacks resources allocated to mental care, it is expected that more psychosocial interventions can be implemented, since it was possible to develop the implementation process according to the methods recommended by the international scientific literature.

  19. 167: CRITICALLY APPRAISE OF THE REPORTING QUALITY OF RANDOMIZED CONTROLLED TRIALS ARTICLES IN THE FIELD OF DIABETES IN MEDICAL GUIDELINES IN IRAN

    Science.gov (United States)

    Aletaha, Azadeh; Baradaran, Hamid Reza; Soltani, Akbar; Ramezani, Amir

    2017-01-01

    Background and aims To determine the quality of randomized controlled clinical trial reports in diabetes research in Iran and their presence in domestic and foreign credible guidelines which can imply whether randomized controlled trial articles in the field of diabetes are of good quality or not with respect to their high level of received citations, quality and credibility. Method We included RCTs conducted on Diabetes mellitus in Iran. Animal studies, educational, interventions, and non-randomized trials were excluded. This was a bibliographic study examining published journal articles involving RCTs in diabetes research from Iranian authors. A systematic search of ten databases(ISI Web of science, Scopus, PubMed, Science Direct, The Cochrane Library, Taylor & Francis Online, Biomed Central, EBSCO, ProQuest and OVID)were undertaken from July 2004–2014. We excluded duplicated publications reporting the same groups of participants and intervention two independent reviewers identify all eligible articles specifically designed data extraction form. Two reviewers assessed the quality of reporting by CONSORT 2010 (Consolidated Standards of Reporting Trials) checklist statement and also evaluate each article with Scientometry tools in 260 valid English diabetes guidelines. Result Overall, we included 185 RCTs on diabetes mellitus, One hundred and eight five (185) studies were included and appraised. Half of them (55.7%) were published in Iranian journals. Most (89.7%) were parallel RCTs, and being performed on type2 diabetic patients (77.8%). Less than half of the CONSORT items (43.2%) were reported in studies, totally. The reporting of randomization and blinding were poor. A few studies 15.1% mentioned the method of random sequence generation and strategy of allocation concealment. And only 34.8% of trials report how blinding was applied. From 185 articles, twelve articles (10%) are presented in 260 Guidelines. Conclusion The reporting quality of abstracts of RCTs

  20. A Critical Appraisal of Foreign Language Research in Content and Language Integrated Learning, Young Language Learners, and Technology-Enhanced Language Learning Published in Spain (2003-2012)

    Science.gov (United States)

    Dooly, Melinda; Masats, Dolors

    2015-01-01

    This state-of-the-art review provides a critical overview of research publications in Spain in the last ten years in three areas of teaching and learning foreign languages (especially English): context and language integrated learning (CLIL), young language learners (YLL), and technology-enhanced language learning (TELL). These three domains have…

  1. Evidence appraisal: a scoping review, conceptual framework, and research agenda.

    Science.gov (United States)

    Goldstein, Andrew; Venker, Eric; Weng, Chunhua

    2017-11-01

    Critical appraisal of clinical evidence promises to help prevent, detect, and address flaws related to study importance, ethics, validity, applicability, and reporting. These research issues are of growing concern. The purpose of this scoping review is to survey the current literature on evidence appraisal to develop a conceptual framework and an informatics research agenda. We conducted an iterative literature search of Medline for discussion or research on the critical appraisal of clinical evidence. After title and abstract review, 121 articles were included in the analysis. We performed qualitative thematic analysis to describe the evidence appraisal architecture and its issues and opportunities. From this analysis, we derived a conceptual framework and an informatics research agenda. We identified 68 themes in 10 categories. This analysis revealed that the practice of evidence appraisal is quite common but is rarely subjected to documentation, organization, validation, integration, or uptake. This is related to underdeveloped tools, scant incentives, and insufficient acquisition of appraisal data and transformation of the data into usable knowledge. The gaps in acquiring appraisal data, transforming the data into actionable information and knowledge, and ensuring its dissemination and adoption can be addressed with proven informatics approaches. Evidence appraisal faces several challenges, but implementing an informatics research agenda would likely help realize the potential of evidence appraisal for improving the rigor and value of clinical evidence. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  2. Appraisal of Meconium at Delivery

    Science.gov (United States)

    Paes, Bosco A.; Thompson, Penelope

    1992-01-01

    A critical appraisal of the scientific literature on managing mesconium in labor identified 15 studies which were used to evaluate intervention strategies. Only four were randomized trials: two on the use of amnioinfusion in labor, one on the technique of bulb versus DeLee catheter suction of the newborn, and one on the need for endotracheal intubation and suction in meconium-stained neonates. Current practice is dictated by the most favorable tradeoff between benefit and risk because of limited scientific evidence. PMID:21221284

  3. Critical appraisal of RapidArc radiosurgery with flattening filter free photon beams for benign brain lesions in comparison to GammaKnife: a treatment planning study.

    Science.gov (United States)

    Abacioglu, Ufuk; Ozen, Zeynep; Yilmaz, Meltem; Arifoglu, Alptekin; Gunhan, Basri; Kayalilar, Namik; Peker, Selcuk; Sengoz, Meric; Gurdalli, Salih; Cozzi, Luca

    2014-05-21

    To evaluate the role of RapidArc (RA) for stereotactic radiosurgery (SRS) of benign brain lesions in comparison to GammaKnife (GK) based technique. Twelve patients with vestibular schwannoma (VS, n = 6) or cavernous sinus meningioma (CSM, n = 6) were planned for both SRS using volumetric modulated arc therapy (VMAT) by RA. 104 MV flattening filter free photon beams with a maximum dose rate of 2400 MU/min were selected. Data were compared against plans optimised for GK. A single dose of 12.5 Gy was prescribed. The primary objective was to assess treatment plan quality. Secondary aim was to appraise treatment efficiency. For VS, comparing best GK vs. RA plans, homogeneity was 51.7 ± 3.5 vs. 6.4 ± 1.5%; Paddick conformity Index (PCI) resulted 0.81 ± 0.03 vs. 0.84 ± 0.04. Gradient index (PGI) was 2.7 ± 0.2 vs. 3.8 ± 0.6. Mean target dose was 17.1 ± 0.9 vs. 12.9 ± 0.1 Gy. For the brain stem, D(1cm3) was 5.1 ± 2.0 Gy vs 4.8 ± 1.6 Gy. For the ipsilateral cochlea, D(0.1cm3) was 1.7 ± 1.0 Gy vs. 1.8 ± 0.5 Gy. For CSM, homogeneity was 52.3 ± 2.4 vs. 12.4 ± 0.6; PCI: 0.86 ± 0.05 vs. 0.88 ± 0.05; PGI: 2.6 ± 0.1 vs. 3.8 ± 0.5; D(1cm3) to brain stem was 5.4 ± 2.8 Gy vs. 5.2 ± 2.8 Gy; D(0.1cm3) to ipsi-lateral optic nerve was 4.2 ± 2.1 vs. 2.1 ± 1.5 Gy; D(0.1cm3) to optic chiasm was 5.9 ± 3.1 vs. 4.5 ± 2.1 Gy. Treatment time was 53.7 ± 5.8 (64.9 ± 24.3) minutes for GK and 4.8 ± 1.3 (5.0 ± 0.7) minutes for RA for schwannomas (meningiomas). SRS with RA and FFF beams revealed to be adequate and comparable to GK in terms of target coverage, homogeneity, organs at risk sparing with some gain in terms of treatment efficiency.

  4. Critical Appraisal of Microbiology Guidelines Endorsed by two Professional Organisations: Société Française De Microbiologie (SFM) and American Society of Microbiology (ASM).

    Science.gov (United States)

    Fonfrède, Michèle; Couaillac, Jean Paul; Augereau, Christine; Lepargneur, Jean Pierre; Watine, Joseph

    2012-07-01

    Medical practice guidelines (GLs) being tools that are mainly designed to evaluate medical professionals, it sounds logical, and fair, that professionals should in turn evaluate GLs. Microbiology being a medical discipline, we used the AGREE instrument, i.e. an established evaluation tool for GLs, in order to evaluate the quality of two major microbiology guidelines, i.e. the SFM GLs and the ASM GLs). Both guidelines remain sub-optimal in their levels of quality, and obtain scores that are not very different from the average scores obtained by many other guidelines in various medical disciplines. We therefore believe that both guidelines need to be modified before they can be recommended without provisos. A higher degree of multi-disciplinary work, including a more formal implication of methodologists, as well as of infectious disease clinicians, and of economists, might perhaps enable future editions of these guidelines to reach higher levels of quality.

  5. Physician Appraisals: Key Challenges

    Directory of Open Access Journals (Sweden)

    Klich Jacek

    2017-06-01

    Full Text Available The main purpose of the article is to identify key criteria being used for physician appraisals and to find how communication skills of physicians are valued in those appraisals. ScienceDirect and EBSCOhost databases were used for this search. The results show that a physician appraisal is underestimated both theoretically and empirically. The particular gap exists with respect to the communication skills of physicians, which are rarely present in medical training syllabi and physician assessments. The article contributes to the theoretical discourse on physician appraisals and points out at the inconsistency between the high status of physicians as a key hospital resource on the one hand and, on the other hand, at inadequate and poorly researched assessment of their performance with a special emphasis on communication skills. The article may inspire health managers to develop and implement up-to-date assessment forms for physicians and good managerial practices in this respect in hospitals and other health care units.

  6. Managerial Competencies and the Managerial Performance Appraisal Process.

    Science.gov (United States)

    Abraham, Steven E.; Karns, Lanny A.; Shaw, Kenneth; Mena, Manuel A.

    2001-01-01

    Human resource managers (n=277) identified six management competencies as critical: leadership, customer focus, results orientation, problem solving, communication skills, and teamwork. However, many companies do not assess these competencies in the management performance appraisal process. (Contains 22 references.) (SK)

  7. An appraisal of construction management practice in Nigeria | Ugwu ...

    African Journals Online (AJOL)

    An appraisal of construction management practice in Nigeria. ... 108 questionnaires were distributed to the key construction actors as follows: 45 to ... conflicting design information, effective co-ordination of resources, critical path method, ...

  8. 12 CFR 564.5 - Appraiser independence.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Appraiser independence. 564.5 Section 564.5 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY APPRAISALS § 564.5 Appraiser independence. (a) Staff appraisers. If an appraisal is prepared by a staff appraiser, that appraiser must be...

  9. Experimentation of RT-LOTOS for a critical function of a power plant instrumentation and control system

    International Nuclear Information System (INIS)

    Andriantsiiferana, L.; Courtiat, J.P.; De Oliveira, R.C.

    1996-01-01

    This document is the final report of the contract between LAAS-CNRS and the EdF Direction of Researches and Studies about the experimentation of RT-LOTOS formal description technique on a critical function of a nuclear power plant instrumentation and control system. This report comprises 4 parts: part 1 describes the RT-LOTOS (Real Time-Language of Temporal Ordering Specifications) tutorial and its RTL tool environment, the different RT-LOTOS operators and semantics, and the RTL tool main functionalities; part 2 deals with the methodology and the global architecture for the specification and validation of the CCT (Central Calculator for Treatment); part 3 gives more details about the different processes identified in the specification architecture and presents the main results obtained for the validation of the nominal functioning; part 4 describes some exceptional situations and shows how some failures and their associated recovery mechanisms can be modelled. (J.S.). 6 refs., 53 figs., 5 tabs., 2 appends

  10. Cumulative clinical experience from over a decade of use of levofloxacin in community-acquired pneumonia: critical appraisal and role in therapy

    Directory of Open Access Journals (Sweden)

    Noreddin AM

    2011-10-01

    Full Text Available Ayman M Noreddin1, Walid F Elkhatib2, Kenji M Cunnion3, George G Zhanel41Department of Pharmacy Practice, Hampton University, Hampton, VA, USA; 2Department of Microbiology and Immunology, Ain-Shams University, Cairo, Egypt; 3Department of Pediatrics, East Virginia Medical School, Norfolk, VA, USA; 4Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada Abstract: Levofloxacin is the synthetic L-isomer of the racemic fluoroquinolone, ofloxacin. It interferes with critical processes in the bacterial cell such as DNA replication, transcription, repair, and recombination by inhibiting bacterial topoisomerases. Levofloxacin has broad spectrum activity against several causative bacterial pathogens of community-acquired pneumonia (CAP. Oral levofloxacin is rapidly absorbed and is bioequivalent to the intravenous formulation such that patients can be conveniently transitioned between these formulations when moving from the inpatient to the outpatient setting. Furthermore, levofloxacin demonstrates excellent safety, and has good tissue penetration maintaining adequate concentrations at the site of infection. The efficacy and tolerability of levofloxacin 500 mg once daily for 10 days in patients with CAP are well established. Furthermore, a high-dose (750 mg and short-course (5 days of once-daily levofloxacin has been approved for use in the US in the treatment of CAP, acute bacterial sinusitis, acute pyelonephritis, and complicated urinary tract infections. The high-dose, short-course levofloxacin regimen maximizes its concentration-dependent antibacterial activity, decreases the potential for drug resistance, and has better patient compliance.Keywords: levofloxacin, community-acquired pneumonia, pharmacodynamics, resistance, pharmacokinetics, clinical use

  11. Texas Teacher Evaluation & Support System (T-TESS) Appraiser Handbook

    Science.gov (United States)

    Texas Education Agency, 2016

    2016-01-01

    The Texas Education Agency's (TEA) approved instrument for evaluating teachers, the Professional Development and Appraisal System (PDAS), was the primary instrument used by 86 percent of local education agencies (LEAs) in the state and has been in place since 1997. In acknowledging the vital roles teachers play in student achievement, and based on…

  12. Conducting effective performance appraisals.

    Science.gov (United States)

    2001-01-01

    According to experts, performance appraisals rate just below firing someone as the least favorite thing managers do. Many factors contribute to this view--one is that current systems do a poor job of evaluating performance and in fact often impede both evaluation and performance. When used as part of an ongoing supportive process of goal setting and feedback, performance appraisals can enhance performance and morale. One alternative to traditional employee evaluation methods is full-circle or 360-degree feedback. Contained in this issue are practical suggestions for preparing employees for performance appraisals which, when followed daily, encourage employees to put their best feet forward as part of their regular routine. Also included is a template specific to assessing the performance of clinical laboratory technologists . Additionally, numerous resources are provided to help you refine appraisal systems to fit your needs. Full-circle feedback is proving to be a boon to managers. It relieves them from being the exclusive "heavies" in evaluating performance, integrates appraisal input from several sources, and incorporates increasing employee skills, competencies, and satisfaction, thus improving productivity of people and processes. And aren't integration and continuous improvement what the laboratory is all about?

  13. Identifying depression post-stroke in patients with aphasia : A systematic review of the reliability, validity and feasibility of available instruments

    NARCIS (Netherlands)

    van Dijk, Mariska J; de Man-van Ginkel, Janneke M; Hafsteinsdóttir, Thóra B; Schuurmans, Marieke J

    OBJECTIVE: To identify and critically appraise the evidence for instruments assessing depression in stroke patients with aphasia. METHODS: The PubMed, CINAHL, Web of Science, Psych Info and Cochrane databases were searched from inception until May 2015. RESULTS: Of the 383 titles found in the

  14. Systematic Review of Measurement Property Evidence for 8 Financial Management Instruments in Populations With Acquired Cognitive Impairment.

    Science.gov (United States)

    Engel, Lisa; Chui, Adora; Beaton, Dorcas E; Green, Robin E; Dawson, Deirdre R

    2018-03-07

    To critically appraise the measurement property evidence (ie, psychometric) for 8 observation-based financial management assessment instruments. Seven databases were searched in May 2015. Two reviewers used an independent decision-agreement process to select studies of measurement property evidence relevant to populations with adulthood acquired cognitive impairment, appraise the quality of the evidence, and extract data. Twenty-one articles were selected. This review used the COnsensus-based Standards for the selection of health Measurement Instruments review guidelines and 4-point tool to appraise evidence. After appraising the methodologic quality, the adequacy of results and volume of evidence per instrument were synthesized. Measurement property evidence with high risk of bias was excluded from the synthesis. The volume of measurement property evidence per instrument is low; most instruments had 1 to 3 included studies. Many included studies had poor methodologic quality per measurement property evidence area examined. Six of the 8 instruments reviewed had supporting construct validity/hypothesis-testing evidence of fair methodologic quality. There is a dearth of acceptable quality content validity, reliability, and responsiveness evidence for all 8 instruments. Rehabilitation practitioners assess financial management functions in adults with acquired cognitive impairments. However, there is limited published evidence to support using any of the reviewed instruments. Practitioners should exercise caution when interpreting the results of these instruments. This review highlights the importance of appraising the quality of measurement property evidence before examining the adequacy of the results and synthesizing the evidence. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. Appraisal of Transport Projects

    DEFF Research Database (Denmark)

    Jensen, Anders Vestergaard

    and robustness measures have been elaborated, which examine the subjective part of the MCDA (in form of criteria weights) and its role in decision support making. For this purpose both deterministic and stochastic sensitivity analyses have been developed. In addition, the focus has been formulating a framework...... into account the interests and preferences of different stakeholders. These various interests and preferences have been revealed by the use of decision conferencing, which engage the stakeholders and provide a common platform for understanding the decision problem. Leading up to this framework, this thesis has......, as robustness of a recommended solution is major concern in the final steps of decision making. As mentioned, the appraisal of transport projects is a complex issues involving conflict of various interests and this calls for new approaches to the practice of appraisal. The presented appraisal framework...

  16. Lower extremity amputation rates in people with diabetes as an indicator of health systems performance. A critical appraisal of the data collection 2000-2011 by the Organization for Economic Cooperation and Development (OECD).

    Science.gov (United States)

    Carinci, F; Massi Benedetti, M; Klazinga, N S; Uccioli, L

    2016-10-01

    Critical appraisal of secondary data made available by the OECD for the time frame 2000-2011. Comparison of trends and variation of amputations in people with diabetes across OECD countries. Generalized estimating equations to test the statistical significance of the annual change adjusting for major potential confounders. A total of 26 OECD countries contributed to the OECD data collection for at least 1 year in the reference time frame, showing a decline in rates of over 40 %, from a mean of 13.2 (median 9.4, range 5.1-28.1) to 7.8 amputations per 100,000 in the general population (9.9, 1.0-18.4). The multivariate model showed an average decrease equal to -0.27 per 100,000 per year (p = 0.015), adjusted by structural characteristics of health systems, showing lower amputation rates for health systems financed by public taxation (-4.55 per 100,000 compared to insurance based, p = 0.002) and non-ICD coding mechanisms (-7.04 per 100,000 compared to ICD-derived, p = 0.001). Twelve-year decrease was stronger among insurance-based financing systems (tax based: -0.16 per 100,000, p = 0.064; insurance based: -0.36 per 100,000; p = 0.046). In OECD countries, amputation rates in diabetes continuously decreased over 12 years. Still, in 2011, one amputation every 7 min could be directly attributed to diabetes. Although interesting, these results should be taken with extreme caution, until common definitions are improved and data quality issues, e.g., a different ability in capturing diabetes diagnoses, are fully resolved.

  17. Motivation Measures in Sport: A Critical Review and Bibliometric Analysis

    OpenAIRE

    Clancy, Rachel B.; Herring, Matthew P.; Campbell, Mark J.

    2017-01-01

    Motivation is widely-researched, in both sport psychology and other fields. As rigorous measurement is essential to understanding this latent construct, a critical appraisal of measurement instruments is needed. Thus, the purpose of this review was to evaluate the six most highly cited motivation measures in sport. Peer-reviewed articles published prior to August 2016 were searched to identify the six most highly cited motivation questionnaires in sport: Sport Motivation Scale (SMS), Intrinsi...

  18. Final Technical Report on Quantifying Dependability Attributes of Software Based Safety Critical Instrumentation and Control Systems in Nuclear Power Plants

    International Nuclear Information System (INIS)

    Smidts, Carol; Huang, Fuqun; Li, Boyuan; Li, Xiang

    2016-01-01

    With the current transition from analog to digital instrumentation and control systems in nuclear power plants, the number and variety of software-based systems have significantly increased. The sophisticated nature and increasing complexity of software raises trust in these systems as a significant challenge. The trust placed in a software system is typically termed software dependability. Software dependability analysis faces uncommon challenges since software systems' characteristics differ from those of hardware systems. The lack of systematic science-based methods for quantifying the dependability attributes in software-based instrumentation as well as control systems in safety critical applications has proved itself to be a significant inhibitor to the expanded use of modern digital technology in the nuclear industry. Dependability refers to the ability of a system to deliver a service that can be trusted. Dependability is commonly considered as a general concept that encompasses different attributes, e.g., reliability, safety, security, availability and maintainability. Dependability research has progressed significantly over the last few decades. For example, various assessment models and/or design approaches have been proposed for software reliability, software availability and software maintainability. Advances have also been made to integrate multiple dependability attributes, e.g., integrating security with other dependability attributes, measuring availability and maintainability, modeling reliability and availability, quantifying reliability and security, exploring the dependencies between security and safety and developing integrated analysis models. However, there is still a lack of understanding of the dependencies between various dependability attributes as a whole and of how such dependencies are formed. To address the need for quantification and give a more objective basis to the review process -- therefore reducing regulatory uncertainty

  19. Final Technical Report on Quantifying Dependability Attributes of Software Based Safety Critical Instrumentation and Control Systems in Nuclear Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Smidts, Carol [The Ohio State Univ., Columbus, OH (United States); Huang, Funqun [The Ohio State Univ., Columbus, OH (United States); Li, Boyuan [The Ohio State Univ., Columbus, OH (United States); Li, Xiang [The Ohio State Univ., Columbus, OH (United States)

    2016-03-25

    With the current transition from analog to digital instrumentation and control systems in nuclear power plants, the number and variety of software-based systems have significantly increased. The sophisticated nature and increasing complexity of software raises trust in these systems as a significant challenge. The trust placed in a software system is typically termed software dependability. Software dependability analysis faces uncommon challenges since software systems’ characteristics differ from those of hardware systems. The lack of systematic science-based methods for quantifying the dependability attributes in software-based instrumentation as well as control systems in safety critical applications has proved itself to be a significant inhibitor to the expanded use of modern digital technology in the nuclear industry. Dependability refers to the ability of a system to deliver a service that can be trusted. Dependability is commonly considered as a general concept that encompasses different attributes, e.g., reliability, safety, security, availability and maintainability. Dependability research has progressed significantly over the last few decades. For example, various assessment models and/or design approaches have been proposed for software reliability, software availability and software maintainability. Advances have also been made to integrate multiple dependability attributes, e.g., integrating security with other dependability attributes, measuring availability and maintainability, modeling reliability and availability, quantifying reliability and security, exploring the dependencies between security and safety and developing integrated analysis models. However, there is still a lack of understanding of the dependencies between various dependability attributes as a whole and of how such dependencies are formed. To address the need for quantification and give a more objective basis to the review process -- therefore reducing regulatory uncertainty

  20. System Performance Testing of the Pulse-Echo Ultrasonic Instrument for Critical Velocity Determination during Hanford Tank Waste Transfer Operations - 13584

    Energy Technology Data Exchange (ETDEWEB)

    Denslow, Kayte M.; Bontha, Jagannadha R.; Adkins, Harold E.; Jenks, Jeromy W.J.; Hopkins, Derek F. [Pacific Northwest National Laboratory, Richland, Washington 99354 (United States); Thien, Michael G.; Kelly, Steven E.; Wooley, Theodore A. [Washington River Protection Solutions, Richland, Washington 99354 (United States)

    2013-07-01

    The delivery of Hanford double-shell tank waste to the Hanford Tank Waste Treatment and Immobilization Plant (WTP) is governed by specific Waste Acceptance Criteria that are identified in ICD 19 - Interface Control Document for Waste Feed. Waste must be certified as acceptable before it can be delivered to the WTP. The fluid transfer velocity at which solid particulate deposition occurs in waste slurry transport piping (critical velocity) is a key waste acceptance parameter that must be accurately characterized to determine if the waste is acceptable for transfer to the WTP. Washington River Protection Solutions and the Pacific Northwest National Laboratory have been evaluating the ultrasonic PulseEcho instrument since 2010 for its ability to detect particle settling and determine critical velocity in a horizontal slurry transport pipeline for slurries containing particles with a mean particle diameter of =14 micrometers (μm). In 2012 the PulseEcho instrument was further evaluated under WRPS' System Performance test campaign to identify critical velocities for slurries that are expected to be encountered during Hanford tank waste retrieval operations or bounding for tank waste feed. This three-year evaluation has demonstrated the ability of the ultrasonic PulseEcho instrument to detect the onset of critical velocity for a broad range of physical and rheological slurry properties that are likely encountered during the waste feed transfer operations between the Hanford tank farms and the WTP. (authors)

  1. Critical Appraisal of Mixed Methods Studies

    Science.gov (United States)

    Heyvaert, Mieke; Hannes, Karin; Maes, Bea; Onghena, Patrick

    2013-01-01

    In several subdomains of the social, behavioral, health, and human sciences, research questions are increasingly answered through mixed methods studies, combining qualitative and quantitative evidence and research elements. Accordingly, the importance of including those primary mixed methods research articles in systematic reviews grows. It is…

  2. Nickel sensitisation in mice: a critical appraisal.

    Science.gov (United States)

    Johansen, Pål; Wäckerle-Men, Ying; Senti, Gabriela; Kündig, Thomas M

    2010-06-01

    The market release of new domestic and industrial chemical and metal products requires certain safety certification, including testing for skin sensitisation. Although various official guidelines have described how such testing is to be done, the validity of the available test models are in part dubious, for which reason regulatory agencies and research aim to further improve and generalise the models for testing of skin sensitisation. We applied a recently published murine model of nickel allergy as to test its applicability in a regulatory setting and to study and better understand the events leading to type-IV hypersensitivity. Nickel was chosen as model hapten since it induces allergic contact dermatitis with high incidence in the general population. Typically, C57BL/6 mice were sensitised and challenged by intradermal applications of nickel, and cutaneous inflammation was analysed by the mouse ear-swelling test, by histology, and by lymphocyte reactivity in vitro. Surprisingly, the study suggested that the skin reactions observed were results of irritant reactions rather than of adaptive immune responses. Non-sensitised mice responded with cutaneous inflammation and in vitro lymphocyte reactivity which were comparable with nickel-sensitised mice. Furthermore, histological examinations as well as experiments in T-cell deficient mice demonstrated that lymphocytes were not involved and that nickel caused an irritant contact dermatitis rather a true allergic type-IV contact dermatitis. The authors question the validity of the described murine model of nickel allergy. Copyright 2010 Japanese Society for Investigative Dermatology. Published by Elsevier Ireland Ltd. All rights reserved.

  3. The keystone species concept: a critical appraisal

    Directory of Open Access Journals (Sweden)

    Robert J. Whittaker

    2012-09-01

    Full Text Available The keystone concept has been widely applied in the ecological literature since the idea was introduced in 1969. While it has been useful in framing biodiversity research and garnering support in conservation policy circles, the terminology surrounding the concept has been expanded to the extent that there is considerable confusion over what exactly a keystone species is. Several authors have argued that the term is too broadly applied, while others have pointed out the technical and theoretical limitations of the concept. Here, we chart the history of the keystone concept’s evolution and summarise the plethora of different terms and definitions currently in use. In reviewing these terms, we also analyse the value of the keystone concept and highlight some promising areas of recent work.

  4. Biomedical waste management in India: Critical appraisal.

    Science.gov (United States)

    Datta, Priya; Mohi, Gursimran Kaur; Chander, Jagdish

    2018-01-01

    The safe and sustainable management of biomedical waste (BMW) is social and legal responsibility of all people supporting and financing health-care activities. Effective BMW management (BMWM) is mandatory for healthy humans and cleaner environment. This article reviews the recent 2016 BMWM rules, practical problems for its effective implementation, the major drawback of conventional techniques, and the latest eco-friendly methods for BMW disposal. The new rules are meant to improve the segregation, transportation, and disposal methods, to decrease environmental pollution so as to change the dynamic of BMW disposal and treatment in India. For effective disposal of BMWM, there should be a collective teamwork with committed government support in terms of finance and infrastructure development, dedicated health-care workers and health-care facilities, continuous monitoring of BMW practices, tough legislature, and strong regulatory bodies. The basic principle of BMWM is segregation at source and waste reduction. Besides, a lot of research and development need to be in the field of developing environmental friendly medical devices and BMW disposal systems for a greener and cleaner environment.

  5. Telomerase and mammalian ageing: a critical appraisal.

    Science.gov (United States)

    Goyns, M H; Lavery, W L

    2000-03-13

    The telomeres that occur at the end of chromosomes are maintained by the activity of telomerase and are thought to be important protective factors in maintaining the integrity of chromosomes. It now appears that in vitro replicative senescence, which has been observed in cultured somatic cells, is due to a loss of telomere length in those cells, caused by inactivity of telomerase. This has led to the proposition that telomerase activity is an important determinant in organismal ageing. However, many cells in the body do not proliferate regularly and therefore will not lose telomere length. Cells that do proliferate frequently have now been shown to have active telomerase. Other cells, such as fibroblasts, that do not have telomerase activity but proliferate only occasionally may not reach the Hayflick limit during the lifetime of an animal. There is also no correlation between telomere length and the maximal lifespan exhibited by different species. Studies of telomerase knock-out mice have reported some aspects of accelerated ageing after three generations, but the relevance of these observations to normal ageing remains unconvincing. The role of telomerase in producing immortal tumour cells and the possibility that activation of telomerase is an important event in malignant transformation is similarly controversial and open to alternative interpretations. The significance of these and other observations, and how they define the role of telomerase in ageing, is discussed.

  6. Biomedical waste management in India: Critical appraisal

    Science.gov (United States)

    Datta, Priya; Mohi, Gursimran Kaur; Chander, Jagdish

    2018-01-01

    The safe and sustainable management of biomedical waste (BMW) is social and legal responsibility of all people supporting and financing health-care activities. Effective BMW management (BMWM) is mandatory for healthy humans and cleaner environment. This article reviews the recent 2016 BMWM rules, practical problems for its effective implementation, the major drawback of conventional techniques, and the latest eco-friendly methods for BMW disposal. The new rules are meant to improve the segregation, transportation, and disposal methods, to decrease environmental pollution so as to change the dynamic of BMW disposal and treatment in India. For effective disposal of BMWM, there should be a collective teamwork with committed government support in terms of finance and infrastructure development, dedicated health-care workers and health-care facilities, continuous monitoring of BMW practices, tough legislature, and strong regulatory bodies. The basic principle of BMWM is segregation at source and waste reduction. Besides, a lot of research and development need to be in the field of developing environmental friendly medical devices and BMW disposal systems for a greener and cleaner environment. PMID:29403196

  7. Clinical Competence Certification: A Critical Appraisal.

    Science.gov (United States)

    Woolliscroft, James O.; And Others

    1984-01-01

    The American Board of Internal Medicine has requested that residency program directors certify the clinical competence of their candidates. The clinical evaluation exercise (CEX) was used by residents at the University of Michigan Hospitals and the results raised questions as to the validity of the CEX. (Author/MLW)

  8. Biomarkers for Lupus Nephritis: A Critical Appraisal

    Directory of Open Access Journals (Sweden)

    Chi Chiu Mok

    2010-01-01

    Full Text Available Kidney disease is one of the most serious manifestations of systemic lupus erythematosus (SLE. Despite the improvement in the medical care of SLE in the past two decades, the prognosis of lupus nephritis remains unsatisfactory. Besides exploring more effective but less toxic treatment modalities that will further improve the remission rate, early detection and treatment of renal activity may spare patients from intensive immunosuppressive therapies and reduce renal damage. Conventional clinical parameters such as creatinine clearance, proteinuria, urine sediments, anti-dsDNA, and complement levels are not sensitive or specific enough for detecting ongoing disease activity in the lupus kidneys and early relapse of nephritis. Thus, novel biomarkers are necessary to enhance the diagnostic accuracy and sensitivity of lupus renal disease, prognostic stratification, monitoring of treatment response, and detection of early renal flares. This paper reviews promising biomarkers that have recently been evaluated in longitudinal studies of lupus nephritis.

  9. Commercial Maritime Information: A Critical Appraisal.

    Science.gov (United States)

    1981-01-01

    Arthur Howard, Chief Inspector U.S. Customs Service, 555 Battery Street, San Francisco, CA 94111 Peter Mel Hughes , Traffic Manager, Port of Richmond...832, Federal Bldg. 10-A, Washington, DC 20591 Perla Londers, Trans-America Realco, 175 W. Jackman Blvd., Chicago, IL 60604 Edward M. MacCutcheon

  10. Exercise electrocardiographic variables: a critical appraisal

    International Nuclear Information System (INIS)

    Detrano, R.; Salcedo, E.; Passalacqua, M.; Friis, R.

    1986-01-01

    To compare four recently proposed methods of analyzing the exercise electrocardiogram with the conventional analysis of ST segment depression, 303 consecutive patients without myocardial infarction who had been referred for coronary arteriography underwent stress electrocardiography and stress thallium imaging. The specificity for the prediction of a greater than 50% coronary obstruction of 0.5, 1.0, 1.5 and 2.0 mm ST segment depression measured in the conventional way was 0.59, 0.73, 0.88 and 0.94, respectively. The specificity of a thallium perfusion defect was 0.79. Sensitivities of the conventional ST depressions, thallium defect, the change in the sum of the R amplitudes and the slope adjusted for heart rate increase were calculated and compared at the cited levels of specificity. R wave changes had a significantly lower sensitivity than did the conventionally analyzed ST depression at each level of specificity. Slope-adjusted ST depression had a slightly higher sensitivity than that of conventional ST depression only at a specificity of 0.73 (0.68 versus 0.65, p = 0.07). R wave-adjusted ST depression was significantly more sensitive than conventional ST depression only at a specificity of 0.94 (0.45 versus 0.36, p = 0.01). Heart rate-adjusted ST depression was more sensitive than conventional ST depression at all of the specificities except 0.59. This pattern of superior accuracy of heart rate-adjusted ST depressions was preserved for the prediction of multivessel coronary disease. Heart rate adjustment is a simpler and more accurate modification of the conventional electrocardiographic analysis than are the other three methods studied

  11. Moody, Suicide and Survival: A Critical Appraisal.

    Science.gov (United States)

    Vicchio, Stephen

    1980-01-01

    The purpose of this paper is to: (1) define suicide; (2) explicate Raymond Moody's position on suicide and survival after death; (3) analyze logical connections between divine commands and moral judgments; and (4) offer constructive comments on suicide and suicide prevention. (Author/RC)

  12. On-line testing of nuclear plant temperature and pressure instrumentation and other critical plant equipment. IAEA regional workshop. Working material

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-12-31

    Under European regional TC project RER/4/011, IAEA and VUJE Training centre organized a workshop on On-line Testing of Nuclear Power Plant Temperature and Pressure Instrumentation and Other Critical Plant Equipment in Trnava, Slovak Republic, from 25 to 29 May 1998. The objective of the workshop was to review the state-of-the-art in NPP instrumentation, cover typical instrumentation problems and solutions, describe technical and regulatory requirements for verifying the performance of nuclear power plant instrumentation, describe new methods developed and applied in NPPs for on-line verification and performance of instrumentation and present new techniques using existing instrumentation to identify the on-set problems in the plant electrical, mechanical and thermal hydraulic systems. Particular emphasis was placed on temperature measurements by Resistance Temperature Detectors (RTDs) and thermocouples and pressure measurements using motion-balanced and forced-balanced pressure transmitters. This proceedings includes papers presented by the invited speakers and the participants each with an abstract as wells as a summary of the Round-Table discussions Refs, figs, tabs

  13. On-line testing of nuclear plant temperature and pressure instrumentation and other critical plant equipment. IAEA regional workshop. Working material

    International Nuclear Information System (INIS)

    1998-01-01

    Under European regional TC project RER/4/011, IAEA and VUJE Training centre organized a workshop on On-line Testing of Nuclear Power Plant Temperature and Pressure Instrumentation and Other Critical Plant Equipment in Trnava, Slovak Republic, from 25 to 29 May 1998. The objective of the workshop was to review the state-of-the-art in NPP instrumentation, cover typical instrumentation problems and solutions, describe technical and regulatory requirements for verifying the performance of nuclear power plant instrumentation, describe new methods developed and applied in NPPs for on-line verification and performance of instrumentation and present new techniques using existing instrumentation to identify the on-set problems in the plant electrical, mechanical and thermal hydraulic systems. Particular emphasis was placed on temperature measurements by Resistance Temperature Detectors (RTDs) and thermocouples and pressure measurements using motion-balanced and forced-balanced pressure transmitters. This proceedings includes papers presented by the invited speakers and the participants each with an abstract as wells as a summary of the Round-Table discussions

  14. Appraising and comparing pressure ulcer guidelines.

    Science.gov (United States)

    Wimpenny, Peter; van Zelm, Ruben

    2007-01-01

    Whilst considerable activity has been related to guideline development for nurses regarding pressure ulcer prevention and management, no attempt has been made to comparatively evaluate these guidelines against some form of quality indicators. To compare and contrast four national pressure ulcer guidelines, and identify similarities and differences in their quality and content. An international comparative appraisal method, using the AGREE (Appraisal of Guidelines Research and Evaluation) instrument, was undertaken to appraise four published pressure ulcer guidelines. Two further domains were added to the AGREE instrument to assess comparability of the guidelines and their perceived contribution to practice. An international group undertook the comparative appraisal. The domain scores for each guideline show some but not total agreement among reviewers. One particular set of guidelines was identified as scoring highest in a majority of AGREE domains. Overall, evidence of variability exists between pressure ulcer guidelines and common areas of development to consider for all guidelines. The results raise many questions concerning the "best" pressure ulcer guideline to use, particularly related to the AGREE scoring. Some notable shortcomings exist in all the pressure ulcer guidelines reviewed and these shortcomings need to be addressed from a quality perspective. However, other issues such as style of reporting and potential contribution to practice might more fully affect choice by practitioners as opposed to guideline developers. Notable differences exist among the four guidelines that are possibly explained by different approaches to development and also because of different cultural factors and intentions for use. Whilst the AGREE tool identifies the quality of the guideline development process it still requires local engagement with practitioners to determine which guideline should be implemented.

  15. Measuring Asian nurses' organizational commitment: a critical analysis of the psychometric properties of two organizational commitment instruments.

    Science.gov (United States)

    Liou, Shwu-Ru; Tsai, Hsiu-Min; Cheng, Ching-Yu

    2013-01-01

    To analyze and compare the psychometric properties and cultural attributes of the Organizational Commitment Questionnaire and the Organizational Commitment Scale to determine their appropriateness for measuring commitment of Asian nurses, the biggest portion of international nurses. The Organizational Commitment Questionnaire was cross-culturally cross-validated when compared with the Organizational Commitment Scale. Both instruments were not tested on Asian nurses. More studies are needed to validate the cultural properties of the Organizational Commitment Scale. Healthcare administrators can use culturally validated instruments, which concern cultural context, including languages and cultural values, to understand Asian nurses' organizational commitment and further lower turnover behavior among them. © 2013 Wiley Periodicals, Inc.

  16. Investigating the Quality of Project-Based Science and Technology Learning Environments in Elementary School: A Critical Review of Instruments

    Science.gov (United States)

    Thys, Miranda; Verschaffel, Lieven; Van Dooren, Wim; Laevers, Ferre

    2016-01-01

    This paper provides a systematic review of instruments that have the potential to measure the quality of project-based science and technology (S&T) learning environments in elementary school. To this end, a comprehensive literature search was undertaken for the large field of S&T learning environments. We conducted a horizontal bottom-up…

  17. The Texts of the Instruments connected with the Agency's Assistance to Finland in Establishing a Sub-Critical Assemblies Project

    International Nuclear Information System (INIS)

    1964-01-01

    The text of the Project Agreement between the Agency and the Government of Finland in connection with the Agency's assistance to that Government in establishing a sub-critical assemblies project is reproduced in Part I of this document for the information of all Members. This Agreement entered into force on 30 July 1963

  18. The Texts of the Instruments connected with the Agency's Assistance to Finland in Establishing a Sub-Critical Assemblies Project

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1964-02-10

    The text of the Project Agreement between the Agency and the Government of Finland in connection with the Agency's assistance to that Government in establishing a sub-critical assemblies project is reproduced in Part I of this document for the information of all Members. This Agreement entered into force on 30 July 1963.

  19. 32 CFR 644.44 - Fee appraisals.

    Science.gov (United States)

    2010-07-01

    ... HANDBOOK Appraisal § 644.44 Fee appraisals. (a) Definitions and procedures. (1) The complete and.... The keynote of this approach lies in the sound development of a proper rate. The appraiser must have a...

  20. The Texts of the Instruments connected with the Agency's Assistance to Mexico in Establishing a Sub-Critical Assembly Project

    International Nuclear Information System (INIS)

    1966-01-01

    The texts of the Supply Agreement between the Agency and the Governments of Mexico and the United States of America, and of the Project Agreement between the Agency and the Government of Mexico in connection with the Agency's assistance to that Government in establishing a sub-critical assembly project.. are reproduced in this document for the information of all Members. Both Agreements entered into force on 20 June 1966

  1. The Texts of the Instruments connected with the Agency's Assistance to Mexico in Establishing a Sub-Critical Assembly Project

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1967-10-25

    The texts of the Supply Agreement between the Agency and the Governments of Mexico and the United States of America, and of the Project Agreement between the Agency and the Government of Mexico, connected with the Agency's assistance to the latter Government in establishing a sub-critical assembly project, are reproduced in this document for the information of all Members. Both Agreements entered into force on 23 August 1967.

  2. The Texts of the Instruments connected with the Agency's Assistance to Mexico in Establishing a Sub-Critical Assembly Project

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1966-07-07

    The texts of the Supply Agreement between the Agency and the Governments of Mexico and the United States of America, and of the Project Agreement between the Agency and the Government of Mexico in connection with the Agency's assistance to that Government in establishing a sub-critical assembly project.. are reproduced in this document for the information of all Members. Both Agreements entered into force on 20 June 1966.

  3. The Texts of the Instruments connected with the Agency's Assistance to Mexico in Establishing a Sub-Critical Assembly Project

    International Nuclear Information System (INIS)

    1967-01-01

    The texts of the Supply Agreement between the Agency and the Governments of Mexico and the United States of America, and of the Project Agreement between the Agency and the Government of Mexico, connected with the Agency's assistance to the latter Government in establishing a sub-critical assembly project, are reproduced in this document for the information of all Members. Both Agreements entered into force on 23 August 1967

  4. An appraisal profile of nostalgia.

    Science.gov (United States)

    van Tilburg, Wijnand A P; Bruder, Martin; Wildschut, Tim; Sedikides, Constantine; Göritz, Anja S

    2018-03-05

    The authors aimed to (a) identify the cognitive appraisals underlying nostalgia and (b) compare nostalgia with other emotions in terms of its appraisal profile. In Study 1, participants (N = 1,125) generated narratives. Next, they reported the level of nostalgia and 31 other emotions that these narratives elicited. Subsequently, participants evaluated the narrative events on several cognitive appraisals. Events that elicited nostalgia were pleasant, involved an irretrievable loss, felt psychologically distant, and were unique-an appraisal profile that differed from all other emotions. In Study 2 (N = 1,261), the authors experimentally varied these appraisals in a vignette paradigm and measured anticipated nostalgia and 10 other emotions. Participants anticipated most nostalgia when events were pleasant, involved irretrievable loss, were distant, and were unique-a profile shared only with longing. In Study 3 (N = 994), the authors used a guided autobiographical recall procedure in which they manipulated appraisals and measured the resultant emotions. Corroborating Studies 1-2, nostalgia was most intense for events that were pleasant, irretrievably lost, temporally distant, and unique. This appraisal profile was not shared by other emotions. The findings delineate the distinguishing cognitive appraisal profile of nostalgia. Nostalgia occupies a special place in the pantheon of emotions. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  5. Current practices in economic appraisal

    NARCIS (Netherlands)

    Mossink, J.C.M.

    2000-01-01

    By means of economic appraisal, the costs and the benefits of health, environment and safety management can be made clear, both at the national level and at the company level. As such it is a tool in advocating good practices. This paper explores the possibilities of economic appraisal for policy

  6. Very high precision and accuracy analysis of triple isotopic ratios of water. A critical instrumentation comparison study.

    Science.gov (United States)

    Gkinis, Vasileios; Holme, Christian; Morris, Valerie; Thayer, Abigail Grace; Vaughn, Bruce; Kjaer, Helle Astrid; Vallelonga, Paul; Simonsen, Marius; Jensen, Camilla Marie; Svensson, Anders; Maffrezzoli, Niccolo; Vinther, Bo; Dallmayr, Remi

    2017-04-01

    We present a performance comparison study between two state of the art Cavity Ring Down Spectrometers (Picarro L2310-i, L2140-i). The comparison took place during the Continuous Flow Analysis (CFA) campaign for the measurement of the Renland ice core, over a period of three months. Instant and complete vaporisation of the ice core melt stream, as well as of in-house water reference materials is achieved by accurate control of microflows of liquid into a homemade calibration system by following simple principles of the Hagen-Poiseuille law. Both instruments share the same vaporisation unit in a configuration that minimises sample preparation discrepancies between the two analyses. We describe our SMOW-SLAP calibration and measurement protocols for such a CFA application and present quality control metrics acquired during the full period of the campaign on a daily basis. The results indicate an unprecedented performance for all 3 isotopic ratios (δ2H, δ17O, δ18O ) in terms of precision, accuracy and resolution. We also comment on the precision and accuracy of the second order excess parameters of HD16O and H217O over H218O (Dxs, Δ17O ). To our knowledge these are the first reported CFA measurements at this level of precision and accuracy for all three isotopic ratios. Differences on the performance of the two instruments are carefully assessed during the measurement and reported here. Our quality control protocols extend to the area of low water mixing ratios, a regime in which often atmospheric vapour measurements take place and Cavity Ring Down Analysers show a poorer performance due to the lower signal to noise ratios. We address such issues and propose calibration protocols from which water vapour isotopic analyses can benefit from.

  7. Still a Deadly Disease? Performance Appraisal Systems in Academic Libraries in the United States

    Science.gov (United States)

    Stilling, Glenn Ellen Starr; Byrd, Allison S.; Mazza, Emily Rose; Bergman, Shawn M.

    2018-01-01

    Performance appraisal of professional librarians in academic libraries is important because of the critical role these employees play. Professional librarians ensure that the library's resources and services are effective, relevant, and integrated within the parent institution. Performance appraisal and job feedback have been understudied in the…

  8. KAERI software safety guideline for developing safety-critical software in digital instrumentation and control system of nuclear power plant

    International Nuclear Information System (INIS)

    Lee, Jang Soo; Kim, Jang Yeol; Eum, Heung Seop.

    1997-07-01

    Recently, the safety planning for safety-critical software systems is being recognized as the most important phase in the software life cycle, and being developed new regulatory positions and standards by the regulatory and the standardization organization. The requirements for software important to safety of nuclear reactor are described in such positions and standards. Most of them are describing mandatory requirements, what shall be done, for the safety-critical software. The developers of such a software. However, there have been a lot of controversial factors on whether the work practices satisfy the regulatory requirements, and to justify the safety of such a system developed by the work practices, between the licenser and the licensee. We believe it is caused by the reason that there is a gap between the mandatory requirements (What) and the work practices (How). We have developed a guidance to fill such gap, which can be useful for both licenser and licensee to conduct a justification of the safety in the planning phase of developing the software for nuclear reactor protection systems. (author). 67 refs., 13 tabs., 2 figs

  9. KAERI software safety guideline for developing safety-critical software in digital instrumentation and control system of nuclear power plant

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jang Soo; Kim, Jang Yeol; Eum, Heung Seop

    1997-07-01

    Recently, the safety planning for safety-critical software systems is being recognized as the most important phase in the software life cycle, and being developed new regulatory positions and standards by the regulatory and the standardization organization. The requirements for software important to safety of nuclear reactor are described in such positions and standards. Most of them are describing mandatory requirements, what shall be done, for the safety-critical software. The developers of such a software. However, there have been a lot of controversial factors on whether the work practices satisfy the regulatory requirements, and to justify the safety of such a system developed by the work practices, between the licenser and the licensee. We believe it is caused by the reason that there is a gap between the mandatory requirements (What) and the work practices (How). We have developed a guidance to fill such gap, which can be useful for both licenser and licensee to conduct a justification of the safety in the planning phase of developing the software for nuclear reactor protection systems. (author). 67 refs., 13 tabs., 2 figs.

  10. MAPS Appraisal Report Form

    CERN Multimedia

    HR Department

    2005-01-01

    As announced in Weekly Bulletin 48/2004, from now onwards, the paper MAPS appraisal report form has been replaced by an electronic form, which is available via EDH (on the EDH desktop under Other Tasks / HR & Training) No changes have been made to the contents of the form. Practical information will be available on the web page http://cern.ch/ais/projs/forms/maps/info.htm, and information meetings will be held on the following dates: 18 January 2005: MAIN AUDITORIUM (500-1-001) from 14:00 to 15:30. 20 January 2005: AB AUDITORIUM II (864-1-D02) from14:00 to 15:30. 24 January 2005: AT AUDITORIUM (30-7-018) from 10:00 to 11:30. Human Resources Department Tel. 73566

  11. Appraising Adaptive Management

    Directory of Open Access Journals (Sweden)

    Kai N. Lee

    1999-12-01

    Full Text Available Adaptive management is appraised as a policy implementation approach by examining its conceptual, technical, equity, and practical strengths and limitations. Three conclusions are drawn: (1 Adaptive management has been more influential, so far, as an idea than as a practical means of gaining insight into the behavior of ecosystems utilized and inhabited by humans. (2 Adaptive management should be used only after disputing parties have agreed to an agenda of questions to be answered using the adaptive approach; this is not how the approach has been used. (3 Efficient, effective social learning, of the kind facilitated by adaptive management, is likely to be of strategic importance in governing ecosystems as humanity searches for a sustainable economy.

  12. Comparison of the Safety Critical Software V and V Requirements for the Research Reactor Instrumentation and Control System

    Energy Technology Data Exchange (ETDEWEB)

    Joo, Sungmoon; Suh, Yong-Suk; Park, Cheol [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2016-10-15

    This study was motivated by a research reactor project where the owner of the project and the equipment vendors are from two different standards frameworks. This paper reviews two major standards frameworks - NRC-IEEE and IAEA-IEC - and the software classification schemes as a background, then discuss the V and V issue. The purpose of this paper is by no means to solve the cross-standards-framework qualification issue, but, rather, is to remind the stakeholders of research reactor projects. V and V are also essential for the approval from regulatory bodies. As standards define or recommend consolidated engineering practices, methods, or criteria, V and V activities for software qualification are not exceptional. Within a standards framework, usually, the processes for the qualification of safety-critical software are well-established such that the safety is maximized while minimizing the compromises in software quality, safety, and reliability. When, however, multiple standards frameworks are involved in a research reactor project, it is difficult for equipment vendors to implement appropriate V and V activities as there is no unified view on this cross-standards-framework qualification issue yet. There are two major standards frameworks for safety-critical software development in nuclear industry. Unfortunately different safety classifications for software and thus different requirements for qualification are in place. What makes things worse is that (i) there are ambiguities in the standards and rooms for each stakeholders’ interpretation, and (ii) there is no one-to-one mapping between the associated V and V methods and activities. These may put the stakeholders of research reactor projects in trouble.

  13. Comparison of the Safety Critical Software V and V Requirements for the Research Reactor Instrumentation and Control System

    International Nuclear Information System (INIS)

    Joo, Sungmoon; Suh, Yong-Suk; Park, Cheol

    2016-01-01

    This study was motivated by a research reactor project where the owner of the project and the equipment vendors are from two different standards frameworks. This paper reviews two major standards frameworks - NRC-IEEE and IAEA-IEC - and the software classification schemes as a background, then discuss the V and V issue. The purpose of this paper is by no means to solve the cross-standards-framework qualification issue, but, rather, is to remind the stakeholders of research reactor projects. V and V are also essential for the approval from regulatory bodies. As standards define or recommend consolidated engineering practices, methods, or criteria, V and V activities for software qualification are not exceptional. Within a standards framework, usually, the processes for the qualification of safety-critical software are well-established such that the safety is maximized while minimizing the compromises in software quality, safety, and reliability. When, however, multiple standards frameworks are involved in a research reactor project, it is difficult for equipment vendors to implement appropriate V and V activities as there is no unified view on this cross-standards-framework qualification issue yet. There are two major standards frameworks for safety-critical software development in nuclear industry. Unfortunately different safety classifications for software and thus different requirements for qualification are in place. What makes things worse is that (i) there are ambiguities in the standards and rooms for each stakeholders’ interpretation, and (ii) there is no one-to-one mapping between the associated V and V methods and activities. These may put the stakeholders of research reactor projects in trouble

  14. Watchful waiting or induction of labour--a matter of informed choice: identification, analysis and critical appraisal of decision aids and patient information regarding care options for women with uncomplicated singleton late and post term pregnancies: a review.

    Science.gov (United States)

    Berger, Bettina; Schwarz, Christiane; Heusser, Peter

    2015-05-07

    Decision-making during pregnancy regarding different options of care can be difficult, particularly when risks of intervention versus no intervention for mother and baby are unclear. Unbiased information and support for decision making may be beneficial in these situations. The management of normal pregnancies at and beyond term is an example of such a situation. In order to determine the need to develop an evidence-based decision aid this paper searches, analyses and appraises patient decision aids and patient information leaflets regarding care options in cases of late term and post-term pregnancies, including complementary and alternative medicine (CAM). A literature search was carried out in a variety of lay and medical databases. written information related to uncomplicated singleton pregnancies and targeted at lay people. Analysis and appraisal of included material by means of quality criteria was set up based on the International Patient Decision Aid Standards accounting for evidence-basing of CAM options. Inclusion of two decision aids and eleven leaflets from four decision aids and sixteen leaflets. One decision aid met the quality criteria almost completely, the other one only insufficiently despite providing some helpful information. Only one leaflet is of good quality, but cannot substitute a decision aid. There is an urgent need for the design of an evidence-based decision aid of good quality for late-term or post-term pregnancy, particularly in German language.

  15. COMMUNICATION OPENNESS IN PERFORMANCE APPRAISAL SYSTEMS ENHANCING JOB SATISFACTION

    Directory of Open Access Journals (Sweden)

    ISMAIL Azman

    2014-06-01

    Full Text Available The aim of this paper is to investigate the relationship between communication openness in performance appraisal systems and job satisfaction. A survey method was employed to gather data from employees who have worked in a privatized postal company in Sarawak, Malaysia. SmartPLS version 2.0 was used to determine the validity and reliability of instrument and test the research hypotheses. The outcomes of SmartPLS path model showed that explanation and feedback were positively and significantly related to job satisfaction. This result confirms that the ability of appraisers to clearly explain the performance appraisal practices and adequately provide feedback in determining performance scores have been important predictors of appraises’ job satisfaction in the studied organization. Further, this study provides discussion, implications and conclusion.

  16. Performance appraisal: carrot or stick? | Quinn | South African ...

    African Journals Online (AJOL)

    To be critically reflective, practitioners need to gather feedback about their performance so that they can reflect on it and develop themselves in those areas in which weaknesses are recognised. The Academic Development Centre staff agreed to participate in a departmental Performance Appraisal process in order to ...

  17. Uranium-mill appraisal program

    International Nuclear Information System (INIS)

    Everett, R.J.; Cain, C.L.

    1982-08-01

    The results of special team appraisals at NRC-licensed uranium mills in the period May to November 1981 are reported. Since the Three Mile Island accident, NRC management has instituted a program of special team appraisals of radiation protection programs at certain NRC-licensed facilities. These appraisals were designed to identify weaknesses and strengths in NRC-licensed programs, including those areas not covered by explicit regulatory requirements. The regulatory requirements related to occupational radiation protection and environmental monitoring at uranium mills have been extensively upgraded in the past few years. In addition, there was some NRC staff concern with respect to the effectiveness of NRC licensing and inspection programs. In response to this concern and to changes in mill requirements, the NRC staff recommended that team appraisals be conducted at mills to determine the adequacy of mill programs, the effectiveness of the new requirements, and mill management implementation of programs and requirements. This report describes the appraisal scope and methodology as well as summary findings and conclusions. Significant weaknesses identified during the mill appraisals are discussed as well as recommendations for improvements in uranium mill programs and mill licensing and inspection

  18. How to appraise a diagnostic test

    Directory of Open Access Journals (Sweden)

    Ramanitharan Manikandan

    2011-01-01

    Full Text Available Urologists frequently encounter problems in making a clinical diagnosis whose resolution requires the use of diagnostic tests. With an ever increasing choice of investigations being available, the urologist often has to decide which diagnostic test(s will best resolve the patient′s diagnostic problem. In this article, we aim to help the urologist understand how to critically appraise studies on diagnostic tests and make a rational choice. This article presents the guiding principles in scientifically assessing studies on diagnostic tests by proposing a clinical scenario. The authors describe a standardized protocol to assess the validity of the test and its relevance to the clinical problem that can help the urologist in decision making. The three important issues to be considered when evaluating the validity of the study are to identify how the study population was chosen, how the test was performed and whether there is a comparison to the gold standard test so as to confirm or refute the diagnosis. Then, the urologist would need to know the probability of the test in providing the correct diagnosis in an individual patient in order to decide about its utility in solving the diagnostic dilemma. By performing the steps described in this article, the urologist would be able to critically appraise diagnostic studies and draw meaningful conclusions about the investigations in terms of validity, results and its applicability to the patient′s problem. This would provide a scientific basis for using diagnostic tests for improving patient care.

  19. A Critical Review of Low Back Pain Guidelines.

    Science.gov (United States)

    Chetty, Laran

    2017-09-01

    Low back pain (LBP) remains one of the most common and challenging musculoskeletal conditions encountered by health care professionals and is a leading cause of absenteeism. Clinical guidelines are often considered best evidence in health care. The aim of this critical review was to assess the quality and recommendations of LBP guidelines using the Appraisal of Guidelines Research and Evaluation (AGREE) instrument. Electronic databases were used to identify LBP guidelines published between 2000 and 2015. Nine guidelines were selected for review from a total of 17. Only five guidelines effectively addressed the AGREE scoring. On the basis of the appraisal and domain scores, only four guidelines were strongly recommended. Improved translation of research evidence from guidelines to clinical practice is needed.

  20. Critical Appraisal of Information on the Web in Practice: Undergraduate Students’ Knowledge, Reported Use, and Behaviour / Évaluation critique de l’information sur la toile : une vision pratique : les connaissances des étudiants de premier cycle, leur uti

    Directory of Open Access Journals (Sweden)

    Neil R. Hogan

    2012-02-01

    Full Text Available Undergraduates use a wide range of information resources for academic and nonacademic purposes, including web sites that range from credible, peer reviewed, online journal sites, to biased and inaccurate promotional web sites. Students are taught basic critical appraisal skills, but do they apply these skills to make decisions about information in different web sites? In an experimental setting, undergraduate students examined pairs of web sites containing conflicting information based on different aspects of critical appraisal, namely credibility of the author of the information, purpose of the web site, and last update of the site, and answered multiple choice questions about the conflicting information. Results indicated that students failed to use critical appraisal criteria, and that while knowledge of and self-reported use of these criteria were related to each other, they were not related to behaviour. This research demonstrates the need for alternative strategies for critical appraisal instruction and assessment. Les étudiants de premier cycle consultent une vaste gamme de sources d’information à des fins universitaires et non universitaires, y compris des sites Web allant de revues en ligne crédibles et évaluées par des pairs à des sites Web promotionnels partials et inexacts. On enseigne aux étudiants des méthodes de base d’évaluation critique, mais mettent-ils ces méthodes en pratique pour prendre des décisions relativement à l’information tirée de différents sites Web? Dans un cadre expérimental, les étudiants de premier cycle ont étudié des paires de sites Web contenant des informations contradictoires en se fondant sur différents aspects de l’évaluation critique, notamment la crédibilité de l’auteur de l’information, l’intention du site Web et la dernière mise à jour du site, et ont répondu à des questions à choix multiples concernant les informations contradictoires. Les r

  1. An appraisal of the quality of published qualitative dental research.

    Science.gov (United States)

    Masood, Mohd; Thaliath, Ebin T; Bower, Elizabeth J; Newton, J Timothy

    2011-06-01

    To appraise the quality of published qualitative research in dentistry and identify aspects of quality, which require attention in future research. Qualitative research studies on dental topics were appraised using the critical appraisal skills programme (CASP) appraisal framework for qualitative research. The percentage of CASP criteria fully met during the assessment was used as an indication of the quality of each paper. Individual criteria were not weighted. Forty-three qualitative studies were identified for appraisal of which 48% had a dental public health focus. Deficiencies in detail of reporting, research design, methodological rigour, presentation of findings, reflexivity, credibility of findings and relevance of study were identified. Problems with quality were apparent irrespective of journal impact factor, although papers from low impact factor journals exhibited the most deficiencies. Journals with the highest impact factors published the least qualitative research. The quality of much of the qualitative research published on dental topics is mediocre. Qualitative methods are underutilized in oral health research. If quality guidelines such as the CASP framework are used in the context of a thorough understanding of qualitative research design and data analysis, they can promote good practice and the systematic assessment of qualitative research. © 2010 John Wiley & Sons A/S.

  2. HOW APPRAISERS DEVELOP FAIR VALUE

    Directory of Open Access Journals (Sweden)

    MIROSLAV ŠKODA

    2012-01-01

    Full Text Available Management is responsible for its own financial decisions. If we take into account, that fair value concept was shown in financial crisis as something that does not work anymore in this way; there is a big need to develop it for the future. Non-professional readers of financial statements believe, however, that company financials are the work of the public accounting firm that had signed the audit certificate. The main reason for bringing this point up is that when companies disclose Fair Value (FV information in their financial statements, they are taking responsibility for the values disclosed. Management may often be encouraged to utilize the services of an outside professional, but at the end of the day, the outside appraiser is a hired gun. Although the appraiser has to take responsibility for his own work, hiring the appraiser does not absolve management of its ultimate responsibility. The obverse of this is also true. Management does not have to hire the appraiser to develop any fair value disclosures made in the financial statements. Developing FV information is not recommended as a do-it yourself undertaking, there is nothing in Generally Accepted Accounting Principles (GAAP or Securities Exchange Commission (SEC regulations, however, that requires an outside appraiser.

  3. A New Appraisal- Lessons from the History of Efforts to Value Green and High-Performance Home Attributes in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Mills, Evan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-10-21

    Appraisers, RESNET, USEPA, USDOE and its National Laboratories, the U.S. Green Buildings Council, and the Vermont Green Homes Alliance. Many activities have resulted, ranging from trainings, to data-gathering instruments, and the emergence of a literature attempting to statistically isolate the effects of green/HP characteristics on home values. In some cases, the results of studies have been overgeneralized and oversold, and embodied flawed methods. Although the green/HP community has encouraged appraisers to focus on exemplary buildings (e.g., LEED or ENERGY STAR Certified), any level of green or energy performance can in fact influence value, including below-average performance (a.k.a. “brown discount”), irrespective of whether or not the building has been formally rated. This overly narrow focus represents a significant missed opportunity. Other surmountable challenges include limitations to non-appraisers’ understanding of the appraisal process (and practical constraints therein). A byproduct of this can be unrealistic expectations of what appraisers can and will do in the marketplace. These challenges notwithstanding, the environment for moving forward has improved. There is better data today (a critical need); expanded efforts to disclose energy use information (characteristics, consumption, bills); improved and more pervasive building energy codes, building rating and labeling initiatives; and a host of federal, state, and local policies that have collectively brought green/HP practices much more into the mainstream. Meanwhile, a renewed focus on professional standards of care and competency for assessing green/HP homes make it increasingly important for appraisers to consider these factors in their assignments. Despite the past four decades of studies, there is little if any discernible uptake of these practices by the appraisal practice at large. It would behoove interested parties to step back and consider what new strategies might be productive. A key

  4. A scoring system for appraising mixed methods research, and concomitantly appraising qualitative, quantitative and mixed methods primary studies in Mixed Studies Reviews.

    Science.gov (United States)

    Pluye, Pierre; Gagnon, Marie-Pierre; Griffiths, Frances; Johnson-Lafleur, Janique

    2009-04-01

    A new form of literature review has emerged, Mixed Studies Review (MSR). These reviews include qualitative, quantitative and mixed methods studies. In the present paper, we examine MSRs in health sciences, and provide guidance on processes that should be included and reported. However, there are no valid and usable criteria for concomitantly appraising the methodological quality of the qualitative, quantitative and mixed methods studies. To propose criteria for concomitantly appraising the methodological quality of qualitative, quantitative and mixed methods studies or study components. A three-step critical review was conducted. 2322 references were identified in MEDLINE, and their titles and abstracts were screened; 149 potentially relevant references were selected and the full-text papers were examined; 59 MSRs were retained and scrutinized using a deductive-inductive qualitative thematic data analysis. This revealed three types of MSR: convenience, reproducible, and systematic. Guided by a proposal, we conducted a qualitative thematic data analysis of the quality appraisal procedures used in the 17 systematic MSRs (SMSRs). Of 17 SMSRs, 12 showed clear quality appraisal procedures with explicit criteria but no SMSR used valid checklists to concomitantly appraise qualitative, quantitative and mixed methods studies. In two SMSRs, criteria were developed following a specific procedure. Checklists usually contained more criteria than needed. In four SMSRs, a reliability assessment was described or mentioned. While criteria for quality appraisal were usually based on descriptors that require specific methodological expertise (e.g., appropriateness), no SMSR described the fit between reviewers' expertise and appraised studies. Quality appraisal usually resulted in studies being ranked by methodological quality. A scoring system is proposed for concomitantly appraising the methodological quality of qualitative, quantitative and mixed methods studies for SMSRs. This

  5. [Elaboration and critical evaluation of clinical guidelines].

    Science.gov (United States)

    García Villar, C

    2015-11-01

    Clinical guidelines are documents to help professionals and patients select the best diagnostic or therapeutic option. Elaborating guidelines requires an efficient literature search and a critical evaluation of the articles found to select the most appropriate ones. After that, the recommendations are formulated and then must be externally evaluated before they can be disseminated. Even when the guidelines are very thorough and rigorous, it is important to know whether they fulfill all the methodological requisites before applying them. With this aim, various scales have been developed to critically appraise guidelines. Of these, the AGREE II instrument is currently the most widely used. This article explains the main steps in elaborating clinical guidelines and the main aspects that should be analyzed to know whether the guidelines are well written. Copyright © 2015 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  6. Analysis of appraisal tool of system security engineering capability maturity based on component

    International Nuclear Information System (INIS)

    Liu Zhenghai; Yang Xiaohua; Zou Shuliang; Liu Yachun; Xiao Jiantian; Liu Zhiming

    2012-01-01

    Spent Fuel Reprocessing is a part of nuclear fuel cycle and is the inevitably choice of nuclear power sustainable development. Reprocessing needs to face with radiological, criticality, chemical hazards. Besides using the tradition appraisal methods based on the security goals, it is a beneficial supplement that using the appraisal method of system security engineering capability maturity model based on the process. Experts should check and approve large numbers of documents during the appraisal based on system security engineering capability maturity model, so it is necessary that developing a tool to assist the expert to complete the appraisal. The method of developing software based on component is highly effective, nimble and reliable. Component technology is analyzed, the methods of extraction model domain components and general components is introduced, and the appraisal system is developed based on component technology. (authors)

  7. 9 CFR 50.9 - Appraisals.

    Science.gov (United States)

    2010-01-01

    ... part must be appraised at their fair market value by an appraiser selected by APHIS. APHIS may decline... veterinarian in charge may grant a reasonable time for the presentation of their registration papers. [67 FR...

  8. Using Expectancy Theory to Explain Performance Appraisal ...

    African Journals Online (AJOL)

    pc

    2018-03-05

    Mar 5, 2018 ... appraisal conducting style, the relation between the performance appraisal system and task ... the article first explains the theory model which is based expectancy theory. II. ... which in return lead to rewards. According to [12],.

  9. 12 CFR 564.3 - Appraisals required; transactions requiring a State certified or licensed appraiser.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Appraisals required; transactions requiring a State certified or licensed appraiser. 564.3 Section 564.3 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY APPRAISALS § 564.3 Appraisals required; transactions requiring a State...

  10. Appraisal of family doctors: an evaluation study.

    NARCIS (Netherlands)

    Lewis, M.I.; Elwyn, G.; Wood, F.

    2003-01-01

    BACKGROUND: Appraisal has evolved to become a key component of workforce management. However, it is not clear from existing proposals for appraisal of doctors whether employers, health authorities or primary care organisations should take responsibility for appraisal processes. AIMS: To evaluate the

  11. 7 CFR 4279.144 - Appraisals.

    Science.gov (United States)

    2010-01-01

    ... value of the collateral. All real property appraisals associated with Agency guaranteed loanmaking and... appraise the property in question. All appraisals will include consideration of the potential effects from... value of the collateral. For additional guidance and information concerning the completion of real...

  12. Environmental bureaucracies appraised

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, E F

    1977-09-01

    Bureaucratic mechanisms as a means of regulating the environment are evaluated. Bureaucracy as a technology is one among several instruments for regulation. Styles of environmentally concerned bureaucracies are described. Both local control and a central power to monitor developments that have a large impact on the environment and to force action beyond local strength should be established. The conflict surrounding choices for strong central powers and for a series of polycentric structures is surveyed. Bureaucracy and conflicting environmental values are discussed. Public participation in environmental bureaucracies is assessed. The institutionalization of environmental problems is reviewed. Basic social decisions should be able to prevent bureaucracy from institutionalizing environmental problems rather than trying to solve them. 1 drawing, 2 photos, 12 references.

  13. Appraisal Psychology, Neurobiology, and Language.

    Science.gov (United States)

    Schumann, John H.

    2001-01-01

    Proposes that the confluence of stimulus appraisal and social cognition that is effected by the neural system in the brain has important implications for language and learning theories. Describes the anatomy and functions of this neural system and discusses how it may operate in motivation for second language acquisition and how in conjunction…

  14. Determining the critical relative humidity at which the glassy to rubbery transition occurs in polydextrose using an automatic water vapor sorption instrument.

    Science.gov (United States)

    Yuan, Xiaoda; Carter, Brady P; Schmidt, Shelly J

    2011-01-01

    Similar to an increase in temperature at constant moisture content, water vapor sorption by an amorphous glassy material at constant temperature causes the material to transition into the rubbery state. However, comparatively little research has investigated the measurement of the critical relative humidity (RHc) at which the glass transition occurs at constant temperature. Thus, the central objective of this study was to investigate the relationship between the glass transition temperature (Tg), determined using thermal methods, and the RHc obtained using an automatic water vapor sorption instrument. Dynamic dewpoint isotherms were obtained for amorphous polydextrose from 15 to 40 °C. RHc was determined using an optimized 2nd-derivative method; however, 2 simpler RHc determination methods were also tested as a secondary objective. No statistical difference was found between the 3 RHc methods. Differential scanning calorimetry (DSC) Tg values were determined using polydextrose equilibrated from 11.3% to 57.6% RH. Both standard DSC and modulated DSC (MDSC) methods were employed, since some of the polydextrose thermograms exhibited a physical aging peak. Thus, a tertiary objective was to compare Tg values obtained using 3 different methods (DSC first scan, DSC rescan, and MDSC), to determine which method(s) yielded the most accurate Tg values. In general, onset and midpoint DSC first scan and MDSC Tg values were similar, whereas onset and midpoint DSC rescan values were different. State diagrams of RHc and experimental temperature and Tg and %RH were compared. These state diagrams, though obtained via very different methods, showed relatively good agreement, confirming our hypothesis that water vapor sorption isotherms can be used to directly detect the glassy to rubbery transition. Practical Application: The food polymer science (FPS) approach, pioneered by Slade and Levine, is being successfully applied in the food industry for understanding, improving, and

  15. Nailfold capillaroscopy microscopy - an interdisciplinary appraisal.

    Science.gov (United States)

    Klein-Weigel, Peter Franz; Sunderkötter, Cord; Sander, Oliver

    2016-09-01

    Nailfold capillaroscopy is a method of great diagnostic value in the differential diagnosis of primary versus secondary Raynaud´s phenomenon, of systemic sclerosis versus other so called connective tissue diseases and of additional diagnostic value in other entities. Rheumatologists, dermatologists, and angiologists in Germany have convened in an interdisciplinary working group in which they synergistically combined their expertise to develop a common nomenclature and standards for the technical performance of nailfold capillary microscopy. The article gives an overview of historical and technical aspects of capillaroscopy, morphologic findings, and disease-specific patterns. It also provides a critical appraisal of its significance in the diagnosis and sequelae of these interdisciplinarily-managed diseases including its performance in children and gives an excursion in the potential perspectives of capillaroscopy in less common indications.

  16. Instruments to assess self-care among healthy children: A systematic review of measurement properties.

    Science.gov (United States)

    Urpí-Fernández, Ana-María; Zabaleta-Del-Olmo, Edurne; Montes-Hidalgo, Javier; Tomás-Sábado, Joaquín; Roldán-Merino, Juan-Francisco; Lluch-Canut, María-Teresa

    2017-12-01

    To identify, critically appraise and summarize the measurement properties of instruments to assess self-care in healthy children. Assessing self-care is a proper consideration for nursing practice and nursing research. No systematic review summarizes instruments of measurement validated in healthy children. Psychometric review in accordance with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) panel. MEDLINE, CINAHL, PsycINFO, Web of Science and Open Grey were searched from their inception to December 2016. Validation studies with a healthy child population were included. Search was not restricted by language. Two reviewers independently assessed the methodological quality of included studies using the COSMIN checklist. Eleven studies were included in the review assessing the measurement properties of ten instruments. There was a maximum of two studies per instrument. None of the studies evaluated the properties of test-retest reliability, measurement error, criterion validity and responsiveness. Internal consistency and structural validity were rated as "excellent" or "good" in four studies. Four studies were rated as "excellent" in content validity. Cross-cultural validity was rated as "poor" in the two studies (three instruments) which cultural adaptation was carried out. The evidence available does not allow firm conclusions about the instruments identified in terms of reliability and validity. Future research should focus on generate evidence about a wider range of measurement properties of these instruments using a rigorous methodology, as well as instrument testing on different countries and child population. © 2017 John Wiley & Sons Ltd.

  17. A Critical Investigation of the Relevance and Potential of IDPS as a Local Governance Instrument for Pursuing Social Justice in South Africa

    Directory of Open Access Journals (Sweden)

    Oliver Njuh Fuo

    2013-12-01

    Full Text Available Unlike the situation in the past, when local government’s role was limited to service delivery, local government is now constitutionally mandated to play an expanded developmental role. As a “co-responsible” sphere of government, local government is obliged to contribute towards realising the transformative constitutional mandate aimed at social justice. South African scholars and jurists share the view that social justice is primarily concerned with the eradication of poverty and extreme inequalities in access to basic services, and aims to ensure that poor people command sufficient material resources to facilitate their equal participation in socio-political life. In order to enable municipalities to fulfil their broad constitutional mandate, the system of integrated development planning (IDPs came into effect in South Africa in 2000. Each municipality is obliged to design, adopt and implement an integrated development plan in order to achieve its expanded constitutional mandate. The IDP is considered to be the chief legally prescribed governance instrument for South African municipalities. The purpose of this article is to explore and critically investigate the relevance and potential of IDPs in contributing towards the achievement of social justice in South Africa. This article argues inter alia that the multitude of sectors that converge in an IDP makes it directly relevant and gives it enormous potential to contribute towards social justice because, depending on the context, municipalities could include and implement strategies that specifically respond to diverse areas of human need. In this regard, the legal and policy frameworks for IDPs provide a structured scheme that could be used by municipalities to prioritise and meet the basic needs of especially the poor. Despite its potential, it is argued that the ability of IDPs to respond to the basic needs of the poor is largely constrained by a series of implementation challenges

  18. 242-A Evaporator crystallizer facility integrated annual safety appraisal

    International Nuclear Information System (INIS)

    1991-01-01

    This report provides the results of the Fiscal Year (FY) 1991 Annual Integrated Safety Appraisal of the 242-A Evaporator Crystallizer Facility in the Hanford 200 East Area. The appraisal was conducted in December 1990 and January 1991, by the Waste Tank Safety Assurance (WTSA) organizations in conjunction with Radiological Engineering, Criticality Safety, Packaging and Shipping Safety, Emergency Preparedness, Environmental Compliance, and Quality Assurance. Reports of these eight organizations are presented as Sections 2 through 7 of this report. The purpose of the appraisal was to verify that the 242-A Evaporator meets US Department of Energy (DOE) and Westinghouse Hanford Company (WHC) requirements and current industry standards of good practice for the areas being appraised. A further purpose was to identify areas in which program effectiveness could be improved. In accordance with the guidance of WHC Management Requirements and Procedures (MRP)5.6, previously identified deficiencies which are being resolved by line management were not repeated as Findings or Observations unless progress or intended disposition was considered to be unsatisfactory

  19. A psychometric appraisal of the DREEM

    Directory of Open Access Journals (Sweden)

    Hammond Sean M

    2012-01-01

    Full Text Available Abstract Background The quality of the Educational environment is a key determinant of a student centred curriculum. Evaluation of the educational environment is an important component of programme appraisal. In order to conduct such evaluation use of a comprehensive, valid and reliable instrument is essential. One of most widely used contemporary tools for evaluation of the learning environment is the Dundee Ready Education Environment Measure (DREEM. Apart from the initial psychometric evaluation of the DREEM, few published studies report its psychometric properties in detail. The aim of this study was to examine the psychometric quality of the DREEM measure in the context of medical education in Ireland and to explore the construct validity of the device. Methods 239 final year medical students were asked to complete the DREEM inventory. Anonymised responses were entered into a database. Data analysis was performed using PASW 18 and confirmatory factor analysis performed. Results Whilst the total DREEM score had an acceptable level of internal consistency (alpha 0.89, subscale analysis shows that two subscales had sub-optimal internal consistency. Multiple group confirmatory factor analysis (using Fleming's indices shows an overall fit of 0.76, representing a weak but acceptable level of fit. 17 of the 50 items manifest fit indices less than 0.70. We sought the best fitting oblique solution to the 5-subscale structure, which showed large correlations, suggesting that the independence of the separate scales is open to question. Conclusions There has perhaps been an inadequate focus on establishing and maintaining the psychometric credentials of the DREEM. The present study highlights two concerns. Firstly, the internal consistency of the 5 scales is quite variable and, in our sample, appears rather low. Secondly, the construct validity is not well supported. We suggest that users of the DREEM will provide basic psychometric appraisal of the

  20. A psychometric appraisal of the DREEM

    LENUS (Irish Health Repository)

    Hammond, Sean M

    2012-01-12

    Abstract Background The quality of the Educational environment is a key determinant of a student centred curriculum. Evaluation of the educational environment is an important component of programme appraisal. In order to conduct such evaluation use of a comprehensive, valid and reliable instrument is essential. One of most widely used contemporary tools for evaluation of the learning environment is the Dundee Ready Education Environment Measure (DREEM). Apart from the initial psychometric evaluation of the DREEM, few published studies report its psychometric properties in detail. The aim of this study was to examine the psychometric quality of the DREEM measure in the context of medical education in Ireland and to explore the construct validity of the device. Methods 239 final year medical students were asked to complete the DREEM inventory. Anonymised responses were entered into a database. Data analysis was performed using PASW 18 and confirmatory factor analysis performed. Results Whilst the total DREEM score had an acceptable level of internal consistency (alpha 0.89), subscale analysis shows that two subscales had sub-optimal internal consistency. Multiple group confirmatory factor analysis (using Fleming\\'s indices) shows an overall fit of 0.76, representing a weak but acceptable level of fit. 17 of the 50 items manifest fit indices less than 0.70. We sought the best fitting oblique solution to the 5-subscale structure, which showed large correlations, suggesting that the independence of the separate scales is open to question. Conclusions There has perhaps been an inadequate focus on establishing and maintaining the psychometric credentials of the DREEM. The present study highlights two concerns. Firstly, the internal consistency of the 5 scales is quite variable and, in our sample, appears rather low. Secondly, the construct validity is not well supported. We suggest that users of the DREEM will provide basic psychometric appraisal of the device in future

  1. ORO appraisal strategy involving use of NDA instrumentation

    International Nuclear Information System (INIS)

    Lux, C.R.

    1977-12-01

    ORO has used the following nondestructive assay (NDA) systems for verifying uranium inventories at contractor-operated installations: gamma spectroscopy, thickness-corrected gamma spectroscopy, passive neutron measurement, and random driver measurement. A brief description of each system is given and results of in-field measurements performed on contractors' inventories utilizing each system are discussed

  2. Analysis of Appraising Agricultural Intangible Asset Value by Cost Method

    OpenAIRE

    Li, Xiao-Juan

    2010-01-01

    On the basis of describing the connotation of agricultural intangible asset and cost method, the technical ideas of appraising by cost method are introduced. The article analyzes the advantages (simple appraisal principle and easy to understand and grasp; overall consideration of various factors related to appraisal result value) and disadvantages (high appraisal cost; difficult to appraise and grasp various appraisal factors) of appraising by cost method. The article also summarizes the prec...

  3. How to improve a critical performance for an ExoMars 2020 Scientific Instrument (RLS). Raman Laser Spectrometer Signal to Noise Ratio (SNR) Optimization

    Science.gov (United States)

    Canora, C. P.; Moral, A. G.; Rull, F.; Maurice, S.; Hutchinson, I.; Ramos, G.; López-Reyes, G.; Belenguer, T.; Canchal, R.; Prieto, J. A. R.; Rodriguez, P.; Santamaria, P.; Berrocal, A.; Colombo, M.; Gallago, P.; Seoane, L.; Quintana, C.; Ibarmia, S.; Zafra, J.; Saiz, J.; Santiago, A.; Marin, A.; Gordillo, C.; Escribano, D.; Sanz-Palominoa, M.

    2017-09-01

    The Raman Laser Spectrometer (RLS) is one of the Pasteur Payload instruments, within the ESA's Aurora Exploration Programme, ExoMars mission. Raman spectroscopy is based on the analysis of spectral fingerprints due to the inelastic scattering of light when interacting with matter. RLS is composed by Units: SPU (Spectrometer Unit), iOH (Internal Optical Head), and ICEU (Instrument Control and Excitation Unit) and the harnesses (EH and OH). The iOH focuses the excitation laser on the samples and collects the Raman emission from the sample via SPU (CCD) and the video data (analog) is received, digitalizing it and transmiting it to the processor module (ICEU). The main sources of noise arise from the sample, the background, and the instrument (Laser, CCD, focuss, acquisition parameters, operation control). In this last case the sources are mainly perturbations from the optics, dark signal and readout noise. Also flicker noise arising from laser emission fluctuations can be considered as instrument noise. In order to evaluate the SNR of a Raman instrument in a practical manner it is useful to perform end-to-end measurements on given standards samples. These measurements have to be compared with radiometric simulations using Raman efficiency values from literature and taking into account the different instrumental contributions to the SNR. The RLS EQM instrument performances results and its functionalities have been demonstrated in accordance with the science expectations. The Instrument obtained SNR performances in the RLS EQM will be compared experimentally and via analysis, with the Instrument Radiometric Model tool. The characterization process for SNR optimization is still on going. The operational parameters and RLS algorithms (fluorescence removal and acquisition parameters estimation) will be improved in future models (EQM-2) until FM Model delivery.

  4. Appraisal patterns of envy and related emotions

    OpenAIRE

    van de Ven, Niels; Zeelenberg, Marcel; Pieters, Rik

    2011-01-01

    Envy is a frustrating emotion that arises from upward social comparison. Two studies investigated the appraisals that distinguish benign envy (aimed at improving one’s own situation) from malicious envy (aimed at pulling down the superior other). Study 1 found that appraisals of deservingness and control potential differentiated both types of envy. We manipulated these appraisals in Study 2 and found that while both did not influence the intensity of envy, they did determine the type of envy ...

  5. 76 FR 72306 - Federal Housing Administration (FHA) Appraiser Roster: Appraiser Qualifications for Placement on...

    Science.gov (United States)

    2011-11-23

    ... disciplinary action in any state in which the appraiser is certified; * * * * * (c) * * * (1) Appraisers subject to state disciplinary action. An appraiser whose state certification in any state has been revoked, suspended, or surrendered as a result of a state disciplinary action is automatically suspended from the...

  6. Positive emotion, appraisal, and the role of appraisal overlap in positive emotion co-occurrence.

    Science.gov (United States)

    Tong, Eddie M W; Jia, Lile

    2017-02-01

    Appraisal research has traditionally focused on negative emotions but has not addressed issues concerning the relationships between several positive emotions and appraisals in daily life and the extent to which co-occurrence of positive emotions can be explained by overlap in appraisals. Driven by a priori hypotheses on appraisal-emotion relationships, this study investigated 12 positive emotions and 13 appraisal dimensions using Ecological Momentary Assessment. The results provide strong evidence that positive emotions and appraisals correlate significantly in daily life. Importantly, we found that the positive emotions' overlap on theoretically relevant, as compared to irrelevant, appraisals was stronger and more predictive of their co-occurrence. Furthermore, appraisal overlap on theoretically relevant appraisals predicted the co-occurrence of positive emotions even when the appraisal of pleasantness was excluded, indicating that positive emotions do not co-occur just by virtue of their shared valence. Our findings affirmed and refined the appraisal profiles of positive emotions and underscore the importance of appraisals in accounting for the commonality and differences among positive emotions. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  7. Test Takers' Performance Appraisals, Appraisal Calibration, and Cognitive and Metacognitive Strategy Use

    Science.gov (United States)

    Phakiti, Aek

    2016-01-01

    The current study explores the nature and relationships among test takers' performance appraisals, appraisal calibration, and reported cognitive and metacognitive strategy use in a language test situation. Performance appraisals are executive processes of strategic competence for judging test performance (e.g., evaluating the correctness or…

  8. Socio-economic status by rapid appraisal is highly correlated with mortality risks in rural Africa

    NARCIS (Netherlands)

    van Bodegom, D.; May, L.; Kuningas, M.; Kaptijn, R.; Thomese, G.C.F.; Meij, H.J.; Amankwa, J.; Westendorp, R.G.J.

    2009-01-01

    Socio-economic status is an important determinant of health and survival in rural Africa and necessitates a practical and valid instrument to implement in health studies. Our objective was to investigate the validity of the rapid appraisal method to assess socio-economic status and its ability to

  9. The Assessment of School Climate: Review and Appraisal of Published Student-Report Measures

    Science.gov (United States)

    Ramelow, Daniela; Currie, Dorothy; Felder-Puig, Rosemarie

    2015-01-01

    School climate measurement is a long-standing topic in educational research. This review article provides an overview and appraisal of school climate measures published between 2003 and 2013 in scientific journals. A search for published school climate instruments for secondary school students was made in three databases. Twelve articles meeting…

  10. Using Probabilistic Models to Appraise and Decide on Sovereign Disaster Risk Financing and Insurance

    OpenAIRE

    Ley-Borrás, Roberto; Fox, Benjamin D.

    2015-01-01

    This paper presents an overview of the structure of probabilistic catastrophe risk models, discusses their importance for appraising sovereign disaster risk financing and insurance instruments and strategy, and puts forward a model and a process for improving decision making on the linked disaster risk management strategy and sovereign disaster risk financing and insurance strategy. The pa...

  11. Educação instrumental e formação cidadã: observações críticas sobre a pertinência social da universidade Instrumental civic education and critical training: remarks on the university of social relevance

    Directory of Open Access Journals (Sweden)

    Pedro Goergen

    2010-05-01

    Full Text Available O ensaio examina a relação entre universidade e sociedade desde a perspectiva dos conceitos de educação instrumental e educação cidadã. Argumenta que a pertinência social da universidade deve responder ao critério de justiça social e democracia que suas contribuições visam incrementar. Restrito ao aspecto do ensino, sob o recorte conceitual da educação instrumental e educação cidadã, o texto sugere que não cabe à universidade promover uma educação instrumental focada apenas na adaptação dos estudantes à realidade socioeconômica, mas também, formar cidadãos autônomos, críticos e reflexivos, socialmente competentes.The paper examines the relationship between university and society from an approach based on instrumental education and civic education. It is argued that the university's social pertinence must address the criteria that its contributions seek to foster, such as social justice and democracy. Restricted to the aspect of teaching, under the conceptual framework of instrumental education and citizen education, the text suggests that it is not up to the university to promote an instrumental education focused on student's adaptation to the social and economic reality, but to shape autonomous, critical and reflexive citizens who are socially competent.

  12. Inflammatory bowel disease-specific health-related quality of life instruments: a systematic review of measurement properties.

    Science.gov (United States)

    Chen, Xin-Lin; Zhong, Liang-Huan; Wen, Yi; Liu, Tian-Wen; Li, Xiao-Ying; Hou, Zheng-Kun; Hu, Yue; Mo, Chuan-Wei; Liu, Feng-Bin

    2017-09-15

    This review aims to critically appraise and compare the measurement properties of inflammatory bowel disease (IBD)-specific health-related quality of life instruments. Medline, EMBASE and ISI Web of Knowledge were searched from their inception to May 2016. IBD-specific instruments for patients with Crohn's disease, ulcerative colitis or IBD were enrolled. The basic characteristics and domains of the instruments were collected. The methodological quality of measurement properties and measurement properties of the instruments were assessed. Fifteen IBD-specific instruments were included, which included twelve instruments for adult IBD patients and three for paediatric IBD patients. All of the instruments were developed in North American and European countries. The following common domains were identified: IBD-related symptoms, physical, emotional and social domain. The methodological quality was satisfactory for content validity; fair in internal consistency, reliability, structural validity, hypotheses testing and criterion validity; and poor in measurement error, cross-cultural validity and responsiveness. For adult IBD patients, the IBDQ-32 and its short version (SIBDQ) had good measurement properties and were the most widely used worldwide. For paediatric IBD patients, the IMPACT-III had good measurement properties and had more translated versions. Most methodological quality should be promoted, especially measurement error, cross-cultural validity and responsiveness. The IBDQ-32 was the most widely used instrument with good reliability and validity, followed by the SIBDQ and IMPACT-III. Further validation studies are necessary to support the use of other instruments.

  13. Social appraisal influences recognition of emotions.

    Science.gov (United States)

    Mumenthaler, Christian; Sander, David

    2012-06-01

    The notion of social appraisal emphasizes the importance of a social dimension in appraisal theories of emotion by proposing that the way an individual appraises an event is influenced by the way other individuals appraise and feel about the same event. This study directly tested this proposal by asking participants to recognize dynamic facial expressions of emotion (fear, happiness, or anger in Experiment 1; fear, happiness, anger, or neutral in Experiment 2) in a target face presented at the center of a screen while a contextual face, which appeared simultaneously in the periphery of the screen, expressed an emotion (fear, happiness, anger) or not (neutral) and either looked at the target face or not. We manipulated gaze direction to be able to distinguish between a mere contextual effect (gaze away from both the target face and the participant) and a specific social appraisal effect (gaze toward the target face). Results of both experiments provided evidence for a social appraisal effect in emotion recognition, which differed from the mere effect of contextual information: Whereas facial expressions were identical in both conditions, the direction of the gaze of the contextual face influenced emotion recognition. Social appraisal facilitated the recognition of anger, happiness, and fear when the contextual face expressed the same emotion. This facilitation was stronger than the mere contextual effect. Social appraisal also allowed better recognition of fear when the contextual face expressed anger and better recognition of anger when the contextual face expressed fear. 2012 APA, all rights reserved

  14. 12 CFR 34.45 - Appraiser independence.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Appraiser independence. 34.45 Section 34.45 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY REAL ESTATE LENDING AND... appraiser shall be engaged directly by the regulated institution or its agent, and have no direct or...

  15. 12 CFR 722.5 - Appraiser independence.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Appraiser independence. 722.5 Section 722.5 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING CREDIT UNIONS APPRAISALS... interest, financial or otherwise, in the property. If the only qualified persons available to perform an...

  16. Appraisal patterns of envy and related emotions

    NARCIS (Netherlands)

    van de Ven, N.; Zeelenberg, M.; Pieters, R.

    2012-01-01

    Envy is a frustrating emotion that arises from upward social comparison. Two studies investigated the appraisals that distinguish benign envy (aimed at improving one’s own situation) from malicious envy (aimed at pulling down the superior other). Study 1 found that appraisals of deservingness and

  17. 45 CFR 1160.12 - Appraisal procedures.

    Science.gov (United States)

    2010-10-01

    ... the amount of partial loss, or damage to, or any reduction in the fair market value as a result..., any reduction in the fair market value of, the indemnified item(s). The appraisers' agreement with... appropriate, such reduction in the fair market value. Disputes between the appraisers with respect to partial...

  18. Appraisal patterns of envy and related emotions.

    Science.gov (United States)

    van de Ven, Niels; Zeelenberg, Marcel; Pieters, Rik

    2012-06-01

    Envy is a frustrating emotion that arises from upward social comparison. Two studies investigated the appraisals that distinguish benign envy (aimed at improving one's own situation) from malicious envy (aimed at pulling down the superior other). Study 1 found that appraisals of deservingness and control potential differentiated both types of envy. We manipulated these appraisals in Study 2 and found that while both did not influence the intensity of envy, they did determine the type of envy that resulted. The more a situation was appraised as undeserved, the more participants experienced malicious envy. Benign envy was experienced more when the situation was not undeserved, and the most when the situation was appraised as both deserved and controllable. The current research also clarifies how the types of envy differ from the related emotions admiration and resentment.

  19. A time series modeling approach in risk appraisal of violent and sexual recidivism.

    Science.gov (United States)

    Bani-Yaghoub, Majid; Fedoroff, J Paul; Curry, Susan; Amundsen, David E

    2010-10-01

    For over half a century, various clinical and actuarial methods have been employed to assess the likelihood of violent recidivism. Yet there is a need for new methods that can improve the accuracy of recidivism predictions. This study proposes a new time series modeling approach that generates high levels of predictive accuracy over short and long periods of time. The proposed approach outperformed two widely used actuarial instruments (i.e., the Violence Risk Appraisal Guide and the Sex Offender Risk Appraisal Guide). Furthermore, analysis of temporal risk variations based on specific time series models can add valuable information into risk assessment and management of violent offenders.

  20. How to transform economics? A philosophical appraisal

    Directory of Open Access Journals (Sweden)

    Deniz Kellecioglu

    2017-11-01

    Full Text Available Ten years after the global financial crisis there is hardly any evidence that the theories, teaching and policies of mainstream economics have changed. This paper is an attempt to contribute to the greater understanding of this persistence, but also to the discussion on what the requirements are to materialise a transformation in economics, given the dismal outcomes in the world economy. The analytical approach of the paper is to utilise relevant philosophical accounts that point out attributes of dominant discourses, and methodological requirements to supersede an already dominant discourse. The objective is to contribute to an improved understanding of factors that obstruct or construct transformations in a knowledge field such as economics; and thereby contribute to transformation efforts, preferably for a more pluralist and emancipatory economics. Given the complexities and the tensions between different philosophical positions, the conclusions of this appraisal are summarised into five criteria that appear essential to realise a successful transformation in economics: critical juncture; dissimilarity; scholar validation; sensibility; and external power. It is suggested to revise efforts to fulfil these criteria as much, and as soon as possible, given the importance and urgency of changing the trajectory of our economies and societies.

  1. CEO performance appraisal: review and recommendations.

    Science.gov (United States)

    Newman, J F; Tyler, L; Dunbar, D M

    2001-01-01

    CEO performance appraisal (PA) is very valuable to an organization, but the chances of obtaining a PA of high quality decrease as executive responsibility increases. The realities of CEO PA are that it: (1) is inevitable; (2) is creative and complex; (3) involves politics; and (4) has a significant effect on the organization and the executive. PA is conducted for legal and social requirements, to enhance communication, to provide opportunities for improvement, and to relate performance to compensation. This article discusses several problems with chief executive officer (CEO) PA and the contemporary approaches that seek to improve it. Three fundamental areas for evaluation are identified: (1) organizational success; (2) areawide health status; and (3) professional role fulfillment. These provide an outline for successful healthcare PA. In addition to a discussion of the strategic considerations behind a successful CEO PA system, several recommendations are offered for the implementation of the annual evaluation process. The final goal of CEO PA is to link its results to CEO incentive compensation. It is strongly recommended that some portion of the CEO's salary directly hinge on his performance in two critical areas: organizational effectiveness and community health status.

  2. Technical safety appraisal of the Idaho Chemical Processing Plant

    International Nuclear Information System (INIS)

    1992-05-01

    On June 27, 1989, Secretary of Energy, Admiral James D. Watkins, US Navy (Retired), announced a 10-point initiative to strengthen environment, safety, and health (ES ampersand H) programs and waste management operations in the Department of Energy (DOE). One of the initiatives involved conducting independent Tiger Team Assessments (TTA) at DOE operating facilities. A TTA of the Idaho National Engineering Laboratory (INEL) was performed during June and July 1991. Technical Safety Appraisals (TSA) were conducted in conjunction with the TTA as its Safety and Health portion. However, because of operational constraints the the Idaho Chemical Processing Plant (ICPP), operated for the DOE by Westinghouse Idaho Nuclear Company, Inc. (WINCO), was not included in the Safety and Health Subteam assessment at that time. This TSA, conducted April 12 - May 8, 1992, was performed by the DOE Office of Performance Assessment to complete the normal scope of the Safety and Health portion of the Tiger Team Assessment of the Idaho National Engineering Laboratory. The purpose of TSAs is to evaluate and strengthen DOE operations by verifying contractor compliance with DOE Orders, to assure that lessons learned from commercial operations are incorporated into facility operations, and to stimulate and encourage pursuit of excellence; thus, the appraisal addresses more issues than would be addressed in a strictly compliance-oriented appraisal. A total of 139 Performance Objectives have been addressed by this appraisal in 19 subject areas. These 19 areas are: organization and administration, quality verification, operations, maintenance, training and certification, auxiliary systems, emergency preparedness, technical support, packaging and transportation, nuclear criticality safety, safety/security interface, experimental activities, site/facility safety review, radiological protection, worker safety and health compliance, personnel protection, fire protection, medical services and natural

  3. Predicting risk of violence through a self-appraisal questionnaire

    Directory of Open Access Journals (Sweden)

    José Manuel Andreu-Rodríguez

    2016-07-01

    Full Text Available The Self-Appraisal Questionnaire (SAQ is a self-report that predicts the risk of violence and recidivism and provides relevant information about treatment needs for incarcerated populations. The objective of the present study was to evaluate the concurrent and predictive validity of this self-report in Spanish offenders. The SAQ was administered to 276 offenders recruited from several prisons in Madrid (Spain. SAQ total scores presented high levels of internal consistency (alpha = .92. Correlations of the instrument with violence risk instruments were statistically significant and showed a moderate magnitude, indicating a reasonable degree of concurrent validity. The ROC analysis carried out on the SAQ total score revealed an AUC of .80, showing acceptable accuracy discriminating between violent and nonviolent recidivist groups. It is concluded that the SAQ total score is a reliable and valid measure to estimate violence and recidivism risk in Spanish offenders.

  4. The appraisal rationalisation of real estate expertise

    Directory of Open Access Journals (Sweden)

    Marina Ciuna

    2013-12-01

    Full Text Available The Italian appraisal practice is characterized by valuations developed in subjective opinions formulated by the valuers, according to the experience and the competence rather than on the survey of the market data of comparable properties. This practice makes up for the lack of information on the real estate market and to the consequent absence of systematic collections of market data. This tradition is in the cadastral appraisal for the rural (1886 and urban properties (1939. The assessed income is appraised for a representative property and wide to all the other properties with arbitrary scores (pure number. The assessed value is derived from the income with fixed multipliers. The reform of the cadastral appraisals (2013 provides the employment of predetermined statistic functions rather than the automated valuation models applied in the mass appraisal. There are therefore ample spaces to rationalize the Italian valuations. For the market appraisal the process of rationalization is based on the comparison between the expertise and the market comparison approach. For the cadastral appraisal the process of rationalization is based on the statistic application to the fixed functions with the survey of a sample of market prices and the ratios study according to the valuation standards.

  5. Selectionist and evolutionary approaches to brain function: a critical appraisal

    Directory of Open Access Journals (Sweden)

    Chrisantha Thomas Fernando

    2012-04-01

    Full Text Available We consider approaches to brain dynamics and function that have been claimed to be Darwinian. These include Edelman’s theory of neuronal group selection, Changeux’s theory of synaptic selection and selective stabilization of pre-representations, Seung’s Darwinian synapse, Loewenstein’s synaptic melioration, Adam’s selfish synapse and Calvin’s replicating activity patterns. Except for the last two, the proposed mechanisms are selectionist but not truly Darwinian, because no replicators with information transfer to copies and hereditary variation can be identified in them. All of them fit, however, a generalized selectionist framework conforming to the picture of Price’s covariance formulation, which deliberately was not specific even to selection in biology, and therefore does not imply an algorithmic picture of biological evolution. Bayesian models and reinforcement learning are formally in agreement with selection dynamics. A classification of search algorithms is shown to include Darwinian replicators (evolutionary units with multiplication, heredity and variability as the most powerful mechanism in a sparsely occupied search space. Examples of why parallel competitive search with information transfer among the units is efficient are given. Finally, we review our recent attempts to construct and analyze simple models of true Darwinian evolutionary units in the brain in terms of connectivity and activity copying of neuronal groups. Although none of the proposed neuronal replicators include miraculous mechanisms, their identification remains a challenge but also a great promise.

  6. A Critical Appraisal of the Juvenile Justice System under ...

    African Journals Online (AJOL)

    It also points out the various difficulties and shortcomings in the treatment of ... of young people, and the rehabilitation and reintegration of young offenders. ... than to impose prison sentences or other repressive measures on young offenders.

  7. Motor unit recruitment during neuromuscular electrical stimulation: a critical appraisal.

    Science.gov (United States)

    Bickel, C Scott; Gregory, Chris M; Dean, Jesse C

    2011-10-01

    Neuromuscular electrical stimulation (NMES) is commonly used in clinical settings to activate skeletal muscle in an effort to mimic voluntary contractions and enhance the rehabilitation of human skeletal muscles. It is also used as a tool in research to assess muscle performance and/or neuromuscular activation levels. However, there are fundamental differences between voluntary- and artificial-activation of motor units that need to be appreciated before NMES protocol design can be most effective. The unique effects of NMES have been attributed to several mechanisms, most notably, a reversal of the voluntary recruitment pattern that is known to occur during voluntary muscle contractions. This review outlines the assertion that electrical stimulation recruits motor units in a nonselective, spatially fixed, and temporally synchronous pattern. Additionally, it synthesizes the evidence that supports the contention that this recruitment pattern contributes to increased muscle fatigue when compared with voluntary actions and provides some commentary on the parameters of electrical stimulation as well as emerging technologies being developed to facilitate NMES implementation. A greater understanding of how electrical stimulation recruits motor units, as well as the benefits and limitations of its use, is highly relevant when using this tool for testing and training in rehabilitation, exercise, and/or research.

  8. New treatment options for fibromyalgia: critical appraisal of duloxetine

    Directory of Open Access Journals (Sweden)

    Nurcan Üçeyler

    2008-06-01

    Full Text Available Nurcan Üçeyler1, Martin Offenbächer2, Frank Petzke3, Winfried Häuser4, Claudia Sommer11Department of Neurology, University of Würzburg, Germany; 2GRP – Generation Research Program, Human Science Center, University of Munich, Germany; 3Department of Anesthesiology, University of Cologne, Germany; 4Center of Pain Therapy, Klinikum Saarbrücken gGmbH, Winterberg 1, Saarbrücken, GermanyAbstract: Fibromyalgia syndrome (FMS is a chronic condition characterized by widespread pain, tender points, fatigue, and sleep disturbance. FMS leads to high disability levels, poor quality of life, and extensive use of medical care. Effective pharmacological treatment options are rare, and treatment effects are often of limited duration. Duloxetine is a new selective serotonin and norepinephrine reuptake inhibitor that is licensed for the treatment of pain in diabetic neuropathy. So far two randomized, placebo-controlled trials have investigated the short-term safety and efficacy of duloxetine 60 mg/day and 120 mg/day in patients suffering from FMS over a period of 12 weeks. Both dosages were superior to placebo in pain relief, and improvement in quality of life and depressive symptoms. The analgesic effect was largely independent of the antidepressant action of duloxetine. The higher dose of 120 mg/day further reduced the tender point count and elevated the tender point pain thresholds. Only mild to moderate adverse effects were reported. Duloxetine 60 mg/day and 120 mg/day has proven to be beneficial in the treatment of FMS symptoms. As true for other antidepressants further studies are needed to assess the long-term efficacy and safety of duloxetine as an additional pharmacological treatment option in FMS.Keywords: fibromyalgia syndrome, duloxetine, antidepressant, review, SNRI

  9. Super thermal power plants and environment: a critical appraisal

    International Nuclear Information System (INIS)

    Sharma, A.K.

    1995-01-01

    This paper discusses the possible impact on the environment by the particulate matters, oxides of sulphur and nitrogen, trace metals and solid/liquid wastes, which are emitted during the combustion of coal in the super thermal power plants of National Thermal Power Corporation (NTPC). The coal consumed by these plants have sufficient sulphur content and ash. Of all the mineral in coal, pyrite is one of the most deleterious in combustion and a major source of oxide of sulphur pollution of the atmosphere. The impact of these on the terrestrial and aquatic environment in and around power plants and on region have been discussed. To arresting such contaminants, some remedial measures are suggested. (author). 14 refs., 1 fig., 3 tabs

  10. Current anti-doping policy: a critical appraisal.

    Science.gov (United States)

    Kayser, Bengt; Mauron, Alexandre; Miah, Andy

    2007-03-29

    Current anti-doping in competitive sports is advocated for reasons of fair-play and concern for the athlete's health. With the inception of the World Anti Doping Agency (WADA), anti-doping effort has been considerably intensified. Resources invested in anti-doping are rising steeply and increasingly involve public funding. Most of the effort concerns elite athletes with much less impact on amateur sports and the general public. We review this recent development of increasingly severe anti-doping control measures and find them based on questionable ethical grounds. The ethical foundation of the war on doping consists of largely unsubstantiated assumptions about fairness in sports and the concept of a "level playing field". Moreover, it relies on dubious claims about the protection of an athlete's health and the value of the essentialist view that sports achievements reflect natural capacities. In addition, costly antidoping efforts in elite competitive sports concern only a small fraction of the population. From a public health perspective this is problematic since the high prevalence of uncontrolled, medically unsupervised doping practiced in amateur sports and doping-like behaviour in the general population (substance use for performance enhancement outside sport) exposes greater numbers of people to potential harm. In addition, anti-doping has pushed doping and doping-like behaviour underground, thus fostering dangerous practices such as sharing needles for injection. Finally, we argue that the involvement of the medical profession in doping and anti-doping challenges the principles of non-maleficience and of privacy protection. As such, current anti-doping measures potentially introduce problems of greater impact than are solved, and place physicians working with athletes or in anti-doping settings in an ethically difficult position. In response, we argue on behalf of enhancement practices in sports within a framework of medical supervision. Current anti-doping strategy is aimed at eradication of doping in elite sports by means of all-out repression, buttressed by a war-like ideology similar to the public discourse sustaining international efforts against illicit drugs. Rather than striving for eradication of doping in sports, which appears to be an unattainable goal, a more pragmatic approach aimed at controlled use and harm reduction may be a viable alternative to cope with doping and doping-like behaviour.

  11. Creative industries, creative class and competitiveness: expert opinions critically appraised

    NARCIS (Netherlands)

    Bontje, M.A.; Musterd, S.

    2009-01-01

    In the debate on urban and regional competitiveness, it has become fashionable to stress the growing importance of creativity for economic development. Especially scientist-consultants with a keen eye for what politicians and business people want to hear have taken centre stage in this discussion.

  12. Understanding adolescents' sleep patterns and school performance: a critical appraisal.

    Science.gov (United States)

    Wolfson, Amy R; Carskadon, Mary A

    2003-12-01

    The present paper reviews and critiques studies assessing the relation between sleep patterns, sleep quality, and school performance of adolescents attending middle school, high school, and/or college. The majority of studies relied on self-report, yet the researchers approached the question with different designs and measures. Specifically, studies looked at (1) sleep/wake patterns and usual grades, (2) school start time and phase preference in relation to sleep habits and quality and academic performance, and (3) sleep patterns and classroom performance (e.g., examination grades). The findings strongly indicate that self-reported shortened total sleep time, erratic sleep/wake schedules, late bed and rise times, and poor sleep quality are negatively associated with academic performance for adolescents from middle school through the college years. Limitations of the current published studies are also discussed in detail in this review.

  13. Critical appraisal of dialogue as a strategy for religious conflict ...

    African Journals Online (AJOL)

    Nigeria has passed through incessant religious conflicts and its attendant consequences of loss of human lives and property. It is unfortunate that despite all the efforts made to resolve religious conflicts in Nigeria through religious dialogue yet peaceful resolution of religious conflicts have remained a mirage. This paper ...

  14. Solar energy in food processing-a critical appraisal.

    Science.gov (United States)

    Eswara, Amruta R; Ramakrishnarao, M

    2013-04-01

    Increasing population and high cost of fuels have created opportunities for using alternate energies for post-harvest processing of foods. Solar food processing is an emerging technology that provides good quality foods at low or no additional fuel costs. A number of solar dryers, collectors and concentrators are currently being used for various steps in food processing and value addition. Society for Energy, Environment and Development (SEED) developed Solar Cabinet Dryer with forced circulation which has been used for dehydration and development of value added products from locally grown fruits, vegetables, leafy greens and forest produce. Drying under simulated shade conditions using UV-reducing Blue filter helps retain nutrients better. Its simple design and ease of handling makes SEED Solar Dryer an ideal choice for application of food processing in rural settings, closer to where the harvest is produced, eliminating the need for expensive transportation or storage of fresh produce. It also creates employment opportunities among the rural population, especially women. Other gadgets based on solar collectors and concentrators currently being used at various steps of food processing are reviewed.

  15. A critical appraisal of the phenomenon of aspirin resistance

    DEFF Research Database (Denmark)

    Svenstrup Poulsen, Tina; Risom Kristensen, Søren; Atar, Dan

    2005-01-01

    Aspirin is the mainstay antiplatelet treatment in patients with high risk of cardiovascular atherothrombotic events, and its beneficial effect is documented in several clinical trials. Nevertheless, the effectiveness of aspirin has been questioned by the emergence of the concept of 'aspirin...

  16. A critical appraisal of euthanasia under Nigerian laws | Obi | Nnamdi ...

    African Journals Online (AJOL)

    Although it is widely accepted that murder is crime under the Nigerian law, a clearly defined stand has not been taken on euthanasia. The Nigerian populace views euthanasia as an unnecessary paradox, murder in disguise, a situation where the supposed healer becomes a killer. This, therefore, forms the nitty-gritty of ...

  17. On the concept of eugenics: preliminaries to a critical appraisal

    Directory of Open Access Journals (Sweden)

    Demetrio Neri

    Full Text Available This paper's main issue is linked to what can be foreseen as the increasing capability of medical genetics to modify the genetic composition of the human species through direct interventions in the human genome for medical and non-medical purposes, i.e., the 'risk' of a resurgence of eugenics. In current discussions on the topic (briefly presented in the first section, the 'phantom of eugenics' is raised several times, but there is a great deal of confusion on what counts as eugenics, partly because of broad conceptual disagreement over the notion itself. Furthermore, according to some scholars there is no hope of overcoming this unsatisfactory conceptual uncertainty. Partly challenging this opinion, the second and third sections of this paper attempt to identify some basic features which could be seen as intrinsically linked to the notion of eugenics, with the aim of reducing the range of conceptual disagreement as a preliminary step in bringing into focus what exactly is wrong with practicing eugenics. The subsequent sections deal with the substantive issue of whether or not to practice eugenics from the point of view of the interest of future generations in the human species' genetic composition. The main moral arguments for and against eugenics are examined from the point of view of our obligations towards future generations, and the conclusion is in favor of a cautious 'open-door' position.

  18. On the concept of eugenics: preliminaries to a critical appraisal

    Directory of Open Access Journals (Sweden)

    Neri Demetrio

    1999-01-01

    Full Text Available This paper's main issue is linked to what can be foreseen as the increasing capability of medical genetics to modify the genetic composition of the human species through direct interventions in the human genome for medical and non-medical purposes, i.e., the 'risk' of a resurgence of eugenics. In current discussions on the topic (briefly presented in the first section, the 'phantom of eugenics' is raised several times, but there is a great deal of confusion on what counts as eugenics, partly because of broad conceptual disagreement over the notion itself. Furthermore, according to some scholars there is no hope of overcoming this unsatisfactory conceptual uncertainty. Partly challenging this opinion, the second and third sections of this paper attempt to identify some basic features which could be seen as intrinsically linked to the notion of eugenics, with the aim of reducing the range of conceptual disagreement as a preliminary step in bringing into focus what exactly is wrong with practicing eugenics. The subsequent sections deal with the substantive issue of whether or not to practice eugenics from the point of view of the interest of future generations in the human species' genetic composition. The main moral arguments for and against eugenics are examined from the point of view of our obligations towards future generations, and the conclusion is in favor of a cautious 'open-door' position.

  19. Proliferative verrucous leukoplakia; a critical appraisal of the diagnostic criteria

    NARCIS (Netherlands)

    Carrard, V.C.; Brouns, E.R.E.A.; van der Waal, I.

    2013-01-01

    Since its introduction in the literature in 1985, the term proliferative verrucous leukoplakia (PVL) has been the subject of an ongoing discussion with regard to its definition. Widespread or multifocal occurrence of oral leukoplakia is not just synonymous to PVL. In the present treatise the

  20. Critical appraisal of cardiac implantable electronic devices: complications and management

    Directory of Open Access Journals (Sweden)

    Padeletti L

    2011-09-01

    Full Text Available Luigi Padeletti1, Giosuè Mascioli2, Alessandro Paoletti Perini1, Gino Grifoni1, Laura Perrotta1, Procolo Marchese3, Luca Bontempi3, Antonio Curnis31Istituto di Clinica Medica e Cardiologia, Università degli Studi di Firenze, Italia; 2Elettrofisiologia, Istituto Humanitas Gavazzeni, Bergamo, Italia; 3Elettrofisiologia, Spedali Civili, Brescia, ItaliaAbstract: Population aging and broader indications for the implant of cardiac implantable electronic devices (CIEDs are the main reasons for the continuous increase in the use of pacemakers (PMs, implantable cardioverter-defibrillators (ICDs and devices for cardiac resynchronization therapy (CRT-P, CRT-D. The growing burden of comorbidities in CIED patients, the greater complexity of the devices, and the increased duration of procedures have led to an augmented risk of infections, which is out of proportion to the increase in implantation rate. CIED infections are an ominous condition, which often implies the necessity of hospitalization and carries an augmented risk of in-hospital death. Their clinical presentation may be either at pocket or at endocardial level, but they can also manifest themselves with lone bacteremia. The management of these infections requires the complete removal of the device and subsequent, specific, antibiotic therapy. CIED failures are monitored by competent public authorities, that require physicians to alert them to any failures, and that suggest the opportune strategies for their management. Although the replacement of all potentially affected devices is often suggested, common practice indicates the replacement of only a minority of devices, as close follow-up of the patients involved may be a safer strategy. Implantation of a PM or an ICD may cause problems in the patients' psychosocial adaptation and quality of life, and may contribute to the development of affective disorders. Clinicians are usually unaware of the psychosocial impact of implanted PMs and ICDs. The main difference between PM and ICD patients is the latter's dramatic experience of receiving a shock. Technological improvements and new clinical evidences may help reduce the total burden of shocks. A specific supporting team, providing psychosocial help, may contribute to improving patient quality of life.Keywords: pacemaker, cardiac cardioverter-defibrillator, cardiac implantable electronic devices, infection, recall, quality of life 

  1. Globalization and Health: A Critical Appraisal | Swende | Nigerian ...

    African Journals Online (AJOL)

    Background: Health has long been recognized as a central feature of development. Globalization tends to be understood as a process of economic integration, but it implies more. It entails openness to trade, ideas, investment, people and culture all of which impact health. Method: Review of relevant literature on ...

  2. A critical appraisal of atomoxetine in the management of ADHD

    Directory of Open Access Journals (Sweden)

    Childress AC

    2015-12-01

    Full Text Available Ann C ChildressCenter for Psychiatry and Behavioral Medicine, Inc., Las Vegas, NV, USAAbstract: Attention-deficit/hyperactivity disorder (ADHD is a common neurobehavioral disorder beginning in childhood and often continuing into adulthood. A wealth of data shows that ADHD symptoms respond well to pharmacological treatment. Stimulant medications, including amphetamine and methylphenidate, are most commonly used to treat ADHD. However, with the approval of atomoxetine (Strattera®, [ATX] by the US Food and Drug Administration in late 2002, an effective non-stimulant option became available. The US Food and Drug Administration approved ATX for the treatment of ADHD in children, adolescents, and adults. Although the effect size of ATX is generally lower than that of stimulants, the American Academy of Child and Adolescent Psychiatry Practice Parameter for the treatment of ADHD lists ATX as a first-line treatment option. ATX is widely prescribed and accounted for 6% of the prescriptions of ADHD visits in the US in 2010. Numerous trials have found that ATX improves quality of life and emotional lability in addition to core ADHD symptoms. Although some improvement may be seen in a patient as early as one week after the initiation of treatment, ATX generally takes longer to have a full effect. The median time to response using 25% improvement in ADHD symptoms in pooled trials was 3.7 weeks. Data from these trials indicate that the probability of symptom improvement may continue to increase up to 52 weeks after treatment is initiated. ATX has been shown to be safe and effective in combination with stimulants. It has also been studied systematically in subjects with ADHD and comorbid oppositional defiant disorder, anxiety, depression, and substance use disorders. The mechanism of action of ATX, its efficacy, and adverse events reported in trials is reviewed.Keywords: attention-deficit/hyperactivity disorder, Strattera, non-stimulants, pharmacotherapy

  3. [Critical appraisal of organ procurement under Maastricht 3 condition].

    Science.gov (United States)

    Puybasset, L; Bazin, J-E; Beloucif, S; Bizouarn, P; Crozier, S; Devalois, B; Eon, B; Fieux, F; Gisquet, E; Guibet-Lafaye, C; Kentish, N; Lienhart, A; Nicolas-Robin, A; Otero Lopez, M; Pelluchon, C; Roussin, F; Beydon, L

    2012-05-01

    The ethics committee of the French Society of Anesthesia and Intensive Care (Sfar) has been requested by the French Biomedical Agency to consider the issue of organ donation in patients after a decision of withdrawing life supporting therapies has been taken. This category of organ donation is performed in the USA, Canada, United Kingdom, the Netherlands and Belgium. The three former countries have published recommendations, which formalize procedures and operations. The Sfar ethics committee has considered this issue and envisioned the different aspects of the whole process. Consequently, it sounds a note of caution regarding the applicability of this type of organ procurement in unselected patient following a decision to withdraw life supporting therapies. According to the French regulation concerning organ procurement in brain dead patients, the committee stresses the need to restrict this specific way of procurement to severely brain injured patients, once confirmatory investigations predicting a catastrophic prognosis have been performed. It suggests that the nature of the confirmatory investigation required should be formalized by the French Biomedical Agency on behalf of the French parliamentarians. This should help preserving population trust regarding organ procurement and provide a framework to medical decision. This text has been endorsed by the Sfar. Copyright © 2012. Published by Elsevier SAS.

  4. Critical appraisal of organ procurement under Maastricht 3 condition.

    Science.gov (United States)

    Puybasset, L; Bazin, J-E; Beloucif, S; Bizouarn, P; Crozier, S; Devalois, B; Eon, B; Fieux, F; Gisquet, E; Guibet-Lafaye, C; Kentish, N; Lienhart, A; Nicolas-Robin, A; Otero Lopez, M; Pelluchon, C; Roussin, F; Beydon, L

    2014-02-01

    The ethics committee of the French Society of Anesthesia and Intensive Care (Sfar) has been requested by the French Biomedical Agency to consider the issue of organ donation in patients after the decision to withdraw life-supportive therapies has been taken. This type of organ donation is performed in the USA, Canada, the United Kingdom, the Netherlands and Belgium. The three former countries have published recommendations formalizing procedures and operations. The French Society of Anesthesia and Intensive Care (Société française d'anesthésie et de reanimation [Sfar]) ethics committee has considered this issue and envisioned the different aspects of the whole process. Consequently, it sounded a note of caution regarding the applicability of this type of organ procurement in unselected patients following a decision to withdraw life-supportive therapies. According to French regulations concerning organ procurement in brain-dead patients, the committee stresses the need to restrict this specific way of procurement to severely brain-injured patients, once confirmatory investigations predicting a catastrophic prognosis have been performed. This suggests that the nature of the confirmatory investigation required should be formalized by the French Biomedical Agency on behalf of the French parliamentarians, which should help preserve population trust regarding organ procurement and provide a framework for medical decision. This text has been endorsed by the Sfar. Copyright © 2013 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

  5. Role of urodynamics in stress urinary incontinence: A critical appraisal

    Science.gov (United States)

    Yande, Shirish Dattatraya; Joglekar, Omkar Vinay; Joshi, Maya

    2016-01-01

    Introduction: Role of urodynamics prior to surgery of stress urinary incontinence (SUI) is under constant debate. Demonstration of the presence of detrusor overactivity is the only aspect that has been emphasized in the literature so far. We believe that there are number of other factors which may influence the evaluation and in turn the choice of surgical management and prediction of outcome of treatment. They are as follows: (1) Presence of voiding inefficiency, (2) asymptomatic detrusor overactivity, (3) and severity of SUI. These features may complicate the precise evaluation of patients of SUI. The main objective of this study is to analyze the dynamics of leakage and voiding using urodynamics. This study also aims at correlating these findings with clinical information. Materials and Methods: One hundred consecutive cases referred to our center for preoperative evaluation of SUI were recruited in the study prospectively. All patients were interrogated using International Consultation on Incontinence Questionnaire. All patients underwent complete urodynamic evaluation including uroflowmetry, filling cystometry, leak point pressure measurement, and pressure flow studies, according to Good Urodynamic Practice guidelines. Patients’ symptoms were correlated with urodynamic findings, with special emphasis on the presence of detrusor overactivity, severity of SUI, voiding efficiency, and presence of bladder outlet obstruction. Clinical information and urodynamic findings were correlated using Chi-square test. Results: There is a statistically significant correlation between the presence of symptoms of urge urinary incontinence and urodynamic findings of detrusor overactivity at P incontinence (in addition to SUI) and urodynamic findings of intrinsic sphincter deficiency at P incontinence and incidental finding of detrusor overactivity at P urinary incontinence can predictably diagnose detrusor overactivity in these cases. However, the incidence of asymptomatic detrusor overactivity remains as high as 15% and may have implication in postoperative results. This study clearly shows that there is a definite incidence of significant voiding dysfunction, which cannot be reliably evaluated without properly conducted pressure flow study. This factor may govern the choice of correct treatment which also predicts the outcome more reliably. Preoperative urodynamic study thus adds a dimension of precision to evaluation of the patients of SUI and may also influence technique and outcome measures in this group of patients. PMID:27721639

  6. Role of urodynamics in stress urinary incontinence: A critical appraisal

    Directory of Open Access Journals (Sweden)

    Shirish Dattatraya Yande

    2016-01-01

    Conclusions: Urodynamic study in SUI has a potential of giving much more information than demonstration of Detrusor Overactivity alone. The predominant symptom of urge urinary incontinence can predictably diagnose detrusor overactivity in these cases. However, the incidence of asymptomatic detrusor overactivity remains as high as 15% and may have implication in postoperative results. This study clearly shows that there is a definite incidence of significant voiding dysfunction, which cannot be reliably evaluated without properly conducted pressure flow study. This factor may govern the choice of correct treatment which also predicts the outcome more reliably. Preoperative urodynamic study thus adds a dimension of precision to evaluation of the patients of SUI and may also influence technique and outcome measures in this group of patients.

  7. A critical appraisal of Western Cape Forum for Intellectual Disability ...

    African Journals Online (AJOL)

    The 2011 the Western Cape Forum for Intellectual Disability v Government of The Republic of South Africa case flagged a lot of issues faced by persons with disabilities relating to access to education in South Africa. The case tackled certain perceptions about the ineducability of persons with profound and severe disability ...

  8. Systematic Cochrane Reviews in Neonatology: A Critical Appraisal

    Directory of Open Access Journals (Sweden)

    Christiane Willhelm

    2013-08-01

    Conclusion: There is an ongoing need for high-quality research in order to reduce the proportion of inconclusive meta-analyses in the field of neonatology. Funding and research agencies will play a vital role in selecting the most appropriate research programs.

  9. roeper and siegel's theory of verbal compounding: a critical appraisal

    African Journals Online (AJOL)

    This theory was proposed within the general framework of a lexicalist approach to morphology/word-formation. It will be assumed that the reader is familiar with the general tenets of this ... Roeper and Siegel (1978) present their theory of verbal compounding within the general ...... "terribly" + "fast" + "drive" ... "ing" lithe act of ...

  10. Critical appraisal of outcomes following open radical prostatectomy.

    Science.gov (United States)

    Galvin, David J; Eastham, James A

    2009-05-01

    Radical prostatectomy has evolved enormously over the last 25 years. Improvements include the use of smaller incisions, reduced blood loss, shorter hospital stays, and surgical refinement to improve the recovery of continence and potency. In addition, new technologies and minimally invasive techniques with the potential to further improve patient outcomes have been introduced. This article focuses on outcomes with open radical prostatectomy and is not meant to compare open radical prostatectomy and minimally invasive approaches. Despite a lack of randomized controlled trials, strong observational cohort studies demonstrate lower rates of positive surgical margins, high 10-year and 15-year biochemical recurrence-free rates, excellent prostate cancer-specific mortality rates, and improved recovery of urinary incontinence and erectile function after open radical prostatectomy. We review publications from the past 24 months regarding oncologic outcome, continence, and erectile function, as well as some earlier manuscripts that emphasize key aspects of open radical prostatectomy. Today open radical prostatectomy is a less-invasive procedure with low morbidity providing excellent control of clinically localized prostate cancer. Although open radical prostatectomy now accounts for a minority of radical prostatectomies in the United States, the concepts that have improved oncologic and quality-of-life outcomes are equally applicable to minimally invasive procedures.

  11. Ultra-processed foods in human health: a critical appraisal.

    Science.gov (United States)

    Gibney, Michael J; Forde, Ciarán G; Mullally, Deirdre; Gibney, Eileen R

    2017-09-01

    The NOVA classification of foods proposes 4 categories: unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods and drinks (UPFDs). It is argued that the latter relies heavily on modifications to foods, resulting in enhanced amounts of salt, added sugar, and fat as well as the use of additives in an attempt to make this food category highly palatable. It further argues that controlling food processing, rather than examining nutrients, should be foremost in shaping nutrition policy. This commentary challenges many of the basic arguments of using the NOVA food classification system to examine the link between food and health. We believe that there is no evidence to uphold the view that UPFDs give rise to hyperpalatable foods associated with a quasi-addictive effect and that the prevailing European Union and US data fail to uphold the assertion that UPFDs, which dominate energy intake, give rise to dietary patterns that are low in micronutrients. With regard to the use of the NOVA food classification in the development of food-based dietary guidelines, we show that the very broad definition of UPFDs makes this impossible. Finally, the available evidence does not support the view that the globalization of food is the driver of increased intakes of UPFDs in low- to middle-income countries but rather that this is driven by small indigenous companies. On balance, therefore, there seems to be little advantage from the use of the NOVA classification compared with the current epidemiologic approach, which relies on the linkage of nutrient intakes to chronic disease with subsequent identification of foods that merit consideration in public health nutrition strategies. © 2017 American Society for Nutrition.

  12. Managing atrial fibrillation in the elderly: critical appraisal of dronedarone

    Directory of Open Access Journals (Sweden)

    Trigo P

    2011-12-01

    Full Text Available Paula Trigo, Gregory W FischerDepartment of Anesthesiology, Mount Sinai School of Medicine, New York, NY, USAAbstract: Atrial fibrillation is the most commonly seen arrhythmia in the geriatric population and is associated with increased cardiovascular morbidity and mortality. Treatment of the elderly with atrial fibrillation remains challenging for physicians, because this unique subpopulation is characterized by multiple comorbidities requiring chronic use of numerous medications, which can potentially lead to severe drug interactions. Furthermore, age-related changes in the cardiovascular system as well as other physiological changes result in altered drug pharmacokinetics. Dronedarone is a new drug recently approved for the treatment of arrhythmias, such as atrial fibrillation and/or atrial flutter. Dronedarone is a benzofuran amiodarone analog which lacks the iodine moiety and contains a methane sulfonyl group that decreases its lipophilicity. These differences in chemical structure are responsible for making dronedarone less toxic than amiodarone which, in turn, results in fewer side effects. Adverse events for dronedarone include gastrointestinal side effects and rash. No dosage adjustments are required for patients with renal impairment. However, the use of dronedarone is contraindicated in the presence of severe hepatic dysfunction.Keywords: atrial fibrillation, elderly, antiarrhythmic agents, amiodarone, dronedarone

  13. Testosterone depot injection in male hypogonadism: a critical appraisal

    Directory of Open Access Journals (Sweden)

    Aksam A Yassin

    2008-01-01

    Full Text Available Aksam A Yassin1, Mohamed Haffejee21Clinic of Urology/Andrology, Segeberger Kliniken, Norderstedt-Hamburg, Germany and Department of Urology, Gulf Medical College School of Medicine, Ajman-UAE 2Urology Division at the University of Witwaterstrand & Johannesburg Hospital, Johannesburg, South AfricaAbstract: Testosterone compounds have been available for almost 70 years, but the pharmaceutical formulations have been less than ideal. Traditionally, injectable testosterone esters have been used for treatment, but they generate supranormal testosterone levels shortly after the 2- to 3-weekly injection interval and then testosterone levels decline very rapidly, becoming subnormal in the days before the next injection. The rapid fluctuations in plasma testosterone are subjectively experienced as disagreeable. Testosterone undecanoate is a new injectable testosterone preparation with a considerably better pharmacokinetic profile. After 2 initial injections with a 6-week interval, the following intervals between two injections are almost always 12-weeks, amounting eventually to a total of 4 injections per year. Plasma testosterone levels with this preparation are nearly always in the range of normal men, so are its metabolic products estradiol and dihydrotestosterone. The “roller coaster” effects of traditional parenteral testosterone injections are not apparent. It reverses the effects of hypogonadism on bone and muscle and metabolic parameters and on sexual functions. Its safety profile is excellent due to the continuous normalcy of plasma testosterone levels. No polycythemia has been observed, and no adverse effects on lipid profiles. Prostate safety parameters are well within reference limits. There was no impairment of uroflow. Testosterone undecanoate is a valuable contribution to the treatment options of androgen deficiency.Keywords: testosterone treatment, testosterone undecanoate, pharmacokinetic profile, clinical efficacy, side effects, sexual dysfunction

  14. Working Group 2: A critical appraisal of model simulations

    International Nuclear Information System (INIS)

    MacCracken, M.; Cubasch, U.; Gates, W.L.; Harvey, L.D.; Hunt, B.; Katz, R.; Lorenz, E.; Manabe, S.; McAvaney, B.; McFarlane, N.; Meehl, G.; Meleshko, V.; Robock, A.; Stenchikov, G.; Stouffer, R.; Wang, W.C.; Washington, W.; Watts, R.; Zebiak, S.

    1990-01-01

    The complexity of the climate system and the absence of definitive analogs to the evolving climatic situation force use of theoretical models to project the future climatic influence of the relatively rapid and on-going increase in the atmospheric concentrations of CO 2 and other trace gases. A wide variety of climate models has been developed to look at particular aspects of the problem and to vary the mix of complexity and resource requirements needed to study various aspects of the problem; all such models have contributed to their insights of the problem

  15. Nuclear magnetic resonance spectroscopy in food applications: a critical appraisal

    International Nuclear Information System (INIS)

    Divakar, S.

    1998-01-01

    Usefulness of Nuclear Magnetic Resonance (NMR) spectroscopy in food applications is presented in this review. Some of the basic concepts of NMR pertaining to one-dimensional and two-dimensional techniques, solid-state NMR and Magnetic Resonance Imaging (MRI) are discussed. Food applications dealt with encompass such diverse areas like nature and state of water in foods, detection and quantitation of important constituents of foods, intact food systems and NMR related to food biology. (author)

  16. A critical appraisal and evaluation of modern PDFs

    Energy Technology Data Exchange (ETDEWEB)

    Accardi, A. [Hampton University, Hampton, VA (United States); Jefferson Lab, Newport News, VA (United States); Alekhin, S. [Universitaet Hamburg, II. Institut fuer Theoretische Physik, Hamburg (Germany); Institute for High Energy Physics, Protvino, Moscow region (Russian Federation); Bluemlein, J. [Deutsches Elektronensynchrotron DESY, Zeuthen (Germany); Garzelli, M.V.; Moch, S. [Universitaet Hamburg, II. Institut fuer Theoretische Physik, Hamburg (Germany); Lipka, K.; Placakyte, R.; Zenaiev, O. [Deutsches Elektronensynchrotron DESY, Hamburg (Germany); Melnitchouk, W.; Sato, N. [Jefferson Lab, Newport News, VA (United States); Owens, J.F. [Florida State University, Tallahassee, FL (United States); Reya, E. [Technische Universitaet Dortmund, Institut fuer Physik, Dortmund (Germany); Vogt, A. [University of Liverpool, Department of Mathematical Sciences, Liverpool (United Kingdom)

    2016-08-15

    We review the present status of the determination of parton distribution functions (PDFs) in the light of the precision requirements for the LHC in Run 2 and other future hadron colliders. We provide brief reviews of all currently available PDF sets and use them to compute cross sections for a number of benchmark processes, including Higgs boson production in gluon-gluon fusion at the LHC. We show that the differences in the predictions obtained with the various PDFs are due to particular theory assumptions made in the fits of those PDFs. We discuss PDF uncertainties in the kinematic region covered by the LHC and on averaging procedures for PDFs, such as advocated by the PDF4LHC15 sets, and provide recommendations for the usage of PDF sets for theory predictions at the LHC. (orig.)

  17. Critical Appraisal of the System of Education and Prospects of ...

    African Journals Online (AJOL)

    The main purpose of this article is to review the South African system of education and assess the country's prospects of meeting current and future manpower and developmental needs. This inquiry is based primarily on an assessment of the current status quo in education in South Africa in order to gain a better ...

  18. Rio - 10 Years After: A Critical Appraisal of Climate Policy

    OpenAIRE

    Böhringer, Christoph; Vogt, Carsten

    2002-01-01

    Ten years after the initial Climate Change Convention from Rio in 1992, the developed world is likely to ratify the Kyoto Protocol which has been celebrated as a milestone in climate protection. Standard economic theory, however, casts doubt that Kyoto will go beyond symbolic policy. In this paper we show that the final concretion of the Kyoto Protocol obeys the theoretical prediction: Kyoto more or less boils down to business-as-usual without significant compliance costs to ratifying parties.

  19. Managing atrial fibrillation in the elderly: critical appraisal of dronedarone.

    Science.gov (United States)

    Trigo, Paula; Fischer, Gregory W

    2012-01-01

    Atrial fibrillation is the most commonly seen arrhythmia in the geriatric population and is associated with increased cardiovascular morbidity and mortality. Treatment of the elderly with atrial fibrillation remains challenging for physicians, because this unique subpopulation is characterized by multiple comorbidities requiring chronic use of numerous medications, which can potentially lead to severe drug interactions. Furthermore, age-related changes in the cardiovascular system as well as other physiological changes result in altered drug pharmacokinetics. Dronedarone is a new drug recently approved for the treatment of arrhythmias, such as atrial fibrillation and/or atrial flutter. Dronedarone is a benzofuran amiodarone analog which lacks the iodine moiety and contains a methane sulfonyl group that decreases its lipophilicity. These differences in chemical structure are responsible for making dronedarone less toxic than amiodarone which, in turn, results in fewer side effects. Adverse events for dronedarone include gastrointestinal side effects and rash. No dosage adjustments are required for patients with renal impairment. However, the use of dronedarone is contraindicated in the presence of severe hepatic dysfunction.

  20. The motivational interviewing skill code : Reliability and a critical appraisal

    NARCIS (Netherlands)

    de Jonge, JM; Schippers, GM; Schaap, CPDR

    The Motivational Interviewing Skill Code (MISC) is a coding system developed to measure adherence to motivational interviewing (MI). MI is an effective clinical style used in different treatment situations. Counsellors practising MI have to follow general principles and avoid certain traps. In the

  1. Smartphone applications for chronic pain management: a critical appraisal

    Directory of Open Access Journals (Sweden)

    Alexander JC

    2016-09-01

    Full Text Available John C Alexander, Girish P JoshiDepartment of Anesthesiology & Pain Management, University of Texas Southwestern Medical Center, Dallas, TX, USAChronic pain is a common condition with significant detrimental physical, psychological, social, and economic impact. The Institute of Medicine estimates that >100 million Americans suffer from chronic pain,1 representing approximately one-third of the entire population of the US.2 Conservative estimates suggest that well over US $500 billion per year is spent in the treatment of these pain conditions, not to mention the lost productivity of these individuals or the burden that their suffering engenders for patients and their families. Despite tremendous efforts, chronic pain continues to be a major societal problem.1Smartphones have become one of the most rapidly adopted technologies in the modern history of mankind allowing for previously unimaginable opportunities for communication and access to information.3 Powering this societal revolution is not so much the onboard or attachable hardware for smartphones, but the dizzying array of software programs that use the hardware to add novel functions; we call the unifying software programs “applications” or, more commonly, “apps”. While each phone comes with onboard technologies, such as Wi-Fi, Bluetooth, lights, microphones, cameras, accelerometers, and even barometers, it is the development of the app that combines these functionalities to create new and innovative uses for the same hardware for everything from Skype4 to Pokémon GO.5The use of such applications within the health care industry continues to grow, and it is estimated that the market for mobile health apps will grow to US$26 billion in 2017.6 The immense size of this market is due to the functional flexibility that apps can provide. These emerging technologies also provide new opportunities to engage with patients and improve health care outcomes. Studies have shown that mobile phone messaging helps to improve patient engagement outside the clinic or hospital and facilitates self-management of chronic diseases such as hypertension, diabetes, and asthma,7 and app-based systems may also be of use in this regard. While the overall market for apps in health care is robust, the market segment for pain management is less than impressive.

  2. Towards Critical Appraisal of Infographics as Scientific Inscriptions

    Science.gov (United States)

    Polman, Joseph L.; Gebre, Engida H.

    2015-01-01

    Teaching young adults about interpreting and creating the sort of multimodal infographics increasingly prevalent in science communication creates considerable challenges for teachers and practitioners, as there is no guide to determine the quality or effectiveness of this new genre of inscriptional forms, and to scaffold students' performances in…

  3. Diphenylcyclopropenone in patients with alopecia areata. A critically appraised topic

    NARCIS (Netherlands)

    Kuin, R. A.; Spuls, P. I.; Limpens, J.; van Zuuren, E. J.

    2015-01-01

    To assess the efficacy and safety of topical diphenylcyclopropenone (DPCP) in patients with alopecia areata. Study selection, data extraction, risk of bias assessment and analyses were carried out independently by two authors. The quality of evidence was rated with Grading of Recommendations

  4. Understanding Cultural Relativism: A critical Appraisal of the Theory

    OpenAIRE

    Yohannes Eshetu

    2017-01-01

    The aim of this review article is to reveal the cons and pros of ethical relativism, especially conventionalism. This article is written with the intention of showing some of the practical upshots of conventionalism without totally denying some of its virtues in a world where diversity of cultures and customs is apparent. The article inquires the question: Is ethical relativism tenable? The review article relies on reviewing secondary sources. What I am arguing in this article is that despite...

  5. 75 A CRITICAL APPRAISAL OF EUTHANASIA UNDER NIGERIAN ...

    African Journals Online (AJOL)

    Fr. Ikenga

    disorder.2 Etymologically, the word is a derivative of two Greek words 'Euthukos' which .... continuation of treatment become futile in the future.37 .... sociological perspective, euthanasia or suicide has not been recognized as a viable option. A.

  6. A Critical Reading of Ecocentrism and Its Meta-Scientific Use of Ecology: Instrumental versus Emancipatory Approaches in Environmental Education and Ecology Education

    Science.gov (United States)

    Hovardas, Tasos

    2013-01-01

    The aim of the paper is to make a critical reading of ecocentrism and its meta-scientific use of ecology. First, basic assumptions of ecocentrism will be examined, which involve nature's intrinsic value, postmodern and modern positions in ecocentrism, and the subject-object dichotomy under the lenses of ecocentrism. Then, we will discuss…

  7. Observance of Sterilization Protocol Guideline Procedures of Critical Instruments for Preventing Iatrogenic Transmission of Creutzfeldt-Jakob Disease in Dental Practice in France, 2017

    Directory of Open Access Journals (Sweden)

    Denis Bourgeois

    2018-04-01

    Full Text Available Effective sterilization of reusable instruments contaminated by Creutzfeldt–Jakob disease in dental care is a crucial issue for public health. The present cross-sectional study investigated how the recommended procedures for sterilization were implemented by French dental practices in real-world settings. A sample of dental practices was selected in the French Rhône-Alpes region. Data were collected by a self-questionnaire in 2016. Sterilization procedures (n = 33 were classified into 4 groups: (1 Pre-sterilization cleaning of reusable instruments; (2 Biological verification of sterilization cycles—Monitoring steam sterilization procedures; (3 Autoclave performance and practitioner knowledge of autoclave use; (4 Monitoring and documentation of sterilization procedures—Tracking and tracing the instrumentation. Answers were provided per procedure, along with the global implementation of procedures within a group (over 80% correctly performed. Then it was verified how adherence to procedure groups varied with the size of the dental practice and the proportion of dental assistants within the team. Among the 179 questionnaires available for the analyses, adherence to the recommended procedures of sterilization noticeably varied between practices, from 20.7% to 82.6%. The median percentages of procedures correctly implemented per practice were 58.1%, 50.9%, 69.2% and 58.2%, in Groups 1, 2, 3 and 4, respectively (corresponding percentages for performing over 80% of the procedures in the group: 23.4%, 6.6%, 46.6% and 38.6%. Dental practices ≥ 3 dental units performed significantly better (>80% procedures of Groups 2 and 4 (p = 0.01 and p = 0.002, respectively, while no other significant associations emerged. As a rule, practices complied poorly with the recommended procedures, despite partially improved results in bigger practices. Specific training regarding sterilization procedures and a better understanding of the reasons leading to their

  8. Analysis for trace mercury concentration. I. Critical evaluation of current procedures. II. A proposed method for determination by instrumental neutron activation analysis

    International Nuclear Information System (INIS)

    Litman, R.

    1975-01-01

    Current methods of sample pretreatments, digestion, lyophilization and extraction, have been found to lead to considerable loss of mercury, at an initial mercury concentration of 1 μg/g, and less. Storage of solutions of mercury at concentrations of less than 1 μg/ml, in glass, Teflon and polyethylene containers, leads to losses by adsorption. Electrochemical reduction of mercury to the metal, and subsequent volatilization, is postulated as the mechanism of loss from the samples studied during lyophilization. A method of instrumental neutron activation analysis, which obviates the above pretreatments, has been developed for mercury concentrations as low as 1 ng/ml

  9. Radioisotope instruments

    CERN Document Server

    Cameron, J F; Silverleaf, D J

    1971-01-01

    International Series of Monographs in Nuclear Energy, Volume 107: Radioisotope Instruments, Part 1 focuses on the design and applications of instruments based on the radiation released by radioactive substances. The book first offers information on the physical basis of radioisotope instruments; technical and economic advantages of radioisotope instruments; and radiation hazard. The manuscript then discusses commercial radioisotope instruments, including radiation sources and detectors, computing and control units, and measuring heads. The text describes the applications of radioisotop

  10. Emotional and Utilitarian Appraisals of Moral Dilemmas Are Encoded in Separate Areas and Integrated in Ventromedial Prefrontal Cortex

    Science.gov (United States)

    Montaser-Kouhsari, Leila; Woodward, James; Rangel, Antonio

    2015-01-01

    Moral judgment often requires making difficult tradeoffs (e.g., is it appropriate to torture to save the lives of innocents at risk?). Previous research suggests that both emotional appraisals and more deliberative utilitarian appraisals influence such judgments and that these appraisals often conflict. However, it is unclear how these different types of appraisals are represented in the brain, or how they are integrated into an overall moral judgment. We addressed these questions using an fMRI paradigm in which human subjects provide separate emotional and utilitarian appraisals for different potential actions, and then make difficult moral judgments constructed from combinations of these actions. We found that anterior cingulate, insula, and superior temporal gyrus correlated with emotional appraisals, whereas temporoparietal junction and dorsomedial prefrontal cortex correlated with utilitarian appraisals. Overall moral value judgments were represented in an anterior portion of the ventromedial prefrontal cortex. Critically, the pattern of responses and functional interactions between these three sets of regions are consistent with a model in which emotional and utilitarian appraisals are computed independently and in parallel, and passed to the ventromedial prefrontal cortex where they are integrated into an overall moral value judgment. SIGNIFICANCE STATEMENT Popular accounts of moral judgment often describe it as a battle for control between two systems, one intuitive and emotional, the other rational and utilitarian, engaged in winner-take-all inhibitory competition. Using a novel fMRI paradigm, we identified distinct neural signatures of emotional and utilitarian appraisals and used them to test different models of how they compete for the control of moral behavior. Importantly, we find little support for competitive inhibition accounts. Instead, moral judgments resembled the architecture of simple economic choices: distinct regions represented emotional

  11. Emotional and Utilitarian Appraisals of Moral Dilemmas Are Encoded in Separate Areas and Integrated in Ventromedial Prefrontal Cortex.

    Science.gov (United States)

    Hutcherson, Cendri A; Montaser-Kouhsari, Leila; Woodward, James; Rangel, Antonio

    2015-09-09

    Moral judgment often requires making difficult tradeoffs (e.g., is it appropriate to torture to save the lives of innocents at risk?). Previous research suggests that both emotional appraisals and more deliberative utilitarian appraisals influence such judgments and that these appraisals often conflict. However, it is unclear how these different types of appraisals are represented in the brain, or how they are integrated into an overall moral judgment. We addressed these questions using an fMRI paradigm in which human subjects provide separate emotional and utilitarian appraisals for different potential actions, and then make difficult moral judgments constructed from combinations of these actions. We found that anterior cingulate, insula, and superior temporal gyrus correlated with emotional appraisals, whereas temporoparietal junction and dorsomedial prefrontal cortex correlated with utilitarian appraisals. Overall moral value judgments were represented in an anterior portion of the ventromedial prefrontal cortex. Critically, the pattern of responses and functional interactions between these three sets of regions are consistent with a model in which emotional and utilitarian appraisals are computed independently and in parallel, and passed to the ventromedial prefrontal cortex where they are integrated into an overall moral value judgment. Significance statement: Popular accounts of moral judgment often describe it as a battle for control between two systems, one intuitive and emotional, the other rational and utilitarian, engaged in winner-take-all inhibitory competition. Using a novel fMRI paradigm, we identified distinct neural signatures of emotional and utilitarian appraisals and used them to test different models of how they compete for the control of moral behavior. Importantly, we find little support for competitive inhibition accounts. Instead, moral judgments resembled the architecture of simple economic choices: distinct regions represented emotional

  12. 12 CFR 564.4 - Minimum appraisal standards.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Minimum appraisal standards. 564.4 Section 564.4 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY APPRAISALS § 564.4 Minimum appraisal standards. For federally related transactions, all appraisals shall, at a minimum: (a...

  13. Stigma, Reflected Appraisals, and Recovery Outcomes in Mental Illness

    Science.gov (United States)

    Markowitz, Fred E.; Angell, Beth; Greenberg, Jan S.

    2011-01-01

    Drawing on modified labeling theory and the reflected appraisals process and using longitudinal data from 129 mothers and their adult children with schizophrenia, we estimate models of the effects of mothers' stigmatized identity appraisals of their mentally ill children on reflected and self-appraisals, and how appraisals affect outcomes…

  14. 9 CFR 52.3 - Appraisal of swine.

    Science.gov (United States)

    2010-01-01

    ... an APHIS employee alone. (b) The appraisal of swine will be based on the fair market value as determined by the meat or breeding value of the animals. Animals may be appraised in groups, provided that where appraisal is by the head, each animal in the group is the same value per head, and where appraisal...

  15. Upward Appraisal: A Tool for the Continuous Improvement of Library Managers' Skills.

    Science.gov (United States)

    Stein, Joan E.

    Effective management and the importance of feedback in relation to improvement are becoming critical issues for libraries. Upward appraisal evaluates managers' performance based on input from their staff, rather than the traditional top-down evaluation format in which a manager is evaluated solely by their superior. This paper discusses the…

  16. Using functional analysis in archival appraisal a practical and effective alternative to traditional appraisal methodologies

    CERN Document Server

    Robyns, Marcus C

    2014-01-01

    In an age of scarcity and the challenge of electronic records, can archivists and records managers continue to rely upon traditional methodology essentially unchanged since the early 1950s? Using Functional Analysis in Archival Appraisal: A Practical and Effective Alternative to Traditional Appraisal Methodologies shows how archivists in other countries are already using functional analysis, which offers a better, more effective, and imminently more practical alternative to traditional appraisal methodologies that rely upon an analysis of the records themselves.

  17. 32 CFR 644.42 - Appraisal report.

    Science.gov (United States)

    2010-07-01

    ... appraisal report shall be divided into four parts as outlined below: PART I—INTRODUCTION 1. TITLE PAGE. This... photograph. The use of color film and photographs is encouraged, especially wherein development cost either...

  18. A critical comparison of clinical decision instruments for computed tomographic scanning in mild closed traumatic brain injury in adolescents and adults.

    Science.gov (United States)

    Stein, Sherman C; Fabbri, Andrea; Servadei, Franco; Glick, Henry A

    2009-02-01

    A number of clinical decision aids have been introduced to limit unnecessary computed tomographic scans in patients with mild traumatic brain injury. These aids differ in the risk factors they use to recommend a scan. We compare the instruments according to their sensitivity and specificity and recommend ones based on incremental benefit of correctly classifying patients as having surgical, nonsurgical, or no intracranial lesions. We performed a secondary analysis of prospectively collected database from 7,955 patients aged 10 years or older with mild traumatic brain injury to compare sensitivity and specificity of 6 common clinical decision strategies: the Canadian CT Head Rule, the Neurotraumatology Committee of the World Federation of Neurosurgical Societies, the New Orleans, the National Emergency X-Radiography Utilization Study II (NEXUS-II), the National Institute of Clinical Excellence guideline, and the Scandinavian Neurotrauma Committee guideline. Excluded from the database were patients for whom the history of trauma was unclear, the initial Glasgow Coma Scale score was less than 14, the injury was penetrating, vital signs were unstable, or who refused diagnostic tests. Patients revisiting the emergency department within 7 days were counted only once. The percentage of scans that would have been required by applying each of the 6 aids were Canadian CT head rule (high risk only) 53%, Canadian (medium & high risk) 56%, the Neurotraumatology Committee of the World Federation of Neurosurgical Societies 56%, New Orleans 69%, NEXUS-II 56%, National Institute of Clinical Excellence 71%, and the Scandinavian 50%. The 6 decision aids' sensitivities for surgical hematomas could not be distinguished statistically (P>.05). Sensitivity was 100% (95% confidence interval [CI] 96% to 100%) for NEXUS-II, 98.1% (95% CI 93% to 100%) for National Institute of Clinical Excellence, and 99.1% (95% CI 94% to 100%) for the other 4 clinical decision instruments. Sensitivity for

  19. Evaluation of the measurement properties of self-reported health-related work-functioning instruments among workers with common mental disorders.

    Science.gov (United States)

    Abma, Femke I; van der Klink, Jac J L; Terwee, Caroline B; Amick, Benjamin C; Bültmann, Ute

    2012-01-01

    During the past decade, common mental disorders (CMD) have emerged as a major public and occupational health problem in many countries. Several instruments have been developed to measure the influence of health on functioning at work. To select appropriate instruments for use in occupational health practice and research, the measurement properties (eg, reliability, validity, responsiveness) must be evaluated. The objective of this study is to appraise critically and compare the measurement properties of self-reported health-related work-functioning instruments among workers with CMD. A systematic review was performed searching three electronic databases. Papers were included that: (i) mainly focused on the development and/or evaluation of the measurement properties of a self-reported health-related work-functioning instrument; (ii) were conducted in a CMD population; and (iii) were fulltext original papers. Quality appraisal was performed using the consensus-based standards for the selection of health status measurement instruments (COSMIN) checklist. Five papers evaluating measurement properties of five self-reported health-related work-functioning instruments in CMD populations were included. There is little evidence available for the measurement properties of the identified instruments in this population, mainly due to low methodological quality of the included studies. The available evidence on measurement properties is based on studies of poor-to-fair methodological quality. Information on a number of measurement properties, such as measurement error, content validity, and cross-cultural validity is still lacking. Therefore, no evidence-based decisions and recommendations can be made for the use of health-related work functioning instruments. Studies of high methodological quality are needed to properly assess the existing instruments' measurement properties.

  20. APPRAISAL ANALYSIS IN FREEDOM WRITERS MOVIE

    Directory of Open Access Journals (Sweden)

    Nani Hidayati

    2017-02-01

    Full Text Available This study attempts to find out conveyed messages in the movie from the realization of the appraisal and narrative structure as well as to describe the use of the Appraisal System to express LaGravenese's (a Attitudes, (bEngagement & (c Graduation towards the main characters in Freedom Writers movie screenplay. Using both quantitative and qualitative descriptive approach for discourse appraisal system analysis, the result of this study reveals several messages of tolerance, earning respect and trust, honor diversity, and striving for success and trust from the realization of Appraisal and Narrative Structure either in the dialogues or monologues of Freedom Writers’ characters. The result from the Appraisal Devices realizing (a Attitudes reveals that LaGravenese likes to express characters’ negative emotion explicitly than implicitly. He likes to express characters’ negative capability than other kinds of Judgments. He appreciates the characters using more Negative Value which denotes that in his opinion, they see each other negatively. (bEngagement used in the screenplay describes that he emphasizes more on characters’ denial towards each other’s opinion and existence with the use of more Disclaim Heterogloss in the screenplay. (cGraduation used in the screenplay describes that the use of more Sharpening Focus indicates he emphasizes on characters’ category boundary more than scaling of intensity. Keywords: Appraisal Devices, Attitude, Engagement, and Graduation.

  1. Etiopathogenesis of cataract: An appraisal

    Directory of Open Access Journals (Sweden)

    Varun B Gupta

    2014-01-01

    Full Text Available Natural eye lens is a crystalline substance to produce a clear passage for light. Cataract is opacity within the clear lens of the eye and is the dominant cause of socio-medical problem i.e., blindness worldwide. The only available treatment of cataract is surgery. However, insufficient surgical facilities in poor and developing countries and post-operative complications inspire researchers to find out other modes of treatment for cataract. In this review, an attempt has been made to appraise various etiological factors of cataract to make their perception clear to build up counterpart treatment. Present study is an assortment of various available literatures and electronic information in view of cataract etiopathogenesis. Various risk factors have been identified in development of cataracts. They can be classified in to genetic factors, ageing (systemic diseases, nutritional and trace metals deficiencies, smoking, oxidative stress etc., traumatic, complicated (inflammatory and degenerative diseases of eye, metabolic (diabetes, galactosemia etc., toxic substances including drugs abuses, alcohol etc., radiation (ultraviolet, electromagnetic waves etc. are implicated as significant risk factors in the development of cataract.

  2. A prática clínica baseada em evidências: parte III - avaliação crítica das informações de pesquisas clínicas Evidence based clinical practice: part III - critical appraisal of clinical research

    Directory of Open Access Journals (Sweden)

    Moacyr Roberto Cuce Nobre

    2004-12-01

    consistente quanto à adequação do desenho de estudo e ao controle dos vícios. Concluímos que se deve oferecer atualização metodológica aos profissionais interessados, e colocar a informação já avaliada à disposição de todos, elaborando e divulgando diretrizes baseadas em evidências.Evidence based health care begins with a clinical question and the search on data bases to retrieve the relevant information, that was the issue of two preceding articles of this series. At present it will be discussed how to critically appraise the medical literature using the clinical epidemiological methodology. Clinical research aims to develop diagnostic and therapeutic procedures measuring association and causality between the exposure and outcome. In this case the exposures are signs, symptoms, laboratorial or image exam, and therapy intervention. It is a mistake to take surrogate end-points instead of clinical outcomes. The main types of clinical study design are diagnostic, prognostic, therapeutic and harm/etiology. Experimental, physiologic and animal studies are useful for the medical undergraduate education, but do not contribute with clinical decisions. The study designs are classified according with the presence of a control group, patient's follow-up, and therapy interventions. The evidence hierarchy was done by the previous characteristics and the presence of systematic bias. Systematic reviews are stronger than the primary observational studies and are on the top when they revised randomized clinical trial. Since 1998 the proportion of evidence based practice guidelines was increasing compared with systematic reviews or other types of practice guidelines, although the former still are in a few numbers. The article critical appraisal must answer the clinical question, and need to have consistent study design and bias under control. In conclusion we ought to offer methodological actualization to interested physicians and put the information already critically assessed

  3. Design philosophy for the new harwell α,β/γ ILW facility and associated NDA instrumentation with regard to criticality safety

    International Nuclear Information System (INIS)

    Chard, P.M.J.; Cooper, T.J.; Croft, S.; Lambert, K.P.; Syme, D.B.; Wilkins, C.G.

    1995-01-01

    A new Alpha Beta/Gamma Waste Facility is currently being commissioned at Harwell. The facility provides for the assay and re-packing of existing Intermediate Level Waste (ILW) cans and future ILW arisings into 400 litre drums which are then stored in an integral vault prior to ultimate disposal. Paramount to the design philosophy for the plant was the safe retrieval and movement of radioactive material throughout the treatment process and the avoidance of criticality and other hazards. This required sound managerial controls underpinned by state-of-the-art non destructive assay (NDA) measurements. These consist primarily of a gamma spectrometer and a passive/active neutron interrogator. Their prime role is to confirm can identity against plant records and enable a fissile inventory to be developed for each can for criticality assessment. An expert system aids interpretation of assay results and the reconciliation of discrepancies. This paper describes the design philosophy with emphasis on the control measures used and the operation of the expert system. (author)

  4. Instrumentation for environmental monitoring: biomedical

    International Nuclear Information System (INIS)

    1979-05-01

    An update is presented to Volume four of the six-volume series devoted to a survey of instruments useful for measurements in biomedicine related to environmental research and monitoring. Results of the survey are given as descriptions of the physical and operating characteristics of available instruments, critical comparisons among instrumentation methods, and recommendations of promising methodology and development of new instrumentation. Methods of detection and analysis of gaseous organic pollutants and metals, including Ni and As are presented. Instrument techniques and notes are included on atomic spectrometry and uv and visible absorption instrumentation

  5. Instrumental interaction

    OpenAIRE

    Luciani , Annie

    2007-01-01

    International audience; The expression instrumental interaction as been introduced by Claude Cadoz to identify a human-object interaction during which a human manipulates a physical object - an instrument - in order to perform a manual task. Classical examples of instrumental interaction are all the professional manual tasks: playing violin, cutting fabrics by hand, moulding a paste, etc.... Instrumental interaction differs from other types of interaction (called symbolic or iconic interactio...

  6. The state of Danish nursing ethnographic research: flowering, nurtured or malnurtured - a critical review.

    Science.gov (United States)

    Uhrenfeldt, Lisbeth; Martinsen, Bente; Jørgensen, Lene Bastrup; Sørensen, Erik Elgaard

    2018-03-01

    Nursing was established in Denmark as a scholarly tradition in the late nineteen eighties, and ethnography was a preferred method. No critical review has yet summarised accomplishments and gaps and pointing at directions for the future methodological development and research herein. This review critically examines the current state of the use of ethnographic methodology in the body of knowledge from Danish nursing scholars. We performed a systematic literature search in relevant databases from 2003 to 2016. The studies included were critically appraised by all authors for methodological robustness using the ten-item instrument QARI from Joanna Briggs Institute. Two hundred and eight studies met our inclusion criteria and 45 papers were included; the critical appraisal gave evidence of studies with certain robustness, except for the first question concerning the congruity between the papers philosophical perspective and methodology and the seventh question concerning reflections about the influence of the researcher on the study and vice versa. In most studies (n = 34), study aims and arguments for selecting ethnographic research are presented. Additionally, method sections in many studies illustrated that ethnographical methodology is nurtured by references such as Hammersley and Atkinson or Spradley. Evidence exists that Danish nursing scholars' body of knowledge nurtures the ethnographic methodology mainly by the same few authors; however, whether this is an expression of a deliberate strategy or malnutrition in the form of lack of knowledge of other methodological options appears yet unanswered. © 2017 Nordic College of Caring Science.

  7. Negative appraisals and fear extinction are independently related to PTSD symptoms.

    Science.gov (United States)

    Zuj, Daniel V; Palmer, Matthew A; Gray, Kate E; Hsu, Chia-Ming K; Nicholson, Emma L; Malhi, Gin S; Bryant, Richard A; Felmingham, Kim L

    2017-08-01

    Considerable research has revealed impaired fear extinction to be a significant predictor of PTSD. Fear extinction is also considered the primary mechanism of exposure therapy, and a critical factor in PTSD recovery. The cognitive theory of PTSD proposes that symptoms persist due to excessive negative appraisals about the trauma and its sequelae. Research has not yet examined the relationship between fear extinction and negative appraisals in PTSD. A cross-sectional sample of participants with PTSD (n =21), and trauma-exposed controls (n =33) underwent a standardized differential fear conditioning and extinction paradigm, with skin conductance response (SCR) amplitude serving as the index of conditioned responses. The Posttraumatic Cognitions Inventory (PTCI) was used to index catastrophic negative appraisals. Participants with PTSD demonstrated a slower decrease in overall SCR responses during extinction and greater negative appraisals compared to the group. A moderation analysis revealed that both negative trauma-relevant appraisals and fear extinction learning were independently associated with PTSD symptoms, but there was no moderation interaction. The current study was limited by a modest sample size, leading to the inclusion of participants with subclinical PTSD symptoms. Further, the current study only assessed fear extinction learning; including a second day extinction recall task may show alternative effects. These findings indicate that negative appraisals and fear extinction did not interact, but had independent relationships with PTSD symptoms. Here we show for the first time in an experimental framework that negative appraisals and fear extinction play separate roles in PTSD symptoms. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2016-03-08

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

  9. Evaluation of tools used to measure critical thinking development in nursing and midwifery undergraduate students: a systematic review.

    Science.gov (United States)

    Carter, Amanda G; Creedy, Debra K; Sidebotham, Mary

    2015-07-01

    Well developed critical thinking skills are essential for nursing and midwifery practices. The development of students' higher-order cognitive abilities, such as critical thinking, is also well recognised in nursing and midwifery education. Measurement of critical thinking development is important to demonstrate change over time and effectiveness of teaching strategies. To evaluate tools designed to measure critical thinking in nursing and midwifery undergraduate students. The following six databases were searched and resulted in the retrieval of 1191 papers: CINAHL, Ovid Medline, ERIC, Informit, PsycINFO and Scopus. After screening for inclusion, each paper was evaluated using the Critical Appraisal Skills Programme Tool. Thirty-four studies met the inclusion criteria and quality appraisal. Sixteen different tools that measure critical thinking were reviewed for reliability and validity and extent to which the domains of critical thinking were evident. Sixty percent of studies utilised one of four standardised commercially available measures of critical thinking. Reliability and validity were not consistently reported and there was a variation in reliability across studies that used the same measure. Of the remaining studies using different tools, there was also limited reporting of reliability making it difficult to assess internal consistency and potential applicability of measures across settings. Discipline specific instruments to measure critical thinking in nursing and midwifery are required, specifically tools that measure the application of critical thinking to practise. Given that critical thinking development occurs over an extended period, measurement needs to be repeated and multiple methods of measurement used over time. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  10. Incremental Validity Analyses of the Violence Risk Appraisal Guide and the Psychopathy Checklist: Screening Version in a Civil Psychiatric Sample

    Science.gov (United States)

    Edens, John F.; Skeem, Jennifer L.; Douglas, Kevin S.

    2006-01-01

    This study compares two instruments frequently used to assess risk for violence, the Violence Risk Appraisal Guide (VRAG) and the Psychopathy Checklist: Screening Version (PCL:SV), in a large sample of civil psychiatric patients. Despite a strong bivariate relationship with community violence, the VRAG could not improve on the predictive validity…

  11. Comparative effectiveness of manipulation, mobilisation and the Activator instrument in treatment of non-specific neck pain: a systematic review

    Directory of Open Access Journals (Sweden)

    Miller Peter

    2006-04-01

    Full Text Available Abstract Background Neck pain is a common problem and different forms of manual therapy are used in its treatment. The purpose of this systematic review was to critically appraise the literature that directly compared manipulation, mobilisation and the Activator instrument for non-specific neck pain. Methods Electronic databases (MEDLINE, MANTIS and CINAHL were searched from their inception to October 2005 for all English language randomised clinical trials that directly compared manipulation, mobilisation and the Activator instrument. Inclusion and exclusion criteria were applied to select the studies and these studies were then evaluated using validated criteria. Results Five such studies were identified. The methodological quality was mostly poor. Findings from the studies were mixed and no one therapy was shown to be more effective than the others. Conclusion Further high quality research has to be done before a recommendation can be made as to the most effective manual method for non-specific neck pain.

  12. [Evaluation of Wits appraisal with superimposition method].

    Science.gov (United States)

    Xu, T; Ahn, J; Baumrind, S

    1999-07-01

    To compare the conventional Wits appraisal with superimposed Wits appraisal in evaluation of sagittal jaw relationship change between pre and post orthodontic treatment. The sample consists of 48-case pre and post treatment lateral head films. Computerized digitizing is used to get the cephalometric landmarks and measure conventional Wits value, superimposed Wits value and ANB angle. The correlation analysis among these three measures was done by SAS statistical package. The change of ANB angle has higher correlation with the change of superimposed Wits than that of the conventional Wits. The r-value is as high as 0.849 (P < 0.001). The superimposed Wits appraisal reflects the change of sagittal jaw relationship more objectively than the conventional one.

  13. Instrumentation Facility

    Data.gov (United States)

    Federal Laboratory Consortium — Provides instrumentation support for flight tests of prototype weapons systems using a vast array of airborne sensors, transducers, signal conditioning and encoding...

  14. Appraising and applying evidence about a diagnostic test during a performance-based assessment

    Directory of Open Access Journals (Sweden)

    Franklin Ellen

    2004-10-01

    Full Text Available Abstract Background The practice of Evidence-based Medicine requires that clinicians assess the validity of published research and then apply the results to patient care. We wanted to assess whether our soon-to-graduate medical students could appraise and apply research about a diagnostic test within a clinical context and to compare our students with peers trained at other institutions. Methods 4th year medical students who previously had demonstrated competency at probability revision and just starting first-year Internal Medicine residents were used for this research. Following an encounter with a simulated patient, subjects critically appraised a paper about an applicable diagnostic test and revised the patient's pretest probability given the test result. Results The medical students and residents demonstrated similar skills at critical appraisal, correctly answering 4.7 and 4.9, respectively, of 6 questions (p = 0.67. Only one out of 28 (3% medical students and none of the 15 residents were able to correctly complete the probability revision task (p = 1.00. Conclusions This study found that most students completing medical school are able to appraise an article about a diagnostic test but few are able to apply the information from the article to a patient. These findings raise questions about the clinical usefulness of the EBM skills possessed by graduating medical students within the area of diagnostic testing.

  15. Avaliação de desempenho dos treinadores desportivos: da inexistência de um instrumento estruturado à valorização dos resultados desportivos Performance appraisal of sports coaches: from the lack of a structured instrument to the enhancement of sports results

    Directory of Open Access Journals (Sweden)

    Jorge Alexandre Pereira Soares

    2011-09-01

    Full Text Available Este estudo procurou compreender o processo e os critérios considerados na avaliação de desempenho dos treinadores pertencentes a nove clubes desportivos da Região Autônoma da Madeira, Portugal. Foi utilizada uma metodologia de carácter qualitativo, com recurso à análise documental da estrutura, dos recursos humanos dos clubes e a uma entrevista semiestruturada realizada aos diretores com responsabilidades na avaliação dos treinadores. Os resultados ilustram um processo de avaliação não estruturado, baseado em informações pouco sistematizadas e rigorosas. Os critérios de avaliação mais relevantes foram os resultados desportivos dos atletas, seguidos das competências de liderança e competências pessoais e sociais do treinador.This study aims to understand the process and the criteria evolved in the performance appraisal of coaches of nine sport clubs in the Autonomous Region of Madeira, Portugal. The methodology used was based on a documentary analysis of the human resources of the institution and it was carried out a semi-structured interview done to the directors responsible for the performance appraisal of the coaches. The results show a less structured evaluation process, based on poor and inaccurate organization data. The most relevant criteria in the evaluation process were the sports scores of athletes, followed by the leadership skills and personal and social skills of the coach.

  16. Performance appraisal and merit recognition exercise 2007

    CERN Multimedia

    HR Department

    2006-01-01

    The 2007 performance appraisal and merit recognition exercise will start in the usual way with annual interviews between staff and their supervisors. This year, these interviews should be held in the period from 8 January 2007 to 16 April 2007. Interconnection with the 5-yearly review, a number of modifications to the procedures relating to the performance appraisal and merit recognition are currently under study. Administrative Circular No. 26 (Procedures governing the Career Development of Staff Members) and the electronic MAPS form in EDH are being reviewed and will be available from January onwards. HR Department will shortly provide further information on this subject. Human Resources Department Tel. 73566

  17. Religion, Psychology and Globalisation Process: Attitudinal Appraisal

    Directory of Open Access Journals (Sweden)

    Emmanuel Orok Duke

    2016-10-01

    Full Text Available A key consequence of globalisation is the integrative approach to reality whereby emphasis is placed on interdependence. Religion being an expression of human culture is equally affected by this cultural revolution. The main objective of this paper is to examine how religious affiliation, among Christians, influences attitudes towards the application of psychological sciences to the assuagement of human suffering. The sociological theory of structural functionalism was deployed to explain attitudinal appraisal. Ethnographic methodology, through quantitative analysis of administered questionnaire, was also used. The study reveals that religious tenets largely shape attitudinal appraisal and redefine the borders of globalisation’s metanarratives.

  18. [Transcultural adaptation of an instrument to evaluate hearing handicap in workers with noise-induced hearing loss].

    Science.gov (United States)

    Holanda, Wanessa Tenório Gonçalves; de Lima, Maria Luiza Carvalho; Figueiroa, José Natal

    2011-01-01

    The noise-induced hearing loss (NIHL) is a chronic and irreversible disease resulting of the exposure to noise in high levels at work. Even in the beginning, this hearing loss can damage in many degrees the worker's quality of life. Before this study, there wasn't an instrument, in Portuguese, to evaluate the psychosocial disadvantages of workers with NIHL. The aim of this research was to make a transcultural adaptation of an especific instrument to evaluate the hearing handicap from the original language to Portuguese, and check the reliability and legitimacy. The selected instrument passed by a process of semantic equivalence that was conducted in five stages: translation, back translation, critical appraisal of the versions, pre-test and a final review by a multi-professional group to develop a consensual version of the instrument for current use in Brazil. The instrument called "Inabilities Scale and Hearing Handicap" had, in general, acceptable psychometric measures, considering the little size of the sample and the fact that workers' hearing loss weren't too significant. Therefore, the Portuguese version of this instrument needs to be further tested in a representative sample of Brazilian workers with NIHL to ratify its utility in order to evaluate hearing handicap in this population.

  19. ORIGINAL Is the Role of Teacher Performance Appraisal in Ethiopia ...

    African Journals Online (AJOL)

    aware of the purposes of the current teacher performance appraisal. However, the ... building, and expensive equipment (Daniel,. 2009). ... development of teachers, teachers' job ...... Appraisers' tend to rate high a person who is similar.

  20. The System of Employee Appraisal in a Company

    OpenAIRE

    Vaverová, Lucie

    2011-01-01

    This bachelor study called "The System of Employee Appraisal in a Company" deals with a general subscription of a personal process "Employee appraisal". It describes the principles of the system of employee appraisal and also covers the conditions necessary for its efficiency and operation. The bachelor study is focused on the system of employee appraisal centrally implemented in company ČEZ, a. s. This system is analyzed and compared with generally stated theoretical principles. The study in...

  1. 12 CFR 528.2a - Nondiscriminatory appraisal and underwriting.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Nondiscriminatory appraisal and underwriting. 528.2a Section 528.2a Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY NONDISCRIMINATION REQUIREMENTS § 528.2a Nondiscriminatory appraisal and underwriting. (a) Appraisal. No savings...

  2. Problems of Clinical Nurse Performance Appraisal System: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Nasrin Nikpeyma

    2014-03-01

    Conclusion: The findings of this study reveal that the nurse performance appraisal system confronts with various problems. Some of these problems are related to organizational context while the others concerned structure, process and results of the performance appraisal system. In order to achieve high quality of patient care as the final goal of performance appraisal, changing and revision of this system is necessary.

  3. Characteristics of Appraisal Systems That Promote Job Satisfaction of Teachers

    Science.gov (United States)

    Deneire, Alexia; Vanhoof, Jan; Faddar, Jerich; Gijbels, David; Van Petegem, Peter

    2014-01-01

    This article examines if and how characteristics of appraisal systems used for secondary school teachers affect job satisfaction. Using multilevel analyses on data of 3 473 teachers in Flanders (Belgium), we found that appraisals with a developmental purpose and appraisals perceived as being a fair judgement, both have a positive impact on job…

  4. Handbook for Conducting Standard CMMI Appraisal Method for Process Improvement (SCAMPI) B and C Appraisals, Version 1.1

    National Research Council Canada - National Science Library

    Hayes, Will; Miluk, Gene; Ming, Lisa; Glover, Margaret; Bisgrove, Jane; Cort, Corrine; Penn, Lynn; Jacobson, Nils; Beynon, Don; Allgood, Bruce

    2005-01-01

    The Standard CMMI Appraisal Method for Process Improvement (SCAMPI) provides a well-defined, publicly available set of methodologies for providing appraisals relative to Capability Maturity Model (trademark) Integration (CMMI) models...

  5. MOOC appraisal: a quality perspective

    Directory of Open Access Journals (Sweden)

    Miguel Baldomero Ramírez-Fernández

    2015-03-01

    Full Text Available The research analyzes the quality of the norms of five MOOC courses of the EDX platform through the EduTool® instrument, a brand registered in the Spanish Patent and Trademark Office (3,087,298, in effect. This tool was the result of a doctoral thesis in the research line of work “2.0 ICT teaching innovation in the European Higher Education Area” of the University Pablo de Olavide of Seville (Spain. This work was developed following the UNE 66181: 2012 norm, where the weights of the sub-factors of each of the dimensions of this standard for quality management of virtual training for MOOCs were analyzed using fuzzy logic. To that end, the quality of a given platform was evaluated by intentional non-probabilistic sampling of the most relevant courses that were available there, in the second quarter of 2014. For the data collection necessary for this procedure, two encoders (a computer engineer and a teacher and educator, both inspectors of education, evaluated the quality of the courses using that instrument. The analytical results show that, in general, the quality of the average MOOC analyzed in the platform is above the score that describes the minimum required by the tool (50%. Thus, the average quality of the platform was 62.62%. Nearly all the courses had a minimum value of the first dimension of 6.66%. As for the second dimension, a quality value of 32.77% was observed. Finally, in the third dimension, all courses exceeded the acceptable quality with 23.19%.

  6. Instrumentation development

    International Nuclear Information System (INIS)

    Ubbes, W.F.; Yow, J.L. Jr.

    1988-01-01

    Instrumentation is developed for the Civilian Radioactive Waste Management Program to meet several different (and sometimes conflicting) objectives. This paper addresses instrumentation development for data needs that are related either directly or indirectly to a repository site, but does not touch on instrumentation for work with waste forms or other materials. Consequently, this implies a relatively large scale for the measurements, and an in situ setting for instrument performance. In this context, instruments are needed for site characterization to define phenomena, develop models, and obtain parameter values, and for later design and performance confirmation testing in the constructed repository. The former set of applications is more immediate, and is driven by the needs of program design and performance assessment activities. A host of general technical and nontechnical issues have arisen to challenge instrumentation development. Instruments can be classed into geomechanical, geohydrologic, or other specialty categories, but these issues cut across artificial classifications. These issues are outlined. Despite this imposing list of issues, several case histories are cited to evaluate progress in the area

  7. Evaluating Housing Problems through Participatory Rural Appraisal ...

    African Journals Online (AJOL)

    Lokoja, a medium sized community in the Middle Belt of Nigeria experienced a massive influx of population in the last twelve years. This study examined housing problems that resulted thereafter. Through a participatory appraisal using group discussion and brainstorming, transect walk and matrix ranking, a sampled ...

  8. Evaluating Housing Problems through Participatory Rural Appraisal ...

    African Journals Online (AJOL)

    Nekky Umera

    Whether in research, development or policy analysis, in social, forestry, irrigation ... Action, Participatory Rural Appraisal involves interaction between the planners and the ..... Park, Obasanjo Layout, the Kogi People Consumer Shops as well as the confluence .... The institutional arrangements under which a person gains ...

  9. Energy considerations in real estate appraising

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-04-01

    Purposes of the seminar on the subject, the basis of this report, include the following: (1) to provide the appraiser an opportunity to learn how to identify and analyze the actual physical consumption of energy as well as the energy-saving improvements in properties under appraisal and in comparable sale and lease properties; (2) to help the appraiser in developing methods to keep meaningful records on the energy consumption of subject and comparable properties so as to observe in an orderly way the behavior of buyers, sellers, tenants, landlords, borrowers, and lenders with respect to energy efficiency; and (3) to assist the appraiser in learning to measure the relative sensitivities of the various segments of the market to energy considerations as indicated by differences in sale prices and rentals. To achieve these goals, the seminar employed two case studies, one for a angle-family residence and one for a multi-family building, both in Topeka, Kansas. The case studies are for illustrative purposes only; in applying the lessons of the seminar to their own daily work, students should be careful to develop information that is pertinent to their subject properties and subject areas and not rely on any of the particulars laid out in the cases.

  10. Implementing performance appraisal : Exploring the employee experience

    NARCIS (Netherlands)

    Farndale, E.; Kelliher, C.

    2013-01-01

    Line managers play an important role as implementers of performance appraisal, enacting procedures designed by the HR function. However, the actual employee experience of these procedures (which may differ from how they were intended or enacted) in terms of perceptions of justice in the process is

  11. Embodied Appraisals and Non-emotional States

    Czech Academy of Sciences Publication Activity Database

    Hvorecký, Juraj

    2010-01-01

    Roč. 20, č. 3 (2010), s. 215-223 ISSN 1210-3055 R&D Projects: GA AV ČR(CZ) KJB900090802 Institutional research plan: CEZ:AV0Z90090514 Keywords : embodied appraisal * non-emotional mental states * valence * emotion Subject RIV: AA - Philosophy ; Religion

  12. Appraisal and financing of electric power projects

    International Nuclear Information System (INIS)

    Sheehan, R.H.

    1975-01-01

    This paper starts with the origin, nature and functions of the World Bank Group, reviews the past lending, describes the criteria used by the Bank in its power project appraisals, discusses the Bank's views on nuclear power, and concludes with a look at the probable future sources of financing of electrical expansion in the less developed countries. (orig./UA) [de

  13. 7 CFR 1955.128 - Appraisers.

    Science.gov (United States)

    2010-01-01

    ... type of properties (such as large farms and business property) requiring valuation. For Farmer Programs... REGULATIONS (CONTINUED) PROPERTY MANAGEMENT Disposal of Inventory Property Use of Contractors to Dispose of Inventory Property § 1955.128 Appraisers. (a) Real property. The State Director may authorize the County...

  14. Intelligence Defined and Undefined: A Relativistic Appraisal

    Science.gov (United States)

    Wechsler, David

    1975-01-01

    Major reasons for the continuing divergency of opinion as regards the nature and meaning of intelligence are examined. An appraisal of intelligence as a relative concept is proposed which advocates the necessity of specifying the reference systems to which a statement about intelligence refers. (EH)

  15. Evaluating Library Staff: A Performance Appraisal System.

    Science.gov (United States)

    Belcastro, Patricia

    This manual provides librarians and library managers with a performance appraisal system that measures staff fairly and objectively and links performance to the goals of the library. The following topics are addressed: (1) identifying expectations for quality service or standards of performance; (2) the importance of a library's code of service,…

  16. Elective abdominal hysterectomy: Appraisal of indications and ...

    African Journals Online (AJOL)

    of hysterectomy did not occur until the 19th century, earlier attempts are known. Some references to hysterectomy date back to 5th century BC, in the time of Hippocrates. In. 1600, Schenck of Grabenberg cataloged 26 cases of vaginal hysterectomy in Europe.[2]. Elective abdominal hysterectomy: Appraisal of indications and.

  17. Persistent Ratee Contaminants in Performance Appraisal.

    Science.gov (United States)

    Van Fleet, David D.; Chamberlain, Howard

    The hypothesis that conventional approaches to evaluating contaminants in performance appraisal overlook important individual ratee effects was examined. A rating form was developed that consisted of the following dimensions and behaviors: warmth; guided discourse or indirect teaching methods; control of subject matter; enthusiasm and reinforcing;…

  18. Understanding cohort differences in appraisals of reconstruction ...

    African Journals Online (AJOL)

    Understanding cohort differences in appraisals of reconstruction priorities of mental health systems in postconflict Liberia. ... Conclusion: This study provides additional support for the premise that the utilization of ... of Liberians and that there are differences in preferences across groups. ... AJOL African Journals Online.

  19. 78 FR 31924 - Appraisal Subcommittee; Policy Statements

    Science.gov (United States)

    2013-05-28

    ... financial institutions regulatory agency engages in, contracts for, or regulates; and b) requires the... officer, director, employee or agent of a federally regulated financial institution would not be permitted... FEDERAL FINANCIAL INSTITUTIONS EXAMINATION COUNCIL [Docket No. AS13-13] Appraisal Subcommittee...

  20. United Nations and multilateralism: appraising USA's unilateralism ...

    African Journals Online (AJOL)

    Multilateralism as symbolized by the United Nations Organization, seems to have come under threat today, and nowhere is this more evident than in the United States-United Nations relations particularly in the area of military interventions around the world. The aim of this paper is to appraise the practice of the principle of ...

  1. 36 CFR 254.9 - Appraisals.

    Science.gov (United States)

    2010-07-01

    ....9 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE LANDOWNERSHIP... contributory value of any interest in land such as water rights, minerals, or timber, to the extent they are... the physical characteristics of the land being appraised; a statement of all encumbrances; title...

  2. The Type and Impact of Evidence Review Group Exploratory Analyses in the NICE Single Technology Appraisal Process.

    Science.gov (United States)

    Carroll, Christopher; Kaltenthaler, Eva; Hill-McManus, Daniel; Scope, Alison; Holmes, Michael; Rice, Stephen; Rose, Micah; Tappenden, Paul; Woolacott, Nerys

    2017-06-01

    As part of the UK National Institute for Health and Care Excellence (NICE) single technology appraisal process, independent evidence review groups (ERGs) critically appraise a company's submission relating to a specific technology and indication. To explore the type of additional exploratory analyses conducted by ERGs and their impact on the recommendations made by NICE. The 100 most recently completed single technology appraisals with published guidance were selected for inclusion. A content analysis of relevant documents was undertaken to identify and extract relevant data, and narrative synthesis was used to rationalize and present these data. The types of exploratory analysis conducted in relation to companies' models were fixing errors, addressing violations, addressing matters of judgment, and the provision of a new, ERG-preferred base case. Ninety-three of the 100 ERG reports contained at least one of these analyses. The most frequently reported type of analysis in these 93 ERG reports related to the category "Matters of judgment," which was reported in 83 reports (89%). At least one of the exploratory analyses conducted and reported by an ERG is mentioned in 97% of NICE appraisal consultation documents and 94% of NICE final appraisal determinations, and had a clear influence on recommendations in 72% of appraisal consultation documents and 47% of final appraisal determinations. These results suggest that the additional analyses undertaken by ERGs in the appraisal of company submissions are highly influential in the policy-making and decision-making process. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  3. Place attachment, place identity and aesthetic appraisal of urban landscape

    Directory of Open Access Journals (Sweden)

    Jaśkiewicz Michał

    2015-12-01

    Full Text Available As the aesthetic of the Polish cities became a topic of wider discussions, it is important to detect the potential role of human-place relations. Two studies (N = 185 & N = 196 were conducted to explore the relationship between place attachment, place identity and appraisal of urban landscape. Satisfaction with urban aesthetic was predicted by two dimensions of place attachment (place inherited and place discovered, local identity (on the trend level and national-conservative identity. Place discovered and European identity were also predictors of visual pollution sensitivity. Place discovered is considered as more active type of attachment that permits both a positive bias concerning the aesthetics of one’s city, and a stronger criticism of the elements that can potentially violate the place’s landscape.

  4. Instrumental analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Jae; Seo, Seong Gyu

    1995-03-15

    This textbook deals with instrumental analysis, which consists of nine chapters. It has Introduction of analysis chemistry, the process of analysis and types and form of the analysis, Electrochemistry on basic theory, potentiometry and conductometry, electromagnetic radiant rays and optical components on introduction and application, Ultraviolet rays and Visible spectrophotometry, Atomic absorption spectrophotometry on introduction, flame emission spectrometry and plasma emission spectrometry. The others like infrared spectrophotometry, X-rays spectrophotometry and mass spectrometry, chromatography and the other instrumental analysis like radiochemistry.

  5. Instrumental analysis

    International Nuclear Information System (INIS)

    Kim, Seung Jae; Seo, Seong Gyu

    1995-03-01

    This textbook deals with instrumental analysis, which consists of nine chapters. It has Introduction of analysis chemistry, the process of analysis and types and form of the analysis, Electrochemistry on basic theory, potentiometry and conductometry, electromagnetic radiant rays and optical components on introduction and application, Ultraviolet rays and Visible spectrophotometry, Atomic absorption spectrophotometry on introduction, flame emission spectrometry and plasma emission spectrometry. The others like infrared spectrophotometry, X-rays spectrophotometry and mass spectrometry, chromatography and the other instrumental analysis like radiochemistry.

  6. LOFT instrumentation

    International Nuclear Information System (INIS)

    Bixby, W.W.

    1979-01-01

    A description of instrumentation used in the Loss-of-Fluid Test (LOFT) large break Loss-of-Coolant Experiments is presented. Emphasis is placed on hydraulic and thermal measurements in the primary system piping and components, reactor vessel, and pressure suppression system. In addition, instrumentation which is being considered for measurement of phenomena during future small break testing is discussed. (orig.) 891 HP/orig. 892 BRE [de

  7. Motivation Measures in Sport: A Critical Review and Bibliometric Analysis.

    Science.gov (United States)

    Clancy, Rachel B; Herring, Matthew P; Campbell, Mark J

    2017-01-01

    Motivation is widely-researched, in both sport psychology and other fields. As rigorous measurement is essential to understanding this latent construct, a critical appraisal of measurement instruments is needed. Thus, the purpose of this review was to evaluate the six most highly cited motivation measures in sport. Peer-reviewed articles published prior to August 2016 were searched to identify the six most highly cited motivation questionnaires in sport: Sport Motivation Scale (SMS), Intrinsic Motivation Inventory (IMI), Situational Motivational Scale (SIMS), Perceptions of Success Questionnaire (POSQ), Behavioural Regulation in Sport Questionnaire (BRSQ), and Task and Ego Orientation in Sport Questionnaire (TEOSQ). The questionnaires were then evaluated and discussed in four sections: Development, Reliability, Correlates, and Summary. Bibliometric data were also calculated (average weighted impact factor) and assessed (e.g., citations per year) to evaluate the impact of the use of each questionnaire. Despite some variance in their psychometric properties, conceptualization, structure, and utility, the six questionnaires are psychometrically strong instruments for quantifying motivation that are widely supported in the literature. Bibliometric analyses suggested that the IMI ranks first and the SMS ranks sixth according to the average weighted impact factors of their original publications. Consideration of each questionnaire's psychometric strengths/limitations, and conceptualization of motivation in the context of specific research questions should guide researchers in selecting the most appropriate instrument to measure motivation in sport. The average weighted impact factor of each questionnaire is a useful value to consider as well. With these points in mind, recommendations are provided.

  8. Motivation Measures in Sport: A Critical Review and Bibliometric Analysis

    Science.gov (United States)

    Clancy, Rachel B.; Herring, Matthew P.; Campbell, Mark J.

    2017-01-01

    Motivation is widely-researched, in both sport psychology and other fields. As rigorous measurement is essential to understanding this latent construct, a critical appraisal of measurement instruments is needed. Thus, the purpose of this review was to evaluate the six most highly cited motivation measures in sport. Peer-reviewed articles published prior to August 2016 were searched to identify the six most highly cited motivation questionnaires in sport: Sport Motivation Scale (SMS), Intrinsic Motivation Inventory (IMI), Situational Motivational Scale (SIMS), Perceptions of Success Questionnaire (POSQ), Behavioural Regulation in Sport Questionnaire (BRSQ), and Task and Ego Orientation in Sport Questionnaire (TEOSQ). The questionnaires were then evaluated and discussed in four sections: Development, Reliability, Correlates, and Summary. Bibliometric data were also calculated (average weighted impact factor) and assessed (e.g., citations per year) to evaluate the impact of the use of each questionnaire. Despite some variance in their psychometric properties, conceptualization, structure, and utility, the six questionnaires are psychometrically strong instruments for quantifying motivation that are widely supported in the literature. Bibliometric analyses suggested that the IMI ranks first and the SMS ranks sixth according to the average weighted impact factors of their original publications. Consideration of each questionnaire's psychometric strengths/limitations, and conceptualization of motivation in the context of specific research questions should guide researchers in selecting the most appropriate instrument to measure motivation in sport. The average weighted impact factor of each questionnaire is a useful value to consider as well. With these points in mind, recommendations are provided. PMID:28337165

  9. Quality Assessment of Clinical Practice Guidelines for Respiratory Diseases in China: A Systematic Appraisal.

    Science.gov (United States)

    Jiang, Mei; Liao, Li-Yue; Liu, Xiao-Qing; He, Wei-Qun; Guan, Wei-Jie; Chen, Hao; Li, Yi-Min

    2015-09-01

    There has been a significant increase in the publication of clinical practice guidelines (CPGs) for respiratory diseases in China. However, little is known about the quality and potential impacts of these CPGs. Our objective was to critically evaluate the quality of Chinese CPGs for respiratory diseases that were published in peer-reviewed medical journals. A systematic search of scientific literature published between 1979 and 2013 was undertaken to identify and select CPGs that were related to respiratory diseases. Four Chinese databases (the Chinese Biomedical Literature database [CBM], the China National Knowledge Infrastructure [CNKI], the VIP database, and the WANFANG database) were used. The quality of eligible guidelines was assessed independently by four reviewers using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. The overall agreement among reviewers was evaluated using an intraclass correlation coefficient. A total of 109 guidelines published in 27 medical journals from 1979 to 2013 were evaluated. The overall agreement among reviewers was considered good (intraclass correlation coefficient, 0.838; 95% CI, 0.812-0.862). The scores of the six AGREE domains were low: 57.3% for scope and purpose (range, 4.2%-80.5%), 23.8% for stakeholder involvement (range, 2.8%-54.2%), 7.7% for rigor of development (range, 0%-27.1%), 59.8% for clarity and presentation (range, 22.2%-80.6%), 10.9% for applicability (range, 0%-22.9%), and 0.6% for editorial independence (range, 0%-16.7%). Scores for all guidelines were below 60%, and only three guidelines (2.8%) were recommended for clinical practice with modifications. The quality of the guidelines was low, and stakeholder involvement, rigor of development, applicability, and editorial independence should be considered in the future development of CPGs for respiratory diseases in China.

  10. Health literacy screening instruments for eHealth applications: a systematic review.

    Science.gov (United States)

    Collins, Sarah A; Currie, Leanne M; Bakken, Suzanne; Vawdrey, David K; Stone, Patricia W

    2012-06-01

    To systematically review current health literacy (HL) instruments for use in consumer-facing and mobile health information technology screening and evaluation tools. The databases, PubMed, OVID, Google Scholar, Cochrane Library and Science Citation Index, were searched for health literacy assessment instruments using the terms "health", "literacy", "computer-based," and "psychometrics". All instruments identified by this method were critically appraised according to their reported psychometric properties and clinical feasibility. Eleven different health literacy instruments were found. Screening questions, such as asking a patient about his/her need for assistance in navigating health information, were evaluated in seven different studies and are promising for use as a valid, reliable, and feasible computer-based approach to identify patients that struggle with low health literacy. However, there was a lack of consistency in the types of screening questions proposed. There is also a lack of information regarding the psychometric properties of computer-based health literacy instruments. Only English language health literacy assessment instruments were reviewed and analyzed. Current health literacy screening tools demonstrate varying benefits depending on the context of their use. In many cases, it seems that a single screening question may be a reliable, valid, and feasible means for establishing health literacy. A combination of screening questions that assess health literacy and technological literacy may enable tailoring eHealth applications to user needs. Further research should determine the best screening question(s) and the best synthesis of various instruments' content and methodologies for computer-based health literacy screening and assessment. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. How Should an Effective Performance Appraisal Be: EFL Teachers’ Perspective

    Directory of Open Access Journals (Sweden)

    Holi Ibrahim Holi Ali

    2012-11-01

    Full Text Available This study is set to examine EFL teachers’ perceptions, views about what makes an effective performance appraisal system by adopting a quantitative survey design for data collection. A total number of 45 college instructors in the Sultanate of Oman responded to survey on: how is an effective performance appraisal perceived by EFL teachers? How do teachers perceive their participation in developing the appraisal system? And how might the present performance appraisal practices be improved? The result reveals that staff participation in developing performance appraisal system and goals, feedback confidentiality, quality appraiser, quality of place and time of appraisal, appraiser-appraisee relationships, and developmental nature of performance appraisal would help in making effective appraisal and the overall PA effectiveness depends mostly on these factors. The result has a significant implication for improving the process of teacher performance appraisal in Oman and enriches the body knowledge of PA in general. The study puts forwards suggestions and recommendations for improving PA practices and exercises in EFL contexts.

  12. Advanced optical instruments technology

    Science.gov (United States)

    Shao, Mike; Chrisp, Michael; Cheng, Li-Jen; Eng, Sverre; Glavich, Thomas; Goad, Larry; Jones, Bill; Kaarat, Philip; Nein, Max; Robinson, William

    1992-08-01

    The science objectives for proposed NASA missions for the next decades push the state of the art in sensitivity and spatial resolution over a wide range of wavelengths, including the x-ray to the submillimeter. While some of the proposed missions are larger and more sensitive versions of familiar concepts, such as the next generation space telescope, others use concepts, common on the Earth, but new to space, such as optical interferometry, in order to provide spatial resolutions impossible with other concepts. However, despite their architecture, the performance of all of the proposed missions depends critically on the back-end instruments that process the collected energy to produce scientifically interesting outputs. The Advanced Optical Instruments Technology panel was chartered with defining technology development plans that would best improve optical instrument performance for future astrophysics missions. At this workshop the optical instrument was defined as the set of optical components that reimage the light from the telescope onto the detectors to provide information about the spatial, spectral, and polarization properties of the light. This definition was used to distinguish the optical instrument technology issues from those associated with the telescope, which were covered by a separate panel. The panel identified several areas for optical component technology development: diffraction gratings; tunable filters; interferometric beam combiners; optical materials; and fiber optics. The panel also determined that stray light suppression instruments, such as coronagraphs and nulling interferometers, were in need of general development to support future astrophysics needs.

  13. Literature Review of Multicultural Instrumentation

    Science.gov (United States)

    Sarraj, Huda; Carter, Stacy; Burley, Hansel

    2015-01-01

    Demographic changes at the national level emphasize a critical need for multicultural education to be included as part of undergraduate education. This critical review of the literature examines 10 multicultural instruments that are suitable for use in K-12 or higher education institutions. This is a novel literature review in that it is the first…

  14. Development and validation of the insulin treatment appraisal scale (ITAS) in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Snoek, Frank J; Skovlund, Søren E; Pouwer, Frans

    2007-01-01

    . Exploratory factor analysis (EFA), internal consistency (Cronbach's alpha) and item-total correlations were determined to test the reliability of the instrument. Concurrent validity was examined by calculating Pearson correlation coefficients between the different measures. Discriminant validity was examined...... 20-item scale was 0.89, suggesting high homogeneity and allowing for calculation of an overall score. Item-total correlations were in the range of 0.46-0.74 for the negative and 0.34 - 0.53 for the positive appraisal scale. The item pertaining to weight gain, as part of the negative appraisal...... subscale, showed low communality and deserves further testing. Concurrent validity was confirmed with low to moderate correlations in the expected direction between ITAS and WHO-5 and PAID. Discriminant validity was confirmed by the fact that patients using insulin had significantly less negative...

  15. Instrumental Capital

    Directory of Open Access Journals (Sweden)

    Gabriel Valerio

    2007-07-01

    Full Text Available During the history of human kind, since our first ancestors, tools have represented a mean to reach objectives which might otherwise seemed impossibles. In the called New Economy, where tangibles assets appear to be losing the role as the core element to produce value versus knowledge, tools have kept aside man in his dairy work. In this article, the author's objective is to describe, in a simple manner, the importance of managing the organization's group of tools or instruments (Instrumental Capital. The characteristic conditions of this New Economy, the way Knowledge Management deals with these new conditions and the sub-processes that provide support to the management of Instrumental Capital are described.

  16. Experimentation of RT-LOTOS for a critical function of a power plant instrumentation and control system; Experimentation de RT-LOTOS pour une fonction critique d`un systeme de controle-commande en centrale

    Energy Technology Data Exchange (ETDEWEB)

    Andriantsiiferana, L.; Courtiat, J.P.; De Oliveira, R.C.

    1996-01-01

    This document is the final report of the contract between LAAS-CNRS and the EdF Direction of Researches and Studies about the experimentation of RT-LOTOS formal description technique on a critical function of a nuclear power plant instrumentation and control system. This report comprises 4 parts: part 1 describes the RT-LOTOS (Real Time-Language of Temporal Ordering Specifications) tutorial and its RTL tool environment, the different RT-LOTOS operators and semantics, and the RTL tool main functionalities; part 2 deals with the methodology and the global architecture for the specification and validation of the CCT (Central Calculator for Treatment); part 3 gives more details about the different processes identified in the specification architecture and presents the main results obtained for the validation of the nominal functioning; part 4 describes some exceptional situations and shows how some failures and their associated recovery mechanisms can be modelled. (J.S.). 6 refs., 53 figs., 5 tabs., 2 appends.

  17. Performance appraisal and advancement exercise 2006

    CERN Multimedia

    Human Resources Department

    2005-01-01

    The 2006 performance appraisal and advancement exercise will start in the usual way with annual interviews between staff and their supervisors. This year, these interviews should be held in the period from 1 December 2005 to 31 March 2006. In this connection, a number of improvements to the procedures relating to the interviews and performance appraisal are currently under study. Administrative Circular No 26 (Procedures governing the Career Development of Staff Members) and the electronic MAPS form in EDH are being reviewed and will be available from December onwards. In the meantime supervisors can start the interview procedure. HR Department will shortly provide further information on this subject. The 2005 MAPS report can be retrieved for consultation at any time via EDH. Human Resources Department Tel. 73566

  18. Performance appraisal and advancement exercise 2006 (Rev)

    CERN Multimedia

    Human Resources Department

    2005-01-01

    The 2006 performance appraisal and advancement exercise will start in the usual way with annual interviews between staff and their supervisors. This year, these interviews should be held in the period from 1 December 2005 to 15 March 2006*. In this connection, a number of improvements to the procedures relating to the interviews and performance appraisals are currently under study. Administrative Circular No. 26 (Procedures Governing the Career Development of Staff Members) and the electronic MAPS form in EDH are being reviewed and will be available from December onwards. In the meantime supervisors can start the interview procedure. HR Department will shortly provide further information on this subject. The 2005 MAPS report can be retrieved for consultation at any time via EDH. * Instead of 31 March, as indicated in the electronic Bulletin No. 47 of 21 November 2005 Human Resources Department Tel. 73566

  19. Naturalizing language: human appraisal and (quasi) technology

    DEFF Research Database (Denmark)

    Cowley, Stephen

    2013-01-01

    Using contemporary science, the paper builds on Wittgenstein’s views of human language. Rather than ascribing reality to inscription-like entities, it links embodiment with distributed cognition. The verbal or (quasi) technological aspect of language is traced to not action, but human specific...... interactivity. This species-specific form of sense-making sustains, among other things, using texts, making/construing phonetic gestures and thinking. Human action is thus grounded in appraisals or sense-saturated coordination. To illustrate interactivity at work, the paper focuses on a case study. Over 11 s......, a crime scene investigator infers that she is probably dealing with an inside job: she uses not words, but intelligent gaze. This connects professional expertise to circumstances and the feeling of thinking. It is suggested that, as for other species, human appraisal is based in synergies. However, since...

  20. Innovative instrumentation

    International Nuclear Information System (INIS)

    Anon.

    1983-01-01

    At this year's particle physics conference at Brighton, a parallel session was given over to instrumentation and detector development. While this work is vital to the health of research and its continued progress, its share of prime international conference time is limited. Instrumentation can be innovative three times — first when a new idea is outlined, secondly when it is shown to be feasible, and finally when it becomes productive in a real experiment, amassing useful data rather than operational experience. Hyams' examples showed that it can take a long time for a new idea to filter through these successive stages, if it ever makes it at all

  1. Innovative instrumentation

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1983-11-15

    At this year's particle physics conference at Brighton, a parallel session was given over to instrumentation and detector development. While this work is vital to the health of research and its continued progress, its share of prime international conference time is limited. Instrumentation can be innovative three times — first when a new idea is outlined, secondly when it is shown to be feasible, and finally when it becomes productive in a real experiment, amassing useful data rather than operational experience. Hyams' examples showed that it can take a long time for a new idea to filter through these successive stages, if it ever makes it at all.

  2. Instrumental aspects

    Directory of Open Access Journals (Sweden)

    Qureshi Navid

    2017-01-01

    Full Text Available Every neutron scattering experiment requires the choice of a suited neutron diffractometer (or spectrometer in the case of inelastic scattering with its optimal configuration in order to accomplish the experimental tasks in the most successful way. Most generally, the compromise between the incident neutron flux and the instrumental resolution has to be considered, which is depending on a number of optical devices which are positioned in the neutron beam path. In this chapter the basic instrumental principles of neutron diffraction will be explained. Examples of different types of experiments and their respective expectable results will be shown. Furthermore, the production and use of polarized neutrons will be stressed.

  3. Appraisal of emotions in media use

    OpenAIRE

    Bartsch, Anne; Vorderer, Peter; Mangold, Roland; Reinhold, Viehoff

    2008-01-01

    Over the past 20 years, research on meta-emotion and related concepts such as meta-mood and need for affect has become fruitful and prominent across a variety of disciplines, including media psychology. This paper reviews the literature on meta-emotion and considers problems regarding the definition and operationalization of this construct. We propose a process model of meta-emotion and emotion regulation to integrate and extend existing work. Drawing on appraisal theories of emotion, we unde...

  4. The problem of appraising qualitative research

    OpenAIRE

    Dixon-Woods, M; Shaw, R; Agarwal, S; Smith, J

    2004-01-01

    

 Qualitative research can make a valuable contribution to the study of quality and safety in health care. Sound ways of appraising qualitative research are needed, but currently there are many different proposals with few signs of an emerging consensus. One problem has been the tendency to treat qualitative research as a unified field. We distinguish universal features of quality from those specific to methodology and offer a set of minimally prescriptive prompts to assist with the assessme...

  5. Bristol cylinder. Vol. 3A - technical appraisal

    Energy Technology Data Exchange (ETDEWEB)

    1983-06-01

    A consultants' report is presented on a UK funded wave energy device known as the Bristol Cylinder. A detailed engineering appraisal is given for each component and aspects of the device including installation, power generation and maintenance. Finally the discounted cost of energy from the device is assessed. For all topics the views of the consultants are compared with those of the team developing the Bristol Cylinder and where discrepancies occur, these are explained and discussed.

  6. Sustainability appraisal and flood risk management

    International Nuclear Information System (INIS)

    Carter, Jeremy G.; White, Iain; Richards, Juliet

    2009-01-01

    This research establishes that sustainability appraisal (SA) has a role to play in strengthening spatial plans in the context of flooding issues. Indeed, evidence has been gathered to indicate that tentative steps are being taken in this direction during the SA of English regional spatial plans, which are used as an illustrative case study. In England as in many other countries, appraisal procedures including SA and strategic environmental assessment (SEA) are enshrined in planning law. An opportunity therefore exists to utilise existing and familiar planning tools to embed flooding considerations within spatial plans at an early stage in the planning process. SA (and similar appraisal tools such as SEA) can therefore usefully aid in the implementation of decision making principles and government policy relating to flooding. Moreover, with the threats associated with climate change becoming increasingly apparent, of which increased flood risk is a particular concern in many countries, there is a need develop appropriate adaptation responses. This article emphasizes the role that SA can play in managing future flood risk in this context

  7. Surgical Instrument

    NARCIS (Netherlands)

    Dankelman, J.; Horeman, T.

    2009-01-01

    The present invention relates to a surgical instrument for minimall-invasive surgery, comprising a handle, a shaft and an actuating part, characterised by a gastight cover surrounding the shaft, wherein the cover is provided with a coupler that has a feed- through opening with a loskable seal,

  8. Weather Instruments.

    Science.gov (United States)

    Brantley, L. Reed, Sr.; Demanche, Edna L.; Klemm, E. Barbara; Kyselka, Will; Phillips, Edwin A.; Pottenger, Francis M.; Yamamoto, Karen N.; Young, Donald B.

    This booklet presents some activities to measure various weather phenomena. Directions for constructing a weather station are included. Instruments including rain gauges, thermometers, wind vanes, wind speed devices, humidity devices, barometers, atmospheric observations, a dustfall jar, sticky-tape can, detection of gases in the air, and pH of…

  9. Music in Peacebuilding: A Critical Literature Review

    Science.gov (United States)

    Sandoval, Elaine

    2016-01-01

    The critical literature review summarizes and appraises studies that have been pursued by music scholars examining the contributions of music to peacebuilding as well as the role of music in violence. These two bodies of literature are rarely brought into dialogue, but I juxtapose them in order to confront the idea of music's exceptionalism as…

  10. MASS APPRAISAL AND REAL ESTATE TAXATION

    Directory of Open Access Journals (Sweden)

    VORONIN V. О.

    2015-12-01

    Full Text Available Raising of problem. The government at the legislative level fixed the definition of market value for tax purposes as mandatory in the implementation of real estate transactions. In order to meet the requirements of objectivity, uniformity and consistency of the results obtained during the evaluation procedures, as well as minimize the influence of subjective factors, there is a need to develop a methodology for evaluating an automated procedure for determining the estimated value of the property based on its market value. To solve this problem, we use special techniques and methods of mass appraisal that incorporates computer-supported statistical analyses, such as multiple regression analysis and adaptive estimation procedure for use in the field of property valuation and property rights. Purpose. Realization of this goal involves the development of the concept of a computer-assisted mass appraisal. The basis of this concept is an adaptive hybrid models of market pricing in different market segments that incorporates software adaptive algorithms for determining the market value by the three evaluation approaches using the results of a multi-level real estate market analysis. It was proposed the utility automated valuation models which is intended for the implementation of a computerized real estate valuation based on the developed software adaptive algorithms. Con-clusion. To achieve this goal have been developed and used concepts underlying of computerized mass appraisal. The basis of this concept is adaptive hybrid pricing models in various segments of the real estate market of Ukraine. The problem is solved by the application of the developed software-based adaptive algorithms for determining the market value of three evaluation approaches using the results of a multi-level analysis of the real estate market. It was pro-posed the model of automated appraisal, according to it was implemented computerization of appraisal procedures on the

  11. How to locate and appraise qualitative research in complementary and alternative medicine

    Science.gov (United States)

    2013-01-01

    Background The aim of this publication is to present a case study of how to locate and appraise qualitative studies for the conduct of a meta-ethnography in the field of complementary and alternative medicine (CAM). CAM is commonly associated with individualized medicine. However, one established scientific approach to the individual, qualitative research, thus far has been explicitly used very rarely. This article demonstrates a case example of how qualitative research in the field of CAM studies was identified and critically appraised. Methods Several search terms and techniques were tested for the identification and appraisal of qualitative CAM research in the conduct of a meta-ethnography. Sixty-seven electronic databases were searched for the identification of qualitative CAM trials, including CAM databases, nursing, nutrition, psychological, social, medical databases, the Cochrane Library and DIMDI. Results 9578 citations were screened, 223 articles met the pre-specified inclusion criteria, 63 full text publications were reviewed, 38 articles were appraised qualitatively and 30 articles were included. The search began with PubMed, yielding 87% of the included publications of all databases with few additional relevant findings in the specific databases. CINHAL and DIMDI also revealed a high number of precise hits. Although CAMbase and CAM-QUEST® focus on CAM research only, almost no hits of qualitative trials were found there. Searching with broad text terms was the most effective search strategy in all databases. Conclusions This publication presents a case study on how to locate and appraise qualitative studies in the field of CAM. The example shows that the literature search for qualitative studies in the field of CAM is most effective when the search is begun in PubMed followed by CINHAL or DIMDI using broad text terms. Exclusive CAM databases delivered no additional findings to locate qualitative CAM studies. PMID:23731997

  12. How to locate and appraise qualitative research in complementary and alternative medicine.

    Science.gov (United States)

    Franzel, Brigitte; Schwiegershausen, Martina; Heusser, Peter; Berger, Bettina

    2013-06-03

    The aim of this publication is to present a case study of how to locate and appraise qualitative studies for the conduct of a meta-ethnography in the field of complementary and alternative medicine (CAM). CAM is commonly associated with individualized medicine. However, one established scientific approach to the individual, qualitative research, thus far has been explicitly used very rarely. This article demonstrates a case example of how qualitative research in the field of CAM studies was identified and critically appraised. Several search terms and techniques were tested for the identification and appraisal of qualitative CAM research in the conduct of a meta-ethnography. Sixty-seven electronic databases were searched for the identification of qualitative CAM trials, including CAM databases, nursing, nutrition, psychological, social, medical databases, the Cochrane Library and DIMDI. 9578 citations were screened, 223 articles met the pre-specified inclusion criteria, 63 full text publications were reviewed, 38 articles were appraised qualitatively and 30 articles were included. The search began with PubMed, yielding 87% of the included publications of all databases with few additional relevant findings in the specific databases. CINHAL and DIMDI also revealed a high number of precise hits. Although CAMbase and CAM-QUEST® focus on CAM research only, almost no hits of qualitative trials were found there. Searching with broad text terms was the most effective search strategy in all databases. This publication presents a case study on how to locate and appraise qualitative studies in the field of CAM. The example shows that the literature search for qualitative studies in the field of CAM is most effective when the search is begun in PubMed followed by CINHAL or DIMDI using broad text terms. Exclusive CAM databases delivered no additional findings to locate qualitative CAM studies.

  13. Health Literacy Screening Instruments for eHealth Applications: A Systematic Review

    Science.gov (United States)

    Collins, Sarah A.; Currie, Leanne M.; Bakken, Suzanne; Vawdrey, David K.; Stone, Patricia W.

    2012-01-01

    Objective To systematically review current health literacy (HL) instruments for use in consumer-facing and mobile health information technology screening and evaluation tools. Design The databases, PubMed, OVID, Google Scholar, Cochrane Library and Science Citation Index, were searched for health literacy assessment instruments using the terms “health”, “literacy”, “computer-based,” and “psychometrics”. All instruments identified by this method were critically appraised according to their reported psychometric properties and clinical feasibility. Results Eleven different health literacy instruments were found. Screening questions, such as asking a patient about his/her need for assistance in navigating health information, were evaluated in 7 different studies and are promising for use as a valid, reliable, and feasible computer-based approach to identify patients that struggle with low health literacy. However, there was a lack of consistency in the types of screening questions proposed. There is also a lack of information regarding the psychometric properties of computer-based health literacy instruments. Limitations Only English language health literacy assessment instruments were reviewed and analyzed. Conclusions Current health literacy screening tools demonstrate varying benefits depending on the context of their use. In many cases, it seems that a single screening question may be a reliable, valid, and feasible means for establishing health literacy. A combination of screening questions that assess health literacy and technological literacy may enable tailoring eHealth applications to user needs. Further research should determine the best screening question(s) and the best synthesis of various instruments’ content and methodologies for computer-based health literacy screening and assessment. PMID:22521719

  14. Research report appraisal: how much understanding is enough?

    Science.gov (United States)

    Lipscomb, Martin

    2014-07-01

    When appraising research papers, how much understanding is enough? More specifically, in deciding whether research results can inform practice, do appraisers need to substantively understand how findings are derived or is it sufficient simply to grasp that suitable analytic techniques were chosen and used by researchers? The degree or depth of understanding that research appraisers need to attain before findings can legitimately/sensibly inform practice is underexplored. In this paper it is argued that, where knowledge/justified beliefs derived from research evidence prompt actions that materially affect patient care, appraisers have an epistemic duty to demand high (maximal) rather than low (minimal) levels of understanding regards finding derivation (i.e. appraisers have a duty to seek a superior epistemic situation). If this argument holds assumptions about appraiser competence/ability and the feasibility of current UK conceptions of evidence based practice are destabilized. © 2014 John Wiley & Sons Ltd.

  15. A comparison of modified versions of the Static-99 and the Sex Offender Risk Appraisal Guide.

    Science.gov (United States)

    Nunes, Kevin L; Firestone, Philip; Bradford, John M; Greenberg, David M; Broom, Ian

    2002-07-01

    The predictive validity of 2 risk assessment instruments for sex offenders, modified versions of the Static-99 and the Sex Offender Risk Appraisal Guide, was examined and compared in a sample of 258 adult male sex offenders. In addition, the independent contributions to the prediction of recidivism made by each instrument and by various phallometric indices were explored. Both instruments demonstrated moderate levels of predictive accuracy for sexual and violent (including sexual) recidivism. They were not significantly different in terms of their predictive accuracy for sexual or violent recidivism, nor did they contribute independently to the prediction of sexual or violent recidivism. Of the phallometric indices examined, only the pedophile index added significantly to the prediction of sexual recidivism, but not violent recidivism, above the Static-99 alone.

  16. Nuclear instrumentation

    International Nuclear Information System (INIS)

    Weill, Jacky; Fabre, Rene.

    1981-01-01

    This article sums up the Research and Development effort at present being carried out in the five following fields of applications: Health physics and Radioprospection, Control of nuclear reactors, Plant control (preparation and reprocessing of the fuel, testing of nuclear substances, etc.), Research laboratory instrumentation, Detectors. It also sets the place of French industrial activities by means of an estimate of the French market, production and flow of trading with other countries [fr

  17. Divided Instruments

    Science.gov (United States)

    Chapman, A.; Murdin, P.

    2000-11-01

    Although the division of the zodiac into 360° probably derives from Egypt or Assyria around 2000 BC, there is no surviving evidence of Mesopotamian cultures embodying this division into a mathematical instrument. Almost certainly, however, it was from Babylonia that the Greek geometers learned of the 360° circle, and by c. 80 BC they had incorporated it into that remarkably elaborate device gener...

  18. Instrumentation development

    International Nuclear Information System (INIS)

    Anon.

    1976-01-01

    Areas being investigated for instrumentation improvement during low-level pollution monitoring include laser opto-acoustic spectroscopy, x-ray fluorescence spectroscopy, optical fluorescence spectroscopy, liquid crystal gas detectors, advanced forms of atomic absorption spectroscopy, electro-analytical chemistry, and mass spectroscopy. Emphasis is also directed toward development of physical methods, as opposed to conventional chemical analysis techniques for monitoring these trace amounts of pollution related to energy development and utilization

  19. Instrumentation maintenance

    International Nuclear Information System (INIS)

    Mack, D.A.

    1976-09-01

    It is essential to any research activity that accurate and efficient measurements be made for the experimental parameters under consideration for each individual experiment or test. Satisfactory measurements in turn depend upon having the necessary instruments and the capability of ensuring that they are performing within their intended specifications. This latter requirement can only be achieved by providing an adequate maintenance facility, staffed with personnel competent to understand the problems associated with instrument adjustment and repair. The Instrument Repair Shop at the Lawrence Berkeley Laboratory is designed to achieve this end. The organization, staffing and operation of this system is discussed. Maintenance policy should be based on studies of (1) preventive vs. catastrophic maintenance, (2) records indicating when equipment should be replaced rather than repaired and (3) priorities established to indicate the order in which equipment should be repaired. Upon establishing a workable maintenance policy, the staff should be instructed so that they may provide appropriate scheduled preventive maintenance, calibration and corrective procedures, and emergency repairs. The education, training and experience of the maintenance staff is discussed along with the organization for an efficient operation. The layout of the various repair shops is described in the light of laboratory space and financial constraints

  20. Applying critical analysis - main methods

    Directory of Open Access Journals (Sweden)

    Miguel Araujo Alonso

    2012-02-01

    Full Text Available What is the usefulness of critical appraisal of literature? Critical analysis is a fundamental condition for the correct interpretation of any study that is subject to review. In epidemiology, in order to learn how to read a publication, we must be able to analyze it critically. Critical analysis allows us to check whether a study fulfills certain previously established methodological inclusion and exclusion criteria. This is frequently used in conducting systematic reviews although eligibility criteria are generally limited to the study design. Critical analysis of literature and be done implicitly while reading an article, as in reading for personal interest, or can be conducted in a structured manner, using explicit and previously established criteria. The latter is done when formally reviewing a topic.

  1. 76 FR 41441 - Federal Housing Administration (FHA) Appraiser Roster: Appraiser Qualifications for Placement on...

    Science.gov (United States)

    2011-07-14

    ... verifiable education in the appraisal requirements established by FHA. Under amended section 202(g) of the... areas and hinder use of FHA single-family programs at a time when use of those programs has increased... higher education and experience standards that HERA sought to be used for FHA-insured transactions (all...

  2. The 2008 Circum-Arctic Resource Appraisal

    Science.gov (United States)

    Moore, Thomas E.; Gautier, Donald L.

    2017-11-15

    Professional Paper 1824 comprises 30 chapters by various U.S. Geological Survey authors, including introduction and methodology chapters, which together provide documentation of the geological basis and methodology of the 2008 Circum-Arctic Resource Appraisal, results of which were first released in August 2008.  Twenty-eight chapters summarize the petroleum geology and resource potential of individual, geologically defined provinces north of the Arctic Circle, including those of northern Alaska, northern Canada, east and west Greenland, and most of Arctic Russia, as well as certain offshore areas of the north Atlantic Basin and the Polar Sea. Appendixes tabulate the input and output information used during the assessment.

  3. Performance appraisal and advancement exercise 2005

    CERN Multimedia

    Human Resources Department

    2004-01-01

    The 2005 performance appraisal and advancement exercise will start in the usual way with annual interviews between staff and their supervisors. These interviews should be held in the period from 15 November 2004 to 15 February 2005 [see Administrative Circular No 26 (Rev. 5) Annex II, § 3. For this exercise, the paper MAPS form has been replaced by an electronic form in the EDH system, which is available via EDH (on the EDH desktop under Other Tasks / HR & Training) No changes have been made to the contents of the form. HR Department will shortly provide further information on this subject. Human Resources Department Tel. 73566

  4. Virtual Sensor Test Instrumentation

    Science.gov (United States)

    Wang, Roy

    2011-01-01

    Virtual Sensor Test Instrumentation is based on the concept of smart sensor technology for testing with intelligence needed to perform sell-diagnosis of health, and to participate in a hierarchy of health determination at sensor, process, and system levels. A virtual sensor test instrumentation consists of five elements: (1) a common sensor interface, (2) microprocessor, (3) wireless interface, (4) signal conditioning and ADC/DAC (analog-to-digital conversion/ digital-to-analog conversion), and (5) onboard EEPROM (electrically erasable programmable read-only memory) for metadata storage and executable software to create powerful, scalable, reconfigurable, and reliable embedded and distributed test instruments. In order to maximize the efficient data conversion through the smart sensor node, plug-and-play functionality is required to interface with traditional sensors to enhance their identity and capabilities for data processing and communications. Virtual sensor test instrumentation can be accessible wirelessly via a Network Capable Application Processor (NCAP) or a Smart Transducer Interlace Module (STIM) that may be managed under real-time rule engines for mission-critical applications. The transducer senses the physical quantity being measured and converts it into an electrical signal. The signal is fed to an A/D converter, and is ready for use by the processor to execute functional transformation based on the sensor characteristics stored in a Transducer Electronic Data Sheet (TEDS). Virtual sensor test instrumentation is built upon an open-system architecture with standardized protocol modules/stacks to interface with industry standards and commonly used software. One major benefit for deploying the virtual sensor test instrumentation is the ability, through a plug-and-play common interface, to convert raw sensor data in either analog or digital form, to an IEEE 1451 standard-based smart sensor, which has instructions to program sensors for a wide variety of

  5. CriticalEd

    DEFF Research Database (Denmark)

    Kjellberg, Caspar Mølholt; Meredith, David

    2014-01-01

    . Since the comments are not input sequentially, with regard to position, but in arbitrary order, this list must be sorted by copy/pasting the rows into place—an error-prone and time-consuming process. Scholars who produce critical editions typically use off-the-shelf music notation software......The best text method is commonly applied among music scholars engaged in producing critical editions. In this method, a comment list is compiled, consisting of variant readings and editorial emendations. This list is maintained by inserting the comments into a document as the changes are made......, consisting of a Sibelius plug-in, a cross-platform application, called CriticalEd, and a REST-based solution, which handles data storage/retrieval. A prototype has been tested at the Danish Centre for Music Publication, and the results suggest that the system could greatly improve the efficiency...

  6. 76 FR 49787 - Rural Water Supply Program Approved Appraisal Reports; Availability

    Science.gov (United States)

    2011-08-11

    ... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Rural Water Supply Program Approved Appraisal...: Reclamation provides assistance for appraisal investigations and feasibility studies for rural water supply... the findings and conclusions of the appraisal investigations that identified the water supply problems...

  7. Critical-thinking ability in respiratory care students and its correlation with age, educational background, and performance on national board examinations.

    Science.gov (United States)

    Wettstein, Richard B; Wilkins, Robert L; Gardner, Donna D; Restrepo, Ruben D

    2011-03-01

    Critical thinking is an important characteristic to develop in respiratory care students. We used the short-form Watson-Glaser Critical Thinking Appraisal instrument to measure critical-thinking ability in 55 senior respiratory care students in a baccalaureate respiratory care program. We calculated the Pearson correlation coefficient to assess the relationships between critical-thinking score, age, and student performance on the clinical-simulation component of the national respiratory care boards examination. We used chi-square analysis to assess the association between critical-thinking score and educational background. There was no significant relationship between critical-thinking score and age, or between critical-thinking score and student performance on the clinical-simulation component. There was a significant (P = .04) positive association between a strong science-course background and critical-thinking score, which might be useful in predicting a student's ability to perform in areas where critical thinking is of paramount importance, such as clinical competencies, and to guide candidate-selection for respiratory care programs.

  8. 25 CFR 11.706 - Appointment and duties of appraiser.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Appointment and duties of appraiser. 11.706 Section 11... OFFENSES AND LAW AND ORDER CODE Probate Proceedings § 11.706 Appointment and duties of appraiser. (a) Upon ordering an estate to be probated, the court shall appoint a disinterested and competent person as an...

  9. 107 an appraisal of the scope of provisions under

    African Journals Online (AJOL)

    Fr. Ikenga

    EZE & EZE: An Appraisal of the Scope of Provisions Under The 1999 Nigerian Constitution for the Control of Pollution. Arising from the Oil and Gas Industry. AN APPRAISAL OF THE .... However, in a historic judgment, a Federal High Court sitting in Benin-City and presided over by Nwokorie J, held that continued gas flaring ...

  10. Employee performance appraisal and productivity levels in selected ...

    African Journals Online (AJOL)

    The focus of this study was on performance appraisal of academic staff of Universities in Nigeria and their productivity levels. The prime problem that necessitated this study was to examine the effectiveness of the subjective methods used in appraising qualitative work attributes of the employees and to assess the extent to ...

  11. Appraisal patterns of emotions in human-product interaction

    NARCIS (Netherlands)

    Demir, E.; Desmet, P.M.A.; Hekkert, P.

    2009-01-01

    Emotional design, i.e., designing with an intention to evoke or to prevent a particular emotion, can be facilitated by understanding the processes underlying emotions. A promising approach to understanding these processes in the current psychological literature is appraisal theory. Appraisal theory

  12. 12 CFR 950.10 - Collateral valuation; appraisals.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Collateral valuation; appraisals. 950.10...-BALANCE SHEET ITEMS ADVANCES Advances to Members § 950.10 Collateral valuation; appraisals. (a) Collateral valuation. Each Bank shall determine the value of collateral securing the Bank's advances in accordance with...

  13. Linking the Teacher Appraisal Process to the School Improvement Plan

    Science.gov (United States)

    Reddekopp, Therese

    2007-01-01

    If a school improvement plan includes input from all stakeholders and focuses on data-driven processes that are linked to teacher appraisal, it can be powerful in leading the school toward the common mission of achieving student success. Linking the school improvement plan to the teacher appraisal process creates a system whereby all individuals…

  14. Evaluating School Health Appraisal scheme in Primary Schools ...

    African Journals Online (AJOL)

    Objectives: This study assessed school health appraisal implementation in primary schools within Abakaliki Metropolis. Materials and Methods: This was a cross sectional descriptive study of the forms of health appraisal in all 31 primary schools in Abakaliki metropolis. Relevant information was obtained from the head ...

  15. A Composite Model for Employees' Performance Appraisal and Improvement

    Science.gov (United States)

    Manoharan, T. R.; Muralidharan, C.; Deshmukh, S. G.

    2012-01-01

    Purpose: The purpose of this paper is to develop an innovative method of performance appraisal that will be useful for designing a structured training programme. Design/methodology/approach: Employees' performance appraisals are conducted using new approaches, namely data envelopment analysis and an integrated fuzzy model. Interpretive structural…

  16. The merits of measuring challenge and hindrance appraisals.

    Science.gov (United States)

    Searle, Ben J; Auton, Jaime C

    2015-01-01

    The challenge-hindrance framework has shown that challenge stressors (work characteristics associated with potential personal gain) tend to have positive outcomes, whereas hindrance stressors (those which obstruct goals) have negative outcomes. However, typical research methods assume that stressors allocated to these categories are appraised consistently by different people and across different situations. We validate new measures of challenge and hindrance appraisals and demonstrate their utility in stress research. We used a cross-sectional survey of American employees (Study 1, n = 333), a diary survey of Australian employees (Study 2, n = 241), and a survey of Australian college students whose performance was evaluated independently (Study 3, n = 350). Even after accounting for the effects of stressors, challenge and hindrance appraisals consistently explained unique variance in affective states, with indications that stressors have indirect effects via appraisals. Such effects were seen within- as well as between-participants (Study 2). Appraisals also had expected associations with specific coping behaviors (Study 1), while challenge appraisal was associated with task performance (Study 3). The scales of challenge and hindrance appraisals were psychometrically sound across multiple contexts. RESULTS highlight the merit of considering appraisal in stress research.

  17. Student feedback on an adapted appraisal model in resource ...

    African Journals Online (AJOL)

    Background. An appraisal model, a type of formal mentorship programme for a cohort of student doctors, is used at the University of Leeds, UK. The University of the Witwatersrand, Johannesburg, South Africa implemented an adapted version of the appraisal process that uses fewer resources. Objective. To explore ...

  18. 50 CFR 34.6 - Schedule of appraisals.

    Science.gov (United States)

    2010-10-01

    ... Secretary shall make fair market value appraisals of areas administered by the Service within five years... reappraised on a schedule of at least once every five years. Until areas are appraised, the fair market value... fee lands added to such areas after that date shall be on the basis of fair market value. ...

  19. Precompetitive achievement goals, stress appraisals, emotions, and coping among athletes.

    Science.gov (United States)

    Nicholls, Adam R; Perry, John L; Calmeiro, Luis

    2014-10-01

    Grounded in Lazarus's (1991, 1999, 2000) cognitive-motivational-relational theory of emotions, we tested a model of achievement goals, stress appraisals, emotions, and coping. We predicted that precompetitive achievement goals would be associated with appraisals, appraisals with emotions, and emotions with coping in our model. The mediating effects of emotions among the overall sample of 827 athletes and two stratified random subsamples were also explored. The results of this study support our proposed model in the overall sample and the stratified subsamples. Further, emotion mediated the relationship between appraisal and coping. Mediation analyses revealed that there were indirect effects of pleasant and unpleasant emotions, which indicates the importance of examining multiple emotions to reveal a more accurate representation of the overall stress process. Our findings indicate that both appraisals and emotions are just as important in shaping coping.

  20. Evaluation of a performance appraisal framework for radiation therapists in planning and simulation

    Energy Technology Data Exchange (ETDEWEB)

    Becker, Jillian, E-mail: jillian.becker@health.qld.gov.au [Radiation Oncology Mater Centre, South Brisbane, Queensland (Australia); Bridge, Pete [School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland (Australia); Brown, Elizabeth; Lusk, Ryan; Ferrari-Anderson, Janet [Radiation Oncology, Princess Alexandra Hospital, Brisbane, Queensland (Australia); Radiation Oncology Mater Centre, South Brisbane, Queensland (Australia)

    2015-06-15

    Constantly evolving technology and techniques within radiation therapy require practitioners to maintain a continuous approach to professional development and training. Systems of performance appraisal and adoption of regular feedback mechanisms are vital to support this development yet frequently lack structure and rely on informal peer support. A Radiation Therapy Performance Appraisal Framework (RT-PAF) for radiation therapists in planning and simulation was developed to define expectations of practice and promote a supportive and objective culture of performance and skills appraisal. Evaluation of the framework was conducted via an anonymous online survey tool. Nine peer reviewers and fourteen recipients provided feedback on its effectiveness and the challenges and limitations of the approach. Findings from the evaluation were positive and suggested that both groups gained benefit from and expressed a strong interest in embedding the approach more routinely. Respondents identified common challenges related to the limited ability to implement suggested development strategies; this was strongly associated with time and rostering issues. This framework successfully defined expectations for practice and provided a fair and objective feedback process that focussed on skills development. It empowered staff to maintain their skills and reach their professional potential. Management support, particularly in regard to provision of protected time was highlighted as critical to the framework's ongoing success. The demonstrated benefits arising in terms of staff satisfaction and development highlight the importance of this commitment to the modern radiation therapy workforce.

  1. Evaluation of a performance appraisal framework for radiation therapists in planning and simulation

    International Nuclear Information System (INIS)

    Becker, Jillian; Bridge, Pete; Brown, Elizabeth; Lusk, Ryan; Ferrari-Anderson, Janet

    2015-01-01

    Constantly evolving technology and techniques within radiation therapy require practitioners to maintain a continuous approach to professional development and training. Systems of performance appraisal and adoption of regular feedback mechanisms are vital to support this development yet frequently lack structure and rely on informal peer support. A Radiation Therapy Performance Appraisal Framework (RT-PAF) for radiation therapists in planning and simulation was developed to define expectations of practice and promote a supportive and objective culture of performance and skills appraisal. Evaluation of the framework was conducted via an anonymous online survey tool. Nine peer reviewers and fourteen recipients provided feedback on its effectiveness and the challenges and limitations of the approach. Findings from the evaluation were positive and suggested that both groups gained benefit from and expressed a strong interest in embedding the approach more routinely. Respondents identified common challenges related to the limited ability to implement suggested development strategies; this was strongly associated with time and rostering issues. This framework successfully defined expectations for practice and provided a fair and objective feedback process that focussed on skills development. It empowered staff to maintain their skills and reach their professional potential. Management support, particularly in regard to provision of protected time was highlighted as critical to the framework's ongoing success. The demonstrated benefits arising in terms of staff satisfaction and development highlight the importance of this commitment to the modern radiation therapy workforce

  2. The effectiveness of health appraisal processes currently in addressing health and wellbeing during spatial plan appraisal: a systematic review.

    Science.gov (United States)

    Gray, Selena; Carmichael, Laurence; Barton, Hugh; Mytton, Julie; Lease, Helen; Joynt, Jennifer

    2011-11-24

    Spatial planning affects the built environment, which in turn has the potential to have a significant impact on health, for good or ill. One way of ensuring that spatial plans take due account of health is through the inclusion of health considerations in the statutory and non statutory appraisal processes linked to plan-making processes. A systematic review to identify evaluation studies of appraisals or assessments of plans where health issues were considered from 1987 to 2010. A total of 6161 citations were identified: 6069 from electronic databases, 57 fromwebsite searches, with a further 35 citations from grey literature, of which 20 met the inclusion criteria. These 20 citations reported on a total of 135 different case studies: 11 UK HIA; 11 non UK high income countries HIA, 5 UK SEA or other integrated appraisal; 108 non UK high income SEA or other integrated appraisal. All studies were in English. No relevant studies were identified reporting on low or middle income countries.The studies were limited by potential bias (no independent evaluation, with those undertaking the appraisal also responsible for reporting outcomes), lack of detail and a lack of triangulation of results. Health impact assessments generally covered the four specified health domains (physical activity, mental health and wellbeing, environmental health issues such as pollution and noise, injury) more comprehensively than SEA or other integrated appraisals, although mental health and wellbeing was an underdeveloped area. There was no evidence available on the incorporation of health in Sustainability Appraisal, limited evidence that the recommendations from any type of appraisal were implemented, and almost no evidence that the recommendations had led to the anticipated outcomes or improvements in health postulated. Research is needed to assess (i) the degree to which statutory plan appraisal processes (SA in the UK) incorporate health; (ii) whether recommendations arising from health

  3. The effectiveness of health appraisal processes currently in addressing health and wellbeing during spatial plan appraisal: a systematic review

    Directory of Open Access Journals (Sweden)

    Gray Selena

    2011-11-01

    Full Text Available Abstract Background Spatial planning affects the built environment, which in turn has the potential to have a significant impact on health, for good or ill. One way of ensuring that spatial plans take due account of health is through the inclusion of health considerations in the statutory and non statutory appraisal processes linked to plan-making processes. Methods A systematic review to identify evaluation studies of appraisals or assessments of plans where health issues were considered from 1987 to 2010. Results A total of 6161 citations were identified: 6069 from electronic databases, 57 fromwebsite searches, with a further 35 citations from grey literature, of which 20 met the inclusion criteria. These 20 citations reported on a total of 135 different case studies: 11 UK HIA; 11 non UK high income countries HIA, 5 UK SEA or other integrated appraisal; 108 non UK high income SEA or other integrated appraisal. All studies were in English. No relevant studies were identified reporting on low or middle income countries. The studies were limited by potential bias (no independent evaluation, with those undertaking the appraisal also responsible for reporting outcomes, lack of detail and a lack of triangulation of results. Health impact assessments generally covered the four specified health domains (physical activity, mental health and wellbeing, environmental health issues such as pollution and noise, injury more comprehensively than SEA or other integrated appraisals, although mental health and wellbeing was an underdeveloped area. There was no evidence available on the incorporation of health in Sustainability Appraisal, limited evidence that the recommendations from any type of appraisal were implemented, and almost no evidence that the recommendations had led to the anticipated outcomes or improvements in health postulated. Conclusion Research is needed to assess (i the degree to which statutory plan appraisal processes (SA in the UK

  4. Effects of appraisal purpose and rating format on performance appraisal accuracy

    OpenAIRE

    Carter, Marta L.

    1989-01-01

    The principle of encoding specificity states that effective information retrieval relies upon consistency of encoding and retrieval cues. The present study generalized this principle to a complex social interaction in order to investigate the relation between certain combinations of pre- and post-observational cues and their effects on information categorization, recognition accuracy, and judgment accuracy. It was hypothesized that two experimental factors, appraisal pur...

  5. Employees' perceptions of justice in performance appraisals.

    Science.gov (United States)

    Vasset, Frøydis; Marnburg, Einar; Furunes, Trude

    2010-05-01

    Of all the tasks undertaken by human resource managers, performance appraisals (PAs) are one of the most unpopular among employees (Meyer 1991, Murphy and Cleveland 1995, Holbrook 2002, Jackman and Strober 2003). As PA guides and plans show (Fletcher 2004, CatalystOne 2010), PAs can be implemented in similar ways in organisations throughout Europe and developed countries elsewhere. But, if employees perceive PA processes as unfair, they may reject the usefulness and validity of the information they receive and so may not be motivated to change behaviour. This article concerns perceptions of organisational justice and explains the results of a study of perceived fairness in PAs among nurses and auxiliary nurses in Norway's municipal health service.

  6. Photographic appraisal of crystal lattice growth technique

    Directory of Open Access Journals (Sweden)

    Kapoor D

    2005-01-01

    Full Text Available Concept of creating mechanical retention for bonding through crystal growth has been successfully achieved in the present study. By using polyacrylic acid, sulphated with sulphuric acid as etchant, abundant crystal growth was demonstrated. Keeping in view the obvious benefits of crystal growth technique, the present SEM study was aimed to observe and compare the changes brought about by different etching agents (phosphoric acid, polyacrylic acid and polyacrylic acid sulphated and to evaluate their advantages and disadvantages in an attempt to reduce iatrogenic trauma caused due to surface enamel alteration. Control and experimental groups were made of 24 and 30 premolars, respectively, for scanning electron microscopic appraisal of normal unetched and etched enamel surface and fracture site and finished surface evaluation. When compared with conventional phosphoric acid and weaker polyacrylic acid, investigations indicated that crystal growth treatment on enamel surface caused minimal iatrogenic trauma and surface alteration were restored to the original untreated condition to a large extent.

  7. Investment appraisal using quantitative risk analysis.

    Science.gov (United States)

    Johansson, Henrik

    2002-07-01

    Investment appraisal concerned with investments in fire safety systems is discussed. Particular attention is directed at evaluating, in terms of the Bayesian decision theory, the risk reduction that investment in a fire safety system involves. It is shown how the monetary value of the change from a building design without any specific fire protection system to one including such a system can be estimated by use of quantitative risk analysis, the results of which are expressed in terms of a Risk-adjusted net present value. This represents the intrinsic monetary value of investing in the fire safety system. The method suggested is exemplified by a case study performed in an Avesta Sheffield factory.

  8. Seismic instrumentation

    International Nuclear Information System (INIS)

    1984-06-01

    RFS or Regles Fondamentales de Surete (Basic Safety Rules) applicable to certain types of nuclear facilities lay down requirements with which compliance, for the type of facilities and within the scope of application covered by the RFS, is considered to be equivalent to compliance with technical French regulatory practice. The object of the RFS is to take advantage of standardization in the field of safety, while allowing for technical progress in that field. They are designed to enable the operating utility and contractors to know the rules pertaining to various subjects which are considered to be acceptable by the Service Central de Surete des Installations Nucleaires, or the SCSIN (Central Department for the Safety of Nuclear Facilities). These RFS should make safety analysis easier and lead to better understanding between experts and individuals concerned with the problems of nuclear safety. The SCSIN reserves the right to modify, when considered necessary, any RFS and specify, if need be, the terms under which a modification is deemed retroactive. The aim of this RFS is to define the type, location and operating conditions for seismic instrumentation needed to determine promptly the seismic response of nuclear power plants features important to safety to permit comparison of such response with that used as the design basis

  9. Meteorological instrumentation

    International Nuclear Information System (INIS)

    1982-06-01

    RFS or ''Regles Fondamentales de Surete'' (Basic Safety Rules) applicable to certain types of nuclear facilities lay down requirements with which compliance, for the type of facilities and within the scope of application covered by the RFS, is considered to be equivalent to compliance with technical French regulatory practice. The object of the RFS is to take advantage of standardization in the field of safety , while allowing for technical progress in that field. They are designed to enable the operating utility and contractors to know the rules pertaining to various subjects which are considered to be acceptable by the ''Service Central de Surete des Installations Nucleaires'' or the SCSIN (Central Department for the Safety of Nuclear Facilities). These RFS should make safety analysis easier and lead to better understanding between experts and individuals concerned with the problems of nuclear safety. The SCSIN reserves the right to modify, when considered necessary any RFS and specify, if need be, the terms under which a modification is deemed retroactive. The purpose of this RFS is to specify the meteorological instrumentation required at the site of each nuclear power plant equipped with at least one pressurized water reactor

  10. Evidence from epidemic appraisals in Nigeria

    Directory of Open Access Journals (Sweden)

    Idoteyin O. Ezirim

    2015-10-01

    Full Text Available Although HIV prevalence has increased in most-at-risk populations (MARPs across Nigeria, effective programming was difficult because Nigeria lacked information for prevention programmes to target interventions that maximise coverage and cost effectiveness. Epidemic appraisals (EA were conducted in eight states to provide evidence for the planning, implementation and co-ordination of prevention interventions. Component 1: Mapping determined the size, typology and locations of MARPs. Component 2: Venue profiling identified and profiled venues where general populations engaged in high-risk behaviours. Component 3: Rural appraisals provided insights into risk behaviours and sexual networking in villages. States used mapping results to prioritise areas with a MARP coverage of 70% – 80% and then scale up interventions for non-brothel-based female sex workers (FSWs instead of focusing on brothel-based FSWs. The eight states prioritisedf unding for the high-coverage areas to ensure a minimum coverage level of 70% – 80% of MARPs was reached. The refocused resources led to cost efficiencies. Applying venue profiling results, six states implemented interventions at bars and night clubs – previously not covered. States also maximised intervention coverage for high-risk general populations; this led to the use of resources for general population interventions in a focused way rather than across an entire state. States focused on condom programmes in rural areas. EA results provided the evidence for focusing interventions for high MARP coverage as well as forhigh-risk general populations. The states applied the results and rapidly refocused their interventions, increasing the likelihood of having an impact on HIV transmission in those states. Nigeria is now implementing EAs in the remaining 29 states to effect national-level impact.

  11. Do scores on three commonly used measures of critical thinking correlate with academic success of health professions trainees? A systematic review and meta-analysis.

    Science.gov (United States)

    Ross, David; Loeffler, Kim; Schipper, Shirley; Vandermeer, Ben; Allan, G Michael

    2013-05-01

    To determine whether the three commonly used measures of critical thinking correlate with academic success of medical professionals in training. The search for English-language articles (from 1980 to 2011) used Medline, Embase, Scopus, Cochrane Library on Ovid, Proquest Dissertations, Health and Psychosocial Instruments, PsychINFO, and references of included articles. Studies comparing critical thinking with academic success among medical professionals were included. Two authors performed study selection independently, with disagreement resolved by consensus. Two authors independently abstracted data on study characteristics, quality, and outcomes, with disagreement resolved by a third author. Critical thinking tests studied were the California Critical Thinking Skills Test (CCTST), California Critical Thinking Disposition Inventory (CCTDI), and Watson-Glaser Critical Thinking Appraisal. Correlation coefficients were pooled in meta-analysis. The search identified 557 studies: 52 met inclusion for systematic review, 41 of which were meta-analyzed. Critical thinking was positively correlated with academic success, r=0.31 (95% confidence intervals [CI] 0.26, 0.35), with a moderate statistical heterogeneity (I=67%). In subgroup analysis, only student type had statistical significance for correlation, although bias was likely due to low numbers for some student types. In direct comparison, using studies that employed two critical thinking tests, the CCTDI (r=0.23, 95% CI 0.15, 0.30) was significantly inferior (PCritical thinking was moderately correlated with academic success of medical professionals in training. The CCTDI was inferior to the CCTST in correlating with academic success.

  12. Negative Trauma Appraisals and PTSD Symptoms in Sri Lankan Adolescents.

    Science.gov (United States)

    Ponnamperuma, Thyagi; Nicolson, Nancy A

    2016-02-01

    The cognitive model posits that negative appraisals play an important role in posttraumatic stress disorder, in children as well as in adults. This study examined correlates of negative appraisals in relation to trauma exposure and their relationship to posttraumatic stress symptoms (PTSS) in 414 Sri Lankan adolescents, aged 12 to 16, living in areas impacted in varying degrees by the 2004 tsunami. In 2008, participants completed measures of negative appraisals, lifetime traumatic events, posttraumatic stress symptoms, internalizing symptoms, ongoing adversity, and social support. The majority (70 %) of the participants reported multiple traumatic events; 25 % met DSM-IV criteria for full or partial PTSD. Adolescents who had experienced more severe events, abusive events, greater cumulative trauma, or greater current adversity reported more negative appraisals. In regression analyses controlling for known risk factors such as female gender, cumulative trauma, ongoing adversity, and low social support, negative appraisals were the best predictor of PTSS, explaining 22 % of the variance. This relationship appeared specific to PTSS, as negative appraisals did not predict internalizing symptoms. Findings confirm the link between negative cognitions concerning traumatic events and persistent PTSS in adolescents, but longitudinal studies are needed to determine whether appraisals contribute to symptom maintenance over time.

  13. Exams? Why worry? Interpreting anxiety as facilitative and stress appraisals.

    Science.gov (United States)

    Strack, Juliane; Esteves, Francisco

    2015-01-01

    The present study examined why people differ in how they appraise the same stressful situation (an approaching exam). We explored whether interpreting anxiety as a facilitative emotion can affect the type of stress appraisal people make. One hundred and three undergraduate students took part in this study, which lasted for 10 days (leading up to an exam). The students completed a daily self-reported evaluation of anxiety, emotional exhaustion, and stress experienced. The findings suggest a process by which a stressful time can be experienced as motivating rather than threatening or emotionally exhausting. For example, interpreting anxiety as facilitative moderated the relationship between anxiety and stress appraisals. When interpreting their anxiety as facilitative, individuals showed a higher tendency to make challenge stress appraisals and a lower tendency to appraising the stressor as a threat. These differences were especially visible with high levels of anxiety. Furthermore, interpreting anxiety as facilitative was negatively associated with emotional exhaustion, but positively associated with the academic performance. These findings suggest an explanation why people differ in how they appraise the same stressor: how people interpret their anxiety may to a large part affect how they appraise difficult events and situations.

  14. Selection, Appraisal, and Retention of Digital Scientific Data: Highlights of an ERPANET/CODATA Workshop

    Directory of Open Access Journals (Sweden)

    E Esanu

    2006-01-01

    Full Text Available CODATA and ERPANET collaborated to convene an international archiving workshop on the selection, appraisal, and retention of digital scientific data, which was held on 15-17 December 2003 at the Biblioteca Nacional in Lisbon, Portugal. The workshop brought together more than 65 researchers, data and information managers, archivists, and librarians from 13 countries to discuss the issues involved in making critical decisions regarding the long-term preservation of the scientific record. One of the major aims for this workshop was to provide an international forum to exchange information about data archiving policies and practices across different scientific, institutional, and national contexts. Highlights from the workshop discussions are presented.

  15. Radiological instrument

    International Nuclear Information System (INIS)

    Kronenberg, S.; McLaughlin, W.L.; Seibentritt, C.R. Jr.

    1986-01-01

    An instrument is described for measuring radiation, particularly nuclear radiation, comprising: a radiation sensitive structure pivoted toward one end and including a pair of elongated solid members contiguously joined together along their length dimensions and having a common planar interface therebetween. One of the pairs of members is comprised of radiochromic material whose index of refraction changes due to anomolous dispersion as a result of being exposed to nuclear radiation. The pair of members further has mutually different indices of refraction with the member having the larger index of refraction further being transparent for the passage of light and of energy therethrough; means located toward the other end of the structure for varying the angle of longitudinal elevation of the pair of members; means for generating and projecting a beam of light into one end of the member having the larger index of refraction. The beam of light is projected toward the planar interface where it is reflected out of the other end of the same member as a first output beam; means projecting a portion of the beam of light into one end of the member having the larger index of refraction where it traverses therethrough without reflection and out of the other end of the same member as a second output beam; and means adjacent the structure for receiving the first and second output beams, whereby a calibrated change in the angle of elevation of the structure between positions of equal intensity of the first and second output beams prior to and following exposure provides a measure of the radiation sensed due to a change of refraction of the radiochromic material

  16. Assessment of sexual difficulties associated with multi-modal treatment for cervical or endometrial cancer: A systematic review of measurement instruments.

    Science.gov (United States)

    White, Isabella D; Sangha, Amrit; Lucas, Grace; Wiseman, Theresa

    2016-12-01

    Practitioners and researchers require an outcome measure that accurately identifies the range of common treatment-induced changes in sexual function and well-being experienced by women after cervical or endometrial cancer. This systematic review critically appraised the measurement properties and clinical utility of instruments validated for the measurement of female sexual dysfunction (FSD) in this clinical population. A bibliographic database search for questionnaire development or validation papers was completed and methodological quality and measurement properties of selected studies rated using the Consensus-based Standards for the selection of health Measurement Instrument (COSMIN) checklist. 738 articles were screened, 13 articles retrieved for full text assessment and 7 studies excluded, resulting in evaluation of 6 papers; 2 QoL and 4 female sexual morbidity measures. Five of the six instruments omitted one or more dimension of female sexual function and only one instrument explicitly measured distress associated with sexual changes as per DSM V (APA 2013) diagnostic criteria. None of the papers reported measurement error, responsiveness data was available for only two instruments, three papers failed to report on criterion validity, and test-retest reliability reporting was inconsistent. Heterosexual penile-vaginal intercourse remains the dominant sexual activity focus for sexual morbidity PROMS terminology and instruments lack explicit reference to solo or non-coital sexual expression or validation in a non-heterosexual sample. Four out of six instruments included mediating treatment or illness items such as vaginal changes, menopause or altered body image. Findings suggest that the Female Sexual Function Index (FSFI) remains the most robust sexual morbidity outcome measure, for research or clinical use, in sexually active women treated for cervical or endometrial cancer. Development of an instrument that measures sexual dysfunction in women who are

  17. Preliminary ethical appraisal of a trial - what's it all about?

    Science.gov (United States)

    Siipi, Helena

    Preliminary ethical appraisal of medical trials is often based on the following four principles: respect for autonomy, beneficence, non-maleficence, and justice. Preliminary ethical appraisal should, however, not be understood solely as application of these four principles to practice. Ethical committees will inevitably interpret the principles and make decisions about their reciprocal importance in connection with each trial. Reasoning does not always proceed from above towards practical recommendations of action, but can instead also be based on a moral rule or practice relating to a certain action. A good preliminary ethical appraisal will also take into account everyday standards of morality, law and shared moral values of the society.

  18. 7 CFR 1980.444 - Appraisal of property serving as collateral.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 14 2010-01-01 2009-01-01 true Appraisal of property serving as collateral. 1980.444... Program § 1980.444 Appraisal of property serving as collateral. (a) Appraisal reports prepared by independent qualified fee appraisers will be required on all property that will serve as collateral. In the...

  19. 41 CFR 102-42.40 - When is an appraisal necessary?

    Science.gov (United States)

    2010-07-01

    ... DISPOSAL OF FOREIGN GIFTS AND DECORATIONS General Provisions Appraisals § 102-42.40 When is an appraisal necessary? An appraisal is necessary when— (a) An employee indicates an interest in purchasing a gift or decoration. In this situation, the appraisal must be obtained before the gift or decoration is reported to...

  20. An Investigation into Appraisal Bias: The Role of Decision Support Tools in Debiasing Valuation Judgments

    Science.gov (United States)

    Tidwell, Owen Alan

    2011-01-01

    Given the nature of the valuation task environment appraisers are often made aware of previous value opinions rendered by appraisers, commonly in the form of an historic appraisal. And, because an appraisal task involves the rendering of market value, a hypothetical, unobservable construct based on probabilities, direct feedback against this…